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| 1 | Endowing a plain fluidic chip with micro-optics: a holographic microscope slide显示文摘Lab-on-a-Chip(LoC)devices are extremely promising in that they enable diagnostic functions at the point-of-care.Within this scope,an important goal is to design imaging schemes that can be used out of the laboratory.In this paper,we introduce and test a pocket holographic slide that allows digital holography microscopy to be performed without an interferometer setup.Instead,a commercial off-the-shelf plastic chip is engineered and functionalized with this aim.The microfluidic chip is endowed with micro-optics,that is,a diffraction grating and polymeric lenses,to build an interferometer directly on the chip,avoiding the need for a reference arm and external bulky optical components.Thanks to the single-beam scheme,the system is completely integrated and robust against vibrations,sharing the useful features of any common path interferometer.Hence,it becomes possible to bring holographic functionalities out of the lab,moving complexity from the external optical apparatus to the chip itself.Label-free imaging and quantitative phase contrast mapping of live samples are demonstrated,along with flexible refocusing capabilities.Thus,a liquid volume can be analyzed in one single shot with no need for mechanical scanning systems. | Vittorio Bianco Biagio Mandracchia Valentina Marchesano Vito Pagliarulo Federico Olivieri Sara Coppola Melania Paturzo Pietro Ferraro | 2017 | Light(Science & Applications)2017,6,1: | 6 |
| 2 | Non-surgical treatment of hilar cholangiocarcinoma显示文摘Cancer of the biliary confluence also known as hilar cholangiocarcinoma(HC)or Klatskin tumor,is a rare type of neoplastic disease constituting approximately 40%-60%of intrahepatic malignancies,and 2% of all cancers.The prognosis is extremely poor and the majority of Klatskin tumors are deemed unresectable upon diagnosis.Most patients with unresectable bile duct cancer die within the first year after diagnosis,due to hepatic failure,and/or infectious complications secondary to biliary obstruction.Curative treatments include surgical resection and liver transplantation in highly selected patients.Nevertheless,very few patients are eligible for surgery or transplant at the time of diagnosis.For patients with unresectable HC,radiotherapy,chemotherapy,photodynamic therapy,and liver-directed minimally invasive procedures such as percutaneous image-guided ablation and intra-arterial chemoembolization are recommended treatment options.This review focuses on currently available treatment options for unresectable HC and discusses future perspectives that could optimize outcomes. | Riccardo Inchingolo Fabrizio Acquafredda Valentina Ferraro Letizia Laera Gianmarco Surico Alessia Surgo Alba Fiorentino Stefania Marini Nicola de'Angelis Riccardo Memeo Stavros Spiliopoulos | 2021 | World Journal of Gastrointestinal Oncology2021,13,11: | 5 |
| 3 | Adipokines and C-reactive protein in relation to bone mineralization in pediatric nonalcoholic fatty liver disease显示文摘AIM: To investigate bone mineral density (BMD) in obese children with and without nonalcoholic fatty liver disease (NAFLD); and the association between BMD and serum adipokines, and high-sensitivity C-reactive protein (HSCRP). METHODS: A case-control study was performed. Cases were 44 obese children with NAFLD. The diagnosis of NAFLD was based on magnetic resonance imaging (MRI) with high hepatic fat fraction (≥ 5%). Other causes of chronic liver disease were ruled out. Controls were selected from obese children with normal levels of aminotransferases, and without MRI evidence of fatty liver as well as of other causes of chronic liver diseases. Controls were matched (1-to 1-basis) with thecases on age, gender, pubertal stage and as closely as possible on body mass index-SD score. All participants underwent clinical examination, laboratory tests, and whole body (WB) and lumbar spine (LS) BMD by dual energy X-ray absorptiometry. BMDZ-scores were calcu- lated using race and gender specific LMS curves. RESULTS: Obese children with NAFLD had a significantly lower LS BMDZ-score than those without NAFLD [mean, 0.55 (95%CI: 0.23-0.86) vs 1.29 (95%CI: 0.95-1.63); P < 0.01]. WB BMD Z-score was also decreased in obese children with NAFLD compared to obese children with no NAFLD, though borderline significance was observed [1.55 (95%CI: 1.23-1.87) vs 1.95 (95%CI: 1.67-2.10); P = 0.06]. Children with NAFLD had significantly higher HSCRP, lower adiponectin, but similar leptin levels. Thirty five of the 44 children with MRI-diagnosed NAFLD underwent liver biopsy. Among the children with biopsy-proven NAFLD, 20 (57%) had nonalcoholic steatohepatitis (NASH), while 15 (43%) no NASH. Compared to children without NASH, those with NASH had a significantly lower LS BMD Z-score [mean, 0.27 (95%CI: -0.17-0.71) vs 0.75 (95%CI: 0.13-1.39); P < 0.05] as well as a significantly lower WB BMD Z-score [1.38 (95%CI: 0.89-1.17) vs 1.93 (95%CI: 1.32-2.36); P < 0.05]. In multiple regression analysis, NASH (standardized β coefficient, -0.272; P < 0.01) and HSCRP (standardized β coefficient, -0.192; P < 0.05) were significantly and independently associated with LS BMD Z-score. Similar results were obtained when NAFLD (instead of NASH) was included in the model. WB BMD Z-scores were significantly and independently associated with NASH (standardized β coefficient, -0.248;P < 0.05) and fat mass (standardized β coefficient, -0.224;P < 0.05). CONCLUSION: This study reveals that NAFLD is associated with low BMD in obese children, and that systemic, low-grade inflammation may accelerate loss of bone mass in patients with NAFLD. | Lucia Pacifico Mario Bezzi Concetta Valentina Lombardo Sara Romaggioli Flavia Ferraro Stefano Bascetta Claudio Chiesa | 2013 | World Journal of Gastroenterology2013,19,25: | 3 |
| 4 | Awake robotic liver surgery:A case report显示文摘BACKGROUND In recent years,minimally invasive liver resection has become a standard of care for liver tumors.Considering the need to treat increasingly fragile patients,general anesthesia is sometimes avoided due to respiratory complications.Therefore,surgical treatment with curative intent is abandoned in favor of a less invasive and less radical approach.Epidural anesthesia has been shown to reduce respiratory complications,especially in elderly patients with pre-existing lung disease.CASE SUMMARY A 77-year-old man with hepatitis-C-virus-related chronic liver disease underwent robotic liver resection for hepatocellular carcinoma.The patient was suffering from hypertension,diabetes and chronic obstructive pulmonary disease.The National Surgical Quality Improvement Program score for developing pneumonia was 9.2%.We planned a combined spinal–epidural anesthesia with conscious sedation to avoid general anesthesia.No modification of the standard surgical technique was necessary.Hemodynamics were stable and bleeding was minimal.The postoperative course was uneventful.CONCLUSION Robotic surgery in locoregional anesthesia with conscious sedation could be considered a safe and suitable approach in specialized centers and in selected patients. | Antonella Delvecchio Gaetano Pavone Maria Conticchio Claudia Piacente Miriam Varvara Valentina Ferraro Matteo Stasi Annachiara Casella Rosalinda Filippo Michele Tedeschi Carmine Pullano Riccardo Inchingolo Vito Delmonte Riccardo Memeo | 2023 | World Journal of Gastrointestinal Surgery2023,15,12: | 0 |
| 5 | Percutaneous insertion of a novel dedicated metal stent to treat malignant hilar biliary obstruction显示文摘BACKGROUND Percutaneous bilateral biliary stenting is an established method for the management of unresectable malignant hilar biliary obstruction.AIM To evaluate the efficacy and safety of a novel uncovered biliary stent, specifically designed for hilar reconstruction.METHODS This, single-center, retrospective study included 18 patients(mean age 71 ± 11 years;61.1% male) undergoing percutaneous transhepatic Moving cell stent(MCS) placement for hilar reconstruction using the stent-in-stent technique for malignant biliary strictures, between November 2020 and July 2021. The Patients were diagnosed with cholangiocarcinoma(12/18;66.6%), gallbladder cancer(5/18;27.7%), and colorectal liver metastasis(1/18;5.5%). Primary endpoints were technical(appropriate stent placement) and clinical(relief from jaundice) success. Secondary endpoints included stent patency, overall survival, complication rates and stent-related complications.RESULTS The technical and clinical success rates were 100%(18/18 cases). According to Kaplan-Meier analysis, the estimated overall patient survival was 80.5% and 60.4% at 6 and 12 mo respectively, while stent patency was 90.9% and 68.2% at 6 mo and 12 mo respectively. The mean stent patency was 172.53 ± 56.20 d and median stent patency was 165 d(range 83-315). Laboratory tests for cholestasis significantly improved after procedure: mean total bilirubin decreased from 15.2 ± 6.0 mg/d L to 1.3 ± 0.4 mg/d L(P < 0.001);mean γGT decreased from 1389 ± 832 U/L to 114.6 ± 53.5 U/L(P < 0.001). One periprocedural complication was reported. Stent-related complications were observed in 5 patients(27.7%), including 1 occlusion(5.5%) and 1 stent migration(5.5 %).CONCLUSION Percutaneous hilar bifurcation biliary stenting with the MCS resulted in excellent clinical and technical success rates, with acceptable complication rates. Further studies are needed to confirm these initial positive results. | Francesco Cortese Fabrizio Acquafredda Andrea Mardighian Maria Teresa Zurlo Valentina Ferraro Riccardo Memeo Stavros Spiliopoulos Riccardo Inchingolo | 2022 | World Journal of Gastrointestinal Oncology2022,14,9: | 0 |