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Gachabayov M, Bergamaschi R, Wasmuth H, Faerden A, Javadov M, Cianchi F, Barnajian M, Popa DE, Lee H. Oncological monitoring after transanal total mesorectal excision for rectal neoplasia. Tech Coloproctol 2023; 27:1411-1412. [PMID: 37812263 PMCID: PMC10638161 DOI: 10.1007/s10151-023-02866-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Affiliation(s)
- M Gachabayov
- Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | - R Bergamaschi
- Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | - H Wasmuth
- Department of Gastrointestinal Surgery, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Faerden
- Department of Digestive Surgery, Akershus University Hospital, Akershus, Norway
| | - M Javadov
- Department of Surgery, Yeditepe University Hospital, Istanbul, Turkey
| | - F Cianchi
- Department of Surgery and Translational Medicine, Careggi Hospital, University of Florence, Florence, Italy
| | - M Barnajian
- Division of Colorectal Surgery, Cedar Sinai Medical Center, Los Angeles, CA, USA
| | - D E Popa
- Department of Surgery, Linköping University Hospital, Linköping, Sweden
| | - H Lee
- Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
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Fortuna L, Bottari A, Bisogni D, Coratti F, Giudici F, Orlandini B, Dragoni G, Cianchi F, Staderini F. Gastric Antral Vascular Ectasia (GAVE) a case report, review of the literature and update of techniques. Int J Surg Case Rep 2022; 98:107474. [PMID: 35963152 PMCID: PMC9386635 DOI: 10.1016/j.ijscr.2022.107474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/30/2022] [Accepted: 07/30/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction and importance Gastric Antral Vascular Ectasia is a rare disorder that causes up to 4 % of severe acute gastrointestinal bleeding. It affects elderly females with iron deficiency anemia due to chronic blood loss as a common presenting sign. Case presentation We report the case of a 70-year-old man admitted to the Urgency Department for severe asthenia associated with abdominal pain and severe anemia. An urgent upper endoscopic examination showed antral hyperemic streaks and vascular ectasias extending from the pyloric ring to the gastric body as well as signs of recent bleeding. Histological results demonstrated the pathognomonic features of GAVE. Clinical discussion The first line treatment is considered argon plasma coagulation (APC), given its wider availability, safety, efficacy and cost-effectiveness. In current literature, other therapies and different types of endoscopic treatments have been proposed, such as EBL, RFA and Yag: laser. To date, there is no specific recommendation that privileges one method over another in the treatment of GAVE, although APC has proven effective and even better in terms of complications and costs than the other techniques. Conclusion In our experience, endoscopic coagulation with APC probes is a relatively easy-to-use technique with low cost, minimal invasiveness and provides immediate results. On the other hand, a standardized algorithm is also required concerning to the different subtypes to give the best treatment in every case.
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Skalamera I, Badii B, Staderini F, Foppa C, Nelli T, Maggioni C, Cianchi F. Epithelial mesenchymal transition related proteins and CD44 as predictors of outcome in gastric cancer in Caucasian patients. European Journal of Surgical Oncology 2020. [DOI: 10.1016/j.ejso.2020.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Coratti F, Barbato G, Manetti A, Cianchi F. Laparoscopic repair of an incarcerated Spigelian hernia - a video vignette. Colorectal Dis 2020; 22:846. [PMID: 32003120 DOI: 10.1111/codi.14995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 02/08/2023]
Affiliation(s)
| | - G Barbato
- Università degli Studi di Firenze, Firenze, Italy
| | | | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Nelli T, Maggioni C, Cianchi F. Transabdominal preperitoneal approach for incarcerated femoral hernia - a video vignette. Colorectal Dis 2020; 22:723. [PMID: 31943642 DOI: 10.1111/codi.14961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/26/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - T Nelli
- Università degli Studi di Firenze, Firenze, Italy
| | - C Maggioni
- Università degli Studi di Firenze, Firenze, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Ghezzi N, Mongelli C, Capezzuoli T, Sorbi F, Cianchi F, Petraglia F. Bleeding and bowel obstruction in giant ovarian serous carcinoma - a video vignette. Colorectal Dis 2020; 22:729. [PMID: 31967392 DOI: 10.1111/codi.14978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/21/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - N Ghezzi
- Università degli Studi di Firenze, Firenze, Italy
| | - C Mongelli
- Università degli Studi di Firenze, Firenze, Italy
| | - T Capezzuoli
- Università degli Studi di Firenze, Firenze, Italy
| | - F Sorbi
- Università degli Studi di Firenze, Firenze, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
| | - F Petraglia
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Barbato G, Maggioni C, Manetti A, Cianchi F. Laparoscopic diastasis recti repair and umbilicus reconstruction - a video vignette. Colorectal Dis 2020; 22:725-726. [PMID: 31955482 DOI: 10.1111/codi.14971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 12/20/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - G Barbato
- Università degli Studi di Firenze, Firenze, Italy
| | - C Maggioni
- Università degli Studi di Firenze, Firenze, Italy
| | | | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Trafeli M, Nelli T, Manetti A, Cianchi F. The gauze technique for a rapid dissection of the pre-peritoneal space in laparoscopic inguinal hernia repair - a video vignette. Colorectal Dis 2020; 22:598-599. [PMID: 31925987 DOI: 10.1111/codi.14958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/26/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - M Trafeli
- Università degli Studi di Firenze, Firenze, Italy
| | - T Nelli
- Università degli Studi di Firenze, Firenze, Italy
| | | | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Nelli T, Cianchi F. Laparoscopic repair of perineal hernia after abdominoperineal excision of the rectum and anus - a video vignette. Colorectal Dis 2020; 22:591-592. [PMID: 31869500 DOI: 10.1111/codi.14939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/26/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - T Nelli
- Università degli Studi di Firenze, Florence, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Florence, Italy
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Coratti F, Maggioni C, Manetti A, Cianchi F. Robotic transversus abdominis release for parastomal hernia and hypogastric incisional hernia - a video vignette. Colorectal Dis 2020; 22:599-600. [PMID: 31943695 DOI: 10.1111/codi.14959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 11/26/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - C Maggioni
- Università degli Studi di Firenze, Firenze, Italy
| | | | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Nelli T, Maggioni C, Mongelli C, Cianchi F. Treatment of rectovaginal postanastomotic fistula with a transanal endoscopic operation - a video vignette. Colorectal Dis 2020; 22:351-352. [PMID: 31692217 DOI: 10.1111/codi.14894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/08/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - T Nelli
- Università degli Studi di Firenze, Firenze, Italy
| | - C Maggioni
- Università degli Studi di Firenze, Firenze, Italy
| | - C Mongelli
- Università degli Studi di Firenze, Firenze, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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12
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Coratti F, Maggioni C, Mongelli C, Nelli T, Cianchi F. Achievement of haemostasis following a double-stapled (Knight-Griffen) anastomosis using the transanal endoscopic operating system - a video vignette. Colorectal Dis 2020; 22:352-353. [PMID: 31698542 DOI: 10.1111/codi.14896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/08/2019] [Indexed: 02/08/2023]
Affiliation(s)
- F Coratti
- Aouc Firenze, Division of Digestive Surgery, Careggi University Hospital, Florence, Italy
| | - C Maggioni
- Università degli Studi di Firenze, Florence, Italy
| | - C Mongelli
- Università degli Studi di Firenze, Florence, Italy
| | - T Nelli
- Università degli Studi di Firenze, Florence, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Florence, Italy
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Coratti F, Nelli T, Maggioni C, Mongelli C, Cianchi F. Laparoscopic sigmoidectomy for perforated diverticulitis with purulent peritonitis - a video vignette. Colorectal Dis 2020; 22:347-348. [PMID: 31638327 DOI: 10.1111/codi.14881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/18/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - T Nelli
- Università degli Studi di Firenze, Firenze, Italy
| | - C Maggioni
- Università degli Studi di Firenze, Firenze, Italy
| | - C Mongelli
- Università degli Studi di Firenze, Firenze, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Firenze, Italy
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Coratti F, Maggioni C, Mongelli C, Nelli T, Cianchi F. Laparoscopic reversal of the Hartmann procedure - a video vignette. Colorectal Dis 2020; 22:224. [PMID: 31554021 DOI: 10.1111/codi.14859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/18/2019] [Indexed: 02/08/2023]
Affiliation(s)
| | - C Maggioni
- Università degli Studi di Firenze, Florence, Italy
| | - C Mongelli
- Università degli Studi di Firenze, Florence, Italy
| | - T Nelli
- Università degli Studi di Firenze, Florence, Italy
| | - F Cianchi
- Università degli Studi di Firenze, Florence, Italy
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Bruzzi M, Auclin E, Lo Dico R, Voron T, Karoui M, Espin E, Cianchi F, Weitz J, Buggenhout A, Malafosse R, Denimal F, Le Malicot K, Vernerey D, Douard R, Emile JF, Lepage C, Laurent-Puig P, Taieb J. Influence of Molecular Status on Recurrence Site in Patients Treated for a Stage III Colon Cancer: a Post Hoc Analysis of the PETACC-8 Trial. Ann Surg Oncol 2019; 26:3561-3567. [PMID: 31209667 DOI: 10.1245/s10434-019-07513-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Recurrence patterns in stage III colon cancer (CC) patients according to molecular markers remain unclear. The objective of the study was to assess recurrence patterns according to microsatellite instability (MSI), RAS and BRAFV600E status in stage III CC patients. METHODS All stage III CC patients from the PETACC-8 randomized trial tested for MSI, RAS and BRAFV600E status were included. The site and characteristics of recurrence were analyzed according to molecular status. Survival after recurrence (SAR) was analyzed. RESULTS A total of 1650 patients were included. Recurrence occurred in 434 patients (26.3%). Microsatellite stable (MSS) patients had a significantly higher recurrence rate (27.2% vs. 18.7%, P = 0.02) with a trend to more pulmonary recurrence (28.8% vs. 12.9%, P = 0.06) when compared to MSI patients. MSI patients experienced more regional lymph nodes compared to MSS (12.9% vs. 4%, P = 0.046). In the MSS population, the recurrence rate was significantly higher in RAS (32.2%) or BRAF (32.3%) patients when compared to double wild-type patients (19.9%) (p < 0.001); no preferential site of recurrence was observed according to RAS and BRAFV600E mutations. Finally, decreased SAR was observed in the case of peritoneal recurrence or more than two recurrence sites. CONCLUSIONS Microsatellite, RAS and BRAFV600E status influences recurrence rates in stage III CC patients. However, only microsatellite status seems to be associated with specific recurrence patterns. More than two recurrence sites and recurrence in the peritoneum were associated with poorer SAR.
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Affiliation(s)
- M Bruzzi
- Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France.
| | - E Auclin
- Department of Digestive Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France.,Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon, Besançon, France
| | - R Lo Dico
- Department of Digestive and Oncological Surgery, Lariboisière Hospital, AP-HP, Paris, France
| | - T Voron
- Department of Digestive and General Surgery, Saint Antoine Hospital, AP-HP, Sorbonne Université, Paris, France
| | - M Karoui
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Pitié-Salpêtrière University Hospital, AP-HP, Paris VI University Institute of Cancerology, Paris, France
| | - E Espin
- Department of General Surgery, Hospital Valle de Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - F Cianchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - J Weitz
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus of the Technical University Dresden, Dresden, Germany
| | - A Buggenhout
- Department of Surgical Gastroenterology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - R Malafosse
- Department of Digestive Surgery, Ambroise-Paré Hospital, AP-HP, Boulogne, France
| | - F Denimal
- Department of Digestive Surgery, Centre Hospitalier Départemental Vendée, La Roche Sur Yon, France
| | - K Le Malicot
- Statistical Department, Fédération Francophone de Cancérologie Digestive, EPICAD, INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, Dijon, France
| | - D Vernerey
- Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon, Besançon, France
| | - R Douard
- Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - J F Emile
- Pathology Department, Ambroise-Paré Hospital, AP-HP, Boulogne, France
| | - C Lepage
- Hepato-Gastroenterology Department, Dijon University Hospital and EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, France
| | - P Laurent-Puig
- Department of Biology, European Georges Pompidou Hospital, AP-HP, INSERM-UMR-S1147, Paris, France
| | - J Taieb
- Department of Digestive Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France
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Skalamera I, Foppa C, Novelli L, Staderini F, Badii B, Montanelli P, Nelli T, Coratti F, Taddei A, Cianchi F. Epithelial mesenchymal transition related proteins as predictors of outcome in gastric cancer in caucasian patients. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Martellucci J, Sturiale A, Bergamini C, Boni L, Cianchi F, Coratti A, Valeri A. Role of transanal irrigation in the treatment of anterior resection syndrome. Tech Coloproctol 2018; 22:519-527. [PMID: 30083782 DOI: 10.1007/s10151-018-1829-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/23/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Transanal irrigation(TAI) has been reported to be an inexpensive and effective treatment for low anterior resection syndrome(LARS). The aim of the present prospective study was to evaluate the use of TAI in patients with significant LARS symptoms at a single medical center. METHODS Patients who had low anterior resection for rectal cancer between April 2015 and May 2016 at the Careggi University Hospital were assessed for LARS using the LARS and the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument (MSKCC BFI) questionnaires 30-40 days after surgery or ileostomy closure (if this was done). Quality of life was evaluated using a visual analog scale and the Short Form-36 Health Survey. All patients with LARS score of 30 or higher were included (early LARS) as were all patients with a LARS score of 30 or higher referred 6 months or longer after surgery performed elsewhere (chronic LARS) in the same study period. Study participants were trained to perform TAI using the Peristeen™ System for 6 months, followed by 3 months of enema therapy following a similar protocol. RESULTS Thirty-three patients were enrolled in the study. Six patients stopped the treatment. The 27 patients (19 early LARS and 8 chronic LARS) who completed the study had a significant decrease in the number of median daily bowel movements [baseline 7 (range 0-14); 6 months 1 (range 0-4); 9 months 4 (range 0-13)]. The median LARS Score fell from 35.1 (range 30-42) (baseline) to 12.2 (range 0-21) after 6 months (p < 0.0001) and then rose to 27 (range 5-39) after 3 months of enema therapy. There was no difference in LARS score decrease at 6 months between the patients with early and chronic LARS (22.5 and 23.9 respectively; p=0.7) and there were no predictors of score decrease. Four components of the SF-36 significantly improved during the TAI period. The MSKCC BFI score significantly improved in several domains. Twenty-three patients (85%) asked to continue the treatment with TAI after the study ended. CONCLUSIONS TAI appears to be an effective treatment for LARS and results in a marked improvement of continence and quality of life. Patients may be assessed and treated for LARS early after surgery since the treatment benefit is similar to that observed in patients with LARS diagnosed 6 months or longer after surgery. The potential rehabilitative role of TAI for LARS is promising and should be further investigated.
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Affiliation(s)
- J Martellucci
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy.
| | - A Sturiale
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy
| | - C Bergamini
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy
| | - L Boni
- Clinical Trial Center, Careggi University Hospital, Florence, Italy
| | - F Cianchi
- General and Endocrine Surgery, Careggi University Hospital, Florence, Italy
| | - A Coratti
- Oncologic and Robotic Surgery, Careggi University Hospital, Florence, Italy
| | - A Valeri
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy
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Peri S, Biagioni A, Cianchi F, Skalamera I, Staderini F, Schiavone N, Papucci L, Magnelli L. Chemotherapy resistance-associated epithelial to endothelial transition in gastric cancer. J BIOL REG HOMEOS AG 2018; 32:30. [PMID: 30761866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- S Peri
- Department Of Biotechnology, Chemistry And Pharmacy, University of Siena - Department of Experimental and Clinical Biomedical Sciences "Mario Serio", university of Florence
| | - A Biagioni
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence
| | - F Cianchi
- Department of Surgery and Translational Medicine (DCMT), University of Florence
| | - I Skalamera
- Department of Surgery and Translational Medicine (DCMT), University of Florence
| | - F Staderini
- Department of Surgery and Translational Medicine (DCMT), University of Florence
| | - N Schiavone
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence
| | - L Papucci
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence
| | - L Magnelli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence
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Badii B, Qirici E, Taddei A, Indennitate G, Macrì G, Staderini F, Foppa C, Bonanomi A, Perigli G, Cianchi F. Early experience of robotic gastrectomy and comparison with laparoscopic gastrectomy for distal gastric cancer. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Staderini F, Cianchi F, Badii B, Skalamera I, Fiorenza G, Foppa C, Qirici E, Perigli G. A unique presentation of a renal clear cell carcinoma with atypical metastases. Int J Surg Case Rep 2015; 11:29-32. [PMID: 25911241 PMCID: PMC4446666 DOI: 10.1016/j.ijscr.2015.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Renal cancer is a relatively common neoplasia with renal clear cell carcinoma being the most frequent histological type. This tumor has a strong tendency to metastasize virtually to all organs. Today, new diagnostic tools allow physicians to distinguish between those patients with "incidental findings" and those with advanced metastatic disease. PRESENTATION OF CASE A 70-year-old male with multiple indolent subcutaneous masses underwent colonoscopy after a positive fecal screening test for colorectal carcinoma. A rectal lesion was discovered but biopsy was negative. CT scan revealed advanced renal cancer involving the peritoneal cavity, retroperitoneum and lung. Biopsy of subcutaneous masses confirmed the suspected metastases. The patient underwent surgery (an open left nephrectomy with rectosigmoid resection and metastases debulking) because of a high risk of bowel obstruction and increasing anemia. After three years of multi-targeted therapy and follow-up, the patient is still asymptomatic and in good general condition. DISCUSSION Treatment of metastatic renal cancer is still controversial even if more than 30% of patients have metastasis at the time of diagnosis. Recently introduced targeted therapies are encouraging but still present problems with side effects and an unlimited period of efficacy. Although there is no consensus, several studies and guidelines consider metastasectomy to be a valid option. CONCLUSION Recent series highlight surgery as a key-point in the management of advanced renal clear cell carcinoma. Our case demonstrates the validity of a surgical strategy supported by a multidisciplinary approach.
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Affiliation(s)
- F Staderini
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
| | - F Cianchi
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - B Badii
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - I Skalamera
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - G Fiorenza
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - C Foppa
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - E Qirici
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - G Perigli
- Unit of General and Endocrine Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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21
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Amedei A, Munari F, Della Bella C, Niccolai E, Benagiano M, Bencini L, Cianchi F, Silvestri E, D'Elios S, Farsi M, Prisco D, Zanotti G, De Bernard M, Kundu M, D'Elios M. Helicobacter Pylori HP0175 Promotes the Production of IL-23, IL-6, IL-1β and TGF-β. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Helicobacter pylori infection induces a chronic gastric inflammatory infiltrate. This study was undertaken to evaluate the type of the innate immune responses elicited by the secreted peptidyl-prolyl cis-trans isomerase of H. pylori (HP0175). The cytokine production induced by HP0175 in neutrophils, and monocytes was evaluated. HP0175 was able to induce the expression of IL-23 in neutrophils, and monocytes, and IL-6, IL-1beta and TGF-beta in monocytes. These findings indicate that HP0175 is able to promote the activation of innate cells and the production of a cytokine milieu that may favour the development of Th17 response.
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Affiliation(s)
- A. Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
| | - F. Munari
- Venetian Institute of Molecular Medicine, university of Padua, Padua, Italy
| | - C. Della Bella
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
| | - E. Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
| | - M. Benagiano
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
| | - L. Bencini
- Department of General and Oncologic Surgery, University of Florence, Florence, Italy
| | - F. Cianchi
- Department of Surgery, University of Florence, Florence, Italy
| | - E. Silvestri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
| | - S. D'Elios
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - M. Farsi
- Department of General and Oncologic Surgery, University of Florence, Florence, Italy
| | - D. Prisco
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
| | - G. Zanotti
- Venetian Institute of Molecular Medicine, university of Padua, Padua, Italy
| | - M. De Bernard
- Venetian Institute of Molecular Medicine, university of Padua, Padua, Italy
| | - M. Kundu
- Department of Chemistry, Bose Institute, Kolkata, India
| | - M.M. D'Elios
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Biomedicine, Institute of Medical Pathology, Florence, Italy
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22
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Cianchi F, Cuzzocrea S, Vinci MC, Messerini L, Comin CE, Navarra G, Perigli G, Centorrino T, Marzocco S, Lenzi E, Battisti N, Trallori G, Masini E. Heterogeneous expression of cyclooxygenase-2 and inducible nitric oxide synthase within colorectal tumors: correlation with tumor angiogenesis. Dig Liver Dis 2010; 42:20-7. [PMID: 19497798 DOI: 10.1016/j.dld.2009.04.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Revised: 04/07/2009] [Accepted: 04/19/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recent studies have shown that the cyclooxygenase (COX) and the inducible nitric oxide synthase (iNOS) pathways are involved in the development of tumor angiogenesis in human cancers. AIMS To investigate whether a different pattern of COX-2 and iNOS expression/activity exists within different areas of colorectal tumors and to analyze the relationship between these two enzymes and tumor angiogenesis. METHODS Microvessel density (MVD) and COX-2, iNOS, vascular endothelial growth factor (VEGF) and VEGF receptor-2 (VEGFR-2) protein expression were evaluated at both the invasive front (IF) and the tumor center (TC) in 46 human colorectal cancer specimens. We also investigated the concentration of PGE2 and NO at the same sites. RESULTS COX-2 and iNOS protein expression and activity were significantly higher within the IF than the TC of the tumor specimens. Similarly, MVD and VEGF/VEGFR-2 expression significantly increased from the TC to the IF. Only COX-2 expression was significantly correlated with MVD and VEGF/VEGFR-2 expression at both the TC and the IF. CONCLUSION Our study shows a heterogeneous expression of COX-2 and iNOS in colorectal cancer. The up-regulation of COX-2 at the IF parallels an increase in vessel density and VEGF/VEGFR-2 expression, thus supporting the hypothesis that the tumor periphery is the most aggressive portion of a colorectal tumor.
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Affiliation(s)
- F Cianchi
- Department of Medical and Surgical Critical Care, University of Florence, Italy.
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23
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Cianchi F, Cortesini C, Magnelli L, Papucci L, Schiavone N, Capaccioli S, Lulli M, Trallori G, Perigli G, Masini E. 3032 POSTER Cannabinoids induce apoptosis through CB1 and CB2 receptor activation in human colon cancer cells. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70960-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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24
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Cianchi F, Cortesini C, Perna F, Fabbroni V, Uliva C, Fabrizi F, Giannini L, Vannacci A, Masini E. Prostaglandin E2 correlates with histamine production in human colorectal cancer. Inflamm Res 2006; 55 Suppl 1:S81-2. [PMID: 16705384 DOI: 10.1007/s00011-005-0053-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- F Cianchi
- Departments of General Surgery, Careggi General Hospital, Florence, Italy
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25
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26
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Masini E, Fabbroni V, Giannini L, Vannacci A, Messerini L, Perna F, Cortesini C, Cianchi F. Histamine and histidine decarboxylase up-regulation in colorectal cancer: correlation with tumor stage. Inflamm Res 2005; 54 Suppl 1:S80-1. [PMID: 15928846 DOI: 10.1007/s00011-004-0437-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- E Masini
- Department of Preclinical and Clinical Pharmacology, University of Florence, Viale G. Pieraccini 6, 50139 Florence, Italy.
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27
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Pucciani F, Iozzi L, Masi A, Cianchi F, Cortesini C. Multimodal rehabilitation for faecal incontinence: experience of an Italian centre devoted to faecal disorder rehabilitation. Tech Coloproctol 2004; 7:139-47; discussion 147. [PMID: 14628156 DOI: 10.1007/s10151-003-0025-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2003] [Accepted: 06/04/2003] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sphincter exercises and biofeedback therapy have been used to treat faecal incontinence but results have been unpredictable and standards of treatment have not yet been established. The aim of this study was to retrospectively evaluate the effects of a new multimodal rehabilitation model on faecal incontinence. METHODS All of the rehabilitative procedures are guided by manometric data. Primary study outcome criteria were the determination of changes or deterioration in incontinence, failure to achieve full continence and/or presence of faecal urgency. The clinical outcome was designed according to the Jorge-Wexner incontinence score. RESULTS Between 1997 and 2001, one hundred forty-nine incontinent patients (85 F and 64 M; age range, 41-73 years; mean age, 60.6 years) underwent multimodal rehabilitation at our outpatient unit. The overall mean incontinence score had significantly improved after treatment ( p<0.001), and 58 patients (38.9%) were symptom free. No patient reported any deterioration in incontinence. Faecal urgency persisted in 23 patients (15.4%). CONCLUSION In conclusion, multimodal rehabilitation, using manometric study, can modify the incontinence score.
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Affiliation(s)
- F Pucciani
- Coloproctology Unit of Careggi-Florence, Department of General Surgery, University of Florence, Viale Morgagni 85, I-50134, Florence, Italy.
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28
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De Filippo C, Luceri C, Caderni G, Pacini M, Messerini L, Biggeri A, Mini E, Tonelli F, Cianchi F, Dolara P. Mutations of the APC gene in human sporadic colorectal cancers. Scand J Gastroenterol 2002; 37:1048-53. [PMID: 12374230 DOI: 10.1080/003655202320378248] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Mutations of the APC gene are reported to occur frequently in sporadic colorectal adenomas and adenocarcinomas. We studied APC gene mutations in cases of human sporadic colorectal cancer in order to evaluate their correlation with pathologic characteristics and clinical prognosis. METHODS Most of the mutations of the APC gene (95%) are nonsense or frame shift mutations, encoding for truncated APC proteins. For this reason, mutation detection of the APC gene was performed using the in vitro synthesized protein (IVSP) assay, analysing the region between nucleotide 2058 and nucleotide 5079 of the gene, containing the mutation cluster region. RESULTS Out of 58 cases of colorectal cancer, 29 presented a mutated form of APC (mutation frequency 50%). We did not find a statistically significant correlation between APC gene mutation and age, sex, localization of the primary tumour, grading, Crohn-like lymphoid reaction or presence of residual adenoma. Tumours with low invasivity (Dukes' stages A and B) were less frequently mutated (12/27, 44.5%) than tumours of Dukes' stage C (15 out of 21, 71.4%), which developed macroscopically secondary metastasis with variable latency after surgery. Highly invasive tumours with synchronous metastases (Dukes' stage D) had, instead, a low frequency of APC mutations (20%, 2/10) (P = 0.02, compared with Dukes' stages A, B and C). CONCLUSIONS These data suggest that more aggressive Dukes' stage D tumours develop metastasis by means of an unknown mechanism, independent of APC mutation.
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Affiliation(s)
- C De Filippo
- Dept of Pharmacology, University of Florence, Italy.
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29
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Luceri C, De Filippo C, Guglielmi F, Caderni G, Messerini L, Biggeri A, Mini E, Tonelli F, Cianchi F, Dolara P. Microsatellite instability in a population of sporadic colorectal cancers: correlation between genetic and pathological profiles. Dig Liver Dis 2002; 34:553-9. [PMID: 12502211 DOI: 10.1016/s1590-8658(02)80088-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Tumours with high-frequency microsatellite instability exhibit unique genotype and phenotype features, whereas the difference between low-frequency microsatellite instability and apparently stable tumours is far from being clear. AIMS To identify distinctive genetic and pathological characteristics of low-frequency microsatellite instability tumours. METHODS Microsatellite instability status of 57 sporadic colorectal cancers and its correlation with genetic, pathological and clinical features was analysed. RESULTS High frequency microsatellite instability and low-frequency microsatellite instability and apparently stable cancers were different in terms of tumour localisation (p=0.015), frequency of APC mutations (p=0.012), occurrence of Crohn's-like/lymphoid reaction (p=0.0353) and morphological evidence of origin from an adenoma (p=0.0338). Specifically, in low-frequency microsatellite instability cancers, APC mutations were very frequent (76.9%, 10/13) and a Crohn's-like/lymphoid reaction was common (38.5%, 5/13). High-frequency microsatellite instability tumours were preferentially located in the right colon and exhibited a higher frequency of loss of heterozygosity at the FHIT locus compared with low-frequency microsatellite instability and apparently stable cases (p=0.0243). Dukes' stage (p=0.0021), tumour localisation (p=0.0410) and pattern of cancer growth (p=0.0374), were the only factors affecting patient survival. However, a borderline improvement was noted in overall survival in high-frequency microsatellite instability and low-frequency microsatellite instability cancer patients (p=0.062). CONCLUSIONS These results indicate that low-frequency microsatellite instability tumours have different genetics and histological features and suggest that they are a distinct group of colorectal cancers.
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Affiliation(s)
- C Luceri
- Department of Pharmacology, Institute of Pathology, University of Florence, Florence, Italy.
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30
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Cianchi F, Cortesini C, Bechi P, Fantappiè O, Messerini L, Vannacci A, Sardi I, Baroni G, Boddi V, Mazzanti R, Masini E. Up-regulation of cyclooxygenase 2 gene expression correlates with tumor angiogenesis in human colorectal cancer. Gastroenterology 2001; 121:1339-47. [PMID: 11729113 DOI: 10.1053/gast.2001.29691] [Citation(s) in RCA: 184] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Recent studies have shown that cyclooxygenase (COX)-2 and its products, prostaglandins (PGs), may be involved in colorectal carcinogenesis. The aim of this study was to determine whether COX-2 expression and PGE(2) production correlate with microvessel density, vascular endothelial growth factor (VEGF) expression, and tumor metastasis in human colorectal cancer. METHODS Tumor samples and adjacent normal mucosa were obtained from 31 surgical specimens. Immunohistochemical expression of COX-2, VEGF, and CD31 was analyzed on paraffin-embedded tissue sections. COX-2 and COX-1 proteins were determined by Western blot analysis. COX-2 and VEGF messenger RNA expressions were evaluated using Northern blot analysis. PGE(2) production was determined by specific radioimmunoassay. RESULTS The immunohistochemical expressions of both COX-2 and VEGF were significantly correlated with microvessel density (P = 0.02 and P = 0.002, respectively). A significant correlation was found between COX-2 and VEGF expression (P = 0.004). Western analysis confirmed the up-regulation of COX-2 protein expression. COX-2 and VEGF genes were overexpressed in tumor specimens as compared with normal mucosa. PGE(2) levels were significantly higher in metastatic tumors than in nonmetastatic ones (P = 0.03). CONCLUSIONS COX-2 is related to tumor angiogenesis in colorectal cancer. It is likely that VEGF is one of the most important mediators of the COX-2 angiogenic pathway.
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Affiliation(s)
- F Cianchi
- Department of General Surgery, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
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31
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Bechi P, Bacci S, Cianchi F, Amorosi A, Nesi G, Dei R, Romagnoli P. Impairment of gastric secretion modulation in duodenal ulcer and in long-term PPI treatment: quantitative morphologic findings and pathophysiologic implications. Dig Dis Sci 2001; 46:1952-9. [PMID: 11575448 DOI: 10.1023/a:1010643300277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Helicobacter pylori affects gastric secretion. This functional effect might have a morphometric counterpart. Therefore, the gastric cell secretory compartment was morphometrically assessed in different pathophysiologic conditions related to Helicobacter pylori infection. Nineteen Helicobacter pylori-positive nonduodenal ulcer subjects, 15 omeprazole chronically treated subjects, and 19 duodenal ulcer patients were studied against 19 controls. Somatostatin, gastrin, enterochromaffin-like, and parietal cell density was assessed in gastric biopsies. No differences in any cell type density were found between Helicobacter pylori-positive nonduodenal ulcer subjects and controls. On the contrary, differences were significant when comparing omeprazole and duodenal ulcer patients to controls (higher density of gastrin, enterochromaffin-like, and parietal cells, lower density of somatostatin cells). In duodenal ulcer a reversion to control values followed Helicobacter pylori eradication and ulcer healing. A direct linear correlation between enterochromaffin-like, gastrin, and parietal cell density was demonstrated. An almost complete map of mucosal cells involved in gastric secretion is provided by this study. The cell density pattern, identical to the omeprazole group, points to an impaired feedback control of secretion in duodenal ulcer. The reversion to control values after Helicobacter pylori eradication and ulcer healing demonstrates the pathogenetic role of Helicobacter pylori-host interaction in these changes.
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Affiliation(s)
- P Bechi
- Clinica Chirurgica, University of Florence, Italy
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32
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Casini Raggi C, Pinzani P, Gelmini S, Tricarico C, Orlando C, Calabrò A, Renzi D, Cianchi F, Valanzano R, Distante V, Cortesini C, Tonelli F, Cataliotti L, Cameron Smith M, Messerini L, Bianchi S, Pazzagli M, Serio M, Maggi M. [Somatostatin receptors in non-endocrine tumours]. MINERVA ENDOCRINOL 2001; 26:149-58. [PMID: 11753238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The study of the antiproliferative action of somatostatin (ss) is important not only to understand the regulation of neuroendocrine tumours that express receptors (sst), but also non-endocrine tumours which express these receptors. We previously demonstrated the presence of sst2 in a wide panel of cell lines from human neuroblastoma. Although hypotheses have been put forward that treatment with ss or its analogs may be beneficial in oncological patients, this does not appear to be the case in neuroblastoma; patients with high sst2 levels (who are therefore sensitive to ss treatment) have per se a relatively positive outcome. Therefore, adjuvant treatment with ss is not necessary. Viceversa, patients with a poor prognosis are essentially characterized by a low expression of sst2 (and therefore are insensitive to a therapy with ss). In these patients adjuvant treatment with ss might be indicated, but would have little chance of success. Although the majority of neuroendocrine tumours expresses sst2, pancreas and prostate cancer express sst1 but not sst2, and are therefore insensitive to octreotide treatment which binds preferentially to sst2. Tumours like colorectal carcinoma and breast cancer also express sst2 in their more favourable forms. However, the concentration of sst2 in colorectal cancer is similar, if not lower than that in the surrounding normal tissue. Therefore, the probability of successful adjuvant therapy with ss is relatively low. In breast cancer, it is possible that sensitivity to estrogens may have a positive influence on the expression of sst2. This might justify clinical trials with ss in breast cancer.
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Affiliation(s)
- C Casini Raggi
- Unità di Endocrinologia, Università degli Studi, Florence, Italy
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Abstract
The ability of the 'alkaline' components of reflux to cause harm in vivo is still open to debate, although these components have been shown in vitro to be capable of damaging the mucosa. The precipitation of bile acids and lysolecithin that occurs at low pH values is the main reason for questioning in vivo mucosal damage. This study was undertaken to determine the composition of gastric aspirates at different original pH values and the degree of solubility of the alkaline components when pH modifications are artificially induced. The samples for chemical analysis were collected from indwelling nasogastric tubes after surgical procedures that did not involve the upper gastrointestinal tract. Bile acid and lysolecithin concentrations were assessed by means of dedicated methods. Thirty-five samples were available for bile acid evaluation and 27 for lysolecithin evaluation. Bile acid and lysolecithin assessments were repeated after pH adjustment at 2, 3.5, 5.5 and 7. For easier assessment of the results, three ranges of the original pH were selected (pH < 2, 2 < or = pH < 5, pH > or = 5). For each pH range, results were pooled together and compared with those in the other pH ranges. Bile acid concentrations were 113+/-48, 339+/-90 and 900+/-303 (mean +/- s.e.m. micromol/L), respectively, in the three groups selected on account of the different original pH values. Differences were significant (p < 0.001). Both taurine- and glycine-conjugated bile acids were represented even at pH < 2. No major differences were observed in bile acid concentration with the artificially induced pH variations. Lysolecithin concentrations were 5.99+/-3.27, 30.80+/-8.43 and 108.37+/-22.17 (mean +/- SEM microg/ml), respectively, in the three groups selected on account of the different original pH ranges. Differences were significant (p < 0.001). No significant differences in lysolecithin concentration were detected with the artificially induced pH variations. In conclusion, both bile acids and lysolecithin are naturally represented in the gastric environment even at very low pH values, although their concentrations decrease on lowering of the naturally occurring pH. Given the concentration variability of bile acids and lysolecithin, further studies are needed to assess the minimal concentration capable of mucosal damage in vivo.
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Affiliation(s)
- P Bechi
- Clinica Clirurgica Generale, Università di Firenze, Florence, Italy
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34
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D'Elios MM, Bergman MP, Azzurri A, Amedei A, Benagiano M, De Pont JJ, Cianchi F, Vandenbroucke-Grauls CM, Romagnani S, Appelmelk BJ, Del Prete G. H(+),K(+)-atpase (proton pump) is the target autoantigen of Th1-type cytotoxic T cells in autoimmune gastritis. Gastroenterology 2001; 120:377-86. [PMID: 11159878 DOI: 10.1053/gast.2001.21187] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS The proton pump H(+),K(+)-adenosine triphosphatase (H(+),K(+)-ATPase) of parietal cells is the major humoral autoantigen in both human and experimental autoimmune gastritis (AIG) characterized by an inflammatory infiltrate in the gastric mucosa and loss of parietal cells. The aim of this study was to detect H(+),K(+)-ATPase-specific T cells in the gastric mucosa of patients with AIG and to define their functional properties. METHODS In vivo-activated T cells from the infiltrates of the gastric mucosa of 5 patients with AIG were isolated and cloned. The ability of gastric T-cell clones to proliferate and to produce cytokines in response to H(+),K(+)-ATPase, as well as their expression of B-cell help, perforin-mediated cytotoxicity, and Fas-Fas ligand-mediated apoptosis in target cells, were assessed. RESULTS A proportion (25%) of the CD4(+) clones from the gastric corpus of AIG patients proliferated in response to porcine H(+),K(+)-ATPase. Most of these clones (88%) showed a Th1 profile, whereas a few secreted both Th1 and Th2 cytokines. Virtually all of the H(+),K(+)-ATPase-specific clones produced tumor necrosis factor alpha and provided substantial help for B-cell immunoglobulin production, and most of them expressed perforin-mediated cytotoxicity against antigen-presenting cells and induced Fas-Fas ligand-mediated apoptosis in target cells. CONCLUSIONS Activation of proton pump-specific Th1 cytotoxic/proapoptotic T cells in the gastric mucosa can represent an effector mechanism for the target cell destruction in AIG.
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Affiliation(s)
- M M D'Elios
- Department of Internal Medicine, University of Florence, Florence, Italy
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35
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Mini E, Biondi C, Morganti M, Napoli C, Mazzoni P, Cianchi F, Tonelli F, Cortesini C, Capaccioli S, Ficari F, Quattrone A, Rossi S, Mazzei T. Marked variation of thymidylate synthase and folylpolyglutamate synthetase gene expression in human colorectal tumors. Oncol Res 2000; 11:437-45. [PMID: 10821538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Patients with advanced colorectal cancer are currently being treated with 5-fluorouracil (5-FU)-based chemotherapy. A growing number of patients with resectable disease receive adjuvant therapy with 5-FU/levamisole (LEV) or 5-FU/folinic acid (LV). However, many patients still fail on these treatments, due to occurrence of natural or acquired tumor resistance. Among clinically relevant mechanisms of resistance to fluoropyrimidines, increased expression of thymidylate synthase (TS) has been emphasized. Another potentially relevant mechanism involves a decrease in folylpolyglutamate synthetase (FPGS) expression. To establish the value of these genes as prognostic factors and predictors of the outcome of 5-FU-based chemotherapy in colorectal cancer, we measured their expression in colorectal tumors from patients undergoing surgery and postoperative chemotherapy and compared it with that in normal colonic mucosa. This was done by a semi quantitative, nonradioisotopic polymerase chain reaction (PCR) method using beta-actin as an internal standard and expressed as a TS/beta-actin or a FPGS/beta-actin mRNA ratio. In tumor samples from 21 colorectal cancer patients, TS gene expression varied 118-fold. The median TS/beta-actin ratio was, in fact, 41.36 x 10(-3) (range 2.49 x 10(-3) to 294.54 x 10(-3)). Little variation in TS gene expression was observed in corresponding normal colic mucosa; the TS/beta-actin gene ratio was lower (median 26.16 x 10(-3); range 8.49 x 10(-3) to 69.49 x 10(-3)). Among tumor explants from 20 patients, FPGS expression varied over 161-fold. A similar marked variation was also observed in normal colonic mucosal samples (over 185-fold). Overall and disease-free survival data suggest an inverse association between the level of tumor TS and FPGS expression and clinical prognosis. The availability of this sensitive and accurate assay for gene expression should now make it possible to extend these laboratory/clinical correlations to larger populations.
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Affiliation(s)
- E Mini
- Dipartimento di Farmacologia Preclinica e Clinica, Università degli Studi di Firenze, Italy
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Baldini F, Bechi P, Cianchi F, Falai A, Fiorillo C, Nassi P. Analysis of the optical properties of bile. J Biomed Opt 2000; 5:321-329. [PMID: 10958619 DOI: 10.1117/1.430003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/1998] [Revised: 01/07/2000] [Accepted: 01/19/2000] [Indexed: 05/23/2023]
Abstract
Invasive bile determination is very useful in the diagnosis of many gastric pathologies. At the moment, this measurement is performed with Bilitec 2000, an optical fiber sensor, that is based on absorption by bilirubin. Nevertheless, erroneous evaluations are possible, due to the different configurations which the bilirubin molecule can adopt. The optical behavior of human samples of pure bile and bile+gastric juice has been examined using an optical fiber spectrophotometer and two suitably modified Bilitec 2000 units. A protocol has been established for the treatment of biological fluids, in order to make it possible to study the behavior of their optical properties as a function of pH and concentration without causing any alteration in the samples. The analysis of pH dependence evidenced the presence of different calibration curves at different pH values: the self-aggregation of the bilirubin molecules observed in pure bile samples was almost totally absent in the gastric samples. Measurements carried out on Bilitec 2000 showed that the most appropriate wavelength for bilirubin detection in the stomach should be 470 nm.
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Affiliation(s)
- F Baldini
- Istituto di Ricerca sulle Onde Elettromagnetiche Nello Carrara del CNR, Firenze, Italy.
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37
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Luceri C, Guglielmi F, De Filippo C, Caderni G, Mini E, Biggeri A, Napoli C, Tonelli F, Cianchi F, Dolara P. Clinicopathologic features and FHIT gene expression in sporadic colorectal adenocarcinomas. Scand J Gastroenterol 2000; 35:637-41. [PMID: 10912665 DOI: 10.1080/003655200750023615] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The putative tumour suppressor gene FHIT (fragile histidine triad) spans the common fragile site FRA3B, which is highly susceptible to breaks and deletions induced by genotoxic agents. Tumours associated with exposure to carcinogens, such as colorectal adenocarcinomas, should be particularly susceptible to alterations in the FHIT gene. We studied the frequency of FHIT alterations and their correlations with clinicopathologic features in sporadic colon carcinomas. METHODS FHIT expression was investigated by reverse transcription polymerase chain reaction in 56 primary sporadic colorectal carcinomas. The same tumours and matched normal tissues were also investigated for loss of heterozygosity by using two markers located inside the FHIT gene. RESULTS Twenty-nine of 56 tumours (51.8%) expressed aberrant FHIT transcripts. Four tumours had absence or nearly undetectable levels of the normal-sized FHIT transcript. Sequencing analysis of the altered transcripts showed FHIT mRNA lacking one or more exons, more frequent deletions of exons 4-5-6 or 4-5-6-7-8. At the genomic level 46.4% (13 of 28) of the cases showed alterations involving FHIT locus. We did not find any correlation between FHIT gene alterations and clinicopathologic characteristics of the tumours. CONCLUSIONS Since the FHIT gene is frequently altered, its role in the molecular pathogenesis of sporadic colon carcinoma deserves further investigation.
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Affiliation(s)
- C Luceri
- Dept of Pharmacology, University of Florence, Florence, Italy
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38
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Abstract
We have found that the anti-apoptotic Bcl-2 family protein, Bcl-w, was frequently expressed in colorectal adenocarcinomas, with 69/75 showing positive staining with anti-Bcl-w IgG. Adenomas demonstrated a much lower frequency of Bcl-w expression (only 1 of 17), as did adenocarcinomas from other epithelial tissues such as breast (0/8), stomach (1112) and cervix (0/12). Bcl-w status could be related to the histopathological classification of the tumours, with TNM stage III tumours showing significantly higher levels of expression than tumours of better prognostic grade (at P = 0.009). Those patients with node involvement also had tumours with significantly elevated levels of Bcl-w (at P = 0.02), compared to those which were node-negative. The results suggest that Bcl-w could play a general role in the progression from adenoma to adenocarcinoma in the colorectal epithelium. Currently, more data are being collected to allow us to assess the importance of Bcl-w for disease progression and patient survival.
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Affiliation(s)
- J W Wilson
- CRC Epithelial Biology Laboratory, Paterson Institute for Cancer Research, Manchester, UK
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39
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Cianchi F, Balzi M, Becciolini A, Faraoni P, Pucciani F, Perigli G, Bechi P, Palomba A, Ciancio G, Cortesini C. Relationship between s-phase fraction and clinical outcome after surgery for colorectal carcinoma. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)80679-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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40
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Cianchi F, Balzi M, Becciolini A, Giachè V, Messerini L, Palomba A, Tisti E, Faraoni P, Chellini F, Pucciani F, Perigli G, Cortesini C. Correlation between DNA content and p53 deletion in colorectal cancer. Eur J Surg 1999; 165:363-8. [PMID: 10365839 DOI: 10.1080/110241599750006910] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To find out whether tumour DNA content correlates with allelic loss of p53 and other pathological features in primary colorectal carcinomas. DESIGN Ongoing prospective study. SETTING University hospital, Italy. SUBJECTS 128 patients who had undergone radical resections for colorectal carcinoma. INTERVENTIONS Flow cytometric measurement of tumour DNA content and detection of allelic loss on the short arm of chromosome 17 by Southern blot (restriction fragment length polymorphism) analysis in fresh tumour specimens. MAIN OUTCOME MEASURES Correlation between DNA ploidy and deletion of p53, as well as between these two genetic events and clinicopathological variables. RESULTS Interpretable DNA histograms were obtained for 122 tumour specimens. Forty-three tumours (35%) were diploid and 79 (65%) aneuploid. The diploid tumours were significantly more common in the proximal colon (from the caecum to the splenic flexure) than in the distal colon (from the descending colon to the rectum) (p = 0.002). The allelic state on the short arm of chromosome 17 was evaluated in 80 heterozygous patients. Forty-four tumour specimens (55%) showed deletion of 17p. Allelic loss of p53 was significantly more common in the distal and rectal tumours than in the proximal ones (p < 0.0001). Aneuploidy was more common among those tumours which had shown deletion of p53 than in those that had not (p = 0.0008). CONCLUSIONS DNA aneuploidy was significantly associated with the deletion of the p53 gene. This suggests that the functional loss of p53 may favour the growth and establishment of an aneuploid cell population within tumours. Tumours of the proximal and distal colon differ in their genetic nature.
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Affiliation(s)
- F Cianchi
- Clinica Chirurgica Generale, Università di Firenze, Florence, Italy
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41
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Bechi P, Cianchi F. Technical aspects and clinical indications of 24-hour intragastric bile monitoring. Hepatogastroenterology 1999; 46:54-9. [PMID: 10228765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Bilitec 2000 is a new device which spectrophotometrically detects the presence of bilirubin in the refluxate. It is, up to date, the only method able to monitor for 24 hours the exposure time of esophageal and/or gastric mucosa to bilirubin-containing reflux. From the technical point of view, a particularly relevant aspect is the necessity of associating pH and Bilitec monitorings. The reason why is that, even in the stomach where Bilitec itself is adequate for assessing the exposure time to duodenogastric reflux, the damaging capability of the different components of reflux strictly depends upon pH. The most correct position inside the stomach for gastric monitoring is the 5 cm-below-the-LES-distal-border-position. The diet needs to be standardized in order to avoid false positive results due to the ingestion of foods with absorption close to bilirubin absorption. Ranges of normality will soon be available from a collaborative European Study. At variance with the indications for esophageal monitoring which are wide (the same as for pH-monitoring), indications for gastric Bilitec monitoring are represented only by severe dyspeptic symptoms possibly related to duodenogastric reflux. An antrum-confined C gastritis in the absence of history of consumption of gastro-lesive drugs strongly suggests the possibility of duodenogastric reflux. In this case, Bilitec monitoring can provide further evidence by measuring the time of exposure of the gastric mucosa to reflux.
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Affiliation(s)
- P Bechi
- Istituto Clinica Chirurgica, Universita di Firenze, Florence, Italy
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42
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Pucciani F, Rottoli ML, Bologna A, Cianchi F, Forconi S, Cutellè M, Cortesini C. Pelvic floor dyssynergia and bimodal rehabilitation: results of combined pelviperineal kinesitherapy and biofeedback training. Int J Colorectal Dis 1998; 13:124-30. [PMID: 9689562 DOI: 10.1007/s003840050149] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Dyschezia may be caused by pelvic floor dyssynergia, which takes place when a paradoxical contraction or a failure to relax the pelvic floor muscles occurs during attempts to defecate. The aim of our study was to set up a new bimodal rehabilitation programme for pelvic floor dyssynergia, which combined pelviperineal kinesitherapy and biofeedback, and to evaluate the results of this treatment. Thirty-five patients (age range: 28-64 years; mean age: 42.5 years) from the outpatient unit of the Clinica Chirurgica of the University of Florence, Italy, and an age-matched group of 10 healthy control subjects (age range: 31-59 years; mean age 45.7 years) with normal bowel habits and without any defecatory disorders, were studied. The 35 patients were symptomatic for dyschezia without slow colonic transit and had been diagnosed as being affected by pelvic floor dyssynergia. No evidence of any organic aetiology was present but all demonstrated both manometric and radiological evidence of inappropriate function of the pelvic floor. All of the patients underwent bimodal rehabilitation, using the combined training programme Clinical evaluation, computerized anorectal manometry and defecography were carried out 1 week before and 1 week after a completed course in bimodal rehabilitation. The control group underwent manometric and defecographic examination. Their results were compared with those of the 35 patients before and after training. After the programme, all 35 patients had a very significant increase in stool frequency (P < 0.001), while laxative and enema-induced bowel movements had become significantly less frequent (P < 0.001). After bimodal rehabilitation, computerized anorectal manometry showed some peculiar results. Resting anal canal pressure had increased but not significantly. Pre-programme values that indicated a shorter duration ("exhaustio") of maximal voluntary contraction than found in the controls had returned to normal values. The rectoanal inhibitory reflex (RAIR), with incomplete relaxation, which had been shorter than that of controls, became normal by the end of the rehabilitation. All RAIR parameters were significantly different especially when pre- and post-treatment values were compared (P < 0.001). No differences were found as regards rectal sensation parameters and rectal compliance between those before or after bimodal rehabilitation. Defecographic pretreatment X-ray films showed indentation of the puborectalis and poor anorectal angle (ARA) opening, at evacuation, with trapping barium of at 50%. After pelviperineal kinesitherapy and biofeedback training, the indentation had disappeared and the ARA had become significantly larger (P < 0.001) during evacuation. No differences were found after rehabilitation, when both were compared with those of controls. The pelvic floor descent was also significantly deeper (P < 0.001) than before the start of the programme. The bimodal rehabilitation technique can be considered a useful therapeutic option for functional dyschezia as shown by our clinical evaluations, manometric data and defecographic reports.
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Affiliation(s)
- F Pucciani
- Istituto di Clinica Chirurgica Generale e Discipline Chirurgiche, Università degli Studi di Firenze, Italy
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Perigli G, Cicchi P, Cianchi F, Artusi R, Olivari D, Caldini A, Cortesini C. Diagnostic value of preoperative DNA measurement on FNA in benign and malignant thyroid neoplasm. J Exp Clin Cancer Res 1998; 17:113-6. [PMID: 9646245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
MESH Headings
- Adenocarcinoma, Follicular/chemistry
- Adenocarcinoma, Follicular/diagnosis
- Adenocarcinoma, Follicular/pathology
- Adenocarcinoma, Follicular/surgery
- Adenoma/chemistry
- Adenoma/diagnosis
- Adenoma/pathology
- Adenoma/surgery
- Adenoma, Oxyphilic/chemistry
- Adenoma, Oxyphilic/diagnosis
- Adenoma, Oxyphilic/pathology
- Adenoma, Oxyphilic/surgery
- Adult
- Aged
- Aged, 80 and over
- Biopsy, Needle
- Carcinoma, Papillary/chemistry
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/surgery
- DNA, Neoplasm/analysis
- Evaluation Studies as Topic
- Female
- Humans
- Hyperplasia
- Male
- Middle Aged
- Ploidies
- Predictive Value of Tests
- Thyroid Gland/pathology
- Thyroid Neoplasms/chemistry
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/surgery
- Thyroidectomy
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Affiliation(s)
- G Perigli
- Dept. of General Surgery, University of Florence, Italy
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44
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Cianchi F, Messerini L, Palomba A, Boddi V, Perigli G, Pucciani F, Bechi P, Cortesini C. Character of the invasive margin in colorectal cancer: does it improve prognostic information of Dukes staging? Dis Colon Rectum 1997; 40:1170-5; discussion 1175-6. [PMID: 9336111 DOI: 10.1007/bf02055162] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The clinical significance and prognostic value of the histopathologic parameters used in both the Dukes and Jass classifications were evaluated to select those with an independent effect on survival after radical surgery for colorectal cancer. METHODS The depth of local spread (limited to the bowel wall or extended beyond it), the number of metastatic lymph nodes (none, 1-4, more than 4), the character of the invasive margin (pushing or infiltrating), and the presence or absence of conspicuous peritumoral lymphocytic infiltration were assessed in 235 patients who had undergone radical resection for colorectal cancer. The influence of these variables on survival was studied by univariate and multivariate analysis. RESULTS No significant difference in survival was found between patients with conspicuous peritumoral infiltrate and those without it; moreover, multivariate analysis failed to show any independent prognostic value for either lymphocytic infiltration or depth of local invasion. However, the character of the invasive margin and the number of metastatic lymph nodes were identified as the only variables with any independent importance on survival. Based on these data, a new prognostic model may be proposed; it uses the character of the infiltrative margin as a discriminating factor among patients within the lymph node-negative (Dukes A and B stages) and lymph node-positive (Dukes C1 and C2 subsets) groups. A good prognosis for Dukes A, B, and C1 patients was associated with pushing tumors; C1 and C2 patients with infiltrating tumors had a poor prognosis. On the whole, the new prognostic model has allowed for the placement of 59.6 percent of our patients into groups that provide a confident prognosis. The clinical outcome of Dukes A and B patients with infiltrating tumors is still uncertain. CONCLUSIONS The character of the invasive margin is an important prognostic factor in colorectal cancer. The association of this parameter with the traditional Dukes classification may provide additional useful prognostic information and aid in the selection of those patients who could most benefit from adjuvant therapy.
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Affiliation(s)
- F Cianchi
- Clinica Chirurgica Generale, Universita' di Firenze, Florence, Italy
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45
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Cianchi F, Giachè V, Becciolini A, Balzi M, Messerini L, Palomba A, Chellini F, Pucciani F, Perigli G, Cortesini C. Evidence for different site-related genetic mechanisms in the pathogenesis of sporadic colorectal cancer. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)85322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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46
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Cianchi F, Carassale G, Palomba A, Pucciani F, Messerini L. [A case of primary hepatic carcinoid. A report of its surgical resolution]. MINERVA CHIR 1997; 52:433-7. [PMID: 9265129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Primary hepatic carcinoid tumors are extremely rare; conversely, the liver is the most frequent site of metastases from gastrointestinal carcinoids. Clinically, primary lesions are characterized, in most cases, by the absence of an overt endocrine syndrome. Histologic findings and immunohistochemical demonstrations of chromogranin and neuron specific enolase, generally, enable the neuroendocrine origin of these neoplasms to be established. Prognosis after surgical treatment of primary hepatic carcinoids seems to be more favorable when compared with other hepatic carcinomas.
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Affiliation(s)
- F Cianchi
- Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi, Firenze
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47
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Bechi P, Romagnoli P, Bacci S, Dei R, Amorosi A, Cianchi F, Masini E. Helicobacter pylori and duodenal ulcer: evidence for a histamine pathways-involving link. Am J Gastroenterol 1996; 91:2338-43. [PMID: 8931414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES A "gastrin link" has been suggested to explain the statistically relevant association between Helicobacter pylori and duodenal ulcer. Given the well known, although not entirely clarified, relationships between gastrin and histamine, the purpose of this study was to assess whether gastric mucosal histamine pathways and, more specifically, histamine-storing cells are involved in the Helicobacter pylori-duodenal ulcer route. METHODS Fasting serum gastrin, gastric mucosal histamine content, and mucosal density of both enterochromaffin-like cells and mast cells were compared in 11 H. pylori-positive, non-duodenal ulcer subjects, in 16 duodenal ulcer patients (all H. pylori positive), and in 11 H. pylori-negative control subjects. RESULTS Fasting serum gastrin concentration and mucosal histamine content were significantly higher in the duodenal ulcer group than in controls, whereas H. pylori-positive, non-ulcer subjects had values that were intermediate between those of the other two groups. Enterochromaffin-like cell density was significantly greater in duodenal ulcer patients than in the other groups. CONCLUSIONS These results demonstrate the involvement of histamine pathways in H. pylori infection and duodenal ulcer. The most original finding in this study was that enterochromaffin-like cell density is three times greater in duodenal ulcer patients than in H. pylori-positive, non-ulcer subjects. This could explain the previous report of an exaggerated acid response to gastrin in duodenal ulcer patients when compared with H. pylori-positive, non-ulcer subjects and thus provide further insight into the pathogenesis of ulcers.
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Affiliation(s)
- P Bechi
- Istituti di Clinica Chirurgica e DC, Dipartimenti di Anatomia Umana ed Istologia, e di Farmacologia Preclinica e Clinica, Università di Firenze, Florence, Italy
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48
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Abstract
The two types of anterior rectocele, "distension" of Type 1 rectocele (T1R) and "displacement" or Type 2 rectocele (T2R), have different anatomical, clinical and therapeutic profiles. The aim of this study was to assess anorectal function in patients with distension or displacement rectocele. Three groups of female patients and one group of healthy female subjects were studied. Both the 10 Group 1 subjects, who had been diagnosed as having T1R, and 10 Group 2 women who had been diagnosed as having T2R, were symptomatic for digital evacuation of the rectum. The 10 Group 3 females had complained of sever idiopathic constipation but had no defecatory disorders. The control group was made up to 10 healthy volunteers. All patients and controls underwent clinical evaluation, colonic transit time (CTT), computerized anorectal manometry (CAM), and defecography. Bowel movements and clinical evaluation were similar for both rectocele groups. In Group 1, CAM detected significantly higher anal pressure (P < 0.05) and more impaired rectoanal inhibitory reflex (RAIR) (P < 0.01) in comparison to the other patients and controls. In Group 2, the lowest anal pressure (P < 0.001) was noted but RAIR was normal. Defecographic results, at rest and during evacuation, showed a significantly (P < 0.001) higher anorectal angle and a more abnormal pelvic floor descent in Group 2 than in the other study groups and controls. Therefore, peculiar anorectal function was present in patients with anterior rectocele. A pelvic floor dyssynergia was noted in the distension rectocele group, while a fall of the pelvic floor was noted in the displacement rectocele group.
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Affiliation(s)
- F Pucciani
- Clinica Chirurgica, Universita degli Studi di Firenze, Italy
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49
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Abstract
Idiopathic chronic constipation has been correlated to neural abnormalities that consist of a reduced number of myenteric plexus neurons and a decreased concentration of VIP-positive nerve fibers within the circular muscle. Recent studies hypothesized the involvement of nitric oxide in motility disorders of the human gut. To date, no information is available on nitric oxide involvement in idiopathic chronic constipation. The density of VIP- and nitric oxide-producing neurons was evaluated by immunocytochemistry using anti-VIP and anti-nitric oxide synthase antibodies in five patients with idiopathic chronic constipation. A low total neuron density was found at the myenteric plexus. The density of VIP-positive neurons was low while that of nitric oxide synthase-positive neurons was high at both plexuses. Our data confirm that idiopathic slow-transit chronic constipation is due to abnormal neurogenic factors. The presence of numerous nitric oxide synthase-positive neurons, all along the colon and at both plexuses, supports the hypothesis that an excessive production of nitric oxide may cause the persistent inhibition of contractions.
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Affiliation(s)
- C Cortesini
- Clinica Chirurgíca Generale, Università di Firenze, Florence, Italy
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50
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Cianchi F, Perigli G, Pucciani F, Nesi G, Amorosi A. [Giant mesenteric fibromatosis: a case report]. Ann Ital Chir 1995; 66:531-5. [PMID: 8687006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The fibromatoses represent a broad group of fibroblastic proliferations characterized by infiltrative growth and a tendency toward recurrence but, unlike malignant fibrous tumors, they do not metastasize. Mesenteric fibromatosis arising from the mesentery of the small bowel is rare. It may be sporadic or may occur in association with polyposis coli and other soft tissue tumors as a component of Gardner's syndrome. We report a case of mesenteric fibromatosis in a 52-year-old man with no evidence of Gardner's syndrome. The neoplasm occupied the whole abdominal cavity, weighing 12 kg, with the greatest diameter being 50 cm. Histological findings (i.e moderate degree of cellularity, lack of nuclear pleomorphism and mitotic figures) allowed to rule out malignancy. Surgical removal is actually the only effective treatment for mesenteric fibromatosis. Excision must be as wide as possible in order to prevent local recurrence. Until now, no satisfactory results have been obtained with external radiotherapy. More recently, anti-inflammatory drugs have been used in the management of this tumor.
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Affiliation(s)
- F Cianchi
- Università degli Studi di Firenze, Clinica Chirurgica Generale e Terapia Chirurgica
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