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Tortora R, Farella N, Morisco F, Coppola C, Izzo F, Salomone Megna A, Federico A, Messina V, Nardone G, Piai G, Ragone E, Adinolfi LE, D’Adamo G, Stanzione M, Francica G, Torre P, De Girolamo V, Coppola N, Guarino M, Dallio M, Rocco L, Di Costanzo GG. Development of a risk score to predict portal vein tumor thrombosis in patients with hepatocellular carcinoma. Eur J Gastroenterol Hepatol 2023; 35:734-741. [PMID: 37115974 PMCID: PMC10234326 DOI: 10.1097/meg.0000000000002549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/29/2022] [Indexed: 04/30/2023]
Abstract
BACKGROUND Portal vein tumor thrombosis (PVTT) is a common complication of hepatocellular carcinoma and is one of the most negative prognostic factors. The management of patients with PVTT is challenging. The aim of the study was to develop a score predictive of tumor thrombosis. METHODS Data from a large cohort of 2243 hepatocellular carcinoma patients (all stages) recorded in the Progetto Epatocarcinoma Campania (January 2013-April 2021) database were analyzed. To construct the score, univariate generalized estimated equation models, the bootstrap approach for internal validation, and a regression coefficient-based scoring system were used. RESULTS PVTT (any location) was found in 14.4% of cases and was related to shorter survival. Males, younger patients, and symptomatic cases were more prevalent among the PVTT group. At multivariate analysis, size ≥5 cm, massive or infiltrative hepatocellular carcinoma growth, and alpha-fetoprotein ≥400 ng/mL were significantly associated with PVTT. A risk prediction score of PVTT based on eight variables was developed. Using a continuous score, the risk was associated with an odds ratio (OR) of 1.30 (1.27-1.34; P < 0.001). Considering a dichotomous score >8 versus a score ≤8 the OR for PVTT was 11.33 (8.55-15.00; P < 0.001). CONCLUSION The risk score for PVTT might be useful for clinicians to optimize hepatocellular carcinoma management by picking out patients with more aggressive cancers and higher mortality rates. Prospective validation of the score is needed before its application in daily clinical practice.
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Affiliation(s)
| | - Nunzia Farella
- UOC Malattie infettive ad indirizzo Ecointerventistico, A.O.R.N dei Colli P.O. D. Cotugno
| | - Filomena Morisco
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Napoli
| | - Carmine Coppola
- UO di Epatologia ed Ecografia Interventistica, OO.RR. Area Stabiese, Gragnano (NA)
| | - Francesco Izzo
- UOC Chirurgia Oncologica Addominale ad indirizzo Epatobiliare, Istituto Nazionale per lo studio e la cura dei Tumori, IRCCS Fondazione Pascale, Napoli
| | | | | | - Vincenzo Messina
- UOC Malattie Infettive, -AORN Sant’Anna e San Sebastiano, Caserta
| | - Gerardo Nardone
- UOC Gastroenterologia ed Epatologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli
| | - Guido Piai
- UOSD Fisiopatologia Epatica con Servizio di Assistenza ai Trapiantati e Trapiantandi Epatici, Dipartimento di Scienze Mediche, AORN Sant’Anna e San Sebastiano, Caserta
| | - Enrico Ragone
- UOC Medicina Infettivologica e dei trapianti UOS Ecointerventistica, Clinica AORN Dei Colli - Ospedale Monaldi
| | - Luigi Elio Adinolfi
- Dipartimento di Scienze Mediche e Chirugiche Avanzate; Università della Campania Luigi Vanvitelli, Napoli
| | | | - Maria Stanzione
- UOC Malattie Infettive, Universita’ della Campania Luigi Vanvitelli, Napoli
| | - Giampiero Francica
- Unita di Ecografia Interventistica, PO Pineta Grande, Castelvolturno (CE)
| | - Pietro Torre
- Divisione di Medicina Interna ed Epatologia, Dipartimento di Medicina, Università di Salerno, Salerno
| | | | - Nicola Coppola
- UOC Malattie tropicali, Universita’ della Campania Luigi Vanvitelli, Napoli, Italy
| | - Maria Guarino
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Napoli
| | - Marcello Dallio
- Dipartimento di Epatogastroenterologia - Università L Vanvitelli, Napoli
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Pisaturo M, Di Fraia A, Occhiello L, Minichini C, Starace M, Iodice V, Farella N, Stanzione M, Coppola N. Genetic Variability in Patients with HCV-Related Hepatocellular Carcinoma. Infect Drug Resist 2021; 14:5199-5208. [PMID: 34908854 PMCID: PMC8665876 DOI: 10.2147/idr.s337647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/10/2021] [Accepted: 11/09/2021] [Indexed: 12/09/2022] Open
Abstract
Background The present paper evaluates the genetic variability of HCV in patients with hepatocellular carcinoma (HCC). Methods Amino acid substitutions (aas) in NS3, NS5A and core regions were analyzed in 17 patients with HCC (Cases) and 13 without HCC (Controls), all naïve to DAAs. For the Cases, a sample of neoplastic liver tissue, non-neoplastic liver tissue and a serum sample were collected; for the Controls, a sample of liver tissue was collected. Sanger sequencing of three regions was performed using homemade protocols. Results Phylogenetic trees showed that there was no difference in the virus populations in the three compartments analyzed for the three HCV regions in patients with HCC. Low variability and no difference between the Cases and Controls were observed in the core and NS5A regions; however, in the NS3 region, a higher variability was observed in the Cases. No difference was observed in the core region between Cases and Controls. In NS3, aa substitutions at positions 103 and 122 were more frequently found in Cases than Controls (in both cases 50% vs 9.1%, p<0.05); moreover, aas in positions 32, 44 (p=0.035 for both), 79 (p=0.008) and 121 (p=0.018) were observed in the Cases and absent in the Controls. Finally, considering the NS5A region, aa substitutions at positions 37 and 54 were more frequently identified in the Cases than the Controls, but without statistical significance. Conclusion These data may suggest a higher aa variability in patients with HCC than in those without, especially in the NS3 region.
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Affiliation(s)
- Mariantonietta Pisaturo
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alessandra Di Fraia
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Laura Occhiello
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carmine Minichini
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mario Starace
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Nunzia Farella
- IX Infectious Disease Unit, AORN dei Colli, Naples, Italy
| | - Maria Stanzione
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Nicola Coppola
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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Pisaturo M, De Angelis G, Maggi P, Sangiovanni V, Numis FG, Gentile I, Masullo A, Rescigno C, Calabria G, Salomone Megna A, Gambardella M, Manzillo E, Giolitto G, Rossomando A, Buonomo AR, Macera M, Messina V, Pagano A, Pisapia R, Farella N, Bosso G, Coppola N, Group C. Clinical Features of Patients with Home Isolation Sars-Cov-2 Infection: A Multicenter Retrospective Study in Southern Italy. Life (Basel) 2021; 11:life11040347. [PMID: 33923857 PMCID: PMC8073533 DOI: 10.3390/life11040347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 01/08/2023] Open
Abstract
To describe epidemiological and clinical features of patients confirmed as having SARS-CoV-2 infection and managed in isolation at home. We performed a multicenter retrospective study enrolling all SARS-CoV-2-positive adults evaluated from 28 February to 31 May 2020 at one of nine COVID-19 Units in southern Italy: we included patients receiving care at home and those admitted to hospital. We defined patients with not-severe disease if they were asymptomatic or experienced a mild infection that did not need oxygen (O2) therapy and those with a severe infection if hospitalized and required O2 therapy. We enrolled 415 patients with SARS-CoV-2 infection: 77 were managed in isolation at home, 338 required hospital management. The 77 patients in home isolation were less frequently male than hospitalized patients (55% vs. 64%; <0.01) and were younger (median age 45 years (IQR:19) vs. 62 (IQR 22); p < 0.01), had a lower Charlson comorbidity index (median 0 (IQR2) vs. 6 (IQR 3); p < 0.01), and included fewer subjects with an underlying chronic disease (36% vs. 59%; p < 0.01). According to a binomial logistic regression analysis, a younger age (OR: 0.96 (95% IC: 0.94–0.98), p < 0.01) and a low Charlson comorbidity index (OR: 0.66 (95% IC: 0.54–0.83); p < 0.01) were independent factors associated with at-home management. The identification of subjects with SARS-CoV-2 infection who could be managed in home isolation is useful in clinical practice. A younger age and no comorbidities were identified as factors independently associated with home management.
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Affiliation(s)
- Mariantonietta Pisaturo
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80100 Naples, Italy; (M.P.); (G.D.A.); (M.M.)
- Third Infectious Diseases Unit, AORN dei Colli, P.O. Cotugno, 34105 Naples, Italy;
| | - Giulia De Angelis
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80100 Naples, Italy; (M.P.); (G.D.A.); (M.M.)
| | - Paolo Maggi
- Infectious Diseases Unit, A.O. S Anna e S Sebastiano, 23868 Caserta, Italy; (P.M.); (V.M.)
| | - Vincenzo Sangiovanni
- Third Infectious Diseases Unit, AORN dei Colli, P.O. Cotugno, 34105 Naples, Italy;
| | - Fabio Giuliano Numis
- Emergency Unit, PO Santa Maria delle Grazie, 80078 Pozzuoli, Italy; (F.G.N.); (A.P.); (G.B.)
| | - Ivan Gentile
- Infectious Disease Unit, University Federico II, 34105 Naples, Italy; (I.G.); (A.R.B.)
| | - Alfonso Masullo
- Infectious Disease Unit, A.O. San Giovanni di Dio e Ruggi D’Aragona, 84100 Salerno, Italy;
| | - Carolina Rescigno
- First Infectious Disease Unit, AORN dei Coli, PO Cotugno, 34105 Naples, Italy; (C.R.); (R.P.)
| | - Giosuele Calabria
- IX Infectious Disease Unit, AORN dei Coli, PO Cotugno, 34105 Naples, Italy; (G.C.); (N.F.)
| | | | - Michele Gambardella
- Infectious Disease Unit, PO S. Luca, Vallo della Lucania, ASL, 84100 Salerno, Italy;
| | - Elio Manzillo
- VIII Infectious Disease Unit, AORN dei Coli, PO Cotugno, 34105 Naples, Italy;
| | - Giancarlo Giolitto
- Infectious Disease Unit, Ospedale Maria S.S. Addolorata di Eboli, ASL, 84100 Salerno, Italy;
| | | | | | - Margherita Macera
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80100 Naples, Italy; (M.P.); (G.D.A.); (M.M.)
| | - Vincenzo Messina
- Infectious Diseases Unit, A.O. S Anna e S Sebastiano, 23868 Caserta, Italy; (P.M.); (V.M.)
| | - Antonio Pagano
- Emergency Unit, PO Santa Maria delle Grazie, 80078 Pozzuoli, Italy; (F.G.N.); (A.P.); (G.B.)
| | - Raffaella Pisapia
- First Infectious Disease Unit, AORN dei Coli, PO Cotugno, 34105 Naples, Italy; (C.R.); (R.P.)
| | - Nunzia Farella
- IX Infectious Disease Unit, AORN dei Coli, PO Cotugno, 34105 Naples, Italy; (G.C.); (N.F.)
| | - Giorgio Bosso
- Emergency Unit, PO Santa Maria delle Grazie, 80078 Pozzuoli, Italy; (F.G.N.); (A.P.); (G.B.)
| | - Nicola Coppola
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80100 Naples, Italy; (M.P.); (G.D.A.); (M.M.)
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Via L. Armanni 5, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-5666223; Fax: +39-081-566-6013
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Coppola N, Onorato L, Panella M, de Stefano G, Mosca N, Minichini C, Messina V, Potenza N, Starace M, Alessio L, Farella N, Sagnelli E, Russo A. Correlation Between the Hepatic Expression of Human MicroRNA hsa-miR-125a-5p and the Progression of Fibrosis in Patients With Overt and Occult HBV Infection. Front Immunol 2018; 9:1334. [PMID: 29951066 PMCID: PMC6008383 DOI: 10.3389/fimmu.2018.01334] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/22/2018] [Accepted: 05/29/2018] [Indexed: 12/16/2022] Open
Abstract
Aims To evaluate the correlation between the hepatic expression pattern of hsa-miR-125a-5p and HBV-DNA and the progression of fibrosis in patients with overt or occult HBV infection. Methods We enrolled all the HBsAg-positive treatment naive patients (overt HBV group) and all the HBsAg-negative patients with hepatocellular carcinoma and with a positive HBV-DNA in their hepatic tissue (occult HBV group), who underwent a diagnostic liver biopsy between April 2007 and April 2015. Tissue concentrations of HBV-DNA and hsa-miR-125a-5p were then analyzed by real-time quantitative PCR. Necroinflammatory activity and fibrosis were evaluated according to the Ishak score. Results During the study period, we enrolled 64 patients with overt and 10 patients with occult HBV infection. In the overt HBV group, 35 of 64 (54.7%) showed a mild fibrosis (staging 0–2), 17 (26.6%) a moderate fibrosis (staging 3–4), while the remaining 12 (18.7%) had a cirrhosis. All patients in the occult HBV group were cirrhotic. Patients with more advanced fibrosis stage showed a higher mean age when compared with those with mild (p < 0.00001) or moderate fibrosis (p < 0.00001) and were more frequently male than patients with staging 0–2 (p = 0.04). Similarly, patients with occult B infection were older than HBsAg-positive patients. Liver concentrations of miR-125a-5p were significantly higher in patients with cirrhosis (9.75 ± 4.42 AU) when compared with patients with mild (1.39 ± 0.94, p = 0.0002) or moderate fibrosis (2.43 ± 2.18, p = 0.0006) and were moderately higher in occult than in overt HBV infection (p = 0.09). Moreover, we found an inverse correlation, although not statistically significant, between the tissue HBV-DNA levels and the staging of fibrosis. Conclusion This study suggests a correlation between the tissue expression of hsa-miR-125a-5p and the progression of liver damage in a group of patients with occult or overt HBV infection. If confirmed, these data suggest the hsa-miR-125a-5p may be a novel biomarker of hepatic damage.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Luigi Vanvitelli, Naples, Italy.,Infectious Diseases Unit, AORN Sant'Anna e San Sebastiano, Caserta, Italy
| | - Lorenzo Onorato
- Department of Mental Health and Public Medicine, University of Campania, Luigi Vanvitelli, Naples, Italy
| | - Marta Panella
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania, Luigi Vanvitelli, Caserta, Italy
| | - Giorgio de Stefano
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Nicola Mosca
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania, Luigi Vanvitelli, Caserta, Italy
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, University of Campania, Luigi Vanvitelli, Naples, Italy
| | - Vincenzo Messina
- Infectious Diseases Unit, AORN Sant'Anna e San Sebastiano, Caserta, Italy
| | - Nicoletta Potenza
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania, Luigi Vanvitelli, Caserta, Italy
| | - Mario Starace
- Department of Mental Health and Public Medicine, University of Campania, Luigi Vanvitelli, Naples, Italy
| | - Loredana Alessio
- Infectious Diseases Unit, AORN Sant'Anna e San Sebastiano, Caserta, Italy
| | - Nunzia Farella
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania, Luigi Vanvitelli, Naples, Italy
| | - Aniello Russo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania, Luigi Vanvitelli, Caserta, Italy
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Coppola N, de Stefano G, Panella M, Onorato L, Iodice V, Minichini C, Mosca N, Desiato L, Farella N, Starace M, Liorre G, Potenza N, Sagnelli E, Russo A. Lowered expression of microRNA-125a-5p in human hepatocellular carcinoma and up-regulation of its oncogenic targets sirtuin-7, matrix metalloproteinase-11, and c-Raf. Oncotarget 2018; 8:25289-25299. [PMID: 28445974 PMCID: PMC5421930 DOI: 10.18632/oncotarget.15809] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 11/08/2016] [Accepted: 02/07/2017] [Indexed: 12/12/2022] Open
Abstract
Human microRNA-125a-5p (miR-125a) is expressed in most tissues where it downregulates the expression of membrane receptors or intracellular transductors of mitogenic signals, thus limiting cell proliferation. Expression of this miRNA generally increases with cell differentiation whereas it is downregulated in several types of tumors, such as breast, lung, ovarian, gastric, colon, and cervical cancers, neuroblastoma, medulloblastoma, glioblastoma, and retinoblastoma. In this study, we focused on hepatocellular carcinoma and used real-time quantitative PCR to measure miR-125a expression in 55 tumor biopsies and in matched adjacent non-tumor liver tissues. This analysis showed a downregulation of miR-125a in 80 % of patients, with a mean decrease of 4.7-fold. Comparison of miRNA downregulation with clinicopathological parameters of patients didn't yield significant correlations except for serum bilirubin. We then evaluated the expression of known targets of miR-125a and found that sirtuin-7, matrix metalloproteinase-11, and c-Raf were up-regulated in tumor tissue by 2.2-, 3-, and 1.7-fold, respectively. Overall, these data support a tumor suppressor role for miR-125a and encourage further studies aimed at the comprehension of the molecular mechanisms governing its expression, eventually leading to treatments to restore its expression in tumor cells.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Giorgio de Stefano
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Marta Panella
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Naples, Italy
| | - Lorenzo Onorato
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Valentina Iodice
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Nicola Mosca
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Naples, Italy
| | - Luisa Desiato
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Naples, Italy
| | - Nunzia Farella
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Mario Starace
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Giulia Liorre
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Nicoletta Potenza
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Aniello Russo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Naples, Italy
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Coppola N, Onorato L, Iodice V, Starace M, Minichini C, Farella N, Liorre G, Filippini P, Sagnelli E, de Stefano G. Occult HBV infection in HCC and cirrhotic tissue of HBsAg-negative patients: a virological and clinical study. Oncotarget 2018; 7:62706-62714. [PMID: 27486882 PMCID: PMC5308760 DOI: 10.18632/oncotarget.10909] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 06/18/2016] [Indexed: 12/19/2022] Open
Abstract
Aim To evaluate the virological and clinical characteristics of occult HBV infection (OBI) in 68 consecutive HBsAg-negative patients with biopsy-proven cirrhosis and HCC. Methods HBV DNA was sought and sequenced in plasma, HCC tissue and non-HCC liver tissue by PCRs using primers for HBV core, surface and x regions. OBI was identified by the presence of HBV DNA in at least two different PCRs. Results OBI was detected in HCC tissue of 13 (20%) patients and in non-HCC liver tissue of 3 of these 13. OBI was detected in HCC tissue of 54.5% of 11 anti-HBs- negative/anti-HBc-positive patients, in 29.4% of 17 anti-HBs/anti-HBc-positive and in 5% of 40 anti-HBs/anti-HBc-negative (p < 0.0005). The 13 patients with OBI in HCC tissue more frequently than the 55 without showed Child-B or -C cirrhosis (53.9% vs. 5.5%, p < 0.0001) and BCLC-B or -C stages (46.1% vs. 1.8%, p < 0.0001). The pre-S1, pre-S2 and S region sequences in HCC tissue showed amino acid (AA) substitutions (F19L, P24L, S59F, T131I, Q129H) and deletions (in positions 4,8, 17 and 86) in the S region, AA substitutions (T40S, P124K, L54P, G76A, N222T and I273L) in pre-S1 region and AA substitutions in pre-S2 region (P41H and P66L). In the 3 patients showing OBI also in non-HCC liver tissue the S, pre-S1 and pre-S2 sequencing displayed patterns of mutations different. Conclusions The study showed a significant correlation between OBI and the severity of liver damage, several patterns of mutations in the S, pre-S1 and pre-S2 regions in HCC tissue, some at their first description.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Lorenzo Onorato
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Valentina Iodice
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy.,Ninth Interventional Ultrasound Unit for Infectious Diseases, Cotugno Hospital, Naples, Italy
| | - Mario Starace
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Nunzia Farella
- Ninth Interventional Ultrasound Unit for Infectious Diseases, Cotugno Hospital, Naples, Italy
| | - Giulia Liorre
- Ninth Interventional Ultrasound Unit for Infectious Diseases, Cotugno Hospital, Naples, Italy
| | - Pietro Filippini
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy.,Infectious Diseases Unit, Caserta Hospital, Caserta, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Giorgio de Stefano
- Ninth Interventional Ultrasound Unit for Infectious Diseases, Cotugno Hospital, Naples, Italy
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de Stefano G, Scognamiglio U, Di Martino F, Parrella R, Scarano F, Signoriello G, Farella N. Retraction: The role of CEUS in characterization of superficial lymph nodes: a single center prospective study. Oncotarget 2017; 8:43595. [PMID: 28672779 PMCID: PMC5522174 DOI: 10.18632/oncotarget.18637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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CLEO Study Group, Ascione A, Adinolfi LE, Amoroso P, Andriulli A, Armignacco O, Ascione T, Babudieri S, Barbarini G, Brogna M, Cesario F, Citro V, Claar E, Cozzolongo R, D’Adamo G, D’Amico E, Dattolo P, De Luca M, De Maria V, De Siena M, De Vita G, Di Giacomo A, De Marco R, De Stefano G, De Stefano G, Di Salvo S, Di Sarno R, Farella N, Felicioni L, Fimiani B, Fontanella L, Foti G, Furlan C, Giancotti F, Giolitto G, Gravina T, Guerrera B, Gulminetti R, Iacobellis A, Imparato M, Iodice A, Iovinella V, Izzi A, Liberti A, Leo P, Lettieri G, Luppino I, Marrone A, Mazzoni E, Messina V, Monarca R, Narciso V, Nosotti L, Pellicelli AM, Perrella A, Piai G, Picardi A, Pierri P, Pietromatera G, Resta F, Rinaldi L, Romano M, Rossini A, Russello M, Russo G, Sacco R, Sangiovanni V, Schiano A, Sciambra A, Scifo G, Simeone F, Sullo A, Tarquini P, Tundo P, Vallone A. Boceprevir or telaprevir in hepatitis C virus chronic infection: The Italian real life experience. World J Hepatol 2016; 8:949-956. [PMID: 27574549 PMCID: PMC4976214 DOI: 10.4254/wjh.v8.i22.949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/23/2016] [Accepted: 07/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To check the safety and efficacy of boceprevir/telaprevir with peginterferon/ribavirin for hepatitis C virus (HCV) genotype 1 in the real-world settings.
METHODS: This study was a non-randomized, observational, prospective, multicenter. This study involved 47 centers in Italy. A database was prepared for the homogenous collection of the data, was used by all of the centers for data collection, and was updated continuously. All of the patients enrolled in this study were older than 18 years of age and were diagnosed with chronic infection due to HCV genotype 1. The HCV RNA testing was performed using COBAS-TaqMan2.0 (Roche, LLQ 25 IU/mL).
RESULTS: All consecutively treated patients were included. Forty-seven centers enrolled 834 patients as follows: Male 64%; median age 57 (range 18-78), of whom 18.3% were over 65; mean body mass index 25.6 (range 16-39); genotype 1b (79.4%); diagnosis of cirrhosis (38.2%); and fibrosis F3/4 (71.2%). The following drugs were used: Telaprevir (66.2%) and PEG-IFN-alpha2a (67.6%). Patients were naïve (24.4%), relapsers (30.5%), partial responders (14.8%) and null responders (30.3%). Overall, adverse events (AEs) occurred in 617 patients (73.9%) during the treatment. Anemia was the most frequent AE (52.9% of cases), especially in cirrhotic. The therapy was stopped for 14.6% of the patients because of adverse events or virological failure (15%). Sustained virological response was achieved in 62.7% of the cases, but was 43.8% in cirrhotic patients over 65 years of age.
CONCLUSION: In everyday practice, triple therapy is safe but has moderate efficacy, especially for patients over 65 years of age, with advanced fibrosis, non-responders to peginterferon + ribavirin.
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de Stefano G, Scognamiglio U, Iodice V, Farella N, Simeone E, Montesarchio V. Efficacy and safety of combined sequential treatment with radiofrequency ablation and sorafenib in patients with hepatocellular carcinoma in intermediate stage ineligible for tace: a prospective randomized open study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Scognamiglio U, De Stefano G, Iodice V, Farella N, Montesarchio V, Simeone E, Chirianni A. The role of CEUS in the differential diagnosis of superficial lymphadenopathy: preliminary results of a prospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.48] [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: 11/14/2022] Open
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11
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de Stefano G, Farella N, Scognamiglio U, Liorre G, Calabria G, Ascione T, Giorgio A, Iodice V. Sorafenib after RFA in HCC patients: a pilot study. Hepatogastroenterology 2015; 62:261-263. [PMID: 25916044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS To investigate the effectiveness and safety of sorafenib after radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). METHODOLOGY 44 intermediate or advanced HCC patients received sorafenib treatment after debulking with RFA therapy. Time to progression (TTP), response rate (RR), duration of sorafenib treatment and adverse effects were evaluated. An explorative comparison was performed with patients treated with sorafenib only. RESULTS At 12 months, TTP was 10.3 months (range: 1-32). RR was 61% with 2 complete responses, and duration of sorafenib therapy was 10.9 months (1-32). No new safety concerns were report-ed. With sorafenib only, TTP was 7.2 months (range: 0-38) and RR was 40%, with one complete response; duration of therapy was 7.3 months (0-38). CONCLUSIONS The sequence of RFA and sorafenib appears effective and safe in HCC patients. These findings could support the use of a sequential treatment with RFA and sorafenib in HCC patients.
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12
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Di Costanzo GG, de Stefano G, Tortora R, Farella N, Addario L, Lampasi F, Lanza AG, Cordone G, Imparato M, Caporaso N. Sorafenib off-target effects predict outcomes in patients treated for hepatocellular carcinoma. Future Oncol 2015; 11:943-51. [DOI: 10.2217/fon.14.291] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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13
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Giorgio A, Calisti G, de Stefano G, Farella N, Scognamiglio U, Giorgio V. Percutaneous treatment of hydatid liver cysts: an update. ACTA ACUST UNITED AC 2013; 7:231-6. [PMID: 23061784 DOI: 10.2174/157489112803521913] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/04/2012] [Accepted: 10/04/2012] [Indexed: 11/22/2022]
Abstract
Liver hydatidosis is the most common clinical presentation of cystic echinococcosis. Although liver cystic hydatidosis is considered a benign disease and many patients do not develop symptoms for years, its complications can be severe and life threatening (usually as a consequence of rupture in the biliary tree, in the peritoneum, in the bronchi, and of anaphylactic shock), thus, treatment is recommended for all viable and active hydatid liver cysts. Among the therapeutical options available for this disease, such as open and laparoscopic surgery and chemotherapy, percutaneous treatments have gained considerable interest over the last two decades, due to their efficacy, safety and high patient acceptability. Percutaneous treatments for liver cystic hydatidosis were once discouraged due to the risk of anaphylaxis following cyst puncture. Following the first uneventful attempts in the mid '80's, these treatments were increasingly used and techniques such as PAIR (Puncture, Aspiration, Injection, Re-aspiration) and its variants were developed and implemented in clinical practice. Although the evidence currently available is not sufficient to support or refuse the superiority of PAIR in terms of efficacy, numerous studies have demonstrated that it carries lower rates of morbidity, mortality, and disease recurrence and is associated with shorter hospital stays compared with surgery. The present review provides a brief history of percutaneous treatments for liver cystic hydatidosis, summarizes the currently available evidence on the subject, gives a brief overview of potential future developments in this field focusing on radiofrequency ablation techniques and presents some new patents on the issue.
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Giorgio A, Calisti G, DE Stefano G, Farella N, DI Sarno A, Amendola F, Scognamiglio U, Giorgio V. Radiofrequency ablation for intrahepatic cholangiocarcinoma: retrospective analysis of a single centre experience. Anticancer Res 2011; 31:4575-4580. [PMID: 22199333] [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: 05/31/2023]
Abstract
PURPOSE To evaluate the usefulness and safety of radiofrequency ablation for primary and recurrent intrahepatic cholangiocarcinoma (ICC) in our single centre experience. MATERIALS AND METHODS Ten patients with ICC refusing or not eligible for surgery underwent radiofrequency ablation for their tumor. The ICC was primary in 9 cases and recurrent, after 2 previous resections, in 1 patient. Radiofrequency ablation was performed percutaneously under ultrasound guidance using a 15G perfused electrode. Technical success of the procedure was assessed by contrast-enhanced ultrasound (CEUS). Technical effectiveness was evaluated by CEUS and contrast enhanced CT 1 month after the last course of a defined ablation protocol. Follow-up contrast enhanced CT or MRI were performed every 3-6 months. RESULTS RFA was always technically successful and effective for ICC lesions ≤3.4 cm and ineffective for lesion ≥4 cm. After a median follow-up of 19.5 months (range 9-64 months), 8 patients were still alive while 2 had died due to tumor progression. The 1-, 3- and 5-year overall survival rate of all patients with ICC of our series were 100%, 83.3% and 83.3%. No major complication was observed. CONCLUSION Radiofrequency ablation seems to be a safe and effective option for small (≤3.4 cm) ICC nodules. In addition it may be considered as a palliative treatment for larger tumors.
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Affiliation(s)
- Antonio Giorgio
- IX Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Via G. Quagliarello 54, 80131 Naples, Italy.
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15
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Giorgio A, Calisti G, di Sarno A, Farella N, de Stefano G, Scognamiglio U, Giorgio V. Characterization of dysplastic nodules, early hepatocellular carcinoma and progressed hepatocellular carcinoma in cirrhosis with contrast-enhanced ultrasound. Anticancer Res 2011; 31:3977-3982. [PMID: 22110230] [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: 05/31/2023]
Abstract
BACKGROUND During the progression from low-grade dysplastic nodule (DN) to progressed hepatocellular carcinoma (HCC), intranodular portal tracts gradually disappear, while unpaired arteries develop increasingly. Contrast-enhanced ultrasound (CEUS) is highly accurate in depicting intranodular vascularity. This study evaluates the usefulness of CEUS in the characterization of DN, early HCC and progressed HCC in cirrhotic livers. MATERIALS AND METHODS Forty consecutive patients with cirrhosis and a single hepatic nodule ≤2 cm underwent CEUS and subsequent ultrasound-guided biopsy of the nodule. Imaging and pathological findings of DN and HCC were compared. RESULTS The homogeneous pattern of hypervascularization during the arterial phase identified progressed HCC with a sensitivity of 90.9% and a specificity of 100%, whereas the inhomogeneous and reticular pattern identified early HCC with a sensitivity of 85.7% and a specificity of 96.1%. CONCLUSION DN, early HCC and progressed HCC can be accurately differentiated with CEUS on the basis of the vascularization pattern during the arterial phase.
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Affiliation(s)
- Antonio Giorgio
- IX Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Via G. Quagliarello 54, 80131 Naples, Italy.
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16
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Giorgio A, Di Sarno A, De Stefano G, Scognamiglio U, Farella N, Mariniello A, Esposito V, Coppola C, Giorgio V. Percutaneous radiofrequency ablation of hepatocellular carcinoma compared to percutaneous ethanol injection in treatment of cirrhotic patients: an Italian randomized controlled trial. Anticancer Res 2011; 31:2291-2295. [PMID: 21737654] [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: 05/31/2023]
Abstract
AIM To compare 5-year survival of patients with a single hepatocellular carcinoma≤3 cm randomly assigned to receive percutaneous ethanol injection or radiofrequency ablation. PATIENTS AND METHODS A total of 285 patients (192 males, mean age 70 years), with a single hepatocellular carcinoma (mean diameter 2.2 cm) were randomly assigned to receive percutaneous ethanol injection (n=143) or radiofrequency ablation (n=142). The primary endpoint of the study was 5-year survival. RESULTS Overall 143 patients underwent percutaneous ethanol injection and 128 radiofrequency ablation. In consideration of segmental location, in fact, 14 patients with 14 hepatocellular carcinomas could not be treated with established radiofrequency and were treated with percutaneous ethanol injection; these patients were not included in the survival evaluation. In the percutaneous ethanol injection and in the radiofrequency ablation groups, 3- and 5-year survival rates of 74% and 68%, and 78% and 68%, and 79% and 70% [corrected] respectively, were observed (p=n.s). In the percutaneous ethanol injection group, 3- and 5-year local recurrence rates were 9.4% and 12.8% respectively; in the radiofrequency group, the 3 and 5 years local recurrence rates were 7.8% and 11.7%, respectively (p=n.s.). The overall costs of percutaneous ethanol injection and radiofrequency ablation were 1359 Euros and 171.000 Euros, respectively (p<0.0001) CONCLUSION Percutaneous ethanol injection and radiofrequency ablation conferred similar 5-year survival. Feasibility is not the same for both procedures. Percutaneous ethanol injection is much cheaper than radiofrequency ablation and should be considered whether in poor and rich countries.
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Affiliation(s)
- A Giorgio
- Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Naples, Italy.
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17
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Giorgio A, Esposito V, Farella N, Di Sarno A, Liorre G, DE Stefano M, Giorgio V, DE Stefano G. Amebic liver abscesses: a new epidemiological trend in a non-endemic area? In Vivo 2009; 23:1027-1030. [PMID: 20023251] [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: 05/28/2023]
Abstract
BACKGROUND Amoebic liver abscess (ALA) is the most common extraintestinal complication of colonic amebiasis. In recent decades its incidence in developed European countries has significantly increased because of travel and immigration of individuals from highly endemic areas. We report our 29-year experience in echo-guided percutaneous needle/catheter drainage (EPND/EPCD) of ALA. PATIENTS AND METHODS From May 1979 to November 2007, 68 ALA corresponding to 56 patients were diagnosed at our Department. All patients were treated with a metronidazole plus EPND/EPCD approach. RESULTS The majority of the cases did not need more than two echo-guided punctures. Two patients, both male immigrants (HIV-negative), had unmodified lesions after two EPNDs: catheter drainage was performed. A quick worsening of their clinical conditions and onset of neurological symptoms occurred; in both patients, computed tomography (CT) revealed a brain abscess. Intravenous medical therapy was started, but both died 4 and 3 days, respectively, after the onset of neurological symptoms (overall mortality rate: 3.57%). CONCLUSION The unfavorable outcome of two cases is a rare example of failure of percutaneous therapy of ALA. Mortality is a possible event even in a non-endemic area such as Italy. More observational data are needed to confirm the possibility of a new epidemiological trend.
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Affiliation(s)
- A Giorgio
- U.O. di Escografia Interventistica IX Divisione, Naples, Italy.
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Abstract
Percutaneous treatment of Hydatid Liver Cyst (HLC) with scolicidal agent under ultrasound guidance is now worldwide used after the advent of Percutaneous-Aspiration-Injection and Re-Aspiration (PAIR) and its modifications. Although HLC represent a benign disease, treatment has to be considered mandatory in symptomatic cysts and recommended in viable cysts because of the risk of severe complications. In this article, clinical indications, PAIR technique with results and complications are discussed. Finally, clinical flow-chart of active and inactive HLCs is reported. The present article is a review of some patents in the Hydatid liver cyst.
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Affiliation(s)
- Antonio Giorgio
- Infectious Disease and Interventional Ultrasound Unit, D. Cotugno Hospital, Naples, Italy
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19
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Giorgio A, de Stefano G, Di Sarno A, Farella N, Giorgio V, Scognamiglio U, Mariniello A, Liorre G, Perrotta A, Mariniello N. Radiofrequency ablation of hepatocellular carcinoma extended into the portal vein: Preliminary results. J Ultrasound 2009; 12:32-7. [PMID: 23396977 DOI: 10.1016/j.jus.2008.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION We report our preliminary results of radiofrequency (RF) ablation of hepatocellular carcinoma (HCC) and neoplastic portal thrombus (NPT) in cirrhotic patients. METHODS Ten patients (7 males and 3 females; mean age 68 yrs) with 10 HCC nodules (37-49 mm) extended into the main portal vein (MPV) underwent RF ablation. Diagnosis of NPT was achieved by fine-needle biopsy. RF ablation was performed firstly on the NPT and then on the HCC. RF ablation was considered successful when complete necrosis of the HCC and complete recanalization of the MPV were achieved. HCC necrosis was evaluated using contrast-enhanced CT. Recanalization of the portal vessels (PV) was analyzed using Color Doppler (CD). RF ablation was performed under ultrasonographic (US) guidance using a perfused electrode needle. RESULTS Complete necrosis of the HCC with complete recanalization of the PV was observed in 7 patients (success rate: 70%). In the remaining 3, necrosis of the HCC ranged from 70% to 95%, and recanalization of the PV was not complete. No major complications occurred. In 2 cases, mild ascites and increased aspartate aminotransferase/alanine aminotransferase (AST/ALT) values were observed. The follow-up ranged from 4 to 24 months; 1 and 2-year survival rates were 77% and 77%, respectively. At the last follow-up, the 7 successful patients were alive and the portal system was still patent. The 3 unsuccessful patients died within 5 months due to progressive disease. CONCLUSION RF ablation can destroy HCC and NPT achieving a high rate of efficacy and low rate of complications. However, to confirm these results a control group and a longer follow-up are required.
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Affiliation(s)
- A Giorgio
- Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Naples, Italy
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Farella N, Lucotte M, Davidson R, Daigle S. Mercury release from deforested soils triggered by base cation enrichment. Sci Total Environ 2006; 368:19-29. [PMID: 16781764 DOI: 10.1016/j.scitotenv.2006.04.025] [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] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Revised: 12/30/2005] [Accepted: 04/06/2006] [Indexed: 05/10/2023]
Abstract
The Brazilian Amazon has experienced considerable colonization in the last few decades. Family agriculture based on slash-and-burn enables millions of people to live in that region. However, the poor nutrient content of most Amazonian soils requires cation-rich ashes from the burning of the vegetation biomass for cultivation to be successful, which leads to forest ecosystem degradation, soil erosion and mercury contamination. While recent studies have suggested that mercury present in soils was transferred towards rivers upon deforestation, little is known about the dynamics between agricultural land-use and mercury leaching. In this context, the present study proposes an explanation that illustrates how agricultural land-use triggers mercury loss from soils. This explanation lies in the competition between base cations and mercury in soils which are characterized by a low adsorption capacity. Since these soils are naturally very poor in base cations, the burning of the forest biomass suddenly brings high quantities of base cations to soils, destabilizing the previous equilibrium amongst cations. Base cation enrichment triggers mobility in soil cations, rapidly dislocating mercury atoms. This conclusion comes from principal component analyses illustrating that agricultural land-use was associated with base cation enrichment and mercury depletion. The overall conclusions highlight a pernicious cycle: while soil nutrient enrichment actually occurs through biomass burning, although on a temporary basis, there is a loss in Hg content, which is leached to rivers, entering the aquatic chain, and posing a potential health threat to local populations. Data presented here reflects three decades of deforestation activities, but little is known about the long-term impact of such a disequilibrium. These findings may have repercussions on our understanding of the complex dynamics of deforestation and agriculture worldwide.
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Affiliation(s)
- N Farella
- Institut des sciences de l'environnement, Université du Québec à Montréal, CP 8888 Succ. Centre-Ville, Montréal, Québec, Canada.
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Cione GP, Arciero G, De Angelis CP, Marano A, Farella N, Cerrone C, Cerbone D, Parmeggiani D, Cimmino G, Perrotta M, Giglio D. [Intrahepatic cholangiocarcinoma: case report]. Suppl Tumori 2005; 4:S46-7. [PMID: 16437896] [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: 05/06/2023]
Abstract
The primitive tumors of the liver are relatively rare in the Western countries (around the 0.7% of all the neoplasms) while they present more elevated incidence in Africa and in the South Asian East. While the hepatocellular carcinoma rises up in the 50-70% of the cases in livers cirrosis, this correlation is not valid for the form of carcinoma to departure from the learned intra and extra biliar. The etiology of the intrahepatic colangiocarcinoma (CC) stays unknown. They have stayed observe, on the other hand, of the conditions sometimes correlated to the development of the CC (Carolí morbs, ulcerative colitis, asbestosis). The CC usually rises up from the epithelial cells of surface that delimit the biliary ducts, although different studies suggest that these tumors can also originate from the learned smaller biliary ducts, from the hepatic cysts of the policistic illness and from the complexes of von Meyenburg. The low incidence of the CC, the clinical atypical debut, the not facility of a precise diagnosis have aroused our interest so that the present job wants to be a modest scientific contribution to this type of pathology.
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Affiliation(s)
- G P Cione
- ASL NA 1, PO San Giovanni Bosco, UOC di Chirurgia Generale d'Urgenza
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Tarantino L, Giorgio A, de Stefano G, Farella N, Perrotta A, Esposito F. Disseminated mycobacterial infection in AIDS patients: abdominal US features and value of fine-needle aspiration biopsy of lymph nodes and spleen. ACTA ACUST UNITED AC 2003; 28:602-8. [PMID: 14628859 DOI: 10.1007/s00261-003-0035-9] [Citation(s) in RCA: 26] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND We evaluated the efficacy of abdominal ultrasound (US) and fine-needle aspiration biopsy (FNAB) in the diagnosis of disseminated mycobacteriosis (DM) in acquired immunodeficiency syndrome (AIDS). METHODS Twelve AIDS patients (nine male, three female; age range, 22-43 years) with DM underwent abdominal US within 2 days after admission with 3.5- to 5-MHz convex probes and a 7.5-MHz linear probe. All patients underwent FNAB of one or two enlarged abdominal lymph nodes. Eight patients underwent FNAB of the spleen. The aspirated specimens were stained with acid fast for quick examination and cultured for isolation of mycobacteria. RESULTS Abdominal US showed enlarged, hypoechoic, round or oval, abdominal lymph nodes (diameter, 10-35 mm; mean, 18 mm) in all patients; splenomegaly (spleen diameter, 14-22 cm; mean, 16.8 mm) in all patients; numerous splenic abscesses (diameter, 3-20 mm) in nine patients; hepatomegaly (right hepatic lobe thickness, 14.5-17 cm) in all patients; small intestinal wall thickening in five patients (maximum bowel wall thickness, 7-15 mm); mild to moderate ascites in six patients; pleural effusion in four patients; bilateral enlargement of the kidneys with hyperechogenicity of the cortex in three patients; and a retroperitoneal tubercular abscess in one patient. No complication occurred after FNAB of lymph nodes and spleens. Fast-acid stain of spleen and/or lymph node FNAB specimens allowed early diagnosis of mycobacteriosis in 12 of 12 cases (100%). Cultures of lymph node aspirates grew mycobacteria in six of 12 patients (50%). Spleen aspirates grew mycobacteria in nine of nine patients (100%). Blood cultures were positive in four of 12 patients (33%). Mycobacterium tuberculosis was diagnosed in six patients and M. avium in five. CONCLUSION Abdominal US features can suggest DM in AIDS patients. Spleen and/or lymph node FNAB indicated the specific diagnosis in 100% of patients.
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MESH Headings
- AIDS-Related Opportunistic Infections/diagnostic imaging
- AIDS-Related Opportunistic Infections/microbiology
- Adult
- Biopsy, Needle
- Female
- Humans
- Male
- Mycobacterium avium-intracellulare Infection/diagnostic imaging
- Peritonitis, Tuberculous/diagnostic imaging
- Peritonitis, Tuberculous/microbiology
- Tuberculosis, Gastrointestinal/diagnostic imaging
- Tuberculosis, Gastrointestinal/microbiology
- Tuberculosis, Hepatic/diagnostic imaging
- Tuberculosis, Hepatic/microbiology
- Tuberculosis, Lymph Node/diagnostic imaging
- Tuberculosis, Lymph Node/microbiology
- Tuberculosis, Splenic/diagnostic imaging
- Tuberculosis, Splenic/microbiology
- Ultrasonography
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Affiliation(s)
- L Tarantino
- Interventional Ultrasound Service D, Cotugno Hospital for Infectious Diseases, Via Quagliariello, 54-80131 Naples, Italy
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Tarantino L, Giorgio A, de Stefano G, Scala V, Esposito F, Liorre G, Farella N, Ferraioli G. Acute appendicitis mimicking infectious enteritis: diagnostic value of sonography. J Ultrasound Med 2003; 22:945-950. [PMID: 14510266 DOI: 10.7863/jum.2003.22.9.945] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To verify the role of sonography in screening of acute appendicitis in patients admitted to an infectious disease unit for suspected acute infectious enteritis. METHODS One hundred eighty consecutive patients (102 male and 78 female; age range, 5-72 years; mean age, 31 years) admitted for suspected infectious enteritis or typhoid fever were prospectively studied with abdominal sonography within 48 hours after admission. None of the patients had peritoneal irritation. Forty-six patients (25%) had white blood cell counts of more than 10,000/mm3 (range, 10,300-18,000/mm3). The diagnosis of acute appendicitis was made when a detectable appendix with an anteroposterior diameter of greater than 7 mm could be seen on sonography. RESULTS Eleven (6%) of 180 patients had thickened appendixes (anteroposterior diameter range, 7-14 mm); 2 of them had periappendiceal abscesses. Four (36%) of 11 patients with acute appendicitis had high white blood cell counts. All sonographic diagnoses of acute appendicitis and periappendiceal abscesses were confirmed at surgery. Sonography ruled out acute appendicitis in 169 patients. In all of them, clinical and sonographic follow-up excluded the diagnosis of acute appendicitis. Normal appendixes were shown on sonography in 38 (22%) of 169 cases and were not detectable in 131 (78%) of 169. CONCLUSIONS Sonography of the appendix is a useful method for early assessment of acute appendicitis in patients thought to have enteritis or typhoid fever.
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Affiliation(s)
- Luciano Tarantino
- Interventional Ultrasound Service, D. Cotugno Hospital for Infectious Diseases, Naples, Italy.
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Giorgio A, Tarantino L, de Stefano G, Scala V, Liorre G, Scarano F, Perrotta A, Farella N, Aloisio V, Mariniello N, Coppola C, Francica G, Ferraioli G. Percutaneous sonographically guided saline-enhanced radiofrequency ablation of hepatocellular carcinoma. AJR Am J Roentgenol 2003; 181:479-84. [PMID: 12876030 DOI: 10.2214/ajr.181.2.1810479] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of our study was to analyze the efficacy, side effects, and short-term complications of saline-enhanced percutaneous radiofrequency ablation performed under sonographic guidance in a series of cirrhotic patients with hepatocellular carcinoma. SUBJECTS AND METHODS. Between September 2000 and June 2002, 84 patients (55 men and 29 women) with cirrhosis who ranged in age from 48 to 74 years (mean age, 64 years) and who had 95 hepatocellular carcinomas (seven patients had two tumors and two patients had three tumors) were treated with high frequency-induced thermotherapy. The diameters of the tumors ranged from 1.5 to 8.5 cm (mean, 3.6 cm). The efficacy of radiofrequency ablation was evaluated with triphasic contrast-enhanced CT performed 4 weeks after the procedure. RESULTS Posttreatment CT showed complete necrosis in 73 (77%) of 95 hepatocellular carcinomas in 62 patients. Complete necrosis based on tumor size was seen in 40 (95%) of 42 tumors with diameters equal to or smaller than 3 cm, 32 (71%) of 45 tumors with diameters between 3.1 and 5.0 cm, and one (12%) of eight tumors with diameters larger than 5.0 cm. Twenty-two hepatocellular carcinomas showed incomplete necrosis. None of the patients experienced major complications. Four patients were lost to follow-up. The length of the follow-up period ranged from 4 to 22 months (mean, 10 months). One patient died 8 months after the radiofrequency ablation treatment. All the remaining patients are still alive. During the follow-up period, eight (10%) of 80 patients showed a local recurrence on sonography and CT. CONCLUSION Our experience suggests that percutaneous radiofrequency ablation of hepatocellular carcinoma with high frequency-induced thermotherapy is safe and effective in the treatment of hepatocellular carcinomas equal to or smaller than 3 cm, fairly effective for hepatocellular carcinomas between 3 and 5 cm, and ineffective for tumors larger than 5 cm.
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Affiliation(s)
- Antonio Giorgio
- Interventional Ultrasound Service, D. Cotugno Hospital, Viale Colli Aminei 491, Naples 80131, Italy
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Giorgio A, Tarantino L, de Stefano G, Francica G, Esposito F, Perrotta A, Aloisio V, Farella N, Mariniello N, Coppola C, Caturelli E. Complications after interventional sonography of focal liver lesions: a 22-year single-center experience. J Ultrasound Med 2003; 22:193-205. [PMID: 12562124 DOI: 10.7863/jum.2003.22.2.193] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To analyze the complications of diagnostic and therapeutic sonographically guided interventional procedures of focal liver lesions observed during a 22-year period in a single center. METHODS Complications of sonographically guided diagnostic and therapeutic procedures on focal liver lesions, observed during a 22-year period in a single center, were reviewed. From 1979 to 2001, 13,222 patients (age range, 7-89 years; mean, 59 years; 8,688 male and 4,534 female) with 13,777 focal liver lesions underwent 16,648 sonographically guided biopsies and 3,035 therapeutic procedures: pyogenic and amebic abscess aspiration, ethanol injection of hydatid liver cysts, and percutaneous ablative treatments (ethanol injection in either multiple or one-shot sessions, radio frequency ablation, and interstitial laser photocoagulation) of primary and secondary liver tumors. RESULTS The overall mortality was 0.06%. No death or major complication occurred after diagnostic procedures and liver abscess drainage. In the therapeutic group mortality was 0.6%: 1 patient died of anaphylactic shock during treatment of a hydatid cyst; 7 patients died after liver tumor ablation with ethanol injection (6 after one-shot treatments and 1 after multisession treatments). Major complications after liver tumor ablative procedures included 10 cases of acute liver failure, 2 cases of acute tubular necrosis, 2 cases of self-limiting hemoperitoneum, 2 cases of paralytic ileum, 2 abscesses, and 1 case of cholangitis. One case of a biliary cyst fistula and 1 case of intracystic hemorrhage occurred after treatment of hydatid liver cysts. CONCLUSIONS Sonographically guided diagnostic biopsy of focal liver lesions and liver abscess drainage are safe procedures. In contrast, liver tumor ablation procedures have a low but definite risk of mortality and major complications. Puncture of hydatid cysts must be performed only in institutions that can treat anaphylactic shock.
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Affiliation(s)
- Antonio Giorgio
- Interventional Ultrasound Service, D. Cotugno Hospital, Naples, Italy.
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Abstract
OBJECTIVE To describe echo color Doppler features of mumps epididymo-orchitis in postpubertal boys and men. METHODS Color Doppler ultrasonographic examinations of the scrotum in 12 patients (14-34 years old) with serologically proven mumps and symptomatic epididymo-orchitis (pain and scrotal swelling) were compared with color Doppler ultrasonographic examinations of the scrotum in 10 healthy control subjects. RESULTS Clinically evident testicular involvement was bilateral in 1 patient and unilateral in 11 patients (9 left- and 2 right-sided). Four (33.3%) of 12 patients had swelling and a heterogeneous echo texture of the epididymis and hydrocele. Two (16.7%) of 12 patients had swelling of both the epididymis and didymus of the involved side, with a heterogeneous echo texture of the didymus due to hypoechoic, irregularly shaped, confluent intraparenchymal areas. Two (16.7%) of 12 patients had only unilateral mild hydrocele and no testicular abnormalities. In 4 (33.3%) of 12 cases, B-mode ultrasonographic examination did not show any testicular abnormalities or hydrocele. Hydrocele was anechoic in 4 cases and multiseptated in 4. In 12 (100%) of 12 patients, color Doppler and power Doppler ultrasonography showed hypervascularity in the parenchyma of the affected testicle. In 11 patients, spectral Doppler examination of the arteries at the testicular hilum showed a significantly lower mean +/- SD resistive index (0.54 +/- 0.03; range, 0.48-0.57) on the inflamed side compared with the opposite unaffected side (mean, 0.66 +/- 0.04; range, 0.71-0.60) (P < .001). In the patient with bilateral involvement, the mean resistive index values in the right and left testicular arteries were 0.57 and 0.55, respectively. The mean resistive index of the 13 inflamed testicles (0.54 +/- 0.03; range, 0.48-0.57) was significantly different from the mean resistive index values of the right (0.68 +/- 0.03) and left (0.67 +/- 0.04) testicular arteries in healthy control subjects (P < .001). The mean resistive index in the 11 unaffected testicles in our patients (0.66 +/- 0.04; range, 0.71-0.60) was not significantly different from the mean resistive index in healthy control subjects. CONCLUSION. Ultrasonographic findings in mumps orchitis are not specific. Echo color Doppler examination is more sensitive than ultrasonography alone for revealing testicular inflammation.
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Affiliation(s)
- L Tarantino
- Ultrasound Service, D. Cotugno Hospital for Infectious Diseases, Naples, Italy
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Giorgio A, Tarantino L, de Stefano G, Francica G, Mariniello N, Farella N, Perrotta A, Aloisio V, Esposito F. Hydatid liver cyst: an 11-year experience of treatment with percutaneous aspiration and ethanol injection. J Ultrasound Med 2001; 20:729-738. [PMID: 11444731 DOI: 10.7863/jum.2001.20.7.729] [Citation(s) in RCA: 33] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To report an 11-year experience of treatment of hydatid liver cysts with double percutaneous aspiration and injection of alcohol. METHODS Of the 129 patients with 174 hydatid liver cysts admitted to our department between January 1988 and January 1999, 79 patients with 119 vital hydatid liver cysts were selected for double percutaneous aspiration and injection of alcohol. Under ultrasonographic guidance, cystic cavities were first drained through fine needles, and then 95% sterile ethanol was injected and left in situ. The same procedure was repeated 3 days later without reaspiration of the injected alcohol. General anesthesia without endotracheal intubation was performed in 21 selected cases. RESULTS Double percutaneous aspiration and injection of alcohol was completed in 78 patients with 118 hydatid liver cysts. In 1 case the procedure could not be accomplished because of an intracystic hemorrhage. A total of 254 punctures were performed, and the ethanol injected per session ranged between 12 and 250 mL. The mean hospital stay was 2.9 days (range, 2-7 days). The overall median follow-up was 48 months (range, 6-122 months). At the last ultrasonographic examination, 45.8% of the treated hydatid liver cysts had a solid pattern, 47.4% were no longer appreciable, and 6.8% had a minimal liquid component. Intracystic relapse occurred in 5% of the patients. In no case were any new cysts observed either in different hepatic segments or in any extrahepatic location. The morbidity rate was 9%, and 1 death occurred (mortality rate, 1.3%). CONCLUSIONS Over a long period, double percutaneous aspiration and injection of alcohol proved to be a substantially safe, effective, and low-cost procedure for hydatid liver cyst treatment.
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Affiliation(s)
- A Giorgio
- Servizio di Ecografia Interventistica, Ospedale D. Cotugno, Naples, Italy
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Tarantino L, Giorgio A, De Stefano G, Farella N. [Ultrasonography in the diagnosis of post-pubertal epidemic parotitis and its complications]. Radiol Med 2000; 99:461-4. [PMID: 11262824] [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: 02/19/2023]
Abstract
PURPOSE To assess the yield of US in the study of salivary glands and other organs involved in post-pubertal mumps. PATIENTS AND METHODS We examined 68 patients with serologically proven post-pubertal mumps (age range 14-34 years). All patients were symptomatic, with fever and salivary gland swelling in 25 cases, marked hyperamylasemia in 32, epigastric pain in 9, unilateral scrotal swelling and/or pain in 19 cases and acute bronchitis in 1 case. All patients underwent US of salivary glands, neck lymph nodes, abdomen and scrotum with 48 hours of admission. RESULTS Salivary glands: Parotid and submandibular glands showed normal echotexture in all patients. The parotid glands also showed multiple hypeoechoic intraparenchymal lymph nodes which were, ovoid or rounded, with smooth margins and a central hyperechoic area, with diameter ranging 3-14 mm (mean 5.4). No intraparenchymal lymph nodes were observed in submandibular glands. Neck: All patients had enlarged submandibular lymph nodes (maximum diameter ranging 5-22 mm; mean 11 mm); swelling was always bilateral and it was symmetric in 19/68 patients (30%) versus asymmetric because of prevailing right side involvement (more numerous and bigger nodes) in the other 47/68 cases (70%). All lymph nodes showed a benign pattern, with an ovoid or elongated shape, homogeneous hypoechoic echotexture and a hyperechoic hilum. Abdomen: The pancreas showed normal volume and normal parenchymal echotexture in all patients. Liver and spleen were always normal. Testes: US showed mild unilateral hydrocele in 10 cases, hydrocele and unilateral swelling of epidymis in 5 cases, hydrocele and swelling of both epidymis and didymis with inhomogeneous echotexture because of intraparenchymal hypeoechoic areas in 2 cases. There were no US changes in 2 cases. CONCLUSIONS US of the salivary glands shows a specific pattern in post-pubertal mumps which has never been reported for other salivary gland diseases. In contrast US signs in other organs are not specific.
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Affiliation(s)
- L Tarantino
- Servizio di Ecografia ed Ecointerventistica, Azienda Ospedaliera D. Cotugno, Napoli.
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Giorgio A, Tarantino L, Farella N, Catalano O, Cusati B, Alaia A, Caturelli E. Interstitial laser photocoagulation under ultrasound guidance of liver tumors: results in 104 treated patients. Eur J Ultrasound 2000; 11:181-8. [PMID: 10874193 DOI: 10.1016/s0929-8266(00)00086-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the efficacy and complications of interstitial laser photocoagulation (ILP) under ultrasound (US) guidance as a technique for focal ablation of liver tumors in patients with normal and impaired hepatic function. PATIENTS AND METHODS A total of 104 patients, 77 with 85 nodules of hepatocellular carcinoma on cirrhosis (29 in Child-Pugh A class, 43 in B e 5 in C class) and 27 patients with hepatic metastases (25 from colon, two from lung carcinoma) underwent ILP under US guidance. Depending on tumor size up to four needles were inserted in the tumor and multiple laser illuminations were performed in one or multiple sessions. Necrosis of the nodules was evaluated with triphasic contrast-enhanced CT. RESULTS Ninety-four patients underwent a single ILP session and nine patients two sessions. CT showed complete necrosis in 70 out of 85 HCC nodules in 65 treated patients and in 24 out of 31 patients with metastases. Three Child C class patients dropped out the control of efficacy by CT because of severe liver failure associated in one case with transient paralytic ileum. One of these patients died 2 months after treatment. Two patients with metastasis dropped the completion of the treatment because of complication occurred after the ILP session (one paralytic ileum, one gastric haemorrage). CONCLUSIONS ILP under US guidance is effective in inducing complete necrosis in small and large liver tumors. Nevertheless, ILP can cause severe derangement of liver function in patients with advanced cirrhosis.
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Affiliation(s)
- A Giorgio
- Interventional Ultrasound Service-D, Cotugno Hospital Naples, Viale colli Aminei 491, 80131, Naples, Italy.
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Giorgio A, Tarantino L, De Stefano G, Farella N, Catalano O, Cusati B, Del Viscovo L, Alaia A. [The echo-guided interstitial laser photocoagulation of malignant liver tumors. The authors' personal technic, immediate results and short-term complications in patients with normal and altered liver function]. Radiol Med 2000; 99:264-9. [PMID: 10884827] [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: 02/17/2023]
Abstract
PURPOSE The literature studies about interstitial laser photocoagulation of liver tumors mainly deal with the treatment of liver metastasis in patients with normal liver function. We report our personal experience with interstitial laser photocoagulation in patients with liver tumors (mostly cirrhotics with hepatocellular carcinoma). Our aim was to evaluate the short term efficacy of percutaneous interstitial laser photocoagulation in inducing focal ablation of liver tumors and the possible complications in patients with normal and impaired liver function. MATERIAL AND METHODS Sixty-six patients (52-80 years; 42 men), 47 with 51 hepatocellular carcinoma nodules (diameter = 1.6-6.6 cm; mean 3.1 cm) on cirrhosis (18 in Child-Pugh A class, 24 in B e 5 in C class) and 19 patients with single liver metastasis (17 from colon, 2 from lung carcinoma; diameter = 3.9 cm; mean: 4.5 cm) underwent interstitial laser photocoagulation under ultrasound guidance. Depending on tumor size up to four needles were inserted in the tumor and multiple laser illuminations were performed: in nodules < or = 2 cm a single optical fiber and a single needle insertion were used, in nodules > 2 < 3 cm, 2-3 fibers were used with a single laser illumination, in nodules > 3 < 4 cm, 4 fibers were inserted and two laser illuminations were performed in the same session after 1.5 cm withdrawal of all fibers in the tumor, in nodules > 4 cm 2 sessions with 2 laser illuminations per session were performed. Necrosis of the nodules was evaluated with triphasic Helical CT 7 days after treatment. Patients with incomplete necrosis at CT were treated with additional interstitial laser photocoagulation sessions to attain complete necrosis. RESULTS Fifty-eight patients underwent a single interstitial laser photocoagulation session, 7 patients 2 session and 1 patient 3 sessions. The range of administered energy per patient was 1200-32,000 Joules (mean: 6700 J). CT showed complete necrosis of 47 nodules in 43 patients with hepatocellular carcinoma and in 15/18 patients with metastasis. Three Child C class patients with mild ascites and hyperbilirubinemia before procedure (nodules O: 1.9, 3.5 and 5.8 cm) dropped out of CT follow-up because of severe liver function impairment with increased ascites and hyperbilirubinemia, associated with transient ileum paraliticus in 1 case. One of these patients died two months after treatment. Two patients with metastasis dropped out of treatment because of complications occurred after the interstitial laser photocoagulation session (1 ileum paraliticus, 1 gastric hemorrhage) and another one refused to continue the treatment.
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Affiliation(s)
- A Giorgio
- Servizio di Ecografia ed Ecointerventistica, Azienda Ospedaliera D. Cotugno, Napoli.
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Roulet M, Lucotte M, Saint-Aubin A, Tran S, Rhéault I, Farella N, De Jesus Da silva E, Dezencourt J, Sousa Passos CJ, Santos Soares G, Guimarães JR, Mergler D, Amorim M. The geochemistry of mercury in central Amazonian soils developed on the Alter-do-Chão formation of the lower Tapajós River Valley, Pará state, Brazil. Sci Total Environ 1998; 223:1-24. [PMID: 9850600 DOI: 10.1016/s0048-9697(98)00265-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In an oxisol-spodosol system developed on the terrestrial surface of the lower Tapajós Valley, the determination of total mercury (Hg), organic carbon (C), iron and aluminum oxy-hydroxide (Fe(cdb) and Al(cdb)) concentrations in the surface soil horizons are used to characterise the geochemical processes controlling the accumulation of Hg in soils under natural vegetation cover and in deforested and cultivated sites. Oxisols from the plateau have homogeneous and relatively high background Hg contents and burdens constituting an important natural reservoir of Hg for the region (90-210 ng/g dry wt. and 19-33 mg/m2 for the first 20 cm). The Fe(cdb) and Al(cdb) contents associated with the fine fraction (< 63 microns) of the soil suggest that oxy-hydroxides and, particularly Al-substituted Fe oxy-hydroxides, control the Hg concentrations observed in all of the soils of the study region. Consequently, the geochemistry of these minerals along the slopes governs the accumulation or the release of the Hg according to the natural evolution of the soil cover and/or following the degradation of soils by erosion after deforestation and cultivation. These observations have important implications for the interpretation of Hg contamination patterns observed in Amazonian aquatic systems that could be linked to different drainage sources of Hg from the terrestrial surface. The sandification and podzolisation that is characteristic of the evolution of numerous pedological systems in the equatorial Amazon could be responsible for exportation of the naturally accumulated Hg, as for other metals, by acidic complexation and migration to the black waters of the Amazon. In the central Amazon region, as a result of the fragility of the soil cover, deforestation and cultivation, affecting principally the superficial soil, promote the selective erosion of fine particles enriched in oxides and Hg. The erosion of soil could be responsible for an important release of Hg, transported in particulate form by drainage waters.
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Affiliation(s)
- M Roulet
- Chaire de recherche en environnement H-Q/CRSNG/UQAM, B.P. 8888, Montréal, Québec, Canada
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