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L. Angrisani F. Favretti F. Furbetta L. Busetto S.B. Doldi E. Lattuada M. Paganelli M. Lucchese N. Basso F.D. Capizzi A. Iuppa G. Lesti N. Di Lorenzo C. Giardiello L. Di Cosmo A. Veneziani S. Lacitignola M. Alkilani P. Forestieri M. Toppino A. Gardinazzi F. Puglisi A. Cascardo P. Bernante G. Silecchia B. Marzano A. Adorni V. Borrelli M. Lorenzo 《Surgery for obesity and related diseases》2005,1(3)
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The authors report an observed case and re-examine the incidence of this defect; they underline the possibility of the diagnosis during the fetal age and the association with one o more defects, sometimes incompatible with the life; in the adult, on the contrary, may be evidence of an associated litiasic pathology of the ++epato-choledocus or of the stenosis of the oddian sphincter. On the base of the diagnostic previous experiences, they elaborate the proposal of an algorythm and underline the utility of a laparoscopic diagnosis either in the pre-operative doubious cases or in the intra-operative diagnosed cases. 相似文献
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Licia Iaccarino Tiziana Ottone Valentina Alfonso Laura Cicconi Mariadomenica Divona Serena Lavorgna Serena Travaglini Aleandra Ferrantini Giulia Falconi Constance Baer Monica Usai Fabio Forghieri Adriano Venditti Maria Ilaria Del Principe William Arcese Maria Teresa Voso Torsten Haferlach Francesco Lo-Coco 《American journal of hematology》2019,94(10):1091-1097
Despite the high probability of cure of patients with acute promyelocytic leukemia (APL), mechanisms of relapse are still largely unclear. Mutational profiling at diagnosis and/or relapse may help to identify APL patients needing frequent molecular monitoring and early treatment intervention. Using an NGS approach including a 31 myeloid gene-panel, we tested BM samples of 44 APLs at the time of diagnosis, and of 31 at relapse. Mutations in PML and RARA genes were studied using a customized-NGS-RNA panel. Patients relapsing after ATRA-chemotherapy rarely had additional mutations (P = .009). In patients relapsing after ATRA/ATO, the PML gene was a preferential mutation target. We then evaluated the predictive value of mutations at APL diagnosis. A median of two mutations was detectable in 9/11 patients who later relapsed, vs one mutation in 21/33 patients who remained in CCR (P = .0032). This corresponded to a significantly lower risk of relapse in patients with one or less mutations (HR 0.046; 95% CI 0.011-0.197; P < .0001). NGS-analysis at the time of APL diagnosis may inform treatment decisions, including alternative treatments for cases with an unfavorable mutation profile. 相似文献
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Clustering of genomic breakpoints at the MLL locus in therapy‐related acute leukemia with t(4;11)(q21;q23)
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Syed Khizer Hasan Gianluca Barba Markus Metzler Mariadomenica Divona Tiziana Ottone Laura Cicconi Brunangelo Falini Cristina Mecucci Francesco Lo‐Coco 《Genes, chromosomes & cancer》2014,53(3):248-254
Genomic characterization of translocation breakpoints is relevant to identify possible mechanisms underlying their origin. The consistent association of anthracylines (e.g., epirubicin and idarubicin) in inducing therapy‐related acute leukemias (t‐AL) with mixed lineage leukemia (MLL) gene rearrangement suggests that MLL translocations are causative events for t‐AL. Using asymmetric multiplex PCR strategy followed by direct DNA sequencing, we characterized the genomic breakpoints of the MLL and AFF1 genes in two patients who developed t‐AL with t(4;11)(q21;q23). Chemotherapeutic treatment of the primary disease in both patients included topoisomerase II (topo II) targeting agents. In one case, the MLL breakpoint was located in intron 9 at nucleotide position chr11:118354284 while the AFF1 breakpoint was in intron 3 at nucleotide position chr4:87992070. The breakpoint junction sequences revealed an insertion of two nucleotides at the MLL‐AFF1 junction. In the other patient, the MLL breakpoint was located in intron 11 at nucleotide position chr11:118359130‐32 and the AFF1 break was in intron 3 at nucleotide position chr4:87996215‐17. The MLL breakpoint found in the latter patient was identical to that of two previously reported cases, strongly suggesting the presence of a preferential site of DNA cleavage in the presence of topo II inhibitor. In addition, microhomologies at the breakpoint junctions were indicative of DNA repair by the non‐homologous end joining (NHEJ) pathway. This study further supports the evidence that MLL breakpoints in therapy‐related acute leukemia with MLL‐AFF1 are clustered in the telomeric half of the breakpoint cluster region that contains topo II recognition sites. © 2013 Wiley Periodicals, Inc. 相似文献
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Angrisani L Furbetta F Doldi SB Basso N Lucchese M Giacomelli M Zappa M Di Cosmo L Veneziani A Turicchia GU Alkilani M Forestieri P Lesti G Puglisi F Toppino M Campanile F Capizzi FD D'Atri C Scipioni L Giardiello C Di Lorenzo N Lacitignola S Belvederesi M Marzano B Bernante P Iuppa A Borrelli V Lorenzo M;Italian Collaborative Study Group for the Lap-Band System 《Obesity surgery》2002,12(6):846-850
Background: Laparoscopic adjustable gastric banding (LAGB) is the most common bariatric operation. This study is a retrospective
analysis of the multicenter Italian experience in patients with BMI >50 over the last 4 years. Methods: An electronic data
sheet made for LAGBoperated patients since January 1996, was mailed and e-mailed to all surgeons involved in this kind of
procedure in Italy. Items regarding patients with BMI >50 were selected. Analysis used Fisher's exact test and logarithmic
regression analysis (P<0.05 significant). Data were expressed as mean ± SD. Results: 239 patients (13.3%), out of 1,797 LapBand? operated patients entered the study (179F / 60M), with mean age 37.6±11.3 years (19-69) and mean BMI 54.6±4.8 (50.1-83.6).
Laparotomic conversion rate was 5.4% (44/239). Postoperative complications occurred in 24 / 239 patients (9.0%). Follow-up
was obtained in 218 / 218, 198 / 198, 121 / 147, 75 / 93, 30 / 38 LAGB patients at 6, 12, 24, 36, and 48 months respectively.
At these time periods, mean BMI was 46.7, 43.9, 42.2, 41.9, and 39.3 kg/m2. At the same intervals, mean %EWL was 24.1, 34.1, 38.8, 38.9, and 52.9%.The number of patients with <25% EWL at 12, 24, 36,
and 48 months follow-up were 34, 10, 4, and 0. Serious co-morbidities (189 in 124 of 239, 57%) had completely resolved 1 year
postoperatively in 74 / 124 of the patients (59.6%). Conclusion: Although super-obese patients following the LAGB remain obese
with BMI >35, in the short-term most lose their co-morbidities, with a very low morbidity and mortality rate. 相似文献
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Gotti E Perico N Gaspari F Cattaneo D Lesti MD Ruggenenti P Segoloni G Salvadori M Rigotti P Valente U Donati D Sandrini S Federico S Sparacino V Mourad G Bosmans JL Dimitrov BD Iordache BE Remuzzi G 《Transplantation proceedings》2005,37(5):2037-2040
Target organs express antigens directly recognized by antigen-specific T cells, thereby precipitating rejection. When early T-cell activation is inhibited, there is a low risk of rejection. We sought to determine the predictive values of serial posttransplant blood cyclosporine trough (C(0)) concentrations to minimize the risk for a first rejection episode compared with 2-hour postdose (C(2)) drug concentrations. The final aim of the study was to identify a concentration range for the best predictive pharmacokinetic parameter that should be targeted to reduce the risk of rejection. This possibility was explored in 334 de novo kidney transplant recipients who participated in the prospective, multicenter Mycophenolate Steroid-Sparing Trial. Among measurements performed during the first 6 months postsurgery, cyclosporine C(0) levels measured early after transplantation were the strongest predictor of acute graft rejection. Levels within 300 to 440 ng/mL were associated with the lowest risk of rejection, while patients with levels lower than 300 ng/mL showed a more than double risk. Cyclosporine trough values predicted allograft rejection with an accuracy of 74%, while C(2) levels had no predictive value. These findings underline the need to target cyclosporine therapy early posttransplant to modulate T-cell activation. 相似文献
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Angrisani L Di Lorenzo N Favretti F Furbetta F Iuppa A Doldi SB Paganelli M Basso N Lucchese M Zappa M Lesti G Capizzi FD Giardiello C Paganini A Di Cosmo L Veneziani A Lacitignola S Silecchia G Alkilani M Forestieri P Puglisi F Gardinazzi A Toppino M Campanile F Marzano B Bernante P Perrotta G Borrelli V Lorenzo M;Italian Collaborative Study Group for LAP-BAND 《Surgical endoscopy》2004,18(10):1524-1527
Background Laparoscopic of the LAP-BAND System placement stage of obesity is a safe operation, but its indication in terms of stage of obesity is controversial. The aim of this study was to evaluate the 5 years stage of obesity results for weight loss in patients with varying preoperative ranges of body mass index (BMI).Methods Data were obtained from the Italian Collaborative Study Group for LAP-BAND System (GILB) registry. Detailed information was collected on a specifically created database (MS Access 2000) for patients operated on in Italy from January 1996 to 2003. Patients operated on between January 1996 and December 1997 were allocated to four groups according to preoperative BMI range: 30–39.9 kg/m2 (group A), 40–49.9 kg/m2 (group B), 50–59.9 kg/m2 (group C), and =60 kg/m2 (group D) percent estimated weight loss respectively. Postoperative complications, mortality, BMI, BMI loss, and (%EWL) were considered in each group. Data are expressed as mean ± SD, except as otherwise indicated. Statistical analysis was done by means of Fishers exact test, and p < 0.05 was considered significant.Results After 5 years from LAP-BAND System surgery, 573 of 3,562 patients were eligible for the study. One hundred fifty-five of 573 (27.0%) were lost to follow-up, 24 of 418 (5.7%) underwent band removal due to complications (gastric pouch dilation, band erosion), eight of 418 (1.9%) were converted to other bariatric procedures, five of 418 (1.2%) died of causes not related to the operation or the band, and 381 of 573 (66.5%) were available for follow-up. Based on 96, 214, 64, and seven patients their preoperative BMI, Were allocated to groups A, B, C, and D, respectively. At time of follow-up mean BMI was 27.5 ± 5.2 in group A, 31.6 ± 4.7 in group B, 37.6 ± 17.3 in group C, and 41.4 ± 6.9 kg/m2 in group D. Mean BMI loss was 9.8 ± 5.4, 12.9 ± 5.2, 15.8 ± 8.1, and 23.2 ± 4.9 kg/m2, respectively, in groups A, B, C, and D. Mean %EWL at the same time was 54.6 ± 32.3 in group A, 54.1 ± 17.2 in group B, 51.6 ± 35 in group C, and 59.l ± 17.1 in group D.Conclusion Initial BMI in this series did not correlate with %EWL 5 years after the operation. In fact %EWL was almost the same in each group, independent of preoperative weight. Initial BMI was an accurate indicator of the results obtained 5 years after LAP-BAND in group C (50–59.9 kg/m2) and D (=60 kg/m2) patients, who remained morbidly obese despite their %EWL. 相似文献
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Andrea Morelli Christian Ertmer Sebastian Rehberg Matthias Lange Alessandra Orecchioni Amalia Laderchi Alessandra Bachetoni Mariadomenica D'Alessandro Hugo Van Aken Paolo Pietropaoli Martin Westphal 《Critical care (London, England)》2008,12(6):R143