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| 1 | Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma显示文摘AIM:To investigate the efficacy of transcatheter embolization/chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. METHODS:A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrastenhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2,infused over 30 min using a peristaltic pump,and followed by Lipiodol and Gelfoam embolization. RESULTS:Patients characteristics were:mean age,62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size,3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm,n = 51; 2.1-3.0 cm,n = 35; 3.1-4.0 cm,n = 29; 4.1-5.0 cm,n = 22; 5.1-6.0 cm,n = 11; and > 6.0 cm,n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%),massive (90%-99%) necrosis in 16 patients (10%),partial (50%-89%) necrosis in 18 patients (11%) and poor (< 50%) necrosis in the remaining 34 patients (21%). The rate of complete necrosis according to the HCC size class was:69%,69%,52%,68%,50% and,13% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. Kaplan-Mayer survival at 24-mo was 88%,68%,59%,59%,45%,and 53% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. CONCLUSION:Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm,TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis. | Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis Petridis Settimo Caruso Gianluca Marrone Giuseppe Mamone Giovanni Vizzini Angelo Luca Bruno Gridelli | 2007 | World Journal of Gastroenterology2007，13，21： | 38 |
| 2 | Interventional radiology procedures in adult patients who underwent liver transplantation显示文摘Interventional radiology has acquired a key role in every liver transplantation(LT)program by treating the majority of vascular and non-vascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplantation.The aim of this paper is to review indications,technical consideration,results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT. | Roberto Miraglia Luigi Maruzzelli Settimo Caruso Mariapina Milazzo Gianluca Marrone Giuseppe Mamone Vincenzo Carollo Salvatore Gruttadauria Angelo Luca Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 11 |
| 3 | Understanding the pathophysiological mechanisms in the pediatric non-alcoholic fatty liver disease: The role of genetics显示文摘Classically, the non-alcoholic fatty liver disease(NAFLD) physiopathology and progression has been summarized in the two hits hypothesis. The first hit is represented by the action of hyperinsulinemia and insulin resistance, accompanying obesity, that leads to liver steatosis increasing the absolute non esterified fatty acids uptake in the liver and the esterification to form triacylglycerol. The oxidative stress is involved in the second hit leading to the progression to nonalcoholic steatohepatitis(NASH) because of its harmful action on steatosic hepatocytes. However, at the present time, the two hits hypothesis needs to be updated because of the discover of genetic polymorphisms involved both in the liver fat accumulation and progression to NASH that make more intriguing understanding the NAFLD pathophysiological mechanisms. In this editorial, we want to underline the role of PNPLA3 I148 M, GPR120 R270 H and TM6SF2 E167 K in the pediatric NAFLD development because they add new pieces to the comprehension of the NAFLD pathophysiological puzzle. The PNPLA3 I148 M polymorphism encodes for an abnormal protein which predisposes to intrahepatic triglycerides accumulation both for a loss-of-function of its triglyceride hydrolase activity and for a gain-of-function of its lipogenic activity.Therefore, it is involved in the first hit, such as TM6SF2 E167 K polymorphisms that lead to intrahepatic fat accumulation through a reduced very low density lipoprotein secretion. On the other hand, the GPR120 R270 H variant, reducing the anti-inflammatory action of the GPR120 receptor expressed by Kuppfer cells, is involved in the second hit leading to the liver injury. | Pierluigi Marzuillo Anna Grandone Laura Perrone Emanuele Miraglia del Giudice | 2015 | World Journal of Hepatology2015，7，11： | 9 |
| 4 | Imaging in liver transplantation显示文摘The aim of this study was to illustrate the role of noninvasive imaging tools such as ultrasonography,multidetector row computed tomography,and magnetic resonance imaging in the evaluation of pediatric and adult liver recipients and potential liver donors,and in the detection of potential complications arising from liver transplantation. | Settimo Caruso Roberto Miraglia Luigi Maruzzelli Salvatore Gruttadauria Angelo Luca Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 8 |
| 5 | Complete spontaneous regression of giant focal nodular hyperplasia of the liver: Magnetic resonance imaging evaluation with hepatobiliary contrast media显示文摘Focal nodular hyperplasia(FNH) of the liver is a benign lesion occurring in 0.6%-3% of the general population that probably reflects a local hyperplastic response of hepatocytes to a vascular abnormality. Most lesions are diagnosed incidentally and the natural history of the disease remains largely unknown. It has been shown that most FNH remain stable, or even regress, over a long follow-up period. We present a patient with FNH of the liver who was followed up for 7 years. A 26-yearold woman with a 5-year history of oral contraceptive use was referred to our hospital in February 2005 for further examination of a liver tumour. The diagnosis of FNH was made using magnetic resonance(MR) imaging with hepatospecific contrast media; this technique allows a correct diagnosis, in particular distinguishing FNH from hepatic adenoma, avoiding an invasive procedure such as the lesion biopsy. After 7-year from the diagnosis, we observed the complete spontaneous regression of the lesion by enhanced MR scanning. In this patient, discontinuation of oral contraceptive use and two childbirths may have influenced the natural history of FNH. To our knowledge, in the English literature there is no report illustrating a complete regression of giant FNH but only studies of decreasing in size. The present case suggests that a young patient with giant FNH should be managed conservatively rather than by resection, because FNH has the potential for spontaneous regression. | Giuseppe Mamone Settimo Caruso Kelvin Cortis Roberto Miraglia | 2016 | World Journal of Gastroenterology2016，22，47： | 7 |
| 6 | From the liver to the heart: Cardiac dysfunction in obese children with non-alcoholic fatty liver disease显示文摘In the last decades the prevalence of non-alcoholic fatty liver disease(NAFLD) has increased as a consequence of the childhood obesity world epidemic. The liver damage occurring in NAFLD ranges from simple steatosis to steatohepatitis, fibrosis and cirrhosis. Recent findings reported that fatty liver disease is related to early atherosclerosis and cardiac dysfunction even in the pediatric population. Moreover, some authors have shown an association between liver steatosis and cardiac abnormalities, including rise in left ventricular mass, systolic and diastolic dysfunction and epicardial adipose tissue thickness. In this editorial, we provide a brief overview of the current knowledge concerning the association between NAFLD and cardiac dysfunction. | Anna Di Sessa Giuseppina Rosaria Umano Emanuele Miraglia del Giudice Nicola Santoro | 2017 | World Journal of Hepatology2017，9，2： | 5 |
| 7 | Pediatric non-alcoholic fatty liver disease:New insights and future directions显示文摘One of the most common complications of childhood obesity is the non-alcoholic fatty liver disease(NAFLD),which is the most common form of liver disease in children.NAFLD is defined by hepatic fat infiltration > 5% hepatocytes,as assessed by liver biopsy,in the absence of excessive alcohol intake,viral,autoimmune and drug-induced liver disease.It encompasses a wide spectrum of liver diseases ranging from simple steatosis to non-alcoholic steatohepatitis,which,in turn,can evolve into cirrhosis and end stage liver disease.Obesity and insulin resistance are the main risk factors for pediatric NAFLD.In fact,NAFLD is strongly associated with the clinical features of insulin resistance especially the metabolic syndrome,prediabetes and type 2 diabetes mellitus(T2D).In particular,it has been clearly shown in obese youth that the prevalence of metabolic syndrome,pre-diabetes and type 2 diabetes increaseswith NAFLD severity progression.Evidence that not all of the obese patients develop NAFLD suggests that the disease progression is likely to depend on complex interplay between environmental factors and genetic predisposition.Recently,a non-synonymous SNP(rs738409),characterized by a C to G substitution encoding an isoleucine to methionine substitution at the amino acid position 148 in the patatin like phospholipase containing domain 3 gene(PNPLA3),has been associated with hepatic steatosis in a multiethnic cohort of adults as well as in children.Another important polymorphisms that acts with PNPLA3 to convey susceptibility to fatty liver in obese youths is the rs1260326 polymorphism in the glucokinase regulatory protein.The pharmacological approach in NAFLD children poorly adherent to or being unresponsive/partially responsive to lifestyle changes,is aimed at acting upon specific targets involved in the pathogenesis.There are some therapeutic approaches that are being studied in children.This article reviews the current knowledge regarding the pediatric fatty liver disease,the new insights and the future directions. | Pierluigi Marzuillo Emanuele Miraglia del Giudice Nicola Santoro | 2014 | World Journal of Hepatology2014，6，4： | 4 |
| 8 | Subcellular localization of alpha-synuclein aggregates and their interaction with membranes显示文摘For more than a decade numerous evidence has been reported on the mechanisms of toxicity of α-synuclein(αS) oligomers and aggregates in α-synucleinopathies.These species were thought to form freely in the cytoplasm but recent reports of αS multimer conformations when bound to synaptic vesicles in physiological conditions,have raised the question about where αS aggregation initiates.In this review we focus on recent literature regarding the impact on membrane binding and subcellular localization of αS toxic species to understand how regular cellular function of αS contributes to pathology.Notably αS has been reported to mainly associate with specific membranes in neurons such as those of synaptic vesicles,ER/Golgi and the mitochondria,while toxic species of αS have been shown to inhibit,among others,neurotransmission,protein trafficking and mitochondrial function.Strategies interfering with αS membrane binding have shown to improve αS-driven toxicity in worms and in mice.Thus,a selective membrane binding that would result in a specific subcellular localization could be the key to understand how aggregation and pathology evolves,pointing out to αS functions that are primarily affected before onset of irreversible damage. | Fabiana Miraglia Alessio Ricci Lucia Rota Emanuela Colla | 2018 | Neural Regeneration Research2018，13，7： | 4 |
| 9 | TM6SF2 E167K variant predicts severe liver fibrosis for human immunodeficiency/hepatitis C virus co-infected patients, and severe steatosis only for a non-3 hepatitis C virus genotype显示文摘AIM To evaluate the impact of the Glu167Lys(E167K) transmembrane 6 superfamily member 2(TM6SF2) variant on the biochemical and morphologic expression of liver lesions in human immunodeficiency virus(HIV)/hepatitis C virus(HCV) co-infected patients.METHODS The study comprised 167 consecutive patients with HIV/HCV coinfection and biopsy-proven chronic hepatitis. A pathologist graded liver fibrosis and necroinflammation using the Ishak scoring system, and steatosis using Kleiner's scoring system. Patients were genotyped for TM6SF2 E167K(rs58542926) by real-time Polymerase chain reaction. The 167 patients, 35 therapy-naive and 132 receiving ART, were prevalently males(73.6%), the median age was 40.7 years and the immunological condition good(median CD4+ cells/mm3 = 505.5).RESULTS The 17 patients with the TM6SF2 E167 K variant, compared with the 150 with TM6SF2-E/E, showed higher AST(P = 0.02) and alanine aminotransferase(P = 0.02) and higher fibrosis score(3.1 ± 2.0 vs 2.3 ± 1.5, P = 0.05). In a multivariate analysis, TM6SF2 E167 K was independently associated with severe fibrosis. The same analysis showed that HCV-genotype 3, present in 42.2% of patients was an independent predictor of severe steatosis. The association of TM6SF2 E167 K with severe steatosis, absent for the whole group of 167 patients, was re-evaluated separately for HCVgenotype 3 and non-3 patients: No factor was independently associated with severe steatosis in the HCV-genotype-3 subgroup, whereas an independent association was observed between severe steatosis and TM6SF2 E167 K in non-3 HCV genotypes. No association between the TM6SF2 E167 K variant and severe liver necroinflammation was observed.CONCLUSION In HIV/HCV coinfection the TM6SF2 E167 K variant is an independent predictor of severe fibrosis, but appears to be independently associated with severe steatosis only for patients with a non-3 HCV genotype. | Caterina Sagnelli Marco Merli Caterina Uberti-Foppa Hamid Hasson Anna Grandone Grazia Cirillo Stefania Salpietro Carmine Minichini Mario Starace Emanuela Messina Patrizia Morelli Emanuele Miraglia Del Giudice Adriano Lazzarin Nicola Coppola Evangelista Sagnelli | 2016 | World Journal of Gastroenterology2016，22，38： | 4 |
| 10 | Abdominal fat interacts with PNPLA 3 I148M, but not with the APOC 3 variant in the pathogenesis of liver steatosis in chronic hepatitis C显示文摘 | R. Zampino N. Coppola G. Cirillo A. Boemio M. Pisaturo A. Marrone M. Macera E. Sagnelli L. Perrone L. E. Adinolfi E. Miraglia del Giudice | 2013 | J Viral Hepat2013，，8： | 3 |
| 11 | TM 6 SF 2 E167K variant is associated with severe steatosis in chronic hepatitis C, regardless of PNPLA 3 polymorphism显示文摘 | Nicola Coppola Zampino Rosa Grazia Cirillo Maria Stanzione Margherita Macera Adriana Boemio Anna Grandone Mariantonietta Pisaturo Aldo Marrone Luigi E. Adinolfi Evangelista Sagnelli Emanuele Miraglia del Giudice | 2015 | Liver Int2015，，8： | 3 |
| 12 | Abdominal fat interacts with PNPLA 3 I148M, but not with the APOC 3 variant in the pathogenesis of liver steatosis in chronic hepatitis C显示文摘 | R. Zampino N. Coppola G. Cirillo A. Boemio M. Pisaturo A. Marrone M. Macera E. Sagnelli L. Perrone L. E. Adinolfi E. Miraglia del Giudice | 2013 | J Viral Hepat2013，，8： | 3 |
| 13 | Pediatric fatty liver disease:Role of ethnicity and genetics显示文摘Non-alcoholic fatty liver disease(NAFLD)comprehends a wide range of conditions,encompassing from fatty liver or steatohepatitis with or without fibrosis,to cirrhosis and its complications.NAFLD has become the most common form of liver disease in childhood as its prevalence has more than doubled over the past 20years,paralleling the increased prevalence of childhood obesity.It currently affects between 3%and11%of the pediatric population reaching the rate of46%among overweight and obese children and adolescents.The prevalence of hepatic steatosis varies among different ethnic groups.The ethnic group with the highest prevalence is the Hispanic one followed by the Caucasian and the African-American.This evidence suggests that there is a strong genetic background in the predisposition to fatty liver.In fact,since 2008several common gene variants have been implicated in the pathogenesis of fatty liver disease.The most important is probably the patatin like phospholipase containing domain 3 gene(PNPLA3)discovered by the Hobbs’group in 2008.This article reviews the current knowledge regarding the role of ethnicity and genetics in pathogenesis of pediatric fatty liver. | Pierluigi Marzuillo Emanuele Miraglia del Giudice Nicola Santoro | 2014 | World Journal of Gastroenterology2014，20，23： | 3 |
| 14 | MDCT, MR and interventional radiology in biliary atresia candidates for liver transplantation显示文摘The multi-detector computed tomography (MDCT) scan and magnetic resonance (MR) of the abdomen play a key role in the work-up to liver transplantation (LT) by identifying congenital anomalies or cirrhosis-related modifications, conditions that can require changes in surgical technique. Moreover, the MDCT and MR scans allow identification of cirrhotic liver hepatic masses, extrahepatic porto-systemic shunts, eventual thrombosis of portal system and radiological signs of portal hypertension associated with biliary atresia (BA). The aim of this paper is to review MDCT, MR imaging and interven-tional radiology procedures performed to evaluate morphological changes and degree of portal hypertension in pediatric patients with end-stage liver disease secondary to BA, who are candidates for LT. Advances in the field of MR, MDCT and in percutaneous minimally invasive techniques have increased the importance of radiology in the management of pediatric patients with BA who are candidates for LT. | Roberto Miraglia Settimo Caruso Luigi Maruzzelli Marco Spada Silvia Riva Marco Sciveres Angelo Luca | 2011 | World Journal of Radiology2011，3，9： | 2 |
| 15 | A case of biliary stones and anastomotic biliary stricture after liver transplant treated with the rendez-vous technique and electrokinetic lithotritor显示文摘The paper studies the combined radiologic and endoscopic approach (rendez vous technique) to the treatment of the biliary complications following liver transplant. The 'rendez-vous' technique was used with an electrokinetic lithotripter, in the treatment of a biliary anastomotic stricture with multiple biliary stones in a patient who underwent orthotopic liver transplant. In this patient, endoscopic or percutaneous transhepatic management of the biliary complication failed. The combined approach, percutaneous transhepatic and endoscopic treatment (rendez-vous technique) with the use of an electrokinetic lithotritor, was used to solve the biliary stenosis and to remove the stones. Technical success, defined as disappearance of the biliary stenosis and stone removal, was obtained in just one session, which definitively solved the complications. The combined approach of percutaneous transhepatic and endoscopic (rendez-vous technique) treatment, in association with an electrokinetic lithotritor, is a safe and feasible alternative treatment, especially after the failure of endoscopic and/or percutaneous trans-hepatic isolated procedures. | Marta Di Pisa Mario Traina Roberto Miraglia Luigi Maruzzelli Riccardo Volpes Salvatore Piazza Angelo Luca Bruno Gridelli | 2008 | World Journal of Gastroenterology2008，14，18： | 2 |
| 16 | Association Between a Polymorphism in Cannabinoid Receptor 2 and Severe Necroinflammation in Patients With Chronic Hepatitis C显示文摘 | Nicola Coppola Rosa Zampino Giulia Bellini Margherita Macera Aldo Marrone Mariantonietta Pisaturo Adriana Boemio Bruno Nobili Giuseppe Pasquale Sabatino Maione Luigi Elio Adinolfi Laura Perrone Evangelista Sagnelli Emanuele Miraglia Del Giudice Francesca | 2013 | Clinical Gastroenterology and Hepatology2013，，： | 2 |
| 17 | Insulin resistance and steatosis in HBV-HCV co-infected patients: Role of PNPLA3 polymorphisms and impact on liver fibrosis progression显示文摘AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected patients.METHODS:Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled:66 had HBV-HCV,66 HBV and 198 HCV infection.Prevalence of steatosis,IR and PNPLA3 polymorphisms and their relation to anthropometric,biochemical,virological and histological parameters were evaluated.RESULTS:Prevalence of steatosis in group HBV-HCV was similar to that in HCV(47.0% vs 49.5%,respec-tively);group HBV showed the lowest steatosis(33.3%).Group HBV-HCV had a lesser degree of steatosis than HCV(P = 0.016),lower HCV RNA levels(P = 0.025) and lower prevalence and degree of IR(P = 0.01).PNPLA3 polymorphisms were associated with steatosis.Group HBV-HCV showed higher levels of liver fibrosis than group HCV(P = 0.001),but similar to that ob-served in HBV group.In HBV-HCV group,liver fibrosis was not associated with steatosis,IR or PNPLA3.HBV infection was the independent predictor of advanced liver fibrosis.CONCLUSION:HBV-HCV co-infected patients have lower degree of hepatic steatosis,IR and HCV RNA than HCV mono-infected;co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance. | Rosa Zampino Adriana Boemio Aldo Marrone Luciano Restivo Maria Chiara Fascione Riccardo Nevola Luigi Elio Adinolfi Nicola Coppola Carmine Minichini Mario Starace Evangelista Sagnelli Grazia Cirillo Emanuele Miraglia del Giudice Maria Stanzione Emanuele Durante-Mangoni Giovanna Salzillo | 2014 | World Journal of Hepatology2014，6，9： | 2 |
| 18 | Percutaneous transarterial embolization of extrahepatic arteroportal fistula显示文摘Arteroportal fi stula is a rare cause of prehepatic portal hypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding. Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the color- Doppler by a turbulent ? ow, and arterialization of portal vein ? ow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confi rming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed. Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension. | Gianluca Marrone Settimo Caruso Roberto Miraglia Ilaria Tarantino Riccardo Volpes Angelo Luca | 2006 | World Journal of Gastroenterology2006，12，34： | 2 |
| 19 | Rituximab-induced IgG hypogammaglobulinemia in children with nephrotic syndrome and normal pre-treatment IgG values显示文摘BACKGROUND In paediatric patients with complicated nephrotic syndrome(NS), rituximab(RTX) administration can induce persistent IgG hypogammaglobulinemia among subjects showing low basal immunoglobulin G(IgG) levels.AIM To evaluate the effect of RTX on IgG levels and infections in patients with complicated NS and normal basal IgG levels.METHODS We consecutively enrolled all patients with complicated NS and normal basal IgG levels undergoing the first RTX infusion from January 2008 to January 2016. Basal IgG levels were dosed after 6 wk of absent proteinuria and with a maximal interval of 3 mo before RTX infusion. The primary outcome was the onset of IgG hypogammaglobulinemia during the follow-up according to the IgG normal values for age [mean ± standard deviation(SD)].RESULTS We enrolled 20 patients with mean age at NS diagnosis of 4.2 ± 3.3 years. The mean age at the first RTX infusion was 10.9 ± 3.5 years. Eleven out of twenty patients(55%) developed IgG hypogammaglobulinemia. None of these patients showed severe or recurrent infections. Only one patient suffered from recurrent acute otitis media and underwent substitutive IgG infusion. Three patients undergoing only the two 'starting doses' experienced normalization of IgG levels. Using Kaplan-Meier analysis, the cumulative proportion of patients free of IgG hypogammaglobulinemia was 57.8% after the first RTX dose, 51.5% after the third dose, 44.1% after the fourth dose, and 35.5% after the fifth dose.CONCLUSION RTX can induce IgG hypogammaglobulinemia in patients with pre-RTX IgG normal values. None of the treated patients showed severe infections. | Pierluigi Marzuillo Stefano Guarino Tiziana Esposito Anna Di Sessa Sara Immacolata Orsini Daniela Capalbo Emanuele Miraglia del Giudice Angela La Manna | 2019 | World Journal of Clinical Cases2019，7，9： | 2 |
| 20 | AC133, a novel marker for human hematopoietic stem and progenitor cells 显示文摘 | Yin AH Miraglia S Zanjani ED | 1997 | Blood1997，90，： | 1 |
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