Surgical approach to multifocal hepatocellular carcinoma with portal vein thrombosis and arterioportal shunt leading to portal hypertension and bleeding: a case report

It is reported the case of a 69 years man who presented to the Emergency Room because of pain and abdominal distension from ascites. After admission and paracentesis placement, he developed a digestive hemorrhage due to oesophageal varices from portal ipertension secondary to the formation of a portal shunt concomitant with a multifocal HepatoCellular Carcinoma (HCC) with portal vein thrombosis (PVT). The patient underwent endoscopic varices ligation, twice transarterial embolization (TAE) of arterial branches feeding the shunt and subsequent left hepatectomy. During the postoperative course he developed mild and transient signs of liver failure and was discharged in postoperative day 16. He is alive and disease free 8 months after surgery

Experimental and Numerical Evaluation of Residual Displacement and Ductility in Ratcheting and Shakedown of an Aluminium Beam

Safety assessment of structures can be obtained employing limit design to overcome uncertainties concerning actual response due to inelastic constitutive behavior and more generally to non-linear structural response and loads' random variability. The limit analysis is used for evaluating the safety of the structures, starting directly from load level without any knowledge of the load history. In the paper, the lower bound calculation is proposed where a new strain-based approach is used that allowed describing the residual stress and displacement in terms of permanent strain. The strategy uses the permanent strain as effective parameters of the procedure so that it is possible to assess the ductility requirements for the complete load program developed till collapse or shakedown. The procedure is compared to experimental results obtained on aluminum beams in shakedown

Experimental and Numerical Evaluation of Residual Displacement and Ductility in Ratcheting and Shakedown of an Aluminum Beam

Safety assessment of structures can be obtained employing limit design to overcome uncertainties concerning actual response due to inelastic constitutive behavior and more generally to non-linear structural response and loads’ random variability. The limit analysis is used for evaluating the safety of the structures, starting directly from load level without any knowledge of the load history. In the paper, the lower bound calculation is proposed where a new strain-based approach is used that allowed describing the residual stress and displacement in terms of permanent strain. The strategy uses the permanent strain as effective parameters of the procedure so that it is possible to assess the ductility requirements for the complete load program developed till collapse or shakedown. The procedure is compared to experimental results obtained on aluminum beams in shakedown

A particular anatomic variation of the course of the left pulmonary artery

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An extreme negative sea level in the Mediterranean Basin: San Giorgio case study compared with Adriatic Sea

The aim of this paper is to discuss the case of an extreme negative sea level phenomenon that occurred along Sicily Island’s coasts (Italy). Sea level time series associated to six stations that are part of the Italian tide gauge network have been analysed. By deriving the tidal residual and by evaluating meteorological parameters’ trends, it was possible to give an explanation to this phenomenon

Morphology of the Veneto Coast

A considerable amount of the North Adriatic coast is currently eroding despite the development of a wide range of measures to protect shorelines from eroding and flooding. The management of Northern Adriatic coast need a multidisciplinary, updating and modular approach. We must understand how natural and man-induced dynamics act on littoral areas. This motivated to initiate a specific research program concerning these issues started in 2003 by a cooperation among CNR-ISMAR, the Autorità di Bacino dei fiumi dell’Alto Adriatico and APAT, Servizio Laguna di Venezia. This paper shows first results of such program in progress

Prognostic role of nodal ratio, LODDS, pN in patients with pancreatic cancer with venous involvement

Background: The UICC/AJCC TNM staging system classifies lymph nodes as N0 and N1 in pancreatic cancer. Aim of the study is to determine whether the number of examine nodes, the nodal ratio (NR) and the logarithm odds of positive lymph nodes (LODDS) may better stratify the prognosis of patients undergoing pancreatectomy combined with venous resection for pancreatic cancer with venous involvement. Methods: A multicenter database of 303 patients undergoing pancreatectomy in 9 Italian referral centers was analyzed. The prognostic impact of number of retrieved and examined nodes, NR, LODDS was analyzed and compared with ROC curves analysis, Pearson test, univariate and multivariate analysis. Results: The number of metastatic nodes, pN, the NR and LODDS was significantly correlated with survival at multivariate analyses. The corresponding AUC for the number of metastatic nodes, pN, the NR and LODDS were 0.66, 0.69, 0.63 and 0.65, respectively. The Pearson test showed a significant correlation between the number of retrieved lymph nodes and number of metastatic nodes, pN and the NR. LODDS had the lower coefficient correlation. Concerning N1 patients, the NR, the LODDS and the number of metastatic nodes were able to significantly further stratify survival (p = 0.040; p = 0.046; p = 0.038, respectively). Conclusions: The number of examined lymph nodes, the NR and LODDS are useful for further prognostic stratification of N1 patients in the setting of pancreatectomy combined with PV/SMV resection. No superiority of one over the others methods was detected

Quercetin derivatives as novel antihypertensive agents: Synthesis and physiological characterization

The antihypertensive flavonol quercetin (Q1) is endowedwith a cardioprotective effect againstmyocardial ischemic damage. Q1 inhibits angiotensin converting enzymeactivity, improves vascular relaxation, and decreases oxidative stress and gene expression. However, the clinical application of this flavonol is limited by its poor bioavailability and low stability in aqueous medium. In the aimto overcome these drawbacks and preserve the cardioprotective effects of quercetin, the present study reports on the preparation of five different Q1 analogs, in which all OH groups were replaced by hydrophobic functional moieties. Q1 derivatives have been synthesized by optimizing previously reported procedures and analyzed by spectroscopic analysis. The cardiovascular properties of the obtained compounds were also investigated in order to evaluate whether chemical modification affects their biological efficacy. The interaction with β-adrenergic receptors was evaluated by molecular docking and the cardiovascular efficacy was investigated on the ex vivo Langendorff perfused rat heart. Furthermore, the bioavailability and the antihypertensive properties of the most active derivative were evaluated by in vitro studies and in vivo administration (1month) on spontaneously hypertensive rats (SHRs), respectively. Among all studied Q1 derivatives, only the ethyl derivative reduced left ventricular pressure (at 10−8M÷10−6Mdoses) and improved relaxation and coronary dilation. NOSs inhibition by L-NAME abolished inotropism, lusitropism and coronary effects. Chronic administration of high doses of this compound on SHR reduced systolic and diastolic pressure. Differently, the acetyl derivative induced negative inotropism and lusitropism (at 10−10M and 10−8 ÷ 10−6 M doses), without affecting coronary pressure. Accordingly, docking studies suggested that these compounds bind both β1/β2-adrenergic receptors. Taking into consideration all the obtained results, the replacement of OHwith ethyl groups seems to improve Q1 bioavailability and stability; therefore, the ethyl derivative could represent a good candidate for clinical use in hypertension

Functionally Graded Plate Fracture by Field Boundary Element

This paper describes the Field Boundary Element Method (FBEM) applied to the fracture analysis of a 2D rectangular plate made of Functionally Graded Material (FGM) to calculate Mode I Stress Intensity Factor (SIF). The case study of this Field Boundary Element Method is the transversely isotropic plane plate. Its material presents an exponential variation of the elasticity tensor depending on a scalar function of position, i.e., the elastic tensor results from multiplying a scalar function by a constant taken as a reference. Several examples using a parametric representation of the structural response show the suitability of the method that constitutes a Stress Intensity Factor evaluation of Functionally Graded Materials plane plates even in the case of more complex geometrie