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Oikonomou P, Nikolaou C, Papachristou F, Sovatzidis A, Lambropoulou M, Giouleka C, Kontaxis V, Linardoutsos D, Papalois A, Pitiakoudis M, Tsaroucha A. Eugenol Reduced ΜPO, CD45 and HMGB1 Expression and Attenuated the Expression of Leukocyte Infiltration Markers in the Intestinal Tissue in Biliopancreatic Duct Ligation-Induced Pancreatitis in Rats. Medicina (Kaunas) 2023; 60:74. [PMID: 38256335 PMCID: PMC10820626 DOI: 10.3390/medicina60010074] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/30/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Inflammation and dysregulation in the intestinal barrier function in acute pancreatitis (AP) trigger pancreatic lesions, systemic inflammatory response, and multiple organ dysfunction. Eugenol, as the main component of clove (Syzygium aromaticum), is known for its antioxidant and anti-inflammatory properties. We studied the potentially beneficial effect of eugenol in a rodent model of biliopancreatic duct ligation-induced AP. Materials and Methods: Rats were randomly divided into three groups: Sham, AP, and AP + eugenol (15 mg/kg/day). Serum TNFα, IL-6, IL-18, and resistin levels, as well as IL-6, TNFα, MPO, HMGB1, and CD45 tissue expression, were determined at various timepoints after the induction of AP. Results: Eugenol attenuated hyperemia and inflammatory cell infiltration in the intestinal mucosal, submucosal, and muscular layers. IL-6 and resistin serum levels were significantly reduced in the AP + eugenol group, while serum TNFα and IL-18 levels remained unaffected overall. TNFα pancreatic and intestinal expression was attenuated by eugenol at 72 h, while IL-6 expression was affected only in the pancreas. MPO, CD45, and HMGB1 intestinal expression was significantly reduced in eugenol-treated rats. Conclusions: Eugenol managed to attenuate the inflammatory response in the intestine in duct ligation-induced AP in rats.
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Affiliation(s)
- Panagoula Oikonomou
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (C.N.); (F.P.)
| | - Christina Nikolaou
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (C.N.); (F.P.)
| | - Fotini Papachristou
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (C.N.); (F.P.)
| | - Apostolos Sovatzidis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
| | - Maria Lambropoulou
- Laboratory of Histology-Embryology, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Charikleia Giouleka
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
| | - Vasileios Kontaxis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
| | - Dimitrios Linardoutsos
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
| | - Apostolos Papalois
- Experimental Research Center, ELPEN Pharmaceuticals, Pikermi, 19009 Athens, Greece;
| | - Michael Pitiakoudis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
| | - Alexandra Tsaroucha
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (A.S.); (C.G.); (V.K.); (D.L.); (M.P.); (A.T.)
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (C.N.); (F.P.)
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Kouri MA, Karnachoriti M, Spyratou E, Orfanoudakis S, Kalatzis D, Kontos AG, Seimenis I, Efstathopoulos EP, Tsaroucha A, Lambropoulou M. Shedding Light on Colorectal Cancer: An In Vivo Raman Spectroscopy Approach Combined with Deep Learning Analysis. Int J Mol Sci 2023; 24:16582. [PMID: 38068905 PMCID: PMC10706261 DOI: 10.3390/ijms242316582] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Raman spectroscopy has emerged as a powerful tool in medical, biochemical, and biological research with high specificity, sensitivity, and spatial and temporal resolution. Recent advanced Raman systems, such as portable Raman systems and fiber-optic probes, provide the potential for accurate in vivo discrimination between healthy and cancerous tissues. In our study, a portable Raman probe spectrometer was tested in immunosuppressed mice for the in vivo localization of colorectal cancer malignancies from normal tissue margins. The acquired Raman spectra were preprocessed, and principal component analysis (PCA) was performed to facilitate discrimination between malignant and normal tissues and to highlight their biochemical differences using loading plots. A transfer learning model based on a one-dimensional convolutional neural network (1D-CNN) was employed for the Raman spectra data to assess the classification accuracy of Raman spectra in live animals. The 1D-CNN model yielded an 89.9% accuracy and 91.4% precision in tissue classification. Our results contribute to the field of Raman spectroscopy in cancer diagnosis, highlighting its promising role within clinical applications.
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Affiliation(s)
- Maria Anthi Kouri
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.A.K.); (E.S.); (D.K.); (E.P.E.)
- Medical Physics Program, Department of Physics and Applied Physics, Kennedy College of Sciences, University of Massachusetts Lowell, 265 Riverside St., Lowell, MA 01854, USA
| | - Maria Karnachoriti
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (M.K.); (S.O.)
| | - Ellas Spyratou
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.A.K.); (E.S.); (D.K.); (E.P.E.)
| | - Spyros Orfanoudakis
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (M.K.); (S.O.)
| | - Dimitris Kalatzis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.A.K.); (E.S.); (D.K.); (E.P.E.)
| | - Athanassios G. Kontos
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (M.K.); (S.O.)
| | - Ioannis Seimenis
- Medical School, National and Kapodistrian University of Athens, 75 Mikras Assias Str., 11527 Athens, Greece;
| | - Efstathios P. Efstathopoulos
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.A.K.); (E.S.); (D.K.); (E.P.E.)
| | - Alexandra Tsaroucha
- Laboratory of Bioethics, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Lambropoulou
- Laboratory of Histology-Embryology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
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Papachristou E, Deftereos S, Asimakidou M, Bekiaridou K, Foutzitzi S, Defteraiou S, Oikonomou P, Gogoulis I, Nikolaou C, Aggelidou M, Sinopidis X, Romanidis K, Tsaroucha A, Kambouri K. Parental Home Safety Practices for Domestic Accident Prevention: How Prepared Were Parents for COVID-19 Confinement? A Cross-Sectional Study. Clin Pract 2023; 13:1449-1459. [PMID: 37987430 PMCID: PMC10660517 DOI: 10.3390/clinpract13060129] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023] Open
Abstract
(1) Background: Children are susceptible to home injuries. How prepared parents were to protect their children from accidents before and during the COVID-19 quarantine is uncertain. (2) Methods: We conducted a community-based, cross-sectional study in Greece between November and December 2021. We asked parents to complete an anonymous questionnaire voluntarily. Questions focused on accident-preventive measures taken at home during the COVID-19 quarantine. (3) Results: A greater proportion of parents took protective measures for a safer home before the lockdown than during the quarantine, while an interesting percentage of parents never utilized preventive measures for their children. Slightly more than half (58.6%) of parents did not seem to worry about a possible increase in domestic accidents during the quarantine. It was observed that those who had one or two children took more protective measures than those with more than two children. Older parents seemed to explain to their children how to access emergency services more often. Mothers stayed at home with the children more often, and their education affected the presence of some of the assessed measures. In our logistic regression modeling, parental concern about accidents was more related to the incidence of an accident during the pandemic and attendance at seminars. (4) Conclusions: Although the COVID-19 lockdowns disorganized family life, parents were aware of the importance of their parenting role in creating a safe environment for children, but according to the study, there is room for improvement.
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Affiliation(s)
- Eirini Papachristou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Savas Deftereos
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (S.D.); (S.F.)
| | - Maria Asimakidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Konstantina Bekiaridou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Soultana Foutzitzi
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (S.D.); (S.F.)
| | | | - Panagoula Oikonomou
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (P.O.); (A.T.)
| | - Ioannis Gogoulis
- Department of General Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (I.G.); (C.N.); (K.R.)
| | - Christina Nikolaou
- Department of General Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (I.G.); (C.N.); (K.R.)
| | - Maria Aggelidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Xenophon Sinopidis
- Department of Pediatric Surgery, Rio University Hospital, University of Patras, 26504 Rio, Greece;
| | - Konstantinos Romanidis
- Department of General Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (I.G.); (C.N.); (K.R.)
| | - Alexandra Tsaroucha
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (P.O.); (A.T.)
| | - Katerina Kambouri
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
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Koutsouki S, Kosmidis D, Nagy EO, Tsaroucha A, Anastasopoulos G, Pnevmatikos I, Papaioannou V. Limitation of Non-Beneficial Interventions and their Impact on the Intensive Care Unit Costs. J Crit Care Med (Targu Mures) 2023; 9:230-238. [PMID: 37969880 PMCID: PMC10644299 DOI: 10.2478/jccm-2023-0028] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/30/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Using a plan to limit non-beneficial life support interventions has significantly reduced harm and loss of dignity for patients at the end of life. The association of these limitations with patients' clinical characteristics and health care costs in the intensive care unit (ICU) needs further scientific evidence. Aim of the study To explore decisions to limit non-beneficial life support interventions, their correlation with patients' clinical data, and their effect on the cost of care in the ICU. Material and Methods We included all patients admitted to the general ICU of a hospital in Greece in a two-year (2019-2021) prospective study. Data collection included patient demographic and clinical variables, data related to decisions to limit (withholding, withdrawing) non-beneficial interventions (NBIs), and economic data. Comparisons were made between patients with and without limitation decisions. Results NBIs were limited in 164 of 454 patients (36.12%). Patients with limitation decisions were associated with older age (70y vs. 62y; p<0,001), greater disease severity score (APACHE IV, 71 vs. 50; p<0,001), longer length of stay (7d vs. 4.5d; p<0,001), and worse prognosis of death (APACHE IV PDR, 48.9 vs. 17.35; p<0,001). All cost categories and total cost per patient were also higher than the patient without limitation of NBIs (9247,79€ vs. 8029,46€, p<0,004). The mean daily cost has not differed between the groups (831,24€ vs. 832,59€; p<0,716). However, in the group of patients with limitations, all cost categories, including the average daily cost (767.31€ vs. 649.12€) after the limitation of NBIs, were reduced to a statistically significant degree (p<0.001). Conclusions Limiting NBIs in the ICU reduces healthcare costs and may lead to better management of ICU resource use.
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Affiliation(s)
| | - Dimitrios Kosmidis
- Nursing Department, International Hellenic University, Didymoteicho, Greece
| | | | - Alexandra Tsaroucha
- Postgraduate program on Bioethics, Laboratory of Bioethics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Kottakis G, Kambouri K, Giatromanolaki A, Valsami G, Kostomitsopoulos N, Tsaroucha A, Pitiakoudis M. Effects of the Antioxidant Quercetin in an Experimental Model of Ulcerative Colitis in Mice. Medicina (Kaunas) 2022; 59:medicina59010087. [PMID: 36676712 PMCID: PMC9861512 DOI: 10.3390/medicina59010087] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
Background and Objectives: Quercetin, a member of the flavanol family found in many fruits, vegetables, leaves and grains has been found to have a wide range of biological effects on human physiology. The aim of this study was to investigate the effects of quercetin, when administered orally in the form of the water-soluble inclusion complex with hydroxypropyl-b-cyclodextrin (Que-HP-β-CD), in an experimental model of ulcerative colitis in mice. Materials and Methods: Animals received either Dextran Sodium Sulphate (DSS), to induce colitis, + Que-HP-β-CD (Group A), DSS alone (Group B) or no intervention (control, Group C) for 7 days. All animals were weighed daily, and evaluation of colitis was performed using the Disease Activity Index (DAI). On day 7 a blood sample was taken from all animals, they were then euthanised, the large intestine was measured, and histological and immunochemical analyses were performed. Results: The DAI demonstrated an increase over time for the groups receiving DSS (Groups A and B) compared with the control group (Group C), with a significant degree of protection being observed in the group that also received quercetin (Group A): The DAI over time slope for Group B was higher than that for Group A by 0.26 points/day (95% Cl 0.20−0.33, p < 0.01). Weight calculations and immunohistochemistry results validated the DAI findings. Conclusions: In conclusion, the administration of quercetin in an ulcerative colitis model in mice presents a therapeutic/prophylactic potential that warrants further investigation.
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Affiliation(s)
- George Kottakis
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-694-529-7747
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | - Georgia Valsami
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Nikolaos Kostomitsopoulos
- Biomedical Research Foundation (BRFAA) of the Academy of Athens, Experimental Surgery and Translational Research, 11527 Athens, Greece
| | - Alexandra Tsaroucha
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Michael Pitiakoudis
- 2nd Department of General Surgery, University of Thrace, 68100 Alexandroupolis, Greece
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Papachristou E, Deftereos S, Oikonomou P, Bekiaridou K, Foutzitzi S, Gogoulis I, Sinopidis X, Romanidis K, Tsaroucha A, Kambouri K. Is It Safe to Stay at Home? Parents’ Perceptions of Child Home Injuries during the COVID-19 Lockdown. Healthcare (Basel) 2022; 10:healthcare10102056. [PMID: 36292503 PMCID: PMC9601692 DOI: 10.3390/healthcare10102056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic and stay-at-home regulations have increased child home injuries. This study illustrates the type and frequency of child home injuries in Greece during the COVID-19 lockdown. Moreover, the survey reports the results on parents’ proposals regarding child injuries at home during the COVID-19 quarantine. A community-based, cross-sectional, descriptive study was conducted from November to December 2021 in Greece. Parents were asked to voluntarily complete an anonymous questionnaire, designed for the needs of the research. A statistical analysis of the data was performed using the Kolmogorov–Smirnov and Shapiro–Wilk tests for a normal distribution, a chi-squared (χ2) test to compare percentages among different groups and a non-parametric Mann–Whitney U test to determine the differences in Likert scale variables between two groups. A total of 130 parents with at least one child were questioned through an online questionnaire survey. Of the parents, 39.3%, stated that the number of accidents in their home increased. The most frequent accidents were injuries (49.3%). Most of the accidents occurred inside the house (75.8%) and were observed among children aged 0–4 years. A high percentage of children’s accidents was observed in rural/island areas or in the suburbs. Children who were with either their father or mother had one accident, and a higher number of accidents occurred when the children were with their grandparents, with the nanny or alone. For those parents who had difficulty supervising their child, child accidents increased compared to parents who had the ability to supervise. It was noticed that parents who knew how to provide a safe home stated that the number of accidents remained the same. Parents must organize a safer home. Authorities should educate parents on child injury prevention and provide them with financial facilities to provide a safer house.
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Affiliation(s)
- Eirini Papachristou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Savas Deftereos
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Department of Experimental Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Konstantina Bekiaridou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Soultana Foutzitzi
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Ioannis Gogoulis
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Xenophon Sinopidis
- Department of Pediatric Surgery, University of Patras, 26504 Patras, Greece
| | - Konstantinos Romanidis
- Department of Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Alexandra Tsaroucha
- Department of Experimental Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-6946335786
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Gaitanidis A, Kandilogiannakis L, Filidou E, Tsaroucha A, Kolios G, Pitiakoudis M. Stem Cell Therapies for Gastrointestinal Anastomotic Healing: A Systematic Review and Meta-Analysis on Results from Animal Studies. Eur Surg Res 2022; 63:173-181. [PMID: 36067736 DOI: 10.1159/000526603] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/22/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite considerable progress in surgical techniques, anastomotic leak (AL) is a common complication after gastrointestinal surgery. Stem cells are a promising therapy to improve healing and have been used in gastrointestinal anastomoses. In this study, we perform a systematic review and meta-analysis to evaluate the efficacy of stem cell therapies in preventing ALs among animal studies. METHODS A systematic review of the literature was performed by searching PubMed, Web of Science, and the Cochrane Library. We considered all anastomoses of the gastrointestinal tract (excl. biliary) from the esophagus to the rectum. Outcomes included AL rates on postoperative day (POD) 7 and the latest time point reported. RESULTS Fourteen studies were identified, evaluating stem cells in gastrointestinal anastomoses, of which 1 was on esophageal, 2 on gastric, 2 on small intestinal, and 9 on colorectal anastomoses. Meta-analysis did not show significant differences in AL rates on POD 7 (odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.04-3.15, p = 0.248, I2 = 34.1%, 95% CI: 0-75.2%, Q = 6.07, df = 4, p = 0.194), but there was a nonsignificant trend for lower AL rates at the latest time point reported (OR 0.28, 95% CI: 0.08-1.01, p = 0.052, I2 = 34%, 95% CI: 0-70.8%, Q = 10.6, df = 7, p = 0.157). CONCLUSION Stem cell therapy may be associated with lower AL rates in gastrointestinal anastomoses, though meta-analysis is severely inhibited by heterogeneous study design. More studies are needed to determine the therapeutic potential of stem cells.
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Affiliation(s)
- Apostolos Gaitanidis
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
| | - Leonidas Kandilogiannakis
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Eirini Filidou
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Alexandra Tsaroucha
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
| | - George Kolios
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Michail Pitiakoudis
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
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Nikolaidou E, Kakagia D, Kaldoudi E, Stouras J, Sovatzidis A, Tsaroucha A. Coagulation Disorders And Mortality In Burn Injury: A Systematic Review. Ann Burns Fire Disasters 2022; 35:103-115. [PMID: 36381344 PMCID: PMC9416686] [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] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/16/2022] [Indexed: 06/16/2023]
Abstract
Even though coagulopathy is a familiar entity in trauma, its relationship to burn injury remains unclear. Literature appears inconsistent as to the conclusions of the use of coagulation assays, either routine methods or newer viscoelastic coagulation assays (VCAs), thromboelastography (TEG) and rotational thromboelastometry (ROTEM), for prediction of patients' coagulation status and mortality. The use of diagnostic assays as mortality markers will be of great importance, since they would recognize at early stages patients with great medical demands and objectify burn injury severity. The aim of this study was to review the literature and evaluate burn patients' characteristics and coagulation markers in the early post burn period. The secondary outcome was to investigate the role of different coagulation assays in mortality prognosis. Literature search was performed using PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Proquest Dissertation and Theses Global, Scopus and Cochrane Library databases. All types of articles referring to adults with any type of burn injury admitted in the first 24h assessing coagulation and mortality were included. PRISMA guidelines ensured the evidence-based process. Eleven studies met the eligibility criteria. This review demonstrated the indubitable relationship of coagulopathy with burn injury and its significant impact on mortality. The rapid and dynamic process of coagulation makes standard coagulation assays unable to detect short-lived haemostatic changes. More susceptible markers such as VCAs need to be applied to the routine assessment of burn patients in order to obtain an overview on coagulopathy and standardize the gained knowledge.
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Affiliation(s)
- E. Nikolaidou
- General Hospital of Thessaloniki “G. Papanikolaou”, Thessaloniki, Greece
| | - D. Kakagia
- Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - E. Kaldoudi
- Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - J. Stouras
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - A. Tsaroucha
- Democritus University of Thrace, Dragana, Alexandroupolis, Greece
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9
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Lamprou I, Kakouratos C, Tsolou A, Pavlidis P, Xanthopoulou ET, Nanos C, Tsaroucha A, Sivridis E, Giatromanolaki A, Koukourakis MI. Lipophagy-related protein perilipin-3 (PLIN3) and resistance of prostate cancer to radiotherapy. Int J Radiat Oncol Biol Phys 2022; 113:401-414. [PMID: 35121129 DOI: 10.1016/j.ijrobp.2022.01.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/17/2021] [Accepted: 01/23/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Radiotherapy is a principal treatment modality for localized and locally advanced prostate cancer (PCa). Metabolic alterations, including lipid metabolism, may reduce treatment efficacy resulting in tumor relapse and poor therapeutic outcome. In the current study, we investigated the role of the lipophagy-related protein perilipin-3 (PLIN3) and the lysosomal acid lipase (LAL) in PCa response to radiotherapy. METHODS AND MATERIALS We explored the in vitro and xenograft (in NOD.SCID and R2G2 mice) response to radiation of either PLIN3-depleted or LAL-depleted hormone-refractory (DU145, PC3), and hormone-responsive 22Rv1 PCa cell lines. Moreover, we evaluated the clinical role of PLIN3 and LAL protein expression in a series of PCa tissue specimens from patients treated with radical radiotherapy. RESULTS In vitro and in vivo experiments showed reduced proliferation and strong radiosensitization of all studied PCa cell lines upon PLIN3 depletion. In vivo experiments demonstrated the significantly augmented radiotherapy efficacy upon PLIN3 depletion, resulting in extensive tissue necrosis. PLIN3 overexpression in tissue specimens was correlated with increased MIB1 proliferation index, increased autophagy flux, reduced response to radiotherapy and poor prognosis. The impact of LAL depletion on radiotherapy was of lesser importance. CONCLUSIONS Assessment of PLIN3 expression may identify subgroups of PCa patients less responsive to radiotherapy, and at high risk of relapse post irradiation. Whether radiotherapy efficacy may be enhanced by concurrent autophagy or PLIN3 inhibition in this sub-group of patients demands clinical evaluation.
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Affiliation(s)
| | | | | | | | | | | | | | - Efthimios Sivridis
- Department of Pathology, Democritus University of Thrace, Alexandroupolis, Greece
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10
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Koukourakis MI, Kavazis C, Giagtzidis A, Mamalis P, Tsaroucha A, Botaitis S, Giatromanolaki A, Pitiakoudis M. Postoperative hypofractionated-accelerated radiotherapy (HypoAR) for locally advanced rectal cancer. Jpn J Clin Oncol 2022; 52:493-498. [PMID: 35079795 DOI: 10.1093/jjco/hyab216] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/31/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND despite the advances in preoperative hypofractionated-accelerated radiotherapy for patients with locally advanced rectal cancer, postoperative radiotherapy delivered with standard fractionation (46-50 Gy in 5 weeks) remains a standard adjuvant schedule. The role of hypofractionated-accelerated radiotherapy in a postoperative setting remains largely unexplored. METHODS eighty-eight patients with rectal cancer infiltrating the rectal wall and/or having metastasis to the perirectal lymph nodes were treated with surgery followed by adjuvant chemotherapy and, subsequently, with hypofractionated-accelerated radiotherapy. Ten fractions of 3.4 Gy were delivered to the pelvis for 10 consecutive fractions, within 12 days. The follow-up of patients alive at the time of analysis ranges from 12-120 months (median 48). RESULTS mild abdominal discomfort and diarrhoea were frequent, but medical medication was demanded in 14/88 (15.9%) of patients. The incidence of late toxicities was low; 4/88 (3.5%) patients complained for intermittent intestinal urgency. Locoregional recurrence occurred in 8/88 patients (9%). The 5-year locoregional relapse-free survival was achieved in 89.7% of patients, and this dropped to 84% in node-positive patients (P = 0.45). The 5-year disease-specific overall survival was 72.4%. Nodal involvement showed a trend to negatively affect prognosis (5-year overall survival 68.2 vs. 79.6%; P = 0.23). CONCLUSION postoperative hypofractionated-accelerated radiotherapy has minimal early and late toxicity. The locoregional control and disease-specific survival rates are similar to the expected from conventional postoperative chemoradiotherapy. The 2.5-fold decrease of radiotherapy treatment time, reduction of waiting lists and the lower overall cost of radiotherapy are additional benefits associated with hypofractionated-accelerated radiotherapy.
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Affiliation(s)
| | | | | | | | | | | | - Alexandra Giatromanolaki
- Department of Pathology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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11
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Schizas D, Papapanou M, Routsi E, Mastoraki A, Lidoriki I, Zavras N, Avgerinos DV, Lazaris AM, Tsaroucha A. Career barriers for women in surgery. Surgeon 2022; 20:275-283. [PMID: 34996719 DOI: 10.1016/j.surge.2021.11.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite the increasing numbers of female medical students, surgery remains male-dominated. PURPOSE To highlight the principal career obstacles experienced by aspiring female surgeons. METHODS A narrative review of literature on the position and career barriers of female surgeons has been conducted, using the MEDLINE and EMBASE databases. MAIN FINDINGS Implicit and even explicit biases against female surgeons remain prevalent, negatively impacting their training performance and overall professional trajectory. Female surgeons are globally underrepresented in leadership positions and senior academic rankings, especially that of a full professor. They feel hampered by lack of effective mentorship, whose value for a successful career has been acknowledged by all medical students, surgeons and surgical leaders. Their work-life imbalance is sometimes expressed as lower likelihood than their male contemporaries of getting married or having children and may be attributed to their conventional association with the role of caretaker, their personal desire to accommodate occupational and family duties and the inadequate implementation of parental leave and childcare policies. Female surgeons' "infertility" may be further explained by direct and indirect pregnancy-related difficulties. Female surgeons are also financially undercompensated compared to their male contemporaries. Finally, specialty-specific challenges should not be overlooked. CONCLUSIONS While encouraging steps have been made, women in surgery feel still hindered by various obstacles. The qualitative, interview-based nature of current literature requires more meticulous studies on these barriers with a more quantitative and objective approach. Attenuation of gender imbalance in surgical specialties requires further changes in mentality and more targeted modifications in relevant policies.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michail Papapanou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
| | - Eleni Routsi
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Aikaterini Mastoraki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Irene Lidoriki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Nikolaos Zavras
- Department of Pediatric Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Dimitrios V Avgerinos
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, NewYork Presbyterian, New York, NY, United States
| | - Andreas M Lazaris
- Department of Vascular Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Alexandra Tsaroucha
- Second Department of Surgery and Laboratory of Experimental Surgery, Democritus University of Thrace, Alexandroupolis, Greece
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12
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Kollaras V, Valsami G, Lambropoulou M, Konstandi O, Kostomistsopoulos N, Pikoulis E, Simopoulos C, Tsaroucha A. Effect of silibinin on the expression of MMP2, MMP3, MMP9 and TIMP2 in kidney and lung after hepatic ischemia/reperfusion injury in an experimental rat model. Acta Cir Bras 2021; 36:e360904. [PMID: 34755764 PMCID: PMC8580512 DOI: 10.1590/acb360904] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The protective effect of silibinin on kidney and lung parenchyma during hepatic ischemia/reperfusion injury (IRI) is explored. METHODS Sixty-three Wistar rats were separated into three groups: sham; control (45 min IRI); and silibinin (200 μL silibinin administration after 45 min of ischemia and before reperfusion). Immunohistochemistry and real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to evaluate the expression levels of MMP2, MMP3, MMP9, and TIMP2 on kidney and lung. RESULTS Comparing sham vs. control groups, confirmed that hepatic IRI increased both renal and lung MMP2, MMP3, MMP9 and TIMP2 expressions starting at 180 min (p<0.001). Comparison of the control vs. silibinin groups showed a statistically significant decrease in the expression levels of MMP2, MMP3, and MMP9 and increase of TIMP2 in kidney and lung parenchyma. The starting point of this decrease was at 120 min after reperfusion, both for kidney and lung parameters, and it was statistically significant at 240 min (p<0.001) for kidney, while silibinin showed a peak of lung protection at 180 min after hepatic reperfusion (p<0.001). CONCLUSIONS Hepatic IRI causes distant kidney and lung damage, while a statistically significant protective action, both on kidney and lung parenchyma, is conveyed by the intravenous administration of silibinin.
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13
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Sotiropoulou M, Katsaros I, Vailas M, Lidoriki I, Papatheodoridis GV, Kostomitsopoulos NG, Valsami G, Tsaroucha A, Schizas D. Nonalcoholic fatty liver disease: The role of quercetin and its therapeutic implications. Saudi J Gastroenterol 2021; 27:319-330. [PMID: 34810376 PMCID: PMC8656328 DOI: 10.4103/sjg.sjg_249_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/29/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease, affecting almost one-third of the general population and 75% of obese patients with type 2 diabetes. The aim of this article is to review the current evidence concerning the role of quercetin, a natural compound and flavonoid, and its possible therapeutic effects on this modern-day disease. Despite the fact that the exact pathophysiological mechanisms through which quercetin has a hepatoprotective effect on NAFLD are still not fully elucidated, this review clearly demonstrates that this flavonoid has potent antioxidative stress action and inhibitory effects on hepatocyte apoptosis, inflammation, and generation of reactive oxygen species, factors which are linked to the development of the disease. NAFLD is closely associated with increased dietary fat consumption, especially in Western countries. The hepatoprotective effect of quercetin against NAFLD merits serious consideration and further validation by future studies.
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Affiliation(s)
- Maria Sotiropoulou
- Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Ioannis Katsaros
- Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michail Vailas
- Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Irene Lidoriki
- Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - George V Papatheodoridis
- Department of Gastroenterology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Nikolaos G Kostomitsopoulos
- Center of Clinical, Experimental Surgery, and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Georgia Valsami
- Department of Pharmacy, Laboratory of Biopharmaceutics-Pharmacokinetics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Tsaroucha
- Laboratory of Experimental Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitrios Schizas
- Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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14
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Papachristou F, Anninou N, Koukoulis G, Paraskakis S, Sertaridou E, Tsalikidis C, Pitiakoudis M, Simopoulos C, Tsaroucha A. Differential effects of cisplatin combined with the flavonoid apigenin on HepG2, Hep3B, and Huh7 liver cancer cell lines. Mutat Res 2021; 866:503352. [PMID: 33985696 DOI: 10.1016/j.mrgentox.2021.503352] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
The potential of apigenin (APG) to enhance cisplatin's (CDDP) chemotherapeutic efficacy was investigated in HepG2, Hep3B, and Huh7 liver cancer cell lines. The presence of 20 μM APG sensitized all cell lines to CDDP treatment (degree of sensitization based on the MTT assay: HepG2>Huh7>Hep3B). As reflected by sister chromatid exchange levels, the degree of genetic instability as well as DNA repair by homologous recombination differed among cell lines. CDDP and 20 μM APG cotreatment exhibited a synergistic genotoxic effect on Hep3B cells and a less than additive effect on HepG2 and Huh7 cells. Cell cycle delays were noticed during the first mitotic division in Hep3B and Huh7 cells and the second mitotic division in HepG2 cells. CDDP and CDDP + APG treatments reduced the clonogenic capacity of all cell lines; however, there was a discordance in drug sensitivity compared with the MMT assay. Furthermore, a senescence-like phenotype was induced, especially in Hep3B and Huh7 cells. Unlike CDDP monotherapy, the combined treatment exhibited a significant anti-invasive and anti-migratory action in all cancer cell lines. The fact that the three liver cancer cell lines responded differently, yet positively, to CDDP + APG cotreatment could be attributed to variations they present in gene expression. Complex mechanisms seem to influence cellular responses and cell fate.
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Affiliation(s)
- Fotini Papachristou
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece; Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece.
| | - Nikolia Anninou
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Georgios Koukoulis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Stefanos Paraskakis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Eleni Sertaridou
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Christos Tsalikidis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Michael Pitiakoudis
- Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Constantinos Simopoulos
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece; Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
| | - Alexandra Tsaroucha
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece; Postgraduate Program in Hepatobiliary and Pancreatic Surgery, 2nd Department of Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, 68 100, Greece
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15
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Fassoulaki A, Tsaroucha A, Micha G, Soulioti E. Bibliometric analysis of alternative performance metrics for peri-operative, critical care and pain medicine journals. Anaesthesia 2021; 76:856-857. [PMID: 33636756 DOI: 10.1111/anae.15444] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Affiliation(s)
| | - A Tsaroucha
- Aretaieio University Hospital, Athens, Greece
| | - G Micha
- Aretaieio University Hospital, Athens, Greece
| | - E Soulioti
- Attikon University Hospital, Athens, Greece
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16
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Tsaroucha A, Kaldis V, Vailas M, Schizas D, Lambropoulou M, Papalois A, Tsigalou C, Gaitanidis A, Pitiakoudis M, Simopoulos C. The positive effect of eugenol on acute pancreatic tissue injury: a rat experimental model. Pan Afr Med J 2021; 38:132. [PMID: 33912302 PMCID: PMC8052617 DOI: 10.11604/pamj.2021.38.132.20202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/29/2019] [Accepted: 01/20/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction we present a rat experimental model used to evaluate the possible reduction in the extent of pancreatic tissue injury in acute pancreatitis cases, after administration of eugenol. Methods one hundred and twenty Wistar rats were used, which were randomly assigned in 3 groups: sham (n=20), control (n=50) and eugenol (n=50). Acute pancreatitis was induced by biliopancreatic ligation in the control and eugenol groups, but not in the Sham group. In the eugenol group, eugenol was administered per-os. Five histopathological parameters, such as edema, inflammatory infiltration, duct dilatation, hemorrhage and acinar necrosis were evaluated. Results at 72 h from acute pancreatitis induction, the total histological score was diminished in the eugenol group (p<0.0005) and duct dilatation and inflammatory infiltration were reduced compared to the control group (p<0.05). In addition, at 72 h, eugenol reduced pancreatic myeloperoxidase activity (p<0.0005). Conclusion eugenol, a highly free radical scavenger agent, may have a preventive role in acute pancreatic injury, as it was evident in our rat experimental model.
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Affiliation(s)
- Alexandra Tsaroucha
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,2nd Department of Surgery and Laboratory of Experimental Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vasileios Kaldis
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Michail Vailas
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,First Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,First Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Lambropoulou
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,Laboratory of Histology-Embryology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Apostolos Papalois
- Experimental-Research Department, ELPEN Pharmaceuticals, Pikermi, Attica, Greece
| | - Christina Tsigalou
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,Laboratory of Microbiology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Apostolos Gaitanidis
- 2nd Department of Surgery and Laboratory of Experimental Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Michael Pitiakoudis
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,2nd Department of Surgery and Laboratory of Experimental Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Constantinos Simopoulos
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,2nd Department of Surgery and Laboratory of Experimental Surgery, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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17
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Charalabopoulos A, Davakis S, Lambropoulou M, Papalois A, Simopoulos C, Tsaroucha A. Apigenin Exerts Anti-inflammatory Effects in an Experimental Model of Acute Pancreatitis by Down-regulating TNF-α. In Vivo 2019; 33:1133-1141. [PMID: 31280202 DOI: 10.21873/invivo.11583] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/06/2019] [Accepted: 06/10/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIM This study investigated the anti-inflammatory effect of apigenin in an experimental model of acute pancreatitis. Inflammatory response was reflected by tissue expression of the cytokine TNF-α coupled with histological examination. MATERIALS AND METHODS Wistar rats were divided into three groups: Sham-group animals underwent laparotomy only, without any other interventions. Control-group animals underwent laparotomy and bilio-pancreatic duct ligation to induce pancreatitis without apigenin administration. Apigenin group animals were further treated with apigenin. Euthanasia was performed at 6, 12, 24, 48 and 72 h post-operatively. RESULTS Over-expression of TNF-α in relation to postoperative time was observed in the control group (p<0.001). In the apigenin group, under-expression of TNF-α in relation to postoperative time was observed (p<0.013). At 72 h, apigenin reduced pancreatic TNF-α expression and prevented pancreatic necrosis. CONCLUSION Apigenin slows progression and reduces severity of acute pancreatitis. Apigenin may serve as an adjunct to a more successful therapeutic strategy in acute pancreatitis.
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Affiliation(s)
- Alexandros Charalabopoulos
- Department of Upper Gastrointestinal and General Surgery, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Essex, U.K.,Experimental-Research Center, ELPEN Pharmaceuticals, Athens, Greece
| | - Spyridon Davakis
- Department of Upper Gastrointestinal and General Surgery, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Essex, U.K. .,First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Lambropoulou
- Department of Histopathology, Faculty of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | | | - Constantinos Simopoulos
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Alexandra Tsaroucha
- Laboratory of Experimental Surgery and Surgical Research, Faculty of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
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18
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Bourogianni O, Pagonidis K, Stathaki M, Tsaroucha A, Papadaki E, Koukouraki S. Pleuropericardial Cyst Mimicking a Metastasis of Differentiated Thyroid Carcinoma on Whole-Body Iodine-131 Scan: a Case Report. Nucl Med Mol Imaging 2019; 53:361-365. [PMID: 31723367 DOI: 10.1007/s13139-019-00604-y] [Citation(s) in RCA: 1] [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] [Received: 01/16/2019] [Revised: 05/02/2019] [Accepted: 07/16/2019] [Indexed: 11/24/2022] Open
Abstract
Post-therapeutic whole-body scan (WBS) with I-131 has been widely used for the follow-up of patients with well-differentiated thyroid cancer (DTC). Although the sensitivity of WBS with I-131 in detection of functioning thyroid tissues is high, its specificity is low. So, a further evaluation is required in cases of unexpected findings. The purpose of the study was to demonstrate that awareness of the potential pitfalls of WBS in DTC, knowledge of physiology and characteristics of radioiodine uptake, and correlation with other imaging modalities are needed to avoid incorrect management of patients with DTC. This is a case report of a 49-year-old woman with an unexpected area of increased I-131 uptake in the posterior lower chest, which was finally diagnosed as a pleuropericardial cyst. Due to the false-positive uptake of I-131 in the chest, an accurate interpretation of the scintigraphic findings should be made.
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Affiliation(s)
- O Bourogianni
- Department of Nuclear Medicine, University Hospital, Heraklion, Crete, Greece
| | - K Pagonidis
- 2Department of Radiology, University of Crete Medical School, Heraklion, Greece
| | - M Stathaki
- Department of Nuclear Medicine, University Hospital, Heraklion, Crete, Greece
| | - A Tsaroucha
- Department of Nuclear Medicine, University Hospital, Heraklion, Crete, Greece
| | - E Papadaki
- Department of Nuclear Medicine, University Hospital, Heraklion, Crete, Greece
| | - S Koukouraki
- 3Department of Nuclear Medicine, University of Crete Medical School, Heraklion, Greece
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Panagiotou A, Tsaroucha A, Chalkias A, Giannaraki S, Romana C. Measurement of cardiac biomarkers in open lobectomies: comparison of combined thoracic epidural anesthesia with general anesthesia to general anesthesia alone. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.034] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Symeonidis N, Lambropoulou M, Pavlidis E, Anagnostopoulos C, Tsaroucha A, Kotini A, Nikolaidou C, Kiziridou A, Simopoulos C. PAK1 Expression in Pancreatic Cancer: Clinicopathological Characteristics and Prognostic Significance. Clin Med Insights Oncol 2019; 13:1179554919831990. [PMID: 30799970 PMCID: PMC6379789 DOI: 10.1177/1179554919831990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/17/2019] [Indexed: 12/15/2022]
Abstract
Background: Improvement of the management of pancreatic cancer requires a better
understanding of the genetic and molecular changes responsible for the
development of the disease. The family of p21-activated kinases (PAKs) and
especially PAK1 appears to mediate many cellular processes that contribute
to the development and progression of pancreatic cancer, but the clinical
relevance of PAK1 expression with the disease still remains unclear. Aim of
the study was to assess the clinical value and the potential prognostic
significance of PAK1 in pancreatic adenocarcinoma. Methods: We investigated the relationship between the PAK1 expression and the clinical
and histopathologic characteristics of pancreatic cancer patients and the
potential significance of PAK1 on survival. We examined tissue samples from
51 patients operated for pancreatic cancer. PAK1 expression was investigated
with immunohistochemistry and correlated to clinicopathological
parameters. Results: PAK1 was detected in all tumor samples and high expression was found in most
patients. High PAK1 expression was also associated with younger age and
well-differentiated tumors, but no association was found between PAK1
expression and Tumor-Node-Metastasis stage as well as deceased or alive
status on follow-up. Moderate to high PAK1 expression favored higher 6-month
and 1-year survival and low PAK1 expression 2-year survival but without
statistical significance. Conclusions Our results indicate that PAK1 could potentially be used as a prognostic
marker in pancreatic cancer. Further studies could clarify whether
utilization of PAK1 in therapeutic protocols for the treatment of pancreatic
cancer will render them more effective.
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Affiliation(s)
- Nikolaos Symeonidis
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,2nd Surgical Propedeutic Department, Hippokratio General Hospital, Thessaloniki, Greece
| | - Maria Lambropoulou
- Laboratory of Histology-Embryology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Efstathios Pavlidis
- Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Alexandra Tsaroucha
- 2nd Department of Surgery and Laboratory of Experimental Surgery-Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Athanasia Kotini
- Laboratory of Medical Physics, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Nikolaidou
- Laboratory of Histology-Embryology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Anastasia Kiziridou
- Department of Pathology, Theagenio Anticancer Hospital, Thessaloniki, Greece
| | - Constantinos Simopoulos
- 2nd Department of Surgery and Laboratory of Experimental Surgery-Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Gaitanidis A, Alevizakos M, Tsalikidis C, Tsaroucha A, Simopoulos C, Pitiakoudis M. Refusal of Cancer-Directed Surgery by Breast Cancer Patients: Risk Factors and Survival Outcomes. Clin Breast Cancer 2018; 18:e469-e476. [DOI: 10.1016/j.clbc.2017.07.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 11/13/2022]
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Gaitanidis A, Alevizakos M, Tsaroucha A, Pitiakoudis M. Outcomes After Surgical Resection Differ by Primary Tumor Location for Metastatic Gastrointestinal Stromal Tumors (GISTs): a Propensity Score Matching Population Study. J Gastrointest Cancer 2018; 50:750-758. [PMID: 30033508 DOI: 10.1007/s12029-018-0137-9] [Citation(s) in RCA: 1] [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: 01/10/2023]
Abstract
PURPOSE Primary tumor location has been identified as an important prognostic factor among patients with gastrointestinal stromal tumors (GISTs). The purpose of this study is to identify how primary tumor location may affect outcomes after resection for patients with metastatic GISTs. METHODS Patients with GISTs and distant metastases at diagnosis were identified in the Surveillance Epidemiology and End Results (SEER) database. Patients that underwent surgery were matched to patients that did not undergo surgery using propensity score matching (PSM) analysis. RESULTS After PSM, 570 patients were identified (males 334 [58.6%], females 236 [41.4%], age 62 ± 13.9 years). Gastric tumors constituted the majority (325 [57%]), followed by small intestinal (136 [23.9%]), colorectal (19 [3.3%]), and retroperitoneal/peritoneal tumors (23 [4%]). Median follow-up was 25.5 months (95% CI 23-29 months). Undergoing surgery was associated with improved disease-specific survival (DSS) on both univariate (median not reached vs. 51 months, p < 0.001) and multivariate analyses (HR 4.98, 95% CI 2.23-11.12, p < 0.001). A sub-analysis of patients with gastric GISTs showed that undergoing surgery was the only significant factor associated with improved DSS (median not reached vs. 39 months, p < 0.001, HR 2.95, 95% CI 1.92-4.53). In contrast, undergoing surgery was not associated with improved survival for small intestinal, colorectal, or retroperitoneal/peritoneal tumors. CONCLUSIONS Surgery for gastric metastatic GISTs is associated with improved survival. No discernible benefit after surgical resection was identified for patients with small intestinal, colorectal, retroperitoneal, or peritoneal metastatic GISTs.
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Affiliation(s)
- Apostolos Gaitanidis
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 68100, Alexandroupoli, Greece.
| | - Michail Alevizakos
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Alexandra Tsaroucha
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 68100, Alexandroupoli, Greece
| | - Michail Pitiakoudis
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 68100, Alexandroupoli, Greece
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Gaitanidis A, Alevizakos M, Tsaroucha A, Tsalikidis C, Pitiakoudis M. Predictive Nomograms for Synchronous Distant Metastasis in Rectal Cancer. J Gastrointest Surg 2018; 22:1268-1276. [PMID: 29663304 DOI: 10.1007/s11605-018-3767-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/28/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Nomograms may be used to quantitatively assess the probability of synchronous distant metastasis. The purpose of this study is to develop predictive nomograms for the presence of synchronous distant metastasis in patients with rectal cancer. METHODS A retrospective analysis of the Surveillance Epidemiology and End Results database was performed for cases diagnosed between 2010 and 2014. RESULTS Overall, 46,785 patients with rectal cancer (27,773 [59.4%] males, mean age 63.9 ± 13.7 years) were identified, of which 6192 (13.2%) had liver metastasis, 2767 (5.9%) had lung metastasis, and 601 (1.3%) had bone metastasis. Age, sex, race, tumor location, tumor grade, primary tumor size, CEA levels, perineural invasion, T stage, N stage, and liver and lung metastasis were found to be associated with the presence of synchronous distant metastasis and were included in the predictive models. The c-indexes of these models were 0.99 for liver metastasis, 0.99 for lung metastasis, and 1 for bone metastasis. CONCLUSIONS Predictive nomograms for the presence of synchronous liver, lung, and bone metastasis were developed and may be used to predict the probability of distant disease in rectal cancer patients.
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Affiliation(s)
- Apostolos Gaitanidis
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 681 00, Alexandroupoli, Greece.
| | - Michail Alevizakos
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Alexandra Tsaroucha
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 681 00, Alexandroupoli, Greece
| | - Christos Tsalikidis
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 681 00, Alexandroupoli, Greece
| | - Michail Pitiakoudis
- Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 681 00, Alexandroupoli, Greece
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Pavlidis ET, Lambropoulou M, Symeonidis NG, Anagnostopoulos C, Tsaroucha A, Kotini A, Nikolaidou C, Kiziridou A, Simopoulos C. The Immunohistochemical Expression MTA 1 Protein and its Prognostic Value in Pancreatic Cancer. J INVEST SURG 2018; 31:142-150. [PMID: 28635511 DOI: 10.1080/08941939.2017.1280565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose/aim: To examine with immunohistochemical assay MTA1 protein expression levels in pancreatic cancer tissues defining its prognostic value. MATERIAL AND METHODS The specimens derived from 51 patients who underwent surgery. The levels of MTA1 protein were compared with the age of the patients, their survival, and prognosis. Also, we studied clinical and histopathological factors such as the degree of tumor differentiation and its stage in correlation with MTA1 protein levels. In parallel, there was correlation between the expression of the ΜΤΑ1 protein and the aforementioned factors regarding survival rate. Furthermore, we independently correlated the patient's survival in relation to whether they had undergone adjuvant chemotherapy or not. RESULTS It has been found to be low, moderate, or high expression of MTA1 levels in 48 out of 51 cancer tissues. Specifically, 49.0% of patients had low expression, 33.3% moderate, and 11.8% high expression of MTA1. Regarding the expression of MTA1 protein in correlation with various clinical and histopathological factors, a statistically significant correlation was observed with the degree of differentiation (p = 0.0068) and with the stage of the disease (p = 0.0173), but not with survival (p = 0.0740) or the age of them (p = 0.1547). Finally, it was found that overexpression of the MTA1protein is a prognostic factor for shorter survival in patients with pancreatic cancer (average 4.67 ± 0.95 months). CONCLUSIONS MTA 1 protein may constitute an important prognostic marker in pancreatic cancer and could improve prognosis and treatment.
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Affiliation(s)
- Efstathios T Pavlidis
- c 2nd Department of Surgery and Laboratory of Experimental Surgery - Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine , Democritus University of Thrace , 68 100 Alexandroupolis , Greece
| | | | - Nikolaos G Symeonidis
- c 2nd Department of Surgery and Laboratory of Experimental Surgery - Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine , Democritus University of Thrace , 68 100 Alexandroupolis , Greece
| | | | - Alexandra Tsaroucha
- d Laboratories of Medical Physics, Department of Pathology , Theagenio Anticancer Hospital , Thessaloniki , Greece
| | - Athanasia Kotini
- d Laboratories of Medical Physics, Department of Pathology , Theagenio Anticancer Hospital , Thessaloniki , Greece
| | | | - Anastasia Kiziridou
- d Laboratories of Medical Physics, Department of Pathology , Theagenio Anticancer Hospital , Thessaloniki , Greece
| | - Constantinos Simopoulos
- c 2nd Department of Surgery and Laboratory of Experimental Surgery - Postgraduate Program in Hepatobiliary/Pancreatic Surgery, School of Medicine , Democritus University of Thrace , 68 100 Alexandroupolis , Greece
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Gaitanidis A, Alevizakos M, Tsaroucha A, Pitiakoudis M. Impact of age on treatment approach and survival in patients with malignant intraductal papillary mucinous neoplasms (IPMNs). Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.01.227] [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: 11/25/2022] Open
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Gaitanidis A, Alevizakos M, Tsaroucha A, Tsalikidis C, Simopoulos C, Pitiakoudis M. Conditional survival analysis for patients with intraductal papillary mucinous neoplasms (IPMNs) undergoing curative resection. Eur J Surg Oncol 2018; 44:693-699. [PMID: 29426780 DOI: 10.1016/j.ejso.2018.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/13/2017] [Accepted: 01/05/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Conditional survival (CS) analysis represents a novel method that may provide more clinically relevant perspectives to cancer management compared to conventional survival analysis. The purpose of this study was to evaluate conditional survival for patients with intraductal papillary mucinous neoplasms (IPMNs) undergoing curative resection. METHODS A retrospective search of the Surveillance Epidemiology and End Results (SEER) database was performed. Three-year conditional survival (i.e. probability that a patient will survive an additional 3 years if they have already survived x years) was calculated using the formula 3-CS(x)=OS(x+3)/OS(x), where OS represents overall survival. RESULTS Overall, 1303 patients were identified, with mean age of 65.2 ± 12.2 years. 3-CS at 1, 3 and 5 years after diagnosis was 35.8%, 47.5% and 44.7%. Patients with stage III/IV disease demonstrated small differences in 3-CS at 1-3 years after diagnosis compared to patients with stage I/II disease (I/II: 35.1%-46.9%, III/IV: 22.1%-42.3%, d range 0.09-0.28), while their 3-CS was superior at 4-5 years after diagnosis (I/II: 41.5%-45.7%, III/IV: 57.9%-64.7%, d range 0.24-0.47). Differences in 3-CS based on tumor grade displayed a different pattern, with small differences at 1-3 years after diagnosis (well-differentiated (WD)/moderately-differentiated (MD): 34.6%-50%, poorly-differentiated (PD)/undifferentiated (UD): 23.2%-40%, d range 0.18-0.24), before becoming prominent at 4-5 years after diagnosis (WD/MD: 50%-51.7%, PD/UD: 24.1%-30%, d range 0.4-0.55). CONCLUSIONS Conditional survival for patients with IPMNs undergoing resection improves over time, especially for patients with high-risk features. This information may be used to provide individualized approaches to surveillance and treatment.
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Affiliation(s)
- Apostolos Gaitanidis
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece.
| | - Michail Alevizakos
- University of Pittsburgh Medical Center, Department of Medicine, Pittsburgh, PA, USA
| | - Alexandra Tsaroucha
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
| | - Christos Tsalikidis
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
| | - Constantinos Simopoulos
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
| | - Michail Pitiakoudis
- Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece
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Gaitanidis A, Alevizakos M, Tsaroucha A, Pitiakoudis M. 998. Impact of age on treatment approach and survival in patients with malignant intraductal papillary mucinous neoplasms (IPMNs). Eur J Surg Oncol 2017. [DOI: 10.1016/j.ejso.2017.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Targher G, Dauriz M, Laroche C, Temporelli PL, Hassanein M, Seferovic PM, Drozdz J, Ferrari R, Anker S, Coats A, Filippatos G, Crespo‐Leiro MG, Mebazaa A, Piepoli MF, Maggioni AP, Tavazzi L, Crespo‐Leiro M, Anker S, Coats A, Ferrari R, Filippatos G, Maggioni A, Mebazaa A, Piepoli M, Amir O, Chioncel O, Dahlström U, Jimenez JD, Drozdz J, Erglis A, Fazlibegovic E, Fonseca C, Fruhwald F, Gatzov P, Goncalvesova E, Hassanein M, Hradec J, Kavoliuniene A, Lainscak M, Logeart D, Merkely B, Metra M, Otljanska M, Seferovic P, Kostovska ES, Temizhan A, Tousoulis D, Andarala M, Ferreira T, Fiorucci E, Gracia G, Laroche C, Pommier C, Taylor C, Cuculici A, Gaulhofer C, Casado EP, Szymczyk E, Ramani F, Mulak G, Schou IL, Semenka J, Stojkovic J, Mehanna R, Mizarienne V, Auer J, Ablasser K, Fruhwald F, Dolze T, Brandner K, Gstrein S, Poelzl G, Moertl D, Reiter S, Podczeck‐Schweighofer A, Muslibegovic A, Vasilj M, Fazlibegovic E, Cesko M, Zelenika D, Palic B, Pravdic D, Cuk D, Vitlianova K, Katova T, Velikov T, Kurteva T, Gatzov P, Kamenova D, Antova M, Sirakova V, Krejci J, Mikolaskova M, Spinar J, Krupicka J, Malek F, Hegarova M, Lazarova M, Monhart Z, Hassanein M, Sobhy M, El Messiry F, El Shazly A, Elrakshy Y, Youssef A, Moneim A, Noamany M, Reda A, Dayem TA, Farag N, Halawa SI, Hamid MA, Said K, Saleh A, Ebeid H, Hanna R, Aziz R, Louis O, Enen M, Ibrahim B, Nasr G, Elbahry A, Sobhy H, Ashmawy M, Gouda M, Aboleineen W, Bernard Y, Luporsi P, Meneveau N, Pillot M, Morel M, Seronde M, Schiele F, Briand F, Delahaye F, Damy T, Eicher J, Groote P, Fertin M, Lamblin N, Isnard R, Lefol C, Thevenin S, Hagege A, Jondeau G, Logeart D, Le Marcis V, Ly J, Coisne D, Lequeux B, Le Moal V, Mascle S, Lotton P, Behar N, Donal E, Thebault C, Ridard C, Reynaud A, Basquin A, Bauer F, Codjia R, Galinier M, Tourikis P, Stavroula M, Tousoulis D, Stefanadis C, Chrysohoou C, Kotrogiannis I, Matzaraki V, Dimitroula T, Karavidas A, Tsitsinakis G, Kapelios C, Nanas J, Kampouri H, Nana E, Kaldara E, Eugenidou A, Vardas P, Saloustros I, Patrianakos A, Tsaknakis T, Evangelou S, Nikoloulis N, Tziourganou H, Tsaroucha A, Papadopoulou A, Douras A, Polgar L, Merkely B, Kosztin A, Nyolczas N, Nagy AC, Halmosi R, Elber J, Alony I, Shotan A, Fuhrmann AV, Amir O, Romano S, Marcon S, Penco M, Di Mauro M, Lemme E, Carubelli V, Rovetta R, Metra M, Bulgari M, Quinzani F, Lombardi C, Bosi S, Schiavina G, Squeri A, Barbieri A, Di Tano G, Pirelli S, Ferrari R, Fucili A, Passero T, Musio S, Di Biase M, Correale M, Salvemini G, Brognoli S, Zanelli E, Giordano A, Agostoni P, Italiano G, Salvioni E, Copelli S, Modena M, Reggianini L, Valenti C, Olaru A, Bandino S, Deidda M, Mercuro G, Dessalvi CC, Marino P, Di Ruocco M, Sartori C, Piccinino C, Parrinello G, Licata G, Torres D, Giambanco S, Busalacchi S, Arrotti S, Novo S, Inciardi R, Pieri P, Chirco P, Galifi MA, Teresi G, Buccheri D, Minacapelli A, Veniani M, Frisinghelli A, Priori S, Cattaneo S, Opasich C, Gualco A, Pagliaro M, Mancone M, Fedele F, Cinque A, Vellini M, Scarfo I, Romeo F, Ferraiuolo F, Sergi D, Anselmi M, Melandri F, Leci E, Iori E, Bovolo V, Pidello S, Frea S, Bergerone S, Botta M, Canavosio F, Gaita F, Merlo M, Cinquetti M, Sinagra G, Ramani F, Fabris E, Stolfo D, Artico J, Miani D, Fresco C, Daneluzzi C, Proclemer A, Cicoira M, Zanolla L, Marchese G, Torelli F, Vassanelli C, Voronina N, Erglis A, Tamakauskas V, Smalinskas V, Karaliute R, Petraskiene I, Kazakauskaite E, Rumbinaite E, Kavoliuniene A, Vysniauskas V, Brazyte‐Ramanauskiene R, Petraskiene D, Stankala S, Switala P, Juszczyk Z, Sinkiewicz W, Gilewski W, Pietrzak J, Orzel T, Kasztelowicz P, Kardaszewicz P, Lazorko‐Piega M, Gabryel J, Mosakowska K, Bellwon J, Rynkiewicz A, Raczak G, Lewicka E, Dabrowska‐Kugacka A, Bartkowiak R, Sosnowska‐Pasiarska B, Wozakowska‐Kaplon B, Krzeminski A, Zabojszcz M, Mirek‐Bryniarska E, Grzegorzko A, Bury K, Nessler J, Zalewski J, Furman A, Broncel M, Poliwczak A, Bala A, Zycinski P, Rudzinska M, Jankowski L, Kasprzak J, Michalak L, Soska KW, Drozdz J, Huziuk I, Retwinski A, Flis P, Weglarz J, Bodys A, Grajek S, Kaluzna‐Oleksy M, Straburzynska‐Migaj E, Dankowski R, Szymanowska K, Grabia J, Szyszka A, Nowicka A, Samcik M, Wolniewicz L, Baczynska K, Komorowska K, Poprawa I, Komorowska E, Sajnaga D, Zolbach A, Dudzik‐Plocica A, Abdulkarim A, Lauko‐Rachocka A, Kaminski L, Kostka A, Cichy A, Ruszkowski P, Splawski M, Fitas G, Szymczyk A, Serwicka A, Fiega A, Zysko D, Krysiak W, Szabowski S, Skorek E, Pruszczyk P, Bienias P, Ciurzynski M, Welnicki M, Mamcarz A, Folga A, Zielinski T, Rywik T, Leszek P, Sobieszczanska‐Malek M, Piotrowska M, Kozar‐Kaminska K, Komuda K, Wisniewska J, Tarnowska A, Balsam P, Marchel M, Opolski G, Kaplon‐Cieslicka A, Gil R, Mozenska O, Byczkowska K, Gil K, Pawlak A, Michalek A, Krzesinski P, Piotrowicz K, Uzieblo‐Zyczkowska B, Stanczyk A, Skrobowski A, Ponikowski P, Jankowska E, Rozentryt P, Polonski L, Gadula‐Gacek E, Nowalany‐Kozielska E, Kuczaj A, Kalarus Z, Szulik M, Przybylska K, Klys J, Prokop‐Lewicka G, Kleinrok A, Aguiar CT, Ventosa A, Pereira S, Faria R, Chin J, De Jesus I, Santos R, Silva P, Moreno N, Queirós C, Lourenço C, Pereira A, Castro A, Andrade A, Guimaraes TO, Martins S, Placido R, Lima G, Brito D, Francisco A, Cardiga R, Proenca M, Araujo I, Marques F, Fonseca C, Moura B, Leite S, Campelo M, Silva‐Cardoso J, Rodrigues J, Rangel I, Martins E, Correia AS, Peres M, Marta L, Silva GF, Severino D, Durao D, Leao S, Magalhaes P, Moreira I, Cordeiro AF, Ferreira C, Araujo C, Ferreira A, Baptista A, Radoi M, Bicescu G, Vinereanu D, Sinescu C, Macarie C, Popescu R, Daha I, Dan G, Stanescu C, Dan A, Craiu E, Nechita E, Aursulesei V, Christodorescu R, Otasevic P, Seferovic P, Simeunovic D, Ristic A, Celic V, Pavlovic‐Kleut M, Lazic JS, Stojcevski B, Pencic B, Stevanovic A, Andric A, Iric‐Cupic V, Jovic M, Davidovic G, Milanov S, Mitic V, Atanaskovic V, Antic S, Pavlovic M, Stanojevic D, Stoickov V, Ilic S, Ilic MD, Petrovic D, Stojsic S, Kecojevic S, Dodic S, Adic NC, Cankovic M, Stojiljkovic J, Mihajlovic B, Radin A, Radovanovic S, Krotin M, Klabnik A, Goncalvesova E, Pernicky M, Murin J, Kovar F, Kmec J, Semjanova H, Strasek M, Iskra MS, Ravnikar T, Suligoj NC, Komel J, Fras Z, Jug B, Glavic T, Losic R, Bombek M, Krajnc I, Krunic B, Horvat S, Kovac D, Rajtman D, Cencic V, Letonja M, Winkler R, Valentincic M, Melihen‐Bartolic C, Bartolic A, Vrckovnik MP, Kladnik M, Pusnik CS, Marolt A, Klen J, Drnovsek B, Leskovar B, Anguita MF, Page JG, Martinez FS, Andres J, Genis A, Mirabet S, Mendez A, Garcia‐Cosio L, Roig E, Leon V, Gonzalez‐Costello J, Muntane G, Garay A, Alcade‐Martinez V, Fernandez SL, Rivera‐Lopez R, Puga‐Martinez M, Fernandez‐Alvarez M, Serrano‐Martinez J, Crespo‐Leiro M, Grille‐Cancela Z, Marzoa‐Rivas R, Blanco‐Canosa P, Paniagua‐Martin M, Barge‐Caballero E, Cerdena IL, Baldomero IFH, Padron AL, Rosillo SO, Gonzalez‐Gallarza RD, Montanes OS, Manjavacas AI, Conde AC, Araujo A, Soria T, Garcia‐Pavia P, Gomez‐Bueno M, Cobo‐Marcos M, Alonso‐Pulpon L, Cubero JS, Sayago I, Gonzalez‐Segovia A, Briceno A, Subias PE, Hernandez MV, Cano MR, Sanchez MG, Jimenez JD, Garrido‐Lestache EB, Pinilla JG, Villa BG, Sahuquillo A, Marques RB, Calvo FT, Perez‐Martinez M, Gracia‐Rodenas M, Garrido‐Bravo IP, Pastor‐Perez F, Pascual‐Figal D, Molina BD, Orus J, Gonzalo FE, Bertomeu V, Valero R, Martinez‐Abellan R, Quiles J, Rodrigez‐Ortega J, Mateo I, ElAmrani A, Fernandez‐Vivancos C, Valero DB, Almenar‐Bonet L, Sanchez‐Lazaro I, Marques‐Sule E, Facila‐Rubio L, Perez‐Silvestre J, Garcia‐Gonzalez P, Ridocci‐Soriano F, Garcia‐Escriva D, Pellicer‐Cabo A, Fuente Galan L, Diaz JL, Platero AR, Arias J, Blasco‐Peiro T, Julve MS, Sanchez‐Insa E, Aured‐Guallar C, Portoles‐Ocampo A, Melin M, Hägglund E, Stenberg A, Lindahl I, Asserlund B, Olsson L, Dahlström U, Afzelius M, Karlström P, Tengvall L, Wiklund P, Olsson B, Kalayci S, Temizhan A, Cavusoglu Y, Gencer E, Yilmaz M, Gunes H. In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the
ESC‐HFA
Heart Failure Long‐Term Registry. Eur J Heart Fail 2016; 19:54-65. [DOI: 10.1002/ejhf.679] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/24/2016] [Accepted: 09/20/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Marco Dauriz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Cécile Laroche
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
| | | | | | | | | | - Roberto Ferrari
- Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research E.S: Health Science Foundation Cotignola Italy
| | - Stephan Anker
- Innovative Clinical Trials, Department of Cardiology & Pneumology University Medical Center Göttingen (UMG) Göttingen Germany
| | - Andrew Coats
- Monash University Australia and University of Warwick Coventry UK
| | | | - Maria G. Crespo‐Leiro
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Complexo Hospitalario Universitario A Coruna CHUAC La Coruna Spain
| | - Alexandre Mebazaa
- Inserm 942, Hôpital Lariboisière Université Paris Diderot Paris France
| | - Massimo F. Piepoli
- Department of Cardiology Polichirurgico Hospital G. da Saliceto Piacenza Italy
| | - Aldo Pietro Maggioni
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
- ANMCO Research Center Florence Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research E.S. Health Science Foundation Cotignola Italy
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Nagorni EA, Kouklakis G, Tsaroucha A, Foutzitzi S, Courcoutsakis N, Romanidis K, Vafiadis K, Pitiakoudis M. Post-laparoscopic cholecystectomy Mirizzi syndrome induced by polymeric surgical clips: a case report and review of the literature. J Med Case Rep 2016; 10:135. [PMID: 27387334 PMCID: PMC4937585 DOI: 10.1186/s13256-016-0932-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/05/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Laparoscopic cholecystectomy is the gold standard treatment of gallbladder disease. Post-cholecystectomy syndrome is a severe postoperative complication which can be caused by multiple mechanisms and can present with multiple disorders. The wide use of laparoscopy induces the need to understand more clearly the presentation and pathophysiology of this syndrome. Post-cholecystectomy Mirizzi syndrome is one form of this syndrome and, according to literature, this is the first report that clearly describes it. CASE PRESENTATION We describe the case of a 62-year-old Greek woman who underwent laparoscopic cholecystectomy because of gallstone disease. A few days after surgery, post-cholecystectomy syndrome gradually developed with mild bilirubin increase in association with epigastric pain, nausea, and vomiting. After performing ultrasound, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography, we conducted a second laparoscopic surgery to manage the obstruction, which was converted to open surgery because of the remaining inflammation from the post-endoscopic retrograde cholangiopancreatography acute pancreatitis. Four polymeric laparoscopic clips were removed because they were identified as the cause of her post-cholecystectomy syndrome. She had a quick recovery without further complications. CONCLUSIONS Postoperative Mirizzi syndrome induced by the migration of polymer laparoscopic clips is a rare (only one case referring to polymeric clips has been published in the literature) but a well-identified complication of laparoscopic cholecystectomy which can confuse the diagnostic and therapeutic field requiring simultaneous immediate management.
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Affiliation(s)
- Eleni-Aikaterini Nagorni
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Georgios Kouklakis
- Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece
| | - Alexandra Tsaroucha
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece
| | - Soultana Foutzitzi
- Department of Radiology and Medical Imaging, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece
| | - Nikos Courcoutsakis
- Department of Radiology and Medical Imaging, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece
| | | | - Michael Pitiakoudis
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece
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Nagorni EA, Kavazis C, Tsalikidis C, Tsaroucha A, Pitiakoudis M. The necessity of a well-structured and qualitative training program for laparoscopic colectomy remains critical. Ann Laparosc Endosc Surg 2016. [DOI: 10.21037/ales.2016.09.09] [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: 11/06/2022]
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Lambropoulou M, Deftereou TE, Kynigopoulos S, Patsias A, Anagnostopoulos C, Alexiadis G, Kotini A, Tsaroucha A, Nikolaidou C, Kiziridou A, Papadopoulos N, Chatzaki E. Co-expression of galectin-3 and CRIP-1 in endometrial cancer: prognostic value and patient survival. Med Oncol 2015; 33:8. [PMID: 26708131 DOI: 10.1007/s12032-015-0723-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 12/14/2015] [Indexed: 12/29/2022]
Abstract
Endometrial cancer is the sixth most common cancer in women. Galectin-3 (GAL-3) and CRIP-1 are multifunctional proteins which seem to be involved in many neoplasias. This study aims to point out correlations between clinicopathological findings and endometrial cancer patient survival to GAL-3 and CRIP-1 expression in order to enfold their diagnostic/prognostic potential. Tissues from 46 patients diagnosed with endometrial cancer were studied by immunohistochemistry, using monoclonal antibodies for GAL-3 and CRIP-1, and expression levels were correlated with clinicopathological findings and survival. Analysis was performed at single protein level or as co-expression. High expression of GAL-3 and CRIP-1 was independently associated with tumor depth and histological grade, respectively. Also, there was a significant correlation between high co-expression of the two proteins and the histological grade (aOR 2.66), the tumor depth (aOR 0.32) and the histological type (aOR 1.32), but not with the patients' age. Moreover, high expression of both proteins was observed in patients with shorter survival times. Interestingly, the co-expression of the two proteins exhibited some degree of monotony (Spearman's ρ = 0.768), indicating a common molecular pathway. This study provides evidence for a prognostic clinical potential of the combined study of GAL-3 and CRIP-1 in endometrial cancer. These factors are poorly studied in endometrium, and their role in the carcinogenetic process and on effective therapy awaits further elucidation.
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Affiliation(s)
- Maria Lambropoulou
- Laboratories of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana, 68 100, Alexandroupolis, Greece.
| | - Theodora-Eleftheria Deftereou
- Laboratories of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana, 68 100, Alexandroupolis, Greece
| | - Sryridon Kynigopoulos
- Laboratories of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana, 68 100, Alexandroupolis, Greece
| | - Anargyros Patsias
- Laboratories of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana, 68 100, Alexandroupolis, Greece
| | - Constantinos Anagnostopoulos
- Laboratories of Biochemistry, School of Medicine, Democritus University of Thrace, 68 100, Alexandroupolis, Greece
| | - Georgios Alexiadis
- Private Radiodiagnostic Center of Alexandroupolis, Theagenio Anticancer Hospital, Thessaloniki, Greece
| | - Athanasia Kotini
- Laboratories of Medical Physics, School of Medicine, Democritus University of Thrace, 68 100, Alexandroupolis, Greece
| | - Alexandra Tsaroucha
- Laboratories of Department of Surgery, School of Medicine, Democritus University of Thrace, 68 100, Alexandroupolis, Greece
| | - Christina Nikolaidou
- Laboratories of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana, 68 100, Alexandroupolis, Greece
| | | | - Nikolaos Papadopoulos
- Laboratories of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana, 68 100, Alexandroupolis, Greece
| | - Ekaterini Chatzaki
- Laboratories of Pharmacology, School of Medicine, Democritus University of Thrace, 68 100, Alexandroupolis, Greece
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Skondras I, Lambropoulou M, Tsaroucha A, Gardikis S, Tripsianis G, Simopoulos C, Vaos G. The role of Apigenin in testicular damage in experimental ischemia-reperfusion injury in rats. Hippokratia 2015; 19:225-230. [PMID: 27418781 PMCID: PMC4938469] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Testicular torsion is an acute urologic emergency occurring in male newborns, children or adolescents. Prolonged ischemia for more than six hours can lead to irreversible testicular damage. Surgical detorsion allows reperfusion and is the only treatment currently available. The aim of this study was to evaluate the antioxidant effect of apigenin (APG) on the testicular ischemia-reperfusion (I/R) injury. METHODS Forty-two Wistar rats were randomly divided into five groups. Sham group underwent operation of the left testis. In the torsion-detorsion groups C15 and C120, the left testis was rotated 1080(o) for three hours. The treatment groups Ap15 and Ap120 received the same surgical procedure as groups C15 and C120, but APG was administered intravenously at the same time of detorsion via the right femoral vein. Left orchiectomy was performed 15 min after detorsion at groups C15 and Ap15, and at 120 min at groups C120 and Ap120 for histopathologic and immunohistochemical evaluation. RESULTS In I/R-untreated groups C15 and C120, there was a moderate to severe distortion of the tubules with lesions that varied between grades III and IV according to histopathological finding. In APG-treated groups Ap15 and Ap120, most of the lesions showed injuries of grades II and III with mild and moderate histopathological features. In Terminal deoxynucleotide transferase dUTP Nick End Labeling (Tunel) assay, APG-treated animals showed a statistically significantly decreased number of apoptotic cells compared to groups C15 and C120. CONCLUSION Intravenous administration of APG seems to have a protective effect on testicular ischemia-reperfusion injury after testicular torsion and detorsion. Hippokratia 2015; 19 (3): 225-230.
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Affiliation(s)
- I Skondras
- Department of Pediatric Surgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - M Lambropoulou
- Laboratory of Histology, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Tsaroucha
- 2 Department of Surgery and Laboratory of Experimental Surgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - S Gardikis
- Department of Pediatric Surgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - G Tripsianis
- Laboratory of Medical Statistics, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - C Simopoulos
- 2 Department of Surgery and Laboratory of Experimental Surgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - G Vaos
- Department of Pediatric Surgery, Democritus University of Thrace, Alexandroupolis, Greece
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Pitiakoudis M, Romanidis K, Giatromanolaki A, Courcoutsakis N, Nagorni EA, Foutzitzi S, Tsaroucha A, Zezos P, Kouklakis G. Single-incision assisted laparoscopic surgery (SILS) in the treatment of an intussusception induced by a solitary hamartomatous polyp: a case report and review of the literature. J Med Case Rep 2015; 9:125. [PMID: 26031291 PMCID: PMC4457091 DOI: 10.1186/s13256-015-0606-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 04/28/2015] [Indexed: 12/18/2022] Open
Abstract
Introduction In this case report, we describe the successful treatment of a small-bowel intussusception, which was caused by a 3cm solitary hamartomatous polyp, with single-incision laparoscopic surgery. Single-incision laparoscopic surgery is a minimally invasive surgical procedure with important advantages that allows the reduction of the intussusception and the resection of the polyp. This case report contributes to the medical literature by describing the advantages of this surgical technique that warrant its consideration as a treatment of choice in similar cases. Case presentation We report a case of a 19-year-old Greek woman who complained about intermittent, non-specific abdominal pain in her left lateral abdomen. She had been admitted to the hospital because of incomplete obstructive ileus. Ultrasound and computed tomography were carried out, which revealed an intussusception of the small bowel. This pathogenic situation was treated by single-incision laparoscopic surgery. Her pathology report revealed a benign, hamartomatous excised polyp of the Peutz-Jeghers type. The patient had a quick recovery without any post-operative complications. Conclusion We recommend single-incision laparoscopic surgery for the safe excision of solitary hamartomatous polyps and the management of their complications, as it represents a potential advance in minimally invasive approaches.
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Affiliation(s)
- Michael Pitiakoudis
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Konstantinos Romanidis
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Alexandra Giatromanolaki
- Department of Pathology, University General Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Nikos Courcoutsakis
- Department of Radiology and Medical Imaging, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Eleni-Aikaterini Nagorni
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Soultana Foutzitzi
- Department of Radiology and Medical Imaging, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Alexandra Tsaroucha
- Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Petros Zezos
- Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
| | - Georgios Kouklakis
- Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.
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Staikou C, Tsaroucha A, Vakas P, Salakos N, Hasiakos D, Panoulis K, Petropoulos G. Maternal and umbilical cord oxygen content and acid-base balance in relation to general, epidural or subarachnoid anesthesia for term elective cesarean section. CLIN EXP OBSTET GYN 2013; 40:367-371. [PMID: 24283167] [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: 06/02/2023]
Abstract
PURPOSE To compare maternal and neonatal oxygenation and acid-base status after elective cesarean section (CS) under different anesthetic techniques. MATERIALS AND METHODS Three hundred and eighty parturients undergoing elective cesarean section were randomly assigned to receive general (GA, n =140), epidural (EA, n = 117) or subarachnoid anesthesia (SA, n =123). Blood gases, oxygen content, and acid-base status parameters were measured in maternal artery and umbilical cord vessels. Neonatal Apgar scores were also recorded. RESULTS Umbilical artery pH, HCO3-, and actual base excess (ABE) were significantly higher in the GA compared to SA group (p < 0.001, p < 0.05, andp < 0.05, respectively). Umbilical vein ABE was lower in the SA compared to GA and EA groups (p < 0.05). Oxygen content in maternal artery was higher in the GA and EA groups compared to the SA group (p < 0.05). Neonatal oxygen content in both cord vessels was higher in the GA group compared to EA and SA groups (p < 0.05). Umbilical venous-arterial difference of PO2, oxygen content, and Apgar scores did not differ significantly among groups. CONCLUSION Neonatal oxygenation and acid-base status values were better preserved when GA was administered for elective CS compared to regional modalities. Apgar scores and neonatal outcomes were not affected by the anesthetic technique.
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Affiliation(s)
- C Staikou
- 1st Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, Athens, Greece.
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Staikou C, Tsaroucha A, Mani A, Fassoulaki A. Transcranial Doppler monitoring of middle cerebral flow velocity in a patient with a ventriculoperitoneal shunt undergoing laparoscopy. J Clin Monit Comput 2012; 26:487-9. [PMID: 22782283 DOI: 10.1007/s10877-012-9380-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 06/28/2012] [Indexed: 11/29/2022]
Abstract
Laparoscopic surgery is possibly associated with a risk of intracranial pressure (ICP) increase due to pneumoperitoneum in patients with ventriculoperitoneal shunts (VPS). Invasive techniques for shunt pressure monitoring are not routinely used because of the possible complications. Transcranial Doppler (TCD) is a non-invasive, safe method which gives accurate information about blood-flow velocities in basal cerebral arteries and indirectly about the ICP. Moreover it is inexpensive and simple in use. We report the use of TCD for middle cerebral flow velocity monitoring in a patient with a VPS who underwent laparoscopic surgery. In the case we present, during 60 min of pneumoperitoneum, TCD showed a sustained, but not clinically significant increase of the Pulsatility Index, with a recorded maximum change of 31 %. We consider that the use of TCD may increase the safety of laparoscopic procedures in patients with preexisting VPS.
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Affiliation(s)
- C Staikou
- Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, 76 Vassilissis. Sophias Ave., 11528 Athens, Greece.
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Papantoniou V, Valsamaki P, Fothiadaki A, Archontaki A, Skalistis V, Marinopoulos S, Liotsou T, Karianos T, Tsakmakli A, Tsaroucha A, Stipsanelli A, Antsaklis A. Serum calcitonin gene-related neuropeptide (CGRP) in patients with benign and malignant breast lesions: Correlation with mammographic breast density. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
78 Background: The aim of this study was to assess the variation of the serum neo-angiogenic neuropeptide CGRP in patients with benign and malignant breast lesions and to evaluate its possible correlation with mammographic findings. Methods: Our study included forty eight women with histologically confirmed breast lesions: mild epithelial hyperplasia (MEH): n=12, florid epithelial hyperplasia (FEH): n=5, atypical hyperplasia (AH): n=4, ductal carcinoma in situ (DCIS): n=5, mixed in situ with invasive ductal carcinoma (DCIS+IDC): n=9 and pure IDC: n=13. Serum CGRP levels were measured by RIA methods and compared among the various groups by Mann-Whitney test. Mammographic breasy density (BD%) was calculated using computer-assisted methods and was correlated with serum CGRP concentration by applying linear regression analysis. Results: Serum CGRP concentration (mean±SD: pg/mL) in the various groups, was: MEH: 96.8±22.5, FEH: 135.5±33.5, AH: 139±44.4, DCIS: 131.4±37.5, DCIS+IDC: 1167.5±927.5, pure IDC: 198±82. DCIS+IDC lesions presented statistically significantly higher serum CGRP levels (versus: MEH p<0.001, FEH p<0.001, AH p<0.001, DCIS p<0.001 and IDC p<0.001). Serum CGRP concentration presented statistically significant correlation with BD% (r=0.947, p<0.0001). Conclusions: Statistically increased serum CGRP concentration was determined in women with DCIS+IDC lesions. The significant correlation between serum CGRP levels and BD, enhances the suggestion that DCIS+IDC represents a distinct pathological entity, associated with an interactive mechanism between BD and serum CGRP expression. Therefore, serum CGRP levels could constitute a future useful preoperative index of the nature or type of suspicious mammographic lesions, in order to schedule the appropriate therapeutic treatment, and potentially propounds the perspective of adjunctive therapeutic administration of anti-CGRP peptides.
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Affiliation(s)
- V. Papantoniou
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - P. Valsamaki
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - A. Fothiadaki
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - A. Archontaki
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - V. Skalistis
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - S. Marinopoulos
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - T. Liotsou
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - T. Karianos
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - A. Tsakmakli
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - A. Tsaroucha
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - A. Stipsanelli
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
| | - A. Antsaklis
- Nuclear Medicine Department, Alexandra University Hospital, Athens, Greece; University Hospital, Athens, Greece; Alexandra Hospital, Athens University Medical School, Athens, Greece; Obstetrics and Gynecology Department, Alexandra University Hospital, Athens, Greece
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Karapanos NT, Bramos D, Tsiftsi A, Saatsakis G, Skaltsiotis E, Kalantaridou A, Takos D, Tsaroucha A, Kairi E, Kottis G, Moulopoulos S, Toumanidis S. What are the Impact of Cardiac Output and Left Ventricular Pressure on Coronary Flow and on Diastolic Coronary Perfusion? A Quantitative Coronary Flow Analysis Model for Cardiovascular Surgical Research. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.870] [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: 11/17/2022]
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Meristoudis G, Ilia I, Tsaroucha A, Giannakopoulos V, Christakopoulou J. Liver and vertebral visualization on lung perfusion scan. Rev Esp Med Nucl 2008; 27:369. [PMID: 18817668 DOI: 10.1157/13126195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- G Meristoudis
- Department of Nuclear Medicine. Sotiria Hospital. Athens. Greece.
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Polychronidis A, Botaitis S, Tsaroucha A, Tripsianis G, Bounovas A, Pitiakoudis M, Simopoulos C. Laparoscopic cholecystectomy in elderly patients. J Gastrointestin Liver Dis 2008; 17:309-313. [PMID: 18836625] [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: 05/26/2023]
Abstract
BACKGROUND Surgery for cholelithiasis is more common in ageing patients. The use of laparoscopic cholecystectomy (LC) in older patients may pose problems because of the comorbid conditions that are concomitant with advanced age and may increase the postoperative LC complications and the frequency of conversion to open surgery. The purpose of this study was to evaluate the outcome of LC in the treatment of gallstones in the elderly (> or = 75 years old). METHODS A retrospective study was conducted in patients who had undergone LC for symptomatic cholelithiasis: out of these, 153 patients were older than 75 years. Conversion rate to open cholecystectomy, complication rate, operative time, and length of stay were compared with those younger than 75 years. Multivariate analysis was used as a control for baseline differences. RESULTS Conversion rate to open cholecystectomy in elderly was 13.1% vs 5.8% (p<0.001). Complication rate was 3.9% vs 1.6%. Operative time was 50 min vs 45 min. No significant difference was found in the hospital stay of both younger and elderly patients who had underwent a successful LC (p=0.079). The presence of inflammation was the only independent risk factors for conversion (p=0.014) and had a marginal independent effect on the development of complications (p=0.079) among elderly patients. CONCLUSION Even though older patients are more likely to present with diseases in more advanced states, LC is safe and should be regarded as the gold-standard approach for elderly patients with cholelithiasis.
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Pitiakoudis M, Kirmanidis M, Tsaroucha A, Christianakis E, Filippou D, Sivridis E, Simopoulos C. Carcinoid tumor of the appendix during pregnancy. A rare case and a review of the literature. J BUON 2008; 13:271-275. [PMID: 18555477] [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: 05/26/2023]
Abstract
We present a rare case of a carcinoid tumor of the appendix that was diagnosed during pregnancy in a 24-year-old female. The patient was admitted to our department for acute abdominal pain localized on the right half of the abdomen, mimicking acute appendicitis. Open appendectomy was carried out and at the histological examination carcinoid was found in the surgical specimen. Only few similar cases were found in the literature reporting appendiceal carcinoid tumor during pregnancy.
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Affiliation(s)
- M Pitiakoudis
- 2nd Surgical Department, Medical School, University of Thrace, Alexandroupolis, Greece
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Meristoudis G, Birbilis C, Ilias I, Tsaroucha A, Batsakis C, Christakopoulou J. Intestinal accumulation of 99mTc-MDP in a patient with protein-losing enteropathy. Eur J Nucl Med Mol Imaging 2007; 35:224. [PMID: 17885754 DOI: 10.1007/s00259-007-0575-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 08/26/2007] [Indexed: 11/26/2022]
Affiliation(s)
- G Meristoudis
- Department of Nuclear Medicine, Sotiria Hospital, Athens, Greece
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Papagoras D, Papalois A, Tsaroucha A, Lytras D, Kyriazanos J, Giannakou N, Laftsidis P, Simopoulos C. Beneficial effect of an antibody against interleukin-2 receptor (daclizumab) in an experimental model of hepatocyte xenotransplantation. World J Gastroenterol 2007; 13:1435-7. [PMID: 17457977 PMCID: PMC4146930 DOI: 10.3748/wjg.v13.i9.1435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the use of Daclizumab (Dmab) as an immunosuppressive agent in an experimental model of hepatocyte xenotransplantation (XenoTx) in rats with fulminant hepatic failure (FHF).
METHODS: Two white male New Zealand rabbits were used as donors and 68 Wistar rats as recipients. FHF was induced by intravenous application of dimethylnitrosamine (DMNA). The isolated hepatocytes of the rabbits were xenotransplanted into the spleen of the rats 24 h after FHF induction. Group A (n = 13): no treatment; Group B (n = 14): FHF and XenoTx; Group C (n = 14): FHF and XenoTx and cyclosporin (CsA); Group D (n = 14): FHF and XenoTx and Dmab; Group E (n = 13): FHF and XenoTx and CsA and Dmab. The rats were followed for 15 d.
RESULTS: Statistical analysis showed better survival among groups D (92.86%) and E (76.92%) compared to group A (all rats died after 72 h), group B (28.57%) or group C (71.43%), although the differences were not statistically significant. Biochemical evaluation of the liver enzymes and histology confirmed satisfactory function and engraftment, respectively.
CONCLUSION: This experimental model has shown the safe, effective and beneficial use of Dmab in a xenotransplantation model of rabbit hepatocytes in rats.
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MESH Headings
- Acute Disease
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Cell Transplantation/methods
- Daclizumab
- Disease Models, Animal
- Hepatocytes/transplantation
- Immunoglobulin G/immunology
- Immunoglobulin G/therapeutic use
- Immunosuppressive Agents/therapeutic use
- Liver Failure, Acute/pathology
- Liver Failure, Acute/surgery
- Male
- Rabbits
- Rats
- Rats, Wistar
- Receptors, Interleukin-2/antagonists & inhibitors
- Receptors, Interleukin-2/immunology
- T-Lymphocytes, Helper-Inducer/immunology
- T-Lymphocytes, Helper-Inducer/pathology
- Transplantation, Heterologous/immunology
- Transplantation, Heterologous/methods
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Affiliation(s)
- Dimitrios Papagoras
- 2nd Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Amarantidis K, Houhouli K, Papatheodorou K, Miloussis A, Matthaios D, Chatzaki E, Lyrantzopoulos N, Tsaroucha A, Tentes A, Kakolyris S. A Dose Escalation Study of Docetaxel Plus Capecitabine in Combination With Gemcitabine in Patients With Advanced Solid Tumors. Oncol Res 2006; 16:281-7. [PMID: 17476973 DOI: 10.3727/000000006783981026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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] Open
Abstract
Capecitabine (CAP), gemcitabine (GEM), and docetaxel (DOC) have shown interesting activity in a wide range of solid tumors. A phase I study was conducted in order to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of their combination in patients with refractory solid tumors. Eighteen patients were enrolled. The patients' median age was 60 years, 15 were male, and 11 were chemo-naive. DOC was administered on day 1 as an 1-h (IV) infusion at escalating doses ranging from 40 to 50 mg/m2. GEM was administered on day 1 as a 30-min (IV) infusion at a standard dose of 1500 mg/m2. CAP was administered orally on days 1 to 7 at escalating doses ranging from 1750 to 2500 mg/m2 given as two daily divided doses. Treatment was repeated every 2 weeks. Five different dose levels were examined. At dose level V two out of three enrolled patients presented DLTs (one patient grade 4 neutropenia and grade 3 stomatitis and another grade 3 diarrhea), and thus the recommended MTD for future phase II studies are CAP 2250 mg/m2, DOC 50 mg/m2, and GEM 1500 mg/m2. A total of 124 treatment cycles were administered. Toxicity was generally mild. Grade 3/4 neutropenia was observed in eight (7%) treatment cycles and grade 3 thrombocytopenia in one (1%). There was no febrile episode. Grade 2/3 asthenia was observed in six (33%) patients, grade 2/3 diarrhea in four (22%), and grade 2/3 hand-foot syndrome in three (17%). Other toxicities were uncommon. There was no treatment-related death. One (6%) CR, four (25%) PRs, and six (38%) SD were observed among 16 evaluable patients. Responses were seen in patients with breast (one CR), gastric (three PRs), and pancreatic (one PR) cancer. These results demonstrate that CAP, DOC, and GEM can be safely combined at clinically relevant doses and this regimen merits further evaluation.
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Affiliation(s)
- K Amarantidis
- Department of Medical Oncology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Greece
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Maltezos E, Amarantidis K, Trichas M, Vasiliadis M, Toromanidou M, Chatzaki E, Karayiannakis A, Tsaroucha A, Romanidis K, Kakolyris S. A Dose Escalation Study of Pegylated Liposomal Doxorubicin (Caelyx) in Combination with Capecitabine (Xeloda) in Patients with Refractory Solid Tumors. Oncology 2006; 69:463-9. [PMID: 16374040 DOI: 10.1159/000090494] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Accepted: 10/01/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Pegylated liposomal doxorubicin (PLD) and capecitabine (CAP) have separately shown significant antitumor activity in a wide range of solid tumors. A phase I study was conducted in order to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of their combination in patients with refractory solid tumors. PATIENTS AND METHODS Fifteen patients with histologically confirmed inoperable solid neoplasms were enrolled. The patients' median age was 65 years, 10 were male, and 12 had a performance status score (WHO) of 0-1. PLD was administered on day 1 as a 1-hour intravenous infusion at escalated doses ranging from 35 to 40 mg/m(2). CAP was administered on days 1-14 per os, at escalated doses ranging from 1,600 to 1,800 mg/m(2), given as two daily divided doses. Treatment was repeated every 3 weeks. RESULTS At the dose of PLD 40 mg/m(2) and CAP 1,800 mg/m(2), all 3 enrolled patients presented DLTs [2 patients grade 3 palmar-plantar erythrodysesthesia (PPE) and 1 patient grade 3 asthenia] and thus, the recommended MTD for future phase II studies is PLD 40 mg/m(2) and CAP 1,700 mg/m(2). A total of 57 treatment cycles were administered. Grade 2/3 neutropenia complicated 9 (17%) cycles and 1 patient was hospitalized for febrile neutropenia. There was no septic death. The main nonhematologic toxicity was PPE grade 2 in 3 (19%) patients and grade 3 in 4 (27%). PPE was the reason of treatment interruption for 3 patients. Other toxicities were mild and easily manageable. Two patients (16%) with partial response suffering from gastric cancer and 5 patients with (42%) stable disease were observed among 12 evaluable patients. CONCLUSIONS The results of this phase I study demonstrate that PLD and CAP can be combined at clinically effective and relevant doses. However, PPE is a common side effect and further investigation is warranted to define its precise role in the treatment of solid malignancies.
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Affiliation(s)
- E Maltezos
- Department of Internal Medicine, School of Medicine, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
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Pitiakoudis M, Koukourakis M, Tsaroucha A, Manavis J, Polychronidis A, Simopoulos C. Malignant retroperitoneal paraganglioma treated with concurrent radiotherapy and chemotherapy. Clin Oncol (R Coll Radiol) 2005; 16:580-1. [PMID: 15630855 DOI: 10.1016/j.clon.2004.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chatzaki E, Euthymiadis C, Kyriaki S, Lambropoulou M, Tsaroucha A, Laftsidis P, Simopoulos K. Urocortin and corticotropin-releasing hormone receptor type 2 expression in the human gallbladder. Neuroendocrinology 2005; 82:177-84. [PMID: 16534239 DOI: 10.1159/000091979] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2005] [Accepted: 01/10/2006] [Indexed: 11/19/2022]
Abstract
The corticotropin-releasing hormone (CRH) system, consisting of CRH and the homologue neuropeptide urocortin together with their receptors CRH(1) and CRH(2) and a specific binding protein (CRH-BP), holds the main role in mediating the response to stressful stimuli. Besides their expression in the brain, CRH peptides and receptors have been found in multiple peripheral sites. Here we investigate the expression of CRH, urocortin, CRH receptors, and CRH-BP in the wall of human normal and inflamed gallbladders, using RT-PCR and immunohistochemistry. Urocortin, but not CRH gene transcripts, was detected in RNA isolated from human gallbladder biopsy specimens. Urocortin immunoreactivity was localized in epithelial cells of the gallbladder mucosa. Gene expression of CRH(2) receptor was also detected, and the receptor protein had a localization similar to that of urocortin. Finally, CRH-BP gene expression and low levels of protein immunoreactivity were also shown. There were no differences in the expression profiles of all the above molecules between normal and inflamed tissues. In conclusion, the CRH system is present in the human gallbladder, urocortin being the major ligand expressed, possibly exerting an autocrine/paracrine biological role via activation of the CRH(2(alpha)) receptors found locally. Further study is required to enfold the biological role of these effectors in gallbladder physiology and pathogenesis.
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Affiliation(s)
- Ekaterini Chatzaki
- Department of Pharmacology, Democritus University of Thrace, Alexandroupolis, Greece.
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Karapantzos I, Tsaroucha A, Polychronidis A, Simopoulos C, Simasko N. Merkel cell carcinoma: report of seven cases. ORL J Otorhinolaryngol Relat Spec 2004; 65:370-4. [PMID: 14981332 DOI: 10.1159/000076057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2003] [Accepted: 09/30/2003] [Indexed: 11/19/2022]
Abstract
Merkel cell carcinoma (MCC) is an infrequent, highly malignant, primary skin tumor derived from neuroendocrine cells. Most MCCs occur in elderly individuals, on sun-exposed areas of the body, with the head and neck being the most common sites. We present 7 patients (2 male and 5 female, age 45-80 years) suffering from MCC and treated between 1993 and 2000. All tumors were located on the head and neck and varied from 0.9 to 2.3 cm in size. Five of the patients had stage II disease, 1 patient had stage Ia disease and 1 patient had stage III disease. Six of the patients had positive regional lymph nodes. All patients had local excision of the tumor. Six of them also had lymph node dissection and in 5 of them a superficial parotidectomy was performed. Five patients received adjuvant radiotherapy and 3 of them also received chemotherapy. Local and cervical lymph node recurrence was observed in only 1 patient. Metastases occurred in 5 patients. One patient died within 10 days for other reasons. The patient with the stage III tumor had a survival of 7 months. The other 5 patients had survivals varying from 15 to 54 months. MCC is a skin tumor with very poor prognosis and high recurrence and metastatic rates. Its treatment is still under discussion. Radical excision of the tumor is the main method of treatment. Selective lymph node dissection is suggested. Superficial parotidectomy seems necessary, especially if the tumor is on the auricle. Adjuvant radio- and chemotherapy may extend survival in case of small-size tumors.
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Affiliation(s)
- Ilias Karapantzos
- Ear, Nose and Throat Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Pitiakoudis M, Mimidis K, Tsaroucha A, Kartalis G, Simopoulos K. Intussusception of the small bowel due to Peutz-Jeghers syndrome: a case report. Ann Ital Chir 2004; 75:75-7. [PMID: 15283392] [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: 04/30/2023]
Abstract
The Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract, melanin pigmentation of the skin and mucous membranes, and an increased risk for cancer. The incidence of surgical complications in these patients is relatively rare, and correlates with the size and location of the polyps. Herein we report the case of a 27-year-old woman presented with episodes of abdominal pain, abdominal distention and intermittent vomiting. Moreover, multiple pigmentation of the mouth was also noted. A preoperative diagnosis of a double jejunal intussusception and jejunal occlusion was based on the findings of small bowel enema and computed tomography. The diagnosis was confirmed at laparotomy.
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Affiliation(s)
- M Pitiakoudis
- 2nd Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Pitiakoudis M, Tsaroucha A, Mimidis K, Constantinidis T, Anagnostoulis S, Stathopoulos G, Simopoulos C. Esophageal and small bowel obstruction by occupational bezoar: report of a case. BMC Gastroenterol 2003; 3:13. [PMID: 12795814 PMCID: PMC165420 DOI: 10.1186/1471-230x-3-13] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2003] [Accepted: 06/09/2003] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Phytobezoar may be a cause of bowel obstruction in patients with previous gastric surgery. Most bezoars are concretions of poorly digested food, which are usually formed initially in the stomach. Intestinal obstruction (esophageal and small bowel) caused by an occupational bezoar has not been reported. CASE PRESENTATION A 70-year old male is presented suffering from esophageal and small bowel obstruction, caused by an occupational bezoar. The patient has worked as a carpenter for 35 years. He had undergone a vagotomy and pyloroplasty 10 years earlier. The part of the bezoar, which caused the esophageal obstruction was removed during endoscopy, while the part of the small bowel was treated surgically. The patient recovered well and was discharged on the 8th postoperative day. CONCLUSIONS Since occupational bezoars may be a cause of intestinal obstruction (esophageal and/or small bowel), patients who have undergone a previous gastric surgery should avoid occupational exposures similar to the presented case.
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Affiliation(s)
- Michail Pitiakoudis
- 2Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Alexandra Tsaroucha
- 2Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Mimidis
- 1Department of Internal Medicine, Endoscopy Unit, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Theodoros Constantinidis
- Department of Public Health, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stavros Anagnostoulis
- 2Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - George Stathopoulos
- Department of Public Health, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Constantinos Simopoulos
- 2Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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