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Triantafillidis JK, Triantafyllidi A, Vagianos C, Papalois A. Favorable results from the use of herbal and plant products in inflammatory bowel disease: evidence from experimental animal studies. Ann Gastroenterol 2016; 29:268-81. [PMID: 27366027 PMCID: PMC4923812 DOI: 10.20524/aog.2016.0059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 02/01/2016] [Indexed: 12/14/2022] Open
Abstract
The use of herbal therapy for inflammatory bowel disease is increasing worldwide. The aim of this study was to review the available literature on the efficacy of herbal therapy in experimental colitis. All relevant studies published in Medline and Embase up to June 2015 have been reviewed. The results of bowel histology and serum parameters have been recorded. A satisfactory number of published experimental studies, and a quite large one of both herbal and plant products tested in different studies have been reported. The results showed that in the majority of the studies, herbal therapy reduced the inflammatory activity of experimental colitis and diminished the levels of many inflammatory indices, including serum cytokines and indices of oxidative stress. The most promising plant and herbal products were tormentil extracts, wormwoodherb, Aloe vera, germinated barley foodstuff, curcumin, Boswellia serrata, Panax notoginseng, Ixeris dentata, green tea, Cordia dichotoma, Plantago lanceolata, Iridoidglycosides, and mastic gum. Herbal therapies exert their therapeutic benefit via various mechanisms, including immune regulation, anti-oxidant activity, inhibition of leukotriene B4 and nuclear factor-κB, and antiplatelet activity. Large, double-blind clinical studies assessing these natural substances should be urgently conducted.
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Affiliation(s)
- John K Triantafillidis
- Inflammatory Bowel Disease Unit, "IASO General" Hospital (John K. Triantafillidis, Aikaterini Triantafyllidi), Athens, Greece
| | - Aikaterini Triantafyllidi
- Inflammatory Bowel Disease Unit, "IASO General" Hospital (John K. Triantafillidis, Aikaterini Triantafyllidi), Athens, Greece
| | - Constantinos Vagianos
- 2 Surgical Department, "Laikon" Hospital, University of Athens (Constantinos Vagianos), Athens, Greece
| | - Apostolos Papalois
- Experimental-Research Center, ELPEN (Apostolos Papalois), Athens, Greece
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Antonopoulos C, Karagianni M, Galanakis N, Vagianos C. Mycotic Splenic Artery Aneurysm Secondary to Coxiella burnetii Endocarditis. Ann Vasc Surg 2010; 24:416.e13-6. [DOI: 10.1016/j.avsg.2009.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 05/27/2009] [Indexed: 10/20/2022]
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Theodorou GL, Mouzaki A, Tsiftsis D, Apostolopoulou A, Mougiou A, Theodori E, Vagianos C, Karakantza M. Effect of non-operative management (NOM) of splenic rupture versus splenectomy on the distribution of peripheral blood lymphocyte populations and cytokine production by T cells. Clin Exp Immunol 2007; 150:429-36. [PMID: 17924970 DOI: 10.1111/j.1365-2249.2007.03517.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Post-traumatic splenectomy is associated with increased postoperative morbidity and mortality and long-term impairment of humoral and cellular immunity. Alternatives to surgery have been developed to minimize or avoid the immediate and/or long-term complications of splenectomy. Herein we investigated the long-term effect of non-operative management (NOM) of the traumatic rupture of the spleen on the distribution of peripheral blood (PB) lymphocyte populations and cytokine production by T cells. PB samples were drawn from six NOM patients, 13 age-matched adults who had undergone splenectomy after trauma (SP patients) and 31 age-matched controls. Cellular phenotypes and the intracellular production of interferon (IFN)-gamma, interleukin (IL)-2, IL-4 and IL-10 cytokines in T cells were determined in whole blood +/- mitogens by flow cytometry. NOM patients did not show any changes in the absolute numbers of lymphocytes or the distribution of their subsets, compared to the controls. In contrast, SP patients showed a sustained increase in the percentage and/or absolute numbers of lymphocytes, CD8 T cells, activated CD8 T cells, natural killer (NK) T cells, NK cells and gammadelta T cells, and a reduction in naive CD4 T cells. The constitutive or induced cytokine production by T cells of the NOM group was similar to the control group, whereas SP patients had increased percentages of constitutive IL-2- and IFN-gamma-producing CD8 T cells and IFN-gamma-producing CD4 T cells. Our findings indicate collectively that the healing process in NOM does not affect the architecture of the spleen to such an extent that it would lead to long-term alterations of the proportions of PB lymphocytes or the T cell cytokine profiles.
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Affiliation(s)
- G L Theodorou
- Division of Hematology, Department of Internal Medicine, Medical School and University Hospital, University of Patras, Patras, Greece
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Mandellos GJ, Lymperopoulos DK, Koukias MN, Tzes A, Lazarou N, Vagianos C. A novel mobile telemedicine system for ambulance transport. Design and evaluation. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:3080-3. [PMID: 17270929 DOI: 10.1109/iembs.2004.1403870] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
It is generally accepted that early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. The focus of this paper is to present the implementation and the evaluation of an ambulance located telemedicine system for pre-hospital patient treatment The primary emphasis is on the vital sign transmission from the accident site or the moving ambulance to the consultation site, using the GSM mobile telephony network. There, the experts evaluate the patient data, decides about the treatment protocol and provide directions to the ambulance's medical staff concerning on the patient handling until the arrival to the hospital.
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Affiliation(s)
- G J Mandellos
- Dept. of Electr. Eng. & Comput. Technol., Patras Univ., Greece
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Karakantza M, Theodorou GL, Mouzaki A, Theodori E, Vagianos C, Maniatis A. In Vitro Study of the Long-Term Effects of Post-Traumatic Splenectomy on Cellular Immunity. Scand J Immunol 2004; 59:209-19. [PMID: 14871299 DOI: 10.1111/j.0300-9475.2004.01379.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [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: 11/29/2022]
Abstract
The purpose of this study was to investigate the effect of splenectomy on cellular immunity. We studied the cellular phenotype and type 1 [interferon-gamma, interleukin-2 (IL-2)] and type 2 (IL-4 and IL-10) cytokine-producing peripheral blood CD4+ and CD8+ T lymphocytes in 22 healthy adults who had undergone post-traumatic splenectomy about 1 to 35 years ago. Splenectomy resulted in a long-term reduction of the percentage of CD4+CD45RA+ cells and a late increase of the percentage and absolute numbers of T-cell receptor gamma/delta cells. Stimulation with Staphylococcal enterotoxin B resulted in normal IL-2 production by CD4+ T cells, indicating that the naïve cells were not anergic. Splenectomy also resulted in long-term priming of both CD4+ and CD8+ T cells. During the first 8 years, both type 1 and type 2 CD4+ T cells were primed to varying degrees. About 8 years later, the percentage of primed type 2 CD4+ T cells subsided, but that of type 1 CD4+ T cells, although decreased, remained detectable over a longer period. Priming of CD8+ T cells persisted throughout the study period. The long-term priming of type 1 CD4+ and CD8+ T cells, which may result in partial impairment of T-cell functions, may explain reported defects of immune responses to recall antigens in splenectomized individuals. In addition, changes in the profile of primed CD4+ T cells with time may be clinically relevant to relapses in autoimmune thrombocytopenia after splenectomy.
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Affiliation(s)
- M Karakantza
- Laboratory Haematology and Transfusion Medicine, Medical School, University of Patras, Patras, Greece.
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Stefanopoulos N, Vagianos C, Stavropoulos M, Panagiotopoulos E, Androulakis J. Deformations and intrusions of the passenger compartment as indicators of injury severity and triage in head-on collisions of non-airbag-carrying vehicles. Injury 2003; 34:487-92. [PMID: 12832173 DOI: 10.1016/s0020-1383(02)00345-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In motor vehicle collisions the mechanism of injury is important in determining severity as well as for triage decisions in the pre-hospital phase of patient management. This study correlates deformation of the basic structures of the passenger compartment [windscreen, control panel (dashboard) and steering wheel] with occupants' injuries in passenger vehicle head-on collisions involving non-airbag-carrying vehicles, with or without compartment intrusion. The study took place in the broad urban area of Patras, over an 18-month period (January 2000-June 2001) and evaluated 48 vehicle crashes. Car and compartment deformation are significant factors affecting occupants' injuries and consequently the appropriate type of further treatment, either in the hospital setting or primary health-care centres. It would be particularly useful to transmit the post-crash condition of a vehicle to the trauma dispatch centre, utilising satellite technology, thus allowing the centre to organise the rescue teams, plan triage in advance and provide the emergency medical personnel with all necessary information before their arrival at the scene of the accident.
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Affiliation(s)
- N Stefanopoulos
- Department of Surgery, Medical School, University of Patras, Patras, Greece.
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Scopa CD, Vagianos C, Kardamakis D, Kourelis TG, Kalofonos HP, Tsamandas AC. bcl-2/bax ratio as a predictive marker for therapeutic response to radiotherapy in patients with rectal cancer. Appl Immunohistochem Mol Morphol 2001; 9:329-34. [PMID: 11759059 DOI: 10.1097/00129039-200112000-00007] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Combined radiation therapy and chemotherapy are adjuvant treatments given after surgery to patients with rectal carcinoma. Because apoptosis seems to play a role in tumor response to radiotherapy, the current study investigates whether there is a correlation between the ratio of bcl-2 oncoprotein and bax expression in rectal adenocarcinoma and the clinical response to radiotherapy. Elective colectomy for primary rectal adenocarcinoma followed by adjuvant radiotherapy and chemotherapy was performed on 35 patients. Tumors were staged as B2 (n = 30) and C (n = 5), and were classified as radiation resistant (n = 19, group A) and radiation nonresistant (n = 16, group B). Immunohistochemical study, using the streptavidin-biotin complex technique and monoclonal antibody to bcl-2 and polyclonal antibody to bax protein was used on paraffin sections. Cases were considered positive if at least 5% of tumor cells displayed cytoplasmic staining for bcl-2 or bax. In each tumor, the bcl-2/bax ratio was calculated dividing the percentage of bcl-2-positive cells by the percentage of bax-positive cells. For statistical analysis, the Mann-Whitney rank sum test and Kruskal-Wallis analysis of variance test were used. Rectal tumors of group A displayed significantly greater bcl-2 immunoreactivity (40.2 +/- 4.2) compared with group B (20.2 +/- 3.8). In contrast, expression of bax protein was less in group A (30.3 +/- 3.3) compared with group B (41.3 +/- 2.3). The bcl-2/bax ratio was greater in group A (1.3 +/- 0.1) compared with group B (0.49 +/- 0.1), and was correlated with poor responsiveness to radiotherapy. The current study indicates that in patients with rectal carcinoma an elevated bcl-2/bax ratio in tissue specimens suggests increased tumor resistance to adjuvant radiotherapy. Thus, in such patients, the bcl-2/bax ratio may serve as a potential molecular marker for prediction of tumor prognosis.
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Affiliation(s)
- C D Scopa
- Department of Pathology, University Hospital, University of Patras, Medical School, Greece.
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Partrinou V, Dougenis D, Kritikos N, Polydorou A, Vagianos C. Treatment of postoperative bronchobiliary fistula by nasobiliary drainage. Surg Endosc 2001; 15:758. [PMID: 11591990 DOI: 10.1007/s004640040046] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/1999] [Accepted: 11/16/1999] [Indexed: 10/24/2022]
Abstract
Bronchobiliary fistula (BBF) is a rare condition. It may present as a complication of echinococcal or amebic liver disease. Management of such a fistula can be very difficult and is often associated with a high rate of morbidity and mortality. We report the case of a 70-year-old woman who presented with a BBF after a one-stage operation for hydatid cysts of the liver and lung that were approached via thoracotomy and transdiaphragmatic incision. The cause of the BBF was an inflammatory collection in the residual liver cavity due to inadequate drainage. This collection eroded the sutured diaphragm, and because of the existing adhesions, it perforated directly into the bronchial system at the area of the previous cystectomy. Initially, endoscopic sphincterotomy was performed to achieve biliary decompression by equalizing intrabiliary and duodenal pressure, but no significant improvement was seen. Subsequently, nasobiliary drainage was instituted by means of an endoscopically inserted, nasobiliary catheter, which further reduced biliary pressure and facilitated biliary flow to the duodenum, as opposed to the fistulous tract. The fistula was successfully closed in a short time. This conservative method reduces the risks of reoperation. Therefore, it should be considered the treatment of choice in the management of bronchobiliary fistula.
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Affiliation(s)
- V Partrinou
- Department of Surgery, University of Patras Medical School, Patras, Greece
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Abstract
BACKGROUND Mucinous cystic neoplasms of the pancreas are uncommon tumors with varying potential for malignancy. Although traumatic splenic rupture is common, spontaneous rupture is a rare event. CADE REPORT We present an unusual case of spontaneous splenic rupture, due to an otherwise asymptomatic mucinous cystadenocarcinoma of the tail of the pancreas. CONCLUSION A tumor of the tail of the pancreas may uncommonly present as spontaneous splenic rupture, probably due to venous congestion and infiltration of the spleen, requiring emergency surgical treatment.
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Affiliation(s)
- V Patrinou
- Department of Surgery, University of Patras Medical School, University Hospital of Patras, Rion Patras, Greece
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Mylonas PG, Matsouka PT, Papandoniou EV, Vagianos C, Kalfarentzos F, Alexandrides TK. Growth hormone and insulin-like growth factor I protect intestinal cells from radiation induced apoptosis. Mol Cell Endocrinol 2000; 160:115-22. [PMID: 10715545 DOI: 10.1016/s0303-7207(99)00215-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [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] [Indexed: 01/14/2023]
Abstract
We studied whether programmed cell death (or apoptosis) is the predominant mechanism in radiation-induced cell damage to rat intestinal mucosa and investigated the mechanism of the protective effect of GH and IGF-I in the same model. Male albino Wistar rats were divided into four groups: controls, radiation, radiation plus GH and radiation plus IGF-I. Radiation was administered on the first day and on day 4. All animals were sacrificed and segments of the terminal ileum were stained with hematoxylin-eosin. Apoptosis of the epithelial cells was identified at the cellular level by the TUNEL stain and was distinguished from necrosis by the characteristic morphology of the cells (cytoplasmic shrinkage, marginal chromatin condensation and generation of nuclear apoptotic bodies). Apoptotic cells in the control animals were few and detected only at the tips of the villi while in the irradiated animals almost all the epithelial cells were apoptotic, distributed from the crypts to the tips of the villi and the mucosa showed severe epithelial atrophy and ulceration. The histologic picture of the mucosa in the GH and IGF-I treated animals was similar to normal controls and apoptotic cells were restricted only at the tips of the villi. DNA and RNA from the mucosa cells were isolated and analyzed by electrophoresis. DNA fragmentation and RNA 28s band ribonuclease cleavage was observed only in the irradiated animals. We have shown that abdominal radiation causes intestinal epithelial cell damage mainly through the induction of apoptosis and the treatment with GH and IGF-I inhibits apoptosis of the cells and preserves the mucosal integrity.
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Affiliation(s)
- P G Mylonas
- Division of Endocrinology, Department of Internal Medicine, University of Patras Medical School, 26500, Patras, Greece.
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Thomopoulos K, Katsakoulis E, Vagianos C, Mimidis K, Margaritis V, Nikolopoulou V. Causes and clinical outcome of acute upper gastrointestinal bleeding: a prospective analysis of 1534 cases. Int J Clin Pract 1998; 52:547-50. [PMID: 10622053] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Despite considerable improvement in the diagnostic and therapeutic approach to patients with acute upper gastrointestinal (GI) bleeding, several studies suggest there has been no overall change in mortality. The aim of this study was to evaluate prospectively the effect of early emergency diagnostic and therapeutic endoscopy and medico-surgical collaboration in the clinical outcome of 1534 patients with acute upper GI bleeding treated in our hospital over the past five years. Emergency endoscopy and injection haemostasis were performed within 24 hours of admission, or immediately after resuscitation, in patients with massive bleeding; patients were then treated with close co-operation between surgeons and gastroenterologists. We observed an increase in the incidence of peptic ulcer (67%) with a simultaneous decrease in the incidence of gastroduodenitis (13.5%) as a cause of bleeding compared with the previous decade. In peptic ulcer bleeding, emergency surgical haemostasis was required in 92 patients (8.9%), while none of the patients with erosive gastroduodenitis required surgical intervention. Overall mortality was 2.9%, and in peptic ulcer bleeding patients 2.1% with a postsurgical mortality of 8.7%. Peptic ulcer remains the main cause of upper GI bleeding. Improved clinical outcome and low mortality can be achieved with early diagnostic and therapeutic endoscopy and medico-surgical collaboration.
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Affiliation(s)
- K Thomopoulos
- Department of Intemal Medicine, University Hospital, Patras, Greece
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Filos K, Dodou V, Patroni O, Vagianos C, Stavropoulos M. A.394 Perioperative nimodipine reduces the requirements for anaesthetics and for intra- and postoperative analgesics. Br J Anaesth 1996. [DOI: 10.1016/s0007-0912(18)31249-2] [Citation(s) in RCA: 2] [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: 10/28/2022] Open
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Dougenis D, Morrit GN, Vagianos C, Farr S, Hedley-Brown A. Motility disorders of the esophagus before and after pneumonectomy for lung carcinoma. Eur Surg Res 1996; 28:461-5. [PMID: 8954323 DOI: 10.1159/000129491] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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: 02/03/2023]
Abstract
It has been noticed that patients undergoing major lung resection may occasionally develop dysphagia. A prospective study was carried out to evaluate if preoperative or postoperative esophageal motility disorders (EMD) occur in patients subjected to pneumonectomy for lung carcinoma. Twenty-five normal volunteers served as control data and 13 patients, who successfully completed manometry before and after pneumonectomy, were included in the final analysis. Studies were performed using a Gaeltec Model 6 ct/sb, 6-channel intraluminal strain gauge transducer probe. Our results demonstrated that EMD occurred in some patients suffering from lung carcinoma. However, motility disorders were most evident following pneumonectomy. These findings may explain the several anecdotal reports of patients developing dysphagia following lung resection after a variable interval of time.
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Affiliation(s)
- D Dougenis
- Department of Surgery, University Hospital, Patras, Greece
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Abstract
Hepatic lymphangiomas are extremely rare; moreover cystic lymphangiomas usually arise in areas such as the neck and axilla, where loose connective tissue allows the expansion of lymphatic channels. The case of a 65-year old male is described, who presented with a solitary lymphangioma in the liver. The lesion was discovered incidentally and due to diagnostic uncertainty was removed surgically. A short review of histology, clinical presentation and preoperative diagnostic difficulties of hepatic lymphangiomas is given.
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Affiliation(s)
- M Stavropoulos
- Department of Surgery, University of Patras, Patras Medical School, Greece
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Vagianos C, Karavias D, Dragotis C, Kalofonos H, Androulakis J. Obstructive jaundice due to intracholedochal blood clot: an unusual early presentation of primary hepatic carcinoma. Br J Clin Pract 1993; 47:222-223. [PMID: 8260348] [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: 05/22/2023]
Abstract
We report a case of early presentation of a hepatocellular carcinoma with obstructive jaundice, due to obstruction of the common bile duct by a blood clot. The possibility of preoperative diagnosis, the surgical treatment and the postoperative outcome are discussed.
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Affiliation(s)
- C Vagianos
- Department of Surgery, University of Patras, Greece
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Vagianos C, Polydorou A, Karatzas T, Vagenas C, Stavropoulos M, Androulakis J. Successful treatment of postoperative external biliary fistula by selective nasobiliary drainage. HPB Surg 1992; 6:115-20; discussion 120-4. [PMID: 1292584 PMCID: PMC2443016 DOI: 10.1155/1992/58436] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A 25-year old man presented with a high output external biliary fistula after an operation for a giant hydatid cyst of the liver. Endoscopic sphincterotomy was inadequate to close the fistula. A nasobiliary tube was selectively inserted into the leaking hepatic duct and bile was continuously aspirated. The fistula and the residual cavity healed completely. Details of the patients' management using this alternative technique, are discussed.
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Affiliation(s)
- C Vagianos
- Department of Surgery, University of Patras, Patras Medical School, Greece
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Vagianos C, Karatzas T, Scopa CD, Panagopoulos C, Tsoni I, Spiliopoulou I, Kalfarentzos F. Neurotensin reduces microbial translocation and improves intestinal mucosa integrity after abdominal radiation. Eur Surg Res 1992; 24:77-83. [PMID: 1582431 DOI: 10.1159/000129191] [Citation(s) in RCA: 25] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The effect of neurotensin (NTN) on preventing microbial translocation and preserving intestinal mucosal integrity after abdominal radiation was studied in rats. Animals were divided into the following groups: I (control), II (radiation control) and III (radiation and NTN). Radiation (1,100 cGy) was administered on the 1st day to groups II and III. NTN (300 micrograms/kg) was given intraperitoneally to group III animals, once daily for 3 days. On the 4th day, mesenteric lymph nodes (MLN) were obtained and cultured. Villi per centimeter (V/cm), villus height (Vh) and mitoses per crypt (M/c) were evaluated from ileal mucosa. Radiation increased positive MLN cultures, while treatment with NTN reduced them significantly. V/cm and Vh also returned to normal levels after NTN treatment, while M/c were increased in all irradiated animals. It was shown that NTN reduces bacterial translocation after abdominal radiation. Examination of ileal mucosa indicates that this can be attributed to the improvement of the mucosal integrity, due to the trophic effect of the hormone on the gut.
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Affiliation(s)
- C Vagianos
- Department of Surgery, University of Patras, Greece
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Vagianos C, Karatzas T, Scopa C, Panagopoulos C, Pitsis A, Kalfarentzos F. Growth hormone improves intestinal mucosa integrity and reduces bacterial translocation after abdominal radiation. Clin Nutr 1991. [DOI: 10.1016/0261-5614(91)90186-g] [Citation(s) in RCA: 2] [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: 11/28/2022]
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Vagianos C, Steen S, Masson P, Fåhraeus T, Sjöberg T, Kugelberg J, Solem JO. Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs. Acta Chir Scand 1990; 156:671-5. [PMID: 2264424] [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: 12/31/2022]
Abstract
Intravenous infusions of 750 and 1000 ml 2.2% sodium citrate were given over a 60 min period to 17 pigs to study its effect on aortic pressure, electrocardiogram, ionised calcium, and citrate clearance. In group 1 (seven pigs) the animals did not receive calcium and the median survival time was 30 min (range 20-70 min). In groups 2 and 3 (five in each group) the pigs were treated with calcium chloride infusions (1 ml 10% calcium chloride to 10 ml citrate) and they all survived. In group 1 the ionised calcium concentrations in blood fell to values below 0.4 mmol/l, after which the blood pressure dropped abruptly. In the animals treated with calcium the mean ionised calcium concentration fell to 0.6 mmol/l, whereas total calcium increased to more than 7 mmol/l. The aortic pressure was consistently within normal values in the groups treated with calcium, but in the group that was not treated the blood pressure fell dramatically. There was no correlation between electrocardiographic changes and ionised calcium concentrations. In summary, calcium was an effective antidote to lethal citrate intoxication, and the only reliable method of determining the necessary dose of calcium was monitoring of ionised calcium concentrations.
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Affiliation(s)
- C Vagianos
- Department of Cardiothoracic Surgery, University Hospital of Lund, Sweden
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Vagianos C, Sjöberg T, Andersson KE, Steen S. Effects of alpha-adrenoceptor active drugs, prostaglandin F2 alpha and vasopressin on cystic and hepatic arteries of pig and man. Pharmacol Toxicol 1990; 66:77-82. [PMID: 1969153 DOI: 10.1111/j.1600-0773.1990.tb00709.x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Human and pig cystic and pig hepatic arteries were suspended in tissue baths and the effect of alpha-adrenoceptor selective drugs, prostaglandin F2 alpha (PGF2 alpha) and vasopressin were investigated. Prazosin fulfilled the criteria for competitive antagonism in concentrations 10(-9)-10(-7) M. The pA2-values were 9.53 in human cystic, 9.74 in pig cystic, and 9.57 in pig hepatic artery. Rauwolscine had no significant effect in the different arteries. In human cystic artery noradrenaline had significantly (P less than 0.05) higher Emax and pEC50-values (135% of the preceding K(+)-induced contraction and 6.4, respectively) compared with pig cystic (106% and 5.7, respectively) and pig hepatic artery (116% and 5.9, respectively). Vasopressin had no effect in the cystic arteries, whereas it had a high potency (pEC50 was 8.5) but low intrinsic activity (Emax was 14%) in pig hepatic artery. Prostaglandin F2 alpha had a significantly higher Emax in human than in pig arteries. No differences were found in pEC50-values. This study indicates a similarity in pharmacological characteristics of some vasoactive drugs especially between pig cystic and hepatic arteries. If this is also true in man, the easily obtainable cystic artery can be used for screening the effect of drugs on the hepatic artery.
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Affiliation(s)
- C Vagianos
- Department of Surgery, University Hospital of Lund, Sweden
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Vagianos C, Steen S, Johansson S, Masson P, Tengborn L, Solem JO. Intraoperative collection of shed blood with citrated compresses for autotransfusion. An experimental study in pigs. Acta Chir Scand 1990; 156:121-6. [PMID: 2330790] [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: 12/31/2022]
Abstract
Six pigs were used to study whether the collection of shed blood by means of surgical compresses instead of suction traumatizes such blood. In an in vivo part of the study, the whole blood volume of the pigs was retransfused after treatment with citrated compresses, and in an in vitro part the blood was treated extensively with compresses and analyzed. All animals survived, with a minor fall in hemoglobin after 48 hours and a rise in serum citrate concentration at the end of the experiment. A study of the coagulation system revealed no important change after retransfusion of compress-treated blood. In the in vitro part of the study, repeatedly squeezing blood from the compresses increased the concentration of free hemoglobin to a maximum of 5 g/l after ten squeezes, whereas platelets were numerically unchanged. The study indicates that collecting shed blood by means of surgical compresses may be a safe and efficient method.
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Affiliation(s)
- C Vagianos
- Department of Cardiothoracic Surgery, University of Lund, Sweden
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Abstract
The procedure of autotransfusion includes the collection of the patient's own blood before, during or after surgery with the aim of retransfusing it either immediately or postoperatively. The increasing demands on the blood banks as well as the growing fear of transfusion transmitted diseases have created a new interest in autotransfusion. Application of autotransfusion will reduce the need for homologous blood and thereby cut the cost.
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Affiliation(s)
- J O Solem
- Department of Cardiothoracic Surgery, University Hospital, Lund, Sweden
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24
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Aberg T, Steen S, Vagianos C, Walther B, Zoucas E, Bengmark S. The effects of pneumatic antishock garments in the treatment of critical abdominal injuries in rats. J Trauma 1988; 28:772-8. [PMID: 3385819 DOI: 10.1097/00005373-198806000-00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Thirty rats were subjected to a standardized critical aortic injury and divided into six groups. In addition to controls, the animals were treated with a pneumatic antishock garment (PASG), massive intravenous or intra-aortic saline infusion, or PASG in combination with either massive intravenous or intra-aortic saline infusion. Twenty-six rats were subjected to a standardized hepatic injury and divided into four groups. In addition to controls, the animals were treated with PASG, massive intravenous saline infusion, or PASG in combination with massive intravenous saline infusion. These animals were allowed to bleed for 5 minutes before the treatment was started. The treatment with PASG alone prolonged the median survival time significantly from 7 min in the control group to greater than 120 min in the PASG group in rats with an aortic injury and from 33 to greater than 120 min in rats with a hepatic injury. Intravenous infusion of saline did not prolong the median survival time. Intravenous infusion in combination with PASG did not have any positive effects on median survival time or median mean aortic pressure and failed to prolong the median survival time significantly in rats with a liver injury, as six out of eight animals developed a lethal pulmonary edema.
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Affiliation(s)
- T Aberg
- Department of Surgery, Lund University, Sweden
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25
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Abstract
Twenty-one cases of hepatic abscesses treated during a period of four years (from 1981 to 1985) at the University of Patras, Greece, are presented. This material includes 10 cases with abscesses caused by suppurated echinococcal cysts, corresponding to 21% of the total number of 47 cases of echinococcal cysts of the liver treated at our department during the same period. A preoperative diagnosis of the suppurated echinococcal cysts by conventional laboratory methods was not reliable. Because of the high frequency of echinococcal disease in our region and the risk of contamination of the peritoneal cavity from echinococcal parasites if the cyst is punctured, the new therapeutic techniques of treating hepatic abscesses by percutaneous drainage have not been applied. The exclusive method of treatment used was surgical drainage which had a satisfactory outcome and a mortality rate as low as 9%.
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Affiliation(s)
- D Karavias
- Department of Surgery, University Hospital, Patras, Greece
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26
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Bengtsson F, Bugge M, Vagianos C, Jeppsson B, Nobin A. Brain serotonin metabolism and behavior in rats with carbon tetrachloride-induced liver cirrhosis. Res Exp Med (Berl) 1987; 187:429-38. [PMID: 3441684 DOI: 10.1007/bf01852181] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Increased brain serotonin metabolism has been suggested as an etiologic factor in the development of portal-systemic encephalopathy (PSE) in connection with liver disease. We therefore investigated brain serotonin metabolism and open-field behavior (spontaneous activity and exploration) in rats with carbon tetrachloride (CCl4)-induced liver cirrhosis. Brain serotonin metabolism was evaluated in rats pretreated with an amino acid decarboxylase inhibitor. The 5-hydroxyindoles were analyzed by high-performance liquid chromatography (HPLC) with electrochemical detection. The results revealed an increased serotonin synthesis rate in all investigated brain regions in rats with histologically verified diffuse micronodular cirrhosis of the liver. Slightly impaired open-field behavior (i.e., decreased spontaneous activity) in the cirrhotic rats could not be excluded. However, the elevated brain serotonin synthesis rate could not be correlated to any abnormalities in open-field behavior.
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Affiliation(s)
- F Bengtsson
- Dept. of Surgery, University of Lund, Sweden
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Asakawa H, Hultberg B, Isaksson A, Jeppsson B, Vagianos C, Bengmark S. beta-Hexosaminidase in plasma and liver after partial hepatectomy in normal and cirrhotic rats. Scand J Gastroenterol 1987; 22:1003-8. [PMID: 2961047 DOI: 10.3109/00365528708991949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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] [Indexed: 02/04/2023]
Abstract
The liver and plasma level of the lysosomal enzyme beta-hexosaminidase was analyzed in partially (about 70%) hepatectomized rats with normal liver or carbon tetrachloride (CCl4)-induced cirrhosis. The enzyme level of the liver did not show marked changes after partial hepatectomy in either normal or cirrhotic rats. In contrast, the plasma basal level was significantly higher in cirrhotic rats and increased to a peak at 6 h, followed by a decrease to a minimum level 24 h after operation. The enzyme returned to its high plasma basal level at 36 h after partial hepatectomy, when the liver had recovered to 70% of its initial weight. In rats with normal liver the plasma beta-hexosaminidase showed another pattern, with a rapid increase at 6 h and thereafter gradually reaching a peak at 36 h after hepatectomy. We conclude that the cells responsible for increased plasma beta-hexosaminidase in cirrhotic rats are situated in the liver.
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Affiliation(s)
- H Asakawa
- Dept. of Surgery, University of Lund, Sweden
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28
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Vagianos C, Puntis M, Jeppsson B, Steen S, Zoucas E, Bengmark S. Increased uptake of 5-FU in experimental liver tumours by simultaneous infusion of norepinephrine. Eur J Cancer Clin Oncol 1987; 23:1323-7. [PMID: 3678326 DOI: 10.1016/0277-5379(87)90115-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The effect of the simultaneous administration of norepinephrine and 5-fluorouracil (5-FU) on the uptake of radiolabelled 5-FU by liver tumours was studied in rats. Three different concentrations of 5-FU were used (15, 1.5 and 0.15 microgram/g body weight). The drugs were infused over a 30 min period via the hepatic artery, following cannulation of the gastroduodenal artery. The radioactivity in liver tumour, normal liver, lungs and intestines was estimated by liquid scintillation counting. At all concentrations tested, an increased uptake of radioactive 5-FU was found in the tumour when norepinephrine was infused. Tumour/liver ratios also increased significantly in all these cases. No significant differences were noted between norepinephrine infused and control animals in the radioactivity in normal liver, lungs and intestines. The effects noted were possibly due to changes in blood flow within the liver, but the possibility of a direct effect of norepinephrine on DNA metabolism is discussed.
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Affiliation(s)
- C Vagianos
- Department of Surgery, Lund University, Sweden
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Vagianos C, Steen S, Zoucas E, Asakawa H, Jeppsson B, Bengmark S. Control of traumatic liver hemorrhage in the cirrhotic rat by intraportal infusion of norepinephrine. Res Exp Med (Berl) 1987; 187:339-46. [PMID: 3432739 DOI: 10.1007/bf01855659] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of intraportal infusion of norepinephrine (NE) on primary hemostasis in the cirrhotic rat was investigated at standardized liver trauma. Cirrhosis was induced by simultaneous administration of increasing amounts of carbontetrachloride (CCl4) and phenobarbitone. Infusion of norepinephrine took place after cannulation of the gastroduodenal vein. Intraportal infusion of NE resulted in a significant increase in arterial blood pressure and portal pressure in all animals. No difference was observed between cirrhotic and control rats. Cirrhotic animals bled longer and more profusely as compared with the controls. Infusion of NE resulted in significant decrease in bleeding time and blood loss. NE did not affect hematocrit, hemoglobin, platelet, or white cell count. Platelet aggregation was not influenced by the compound. In conclusion, intraportal infusion of NE proved effective in decreasing hemorrhage at liver trauma in cirrhotic rats.
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Affiliation(s)
- C Vagianos
- Dept. of Surgery, Lund University, Sweden
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30
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Vagianos C, Zoucas E, Steen S, Bengmark S. Effect of intraarterial, intraportal or combined norepinephrine infusion on hemorrhage at experimental liver trauma in the rat. Eur Surg Res 1987; 19:124-8. [PMID: 3816888 DOI: 10.1159/000128690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The effect of intraarterial, intraportal or simultaneous intraarterial and intraportal norepinephrine (NE) infusion on hemorrhage after standardized liver trauma was evaluated in the rat. Infusion of NE through a catheter in the gastroduodenal artery or/and vein, was started 5 min prior to the liver trauma and continued throughout the experiment. Blood pressure was continuously registered after cannulation of the femoral artery. Standardized liver trauma involved resection of the left anterior liver lobe. Bleeding time, blood loss from the traumatized liver surface, hemoglobin (Hb), hematocrit (Hct), platelet count (PC) and white blood cell count (WBC) were measured. Infusion of NE resulted in significant increase of blood pressure compared with controls. Infusion of NE (i.a., i.p., i.a. + i.p.) caused significant decrease in bleeding time and blood loss. Hb, Hct, PC and WBC were not affected. NE infusion proved effective in decreasing hemorrhage at liver trauma; the route of administration did not influence the results.
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