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Acute esophageal necrosis: A systematic review and pooled analysis

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World Journal of Gastrointestinal Surgery 2020年第3期12卷 104-115页

作者： dimitrios Schizas Nikoletta A Theochari Konstantinos S Mylonas Prodromos Kanavidis Eleftherios Spartalis Stamatina Triantafyllou Konstantinos P Economopoulos dimitrios Theodorou Theodore Liakakos First Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Medicine Surgery Working GroupSociety of Junior DoctorsAthens 15122Greece Laboratory of Experimental Surgery and Surgical Research N.S.Christeas National and Kapodistrian University of AthensAthens 11527Greece First Propedeutic Department of Surgery National and Kapodistrian University of AthensHippocration General HospitalAthens 11527Greece Department of Surgery Duke University Medical CenterDurhamNC 27708United States

BACKGROUND Acute esophageal necrosis(AEN)is a rare entity with multifactorial etiology,usually presenting with signs of upper gastrointestinal *** To systematically review all available data on demographics,clinical features,outcomes and management of this medical *** A systematic literature search was performed with respect to the PRISMA statement(end-of-search date:October 24,2018).Data on the study design,interventions,participants and outcomes were extracted by two independent *** Seventy-nine studies were included in this ***,114 patients with AEN were identified,of whom 83 were males and 31 *** patient age was 62.1±*** most common presenting symptoms were melena,hematemesis or other manifestations of gastric bleeding(85%).The lower esophagus was most commonly involved(92.9%).The most widely implemented treatment modality was conservative treatment(75.4%),while surgical or endoscopic intervention was required in 24.6%of the *** overall followup was 66.2±101.8 *** 29.9%of patients died either during the initial hospital stay or during the follow-up *** symptoms on presentation[Odds ratio 3.50(1.09-11.30),P=0.03]and need for surgical or endoscopic treatment[surgical:Odds ratio 1.25(1.03-1.51),P=0.02;endoscopic:Odds ratio 1.4(1.17-1.66),P<0.01]were associated with increased odds of complications.A sub-analysis separating early versus late cases(after 2006)revealed a significantly increased frequency of surgical or endoscopic intervention(9.7%vs 30.1%respectively,P=0.04)CONCLUSION AEN is a rare condition with controversial pathogenesis and unclear optimal *** the frequency of surgical and endoscopic intervention has increased in recent years,outcomes have remained the ***,further research work is needed to better understand how to best treat this potentially lethal disease.

关键词： Acute esophageal necrosis Black esophagus Acute necrotizing esophagitis

Global dissemination of minimally invasive living donor hepatectomy: What are the barriers?

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 776-787页

作者： Christos dimitrios Kakos Angelos Papanikolaou Ioannis A Ziogas Georgios Tsoulfas Surgery Working Group Society of Junior DoctorsAthens 15123Greece Department of Transplant Surgery Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54622Greece Department of Surgery Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Surgery University of Colorado Anschutz Medical CampusAuroraCO 80045United States

Minimally invasive donor hepatectomy(MIDH)is a relatively novel procedure that can potentially increase donor safety and contribute to faster rehabilitation of *** an initial period in which donor safety was not effectively validated,MIDH currently seems to provide improved results,provided that it is conducted by experienced *** selection criteria are crucial to achieve better outcomes in terms of complications,blood loss,operative time,and hospital *** a pure laparoscopic technique,various approaches have been recommended such as hand-assisted,laparoscopic-assisted,and robotic *** latter has shown equal outcomes compared to open and laparoscopic approaches.A steep learning curve seems to exist in MIDH,mainly due to the fragility of the liver parenchyma and the experience needed for adequate control of *** review investigated the challenges and the opportunities of MIDH and the barriers to its global *** need expertise in liver transplantation,hepatobiliary surgery,and minimally invasive techniques to perform *** can be categorized into surgeon-related,institutionalrelated,and *** robust data and the creation of international registries are needed for further evaluation of the technique and the acceptance from more centers worldwide.

关键词： Minimally invasive donor hepatectomy Liver transplantation Living donation Laparoscopic donor hepatectomy Global surgery

Barrett's esophagus with high-grade dysplasia:Focus on current treatment options

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World Journal of Gastroenterology 2011年第37期17卷 4174-4183页

作者： Leonidas Lekakos Nikolaos P Karidis dimitrios Dimitroulis Christos Tsigris Gregory Kouraklis Nikolaos Nikiteas Second Propedeutic Department of Surgery Medical SchoolUniversity of AthensGeneral Hospital LaikoAthens 11527Greece Christos Tsigris First Department of SurgeryMedical SchoolUniversity of AthensGeneral Hospital LaikoAthens 11527Greece

High-grade dysplasia(HGD) in Barrett's esophagus(BE) is the critical step before invasive esophageal *** its natural history remains unclear,an aggressive therapeutic approach is usually *** represents the only treatment able to reliably eradicate the neoplastic *** healthy patients with reasonable life expectancy,vagal-sparing esophagectomy,with associated low mortality and low early and late postoperative morbidity,is considered the treatment of choice for BE with *** unfit for surgery should be managed in a less aggressive manner,using endoscopic ablation or endoscopic mucosal resection of the entire BE segment,followed by lifelong *** eligible for surgery who present with a long BE segment,multifocal dysplastic lesions,severe reflux symptoms,a large fixed hiatal hernia or dysphagia comprise a challenging group with regard to the appropriate treatment,either surgical or endoscopic.

关键词： Barrett's esophagus High-grade dysplasia Endoscopic ablation Endoscopic excision Surgical treatment

Adrenal ganglioneuroma:What you need to know

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World Journal of Clinical Cases 2017年第10期5卷 373-377页

作者： Konstantinos S Mylonas dimitrios Schizas Konstantinos P Economopoulos Division of Pediatric Surgery Massachusetts General HospitalHarvard Medical School Surgery Working Group Society of Junior Doctors First Department of Surgery Laiko General HospitalNational and Kapodistrian University of Athens Department of Surgery Duke University Medical Center

Adrenal ganglioneuromas(GNs) constitute rare,differentiated tumors which originate from neural crest cells. GNs are usually hormonally silent and tend to be discovered incidentally on imaging tests. Adrenalectomy is the gold standard for the treatment of primary adrenal GNs. Nevertheless,preoperative differential diagnosis of GNs remains extremely challenging,and thus histopathological examination is required in order to confirm the diagnosis of GN. Overall,prognosis after surgical resection seems to be excellent,without any recurrences or need for adjuvant therapy.

关键词： Ganglioneuroma Neurogenic tumors Neural crest Adrenalectomy

Use of a device that applies external kneading-like force on the abdomen for treatment of constipation

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World Journal of Gastroenterology 2005年第13期11卷 1971-1975页

作者： Konstantinos Mimidis David Galinsky Efraim Rimon Vassilios Papadopoulos Yehuda Zicherman dimitrios Oreopoulos Democritus University of Thrace Faculty of Health Sciences Kaplan Medical Center ADM Ltd Toronto Western Hospital

AIM: To evaluate the efficacy of a recently developed device that applies kneading-like motion on the abdomen in improving constipation in elderly long-term care patients. METHODS: Thirty constipated elderly patients were randomly selected from two nursing homes. They were instructed to use the device once daily for 20 min. Rate of bowel movements, volume and consistency of stool and the use of laxantia were all recorded during a 3-wk baseline period and for 12-wk treatment period. Colonic transit time (CTT) was measured in 13 patients by radiopaque markers during the baseline and at the end of treatment. RESULTS: Bowel movement rate (BM/week) increased from 1.4±0.4 BM/wk during baseline to 3.9±0.8 BM/wk during treatment (P<5.0×10-7). Stool amount that was 'low' in 30 patients during baseline increased in 21 patients at the end of the study period (x2 = 19.048-P= 1.3×10-5). Stool consistency,that was 'hard' in 25 patients and 'soft' in 5 patients during baseline, ameliorated in 23 patients at the end of the study (only 2 patients referred 'hard' stool) (x2 = 21.043-P= 4.0×10-6). The mean baseline CTT measured was 92.3±32.3 h at baseline and decreased to 49.4±31.3 h during the study period (P = 0.000208). No side effects were observed during the study period. CONCLUSION: External mechanical vibration of the abdomen reduced CTT and helped to relieve severe constipation in elderly constipated patients.

关键词： Constipation Laxatives Colon transit time

Immunohistochemical localization of glutathione S-transferase-pi in human colorectal polyps

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World Journal of Gastroenterology 2008年第26期14卷 4179-4184页

作者： Eleni Gaitanarou Eleni Seretis dimitrios Xinopoulos Emmanuel Paraskevas Niki Arnoyiannaki Irene Voloudakis-Baltatzis Department of Electron Microscopy-Cell Biology "G. Papanicolaou" Research Center of Oncology and Experimental Surgery"Agios Savvas" Anticancer Hospital of Athens Athens 11522Greece Department of Electron Microscopy-Cell Biology "G. Papanicolaou" Research Center of Oncology and Experimental Surgery"Agios Savvas" Anticancer Hospital of Athens Athens 11522Greece Department of Gastroenterology "Agios Savvas" Anticancer Hospital of AthensAthens 11522Greece Department of Gastroenterology "Agios Savvas" Anticancer Hospital of AthensAthens 11522Greece Department of Pathology of the Regional Anticancer-Oncologic Hospital of Athens "Agios Savvas" Athens 11522Greece Department of Electron Microscopy-Cell Biology "G. Papanicolaou" Research Center of Oncology and Experimental Surgery"Agios Savvas" Anticancer Hospital of Athens Athens 11522Greece

AIM:To investigate the distribution of the placental form of glutathione-S-transferase (GST) in colon polyps in order to evaluate the role of GST-pi in these tissues. METHODS: Sixteen polyp tissues removed at colonoscopy were examined. Tissues were investigated histologically and ultrastructurally. GST-pi expression was also analysed immunohistochemically, using peroxidase anti-peroxidase (PAP) method and immunogold labelling method, for light and electron microscope respectively. RESULTS: All polyp tissues examined were adenoma of low, mild and high-grade dysplasia as shown in the histopathological reports. Nevertheless, the examination of the above specimens with electron microscope revealed that 3 of 9 adenoma of mild dysplasia had ultrastuctural features similar to high-grade dysplasia adenoma. GST-pi was variably expressed in adenoma, with the lowest relative levels occurring in low-gradeadenoma and the highest levels found in high-grade adenoma. GST-pi was located mainly in undifferentiated epithelial cells. GST-pi positive particles were found in the cytoplasm and especially in the nucleus adjacent to the nuclear membrane of these cells. CONCLUSION:The overexpression of GST-pi in mildgrade adenomas with significant subcellular changes and in the majority of high-grade dysplasia adenoma suggests that this might be related to the carcinogenetic proceeding. Immunohistochemical localization of GST-pi in combination with ultrastructural changes indicate that GST-pi might be a sensitive agent for the detection of preneoplastic transformations in adenoma.

关键词： Glutathione S-transferase-pi Colorectal polyps Adenoma Electron microscopy Peroxidase anti-peroxidase method Immunogold method

Obstructive ileus due to a giant fibroepithelial polyp of the anus

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World Journal of Gastroenterology 2009年第29期15卷 3687-3690页

作者： Ioannis Galanis dimitrios Dragoumis Michail Tsolakis Konstantinos Zarampoukas Thomas Zarampoukas Konstantinos Atmatzidis 2nd Surgical Clinic Aristotle University of Thessaloniki "G. Gennimatas" District Hospital Ethnikis Aminis 41 Thessaloniki 54 635 Greece

Fibroepithelial polyps or hypertrophied anal papillae are essentially skin tags that project up from the dentate line and the junction between the skin and the epithelial lining of the anus. They are usually small in size, but sometimes they become enlarged, causing unexpected medical conditions. An extremely rare case of a giant hypertrophied anal papilla complicated by obstructive ileus is reported. Fibroepithelial anal polyp, despite its size, should be included in the differential diagnosis of a smooth mass located near the anal verge, especially in a patient with a history of chronic anal irritation or infection.

关键词： Anus Fibroepithelial polyp Hypertrophiedanal papillae Ileus Intestinal obstruction

COVID-19 and the cardiovascular system-current knowledge and future perspectives

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World Journal of Clinical Cases 2022年第27期10卷 9602-9610页

作者： dimitrios G Chatzis Kalliopi Magounaki Ioannis Pantazopoulos Sonu Menachem Maimonides Bhaskar Medical School European University CyprusNicosia 2404Cyprus Department of Internal Medicine KAT General HospitalAthens 14561Greece Department of Emergency Medicine Faculty of MedicineUniversity of ThessalyLarissa 41500Greece NSW Brain Clot Bank NSW Health PathologySydneyNSW 2170Australia Department of Neurology and Neurophysiology Liverpool Hospital and South Western Sydney Local Health DistrictSydneyNSW 2170Australia

The current coronavirus disease 2019(COVID-19) pandemic has had devastating impact on populations around the *** high mortality rates in patients with COVID-19 has been attributed to the influence of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),its causative viral agent,on several physiological systems in human body,including the respiratory,cardiovascular,and neurological *** is emerging evidence on propensity of this virus to attack cardiovascular ***,various pathophysiological mechanisms by which SARS-CoV-2 interacts with cardiovascular system and leads to high morbidity and mortality,including cardiovascular complications,are poorly *** mini review aims to provide an update on the current knowledge and perspectives on areas of future research.

关键词： COVID-19 Angiotensin-converting enzyme 2 receptors Cardiovascular manifestations Therapies

Colorectal cancer,screening and primary care: A mini literature review

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World Journal of Gastroenterology 2017年第33期23卷 6049-6058页

作者： Athanasios Hadjipetrou dimitrios Anyfantakis Christos G Galanakis Miltiades Kastanakis Serafim Kastanakis Primary Health Care Centre of Kissamos First Department of Surgery Saint George General Hospital of Chania Private Family Practice Unit in Chania Department of Internal Medicine Saint George General Hospital of Chania

Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 700000. The western way of life,that is being rapidly adopted in many regions of the world,is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore,the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians(PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein,we review the main topics of CRC in the current literature,in order to better understand its pathogenesis,risk and protective factors,as well as screening techniques. Furthermore,we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.

关键词： Colorectal cancer Prevention Diagnosis Screening Primary care