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Pseudopolyps in inflammatory bowel diseases: Have we learned enough?

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World Journal of Gastroenterology 2017年第9期23卷 1541-1551页

作者： dimitrios S Politis konstantinos H katsanos Epameinondas V Tsianos dimitrios k christodoulou Department of Gastroenterology University Hospital of IoanninaFaculty of MedicineSchool of Health SciencesUniversity of Ioannina45110 IoanninaGreece

Pseudopolyps are a well described entity in the literature and even though the exact pathogenesis of their formation is not completely understood, they are considered non-neoplastic lesions originating from the mucosa after repeated periods of inflammation and ulceration associated with excessive healing processes. Their occurrence is less common in Crohn's disease than in ulcerative colitis, and their overall prevalence ranges from 4% to 74%; moreover, they are found more often in colon but have been detected in other parts of the gastrointestinal tract as well. When their size exceeds the arbitrary point of 1.5 cm, they are classified as giant pseudopolyps. Clinical evaluation should differentiate the pseudopolyps from other polypoid lesions, such as the dysplasiaassociated mass or lesion, but this situation represents an ongoing clinical challenge. Pseudopolyps can provoke complications such as bleeding or obstruction, and their management includes medical therapy, endoscopy and surgery; however, no consensus exists about the optimal treatment approach. Patients with pseudopolyps are considered at intermediate risk for colorectal cancer and regular endoscopic monitoring is recommended. Through a review of the literature, we provide here a proposed classification of the characteristics of pseudopolyps.

关键词： Pseudopolyps Inflammatory polyps Post-inflammatory polyps Giant pseudopolyps Ulcerative colitis Inflammatory bowel disease Crohn’s disease Classification Dysplasia-associated mass or lesion

Lipidomics in non-alcoholic fatty liver disease

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World Journal of Hepatology 2020年第8期12卷 436-450页

作者： Sofia kartsoli Christina E kostara Vasilis Tsimihodimos Eleni T Bairaktari dimitrios k christodoulou Department of Gastroenterology School of Health SciencesFaculty of MedicineUniversity of IoanninaIoannina 45110Greece Laboratory of Clinical Chemistry School of Health SciencesFaculty of MedicineUniversity of IoanninaIoannina 45110Greece Department of Internal Medicine School of Health SciencesFaculty of MedicineUniversity of IoanninaIoannina 45110Greece

Non-alcoholic fatty liver disease(NAFLD),the most common chronic liver disorder in Western countries,comprises steatosis to nonalcoholic steatohepatitis(NASH),with the latter having the potential to progress to *** transition from isolated steatosis to NASH is still poorly understood,but lipidomics approach revealed that the hepatic lipidome is extensively altered in the setting of steatosis and steatohepatitis and these alterations correlate with disease *** data suggest that both quantity and quality of the accumulated lipids are involved in pathogenesis of *** in glycerophospholipid,sphingolipid,and fatty acid composition have been described in both liver biopsies and plasma of patients with NAFLD,implicating that specific lipid species are involved in oxidative stress,inflammation,and cell *** this article,we summarize the findings of main human lipidomics studies in NAFLD and delineate the currently available information on the pathogenetic role of each lipid class in lipotoxicity and disease progression.

关键词： Lipidomics Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Lipotoxicity Fatty acids Ceramides

Has the time been reached for pseudopolyps to be re-enrolled in endoscopic inflammatory bowel disease scores?

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World Journal of Gastrointestinal Endoscopy 2019年第6期11卷 424-426页

作者： dimitrios S Politis konstantinos H katsanos konstantinos Papamichael Maria Saridi Eleni Albani dimitrios k christodoulou Department of Gastroenterology University Hospital of IoanninaFaculty of MedicineSchool of Health SciencesUniversity of IoanninaIoannina 45110Greece Center for Inflammatory Bowel Diseases Division of GastroenterologyBeth-Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States General Hospital of Corinth Department of Social and Educational PolicyUniversity of PeloponneseCorinth 20100Greece Department of Nursing TEI of Western GreecePatra 26334Greece

Patients with inflammatory bowel diseases (IBD) represent heterogeneous groups with different characteristics and different clinical course. A great deal of effort is made to discover proxies for more severe disease needing more intense treatment and early intervention to gain the maximum therapeutic benefit. Endoscopy remains an invaluable method in assessment of patients with IBD. Pseudopolyps are often encountered during endoscopy and, although they are a well described entity, their presence is of unclear importance. In one of our recent studies and in conjunction with one study with a large cohort of patients with IBD and pseudopolyps, patients with pseudopolyps were found to face a higher inflammatory burden in terms of receiving more intense biological treatment. This letter comes as a comment and proposition regarding the concept of reevaluation of pseudopolyps as a promising marker in IBD scores.

关键词： Pseudopolyps Inflammatory bowel diseases Treatment escalation Endoscopic scores

Small bowel parasitosis as cause of obscure gastrointestinal bleeding diagnosed by capsule endoscopy

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World Journal of Gastrointestinal Endoscopy 2010年第11期2卷 369-371页

作者： dimitrios k christodoulou dimitrios E Sigounas konstantinos H katsanos Georgios Dimos Epameinondas VTsianos Hepato- Gastroenterology 1st Department of Internal MedicineUniversity Hospital of IoanninaMedical School of IoanninaIoannina 45100Greece Department of Internal Medicine General Hospital of Ioannina"Hatzikosta"Ioannina 45001Greece

Hookworm infection is a relatively common cause of anemia in endemic ***,it is rarely encountered in *** this report we describe the case of a 24-year old patient originating from an endemic area who was admitted due to severe anemia,with an Hct of 15.6%and eosinophilia(Eosinophils:22.4%).While both esophagogastroduodenoscopy and colonoscopy were non-diagnostic,capsule endoscopy revealed a large number of hookworms infesting his small bowel and withdrawing *** patient was successfully treated with *** endoscopy was proven an important tool in diagnosing intestinal parasitosis.

关键词： Ancylostoma duodenale Parasitosis Capsule endoscopy Obscure gastrointestinal bleeding Anemia

Role of wireless capsule endoscopy in the follow-up of inflammatory bowel disease

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World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 643-651页

作者： Ioannis V Mitselos dimitrios k christodoulou konstantinos H katsanos Epameinondas V Tsianos Department of Gastroenterology University Hospital of Ioannina Faculty of Medicine School of Health Sciences University of Ioannina

The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure's inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn's disease patients who have undergone ileocolonic resection for the treatment of Crohn's disease complications, and in patients' management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis.

关键词： Small bowel capsule endoscopy Coloncapsule endoscopy Crohn's disease Ulcerative colitis Indeterminate colitis Postoperative Ileal pouch-analanastomosis Refractory pouchitis

Diagnosis and endoscopic treatment of esophago-bronchial fistula due to gastric heterotopy

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World Journal of Gastrointestinal Endoscopy 2010年第4期2卷 138-142页

作者： konstantinos H katsanos dimitrios k christodoulou Sevasti kamina kosmidou Maria Evangelia Lambri Stavroula Theodorou konstantinos Tsampoulas Mitsi Vasiliki Epameinondas V Tsianos Department of Internal Medicine and Hepato-Gastroenterology Unit University Hospital of IoanninaIoannina 45110Greece Department of Pathology University Hospital of IoanninaIoannina45110Greece Department of Radiology University Hospital of IoanninaIoannina 45110Greece

Heterotopic gastric mucosa patches are congenital gastrointestinal abnormalities and have been reported to occur anywhere along the gastrointestinal tract from mouth to *** of heterotopic gastric mucosa include dysphagia,upper gastrointestinal bleeding,upper esophageal ring stricture,adenocarcinoma and fistula *** this case report we describe the diagnosis and treatment of the first case of esophago-bronchial fistula due to heterotopic gastric mucosa in mid esophagus.A 40-year old former professional soccer player was referred to our department for treatment of an esophago-bronchial *** examination of the biopsies taken from the esophageal fistula revealed the presence of gastric heterotopic *** decided to do a non-surgical therapeutic endoscopic procedure.A sclerotherapy catheter was inserted through which 1 mL of ready to use synthetic surgical glue was applied in the fistula and it closed the fistula opening with excellent results.

关键词： Gastric heterotopy Esophago-bronchial fistula Ectopic gastric mucosa Heterotopic gastric mucosa Esophagus Esophageal fistula therapy

Direct adaptive regulation of unknown nonlinear systems with analysis of the model order problem

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Journal of Zhejiang University-Science C(Computers and Electronics) 2011年第1期12卷 1-16页

作者： dimitrios THEODORIDIS Yiannis BOUTALIS Manolis christodoulou Department of Electrical and Computer Engineering Democritus University of Thrace Department of Industrial Informatics Technological Education Institute of Kavala Chair of Automatic Control University of Erlangen-Nuremberg Department of Electronic and Computer Engineering Technical University of Crete Dipartimento di Automatica et Informatica Politecnico di Torino

A new method for the direct adaptive regulation of unknown nonlinear dynamical systems is proposed in this paper,paying special attention to the analysis of the model order *** method uses a neurofuzzy (NF) modeling of the unknown system,which combines fuzzy systems (FSs) with high order neural networks (HONNs).We propose the approximation of the unknown system by a special form of an NF-dynamical system (NFDS),which,however,may assume a smaller number of states than the original unknown *** omission of states,referred to as a model order problem,is modeled by introducing a disturbance term in the approximating *** development is combined with a sensitivity analysis of the closed loop and provides a comprehensive and rigorous analysis of the stability *** adaptive modification method,termed ‘parameter hopping’,is incorporated into the weight estimation algorithm so that the existence and boundedness of the control signal are always *** applicability and potency of the method are tested by simulations on well known benchmarks such as ‘DC motor’ and ‘Lorenz system’,where it is shown that it performs quite well under a reduced model order ***,the proposed NF approach is shown to outperform simple recurrent high order neural networks (RHONNs).

关键词： Neuro-fuzzy systems Direct adaptive regulation Model order problems Parameter hopping

Herpes simplex virus type 1 in peptic ulcer disease: An inverse association with Helicobacter pylori

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World Journal of Gastroenterology 2005年第42期11卷 6644-6649页

作者： klisthenis Tsamakidis Efstathia Panotopoulou dimitrios Dimitroulopoulos dimitrios Xinopoulos Maria christodoulou Alexandra Papadokostopoulou Ioannis karagiannis Elias kouroumalis Emmanuel Paraskevas Department of Gastroenterology "Agios Savvas" Anticancer Hospital Athens Greece Papanicolaou Research Center of Oncology and Experiment Surgery Athens Greece Department of Gastroenterology University Hospital Heraklion Crete Greece

AIM： To assess the frequency of herpes simplex virus type I in upper gastrointestinal tract ulcers and normal mucosa with the modern and better assays and also with a larger number of well characterized patients and controls and its relationship to Helicobacter pylori（H pylori）. METHODS： Biopsy specimens from 90 patients （34 with gastric ulcer of the prepyloric area and 56 with duodenal ulcer） were evaluated. Biopsies from 50 patients with endoscopically healthy mucosa were considered as the control group. The method used to identify herpes simplex virus-1 （HSV-1） was polymerase chain reaction. Hpylori was detected by the CLO-test and by histological method. RESULTS： Herpes simplex virus-1 was detected in 28 of 90 patients with peptic ulcer （31%） Ⅲ of 34 patients with gastric ulcer （32.4%） and 17 of 56 with duodenal ulcer （30.4%）1 exclusively close to the ulcerous lesion. All control group samples were negative for HSV-1. The likelihood of Hpylori negativity among peptic ulcer patients was significantly higher in HSV-1 positive cases than in HSV-1 negative cases （P = 0.009）. Gastric ulcer patients with HSV-1 positivity were strongly associated with an increased possibility of Helicobacter pylori negativity compared to duodenal ulcer patients （P = 0.010）. CONCLUSION： HSV-1 is frequent in upper gastrointestinal tract ulcers but not in normal gastric andduodenal mucosa. There is an inverse association between HSV-1 and Hpylori infection.

关键词： HSV-1 Herpes simplex virus type 1 Pepticulcer Duodenal ulcer Gastric ulcer PCR~ Polymerasechain reaction Hpylori Non-steroidal anti-inflammatorydrugs

A physical interpretation of the Titius-Bode rule and its connection to the closed orbits of Bertrand's theorem

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Research in Astronomy and Astrophysics 2017年第12期17卷 101-106页

作者： Dimitris M.christodoulou Demosthenes kazanas Lowell Center for Space Science and Technology University of Massachusetts LowellLowellMA 01854USA Department of Mathematical Sciences University of Massachusetts LowellLowellMA 01854USA NASA Goddard Space Flight Center Laboratory for High-Energy AstrophysicsCode 663GreenbeltMD 20771USA

We consider the geometric Titius-Bode rule for the semimajor axes of planetary orbits. We derive an equivalent rule for the midpoints of the segments between consecutive orbits along the radial direction and we interpret it physically in terms of the work done in the gravitational field of the Sun by particles whose orbits are perturbed around each planetary orbit. On such energetic grounds, it is not surprising that some exoplanets in multiple-planet extrasolar systems obey the same relation. However,it is surprising that this simple interpretation of the Titius-Bode rule also reveals new properties of the bound closed orbits predicted by Bertrand’s theorem, which has been known since 1873.

关键词： planets and satellites:formation planets and satellites:general protoplanetary disks