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Use of isolated Roux loop for pancreaticojejunostomy reconstruction after pancreaticoduodenectomy

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World Journal of Gastroenterology 2010年第25期16卷 3178-3182页

作者： Konstantinos Ballas Nikolaos Symeonidis Savvas Rafailidis Theodoros Pavlidis georgios Marakis Nikolaos Mavroudis Athanasios Sakantamis Second Propedeutical Department of Surgery Ippokratio General Hospital Aristotle University of Thessaloniki 49 Konstantinoupoleos str Thessaloniki 54642 Thessaloniki Greece

AIM: To evaluate the efficacy of the isolated Roux loop technique in decreasing the frequency of pancreaticojejunal anastomosis failure. METHODS: We retrospectively reviewed 88 consecutive patients who underwent pancreaticoduodenectomy (standard or pylorus-preserving). Single jejunal loop was used in 42 patients (SL group) while isolated Roux loop was used in 46 patients (RL group). Demographic characteristics (age, gender) and perioperative results (major/minor complications, mortality, hospital stay) were compared between the two groups. RESULTS: Mortality was almost equal in both groups and overall mortality was 2.27%. Leak rate from the pancreaticojejunal anastomosis and hospital stay were lower in the RL group without significant difference. Morbidity was 39.1% in the RL group, insignificantly higherthan the SL group. Operative time was almost 30 min longer in the RL group. CONCLUSION: The isolated Roux loop, although an equally safe alternative, does not present advantages over the traditional use of a single jejunal loop. Randomized controlled studies are required to further clarify its efficacy.

关键词： Pancreaticojejunal anastomosis Isolated Roux loop Whipple pancreaticoduodenectomy Pancreatic leak

The use of demersal trawling discards as a food source for two scavenging seabird species:a case study of an eastern Mediterranean oligotrophic marine ecosystem

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Avian Research 2018年第3期9卷 239-252页

作者： georgios Karris Vlasis Ketsilis-Rinis Anastasia Kalogeropoulou Stavros Xirouchakis Athanasios Machias Irida Maina Stefanos Kavadas Department of Environmental Technology Technological Educational Institute(TEI)of Ionian Islands29100 PanagoulaZakynthosGreece Department of Biology University of Patras26500 PatraGreece Natural History Museum of Crete PO Box 220871409 CreteGreece Institute of Marine Biological Resources and Inland Waters Hellenic Centre for Marine Research46.7 km Athens.Sounio Ave19013 AnavyssosAttikiGreece

Background: The banning of fisheries discards by imposing an obligation to land unwanted catch constitutes a key point of the Common Fishery Policy reform proposed by the European Commission. The effect of such a ban on discards on top marine predators such as seabirds is largely unknown, especially in oligotrophic systems of the Medi?terranean. The current study investigates the presence of scavenging seabirds around fishing trawlers as well as the exploitation of discards produced by bottom trawlers in the eastern Ionian ***: On?board observations were randomly conducted in May and December 2014, in order to record the presence and use of fishery discards by two common seabird species, namely, Scopoli's Shearwater(Calonectris diomedea) and the Yellow?legged Gull(Larus michahellis).Results: A total of 3400 seabirds were counted during May of which 2190 individuals were Scopoli's Shearwaters and 1210 were Yellow?legged Gulls. The latter species was the only scavenger observed during winter and in total, 768 individuals were counted. Differences in species abundance in the study area are related to breeding phenology and migratory movements. The number of seabirds attending bottom trawler operations during morning and afternoon hours showed no significant differences for both seabird species. Both scavenging seabirds extensively exploited fishery discards, which were mainly demersal fish, and consumed 70–80% of the total fishery discards biomass; how?ever, they appeared to avoid poisonous species and/or large?sized fish. Yellow?legged Gulls displayed kleptoparasitic behaviour on Scopoli's Shearwater during feeding experiments. The number of such incidents depended on the number of gulls around the fishing vessel, with more than 90% success ***: Considering the average annual biomass of discards estimations and the consumption rate found in this work, 106.1–117.9 t may be offered as a food subsidy to scavenging seabirds in the study area and shou

关键词： Discards Fisheries Scopoli's Shearwater Yellow-legged Gull

Platelet rich plasma effectiveness in bowel anastomoses:A systematic review

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1736-1753页

作者： georgios Geropoulos Kyriakos Psarras Dimitrios Giannis Eirini Chrysovalantou Martzivanou Maria Papaioannou Christos Dimitrios Kakos Efstathios Theodoros Pavlidis Nikolaos Symeonidis georgios Koliakos Theodoros Efstathios Pavlidis Department of General Surgery University College London HospitalsLondon NW12BUUnited Kingdom Laboratory of Scientific Research and Experimental Surgery 2nd Propedeutic Department of SurgerySchool of MedicineAristotle UniversityThessaloniki 54642Greece Surgery Working Group Society of Junior DoctorsAthens 15123Greece Institute of Health Innovations and Outcomes Research Feinstein Institutes for Medical ResearchManhassetNY 11030United States Laboratory of Biological Chemistry School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 54124Greece

BACKGROUND Anastomotic leak constitutes a major problem in abdominal *** insufficiency,topical or systemic factors contribute to disrupted healing of the performed bowel anastomosis and result in anastomosis leakage,with detrimental effects on patient postoperative *** the investigation of several factors and the invention of protective materials,the ideal agent to prevent anastomotic leaks is yet to be *** To study the effect of platelet rich plasma(PRP)on the healing of bowel *** A systematic literature search was performed in PubMed,EMBASE,and Scopus databases to identify studies investigating the effect of PRP application on bowel *** Eighteen studies were eligible with a total population of 712 animals including rats(14 studies),rabbits(2 studies)and pigs(2 studies).No postoperative complications were reported following PRP *** out of 18 studies reported a statistically significant higher anastomosis bursting pressure in PRP groups compared to control either in healthy animals or animal models with underlying condition or intervention,such as intraperitoneal chemotherapy or *** results were reported by ten studies in terms of tissue hydroxyproline *** study reported significant increase in collagen deposition in PRP *** application resulted in significantly decreased inflammatory cell infiltration in the presence of peritonitis or intraperitoneal chemotherapy(6 studies).CONCLUSION The application of PRP is associated with improved bowel anastomosis outcomes,especially in animal models having an underlying condition affecting the normal healing *** application seems to augment the normal healing process under these ***,further studies are needed to investigate the potential role of PRP on bowel anastomosis healing,especially in clinical settings.

关键词： Platelet rich plasma Colonic anastomosis Small bowel anastomosis Large bowel anastomosis Bowel anastomosis Surgery

Effect of Endocuff use on colonoscopy outcomes: A systematic review and meta-analysis

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World Journal of Gastroenterology 2019年第9期25卷 1158-1170页

作者： Konstantinos Triantafyllou Paraskevas Gkolfakis georgios Tziatzios Ioannis S Papanikolaou Lorenzo Fuccio Cesare Hassan Hepatogastroenterology Unit Second Department of Internal Medicine - Propaedeutic Research Institute and Diabetes Center Medical School National and Kapodistrian University of Athens ‘‘Attikon" University General Hospital Department of Medical and Surgical Sciences S. Orsola-Malpighi University Hospital Endoscopy Unit Nuovo Regina Margherita Hospital

BACKGROUND Endocuff-a plastic device with flexible projections-mounted on the distal tip of the colonoscope, promises improved colonic mucosa *** To elucidate the effect of Endocuff on adenoma detection rate(ADR), advanced ADR(AADR) and mean number of adenomas per colonoscopy(MAC).METHODS Literature searches identified randomized-controlled trials evaluating Endocuffassisted colonoscopy(EAC) vs conventional colonoscopy(CC) in terms of ADR,AADR and MAC. The effect size on study outcomes was calculated using fixed or random effect model, as appropriate, and it is shown as relative risk(RR) [95%confidence interval(CI)] and mean difference(MD)(95%CI). The rate of device removal in EAC arms was also *** We identified nine studies enrolling 6038 patients. All studies included mixed population(screening, surveillance and diagnostic examinations). Seven and two studies evaluated the first and the second-generation device, respectively. EAC was associated with increased ADR compared to CC [RR(95%CI): 1.18(1.05-1.32); Ι~2 = 71%]; EAC benefits more endoscopists with ADR ≤ 35% compared to those with ADR > 35% [RR(95%CI): 1.37(1.08-1.74); Ι~2 = 49% vs 1.10(0.99-1.24); Ι~2= 71%]. In terms of AADR and MAC, no difference was detected between EAC and CC [RR(95%CI): 1.03(0.85-1.25); Ι~2 = 15% and MD(95%CI): 0.30(-0.17-0.78);Ι~2 = 99%]. Subgroup analysis did not show any difference between the two device generations regarding all three endpoints. In EAC arms, the device had to be removed in 3%(95%CI: 2%-5%) of the cases mainly due to tortuous sigmoid or presence of diverticula along *** EAC increases ADR compared to CC, especially for endoscopists with lower ADR. On the other hand, no significant effect on AADR and MAC was detected.

关键词： Adenoma detection rate Colonoscopy Adenoma Detection Endocuff Endocuff-Vision

Role of innovative 3D printing models in the management of hepatobiliary malignancies

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World Journal of Hepatology 2019年第7期11卷 574-585页

作者： Peter Bangeas Vassilios Tsioukas Vasileios N Papadopoulos georgios Tsoulfas Department of Surgery Aristotle University of ThessalonikiThessaloniki 54124Greece Department of School of Rural and Surveying Engineering Aristotle University of ThessalonikiThessaloniki 54124Greece

Three-dimensional (3D) printing has recently emerged as a new technique in various liver-related surgical fields. There are currently only a few systematic reviews that summarize the evidence of its impact. In order to construct a systematic literature review of the applications and effects of 3D printing in liver surgery, we searched the PubMed, Embase and ScienceDirect databases for relevant titles, according to the PRISMA statement guidelines. We retrieved 162 titles, of which 32 met the inclusion criteria and are reported. The leading application of 3D printing in liver surgery is for preoperative planning. 3D printing techniques seem to be beneficial for preoperative planning and educational tools, despite their cost and time requirements, but this conclusion must be confirmed by additional randomized controlled trials.

关键词： Three-dimensional printing Three-dimensional models Liver Surgery Hepatic phantom models

Introduction of a digital near-vision reading test for normal and low vision adults:development and validation

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Eye and Vision 2020年第1期7卷 497-511页

作者： georgios Labiris Eirini-Kanella Panagiotopoulou Eleftherios Chatzimichael Maria Tzinava Asimina Mataftsi Konstantinos Delibasis Department of Ophthalmology University Hospital of AlexandroupolisDragana68100 AlexandroupolisGreece Department of Computer Science and Biomedical Informatics University of Thessaly35100LamiaGreece 2nd Department of Ophthalmology Aristotle University of Thessaloniki56429ThessalonikiGreece

Background:MNREAD is an advanced near-vision acuity chart that has already been translated and validated in Greek *** that no validated Greek digital near-vision test exists,our primary objective was to develop and validate a digital near-vision reading test based on the fundamental properties of the Greek printed MNREAD(MNREAD-GR).Methods:This is a prospective,comparative study.A digital near-vision chart was developed(Democritus Digital Acuity Reading Test-DDART)with text size calibration,audio recording for automatic reading timing,as well as automatic calculation of reading acuity(RA),maximum reading speed(MRS),critical print size(CPS)and reading accessibility index(ACC).Normal and low vision subjects participated in the validation process,responding to MNREAD-GR and DDART at the same day,at a 40 cm viewing *** in all parameters between the charts were compared with t-test and intraclass correlation coefficients(ICCs).Within 15 days,all participants responded again to DDART in a different set of sentences to assess its test-retest ***:One hundred patients(normal vision group-NVG:70 patients;low vision group-LVG:30 patients)responded to both reading ***-significant differences were detected for all parameters between DDART and MNREAD-GR except for MRS and ACC that were significantly higher in MNREAD-GR in NVG(p<0.01).NVG participants demonstrated sufficient ICCs that ranged from 0.854 to 0.963,while LVG demonstrated ICCs for RA,ACC,MRS and CPS equal to 0.986,0.894,0.794 and 0.723,*** parameters calculated with DDART demonstrated excellent test-retest reliability(ICCs:0.903-0.956).Conclusions:The proposed reading test presented comparable validity and repeatability to MNREAD-GR suggesting that it can be used both in normal and low vision Greek patients.

关键词： Digital near-vision chart Critical print size Reading acuity Reading speed Presbyopia Low vision

磁性纳米结构中由激光引起的超快自旋动力学研究

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物理学报 2011年第1期60卷 683-690页

作者：李春杨帆 georgios Lefkidis Wolfgang Hubner 西北工业大学力学与土木建筑学院西安710072 西北工业大学出版社西安710072 凯泽斯劳滕工业大学物理系和OPTMAS研究中心德国凯泽斯劳滕67653

以单个磁性中心的NiO以及由Co和Ni等元素构成的双磁性中心的纳米结构为例,总结了近年所做的主要工作.为了在理论上实现磁性纳米结构中的超快自旋翻转和转移,提出了一种称为Λ进程(Λprocess)的超快自旋转换机理.在实际计算中,首先采用... 详细信息

以单个磁性中心的NiO以及由Co和Ni等元素构成的双磁性中心的纳米结构为例,总结了近年所做的主要工作.为了在理论上实现磁性纳米结构中的超快自旋翻转和转移,提出了一种称为Λ进程(Λprocess)的超快自旋转换机理.在实际计算中,首先采用量子化学第一性原理计算得到磁性纳米结构中精确的隙间d电子态,然后考虑外加磁场和自旋轨道耦合分析磁性原子中的自旋局域化程度,最后引入激光脉冲项,研究在其作用下材料的自旋态经由Λ进程实现转换的时间历程.研究结果表明自旋翻转和转移可以在线偏振光的作用下在亚皮秒的时间尺度内完成.为了进一步实现对磁性分子自旋操控的检测和监控,采用附加于磁性中心上的CO分子对磁性分子进行标记.计算得到的与自旋态相关的C—O键振动频率表明自旋操控可以较容易地经由红外光谱实验间接监控.

关键词：超快自旋动力学第一性原理计算 Λ进程磁性纳米结构

Perioperative blood management strategies for patients undergoing total knee replacement:Where do we stand now?

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World Journal of Orthopedics 2017年第6期8卷 441-454页

作者： Tzatzairis Themistoklis Vogiatzaki Theodosia Kazakos Konstantinos Drosos I georgios Department of Orthopaedic Surgery Medical SchoolDemocritus University of ThraceUniversity General Hospital of Alexandroupolis Department of Anaesthesia Medical SchoolDemocritus University of ThraceUniversity General Hospital of Alexandroupolis

Total knee replacement(TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions(ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously. Many blood conservation strategies have been attempted including preoperative autologous blood donation, acute normovolemic haemodilution, autologous blood transfusion, intraoperative cell saver, drain clamping, pneumatic tourniquet application, and the use of tranexamic acid. For practical and clinical reasons we will try to classify these strategies in three main stages/pillars: Pre-operative optimization, intra-operative and post-operative protocols. The aim of this work is review the strategies currently in use and reports our experience regarding the perioperative blood management strategies in TKR.

关键词： Total knee replacement Transfusion Total knee arthroplasty Blood loss Autologous blood donation Blood management Perioperative Tranexamic acid Tourniquet Haemodilution Anaemia Transfusion protocol

A Conceptual Deficiency for the Use of Christoffel Connection in Gravity Theories

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Journal of Modern Physics 2020年第7期11卷 1013-1030页

作者： georgios Kofinas Research Group of Geometry Dynamical Systems and Cosmology Department of Information and Communication Systems Engineering University of the Aegean Karlovassi Samos Greece

Christoffel connection (or Levi-Civita affine connection) did not enter gravity as an axiom of minimal length for the free fall of particles (where anyway length action is not defined for massless particles), nor out of economy, but from the weak equivalence principle (gravitational force is equivalent to acceleration according to Einstein) together with the identification of the local inertial frame with the local Lorentz one. This identification implies that the orbits of all particles are given by the geodesics of the Christoffel connection. Here, we show that in the presence of only massless particles (absence of massive particles), the above identification is inconsistent and does not lead to any connection. The proof is based on the existence of projectively equivalent connections and the absence of proper time for null particles. If a connection derived by some kinematical principles for the particles is to be applied in the world, it is better for these principles to be valid in all relevant spacetime rather than different principles to give different connections in different spacetime regions. Therefore, our result stated above may imply a conceptual insufficiency of the use of the Christoffel connection in the early universe where only massless particles are expected to be present (whenever at least some notions, like orbits, are meaningful), and thus of the total use of this connection. If in the early universe, the notion of a massive particle, which appears latter in time, cannot be used, in an analogous way in a causally disconnected high-energy region (maybe deep interior of astrophysical objects or black holes), the same conclusions could be extracted if only massless particles are present.

关键词： Particle Kinematics Massless Particles Equivalence Principle Local Inertial Frames Local Lorentz Frames