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Asian Journal of Andrology 2022年第2期24卷 226-227页

作者： Fotios Dimitriadis Vasileios Palapelas Athanasios Zachariou ioannis sokolakis Department of Urology Aristotle UniversitySchool of MedicineThessalonikiGreece 3^(rd)Department of Obstetrics and Gynecology Aristotle UniversitySchool of MedicineThessalonikiGreece Department of Urology Ioannina UniversitySchool of MedicineIoanninaGreece Department of Urology Martha-Maria Hospital NurembergNurembergGermany

The article by Wu et al.1 is an interesting and meticulous work investigating the role of human umbilical cord Wharton’s jelly-derived mesenchymal stem cells(hWJ-MSCs)in the treatment of erectile dysfunction(ED)in th... 详细信息

关键词： diabetic al jelly

Retinal capillary plexus in Parkinson’s disease using optical coherence tomography angiography

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International Journal of Ophthalmology(English edition) 2024年第1期17卷 131-136页

作者： ioannis Giachos Spyridon Doumazos Anastasia Tsiogka Konstantina Manoli George Tagaris Tryfon Rotsos Vassilios Kozobolis ioannis Iliopoulos Marilita Moschos First Department of Ophthalmology National and Kapodistrian University of Athens Medical SchoolAthens 11527Greece Department of Neurology General Hospital of Athens“Georgios Gennimatas”Athens 11527Greece Department of Ophthalmology Faculty of MedicineSchool of Health SciencesUniversity of PatrasPatras 26504Greece Neurology Department Democritus University of ThraceAlexandroupolis 68100Greece

AIM:To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson’s disease(PD)using optical coherence tomography angiography(OCT-A).METHODS:A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens,“Georgios Gennimatas”from March 2021 to March 2022 was conducted.Totally 44 patients with PD were included and 18 healthy controls were examined,hence a total of 124 eyes were enrolled in the study.The foveal and parafoveal superficial and deep capillary plexus vascular density(fSCP-VD,fDCP-VD,pSCP-VD,pDCP-CD)and foveal avascular zone(FAZ)were quantified with OCTA.Optical coherence tomography(OCT)was used to measure macular thickness.Our statistical analysis was conducted by using a mixed effect linear regression model.RESULTS:After adjustment for age and gender,the mean parafoveal superficial capillary plexus vascular density(pSCP-VD)and mean parafoveal deep capillary plexus vascular density(pDCP-VD)were significantly decreased in individuals with PD(P<0.001 in both)by-2.35(95%CI-3.3,-1.45)and-7.5(95%CI-10.4,-4.6)respectively.fSCP-VD and fDCP-VD didn’t approach statistical significance.The FAZ area and perimeter were significantly decreased(P<0.001 in both)by-0.1 mm^(2)(95%CI-0.13,-0.07)and-0.49 mm^(2)(95%CI-0.66,-0.32)respectively.Circularity didn’t approach statistical significance.Central retinal thickness(CRT)was significantly decreased in individuals with PD(P<0.001)by-23.1μm(95%CI-30.2,-16)and temporal retinal thickness(TRT)was decreased(P=0.025)by-11μm(95%CI-22,-1.5)while nasal retinal thickness(NRT)only approached statistical significance(P=0.066).CONCLUSION:The mean pSCP-VD,pDCP-VD,CRT and TRT are significantly decreased and FAZ is altered in individuals with PD.These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.

关键词： Parkinson’s disease optical coherence tomography angiography retinal vascular density foveal avascular zone

Epinephrine also acts on beta cells and insulin secretion

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World Journal of Clinical Cases 2024年第9期12卷 1712-1713页

作者： Lina Zabuliene ioannis Ilias Faculty of Medicine Vilnius UniversityVilnius LT-03101Lithuania Department of Endocrinology “Hippokration”General HospitalAthens GR-11527Greece

In a recent review examining neurotransmitter modulation of insulin secretion,the significant impact of epinephrine was not addressed.Its primary action involves inhibiting insulin release via alpha-adrenergic receptors,thereby reducing the response to insulin secretion stimulators,through the activation of K+channels and resulting in membrane hyperpolarization in beta cells.

关键词： Epinephrine Insulin Islets Glucose Human

First case of fungal keratitis secondary to Yamadazyma mexicana

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1164-1167页

作者： ioannis Giachos Aristea Velegraki Sotiria Palioura First Department of Ophthalmology National and Kapodistrian University of Athens Medical SchoolAthens 11527Greece Mycology Research Laboratory Microbiology DepartmentMedical SchoolNational and Kapodistrian University of AthensAthen 11527Greece BIOIATRIKI S.A Healthcare Group Athens 11526Greece Department of Ophthalmology University of Cyprus Medical SchoolNicosia 2109Cyprus

Dear Editor,Fungal keratitis is a serious and potentially sightthreatening infection that poses a global health concern,with higher incidence rates reported in low-income countries and regions with tropical climates[1-3].Risk factors for fungal keratitis include trauma with vegetative matter,contact lens wear,history of ocular surgery,chronic topical steroid use,low socioeconomic status and tropical climate[1-2].Fungi have the propensity to penetrate deep into the corneal stroma,making the infection difficult to treat with topical antifungal agents alone.Complications such as corneal perforation and endophthalmitis can arise in severe cases,making early identification of the causative fungal pathogen of utmost importance[4-5].Moreover,obtaining susceptibilities to the available antifungal agents can be sight and eye saving[5].

关键词： arise steroid income

Management of obstructed colorectal carcinoma in an emergency setting:An update

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 598-613页

作者： Efstathios T Pavlidis ioannis N Galanis Theodoros E Pavlidis 2nd Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Colorectal carcinoma is common,particularly on the left side.In 20%of patients,obstruction and ileus may be the first clinical manifestations of a carcinoma that has advanced(stage II,III or even IV).Diagnosis is based on clinical presentation,plain abdominal radiogram,computed tomography(CT),CT colonography and positron emission tomography/CT.The best management strategy in terms of short-term operative or interventional and long-term oncological outcomes re-mains unknown.For the most common left-sided obstruction,the first choice should be either emergency surgery or endoscopic decompression by self-expen-dable metal stents or tubes.The operative plan should be either one-stage or two-stage resection.One-stage resection with on-table bowel decompression and irrigation can be accompanied or not accompanied by proximal defunctioning stoma(colostomy or ileostomy).Primary anastomosis is more convenient but has increased risks of anastomotic leakage and morbidity.Two-stage resection(Hart-mann’s procedure)is safer and the most widely used despite temporally affecting quality of life.Damage control surgery in high-risk frail patients is less frequently performed since it can be successfully substituted with endoscopic stenting or tubing.For the less common right-sided obstruction,one-stage surgical resection is more beneficial than endoscopic decompression.The role of minimally invasive surgery(laparoscopic or robotic)is a subject of debate.Emergency laparoscopic-assisted management is advantageous to some extent but requires much expertise due to inherent difficulties in dissecting the distended colon and the risk of rup-ture and subsequent septic complications.The decompressing stent as a bridge to elective surgery more substantially decreases the risks of morbidity and mortality than emergency surgery for decompression and has equivalent medium-term overall survival and disease-free survival rates.Its combination with neoadjuvant chemotherapy or radiation may have a positive effect on long-term oncological outcomes

关键词： Acute abdomen Obstructive ileus Colorectal carcinoma Emergency surgery Colectomy Intraluminal metal stents

New trends in diagnosis and management of gallbladder carcinoma

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 13-29页

作者： Efstathios T Pavlidis ioannis N Galanis Theodoros E Pavlidis ^(nd)Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder(GB)carcinoma,although relatively rare,is the most common biliary tree cholangiocarcinoma with aggressiveness and poor prognosis.It is closely associated with cholelithiasis and long-standing large(>3 cm)gallstones in up to 90%of cases.The other main predisposing factors for GB carcinoma include molecular factors such as mutated genes,GB wall calcification(porcelain)or mainly mucosal microcalcifications,and GB polyps≥1 cm in size.Diagnosis is made by ultrasound,computed tomography(CT),and,more precisely,magnetic resonance imaging(MRI).Preoperative staging is of great importance in decisionmaking regarding therapeutic management.Preoperative staging is based on MRI findings,the leading technique for liver metastasis imaging,enhanced three-phase CT angiography,or magnetic resonance angiography for major vessel assessment.It is also necessary to use positron emission tomography(PET)-CT or ^(18)F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic uptake.Staging laparoscopy may detect dissemination not otherwise found in 20%-28.6%of cases.Multimodality treatment is needed,including surgical resection,targeted therapy by biological agents according to molecular testing gene mapping,chemotherapy,radiation therapy,and immunotherapy.It is of great importance to understand the updated guidelines and current treatment options.The extent of surgical intervention depends on the disease stage,ranging from simple cholecystectomy(T1a)to extended resections and including extended cholecystectomy(T1b),with wide lymph node resection in every case or IV-V segmentectomy(T2),hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y,and adjacent organ resection if necessary(T3).Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery,but much attention must be paid to avoiding injuries.In addition to surgery,novel targeted treatment along with immunotherapy and recen

关键词： Biliary tract neoplasms Extrahepatic cholangiocarcinoma Gallbladder carcinoma Gallbladder diseases Biliary tree diseases Gastrointestinal malignancies

Extending the decision-making process during yellow phase from human drivers to autonomous vehicles:A microsimulation study with safety considerations

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Journal of Traffic and Transportation Engineering(English Edition) 2024年第2期11卷 362-379页

作者： Efthymis Papadopoulos Anastasia Nikolaidou Emmanouil Lilis ioannis Politis Panagiotis Papaioannou Transport Engineering Laboratory School of Civil EngineeringFaculty of EngineeringAristotle University of ThessalonikiThessaloniki 54124Greece

One of the main factors affecting the safety of signalised intersections is the stop/go behaviour during the yellow interval.Although previous research has exhaustively examined drivers’stop/go decision-making,the expected autonomous vehicles’(AVs’)stop/go behaviour has not yet been thoroughly investigated.Through a series of simulation experiments developed for conventional and autonomous vehicles using different carfollowing,lane-changing,lateral placement and stop/go model parameter values,we examine here whether the default VISSIM stop/go parameter values can adequately replicate the observed drivers’behaviour at the considered intersection and assess the suitability of using the currently available options,albeit referring to human drivers,to simulate the expected stop/go behaviour of AVs.We also propose a policy framework for determining the desired behaviour of AVs in yellow interval,which is integrated into an AVs logic and achieved in the last simulation to explore the effect of automation on the stop/go outcome and,hence,on the safety level of signalised intersections.Several data analysis and modeling techniques were used for the formulation of certain scenarios,including binary choice models.The default stop/go parameter values were found unfit to replicate the observed stop/go behaviour and subjected to calibration.Compared to the currently available options,the proposed AVs logic proved to produce the most accurate results,in terms of the stop/go simulation outcome.Regarding the impact of automation on the stop/go outcome,the simulation experiments showed that AVs preferred a more conservative behaviour in favor of road safety,as indicated by the significant reduction(≈15%)in the number of vehicles crossing the stop line during the yellow light and zero instances of red light violation.However,compared to the conservative drivers represented by the default stop/go parameter values,AVs preferred a more rational behaviour in favor of intersection capacity without compromising road safety.

关键词： Driver behaviour AVs behaviour Signalised intersection Choice model Micro-simulation Policy framework

Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

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World Journal of Gastroenterology 2024年第10期30卷 1461-1465页

作者： Efstathios T Pavlidis ioannis N Galanis Theodoros E Pavlidis 2^(nd) Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Pancreatobiliary intraductal papillary neoplasms(IPNs)represent precursors of pancreatic cancer or bile duct cholangiocarcinoma that can be detected and treated.Despite advances in diagnostic methods,identifying these premalignant lesions is still challenging for treatment providers.Modern imaging,biomarkers and molecular tests for genomic alterations can be used for diagnosis and follow-up.Surgical intervention in combination with new chemotherapeutic agents is considered the optimal treatment for malignant cases.The balance between the risk of malignancy and any risk of resection guides management policy;therefore,treatment should be individualized based on a meticulous preoperative assessment of high-risk stigmata.IPN of the bile duct is more aggressive;thus,early diagnosis and surgery are crucial.The conservative management of low-risk pancreatic branch-duct lesions is safe and effective.

关键词： Biliary tree diseases Pancreatic cystic neoplasms Biliary tract neoplasms Extrahepatic cholangiocarcinoma Pancreatic adenocarcinoma

The Transmission,Establishment and Cross-cultural Integration of Chinese Medicine in the Mainstream Healthcare,through the Eyes of a Generation of Visionaries and Pioneers

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Chinese Medicine and Culture 2024年第1期7卷 1-4页

作者： ioannis Solos Charles Buck Saint George Clinic and Research Institute Scottsdale 85251the United States of America Northern College of Acupuncture Micklegate YO16LJthe United Kingdom

It has historically been very difficult to trace the history of the westward transmission of Chinese medicine through the accounts of its protagonists. Many of the early scholars such as Jack Worsley, Dick Van Buren, and Joe Goodman were reluctant to divulge information about the source of their knowledge, or their professional qualifications. Others, such as John Shen and Hong Yuan-bain were early 20th century immigrants who transmitted highly personalized versions of acupuncture and Chinese medicine to select disciples. Eventually, a new class of scholars appeared, including names such as Ted Kaptchuk, Peter Deadman, Nigel Wiseman, William Morris, Peter Eckman, John Mc Donald, Charles Buck, and the late Giovanni Maciocia who looked for answers back in China, developed translation methodologies and terminology, compiled the main textbooks currently in use at TCM colleges, overcame enormous scholastic adversity, developed courses and pursued the regulation and accreditation of TCM in various countries. This special issue synopsizes the path towards the global acculturation of TCM over the last 50 years, the main protagonists, the enormous accomplishments they have achieved for the profession, their philosophy, their clinical perspectives and visions for the future.

关键词： Chinese medicine Cross-cultural integration Westward transmission James Reston Acupuncture History

Traumatic lumbar hernia: A systematic review of the literature

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Chinese Journal of Traumatology 2024年第1期27卷 53-57页

作者： ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios KManatakis Department of Surgery Stony Brook University HospitalStony BrookNew YorkUSA Department of Surgical Oncology St Savvas Cancer HospitalAthensGreece nd Department of Surgery Athens Naval and Veterans HospitalAthensGreece Department of Surgery Naval Hospital of CreteChaniaGreece

Purpose:Traumatic lumbar hernia(TLH)constitutes a protrusion of content through a defect in the posterior abdominal wall,as a result of injury.This rare entity has been described in limited number of cases.Methods:A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology guidelines.The English literature from 1990 until 2021 was reviewed,using PubMed,EMBASE and Google Scholar bibliographic databases,to identify case reports and case series with patients that were diagnosed with TLH.For each eligible study,demographics,clinical presentation,hernia characteristics,preoperative imaging investigations,operation details,and postoperative data were extracted for assessment.Statistical analysis was performed on SPSS,version 20.0.Results:A total of 62 studies were included for review,with 164 patients with TLH.Mean age was(42.6±14.3)years(47.6%males,31.1%females,gender not specified in 35 cases).Mean diameter of hernia neck was(6.3±3.1)cm,while the triangles of Petit and Grynfeltt were affected in 74.5%and 14.6%,respectively.Patients diagnosed in the emergency setting account for 54.2%,with CT scan establishing diagnosis in all but one case(97.7%).A delayed diagnosis was made in 45.8%,at a mean 1 year following trauma.Flank bulging(82.8%)and chronic back pain(34.3%)were the most frequent symptoms.In both delayed and acute group,open surgery(63.6%and 92.3%,respectively)was the preferred surgical approach.Postoperative complications were reported in 11.4%of acute and 15.0%of delayed patients.Hernia recurrence was 7%.Conclusions:TLH is uncommon with 164 cases described since 1990.CT scan is the gold standard in diagnosis.Open surgery is generally the preferred approach,particularly in the emergency setting.Acute TLH can be treated either by primary suture repair or mesh,depending on the local conditions,whereas delayed cases usually require a mesh.

关键词： Lumbar hernia Petit Grynfeltt Traumatic lumbar hernia Trauma