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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 *** is closely associated with cholelithiasis and long-standing large(>3 cm)gallstones in up to 90%of *** 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 *** is made by ultrasound,computed tomography(CT),and,more precisely,magnetic resonance imaging(MRI).Preoperative staging is of great importance in decisionmaking regarding therapeutic *** 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 *** 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 *** laparoscopy may detect dissemination not otherwise found in 20%-28.6%of *** treatment is needed,including surgical resection,targeted therapy by biological agents according to molecular testing gene mapping,chemotherapy,radiation therapy,and *** is of great importance to understand the updated guidelines and current treatment *** 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 *** addition to surgery,novel targe

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

The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation:A randomized,physiological,crossover study

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Journal of Intensive Medicine 2024年第2期4卷 202-208页

作者： Elena Lytra Stelios Kokkoris ioannis Poularas Dimitrios Filippiadis Demosthenes Cokkinos Dimitrios Exarhos Spyros Zakynthinos Christina Routsi 1st Department of Intensive Care Medical SchoolNational and Kapodistrian University of AthensEvangelismos HospitalAthensGreece Radiology Department Evangelismos HospitalAthensGreece 2nd Radiology Department Medical SchoolNational and Kapodistrian University of AthensAttikon HospitalAthensGreece

Background Compared to conventional oxygen devices,high-flow oxygen treatment(HFOT)through the nasal cannulae has demonstrated clinical *** data exist on whether such effects are also present in HFOT through ***,we aimed to examine the short-term effects of HFOT through tracheostomy on diaphragmatic function and respiratory parameters in tracheostomized patients on prolonged mechanical *** A randomized,crossover,physiological study was conducted in our ICU between December 2020 and April 2021,in patients with tracheostomy and prolonged mechanical *** patients underwent a 30-min spontaneous breathing trial(SBT)and received oxygen either via T-piece or by HFOT through tracheostomy,followed by a washout period of 15-min breathing through the T-piece and receipt of 30-min oxygen with the other modality in a randomized crossover *** the start and end of each session,blood gasses,breathing frequency(f),and tidal volume(vT)via a Wright's spirometer were measured,along with diaphragm ultrasonography including diaphragm excursion and diaphragmatic thickening fraction,which expressed the inspiratory muscle *** Eleven patients were enrolled in whom 19 sessions were uneventfully completed;eight patients were studied twice on two different days with alternate sessions;and three patients were studied *** were randomly assigned to start the SBT with a T-piece(n=10 sessions)or with HFOT(n=9 sessions).With HFOT,vT and minute ventilation(vE)significantly increased during SBT(from[465±119]mL to[549±134]mL,Pvely),but they did not change significantly during SBT with T-piece(from[495±132]mL to[461±123]mL and from[12.8±4.4]mL to[12.0±4.4]mL,respectively);f/vT decreased during HFOT(from[64±31]breaths/(min∙L)to[49±24]breaths/(min∙L),P<0.001),but it did not change significantly during SBT with T-piece(from[59±28]breaths/(min∙L)to[64±33]breaths/(m

关键词： Diaphragm Diaphragm ultrasonography High-flow oxygen Prolonged mechanical ventilation Tracheostomy

Evaluation of Technical Education by Using a Modern Structured MOODLE Laboratory Course, in Relation to Recent Data

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Journal of Intelligent Learning Systems and Applications 2024年第3期16卷 316-339页

作者： Gerasimos vlassopoulos George Albert Karikas Efstathia Papageorgiou ioannis Psaromiligkos Niki Giannouli Pigi vlassopoulou Petros Karkalousos Department of Biomedical Sciences University of West Attica Athens Greece

E-learning platforms support education systems worldwide, transferring theoretical knowledge as well as soft skills. In the present study high-school pupils’, and adult students’ opinions were evaluated through a modern structured MOODLE interactive course, designed for the needs of the laboratory course “Automotive Systems”. The study concerns Greek secondary vocational education pupils aged 18 and vocational training adult students aged 20 to 50 years. The multistage, equal size simple random cluster sample was used as a sampling method. Pupils and adult students of each cluster completed structured 10-question questionnaires both before and after attending the course. A total of 120 questionnaires were collected. In general, our findings disclosed that the majority of pupils and adult students had significantly improved their knowledge and skills from using MOODLE. They reported strengthening conventional teaching, using the new MOODLE technology. The satisfaction indices improved quite, with the differences in their mean values being statistically significant.

关键词： Information and Communication Technologies (ICT) Distance Learning E-Learning Students’ Opinions Education in Greece I.C.T. in Greece Students Pupils Adults Adult Students MOODLE MOOC (v.H.S.) vocational High Schools (S.H.v.T.) Schools of Higher vocational Training vocational Profession Interactive Lessons Courses Training Laboratory Course Secondary Education Automotive Systems Car Systems

Hesitant steps from the artificial skin to organ regeneration

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Regenerative Biomaterials 2018年第4期5卷 189-195页

作者： ioannis v.Yannas Department of Mechanical Engineering Massachusetts Institute of TechnologyCambridgeMA 02139USA

This is a historical account of the steps,both serendipitous and rational,that led my group of students and colleagues at MIT and Harvard Medical School to discover induced organ *** research led to methods for growing back in adult mammals three heavily injured organs,skin,peripheral nerves and the *** conclude that regeneration in adults is induced by a modification of normal wound healing.

关键词： skin regeneration peripheral nerve regeneration contraction blocking dermis regeneration template

RSDM:A Powerful Direct Method to Predict the Asymptotic Cyclic Behavior of Elastoplastic Structures

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Chinese Journal of Mechanical Engineering 2021年第6期34卷 21-38页

作者： Konstantinos v.Spiliopoulos ioannis A.Kapogiannis Institute of Structural Analysis and Antiseismic Research Department of Civil EngineeringNational Technical University of AthensZografou Campus157-80 AthensGreece

Mechanical engineering structures and structural components are often subjected to cyclic thermomechanical loading which stresses their material beyond its elastic limits well inside the inelastic *** on the level of loading inelastic strains may lead either to failure,due to low cycle fatigue or ratcheting,or to safety,through elastic ***,it is important to estimate the asymptotic stress state of such *** state may be determined by cumbersome incremental time-stepping *** methods,alternatively,have big computational advantages as they focus on the characteristics of these states and try to establish them,in a direct way,right from the beginning of the *** the very few such general-purpose direct methods,a powerful direct method which has been called RSDM has appeared in the *** method may directly predict any asymptotic state when the exact time history of the loading is *** advantage of the method is due to the fact that it addresses the physics of the asymptotic cycle and exploits the cyclic nature of its expected residual stress *** on RSDM a method for the shakedown analysis of structures,called RSDM-S has also been *** most direct methods for shakedown,RSDM-S does not need an optimization algorithm for its *** RSDM and RSDM-S may be implemented in any Finite Element Code.A thorough review of both these methods,together with examples of implementation are presented herein.

关键词： Direct methods RSDM RSDM-S Shakedown Alternating plasticity Ratcheting

Clinical impact of microbiome in patients with decompensated cirrhosis

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World Journal of Gastroenterology 2018年第34期24卷 3813-3820页

作者： Theodora Oikonomou George v Papatheodoridis Michael Samarkos ioannis Goulis Evangelos Cholongitas Fourth Department of Internal Medicine Hippokration General Hospital Medical School of Aristotle University of Thessaloniki Academic Department of Gastroenterology Laiko General Hospital Medical School of National and Kapodistrian University of Athens First Department of Internal Medicine Laiko General Hospital Medical School of National and Kapodistrian University of Athens

Cirrhosis is an increasing cause of morbidity and mortality. Recent studies are trying to clarify the role of microbiome in clinical exacerbation of patients with decompensated cirrhosis. Nowadays, it is accepted that patients with cirrhosis have altered salivary and enteric microbiome, characterized by the presence of dysbiosis. This altered microbiome along with small bowel bacterial overgrowth, through translocation across the gut, is associated with the development of decompensating complications. Studies have analyzed the correlation of certain bacterial families with the development of hepatic encephalopathy in cirrhotics. In general, stool and saliva dysbiosis with reduction of autochthonous bacteria in patients with cirrhosis incites changes in bacterial defenses and higher risk for bacterial infections, such as spontaneous bacterial peritonitis, and sepsis. Gut microbiome has even been associated with oncogenic pathways and under circumstances might promote the development of hepatocarcinogenesis. Lately, the existence of the oral-gutliver axis has been related with the development of decompensating events. This link between the liver and the oral cavity could be via the gut through impaired intestinal permeability that allows direct translocation of bacteria from the oral cavity to the systemic circulation. Overall, the contribution of the microbiome to pathogenesis becomes more pronounced with progressive disease and therefore may represent an important therapeutic target in the management of cirrhosis.

关键词： Microbiome Dysbiosis Oral-gut-liver axis Hepatic encephalopathy Decompensated cirrhosis Liver carcinoma

Thrombosis and inflammatory bowel disease-the role of genetic risk factors

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World Journal of Gastroenterology 2008年第28期14卷 4440-4444页

作者： Georgia Tsiolakidou ioannis E Koutroubakis Department of Gastroenterology University Hospital Heraklion CreteHeraklion 71110Greece

Thromboembolism is a significant cause of morbidity and mortality in patients with inflammatory bowel disease （IBD）. Recent data suggest thromboembolism as a disease-specific extraintestinal manifestation of IBD, which is developed as the result of multiple interactions between acquired and genetic risk factors. There is evidence indicating an imbalance of procoagulant, anticoagulant and fibrinolitic factors predisposing in thrombosis in patients with IBD. The genetic factors that have been suggested to interfere in the thrombotic manifestations of IBD include factor v Leiden, factor Ⅱ （prothrombin, G20210A）, methylenetetrahydrofolate reductase gene mutation （MTHFR, 6777T, plasminogen activator inhibitor type 1 （PAI-1） gene mutation and factor X Ⅲ （val34leu）. In this article we review the current data and future prospects on the role of genetic risk factors in the development of thromboembolism in TBD.

关键词： Crohn's disease Factor Ⅴ Leiden Genetics Thrombosis Ulcerative colitis

Circulating autoantibodies to endogenous erythropoietin are associated with chronic hepatitis C virus infection-related anemia

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 289-295页

作者： Aristotelis Tsiakalos Theoharis voumvas Alexandros Psarris Christina K Oikonomou Dimitrios C Ziogas ioannis Ketikoglou Grigorios Hatzis Nikolaos v Sipsas Department of Pathophysiology Laikon General Hospital Medical School National and Kapodistrian University of Athens Athens Greece hird Department of Internal Medicine Laikon General Hospital Medical School National and Kapodistrian University of Athens Athens Greece Microbiology Department Red Cross General Hospital Athens Greece Department of Internal Medicine Hippocration General Hospital Athens Greece

BACKGROUND： Chronic hepatitis C virus （HCv） infection is associated with autoimmune phenomena and is often complicated by anemia. Circulating autoantibodies to endogenous erythropoietin （anti-EPO） have been detected in patients with chronic viral infections and were correlated to anemia. The present study aimed to determine anti-EPO prevalence in pa- tients with chronic HCv infection and investigate its possible association with anemia. METHODS： Ninety-three consecutive patients （62 males and 31 females） with chronic HCv infection, who had never re- ceived antiviral therapy or recombinant EPO, were enrolled in the study. Circulating anti-EPO were detected in the serum by using an ELISA assay. Quantitative determination of serum EPO levels was done by radioimmunoassay. HCv RNA viral load t and genotype sequencing were also performed. RESULTS： Circulating anti-EPO were detected in 10.8% of HCv-infected patients and the prevalence of anti-EPO was significantly higher in patients with anemia （19.4% vs 5.3%, P=0.040） compared to that in those without anemia. Compared to anti-EPO negative cases, anti-EPO positive patients had higher frequency of anemia （70.0% vs 34.9%, P=0.030）, lower EPO concentrations （median 16.35 vs 30.65 mU/mL, P=0.005）, and higher HCv RNA viral load （median 891.5x103 vs 367.5x 103 IU/mL, P=0.016）. In multivariate regression anal- ysis the presence of anti-EPO remained an independent predictor of anemia （adjusted OR： 14.303, 95% CI： 1.417-36.580, P=0.024）. EPO response to anemia was less prominent among anti-EPO positive patients （P=0.001）. CONCLUSIONS： Circulating anti-EPO are detected in a significant proportion of treatment-naive HCv-infected patients and are independently associated with anemia, suggesting a further implication of autoimmunity in the pathophysiology of HCv-related anemia.

关键词： hepatitis C virus erythropoietin anemia autoantibodies

Risk Management in On-Line Banking

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Intelligent Information Management 2011年第4期3卷 112-118页

作者： ioannis v. Koskosas 不详

In the context of goal setting, the more difficult the goal, given feedback on performance, the more focused is individuals’ attention and persistence to accomplish the goal and in turn, their performance is also improved. Similarly, when the goal is multi-complex and performance time constraint, the deployment of specific strategies maybe the best approach developed. In effect of the above, this investigation takes a socio-psychological and organizational perspective in setting information systems (IS) security goals. In doing so, three important issues of goal setting are identified, these are: trust, culture and risk communication. Since system security breaches are still on the rise, the performance of managing such online risks is not the one expected. The framework suggested in this paper aims to contribute to socio-psychological and organizational values by enhancing the performance of the IS risk management process with a focus on security risks.

关键词： Online Banking Trust Culture Risk Communication Goal Setting