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Patients with multiple synchronous colonic cancer hepatic metastases benefit from enrolment in a “liver first” approach protocol

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World Journal of Hepatology 2014年第7期6卷 513-519页

作者： Dimitrios Kardassis Achilleas Ntinas Dimosthenis Miliaras Alexros Kofokotsios konstantinos papazisis Dionisios Vrochides Centre for Hepato-Pancreato-Biliary Surgery "Euromedica Ge-niki Kliniki" General Hospital 54645 Thessaloniki Greece Department of Pathology "Euromedica Geniki Kliniki" General Hospital 54645 Thessaloniki Greece Department of Interventional Gastroenterology "Euromedica Geniki Kliniki" General Hospital54645 Thessaloniki Greece Department of Medical Oncology "Eu-romedica Geniki Kliniki" General Hospital 54645 Thessaloniki Greece

AIM: To assess a protocol for treating patients with multiple synchronous colonic cancer liver metastases, which are unresectable in one stage. METHODS: Patients enrolled in the "liver first" protocol presented with colon-only(not rectal) cancer and multiple synchronous hepatic metastases(type Ⅱ or Ⅲ). All patients showed good performance status(ECOG PS 0-1) and were treated with curative intent. Complete oncologic staging including positron emission tomography-computed tomography was performed in order to rule out extrahepatic disease. If bowel obstruction was imminent, an intraluminal colonic stent was placed endoscopically. Subsequently, all patients received standardised neo-adjuvant chemotherapy, that is, FOLFOX or XELOX regimens combined with an antiangiogenic agent(bevacizumab or cetuximab). Provided that a response to chemotherapy was observed, patients underwent either one or two hepatectomies with or without portal vein embolization followed by the indicated colectomy. Further chemotherapy was administered after each procedure. Re-staging was performed after each chemotherapeutic treatment. Disease progression at any stage resulted in discontinuation of the protocol and conversion to palliative disease ***: Prospectively recorded data from 11 consecutive patients(8 men) were analysed for this study. Their mean age at the time of their first assessment was 65.7(SD ± 15.3) years. Six(54.6%) patients presented with type Ⅲ metastatic disease. The minimum and maximum follow-up periods were 7.3 and 39.6 mo, respectively. The mean overall survival of all patients was 16.5(95%CI: 10.0-23.2) mo. A colonic stent had to be placed in 5(45.5%) patients due to the onset of an intraluminal obstruction. Four(36.4%) patients succeeded in completing all planned surgical operations. Their mean overall survival was 27.2(95%CI: 15.1-39.3) mo and the mean disease-free survival was 7.7(95%CI: 3.0-12.5) mo. Patients, who were obliged to shift to palliative treatmen

关键词： Clinical protocols Colectomy Colon cancer Hepatectomy Liver neoplasm

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Assessment of the Most Common Pterygium Symptoms Leading to the Decision for Its Surgical Removal

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Open Journal of Ophthalmology 2013年第3期3卷 68-69页

作者： Vasileios Konidaris Evgenia Kanonidou Christina Kanonidou Leonidas papazisis Department of Ophthalmology General Hospital of Veria Veria Greece.

Purpose: Pterygium is a benign growth of conjunctival tissue frequently related to chronic sunlight exposure and hot and dry climate. Purpose of this study was to evaluate the predominant symptoms in patients with pterygium leading to its surgical removal decision. Methods: 31 patients (19 males, 12 females), mean age 48.75 years old (SD 8.5), with primary pterygium and no other eye disease participated in the study. The predominant symptoms caused by the pterygium were assessed using a questionnaire. Results: The predominant symptoms associated with the pterygium were: discomfort/feeling of foreign body in 31 patients (100%), redness in 23 (74%), increased lacrimation in 17 (55%), aesthetic reasons in 12 (39%), visual disturbance (astigmatism/extension of the pterygium to the optical axis) in 4 (13%). In one case, despite the absence of annoying symptoms, surgical excision was proposed due to the atypical appearance of pterygium. For younger patients, the predominant reason for choosing surgical removal was that the patients are not content with external appearance caused by pterygium and in contrast lacrimation was the predominant reason for the older. In most patients, visual disturbance was not a significant cause although astigmatism in eyes with pterygium was 3.51 D (SD 1.82) and 0.95 D (SD 0.78) in healthy eyes respectively. Discussion: The main symptom in patients with pterygium is foreign body sensation;meanwhile aesthetic consideration and increased lacrimation are the main reasons leading to surgical removal decision for younger and older patients, respectively.

关键词： Pterygium Pterygium Surgery Astigmatism

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Preoperative Management of Cataract Surgery Candidates: An Evaluation of Their Perception and Preferences

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Open Journal of Ophthalmology 2013年第3期3卷 90-92页

作者： Evgenia Kanonidou Vasileios Konidaris Christina Kanonidou Leonidas papazisis Department of Ophthalmology General Hospital of Veria Veria Greece.

Purpose: To assess the primary visual disability in patients with cataract and to evaluate their preference regarding the visual outcome after surgery. Materials and Methods: 120 patients (66 males, mean age 76.3 years, mean best corrected visual acuity 5.2/10 binocularly) participated. Perception regarding the primary visual disability related to cataract and preference of visual outcome after surgery were assessed by a questionnaire. All study procedures adhered to the principles outlined in the Declaration of Helsinki for research involving human subjects, and all participants gave written informed consent before their participation. Results: 74 patients (61.6%) had difficulty in distant vision, 5 (4.2%) in near vision, 17 (14.2%) mentioned blurred vision, 14 (11.7%) difficulty in driving especially at night, 7 (5.8%) complained about monocular diplopia and 3 (2.5%) about anisometropia. All mentioned that they preferred to obtain clear distant and near vision after cataract surgery. Conclusions: There was an interesting variety in visual disability related to cataract. The difficulty in distant vision was the primary visual deficit in the majority of the patients and the preference for clear distant and near vision was the desired postoperative visual outcome.

关键词： Cataract Visual Outcome Visual Disability Quality of Life

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