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Disparities in colorectal cancer in African-Americans vs Whites: Before and after diagnosis

World Journal of Gastroenterology 2009年第30期15卷 3734-3743页

作者： Anastasios Dimou kostas n syrigos Muhammad Wasif Saif Yale Cancer Center Yale School of MedicineNew HavenCT 06520United States

There are differences between African-American and white patients with colorectal cancer, concerning their characteristics before and after diagnosis. Whites are more likely to adhere to screening guidelines. This is also the case among people with positive family history. Colorectal cancer is more frequent in Blacks. Studies have shown that that since 1985, colon cancer rates have dipped 20% to 25% for Whites, while rates have gone up for African-American men and stayed the same for African-American women. Overall, African-Americans are 38% to 43% more likely to die from colon cancer than are Whites. Furthermore, it seems that there is an African-American predominance in right-sited tumors. African Americans tend to be diagnosed at a later stage, to suffer from better differentiated tumors, and to have worse prognosis when compared with Whites. Moreover, less black patients receive adjuvant chemotherapy for resectable colorectal cancer or radiation therapy for rectal cancer. Caucasians seem to respond better to standard chemotherapy regimens than AfricanAmericans. Concerning toxicity, it appears that patients of African-American descent are more likely to develop 5-FU toxicity than Whites, possibly because of their different dihydropyridine dehydrogenase status. Last but not least, screening surveillance seems to be higher among white than among black long-term colorectal cancer survivors. Socioeconomic and educational status account for most of these differences whereas little evidence exists for a genetic contribution in racial disparity. Understanding the nature of racial differences in colorectal cancer allows tailoring of screening and treatment interventions.

关键词：大肠癌非洲诊断美国

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在周期性的 glucagonoma 的骨头损害: 一份案例报告和文学的评论

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World Journal of Gastrointestinal Oncology 2012年第6期4卷 152-155页

作者： Cristian Ghetie Daniel Cornfeld Vassilios S Ramfidis kostas n syrigos Muhammad W Saif Danbury Hospital Danbury CT 06810 United States Department of Diagnostic Radiology Yale School of Medicine New Haven CT 06510 United States Third Department of Medicine Sotiria General Hospital Athens Medical School Athens 11527 Greece Section of Medical Oncology Yale School of Medicine New Haven CT 06510 United States Division of Hematology and Oncology Department of Medicine Columbia University NY 10032 United States

Glucagonomas are rare neuroendocrine tumors that arise from cells of the pancreatic islets. Most of them are malignant and usually present as metastatic disease. Sites most commonly involved in metastases are the liver and regional lymph nodes. Bone metastases are rare events and only a few cases have been reported in the literature. We present the case of a 53-year-old male with a medical history of recurrent non-functioning glucagonoma. He presented 17 years after the initial diagnosis with new blastic bone lesions involving the T1 vertebra and the sacrum. Diagnostic steps and medical management in metastatic glucagonoma are also reviewed.

关键词： Glucagonoma Bone metastases Blastic lesion Octreoscan

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Fever as the only manifestation of hypersensitivity reactions associated with oxaliplatin in a patient with colorectal cancer Oxaliplatin-induced hypersensitivity reaction

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World Journal of Gastroenterology 2007年第39期13卷 5277-5281页

作者： M Wasif Saif Shailja Roy Leslie Ledbetter Jennifer Madison kostas syrigos Yale University School of Medicine New Haven CT 06520 United States University of Alabama at Birmingham Birmingham AL United States Athens Medical School Sotiria General HospitalAthens Greece

Hypersensitivity reactions (HSR) to oxaliplatin in patients with colorectal cancer include facial ushing, erythema, pruritis, fever, tachycardia, dyspnea, tongue swelling, rash/hives, headache, chills, weakness, vomiting, burning sensations, dizziness, and edema. We report a patient with fever as the sole manifestation of initial HSR, review the literature and discuss the management of HSR. A 57-year-old female with T3n2M0 rectal adenocarcinoma received modified FOLFOX-6. She tolerated the first 8 cycles without any toxicities except grade 1 peripheral neuropathy and nausea. During 9th and 10th infusions, she developed fever to a maximum of 38.3℃ with stable hemodynamic status despite medications. During 11th infusion, she developed grade 3 HSR consisting of symptomatic bronchospasm, hypotension, nausea, vomiting, cough, and fever. On examination, she was pale, cyanotic, with a temperature of 38.8℃, BP dropped to 95/43 mm Hg, pulse of 116/min and O2 saturation of 88%-91%. She was hospitalized for management and recovered in 24 h. Fever alone is not a usual symptom of oxaliplatin HSR. It may be indicative that the patient may develop serious reactions subsequently, as did our patient who developed hypotension with the third challenge. Treatment and prevention consists of slowing the infusion rate, use of steroids and antagonists of Type 1 and 2 histamine receptor antagonists, whereas desensitization could help to provide the small number of patients who experience severe HSR with the ability to further receive an effective therapy for their colorectal cancer.

关键词：过敏性反应结肠直肠癌患者临床

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Cholangiocarcinoma:principles and current trends

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Hepatobiliary & Pancreatic Diseases International 2011年第1期10卷 10-20页

作者： George n Zografos Athanasios Farfaras Flora Zagouri Dimosthenis Chrysikos kostas Karaliotas Third Department of Surgery Athens General HospitalAthensGreece Department of Clinical Therapeutics Alexandra HospitalAthensGreece Department of Surgery Red Cross HospitalAthensGreece

BACKGROUnD:Cholangiocarcinoma(CCA)is a lethal cancer of the biliary epithelium,originating from the liver(intrahepatic),at the confluence of the right and left hepatic ducts(hilar)or in the extrahepatic bile ducts.It is a rare malignancy associated with poor prognosis.DATA SOURCES:We searched the PubMed/MEDLInE database for relevant articles published from 1989 to 2008.The search terms used were related to 'cholangiocarcinoma' and its ' treatment'.Although no language restrictions were imposed initially,for the full-text review and final analysis,our resources only permitted the review of articles published in English.This review deals with the treatment of cholangiocarcinoma,the principles and the current trends.RESULTS:The risks and prognostic factors,symptoms and differential diagnosis are thoroughly discussed.In addition,the tools of preoperative diagnosis such as endoscopic retrograde cholangiopancreatography,digital image analysis,fluorescence in situ hybridization and magnetic resonance cholangiopancreatography are reviewed.Moreover,the treatment of CCA is discussed.COnCLUSIOnS:The only curative treatment available is surgical management.Unfortunately,many patients present with unresectable tumors,the majority of whom die within a year of diagnosis.Surgical treatment involves major resections of the liver,pancreas and bile duct,with considerable mortality and morbidity.However,in selected cases and where indicated,appropriate management with aggressive surgery may achieve a good outcome with a prolonged survival expectancy.

关键词： cholangiocarcinoma treatment prognostic factors risk factors surgery

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Micromechanical experiments using a new inter-granule loading apparatus on gravel to ballast-sized materials

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Friction 2020年第1期8卷 70-82页

作者： Chitta Sai SAnDEEP kostas SEnETAKIS City University of Hong Kong Hong Kong SARChina

Micromechanical and tribological studies of geological materials with a particular focus on their contact-mechanics behavior at the grain scale are currently a major interest in the engineering and geoscience disciplines. In this study, a new robust micromechanical apparatus developed at the City University of Hong Kong is described;it is capable of conducting inter-granule(or inter-particle) loading tests on fine gravel to ballast-sized materials of sizes as small as 5-10 mm to granules(or ballast) as big as 50 mm. The focus of our study is the description of the major technical features of the new apparatus and its performance and repeatability in conducting experiments on reference grains of chrome steel balls and glass balls;in addition, we conducted a preliminary set of experiments on crushed granitic rock, which is a material widely used in geotechnical and transportation infrastructure. The representative results of these experiments are presented in terms of the normal force-displacement relationship, friction, and tangential stiffness. The newly developed large-size apparatus is further compared with a well-established apparatus that can conduct micromechanical tests on sand-sized materials.

关键词： experimental micromechanics contact mechanics linear bearings inter‐particle friction granite debris flow ballast

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Fluxes,stocks and availability of nitrogen in evergreen broadleaf and fir forests:similarities and differences

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Journal of Forestry Research 2021年第5期32卷 2059-2066页

作者： Panagiotis Michopoulos Athanassios Bourletsikas kostas Kaoukis o.demeter-institute of mediterranean forest ecosystems terma alkmanos11528 athensgreece

In this study,nitrogen fluxes or flows in litterfall,nitrogen stocks and available nitrogen in soils of two plots representing evergreen broadleaf and Bulgarian fir forests were assessed.Both plots are in good quality sites and for this reason,the litterfall quantities and nitrogen fluxes were relatively high.The woody litterfall flux of nitrogen was significantly higher in the fir forest than in the evergreen broadleaf one.The total nitrogen stock was higher in the soil under the fir forest.However,the percentage of the available nitrogen(ammonium+nitrates)was significantly higher in the upper 20 cm soil layer of the evergreen broadleaf forest in spite of the higher average C/n ratios in the foliar litterfall of the broadleaf forest and insignificant difference of the C/n ratios in all soil layers of the two ecosystems.The microclimatic conditions(higher soil temperatures in the evergreen broadleaf forest)is probable possible cause for this difference.The available nitrogen in the soils and its retranslocation from senescing leaves cover the nitrogen requirements of trees.It is hypothesized that trees may also take up nitrogen from deeper soil layers.

关键词： Maquis Fir nitrogen Litterfall fluxes Soil

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α2-Heremans-schmid glycoprotein(fetuin A)downregulation and its utility in inflammatory bowel disease

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World Journal of Gastroenterology 2017年第3期23卷 437-446页

作者： Anastassios C Manolakis Gregory Christodoulidis Andreas n Kapsoritakis Panagiotis Georgoulias Elisavet K Tiaka kostas Oikonomou Varvara J Spyros P Potamianos Department of Gastroenterology University of ThessalySchool of Medicine41110 LarissaGreece Department of Surgery University of ThessalySchool of Medicine41110 LarissaGreece Laboratory of nuclear Medicine University of ThessalySchool of Medicine41110 LarissaGreece

AIM To investigate the impact of inflammatory bowel disease (IBD) on α2-Heremans-Schmid Glycoprotein(AHSG/fetuin A) and potential associations with disease and patient characteristics.METHODS AHSG serum levels were determined in treatment-na?ve newly-diagnosed patients, 96 with ulcerative colitis(UC), 84 with Crohn's disease (CD), 62 with diarrheapredominant or mixed irritable bowel syndrome (IBS, D- and M- types) and 180 healthy controls (HC), by an enzyme linked immunosorbent assay (ELISA).All patients were followed for a minimum period of 3 years at the Gastroenterology Department of the University Hospital of Larissa, Greece. C-reactive protein(CRP), anti-glycan antibodies, anti-Saccharomyces cerevisiae mannan antibodies Ig G, anti-mannobioside carbohydrate antibodies Ig G, anti-laminariobioside carbohydrate antibodies Ig G and anti-chitobioside carbohydrate antibodies Ig A were also determined via immunonephelometry and ELISA, respectively.RESULTS The mean ± SE of serum AHSG, following adjustment for confounders, was 0.32 ± 0.02 g/L in IBD, 0.32 ± 0.03 g/L in CD and 0.34 ± 0.03 g/L in UC patients, significantly lower than in IBS patients(0.7 ± 0.018 g/L) and HC (0.71 ± 0.02 g/L) (P n all cases). AHSG levels were comparable between the CD and UC groups. Based on AHSG levels IBD patients could be distinguished from HC with about 90% sensitivity and specificity. Further adjusted analysis verified the inverse association between AHSG and penetrating, as well as stricturing CD (partial correlation coefficient: -0.45 and -0.33, respectively) (P ng for confounding factors, inverse correlations between AHSG and CRP and the need for anti-TnFα therapy or surgery, were found (partial correlation coefficients:-0.31,-0.33,-0.41, respectively, P n all cases). Finally, IBD individuals who were seropositive, for at least one marker, had AHSG levels falling within the two lower quartiles (OR = 2.86, 95%CI: 1.5-5.44, P < 0.001) while those with at least two serological markers pos

关键词： Inflammatory bowel disease Irritable bowel syndrome Fetuin A

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nutrients in litterfall,forest floor and mineral soils in two adjacent forest ecosystems in Greece

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Journal of Forestry Research 2020年第1期31卷 291-301页

作者： Panagiotis Michopoulos kostas Kaoukis George Karetsos Theodoros Grigoratos Constantini Samara H.A.O.DEMETER-Institute of Mediterranean Forest Ecosystems Terma Alkmanos11528 AthensGreece Department of Chemistry Environmental Pollution Control LaboratoryAristotle University Thessaloniki54124 ThessalonikiGreece Sustainable Transport Unit(STU) Institute for EnergyTransport and Climate Change(IETC)Joint Research Centre(JRC)Via E Fermi 274921027 IspraItaly

The fluxes of masses and the nutrients Ca,Mg,K,n,P and S were determined in the litterfall of two adjacent forest ecosystems of Hungarian oak(Quercus frainetto L.)and European beech(Fagus sylvatica L.)in a mountainous area of northeastern Greece in 2010–2015.The foliar litterfall for both species reached about 70%of the total litterfall,and was significantly higher from the other two fractions(woody and rest litterfall).The fluxes of masses and nutrients were compared between ecosystems for each fraction separately.Only one significant statistical difference was found,that of K in the woody litterfall.In addition,the stocks of masses and nutrients were calculated in the forest floors and mineral soils of the two ecosystems.Likewise,the stocks of nutrients in the forest floors and mineral soils were compared between ecosystems.In the L horizon of the forest floors,statistical differences,as a result of species effect,were found for the stocks of Ca and n.In the FH horizons,the masses and all the nutrient stocks differed significantly,as the beech plot had much higher quantities of organic matter and nutrients.These higher quantities were probably due to low soil temperatures(microclimate)and high acidity in the beech plot(species effect)that slowed down decomposition.In the mineral soils,the propagation of random error derived from random errors of the individual soil layers was an important factor in the statistical comparisons.Because of the soil acidity in the beech plot,the stocks of exchangeable base cations were significantly higher in the oak plot,whereas the other nutrient stocks did not differ.

关键词： Beech Oak Litterfall Forest floor Mineral soil nutrients

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Blunted perception of dyspnea in asthmatic children: A potential misleading criterion

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World Journal of Clinical Pediatrics 2015年第3期4卷 38-40页

作者： Konstantinos Douros Barbara Boutopoulou kostas n Priftis 3rd Department of Pediatrics "Attikon" Hospital University of Athens School of Medicine

Dyspnea(or breathlessness) is a symptom describing a perceived experience of breathing discomfort. Children's awareness of dyspnea is variable and there is only a poor correlation between the objective respiratory distress measurements and the subjectively awareness of dyspnea. Those who do not perceive dyspnea may not be motivated to comply with their daily prophylactic treatment. Since dyspnea is the main symptom of asthma, and disease management is based largely on the description of symptoms between clinic visits, unreliable symptom report may mislead decision-making for longterm treatment of asthma. Thus, therapeutic decisions should not be taken solely on patients' perception and description of dyspnea.

关键词： Breathlessness Respiratory distress Tachypnea Asthma Symptom

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Role of vitamin D in cystic fibrosis and non-cystic fibrosis bronchiectasis

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World Journal of Clinical Pediatrics 2017年第3期6卷 132-142页

作者： Maria Moustaki Ioanna Loukou kostas n Priftis Konstantinos Douros Cystic Fibrosis Unit "Aghia Sophia" Children’s Hospital Pediatric Allergy and Respiratory Unit 3rd Department of Pediatrics "Attikon" Hospital University of Athens School of Medicine

Bronchiectasis is usually classified as cystic fibrosis(CF) related or CF unrelated(non-CF); the latter is not considered an orphan disease any more, even in developed countries. Irrespective of the underlying etiology, bronchiectasis is the result of interaction between host, pathogens, and environment. Vitamin D is known to be involved in a wide spectrum of significant immunomodulatory effects such as down-regulation of pro-inflammatory cytokines and chemokines. Respiratory epithelial cells constitutively express 1α-hydroxylase leading to the local transformation of the inactive 25(OH)-vitamin D to the active 1,25(OH)_2-vitamin D. The latter through its autocrine and paracrine functions up-regulates vitamin D dependent genes with important consequences in the local immunity of lungs. Despite the scarcity of direct evidence on the involvement of vitamin D deficiency states in the development of bronchiectasis in either CF or non-CF patients, it is reasonable to postulate that vitamin D may play some role in the pathogenesis of lung diseases and especially bronchiectasis. The potential contribution of vitamin D deficiency in the process of bronchiectasis is of particular clinical importance, taking into consideration the increasing prevalence of vitamin D deficiency worldwide and the significant morbidity of bronchiectasis. Given the well-established association of vitamin D deficiency with increased inflammation, and the indicative evidence for harmful consequences in lungs, it is intriguing to speculate that the administration of vitamin D supplementation could be a reasonable and cost effective supplementary therapeutic approach for children with non-CF bronchiectasis. Regarding CF patients, maybe in the future as more data become available, we have to re-evaluate our policy on the most appropriate dosage scheme for vitamin D.

关键词： Vitamin D Bronchiectasis Cystic fibrosis Vitamin D supplementation

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