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Atypical anastomotic malignancies of small bowel after subtotal gastrectomy with BillorthⅡgastroenterostomy for peptic ulcer:Report of three cases and review of the literature

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World Journal of Gastrointestinal Oncology 2018年第7期10卷 194-201页

作者： Efstathios Kotidis Orestis Ioannidis manousos george pramateftakis Konstantinos Christou Ioannis Kanellos Konstantinos Tsalis Fourth Surgical Department Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece

AIM To present patients who developed small-bowel malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy for ulcer,to review relevant literature,and to attempt to interpret the reasons those cancers developed to these postsurgical non-gastric sights.METHODS For the current retrospective study and review of literature,the surgical and histopathological records dated from January 1,1993 to December 31,2017 of our department were examined,searching for patients who have undergone surgical treatment of small-bowel malignancy to identify those who have undergone subtotal gastrectomy for benign peptic ulcer.A systematic literature search was also conducted using Pub Med,EMBASE,and Cochrane Library to identify similar cases.RESULTS We identified three patients who had developed smallintestine malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy with Billroth Ⅱ gastroenterostomy for benign peptic ulcertwo patients with adenocarcinoma originated in the Braun anastomosis and one patient with lymphoma of the efferent loop.All three patients were submitted to surgical resection of the tumor with Roux-en-Y reconstruction of the digestive tract.In the literature review,we only found one case of primary small-intestinal cancer that originated in the efferent loop after Billroth Ⅱ gastrectomy because of duodenal ulcer but none reporting Braun anastomosis adenocarcinoma following partial gastrectomy for benign disease.We also did not find any case of efferent loop lymphoma following gastrectomy.CONCLUSION Anastomotic gastric cancer following distal gastrectomy for peptic ulcer is a well-established clinical entity.However,malignancies of the afferent or efferent loop of the gastrointestinal anastomosis are extremely uncommon.The substantial diversion of the potent carcinogenic pancreaticobiliary secretions through the Braun anastomosis and the stomach hypochlorhydria,allowing the formation of carcinogenic factors from food,are the two most promi

关键词： Anastomotic cancer Efferent loop Braun anastomosis Adenocarcinoma Anaplastic large cell lymphoma

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Effects of albumin/glutaraldehyde glue on healing of colonic anastomosis in rats

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World Journal of Gastroenterology 2017年第31期23卷 5680-5691页

作者： Kalliopi Despoudi Ioannis Mantzoros Orestis Ioannidis Aggeliki Cheva Nikolaos Antoniou Dimitrios Konstantaras Savvas Symeonidis manousos george pramateftakis Efstathios Kotidis Stamatis Angelopoulos Konstantinos Tsalis Fourth Surgical Department Medical SchoolAristotle University of Thessaloniki Department of Pathology General Hospital“G.Papanikolaou”57010 ThessalonikiGreece

AIM To evaluate the effect of local surgical adhesive glue(albumin/glutaraldehyde-Bioglue) on the healing of colonic anastomoses in rats.METHODS Forty Albino-Wistar male rats were randomly divided into two groups, with two subgroups of ten animals each. In the control group, an end-to-end colonic anastomosis was performed after segmental resection. In the Bioglue group, the anastomosis was protected with extraluminar application of adhesive glue containing albumin and glutaraldehyde. Half of the rats were sacrificed on the fourth and the rest on the eighth postoperative day. Anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded. Other parameters of healing, such as hydroxyproline and collagenase concentrations, were evaluated. The experimental data were summarized and computed from the results of a one-way ANOVA. Fisher's exact test was applied to compare percentages. RESULTS Bursting pressures, adhesion formation, inflammatory cell infiltration, and collagen deposition were significantly higher on the fourth postoperative day in the albumin/glutaraldehyde group than in the control group. Furthermore, albumin/glutaraldehyde significantly increased adhesion formation, inflammatory cell infiltration, neoangiogenesis, and collagen deposition on the eighth postoperative day. There was no difference in fibroblast activity or hydroxyproline and collagenase concentrations. CONCLUSION Albumin/glutaraldehyde, when applied on colonic anastomoses, promotes their healing in rats. Therefore, the application of protective local agents in colonic anastomoses leads to better outcomes.

关键词：粘附爆炸压力 Bioglue Albumin/glutaraldehyde 骨胶原结肠的吻合

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Experimental models of high-risk bowel anastomosis in rats:A systematic review

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World Journal of Experimental Medicine 2024年第2期14卷 114-131页

作者： Georgios Ntampakis manousos-Georgios pramateftakis Elissavet Anestiadou Stefanos Bitsianis Orestis Ioannidis Chryssa Bekiari george Koliakos Maria Karakota Anastasia Tsakona Angeliki Cheva Stamatios Angelopoulos Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece Laboratory of Anatomy and Histology School of Veterinary MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 54124Greece Experimental and Research Center Papageorgiou General Hospital of ThessalonikiThessaloniki 56403Greece Laboratory of Biochemistry Faculty of MedicineAristotle University of ThessalonikiThessaloniki 54124Greece Department of Pathology Faculty of MedicineAristotle University of ThessalonikiThessaloniki 54124Greece

BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.

关键词： High-risk anastomosis Rats Experimental models Bowel Colon Anastomotic leak Colon resection Inflammatory bowel disease Intra-abdominal sepsis Bursting pressure

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Surgical treatment of hepatic metastases from colorectal cancer

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World Journal of Gastrointestinal Oncology 2011年第1期3卷 1-9页

作者： Georgios Tsoulfas manousos Georgios pramateftakis Ioannis Kanellos Department of Surgery Aristoteleion University of ThessalonikiThessaloniki 54622Greece

Colorectal carcinoma is one of the most frequent cancers in Western societies with an incidence of around 700 per million people.About half of the patients develop metastases from the primary tumor and liver is the primary metastatic site.Improved survival rates after hepatectomy for metastatic colorectal cancer have been reported in the last few years and these may be the result of a variety of factors,such as advances in systemic chemotherapy,radiographic imaging techniques that permit more accurate determination of the extent and location of the metastatic burden,local ablation methods,and in surgical techniques of hepatic resection.These have led to a more aggressive approach towards liver metastatic disease,resulting in longer survival.The goal of this paper is to review the role of various forms of surgery in the treatment of hepatic metastases from colorectal cancer.

关键词： Hepatic metastases Colorectal cancer Liver resection

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A simple alternative technique for harvesting split thickness skin grafts

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World Journal of Surgical Procedures 2013年第2期3卷 4-7页

作者： Leonidas Pavlidis manousos-Georgios pramateftakis Nikolaos Costogloudis Georgia-Alexandra Spyropoulou Efterpi Demiri Plastic Surgery Department Aristotle University of Thessaloniki Papageorgiou Hospital 54124 Thessaloniki Greece Department of Surgery European Interbalkan Medical Center 54124 Thessaloniki Greece

AIM: To assess the use of a simple split skin graft harvesting technique, requiring only a scalpel and a swab.METHODS: During the last 8 mo, we operated on a consecutive series of 52 patients(30 males, 22 females) with a mean age of 60 years(33-80). We used the technique we present in order to cover small skin defects. All procedures were performed under local anesthesia. Thirty-seven patients underwent bedside surgery, 8 patients were operated on in the outpatient department and the remaining 7 had their graft harvested in the operating room. After antiseptic preparation of the donor site, the margins of the graft were drawn by the use of a surgical marker. A No 15 scalpel was used for the graft elevation, under constant traction with a moist swab.RESULTS: All procedures were completed successfully without immediate complications. The patients tolerated the procedure well. The mean operative time was 15 min. Twenty-four donor sites were left to heal by secondary intention, whereas 28 were sutured with interrupted 3/0 silk sutures in order to heal by primary intention. All 24 sites that were left to heal by secondary intention healed completely in approximately 14 d. For the sites that were sutured, the sutures were removed on the 10 th postoperative day. Out of the 52 operated cases, 6 patients(11%) developed complications. In 4 patients, the split thickness skin grafts were partially lost, whereas in 2 patients the grafts were completely lost. Wound dehiscence was observed in 2 patients, which were treated with local antiseptic and antibiotic therapy.CONCLUSION: The skin graft technique described is simple, costless and effective and can be performed even on an outpatient basis, without the need for special equipment.

关键词： Skin graft Skin defect Split thickness Skin reconstruction Dermatome Tissue harvesting

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Point-of-need molecular processing of biosamples using portable instrumentation to reduce turnaround time

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Biosafety and Health 2020年第3期2卷 177-182页

作者： manousos E.Kambouris Stavroula Siamoglou Zoe Kordou Aphroditi Milioni Stamatis Vassilakis Stavroula Goudoudaki Stavroula Kritikou Yiannis Manoussopoulos Aristea Velegraki george P.Patrinos Department of Pharmacy University of PatrasRio Patras 26504Greece Department of Microbiology School of MedicineNational and Kapodistrian University of AthensMikras Asias 75Athens 11527Greece Plant Protection Division of Patras Institute of Industrial and Forage PlantsN.E.O&AmerikisPatras 26004Greece United Arab Emirates University College of Medicine and Health SciencesDepartment of PathologyAl-AinUnited Arab Emirates United Arab Emirates University Zayed Center of Health SciencesAl-AinUnited Arab Emirates

Infectious agents,both standard and emerging or engineered,might initiate outbreaks with global impact and/or existential-level threat potential.Such agents might infect human,livestock,exploitable plant cultures or the environment at large.Instead of responding by sampling teams which may also carry out prolonged surveillance,a more effective concept is to pre-process the samples,possibly to nucleic acid extract so as to transport them without biological risks by standard channels,or to process them up to a point and return the results,leaving the samples which only need specialized tests and dedicated equipment.In this context a portable device,allowing multiple routine and crisis-management applications due to its inherent flexibility,is scrutinized against alternatives and possible needs so as to develop a novel standard of surveillance and intervention,meant to facilitate containment by providing faster much more reliable laboratory results at a fraction of older generation mobile nucleic acids analyzers.Additional steps,such as agarose in pills and buffers pre-packaged in expendable syringes with pistons locked by improvised safety features may improve the Complexity Level of the whole system so as to make it appealing to intervention/crisis management personnel,while the instrument proper may double as backup for respective benchtop devices.

关键词： Point-of-Need Biosurveillance Public health Biosecurity-biosafety Portable PCR Portable NGS Quarantine pathogens

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Molecular markers(PECAM-1,ICAM-3,HLA-DR)determine prognosis in primary non-Hodgkin's gastric lymphoma patients

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World Journal of Gastroenterology 2006年第12期12卷 1924-1932页

作者： Alexander Darom Ilias P Gomatos Emmanuel Leandros Emmu Chatzigianni Dimitris Panousopoulos manousos M Konstadoulakis george Androulakis Laboratory of Surgical Research First Department of Propaedeutic SurgeryAthens Medical SchoolHippokration Hospital of Athens114 Q.Sofia Ave11527 AthensGreece

瞄准：与主要 non-Hodgkin 的胃的淋巴瘤在病人调查 PECAM-1， ICAM-3 和 HLA 医生抗原的预示的意义。方法：我们免疫组织化学地在 36 个 B 房间麦芽类型主要胃的淋巴瘤病人学习了 PECAM-1， ICAM-3 和 HLA 医生抗原表示。十非恶意并且... 详细信息

瞄准：与主要 non-Hodgkin 的胃的淋巴瘤在病人调查 PECAM-1， ICAM-3 和 HLA 医生抗原的预示的意义。方法：我们免疫组织化学地在 36 个 B 房间麦芽类型主要胃的淋巴瘤病人学习了 PECAM-1， ICAM-3 和 HLA 医生抗原表示。十非恶意并且十个健康胃的织物标本被用作控制。Clinicopathological 和幸存数据与染色的结果被相关。结果：HLA 医生抗原表示在 33 个胃的淋巴瘤病人(91.7%) 和 6 个非恶意的病人(54.5%) 被检测。PECAM-1 染色了 10 个病人(27.8%) 的肿瘤房间， 9 个病人(25%) 的 endothelial 并且煽动性有良性的胃的疾病的 4 个病人(40%) 渗入。ICAM-3 表示在 17 个病人(47.2%) 的肿瘤房间上被观察，当 5 个非恶意的病人(50%) 被染色时积极也。任何一个都没为任何学习的基因健康控制被染色。在里面多，变量分析， HLA 医生抗原和 PECAM-1 被证明是与联系的统计上重要的独立预示的因素一赞成并且不利预后分别地(P=0.009 和 P=0.003 ) 。在 univariate 分析， PECAM-1 (+)/ICAM-3 (-) 和 HLA 医生(-)/ICAM-3 (-) 病人与确切相反的基因表示模式与那些相比展出了显著地减少的全面幸存(P=0.0041 和 P=0.0091，分别地) 。是 HLA 医生(+)/ICAM-3 (+)/PECAM-1 (-)(n=8 ) 的那些病人让显著地更高的幸存与这个组(n=24 )(P=0.0289 ) 的其余部分相比评价。结论：PECAM-1， ICAM-3 和 HLA 医生分别地是肿瘤扩大潜力和主人免疫者监视的代表性的标记。他们的联合使用可以帮助我们识别能得益于更好攻击的治疗学的协议的高风险的病人。

关键词：分子标记 PECAM-1 ICAM-3 HLA-DR 疾病预防非霍奇金胃病胃淋巴瘤

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Biosecurity Threats about the Combination of Aerobiology, Morphology and Genetic Manipulation of Fungal Spores

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Journal of Life Sciences 2013年第2期7卷 131-134页

作者： manousos E. Kambouris Aristea Velegraki george P. Patrinos Konstantinos Poulas Department of Medical Laboratories ATEI of Athens Egaleo 12210 Greece Department of Microbiology Medical School National and Kapodistrian University of Athens Athens 11527 Greece Laboratory of Molecular Biology and Immunology Department of Pharmacy University of Patras Rio Patras 26500 Greece

The passive flight of large numbers of mitospores ensures propagation and survival of many fungal species. Moreover, many fungi have a surplus DNA context which allows for easier manipulation and tampering, especially when inserting eukaryotic genes and translation systems. These facts taken together suggest a high prominence of the sporogonic airborne fungi in biosecurity/biodefence priority lists, but due to the low virulence and mortality of the fungal pathogens, they do not figure high, or, sometimes, not at all. The disruptive effect of biosecurity fungal threats is important per se and genetic manipulations are to further it. Novel, long range and high-persistence sampling methods, using robotics and unmanned systems already fielded in other applications may extend surveillance and responsive sampling. Effects-based, proteomic approaches may provide a solution for deliberate incidents, while polyphasic taxonomy may resolve spontaneous incidents and assist medical diagnosis, but in the biosecurity context, where mass collection and processing of samples and speed in producing robust results are vital, complex approaches might be proved more of a hindrance than an asset.

关键词：真菌孢子遗传操作安全威胁生物学形态学大气操纵无人驾驶系统

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