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Acute esophageal necrosis: A systematic review and pooled analysis

World Journal of Gastrointestinal Surgery 2020年第3期12卷 104-115页

作者： Dimitrios Schizas nikoletta a theochari Konstantinos S Mylonas Prodromos Kanavidis Eleftherios Spartalis Stamatina Triantafyllou Konstantinos P Economopoulos Dimitrios Theodorou Theodore Liakakos First Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Medicine Surgery Working GroupSociety of Junior DoctorsAthens 15122Greece Laboratory of Experimental Surgery and Surgical Research N.S.Christeas National and Kapodistrian University of AthensAthens 11527Greece First Propedeutic Department of Surgery National and Kapodistrian University of AthensHippocration General HospitalAthens 11527Greece Department of Surgery Duke University Medical CenterDurhamNC 27708United States

BACKGROUND Acute esophageal necrosis(AEN)is a rare entity with multifactorial etiology,usually presenting with signs of upper gastrointestinal *** To systematically review all available data on demographics,clinical features,outcomes and management of this medical *** A systematic literature search was performed with respect to the PRISMA statement(end-of-search date:October 24,2018).Data on the study design,interventions,participants and outcomes were extracted by two independent *** Seventy-nine studies were included in this ***,114 patients with AEN were identified,of whom 83 were males and 31 *** patient age was 62.1±*** most common presenting symptoms were melena,hematemesis or other manifestations of gastric bleeding(85%).The lower esophagus was most commonly involved(92.9%).The most widely implemented treatment modality was conservative treatment(75.4%),while surgical or endoscopic intervention was required in 24.6%of the *** overall followup was 66.2±101.8 *** 29.9%of patients died either during the initial hospital stay or during the follow-up *** symptoms on presentation[Odds ratio 3.50(1.09-11.30),P=0.03]and need for surgical or endoscopic treatment[surgical:Odds ratio 1.25(1.03-1.51),P=0.02;endoscopic:Odds ratio 1.4(1.17-1.66),P<0.01]were associated with increased odds of complications.A sub-analysis separating early versus late cases(after 2006)revealed a significantly increased frequency of surgical or endoscopic intervention(9.7%vs 30.1%respectively,P=0.04)CONCLUSION AEN is a rare condition with controversial pathogenesis and unclear optimal *** the frequency of surgical and endoscopic intervention has increased in recent years,outcomes have remained the ***,further research work is needed to better understand how to best treat this potentially lethal disease.

关键词： Acute esophageal necrosis Black esophagus Acute necrotizing esophagitis

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Low rectal cancer:Sphincter preserving techniques-selection of patients,techniques and outcomes

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World Journal of Gastrointestinal Oncology 2015年第7期7卷 55-70页

作者： nikoletta Dimitriou Othon Michail Dimitrios Moris John Griniatsos 1st Department of Surgery University of AthensMedical SchoolLaiko Hospital

Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal Plan E for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic Micro Surgery(TEM) and Trans Anal Minimally Invasive Surgery(TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery.

关键词： Low rectal cancer Sphincter preservingsurgery Intersphincteric resection Anterior PerinealPlanE for Ultra-low Anterior Resection of the Rectum Total mesorectal excision TransAnal Minimally InvasiveSurgery Transanal Total Mesorectal Excision Quality oflife Oncological outcome Functional outcome

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Complete mesocolic excision: Techniques and outcomes

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World Journal of Gastrointestinal Oncology 2015年第12期7卷 383-388页

作者： nikoletta Dimitriou Othon Michail Dimitrios Moris John Griniatsos 1st Department of Surgery University of AthensMedical SchoolLaiko Hospital

Complete mesocolic excision(CME) for the treatment of colon cancer was first introduced in the West in 2008. The first aim of this procedure is to remove the afflicted colon and its accessory lymphovascular supply by resecting the colon and mesocolon in an intact envelope of visceral peritoneum, which holds potentiallyinvolved lymph nodes. The second component of CME is a central vascular tie to remove completely all lymph nodes in the central(vertical) direction. In its original iteration, CME was performed via laparotomy, although many centers preferentially perform laparoscopic surgery, with its associated benefits and similar oncolo-gical outcomes, as the standard treatment for colonic cancer. Here, we present the surgical techniques for CME in open and laparoscopic surgery, as well as the surgical, pathological and oncological outcomes of the procedure that are available to date. Because there are no randomized control trials comparing CME to "standard" colon surgery, the principles underlying CME seem anatomical and logical, and the results published from the Far East, reporting an 80% 5-year survival rate for Stage III cancer, should guide us.

关键词： Colon cancer Complete mesocolic excision Laparotom

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Lymph node,peritoneal and bone marrow micrometastases in gastric cancer:Their clinical significance

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World Journal of Gastrointestinal Oncology 2012年第2期4卷 16-21页

作者： John Griniatsos Othon Michail nikoletta Dimitriou Ioannis Karavokyros 1st Department of Surgery University of AthensMedical SchoolGR 115-27AthensGreece

The 7th TNM classification clearly states that micro-metastases detected by morphological techniques(HE stain and immunohistochemistry) should always be reported and calculated in the staging of the disease(pN1mi or M1),while patients in whom micrometas-tases are detected by non-morphological techniques(e.g.,ow cytometry,reverse-transcriptase polymerase chain reaction) should still be classif ied as N0 or *** gastric cancer patients,micrometastases have been de-tected in lymph nodes,the peritoneal cavity and bone ***,the clinical implications and/or their prognostic signif icance are still a matter of ***-rent literature suggests that lymph node micrometasta-ses should be encountered for the loco-regional staging of the disease,while skip lymph node micrometastases should also be encountered in the total number of infiltrated lymph *** fluid cytology ex-amination should be obligatorily performed in pT3 or pT4 tumors.A positive cytology classif ies gastric cancer patients as stage Ⅳ.Although a curative resection is not precluded,these patients face an overall dismal *** patients with a positive cytology should be treated similarly to patients with macroscopic peritoneal recurrence should be evaluated ***-tric cancer cells are detected with high incidence in the bone ***,the published results make comparison of data between groups almost impossible due to severe methodological *** these meth-odological problems are overcome in the future,specif ic target therapies may be designed for specif ic groups of patients.

关键词： Gastric cancer D2 lymphadenectomy Lymph node micrometastases Peritoneal micrometastases Bone marrow micrometastases

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Impact of direct-acting antivirals on the recurrence of hepatocellular carcinoma in chronic hepatitis C

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Hepatoma Research 2022年第1期8卷 327-339页

作者： nikoletta M.Tagkou Nicolas Goossens Francesco Negro Division of Gastroenterology and Hepatology Geneva University HospitalsGeneva 1211Switzerland Division of Clinical Pathology Geneva University HospitalsGeneva 1211Switzerland

Chronic hepatitis C virus(HCV)infection is estimated to affect 56.8 million individuals globally and is a major and independent risk factor for the development of hepatocellular carcinoma(HCC).After the introduction of safe and potent direct-acting antivirals(DAAs),capable of curing HCV infection also in patients with advanced liver disease at high risk of HCC,the beneficial effect on a de novo HCC development after viral clearance has been ***,studies addressing the relationship between DAA-induced eradication and risk of HCC recurrence(i.e.,reappearance of HCC treated before starting antivirals)have produced contradictory data,suggesting either an increase or a decrease of HCC recurrence rate,while some report no effect of these ***,there seems to be an unclear benefit of viral clearance in patients with a history of HCC curative treatment,where the recurrence rate remains worryingly *** short review aims to summarize current evidence on the impact of DAAs on HCC recurrence rates,the pathogenic mechanisms and characteristics of HCC recurrence after DAA treatment,the predictors of tumor recurrence,and the impact of DAAs on overall survival.

关键词： Hepatitis C virus hepatocellular carcinoma liver oncogenesis direct-acting antivirals tumor recurrence

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Routine modified D2 lymphadenectomy performance in pT1-T2N0 gastric cancer

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World Journal of Gastroenterology 2009年第44期15卷 5568-5572页

作者： John Griniatsos Hara Gakiopoulou Eugenia Yiannakopoulou nikoletta Dimitriou Gerasimos Douridas Afrodite Nonni Theodoros Liakakos Evangelos Felekouras 1st Department of Surgery University of AthensMedical School LAIKO HospitalGR 115-27AthensGreece Department of Pathology University of AthensMedical SchoolLAIKO HospitalGR 115-27AthensGreece 3rd Department of Surgery University of AthensMedical SchoolATTIKO HospitalGR 115-27Athens Greece

AIM： To evaluate routine modified D2 lymphadenectomy in gastric cancer, based on immunohistochemicaUy detected skip micrometastases in level 11 lymph nodes. METHODS： Among 95 gastric cancer patients who were routinely submitted to curative modified D2 lymphadenectomy, from January 2004 to December 2008, 32 were classified as pN0. All level I lymph nodes of these 32 patients were submitted to immunohistochemistry for micrometastases detection. Patients in whom micrometastases were detected in the level Ⅰ lymph node stations （n = 4） were excluded from further analysis. The level 11 lymph nodes of the remaining 28 patients were studied immunohistochemically for micrometastases detection and constitute the material of the present study. RESULTS： Skip micrometastases in the level Ⅱ lymph nodes were detected in 14% （4 out of 28） of the patients. The incidence was further increased to 17% （4 out of 24） in the subgroup of T1-2 gastric cancer patients. All micrometastases were detected in the No. 7 lymph node station. Thus, the disease was upstaged from stage Ⅰ A to Ⅰ B in one patient and from stage Ⅰ B to Ⅱ in three patients. CONCLUSION： In gastric cancer, true R0 resection may not be achieved without modified D2 lymphadenectomy. Until D2＋/D3 lymphadenectomy becomes standard, modified D2 lymphadenectomy should be performed routinely.

关键词： Gastric cancer D2 gastrectomy D2 lymphadenectomy Micrometastases Skip metastases Skip micrometastases

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Retroperitoneal perivascular epithelioid cell tumours: A case report and review of literature

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World Journal of Clinical Cases 2019年第21期7卷 3524-3534页

作者： Zisis Touloumis Niki Giannakou Christos Sioros Argiro Trigka Maria Cheilakea nikoletta Dimitriou John Griniatsos Department of Surgery Athens Medical GroupAthens 11525Greece Department of Pathology Athens Medical GroupAthens 11525Greece Emergency Department Konstantopouleio General HospitalN.Ionia 14233Greece Department of Surgery National and Kapodistrian University of AthensAthens 11527Greece

BACKGROUND The perivascular epithelioid cell tumour(PEComa)family of tumours mainly includes renal and hepatic angiomyolipomas,pulmonary lymphangioleiomyomatosis and clear cell“sugar”tumour of the *** uncommon tumours with similar morphological and immunophenotypical characteristics arising at a variety of sites(abdominal cavity,digestive tract,retroperitoneum,skin,soft tissue and bones)are also included in the PEComa family and are referred to as PEComas not otherwise *** SUMMARY We present a 37-year-old female patient who underwent resection of an 8.5 cm×8 cm×4 cm retroperitoneal tumour,which eventually was diagnosed as PEComa of uncertain biological *** years after the operation,the patient remains without any evidence of recurrence.A search was performed in the Medline and EMBASE databases for articles published between 1996 and 2018,and we identified 31 articles related to retroperitoneal and perinephric *** focused on sex,age,maximum dimension,histological and immunohistochemical characteristics of the tumour,follow-up and long-term ***-four retroperitoneal(including the present one)and ten perinephric PEComas were identified,carrying a malignant potential rate of 44%and 60%,*** half of the potentially malignant PEComas presented with or developed metastases during the course of the *** Retroperitoneal PEComas are not as indolent as they are supposed to *** surgical resection constitutes the treatment of choice for localized disease,while mammalian target of the rapamycin(mTOR)inhibitors constitute the most promising therapy for disseminated *** role of mTOR inhibitors as adjuvant or neoadjuvant therapies needs to be evaluated in the future.

关键词： Perivascular epithelioid cell tumour Retroperitoneum Mammalian target of the rapamycin inhibitors Tuberous sclerosis complex Case report Treatment

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Beneficial effect of an antibody against interleukin-2 receptor (daclizumab) in an experimental model of hepatocyte xenotransplantation

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World Journal of Gastroenterology 2007年第9期13卷 1435-1437页

作者： Dimitrios Papagoras Apostolos Papalois Alexandra Tsaroucha Dimitrios Lytras John Kyriazanos nikoletta Giannakou Prodromos Laftsidis Constantine Simopoulos 2~(nd) Department of Surgery Medical School "Democritus" University of Thrace AlexandroupolisGreece 2~(nd) Department of Surgery Medical School "Democritus" University of Thrace AlexandroupolisGreeceExperimental-Research Department Elpen Pharmaceuticals Athens Greece Department of Pathology "Aghia Olga" General Hospital AthensGreece

AIM: To investigate the use of Daclizumab (Dmab) as an immunosuppressive agent in an experimental model of hepatocyte xenotransplantation (XenoTx) in rats with fulminant hepatic failure (FHF). METHODS: Two white male New Zealand rabbits were used as donors and 68 Wistar rats as recipients. FHF was induced by intravenous application of dimethylnitrosamine (DMNA). The isolated hepatocytes of the rabbits were xenotransplanted into the spleen of the rats 24 h after FHF induction. Group A (n = 13): no treatment; Group B (n = 14): FHF and XenoTx; Group C (n = 14): FHF and XenoTx and cyclosporin (CsA); Group D (n = 14): FHF and XenoTx and Dmab; Group E (n = 13): FHF and XenoTx and CsA and Dmab. The rats were followed for 15 d. RESULTS: Statistical analysis showed better survival among groups D (92.86%) and E (76.92%) compared to group A (all rats died after 72 h), group B (28.57%) or group C (71.43%), although the differences were not statistically significant. Biochemical evaluation of the liver enzymes and histology confirmed satisfactory function and engraftment, respectively. CONCLUSION: This experimental model has shown the safe, effective and beneficial use of Dmab in a xenotransplantation model of rabbit hepatocytes in rats.

关键词： Transplantation Hepatocytes Daclizumab Cyclosporin

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High-throughput extraction on a dynamic solid phase for low-abundance biomarker isolation from biological samples

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Microsystems & Nanoengineering 2023年第5期9卷 101-112页

作者： Lucile Alexandre Monica Araya-Farias Manh-Louis Nguyen nikoletta Naoumi Giacomo Gropplero Electra Gizeli Laurent Malaquin Stéphanie Descroix Laboratoire Physico-Chimie Curie CNRS UMR 168Institut CuriePSL Research UniversityParisFrance Institut Pierre-Gilles de Gennes(IPGG) Sorbonne UniversityParisFrance Department of Biology University of CreteHeraklionGreece Institute of Molecular Biology and Biotechnology(IMBB)-FORTH HeraklionGreece Laboratoire d’analyse et d’architecture des systèmes(LAAS)CNRS Elia GroupToulouseFrance Present address:Frédéric Joliot Institute for Life Sciences Pharmacology and Immunoanalysis UnitImmunoanalysis Studies and Research LaboratoryAlternative Energies and Atomic Energy Commission(CEA)Gif-sur-YvetteFrance

Liquid biopsy,in particular circulating tumor DNA(ctDNA)analysis,has paved the way for a new noninvasive approach to cancer diagnosis,treatment selection and *** a crucial step in the analysis,the extraction of the genetic material from a complex matrix needs to meet specific requirements such as high specificity and low loss of ***,we developed a new generation of microfluidic fluidized beds(FBs)that enable the efficient extraction and preconcentration of specific ctDNA sequences from human serum with flow rates up to 15µL/*** first demonstrated that implementation of a vibration system inducing flow rate fluctuations combined with a mixture of different bead sizes significantly enhanced bead homogeneity,thereby increasing capture *** advantage of this new generation of high-throughput magnetic FBs,we then developed a new method to selectively capture a double-stranded(dsDNA)BRAF mutated DNA sequence in complex matrices such as patient ***,as proof of concept,ligation chain reaction(LCR)assays were performed to specifically amplify a mutated BRAF sequence,allowing the detection of concentrations as low as 6×104 copies/µL of the mutated DNA sequence in serum.

关键词： diagnosis specificity thereby

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The Role of Bioactive Lipids and Statins in COVID-19 Disease and Their Use in the Therapeutic Approach. Are These Effective?

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Journal of Biosciences and Medicines 2021年第7期9卷 143-173页

作者： Sivaropoulos Nektarios Aligizakis Eftychios Gryllaki nikoletta Primary Care Health Center of Spili Crete Greece Primary Care Health Center of Spili Crete Greece Primary Care Health Center of Spili Crete Greece

COVID-19 disease constitutes a significant threat to human existence worldwide due to the increased transmissibility, morbidity and mortality caused by the still unknown SARS-COV2 virus. A critical issue is the lack of effectiveness of drug options. In our research, a literature review, we explore the role of bioactive lipids and statins can play, as a main or adjunctive treatment in the COVID-19. We reviewed 150 articles in the Databases (PubMed/MEDLINE, Google Scholar, Embassy and Cochrane) relatives of the use of bioactive lipids and statins in severe COVID-19 disease and we selected 117 articles that fit with our research question. So, our research constitutes a bibliography review of 117 articles, finally. The administration of exogenous bioactive lipids (BALs), Omega 3 EPA, DHA supplements induces the suppression of pro-inflammatory cytokines, the prevention of cytokine storm and enhancing the therapeutic benefit by accelerating recovery. Therefore, they potentially reduce the need for ICU hospitalization and the number of intensive care unit days of stay, accelerating recovery thus also numerically reducing critical cases. The possible harms of lipids should be considered. There are positive and negative effects regarding the use of statins. According to the literature, Statins offer beneficial effects on COVID-19 disease. For de novo statin use in COVID-19 patients, the Benefit/Risk ratio should be taken into account. In conclusion, although lipids and statins seem to benefit patients with severe COVID-19 disease, nevertheless, more double blind randomized studies are needed to determine their safety and efficacy profile.

关键词： Bioactive Lipids/Statins/Therapeutic Options of Severe COVID-19

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