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Robotic-assisted microsurgery in andrology: a systematic review

Asian Journal of Andrology 2023年第4期25卷 454-461页

作者： Konstantinos Douroumis Eleftherios Spartalis Konstantinos Stravodimos panagiotis K Levis Gerasimos Tsourouflis Dimitrios Dimitroulis Nikolaos I Nikiteas Hellenic Minimally Invasive and Robotic Surgery(MIRS)Study Group National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 15bGoudiAthens 11527Greece First Department of Urology National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece Second Department of Propaedeutic Surgery National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece

Robot-assisted surgery is the gold standard of treatment in many fields of urology. In this systematic review, we aim to reportits usage in andrology and to evaluate any advantages. A systematic search of the PubMed and Cochrane Library databases wasconducted to identify articles referring to robotic-assisted microsurgery in andrology. The search strategy was in line with thePreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook. Thearticles were then reviewed by two authors. A qualitative analysis of the articles that met the inclusion criteria was ***-one articles that met the inclusion criteria were reviewed. The first results for robot-assisted vasovasostomy (RAVV) areencouraging as excellent patency rates, short operative times, and learning curves were achieved. Interestingly, patency rates weregreater in some case series for RAVV than for microsurgical vasovasostomy, with a statistically significant difference. In addition,robot has been shown to be of great use in bypassing fibrotic changes in cases of iatrogenic vasal injuries, difficulties encounteredwith traditional microsurgery. In addition, the feasibility of robot-assisted microsurgery has been proven for varicocelectomy andmicrosurgical denervation of the spermatic cord, with acceptable improvement in sperm parameters and pain, respectively. Thecurrent evidence suggests that there are potential advantages of the use of robots in andrology. However, for robotic surgery tobecome incorporated into the daily use of the andrologists, large, multicenter randomized trials are needed. As robotics systemsare becoming standard in urology practice, it is reasonable for one to believe that they will also find their place in andrology.

关键词： andrology male infertility robotic surgical procedures varicocele vasovasostomy

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Role of autophagy in cholangiocarcinoma:An autophagy-based treatment strategy

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1229-1243页

作者： Evangelos Koustas Eleni-Myrto Trifylli panagiotis Sarantis Athanasios G Papavassiliou Michalis V Karamouzis Department of Biological Chemistry Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

Cholangiocarcinomas(CCAs)are diverse biliary epithelial tumours involving the intrahepatic,perihilar and distal parts of the biliary *** three entirely variable entities have distinct epidemiology,molecular characteristics,prognosis and strategy for clinical ***,many cholangiocarcinoma tu-mor-cells appear to be resistant to current chemotherapeutic *** role of autophagy and the therapeutic value of autophagy-based therapy are largely unknown in *** multistep nature of autophagy offers a plethora of re-gulation points,which are prone to be deregulated and cause different human diseases,including ***,it offers multiple targetable points for designing novel therapeutic *** cells have evolved to use auto-phagy as an adaptive mechanism for survival under stressful conditions such as energy imbalance and hypoxic region of tumors within the tumor microenvir-onment,but also to increase invasiveness and resistance to *** purpose of this review is to summarize the current knowledge regarding the interplay between autophagy and cholangiocarcinogenesis,together with some preclinical studies with agents that modulate autophagy in order to induce tumor cell ***,a combinatorial strategy,which comprises the current anti-cancer agents and autophagy modulators,would represent a positive CCA patient approach.

关键词： Autophagy Autophagy modulators Chemotherapy Cholangiocarcinoma

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Extrahepatic right portal vein ligation allows parenchyma-sparing en bloc resection of segments 7, 8 and 4a for liver tumors engaging the right and middle hepatic veins

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Hepatobiliary & Pancreatic Diseases International 2015年第5期14卷 539-542页

作者： Charalampos Farantos Nikolaos Arkadopoulos Pantelis Vassiliu panagiotis Kokoropoulos Nikolaos Economopoulos Aggeliki Pandazi Vassilis Smyrniotis Fourth Department of Surgery Athens University Medical School Attikon University Hospital Second Department of Radiology Athens University Medical School Attikon University Hospital Second Department of Anesthesiology Athens University Medical School Attikon University Hospital

Right trisectionectomy for posterior liver tumors engaging the right and middle hepatic veins may lead to post-hepatectomy liver failure if the anticipated liver remnant is small. In such patients we developed a parenchymasparing one-step approach, that includes extrahepatic right portal vein ligation accompanied by en bloc resection only of segments 7, 8 and 4a and resection of the right and middle hepatic veins. The technique was applied in 3 patients with normal liver function, where according to the preoperative computed tomography the volume of segments 1, 2 and 3 ranged between 17% and 20% of the total liver volume. In all patients liver biochemistry improved rapidly postoperatively and a doubling of volume of segments 1, 2 and 3 was achieved by the third postoperative week, as extrahepatic right portal vein ligation ameliorated reperfusion injury of the remaining segments 5 and 6 and induced hypertrophy of segments 1, 2, 3 and 4b. There was no mortality or long-term *** are alive and free of disease 74, 50 and 17 months after the operation, respectively. We propose that the term ＂extended upper right sectionectomy＂ may be considered for the en bloc resection of segments 7, 8 and 4a, in future revisions ofthe Brisbane 2000 terminology of hepatic anatomy and resections.

关键词： liver trisectionectomy extrahepatic right portal vein ligation parenchyma-sparing hepatectomy

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Upgraded role of autophagy in colorectal carcinomas

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World Journal of Gastrointestinal Oncology 2018年第11期10卷 367-369页

作者： Evangelos Koustas panagiotis Sarantis Athanassios G Papavassiliou Michalis V Karamouzis Division of Molecular Oncology Department of Biological Chemistry Medical SchoolNational and Kapodistrian University of Athens

Autophagy is a basic catabolic process closely asso-ciated with degradation of cellular components. The role of autophagy in colorectal cancer(CRC) remains controversial. The mechanism of autophagy has been identified as protecting mechanism against tumorige-nesis by isolation of damaged organelles or as cytopro-tective provides energy in hypoxic regions of CRC tumors. Mutations in proto-oncogenes, such as RAS and BRAF, have been associated with autophagy initiation through signaling pathways of BRAF/MEK/ERK and PI3 K/AKT/m TOR. A combination therapy of chemotherapeutic agents and autophagy inhibitors such as hydroxychloroquine or immunotherapy might represent a major step that could be evaluated as a putative novel therapeutic strategy in CRC patients.

关键词： Autophagy Tumorigenesis Clinical trials Autophagy inhibitors Colorectal cancer

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Greater Biosynthetic Liver Dysfunction in Primary Sclerosing Cholangitis Suggests Co-existent or Impending Cholangiocarcinoma

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Journal of Clinical and Translational Hepatology 2016年第1期4卷 1-4页

作者： panagiotis Trilianos Abhishek Agnihotri Enver Ucbilek Ahmet Gurakar Department of Gastroenterology & Hepatology Section of Transplant Hepatology The Johns Hopkins School of MedicineBaltimore MD USA Department of Medicine MetroWest Medical Center Framingham MA USA Department of Gastroenterology & Hepatology Section of Transplant Hepatology The Johns Hopkins School of MedicineBaltimore MD USA

Background and Aim:Patients with primary sclerosing cholangitis (PSC) who develop cholangiocarcinoma (CCA)have a median survival of less than 6 *** half of cases,PSC and CCA will be diagnosed either concurrently or within a year of one *** aim of the present study is to demonstrate that the degree of biochemical liver dysfunction is associated with concomitant or impending ***:We did a chart review of patients diagnosed with PSC and CCA up to 18 months from presentation (“CCA” group) as well as patients with PSC that underwent transplantation with no sign of CCA in their explanted liver (“nCCA” group).Along with demographic data and follow-up length,we recorded their presenting liver function tests,including alanine and aspartate aminotransferases (ALT,AST),total bilirubin (TBil),alkaline phosphatase (ALP),international normalization ratio (INR),and serum Ca 19-9 *** between mean values of the two groups were analyzed with a student's ***:Twenty-four patients were *** “CCA”group consisted of eight patients,and the “non-CCA” group had 16 *** was no significant difference between the two groups in their presenting values of ALT,ALP,or serum Ca ***,the “CCA” group had significantly higher levels of AST,TBil,and ***:Patients with PSC and concurrent or impending CCA appear to exhibit significantly greater biochemical liver dysfunction than those who do not develop ***,newly-diagnosed PSC patients presenting with these findings may warrant more rigorous evaluation.

关键词： Cholestatic disease Malignancy Liver transplantation Liver function tests

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Resin foraging dynamics in Varroa destructor-infested hives: a case of medication of kin?

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Insect Science 2019年第2期26卷 297-310页

作者： Michelina Pusceddu Giannella Piluzza panagiotis Theodorou Franco Buffa Luca Ruiu Simonetta Bullitta Ignazio Floris Alberto Satta Dipartimento di Agraria sezione di Patologia vegetate ed Entomologia Universita di Sassari Sassari Italy lstituto per il Sistema Produzione Animate in Ambiente Mediterraneo (ISPAAM uos Sassari) Consiglio Nazionale delle Ricerche (CNR) Baldinca-Li Punti Sassari Italy General Zoology Institute for Biology Martin Luther University Halle-Wittenberg Halle (Saale) Germany German Centre for integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig Leipzig Germany

t Social insects have evolved colony behavioral, physiological, and organiza. tional adaptations (social immunity) to reduce the risks of parasitization and/or disease transmission. The collection of resin from various plants and its use in the hive as propolis is a clear example of behavioral defense. For Apis mellifera, an increased propolis content in the hive may correspond to variations in the microbial load of the colony and to a downregulation of an individual bee's immune response. However, many aspects of such antimicrobial mechanism still need to be clarified. Assuming that bacterial and fungal infection mechanisms differ from the action of a parasite, we studied the resin collection dynamics in Varroa destructor-infested honeybee colonies. Comparative experiments involving hives with different mite infestation levels were conducted in order to assess the amount of resin collected and propolis quality within the hive, over a 2-year period (2014 and 2015). Our study demonstrates that when A. mellifera colonies are under stress because of Varroa infestation, an increase in the number of resin foragers is recorded, even if a general intensification of the foraging activity is not observed. A reduction in the total polyphenolic content in propolis produced in infested versus uninfested hives was also noticed. Considering that different propolis types show varying levels of inhibition against a variety of honey bee pathogens in vitro, it would be very important to study the effects against Varroa of two diverse types of propolis: from Varroa-free and from Varroa-infested hives.

关键词： Apis mellifera host-parasite interaction polyphenols propolis selfmedication social immunity

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Distribution and quantification of Pb in an evergreen broadleaved forest in three hydrological years

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Journal of Forestry Research 2020年第6期31卷 2225-2234页

作者： panagiotis Michopoulos Athanassios Bourletsikas Kostas Kaoukis Marios Kostakis Nikolaos SThomaidis Ioannis IPassias Helen Kaberi Stelios Iliakis H.A.O.demeter-institute of mediterranean forest ecosystems terma alkmanos11528 athensgreece laboratory of analytical chemistry department of chemistrynational and kapodistrian university of athens15771 athensgreece institute of oceanography hellenic centre for marine research46.7 km athinon-souniou ave19013 anavyssosgreece

The distribution,quantification and fluxes of Pb were examined in an evergreen broadleaved forest in western Greece for three hydrological *** specifically,concentrations and annual fluxes of Pb were determined in bulk and throughfall deposition as well as *** Pb concentrations were also measured in forest floor and mineral soil up to 80 cm and the isotopic ratios of 206Pb/207Pb were determined in soil layers and the parent rock *** variability in the fluxes of the metal among the three hydrological years were found,evidence of the variability of Pb deposition in *** fractions with a large surface area,like holm oak flowers,had high Pb *** a steady state model and considering the Pb amounts in throughfall and litterfall as inputs on the forest floor,the mean residence time of Pb in the forest floor was 94 years with a coefficient of variation equal to 41%.More observations are needed to lower the variability of the mean residence *** isotopic ratio in the rock material was defined as the lithogenic *** statistical tests showed that the petrol derived Pb migrated to the depth of 20 cm and its percentages in the soil pedon was in the range of 62%in the L horizon to 11%in the 10–20cm *** higher depths(>40 cm)preindustrial anthropogenic Pb affected the isotopic *** the forest under consideration is remote from industrial activities,the results can serve as a baseline for future studies on Pb distribution and quantification.

关键词： Evergreen broadleaved forest Lead Throughfall Litterfall Forest floor Soil Isotopic ratios

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Aggressive treatment of acute anal fissure with 0.5% nifedipine ointment prevents its evolution to chronicity

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World Journal of Gastroenterology 2006年第38期12卷 6203-6206页

作者： panagiotis Katsinelos Jannis Kountouras George Paroutoglou Athanasios Beltsis Grigoris Chatzimavroudis Christos Zavos Taxiarchis Katsinelos Basilis Papaziogas Department of Endoscopy and Motility Unit Central Hospital Thessaloniki Greece Department of Gastroenter- ology Second Medical Clinic Aristotle University of Thessaloniki Ippokration Hospital Thessaloniki Greece

AIM： To investigate the efficacy of topical application of 0.5% nifedipine ointment in healing acute anal tissue and preventing its progress to chronicity. METHODS： Thirty-one patients （10 males, 21 females） with acute anal fissure from September 1999 to January 2005 were treated topically with 0.5% nifedipine ointment （t.i.d.） for 8 wk. The patients were encouraged to follow a high-fiber diet and assessed at 2, 4 and 8 wk post-treatment. The healing of fissure and any side effects were recorded. The patients were subsequently followed up in the outpatient clinic for one year and contacted by phone every three months thereafter, while they were encouraged to come back if symptoms recurred. RESULTS： Twenty-seven of the 31 patients completed the 8-wk treatment course, of them 23 （85.2%） achieved a complete remission indicated by resolution of symptoms and healing of fissure. Of the remaining four unhealed patients （14.8%）, 2 opted to undergo lateral sphincterotomy and the other 2 to continue therapy for four additional weeks, resulting in healing of fissure. All the 25 patients with complete remission had a mean follow-up of 22.9 ± 14 （range 6-52） too. Recurrence of symptoms occurred in four of these 25 patients （16%） who were successfully treated with an additional 4-wk course of 0.5% nifedipine ointment. Two of the 27 （7.4%） patients who completed the 8-wk treatment presented with moderate headache as a side effect of nifedipine. CONCLUSION： Topical 0.5% nifedipine ointment, used as an agent in chemical sphincterotomy, appears to offer a significant healing rate for acute anal fissure and might prevent its evolution to chronicity.

关键词： Acute anal fissure Nifedipine Calcium channel blockers Topical treatment

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Simultaneous resection of synchronous colorectal liver metastases:a promising alternative to staged resections

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Hepatobiliary Surgery and Nutrition 2021年第5期10卷 720-723页

作者： Nikolaos Machairas Martin de Santibañes panagiotis Dorovinis Adam Enver Frampton nd Department of Propaedeutic Surgery National and Kapodistrian University of AthensMedical SchoolAthensGreece Department of Surgery Division of HPB SurgeryLiver&Transplant UnitHospital Italiano de Buenos AiresArgentina HPB Surgical Unit Royal Surrey County Hospital NHS Foundation TrustGuildfordSurreyUK Surrey Cancer Research Institute Department of Clinical and Experimental MedicineFaculty of Health and Medical SciencesThe Leggett BuildingUniversity of SurreyGuildfordUK

Management of patients with synchronous colorectal liver metastases(SCRLM)has transformed dramatically over the past 2 decades(1-3).A step-by-step,patient tailored approach as orchestrated by a multidisciplinary tumor board(MDT),combined with advances in surgical techniques,perioperative care and the evolution of systemic therapies have led to remarkable long-term outcomes(2,4).In particular,selected patients with resectable SCRLM undergoing surgery have been reported to enjoy 5-year survival rates as high as 76%(1).However,the optimal surgical strategy for these patients remains elusive with multiple retrospective studies presenting conflicting outcomes(4).In their up-to-date review of the literature Lillemoe and Vauthey sought to evaluate and critically appraise currently available surgical treatment strategies for patients presenting with SCRLM.

关键词： colorectal metastases transformed

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Multimodal teaching,learning and training in virtual reality:a review and case study

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Virtual Reality & Intelligent Hardware 2020年第5期2卷 421-442页

作者： Stéphanie PHILIPPE Alexis DSOUCHET Petros LAMERAS panagiotis PETRIDIS Julien CAPORAL Gildas COLDEBOEUF Hadrien DUZAN Department of Research ManzalabParisFrance Paragraph Laboratory Paris 8 UniversitySaint-DenisFrance School of Computing Electronics and MathematicsCoventry UniversityUnited Kingdom Aston Business School Aston UniversityUnited Kingdom Manzalab Singapore

It is becoming increasingly prevalent in digital learning research to encompass an array of different meanings,spaces,processes,and teaching strategies for discerning a global perspective on constructing the student learning *** is an emergent phenomenon that may influence how digital learning is designed,especially when employed in highly interactive and immersive learning environments such as Virtual Reality(VR).VR environments may aid students'efforts to be active learners through consciously attending to,and reflecting on,critique leveraging reflexivity and novel meaning-making most likely to lead to a conceptual *** paper employs eleven industrial case-studies to highlight the application of multimodal VR-based teaching and training as a pedagogically rich strategy that may be designed,mapped and visualized through distinct VR-design elements and *** outcomes of the use cases contribute to discern in-VR multimodal teaching as an emerging discourse that couples system design-based paradigms with embodied,situated and reflective praxis in spatial,emotional and temporal VR learning environments.

关键词： Virtual reality Multimodality Training Teaching and learning Semiotic resources

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