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Acute upper gastrointestinal bleeding in operated stomach: Outcome of 105 cases

World Journal of Gastroenterology 2005年第29期11卷 4570-4573页

作者： vassiliki n nikolop.ulou Konstantinos C Thomopoulos George I Theocharis vassiliki A Arvaniti Constantine E Vagianos Division of Gastroenterology Department of Internal Medicine University Hospital Patras Greece Department of Surgery University Hospital Patras Greece

AIM: To compare the causes and clinical outcome of patients with acute upper gastrointestinal bleeding (AUGB) and a history of gastric surgery to those with AUGB but without a history of gastric surgery in the ***: The causes and clinical outcome were compared between 105 patients with AUGB and a history of gastric surgery, and 608 patients with AUGB but without a history of gastric ***: Patients who underwent gastric surgery in the past were older (mean age: 68.1±11.7 years vs 62.8±17.8 years, P= 0.001), and the most common cause of bleeding was marginal ulcer in 63 patients (60%). no identifiable source of bleeding could be found in 22 patients (20.9%) compared to 42/608 (6.9%) in patients without a history of gastric surgery (P = 0.003). Endoscopic hemostasis was permanently successful in 26 out of 35 patients (74.3%) with peptic ulcers and active bleeding or non-bleeding visible vessel. nine patients (8.6%) were operated due to continuing or recurrent bleeding,compared to 23/608 (3.8%) in the group of patients without gastric surgery in the past (P= 0.028). Especially in peptic ulcer bleeding patients, emergency surgery was more common in the group of patients with gastric surgery in the past [9/73 (12.3%) vs 19/360 (5.3%), P = 0.025].Moreover surgically treated patients in the past required more blood transfusion (3.3±4.0 vs 1.5±1.7, P = 0.0001) and longer hospitalization time (8.6±4.0 vs 6.9±4.9 d,P = 0.001) than patients without a history of gastric surgery. Mortality was not different between the two groups [4/105 (3.8%) vs 19/608 (3.1%)].COnCLUSIOn: Upper gastrointestinal bleeding seems to be more severe in surgically treated patients than in non-operated patients.

关键词： Operated stomach Active bleeding Endoscopic hemostasis

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Acute upper gastrointestinal bleeding in octοgenarians:Clinical outcome and factors related to mortality

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World Journal of Gastroenterology 2008年第25期14卷 4047-4053页

作者： George J Theocharis vassiliki Arvaniti Stelios F Assimakopoulos Konstantinos C Thomopoulos Vassilis Xourgias Irini Mylonakou vassiliki n nikolop.ulou Division of Gastroenterology Department of Internal Medicine University Hospital of Patras Department of Gastroenterology "Tzaneio" General Hospital Department of Internal MedicineUniversity Hospital of Patras

AIM: To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS: We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (> 80 years old). RESULTS: Four hundred and sixteen patients over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P = 0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P = 0.05) and more patients died in the group of octogenarians compared to the younger age group (P = 0.02). Inability to perform endoscopic examination (P = 0.002), presence of high risk for rebleeding stigmata (P = 0.004), urea on admission (P = 0.036), rebleeding (P = 0.004) and presenceof severe co-morbidity (P n multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P = 0.032). COnCLUSIOn: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

关键词： Acute upper gastrointestinal bleeding Octogenarians Elderly Co-morbidity Mortality

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Pleiotropic effects of bombesin and neurotensin on intestinal mucosa: not just trefoil peptides

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World Journal of Gastroenterology 2008年第22期14卷 3602-3603页

作者： Stelios F Assimakopoulos Chrisoula D Scopa vassiliki n nikolop.ulou Constantine E Vagianos Department of Internal Medicine School of Medicine University of Patras Patras 26110 Greece Department of Pathology School of Medicine University of Patras Patras 26110 Greece Division of Gastroenterology Department of Internal Medicine School of Medicine University of Patras Patras 26110 Greece First Surgical Department "Saint Panteleimon" General Hospital of Nikaia Piraeus 18454 Greece

Bombesin and neurotensin are neuropeptides which exert a wide spectrum of biological actions on gastrointestinal tissues influencing intestinal growth and adaptation, intestinal motility, blood flow, secretion, nutrient absorption and immune response. Based mainly on their well-established potent enterotrophic effect, numerous experimental studies investigated their potential positive effect on the atrophic or injured intestinal mucosa. These peptides proved to be effective mucosa-healing factors, but the potential molecular and cellular mechanisms for this action remained unresolved. In a recently published study (World J Gastroenterol 2008; 14(8): 1222-1230), it was shown that their protective effect on the intestine in experimentally induced inflammatory bowel disease was related to anti-inflammatory, antioxidant and antiapoptotic actions. These results are in close agreement with our previous studies on jaundiced and hepatectomized rats that showed a regulatory effect of bombesin and neurotensin on critical cellular processes such as enterocyte' proliferation and death, oxidative stress and redox equilibrium, tight junctions' formation and function, and inflammatory response. The pleiotropic effects of bombesin and neurotensin on diverse types of intestinal injury may justify their consideration for clinical trials.

关键词： Bombesin neurotensin Pleiotropic neuropeptides Regulatory peptides

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Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome

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World Journal of Gastroenterology 2005年第9期11卷 1365-1368页

作者： Konstantinos C Thomopoulos Konstantinos P Mimidis George J Theocharis Anthie G Gatopoulou Georgios n Kartalis vassiliki n nikolop.ulou Department of Internal Medicine the First Department of Internal Medicine

AIM: Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy. The purpose of this study was to describe the causes and clinical outcome of these patients. METHODS: From January 1999 to October 2003, 111 patients with acute upper gastrointestinal bleeding (AUGIB) were hospitalized while on oral anticoagulants. The causes and clinical outcome of these patients were compared with those of 604 patients hospitalized during 2000-2001 with AUGIB who were not taking warfarin. RESULTS: The most common cause of bleeding was peptic ulcer in 51 patients (45%) receiving anticoagulants compared to 359/604 (59.4%) patients not receiving warfarin (Pno identifiable source of bleeding could be found in 33 patients (29.7%) compared to 31/604 (5.1%) patients not receiving anticoagulants (P=0.0001). The majority of patients with concurrent use of non-steroidal anti-inflammatory drugs (nSAIDs) (26/35, 74.3%) had a peptic ulcer as a cause of bleeding while 32/76 (40.8%) patients not taking a great dose of nSAIDs had a negative upper and lower gastrointestinal endoscopy. Endoscopic hemostasis was applied and no complication was reported. Six patients (5.4%) were operated due to continuing or recurrent hemorrhage, compared to 23/604 (3.8%) patients not receiving anticoagulants. Four patients died, the overall mortality was 3.6% in patients with AUGIB due to anticoagulants, which was not different from that in patients not receiving anticoagulant therapy. COnCLUSIOn: Patients with AUGIB while on long-term anticoagulant therapy had a clinical outcome, which is not different from that of patients not taking anticoagulants. Early endoscopy is important for the management of these patients and endoscopic hemostasis can be safely applied.

关键词： AUGIB Anticoagulant therapy Endoscopy

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Intestinal failure in obstructive jaundice

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World Journal of Gastroenterology 2005年第24期11卷 3806-3807页

作者： Stelios F.Assimakopoulos Constantine E.Vagianos Aristides Charonis vassiliki n.nikolop.ulou Chrisoula D.Scopa Department of Internal Medicine Department of Surgery Laboratory of Cell Biology Department of Pathology

TO THE EDITORWe read with great interest the article by Ding LA and LiJS, which aimed to review the current knowledge on the physiology of normal intestinal barrier function and highlight the role of intestinal failure after various injurious insults in the development of septic complications or multiple organ failure with subsequent rapid clinical deterioration or even death.

关键词： Intestinal failure Obstructive jaundice

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Experimental obstructive jaundice alters claudin-4 expression in intestinal mucosa: Effect of bombesin and neurotensin

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World Journal of Gastroenterology 2006年第21期12卷 3410-3415页

作者： Stelios F Assimakopoulos Constantine E Vagianos Aristides S Charonis Ilias H Alexandris Iris Spiliopoulou Konstantinos C Thomopoulos vassiliki n nikolop.ulou Chrisoula D Scopa Department of Internal Medicine School of Medicine University of PatrasPatrasGreece Department of Surgery School of Medicine University of PatrasPatrasGreece Section of Histology Center for Basic Research Foundation of Biomedical Research of the Academy of AthensAthensGreece Department of Microbiology School of Medicine University of PatrasPatrasGreece Department of Internal Medicine Division of Gastroenterology School of MedicineUniversity of PatrasPatrasGreece Department of Pathology School of Medicine University of PatrasPatrasGreece

AIM： To investigate the influence of experimental obstructive jaundice and exogenous bombesin （BBS） and neurotensin （nT） administration on the expression of the tight junction （TJ）-protein claudin-4 in intestinal epithelium of rats. METHODS： Forty male Wistar rats were randomly divided into five groups： Ⅰ = controls, Ⅱ = sham operated,Ⅲ = bile duct ligation （BDL）,Ⅳ = BDL＋BBS （30μg/kg per d）, V = BDL＋nT （300μg/kg per d）. At the end of the experiment on d 10, endotoxin was measured in portal and aortic blood. Tissue sections of the terminal ileum were examined histologically and immunohistochemically for evaluation of claudin-4 expression in intestinal epithelium. RESULTS： Obstructive jaundice led to intestinal barrier failure demonstrated by significant portal and aortic endotoxemia. Claudin-4 expression was significantly increased in the upper third of the villi in jaundiced rats and an upregulation of its lateral distribution was noted. Administration of BBS or nT restored claudin-4 expression to the control state and significantly reduced portal and aortic endotoxemia. COnCLUSIOn： Experimental obstructive jaundice increases claudin-4 expression in intestinal epithelium,which may be a key factor contributing to the disruption of the mucosal barrier. Gut regulatory peptides BBS and nT can prevent this alteration and reduce portal and systemic endotoxemia.

关键词： Obstructive jaundice Tight junctions Claudin-4 Intestinal permeability Intestinal barrier Regulatory peptides Bombesin neurotensin

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Effect of bombesin and neurotensin on gut barrier function in partially hepatectomized rats

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World Journal of Gastroenterology 2005年第43期11卷 6757-6764页

作者： Stelios F Assimakopoulos Ilias H Alexandris Chrisoula D Scopa Panagiotis G Mylonas Konstantinos C Thomopoulos Christos D Georgiou vassiliki n nikolop.ulou Constantine E Vagianos Department of Internal Medicine Department of Surgery Department of Pathology Department of Internal edicine Department of Biology

AIM： To investigate the effect of regulatory peptides bombesin （BBS） and neurotensin （nT） on intestinal barrier function in partially hepatectomized rats. METHODS： ninety male Wistar rats were randomly divided into five groups： Ⅰ （n = 10）： controls, Ⅱ （n = 20）： sham operated, Ⅲ （n = 20）： partial hepatectomy 70% （PHx）, Ⅳ （n = 20）： PHx＋BBS （30 μg/kg/d）, Ⅴ （n = 20）： PHx＋nT （300 μg/kg/d）. Groups IV and V were treated for 8 days before PHx and 48 h post surgery. At the end of the experiment, on day 10, intestinal barrier function was assessed by measuring endotoxin concentrations in portal and aortic blood. Tissue sections of the terminal ileum were examined histologically and villus density, mucosal thickness, mitotic activity and apoptosis in crypts were assessed. In addition, ileal mucosa was analyzed for DnA and protein content and microbiological analysis was performed in cecal contents. To estimate intestinal oxidative stress, lipid peroxidation was determined on tissue homogenates from terminal ileum. RESULTS： BBS or nT administration significantly reduced portal and systemic endotoxemia observed 48 h after partial hepatectomy. In hepatectomized rats （group Ⅲ）, a trend towards induction of mucosal atrophy was observed, demonstrated by the reduction of villus density, mucosal thickness, protein content and significant reduction of DnA, while these alterations were reversed by regulatory peptides administration. This trophic effect of BBS and nT was accompanied by induction of mitoses above control levels and a significant reduction of apoptosis in intestinal crypts. Intestinal lipid peroxidation was found significantly lower in PHx group and regulatory peptides exerted an antioxidant action, further decreasing this parameter of oxidative stress. The ：bacterial population of E. coli and aerobic Gram （＋） cocci was increased in cecal content of hepatectomized rats, while this parameter was not affected by the administration of BBS or nT. COnCLUSIOn： Gut regulatory pep

关键词： Hepatectomy Rats Bombesin neurotensin Intestinal barrier Apoptosis Oxidative stress

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Metabolic and functional effects of exercise training in diabetic kidney transplant recipients

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World Journal of Transplantation 2022年第7期12卷 184-194页

作者： vassiliki Michou Maria nikodimopoulou Asterios Deligiannis Evangelia Kouidi Sports Medicine Laboratory School of Physical Education&Sport ScienceAristotle UniversityThessaloniki 57001Greece Transplant Surgery Clinic of Aristotle University of Thessaloniki Hippokration General HospitalThessaloniki 54642Greece

BACKGROUnD Physical activity levels are significantly lower in kidney transplant(KT)recipients compared to the general *** effects of exercise training in KT recipients with diabetes mellitus remain unclear,and so little is known about the role of increased exercise on cardiovascular risk and metabolic profile of KT *** To investigate the effects of a 6-mo home-based exercise training program on functional capacity,glucose levels and lipid profile of diabetic KT *** In total,21 type II diabetic KT recipients were randomly assigned into two groups:Exercise(n=11,aged 52.9±10.1 years)and control(n=10,aged 53.01±9.5 years).All participants at baseline and the end of the study underwent biochemical tests for fasting plasma glucose levels,glycated hemoglobin and lipid profile and cardiopulmonary exercise testing for maximum oxygen uptake[(VO2)peak]*** exercise group followed a 6-mo supervised home-based aerobic and progressive resistance exercise program of moderate intensity 3 times per week,while the control group continued to receive usual *** At the end of the 6-mo study,the exercise group had significantly lower values in fasting plasma glucose by 13.4%(from 120.6±28.9 mg/dL to 104.8±21.9 mg/dL,P=0.01),glycated hemoglobin by 1.5%(from 6.7%±0.4 to 6.6%±0.4,P=0.01)and triglycerides by 8.5%(from 164.7±14.8 mg/dL to 150.8±11.6 mg/dL,Pnd higher values in high-density lipoprotein by 10.2%(from 51.4±8.8 mg/dL to 57.2±8.7 mg/dL,Pnd(VO_(2))_(peak)by 4.7%(from 22.7±3.3 to 23.8±4.2,P=0.02)than the control *** were statistically significant differences between the two groups at the end of the study for fasting plasma glucose(decreased by 9.6%,Pnd(VO_(2))_(peak)(increased by 4.4%,P=0.01).Finally,after training,there was a moderate,positive linear relationship between(VO_(2))_(peak)and glycated hemoglobin in the exercise group(r=0.408,P=0.03).COnCLUSIOn The res

关键词： Renal transplant recipients Diabetes mellitus exercise Lipid profile Glucose control Functional capacity

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Height-diameter models for King Boris fir(Abies borisii regis Mattf.) and Scots pine(Pinus sylvestris L.) in Olympus and Pieria Mountains, Greece

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Journal of Mountain Science 2024年第5期21卷 1475-1490页

作者： Dimitrios I.RAPTIS Dimitra PAPADOPOulou Angeliki PSARRA Athanasios A.FALLIAS Aristides G.TSITSAnIS vassiliki KAZAnA Renewable natural Resource Management and Bioeconomy Laboratory Department of Forest and Natural Environment SciencesInternational Hellenic University66100 DramaGreece

In forest science and practice, the total tree height is one of the basic morphometric attributes at the tree level and it has been closely linked with important stand attributes. In the current research, sixteen nonlinear functions for height prediction were tested in terms of their fitting ability against samples of Abies borisii regis and Pinus sylvestris trees from mountainous forests in central Greece. The fitting procedure was based on generalized nonlinear weighted regression. At the final stage, a five-quantile nonlinear height-diameter model was developed for both species through a quantile regression approach, to estimate the entire conditional distribution of tree height, enabling the evaluation of the diameter impact at various quantiles and providing a comprehensive understanding of the proposed relationship across the distribution. The results clearly showed that employing the diameter as the sole independent variable, the 3-parameter Hossfeld function and the 2-parameter n?slund function managed to explain approximately 84.0% and 81.7% of the total height variance in the case of King Boris fir and Scots pine species, respectively. Furthermore, the models exhibited low levels of error in both cases(2.310m for the fir and 3.004m for the pine), yielding unbiased predictions for both fir(-0.002m) and pine(-0.004m). notably, all the required assumptions for homogeneity and normality of the associated residuals were achieved through the weighting procedure, while the quantile regression approach provided additional insights into the height-diameter allometry of the specific species. The proposed models can turn into valuable tools for operational forest management planning, particularly for wood production and conservation of mountainous forest ecosystems.

关键词： Generalized nonlinear weighted regression Monte Carlo cross-validation Mountainous ecosystems Quantile regression Central Greece

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Oxidative imbalance increases the risk for colonic polyp and colorectal cancer development

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World Journal of Gastrointestinal Oncology 2022年第11期14卷 2208-2223页

作者： Dimitrios Tsounis vassiliki Villiotou Angeliki Melpidou Chara Pantsiou Alexandra Argyrou Charis Giannopoulou Adriani Grigoratou Dimitra Rontogianni Gerassimos J Mantzaris George Papatheodoridis Department of Gastroenterology 251 General Hospital of Hellenic Air ForceAthens 11525Greece Department of Biochemistry Metaxa Anticancer HospitalPiraeus 18537Greece Department of Biochemistry Evangelismos HospitalAthens 10676Greece Department of nuclear Medicine and Positron Emission Tomography Computed Tomography Evangelismos HospitalAthens 10676Greece Department of Pathology Evangelismos HospitalAthens 10676Greece Department of Gastroenterology EvangelismosOphthalmiatreion Athinon and Polyclinic HospitalsAthens 10676Greece Academic Department of Gastroenterology Athens University Medical SchoolLaikon General HospitalAthens 11527Greece

BACKGROUnD The role of oxidative stress in the pathogenesis of colorectal carcinoma(CRC)has garnered considerable interest *** oxidative factors have been implicated in the pathogenesis of adenomatous polyps and ultimately *** To evaluate the effect of oxidative imbalance as quantified by specific serological markers in the development of sporadic colon *** A total of 170 patients that underwent endoscopy of the lower gastrointestinal tract in a tertiary center within 3 years were included in the *** were allocated in three groups;those with sporadic colon adenocarcinoma(n=56,32.9%),those with colonic polyps(n=33,19.4%)and healthy controls(n=81,47.7%).All patients were evaluated for oxidant activity and antioxidant capacity with serum measurements of specific markers such as vitamins A,25(OH)D3,E,C,B12,folic acid,glutathione,selenium(Se),zinc(Zn),free iron(Fe^(2+)),and malondialdehyde and results were compared between *** Serum levels of vitamins C,E,D,Se,Zn,vitamin B12 and total antioxidant capacity were significantly lower in the combined neoplasia/polyp group than in the control group(P=0.002,P=0.009,Pnd Pndingly).Increased levels of vitamin E(P=0.004),vitamin D(Pnd Zn(Pn the development of *** vitamin D(Pnd Zn(P=0.036),this effect seems to extend to the development of colon polyps as *** the other hand,elevated serum levels of malondialdehyde are associated with a higher risk of CRC(OR=2.09 compared to controls,P=0.004).Regarding colonic polyp development,increased concentrations of vitaminΑand Fe^(2+) are associated with a higher risk,whereas lower levels of malondialdehyde with a lower *** Increased oxidative stress may play an important role in the pathogenesis and progression of ***’presence may exert a protective effect in the very early stages

关键词： Oxidative imbalance Reactive oxygen species Colorectal adenocarcinoma Colonic polyps Antioxidant capacity

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