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Renal transplantation in gigantism: A case report

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World Journal of Transplantation 2022年第4期12卷 65-71页

作者： Jeevan Prakash Gopal Sotirios Charalampidis Jinpo Xiang Frank JMF Dor vassilios e papalois Imperial College Renal and Transplant Center Imperial College Healthcare NHS TrustHammersmith HospitalLondon W120HSUnited Kingdom Imperial College School of Medicine Imperial CollegeLondon W120HSUnited Kingdom Department of Surgery and Cancer Imperial CollegeLondon W120HSUnited Kingdom

BACKGROUND Gigantism,characterized by excessive growth and height is due to increased secretion of growth hormone,most commonly from a pituitary *** addition to the surgical and anesthetic complexity,the extreme stature of these patients presents a unique challenge for kidney transplantation in deciding whether to proceed with a single or dual kidney *** lack of relevant literature further adds to the *** SUMMARY A 45-year-old patient with untreated gigantism and end stage renal failure on renal replacement therapy was waitlisted for a deceased donor dual kidney transplantation due to the extreme physical stature(Height-247 cm and weight-200 kg).He was offered 2 kidneys from a 1-0-1 HLA mismatched 24-year-old DCD donor(Height-179 cm and weight-75 kg),and was planned for a bilateral retroperitoneal implantation into the recipient external iliac *** immunosuppression consisted of alemtuzumab induction(50 mg)and steroidfree maintenance with *** donor’s right kidney was uneventfully implanted extra-peritoneally into the right external iliac *** contralateral exposure,the left common and external iliac arteries were ectatic and frail.A complex vascular reconstruction was not preferred in order to preserve the arterial supply to the left lower limb,to minimise the cold ischemia time and prevent additional warm ischemic insult to the second ***,it was decided not to proceed with dual *** concerns of nephron mass insufficiency,the graft function was remarkable with a serum creatinine of 120μmol/L within a month from transplantation and 94μmol/L at 1-year post transplantation,and without *** To our knowledge,this is the first case report on kidney transplantation in *** it is believed that dual kidney transplantation is ideal,a single kidney transplantation from an appropriately selected donor can provide sufficient functioning nephron mass in patients with

关键词： Gigantism Giantism Renal transplantation Kidney transplantation Pituitary adenoma Case report

New Year's greeting and overview of World Journal of Transplantation in 2021

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World Journal of Transplantation 2021年第2期11卷 7-15页

作者： Jia-Ping Yan Sami Akbulut vassilios e papalois Maurizio Salvadori Science editor Development Department Baishideng Publishing Group IncPleasantonCA 94566United States Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey Directorate of Renal and Transplant Services 4th Floor Hammersmith HouseHammersmith HospitalLondon W120HSUnited Kingdom Department of Transplantation Renal Unit Careggi University HospitalFlorence 50139Italy

World Journal of Transplantation(WJT)was launched in December *** we are celebrating WJT’s 10-year anniversary,we are very proud to share with you that since its first issue,WJT has published 312 articles,which have been cited 2786 times(average cites per article of 9.0).Together with an excellent team effort by our authors,editorial Board members,independent expert referees,and staff of the editorial Office,WJT advanced in *** this editorial,we summarize the journal’s bibliometrics,including its citation report,published articles in 2020,peer review rate and manuscript invitation metrics,as well as its editorial Board members and existing problems of *** overall aim of this editorial is to promote the development of WJT in *** appreciate the continuous support and submissions from authors and the dedicated efforts and expertise by our invited *** collective support will allow us to be even more productive in *** addition,we commit to working with you all to raise the academic influence of WJT over the upcoming ***,on behalf of WJT,we wish you and your families the best for the New Year.

关键词： World Journal of Transplantation Citations Articles Country Manuscript type Topics Peer-review editorial Board Problems Development

Immunotherapy of gastric cancer:Present status and future perspectives

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World Journal of Gastroenterology 2024年第8期30卷 779-793页

作者： John K Triantafillidis Manousos M Konstadoulakis Apostolos e papalois Inflammatory Bowel Disease Unit “Metropolitan General”HospitalHolargos 15562AtticaGreece.Hellenic Society for Gastrointestinal Oncology354 Iera OdosChaidari 12461AtticaGreece Second Department of Surgery University of Athens School of MedicineAretaieion HospitalAthens 11528AtticaGreece Unit of Surgical Research and Training Second Department of SurgeryUniversity of AthensSchool of MedicineAretaieion HospitalAthens 11528AtticaGreece

In this editorial,we comment on the article entitled“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review(1999-2023),”which was published in the recent issue of the World Journal of *** focused on the results of the authors’bibliometric analysis concerning gastric cancer immunotherapy,which they analyzed in depth by compiling the relevant publications of the last 20 *** that,we briefly describe the most recent data concerning the epidemiological parameters of gastric cancer(GC)in different countries,attempting to give an interpretation based on the etiological factors involved in the etiopathogenesis of the *** then briefly discuss the conservative treatment(chemotherapy)of the various forms of this malignant *** describe the treatment of resectable tumors,locally advanced neoplasms,and unresectable(advanced)*** attention is given to modern therapeutic approaches with emphasis on immunotherapy,which seems to be the future of GC treatment,especially in combination with *** is also a thorough analysis of the results of the study under review in terms of the number of scientific publications,the countries in which the studies were conducted,the authors,and the scientific centers of origin,as well as the clinical studies in ***,an attempt is made to draw some conclusions and to point out possible future directions.

关键词： Gastric cancer Chemotherapy Immunotherapy Immune checkpoint inhibitors Bibliometrics Scientometrics

Combination treatment of inflammatory bowel disease:Present status and future perspectives

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World Journal of Gastroenterology 2024年第15期30卷 2068-2080页

作者： John K Triantafillidis Constantinos G Zografos Manousos M Konstadoulakis Apostolos e papalois Inflammatory Bowel Disease Unit "Metropolitan General"HospitalHolargos 15562AtticaGreece Hellenic Society for Gastrointestinal Oncology 354 Iera OdosChaidari 12461AtticaGreece The 2^(nd)Department of Surgery University of AthensSchool of MedicineAretaieion HospitalAthens 11528Greece Unit of Surgical Research and Training The 2^(nd)Department of SurgeryUniversity of AthensSchool of MedicineAretaieion HospitalAthens 11528Greece

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challenge for the clinical *** seems to be no exaggeration to say that in these patients,not only the scientific background of the gastroenterologist is tested,but also the abundance of“gifts”that he should possess(insight,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the *** daily clinical practice,depending on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical *** combin-ations include not only the first-line drugs(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drugs(immunosuppressants and biologic agents).It is a fact that despite the significant therapeutic advances there is still a significant percentage of patients who do not satisfactorily respond to the treatment ***,a part of these patients are going to *** recent years,several small-size clinical studies,reviews,and case reports have been published combining not only biological agents with other drugs(e.g.,immunosuppressants or corticosteroids)but also the combination of two biologi-cal agents simultaneously,especially in severe *** our opinion,it is at least a strange(and largely unexplained)fact that we often use combinations of drugs in a given patient although studies comparing the simultaneous administration of two or more drugs with monotherapy are very *** mentioned above,there is a timid tendency in the literature to combine two biological agents in severe cases unresponsive to the applied treatment or patients with severe extraintestinal *** appropriate dosage,the duration of the administration,the suitable timing for checking the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research *** this

关键词： Biologics for immune-mediated conditions Dual-targeted treatment Combination treatment Inflammatory bowel disease Crohn’s

early-onset gastrointestinal cancer:An epidemiological reality with great significance and implications

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 583-597页

作者： John K Triantafillidis Konstantinos Georgiou Manousos M Konstadoulakis Apostolos e papalois Department of IBD and GI endoscopy Metropolitan General HospitalHolargos 15562AthensGreece.Hellenic Society for Gastrointestinal Oncology354 Iera OdosChaidari 12461AtticaGreece 2nd Department of Surgery University of Athens School of MedicineAretaieion HospitalAthens 11528Greece

During the last few years,epidemiological data from many countries suggest that the incidence and prevalence of many cancers of the digestive system are shifting from the older to the younger ages,the so-called“early-onset cancer”.This is particularly evident in colorectal cancer and secondarily in other malignant digestive neoplasms,mainly stomach and in a lesser degree pancreas,and biliary *** should be emphasized that data concerning digestive neoplasms,except for those referring to the colon and stomach,could be characterized as rather *** exact magnitude of the shift in younger ages is expected to become clearer shortly,as long as relevant epidemiological data from many parts of the world would be *** most important question concerns the etiology of this phenomenon,since its magnitude cannot be explained solely by the better diagnostic methodology and the preventive programs applied in many *** existing data support the assumption that a number of environ-mental factors may play a primary role in influencing carcinogenesis,sometimes from *** that have appeared in the last decades related mainly to eating habits,consistency of gut microbiome and an increase of obese people interacting with genetic factors,ultimately favor the process of *** these factors however,are not entirely sufficient to explain the age-related changes in the frequency of digestive *** of the individual effect of each of the already known factors or factors likely to be involved in the etiology of this phenomenon and studies using state-of-the-art technologies to accurately determine the degree of the population exposure to these factors are *** this article,we attempt to describe the epidemiological data supporting the age-shifting of digestive malignancies and their possible ***,we propose some measures regarding the attitude of the scientific community to this alarming phenomenon.

关键词： Gastrointestinal cancer endoscopy epidemiology early-onset environment

Anticoagulation in simultaneous pancreas kidney transplantation - On what basis?

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World Journal of Transplantation 2020年第7期10卷 206-214页

作者： Jeevan Prakash Gopal Frank JMF Dor Jeremy S Crane Paul e Herbert vassilios e papalois Anand SR Muthusamy Imperial College Renal and Transplant Center Imperial College Healthcare NHS TrustHammersmith HospitalLondon W120HSUnited Kingdom Department of Surgery and Cancer Imperial CollegeLondon W120HSUnited Kingdom

BACKGROUND Despite technical refinements,early pancreas graft loss due to thrombosis continues to *** coagulation tests(CCT)do not detect hypercoagulability and hence the hypercoagulable state due to diabetes is left ***(TeG)is an in-vitro diagnostic test which is used in liver transplantation,and in various intensive care settings to guide *** is better than CCT because it is dynamic and provides a global hemostatic profile including *** To compare the outcomes between TeG and CCT(prothrombin time,activated partial thromboplastin time and international normalized ratio)directed anticoagulation in simultaneous pancreas and kidney(SPK)transplant *** A single center retrospective analysis comparing the outcomes between TeG and CCT-directed anticoagulation in SPK recipients,who were matched for donor age and graft type(donors after brainstem death and donors after circulatory death).Anticoagulation consisted of intravenous(IV)heparin titrated up to a maximum of 500 IU/h based on CCT in conjunction with various clinical parameters or directed by TeG *** loss due to thrombosis,anticoagulation related bleeding,radiological incidence of partial thrombi in the pancreas graft,thrombus resolution rate after anticoagulation dose escalation,length of the hospital stays and,1-year pancreas and kidney graft survival between the two groups were *** Seventeen patients who received TeG-directed anticoagulation were compared against 51 contemporaneous SPK recipients(ratio of 1:3)who were anticoagulated based on *** graft losses occurred in the TeG group,whereas 11 grafts(7 pancreases and 4 kidneys)were lost due to thrombosis in the CCT group(P=0.06,Fisher’s exact test).The overall incidence of anticoagulation related bleeding(hematoma/gastrointestinal bleeding/hematuria/nose bleeding/re-exploration for bleeding/post-operative blood transfusion)was 17.65%in the TeG group and 45

关键词： Anticoagulation Pancreas transplantation Thromboelastography Thrombosis Hypercoagulability

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：肝细胞移植异种移植实验模型抗体白介素-2受体

Sedation in gastrointestinal endoscopy: Current issues

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World Journal of Gastroenterology 2013年第4期19卷 463-481页

作者： John K Triantafillidis emmanuel Merikas Dimitrios Nikolakis Apostolos e papalois Department of Gastroenterology and Center for Inflammatory Bowel Disease "Saint Panteleimon" General HospitalNikaia12461 HaidariGreece experimental Research Center ELPEN Pharmaceuticals19009 AthensGreece

Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate(conscious) *** sedation,using midazolam and an opioid,is the standard method of sedation,although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional ***,the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and,consequently,its low risk of inducing hepatic *** the future,propofol could become the preferred sedation agent,especially for routine *** is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with *** opioids,pethidine and fentanyl are the most popular.A number of other substances have been tested in several clinical trials with promising *** them,newer opioids,such as remifentanil,enable a faster *** controversy regarding the administration of sedation by an endoscopist or an experienced nurse,as well as the optimal staffing of en-doscopy units,continues to be a matter of *** sedation in special clinical circumstances,such as in the cases of obese,pregnant,and elderly individuals,as well as patients with chronic lung,renal or liver disease,requires modification of the dose of the drugs used for *** the great majority of patients,sedation under the supervision of a properly trained endoscopist remains the standard practice *** this review,an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature.

关键词： Gastrointestinal endoscopy endoscopy Sedation Analgesia Digestive system

effects of mycophenolate mofetil vs cyclosporine administration on graft survival and function after islet allotransplantation in diabetic rats

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World Journal of Gastroenterology 2005年第18期11卷 2733-2738页

作者： Constantin Fotiadis Paraskevi Xekouki Apostolos e papalois PantelisT Antonakis Ioannis Sfiniadakis Dimitrios Flogeras eleutheria Karampela George Zografos 3~(rd) Department of Surgery Athens University Medical School Athens Greece experimentalResearch Unit eLPeN Pharma Athens Greece Department of Pathology Naval Hospital Athens Greece

AIM: To develop an experimental model of islet allotransplantation in diabetic rats and to determine the positive or adverse effects of MMF as a single agent. MeTHODS: Thirty-six male Wistar rats and 18 male Lewis rats were used as recipients and donors respectively. Diabetes was induced by the use of streptozotocin (60 mg/kg) intraperitoneally. Unpurified islets were isolated using the collagenase digestion technique and transplanted into the splenic parenchyma. The recipients were randomly assigned to one of the following three groups: group A (control group) had no immunosuppression; group B received cyclosporine (CsA) (5 mg/kg); group C receivedmycophenolate mofetil (MMF) (20 mg/kg). The animalswere killed on the 12th d. Blood and grafted tissues were obtained for laboratory and histological assessment. ReSULTS: Median allograft survival was significantly higher in the two therapy groups than that in the controls (10 and 12 d for CsA and MMF respectively vs 0 d for the control group, P＜0.01). No difference in allograft survival between the CsA and MMF groups was found. However,MMF had less renal and hepatic toxicity and allowed weight ***: Monotherapy with MMF for immunosu ppression was safe in an experimental model of islet allotransplantation and was equally effective with cyclosporine, with less toxicity.

关键词：麦考酚酸吗乙酯药物治疗器官移植糖尿病小鼠动物实验