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宫颈癌患者脊髓髓内和软脑膜转移1例

世界核心医学期刊文摘（妇产科学分册） 2006年第10期2卷 48-48页

作者： Ka.tritis E. Moulopoulos L.a. Politi Ek. a. bamias 朱磊 Depa.tment of Clinica. Thera.eutics Alexandra Hospital Athens University School of Medicine 31 Komninon St Haidari 124 62 Athens Greece

Ba.kground.: Neopla.tic meningitis in pa.ients with ca.cinoma.of the uterine cervix is unusua. in the course of their disea.es. Even more unusua. a.e intra.edulla.y spina. meta.ta.es. Ca.e.: We report the ca.e of a.64-yea.-old woma. who presented with leptomeningea. a.d intra.edulla.y spina. cord meta.ta.es from a.gra.e 2 squa.ous cell ca.cer of the uterine cervix. This is just the second ca.e of intra.edulla.y meta.ta.es from cervica. ca.cinoma. Conclusion.: Neopla.tic meningitis or intra.edulla.y meta.ta.es a.e extremely ra.e in the course of uterine cervix ca.cinoma. Nevertheless, when indica.ed by symptoms, pa.ients should undergo MRI of the bra.n a.d/or spine a.d ha.e a.lumba. puncture performed, for the dia.nosis of this deva.ta.ing complica.ion. Trea.ment is ma.nly pa.lia.ive but ma. offer symptom relief.

关键词：软脑膜脑脊膜转移姑息性腰椎穿刺

Mucins in neopla.ms of pa.crea.,a.pulla.of Va.er a.d bilia.y system

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World Journa. of Ga.trointestina. Oncology 2016年第10期8卷 725-734页

作者： Dimitrios Moschovis Giorgos bamias Ioa.na.Della.etsima Depa.tment of Ga.troenterology Agios Panteleimon General Hospital a.a.emic Depa.tment of Ga.troenterology Medical SchoolNational and Kapodistrian University of AthensLaikon Hospital First Depa.tment of Pa.hology Medical SchoolNational and Kapodistrian University of Athens

Tumors of the pa.crea.,the a.pulla.of Va.er,a.d the extra.epa.ic a.d intra.epa.ic bile ducts ha.e significa.t histologica. simila.ities due to the common embryonic origin of the pa.crea.obilia.y *** obvia.es the need for discovery of bioma.kers with dia.nostic a.d prognostic va.ue for these ***,especia.ly MUC-1,-2,-4 a.d-5a.,a.e importa.t ca.dida.es for developing into such relia.le *** expression of MUC1 occurs in pa.crea.ic ducta. a.enoca.cinoma. a.d is a.socia.ed with increa.ed degrees of dyspla.ia.in pa.crea.ic intra.pithelia. neopla.ia.Pa. IN).Positive expression of MUC2 in intra.ucta. pa.illa.y mucinus neopla.ms(IPMN) of the intestina. type indica.es high potentia. progression to inva.ive ca.cinoma.with de novo expression of MUC1,while a.sence of MUC2 expression in IPMNs of ga.tric type implies low potentia. to ma.igna.t *** novo MUC4 expression correla.es to the severity of dyspla.ia.in Pa. IN a.d is a.socia.ed with a.poor prognosis in pa.ients with pa.crea.ic ducta. *** bilia.y intra.pithelia. neopla.ia.Bil IN),increa.ed expression of MUC1 is a.socia.ed with higher degrees of *** chola.gioca.cinoma.(ICC) a.e cha.a.terized by increa.ed expression of a.l glycoforms of *** MUC2 expression in intra.ucta. pa.illa.y neopla.m of the bile ducts(IPNB) of the intestina. type indica.es high ma.igna.t potentia. with de novo expression of MUC1 in the inva.ive *** MUC2 expression in a.y degree of Bil IN ma. prove useful in differentia.ing them from *** novo expression of MUC4 is a.socia.ed with poor prognosis in pa.ients with ICC or ca.cinoma.of the extra.epa.ic bile ducts(EHBDC).High de novo expression of MUC5 a. is found in a.l degrees of Bil IN a.d a.l types of IPNB a.d *** MUC5 a. is useful in the detection of neopla.tic lesions of the bile duct a. a. ea.ly *** expression of mucin MUC1 in ca.cinoma.of the a.pulla.of Va.er a.socia.ed with unfa.ora.le b

关键词： a.pulla.Va.er neopla.ms Bilia.y system neopla.ms Mucins Pa.crea.ic neopla.ms

Ma.a.ement of hepa.itis B virus infection in pa.ients with infla.ma.ory bowel disea.e under immunosuppressive trea.ment

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World Journa. of Ga.troenterology 2021年第25期27卷 3762-3779页

作者： Georgios a.ia.is Eva.thia.Za.peli Spyridon Michopoulos Giorgos bamias Ga.troenterology Depa.tment "Alexandra"HospitalAthens 11528Greece GI Unit 3^(rd)Academic Department of Internal MedicineNational and Kapodistrian University of AthensSotiria HospitalAthens 11526Greece

Hepa.itis B rema.ns a.significa.t globa. clinica. problem,despite the implementa.ion of sa.e a.d effective va.cina.ion *** preva.ence of hepa.itis B virus(HBV)in pa.ients with infla.ma.ory bowel disea.e(IBD)la.gely follows the regiona. epidemiologic *** screening with hepa.itis B surfa.e a.tigen(HBsa.),a.d a.tibodies to hepa.itis B surfa.e(a.ti-HBs)a.d core(a.ti-HBc)proteins is a.key element in the ma.a.ement of IBD pa.ients a.d,idea.ly,should be performed a. IBD *** of individua. ca.es should be done a.cording to the serologic profile a.d the IBD-specific trea.ment,with pa.ticula. empha.is in pa.ients receiving immunosuppressive *** pa.ients who ha.e not contra.ted HBV,va.cina.ion is indica.ed to a.complish protective *** in immunosuppressed pa.ients,however,is a.cha.lenging issue a.d severa. stra.egies for prima.y a.d reva.cina.ion ha.e been *** risk of HBV rea.tiva.ion in pa.ients with IBD should be considered in both HBsa.-positive a.d HBsa.-nega.ive/a.ti-HBc-positive pa.ients,when immunosuppressive thera.ies a.e *** rea.tiva.ion is preventa.le via.the a.ministra.ion of prophyla.tic nucleot(s)ide a.a.ogues a.d should be the sta.da.d a.proa.h in HBsa.-positive ***-nega.ive/a.ti-HBcpositive pa.ients represent a.non-homogeneous group a.d bea. a.significa.tly lower risk of HBV ***,serologica. a.d molecula. monitoring is currently the recommended a.proa.h for a.ti-HBc *** HBV infection is ra.ely reported in IBD *** the present review,we outline the problems a.socia.ed with HBV infection in pa.ients with IBD a.d present upda.ed evidence for their ma.a.ement.

关键词： Hepa.itis B virus Infla.ma.ory bowel disea.e Rea.tiva.ion Immunosuppression Va.cina.ion Prophyla.is

Decoy receptor 3: Its role a. bioma.ker for chronic infla.ma.ory disea.es

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World Journa. of Immunology 2013年第3期3卷 44-53页

作者： Spyros I Sia.a.ella. Giorgos bamias a.a.emic Depa.tment of Ga.troenterology Ethnikon and Kapodistriakon University Laikon Hospital 11527 Athens Greece

Members of the tumor-necrosis fa.tor-α(TNF-α) a.d TNF-α receptor(TNFR) superfa.ilies of proteins(TNFSF a.d TNFRSF, respectively) pla. importa.t roles in the function of the immune system. Decoy receptor 3(Dc R3, TNFRSF6b) is a.decoy receptor tha. binds to three TNFSF liga.ds, Fa. L, LIGHT a.d TL1 a. a.socia.ion to these liga.ds competes with the corresponding functiona. receptors a.d blocks downstrea. signa.ing, lea.ing to immunomodula.ory effects, including the prevention of a.optosis. Dc R3 la.ks a.tra.smembra.e region a.d exists only a. a.secreted protein, which is detecta.le in biologica. fluids. Recent studies ha.e shown tha. Dc R3 is upregula.ed a.d ma. be pa.hogenetica.ly implica.ed in severa. a.d diverse chronic infla.ma.ory disea.es. The strongest a.socia.ions ha.e been described for rheuma.ologica. disea.es, ma.nly systemic lupus erythema.osus a.d rheuma.oid a.thritis, infla.ma.ory bowel disea.e, a.d serious infectious conditions, including systemic infla.ma.ory response syndrome. In the ma.ority of these conditions, Dc R3 m RNa.a.d protein expression is eleva.ed both a. the ta.get tissues a. well a. in the systemic circula.ion. Dc R3 concentra.ion in the serum is untra.ea.le in the ma.ority of hea.thy individua.s but ca. be detected in pa.ients with va.ious infla.ma.ory disea.es. In mostsuch ca.es, soluble Dc R3 correla.es with disea.e severity, a. pa.ients with severe forms of disea.e ha.e significa.tly higher levels tha. pa.ients with milder or no a.tivity. In a.dition, effective a.ti-infla.ma.ory trea.ment lea.s to the disa.pea.a.ce of soluble Dc R3 from the circula.ion. Ta.en together, current evidence suggests tha. serum Dc R3 ma. become a.useful bioma.ker for chronic infla.ma.ory disorders, a. it is upregula.ed in response to infla.ma.ory stimuli, a.d ma. serve both a. a.prognostic ma.ker for disea.e severity a.d a. a.surroga.e indica.or of response to trea.ment.

关键词： Decoy receptor 3 Tumor necrosis fa.tor receptor superfa.ily of proteins Chronic infla.ma.ion Infection Disea.e a.tivity Bioma.ker

Ea.ly ileocolonoscopy with biopsy for the eva.ua.ion of persistent post-tra.spla.ta.ion dia.rhea

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World Journa. of Ga.troenterology 2010年第30期16卷 3834-3840页

作者： Giorgos bamias John Boletis Theodoros a.gyropoulos Chrysa.thi Ska.ioti Spyros I Sia.a.ella. Ioa.na.Della.etsima.Irene Zouboulis-Va.ia.is George L Da.kos Spiros D La.a. Ga.troenterology Division 1st Department of Internal MedicinePropaedeuticMedical SchoolUniversity of Athens"Laikon" Hospital11527AthensGreece Depa.tment of Nephrology a.d Rena. Tra.spla.ta.ion Unit "Laikon" Hospital11527AthensGreece 1st Depa.tment of Pa.hology University of Athens"Laikon"Hospital11527AthensGreece

a.M: To investiga.e the signifi ca.ce of ileocolonoscopy with histology in the eva.ua.ion of post-tra.spla.ta.ion persistent dia.rhea.(PD). METHODS: We retrospectively reviewed a.l records of rena. tra.spla.t pa.ients with PD, over a.3-yea. period. a.l pa.ients were referred for ileocolonoscopy with biopsy, following a.nega.ive initia. dia.nostic work up. Clinica. a.d epidemiologica. da.a.were compa.ed between ca.es with infectious or drug-induced dia.rhea. RESULTS: We identif ied 30 episodes of PD in 23 rena.tra.spla.t pa.ients (1-3 ca.es per pa.ient). There were 16 ma.e pa.ients a.d the mea. a.e a. the time of PD wa. 51.4 yea.s. The a.era.e time from tra.spla.ta.ion to a.PD episode wa. 62.3 ± 53.2 mo (ra.ge 1-199 mo). Ileocolonoscopy detected mucosa. a.norma.ities in 19 ca.es, wherea. the intestina. mucosa.a.pea.ed norma. in 11 ca.es. Histologica. exa.ina.ion a.hieved a.specific dia.nosis in 19/30 ca.es (63.3%). In nine out of 11 ca.es (82%) with norma. endoscopic a.pea.a.ce of the mucosa. histologica. exa.ina.ion of blinded biopsies provided a.specif ic dia.nosis. The etiology of PD wa. infectious in 11 ca.es (36.6%), drug-rela.ed in 10 (33.3%), of other ca.ses in three (10%), a.d of unknown origin in six ca.es (20%). Infectious dia.rhea.occurred in significa.tly longer interva.s from tra.spla.ta.ion compa.ed to drug-rela.ed PD (85.5 ± 47.6 mo vs 40.5 ± 44.8 mo, P a.cordingly, PD due to drug-toxicity wa. ra.ely seen a.ter the f irst yea. post-tra.spla.ta.ion. Clinica. improvement followed thera.eutic intervention in 90% of ca.es. Modif ica.ion of immunosuppressive regimen wa. a.oided in 57% of pa.ients. CONCLUSION: Ea.ly ileocolonoscopy with biopsies from both a.fected a.d norma. mucosa.is a. importa.t a.junctive tool for the etiologica. dia.nosis of PD in rena. tra.spla.t pa.ients.

关键词： Endoscopy Post-tra.spla.ta.ion dia.rhea Histology Enteric infections Mycophenola.e mofetilcolitis

Feca. ca.protectin mea.urement is a.ma.ker of shortterm clinica. outcome a.d presence of mucosa. hea.ing in pa.ients with infla.ma.ory bowel disea.e

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World Journa. of Ga.troenterology 2017年第41期23卷 7387-7396页

作者： a.ha.a.ios Kosta. Spyros I Sia.a.ella. Cha.a.a.bos Kosmidis a.na.Ta.ou Joa.na.Nikou Georgios Ma.opoulos John Vla.hogia.na.os George V Pa.a.heodoridis Ioa.nis Pa.a.onsta.tinou Giorgos bamias Depa.tment of Ga.troenterology University of Athens Medical School Laiko General Hospital Bioche-mistry Depa.tment Laiko General Hospital 2nd Depa.tment of Surgery University of Athens Medical School Areteion General Hospital

a.M To eva.ua.e the utility of feca. ca.protectin(FC) in predicting rela.se a.d endoscopic a.tivity during follow-up in a. infla.ma.ory bowel disea.e(IBD) *** a.l FC mea.urements tha. were obta.ned during a.3-yea. period from pa.ients with infla.ma.ory bowel disea.e in clinica. remission were identified. Da.a.rega.ding the short-term(6 mo) course of the disea.e were extra.ted from the medica. files. Exclusion criteria.were defined a.:(1) a. esta.lished fla.e of the disea.e a. the time of FC mea.urement,(2) Loss to follow up within 6 mo from ba.eline FC mea.urement, a.d,(3) Insufficient da.a.on file. Sta.istica. a.a.ysis wa. performed to eva.ua.e whether ba.eline FC mea.urement could predict the short term clinica. rela.se a.d/or the presence of mucosa. *** We included 149 [Crohn's disea.e(CD) = 113, Ulcera.ive colitis(UC) = 36, ma.e = 77] IBD pa.ients in our study. Within the determined 6-month period post-FC mea.urement, 47(31.5%) ha. a.disea.e fla.e. a.ong 76 pa.ients who underwent endoscopy, 39(51.3%) ha. mucosa. hea.ing. Ba.eline FC concentra.ions were significa.tly higher in those who ha. clinica. rela.se compa.ed to those who rema.ned in remission during follow up(481.0 μg/g, 286.0-600.0 vs 89.0, 36.0-180.8, P a.t predictive va.ue of ba.eline media. with IQR FC for clinica. rela.se wa. confirmed by multiva.ia.e Cox a.a.ysis [HR for 100μg/g: 1.75(95%CI: 1.28-2.39), P = 0.001]. Furthermore, lower FC ba.eline va.ues significa.tly correla.ed to the presence of mucosa. hea.ing in endoscopy(69.0 μg/g, 30.0-128.0 vs 481.0, 278.0-600.0, in those with mucosa. infla.ma.ion, media. with IQR, P a.le to extra.t cut-off va.ues for FC concentra.ion with a.high sensitivity a.d specificity for predicting clinica. rela.se(261 μg/g with a.C = 0.901, sensitivity 87.2%, specificity 85.3%, P a. hea.ing(174 μg/g with a.C = 0.956, sensitivity 91.9%, specificity 87.2%, P a. better tha. CRP in

关键词： Feca. ca.protectin Bioma.ker Infla.ma.ory bowel disea.e Mucosa. hea.ing Clinica. outcome Rela.se Ulcera.ive colitis Crohn’s disea.e

Predictors of response to a.ti-tumor necrosis fa.tor thera.y in ulcera.ive colitis

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World Journa. of Ga.trointestina. Pa.hophysiology 2014年第3期5卷 293-303页

作者： Eva.thia.Za.peli Micha.is Gizis Spyros I Sia.a.ella. Giorgos bamias Ga.troenterology Depa.tment Alexandra General Hospital a.a.emic Depa.tment of Ga.troenterology Ethnikon and Kapodistriakon University of Athens Laikon Hospital

Ulcera.ive colitis(UC) is a. immune-media.ed, chronic infla.ma.ory disea.e of the la.ge intestine. Its course is cha.a.terized by fla.es of a.ute infla.ma.ion a.d periods of low-gra.e chronic infla.ma.ory a.tivity or remission. Monoclona. a.tibodies a.a.nst tumor necrosis fa.tor(a.ti-TNF) a.e pa.t of the thera.eutic a.ma.enta.ium a.d a.e used in ca.es of modera.e to severe UC tha. is refra.tory to conventiona. trea.ment with corticosteroids a.d/or immunosuppressa.ts. Thera.eutic response to these a.ents is not uniform a.d a.la.ge percenta.e of pa.ients either fa.l to improve(prima.y non-response) or lose response a.ter a.period of improvement(seconda.y non-response/loss of response). In a.dition, the use of a.ti-TNF a.ents ha. been rela.ed to uncommon but potentia.ly serious a.verse effects tha. preclude their a.ministra.ion or lea. to their discontinua.ion. Fina.ly, use of these medica.ions is a.socia.ed with a.considera.le cost for the hea.th system. The identifica.ion of pa.a.eters tha.ma. predict response to a.ti-TNF drugs in UC would help to better select for pa.ients with a.high proba.ility to respond a.d minimize risk a.d costs for those who will not respond. a.a.ysis of the ma.or clinica. tria.s a.d the a.cumula.ed experience with the use of a.ti-TNF drugs in UC ha. resulted to the report of such prognostic fa.tors. Included a.e clinica. a.d epidemiologica. cha.a.teristics, la.ora.ory ma.kers, endoscopic indica.ors a.d molecula.(immunologica./genetic) signa.ures. Such predictive pa.a.eters of long-term outcomes ma. either be present a. the commencement of trea.ment or determined during the ea.ly period of thera.y. Va.ida.ion of these prognostic ma.kers in la.ge cohorts of pa.ients with va.ia.le cha.a.teristics will fa.ilita.e their introduction into clinica. pra.tice a.d the best selection of UC pa.ients who will benefit from a.ti-TNF thera.y.

关键词： Ulcera.ive colitis Inflixima. a.a.imuma. a.ti-tumor necrosis fa.tor Predictors of response Persona.ized trea.ment

Ma.kers of ba.teria. tra.sloca.ion in end-sta.e liver disea.e

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World Journa. of Hepa.ology 2015年第20期7卷 2264-2273页

作者： Ioa.nis Koutsouna. Ga.yfa.lia.Ka.tsa.Spyros I Sia.a.ella. Giorgos bamias a.a.emic Depa.tment of Ga.troenterology Ethnikon and Kapodistriakon University School of Medical Sciences Laikon General Hospital

Ba.teria. tra.sloca.ion(BT) refers to the pa.sa.e of via.le ba.teria.or ba.teria. products from the intestina. lumen, through the intestina. epithelium, into the systemic circula.ion a.d extra.ntestina. loca.ions. The three principa. mecha.isms tha. a.e thought to be involved in BT include ba.teria. overgrowth, disruption of the gut mucosa. ba.rier a.d a. impa.red host *** is commonly observed in liver cirrhosis a.d ha. been shown to pla. a. importa.t role in the pa.hogenesis of the complica.ions of end sta.e liver disea.e, including infections a. well a. hepa.ic encepha.opa.hy a.d hepa.orena. syndrome. Due to the importa.ce of BT in the na.ura. history of cirrhosis, there is intense interest for the discovery of bioma.kers of BT. To da.e, severa. such ca.dida.es ha.e been proposed, which include ba.teria. DNa. soluble CD14, lipopolysa.cha.ides endotoxin, lipopolysa.cha.ide-binding protein, ca.protectin a.d proca.citonin. Studies on the a.socia.ion of these ma.kers with BT ha.e demonstra.ed not only promising da.a.but, oftentimes, contra.ictory results. a. a.consequence, currently, there is no optima. ma.ker tha. ma. be used in clinica. pra.tice a. a.surroga.e for the presence of BT.

关键词： End sta.e liver disea.e Cirrhosis Soluble CD14 Ba.

Probiotics in infla.ma.ory bowel disea.e: Pa.hophysiologica. ba.kground a.d clinica. a.plica.ions

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World Journa. of Immunology 2013年第3期3卷 31-43页

作者： Cristia.o Pa.nini Gia.fra.co Delle Fa.e Giorgos bamias Fa.ulty of Medicine a.d Psychology S.Andrea Hospital Sapienza University Rome 00189 Italy a.a.emic Depa.tment of Ga.troenterology Laikon Hospital Ethnikon and Kapodistriakon University Athens 11527 Greece

Ulcera.ive colitis a.d Crohn's disea.e, collectively termed the infla.ma.ory bowel disea.es(IBD), a.e chronic infla.ma.ory disorders of the ga.trointestina. tra.t. a."dysbiotic" rela.ionship between the commensa. gut flora.a.d the intestina. mucosa.a.socia.ed immune system ha. been a. the core of the pa.hogenesis of these conditions. Probiotics a.e "good ba.teria. with the a.ility to benefit the hea.th of the host a.d their thera.eutic a.plica.ion ha. been studied in IBD. The theoretica. ba.is for such utiliza.ion relies upon the a.ility of probiotic microorga.isms to interfere with the dysregula.ed homeosta.is tha. ta.es pla.e in IBD a.d restore the immune-ba.teria. intera.tion a. the intestina. mucosa. Proposed mecha.isms of a.tion include the reconstitution of a.tered flora.composition, enha.cement of the integrity of the epithelia. ba.rier, promotion of tolerogenic a.tion by dendritic cells, strengthening of the defensive mecha.isms of the inna.e immunity, a.d the suppression of pro-infla.ma.ory a.a.tive immune responses. Despite this a.unda.ce of supporting experimenta. evidence, clinica. a.plica.ion of probiotics in IBD ha. been disa.pointing. Possible expla.a.ions for such discrepa.cy include the grea. diversity of microorga.isms tha. fa.l under the definition of probiotics, the la.k of sta.da.diza.ion of dosa.es a.d a.ministra.ion schemes, the heterogeneity between clinica. tria.s, a.d the inclusion in the trea.ment a.ms of pa.ients with a.la.ge va.iety of clinica. phenotypes. a.dressing these importa.t issues will be critica. for the optima. usa.e of probiotic-ba.ed thera.ies for pa.ients with IBD.

关键词： Probiotics Commensa. flora Mucosa.a.socia.ed immune system Infla.ma.ory bowel disea.e Clinica. tria.s Pouchitis Ulcera.ive colitis Crohn’s disea.e