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Immune-modulating therapy in acute pancreatitis:Fact or fiction

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World Journal of Gastroenterology 2014年第41期20卷 15200-15215页

作者： Karolina Akinosoglou charalambos Gogos Department of Internal Medicine and Infectious Diseases University General Hospital of Patras

Acute pancreatitis(AP) is one of the most common diseases of the gastrointestinal tract,bearing significant morbidity and mortality *** treatment of AP remains unspecific and supportive and is mainly targeted to aggressively prevent systemic complications and organ failure by intensive *** acute pancreatitis shares an indistinguishable profile of inflammation with sepsis,therapeutic approaches have turned towards modulating the systemic inflammatory ***,among others,have included pro- and antiinflammatory modulators,cytokines,chemokines,immune cells,adhesive molecules and *** though,initial results in experimental models have been encouraging,clinical implementation of immuneregulating therapies in acute pancreatitis has had a slow *** reasons include difficulty in clinical translation of experimental data,poor understanding of inflammatory response time-course,flaws in experimental designs,need for multimodal approaches and commercial *** immune-modulation in acute pancreatitis remains a fact or just fiction remains to be seen in the future.

关键词： Acute pancreatitis Immune-modulation Systemic inflammatory response syndrome Multiple organ dysfunction syndrome Endoscopic retrograde cholangiopancreatography

Biomarkers, erectile dysfunction, and cardiovascular risk prediction： the latest of an evolving concept

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Asian Journal of Andrology 2015年第1期17卷 17-20,I0006页

作者： charalambos Vlachopoulos Nikolaos Ioakeimidis Christodoulos Stefanadis Department of Cardiology Cardiovascular Diseases and Sexual Health Unit Athens Medical School Hippokration Hospital Athens Greece.

A number of circulating and imaging biomarkers are robustly associated with cardiovascular （CV） risk. The overall expectation from a biomarker in the erectile dysfunction （ED） setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker-guided prevention an attainable goal.

关键词： biomarkers erectile dysfunction risk prediction

Clinical significance of erectile dysfunction developing after acute coronary event： exception to the rule or confirmation of the artery size hypothesis？

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Asian Journal of Andrology 2015年第1期17卷 21-25,I0006页

作者： Piero Montorsi Paolo M Ravagnani charalambos Vlachopoulos Department of Clinical Sciences and Community Health Cardiovascular Section University of Milan Centro Cardiologico Monzino IRCCS Milan Italy Department of Cardiology Athens Medical School Greece.

Erectile dysfunction （ED） has been found to frequently precedes the onset of coronary artery disease （CAD）, representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a ＂window opportunity＂ to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis （ASH） has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels （i.e. the penile artery） being able to less well tolerate the same amount of plaque when compared with larger ones （i.e. the coronary artery）. If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH.

关键词： artery size hypothesis coronary artery disease erectile dysfunction

Gastric signet-ring adenocarcinoma presenting with breast metastasis

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World Journal of Gastroenterology 2006年第18期12卷 2958-2961页

作者： Anastasios L Boutis charalambos Andreadis Frideriki Patakiouta Despina Mouratidou 3rd Department of Clinical Oncology Theagenion Cancer HospitalThessalonikiGreece Division of Pathology Theagenion Cancer HospitalThessalonikiGreece

Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features. Estrogen （ER） and progesterone receptors （PR） and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a highgrade adenocarcinoma, identical with that of the breast. Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases （Krukenberg＇s tumor）. A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.

关键词： Gastric adenocarcinoma Signet-ring Breast metastasis Ovarian metastasis

Laparoscopic cholecystectomy: A report from a single center

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World Journal of Gastroenterology 2006年第24期12卷 3887-3890页

作者： Konstantinos Vagenas Stavros N Karamanakos charalambos Spyropoulos Spyros Panagiotopoulos Menelaos Karanikolas Michalis Stavropoulos Department of Surgery School of Medicine University of PatrasRion University Hospital26500 PatrasGreece Department of Anaesthesiology and Critical Care Medicine School of Medicine University of PatrasRion University Hospital26500 PatrasGreece

AIM： To review and evaluate our experience in laparoscopic cholecystectomy. METHODS： A retrospective analysis was performed on data collected during a 13-year period （1992-2005） from 1220 patients who underwent laparoscopic cholecystectomy. RESULTS： Mortality rate was 0%. The overall morbidity rate was 5.08% （n = 62）, with the most serious complications arising from injuries to the biliary tree and the cystic artery. In 23 （1.88%） cases, cholecystectomy could not be completed laparoscopically and the operation was converted to an open procedure. Though the patients were scheduled as day-surgery cases, the average duration of hospital stay was 2.29 d, as the complicated cases with prolonged hospital stay were included in the calculation. CONCLUSION： Laparoscopic cholecystectomy is a safe, minimally invasive technique with favorable results for the patient.

关键词： Laparoscopy Cholecystectomy Minimallyinvasive

A rare etiology of post-endoscopic retrograde cholangiopancreatography pneumoperitoneum

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World Journal of Gastroenterology 2008年第18期14卷 2917-2919页

作者： Stelios F Assimakopoulos Konstantinos C Thomopoulos Sofia Giali Christos Triantos Dimitrios Siagris charalambos Gogos Department of Internal Medicine 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

Major complications of endoscopic retrograde cholangiopancreatography (ERCP) include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. The occurrence of free air in the peritoneal cavity post- ERCP is a rare event (< 1%), which is usually the result of duodenal or ductal perforation related to therapeutic ERCP with sphincterotomy. We describe for the first time a different aetiology of pneumoperitoneum, in an 84-year-old woman with pancreatic cancer and a large hepatic metastasis, after ERCP with common bile duct stent deployment. Our patient developed, pneumoperitoneum due to air leakage from rupture of intrahepatic bile ducts and Glisson’s capsule in the area of a peripheral large hepatic metastasis. The potential mechanism underlying this complication might be post- ERCP pneumobilia and increased pressure of intrahepatic bile ducts leading to rupture of intrahepatic bile ducts in the liver metastatic mass owing to neoplastic tissue friability. This case indicates the need for close clinical and radiological observation of patients with hepatic masses (primary or metastatic) subjected to ERCP. In such patients, avoidance of excessive air insufflation during ERCP and/or placement of a nasogastric tube for bowel decompression immediately after ERCP might be a reasonable strategy to prevent such unusual complications.

关键词： Endoscopic retrograde cholangiopancreatx ography Pneumoperitoneum Complications Pneumobilia Hepatic metastases

One-year outcomes of resveratrol supplement with aflibercept versus aflibercept monotherapy in wet agerelated macular degeneration

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International Journal of Ophthalmology(English edition) 2023年第9期16卷 1496-1502页

作者： Ioannis Datseris Nikolaos Bouratzis charalambos Kotronis Iordanis Datseris Malvina-Efthimia Tzanidaki Alexandros Rouvas Nikolaos Gouliopoulos Ophthalmological Institute OMMA Athens 11525Greece Specialized Eye Hospital“Ophthalmiatreion”Athinon Athens 10672Greece 2^(nd)Department of Ophthalmology Medical School of University of Athens“Attikon”University HospitalAthens 12462Greece

AIM:To determine the one-year outcomes of resveratrol oral supplement in patients suffering from wet age-related macular degeneration(AMD).METHODS:Fifty naïve and previously untreated patients suffering from wet AMD,were randomly assigned in two subgroups of 25 patients *** the participants were treated with 3 monthly intravitreal injections of 2.0 mg aflibercept(IAIs)followed by injections“according to need”,while in one group the patients also received daily two tablets of resveratrol oral *** to treatment initiation,a complete ophthalmological examination,including best corrected visual acuity(BCVA)and contrast sensitivity evaluation,optical coherence tomography(OCT)scans,fundus autofluorescence(FAF),fluorescein angiography,indocyanine green angiography,and OCT angiography(OCTA),was performed to every participant,while all of them completed the Hospital Anxiety and Depression Scale(HADS)questionnaire,in order to assess their quality of life(QoL)*** patients were assessed monthly for 1y with FAF,and OCT or OCTA;the main endpoints were the number IAIs,the changes in BCVA,in contrast sensitivity,and in patients’QoL ***:No significant differences were present between the groups regarding the baseline demographic and clinical *** the 12-month period,a similar number of IAIs was applied in both groups(4.52±1.00 vs 4.28±0.90,P=0.38),while the rest of the clinical data also did not differ significantly after the completion of the study ***,for HADS Depression(11.88±2.51 vs 8.28±1.54,P<0.001)and HADS Anxiety(11.92±2.52 vs 7.76±1.51,P<0.001)questionnaires values,the score was significantly better in patients who received resveratrol ***,a statistically significant difference was detected in the mean change from baseline values of contrast sensitivity(0.17±0.19 vs 0.35±0.24,P=0.005),HADS Depression(0.08±1.38 vs-3.88±1.48,P<0.001),and HADS Anxiety(0.36±1.98 vs-5.12±2.70,P<0.001)scores,in favour of the pati

关键词： wet age-related macular degeneration resveratrol aflibercept Hospital Anxiety and Depression Scale contrast sensitivity

Role for mycobacterial infection in pathogenesis of primary biliary cirrhosis?

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World Journal of Gastroenterology 2012年第35期18卷 4855-4865页

作者： Daniel Smyk Eirini I Rigopoulou Yoh Zen Robin Daniel Abeles charalambos Billinis Albert Pares Dimitrios P Bogdanos Institute of Liver Studies and Liver Unit King's College London School of Medicine at King's College Hospital and Kings College Hospital NHS Trust Foundation TrustLondon SE5 9RSUnited Kingdom Institute of Biomedical Research and Technology(BIOMED) CERETETHLarissa 41222Greece Dimitrios P Bogdanos Department of MedicineUniversity Hospital of LarissaUniversity of Thessaly Medical SchoolBiopolisLarissa 41110Greece Faculty of Veterinary Medicine University of Thessaly Liver Unit Digestive Diseases InstituteHospital ClínicIDIBAPSCIBEREHDUniversity of BarcelonaBarcelona 08036Spain

Primary biliary cirrhosis （PBC） is a progressive cho- lestatic liver disease characterized by the immune- mediated destruction of biliary epithelial cells in small intrahepatic bile ducts. The disease is characterized by circulating antimitochondrial antibodies （AMAs） as well as disease-specific antinuclear antibodies, cholestatic liver function tests, and characteristic histological fea- tures, including granulomas. A variety of organisms are involved in granuloma formation, of which mycobacte- ria are the most commonly associated. This has led to the hypothesis that mnycobacteria may be involved in the pathogenesis of PBC, along with other infectious agents. Additionally, AMAs are found in a subgroup of patients with rnycobacterial infections, such as lep- rosy and pulmonary tuberculosis. Antibodies against species-specific mycobacterial proteins have been re- ported in patients with PBC, but it is not clear whether these antibodies are specific for the disease. In addi- tion, data in support of the involvement of the role of molecular mimicry between rnycobacterial and human mitochondrial antigens as triggers of cross-reactive im- mune responses leading to the loss of immunological tolerance, and the induction of pathological features have been published. Thus, antibodies against myco- bacterial heat shock protein appear to cross-recognize AMA-specific autoantigens, but it is not clear whether these autoantibodies are mycobacterium-species-spe- cific, and whether they are pathogenic or incidental. The view that mycobacteria are infectious triggers of PBC is intriguing, but the data provided so far are not conclusive.

关键词： Antimitochondrial antibodies Autoantibody Autoimmunity Cholestasis Heat shock Infection Liverdisease Liver failure Mycobacterium Tuberculosis

Primary liposarcoma of esophagus:A case report

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World Journal of Gastroenterology 2006年第7期12卷 1149-1152页

作者： Theodore D Liakakos Theodore G Troupis charalambos Tzathas Konstantina Spirou Irene Nikolaou Spiridon Ladas Gabriel M Karatzas Department d~Department

Liposarcoma is the most common soft tissue sarcoma in adult life while esophageal liposarcoma is an extremely rare tumor. In the world literature, only 14 cases of esophageal liposarcomas have been described. We report a 72-year old male patient who was urgently admitted to our hospital for acute epigastric pain with a burning retrosternal sensation, persistent nausea, vomiting and dysphagia. Barium swallow, upper gastrointestinal （GI） endoscopy, esophageal manometry and CT scan, failed to accurately diagnose the lesion. After surgical resection of an esophageal polypoid tumor, the histological examination revealed a well-differentiated grade Ⅰ liposarcoma. Diagnostic and therapeutic tools were discussed and the results of literature were reviewed.

关键词： Liposarcoma Esophagus Surgical treatment