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Modelling of temperature and strain rate dependent behaviour of pearlitic steel in block braked railway wheels

Railway Engineering Science 2021年第4期29卷 362-378页

作者： Ali Esmaeili Johan Ahlstrom Magnus Ekh dimitrios Nikas Tore Vernersson CHARMEC/Department of Industrial and Materials Science Chalmers University of TechnologyGothenburgSweden Now at Department of Engineering and Physics Karlstad UniversityKarlstadSweden CHARMEC/Department of Mechanics and Maritime Sciences Chalmers University of TechnologyGothenburgSweden

Block braked railway wheels are subjected to thermal and rolling contact *** thermal loading results in high temperatures and thermal stresses which cause slow time dependent processes such as creep,relaxation and static recovery of the wheel *** the same time,the rolling contact loading implies a very fast mechanical load *** paper is focused on material modeling of pearlitic steel for a wide range of loading rates at elevated *** starting point is a viscoplasticity model including nonlinear isotropic and kinematic *** Delobelle overstress function is employed to capture strain rate dependent response of the *** model also includes static recovery of the hardening to capture slower viscous(diffusion dominated)behaviour of the *** for the pearlitic wheel steel ER7 in terms of cyclic strain-controlled uniaxial tests with hold-time,uniaxial ratchetting tests including rapid cycles and biaxial cyclic tests with tension/compression and torsion are used to calibrate the material *** experiments were performed under isothermal conditions at different *** the ratchetting tests,higher loading rates are obtained and these have been used to calibrate the high strain rate response of the viscoplasticity *** paper is concluded with a numerical example of a block braked wheel where the importance of accounting for the viscoplasticity in modelling is highlighted.

关键词： Block braking High temperatures Pearlitic steel Railway wheels Viscoplasticity

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Antithrombotic therapy in TAVI

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Journal of Geriatric Cardiology 2018年第1期15卷 66-75页

作者： Manolis Vavuranakis Konstantinos Kalogeras Angelos Michail Kolokathis dimitrios Vrachatis Nikolaos Magkoutis Gerasimos Siasos Euaggelos Oikonomou Maria Kariori Theodoros Papaioannou Maria Lavda Carmen Moldovan Ourania Katsarou dimitrios Tousoulis The First Department of Cardiology Hippokration Hospital Medical School National & Kapodistrian University of Athens Ilioupoli Greece

Transcatheter aortic valve implantation （TAVI） carries a significant thromboembolic and concomitant bleeding risk, not only during the procedure but also during the periprocedural period. Many issues concerning optimal antithrombotic therapy after TAVI are still under debate. In the present review, we aimed to identify all relevant studies evaluating antithrombotic therapeutic strategies in relation to clinical outcomes after the procedure. Four randomized control trials （RCT） were identified analyzing the post-TAVI antithrombotic strategy with all of them utilizing aspirin lifelong plus clopidogrel for 3-6 months. Seventeen registries have been identified, with a wide variance among them regarding baseline characteristics, while concerning antiplatelet therapy, clopidogrel duration was ranging from 3-12 months. Four non-randomized trials were identified, comparing single vs. dual antiplatelet therapy after TAVI, in respect of investigating thromboembolic outcome events over bleeding complications. Finally, limited data from a single RCT and a retrospective study exist with regards to anticoagulant treatment during the procedure and the optimal antithrombotic therapy when concomitant atrial fibrillation. In conclusion, due to the high risk and frailty of the treated population, antithrombotic therapy after TAVI should be carefully evaluated. Diminishing ischaemic and bleeding complications remains the main challenge in these patients with further studies to be needed in this field.

关键词： Antiplatelets Antithrombotic Bleeding Stroke Transcatheter aortic valve implantation

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Surgical treatment outcome of painful traumatic neuroma of the infrapatellar branch of the saphenous nerve during total knee arthroplasty

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World Journal of Orthopedics 2021年第12期12卷 1008-1015页

作者： Byron Chalidis dimitrios Kitridis Panagiotis Givissis The First Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece

BACKGROUND Development of infrapatellar saphenous neuroma(ISN)is a well-recognized reason for knee pain following total knee arthroplasty(TKA).So far,very few studies have addressed the development of painful ISN after TKA and its impact on functional outcome and patient *** To present the results of surgical treatment for ISN after primary TKA,the level of pain relief,and the improvement of knee motion and *** Fifteen patients(13 women,2 men)with persistent medial pain for more than six months after primary TKA,due to osteoarthritis,underwent surgical excision of *** diagnosis was confirmed with the presence of Tinel’s sign along the course of the infrapatellar branch of the saphenous nerve and with pain relief after selective nerve block using local *** loosening,malalignment,instability and infection were excluded systematically in all patients as a source of *** relief in terms of visual analog scale(VAS),active knee range of motion(ROM),and the Knee Society Score(KSS)for pain and function were evaluated preoperatively and at least six months *** The mean patients’age was 71.3±5.4 years *** mean interval between TKA and neuroma excision was 10 mo(range,6 to 14 mo),while the mean follow-up was 8 mo(range:6 to 11 mo).All 15 patients experienced almost complete immediate pain relief and resolution of allodynia and hyperesthesia after *** on the VAS scale improved from 8.6±1.3 preoperatively to 0.8±0.9 at the final follow-up(P=0.001).KSS pain and function scores were improved from 49.3±5.9 and 62.7±12.8 before surgery to 91.8±4.2 and 75.3±11.3 after surgery,respectively(P=0.001 and P=0.015).Active knee ROM was also increased postoperatively from 96±4 to 105±6 degrees(P=0.001).There were no complications and no further operations *** ISN should be considered a potential cause of persistent pain following *** excision not only provides immediate pain relief an

关键词： Total knee arthroplasty Infrapatellar branch of saphenous nerve Neuroma Neurogenic pain Knee osteoarthritis

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Association of liver cirrhosis related IgA nephropathy with portal hypertension

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World Journal of Gastroenterology 2007年第43期13卷 5783-5786页

作者： Georgios Kalambokis Leonidas Christou dimitrios Stefanou Evdokia Arkoumani Epameinondas V Tsianos Division of Internal Medicine and Hepato-gastroenterology Unit University Hospital Ioannina Greece Department of Pathology University Hospital Ioannina Greece

A high incidence of IgA nephropathy has been reported in patients with liver cirrhosis, though, clinically evident nephrotic syndrome is very uncommon. Impaired hepatic clearance of circulating IgA immune complexes and subsequent deposition in renal glomeruli has been considered principally in the pathogenesis of liver cirrhosis associated IgA nephropathy. Here we report on a patient with cryptogenic liver cirrhosis and splenic vein thrombosis, who presented with nephrotic syndrome. Renal biopsy showed findings consistent with IgA nephropathy. Lower endoscopy showed features of portal hypertensive colopathy. Following initiation of propranolol and anticoagulant treatment to reduce portal pressure, a gradual decrease of proteinuria and hematuria to normal range was noted. The potential pathogenetic role of portal hypertension in the development of IgA nephropathy in cirrhotic patients is discussed.

关键词： IgA nephropathy Nephrotic syndrome Portalhypertension Liver cirrhosis

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Primary adrenal Ewing sarcoma:A systematic review of the literature

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世界临床病例杂志 2023年第28期11卷 6782-6791页

作者： dimitrios K Manatakis Ioannis Tsouknidas Emmanouil Mylonakis Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Aikaterini Mastoropoulou dimitrios P Korkolis 2^(nd)Department of Surgery Athens Naval and Veterans HospitalAthens 11521Greece General Surgery Lankenau Medical CenterMain Line HealthWynnewoodPA 19096United States Department of Surgical Oncology St Savvas Cancer HospitalAthens 11522Greece Department of Surgery Naval Hospital of CreteChania 73200Greece Department of Pediatrics Stony Brook University HospitalStony BrookNY 11794United States

BACKGROUND Ewing sarcoma(ES)is a malignant neoplasm of neuroectodermal origin and is commonly observed in children and young *** musculoskeletal system is the main body system impacted and ES is rarely seen in the visceral organs particularly the adrenal *** To present a comprehensive review of primary adrenal ES,with emphasis on diagnosis,therapy and oncological *** A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses ***/MEDLINE,EMBASE and Google Scholar bibliographic databases were searched to identify articles from 1989 to 2022 and included patients with ES/primitive neuroectodermal tumor(PNET)of the adrenal ***,Google Scholar and EMBASE medical databases were searched,combining the terms“adrenal”,“ES”and“PNET”.Demographic,clinical,pathological and oncological data of patients were analyzed by SPSS version *** A total of 52 studies were included for review(47 case reports and 5 case series)with 66 patients reported to have primary adrenal *** age at diagnosis was 26.4±15.4 years(37.9%males,57.6%females,sex not reported in 3 cases).The most frequent complaint was abdominal/flank pain or discomfort(46.4%)followed by a palpable mass(25.0%),and the average duration of symptoms was 2.6±3.1 *** imaging modality of choice was computed tomography scan(81.5%),followed by magnetic resonance imaging(20.4%).Preoperative staging revealed that 17 tumors(27.9%)were metastatic and 14 patients had inferior vena cava or renal vein neoplastic thrombus at initial *** adrenalectomy was performed in the majority of cases(80.0%),of which 27.9%required more extensive *** invasive surgery was attempted in 8.2%of *** surgical resection was achieved in 89.4%of the *** therapy was administered to 32 patients,in the form of chemotherapy(62.5%),radiotherapy(3.1%)or combination(34.4%).Median overall s

关键词： Ewing sarcoma Primary adrenal tumor Adrenalectomy

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Synthesis of carbon nanotubes loaded hydroxyapatite: Potential for controlled drug release from bone implants

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Journal of Advanced Ceramics 2016年第3期5卷 232-243页

作者： Lisa COSTANTINI Nikolaos BOUROPOULOS dimitrios G.FATOUROS Ioanna KONTOPOULOU Marta ROLDO School of Pharmacy and Biomedical Science University of Portsmouth St Michael's BuildingWhite Swan Road Portsmouth UK Department of Materials Science University of Patras 26504 Rio Patras GreeceFoundation for Research and Technology Hellas-Institute of Chemical Engineering and High Temperature Chemical Processes—FORTH/ICEHT P.O.Box 1414 GR 26504 Patras Greece Department of Pharmaceutical Technology School of Pharmacy Aristotle University of ThessalonikiGR-54124 Thessaloniki Greece Department of Materials Science University of Patras 26504 Rio Patras Greece

Carbon nanotubes (CNTs) can support the building of flexible and porous scaffolds for bone regeneration. Various studies have looked at the mixing of CNTs with hydroxyapaptite for the formulation of bone implants. In the present work, we report the one step preparation and characterisation of chitosan/hydroxyapatite/CNTs composite materials obtained by wet precipitation of hydroxyapatite (HA) in the presence of chitosan or its amphiphilic derivative N-octyl-O-sulphate chitosan and CNTs. The in situ precipitation of HA assured inclusion of the polysaccharide and the CNTs in the HA structure and provided materials with the ability to control the release of different model drugs.

关键词： carbon nanotubes (CNTs) hydroxyapatite (HA) composites bone regeneration chitosan

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Beta-blocker treatment in heart failure patients with atrial fibrillation:challenges and perspectives

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Journal of Geriatric Cardiology 2021年第5期18卷 362-375页

作者： Emmanouil Chourdakis Ioanna Koniari dimitrios Velissaris Grigorios Tsigkas Nikolaos G Kounis Neriman Osman Krankenhaus der Barmherzigen Brüder Trier Germany Manchester Heart Institute Manchester University Foundation TrustManchesterUnited Kingdom Department of Internal Medicine University Hospital of PatrasPatrasGreece Cardiology Department University Hospital of PatrasPatrasGreece

Heart failure(HF)and atrial fibrillation(AF)are common conditions that share similar clinical phenotype and frequently *** classification of HF in patients with preserved ejection fraction(>50%,HFpEF),midrange reduced EF(40%−49%,HFmrEF)and reduced EF(<40%,HFrEF)are crucial for optimising the therapeutic approach,as each subgroup responds *** constitute an important component of our pharmacological regimen for chronic *** administration is reccomended in patients with HF with reduced ejection fraction in stable sinus rhythm,due to improvement of symptoms,the better long termoutcome and *** beneficial role of betablocker use in patients with preserved EF still remain unclear,as no treatment showed a positive impact,regarding morbidity or mortality *** presence of AF in HF patients increases as the disease severity evolves and is associated with a higher rate of cardiovascular morbidity and *** more question is the use of betablocker in HF patients irrespective of EF and concomitant *** are many conflicting data and publications,regarding the beta blocker benefit in this ***,it is supported an attenuation of betablockers beneficial effect in HF patients with AF.A design of more randomised trials/studies with HF patients and concomitant AF may improve our clinical approach of betablockers use and identify the patients with HF,who mostly profit from an invasive approach.

关键词： treatment evolve mostly

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Acute esophageal necrosis: A systematic review and pooled analysis

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World Journal of Gastrointestinal Surgery 2020年第3期12卷 104-115页

作者： dimitrios Schizas Nikoletta A Theochari Konstantinos S Mylonas Prodromos Kanavidis Eleftherios Spartalis Stamatina Triantafyllou Konstantinos P Economopoulos dimitrios Theodorou Theodore Liakakos First Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Medicine Surgery Working GroupSociety of Junior DoctorsAthens 15122Greece Laboratory of Experimental Surgery and Surgical Research N.S.Christeas National and Kapodistrian University of AthensAthens 11527Greece First Propedeutic Department of Surgery National and Kapodistrian University of AthensHippocration General HospitalAthens 11527Greece Department of Surgery Duke University Medical CenterDurhamNC 27708United States

BACKGROUND Acute esophageal necrosis(AEN)is a rare entity with multifactorial etiology,usually presenting with signs of upper gastrointestinal *** To systematically review all available data on demographics,clinical features,outcomes and management of this medical *** A systematic literature search was performed with respect to the PRISMA statement(end-of-search date:October 24,2018).Data on the study design,interventions,participants and outcomes were extracted by two independent *** Seventy-nine studies were included in this ***,114 patients with AEN were identified,of whom 83 were males and 31 *** patient age was 62.1±*** most common presenting symptoms were melena,hematemesis or other manifestations of gastric bleeding(85%).The lower esophagus was most commonly involved(92.9%).The most widely implemented treatment modality was conservative treatment(75.4%),while surgical or endoscopic intervention was required in 24.6%of the *** overall followup was 66.2±101.8 *** 29.9%of patients died either during the initial hospital stay or during the follow-up *** symptoms on presentation[Odds ratio 3.50(1.09-11.30),P=0.03]and need for surgical or endoscopic treatment[surgical:Odds ratio 1.25(1.03-1.51),P=0.02;endoscopic:Odds ratio 1.4(1.17-1.66),P<0.01]were associated with increased odds of complications.A sub-analysis separating early versus late cases(after 2006)revealed a significantly increased frequency of surgical or endoscopic intervention(9.7%vs 30.1%respectively,P=0.04)CONCLUSION AEN is a rare condition with controversial pathogenesis and unclear optimal *** the frequency of surgical and endoscopic intervention has increased in recent years,outcomes have remained the ***,further research work is needed to better understand how to best treat this potentially lethal disease.

关键词： Acute esophageal necrosis Black esophagus Acute necrotizing esophagitis

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Global dissemination of minimally invasive living donor hepatectomy: What are the barriers?

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 776-787页

作者： Christos dimitrios Kakos Angelos Papanikolaou Ioannis A Ziogas Georgios Tsoulfas Surgery Working Group Society of Junior DoctorsAthens 15123Greece Department of Transplant Surgery Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54622Greece Department of Surgery Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Surgery University of Colorado Anschutz Medical CampusAuroraCO 80045United States

Minimally invasive donor hepatectomy(MIDH)is a relatively novel procedure that can potentially increase donor safety and contribute to faster rehabilitation of *** an initial period in which donor safety was not effectively validated,MIDH currently seems to provide improved results,provided that it is conducted by experienced *** selection criteria are crucial to achieve better outcomes in terms of complications,blood loss,operative time,and hospital *** a pure laparoscopic technique,various approaches have been recommended such as hand-assisted,laparoscopic-assisted,and robotic *** latter has shown equal outcomes compared to open and laparoscopic approaches.A steep learning curve seems to exist in MIDH,mainly due to the fragility of the liver parenchyma and the experience needed for adequate control of *** review investigated the challenges and the opportunities of MIDH and the barriers to its global *** need expertise in liver transplantation,hepatobiliary surgery,and minimally invasive techniques to perform *** can be categorized into surgeon-related,institutionalrelated,and *** robust data and the creation of international registries are needed for further evaluation of the technique and the acceptance from more centers worldwide.

关键词： Minimally invasive donor hepatectomy Liver transplantation Living donation Laparoscopic donor hepatectomy Global surgery

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Barrett's esophagus with high-grade dysplasia:Focus on current treatment options

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World Journal of Gastroenterology 2011年第37期17卷 4174-4183页

作者： Leonidas Lekakos Nikolaos P Karidis dimitrios Dimitroulis Christos Tsigris Gregory Kouraklis Nikolaos Nikiteas Second Propedeutic Department of Surgery Medical SchoolUniversity of AthensGeneral Hospital LaikoAthens 11527Greece Christos Tsigris First Department of SurgeryMedical SchoolUniversity of AthensGeneral Hospital LaikoAthens 11527Greece

High-grade dysplasia(HGD) in Barrett's esophagus(BE) is the critical step before invasive esophageal *** its natural history remains unclear,an aggressive therapeutic approach is usually *** represents the only treatment able to reliably eradicate the neoplastic *** healthy patients with reasonable life expectancy,vagal-sparing esophagectomy,with associated low mortality and low early and late postoperative morbidity,is considered the treatment of choice for BE with *** unfit for surgery should be managed in a less aggressive manner,using endoscopic ablation or endoscopic mucosal resection of the entire BE segment,followed by lifelong *** eligible for surgery who present with a long BE segment,multifocal dysplastic lesions,severe reflux symptoms,a large fixed hiatal hernia or dysphagia comprise a challenging group with regard to the appropriate treatment,either surgical or endoscopic.

关键词： Barrett's esophagus High-grade dysplasia Endoscopic ablation Endoscopic excision Surgical treatment

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