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Acute upper gastroi.testi.al bleedi.g i. operated stomach: Outcome of 105 cases

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

作者： Vassi.i.i.N nikolopoulou Konstanti.os C Thomopoulos George i.Theochari. Vassi.i.i.A Arvani.i.Constanti.e e Vagi.nos Di.i.i.n of Gastroenterology Department of i.ternal Medi.i.e University Hospital Patras Greece Department of Surgery Uni.ersi.y Hospi.al Patras Greece

Ai.: To compare the causes and cli.i.al outcome of pati.nts wi.h acute upper gastroi.testi.al bleedi.g (AUGB) and a hi.tory of gastri. surgery to those wi.h AUGB but wi.hout a hi.tory of gastri. surgery i. the ***: The causes and cli.i.al outcome were compared between 105 pati.nts wi.h AUGB and a hi.tory of gastri. surgery, and 608 pati.nts wi.h AUGB but wi.hout a hi.tory of gastri. ***: Pati.nts who underwent gastri. surgery i. 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 bleedi.g was margi.al ulcer i. 63 pati.nts (60%). No i.enti.i.ble source of bleedi.g could be found i. 22 pati.nts (20.9%) compared to 42/608 (6.9%) i. pati.nts wi.hout a hi.tory of gastri. surgery (P = 0.003). endoscopi. hemostasi. was permanently successful i. 26 out of 35 pati.nts (74.3%) wi.h pepti. ulcers and acti.e bleedi.g or non-bleedi.g vi.i.le vessel. Ni.e pati.nts (8.6%) were operated due to conti.ui.g or recurrent bleedi.g,compared to 23/608 (3.8%) i. the group of pati.nts wi.hout gastri. surgery i. the past (P= 0.028). especi.lly i. pepti. ulcer bleedi.g pati.nts, emergency surgery was more common i. the group of pati.nts wi.h gastri. surgery i. the past [9/73 (12.3%) vs 19/360 (5.3%), P = 0.025].Moreover surgi.ally treated pati.nts i. the past requi.ed more blood transfusi.n (3.3±4.0 vs 1.5±1.7, P = 0.0001) and longer hospi.ali.ati.n ti.e (8.6±4.0 vs 6.9±4.9 d,P = 0.001) than pati.nts wi.hout a hi.tory of gastri. surgery. Mortali.y was not di.ferent between the two groups [4/105 (3.8%) vs 19/608 (3.1%)].CONCLUSi.N: Upper gastroi.testi.al bleedi.g seems to be more severe i. surgi.ally treated pati.nts than i. non-operated pati.nts.

关键词： Operated stomach Acti.e bleedi.g endoscopi. hemostasi.

Plei.tropi. effects of bombesi. and neurotensi. on i.testi.al mucosa: Not just trefoi. pepti.es

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

作者： Steli.s F Assi.akopoulos Chri.oula D Scopa Vassi.i.i.N nikolopoulou Constanti.e e Vagi.nos Department of i.ternal Medi.i.e School of Medicine University of Patras Patras 26110 Greece Department of Pathology School of Medicine University of Patras Patras 26110 Greece Di.i.i.n of Gastroenterology Department of Internal Medicine School of Medicine University of Patras Patras 26110 Greece Fi.st Surgi.al Department "Saint Panteleimon" General Hospital of Nikaia Piraeus 18454 Greece

Bombesi. and neurotensi. are neuropepti.es whi.h exert a wi.e spectrum of bi.logi.al acti.ns on gastroi.testi.al ti.sues i.fluenci.g i.testi.al growth and adaptati.n, i.testi.al moti.i.y, blood flow, secreti.n, nutri.nt absorpti.n and i.mune response. Based mai.ly on thei. well-establi.hed potent enterotrophi. effect, numerous experi.ental studi.s i.vesti.ated thei. potenti.l posi.i.e effect on the atrophi. or i.jured i.testi.al mucosa. These pepti.es proved to be effecti.e mucosa-heali.g factors, but the potenti.l molecular and cellular mechani.ms for thi. acti.n remai.ed unresolved. i. a recently publi.hed study (World J Gastroenterol 2008; 14(8): 1222-1230), i. was shown that thei. protecti.e effect on the i.testi.e i. experi.entally i.duced i.flammatory bowel di.ease was related to anti.i.flammatory, anti.xi.ant and anti.poptoti. acti.ns. These results are i. close agreement wi.h our previ.us studi.s on jaundi.ed and hepatectomi.ed rats that showed a regulatory effect of bombesi. and neurotensi. on cri.i.al cellular processes such as enterocyte' proli.erati.n and death, oxi.ati.e stress and redox equi.i.ri.m, ti.ht juncti.ns' formati.n and functi.n, and i.flammatory response. The plei.tropi. effects of bombesi. and neurotensi. on di.erse types of i.testi.al i.jury may justi.y thei. consi.erati.n for cli.i.al tri.ls.

关键词： Bombesi. Neurotensi. Plei.tropi. Neuropepti.es Regulatory pepti.es

i.testi.al fai.ure i. obstructi.e jaundi.e

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

作者： Steli.s F.Assi.akopoulos Constanti.e e.Vagi.nos Ari.ti.es Charoni. Vassi.i.i.N.nikolopoulou Chri.oula D.Scopa Department of i.ternal Medi.i.e Department of Surgery Laboratory of Cell Bi.logy Department of Pathology

TO THe eDi.ORWe read wi.h great i.terest the arti.le by Di.g LA and Li.S, whi.h ai.ed to revi.w the current knowledge on the physi.logy of normal i.testi.al barri.r functi.n and hi.hli.ht the role of i.testi.al fai.ure after vari.us i.juri.us i.sults i. the development of septi. compli.ati.ns or multi.le organ fai.ure wi.h subsequent rapi. cli.i.al deteri.rati.n or even death.

关键词： i.testi.al fai.ure Obstructi.e jaundi.e

experi.ental obstructi.e jaundi.e alters claudi.-4 expressi.n i. i.testi.al mucosa: effect of bombesi. and neurotensi.

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

作者： Steli.s F Assi.akopoulos Constanti.e e Vagi.nos Ari.ti.es S Charoni. i.i.s H Alexandri. i.i. Spi.i.poulou Konstanti.os C Thomopoulos Vassi.i.i.N nikolopoulou Chri.oula D Scopa Department of i.ternal Medi.i.e School of Medi.i.e University of PatrasPatrasGreece Department of Surgery School of Medi.i.e University of PatrasPatrasGreece Secti.n of Hi.tology Center for Basi. Research Foundation of Biomedical Research of the Academy of AthensAthensGreece Department of Mi.robi.logy School of Medi.i.e University of PatrasPatrasGreece Department of i.ternal Medi.i.e Di.i.i.n of Gastroenterology School of MedicineUniversity of PatrasPatrasGreece Department of Pathology School of Medi.i.e University of PatrasPatrasGreece

Ai.： To i.vesti.ate the i.fluence of experi.ental obstructi.e jaundi.e and exogenous bombesi. （BBS） and neurotensi. （NT） admi.i.trati.n on the expressi.n of the ti.ht juncti.n （TJ）-protei. claudi.-4 i. i.testi.al epi.heli.m of rats. MeTHODS： Forty male Wi.tar rats were randomly di.i.ed i.to fi.e groups： Ⅰ = controls, Ⅱ = sham operated,Ⅲ = bi.e duct li.ati.n （BDL）,Ⅳ = BDL＋BBS （30μg/kg per d）, V = BDL＋NT （300μg/kg per d）. At the end of the experi.ent on d 10, endotoxi. was measured i. portal and aorti. blood. Ti.sue secti.ns of the termi.al i.eum were exami.ed hi.tologi.ally and i.munohi.tochemi.ally for evaluati.n of claudi.-4 expressi.n i. i.testi.al epi.heli.m. ReSULTS： Obstructi.e jaundi.e led to i.testi.al barri.r fai.ure demonstrated by si.ni.i.ant portal and aorti. endotoxemi.. Claudi.-4 expressi.n was si.ni.i.antly i.creased i. the upper thi.d of the vi.li.i. jaundi.ed rats and an upregulati.n of i.s lateral di.tri.uti.n was noted. Admi.i.trati.n of BBS or NT restored claudi.-4 expressi.n to the control state and si.ni.i.antly reduced portal and aorti. endotoxemi.. CONCLUSi.N： experi.ental obstructi.e jaundi.e i.creases claudi.-4 expressi.n i. i.testi.al epi.heli.m,whi.h may be a key factor contri.uti.g to the di.rupti.n of the mucosal barri.r. Gut regulatory pepti.es BBS and NT can prevent thi. alterati.n and reduce portal and systemi. endotoxemi..

关键词： Obstructi.e jaundi.e Ti.ht juncti.ns Claudi.-4 i.testi.al permeabi.i.y i.testi.al barri.r Regulatory pepti.es Bombesi. Neurotensi.

effect of bombesi. and neurotensi. on gut barri.r functi.n i. parti.lly hepatectomi.ed rats

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

作者： Steli.s F Assi.akopoulos i.i.s H Alexandri. Chri.oula D Scopa Panagi.ti. G Mylonas Konstanti.os C Thomopoulos Chri.tos D Georgi.u Vassi.i.i.N nikolopoulou Constanti.e e Vagi.nos Department of i.ternal Medi.i.e Department of Surgery Department of Pathology Department of i.ternal edi.i.e Department of Bi.logy

Ai.： To i.vesti.ate the effect of regulatory pepti.es bombesi. （BBS） and neurotensi. （NT） on i.testi.al barri.r functi.n i. parti.lly hepatectomi.ed rats. MeTHODS： Ni.ety male Wi.tar rats were randomly di.i.ed i.to fi.e groups： Ⅰ （n = 10）： controls, Ⅱ （n = 20）： sham operated, Ⅲ （n = 20）： parti.l hepatectomy 70% （PHx）, Ⅳ （n = 20）： PHx＋BBS （30 μg/kg/d）, Ⅴ （n = 20）： PHx＋NT （300 μg/kg/d）. Groups i. and V were treated for 8 days before PHx and 48 h post surgery. At the end of the experi.ent, on day 10, i.testi.al barri.r functi.n was assessed by measuri.g endotoxi. concentrati.ns i. portal and aorti. blood. Ti.sue secti.ns of the termi.al i.eum were exami.ed hi.tologi.ally and vi.lus densi.y, mucosal thi.kness, mi.oti. acti.i.y and apoptosi. i. crypts were assessed. i. addi.i.n, i.eal mucosa was analyzed for DNA and protei. content and mi.robi.logi.al analysi. was performed i. cecal contents. To esti.ate i.testi.al oxi.ati.e stress, li.i. peroxi.ati.n was determi.ed on ti.sue homogenates from termi.al i.eum. ReSULTS： BBS or NT admi.i.trati.n si.ni.i.antly reduced portal and systemi. endotoxemi. observed 48 h after parti.l hepatectomy. i. hepatectomi.ed rats （group Ⅲ）, a trend towards i.ducti.n of mucosal atrophy was observed, demonstrated by the reducti.n of vi.lus densi.y, mucosal thi.kness, protei. content and si.ni.i.ant reducti.n of DNA, whi.e these alterati.ns were reversed by regulatory pepti.es admi.i.trati.n. Thi. trophi. effect of BBS and NT was accompani.d by i.ducti.n of mi.oses above control levels and a si.ni.i.ant reducti.n of apoptosi. i. i.testi.al crypts. i.testi.al li.i. peroxi.ati.n was found si.ni.i.antly lower i. PHx group and regulatory pepti.es exerted an anti.xi.ant acti.n, further decreasi.g thi. parameter of oxi.ati.e stress. The ：bacteri.l populati.n of e. coli.and aerobi. Gram （＋） cocci.was i.creased i. cecal content of hepatectomi.ed rats, whi.e thi. parameter was not affected by the admi.i.trati.n of BBS or NT. CONCLUSi.N： Gut regulatory pep

关键词： Hepatectomy Rats Bombesi. Neurotensi. i.testi.al barri.r Apoptosi. Oxi.ati.e stress