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

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

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Intraoperative cholangiography 2020:Quo vadis? A systematic review of the literature

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Hepatobiliary & Pancreatic Diseases International 2022年第2期21卷 145-153页

作者： konstantinos georgiou Gabriel Sandblom Nicholas Alexakis Lars Enochsson First Department of Propaedeutic Surgery Hippokration General Hospital of AthensAthens Medical SchoolNational and Kapodistrian University of AthensAthens 10679Greece Department of Clinical Science and Education Department of SurgeryKarolinska InstitutetSödersjukhusetStockholm 17177SESweden Department of Surgical and Perioperative Sciences SurgeryUmeåUniversityUmeå90187SESweden

Background: There are few randomized controlled trials with sufficient statistical power to assess the effectiveness of intraoperative cholangiography(IOC) in the detection and treatment of common bile duct injury(BDI) or retained stones during cholecystectomy. The best evidence so far regarding IOC and reduced morbidity related to BDI and retained common bile duct stones was derived from large populationbased cohort studies. Population-based studies also have the advantage of reflecting the outcome of the procedure as it is practiced in the community at large. However, the outcomes of these population-based studies are conflicting. Data sources: A systematic literature search was conducted in 2020 to search for articles that contained the terms “bile duct injury”, “critical view of safety”, “bile duct imaging” or “retained stones” in combination with IOC. All identifed references were screened to select population-based studies and observational studies from large centers where socioeconomic or geographical selections were assumed not to cause selection bias. Results: The search revealed 273 references. A total of 30 articles fulflled the criteria for a large observational study with minimal risk for selection bias. The majority suggested that IOC reduces morbidity associated with BDI and retained common bile duct stones. In the short term, IOC increases the cost of surgery. However, this is offset by reduced costs in the long run since BDI or retained stones detected during surgery are managed immediately. Conclusions: IOC reduces morbidity associated with BDI and retained common bile duct stones. The reports reviewed are derived from large, unselected populations, thereby providing a high external validity. However, more studies on routine and selective IOC with well-defned outcome measures and sufficient statistical power are needed.

关键词： Cholangiography Cholecystectomy Bile duct stones Bile duct injury Cost

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Gut microbiome:Linking together obesity,bariatric surgery and associated clinical outcomes under a single focus

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 59-72页

作者： konstantinos georgiou Nikolay A Belev Tilemachos Koutouratsas Hector Katifelis Maria Gazouli The First Propaedeutic Surgical Unit Hippocrateion Athens General HospitalMedical SchoolNational and Kapodistrian University of AthensAthens 11527Greece Medical Simulation Training Center Research Institute of Medical University of Plovdivand UMPHAT“Eurohospital”Medical University of PlovdivPlovdiv 4002Bulgaria Basic Medical Sciences Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

Obesity is increasingly prevalent in the post-industrial era,with increased mortality *** gut microbiota has a central role in immunological,nutritional and metabolism mediated functions,and due to its multiplexity,it is considered an independent *** high-throughput sequencing techniques have allowed phylogenetic exploration and quantitative analyses of gut microbiome and improved our current understanding of the gut microbiota in health and *** role in obesity and its changes following bariatric surgery have been highlighted in several *** to current literature,obesity is linked to a particular microbiota profile that grants the host an augmented potential for calorie release,while limited diversity of gut microbiome has also been ***,bariatric surgery procedures represent effective interventions for sustained weight loss and restore a healthier microbiota,contributing to the observed fat mass reduction and lean mass ***,newer evidence has shown that gut microbiota is only partially recovered following bariatric ***,several targets including FGF15/19(a gutderived peptide),could be responsible for the favorable metabolic changes of bariatric *** randomized controlled trials and larger prospective studies that include well-defined cohorts are required to better identify associations between gut microbiota,obesity,and bariatric surgery.

关键词： Bariatric surgery Obesity Gut microbiota Micronutrient deficiency Probiotics

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Association between homeobox protein transcript antisense intergenic ribonucleic acid genetic polymorphisms and cholangiocarcinoma

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World Journal of Clinical Cases 2021年第8期9卷 1785-1792页

作者： Dimitra Ioanna Lampropoulou konstantinos Laschos Gerasimos Aravantinos konstantinos georgiou konstantinos Papiris George Theodoropoulos Maria Gazouli Dimitrios Filippou Medical Oncology General Oncology Hospital of Kifissia“Agioi Anargiroi”Athens 14564Greece 1st Department of Propaedeutic Surgery Hippokration General Hospital of AthensAthens Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece Endoscopic Surgery Department Hippokration General HospitalAthens 11527Greece Basic Medical Sciences Athens Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece Anatomy and Surgical Anatomy Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

BACKGROUND Cholangiocarcinoma(CCA)represents a rare but highly aggressive malignancy that is often challenging to diagnose,especially in early *** role of existing tumor biomarkers for CCA diagnosis,remains controversial due to their low sensitivity and *** evidence has implicated long non-coding ribonucleic acid polymorphisms with cancer susceptibility in a variety of tumor *** association between long non-coding ribonucleic acid homeobox protein transcript antisense intergenic ribonucleic acid(HOTAIR)polymorphisms and CCA risk has not been reported *** To investigate the influence of HOTAIR variants on the risk of CCA *** We conducted a case-control study in which three HOTAIR single nucleotide polymorphisms(rs920778,rs4759314 and rs7958904)were genotyped in a Greek *** study population included 122 CCA patients(80 males and 42 females)and 165 healthy *** polymorphisms under investigation were examined in peripheral blood *** HOTAIR rs4759314 AG and GG genotypes were associated with a significantly increased CCA risk[P=0.004,odds ratio:3.13;95%confidence interval:1.65-5.91 and P=0.005,odds ratio:12.31;95%confidence interval:1.48-101.87,respectively].However,no significant associations of HOTAIR rs920778,and rs7958904 were ***,we found no significant associations between rs4759314 AA genotype and CCA *** HOTAIR rs4759314 AG and GG genotypes may be implicated with CCA development and may serve as a potential diagnostic biomarker.

关键词： Cholangiocarcinoma Homeobox protein transcript antisense intergenic ribonucleic acid polymorphisms Rs920778 Rs4759314 Rs7958904

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Association of dissected ascending aorta diameter with preoperative adverse events in patients with acute type A aortic dissection

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World Journal of Cardiology 2022年第4期14卷 231-238页

作者： George Samanidis Meletios Kanakis Charalampos georgiou konstantinos Perreas Department of Adult Cardiac Surgery Onassis Cardiac Surgery CenterAthens 17674Greece Department of Pediatric and Congenital Heart Surgery Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUND Acute type A aortic dissection(ATAAD)is a life-threatening disease associated with high morbidity and *** To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse *** A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this *** characteristics and perioperative data were *** all patients,preoperative chest and abdomen computed tomography(CT)scans were *** Median age of the patients was 61.5(52.5-70.5)years and median body mass index(BMI)was 28.2(25.1-32.6)cm^(2).The number of female patients was 37(25%).Median diameter of the ascending aorta was 5.0(4.5-6)cm and 53.8%of the patients had an aortic diameter5.5 cm,most of the patients with ATAAD had an aortic diameter of less than 5.5 *** diameter of the ascending aorta in patients diagnose with ATAAD is not associated with preoperative adverse events.

关键词： Acute Aortic dissection Type A Ascending aorta Diameter

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The computerized LASSI-BC Test versus the Standard LASSI-L Paper-and-Pencil Version in Community-Based-Samples

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Advances in Alzheimer's Disease 2024年第1期13卷 11-25页

作者： Rosie E. Curiel Cid Alexandra Ortega Ubbo Visser Marcela Kitaigorodsky D. Diane Zheng Diana Hincapie Kirsten Horne Crenshaw Ashleigh Beaulieu Brooke Bosworth Liz Gallardo Emory Neer Sofia Ramirez Elizabeth A. Crocco Mike georgiou Efrosyni Sfakianaki David A. Loewenstein Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences Miller School of Medicine University of Miami Miami FL USA Department of Computer Sciences University of Miami Coral Gables FL USA Nova Southeastern University Fort Lauderdale FL USA Department of Radiology and Nuclear Medicine Miller School of Medicine University of Miami Miami FL USA

Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.

关键词： Mild Cognitive Impairment Proactive Semantic Interference LASSI-L Computerized Cognitive Assessment

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The association of aromatase （CYP19） gene variants wil sperm concentration and motility

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Asian Journal of Andrology 2011年第2期13卷 292-297页

作者： Leandros Lazaros Nectaria Xita Apostolos Kaponis Elissavet Hatzi Nicolaos Plachouras Nicolaos Sofikitis konstantinos Zikopoulos Ioannis georgiou Genetics and IVF Unit Department of Obstetrics and Gynaecology Medical School University of Ioannina Ioannina 45110 Greece Department of Endocrinology MedicalSchool University of Ioannina Ioannina 45110 Greece Department of Urology Medical School University of Ioannina Ioannina 45110 Greece

The irreversible transformation of androgens into oestrogens is catalysed by cytochrome P450 aromatase. In the present study, we explored the contribution of the （TTTA）n polymorphism in the aromatase gene （CYP19） to sperm concentration and motility. Ninety normozoospermic and 60 oligospermic men were examined during infertility examinations. DNA was extracted from spermatozoa, and the CYP19（TTTA）n polymorphism was genotyped by PCR. Genotype analysis revealed six CYP19（TTTA）n alleles with 7-12 repeats. The allelic distribution of the CYP19（TTTA）n polymorphism differed between normozoospermic and oligospermic men （P〈0.01）. Oligospermic men less frequently had long CYP19 alleles than did normozoospermic men （25 and 37.8%, respectively; P〈0.02）. The higher frequency of short CYP19alleles in oligospermic men compared to normozoospermic men （43.3 and 28.3%, respectively; P〈0.01） was primarily due to the distribution of the CYP19 （TTTA）7 allele. The CYP19 （TTTA）7 allele was associated with lower sperm concentration in normozoospermic men {P〈0.01） and in the total study population {P〈0.01）; it was also associated with lower sperm motility in normozoospermic men （P〈0.05） and in the total study population （P〈0.01）. In conclusion, the CYP19 （TTTA）7 allele probably impairs aromatase activity, which in turn alters aromatase and oestrogen levels in the testis, leading to decreased sperm concentration and motility. These findings support the significance of cytochrome P450 aromatase in human spermatogenesis and consequently in semen quality.

关键词： androgen male infertility oestrogen semen quality spermatogenesis

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Phosphatidylethanolamine N-methyltransferase and choline dehydrogenase gene polymorphisms are associated with human sperm concentration

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Asian Journal of Andrology 2012年第5期14卷 778-783页

作者： Leandros Lazaros Nectaria Xita Elissavet Hatzi Apostolos Kaponis Georgios Makrydimas Atsushi Takenaka Nikolaos Sofikitis Theodoros Stefos konstantinos Zikopoulos Ioannis georgiou Genetics and IVF Unit Department of Obstetrics and Gynecology Medical School University of Ioannina Ioannina 45110 Greece Department of Endocrinology Medica School University of Ioannina Ioannina 45110 Greece Department of Urology Tottori University Faculty of Medicine Totteri 683-8504 Japan Department of Urology Medical School University of Ioannina Ioannina 45110 Greece

Choline is a crucial factor in the regulation of sperm membrane structure and fluidity, and this nutrient plays an important role in the maturation and fertilizing capacity of spermatozoa. Transcripts of phosphatidylethanolamine N-methyltransferase （PEMT） and choline dehydrogenase （CHDH）, two basic enzymes of choline metabolism, have been observed in the human testis, demonstrating their gene expression in this tissue. In the present study, we explored the contribution of the PEMTand CHDHgene variants to sperm parameters. Two hundred oligospermic and 250 normozoospermic men were recruited. DNA was extracted from the spermatozoa, and the PEMT -774G〉C and CHDH ＋432G〉T polymorphisms were genotyped. The genotype distribution of the PEMT-774G〉C polymorphism did not differ between oligospermic and normozoospermic men. In contrast, in the case of the CHDH ＋432G〉T polymorphism, oligospermic men presented the CHDH432GIG genotype more frequently than normozoospermic men （62% vs. 42%, P〈0.001）. The PEMT774GIG genotype was associated with a higher sperm concentration compared to the PEMT774GIC and 774C/C genotypes in oligospermic men （12.5±5.6× 10^6 spermatozoa m1-1 vs. 8.3±5.2×10^6 spermatozoa m1-1, P〈0.002） and normozoospermic men （81.5±55.6×10^6 vs. 68.1±44.5×10^6 spermatozoa m1-1, P〈0.006）. In addition, the CHDH432G/G genotype was associated with higher sperm concentration compared to CHDH432G.T and 432T/T genotypes in oligospermic （11.8±5.1×10^6 vs. 7.8±5.3×10^6 spermatozoa m1-1, P〈0.003） and normozoospermic men （98.6±62.2×10^6 vs. 58.8±＋33.6×10^6 spermatozoa m1-1, P〉0.001）. In our series, the PEMT-774G〈C and CHDH ＋432G〈T polymorphisms were associated with sperm concentration. This finding suggests a possible influence of these genes on sperm quality.

关键词： choline dehydrogenase male infertility phosphatidylethanolamine N-methyltransferase phospholipids spermconcentration

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Acute chylous peritonitis due to acute pancreatitis

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World Journal of Gastroenterology 2012年第16期18卷 1987-1990页

作者： Georgios K georgiou Haralampos Harissis Michalis Mitsis Haralampos Batsis Michalis Fatouros Department of Surgery University Hospital of Ioannina45500 IoanninaGreece

We report a case of acute chylous ascites formation presenting as peritonitis(acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol *** development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal ***,when accumulation of "chyle" occurs rapidly,the patient may present with signs of *** diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral *** than 100 cases of acute chylous peritonitis have been *** is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days(or even weeks) after the onset of symptoms of *** is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of *** patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal ***,abdominal computed tomography imaging was not diagnostic for *** abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

关键词：急性胰腺炎腹膜炎乳糜发病症状全肠外营养恶性肿瘤临床表现十二指肠

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Genetic and epigenetic risks of intracytoplasmic sperm injection method

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Asian Journal of Andrology 2006年第6期8卷 643-673页

作者： Ioannis georgiou Maria Syrrou Nicolaos Pardalidis konstantinos Karakitsios Themis Mantzavinos Nikolaos Giotitsas Dimitrios Loutradis Fotis Dimitriadis Motoaki Saito Ikuo Miyagawa Pavlos Tzoumis Anastasios Sylakos Nikolaos Kanakas Theodoros Moustakareas Dimitrios Baltogiannis Stavros Touloupides Dimitrios Giannakis Michael Fatouros Nikolaos Sofikitis Laboratory of Molecular Urology and Genetics of Human Reproduction Department of Urology loannina University School of Medicine loannina 45110 Greece Cytogenetics Unit Laboratory of General Biology Medical School University of loannina loannina 45110 Greece Department of Urology Tottori University School of Medicine Yonago 683 Japan Department of Molecular Pharmacology Tottori University School of Medicine Yonago 683 Japan

Pregnancies achieved by assisted reproduction technologies, particularly by intracytoplasmic sperm injection （ICSI） procedures, are susceptible to genetic risks inherent to the male population treated with ICSI and additional risks inherent to this innovative procedure. The documented, as well as the theoretical, risks are discussed in the present review study. These risks mainly represent thatconsequences of the genetic abnormalities underlying male subfertility （or infertility） and might become stimulators for the development of novel approaches and applications in the treatment of infertility. In addition, risks with a polygenic background appearing at birth as congenital anomalies and other theoretical or stochastic risks are discussed. Recent data suggest that assisted reproductive technology might also affect epigenetic characteristics of the male gamete, the female gamete, or might have an impact on early embryogenesis. It might be also associated with an increased risk for genomic imprinting abnormalities.

关键词： genetic risks epigenetic risks intracytoplasmic sperm injection testis male infertility

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