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Long acting octreotide in the treatment of advanced hepatocellular cancer and overexpression of somatostatin receptors: Randomized placebo-controlled trial

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World Journal of Gastroenterology 2007年第23期13卷 3164-3170页

作者： D Dimitroulopoulos D Xinopoulos K Tsamakidis A Zisimopoulos E Andriotis D Panagiotakos A Fotopoulou C Chrysohoou A Bazinis D Daskalopoulou E Paraskevas Liver cancer Unit "Agios Savvas" Cancer Hospital Athens Greece Laboratory of Biostatistics Department of Nursing University of Athens Greece Hippokration hospital University of Athens Greece Psychiatric Department "Agios Savvas" Cancer Hospital Athens Greece

AIM: To estimate if and to what extent long acting octreotide (LAR) improves survival and quality of life in patients with advanced hepatocellular carcinoma (HCC). METHODS: A total of 127 cirrhotics, stages A-B, due to chronic viral infections and with advanced HCC, were enrolled in the study. Scintigraphy with 111Indium labeled octreotide was performed in all cases. The patients with increased accumulation of radionuclear compound were randomized to receive either oral placebo only or octreotide/octreotide LAR only as follows: octreotide 0.5mg s.c. every 8 h for 6 wk, at the end of wk 4-8 octreotide LAR 20 mg i.m. and at the end of wk 12 and every 4 wk octreotide LAR 30mg i.m.. Follow-up was worked out monthly as well as the estimation of quality of life (QLQ-C30 questionnaire). Patients with negative somatostatin receptors (SSTR) detection were followed up in the same manner. RESULTS: Scintigraphy demonstrated SSTR in 61 patients. Thirty were randomized to receive only placebo and 31 only octreotide. A significantly higher survival time was observed for the octreotide group (49 ± 6 wk) as compared to the control group (28 ± 1 wk) and to the SSTR negative group (28 ± 2 wk), LR = 20.39, df = 2, P < 0.01. The octreotide group presented 68.5% lower hazard ratio [95% CI (47.4%-81.2%)]. During the f irst year, a 22%, 39% and 43% decrease in the QLQ-C30 score was observed in each group ***: The proposed therapeutic approach has shown to improve the survival and quality of life in SSTR positive patients with advanced HCC.

关键词： Hepatocellular cancer Somatostatin Long acting octreotide Somatostatin receptors Quality of life

Traumatic lumbar hernia: A systematic review of the literature

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Chinese Journal of Traumatology 2024年第1期27卷 53-57页

作者： Ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios KManatakis Department of Surgery Stony Brook University HospitalStony BrookNew YorkUSA Department of Surgical Oncology St Savvas Cancer HospitalAthensGreece nd Department of Surgery Athens Naval and Veterans HospitalAthensGreece Department of Surgery Naval Hospital of CreteChaniaGreece

Purpose:Traumatic lumbar hernia(TLH)constitutes a protrusion of content through a defect in the posterior abdominal wall,as a result of *** rare entity has been described in limited number of ***:A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology *** English literature from 1990 until 2021 was reviewed,using PubMed,EMBASE and Google Scholar bibliographic databases,to identify case reports and case series with patients that were diagnosed with *** each eligible study,demographics,clinical presentation,hernia characteristics,preoperative imaging investigations,operation details,and postoperative data were extracted for *** analysis was performed on SPSS,version ***:A total of 62 studies were included for review,with 164 patients with *** age was(42.6±14.3)years(47.6%males,31.1%females,gender not specified in 35 cases).Mean diameter of hernia neck was(6.3±3.1)cm,while the triangles of Petit and Grynfeltt were affected in 74.5%and 14.6%,*** diagnosed in the emergency setting account for 54.2%,with CT scan establishing diagnosis in all but one case(97.7%).A delayed diagnosis was made in 45.8%,at a mean 1 year following *** bulging(82.8%)and chronic back pain(34.3%)were the most frequent *** both delayed and acute group,open surgery(63.6%and 92.3%,respectively)was the preferred surgical *** complications were reported in 11.4%of acute and 15.0%of delayed *** recurrence was 7%.Conclusions:TLH is uncommon with 164 cases described since *** scan is the gold standard in *** surgery is generally the preferred approach,particularly in the emergency *** TLH can be treated either by primary suture repair or mesh,depending on the local conditions,whereas delayed cases usually require a mesh.

关键词： Lumbar hernia Petit Grynfeltt Traumatic lumbar hernia Trauma

Immunohistochemical localization of glutathione S-transferase-pi in human colorectal polyps

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World Journal of Gastroenterology 2008年第26期14卷 4179-4184页

作者： Eleni Gaitanarou Eleni Seretis Dimitrios Xinopoulos Emmanuel Paraskevas Niki Arnoyiannaki Irene Voloudakis-Baltatzis Department of Electron Microscopy-Cell Biology "G. Papanicolaou" Research Center of Oncology and Experimental Surgery"Agios Savvas" Anticancer Hospital of Athens Athens 11522Greece Department of Electron Microscopy-Cell Biology "G. Papanicolaou" Research Center of Oncology and Experimental Surgery"Agios Savvas" Anticancer Hospital of Athens Athens 11522Greece Department of Gastroenterology "Agios Savvas" Anticancer Hospital of AthensAthens 11522Greece Department of Gastroenterology "Agios Savvas" Anticancer Hospital of AthensAthens 11522Greece Department of Pathology of the Regional anticancer-Oncologic hospital of Athens "agios savvas" Athens 11522Greece Department of Electron Microscopy-Cell Biology "G. Papanicolaou" Research Center of Oncology and Experimental Surgery"Agios Savvas" Anticancer Hospital of Athens Athens 11522Greece

AIM:To investigate the distribution of the placental form of glutathione-S-transferase (GST) in colon polyps in order to evaluate the role of GST-pi in these tissues. METHODS: Sixteen polyp tissues removed at colonoscopy were examined. Tissues were investigated histologically and ultrastructurally. GST-pi expression was also analysed immunohistochemically, using peroxidase anti-peroxidase (PAP) method and immunogold labelling method, for light and electron microscope respectively. RESULTS: All polyp tissues examined were adenoma of low, mild and high-grade dysplasia as shown in the histopathological reports. Nevertheless, the examination of the above specimens with electron microscope revealed that 3 of 9 adenoma of mild dysplasia had ultrastuctural features similar to high-grade dysplasia adenoma. GST-pi was variably expressed in adenoma, with the lowest relative levels occurring in low-gradeadenoma and the highest levels found in high-grade adenoma. GST-pi was located mainly in undifferentiated epithelial cells. GST-pi positive particles were found in the cytoplasm and especially in the nucleus adjacent to the nuclear membrane of these cells. CONCLUSION:The overexpression of GST-pi in mildgrade adenomas with significant subcellular changes and in the majority of high-grade dysplasia adenoma suggests that this might be related to the carcinogenetic proceeding. Immunohistochemical localization of GST-pi in combination with ultrastructural changes indicate that GST-pi might be a sensitive agent for the detection of preneoplastic transformations in adenoma.

关键词： Glutathione S-transferase-pi Colorectal polyps Adenoma Electron microscopy Peroxidase anti-peroxidase method Immunogold method

Scintigraphic detection of carcinoid tumors with a cost effectiveness analysis

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World Journal of Gastroenterology 2004年第24期10卷 3628-3633页

作者： DimitrisDimitroulopoulos DimitrisXynopoulos KlisthenisTsamakidis EmmanouelParaskevas Athanassios Zisimopoulos Efthymios Andriotis Ekaterini Fotopoulou Nikiforos Apostolikas Marios Kontis Ioannis Paraskevas Gastroenterology Unit Agios Savvas Cancer HospitalAthensGreece Section of Nuclear Medicine Agios Savvas Cancer HospitalAthensGreece CT Department.agios savvas cancer hospital AthensGreece First Radiology-Oncology Department Agios Savvas Cancer HospitalAthensGreece Pathology Department Agios Savvas Cancer HospitalAthensGreece Economics and Statistics Department Agios Savvas Cancer HospitalAthensGreece City University London LondonUnited Kingdom

AIM: To evaluate the diagnostic sensitivity and accuracy and the cost-effectiveness of this technique in the detection of gastroenteropancreatic cardnoid tumors and their metastases in comparison with conventional imaging ***: Somatostatin receptor scintigraphy (SRS) was performed in 24 patients with confirmed carcinoids and 7 under investigation. The results were compared with those of conventional imaging methods (chest X-ray, upper abdominal ultrasound, chest CT, upper and lower abdominal CT). Also a cost-effectiveness analysis was performed comparing the cost in Euro of several combinations of SRS with conventional imaging ***: SRS visualized primary or metastatic sites in 71.0% of cases and 61.3% of conventional imagings. The diagnostic sensitivity of the method was higher in patients with suspected lesions (85.7% vs57.1%). SRS was less sensitive in the detection of metastatic sites (78.9% vs 84.2%). The undetectable lesions by SRS metastatic sites were all in the liver. Between several imaging combinations, the combinations of chest X-ray/upper abdominal CT/SRS and chest CT/upper abdominal CT/SRS showed the highest sensitivity (88.75%) in terms of the number of detected lesions. The combinations of chest X-ray/upper abdominal US/SRS and chest CT/upper abdominal ultrasound/SRS yielded also a quite similar sensitivity (82%). Compared to the cost of the four sensitive combinations the combination of chest X-ray/upper abdominal ultrasound/SRS presented the lower cost,1183.99 Euro vs 1251.75 Euro for chest CT/upper abdominal ultrasound/SRS, 1294.93 Euro for chest X/ray/upper abdominal CT/SRS and 1362.75 Euro for chest CT/upper abdominal CT/***: SRS imaging is a very sensitive method for the detection of gastroenteropancreatic carcinoids but is less sensitive than ultrasound and CT in the detection of liver metastases. Between several imaging combinations, the combination of chest X-ray/upper abdominal CT/SRS shows the highest s

关键词：良性肿瘤成本效力关系 CT 敏感性腹部

Solitary fibrous tumor of the liver expressing CD34 and vimentin:A case report

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World Journal of Gastroenterology 2008年第40期14卷 6261-6264页

作者： Dimitris P Korkolis Katerina Apostolaki Chrysanthi Aggeli George Plataniotis Emmanuel Gontikakis Dimitra Volanaki Maria Sebastiadou Dimitris Dimitroulopoulos Dimitris Xinopoulos George N Zografos Perikles P Vassilopoulos Department of Surgical Oncology Hellenic Anticancer Institute"Saint Savvas" Hospital Department of Surgical Pathology Hellenic Anticancer Institute"Saint Savvas" Hospital Department of Gastroenterology Hellenic Anticancer Institute"Saint Savvas" Hospital Department of Surgery General Hospital of Athens

A case of a successfully treated solitary fibrous tumor (SFT) of the liver is *** 82-year-old female presented with left upper abdominal discomfort,a firm mass on palpation,and imaging studies revealed a large tumor,15 cm in diameter,arising from the left lobe of the liver.A formal left hepatectomy was *** evaluation showed spindle and fibroblast-like cells within the collagenous *** disclosed diffuse CD34 and positive vimentin,supporting the diagnosis of a benign *** patient remained well 21 months after *** of the liver is a very rare neoplasm of mesenchymal *** most cases it is a benign lesion,although some may have malignant histological features and recur locally or *** less than 30 reported cases in the literature,little can be said regarding its natural history or the benefits of adjuvant *** surgical resection remains the cornerstone of its treatment.

关键词： Liver neoplasm Solitary fibrous tumor CD34 Vimentin

Herpes simplex virus type 1 in peptic ulcer disease: An inverse association with Helicobacter pylori

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World Journal of Gastroenterology 2005年第42期11卷 6644-6649页

作者： Klisthenis Tsamakidis Efstathia Panotopoulou Dimitrios Dimitroulopoulos Dimitrios Xinopoulos Maria Christodoulou Alexandra Papadokostopoulou Ioannis Karagiannis Elias Kouroumalis Emmanuel Paraskevas Department of Gastroenterology "agios savvas" anticancer hospital Athens Greece Papanicolaou Research Center of Oncology and Experiment Surgery Athens Greece Department of Gastroenterology University hospital Heraklion Crete Greece

AIM： To assess the frequency of herpes simplex virus type I in upper gastrointestinal tract ulcers and normal mucosa with the modern and better assays and also with a larger number of well characterized patients and controls and its relationship to Helicobacter pylori（H pylori）. METHODS： Biopsy specimens from 90 patients （34 with gastric ulcer of the prepyloric area and 56 with duodenal ulcer） were evaluated. Biopsies from 50 patients with endoscopically healthy mucosa were considered as the control group. The method used to identify herpes simplex virus-1 （HSV-1） was polymerase chain reaction. Hpylori was detected by the CLO-test and by histological method. RESULTS： Herpes simplex virus-1 was detected in 28 of 90 patients with peptic ulcer （31%） Ⅲ of 34 patients with gastric ulcer （32.4%） and 17 of 56 with duodenal ulcer （30.4%）1 exclusively close to the ulcerous lesion. All control group samples were negative for HSV-1. The likelihood of Hpylori negativity among peptic ulcer patients was significantly higher in HSV-1 positive cases than in HSV-1 negative cases （P = 0.009）. Gastric ulcer patients with HSV-1 positivity were strongly associated with an increased possibility of Helicobacter pylori negativity compared to duodenal ulcer patients （P = 0.010）. CONCLUSION： HSV-1 is frequent in upper gastrointestinal tract ulcers but not in normal gastric andduodenal mucosa. There is an inverse association between HSV-1 and Hpylori infection.

关键词： HSV-1 Herpes simplex virus type 1 Pepticulcer Duodenal ulcer Gastric ulcer PCR~ Polymerasechain reaction Hpylori Non-steroidal anti-inflammatorydrugs

Rectal neuroendocrine tumor with uncommon metastatic spread:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2016年第2期8卷 231-234页

作者： Nikolaos Tsoukalas Michail Galanopoulos Maria Tolia Maria Kiakou Georgios Nakos Aristoula Papakostidi Georgios Koumakis department of medical oncology 401 general military hospital11525 AthensGreece second department of medical oncology "agios savvas"anticancer hospital11525 AthensGreece department of gastroenterology general hospital of athens"evaggelismos"10676 AthensGreece department of pathology 401 general military hospital11525 AthensGreece

Neuroendocrine tumors of the gastrointestinal tract are rare neoplasms. Rectal neuroendocrine tumors consist approximately the 5%-14% of all neuroendocrine neoplasms in Europe. These tumors are diagnosed in relatively young patients,with a mean age at diagnosis of 56 years. Distant metastases from rectal neuroendocrine tumors are not very common. Herein we describe a case of a rectal neuroendocrine tumor which metastasized to the lung,mediastinum and orbit. This case underscores the importance of early identification and optimal management to improve patient's prognosis. Therefore,the clinical significance of this case is the necessity of physicians' awareness and education regarding neuroendocrine tumors' diagnosis and management.

关键词： Rectum Uncommon metastatic spread Neuroendocrine tumor Rectal neuroendocrine tumor Rectal neuroendocrine neoplasm

Concomitant gastric adenocarcinoma and stromal tumor in a woman with polymyalgia rheumatica

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World Journal of Gastroenterology 2008年第43期14卷 6750-6752页

作者： Panteleimon Kountourakis Niki Arnogiannaki Ilias Stavrinides Nikiforos Apostolikas Gerasimos Rigatos First Department of Medical Oncology Saint Savvas Anticancer HospitalAthensGreece Pathology Department Saint Savvas Anticancer HospitalAthensGreece

Gastrointestinal stromal tumors （GISTs） are rare neoplasms （1%） of the gastrointestinal tract and to our knowledge only rare cases of synchronous presentation of gastric carcinomas and GISTs are reported in the literature. A 72-year-old female with a simultaneous presentation of gastric adenocarcinoma and GIST is presented. Moreover, due to polymyalgia rheumatica the patient received corticosteroids as treatment for the last 3 years. The concomitant occurrence of these neoplasms may involve common carcinogenic factors and there could be an association with polymyalgia rheumatica either as a paraneoplastic presentation or due to its treatment with corticosteroids.

关键词： Gastric adenocarcinoma Gastrointestinal stromal tumor Paraneoplastic presentation Polymyalgia rheumatica Corticosteroids

The Phenomenon of Oncology Nurses’ Tendency to Change Duties in Greek Public hospitals: A Study of Its Causes and Suggestions

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Open Journal of Nursing 2021年第7期11卷 578-590页

作者： Charalampos Platis Nantia Papadopoulou Maria-Elisavet Psomiadi Paraskevi Theofilou Petros Galanis Greek D.R.G. Institute SA Athens Greece general anti-cancer hospital agios savvas Athens Greece Ministry of Health Athens Greece National and Kapodistrian University of Athens Athens Greece

Background: The concept of job satisfaction is of great importance regarding its impact on employees’ productivity and efficiency. Especially for oncology nurses has become apparent over the past decades that job satisfaction is a determinant factor not only for the quality of services they provide but also of their tendency to change duties and resign from workplace. While this phenomenon is vastly described by the literature, no survey that investigates nursing personnel’s tendency to resign from workplace has been conducted in Greece. Objectives: To investigate oncology nurses’ job satisfaction while examining the causes of their dissatisfaction in regard to their tendency to change duties, either by departing from the oncology field or by resigning. Material and Method: Using a structured questionnaire, a survey was conducted in four hospitals in the region of Attica that fall within the Greek National Health System, ESY. The research sample comprised 278 oncology nurses, men and women, with varied work experience. The data were analyzed using the SPSS software, applying descriptive statistics, inferential statistics, and Principal Component Analysis. Results: Our findings concerning participants’ job satisfaction were mainly positive. Most of the oncology nurses partaking in the study expressed their willingness to remain in their current workplace, as their placements enable them to diffuse in their tasks the knowledge and experience previously acquired. Conclusion: As oncology nurses’ job satisfaction influences their overall performance and dedication in their profession, parameters as working conditions, equal distribution of the workload, independent decision making and seniors’ management recognition of their work, need to be considered as primarily fields of improvement. With this being the first study in Greece that investigates oncology nurses’ job satisfaction in rela

关键词： Job Satisfaction Oncology Nurses Burnout Syndrome Resigning from Workplace