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Mechanical behavior of colonic anastomosis in experimental settings as a measure of wound repair and tissue integrity

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World Journal of Gastroenterology 2006年第35期12卷 5668-5673页

作者： Konstantinos A Ekmektzoglou Georgios C Zografos stavros K Kourkoulis Ismene A Dontas Panagiotis K Giannopoulos Κaterina A Marinou Maria V Poulakou Despina n Perrea laboratory of experimental sur- gery and surgical research "ns christeas" University of Athens Medical School Athens Greece 1st Univer- sity Department of General surgery Athens School of Medicine Hippocration Hospital Athens Greece laboratory of Testing and Materials De- partment of Mechanics National Technical University of Athens Greece BVMs MVM Laboratory of Experimen- tal Surgery and Surgical Research "NS Christeas" University of Athens Medical School Athens Greece and Greek Ministry of Rural Development and Food General Directorate of Veterinary Services

AIM: To determine the mechanical properties of anasto- motic colonic tissue in experimental settings and there- fore give a measure of wound healing. METHODs: Thirty-six male Wistar rats were used as ex- perimental models of anastomotic tissue integrity. On the 5th post-operative day, the tensile strength was measured by application of an axial force, providing a quantitative measure of anastomotic dehiscence and leakage. REsULTs: Diagrams of the load as a function of the time [P = P (t)] and of the displacement also as a func- tion of time [Δs = Δs (t)] were recorded for each test, permitting the design of the load versus the displace- ment diagram and thus providing significant data about the critical values of anastomotic failure. Quantitative data were obtained concerning the anastomotic strength of both control specimens (healthy rats), as well as spec- imens from non-healthy rats for comparison. COnCLUsIOn: This experimental model provides an excellent method of measuring anastomotic strength. Despite the relative small number of specimens used, this method provides an accurate way of measuring wound repair. More experimental measurements need to be performed to correlate emerging tensile strength val-ues to anastomotic failure.

关键词： Mechanical behavior Failure load Colon Anastomosis Wound healing

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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),Pssociated 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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Role of platelet-rich plasma in ischemic heart disease: An update on the latest evidence

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World Journal of Cardiology 2015年第10期7卷 665-670页

作者： Eleftherios spartalis Periklis Tomos Demetrios Moris Antonios Athanasiou Charalampos Markakis Michael D spartalis Theodore Troupis Dimitrios Dimitroulis Despina Perrea second Department of Propedeutic surgery Athens University Medical School "Laiko" Hospital Department of Cardiology Onassis Cardiac Surgery Center Department of Anatomy Medical School University of Athens laboratory of experimental surgery and surgical research "n.s.christeas" Medical School University of Athens

Myocardial infarction is the most common cause of congestive heart failure. novel strategies such as directly reprogramming cardiac fibroblasts into cardiomyocytes are an exciting area of investigation for repair of injured myocardial tissue. The ultimate goal is to rebuild functional myocardium by transplanting exogenous stem cells or by activating native stem cells to induce endogenous repair. Cell-based myocardial restoration, however, has not penetrated broad clinical practice yet. Plateletrich plasma, an autologous fractionation of whole blood containing high concentrations of growth factors, has been shown to safely and effectively enhance healing and angiogenesis primarily by reparative cell signaling. In this review, we collected all recent advances in novel therapies as well as experimental evidence demonstrating the role of platelet-rich plasma in ischemic heart disease, focusing on aspects that might be important for future successful clinical application.

关键词： Platelet-rich plasma Ischemic heart disease Myocar

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A concomitant review of the effects of diabetes mellitus and hypothyroidism in wound healing

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World Journal of Gastroenterology 2006年第17期12卷 2721-2729页

作者： Konstantinos A Ekmektzoglou Georgios C Zografos laboratory of experimental surgery and surgical research <n.s.christeas> Athens school of Medicine AthensGreece 1st University Department of General surgery Athens school of Medicine Hippocration HospitalAthensGreece

This paper reviews the negative impact of diabetes mellitus or hypothyroidism on wound healing, both in experimental and clinical settings. since both are metabolic disorders of great clinical importance, special attention is given, not only to their pathophysiology, but also to their biochemical and histological effects on tissue integrity and regeneration. Also, special focus is awarded on wound healing of the gastrointestinal tract, i.e. in intestinal anastomosis, and how these disorders can lead to wound dehiscence. since diabetes mellitus and hypothyroidism can coexist in clinical settings, more research must be directed on their influence on wound healing, considering them as one clinical entity.

关键词： Diabetes mellitus Hypothyroidism Wound healing Anastomosis

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Overexpression of n-cadherin is correlated with metastasis and worse survival in colorectal cancer patients

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Chinese science Bulletin 2013年第28期58卷 3529-3534页

作者： ZHUO HongQing JIAnG KeWei DOnG LingYi ZHU Yi Lü Liang Lü You ZHAnG YanBin ZHAnG Hui YE YingJiang WAnG shan Department of Gastrointestinall surgery Laboratory of Surgical OncologyPeking University People's Hospital Peking University

n-cadherin is related to the progression and metastases of several solid ***,it was still unclear whether n-cadherin is overexpressed in colorectal malignant tumors that have stronger malignant *** this study,we used immunohistochemistry to detect the expression patterns of n-cadherin in both the primary tumors and their normal mucosa tissues of 120patients with colorectal *** revealed that n-cadherin was expressed in 78.3%(94/120)of colorectal tumor tissues and in only 9.2%(11/120)of paired distant normal mucosa tissues with a significant difference(P=0.000).The low,moderate,and high expression of n-cadherin protein was 42.5%,30.8%,and 26.7%,respectively.n-cadherin overexpression was associated with advanced TnM stage,lymph nodes metastasis and distant metastasis(Pnts with n-cadherin overexpressed showed the obvious lower overall survival rate than those with moderate and low expression,and patients with low expression had a better survival rate than those with moderate and high expression(Pn conclusion,high n-cadherin expression may lead to tumor aggressiveness and metastatic potential in colorectal cancer,and may prove to be a possible prognostic factor.

关键词：大肠癌患者恶化恶性肿瘤过度表达免疫组化法表达模式肿瘤组织

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Implication of gut microbiome in immunotherapy for colorectal cancer

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World Journal of Gastrointestinal Oncology 2022年第9期14卷 1665-1674页

作者： Evangelos Koustas Eleni-Myrto Trifylli Panagiotis sarantis nikolaos Papadopoulos Georgios Aloizos Ariadne Tsagarakis Christos Damaskos nikolaos Garmpis Anna Garmpi Athanasios G Papavassiliou Michalis V Karamouzis Department of Biological Chemistry Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece 1st Department of Internal Medicine 417 Army Share Fund Hospital of AthensAthens 11521AtticaGreece Beth Israel Deaconess Medical Center BostonMA 02215United States n.s.christeas laboratory of experimental surgery and surgical research Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece second Department of Propedeutic surgery Laiko General HospitalMedical SchoolNational and Kapodistrian University of AthensAthens 11527Greece First Department of Pathology Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

Colorectal cancer(CRC) constitutes the third most frequently reported malignancy in the male population and the second most common in women in the last two decades. Colon carcinogenesis is a complex, multifactorial event, resulting from genetic and epigenetic aberrations, the impact of environmental factors, as well as the disturbance of the gut microbial ecosystem. The relationship between the intestinal microbiome and carcinogenesis was relatively undervalued in the last decade. However, its remarkable effect on metabolic and immune functions on the host has been in the spotlight as of recent years. There is a strong relationship between gut microbiome dysbiosis, bowel pathogenicity and responsiveness to anti-cancer treatment;including immunotherapy. Modifications of bacteriome consistency are closely associated with the immunologic response to immunotherapeutic agents. This condition that implies the necessity of gut microbiome manipulation. Thus, creatingan optimal response for CRC patients to immunotherapeutic agents. In this paper, we will review the current literature observing how gut microbiota influence the response of immunotherapy on CRC patients.

关键词： Colorectal cancer Gut microbiome Immunotherapy Checkpoint inhibitors Tumor micro-environment

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From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

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World Journal of Gastroenterology 2017年第29期23卷 5282-5294页

作者： Dimitrios Dimitroulis Christos Damaskos serena Valsami spyridon Davakis nikolaos Garmpis Eleftherios spartalis Antonios Athanasiou Demetrios Moris stratigoula sakellariou stylianos Kykalos Gerasimos Tsourouflis Anna Garmpi Ioanna Delladetsima Konstantinos Kontzoglou Gregory Kouraklis second Department of Propedeutic surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens Blood Transfusion Department Aretaieion Hospital Medical School National and Kapodistrian Athens University First Department of surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens n.s. christeas laboratory of experimental surgery and surgical research Medical School National and Kapodistrian University of Athens Department of surgery Mercy University Hospital Lerner research Institute Cleveland Clinic Foundation First Department of Pathology Medical School National and Kapodistrian University of Athens Internal Medicine Department Laiko General Hospital University of Athens Medical School

Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer staging system remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

关键词： Hepatocellular Cancer Epidemiology Treatment Diagnosis staging Transplantation

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spontaneous pancreatic undifferentiated pleomorphic sarcoma in a laboratory rat: A case report

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Animal Models and experimental Medicine 2019年第3期2卷 222-225页

作者： Petros Ypsilantis soultana Meditskou Maria Lambropoulou Theodora Papamitsou Constantinos simopoulos laboratory of experimental surgery and surgical research School of MedicineDemocritus University of ThraceAlexandroupolisGreece laboratory of Histology and Embryology Aristotle University of ThessalonikiThessalonikiGreece laboratory of Histology and Embryology School of MedicineDemocritus University of ThraceAlexandroupolisGreece

We present a case of spontaneous undifferentiated/unclassified sarcoma,of a pleomorphic subtype formerly known as malignant fibrous histiocytoma(UPs/MFH),arising from the pancreas of a laboratory *** mass was excised after laparotomy from a 6‐month‐old female laboratory Wistar *** presented a giant multilobulated mass of irregular shape,which had arisen from the pancreas and occupied almost the entire peritoneal *** the tumor was characterized by a highly variable morphological pattern,with frequent transitions from storiform to pleomorphic *** extensive immunohistochemical examination revealed no specific lines of *** positivity was observed only to MIB‐1(high Ki‐67 proliferation index),vimentin and CD68 *** diagnosis was compatible with UPs/*** the best of our knowledge,the present case is the first report of a spontaneous primary UPs/MFH arising from the pancreas of a laboratory rat.

关键词： malignant fibrous histiocytoma pancreas pleomorphic rat undifferentiated sarcoma

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Hepatic metastases from gastric cancer:A surgical perspective

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World Journal of Gastroenterology 2015年第41期21卷 11489-11492页

作者： Guido Alberto Massimo Tiberio Franco Roviello Annibale Donini Giovanni de Manzoni surgical Clinic Department of Clinical and Experimental Sciences University of Brescia surgical Oncology Department of Human Pathology and Oncology University of Siena Division of General surgery Department of Surgical SciencesRadiology and DentistryUniversity of Perugia General surgery University of Verona

Management of patients with hepatic metastases as the sole metastatic site at diagnosis of gastric cancer(synchronous setting) or detected during follow-up(metachronous) is controversial. The prevailing attitude in these cases is passive, leading to surgical palliation and, possibly, to chemotherapy. Authors focused this editorial in order to promote a more pragmatic attitude. They stress the importance of recognizing the good candidates to curative surgery of both gastric cancer and hepatic metastases(synchronous setting) or hepatic disease alone(metachronous disease) from those who will not benefit from surgical therapy. In fact, in adequately selected subgroup of patients surgery, especially if integrated in multimodal therapeutic strategies, may achieve unexpected 5-year survival rates, ranging from 10% to 40%. The critical revision of the literature suggests that some simple clinical criteria exist that may be effectively employed in patients selection. These are mainly related to the gastric cancer(factors T, n, G) and to the extent of hepatic involvement(factor H). Upon these criteria it is possible to adequately select about 50% of cases. In the remaining 50% of cases a critical discussion on a case-by-case basis is recommended, considering that among these patients some potential long-survivors exist, that survival is strictly influenced by the ablation of the tumor bulk and by multimodality treatments including chemotherapy and that in expert institutions this kind of surgery is performed with very low mortality and morbidity rates.

关键词： Gastric cancer Hepatic metastases surgical palliat

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Gender differences in trauma,shock and sepsis

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Military Medical research 2019年第1期6卷 67-77页

作者： Florian Bosch Martin K.Angele Irshad H.Chaudry Department of General Visceraland Transplant SurgeryLudwig Maximilians-University Munich Center for surgical research and Department of surgery University of Alabama at Birmingham

Despite efforts in prevention and intensive care, trauma and subsequent sepsis are still associated with a high mortality rate. Traumatic injury remains the main cause of death in people younger than 45 years and is thus a source of immense social and economic burden. In recent years, the knowledge concerning gender medicine has continuously increased. A number of studies have reported gender dimorphism in terms of response to trauma, shock and ***, the advantageous outcome following trauma-hemorrhage in females is not due only to sex. Rather, it is due to the prevailing hormonal milieu of the victim. In this respect, various experimental and clinical studies have demonstrated beneficial effects of estrogen for the central nervous system, the cardiopulmonary system, the liver, the kidneys, the immune system, and for the overall survival of the host. nonetheless, there remains a gap between the bench and the bedside. This is most likely because clinical studies have not accounted for the estrus cycle. This review attempts to provide an overview of the current level of knowledge and highlights the most important organ systems responding to trauma, shock and sepsis. There continues to be a need for clinical studies on the prevailing hormonal milieu following trauma, shock and sepsis.

关键词： Trauma-hemorrhage Cardiopulmonary bypass Gender morphism Hormonal milieu Estrogens

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