1
|
Goumenos S, Kakouratos G, Trikoupis I, Gavriil P, Gerasimidis P, Soultanis K, Patapis P, Kontogeorgakos V, Papagelopoulos P. Clinical Outcome after Surgical Treatment of Sacral Chordomas: A Single-Center Retrospective Cohort of 27 Patients. Cancers (Basel) 2024; 16:973. [PMID: 38473334 DOI: 10.3390/cancers16050973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction: The aims of our study were (1) to determine disease-specific and disease-free survival after the en-bloc resection of sacral chordomas and (2) to investigate potential risk factors for tumor recurrence and major postoperative wound-related complications. Methods: We retrospectively analyzed 27 consecutive patients with sacral chordomas who were surgically treated in our institution between 2004 and 2022. Three patients (11.1%) had a recurrent tumor and four patients (14.8%) had history of a second primary solid tumor prior to or after their sacral chordoma. A combined anterior and posterior approach, colostomy, plastic reconstruction, and spinopelvic instrumentation were necessitated in 51.9%, 29.6%, 37%, and 7.4% of cases, respectively. The mean duration of follow-up was 58 ± 41 months (range= 12-170). Death-related-to-disease, disease recurrence, and major surgical site complications were analyzed using Kaplan-Meier survival analysis, and investigation of the respective risk factors was performed with Cox hazard regression. Results: The estimated 5-year and 10-year disease-specific survival was 75.3% (95% CI = 49.1-87.5%) and 52.7% (95% CI = 31-73.8%), respectively. The estimated 1-year, 5-year, and 10-year disease-free survival regarding local and distant disease recurrence was 80.4% (95% CI = 60.9-91.1%), 53.9% (95% CI = 24.6-66.3%), and 38.5% (95% CI = 16.3-56.2%), respectively. The mean survival of the recurred patients was 61.7 ± 33.4 months after their tumor resection surgery. Conclusions: Despite the high relapse rates and perioperative morbidity, long-term patient survival is not severely impaired. Positive or less than 2 mm negative resection margins have a significant association with disease progression.
Collapse
Affiliation(s)
- Stavros Goumenos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Georgios Kakouratos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Ioannis Trikoupis
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Panagiotis Gavriil
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Pavlos Gerasimidis
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Konstantinos Soultanis
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Pavlos Patapis
- 3rd Department of Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Vasileios Kontogeorgakos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Panayiotis Papagelopoulos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| |
Collapse
|
2
|
Karampetsou N, Bletsa E, Oikonomou E, Pliaka V, Minia A, Patapis P, Kontzoglou K, Alexopoulos L, Tousoulis D, Perrea D, Chloroyiannis I. Resistin and ICAM-1 as highly expessed proteins in epicardial adipose tissue. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
3
|
Savvidou O, Liontos M, Tsantes AG, Papadopoulos DV, Trikoupis IG, Patapis P, Papagelopoulos PJ. Endoprosthetic Reconstruction of Type II Pelvic Resections. J Long Term Eff Med Implants 2020; 30:69-76. [PMID: 33389918 DOI: 10.1615/jlongtermeffmedimplants.2020035494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of the study was to evaluate the outcomes of pedestal cup and METS coned hemipelvis implants for periacetabular reconstruction after type II pelvic resections, including complications, failure rates, and functional outcomes. We retrospectively reviewed 25 patients, divided in two groups, who underwent internal hemipelvectomy and periacetabular reconstruction using either a pedestal cup (Group A = 13) or a METS coned hemipelvis (Group B = 12). The clinical, radiological, and oncological outcomes, as well as the complications, were assessed. There were no differences between the two groups regarding capacity for independent walking at 12 months and functional results. Mechanical and nonmechanical complication rates were also similar for the two groups. The two-year cumulative incidence of failure was 7.6% (95% CI 0.3-18.3) for group A and 8.8% (95% CI 1.7-20.1) for group B, while the four-year cumulative incidence of failure was 11% (95% CI 0.2-28.9) and 14.1% (95% CI 2.2-33.1), respectively. This study showed that both types of pelvic implants are reliable options for periacetabular reconstruction of bone defects after type II oncologic pelvic resections, having similar complication rates and functional results.
Collapse
Affiliation(s)
- Olga Savvidou
- First Department of Orthopedics, National and Kapodistrian University of Athens, ATTIKON University General Hospital, Athens, Greece
| | - Markos Liontos
- First Department of Orthopedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, 12462, Athens, Greece
| | - Andreas G Tsantes
- First Department of Orthopedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, 12462, Athens, Greece
| | - Dimitrios V Papadopoulos
- First Department of Orthopedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, 12462, Athens, Greece
| | - Ioannis G Trikoupis
- First Department of Orthopedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, 12462, Athens, Greece
| | - Pavlos Patapis
- First Department of Orthopedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, 12462, Athens, Greece
| | - Panayiotis J Papagelopoulos
- P.N. Soukakos Orthopaedic Research and Education Center, Sylvia Ioannou Biomechanics and Gait Analysis Laboratory, Attikon University Hospital, First Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
4
|
Koumarianou A, Krivan S, Machairas N, Ntavatzikos A, Pantazis N, Schizas D, Martikos G, Kampoli K, Misiakos EP, Patapis P, Liakakos T. Ten-year survival outcomes of patients with potentially resectable gastric cancer: impact of clinicopathologic and treatment-related risk factors. Ann Gastroenterol 2019; 32:99-106. [PMID: 30598599 PMCID: PMC6302201 DOI: 10.20524/aog.2018.0320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 09/01/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Despite therapeutic advancements, gastric cancer (GC) remains a leading cause of death worldwide. METHODS This retrospective cohort study statistically analyzed the clinicopathologic characteristics, treatments and outcomes of patients with potentially resectable GC managed at our institution between 2006 and 2010. The STROBE checklist was applied. RESULTS Preoperative assessment of 164 GC patients (male: female ratio 1.87, median age 65 years) assigned 132 (80.5%) to total (56; 42.4%) or subtotal (76; 57.6%) gastrectomy. Resection margins were microscopically tumor-free (R0) in 100 (75.8%), microscopically infiltrated (R1) in 25 (18.9%) and macroscopically infiltrated (R2) in 7 (5.3%) patients. Nodal plane dissection was D0 in 34 (25.8%), D1 in 62 (47.0%) and D2 in 36 (27.3%) patients. Early GC was diagnosed in 19 patients (14.4%). Fluorouracil-based chemotherapy was administered in 69.7% and chemoradiation in 18.2% of patients. The 5- and 10-year survival rates of patients with R0 resection were 74% and 65.4%, respectively. The 2-year survival rates for R1 and R2 resection were 28.9% and 0% respectively. The 5- and 10-year survival rates according to nodal plane dissection were 55.6% and 41.4% for D2, and 53.2% and 49.7% for D1, respectively. On multivariate analysis, T4, N3 and R1/R2 remained independent negative prognostic factors for overall survival. Microscopic or macroscopic infiltration of surgical margins was the worst adverse prognostic factor for survival. CONCLUSION These results are equivalent to those from centers of excellence and indicate the urgent need for improvements in the field, particularly in the development of predictive models to guide personalized therapy.
Collapse
Affiliation(s)
- Anna Koumarianou
- Hematology Oncology Unit, Fourth Department of Internal Medicine (Anna Koumarianou, Katerina Kampoli)
- Correspondence to: Anna Koumarianou MD, PhD, Medical Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, Rimini 1, 12462 Athens, Greece, e-mail:
| | - Sylvia Krivan
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| | - Nikolaos Machairas
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| | | | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics (Nikos Pantazis), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| | - George Martikos
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| | - Katerina Kampoli
- Hematology Oncology Unit, Fourth Department of Internal Medicine (Anna Koumarianou, Katerina Kampoli)
| | - Evangelos P. Misiakos
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| | - Pavlos Patapis
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| | - Theodoros Liakakos
- Third Department of Surgery (Sylvia Krivan, Nikolaos Machairas, Dimitrios Schizas, George Martikos, Evangelos P. Misiakos, Pavlos Patapis, Theodoros Liakakos)
| |
Collapse
|
5
|
Ntavatzikos A, Spathis A, Patapis P, Peros G, Panayiotides I, Papadopoulos I, Koumarianou A. Implications of thymidylate synthase gene polymorphisms, KRAS and BRAF mutations in the survival of patients with colorectal cancer treated with adjuvant chemotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
6
|
Bakopoulos A, Koliakos N, Tsilimigras DI, Schizas D, Moris D, Angelopoulos A, Spanakos S, Spartalis E, Patapis P, Skandalakis P, Troupis T. Management of ruptured liver segment IV hepatocellular carcinoma: is transarterial embolization (TAE) superior to chemoembolization (TACE)?-the jury is still out. Ann Transl Med 2018; 6:272. [PMID: 30094258 DOI: 10.21037/atm.2018.06.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
HCC rupture is a potentially life-threatening complication owing to underlying vascular dysfunction and coagulopathy. There is still a debate in the literature concerning the best approach in patients presenting in the emergency setting with shock due to spontaneous HCC rupture. In the current report, we describe the case of a 66-year-old female patient with ruptured HCC who was treated successfully by emergency transarterial embolization (TAE) with complete response proved by gradual shrinkage of the tumor. This impressive complete response suggests that TAE followed by elective hepatectomy could be an efficient approach for patients with Child-Pugh class A liver function and adequate liver remnant. More studies are needed in order to construct specific guidelines for the treatment of rHCC that will be based on the disease severity and the patient status.
Collapse
Affiliation(s)
- Anargyros Bakopoulos
- Third Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Koliakos
- Third Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Diamantis I Tsilimigras
- Third Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- Third Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Demetrios Moris
- Department of Surgery, Duke University Medical Center, Duke University, Durham, NC, USA
| | - Argiris Angelopoulos
- Department of Anatomy, Faculty of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Spanakos
- Department of Anatomy, Faculty of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- Laboratory of Experimental Surgery and Surgical Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Pavlos Patapis
- Third Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Skandalakis
- Department of Anatomy, Faculty of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Troupis
- Department of Anatomy, Faculty of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
7
|
Misiakos E, Agrogiannis G, Patapis P, Dontas I, Petropoulos K, Machairas N, Giamarellos-Bourboulis” E, Liakakos T, Machairas A. Expression of Tissue IGF 1, TGFß and EGFR in the Sequential Steps of Intestinal Adaptation in a Rat Model of Short Bowel Syndrome. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2013.11680898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- E.P. Misiakos
- 3rd Department of Surgery,University of Athens School of Medicine,Attikon University Hospital, Athens, Greece
| | - G. Agrogiannis
- 1st Department of Pathology,University of Athens School of Medicine, Athens, Greece
| | - P. Patapis
- 3rd Department of Surgery,University of Athens School of Medicine,Attikon University Hospital, Athens, Greece
| | - I. Dontas
- 3rd Department of Surgery,University of Athens School of Medicine,Attikon University Hospital, Athens, Greece
| | - K. Petropoulos
- Laboratory of Experimental Surgery & Surgical Research, University of Athens School of Medicine, Athens, Greece
| | - N. Machairas
- 3rd Department of Surgery,University of Athens School of Medicine,Attikon University Hospital, Athens, Greece
| | | | - T. Liakakos
- 3rd Department of Surgery,University of Athens School of Medicine,Attikon University Hospital, Athens, Greece
| | - A. Machairas
- 3rd Department of Surgery,University of Athens School of Medicine,Attikon University Hospital, Athens, Greece
| |
Collapse
|
8
|
Karakaxas D, Gazouli M, Coker A, Agalianos C, Papanikolaou IS, Patapis P, Liakakos T, Dervenis C. Genetic polymorphisms of inflammatory response gene TNF-α and its influence on sporadic pancreatic neuroendocrine tumors predisposition risk. Med Oncol 2014; 31:241. [PMID: 25213764 DOI: 10.1007/s12032-014-0241-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 09/05/2014] [Indexed: 12/17/2022]
Abstract
The diagnosed incidence of pancreatic neuroendocrine tumors (pNETs) is increasing; however, their etiology remains poorly understood. PNETs are a rare, heterogeneous group of tumors arising from the endocrine cells of the pancreas, and genetic risk factors for sporadic pNETs are inadequately understood. It is known that pNETs secrete biogenic amines, hormones and growth factors, tumor necrosis factor-a (TNF-α) being one of them. Furthermore, cytokines and other proinflammatory mediators have been implicated in inflammatory pancreatic diseases including pancreatitis and cancer. The aim of our study was to analyze TNF-α promoter gene polymorphisms as risk factors for pNETs using germline DNA collected in a population-based case-control study of pancreatic cancer [42 pNET cases, 78 pancreatic ductal adenocarcinoma (PDAC) cases, 17 intraductal papillary mucinous neoplasm (IPMN) and 98 healthy controls] conducted in the Athens, Greece and Izmir, Turkey areas. For subsequent analysis, we excluded cases and controls with known genetic syndromes. The CC genotype at the -1031 position was more frequent in pNET and IPMN patients (p=0.0002 and p=0.009, respectively), suggesting its possible role in pNET development. Furthermore, the AA genotype at the -308 position was overrepresented in IPMN cases (p=0.03), and AA genotype at the -238 position was more frequent in PDAC cases (p=0.03) compared to healthy individuals. With regard to tumor characteristics, no statistically significant association was detected. Our findings suggest the putative role of TNF-α -1031 polymorphism in the development of pNET and IPMN, whereas the -308 polymorphism seems to be overrepresented among IPMN cases and -238 polymorphism among PDAC cases.
Collapse
|
9
|
Karakaxas D, Gazouli M, Liakakos T, Vaiopoulou A, Apessou D, Papaparaskeva K, Patapis P, Dervenis C. Pancreatic neuroendocrine tumors: current opinions on a rare, but potentially curable neoplasm. Eur J Gastroenterol Hepatol 2014; 26:826-35. [PMID: 24987821 DOI: 10.1097/meg.0000000000000138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Pancreatic neuroendocrine tumors (PNETs) share a unique genetic identity, functional behavior, and clinical course. Compared with tumors of the exocrine pancreas, they are rare and show a different biologic behavior and prognosis. On the basis of data from recent studies, all PNETs, outside of small insulinomas, should be considered potentially malignant and treated accordingly. Untreated tumors have a high possibility to grow locally into adjacent structures or spread to distant organs. Although surgical excision irrespective of tumor functioning or nonfunctioning state remains the cornerstone of therapy, providing the best disease-free and survival rates to date, the understanding of the genetic nature of the disease yields new 'targets' to consider in drug development. The aim of this review is to summarize all recent advances of genetic research and new drug development in terms of PNETs, especially their genetic identity and subsequent alterations leading to the development of near or total malignant activity, and the new medical treatment strategies of this potentially curable disease on the basis of therapeutical agents acting, where possible, at the genetic level.
Collapse
Affiliation(s)
- Dimitrios Karakaxas
- aSurgical Department-HPB Surgical Unit, Konstantopouleion Agia Olga General Hospital bLaboratory of Biology, Department of Basic Medical Science, School of Medicine, University of Athens cThird Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Koumarianou A, Krivan S, Patapis P, Missiakos E, Martikos G, Charalabopoulos A, Schizas D, Petropoulos K, Bakopoulos A, Katsaounis P, Xiros N, Kouloulias V, Peros G, Karatzas G, Macheras A, Liakakos T. A restrospective study of treatments and outcome in gastric cancer patients: A report from a single institution. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Anna Koumarianou
- Fourth Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Sylvia Krivan
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| | - Pavlos Patapis
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| | | | - George Martikos
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| | | | - Dimitrios Schizas
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| | | | - Aris Bakopoulos
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| | - Panagiotis Katsaounis
- Second Department of Internal Medicine and Research Institute, Attikon University Hospital, Athens, Greece
| | - Nikolaos Xiros
- Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University Hospital, Athens, Greece
| | | | - George Peros
- Fourth Department of Surgery, Attikon University Hospital, Athens, Greece
| | - Gabriel Karatzas
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| | | | - Theodoros Liakakos
- Third Department of Surgery, Attikon University Hospital, ATHENS, Greece
| |
Collapse
|
11
|
Koumarianou A, Christodoulou MI, Patapis P, Papadopoulos I, Liakata E, Giagini A, Stavropoulou A, Poulakaki N, Tountas N, Xiros N, Economopoulos T, Pectasides D, Tsitsilonis OE, Pappa V. The effect of metronomic versus standard chemotherapy on the regulatory to effector T-cell equilibrium in cancer patients. Exp Hematol Oncol 2014; 3:3. [PMID: 24456704 PMCID: PMC3906764 DOI: 10.1186/2162-3619-3-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 01/11/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The host's immune system is crucially involved in cancer development and progression. The ratio of regulatory to effector T-cells, as well as the interplay of T-cells with therapeutic agents, impact on cancer prognosis. The current study aimed to comparatively investigate the effect of metronomic and standard chemotherapy on the number and functionality of peripheral regulatory and effector T-cells in cancer patients. METHODS CD4+CD25+ regulatory and CD4+CD25- effector T-cells were purified from the peripheral blood of 36 cancer patients and co-cultured in the presence of a polyclonal stimulus. The proliferative capacity and frequency of CD4+CD25+/CD4+CD25- T-cells were analysed before and during various chemotherapeutic regimes, by ELISA and flow cytometry, respectively. RESULTS Chemotherapy shifted immune responses in favour of regulatory T-cells. The relative ratio of regulatory to effector T-cells increased, and the T-cell-mediated suppressive activity of regulatory on effector T-cells was augmented. This effect was more profound in metronomic than in standard chemotherapeutic approaches. Moreover, an association between the chemotherapy strategy followed and the mode of action of specific drugs (anti-mitotic, anti-DNA) was revealed. CONCLUSIONS In comparison to standard chemotherapeutic strategies, metronomic approaches, though more patient-friendly, result in a significantly more prominent expansion of regulatory T-cells that aggravate the regulatory to effector T-cell imbalance. Our findings impact on the modulation of chemotherapy-treated patients' anti-tumor immunity and, thus, may be proven useful for selecting the most advantageous drug-delivery strategy, particularly when immunotherapeutics are eventually to be applied.
Collapse
Affiliation(s)
- Anna Koumarianou
- Fourth Department of Internal Medicine, Attikon University Hospital, Rimini 1 Street, 12462 Athens, Greece.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Misiakos EP, Agrogiannis G, Patapis P, Dontas I, Petropoulos K, Machairas N, Giamarellos-Bourboulis E, Liakakos T, Machairas A. Expression of tissue IGF 1, TGFbeta and EGFR in the sequential steps of intestinal adaptation in a rat model of short bowel syndrome. Acta Chir Belg 2013; 113:129-138. [PMID: 23741932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The long-term morphological changes and the expression of tissue growth factors IGF 1, TGFbeta and EGFR in the gut mucosa, during the process of intestinal adaptation were examined. METHODS Four groups of rats were used: a. Sham rats (n = 10) underwent bowel transection and reanastomosis, b. SBS rats underwent an 80% small bowel resection: group A rats (n = 10) were sacrificed 15 days after surgery, group B (n = 10), 30 days after surgery, and group C (n = 10), 60 days after surgery. Morphological small bowel parameters (villus height, lumen diameter and others) of adaptation were examined sequentially. Tissue samples were studied immunohistochemically for the detection of IGF 1, TGFbeta, and EGFR. RESULTS There was a significant increase in all morphological parameters at day 15, in the intestinal samples; a further increase followed at day 30 and day 60 (p < 0.0001). Accordingly, an increase in the expression of IGF 1, TGFbeta and EGFR was noted at day 15 (p < 0.05), and at day 30 (NS). CONCLUSION Intestinal adaptation is an ongoing process lasting more than 2 months after massive small bowel resection. Peptide growth factors are expressed in the intestine continuously during this period, but the first two weeks are the most critical for the mucosal growth.
Collapse
Affiliation(s)
- E P Misiakos
- 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece.
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
The complexity of pelvic anatomy and the extent of tumor growth makes treatment of patients with primary bone sarcomas in the pelvis difficult in terms of local control. Before the 1970s, most tumors in the bony pelvis were surgically treated with hindquarter amputation. Currently, improved techniques for clinical staging, adjuvant treatments, evolutions in metallurgy, and development of new surgical techniques make limb-salvage surgery and reconstruction possible alternatives to hemipelvectomy and resection-arthrodesis. The advantages of amputation over resections at the pelvis are a lower incidence of complications, a limited area at risk for recurrence, and a faster recovery time compared with all but the most limited pelvic resections. The disadvantages, especially after periacetabular resections, are leg-length discrepancy and impaired hip and gait function. The indication for limb salvage is the ability to obtain wide margins without compromising survival and function. Although having to resect the sciatic nerve to obtain adequate margins does not always mean that an amputation should be performed, the combination of a major pelvic resection and the functional consequences of sciatic nerve resection results in an extremity usually not worth saving; loss of femoral nerve function does not result in a significant gait disturbance, especially if the hemipelvis is stable. Reconstruction options after major pelvic resections have also evolved, but they remain difficult, especially when the acetabulum is involved.
Collapse
Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, ATTIKON University Hospital, Athens University Medical School, Athens, Greece
| | | | | | | | | | | | | |
Collapse
|
14
|
Mavrogenis AF, Soultanis K, Patapis P, Papagelopoulos PJ. Anterior thigh flap extended hemipelvectomy and spinoiliac arthrodesis. Surg Oncol 2011; 20:e215-21. [PMID: 21798737 DOI: 10.1016/j.suronc.2011.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 07/02/2011] [Accepted: 07/06/2011] [Indexed: 12/01/2022]
Abstract
We present the technique of anterior thigh flap extended external hemipelvectomy with spinoiliac arthrodesis in treatment of the patient with recurrent low-grade pelvic chondrosarcoma extending to the lower lumbar spine. Extended hemipelvectomy involves skeletal resection beyond the standard hemipelvectomy that is the SI joint by removal of contiguous musculoskeletal structures, such as elements of the sacral and lumbar spine or contralateral pelvic bone, in addition to the affected innominate bone. Spinoiliac arthrodesis reestablishes spinopelvic stability; the anterior thigh musculocutaneous flap provides reliable well-vascularized soft tissue coverage. This technique may serve an important role in the surgical management of patients with low-grade pelvic malignancies.
Collapse
Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, Attikon University Hospital, Athens University Medical School, 41 Ventouri Street, 15562 Holargos, Athens, Greece
| | | | | | | |
Collapse
|
15
|
Lazaris AM, Tsapralis D, Patapis P, Mproutzos E, Tzathas H, Kakisis JD, Vasdekis SN. Aortoiliac endograft-enteric fistula due to an ingested toothpick. J Vasc Surg 2009; 50:640-3. [DOI: 10.1016/j.jvs.2009.03.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 03/31/2009] [Accepted: 03/31/2009] [Indexed: 10/20/2022]
|
16
|
Lazaris AM, Maheras AN, Vasdekis SN, Karkaletsis KG, Charalambopoulos A, Kakisis JD, Martikos G, Patapis P, Giamarellos-Bourboulis EJ, Karatzas GM, Liakakos TD. Protective Effect of Remote Ischemic Preconditioning in Renal Ischemia/Reperfusion Injury, in a Model of Thoracoabdominal Aorta Approach. J Surg Res 2009; 154:267-73. [DOI: 10.1016/j.jss.2008.06.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 06/05/2008] [Accepted: 06/24/2008] [Indexed: 11/26/2022]
|
17
|
Fotiadis C, Georgopoulos I, Stoidis C, Patapis P. Primary tumors of the spleen. Int J Biomed Sci 2009; 5:85-91. [PMID: 23675122 PMCID: PMC3614769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Accepted: 05/26/2009] [Indexed: 10/28/2022]
Abstract
Tumors of the spleen are rare compared to the incidence of such tumors in other parenchymatous organs. Their classification has varied with both time and author. They can be divided into two main categories: nonlymphoid and lymphoid. The most common nonlymphoid tumors are the vascular tumors which include benign and malignant haemangiomas, littoral cell angiomas, lymphangiomas and haemangioendotheliomas. The remaining nonlymphoid tumors, such as fibrosarcoma, neurinoma, and lipoma are very uncommon. The lymphoid tumors include Hodgkin's and non Hodgkin's lymphoma, histiocytic lymphoma and plasmacytoma. Metastatic tumors to the spleen mainly originate from melanoma, breast and lung lesions. However, metastases to the spleen are rare compared to those of other parenchymatous organs.
Collapse
Affiliation(s)
- C Fotiadis
- 3rd Department of Surgery, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital of Athens, Greece
| | | | | | | |
Collapse
|
18
|
Liakakos T, Patapis P, Misiakos E, Macheras A. Expectations and challenges of laparoscopic total gastrectomy. Surg Endosc 2009; 23:1927-9. [PMID: 19449074 DOI: 10.1007/s00464-009-0505-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 02/06/2009] [Indexed: 01/02/2023]
|
19
|
Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopedics, ATTIKON General University Hospital, Athens University Medical School, Athens, Greece
| | | | | | | |
Collapse
|
20
|
Mavrogenis AF, Patapis P, Papaparaskeva KT, Galanis EC, Papagelopoulos PJ. Extraskeletal myxoid chondrosarcoma of the perineum. Orthopedics 2009; 32:216. [PMID: 19309044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Extraskeletal myxoid chondrosarcoma is an aggressive tumor with significant metastatic potential. A 40-year-old man presented with an asymptomatic mass at the left ischial fossa. Magnetic resonance imaging showed a 9x6-cm mass with variable signal intensity and cystic formations. A computed tomography scan of the chest showed multiple pulmonary nodules. A computed tomography-guided core needle biopsy was consistent with low-grade extraskeletal myxoid chondrosarcoma. Despite the presence of lung metastases, wide resection of the primary tumor was performed. Wide resection included the perineal mass and the adjacent ischiopubic ramus. Postoperative recovery was uneventful. One month postoperatively, thoracotomy was performed, and approximately 20 pulmonary nodules were excised. Histological analysis of the excised specimens was consistent with extraskeletal myxoid chondrosarcoma metastases. Two years postoperatively, the patient is alive without evidence of local recurrence or distant disease. Extraskeletal myxoid chondrosarcoma is an unusual soft tissue sarcoma with ultrastructural and molecular features distinct from that of skeletal myxoid chondrosarcoma. The EWS-CHN gene fusion is highly specific to extraskeletal myxoid chondrosarcoma; the gene fusion is positive in >or=75% of cases. Treatment should include wide excision for local tumor control. Resection of the lung metastases is feasible. Because of the prolonged survival of patients with extraskeletal myxoid chondrosarcoma, long-term follow-up is recommended for early detection of local recurrence or distant metastases.
Collapse
Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopedics, Athens University Medical School, Athens, Greece
| | | | | | | | | |
Collapse
|
21
|
|
22
|
Abstract
BACKGROUND AND AIMS Incisional hernia repair with mesh is considered a clean operation and it is not recommended to be perfomed at the same time with a potentially contaminated operation. The aim of this study is to assess the short-term results of a group of patients who underwent a colon operation and simultaneous incisional hernia repair with an onlay polypropylene mesh technique. PATIENTS AND METHODS From Novemberto June 2006, 19 patients underwent incisional hernia repair with polypropylene mesh, with simultaneous colonic operation. In 13 patients reestablishment of bowel continuity after a Hartmann procedure was done, whereas in four patients a loop colostomy was closed. Two patients underwent colectomy for cancer. RESULTS Post-operatively one patient had a seroma and two others had wound infections which required mesh removal. The mean follow-up was 70.15 +/- 48.40 months (range 3 to 142 months). During this period five patients died, four from progression of malignancy and one from myocardial infarction. Three patients (15.78%) developed recurrence, two patients with previous Hartmann's operation for complicated diverticulitis and wound infection and the third patient due to inappropriate mesh fixation with buttonhole hernia development. CONCLUSION Prosthetic repair of incisional hernias can be safely performed simultaneously with a colonic operation, with an acceptable rate of infectious complications and recurrence. It is unjustifiable to avoid the use of mesh in a potentially contaminated field when an appropriate technique is used.
Collapse
Affiliation(s)
- A Machairas
- 3rd Department of Surgery, University of Athens School of Medicine, 'Attikon' University Hospital, Athens, Greece
| | | | | | | | | | | |
Collapse
|
23
|
Suleiman SH, Salim OEH, Yousif DO, Eltahir MA, Elzaki K, Ibrahim SZ, Ahmed KM, Mudawi HM, Vini L, Silyvridou A, Kakana C, Janinis J, Diamantidou E, Navrozidou C, Boulogianni G, Hourmouzi D, Kopanakis K, Macheras A, Charalabopoulos A, Bistarakis D, Xylardistos P, Shizas D, Petropoulos K, Bakopoulos A, Liakakos T, Oikonomopoulos N, Martikos G, Patapis P, Misiakos E, Tsapralis D, Azas A, Charalobopoulos A, Liakakos L, Millo P, Allieta R, Nardi M, Brachet Contul R, Scozzari G, Alexandrou I, Lainakis N, Efstathiou E, Demetriadis D, Dolatzas T, Antypas S, Parini U, Persico F, Loffredo A, Lale Murix E, Fabozzi M, Roveroni M, Usai A, Da Broi J, Nardi MJ, Roustanis E, Benetatos N, Pappas-Gogos G, Tsimogiannis KE, Tsimoyiannis EC, Pramateftakis MG, Mantzoros I, Kanellos I, Demetriades H, Angelopoulos S, Despoudi K, Lazarides H, Tsachalis T, Sapidis N, Gouvas N, Tsiaoussis J, Pechlivanides G, Zervakis N, Xynos E. Abstracts Colorectal Games, Rethymnom, Crete, Greece, May 2008. Tech Coloproctol 2008. [DOI: 10.1007/s10151-008-0432-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Abstract
Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Moreover, immunosuppression is a major risk factor. Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting. Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three, splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited, and a study for additional risk factors may be necessary.
Collapse
|
25
|
Economopoulos N, Kelekis NL, Argentos S, Tsompanlioti C, Patapis P, Nikolaou I, Gouliamos A. Bright-dark ring sign in MR imaging of hepatic epithelioid hemangioendothelioma. J Magn Reson Imaging 2008; 27:908-12. [DOI: 10.1002/jmri.21052] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
26
|
Papagelopoulos PJ, Mavrogenis AF, Mastorakos DP, Patapis P, Soucacos PN. Current concepts for management of soft tissue sarcomas of the extremities. J Surg Orthop Adv 2008; 17:204-215. [PMID: 18851808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Wide resection and limb-salvage surgery remain the gold standard for the management of patients with soft tissue sarcomas of the extremities. Innovations in understanding tumor biology and limb-salvage techniques have led amputation rates to decline. Radiation therapy and novel chemotherapy agents and dosing regimens are supplementing oncology-related surgical treatment. A multidisciplinary team approach with input from oncologists, pathologists, radiation oncologists, and orthopaedic and plastic surgeons is necessary for the management of patients with soft tissue sarcomas of the extremities.
Collapse
Affiliation(s)
- Panayiotis J Papagelopoulos
- First Department of Orthopaedics, ATTIKON University Hospital, University of Athens, School of Medicine, Athens, Greece.
| | | | | | | | | |
Collapse
|
27
|
Michopoulos I, Kalkavoura C, Michalopoulou P, Fineti K, Kalemi G, Psarra M, Gournellis R, Christodoulou C, Douzenis A, Patapis P, Protopapas K, Lykouras L. [Hospital anxiety and depression scale (HADS): Validation in a Greek general hospital sample]. Psychiatriki 2007; 18:217-224. [PMID: 22466626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED The Hospital Anxiety and Depression Scale (HADS) has been translated and widely used in several countries to assess anxiety and depression in general hospital patients with good results. Material-Method The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of Internal Medicine and Surgical Departments). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used as "gold standards" for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α=0.884 (0.829 for anxiety and 0.840 for depression) and stability (test-retest Intraclass Correlation Coefficient 0.944). Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722-0.749). CONCLUSIONS The Greek version of HADS showed good psychometric properties and could prove as a good tool for clinicians to assess anxiety and depression in general hospital patients.
Collapse
Affiliation(s)
- I Michopoulos
- Second Department of Psychiatry, Athens University Medical School, 'Attikon' General Hospital, Athens, Greece
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Misiakos EP, Troupis T, Hatzikokolis S, Macheras A, Liakakos T, Patapis P, Karatzas G. Limberg flap reconstruction for the treatment of pilonidal sinus disease. Chirurgia (Bucur) 2006; 101:513-7. [PMID: 17278644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Pilonidal disease is a common chronic disorder of the sacrococcygeal area affecting young people. Recent reports have advocated different surgical approaches, such as open or closed technique, but recurrence complicates all forms of treatment. We conducted this case review to evaluate the validity of Limberg flap reconstruction method in the treatment of chronic recurrent pilonidal disease. In the period between September 2003 and December 2004, 32 male patients with complicated/recurrent pilonidal disease were operated on using the Limberg flap reconstruction method. The patients' mean age was 26.4 + 1.6 years (range 19-47 years). All patients fared well, had a satisfactory wound healing, had minimal pain and were mobilized immediately after surgery. They stayed at hospital for 6 to 32 hours. No patient had serious wound infection or flap ischemia. They all returned to normal activity within 4 to 12 days. Follow-up ranged between 14 and 28 months. No patient had recurrence during the above period. Limberg flap reconstruction has several advantages compared to the classical surgical methods for the treatment of pilonidal disease. The patients have a short hospital stay, are mobilized soon after surgery and have a minimal morbidity and recurrence rate.
Collapse
Affiliation(s)
- E P Misiakos
- 3rd Department of Surgery, University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.
| | | | | | | | | | | | | |
Collapse
|
29
|
Kouraklis G, Patapis P, Misiakos E, Glinavou A, Sioka C, Karayiannakos PE. Effects of acetylsalicylic acid on experimental atherogenesis induced in rabbits. INT ANGIOL 2004; 23:139-43. [PMID: 15507891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
AIM Inflammation related processes play a key role in the current etiologic model of atherosclerosis and its acute complications. In addition, platelet-derived growth factors stimulate the neointimal proliferation of restenosis after coronary interventions. Reducing platelet accumulation at treated sites may attenuate restenosis. The purpose of this experimental study was to investigate the effect of acetylsalicylic acid (ASA), a widely used anti-platelet and anti-inflammatory agent on the development and extent of atherosclerosis. METHODS Fourty-eight male white New Zealand rabbits were separated in 4 groups (12 animals each group). Group I received a diet of 2% cholesterol and 6% corn oil for 3 months. Group II received a diet of 2% cholesterol and 6% corn oil and in addition received 3 mg of ASA/kg daily intramuscular (i.m.) for 3 months. Group III received the same diet, and in addition received 10 mg of ASA/kg daily i.m. for 3 months. Group IV received the same diet and in addition received 50 mg of ASA/kg daily i.m. for 3 months. Animals were sacrificed after 3 months. RESULTS ASA reduced the serum levels of total cholesterol, total lipids, triglycerides and LDL cholesterol. There was significant difference in the extent of atherosclerotic lesions between animals which received different doses of ASA and that animals which did not received any ASA. High dose ASA treatment resulted in an increase in fasting plasma glucose, associated with a reduction in total cholesterol and triglycerides. CONCLUSION Our results suggest that there is a protective effect on atherosclerosis development of ASA down stream from where it lowers plasma fatty acid concentrations. However, further studies are required to verify that effect.
Collapse
Affiliation(s)
- G Kouraklis
- 2nd Department of Propedeutic Surgery and Laboratory of Experimental Surgery and Surgical Research, School of Medicine, University of Athens, Athens, Greece.
| | | | | | | | | | | |
Collapse
|
30
|
Karatzas G, Kouraklis G, Karayiannakis A, Patapis P, Givalos N, Kaperonis E. Ampullary carcinoid and jejunal stromal tumour associated with von Recklinghausen's disease presenting as gastrointestinal bleeding and jaundice. Eur J Surg Oncol 2000; 26:428-9. [PMID: 10873367 DOI: 10.1053/ejso.1999.0911] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We report a very rare case of a 36-year-old woman with von Recklinghausen's disease, synchronous carcinoid of the ampulla of Vater and stromal tumour of the jejunum, who presented with gastrointestinal bleeding and jaundice.
Collapse
Affiliation(s)
- G Karatzas
- Second Department of Propedeutic Surgery, University of Athens Medical School, Athens, Greece
| | | | | | | | | | | |
Collapse
|
31
|
Patapis P, Irani S, Mirza DF, Gunson BK, Lupo L, Mayer AD, Buckels JA, Pirenne J, McMaster P. Outcome of graft function and pregnancy following liver transplantation. Transplant Proc 1997; 29:1565-6. [PMID: 9123426 DOI: 10.1016/s0041-1345(96)00676-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- P Patapis
- Liver Unit, Queen Elizabeth Hospital, Birmingham, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Lupo L, Pirenne J, Gunson B, Nishimura Y, Mirza DF, Patapis P, Mayer AD, Buckels JA, McMaster P. Acute-pancreatitis after orthotopic liver transplantation. Transplant Proc 1997; 29:473. [PMID: 9123088 DOI: 10.1016/s0041-1345(96)00210-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- L Lupo
- Liver and Hepatobiliary Unit, Queen Elizabeth University Hospital, Edgbaston, Birmingham, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
Initial clinical trials of FK did not incorporate available FK levels, and difficulties were quickly experienced particularly with neurotoxicity and nephrotoxicity. The introduction of routine assay allowed broad parameters to be identified, which assisted in evaluating effective therapeutic parameters. Levels approximately 20 ng/ml were frequently associated with toxicity and the initial therapeutic range between 10-25 ng/ml was probably excessive. Reliable effective assay > 5 ng/ml using the Abbott IMx is not available, and many patients will have excellent hepatic or renal function with what are currently undetectable levels of FK. However, IncStar have an ELISA assay with a sensitivity of 0.5 mg/ml. Clinical practice does not, at this time, dictate elevation of FK, although careful monitoring continues. Education of oral administration from 0.15 mg/kg to 0.1 mg/kg in combination therapy with steroids and 0.05 mg/kg with azathioprine and steroids has led to revision of therapeutic parameters, e.g., 5-15 ng/ml is now widely used. Therapeutic drug monitoring is important to avoid unnecessary toxicity, but the lower limit has not been fully defined. Clearly, many patients with < 5 ng/ml have excellent hepatic function.
Collapse
Affiliation(s)
- P McMaster
- Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
| | | | | | | | | | | |
Collapse
|
34
|
Liapis C, Sechas M, Iliopoulos D, Dousaitoy B, Verikopkos C, Patapis P, Zografos G, Kolyva B, Skalkeas GR. Seasonal variation in the incidence of ruptured abdominal aortic aneurysm. Eur J Vasc Surg 1992; 6:416-8. [PMID: 1298219 DOI: 10.1016/s0950-821x(05)80290-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This retrospective study was performed in order to correlate the season with the risk of rupture of an abdominal aortic aneurysm (AAA). From December 1968 to December 1990, 224 patients, 203 males (90.63%) and 21 females (9.37%), mean age 71 years, underwent surgery either urgently because of rupture or expansion (group A, 66 patients, 22.46%) or electively (group B, 158 patients, 70.53%) for AAA. Of the 66 patients in group A, 61 were male (92.4%) and five female (7.55%) with a mean age of 73 years. Of the 158 patients in group B, 142 were male (89.8%) and 16 female (10.1%). The frequency distribution of electively admitted and operated cases of AAA was shown to be similar during all seasons but the admissions of ruptured AAA were shown by non-parametric statistical analysis to increase during the autumn (p less than 0.05) with 43.9% of the cases being admitted during September, October and November. The male to female ratio and the ratio of the number of aneurysms ruptured to the total number of aneurysms did not change significantly. The explanation of this phenomenon is obscure and needs further epidemiological investigation to assess the seasonal variability or various parameters such as hypertension.
Collapse
Affiliation(s)
- C Liapis
- Second Department of Propedeutic Surgery, University of Athens Medical School, Greece
| | | | | | | | | | | | | | | | | |
Collapse
|