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Bali C, Georvasili VK, Mitsis M, Vartholomatos G, Markopoulos GS. A response to 'A commentary on "Detection of cancer cells and tumor margins during colorectal cancer surgery by intraoperative flow cytometry"'. Int J Surg 2023; 109:3740-3741. [PMID: 37737905 PMCID: PMC10651240 DOI: 10.1097/js9.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Christina Bali
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences
| | - Vaia K. Georvasili
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences
- Biobank Cancer Center, University of Ioannina
| | - George Vartholomatos
- Hematology Laboratory-Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, Ioannina, Greece
| | - Georgios S. Markopoulos
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences
- Hematology Laboratory-Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, Ioannina, Greece
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Lianos GD, Bali CD, Vlachos K, Drosou P, Rausei S, Mitsis M, Schizas D. Complete mesogastric excision for gastric cancer: is it the future of gastric cancer surgery? Per Med 2023; 20:461-466. [PMID: 37811582 DOI: 10.2217/pme-2023-0028] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Gastric cancer remains undoubtedly one of the most common and deadly cancers worldwide. The global incidence shows wide geographic variation with a high prevalence in Asia. Besides that, there are evident differences in epidemiology, histopathology, tumor location, diagnosis and treatment strategy between east and west countries. Gastric cancer represents an aggressive disease, with many factors influencing its development and also recurrence after surgical resection. New knowledge of disease spread and new routes of metastases are now emerging and the 'novel' concept of complete mesogastric excision for gastric cancer is under consideration and debate. This article aims to analyze and highlight this new concept after a careful literature review, offering also a view toward the future.
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Affiliation(s)
- Georgios D Lianos
- Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece
| | - Christina D Bali
- Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece
| | | | - Panagiota Drosou
- Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece
| | - Stefano Rausei
- Department of Surgery, Cittiglio-Angera Hospital, ASST Settelaghi, Cittiglio, 21033, Italy
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, 11527, Greece
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Markopoulos GS, Vartholomatos G, Alexiou GΑ, Tatsis V, Bali C, Mitsis M. Resection margin status evaluation in gastric cancer surgery by intraoperative flow cytometry. J Surg Oncol 2023; 127:896-897. [PMID: 36598180 DOI: 10.1002/jso.27187] [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] [Received: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Georgios S Markopoulos
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.,Hematology Laboratory-Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, Ioannina, Greece
| | - George Vartholomatos
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.,Hematology Laboratory-Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, Ioannina, Greece
| | - George Α Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Vasileios Tatsis
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christina Bali
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.,Biobank Cancer Center, University of Ioannina, Ioannina, Greece
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Duni A, Kitsos A, Bechlioulis A, Markopoulos GS, Lakkas L, Baxevanos G, Mitsis M, Vartholomatos G, Naka KK, Dounousi E. Differences in the Profile of Circulating Immune Cell Subsets in Males with Type 2 Cardiorenal Syndrome versus CKD Patients without Established Cardiovascular Disease. Biomedicines 2023; 11:biomedicines11041029. [PMID: 37189647 DOI: 10.3390/biomedicines11041029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Maladaptive activation of the immune system plays a key role in the pathogenesis of chronic kidney disease (CKD). Our aim was to investigate differences in circulating immune cells between type 2 cardiorenal syndrome (CRS-2) patients and CKD patients without cardiovascular disease (CVD). CRS-2 patients were prospectively followed up, with the primary endpoint being all-cause and cardiovascular mortality. Method: A total of 39 stable males with CRS-2 and 24 male CKD patients matched for eGFR (CKD-EPI) were enrolled. A selected panel of immune cell subsets was measured by flow cytometry. Results: Compared to CKD patients, CRS-2 patients displayed higher levels of proinflammatory CD14++CD16+ monocytes (p = 0.04) and T regulatory cells (Tregs) (p = 0.03), lower lymphocytes (p = 0.04), and lower natural killer cells (p = 0.001). Decreased lymphocytes, T-lymphocytes, CD4+ T-cells, CD8+ T-cells, Tregs, and increased CD14++CD16+ monocytes were associated with mortality at a median follow-up of 30 months (p < 0.05 for all). In a multivariate model including all six immune cell subsets, only CD4+ T-lymphocytes remained independent predictors of mortality (OR 0.66; 95% CI 0.50–0.87; p = 0.004). Conclusion: Patients with CRS-2 exhibit alterations in immune cell profile compared to CKD patients of similar kidney function but without CVD. In the CRS-2 cohort, CD4+ T-lymphocytes independently predicted fatal cardiovascular events.
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Lianos GD, Frountzas M, Schizas D, Baltagiannis EG, Alexiou GA, Bali C, Glantzounis GK, Mitsis M, Vlachos K. Surgical oncology during the post-COVID-19 era: What is next? J Surg Oncol 2022; 127:7-10. [PMID: 36129404 DOI: 10.1002/jso.27104] [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: 09/04/2022] [Accepted: 09/11/2022] [Indexed: 11/07/2022]
Abstract
During first outburst of COVID-19, several strategies had been applied for surgical oncology patients to minimize COVID-19 transmission. COVID-19 infection seemed to compromise survival and major complication rates of surgical oncology patients. However, survival, tumor progression and recurrence rates of surgical oncology patients were associated to the consequences of COVID-19 pandemic on their management. In addition, the severity of COVID-19 infections has been downgraded. Therefore, management of surgical oncology patients should be reconsidered.
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Affiliation(s)
- Georgios D Lianos
- Department of Surgery, School of Health Sciences, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Maximos Frountzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Evangelos G Baltagiannis
- Department of Surgery, School of Health Sciences, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - George A Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Christina Bali
- Department of Surgery, School of Health Sciences, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Georgios K Glantzounis
- Department of Surgery, School of Health Sciences, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, School of Health Sciences, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Konstantinos Vlachos
- Department of Surgery, School of Health Sciences, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, Ioannina, Greece
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Anastasiadi Z, Mantziou S, Akrivis C, Paschopoulos M, Balasi E, Lianos GD, Alexiou GA, Mitsis M, Vartholomatos G, Markopoulos GS. Intraoperative Flow Cytometry for the Characterization of Gynecological Malignancies. Biology 2022; 11:biology11091339. [PMID: 36138818 PMCID: PMC9495699 DOI: 10.3390/biology11091339] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 12/23/2022]
Abstract
Simple Summary Aneuploidy and high proliferative potential are distinct features of neoplastic cells. Based on the established role of intraoperative flow cytometry in various types of cancer, the aim of the present study was to investigate its role in cancer cell identification during surgery for gynecological malignancies. The analysis time was 5–6 min per sample. A large percentage of tumors were characterized as aneuploid, while all tumor samples had a significantly high proliferation. Flow cytometry was performed in accordance with pathological evaluation, and the method had high sensitivity and specificity. Our results verify the value of intraoperative flow cytometry in gynecological malignancies, and warrant further investigation in multicenter studies. Abstract Cell-cycle analysis has shown the presence of aneuploidy to be associated with poor prognosis. We developed an innovative rapid cell-cycle analysis protocol (the Ioannina protocol) that permitted the intraoperative identification of neoplastic cells in a plethora of malignancies. Herein, we aimed to investigate the potential role of cell-cycle analysis in the intraoperative characterization of gynecological malignancies. Women who underwent surgery for gynecological malignancies in our institution over a three-year period were included in this study. Permanent section pathology evaluation was used as the gold standard for malignancy evaluation. Total accordance was observed between flow cytometry and pathology evaluation. In total, 21 aneuploid cancers were detected following DNA index calculation. Of these, 20 were hyperploid and 1 was hypoploid. In addition, tumor samples were characterized by a significantly lower percentage of cells in G0/G1, as well as an induced tumor index. The response time for flow cytometry to obtain results was 5–6 min per sample. It seems that flow cytometry analyses for intraoperative tumor evaluation can be safely expanded to gynecological malignancies. This is a novel practical approach that has been proven valuable in several tumor types to date, and also seems to be reliable for gynecological malignancies. Intraoperative flow cytometry is expected to be crucial in decisions of lymph node dissection in endometrial cancers, due to its rapid response regarding the tumor invasion of part or all of the myometrial thickness. In this way, the surgeon can quickly modify the plane of dissection. Our results warrant the further investigation of applying iFC in larger, multicenter studies.
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Affiliation(s)
- Zoi Anastasiadi
- Department of Obstetrics and Gynecology, ‘G. Chatzikosta’ General Hospital, 45001 Ioannina, Greece
| | - Stefania Mantziou
- Haematology Laboratory-Unit of Molecular Biology, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Christos Akrivis
- Department of Obstetrics and Gynecology, ‘G. Chatzikosta’ General Hospital, 45001 Ioannina, Greece
| | - Minas Paschopoulos
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Eufemia Balasi
- Pathology Department, ‘G. Chatzikosta’ General Hospital, 45001 Ioannina, Greece
| | - Georgios D. Lianos
- Department of Surgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - George A. Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
- Neurosurgical Institute, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - George Vartholomatos
- Haematology Laboratory-Unit of Molecular Biology, University Hospital of Ioannina, 45500 Ioannina, Greece
- Neurosurgical Institute, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
- Correspondence: (G.V.); (G.S.M.)
| | - Georgios S. Markopoulos
- Haematology Laboratory-Unit of Molecular Biology, University Hospital of Ioannina, 45500 Ioannina, Greece
- Neurosurgical Institute, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
- Correspondence: (G.V.); (G.S.M.)
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Karaolanis GI, Antonopoulos CN, Georgakarakos E, Lianos GD, Mitsis M, Glantzounis GK, Giannoukas A, Kouvelos G. Colour Duplex and/or Contrast-Enhanced Ultrasound Compared with Computed Tomography Angiography for Endoleak Detection after Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11133628. [PMID: 35806912 PMCID: PMC9267587 DOI: 10.3390/jcm11133628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/31/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
This study aims to assess the role of Color Duplex Ultrasound with or without contrast media for surveillance following endovascular aortic aneurysm repair (EVAR). A systematic search of the literature published until April 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The pooled rates of endoleak detection through Contrast-Enhanced or Color Duplex Ultrasound (CEUS or CDUS) and Computed Tomography Angiography (CTA) with 95% confidence intervals (CIs) were estimated using random-effect analysis. Thirty-eight studies were considered eligible for inclusion. The total number of patients in the included studies was 5214 between 1997 and 2021. The overall pooled rate of endoleak detection using CDUS and CTA was 82.59% and 97.22%, while the rates for CEUS and CTA were 96.67% and 92.82%, respectively. The findings of the present study support the use of the CEUS for endoleak detection. However, it should be integrated into institutional protocols for EVAR surveillance to further evaluate its clinical utility in the post-EVAR period before it can be recommended as the sole imaging modality after EVAR.
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Affiliation(s)
- Georgios I. Karaolanis
- Vascular Unit, Department of Surgery, University Hospital of Ioannina and School of Medicine, 455 00 Ioannina, Greece
- Correspondence:
| | - Constantine N. Antonopoulos
- Department of Vascular Surgery, “Attikon” University Hospital, National and Kapodistrian University of Athens, 124 61 Athens, Greece;
| | - Efstratios Georgakarakos
- Department of Vascular Surgery, University Hospital of Alexandroupolis, “Democritus” University of Thrace, 681 00 Alexandroupolis, Greece;
| | - Georgios D. Lianos
- Department of Surgery, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece; (G.D.L.); (M.M.); (G.K.G.)
| | - Michail Mitsis
- Department of Surgery, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece; (G.D.L.); (M.M.); (G.K.G.)
| | - Georgios K. Glantzounis
- Department of Surgery, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece; (G.D.L.); (M.M.); (G.K.G.)
| | - Athanasios Giannoukas
- Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, 411 10 Larissa, Greece; (A.G.); (G.K.)
| | - George Kouvelos
- Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, 411 10 Larissa, Greece; (A.G.); (G.K.)
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Kyrochristos ID, Glantzounis GK, Goussia A, Eliades A, Achilleos A, Tsangaras K, Hadjidemetriou I, Elpidorou M, Ioannides M, Koumbaris G, Mitsis M, Patsalis PC, Roukos D. Proof-of-Concept Pilot Study on Comprehensive Spatiotemporal Intra-Patient Heterogeneity for Colorectal Cancer With Liver Metastasis. Front Oncol 2022; 12:855463. [PMID: 35402285 PMCID: PMC8986149 DOI: 10.3389/fonc.2022.855463] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The mechanisms underlying high drug resistance and relapse rates after multi-modal treatment in patients with colorectal cancer (CRC) and liver metastasis (LM) remain poorly understood. Objective We evaluate the potential translational implications of intra-patient heterogeneity (IPH) comprising primary and matched metastatic intratumor heterogeneity (ITH) coupled with circulating tumor DNA (ctDNA) variability. Methods A total of 122 multi-regional tumor and perioperative liquid biopsies from 18 patients were analyzed via targeted next-generation sequencing (NGS). Results The proportion of patients with ITH were 53% and 56% in primary CRC and LM respectively, while 35% of patients harbored de novo mutations in LM indicating spatiotemporal tumor evolution and the necessity of multiregional analysis. Among the 56% of patients with alterations in liquid biopsies, de novo mutations in cfDNA were identified in 25% of patients, which were undetectable in both CRC and LM. All 17 patients with driver alterations harbored mutations targetable by molecularly targeted drugs, either approved or currently under evaluation. Conclusion Our proof-of-concept prospective study provides initial evidence on potential clinical superiority of IPH and warrants the conduction of precision oncology trials to evaluate the clinical utility of I PH-driven matched therapy.
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Affiliation(s)
- Ioannis D. Kyrochristos
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | - Anna Goussia
- Department of Pathology, Ioannina University Hospital, Ioannina, Greece
| | | | | | | | | | | | | | | | - Michail Mitsis
- Department of Surgery, Ioannina University Hospital, Ioannina, Greece
- Cancer Biobank Centre, Ioannina University, Ioannina, Greece
| | - Philippos C. Patsalis
- NIPD Genetics, Nicosia, Cyprus
- Department of Human Genetics, School of Medicine, University of Nicosia Medical School, Nicosia, Cyprus
| | - Dimitrios Roukos
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece
- Department of Surgery, Ioannina University Hospital, Ioannina, Greece
- Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- *Correspondence: Dimitrios Roukos,
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Falidas E, Kitsiouli E, Spyropoulou D, Tsiambas E, Kalogirou A, Tsouvelas G, Papadopoulos S, Mitsis M, Lekka M, Mastronikoli S, Peschos D, Dimas O, Vlachos K. Secretory Phospholipase A2 Digital Expression Analysis in Colon Adenocarcinoma. In Vivo 2022; 36:738-742. [PMID: 35241529 DOI: 10.21873/invivo.12760] [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: 10/31/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Phospholipases A2 represent a family of enzymes that regulate the metabolism of phospholipids by hydrolyzing them into fatty acids. Secretory phospholipase A2 (SPLA2) catalyzes the calcium-dependent 2-acyl groups hydrolysis to produce 3-sn-phosphoglycerides. This study aimed to investigate SPLA2 expression in colon adenocarcinoma (CA). MATERIALS AND METHODS Thirty (n=30) formalin-fixed, paraffin-embedded primary CA tissue sections were used and analyzed. Immunohistochemistry was performed using an anti-SPLA2 antibody. Digital image analysis was also implemented for evaluating objectively the corresponding protein expression levels. RESULTS Increased SPLA2 protein expression (high & moderate immunostaining levels) was observed in 23/30 (76.6%) cases, whereas 7/30 (23.4%) CA tissues demonstrated low protein levels. High expression levels were detected in 9/30 (30%) cases. SPLA2 overall expression was strongly associated with tumor diameter (p=0.004), whereas other statistically significant associations were not observed (stage: p=0.971, inflammatory infiltration: p=0.795; carcinoma location: p=0.340; differentiation grade: p=0.748; sex: p=0.369; ulceration: p=0.433). CONCLUSION SPLA2 over-expression is observed in significant subsets of CAs correlating with advanced tumor growth progression (increased diameter). SPLA2 seems to influence endogenous cell responses by its crucial enzymatic activity and can potentially be a biomarker for monitoring CA patients.
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Affiliation(s)
| | - Eirini Kitsiouli
- Laboratory of Biochemistry, Chemistry Department, University of Ioannina, Ioannina, Greece
| | - Despoina Spyropoulou
- Department of Radiation Oncology, Medical School, University of Patras, Patras, Greece
| | | | | | - George Tsouvelas
- Department of Nursing, University of West Attica, Athens, Greece
| | - Stylianos Papadopoulos
- Laboratory of Biochemistry, Chemistry Department, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Marilena Lekka
- Laboratory of Biochemistry, Chemistry Department, University of Ioannina, Ioannina, Greece
| | | | - Dimitrios Peschos
- Department of Physiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Odysseas Dimas
- 2 Department of Internal Medicine, "Gennimatas" General Hospital, Athens, Greece
| | - Konstantinos Vlachos
- Department of Surgery, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
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10
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Lianos GD, Alexiou GA, Rausei S, Galani V, Mitsis M, Kyritsis AP. Repurposing antipsychotic drugs for cancer treatment: current evidence and future perspectives. Expert Rev Anticancer Ther 2021; 22:131-134. [PMID: 34612130 DOI: 10.1080/14737140.2022.1987221] [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: 10/20/2022]
Affiliation(s)
- Georgios D Lianos
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - George A Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Stefano Rausei
- Department of Surgery, ASST Valle Olona, Gallarate, Italy
| | - Vasiliki Galani
- Neurosurgical Institute, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
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Abstract
This study presents a rare case of unilateral posterior scleritis as an ophthalmic manifestation of a paraneoplastic syndrome. A 61-year-old man presented to our department complaining of gradual worsening of vision in his left eye. Visual acuity was 10/10 and 3/10 in his right and left eye, respectively. He also mentioned that he experienced posterior ocular pain while sleeping at night, but was otherwise asymptomatic. His past ophthalmic and medical history were clear. A thorough clinical, imaging (fundus photography, optical coherence tomography, fluorescein angiography, and B-scan), and laboratory investigation was carried out. A diagnosis of posterior scleritis was made, but no obvious cause or underlying disease was identified even after a thorough systematic assessment. Regular follow-up within the next few months did not reveal any further pathological findings. Finally, 6 months after the initial presentation, the patient was diagnosed with colon cancer. Posterior scleritis can present as an ophthalmic manifestation of a paraneoplastic syndrome in patients with an underlying malignancy, even months before the presentation of systemic symptoms and diagnosis of the underlying disease. In conclusion, in patients (especially older adults) with posterior scleritis, the possibility of a malignant neoplasia must not be ignored or underestimated (paraneoplastic syndrome).
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Affiliation(s)
- Dimitrios Kalogeropoulos
- University of Ioannina School of Health Sciences Faculty of Medicine, Department of Ophthalmology, Ioannina, Greece
| | - Konstantinos Katsikatsos
- University of Ioannina School of Health Sciences Faculty of Medicine, Department of Ophthalmology, Ioannina, Greece
| | - Michail Mitsis
- University of Ioannina School of Health Sciences Faculty of Medicine, Department of Surgery, Ioannina, Greece
| | - Chris Kalogeropoulos
- University of Ioannina School of Health Sciences Faculty of Medicine, Department of Ophthalmology, Ioannina, Greece
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12
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Falidas E, Kitsiouli E, Tsounis D, Kalogirou A, Tsiambas E, Tsouvelas G, Papadopoulos S, Mitsis M, Lekka M, Vlachos K. Impact of peroxiredoxin-6 expression on colon adenocarcinoma. J BUON 2021; 26:1893-1897. [PMID: 34761597] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Peroxiredoxins (Prdxs) represent a family of proteins that act as antioxidant enzymes and are involved in a variety of metabolic functions including mainly the intracellular hydrogen peroxide (H2O2) levels reduction. Especially, Prdx-6 protein encoded by the PRDX6 gene (1q25.1) regulates also phospholipid modifications and induces response to oxidative stress and injuries. Our aim was to investigate the expression of Prdx-6 in colon adenocarcinoma (CA). METHODS A series of 30 formalin-fixed, paraffin-embedded primary CAs tissue sections were used and analyzed. Immunohistochemistry was performed using an anti-Prdx-6 antibody. Digital image analysis was also implemented for evaluating objectively the protein expression levels on the corresponding stained cells. RESULTS Prdx-6 protein overexpression (increased immunostaining levels) was observed in 12/30 (40%) cases, whereas 18/30 (60%) CA tissues demonstrated low to moderate protein levels, respectively. Prdx-6 overall expression was strongly associated with the stage of the examined tumors (p=0.011), whereas other statistical significances were not assessed (inflammatory infiltration: p=0.364; carcinoma location: p=0.93; differentiation grade: p=0.517; tumor diameter: p=0.983; ulceration: p=0.622). CONCLUSIONS Prdx-6 overexpression is observed in a significant subset of CAs correlating with aggressive biological behavior (advanced stage). Prdx-6 is a crucial enzyme for oxidative stress/injury endogenous cell response and should be an interesting agent as a biomarker and potential therapeutic target.
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13
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Affiliation(s)
- Evangelos G Baltagiannis
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, 45110, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece
| | - Demosthenis E Ziogas
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, 45110, Greece.,Department of Surgery, General Hospital of Ioannina, Ioannina, 45445, Greece
| | - William C Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, 999077, China
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece.,Cancer Biobank Centre, Ioannina University, Ioannina, 45110, Greece
| | - Dimitrios H Roukos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, 45110, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, 45500, Greece.,Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece
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14
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Alexiou GA, Lianos GD, Tzima A, Sotiropoulos A, Nasios A, Metaxas D, Zigouris A, RN JZ, Mitsis M, Voulgaris S. Neutrophil to lymphocyte ratio as a predictive biomarker for computed tomography scan use in mild traumatic brain injury. Biomark Med 2020; 14:1085-1090. [DOI: 10.2217/bmm-2020-0150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: Traumatic brain injury (TBI) is a serious health concern. We set out to investigate the role of neutrophil-to-lymphocytes ratio (NLR) at admission for predicting the need for computed tomography (CT) in mild-TBI. Materials & methods: A retrospective study of adult patients who presented with mild-TBI Results: One hundred and thirty patients met the inclusion criteria. Seventy-four patients had positive CT-findings. The mean NLR-levels at presentations were 5.6 ± 4.8. Patients with positive CT-findings had significant higher NLR-levels. Receiver operating characteristic curve analysis was conducted and the threshold of NLR-levels for detecting the cases with positive CT-findings was 2.5, with 78.1% sensitivity and 63% specificity Conclusion: To the best of our knowledge no previous study has assessed the value of NLR-levels for predicting the need for CT in mild-TBI.
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Affiliation(s)
- George A Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Georgios D Lianos
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Aggeliki Tzima
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | | | - Anastasios Nasios
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Dimitris Metaxas
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Andreas Zigouris
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Jolanda Zika RN
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Spyridon Voulgaris
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
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15
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Affiliation(s)
- Evangelos G Baltagiannis
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Ioannis D Kyrochristos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Demosthenes E Ziogas
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, 'G. Hatzikosta' General Hospital, Ioannina, Greece
| | - Anna Goussia
- Department of Pathology, University Hospital of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.,Cancer Biobank Centre, Ioannina University, Ioannina, Greece
| | - Dimitrios H Roukos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.,Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
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16
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Koutsias S, Karaolanis GI, Papafaklis MI, Peroulis M, Tzimas P, Lakkas L, Mitsis M, Naka KK, Michalis LK. Simultaneous Transcatheter Aortic Valve Implantation and Infrarenal Aortic Aneurysm Repair for Severe Aortic Stenosis and Abdominal Aortic Aneurysm: Report of 2 Cases and Literature Review. Vasc Endovascular Surg 2020; 54:544-548. [PMID: 32458751 DOI: 10.1177/1538574420927864] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The prevalence of concomitant abdominal aortic aneurysm (AAA) and severe aortic stenosis (AS) has been increasing in the elderly population. Both conditions have adverse outcomes, if not adequately managed. No clear recommendations are available in the literature until today, in regards of the management sequence making thus the decision-making challenging. We report 2 cases of AAA and significant AS treated with endovascular aortic repair (EVAR) and transcatheter aortic valve implantation (TAVI) during the same procedure and a review of the literature on this topic. Based on our experience, the combined procedure with TAVI followed by EVAR seems to be feasible, safe, and effective while detailed preoperative planning and a carefully tailored management strategy by a multidisciplinary team are essential.
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Affiliation(s)
- Stylianos Koutsias
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Georgios I Karaolanis
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Michail I Papafaklis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Michail Peroulis
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Petros Tzimas
- Department of Anesthesiology, University Hospital of Ioannina, Ioannina, Greece
| | - Lampros Lakkas
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Katerina K Naka
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Lampros K Michalis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
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17
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Pappas-Gogos G, Baltagiannis EG, Kyrochristos ID, Ziogas DE, Goussia A, Mitsis M, Roukos DH. Predictive and patient-monitoring biomarkers: precision in the management of colorectal cancer. Biomark Med 2020; 14:335-339. [PMID: 32250157 DOI: 10.2217/bmm-2020-0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Georgios Pappas-Gogos
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Evangelos G Baltagiannis
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Ioannis D Kyrochristos
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Demosthenes E Ziogas
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, 'G Hatzikosta' General Hospital, Ioannina, Greece
| | - Anna Goussia
- Department of Pathology, University Hospital of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Dimitrios H Roukos
- Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.,Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
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18
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Affiliation(s)
- Ioannis D Kyrochristos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Evangelos G Baltagiannis
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
- Cancer Biobank Centre, Ioannina University, Ioannina, Greece
| | - Dimitrios H Roukos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
- Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
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19
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Lianos GD, Alexiou GA, Exarchos C, Rausei S, Mitsis M, Voulgaris S. Prognostic significance of neutrophil-to-lymphocyte ratio in several malignancies: where do we stand? Biomark Med 2020; 14:169-172. [DOI: 10.2217/bmm-2019-0497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Georgios D Lianos
- Department of Surgery, University of Ioannina School of Medicine, Ioannina, Greece
| | - George A Alexiou
- Deparment of Neurosurgery, University of Ioannina School of Medicine, Ioannina, Greece
| | - Christos Exarchos
- Deparment of Neurosurgery, University of Ioannina School of Medicine, Ioannina, Greece
| | - Stefano Rausei
- Department of Surgery, ASST Valle Olona, Gallarate, Varese, Italy
| | - Michail Mitsis
- Department of Surgery, University of Ioannina School of Medicine, Ioannina, Greece
| | - Spyridon Voulgaris
- Deparment of Neurosurgery, University of Ioannina School of Medicine, Ioannina, Greece
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20
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Antoniou P, Ziogas DE, Vlachioti A, Lykoudis EG, Mitsis M, Roukos DH. Genomic and transcriptional heterogeneity-based precision in personalized treatment for breast cancer. Per Med 2019; 16:361-364. [PMID: 31507233 DOI: 10.2217/pme-2019-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Persefoni Antoniou
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, Ioannina University Hospital, Ioannina, Greece
| | - Demosthenes E Ziogas
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, 'G Hatzikosta' General Hospital, Ioannina, Greece
| | - Aikaterini Vlachioti
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Gynecology, General Hospital, Preveza, Greece
| | - Eustathios G Lykoudis
- Cancer Biobank Centre, Department of Medicine, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, Ioannina University Hospital, Ioannina, Greece.,Cancer Biobank Centre, Department of Medicine, University of Ioannina, Ioannina, Greece
| | - Dimitrios H Roukos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, Ioannina University Hospital, Ioannina, Greece.,Cancer Biobank Centre, Department of Medicine, University of Ioannina, Ioannina, Greece.,Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
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21
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Abstract
BACKGROUND Early gastric cancer (EGC) is more common nowadays and is related a to low percentage of lymph node metastasis. For this reason, there is enormous interest to implicate minimally invasive approaches. Recently, special efforts have been made towards a potential intraoperative (real-time) lymph node metastasis (LNM) assessment, as nodal disease status could not be identified with precision before or during surgery. In this direction, accurate prediction of the LNM status through sentinel LN mapping has been attempted, as an approach to the intraoperative detection of sentinel lymph nodes (SLNs). A careful literature search was conducted in order to clarify the potential clinical application of SN biopsy in the gastric cancer field. CONCLUSION The real clinical application of SN biopsy in gastric cancer treatment has been more than challenging due to the "complicated" nature of gastric lymphatic drainage and the high possibility of "skip" metastasis phenomenon. Notably, sophisticated technical aspects, such as the preferred tracer used and the potential "ideal" method to verify the presence of metastases in the resected SLNs, made SN biopsy application in gastric cancer field extremely demanding. Assessing the potential role of SN navigation for gastric cancer treatment in the era of advanced technology, where the minimally invasive surgical approaches are in the top of the scientific interest, it has to be highlighted that SN navigation for gastric cancer is a topic that remains highly controversial, and the need for future clinical trials on this topic is obvious.
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Affiliation(s)
- Georgios D Lianos
- Department of Surgery, University Hospital of Ioannina and School of Medicine, University of Ioannina, 45110, Ioannina, Greece.
| | - Christina D Bali
- Department of Surgery, University Hospital of Ioannina and School of Medicine, University of Ioannina, 45110, Ioannina, Greece
| | - Natasha Hasemaki
- 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgios K Glantzounis
- Department of Surgery, University Hospital of Ioannina and School of Medicine, University of Ioannina, 45110, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina and School of Medicine, University of Ioannina, 45110, Ioannina, Greece
| | - Stefano Rausei
- Department of Surgery, ASST Valle Olona, Gallarate, Italy
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22
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Antoniou P, Ziogas DE, Mitsis M, Roukos DH. Precision oncology in patients with nonmetastatic disease: emerging reality or illusion. Future Oncol 2019; 15:1805-1810. [PMID: 31170806 DOI: 10.2217/fon-2019-0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Persefoni Antoniou
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, Ioannina University Hospital, Ioannina, Greece
| | - Demosthenes E Ziogas
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, 'G Hatzikosta' General Hospital, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, Ioannina University Hospital, Ioannina, Greece.,Cancer Biobank Centre, University of Ioannina, Ioannina, Greece
| | - Dimitrios H Roukos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, Ioannina University Hospital, Ioannina, Greece.,Cancer Biobank Centre, University of Ioannina, Ioannina, Greece.,Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
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23
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Mitsis M, Markopoulos G, Alexiou GA, Vartholomatos E, Lazari D, Hodaj E, Nastos D, Lianos G, Zagorianakou P, Galani V, Kyritsis AP. Antiproliferative and cytotoxic action of N-(p-coumaroyl) serotonin in lung cancer cells. J BUON 2018; 23:1693-1698. [PMID: 30610796] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Lung cancer is among the leading causes of cancer-related cases and cancer-associated deaths. Tumor cells frequently acquire chemoresistance and, due to that, new therapies are always needed in the fight against cancer. Pharmaceutical plants continue to offer novel compounds as anticancer therapies. METHODS We studied the action of N-p-coumaroyl-serotonin (CS), a natural compound from Centaurea seed and safflower on a lung adenocarcinoma cell line. Cytotoxic or antiproliferative effect was studied using the MTT assay. Cell cycle, caspase-8 activation, mitochondrial membrane potential (MMP) and expression of CD15/CD56/CD24/CD44/CD58/CD71 were studied by flow cytometry. RESULTS CS exterted antiproliferative and cytotoxic activity, independent of mitochondrial membrane disruption. This compound caused S phase arrest and a decrease in the expression of CD24/CD44/CD58/CD71. CONCLUSION This is the first report on the in vitro action of CS against lung cancer, necessitating further studies towards its use as a potential anticancer agent.
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Affiliation(s)
- Michail Mitsis
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
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24
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Kyrochristos ID, Ziogas DE, Antoniou P, Mitsis M, Lykoudis EG, Roukos DH. Breakthrough cancer genome analysis in time and space: novel oncotargets and early drug development. Pharmacogenomics 2018; 19:1303-1310. [PMID: 30348059 DOI: 10.2217/pgs-2018-0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ioannis D Kyrochristos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Demosthenes E Ziogas
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, 'G Hatzikosta' General Hospital, Ioannina, Greece
| | - Persefoni Antoniou
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | | | - Dimitrios H Roukos
- Centre for Biosystems & Genome Network Medicine, Ioannina University, Ioannina, Greece.,Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.,Department of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
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25
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Zerdes I, Tolia M, Tsoukalas N, Mitsis M, Kardamakis D, Pistevou-Gombaki K, Tsekeris P, Kyrgias G. Systemic therapy of metastatic renal cell carcinoma: Review of the current literature. Urologia 2018; 86:3-8. [PMID: 30270773 DOI: 10.1177/0391560318802166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION: Renal cell carcinoma represents a neoplasm with usually aggressive behavior. Due to its nature, it is often diagnosed in an advanced stage or when metastatic dissemination has been occurred. The aim of this review is to provide an overview of the current management of metastatic renal cell carcinoma and briefly discuss the potential new therapeutic strategies for this disease. METHODS: Review of the literature was performed in PubMed/MEDLINE, Cochrane, and EMBASE and we included English articles up to February 2018. RESULTS: Over the past years, many efforts have been made in the context of confronting metastatic disease and led to the introduction of targeted therapies. More available agent options, including various tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors, can be served nowadays as the first-, second-, and third-line therapy in the metastatic setting of the disease providing better outcomes. DISCUSSION: Moreover, regarding the recent advances in the field of cancer immunotherapy, the landscape of metastatic renal cell carcinoma management is being shaped toward novel immunotherapeutic interventions alone or in combination with other types of therapy.
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Affiliation(s)
- Ioannis Zerdes
- 1 Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Tolia
- 2 Department of Radiotherapy, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | | | - Michail Mitsis
- 4 Surgery Clinic, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dimitrios Kardamakis
- 5 Department of Radiation Oncology, University of Patras Medical School, Patras, Greece
| | - Kyriaki Pistevou-Gombaki
- 6 Radiation Oncology Clinic, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Perikles Tsekeris
- 7 Department of Radiotherapy, University Hospital of Ioannina, Ioannina, Greece
| | - George Kyrgias
- 2 Department of Radiotherapy, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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26
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Lianos GD, Hasemaki N, Glantzounis GK, Mitsis M, Rausei S. Assessing safety and feasibility of 'pure' laparoscopic total gastrectomy for advanced gastric cancer in the West. Review article. Int J Surg 2018; 53:275-278. [PMID: 29602017 DOI: 10.1016/j.ijsu.2018.03.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/27/2018] [Accepted: 03/23/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Gastric cancer is reported to be the fourth most common cancer and the second leading cause of cancer-related death worldwide. Minimally invasive surgical treatment for gastric cancer is a very challenging approach which offers undoubtedly important advantages. MATERIALS AND METHODS There is intense debate concerning the minimally invasive surgical approach for advanced gastric cancer especially in the Western population. A careful literature search was conducted in order to clarify the feasibility and safety of pure laparoscopic total gastrectomy in the West. RESULTS Herewith we aim to summarize the current scientific evidence assessing the feasibility and short-term outcomes of laparoscopic gastrectomy for advanced gastric cancer in the West. A lack of data from Western institutions regarding minimally invasive surgical approach for gastric cancer is yet a reality. Nevertheless, the laparoscopic procedure appears to provide satisfactory short-term oncologic outcomes and improved postoperative outcomes. CONCLUSION It is obvious that future well-conducted trials on long-term results are necessary for Western patients in order safe conclusions to be reached regarding a potential definitive 'place' for laparoscopy in the curative gastric cancer treatment.
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Affiliation(s)
- Georgios D Lianos
- Department of Surgery, University Hospital of Ioannina and University of Ioannina, Ioannina, 45110, Greece; Department of Surgery, General Hospital of Preveza, Preveza, Greece.
| | - Natasha Hasemaki
- Department of Surgery, General Hospital of Preveza, Preveza, Greece
| | - Georgios K Glantzounis
- Department of Surgery, University Hospital of Ioannina and University of Ioannina, Ioannina, 45110, Greece
| | - Michail Mitsis
- Department of Surgery, University Hospital of Ioannina and University of Ioannina, Ioannina, 45110, Greece
| | - Stefano Rausei
- Department of Surgery, University of Insubria, Varese, Italy
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27
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Mitsis M, Alexiou GA, Vartholomatos E, Markopoulos G, Lazari D, Hodaj E, Nastos D, Zagorianakou P, Galani V, Kyritsis AP. N-(p-coumaroyl) serotonin induces cell cycle arrest and apoptosis in breast cancer cells. J BUON 2018; 23:129-133. [PMID: 29552772] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Breast cancer is the most commonly diagnosed malignancy among women. Breast cancer cells may develop resistance to current chemotherapy, thus new chemotherapeutic agents are urgently needed. METHODS A major number of drugs with anticancer activity have been isolated from plants. Herewith, we investigated for the first time the effect of N-(p-coumaroyl) serotonin (CS), isolated from Centaurea seed on a drug-resistant breast carcinoma (MCF-7) cells. Viability and proliferation of the cells were examined with trypan blue exclusion assay and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Caspace-8, cell cycle, and CD24/CD44/CD56/ CD58/CD71/CD15 expression were tested with flow cytometry. RESULTS Treatment with CS significantly reduced cell viability. Induction of cell death and cell cycle arrest was confirmed with flow cytometry. After treatment with CS, there was a dose-dependent decrease in CD24/CD44/CD58/CD71 expression, whereas there was no change in CD56 and CD15 expression. CONCLUSION The treatment of breast cancer cells with CS may represent a novel therapeutic strategy and requires further investigation.
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Affiliation(s)
- Michail Mitsis
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
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28
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Mitsis M, Koliou P, Bali C, Ntounousi E, Tatsis V, Nousias V, Lianos GD, Vartholomatos G, Nastos D. In Surgical Colon Cancer Patients Extended-Duration Thromboprophylaxis (30 days) with the Highest Dose of Tinzaparin (4,500 IU s.c./q.d.) Normalizes the Postoperative VEGF Levels. J Cancer 2017; 8:2899-2906. [PMID: 28928880 PMCID: PMC5604440 DOI: 10.7150/jca.20107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/30/2017] [Indexed: 01/05/2023] Open
Abstract
Background/Purpose: In colon cancer (CC) patients preoperative (pre-op) levels of VEGF-A165 (VEGF) is a strong predictor for disease recurrence. Elevated postoperative (post-op) VEGF levels could have undesirable effects by enhancing tumor growth and metastasis formation. It has been suggested that thromboprophylaxis with a Low Molecular Weight Heparin (LMWH) in surgical cancer patients, further to thromboembolic protection, may exert some anti-neoplastic properties, as well. The aim of our study was to assess the potential impact of the LMWH Tinzaparin (Innohep® - Leo Pharma, Copenhagen, Denmark), given at different doses and for different perioperative (peri-op) periods, upon the post-op variability of serum VEGF levels in surgical CC patients. Methods: A total of 54 consecutive CC patients who underwent a curative resection were randomized in four groups according to their peri-op thromboprophylaxis scheme, which was based on administrating Tinzaparin in different doses and at different periods, as follows: group I: 3,500 IU for 10 days, group II: 3,500 IU for 30 days, group III: 4,500 IU for 10 days and group IV: 4,500 IU for 30 days. Serum VEGF concentrations were evaluated on the pre-op day (Day 0) and on the 10th and 30th post-op days (Day 10 and Day 30, respectively). For statistical analyses the mixed design ANOVA was used. P < 0.05 was considered significant. Results: On Day 0, VEGF didn't differ between groups I, II, III and IV (p>0.05, for every comparison). On Day 10, VEGF was increased in all groups. Between Day 10 and Day 30, VEGF remained stable in groups I (p=0.031) and II (p=1.000) and increased significantly in group III (p=0.005). On the contrary, VEGF decreased significantly in group IV (p<0.001). The most remarkable finding was observed when we compared VEGF between Day 0 and Day 30: while in groups I, II and III, VEGF remained significantly higher compared to Day 0 (p<0.001, p=0.041 and p<0.001, respectively), on the contrary, in group IV (extended-duration with the highest dose of 4,500 IU of tinzaparin) it was comparable to Day 0 (p=1.000). Conclusions: In surgical CC patients only the recommended thromboprophylaxis scheme with the highest prophylactic dose of Tinzaparin (4,500 IU) for extended-duration (30 days) normalizes VEGF levels at the end of the first post-op month by reducing them to the pre-op levels.
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Affiliation(s)
- Michail Mitsis
- Department of Surgery, University Hospital of Ioannina, Greece
| | | | - Christina Bali
- Department of Surgery, University Hospital of Ioannina, Greece
| | | | | | | | | | - Georgios Vartholomatos
- Unit of Molecular Biology of the Haematology Laboratory, University Hospital of Ioannina, Greece
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Velentza L, Tolia M, Christakou C, Nikolaou M, Zerdes I, Tsoukalas N, Hajiioannou J, Tsanadis K, Rigas G, Mitsis M, Theodorou K, Pistevou-Gombaki K, Tsekeris P, Kyrgias G. Addressing the post-irradiation hypothalamic-pituitary endocrine abnormalities of brain tumors in pediatric patients. J BUON 2017; 22:1240-1245. [PMID: 29135108] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Hypothalamic-pituitary axis is susceptible to radiotherapy, causing endocrine disorders to childhood cancer survivors. We conducted a systematic review in order to assess the radiation-induced toxicity that leads to hormone secretion abnormalities and their severity in children with brain tumors. METHODS The data were collected by relevant studies on PubMed and EMBASE. Articles up to December 2016 were included. We selected studies which focused on children patients (<18 yr old) with brain tumors treated with radiotherapy and the consequences for their endocrine system. RESULTS Growth hormone (GH) deficiency was the most common post-irradiation abnormality among children cancer survivors, followed by gonadotrophin (GT), thyroid stimulating hormone (TSH), corticotropin (ACTH) and prolactin (PRL) disorders. CONCLUSIONS The age of the patient, total radiotherapy dose, number of fractions, fraction size and the duration of treatment seem to determine the severity of these disturbances.
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Affiliation(s)
- Louloudenia Velentza
- University of Thessaly, School of Health Sciences, Faculty of Medicine, Larissa, Greece
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Zerdes I, Tolia M, Nikolaou M, Tsoukalas N, Velentza L, Hajiioannou J, Mitsis M, Kyrgias G. How can we effectively address the paraneoplastic dermatomyositis: Diagnosis, risk factors and treatment options. J BUON 2017; 22:1073-1080. [PMID: 28952230] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Dermatomyositis (DM) represents an auto-immune inflammatory myopathy. In this review, we analyzed the incidence of DM as a clinical manifestation highlighting the peculiar clinical and treatment characteristics of this disease when occurring in the context of different malignancies. METHODS A systematic literature review was performed based on database search in PubMed/Medline and included English articles until December 2016. RESULTS In up to 20% of cases DM appears as a paraneoplastic syndrome associated with multiple malignancies such as ovarian, breast, prostate, lung, nasopharyngeal and colorectal cancer, and non-Hodgkin lymphomas. It can be presented either before, in the time, or after cancer diagnosis. Systemic sclerosis and mixed connective-tissue disease represent common coinciding disorders. Particular caution should be given in the radiotherapy because the microvascular endothelial radiation damage and autoimmune inflammatory collagen vascular disease caused by DM may be additive. There is a higher risk of late toxicity in the presence of other concurrent vascular diseases, including diabetes, hypertension or administration of chemotherapy. Prednisone represents the first-line treatment option but immunosuppressive drugs such as azathioprine and methotrexate may also be incorporated in the therapeutic armamentarium especially when DM is associated with malignancy. Intravenous immunoglobulin could be a promising alternative in prednisone-resistant cases. The effectiveness of therapies with antigen-specific agents such as monoclonal antibodies is currently under investigation. CONCLUSIONS Timely diagnosis coupled with a treatment plan focused on muscular endurance and improvement of skin lesions and other symptoms offer a favorable response to therapy along with the achievement of a higher quality of life for these patients.
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Affiliation(s)
- Ioannis Zerdes
- University of Ioannina, School of Health Sciences, Faculty of Medicine, Ioannina, Greece
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Anastasiadi Z, Lianos GD, Ignatiadou E, Harissis HV, Mitsis M. Breast cancer in young women: an overview. Updates Surg 2017; 69:313-317. [PMID: 28260181 DOI: 10.1007/s13304-017-0424-1] [Citation(s) in RCA: 347] [Impact Index Per Article: 49.6] [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: 10/30/2016] [Accepted: 02/16/2017] [Indexed: 02/06/2023]
Abstract
Despite dramatic advances in cancer research setting, breast cancer remains a major health problem and represents currently a top biomedical research priority. Worldwide, breast cancer is the most common cancer affecting women, and its incidence and mortality rates are expected to increase significantly the next years. Recently the researchers' interest has been attracted by breast cancer arising in young women. Current evidence suggests that in women aged <45 years, breast cancer is unquestionably the leading cause of cancer-related deaths. This type of cancer seems to be highly heterogeneous and has potentially aggressive and complex biological features. However, management strategies, recommendations and options are not age based and the 'complex' biology of this type of cancer remains uncertain and unexplored. In this review, we summarize the latest scientific information on breast cancer arising in young women highlighting the heterogeneity and the complex nature of this type of cancer.
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Affiliation(s)
- Zoi Anastasiadi
- Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Georgios D Lianos
- Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece.
| | | | | | - Michail Mitsis
- Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece
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Mitselou A, Papadatos SS, Tsoultsidou S, Fragkouli K, Mitsis M, Vougiouklakis T, Galani V. Giant Metastatic Liver Tumor of Unknown Primary Origin: Thoracic Autopsy Solves the Mystery. Acta Medica (Hradec Kralove) 2017; 60:163-166. [PMID: 29716684 DOI: 10.14712/18059694.2018.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A 59-year-old male patient was hospitalized in the Internal Medicine Department for investigation of hepatic metastases from an unknown primary neoplasm. During the hospitalization the patient died from acute myocardial infarction. The autopsy revealed a 8.2 kilograms (kg) liver that was diffusely infiltrated by whitish metastatic masses. No other tumor was detected, apart from a 2.5 centimeters (cm) pulmonary nodule next to the right intermediate bronchus that was histologically compatible with small cell lung cancer (SCLC). Despite the fact that hepatic metastases from SCLCs are common, diffuse metastatic hepatomegaly from a malignant pulmonary nodule are rarely seen. Given that the most common cause of malignancy-related death is lung cancer, early diagnosis and appropriate management of pulmonary nodules is of paramount importance.
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Affiliation(s)
- Antigony Mitselou
- Department of Forensic Medicine and Toxicology, University of Ioannina, Greece
| | - Stamatis S Papadatos
- 3rd Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Sotiria General Hospital, Athens, Greece
| | - Savvina Tsoultsidou
- Department of Forensic Medicine and Toxicology, University of Ioannina, Greece
| | - Kleio Fragkouli
- Department of Forensic Medicine and Toxicology, University of Ioannina, Greece
| | | | | | - Vasiliki Galani
- Department of Anatomy-Histology-Embryology, University of Ioannina, Greece.
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Lianos GD, Hasemaki N, Vaggelis G, Karampa A, Anastasiadi Z, Lianou A, Papanikolaou S, Floras G, Bali CD, Lekkas E, Katsios C, Mitsis M. Sentinel node navigation in gastric cancer: new horizons for personalized minimally invasive surgical oncology? Transl Gastroenterol Hepatol 2016; 1:91. [PMID: 28138656 DOI: 10.21037/tgh.2016.12.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/24/2016] [Indexed: 12/23/2022] Open
Abstract
Complete (R0) resection and regional lymph nodes (LNs) dissection represent undoubtedly the basic surgical tools for patients with gastric cancer. It is reported that the LN metastasis rate in patients with early gastric cancer (EGC) is approximately 15-20%. Therefore, the innovative clinical application of sentinel node navigation surgery (SNNS) for EGC might be able to prevent unnecessary LN dissection as well as to reduce significantly the volume of gastric resection. Recent evidence suggests that double tracer methods appear superior compared to single tracer techniques. However, the researchers' interest is now focused on the identification of new LN detection methods utilizing sophisticated technology such as infrared ray endoscopy, fluorescence imaging and near-infrared technology. Despite its notable limitations, hematoxylin-eosin is still considered the mainstay staining for assessing the metastatic status of LNs. In this review, we summarize the current evidences and we provide the latest scientific information assessing safety, efficacy and potential limitations of the innovative sentinel node (SN) navigation technique for gastric cancer. We try also to provide a "view" towards a future potential application of personalized minimally invasive surgery in gastric cancer field.
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Affiliation(s)
- Georgios D Lianos
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece; ; Department of Surgery, General Hospital of Preveza, Preveza, Greece
| | - Natasha Hasemaki
- Department of Surgery, General Hospital of Preveza, Preveza, Greece
| | | | | | - Zoi Anastasiadi
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
| | - Aikaterini Lianou
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
| | | | - Grigorios Floras
- Department of Surgery, General Hospital of Preveza, Preveza, Greece
| | - Christina D Bali
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
| | | | - Christos Katsios
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Department of Surgery, Ioannina University Hospital & University of Ioannina, Ioannina, Greece
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Dounousi E, Mitsis M, Naka KK, Pappas C, Lakkas L, Harisis C, Pappas K, Koutlas V, Tzalavra I, Spanos G, Michalis LK, Siamopoulos KC. Differences in cardiac structure assessed by echocardiography between renal transplant recipients and chronic kidney disease patients. Transplant Proc 2015; 46:3194-8. [PMID: 25420857 DOI: 10.1016/j.transproceed.2014.10.034] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in predialysis chronic kidney disease (CKD) and dialysis patients as well as in renal transplant recipients (RTRs). Left ventricular hypertrophy (LVH) starts early during the course of CKD and is a strong predictor of CVD in this population. Regression of LVH after a successful renal transplantation remains a debatable issue among investigators, whereas there is little data comparing echocardiographic measurements between patients with predialysis CKD and RTRs. AIM The aim of this study was to compare echocardiographic measurements of LV structure and function between predialysis CKD patients and RTRs of similar renal function level. PATIENTS AND METHODS We conducted a case control study with individual (1:2) matching from the Renal Transplant and the predialysis CKD Outpatient Clinic. For each of the 36 RTRs, two matched for gender, age and estimated glomerular filtration rate (eGFR) predialysis CKD outpatients (72 patients) were included. All patients underwent transthoracic echocardiography and LV mass, LV mass index [LVM and LVMI = LVM/BSA g/m(2)] and indices of systolic function were measured. In a subgroup of 12 RTRs we retrospectively assessed and compared the LVMI measurements at three different time points, during predialysis, dialysis and post transplant period. RESULTS The prevalence of LVH was 33% in RTRs and 52% in CKD patients (ns). RTRs had significantly lower LVM and LVMI levels compared with predialysis CKD patients (P = .006 and P = .008) while the other echocardiographic indices did not differ. In the subgroup of 12 RTRs, post-transplant LVMI levels (105 ± 25 g/m(2)) were significantly lower in comparison with predialysis (147 ± 57 g/m(2)) and dialysis LVMI levels (169 ± 72 g/m(2)) (P = .01, P = .01, respectively). CONCLUSION RTRs had significantly lower LVMI compared with predialysis CKD patients of similar age, renal function, hemoglobin and blood pressure level.
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Affiliation(s)
- E Dounousi
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - M Mitsis
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - K K Naka
- Cardiology Department, University Hospital of Ioannina, Ioannina, Greece
| | - C Pappas
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - L Lakkas
- Cardiology Department, University Hospital of Ioannina, Ioannina, Greece
| | - C Harisis
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - K Pappas
- Cardiology Department, University Hospital of Ioannina, Ioannina, Greece
| | - V Koutlas
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - I Tzalavra
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - G Spanos
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - L K Michalis
- Cardiology Department, University Hospital of Ioannina, Ioannina, Greece
| | - K C Siamopoulos
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
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Affiliation(s)
- O Balafa
- Department of Nephrology1 Department of Surgery2 Internal Medicine3 University of Ioannina Ioannina, Greece
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Schachtner T, Reinke P, Dorje C, Mjoen G, Midtvedt K, Strom EH, Oyen O, Jenssen T, Reisaeter AV, Smedbraaten YV, Sagedal S, Mjoen G, Fagerland MW, Hartmann A, Thiel S, Zulkarnaev A, Vatazin A, Vincenti F, Harel E, Kantor A, Thurison T, Hoyer-Hansen G, Craik C, Kute VB, Shah PS, Vanikar AV, Modi PR, Shah PR, Gumber MR, Patel HV, Engineer DP, Shah VR, Rizvi J, Trivedi HL, Malheiro J, Dias L, Martins LS, Fonseca I, Pedroso S, Almeida M, Castro-Henriques A, Cabrita A, Costa C, Ritta M, Sinesi F, Sidoti F, Mantovani S, Di Nauta A, Messina M, Cavallo R, Verflova A, Svobodova E, Slatinska J, Slavcev A, Pokorna E, Viklicky O, Yagan J, Chandraker A, Messina M, Diena D, Tognarelli G, Ranghino A, Bussolino S, Fop F, Segoloni GP, Biancone L, Leone F, Mauro MV, Gigliotti P, Lofaro D, Greco F, Perugini D, Papalia T, Perri A, Vizza D, Giraldi C, Bonofilgio R, Luis-Lima S, Marrero D, Gonzalez-Rinne A, Torres A, Salido E, Jimenez-Sosa A, Aldea-Perona A, Gonzalez-Posada JM, Perez-Tamajon L, Rodriguez-Hernandez A, Negrin-Mena N, Porrini E, Mjoen G, Pihlstrom H, Dahle DO, Holdaas H, Von Der Lippe N, Waldum B, Brekke F, Amro A, Reisaeter AV, Os I, Klin P, Sanabria H, Bridoux P, De Francesco J, Fortunato RM, Raffaele P, Kong J, Son SH, Kwon HY, Whang EJ, Choi WY, Yoon CS, Thanaraj V, Theakstone A, Stopper K, Ferraro A, Bhattacharjya S, Devonald M, Williams A, Mella A, Messina M, Gallo E, Fop F, Di Vico MC, Diena D, Pagani F, Gai M, Ranghino A, Segoloni GP, Biancone L, Cho HJ, Nho KW, Park SK, Kim SB, Yoshida K, Ishii D, Ohyama T, Kohguchi D, Takeuchi Y, Varga A, Sandor B, Kalmar-Nagy K, Toth A, Toth K, Szakaly P, Zulkarnaev A, Vatazin A, Kildushevsky A, Fedulkina V, Kantaria R, Staeck O, Halleck F, Rissling O, Naik M, Neumayer HH, Budde K, Khadzhynov D, Bhadauria D, Kaul A, Prasad N, Sharma RK, Sezer S, Bal Z, Erkmen Uyar M, Guliyev O, Erdemir B, Colak T, Ozdemir N, Haberal M, Caliskan Y, Yazici H, Artan AS, Oto OA, Aysuna N, Bozfakioglu S, Turkmen A, Yildiz A, Sever MS, Yagisawa T, Nukui A, Kimura T, Nannmoku K, Kurosawa A, Sakuma Y, Miki A, Damiano F, Ligabue G, De Biasi S, Granito M, Cossarizza A, Cappelli G, Martins LS, Fonseca I, Malheiro J, Henriques AC, Pedroso S, Almeida M, Dias L, Davide J, Cabrita A, Von During ME, Jenssen TG, Bollerslev J, Godang K, Asberg A, Hartmann A, Bachelet T, Martinez C, Bello A, Kejji S, Couzi L, Guidicelli G, Lepreux S, Visentin J, Congy-Jolivet N, Rostaing L, Taupin JL, Kamar N, Merville P, Sezer S, Bal Z, Erkmen Uyar M, Ozdemir H, Guliyev O, Yildirim S, Tutal E, Ozdemir N, Haberal M, Sezer S, Erkmen Uyar M, Bal Z, Guliyev O, Sayin B, Colak T, Ozdemir Acar N, Haberal M, Banasik M, Boratynska M, Koscielska-Kasprzak K, Kaminska D, Bartoszek D, Mazanowska O, Krajewska M, Zmonarski S, Chudoba P, Dawiskiba T, Protasiewicz M, Halon A, Sas A, Kaminska M, Klinger M, Stefanovic N, Cvetkovic T, Velickovic - Radovanovic R, Jevtovic - Stoimenov T, Vlahovic P, Rungta R, Das P, Ray DS, Gupta S, Kolonko A, Szotowska M, Kuczera P, Chudek J, Wiecek A, Sikora-Grabka E, Adamczak M, Szotowska M, Kuczera P, Madej P, Wiecek A, Amanova A, Kendi Celebi Z, Bakar F, Caglayan MG, Keven K, Massimetti C, Imperato G, Zampi G, De Vincenzi A, Fabbri GDD, Brescia F, Feriozzi S, Filipov JJ, Zlatkov BK, Dimitrov EP, Svinarov DA, Poesen R, De Vusser K, Evenepoel P, Kuypers D, Naesens M, Meijers B, Kocak H, Yilmaz VT, Yilmaz F, Uslu HB, Aliosmanoglu I, Ermis H, Dinckan A, Cetinkaya R, Ersoy FF, Suleymanlar G, Fonseca I, Oliveira JC, Santos J, Martins LS, Almeida M, Dias L, Pedroso S, Lobato L, Castro-Henriques A, Mendonca D, Watarai Y, Yamamoto T, Tsujita M, Hiramitsu T, Goto N, Narumi S, Kobayashi T, Dahle DO, Holdaas H, Reisaeter AV, Dorje C, Mjoen G, Line PD, Hartmann A, Housawi A, House A, Ng C, Denesyk K, Rehman F, Moist L, Musetti C, Battista M, Izzo C, Guglielmetti G, Airoldi A, Stratta P, Musetti C, Cena T, Quaglia M, Fenoglio R, Cagna D, Airoldi A, Amoroso A, Stratta P, Palmisano A, Degli Antoni AM, Vaglio A, Piotti G, Cremaschi E, Buzio C, Maggiore U, Lee MC, Hsu BG, Zalamea Jarrin F, Sanchez Sobrino B, Lafuente Covarrubias O, Karsten Alvarez S, Dominguez Apinaniz P, Llopez Carratala R, Portoles Perez J, Yildirim T, Yilmaz R, Turkmen E, Altindal M, Arici M, Altun B, Erdem Y, Dounousi E, Mitsis M, Naka K, Pappas H, Lakkas L, Harisis H, Pappas K, Koutlas V, Tzalavra I, Spanos G, Michalis L, Siamopoulos K, Iwabuchi T, Yagisawa T, Kimura T, Nanmoku K, Kurosawa A, Yasunaru S, Lee MC, Hsu BG, Yoshikawa M, Kitamura K, Fuji H, Fujisawa M, Nishi S, Carta P, Zanazzi M, Buti E, Larti A, Caroti L, Di Maria L, Minetti EE, Shi Y, Luo L, Cai B, Wang T, Zou Y, Wang L, Kim Y, Kim HS, Choi BS, Park CW, Yang CW, Kim YS, Chung BH, Baek CH, Kim M, Kim JS, Yang WS, Han DJ, Park SK, Mikolasevic I, Racki S, Lukenda V, Persic MP, Colic M, Devcic B, Orlic L, Sezer S, Gurlek Demirci B, Guliyev O, Colak T, Say N CB, Ozdemir Acar FN, Haberal M, Vali S, Ismal K, Sahay M, Civiletti F, Cantaluppi V, Medica D, Mazzeo AT, Assenzio B, Mastromauro I, Deambrosis I, Giaretta F, Fanelli V, Mascia L, Musetti C, Airoldi A, Quaglia M, Guglielmetti G, Battista M, Izzo C, Stratta P, Lakkas L, Naka K, Dounousi E, Koutlas V, Gkirdis I, Bechlioulis A, Evangelou D, Zarzoulas F, Kotsia A, Balafa O, Tzeltzes G, Nakas G, Pappas K, Kalaitzidis R, Katsouras C, Michalis L, Siamopoulos K, Tutal E, Erkmen Uyar M, Uyanik S, Bal Z, Guliyev O, Toprak SK, Ilhan O, Sezer S, Bal Z, Ekmen Uyar M, Guliyev O, Sayin B, Colak T, Sezer S, Haberal M, Hernandez Vargas H, Artamendi Larranaga M, Ramalle Gomara E, Gil Catalinas F, Bello Ovalle A, Pimentel Guzman G, Coloma Lopez A, Sierra Carpio M, Gil Paraiso A, Dall Anesse C, Beired Val I, Huarte Loza E, Choy BY, Kwan L, Mok M, Chan TM, Yamakawa T, Kobayashi A, Yamamoto I, Mafune A, Nakada Y, Tannno Y, Tsuboi N, Yamamoto H, Yokoyama K, Ohkido I, Yokoo T, Luque Y, Anglicheau D, Rabant M, Clement R, Kreis H, Sartorius A, Noel LH, Timsit MO, Legendre C, Rancic N, Vavic N, Dragojevic-Simic V, Katic J, Jacimovic N, Kovacevic A, Mikov M, Veldhuijzen NMH, Rookmaaker MB, Van Zuilen AD, Nquyen TQ, Boer WH, Mjoen G, Pihlstrom H, Dahle DO, Holdaas H, Sahtout W, Ghezaiel H, Azzebi A, Ben Abdelkrim S, Guedri Y, Mrabet S, Nouira S, Ferdaws S, Amor S, Belarbia A, Zellama D, Mokni M, Achour A, Viklicky O, Parikova A, Slatinska J, Hanzal V, Fronek J, Orandi BJ, James NT, Montgomery RA, Desai NM, Segev DL, Fontana F, Ballestri M, Magistroni R, Damiano F, Cappelli G. TRANSPLANTATION CLINICAL 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu160] [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: 11/13/2022] Open
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Dounousi E, Mitsis M, Spanos G, Pappas C, Koutlas V, Tzalavra I, Xarisis C, Glantzounis G, Fatouros M, Siamopoulos KC. Assessment of nonimmunologic factors in kidney transplant recipients according to Kidney Disease Improving Global Outcomes. Transplant Proc 2012; 44:2709-11. [PMID: 23146500 DOI: 10.1016/j.transproceed.2012.09.010] [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: 10/27/2022]
Abstract
INTRODUCTION Cardiovascular disease is the primary cause of death among kidney transplant recipients (KTRs), whereas chronic allograft nephropathy (CAN) is the main reason leading to end-stage chronic kidney disease. The etiologies of both entities include immunologic and nonimmunologic factors. The management of modifiable nonimmunologic parameters has recently been identified by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. The aim of our study was to assess the implementation of these guidelines in the outpatient kidney transplantation clinic of our hospital. PATIENT AND METHODS We retrospectively monitored the records of 48 transplanted KTRs including 32 males of overall mean age 45.1 ± 10.7 years regarding control of anemia, dyslipidemia, mineral bone disorder (MBD), and blood pressure (BP) levels. Data were recorded every 6 months for 2 years, starting 1 year after renal transplantation. RESULTS The estimated glomerular filtration rate of patients at baseline was 60.3 ± 18.8 mL/min/1.73 m(2) with no significant change during 2 years of follow-up. The control of anemia was satisfactory in 42 patients (88%) with hemoglobin values ≥ 11 g/dL during the follow-up. Regarding dyslipidemia management, the aggregate of patients showed fasting triglycerides ≤500 mg/dL in all measurements. The percentage of KTRs with LDL ≤100 mg/dL tended to improve from baseline versus the end of the study period (20.8% vs 41.7%). Serum calcium was satisfactorily controlled in 77% of patients, serum phosphorus in all patients, whereas parathyroid hormone (PTH) was abnormal in 60% of KTRs with chronic kidney disease stages 3-5. Finally, the BP goal of <130/80 mm Hg was achieved in approximately half of the patients. CONCLUSION Control of nonimmunologic factors was satisfactory in terms of renal anemia and MBD, whereas dyslipidemia and BP levels were inadequately controlled. There is a clear need for better integration into clinical practice of KDIGO guidelines with regard to modifiable nonimmunologic factors.
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Affiliation(s)
- E Dounousi
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
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Koliou P, Mitsis M, Kolaitis N, Batsis C, Messinis T, Saranti M, Vartholomatos G, Fatouros M. PO-31 Hypercoagulation in colon and breast cancer patients undergoing surgery as revealed by increased platelet function. Thromb Res 2010. [DOI: 10.1016/s0049-3848(10)70081-5] [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: 10/19/2022]
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Vlachos K, Mitsis M, El Tayar A, Papalois V, Hakim N. Distal transplant pancreatectomy during SPK: successful clinical outcome. Int Surg 2008; 93:189-191. [PMID: 19731850] [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: 05/28/2023] Open
Abstract
Simultaneous pancreas and kidney transplantation (SPK) is considered an extremely effective and well-established therapeutic option for selected patients with end-stage renal disease (ESRD), secondary to type 1 diabetes. Vascular complications in pancreas transplantation are more common than in any other solid organ transplant. Thrombosis is the most frequently observed surgical complication of pancreatic transplantation. We report a case of a successful management regarding the thrombosed distal pancreatic segment during SPK transplantation.
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Alexiou GA, Papanikolaou G, Mitsis M, Nastos D, Kappas AM. Ileoileal intussusception due to an inverted Meckel's diverticulum in a child. Acta Gastroenterol Belg 2007; 70:308. [PMID: 18074745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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41
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Matsagas MI, Mitsis M, Batsis C, Rigopoulos C, Kappas AM. A renal artery aneurysm incidentally found at operation. Should it be resected? INT ANGIOL 2004; 23:189-91. [PMID: 15507899] [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
A rare case of a patient with a ruptured abdominal aortic aneurysm (AAA) and an incidentally found left renal artery aneurysm (RAA) is presented. Successful repair of both aneurysms was simultaneously performed. The indications for such a surgical approach are also discussed.
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Affiliation(s)
- M I Matsagas
- Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece.
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42
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Skrekas G, Papalois VE, Mitsis M, Hakim NS. Laparoscopic live donor nephrectomy: a step forward in kidney transplantation? JSLS 2003; 7:197-206. [PMID: 14558706 PMCID: PMC3113198] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Open donor nephrectomy for live donor kidney transplantation is a safe procedure that has been used for more than 30 years with excellent results. Laparoscopic donor nephrectomy is a relatively new technique that has the potential of decreased postoperative pain, less incisional morbidity, and shorter recovery time. Furthermore, it has been reported that this potentially less traumatic approach increases the number of potential live donors. This review article focuses on the currently used laparoscopic techniques in live kidney donation as well as the controversy regarding its efficacy, safety, and future.
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Zalavras CG, Giotopoulou S, Dokou E, Mitsis M, Ioannou HV, Tsaousi C, Tzolou A, Kolaitis N, Vartholomatos G. Prevalence of the G20210A prothrombin gene mutation in Northwestern Greece and association with venous thromboembolism. INT ANGIOL 2003; 22:55-7. [PMID: 12771857] [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: 03/02/2023]
Abstract
AIM The G20210A mutation of the prothrombin gene is a genetic risk factor for venous thromboembolism (VTE). Variability exists in the mutation prevalence in both normal individuals and VTE patients. The aim of this study was to determine the mutation prevalence in Northwestern Greece and evaluate its association with VTE. METHODS Presence of the G20210A mutation was investigated using DNA analysis in 176 consecutive patients with a history of venous thrombosis or pulmonary embolism and in 300 healthy controls, all Caucasian residents of Northwestern Greece. RESULTS The mutation was present 12 patients (6.8%) and 8 controls (2.7%). The odds ratio for presence of the mutation versus the normal genotype in VTE was 2.7 (95% CI: 1.1 to 6.7), which was statistically significant. The prevalence of the G20210A prothrombin gene mutation in Northwestern Greece is 2.7% (95% CI: 0.8% to 4.4%) with an allele frequency of 1.3% (95% CI: 0.4% to 2.3%). CONCLUSION The G20210A mutation of the prothrombin gene is associated with VTE in the Caucasian residents of this geographic region.
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Affiliation(s)
- Ch G Zalavras
- Department of Orthopaedic Surgery, University Hospital of Ioannina, Ioannina, Greece
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Zalavras CG, Giotopoulou S, Dokou E, Mitsis M, Ioannou HV, Tzolou A, Kolaitis N, Vartholomatos G. Lack of association between the C677T mutation in the 5,10-methylenetetrahydrofolate reductase gene and venous thromboembolism in Northwestern Greece. INT ANGIOL 2002; 21:268-71. [PMID: 12384649] [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: 02/26/2023]
Abstract
BACKGROUND Hyperhomocysteinemia has been associated with venous thrombosis. Under known and unknown conditions the C677T mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene is accompanied by elevated levels of homocysteine. However, the relationship of this mutation with venous thromboembolism (VTE) remains controversial. The purpose of this study was to evaluate the association of the MTHFR mutation with VTE. METHODS The presence of the C677T mutation in the MTHFR gene was investigated in a population of 176 consecutive patients with a history of venous thromboembolism and in a control group of 300 healthy subjects, using DNA analysis. RESULTS The prevalence of homozygosity in the patient group was 13.6% and in healthy subjects 10%. The odds ratio for venous thromboembolism in the presence of the homozygous genotype (677TT) was 1.4 (95% confidence interval (C.I.), 0.8 to 2.5), which was not statistically significant. CONCLUSIONS Homozygosity for the T677 allele of the MTHFR gene, although slightly more prevalent in patients compared to controls, has not been found in association with venous thromboembolism.
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Affiliation(s)
- Ch G Zalavras
- Department of Orthopaedic Surgery, Unit of Molecular Biology, University Hospital of Ioannina, Ioannina, Greece
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Baltoyiannis G, Christodoulos N, Mitsis M, Stephanou D, Ioannou H, Nousias V, Kappas AM. A comparative experimental study of the effects of diclofenac and ketoprofen on the small-bowel mucosa of canines. Res Exp Med (Berl) 2001; 200:125-35. [PMID: 11271513 DOI: 10.1007/bf03220020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The aim of this experimental study was to investigate the effect of diclofenac sodium and ketoprofen, two non-steroidal anti-inflammatory drugs (NSAIDs) with different excretion pathways, and the role of other enteric factors during simultaneous administration of these drugs on the development of mucosal lesions of the small intestine in canines. Twenty-five animals were divided into three groups. Group I included 10 canines, 5 with diclofenac sodium (group Ia) and 5 with ketoprofen administration (group Ib). Group II included 5 animals in which a segment of ileum was surgically isolated from the rest of the small intestine. Group III included 10 animals in two subgroups of 5; a segment of ileum was surgically isolated in both subgroups; groups IIIa received diclofenac and group IIIb ketoprofen. Histological examination of the specimens taken revealed macroscopic and microscopic mucosal lesions in 5/5 animals in group Ia, whereas none of the 5 animals in group Ib had any lesions. Group II did not reveal any mucosal lesions. Three out of 5 animals (60%) administered diclofenac in group IIIa had intestinal mucosal lesions, but none of the 5 revealed lesions in the isolated loop of ileum. No lesions were observed in the isolated loop or in the rest of the intestinal mucosa in the animals in group IIIb. Our results suggest that NSAIDs produce intestinal mucosal lesions not only when administered per mouth but also after intramuscular administration. Diclofenac, unlike ketoprofen, was responsible for the development of lesions in the intestinal mucosa. The role of drugs and/or their metabolites in the intestine and certain other factors must still be determined.
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Affiliation(s)
- G Baltoyiannis
- Department of Surgery, University Hospital of Ioannina, Greece.
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46
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Ioannou HV, Mitsis M, Eleftheriou A, Matsagas M, Nousias V, Rigopoulos C, Vartholomatos G, Kappas AM. The prevalence of factor V Leiden as a risk factor for venous thromboembolism in the population of North-Western Greece. INT ANGIOL 2000; 19:314-8. [PMID: 11305729] [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: 02/19/2023]
Abstract
BACKGROUND Many predisposing factors have been associated with the development of venous thromboembolism. Recently, Factor V Leiden has been described as a common genetic risk factor. The geographic distribution of this genetic abnormality in the general population greatly varies. The prevalence of the Factor V Leiden mutation in Europe is high, particularly in Greece, where according to some authors it is especially high. The purpose of this study was to estimate the prevalence of the Factor V Leiden mutation in patients presenting with at least one episode of venous thromboembolism and to compare it with that of the general population. METHODS Blood samples were drawn from 388 subjects. 240 healthy blood donors (controls) and 148 unselected patients with a history of one or more episodes of venous thrombosis. DNA analysis was performed using the polymerase chain reaction to amplify the factor V gene exon 10, and to detect the Factor V Leiden point mutation. RESULTS DNA analysis revealed Factor V Leiden mutations in eight (3.3%) control subjects (seven heterozygous and one homozygous) and in twenty-four (16.2%) patients, (twenty-two heterozygous and two homozygous). The difference between the two groups is statistically significant (p<0.0001; chi2 test). CONCLUSIONS The prevalence of the Factor V Leiden mutation in the general population of North-Western Greece is 3.3%, which is within the same range as that reported for other European countries. The Factor V Leiden mutation is one of the most important predisposing genetic factors in the development of venous thrombosis and was present in 16.2% of our patients.
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Affiliation(s)
- H V Ioannou
- Department of Surgery, University Hospital of Ioannina, Greece.
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Baltoyannis G, Mitsis M, Nathanael C, Batsis C, Pappas S, Nastos D, Kappas AM. Submucosa of canine small intestine as an alternative medium-diameter autogenous arterial graft. INT ANGIOL 2000; 19:280-4. [PMID: 11201599] [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: 02/19/2023]
Abstract
BACKGROUND Small intestinal canine submucosa has been used in previous studies as a large diameter arterial graft and has shown acceptable patency rates. The aim of our experimental study was to assess its effectiveness when it is used as an autogenous medium-sized diameter arterial graft (5-7 mm). METHODS Fifteen mongrel dogs were included and underwent laparotomy under general anaesthesia. The mucosa, tunica muscularis and serosa were removed from a resected intestinal segment. The remaining tube, which consisted of the submucosa and the basilar tunica mucosa, represented the experimental graft which was used to replace a proportional gap of the canine infrarenal aorta. Ascertainment of peripheral pulses, measurement of the intra-aortic pressures, aortography and in vivo/in situ observation before the sacrifice of the animals, were the procedures used for verification of the graft's patency. RESULTS The resistance to thrombogenicity of the graft was considered satisfactory: nine out of 10 grafts remained patent for postoperative intervals ranging from one day to one year; one graft showed partial obstruction due to a technical perioperative error. The grafts showed also excellent physical characteristics (ease of handling and suturing, blood impermeability and durability), resistance to infection and showed no tendency to develop myointimal hyperplasia. CONCLUSIONS Small intestinal canine submucosa showed satisfactory haemodynamic properties, long-term patency and resistance to infection, when used as a medium-diameter arterial substitute.
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Affiliation(s)
- G Baltoyannis
- Department ot Surgery, School of Medicine, Ioannina University, Greece
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Mitsis M, Ioannou H, Eleftheriou A, Nousias V, Basioukas C, Kakosimos G, Batsis C, Vartholomatos G. Combined genetic defect (homogeneity for factor V Leiden and heterogeneity for prothrombin G20210A allele), in a young patient, with recurrent deep vein thrombosis and serious postphlebitic syndrome--a case report. Angiology 2000; 51:325-9. [PMID: 10779003 DOI: 10.1177/000331970005100408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Just a few years ago, resistance to activated protein C (APCR) was reported to be of high significance representing a strong predisposing factor in the development of venous thrombosis (VT). A little while later, APCR was established to be the result of a point mutation of the factor V gene (factor V Leiden: a G-to-A transition at position 1691). Up to today, it is not certain whether factor V Leiden is in itself able to lead to VT, or whether it acts in synergy with other factors. Nevertheless, heterozygous subjects have a tenfold increase in the risk of VT when compared to general population, whereas the risk is 80 times greater in homozygous individuals. In 1996, a prothrombin gene mutation (prothrombin G20210A allele), which is a single-nucleotide G-to-A transition at position 20210 in the sequence of the 3'-untranslated region (3'UTR) on chromosome 11, was discovered. The presence of this mutant gene results in elevated plasma prothrombin concentrations, increasing the possibility for the development of VT. However, the coexistence of these two abnormalities, as well as the clinical consequence, have not yet been studied. So far, only a few reports are found in the literature describing the coexistence of both mutations. The authors present a 25-year-old patient with a simultaneous double mutation of the FV and F II gene. The patient was homozygous for the factor V Leiden and heterozygous for the prothrombin G20210A allele. It is unclear whether the coexistence of the two predisposes more to the development of VT than the summation of the two as independent factors.
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Affiliation(s)
- M Mitsis
- Department of Surgery, University Hospital of Ioannina, Greece
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Giannoukas AD, Fatouros M, Batsis H, Mitsis M, Matsagas M, Koulouras V, Tsampoulas C, Kappas M, Cassioumis A. Symptomatic deep venous thrombosis of the lower limb. INT ANGIOL 1998; 17:151-4. [PMID: 9821027] [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: 02/09/2023]
Abstract
BACKGROUND Deep vein thrombosis (DVT) is a common problem in clinical practice causing severe complications. In this retrospective study, the distribution and extent of DVT in the lower limb in symptomatic patients were evaluated. Certain risk factors were also investigated. METHODS The venograms of 187 symptomatic individuals (postoperative, medical, and out-patient) with suspected DVT and symptoms having been present for less than 6 days, were reviewed. Seventy-seven limbs of 76 patients had DVT. Twenty-seven were male (age range 14-82 years, mean 57) and 49 female (age range 12-82, mean 56). RESULTS Age over 40 years and gender (female) were significant predisposing factors, (Z = 4.23, p < 0.001 and Z = 2.19, p < 0.05 respectively). Isolated calf DVT alone was the most common pattern (46%, 36 of 77 limbs), and no difference was seen between postoperative and medical patients (chi 2-test, p = 0.7). Postoperative DVT was found in 29 (38%) limbs. Prophylaxis with LMWH had been given in only 15 of them (52%). No difference was seen in the distribution and extent of thrombosis in relation to the prophylaxis with LMWH (chi 2-test, p = 0.34). CONCLUSIONS Identification of the predisposing factors may enable us to distinguish patients at high risk of developing DVT. The majority of the thrombi commenced in the calf veins and thus meticulous investigation of these veins in symptomatic patients with suspected DVT is necessary.
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Affiliation(s)
- A D Giannoukas
- Department of Surgery, School of Medicine, University of Ioannina, Greece
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