41 results on '"D. Botsios"'
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2. Contents Vol. 16, 1999
- Author
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M. Caínzos Fernández, Hiroyasu Makuuchi, D. Botsios, Huug Obertop, Stephen O’Neil, J. García Iglesias, T. El-Sefi, C.G. Larsen, H.A. Bruining, J. Gram, N.O. Jacobsen, G. Mai, Thomas M. van Gulik, Masayuki Imamura, H.U. Baer, L.S. Jensen, Akio Morimoto, C.G. Curti, Hjörtur Gislason, Kohichi Fujii, Tun Aung, Hisashi Onodera, S. Agelopoulos, Moshe Schein, A. Rios Rios, M. Osman, H. van Goor, F. Fernández López, Tomoo Tajima, Odd Søreide, C. Dervenis, Shunzo Maetani, Marc A. Borge, Hisao Nakasaki, Asgaut Viste, Kazuyuki Kawamoto, J. Potel Lesquereux, Djamila Boerma, Valeriu E. Andrei, S.L. Jensen, Norio Shiraishi, D. Berchtold, R. Conde Freire, G.L. Ong, S.B. Lausten, L.H. Ottesen, J. Triller, H. Demetriades, Seigo Kitano, Daisuke Ikeuchi, C. Couinaud, Shugen Kan, R.F.A. Weber, Dirk J. Gouma, Leslie Wise, R.F. Fenchel, J. Dadoukis, Takeshi Katsuta, E.M. Bladbjerg, Yosuke Adachi, E. Tønnesen, J.M. Läuffer, J.E.J. Krige, T.M. Ibrahim, P.C. Bornman, M.L. Jacobs, J. Evagelou, H.C.J.L. Buscher, B. Gesser, Gerard V. Aranha, and Masanori Aramaki
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Traditional medicine ,business.industry ,Gastroenterology ,Medicine ,Surgery ,business - Published
- 1999
3. Newsletter – Fall 1998
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A.W. Osborne, Brătucu E, Simon Msika, Dan Ulmeanu, Hidenori Yanagi, K. Manafis, Ji-Zhen Lu, S.F. Purkiss, Ye-Qin Yu, Husnu Sönmez, Hans Friis-Andersen, L. Bühler, Frank Viborg Mortensen, Edouard Pelissier, P. Beckerhinn, Zeng-Chen Ma, Jia Fan, Jian Zhou, S.Y.Y. Chan, Mohsen Bayat, Takehira Yamamura, Bent Erling Lindblad, Shuang-Jian Qiu, J. Dadoukis, D. Botsios, W. Blauensteier, J. Styrud, Ebbe Stender Hansen, Beat Gysi, Hitoshi Tonouchi, Hugues Levard, Yasutsugu Shoji, Andreas Glättli, W.G. Mouton, Sinan Zeren, Masato Kusunoki, G. Mentha, Hideki Itoh, Koichi Matsumoto, Delia Bota, A. Glättli, B. Fournier, Jean-Marie Hay, Kenan Bicakci, Zhao-You Tang, Suavi Ozkan, Ch. Maurer, K. Tsalis, Hiroki Ikeuchi, Kirsten Østergård Christensen, Abe Fingerhut, Ph Morel, Hiroshi Suzuki, Ch. Demetriades, J. Oberholzer, A. Caulfield, Ch. Glaser, Markus Naef, S. Eriksson, A. Zisiadis, Tsuneki Kinoshita, Orhan Demircan, C. Armbruster, Betty Célicout, L. Granström, Stig Mindedal Jespersen, N. Cretin, Xin-Da Zhou, Susan Galandiuk, Kristian Høy, S. Kriwanek, Ediz Coşar, M. Gschwantler, Hans Ulrich Baer, V. Kuzinkovas, H.U. Baer, F. Holzinger, and Zhi-Quan Wu
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Gerontology ,medicine.medical_specialty ,business.industry ,General surgery ,Gastroenterology ,medicine ,Surgery ,business - Published
- 1998
4. EDS News EDS News
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Christian Seiler, O. Schöb, Junichi Mikuni, Thomas Lang, Eric H.J. Belgers, J. Perissat, Karl Søndenaa, P. Kiesler, J.P. Campion, M. Gadenstätter, Ralph A. Schmid, P. Petropoulos, R. Schlumpf, P. Buchmann, Yoshihiro Muto, Yitzhak Rosso, M.W. Büchler, Wojciech Tolwinski, J. Himpens, Arno P.A. Oomen, Larisa V. Kuznetsova, I. Dadoukis, Eliahu Entebi, D. Covi, B. Anderberg, Ch. Sartoretti, P. Ledaguenel, Tsuneaki Fujiya, Georg Kacl, Jon Arne Søreide, K. Nassiopoulos, Toshiomi Kusano, G.J. Maddern, Barbara Decurtins, Tohoru Sugawara, I. Kanellos, Kiyoaki Ouchi, D. De Lorenzi, J. Bruyns, Jan Geerdsen, E. Bardaxoglou, I. Goulimaris, L. Krähenbühl, Elling Ulvestad, Yasuhiko Kamiyama, S. Landen, G. Arlt, Kojin Endo, K. Glaser, Markus A. Röthlin, Xing-yi Zhang, Osamu Tamai, Michael Nobel, Andreas Zollinger, V. Schumpelick, Masayuki Shiraishi, M. Messner, Peter Vogelbach, R. Bruhin, G.B. Cadière, Shimonov M, Bogdan Zalewski, Nils Christensen, Christian N. Meyer, C. Doherty, B. Launois, Heinz U. Rieder, D. Collet, Robert T. Mathie, N. Hennes, Masamori Shimabuku, Tsutomu Isa, Bogna Okulczyk, G. Eickmann, Masato Furukawa, D. Botsios, Henryk Dadan, B. Ulrich, Jan-Willem H.C. Daemen, A. Kreczy, Joar Svanvik, M. Aleksic, Kurt Borch, Hidemaro Ono, Eric Kullman, Shai Shinhar, Hiroshi Miyazato, B. Meunier, Yoichiro Kakugawa, Anthony M. Wheatley, Chr. Chanson, Ch. Demetriades, L. Ruso, E.E. Mason, Renward Hauser, Gauke Kootstra, G. Spiliopoulos, and G. Schwab
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business.industry ,Gastroenterology ,Media studies ,Medicine ,Surgery ,business - Published
- 1997
5. Suprapubic Percutaneous Cystostomy versus Urethral Catheterisation in Abdominal Surgery
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D. Botsios, Ch. Demetriades, Ioannis Kanellos, I. Dadoukis, and I. Goulimaris
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medicine.medical_specialty ,animal structures ,business.industry ,fungi ,Gastroenterology ,Urethral catheterisation ,Percutaneous cystostomy ,Surgery ,Prospective trial ,Suprapubic catheterisation ,medicine ,business ,Abdominal surgery - Abstract
Background: We conducted a randomised, prospective trial to evaluate the safety and effectiveness of suprapubic percutaneous cystostomy (SPC) in comparison with pemrethral catheteri
- Published
- 1997
6. Posters
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H. Spapen, M. Diltoer, K. Delanghe, G. Ingels, L. Huyghens, C. Jones, R. D. Griffiths, R. R. Macmillan, C. Harris, S. T. Atherton, P. Nee, M. Köller, P. Wachtler, M. Senkal, M. Kemen, W. König, L. Kompan, M. M. Berger, R. Chioléro, A. Pannatier, C. Cayeux, L. Tappy, J. López Martínez, M. Sánchez Castilla, R. Díaz Abad, M. A. García Salazar, M. J. Jiménez Martín, F. Del Nogal Sáez, I. Leonard, B. Harte, J. Collier, S. Maguire, D. Phelan, Rong Xinzhou, Xiao Guangxia, Li Ao, Zhang Yaping, G. Briassoulis, S. Venkataraman, A. Thompson, R. Khorram, W. Kauhl, A. Heiden, R. Hettich, W. Behrendt, M. Bitzani, D. Matamis, K. Koletsos, N. Pondikidis, D. Botsios, D. Riggos, and A. Ye. Shestopalov
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Critical Care and Intensive Care Medicine - Published
- 1996
7. Comparison of two methods, the thermodilution method of Fick and the Douglas bag method, in estimating the resting energy expenditure (REE)
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D. Riggos, D. Matamis, D. Botsios, M. Bizani, K. Koletsos, N. Gerogianni, and D. Lagonidis
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Mechanical ventilation ,Icu patients ,medicine.medical_specialty ,Measurement method ,Nutrition and Dietetics ,Critically ill ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Surgery ,Endocrinology ,Energy expenditure ,Intensive care ,Statistics ,Basal metabolic rate ,medicine ,Resting energy expenditure ,business - Abstract
Critically ill patients need appropriate nutritional support strictly correlated to their REE to avoid complications either from hypo or hyper alimentation. Resting Energy Expenditure (REE) in the I.C.U setting can be measured or calculated by several methods. The aim of our study was to compare two methods of indirect calorimetry. The REE calculated by the Fick equation (REET) and the traditional method of Douglas bag (REEi). Twelve ICU patients on mechanical ventilation were studied and the following results were obtained REET = 2295±552 Kcal/day and REEi = 2339±512 Kcal/day (mean±sd). A good correlation between the two methods showed by regression analysis. We conclude that the evaluation of REE using the thermodilution method of Fick is reliable in estimating the energy expenditure of critical ill patients.
- Published
- 1995
8. Laparoscopic Cholecystectomy in Two Patients with Symptomatic Cholelithiasis and Situs inversus totalis
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S. Agelopoulos, D. Botsios, J. Evagelou, C. Dervenis, H. Demetriades, and J. Dadoukis
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Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,medicine.medical_treatment ,Cholelithiasis ,X ray computed ,Cholecystitis ,otorhinolaryngologic diseases ,medicine ,Genetic predisposition ,Humans ,Laparoscopic cholecystectomy ,business.industry ,General surgery ,Situs inversus viscerum ,Gastroenterology ,Middle Aged ,Situs Inversus ,medicine.disease ,Surgery ,Situs inversus ,Cholecystectomy, Laparoscopic ,Female ,Cholecystectomy ,Tomography, X-Ray Computed ,business - Abstract
Background: Situs inversus viscerum is a rare condition with a genetic predisposition. We report 2 patients with situs inversus totalis and symptomatic cholelithiasis successfully treated via laparoscopic cholecystectomy. Patients and Methods: The first patient was a 61-year-old female presenting with pain in the left upper quadrant associated with fever, chills, nausea and vomiting. The abdomen was tender with guarding and rebounding pain in the same region. Abdominal ultrasound and CT scan confirmed the diagnosis of gallstones as well as situs inversus with the liver and gallblader on the left side and the spleen on the right. The second patient was a 37-year-old male with known situs inversus who presented with biliary colic due to cholelithiasis. In both patients cholecystectomy was performed laparoscopically in a reverse fashion. Results: Laparoscopic cholecystectomy was carried out successfully despite the reversed anatomic relationships and both patients made a smooth recovery. Conclusion: Cholelithiasis occurring with situs inversus totalis is rare and may present a diagnostic problem. Laparoscopic cholecystectomy can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.
- Published
- 1999
9. Splanchnic ischemia during laparoscopic cholecystectomy
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Katerina Kotzampassi, E. Eleftheriadis, J. Dadoukis, D. Botsios, E. Tzartinoglou, and H. Farmakis
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Adult ,Laparoscopic surgery ,Insufflation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Ischemia ,Middle Aged ,medicine.disease ,Surgery ,Cholecystectomy, Laparoscopic ,Pneumoperitoneum ,Laparotomy ,medicine ,Humans ,Female ,Cholecystectomy ,Splanchnic Circulation ,business ,Pneumoperitoneum, Artificial ,Perfusion ,Liver Circulation ,Abdominal surgery - Abstract
Background: Experimental studies have shown that elevation of intraabdominal pressure by means of gas insufflation produces hemodynamic disturbances in the peritoneal viscera, leading to splanchnic ischemia. The purpose of this clinical investigation is to reproduce the experimental data in humans undergoing laparoscopic cholecystectomy. Methods: Sixteen females participated in this study. Eight of them (the control group) were subjected to open laparotomy for biliary surgery, while on the remaining eight laparoscopic cholecystectomy was performed. In all patients hepatic microcirculation was registered during the time of operation using the laser-Doppler technique. A single-fiber laser-Doppler microprobe was introduced transcutaneously within the hepatic parenchyma, through a Chiba needle, under direct or laparoscopic vision. Additionally, gastric intramucosal/intramural pH, a low level of which indicates tissue ischemia, was assessed by means of a tonometric nasogastric catheter. Hepatic microcirculation and gastric intramucosal/intramural pH were assessed between controls and pneumoperitoneum-subjected patients, and within the laparoscopic surgery group, i.e., during pneumoperitoneum and after abdominal deflation. Results: Hepatic microcirculation was found to be significantly decreased in laparoscopic surgery patients in relation to controls (22.21±5.48 vs 57.52±18.06 perfusion units of flow, P=0.0001) as was gastric intramural pH (7.15±0.16 vs 7.37±0.02, P=0.003). Similarly, immediately after abdominal deflation, hepatic microcirculation exhibited a sudden elevation (22.21±5.48 vs 67.49±7.93 perfusion units of flow, P=0.0001), while gastric intramural pH return to its normal values (7.15±0.16 vs 7.43±0.07, P=0.0001). Conclusions: It is concluded that during laparoscopic cholecystectomy abdominal organs are hypoperfused, leading to a splanchnic ischemia environment. The clinical significance of these events remains to be clarified.
- Published
- 1996
10. Effect of early postoperative enteral feeding on the healing of colonic anastomoses in rats. Comparison of three different enteral diets
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H, Demetriades, D, Botsios, D, Kazantzidou, L, Sakkas, K, Tsalis, K, Manos, and I, Dadoukis
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Dietary Fiber ,Rupture ,Wound Healing ,Enteral Nutrition ,Time Factors ,Colon ,Glutamine ,Anastomosis, Surgical ,Animals ,Tissue Adhesions ,Rats, Wistar ,Diet ,Rats - Abstract
This experimental study compares the effects of early postoperative administration of three enteral diets of different compositions on the healing of colonic anastomoses. Sixty Wistar rats were subjected to colonic anastomoses. Following surgery, the rats were randomly allocated to four groups of 15 each. The rats in control group A received an electrolyte and glucose solution, the rats in group B received a complete balanced nutrition, in group C a complete balanced nutrition supplemented with fiber and in group D an isocaloric specialized elemental nutrition enriched with glutamine. The rats were sacrificed on day 7 following operation. Rupture of the anastomosis was higher in rats of the control group compared to the other three groups. Adhesion formation was more extensive in group A in comparison to the other three groups. The anastomotic bursting pressures were statistically significantly higher in groups C and D compared to the other two groups (p0.05). There was no statistically significant difference between group C and D (p0.05) while a statistically significant difference was noted between group B and group A (p0.05). Histological examination showed more profound inflammatory reaction in group A compared to the other three groups. There was also a statistically significant difference between group B and groups C and D while inflammatory reaction was of no statistically significant difference between group C and group D. Healing of the anastomoses was statistically significantly impaired in group A compared to the other three groups. There was no statistically significant difference between group C and group D while a statistically significant difference was found between group B and groups C and D. In conclusion, early postoperative enteral feeding improves healing of experimental colonic anastomoses in rats. This effect was more evident when fiber-supplemented diets or diets enriched with glutamine were administered.
- Published
- 1999
11. Management of large rectal wall defects with open pedicle grafts of small intestine. An experimental study
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C, Demetriades, D, Botsios, K, Tsalis, K, Manafis, A, Zisiadis, and J, Dadoukis
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Male ,Disease Models, Animal ,Wound Healing ,Dogs ,Graft Survival ,Intestine, Small ,Suture Techniques ,Tissue Transplantation ,Rectum ,Animals ,Female ,Intestinal Mucosa ,Follow-Up Studies - Abstract
The aim of this study was to evaluate the possible repair of large rectal wall defects using an open pedicle ileal graft as a mucosal patch. This experiment was carried out in 14 adult mongrel dogs. By excision of a portion of the antimesenteric wall comprising 50-70% of the circumference and measuring 5-6 cm in length, a suitable full thickness defect was created in the lower part of the rectum. A segment of the distal ileum was then isolated on a mesenteric pedicle and opened from its antimesenteric border. This was sutured over the defect in two layers. The animals were observed for a period of 15 days to 12 months. All the animals survived the operation apart from 1 dog that died of fecal peritonitis. Function of the rectum generally remained normal. Barium X-ray did not show any obstruction, shrinkage of the patch, lumen dilatation or extravasation. At the time of autopsy pedicles of ileal grafts appeared intact and pulsating. On gross examination there was no evidence of focal hemorrhage, ulceration or any cicatricial thickening of the grafts. Healing was good and the ileal mucosa retained its villi and general characteristics without any major inflammatory reactions. There was an increase in the number of goblet cells which returned to normal in 6 months.
- Published
- 1998
12. External Biliary Fistula
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J. Prousalidis, D. Botsios, H. Aletras, Stylianos Apostolidis, Vassilis N Papadopoulos, J. Dadoukis, and E. Tzartinoglou
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medicine.medical_specialty ,Biliary Fistula ,Hepatology ,Common bile duct ,Bile duct ,business.industry ,Fistula ,Biliary fistula ,lcsh:Surgery ,lcsh:RD1-811 ,Anastomosis ,medicine.disease ,Surgery ,Catheter ,medicine.anatomical_structure ,Postoperative Complications ,medicine ,Humans ,lcsh:Diseases of the digestive system. Gastroenterology ,Spontaneous discharge ,lcsh:RC799-869 ,business ,Bile leak ,Research Article - Abstract
We report 210 cases of external biliary fistula treated in our clinics between 1970–1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases after exploration of common bile duct, in 4 cases due to disruption of biliary-intestinal anastomosis, and in 2 cases due to liver trauma. In 85 cases bile leak was observed after cholecystomy, in 103 cases after hydatid disease surgery, and in 4 cases after the passage of P.T.C. catheter. In one patient the appearance of the fistula was due to spontaneous discharge of a gallbladder empyema. 173 cases were managed conservatively, and 37 cases surgically.
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- 1998
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13. Subject Index Vol. 16, 1999
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H.A. Bruining, L.S. Jensen, C.G. Curti, M. Caínzos Fernández, Moshe Schein, C. Couinaud, J. Dadoukis, Takeshi Katsuta, D. Botsios, Huug Obertop, Hiroyasu Makuuchi, Hjörtur Gislason, J. García Iglesias, N.O. Jacobsen, Thomas M. van Gulik, Masayuki Imamura, Hisao Nakasaki, E. Tønnesen, Yosuke Adachi, D. Berchtold, L.H. Ottesen, S. Agelopoulos, J.M. Läuffer, Asgaut Viste, J.E.J. Krige, Hisashi Onodera, Kohichi Fujii, J. Potel Lesquereux, Seigo Kitano, H.U. Baer, R. Conde Freire, Valeriu E. Andrei, S.L. Jensen, H. Demetriades, E.M. Bladbjerg, Norio Shiraishi, Shunzo Maetani, Tun Aung, Marc A. Borge, M. Osman, Tomoo Tajima, J. Gram, Daisuke Ikeuchi, Odd Søreide, G.L. Ong, J. Triller, Shugen Kan, R.F.A. Weber, Leslie Wise, M.L. Jacobs, S.B. Lausten, J. Evagelou, R.F. Fenchel, G. Mai, H. van Goor, Dirk J. Gouma, Gerard V. Aranha, Masanori Aramaki, T.M. Ibrahim, P.C. Bornman, H.C.J.L. Buscher, Akio Morimoto, B. Gesser, Kazuyuki Kawamoto, Stephen O’Neil, F. Fernández López, Djamila Boerma, A. Rios Rios, C. Dervenis, T. El-Sefi, and C.G. Larsen
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Index (economics) ,business.industry ,Statistics ,Gastroenterology ,Medicine ,Surgery ,Subject (documents) ,business - Published
- 1999
14. Prof. Dr. Wolf Isselhard
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Y. Yamaoka, S. Kinugasa, K. Asonuma, A.M.J. Shapiro, R.G. Hahn, Andrea Günen-Frank, D. Botsios, M. Chilcott, H. Demetriades, N. Nagasue, A. Nastasi, M. Inagaki, M. Nozawa, H. Schima, K. Øvrebø, R. Ullrich, M. Rawlins, E. Gullichsen, H. Kohno, S. Kasai, J. Fevang, I. Dadoukis, M. Mito, J. Niinikoski, D. Savioz, Y. Inomata, D. Kazantzidou, H. Nishizawa, K. Kuttila, Corinna Ludwig, J.M.H. Hendriks, J. Kössi, O. Peltola, T. Kiuchi, M. Savioz, Ph. Morel, L. Riddez, H. Egawa, A. Jeanjacquot, T. Ekfors, K. Svanes, K. Tanaka, J.D. Graf, E.J.M. Eyskens, K. Tsalis, Y. Mitsumoto, H. Nakayama, W. Trubel, H. Ikebukuro, M. Laato, L. Yu, P. Van Schil, K. Ogawa, O. Røkke, J. Peltonen, Y. Soda, S. Uemoto, E. Günen, S. Okamoto, S. Yabe, D. Kumar Dhar, P. Polterauer, K. Manos, T. Herbst, L. Sakkas, S. Schwarzacher, J.F. Bolle, and L. Johnson
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Surgery - Published
- 1999
15. Recombinant human growth hormone administration in multitrauma patients: effect on nitrogen balance
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G. Koletsos, D. Botsios, Gerasimos E Krassas, M. Bitzani, T. Kaltsas, N. Pontikides, D. Rigos, and T.C. Constantinidis
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medicine.medical_specialty ,Nitrogen balance ,business.industry ,Endocrinology, Diabetes and Metabolism ,Human growth hormone ,law.invention ,Endocrinology ,law ,Internal medicine ,Recombinant DNA ,medicine ,business ,Administration (government) - Published
- 1998
16. Synbiotics administration leads to attenuated mucosal inflammatory neutrophil infiltration and increased hematocrit in experimental ulcerative colitis.
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Varnalidis I, Ioannidis O, Papadopoulou A, Poutahidis T, Taitzoglou I, Ampas Z, Chatzakis C, Galanos-Demiris K, Mantzoros I, Pramateftakis MG, Kotidis E, Angelopoulos S, Botsios D, and Tsalis K
- Subjects
- Animals, Body Weight, Colitis, Ulcerative blood, Colitis, Ulcerative enzymology, Colitis, Ulcerative pathology, Colon pathology, Dextran Sulfate, Erythrocyte Count, Erythrocyte Indices, Gastrointestinal Microbiome, Hemoglobin A analysis, Male, Neutrophils enzymology, Organ Size, Peroxidase analysis, Platelet Count, Random Allocation, Rats, Rats, Wistar, Colitis, Ulcerative therapy, Hematocrit, Neutrophil Infiltration, Synbiotics administration & dosage
- Abstract
Objective: The objective of the study was to estimate the effects of synbiotics on laboratory, macroscopic, and histopathologic features in dextran sulfate sodium (DSS) experimental colitis., Materials and Methods: A total of 40 Wistar rats received 5% of DSS in their drinking water for 8 days to induce ulcerative colitis (UC). Eight rats were sacrificed to confirm the presence of UC. The remaining rats were randomly assigned to two groups: the synbiotics group, which received synbiotics once per day and the control group, which received tap water for another 8 days., Results: On the 8
th day of DSS administration animals developed UC with bloody diarrhea. In the majority of the hematologic variables studied (hemoglobin [HB], red blood cells, platelets, mean corpuscular volume, and mean corpuscular HB), in bodyweight and histopathologic colitis score there was no significant difference between groups. However, the synbiotics group, compared to control, presented a significantly greater colon length on the 4th day, significantly increased hematocrit (HT) on the 8th day, and a significantly decreased number of myeloperoxidase positive cells on the 8th day. Furthermore, there was a trend toward histopathological and clinical improvement., Conclusions: Administration of synbiotics in the experimental UC results in an attenuation of mucosal inflammatory neutrophil infiltration and an increase in HT., (Copyright: © 2020 Permanyer.)- Published
- 2020
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17. Variations of renal tissue oxygenation during abdominal compartment syndrome and sepsis.
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Kalfadis S, Nalbanti V, Ioannidis O, Porfiriou G, Botsios D, and Tsalis K
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- Animals, Dogs, Female, Male, Carbon Dioxide metabolism, Intra-Abdominal Hypertension physiopathology, Kidney metabolism, Oxygen metabolism, Sepsis physiopathology
- Abstract
Purpose: This experimental study was designed to evaluate the renal tissue oxygenation under the coexistence of abdominal compartment syndrome and sepsis., Material and Methods: Fourteen non-breed dogs were divided into two groups: the control group (8) and the study group (6). Sepsis was established with intravenous endotoxin infusion at 100μg/kg for over 30min. Insufflation of CO
2 in the peritoneal cavity was used for the increase in intra-abdominal pressure (IAP). A special catheter placed and fixed in the renal cortex at a depth of 3mm from the renal capsule was used for the measurement of renal tissue oxygenation., Results: Study parameters were recorded at the starting phase, at IAP of 15mmHg and 30mmHg and after decompression of the abdomen in the control group, and at the same intervals plus the induction of sepsis, prior to increasing abdominal pressure, in the study group. With the elevation of the IAP a reduction of renal tissue oxygenation presents itself, which is more pronounced in the presence of sepsis, especially for IAP over 15mmHg. Like other parameters, after abdominal decompression the renal tissue oxygenation returns to the initial levels, independently of sepsis., Conclusions: The afferent arterioles vasoconstriction, which takes place during sepsis, and the intra-renal shunt, which occurs and leads to blood diversion to the medulla from the renal cortex due to the combination of intra-abdominal hypertension (IAH) and sepsis, seem to explain this finding., (Copyright © 2017. Published by Elsevier B.V.)- Published
- 2017
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18. Treatment with Mesna and n-3 polyunsaturated fatty acids ameliorates experimental ulcerative colitis in rats.
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Triantafyllidis I, Poutahidis T, Taitzoglou I, Kesisoglou I, Lazaridis C, and Botsios D
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- Animals, Apoptosis drug effects, Biomarkers metabolism, Caspase 3 metabolism, Colitis, Ulcerative chemically induced, Colitis, Ulcerative metabolism, Colitis, Ulcerative pathology, Colon metabolism, Colon pathology, Cytoprotection, Dextran Sulfate, Disease Models, Animal, Intestinal Mucosa metabolism, Intestinal Mucosa pathology, Male, Nitric Oxide Synthase Type II metabolism, Oxidative Stress drug effects, Peroxidase metabolism, Rats, Wistar, Time Factors, Transcription Factor RelA metabolism, Antioxidants pharmacology, Colitis, Ulcerative prevention & control, Colon drug effects, Fatty Acids, Omega-3 pharmacology, Intestinal Mucosa drug effects, Mesna pharmacology
- Abstract
Oxidative damage is a central feature of ulcerative colitis. Here, we tested whether the antioxidant Mesna, when administered alone or in combination with n-3 polyunsaturated fatty acids (n-3 PUFAs), affects the outcome of dextran sodium sulphate (DSS)-induced ulcerative colitis in rats. After the induction of colitis, DSS-treated rats were further treated orally (p.o), intraperitoneally (i.p) or intrarectally (i.r) for either 7 or 14 days with Mesna, n-3 PUFAs or both. Rats were euthanized at the end of each treatment period. Clinical disease activity index was recorded throughout the experiment. At necropsy colorectal gross lesions were scored. Colitis was scored histologically, and the expression of myeloperoxidase (MPO), caspase-3, inducible nitric oxide synthase (iNOS) and nuclear factor κB (NF-κΒ) in colonic tissue was assessed by immunohistochemistry. Mesna alone was sufficient to significantly reduce colorectal tissue damage when administered orally or intraperitoneally. Orally coadministered n-3 PUFAs enhanced this effect, resulting in the significant suppression of DSS colitis after 7 days, and a remarkable recovery of colorectal mucosa was evident after 14 days of treatment. The amelioration of colon pathology co-existed with a significant decrease in MPO expression, overexpression of iNOS and reduction of nuclear NF-κB p65 in inflammatory cells, and the suppression of apoptosis in colonic epithelial cells. The simultaneous administration of Mesna and n-3 PUFAs is particularly effective in ameliorating DSS colitis in rats, by reducing oxidative stress, inflammation and apoptosis, probably through a mechanism that involves the inhibition of NF-κB and overexpression of iNOS., (© 2016 The Authors. International Journal of Experimental Pathology © 2016 International Journal of Experimental Pathology.)
- Published
- 2015
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19. The effect of glutamine and synbiotics on the healing of colonic anastomosis.
- Author
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Sapidis N, Tziouvaras C, Ioannidis O, Kalaitsidou I, and Botsios D
- Subjects
- Animals, Biomechanical Phenomena, Female, Male, Rats, Rats, Wistar, Wound Healing, Anastomosis, Surgical, Colon surgery, Glutamine therapeutic use, Postoperative Care methods, Synbiotics
- Abstract
Introduction: Intestinal wound healing is an essential process for surgical reconstruction of the digestive tract. The purpose of this study is to evaluate the effect of perioperative administration of glutamine and synbiotics on the biological behavior of intestinal mucosal barrier and the healing of colonic anastomosis in rats., Material and Methods: 80 Wistar rats were divided in five groups. A: Control. B: Mechanical bowel preparation and antibiotics.C: Glutamine. D: Synbiotics. E: Glutamine and synbiotics. The animals were sacrificed on 3rd and 7th postoperative day., Results: Zero mortality and no septic complications were noted. On 3rd postoperative days, a significant weight loss was observed in all groups in comparison with the preoperative weights, but on the 7th day in groups C and E, in contrast with the other groups, weight loss was not significant. On the 3rd postoperative day, neoangiogenesis, inflammatory infiltration and fibroblast activity were significantly enhanced in group E compared to control. On the 7th postoperative day in group E fibroblast activity was significantly enhanced and inflammatory infiltration was significantly limited compared to control. The bursting pressures as well as the hydroxyproline tissue content were significantly higher in the group E on 3rd and 7th postoperative days. The percentage of positive mesenteric lymph node cultures were significantly limited in group E compared to control., Conclusions: The administration of synbiotics in conjunction with glutamine resulted in increasing the mechanical strength of the anastomosis, thus increasing the bursting pressure and decreasing or effacing of anastomotic dehiscence and limiting bacterial translocation.
- Published
- 2014
20. Artificial nutrition and intestinal mucosal barrier functionality.
- Author
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Anastasilakis CD, Ioannidis O, Gkiomisi AI, and Botsios D
- Subjects
- Bombesin immunology, Bombesin therapeutic use, Food, Formulated, Glutamine immunology, Glutamine therapeutic use, Humans, Immunity, Mucosal, Intestinal Mucosa immunology, Multiple Organ Failure prevention & control, Neurotransmitter Agents therapeutic use, Systemic Inflammatory Response Syndrome prevention & control, Bacterial Translocation immunology, Enteral Nutrition, Intestinal Mucosa physiology, Multiple Organ Failure immunology, Parenteral Nutrition Solutions standards, Parenteral Nutrition, Total, Systemic Inflammatory Response Syndrome immunology
- Abstract
The gastrointestinal tract has a major role in digestion and absorption of nutrients while playing a leading role in defense of the body. It forms a shield against the invasion of various microorganisms or their products (e.g. antigens, toxins) and therefore it is important to establish its integrity and functionality. That depends on the route of administration and the composition of the artificial nutrition. This study concentrates on the influences of different kinds of artificial nutrition in the functionality of the intestinal mucosal barriers. It seems that full macromolecular solutions of enteral nutrition ensure an adequate mucous immune response, while a lack of nutritional stimulus in the lumen leads rapidly to a dysfunction of gastric-associated lymphatic tissue and mucosal immune system. This dysfunction renders the patients susceptible to infections in distant organs, hospital pneumonia, and multiorgan failure of non-infectious etiology. In patients with indication of total parenteral nutrition administration, addition of bombesin or glutamine preserves mucosal immune response and may limit the adverse effects., (© 2013 S. Karger AG, Basel.)
- Published
- 2013
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21. Diagnostic and therapeutic review of cystic parathyroid lesions.
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Pontikides N, Karras S, Kaprara A, Cheva A, Doumas A, Botsios D, Moschidis A, Efthimiou E, Wass J, and Krassas G
- Subjects
- Adenoma diagnosis, Adenoma pathology, Adenoma surgery, Adult, Aged, 80 and over, Algorithms, Biopsy, Needle, Cysts surgery, Female, Humans, Hypercalcemia diagnosis, Male, Middle Aged, Parathyroid Diseases pathology, Parathyroid Glands pathology, Parathyroid Neoplasms diagnosis, Parathyroid Neoplasms pathology, Parathyroid Neoplasms surgery, Cysts diagnosis, Parathyroid Diseases diagnosis, Parathyroid Diseases surgery, Parathyroid Hormone blood
- Abstract
Background: Parathyroid cysts (PC) are uncommon entities in routine clinical practice. The vast majority are nonfunctioning and are commonly present as asymptomatic nodular cervical lesions. PC should be considered in the differential diagnosis of an asymptomatic neck mass. Large PC can manifest with compressive symptoms of the surrounding tissues., Objective: The aim of this study is to describe nine new cases of PC and review the current literature regarding the clinical presentation, the aetiopathology, the diagnostic procedures, as well as the therapeutic approaches for this relatively rare clinical entity. METHODS-PATIENTS: We present nine new patients (7 females and 2 males) diagnosed with PC, which in three were ectopic. The diagnosis of PC was based on the elevated levels of PTH in the cysts fluid. Six of the patients had nonfunctioning parathyroid lesions, while the other three had functioning ones. Patients with functioning PC had elevated serum calcium and PTH levels. Five out of nine of the cases had no symptoms, while two patients had compressive symptoms and the other two had signs and symptoms of hypercalcaemia. Needle aspiration (NA) was performed in five out of six patients with nonfunctioning PC. Surgery was the treatment in all three patients with functioning PC., Results: Remission after NA was achieved in four out of five patients with non-functioning PC (follow-up time: 17.7±2.3 months). In two of them, two and three aspirations were needed. One patient with nonfunctioning PC submitted to surgery with no previous NA. Patients with functioning PC maintained remission after surgery (mean follow-up time: 22.1±2.9 months). In one of them, a second surgery was performed due to the co-existence of an ectopic parathyroid adenoma., Conclusions: The diagnosis of a PC can be established by finding high levels of PTH in the fluid collected by the aspiration of the cyst. PTH and Ca levels in the serum can differentiate functioning from nonfunctioning PC. The treatment of choice in nonfunctioning cysts is aspiration. Surgical removal of the cyst is indicated in hyperfunctioning cysts in cases of relapse after NA in nonfunctioning cysts and when compressive symptoms are present. Based on our series, which appears to be one of the largest reported, we propose a diagnostic algorithm to guide the diagnostic and therapeutic approach to PC.
- Published
- 2012
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22. Omega 3 fatty acids supplementation has an ameliorative effect in experimental ulcerative colitis despite increased colonic neutrophil infiltration.
- Author
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Varnalidis I, Ioannidis O, Karamanavi E, Ampas Z, Poutahidis T, Taitzoglou I, Paraskevas G, and Botsios D
- Subjects
- Animals, Blood Cell Count, Body Weight drug effects, Colitis, Ulcerative chemically induced, Colitis, Ulcerative pathology, Colon pathology, Dextran Sulfate, Immunohistochemistry, Intestinal Mucosa pathology, Male, Peroxidase metabolism, Rats, Rats, Wistar, Tissue Fixation, Colitis, Ulcerative drug therapy, Fatty Acids, Omega-3 therapeutic use, Neutrophil Infiltration drug effects
- Abstract
Purpose: omega 3 polyunsaturated fatty acids have anti-inflammatory properties and can be beneficial in the treatment of inflammatory diseases, such as ulcerative colitis. Dextran sodium sulphate (DSS) colitis in rats appears to mimic nearly all of the morphological characteristics and lesion distributions of ulcerative colitis. The purpose of the current study was to investigate the efficacy of omega 3 fatty acids in the treatment of experimental ulcerative colitis., Methods: thirty-six Wistar rats were randomly assigned to group A or group B receiving 5% dextran sulfate sodium (DSS) in their drinking water for eight days. For the next eight days post-DSS, group A animals received tap-water, and group B animals were fed a nutritional solution containing high levels of omega 3 polyunsaturated fatty acids (ProSure®, Abbott Laboratories, Zwolle, Netherlands) once per day, administrated with a orogastric feeding tube., Results: animals fed an omega 3 rich diet exhibited a statistically significant increase in hematocrit and hemoglobin levels, compared to animals drinking tap water, and a trend towards histopathological and clinical improvement, with the administration of omega 3 fatty acids ameliorating epithelial erosion by day 8 post-DSS, but no statistically significant difference was observed between group A and group B animals at 4 or 8 days post-DSS. Also, a statistically significant increase in neutrophil infiltration was observed, as depicted by myelohyperoxidase activity., Conclusion: our findings support a positive role of omega 3 polyunsaturated fatty acids supplementation in an experimental model of ulcerative colitis despite the increased colonic neutrophil infiltration. Further studies are needed in order to investigate the role of increased neutrophils in colonic mucosa.
- Published
- 2011
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23. Subcapsular liver biloma due to gallbladder perforation after acute cholecystitis.
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Kalfadis S, Ioannidis O, Botsios D, and Lazaridis C
- Subjects
- Aged, Aged, 80 and over, Humans, Male, Bile, Cholecystitis, Acute complications, Gallbladder Diseases complications, Liver Diseases etiology
- Published
- 2011
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24. Nutritional modulation of the inflammatory bowel response.
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Ioannidis O, Varnalidis I, Paraskevas G, and Botsios D
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- Amino Acids therapeutic use, Animals, Antioxidants therapeutic use, Colitis, Ulcerative physiopathology, Crohn Disease physiopathology, Humans, Intestine, Large microbiology, Intestine, Large physiopathology, Lipids therapeutic use, Oxidative Stress drug effects, Prebiotics, Probiotics therapeutic use, Colitis, Ulcerative etiology, Colitis, Ulcerative therapy, Crohn Disease etiology, Crohn Disease therapy, Intestine, Large immunology
- Abstract
Crohn's disease and ulcerative colitis represent distinct phenotypic forms of inflammatory bowel disease and continue to be a common cause of morbidity. The corticosteroids and the immunomodulatory drugs, which are the basis of treatment for the inflammatory bowel diseases, do not assure always satisfactory outcomes. Nutrition has been used in order to modify the inflammatory response of various chronic inflammatory diseases, including Crohn's disease and ulcerative colitis. In the pathogenesis of inflammatory bowel diseases, the intestinal microflora and the intestinal mucosal disorders play a crucial role. Also, the release of reactive oxygen species is a significant factor of initiation and preservation of the inflammatory reaction in these diseases. The advantages of the nutritional treatment derive from the sequestration of intraluminal agents which may promote the inflammatory bowel response or, alternatively, nutrition is able to modify the immune response, reducing the uncontrolled inflammatory reaction. Furthermore, nutrition can enhance the mucosal barrier function and consists a significant source of antioxidants. This review focuses on certain nutritional components that modulate the inflammatory response of the bowel and aims to present a rational thesis regarding the use of nutritional agents in the management of inflammatory bowel diseases., (Copyright © 2011 S. Karger AG, Basel.)
- Published
- 2011
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25. Nutrition support in acute pancreatitis.
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Ioannidis O, Lavrentieva A, and Botsios D
- Subjects
- Contraindications, Dietary Supplements, Humans, Inpatients, Malnutrition etiology, Pancreatitis complications, Enteral Nutrition methods, Malnutrition prevention & control, Pancreatitis physiopathology, Parenteral Nutrition methods
- Abstract
In the majority (80%) of patients with acute pancreatitis, the disease is self limiting and, after a few days of withholding feeding and intravenous administration of fluids, patients can again be normally fed orally. In a small percentage of patients, the disease progresses to severe necrotic pancreatitis, with an intense systemic inflammatory response and often with multiple organ dysfunction syndrome. As mortality is high in patients with severe disease and as mortality and morbidity rates are directly related to the failure of establishing a positive nitrogen balance, it is assumed that feeding will improve survival in patients with severe disease. The aim of nutritional support is to cover the elevated metabolic demands as much as possible, without stimulating pancreatic secretion and maximizing self-digestion. The administration of either total parenteral nutrition or jejunal nutrition does not stimulate pancreatic secretion. Recently, a series of controlled clinical studies has been conducted in order to evaluate the effectiveness of enteral nutrition with jejunal administration of the nutritional solution. The results have shown that enteral nutrition, as compared to total parenteral nutrition, was cheaper, safer and more effective as regards the suppression of the immunoinflammatory response, the decrease of septic complications, the need for surgery for the management of the complications of acute pancreatitis and the reduction of the total hospitalization period. It did not seem to affect mortality or the rate of non-septic complications. In conclusion, enteral nutrition should be the preferred route of nutritional support in patients with acute pancreatitis.
- Published
- 2008
26. Reliability of selective surveillance colonoscopy in the early diagnosis of colonic ischemia after successful ruptured abdominal aortic aneurysm repair.
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Megalopoulos A, Vasiliadis K, Tsalis K, Kapetanos D, Bitzani M, Tsachalis T, Batziou E, and Botsios D
- Subjects
- Aged, Aneurysm, Ruptured mortality, Aortic Aneurysm, Abdominal mortality, Colectomy, Early Diagnosis, Female, Humans, Ischemia etiology, Ischemia mortality, Ischemia surgery, Male, Odds Ratio, Patient Selection, Predictive Value of Tests, Reproducibility of Results, Risk Assessment, Risk Factors, Severity of Illness Index, Treatment Outcome, Aneurysm, Ruptured surgery, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis Implantation adverse effects, Colon blood supply, Colonoscopy, Ischemia diagnosis
- Abstract
Purpose: To evaluate the reliability of selective surveillance colonoscopy based on 6 specific perioperative risk factors in the early diagnosis of colonic ischemia (CI) after successful ruptured abdominal aortic aneurysm (rAAA) repair., Patients and Methods: From 1999 to 2005, 62 consecutive patients underwent rAAA repair. In 59 of them, routine aggressive surveillance colonoscopy was offered every 12 hours within the first 48 hours, and CI was graded consistently. Patients with stage I or stage II CI were treated conservatively and were followed up with repeat colonoscopy, whereas patients with stage III CI underwent immediate laparotomy and colectomy. In parallel, 6 specific perioperative risk factors (PRFs) were retrospectively analyzed., Results: Overall mortality was 33.9%. Nineteen patients (32.2%) developed CI and 12 (63.2%) of them survived. Thirteen (22%) had grade III CI and among these 6 survived. In patients with CI the mortality rate was 36.2%. Patients with less than 3 PRFs had no CI whereas all instances of CI could be diagnosed if colonoscopy was offered selectively in patients with more than 3 PRFs. The positive predictive value of CI increased with the number of PRFs. Patients with 5 or 6 PRFs were about 101 times more likely to develop CI compared with patients with 0 to 4 PRFs (P<.001)., Conclusion: Our study showed that CI is a frequent complication after successful rAAA repair and could reliably be early diagnosed if surveillance colonoscopy was offered selectively in patients with more than three PRFs.
- Published
- 2007
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27. A single-center experience in the management of Altemeier-Klatskin tumors.
- Author
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Tsalis K, Vasiliadis K, Kalpakidis V, Christoforidis E, Avgerinos A, Botsios D, Megalopoulos A, Haidich AB, and Betsis D
- Subjects
- Adult, Aged, Aged, 80 and over, Anastomosis, Surgical methods, Bile Duct Neoplasms diagnosis, Bile Duct Neoplasms mortality, Cholangiopancreatography, Endoscopic Retrograde, Cholangiopancreatography, Magnetic Resonance, Female, Follow-Up Studies, Hepatic Duct, Common, Humans, Kaplan-Meier Estimate, Klatskin Tumor diagnosis, Klatskin Tumor mortality, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Survival Rate, Tomography, X-Ray Computed, Treatment Outcome, Bile Duct Neoplasms surgery, Hepatectomy methods, Klatskin Tumor surgery
- Abstract
Aim: of this study is to present our experience in the management of patients with Altemeier-Klatskin tumor, with particular focus on the risk factors that influence survival after tumor resection., Methods: Over a 15-year period, 37 patients with hilar cholangiocarcinoma were managed in our Department. The mean age of the patients was 62.5 years. Twenty-one patients were treated by palliative measures while sixteen patients had resection of the tumor and 11 of these had negative histological margins. An associated major hepatectomy was performed in six. In parallel, certain risk factors that could influence survival were analyzed., Results: The resectability rate was 43.2%. The 30-day mortality rate was 7.4% and postoperative morbidity was 37.5%. The sites of the resected tumors were Bismuth-Corlette type I lesions in 3 patients, type II in 6, type IIIa in 2, and type IIIb in 5. The median survival of patients undergoing resection was significantly higher than of patients not undergoing resection (p<0.001). Furthermore, patients with R0 resection and histological clear margins experienced significantly superior survival than patients with R1 resection and positive margins (p=0.001, and p<0.001 respectively). Resections resulting in cancer-positive margins did not portend a survival benefit., Conclusion: Negative surgical margins, tumor differentiation and infiltrating macroscopic appearance, were statistically significant prognostic factors. Our findings emphasize that complete resection of the tumor with negative histological margins offers the best possibility of long-term survival, and that the addition of hepatectomy to biliary resection results in a greater number of patients with margin negative resections.
- Published
- 2007
28. Management of nonfunctioning pancreatic endocrine tumors in the context of multiple endocrine neoplasia type 1 syndrome.
- Author
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Botsios D, Vasiliadis K, Tsalis K, Iordanidis F, Megalopoulos A, Tsachalis T, Blouhos K, and Betsis D
- Subjects
- Adolescent, Adult, Chemotherapy, Adjuvant, Drug Therapy, Combination, Endosonography, Female, Fluorouracil administration & dosage, Fluorouracil therapeutic use, Follow-Up Studies, Humans, Immunohistochemistry, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Endocrine Neoplasia Type 1 diagnosis, Multiple Endocrine Neoplasia Type 1 drug therapy, Multiple Endocrine Neoplasia Type 1 pathology, Pancreas pathology, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms pathology, Streptozocin administration & dosage, Streptozocin therapeutic use, Time Factors, Tomography, X-Ray Computed, Multiple Endocrine Neoplasia Type 1 surgery, Pancreatectomy, Pancreatic Neoplasms surgery
- Abstract
Unlabelled: The aim of our study is to present our experience in the surgical treatment of nonfunctioning pancreatic endocrine tumors (NFPETs) in patients with multiple endocrine neoplasia type 1 (MEN-1)., Patients and Method: Between 1996 and 2006 a total of 11 patients with clinically confirmed MEN 1 syndrome were monitored in an annual screening program that included evaluation of the pancreas. Our policy was to use Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Endoscopic Ultrasound (EUS) in combination with biochemical screening in an effort to early diagnose and categorize the pancreatic involvement in MEN-1., Results: NFPETs were identified in 4 female patients (36.4%). Diagnosis of NFPET was established 4.2 years later than that of MEN 1. The median tumor diameter at diagnosis was 2.2 cm (range 1.8-2.6 cm). All patients were treated by distal pancreatectomy. Diagnosis of NFPET was established in histological sections by staining with neuroendocrine tumor markers. Adjuvant therapy with streptozocin in combination with 5-fluorouracil was applied in two patients. After surgery the patients were followed up annually with clinical evaluation, biochemical tests and imaging studies., Conclusions: Early detection of NFPETs in patients with MEN-1 syndrome can be accomplished by biochemical and radiological screening program. NFPETs should be removed when diagnosed, in order to achieve a timely and efficient prophylaxis against further tumor growth and malignant development.
- Published
- 2007
29. Uncontrollable intra-abdominal bleeding necessitating low anterior resection of the rectum after stapled hemorrhoidopexy: report of a case.
- Author
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Blouhos K, Vasiliadis K, Tsalis K, Botsios D, and Vrakas X
- Subjects
- Adult, Colectomy, Gastrointestinal Hemorrhage etiology, Humans, Male, Digestive System Surgical Procedures adverse effects, Gastrointestinal Hemorrhage surgery, Hemorrhoids surgery, Surgical Stapling adverse effects
- Abstract
Stapled hemorrhoidopexy (SH) has become a widely accepted surgical procedure for hemorrhoids; however, one of the most serious complications of this technique is severe bleeding. We report a case of extensive hemoperitoneum after SH for third-degree hemorrhoids. On postoperative day (POD) 1, the patient complained of severe abdominal pain and clinical signs of peritonitis soon became evident. Computed tomography (CT) showed blood in the abdomen. We performed an emergency exploratory laparotomy, which revealed extensive hemoperitoneum, and a devitalized, edematous rectum with a tense hematoma, approximately 1 cm above the staple line and extending up to the level of the peritoneal reflection. We also found a small seromuscular laceration in the anterior aspect of the rectum just above the peritoneal reflection. This small laceration was bleeding actively. Thus, we performed a low anterior resection and the patient was discharged from hospital 10 days later. We report this case to raise awareness of the possibility of life-threatening intra-abdominal complications without evidence of typical rectal bleeding.
- Published
- 2007
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30. Adrenocortical oncocytoma -- a rare tumor of undefined malignant potential: report of a case.
- Author
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Botsios D, Blouhos K, Vasiliadis K, Asimaki A, Tsalis K, and Betsis D
- Subjects
- Adenoma, Oxyphilic surgery, Adrenal Cortex Neoplasms surgery, Adrenalectomy, Adult, Biopsy, Fine-Needle, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Adenoma, Oxyphilic diagnosis, Adrenal Cortex Neoplasms diagnosis
- Abstract
Adrenocortical oncocytomas are exceptionally rare. To our knowledge, only 23 cases have been reported in the world literature, most of which were benign and nonfunctioning. We report a case of adrenocortical oncocytoma diagnosed by pathological examination of an extirpated right adrenal mass in a young woman. We discuss this case and review the literature on this unusual entity.
- Published
- 2007
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31. Pseudoaneurysm of the popliteal artery complicated by peroneal mononeuropathy in a 4-year-old child: report of a case.
- Author
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Megalopoulos A, Vasiliadis K, Siminas S, Givissis P, Vargiami E, Zafeiriou D, Botsios D, and Betsis D
- Subjects
- Aneurysm, False surgery, Child, Preschool, Humans, Male, Mononeuropathies physiopathology, Peroneal Neuropathies physiopathology, Popliteal Artery surgery, Aneurysm, False etiology, Mononeuropathies complications, Peroneal Neuropathies complications, Popliteal Artery pathology, Wounds, Nonpenetrating complications
- Abstract
Pseudoaneurysms of the popliteal artery (PPA) rarely occur in children. In fact, we found only 10 cases reported in the medical literature. We report the case of a 4-year-old boy who presented with a painful palpable mass in the right popliteal fossa. He also had mild, painless right foot-drop and difficulty toe-walking on the same side. The diagnosis of a PPA was based on the findings of triplex ultrasound and computed tomographic-angiography. We attributed the cause of the lesion to blunt trauma, which he had suffered 2 years earlier. Thorough preoperative evaluation excluded the possibility of a self-immune process or a bone tumor in the region. Neurological examination demonstrated a mild, isolated, peripheral mononeuropathy of the right peroneal nerve. Thus, we performed surgical repair using an autologous reversed great saphenous vein graft. The patient had an uneventful postoperative course and his peripheral neuropathy and foot-drop resolved completely within 1 month after surgery. Now, after 3 years of follow-up, the patient has a patent graft and a fully functioning limb. PPAs are rare, especially in children, and trauma is the predominating underlying cause. PPAs should be treated immediately after diagnosis because their complications are associated with high rates of functional impairment and even limb loss.
- Published
- 2007
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32. Our local experience with the surgical treatment of ampullary cancer.
- Author
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Botsios D, Zacharakis E, Lambrou I, Tsalis K, Christoforidis E, Kalfadis S, Zacharakis E, Betsis D, and Dadoukis I
- Abstract
Background: The aim of this study is to report the outcome after surgical treatment of 32 patients with ampullary cancers from 1990 to 1999., Methods: Twenty-one of them underwent pancreaticoduodenectomy and 9 local excision of the ampullary lesion. The remaining 2 patients underwent palliative surgery., Results: When the final histological diagnosis was compared with the preoperative histological finding on biopsy, accurate diagnosis was preoperatively established in 24 patients. The hospital morbidity was 18.8% as 9 complications occurred in 6 patients. Following local excision of the ampullary cancer, the survival rate at 3 and 5 years was 77.7% and 33.3% respectively. Among the patients that underwent Whipple's procedure, the 3-year survival rate was 76.2% and the 5-year survival rate 62%., Conclusion: In this series, local resection was a safe option in patients with significant co-morbidity or small ampullary tumors less than 2 cm in size, and was associated with satisfactory long-term survival rates.
- Published
- 2005
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33. Endoscopic management of retained bile stones with an indwelling T-tube.
- Author
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Christoforidis E, Vasiliadis K, Goulimaris I, Botsios D, Tsorlini H, and Betsis D
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Treatment Failure, Choledocholithiasis surgery, Prostheses and Implants, Sphincterotomy, Endoscopic
- Abstract
Background: Endoscopic sphincterotomy (ES) is widely used for the treatment of residual bile duct stones in patients who had common bile duct (CBD) exploration and T-tube insertion., Methods: In a 4-year period 45 patients were referred for endoscopic removal of residual bile duct stones. All patients had been operated 7-15 days earlier for choledocholithiasis and had a T-tube in the common bile duct (CBD)., Results: Four patients were excluded. Three patients had a periampullary carcinoma and the fourth patient had no residual stone seen at cholangiography. All patients had a successful ES, conventional in 34, precut-knife in 3, and with the rendezvous technique in 4 patients. In 24 patients, all having stones distal to the T-tube, complete clearance of the CBD was achieved during one session and the T-tube was removed after 48 h. In the remaining 17 patients (15 having stones proximal to the T-tube), the T-tube had to be removed first and following stone extraction, a plastic stent was inserted in the CBD. Complete bile duct clearance and stent removal was achieved in a second session 3-4 weeks later. There were no serious complications or biliary related symptoms after the procedures and after a mean follow-up period of 18 months., Conclusion: The endoscopic technique is safe and efficient for the treatment of residual stones after CBD exploration with a T-tube insertion, offering immediate cure compared to the percutaneous techniques. It is also an ideal method for the diagnosis of periampullary carcinomas.
- Published
- 2004
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34. Current treatment of colorectal liver metastases.
- Author
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Tsalis K, Vasiliadis K, Christoforidis E, Vergos O, Angelopoulos S, Botsios D, and Betsis D
- Subjects
- Adenocarcinoma mortality, Adenocarcinoma pathology, Adenocarcinoma therapy, Aged, Chemotherapy, Adjuvant, Colorectal Neoplasms mortality, Colorectal Neoplasms therapy, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Risk Assessment, Sampling Studies, Survival Analysis, Treatment Outcome, Adenocarcinoma secondary, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Colorectal Neoplasms pathology, Hepatectomy methods, Liver Neoplasms secondary, Liver Neoplasms therapy
- Abstract
Background: The aim of our study is to present our experience in the treatment of liver metastases in patients with colorectal cancer., Patients and Methods: Between 1997 and 2003 a total of 12 patients with liver metastases from a primary colorectal cancer were treated in our department. They were 8 males and 4 females with a median age of 64 years (range 56-70 years)., Results: Ten patients underwent liver resection. The surgical procedures were 4 major hepatectomies (3 right hepatectomies, 1 left lobectomy) and 9 wedge liver resections. In total, 16 metastatic lesions were resected. Already at the time of the primary tumour, 5 patients presented with a synchronous liver metastasis. In 3 of them, liver metastasis was resected together with the primary tumour, and in the rest, resection was performed 1 month after the initial operation. In 5 patients liver metastases were metachronous and were diagnosed 3-14 months after the initial operation. The median survival of the patients was 39 months. Two patients (one with 2 metastatic lesions) underwent radiofrequency ablation (RFA) of the metachronous metastatic lesions and remain well 3-6 months postoperatively., Conclusions: Hepatectomy is the treatment of choice for hepatic metastasis of colorectal cancer, whenever feasible. Recent promising treatments such as RFA can further improve the outcome of these patients.
- Published
- 2004
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35. Extramedullary hemopoiesis in a thyroid nodule with extensive bone metaplasia and mature bone formation.
- Author
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Pontikides N, Botsios D, Kariki E, Vassiliadis K, and Krassas GE
- Subjects
- Adult, Female, Humans, Metaplasia pathology, Ossification, Heterotopic pathology, Osteogenesis, Thyroid Nodule surgery, Thyroid Nodule ultrastructure, Thyroidectomy, Bone and Bones pathology, Hematopoiesis, Extramedullary physiology, Thyroid Nodule pathology
- Abstract
Thyroid nodules may undergo a wide range of degenerative change such as infarction, hemorrhage, or fibrosis, which may be localized or extensive and associated with calcification or even ossification. However, the detection of true bone formation in a thyroid nodule is a very rare occurrence. Extramedullary hemopoiesis (EMH) has been described in almost every organ of the body, mainly in tissues active in hemopoiesis in embryonic life. It is extremely rare for EMH to occur in the thyroid gland especially in patients without known chronic anemia. We describe a case of a cold thyroid nodule with histologically proven extensive bone metaplasia and formation of mature bone with foci of hemopoietic tissue in a young woman without chronic anemia, which, to the best of our knowledge, is the first to be reported in the English language literature.
- Published
- 2003
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36. Laparoscopic cholecystectomy in two patients with symptomatic cholelithiasis and situs inversus totalis.
- Author
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Demetriades H, Botsios D, Dervenis C, Evagelou J, Agelopoulos S, and Dadoukis J
- Subjects
- Adult, Cholecystitis diagnostic imaging, Cholecystitis surgery, Cholelithiasis diagnostic imaging, Female, Humans, Male, Middle Aged, Situs Inversus diagnostic imaging, Tomography, X-Ray Computed, Cholecystectomy, Laparoscopic, Cholelithiasis surgery, Situs Inversus surgery
- Abstract
Background: Situs inversus viscerum is a rare condition with a genetic predisposition. We report 2 patients with situs inversus totalis and symptomatic cholelithiasis successfully treated via laparoscopic cholecystectomy., Patients and Methods: The first patient was a 61-year-old female presenting with pain in the left upper quadrant associated with fever, chills, nausea and vomiting. The abdomen was tender with guarding and rebounding pain in the same region. Abdominal ultrasound and CT scan confirmed the diagnosis of gallstones as well as situs inversus with the liver and gallbladder on the left side and the spleen on the right. The second patient was a 37-year-old male with known situs inversus who presented with biliary colic due to cholelithiasis. In both patients cholecystectomy was performed laparoscopically in a reverse fashion., Results: Laparoscopic cholecystectomy was carried out successfully despite the reversed anatomic relationships and both patients made a smooth recovery., Conclusion: Cholelithiasis occurring with situs inversus totalis is rare and may present a diagnostic problem. Laparoscopic cholecystectomy can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.
- Published
- 1999
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37. Effect of early postoperative enteral feeding on the healing of colonic anastomoses in rats. Comparison of three different enteral diets.
- Author
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Demetriades H, Botsios D, Kazantzidou D, Sakkas L, Tsalis K, Manos K, and Dadoukis I
- Subjects
- Animals, Diet, Dietary Fiber administration & dosage, Glutamine administration & dosage, Rats, Rats, Wistar, Rupture etiology, Time Factors, Tissue Adhesions etiology, Wound Healing, Anastomosis, Surgical adverse effects, Colon surgery, Enteral Nutrition
- Abstract
This experimental study compares the effects of early postoperative administration of three enteral diets of different compositions on the healing of colonic anastomoses. Sixty Wistar rats were subjected to colonic anastomoses. Following surgery, the rats were randomly allocated to four groups of 15 each. The rats in control group A received an electrolyte and glucose solution, the rats in group B received a complete balanced nutrition, in group C a complete balanced nutrition supplemented with fiber and in group D an isocaloric specialized elemental nutrition enriched with glutamine. The rats were sacrificed on day 7 following operation. Rupture of the anastomosis was higher in rats of the control group compared to the other three groups. Adhesion formation was more extensive in group A in comparison to the other three groups. The anastomotic bursting pressures were statistically significantly higher in groups C and D compared to the other two groups (p < 0.05). There was no statistically significant difference between group C and D (p > 0.05) while a statistically significant difference was noted between group B and group A (p < 0.05). Histological examination showed more profound inflammatory reaction in group A compared to the other three groups. There was also a statistically significant difference between group B and groups C and D while inflammatory reaction was of no statistically significant difference between group C and group D. Healing of the anastomoses was statistically significantly impaired in group A compared to the other three groups. There was no statistically significant difference between group C and group D while a statistically significant difference was found between group B and groups C and D. In conclusion, early postoperative enteral feeding improves healing of experimental colonic anastomoses in rats. This effect was more evident when fiber-supplemented diets or diets enriched with glutamine were administered.
- Published
- 1999
- Full Text
- View/download PDF
38. Management of large rectal wall defects with open pedicle grafts of small intestine. An experimental study.
- Author
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Demetriades C, Botsios D, Tsalis K, Manafis K, Zisiadis A, and Dadoukis J
- Subjects
- Animals, Disease Models, Animal, Dogs, Female, Follow-Up Studies, Graft Survival, Intestinal Mucosa pathology, Male, Rectum injuries, Suture Techniques, Wound Healing physiology, Intestine, Small transplantation, Rectum surgery, Tissue Transplantation methods
- Abstract
The aim of this study was to evaluate the possible repair of large rectal wall defects using an open pedicle ileal graft as a mucosal patch. This experiment was carried out in 14 adult mongrel dogs. By excision of a portion of the antimesenteric wall comprising 50-70% of the circumference and measuring 5-6 cm in length, a suitable full thickness defect was created in the lower part of the rectum. A segment of the distal ileum was then isolated on a mesenteric pedicle and opened from its antimesenteric border. This was sutured over the defect in two layers. The animals were observed for a period of 15 days to 12 months. All the animals survived the operation apart from 1 dog that died of fecal peritonitis. Function of the rectum generally remained normal. Barium X-ray did not show any obstruction, shrinkage of the patch, lumen dilatation or extravasation. At the time of autopsy pedicles of ileal grafts appeared intact and pulsating. On gross examination there was no evidence of focal hemorrhage, ulceration or any cicatricial thickening of the grafts. Healing was good and the ileal mucosa retained its villi and general characteristics without any major inflammatory reactions. There was an increase in the number of goblet cells which returned to normal in 6 months.
- Published
- 1998
- Full Text
- View/download PDF
39. External biliary fistula.
- Author
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Dadoukis J, Prousalidis J, Botsios D, Tzartinoglou E, Apostolidis S, Papadopoulos V, and Aletras H
- Subjects
- Biliary Fistula mortality, Biliary Fistula surgery, Humans, Postoperative Complications, Biliary Fistula etiology, Biliary Fistula therapy
- Abstract
We report 210 cases of external biliary fistula treated in our clinics between 1970-1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases after exploration of common bile duct, in 4 cases due to disruption of biliary-intestinal anastomosis, and in 2 cases due to liver trauma. In 85 cases bile leak was observed after cholecystomy, in 103 cases after hydatid disease surgery, and in 4 cases after the passage of P.T.C. catheter. In one patient the appearance of the fistula was due to spontaneous discharge of a gallbladder empyema. 173 cases were managed conservatively, and 37 cases surgically.
- Published
- 1998
- Full Text
- View/download PDF
40. Splanchnic ischemia during laparoscopic cholecystectomy.
- Author
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Eleftheriadis E, Kotzampassi K, Botsios D, Tzartinoglou E, Farmakis H, and Dadoukis J
- Subjects
- Adult, Female, Humans, Liver Circulation, Middle Aged, Pneumoperitoneum, Artificial adverse effects, Cholecystectomy, Laparoscopic adverse effects, Ischemia etiology, Splanchnic Circulation physiology
- Abstract
Background: Experimental studies have shown that elevation of intraabdominal pressure by means of gas insufflation produces hemodynamic disturbances in the peritoneal viscera, leading to splanchnic ischemia. The purpose of this clinical investigation is to reproduce the experimental data in humans undergoing laparoscopic cholecystectomy., Methods: Sixteen females participated in this study. Eight of them (the control group) were subjected to open laparotomy for biliary surgery, while on the remaining eight laparoscopic cholecystectomy was performed. In all patients hepatic microcirculation was registered during the time of operation using the laser-Doppler technique. A single-fiber laser-Doppler microprobe was introduced transcutaneously within the hepatic parenchyma, through a Chiba needle, under direct or laparoscopic vision. Additionally, gastric intramucosal/intramural pH, a low level of which indicates tissue ischemia, was assessed by means of a tonometric nasogastric catheter. Hepatic microcirculation and gastric intramucosal/intramural pH were assessed between controls and pneumoperitoneum-subjected patients, and within the laparoscopic surgery group, i.e., during pneumoperitoneum and after abdominal deflation., Results: Hepatic microcirculation was found to be significantly decreased in laparoscopic surgery patients in relation to controls (22.21 +/- 5.48 vs 57.52 +/- 18.06 perfusion units of flow, P = 0.0001) as was gastric intramural pH (7.15 +/- 0.16 vs 7.37 +/- 0.02, P = 0.003). Similarly, immediately after abdominal deflation, hepatic microcirculation exhibited a sudden elevation (22.21 +/- 5.48 vs 67.49 +/- 7.93 perfusion units of flow, P = 0.0001), while gastric intramural pH return to its normal values (7.15 +/- 0.16 vs 7.43 +/- 0.07, P = 0.0001)., Conclusions: It is concluded that during laparoscopic cholecystectomy abdominal organs are hypoperfused, leading to a splanchnic ischemia environment. The clinical significance of these events remains to be clarified.
- Published
- 1996
- Full Text
- View/download PDF
41. Ultrastructural alterations of the rat intestinal epithelium fed with polymeric, oligopeptidic or elementary full diet, following starvation.
- Author
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Botsios D, Economou L, Manthos A, Tsolaki M, Sioga A, Agelopoulos S, Dadoukis I, and Foroglou C
- Subjects
- Amino Acids pharmacology, Animals, Endoplasmic Reticulum drug effects, Endoplasmic Reticulum ultrastructure, Epithelium drug effects, Epithelium ultrastructure, Intestinal Mucosa drug effects, Jejunum drug effects, Jejunum ultrastructure, Male, Microvilli drug effects, Microvilli ultrastructure, Rats, Rats, Wistar, Weight Gain drug effects, Dietary Proteins pharmacology, Food, Formulated, Intestinal Mucosa ultrastructure, Oligopeptides pharmacology, Starvation pathology
- Abstract
In this study the ultrastructure of rat jejunal epithelial cells was examined, following a starvation period of 72 hours and an enteral refeeding period of 12 days, with either Nutrison, Pepti 2000, or Nutri 2000. Most changes occurred in the animals examined immediately after the 72-hour starvation period; these mainly included a significant decrease in microvilli population, occasional cell membrane disintegration, and a usual microvesicular appearance and degranulation of the rough endoplasmic reticulum. No alterations were found in the normally-fed animals (control group). This was also practically the same for the Pepti 2000 group. In the Nutrison group, a small amount of changes were found, while in the Nutri 2000 group many alterations were detected, which nevertheless were fewer than in the starved animals. The results demonstrate that the micromorphological alterations of the intestinal epithelium caused by starvation improve faster when an oligopeptidic formula is provided, which consequently results in faster and better absorption of the nutrients.
- Published
- 1993
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