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| 1 | Pathophysiology of increased intestinal permeability in obstructive jaundice显示文摘Despite advances in preoperative evaluation and postoperative care, intervention, especially surgery, for relief of obstructive jaundice still carries high morbidity and mortality rates, mainly due to sepsis and renal dysfunction. The key event in the pathophysiology of obstructive jaundice-associated complications is endotoxemia of gut origin because of intestinal barrier failure. This breakage of the gut barrier in obstructive jaundice is multi-factorial, involving disruption of the immunologic, biological and mechanical barrier. Experimental and clinical studies have shown that obstructive jaundice results in increased intestinal permeability. The mechanisms implicated in this phenomenon remain unresolved, but growing research interest during the last decade has shed light in our knowledge in the field. This review summarizes the current concepts in the pathophysiology of obstructive jaundice-induced gut barrier dysfunction, analyzing pivotal factors, such as altered intestinal tight junctions expression, oxidative stress and imbalance of enterocyte proliferation and apoptosis. Clinicians handling patients with obstructive jaundice should not neglect protecting the intestinal barrier function before, during and after intervention for the relief of this condition, which may improve their patients’ outcome. | Stelios F Assimakopoulos Chrisoula D Scopa Constantine E Vagianos | 2007 | World Journal of Gastroenterology2007，13，48： | 48 |
| 2 | Experimental obstructive jaundice alters claudin-4 expression in intestinal mucosa: Effect of bombesin and neurotensin显示文摘瞄准:调查试验性的妨碍的黄疸和外长的 bombesin 和 neurotensin (NT )(BBS ) 的影响紧密的连接(TJ ) 的表示上的管理在老鼠的肠上皮的蛋白质 claudin-4。方法:四十只男 Wistar 老鼠随机被划分成五个组:我 = 控制, II = 假冒操作, III = 胆汁管结扎(BDL ) , IV = BDL+BBS (30 microg/kg 每 d ) , V = BDL+NT (300 microg/kg 每 d ) 。在 d 的实验的结束 10,内毒素在门和大动脉的血被测量。终端回肠的织物节组织学地被检验并且免疫组织化学地为在肠上皮的 claudin-4 表示的评估。结果:妨碍的黄疸导致了重要的门和大动脉的 endotoxemia 表明的肠的障碍失败。Claudin-4 表示显著地被增加在上面在 jaundiced 老鼠的第三根绒毛并且一起来它的侧面的分发的规定被注意。BBS 或 NT 的管理恢复了 claudin-4 表示到控制状态并且显著地减少了门和大动脉的 endotoxemia。结论:在肠上皮的试验性的妨碍的黄疸增加 claudin-4 表示,它可以是贡献粘膜障碍的混乱的一个关键因素。毁坏规章的肽 BBS, NT 能阻止这扇改变和还原剂门和全身的 endotoxemia。 | Stelios F Assimakopoulos Constantine E Vagianos Aristides S Charonis Ilias H Alexandris Iris Spiliopoulou Konstantinos C Thomopoulos Vassiliki N Nikolopoulou Chrisoula D Scopa | 2006 | World Journal of Gastroenterology2006，12，21： | 21 |
| 3 | Acute upper gastrointestinal bleeding in operated stomach: Outcome of 105 cases显示文摘AIM: To compare the causes and clinical outcome of patients with acute upper gastrointestinal bleeding (AUGB) and a history of gastric surgery to those with AUGB but without a history of gastric surgery in the past.METHODS: The causes and clinical outcome were compared between 105 patients with AUGB and a history of gastric surgery, and 608 patients with AUGB but without a history of gastric surgery.RESULTS: Patients who underwent gastric surgery in the past were older (mean age: 68.1±11.7 years vs 62.8±17.8 years, P= 0.001), and the most common cause of bleeding was marginal ulcer in 63 patients (60%). No identifiable source of bleeding could be found in 22 patients (20.9%) compared to 42/608 (6.9%) in patients without a history of gastric surgery (P = 0.003). Endoscopic hemostasis was permanently successful in 26 out of 35 patients (74.3%) with peptic ulcers and active bleeding or non-bleeding visible vessel. Nine patients (8.6%) were operated due to continuing or recurrent bleeding,compared to 23/608 (3.8%) in the group of patients without gastric surgery in the past (P= 0.028). Especially in peptic ulcer bleeding patients, emergency surgery was more common in the group of patients with gastric surgery in the past [9/73 (12.3%) vs 19/360 (5.3%), P = 0.025].Moreover surgically treated patients in the past required more blood transfusion (3.3±4.0 vs 1.5±1.7, P = 0.0001) and longer hospitalization time (8.6±4.0 vs 6.9±4.9 d,P = 0.001) than patients without a history of gastric surgery. Mortality was not different between the two groups [4/105 (3.8%) vs 19/608 (3.1%)].CONCLUSION: Upper gastrointestinal bleeding seems to be more severe in surgically treated patients than in non-operated patients. | Vassiliki N Nikolopoulou Konstantinos C Thomopoulos George I Theocharis Vassiliki A Arvaniti Constantine E Vagianos | 2005 | World Journal of Gastroenterology2005，11，29： | 9 |
| 4 | Bile duct ligation in rats: A reliable model of hepatorenal syndrome?显示文摘The two most widely used experimental models of advanced liver disease are the administration of carbon tetrachloride, and common bile duct ligation (BDL), however, neither has been systematically evaluated as a model of hepatorenal syndrome (HRS). The BDL model in rats, studied at diverse time points, induced a progressive renal dysfunction without structural changes in the kidney. The authors concluded that BDL is a good model for further studies of HRS and its treatment. However, the renal impairment observed at the acute phase of the BDL model is based on a different pathophysiology than that of HRS. Specifi cally, in acute obstructive jaundice, cholemia predominates over parenchymal liver disease (reversible at this stage without portal hypertension or cirrhosis) and independently induces negative inotropic and chronotropic effects on the heart, impaired sympathetic vasoconstriction response and profound natriuresis and diuresis that might lead to volume depletion. In addition, systemic endotoxemia contributes to the prerenal etiology of renal impairment and promotes direct nephrotoxicity and acute tubular necrosis. On the other hand, the renal failure observed in the chronic BDL model (with development of biliary cirrhosis, portal hypertension and ascites) shares pathophysiological similarities with HRS, but the accordance of the chronic BDL model to the diagnostic criteria of HRS (e.g. absence of spontaneous bacterial peritonitis, no renal function improvement after plasma volume expansion) should have been confirmed. In conclusion, we think that the BDL model is not suitable for the study of the natural history of HRS, but the chronic BDL model might be valid for the study of established HRS and its potential therapies. | Stelios F Assimakopoulos Constantine E Vagianos | 2009 | World Journal of Gastroenterology2009，15，1： | 9 |
| 5 | Effect of bombesin and neurotensin on gut barrier function in partially hepatectomized rats显示文摘AIM: To investigate the effect of regulatory peptides bombesin (BBS) and neurotensin (NT) on intestinal barrier function in partially hepatectomized rats.METHODS: Ninety male Wistar rats were randomly divided into five groups: Ⅰ (n = 10): controls, Ⅱ (n =20): sham operated, Ⅲ (n = 20): partial hepatectomy 70% (PHx), Ⅳ (n = 20): PHx+BBS (30 μg/kg/d), Ⅴ (n= 20): PHx+NT (300 μg/kg/d). Groups Ⅳ and Ⅴ were treated for 8 days before PHx and 48 h post surgery.At the end of the experiment, on day 10, intestinal barrier function was assessed by measuring endotoxin concentrations in portal and aortic blood. Tissue sections of the terminal ileum were examined histologically and villus density, mucosal thickness, mitotic activity and apoptosis in crypts were assessed. In addition, ileal mucosa was analyzed for DNA and protein content and microbiological analysis was performed in cecal contents.To estimate intestinal oxidative stress, lipid peroxidation was determined on tissue homogenates from terminal ileum.RESULTS: BBS or NT administration significantly reduced portal and systemic endotoxemia observed 48 h after partial hepatectomy. In hepatectomized rats (group Ⅲ), a trend towards induction of mucosal atrophy was observed, demonstrated by the reduction of villus density, mucosal thickness, protein content and significant reduction of DNA, while these alterations were reversed by regulatory peptides administration.This trophic effect of BBS and NT was accompanied by induction of mitoses above control levels and a significant reduction of apoptosis in intestinal crypts.Intestinal lipid peroxidation was found significantly lower in PHx group and regulatory peptides exerted an antioxidant action, further decreasing this parameter of oxidative stress. The bacterial population of E. coli and aerobic Gram (+) cocci was increased in cecal content of hepatectomized rats, while this parameter was not affected by the administration of BBS or NT.CONCLUSION: Gut regulatory peptides BBS and NT improve intestinal barrier function and reduce endotoxemia in experimental partial hepatectomy. This effect is, at least in part, mediated by their trophic,antiapoptotic, mitogenic, and antioxidant effect on the intestinal epithelium. This observation might be of potential value in patients undergoing liver resection. | Stelios F Assimakopoulos Ilias H Alexandris Chrisoula D Scopa Panagiotis G Mylonas Konstantinos C Thomopoulos Christos D Georgiou Vassiliki N Nikolopoulou Constantine E Vagianos | 2005 | World Journal of Gastroenterology2005，11，43： | 8 |
| 6 | Effects of mycophenolate mofetil vs cyclosporine administration on graft survival and function after islet allotransplantation in diabetic rats显示文摘AIM: To develop an experimental model of islet allotransplantation in diabetic rats and to determine the positive or adverse effects of MMF as a single agent. METHODS: Thirty-six male Wistar rats and 18 male Lewis rats were used as recipients and donors respectively. Diabetes was induced by the use of streptozotocin (60 mg/kg) intraperitoneally. Unpurified islets were isolated using the collagenase digestion technique and transplanted into the splenic parenchyma. The recipients were randomly assigned to one of the following three groups: group A (control group) had no immunosuppression; group B received cyclosporine (CsA) (5 mg/kg); group C receivedmycophenolate mofetil (MMF) (20 mg/kg). The animalswere killed on the 12th d. Blood and grafted tissues were obtained for laboratory and histological assessment. RESULTS: Median allograft survival was significantly higher in the two therapy groups than that in the controls (10 and 12 d for CsA and MMF respectively vs 0 d for the control group, P<0.01). No difference in allograft survival between the CsA and MMF groups was found. However,MMF had less renal and hepatic toxicity and allowed weight gain.CONCLUSION: Monotherapy with MMF for immunosu ppression was safe in an experimental model of islet allotransplantation and was equally effective with cyclosporine, with less toxicity. | Constantin Fotiadis Paraskevi Xekouki Apostolos E Papalois PantelisT Antonakis Ioannis Sfiniadakis Dimitrios Flogeras Eleutheria Karampela George Zografos | 2005 | World Journal of Gastroenterology2005，11，18： | 7 |
| 7 | Pleiotropic effects of bombesin and neurotensin on intestinal mucosa: Not just trefoil peptides显示文摘Bombesin and neurotensin are neuropeptides which exert a wide spectrum of biological actions on gastrointestinal tissues influencing intestinal growth and adaptation, intestinal motility, blood flow, secretion, nutrient absorption and immune response. Based mainly on their well-established potent enterotrophic effect, numerous experimental studies investigated their potential positive effect on the atrophic or injured intestinal mucosa. These peptides proved to be effective mucosa-healing factors, but the potential molecular and cellular mechanisms for this action remained unresolved. In a recently published study (World J Gastroenterol 2008; 14(8): 1222-1230), it was shown that their protective effect on the intestine in experimentally induced inflammatory bowel disease was related to anti-inflammatory, antioxidant and antiapoptotic actions. These results are in close agreement with our previous studies on jaundiced and hepatectomized rats that showed a regulatory effect of bombesin and neurotensin on critical cellular processes such as enterocyte' proliferation and death, oxidative stress and redox equilibrium, tight junctions' formation and function, and inflammatory response. The pleiotropic effects of bombesin and neurotensin on diverse types of intestinal injury may justify their consideration for clinical trials. | Stelios F Assimakopoulos Chrisoula D Scopa Vassiliki N Nikolopoulou Constantine E Vagianos | 2008 | World Journal of Gastroenterology2008，14，22： | 4 |
| 8 | Aerobic vs anaerobic exercise training effects on the cardiovascular system显示文摘Physical exercise is one of the most effective methods to help prevent cardiovascular(CV) disease and to promote CV health. Aerobic and anaerobic exercises are two types of exercise that differ based on the intensity, interval and types of muscle fibers incorporated. In this article, we aim to further elaborate on these two categories of physical exercise and to help decipher which provides the most effective means of promoting CV health. | Harsh Patel Hassan Alkhawam Raef Madanieh Niel Shah Constantine E Kosmas Timothy J Vittorio | 2017 | World Journal of Cardiology2017，9，2： | 2 |
| 9 | Biomechanics of posterior shoulder instability-current knowledge and literature review显示文摘Posterior instability of the shoulder is a rare condition and represents about 10% of shoulder instability. It has become more frequently recognized in the last year,even though it is more difficult to diagnose than anterior shoulder instability. As this form of shoulder pathology is somewhat rare,biomechanical knowledge is limited. The purpose of our study was to perform an extensive literature search,including PubMed and Medline,and to give an overview of the current knowledge on the biomechanics of posterior shoulder instability. The Pub Med/Medline databases were utilized,and all articles related to posterior shoulder instability and biomechanics were included to form a comprehensive compilation of current knowledge. A total of 93 articles were deemed relevant according to our inclusion and exclusion criteria. As expected with any newly acknowledged pathology,biomechanical studies on posterior shoulder instability remain limited in the literature. Current biomechanical models are performed in a static manner,which limits their translation for explaining a dynamic pathology. Newer models should incorporate dynamic stabiliza-tion of both the rotator cuff and scapulothoracic joint. There is a current lack of knowledge with regards to the pathomechanism of posterior shoulder instability,with no consensus on appropriate treatment regimens. Further investigation is therefore required at both basic science and clinical levels. | Henrik Constantin B?cker Samuel E Galle Mauro Maniglio Melvin Paul Rosenwasser | 2018 | World Journal of Orthopedics2018，9，11： | 2 |
| 10 | Stimulation of oval cell and hepatocyte proliferation by exogenous bombesin and neurotensin in partially hepatectomized rats显示文摘AIM:To investigate the effect of the neuropeptides bombesin(BBS)and neurotensin(NT)on oval cell proliferation in partially hepatectomized rats not pretreated with a known hepatocyte inhibitor.METHODS:Seventy male Wistar rats were randomly divided into five groups:Ⅰ=controls,Ⅱ=sham operated,Ⅲ=partial hepatectomy 70%(PHx),Ⅳ=PHx+ BBS(30μg/kg per day),Ⅴ=PHx+NT(300μg/kg per day).Forty eight hours after liver resection,portal en-dotoxin levels and hepatic glutathione redox state were determined.α-fetoprotein(AFP)mRNA(in situ hybridisation),cytokeratin-19 and Ki67 antigen expression (immunohistochemistry)and apoptosis(TUNEL)were evaluated on liver tissue samples.Cells with morphological features of oval cells that were cytokeratin-19 (+)and AFP mRNA(+)were scored in morphometric analysis and their proliferation was recorded.In addition,the proliferation and apoptotic rates of hepatocytes were determined.RESULTS:In the control and sham operated groups,oval cells were significantly less compared to groups Ⅲ,ⅣandⅤ(P<0.001).The neuropeptides BBS and NT significantly increased the proliferation of oval cells compared to groupⅢ(P<0.001).In addition,BBS and NT induced a significant increase of hepatocyte proliferation(P<0.001),whereas it decreased their apoptotic activity(P<0.001)compared to groupⅢ.BBS and NT significantly decreased portal endotoxemia (P<0.001)and increased the hepatic GSH:GSSG ratio (P<0.05 and P<0.001,respectively)compared to groupⅢ.CONCLUSION:BBS and NT stimulated oval cell proliferation in a model of liver regeneration,without use of concomitant suppression of hepatocyte proliferation as oval cell activation stimuli,and improved the hepatocyte regenerative response.This peptides-induced combined stimulation of oval cell and hepatocyte proliferation might serve as a possible treatment modality for several liver diseases. | Stelios F Assimakopoulos Athanassios C Tsamandas Ilias H Alexandris Christos Georgiou Constantine E Vagianos Chrisoula D Scopa | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 2 |
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| 12 | Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care显示文摘 | Katharine Bushby Richard Finkel David J Birnkrant Laura E Case Paula R Clemens Linda Cripe Ajay Kaul Kathi Kinnett Craig McDonald Shree Pandya James Poysky Frederic Shapiro Jean Tomezsko Carolyn Constantin | 2010 | Lancet Neurology2010，，2： | 1 |
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| 16 | Conservative vs restrictive individualized goal-directed fluid replacement strategy in major ab dominal surgery:A prospective randomized trial显示文摘 | Futier E Constantin JM Petit A | | 0，，12： | 1 |
| 17 | Intraoperative recruitment maneuver reverses detrimental pneumo- peritoneum-induced respiratory effects in healthy weight and obese patients undergoing laparoseopy显示文摘 | Futier E Constantin JM Pelosi P | 2010 | Anesthesiology2010，113，6： | 1 |
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