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1History of the infantile hepatic hemangioma:From imaging to generating a differential diagnosis显示文摘We aim to provide an up-to-date summary of infantile hepatic hemangioma(IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver.Eligible peer-reviewed articles on hepatic infantile hemangiomas,published between 2000 and 2015,were reviewed for this study.IHH is the most common hepatic vascular tumor in children.Once a liver mass is identified in an infant,the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma,hepatoblastoma,metastatic neuroblastoma,so careful physical examination,imaging studies,and,if indicated,tumor markers and biopsy,are of pivotal importance to ascertain the correct diagnosis.Despite the benign nature of IHHs,some of these lesions may demand medical and/or surgical intervention,especially for multiple and diffuse IHH.Complications can include hepatomegaly,hypothyroidism and cardiac failure.Therefore,a close follow-up is required until complete involution of the lesions.We propose an algorithm to guide the physicians towards the proper management of hepatic lesions.Maria Gnarra Gerald Behr Alison Kitajewski June K Wu Sudha A Anupindi Carrie J Shawber Nick Zavras Dimitrios Schizas Chris Salakos Konstantinos P Economopoulos 2016World Journal of Clinical Pediatrics2016,5,3:27
2Pancreatico-biliary endoscopic ultrasound:A systematic review of the levels of evidence,performance and outcomes显示文摘Our aim was to record pancreaticobiliary endoscopic ultrasound(EUS) literature of the past 3 decades and evaluate its role based on a critical appraisal of published studies according to levels of evidence(LE).Original research articles(randomized controlled trials,prospective and retrospective studies),meta-analyses,reviews and surveys pertinent to gastrointestinal EUS were included.All articles published until September 2011 were retrieved from PubMed and classified according to specific disease entities,anatomical subdivisions and therapeutic applications of EUS.The North of England evidencebased guidelines were used to determine LE.A total of 1089 pertinent articles were reviewed.Published research focused primarily on solid pancreatic neoplasms,followed by disorders of the extrahepatic biliary tree,pancreatic cystic lesions,therapeutic-interventional EUS,chronic and acute pancreatitis.A uniform observation in all six categories of articles was the predominance of LE Ⅲ studies followed by LE Ⅳ,Ⅱb,Ⅱa,Ⅰb and Ⅰ a,in descending order.EUS remains the most accurate method for detecting small(< 3 cm) pancreatic tumors,ampullary neoplasms and small(< 4 mm) bile duct stones,and the best test to define vascular invasion in pancreatic and peri-ampullary neoplasms.Detailed EUS imaging,along with biochemical and molecular cyst fluid analysis,improve the differentiation of pancreatic cysts and help predict their malignant potential.Early diagnosis of chronic pancreatitis appears feasible and reliable.Novel imaging techniques(contrast-enhanced EUS,elastography) seem promising for the evaluation of pancreatic cancer and autoimmune pancreatitis.Therapeutic applications currently involve pancreaticobiliary drainage and targeted fine needle injection-guided antitumor therapy.Despite the ongoing development of extra-corporeal imaging modalities,such as computed tomography,magnetic resonance imaging,and positron emission tomography,EUS still holds a leading role in the investigation of the pancreaticobiliary area.The major challenge of EUS evolution is its expanding therapeutic potential towards an effective and minimally invasive management of complex pancreaticobiliary disorders.Pietro Fusaroli Dimitrios Kypraios Giancarlo Caletti Mohamad A Eloubeidi 2012World Journal of Gastroenterology2012,18,32:17
3Systemic treatment for hepatocellular carcinoma:Still unmet expectations显示文摘Many patients with hepatocellular carcinoma(HCC) are diagnosed in an advanced stage, so they cannot be offered the option of curative treatments. The results of systemic chemotherapy are unsatisfactory and this has led to molecular targeted approaches.HCC develops in chronically damaged tissue due to cirrhosis in most patients. Several different cell types and molecules constitute a unique microenvironment in the liver, which has significant implications in tumor development and invasion. This, together with genome instability, contributes to a significant heterogeneity which is further enhanced by the molecular differences of the underlying causes. New classifications based on genetic characteristics of the tissue microenvironment have been proposed and key carcinogenic signaling pathways have been described. Tumor and adjacent tissue profiling seem biologically promising, but have not yet been translated into clinical settings. The encouraging first results with molecular- genetic signatures should be validated and clinically applicable. A more personalized approach to modern management of HCC is urgently needed.Dimitrios N Samonakis Elias A Kouroumalis 2017World Journal of Hepatology2017,9,2:6
4Interferon-a plus lamivudine vslamivudine reduces breakthroughs, but does not affect sustained response in HBeAg negative chronic hepatitis B显示文摘AIM: To investigate the efficacy of combination treatment of IFN-α and lamivudine compared to lamivudine monotherapy, after 24 mo of administration in HBeAg-negative hepatitis B patients.METHODS: Fifty consecutive patients were randomly assigned to receive IFN-α-2b (5 MU thrice per week, n = 24) plus lamivudine (100 mg daily) or lamivudine only (n = 26) for 24 mo. Patients were followed up for further 6 mo. The primary outcome was the proportion with sustained virological response (undetectable serum HBV DNA concentrations) and or sustained biochemical response (transaminase levels within normal range) at 30 mo (6 mo after the end of therapy). Secondary end-points were timed from initial virological (biochemical) response to VBR (BBR, respectively) and the emergence of YMDD mutants across the two arms.RESULTS: Five of twenty-four (21%) patients in the combination arm vs 3/26 (12%) in the lamivudine arm had sustained response (i.e., normal serum transaminase levels and undetectable HBV DNA by PCR assay) 6 mo after treatment discontinuation. A reduction in the emergence of YMDD mutants and in the development of virological breakthroughs was observed in patients receiving combination treatment (10% vs46%, P= 0.01 and 14% vs46%, P= 0.03,respectively).Time from initial virologic response to virologic breakthrough (VBR) was greater among initial responders receiving combination treatment compared to those receiving lamivudine (22.9 mo vs 15.9 mo, respectively; P = 0.005).CONCLUSION: Our results demonstrate that IFN-α plus lamivudine combination therapy does not increase the sustained response, compared to lamivudine. However,combination therapy reduces the likelihood of VBR due to YMDD mutants and prolongs the time period until the breakthrough development.Michalis Economou Spilios Manolakopoulos Thomas A Trikalinos Spyros Filis Sotiris Bethanis Dimitrios Tzourmakliotis Alec Avgerinos Sotiris Raptis Epameinondas V Tsianos 2005World Journal of Gastroenterology2005,11,37:6
5Potential implications of Helicobacter pylori-related neutrophil-activating protein显示文摘Helicobacter pylori (H.pylori) virulence factors promote the release of various chemoattractants/inflammatory mediators,including mainly the neutrophilattractant chemokine interleukin-8 and neutrophilactivating protein (NAP),involved in H.pylori-induced gastric pathologies.Co-administration of Chios mastic gum (CMG),which inhibits H.pylori NAP,with an H.pylori eradication regimen might add clinical benefits against H.pylori-related gastric pathologies,but possibly not CMG as main therapy.Although H.pylori NAP and other H.pylori-related cytotoxins [i.e.,vaculating cytotoxin (VacA)] appear to play a major role in generating and maintaining the H.pylori-associated gastric inflammatory response and H.pylori NAP is a promising vaccine candidate against H.pylori infection (H.pylori-I),concerns regarding its potential drawbacks,particularly neurogenic ones,due to possible crossmimicry,should be considered.Possible cross-mimicry between H.pylori NAP and/or bacterial aquaporin (AQP) and neural tissues may be associated with the anti-AQP-4 antibody-related neural damage in multiple sclerosis (MS)/neuromyelitis optica patients.Moreover,the sequence homology found between H.pylori VacA and human Na+/K+-ATPase A subunit suggests that antibodies to VacA involve ion channels in abaxonal Schwann cell plasmalemma resulting in demyelination in some patients.A series of factors have been implicated in inducing blood-brain barrier (BBB) disruption,including inflammatory mediators (e.g.,cytokines and chemokines induced by H.pylori-I) and oxidative stress.BBB disruption permits access of AQP4-specific antibodies and T lymphocytes to the central nervous system,thereby playing a major role in multiple sclerosis pathogenesis.Relative studies show a strong association between H.pylori-I and MS.H.pylori-I induces humoral and cellular immune responses that,owing to the sharing of homologous epitopes (molecular mimicry),cross-react with components of nerves,thereby contributing and perpetuating neural tissue damage.Finally,H.pylori NAP also plays a possible pathogenetic role in both gastric and colon oncogenesis.Jannis Kountouras Christos Zavos Georgia Deretzi Emmanuel Gavalas Dimitrios Chatzopoulos Panagiotis Katsinelos Elena Tsiaousi Stergios Gagalis Stergios A Polyzos Ioannis Venizelos 2012World Journal of Gastroenterology2012,18,5:5
6Clinical outcomes of compensated and decompensated cirrhosis: A long term study显示文摘AIM: To study these characteristics and prognostic patterns in a Greek patient population.METHODS: We analyzed a large cohort of cirrhotic patients referred to the department of Gastroenterology and Hepatology and the outpatient clinics of this tertiary hospital, between 1991 and 2008. We included patients with established cirrhosis, either compensated or decompensated, and further decompensation episodes were registered. A data base was maintained and updated prospectively throughout the study period.We analyzed differences in cirrhosis aetiology, time to and mode of decompensation, hepatocellular carcinoma(HCC) occurrence and ultimately patient survival.RESULTS: Five hundreds and twenty-two patients with median age 67(range, 29-91) years and average follow up 9 years-10 mo(range, 1-206 mo) were studied. Commonest aetiology was hepatitis C virus(HCV, 41%) followed by alcohol(31%). The median survival time in compensated cirrhotics was 115 mo(95%CI: 95-133), whereas in decompensated patients was 55 mo(95%CI: 36-75). HCV patients survived longer while HBV patients had over twice the risk of death of HCV patients. The median time to decompensation was 65 mo(95%CI: 51-79), with alcoholics having the highest risk(RR = 2.1 vs HCV patients). Hepatitis B virus(HBV) patients had the highest risk of HCC, alcoholics the lowest. Leading causes of death: liver failure, hepatorenal syndrome, sepsis and HCC progression. CONCLUSION: Cirrhosis aetiology and decompensation at presentation were predictors of survival. Alcoholics had the highest decompensation risk, HBV cirrhotics the highest risk of HCC and HCV cirrhotics the highest decompensation-free time.Dimitrios N Samonakis Mairi Koulentaki Constantina Coucoutsi Aikaterini Augoustaki Chryssavgi Baritaki Emmanuel Digenakis Nikolaos Papiamonis Maria Fragaki Erminia Matrella Elias A Kouroumalis Maria Tzardi 2014World Journal of Hepatology2014,6,7:4
7Serum zonulin levels in patients with liver cirrhosis:Prognostic implications显示文摘BACKGROUND Increased gut permeability and bacterial translocation play an important role in liver cirrhosis.Zonulin is a recently recognized protein involved in the disintegration of the intestinal barrier.AIM To investigate possible differences in serum zonulin levels among patients with different cirrhosis stages and their potential prognostic implications.METHODS Consecutive cirrhotic patients who attended our liver clinic were included in the study.Serum zonulin levels,clinical,radiological and biochemical data were collected at baseline.Patients who accepted participation in a regular surveillance program were followed-up for at least 12 mo.RESULTS We enrolled 116 cirrhotics[mean Child-Turcotte-Pugh(CTP)score:6.2±1.6;model for end-stage liver disease score:11±3.9].The causes of cirrhosis were viral hepatitis(39%),alcohol(30%),non-alcoholic fatty liver disease(17%),and other(14%).At baseline,53% had decompensated cirrhosis,48% had ascites,and 32% had history of hepatic encephalopathy.Mean zonulin levels were significantly higher in patients with CTP-B class than CTP-A class(4.2±2.4 ng/dL vs 3.5±0.9 ng/dL,P=0.038),with than without ascites(P=0.006),and with than without history of encephalopathy(P=0.011).Baseline serum zonulin levels were independently associated with the probability of decompensation at 1 year(P=0.039),with an area under the receiving operating characteristic of 0.723 for predicting hepatic decompensation.Higher CTP score(P=0.021)and portal vein diameter(P=0.022)were independent predictors of mortality.CONCLUSION Serum zonulin levels are higher in patients with more advanced chronic liver disease and have significant prognostic value in identifying patients who will develop decompensation.Theodoros A Voulgaris Dimitrios Karagiannakis E Hadziyannis Spilios Manolakopoulos Georgios P Karamanolis George Papatheodoridis John Vlachogiannakos 2021World Journal of Hepatology2021,13,10:2
8Breast cancerfollowing diethylstilbestrol exposure in utero: insights from a tragedy显示文摘Hans O A Pagona L Dimitrios T 2012European Journal of Epidemiology2012,27,1:1
9Assessment of convection, hot-air combined with microwave- vacuum and freeze- drying methods for mushrooms with regard to product quality 显示文摘Dimitrios A Albert H Joachim M 2011International Journal of Food Science and Technology2011,46,:1
10A new TOPSIS-based multi-criteria approach to personnel selection显示文摘ALECOS K DIMITRIOS A 2010Expert Systems with Applications2010,,37:1
11A note on the phase locking value and its properties 显示文摘Sergul A Dimitrios P Richsard M L 2013Neuroimage2013,74,1:1
12Tob, a member of the APRO family, regulates immunological quiescence and tumor suppression 显示文摘Dimitrios T Vassiliki A B 2009Cell Cycle2009,8,:1
13Energy-Efficient Routing Protocols in Wireless Sensor Networks: A Survey 显示文摘Nikolaos A Pantazis Stefanos A Nikolidakis Dimitrios D Vergados 2012IEEE Communications Surveys and Tutorials2012,,99:1
14Breast cancer following diethylstilbestrol exposure in utero: insights from a tragedy 显示文摘Hanso A Pagona L Dimitrios T 2012European Joumal of Epidemiology2012,27,1:1
15Tsamboulas, Seraphim Kapros, Freight Village evaluation under uncertainty with public and private financing 显示文摘Dimitrios A 2003Transport Policy2003,,10:1
16Effects ofheat treatment on atmospheric composition and color of peeled whiteasparagus in modified atmosphere packaging显示文摘ANASTASIOS S S DIMITRIOS G B PAVLOS T A 2010Innovative FoodScience and Emerging Technologies2010,11,1:1
17Serum proteome profiling detects myelodysplastic syndromes and identifies CXC chemokine ligands 4 and 7 as markers for advanced disease显示文摘Manuel A Dimitrios S Ulrich G 2007Proc Natl Acad Sci USA2007,104,4:1
18Assessing the Drivers of Biodiversity in Madagascar by Quantifying Its Hydrologic Properties at the Watershed Seale显示文摘Dimitrios S Ziad S H Emmanouil N A 2014Remote Sensing Envi- ronment2014,148,:1
19Earth return impedances of conductor arrangements in multilayer soils, part I: theoretical model显示文摘Tsiamitros Dimitrios A Papagiannis Grigoris K Dokopoulos Petros S 2008IEEE Transactions on Power Delivery2008,23,4:1
20Themodynamic analysis of the themochemical decoposition of H2S in the presence of iron sulphide显示文摘Dimitrios B Robert A 1991The Canadian T of Chemical Engineering1991,69,4:1
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