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| 1 | A case of successful management with splenectomy of intractable ascites due to congenital dyserythropoietic anemia type II-induced cirrhosis显示文摘The congenital dyserythropoietic anemias comprise agroup of rare hereditary disorders of erythropoiesis,characterized by ineffective erythropoiesis as thepredominant mechanism of anemia and by characteristicmorphological aberrations of the majority of erythroblastsin the bone marrow.Congenital dyserythropoieticanemia type II is the most frequent type.All types ofcongenital dyserythropoietic anemias distinctly share ahigh incidence of iron loading.Iron accumulation occurseven in untransfused patients and can result in heartfailure and liver cirrhosis.We have reported about apatient who presented with liver cirrhosis and intractableascites caused by congenital dyserythropoietic anemiatype Ⅱ.Her clinical course was further complicatedby the development of autoimmune hemolyticanemia.Splenectomy was eventually performed whichachieved complete resolution of ascites,increase ofhemoglobin concentration and abrogation of transfusionrequirements. | Themistoklis Vassiliadis Vassilia Garipidou Vassilios Perifanis Konstantinos Tziomalos OIga Giouleme Kalliopi Patsiaoura Michalis Avramidis Nikolaos Nikolaidis Sofia Vakalopoulou Ioannis Tsitouridis Antonios Antoniadis Panagiotis Semertzidis Anna Kioumi Evangelos Premetis Nikolaos Eugenidis | 2006 | World Journal of Gastroenterology2006，12，5： | 47 |
| 2 | MELD vs Child-Pugh and creatinine-modified Child-Pugh score for Dredicting survival in patients with decompensated cirrhosis显示文摘AIM: Model of End-stage Liver Disease (MELD) score has recently gained wide acceptance over the old Child-Pugh score in predicting survival in patients with decompensated cirrhosis, although it is more sophisticated. We compared the predictive values of MELD, Child-Pugh and creatinine modified Child-Pugh scores in decompensated cirrhosis. METHODS: A cohort of 102 patients with decompensated cirrhosis followed-up for a median of 6 mo was studied.Two types of modified Child-Pugh scores estimated by adding 0-4 points to the original score using creatinine levels as a sixth categorical variable were evaluated.RESULTS: The areas under the receiver operating characteristic curves did not differ significantly among the four scores, but none had excellent diagnostic accuracy (areas:0.71-0.79). Child-Pugh score appeared to be the worst, while the accuracy of MELD was almost identical with that of modified Child-Pugh in predicting short-term and slightly better in predicting medium-term survival. In Cox regression analysis, all four scores were significantly associated with survival, while MELD and creatinine-modified Child-Pugh scores had better predictive values (c-statistics: 0.73 and 0.69-0.70) than Child-Pugh score (c-statistics: 0.65). Adjustment for gamma-glutamate transpeptidase levels increased the predictive values of all systems (c-statistics: 0.77-0.81). Analysis of the expected and observed survival curves in patients subgroups according to their prognosis showed that all models fit the data reasonably well with MELD probably discriminating better the subgroups with worse prognosis. CONCLUSION: MELD compared to the old Child-Pugh and particularly to creatinine-modified Child-Pugh scores does not appear to offer a clear advantage in predicting survival in patients with decompensated cirrhosis in daily clinical practice. | George V. Papatheodoridis Evangelos Cholongitas Eleni Dimitriadou Giota Touloumi Vassilios Sevastianos Athanasios J. Archimandritis | 2005 | World Journal of Gastroenterology2005，11，20： | 30 |
| 3 | Multipotent role of platelets in inflammatory bowel diseases:A clinical approach显示文摘There is evidence that inflammatory bowel diseases(IBD)combine both inflammation and coagulation in their pathogenesis and clinical manifestations.Although platelets(PLT)are well known for their role in hemo stasis,there are a rising number of studies supporting their considerable role as inflammatory amplifiers in chronic inflammatory conditions.IBD are associated with several alterations of PLT,including number shape,and function,and these abnormalities are main ly attributed to the highly activated state of circulating PLT in IBD patients.When PLT activate,they increase in size,release a great variety of bio-active inflamma tory and procoagulant molecules/particles,and express a variety of inflammatory receptors.These inflamma tory products may represent a part of the missing link between coagulation and inflammation,and can be considered as possible IBD pathogenesis instigators.In clinical practice,thrombocytosis is associated both with disease activity and iron deficiency anemia.Controlling inflammation and iron replacement in anemic patient usually leads to a normalization of PLT count.The aim of this review is to update the role of PLT in IBD and present recent data revealing the possible therapeutic implications of anti-PLT agents in future IBD remedies. | Evangelos Voudoukis Konstantinos Karmiris Ioannis E Koutroubakis | 2014 | World Journal of Gastroenterology2014，20，12： | 27 |
| 4 | Review article: Update on current and emergent data on hepatopulmonary syndrome显示文摘Hepatopulmonary syndrome(HPS) is a frequent pulmonary complication of end-stage liver disease, characterized by impaired arterial oxygenation induced by intrapulmonary vascular dilatation. Its prevalence ranges from 4% to 47% in patients with cirrhosis due to the different diagnostic criteria applied among different studies. Nitric oxide overproduction and angiogenesis seem to be the hallmarks of a complicated pathogenetic mechanism, leading to intrapulmonary shunting and ventilation-perfusion mismatch. A classification of HPS according to the severity of hypoxemia has been suggested. Contrast-enhanced echocardiography represents the gold standard method for the detection of intrapulmonary vascular dilatations which is required, in combination with an elevated alveolar arterial gradient to set the diagnosis. The only effective treatment which can modify the syndrome's natural history is liver transplantation. Although it is usually asymptomatic, HPS imparts a high risk of pretransplantation mortality, independently of the severity of liver disease, while there is variable data concerning survival rates after liver transplantation. The potential of myocardial involvement in the setting of HPS has also gained increasing interest in recent research. The aim of this review is to critically approach the existing literature of HPS and emphasizeunclear points that remain to be unraveled by future research. | Stergios Soulaidopoulos Evangelos Cholongitas George Giannakoulas Maria Vlachou Ioannis Goulis | 2018 | World Journal of Gastroenterology2018，24，12： | 26 |
| 5 | Gastrointestinal dysfunction in liver cirrhosis显示文摘Patients with liver cirrhosis exhibit several features of gut dysfunction which may contribute to the development of cirrhosis complications as well as have an impact on nutritional status and health-related quality of life.Gastrointestinal symptoms are common in cirrhosis and their pathophysiology probably involves factors related to liver disease severity,psychological distress,and gut dysfunction(e.g.,increased gastric sensitivity to distension and delayed gut transit).They may lead to reduced food intake and,thus,may contribute to the nutritional status deterioration in cirrhotic patients.Although tense ascites appears to have a negative impact on meal-induced accommodation of the stomach,published data on gastric accommodation in cirrhotics without significant ascites are not unanimous.Gastric emptying and small bowel transit have generally been shown to be prolonged.This may be related to disturbances in postprandial glucose,insulin,and ghrelin levels,which,in turn,appear to be associated to insulin resistance,a common finding in cirrhosis.Furthermore,small bowel manometry disturbances and delayed gut transit may be associated with the development of small bowel bacterial overgrowth.Finally,several studies have reported intestinal barrier dysfunction in patients with cirrhosis(especially those with portal hypertension),which is related to bacterial translocation and permeation of intestinal bacterial products,e.g.,endo-toxin and bacterial DNA,thus potentially being involved in the pathogenesis of complications of liver cirrhosis. | Evangelos Kalaitzakis | 2014 | World Journal of Gastroenterology2014，20，40： | 24 |
| 6 | Role of soluble triggering receptor expressed on myeloid cells in inflammatory bowel disease显示文摘瞄准:为了调查可溶的被触发的可能的角色,受体在煽动性的肠疾病(IBD ) 的致病在骨髓的上表示了 cells-1 (sTREM-1 ) 。方法:58 个病人被注册;十九个健康志愿者用作控制;8 个病人与 Crohn 的疾病被诊断,并且 31 与 ulcerative。有 Crohn 的疾病和 ulcerative 的病人的临床、内视镜的活动索引分别地被估计。在承认之上,血被取样;sTREM-1 和 TNFalpha 被 thiobarbitourate 试金被免疫分析和 malondialdehyde (MDA ) 测量,在通过一个 HPLC 系统的经过以后。结果:控制,有 Crohn 的疾病的病人和有 ulcerative 的病人的 TNFalpha 的中部的 +/- SE 是 6.02 +/- 3.94, 7.98 +/- 5.08 (P = NS 对控制) ,并且 8.45 +/- 4.15 ng/L (P = 0.018 对控制) 分别地。sTREM-1 的各自的价值是 53.31 +/- 32.93, 735.10 +/- 197.17 (P = 0.008 对控制) 并且 435.82 +/- 279.71 ng/L (P = 0.049 对控制) 。sTREM-1 断然与 Crohn 的疾病活动索引和 ulcerative 的临床、内视镜的活动索引被相关(P = 0.002, 0.001 和 0.009,分别地) 。有 ulcerative 的病人的 sTREM-1 断然与 TNFalpha 被相关(P = 0.001 ) 。结论:sTREM-1 似乎在与肠粘膜的炎性反应的度的关联在 IBD 作为一个新奇调停人表现。 | Michalis Tzivras Vassilios Koussoulas Evangelos J Giamarellos-Bourboulis Dimitrios Tzivras Thomas Tsaganos Pantelis Koutoukas Helen Giamarellou Athanasios Archimandritis | 2006 | World Journal of Gastroenterology2006，12，21： | 17 |
| 7 | Current treatment for colorectal liver metastases显示文摘Surgical resection offers the best opportunity for survival in patients with colorectal cancer metastatic to the liver,with five-year survival rates up to 58% in selected cases.However,only a minority are resectable at the time of diagnosis.Continuous research in this field aims at increasing the percentage of patients eligible for resection,refining the indications and contraindications for surgery,and improving overall survival.The use of surgical innovations,such as staged resection,portal vein embolization,and repeat resection has allowed higher resection rates in patients with bilobar disease.The use of neoadjuvant chemotherapy allows up to 38% of patients previously considered unresectable to be significantly downstaged and eligible for hepatic resection.Ablative techniques have gained wide acceptance as an adjunct to surgical resection and in the management of patients who are not surgical candidates.Current management of colorectal liver metastases requires a multidisciplinary approach,which should be individualized in each case. | Evangelos P Misiakos Nikolaos P Karidis Gregory Kouraklis | 2011 | World Journal of Gastroenterology2011，17，36： | 17 |
| 8 | Relation between common polymorphisms in genes related to inflammatory response and colorectal cancer显示文摘瞄准:在象 interleukin ( IL )那样的煽动性的反应相关的基因调查在普通单个核苷酸多型性( SNP )之间的协会-6, IL-8 ,肿瘤坏死因素高山哈( TNFalpha ), peroxisome 激活proliferators 的受体鲸鱼群妈( PPARgamma ),细胞间的粘附 molecule-1 ( ICAM-1 )和颜色的风险在一组希腊病人的表面的癌症( CRC )。方法:学习组由 222 个 CRC 病人和 200 健康控制组成了。Genotyping 用 PRC-RFLP 的等位基因特定的 PCR 被执行,结果被定序证实。我们在 IL-6 学习了 SNP 的协会(-174G>C), IL-8 (-251T>A), TNFalpha (-308G>A), ICAM-1 (R241G 和 K469E ) ,和 PPARgamma (Pro12Ala ) 基因和 CRC 的风险。结果:ICAM-1 的 IL-6 -174G, R241 和 K469 等位基因与 CRC 的增加的风险被联系(或 = 1.77, 95% CI:1.34-2.34;或 = 1.83, 95% CI:1.23-2.72;并且或 = 1.35, 95% CI:1.03-1.77 分别地) 。IL-8 和 TNFalpha 多型性没有效果。而 PPARgamma Pro12 遗传型与疾病的增加的风险被联系(或 = 1.78, 95% CI:1.25-2.49 ) 。结论:在在免疫逻辑的普通 SNP 之间的协会反应相关的基因和 CRC 在现在的学习被报导。除了使恶意开始和前进的机制清楚些, SNP 可以改进在风险的为亚人口的适当屏蔽。 | George Theodoropoulos Ioannis Papaconstantinou Evangelos Felekouras Nikolaos Nikiteas Petros Karakitsos Dimitris Panoussopoulos Andreas Ch Lazaris Efstratios Patsouris John Bramis Maria Gazouli | 2006 | World Journal of Gastroenterology2006，12，31： | 16 |
| 9 | Clinical impact of microbiome in patients with decompensated cirrhosis显示文摘Cirrhosis is an increasing cause of morbidity and mortality. Recent studies are trying to clarify the role of microbiome in clinical exacerbation of patients with decompensated cirrhosis. Nowadays, it is accepted that patients with cirrhosis have altered salivary and enteric microbiome, characterized by the presence of dysbiosis. This altered microbiome along with small bowel bacterial overgrowth, through translocation across the gut, is associated with the development of decompensating complications. Studies have analyzed the correlation of certain bacterial families with the development of hepatic encephalopathy in cirrhotics. In general, stool and saliva dysbiosis with reduction of autochthonous bacteria in patients with cirrhosis incites changes in bacterial defenses and higher risk for bacterial infections, such as spontaneous bacterial peritonitis, and sepsis. Gut microbiome has even been associated with oncogenic pathways and under circumstances might promote the development of hepatocarcinogenesis. Lately, the existence of the oral-gutliver axis has been related with the development of decompensating events. This link between the liver and the oral cavity could be via the gut through impaired intestinal permeability that allows direct translocation of bacteria from the oral cavity to the systemic circulation. Overall, the contribution of the microbiome to pathogenesis becomes more pronounced with progressive disease and therefore may represent an important therapeutic target in the management of cirrhosis. | Theodora Oikonomou George V Papatheodoridis Michael Samarkos Ioannis Goulis Evangelos Cholongitas | 2018 | World Journal of Gastroenterology2018，24，34： | 16 |
| 10 | Omnidirectional iridescence via cylindricallypolarized femtosecond laser processing显示文摘We report the femtosecond(fs)laser fabrication of biomimetic omnidirectional iridescent metallic surfaces exhibiting efficient diffraction for practically any angle of light incidence.Such diffractive behavior is realized by means of multi-directional low-spatial-frequency,laser-induced periodic surface structures(LSFL)formed upon exploiting the cylindrical symmetry of a cylindrical vector(CV)fs field.We particularly demonstrate that the multi-directional gratings formed on stainless steel surface by a radially polarized fs beam,could mimic the omnidirectional structural coloration properties found in some natural species.Accordingly,the fabricated grating structures can spatially disperse the incident light into individual wavelength with high efficiency,exhibiting structural iridescence at all viewing angles.Analytical calculations using the grating equation reproduced the characteristic variation of the vivid colors observed as a function of incident angle.We envisage that our results will significantly contribute to the development of new photonic and light sensing devices. | Nikolaos Livakas Evangelos Skoulas Emmanuel Stratakis | 2020 | Opto-Electronic Advances2020，3，5： | 14 |
| 11 | Combined hepatocellular-cholangiocarcinoma:An update on epidemiology,classification,diagnosis and management显示文摘Background:Combined hepatocellular-cholangiocarcinoma(CHC)is a rare subtype of primary hepatic malignancies,with variably reported incidence between 0.4%–14.2%of primary liver cancer cases.This study aimed to systematically review the epidemiological,clinicopathological,diagnostic and therapeutic data for this rare entity.Data sources:We reviewed the literature of diagnostic approach of CHC with special reference to its clinical,molecular and histopathological characteristics.Additional analysis of the recent literature in order to evaluate the results of surgical and systemic treatment of this entity has been accomplished.Results:The median age at CHC’s diagnosis appears to be between 50 and 75 years.Evaluation of tumor markers[alpha fetoprotein(AFP),carbohydrate antigen 19–9(CA19–9)and carcinoembryonic antigen(CEA)]along with imaging patterns provides better opportunities for CHC’s preoperative diagnosis.Reported clinicopathologic prognostic parameters possibly correlated with increased tumor recurrence and grimmer survival odds include advanced age,tumor size,nodal and distal metastases,vascular and regional organ invasion,multifocality,decreased capsule formation,stem-cell features verification and increased GGT as well as CA19–9 and CEA levels.In case of inoperable or recurrent disease,combinations of cholangiocarcinoma-directed systemic agents display superior results over sorafenib.Liver-directed methods,such as transarterial chemoembolization(TACE),percutaneous ethanol injection(PEI),hepatic arterial infusion chemotherapy(HAIC),radioembolization and ablative therapies,demonstrate inferior efficacy than in cases of hepatocellular carcinoma(HCC)due to CHC’s common hypovascularity.Conclusions:CHC demonstrates an overlapping clinical and biological pattern between its malignant ingredients.Natural history of the disease seems to be determined by the predominant tumor element.Gold standard for diagnosis is histology of surgical specimens.Regarding therapeutic interventions,major hepatectomy is acknowledged as the cornerstone of treatment whereas minor hepatectomy and liver transplantation may be applied in patients with advanced cirrhosis.Despite all therapeutic attempts,prognosis of CHC remains dismal. | Dimitrios Schizas Aikaterini Mastoraki Eleni Routsi Michail Papapanou Dimitrios Tsapralis Pantelis Vassiliu Konstantinos Toutouzas Evangelos Felekouras | 2020 | Hepatobiliary & Pancreatic Diseases International2020，19，6： | 14 |
| 12 | Laparoscopic splenectomy:Current concepts显示文摘Since early 1990's,when it was inaugurally introduced,laparoscopic splenectomy has been performed with excellent results in terms of intraoperative and postoperative complications.Nowadays laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen.However some contraindications still apply.The evolution of the technology has allowed though,cases which were considered to be absolute contraindications for performing a minimal invasive procedure to be treated with modified laparoscopic approaches.Moreover,the introduction of advanced laparoscopic tools for ligation resulted in less intraoperative complications.Today,laparoscopic splenectomy is considered safe,with better outcomes in comparison to open splenectomy,and the increased experience of surgeons allows operative times comparable to those of an open splenectomy.In this review we discuss the indications and the contraindications of laparoscopic splenectomy.Moreover we analyze the standard and modified surgical approaches,and we evaluate the short-term and long-term outcomes. | Evangelos P Misiakos George Bagias Theodore Liakakos Anastasios Machairas | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，9： | 14 |
| 13 | Monocytes in systematic inflammatory response syndrome:Differences between sepsis and acute pancreatitis显示文摘AIM: To unravel the differences between systematic in- flammatory response syndrome (SIRS) of acute pancre- atitis compared to the same syndrome in sepsis. METHODS: Twenty-five patients were enrolled, 12 with sepsis and 13 acute pancreatitis. After diagnosis 20 ml blood was sampled. Half were assayed for isolation of monocytes and 10 ml was centrifuged for serum test of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6). Half of monocytes were incubated in the presence of patients’ serum and supernatants were collected. The other half was treated for estimation of optical photom- etry under caspase-3 inhibition. TNFα and IL-6 were es- timated by an enzyme immunoassay. RESULTS: median ± SE of serum IL-6 in septic patients and acute pancreatitis patients was 192.30 ± 35.40 ng/L and 21.00 ± 16.05 ng/L, respectively (P < 0.01). Re- spective values of caspase-3 were 0.94 ± 0.17 pmol/min 104 cells and 0.34 ± 0.09 pmol/min 104 cells (P < 0.05). IL-6 of monocyte supernatants of patients with sepsis was significantly increased after addition of patients’ serum, while that of patients with acute pancreatitis did not show significant difference. CONCLUSION: The data have shown that monocyte activity is different between acute pancreatitis and sepsis. This phenomenon might be explained as a different pathway to the pro-inflammatory cytokines release or could be a novel anti-inflammatory response in acute pancreatitis. | Vassilios Koussoulas Michalis Tzivras Vassiliki Karagianni Ekaterini Spyridaki Diamantis Plachouras Helen Giamarellou Evangelos J Giamarellos-Bourboulis | 2006 | World Journal of Gastroenterology2006，12，41： | 13 |
| 14 | Diabetes mellitus and electrolyte disorders显示文摘Diabetic patients frequently develop a constellation of electrolyte disorders. These disturbances are particularly common in decompensated diabetics, especially in the context of diabetic ketoacidosis or nonketotic hyperglycemic hyperosmolar syndrome. These patients are markedly potassium-, magnesium- and phosphatedepleted. Diabetes mellitus(DM) is linked to both hypo- and hyper-natremia reflecting the coexistence of hyperglycemia-related mechanisms, which tend to change serum sodium to opposite directions. The most important causal factor of chronic hyperkalemia in diabetic individuals is the syndrome of hyporeninemic hypoaldosteronism. Impaired renal function, potassiumsparing drugs, hypertonicity and insulin deficiency are also involved in the development of hyperkalemia. This article provides an overview of the electrolyte disturbances occurring in DM and describes the underlying mechanisms. This insight should pave the way for pathophysiology-directed therapy, thus contributing to the avoidance of the several deleterious effects associated with electrolyte disorders and their treatment. | George Liamis Evangelos Liberopoulos Fotios Barkas Moses Elisaf | 2014 | World Journal of Clinical Cases2014，2，10： | 13 |
| 15 | EUS-guided drainage is more successful in pancreatic pseudocysts compared with abscesses显示文摘AIM: To compare the results for endoscopic ultrasound (EUS)-guided drainage of clear fluid pancreatic pseudocysts with the results for abscess drainage. METHODS: All patients referred for endoscopic drainage of a fluid collection were prospectively included. The outcome was recorded. RESULTS: Altogether 26 pseudocysts or abscesses were treated in 25 (6 female) patients. One endoscopist performed the procedures. Non-infected pseudocysts were present in 15 patients and 10 patients had infected fluid collections. The cyst size ranged between 28 cm × 13 cm and 5 cm × 5 cm. The EUS drainage was successful in 94% of the pseudocysts and in 80% of the abscesses (P = 0.04). The complication rate in pseudocysts was 6% and in abscesses was 30% (P = 0.02). Recurrence of a pseudocyst occurred in one patient (4%) after 6 mo; the patient was successfully retreated. CONCLUSION: EUS-guided drainage of pseudocysts is associated with a higher success rate and a lower complication rate compared with abscess drainage. | Riadh Sadik Evangelos Kalaitzakis Anders Thune Jan Hansen Claes Jnson | 2011 | World Journal of Gastroenterology2011，17，4： | 12 |
| 16 | Overview of coronary artery variants, aberrations and anomalies显示文摘Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The rapid advancement of imaging techniques, including computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography, have provided us with a wealth of new information on the subject. Anomalous origin of a coronary artery from the contralateral sinus is the anomaly most frequently associated with sudden cardiac death, in particular if the anomalous coronary artery has a course between the aorta and the pulmonary artery. However, other coronary anomalies, like anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae, have also been implicated in cases of sudden cardiac death. Patients are usually asymptomatic, and in most of the cases, coronary anomalies are discovered incidentally during coronary angiography or on autopsy following sudden cardiac death. However, in some cases, symptoms like angina, syncope, heart failure and myocardial infarction may occur. The aims of this article are to present a brief overview of the diverse coronary variants and anomalies, focusing especially on anatomical features, clinical manifestations, risk of sudden cardiac death and pathophysiologic mechanism of symptoms, as well as to provide valuable information regarding diagnostic workup, follow-up, therapeutic choices and timing of surgical treatment. | Stylianos Kastellanos Konstantinos Aznaouridis Charalambos Vlachopoulos Eleftherios Tsiamis Evangelos Oikonomou Dimitris Tousoulis | 2018 | World Journal of Cardiology2018，10，10： | 12 |
| 17 | Cytopathologic diagnosis of fine needle aspiration biopsies of thyroid nodules显示文摘Fine-needle aspiration(FNA) cytology is an important diagnostic tool in patients with thyroid lesions.Several systems have been proposed for the cyropathologic diagnosis of the thyroid nodules.However cases with indeterminate cytological findings still remain a matter of debate.In this review we analyze all literature regarding Thyroid Cytopathology Reporting systems trying to identify the most suitable methodology to use in clinical practice for the preoperative diagnosis of thyroid nodules.A review of the English literature was conducted,and data were analyzed and summarized and integrated from the authors' perspective.The main purpose of thyroid FNA is to identify patients with higher risk for malignancy,and to prevent unnecessary surgeries for benign conditions.The Bethesda System for Reporting Thyroid Cytopathology is the most widely used system for the diagnosis of thyroid FNA specimens.This system also contains guidelines for the diagnosis and treatment of indeterminate or suspicious for malignancy cases.In conclusion,patients who require repeated FNAs for indeterminate diagnoses will be resolved by repeat FNA in a percentage of 72%-80%. | Evangelos P Misiakos Niki Margari Christos Meristoudis Nickolas Machairas Dimitrios Schizas Konstantinos Petropoulos Aris Spathis Petros Karakitsos Anastasios Machairas | 2016 | World Journal of Clinical Cases2016，4，2： | 12 |
| 18 | Management of patients with hepatitis B in special populations显示文摘The development of effective nucleos(t)ide analogs(NAs)against hepatitis B virus(HBV)has improved the outcome of patients with chronic hepatitis B(CHB).This review updates issues related to the management of CHB patients included in special populations.Entecavir(ETV)and tenofovir(TDF)represent the currently recommended first-line NAs in patients with HBV decompensated cirrhosis.The combination of HBV immunoglobulin(usually for a finite duration)and NA is considered the standard of care for prophylaxis against HBV recurrence after liver transplantation.TDF is the best choice for hemodialysis patients and in patients with chronic kidney disease with nucleoside resistance.ETV and telbivudine are the preferred options in na?ve renal transplant recipients and with low viremia levels,respectively.All hepatitis B surface antigen(HBs Ag)-positive candidates should be treated with NAs before renal transplantation to achieve undetectable HBV DNA at the time of transplantation.Conventional interferon or NAs can also be used in children,on the basis of well-established therapeutic indication.Pregnant women at high risk of perinatal transmission could be treated with lamivudine,telbivudine or TDF in the last trimester of pregnancy.HBs Ag-positive patients under immunosuppression should receive NA preemptively(regardless of HBV DNA levels)up to 12 mo after its cessation.In HBs Ag negative,anti-HBc positive patients under immunosuppression,further studies are needed to form a final conclusion;however,it seems that anti-HBV prophylaxis is justified in such patients with hematological diseases and/or for those receiving rituximab-containing regimens,regardless of their antiHBs or serum HBV DNA status. | Evangelos Cholongitas Konstantinos Tziomalos Chrysoula Pipili | 2015 | World Journal of Gastroenterology2015，21，6： | 11 |
| 19 | Evidence for the role of gastric mucosa at the secretion of soluble triggering receptor expressed on myeloid cells(strem-1) in peptic ulcer disease显示文摘AIM: To investigate the role of gastric mucosa at the secretion of sTREM-1 in peptic ulcer. METHODS: Seventy two patients were enrolled; 35 with duodenal, 21 with gastric ulcer and 16 with chronic gastritis. Patients were endoscoped and gastric juice was aspirated. Patients with duodenal and gastric ulcer underwent a second endoscopy post-treatment. Biopsies were incubated in the absence/presence of endotoxins or gastric juice. Supernatants were collected and sTREM-1 and TNFα were measured by enzyme immunoabsorbent assays. Scoring of gastritis was performed before and after treatment according to updated Sydney score. RESULTS: Patients with duodenal and gastric ulcer and those with chronic gastritis had similar scores of gastritis. sTREM-1 was higher in supernatants of tissue samples of H pylori-positive than of H pylori-negative patients with gastric ulcer. Median (± SE) sTREM-1 was found increased in supernatants of patients with gastric ulcer before treatment (203.21 ± 88.91 pg/1000 cells) compared to supernatants either from the same patients post-treatment (8.23 ± 5.79 pg/1000 cells) or from patients with chronic gastritis (6.21 ± 0.71 pg/1000 cells) (P < 0.001 and < 0.001, respectively). Similar differences for sTREM-1 were recorded among LPS-stimulated tissue samples of patients (P = 0.001). Similar differences were not found for TNFα. Positive correlations were found between sTREM-1 of supernatants from patients withboth duodenal and gastric ulcer before treatment and the degree of infiltration of neutrophils and monocytes. CONCLUSION: sTREM-1 secreted by the gastric mucosa is an independent mechanism connected to the pathogenesis of peptic ulcer. sTREM-1 was released at the presence of H pylori from the inflamed gastric mucosa in the field of gastric ulcer. | Vassilios Koussoulas Spyridon Vassiliou Ekaterini Spyridaki Maria Demonakou Ilia Vaki Charalambos Barbatzas Helen Giamarellou Evangelos J Giamarellos-Bourboulis | 2007 | World Journal of Gastroenterology2007，13，34： | 11 |
| 20 | Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly:A study of 33 cases显示文摘AIM: To evaluate different types of treatment for sigmoid volvulus and clarify the role of endoscopic intervention versus surgery. METHODS: A retrospective review of the clinical presentation and imaging characteristics of 33 sigmoid volvulus patients was presented, as well as their diagnosis and treatment, in combination with a literature review. RESULTS: In 26 patients endoscopic detorsion was achieved after the first attempt and one patient died because of uncontrollable sepsis despite prompt operative treatment. Seven patients had unsuccessful endoscopic derotation and were operated on. On two patients with gangrenous sigmoid, Hartmann's procedure was performed. In five patients with viable colon, a sigmoid resection and primary anastomosis was carried out. Three patients had a lavage 'on table' prior to anastomosis, while in the remaining 2 patients a diverting stoma was performed according to the procedure of the first author. Ten patients were operated on during their first hospital stay (3 to 8 d after the deflation). All patients had viable colon; 7 patients had a sigmoid resection and primary anastomosis, 2 patients had sigmoidopexy and one patient underwent a near-total colectomy. Two patients (sigmoidectomy-sigmoidopexy) had recurrences of volvulus 43 and 28 mo after the initial surgery. Among 15 patients who were discharged from the hospital after non-operative deflation, 3 patients were lost to follow-up. Of theremaining 12 patients, 5 had a recurrence of volvulus at a time in between 23 d and 14 mo. All the five patients had been operated on and in four a gangrenous sigmoid was found. Three patients died during the 30 d postoperative course. The remaining seven patients were admitted to our department for elective surgery. In these patients, 2 subtotal colectomies, 3 sigmoid resections and 2 sigmoidopexies were carried out. One patient with subtotal colectomy died. Taken together of the results, it is evident that after 17 elective operations we had only one death (5.9%), whereas after 15 emergency operations 6 patients died, which means a mortality rate of 40%. CONCLUSION: Although sigmoid volvulus causing intestinal obstruction is frequently successfully encountered by endoscopic decompression, however, the principal therapy of this condition is surgery. Only occasionally in patients with advanced age, lack of bowel symptoms and multiple co-morbidities might surgical repair not be considered. | Michael Safioleas Constantinos Chatziconstantinou Evangelos Felekouras Michael Stamatakos Ioannis Papaconstantinou Anastasios Smirnis Panagiotis Safioleas Alkiviades Kostakis | 2007 | World Journal of Gastroenterology2007，13，6： | 10 |
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