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| 1 | Pathophysiological consequences of obstructive jaundice and perioperative management显示文摘Background: Obstructive jaundice is a common problem in daily clinical practice. Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management.Data sources: A Pub Med was searched for relevant articles published up to August 2016. The effect of obstructive jaundice on proinflammatory cytokines, coagulation status, hemodynamics and organ functions were evaluated.Results: The effects of obstructive jaundice included biliary tree, the hepatic cell and liver function as well as systemic complications. The lack of bile in the gut, the disruption of the intestinal mucosal barrier,the increased absorption of endotoxin and the subsequent endotoxemia cause proinflammatory cytokine production(TNF-α, IL-6). Bilirubin induces systemic inflammatory response syndrome which may lead to multiple organ dysfunction syndrome. The principal clinical manifestations include hemodynamic instability and acute renal failure, cardiovascular suppression, immune compromise, coagulation disorders,nutritional impairment, and wound healing defect. The proper management includes full replacement of water and electrolyte deficiency, prophylactic antibiotics, lactulose, vitamin K and fresh frozen plasma,albumin and dopamine. The preoperative biliary drainage has not been indicated in overall, but only in a few selected cases.Conclusion: The perioperative management is an essential measure in improving the outcome after the appropriate surgical operation in jaundiced patients especially those with malignancy. | Efstathios T Pavlidis Theodoros E Pavlidis | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 63 |
| 2 | Advances in prognostic factors in acute pancreatitis:a mini-review显示文摘BACKGROUND:Early assessment of the severity of acute pancreatitis is essential to the proper management of the disease.It is dependent on the criteria of the Atlanta classification system.DATA SOURCES:PubMed search of recent relevant articles was performed to identify information about the severity and prognosis of acute pancreatitis.RESULTS:The scoring systems included the Ranson's or Glasgow's criteria ≥3,the APACHE II classification system ≥8,and the Balthazar's criteria ≥4 according to the computed tomography enhanced scanning findings.The single factors on admission included age >65 years,obesity,hemoconcentration(>44%),abnormal chest X-ray,creatinine >2 mg/dl,C-reactive protein>150 mg/dl,procalcitonin >1.8 ng/ml,albumin <2.5 mg/dl,calcium <8.5 mg/dl,early hyperglycemia,increased intra-abdominal pressure,macrophage migration inhibitory factor,or a combination of IL-10 >50 pg/ml with calcium <6.6 mg/dl.CONCLUSION:The prediction of the severity of acute pancreatitis is largely based on well defined multiple factor scoring systems as well as several single risk factors. | Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，5： | 25 |
| 3 | Role of bevacizumab in colorectal cancer growth and its adverse effects:A review显示文摘Angiogenesis affects both wound healing and malignant cell growth through nutrients and oxygen.Vascular endothelial growth factor(VEGF) is the most important element involved in this complex process.Inhibition of VEGF influences angiogenesis and may restrict tumor growth and metastatic ability.Modern antiangiogenic therapy is based on this theory.Bevacizumab is a recombinant humanized monoclonal antibody(immunoglobulin G1) which binds with VEGF-A forming a large molecule.It can not be bound with VEGF tyrosine kinase receptors preventing VEGF-A incorporation;thus its activity is inhibited inducing blockage of VEGFmediated angiogenesis.Bevacizumab,in combination with chemotherapy or other novel targeted therapeutic agents,is currently used more frequently in clinical practice,mainly for managing advanced colorectal cancer.It is also used for managing other malignancies,such as breast cancer,pancreatic cancer,prostate cancer,non small-cell lung cancer,metastatic renal carcinoma and ovarian tumors.Although it is generally considered a safe treatment,there are reports of some rare side effects which should be taken into account.Recent experiments in rats and mice show promising results with a wider therapeutic range. | Efstathios T Pavlidis Theodoros E Pavlidis | 2013 | World Journal of Gastroenterology2013，19，31： | 24 |
| 4 | Modified porous tantalum rod technique for the treatment of femoral head osteonecrosis显示文摘AIM: To study a modified porous tantalum technique for the treatment of osteonecrosis of the femoral head.METHODS: The porous tantalum rod was combined with endoscopy,curettage,autologous bone grafting and use of bone marrow aspirates from iliac crest aspiration in 49 patients(58 hips) with a mean age of 38 years.The majority of the patients had idiopathic osteonecrosis,followed by corticosteroid-induced osteonecrosis.Thirtyeight hips were of Steinberg stage Ⅱ disease and 20 hips were of stage Ⅲ disease.Patients were followed for 5 years and were evaluated clinically with the Merle D'Aubigne and Postel score and radiologically.The primary outcome of the study was survival based on the conversion to total hip arthroplasty(THA).Secondary outcomes included deterioration of the osteonecrosis to a higher disease stage at 5 years compared to the preoperative period and identification of factors that were associated with survival.The Kaplan-Meier survival analysis was performed to evaluate the survivorship ofthe prosthesis,and the Fisher exact test was performed to test associations between various parameters with survival.RESULTS: No patient developed any serious intraoperative or postoperative complication including implant loosening or migration and donor site morbidity.During the 5-year follow up,1 patient died,7 patients had disease progression and 4 hips were converted to THA.The 5-year survival based on conversion to THA was 93.1% and the respective rate based on disease progression was 87.9%.Stage Ⅱ disease was associated with statistically significant better survival rates compared to stage Ⅲ disease(P = 0.04).The comparison between idiopathic and non-idiopathic osteonecrosis and between steroid-induced and non-steroid-induced osteonecrosis did not showed any statistically significant difference in survival rates.The clinical evaluation revealed statistically significantly improved Merle d'Aubigne scores at 12 mo postoperatively compared to the preoperative period(P < 0.001).The mean preoperative Merle d'Aubigne score was 13.0(SD: 1.8).The respective score at 12 mo improved to 17.0(SD: 2.0).The 12-mo mean score was retained at 5 years.CONCLUSION: The modified porous tantalum rod technique presented here showed encouraging outcomes.The survival rates based on conversion to THA are the lowest reported in the published literature. | Emilios E Pakos Panayiotis Megas Nikolaos K Paschos Spyridon A Syggelos Antonios Kouzelis Georgios Georgiadis Theodoros A Xenakis | 2015 | World Journal of Orthopedics2015，6，10： | 20 |
| 5 | Circulating endothelial and progenitor cells:Evidence from acute and long-term exercise effects显示文摘Circulating bone-marrow-derived cells,named endothelial progenitor cells(EPCs),are capable of maintaining,generating,and replacing terminally differentiated cells within their own specific tissue as a consequence of physiological cell turnover or tissue damage due to injury.Endothelium maintenance and restoration of normal endothelial cell function is guaranteed by a complex physiological procedure in which EPCs play a significant role.Decreased number of peripheral blood EPCs has been associated with endothelial dysfunction and high cardiovascular risk.In this review,we initially report current knowledge with regard to the role of EPCs in healthy subjects and the clinical value of EPCs in different disease populations such as arterial hypertension,obstructive sleep-apnea syndrome,obesity,diabetes mellitus,peripheral arterial disease,coronary artery disease,pulmonary hypertension,and heart failure.Recent studies have introduced the novel concept that physical activity,either performed as a single exercise session or performed as part of an exercise training program,results in a significant increase of circulating EPCs.In the second part of this review we provide preliminary evidence from recent studies investigating the effects of acute and long-term exercise in healthy subjects and athletes as well as in disease populations. | Matina Koutroumpi Stavros Dimopoulos Katherini Psarra Theodoros Kyprianou Serafim Nanas | 2012 | World Journal of Cardiology2012，4，12： | 18 |
| 6 | Improvement of gastric emptying by enhanced recovery after pancreaticoduodenectomy显示文摘BACKGROUND: Enhanced recovery after surgery(ERAS) has improved postoperative outcomes particularly in colorectal surgery. This study aimed to assess compliance with an ERAS protocol and evaluate its effect on postoperative outcomes in patients undergoing pancreaticoduodenectomy. METHODS: Fifty patients who had received conventional peri operative management from 2005 to 2009(conventional group)were compared with 75 patients who had received perioperative care with an ERAS protocol(fast-track group) from 2010 to2014. Mortality, complications, readmissions and length of hospital stay were evaluated and compared in the groups.RESULTS: Compliance with each element of the ERAS pro tocol ranged from 74.7% to 100%. Uneventful patients had a significant higher adherence to the ERAS protocol(87.5% vs40.7%; P<0.001). There were no significant differences in de mographics and perioperative characteristics between the two groups. Patients in the fast-track group had a shorter time to remove the nasogastric tube, start liquid diet and solid food pass flatus and stools, and remove drains. No difference was found in mortality, relaparotomy, readmission rates and over all morbidity. However, delayed gastric emptying and length of hospital stay were significantly reduced in the fast-track group. The independent effect of the ERAS protocol in reduc ing delayed gastric emptying and length of hospital stay was confirmed by multivariate analysis.CONCLUSION: ERAS pathway was feasible and safe in improving gastric emptying, yielding an earlier postoperative recovery, and reducing the length of hospital stay. | Efstratios Zouros Theodoros Liakakos Anastasios Machairas Paulos Patapis Christos Agalianos Christos Dervenis | 2016 | Hepatobiliary & Pancreatic Diseases International2016，15，2： | 16 |
| 7 | Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment显示文摘Spondyloarthropathies(SpA) include many different forms of inflammatory arthritis and can affect the spine(axial SpA) and/or peripheral joints(peripheral SpA) with Ankylosing spondylitis(AS) being the prototype of the former. Extraarticular manifestations, like uveitis, psoriasis and inflammatory bowel disease(IBD) are frequently observed in the setting of SpA and are, in fact, part of the SpA classification criteria. Bowel involvement seems to be the most common of these manifestations. Clinically evident IBD is observed in 6%-14% of AS patients, which is significantly more frequent compared to the general population. Besides, it seems that silent microscopic gut inflammation, is evident in around 60% in AS patients. Interestingly, occurrence of IBD has been associated with AS disease activity. For peripheral SpA, two different forms have been proposed with diverse characteristics. Of note, SpA(axial or peripheral) is more commonly observed in Crohn's disease than in ulcerative colitis. The common pathogenetic mechanisms that explain the link between IBD and SpA are still ill-defined. The role of dysregulated microbiome along with migration of T lymphocytes and other cells from gut to the joint('gut-joint' axis) has been recognized, in the context of a genetic background including associations with alleles inside or outside the human leukocyte antigen system. Various therapeutic modalities are available with monoclonal antibodies against tumour necrosis factor, interleukin-23 and interleukin-17, being the most effective. Both gastroenterologists and rheumatologists should be alert to identify the coexistence of these conditions and ideally follow-up these patients in combined clinics. | George E Fragoulis Christina Liava Dimitrios Daoussis Euangelos Akriviadis Alexandros Garyfallos Theodoros Dimitroulas | 2019 | World Journal of Gastroenterology2019，25，18： | 13 |
| 8 | Current opinion on lymphadenectomy in pancreatic cancer surgery显示文摘BACKGROUND:Adenocarcinoma of the pancreas exhibits aggressive behavior in growth,inducing an extremely poor prognosis with an overall median 5-year survival rate of only 1%-4%.Curative resection is the only potential therapeutic opportunity. DATA SOURCES:A PubMed search of relevant articles published up to 2009 was performed to identify information about the value of lymphadenectomy and its extent in curative resection of pancreatic adenocarcinoma. RESULTS:Despite recent advances in chemotherapy,radio-therapy or even immunotherapy,surgery still remains the major factor that affects the outcome.The initial promising performance in Japan gave conflicting results in Western countries for the extended and more radical pancreatectomy; it has failed to prove beneficial.Four prospective,randomized trials on extended versus standard lymphadenectomy during pancreatic cancer surgery have shown no improvement in long-term survival by the extended resection.The exact lymph node status,including malignant spread and the total number retrieved as well as the lymph node ratio,is the most important prognostic factor.Positive lymph nodes after pancreatectomy are present in 70%.Paraaortic lymph node spread indicates poor prognosis. CONCLUSIONS:Undoubtedly,a standard lymphadenectomy including>15 lymph nodes must be no longer preferred in patients with the usual head location.The extended lymphadenectomy does not have any place,unless in randomized trials.In cases with body or tail location,the radical antegrade modular pancreatosplenectomy gives promising results.Nevertheless,accurate localization and detailed examination of the resected specimen are required for better staging. | Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，1： | 12 |
| 9 | Timing of laparoscopic cholecystectomy for acute cholecystitis: A prospective non randomized study显示文摘AIM: To study the timing of laparoscopic cholecy- stectomy for patients with acute cholecystitis.METHODS: Between January 2002 and December 2005, all American Society of Anesthesiologists classification (ASA)—RESULTS: One hundred and twenty-nine patients underwent laparoscopic cholecystectomy for acute cholecystitis during the index admission. Thirty six were assigned to group 1, 58 to group 2, and 35 to group 3. The conversion rate and morbidity for the whole cohort of patients were 4.6% and 10.8%, respectively. There was no significant difference in the conversion rate, morbidity and postoperative hospital stay between the three groups.CONCLUSION: Laparoscopic cholecystectomy for acute cholecystitis during the index admission is safe, regardless of the time elapsed from the onset of symptoms. This policy can result in an overall shorter hospitalization. | George Tzovaras Dimitris Zacharoulis Paraskevi Liakou Theodoros Theodoropoulos George Paroutoglou Constantine Hatzitheofilou | 2006 | World Journal of Gastroenterology2006，12，34： | 11 |
| 10 | Clock genes:Their role in colorectal cancer显示文摘Clock genes create a complicated molecular time-keeping system consisting of multiple positive and negative feedback loops at transcriptional and translational levels.This circadian system coordinates and regulates multiple cellular procedures implicated in cancer development such as metabolism,cell cycle and DNA damage response.Recent data support that molecules such as CLOCK1,BMAL1 and PER and CRY proteins have various effects on c-Myc/p21 and Wnt/β-catenin pathways and influence multiple steps of DNA damage response playing a critical role in the preservation of genomic integrity in normal and cancer cells.Notably,all these events have already been related to the development and progression of colorectal cancer(CRC).Recent data highlight critical correlations between clock genes’expression and pathogenesis,progression,aggressiveness and prognosis of CRC.Increased expression of positive regulators of this circadian system such as BMAL1 has been related to decrease overall survival while decreased expression of negative regulators such as PER2 and PER3 is connected with poorer differentiation,increased aggressiveness and worse prognosis.The implications of these molecules in DNA repair systems explain their involvement in the development of CRC but at the same time provide us with novel targets for modern therapeutic approaches for patients with advanced CRC. | Theodoros Karantanos George Theodoropoulos Dimitrios Pektasides Maria Gazouli | 2014 | World Journal of Gastroenterology2014，20，8： | 10 |
| 11 | A case of hepatocellular carcinoma arising within large focal nodular hyperplasia with review of the literature显示文摘Focal nodular hyperplasia (FNH) is a relatively rare benign hepatic tumor, usually presenting as a solitary lesion; however, multiple localizations have also been described. The association of FNH with other hepatic lesions, such as adenomas and haemangiomas has been reported by various authors. We herein report a case of a hepatocellular carcinoma arising within a large focal nodular hyperplasia, in a young female patient. | Theodoros Petsas Athanasios Tsamandas Irene Tsota Dionisios Karavias Chrysoula Karatza Vassilios Vassiliou Dimitrios Kardamakis | 2006 | World Journal of Gastroenterology2006，12，40： | 10 |
| 12 | Genetic and epigenetic risks of intracytoplasmic sperm injection method显示文摘怀孕由帮助繁殖技术完成了,特别地由胞质内精子注射(ICSI ) 过程,产生对与 ICSI 对待的男人口固有的基因风险和对这个创新过程固有的另外的风险。记录,以及理论,风险在现在的评论学习被讨论。这些风险主要表示位于男性下面的基因畸形的后果代替生育力(或不孕) 并且可能在不孕的治疗为新奇途径和应用的发展成为激发器。另外,冒的风险,当先天的异例和另外的理论或随机的风险被讨论,一个复合基因背景出现在出生。最近的数据建议那种帮助繁殖技术可能也影响雄配子,雌配子,或力量的渐成说特征影响早胚胎开始。它可能也为印畸形的 genomic 与增加的风险被联系。 | Ioannis Georgiou Maria Syrrou Nicolaos Pardalidis Konstantinos Karakitsios Themis Mantzavinos Nikolaos Giotitsas Dimitrios Loutradis Fotis Dimitriadis Motoaki Saito Ikuo Miyagawa Pavlos Tzoumis Anastasios Sylakos Nikolaos Kanakas Theodoros Moustakareas Dimitrios Baltogiannis Stavros Touloupides Dimitrios Giannakis Michael Fatouros Nikolaos Sofikitis | 2006 | Asian Journal of Andrology2006，8，6： | 9 |
| 13 | Autoimmune pancreatitis versus pancreaticcancer: a comprehensive review withemphasis on differential diagnosis显示文摘BACKGROUND: Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis with a discrete pathophysiology occasional diagnostic radiological findings, and characteristic histological features. Its etiology and pathogenesis are still under investigation, especially during the last decade Another aspect of interest is the attempt to establish specific criteria for the differential diagnosis between autoimmune pancreatitis and pancreatic cancer, entities that are frequently indistinguishable. DATA SOURCES: An extensive search of the PubMed database was performed with emphasis on articles about the differential diagnosis between autoimmune pancreatitis and pancreatic cancer up to the present. RESULTS: The most interesting outcome of recent research is the theory that autoimmune pancreatitis and its various extra-pancreatic manifestations represent a systemic fibro inflammatory process called IgG4-related systemic disease The diagnostic criteria proposed by the Japanese Pancreatic Society, the more expanded HISORt criteria, the new definitions of histological types, and the new guidelines of the International Association of Pancreatology help to establish the diagnosis of the disease types. CONCLUSION: The valuable help of the proposed criteria for the differential diagnosis between autoimmune pancreatitis and pancreatic cancer may lead to avoidance of pointless surgical treatments and increased patient morbidity. | Kyriakos Psarras Minas E Baltatzis Efstathios T Pavlidis Miltiadis A Lalountas Theodoros E Pavlidis Athanasios K Sakantamis | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，5： | 9 |
| 14 | Risk of colorectal neoplasm in patients with acromegaly: A meta-analysis显示文摘AIM: To examine the risk of colorectal neoplasm in acromegalic patients by meta-analyzing all relevant controlled studies. METHODS: Extensive English language medical literature searches for human studies, up to December 2007, were performed using suitable keywords. Pooled estimates [odds ratio (OR) with 95% confidence intervals (CI)] were obtained using either the fixed or random-effects model as appropriate. Heterogeneity between studies was evaluated with the Cochran Q test whereas the likelihood of publication bias was assessed by constructing funnel plots. Their symmetry was estimated by the adjusted rank correlation test. RESULTS: For hyperplastic polyps the pooled ORs with 95% CI were 3.557 (2.587-4.891) by fixed effects model and 3.703 (2.565-5.347) by random effects model. The Z test values for overall effect were 7.81 and 6.984, respectively (P < 0.0001). For colon adenomas the pooled ORs with 95% CI were 2.486 (1.908-3.238) (fixed effects model) and 2.537 (1.914-3.364) (random effects model). The Z test values were 6.747 and 6.472, respectively (P < 0.0001). For colon cancer the pooled OR with 95% CI was identical for both fixed and random effects model (OR, 4.351; 95% CI, 1.533-12.354; Z = 2.762, P = 0.006]. There was no significant heterogeneity and no publication bias in all the above meta-analyses. CONCLUSION: Acromegaly is associated with an increased risk of colorectal neoplasm. | Theodoros Rokkas Dimitrios Pistiolas Panos Sechopoulos Georgios Margantinis Georgios Koukoulis | 2008 | World Journal of Gastroenterology2008，14，22： | 8 |
| 15 | Apolipoprotein J as a predictive biomarker for restenosis after carotid endarterectomy: a retrospective study显示文摘颈动脉 endarterectomy (CEA ) 是为在大多数病人的击预防的一种有效外科的选择。在 CEA 以后的狭窄能导致重新干预和不利事件,但是预言狭窄的因素糟糕被理解。Apolipoprotein J (ApoJ ) 被认为是脉管的狭窄的一个新奇预兆的因素并且与与动脉粥样硬化和房间周期阶段有关的很多过程被联系。这研究的目的是阐明在内部颈动脉动脉(集成通信适配器) 的 Apo J 的预兆的价值狭窄追随者 CEA。都检验的这回顾的研究有希望地为在一个 2 年的时期上在我们的外科的部门经历了 CEA 的病人收集了数据。100 个病人的浆液 ApoJ 层次被检验;经历了 CEA 的 56 个病人包括了脉管的组(VG ) ,并且经历了次要的外科的 44 个病人包括了控制组(CG ) 。ApoJ 样品外科手术前地被获得,在外科的过程以后并且在 1, 6 和 12 个月的 24 h 此后在后续期间。在在 CG 和 VG 之间的 ApoJ 层次的外科手术前的差别是统计上 signifcant;吝啬的价值是 39.11 并且每个方法的能力在正常之间区别吗?? | Anastasios MASKANAKIS Nikolaos PATELIS Georgios KARAOLANIS Spyridon DAVAKIS Dimitrios SCHIZAS Despina PERREA Chris KLONARIS Sotirios GEORGOPOULOS Theodoros LIAKAKOS Chris BAKOYIANNIS | 2018 | Acta Pharmacologica Sinica2018，39，7： | 6 |
| 16 | Post-cardiac arrest syndrome:Mechanisms and evaluation of adrenal insufficiency显示文摘Cardiac arrest is one of the leading causes of death and represents maximal stress in humans. After restoration of spontaneous circulation, post-cardiac arrest syndrome is the predominant disorder in survivors. Besides the post-arrest brain injury, the post-resuscitation myocardial stunning, and the systemic ischemia/reperfusion response, this syndrome is characterized by adrenal insufficiency, a disorder that often remains undiagnosed. The pathophysiology of adrenal insufficiency has not been elucidated. We performed a comprehensive search of three medical databases in order to describe the major pathophysiological disturbances which are responsible for the occurrence of the disorder. Based on the available evidence, this article will help physicians to better evaluate and understand the hidden yet deadly post-cardiac arrest adrenal insufficiency. | Athanasios Chalkias Theodoros Xanthos | 2012 | World Journal of Critical Care Medicine2012，1，1： | 5 |
| 17 | Omeprazole maintenance therapy prevents recurrent ulcer bleeding after surgery for duodenal ulcer显示文摘瞄准:与周期性的溃疡为十二指肠溃疡在外科以后流血在病人评估 omeprazole 维护治疗。方法:我们与周期性的溃疡为十二指肠溃疡在外科以后流血学习了 15 个连续病人。维护治疗在溃疡愈合以后被给的 Omeprazole (20 mg/d ) 。除了临床的后续,回廊 24-h 胃的 pH 试金与以前的十二指肠溃疡外科而是没有溃疡复发在那些病人和控制被执行在前并且在 omeprazole 治疗期间。结果:所有 15 溃疡在为 2 瞬间与 omeprazole (40 mg/d ) 被对待以后被愈合。有二的十一个病人(1-9 ) 周期性的溃疡流血的事件完成了后续(43, 12-72 瞬间) 。任何一个都没他们有一个流血事件当时在 omeprazole 上。一个病人中止了治疗并且有周期性的流血。在病人的胃的 pH<4 的中部的 24-h 部分时间是 80, 46-95% ,并且被归结为 32,由 omeprazole (P=0.002 ) 的 13-70% 。结论:有 omeprazole (20 mg/day ) 的长期的维护治疗在阻止周期性的溃疡流血是有效的。 | Konstantinos Demertzis Dimitrios Polymeros Theodoros Emmanuel Konstantinos Triantafyllou Pericles Tassios Spiros D Ladas | 2006 | World Journal of Gastroenterology2006，12，5： | 5 |
| 18 | 腰部的脊骨的磁性的回声成像上的过渡 lumbosacral 解剖的预言显示文摘 AIM:To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra(LSTV) in magnetic resonance imaging(MRI) studies of the spine.METHODS:The lumbar spine MRI studies of 50 subjects with LSTV and 50 subjects with normal lumbosacral anatomy were retrospectively evaluated.In each study,the mid-sagittal T2-weighted image was used to measure the angle formed by a line parallel to the superior surface of the sacrum and a line perpendicular to the axis of the scan table(A-angle),as well as the angle formed by a line parallel to the superior endplate of the L3 vertebra and a line parallel to the superior surface of the sacrum(B-angle).RESULTS:The total study population consisted of 100 subjects(46 males,54 females,51 ± 16 years old).There were no differences in age and sex between the two groups.Both A-angle and B-angle were significantly increased in subjects with LSTV compared to controls(P < 0.05).The optimal cut-off values of A-angle and B-angle for the prediction of LSTV were 39.8°(sensitivity = 80%,specificity = 80%,accuracy = 83%;95% confidence interval = 74%-89%,P = 0.0001) and 35.9°(sensitivity = 80%,specificity = 54%,accuracy = 69%;95% confidence interval = 59%-78%,P = 0.0005),respectively.CONCLUSION:On sagittal MR images of the lumbar spine,an increased A-angle and/or B-angle should alert the radiologist to the presence of LSTV. | Majid Chalian Theodoros Soldatos John A Carrino Alan J Belzberg Jay Khanna Avneesh Chhabra | 2012 | World Journal of Radiology2012，4，3： | 5 |
| 19 | Current surgical management of pancreatic endocrine tumor liver metastases显示文摘BACKGROUND: The management of metastatic disease in pancreatic endocrine tumors (PETs) demands a multidisciplinary approach and the cooperation of several medical specialties. The role of surgery is critical, even when a radical excision cannot always be achieved. DATA SOURCES: A PubMed search of relevant articles published up to February 2011 was performed to identify current information about PET liver metastases regarding diagnosis and management, with an emphasis on surgery. RESULTS: The early diagnosis of metastases and their accurate localization, most commonly in the liver, is very important. Surgical options include radical excision, and palliative excision to relieve symptoms in case of failure of medical treatment. The goal of the radical excision is to remove the primary tumor bulk and all liver metastases at the same time, but unfortunately it is not feasible in most cases. Palliative excisions include aggressive tumor debulking surgeries in well-differentiated carcinomas, trying to remove at least 90% of the tumor mass, combined with other additional destructive techniques such as hepatic artery embolization or chemoembolization to treat metastases or chemoembolization to relieve symptoms in cases of rapidly growing tumors. The combination of chemoembolization and systemic chemotherapy results in better response and survival rates. Other local destructive techniques include ethanol injection, cryotherapy and radiofrequency ablation. CONCLUSION: It seems that the current management of PETs can achieve important improvements, even in advanced cases. | Theodoros E Pavlidis Kyriakos Psarras Nikolaos G Symeonidis Efstathios T Pavlidis Athanasios K Sakantamis | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，3： | 5 |
| 20 | Role of stenting in the palliation of gastroesophageal junction cancer: A brief review显示文摘Gastroesophageal junction cancer has an increasing in-cidence in western countries. It is inoperable when firstmanifested in more than 50% of cases. So, palliationis the only therapeutic option for the advanced diseaseto relieve dysphagia and its consequences in weakenedpatients with an estimated mean survival under 6 mo.This article has tried to identify trends focusing on cur-rent information about the best palliative treatment,with an emphasis on the role of stenting. Self-expand-ing stent placement, either metal or plastic, is the mainmanagement option. However, this anatomical loca-tion creates some particular problems for stent safetyand effectiveness which may be overcome by properlydesigned novel stents. The stents ensure a good qual-ity of life and must be preferred over other alterna-tive methods of loco-regional modalities, i.e., externalradiation, laser thermal or photodynamic therapy. Al-though stent placement is generally a simple, safe andeffective method, there are sometimes complications,increasing the morbidity and mortality rate. Bypassoperative procedures have now been abandoned as afirst choice. The stomach instead of the colon must beused for a bypass operation when it is needed. Chemo-therapy, despite the toxicity, and intraluminal radiation(brachytherapy) have a well-defined role. | Theodoros E Pavlidis Efstathios T Pavlidis | 2014 | World Journal of Gastrointestinal Surgery2014，6，3： | 5 |
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