Biomedical subjects

Alexandra K Tsaroucha

Publications and source records attributed to Alexandra K Tsaroucha.

8 recordsLinked to original sources

PubMed2006

Primary hydatid disease in a retroplaced gallbladder.

A 60-year-old man with abdominal distension, fever, vomiting and pain on the right upper quadrant of the abdomen was admitted to our hospital. US revealed a well circumscribed lesion of mixed echogenicity. CT revealed hypoplasia of the right liver lobe, and a cystic mass with solid components replacing a retroplaced gallbladder. On T1-weighted MR images the lesion had low signal intensity and presented mild peripheral post-contrast enhancement, while on T2-weighted images the periphery was of moderately high signal intensity and the centre of fluid-like, high signal intensity. Adjacent liver parenchyma had relatively high signal intensity on T2-weighted images. The patient underwent exploratory laparotomy, and a hydatid cyst of the gallbladder that was inflamed was evidenced.

Cholangiography↗

PubMed2005

Hydatid disease of the abdomen and other locations.

We present patients treated for hydatid disease in our hospital (in northeastern Greece) over the last 20 years. In the period from 1984 to 2003, a total of 135 patients (54 male, 81 female) were treated for echinococcal disease (age 15-85 years). In 111 (82.2%) patients only the liver was affected; 9 (6.7%) patients had concomitant hepatic and extrahepatic hydatid disease; and 15 (11.1%) patients had only extrahepatic disease. Clinical symptoms in patients with hepatic locations of the disease included abdominal pain localized in the epigastrium or right upper quadrant of the abdomen, tenderness, hepatomegaly with palpable abdominal mass, jaundice, fever, and anaphylactic reaction. All the patients were treated surgically. Surgical techniques included partial cystectomy and drainage, cystectomy and capitonage, cystectomy and omentoplasty, only drainage, left lateral hepatectomy, total pericystectomy, and laparoscopic pericystectomy. Rupture into the bile duct was managed by T-tube drainage or biliodigestive anastomosis. Symptoms and surgical treatment for extrahepatic cysts varied according to the location of the cyst. The median cyst diameter of all patients was 11 cm. The postoperative complication rate was 17.0%. Two patients died (1.5%). The median hospital stay was 18 days. The recurrence rate was 6.7%. The study suggests that treatment of this benign disease should be the less radical surgical technique combined with pre- and postoperative anthelmintic administration. The surgical treatment should be combined with careful use of scolicidal fluids and aspiration of the cyst to avoid contamination and minimize the risk of recurrence.

Abdominal Cavity↗

PubMed2005

U-stitching splenorraphy technique: experimental and clinical study.

BACKGROUND: The aim of the present study was to describe the laboratory development and the subsequent clinical utility of the U-stitching technique for splenorraphy over the recent years in a general non-trauma hospital. Patients with splenectomies and patients treated conservatively during the same time period, are also presented. METHODS: In the 15-year period from September 1988 until September 2003, 65 patients were diagnosed with splenic injury following admission to 2nd Department of Surgery, Democritus University Hospital, after blunt abdominal trauma. During the first 3 years, 14 patients were admitted; one of them was treated conservatively and 13 had splenectomies. Because computed tomography (CT) was not available at that time, these 14 patients form a control group. During the remaining 12-year period, 51 patients (39 male and 12 female; age, 4-82 years; mean, 31.1 years; SD, 19.7 years) were treated conservatively or surgically, either with splenectomy or with splenorraphy. Splenorraphy was performed using the U-stitching technique. This alternative splenorraphy technique was first tested on experimental models at 2nd Department of Surgery, Democritus University Hospital, then followed by successful clinical application. The medical records for these patients were reviewed to extract the data for the present study. RESULTS: Thirty-six patients (70.6% of 51 patients) were treated surgically; of these, 21 (41.2% of 51 patients) had splenectomy and 15 (29.4% of 51 patients) had splenorraphy. Non-operative treatment was initially given to 15 patients (29.4% of 51 patients). Two of them had delayed rupture of the spleen and underwent splenectomy (at 8 and 40 days). The total number of preserved spleens was 28 of 51 (54.9%). None of the patients with conservative treatment or splenorraphy died. One patient with splenectomy died later from overwhelming sepsis. CONCLUSIONS: Splenic salvage is now a treatment goal. If the patient is haemodynamically unstable and splenorraphy is possible, the U-stitching technique is a promising approach.

Adult↗

PubMed2003

Cystadenocarcinoma of the appendix: an incidental imaging finding in a patient with adenocarcinomas of the ascending and the sigmoid colon.

BACKGROUND: Primary adenocarcinomas of the appendix are uncommon. Mucoceles that result from mucinous adenocarcinomas of the appendix may be incidentally detected on imaging. CASE PRESENTATION: A case of a mucocele of the appendix, due to cystadenocarcinoma, is presented as an incidental imaging finding in a female, 86-year-old patient. The patient was admitted due to rectal hemorrhage and underwent colonoscopy, x-ray, US and CT. Adenocarcinoma of the ascending colon, adenomatous polyp of the sigmoid colon and a cystic lesion in the right iliac fossa were diagnosed. The cystic lesion was characterized as mucocele. The patient underwent right hemicolectomy, excision of the mucocele and sigmoidectomy. She recovered well and in two-year follow-up is free from cancer. CONCLUSIONS: Preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management, but it is difficult on imaging studies. Small lymph nodes or soft tissue stranding in the surrounding fat on computed tomography examination may suggest the possibility of malignancy.

Adenocarcinoma↗

PubMed2003

Phytobezoars as a cause of small bowel obstruction associated with a carcinoid tumor of the ileocecal area.

Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.

Aged↗

PubMed2003

Serum levels of c-erbb-2 correlate with advanced stage and liver metastasis in colorectal cancer.

OBJECTIVE: To study the clinical significance of soluble c-erbB-2 in the serum of patients with colorectal cancer. METHODS: Serum c-erbB-2 levels were measured by an enzyme-linked immunosorbent assay in 52 patients with colorectal cancer and in 35 healthy controls. Their association with clinicopathological features, serum carcinoembryonic antigen (CEA) and patient survival was also evaluated. RESULTS: Serum c-erbB-2 levels in colorectal cancer patients were significantly higher than those in controls and correlated significantly with Dukes' stage and with the presence of liver metastases. Patients with elevated serum c-erbB-2 levels showed shorter survival compared with those with normal serum c-erbB-2 levels although the difference was not statistically significant. There was no relationship between serum c-erbB-2 and CEA levels. Elevated serum c-erbB-2 levels showed a moderate specificity and a low sensitivity in colorectal cancer diagnosis with their sensitivity being lower compared with the sensitivity of CEA. CONCLUSION: Serum c-erbB-2 levels in colorectal cancer patients are significantly higher compared with healthy controls and correlate with advanced disease stage and the presence of liver metastases. However, their clinical usefulness remains questionable.

Adenocarcinoma↗

PubMed2003

Serum levels of intercellular adhesion molecule-1 correlate with advanced and metastatic disease and poor prognosis in gastric cancer.

OBJECTIVE: The aim of this study was to compare the levels of intercellular adhesion molecule-1 in gastric cancer patients and healthy controls and to evaluate their clinical significance. METHODS: The serum levels of the intercellular adhesion molecule-1 were measured in 53 patients with gastric cancer and in 39 healthy controls by an enzyme linked immunosorbent assay and were associated with clinicopathological features, patient survival and established tumor markers. RESULTS: Serum levels of intercellular adhesion molecule-1 in patients with gastric cancer were significantly higher in comparison with healthy controls. These levels correlated with tumor stage, and with lymph node and distant metastases. Elevated serum levels of intercellular adhesion molecule-1 were a significant prognostic factor for poor survival but not independent of disease stage and type of resection. Elevated serum ICAM-1 levels correlated significantly with both elevated serum CA 19-9 and elevated CEA levels. CONCLUSION: Serum levels of intercellular adhesion molecule-1 in gastric cancer patients correlate with advanced and metastatic disease and with poor prognosis although their use as tumor markers remains to be determined.

Adenocarcinoma↗

PubMedDate not supplied

Serum leptin levels and their response during laparoscopic and open cholecystectomy.

We compared serum leptin responses during and after laparoscopic and open cholecystectomy, and assessed their correlation with the responses of inflammatory cytokines. Serum levels of leptin, interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were measured by an enzyme-linked immunoassay in 31 patients who underwent laparoscopic cholecystectomy and in 24 patients who underwent open cholecystectomy. Serum samples were obtained preoperatively, at 10 and 30 min after the commencement of surgery, and at 6 and 24 h after the operation. The cumulative responses of leptin, IL-1alpha, IL-6 and TNF-alpha to surgery were calculated and the associations between them were evaluated. Serum leptin levels were significantly increased at 24 h after both procedures. The serum leptin concentration at this time point and the cumulative leptin response were significantly lower after laparoscopic cholecystectomy than after open cholecystectomy. Changes in serum IL-1alpha, TNF-alpha and IL-6 concentrations showed similar kinetics in both groups, with postoperative IL-6 levels being consistently lower in the laparoscopic cholecystectomy group. Cumulative IL-6 and TNF-alpha responses were significantly lower after laparoscopic cholecystectomy than after open cholecystectomy. The cumulative responses of leptin, IL-1alpha and IL-6 correlated significantly with each other. Leptin may be involved in the systemic inflammatory response to surgical injury, and the postoperative leptin elevation and cumulative leptin response are significantly lower after laparoscopic cholecystectomy than after open cholecystectomy.

Adult↗