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Biomedical subjects

C Katsohis

Publications and source records attributed to C Katsohis.

9 recordsLinked to original sources
PubMed2000

Fluorouracil and leucovorin with or without interferon alfa-2a as adjuvant treatment, in patients with high-risk colon cancer: a randomized phase III study conducted by the Hellenic Cooperative Oncology Group.

BACKGROUND: It has been shown in randomized studies that adjuvant treatment with the combination of fluorouracil (FU) and levamisole reduced the risk of recurrence and deaths of patients with stage III colon cancer. Pharmacological studies of FU led to its use in combination with a number of modulating agents including interferon-alpha and leucovorin (LV) that appear to enhance its activity in vitro. Furthermore, a meta-analysis suggested that the combination of FU with LV increased the response rate as compared to FU monotherapy in patients with advanced colorectal cancer. PURPOSE: To evaluate the impact of adjuvant treatment with the combination of FU and LV with or without interferon alfa-2a (IFN) on disease-free survival (DFS) and overall survival (OS) for patients with stage II or III colon cancer. PATIENTS AND METHODS: From August 1989 to July 1997, 280 patients with stage II and III colon cancer entered the study and were randomly assigned to receive either the combination of FU (600 mg/m(2)/week x 6, followed by a 2-week rest) and LV (500 mg/m(2)/week x 6 as a 2-hour infusion, followed by a 2-week rest) for 4 cycles (group A, 139 patients), or the same chemotherapy plus recombinant IFN (3 MU subcutaneously 3 times a week) for 1 year (group B, 141 patients). RESULTS: A total of 109 patients (78.9%) of group A and 119 (84.4%) of group B completed four cycles of chemotherapy. Also, 51.4% of patients of group A and 53.9% of group B received > or =80% of the planned dose of FU. One patient (group A) was found to be ineligible and was not included in the analysis. The median relative dose intensity of FU in the two groups was 0.90 and 0.85, respectively. As of August 1998, after a median follow up of 4 years, there was no significant difference in either 3-year DFS (group A, 83.1%; group B, 75.9%, p = 0.14) or OS (group A, 84.5%; group B, 80.0%, p = 0.27). In the Cox model, stage of disease, number of infiltrated nodes, tumor grade and presence of regional implants were identified as significant prognostic factors for OS. Grade 3-4 toxicities, mainly diarrhea, were observed in 26.1% of patients of group A and in 24.8% of group B. There were no treatment-related deaths. CONCLUSIONS: The addition of IFN to the combination of FU with LV postoperatively does not improve DFS and OS of patients with stage II or III colon cancer.

Adult↗
PubMed1999

Myoelectric assessment of large bowel viability: an experiment in dogs.

OBJECTIVE: To design a device for myoelectric assessment of intestinal ischaemia and compare it with every day surgical experience and Doppler signals recorded on the bowel wall. DESIGN: Experimental study. SETTING: Thessaloniki university hospital, Greece. MATERIAL: 12 adult mongrel dogs. INTERVENTIONS: On the first day the large intestine was devascularised for a length of 20 cm, 5 cm away from the ileocaecal valve, and the threshold of the electric stimulus (mA) required to produce a contraction of the normal large bowel was recorded. On the second day, measurements were made on the ischaemic segment of the large bowel at 0.5 cm intervals. Bowel resection and anastomoses were done at the stimulus level of 40 mA. RESULTS: The mean (SD) stimulus threshold of the normal large intestine was 12.2 mA. The necrotic intestine demanded current stimulus of 100 mA or failed to contract. On the eighth postoperative day the animals were killed to assess anastomotic healing. Of the 12 anastomoses made at the 40 mA stimulus point, only one ruptured. The 40 mA limit of the stimulus level seems to be of value in assessments of bowel viability in vivo. CONCLUSION: The use of a personal computer as a read out device makes myoelectric analysis easier and more reliable in the assessment of intestinal viability. This method may have a clinical application.

Anastomosis, Surgical↗
PubMed1998

Uncommon sites of hydatid disease.

Echinococcosis remains an endemic surgical problem in many Mediterranean countries. We report our experience with such cases when the disease is located in uncommon sites, outside the liver and lungs. This study was an effort similar to a previous one but with more cases and additional information. Between 1967 and 1994 a total of 49 patients suffering from hydatid cysts located in various organs other than the liver and lungs presented to our clinic. There were 28 men and 21 women, with their ages ranging from 10 to 66 years and 22 to 80 years, respectively. Among these patients, 25 had the parasitic cyst in the peritoneal cavity, 10 in the spleen, 5 in the kidney, 3 in the spinal column, 2 in the retroperitoneal space, 1 in the abdominal wall, 1 in the myocardium, 1 in the thoracic wall, and 1 in the thigh. Their hospital stay was 9 to 88 days (average 27 days). Only two patients--one with cardiac hydatidosis and one with spinal hydatidosis--died postoperatively. Three patients with multiple cysts in the peritoneum and one with cysts in the thigh had recurrences of the disease and were reoperated successfully.

Adult↗
PubMed1996

Subtotal cholecystectomy.

Subtotal cholecystectomy has been carried out in 34 patients from 1972 to 1992. In the same period 1620 total cholecystectomies were performed. The indications were severe inflammation and/or severe fibrosis in 31 patients, and Mirizzi syndrome type 1 in 3 patients. The morbidity was insignificant, but one patient died, due to severe sepsis. In follow up studies ranging from 6 months to 9 years, there was one patient with retained stones in the common bile duct. No other post cholecystectomy sequelae were noticed in the remaining 32 patients. Subtotal cholecystectomy is a safe, feasible and definitive operation in patients for whom the standard operation could be dangerous. This operation is less burdensome to the patient, and is accompanied by fewer complications than ordinary cholecystostomy.

Adult↗
PubMed1996

Acute cholecystitis in aged patients.

The aim of this study is the analysis of the results in 62 patients over 70 years of age with acute cholecystitis treated in our Department from 1970 to 1990. The clinical picture in 47 patients was mild and in 15 severe. In 14 cases (10 calculous, 4 acalculous) the acute cholecystitis subsided with antibiotics (Group A). In 48 more cases (45 calculous, 3 acalculous) following 1-3 days conservative treatment, operation was undertaken. Besides acute cholystitis there was gangrene of gallbladder in 10, choledocholithiasis in 7 and choloperitoneum without perforation in 7 cases. Cholecystostomy in 25, cholecystectomy in 15 and cholecystectomy with exploration of the bill duct in 8 cases was performed (Group B). There was one death in group A and 3 deaths in group B. The hospital stay was 20 days. In conclusion the clinical findings in acute cholecystitis in the aged are usually mild. In the case of failure of medical treatment, after 2-3 days emergency surgery should be performed.

Acute Disease↗
PubMed1996

Hanging noncalculous gallbladder.

The removal of acalculous and not acutely inflamed gall-bladder in patients with typical biliary pain remains a questionable procedure. This study was conducted to present our experience. In the period 1982-90, 1089 cases of calculous and acalculous gallbladder disease were treated in our clinic. In this period, 27 patients were subjected to cholecystectomy because of an acalculous, non inflamed gallbladder which was elongated lying in an abnormal position with a long cystic duct. The mean duration of symptoms supportive of cholelithiasis, was 5 years. Oral cholecystogram and ultrasonography led to the diagnosis and other causes of chronic abdominal pain were excluded. There were 13 lumbar, 9 pelvic and 5 iliac gallbladders, with poor function in 20 of them. During cholecystectomy, the organ was invested by peritoneum and suspended in 7 cases from a mesentery. On pathological examination mild chronic inflammation was reported in 19 cases and minimal changes in 8. The minimum follow up was one year and the maximum 9 years. Complete relief of symptoms was achieved in all the cases. In conclusion, cholecystectomy should be offered in these symptomatic "hanging" gallbladders.

Adult↗
PubMed1995

High-dose epirubicin and r-met-hu G-CSF (filgrastim) in the treatment of patients with advanced breast cancer: A Hellenic Cooperative Oncology Group study.

The delivery of high-dose epirubicin in patients with advanced breast cancer usually entails serious myelotoxicity and frequent treatment delays. Concurrent administration of G-CSF probably allows the administration of epirubicin on schedule with minimal morbidity. From August 1990 to February 1992, 42 women with advanced breast cancer were treated with six cycles of epirubicin 110 mg/m2 every 4 weeks. Filgrastim 5 micrograms/kg per day for 14 days was administered subcutaneously starting 24 hours after chemotherapy. All patients had multiple metastatic sites, and 39 had visceral metastases. All cases were evaluable for response, toxicity, and survival. Treatment was delayed in only two cases. The actually administered average dose per unit time per patient amounted to 99.6% of the dose prescribed by the protocol. Two (4.5%; 95% confidence interval [C.I.] 0-16%) patients demonstrated a complete response and 14 (33%; 95% C.I. 19-49%) a partial response. Median time to progression was 31 weeks and median survival was 60 weeks. Severe granulocytopenia was seen in six patients; stomatitis and diarrhea in one patient each. Myoskeletal pain was noticed in 23 (55%) patients, while cardiac problems were reported in 3 cases. The present study shows that the prophylactic use of r-met-hu G-CSF allows the administration of high-dose epirubicin every 4 weeks with minimal morbidity and an improved quality of life.

Adult↗
PubMed1982

A new method of repairing extensive tubular tracheal defects. Experimental work.

After a short review of several surgical methods used for the reconstruction of long tubular tracheal defects a new surgical method that was carried out on 36 dogs is described. Seven dogs were excluded from the experiment because of failure in the creation of the 'graft' consisting of heavy Marlex mesh and fascia lata, 'biologically' organized together during the first-stage operation. Twenty-nine dogs were subjected to the second-stage operation during which a tracheal defect, created after removing 5 to 11 cartilaginous tracheal rings, was bridged with the 'graft' taken from the site of implantation of heavy Marlex mesh and formed in a cylindrical fashion. The period and the rate of survival were both significant in many instances. The main characteristics were the relative lack of granulation tissue, usually developing at the lines of anastomoses in other series, and the appearance of new epithelium which, in a good number of cases, partially or almost completely covered the lumen of the new trachea.

Animals↗