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Biomedical subjects

Constantinos E Simopoulos

Publications and source records attributed to Constantinos E Simopoulos.

7 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↗
PubMed2005

Prophylactic intravenous ondansetron and dolasetron in intrathecal morphine-induced pruritus: a randomized, double-blinded, placebo-controlled study.

Pruritus is the most common side effect of intrathecal morphine for postoperative pain relief. Activation of central 5-hydroxytryptamine subtype 3 (5-HT3) receptors is one of its possible mechanisms. The role of 5-HT3 antagonists in the prevention of pruritus has not been clearly established. In a prospective, randomized, double-blind, placebo-controlled study, we evaluated the efficacy of prophylactic administration of ondansetron and dolasetron for the prevention of intrathecal morphine-induced pruritus. The patients were randomized into 3 groups to receive either 4 mg ondansetron IV (group O, n = 35), 12.5 mg dolasetron IV (group D, n = 35) or 5 mL placebo (group P, n = 35) 30 min before administration of spinal anesthesia with 10 to 17.5 mg of 0.5% hyperbaric bupivacaine and 0.25 mg of morphine for urologic, orthopedic, or vascular surgery. Patients were evaluated for incidence and severity of pruritus at arrival to the postanesthesia care unit and at 2, 4, 8, and 24 h postoperatively. The incidence and severity of pruritus was significantly less frequent in the ondansetron and dolasetron groups compared with placebo (34%, 20%, and 66% respectively, P < 0.01). Patients who received 5-HT3 antagonist reported significantly less total severity of pruritus compared with placebo during the first 8 h and the severe pruritus was observed only in patients within P group (P group: 4 of 35; 11%, O or D group: 0 of 35; 0%, P < 0.05). We conclude that the prophylactic use of ondansetron and dolasetron helps to reduce the incidence and severity of intrathecal morphine-induced pruritus.

Adult↗
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↗