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Biomedical subjects

E Misiakos

Publications and source records attributed to E Misiakos.

13 recordsLinked to original sources
PubMed2004

Effects of acetylsalicylic acid on experimental atherogenesis induced in rabbits.

AIM: Inflammation related processes play a key role in the current etiologic model of atherosclerosis and its acute complications. In addition, platelet-derived growth factors stimulate the neointimal proliferation of restenosis after coronary interventions. Reducing platelet accumulation at treated sites may attenuate restenosis. The purpose of this experimental study was to investigate the effect of acetylsalicylic acid (ASA), a widely used anti-platelet and anti-inflammatory agent on the development and extent of atherosclerosis. METHODS: Fourty-eight male white New Zealand rabbits were separated in 4 groups (12 animals each group). Group I received a diet of 2% cholesterol and 6% corn oil for 3 months. Group II received a diet of 2% cholesterol and 6% corn oil and in addition received 3 mg of ASA/kg daily intramuscular (i.m.) for 3 months. Group III received the same diet, and in addition received 10 mg of ASA/kg daily i.m. for 3 months. Group IV received the same diet and in addition received 50 mg of ASA/kg daily i.m. for 3 months. Animals were sacrificed after 3 months. RESULTS: ASA reduced the serum levels of total cholesterol, total lipids, triglycerides and LDL cholesterol. There was significant difference in the extent of atherosclerotic lesions between animals which received different doses of ASA and that animals which did not received any ASA. High dose ASA treatment resulted in an increase in fasting plasma glucose, associated with a reduction in total cholesterol and triglycerides. CONCLUSION: Our results suggest that there is a protective effect on atherosclerosis development of ASA down stream from where it lowers plasma fatty acid concentrations. However, further studies are required to verify that effect.

Animals↗
PubMed2002

Management of enterochromaffin-like gastric carcinoid tumour metastasized to the liver.

We report the rare case of a patient suffering from pernicious anaemia and a history of flushing and diarrhoea. The patient was found to have microcarcinoids with multiple gastric polyps and a solitary liver metastasis. He was successfully managed with subtotal gastrectomy, while the liver metastasis was cured by Interferon-alpha and octreotide administration.

Aged↗
PubMed1999

Inclusion of entire pancreas in the composite liver and intestinal graft in pediatric intestinal transplantation.

An entire pancreatico-duodenal complex was included in the liver and intestinal graft in eight children who received small-size grafts. This method showed several advantages compared to the traditional approach. They included reducing time for graft preparation by eliminating donor pancreas resection, no necessity of biliary reconstruction and leaving natural tissue support for blood vessels. The method was not associated with an increased risk of complications such as pancreatitis or rejection. It should be considered in pediatric liver and intestinal transplant recipients who require small-size grafts.

Age Factors↗
PubMed1999

Changing patterns in advanced gastric carcinoma.

A retrospective study on patients with gastric cancer during the periods 1984-88 (n = 63 patients) and 1989-93 (n = 59 patients) was made. The aim of the study was to assess any changing patterns in tumour distribution, surgical management and survival during the two periods. When the diagnosis was made, the majority of tumours were advanced: 58 were stage IV and 21 were stage IIIB, with 43 tumours at earlier stages. The incidence of proximally located gastric adenocarcinomas increased from 15.9 to 27.1%, while the incidence of carcinomas located in the body decreased from 34.9 to 23.7%. The majority of patients underwent conservative gastrectomy. The proportion of proximal gastrectomies increased from 3.2 to 15.3 per cent (p = 0.02), whereas the proportion of combined resection of adjacent organs decreased from 38.1 to 22.0 per cent (p = 0.04). Perioperative mortality rate decreased from 17.5 to 1.7 per cent (p = 0.003). Prognosis remained unchanged in the two periods; overall 5-year survival is calculated as 12 per cent.

Adenocarcinoma↗
PubMed1997

Surgical treatment for splenic hydatidosis.

Splenic involvement is rare in patients with hydatid disease even in endemic countries. The spleen is the third most commonly involved organ after the liver and the lung. In our series splenic echinococcosis represents 5.8% of abdominal hydatid disease. During the last 22 years, 14 patients were operated on for splenic hydatid cysts in our department. In 10 patients the spleen was the only location of hydatid disease; in 2 patients there was concomitant liver hydatid disease; one patient had disseminated intraabdominal disease; and one patient had a coexisting hydatid cyst in the quadriceps femoris muscle. Plain abdominal films, ultrasonography, and computed tomography scans were most useful for establishing the diagnosis. All patients underwent splenectomy alone or combined with management of cysts at other sites, except for two patients who underwent omentoplasty and one patient who underwent external drainage. One patient died during the early postoperative period (mortality rate 7%), and three patients had minor complications. Splenic hydatid disease should be included in the differential diagnosis when a splenic cyst is identified, especially in patients with a history of hydatid disease. Surgery remains the treatment of choice to avoid serious complications.

Adult↗
PubMed1997

Surgical treatment of gastrointestinal B-cell mucosa-associated lymphoid tissue lymphomas.

We retrospectively evaluated clinicopathologic features of 35 patients treated for primary gastrointestinal lymphomas of MALT type (mucosa-associated lymphoid tissue) between 1970 and 1993. Fourteen patients (40%) were treated for acute abdominal conditions (bowel obstruction in 8, perforation in 2, and gastrointestinal bleeding in 4), and the rest had exploratory laparotomy. The tumor was located in the stomach in 23 patients (66%), in the jejunum and ileum in 10 (29%), and in the large intestine in 2 (6%). The type of operation was defined according to site and extent of disease. Most patients received chemotherapy postoperatively. Staging was done according to the Ann Arbor classification. Survival depended on stage and extension of the disease; 5-year survival was 45%. Surgical resection followed by adjuvant chemotherapy is warranted when the patient is considered to be a surgical candidate.

Adolescent↗
PubMed1997

Management of foreign bodies of the rectum: report of 21 cases.

This is a report of 21 patients treated for non-therapeutic introduction of rectal foreign bodies in our institution. Nine out of 18 patients had manual transanal extractions performed under general anaesthesia while eight patients required insertion of retractors and gynaecological forceps. In three patients the vacuum from the hollow objects was abolished by passing a catheter through the anus to a point above the object. One of the patients required colotomy for retrieval of a wooden object. In three patients free perforations were obvious clinically with peritoneal signs and free air on plain abdominal radiographs. Treatment was end-sigmoid colostomy and mucous fistula, oversewing of the perforation and peritoneal irrigation. There were no deaths and only one complication occurred, a rectovaginal fistula.

Adult↗
PubMed1996

Cystic dilatations of the common bile duct in adults.

Cystic dilatations of the common bile duct are believed to be of congenital etiology with most cases presenting in childhood. During the last 20 years, 10 patients with cystic dilatations of the bile duct were treated in our Department. There were 5 men and 5 women with an age range of 35-81 years. Clinical presentation consisted of right hypohondrial pain, nausea, vomiting and a history of obstructive jaundice. Diagnosis was established by ultrasound, cholangiography and ERCP in most cases. According to the Todani classification system, 5 patients had type I cysts, 4 had type II and one had type III. At the time of surgery, main associated diseases were choledocholithiasis in 3 cases and cholangitis in 2 cases. One patient (type III) underwent endoscopic sphincterotomy; 4 patients underwent internal drainage and 2 of them developed mild cholangitis postoperatively; 5 patients underwent excision of the cyst and a biliary-enteric bypass and developed no main complications. Patients remained in good health during long-term follow-up. We conclude that cyst excision is the treatment of choice for adults in order to reduce postoperative morbidity and the potential risk of malignancy.

Adult↗
PubMed1995

Therapeutic strategies for pancreatic pseudocysts.

During the last 15 years, a total of 26 patients were treated for pancreatic pseudocysts, at the 2nd Department of Propaedeutic Surgery, University of Athens. There were 16 (61.5%) men and 10 (38.5%) women aged between 19 and 82 years old (mean age 61 years). Dominating symptoms in most patients were epigastric mass and pain, nausea, vomiting, mild fever and leucocytosis, and persistent elevation of serum amylase. Imaging studies, such as ultrasound, CT scan, and ERCP, were mostly helpful in establishing diagnosis. In most cases, attack of acute pancreatitis preceded with the exception of two cases where there was chronic pancreatitis and another which was post-traumatic. Rapid progression of underlying pancreatitis led to urgent laparotomy in two patients (7.7%). Elective surgery was performed in 22 patients (84.6%), 1-7 months after onset of pancreatitis (median 2 months). Selection of operative procedure depended on the patient and cyst condition. Cystogastrostomy was performed in 18 patients (69.2%), cystojejunostomy in three patients (11.5%), and external drainage in three patients (11.5%). There were three postoperative deaths (11.5%). Haemorrhage and infection were the main complications. Percutaneous drainage was performed in two cases (7.7%) (one for a cyst remnant after an operative procedure), and medical treatment with somatostatin in another case (3.8%) with excellent clinical results. In conclusion, conservative treatment of pancreatic pseudocysts has good clinical results, but it is not always indicated. Surgical drainage remains the preferred method of treatment.

Adult↗
PubMed1994

Surgical treatment of extracranial carotid aneurysms.

During the past 23 years, 12 patients with aneurysm of the carotid bifurcation were treated in our department. There were 11 men and one woman between 20 and 68 years (mean age 54.2 years). In as much as 217 patients were operated on for extracranial occlusive carotid disease during the same period, the incidence of these aneurysms in our series has been estimated to be 5%. Eleven patients presented with TIAs ipsilateral to the aneurysm. One patient presented with a painful pulsatile enlarging mass in the neck (ruptured aneurysm) without any neurological complications. Eleven patients underwent surgical repair. Ligation of the common carotid artery was done in one patient, resection of the aneurysm with end-to-end anastomosis was performed in 2 patients, aneurysmorraphy in 4, excision and reconstruction with reversed saphenous vein in one, excision and reconstruction with PTFE graft in one and 2 patients underwent endarterectomy and angioplasty of the carotid bifurcation. One patient with a high internal carotid artery aneurysm (base of the skull) was classified as nonoperable. There were no deaths or strokes postoperatively. Persistent cranial nerve injury was noted in 1 case (8%). Follow-up at 6 months - 10 years (mean 5.5 years) yielded and incidence of post-op TIAs of 8% attributed to intracranial occlusive disease. Surgical correction is the treatment of choice for extracranial carotid aneurysm and can be performed with a very low morbidity and mortality and carries excellent long-term results.

Blindness↗
PubMedDate not supplied

Diagnostic evaluation and surgical management of hydatid disease of the liver.

Human echinococcosis is still endemic in some areas of the world, including Mediterranean countries. Because there is no effective medical therapy, surgery remains the principal mode of treatment. A consecutive of 132 patients operated on for liver hydatid disease between January 1977 and February 1993 were analyzed. There were 60 men (45.4%) and 72 women (54.6%) aged 31 to 88 years (mean 56 years). The right lobe of the liver was affected in 68 cases (51.5%), the left lobe in 31 cases (23.5%), and both lobes in 14 cases (10.6%); there were multiple liver cysts in 7 cases (5.3%), concomitant cysts in other parenchymal organs in 4 cases (3.0%), and disseminated intraabdominal hydatid disease in 8 cases (6.1%). Clinical symptomatology consisted of abdominal pain, fever, jaundice, urticaria, and an abdominal mass. Preoperative diagnosis was established using imaging studies: plain abdominal films, ultrasonography, computed tomography, and serologic tests. Three patients (2.3%) underwent simple closure without drainage, 7 patients (5.3%) cyst excision, 4 patients (3.0%) marsupialization, 1 patient (0.8%) left lateral segmentectomy, 15 patients (11.3%) external drainage, 69 patients (52.3%) omentoplasty, and 33 patients (25.0%) combinations of procedures. Postoperative morbidity was low and consisted of hepatic abscess development, wound infection, bowel obstruction, and biliary leaks. Six patients (4.5%) had recurrent disease. One patient died during the postoperative period because of septic complications. Among the surgical techniques we used, excision of the cyst (when feasible) and omentoplasty produced the lowest complication rates and the best clinical results.

Adult↗
PubMedDate not supplied

Diagnostic approach and management of active lower gastrointestinal hemorrhage.

We evaluated 67 patients with acute bleeding of the lower gastrointestinal tract, for diagnostic accuracy of colonoscopy, and scintigraphy. Fifty-nine patients were stable after initial resuscitation and underwent colonoscopy. The source of hemorrhage was identified in 30 patients (50.8%). Tc-labeled red blood cells scintigram was undergone in 23 patients with a sensitivity of 43.4%. The identification of the bleeding source reached 75.4% when colonoscopy was used in combination with scintigraphy. Eleven patients with lower gastrointestinal bleeding requiring transfusion of 5 units of red blood cells or more had a diagnostic exploratory laparotomy, and the diagnosis was ascertained during operation in nine. The postoperative mortality rate was 18.1%. We conclude that in patients with active gastrointestinal bleeding, colonoscopy in combination with scintigraphy detect at a higher rate the cause and the site of bleeding and possibly improve the prognosis.

Adolescent↗