Symptomatic heterotopic pancreas of the stomach.
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Adult↗
Biomedical subjects
G Kouraklis
Publications and source records attributed to G Kouraklis.
Malignant rhabdoid tumor of the kidney and soft tissues. Evidence for a diverse morphological and immunocytochemical phenotype.
Three malignant rhabdoid tumors of the kidney and two extrarenal rhabdoid tumors of soft tissues were studied by light and electron microscopy and by immunocytochemistry for the expression of keratin, vimentin, desmin, neurofilament triplet proteins, epithelial membrane antigen, myoglobin, and HNK-1 (Leu-7). Electron microscopy revealed the characteristic cytoplasmic whorled filamentous inclusions in all tumors. An epithelial phenotype (presence of cytoplasmic tonofilaments) was observed in two tumors (one renal and one extrarenal); and a focal primitive neural phenotype (cytoplasmic processes with neurosecretory granules), in a renal rhabdoid tumor. Strands of basal lamina were seen in two renal and one extrarenal rhabdoid tumors. Evaluation of basal lamina was more difficult in the third renal rhabdoid tumor, in which tissue preservation was not optimal. Primitive attachments were present in all rhabdoid tumors. Immunocytochemical staining supported a diverse phenotype, ranging from epithelial and/or mesenchymal to myogenous and/or neuroectodermal. Simultaneous expression of several of the studied antigenic determinants by the same tumor was noted. The findings suggest that both renal and extrarenal rhabdoid tumors express a diverse morphological and immunocytochemical phenotype.
Child, Preschool↗
Lower gastrointestinal haemorrhage secondary to an ileal lipoma protruding into the caecum.
We report the case of a patient with lower gastrointestinal haemorrhage. The cause of the haemorrhage was a lipoma of the terminal ileum that protruded into the caecum. The diagnosis was made endoscopically and radiologically. It was surgically treated with local excision.
Aged↗
Expression of PDGF-A, TGFb and VCAM-1 during the developmental stages of experimental atherosclerosis.
PURPOSE: A considerable number of growth factors, cytokines, and adhesion molecules are implicated in the development of atherosclerotic lesions. These molecules interact in a complex network influencing the evolution of several processes, such as lipid metabolism, cellular proliferation and tissue repair. The aim of this study was to evaluate the expression of the growth factors PDGF-A, and TGFb, and the adhesion molecule VCAM-1 in the sequential steps of experimental atherogenesis. METHODS: Forty-two New Zealand white male rabbits were divided into 4 groups. The group A rabbits (n = 8) received normal diet and served as control animals. The remaining groups were fed with a diet enriched with 1% cholesterol and 6% corn oil. The rabbits of group B (n = 9) were sacrificed 1 month after the beginning of the study, of group C (n = 15) after 2 months and of group D (n = 10) after 3 months. In tissue sections of the aortic arch the antibodies of the prementioned factors were detected immunohistochemically. RESULTS: In group A only TGFb and PDGF-A were detectable. In lesions of the first month PDGF-A expression was high but declined towards the third month. VCAM-1 expression was getting more intense up to the second month and subsided thereafter. TGFb expression intensified towards the third month. Changes in the expression of these factors were statistically significant. CONCLUSION: PDGF-A, responsible for the uncontrollable growth of smooth muscle cells, and VCAM-1, regulating monocyte recruitment in the intima, acts mainly during the early stages of atherogenesis. TGFb, one of the main factors controlling the formation of connective tissue matrix, has a gradually increasing expression towards the third month contributing probably to the fibrous plaque formation.
Animals↗
Preliminary evaluation of the potential prognostic value of serum levels of immunoglobulins (IgA, IgM, IgG, IgE) in patients with gastric cancer.
Sixty patients with advanced gastric carcinoma who refused to receive cytotoxic chemotherapy were examined for serum immunoglobulin levels (IgG, IgM, IgA, IgE). Three samples were obtained every two months thereafter. The group of patients who had above-normal values of one or more of the examined immunoglobulins had a longer survival than the other (p < 0.024). Immunoglobulin values were independent of the Helicobacter pylori antibody titer and of acute phase reactants. It is concluded that survival potentially correlates with serum immunoglobulin levels. Further studies including larger numbers of patients and correlating serum immunoglobulin levels with specific clinical parameters are needed to establish the prognostic role of serum immunoglobulins in patients with gastric carcinoma.
Adult↗
Epidural analgesia attenuates the systemic stress response to upper abdominal surgery: a randomized trial.
The effects of combined general anaesthesia and epidural analgesia in various endocrine and metabolic parameters were studied before, during, at the end, and 72 h after upper abdominal surgery, in an effort to further elucidate the role of epidural analgesia in the endocrine and metabolic response. 50 patients were randomly assigned into groups A and B, which received general anaesthesia alone and combined general anaesthesia and epidural analgesia, respectively. The effects of surgical stress in the plasma concentration of ACTH (P <0.001), cortisol (P <0.01), aldosterone (P <0.05), FFA (P <0.05) and glucose (P <0.01) were significantly less pronounced in the group of patients who received combined general anaesthesia and epidural analgesia. However, there were no significant differences between the two groups in regard with plasma TSH, T3, T4, glucagon or Na+ concentration. These results indicate that the combination of general anaesthesia and epidural analgesia attenuate, but does not inhibit, the endocrine and metabolic response to upper abdominal surgery.
Adrenocorticotropic Hormone↗
Diverticular disease of the small bowel: report of 27 cases.
Diverticula of the small bowel are usually asymptomatic but occasionally can present with serious complications. Because of the rarity of small bowel diverticulosis and the limited case number in most published reports, we analyzed one of the largest series with symptomatic small bowel diverticular disease. In this retrospective review, we studied 27 symptomatic patients with diverticula of the small bowel that was treated surgically. The study included 13 male and 14 female patients (age range, 30-87 years; mean age, 69.3 years). Fourteen patients underwent an elective operation for chronic refractory symptoms. Thirteen patients underwent emergency surgery because of rupture of the diverticula and associated peritonitis, diverticulitis and small bowel obstruction, or lower gastrointestinal bleeding. Surgical treatment consisted of resection of the intestinal segment containing the diverticula. All patients were symptom-free postoperatively and no "short bowel" problems developed. Abdominal pain, gastrointestinal bleeding, and bowel obstruction were the most common clinical symptoms. Small bowel diverticulosis should be treated surgically only when refractory symptoms or severe complications are present.
Adult↗
Local recurrence after radical surgery for colorectal cancer.
Local recurrence of colorectal cancer after curative surgery is a major clinical problem. The aim of our study was to present our experience in this field. Between January 1990 and December 2000, 572 patients underwent resection for colorectal cancer in our department; 66 of them had local recurrence within the first 2 years. Most of those patients had Dukes' stage B (n = 24) or stage C (n = 37) tumors, which were located mainly in the rectum (n = 40) and sigmoid colon (n = 18). The incidence of local recurrence was 11% and 15.9% for tumors that were Dukes' stages B and C, respectively. Thirty-five of 66 patients received palliative treatment, and 28 of them died within 9 months. The remaining 31 patients underwent radical excision of the recurrent tumor: 11 of these patients died within 2 years, and 20 were still alive after 30 months. The only hope for long-term survival for patients presenting with local recurrence from colorectal cancer after primary radical treatment is to identify local recurrence at an early stage and treat it in a radical manner.
Adult↗
Palliative treatment for bile duct carcinoma.
BACKGROUND/AIMS: Extrahepatic bile duct carcinoma remains a very difficult problem for the surgeon. The aim of this study was to evaluate the differences between surgical treatment and endoscopic or transhepatic dilatation and intubation. METHODOLOGY: Clinical data from 62 consecutive patients with carcinoma of the extrahepatic bile ducts, who underwent palliative treatment during the past 25 years in our department, were retrospectively analyzed. Preoperative assessment defined site, stage and resectability of tumors. RESULTS: Tumors were located in the upper third of the bile duct in 32 cases, in the middle third in 17 cases and in the distal third in 13 cases. Transtumoral dilatation was performed in 36 patients (Group A) and cholangioenteric bypass in the remaining 26 patients (Group B). The overall mortality rate was 12.9%. The average survival rate was 6.5 months in group A and 7.3 months in group B. CONCLUSIONS: In conclusion we suggest that the cholangioenteric bypass offers a better quality of life than non-operative techniques.
Aged↗
Gastrointestinal carcinoid tumors: 10-year experience of a general surgical department.
Gastrointestinal (GI) carcinoids are rare neuroendocrine tumors of great interest because of the multitude of the peptide hormones they produce, their clinical manifestations, the carcinoid syndrome they cause, their biologic behavior, and the methods of their surgical and adjuvant treatment. In this retrospective study, 25 patients with carcinoid tumors admitted and surgically treated in our department during the last 10 years are presented. Most of the cases were located in the ileum (n = 8) and appendix (n = 12). The remaining cases were located in the rectum (n = 2), stomach (n = 1), duodenum (n = 1), and ileocecal valve (n = 1). After tumor resection and postoperative treatment, mainly with somatostatin analogs, our patients had a good recovery, and only five deaths were reported during follow-up. Carcinoids, despite the fact that they are usually silent and diagnosed with advanced stage, have good prognosis and offer, after effective treatment, long survival.
Adolescent↗
The influence of hemodilution on left ventricular function.
In nine anesthetized mongrel dogs anemia was produced by exchanging blood with plasma substitute thus reducing hemoglobin gradually in three steps. Aortic, atrial and ventricular blood pressures, cardiac output, electrocardiogram, phonocardiogram and the first derivative of the left ventricular pressure were continuously monitored. Blood samples were taken to determine hemoglobin, blood gases and whole blood viscosity. Progressive hemodilution resulted in a significant increase in cardiac output and left ventricular stroke work, while total peripheral resistance, oxygen content and whole blood viscosity decreased significantly. There were no significant changes in cardiac pressures, myocardial contractility, diastolic pressure time index and blood gases. The oxygen supply/demand ratio had gradually declined, while electrocardiogram showed no significant changes. These results suggest that moderate isovolemic hemodilution in animals with normal coronary vessels does not impair left ventricular function as this was manifested by the unchanged hemodynamic and electrocardiographic findings.
Animals↗
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↗