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| 1 | Pathophysiology of increased intestinal permeability in obstructive jaundice显示文摘Despite advances in preoperative evaluation and postoperative care, intervention, especially surgery, for relief of obstructive jaundice still carries high morbidity and mortality rates, mainly due to sepsis and renal dysfunction. The key event in the pathophysiology of obstructive jaundice-associated complications is endotoxemia of gut origin because of intestinal barrier failure. This breakage of the gut barrier in obstructive jaundice is multi-factorial, involving disruption of the immunologic, biological and mechanical barrier. Experimental and clinical studies have shown that obstructive jaundice results in increased intestinal permeability. The mechanisms implicated in this phenomenon remain unresolved, but growing research interest during the last decade has shed light in our knowledge in the field. This review summarizes the current concepts in the pathophysiology of obstructive jaundice-induced gut barrier dysfunction, analyzing pivotal factors, such as altered intestinal tight junctions expression, oxidative stress and imbalance of enterocyte proliferation and apoptosis. Clinicians handling patients with obstructive jaundice should not neglect protecting the intestinal barrier function before, during and after intervention for the relief of this condition, which may improve their patients’ outcome. | Stelios F Assimakopoulos Chrisoula D Scopa Constantine E Vagianos | 2007 | World Journal of Gastroenterology2007，13，48： | 48 |
| 2 | Experimental obstructive jaundice alters claudin-4 expression in intestinal mucosa: Effect of bombesin and neurotensin显示文摘瞄准:调查试验性的妨碍的黄疸和外长的 bombesin 和 neurotensin (NT )(BBS ) 的影响紧密的连接(TJ ) 的表示上的管理在老鼠的肠上皮的蛋白质 claudin-4。方法:四十只男 Wistar 老鼠随机被划分成五个组:我 = 控制, II = 假冒操作, III = 胆汁管结扎(BDL ) , IV = BDL+BBS (30 microg/kg 每 d ) , V = BDL+NT (300 microg/kg 每 d ) 。在 d 的实验的结束 10,内毒素在门和大动脉的血被测量。终端回肠的织物节组织学地被检验并且免疫组织化学地为在肠上皮的 claudin-4 表示的评估。结果:妨碍的黄疸导致了重要的门和大动脉的 endotoxemia 表明的肠的障碍失败。Claudin-4 表示显著地被增加在上面在 jaundiced 老鼠的第三根绒毛并且一起来它的侧面的分发的规定被注意。BBS 或 NT 的管理恢复了 claudin-4 表示到控制状态并且显著地减少了门和大动脉的 endotoxemia。结论:在肠上皮的试验性的妨碍的黄疸增加 claudin-4 表示,它可以是贡献粘膜障碍的混乱的一个关键因素。毁坏规章的肽 BBS, NT 能阻止这扇改变和还原剂门和全身的 endotoxemia。 | Stelios F Assimakopoulos Constantine E Vagianos Aristides S Charonis Ilias H Alexandris Iris Spiliopoulou Konstantinos C Thomopoulos Vassiliki N Nikolopoulou Chrisoula D Scopa | 2006 | World Journal of Gastroenterology2006，12，21： | 21 |
| 3 | Acute upper gastrointestinal bleeding in operated stomach: Outcome of 105 cases显示文摘AIM: To compare the causes and clinical outcome of patients with acute upper gastrointestinal bleeding (AUGB) and a history of gastric surgery to those with AUGB but without a history of gastric surgery in the past.METHODS: The causes and clinical outcome were compared between 105 patients with AUGB and a history of gastric surgery, and 608 patients with AUGB but without a history of gastric surgery.RESULTS: Patients who underwent gastric surgery in the past were older (mean age: 68.1±11.7 years vs 62.8±17.8 years, P= 0.001), and the most common cause of bleeding was marginal ulcer in 63 patients (60%). No identifiable source of bleeding could be found in 22 patients (20.9%) compared to 42/608 (6.9%) in patients without a history of gastric surgery (P = 0.003). Endoscopic hemostasis was permanently successful in 26 out of 35 patients (74.3%) with peptic ulcers and active bleeding or non-bleeding visible vessel. Nine patients (8.6%) were operated due to continuing or recurrent bleeding,compared to 23/608 (3.8%) in the group of patients without gastric surgery in the past (P= 0.028). Especially in peptic ulcer bleeding patients, emergency surgery was more common in the group of patients with gastric surgery in the past [9/73 (12.3%) vs 19/360 (5.3%), P = 0.025].Moreover surgically treated patients in the past required more blood transfusion (3.3±4.0 vs 1.5±1.7, P = 0.0001) and longer hospitalization time (8.6±4.0 vs 6.9±4.9 d,P = 0.001) than patients without a history of gastric surgery. Mortality was not different between the two groups [4/105 (3.8%) vs 19/608 (3.1%)].CONCLUSION: Upper gastrointestinal bleeding seems to be more severe in surgically treated patients than in non-operated patients. | Vassiliki N Nikolopoulou Konstantinos C Thomopoulos George I Theocharis Vassiliki A Arvaniti Constantine E Vagianos | 2005 | World Journal of Gastroenterology2005，11，29： | 9 |
| 4 | Bile duct ligation in rats: A reliable model of hepatorenal syndrome?显示文摘The two most widely used experimental models of advanced liver disease are the administration of carbon tetrachloride, and common bile duct ligation (BDL), however, neither has been systematically evaluated as a model of hepatorenal syndrome (HRS). The BDL model in rats, studied at diverse time points, induced a progressive renal dysfunction without structural changes in the kidney. The authors concluded that BDL is a good model for further studies of HRS and its treatment. However, the renal impairment observed at the acute phase of the BDL model is based on a different pathophysiology than that of HRS. Specifi cally, in acute obstructive jaundice, cholemia predominates over parenchymal liver disease (reversible at this stage without portal hypertension or cirrhosis) and independently induces negative inotropic and chronotropic effects on the heart, impaired sympathetic vasoconstriction response and profound natriuresis and diuresis that might lead to volume depletion. In addition, systemic endotoxemia contributes to the prerenal etiology of renal impairment and promotes direct nephrotoxicity and acute tubular necrosis. On the other hand, the renal failure observed in the chronic BDL model (with development of biliary cirrhosis, portal hypertension and ascites) shares pathophysiological similarities with HRS, but the accordance of the chronic BDL model to the diagnostic criteria of HRS (e.g. absence of spontaneous bacterial peritonitis, no renal function improvement after plasma volume expansion) should have been confirmed. In conclusion, we think that the BDL model is not suitable for the study of the natural history of HRS, but the chronic BDL model might be valid for the study of established HRS and its potential therapies. | Stelios F Assimakopoulos Constantine E Vagianos | 2009 | World Journal of Gastroenterology2009，15，1： | 9 |
| 5 | Effect of bombesin and neurotensin on gut barrier function in partially hepatectomized rats显示文摘AIM: To investigate the effect of regulatory peptides bombesin (BBS) and neurotensin (NT) on intestinal barrier function in partially hepatectomized rats.METHODS: Ninety male Wistar rats were randomly divided into five groups: Ⅰ (n = 10): controls, Ⅱ (n =20): sham operated, Ⅲ (n = 20): partial hepatectomy 70% (PHx), Ⅳ (n = 20): PHx+BBS (30 μg/kg/d), Ⅴ (n= 20): PHx+NT (300 μg/kg/d). Groups Ⅳ and Ⅴ were treated for 8 days before PHx and 48 h post surgery.At the end of the experiment, on day 10, intestinal barrier function was assessed by measuring endotoxin concentrations in portal and aortic blood. Tissue sections of the terminal ileum were examined histologically and villus density, mucosal thickness, mitotic activity and apoptosis in crypts were assessed. In addition, ileal mucosa was analyzed for DNA and protein content and microbiological analysis was performed in cecal contents.To estimate intestinal oxidative stress, lipid peroxidation was determined on tissue homogenates from terminal ileum.RESULTS: BBS or NT administration significantly reduced portal and systemic endotoxemia observed 48 h after partial hepatectomy. In hepatectomized rats (group Ⅲ), a trend towards induction of mucosal atrophy was observed, demonstrated by the reduction of villus density, mucosal thickness, protein content and significant reduction of DNA, while these alterations were reversed by regulatory peptides administration.This trophic effect of BBS and NT was accompanied by induction of mitoses above control levels and a significant reduction of apoptosis in intestinal crypts.Intestinal lipid peroxidation was found significantly lower in PHx group and regulatory peptides exerted an antioxidant action, further decreasing this parameter of oxidative stress. The bacterial population of E. coli and aerobic Gram (+) cocci was increased in cecal content of hepatectomized rats, while this parameter was not affected by the administration of BBS or NT.CONCLUSION: Gut regulatory peptides BBS and NT improve intestinal barrier function and reduce endotoxemia in experimental partial hepatectomy. This effect is, at least in part, mediated by their trophic,antiapoptotic, mitogenic, and antioxidant effect on the intestinal epithelium. This observation might be of potential value in patients undergoing liver resection. | Stelios F Assimakopoulos Ilias H Alexandris Chrisoula D Scopa Panagiotis G Mylonas Konstantinos C Thomopoulos Christos D Georgiou Vassiliki N Nikolopoulou Constantine E Vagianos | 2005 | World Journal of Gastroenterology2005，11，43： | 8 |
| 6 | Hemobilia secondary to hepatic artery pseudoaneurysm: An unusual complication of bile leakage in a patient with a history of a resected Ⅲb Klatskin tumor显示文摘我们由于 resected 门 cholangiocarcinoma (类型 IIIb Klatskin 肿瘤) 与双 bilo 伤寒吻合的 16 年的历史报导一个 74 岁的女人的一个案例。与对导致了大肝内 biloma 的良性的吻合狭窄第二等的胆管炎介绍的病人。以便恢复吻合的明显并且克服胆管炎,几次尝试发生了,包括 endobiliary 小型机关枪的一种叮当响,帮助汽球的 biloplasty 和 transhepatic billiary 排水。吻合明显被完成,复杂,然而由坚持上面的胃肠的流血,作为胆道出血介绍了。左肝的动脉的一个导致 biloma 的假动脉瘤被诊断。这破裂了进胆道,并且介绍了胆道出血的实际原因。假动脉瘤的选择栓塞控制出血结果,并且成功地与吻合的 transhepatic 膨胀和 biloma 的经皮的排水被相结合。病人最终被治好并且似乎处于优秀状况, 5 瞬间术后疗法。 | Dimitrios Siablis Zafiria G.Papathanassiou Dimitrios Karnabatidis Nikolaos Christeas Constantine Vagianos | 2005 | World Journal of Gastroenterology2005，11，33： | 7 |
| 7 | Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature显示文摘为不平常却记录得好的享受的脾的动静脉瘘(SAVF ) 报道门静脉高血压的有能力的原因([1-4 ]) 。突然由于 SAVF 形成开发了门静脉高血压的 50 岁的经产的女性的一个盒子被介绍。受不了的病人在过去的 12 天期间重复了 haematemesis 和 melaena 的事件,因此, emer 轻轻地为管理进入医院。临床并且实验室调查当肝实质的不在时建立了门静脉高血压的诊断疾病。内视镜检查法揭示了多重食道的流血静脉曲张。腹的计算断层摄影术(CT ) 和 transfemoral 腹的动脉 X 线摄影法记录了一根曲折、动脉瘤的脾的动脉并且一根扩大脾的静脉的早熟的充满的存在, SAVF 高度暗示的调查结果。上述的脉管的反常成功地与经皮的 transcatheter embolization 被对待。既不复发也不其它复杂并发症被观察。 | Dimitrios Siablis Zafiria G Papathanassiou Dimitrios Karnabatidis Nikolaos Christeas Konstantinos Katsanos Constantine Vagianos | 2006 | World Journal of Gastroenterology2006，12，26： | 6 |
| 8 | Pleiotropic effects of bombesin and neurotensin on intestinal mucosa: Not just trefoil peptides显示文摘Bombesin and neurotensin are neuropeptides which exert a wide spectrum of biological actions on gastrointestinal tissues influencing intestinal growth and adaptation, intestinal motility, blood flow, secretion, nutrient absorption and immune response. Based mainly on their well-established potent enterotrophic effect, numerous experimental studies investigated their potential positive effect on the atrophic or injured intestinal mucosa. These peptides proved to be effective mucosa-healing factors, but the potential molecular and cellular mechanisms for this action remained unresolved. In a recently published study (World J Gastroenterol 2008; 14(8): 1222-1230), it was shown that their protective effect on the intestine in experimentally induced inflammatory bowel disease was related to anti-inflammatory, antioxidant and antiapoptotic actions. These results are in close agreement with our previous studies on jaundiced and hepatectomized rats that showed a regulatory effect of bombesin and neurotensin on critical cellular processes such as enterocyte' proliferation and death, oxidative stress and redox equilibrium, tight junctions' formation and function, and inflammatory response. The pleiotropic effects of bombesin and neurotensin on diverse types of intestinal injury may justify their consideration for clinical trials. | Stelios F Assimakopoulos Chrisoula D Scopa Vassiliki N Nikolopoulou Constantine E Vagianos | 2008 | World Journal of Gastroenterology2008，14，22： | 4 |
| 9 | Stimulation of oval cell and hepatocyte proliferation by exogenous bombesin and neurotensin in partially hepatectomized rats显示文摘AIM:To investigate the effect of the neuropeptides bombesin(BBS)and neurotensin(NT)on oval cell proliferation in partially hepatectomized rats not pretreated with a known hepatocyte inhibitor.METHODS:Seventy male Wistar rats were randomly divided into five groups:Ⅰ=controls,Ⅱ=sham operated,Ⅲ=partial hepatectomy 70%(PHx),Ⅳ=PHx+ BBS(30μg/kg per day),Ⅴ=PHx+NT(300μg/kg per day).Forty eight hours after liver resection,portal en-dotoxin levels and hepatic glutathione redox state were determined.α-fetoprotein(AFP)mRNA(in situ hybridisation),cytokeratin-19 and Ki67 antigen expression (immunohistochemistry)and apoptosis(TUNEL)were evaluated on liver tissue samples.Cells with morphological features of oval cells that were cytokeratin-19 (+)and AFP mRNA(+)were scored in morphometric analysis and their proliferation was recorded.In addition,the proliferation and apoptotic rates of hepatocytes were determined.RESULTS:In the control and sham operated groups,oval cells were significantly less compared to groups Ⅲ,ⅣandⅤ(P<0.001).The neuropeptides BBS and NT significantly increased the proliferation of oval cells compared to groupⅢ(P<0.001).In addition,BBS and NT induced a significant increase of hepatocyte proliferation(P<0.001),whereas it decreased their apoptotic activity(P<0.001)compared to groupⅢ.BBS and NT significantly decreased portal endotoxemia (P<0.001)and increased the hepatic GSH:GSSG ratio (P<0.05 and P<0.001,respectively)compared to groupⅢ.CONCLUSION:BBS and NT stimulated oval cell proliferation in a model of liver regeneration,without use of concomitant suppression of hepatocyte proliferation as oval cell activation stimuli,and improved the hepatocyte regenerative response.This peptides-induced combined stimulation of oval cell and hepatocyte proliferation might serve as a possible treatment modality for several liver diseases. | Stelios F Assimakopoulos Athanassios C Tsamandas Ilias H Alexandris Christos Georgiou Constantine E Vagianos Chrisoula D Scopa | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 2 |
| 10 | Nutrition assessment of patients with inflammatory bowel disease 显示文摘 | Vagianos K Bector S McConnell J | 2007 | JPEN J Parenter Enteral Nutr2007，31，4： | 1 |
| 11 | Evidence for intestinal oxidative stress in obstructive jaundice- induced gut barrier dysfunction in rats 显示文摘 | Assimakopoulos SF Vagianos CE Patsoukis N | 2004 | Acta Physiol Scand2004，180，2： | 1 |
| 12 | bcl-2/bax ratio as a predictive marker for therapeutic response to radiotherapy in patients with rectal cancer显示文摘 | Scopa CD Vagianos C Kardamakis D | 2001 | Appl Immunohistochem Mol Morphol2001，9，4： | 1 |
| 13 | Con- servative surgery in the treatment of hepatic hydatido- sis显示文摘 | Vagianos CE Karavias DD Kakkos SK et ol | 1995 | Eur J Surg1995，161，6： | 1 |
| 14 | bcl-2/bax ratio as a predictive marker for therapeutic response to radiotherapy in patients with rectal cancer显示文摘 | Scopa CD Vagianos C Kardamakis D | 2001 | Appl Immunohistochem Mol Morphol2001，9，4： | 1 |
| 15 | Changes in aetiology and clinical outcome of acute upper gastrointestinal bleeding during the last 15 years显示文摘 | Thomopoulos K Vagenas K Vagianos C | 2004 | Eur J Gastroenteml Hepatol2004，16，2： | 1 |
| 16 | Nutritionassessment of patients with inflammatory bowel disease 显示文摘 | VAGIANOS K BECTOR S MCCONNELL J | 2007 | Jpen JParenter Enteral Nutr2007，31，4： | 1 |
| 17 | The Role of Enteral Nutrition in Patients with Inflammatory Bowel Disease: Current Aspects显示文摘 | John K. Triantafillidis Costas Vagianos Apostolos E. Papalois Demosthenes Bouros | 2015 | BioMed Research International2015，，： | 1 |
| 18 | Evidence for intestinal oxidative stress in obstructive jaundice-induced gut barrier dysfunction in rats显示文摘 | Assimakopoulos SF Vagianos CE Patsoukis N | 2004 | Acta Physiol Scand2004，180，： | 1 |
| 19 | Retransfusion of unwashed blood is safe and effect-tive显示文摘 | Vagianos C | 2004 | Pro Transfusion Alternatives in Transfusion Medicine2004，6，1： | 1 |
| 20 | Changes in aetiology and clinical outcome of acute upper gastrointestinal bleeding during the last 15 years显示文摘 | Thomopoulos KC Vagenas KA Vagianos CE | 2004 | Eur J Gastroenterol Hepatol2004，16，2： | 1 |
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