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E Eleftheriadis

Publications and source records attributed to E Eleftheriadis.

54 records · Page 3Linked to original sources
PubMed1988

Endoscopic observations of the residual cavity after liver hydatid disease surgery.

Endoscopic inspection of the residual cavity after liver hydatid disease surgery has the potential of determining the cause of delayed cavity obliteration by providing information about the inner surface condition. We therefore performed endoscopy whenever there was an unsatisfactory rate of reduction of the residual cavity size. Over the last 6 years, 72 patients have been operated upon for liver hydatid disease. Of these, 42 had wide-bore catheter drainage of the echinococcal cavity and 30 had primary surgical closure. In 17 of 42 patients, endoscopy was performed 3-14 months postoperatively, because the cavity showed no evidence of reduction in size. A flexible choledochoscope was passed through the transcutaneous drainage fistula. Silk sutures were found four times and residual parasitic elements were found 3 times. These were all removed. In 13 patients, the cavity was inspected within 6 months postoperatively; their inner cavity surfaces were covered with white soft areolar tissue. The other 4 patients' cavities were examined within 6-14 months; hard fibrous connective tissue was found. Two patients required reoperation, and in both cases the cavity collapsed within 3-12 months postoperatively. We conclude, that endoscopy of the residual cavity is a useful procedure for both recognition and removal of the cause of delay in the cavity obliteration and can lead to collapse of the cavity.

Echinococcosis, Hepatic↗
PubMed1988

Common bile-duct mucosa in choledochoduodenostomy patients--histological and histochemical study.

We describe the histological and histochemical changes of the common bile-duct mucosa in specimens obtained by means of peroral cholangioscopy, 1-12 years after choledochoduodenal anastomosis. Our findings--hyperplasia of the superficial epithelium, metaplastic goblet cells containing predominantly acid sialomucins, and pyloric-like gland formation containing neutral mucins--express a morphological and functional differentiation of the common bile-duct mucosa that probably facilitates its survival in a different environment. We consider that these adaptive changes may explain the uneventful long-term postoperative period of choledochoduodenostomized patients.

Choledochostomy↗
PubMed1988

Ultrastructural changes of the renal cortex after septic shock in rats.

The purpose of this study was to observe the ultrastructural changes of the renal cortex that occur in septic shock. Twenty male Wistar rats were used. They were divided into 4 groups of five animals each one. A septic shock was caused by intraperitoneal injection of 5 x 10(6) living E. Coli, in a dose of 2ml/100gr B. W., in four rats of each group. The fifth rat of each group was used as control, and was injected by an equal volume of normal saline. A small segment from the right kidney was excised from every rat of each group, respectively 1, 2, 4 and 6 hours after the onset of the shock. Morphologically, alterations of the endothelium of the peritubular and glomerular capillaries were found. The endothelial layer was thick with many cytoplasmic folds. In the glomeruli, the basal lamina as well as the overlying epithelial podocytes and their foot processes were swollen. The urinary space contained erythrocytes and cell debris. Lesions of the proximal and distal tubule epithelium were also observed. The basal infoldings of the cell membrane disappeared in many epithelial cells of the proximal tubule and the brush border showed varying degrees of disruption. Within the tubular lumen much cellular debris was found. The epithelium of the distal tubule was thinner in some portions and in others it was swollen. The lesions were focal during the first hour after the onset of shock, while at the fourth and sixth hours they were most extensive. In conclusion, the ultrastructural findings after septic shock were non-specific and indicated cellular injury.

Animals↗
PubMed1988

Duodenal varices after sclerotherapy for esophageal varices.

Two cases of post-sclerotherapy duodenal varices formation, one with bleeding, are herein reported, their diagnosis established endoscopically. Review of the literature indicates that the development of duodenal varices after endoscopic sclerotherapy for esophageal varices is very rare. We discuss the possible mechanisms of their formation.

Duodenum↗
PubMed1987

Choledochoscopy in intrabiliary rupture of hydatid cyst of the liver.

From 1981-1985, 62 patients have been operated upon for hydatid disease of the liver. Nine patients presented with hepatic colic, chill and fever; seven cases also showed obstructive jaundice, as their cysts had ruptured into the biliary tree. A large communication between the pericyst cavity and the bile ducts was confirmed at operation. The common bile duct was explored in all nine patients and laminated membranes and daughter cysts were found in three cases. Following this, choledochoscopy was performed. Retained membranes and a stone were revealed in one of these three patients. In two other cases from the remaining six negative explorations, laminated membranes were also found. We therefore recommend choledochoscopy not only in biliary lithiasis, but in every case of intrabiliary rupture of a hydatid cyst of the liver.

Adult↗
PubMed1986

Endoscopic anatomy of choledochoduodenostomy in relation to clinical observations.

Thirty patients having undergone choledochoduodenostomy for benign biliary diseases were studied by means of endoscopy. The endoscopic anatomy of the anastomosis was classified into two types. Inflammatory changes of the choledochal mucosa adjacent to the stoma were found in nine cases. Endoscopy of the proximal and distal (blind) segment of the common bile duct was accomplished in 19 and nine patients, respectively. It is very probable that these inflammatory mucosal changes could lead to complications.

Biliary Tract Diseases↗
PubMed1985

Rigid or flexible choledochoscopy?

This is a comparative study of two types of choledochoscopes: The Wolf rigid scope and the flexible CHF B3 Olympus scope. These were used for the exploration of 120 consecutive cases of common bile duct disease covering a 4-year period. The rigid and the flexible choledochoscopes were used in 30 and 88 cases, respectively, while in another 2 cases both scopes were used to complete the examination. We established that the Wolf scope does not provide ease of handling in inexperienced hands. Its low price and durability under rough handling should not be an excuse for recommending it for beginners. On the other hand, the Olympus scope is an expensive and delicate instrument, which is much easier to handle. Both choledochoscopes can, however, equally provide good results in experienced hands.

Common Bile Duct Diseases↗
PubMedDate not supplied

Hemodynamic events in the peritoneal environment during pneumoperitoneum in dogs.

The purpose of this experimental study was to determine the hemodynamic conditions of intraperitoneal viscera during pneumoperitoneum by using either CO2 gas or helium (He) for insufflation. In 16 mongrel dogs (divided into a CO2 group and an He group) subjected to 14 mmHg pneumoperitoneum for 60 min, the following parameters were assessed at times before and 1, 2, 5, 15, 30, 45, and 60 min thereafter: (1) intestinal mucosal blood flow, by means of a laser-Doppler probe inplanted into a jejunal loop; (2) portal pressure and portal blood pCO2, through a catheter inserted via a mesenteric jejunal vein; (3) intramural jejunal pH (pHi), by means of a Tonometer, which expresses the degree of tissue ischemia; (4) inferior vena cava pressure and blood pCO2, through a catheter inserted via a femoral vein; and (5) from the systemic circulation pulse rate, arterial blood pressure, CO, CVP, PVP, SaO2, pCO2, and paO2 were measured through a catheter placed into a femoral artery and a Swan-Ganz thermodilution catheter inserted via external jugular vein: CI and SVR were then calculated. Jejunal mucosal blood flow was found decreased (P < 0.0001) and pHi revealed gut mucosal ischemia. Portal and inferior vena cava pressures were found to be elevated (P < 0.0001), as was blood pCO2 of these vessels (P < 0.001), in only the CO2 group. From the systemic circulation, arterial blood pressure, CO, CI, SaO2, and paO2 revealed a decrease (P < 0.001) while arterial pCO2 (only CO2 group), CVP, SVR, and PVP revealed an increase (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

The 'mosaic-like' pattern of portal hypertensive gastric mucosa after variceal eradication by sclerotherapy.

The 'mosaic-like' pattern of portal hypertensive gastric mucosa has been evaluated endoscopically in 38 patients referred for elective sclerotherapy, before the first session, after the complete eradication of varices and six months later. Of 38 patients studied, 18 patients exhibited mild, and 20 patients exhibited negative, findings of congestive gastropathy prior to sclerotherapy. Seventeen and 18 patients, respectively, developed aggravated changes of congestive gastropathy after the completion of sclerotherapy (P = 0.003). We consider that obliteration of varices by means of endoscopic sclerotherapy influences the development of gastric congestion changes in the majority of patients. However, further studies are required to relate the direction of blood flow in the portal system as well as the level of portal pressure with the congestive gastropathy findings in such patients.

Esophageal and Gastric Varices↗
PubMedDate not supplied

The implication of nitric oxide in the process of bacterial translocation.

Since there is increasing evidence indicating nitric oxide [NO] would play a role in sepsis, we decided to investigate whether this multifaceted mediator is directly implicated in the process of bacterial translocation. A total of 48 rats received intraperitoneal either Zymosan A (group Z) for systemic inflammation production or sodium chloride solution (controls); they were then further subdivided into three groups of eight animals each, being given, through the tail vein: L-NAME (N-nitro-L-arginine] for inhibition of NO production; SNP (sodium nitroprusside) as NO donor; or sodium chloride as control. After 2 h, the mesenteric lymph node complex was excised, under sterile conditions, and, using standard bacteriological techniques, bacterial translocation was assessed as colony forming units per gram of tissue (CFU/g). Statistical evaluation of the bacteriological data revealed a significant increase of bacterial translocation in all rats subjected to systemic inflammation (group Z) versus controls (P = 0.01) Control rats that were subjected to L-NAME treatment exhibited a statistically significant increase (P = 0.001) in CFU/g compared to sodium chloride treated rats, while SNP treatment revealed no difference in relation to sodium chloride treated rats. Group Z rats, subjected to L-NAME treatment, similarly exhibited a statistically significant increase (P = 0.01) in CFU/g compared to sodium chloride treated rats, while SNP treatment led to a statistical increase of bacterial translocation in relation to sodium chloride treated rats (P = 0.05). The results of this study lead us to suggest that NO appears to participate in the process of bacterial translocation.

Animals↗
PubMedDate not supplied

Long-term results after esophagoplasty with colon. An endoscopic study.

Eight patients from a series of 13 having esophageal resection and colon interposition for benign disease have been evaluated by endoscopic testing, with special emphasis on the mucosal long-term changes of the colon segment and their histologic documentation. The average follow-up period was 7.2 years. All patients were in a satisfactory nutritional state but described problems associated with eating, such as regurgitation of undigested foods and substernal postprandial heartburn. No stricture was present but endoscopy confirmed the existence of food in the haustra. There was no gross evidence of colitis but the histological evaluation revealed inflammatory cell infiltration or fibrosis in all patients but one. It is believed that the main cause of mucosal damage is the prolonged cascading of food and delayed emptying, leading to digestion in the haustra.

Colon↗
PubMedDate not supplied

Hepatic tissue microcirculation, oxygenation and energy charge in ischemia-reperfusion subjected cirrhotic rat liver.

BACKGROUND/AIMS: The hemodynamic disturbances in the cirrhotic liver following severe variceal bleeding and subsequent restoration by blood transfusion is an ischemia/reperfusion injury event which represents the clinical situation of liver dysfunction. Therefore, the aim of this study was to evaluate the microcirculation, oxygenation and energy charge of the cirrhotic rat liver after ischemia/reperfusion. METHODOLOGY: In eight carbon tetrachloride-induced cirrhotic rats and an equal number of controls subjected to 30 minutes of ischemia and 60 minutes of reperfusion by hepatoduodenal ligament clamping, the following parameters were assessed: hepatic microcirculation by laser-Doppler fluxmetry, hepatic tissue oxygenation by a Clark-type electrode, hepatic energy charge by tissue sampling and adenine-nucleotides determination by means of high-performance liquid chromatography. RESULTS: At baseline, liver microcirculation was found to be significantly decreased in the cirrhotics versus controls groups. Ischemia led to a reduction in both groups, while reperfusion improved microcirculation, but not to the baseline level. Oxygenation was reduced during ischemia and restored after reperfusion in both groups. Hepatic energy charge was reduced in the cirrhotics versus controls at baseline, and significantly decreased during ischemia in both groups. At reperfusion, a further reduction was found in the cirrhotic group, while in the control group it was restored to baseline. CONCLUSION: Hepatic microcirculation, oxygenation and energy charge are subjected to different degrees of diminution after ischemia/reperfusion in the cirrhotic rat liver.

Adenine Nucleotides↗
PubMedDate not supplied

24-hr measurement of gastric mucosal perfusion in conscious humans.

BACKGROUND/AIMS: Gastric mucosal blood flow estimation in humans is obtained through an endoscope and the time of measurement lasts only a few minutes. Thinking that long-term monitoring of mucosal perfusion would be a significant contribution to the study of gastric physiology, we registered gastric mucosal blood flow continuously for 24 hours, using single fiber laser-Doppler technology. METHODOLOGY: The study was undertaken in 16 healthy subjects (8 of them had their gastric acidity inhibited with a proton pump inhibitor) and in 8 patients with an endoscopically proven, active duodenal ulcer. A 140 cm-long single fiber laser-Doppler microprobe was positioned through a gastrointestinal tube in the middle of the gastric corpus and the mucosal microcirculation was monitored from 14.00 h until 13.59 h the following day. Data were stored and processed to evaluate the probable circadian rhythms, using maximum entropy spectrum analysis. RESULTS: We found that the daily variations of gastric mucosal perfusion follow a circadian rhythm. The respective patterns with maximum and minimum values were: healthy controls, maximum at 02.00, 10.00, 18.00 h and minimum at 5.30, 14.00 and 22.00 h. Healthy controls treated by a proton pump inhibitor, maximum at 02.00, 07.00, 18.00 h and minimum at 04.00, 12.00 and 22.00 h. Ulcer patients, maximum 07.00 and 21.00 h and minimum at 17.00 and 24.00 h. CONCLUSIONS: It is concluded that long-term measurement of gastric mucosal blood flow in conscious humans is feasible and that this factor of gastric physiology follows a concrete circadian rhythm, which is not particularly influenced by acid inhibition, but is completely distorted in ulcer patients.

Adult↗