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Biomedical subjects

F Kalfarentzos

Publications and source records attributed to F Kalfarentzos.

At least 37 records · Page 2Linked to original sources
PubMed1996

Oral ornithine a-ketoglutarate accelerates healing of the small intestine and reduces bacterial translocation after abdominal radiation.

The effect of dietary ornithine a-ketoglutarate (OKG) on intestinal mucosal integrity and bacterial translocation was studied in rats following administration of a single dose of abdominal radiation (1100 cGy). Following the radiation injury the rats were randomized to receive a nutritionally incomplete diet which contained only water and OKG or a control diet with water and the non-essential amino-acid glycine. Four days after radiation, rats were anaesthetized and a laparotomy was performed. Cultures from mesenteric lymph nodes were taken and two tissue samples from the terminal ileum were also taken for light microscopy, protein and DNA determination. We examined the following parameters: number of villi per cm (V/cm), villus height (Vh), number of mitoses per crypt (M/c) and we measured the mucosal protein and DNA content. Nine of 16 rats who received the OKG-free diet had positive cultures but only 3 of 18 rats who received the OKG-enriched diet (P= 0.002). The group on the OKG-enriched diet had a better intestinal mucosal architecture than the group on the OKG-free diet and the studied parameters of the gut mucosa were significantly better: (V/cm: 130 +/- 8.1 vs 99 +/- 7.9, P = 0.001. Vh(mm): 0.40 +/- 0.03 vs 0.24 +/- 0.05, P= 0.002. M/c: 1.71 +/- 0.03 vs 0.34 +/- 0.2, P= 0.001, Protein (mg/cm): 2.300 +/- 0.033 vs 1.207 +/- 0.014, P = 0.002. DNA (microg/cm): 203 +/- 6.41 vs 130 +/- 4.94, P = 0.001. We conclude that OKG-enriched diet prevents the deleterious effects of radiation on intestinal mucosal morphology and integrity, abolishing thus, the increased bacterial translocation observed after abdominal radiation.

Journal Article↗
PubMed1995

The effect of parenteral indomethacin on T-lymphocyte subpopulations and cytokine production in patients under major surgical operations.

Major surgical trauma has been considered as a cause of immunosuppression mainly through the production of prostaglandin E2 from activated monocytes/macrophages. In the present study we investigated the effect of parenteral indomethacin--a cyclo-oxygenase inhibitor--on T-lymphocyte subsets and cytokine production in patients under major operations. We studied 20 patients undergoing major surgical procedures, 10 of whom were randomly treated pre- and post-operatively with indomethacin (group 2) and 10 were not (group 2). We measured total T-cells, T-helper, T-suppressor, T-helper/T-suppressor (Th/Ts) cell ratio, NK-cells and interleukin (IL-1) and tumor necrosis factor production by endotoxin- or phytohemagglutinin-stimulated peripheral blood mononuclear cells, before operation and at days 1, 3 and 7 postoperatively. We detected a significant increase in Th/Ts cell ratio and an improvement in delayed type hypersensitivity response in the treated group at day 3. We believe that the above immunomodulating effect of in vivo cyclo-oxygenase inhibition may be beneficial in patients under major surgical procedures with a high susceptibility to postoperative infections.

Adult↗
PubMed1995

Intramural gastric actinomycosis.

We report a case of intramural gastric actinomycosis and review the features of the additional 16 cases of this uncommon infection reported in the literature. The patient had gastrointestinal symptoms, weight loss, and fever after gastric operation. At laparotomy, an infiltrating gastric tumor-like lesion was found. Histology revealed actinomycosis, and the patient was successfully treated with oral penicillin. Because of its rarity, intramural actinomycosis is an entity overlooked by most surgeons. Reporting of such cases may help increase the awareness of this important and curable disease.

Actinomycosis↗
PubMed1995

The effect of dietary omega-3 polyunsaturated fatty acids on T-lymphocyte subsets of patients with solid tumors.

The effect of omega-3 polyunsaturated fatty acids (PUFA) on the immune system seems to be beneficial. There has been a number of studies concerning the effect of dietary omega-3 PUFA on different immune parameters. The aim of our present study was to investigate the effect of dietary omega-3 PUFA on T-cell subsets and natural killer (NK) cells of patients with solid tumors. We studied 20 patients with solid tumors who received 18 g fish oil/day for 40 consecutive days. We detected a significant increase in T-helper/T-suppressor cell ratio 40 days into omega-3 supplementation, due mainly to a decrease in the number of suppressor T cells. We concluded that dietary omega-3 fatty acids may have a beneficial effect on the already compromised immune system of patients suffering from solid tumors.

Adult↗
PubMed1994

Medium- and long-chain triglycerides have different effects on the synthesis of tumor necrosis factor by human mononuclear cells in patients under total parenteral nutrition.

OBJECTIVE: Lipid emulsions containing both long- and medium-chain triglycerides (LCT/MCT) have been used in total parenteral nutrition (TPN) regimens and seem to have certain advantages for seriously ill patients. The aim of the present study was to investigate the effect of lipid emulsions containing 100% LCT or 50% LCT/50% MCT on tumor necrosis factor (TNF) production by human mononuclear cells. STUDY DESIGN: This was a prospective study, in which 20 malnourished patients were randomly allocated to receive either 100% LCT or 50% LCT/50% MCT for > 30 days. We measured TNF synthesis before initiation of TPN, as well as at 15 and 30 days during TPN. SETTING: Departments of Medicine and Surgery, Patras University Medical School, Patras, Greece. PARTICIPANTS: Members of the staff of the Departments of Medicine and Surgery, Patras University Medical School. RESULTS: We found that TNF production was significantly (p < 0.01) elevated at 30 days in the LCT group, while no significant differences were detected in the LCT/MCT group. CONCLUSIONS: It is concluded that long-term TPN formulas, where LCT have been partially replaced by MCT, do not change TNF synthesis by peripheral blood mononuclear cells, and this may be beneficial in seriously ill, cachectic patients.

Adult↗
PubMed1993

Treatment of fistulas of the gastrointestinal tract with total parenteral nutrition and octreotide in patients with carcinoma.

The development of a fistula is a serious postoperative complication. Conservative medical treatment with total parenteral nutrition, skin care and intensive infection control usually succeeds in closing fistulas (60 to 75 percent), but the treatment is of long duration (two to three months), high cost and high morbidity related to prolonged hospitalization. We have used octreotide, a long half-life stomatostatin analog, in 40 patients from two European university centers with postoperative enterocutaneous fistulas. Twenty-two patients had low fistula output and 28 patients had high fistula output. Spontaneous closure was achieved in 77.5 percent of the patients after a mean of 13.6 days. One patient died. Glucose intolerance, which has been reported with stomatostatin treatment of fistulas, was not observed. Previous chemotherapy or radiotherapy or low albumin level (23 grams per deciliter) negatively influenced fistula closure. As an adjunct treatment to primary care (total parenteral nutrition, skin care and infection control), octreotide is efficient in reducing fistula output and accelerating spontaneous fistulas closure.

Adult↗
PubMed1992

Gallbladder contraction after hormonal manipulations in normal subjects and patients under total parenteral nutrition.

Total parenteral nutrition (TPN) induces biliary dilatation, sludge and formation of gallstones. Cholecystokinin (CCK) induces gallbladder (GB) contraction. During thyrotropin-releasing hormone (TRH) testing for thyroid function, we observed that patients felt a strong micturition reflex attributable to smooth muscle contraction of the bladder. The possibility of GB contraction after TRH administration was studied compared to cholecystokinin-octapeptide (CCK-OP) and/or fatty meal administration. The effect of intravenous (IV) CCK-OP, TRH and a combination of the two on GB volume was studied in normal volunteers without GB or liver disease and in patients receiving TPN for greater than 2 weeks. Subjects included six normal volunteers who received an oral fatty meal only, 18 other normal volunteers (Group A) and 18 TPN patients (Group B). Gallbladder contraction was estimated by ultrasound prior to and after administration of the fatty meal; in the other 36 subjects, GB contraction was calculated prior to and after administration of CCK-OP, TRH, or both. Results are expressed as a percentage of the GB basal volume using each subject as his or her own control. Group A and Group B were each divided into three equal subgroups receiving IV CCK-OP (A1, B1), TRH (A2, B2), or both (A3, B3).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Neurotensin reduces microbial translocation and improves intestinal mucosa integrity after abdominal radiation.

The effect of neurotensin (NTN) on preventing microbial translocation and preserving intestinal mucosal integrity after abdominal radiation was studied in rats. Animals were divided into the following groups: I (control), II (radiation control) and III (radiation and NTN). Radiation (1,100 cGy) was administered on the 1st day to groups II and III. NTN (300 micrograms/kg) was given intraperitoneally to group III animals, once daily for 3 days. On the 4th day, mesenteric lymph nodes (MLN) were obtained and cultured. Villi per centimeter (V/cm), villus height (Vh) and mitoses per crypt (M/c) were evaluated from ileal mucosa. Radiation increased positive MLN cultures, while treatment with NTN reduced them significantly. V/cm and Vh also returned to normal levels after NTN treatment, while M/c were increased in all irradiated animals. It was shown that NTN reduces bacterial translocation after abdominal radiation. Examination of ileal mucosa indicates that this can be attributed to the improvement of the mucosal integrity, due to the trophic effect of the hormone on the gut.

Animals↗
PubMed1992

The incidence of delayed pneumothorax as a complication of subclavian vein catheterisation.

Delayed pneumothorax after subclavian vein catheterisation is a poorly recognised complication which can result hours or days after the catheter placement. We present our experience, during a three-year prospective study of 318 patients with 343 catheter placements in the subclavian vein. Seven patients (2.2%) developed pneumothorax immediately after the subclavian vein catheterisation. Two patients (0.6%) developed delayed asymptomatic pneumothorax that was recognised 48 and 72 hours after the catheter placement. The importance of recognition and treatment of this complication is obvious in patients with a central venous catheter, especially when they are to be operated under general anaesthesia and/or mechanical respiratory support.

Adult↗
PubMed1991

Effect of glutamine on intestinal mucosal integrity and bacterial translocation after abdominal radiation.

This study evaluates the effect of oral glutamine on intestinal mucosal integrity and bacterial translocation in rats. 80 animals were randomised into four groups: group 1 (chow diet and water), group 2 (chow diet and glutamine 3%), group 3 (radiation, chow diet and water), group 4 (radiation, chow diet and glutamine 3%). Groups 1 and 2 were fed for 5 days, then sacrificed. Groups 3 and 4 were fed for 12 days, irradiated on the 5th day and sacrificed on 1st, 3rd and 7th post-radiation days. Cultures from the mesenteric lymph nodes (MLN), portal vein (PV) and aorta (A) were taken and two tissue samples were also taken from the terminal ileum for light and electron microscopic examination. In non-radiated rats glutamine did not alter the histologic parameters of villous height (VH), mitoses per crypt (M/C) and muscle thickness (MT). Group 3 rats had severe mucosal damage associated with a significant decrease of VH (p < 0.0001) and M/C (p < 0.01) on 1st and 3rd post-radiation days respectively. In contrast, group 4 rats maintained their mucosal structure and had a significant increase of VH and M/C (p < 0.0001) on post-radiation days 1 and 3. Bacterial translocation in MLN was 87.5% (p < 0.002) and 75% (p < 0.04) on 1st and 3rd post-radiation days respectively in group 3, and fell significantly to 12.5% (p < 0.002) in group 4. The data demonstrate that glutamine helps maintain the integrity of the intestinal mucosa and thereby reduces the incidence of bacterial translocation following abdominal irradiation.

Journal Article↗
PubMed1991

Complications of splenic tissue reimplantation.

Splenic tissue reimplantation employing the omental implantation technique was applied in 23 patients undergoing splenectomy for traumatic or iatrogenic splenic injury. Four complications were encountered after autotransplantation (17.4%). Two of these consisted of small bowel obstruction due to postoperative adhesions and were successfully managed by lysis of the adhesions. The other two complications were aseptic necrosis of the splenic transplants and were treated with ablation of the autolysed transplants. A case of abnormal splenic tissue reimplantation in a male patient with unsuspected myelofibrosis is also discussed. He underwent an emergency laparotomy for rupture of a subcapsular splenic haematoma. It is concluded that splenic tissue implantation in the greater omentum is associated with important early morbidity and this should be taken into account whenever application of the method is considered.

Adolescent↗
PubMed1991

Radical consequence in the sexuality of male patients operated for colorectal carcinoma.

Sixty sexually-active male patients affected by colorectal cancer and surgically treated at the Department of Surgery at University of Patras between 1981 and 1987 were interviewed by structured questionnaire to evaluate the etiology of sexual dysfunction. Patients were divided into three groups: (1) 20 patients, mean age 60.5 years (range 39-70), subjected to high anterior resection for carcinoma of the sigmoid colon (not lower than 18 cm from the anal margins, 1.2% Dukes' A, 31% Dukes' B, 67.8% Dukes' C); (2) 20 patients, mean age 62.4 years (range 43-70), subjected to low anterior resection (not more than 8 cm from the anal margins, 3% Dukes' A, 36% Dukes' B, 61% Dukes' C); and (3) 20 patients, mean age 59.75 years (range 27-70), subjected to abdominoperineal surgery (Miles' technique) in whom the malignancy was in the distal rectum (8% Dukes' A, 32% Dukes' B, 60% Dukes' C). The first group served as the control. All the anastomoses in the low anterior resection group were performed by manual suture. Statistical evaluation of the three groups was by the chi 2-test. The form of sexual dysfunction, (1) cessation of sexual relationship, (2) absence of erection, (3) impossible penetration or (4) absence of ejaculation, varied according to the type of operation, the frequency of each form being 5%, 5%, 30%, 20% for the high anterior resection, 65%, 45%, 60%, 50% for Miles' operation and 20%, 25%, 45%, 5% for the low anterior resection respectively.

Adult↗
PubMed1990

Treatment of enterocutaneous fistulas with TPN and somatostatin, compared with patients who received TPN only.

Eighteen patients with post-operative enterocutaneous fistulas were treated with total parenteral nutrition (TPN), skin care, infection control and intravenous somatostatin (SMS) 250 micrograms/h. This group was compared with 30 patients treated with standard medical treatment (total parenteral nutrition (TPN), skin care and infection control). In the SMS group the fistula output was reduced to 50% in three days and spontaneous closure was observed in 14 patients after a mean of 6.1 +/- 3.1 days of treatment with SMS, and in 18.2 +/- 6.3 days after the TPN administration. In the control group the fistula output was reduced by up to 50% after a week and spontaneous closure occurred in 20 patients in a mean of 27.4 +/- 8.7 days after the start of treatment. These results are statistically significant. There was one (5.5%) death in the SMS group compared with three (10%) deaths in the other, and glucose intolerance was observed in two (11%) patients in the SMS group. Somatostatin has been shown to be useful in the conservative treatment of enterocutaneous fistulas because of its ability to reduce output and accelerate closure.

Adult↗
PubMed1988

Total parenteral nutrition by intraperitoneal feeding in rabbits.

The possibility of intraperitoneal (IP) parenteral nutrition was suggested after the observation that glucose and amino acids pass from the peritoneal cavity into the systemic circulation. We used rabbits to study the characteristics of the transfer of glucose, lipids and amino acids. An IP injection of glucose 25% (1 g/kg) produced a peak level in the serum within 40 min. A 20% fat solution (1 g/kg) showed maximum serum levels of triglycerides and total lipid in 2.5 h, while a standard amino acid solution (1.5 g/kg) enriched with 25 14C-phenylalanine peaked serum levels in 16 min. The 4 rabbits survived for 28 days with IP glucose, amino acids and lipids as the only form of nutrition, apart from water. When sacrificed after 28 days histology of peritoneum, liver, spleen, gut and kidney showed no abnormality. We conclude that the basic nutritional components are adequately absorbed through the peritoneum, and that long-term nutritional support can be achieved uneventfully with IP administration of nutritional solutions.

Absorption↗
PubMed1986

The role of hypoalbuminemia in the development of the TPN-associated cholestasis.

Forty-one patients undergoing total parenteral nutrition (TPN), were studied in a prospective manner. We found that patients with low serum albumin were more likely to develop cholestasis than patients with normal serum albumin. None of the patients with normal serum albumin developed cholestasis. Fifty-one per cent of patients with low serum albumin (< 3.0 g/dl) developed cholestasis (p < 0.05). In those who developed cholestasis there was a significant, correlation (r = 0.816, p < 0.001) between the serum albumin and the number of days after start of TPN when cholestasis appeared.

Journal Article↗