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      • SCOPUSSCIEKCI등재

        Patients on Anticoagulants after a Head Trauma : Is a Negative Initial CT Scan Enough? Report of a Case of Delayed Subdural Haematoma and Review of the Literature

        Hadjigeorgiou, Georgios F.,Anagnostopoulos, Christos,Chamilos, Christos,Petsanas, Adamantios The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.55 No.1

        Mild traumatic brain injury is common in elderly patients, many of whom are on anticoagulant. The common practice is to discharge these patients from the emergency room if the computed tomography (CT) of the brain is normal. However, a very small proportion of these patients may develop a life threatening intracranial haematoma in the following days. We present here a case of a 66-year-old male on anticoagulant therapy that developed a subdural haematoma 48 hours after a mild head injury, with a normal initial CT scan of the brain. The patient underwent a craniotomy with evacuation of a large subdural clot. Postoperatively he had progressively improved and six months later has a Glasgow Outcome Score of three. This case is characterized by the delayed onset of a subdural haematoma in a patient on anticoagulation and we discuss here the possible pathogenesis related to this phenomenon. We also briefly review the pertinent literature and the current guidelines for the management of this type of head injuries.

      • KCI등재

        Effect of oxytocin infusion on luteal blood flow and progesterone secretion in dairy cattle

        Christos N. Brozos,Metin S. Pancarci,Javier Valencia,Nikola Beindorff,Evaggelos Kiossis,Heinrich Bollwein,Georgios Tsousis 대한수의학회 2012 JOURNAL OF VETERINARY SCIENCE Vol.13 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        The objective of this study was to investigate the effects of oxytocin infusion on corpus luteum (CL) function during early to mid-diestrus by measuring luteal size (LS) and luteal blood flow (LBF) along with plasma levels of progesterone (P4) and prostaglandin metabolites (13,14-dihydro-15-keto-prostaglandin F2a, PGFM). On day (D) 7 of the estrus cycle (D1 = ovulation), seven cows received 100 IU of oxytocin (OXY) or placebo (PL) following a Latin square design. LS and LBF increased in both groups over time and no differences were observed between the groups. PGFM did not differ either within the groups over time or between the groups at any time point. P4 of the OXY group was higher compared to that of the the PL group 360 min after the infusion (p = 0.01) and tended to be higher at the time points 450 min, 48 h, and 72 h (all p = 0.08). Results from this study support the hypothesis that OXY is not directly involved in the mechanism(s) governing blood flow of the CL and has no remarkable effects either on luteal size or P4 and PGFM plasma levels. Further investigation is needed to elucidate the role of OXY in CL blood flow during early and late luteal phases.

      • KCI등재후보

        Prognostic value of COL6A3 in pancreatic adenocarcinoma

        Christos Svoronos,Georgios Tsoulfas,Maria Souvatzi,Efthimios Chatzitheoklitos 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.1

        Backgrounds/Aims: Pancreatic cancer is one of the most fatal human malignancies with poor prognosis, despite advances in therapy. Here, we evaluated the potential role of collagen type VI 3 chain (COL6A3) as a non-invasive biomarker for pancreatic adenocarcinoma. Methods: In this study, we investigated immunohistochemically the expression of COL6A3 in 30 patients with resectable pancreatic adenocarcinoma by immunohistochemistry in a tissue sample of the cancer and a tissue sample of normal pancreas for each patient. Also, we looked for associations between COL6A3 and other prognostic factors of pancreatic cancer. Results: All of the pancreatic cancer tissue samples revealed in different ranges of intensity from weak (+1) in 16.67%, moderate (+2) in 50%, to strongly positive (+3) in 33.33% staining for COL6A3. We found no moderate or strongly positive staining in normal pancreatic tissue. There was only weak positive staining in 23 samples (76.67%) and 7 (23.30%) were negative. Also, there was significant correlation between COL6A3 moderate and strongly expression and negative prognostic factors for pancreatic cancer. Conclusions: The greatest density of COL6A3 was observed in pancreatic cancer tissues and was correlated with negative prognostic factors for pancreatic cancer. Therefore, we suggest that COL6A3 could be used as prognostic factor in pancreatic cancer, but more studies need to prove its value.

      • KCI등재후보

        Prognostic value of COL6A3 in pancreatic adenocarcinoma

        Christos Svoronos,Georgios Tsoulfas,Maria Souvatzi,Efthimios Chatzitheoklitos 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.1

        Backgrounds/Aims: Pancreatic cancer is one of the most fatal human malignancies with poor prognosis, despite advances in therapy. Here, we evaluated the potential role of collagen type VI α3 chain (COL6A3) as a non-invasive biomarker for pancreatic adenocarcinoma. Methods: In this study, we investigated immunohistochemically the expression of COL6A3 in 30 patients with resectable pancreatic adenocarcinoma by immunohistochemistry in a tissue sample of the cancer and a tissue sample of normal pancreas for each patient. Also, we looked for associations between COL6A3 and other prognostic factors of pancreatic cancer. Results: All of the pancreatic cancer tissue samples revealed in different ranges of intensity from weak (+1) in 16.67%, moderate (+2) in 50%, to strongly positive (+3) in 33.33% staining for COL6A3. We found no moderate or strongly positive staining in normal pancreatic tissue. There was only weak positive staining in 23 samples (76.67%) and 7 (23.30%) were negative. Also, there was significant correlation between COL6A3 moderate and strongly expression and negative prognostic factors for pancreatic cancer. Conclusions: The greatest density of COL6A3 was observed in pancreatic cancer tissues and was correlated with negative prognostic factors for pancreatic cancer. Therefore, we suggest that COL6A3 could be used as prognostic factor in pancreatic cancer, but more studies need to prove its value.

      • KCI등재

        Duration of Implantable Cardiac Monitoring and Detection of Atrial Fibrillation in Ischemic Stroke Patients: A Systematic Review and Meta-Analysis

        Georgios Tsivgoulis,Aristeidis H. Katsanos,Martin Köhrmann,Valeria Caso,Fabienne Perren,Lina Palaiodimou,Spyridon Deftereos,Sotirios Giannopoulos,John Ellul,Christos Krogias,Dimitris Mavridis,Sokratis 대한뇌졸중학회 2019 Journal of stroke Vol.21 No.3

        Background and Purpose Current guidelines do not provide firm directions on atrial fibrillation (AF) screening after ischemic stroke (IS). We sought to investigate the association of implantable cardiac monitoring (ICM) duration with the yield of AF detection in IS patients. Methods We included studies reporting AF detection rates by ICM in IS patients with negative initial AF screening. We excluded studies reporting prolonged cardiac monitoring with devices other than ICM, not providing AF detection rates or monitoring duration, and reporting overlapping data for the same population. The random-effects model was used for all pooled estimates and meta-regression analyses. Results We included 28 studies (4,531 patients, mean age 65 years). In meta-regression analyses, the proportion of AF detection by ICM was independently associated with monitoring duration (coefficient=0.015; 95% confidence interval [CI], 0.005 to 0.024) and mean patient age (coefficient=0.009; 95% CI, 0.003 to 0.015). No associations were detected with other patient characteristics, including IS subtype (cryptogenic vs. embolic stroke of undetermined source) or time from IS onset to CM implantation. In subgroup analyses, significant differences (P<0.001) in the AF detection rates were found for ICM duration (<6 months: 5% [95% CI, 3% to 6%]; ≥6 and ≤12 months: 21% [95% CI, 16% to 25%]; >12 and ≤24 months: 26% [95% CI, 22% to 31%]; >24 months: 34% [95% CI, 29% to 39%]). Conclusions Extended duration of ICM monitoring and increased patient age are factors that substantially increase AF detection in IS patients with initial negative AF screening.

      • KCI등재후보

        Intraoperative Vagal Nerve Stimulation in a Patient with Long QT Syndrome during Thyroidectomy

        Gerasimos Kritikos,Christos Christoforides,Dimitrios Moutafis,Ioannis Papandrikos,Afroditi Arambatzi,Georgios Misichronis,Andreas Koureas,Gianlorenzo Dionigi,Kyriakos Vamvakidis 대한갑상선-내분비외과학회 2019 The Koreran journal of Endocrine Surgery Vol.19 No.2

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        Intraoperative neural monitoring (IONM) of the recurrent laryngeal nerve is a useful tool during thyroidectomies for the safe accomplishment of the operation. The latest guidelines suggest that stimulation of vagus nerve is prerequisite for proper use of IONM. In the current bibliography there are not any data for the safety of vagal nerve stimulation in patients with certain diseases, such as long QT syndrome (LQTS). Here we present a case of a 51-year-old female patient with a known history of LQTS, who successfully underwent thyroidectomy and parathyroidectomy in our department with vagal nerve stimulation during IONM. Many concerns were raised preoperatively about the safety of vagus stimulation since it enervates myocardium and controls heart rate through the parasympathetic system. For this reason, the operation took place with a specialist cardiologist stand by ready to intervene, and a defibrillator ready for use. However, there were not any complications intraoperatively or postoperatively.

      • SCIESCOPUSKCI등재

        Factors affecting the success of resynchronization protocols with or without progesterone supplementation in dairy cows

        Annette Forro,Georgios Tsousis,Nicola Beindorff,Ahmad Reza Sharifi,Christos Brozos,Heinrich Bollwein 대한수의학회 2015 JOURNAL OF VETERINARY SCIENCE Vol.16 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        The objective of this study was to investigate factors that influence the success of resynchronization protocols for bovines with and without&nbsp;progesterone supplementation. Cow synchronized and not found pregnant were randomly assigned to two resynchronization protocols:&nbsp;ovsynch without progesterone (P4) supplementation (n = 66) or with exogenous P4 administered from Days 0 to 7 (n = 67). Progesterone&nbsp;levels were measured on Days 0 and 7 of these protocols as well as 4 and 5 days post-insemination. Progesterone supplementation raised the&nbsp;P4 levels on Day 7 (<i>p</i> < 0.05), but had no overall effect on resynchronization rates (RRs) or pregnancy per artificial insemination (P/AI).&nbsp;However, cows with Body Condition Score (BCS) > 3.5 had increased P/AI values while cows with BCS < 2.75 had decreased P/AI rates&nbsp;after P4 supplementation. Primiparous cows had higher P4 values on Day 7 than pluriparous animals (<i>p</i> = 0.04) and tended to have higher&nbsp;RRs (<i>p</i> = 0.06). Results of this study indicate that progesterone supplementation in resynchronization protocols has minimal effects on&nbsp;outcomes. Parity had an effect on the levels of circulating progesterone at initiation of the protocol, which in turn influenced the RR.

      • KCI등재

        Epistaxis in dental and maxillofacial practice: a comprehensive review

        George Psillas,Grigorios Georgios Dimas,Despoina Papaioannou,Christos Savopoulos,Jiannis Constantinidis 대한구강악안면외과학회 2022 대한구강악안면외과학회지 Vol.48 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphe-nopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in pa-tients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

      • KCI등재

        Extensive Inferior Vena Cava Thrombosis Related to COVID-19 Infection in a Patient with Retrievable Filter Due to Multiple Pelvic Bone Fractures

        George S. Georgiadis,Christos Argyriou,Stylianos Tottas,Soultana Foutzitzi,Georgios Drosos 대한혈관외과학회 2022 Vascular Specialist International Vol.38 No.1

        Inferior vena cava (IVC) thrombosis is often attributed to IVC filters. Here, we describe the first case of IVC filter thrombosis associated with severe acute respiratory syndrome coronavirus-2 infection in a 34-year-old male with multiple pelvic fractures. The IVC filter was initially placed prophylactically prior to major orthopedic trauma reconstruction complicated by silent pulmonary embolism, precluding the safe transition to therapeutic anticoagulation due to the high hemorrhagic risk from pelvic fracture fixation. This case highlights the potentially increased risk of severe complications in patients receiving vascular care if they were to contract coronavirus disease-2019 (COVID-19) in the hospital. IVC filter placement in the patient resulted in complete IVC thrombosis after he acquired COVID-19 infection. Prophylactic doses of low molecular weight heparin could not prevent this complication. However, prompt initiation of therapeutic anticoagulation with rivaroxaban led to the complete resolution of IVC thrombosis over weeks after viral negativization and discharge.

      • KCI등재

        Primary Epiploic Appendagitis Mimicking Acute Appendicitis: A Case Report and Narrative Review of the Literature

        Maria Alexandra Kefala,Kostas Tepelenis,Christos K. Stefanou,Stefanos K. Stefanou,Georgios Papathanakos,Aikaterini Kitsouli,Nikolaos Tepelenis,Panagiotis Kitsoulis 대한소화기학회 2020 대한소화기학회지 Vol.76 No.2

        Primary epiploic appendagitis is uncommon and is estimated to induce 1.1–1.3% of all abdominal pain. We report a 42-year-old male who appeared in the morning in the emergency department with abdominal pain localized in the right lower abdomen and associated with anorexia and nausea. Clinical examination, laboratory tests, and abdominal ultrasound revealed deep tenderness at Mc Burney point and a mild elevation of CRP (0.7 mg/dL). In the evening, the symptoms were exacerbated, and a diagnostic laparoscopy was performed. Intra-operatively, the appendix was normal and a twisted, necrotic epiploic appendage originating from the antimesenteric border of the mid ascending colon was found. Laparoscopic resection of the necrotic epiploic appendage and prophylactic appendectomy was carried out. Histology indicated the diagnosis of the necrotic epiploic appendage. Postoperatively, the patient recovered without complications. Although the preoperative diagnosis of primary epiploic appendagitis has improved due to abdominal ultrasound and mainly CT, there are still cases which are diagnosed during laparoscopy. The treatment of choice is conservative management, while the use of antibiotics remains controversial. The relapse and complication rates are rare. Surgical excision, particularly laparoscopic, should be considered in cases of uncertain diagnosis, persistent symptoms, or recurrence.

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