Showing papers by "University of Ioannina published in 1994"

Liver involvement in primary sjögren's syndrome

Abstract: Three hundred patients with primary Sjogren's syndrome (pSS) were investigated for liver involvement using clinical, biochemical, immunological and histological data. Seven per cent of patients showed evidence of liver disease either subclinical (2%) or asymptomatic (5%) with elevated liver enzymes. In 6.6% of patients antimitochondrial antibodies (AMA) were detected by immunofluorescence and 27% of pSS patients showed antibodies to pyruvate dehydrogenase (a-PDH) using ELISA. AMA-positive patients were further investigated with transcutaneous liver biopsy. Ninety-two per cent of patients with AMA showed liver involvement with features of chronic cholangitis similar to stage I primary biliary cirrhosis. It is concluded that liver involvement in pSS patients is rare and subclinical with histological features predominantly of stage I primary biliary cirrhosis. AMA is the most sensitive indicator of underlying liver pathology in pSS patients.

Left triangulated categories arising from contravariantly finite subcategories

Abstract: Let modA be the category of finitely generated right A-modules over an artin algebra ⋀, and F be an additive subfunctor of . Let P(F) denote the full sucategory of A with objects the F-projective modules. If the functor F has enough F- projectives, then we show that the stable category mod p(F)⋀ has a left triangulated structure. In case , the above statement implies that the stable category mod p⋀ has a left triangulated structure. Dual statements for the case of F-injective modules are also true

Primary gastric lymphomas: a clinicopathologic study with literature review.

Abstract: Prognostic factors and treatment results were analysed in 28 consecutive patients with primary gastric lymphoma (PGL) diagnosed and treated, all by surgery and in many cases with additional chemotherapy (CT) and/or radiotherapy (RT), between 1977 and 1988. There were 13 patients in stage IE, 5 in IIE, and 10 in stage IV. The resection rate was 96.4% (27/28). Sixteen patients underwent an extended total and 11 a subtotal gastrectomy. Seventeen out of 25 cases (68%) were diagnosed by endoscopic biopsies. In 10 endoscopically diagnosed PGL cases the clinical staging and separation between stages IE and IIE from stage IV, due to ultrasonographic scan, computed tomography and bone marrow biopsy, was correct and the same with the surgical-pathological staging information. According to the Kiel-classification 18 patients had a low-grade and 9 patients a high-grade lymphoma. One patient could not be classified. All patients were completely followed-up, in an average time of 52 months. The probability of overall 5-year survival was 92% in stage IE, 75% in stage IIE, 88% in stages IE+IIE together, and 35% in stage IV. Extent of surgery (total vs. subtotal gastrectomy), Kiel-classification (low-grade vs. high-grade malignant histologic subtypes) and adjuvant CT in patients with stage IE (all 11 patients without CT remain in complete remission after an average of 45 months) did not significantly influence survival. The sole prognostic factor with proven impact on survival was the stage of disease (IE+IIE vs. IV: P = 0.001). For the Kiel-classification in particular there was no significant difference between low-grade and high-grade lymphomas with regard to the sex, symptomatic, extent of surgery, and stage at operation. These findings, together with data from the literature, suggest that gastric resection seems to be the optimal primary treatment in clinically assessed stages IE or IIE. In patients with stage IE disease, surgical resection can result in a cure, with no need for further therapy. The CT and/or RT can be effective in unresected and even bulky cases. Because of the difference in primary treatment, a preoperative clinical staging and separation between early stages from stage IV is always indicated.

On an m -point boundary-value problem for second-order ordinary differential equations

Abstract: where q E (0, 1) is given. We obtain conditions for the existence and uniqueness of a solution for the boundary-value problem (2), using the Leray-Schauder continuation theorem [2]. We give an example of a three-point boundary-value problem where the existence condition is not satisfied and no solution exists. Gupta [3] recently studied the boundary-value problem (2) when Q! = 1. Our results on the three-point boundary-value problem (2) extend the results of Gupta [3], to the case of general CY. (See also [4, 51.) We use the classical spaces C[O, 11, C’[O, 11, Lk[O, 11, and L”[O, l] of continuous, k-times continuously differentiable, measurable real-valued functions whose kth power of the absolute value is Lebesgue integrable on [0, 11, or measurable functions that are essentially bounded

On Legendre curves in contact 3-manifolds

Abstract: It is first observed that on a 3-dimensional Sasakian manifold the torsion of a Legendre curve is identically equal to +1. It is then shown that, conversely, if a curve on a Sasakian 3-manifold has constant torsion +1 and satisfies the initial conditions at one point for a Legendre curve, it is a Legendre curve. Furthermore, among contact metric structures, this property is characteristic of Sasakian metrics. For the standard contact structure onR3 with its standard Sasakian metric the curvature of a Legendre curve is shown to be twice the curvature of its projection to thexy-plane with respect to the Euclidean metric. Thus this metric onR3 is more natural for the study of Legendre curves than the Euclidean metric.

Obstetric and gynaecological profile in patients with primary Sjögren's syndrome.

Abstract: OBJECTIVE--To describe the effects of Sjogren9s syndrome (SS) on the fertility, parity and sexual activity as well as investigating the aetiopathology of dyspareunia in female patients. METHODS--Fifty one female patients with primary SS (pSS) and 57 healthy controls were interviewed concerning their past gynaecological, obstetric and sexual history and underwent a complete gynaecological examination. Punch biopsy of the vagina was performed in six patients and one healthy individual. In addition, the vaginal tissue was evaluated following hysterectomy in two patients with pSS. RESULTS--No differences were observed in fertility, parity or reproductive success rate between patients and controls. Atrophy of the external genitalia and production of cervical mucus in both patients and controls correlated with age and menopause, but not with other clinical or serological pSS manifestations. Dyspareunia was observed in 40% of the patients during the premenopause period compared with 3% observed in controls. Half of the patients, however, had an obvious aetiology for dyspareunia (trauma or inflammation) not related to pSS. The histological picture of the patients9 vaginal tissue revealed perivascular infiltration. Finally, pSS patients appeared to have a similar intercourse frequency with the controls. However, unlike that observed in controls, the intercourse frequency did not diminish with age nor with the presence of dyspareunia. CONCLUSION--The fertility, parity and sexual activity of pSS patients does not appear to differ from that of the healthy population. Dyspareunia is a frequent symptom in these patients and local perivascular in these patients and local perivascular inflammation may contribute to the expression of this manifestation.

Incidence of inflammatory bowel disease in north west Greece: rarity of Crohn's disease in an area where ulcerative colitis is common.

Abstract: Ulcerative colitis (UC) and Crohn's disease (CD) are generally regarded as diseases of affluent societies of the Western World, although their frequency in less affluent areas is not well established. This retrospective study therefore, assesses the incidence of UC and CD in a semirural area of north west Greece during the 10 year period 1982-1991. By the 31 December 1991, 61 patients had met standard diagnostic criteria for UC (annual incidence 4.0/10(5), 95% confidence intervals 3.0 to 5.0/10(5)) and only five patients met the diagnostic criteria for CD (annual incidence 0.3/10(5), 95% confidence intervals 0.1 to 0.8/10(5)) in this area of 157,214 inhabitants. UC incidence was lowest in the first three years at 1.8/10(5) per annum and subsequently increased to 4.8 and 5.1/10(5) per annum for the successive four and three year periods respectively. UC incidence was slightly higher in men. A third of all cases of UC had pancolitis while a quarter had only proctitis. More than one half were categorised as having moderate or severe colitis. Three quarters of the patients resided in urban areas. The incidence of CD was a twelfth of the UC incidence, which is in considerable contrast with most Western countries where the incidence of CD is usually no less than a third that for UC. The rarity of CD points to the absence of aetiological environmental factors specific for CD.

Pressure covariability over the Atlantic, Europe and N. Africa. application: Centers of action for temperature, winter precipitation and summer winds in Athens, Greece

Abstract: This paper deals with the surface pressure covariability over the Altantic/European sector of the Northern Hemisphere, using monthly grid point data for the 100 year period 1890–1989. Factor analysis is applied to 90 grid point time series for January, February, July, and August. The initial 90 pressure variables can be reduced to 7–8 factors in winter and 10 in summer. A winter teleconnection was identified, known as the seesaw phenomenon, between the Icelandic low and the Azores subtropical anticyclone. In order to define the centers of action for temperature, winter precipitation and summer northerly wind frequency (etesian days) in Athens and in the Aegean sea, the variability of the factor scores and of these weather elements is compared. It is shown that the center of action for temperature in Athens is found to be in north and northwest Europe (centered over southern Scandinavia). For winter precipitation, the center of action is located in the west and southwest Mediterranean and northwest Africa. Finally, for the etesian winds frequency variability, this center of action is found over the northern Adriatic and northern former Yugoslavia, while there is no evidence of influence by the southwest Asia thermal low.

Acid-base and electrolyte abnormalities in alcoholic patients.

Abstract: This study was undertaken to analyze the acid-base and electrolyte abnormalities and the pathogenetic mechanisms involved in alcoholic patients admitted to our department for causes related to alcohol abuse. We studied 79 alcoholic patients aged 31-78 years. None had any other disease or was receiving drugs influencing acid-base balance and electrolyte parameters. On their admission and before any therapeutic intervention laboratory investigation of the acid-base status and electrolyte parameters in both sera and urine was carried out. Thirty-two patients (40.5%) had acid-base disturbances. Ten patients (12.6%) had pure respiratory alkalosis, 2 patients (2.5%) pure metabolic alkalosis, while 20 patients (25.3%) had the so-called syndrome of alcoholic ketoacidosis. Forty-one patients (52%) had electrolyte abnormalities. Eighteen patients (22.8%) had hyponatremia. However, 5 patients had pseudohyponatremia due to alcohol-induced hypertriglyceridemia. Two patients (2.5%) with increased insensible losses had hypernatremia. Hypokalemia was found in 10 patients (12.6%), hypomagnesemia in 25 patients (31.6%), hypophosphatemia in 23 patients (29.1%), hyperphosphatemia in 2 patients (2.5%), and hypocalcemia in 17 patients (21.5%). However, only 7 patients had true hypocalcemia. In conclusion, alcoholic patients develop a series of acid-base and electrolyte disturbances owing to various pathogenetic mechanisms.

Evaluation of six tumor markers in patients with carcinoma of unknown primary

Abstract: We have retrospectively evaluated six serum tumor markers in 85 patients with carcinoma of unknown primary. The serum levels of carcinoembryonic antigen (CEA), CA 19-9, CA 15-3, CA 125, β-chorionic gonadotropin (β-HCG) and α-fetoprotein (AFP) were related with the histological pattern (undifferentiated carcinoma or adenocarcinoma), the number and the site of metastases, as well as the response to chemotherapy and the patients' survival. More than 40% of the patients had increased serum levels of all six tumor markers, except of AFP which was found to be increased in only 17% of them. Increased levels of CA 19-9 were related to metastatic adenocarcinoma, whereas CA 19-9 and CA 15-3 had a relationship with more advanced disease. Patients with liver involvement had higher mean levels of CEA and CA 19-9 as compared to those with nodal disease. None of these markers was found to have a predictive value for response to chemotherapy or survival. Although the present study has a retrospective nature, it allows us to conclude that patients with CUP have a nonspecific over-expression of the above serum tumor markers and that routine use of these markers does not offer any diagnostic or prognostic assistance. © 1994 wiley-Liss, lnc.

Major limb replantation in children.

Abstract: After the first successful replantation of a completely amputated extremity in a 12-year-old boy undertaken by Ronald Malt at the Massachusetts General Hospital in 1962 (Malt and McKhann, Journal of the American Medical Association, 189:716–722, 1964) numerous series of major limb replantations have been reported in adults. The reports of major limb replantation in children are relatively rare and are usually included in adult series. During the last 14 years, 18 children with major limb amputations were treated at the Microsurgical and Replantation Unit of the Department of Orthopaedic Surgery at the University of Ioannina Medical School. Of these, 13 were complete amputations (11 upper extremity and 2 lower extremity), while 5 were incomplete nonviable amputations (3 upper extremity and 2 lower extremity). The success rate following replantation of the complete amputations was 76.9%, while for the incomplete, nonviable amputations success was 80%. Preoperative evaluation, operative management, postoperative care, and the results of this difficult but rewarding procedure are analysed and discussed in this review. © 1994 Wiley-Liss, Inc.

Nerve grafting in peripheral nerve microsurgery of the upper extremity

Abstract: The use of microsurgical techniques is essential in peripheral nerve surgery, in which dissection at the fascicular level is required. Magnification with an operating microscope allows for an accurate evaluation of the severity of the trauma to the nerve tissue and permits atraumatic interfascicular dissection. Fascicular or interfascicular dissection and repair with the use of nerve grafts was carried out in 220 peripheral nerve lesions of the upper extremity. Our results of nerve-grafting in the upper extremity (median, ulnar, and radial-nerves) indicate an inverse association between the age of the patient and the delay between injury and grafting. In addition, we found that nerve grafting without tension produces superior results over simple neurorrhaphy under tension and permits better axonal growth and nerve recovery.

Neural and vascular complications of arthroscopic meniscal surgery.

Abstract: Injuries to vessels and nerves are very rare complications of arthroscopic meniscal surgery. The clinical development and diagnosis of such complications are described and illustrated by cases described in the literature and by two of our own cases. Typical patterns of injury are simulated by dissection of cadaver knees. To avoid neural complications in suturing the menisci, on the medial side the joint capsule has to be prepared when using the inside-out orthe outside-in technique. On the lateral side the outside-in technique can be performed by small suture incisions in this area when the lateral knee structures can be palpated. When using the inside-out technique the peroneal nerve must be dissected free. When resecting the posterior horn of the medial meniscus forced external rotation of the knee should be avoided because in this position the popliteal artery and the medial inferior genicular artery lie close to the posterior horn.

Successful treatment of venous congestion in free skin flaps using medical leeches.

Abstract: Of 74 patients with extensive skin loss of the upper and lower extremities who were treated with free skin flaps, 20 patients presented with venous insufficiency within the immediate 6 to 12 hours following surgery. In 17 of these patients, the venous congestion after free tissue transfer was successfully treated with medical leeches. The remaining three skin flaps did not survive, despite leeching, as well as exploration and revision of the venous anastomoses. The results from this small number of patients with free skin tissue transfer are encouraging, suggesting that in the presence of venous congestion, the use of medicinal leeches is a desirable modality of treatment.

Redox Treatment of an Fe/Al Pillared Montmorillonite. A Mössbauer Study

Abstract: Pillared structures with an interlayer opening of ∼0.3 nm were obtained after successive heat treatments of the PILC precursor in reducing and oxidizing conditions. This precursor was prepared by reacting a Na+-montmorillonite with an intercalant containing Al and Fe oxo-hydroxides (Al/Fe = 1). Powder X-ray diffraction, elemental analysis, 57Fe Mossbauer spectroscopy, catalytic activity measurements and surface area data were used to characterize the samples. On the basis of Mossbauer spectra taken at temperatures between 4.2 and 300 K, it is deduced that oxidizing steps produce Al substituted maghemite which converts into Al substituted magnetite upon reducing heat treatment. Firing the precursor in oxidizing atmosphere forms pillars of few nm in diameter. However, heating under reducing conditions yields pillars of smaller diameter. This later behaviour is maintained even after reheating the material in oxidizing atmosphere. From the temperature dependence of Mossbauer spectra it is deduced that the diameter of the Fe oxide particles in the pillars is smaller than 10 nm.

Transpositional microsurgery in multiple digital amputations.

Abstract: In 34 of the 62 patients treated for complete multiple digital amputations, the severed part was not replanted in its anatomical position, but in the place of the most useful stump. This procedure is defined as transpositional digital microsurgery and refers to the transposition and replantation of any digit to another stump which plays a more significant role in the function of the hand. Twenty-eight patients had transposition of a digit, while six patients underwent thumb transposition. All except six of the transposed digits survived, while all of the thumbs survived the surgical procedure. The cosmetic appearance of the hand with a transposed digit or thumb was acceptable to the patients. Two-point discrimination was assessed to be 10-14 mm for the transposed digits, and the functional ability of the transplanted digit was comparable to digits which were replanted in their anatomical position. In conclusion, transpositional digital microsurgery remains a useful alternative for the treatment of multiple digit amputations, particularly in patients with severely damaged non-replantable amputated parts.