Papers by Evangelos Athanassiou
Low-grade appendiceal tumor · Acute abdomen We present the case of a female patient admitted to o... more Low-grade appendiceal tumor · Acute abdomen We present the case of a female patient admitted to our University Hospital with acute abdominal pain mimicking an intraperitoneal septic condition caused possibly by acute appendicitis. CT and ultrasound scan showed a mass situated in the right iliac fossa. The patient was submitted to laparotomy and right hemicolectomy. The operative findings were suggestive of an appendiceal mucocele. The histology report revealed a low-grade appendiceal mucinous neoplasm. The patient had no clinical, biochemical or visual signs of disease recurrence 6 months postoperatively.
Laparoscopic Appendectomy: Differences between Male and Female Patients with Suspected Acute Appendicitis
World Journal of Surgery, 2007
The role of laparoscopy in the management of patients with suspected acute appendicitis remains c... more The role of laparoscopy in the management of patients with suspected acute appendicitis remains controversial. It has been suggested that laparoscopy is useful mainly in young women of reproductive age because of the high incidence of wrong diagnosis in these patients. Different management protocols for patients with suspected acute appendicitis were prospectively used in male and female patients; women of reproductive age were treated laparoscopically, while men were randomised to open or laparoscopic appendectomy. From September 2002 to September 2005, 132 patients-54 women and 78 men-with suspected acute appendicitis were treated according to the protocol. The incidence of wrong diagnosis in female patients was high (26% and the conversion rate low (5.5%). In contrast, in the laparoscopic male subgroup, these rates showed a reverse relationship (5.2% and 18.5%, respectively). Morbidity did not differ between female and male patients or between the 2 arms of the male group. Laparoscopic appendectomy took longer to perform without affecting significantly the needs for postoperative analgesia, the duration of hospital stay and the time to return to normal activities when compared with open appendectomy in men. Laparoscopic appendectomy is at least as safe as the open procedure in the male population, although it does not appear to offer any obvious advantage over the open procedure. The diagnostic advantage that laparoscopy offers to fertile women makes the procedure attractive for this population.
Open Access
Acute occlusion of the celiac axis and its branches with perforation of gastric fundus and spleni... more Acute occlusion of the celiac axis and its branches with perforation of gastric fundus and splenic infarction, findings on spiral computed tomography: a case report
Scientific Reports, 2019
Extracellular matrix (ECM)-adhesion proteins and actin cytoskeleton are pivotal in cancer cell in... more Extracellular matrix (ECM)-adhesion proteins and actin cytoskeleton are pivotal in cancer cell invasion. Ras Suppressor-1 (RSU-1), a cell-ECM adhesion protein that interacts with PINCH-1, thus being connected to Integrin Linked Kinase (ILK), alpha-parvin (PARVA), and actin cytoskeleton, is up-regulated in metastatic breast cancer (BC) samples. Apart from the originally-identified gene (RSU-1L), an alternatively-spliced isoform (RSU-1-X1) has been reported. We used non-invasive MCF-7 cells, expressing only RSU-1L, and highly invasive MDA-MB-231-LM2 expressing both isoforms and generated stable shRNA-transduced cells lacking RSU-1L, while the truncated RSU-1-X1 isoform was depleted by siRNA-mediated silencing. RSU-1L depletion in MCF-7 cells resulted in complete abrogation of tumor spheroid invasion in three-dimensional collagen gels, whereas it promoted MDA-MB-231-LM2 invasion, through a compensatory upregulation of RSU-1-X1. When RSU-1-X1 was also eliminated, RSU-1L-depletion-induced migration and invasion were drastically reduced being accompanied by reduced urokinase plasminogen activator expression. Protein expression analysis in 23 human BC samples corroborated our findings showing RSU-1L to be upregulated and RSU-1-X1 downregulated in metastatic samples. We demonstrate for the first time, that both RSU-1 isoforms promote invasion in vitro while RSU-1L elimination induces RSU-1-X1 upregulation to compensate for the loss. Hence, we propose that both isoforms should be blocked to effectively eliminate metastasis. Breast cancer (BC) is the most frequent type of cancer in women. When BC is characterized as non-invasive or in situ, the prognosis is far better than when it is characterized as metastatic or invasive. In fact, over 90% of cancer mortality is associated with disseminated disease rather than the primary tumor 1-3. Thus, gaining more knowledge on the molecular mechanism of metastasis and the key players involved might provide new insights on how to inhibit it. Cancer metastasis is a multi-step process where tumor cells first detach from the primary site, degrade surrounding matrix and intravasate into blood or lymphatic vessels. Cancer cells are then attracted by preferred target tissues where they adhere, migrate, and invade through surrounding matrix to finally establish
Clinical Imaging, 2019
Background: Conventional breast magnetic resonance imaging (MRI), including dynamic contrast-enha... more Background: Conventional breast magnetic resonance imaging (MRI), including dynamic contrast-enhanced MR mammography, may lead to ambiguous diagnosis and unnecessary biopsies. Purpose: To investigate the contribution of quantitative diffusion tensor imaging (DTI) in the discrimination between benign and malignant breast lesions at 3 T MRI. The study included a total of 86 lesions (44 benign and 42 malignant) in 58 women (34 with malignant lesions, 23 with benign lesions and 1 with both types of lesions). All patients were examined on a 3 T MRI scanner. Fractional Anisotropy (FA), Mean Diffusivity (MD), Apparent Diffusion Coefficient (ADC), as well as eigenvalues (λ 1 , λ 2 , λ 3 ) were calculated and compared between benign and malignant lesions using two different software packages (GE Functool and ExploreDTI). Results: Malignant lesions exhibited significantly lower ADC values compared to benign ones (ADC mal = 1.06 × 10 -3 mm 2 /s, ADC ben = 1.54 × 10 -3 mm 2 /s, p-value < 0.0001). FA measurements in carcinomas indicated slightly higher values than those in benign lesions (FA mal = 0.20 ± 0.07, FA ben = 0.15 ± 0.05, p-value = 0.0003). Eigenvalues λ 1 , λ 2 , λ 3 , showed significantly lower values in malignant tumors compared to benign lesions and normal breast tissue. ROC curve analysis of ADC and DTI metrics demonstrated that ADC provides high diagnostic performance (AUC = 0.944) while, MD and λ 1 showed best discriminative results (AUC = 0.906) for the differentiation of malignant and benign lesions in contrast to other DTI parameters. The addition of eigenvalue analysis improves DTI's ability to differentiate between benign and malignant breast lesions.
Appendicectomy for obstrutive appendicitis
Journal of Clinical Pathology
Clinical & Experimental Metastasis, 2015
Metastasis, responsible for most deaths from breast cancer (BC), is a multistep process leading t... more Metastasis, responsible for most deaths from breast cancer (BC), is a multistep process leading to cancer cell spread. Extracellular matrix (ECM)-related adhesion and apoptosis resistance play pivotal role in metastasis. Ras suppressor-1 (RSU-1) localizes to cell-ECM adhesions and binds to pro-survival adhesion protein PINCH-1. Little is known about the role of RSU-1 in BC. In the present study, we investigated the role of RSU-1 in BC metastasis using two BC cell lines that differ in terms of their metastatic potential and a set of 32 human BC samples from patients with or without lymph node metastasis. We show that RSU-1 is upregulated in the aggressive MDA-MB-231 cells compared to MCF-7 and that its silencing by siRNA leads to upregulation of PINCH-1, induction of proliferation and reduction of apoptosis through downregulation of the pro-apoptotic gene p53-upregulated-modulator-ofapoptosis (PUMA). Our findings in the cell lines were further validated in the human BC tissues where normal adjacent tissues were used as controls. We demonstrate for the first time, that RSU-1 expression is upregulated in metastatic BC samples and downregulated in non-metastatic while it is negatively correlated with PINCH-1 and positively correlated with PUMA expression, suggesting that a pro-apoptotic mechanism is in place in metastatic BC samples and identifying RSU-1 as a potentially interesting molecule that needs to be evaluated further as a novel BC metastasis biomarker.
Journal of Clinical Medicine Research, 2012
Hyperglycaemia is a major health risk and a negative determinant of surgical outcome. Despite its... more Hyperglycaemia is a major health risk and a negative determinant of surgical outcome. Despite its increasing prevalence, the limited treatments for restoration of normoglycaemia make its effective management a highly complex individualized clinical art. In this context, we review the mechanisms leading to hyperglycaemic damage as the basis for effective management of surgical complications of diabetic and non diabetic critically ill patients.
World Journal of Gastroenterology, 2011
AIM: To study the outcome of patients undergoing sur� gical resection of the bowel for sustained ... more AIM: To study the outcome of patients undergoing sur� gical resection of the bowel for sustained radiation�in� duced damage intractable to conservative management. METHODS: During a 7�year period we operated on 17 cases (5 male, 12 female) admitted to our surgical department with intestinal radiation injury (IRI). They were originally treated for a pelvic malignancy by sur� gical resection followed by postoperative radiotherapy. During follow�up, they developed radiation enteritis requiring surgical treatment due to failure of conserva� tive management. RESULTS: IRI was located in the terminal ileum in 12 patients, in the rectum in 2 patients, in the descending colon in 2 patients, and in the cecum in one patient. All patients had resection of the affected region(s). There were no postoperative deaths, while 3 cases presented with postoperative complications (17.7%). All patients remained free of symptoms without evidence of recur� rence of IRI for a median follow�up period of 42 mo (range, 6�96 mo). CONCLUSION: We report a favorable outcome without IRI recurrence of 17 patients treated by resection of the diseased bowel segment.
Ultrastructural Immunostaining of Infiltrating Ductal Breast Carcinomas with the Monoclonal Antibody H: A Comparative Study with Cytokeratin 8
Ultrastructural Pathology, 2003
The monoclonal antibody H (mAbH) detects an epitope consisting of an O-linked N-acetyl glucosamin... more The monoclonal antibody H (mAbH) detects an epitope consisting of an O-linked N-acetyl glucosamine (O-GlcNAc) and neighboring amino acids. This epitope has been found by using extracts from the MCF-7 human breast carcinoma cell line in immunoblotting experiments, on cytokeratin 8 (CK8) and 5 other polypeptides. In the present study, a double immunogold method was applied for the colocalization of CK8 and mAbH epitope on epoxy thin sections in 18 cases of infiltrating ductal breast carcinomas (IDBC) and in 6 cases of fibroadenomas, to study the accurate subcellular distribution of CK8 in breast cancer cells, as compared to the 5 polypeptides, recognized by mAbH. Furthermore, a detailed quantitative evaluation of the double immunolocalization over the cellular compartments of cancer cells was undertaken with the aid of a computerized image analysis system and the results were assessed statistically. The distribution pattern of CK8 and the mAbH epitope in the neoplastic mammary epithelial cells was similar in IDBC as compared to fibroadenomas, while the gold labeling intensity of these epitopes differed over the cellular compartments between malignant and benign biopsies. The results reveal the significance of the role of CK8 and O-GlcNAc glycosylation in the biology of the neoplastic mammary cells in vivo, determining their malignant potential.
Appendicectomy for obstructive appendicopathy
Journal of Clinical Pathology, 2008
We read the letter from Evangelos Athanassiou and Constantinos Hatzitheofilou with interest.1 We ... more We read the letter from Evangelos Athanassiou and Constantinos Hatzitheofilou with interest.1 We reported a preliminary investigation of an anomaly …
Surgical Ablative Procedures in Advanced Breast Cancer
Use of albumin polymers during breast cancer surgery improves postoperative seroma outcome
Surgical technology international, 2009
The effect of an albumin polymer instillation (Bioglue® Cryolife, Inc., Kenneaw, GA, USA) during ... more The effect of an albumin polymer instillation (Bioglue® Cryolife, Inc., Kenneaw, GA, USA) during breast cancer surgery on postoperative seroma formation was evaluated. Two groups of 34 consecutive patients, treated during operation with and without polymer, were followed postoperatively by weekly ultrasound and clinical evaluation. Seroma was aspirated when the volume exceeded 250 mL. Statistical comparison between 33 of the patients with adhesive- and 32 with non-adhesive-treated patients showed that the former patient group clearly outperformed the latter in production (p<0.001) and duration (p<0.01) of seroma. Seroma outcome depended on body mass index (BMI) (>30 & <30, p<0.007), not on patient age (p<0.240) or nodes ratio (p<0.613). Repeated aspirations were made in 37.5% non-polymer treated- and 21.21% polymer-treated patients. The findings demonstrated that use of albumin polymers during breast cancer surgery lowers postoperative seroma outcome significantly.
Use of albumin polymers during breast cancer surgery improves postoperative seroma outcome
Surgical Technology International, Feb 1, 2009
The effect of an albumin polymer instillation (Bioglue® Cryolife, Inc., Kenneaw, GA, USA) during ... more The effect of an albumin polymer instillation (Bioglue® Cryolife, Inc., Kenneaw, GA, USA) during breast cancer surgery on postoperative seroma formation was evaluated. Two groups of 34 consecutive patients, treated during operation with and without polymer, were followed postoperatively by weekly ultrasound and clinical evaluation. Seroma was aspirated when the volume exceeded 250 mL. Statistical comparison between 33 of the patients with adhesive- and 32 with non-adhesive-treated patients showed that the former patient group clearly outperformed the latter in production (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and duration (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) of seroma. Seroma outcome depended on body mass index (BMI) (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;30, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.007), not on patient age (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.240) or nodes ratio (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.613). Repeated aspirations were made in 37.5% non-polymer treated- and 21.21% polymer-treated patients. The findings demonstrated that use of albumin polymers during breast cancer surgery lowers postoperative seroma outcome significantly.
The role of parathyroid hormone monitoring after total thyroidectomy in predicting post-thyroidectomy related hypocalcaemia
Mitogen-inducible Gene-2 (MIG2) and migfilin expression is reduced in samples of human breast cancer
Anticancer research, 2013
Cell adhesion proteins that connect each cell to neighboring cells and the extracellular matrix p... more Cell adhesion proteins that connect each cell to neighboring cells and the extracellular matrix play a fundamental role in metastasis. Mitogen-inducible gene-2 (MIG2), is a cell-matrix adhesion protein, which through migfilin, interacts with filamin-A, being linked to actin cytoskeleton. Recent studies have implicated both MIG2 and migfilin in cancer, but little is known regarding their expression in breast cancer. In this study, we investigated this topic. mRNA and protein expression was examined in 30 breast cancer samples and compared to that of normal adjacent tissue using real time-polymerase chain reaction (PCR) and western blotting. Our results showed that expression of MIG2 and migfilin was significantly reduced in the majority of the breast cancer tissues compared to normal tissues regardless of metastatic status and disease stage. Both MIG2 and migfilin are down-regulated in breast cancer.
Evaluation of arterial blood sampling using the B 109 syringe (radiometer)
Acta anaesthesiologica Belgica, 1986
Arterial blood gas measurements were performed after sampling with two different syringes (B 109 ... more Arterial blood gas measurements were performed after sampling with two different syringes (B 109 Radiometer and "ONCE" ASIK) and storage of the samples at 0-4 degrees C for 15 min. The blood samples were analysed in an ABL3 blood gas analyser. We found no statistically significant difference between the mean PaO2, PaCO2 and pH values with either technique of sampling. The B 109 syringe does not offer any advantages over the common plastic 2.5 ml. syringe ("ONCE").
Canadian Anaesthetists’ Society Journal, 1985
Adrenalectomy for disseminated breast cancer
BMJ, 1966
Forty-three patients (two males and 41 females) were submitted to bilateral adrenalectomy for dis... more Forty-three patients (two males and 41 females) were submitted to bilateral adrenalectomy for disseminated mammary carcinoma. Several factors were considered for their prognostic value in predicting the response to endocrine ablation. The age of the patients, the treatment of the primary lesion, the free interval, the location of metastases and the involvement of regional lymph nodes did not affect the response to adrenalectomy. Response to therapeutic castration was directly correlated to the response to adrenalectomy (P less than 0.01); this is a valuable predicting factor that should be taken into consideration before proceeding to bilateral adrenalectomy. A statistically significant variation in survival between the responders and nonresponders was found (P less than 0.05). Finally, the high response rate to the operation (53.4%) can be attributed to the complete removal of the adrenal tissue during the operation.
Adrenocortical function and metastatic breast cancer]
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Papers by Evangelos Athanassiou