Biomedical subjects

G Kourounis

Publications and source records attributed to G Kourounis.

At least 19 recordsLinked to original sources

PubMed2006

Primary peritoneal psammocarcinoma: a case presenting synchronously with bowel carcinoma.

BACKGROUND: Psammocarcinomas are rare epithelial tumors usually originating from the ovarian surface epithelium or the peritoneum. In our case, a peritoneal psammocarcinoma was incidental surgical finding during laparotomy. CASE: An 83-year-old woman underwent surgery for bowel obstruction. Intraoperativelly, a bowel carcinoma was documented. Notable were numerous small disseminated peritoneal nodules that studded the omentum and bowel serosa. At reintervention, similar nodules were observed in the serosal surface of the two ovaries, uterus, left salpinx, and omentum. The nodules corresponded histologically to psammocarcinoma of peritoneal origin. Despite not receiving adjuvant treatment, the patient is still alive 53 months following the second operation, without signs of metastases or disease recurrence. CONCLUSION: Though unpredictable, psammocarcinomas might run an indolent course, and decisions regarding management should be individualized.

Adenocarcinoma, Papillary↗

PubMed2006

Polycystic ovarian syndrome, insulin resistance and thickness of the endometrium.

INTRODUCTION: Disorders possibly associated with insulin resistance (IR) are hyperandrogenemia, hirsutism, irregular menstrual cycles, central obesity and polycystic ovarian syndrome (PCOS). It is known that PCOS is related to a high risk of endometrial hyperplasia after many years of estrogen stimulation from anovulation. OBJECTIVES: The purpose of the study was to estimate the thickness of the endometrium in women with IR without a diagnosis of PCOS and in women with PCOS without IR. STUDY DESIGN: Three groups of women included in the study: 15 women diagnosed as IR without PCOS, 16 women diagnosed as PCOS without IR and 20 women used as controls matched for age and body mass index (BMI) with the previous patients. Thickness of the endometrium was estimated in all cases with a transvaginal ultrasound in three consecutive measures during a cycle. RESULTS: The mean thickness of the endometrium was statistically higher in the PCOS group (11.1mm), and in the IR group (9.6mm), compared with the control group (6.2mm) (F=13.1, p<0.001). CONCLUSIONS: It is concluded that both in women diagnosed as having insulin resistance without PCOS, and in women with PCOS without insulin resistance, the ultrasonographically estimated thickness of the endometrium is relatively high and a closer follow-up of these women is required in order to detect those in risk to develop hyperplasia and/or atypia.

Adult↗

PubMed2006

Correlation of mammographic appearance and molecular prognostic factors in high-grade breast carcinomas.

The aim of our study was to evaluate the association between the mammographic appearance and the biologic characteristics of high-grade breast carcinomas. Three hundred and twenty patients with breast carcinomas were studied. Histological examination showed 83 (26%) high-grade ductal carcinomas. Immunohistochemistry was carried out by using antibodies against estrogen receptor (ER), progesterone receptor (PR), HER-2/neu, p53 and cathepsin D. In 60/83 high-grade carcinomas we studied the mammographic appearance. Asymmetric density with poorly defined margins without microcalcifications was the major mammographic finding in 49/60 (approximately 82%) high-grade ductal carcinomas. HER-2/neu positivity (68.7%) and p53 positivity (48.2%) were statistically correlated with asymmetric density with poorly defined margins without microcalcifications in high-grade carcinomas. We observed loss of ER and PR receptors in 50%, whereas loss of PR receptors was observed in 65% of high-grade breast carcinomas. Cathepsin D (> 20%) was detected in 38.5% of high-grade carcinomas. Our findings suggest a significant relationship between mammographic appearance and biologic markers in high-grade breast carcinomas.

Adult↗

PubMed2006

Immunohistochemical detection of HPV proteins and c-erbB receptors in cervical lesion specimens from young women.

The intention of the present study was to assess immunohistochemically the expression of c-erbB receptor family in cervical carcinoma specimens of young women. Simultaneously, HPV was detected in the same specimens using immunohistochemical assays. Seventy-five cervical intraepithelial and invasive cancer specimens were assessed retrospectively. Positive c-erbB-2 immunostaining was revealed in 11.7% of tumor specimens, while for c-erbB-3 and c-erbB-4 receptor the corresponding figures were 32% and 49.3%, respectively. Concerning HPV infection-markers, positive immunostaining was found in 31% of cases, while coilocytes were detected in 64% of patients. The correlation of c-erbB receptor expression with malignant aggressiveness in cervical cancer cells concurs with similar data regarding other neoplasias, thus rendering these receptors an important predictive factor and future therapeutic target.

Adult↗

PubMed2006

Is dosage of hormone replacement therapy related with endometrial polyp formation?

PURPOSE OF INVESTIGATION: To evaluate the effect of different doses of hormone replacement therapy (HRT) on endometrial polyp formation. METHODS: 398 menopausal women were initially evaluated through transvaginal ultrasound and patients who already had endometrial polyps were excluded from the study. One hundred and six (26.6%) eligible patients were enrolled and randomized into two groups of 53 patients to receive two different doses of HRT. RESULTS: Six patients with endometrial polyps were detected in the first group and one patient in the second one (p = 0.0502 for total chi-square and p = .1172 for chi-square with continuity correction) after a mean duration of treatment of 26 months and 28,5 months, respectively. There was no difference in the mean number or the mean volume of the polyps between the two subgroups with positive results. CONCLUSION: Our study showed that endometrial polyp formation may be related with HRT dosage.

Dose-Response Relationship, Drug↗

PubMed2006

Women younger than 50 years with endometrial cancer.

PURPOSE OF INVESTIGATION: The purpose of the study was to evaluate if known risk factors for endometrial cancer in menopausal women are also related to endometrial cancer in younger ages. METHODS: Eighty-one patients with a mean age of 46.3 years diagnosed with endometrial cancer (EC) (histologically confirmed) from January of 1992 to December of 2004 were included in the study. The EC group of patients was compared with 100 patients (control group) randomly selected from the gynecologic clinic (inclusion criteria: age 43-48 years) without any endometrial cancer diagnoses that were evaluated for the same factors. RESULTS: Mean BMI was 34.4 kg/m2 (SD = 8.8) in the first group and 28.3 (SD = 7.6) in the second one (p < 0.001). None of the women in the EC group reported any history of oral contraception. With the exception of hypertension and ovarian cancer (probably related to small numbers) all other comparisons were statistically significant (although some only marginally). DISCUSSION: From the results of our study, it seems that body mass index (BMI), parity, type of menstrual cycles, history of polycystic ovarian (PCO) syndrome and diabetes are possibly related to endometrial cancer in women younger than 50 years of age, and the strongest relation was found with increased BMI. Also, there was no increased incidence of hypertensive disease in the EC group. CONCLUSION: Prospective studies are needed for final conclusions.

Adult↗

PubMed2006

Synchronous primary endometrial and ovarian cancers: a case report.

Synchronous primary cancers of the endometrium and ovary are relatively uncommon in the general population. The patient, a 49-year-old postmenopausal Greek woman, presented with abdominal pain and a pelvic mass. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, total omentectomy, appendectomy and pelvic lymph node dissection. The histopathology revealed synchronous primary cancers of the endometrium and right ovary. She underwent postoperative chemotherapy. Thirty-nine months after surgery, she remains well without evidence of recurrence.

Endometrial Neoplasms↗

PubMed2006

Expression of the epidermal growth factor system in endometrial cancer after adjuvant tamoxifen treatment for breast cancer.

The aim of our study was to describe the expression of cerbB-1, cerbB-2, cerbB-3 and cerbB-4 in endometrial cancer tissue and its correlation with clinicopathologic features and prognosis of endometrial cancer patients diagnosed during or after tamoxifen treatment for breast cancer. Thirteen tamoxifen-related endometrial cancers were identified from the archives of the Department of Obstetrics and Gynecology of the University of Patras, Medical School. Tissue specimens from endometrial lesions were immunostained for cerbB-1, cerbB-2, cerbB-3 and cerbB-4. For cerbB-1, five cases were positive and eight were negative. For cerbB-2, ten cases were positive and three were negative. For cerbB-3, nine cases were positive and four were negative. For cerbB-4, eight cases were positive and five were negative. However, a limitation of our study is that the number of cases was small, and further investigations are necessary to allow a more focused evaluation of cerbB-1, cerbB-2, cerbB-3 and cerbB-4 status, as a prognostic factor for endometrial cancer after tamoxifen treatment.

Aged↗

PubMed2005

Increased activity of lysosomal enzymes in the peritoneal fluid of patients with gynecologic cancers and pelvic inflammatory disease.

PURPOSE: To investigate whether the activity of lysosomal enzymes is increased in the peritoneal fluid of patients with gynecologic cancers compared to activity in the peritoneal fluid from normal subjects and those with pelvic inflammatory disease, and fluid from benign ovarian cysts. PATIENTS AND METHODS: beta-glucuronidase, beta-galactosidase, and alpha-mannosidase activity was measured in the peritoneal fluid from patients with gynecologic cancer, pelvic inflammatory disease, and normal subjects, and fluid from benign ovarian cysts. RESULTS: The mean+/-SD of beta-glucuronidase, beta-galactosidase, and alpha-mannosidase activity in the gynecologic cancers was 120+/-50 nmol, 203+/-86 nmol, and 240+/-119 nmol 4-methylumbelliferone/ml/h, respectively; in the normal control subjects it was 22+/-9 nmol, 46+/-10 nmol, and 80+/-23 nmol, respectively (P=0.00003, 0.0001, and 0.0001, respectively). The activity was increased even in cases without malignant cells in the peritoneal fluid. In pelvic inflammatory disease it was 148+/-82 nmol, 278+/-112 nmol, and 291+/-140 nmol, respectively. The activity in the fluid of the ovarian cysts was similar to that of the normal peritoneal fluid. There was a significant positive correlation between enzyme activity and stage of cancer, that was stronger for beta-glucuronidase (r=0.889, P=0.003). CONCLUSION: The increased lysosomal enzyme activity in gynecologic cancers, without overlapping between patients and normal subjects or benign ovarian cyst fluid, indicates that such measurements might be applied for diagnostic purposes.

Adenocarcinoma↗

PubMed2005

Factors associated with initiation and duration of breastfeeding in Greece.

AIM: Our aim was to study factors affecting the initiation, progress and duration of breastfeeding in Greece. METHODS: We studied 938 infants born in 2001 in 17 maternity hospitals in Greece. RESULTS: The percentage of breastfeeding infants was 85.5%. The actual progress of breastfeeding was different from the one that the mothers intended to follow. Although the majority of women claimed in the beginning that they would breastfeed mainly for four to six months (23.2%) and 12-14 months (23.1%), the majority had discontinued breastfeeding by the fourth month (58.5%) and only 7.3% breastfed for more than one year. The initiation time of breastfeeding was positively influenced by natural delivery (p = 0) and pleasant delivery (p = 0.397). Smoking was negatively associated with the duration of breastfeeding (p = 0) and the infants of smokers breastfed mainly for one to two months (38.7%). Exclusive breastfeeding in the maternity hospital was positively associated with the mother's intention to refuse to use a mixed diet after being discharged (p = 0). CONCLUSION: Greater support is needed so that women can implement their original intentions concerning the progress of breastfeeding.

Breast Feeding↗

PubMed2005

Leiomyosarcoma of the vulva: a case report.

Primary sarcoma of the vulva is a rare tumor. Leiomyosarcoma is the most common histologic variant of vulvar sarcoma. The patient, a 55-year-old, gravida 4, para 2 postmenopausal Greek woman, presented with a 5-year history of progressive enlargement of the right labia majora. On vaginal examination there was a 8 x 9 cm raised, ulcerated and irregular mass of the right labia majora. Despite surgery, the patient died six months later because of multiple metastases.

Diagnosis, Differential↗

PubMed2005

Primary malignant melanoma of the vagina: a case report.

Primary malignant melanoma of the vagina is a very rare, but very aggressive tumor. We describe a case of primary vaginal melanoma and review the literature. The patient, a 73-year-old, gravida 2, para 2 postmenopausal Greek woman, presented with abnormal vaginal bleeding for 30 days. On vaginal examination there was a 5.5 x 5 x 2 cm raised, ulcerated and irregular lesion on the posterior vaginal wall. Pathology examination of the entire specimen demonstrated a nodular vaginal melanoma. The histologic diagnosis was confirmed by positive immunostaining. The patient began postoperative immunotherapy with interferon-a2b. She died 25 months later because of cerebral metastases. In conclusion, the prognosis of vaginal melanoma is very poor, despite the treatment modality, because most cases are diagnosed at a late stage.

Aged↗

PubMed2005

Factors influencing the initiation and progress of breastfeeding in Greece.

OBJECTIVE: The aim of this study was to investigate and assess the factors associated with the initiation, progress, and duration of breastfeeding in Greece. METHODS: We studied 1,010 infants born from 862 women from 1996 to 2000 in 17 hospitals. We followed the mothers for the period January-October 2001, while they were at the maternity hospitals to give birth to their next child. RESULTS: Statistical analysis of the data showed that factors positively associated with the duration of breast-feeding were the application of rooming-in (p = 0.0001), the initiation time of breast-feeding--mainly one to six hours after delivery (p = 0.0004), natural delivery (p = 0), pleasant delivery (p = 0.0142), the time the decision about breastfeeding was taken (p = 0), the fact that it was mainly a maternal decision and the mothers were not influenced by a specific person (p = 0.0272) and the fact that no mixed diet was administered (p = 0). Smoking was negatively associated with the duration of breastfeeding (p = 0.0036). Factors not associated with the duration of breastfeeding were: number of the mother's family members (p = 0.1231), whether the women themselves were breastfed as babies (p = 0.03924), some elements of their personality (p = 0.3871) as well as their beliefs concerning maternal milk (p = 0.1922). CONCLUSIONS: From our results we have indications as to which factors are related or unrelated to the initiation and progress of breastfeeding in Greece.

Breast Feeding↗

PubMed2004

Spinocerebellar ataxia and hypergonadotropic hypogonadism associated with familial sensorineural hearing loss.

Cerebellar ataxia has been described as being associated with hypogonadism for almost 100 years. In the majority of cases, hypogonadism is hypogonadotropic. The association of cerebellar ataxia with hypergonadotropic hypogonadism is a rare genetic disorder with a recessive mode of inheritance. Cerebellar ataxia and hypogonadism can also occur associated with a large spectrum of additional clinical manfestations, including mental retardation, sensorineural deafness, choroidal dystrophy, ectodermal dysplasia and short stature, and polyneuropathy. We report the case of a woman with early-onset spinocerebellar ataxia, primary amenorrhea due to hypergonadotropic hypogonadism, and late-onset sensorineural hearing loss. Additional family members from the father's side are affected with late-onset hearing loss, suggesting a dominant mode of inheritance.

Adult↗

PubMed2004

Effect on endometrium of combined oestrogen-progestogen replacement therapy of 1 mg 17beta-estradiol and 0.5 mg norethisterone acetate.

The purpose of the study was to determine the effects of low-dose hormone replacement therapy (HRT) on ultrasound thickness of the endometrium and on endometrial histology in postmenopausal women. Two hundred and fifty-four postmenopausal women were included in the study; 124 completed three years of treatment with continuous HRT containing 1 mg oestradiol and 0.5 mg norethisterone acetate daily, and 130 women did not take HRT during the same time (control group). Ultrasound scan showed that the mean thickness of the endometrium was similar between the groups under investigation at the end of the study. Ninety-one percent of the women in the HRT group and 78% in the control group had an atrophic or unassessable endometrium and no cases of endometrial hyperplasia or malignancy were detected in either group at endometrial biopsy at the end of the study. It seems that low-dose continuous HRT of moderate duration is not associated with either endometrial hyperplasia or malignancy.

Endometrium↗

PubMed2004

Treatment delay and pathology results in women with low-grade squamous intraepithelial lesions. A preliminary study.

Regression rate of CIN 1 (LSIL) can reach 85%. The purpose of this study was to investigate retrospectively pathology specimens in CIN 1 cases who delayed treatment > 2 years despite the persistence of the lesion. One hundred and fifteen women diagnosed with CIN 1 were separated in two groups as follows: A) 92 women who underwent ablative treatment within three months after the completion of two years; B) 23 women who delayed ablative treatment for a mean interval of > 1 year after the completion of two years. Exclusion criteria were normal cytology and colposcopy results within the completion of two years. The chi-square, t-test and Kaplan-Meier method were used for analysis. Persistence of LSIL lesions was observed in 84% of the first group and persistence or regression of the lesion in 78% of the second one. The study suggests the possibility of prolongation of the observation period after LSIL diagnosis. Prospective studies with close follow-up are needed for final conclusions.

Adult↗

PubMed2004

Normal colposcopy following abnormal Pap smear evoking LGSIL: a follow-up study.

The aim of this study was to determine the optimal treatment policy in women presenting with an abnormal Pap smear showing low-grade squamous intraepithelial lesion (LGSIL), who additionally had normal colposcopic findings. We prospectively studied 160 women with LGSIL and normal colposcopy, and divided them into two groups. Group A, consisting of 54 women, was followed-up for a mean period of 42 months and had a new control smear 12 months after the initial one. Group B, consisting of 106 women, was followed-up for a mean period of 44 months and had two consecutive control smears (6 and 12 months after the initial), and a new colposcopy, depending on the findings. At the end of the first year, the lesion persisted in 37% and 39% of the patients in groups A and B, respectively. At the end of the study, regression or persistence of the LGSIL was revealed in 63% and 61% of the women in groups A and B, respectively. Aggravation of the lesions occurred after 16.5 and 15 months, respectively, in groups A and B. Our findings suggest that women with LGSIL and normal colposcopy do not need further therapeutic measures during the first year after the initial smear.

Adolescent↗

PubMed2004

The use of erythropoietin in gynecologic cancer patients.

PURPOSE: To investigate the possible benefits of erythroproietin ingestion in patients with various gynecological cancers with proven severe iron deficiency anemia. METHOD: Seven patients with gynecological cancer were included in the study. Nadir hematocrit values were found to be 20-24% before the initiation of recombinant human erythropoietin treatment. Initial therapy started at 50 units/kg/dose, three times weekly for a month. The dose was modified according to the rise of hemoglobin after a month's period. The dose was modified according to the rise of hemoglobin after a month's period. If the rise was greater than 2 g/dl the dose was changed to 25 units/kg two times weekly and if it was less than 2 g/dl it was changed to 25 units/kg three times weekly per month. Five patients were simultaneously given erythropoietin therapy and iron supplementation. RESULTS: We confirmed a rise in the hematocrit values which averaged 0.5-1.5% weekly till the upper limit. Reticulocyte and hematocrit values were higher in the erythropoietin plus iron group (five cases). CONCLUSION: In this small series, erythropoietin appeared to be effective in treating severe iron deficiency in gynecologic cancer patients. Further investigation is needed to confirm these results.

Anemia, Iron-Deficiency↗