Biomedical subjects

J Daniilidis

Publications and source records attributed to J Daniilidis.

At least 19 recordsLinked to original sources

PubMed2007

[Angiographic evaluation and embolization of juvenile nasopharyngeal angiofibroma].

OBJECTIVE: In juvenile nasopharyngeal angiofibroma (JNA), analysis of tumor extension and blood supply is useful for controlling intraoperative bleeding and helps in determining the appropriate surgical approach. The purpose of this study was to evaluate angiographic findings and the efficacy and benefits of preoperative embolization of JNA. PATIENTS AND METHODS: Twenty-one male patients with JNA (mean age 13.3 years) were included in this study. The tumors were embolized with particles of gel foam. Surgical removal was achieved through transantral approach (n=2), lateral rhinotomy (n=13), midfacial degloving (n=4), and endonasally (n=2). RESULTS: The blood supply was exclusively homolateral in 18 patients, deriving mainly from the external carotid artery, and bilateral in three. There were no connections between the branches of the internal and external carotid arteries. Intratumoral embolization was achieved in all patients. No major complications occurred. Mean blood loss during surgery was 560 ml. The recurrence rate was 14%. CONCLUSION: Preoperative angiographic evaluation and embolization of JNA are important tools for planning surgical approach. Embolization reduces significantly the intraoperative blood loss, minimizes the need of blood transfusion, and makes resection easier.

Adolescent↗

PubMed2006

Polyarteritis nodosa and cochlear implantation.

Polyarteritis nodosa is a systemic disease which affects the small to medium-sized muscular arteries. Sudden or progressive, bilateral hearing loss is a presenting otologic manifestation. To date, no case of cochlear implantation in patients with polyarteritis nodosa has been reported. The authors present a case of polyarteritis nodosa (confirmed by biopsy) in a 71-year-old man with progressive, bilateral sensorineural hearing loss who underwent cochlear implantation. A successful full insertion of the Nucleus 3G electrode array was achieved without surgical or post-operative complications. The patient immediately showed a positive subjective response and, at three month post-operative evaluation, had gained useful open-set speech perception. A review of five temporal bone cases with hearing loss and polyarteritis nodosa revealed the possibility of fibrosis and ossification in the basal turn of the cochlea, of which the surgeon should be aware prior to cochlear implantation.

Aged↗

PubMed2006

Paclitaxel and gemcitabine vs. paclitaxel and pegylated liposomal doxorubicin in advanced non-nasopharyngeal head and neck cancer. An efficacy and cost analysis randomized study conducted by the Hellenic Cooperative Oncology Group.

BACKGROUND: The prognosis of patients with recurrent and/or metastatic head and neck cancer (HNC) is poor. Median survival of these patients following chemotherapy is in the range of 6 to 9 months. In the present randomized phase III trial we compared two new combinations containing new drugs with proven activity in phase II studies with patients with HNC. PATIENTS AND METHODS: From November 1999 until November 2004, 166 eligible patients with HNC were enrolled in the study. They were treated with paclitaxel 175 mg/m(2) on day 1 and gemcitabine 1000 mg/m(2) on days 1 and 8 every 3 weeks (group A, 85 patients) or with paclitaxel, as in group A, and pegylated liposomal doxorubicin 40 mg/m(2) on day 1 every 4 weeks (group B, 81 patients). RESULTS: There was no significant difference in response rate (20% versus 29%, P = 0.21), time to disease progression (median; 4.4 months versus 6.0 months, P = 0.09) and survival (median; 8.6 months versus 11.05 months, P = 0.25). Both regimens were generally well tolerated. The most frequently reported side effect, apart from alopecia, was neutropenia. Overall, there was no significant difference in severe toxicity between the two treatment arms. CONCLUSIONS: The present study could not demonstrate a survival benefit with either regimen. Both treatments were well tolerated. Randomized studies comparing each of the two regimens with standard chemotherapy are warranted.

Adult↗

PubMed2006

Primary aneurysmal bone cyst of the maxillary sinus in a child: case report and review of the literature.

Our case report describes a primary aneurysmal bone cyst (ABC) of the maxillary sinus in a 12-year-old girl. The young patient presented with progressive diplopia, strabismus, and rapidly growing painless swelling of the left cheek. Imaging studies showed a heterogeneous contrast enhancing mass expanding the left maxillary sinus. The lesion was completely resected endoscopically and histological examination reported it as an ABC. The patient recovered well and is free of recurrence 9 months following surgery. ABC is a benign lesion usually associated with other bone pathology (fibrous dysplasia). It may behave aggressively and invade the orbit; so resection is necessary. Minimally invasive techniques such as endoscopic sinus surgery can be performed successfully in select cases. Long follow up is important because recurrence may occur, in which case further resection is warranted.

Bone Cysts, Aneurysmal↗

PubMed2006

Classic (Mediterranean) Kaposi's sarcoma of the true vocal cord: a case report and review of the literature.

Kaposi's sarcoma (KS) is a rare subcutaneous lesion linked mainly with patients suffering from acquired immunodeficiency syndrome. The aim of the present study is to present the first documented case of classic Kaposi's sarcoma (CKS) located in the right true vocal cord. A 62 year old male presented with cough and hoarseness for 2 months. Clinical examination revealed a nodule on the right vocal cord. The patient underwent surgery and the lesion was removed and biopsied. The histopathology report showed that the lesion was KS but with no complete removal of the lesion, since the surgical margins of the nodule were not healthy. The patient, although fully informed, refused any further treatment. Further laboratory tests were performed, revealing an HIV-negative immunodeficiency profile. Although (Mediterranean) CKS is not an aggressive malignancy, surgery with complete removal of the affected area is indicated when it is applicable. Moreover, conservative treatment and follow up of the patient is essential in order to prevent relapse or other primary lesions.

Greece↗

PubMed2006

[Solitary fibrous tumor of the nose and paranasal sinuses].

OBJECTIVE: The solitary fibrous tumor is an uncommon, benign lesion with a mesenchymal origin which arises most commonly from the pleura and, in extremely rare cases, from the mucosa of the nose and paranasal sinuses. PATIENT AND METHODS: We describe a case of solitary fibrous tumor in the nasal cavity with an extension into both ethmoid sinuses and destruction of the nasal septum in a 64-year-old woman presenting with nasal obstruction and frontal headache. In the histopathologic examination and by immunohistochemistry, the tumor was composed of spindle cells and nodular collagen, and was confirmed as a solitary fibrous tumor. It was completely removed using an endonasal approach with the patient being free of any complaints and without evidence of disease 2 years after surgery. CONCLUSIONS: Solitary fibrous tumor should be included in diagnostic considerations in patients with sinonasal masses, especially in cases with the appearance of spindle cells. Diagnostic procedures, clinicopathological features, therapeutic options and prognosis of the such tumors are discussed.

Female↗

PubMed2004

[Frey's syndrome of the external auditory canal].

Frey's syndrome of the external auditory canal is extremely rare. A 55-year old woman presented with a 6 month history of unilateral gustatory otorrhea. She never complained of hearing impairment, tinnitus, vertigo or otalgia. No trauma or surgical signs were evident near the ear or parotid gland. Examination of the ear showed an intact tympanic membrane without disease. A diagnosis of gustatory sweating syndrome was suggested by the observation of sweat production after chewing and by Minor's starch-iodine test. Symptoms were relieved after tympanic neurectomy. The pathogenesis, differential diagnosis and treatment options are discussed.

Chorda Tympani Nerve↗

PubMed2003

Low-frequency hearing assessment by middle latency responses in children with pervasive developmental disorder.

OBJECTIVE: In this study, we assessed middle latency responses (MLR) in children diagnosed with pervasive developmental disorder (PDD) in order to detect low-frequency auditory thresholds. METHODS: 35 children, 25 males and 10 females, aged below 5, diagnosed with PDD were referred to rule out any possible hearing deficit. Audiologic evaluation included free-field testing, tympanometry, and both MLR and auditory brainstem responses. A control group of 15 normal children matched for sex and age were used. RESULTS: In 9 out of 35 children (25%), low-frequency sensory hearing loss was revealed. The hearing loss was unilateral in seven children and bilateral in two, and varied from slight to severe. In four out of the nine cases (44%), parents had not suspected hearing loss, since these children always responded to sound. CONCLUSIONS: Among children diagnosed with PDD a significant proportion (25%) was affected by low-frequency sensory hearing loss, detected by MLR. In these children, when low-frequency hearing loss was found bilateral or severe unilateral, aural rehabilitation was initiated in order to improve their responses to auditory stimuli and their impaired communication with the environment. PDD children, even if their reaction to sound is normal, must be referred to thorough audiometric evaluation while low-frequency hearing level should always be tested.

Acoustic Impedance Tests↗

PubMed2002

Facial electroneurography on the contralateral side in unilateral Bell's palsy.

In this study, ten patients who exhibited severe unilateral Bell's palsy of the House-Brackmann grade V underwent facial electroneurography (ENoG) on the contralateral, healthy side. Serial ENoG was conducted in seven consecutive sessions within 6 months at a given current intensity level of stimulation. According to our results, all the patients presented a rise in the maximum compound-action potential (MCAP) amplitude on the healthy side within 20 to 45 days from the onset of the palsy and shortly after the onset of the recovery of the facial function. This was attributed to the central contralateral compensatory process, which restores balanced facial function. Based on our data, a hypothetical model is shown, which demonstrates the clinical course of the contralateral MCAP values and reflects the plasticity effect of the central nervous system after the onset of Bell's palsy.

Action Potentials↗

PubMed2001

[Combined radiochemotherapy in locally advanced nasopharyngeal carcinoma].

BACKGROUND: Nasopharyngeal cancer (NPC) is a tumor of epidermoid origin with an entirely different biological behavior than other carcinoma of the head and neck region. PATIENTS/METHODS: A retrospective analysis was performed in 93 cases with locally advanced NPC treated with induction chemotherapy followed by radiation therapy (RT; 79 patients) or concomitant RT and chemotherapy. RESULTS: Totally 66 patients (71%) achieved a complete response (CR), 68% of the patients treated with induction chemotherapy followed by RT, 86% with concomitant chemoradiotherapy. After a median follow-up of 5.5 years 28 out of these 66 relapsed, 25 of them locoregionally. Median time to progression was 22.5 months, median overall survival (OS) 45 months, 5-year actuarial survival was 41.5%. Age, T and N classification, histological type and type of chemotherapy were independent significant factors for OS. CONCLUSIONS: Combined chemotherapy and RT in patients with locally advanced NPC result in a high CR rate. The main problem remains the locoregional control. Randomized studies are needed in order to define the optimal use of chemotherapy in combination with RT.

Adolescent↗

PubMed2001

Can HLA typing predict the outcome of grass pollen immunotherapy?

OBJECTIVE: The aim of this study was to investigate the relationship between HLA molecules and the positive or negative response of atopic patients to specific immunotherapy (SIT). METHODS: We studied 42 atopic multisensitive patients undergoing grass pollen immunotherapy, 42 parents of patients (30 mothers and 12 fathers) and 173 control individuals. HLA class I and class II antigens were typed by a microlymphocytotoxicity test. The typing of DRB1* alleles for atopic patients and their parents was based on the reverse hybridization principle, while for the control group, DNA-RFLP and PCR-SSP methods were used. RESULTS: The frequency of B14 and DRB1*1101-4 antigens/alleles, as well as the A2B5DR11 haplotype, showed a statistically significant difference in those patients who responded to immunotherapy. On the other hand, HLA-A28, B8 and DRB1*0301 antigens/alleles, as well as the frequency of the A1B8 and A1B8DR3 haplotypes, were found to be significantly higher in patients who responded poorly to SIT. DISCUSSION: Our findings support the hypothesis that treatment responsiveness may show an association to HLA molecules, which could thus play a role in the immunological selection and monitoring of atopic patient candidacy for SIT.

Adolescent↗

PubMed1999

Paclitaxel and gemcitabine in advanced non-nasopharyngeal head and neck cancer: a phase II study conducted by the Hellenic Cooperative Oncology Group.

BACKGROUND: Paclitaxel as monotherapy or in combination with other drugs has demonstrated significant activity in patients with squamous cell carcinoma of the head and neck region (SCCHN). Preclinical studies have shown gemcitabine to be highly active in SCCHN cell lines. PURPOSE OF THE STUDY: To evaluate the activity and toxicity of the combination of paclitaxel by three-hour infusion and gemcitabine as first-line chemotherapy in patients with recurrent and/or metastatic head and neck cancer (HNC). PATIENTS AND METHODS: From September 1996 until May 1998, 44 patients with non-nasopharyngeal recurrent and/or metastatic HNC entered the study. There were 37 men and seven women with a median age of 61 years (range 35-79) and a median performance status of 1 (range 0-2). The location of the primary tumor in the majority of them was either the larynx or the oral cavity. Treatment consisted of six cycles of gemcitabine 1100 mg/m2 over 30 min on days 1 and 8 immediately followed on day 1 by paclitaxel 200 mg/m2 by three-hour infusion. The treatment was repeated every three weeks. RESULTS: Twenty-four (55%) patients completed all six cycles of treatment. A total of 205 cycles were administered, 165 (81%) of them at full dose. The median relative dose intensity (DI) of gemcitabine was 0.93 and of paclitaxel 0.95. Except for alopecia, which was universal, grade 3-4 toxicities included neutropenia (21%), thrombocytopenia (5%), anemia (5%), infection (5%), flu-like syndrome (5%) and peripheral neuropathy (2%). Five (11%) patients achieved complete and 13 (30%) partial responses, for an overall response rate of 41%. After a median follow-up of 13 months, the median time to progression was four months and median survival nine months. CONCLUSIONS: The combination of paclitaxel and gemcitabine is active and well tolerated in patients with recurrent and/or metastatic HNC-randomized studies comparing this combination with other regimens are warranted.

Adult↗

PubMed1999

Squamous cell carcinoma antigen, circulating immune complexes, and immunoglobulins in monitoring squamous cell carcinoma of head and neck: a study of the hellenic co-operative oncology group (HeCOG).

This study investigates the clinical utility of squamous cell carcinoma antigen (SCC-Ag), circulating immune complexes (CIC), and immunoglobulins (IgA, IgG, IgM) in the diagnosis, monitoring, and prognosis of 117 squamous cell carcinoma of the head and neck (SCC-HN) patients having local and/or systemic treatment. Serum marker levels were measured in a prospective study. SCC-Ag was positive in 28.2% of patients, the CIC in 63.2%, the IgA in 11.1%, the IgG in 15.4%, and the IgM in 9.44%. Statistically significant correlation was found between the initial SCC-Ag levels and tumor localization, whereas the CIC levels were increasing significantly with progressing disease stages. It was also found that the significant decrease of SCC-Ag, IgA, and CIC levels at the end of treatment was correlated with an increased incidence of disease-free status. The initial values of IgG and the disease stage were significantly correlated with a favorable treatment outcome. The pretreatment elevated SCC-Ag and IgM serum values showed a significant trend to predict a disease progression. Using a Cox proportional hazards model the IgG serum values, the primary site, and the disease stage were significant predictors for time to progression. The significant decrease of SCC-Ag, IgA, and CIC values at the completion of treatment was correlated with an increased incidence of disease-free status. This study indicates that only the estimation of SCC-Ag and in some degree the IgM and/or IgG is a potential tool for monitoring the efficacy of treatment or disease recurrence in SCC-HN.

Adult↗

PubMed1999

Intrasphenoidal encephalocele and spontaneous CSF rhinorrhoea.

Intrasphenoidal encephalocele is a rare clinical entity. In the international literature only 16 cases have been reported up today, with female predominance. Clinically they manifest at middle and advanced ages (40-67 years), when spontaneous CSF rhinorrhoea or recurrent meningitis occurs. We present our case, a 46 years old female, who had CSF rhinorrhoea from the right vestibule for 10 months. The diagnosis was based on the history and the high-resolution brain and skull base CT-scanning in conjunction with opaque fluid injection in the subarachnoidal space through a lumbar puncture. She was successfully treated with an operation, through an endonasal trans-ethmoid microendoscopic approach, using the Draf and Stammberger technique. We discuss the pathogenesis of the intrasphenoidal encephalocele, the existence of small occult defects in the skull base, which cause, at the middle and advanced ages, CSF fistula with spontaneous CSF rhinorrhoea and/or recurrent meningitis. Finally we emphasize the advantages of the endonasal surgical approach for the treatment of this condition.

Cerebrospinal Fluid Rhinorrhea↗

PubMed1997

Long-term survival data and prognostic factors of a complete response to chemotherapy in patients with head and neck cancer treated with platinum-based induction chemotherapy: a Hellenic Co-operative oncology Group study.

A group of 154 patients with locally advanced head and neck cancer, treated with platinum-based induction chemotherapy, were followed up for 5 years and several pretreatment characteristics were analyzed for possible correlation to a complete response (CR) to chemotherapy, time to progression (TTP) and overall survival (OS). Clinical stage (p = 0.0024) and a history of smoking (p = 0.0125) were selected as important prognostic factors for CR by step wise logistic regression. We also identified response to chemotherapy (p = 0.0120), age (p = 0.0066), clinical stage (p = 0.0363), N stage (p = 0.0028), and tumor grade (p = 0.0101) as significant prognostic variables for TTP. Response to chemotherapy (p < 0.0001) and age (p = 0.0017) were found also significant for OS. These long-term prognostic factors which retain their prognostic significance after several years of follow-up could be helpful in the design of future trials in this patient population.

Adolescent↗

PubMed1997

Paclitaxel by three-hour infusion and carboplatin in advanced carcinoma of nasopharynx and other sites of the head and neck. A phase II study conducted by the Hellenic Cooperative Oncology Group.

BACKGROUND: Paclitaxel has been demonstrated to have significant activity in recurrent or metastatic head and neck cancer (HNC). In addition, the combination of paclitaxel and cisplatin is active in untreated patients with inoperable HNC. Substitution of carboplatin for cisplatin allows the treatment to be delivered on an outpatient basis. PURPOSE OF THE STUDY: To evaluate the activity and toxicity of the combination of paclitaxel by three-hour infusion and carboplatin as first-line chemotherapy in patients with recurrent or metastatic HNC. PATIENTS AND METHODS: From March 1994 until August 1996, 49 patients with recurrent or metastatic HNC were treated with paclitaxel (200 mg/m2, by three-hour infusion) followed by carboplatin at an AUC of 7 mg.min/ml, every four weeks. G-CSF was administered prophylactically on days 2 to 12 of each cycle. There were 41 men and 8 women with a median age of 57 years (range 23-73). The majority of the patients were symptomatic and they had recurrent disease locoregionally. Fourteen patients had nasopharyngeal cancer (NPC) and 35 had squamous cell cancers of other areas of the head and neck region (non-NPC). RESULTS: At the completion of treatment, two patients with NPC demonstrated complete and six partial responses for an overall response rate of 57% (95% CI 29%-82%). Among patients with non-NPC, the response rate was 23% (95% CI 9%-37%). After a median follow up period of 15 months, the median time to progression was 4.3 months in the non-NPC group and 16.5 months in the NPC group. At the time of the analysis, median survival had not been reached in NPC while it was 7.3 months in non-NPC patients. Grade 3-4 toxicities included anemia (2%) and leukopenia, thrombocytopenia, stomatitis, nausea/vomiting and diarrhea (4% each). CONCLUSIONS: The combination of paclitaxel and carboplatin appears to be well tolerated but only moderately active in patients with advanced non-NPC of the head and neck region. However, its activity appears promising in NPC and deserves further investigation.

Adult↗

PubMed1997

Paclitaxel and carboplatin in recurrent or metastatic head and neck cancer: a phase II study.

Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) appears to be one of the most active drugs in the treatment of advanced head and neck cancer. The maximum tolerated dose of paclitaxel in combination with carboplatin is currently being evaluated in phase I/II studies. We designed a phase II study to evaluate the activity and acute and cumulative toxicity of this combination in patients with recurrent or metastatic cancer of the head and neck. Chemotherapy consisted of paclitaxel 200 mg/m2, given as a 3-hour infusion, and carboplatin dosed to an area under the concentration-time curve of 7 mg x min/mL, administered every 28 days. Granulocyte colony-stimulating factor (5 microg/kg) also was given on days 2 to 12 of each cycle. At the time of this report, 41 patients had entered this study. Primary sites included the nasopharynx (10 patients), larynx (18), oral cavity (three), oropharynx (six), hypopharynx (three), and unknown (one). Among 25 evaluable patients with non-nasopharyngeal cancer, there were two complete responses and three partial responses, for an overall response rate of 20% (95% confidence interval, 4% to 36%). Among eight evaluable patients with nasopharyngeal cancer, four achieved a complete response and two a partial response. Grade 3 to 4 toxicities included anemia (2.5%), leukopenia (7.5%), thrombocytopenia (5%), vomiting (5%), stomatitis (2.5%), and infection (5%). These preliminary data indicate that the combination of paclitaxel and carboplatin is active against advanced head and neck cancer, particularly when used in the treatment of nasopharyngeal cancer.

Adult↗

PubMed1994

Does substitution of surgery with induction chemotherapy preserve organ function in inoperable head and neck cancer? A retrospective analysis of 73 cases.

From August, 1984 until May, 1991, 154 patients with locally advanced head and neck cancer were treated with 3 cycles of platinum-containing induction chemotherapy followed by definitive radiotherapy. Among them, there were 32 patients with cancer of oropharynx or hypopharynx and 41 patients with cancer of larynx, who were treated with this combined approach with the intention of preserving the involved organ. After the completion of chemotherapy 5 (16%) patients with pharyngeal tumors achieved a complete response (CR) and 14 (44%) a partial response (PR). After the completion of radiotherapy the CR rate was increased to 38%. After induction chemotherapy 7 (17%) of the 41 patients with cancer of the larynx achieved a CR and 25 (61%) a PR. The CR rate was tripled (68%) following radiotherapy and salvage surgery. So far, 8 complete responders with pharyngeal and 6 with laryngeal tumors relapsed mainly locoregionally. With a minimum follow-up of 22 months, median time to progression was 8 months for patients with cancer of the pharynx and 13 months for patients with cancer of the larynx. Median survival for these two groups of patients was 13 and 24 months respectively. In patients with locally advanced cancer of the oropharynx, hypopharynx or larynx induction chemotherapy followed by radiotherapy may delay in many or even omit in a few patients the necessity of radical surgery without compromising survival.

Adult↗