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Biomedical subjects

J Ioannovich

Publications and source records attributed to J Ioannovich.

17 recordsLinked to original sources
PubMed2004

Reverse dorsal digital and intercommissural flaps used for digital reconstruction.

Reverse dorsal digital and intercommissural flaps offer a simple and versatile option for skin cover of distal finger defects, especially when other local flaps are not available. Twenty-one reverse dorsal digital flaps were used, on an outpatient basis, to cover dorsal soft tissue defects over or beyond the PIP joint. All the flaps were transposed as reverse island flaps. The average size of the defects was 2.5 cm(2) and they were all used to cover exposed tendon, bone, joint or a combination. Twenty flaps survived completely and did not present any feature of circulatory difficulty. Marginal necrosis of one flap was noticed, while two patients complained of swollen finger 6 months later. No morbidity was reported and the patients maintained good range of motion. Various other types of flaps that have been used to reconstruct distal digital skin defects are reviewed and compared with the reverse dorsal digital and metacarpal flaps.

Adolescent↗
PubMed2004

Vinorelbine in combination with interleukin-2 as second-line treatment in patients with metastatic melanoma. A phase II study of the Hellenic Cooperative Oncology Group.

OBJECTIVES: To evaluate the efficacy and toxicity of the combination of vinorelbine and interleukin (IL)-2 in patients with metastatic melanoma as second-line chemotherapy. PATIENTS AND METHODS: Twenty-two patients with histologically confirmed stage IV melanoma previously treated with temozolomide-based chemotherapy--only one regimen of chemotherapy for disseminated disease was allowed--were treated with vinorelbine 30 mg/m2 on days 1 and 15 and IL-2 subcutaneous 9 x 10(6) once daily on days 2-6 and 16-19 every 4 weeks for maximum of six cycles. RESULTS: From January 2000 to July 2001, 22 patients entered the study; the median age was 56 years. Among 20 evaluable patients there were 2 (9.1%) objective responses including 1 complete response and 1 partial response. Five (22.7%) had stabilization of their disease, and 13 (59.1%) progressed. The median time to progression (TTP) was 2.9 months and the median overall survival was 9.1 months. There was a significant difference in TTP in patients who responded or remained stable (median TTP 10.75 months) and those who progressed (median TTP 2.1 months) (p<0.05). There was also a difference in survival in the two groups (p<0.05 (28 vs. 8 months). The most common side effects were flulike symptoms, such as fever, chills, fatigue, and injection site reaction. Grade 3 hematological toxicity rarely occurred. One patient discontinued therapy because of fatigue and anorexia. There were no treatment-related deaths. CONCLUSIONS: The combination of vinorelbine and IL-2 provides clinical benefit in patients recurring or progressing on first-line chemotherapy for metastatic melanoma, with manageable toxicity.

Adult↗
PubMed2002

Prognostic significance of the sequential detection of circulating melanoma cells by RT-PCR in high-risk melanoma patients receiving adjuvant interferon.

The purpose of this study was to address the prognostic significance of circulating melanoma cells by reverse transcriptase-polymerase chain reaction in the peripheral blood of stage IIB and III melanoma patients on high-dose adjuvant interferon at multiple sequential time points from initiation of treatment. Tyrosinase mRNA in peripheral blood from these patients was assayed by reverse transcriptase polymerase chain reaction prior to initiation of adjuvant interferon, at completion of 1 month of intravenous interferon and at 3 monthly intervals until progression. Four hundred and eighteen blood samples from 60 melanoma patients were analysed. The median follow-up time calculated from the time of inclusion in the study was 23 months (range 2-38 months). Tyrosinase mRNA in blood was detected in 42 (70%) of 60 patients: 16 (76%) of 21 stage IIB patients and 26 (66% ) of 39 stage III patients. The presence of tyrosinase mRNA in blood was correlated with a shorter disease-free survival (P : 0.03) and in multivariante analysis was an independent prognostic factor for relapse. Patients who seroconverted to a negative reverse-transcriptase-polymerase chain reaction after induction treatment had a significantly lower probability of recurrence. The presence of circulating melanoma cells is a marker of a high relapse risk and shorter disease-free survival whether detected postoperatively or during follow-up. Tyrosinase mRNA amplification by reverse-transcriptase-polymerase chain reaction may be a useful tool for monitoring the efficacy of adjuvant treatment in stage IIB and III melanoma patients.

Adult↗
PubMed2000

Lectin-binding pattern of primary malignant melanomas and melanocytic nevi.

A panel of six biotinylated lectins was applied in order to study the composition and distribution of plasma membrane carbohydrate residues in 83 primary cutaneous melanomas (MMs) and in 85 melanocytic nevi (MN) with the avidin-biotin peroxidase technique. No clear-cut differences between MN and MMs were observed with regard to the staining with lectins. In MN and MMs derived from different patients, the lectin-binding pattern was variable and heterogeneous even within the individual nevi or melanomas. It seems reasonable, therefore, to assume that the lectin-binding pattern cannot be regarded as a reliable histochemical marker for the differentiation of MN from MMs. Moreover, because the pattern reveals no statistically significant correlation with the thickness or the depth of invasion of MM, it seems to lack prognostic significance.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1992

Megalomastia: histological, histochemical and immunohistochemical study.

Megalomastia is a rare entity characterized by an uncommon enlargement of both breasts. Unilateral megalomastia is extremely rare. The purpose of this study was to collect information concerning the history of patients with this condition and to investigate its histology in order to outline the profile of this peculiar entity. Fifty cases of megalomastia were studied. In 41 data concerning the history of the patients was complete; there were 32 juvenile, 7 gravid and 2 adult type cases. All three unilateral megalomastias were in the juvenile group. A family history of megalomastia was frequently present; gravid megalomastia was more closely connected with a maternal familial history. A case of simultaneous megalomastia in monozygotic twins is included. The final size achieved by the breasts was independent of the type of megalomastia, the rapidity of breast development and the body weight of the patients. It was greater in breasts containing abundant adipose tissue and less in fibrous breasts. In all cases of megalomastia associated with pregnancy the breasts had lost the ability to produce milk. The main histological feature in all cases was severe damage and destruction of the lobular units associated with extensive fibrosis. In some breasts of all three types of megalomastia ramified new ducts named "juvenile units" had developed and had proceeded to atrophy. Immunohistochemistry revealed that the epithelium of these units was negative for oestrogen and positive to progesterone receptors. A biphasic pathological appearance, consisting of atrophic lobular units and "juvenile units", is diagnostic of megalomastia.

Adipose Tissue↗
PubMed1991

Epidemiological data on burn injuries in Greece: a statistical evaluation.

This is a statistical evaluation of 4114 burns treated in Greek Hospitals during 1986. The results are based on a questionnaire that was sent to all Greek hospitals. The distribution of burns in every health district, the causes of burns, the educational status and the occupation of burn victims are examined. The adequacy of the present burn care facilities in Greece and the future prospects for better burn care are also discussed.

Accidents, Occupational↗
PubMed1981

Cholesterol and obesity as prognostic factors in breast cancer.

Analysis of disease-free survival rates in 374 women with operable breast cancer revealed that preoperative weight, particularly in combination with serum cholesterol, is a significant prognostic determinant. Overall, women weighing under 150 pounds had a significantly higher cumulative five-year disease-free survival rate (67%) compared with women weighing more (49%) (z = 2.2298, P = 0.026). Women with low serum cholesterol levels had better cumulative five-year disease-free survival (67%) than women with high serum cholesterol levels (58%) (z = 1.1008, P = 0.27). The combination of high weight and high serum cholesterol levels was associated with an extremely poor cumulative five-year disease-free survival (32%) compared with that observed for women in whom values of either, or both, variables were low (68%) (z = 3.7843, P = 0.0004). These patterns in disease-free survival persisted even after controlling for tumor stage. The findings indicate that weight and cholesterol, in addition to their previously reported effect on the risk of breast cancer development, influence significantly the subsequent course of the disease.

Adult↗
PubMed1980

Parity and prognosis in breast cancer.

Analysis of five-year disease-free survival rates in 608 women with operable breast cancer revealed that the reproductive history is a significant prognostic determinant. Overall parous women had a significantly higher cumulative five-year disease-free survival rate (60%), compared to the nulliparous (46%) (z = 2.5, p = 0.012). Significant differences were also noted when gravidity in addition to parity was taken as the determinant. The corresponding disease-free survival rates were 61% and 50%, respectively (z = 1.98, p = 0.048). Five-year survival rates were influenced in a similar manner by these variables but the observed differences were less significant. The trend toward higher survival rates in parous and gravidae women were noted in all tumor stages but achieved statistical significance only in stage III. The findings indicate that parity and gravidity affect not only the risk of breast cancer development but also the subsequent course of the disease. Parity seems to be a strong risk and prognostic factor than gravidity.

Breast Neoplasms↗
PubMed1975

[A new apparatus for finger occlusion plethysmography. Disucssion of the method and diagnostic possibilities].

Based on the principles of an apparatus for the venous-occlusion plethysmography of the finger, which was developed by Goetz in 1934 and which was adapted for clinical usage by the authors of this article in 1971, a largely improved apparatus, which is also suitable for the usage in hospitals, is now presented. The various clinical methods of examination for the diagnosis of acrale bloodflow disturbances are discussed. Angioneuropathies (as for instance the Raynaud-syndrome) of diseases, which are connected with injuries of vessel-walls and stenosis resp. occlusion (M. Raynaud), can be differentiated with great certainty by means of the temperatures (15 degrees C and 32 degrees C), the quotient and the partial analysis of the volume-pulse form.

Fingers↗
PubMedDate not supplied

Psychiatric disorders in burn patients: a follow-up study.

BACKGROUND: We report on a prospective study of 45 patients with burn injuries admitted to a major burn unit in the greater Athens area. The study aimed to explore the prevalence of psychological and psychiatric disorders among burn survivors. METHODS: The sample comprised all consecutive cases of adult burn patients in a 6-month period. Personal interviews were conducted by the administration of the Langner scale and the DSM-III-R Structured Clinical Interview. Twelve months later, 30 patients of the baseline sample were reexamined. RESULTS: Psychological impairment was found to be 45.5 and 40% at the baseline and follow-up assessments, respectively. The extent of burns was found to be associated with psychological impairment. The prevalence of psychiatric disorders (any DSM-III nosological entity) reached 46.6% at both baseline and follow-up examinations. Posttraumatic stress disorder was diagnosed in 17.8 and 20.0% of burn survivors at the baseline and the 12-month follow-up assessments, respectively. Logistic regression analysis revealed that face disfigurement was the only burn characteristic significantly associated with the presence of psychiatric morbidity. CONCLUSIONS: The results of the study suggest that the extent of burns is not so important when compared to the possibility of disfigurement from the point of risk of developing a psychiatric disorder.

Adult↗