Biomedical subjects

K Markou

Publications and source records attributed to K Markou.

8 recordsLinked to original sources

PubMed2006

Laryngeal tuberculosis presenting as supraglottic carcinoma: case report and literature review.

Laryngeal tuberculosis is a rare extra-pulmonary manifestation of tuberculosis, and frequently presents with tumour-like symptoms and clinical findings. Uncommon clinical features are to be expected by the ENT specialist, who should be aware of these recently changing presentations. Despite the dramatic reduction of the incidence of the disease during the last few decades, a perceptible increase in case reports has lately been noted and may prove significant. Treatment remains conservative and long-term follow-up is suggested. A relevant case of laryngeal tuberculosis presenting as a supraglottic carcinoma is presented, its diagnosis and management are detailed, and suggestions are offered based on a literature review.

Adult↗

PubMed2005

Factors influencing tumour relapse after total laryngectomy.

OBJECTIVES: To determine the prognostic factors predictive of tumour recurrence after surgical treatment for laryngeal carcinoma with total laryngectomy. STUDY DESIGN/METHODS: Retrospective review of 308 patients with laryngeal carcinoma who underwent total laryngectomy in the ENT Department of AHEPA University Hospital between 01/01/1992 and 31/12/1999. In 238 patients, total laryngectomy was performed as primary treatment of laryngeal carcinoma, and in 70 others as treatment of tumour recurrence following radiotherapy or partial surgery. Follow-up was standardized, following a strict protocol, the mean follow-up time was 68 months. RESULTS: During post-operative follow-up, recurrences were observed in 96 of 308 patients (31%). The relapse rates were 27% (65 of 238) for patients treated with primary total laryngectomy, and 44% (31 of 70) for those treated for recurrence following previous treatment. The difference in relapse rates was statistically significant. In 39 of 238 (16%) cases treated with primary total laryngectomy cervical lymph node infiltration was present at diagnosis and radical or modified neck dissection was performed. The tumour recurrence rate in this group was 46% (18 of 39), while in metastatic node-free patients the relapse rate was 24% (47 of 199) [p < 0.05]. Primary laryngectomy was effective in 82% of glottic, 70% of supraglottic, and only 59% of transglottic carcinoma. Concerning primary tumour extension at the time of surgery, total laryngectomy proved effective in 85% of T2 tumours, 81% of T3, and only 55% for T4. The higher recurrence rates for supraglottic and transglottic tumours seem related mainly to the higher rates of cervical lymph node metastasis at diagnosis. The majority of tumour recurrences were observed during the first two years of post-operative follow-up. Thus, 76% of the 308 patients remained disease-free after the first year of post-operative follow-up, 68% after the second year, and 67% after the fifth follow-up year. Of the 96 recurrences documented until now, 91 were loco-regional (19 at the tracheostomy), and only 5 involved distant metastases. Sixteen of the 308 patients (5%) subjected to total laryngectomy have since developed second primary neoplasms, most often involving the lungs (10 patients). CONCLUSIONS: Prognostic factors for recurrence following total laryngectomy include: performance of total laryngectomy as salvage surgery, degree of tumour extension, infiltration of cervical lymph nodes at the time of initial diagnosis, poor initial tumour differentiation and trans-glottic/sub-glottic tumour localization.

Disease-Free Survival↗

PubMed2002

Is the labyrinthine dysfunction a causative factor in idiopathic scoliosis?

The cause of idiopathic scoliosis remains unknown, although research has possibly eliminated some hypothetical causes. Recent reports associating scoliosis convexity with equilibrium control central processing and motor lateralization have suggested that idiopathic scoliosis is connected causally with the motor cortex. In order to analyze these factors a study of labyrinthine function was carried out. This study included seventeen female patients 12 to 14 years old (mean age= 13.36y) with right thoracic idiopathic scoliosis and twelve normal control females 12 to 14 years old (mean age =13.1y). An electro-nystagmographic study of labyrinthine function (potential nystagmus) was performed in all the patients of the study with caloric tests. The nystagmus was recorded with the electronystagmographic technique (ENG) using Hartmann device. We evaluate these parameters: Slow phase velocity (SPV), Total amplitude (Tamp), Frequency of nystagmus (Freq). No children of the study presented spontaneous nystagmus. No correlation was found between the convexity of the curvature and the direction of nystagmus in posture tests. There were no significant differences between left- and right- beating nystagmus. The results are discussed with special reference to aetiology in idiopathic scoliosis.

Adolescent↗

PubMed2001

Transiently evoked otoacoustic emissions as a prognostic indicator in idiopathic sudden hearing loss.

Idiopathic sudden sensorineural hearing loss (ISHL) remains a controversial topic. So far, there are no proven objective auditory factors to establish prognosis. Otoacoustic emissions reflect the functional integrity of the outer hair cells. The aim of this study was to assess the presence of transiently evoked otoacoustic emissions (TEOAEs) in the early stages of ISHL cases as a prognostic indicator. Thirty patients hospitalized for ISHL were included in the study. All patients underwent pure-tone audiometry (PTA) and TEOAE recordings on the admission day and at least three measures on the subsequent eight days. The audiometric threshold improvement at each frequency was correlated with the TEOAE parameters on each measure. Finally, the presence of TEOAEs on early examination was correlated with PTA threshold improvement. Twenty-three out of 30 patients experienced hearing recovery. Fourteen of the recovered patients had recordable TEOAEs or acceptable TEOAE peak amplitudes in some frequency bands on the first two measures, despite having audiometric thresholds greater than 40 dB HL. It thus seems that TEOAEs might serve as a clinical tool for prediction of recovery in ISHL cases.

Hearing Loss, Sudden↗

PubMed2001

The efficacy of medication on tinnitus due to acute acoustic trauma.

Seventy-two young males suffering from acute acoustic trauma with tinnitus due to gunshots were included prospectively in the study. Forty of the subjects had the left ear affected, four the right ear and the remaining 28 sustained bilateral acoustic traumas. The mean time of admission after onset of symptoms was 28 days (5-88 days). The subjects were randomly categorized into three groups: group A received trimetazidine, prednisolone and complex B vitamins; group B were treated only with trimetazidine; and group C received prednisolone and complex B vitamins. At 3-month follow up, tinnitus had been completely eradicated in only eight subjects and had in 17. No statistically significant difference was found between the three groups concerning improvement of tinnitus. However, it was found that early admission predisposed towards better prognosis. The degree of hearing improvement after medication did not seem to correlate with the relief of tinnitus.

Acute Disease↗

PubMed2001

Iodine-Induced hypothyroidism.

Iodine is an essential element for thyroid hormone synthesis. The thyroid gland has the capacity and holds the machinery to handle the iodine efficiently when the availability of iodine becomes scarce, as well as when iodine is available in excessive quantities. The latter situation is handled by the thyroid by acutely inhibiting the organification of iodine, the so-called acute Wolff-Chaikoff effect, by a mechanism not well understood 52 years after the original description. It is proposed that iodopeptide(s) are formed that temporarily inhibit thyroid peroxidase (TPO) mRNA and protein synthesis and, therefore, thyroglobulin iodinations. The Wolff-Chaikoff effect is an effective means of rejecting the large quantities of iodide and therefore preventing the thyroid from synthesizing large quantities of thyroid hormones. The acute Wolff-Chaikoff effect lasts for few a days and then, through the so-called "escape" phenomenon, the organification of intrathyroidal iodide resumes and the normal synthesis of thyroxine (T4) and triiodothyronine (T3) returns. This is achieved by decreasing the intrathyroidal inorganic iodine concentration by down regulation of the sodium iodine symporter (NIS) and therefore permits the TPO-H202 system to resume normal activity. However, in a few apparently normal individuals, in newborns and fetuses, in some patients with chronic systemic diseases, euthyroid patients with autoimmune thyroiditis, and Graves' disease patients previously treated with radioimmunoassay (RAI), surgery or antithyroid drugs, the escape from the inhibitory effect of large doses of iodides is not achieved and clinical or subclinical hypothyroidism ensues. Iodide-induced hypothyroidism has also been observed in patients with a history of postpartum thyroiditis, in euthyroid patients after a previous episode of subacute thyroiditis, and in patients treated with recombinant interferon-alpha who developed transient thyroid dysfunction during interferon-a treatment. The hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T4 replacement therapy may be required in some patients. The patients who develop transient iodine-induced hypothyroidism must be followed long term thereafter because many will develop permanent primary hypothyroidism.

Amiodarone↗

PubMed1999

Growth and pubertal development in elite female rhythmic gymnasts.

Optimal growth depends upon both environmental and genetic factors. Among environmental factors that could alter growth and sexual maturation are stress and intensive physical training. The influence of these factors has been documented in a variety of sports, but there is limited information on rhythmic gymnasts, who have entirely different training and performance requirements. The study was conducted during the 13th European Championships in Patras, Greece, and included 255 female rhythmic gymnasts, aged 11-23 yr. The study included measurement of height and weight, assessment of breast and pubic hair development, estimation of body fat and skeletal maturation, and registration of menarcheal age and parental height. Gymnasts were taller than average height for age, with mean height above and mean weight below the 50th percentile. Actual height SD score was positively correlated to weight SD score (P < 0.001), number of competitions (P = 0.01), and body mass index (BMI; P < 0.001). Predicted adult height SD score was positively correlated to weight SD score (P < 0.001) and negatively to body fat (P = 0.004). There was a delay in skeletal maturation of 1.3 yr (P < 0.001). Pubertal development was following bone age rather than chronological age. The mean age of menarche was significantly delayed from that of their mothers and sisters (P = 0.008 and P = 0.05, respectively), was positively correlated to the intensity of training and to the difference between chronological age and bone age (P < 0.001 and P = 0.002, respectively), and was negatively correlated to body fat (P < 0.001). In the elite female rhythmic gymnasts, psychological and somatic efforts have profound effects on growth and sexual development. Despite these aberrations, adult height is not expected to be affected.

Adolescent↗

PubMed1996

[Treatment of postoperative "uncontrollable" nosebleed by embolization of the maxillary artery].

BACKGROUND: Embolization of the maxillary artery is a successful treatment, alternative in cases of recurrent severe nosebleeds when anterior and posterior nasal packing have failed to achieve permanent control. PATIENTS AND METHOD: Two cases of male patients are presented who suffered from severe nosebleeds after a submucous resection of the septum, electrocautery of the inferior turbinate, and submucosal conchotomy. Anterior and posterior nasal packing proved to be unsuccessful. Angiography of the internal and external carotid artery was performed and selective embolization of the mayillary artery with absorbable material followed. RESULTS: In both cases embolization was successful and uneventful. Twenty-four hours after treatment, the nasal packing was removed and no recurrence was observed. CONCLUSION: Selective embolization of the maxillary artery is a successful alternative for the treatment of severe recurrent nosebleeding-equally effective with surgical ligation of the bleeding arteries.

Adult↗