Biomedical subjects

K Papadias

Publications and source records attributed to K Papadias.

15 recordsLinked to original sources

PubMed2005

Extragenital cystic lesions of peritoneum, mesentery and retroperitoneum of the female. Clinicopathological characteristics of 19 cases.

The clinicopathological characteristics are presented of 19 extragenital cystic lesions of female patients located at the retroperitoneum (9 cases), the mesentery (6 cases) and the peritoneum (4 cases). Median age was 42.3 years and the main symptom was abdominal pain. The cysts measured 4-27 cm in diameter and were classified as: epithelial (7/19), mesothelial (5/19), vascular (2/19), parasitic (1/19) and developmental in origin (4/19). Of the cases 18/19 were benign lesions and one case was a borderline mucinous cystic tumor. Immunohistochemistry by a streptavidin-biotin method was performed to investigate CEA transcripts (MoAb, Novosan), CA125 (MoAb, CIS Diagnostics), vimentin (MoAb Ve6, Novocastra), secretory component (a polyclonal antibody, DAKO), Factor VIII (MoAb, DAKO), CD34 (MoAb, Scytec), calretinin (a polyclonal antibody, Zymed, San Francisco, CA). Cytokeratins were of low and high molecular weight (Immunon, AE1-MoAb). The results are helpful in the correct classification of various tumors. The treatment of choice is complete surgical resection of the tumors.

Adult↗

PubMed2005

Teratomas of the ovary: a clinico-pathological evaluation of 87 patients from one institution during a 10-year period.

AIM: To present the classification and diagnostic problems encountered between teratomas and other ovarian tumors as well as with other benign entities diagnosed and treated in our institution. METHODS: We analysed retrospectively the clinical and pathological characteristics of 87 teratomas examined in our hospital during the last ten years. RESULTS: Teratomas constituted 5% of all ovarian tumors. The age range was from 11-69 years old (median: 35). The most frequent symptom was lower abdominal pain in 68% of patients. A pelvic mass was noted in 3% of cases. A pregnancy was present in 3% of patients. In ten cases the tumors were bilateral. Tumor size ranged from 1-16 cm in diameter (median: 7.17 cm). The treatment consisted of cystectomy in 66% of the cases, oophorectomy in 23% or hysterectomy with both adnexa in 11% of cases. Fifty-seven cases presented with a histological diagnosis of mature teratoma, biphasic or triphasic type, three cases with monodermal teratoma, ten cases with ovarian neoplasms of mixed type, 15 cases with epidermal cysts, and two cases with benign cysts. Malignant changes within the teratomas were seen in 5% cases. CONCLUSION: Teratomas are common ovarian tumors at any age, especially during the reproductive age, with a low rate of complications and malignant transformation. The treatment should be based on patient age, fertility status, tumor size, the cystic or solid nature of the tumor and bilaterality.

Adolescent↗

PubMed2005

Ectopic decidua mimicking metastatic lesions--report of three cases and review of the literature.

The development of ectopic decidua is generally considered as a physiologic phenomenon of pregnancy, even though it has been occasionally noted in non-pregnant women. We present three cases of ectopic decidua located in the greater omentum and discuss the histopathologic characteristics, as well as the problems encountered in the differential diagnosis from metastatic lesions. Decidual transformation of the omentum could simulate, both grossly and microscopically, malignant neoplastic lesions such as malignant deciduoid mesothelioma, metastatic mucin-producing adenocarcinoma or even metastatic squamous carcinoma. The application of immunohistochemistry is essential for the establishment of the diagnosis, especially in the presence of deceptively atypical vacuolated cells resembling carcinoma cells. Ectopic decidua does not require any therapeutic intervention because it usually regresses postpartum without any complications.

Adult↗

PubMed2005

Squamous cell carcinomas of the ovary: report of four cases and literature review.

Two cases of squamous cell carcinoma developing in mature cystic teratoma and two cases with a malignant change involving an ovarian epidermal cyst diagnosed in our institution over a 15-year-period are reported. This is a reminder that such changes may occur and issues regarding the problem of the differential diagnosis and management of these rare complications are discussed.

Adult↗

PubMed2004

Extraovarian mullerian-type cystic tumors of the female. A report of six cases and review of the literature.

Six cases of extraovarian cystic tumors of mullerian type are reported. Patient age ranged from 27-71 years. Tumor diameters were 5-11 cm and were located in the mesentery (4/6) and retroperitoneum (2/6). Four tumors were of mucinous type (1/4 of borderline malignancy) and two of serous type. These tumors clinically and histopathologically mimic other primary tumors of the peritoneum. The problems of differential diagnosis are discussed.

Abdominal Neoplasms↗

PubMed2004

Malignant neoplasms arising in endometriosis: clinicopathological study of 14 cases.

During the last 15-year period in our laboratory, 14 cases of malignant change of endometriosis were diagnosed in women 37-70 years of age. Seven cases were adenocarcinomas, one case was an adenosarcoma and six cases presented the morphology of endometrial stromal sarcoma. Eleven cases developed in various sites of the genital system (5/11 in the ovaries, 3/11 in the uterus 2/11 in the vagina, 1/11 in the tubal wall) and three cases in extragenital sites (1/3 in the omentum, 1/3 in the pelvis, 1/3 in the colon). Immunohistochemical investigation for the expression of cytokeratines, vimentin, hormonal receptors, E-cadherin, desmine and smooth muscle actin was performed by a streptavidin-biotin method. The immunopathology profile and follow-up results after therapy are presented.

Adenocarcinoma↗

PubMed2000

Bone mineral density in women with idiopathic hirsutism.

Idiopathic hirsutism is relatively uncommon, affecting approximately 6% of hirsute women. In the present study we compared the bone mineral density (BMD) of women with idiopathic hirsutism with controls. A group of 20 women diagnosed with idiopathic hirsutism was evaluated with respect to BMD and the findings were compared to those of a control group consisting of 10 normal women. Hirsutism was graded according to the Ferriman-Gallwey score and threshold was considered to be a score more than 4. There was no statistically significant difference with respect to patients' mean age, BMI and body fat composition. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), androstenedione, testosterone, free testosterone, 17 alpha-hydroxyprogesterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG) and estradiol were assessed in both groups and no statistically significant differences were found. There was no statistically significant difference with respect to bone turnover--which was evaluated by determining the serum levels of parathyroid hormone, calcium, alkaline phosphatase and osteocalcin as well as the urinary secretion of calcium and hydroxyproline, corrected for the creatinine values--between the two groups. Statistical analysis was performed using the t test for unpaired data to compare age, BMD and biochemical data, and Wilcoxon's rank test was used to compare physical activity and calcium intake. Statistical significance was defined as p < 0.05. The BMD at the level of the 2nd to 4th lumbar vertebrae (L2-L4) and the total BMD were higher in women with idiopathic hirsutism compared to those in the control group, suggesting a possible direct effect of androgens on the osseous tissue of hirsute women.

17-alpha-Hydroxyprogesterone↗

PubMed2000

The effect of combined oral contraception with or without spironolactone on bone mineral density of hyperandrogenic women.

We studied the effect of treatment with combined oral contraception (COC) with or without spironolactone on the bone mineral density (BMD) of hyperandrogenic women. A group of 22 women (group 1) was treated with ethinylestradiol plus desogestrel for 21 days each month for 12 months, while another group of 21 patients (group 2) was treated with ethinylestradiol and desogestrel for 21 days each month plus spironolactone daily for 12 months. There was no statistically significant difference with respect to mean age, body mass index (BMI) and BMD between the two groups of patients before the treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), androstenedione, total testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), prolactin and estradiol were assessed in both groups and no statistically significant difference was found before treatment. Nor was there any statistically significant difference in bone turnover between the two groups. Statistical analysis was performed using the Student's t test for unpaired data to compare age, BMD and biochemical data, and statistical significance was defined as p < 0.05. The BMD before and after 12 months of treatment showed no statistically significant difference between the patients of group 1 and those of group 2, suggesting that both ethinylestradiol plus desogestrel, and ethinylestradiol and desogestrel plus spironolactone daily for 12 months at the given doses do not affect the BMD of the treated women, while the addition of spironolactone improves the efficacy of hirsutism treatment.

Adult↗

PubMed1999

Evaluation of serum prolactin levels in patients with endometriosis and infertility.

The aim of this study was to clarify the significance of serum prolactin concentrations in patients with infertility and endometriosis. Forty patients with infertility and laparoscopically proven endometriosis were recruited into the study. Basal serum prolactin levels and prolactin levels after TRH administration were measured. The mean basal serum prolactin concentrations were 12.5, 16.5, 19.5, and 26.5 ng/ml and those after thyrotropin-releasing hormone (TRH) administration were 88.3, 114.2, 125.3 and 138.8 ng/ml in patients with stages I, II, III and IV endometriosis, respectively. A statistically significant relationship was found between the basal serum prolactin levels as well as those after TRH injection and the stage of the endometriosis. The patients were divided in two groups. Group I consisted of 20 patients who did not receive any treatment, while group II consisted of 20 patients who were initially treated with GnRH analogues for 24 week and subsequently with several therapeutic schemes in order to improve their fecundity. The pregnancy rate was not different between the two groups. The patients, however, who did not become pregnant had higher serum prolactin concentrations after TRH administration as compared to those who conceived. We conclude that occult hyperprolactinemia may be a cause of infertility in patients with endometriosis.

Adult↗

PubMed1994

Immune dysfunction in patients with unexplained repeated abortions.

OBJECTIVES: To examine the immunological profiles by antiphospholipid antibodies IgG, IgM, IgA immunoglobulins ACA, as well as C3, C4 complement component levels. METHODS: A group of 44 women with a history of three or more consecutive pregnancy losses was compared with 34 normal women. RESULTS: Our results showed lower levels of IgG immunoglobulins for the patient group (P < 0.001) while the C3, C4 complement component levels remained unaltered. Anticardiolipin antibodies were positive in ten patients for IgG or IgM isotypes or for both presenting a prevalence of 22.7% while none of the control subjects had ACA positive titers. The lupus anticoagulant was not detected in either group. Ten patients (22.7%) presented positive autoantibody tests as compared with only 3 (8.8%) of the control group. No statistical differences were found between the two groups when the frequency of each autoantibody's positive tests were examined separately. CONCLUSIONS: An inconsistent immune derangement seems to be present in recurrent aborters with the presence of anticardiolipin antibodies as the stronger representative marker of immune alteration.

Abortion, Habitual↗

PubMed1994

Five years' follow-up in two patients with borderline tumours of the ovary hyperstimulated by gonadotrophin therapy for in-vitro fertilization.

In two women (36 and 30 years old) during infertility evaluation by ultrasound, an ovarian cyst was found on the left side (5 x 7 and 6 x 9 cm respectively). In both cases, it was decided to perform a unilateral salpingo-oophorectomy, keeping the other ovary (after a negative biopsy) for a future in-vitro fertilization (IVF) procedure with their own oocytes. The histology report for each patient showed the cyst was an epithelial borderline tumour. The first woman achieved a pregnancy and delivered a healthy baby after the first IVF attempt, while the second is currently undergoing her third attempt. This paper reports on a follow-up 5 years after the first IVF attempt.

Adult↗

PubMed1992

Pregnancy after in vitro fertilization in a patient with borderline tumor of the ovary.

A 36 year old woman with unilateral tubal disease was found, during infertility evaluation, to have epithelial tumor of borderline malignancy in one ovary. She was treated with salpingo-oophorectomy and three months later she asked to participate in our IVF program. High doses of gonadotropins were given for controlled hyperstimulation and a successful pregnancy and live birth was achieved.

Adult↗

PubMed1989

Culture of seminal fluid in infertile men and relationship to semen evaluation.

Bacterial flora of the seminal fluid and its influence on semen quality, was examined in 225 asymptomatic unselected men. Each semen sample was cultured aerobically, anaerobically, for genital mycoplasmas, and for Chlamydia trachomatis. Semen analysis was made according to standard methods recommended by the W.H.O. All 225 semen samples had microbial isolates. All isolates had colony counts of 10(2) colony forming units (cfu/ml). Thirty-three cases had greater than 10(2) cfu/ml, 85 cases had greater than 10(3) cfu/ml and 78 cases greater than 10(5) cfu/ml. The most common organisms isolated were Ureaplasma urealyticum in 86 samples and C. trachomatis in 26 samples. The most frequent abnormal parameters were viability (117 of 212, 52%), motility (85 of 212, 40%) and number of sperm cells (74 of 225, 32.8%). No significant correlation was found between abnormal semen parameters and presence of U. urealyticum, and C. trachomatis. We concluded that asymptomatic bacteriospermia (infection) in the semen did not significantly affect the count, motility or morphologic features of the specimen.

Bacteria↗

PubMed1989

[Shoulder dystocia].

In this study, 49 cases of shoulder dystocia have been examined. These cases took place in Athens University Second Gynecological and Obstetrics Department, over a period of ten years, from 1975 to 1985. In 23 cases, the delivery was normal, in 20 cases it was necessary to use a vacuum extractor and in 6 cases a forceps. In none of the above cases was there a Cesarean Section, because the cases were not regarded as a fetopelvic disproportion, but as cases which justify normal delivery. There follows a general outline of the treatment to be applied in cases of shoulder dystocia, including a generous episiotomy, the application, if possible, of a muscular relaxation by inhalation anesthesia, and the application of certain obstetric manipulations. In our cases, we applied general anesthesia in 7 cases and local in 39, whereas in 3 was no anesthesia at all. The obstetric manipulations we applied were those of McRoberts in 15 cases, of Jacquemier in 10 cases, of Wood in 15 cases, of Barnum in 5 cases, of Hibbard in 8 cases and of Couder in 6 cases. Our results also appear in tables I and II. In 36 cases, out of 49, (73.49%), the fetal weight was over 4,000 g. In 23 cases (47%) the mother had gained 12 kg during pregnancy. Also, in our study, 20% of the cases (10 mothers) were multiparous and 45% (22 mothers) had a prolonged second stage of labour by more than one hour. Class A (by White) diabetes was found in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

The predictive value of double Gn-RH provocation test in unprimed Gn-RH-primed and steroid-primed female patients with Kallmann's syndrome.

OBJECTIVE: To determine the degree of hypophyseal deficiency in Kallmann's syndrome, and the effects of Gn-RH priming and HRT. PATIENTS AND METHODS: Seven female patients with complete Kallmann's syndrome were subjected to dynamic tests (chlorpromazine, TRH and double Gn-RH provocation test) immediately after their first admission to the hospital. In five patients the diagnosis was established for the first time (unprimed patients), while in the other two cases the diagnosis has been established earlier and the patients were already receiving hormonal replacement therapy (HRT-primed patients). In the 5 unprimed patients, 100 microg Gn-RH s.c. were administered daily for 28-32 days and the double Gn-RH test was repeated immediately after. RESULTS: The gonadotropic response of the unprimed patients in the administration of Gn-RH was insufficient, mainly in the second stimulation, with secretory dominance of FSH (ratio LH/FSH <1), while after the monthly Gn-RH priming, the gonadotropic response to Gn-RH had improved, with a considerable increase in the peak values of plasma FSH and LH after both stimulations, and the LH/FSH ratio was reversed to >1. In the two primed patients, the gonadotropic response to Gn-RH administration was better in both stimulations than that of the unprimed patients. CONCLUSIONS: Both the short-term Gn-RH and the long-term HRT priming improve the secretory promptitude of the hypophyseal cells for both gonadotropins, while after long-term Gn-RH priming the LH-secreting cells are capable of both release and synthesis of the hormone, as can be seen by the results of the second stimulation in the Gn-RH primed patients. Consequently, for women with Kallmann's syndrome who wish to become pregnant, ovulation induction and conception can be achieved sooner and with less cost if they are previously primed.

Adolescent↗