PubMed Health⌕ Search

Biomedical subjects

M Paschopoulos

Publications and source records attributed to M Paschopoulos.

At least 19 recordsLinked to original sources
PubMed2006

Fetal anal atresia presenting as transient bowel dilatation at 16 weeks of gestation.

Congenital anal atresia is a rare abnormality which in two thirds of the cases is associated with other congenital abnormalities or syndromes. Prenatal diagnosis is usually achieved in cases with coexisting abnormalities. The diagnosis of isolated anal atresia is extremely difficult and can be suspected in the presence of colon dilatation. We present the case of a fetus in which marked dilatation of the colon was diagnosed at 16 weeks of gestation. Four weeks later the sonographic appearance of the bowel was normal and remained normal for the rest of the pregnancy. Anal atresia was diagnosed immediately after birth and corrected surgically. No other abnormalities were present. This case report illustrates that in anal atresia, bowel dilatation may be only transient.

Adult↗
PubMed2006

Reproductive outcome in patients treated by oral methotrexate or laparoscopic salpingotomy for the management of tubal ectopic pregnancy.

OBJECTIVE: To determine the reproductive outcome of women who have received methotrexate or been treated by laparoscopic salpingotomy (LS) for ectopic tubal pregnancy. STUDY DESIGN: The study consisted of 123 participants, all women with tubal pregnancies, who had been treated either by methotrexate per os or by laparoscopic salpingotomy. The reproductive outcome of these women was estimated after a follow-up time-period of ten years. RESULTS: In the methotrexate group, consisting of 34 women, the fertility rate was 82% with a mean interval time to conceive of 9.4 months after the treatment. In the group treated by LS, consisting of 89 women, the fertility rate was 82.6% and the mean interval time to conceive was 11.7 months. CONCLUSION: The reproductive outcome of the women who received either per os treatment of methotrexate or LS for tubal pregnancy, remains high. Both therapeutic methods constitute reliable solutions for managing ectopic pregnancy.

Abortifacient Agents, Nonsteroidal↗
PubMed2004

Selecting distending medium for out-patient hysteroscopy. Does it really matter?

BACKGROUND: The aim of this prospective randomized study was to evaluate the role of carbon dioxide (CO2) and normal saline for diagnostic accuracy in out-patient hysteroscopy. METHODS: Women admitted to our Department in order to undergo total abdominal hysterectomy also underwent diagnostic hysteroscopy, 12-24 h prior to surgery. The selection of distending medium was made after randomization. Two groups of patients were formed, group A (CO2; n=39) and group B (normal saline; n=35). More than half of the women in the study population were post-menopausal. Post-hysteroscopy, all women were asked to rank any symptom that they felt during the procedure on a 4-point scale (0=none; 1=mild; 2=severe; 3=inability to perform hysteroscopy). The hysteroscopic diagnosis was compared with the macroscopic findings and the histological examination of the surgical specimen after hysterectomy. RESULTS: The percentage who completed hysteroscopy was 89.74% within group A and 97.14% within group B. Most patients of both groups felt some pain of mild intensity. The diagnostic accuracy of hysteroscopy was similar for both media when major pathology [large polyps (group A 91.7%; group B 92.7%), myomas (group A 81.25%; group B 92.7%) and/or hyperplasia (group A 87.5%; group B 90.2%)] of the endometrial cavity was detected. In contrast, in cases of minor pathology (small polyps, mucosal elevations, crypts, hypervascularization), hysteroscopy with saline presented with significantly higher diagnostic accuracy (85.4%) compared with hysteroscopy with CO2 (64.6%). CONCLUSIONS: In out-patient hysteroscopy, CO2 and normal saline were comparable with regard to patient discomfort and for the detection of major pathology of the endometrial cavity. Normal saline seems to be the most appropriate medium for the detection of minor pathology of the endometrial cavity.

Adult↗
PubMed2003

Factors affecting outcome after incomplete excision of cervical intraepithelial neoplasia.

PURPOSE: Conservative treatment for cervical intraepithelial neoplasia (CIN) by ablative or excisional techniques is widely used. However, women with incomplete excision have a variable risk of CIN recurrence. The aim of this study was to identify possible risk factors for recurrence of CIN after large loop excision of the transformation zone (LLETZ) with involved margins of excision. METHODS: All cases of women treated with LLETZ for CIN between 1989-2000, in whom histological evaluation of the excised specimen revealed extension of CIN to the excision margins, were retrospectively studied. A woman was considered to have recurrence when she had histologically confirmed CIN following a second LLETZ or hysterectomy during the follow-up period. The characteristics that were examined as possible risk factors were age, parity, smoking habit, grade of initial lesion and extension to the endo- or ectocervical margin. RESULTS: Treatment failure was diagnosed in 18 out of 65 (27.7%) women with involved margins. The only characteristic that reached statistical significance was age. The mean age of women with recurrence was 35.8 years, whereas the mean age of women without recurrence was 32.8 years (p = 0.044). Also, a trend was evident in women with high-grade initial lesions (CIN II-III) (p = 0.168) and involvement of the endocervical margins (p = 0.149). No differences were observed between the two groups regarding parity and smoking habit. CONCLUSIONS: Increased age is a risk factor for recurrence in women with incomplete excision of CIN after LLETZ. Larger studies are required for definite conclusions.

Adult↗
PubMed2002

An observational study of women with positive HPV-DNA tests and normal cytology and colposcopy.

PURPOSE: High risk human papillomaviruses (HPV) are implicated in the aetiology of malignant cervical disease. The usefulness of HPV DNA tests in identifying women at risk of cervical cancer as an adjunct to cervical cytology is under evaluation. PATIENTS AND METHODS: This is a retrospective analysis of 47 women positive for high risk HPV but with negative cytology and negative colposcopy at the start of the study. Women were observed for three years or more (in 96% cases) using six-monthly combined HPV DNA tests, cytological and colposcopic evaluation. RESULTS: At the end of follow-up, 29/47 (62%) women were still positive for high risk HPV, 45/47 (96%) women had normal cytology and 47/47 (100%) women continued to have normal colposcopy. CONCLUSIONS: Normal colposcopy has an excellent negative predictive value for HPV positive women with normal cytology. These women can be safely screened cytologically on a three-yearly basis.

Adult↗
PubMed2002

Surgical management of early stage cervical cancer: ten years experience from one Greek health region.

PURPOSE OF INVESTIGATION: Cervical cancer is the second most common malignancy in women, in both incidence and mortality. In the present study, we report our results of treating 93 consecutive patients with early invasive cervical cancers (Stages I-IIA). METHODS: The patients of this study comprised all women recognized with stage I-IIA cervical cancer during 1991-2000. Patients with stage IA1 cervical cancer without lymphvascular space involvement underwent either conservative management by means of large loop conization or simple hysterectomy. The remaining patients underwent radical hysterectomy and lymphadenectomy or radiation therapy. Mean (+/- SD) duration of follow-up was 6 (+/- 1.7) years. RESULTS: The mean (+/- SD) age of patients with stage I-IIA cervical cancer was 41.3 (+/- 9.1) year. Thirty-five patients with stage [A1 disease were managed conservatively with loop excision and 19 patients subsequently became pregnant. Fifty-two patients with stage IA2, IB and IIA cervical carcinoma underwent radical hysterectomy and lymphadenectomy. CONCLUSION: Young women with stage IA1 cervical carcinoma wishing future fertility who undergo loop excision have a 100% cure rate. Women with stage IA2, IB, and IIA cervical cancer should undergo radical hysterectomy and lymphadenectomy or radiation therapy.

Adult↗
PubMed2001

Effects of ball cauterization following loop excision and follow-up colposcopy.

OBJECTIVE: To investigate whether central diathermy ball cauterization after loop excision affects satisfactory colposcopy at follow-up. METHODS: One hundred one consecutive women with the squamocolumnar junction visible at the ectocervix scheduled for loop excision were assigned alternately into two groups. In group A, diathermy ball cauterization was applied to the entire crater following excision. In group B, cauterization was avoided in a 2-3-mm zone around the new os. The women were re-examined 4 months postoperatively by colposcopy and microcolpohysteroscopy with specific intention to identify the location of the squamocolumnar junction. The examiners performing colposcopy and microcolpohysteroscopy were not aware of each other's interpretation, or of the method of cauterization used. RESULTS: Follow-up colposcopy was satisfactory in 12 women in group A (24%) and 47 women in group B (92.2%) (P <.001). Forty-three women (86%) in group A and ten in group B (19.6%) had the squamocolumnar junction partly or fully located within the cervical canal (P <.001). Microcolpohysteroscopy located the squamocolumnar junction at a mean depth of 4.5 +/- 2.4 mm (+/- standard deviation [SD]) in the women in group A and 1 +/- 0.9 mm in group B (P <.001). Microcolpohysteroscopy could not be performed in 13 women in group A (26%) and one woman in group B (2%) (P <.001). CONCLUSION: Diathermy ball cauterization at the new cervical os after loop excision results in a shift of the squamocolumnar junction toward the endocervical canal, and predisposes to cervical stenosis, thereby decreasing satisfactory colposcopy rates.

Adult↗
PubMed2001

Vaginoscopic hysteroscopy and transvaginal sonography in the evaluation of patients with abnormal uterine bleeding.

STUDY OBJECTIVE: To compare accuracy of vaginoscopic hysteroscopy, a new method of outpatient hysteroscopy, with that of transvaginal sonography in diagnosing intracavitary pathology in women with abnormal uterine bleeding. DESIGN: Retrospective comparative study (Canadian Task Force classification II-2). SETTING: Department of gynecology in a tertiary care university hospital. PATIENTS: Three hundred ninety-seven consecutive patients. INTERVENTIONS: Vaginoscopic hysteroscopy, transvaginal sonography, and histologic evaluation of endometrium. MEASUREMENTS AND MAIN RESULTS: Findings at hysteroscopy and sonography were compared with histopathologic results, considered the gold standard diagnosis. Sensitivity, specificity, and positive and negative likelihood ratios were 92%, 95%, 18.4, and 0.08 for vaginoscopic hysteroscopy and 67%, 87%, 5.15, and 0.38 for transvaginal sonography, respectively. CONCLUSION: Vaginoscopic hysteroscopy is quick and well tolerated, and more accurate in detecting intracavitary uterine pathology than transvaginal sonography. More research is required to determine its place in patients with abnormal uterine bleeding, especially premenopausal women.

Adult↗
PubMed1999

Association of estrogen receptor gene polymorphisms with endometriosis.

OBJECTIVE: To explore the association of the estrogen receptor two-allele (point) polymorphism and multiallele (microsatellite) polymorphism with endometriosis. DESIGN: Case-control study. SETTING: Genetics and Endoscopy Unit, Department of Obstetrics and Gynecology, Ioannina University HOSPITAL, Ioannina, Greece. PATIENT(S): Fifty-seven women with surgically and histologically diagnosed endometriosis of stages I-IV. INTERVENTION(S): Diagnostic laparoscopy. MAIN OUTCOME MEASURE(S): Frequency and distribution of the estrogen receptor gene polymorphisms. RESULT(S): There was a statistically significant difference between the patients and the controls in the frequency of the two-allele Pvu II polymorphism (0.72 vs. 0.49) and in the median repeats of the (TA)n multiallele polymorphism (15 vs. 20 repeats). In both groups, linkage was found between the fewer (TA)n repeats (range, 12-19) and the positive Pvu II polymorphism. CONCLUSION(S): The variability of the estrogen receptor gene likely contributes to the pathogenesis of endometriosis.

Adult↗
PubMed1998

A randomized study of local or general anesthesia for laser conization of the cervix.

Laser Conization of the cervix was performed in both inpatient and outpatient settings with either local or general anesthesia. All of the patients included had abnormal cervical smears, abnormal colposcopic findings and were allocated to one of two groups, A and B. Patients in group A had general anesthesia while patients in group B had only local anesthesia. A standard operative technique, was used and all patients had estimation of blood loss, recording of operative time, surgical suite time, anesthesia induction time, and assessment of postoperative pain and morbidity. Statistical analysis was performed using the student t-test. We concluded that laser conization of the cervix can be performed more cheaply with local anesthesia than with general anesthesia and with little discomfort, less nausea, and vomitting.

Adolescent↗
PubMed1998

Uterine artery Doppler velocimetry with leiomyomas.

The study was conducted to establish a correlation between Doppler velocimetry in relation to uterine weight in any phase of the menstrual cycle and symptoms in women who have leiomyomas. Doppler velocimetry was carried out on both uterine arteries in 18 pre-menopausal women and one post-menopausal woman prior to undergoing abdominal hysterectomy at Winthrop University Hospital in Mineola, NY and at Ioannina University Hospital. The t-test was used for statistical analysis. Changes in flow velocity correlated directly with uterine size. When a division at 500 g was used, S/D ratio was 2.74 +/- 0.53 for larger uteri vs. 4.2 +/- 1.24 for smaller uteri, p < 0.006. Eight women presented heavy bleeding and the mean S/D ratio was 3.75 +/- 1.36 while eleven women presented mild bleeding and the mean S/D ratio was 3.51 +/- 1.2 (p > 0.5). Thus the study has demonstrated that in cases of uterine leiomyomas, the uterine artery flow increases although angiography had previously shown decreased vascularity within the tumor.

Arteries↗
PubMed1998

The effects of tamoxifen on the endometrium, blood flow of the uterine arteries and serum lipoprotein (a) levels in postmenopausal women.

The purpose of this study was to evaluate the effect of tamoxifen therapy on the endometrium by transvaginal color Doppler sonography and on lipid profile focusing on lipoprotein (a) [Lp(a)] levels. Seventy-five postmenopausal breast cancer patients were examined by transvaginal color Doppler sonography and serum Lp(a) levels. Lipid parameters were measured after overnight fasting. Forty of the patients were treated with tamoxifen (20-30 mg/day) for at least 1 year. The remaining 35 patients did not receive tamoxifen and were used as controls. Statistical analysis was performed using t-test and Mann-Whitney U-test (Systat version 5.0). The patients receiving tamoxifen had significantly thicker endometrium (7.9 +/- 3.6 mm) compared to the control group (4.5 +/- 1.8 mm) (p < or = 0.001). The mean pulsatility index and resistance index of the uterine arteries in the tamoxifen group were 2.063 +/- 0.49 and 0.83 +/- 0.07, respectively, and were significantly lower than those of the control group (2.69 +/- 0.16 and 0.88 +/- 0.02) (p < 0.001). In addition, tamoxifen decreased total cholesterol (p < 0.001) and low-density lipoprotein cholesterol (p <0.001) and apolipoprotein B (p < 0.05) significantly. Tamoxifen also increased high density lipoprotein cholesterol (p < 0.05) and apolipoprotein A-I (p < 0.05). These results indicate that tamoxifen stimulates the endometrium and acts as an anti-atherogenic agent in postmenopausal women.

Aged↗
PubMed1998

Laparoscopic treatment of interstitial pregnancy using the harmonic scalpel.

OBJECTIVE: To evaluate a laparoscopic technique of cornual resection using the harmonic scalpel. METHODS: Four patients with unruptured interstitial pregnancies were treated laparoscopically using the harmonic scalpel at Ioannina University Hospital. RESULTS: There were no failures in the technique in any of our patients. CONCLUSION: Our study suggests that interstitial pregnancies of a maximum gestational age of 7-8 weeks and sac diameter less than 4-5 cm may be treated laparoscopically.

Abortifacient Agents, Nonsteroidal↗
PubMed1997

Vaginoscopic approach to outpatient hysteroscopy.

STUDY OBJECTIVE: To evaluate a new method of outpatient hysteroscopy. DESIGN: Prospective observational study. SETTING: Departments of Obstetrics and Gynecology, Medical School of Ioannina, Greece, and Brooklyn Hospital Center, Brooklyn, New York. PATIENTS: Three hundred twenty-four women, 316 of whom were symptomatic and 8 asymptomatic. INTERVENTIONS: Hysteroscopic vaginoscopy with directed endometrial biopsies. MEASUREMENTS AND MAIN RESULTS: The procedure was successful and well tolerated in 211 (65%) women. In 90 (27.9%) women, the procedure was successful but with significant pelvic pain, and in the remaining 23 (7.1%) it was complicated by either vagal reaction or complete intolerance. Hysteroscopic findings were in agreement with histopathologic results in 290 (89.5%) patients. In all 12 women with endometrial adenocarcinoma, hysteroscopic findings were identical with histopathologic results. CONCLUSION: The vaginoscopic approach is effective for outpatient hysteroscopy.

Adult↗
PubMed1995

Seckel syndrome in a family with three affected children and hematological manifestations associated with chromosome instability.

In the present communication we report on a family with three children affected by Seckel-syndrome with mental deficiency, microcephaly, micrognathia and severe growth deficiency. All patients had chromosome instability, which was employed for the prenatal diagnosis of a fourth fetus suspected as a potential Seckel syndrome patient, and one of them had additional hematological disorders. As this condition has been previously characterized as a Seckel syndrome subgroup we report our data concerning this distinct entity.

Abnormalities, Multiple↗
PubMedDate not supplied

Placental laterality may be a random event and not the result of inherent uterine artery pathology.

OBJECTIVE: To determine whether placental laterality and discordant uterine artery impedance during pregnancy is a random event or the result of uterine artery pathology. METHODS: We identified 50 patients with unilateral placenta and pathologic uterine artery impedance during their current pregnancy and enrolled them in the study. Thirty-three of these patients met the inclusion criteria and returned during the first 10 days of their third normal menstrual cycle after delivery. We examined the pelvic anatomy to rule out any pelvic pathology and then used color and pulsed wave duplex Doppler to identify the uterine artery in the immediate vicinity of the paracervical area at the level of the isthmus. We obtained the uterine artery resistance index (RI) from each uterine artery. We performed statistical analysis by means of t-test. RESULTS: The uterine artery ipsilateral to the placenta exhibited significantly lower impedance than the contralateral in the pregnant state. When the placenta was right, the values (mean +/- SD) were 0.60 +/- 0.11 vs. 0.73 +/- 0.09 for the right and left artery, respectively. When the placenta was left the values were 0.57 +/- 0.08 vs. 0.77 +/- 0.07 for the left and right uterine artery, respectively. In the nonpregnant state, the corresponding values were 0.90 +/- 0.04 vs. 0.90 +/- 0.05 and 0.91 +/- 0.05 vs. 0.90 +/- 0.04, respectively. CONCLUSION: In patients with a unilateral placenta and discordant pathological uterine artery impedance during pregnancy, there is no evidence of discordant impedance between the two uterine arteries in the postpartum period. We speculate that the location of placental implantation may not be the result of preexisting uterine artery discordant impedance.

Arteries↗