Biomedical subjects
Publications and source records attributed to P Anastasiadis.
This study reports our experience in the application of magnetoencephalography (MEG) and magnetocardiography (MCG) in neonates. Results gained from our studies, lead us to believe that MEG and MCG could provide clinical practice with non-invasive, rapid and easy to perform methods, which could be adjuncts to conventional methods for the evaluation of neonatal brain and heart function.
OBJECTIVES: To elucidate the hemodynamics of the uterine artery in normal and abnormal pregnancies by use of Doppler ultrasound and SQUID biomagnetometry. METHOD: Two hundred and three women (gestational age 28-42 weeks) were included in the study. Forty-three of them had preeclampsia and/or intrauterine growth restriction and 160 were normal. Uterine artery waveform measurements were evaluated by use of pulsatility index (PI) (normal value PI<1.45). Biomagnetic signals of uterine arteries were recorded and analyzed with Fourier analysis. The biomagnetic signals were distributed according to spectral amplitudes as high (140-300 fT/ radicalHz), low (50-110 fT/ radicalHz) and borderline (111-139 fT/ radicalHz). RESULTS: There was a statistically significant difference between normal and abnormal pregnancies concerning the waveform amplitudes (p < 0.001) and the PI index (p < 0.001). Specifically, we noticed high biomagnetic amplitudes in most normal pregnancies (92.5%) and low biomagnetic amplitudes in most preeclamptic cases (90.7%). CONCLUSIONS: Our study results indicated that biomagnetic measurements of uterine artery might prove to be useful in the evaluation of the fetal well being, especially in cases of preeclampsia and intrauterine growth restriction.
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PURPOSE OF INVESTIGATION: To study the prevalence and the epidemiologic characteristics of major congenital anomalies (MCAs) in two different populations in Thrace-Greece. METHODS: The ethnic origin of all mothers who delivered in our department and the types of MCAs were determined. We compared the frequencies of MCAs between Christians and Muslims. The chi-square test, t-test, binary and multinomial logistic regression analysis were performed. RESULTS: The prevalence of MCAs was significantly higher in Muslims as compared to Christians (51/4,028 (12.78%) vs 49/5,994 (8.17%), p = 0.035). However, the frequencies of each type of MCA in the total number of deliveries between the two groups did not differ significantly. The central nervous system malformations were most frequently associated with perinatal mortality. CONCLUSION: This is the first study in Greece showing that there is probably a higher prevalence of MCAs in Muslims as compared to Christians, although it can not be elucidated whether this increased risk is related to specific differences between them.
OBJECTIVE: To assess the value of biomagnetic recordings of the umbilical artery over Doppler ultrasound screening in order to predict complications of impaired uteroplacental blood flow in fetuses with intrauterine growth restriction (IUGR). METHODS: Our study population included 11 IUGR preeclamptic (34-37-weeks gestation; birth weight 1969 +/- 129 g) and 19 normal pregnancies (34-37-weeks gestation; birth weight 3195 +/- 229 g). Umbilical artery Doppler ultrasound waveform measurements were expressed in terms of pulsatility index (PI). Biomagnetic signals (waveforms) recorded from the IUGR umbilical artery were expressed in terms of magnetic power spectral amplitudes. RESULTS: In all cases, the frequency band considered was 2 to 7 Hz. The spectral amplitudes were low (mean: 117+/-24 fT/ radical Hz) in most (90.9%) IUGR pregnancies and high (mean: 224+/-37 fT/ radical Hz) in most normal pregnancies (89.5%). There was a statistically significant difference between normal and IUGR pregnancies with respect to spectral amplitudes (p < 0.0001), Doppler PI (p < 0.0005), pH (p < 0.0005) and Apgar score (p < 0.0005). Multiple linear regression analysis revealed an influence of PI, pH and Apgar scores on the biomagnetic values (ANOVA: p < 0.0005). CONCLUSION: Our data imply that biomagnetic values of the umbilical artery flow could prove to be a helpful method for the evaluation of fetal well being especially in pregnancies complicated with preeclampsia and growth restriction.
The aim of this study was to investigate the presence of any non-linearity in the magneto-encephalographic recordings (MEG) in neonates born to pre-eclamptic mothers in comparison with the ones born to mothers having uncomplicated pregnancies, in order to find out differences in the mechanisms underlying their brain waves. Our study population consisted of 40 term neonates who were delivered normally, without any clinical signs of brain damage. Thirty of them had a normal pregnancy and labour with normal Apgar scores, umbilical cord pH, and birth weight, while 10 neonates had suffered a pre-eclamptic pregnancy. The above analysis of the MEG in the neonatal pre-eclamptic brain showed a lower dimension complexity as compared with the normal neonatal brain and a lower first Lyapunov exponent which means lower information processing. The non-linear analysis of the MEG activities in neonates may offer important perspectives to understand significant features of their brain function.
PURPOSE OF INVESTIGATION: To determine the therapeutic efficacy of the use of gall stone forceps and curettage in endometrial polyps removal, after their detection with diagnostic hysteroscopy. METHODS: From 1997 to 2001, we conducted a prospective study in 53 patients who presented at our department for menstrual disorders, infertility problems or postmenopausal bleeding and in whom endometrial polyps were detected by hysteroscopy. All patients received general anesthesia and after hysteroscopic detection of the polyps' location, their removal was attempted by use of Desjardins gall stone forceps and curettage. Immediately after the procedure, a second hysteroscopy was performed in order to detect remnants of the polyps. RESULTS: Fifty patients presented with only one polyp, two with two polyps and one with three polyps. The mean diameter of the polyps ranged from 0.5 to 3 cm. The hysteroscopic appearance of all polyps was not suggestive of malignancy. During the second hysteroscopy we found parts or whole polyps in five and two cases, respectively, accounting for a therapeutic success of 86.8%. The hospitalization time for all patients was 24 hours and occurred no intraoperative or postoperative complications. CONCLUSION: Our method seems to be safe, with low cost and sufficient therapeutic outcome and could be used in hospitals with availability of diagnostic hysteroscopy only.
Anatomic gynecologic anomalies, including congenital absence of the uterus, occur with surprising frequency in referral practice of reproductive endocrinology and reproductive surgery. Female individuals with uterus agenesis have normal external genitalia and, therefore, the diagnosis is rarely made in infancy. We report a case of congenital absence of the uterus in a young woman 25 years old, presenting with primary amenorrhea. The patient had a normal karyotype and normal secondary sex characteristics. Sex hormones were within normal limits, indicating normal function of the hypothalamic-pituitary-ovarian axis. The diagnosis was set by bimanual gynecologic examination, which was followed by vaginal ultrasound examination. The patient underwent a laparoscopic investigation, which revealed the absence of the uterus and the presence of small rudimentary uterine horns, connected to normal fallopian tubes. Ovarian morphology was bilaterally normal. In conclusion we believe that every patient with genital tract abnormalities has to be dealt with individually, depending on the patient's anatomy, desires and age.
Fetal small bowel obstruction is usually diagnosed by sonography in the late second or early third trimester. We report two such cases of different etiology: a case of meconium ileus due to cystic fibrosis and a case of intestinal atresia. The only sonographic finding that allowed differentiation between them was the echogenic bowel in the case of cystic fibrosis.
PURPOSE: The aim of the present study is to describe the prevalence of proliferative breast lesions in cases of benign and malignant tumors of the breast as well as to assess the contribution of rapid intraoperative imprint cytology in the diagnosis of proliferative breast disease. METHODS: Frozen section and intraoperative imprint cytology were performed on breast tissue biopsies from 486 breast cancer patients who underwent primary surgical treatment. Imprints were stained either by the Papanicolaou (Pap) or the May Grünwald-Giemsa (MGG) or the Hematoxylin eosin (HE) technique. Cytologic diagnoses were compared to the histopathologic ones from paraffin sections. RESULTS: Sclerosing adenosis was the most common finding in benign breast biopsies while in breast cancer the prevalence of the lesion was reduced by half. On the other hand, atypical hyperplasias in malignant biopsies were almost twice as many as in benign ones. Imprint cytology presented high sensitivity and specificity (99% and 96% respectively) in distinguishing benign proliferative from malignant lesions as a whole, but regarding atypical hyperplasias the specificity was significantly reduced (76% vs 96%). CONCLUSION: Clarification of cytologic diagnostic criteria and expertise in cytologic interpretation could show off intraoperative imprint cytology as a useful and inexpensive diagnostic tool providing the surgeon with prompt and accurate information regarding the nature of breast lesions.
OBJECTIVE: To evaluate the contribution of the rapid intraoperative cytology (peritoneal washing [PW] cytology together with imprint cytology performed on lymph node samples) in the assessment of peritoneal and retroperitoneal dissemination of cervical cancer. METHODS: Seventy-nine patients with clinical Stage IA2-IIA cervical cancer underwent PW cytology and imprint cytology performed on retroperitoneal lymph node samples during primary surgical treatment. Cytologic specimens were stained with the May-Grünwald-Giemsa (MGG) and hematoxylin-eosin (HE) techniques. Pertinent histologic sections of the cervical lesions, of the cell blocks prepared from PW sediments, and of the lymph node sampling were studied and compared with the cytologic findings. RESULTS: PW cytology was positive in 2.5% of the patients, and lymph node imprints revealed metastases in 19% of the patients. Cervical adenocarcinomas presented increased rates of metastatic disease in both the peritoneal cavity and retroperitoneum. HE presented higher sensitivity in detecting malignant cells in the peritoneal fluids, while MGG gave more accurate results in the diagnosis of lymph node metastases. CONCLUSIONS: Cytologic evaluation of intraperitoneal and retroperitoneal spread of cervical cancer by use of PW cytology and imprint cytology performed on lymph node samples contributes to the assessment of the extent of disease and therefore could be useful in further treatment of the patient.
OBJECTIVE: The aim of our study was to determine the correlation of abnormal umbilical artery interleukin-6 levels with pregnancies complicated by preterm delivery and pre-eclampsia. METHOD: Cord serum (umbilical artery) was collected at delivery by cesarean section or spontaneous delivery. Samples were retrieved from patients with normal and abnormal pregnancies. Patients were divided into three groups: group 1, a control group of samples from uncomplicated pregnancies (n = 24); group 2, patients with pre-eclampsia (n = 21); and group 3, patients having had preterm delivery (n = 29). Interleukin-6 was measured by bioassays. Statistics were performed with the Mann-Whitney U-, Student's t- and the Kruskal-Wallis tests. RESULTS: Interleukin-6 levels in women with preterm delivery were statistically higher compared to those of normal pregnancies (P < 0.05) and lower in the cord serum of pre-eclamptic when compared to those of normal pregnancies (P < 0.05). CONCLUSION: In conclusion, we believe that further investigations could elucidate the role of this pleiotropic cytokine in both, normal and pathologic reproductive biology, and determine the clinical utility of IL-6 measurements in obstetric practice.
AIMS: To investigate episialin/MUC1 expression in the normal, hyperplastic and neoplastic endometrium, and relate patterns of tumour MUC1 reactivity with histopathological characteristics, oestrogen and progesterone receptor (ER and PR) status, bcl-2 and p53 oncoproteins and with clinical behaviour. METHODS AND RESULTS: We studied 42 normally cycling endometria, 45 endometrial hyperplasias of various forms, and 111 endometrial carcinomas of endometrioid and non-endometrioid cell types with specific monoclonal antibodies employing standard immunohistochemical techniques. The follow-up period ranged from 34 to 182 months with a median of 86 months. Epithelial mucin episialin/MUC1 was consistently expressed in the normal endometrium, following a cyclical pattern: "apical membrane staining" in early and mid-proliferative endometrium; "purely cytoplasmic staining" in late proliferative endometrium; and "cytoplasmic staining with intraluminal secretions" in secretory endometrium. Immunostaining patterns in simple and complex hyperplasia were similar to late proliferative endometrium, while atypical hyperplasias and endometrial carcinomas either simulated patterns of proliferative endometrium or lacked MUC1 reactivity. Membranous MUC1 positivity was statistically more frequent in endometrioid carcinomas compared with carcinomas of non-endometrioid type (P = 0.006). Cytoplasmic MUC1 positivity was significantly associated with poor prognosis, while MUC1-negative carcinomas were associated with PR expression and an improved survival (P=0.04). There was no association of MUC1 patterns with bcl-2 and p53 immunoreactivity or with other histopathological variables. CONCLUSIONS: Episialin/MUC1 is an integral component of the normal premenopausal endometrium and is probably hormonally regulated. It is frequently expressed in endometrial hyperplasias and carcinomas. The loss of MUC1 expression from endometrial carcinomas is associated with a favourable prognosis.
A rare case of sirenomelia at 38 weeks of gestation is reported. Fusion of the lower extremities and incomplete development of the bony pelvis was associated with agenesis of the urinary and genital systems, anorectal atresia and a single large umbilical artery. There was complete situs inversus of the single lower limb. This was composed of two partially fused femurs, a common tibia without fibula, and a rudimentary foot having three metatarsal bones and their corresponding toes. The present case was also interesting for its association with hypoplasia of the lungs. The pathogenesis of sirenomelia is discussed.
OBJECTIVE: To investigate the differentiation in attitudes towards contraceptive pill use in two different populations in Thrace, Greece. A retrospective study on representatives of the two major religious subgroups in Thrace: 127 Orthodox Christians and 120 Muslims. The questionnaire was designed to investigate women's opinions concerning the possible beneficial and adverse effects of the contraceptive pill. RESULTS: In comparison with Christians, a higher percentage of Muslims responded 'don't know' in questions about the pill's efficacy in regulating menses (p = 0.019), 'yes' concerning the inconvenience of daily uptake (p = 0.032) and the pill's contribution to nausea (p = 0.003), and 'maybe' in the question concerning the pill's contribution to depression and headaches (p < 0.001). A higher percentage of Christians responded 'yes' concerning the pill's contribution to depression and headaches, and 'don't know' concerning the pill's contribution to nausea. There were no significant differences in the responses to the remaining questions, and it was clear that most women believed that use of the pill is correlated with increased risk of cardiovascular disease and cancer. CONCLUSIONS: Muslims appeared more reluctant than Christians to use the pill as a contraceptive method. Christians seemed to be better informed about the pill's phamacological actions and beneficial effects, but both populations were unaware of current information regarding the pill's safety. There is a need to promote information about these topics in Thrace.
BACKGROUND: Vascular endothelial growth factor (VEGF) is an important endothelial cell mitogen associated with increased angiogenesis and aggressive tumor behavior. Its stimulating effect on endothelial cells basically is dependent on the presence of specific VEGF receptors, such as the flk-1(KDR) receptor. This study investigates the roles of VEGF and of a functionally intact angiogenic pathway, "VEGF/flk-1(KDR)," in patients with endometrial carcinoma and their significance in prognosis and therapy. METHODS: A series of 121 endometrial carcinomas were studied. The expression of VEGF by endometrial tumor cells was assessed using the monoclonal antibody (MoAb) VG1. VEGF/KDR complexes on tumor endothelium or activated microvessel density (aMVD) were identified using the MoAb 11B5. In addition, the standard microvessel density (sMVD) was assessed with anti-CD31. In all tumors, the alkaline phosphatase/antialkaline phosphatase technique was employed. A Fisher exact test or an unpaired, two-tailed t test was used for testing correlations between categoric tumor variables, whereas a log-rank test was used to determine statistical differences between life tables. A Cox proportional hazards model was used to assess the effect of tumor variables on overall survival. RESULTS: Cytoplasmic VEGF expression in > 50% of tumor cells was associated significantly with aMVD (P < 0.0001) and with sMVD (P < 0.003). In univariate survival analysis, VEGF (P = 0.0002), aMVD (P = 0.001), and sMVD (P = 0.0009) were significant prognostic variables. Equally important were the histologic parameters tumor type (P = 0.03), tumor grade (P = 0.003), and disease stage (P < 0.0001). In multivariate analysis, disease stage was the most important independent prognostic factor (P < 0.0001), followed by VEGF/KDR (P < 0.01), and VEGF (P < 0.04). Furthermore, VEGF and VEGF/KDR were the only independent prognostic variables for patients with Stage I endometrioid adenocarcinoma. CONCLUSIONS: sMVD and the angiogenic factor VEGF are important indicators of a poor prognosis in patients with endometrial carcinoma. VEGF/KDR complexes define a subgroup of patients with endometrial carcinoma with an even worse prognosis.
p120-catenin (p120(ctn)) interacts with the cytoplasmic tail of cadherins and is thought to regulate cadherin clustering during formation of adherens junctions. Several observations suggest that p120 can both positively and negatively regulate cadherin adhesiveness depending on signals that so far remain unidentified. Although p120 tyrosine phosphorylation is a leading candidate, the role of this modification in normal and Src-transformed cells remains unknown. Here, as a first step toward pinpointing this role, we have employed two-dimensional tryptic mapping to directly identify the major sites of Src-induced p120 phosphorylation. Eight sites were identified by direct mutation of candidate tyrosines to phenylalanine and elimination of the accompanying spots on the two-dimensional maps. Identical sites were observed in vitro and in vivo, strongly suggesting that the physiologically important sites have been correctly identified. Changing all of these sites to phenylalanine resulted in a p120 mutant, p120-8F, that could not be efficiently phosphorylated by Src and failed to interact with SHP-1, a tyrosine phosphatase shown previously to interact selectively with tyrosine-phosphorylated p120 in cells stimulated with epidermal growth factor. Using selected tyrosine to phenylalanine p120 mutants as dominant negative reagents, it may now be possible to selectively block events postulated to be dependent on p120 tyrosine phosphorylation.
In endometrial tissues, malignant change may be accompanied by a loss of hormone dependence which is, usually, reflected in a parallel loss of oestrogen and progesterone receptors (ER and PR). In this study, the steroid receptor status of 164 endometrial carcinomas was related to intratumoural angiogenesis and the apoptotic proteins bcl-2 and p53. Relationships to conventional histopathological features and patient survival were also sought. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissues. The mean follow-up was 55 months (range 19-167 months). Specific nuclear staining for ER and PR was detected in 35% and 32% of endometrial carcinomas, respectively, and was very commonly co-expressed (P<0.0001). The failure of demonstrating a steroid receptor complement in endometrial neoplasms was, in general terms, an adverse prognostic sign. Thus, ER or PR loss was significantly associated with non-endometrioid carcinomas (ER P=0.01; PR P=0.004) and with deep myometrial invasion (ER P<0.0002), high intratumoural angiogenesis (PR P<0.01) and the absence of bcl-2 expression (PR P<0.005). There was a trend for patients with ER or simultaneous ER/PR expression to have an improved survival, but this association did not reach the level of statistical significance. In multivariate analysis (all stages), tumour cell type (endometrioid versus non-endometrioid carcinomas) and stage of disease were the only variables associated with prognosis (P=0.01 and P<0.0001, respectively), with tumour cell type retaining its independent prognostic value and within stage-I endometrial carcinomas (P=0.02). It is suggested that the loss of steroid hormone receptors in endometrial carcinomas is associated with a more aggressive phenotype and the switching-on of angiogenic pathways.