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P Ravazoula

Publications and source records attributed to P Ravazoula.

At least 19 recordsLinked to original sources
PubMed2006

Primary peritoneal psammocarcinoma: a case presenting synchronously with bowel carcinoma.

BACKGROUND: Psammocarcinomas are rare epithelial tumors usually originating from the ovarian surface epithelium or the peritoneum. In our case, a peritoneal psammocarcinoma was incidental surgical finding during laparotomy. CASE: An 83-year-old woman underwent surgery for bowel obstruction. Intraoperativelly, a bowel carcinoma was documented. Notable were numerous small disseminated peritoneal nodules that studded the omentum and bowel serosa. At reintervention, similar nodules were observed in the serosal surface of the two ovaries, uterus, left salpinx, and omentum. The nodules corresponded histologically to psammocarcinoma of peritoneal origin. Despite not receiving adjuvant treatment, the patient is still alive 53 months following the second operation, without signs of metastases or disease recurrence. CONCLUSION: Though unpredictable, psammocarcinomas might run an indolent course, and decisions regarding management should be individualized.

Adenocarcinoma, Papillary↗
PubMed2006

Correlation of mammographic appearance and molecular prognostic factors in high-grade breast carcinomas.

The aim of our study was to evaluate the association between the mammographic appearance and the biologic characteristics of high-grade breast carcinomas. Three hundred and twenty patients with breast carcinomas were studied. Histological examination showed 83 (26%) high-grade ductal carcinomas. Immunohistochemistry was carried out by using antibodies against estrogen receptor (ER), progesterone receptor (PR), HER-2/neu, p53 and cathepsin D. In 60/83 high-grade carcinomas we studied the mammographic appearance. Asymmetric density with poorly defined margins without microcalcifications was the major mammographic finding in 49/60 (approximately 82%) high-grade ductal carcinomas. HER-2/neu positivity (68.7%) and p53 positivity (48.2%) were statistically correlated with asymmetric density with poorly defined margins without microcalcifications in high-grade carcinomas. We observed loss of ER and PR receptors in 50%, whereas loss of PR receptors was observed in 65% of high-grade breast carcinomas. Cathepsin D (> 20%) was detected in 38.5% of high-grade carcinomas. Our findings suggest a significant relationship between mammographic appearance and biologic markers in high-grade breast carcinomas.

Adult↗
PubMed2006

Immunohistochemical detection of HPV proteins and c-erbB receptors in cervical lesion specimens from young women.

The intention of the present study was to assess immunohistochemically the expression of c-erbB receptor family in cervical carcinoma specimens of young women. Simultaneously, HPV was detected in the same specimens using immunohistochemical assays. Seventy-five cervical intraepithelial and invasive cancer specimens were assessed retrospectively. Positive c-erbB-2 immunostaining was revealed in 11.7% of tumor specimens, while for c-erbB-3 and c-erbB-4 receptor the corresponding figures were 32% and 49.3%, respectively. Concerning HPV infection-markers, positive immunostaining was found in 31% of cases, while coilocytes were detected in 64% of patients. The correlation of c-erbB receptor expression with malignant aggressiveness in cervical cancer cells concurs with similar data regarding other neoplasias, thus rendering these receptors an important predictive factor and future therapeutic target.

Adult↗
PubMed2005

Involvement of dysadherin and E-cadherin in the development of testicular tumours.

Testicular neoplasms are comprised of a variety of histologically different forms, and their pathogenesis has not been elucidated. Dysadherin is a recently described cell membrane glycoprotein, which has an anticell-cell adhesion function and downregulates E-cadherin. In this study, we examined immunohistochemically the expression of E-cadherin and dysadherin in 120 testicular neoplasms (37 seminomas-26 classic, five spermatocytic and six anaplastic-, 45 embryonal carcinomas, 10 mixed germ cell tumours, two yolk sac tumours, 10 mature and eight immature teratomas and eight non-Hodgkin B-cell lymphomas), clinical stage I. The intensity, the expression pattern and the percentage of neoplastic cell staining was recorded and correlated with the histologic type and vascular/lymphatic invasion. Dysadherin was not expressed in non-neoplastic germ cells, neither in CIS/ITGCNU, but it was highly expressed in all types of germ cell tumours, that demonstrated either embryonic phenotype or somatic differentiation, in most terminally differentiated neoplasms, and in all lymphomas. Dysadherin expression did not correlate with vascular invasion. Increased dysadherin expression was correlated with aberrant E-cadherin expression in most tumours. In 17% of embryonal carcinomas colocalisation of dysadherin and membranous E-cadherin staining was noted. This is the first report on dysadherin expression and its association with E-cadherin in testicular tumours. Since dysadherin is not normally expressed in non-neoplastic testis, it is conceivable that it plays a role in the neoplastic transformation of germ cells. In testicular tumours, as in other neoplasms, dysadherin downregulates E-cadherin expression, at least in part.

Adolescent↗
PubMed2005

Advanced soft computing diagnosis method for tumour grading.

OBJECTIVE: To develop an advanced diagnostic method for urinary bladder tumour grading. A novel soft computing modelling methodology based on the augmentation of fuzzy cognitive maps (FCMs) with the unsupervised active Hebbian learning (AHL) algorithm is applied. MATERIAL AND METHODS: One hundred and twenty-eight cases of urinary bladder cancer were retrieved from the archives of the Department of Histopathology, University Hospital of Patras, Greece. All tumours had been characterized according to the classical World Health Organization (WHO) grading system. To design the FCM model for tumour grading, three experts histopathologists defined the main histopathological features (concepts) and their impact on grade characterization. The resulted FCM model consisted of nine concepts. Eight concepts represented the main histopathological features for tumour grading. The ninth concept represented the tumour grade. To increase the classification ability of the FCM model, the AHL algorithm was applied to adjust the weights of the FCM. RESULTS: The proposed FCM grading model achieved a classification accuracy of 72.5%, 74.42% and 95.55% for tumours of grades I, II and III, respectively. CONCLUSIONS: An advanced computerized method to support tumour grade diagnosis decision was proposed and developed. The novelty of the method is based on employing the soft computing method of FCMs to represent specialized knowledge on histopathology and on augmenting FCMs ability using an unsupervised learning algorithm, the AHL. The proposed method performs with reasonably high accuracy compared to other existing methods and at the same time meets the physicians' requirements for transparency and explicability.

Algorithms↗
PubMed2005

An image-analysis system based on support vector machines for automatic grade diagnosis of brain-tumour astrocytomas in clinical routine.

An image-analysis system based on the concept of Support Vector Machines (SVM) was developed to assist in grade diagnosis of brain tumour astrocytomas in clinical routine. One hundred and forty biopsies of astrocytomas were characterized according to the WHO system as grade II, III and IV. Images from biopsies were digitized, and cell nuclei regions were automatically detected by encoding texture variations in a set of wavelet, autocorrelation and parzen estimated descriptors and using an unsupervised SVM clustering methodology. Based on morphological and textural nuclear features, a decision-tree classification scheme distinguished between different grades of tumours employing an SVM classifier. The system was validated for clinical material collected from two different hospitals. On average, the SVM clustering algorithm correctly identified and accurately delineated 95% of all nuclei. Low-grade tumours were distinguished from high-grade tumours with an accuracy of 90.2% and grade III from grade IV with an accuracy of 88.3% The system was tested in a new clinical data set, and the classification rates were 87.5 and 83.8%, respectively. Segmentation and classification results are very encouraging, considering that the method was developed based on every-day clinical standards. The proposed methodology might be used in parallel with conventional grading to support the regular diagnostic procedure and reduce subjectivity in astrocytomas grading.

Astrocytoma↗
PubMed2005

Leiomyosarcoma of the vulva: a case report.

Primary sarcoma of the vulva is a rare tumor. Leiomyosarcoma is the most common histologic variant of vulvar sarcoma. The patient, a 55-year-old, gravida 4, para 2 postmenopausal Greek woman, presented with a 5-year history of progressive enlargement of the right labia majora. On vaginal examination there was a 8 x 9 cm raised, ulcerated and irregular mass of the right labia majora. Despite surgery, the patient died six months later because of multiple metastases.

Diagnosis, Differential↗
PubMed2005

Primary malignant melanoma of the vagina: a case report.

Primary malignant melanoma of the vagina is a very rare, but very aggressive tumor. We describe a case of primary vaginal melanoma and review the literature. The patient, a 73-year-old, gravida 2, para 2 postmenopausal Greek woman, presented with abnormal vaginal bleeding for 30 days. On vaginal examination there was a 5.5 x 5 x 2 cm raised, ulcerated and irregular lesion on the posterior vaginal wall. Pathology examination of the entire specimen demonstrated a nodular vaginal melanoma. The histologic diagnosis was confirmed by positive immunostaining. The patient began postoperative immunotherapy with interferon-a2b. She died 25 months later because of cerebral metastases. In conclusion, the prognosis of vaginal melanoma is very poor, despite the treatment modality, because most cases are diagnosed at a late stage.

Aged↗
PubMed2004

A second Pap smear during colposcopy: is it really worth it?

The aim of this study was to determine whether the clinical value of a second Pap smear during colposcopy outweighed its cost-effectiveness and reliability parameters. We studied retrospectively 569 cases focusing on A) The initial Pap smear, B) The smear performed during colposcopy, C) The colposcopic findings, and D) The histopathological reports of the cases where biopsy sampling was performed. In 380 patients (67%), the second Pap smear corresponded to the first one. In 13% of the patients, the cytological lesions were worse (particularly in 2% of the patients staging increased from HPV-associated reactive cellular changes to CIN II, or from CIN I to CIN III), and in 20% slighter than the initial. In 79% of the cases revealing more serious lesions in the second smear, the histological result of the biopsy corresponded to that of the initial smear. Conclusively, only 2% seem to benefit from a second repeat Pap smear during referral colposcopy.

Adolescent↗
PubMed2004

Normal colposcopy following abnormal Pap smear evoking LGSIL: a follow-up study.

The aim of this study was to determine the optimal treatment policy in women presenting with an abnormal Pap smear showing low-grade squamous intraepithelial lesion (LGSIL), who additionally had normal colposcopic findings. We prospectively studied 160 women with LGSIL and normal colposcopy, and divided them into two groups. Group A, consisting of 54 women, was followed-up for a mean period of 42 months and had a new control smear 12 months after the initial one. Group B, consisting of 106 women, was followed-up for a mean period of 44 months and had two consecutive control smears (6 and 12 months after the initial), and a new colposcopy, depending on the findings. At the end of the first year, the lesion persisted in 37% and 39% of the patients in groups A and B, respectively. At the end of the study, regression or persistence of the LGSIL was revealed in 63% and 61% of the women in groups A and B, respectively. Aggravation of the lesions occurred after 16.5 and 15 months, respectively, in groups A and B. Our findings suggest that women with LGSIL and normal colposcopy do not need further therapeutic measures during the first year after the initial smear.

Adolescent↗
PubMed2003

Immunohistochemical expression of glucose transporter Glut1 and cyclin D1 in breast carcinomas with negative lymph nodes.

All malignant cells appear to have increased needs for glucose in vitro as well as in vivo. The enhanced glucose uptake is mediated through transporters (Gluts), whose action and expression are regulated by oncogenes and growth factors. Cyclin D1 is a nuclear protein that plays an important role in regulating the cell cycle by promoting entry of cells from the G1 to S phase. Increased expression of Glut1 glucose transporter and cyclin D1 have been reported in several neoplasms. In the present study we examined the expression of Glut1 and cyclin D1 in breast carcinomas with negative lymph nodes. We studied 78 infiltrating ductal carcinomas (25 grade 1, 36 grade 2, and 17 grade 3) with negative lymph nodes. Glut1 was expressed in 28% of grade 1, 63.8% of grade 2 and 58.7% of grade 3 carcinomas. Nuclear expression of cyclin D1 was detected in 32% of grade 1, 44.4% of grade 2, and 41.2% of grade 3 carcinomas. From our study it appears that in breast carcinomas with negative lymph nodes Glut1 expression is better correlated to the grade of the neoplasm than cyclin D1.

Biomarkers, Tumor↗
PubMed2002

A computer-based diagnostic and prognostic system for assessing urinary bladder tumour grade and predicting cancer recurrence.

PURPOSE: A computer-based system was designed, incorporating subjective criteria employed by pathologists in their usual microscopic observation of tissue samples and measurements of nuclear characteristics, with the purpose of automatically assessing urinary bladder tumour grade and predicting cancer recurrence. MATERIAL AND METHODS: Ninety-two cases with urine bladder carcinoma were diagnosed and followed-up. Forty-seven patients had cancer recurrence. Each case was represented by eight histological (subjective) features, evaluated by pathologists, and thirty-six automatically extracted nuclear features. Grading and prognosis were performed by neural-network based classifiers employing both histological and nuclear features. RESULTS: Employing a combination of histological and nuclear features, highest classification accuracy was 82%, 80.5%, and 93.1% for tumours of grade I, II and III respectively. The prognostic-system, gave a significant prognostic assessment of 72.8% with a confidence of 74.5% that cancer might recur and of 71.1% that might not, employing two histological features and two textural nuclear features. CONCLUSIONS: The system for grading and predicting tumour recurrence may serve as a second opinion tool and features employed for designing the system may be of value to pathologists using descriptive grading systems.

Decision Support Systems, Clinical↗
PubMed2001

S-100 protein-positive dendritic cells and CD34-positive dendritic interstitial cells in palatine tonsils.

Dendritic cells (DCs) are effective antigen-presenting cells and have been shown to mature from precursor CD34-positive stromal cells (dendritic interstitial cells, DICs) or monocytes. To gain insight into the local immune response in human tonsils, we investigated immunohistochemically the presence of DCs and DICs in 17 non-hyperplastic and 13 hyperplastic tonsils. Dense infiltrates of S-100-positive DCs were noted in the majority of hyperplastic tonsils, while there were fewer in non-hyperplastic tonsils. DICs were noted specifically at the periphery in the dense hemi-capsule cap that separates the tonsil from the underlying muscle. In addition, their small number suggests that the accumulation of S-100 dendritic cells in hyperplastic palatine tonsils is achieved through migration from other sites rather than through maturation from precursors locally.

Adult↗
PubMed2001

Excessive verumontanum hyperplasia causing infertility.

Retrograde ejaculation is an uncommon cause of infertility in otherwise healthy men. We hereby report a previously undescribed verumontanum hyperplasia as a cause of retrograde ejaculation in a 32-year-old male that was successfully treated by transurethral resection.

Adult↗
PubMed2000

An experimental approach of the Doppler perfusion index of the liver in detecting occult hepatic metastases: histological findings related to the hemodynamic measurements in Wistar rats.

Image-directed colour Doppler sonography has been successfully introduced for the detection of hepatic haemodynamic changes in the presence of liver metastases. The aim of our study was to correlate these haemodynamic changes with the liver histology at the time of measurement. We experimentally induced liver metastases in 30 male Wistar rats by inoculating Walker 256 tumour subcutaneously. The animals were assigned into three groups of ten and were studied sonographically at 4, 7 and 15 days after tumour implantation. Another group of ten normal animals were used as controls. Portal vein and hepatic artery measurements included resistance index (PVRI, HARI) and flow volume (PVFV, HAFV). Doppler perfusion index (DPI) of the liver was calculated as the ratio of HAFV/PVFV + HAFV. Liver histology followed each Doppler measurement. Metastases were first encountered on day 4, as small groups of cells in the connective tissue of the porta hepatis and the portal triads without apparent vascular association. Distinct elevation of HAFV and DPI was recorded in comparison with the controls (p = 0.0004 and p = 0.0005, respectively). PVFV reduction was subtle. Up to day 15 there were no significant changes in the measurements. Our data suggest that HAFV and DPI can efficiently detect early liver metastases and this is in accordance with existing clinical reports. Haemodynamic changes seem to originate from the early non-vascular phase of the metastases.

Animals↗
PubMed2000

Percutaneous treatment of large symptomatic renal cysts.

PURPOSE: To evaluate the efficacy of alcohol in combination with tetracycline for the treatment of symptomatic renal cysts. PATIENTS AND METHODS: Twenty-four patients age 45 to 77 years (mean 66 years) with a large (5-13-cm; mean 7.5-cm) symptomatic renal cyst associated with flank pain were treated by aspiration under ultrasound guidance and injection of alcohol and tetracycline. Patients were followed with ultrasonography at 1, 6, and 12 months and once a year thereafter. RESULTS: The aspirated volume ranged from 65 to 1500 mL (mean 360.5 mL). Two patients experienced mild pain during alcohol injection, but the procedure was completed successfully. One patient reported severe pain after tetracycline injection. The tetracycline was immediately aspirated, and the procedure was then aborted. The remaining patients were relieved of their symptoms after treatment, and they remained symptom free during a mean follow-up of 20 months (range 7-36 months). CONCLUSIONS: The combination of alcohol and tetracycline is safe and effective and offers a very favorable minimally invasive therapeutic alternative for the treatment of symptomatic renal cysts.

Aged↗
PubMed2000

Pheochromocytoma of the urinary bladder presenting only with macroscopic hematuria.

Pheochromocytoma of the bladder is an unusual tumor that typically presents with hypertensive crises related to micturition. We describe a case of bladder pheochromocytoma in a 42-year-old female in which macroscopic hematuria was the only alarming symptom. The diagnostic and operative issues of this type of tumor are discussed, along with the challenging treatment option of transurethral resection. Diagnosis, treatment and follow-up trends of this rare tumor are reviewed.

Adult↗