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Ymittos Athens, Greece

Mylona S.,Red Cross | Patsoura S.,Red Cross | Galani P.,Amalia Fleming Hospital | Karapostolakis G.,Red Cross | And 2 more authors.
Skeletal Radiology | Year: 2010

Objective To evaluate the efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation for the treatment of osteoid osteomas in common and in technically challenging locations. Materials and methods Twenty-three patients with osteoid osteomas in common (nine cases) and technically challenging [14 cases: intra-articular (n=7), spinal (n=5), metaphyseal (n=2)] positions were treated with CT-guided RF ablation. Therapy was performed under conscious sedation with a seven-array expandable RF electrode for 8-10 min at 80-110°C and power of 90-110 W. The patients went home under instruction. A brief pain inventory (BPI) score was calculated before and after (1 day, 4 weeks, 6 months and 1 year) treatment. Results All procedures were technically successful. Primary clinical success was 91.3% (21 of total 23 patients), despite the lesions' locations. BPI score was dramatically reduced after the procedure, and the decrease in BPI score was significant (P<0.001, paired t-test; n-1=22) for all periods during follow up. Two patients had persistent pain after 1 month and were treated successfully with a second procedure (secondary success rate 100%). No immediate or delayed complications were observed. Conclusion CT-guided RF ablation is safe and highly effective for treatment of osteoid osteomas, even in technically difficult positions.

Mylona S.,Red Cross | Karagiannis G.,Red Cross | Patsoura S.,Red Cross | Galani P.,Amalia Fleming Hospital | And 2 more authors.
CardioVascular and Interventional Radiology | Year: 2012

Purpose To evaluate the safety and efficacy of CT-guided radiofrequency (RF) ablation for the palliative treatment of recurrent unresectable rectal tumors. Materials and Methods Twenty-seven patients with locally recurrent rectal cancer were treated with computed tomography (CT)-guided RF ablation. Therapy was performed with the patient under conscious sedation with a seven- or a nine-array expandable RF electrode for 8-10 min at 80-110°C and a power of 90-110 W. All patients went home under instructions the next day of the procedure. Brief Pain Inventory score was calculated before and after (1 day, 1 week, 1 month, 3 months, and 6 months) treatment. Results Complete tumor necrosis rate was 77.8% (21 of a total 27 procedures) despite lesion location. BPI score was dramatically decreased after the procedure. The mean preprocedure BPI score was 6.59, which decreased to 3.15, 1.15, and 0.11 at postprocedure day 1, week 1, and month 1, respectively, after the procedure. This decrease was significant (p<0.01 for the first day and p<0.001 for the rest of the follow-up intervals (paired Student t test; n - 1 = 26) for all periods during follow-up. Six patients had partial tumor necrosis, and we were attempted to them with a second procedure. Although the necrosis area showed a radiographic increase, no complete necrosis was achieved (secondary success rate 65.6%). No immediate or delayed complications were observed. Conclusion CT-guided RF ablation is a minimally invasive, safe, and highly effective technique for treatment of malignant rectal recurrence. The method is well tolerated by patients, and pain relief is quickly achieved. © Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011.

Tousoulis D.,National and Kapodistrian University of Athens | Koumallos N.,National and Kapodistrian University of Athens | Antoniades C.,National and Kapodistrian University of Athens | Antonopoulos A.S.,National and Kapodistrian University of Athens | And 7 more authors.
American Journal of Hypertension | Year: 2010

Background: Angiotensin type 2 receptor (AT2R), plays a crucial role in blood pressure regulation and atherogenesis. AT2R gene is located on chromosome X and the biological effect of polymorphism A1675G in this gene needs to be further specified. We examined the impact of A1675G on the risk and the severity of coronary artery disease (CAD), and the expression of proatherogenic inflammatory molecules in hypertensive patients. Methods:The study population consisted of 146 with CAD (102 with hypertension) and 266 age-matched individuals without CAD (114 with hypertension). The presence of A1675G polymorphism on AT2R gene was determined by PCR. Serum levels of C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in all the participants. Results:The G allele was associated with decreased risk of CAD among hypertensives (odds ratio (OR) (95% confidence interval (CI))): 0.4 (0.2-0.9), P = 0.01) and less aggressive angiographic CAD (P < 0.001). The G allele was associated with lower IL-6 (median (25-75th percentile): 1.4 (0.6-3.8)), sVCAM-1 (621 (476-799)), CRP (1.2 (0.6-1.7)), and fibrinogen (369 (320-416)) vs. A allele (IL-6: 2.4 (1.1-4.5) P < 0.01, sVCAM-1: 702 (548-925) P < 0.05, CRP: 3.5 (2.0-6.1) P < 0.001, and fibrinogen: 407 (348-514) P < 0.01). The effect of A1675G on serum IL-6, sVCAM-1, and fibrinogen was driven by its effect among hypertensives (IL-6 3.1 (2.1-5.6 in A vs. 1.2 (0.3-3.4) in G P < 0.001, sVCAM-1: 890 (560-1000) in A vs. 556 (377-788) in G P < 0.01, and fibrinogen: 408 (354-510) in A vs. 369 (324-418) in G P < 0.001) whereas it had no effect among nonhypertensives. Conclusions: Genetic polymorphism A1675G on AT2R gene affects cardiovascular risk and the severity of atherosclerosis by modifying systemic inflammation, especially in hypertensive males. © 2010 American Journal of Hypertension, Ltd.

Kakouros N.,Johns Hopkins University | Kakouros S.,Amalia Fleming Hospital | Lekakis J.,National and Kapodistrian University of Athens | Rizos I.,National and Kapodistrian University of Athens | Cokkinos D.,Academy of Athens
Echocardiography | Year: 2011

Background: Ischemic involvement of the right ventricle (RV) can complicate the early course of inferior ST elevation myocardial infarction (IMI) and has significant management implications but its diagnosis is difficult. This study assessed RV involvement in the acute and late phase of IMI by pulse-wave tissue Doppler (PW-TDI) and RV myocardial performance index (RVMPI). Methods: We prospectively evaluated 38 patients with first IMI, of whom 14 had RV involvement and 24 no RV involvement, as defined by ST segment elevation ≥0.1 mV in lead V4R. Thirty age-matched healthy subjects served as controls. Echocardiographic assessment included PW-TDI measurements from the lateral tricuspid annulus with MPI evaluation and was repeated at 6-month follow-up. Results: Peak systolic velocity of the tricuspid annulus, S', was significantly lower and RVMPI higher in patients with RVMI compared to patients without RVMI and controls. Patients with proximal RCA lesion had lower S' and higher RVMPI than patients with distal RCA or left coronary lesion. In the acute setting, the index S'/MPI < 17 was perfectly discriminatory for RV involvement and had moderate sensitivity and specificity (85%, 87%) for identifying proximal RCA disease. S'/MPI < 23 at 6 months had moderate-to-good sensitivity and specificity in identifying patients with previous RVMI. Conclusions: Echocardiographic assessment of the RV by PW-TDI of the lateral tricuspid annulus, with derivation of MPI is a sensitive and specific marker of RV involvement in first IMI and remains so 6 months after the ischemic event. The novel index of S'/MPI appears to have potentially improved diagnostic accuracy in identifying RV involvement and proximal RCA lesion. © 2011, Wiley Periodicals, Inc.

Manolakis A.C.,University of Thessaly | Kapsoritakis A.N.,University of Thessaly | Kapsoritaki A.,Amalia Fleming Hospital | Tiaka E.K.,University of Thessaly | And 6 more authors.
Digestive Diseases and Sciences | Year: 2013

Background: Toll-like receptor (TLR) polymorphisms, and especially TLR-4 Asp299Gly and TLR-4 Thr399Ile, have been linked with Crohn's disease (CD) and to a lesser extent with ulcerative colitis (UC), CD behavior, and compromised seroreactivity to microbial antigens. Available data, however, are conflicting. Aims: To address these issues, the distribution of TLR-4 polymorphic alleles was assessed in patients with UC, CD, and healthy controls (HC), considering patient and disease characteristics as well as related serological markers. Methods: TLR-4 Asp299Gly and TLR-4 Thr399Ile polymorphisms were determined in 187 UC and 163 CD patients and 274 randomly selected HC. C reactive protein, anti-Saccharomyces cerevisiae mannan antibodies, anti-mannobioside carbohydrate antibodies, anti-laminariobioside carbohydrate antibodies IgG, and anti-chitobioside carbohydrate antibodies (ACCA) IgA levels were also assessed. Results: UC and especially pancolitis patients carried the mutant alleles more frequently compared to CD patients and HC or UC patients with different disease extents (P = 0.002 and P < 0.0001, respectively). Involvement of the colon was more frequent in CD patients with mutant TLR-4 compared to those with wild-type alleles (P = 0.004). Levels and positivity rates of ACCA IgA were lower in inflammatory bowel disease (IBD) patients carrying the mutant compared to those with wild-type alleles (0.075 < P < 0.05). Despite the mutant TLR-4 predisposition for UC pancolitis, smoking was associated with more limited disease (P < 0.001). Conclusions: The presence of TLR-4 Asp299Gly and TLR-4 Thr399Ile polymorphisms is related to UC pancolitis, involvement of the colon in CD, and lower ACCA IgA levels. Smoking reduces the extent of UC, even in the presence of mutant alleles. © 2012 Springer Science+Business Media, LLC.

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