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Ymittos Athens, Greece

Komninaka V.,Thalassaemia Center | Kolomodi D.,Laikon General Hospital | Christoulas D.,251 General Air Force Hospital | Marinakis T.,Georgios Gennimatas General Hospital | And 5 more authors.
European Journal of Haematology | Year: 2015

Objective: The aim of this study was to evaluate bone involvement in patients with Gaucher disease (GD) and to propose a novel semi-quantitative magnetic resonance imaging (MRI) staging. Methods: MRI of the lumbar spine, femur, and tibia was performed in 24 patients with GD and 24 healthy controls. We also measured circulating levels of C-C motif ligand-3 (CCL-3) chemokine, C-telopeptide of collagen type-1 (CTX), and tartrate-resistant acid phosphatase isoform type-b (TRACP-5b). Results: We used the following staging based on MRI data: stage I: region of interest (ROI) 1/2 of normal values and bone infiltration up to 30%; stage II: ROI 1/3 of normal values and bone infiltration from 30 to 60%; stage III: ROI 1/4 of normal values and bone infiltration from 60% to 80%; and stage IV: detection of epiphyseal infiltration, osteonecrosis and deformity regardless of the ROI's values. All but two patients had abnormal MRI findings: 9 (37.5%), 6 (25%), 3 (12.5%), and 4 (16.7%) had stages I-IV, respectively. Patients with GD had elevated chitotriosidase, serum TRACP-5b, and CCL-3 levels (P < 0.001). Conclusions: We propose an easily reproducible semi-quantitative scoring system and confirm that patients with GD have abnormal MRI bone findings and enhanced osteoclast activity possibly due to elevated CCL-3. © 2015 John Wiley & Sons A/S. Source


Skoura E.,Evangelismos Hospital | Rondogianni P.,Evangelismos Hospital | Alevizaki M.,Alexandra Hospital | Tzanela M.,Evangelismos Hospital | And 4 more authors.
Nuclear Medicine Communications | Year: 2010

PURPOSE: Many patients with medullary thyroid carcinoma (MTC) have persistently elevated calcitonin levels after initial treatment, indicating disease recurrence. Conventional imaging is often negative or shows equivocal findings. In this study we report our experience with 2-deoxy-2-[F]fluoro-D- glucose positron emission tomography/computed tomography ([F]FDG-PET/CT) in the evaluation of this specific group. Methods: Between February 2007 and May 2009, 38 [F]FDG-PET/CT scans were performed on 32 patients with MTC and elevated calcitonin levels for localization of recurrent disease. Six of these patients had a second [F]FDG-PET/CT scan. Results: Among the 38 [F]FDG-PET/CT scans there were 18 positive and 20 negative scans. Out of the 18 positive scans, 17 were true positive and one false positive. These findings suggest that [F]FDG-PET/CT provides additional information in almost half of all cases (overall per patient sensitivity of 47.4%) but using a serum calcitonin cut-off of 1000pg/ml this rate is increased to 80%. An interesting finding of the study was that none of the six patients with multiple endocrine neoplasia type IIA syndrome had a positive [F]FDG-PET/CT scan for MTC. When these patients were excluded, the overall per patient sensitivity rose to 60% and in patients with calcitonin levels >1000pg/ml this rate increased to 100%. The mean SUVmax of all lesions showing [F]FDG uptake was 3.96±1.61 (range, 2-7). Conclusion: [F]FDG-PET/CT seems to be valuable for the detection of recurrence in patients with highly elevated calcitonin levels and negative conventional imaging findings. In addition, it seems that the sensitivity of [F]FDG-PET/CT may be higher in patients with sporadic or familial MTC than in patients with MTC as part of multiple endocrine neoplasia type IIA syndrome. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Giagtzidis I.,Hippokrateio General Hospital | Karkos C.,Hippokrateio General Hospital | Pitoulias G.,Georgios Gennimatas General Hospital | Papazoglou K.,Hippokrateio General Hospital
International Angiology | Year: 2015

It has been postulated that atherosclerosis should be considered as a chronic inflammatory process and peripheral arterial disease (PAD) is a manifestation of such an atherosclerotic vascular disease. Matrix metalloproteinases (MMPs) are significant circulating biomarkers which play a pivotal role in the initiation, progression and clinical manifestations of PAD. This review summarizes the current body of evidence with regard to the association between MMPs and PAD. Source


Kastritis E.,National and Kapodistrian University of Athens | Zagouri F.,National and Kapodistrian University of Athens | Symeonidis A.,University of Patras | Roussou M.,National and Kapodistrian University of Athens | And 19 more authors.
Leukemia | Year: 2014

Suppression of uninvolved immunoglobulins is common in multiple myeloma (MM) but the prognostic significance of this phenomenon has not been assessed. We evaluated the prognostic significance of the preservation of uninvolved immunoglobulins in 1755 consecutive, unselected, patients with newly diagnosed, symptomatic MM with pre-therapy immunoglobulin levels measured by nephelometry. Suppression of at least one uninvolved immunoglobulin was observed in 87% of patients and was more common in patients with immunoglobulin A myeloma, those aged over 65 years, in patients with advanced-International Staging System (ISS) stage, extensive-bone marrow infiltration, anemia, low platelet counts, high levels of serum M-monoclonal protein or renal dysfunction. Patients with preserved immunoglobulins had a better survival than patients with suppressed immunoglobulins (median survival 55 vs 41.5 months, P<0.001). In multivariate analysis, preservation of uninvolved immunoglobulins was independently associated with better survival (hazard ratio: 0.781, 95% confidence interval: 0.618-0.987, P=0.039); irrespective of the treatment. In a subset of 500 patients, which were strictly followed for disease progression, preservation of uninvolved immunoglobulins was associated with a significantly longer progression-free survival (60 vs 25 months, P<0.001), independently of other common prognostic factors. In conclusion, preservation of uninvolved immunoglobulins in newly diagnosed patients with symptomatic MM was independently associated with long term disease control and improved survival.Leukemia advance online publication, 11 April 2014; doi:10.1038/leu.2014.110. Source


Kastritis E.,National and Kapodistrian University of Athens | Zagouri F.,National and Kapodistrian University of Athens | Symeonidis A.,University of Patras | Roussou M.,National and Kapodistrian University of Athens | And 19 more authors.
Leukemia | Year: 2014

Suppression of uninvolved immunoglobulins is common in multiple myeloma (MM) but the prognostic significance of this phenomenon has not been assessed. We evaluated the prognostic significance of the preservation of uninvolved immunoglobulins in 1755 consecutive, unselected, patients with newly diagnosed, symptomatic MM with pre-therapy immunoglobulin levels measured by nephelometry. Suppression of at least one uninvolved immunoglobulin was observed in 87% of patients and was more common in patients with immunoglobulin A myeloma, those aged over 65 years, in patients with advanced-International Staging System (ISS) stage, extensive-bone marrow infiltration, anemia, low platelet counts, high levels of serum M-monoclonal protein or renal dysfunction. Patients with preserved immunoglobulins had a better survival than patients with suppressed immunoglobulins (median survival 55 vs 41.5 months, P<0.001). In multivariate analysis, preservation of uninvolved immunoglobulins was independently associated with better survival (hazard ratio: 0.781, 95% confidence interval: 0.618-0.987, P=0.039); irrespective of the treatment. In a subset of 500 patients, which were strictly followed for disease progression, preservation of uninvolved immunoglobulins was associated with a significantly longer progression-free survival (60 vs 25 months, P<0.001), independently of other common prognostic factors. In conclusion, preservation of uninvolved immunoglobulins in newly diagnosed patients with symptomatic MM was independently associated with long term disease control and improved survival. © 2014 Macmillan Publishers Limited. All rights reserved. Source

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