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Tsirakis G.,University Hospital of Heraklion | Pappa C.A.,Venizelion General Hospital of Heraklion | Kolovou A.,General Hospital of Chania | Kokonozaki M.,University Hospital of Heraklion | And 2 more authors.
Hematology | Year: 2015

Objective: Interleukin-22 (IL-22) is a cytokine participating in many aspects of inflammation. Multiple myeloma (MM) is a malignant disease of plasma cells with characteristic immune deregulation. We estimated serum levels of IL-22 in MM patients, both in activity and remission, in order to apprehend its possible participation in MM biology. Methods: We measured serum levels of IL-22 along with beta-2 microglobulin (B2M), paraprotein, and interleukin-1beta (IL-1beta), as well as degree of bone marrow infiltration, in 51 patients with active MM and in 22 of them in remission. Results: We found that IL-22 was higher in active MM patients, compared to both controls and patients in remission, and also in patients in remission compared to controls. Moreover, IL-22 was increasing in parallel with the disease stage and also correlated with B2M, IL1-beta, and degree of infiltration. Discussion:We suggest that the elevated levels of IL-22 in active MMpatients, in parallel with disease activity, and in positive correlation with IL-1beta, may represent the inflammatory element of the disease. This increased occurrence of IL-22 may enhance myeloma proliferation and growth, and moreover, may participate in the mechanisms of immune deregulation. © W. S. Maney & Son Ltd 2015.

Pappa C.,Venizelion Hospital of Heraklion | Alexandrakis M.,University Hospital of Heraklion | Boula A.,Venizelion Hospital of Heraklion | Psarakis F.,University Hospital of Heraklion | And 4 more authors.
Hematological Oncology | Year: 2013

Angiogenesis is an essential process for the expansion of multiple myeloma (MM), in which many angiogenic factors participate. Endoglin (CD105) is a transforming growth factor-β co-receptor, being mainly expressed in angiogenic endothelial cells and has been used as a marker of tumor angiogenesis, having prognostic potential. The aim of the study was to evaluate serum levels of soluble CD105 (sCD105) in MM patients, both during diagnosis and after effective conventional chemotherapy, in the plateau phase, and to correlate them with the clinical stage of the disease, as well as with the known angiogenic factors vascular endothelial growth factor, angiogenin and interleukin-18 (IL-18). Serum levels of the aforementioned factors were measured, by enzyme-linked immunosorbent assay, in 56 newly diagnosed MM patients, in 35 of them who entered plateau phase and in 24 healthy controls. Bone marrow aspirations were also performed in all patients to determine plasma cell infiltration. All measured cytokines were higher in MM patients compared with controls and with advancing disease stage (p<0.001 for all cases). Furthermore, the values of all factors decreased significantly in the plateau phase (p<0.001 for all cases). Serum levels of sCD105 correlated with the other angiogenic cytokines, whereas only serum levels of angiogenin had prognostic value for the survival. In conclusion, CD105 and the angiogenic cytokines vascular endothelial growth factor, angiogenin and IL-18, seem to have emerging roles both in angiogenesis and tumor growth in MM. © 2013 John Wiley & Sons, Ltd.

Chaidas K.S.,General Hospital of Volos | Kaditis A.G.,National and Kapodistrian University of Athens | Papadakis C.E.,General Hospital of Chania | Papandreou N.,General Hospital of Volos | And 2 more authors.
Laryngoscope | Year: 2013

Objectives/Hypothesis Adenoidectomy and tonsillectomy (TE) is the standard treatment for obstructive sleep-disordered breathing (SDB) in children with adenotonsillar hypertrophy. Tonsilloplasty (TP) is a new surgical technique that includes partial TE. The purpose of this study was to assess the short- and long-term outcomes of TP compared to TE. Study Design A comparison study. Methods Children with SDB and tonsillar hypertrophy underwent TP or TE. The two groups were compared regarding immediate postoperative course and long-term effects. Results Fifty-one children (age, 6.3 ± 2.5 years) underwent TE, and 50 children (age, 5.9 ± 2.1 years) had TP. The TP group had significantly less intraoperative bleeding compared to the TE group (25.6 ± 8.2 vs. 38.3 ± 12.3 mL, P <.001). Subjects with TP were pain free earlier than children with TE (4.5 ± 0.4 vs. 7.7 ± 0.4 days, P <.001) and returned to a normal diet sooner (3.8 ± 0.2 vs. 7.1 ± 0.3 days, P <.001). By the 3rd to 4th postoperative night, upper airway obstruction was relieved in all participants. Six years postoperatively, 48 of 51 children in the TE group and 43 of 50 children in the TP group participated in a telephone survey. No significant differences were found between the two groups regarding the frequency of recurrent snoring (30.2% in TP vs. 25% in TE), apneas (4.7% vs. 0%), and upper airway infections per year (P >.05). Conclusions TP is an alternative surgical method for treatment of SDB related to tonsillar hypertrophy with favorable postoperative course and comparable long-term results. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Philippakis G.E.,Jilin Heart Hospital | Moustardas M.,General Hospital of Chania
International Journal of Surgery Case Reports | Year: 2013

INTRODUCTION: Primary aortoenteric fistula is a rare clinical situation with a high mortality rate. One should suspect that condition when an abdominal aortic aneurysm is known to be present. We describe the case of a 60 year old man who presented with upper gastrointestinal bleeding as the first and sole manifestation of an abdominal aortic aneurysm, due to the rupture of the aneurysm in the jejunum. PRESENTATION OF CASE: The patient was admitted with hematemesis and melena. He reported no abdominal pain. Upper gastrointestinal endoscopy disclosed no bleeding or lesions of the stomach and duodenum. Bleeding stopped the following day, only to recur 4 days later. The patient was then subjected to abdominal CT scan, which revealed the presence of a subrenal aortic aneurysm, with fistulization to the small intestine. At laparotomy the aortic aneurysm was adherent to the first centimeters of jejunum. The diseased aorta was excised and replaced with a Dacron Y graft in situ. DISCUSSION: Primary aortojejunal fistulas are only rarely encountered. They usually are the result of a nonspecific aneurysm of the abdominal aorta. They usually manifest with premonitory bleeding, followed by catastrophic hemorrhage few days later. Even with surgery the mortality rate is high. CONCLUSION: Diagnosis of primary aortoenteric fistula requires a high index of suspicion in cases of upper gastrointestinal bleeding, especially when endoscopy is negative and there is no knowledge of the existence of an abdominal aortic aneurysm. CT scan and prompt surgery are crucial to the survival of these patients. © 2013 Surgical Associates Ltd.

Kounelakis M.G.,Technical University of Crete | Zervakis M.E.,Technical University of Crete | Giakos G.C.,University of Akron | Postma G.J.,Radboud University Nijmegen | And 2 more authors.
IEEE Journal of Biomedical and Health Informatics | Year: 2013

The proposed analysis considers aspects of both statistical and biological validation of the glycolysis effect on brain gliomas, at both genomic and metabolic levels. In particular, two independent datasets are analyzed in parallel: one engaging genomic (microarray expression) data and the other metabolomic (magnetic resonance spectroscopy imaging) data. The aim of this study is twofold. First to show that, apart from the already studied genes (markers), other genes such as those involved in the human cell glycolysis significantly contribute in gliomas' discrimination. Second, to demonstrate how the glycolysis process can open new ways toward the design of patient-specific therapeutic protocols. The results of our analysis demonstrate that the combination of genes participating in the glycolytic process (ALDOA, ALDOC, ENO2, GAPDH, HK2, LDHA, LDHB, MDH1, PDHB, PFKM, PGI, PGK1, PGM1, and PKLR) with the already known tumor suppressors (PTEN, Rb, and TP53), oncogenes (CDK4, EGFR, and PDGF), and HIF-1 enhance the discrimination of low- versus high-grade gliomas, providing high prediction ability in a cross-validated framework. Following these results and supported by the biological effect of glycolytic genes on cancer cells, we address the study of glycolysis for the development of new treatment protocols. © 2011 IEEE.

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