A Gouliamos

Athens State University, Athens, Alabama, United States

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Publications (100)149.87 Total impact

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    ABSTRACT: Background: Hypofractionated Radiotherapy (RT) regimens for breast cancer, although reduce cost and time for patients and health care systems, could have a negative impact on normal underlying lung tissue. We studied and compared lung function and the post-RT radiological changes using High-Resolution Computed Tomography (HRCT) in early breast cancer patients, treated with 3-Dimentional conformal whole breast radiotherapy (WBRT) using either conventional or hypofractionated regime. Patients and Methods: Between 2008 and 2009, 61 early breast cancer patients (T1-2N0M0) were randomised into two groups .Group A (n=31) received standard radiotherapy with 50Gy/25f/5w plus boost 10Gy/5f/1w to tumour bed. Group B (n=30) received 43.2Gy/16f/22d plus boost 10Gy/5f/1w to tumour bed. Patients of both groups were subjected to dynamic lung testing, using spirometry and gas diffusion tests on Day 0 (D0, before RT), during RT and after completion of RT at 3 and 6 months. HRCT scans were performed in all patients at baseline, and 3,6,12 months after completion of RT. Respiratory symptoms were recorded at 3 and 6 months post completion of RT. Dosimetric factors, such as Central Lung Dose (CLD), lung Volume receiving more 20 Gy (V20), D25 and Mean Lung Dose (MLD) were calculated for all patients. Results: At 3 months after RT, the pulmonary changes were classified at HRCT as follows: 91.8 % were Grade 0, 8.19 % Grade 1, and 0 % Grade 2. At 6 months, 86.98 % were Grade 0, 11.47 % Grade 1, and 1.6 % Grade 2. At 12 months, 88.52 % were Grade 0, 9.19 % Grade 1 and 3.27% Grade 2. Univariate analysis showed strong association between radiation pneumonitis, age and all dosimetric parameters. There was no association between fractionation type and incidence of RN. FEV1, FVC, FEV 25, FEV 50 and DLCO showed no statistically significant reduction in both treatment groups in 3 and 6 months following completion of RT, compared to baseline. Multivariate analysis showed no relation between HRCT findings and other variables (age, smoking, chemotherapy, hormonotherapy, V20). Conclusion: Lung toxicity, as assessed with HRCT and PFTs, was minimal in both treatment arms and our results are in consistency with other published data. Hypofractionated RT was a safe modality and well tolerated by the majority of the patients. Longer follow-up is required for robust assessment of incidence of late lung fibrosis in our series.
    Hippokratia 07/2013; 17(3):233-8. · 0.59 Impact Factor
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    ABSTRACT: Background: In this report, we investigated the prognostic value of the cell cycle analysis parameters of patients with unresectable locally advanced head and neck squamous carcinoma treated with two different radiotherapy regimens. The secondary endpoint was the evaluation of quality of life before and after radiotherapy in both schedules. Methods: Twenty two patients were randomized to receive either conventional (70 Gy/2 Gy/fr) or accelerated (64.4 Gy/2.3Gy/fr) 3-D Conformal RT. A fine-needle aspiration (FNA) of the primary or gross adenopathy combined with flow cytometry was carried out before any treatment. QLQ-H&N35 questionnaire was assessed in all patients, performed at baseline and a week after radiotherapy. Results: Finally, specimens from only nine patients were eligible for flow cytometry. The spearman rho correlation showed no statistical significance between the expression malignant cells in the different cell cycle phases and overall survival, except a trend in S phase (rho= -0.54, P=0.088). A significant (p < 0.05, Wilcoxon test) better outcome (pre vs post-RT) was observed in the scales of global QoL H&N 35 at 29 out of the 35 scales in both RT schedules. No statistical difference was found in QoL H&N 35 scales for conventional versus accelerated schedule of radiotherapy (P>0.05, Mann Whitney test). No difference in survival was noted between the two groups (P=0.92, log-rank test). Acute and late radiation induced toxicity was also equivalent in both schedules. Conclusions: This study identified that both radiotherapy arms were equivalent in terms of QoL and toxicity. The number of cells in S phase correlated negatively but not-significantly with overall survival. A statistical significant improvement of quality of life was observed one month after the end of irradiation in both arms. More patients with eligible for analysis specimens are needed for the extraction of safe results.
    Head & Neck Oncology 04/2013; 5(4):36. · 3.13 Impact Factor
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    ABSTRACT: Radionuclides have been long used for the palliation of skeletal-related metastatic pain. They are almost invariably used as the last resource for pain palliation. Their use as single agents with dose escalations, in combination with biphosphonates or chemotherapy is well known in the peer-reviewed literature; however, little is known about the combination between different agents. In our study, we used consecutive administration of 2 different radionuclides such as (186)Re-1,1-hydroxyethylidenediphosphonate ((186)Re-HEDP) and (89)Strontium Chloride ((89)Sr-Cl) separated by adequate period of time to allow bone marrow recovery in patients with high chance of bone pain relapse and compared it with (89)Sr-Cl and chemotherapy group and (186)Re-HEDP with bisphosphonates. The end result was that treatment with consecutive radionuclides was much more effective and safe than the other 2 groups.
    The American journal of hospice & palliative care 12/2012;
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    ABSTRACT: Aim: Aim of this study was to evaluate the effectiveness of non-carrier added (n. c. a.) [177Lu]DOTA-TATE in inoperable liver metastases, positive for sst2 receptor overexpression (verified by Octreoscan and confirmed by biopsy) due to neuroendocrine gastroenteropancreatic (GEP) tumors. [177Lu]DOTA-TATE has been infused after selective catheterization of the hepatic artery, minimising in parallel the toxicity of non-target tissues. Methods: The dose per session administered to each patient (12 cases in total) was 7400 MBq (200 mCi). Repetitions did not exceed 6-fold with treatment intervals of 5-8 weeks. Response assessment was classified according to the therapeutic benefit. Absorbed doses delivered to metastases, kidneys and red marrow were calculated according to OLINDA 1.1 program and the derived values were correlated to the Response Evaluating Criteria in Solid Tumors (RECIST). CT/MRI scans were performed as baseline before, during and after the end of treatment and monthly ultrasound images for follow-up estimation and measurements. Toxicity (World Health Organization criteria) was measured using blood and urine tests of renal, hepatic and bone marrow function. Results: None of the patients resulted complete response (0.0%); partial response was assessed in 8 (66.7%), disease stabilization in 3 (25%) and progressive disease in 1(8.3%). A 14-month median survival time was estimated for all patients, so far. Eight of 12 (66.7%) showed a mean target diameter shrinkage ranging from 33% to 45%. The organ average radiation dose estimation was found as follows: a) liver tumor 20.8 mGy/MBq; b) liver 0.14 mGy/MBq; c) kidneys 0.41 mGy/MBq; d) spleen 1.4 mGy/MBq; and f) bone marrow 0.022 mGy/MBq. The average absorbed dose per session to a tumor for a spherical mass of 20 g was estimated to be 20.8 mGy/MBq, depending on the histotype of the tumor. WHO toxicity grade 2 to 3 erythro-, leuko- and thrombo-cytopenia occurred in 9 (75%) cases observed about after the third session. Conclusion: In unresectable metastatic liver lesions positive for somatostatin receptors repeated, trans-hepatic high doses of [177Lu]DOTA-TATE resulted in a more than promising therapeutic outcome with a partial response in 75% of the treated patients. Given the loco-regional modality character of the administration technique, no nephro-toxicity has been so far observed whereas a remarkable myelotoxicity was noticed.
    The quarterly journal of nuclear medicine and molecular imaging: official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... 12/2012; 56(6):551-8. · 1.92 Impact Factor
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    ABSTRACT: Purpose: To investigate the differences in anxiety and self-efficacy beliefs as well as the sociodemographic and clinical characteristics, between cancer and chronically-ill patients. Methods: A total of 175 patients from a pain relief and palliative care unit participated in this study. Patient sociode-mographic and clinical characteristics were recorded. Patients completed the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI) and the Greek version of the General Perceived Self-Efficacy Scale (GSE). Results: No statistically significant differences were found between the two patient populations regarding self-efficacy. Statistically significant differences were found between chronically-ill and cancer patients in the scales of "emotionality" (p<0.0005), and "self-deprecation" (p<0.0005). Statistically significant negative correlations were found between all STAI scales and self-efficacy for both cancer and chronically-ill patients (r ranged from -0.231 to -0.503). Conclusion: Chronically-ill patients experienced increased anxiety compared to cancer patients. Self-efficacy had a significant negative correlation with anxiety between the two groups of patients.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 10/2012; 17(4):785-790. · 0.76 Impact Factor
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    ABSTRACT: MYSTAKIDOU K., PARPA E., PANAGIOTOU I., TSILIKA E., GALANOS A. & GOULIAMOS A. (2012) European Journal of Cancer Care Caregivers' anxiety and self-efficacy in palliative care This study examined the relationship between caregivers' anxiety supporting a patient with advanced cancer and self-efficacy and their socio-demographic characteristics, and then whether these variables could influence their self-efficacy. One hundred and seven caregivers of advanced cancer patients participated in the study and completed the Greek versions of the State-Trait Anxiety Inventory (STAI) and the General Perceived Self-efficacy Scale (GSE). Significant comparisons were found between State anxiety and female gender (P= 0.009), cohabitation (P= 0.002) and relationship with the patient (P= 0.004); statistically significant associations were found between State, Trait anxiety and self-efficacy scores of caregivers (P < 0.0005 respectively). A multiple regression model (enter method) showed women (P= 0.005), spouses (P= 0.01) and self-efficacy (P= 0.02) as the significant predictors of State anxiety. Furthermore, self-efficacy seemed to be the strongest contributor of trait anxiety (P < 0.0005). Female caregivers and spouses of advanced cancer patients experience more state anxiety levels than men and other caregivers respectively. In addition, caregivers with low self-efficacy are more likely to have elevated anxiety scores than self-efficacious caregivers. These findings can help healthcare professionals focus on some problems common to caregivers of cancer patients and plan appropriate interventions.
    European Journal of Cancer Care 09/2012; · 1.31 Impact Factor
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    ABSTRACT: To illustrate quantitative discomanometry's (QD) diagnostic efficacy and predictive value in discogenic-pain evaluation in a prospective study correlating intradiscal pressure values with pain reduction after percutaneous image-guided technique (i.e., percutaneous decompression, PD). During the last 3 years, 36 patients [21 male and 15 female (mean age 36 ± 5.8 years)] with intervertebral disc hernia underwent QD before PD. Under absolute sterilization and fluoroscopy, a mixture of contrast medium and normal saline (3:1 ratio) was injected. A discmonitor performed a constant rate injection and recorded pressure and volume values, thus producing the relative pressure-volume curve. PD was then performed. Pain reduction and improved mobility were recorded at 3, 12, and 24 months after PD using clinical evaluation and a numeric visual scale (NVS; 0 to 10 units). Mean pain values of 7.5 ± 1.9 (range 4 to 8) NVS units were recorded before PD; these decreased to 2.9 ± 2.44 at 3 months, 1.0 ± 1.9 at 12 months, and 1.0 ± 1.9 NVS units at 24 months after PD. Recorded correlations (pressure, volume, significant pain-reduction values) with bilateral statistical significance included a maximum injected volume of 2.4 ml (p = 0.045), P (o) < 14 psi [initial pressure required to inject 0.1 ml of the mixture inside the disc (p = 0.05)], P (max) ≤ 65 psi [greatest pressure value on the curve (p = 0.018)], and P (max) - P (o) ≤ 47 psi (p = 0.038). Patients meeting these pressure or volume cut-off points, either independently or as a total, had significant pain reduction (>4 NVS units) after PD. No complications were noted. QD is an efficient technique that may have predictive value for discogenic pain evaluation. It might serve as a useful tool for patient selection for intervertebral disc therapies.
    CardioVascular and Interventional Radiology 08/2011; 35(5):1145-53. · 2.09 Impact Factor
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    ABSTRACT: This study aimed to describe a spectrum of magnetic resonance (MR) imaging findings in a case series of four patients with recurrent vertebral hydatid disease (HD). Four patients with recurrent spinal HD, who were studied with MR imaging at 1.5T or 0.5T MR units, were encountered during a ten-year period. All patients had a history of repeated spinal surgery for hydatid resection. HD involving the lumbar spine was found in two patients, the thoracolumbar spine in one patient and the lumbosacral in one patient. Skip lesions were seen in one patient. All patients had extensive involvement of the extradural space, soft tissues of the back and posterior vertebral elements. HD involving the vertebral body, intervertebral disk and iliopsoas muscles were noted in three, two and three patients, respectively. Bone and extradural hydatids were typically small, and appeared hypointense on T1-weighted images, with a mildly enhancing rim on post-contrast T1-weighted images. Sacral hydatid was an expansile multicystic process. Muscle hydatids were large, surrounded by a gadolinium-enhancing rim and assumed a variety of patterns - either multilocular or a nonspecific inhomogenous cystic or dumbbell configuration. MR imaging is a valuable diagnostic tool for follow-up of patients with vertebral HD. Recurrent HD is characterised by extensive involvement of soft tissues of the back and extradural space. Extension into the intervertebral disk and iliopsoas muscles and skip lesions in the extradural space are not uncommon.
    Singapore medical journal 06/2011; 52(6):440-5. · 0.63 Impact Factor
  • Radiotherapy and Oncology 03/2011; 98:S41. · 4.52 Impact Factor
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    ABSTRACT: Radiotherapy is widely used to treat patients with prostate cancer. Using conventional x-ray simulation is often difficult to accurately localize the extent of the tumor, to cover exactly the lymph nodes at risk and shield the organs at risk. We report on the results of a study comparing target localization with conventional and virtual simulation. One hundred prostate cancer patients underwent both conventional and virtual simulation. The conventional simulation films were compared with digitally reconstructed radiographs (DDRs) produced from the computed tomography (CT) data. All patients underwent target localization for radical prostate radiotherapy. The treatment fields were initially marked with a conventional portal film on linear accelerator (LINAC), plain x-ray film and available diagnostic imaging. Each patient then had a CT and these simulated treatment fields were reproduced within the virtual simulation planning system. The treatment fields defined by the clinicians using each modality were compared in terms of field area and implications for target coverage. Virtual simulation showed significantly greater clinical tumor volume coverage and less normal tissue volume irradiated compared with conventional simulation (p <0.001). CT localization and virtual simulation allow more accurate definition of the clinical target volume. This could enable a reduction in geographical misses, reducing at the same time treatment-related toxicity.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 01/2011; 16(2):309-15. · 0.76 Impact Factor
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    ABSTRACT: Gastrointestinal side effects can often complicate radiotherapy (RT) in cancer patients. This work presents results of a retrospective open label study aiming to evaluate the optimum prophylactic treatment for nausea and vomiting in patients receiving fractionated radical or palliative RT. 576 cancer patients were allocated in 5 treatment groups: 120 patients received tropisetron, 129 tropisetron plus dexamethasone, 101 metochlopramide, 119 dexamethasone, and 107 received metochlopramide plus dexamethasone. To determine the optimum antiemetic prophylactic treatment, nausea and vomiting were evaluated at baseline, 24 and 72 h after the initiation of RT, and at the end of every week during RT. Adverse effects, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and the intensity of nausea and vomiting were recorded. Statistically significant differences in incidence and intensity of nausea and vomiting were found among the 5 antiemetic treatment groups from the 1st till the 5th week of the RT. Tropisetron + dexamethasone group had significantly reduced odds for nausea and vomiting, and significantly less severe nausea and vomiting than any other treatment group. Factors significantly associated with increased ECOG PS were palliative RT, dose fraction >3Gy, field size >200 cm(2), and treatment with metochlopramide, metochlopramide+dexamethasone and dexamethasone. Patients receiving prophylactic antiemetic treatment with tropisetron+dexamethasone completed RT with lower intensity of nausea and vomiting and lower ECOG PS scores compared to groups that received other antiemetic treatments.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 01/2010; 15(1):29-35. · 0.76 Impact Factor
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    ABSTRACT: To prospectively evaluate the predictive value of various bone formation and resorption markers in patients with bone metastases from prostate cancer after palliative treatment with (186)Re-1,1-hydroxyethylidene diphosphonate ((186)Re-HEDP). Included in the study were 36 men with prostate cancer, suffering from painful osseous metastases and treated with (186)Re-HEDP. None had received any treatment that would have interfered with bone metabolism before (186)Re-HEDP treatment or throughout the follow-up period. For each patient, pretreatment and posttreatment serum levels of osteocalcin (OC), bone alkaline phosphatase (BALP), aminoterminal (PINP) and carboxyterminal (PICP) propeptides of type I collagen, amino-terminal (NTx) and carboxyterminal (CTx) telopeptides of type I collagen and their combinations were compared with the level and duration of pain response to radionuclide treatment. Pain response was correlated only with pretreatment NuTaux/PINP, PICP/PINP and NTx/CTx ratios and posttreatment decrease in baseline NTx and PICP values (p = 0.0025-0.035). According to multivariate and ROC analyses, the best marker-derived predictors of better and longer duration of response to (186)Re-HEDP treatment were a posttreatment decrease in NTx of > or = 20% (RR = 3.44, p = 0.0005) and a pretreatment NTx/PINP ratio of > or = 1.2 (RR = 3.04, p = 0.036) NTx, a potent collagenous marker of bone resorption, along with the novel NTx/PINP ratio provide useful cut-off values for identifying a group of patients suffering from painful osseous metastases from hormone-refractory prostatic carcinoma who do not respond to palliative treatment with (186)Re-HEDP. This information could help avoid an inefficient and expensive radionuclide treatment. Also, in the cohort of patients who will eventually undergo such treatment, the medium-term posttreatment changes in NTx offer valuable predictive information regarding long-term palliative response.
    European Journal of Nuclear Medicine 08/2009; 37(1):103-13. · 4.53 Impact Factor
  • Journal of Clinical Densitometry - J CLIN DENSITOM. 01/2009; 12(1):105-105.
  • Ejc Supplements - EJC SUPPL. 01/2009; 7(2):297-298.
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    ABSTRACT: Squamous cell carcinoma of the head and neck (SCCHN) region is among the most frequent human tumors due to the alcohol and tobacco abuse. Its management has evolved gradually from surgery as the mainstay of therapy to irradiation as the principal treatment. When radiation therapy is combined with chemotherapy, additional benefit is obtained. The value of chemoradiotherapy (CRT) is, however, counterbalanced by increased and often prohibitive toxicity, particularly among patients with coexisting medical conditions and decreased performance status. A member of the ErbB family of receptor tyrosine kinases known as the epidermal growth factor receptor (EGFR) is abnormally activated in epithelial cancers, including head and neck cancers. Overexpression of EGFR is a feature associated with poor clinical outcome. It is observed that radiation increases the expression of EGFR in cancer cells and the blockade of EGFR signaling sensitizes cells to the effects of radiation. The cytotoxic effects of radiation therapy in squamous cell carcinoma could be enhanced by cetuximab (erbitux), a monoclonal antibody against the ligand-binding domain of EGFR. The major studies that focus on the efficacy of adding cetuximab to radiotherapy in the treatment of patients with head and neck cancer and its impact in quality of life are reviewed in this study.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 01/2009; 14(1):19-25. · 0.76 Impact Factor
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    ABSTRACT: Young, normotensive, and non-obese women with polycystic ovary syndrome (PCOS) may present abnormal hemodynamic alterations (HA). The purpose of this study was to investigate heart rate (HR), intima-media thickness (IMT), and diameter (DCCA) in the common carotid arteries (CCA), flow velocities, and resistance index in both extracranial carotid and vertebral arteries (VA), in the abdominal aorta (AO) and in the renal arteries (RA) in PCOS women and matched controls. This was a case-control study conducted at a tertiary University Hospital. We studied 53 PCOS women and 53 healthy matched volunteers as controls. The previously reported parameters were assessed using color Doppler ultrasonography. HR, IMT in the CCA, and peak systolic velocity in all examined arteries were significantly increased in PCOS women compared to controls. On the contrary, DCCA was significantly decreased in PCOS women compared to controls. End diastolic velocity (EDV) in both VA and RA, in the AO and in the left extracranial carotid system was significantly increased in the PCOS group compared to controls. Furthermore, the peripheral resistance (PR) of AO and right external carotid artery was also found to be increased while in both RA and in left VA, PR was decreased. No further statistical significant HA in EDV and PR were noted. The results of this study provide evidence for a mild hyperdynamic circulation in young, normotensive, non-obese women with PCOS compared to controls, indicating a mild sympathetic activation at an early age, which may be an underlying cause of hypertension and cardiovascular risk.
    Journal of endocrinological investigation 12/2008; 31(11):1001-7. · 1.65 Impact Factor
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    ABSTRACT: We aimed to carry out a systematic assessment of gray-scale and color Doppler ultrasonography (CDUS) findings of reactivated post-traumatic/postoperative chronic osteomyelitis (COM) in adults. Gray-scale and color Doppler ultrasonography were performed on 40 consecutive patients with a history of long-standing post-traumatic/post-operative chronic osteomyelitis and clinical suggestion of reactivation, in a 32-month-period. All patients had metallic implants: 16 internal fixations, nine external fixations, 11 hip arthroplasties and four knee arthroplasties. The final diagnosis of reactivated COM was based upon biopsy findings, with microbiological and histological examination (n = 27), or a combination of laboratory, clinical and magnetic resonance (MR) findings (n = 13). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of sonographic signs, including fistulous tracts, periosteal thickening, cortical discontinuity, soft tissue abscess and cellulitis, juxtacortical fluid, distension of the pseudocapsule in arthroplasties, and periosteal vascularity, were estimated. Statistically significant differences between patients with and without reactivated COM were found for fistulous tracts (P < 0.0001), juxtacortical fluid collections (P < 0.001) periosteal thickening (P < 0.01), distension of pseudocapsule (P < 0.05), and periosteal vascularity (P < 0.0001). Low-resistance arterial flow of periosteal vessels presented the highest sensitivity (92%), specificity, and PPV (100%), yielding only two false negative results in two obese patients. Among gray-scale findings, the presence of a fistulous tract yielded the highest specificity and PPV (100%), whereas periosteal thickening was the most sensitive (92%), though not specific, finding (specificity 50%). A constellation of gray-scale and CDUS findings can be highly indicative of reactivated bone infection in patients with long-standing chronic post-traumatic/post-operative osteomyelitis.
    Skeletal Radiology 12/2008; 38(4):363-9. · 1.74 Impact Factor
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    ABSTRACT: The aim of this study is to evaluate effectiveness of interstitial magnetic resonance lymphography as an examination for the depiction of the lymphatic system in humans by comparison with direct x-ray lymphography. We studied 14 subjects (two volunteers and 12 patients with clinical suspicion of lymphedema of the lower extremities). We first administered subcutaneous gadobutrol between the toes and performed MR lymphography. After seven days, we injected lipiodol into the lymph vessels of 8 patients and performed x-ray direct lymphography to compare findings of two methods. We identified the normal lymphatic system (lymph vessels and inguinal lymph nodes) of volunteers. In seven subjects, we were able to image an abnormal lymphatic system with decreased number of lymph vessels, lymphoceles, and ectatic lymph vessels. In three subjects we identified both an abnormal lymphatic and venous system and in two patients only the venous system. In all cases x-ray direct lymphography confirmed the findings of the MR lymphography. No side effects were observed from either contrast agent. We expect that in the future, interstitial MR lymphography will be improved and evolve into a valuable diagnostic tool for the evaluation of lymphatic diseases particularly those who present with primarily lymphedema in the lower limbs or second, in regions other than extremities.
    Lymphology 10/2008; 41(3):116-25. · 1.02 Impact Factor
  • Regional Anesthesia and Pain Medicine 09/2008; 33. · 3.46 Impact Factor
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Regional Anesthesia and Pain Medicine 08/2008; 33(5):e241. · 3.46 Impact Factor

Publication Stats

583 Citations
149.87 Total Impact Points

Institutions

  • 1990–2012
    • Athens State University
      Athens, Alabama, United States
  • 2009
    • Attikon University Hospital
      Athínai, Attica, Greece
  • 2002
    • National and Kapodistrian University of Athens
      Athínai, Attica, Greece
  • 2000
    • University of Crete
      Retimo, Crete, Greece
  • 1998
    • Κωνσταντοπούλειο νοσοκομείο Νέας Ιωνίας (Η Αγία Όλγα)
      Athínai, Attica, Greece
  • 1997–1998
    • Eginition Hospital Athens
      Athínai, Attica, Greece