George Zografos

Publications (46)87.22 Total impact

• Article: Self-Locking First Stitch in Suture Reinforcement of the Laparoscopic Gastric Sleeve.

  Konstantinos Albanopoulos, Ioannis Flessas, George Zografos, Emmanuel Leandros
  Obesity Surgery 04/2013; · 3.29 Impact Factor
• Article: Incidence, Risk Factors, and Outcome of Portal Vein Thrombosis After Laparoscopic-Assisted Splenectomy in β-Thalassemia Patients: A Prospective Exploratory Study.

  Nicholas Alexakis, Dimitrios Dardamanis, Konstandinos Albanopoulos, Nikolaos Ptohis, Maria Skalistira, Markisia Karagiorga, George Zografos, Emmanuel Leandros
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  ABSTRACT: Abstract Background: Portal vein system thrombosis (PVT) is an infrequent but potentially serious complication after laparoscopic splenectomy. Patients with β-thalassemia are at higher risk as they have splenomegaly and hypercoagulability. Subjects and Methods: Forty-eight β-thalassemia patients who underwent hand-assisted laparoscopic splenectomy or laparoscopic splenectomy were studied prospectively with pre- and postoperative Doppler ultrasonography or computed tomography scanning. Results: The incidence of PVT was 8.3% (95% confidence interval [CI] 0.2%-16.4%) (4 of 48 patients). Spleen weight was the only independent factor associated with the presence of PVT. The odds ratio for spleen weight (100 g increase) was 1.46 (95% CI 1.10-1.94, P=.010). Receiver operator characteristic curve analysis showed that the optimal cutoff of spleen weight to the prediction of PVT was 1543 g. Thrombosis resolution was observed after a median of 165 days. Conclusions: Patients with β-thalassemia who undergo laparoscopic-assisted splenectomy are at high risk of postoperative PVT. Close postoperative surveillance and aggressive coagulation prophylaxis are needed in these patients. Larger studies are required to confirm the present findings.
  Journal of Laparoendoscopic & Advanced Surgical Techniques 01/2013; · 1.40 Impact Factor
• Article: C-reactive protein, white blood cells, and neutrophils as early predictors of postoperative complications in patients undergoing laparoscopic sleeve gastrectomy.

  Konstantinos Albanopoulos, Leonidas Alevizos, Maria Natoudi, Dimitrios Dardamanis, Evangelos Menenakos, Konstantinos Stamou, George Zografos, Emmanuel Leandros
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  ABSTRACT: BACKGROUND: Early detection and treatment of complications after laparoscopic sleeve gastrectomy (LSG) are mandatory. This study aimed to evaluate C-reactive protein (CRP), white blood cell (WBC) count, and neutrophil (NEU) count in relation to the early diagnosis of major surgical complications after LSG. METHODS: A prospective study of 177 patients who underwent LSG during 2008-2011 was performed. Measurements of WBC, NEU, and CRP performed on postoperative days 0, 1, 3, 5, 7, 9, 11, 13, and 30 were correlated with postoperative surgical complications. RESULTS: Both WBC and NEU were correlated with leak or abscess on postoperative days 3, 5, 7, 9, and 11, whereas on day 1, only NEU was significantly increased. Elevated CRP was correlated with leak or abscess on all the days (p < 0.001). The parameters measured were not correlated with postoperative bleeding unless leak or abscess coexisted. According to receiver operating characteristic (ROC) analysis, CRP detected leak or abscess with remarkably higher sensitivity and specificity than WBC or NEU on all the days. Moreover, the area under the curve (AUC) of CRP was higher than the AUC of WBC or NEU, suggesting important statistical significance. On day 1, WBC and NEU achieved 77.8 and 78.3 % sensitivity, respectively, and an even lower specificity (68.4 and 52.6 %), whereas a CRP cutoff at 150 mg/l achieved 83.2 % sensitivity and 100 % specificity. On day 3, the sensitivity and specificity of CRP reached 100 % (cutoff level, 200 mg/l), and on day 5, CRP achieved 83.2 % sensitivity and 100 % specificity (cutoff level, 150 mg/l), whereas for WBC and NEU, specificity was high (>92 %), but sensitivity did not exceed 78.2 %. CONCLUSION: Because CRP detected leak or abscess after LSG with remarkably higher sensitivity and specificity than WBC or NEU, CRP seems to be a more accurate market for the early detection of these complications.
  Surgical Endoscopy 10/2012; · 4.01 Impact Factor
• Article: Current advantages in the application of proteomics in inflammatory bowel disease.

  Anna Vaiopoulou, Maria Gazouli, George Theodoropoulos, George Zografos
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  ABSTRACT: Since the formulation of the concept of proteomics, a plethora of proteomic technologies have been developed in order to study proteomes. In inflammatory bowel disease (IBD), several studies use proteomics to try to better understand the disease and discover molecules which can be used as biomarkers. Biomarkers should be able to be used for diagnosis, therapy and prognosis. Although several biomarkers have been discovered, few biomarkers have clinical value. In this review, we analyze and report the current use of proteomic techniques to highlight biomarkers characterizing IBD, and different stages of disease activity. We also report the biomarkers and their potential clinical value.
  Digestive Diseases and Sciences 06/2012; 57(11):2755-64. · 2.12 Impact Factor
• Article: Delayed tracheal rupture after thyroidectomy.

  Leonidas Alevizos, Dimitrios Tsamis, Konstantinos Koutsoumanis, George Zografos
  The American surgeon 04/2012; 78(4):E227-8. · 1.28 Impact Factor
• Article: Coexistence of tumor-induced osteomalacia and primary hyperparathyroidism.

  Athina Markou, Vassiliki Tsiama, Symeon Tournis, Labrini Papanastasiou, Vaios Tsiavos, Aikaterini Dassou, Vasiliki Vlachou, Eugenia Papaliodi, Niki Asimaki, George Zografos, George Piaditis
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  ABSTRACT: To present an unusual case of coexisting tumor-induced osteomalacia (TIO) and primary hyperparathyroidism (PHPT). We report the clinical features, imaging studies, and the results of laboratory investigations before and after surgical resection of both a soft-tissue tumor and a parathyroid adenoma. A 44-year-old woman was referred to the endocrinology department with a diagnosis of PHPT accompanied by unusually severe hypophosphatemia, despite having received treatment with cinacalcet. Debilitating muscle weakness and bone pain, severe phosphaturia and hypophosphatemia, inappropriately normal calcitriol, and elevated fibroblast growth factor-23 and intact parathyroid hormone levels raised the suspicion of coexisting TIO and PHPT. Imaging studies were negative, but histologic characteristics of a palpable subcutaneous mass from the patient's thigh revealed a phosphaturic mesenchymal tumor. Complete remission after surgical removal of both the soft-tissue tumor and the parathyroid adenoma confirmed the diagnosis. The coexistence of TIO and PHPT has not been described before and can cause life-threatening hypophosphatemia. Diagnosis and localization of the tumor is of paramount importance since surgery is the treatment of choice for both TIO and PHPT.
  Endocrine Practice 09/2011; 17(6):e144-8. · 2.49 Impact Factor
• Article: Prospective comparative study of the efficacy of staple-line reinforcement in laparoscopic sleeve gastrectomy.

  Konstantinos M Stamou, Evangelos Menenakos, Dimitris Dardamanis, Calliope Arabatzi, Leonidas Alevizos, Konstantinos Albanopoulos, Emmanuel Leandros, George Zografos
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  ABSTRACT: Staple-line reinforcement has been used with promising results in laparoscopic gastric bypass in order to reduce leakage, increase staple-line integrity, and diminish staple-site bleeding. The purpose of this study was to determine if staple-line reinforcement with bovine pericardial strips reduces surgical complications of laparoscopic sleeve gastrectomy (LSG). This is a prospective comparative study of all patients who underwent LSG by a standard operative team in an 18-month period. Patients were enrolled in group A if they received staple-line reinforcement and in group B when not. The staple line was reinforced with bovine pericardium strips [Peri-Strips Dry (PSD)]. In total, 187 patients, with a median preoperative BMI of 45.3 kg/m(2) (range = 35.1-72.7), underwent LSG. Ninety-six patients were enrolled in group A and 91 in group B; the two groups were comparable in their various characteristics. Morbidity rate representing grade III-IV surgical complications reached 7.4% and mortality rate was 0.5%. Reinforcement with PSD significantly reduced the occurrence of bleeding from the staple line and intra-abdominal collections (P = 0.012 and 0.026). The leak rate was not significantly reduced in group A. Patients in group A required fewer days of hospitalization. Reinforcement of the staple line in LSG resulted in significantly fewer surgical complications compared to standard stapling of the gastric tube. The additional cost due to the reinforcement of the staple line may be counterbalanced by the reduction in the length of hospitalization.
  Surgical Endoscopy 06/2011; 25(11):3526-30. · 4.01 Impact Factor
• Article: Serum adiponectin levels and tissue expression of adiponectin receptors are associated with risk, stage, and grade of colorectal cancer.

  Spyros P Gialamas, Eleni Th Petridou, Sofia Tseleni-Balafouta, Themistoklis N Spyridopoulos, Ioannis L Matsoukis, Agathi Kondi-Pafiti, George Zografos, Christos S Mantzoros
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  ABSTRACT: Adiponectin has been associated with colorectal cancer (CRC) risk. This study aims to investigate the association of both adiponectin and tissue expression of its receptors with CRC risk as well as clinicopathological characteristics, notably stage and grade. Determination of serum adiponectin and immunohistochemical expression of adiponectin receptors in adenocarcinoma/normal colorectal tissue was performed in samples from 104 newly diagnosed CRC patients and 208 age- and sex-matched controls. Multiple logistic regression odds ratios and 95% confidence intervals for CRC risk were derived, controlling for a series of covariates. Serum adiponectin was negatively associated with CRC risk (odds ratio, 0.72; confidence interval, 0.53-0.99) and also with tumor grade (P = .05). Expression of both adiponectin receptors was stronger in adenocarcinoma vs normal tissue (P = .001). AdipoR1 expression was negatively associated with nodal stage (P = .03); AdipoR2 expression was positively associated with tumor, node, metastasis stage (P = .01). Established positive associations with red meat consumption and diabetes, and negative associations with physical exercise and plant food consumption were confirmed along with a more than 60% higher risk associated with central obesity. Adiponectin levels and tissue expression of hormonal receptors seem to be associated not only with CRC risk but also with components of clinicopathological characteristics; given power limitations, these results should be interpreted with caution. The exact nature of the association and the underlying pathophysiological mechanisms need to be further examined in large prospective studies assessing adiponectin and its receptors as novel targets for exploring CRC growth.
  Metabolism: clinical and experimental 05/2011; 60(11):1530-8. · 2.59 Impact Factor
• Article: Alternations of 14-3-3 θ and β protein levels in brain during experimental sepsis.

  Nikolaos Memos, Agapi Kataki, Emmy Chatziganni, Marilena Nikolopoulou, Euthimios Skoulakis, Christos Consoulas, George Zografos, Manousos Konstadoulakis
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  ABSTRACT: The 14-3-3 family members play a crucial role in the determination of cell fate, exerting their antiapoptotic activity through directly interfering with the critical function of the mitochondrial core proapoptotic machinery. Dimerization of 14-3-3 is vital for the interaction with many of its client proteins and is regulated by phosphorylation. In a previous study, we observed time-dependent neuronal apoptosis during sepsis. Therefore, in the present study, we sought to evaluate the expression of 14-3-3 θ and β isoforms in septic brain and their association with apoptosis. Sepsis was induced by a CLP model in Wistar rats that were sacrificed at predefined time points. Flow cytometric analysis showed a sepsis-induced, time-dependent alteration of 14-3-3 θ and β isoforms in both Neun(+) and GFAP(+) cells. 14-3-3 θ was linearly correlated with apoptosis, and stratified analysis for alive and apoptotic neuronal cells demonstrated a gradual down-regulation of θ isoform in alive neurons and astrocytes. The phospho-P38 (pP38) MAP kinase levels were altered in a time-dependent manner during sepsis, presenting a peak at 6 hr post-CLP. A significant correlation between the two isoforms of 14-3-3 was observed in septic rats, with the θ isoform predominant at all time points. The hippocampus, Purkinje cells, and glia-like cells showed intense immunohistochemical reactivity for 14-3-3 θ isoform, whereas the choroid plexus showed constantly increased β isoform expression. Our results showed that sepsis alters the expression of both 14-3-3 θ and β isoforms in a time-, cell-, and topography-dependent manner.
  Journal of Neuroscience Research 05/2011; 89(9):1409-18. · 2.74 Impact Factor
• Article: Long-term plasma ghrelin and leptin modulation after sleeve gastrectomy in Wistar rats in comparison with gastric tissue ghrelin expression.

  Panagiotis Patrikakos, Konstantinos G Toutouzas, Maria Gazouli, Despoina Perrea, Evangelos Menenakos, Stefanos Papadopoulos, George Zografos
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  ABSTRACT: Sleeve gastrectomy (SG) is a gaining ground operation amongst the ones applied for treatment of morbid obesity. Though SG is a food limiting operation, the removal of the gastric fundus where ghrelin is mainly produced may indicate a hormonal impact of the procedure. The purpose of this experiment is to study how SG affects the levels of ghrelin and leptin. Twenty-four male, adult, diet induced obese Wistar rats were divided randomly into groups, one submitted to SG and the other to a sham operation. Fasting blood samples were taken before the operation and 14 weeks after the operation (leptin and acylated and des-acyl ghrelin levels were measured). Tissue samples from the gastric fundus were taken during the operation and at the end of the experiment, and ghrelin expression was measured with RT-PCR. Statistically significant weight loss was achieved comparing the weight progress of the SG group and the sham operation group. Serum leptin levels were significantly reduced in the SG group (p < 0.05) but not in the sham operation group. Serum acylated ghrelin was not significantly affected in both groups, but a significant decrease was documented in serum des-acyl ghrelin in the SG group (p < 0.05). RT-PCR analysis of the gastric fundus documented a significant decrease (p < 0.0001) in the expression of ghrelin in the SG group. SG may lead in significant long-term weight loss. SG affects the serum levels of leptin and des-acyl ghrelin but not the levels of acylated ghrelin in this animal model.
  Obesity Surgery 05/2011; 21(9):1432-7. · 3.29 Impact Factor
• Article: Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing two different techniques. Preliminary results.

  Konstantinos Albanopoulos, Leonidas Alevizos, John Flessas, Evangelos Menenakos, Konstantinos M Stamou, Joanna Papailiou, Maria Natoudi, George Zografos, Emmanuel Leandros
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  ABSTRACT: Sleeve gastrectomy involves the creation of small gastric reservoir based on lesser curvature of the stomach, which is fashioned by a longitudinal gastrectomy that preserves the antrum and pylorus together with its vagal innervation. The main complications in the early postoperative course are bleeding and gastric leak. In order to reduce these complications the staple line can be reinforced in many different ways. The purpose of this study was to randomly compare two different techniques in laparoscopic sleeve gastrectomy (LSG): buttressing the staple line at the gastroesophageal junction (angle of Hiss) with Gore Seamguard and staple-line suturing with PDS 2.0. Between July 2009 and July 2010, 90 patients were prospectively and randomly enrolled in the two different techniques of handling the staple line during LSG. Forty-eight of these patients belonged in group A (application of Gore Seamguard) and 42 in group B (application of a continuous suture). Operative and postoperative complications were recorded. Postoperative leak affected two patients in group A (4.2%) and bleeding occurred in one patient of group A (2%). Total complication rate was 6.2% for group A. No major surgical complication occurred in group B. The differences between the two groups did not reach statistical significance. No significant difference is evidenced in terms of bleeding and postoperative leak between the two techniques of enhancing the staple line in LSG. Suturing of the staple line may be more time consuming but costs are considerably less.
  Obesity Surgery 05/2011; 22(1):42-6. · 3.29 Impact Factor
• Article: Routine abdominal drains after laparoscopic sleeve gastrectomy: a retrospective review of 353 patients.

  Konstantinos Albanopoulos, Leonidas Alevizos, Dimitrios Linardoutsos, Evangelos Menenakos, Konstantinos Stamou, Konstantinos Vlachos, George Zografos, Emmanuel Leandros
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  ABSTRACT: Complications after laparoscopic sleeve gastrectomy (LSG) are usually silent and difficult to interpret. Our purpose was to evaluate the utility of routine placement of intraperitoneal drains at the end of LSG in detection and management of postoperative complications. This is a retrospective study of all patients that underwent LSG by a standard operative team in a 3-year period. Patients were enrolled in Group A when an intraperitoneal drain was placed and Group B when not. Three hundred and fifty-three patients underwent LSG with a median preoperative BMI of 46.4 k/m2. Two hundred and one patients were enrolled in group A and 152 in group B; the two groups were comparable in their characteristics. Staple line leak, bleeding, and abscess were observed in 4%, 2.9%, and 2.5% of group A and 2.6%, 1.9%, and 1.9% of group B and the differences did not reach statistical significance. In 50% of patients with drain and leak, per os blue de methylene test was negative and in another 50% leak took place after the fourth postoperative day when drain was already taken off. Abscesses were observed significantly more often in patients that had suffered postoperative bleeding (p < 0.001) or had undergone laparoscopic adjustable gastric banding (LAGB) in the past (p = 0.02). Placement of drains does not facilitate detection of leak, abscess, or bleeding. Furthermore, they don't seem to eliminate the reoperation rates for these complications. Maybe patients with previous LAGB and intraperitoneal bleeding could benefit from placement of a drain that will remain for more than 5 days.
  Obesity Surgery 12/2010; 21(6):687-91. · 3.29 Impact Factor
• Article: Clinical implications of sleeve gastrectomy as a source of spleen infarction or ischemia.

  Konstantinos M Stamou, Evangelos Menenakos, Ilias P Gomatos, Sotirios-George D Panousopoulos, Spyridon Smparounis, Emmanuel Leandros, George Zografos
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  ABSTRACT: Splenic arterial demarcation has been observed during laparoscopic sleeve gastrectomy (LSG). The present study aims to detect its actual incidence during LSG and clarify its clinical significance. This is a prospective observational study of 287 consecutive patients that underwent LSG by the same surgical team over 3 years. In all patients, the gastric fundus was mobilized using a standard technique. Before withdrawal of the pneumoperitoneum, the spleen was exposed and carefully inspected for evidence of arterial demarcation. Patients with a clear demarcation were followed with Doppler ultrasound. Computed tomography scan with oral contrast was performed to rule out septic complications. Median preoperative body mass index was 46 kg/m(2) (range 35.1-78). Median operative time was 58 min (range 42-185), median hospital stay was 3 days (range 3-45), and overall morbidity rate was 8.6%. Intraoperative demarcation of the upper splenic pole was evident in 12 patients (4.1%). Eleven patients had uneventful postoperative course. One patient raised temperature of 38.5°C at the 7th postoperative day and was readmitted for further treatment. Once afebrile, the patient was discharged on the 10th postoperative day and continued on prophylactic low molecular weight heparin (tinzaparin, 7,500 U sc.) for 20 days. Splenic discoloration following LSG is an uncommon complication with minimal clinical significance, which could be related to hematoma, venous congestion, or ischemia. The possibility of a late splenic abscess cannot be ruled out. No risk factors can be identified preoperatively.
  Obesity Surgery 11/2010; 21(10):1490-3. · 3.29 Impact Factor
• Source

  Available from: Maria I Korontzi

  Article: Redox state and the potential role of antioxidant compounds in liver ischemia/reperfusion injury

  Maria I Korontzi, Apostolos Papalois, Ilias Kouerinis, Andreas C Lazaris, George Theodoropoulos, George Zografos
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  ABSTRACT: Hepatic ischemia/reperfusion (I/R) injury consists of a sequel of cellular and humoral events that finally leads to parenchymal and nonparenchymal cell death. It is of utmost importance as regards the outcome of liver transplantation and liver resections. There is ample evidence that the key role in the inflicted injury is ascribed to reactive oxygen species (ROS) generated mainly by Kupffer cells and neutrophils during reperfusion, with the participation of endothelial cells and hepatocytes. ROS can procure serious damage to cellular membranes and genomic material. The disaster culminates with the initiation of several inflammatory mediators. On the other hand, cells posses a very potent, enzymatic and non enzymatic antioxidant system capable to mitigate oxidant stress or scavenge ROS, thus preserving to some extent cellular redox state. When the imbalance between oxidant stress and antioxidant systems predominates, cell death ensues. The spectre of liver I/R injury therapeutic options includes a plethora of antioxidant agents, natural or synthetic, and extends to genetic modifications. The aim of this article is to review the current knowledge on the generation and mode of action of ROS and to give a further insight on the antioxidant compounds that comprise the therapeutic quiver of this complicated syndrome.
  International Journal of Medicine and Medical Sciences. 08/2010; 2:200-209.
• Source

  Available from: Joanna Papailiou

  Article: Morbid obesity and sleeve gastrectomy: how does it work?

  Joanna Papailiou, Konstantinos Albanopoulos, Konstantinos G Toutouzas, Christos Tsigris, Nikolaos Nikiteas, George Zografos
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  ABSTRACT: Laparoscopic sleeve gastrectomy is known to be a safe and effective procedure for treating morbid obesity and is performed with increasing frequency both in Europe and the USA. Despite its broad use, many questions about the remaining gastric tube diameter, its long-term efficacy, its effects on gastric emptying, and the hormones involved still remain to be answered. In order to use such a relatively new surgical procedure wisely, it is essential for every surgeon and physician to understand how sleeve gastrectomy acts in obesity and what its potential benefits on the patients' metabolism are. This review focuses on the most important pathophysiologic questions referred to sleeve gastrectomy on the literature so far, in an attempt to evaluate the different issues still pending on the subject.
  Obesity Surgery 04/2010; 20(10):1448-55. · 3.29 Impact Factor
• Article: Predictors of survival in stage IV metastatic colorectal cancer.

  Michalis Zacharakis, Ioannis D Xynos, Andreas Lazaris, Tsaousi Smaro, Christos Kosmas, Anna Dokou, Evangelos Felekouras, Efstathios Antoniou, Aris Polyzos, John Sarantonis, John Syrios, George Zografos, Alexandros Papalambros, Nikolas Tsavaris
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  ABSTRACT: The aim of this study was to evaluate predictors of survival in stage IV metastatic colorectal cancer (CRC). A total of 541 patients with histologically proven metastatic CRC (UICC stage IV) were retrospectively analysed and 37 variables were tested for their potential relationship to survival. Mean survival time was recorded at 12.8 months [95% confidence interval (CI) 12.0-13.5]. Three factors were independently associated with improved survival: combination chemotherapy, improved performance status and dermatological complications. Eight factors were independently associated with unfavorable survival: worsened performance status, C-reactive protein >5 mg/dl, anemia, anorexia, weight loss > or =10%, fatigue, hypoalbuminemia and blood transfusions. A number of factors could be used as predictors of survival in patients with stage IV metastatic CRC. Patients who are relatively fit, have low CRP levels and tolerate combination chemotherapy appear to have a more favorable survival outcome.
  Anticancer research 02/2010; 30(2):653-60. · 1.73 Impact Factor
• Article: Health-related Quality of Life in Vacuum-Assisted Breast Biopsy: short-term effects, long-term effects and predictors

  Philip Domeyer, Theodoros Sergentanis, Flora Zagouri, George Zografos
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  ABSTRACT: Abstract Background The impact of Vacuum-assisted breast biopsy (VABB, 11-Gauge) upon Health-related Quality of Life (HRQoL) remains an open field. This study aims to: i) assess short-term (4 days after VABB) responses in terms of HRQoL after VABB, ii) evaluate long-term (18 months after VABB) responses, if any, and iii) examine whether these responses are modified by a variety of possible predictors (anthropometric, sociodemographic, lifestyle habits, breast-related parameters, reproductive history, VABB-related features and complications, seasonality). Methods This study included 102 eligible patients undergoing VABB and having benign lesions. A variable number of cores (24-96 cores) has been excised. HRQoL was assessed by EQ-5D and SF-36^®questionnaires: i) in the morning of the VABB procedure day (baseline measurement), ii) four days after VABB (early post-biopsy measurement) and iii) 18 months after VABB (late post-biopsy measurement). Statistical analysis comprised two steps: i. evaluation of differences in EQ-5D/SF-36 dimensions and calculated scores (baseline versus early post-biopsy measurement and baseline versus late post-biopsy measurement) and ii. assessment of predictors through multivariate linear, logistic, ordinal logistic regression, as appropriate. Results At baseline patients presented with considerable anxiety (EQ-5D anxiety/depression dimension, EQ-5D TTO/VAS indices, SF-36 Mental Health dimension). At the early post-biopsy measurement women exhibited deterioration in Usual Activities (EQ-5D) and Role Functioning-Physical dimensions. At the late measurement women exhibited pain (EQ-5D pain/discomfort and SF-36 Bodily Pain), deterioration in Physical Functioning (SF-36 PF) and overall SF-36 Physical Component Scale (PCS). Mastalgia, older age and lower income emerged as significant predictors for baseline anxiety, whereas seasonality modified early activities-related responses. Pain seemed idiosyncratic. Conclusions The HRQoL profile of patients suggests that VABB exerts effects prior to its performance at a psychological level, immediately after its performance at a functioning-physical level and entails long-term effects associated with pain.
  Health and Quality of Life Outcomes. 01/2010;
• Article: Pheochromocytoma associated with neurofibromatosis type 1: concepts and current trends

  George Zografos, George Vasiliadis, Flora Zagouri, Chrysanthi Aggeli, Dimitris Korkolis, Sophia Vogiaki, Matina Pagoni, Gregory Kaltsas, George Piaditis
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  ABSTRACT: Abstract Background Neurofibromatosis Type 1(NF-1) has autosomal dominant inheritance with complete penetrance, variable expression and a high rate of new mutation. Pheochromocytoma occurs in 0.1%-5.7% of patients with NF-1. Case presentation We present the case of a 37-year-old patient with laparoscopically resected pheochromocytoma. He was investigated for hypertension, flushing and ectopic heart beat. Abdominal CT and MRI revealed a mass measuring 8 × 4 cm in the right adrenal gland. The diagnosis of pheochromocytoma was confirmed by elevated 24-hour urine levels of VMA, metanephrines and catecholamines as well as positive MIBG scan. The patient presented with classic clinical features of NF-1, which was confirmed by pathologic evaluation of an excised skin nodule. The patient underwent laparoscopic right adrenalectomy through a transabdominal approach and was discharged on the second postoperative day, being normotensive. The patient is normotensive without antihypertensive therapy 11 years after the procedure. Conclusion Nowadays in the era of laparoscopy, patients with pheochromocytoma reach the operating theatre easier than in the past. Despite, the feasibility and oncological efficacy of the laparoscopic approach to the adrenals, continued long term follow-up is needed to establish the minimally invasive technique as the preferred approach. Furthermore, these patients should be further investigated for other neoplasias and stigmata of other neurocutaneous syndromes, taking into account the association of the familial pheochromo-cytoma with other familial basis inherited diseases.
  World Journal of Surgical Oncology. 01/2010;
• Article: Volume of blood suctioned during vacuum-assisted breast biopsy predicts later hematoma formation

  Flora Zagouri, Theodoros Sergentanis, Philip Domeyer, Dimosthenis Chrysikos, Georgia Giannakopoulou, Nikolaos Michalopoulos, Panagiotis Safioleas, Ioannis Flessas, Effrosyni Panopoulou, Garifallia Bletsa, George Zografos
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  ABSTRACT: Abstract Background To evaluate whether the volume of blood suctioned during vacuum-assisted breast biopsy (VABB) is associated with hematoma formation and progression, patient's age and histology of the lesion. Findings 177 women underwent VABB according to standardized protocol. The volume of blood suctioned and hematoma formation were noted at the end of the procedure, as did the subsequent development and progression of hematoma. First- and second-order logistic regression was performed, where appropriate. Cases with hematoma presented with greater volume of blood suctioned (63.8 ± 44.7 cc vs. 17.2 ± 32.9 cc; p < 0.001, Mann-Whitney-Wilcoxon test for independent samples, MWW); the likelihood of hematoma formation was increasing till a volume equal to 82.6 cc, at which the second-order approach predicts a maximum. The volume of blood suctioned was positively associated with the duration of the procedure (Spearman's rho = 0.417, p < 0.001); accordingly, hematoma formation was also positively associated with the latter (p = 0.004, MWW). The volume of blood suctioned was not associated with patients' age, menopausal status and histopathological diagnosis. Conclusion The likelihood of hematoma is increasing along with increasing amount of blood suctioned, reaching a plateau approximately at 80 cc of blood lost.
  BMC Research Notes. 01/2010;
• Source

  Available from: Andreas Lazaris

  Article: Decreased Hsp90 expression in infiltrative lobular carcinoma: an immunohistochemical study.

  Flora Zagouri, Theodoros Sergentanis, Afrodite Nonni, Christos Papadimitriou, Anastasia Pazaiti, Nikolaos V Michalopoulos, Panagiotis Safioleas, Andreas Lazaris, George Theodoropoulos, Effstratios Patsouris, George Zografos
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  ABSTRACT: Elevated Hsp90 expression has been documented in breast ductal carcinomas, whereas decreased Hsp90 expression has been reported in precursor lobular lesions. This study aims to assess Hsp90 expression in infiltrative lobular carcinomas of the breast. Tissue specimens were taken from 32 patients with infiltrative lobular carcinoma. Immunohistochemical assessment of Hsp90 was performed both in the lesion and the adjacent normal breast ducts and lobules; the latter serving as control. Concerning Hsp90 assessment: i) the percentage of positive cells and ii) the intensity were separately analyzed. Subsequently, the Allred score was adopted and calculated. The intensity was treated as an ordinal variable-score (0: negative, low: 1, moderate: 2, high: 3). Statistical analysis followed. All infiltrative lobular carcinoma foci mainly presented with a positive cytoplasmic immunoreaction for Hsp90. Compared to the adjacent normal ducts and lobules, infiltrative lobular carcinoma exhibited a statistically significant decrease in Hsp90 expression, both in terms of Hsp90 positive cells (%) and Allred score (74.2 +/- 11.2 vs. 59.1 +/- 14.2 p = 0.0001; 7.00 +/- 0.95 vs. 6.22 +/- 1.01, p = 0.007, Wilcoxon matched-pairs signed-ranks test). Concerning the intensity of Hsp90 immunostaining only a marginal decrease was noted (2.16 +/- 0.68 vs. 1.84 +/- 0.63, p = 0.087, Wilcoxon matched-pairs signed-ranks test). ILC lesions seem to exhibit decreased Hsp90 expression, a finding contrary to what might have been expected, given that high Hsp90 expression is a trait of invasive ductal carcinomas.
  BMC Cancer 01/2010; 10:409. · 3.01 Impact Factor