Panayiotis Skandalakis

National and Kapodistrian University of Athens, Athínai, Attica, Greece

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Publications (23)28.38 Total impact

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    ABSTRACT: Research interest on abdominal aorta branches and abdominal viscera morphometry is renewed by technologic evolution and development of new radiologic and clinical applications including grafted stents and chemoembolization materials. Despite that, data on morphometry of abdominal aorta branches and abdominal viscera are lacking. To investigate this subject authors performed a morphometric study on 50 adult fresh and embalmed Caucasian cadavers and examined abdominal aorta branches', kidney's and spleen's morphometry. Our results on arteries' morphometry did not differ significantly from those of the literature yet we discovered significant differences between fresh and embalmed cadavers on viscera morphometry, spleen and kidneys. We also found previously unreported correlations between abdominal aorta branches' morphometric characteristics. Even more we identified correlations between regional arteries and viscera morphometric characteristics, proposing a new factor determining viscera development. Finally we performed an extensive literature review so to place our results in an anatomic, embryologic and even more a clinical context. We believe that our results add knowledge on abdominal aorta branches and viscera morphometry and are valuable for clinical, radiological and surgical applications including visceral arteries' aneurysms investigation and treatment, chemoembolization procedures, grafted stents design and transplantation.
    No preview · Article · Sep 2015 · Folia morphologica
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    ABSTRACT: In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area's regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion.
    Full-text · Article · Feb 2014 · Journal of Brachial Plexus and Peripheral Nerve Injury
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    ABSTRACT: Description of a rare variation is provided alongside with a review of the literature with special references to anatomic, embryologic, and clinical issues it may create. This was a cadaveric dissection conducted during a pregraduate anatomy course that is accompanied by short review of the literature and critical appraisal. During dissection of the neck region of a male cadaver, the superior thyroid artery occurred from the common carotid artery bilaterally and the lingual artery occurred from the carotid bifurcation on the left side. Superior thyroid artery originating from common carotid artery or carotid bifurcation is a common variation, but the lingual artery originating from the common carotid artery or carotid bifurcation is very rare (<1%). Its existence can have a significant impact on treatment success and potentially lead to errors during interventions at the neck region. A high level of suspicion is required.
    No preview · Article · Nov 2013 · Annals of Vascular Surgery
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    ABSTRACT: The present study describes analytically a rare case in which a trifurcation of Femoral Artery in Superficial Femoral Artery, Deep Femoral Artery and Lateral Circumflex Femoral Artery was found during dissection of a cadaver. This variation can be considered as a subdivision of Lateral Circumflex Femoral Artery arising from Femoral Artery (frequency: 15% according to Lipper and Pabst) but diameters of the vessels (Lateral Circumflex Femoral Artery was measured at 0.4 cm, of Deep Femoral Artery at 0.55 cm, Femoral Artery at 1 cm and Superficial Femoral Artery at 0.6 cm) and small distance between origin of Deep Femoral Artery and inguinal ligament indicate instead a true trifurcation rather than a simple subdivision. The anatomic variations of the branching pattern of the femoral region arteries concerning both their origin and course are especially important due to the numerous operations performed in the femoral region that implicate various specialties such as orthopedic surgery, plastic surgery, vascular surgery, general surgery and invasive cardiology.
    No preview · Article · Jun 2013 · Artery Research
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    ABSTRACT: The purpose of this historical review is to add new elements to the international literature in relation to the birth and progress of the science of anatomy in modern Greece. Step by step, it outlines the efforts of prominent Greek anatomists to establish the course of the basic science of anatomy in the newly founded Medical School, the laborious effort to collect cadaveric material to compile museum anatomical collections and to gradually build the foundations of modern anatomy science at the Medical School of the Athenian University.
    Full-text · Article · Aug 2012 · Italian journal of anatomy and embryology = Archivio italiano di anatomia ed embriologia
  • Eleni Panagouli · Theodore Troupis · Panayiotis Skandalakis · Dionysios Venieratos

    No preview · Article · Feb 2012 · The American surgeon

  • No preview · Article · Dec 2011 · The American surgeon
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    ABSTRACT: Objective To investigate the anatomical variability of the palatine structures in Greek population.Material and methods71 Greek adult dry human skulls were examined to detect the position of the greater palatine (GPF) and lesser palatine foramina (LPF) related to adjacent anatomical landmarks.ResultsThe perpendicular distance of the GPF to the midline sagittal suture was 1.53 cm and 0.3 cm from the inner border of the alveolar ridge. The mean distance from the posterior palatal border was consistent 0.46 cm on the right and 0.47 cm on the left side of the skulls. In the greater majority of the skulls (76.2%), the GPF were between proximal–distal surfaces of the 3rd maxillary molar. A single LPF was observed in 53.45% of the skulls, two LPF were observed in 31% of the skulls bilaterally and five LPF were rare (2.1%). The commonest position of LPF was at the junction of the palatine bone and the inner lamella of the pterygoid plate (71.9%).Conclusion Our results can help clinicians localize the palatine foramina in patients with and without maxillary molars and to predict the depth of a needle to anaesthetise the maxillary nerve with greater success when performing surgical procedures in the hard and soft palate.
    Full-text · Article · Nov 2011 · Journal of Cranio-Maxillofacial Surgery
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    ABSTRACT: The postsynaptic fibers of the pterygopalatine or sphenopalatine ganglion (PPG or SPG) supply the lacrimal and nasal glands. The PPG appears to play an important role in various pain syndromes including headaches, trigeminal and sphenopalatine neuralgia, atypical facial pain, muscle pain, vasomotor rhinitis, eye disorders, and herpes infection. Clinical trials have shown that these pain disorders can be managed effectively with sphenopalatine ganglion blockade (SPGB). In addition, regional anesthesia of the distribution area of the SPG sensory fibers for nasal and dental surgery can be provided by SPGB via a transnasal, transoral, or lateral infratemporal approach. To arouse the interest of the modern-day clinicians in the use of the SPGB, the advantages, disadvantages, and modifications of the available methods for blockade are discussed.▪
    No preview · Article · Sep 2011 · Pain Practice
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    Maria Piagkou · Theano Demesticha · Panayiotis Skandalakis · Elizabeth O Johnson
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    ABSTRACT: Various anatomic structures including bone, muscle, or fibrous bands may entrap and potentially compress branches of the mandibular nerve (MN). The infratemporal fossa is a common location for MN compression and one of the most difficult regions of the skull to access surgically. Other potential sites for entrapment of the MN and its branches include, a totally or partially ossified pterygospinous or pterygoalar ligament, a large lamina of the lateral plate of the pterygoid process, the medial fibers of the lower belly of the lateral pterygoid muscle and the inner fibers of the medial pterygoid muscle. The clinical consequences of MN entrapment are dependent upon which branches are compressed. Compression of the MN motor branches can lead to paresis or weakness in the innervated muscles, whereas compression of the sensory branches can provoke neuralgia or paresthesia. Compression of one of the major branches of the MN, the lingual nerve (LN), is associated with numbness, hypoesthesia, or even anesthesia of the tongue, loss of taste in the anterior two thirds of the tongue, anesthesia of the lingual gums, pain, and speech articulation disorders. The aim of this article is to review, the anatomy of the MN and its major branches with relation to their vulnerability to entrapment. Because the LN expresses an increased vulnerability to entrapment neuropathies as a result of its anatomical location, frequent variations, as well as from irregular osseous, fibrous, or muscular irregularities in the region of the infratemporal fossa, particular emphasis is placed on the LN.
    Full-text · Article · Mar 2011 · Clinical Anatomy
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    ABSTRACT: The present study describes analytically a rare case in which lingual and facial arteries arise together from an external carotid artery in a common trunk. Thirty anatomic dissections were performed on 15 cadavers in the macroscopic laboratory in the Department of Anatomy of the Medical School of National and Kapodistrian University of Athens. One common trunk from which originated lingual and facial arteries was found. The frequency of this morphology is measured at 6 per cent. The length of the common trunk is measured at 7.3 mm between its origin and its diversion at the facial artery and lingual artery, its diameter at 2.8 mm, its distance from carotid bifurcation at 7.9 mm, and from the superior thyroid artery at 3.3 mm. At the left side of the neck region, facial and lingual arteries arose separately. The anatomic variations of the branching pattern of the external carotid artery and the micrometric values of the vessels are especially important as a result of the numerous operations performed in the neck region that implicate various specialties such as general surgery, head and neck surgery, plastic surgery, and maxillofacial surgery.
    No preview · Article · Feb 2011 · The American surgeon
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    ABSTRACT: As colorectal cancer and colorectal liver metastases become a serious public health problem, new treatment modalities are needed in order to achieve better results. In the last decade there has been very important progress in oncology, with new and more effective chemotherapeutic agents administered alone or in combination improving the resectability rate in up to 40% of patients with colorectal liver metastases. Advances in interventional radiology, in particular, with the use of portal vein embolization and radiofrequency thermal ablation are new strategies allowing major liver resections and treatment of small liver metastases or early recurrences. Surgery, however, remains the gold standard strategy with intention to treat. In this review article we will describe the advanced role of surgery in the multidisciplinary approach to colorectal liver metastases, and the clinical problems the liver surgeon has to deal with, such as the resectability of the metastases, the presence of bilobar liver lesions and extrahepatic disease, the impact of chemotherapy in already resectable liver metastases, the problem of vanishing metastases after chemotherapy and the dilemma of staged or combined liver and colon operations and which organ first in the clinical scenario of synchronous colorectal liver metastases.
    Full-text · Article · Jul 2010 · World Journal of Gastroenterology

  • No preview · Article · Jul 2010 · The American surgeon
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    ABSTRACT: The present report describes a rare case in which the left gastric artery arises directly from the abdominal aorta and the right hepatic artery from the superior mesenteric artery, as observed during the dissection of a female cadaver. The left gastric artery usually rises as one of the three branches of the celiac trunk, which was originally described by Haller in 1756, whereas the right hepatic artery usually originates from the proper hepatic artery. The knowledge of the typical anatomy of the abdominal arteries, and their variations, is especially important due to the numerous interventions performed in the abdominal area.
    No preview · Article · Jun 2008 · The American surgeon
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    ABSTRACT: Access to local providers of primary health care (PHC) services and their utilisation is a challenge faced by the authorities of developed as well as developing countries. The aim of our study was to assess and evaluate the level of satisfaction with the currently provided cardiovascular and PHC services in the southernmost region of continental Greece (and of the European Union), Southern Mani. The sample (422 individuals, 375 of whom finally participated: 187 men and 188 women, response ratio: 88.86%), was selected between January-December 2006, using stratified randomisation by sex and age. Participants were asked to fill in a validated questionnaire containing socio-demographic data and items about the health needs/level of satisfaction with cardiovascular health and PHC services, as well as two indices for cardiovascular health: i) frequency of international normalised ratio (INR) measurement in case of atrial fibrillation, and ii) history of timely thrombolysis in case of acute myocardial infarction. The majority of the responders stated that their level of satisfaction with PHC services was "low" or "very low" (total: 52.80%), while the percentage of dissatisfaction with cardiovascular health services was 56.0%. In addition, most of the participants expressed a strong wish for improvement of PHC services (71.33%). The level of satisfaction with PHC services was higher than with cardiovascular health services (2.49 +/- 1.26 vs. 2.38 +/- 1.24; p < 0.001). Satisfaction scores for both cardiovascular health and PHC services were negatively associated with the distance from the nearest PHC Unit. Only 11.1% of patients (95% CI: 0.3%-48.2%) reported annual testing of prothrombin time more than once, while among those with a history of acute myocardial infarction, none reported timely thrombolysis (0%, one-sided 97.5% CI: 0%-41.0%). It is evident that a large portion of the Southern Mani population perceives the provided cardiovascular health and PHC services as problematic, while the distance from the nearest PHC unit seems to be one of the most important factors and predictors of dissatisfaction. The provision of efficient PHC services in isolated areas is a matter that should be re-evaluated.
    Full-text · Article · May 2008 · Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē
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    ABSTRACT: Nitric oxide (NO) is an important signal molecule in many types of cells and tissues. Efficiently balanced NO production was noted to play an important role in the healing of burns. However, the exact pathophysiological role of NO in burns and its potent relation with clinical and laboratory parameters has not been elucidated. A cohort of 23 burn patients followed for 5 days were enrolled. NO, antioxidant capacity (AC), NO synthase (NOS) activity and xanthine oxidase (XO) activity were indirectly determined by fluorophotometer. Multiple regression against total burn surface area (TBSA), age, weight, height, proximity of septic episode, hemoglobin, white blood cells, percent of neutrophils, platelets, glucose, urea, potassium, sodium and albumin was performed. Elevation of NO, XO and AC levels is observed from day 2 (p<0.00001), day 4 (p=0.005) and day 6 (p=0.036), respectively. At the end of follow-up period (day 6), NO production was found to independently correlate with TBSA, glucose levels and percent of neutrophils (p=0.0004), AC with age, hemoglobin and glucose levels (p=0.012), and NOS with proximity of septic episode and glucose levels (p=0.027). NO production exerts its prophylactic effect from the first 24h after burn, and is independently correlated with severe injury, enhanced neutrophil motivation and augmented glucose levels, thus possibly representing a response to stress. This need might trigger induction of XO and salvage of antioxidants, as suggested by their rise at a later stage. These data underline that an effort to compromise stress and to administer antioxidants could be a priority in the treatment of these patients.
    No preview · Article · Jan 2008 · Burns
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    ABSTRACT: Differential diagnosis of distended post-op colon can be misleading when based solely to imaging findings. A case report of an artefact giving the impression of faecal leak or foreign body (gossypiboma) in Spiral Computerized Tomography after colonic surgery is presented. The patient was managed conservatively due to the lack of clinical evidence of abdominal emergency, A second CT scan twenty days later revealed no findings besides minor colonic diverticulas.
    Preview · Article · Jul 2007 · Annali italiani di chirurgia
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    ABSTRACT: Evaluate the performance and safety of the FiberNet Embolic Protection System during carotid artery intervention. Carotid Angioplasty and Stenting (CAS) can be proposed to treat the majority of carotid stenoses. Brain embolization takes place and routine use of Embolic Protection Devices (EPD) is warranted. Many EPDs have significant limitations, which may be addressed by a new EPD, the FiberNet (Lumen Biomedical, Plymouth, MN). The system consists of a 3-dimensional expandable filter made of fibers, which expand radially, mounted onto a 0.014'' wire and retrieval catheter. FiberNet can capture particles as small as 40 microm without compromising flow. 35 lesions treated in 34 patients. Male 67.6%. Age: 71.4 +/- 8.8 (50-85). Average stenosis 84.5% +/- 7.9 (70-99). 29.4% were symptomatic. Technical success: 34/35 (97%). No stroke or death within 30 days. Neurological events: two permanent amaurosis, one amaurosis fugax. All samples visually contained significant amounts of emboli. The mean surface area of debris caught was 63.8 mm(2) (37.7-107.5). Comparisons were made with other EPDs. The mean surface area of debris caught was 12.2 mm(2) (2.7-34.3). No changes were noted in CT/MRI at 30-day post procedure. The first human use of this new novel EPD in carotid artery stenting is encouraging. The FiberNet was easy to use and confirmed the ability to capture particles less than 100 microm. The feasibility of the FiberNet has been demonstrated. Additional patients will demonstrate the overall safety and efficacy of this new EPD device.
    Preview · Article · Jun 2007 · Catheterization and Cardiovascular Interventions
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    ABSTRACT: The authors report a case of an extended retroperitoneal abscess that developed secondarily after a duodenal diverticulum perforation. The diagnosis was established preoperatively endoscopically and by abdominal CT scan. The patient was treated surgically. The authors performed a subtotal gastrectomy and reconstruction with antecolic Billroth II anastomosis to bypass the inflamed region, as well as simultaneous drainage of the retroperitoneal abscess. The postoperative course of the patient was uncomplicated. The authors suggest that this method may be an acceptable approach in the management of similar cases, in which conservative or endoscopic means have failed.
    No preview · Article · Feb 2007 · The American surgeon
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    Dimitrios K Filippou · N Pashalidis · P Skandalakis · S Rizos
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    ABSTRACT: Malignant gastrointestinal stromal tumor (GIST) consists a rare neoplasm, developing in small intestine and stomach. The presenting manifastations include weakness, weight loss, nausea, melena and anaemia. The present case refers to a 65 years old female patient with a GIST of the ampulla of Vater presenting with obstructive jaundice. Diagnosis was achieved pre-operatively by biopsies collected through diagnostic ERCP. The tumour was locally excised, with preservation of the ampulla. The histological analysis suggested low grade GIST positive for both CD 117 (c-kit) and CD34. Two years after the surgery the patient remains free of disease. Malignant GIST of the ampulla of the Vater is extremely rare as only few similar cases have been described in the literature. This is the first time a GIST being presented as obstructive jaundice ever reported. Despite the unavailability of EUS-FNA, the diagnosis was set preoperatively and the tumor was resected.
    Preview · Article · Jul 2006 · Journal of Postgraduate Medicine

Publication Stats

202 Citations
28.38 Total Impact Points

Institutions

  • 2011-2013
    • National and Kapodistrian University of Athens
      • Division of Anatomy
      Athínai, Attica, Greece
  • 2008-2011
    • Harokopion University of Athens
      Athínai, Attica, Greece
  • 2007
    • Κωνσταντοπούλειο νοσοκομείο Νέας Ιωνίας (Η Αγία Όλγα)
      Athínai, Attica, Greece
  • 2006-2007
    • Laiko Hospital
      Athínai, Attica, Greece