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E Koumantakis

Publications and source records attributed to E Koumantakis.

At least 55 records · Page 3Linked to original sources
PubMed1998

Increased levels of interleukin-8 in human seminal plasma.

The role of cell-mediated immunity in the aetiopathogenesis of male infertility is far from being defined. The cytochemokine interleukin-8 (IL-8) has a key role in T-cell mediated immune responses. The aim of this study was to confirm the presence of IL-8 in human seminal plasma, to show differences between IL-8 concentrations in fertile and infertile subjects, and to show the potential relationship between IL-8 amounts in semen and spermiogram parameters. IL-8 levels were determined in the seminal plasma of 77 men divided as follows: (a) into seven groups according to the aetiological diagnosis of fertility and (b) into two groups on the basis of a normal or abnormal spermiogram. The mean value of IL-8 in the seminal plasma was 31.5 times higher than the upper limit in normal serum. There is a borderline statistical significant difference among the means of the various groups (P < 0.051). The Tukey's HSD test for multiple comparisons indicated no two groups as being significantly different, whereas the less conservative test LSD showed significant differences between the group with infection and groups with normal controls, Klinefelter's syndrome, mumps orchitis, cryptorchidism, or varicocele. There was no significant difference in IL-8 levels between men with normal and those with abnormal spermiograms. Furthermore, there was no correlation between IL-8 levels and the variables of the spermiogram. Even though the conclusions of this study have to be tempered by the sample size, IL-8 concentration in seminal plasma may be considered as a potential marker for the diagnosis of male accessory gland infection.

Adolescent↗
PubMed1998

Detection of herpes simplex virus (HSV) in aborted material using the polymerase chain reaction technique.

OBJECTIVE: To investigate the contribution of HSV to the aetiopathogenesis of spontaneous abortion. DESIGN: A hospital-based, case-control study. SETTING: Department of Obstetrics and Gynecology, University Hospital and Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion, Crete, Greece. POPULATION AND METHODS: Abortion material from 102 cases of women with spontaneous abortion was analysed for the presence of HSV DNA applying the PCR technique. Serological assays were used for the detection of specific IgM and IgG antibodies in the maternal sera of 90 pregnant women with successful outcome of their pregnancy while 70 non-pregnant women at reproductive age were also examined as control. RESULTS: The HSV genome was detected by PCR amplification in 3 cases of spontaneous abortion, 2 of them exhibited serological markers of virus reactivation while the 3rd showed a past infection. There were no obvious clinical manifestations indicating a current herpes infection. Both groups of pregnant women, either with spontaneous abortion or with a successful outcome of pregnancy, displayed serological markers of HSV reactivation at higher rates compared with non-pregnant women (chi2, p < 0.05). CONCLUSIONS: Using the PCR technique we were able to detect the HSV genome in gestational tissues of spontaneous abortions, even in cases without any clinical symptoms or seropositivity for a primary infection. Serological assays were not very useful for the elucidation of the role of HSV in inducing spontaneous abortions, although they indicate that the state of pregnancy predisposes to HSV reactivation. However, the detection of HSV in 3 out of a total number of 102 cases does not support HSV infection as a major abortion-related factor.

Abortion, Spontaneous↗
PubMed1998

A pilot study on concurrent platinum chemotherapy and intracavitary brachytherapy for locally advanced cancer of the uterine cervix.

This study aims to evaluate the feasibility, toxicity and efficacy of concurrent chemotherapy with platinum compounds and brachytherapy, for locally advanced carcinoma of the cervix (Stages IIA/B, IIIA). The hypothesis was that synchronous chemo-brachytherapy may be sufficient to cause down-staging of the tumour, to render it operable, and hopefully improve the prognosis. 36 women with locally advanced cervical cancer were treated with concomitant brachytherapy and chemotherapy before surgery and/or definitive external radiotherapy. All patients received two caesium-137 Selectron MDR applications, 1 week apart. The dose calculated to point A for each implant was 20-25 Gy. Chemotherapy consisting of continuous cisplatin infusion (50 mg m2) and of carboplatin (300 mg m-2) was given simultaneously with intracavitary irradiation during the first and second application, respectively. The combined therapy was followed when feasible by radical hysterectomy, pelvic lymphadenectomy and pelvic radiotherapy. Patients deemed ineligible for surgery because of poor response were given full dose external radiotherapy. 31/36 patients were treated by Wertheim hysterectomy of whom 10 had negative lymph nodes and resection margins. Definitive external radiotherapy was given in the remaining five patients. Overall, 83% were disease free at 2.8 years mean follow-up. The most frequent acute side-effects of chemobrachytherapy were nausea and vomiting. No renal toxicity was observed. Thrombocytopenia was seen in five patients and was responsible for delayed surgery in four patients. Concerning late effects, two patients developed grade 2 intestinal sequelae, two mild frequency and two vaginal stenosis. One rectovaginal and one vesicovaginal fistula developed in two patients; and a third patient had a fistula associated with tumour recurrence. Concurrent brachytherapy and chemotherapy with platinum compounds is well tolerated and effective in reducing tumour bulk before definitive local treatment (surgery or external radiotherapy), in patients with locally advanced carcinoma of the uterine cervix.

Adult↗
PubMed1998

Low-malignant potential epithelial tumors of the ovary: a clinicopathological study.

Low-malignant potential (LMP) epithelial tumors of the ovary are a group which occupy an intermediate position between the benign and those of the frankly malignant ovarian neoplasms. The actual incidence, present age and treatment are still being discussed. During the period 1991-1996, from the 650 ovarian tumors which were diagnosed and treated in our institution, 401 were epithelial tumors. The LMP serous epithelial tumors consisted of 4.36% of all serous tumors while LMP mucinous tumors were 9.70% of all mucinous tumors. The LMP serous tumors had an 8 cm diameter on average, 83% were unilocular and 76.5% unilateral. The LMP mucinous tumors had a 17 cm diameter on average, 95% were multilocular and 95% unilateral. The mean age at diagnosis was 39 years for LMP serous tumors and 48 years for LMP mucinous tumors.

Adenocarcinoma, Mucinous↗
PubMed1998

Conservative treatment of multiple pregnancies after delivery and a fetal miscarriage: two case reports.

Due to the increased availability of infertility treatment, multiple pregnancies, with various resulting complications, have become more common. Two cases of triplet pregnancies with delayed delivery--interval ranged from 6 to 56 days--are reported. The first woman in the 23rd week of a triplet pregnancy came to the hospital because of premature rupture of membranes of one amniotic sac and had a miscarriage of one of the fetuses the same day. The second woman in the 26th week of a triplet pregnancy also came to the hospital because of bleeding and contractions and had vaginal delivery of the first triplet a few hours later. After confirming that the remaining two fetuses were in good condition, both patients were kept under observation with only antibiotic therapy for the first one and antibiotic and tocolysis for the second. Fifty-six days following admission to our hospital the first woman gave birth to twins while in her 32nd week. The second woman gave birth six days following admission (in her 27th week). The successful outcome of these cases demonstrates that non-intervening conservative methods could be a feasible alternative to invasive intervention. We hope that our cases will encourage more physicians to try out and report non-intervening methods so that enough information can be gathered to help make correct management decisions in the future.

Abortion, Spontaneous↗
PubMed1998

Cytokine levels in seminal plasma.

We have studied IL-2, SIL-2R, and sCD4 concentrations in the seminal plasma of 20 healthy men (controls), 20 oligozoospermics and 20 azoospermics by the "sandwich" enzyme immunoassay technique. We have also measured IL-2, SIL-2R and sCD4 in the two fractions of the split ejaculate of 10 healthy men. Our results show that the mean IL-2 and sCD4 concentrations in the seminal plasma were significantly higher compared to the levels in the serum of normal men; furthermore, there were no significant differences of SIL-2R and sCD4 between the group of normal men and the groups of men with oligozoospermia or azoospermia. On the contrary, significantly higher levels of IL-2 and sCD4 were found in the first compared to the second fraction of the split ejaculates. Our results support the view that the estimation of IL-2 in seminal plasma has value concerning the quality of semen. On the contrary, the estimation of SIL-2R and sCD4 in seminal plasma are valueless concerning normal or abnormal semen. Finally, the prostate seems to be the main site or origin of IL-2 and sCD4.

CD4 Antigens↗
PubMed1998

Pseudo-Meigs' syndrome caused by paraovarian fibroma.

Meigs' syndrome includes an ovarian tumor, usually fibroma, associated with hydrothorax and ascites. It is accepted that uterine tumors, like fibromas, can also be associated with ascites and hydrothorax, but this is extremely rare. The mechanism of formation of peritoneal and pleural effusion is not well documented. The most likely pathogenesis ascribes the fluid formation to the filtration of interstitial fluid in the peritoneal through the tumor capsule, and the diffusion to the pleural space through the diaphragm lymphatic vessels at the foramen of Bochdalek. Paraovarian fibromas are also extremely rare neoplasms, probably of paramesonephric origin. It has been hypothesised that they can develop by proliferation of connective tissue cells around the Wolfian remnants. In this article, probably for the first time, a case of paraovarian fibroma with ascites and hydrothorax is presented.

Ascites↗
PubMed1998

Unexpected increase of the CA 19-9 tumour marker in patients with endometriosis.

The purpose of this study was to investigate whether the ovarian function of women with endometriosis could be identified by serologic concentration of the oncofetal antigen CA 19-9 before, during and after treatment for 6 months with danazol. A total of 15 women with endometriosis, 20-40 years old, were studied. The serum CA 19-9 antigen was measured by immunoradiometric assay. The measurement of CA 19-9 was repeated during the last 15 days of a 6-month therapy period with danazol and after 3 months from the end of the therapy in only seven women. It was found that: 1) Eight out of 15 women (53.3%) showed higher CA 19-9 values than the upper normal limit. 2) Danazol caused a significant decrease in the antigen values which remained stable after the cessation of therapy. This data suggests that endometriosis should be classified among other diseases which cause an increase in the serum levels of CA 19-9 and that ovarian function is related to antigen levels.

Adult↗
PubMed1997

Laser-induced fluorescence detection of malignancies in the female genital tract via their natural emission and hypocrellin (HA) probing.

A laser-induced fluorescence-guided biopsy system has been developed for the screening and early detection of malignancies in the female inner/outer genital tract. Fluorescence spectra were recorded during exposure of normal and malignant tissue to He-Cd laser (442 nm) radiation. A characteristic increase in the fluorescence signal at 600 nm for malignant tissue was observed after treatment of the samples with hypocrellin (HA). This, combined with the spectral distribution of tissue natural fluorescence, allowed for the development of simple algorithms, based on the intensity difference. A subsequent index of discrimination between normal and various malignant tissues has been calculated. These results suggest that monitoring of this index during colposcopy could enhance selective detection of the malignant tissue, reducing the risk of leaving pathologic tissue untreated during standard exploratory surgical procedures.

Algorithms↗
PubMed1997

Spectral variations of laser-induced tissue emission during in vivo detection of malignancies in the female genital tract.

A laser-based fluorescence-guided biopsy system has been developed for the screening and early detection of malignancies in the female inner/outer genital tract. Fluorescence spectra were recorded during in vivo exposure of normal and malignant tissue to He-Cd laser (442 nm) radiation. Spectral distribution of tissue natural fluorescence allowed for the development of simple algorithms, based on spectral intensity variations. A subsequent index of discrimination between normal and various malignant tissues has been calculated. This study focuses on the variability of the experimental data and the possible sources of spectral variations. These results suggest that monitoring of this index during colposcopy could enhance selective detection of the malignant tissue, reducing the risk of leaving pathologic tissue untreated during standard exploratory surgical procedures.

Biopsy↗
PubMed1997

Cervical cytology in adolescence.

The prevalence of cervical intraepithelial neoplasia in young women is increasing worldwide. Frequency of the abnormal Papanicolau smears was examined in sexually active young females aged 13 to 19 years. The smears were reported as within normal limits or with benign cellular changes due to inflammation in 96.2% of cases. The cytological changes were related in 2.5% of cases of HPV infection, in 1.0% of cases to CIN I and in 0.3% of cases to CIN II. These results show a frequency of 3.8% of abnormal smears.

Adolescent↗
PubMed1997

Adolescent laparoscopy.

Laparoscopy is a useful and safe diagnostic procedure that provides excellent visualization of the pelvic structures and often permits the diagnosis of gynecologic disorders and pelvic surgery without laparotomy. During the period 1994-1996 40 laparoscopies were performed as a diagnostic procedure on adolescents aged between 14-19 years. In 21 cases of primary amenorrhea the laparoscopy showed 12 cases of Rokitanski-Kuster-Hauser syndrome (57.2%), hematocolpos-hematometra 4 (19.0%), polycystic ovarian disease 2 (9.5%), late onset of puberty 2 (9.5%) and gonadal dysgenesis 1 (4.8%). Laparoscopy which was performed in 12 cases of pelvic pain showed 6 with normal genitalia (50%), endometriosis in 2 (16.7%, infection in 2 (16.7%), fibroma in 1 (8.3%) and torsion in 1 (8.3%). Four laparoscopies were performed for ovarian mass; three cystic masses and one case of endometriosis were detected.

Adolescent↗
PubMed1997

Decreased sensitivity to insulin during treatment with danazol in women with endometriosis.

The aim of this study was to verify to what extent danazol alters insulin sensitivity. To this end, insulin tests were performed before the application of danazol and during the last 15 days of a six-month treatment with this agent on nine women, from 21 to 37 years of age, who had endometriosis. The same test was also performed on nine healthy women, 21 to 35 years of age, in whom laparoscopy did not reveal endometriosis or other pelvic pathology. It was found that the total response of glucose to insulin was significantly lower in women with endometriosis during treatment with danazol than it was in the same women before the application of this agent or in normal women too. Our results support the view that danazol induces resistance to insulin.

Adult↗
PubMed1997

Comparative study of plasma carnitine: determination in the neonate and in normal delivery.

Free total plasma carnitine and acylcarnitine were determined in 20 mothers with normal deliveries and their neonates. Women of reproductive age and children constituted the comparative control groups. The mothers had lower total and free carnitine concentrations as compared to the neonates and the differences were statistically significant. The acylcarnitine values in the mothers were higher but the differences were not statistically significant. The women had higher total and free carnitine concentrations as compared to the children, while the values of acylcarnitine were higher in the children and the differences were statistically significant. The women had higher total free carnitine concentration as compared to the mothers and the differences were statistically very significant. In contrast the concentration of acylcarnitine was higher in the mothers than in the women and the difference was statistically significant. The children had higher total and free carnitine concentrations as compared to the neonates. On the other hand the concentration of acylcarnitine was higher in the neonates than in the children. The difference was statistically significant. It appears that transfer of maternal carnitine to the fetus constitutes the main factor of determining carnitine concentration in the neonate.

Adult↗
PubMed1996

Oocyte donation to women over 40 years of age: pregnancy complications.

Recently, oocyte donation to women of advanced age has led to a considerable number of conceptions, thus increasing the age limit for becoming pregnant. A main consideration encountered by physicians, though, is the potential medical and obstetric complications of a pregnancy at an advanced age. In this study, the obstetric complications, as well as the perinatal outcome, of pregnancies of aged recipients (above 40) are presented and compared to those of younger recipients. A significantly higher incidence of gestational diabetes (P < 0.001), an increased incidence of pre-eclampsia (at the 10% level of significance) and an increased risk for thrombophlebitis (again at the 10% level) was observed in the older patients, but a careful follow-up during their pregnancy led to a highly satisfactory obstetric and perinatal outcome. A rigorous precycle medical screening (especially for cardiovascular diseases and diabetes) and a careful follow-up during pregnancy is, therefore, imperative so that oocyte donation to older women is not withheld and continues to provide fertility possibilities to otherwise sterile patients.

Adult↗
PubMed1996

The evaluation of morphological abnormalities of human spermatozoa in fertile and infertile men.

Spermatozoal morphology in semen from 114 fertile men, 107 infertile men with varicocele and 35 infertile men with infection of the accessory genital organs, aged from 18 to 53 years were evaluated by Papanicolaou-stained smears in order to investigate: (a) the frequency of abnormalities in the neck and tail of spermatozoa with an abnormal head and (b) the ability of prediction of the morphology of one sperm part when the morphology of another part is known. The investigation showed that: (1) morphological abnormalities in the neck are significantly higher (P < 0.001, P < 0.01), when the head was abnormal, compared to spermatozoa with a normal head in fertile men and in men with varicocele, respectively; (2) morphological abnormalities in the tail are also higher (0.05 < P < 0.1) in spermatozoa with an abnormal head in men with infection; (3) the proportional reduction of error (PRE) was low in all cases. Our results show that spermatozoa with abnormal heads more often present morphological abnormalities of their counterparts compared to spermatozoa with normal heads. Nevertheless, no prediction can be made on the nature of the morphology of a part of a spermatozoon on the basis of knowledge of its morphology of another part.

Adolescent↗