Biomedical subjects

J Gogas

Publications and source records attributed to J Gogas.

At least 37 records · Page 2Linked to original sources

PubMed1998

Evaluation of cytological morphologic criteria and AgNOR expression in male breast lesions.

Fine needle aspiration (FNA) breast smears from 81 male patients have been examined in our laboratory between 1988 and 1994. The cytological criteria for diagnosing male breast lesions and the expression of nuclear organizer regions were evaluated. Of the 81 cases examined cytologically, 50 cases were proven cytologically and histologically to be inactive gynaecomastia, two cases showed florid gynaecomastia and there were 10 adenocarcinomas; in the 17 cases in which no cytological evidence of gynaecomastia or malignancy was found, the histological diagnosis was gynaecomastia in 13 and there was one case of mastopathy; in two cases suspicious of malignancy on cytology the histological examination proved to be florid gynaecomastia in one case and the other showed an adenocarcinoma. The absolute specificity of FNA in this study was 74.28%, the complete specificity 98.5%, the absolute sensitivity 90.9% and the complete sensitivity 100%. The overall accuracy was 97.5%, the positive predictive value 91.66% and the negative predictive value 98.5%. In all cases of male breast carcinoma, AgNOR mean value was > or = 3; thus, it appears that AgNOR mean value 3 could be used as a cut-off value between benign and malignant male breast lesions. Our experience suggests that FNA is an acceptable procedure for the investigation of male breast lesions.

Adenocarcinoma↗

PubMed1998

Thyroid function in postmenopausal women with breast cancer on tamoxifen.

In 42 postmenopausal women with breast cancer, aged 48-85 years (mean age 62.4 years) serum thyroid hormone concentrations were measured before and after 6 months of tamoxifen therapy (20 mg daily). In particular triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroxine-binding globulin (TBG) and thyroid-stimulating hormone (TSH) concentrations before and 30 minutes after thyrotrophin-releasing hormone (TRH) administration (200 microg i.v.) were measured before and 6 months after tamoxifen therapy. T3 and T4 concentrations increased significantly (p<0.001 and p<0.05, respectively) whereas FT3 and FT4 remained unchanged (p>0.05), TBG increased significantly (p<0.001) and basal TSH concentrations as well as TSH response to TRH injection increased significantly (p<0.05) after tamoxifen therapy. It is concluded that tamoxifen administration changes thyroid hormone concentrations. However free thyroid hormone levels remain unchanged and the patients remain euthyroid after long-term tamoxifen therapy.

Aged↗

PubMed1998

99mTc Tetrofosmin imaging in breast tumours.

Eighty-five women, 18 to 80 years of age, with palpable breast lumps were studied 1-4 days before surgery in order to evaluate 99mTc Tetrofosmin imaging for the detection of malignant breast tumours. Intravenous injection of 99mTc Tetrofosmin was followed by 3 min planar images at 5-60 min postinjection. In the latter 57 patients, planar imaging was preceded by a dynamic study of 20x5 sec images. The myocardium was always included in the field of the left breast. Count rates in suspicious areas were compared with normal tissue areas in the same and the opposite breast and with myocardial counts. Data analysis showed that 77 of the 85 scan results were in agreement with the histological findings; six scans were false negative and two false positive for malignancy. The sensitivity of the method was 90.32% and the specificity 91.30%, with a positive predictive value of 96.55%. We conclude that breast scanning with 99mTc Tetrofosmin may play an important role in the detection of breast malignancies.

Adolescent↗

PubMed1997

A feasibility study of 1-h paclitaxel infusion in patients with solid tumors.

The optimal schedule for paclitaxel administration has not yet been determined. This phase I/II study was carried out to evaluate the safety of paclitaxel administration by 1-h infusion in the outpatient setting. A total of 43 patients with advanced pretreated malignancies (18 breast, 18 ovarian, and 7 non-small-cell lung cancers) received at least 2 cycles of paclitaxel given at 175 mg/ m2 in a single dose by 1-h i.v. infusion. This protocol was repeated every 21 days. All patients were premedicated as follows: promethazine given i.m. at 50 mg, dexamethasone given at 16 mg in 250 ml normal saline by i.v. infusion for 20 min and ranitidine given i.v. at 50 mg in 250 ml normal saline over 15 min, all premedication being carried out 1 h before the paclitaxel infusion. In a total of 156 cycles, only 1 patient presented with a hypersensitivity reaction (grade 2 urticaria in 1 cycle) and another patient developed transient facial flushing (in 1 cycle: this was resolved by slowing of the infusion rate) on this schedule of paclitaxel administration. Other adverse side effects were usually mild and well tolerated. Alopecia was universal; myelosuppression was uncommon because our patients were supported with granulocyte colony-stimulating factor (G-CSF, lenograstim) given at 34 IU/day in the presence of a neutrophil count of < 500 microliters; neutropenia was seen in 50/156 (32%) cycles and was mild. Neurotoxicity was the most serious adverse effect, and all patients experienced mild to severe neuro-muscular toxicity, mainly in the form of peripheral sensorimotor neuropathy and myalgias. In conclusion, 1-h paclitaxel administration is safe and reduces the duration of treatment, making its use more convenient and easy in the outpatient setting. A prospective comparison of 1-h versus 3-h paclitaxel infusion in terms of efficacy and toxicity is the subject of our current randomized study.

Aged↗

PubMed1997

DNA ploidy and pS2 protein expression in breast cancer.

The DNA content of ductal breast carcinomas of varying histological grade was measured using static image cytometry and correlated with pS2 expression in the tumour cells. Our study was performed on imprint of surgical biopsies of 60 women with ductal breast cancer. A statistically significant difference was observed between pS2+ expression and grade of malignancy (P < 0.001). The percentage of euploid tumours significantly decreased from grade I to grade II to grade III (P = 0.01). The percentage of aneuploid tumours increased from pS2+ to pS2- breast tumours (P < 0.001). These findings may be indicative of pS2 and DNA ploidy alterations and tumour aggressiveness.

Aneuploidy↗

PubMed1997

Surgical treatment of gastrointestinal B-cell mucosa-associated lymphoid tissue lymphomas.

We retrospectively evaluated clinicopathologic features of 35 patients treated for primary gastrointestinal lymphomas of MALT type (mucosa-associated lymphoid tissue) between 1970 and 1993. Fourteen patients (40%) were treated for acute abdominal conditions (bowel obstruction in 8, perforation in 2, and gastrointestinal bleeding in 4), and the rest had exploratory laparotomy. The tumor was located in the stomach in 23 patients (66%), in the jejunum and ileum in 10 (29%), and in the large intestine in 2 (6%). The type of operation was defined according to site and extent of disease. Most patients received chemotherapy postoperatively. Staging was done according to the Ann Arbor classification. Survival depended on stage and extension of the disease; 5-year survival was 45%. Surgical resection followed by adjuvant chemotherapy is warranted when the patient is considered to be a surgical candidate.

Adolescent↗

PubMed1997

DNA content and p53 protein expression in ductal breast cancer.

The DNA content of 85 ductal breast cancers of different histological grades was evaluated using static cytometry and correlated with immunocytochemical expression of p53 protein in tumour cells in cytological material. A statistically significant difference was observed between p53 protein expression and grade of malignancy (P < 0.001). The percentage of euploid tumours significantly decreased from grade I through grade II to grade III tumours (P < 0.001). Clonal DNA heterogeneity was observed in 26.6% of cases analysed and was correlated with p53 protein expression (P < 0.001). These changes probably reflect genomic alterations which may affect potential malignancy of breast cancer.

Adult↗

PubMed1997

Sex hormones in postmenopausal women with breast cancer on tamoxifen.

In 42 postmenopausal women with breast cancer aged 48-85 (mean age 62.4) years, the blood sex hormone levels were measured before and after 6 months of tamoxifen administration (20 mg daily). Follicle-stimulating hormone and luteinizing hormone levels decreased after tamoxifen administration (p < 0.001), but remained in the postmenopausal range, oestradiol levels increased (p < 0.05), sex hormone binding globulin levels increased (p < 0.001), testosterone levels remained stable (p > 0.1), free testosterone levels decreased (p < 0.001), delta4-androstenedione, 17-hydroxyprogesterone, and dehydroepiandrosterone sulfate levels remained unchanged (p > 0.1), and basal prolactin levels and their response to thyrotrophin-releasing hormone injection decreased significantly (p < 0.001) after tamoxifen therapy. It is concluded that tamoxifen has many and diverse effects on sex hormone levels, and its adverse effects do not affect the biological status of the patient, except perhaps for oestradiol, that increases in some cases, whose possible effect must be studied.

Aged↗

PubMed1997

Management of foreign bodies of the rectum: report of 21 cases.

This is a report of 21 patients treated for non-therapeutic introduction of rectal foreign bodies in our institution. Nine out of 18 patients had manual transanal extractions performed under general anaesthesia while eight patients required insertion of retractors and gynaecological forceps. In three patients the vacuum from the hollow objects was abolished by passing a catheter through the anus to a point above the object. One of the patients required colotomy for retrieval of a wooden object. In three patients free perforations were obvious clinically with peritoneal signs and free air on plain abdominal radiographs. Treatment was end-sigmoid colostomy and mucous fistula, oversewing of the perforation and peritoneal irrigation. There were no deaths and only one complication occurred, a rectovaginal fistula.

Adult↗

PubMed1997

[Experiences with surgical therapy of hepatic echinococcosis].

Between January 1984 and December 1990, 56 patients with hydatid liver disease were treated surgically at our Department. Diagnosis was made by using clinical criteria, serology and imaging techniques. Most frequent clinical symptom was abdominal pain or local discomfort (38 patients, 68%). Plain X-ray of the abdomen was helpful in 20 patients (36%), liver ultrasound in 53 (93%) and computerised tumorgraphy in 56 patients, (100%). The immunoelectrophoresis test of "arc 5" was sensitive in 51 patients (91%). Thirty patients (53%) underwent partial resection and omentoplasty, 17 patients (30%) underwent external drainage, two cystic resection (3%), one left lateral lobectomy (2%) and six (11%) underwent omentoplasty and T-tube insertion. Fatal complications did not occur. Four patients developed hepatic abscess (7%), three wound infection (5%), one bowel obstruction (2%) and in five instances (8%) drainage was maintained for more than three months. Of the 49 patients available for follow-up (87%), three (6%) developed recurrent disease.

Adult↗

PubMed1997

Application of the learning vector quantizer to the classification of breast lesions.

OBJECTIVE: To investigate the potential of the learning vector quantization (LVQ) neural network for the discrimination of benign from malignant breast lesions. STUDY DESIGN: Using a custom image analysis system on Giemsa-stained smears, 25 parameters describing the size, shape and texture of the cell nucleus were measured. Three thousand nuclei from a total of 9,356 were selected as a training set for the neural network, and the whole data set was used for testing. An additional 238 cells from 16 cases without final cytologic diagnoses were evaluated by the system. The total number of cells (9,594) was collected from 100 patients (68 carcinomas and 32 benign lesions). RESULTS: Cytologic examination of the cases gave two false positive and two false negative results. However, in eight cases of ductal breast carcinoma and in eight cases of benign lesions, histologic confirmation was necessary in order to confirm the cytologic diagnosis. Application of the LVQ permitted correct classification of 87.41% of the cells. Classification at the patient level by using a hypothesis test for proportion with a hypothesis value equal to 50% permitted the correct diagnosis in 98% of patients. CONCLUSION: These results indicate that the use of neural networks combined with image morphometry and statistical techniques may offer useful information about the potential for malignancy, improving the diagnostic accuracy of fine needle aspiration of breast lesions.

Breast↗

PubMed1997

Findings of computerised nuclear morphometry of papillary thyroid carcinoma in correlation with known prognostic factors.

The aim of this study was the evaluation of the usefulness of nuclear morphometry in the pathology of papillary thyroid carcinoma by computer-aided image analysis and the statistical comparison of nuclear morphometric parameters with age of patients, tumor size and the presence or not of thyroid capsule invasion. Thirty three cases of papillary thyroid carcinoma were classified in two groups according to patients' age (group I: < 45 years and group II: > 45 years), according to tumor's size (group I: < 2.5 cm, group II: > 2.5 cm) and to the presence or not of thyroid capsule invasion (group I: invasion (+), group II: no invasion (-)). The following six nuclear morphometric parameters were measured in a large number of randomly selected nuclei of each case: area, perimeter, major axis length, minor axis length, elongation and roundness. The statistical analysis was performed using special algorithms and the results of the two groups of each prognostic factor examined, were compared for each of the measured parameter using the t-test. When the classification was associated with age it was shown that younger people (group I) have lower area, perimeter, major axis length, elongation and roundness means of papillary thyroid carcinoma nuclei than older ones (group II) whereas minor axis length did not show any difference between the two groups. When the classification was associated with tumor size it was shown that younger people (group I) have lower area, perimeter, major axis length means of papillary thyroid carcinoma nuclei than older ones (group II) whereas minor axis length, elongation and roundness did not show any difference between the two groups. Finally, when the cases were classified according to the presence or not of the capsule invasion it was shown that younger people (group I) have lower area, perimeter, major axis length means of papillary thyroid carcinoma nuclei than older ones (group II) whereas roundness did not showed any difference between the two groups. On the other hand younger people (group I) have higher elongation and roundness means than the older ones (group II). Nuclear morphometry in association with the patients' follow-up could represent an important prognostic index for papillary thyroid carcinoma.

Adult↗

PubMed1996

Cystic dilatations of the common bile duct in adults.

Cystic dilatations of the common bile duct are believed to be of congenital etiology with most cases presenting in childhood. During the last 20 years, 10 patients with cystic dilatations of the bile duct were treated in our Department. There were 5 men and 5 women with an age range of 35-81 years. Clinical presentation consisted of right hypohondrial pain, nausea, vomiting and a history of obstructive jaundice. Diagnosis was established by ultrasound, cholangiography and ERCP in most cases. According to the Todani classification system, 5 patients had type I cysts, 4 had type II and one had type III. At the time of surgery, main associated diseases were choledocholithiasis in 3 cases and cholangitis in 2 cases. One patient (type III) underwent endoscopic sphincterotomy; 4 patients underwent internal drainage and 2 of them developed mild cholangitis postoperatively; 5 patients underwent excision of the cyst and a biliary-enteric bypass and developed no main complications. Patients remained in good health during long-term follow-up. We conclude that cyst excision is the treatment of choice for adults in order to reduce postoperative morbidity and the potential risk of malignancy.

Adult↗

PubMed1995

Relationship of epidermal growth factor receptor (EGFR), proliferating cell nuclear antigen (PCNA) and vimentin expression and various prognostic factors in breast cancer patients.

Cytologic specimens (FNA) from 42 primary invasive ductal breast carcinomas and 22 matched specimens of cancer tissue were tested for EGFR status, PCNA index and vimentin expression by immunocytochemical staining, using an Extravidin-Biotin method, and their relationship with various prognostic factors was investigated. EGFR positivity, high PC10 score and vimentin positivity were significantly correlated with high histologic grade. The coordinate expression of EGFR, PCNA and vimentin was significantly associated with ER-negative breast carcinomas. A positive trend was observed between high proliferating tumours and EGFR expression. EGFR status and PCNA index were not correlated with axillary lymph node involvement, tumour size, age and menopausal status. Vimentin was preferentially expressed in tumours, with lymph node metastases. Co-expression of EGFR, PCNA and vimentin was determined in most cases. These data suggest that EGFR status, PCNA index and vimentin expression may be important for the prediction of biologically aggressive tumours.

Adult↗

PubMed1995

DNA ploidy and vimentin expression in primary breast cancer.

The DNA content of 50 breast cancers of varying tumour type, grade and stage was measured using static image cytometry, and correlated with vimentin expression in the tumour cells. A tendency to increased vimentin expression and aneuploidy was observed in high grade and late stage tumours. A statistically significant difference was observed in DNA index and ploidy balance between grade 1 and grades 2 and 3 carcinomas (P < 0.05) and between grade I and stage II carcinomas (P < 0.05). There was a significant difference in the expression of vimentin between grades 1, 2, 3 (P < 0.001), and stages I, II, and III ductal carcinomas (P < 0.05). No significant difference was observed in the proliferation index and the degree of hyperploidy (P > 0.05) Clonal heterogeneity was observed in 25% of breast carcinomas, and was associated with increased vimentin expression. These changes may be indicative of genomic alteration and tumour aggressiveness.

Biomarkers, Tumor↗

PubMed1995

Changing trends in management of carotid body tumors.

UNLABELLED: The purpose of this retrospective study was to evaluate the preoperative diagnostic modalities and aggressive operating management as well as the determination of benefit of preop embolization on the course of carotid body tumor (CBT). Between 1975 and 1993, 14 patients were treated for CBT in our department. The preoperative evaluation included angiography (14/14, 100%), Duplex scanning (6/14, 43%), and CT scanning (9/14, 64%). Five tumors (36%) were type I, four (28%) type II, and five (36%) type III, according to the Shamblin classification. In twelve cases the tumors were successfully excised without ligation of the external carotid artery. One of these patients, who had a very large tumor, underwent preop embolization. In two patients the tumors were found to extend intracranially, and the patients were referred for radiation therapy. There were no deaths or cerebrovascular complications. Temporary cranial nerve injury was noted in two cases. The pathology report revealed paragangliomas without any evidence of malignancy. Follow up of patients (6 months-18 years) showed no recurrence of the tumors in the operated cases and local recurrence in the radiation group. CONCLUSION: 1. Arteriography remains the golden standard for diagnosis of CBT. Tripplex scanning and CT are helpful for postop follow-up. 2. Surgical removal is the ideal treatment. Preoperative embolization is helpful in diminishing intraoperative blood requirements. 3. CBT, although benign, should be treated as soon as it is diagnosed, before difficulty in excision arises.

Carotid Body Tumor↗

PubMed1994

Periareolar nonpuerperal breast infection: treatment of 38 cases.

Periareolar nonpuerperal breast infection is a troublesome entity whose treatment is still a matter of debate. Thirty-eight female patients--9 with acute infection and 29 with chronic infection--were prospectively studied over a 3-year period. Sixty isolates were harvested from 50 pus specimens obtained by fine-needle aspiration, with a predominance of staphylococci (23 isolates) and peptostreptococci (18 isolates). On the basis of these findings, an antimicrobial regimen consisting most often of amoxicillin plus clavulanic acid was administered for 6-8 weeks. Simultaneous surgery was required in 13 cases (34.2%). Despite a good response during therapy, 7 (21.9%) of 32 patients relapsed during a follow-up period of < or = 3 years; all 7 patients had presented with chronic infection. We conclude that prolonged therapy with agents active against both staphylococci and anaerobes is essential in periareolar breast infection; in cases with an established fistula, radical surgery (i.e., fistulotomy or fistulectomy) appears inevitable.

Acute Disease↗

PubMed1994

Hamartomas of the breast.

Hamartomas of the breast are rare tumor-like lesions composed of ducts, lobules, fat, and fibrous tissue. The clinical and pathologic findings of six cases of patients ranging in age from 19 to 63 years are reported. Diagnosis is difficult, and we emphasize that fine needle aspiration and cytology of the smears is not diagnostic for hamartomas.

Adult↗