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Search Results: 1 - 10 of 190908 matches for " Nikolaos G. Koulouris "
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Polymorphisms of GSTs in Lung Adenocarcinoma Patients Followed in the Context of a Biobank  [PDF]
Fotis Vlastos, Georgios Hillas, Nektarios Anagnostopoulos, Jean Michel Vignaud, Nadine Martinet, Nikolaos G. Koulouris
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.48A004

Background: Lung Adenocarcinoma (ADC) has been recently associated with distinct molecular changes, leading to the development of molecular-based targeted therapy. The Nancy’s Centre of Biological Resources (“Centre des Ressources Biologiques”, CRB) is an ISO 9001-2000 certified biobank with biological material and follow-up data from lung cancer patients, which collected during the last 20 years. Objective: To estimate and compare the frequency of Glutathionne S-Transferase (GST) polymorphisms in a French population of ADC patients. Methods: A retrospective study was conducted by the CRB between 1988 and 2007: 296 consecutive patients operated upon for ADC and 447 healthy subjects were evaluated. Genomic DNA was obtained from peripheral blood samples collected in EDTA tubes. The DNA was extracted using proteinase K digestion and phenol: chloroform purification. The GST polymorphisms were studied with duplex SYBR Green q PCR using specific primers and results being read on melt curves. Results: Two GST classes were monitored during this research. The Mu class GST (GSTM) and the Theta class GST (GSTT) members. We studied the incidence of each genotype, as well as the GSTMT (combined Mu and Theta class) and null genotype in ADC and control patients. ADC patients had a higher incidence of

Role of quantitative CT in predicting postoperative FEV1 and chronic dyspnea in patients undergoing lung resection
Chrysovalantis V Papageorgiou, Dimosthenis Antoniou, Georgios Kaltsakas, Nikolaos G Koulouris
Multidisciplinary Respiratory Medicine , 2010, DOI: 10.1186/2049-6958-5-3-188
Abstract: Quantitative CT is the analysis of data acquired during normal chest CT scan using the system's software. By applying a dual threshold of -500 to -910 Hounsfield Units, functional lung volumes are estimated and postoperative FEV1 can be predicted by reducing the preoperative measurement by the fraction of the part to be resected.Studies have shown that preoperative predictions correlate well with the actual postoperative measurements. Additionally, quantitative CT results are in good agreement with perfusion scintigraphy predictions. Newer radiological techniques such as perfusion MRI and co-registered SPECT/CT have also been used in the preoperative evaluation with similar results.In conclusion, chest CT which is obligatory for staging, can be used for quantitative analysis of the already available data. It is technically simple, providing an accurate prediction of postoperative FEV1. Thus, quantitative CT appears to be a useful tool in the preoperative evaluation of lung cancer patients undergoing lung resection.Lung resection is the mainstay of treatment in patients with early stage non-small cell lung cancer. Operability is determined based on the stage, histology and the respiratory reserve which has to be carefully evaluated preoperatively, in order to avoid serious postoperative complications. According to current guidelines, this evaluation includes measurement of the forced expiratory volume in 1 second (FEV1), diffusing capacity for carbon monoxide (DLCO) and values < 80% predicted require further investigation with exercise testing and estimation of VO2 max [1]. If exercise testing is not available, it can be replaced by stair climbing. However, if altitude reaching is less than 22 meters, then VO2 max measurement is highly recommended. Values < 10 ml/kg/min indicate increased risk and other treatment modalities should be chosen. Values > 20 ml/kg/min indicate that the patient can undergo resection up to pneumonectomy. Values from 10 to 20 ml/kg/min requi
Immune Response to Mycobacterial Infection: Lessons from Flow Cytometry
Nikoletta Rovina,Marios Panagiotou,Konstantinos Pontikis,Magdalini Kyriakopoulou,Nikolaos G. Koulouris,Antonia Koutsoukou
Journal of Immunology Research , 2013, DOI: 10.1155/2013/464039
Abstract: Detecting and treating active and latent tuberculosis are pivotal elements for effective infection control; yet, due to their significant inherent limitations, the diagnostic means for these two stages of tuberculosis (TB) to date remain suboptimal. This paper reviews the current diagnostic tools for mycobacterial infection and focuses on the application of flow cytometry as a promising method for rapid and reliable diagnosis of mycobacterial infection as well as discrimination between active and latent TB: it summarizes diagnostic biomarkers distinguishing the two states of infection and also features of the distinct immune response against Mycobacterium tuberculosis (Mtb) at certain stages of infection as revealed by flow cytometry to date. 1. Introduction Following diagnosis of mycobacterial infection, distinguishing active from latent tuberculosis is critical because the management of the patient diverges between the two stages; a targeted approach based on clear-cut diagnosis graces the patients with more efficient treatment avoiding their exposure to unnecessary and potentially harmful interventions. Targeting latent tuberculosis (LTBI) is a widely acknowledged priority for tuberculosis control. LTBI affects a significant share of the world population today. In 2000, in the United States alone, an estimated 11,213,000 residents representing 4.2% of the civilian, noninstitutionalized population aged >1 year had LTBI; of these persons, only 25.5% had been diagnosed, and only 13.2% had been prescribed treatment [1, 2]. Attacking this vast reservoir of mycobacterial infection offers a unique opportunity for a vital strike against mycobacterial infection; treatment of LTBI can reduce the risk of development of disease by as much as 90 percent, thus benefiting the individual as well as the public health. Targeting LTBI becomes even more important nowadays due to the increasing frequency of patients susceptible to developing active TB. To this latter category belong the growing group of patients receiving immunosuppressive therapies such as corticosteroids or antitumor necrosis factor-alpha (TNF-α), transplant patients, and those with HIV infection all of whom are at increased risk of rapid progression of a recently acquired tuberculous infection and of reactivation of latent TB infection [3–6]. In the absence of gold standard, flow cytometry attempts to provide an efficient method of decoding the immune response to the Mtb, development of efficient immune-based interventions, and also rapid diagnosis of mycobacterial infection. Following a brief review
P Wave Analysis in Patients with Sarcoidosis  [PDF]
Elias Gialafos, Elias Perros, Aggeliki Rapti, Theodore G. Papaioannou, Vassilios Kouranos, Ioannis Moyssakis, Konstantina Aggeli, Georgios Dimopoulos, Charalambos Kostopoulos, Eleftherios Stamboulis, John Gialafos, Christodoulos Stefanadis, Nikolaos Koulouris, Myron Mavrikakis
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.49070
Abstract: Introduction: Atrial arrhythmias in patients with sarcoidosis (Sar) are not unusual and can occur due to either atrial myocardial fibrosis and/or due to autonomic nervous system imbalance. Electrocardiographic markers (ECG), like maximum and minimum P wave duration and P wave dispersion {Pdis = Pmax ﹣Pmin} reflect atrial depolarization inhomogeneity and can indicate patients prone to develop atrial arrhythmias while standard deviation of RR interval (SDNN) is an index of heart rate variability, reflecting autonomic nervous system (ANS) activity. Methods: 90 patients with sarcoidosis (41 males/49 females) enrolled in this multicenter prospective study underwent digital electrocardiography, echocardiography and pulmonary function tests (PFTs). Diastolic and systolic indices of right and left ventricle were measured echocardiographically including Doppler parameters while Pmax, Pmin, Pdis and SDNN were measured in a 5-minute duration digital electrocardiogram. All consecutive patients were compared to 65 healthy volunteers (30 males/35 females). Results: Although heart rate and the echocardiographic indices were similar among the two groups, the electrocardiographic indices were significantly prolonged in the patient group compared to controls. Maximum P wave duration was correlated with SDNN (p < 0.05, r = ﹣0.272) and the age of the patients (p < 0.05, r = 0.219) while Pdis was correlated with SDNN
Driving-Related Neuropsychological Performance in Stable COPD Patients
Foteini Karakontaki,Sofia-Antiopi Gennimata,Anastasios F. Palamidas,Theocharis Anagnostakos,Epaminondas N. Kosmas,Anastasios Stalikas,Charalambos Papageorgiou,Nikolaos G. Koulouris
Pulmonary Medicine , 2013, DOI: 10.1155/2013/297371
Abstract: Background. Cognitive deterioration may impair COPD patient’s ability to perform tasks like driving vehicles. We investigated: (a) whether subclinical neuropsychological deficits occur in stable COPD patients with mild hypoxemia (PaO2 > 55?mmHg), and (b) whether these deficits affect their driving performance. Methods. We recruited 35 stable COPD patients and 10 normal subjects matched for age, IQ, and level of education. All subjects underwent an attention/alertness battery of tests for assessing driving performance based on the Vienna Test System. Pulmonary function tests, arterial blood gases, and dyspnea severity were also recorded. Results. COPD patients performed significantly worse than normal subjects on tests suitable for evaluating driving ability. Therefore, many (22/35) COPD patients were classified as having inadequate driving ability (failure at least in one of the tests), whereas most (8/10) healthy individuals were classified as safe drivers ( ). PaO2 and FEV1 were correlated with almost all neuropsychological tests. Conclusions. COPD patients should be warned of the potential danger and risk they face when they drive any kind of vehicle, even when they do not exhibit overt symptoms related to driving inability. This is due to the fact that stable COPD patients may manifest impaired information processing operations. 1. Introduction It is increasingly recognized that chronic obstructive pulmonary disease (COPD) is a multicomponent disease, but relatively little attention has been paid to its impact on neuropsychological function. Several studies have identified neuropsychological deficits in COPD patients [1–3]. The extent of this dysfunction appears to be related to the level of hypoxemia [4–8]. Subclinical cognitive deficits can even be detected in COPD patients with mild hypoxemia ( ?mm?Hg) [9, 10]. Neuropsychological tests aim to provide standardized and objective measurements is the function of specific cognitive domains. The tasks, performed as part of the neuropsychological testing, often closely resemble mental challenges encountered in everyday life. One of the commonest mental challenges in everyday life is driving performance. The latter is a complex task highly dependent on the cognitive function, involving perceptual, motor, and decision making skills. Therefore, our hypothesis was that driving ability may be impaired even in stable COPD patients with mild hypoxemia. Road testing per se is the gold standard for assessing driving ability [11], but it is time consuming, expensive, and potentially hazardous. Simulators, which
Pulmonary Dysfunction in COPD
Kostas Spiropoulos,Kiriakos Karkoulias,Nikolaos Koulouris,Edgardo D'Angelo
Pulmonary Medicine , 2013, DOI: 10.1155/2013/535820
Physiological techniques for detecting expiratory flow limitation during tidal breathing
N.G. Koulouris,G. Hardavella
European Respiratory Review , 2011,
Abstract: Patients with severe chronic obstructive pulmonary disease (COPD) often exhale along the same flow–volume curve during quiet breathing as they do during the forced expiratory vital capacity manoeuvre, and this has been taken as an indicator of expiratory flow limitation at rest (EFLT). Therefore, EFLT, namely attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. EFLT leads to small airway injury and promotes dynamic pulmonary hyperinflation, with concurrent dyspnoea and exercise limitation. In fact, EFLT occurs commonly in COPD patients (mainly in Global Initiative for Chronic Obstructive Lung Disease III and IV stage), in whom the latter symptoms are common, but is not exclusive to COPD, since it can also be detected in other pulmonary and nonpulmonary diseases like asthma, acute respiratory distress syndrome, heart failure and obesity, etc. The existing up to date physiological techniques of assessing EFLT are reviewed in the present work. Among the currently available techniques, the negative expiratory pressure has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, noninvasive, practical and accurate new technique.
Multi-organ failure with atypical liver granulomas following intravesical Bacillus Calmette-Guerin instillation
Michail Kaklamanos, Georgia Hardavella, Rodoula Trigidou, Georgios Dionellis, Nikolaos Paissios, Nikolaos Koulouris, Constantin Goritsas
World Journal of Hepatology , 2011,
Abstract: Bacillus Calmette-Guerin (BCG) intravesical instillation has been adopted in the treatment of patients with superficial bladder cancer. BCG-induced disseminated infection, though rare, has been associated with the histological finding of epithelioid granulomas in different organs, including the liver. We report the case of an adult patient with multi-organ failure, who developed sepsis, acute respiratory failure and acute hepatic failure with encephalopathy whose liver biopsy confirmed the presence of atypical, granulomatous-like lesions. Recovery was observed only after empirical therapy for Mycobacterium bovis with isoniazid, rifampicin, ethambutol and steroids was introduced. This case highlights the importance of a thorough patient assessment in order to exclude other more common causes of hepatic granulomas and to confirm diagnosis. Histological findings may be non-specific when the liver is involved in BCG-induced disseminated infection.
Methods for Assessing Expiratory Flow Limitation during Tidal Breathing in COPD Patients
Nickolaos G. Koulouris,Georgios Kaltsakas,Anastasios F. Palamidas,Sofia-Antiopi Gennimata
Pulmonary Medicine , 2012, DOI: 10.1155/2012/234145
Abstract: Patients with severe COPD often exhale along the same flow-volume curve during quite breathing as during forced expiratory vital capacity manoeuvre, and this has been taken as indicating expiratory flow limitation at rest ( E F L T ). Therefore, E F L T , namely, attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. E F L T leads to small airway injury and promotes dynamic pulmonary hyperinflation with concurrent dyspnoea and exercise limitation. In fact, E F L T occurs commonly in COPD patients (mainly in GOLD III and IV stage) in whom the latter symptoms are common. The existing up-to-date physiological methods for assessing expiratory flow limitation ( E F L T ) are reviewed in the present work. Among the currently available techniques, the negative expiratory pressure (NEP) has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, non invasive, most practical, and accurate new technique. 1. Introduction Some experts use the term chronic airflow limitation as a synonym for chronic obstructive pulmonary disease (COPD) to indicate the reduction in maximum expiratory flow that occurs in this disease (and indeed in other pulmonary diseases). Patients with severe COPD often exhale along the same flow-volume curve during quite breathing as during forced expiratory vital capacity manoeuvre, and this has been taken as indicating flow limitation at rest ( E F L T ). Consequently, the term tidal expiratory flow limitation ( E F L T ) is used to indicate that maximal expiratory flow is achieved during tidal breathing at rest or during exercise. This is characteristic of intrathoracic flow obstruction. The former term does not imply that E F L T actually occurs during tidal breathing [1]. The location of expiratory flow limitation is considered to be in the central airways (4th–7th generation) and move to the periphery during forced expiratory manoeuvres. It is located beyond the 7th (i.e., from the 8th onwards) generation during tidal breathing [2–4]. Tidal expiratory flow limitation ( E F L T ) [5–8] plays a central role according to a recent hypothesis [5] on the transition from small airways disease (SAD) to overt COPD in smokers. E F L T implies inhomogeneity of ventilation distribution with concurrent impairment of gas exchange and unevenly distributed stress and strain within the lung, which is amplified by tissue interdependence [6, 7] and may lead to small airway injury [5–8]. Initially, the latter is
In Vitro Evaluation of the Staining Effects of Two Intracanal Medicaments over a 3-Month Period  [PDF]
Taxiarchis G. Kontogiannis, Anastasios Koursoumis, Nikolaos P. Kerezoudis
Open Journal of Stomatology (OJST) , 2014, DOI: 10.4236/ojst.2014.48052
Abstract: Aim: The aim of this study was to evaluate in vitro the tooth color alterations associated with two intracanal medicaments, calcium hydroxide and calcium hydroxide combined with aquatic solution of chlorexidine, for up to three months post-treatment. Materials & Methods: Thirty-one intact human anterior mature teeth were used. Black adhesive tape with a 4-mm diameter window was used to standardize the enamel surface intended for color analysis. After access cavity preparation, cleaning and shaping were completed with rotary nickel-titanium files. The teeth were randomly divided into two groups (n = 15), each according to the intracanal medicament used: (A) calcium hydroxide paste (UltraCalTM XSTM Ultradent Products, Inc., USA); (B) 2% chlorhexidine aquatic solution combined with pure calcium hydroxide powder. In one tooth, no medicament was placed (pilot). The enamel surfaces were colormetrically evaluated at the following time intervals: before placing the medicaments, immediately after placement, after 1 week as well as after 1, 2 and 3 months post-treatment. The CIE color parameters (L*, a*, b*) were recorded for each material and the corresponding color differences (ΔΕ) were calculated and statistically analyzed. Results: The most significant factor in tooth discoloration was the time intervals. The most important changes of the ΔΕ values were recorded after the 1st week and after the 3rd month. L* presented an overall increase in both groups, resulting in a higher lightness of the crown color. Only L* did show significant alterations during specific time intervals. Conclusions: There is no statistically significant relationship between the type of intracanal medicament and tooth color alteration. Time is statistically the most important factor affecting the discoloration ability of Ca(OH)2, either combined with chlorexidine or not. Consequently, the clinician should always take this into account before using such medicaments for a long-term treatment.
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