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Search Results: 1 - 10 of 519 matches for " Stavros Mathioulakis "
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Multiple giant diverticula of the jejunum causing intestinal obstruction: report of a case and review of the literature
Evangelos Falidas, Konstantinos Vlachos, Stavros Mathioulakis, Fotis Archontovasilis, Constantinos Villias
World Journal of Emergency Surgery , 2011, DOI: 10.1186/1749-7922-6-8
Abstract: Multiple diverticulosis of the jejunum constitutes an uncommon pathology of the small bowel. The disease is often asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain and discomfort. Related complications such as diverticulitis, hemorrhage, obstruction and perforation present high mortality and morbidity rates. We herein report a case of a 55 year-old man presented at the emergency department because of acute abdominal pain, vomiting and fever. Preoperative radiological examination followed by laparotomy revealed multiple and giant jejunal diverticula causing intestinal obstruction. We also review the literature for this uncommon disease.A 55-year old man arrived at the emergency department complaining of 48-hour lasting intense abdominal pain and vomiting. The patient had a free medical history and was not receiving any drugs at that time. He mentioned a two-year-lasting remittent abdominal pain, fullness and often abdominal distension. The patient also mentioned a particular intolerance of pulse and vegetables.Physical examination revealed a distended abdomen with increased bowel peristalsis. Rectal examination was normal. Only his temperature was elevated (38.2°C) while other vital parameters were within normal limits. Abnormal laboratory findings included leukocytosis (13300/mm3), anemia (Hct:30%), hypokalemia (3.2 mmol/l) and hypoalbuminemia (2.80 mmol/l). C-reactive protein was also elevated (4.57 mg/dl). A plain abdominal X-ray showed multiple air-fluid levels and dilated intestinal loops suggesting intestinal obstruction but not signs of perforation (Figure 1). Abdominal ultrasonography revealed dilated and hyperactive intestinal loops but not free intraperitoneal fluid. Gallstones were also incidentally found. The abdominal computed tomography (CT) scan demonstrated multiple distended small bowel loops and jejunal diverticula. The patient had a nasogastric tube and received intravenously flu
Recurrent Urinary Tract Infections due to Asymptomatic Colonic Diverticulitis
Evangelos Falidas,Georgios Anyfantakis,Stavros Boutzouvis,Michail Kyriakopoulos,Stavros Mathioulakis,Konstantinos Vlachos,Constantinos Villias
Case Reports in Medicine , 2012, DOI: 10.1155/2012/934168
Abstract: Colovesical fistula is a common complication of diverticulitis. Pneumaturia, fecaluria, urinary tract infections, abdominal pain, and dysuria are commonly reported. The authors report a case of colovesical fistula due to asymptomatic diverticulitis, and they emphasize the importance of deeply investigate recurrent urinary tract infection without any bowel symptoms. They also briefly review the literature.
Primary retroperitoneal mucinous cystadenoma of borderline malignancy in a male patient. Case report and review of the literature
Evangelos Falidas, Stefanos Konstandoudakis, Konstantinos Vlachos, Fotios Archontovasilis, Stavros Mathioulakis, Stavros Boutzouvis, Constantinos Villias
World Journal of Surgical Oncology , 2011, DOI: 10.1186/1477-7819-9-98
Abstract: We herein report a case of a 37 year old man undergone laparotomy for a sizable retroperitoneal tumor resulting after the histological examination to a primary retroperitoneal mucinous cystadenoma of borderline malignancy.This is the third case of primary retroperitoneal mucinous cystadenoma of borderline malignancy in a male patient reported in the literature. The preoperative diagnosis is impossible. Laparotomy constitutes the only diagnostic and curative approach.The primary retroperitoneal mucinous cystadenoma is a rare tumor that affects, almost exclusively women [1]. The preoperative diagnosis is impossible in most of cases because of the rarity, the position and the texture of the tumor. We report a case of a 37 year-old male patient, with primary retroperitoneal mucinous cystadenoma of borderline malignancy; this may be the third case registered in the literature.A 37 year old man arrived at the outpatient facilities of our clinic complaining of a remittent pain at the right lateral abdomen and a palpable mass that was constantly growing up during the last twelve months. His medical history included an uneventful appendicectomy in his childhood, 27 years ago and spontaneous pneumothorax 15 years ago. By that time, he was under medication with antacids because of gastritis. He did not mention any evacuation or urination symptoms.Physical examination revealed a firm, sizeable and hard mass at the right abdomen (Figure 1), extending from the inferior ribs to the right iliac crest. Laboratory findings were within normal limits. The ultrasound (US) of the abdomen demonstrated a compact mass of uneven shape at the right abdomen, extended from the liver to the minor pelvis. Abdominal computed tomography (CT) scan, demonstrated a cystic textured lesion, extended from the lower pole of the right kidney to the right iliac fossa, with a cefalocaudal diameter of 11 cm (Figure 2). There were small diaphragms within the mass, enforced by the intravenous administration of
Rectus Abdominis Muscle Malignant Fibrous Histiocytoma Causing a Large Abdominal Wall Defect: Reconstruction with Biological Mesh
Evangelos Falidas,Stavros Gourgiotis,Christina Goudeli,Stavros Mathioulakis,Konstantinos Vlachos,Constantinos Villias
Case Reports in Surgery , 2014, DOI: 10.1155/2014/723851
Abstract: Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh. 1. Introduction Malignant fibrous histiocytoma (MFH) is a pleomorphic sarcoma. It was first described as malignant histiocytoma and fibrous xanthoma by Ozzello et al. [1] and was established a soft tissue sarcoma arising from fibroblasts and histiocytes [1, 2]. MFH is a relatively rare tumor that occurs throughout the body [3]. However, it is also the most common sarcoma appearing during the 6th and 7th decades, while men are more often affected than women. The most frequent site of MFH is the extremities (lower extremity 49%, upper extremity 19%) followed by the retroperitoneum (16%) and peritoneal cavity (5%–10%) [4]. The introduction of biological meshes (BMs) like Permacol (PM), Strattice, and Surgisis has opened new alternatives. BMs products have several potential advantages over other synthetic permanent materials in selected clinical situations. Indications for implantation of a BM in abdominal wall reconstruction include contaminated wounds, complex repairs at high risk for developing wound-healing problems, high likelihood of a cutaneous exposure, and unavoidable direct placement of mesh over bowel [5]. We herein report the case of an 84-year-old man with a MFH in the rectus abdominis muscle, treated by removal of the tumor and the muscle, which was reconstructed with BM. 2. Case Presentation An 84-year-old male was admitted complaining about abdominal pain and a palpable mass in the abdominal wall. His medical history included atrial fibrillation, chronic obstructive pulmonary disease, and open cholecystectomy performed 2 years ago. During the clinical examination, a large, immobile, and slightly painful mass was palpated at the level of the left rectus abdominis muscle. Abnormal laboratory findings included leukocytosis (14,323/mm3), Hb: 9?g/dL, and INR: 4. Although the patient’s reported history of a two-month growing mass, spontaneous rectus abdominis rupture was
Sclerosing Mesenteritis: Diverse clinical presentations and dissimilar treatment options. A case series and review of the literature
Konstantinos Vlachos, Fotis Archontovasilis, Evangelos Falidas, Stavros Mathioulakis, Stefanos Konstandoudakis, Constantinos Villias
International Archives of Medicine , 2011, DOI: 10.1186/1755-7682-4-17
Abstract: Sclerosing mesenteritis (SM) is a rare, non-specific, benign and chronic fibroinflammatory disorder of unknown etiology that primarily affects the small bowel mesentery. It usually involves the root of the small bowel mesentery, but it can also involve the mesocolon, the peripancreatic and omental fat, and infrequently the retroperitoneal or pelvic fat [1-6]. The first known series was published in 1924 [2,7]. In that series the disease was described under the names of "retractile mesenteritis" and "mesenteric sclerosis". Since then these terms have undergone serious elaboration on the basis of the predominant histology in order to better describe the disease, including mesenteric lipodystrophy (predominantly fatty degeneration and necrosis), mesenteric panniculitis (marked chronic inflammation) and retractile mesenteritis or mesenteric fibrosis (predominant fibrosis) [4,6]. Furthermore, mesenteric Weber-Christian disease, liposclerotic mesenteritis, lipomatosis and lipogranuloma of the mesentery are numerous other names that have been used to describe the disease [8]. Emory et al in 1997 [1], after a thorough review of 84 cases concluded that all this uncertainty is partly due to the variable histological features of a single pathological entity characterized by a non-specific inflammatory processes in the mesenteric fat, that may ultimately lead to retraction and fibrosis. This varied terminology has caused considerable confusion, but the condition can now be evaluated as a single disease with two pathological subgroups. When inflammation and fatty necrosis are predominant components of the process, it is called "mesenteric panniculitis", while if fibrosis and retraction are the principals components, it is called ''retractile mesenteritis''. The overall presence of some degree of fibrosis makes the pathological term "sclerosing mesenteritis" the most accurate and preferred term in most cases [1]. More than 250 cases have been reported in world literature [9-12] a
Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report
Evangelos Falidas, Efstathios Rallis, Vasiliki-Kalliopi Bournia, Stavros Mathioulakis, Emmanouil Pavlakis, Constantinos Villias
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-397
Abstract: We report the case of a 75-year-old Caucasian man with tophaceous multiarticular gout, soft-tissue involvement and ulcerated tophi on the first metatarsophalangeal joint of the left foot, on the first interphalangeal joint of the right foot and on the left thumb.Ulcers due to tophaceous gout are currently uncommon considering the positive effect of pharmaceutical treatment in controlling hyperuricemia. Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain, infection and joint destruction.Gout is a common disorder of uric acid metabolism, characterized by recurrent episodes of inflammatory arthritis, tophaceous soft tissue deposits of monosodium urate crystals, uric acid renal calculi and chronic nephropathy. We report the case of a 75-year-old Caucasian man suffering tophaceous multiarticular gout and soft-tissue involvement, presenting with ulcerated tophi overlying the first metatarsophalangeal joint of the left foot, the first interphalangeal joint of the right foot and the left thumb. We also emphasize the disabling effects of the under-treated hyperuremic arthropathy.A 75-year old Caucasian man with a long-standing history of tophaceous gout and several recurrent episodes of arthritis during the past five years presented with a large, painful, ulcerated tophus located on the first metatarsophalangeal joint of his left foot to our emergency department. He had intentionally interrupted treatment with allopurinol four months previously; however, he did not report any recent deviations from his standard diet, any alcohol abuse or diuretic treatment. Five days before presenting to the emergency department, a tophus on the first toe of his left foot had become painful, red and swollen. He tried a course of non-steroidal anti-inflammatory drugs (NSAIDs) without improvement. Ten hours before seeking medical assistance, the tophus burst releasing a viscous, chalk-like material.On physical exam
Electromagnetic Wave Propagation into Fresh Water  [PDF]
Shan Jiang, Stavros Georgakopoulos
Journal of Electromagnetic Analysis and Applications (JEMAA) , 2011, DOI: 10.4236/jemaa.2011.37042
Abstract: Wireless communications from air to fresh water are studied here. Our analysis relies on plane wave propagation mod-els. Specifically, the transmission loss and propagation loss of RF waves penetrating into fresh water are calculated for various propagation depths. Even though RF wireless communications are not well suited for seawater due to its high attenuation, our paper illustrates that RF communications from air to fresh water are possible. Finally, this work de-rives the optimum frequencies, which provide minimum attenuation and maximum propagation depth, for RF commu-nications from air to fresh water.
Simulation of Olive Kernel Gasification in a Bubbling Fluidized Bed Pilot Scale Reactor  [PDF]
Stavros Michailos, Anastasia Zabaniotou
Journal of Sustainable Bioenergy Systems (JSBS) , 2012, DOI: 10.4236/jsbs.2012.24021
Abstract:

The main aim of this study is to develop a comprehensive process model for biomass gasification in a pilot scale bubbling fluidized bed gasifier using the ASPEN PLUS simulator. A drawback in using ASPEN PLUS is the lack of a library model to simulate fluidized bed unit operation. However, it is possible for users to input their own models, using FORTRAN codes nested within the ASPEN PLUS input file, to simulate operation of a fluidized bed. The products of homogeneous reactions are defined by Gibbs equilibrium and reaction rate kinetics are used to determine the products of char gasification. Governing hydrodynamic equations for a bubbling bed and kinetic expressions for the char combustion were adopted from the literature. Different sets of gasification results for the operation conditions (temperature and air equivalence ratio (ER)) obtained from the our pilot-scale gasifier having a capacity of 1 kg/hr of olive kernel as feeding biomass, were used to demonstrate the validation of the model. The simulation results received from the application of the model were compared with the above experimental results and showed good agreement.

An Average Distance Based Self-Relocation and Self-Healing Algorithm for Mobile Sensor Networks  [PDF]
Yipeng Qu, Stavros V. Georgakopoulos
Wireless Sensor Network (WSN) , 2012, DOI: 10.4236/wsn.2012.411037
Abstract: The sensing coverage of a wireless sensor network is an important measure of the quality of service. It is desirable to develop energy efficient methods for relocating mobile sensors in order to achieve optimum sensing coverage. This paper introduces an average distance based self-relocation and self-healing algorithm for randomly deployed mobile sensor networks. No geo-location or relative location information is needed by this algorithm thereby no hardware such as GPS is required. The tradeoff is that sensors need to move longer distance in order to achieve certain coverage. Simulations are conducted in order to evaluate the proposed relocation and self-healing algorithms. An average of 94% coverage is achieved in the cases that we are examined with or without obstacles.
Sonographic evaluation of solid breast nodules
T Stavros
Breast Cancer Research , 2004, DOI: 10.1186/bcr822
Abstract: These studies show that sonography is useful in the characterization of solid breast masses. Characterizing solid breast nodules into BIRADS categories defines carcinomas that might have been missed clinically or mammographically. It identifies a BIRADS 3 group that has far less than 2% risk of being malignant and can offer the patient the option of follow-up rather than biopsy. Currently, approximately 80% of patients with BIRADS 3 solid nodules are electing to be followed rather than to undergo biopsy. It improves the accuracy of the diagnosis of malignant breast lesions. Importantly, it also accurately defines a population of benign solid breast lesions that do not require biopsy when strict sonographic criteria of benignity are present.To achieve the desired sensitivity and negative predictive values of 98% or greater the algorithm must be strictly adhered to. When the patient elects to be followed rather than undergo biopsy, follow-up should be performed in 6 months, not 1 year. The malignant lesions at most risk to be mischaracterized as BIRADS 3 are higher grade invasive ductal carcinomas that grow rapidly enough for change to be readily detected at 6 months.
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