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Demiri E, Dionyssiou D, Kyriazidis I, Drougou A, Tsimponis A. Predesigned chimeric deep inferior epigastric perforator and inguinal lymph node flap for combined breast and lymphedema reconstruction: A comprehensive algorithmic approach. JPRAS Open 2024; 40:1-18. [PMID: 38389651 PMCID: PMC10879689 DOI: 10.1016/j.jpra.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/24/2024] Open
Abstract
The combined use of a deep inferior epigastric perforator (DIEP) flap coupled with vascularized inguinal lymph nodes (VILNs) for simultaneous breast and lymphedema reconstruction has already been well established, and promising results have been reported. However, a standardized approach for the planning and shaping of this combined flap is still lacking. We aimed to propose a comprehensive algorithmic approach for delayed unilateral breast and lymphedema reconstruction using a predesigned abdominal flap associated with inguinal lymph node transfer. We present in detail the preoperative measurements and surgical technique of the chimeric flap, which combines a predesigned DIEP template and a preselected inguinal lymph node flap, based on the preoperative computed tomography angiography and SPEC-CT findings, respectively; four different flap types are described according to the location of the pedicles of the two flap components. Our results of a series of 34 consecutive female patients with unilateral mastectomy and arm lymphedema, who underwent this combined predesigned reconstructive procedure, are retrospectively analyzed and reported. We recorded a high survival rate of the chimeric flaps in our series, with only one case of partial ischemic loss of a DIEP skin island. In the majority of our patients, the pedicles of the combined flaps were located in opposite positions. After a mean 35-month follow-up, we recorded a 47% mean volume difference reduction of the lymphedematous compared to the unaffected arm; no donor-site lymphedema was documented. Self-evaluation questionnaires showed high patient satisfaction rates regarding breast reconstruction. This algorithmic approach provides standardized guidance for accurate design and transfer of the DIEP-VILN chimeric flap while achieving highly satisfactory outcomes for both breast and lymphedema reconstruction.
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Affiliation(s)
- Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki Greece
- Interbalkan Medical Center, Thessaloniki Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki Greece
- Interbalkan Medical Center, Thessaloniki Greece
| | - Ioannis Kyriazidis
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki Greece
| | - Avra Drougou
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki Greece
| | - Antonios Tsimponis
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki Greece
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Monou PK, Andriotis E, Tzetzis D, Tzimtzimis E, Panteris E, Andreadis D, Demiri E, Vizirianakis IS, Fatouros DG. Evaluation of 3D-Printed Solid Microneedles Coated with Electrosprayed Polymeric Nanoparticles for Simultaneous Delivery of Rivastigmine and N-Acetyl Cysteine. ACS Appl Bio Mater 2024. [PMID: 38591866 DOI: 10.1021/acsabm.3c00750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
In the current study, coated microneedle arrays were fabricated by means of digital light processing (DLP) printing. Three different shapes were designed, printed, and coated with PLGA particles containing two different actives. Rivastigmine (RIV) and N-acetyl-cysteine (NAC) were coformulated via electrohydrodynamic atomization (EHDA), and they were incorporated into the PLGA particles. The two actives are administered as a combined therapy for Alzheimer's disease. The printed arrays were evaluated regarding their ability to penetrate skin and their mechanical properties. Optical microscopy and scanning electron microscopy (SEM) were employed to further characterize the microneedle structure. Confocal laser microscopy studies were conducted to construct 3D imaging of the coating and to simulate the diffusion of the particles through artificial skin samples. Permeation studies were performed to investigate the transport of the drugs across human skin ex vivo. Subsequently, a series of tape strippings were performed in an attempt to examine the deposition of the APIs on and within the skin. Light microscopy and histological studies revealed no drastic effects on the membrane integrity of the stratum corneum. Finally, the cytocompatibility of the microneedles and their precursors was evaluated by measuring cell viability (MTT assay and live/dead staining) and membrane damages followed by LDH release.
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Affiliation(s)
- Paraskevi Kyriaki Monou
- Department of Pharmacy, Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
| | - Eleftherios Andriotis
- Department of Pharmacy, Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios Tzetzis
- Digital Manufacturing and Materials Characterization Laboratory, School of Science and Technology, International Hellenic University, 57001 Thessaloniki, Greece
| | - Emmanouil Tzimtzimis
- Digital Manufacturing and Materials Characterization Laboratory, School of Science and Technology, International Hellenic University, 57001 Thessaloniki, Greece
| | - Emmanuel Panteris
- Department of Botany, School of Biology, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Efterpi Demiri
- Clinic of Plastic and Reconstructive Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis S Vizirianakis
- Department of Pharmacy, Laboratory of Pharmacology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios G Fatouros
- Department of Pharmacy, Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
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Kyriazidis I, Demiri E, Dionyssiou D. Comparing the Impact of Diluents and Injection Techniques on Patient Comfort During Indocyanine Green Lymphangiography: A Prospective Study. Lymphat Res Biol 2024; 22:120-123. [PMID: 38593453 DOI: 10.1089/lrb.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background: Indocyanine green (ICG) lymphography, a key diagnostic tool for lymphedema, is influenced by the dilution process of ICG dye, impacting patient experience. Methods and Results: In our study, we assessed three different ICG diluents-water for injection (WFI), normal saline (NS), and Dextrose® plus human albumin-in five healthy volunteer individuals undergoing superficial lymphography of the upper limb over 3 weeks. Results indicated that NS, as a diluent for ICG, caused the least discomfort during injection, in contrast to WFI, which led to the highest levels of discomfort. Transport time of ICG from the injection site to the axillary lymph nodes was notably shorter in intradermal injections than in subdermal injections. Conclusion: Our findings advocate for using NS as the optimal and cost-effective diluent for ICG, enhancing patient experience.
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Affiliation(s)
- Ioannis Kyriazidis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Kyriazidis I, Antoniou A, Demiri E, Pavlidis L, Papas A. Bilateral Hematoma Following Air Travel after Breast Augmentation: A Cautionary Tale and Literature Review. Plast Reconstr Surg Glob Open 2024; 12:e5639. [PMID: 38435464 PMCID: PMC10906603 DOI: 10.1097/gox.0000000000005639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
In this study, we report a rare incidence of bilateral hematoma following air travel in a patient who had recently undergone breast augmentation surgery. The case underscores the potential risks associated with flying shortly after such procedures. Through a literature review, we aimed to explore the incidence rates and highlight the need for further research in this area. This case report aims to raise awareness among healthcare professionals and patients about the need for cautious post-surgical travel planning to mitigate the risk of similar complications.
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Affiliation(s)
- Ioannis Kyriazidis
- From the Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Antonios Antoniou
- From the Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- From the Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Leonidas Pavlidis
- From the Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Athanasios Papas
- From the Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
- School of Medicine, European University Cyprus, Nicosia, Cyprus
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Dionyssiou D, Nguyen D, Topalis A, Deptula P, Paukshto M, Zaitseva T, Demiri E, Cheva A, Rockson S. Treatment of Rat Lymphedema by Propeller Lymphatic Tissue Flap Combined with Nanofibrillar Collagen Scaffolds. J Reconstr Microsurg 2024; 40:145-155. [PMID: 37142251 DOI: 10.1055/a-2086-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND The aim of our study was to evaluate a new propeller vascularized lymphatic tissue flap (pVLNT) combined with aligned nanofibrillar collagen scaffolds (CS) (BioBridge) in reducing lymphedema in the rat lymphedema model. METHODS Unilateral left hindlimb lymphedema was created in 15 female Sprague-Dawley rats following inguinal and popliteal lymph nodes (LN) resection and radiation. An inguinal pVLNT was elevated from the contralateral groin and transferred through a skin tunnel to the affected groin. Four collagen threads were attached to the flap and inserted in the hindlimb at the subcutaneous level in a fan shape. The three study groups consisted of group A (control), group B (pVLNT), and group C (pVLNT + CS). Volumetric analysis of both hindlimbs was performed using micro-computed tomography imaging before the surgery (at initial time point) and then at 1 and 4 months, postoperatively, and the relative volume difference (excess volume) was measured for each animal. Lymphatic drainage was assessed by indocyanine green (ICG) fluoroscopy for number and morphology of new collectors and the time required for ICG to move from injection point to the midline. RESULTS Four months after the induction of lymphedema, an increased relative volume difference remained in group A (5.32 ± 4.74%), while there was a significant relative volume reduction in group B (-13.39 ± 8.55%) and an even greater reduction in group C (-14.56 ± 5.04%). ICG fluoroscopy proved the functional restoration of lymphatic vessels and viability of pVLNT in both B and C groups. Notably, only group C demonstrated statistically significant improvements in lymphatic pattern/morphology and in the number of lymphatic collectors as compared with the control group A. CONCLUSION The pedicle lymphatic tissue flap combined with SC is an effective procedure for the treatment of lymphedema in rats. It can be easily translated into treatment of humans' lower and upper limb lymphedema and further clinical studies are warranted.
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Affiliation(s)
- Dimitrios Dionyssiou
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dung Nguyen
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California
| | - Anastasios Topalis
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Peter Deptula
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California
| | | | | | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angeliki Cheva
- Laboratory of Pathology, Medical School, Aristotle University, Thessaloniki, Greece
| | - Stanley Rockson
- Center for Lymphatic and Venous Disorders, Stanford University School of Medicine, Stanford, California
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Tsimponis A, Dionyssiou D, Papamitsou T, Demiri E. The effect of host tissue and radiation on fat-graft survival: A comparative experimental study. JPRAS Open 2023; 38:134-146. [PMID: 37929062 PMCID: PMC10623108 DOI: 10.1016/j.jpra.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/27/2023] [Indexed: 11/07/2023] Open
Abstract
Because lipofilling is often associated with various reconstructive procedures, especially breast reconstructions, improving fat-graft retention remains a major concern for plastic surgeons. We conducted an experimental protocol in a rat model simulating an autologous breast reconstruction method using the fat-augmented latissimus dorsi myocutaneous (LDM) flap. This study aimed to compare the survival rates of autologous adipocytes when injected subcutaneously and intramuscularly and to evaluate the role of recipient host tissue, volume of the injected fat, and postoperative radiation on fat-graft retention. Thirty rats were divided into five groups (A, B, C, D, and E), of six rats each. All animals underwent a pedicled LDM flap transfer to the anterior thoracic wall, and different volumes of autologous fat were injected into three recipient areas, namely, the pectoralis major and latissimus dorsi muscles and the subcutaneous tissue of the flap's skin island, as follows: 1 mL of fat was injected in total in group A, 2 mL in groups B and D, and 5 mL in group C. Group D animals received postoperative radiation (24 Gy), whereas group E animals (controls) did not undergo any fat grafting procedure. Eight weeks after surgery, adipocyte survival was assessed in all groups using histological and immunochemistry techniques. The results showed that the pectoralis major muscle was the substrate with the highest adipocyte survival rates, which were proportional to the amount of fat injected, followed by the latissimus dorsi muscle and the subcutaneous tissue. Increased volumes of transplanted fat into the subcutaneous tissue did not correspond to increased adipocyte survival. Irradiation of host tissues resulted in a statistically significant decrease in surviving adipocytes in all three recipient sites (p<0.001). Our study strongly suggests that muscle ensures optimal fat-graft retention, whereas postoperative radiation negatively affects adipocyte survival following fat transplantation.
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Affiliation(s)
- Antonios Tsimponis
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki Greece
| | - Theodora Papamitsou
- Laboratory of Histology-Embryology, Aristotle University of Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki Greece
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Kyriazidis I, Demiri E, Dionyssiou D. Facilitated Small Venous Anastomosis with Couplers using an Intravenous Catheter Suction System. J Reconstr Microsurg 2023; 39:e1-e2. [PMID: 36928901 DOI: 10.1055/a-2056-2069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Ioannis Kyriazidis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Tsimponis A, Dionyssiou D, Miliaras S, Demiri E. Consecutive bilateral breast reconstruction using different autologous flaps: can symmetrical results still be achieved? A case report. Case Reports Plast Surg Hand Surg 2023; 10:2197500. [PMID: 37389323 PMCID: PMC10304431 DOI: 10.1080/23320885.2023.2197500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/27/2023] [Indexed: 07/01/2023]
Abstract
We report a 60-year-old patient who underwent bilateral mastectomy at different times, followed by immediate autologous reconstruction with different flaps: deep-inferior epigastric-perforator flap on one breast, and fat-augmented latissimus dorsi on the contralateral side. At 20-month follow-up, good symmetry was recorded; patient-reported outcome measurements revealed high satisfaction scores.
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Affiliation(s)
- Antonios Tsimponis
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Spyros Miliaras
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Dionyssiou D, Papas A, Drougou A, Tsamaldoupis A, Arsos G, Demiri E. Simultaneous upper limb melanoma and breast cancer related lymphedema management. Case Reports Plast Surg Hand Surg 2023; 10:2182308. [PMID: 36860493 PMCID: PMC9970225 DOI: 10.1080/23320885.2023.2182308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
We present a rare case of a patient with malignant melanoma in the lymphedematous arm associated with breast cancer and its lymphedema management. Histology of previous lymphadenectomy and results of current lymphangiographies suggested the need for SLN biopsy, and simultaneously perform of distal LVAs to manage lymphedema.
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Affiliation(s)
- Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Greece. GH Papageorgiou, Thessaloniki, Greece,CONTACT Dimitrios Dionyssiou Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Greece., Department of Plastic Surgery, General Hospital “Papageorgiou”, Thessaloniki, 54603, Greece
| | - Athanasios Papas
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Greece. GH Papageorgiou, Thessaloniki, Greece
| | - Avra Drougou
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Greece. GH Papageorgiou, Thessaloniki, Greece
| | | | - Georgios Arsos
- Department of Nuclear Medicine, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece,GH Papageorgiou, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Greece. GH Papageorgiou, Thessaloniki, Greece
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Spyropoulou GA, Vahtsevanos K, Antoniades K, Karagergou E, Papadopoulou S, Demiri E. Anterolateral thigh harvesting for head and neck reconstruction without Doppler: Risky or not? Oral and Maxillofacial Surgery Cases 2023. [DOI: 10.1016/j.omsc.2023.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Papaconstantinou A, Koletsa T, Demiri E, Tzorakoleftheraki SE, Gasteratos K, Pavlidis L, Dionyssiou D, Spyropoulou GA. Investigation of Autologous Fat Transfer in Capsule Formation around Silicone Implants in a Rat Model. Plast Reconstr Surg 2022; 149:881-887. [PMID: 35139050 DOI: 10.1097/prs.0000000000008923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In this experimental study, the authors investigated whether fat placement in the pocket during implant insertion affects capsule formation. METHODS Twenty albino Wistar rats, 400 g each, were used. The rats were divided into two groups, A and B, of 10 rats each. At the dorsum of each rat, four pockets (2 × 2 cm each) were dissected, two left and two right of the midline. In each pocket, a 1 × 1 × 1.5-cm silicone implant was inserted. In the two left pockets, only silicone implants were placed (control). In the two right pockets, 0.4 ml of fat was injected around the implant. Animals in group A were killed 2 months postoperatively, and those in group B were killed 4 months postoperatively. The implants were dissected with the capsule and sent for histopathologic examination. RESULTS The data of the fat transfer group was compared with control in groups A and B. Capsule thickness, neovascularization, myofibroblast layer thickness, and mast cell population demonstrated no statistically significant difference in either group A (p = 0.385, p = 0.862, p = 0.874, and p = 0.210, respectively) or group B (p = 0.338, p = 1.000, p = 0.288, and p = 0.344, respectively). Inflammation was statistically significantly less (p = 0.07) at 4 months (group B) in the fat transfer group compared to the control group. Likewise, cellularity was statistically significantly less (p = 0.019) at 4 months for the fat transfer group compared with the control group. CONCLUSION Fat injection in the pocket during implant placement may reduce inflammation and cellularity of capsules and predispose to faster capsule maturation. CLINICAL RELEVANCE STATEMENT PLEASE PROVIDE 1- TO 2-SENTENCE STATEMENT.
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Affiliation(s)
- Anthony Papaconstantinou
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Triantafyllia Koletsa
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Efterpi Demiri
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Sofia-Eleni Tzorakoleftheraki
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Kostantinos Gasteratos
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Leonidas Pavlidis
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Dimitrios Dionyssiou
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Georgia-Alexandra Spyropoulou
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
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Abstract
Background: Lymphedema is a debilitating and progressive clinical entity characterized by abnormal accumulation of lymph and fluid in the extracellular space. Most of the cases in western population are related to cancer treatment. Research on cancer-related lymphedema (CRL) is mounting for potential risk factors associated to disease, treatment, or patient. However, only a few cancer survivors with the same risk factors will develop lymphedema, giving rise to the hypothesis that inherited genetic susceptibility may play a role in CRL pathophysiology. This systematic review aimed to identify, critically appraise, and summarize the results of individual studies that have examined the genetic predisposition to CRL. Methods and Results: A comprehensive literature search in MEDLINE, Cochrane, and Scopus was conducted from inception to February 2021. Screening of available studies and quality of the included studies were carried out by two reviewers independently. Eight studies fulfilled eligibility criteria, involving 573 women with breast-cancer related lymphedema (BCRL) among 1,481 participants. Associations between the development of CRL and genetic factors were observed for variations in 23 genes in patients with BCRL. Conclusions: The present systematic review is the first examining specifically the genetic predisposition in CRL. Statistically significant genetic variations were found in 23 genes in patients with BCRL. These preliminary findings highlight the importance of genetic susceptibility in the development of CRL, altering the traditional perception of its iatrogenic etiology. Additional well-designed research, aiming toward the confirmation of previously performed genetic analyses and functional assessment of the genetic variations, is required.
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Affiliation(s)
- Nikolaos Kapellas
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Alexandros Lampropoulos
- 1st Laboratory of Medical Biology and Genetics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Xenikakis I, Tsongas K, Tzimtzimis EK, Katsamenis OL, Demiri E, Zacharis CK, Georgiou D, Kalogianni EP, Tzetzis D, Fatouros DG. Transdermal delivery of insulin across human skin in vitro with 3D printed hollow microneedles. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2021.102891] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Demiri E, Georgiadou E, Goula OC, Tzorakoeleftheraki SE, Karagergou E, Hytiroglou P. A rare case of congenital plexiform fibrohistiocytic tumor of the foot in a 4-year-old boy: case report and literature review. Case Reports Plast Surg Hand Surg 2021; 8:164-168. [PMID: 34621916 PMCID: PMC8491708 DOI: 10.1080/23320885.2021.1986049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The plexiform fibrohistiocytic tumor (PFHT) is an infrequent soft-tissue neoplasm with uncertain biological behavior. We report a rare congenital PFHT case in a 4-year-old boy, treated with wide excision and skin grafting. After a 52-month follow-up, no recurrence, regional or distant metastases were documented. A literature review on the management of PFHTs is reported.
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Affiliation(s)
- Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou Hospital, Periferiaki Odos Neas Efkarpias, Thessaloniki, Greece
| | - Eleni Georgiadou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou Hospital, Periferiaki Odos Neas Efkarpias, Thessaloniki, Greece
| | - Olga-Christina Goula
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou Hospital, Periferiaki Odos Neas Efkarpias, Thessaloniki, Greece
| | - Sofia-Eleni Tzorakoeleftheraki
- Department of Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Karagergou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou Hospital, Periferiaki Odos Neas Efkarpias, Thessaloniki, Greece
| | - Prodromos Hytiroglou
- Department of Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kotoula V, Papadopoulou K, Tikas I, Fostira F, Vrettou E, Chrisafi S, Fountzilas E, Koliou GA, Apostolou P, Papazisis K, Zaramboukas T, Asimaki-Vlachopoulou A, Miliaras S, Ananiadis A, Poulios C, Natsiopoulos I, Tsiftsoglou A, Demiri E, Fountzilas G. Follow-up of tissue genomics in BRCA1/2 carriers who underwent prophylactic surgeries. Breast Cancer 2021; 28:1367-1382. [PMID: 34304347 DOI: 10.1007/s12282-021-01276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The genomic status of non-malignant tissues from carriers of pathogenic germline BRCA1/2 (gBRCA1/2) variants may reveal information towards individualized prophylaxis. We performed spatiotemporal tissue genotype comparisons in a real-life cohort of gBRCA1/2 carriers of Greek origin, who underwent multiple risk-reducing/prophylactic surgeries at various time points. METHODS Fifty-three women (median age 36 years) within cancer families were observed for up to 37.5 years; 43 were cancer carriers and 10 were healthy carriers. Histology review and genotyping were performed for 187 paraffin tissues (average: 3.5 per carrier) including 46 carcinomas (40 breast) and 141 non-malignant breast and gynecological samples. RESULTS High allelic imbalance (AI) and somatic pathogenic TP53 variants were present in cancer carriers only (p values < 0.0001). High AI was associated with gBRCA1/2 indels (p < 0.0001) and gBRCA2 alterations (p = 0.0109). Somatic (pathogenic) variants were infrequently shared between non-malignant tissues and matched carcinomas. Aberrations of gBRCA1 variant heterozygosity were noticed in tissues from cancer carriers only (13/43, 30.2%). These pertained to classic LOH (neoplastic lesions in 9/43 carriers, 20.9%) and under-representation of the germline variants (5 samples, 4 non-malignant, all in the breast). Both aberrations coexisted in matched samples in one case. Over time, germline variant heterozygosity prevailed in non-malignant tissues; intra-carrier genomic alterations were aggravated (21.1%), ameliorated (26.3%) or remained stable. CONCLUSION This real-life case study supports the need to address tissue genotypes from prophylactic surgeries in combination with polygenic scores towards personalized prophylaxis. To this end, knowing the traditionally classified pathogenic potential of a gBRCA1/2 variant may not be enough.
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Affiliation(s)
- Vassiliki Kotoula
- Department of Pathology, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, University Campus, bld. 17b, 54124, Thessaloníki, Greece. .,Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloníki, Greece.
| | - Kyriaki Papadopoulou
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Ioannis Tikas
- Department of Pathology, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, University Campus, bld. 17b, 54124, Thessaloníki, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research NCSR Demokritos, Athens, Greece
| | - Eleni Vrettou
- Department of Pathology, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, University Campus, bld. 17b, 54124, Thessaloníki, Greece
| | - Sofia Chrisafi
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Elena Fountzilas
- Second Department of Medical Oncology, Euromedica General Clinic of Thessaloniki, Thessaloníki, Greece.,European University of Cyprus, Nicosia, Cyprus
| | | | - Paraskevi Apostolou
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research NCSR Demokritos, Athens, Greece
| | - Konstantinos Papazisis
- Department of Medical Oncology, Interbalkan European Medical Center, Thessaloníki, Greece
| | - Thomas Zaramboukas
- Department of Pathology, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, University Campus, bld. 17b, 54124, Thessaloníki, Greece
| | | | - Spyros Miliaras
- First Department of Surgery, Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, Thessaloníki, Greece
| | | | - Christos Poulios
- Department of Pathology, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, University Campus, bld. 17b, 54124, Thessaloníki, Greece
| | - Ioannis Natsiopoulos
- Department of Breast Surgery, Interbalkan European Medical Center, Thessaloníki, Greece
| | - Aris Tsiftsoglou
- Department of Surgery, St. Luke's Hospital, Thessaloníki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, Thessaloníki, Greece
| | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloníki, Greece.,Aristotle University of Thessaloniki, Thessaloníki, Greece.,German Oncology Center, Limassol, Cyprus
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Demiri E, Pagkalos A, Tsangaris E, Drougou A, Pavlidis L, Dionyssiou D, Pagkalos G. Greek translation and cultural adaptation of new scales and checklists for the BREAST-Q Reconstruction Module. Eur J Plast Surg 2021. [DOI: 10.1007/s00238-021-01846-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Papaconstantinou A, Koletsa T, Demiri E, Gasteratos K, Tzorakoleftheraki SE, Pavlidis L, Spyropoulou GA. Nonsurgical treatment of capsular contracture: Review of clinical studies. J Int Med Res 2021; 48:300060520927873. [PMID: 32496144 PMCID: PMC7273769 DOI: 10.1177/0300060520927873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Capsular contracture is one of the most distressing complications of breast implant use in both aesthetic and reconstructive plastic surgery procedures. This systematic review was performed to assess the effectiveness of all nonsurgical treatments for established capsular contracture.
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Affiliation(s)
- Anthony Papaconstantinou
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Efterpi Demiri
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kostantinos Gasteratos
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Leonidas Pavlidis
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Demiri E, Tsimponis A, Pavlidis L, Spyropoulou GA, Foroglou P, Dionyssiou D. Reverse neurocutaneous vs propeller perforator flaps in diabetic foot reconstruction. Injury 2020; 51 Suppl 4:S16-S21. [PMID: 32184012 DOI: 10.1016/j.injury.2020.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/23/2020] [Accepted: 03/07/2020] [Indexed: 02/02/2023]
Abstract
Introduction Reverse neurocutaneous and propeller perforator flaps are both used to reconstruct diabetic distal lower limb defects. Our study aims to compare outcomes between these two groups of flaps with an emphasis on indications and complication rates. Method A retrospective analysis was conducted, reviewing data from 54 diabetic patients who underwent reconstruction of acute or chronic wounds of the foot and ankle between 2005-2018. Thirty-four patients (Group A) had a reverse neurocutaneous flap (NCF): nineteen sural and fifteen lateral supramalleolar flaps. Twenty patients (Group B) had a propeller flap (PF) based on peroneal (n = 13) or posterior tibial artery perforators (n = 7). All patients had a preoperative Doppler examination to identify the nutrient artery of the flap. In both groups, we recorded patients' demographics, characteristics of the defect, postoperative complications and time to heal. Follow-up ranged from 6 to 59 months. Student's t-test and chi-squared test were used for statistical analysis. Results Mean patients' age was 59.1 and 50.8 years for Group A and B, respectively. Defects were located at the Achilles zone (n = 16), posterior heel (n = 14), foot dorsum (n = 9), lateral and medial malleolar areas (n = 8), anterior ankle (n = 5) and lateral foot (n = 2). Mean size of the defect was 42.8 cm2 in Group A and 23 cm2 in Group B. Uneventful healing was recorded in 20/34 neurocutaneous flaps and in 12/20 propeller flaps; complications included two complete flap losses (one NCF, one PF), seventeen distal flap necroses (10 NCFs, 7 PFs), fifteen delayed wound healing events over the donor or recipient site (12 NCFs, 3 PFs). Secondary surgeries were required in 15 NCF and 8 PF patients. Mean healing time was 48.1 and 40.7 days for Group A and B, respectively. All patients, except one NCF case, which resulted in leg amputation, returned to previous levels of ambulation. Conclusion Reverse neurocutaneous and propeller flaps may provide stable reconstruction of diabetic lower limb defects; neurocutaneous flaps are specially indicated for larger and more distally located defects, although they might be associated with longer healing time and additional revision surgeries. Propeller flaps were more frequently used in younger patients for smaller and more proximally located defects.
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Affiliation(s)
- Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Papageorgiou Hospital, Thessaloniki, Greece.
| | - Antonios Tsimponis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Papageorgiou Hospital, Thessaloniki, Greece
| | - Leonidas Pavlidis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Papageorgiou Hospital, Thessaloniki, Greece
| | - Georgia-Alexandra Spyropoulou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Papageorgiou Hospital, Thessaloniki, Greece
| | - Periclis Foroglou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Papageorgiou Hospital, Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Papageorgiou Hospital, Thessaloniki, Greece
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Dionyssiou D, Pagkalos A, Papas A, Pavlidis L, Spyropoulou GA, Demiri E. Evolution and refinements of a dorsal adipofascial digital artery perforator flap. Injury 2020; 51 Suppl 4:S48-S53. [PMID: 32173080 DOI: 10.1016/j.injury.2020.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/21/2020] [Accepted: 03/07/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Soft tissue defects to the dorsum of fingers are quite demanding for the reconstructive surgeon especially in the cases that bone and extensor tendons are exposed. The purpose of our study was to describe a new adipofascial island flap by a single dorsal digital perforator (dorsal adipofascial digital artery perforator, DADAP). MATERIALS Methods: In 8 patients (7 male, 1 female), 12 soft tissue defects to the dorsum of the fingers (3 index, 6 middle, 2 ring, 1 little finger), ranging from 1 × 2 cm to 2 × 4 cm, were reconstructed using the DADAP flap. RESULTS The flaps sizes ranged from 2.5 × 1.5 cm to 8 × 3 cm. The defects were covered in 9 cases by a propeller-rotation type flap and in 3 by a turn-over flap. In 4 cases a tendon graft was used to cover the tendon defect and in 3 cases an open joint was reconstructed. In all cases a splint thickness skin graft (SSG) covered the flaps. Mean follow-up was 18 months. One patient developed distal tip flap necrosis and was treated conservatively. Delayed wound healing with partial SSG failure due to haematoma was observed in 3 fingers, but the underlying flap was viable and complete healing was achieved by secondary intention. CONCLUSIONS The use of DADAP flap is a fast, safe and reliable solution to cover the defects of the dorsum of fingers and can be performed under local anaesthesia as a day surgery.
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Affiliation(s)
- Dimitrios Dionyssiou
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Anastasios Pagkalos
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Papas
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leonidas Pavlidis
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Alexandra Spyropoulou
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Spyropoulou GAC, Pavlidis L, Herrmann S, Tsimponis A, Foroglou P, Delimpaltas A, Demiri E, Cohen M. Can Cosmetics' Advertisements Be An Indicator of Different Perceptions of Beauty Amongst Countries? Aesthetic Plast Surg 2020; 44:1871-1878. [PMID: 32215696 DOI: 10.1007/s00266-020-01679-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Concepts of beauty are different amongst different cultures and civilizations. The objective of this study was to evaluate beauty perceptions through cosmetic advertisements in an effort to further appreciate beauty understanding amongst lay people in various parts of the world. To achieve these objectives, we reviewed cosmetics' advertisements to study whether the concept of beauty varies amongst different countries. MATERIALS AND METHODS We used the keywords "cosmetics" and "advertisements" in YouTube search engine in all existing languages in Google translator and came up with advertisements from 18 countries. The faces of the models were compared against Marquardt® beauty mask template in order to have a mean to objectively test symmetry with a mathematical computer model. The weak point of our study is that we can present no model photographs due to General Data Protection Regulation. RESULTS Advertisements retrieved in total were 257. Characteristics with no statistically significant difference (SSD) amongst models in different parts of the world were: symmetry (p = 0.187), high cheek bones (p = 0.325), small noses (p = 0.72), thin jaws (p = 0.98), lush hair (p = 0.54), clean and smooth skin (p = 0.367), and white toothed smile (p = 0.235). Characteristics with SSD were: in Latin America, USA, and Australia tanned models and fuller lips were preferred (p < 0.001), whilst in Asia milky white skin models and small mouth were preferred. Age ratio (p = 0.022) was lower amongst models in Southeast Asia compared to American, European, Indian, Australian, and Arab models. Arab and Southeast Asia women had intense eyebrows (p < 0.001) and used artificial eyelashes. CONCLUSIONS All the common characteristics noted by the two independent surgeons (GAS and LP) referred to symmetry, youthfulness, and health. Differences noticed reflected cultural influences in the perception of beauty. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Theodoridis K, Aggelidou E, Manthou ME, Keklikoglou K, Tsimponis A, Demiri E, Bakopoulou A, Mihailidis A, Kritis A. An effective device and method for enhanced cell growth in 3D scaffolds: Investigation of cell seeding and proliferation under static and dynamic conditions. Mater Sci Eng C Mater Biol Appl 2020; 114:111060. [PMID: 32993978 DOI: 10.1016/j.msec.2020.111060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/26/2020] [Accepted: 05/05/2020] [Indexed: 12/26/2022]
Abstract
Cell adhesion on 3D-scaffolds is a challenging task to succeed high cell densities and even cell distribution. We aimed to design a 3D-cell Culture Device (3D-CD) for static seeding and cultivation, to be used with any kind of scaffold, limiting cell loss and facilitating nutrient supply. 3D printing technology was used for both scaffold and device fabrication. Apart from testing the device, the purpose of this study was to assess and compare static and dynamic seeding and cultivation methods, of wet and dry scaffolds, under normoxic and hypoxic conditions and their effects on parameters such as cell seeding efficiency, cell distribution and cell proliferation. Human adipose tissue was harvested and cultured in 3D-printed poly(epsilon-caprolactone) scaffolds. Micro-CT scans were performed and projection images were reconstructed into cross section images. We created 3D images to visualize cell distribution and orientation inside the scaffolds. The group of prewetted scaffolds was the most favorable to cell attachment. The 3D-cell Culture Device (3D-CD) enhanced cell seeding efficiency with almost no cell loss. We suggest that the most favorable outcome can be produced with static seeding in the device for 24 h, followed either by static cultivation in the same device or by dynamic cultivation.
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Affiliation(s)
- Konstantinos Theodoridis
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece.
| | - Eleni Aggelidou
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Maria-Eleni Manthou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; Laboratory of Histology, Embryology and Anthropology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Kleoniki Keklikoglou
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research (HCMR), Thalassocosmos, 71003 Heraklion, Crete, Greece
| | - Antonios Tsimponis
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Athina Bakopoulou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), GR-54124 Thessaloniki, Greece
| | - Athanasios Mihailidis
- Laboratory of Machine Elements and Machine Design, School of Mechanical Engineering, Aristotle University of Thessaloniki (A.U.Th.), GR-54624 Thessaloniki, Greece
| | - Aristeidis Kritis
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
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Spyropoulou GA, Pavlidis L, Herrmann S, Tsimponis A, Foroglou P, Delimpaltas A, Demiri E, Cohen M. Correction to: Can Cosmetics' Advertisements Be An Indicator of Different Perceptions of Beauty Amongst Countries? Aesthetic Plast Surg 2020; 44:1952. [PMID: 32358667 DOI: 10.1007/s00266-020-01714-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Georgia-Alexandra Spyropoulou's name appeared incorrectly in the original publication of this article. It appears correctly here.
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Affiliation(s)
- Georgia Alexandra Spyropoulou
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.
| | - Leonidas Pavlidis
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Steve Herrmann
- Hunfalvy Bilingual Secondary Vocational School, 1011, BudapestPonty utca 3, Hungary
| | - Antonis Tsimponis
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Periclis Foroglou
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Alexandros Delimpaltas
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Mimis Cohen
- Division of Plastic, Reconstructive and Cosmetic Surgery, Craniofacial Center, University of Illinois, Chicago, IL, USA
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Tziveleka LA, Sapalidis A, Kikionis S, Aggelidou E, Demiri E, Kritis A, Ioannou E, Roussis V. Hybrid Sponge-Like Scaffolds Based on Ulvan and Gelatin: Design, Characterization and Evaluation of Their Potential Use in Bone Tissue Engineering. Materials (Basel) 2020; 13:E1763. [PMID: 32283814 PMCID: PMC7178717 DOI: 10.3390/ma13071763] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 01/01/2023]
Abstract
Ulvan, a bioactive natural sulfated polysaccharide, and gelatin, a collagen-derived biopolymer, have attracted interest for the preparation of biomaterials for different biomedical applications, due to their demonstrated compatibility for cell attachment and proliferation. Both ulvan and gelatin have exhibited osteoinductive potential, either alone or in combination with other materials. In the current work, a series of novel hybrid scaffolds based on crosslinked ulvan and gelatin was designed, prepared and characterized. Their mechanical performance, thermal stability, porosity, water-uptake and in vitro degradation ability were assessed, while their morphology was analyzed through scanning electron microscopy. The prepared hybrid ulvan/gelatin scaffolds were characterized by a highly porous and interconnected structure. Human adipose-derived mesenchymal stem cells (hADMSCs) were seeded in selected ulvan/gelatin hybrid scaffolds and their adhesion, survival, proliferation, and osteogenic differentiation efficiency was evaluated. Overall, it was found that the prepared hybrid sponge-like scaffolds could efficiently support mesenchymal stem cells' adhesion and proliferation, suggesting that such scaffolds could have potential uses in bone tissue engineering.
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Affiliation(s)
- Leto-Aikaterini Tziveleka
- Section of Pharmacognosy and Chemistry of Natural Products, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece; (L.-A.T.); (S.K.); (E.I.)
| | - Andreas Sapalidis
- Institute of Nanosciences and Nanotechnology, NCSR “Demokritos”, Aghia Paraskevi, 15310 Attiki, Greece;
| | - Stefanos Kikionis
- Section of Pharmacognosy and Chemistry of Natural Products, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece; (L.-A.T.); (S.K.); (E.I.)
| | - Eleni Aggelidou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.A.); (A.K.)
| | - Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Aristeidis Kritis
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.A.); (A.K.)
| | - Efstathia Ioannou
- Section of Pharmacognosy and Chemistry of Natural Products, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece; (L.-A.T.); (S.K.); (E.I.)
| | - Vassilios Roussis
- Section of Pharmacognosy and Chemistry of Natural Products, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece; (L.-A.T.); (S.K.); (E.I.)
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Spyropoulou G, Pavlidis L, Trakatelli M, Foroglou P, Pagkalos A, Tsimponis A, Lampros E, Delimpaltas A, Demiri E. Cutaneous squamous cell carcinoma with incomplete margins demonstrate higher tumour grade on re‐excision. J Eur Acad Dermatol Venereol 2020; 34:1478-1481. [DOI: 10.1111/jdv.16167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022]
Affiliation(s)
- G.‐A. Spyropoulou
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - L. Pavlidis
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - M. Trakatelli
- 2nd Clinic of Dermatology Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - P. Foroglou
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Pagkalos
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Tsimponis
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - E. Lampros
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Delimpaltas
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - E. Demiri
- Clinic of Plastic and Reconstructive Surgery Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
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Karagergou E, Dionyssopoulos A, Karayannopoulou M, Psalla D, Theodoridis A, Demiri E, Koliakos G. Adipose-derived stromal vascular fraction aids epithelialisation and angiogenesis in an animal model. J Wound Care 2019; 27:637-644. [PMID: 30332355 DOI: 10.12968/jowc.2018.27.10.637] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Limited data exist regarding the correlation between adipose-derived stromal vascular fraction (SVF) and wound healing. The aim of this study was to investigate the direct effect of intradermally injected SVF on full-thickness cutaneous wounds in a murine model. METHOD Wistar rats were divided into three groups (A, B and C) according to their day of euthanasia (day 7, 16 and 21). Inguinal fat pad was excised and SVF enzymatically extracted. Full-thickness cutaneous wounds were created on each side of the dorsum; SVF injected intradermally at one side while the contralateral wound served as control receiving normal saline. Postoperatively, evaluation of wound healing was performed by planimetry (percentages of wound contraction, epithelialisation and total wound healing) on days 0, 3, 5, 7, 10, 13, 16 and 21, and histology and immunochemistry (cellular infiltration score, collagen production score, neoangiogenesis and epithelial thickness) on days 7, 16 and 21. RESULTS Despite the high rate of wound contraction, it was significantly lower in the SVF-treated wounds on day 21 (p=0.037). On days 13, 16 and 21, the percentages of epithelialisation were higher in the SVF-treated wounds compared with control wounds (p=0.026, p=0.048 and p=0.05, respectively). Histologically, the number of new vessels was significantly higher in the SVF-treated wounds compared with controls on days seven (p=0.028) and 16 (p=0.027). This was also confirmed by immunohistochemistry. No significant differences were found between treated and control wounds regarding cellular infiltration score, collagen production score and epithelial thickness. CONCLUSION Data indicate that intradermally injected SVF increases angiogenesis and enhances epithelialisation in full-thickness cutaneous wounds in rats.
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Affiliation(s)
- Eleni Karagergou
- Department of Plastic Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Dionyssopoulos
- Department of Plastic Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Karayannopoulou
- Department of Clinical Studies, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Psalla
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Theodoridis
- Laboratory of Animal Production Economics, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Koliakos
- Department of Biochemistry, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece, and Biohellenika Biotechnology Company S.A, Thessaloniki, Greece
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Foroglou P, Demiri E, Koliakos G, Karathanasis V. Autologous administration of adipose stromal cells improves skin flap survival through neovascularization: An experimental study. Int Wound J 2019; 16:1471-1476. [PMID: 31486248 DOI: 10.1111/iwj.13216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 08/13/2019] [Accepted: 08/18/2019] [Indexed: 11/27/2022] Open
Abstract
One of the most severe complications in aesthetic and reconstructive surgeries is the partial or total necrosis of a skin flap. In our experimental study, we demonstrated the use of adipose-derived stem cells in the increase of skin flap survival rates. Stem cells were isolated from the fat of Wistar rats and genetically modified to permanently produce a green fluorescent protein (GFP). Two random-pattern skin flaps (2 cm × 8 cm) were elevated on the dorsal area of the spine, and after being separated from the surgical wounds with a thin silicone sheet, they were placed back onto their original location. Then, the autologous GFP-producing cells were injected intradermally into the dorsal area of the rats. At the seventh day, after the implantation of the stem cells, a clinical and immunohistochemical control was performed. The fluorescence microscopy revealed green vascular formations, suggesting that autologous GFP stromal cells were converted into endothelial cells through neovascularization. In the control skin flaps, where no stromal cells were used, no fluorescence was observed. The statistical analysis showed significantly lower necrosis rates in the right-sided flaps (i.e., the flaps where adipose-derived stromal cells were injected) compared with the left-sided ones. Findings from our study demonstrate that adipose-derived stem cells play an important role in the improvement of skin flap survival. Neovascularization is an effective way of achieving it.
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Affiliation(s)
- Pericles Foroglou
- Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Koliakos
- Department of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Karathanasis
- Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Foroglou P, Farmakis G, Antoniou A, Demiri E. A critical survey of a dedicated craniofacial surgery outpatient's clinic within a public health service structure. Hell J Nucl Med 2019; 22 Suppl 2:28-33. [PMID: 31802041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
The management of craniofacial conditions, especially in the setting of a large general hospital, is ideally achieved by a focused team in a multidisciplinary clinic. The purpose of this article was to present the design, modus operandi and outcomes of a newly formed dedicated craniofacial multidisciplinary outpatients' clinic at the first year of operation endpoint within a public healthcare structure.
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Affiliation(s)
- P Foroglou
- Plastic Surgery Department. Medical Faculty - School of Health Sciences. Aristotle University of Thessaloniki. Papageorgiou General Hospital, Greece.
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Dionyssiou D, Demiri E, Sarafis A, Goula CO, Tsimponis A, Arsos G. Functional lymphatic reconstruction with the "Selected Lymph Node" technique guided by a SPECT-CT lymphoscintigraphy. J Surg Oncol 2019; 120:911-918. [PMID: 31376162 DOI: 10.1002/jso.25650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/18/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND A new technique named "Selected Lymph Node" ("SeLyN") was evaluated, aiming to identify the most functional groin lymph nodes (LNs) for an effective LN transplantation. METHODS Bilateral lower-limb SPECT-CT was performed in the upper-limb lymphedema patients, to select the most radioactive inguinal LN. Recorded data included demographics, stage, etiology of lymphedema, flap consistency in accordance to preoperative findings, flap size, number of LN, and harvesting time. Infection episodes per year and volume changes of the upper limbs were documented. Donor-site complications were recorded and lower-limb evaluation was performed through clinical examination, volume analysis, and lymphoscintigraphy. RESULTS A total of 41 patients underwent a "SeLyN" transfer technique. The mean flap size was 28.34 cm2 containing a mean of 3.4 LNs. The mean time spent on flap harvest was 39 minutes. A mean 56.5% volume reduction (P < .001) and a mean 1.41 to 0.29 infection episodes per patient per year (P < .001) were recorded. Clinical evaluation and lymphography of the donor site advocated no major complications for a mean follow-up period of 42.5 months. CONCLUSIONS "SeLyN" is a safe and effective technique in selecting the most suitable LNs, minimizing the donor-site morbidity, and decreasing the overall operating time.
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Affiliation(s)
- Dimitrios Dionyssiou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Alexandros Sarafis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Christina-Olga Goula
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Antonios Tsimponis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Georgios Arsos
- 3rd Department of Nuclear Medicine, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
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Theodoridis K, Aggelidou E, Manthou M, Demiri E, Bakopoulou A, Kritis A. Assessment of cartilage regeneration on 3D collagen-polycaprolactone scaffolds: Evaluation of growth media in static and in perfusion bioreactor dynamic culture. Colloids Surf B Biointerfaces 2019; 183:110403. [PMID: 31400614 DOI: 10.1016/j.colsurfb.2019.110403] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 12/22/2022]
Abstract
Efforts on bioengineering are directed towards the construction of biocompatible scaffolds and the determination of the most favorable microenvironment, which will better support cell proliferation and differentiation. Perfusion bioreactors are attracting growing attention as an effective, modern tool in tissue engineering. A natural biomaterial extensively used in regenerative medicine with outstanding biocompatibility, biodegradability and non-toxic characteristics, is collagen, a structural protein with undisputed beneficial characteristics. This is a study designed according to the above considerations. 3D printed polycaprolactone (PCL) scaffolds with rectangular pores were coated with collagen either as a coating on the scaffold's trabeculae, or as a gel-cell solution penetrating scaffolds' pores. We employed histological, molecular and imaging techniques to analyze colonization, proliferation and chondrogenic differentiation of Adipose Derived Mesenchymal Stem Cells (ADMSCs). Two different differentiation culture media were employed to test chondrogenic differentiation on gelated and non gelated PCL scaffolds in static and in perfusion bioreactors dynamic culture conditions. In dynamic culture, non gelated scaffolds combined with our in house TGF-β2 based medium, augmented chondrogenic differentiation performance, which overall was significantly less favorable compared to StemPro™ propriety medium. The beneficial mechanical stimulus of dynamic culture, appears to outgrow the disadvantage of the "weaker" TGF-β2 medium used for chondrogenic differentiation. Even though cells in static culture grew well on the scaffold, there was limited penetration inside the construct, so the purpose of the 3D culture was not fully served. In contrast dynamic culture achieved better penetration and uniform distribution of the cells within the scaffold.
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Affiliation(s)
- Konstantinos Theodoridis
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Eleni Aggelidou
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Marilena Manthou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; Laboratory of Histology, Embryology and Anthropology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Athina Bakopoulou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), GR-54124, Thessaloniki, Greece
| | - Aristeidis Kritis
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece.
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Alexopoulos G, Pavlidis L, Tsagarakis M, Delimpaltas A, Tsimponis A, Papalois A, Batistatou A, Papoudou-Bai A, Barritault D, Demiri E, Spyropoulou GA. Can ReGeneraTing Agents Improve Functional Recovery of Transected Peripheral Nerve through a Nerve Gap Bridged with an Artery Graft? J Reconstr Microsurg Open 2019. [DOI: 10.1055/s-0039-1692453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background The purpose of this study was to use artery grafts filled with CACIPLIQ20 and see if they promote nerve regeneration.
Methods Sixty male Wistar rats were used. The rats were randomly divided into four experimental groups (n = 15): transected control group (negative control group [NCG]), sham-operated group (positive control group [SO]) artery graft group filled with saline (AG/NS), and CACIPLIQ20-treated group (AG/CACIPLIQ20). Fifteen rats were used as artery graft donors. In the SO group, the sciatic nerve was dissected from the surrounding tissues and left intact. In the NCG, AG/NS and AG/CACIPLIQ20) groups, a 10-mm gap was created in the left sciatic nerve. In the NCG group, the gap was not bridged with a graft. In the AG/NS group, the gap was bridged with a graft filled with saline. In the AG/CACIPLIQ20 group, the graft was filled with CACIPLIQ20. Walking track analysis was performed at 4, 8, 12, and 16 weeks after surgery. At 16 weeks postoperatively, the rats were sacrificed, nerve sections were harvested for histopathology analysis, and the weight ratio of the gastrocnemius muscle was measured.
Results There was no significant difference in myelin sheath thickness between the AG/NS and AG/CACIPLIQ20 groups. Muscle weight in the AG/CACIPLIQ20 group was higher but not statistically significant (p = 0.168) compared with the AG/NS group. Also, AG/CACIPLIQ20 mean was better than AG/NS mean, although there was no statistically significant difference (p = 0.605).
Conclusion There could be an indication that CACIPLIQ20 improves functional recovery of a transected peripheral nerve through a nerve gap bridged with an artery graft.
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Affiliation(s)
| | - Leonidas Pavlidis
- Clinic of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Myron Tsagarakis
- Department of Plastic and Reconstructive Surgery, ENI Medical Group, Kavos Lefkimi, Corfu, Greece
| | - Alexandros Delimpaltas
- Clinic of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Tsimponis
- Clinic of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Papalois
- Department of Research and Development, "ELPEN" Pharmaceuticals, Athens, Greece
| | - Anna Batistatou
- Department of Pathology, Panepistimio Ioanninon, Ioannina, Greece
| | | | | | - Efterpi Demiri
- Clinic of Plastic Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Pavlidis L, Spyropoulou GA, Demiri E. Comparing Efficacy and Costs of Four Facial Fillers in Human Immunodeficiency Virus-Associated Lipodystrophy. Plast Reconstr Surg 2018; 142:583e-584e. [DOI: 10.1097/prs.0000000000004741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kotoula V, Demiri E, Fostira F, Vrettou E, Papadopoulou K, Tikas I, Papazisis K, Zaramboukas T, Asimaki-Vlachopoulou A, Miliaras S, Fountzilas E, Ananiadis A, Chrisafi S, Poulios C, Natsiopoulos I, Tsiftsoglou A, Fountzilas G. Abstract 1359: Somatic involution of pathogenic BRCA1 germline mutations. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
There is currently a wealth of data on the tumor genomic contexture from BRCA1/2 carriers, particularly breast and ovarian carcinomas. By contrast, little attention has as yet been paid to the genomic status of cancer-related normal tissues from these individuals. Here, we investigated the status of pathogenic BRCA1 germline mutations (GM) in breast (B) and gynecologic (GYN) tissues.
Methods: We examined 121 DNA samples (48 B; 36 GYN; 37 tumors) from an equal number of paraffin blocks obtained upon prophylactic or debulking surgery from 44 BRCA1/2 carriers (mean age 38 yrs, range 24-62; 43 BRCA1 carriers). Six women had never had cancer manifestation (CM). At the time of surgery, 32 were cancer-free but had received neo- or adjuvant chemotherapy, and 6 had concurrent cancer without prior treatment. Following multimethod DNA quality control, mutation validation and sample identity match to exclude false negatives, we interrogated GM presence in tissues in comparison to clinicopathologic data and tumor genotypes (60-gene panel; mean read depth over 800).
Results: In 19 samples from 13 BRCA1 carriers, including 13 normal B/GYN and 6 tumors, the germline mutation was present at frequencies lower than 5% (observed with the integrated genome viewer) up to 12%, or it was undetectable with Sanger sequencing and multiplex PCR. This condition, termed GM-loss, was present in 13 GYN, 12 of which in the histologically normal tube, and in only 3 B with fibrocystic disease (p=0.0210). It was also present in one ovarian thecoma but it was absent in usual or atypical hyperplasia in B. GM-loss was observed in 9/55 normal tissues from breast cancer and in 4/6 normal tissues from ovarian cancer patients, while it was absent in the normal tissues from women without CM (p=0.0002). GM-loss mostly affected the BRCA1 BRCT functional domain (p<0.0001) and concerned large deletions (10/17 samples), small indels (5/32; 15.6%) and less so single-nucleotide substitutions (4/66; 6.0%; p<0.0001). Normal tissue GM-loss was rather localized, e.g., in 10 patients with multiple samples it was present in only one B or fallopian tube. It was, however, related to the status of concurrent ovarian tumors in 3/6 cases. In the normal tube of these patients, next to the low-frequency GM a somatic pathogenic BRCA1 mutation was present at 25-41% allelic frequency; the same was observed in one breast tumor after neoadjuvant chemotherapy. Three of the replaced GMs were indels, two corresponded to the well-known BRCA1 p.Q1777fs, and all novel mutations were missense.
Conclusions: We observed BRCA1 GM-loss in normal tissues, breast and mostly fallopian tube, in about 30% of the carriers in the present cohort, all with previous or concurrent cancer. The phenomenon seems analogous to the GM reversion described in tumors but, as shown, it may also occur in the absence of prior treatment. Its origin and impact on cancer dynamics and therapeutic approaches seem worth further pursuing with functional studies.
Citation Format: Vassiliki Kotoula, Efterpi Demiri, Florentia Fostira, Eleni Vrettou, Kyriaki Papadopoulou, Ioannis Tikas, Konstantinos Papazisis, Thomas Zaramboukas, Asimina Asimaki-Vlachopoulou, Spyridon Miliaras, Elena Fountzilas, Ananias Ananiadis, Sofia Chrisafi, Christos Poulios, Ioannis Natsiopoulos, Aris Tsiftsoglou, George Fountzilas. Somatic involution of pathogenic BRCA1 germline mutations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1359.
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Fastré E, Lanteigne LE, Helaers R, Giacalone G, Revencu N, Dionyssiou D, Demiri E, Brouillard P, Vikkula M. Splice-site mutations in VEGFC
cause loss of function and Nonne-Milroy-like primary lymphedema. Clin Genet 2018. [DOI: 10.1111/cge.13204] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Fastré
- Human Molecular Genetics, de Duve Institute; University of Louvain; Brussels Belgium
| | - L-E. Lanteigne
- Human Molecular Genetics, de Duve Institute; University of Louvain; Brussels Belgium
| | - R. Helaers
- Human Molecular Genetics, de Duve Institute; University of Louvain; Brussels Belgium
| | | | - N. Revencu
- Center for Human Genetics, Cliniques universitaires Saint-Luc; University of Louvain; Brussels Belgium
| | - D. Dionyssiou
- Department of Plastic Surgery, Papageorgiou Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - E. Demiri
- Department of Plastic Surgery, Papageorgiou Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - P. Brouillard
- Human Molecular Genetics, de Duve Institute; University of Louvain; Brussels Belgium
| | - M. Vikkula
- Human Molecular Genetics, de Duve Institute; University of Louvain; Brussels Belgium
- Walloon Excellence in Lifesciences and Biotechnology (WELBIO); University of Louvain; Bussels Belgium
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Kotoula V, Demiri E, Fostira F, Vrettou E, Papadopoulou K, Tikas I, Papazisis K, Zaramboukas T, Asimaki-Vlachopoulou A, Miliaras S, Fountzilas E, Ananiadis A, Chrisafi S, Poulios C, Natsiopoulos I, Tsiftsoglou A, Fountzilas G. Abstract P3-04-04: Germline and somatic mutation status in tissues from BRCA1/2 carriers. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-04-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background – aim: In carriers of BRCA1/2 pathogenic mutations (mut), it is expected that the germline mut is present in all tissues, particularly in normal; the somatic mut status in normal tissues from these patients is usually not addressed. We investigated the mut status in normal and tumor tissues in a real-life cohort of BRCA1/2 carriers who underwent prophylactic surgery.
Methods: All 53 women had known BRCA1/2 germline mut that had been assessed independently; 42 had previous cancer manifestation (PCM); all had prophylactic mastectomy; 22 had prophylactic hystero-salpingo-oophorectomy. By using a 60-gene NGS panel, we examined the mut status of 231 samples, 39 peripheral blood and 192 paraffin tissues (FFPE: 46 tumors, out of which 43 breast; 97 normal breast [NB]; 49 normal ovary and salpinx [NGYN]). Germline mut status was interrogated in tissues with the above panel, Sanger sequencing and a multiplex PCR protocol for large exonic deletions, along with extensive FFPE DNA quality control (QC) to exclude false negatives.
Results: Eight patients carried germline BRCA2 and 45 BRCA1 mut (29 in the BRCT-domain; 31 substitutions/indels). We identified somatic mut in 85% of the tumors and in 64% of the normal samples; mut were found significantly more often (p=0.003) and in higher numbers (p<0.001) in NGYN than in NB. In NB and NGYN, top 3 genes with somatic mut were BRCA2 (28%), BRCA1 (17%), TP53 (7%). In tumors, somatic mut were most frequent in TP53 (49%; p<0.001) and BRCA1 (38%; p=0.039). Among all tissue types, the 5 tumors post-neoadjuvant treatment had the highest and NB the lowest mut load (p=0.001). In NB and NGYN, mut load was not affected by PCM or BRCA1 mut domain but it was higher in BRCA1 vs. BRCA2 carriers (p=0.027) and in those with BRCA1 substitutions/indels vs. exon deleting and skipping mut (p<0.001). In tumors, germline BRCA1 substitutions/indels were associated with higher mut load (p=0.014). We validated germline mut status in all blood samples and in 111 tissue samples that passed FFPE DNA QC from 40 patients. The germline mut was not found in 14 samples (4 breast tumors; 3 NB; 7 NGYN) from 10 (25%) patients, all BRCA1 carriers, 9 with germline mut in the BRCT-domain. The only non-BRCT domain germline mut that was lost in one breast tumor, p.V1234fs, was replaced by the R1751* (validated), again in the BRCT domain. In normal tissues, those with lost germline mut had significantly less somatic mut compared to those with preserved germline mut (p<0.001).
Conclusions: In BRCA1/2 carriers, somatic mut in BRCA genes and TP53 are present in normal breast and GYN tissues, more frequently in the latter, and seem associated with the mutated gene and with the type of mut in the germline. The mut status of normal breast tissue does not seem to be affected by neoadjuvant chemotherapy for breast cancer. The observed BRCA1 germline mut loss, particularly in normal tissues, may be approached as a negative selection for the inherited mut; similarly to the described germline mut reversion after chemotherapy, tissues may react to deleterious effects of haploinsufficiency, which needs functional validation.
Citation Format: Kotoula V, Demiri E, Fostira F, Vrettou E, Papadopoulou K, Tikas I, Papazisis K, Zaramboukas T, Asimaki-Vlachopoulou A, Miliaras S, Fountzilas E, Ananiadis A, Chrisafi S, Poulios C, Natsiopoulos I, Tsiftsoglou A, Fountzilas G. Germline and somatic mutation status in tissues from BRCA1/2 carriers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-04-04.
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Affiliation(s)
- V Kotoula
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E Demiri
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - F Fostira
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E Vrettou
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - K Papadopoulou
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - I Tikas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - K Papazisis
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - T Zaramboukas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | | | - S Miliaras
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E Fountzilas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - A Ananiadis
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - S Chrisafi
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - C Poulios
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - I Natsiopoulos
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - A Tsiftsoglou
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - G Fountzilas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
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Demiri E, Dionyssiou D, Tsimponis A, Goula OC, Mιlothridis P, Pavlidis L, Spyropoulou GA, Foroglou P. Donor-Site Lymphedema Following Lymph Node Transfer for Breast Cancer-Related Lymphedema: A Systematic Review of the Literature. Lymphat Res Biol 2017; 16:2-8. [PMID: 29087763 DOI: 10.1089/lrb.2017.0043] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Abstracts Background: Among current surgical options used for treating breast cancer-related lymphedema (BCRL), autologous lymph node transfer (ALNT) is shown to provide favorable results. However, postoperative donor-site lymphedema (DSL), following the lymphatic flap harvesting from the groin area, has already been reported. Our aim is to summarize the recent literature for evidence of DSL following an ALNT for BCRL. METHODS AND RESULTS A PubMed bibliographic search was performed for published studies evaluating donor-site complications following LNT in BCRL patients. We recorded demographic data of the patients, the type of flap used, the follow-up, the donor-site morbidity, and the diagnostic tests performed pre- and postoperatively. Statistical analysis was conducted to document any correlation between the incidence of DSL and the abovementioned recorded parameters. According to our results, 11 studies met the inclusion criteria. From a total of 189 patients, three cases with DSL of the lower limb were reported (1.6%). No statistically significant correlations were found. CONCLUSION ALNT has become increasingly popular and is considered an effective surgical option for treating BCRL of the upper limb. Although the incidence of postoperative DSL is low, insufficient data on patients' demographics, surgical details, and postoperative assessment do not allow extracting significant correlations. Meticulous technique of lymph node harvesting should be seriously considered to further minimize this infrequent but debilitating complication.
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Affiliation(s)
- Efterpi Demiri
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Antonios Tsimponis
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Olga Christina Goula
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Panagiotis Mιlothridis
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Leonidas Pavlidis
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Georgia Alexandra Spyropoulou
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Perikles Foroglou
- Department of Plastic Surgery, Faculty of Health Sciences, School of Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece
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Foroglou P, Goula OC, Tsimponis A, Georgiadou E, Demiri E. Autologous free fat transfer in patients with velopharyngeal insufficiency. Hell J Nucl Med 2017; 20 Suppl:131-135. [PMID: 29324922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
AIM To report our initial experience and preliminary results of autologous free fat transfer to improve speech and hypernasality in patients with velopharyngeal insufficiency (VPI) as a sequela of cleft lip and palate repair. MATERIAL AND METHODS To date 2 patients with a mean age of 25 years were treated with this method. Both had initially received multiple procedures elsewhere for cleft lip and palate repair. We recorded the number of free fat transfer sessions, anatomical places of placement and volumes injected in-patient stay, occurrence or absence of complications and effectiveness of this operation in terms of clinical speech evaluation, functional velopharyngeal closure measurements and speech improvement percentage by an Ear, Nose and Throat (ENT) specialist. RESULTS Two autologous free fat transfer sessions per patient were performed. Mean hospitalization time was 1 day per operation. Following liposuction, autologous free fat was transferred to the following anatomical areas: a) Passavant's ridge, b) uvula, c) palatopharyngeal and palatoglossal folds. The volume of fat injected varied from 6.5 cc to 8 cc per session. Postoperative periods were uneventful for both cases in each session. On clinical examination, improvement in speech was noted as well as a reduction in hypernasality with an improvement in articulation and audibility of consonant words, which were also reported by the patients' relatives. This was confirmed by objective nasendoscopy velopharyngeal closure measurements, both during speech and deglutition. CONCLUSION Augmentation pharyngoveloplasty with autologous free fat transfer in patients with velopharyngeal insufficiency is a safe and innovative alternative, particularly for small to medium degrees of structural velophayngeal dysfunction.
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Affiliation(s)
- Pericles Foroglou
- Plastic Surgery Department, Medical Section, Faculty of Health Sciences, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece. ,
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Kotoula V, Demiri E, Fostira F, Vrettou E, Charalambous E, Tikas I, Papazisis K, Zaramboukas T, Asimaki-Vlachopoulou A, Miliaras S, Fountzilas E, Ananiadis A, Chrisafi S, Poulios C, Natsiopoulos I, Tsiftsoglou A, Fountzilas G. Genomic features of normal tissues from prophylactic surgery in BRCA1/2 mutation carriers. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13055 Background: Genomic alterations in normal tissues from pathogenic germline BRCA1/2 mutation (mut) carriers are as yet poorly described. We investigated the genomic status of normal breast (NB) and hystero-salpingo-oophorectomy (GYN) tissues removed upon prophylactic surgery in a real-life cohort of BRCA1/2 carriers. Methods: By using targeted NGS we examined the mut status of 220 samples (39 peripheral blood and 181 paraffin tissue) from 53 BRCA1/2 carriers who underwent prophylactic surgery, 42 with and 11 without prior cancer manifestation (PCM). We compared germline BRCA1/2 mut status with tumor, NB and GYN mut status. Results: Eight patients carried germline BRCA2 and 45 BRCA1 mut. Somatic mut were most frequent in BRCA2 (28%), BRCA1 (17%), TP53 (7%) among 136 NB and GYN samples; and, in TP53 (49%; p < 0.001) and BRCA1 (38%; p = 0.039) among 45 tumor samples. Among all tissue types, the 85 NB had the lowest mut load (p = 0.001). In NB and GYN, mut load was higher in BRCA1 vs. BRCA2 carriers (p = 0.027) and in those with BRCA1 substitutions/indels vs. exon deleting and skipping mut (p < 0.001). In tumors, only germline BRCA1 substitutions/indels were associated with higher mut load (p = 0.014). Preservation of germline mut in tissues was assessable in 84 samples from 26 patients. The germline mut was lost in 8 tumor and NB samples from 6 patients (23%) with PCM. Somatic deleterious mut in the BRCA1 BRCT-domain emerged in two such cases; the rest had combinations of TP53, MRE11A and NF1 mut. GYN samples from these patients retained the germline mut and presented the highest mut load among all examined samples (p < 0.001). Conclusions: Somatic mut in normal tissues from BRCA1/2 carriers are affected by the inherited mutated gene and by the type of the germline mut concerning BRCA1. Germline BRCA1 mut may be substituted by somatic mut in tumor and normal tissues, in an organ specific manner. Mutagenesis in tumors and normal tissues appear to be driven by different pathways. Our findings shed new light on the biological impact of BRCA1/2 mut in tissues.
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Affiliation(s)
| | - Efterpi Demiri
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | | | - Eleni Vrettou
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | | | - Ioannis Tikas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | | | | | | | | | | | | | - Sofia Chrisafi
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
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Pavlidis L, Spyropoulou GA, Chatzinikolaou F, Demiri E. Severe iatrogenic nostril stenosis. Indian J Plast Surg 2017; 49:431-432. [PMID: 28216834 PMCID: PMC5288929 DOI: 10.4103/0970-0358.197248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Leonidas Pavlidis
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Fotios Chatzinikolaou
- Department of Forensic Medicine and Toxicology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Spyropoulou GA, Pavlidis L, Milothridis P, Zaraboukas T, Demiri E. Dupuytren in a Child: Rare Presentation of a Rare Clinical Entity. J Hand Surg Am 2016; 41:e477-e479. [PMID: 27653143 DOI: 10.1016/j.jhsa.2016.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/13/2016] [Accepted: 08/15/2016] [Indexed: 02/02/2023]
Abstract
Dupuytren disease in children younger than 10 years is rare and only 8 histologically proven cases have been reported. A histologically proven Dupuytren disease in a 10-year-old with an uncommon clinical presentation as a nodule on the radial side of the middle phalanx of the little finger is documented. Dupuytren's disease should be in the differential diagnosis in cases of nodules and contractures in the palm and fingers of children.
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Affiliation(s)
- Georgia-Alexandra Spyropoulou
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
| | - Leonidas Pavlidis
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Panagiotis Milothridis
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | | | - Efterpi Demiri
- Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Fountzilas E, Kotoula V, Zagouri F, Giannoulatou E, Kouvatseas G, Pentheroudakis G, Koletsa T, Bobos M, Papadopoulou K, Samantas E, Demiri E, Miliaras S, Christodoulou C, Chrisafi S, Razis E, Fostira F, Pectasides D, Zografos G, Fountzilas G. Disease evolution and heterogeneity in bilateral breast cancer. Am J Cancer Res 2016; 6:2611-2630. [PMID: 27904775 PMCID: PMC5126277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023] Open
Abstract
Bilateral breast cancers (BBC) are currently treated as independent tumors arising in the same patient. Herein, we investigated whether BBC indeed evolve independently at the genomic level. We examined paired targeted next generation sequencing genotypes from 155 paraffin tumors corresponding to 76 BBC patients (75 women and one man; 52 concurrent and 24 metachronous), for coding mutations (amino acid changing, minor allele frequency <0.1%) and single nucleotide polymorphism (SNP) zygosity. Germline genotypes were available for 29 patients. Mutations were present in 80 tumors (54/76 patients; 71%), were mostly tumor-private (90%), more frequent in TP53 (19%), PIK3CA (14%), CDH1, GATA3, MLL3. TP53 mutations were more frequent in metachronous tumors (P<0.001); hormone receptor negative (P<0.001); with higher Ki-67 (P=0.002); and, in younger patients (P=0.01). Hypermutated tumors, all TP53 mutated, were diagnosed as the first incidence in 5 patients; their metachronous counterparts were mutation poor without TP53 involvement. Paired tumors shared common mutations at intratumoral frequency >20% in 10/54 comparable BBC (18.5%), 8/10 concurrent. SNP zygosity status was less preserved in metachronous, compared to concurrent disease. Pathogenic germline mutations were present in 10/29 patients, 9 in BRCA1 and one in TP53 (p.Phe341Val, first report in the germline). BBC demonstrated extensive inter- and intra-patient heterogeneity in the present thus far largest series of corresponding paired genotypes. The majority evolve independently and unpredictably, supporting current clinical practice. A considerable minority though, retains clonal origin and may be regarded as a distinct group for therapeutic interventions among concurrent BBC.
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Affiliation(s)
- Elena Fountzilas
- Department of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of MedicineThessaloniki, Greece
| | - Vassiliki Kotoula
- Department of Pathology, Aristotle University of Thessaloniki School of Health Sciences, Faculty of MedicineThessaloniki, Greece
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of ThessalonikiThessaloniki, Greece
| | - Flora Zagouri
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens School of MedicineAthens, Greece
| | - Eleni Giannoulatou
- Victor Chang Cardiac Research InstituteDarlinghurst, NSW, Australia
- The University of New South WalesKensington, NSW, Australia
| | | | | | - Triantafyllia Koletsa
- Department of Pathology, Aristotle University of Thessaloniki School of Health Sciences, Faculty of MedicineThessaloniki, Greece
| | - Mattheos Bobos
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of ThessalonikiThessaloniki, Greece
| | - Kyriaki Papadopoulou
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of ThessalonikiThessaloniki, Greece
| | - Epaminontas Samantas
- Third Department of Medical Oncology, Agii Anargiri Cancer HospitalAthens, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Papageorgiou Hospital, Aristotle University of Thessaloniki School of MedineThessaloniki, Greece
| | - Spyros Miliaras
- First Department of Surgery, Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of MedicineThessaloniki, Greece
| | | | - Sofia Chrisafi
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of ThessalonikiThessaloniki, Greece
| | - Evangelia Razis
- Third Department of Medical Oncology, Hygeia HospitalAthens, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRaSTES, National Centre for Scientific Research DemokritosAthens, Greece
| | - Dimitrios Pectasides
- Oncology Section, Second Department of Internal Medicine, Hippokration HospitalAthens, Greece
| | - George Zografos
- Breast Unit, National and Kapodistrian University of Athens School of MedicineAthens, Greece
| | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of ThessalonikiThessaloniki, Greece
- Aristotle University of ThessalonikiThessaloniki, Greece
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Gousopoulos E, Proulx ST, Bachmann SB, Scholl J, Dionyssiou D, Demiri E, Halin C, Dieterich LC, Detmar M. Regulatory T cell transfer ameliorates lymphedema and promotes lymphatic vessel function. JCI Insight 2016; 1:e89081. [PMID: 27734032 DOI: 10.1172/jci.insight.89081] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Secondary lymphedema is a common postcancer treatment complication, but the underlying pathological processes are poorly understood and no curative treatment exists. To investigate lymphedema pathomechanisms, a top-down approach was applied, using genomic data and validating the role of a single target. RNA sequencing of lymphedematous mouse skin indicated upregulation of many T cell-related networks, and indeed depletion of CD4+ cells attenuated lymphedema. The significant upregulation of Foxp3, a transcription factor specifically expressed by regulatory T cells (Tregs), along with other Treg-related genes, implied a potential role of Tregs in lymphedema. Indeed, increased infiltration of Tregs was identified in mouse lymphedematous skin and in human lymphedema specimens. To investigate the role of Tregs during disease progression, loss-of-function and gain-of-function studies were performed. Depletion of Tregs in transgenic mice with Tregs expressing the primate diphtheria toxin receptor and green fluorescent protein (Foxp3-DTR-GFP) mice led to exacerbated edema, concomitant with increased infiltration of immune cells and a mixed TH1/TH2 cytokine profile. Conversely, expansion of Tregs using IL-2/anti-IL-2 mAb complexes significantly reduced lymphedema development. Therapeutic application of adoptively transferred Tregs upon lymphedema establishment reversed all of the major hallmarks of lymphedema, including edema, inflammation, and fibrosis, and also promoted lymphatic drainage function. Collectively, our results reveal that Treg application constitutes a potential new curative treatment modality for lymphedema.
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Affiliation(s)
| | - Steven T Proulx
- Institute of Pharmaceutical Sciences, ETH Zurich, Switzerland
| | | | | | - Dimitris Dionyssiou
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Cornelia Halin
- Institute of Pharmaceutical Sciences, ETH Zurich, Switzerland
| | | | - Michael Detmar
- Institute of Pharmaceutical Sciences, ETH Zurich, Switzerland
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Fountzila E, Kotoula V, Zagouri F, Giannoulatou E, Kouvatseas G, Pentheroudakis G, Koletsa T, Bobos M, Papadopoulou K, Samantas E, Demiri E, Miliaras S, Christodoulou C, Chrisafi S, Razis E, Fostira F, Pectasides D, Zografos G, Fountzilas G. Patient-private disease evolution and heterogeneity in bilateral breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Foroglou P, Karathanasis V, Demiri E, Koliakos G, Papadakis M. Role of adipose-derived stromal cells in pedicle skin flap survival in experimental animal models. World J Stem Cells 2016; 8:101-5. [PMID: 27022440 PMCID: PMC4807308 DOI: 10.4252/wjsc.v8.i3.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/23/2015] [Accepted: 01/21/2016] [Indexed: 02/06/2023] Open
Abstract
The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adipose-derived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.
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Affiliation(s)
- Pericles Foroglou
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vasileios Karathanasis
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Efterpi Demiri
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - George Koliakos
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Marios Papadakis
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Seretis K, Goulis DG, Koliakos G, Demiri E. The effects of abdominal lipectomy in metabolic syndrome components and insulin sensitivity in females: A systematic review and meta-analysis. Metabolism 2015; 64:1640-9. [PMID: 26475176 DOI: 10.1016/j.metabol.2015.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/06/2015] [Accepted: 09/19/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Adipose tissue is an endocrine organ, which is implicated in the pathogenesis of obesity, metabolic syndrome and diabetes. Lipectomy offers a unique opportunity to permanently reduce the absolute number of fat cells, though its functional role remains unclear. This systematic and meta-analysis review aims to assess the effect of abdominal lipectomy on metabolic syndrome components and insulin sensitivity in women. METHODS A predetermined protocol, established according to the Cochrane Handbook's recommendations, was used. An electronic search in MEDLINE, Scopus, the Cochrane Library and CENTRAL electronic databases was conducted from inception to May 14, 2015. This search was supplemented by a review of reference lists of potentially eligible studies and a manual search of key journals in the field of plastic surgery. Eligible studies were prospective studies with ≥1month of follow-up that included females only who underwent abdominal lipectomy and reported on parameters of metabolic syndrome and insulin sensitivity. RESULTS The systematic review included 11 studies with a total of 271 individuals. Conflicting results were revealed, though most studies showed no significant metabolic effects after lipectomy. The meta-analysis included 4 studies with 140 subjects. No significant changes were revealed between lipectomy and control groups. CONCLUSIONS This meta-analysis provides evidence that abdominal lipectomy in females does not affect significantly the components of metabolic syndrome and insulin sensitivity. Further high quality studies are needed to elucidate the potential metabolic effects of abdominal lipectomy. Systematic review registration PROSPERO CRD42015017564 (www.crd.york.ac.uk/PROSPERO).
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Affiliation(s)
- Konstantinos Seretis
- Plastic Surgeon, private practice, Zurich, Switzerland; Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, Greece.
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Georgios Koliakos
- Laboratory of Biochemistry, Medical School, Aristotle University of Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, Greece
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Kostogloudis N, Demiri E, Tsimponis A, Dionyssiou D, Ioannidis S, Chatziioannidis I, Nikolaidis N. Severe Extravasation Injuries in Neonates: A Report of 34 Cases. Pediatr Dermatol 2015; 32:830-5. [PMID: 26337780 DOI: 10.1111/pde.12664] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Extravasation injuries are a common and challenging problem in hospitalized newborns. Accidental infusion leakage into the surrounding tissues in immature infants may frequently result in skin necrosis, with significant risk of functional and cosmetic impairment. MATERIAL AND METHODS In the present study we reviewed 34 cases of severe extravasation injuries occurring in 1,409 neonates hospitalized in a single neonatal unit over 24 months (incidence 2.4%). Total parenteral nutrition solutions were involved in most cases. All patients were treated within 30 minutes after the injury was recorded using a flush-out technique with normal saline irrigation and occlusive paraffin dressings of the infiltrated area. RESULTS The majority of injuries affected preterm, low-birthweight infants (mean gestation 32 wks + 6 days, mean birth weight 1,885 g), with a mean age at the time of injury of 11.6 days and a mean weight of 2,045 g. Neither gestational age (p = 0.87) or birthweight significantly affected (p = 0.07) the incidence of extravasation injuries, although the incidence of skin necrosis had a significant correlation with gestational age (p = 0.009) and birthweight (p < 0.001). All patients responded well to treatment and their wounds healed uneventfully within a maximum of 25 days without the need for secondary surgery for skin coverage. CONCLUSION Extravasation injuries in extremely preterm and low-birthweight infants are more likely to lead to skin necrosis. Peripheral venous catheterization should be performed with caution in these patients to prevent such injuries. Immediate irrigation with normal saline is recommended to reduce toxic sequelae in the infiltrated area.
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Affiliation(s)
- Nikolaos Kostogloudis
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
| | - Antonios Tsimponis
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Dionyssiou
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Ioannidis
- Department of Plastic Surgery, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
| | - Ilias Chatziioannidis
- 2nd Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Nikolaidis
- 2nd Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece
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Foroglou P, Tsimponis A, Goula OC, Demiri E. Assessing an avoidable and dispensable reoperative entity: Self-referred flawed cleft lip and palate repair. Hell J Nucl Med 2015; 18 Suppl 1:140. [PMID: 26665223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 10/10/2013] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Cleft lip and palate (CLP) is comprised within the wide range of congenital deformities of the maxillofacial region with an overall incidence on the increase from 1:1000 to 1:700 live births thus being the most common congenital birth error. Failure of the lateral and medial nasal processes to fuse with the anterior extension of maxillary processes and of the palatal shelves between the 4th and 8th gestational week results in cleft lip and palate. Clefts include different types with variable severity, confirming the complexity and unpredictable expression of cleft modality and have a multifactorial aetiology. Functional impairment, aesthetic disturbances and psychosocial effects are common sequalae in patients with cleft lip and palate. The main long-term morbidity of this condition may include dysfunctional speech, impaired hearing and communication, as well as dental problems. These complications are followed by unfavourable surgical outcome and aesthetic appearance, which all seem to affect this group of patients significantly and have an impact significantly both quality of life and healthcare. Treatment requirements of cleft patients are multifactorial and a multi-disciplinary approach and intervention at multiple levels is necessary. Yet, in this country, resources available to parents and consistent publicity given to this issue and its treatment are still inadequate in spite of the introduction of "Centres of Excellence" and Unified Hospitalization Coding or DRG equivalents to optimize health management. The multi-disciplinary approach to cleft management has been a reality for over a century while cleft treatment protocols are still being evaluated in order to optimise standards of cleft care. According to relevant guidelines primary surgical management of lip and palate defects is performed during the first 3 to 9 months of life. Secondary operations in the form of revisional lip and nose procedures are performed at later stages aiming with an aesthetically improved outcome. Indications for surgery include widened scars, lip contour deformities, shortened lips, poorly defined and flattened nasal tip, short columella and irregularities of the nostrils (narrow or high-riding) and cartilages. Wound dehiscence, contractures, vermilion notching, white roll malalignment and orovestibular fistulas are possible unfavourable results after cleft lip repair. The psychological status of children and adults with repaired cleft lip and palate has been the subject of extensive research especially regarding the way of their evaluation facial appearance, satisfaction and need for secondary corrective surgical procedures in the hope of increasing their self-esteem and self-confidence. CONCLUSION The aim of this study was to assess secondary CLP deformity management in an accredited present-day tertiary hospital facility with an existing infrastructure of a specialist teams however not formed in a multidisciplinary group. Equally, to answer questions of specific operation indications and choice as related to prior surgeries, hospitalization time and cost, provision of adequate preoperative information, correlation between paediatric and plastic surgeons and effect of post-plastic surgical care on patients' health and well-being. It also aims at presenting, beyond our current primary cleft lip and palate repair approach, appropriate indications and timing of secondary repair and achieved results.
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Affiliation(s)
- Pericles Foroglou
- Department of Plastic Surgery, Medical Section-Faculty of Health Sciences-Aristotle University of Thessaloniki, Papageorgiou General Hospital, Ring Road - Nea Efkarpia, Thessaloniki 56403 - Greece.
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Tagkalakis P, Dionyssopoulos A, Karkavelas G, Demiri E. Topical use of Rectogesic® and Emla® to improve cutaneous blood perfusion following thermal injury. A comparative experimental study. Ann Burns Fire Disasters 2015; 28:134-41. [PMID: 27252612 PMCID: PMC4837490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/29/2014] [Accepted: 02/14/2015] [Indexed: 06/05/2023]
Abstract
Early post-burn ischemic necrosis of the skin is of particular interest in modern burn research. The purpose of this study was to test the hypothesis that blood perfusion could be improved by the topical application of vasoactive substances. A sample of 55 wistar rats was used to investigate the effect of 0,4% nitroglycerin ointment (Rectogesic(®)) comparatively to no application and placebo. The beneficiary action of 5% prilocaine/lidocaine cream (EMLA(®)) in burn blood perfusion was also tested comparatively to Rectogesic(®). Both preparations were tested respectively to non burned controls. Laser Doppler assessment of blood flow at 15, 30, 45, 60, 120 and 180 minutes after preparation application, demonstrated that the use of Rectogesic(®) improved perfusion at all measurements compared to placebo and to no preparation application (p&0,05). There was no statistical significant difference in the effect of the two preparations.
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Affiliation(s)
- P. Tagkalakis
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Papageorgiou”, Thessaloniki, Greece
| | - A. Dionyssopoulos
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Papageorgiou”, Thessaloniki, Greece
| | - G. Karkavelas
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Papageorgiou”, Thessaloniki, Greece
| | - E. Demiri
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Papageorgiou”, Thessaloniki, Greece
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Dionyssiou D, Demiri E, Batsis G, Pavlidis L. Revision breast and chest wall reconstruction in Poland and pectus excavatum following implant complication using free deep inferior epigastric perforator flap. Indian J Plast Surg 2015; 48:85-8. [PMID: 25991894 PMCID: PMC4413498 DOI: 10.4103/0970-0358.155277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This study aims to present the case of a female patient with Poland's syndrome and pectus excavatum deformity who underwent breast and chest wall reconstruction with a pre-shaped free deep inferior epigastric perforator flap. A 57-year-old female patient with Poland's syndrome and pectus excavatum presented with a Baker III capsular contracture following a previously performed implant-based right breast reconstruction. After a chest and abdominal CT angiography, she was staged as 2A1 chest wall deformity according to Park's classification and underwent implant removal and capsulectomy, followed by a pre-shaped free abdominal flap transfer, providing both breast reconstruction and chest wall deformity correction in a single stage operation. Post-operative course was uneventful, and the aesthetic result remains highly satisfactory 24 months after surgery. Deep inferior epigastric free flap represents an interesting reconstructive solution when treating Poland's syndrome female patients with chest wall and breast deformities.
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Affiliation(s)
- Dimitrios Dionyssiou
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki, Periferiaki odos Thessalonikis, Thessaloniki 56403, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki, Periferiaki odos Thessalonikis, Thessaloniki 56403, Greece
| | - Georgios Batsis
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki, Periferiaki odos Thessalonikis, Thessaloniki 56403, Greece
| | - Leonidas Pavlidis
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki, Periferiaki odos Thessalonikis, Thessaloniki 56403, Greece
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Seretis K, Demiri E. Metabolic effects of large-volume liposuction for obese healthy women: a meta-analysis of fasting insulin levels. Aesthetic Plast Surg 2015; 39:278-9. [PMID: 25691080 DOI: 10.1007/s00266-015-0447-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/06/2015] [Indexed: 11/29/2022]
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Dionyssiou D, Demiri E, Panagou A, Pavlidis L, Arsos G. Outcomes of treating stage-II lymphedema patients with free lymph node transfer: A prospective control study. J Plast Reconstr Aesthet Surg 2014. [DOI: 10.1016/j.bjps.2014.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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