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Beka D, Marogianni C, Ralli S, Karyda O, Hatziioannou J, Hadjiigeorgiou GM, Dardiotis E, Bizakis I, Skoulakis CE, Lachanas VA. Bilateral Vocal Cord Palsy as the Only Symptom of Thymoma Associated-Myasthenia Gravis. Maedica (Bucur) 2022; 17:230-233. [PMID: 35733730 PMCID: PMC9168577 DOI: 10.26574/maedica.2022.17.1.230] [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] [Indexed: 06/15/2023]
Abstract
Bilateral vocal cord paresis is a rare phenomenon caused by different underlying etiologies. Myasthenia gravis is included in this long differential diagnosis. Usually, it happens as part of a serious clinical state of a patient, that also suffers from generalized muscle weakness, diplopia, dysphagia, eyelid ptosis. In our case, a 58-year-old woman presented in the emergency room with solely dyspnea, caused by bilateral cord palsy, and that appeared to be the only symptom of thymoma associated-myasthenia gravis. Another interesting fact about this case is the quick recovery and no need for tracheostomy and intubation in the first hours of her admission to hospital.
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Affiliation(s)
- Despoina Beka
- Department of Otorhinolaryngology, General Hospital Asklepieion of Voula, Greece
| | - Chrysoula Marogianni
- Department of Neurology, University of Thessaly, University Hospital of Larissa, Greece
| | - Styliani Ralli
- Department of Neurology, University of Thessaly, University Hospital of Larissa, Greece
| | - Ourania Karyda
- Department of Otorhinolaryngology, University Hospital of Larissa, Greece
| | | | | | - Efthimios Dardiotis
- Department of Neurology, University of Thessaly, University Hospital of Larissa, Greece
| | - Ioannis Bizakis
- Department of Otorhinolaryngology, University Hospital of Larissa, Greece
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Xiromerisiou G, Kalampokini S, Rikos D, Provatas A, Tsouris Z, Markou K, Ralli S, Dardiotis E. Posterior reversible encephalopathy in a GT1a positive oculopharyngeal variant of Guillain-Barré syndrome: A case-report and review of the literature. Clin Neurol Neurosurg 2020; 196:106037. [DOI: 10.1016/j.clineuro.2020.106037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 11/16/2022]
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Sokratous M, Lucia S, Bourinaris T, Marogianni C, Arnaoutoglou M, Patrikiou E, Ralli S, Markou A, Dardiotis E, Houlden H, Hadjigeorgiou GM, Xiromerisiou G. Prevalence of C9orf72 hexanucleotide repeat expansion in Greek patients with sporadic ALS. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:470-472. [PMID: 32338076 DOI: 10.1080/21678421.2020.1757115] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A total of 178 consecutive patients with definite sALS without frontotemporal dementia (FTD) were enrolled in this study, after complete clinical evaluation. A Repeat-Primed Polymerase Chain Reaction (RP-PCR) protocol was applied to detect the G4C2 repeats expansions. In the studied sALS patients, 5.06% (n = 9) carried the C9orf72 mutation. Among carriers, 2/3 of them were females and spinal onset accounted for 78% and bulbar for 22%, while the mean age of onset was about 60 years. Our study showed that the prevalence of C9orf72 repeat expansion in Greek sALS patients is similar to the overall frequency of the mutation in European populations. The pathogenic mutation remains a promising biomarker for genetic testing and targeted treatment.
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Affiliation(s)
- Maria Sokratous
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Schottlaender Lucia
- Argentine National Scientific and Technological Research Council (CONICET), FLENI Neurological Research Institute, Buenos Aires, Argentina
| | - Thomas Bourinaris
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Chrysoula Marogianni
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Marianthi Arnaoutoglou
- First Neurology Clinic, AHEPA Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Patrikiou
- Faculty of Medicine, Department of Rheumatology and Clinical Immunology, School of Health Sciences, University of Thessaly, Larisa, Greece, and
| | - Styliani Ralli
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Aikaterini Markou
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Efthimios Dardiotis
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Georgios M Hadjigeorgiou
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Georgia Xiromerisiou
- Faculty of Medicine School of Health Sciences, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
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Hadjigeorgiou GM, Kountra PM, Koutsis G, Tsimourtou V, Siokas V, Dardioti M, Rikos D, Marogianni C, Aloizou AM, Karadima G, Ralli S, Grigoriadis N, Bogdanos D, Panas M, Dardiotis E. Replication study of GWAS risk loci in Greek multiple sclerosis patients. Neurol Sci 2018; 40:253-260. [PMID: 30361804 DOI: 10.1007/s10072-018-3617-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 06/10/2018] [Accepted: 10/20/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To validate in an ethnically homogeneous Greek multiple sclerosis (MS) cohort, genetic risk factors for the disease, identified through a number of previous multi-ethnic genome-wide association studies (GWAS). METHODS A total of 1228 MS cases and 1014 controls were recruited in the study, from 3 MS centers in Greece. We genotyped 35 susceptibility SNPs that emerged from previous GWAS or meta-analyses of GWAS. Allele and genotype single locus regression analysis, adjusted for gender and site, was performed. Permutation testing was applied to all analyses. RESULTS Six polymorphisms reached statistical significance (permutation p value < 0.05). In particular, rs2760524 of LOC105371664, near RGS1 (permutation p value 0.001), rs3129889 of HLA-DRA, near HLA-DRB1 (permutation p value < 1.00e-04), rs1738074 of TAGAP (permutation p value 0.007), rs703842 of METTL1/CYP27B1 (permutation p value 0.008), rs9596270 of DLEU1 (permutation p value < 1.00e-04), and rs17445836 of LincRNA, near IRF8 (permutation p value 0.001) were identified as susceptibility risk factors in our group. CONCLUSION The current study replicated a number of GWAS susceptibility SNPs, which implies that some similarities between the examined Greek population and the MS genetic architecture of the GWAS populations do exist.
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Affiliation(s)
| | - Persia-Maria Kountra
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Georgios Koutsis
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, University of Athens, Medical School, Athens, Greece
| | - Vana Tsimourtou
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Maria Dardioti
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Dimitrios Rikos
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Chrysoula Marogianni
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Georgia Karadima
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, University of Athens, Medical School, Athens, Greece
| | - Styliani Ralli
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Nikolaos Grigoriadis
- Laboratory of Experimental Neurology and Neuroimmunology, B' Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Bogdanos
- Cellular Immunotherapy & Molecular Immunodiagnostics, Biomedical Section, Centre for Research and Technology-Hellas (CERTH), Institute for Research and Technology-Thessaly (IRETETH), Larissa, Greece
| | - Marios Panas
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, University of Athens, Medical School, Athens, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly, Larissa, Greece
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5
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Dardiotis E, Siokas V, Sokratous M, Tsouris Z, Michalopoulou A, Andravizou A, Dastamani M, Ralli S, Vinceti M, Tsatsakis A, Hadjigeorgiou GM. Genetic polymorphisms in amyotrophic lateral sclerosis: Evidence for implication in detoxification pathways of environmental toxicants. Environ Int 2018; 116:122-135. [PMID: 29677557 DOI: 10.1016/j.envint.2018.04.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece.
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Maria Sokratous
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Amalia Michalopoulou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Athina Andravizou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Metaxia Dastamani
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Styliani Ralli
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Marco Vinceti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
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6
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Mitropoulos K, Merkouri Papadima E, Xiromerisiou G, Balasopoulou A, Charalampidou K, Galani V, Zafeiri KV, Dardiotis E, Ralli S, Deretzi G, John A, Kydonopoulou K, Papadopoulou E, di Pardo A, Akcimen F, Loizedda A, Dobričić V, Novaković I, Kostić VS, Mizzi C, Peters BA, Basak N, Orrù S, Kiskinis E, Cooper DN, Gerou S, Drmanac R, Bartsakoulia M, Tsermpini EE, Hadjigeorgiou GM, Ali BR, Katsila T, Patrinos GP. Genomic variants in the FTO gene are associated with sporadic amyotrophic lateral sclerosis in Greek patients. Hum Genomics 2017; 11:30. [PMID: 29216901 PMCID: PMC5721583 DOI: 10.1186/s40246-017-0126-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 10/13/2017] [Accepted: 11/17/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a devastating disease whose complex pathology has been associated with a strong genetic component in the context of both familial and sporadic disease. Herein, we adopted a next-generation sequencing approach to Greek patients suffering from sporadic ALS (together with their healthy counterparts) in order to explore further the genetic basis of sporadic ALS (sALS). RESULTS Whole-genome sequencing analysis of Greek sALS patients revealed a positive association between FTO and TBC1D1 gene variants and sALS. Further, linkage disequilibrium analyses were suggestive of a specific disease-associated haplotype for FTO gene variants. Genotyping for these variants was performed in Greek, Sardinian, and Turkish sALS patients. A lack of association between FTO and TBC1D1 variants and sALS in patients of Sardinian and Turkish descent may suggest a founder effect in the Greek population. FTO was found to be highly expressed in motor neurons, while in silico analyses predicted an impact on FTO and TBC1D1 mRNA splicing for the genomic variants in question. CONCLUSIONS To our knowledge, this is the first study to present a possible association between FTO gene variants and the genetic etiology of sALS. In addition, the next-generation sequencing-based genomics approach coupled with the two-step validation strategy described herein has the potential to be applied to other types of human complex genetic disorders in order to identify variants of clinical significance.
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Affiliation(s)
| | - Eleni Merkouri Papadima
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | | | - Angeliki Balasopoulou
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | - Kyriaki Charalampidou
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | - Vasiliki Galani
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | | | | | - Styliani Ralli
- School of Medicine, University of Thessaly, Larisa, Greece
| | | | - Anne John
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE
| | | | | | - Alba di Pardo
- Departments of Neurology and Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Fulya Akcimen
- Suna and Inan Kirac Foundation, NDAL, Bogazici University, Istanbul, Turkey
| | - Annalisa Loizedda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,CNR IRGB, Cagliari, Italy
| | - Valerija Dobričić
- Institute of Neurology CCS, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Novaković
- Institute of Neurology CCS, School of Medicine, University of Belgrade, Belgrade, Serbia.,Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
| | - Vladimir S Kostić
- Institute of Neurology CCS, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Clint Mizzi
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | - Brock A Peters
- Complete Genomics Inc., Mountain View, CA, USA.,BGI Shenzhen, Shenzhen, People's Republic of China
| | - Nazli Basak
- Suna and Inan Kirac Foundation, NDAL, Bogazici University, Istanbul, Turkey
| | - Sandro Orrù
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Evangelos Kiskinis
- Departments of Neurology and Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David N Cooper
- Institute of Medical Genetics, Cardiff University, Cardiff, UK
| | - Spyridon Gerou
- ANALYSI Diagnostic Laboratories S.A, Thessaloniki, Greece
| | | | - Marina Bartsakoulia
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | - Evangelia-Eirini Tsermpini
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | | | - Bassam R Ali
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE
| | - Theodora Katsila
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece
| | - George P Patrinos
- Department of Pharmacy, University of Patras School of Health Sciences, Campus, Rion, GR-26504, Patras, Greece. .,Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE.
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8
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Xiromerisiou G, Dardiotis E, Tsironi EE, Hadjigeorgiou G, Ralli S, Kara E, Petalas A, Tachmitzi S, Hardy J, Houlden H. THAP1 mutations in a Greek primary blepharospasm series. Parkinsonism Relat Disord 2012; 19:404-5. [PMID: 23036512 DOI: 10.1016/j.parkreldis.2012.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/14/2012] [Accepted: 08/29/2012] [Indexed: 11/16/2022]
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9
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Dardiotis E, Patramani G, Ralli S, Hadjigeorgiou GM. Teaching NeuroImages: Isolated bilateral trigeminal nerve palsy. Neurology 2011; 76:e115. [PMID: 21670430 DOI: 10.1212/wnl.0b013e31821f4622] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Biopolis, Mezourlo Hill, Larissa 41100, Greece
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10
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Xiromerisiou G, Kyratzi E, Dardiotis E, Bozi M, Tsimourtou V, Stamboulis E, Ralli S, Vassilatis D, Gourbali V, Kountra PM, Fountas K, Papadimitriou A, Stefanis L, Hadjigeorgiou GM. Lack of association of the UCHL-1
gene with Parkinson's disease in a greek cohort: A haplotype-tagging approach. Mov Disord 2011; 26:1955-7. [DOI: 10.1002/mds.23694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 01/11/2011] [Accepted: 01/24/2011] [Indexed: 11/10/2022] Open
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Protogerou G, Ralli S, Tsougos I, Patramani I, Hadjigeorgiou G, Fezoulidis I, Kapsalaki EZ. T2 FLAIR Increased Signal Intensity at the Posterior Limb of the Internal Capsule: Clinical Significance in ALS Patients. Neuroradiol J 2011; 24:226-34. [PMID: 24059612 DOI: 10.1177/197140091102400210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 03/02/2011] [Indexed: 11/15/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by progressive upper and lower motor neuron degeneration. A hyperintense signal on T2-weighted images along the corticospinal tract has been reported in patients with confirmed ALS. However, the specificity of this finding is under consideration, since it is also identified in healthy controls. Moreover, the correlation of this finding with disease progression has not yet been established. The purpose of our study is to evaluate the frequency with which this high signal appears in the posterior limb of the internal capsule (PLIC), compare visual with quantitative measurements, and correlate these with the progression of the disease. Our prospective clinical study included 24 patients and 51 healthy volunteers. In the ALS patient group, the diagnosis was established according to the criteria of El Escorial in the revised form of Airlee House. All patients were neurologically examined and underwent diagnostic procedures to exclude other diseases resembling ALS. The initial MRI was performed six months to two years after the onset of symptomatology. All ALS patients were clinically examined regarding their symptoms from the upper and lower motor neurons. Follow-up MRIs were performed in nine out of 24 patients over a period of six months. Signal changes in the PLIC are visually evaluated on FLAIR images, and are classified as distinct, mild or no signal change. Fractional anisotropy (FA) measurements are performed by placing a region of interest (ROI) in the PLIC bilaterally. Both findings are being compared. Mild signal changes were visualized in the PLIC in ten volunteers and seven patients. Distinct T2 FLAIR signal changes were visualized in the PLIC in seven ALS patients. No distinct signal change was visualized in the controls. Moreover this increased T2 FLAIR signal change became more accentuated with disease progress. FA measurements in patients were lower than in age-matched healthy subjects, with a further decrease with disease progression. Our findings indicate that although mild hyperintensity of the PLIC is not pathognomonic for ALS, detection of a distinct PLIC hyperintensity that gradually accentuates might actually be a sign of progressive ALS. This finding is supported by the progressively decreasing FA measurements. Larger numbers of patients need to be included and re-evaluated to obtain statistically significant results.
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Affiliation(s)
- G Protogerou
- Department of Radiology, University Hospital of Larissa, University of Thessaly, School of Medicine; Larissa, Greece -
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12
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Aggelakis K, Zacharaki F, Dardiotis E, Xiromerisiou G, Tsimourtou V, Ralli S, Gkaraveli M, Bourpoulas D, Rodopoulou P, Papadimitriou A, Hadjigeorgiou G. Interleukin-1B and interleukin-1 receptor antagonist gene polymorphisms in Greek multiple sclerosis (MS) patients with bout-onset MS. Neurol Sci 2009; 31:253-7. [DOI: 10.1007/s10072-009-0155-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2009] [Accepted: 09/10/2009] [Indexed: 11/28/2022]
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13
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Mantouvalou M, Ralli S, Arnaoutoglou H, Tziris G, Papadopoulos G. Spinal anesthesia: comparison of plain ropivacaine, bupivacaine and levobupivacaine for lower abdominal surgery. Acta Anaesthesiol Belg 2008; 59:65-71. [PMID: 18652102] [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] [Indexed: 05/26/2023]
Abstract
This study was performed to compare the anesthetic efficacy and safety of three local anesthetic agents: racemic bupivacaine and its two isomers: ropivacaine and levobupivacaine, in patients undergoing lower abdominal surgery. One hundred-twenty patients, ASA I-III, were randomized to receive an intrathecal injection of one of three local anesthetic solutions. Group A (n = 40) received 3 ml of isobaric bupivacaine 5 mg/ml (15 mg). Group B (n = 40) received 3 ml of isobaric ropivacaine 5 mg/ml (15 mg). Group C (n = 40) received 3 ml of isobaric levobupivacaine 5 mg/ml (15 mg). The onset and duration of sensory block at dermatome level T8, maximum upper spread of sensory block, time for 2-segment regression of sensory block as well as the onset, intensity and duration of motor block were recorded, as were any adverse effects, such as bradycardia, hypotension, hypoxia, tremor, nausea and/or vomiting. Time to unassisted standing up and voluntary micturition was also recorded. The onset of motor block was significantly faster in the bupivacaine group compared with that in the ropivacaine group and almost the same of that in the levobupivacaine group (P < 0.05). Ropivacaine presented a shorter duration of both motor and sensory block than bupivacaine and levobupivacaine (P < 0.05). Bupivacaine required more often the use of a vasoactive drug (ephedrine) compared to both ropivacaine and levobupivacaine and of a sympathomimetic drug (atropine) compared to the ropivacaine group.
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Affiliation(s)
- M Mantouvalou
- Department of Anesthetics, Western Attica General Hospital, Greece.
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14
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Hadjigeorgiou GM, Stefanidis I, Dardiotis E, Aggellakis K, Sakkas GK, Xiromerisiou G, Konitsiotis S, Paterakis K, Poultsidi A, Tsimourtou V, Ralli S, Gourgoulianis K, Zintzaras E. Low RLS prevalence and awareness in central Greece: an epidemiological survey. Eur J Neurol 2007; 14:1275-80. [PMID: 17956448 DOI: 10.1111/j.1468-1331.2007.01966.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Restless legs syndrome (RLS) is a sensorimotor disorder with a general population prevalence of 3-10%. A single, previous epidemiological study performed in south-east Europe reported the lowest prevalence rate amongst European countries. We conducted a population-based survey of RLS in central Greece. A total of 4200 subjects were randomly recruited. We used the international RLS study group criteria for diagnosis and the severity scale for severity assessment in subjects with RLS. We also included questions to assess the level of awareness of RLS in our region. A total of 3033 subjects were screened. The overall lifetime prevalence was 3.9% with a female-to-male ratio of 2.6:1. Nearly half of RLS patients reported moderate to severe intensity of symptoms. After adjustment for multiple comparisons we found no association of RLS with education level, smoking, alcohol intake, caffeine consumption, shift work, professional pesticide use or comorbid illness. Our study revealed a low level of awareness amongst the population and physicians in our region and sub-optimal management. We provide further evidence for low prevalence of RLS in south-east Europe and a low level of awareness of RLS in our region.
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Affiliation(s)
- G M Hadjigeorgiou
- Department of Neurology, Medical School of Larissa, University of Thessaly, Larissa, Greece.
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Rowland-Goldsmith MA, Maruyama H, Kusama T, Ralli S, Korc M. Soluble type II transforming growth factor-beta (TGF-beta) receptor inhibits TGF-beta signaling in COLO-357 pancreatic cancer cells in vitro and attenuates tumor formation. Clin Cancer Res 2001; 7:2931-40. [PMID: 11555612] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
UNLABELLED Human pancreatic ductal adenocarcinomas overexpress transforming growth factor-betas (TGF-betas). This overexpression has been correlated with decreased patient survival. TGF-betas bind to a type II TGF-beta receptor (TbetaRII) dimer, which heterotetramerizes with a type I TGF-beta receptor (TbetaRI) dimer, thereby activating downstream signaling. PURPOSE AND EXPERIMENTAL DESIGN To determine whether blocking TGF-beta actions would suppress pancreatic cancer cell growth in vivo, we expressed a soluble TbetaRII, encoding amino acids 1-159 of the extracellular domain in COLO-357 human pancreatic cancer cells. This cell line expresses all of the three mammalian TGF-beta isoforms and is growth inhibited by TGF-beta in vitro. RESULTS COLO-357 clones expressing soluble TbetaRII were no longer growth inhibited by exogenous TGF-beta1 and exhibited a marked decrease in their invasive capacity in vitro. When injected s.c. into athymic mice, these clones exhibited attenuated growth rates and angiogenesis and decreased levels of plasminogen activator inhibitor-1 mRNA as compared with tumors formed by sham-transfected cells. CONCLUSIONS These results indicate that endogenous TGF-betas can confer a growth advantage in vivo to a pancreatic cancer cell line that is growth inhibited in vitro and suggest that a soluble receptor approach can be used to block these tumorigenic effects of TGF-betas.
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