The diagnostic yield of fluorine18 fluorodeoxyglucose positron emission tomography computed tomography in recurrent testicular seminoma. Urol Ann 2016 Vol 8, Issue 4, 496-499. A. Bantis, P. Sountoulides, L. Metaxa, P. Pavlidis, El. Aggelonidou, H. Arif, A. ZisimopoulosTesticular cancer is the most frequent malignancy in men between 20 and 40 years of age, with an incidence of 4–10/100,000. Germ cell testis tumors, generally, are classified to pure seminomas and to a more heterogeneous
group of nonseminomatous tumors, which include teratomas, chorionic carcinomas, embryonal cell tumors, and mixed tumors The incidence of seminomas has been on the rise over the last 30 years. About 25% of patients with seminoma present with advanced disease and around 15–20% of Stage I are harboring undetected metastatic disease, usually in the retroperitoneum
that will likely cause tumor relapse after orchiectomy alone. We report the case of a 32‑year‑old patient who underwent a left orchiectomy for a pT1 pure testicular seminoma in 2009. The patient did not consent to adjuvant chemotherapy at that time and opted for surveillance. His follow‑up imaging
with computed tomography (CT) scan and tumor markers were normal until September 2013, when he presented with a palpable mass in the right hemiscrotum and elevated The use of positron emission tomography‑computed tomography (PET‑CT) scan imaging is undoubtedly a
significant evolution in oncological urology, although at present of limited use in every day urology practice. The aim of this study is to highlight the indication and diagnostic accuracy of fluorine‑18 fluorodeoxyglucosePET/CT in the staging of a patient with metachronous bilateral testicular seminoma, elevated tumor markers,and equivocal conventional imaging findings.
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Second-Look Flexible Nephroscopy Combined with Holmium:YAG Laser Lithotripsy Under Local Anesthesia: a Prospective Study. Urology. 2016 Sep 14. pii: S0090-4295(16)30596-9. doi: 10.1016/j.urology.2016.06.07 Giannakopoulos A, Bantis A et alTo present a prospectively studied series of patients who underwent second-look flexible nephroscopy combined with holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy under local anesthesia for residual stone removal after percutaneous nephrolithotomy (PCNL).Thirty consecutive eligible patients who underwent a PCNL procedure in the previous 48-96 hours were included. The inclusion criteria were the following: (1) 1 or 2 residual stones 0.8-1.5 cm in diameter and (2) age >18 years. Approximately 15 mL of a 2% solution of lidocaine hydrochloride was injected through the nephrostomy tube, which was then clamped for 15 minutes. Flexible nephroscopy was combined with Ho:YAG laser lithotripsy set at 0.8 Joules and 8 Hz. Patients were asked to rate their pain intensity using the numeric rating scale (NRS).There were 14 (46.7%) men and 16 (53.3%) women in the study, with a mean age of 45.2 ± 17.5 years. Twenty-one (70%) patients had 1 stone and 9 (30%) had 2 stones needing fragmentation. Twenty-eight (93.3%) patients successfully underwent the procedure under local anesthesia. The mean NRS value was 1.39 ± 1.08 (range 0-5). For the entire group, there was a statistically significant difference between those patients with 1 stone vs 2 stones needing fragmentation (NRS scores of 1.1 ± 0.77 vs 2.1 ± 1.36, respectively, P = .033). Operative time >30 minutes was associated with higher NRS score. The stone-free rate under local anesthesia was 86.7%.For patients with a minimal to moderate residual stone burden after PCNL, second-look flexible nephroscopy can be combined with Ho:YAG laser lithotripsy using only local anesthesia. Περισσότερα »
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Υγεία 2015-2016. Ιατρικές ώρες. Τεύχος 14 σελ 4-5, Οκτώβριος 2016Α. ΜπαντήςΠερισσότερα »
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Can tumor necrosis factor a (TNF-a) and interleukin 6 (IL-6) be used as prognostic markers of infection following ureteroscopic lithrotripsy and extracorporeal shock wave lithotripsy for ureteral stones? Hell J Nucl Med. 2015 Sep-Dec;18 Suppl 1:160.Bantis A. et alUreteroscopic lithotripsy (URS) and Extracorporeal shock wave lithotripsy (ESWL) are highly effective for the treatment of uretral lithiasis and remain the treatment option for the majority of patients for more than two decades. In the present study we aimed to evaluate the levels of serum tumor necrosis factor A (TNFa) and interleucin 6 (IL6) in patients undergoing ESWL and URS.A total number of seventy patients were involved in our study. Thirty patients (17 males, 13 females), with a mean age of 43 had underwent ESWL and thirty patients (19 males, 11 females), with a mean age of 47 (range: 26-68) underwent URS lithotripsy. Ten healthy volunteers serving as the control group were enrolled in this study. Serum samples for TNF-a and IL-6 were obtained before URS and ESWL and after the procedure at 1, 24, and 48 hours and at 2, 24, and 48 hours, respectively. The pre ESWL/URS and post ESWL/URS levels were compared and correlated with possible tissue damage. According to ESWL procedure we found that serumTNF-a levels were significantly increased after one hour (P<0,001) and after 24 hours (P=0.007). Furthermore, IL-6was significantly increased at 2 (P< 0,001), 24 and 48 hours post ESWL (P=0,003 and 0,002) respectively. For URS serum TNF-a levels were statistical significantly correlated preoperatively with one hour (P=0,0083) and 48 hours (P<0,001) after URS and IL-6 with 2 and 24 hours (P<0,001). In 3 patients for URS and 1 for ESWL we observed post procedure fever (>38.5C(o)). All those patients had preoperatively high values of TNF-a and Il-6 that increased at 1 and 2-hours respectively. In conclusion, high pre ESWL/URS levels of serum TNF-a and IL-6 may indicate a predisposition for post ESWL/URS inflammation and infection following URS lithotripsy or ESWL procedure Περισσότερα »
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Tumor necrosis factor A and interleucin 6 serum values in patients undergoing extracorporeal shock wave lithotripsy for ureteral stones. Hell J Nucl Med. 2015 Sep-Dec;18 Suppl 1:103-108.Bantis A. et alExtracorporeal shock wave lithotripsy (ESWL) is highly effective for the treatment of uretral lithiasis and remains the first treatment option for the majority of patients when ureteral lithiasis can not be treated otherwise for more than two decades. In the present study we aim to evaluate the levels of serum tumor necrosis factor a (TNF-a) and interleucin 6 (IL-6) in patients undergoing ESWL and investigate whether preESWL levels of serum TNF-a and IL-6 correllate with any possible infectious complications after ESWL.Thirty patients (17 males and 13 females), with a mean age of 43 who underwent ESWL for ureteral stones and 10 healthy volunteers serving as the control group were enrolled in this study. Serum samples for TNF-a and IL-6 were obtained before ESWL and after ESWL, 1, 24, and 48 hours and 2, 24, and 48 hours, respectively. The preESWL and postESWL serum TNF-a levels and IL-6 were compared and correlated with possible tissue damage and infectious complications.We found that serum TNF-a levels were significantly decreased one hour (P<0,001) and increased 24 hours (P=0.007) after ESWL. Furthermore IL-6 was also significantly increased 2 hours (P<0,001), 24 and 48 hours after ESWL (P=0,003 and 0,002 respectively). In 3 patients we observed fever (39 (o)C) postESWL procedure with negative urine culture and high serum values of TNF-a and IL6 preESWL.A high specific markers such as serum TNF-a levels (15-25pg/ml) and IL-6 (25-35pg/ml) might be useful to identifying patients with possible infection following ESWL lithotripsy. However, further studies are needed to get more accurate results Περισσότερα »
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Radiological findings and the clinical importance of megacalycosis. Res Rep Urol. 2015 Oct 19;7:153-5. Bantis A. et alTo describe the radiological findings and the clinical importance of megacalycosis.On the basis of a case report and literature review, diagnostic criteria and clinical significance of megacalycosis are presented.Megacalycosis is mostly asymptomatic and is usually discovered either accidentally or as a result of its complications, such as stone formation, flank pain, hematuria, infection, and fever. The renal pelvis, infundibulum, and ureter are not dilated. Calyces have a semilunar configuration rather than the conventional triangular or conical form. The tip of each pyramid is flat, and the calyces possess neither fornix nor papillae impressions. The number of calyces is increased compared to the healthy condition, typically from 20-25. The renal parenchyma has a normal width but with a slight narrowing of the renal medulla. The kidney exhibits normal function, in particular with respect to its ability to concentrate the urine.Megacalycosis is a rare, usually unilateral dilatation of the kidney calyces in the presence of a normal, undilated renal pelvis and ureter. Its pathological significance lies in the occurrence of complication Περισσότερα »
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Δυό μέτρα και δύο σταθμά. Οι Εθνικές αδικίες του παρελθόντος που επαναλαμβάνονται. Ιατρικές ώρες Τεύχος 13 σελ 9-13, Ιούνιος 2015.Α. ΜπαντήςΠερισσότερα »
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Επιστολή έκδοσης Ιατρικές ώρες Τεύχος 13 σελ 4-6, Ιούνιος 2015Α. ΜπαντήςΠερισσότερα »
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Η πραγματικότητα πίσω απο το Ελληνικό Success Story. Ιατρικές ώρες Τεύχος 12 σελ 14, Μάιος 2014Α. ΜπαντήςΠερισσότερα »
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Η Ελληνική κρίση ενισχύει την Αγοραπωλησία οργάνων. Ιατρικές ώρες Τεύχος 12 σελ 13, Μάιος 2014Α. ΜπαντήςΠερισσότερα »
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Επιστολή Ιατρού προς τον Υπουργό Υγείας. Ιατρικές ώρες Τεύχος 12 σελ 12, Μάιος 2014Α. ΜπαντήςΠερισσότερα »
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Η κρίση υγείας στην Ελλάδα: από την αυστηρότητα (austerity) στην απαξίωση (denialism). Ιατρικές ώρες Τεύχος 12 σελ 8-11, Μάιος 2014Α. ΜπαντήςΠερισσότερα »
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Conservative Management of Penile Trauma may be Complicated by Abscess Formation. Clin Pract. 2014 Nov 25;4(3):648. Bantis A. et alBlunt penile trauma during sexual activity, although highly underreported due to the associated patient embarrassment, constitutes a real urological emergency requiring immediate attention and possibly early surgical intervention. We report a case of a 58-year old man who presented with penile pain following excessive masturbation. Although there were no clinical signs of penile deformity or hematoma, magnetic resonance imaging revealed the presence of a rupture in the tunica albuginea. The patient opted for non-surgical management and his recovery period was complicated by the formation of an abscess at the site of the albugineal tear thus prolonging his hospital stay. The abscess was surgically drained and the patient reports to have normal erections at 3-month follow up. Περισσότερα »
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Metastatic Mucinous Adenocarcinoma of the Prostate at PSA value of 8.6 ng/ml 5-years follow up after Prostatectomy, Radiotherapy and Androgen Deprivation. Case Report Urology 2014, Volume 2014 (2014), Article ID 218628, 3 pages.Bantis A.introduction. Mucinous adenocarcinoma of the prostate is a rare variant of prostate cancer. Its malignant potential and the clinical course of the affected patients remain, by and large, controversial. No data exist about the course of metastatic mucinous adenocarcinoma of the prostate. Case Presentation. This case report describes the excellent clinical course of a 68-year-old patient with metastatic mucinous adenocarcinoma of the prostate, treated by radical prostatectomy, irradiation, and androgen deprivation. Conclusion. In our case, mucinous adenocarcinoma of the prostate does not appear to behave differently than acinar prostate cancer. Its malignant potential is dependent on its Gleason score. Περισσότερα »
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Serum cytocines values in patients after endoscopic surgery for ureteral lithiasis. Hellenic Journal of Nuclear Medicine January-April 2014 (Suppl) 20-23.Bantis A.Obstructive uropathy due to ureteral stones can cause renal infection and, if left untreated, can cause impairment of renal function. Endoscopic surgery such as ureteroscopy (URS) and laser lithotripsy are the primary therapeutic approach. Cytokines as non invasive markers may have a role to diagnose ureteral damage and infection. We aimed to evaluate serum cytokine levels of tumor necrosis factor-a (TNFa) and interleukin-6 (IL6) in patients undergoing URS and holmium laser lithotripsy. The study included 40 patients (male 25 and 15 female) with a mean age of 47 years and 10 healthy blood donors serving as the control group. None of them had any additional systemic diseases, previous insertion of a ureteral double "j" stent or of a nephrostomy tube, neoplasmatic disease ot renal insufficiency. Routine urine examination and urine culture were obtained to exclude urinary infection. Preoperatively and 1h, 2h, 24h and 48h postoperatively serum samples of TNF-a and IL-6 were collected and measured. Serum TNFa and IL-6 values were correlated with the other variables measured from blood samples after the URS using paired samples Students t-test with confidence interval 95%. A P value of less than 0.01 was considered statistically significant. Correlation between serum TNF-a and IL6 levels with healthy donors were statistically significant in 1h (0.004), 2h (0.001), 24h (0.001) and 48h (0.001 and 0.001) postoperatively, respectively. In conclusion, our study shows that cytokines could be helpful as markers of renal tissue damage. However, further studies are needed to get more accurate results Περισσότερα »
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Comment on "A Biochemical Evaluation on Inflammatory Markers after Ureteroscopic Lithotripsy". Int Sch Res Notices. 2014 Sep 10;2014:919801Sountoulides P, Bantis AΠερισσότερα »
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Can Tumor Necrosis Factor a (TNF-a) and Interleukin 6 (IL-6) be used as prognostic markers of infection following ureteroscopic 2014, ISRN Urology Jan 30;2014:457063.Bantis A.Introduction. Ureteroscopic lithotripsy (URS) although highly effective for the treatment of ureteral stones is associated with certain complications, the more common of which are postoperative fever and infection. In the present study we aimed to evaluate the levels of serum cytokines in patients undergoing ureteroscopic lithotripsy and investigate any possible correlation between levels of cytokines and infectious complications after URS. Materials and Methods. Thirty patients (19 males, 11 females), with a mean age of 47 (range: 26-68) that underwent URS lithotripsy for ureteral stones, and 10 healthy volunteers serving as the control group were enrolled in this study. Serum samples for TNF- α and IL-6 were obtained before surgical intervention and after 1, 24, and 48 hours and 2 , 24, and 48 hours, respectively. The preoperative and postoperative levels were compared and correlated with the possible complications after URS. Results. Serum TNF- α levels were statistically significant, increased 1 hour (P = 0.0083) and 48 hours (P < 0.001) after operation. IL-6 levels were found statistically significant, elevated after 2 and 24 hours from the URS (P < 0.001). In 2 patients we observed postoperative fever (>38.5°C). These two patients had high preoperative values of TNF- α and IL-6 ( 30 and 50 pg/mL, resp.) and these values increased postoperatively. Conclusion. High preoperative levels of serum TNF- α and IL-6 may indicate a predisposition for postoperative inflammation and infection following URS lithotripsy. Περισσότερα »
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Επιστολή έκδοσης Ιατρικές ώρες Τεύχος 11 σελ 4-5, Ιούλιος 2013Α.ΜπαντήςΠερισσότερα »
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Prostatic specific antigen and bone scan in the diagnosis and follow-up of prostate cancer. Can diagnostic significance of PSA be increased? Hell J Nucl Med. 2012 Sep-Dec;15(3):241-6. Bantis A, Grammaticos P. Prostate cancer (PC) is currently the most frequently diagnosed cancer in males and constitutes a major health issue in developed countries. On the other hand, the majority of PC cases are considered clinically not significant and certainly not lethal. These discrepancies highlight the need for the early detection of especially those cases that have aggressive features and call for early and radical intervention. The clinical use of prostatic specific antigen (PSA) towards this end is recognized as inadequate since PSA is prostate specific, but not a PC specific marker, as it is known to increase in other prostate diseases such as benign hyperplasia, inflammations, transrectal ultrasound examination, biopsy and after transurethral prostatectomy. However due to lack of other more specific markers, digital rectal examination combined with serum PSA are suggested for PC screening and diagnosis. With regard to advanced disease where bone involvement is the rule, nuclear medicine bone scan using radioactive bisphosphonates such as technetium-99m methylene-diphosphonate is quite common and reliable technique for detecting and monitoring bone metastases. The major advantage of nuclear scintigraphy is its ability to reveal bone metastases significantly earlier than the conventional X-ray imaging techniques. PSA density, velocity, doubling time and free to total PSA ratio increase the significance of serum PSA in diagnosing PC. The combination of an increased PSA (>20ng/mL) and a high biopsy Gleason score (>8) enhances the possibility of bone metastases (P<0001) and mandates a bone scan. In conclusion, serum PSA testing is currently recommended in symptomatic PC patients for disease staging and treatment monitoring and in asymptomatic selected population groups aged more than 50 years. It is reasonable to suggest that PSA density, velocity, doubling time and free to total PSA ratio or combining PSA with Gleason score shall greatly increase PSA specificity in detecting PC cases. Radioisotopic bone scan by SPET or PET can demonstrate osseous metastases at later stages of PC, but should also be applied in cases falsely considered as an early stage of PC, for better staging and for periodic follow-up of the disease. Περισσότερα »
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”Laparoscopic Transvesical Resection of an En Bloc Bladder Cuff and Distal Ureter during Nephroureterectomy," ScientificWorldJournal. 2012;2012:658096 Giannakopoulos S, Toufas G, Dimitriadis Ch, Giannopoulos S, Kalaitzis Ch, Bantis A, Patris E, Touloupidis S.The most appropriate technique for excising the distal ureter and bladder cuff during laparoscopic nephroureterectomy is still debated. We report our experience with a pure laparoscopic transvesical method that duplicates the long-standing open transvesical approach.Seven men and three women diagnosed with upper tract transitional cell carcinoma were treated with this procedure. Three intravesical ports were inserted, and pneumovesicum was established at 12 mmHg. Transvesical laparoscopic circumferential detachment of the bladder cuff and en bloc mobilization of the last centimeters of the distal ureter were performed, followed by the closure of the bladder defect. Subsequently, a nephrectomy was performed either laparoscopically or using an open flank approach.The median age was 68.5 years. The procedure was completed uneventfully in all cases. The median operating time for distal ureter excision was 82.5 minutes (range 55-120). No complications directly related to the pneumovesicum method were recorded. The median follow-up period was 31 months (range 12-55). During the follow-up period, two patients (20%) died from the disease, and a bladder tumor developed in three cases (30%).The laparoscopic transvesical resection of the en bloc bladder cuff and distal ureter is a reliable, effective, and oncologically safe technique, at least in the midterm. Περισσότερα »
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Single inguinal node metastasis of stage I testicular seminoma shown by scrotal scintigraphy, 6 months following radical orchiectomy. Hell J Nucl Med. 2012 May-Aug;15(2):150-2. Epub 2012 Jun 27. Bantis A, Sountoulides P, Kalaitzis C, Nikolaos B, Giannakopoulos S, Zissimopoulos A. Lymphatic drainage of the testes is known to follow a predictable pathway that usually involves the retroperitoneal, paraaortic, paracaval and interaortocaval nodal chains. Herein we report the case of a 41 years old man with a stage I testicular seminoma, with an unexpected inguinal lymph node metastasis. During his routine follow-up visit, 6 months after radical orchiectomy, a spherical mass in the right inguinal region was palpated. Thoraco-abdominal CT did not reveal any evidence of retroperitoneal enlarged lymph nodes or distant metastases, but showed a 2cm right inguinal mass. Scrotal scintigraphy with technetium-99m pertechnetate was performed in order to evaluate the local vascularity of the right inguinal area. The angiographic phase (0-1min) and the blood pool images at 15, 30, 45 and 60min revealed high uptake in the right inguinal region, suggesting a hyperemic mass suspicious for tumor recurrence. The excised mass was found to be an enlarged lymph node infiltrated with seminoma. The patient received adjuvant radiotherapy to which he showed a complete response and has been disease free at 2 years follow-up. In conclusion, in the case presented scrotal scintigraphy showed a hyperemic mass at the right inguinal region that proved to be the sentinel node of a stage I testicular seminoma and was treated accordingly. Περισσότερα »
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A simplified technique for ureteral spatulation in laparoscopic pyeloplasty. J Endourol. 2012 Jun;26(6):618-20. Epub 2011 Oct 4. Giannakopoulos S, Efthimiou I, Bantis A, Kalaitzis C, Touloupidis S. One of the most difficult, time-consuming, and at the same time critical steps of laparoscopic pyeloplasty is ureteral spatulation. We describe a reproducible technique that greatly simplifies this surgical step. Using standard laparoscopic scissors, the ureter is partially cut just inferior to the ureteropelvic junction (UPJ) at a point where a normal (nonstenotic) ureter is discerned. This first cut involves only half of the circumference of the ureter. The ureter remains attached to the UPJ. Through the most cephalad port, a 5-mm articulating laparoscopic scissors is inserted in the abdomen. The instrument is fully articulated so that the axis of the jaws is almost in line with the ureteral axis. The jaws are opened, one jaw is inserted in the ureteral lumen, and the ureter is spatulated to the requisite length. At this point, the first apical ureteral stitch is placed outside-in while the ureter is stabilized by its remaining attachment to the UPJ. Subsequently, the ureter is freed completely from the UPJ; the UPJ is excised, and the rest of the procedure is performed in a standard fashion Περισσότερα »
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Minimal invasive treatment options in pregnant women with ovarian vein syndrome. Arch Gynecol Obstet. 2012 Jan;285(1):83-5. Epub 2011 May 27. Kalaitzis C, Zissimopoulos A, Bantis A, Giannakopoulos S, Galazios G, Limperis V, Touloupidis S.To describe the treatment modalities of symptomatic ovarian vein syndrome in pregnancy.In our study, we included 12 pregnant women with right ureter and kidney dilatation; caused by ureteric obstruction. In 11 out of 12, we insert a DJ stent and in one woman we applied percutaneous nephrostomy, because of intermittent abdominal pain, resistant on analgetic therapy or feverish pyelonephritis. DJ stents and nephrostomy were inserted under ultrasound guidance without anaesthesia.After insertion of DJ stents, respective percutaneous nephrostomy colic attacks went back immediately and the feverish pyelonephritis in few days. At no time during these procedures, there was a risk for pregnancy.Ovarian vein syndrome in pregnancy can lead to violent colic pain and can become complicated by accompanied pyelonephritis. In these cases insertion of a DJ stent or percutaneous nephrostomy under ultrasound guidance is possible and safe, and leads to an improvement of complaints immediately. Περισσότερα »
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Positive lymphoscintigraphy (ILS) and negative computed tomography for metastatic penile cancer. Hell J Nucl Med. 2011 Sep-Dec;14(3):309-10. Bantis A, Sountoulides P, Kalaitzis C, Boussios N, Giannakopoulos S, Zissimopoulos A. Penile carcinoma usually occurs in older than 40 years men with an incidence in western communities of 0.5 to 1.6 per 100,000 men per year while in developing countries the rate is much higher in men. Extensive lymph node dissection of lymphatic inguinal metastases evident by inguinal lymphoscintigraphy (ILS) induces improved overall survival. A 75 years old male with penile squamous cell carcinoma stage pT2N0M0 of less than 2cm diameter, with tumor invasion of the penis corpora underwent partial penectomy with a 2-cm disease-free margin. Three months postoperation, computed tomography (CT) was negative for local recurrence or distant metastases. A dynamic ILS was performed after local anaesthesia and intradermal injection of 80MBq of (99m)Tc-nanocolloid at the lower edge of the left and right inguinal ducts. The lymphatic chain and a hot spot suggestive of a first draining lymph node appeared after 15min on the right inguinal region in the second zone according to Daseler mapping. The left inguinal area was negative for sentinel node (SN). In view of this finding an exploratory laparotomy was performed and pathology showed that this lymph node that was probably a SN was infiltrated by the squamous cell carcinoma. The patient was upstaged to T2N1M0 and scheduled to receive adjuvant chemotherapy with two courses of cisplatin and 5-fluorouracil. While T1 and T2 tumours of diameters <2cm are best treated with penile-preserving methods such as circumciand/or local excision. Tumours of T2 >2cm, T3 tumours, and T4 tumours are treated with glans amputation and/or partial or total penile amputation. Imaging with magnetic resonance imaging (MRI) or computed tomography (CT) scan do not always give accurate staging information, because positive findings are usually found only in patients with clinically palpable, enlarged inguinal lymph nodes. Computed tomography and MRI have low sensitivity to identify occult metastases, because they present criteria for malignant involvement mainly based on the size of the lesions. The main pitfall of these diagnostic modalities is due to occult metastatic disease occurring within normal sized nodes. Approximatively 20% of the patients with non palpable lymph nodes harbour occult inguinal metastases, and there is evidence that this group of patients may benefit from early surgical dissection of the inguinal nodes, compared to a wait-and-see policy. It is understood that current imaging techniques cannot accurately detect occult metastases, while ILS is more reliable. In 80% of patients with penile cancer, after ILS, drainage to both groins is observed. Bilateral nodes are often visualized early, sometimes asynchronously with one of the lymph nodes filling late. This is why delayed images are recommended. Pitfalls of ILS are: a) Contamination of the skin with the tracer and b) radiopharmaceutical entering the blood. There are also several reasons that may account for absent or faint SN uptake: low dose of the tracer or low tracer quality, patient's age (better in young patients), tumor involvement of the sentinel node, and finally too short or too long interval between tracer injection and ILS. The ILS can be mapped according to Daseler's inguinal zones. Penile cancer drains directly to the nodes in the superior and central Daseler zones. According to others, the majority (73%) of SN was located in the medial superior, 8.7% in the lateral superior, and 18.3% in the central zone. No drainage was seen on the two inferior quadrants. The majority (62.1%) of higher-tier nodes was found in the external iliac zone. Inguinal LS can save us from watchful waiting in cases of otherwise occult metastases. In conclusion, ILS has shown lymph node metastases while clinical and CT examinations were negative. The false positive and false negative results of ILS are mentioned. Περισσότερα »
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Bisphosphonate-induced osteonecrosis of the jaw in patients with bone metastatic, hormone-sensitive prostate cancer. Risk factors and prevention strategies. Tumori. 2011 Jul-Aug;97(4):479-83. doi: 10.1700/950.10401. Bantis A, Zissimopoulos A, Sountoulides P, Kalaitzis C, Giannakopoulos S, Deftereos S, Tsakaldimis G, Thomaidis V, Touloupidis S.Evidence from the literature suggests that osteonecrosis of the jaw is emerging as a serious complication of treatment with bisphosphonates for patients with advanced prostate cancer.This study is a series of 60 patients with osseous metastases from prostate cancer under complete androgen deprivation therapy. All patients also received bisphosphonates intravenously every 3 to 4 weeks. Over a period of 3 and a half years, we recorded the incidence, presenting signs and symptoms of osteonecrosis of the jaw among those patients and the diagnostic workup required.Nine of the 60 patients with metastatic prostate cancer were found to be affected with osteonecrosis of the jaw secondary to bisphosphonate administration at the Urology Department at the University Hospital of Alexandroupolis between January 2006 and August 2009. For diagnostic reasons, all 9 patients underwent computed tomography scan and magnetic resonance imaging of the maxillary region, as well as a three-phase whole body bone scan. There is evidence that administration of bisphosphonates in patients with advanced prostate cancer may increase the risk of osteonecrosis of the jaw. Guidelines regarding the diagnosis and management of those patients are needed. Περισσότερα »
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The influence of ejaculation and abstinence on urinary flow rates. Neurourol Urodyn. 2011 Nov;30(8):1571-5. doi: 10.1002/nau.21157. Epub 2011 Jul 20. Cindolo L, De Nunzio C, Sountoulides P, Bantis A, Tubaro A, Schips L. To investigate the relationship between urinary flow rate and ejaculation in healthy young men.Young men were voluntarily enrolled in the study. All subjects were healthy, and sexually active, without neurological diseases, genital, or urethral surgery and they were not under any medications. Subjects were evaluated with ultrasound, uroflowmetry, and post-void residual urine (PVR) measurement. All subjects were followed for 22 days (T) with daily uroflowmetry, and were instructed to ejaculate only on specific days (0, 6 and 22) during the study period. On days 0, 6 and 22 uroflow measurements were performed between 2 and 6 hr following ejaculation. Uroflowmetry parameters before and after ejaculation and during abstinence were compared. Data presented a non-normal distribution and the non-parametric Wilcoxon-match-paired test and Kruskal-Wallis test were used for statistical analysis.18 subjects (mean age 27.4 years) completed the study. A total of 414 uroflow charts were collected. A statistical significant increase in Qmax was observed after ejaculation (T-1 Qmax: 22.7 ± 5.4 vs. T0 Qmax: 25.7 ± 8, P = 0.002; T5 Qmax 23.2 ± 5.4 vs. T6 Qmax 25.4 ± 8, P = 0.031; T21 Qmax 21 ± 4.8 vs. T22 Qmax 24.5 ± 7.9, P = 0.031). Sexual abstinence resulted in a progressive, statistically significant decline in Qmax rates (T0 Qmax 25.7 ± 8 vs. T5 23.2 ± 5.4 P = 0.035; T6 Qmax 25.4 ± 8 vs. T21 Qmax 21 ± 4.8, P = 0.01). PVR did not change during the study period.Our results suggest that in young healthy men micturition might be influenced by ejaculation. Our findings, if confirmed in larger series of patients with LUTS, should support that sexual status and activity could represent an important confounding factor in the interpretation of uroflowmetry traces. Περισσότερα »
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A case report of urinary bladder carcinosarcoma and review of the literature. Case Rep Urol. 2011;2011:415675. Epub 2011 Jun 30. Zachariadis C, Efthimiou I, Giannakopoulos S, Bantis A, Giatromanolaki A, Sivridis E, Touloupidis S. Carcinosarcoma of the bladder is an unusual tumour characterized by a combination of malignant epithelial and soft tissue elements. Most of the reported cases have been case reports or small series. Optimal treatment is uncertain. We herein report our experience in such a case treated with transurethral resection followed by radiotherapy with adverse final outcome. Treatment of bladder carcinosarcomas should be aggressive and multimodal but optional treatment is still unknown. Radiotherapy alone is insufficient as a treatment option of these aggressive tumors Περισσότερα »
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Tissue polypeptide antigen in the follow-up of patients with urinary bladder cancer compared with conventional urine cytology. Hell J Nucl Med. 2010 Sep-Dec;13(3):213-7. Bantis A, Zissimopoulos A, Sountoulides P, Giannakopoulos S, Kalaitzis C, Athanassiadou P, Agelonidou E, Touloupidis S.The incidence of bladder cancer has demonstrated a rapid increase during the last decades. The aim of this study is to determine the clinical value of serum tissue polypeptide antigen (TPA) as a tumour marker for urinary bladder cancer in comparison with conventional urine cytology. Urine and blood samples were obtained from a total of 108 patients (group A) with a known history of bladder cancer, who presented for their routine 3 month follow-up. These 108 patients included 45 patients with high grade and 63 patients with low grade bladder cancer, and 30 patients with lower urinary tract symptoms (LUTS) and no history of bladder cancer (group B). Urine and blood samples from fifty healthy adults (group C) were also tested; this group served as the control group for estimating the normal range of serum TPA values. In all group A patients cystoscopy and/or bladder biopsies were performed. All blood and urine samples were tested for TPA and conventional urine cytology respectively. Results showed that the upper normal range for TPA was 1.0 ng/mL(0.9 ± 0.04) in the control group. For the subgroups of patients with high and low grade bladder cancer elevated serum TPA levels were found in 52% and 40% of the patients respectively. The overall serum TPA sensitivity and specificity were 50% and 85% respectively for patients with known bladder cancer (group A). We found the sensitivity of cytology for high grade bladder (GIII) carcinomas to be 72%; however when urine cytology was combined with serum TPA the overall sensitivity reached 80%. We conclude that serum TPA combined with urine cytology may be used as a prognostic marker for bladder cancer. Περισσότερα »
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Sodium sensitivity and its role in the maintenance of high blood pressure in two-kidney, one-clip renovascular hypertension after removal of the clipped kidney in rats. Minerva Urol Nefrol. 2010 Sep;62(3):225-9. Kalaitzis C, Pasadakis P, Bantis A, Giannakopoulos S, Touloupidis S. The aim of the present study was to define the role of sodium balance and sodium sensitivity in the maintenance of two-kidney, one-clip renovascular hypertension in rats.Six months after induction of hypertension, systolic blood pressure, sodium balance, water intake and urine excretion were measured under normal conditions, after nephrectomy of the clipped kidney, and under conditions of sodium load.No difference between control rats and rats with or without post-Goldblatt hypertension emerged during the development of renovascular hypertension and after nephrectomy of the clipped kidney. Under conditions of high sodium intake, the contalateral kidney of the post-Goldblatt hypertensive rats was unable to excrete surplus sodium. Sodium retention was not correlated with water retention. In contrast to the controls, systolic blood pressure increased in the animals with post-Goldblatt hypertension and those with post-Goldblatt normotension during the sodium load period. No correlation was found between blood pressure increase and sodium retention. The animals were considered sodium sensitive in relation to blood pressure.In the chronic phase of two kidney-one clip renovascular hypertension, the post-Goldblatt hypertensive and the post-Goldblatt normotensive animals showed sodium sensitivity of blood pressure. The contralateral kidney of the post-Goldblatt hypertensive animals was unable to excrete surplus sodium under conditions of high sodium intake. But this inability and the sodium sensitivity of blood pressure cannot be thought responsible for the maintenance of renovascular hypertension in this mode Περισσότερα »
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Perforation of the urinary bladder caused by transurethral insertion of a pencil for the purpose of masturbation in a 29-year-old female. Case Report Med. 2010;2010. pii: 460385. Epub 2010 Aug 25. Bantis A, Sountoulides P, Kalaitzis C, Giannakopoulos S, Agelonidou E, Foutzitzi S, Touloupidis S.The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation Περισσότερα »
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Use of an angiographic catheter to facilitate fluoroscopy-guided percutaneous renal access in cases with diffuse contrast extravasation. J Endourol. 2010 Oct;24(10):1575-8. Giannakopoulos S, Bantis A, Kalaitzis C, Touloupidis S.Occasionally during percutaneous surgery, significant contrast extravasation obscures the field, making fluoroscopic access no longer feasible. Herein, we describe a salvage technique.The cystoscopically placed, open-end ureteral catheter is exchanged with an angled-tip angiographic catheter. With the aid of a guidewire and under fluoroscopic guidance, the tip of the catheter is placed in a posterior calix. The "bull's eye" technique is then applied to direct the needle into the tip of the catheter. This technique was used in four cases over a 7-year period.Successful access was accomplished in all cases through a middle or upper calix.The catheter serves as a target for providing access to the renal collecting system and facilitates final tract dilatation. Περισσότερα »
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Telomerase RNA expression and DNA ploidy as prognostic markers of prostate carcinomas. Tumori. 2009 Nov-Dec;95(6):744-52. Bantis A, Patsouris E, Gonidi M, Kavantzas N, Tsipis A, Athanassiadou AM, Aggelonidou E, Athanassiadou PThe objective of this study was to determine whether there was a correlation between telomerase RNA expression and DNA ploidy status with clinicopathological parameters and biochemical recurrence after radical prostatectomy.Telomerase RNA expression and DNA ploidy were evaluated in imprint smear samples obtained from 112 prostates after radical prostatectomy. The results were correlated with pathological stage, Gleason score and serum PSA. Positive telomerse RNA expression was detected in 67.8% of prostate carcinomas. The multiple linear regression model showed a statistically significance increase in telomerase RNA expression with increased Gleason score (P < 0.0001) and preoperative serum PSA values (P = 0.0125). DNA ploidy status also varied significantly with Gleason score (P < 0.0001) and preoperative serum PSA values (P = 0.0110). Five patients with diploid tumors and negative telomerase RNA expression developed a recurrence. However, recurrence was associated with DNA aneuploidy (P = 0.001) as well as with high telomerase RNA overexpression (P = 0.001). We conclude that telomerase RNA expression and DNA ploidy could be additional markers in the field of prognosis of prostate carcinomas. Περισσότερα »
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The prognostic value of serum chromogranin A and prostate specific antigen in prostate cancer patients for progression to the hormone resistance state. Hell J Nucl Med. 2009 Sep-Dec;12(3):234-7 Zissimopoulos A, Bantis A, Sountoulides P, Giannakopoulos S, Kalaitzis C, Agelonidou E, Touloupidis SProstate adenocarcinomas (PAC) consist mainly of tumour cells of luminal immunophenotype and scattered neuroendocrine (NE) cells. NE cells are defined by chromogranin A (CgA) immunoreactivity. T he aim of this study is the evaluation of CgA serum levels in monitoring prostate cancer (PC) patients under complete androgen deprivation (CAD) in comparison with the prostate specific antigen (PSA) as a prognostic marker of androgen resistance and bone metastases. Ninety-two patients with newly diagnosed PAC and 30 healthy blood donors serving as the control group were enrolled in the study. Serum CgA and PSA values were measured. All patients had locally advanced or metastatic disease and received CAD treatment. In the group of PAC patients bone scanning with 925MBq (99m)Tc-MDP revealed the presence of bone metastatic lesions in 50 patients (29 with more than 3 lesions and 21 with less than 3 lesions). The other 42 patients had no bone metastases. The patients and the control group were re-evaluated after 1 year. Our results showed that serum CgA positively correlated with multiple bone metastases and higher Gleason score, serum levels of CgA and PSA. Levels of PSA were significantly higher in patients with PAC and bone metastases compared with those with no bone metastases (P<0.001). In patients with multiple bone metastases and Gleason Score >7 elevated serum levels of CgA higher than those of PSA were found. In conclusion, serum CgA levels is a valuable marker for predicting the presence of multiple bone metastases in PAC patients. Combined with PSA, CgA can predict disease progression in patients with advanced PAC under CAND treatment and is correlated with poor prognosis. Περισσότερα »
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Osteolytic bone destruction resulting from relapse of a testicular tumour 23 years after inguinal orchiectomy and adjuvant chemotherapy: a case report. J Med Case Reports. 2009 Jul 31;3:8702 Kalaitzis C, Bantis A, Tsakaldimis G, Giannakopoulos S, Sivridis E, Touloupidis S. Late relapse of a testicular germ cell tumour is an uncommon occurrence. We report a case of osteolytic bone metastasis appearing 23 years after the initial treatment of a metastatic testicular mixed tumour (choriocarcinoma and embryonal carcinoma). This is one of the longest periods of recurrence reported for testicular germ cell tumours.A 52-year-old Caucasian man who underwent a right inguinal orchiectomy due to testicular tumour in 1984 presented to our outpatient clinic in a generally bad condition of health and with severe pain of his right hip joint and os ischii caused by osteolytic metastasis.This case emphasizes the need for a life-long follow-up of patients with primary metastatic testicular cancer. Περισσότερα »
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Prostate cancer incidence, mortality, total and free prostate specific antigen. Hell Nucl Med. 2009 May-Aug;12(2):106-9. Review. Bantis A, Vasiliou OThe causes of prostate cancer (PC) and its progression are not yet known. Mortality and incidence from PC has increased throughout European countries until early 1990s. In Greece, PC is the second commonest cancer in men after lung cancer. The traditional Greek diet old in its origin may protect against common chronic diseases, including PC. Hormonal causes have been postulated in the aetiology of PC, mainly because androgen ablation causes regression of PC. Total and free prostate specific antigen (PSA and fPSA) screening were introduced to detect PC at an early stage, to reduce PC specific mortality, differentiate PC from hypertrophy and monitor response after hormonal treatment in advanced PC. Περισσότερα »
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"Vanishing penis" and urinary retention due to locally destructive penile cancer. ScientificWorldJournal. 2009 Mar 1;9:158-62. Sountoulides P, Bantis A, Zachos I, Asouhidou I, Pantazakos A.Περισσότερα »
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Ο ρόλος των ανδρογόνων στο φυσιολογικό και στο καρκινικό προστατικό κύτταρο. Άρθρο ανασκόπησης. Γαληνός 2008; 50(4) 237-252.Α.ΜπαντήςΠερισσότερα »
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Καρκίνος του προστάτη. Από την εποχή της όξινης προστατικής φωσφατάσης στους μη ειδικούς βιολογικούς δείκτες και το ειδικό προστατικό αντιγόνο. Μέρος Δεύτερο οι μη ειδικοί βιολογικοί δείκτες- συγκριτική αξιολόγηση της όξινης προστατικής φωσφατάσης και του ειδικού προστατικού αντιγόνου του ορού. Ιατρικά Χρονικά 2008; Vol31, 118-120.Α. ΜπαντήςΠερισσότερα »
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Four prognostic indices in advanced prostate cancer patients, under palliative androgen deprivation treatment. Hell J Nucl Med. 2008 Jan-Apr;11(1):21-5. Bantis A, Zissimopoulos A, Kalaitzis C, Giannakopoulos S, Sountoulides P, Parmenopoulou V, Agelonidou E, Touloupidis S. Prostate cancer (PCa) is the second leading cause of death in men aged 40 years and older ]and prognostic indices are useful in suggesting its proper treatment. The aim of this study was to evaluate the prognostic value of Gleason score (GS), TNM staging system, initial serum prostate specific antigen (PSA) and bone scintigraphy (BS) in patients with PCa under hormonal palliative treatment, in the development and progression of recurrent PCa. Our methods were as follows: Between January 2005 and December 2007, we have studied at the University General Hospital of Alexandroupolis fourty patients of mean age 77+/-7.2 years with advanced PCa under palliative treatment with antiandrogens and luteinizing hormone-releasing hormone analogues. PCa was diagnosed histologically, based on the TNM system after transrectal ultrasonography guided biopsy. The Gleason score assessment was made as described by others. Metastases were confirmed by a positive bone scintigraphy with 925 MBq (99m)Tc-MDP using a tomographic gamma camera, computerized axial tomography or magnetic resonance imagining. Measurements of PSA were conducted by the radioimmunoassay method. We also examined 20 healthy blood donors (median age 45+/-6.1 years) as controls, in order to estimate the cut-off value of PSA. Our results show the following: Thirteen of our patients had 1-6 "hot" spots and 27 had more than 6 "hot" spots in the bone scan. The median Gleason score was 7 (modal Gleason score 3+4). Serum PSA levels were higher in patients with PCa and bone metastases in comparison to those with PCa without bone metastases. Very high values of PSA (more than 50 ng/ml) were found in patients with multiple bone metastases (>6 "hot" spots). In conclusion, our findings demonstrate that the prognostic value of GS (P=0.043), TNM staging (P=0.1410), serum PSA levels (P=0.002) and BS (P=0.0135) when used alone, not always improve the prognosis to hormone indepentent but when combined (P<0.001) increase the prognosis in patients with advanced PCa under hormonal palliative treatment. Περισσότερα »
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Massive hematuria due to a congenital renal arteriovenous malformation mimicking a renal pelvis tumor: a case report. J Med Case Reports. 2008 May 5;2:144. Sountoulides P, Zachos I, Paschalidis K, Asouhidou I, Fotiadou A, Bantis A, Palasopoulou M, Podimatas T.Congenital renal arteriovenous malformations (AVMs) are very rare benign lesions. They are more common in women and rarely manifest in elderly people. In some cases they present with massive hematuria. Contemporary treatment consists of transcatheter selective arterial embolization which leads to resolution of the hematuria whilst preserving renal parenchyma.A 72-year-old man, who was heavy smoker, presented with massive hematuria and flank pain. CT scan revealed a filling defect caused by a soft tissue mass in the renal pelvis, which initially led to the suspicion of a transitional cell carcinoma (TCC) of the upper tract, in view of the patient's age and smoking habits. However a subsequent retrograde study could not depict any filling defect in the renal pelvis. Selective right renal arteriography confirmed the presence of a renal AVM by demonstrating abnormal arterial communication with a vein with early visualization of the venous system. At the same time successful selective transcatheter embolization of the lesion was performed.This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria. In the case presented, a congenital renal AVM proved to be the cause of massive upper tract hematuria and flank pain in spite of the initial evidence indicating the likely diagnosis of a renal pelvis tumor. Περισσότερα »
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Association between bone scintigraphy and serum levels of procollagen (I) and PSA in the detection of bone disease in prostate cancer patients. J BUON. 2008 Jan-Mar;13(1):69-74. Zissimopoulos A, Bantis A, Stellos K, Petrakis G, Matthaios D.To evaluate the clinical usefulness of serum procollagen I carboxyterminal propeptide (PICP) and prostate specific antigen (PSA) in relation to bone scan results in Greek patients with prostate cancer (PC).108 patients (mean age 58+/-4.3 years; range 42-81) with PC and 52 healthy blood donors as control group were examined for serum PICP and PSA levels. The diagnosis of PC was confirmed histologically. Bone metastases were diagnosed in 68 of the patients with the use of (99m)Tc-MDP bone scan, while 40 patients had no bone metastases. During the one year follow-up new PICP and PSA measurements were obtained along with a new bone scan for all groups studied.The levels of serum PICP and PSA were significantly higher in patients with PC and bone metastases in comparison to patients with no bone metastases. The sensitivity and specificity of the combination of PICP and PSA were 78% and 96%, respectively.PICP could be useful for diagnosing early bone metastases of prostate adenocarcinoma and in combination with PSA and bone scan can be an additional tool in the follow-up of patients with PC. Περισσότερα »
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Η χρήση του εύκαμπτου κυστεοσκοπίου και η ταυτόχρονη εκτομή των επιφανειακών νεοπλασμάτων της ουροδόχου κύστης με Holmium laser. Γαληνός 2007 (49)4, 311-317.Α.Μπαντής. Περισσότερα »
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Ο ρόλος των ανδρογόνων στην κλινική συμπεριφορά του προστατικού καρκίνου και στον έλεγχο της ορμονικής του θεραπείας. Info Urology 2007, 6-7.Π. Σουντουλίδης, Α.ΜπαντήςΠερισσότερα »
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Ηθικός κίνδυνος και προκλητή ζήτηση στον τομέα της υγείας. medical express 2007, (16) 149, 20-23.Α.ΜπαντήςΠερισσότερα »
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Πολιτικές μεταρρυθμίσεις των συστημάτων υγείας. Υποβάθμιση ή αναβάθμιση; Μελέτη της Σουηδίας, Δανίας και Γερμανίας. Πολιτική και Οικονομία 2007, (23) 53-58.Α.ΜπαντήςΠερισσότερα »
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Φυτοθεραπεία για την καλοήθη υπερπλασία του προστάτη. Popular medicine 2007, (50) 66-70.Α.ΜπαντήςΠερισσότερα »
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Αυτόματος πλήρης ακρωτηριασμός πέους από διηθητικό καρκίνο. Ελληνική Ουρολογία 2007,19:67-70.Π. Σουντουλίδης, Α.Μπαντής, Ι Ζάχος, Π. ΠολίτηςΠερισσότερα »
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Arteriovenous malformation of the spermatic cord as the cause of acute scrotal pain: a case report. Journal of Medical Case Reports2007, 1:110 doi:10.1186/1752-1947-1-110. P Sountoulides, A Bantis, I Asouhidou and E Aggelonidou. Arteriovenous malformations of the lower urinary tract are uncommon lesions, usually presenting as scrotal masses. A case of recurrent acute scrotal pain mimicking testicular torsion that was attributed to the presence of an arteriovenous malformation of the spermatic cord is described. To our knowledge this is the first reported case of an arteriovenous malformation of the spermatic cord presenting with acute scrotal pain. Περισσότερα »
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Correlation of serum prostate specific antigen, volume and intravesical prostatic protrusion of diagnosing bladder outlet obstruction in patients with benign prostate hyperplasia. Hell J Nucl Med 2007,10,138-143 A. Bantis , A. Zissimopoulos, Ch. Kalaitzis, S. Gianakopoulos, P. Sountoulides, E. Agelonidou, Ch. Voudalikakis, S. Touloupidis.Περισσότερα »
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Serum testosterone, dihydrotestosterone, luteinizing hormone and follicle-stimulating hormone versus prostate specific antigen in patients with localized prostate adenocarcinoma who underwent radical prostatectomy. Radioimmunoassays measurements. Hell J Nucl Med 2007, 10, 56-61. A Bantis.The relation of steroid hormones (SH) with carcinogenesis is not well understood. There is a variation of opinions among researchers about the prognostic value of serum SH in patients with localized prostate cancer (PC). The aim of this was to study serum SH in patients with localized PC before and after radical prostatectomy (RP). Seventy patients with mean age 67+/-8 years, were studied. The diagnosis was confirmed by histology after a biopsy. None of the patients was submitted to hormonal treatment or radiotherapy prior to RP. Serum testosterone (TST), dihydrotestosterone (DHT), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were examined prior RP and one year following RP, by radioimmuno assay (RIA) or immunoradiometric assay (IRMA) methods. Based on serum PSA levels before and one year after RP, 66 of the patients did not have biochemical recurrence while 4 patients developed biochemical recurrence due to residual disease and were treated with flutamide and a LH-RH analogue. In the group of 66 patients there was a statistically significant increase in serum TST (P<0.001), LH (P=0.004) and FSH (P<0.001), and statistically significant decrease in serum DHT (P<0.001). In the four patients with biochemical recurrence, TST increased and serum DHT, LH and FSH decreased. In this group the reduction of DHT and LH, FSH were due to treatment with flutamide and a LH-RH analogue respectively. Our findings suggest that after RP increase of serum LH and FSH may have caused an increase in serum TSH and a decrease of serum DHT. If those changes are due to the hypothalamic-pituitary axis it may be that the prostate neoplasm before RP may have secreted a substance that induced a negative feedback to the pituitary gonadotrophin secretion, which was unrelated to varying serum PSA levels. Περισσότερα »
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The expression of metallothioneins on imprint smears of prostate carcinoma: correlation with clinicopathologic parameters and tumor proliferative capacity. Tumori 2007, 93, 189-194. P Athanassiadou, A Bantis , M Gonidi ,P Athanassiades , E Agelonidou , D Grapsa , P Nikolopoulou , E Patsouris. Metallothioneins are a family of metalbinding cysteine-rich proteins that play an important role in cellular processes such as proliferation and apoptosis, protection against oxidative stress and metal ion homeostasis and detoxification. Recent findings suggest that metallothioneins might play a significant role in the development and progression of prostate cancer. It has been also demonstrated that Ki67 expression may have prognostic value for disease-free survival in cases of prostate carcinoma.Imprint smears samples obtained from 70 patients immediately after radical prostatectomy for prostatic carcinoma were immunostained with monoclonal antibodies against metallothioneins and Ki-67. Metallothionein expression was correlated with Ki-67 immunostaining, Gleason score, stage, preoperative prostate-specific antigen levels and biochemical recurrence.Metallothionein expression was shown to correlate strongly with Gleason score (P < 0.001) and significantly with pathological staging and Ki-67 immunostaining (P < 0.001, P < 0.05, respectively). In contrast, no significant association between metallothioneins and preoperative PSA was demonstrated. Both of the studied markers (metallothioneins and Ki-67) correlated with recurrence (P = 0.009, P = 0.006, respectively).The present findings support the independent predictive value of metallothioneins and Ki-67 in prostate cancer. However, additional data are needed in order to reveal the factors that influence the expression of metallothioneins in epithelial neoplastic cells and clarify their mechanism of action. Περισσότερα »
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Οι παρεμβάσεις του ΝΔ3329/ΦΕΚ/Α/81/2005 επί του υφισταμένου Νομικού πλαισίου του Εθνικού Συστήματος Υγείας & Κοινωνικής Αλληλεγγύης. Θρακών Υγεία 2006 (2-5) 14-17.Α.Μπαντής Περισσότερα »
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Φυτοθεραπεία και καλοήθης υπερπλασία του προστάτη Καλοήθης Υπερπλασία του προστάτη αδένα (μέρος δεύτερο). alternative medicine. 2006 (10) 18-22.A. Μπαντής.Περισσότερα »
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Φυτοθεραπεία και καλοήθης υπερπλασία του προστάτη Καλοήθης Υπερπλασία του προστάτη αδένα (μέρος πρώτο). alternative medicine 2006 (9)12-16. Α.ΜπαντήςΠερισσότερα »
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Η ποιότητα των παρεχόμενων υπηρεσιών του Εθνικού Συστήματος Υγείας. Πολιτική και Οικονομία 2006 (20) 46-54.Α.Μπαντής Περισσότερα »
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Πολιτική Υγείας. Αξιολόγηση της Ελληνικής πραγματικότητας και προτάσεις βελτίωσης. Πολιτική και Οικονομία 2006 (19) 41-47.Α.Μπαντής Περισσότερα »
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Οστικές επιπλοκές της θεραπείας για προστατικό καρκίνο. Ογκολογική Ενημέρωση 2006 8 (2), 112-116.Α.Μπαντής Περισσότερα »
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Νεοφιλελεύθερες επιλογές στον χώρο της υγείας. Διάγνωση 2006 (2) σελ 10.Α.ΜπαντήςΠερισσότερα »
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Φροντίδα κατ' οίκον. Η εναλλακτική μορφή περίθαλψης με στόχο την αποσυμφόρηση των Νοσηλευτικών Ιδρυμάτων. Φαρμακευτική Αγωγή 2006 18(149),19-21.Α. ΜπαντήςΠερισσότερα »
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Η χρήση του Holmium laser στην καλοήθη υπερπλασία του προστάτη. Γαληνός 2006 (48) ,135-143.Α.Μπαντής. Περισσότερα »
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Penile necrosis with complete organ loss caused by squamous cell carcinoma. Intern Journal of Urology 1528-8390, vol 3 nr2. P. Sountoulides, A. Bantis, I. Zachos, P. Politis, T Podimatas, A. PantazakosΠερισσότερα »
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Prognostic value of DNA analysis of prostate adenocarcinoma; Correlation to clinicopathologic predictors. J Clin Cancer Res 24(2),207-212,2005. Bantis A., M.Gonidi, E.Petrakakou, Ch.Tsolos A.Liossi, E.Aggelonidou, A.M. Athanassiadou, P.AthanassiadouThe ability to accurately predict tumor behavior and patient survival is a problem in managing patients with prostate cancer. DNA ploidy provides important information for the evaluation of the prognosis of prostate cancer. The aim of this study was to investigate the DNA ploidy in imprints from prostate adenocarcinomas in a group of 70 patients in relation to Gleason score, tumor differentiation, stage and PSA serum levels. The DNA content was studied in Feulgen-stained imprint smears through the image analysis technique using a SAMBA 2005 Image analyzer. According to our measurements, a strong correlation was observed between DNA ploidy status and tumor differentiation (p<0.001). A statistically significant difference was found between DNA aneuploidy and increased pretreatment PSA serum levels (>4 ng/ml) (p<0.001), as well as between ploidy pattern and stage of the disease (p<0.001). Our results conclude that DNA ploidy status appears to be an additional marker in the field of prognosis of prostatic adenocarcinoma and could provide useful information on the potential behavior of prostate cancer. Περισσότερα »
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Εθνικό Σύστημα Υγείας και Κοινωνικής Αλληλεγγύης. Προκλήσεις της κοινωνικής πολιτικής και διαμόρφωση της πολιτικής υγείας. medical express 2005 (15) 142, 12-18Α.ΜπαντήςΠερισσότερα »
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Καρκίνος του προστάτη. Παθολογοανατομικά χαρακτηριστικά και θεραπευτική προσέγγιση. medical express 2005 (14) 136, 20-24Α. ΜπαντήςΠερισσότερα »
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Καρκίνος του προστάτη.Αιτιολογία: ενδογενείς και εξωγενείς παράγοντες medical express 2005 (14) 135, 18-20.Α. ΜπαντήςΠερισσότερα »
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Επιδημιολογία του καρκίνου του προστάτη. Στατιστικά και φυλετικά στοιχεία medical express 2005 (14) 134, 22-26. Α. ΜπαντήςΠερισσότερα »
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Κυτταρικός πολλαπλασιασμός, αυξητικοί παράγοντες και απόπτωση Info Urology 2005 (38).Α. Μπαντής.Περισσότερα »
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Κυτταρικός κύκλος, κυκλίνες και ογκογένεση Info Urology 2005 (37) 14. Α.Μπαντής. Περισσότερα »
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Expression of p120, ki-67 and PCNA as proliferation biomarkers in imprint smears of prostate carcinoma and their prognostic value. Cytopathology 15, 25-31, 2004. Bantis A, Giannopoulos A et al The cell proliferation markers p120, Ki-67 and proliferating cell nuclear antigen (PCNA) recognize nuclear antigens. The expression of these proteins by immunostaining methods was reported to be of value in determining the prognosis of patients with malignant diseases. In this study, we evaluated the prognostic significance of the expression of nuclear antigens p120, PCNA and Ki-67 in prostate cancer and compared the results with other prognostic factors. Imprint smear samples obtained from 70 patients immediately after radical prostatectomy for prostatic carcinoma were immunostained with monoclonal antibodies against p120, Ki-67 and PCNA. The immunostaining results were correlated with Gleason score, tumour differentiation, stage and prostatic specific antigen (PSA) levels. Our findings demonstrate that p120, Ki-67 and PCNA expression in prostatic carcinoma smears, correlated significantly with the degree of Gleason score (P < 0.001). When combining p120, Ki-67 and PCNA positivity with tumour differentiation there was a significant association among these parameters (P < 0.001). Overexpression of p120, Ki-67 and PCNA, was also associated with increased PSA serum levels (>4 ng/ml) (P < 0.001). The distribution of p120, Ki-67 and PCNA expression in prostate carcinomas was not statistically significant for Ki-67 (P = 0.69) and p120 (P = 0.22) but was significant for PCNA (P < 0.001) as far as the histological stage (T2a, T2b, T2c, T3a). P120, Ki-67 and PCNA expression had significant prognostic value for disease-free survival. Our results conclude that nuclear antigens p120, Ki-67 and PCNA appear to be additional markers in the field of prognosis of prostatic carcinoma.
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Τελομερίδιο & Τελομεράση. Η έκρηξη προς την καρκινογένεση. Info Urology 2004 (36) 8.Α.Μπαντής Περισσότερα »
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Telomerase expression as a marker in prostate cancer: correlation to clinicopathologic predictors. J Clin Cancer Res 22(4),613-618,2003. P. Athanassiadou, A. Bantis, M. Gonidi, A. Liossi, A. Kyriakidis, E.Petrakakou, A. Giannopoulos The aim of this study was to investigate by an in situ hybridization procedure the Telomerase expression as a marker in prostate cancer and to correlate these results with several prognostic factors concerning this cancer. Imprint smear samples were obtained from 70 prostates removed from patients who underwent radical prostatectomy for prostate adenocarcinoma. Telomerase expression in cancerous prostate smears was studied using an in situ hybridization procedure. The results were correlated with prognostic factors such as pathologic staging, Gleason grading, PSA serum levels and tumour differentiation. Positive Telomerase expression was detected in 88.6% prostate cancer smears. Telomerase expression was significantly correlated with the Gleason score (p < 0.001), tumour differentiation (p < 0.001) and PSA serum levels (p = 0.002). The distribution of Telomerase expression according to histopathological staging was not statistically significant (p < 0.56). In conclusion Telomerase expression could be a marker indicating the malignant potential of prostate cancer Περισσότερα »
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Επίσχεση των ούρων οφειλόμενη σε λειομύωμα της γυναικείας ουρήθρας. Ελληνική Ουρολογία 2002,14:271-274.Α. Μπαντής, Ε. Χατζηδημητρίου, Αλ. Κυριακίδης, Αθ. Κυριακίδης Περισσότερα »
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Αξιολόγηση της ταξινόμησης κατά Bosniak για τη διαφορική διάγνωση των κυστικών μορφωμάτων του νεφρού Ελληνική Ουρολογία 2002,14:259-263.Α. Μπαντής, Αλ. Κυριακίδης, Αθ. Κυριακίδης. Περισσότερα »
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Ενδομητρίωση ουροδόχου κύστης σε γυναίκα Ελληνική Ουρολογία 2002, 14 :195-204Α. Μπαντής, Αλ. Κυριακίδης, Ε. Χατζηδημητρίου, , Αθ. Κυριακίδης Περισσότερα »
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Αντιμετώπιση μεγάλου βαθμού αιμορραγίας κατά την διάρκεια χειρουργικής επεμβάσεως για πρόπτωση της γυναικείας ουρήθρας. Ελληνική Ουρολογία 2002,14:268-270.Α.Μπαντής, Αλ. Κυριακίδης, Γ. Κοματσουλάκης, Αθ. ΚυριακίδηςΠερισσότερα »
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Prognostic significance of DNA ploidy in clinically resectable prostate adenocarcinoma. B J U Vol 90 Sup (2) September 2002 pp: 61. A. Bantis, P. Athanassiadou, N. Kavantzas, Ath. Kyriakidis, A. Liosi , A Giannopoulos Περισσότερα »
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Immunocytochemical detection of Telomerase in prostate carcinoma in correlation to DNA ploidy and prognostic factors. Ann of Oncol (suppl 5), pp 94,2002. Bantis A, Giannopoulos A, Gonidi M Περισσότερα »
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P 120 expression in prostate adenocarcinoma imprint smears correlation with ki-67, PCNA , ploidy and prognostic factors: Cytopathology pp 162,2002. Athanassiadou P, Bantis A, Gonidi M et al Περισσότερα »
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Early removal of urethral catheter following radical prostatectomy with the use of biological surgical adhesive at the vesico-urethral anastomosis. European Urology Supp.(1) 2002 pp 69 Al Kyriakides, Κ. Rokkas ,A. Bantis Περισσότερα »
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Ημιλαπαροσκοπική χειρουργική Λαπαροενδοσκοπική Χειρουργική 2001 (3):11Κυριακίδης ΑΘ, Λέανδρος Ε, Κυριακίδης Αλ, Α. Μπαντής Περισσότερα »
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Υποβοηθούμενη λαπαροσκόπηση. Ελληνική Ουρολογία 2001, 14 :102-107Αθ. Κυριακίδης, Ε. Λέανδρος, Αλ Κυριακίδης, Α. Μπαντής Περισσότερα »
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