DIPLOME DE DOCTEUR EN MEDECINE : ECOLE DE MEDECINE, UNIVERSITE D’ATHENES DATE : 25/11/89
DOCTORAT : ECOLE DE MEDECINE, UNIVERSITE D’ATHENES DATE : 26/11/89
FORMATION (résident, post-résident…)
HOPITAL VILLE/PAYS FONCTION DATES : DE/A HOPITAL DE L’AVIATION MILITAIRE ATHENES/GRECE Service traumatologie, Service de médecine aérospatiale Résident en chirurgie Orthopédique, formation en aviation aérospatiale 15/6/89- 17/8/89 HOPITAL MILITAIRE D’ATHENES ATHENES/GRECE 1er service de chirurgie générale et digestive (Dr PSATHAS) Résident en chirurgie viscérale et digestive 10/10/91 -30/11/91 HOPITAL GENERAL D’ ATHENES “G. GENNIMATAS” ATHENES/GRECE 1er service de chirurgie générale et digestive (Dr POLYMEROPOULOS) Résident en chirurgie viscérale et digestive 19/3/92 – 29/1/93 « LAIKON » HOPITAL UNIVERSITAIRE D’ATHENES ATHENES/GRECE 1er service de chirurgie digestive et vasculaire (Pr. Bastounis) Résidant en chirurgie viscérale et digestive et vasculaire 28/3/94 - 1/1/96 HOPITAL UNIVERSITAIRE/ UNIVERSITY OF YALE NEW HEAVEN CT / ETATS UNIS Surgical department (Pr MERREL) Surgical Research Fellow 1/1/96 - 1/6/96 « LAIKON » HOPITAL UNIVERSITAIRE D’ATHENES ATHENES/GRECE 1er service de chirurgie digestive et vasculaire (Pr. BASTOUNIS) Résident en chirurgie viscérale et digestive et vasculaire 1/6/96 / 29/6/97
CHU AVICENNE-BOBIGNY
PARIS / FRANCE Service de chirurgie digestive et oncologique (Pr. BENICHOU)
stage de formation en chirurgie oncologique 10/2/98 -31/3/98 CHU SAINT-ANTOINE PARIS / France Service de chirurgie digestive (Pr. PARC) stage de formation en chirurgie colorectale 29/4/98 – 10/7/98 UNIVERSITE LIBRE DE BRUXELLES, HOPITAL SAINT -PIERRE
BRUXELLES/BELGIQUE Service de chirurgie digestive (Pr. CADIERE) Assistant (Fellow) en chirurgie viscérale et digestive Formation en chirurgie coelioscopique 1/8/00 - 1/2/01
HOPITAL DE POISSY POISSY/France Service de chirurgie viscerale (Dr. Elie Chouillard) Chef de climique-Assistant formation en chirurgie coelioscopique du colon et rectum et de l’obesité . 1/1/08- 20/06/08
FONCTION ACTUELLE :
Je suis chef de clinique-assistant à l’hôpital de la Chanee en Crète, Grèce. J’opère et assure les suivis postopératoires des malades. J’effectue des gardes sur place et des consultations. Je donne des cours d’enseignement théoriques et pratiques aux internes du service. Je pratique la chirurgie digestive (colon, rectum, vésicule, estomac), la chirurgie thyroïdienne, la chirurgie proctologique, veineuse et la chirurgie mammaire. Par chirurgie coelioscopique je pratique la cholécystectomie et l’appendicectomie.
STAGES DE PERFECTIONNEMENT
TRAUMATOLOGIE : -DIPLÔME ATLS (Advanced Trauma Life Support :UNIVERSITE D’ATHENES 12-14/11/97 -DIPLÔME DSTC (Definitive Surgical Trauma Care) : UNIVERSITE DE LARISSA 3-5/12/07):
CHIRURGIE COELIOSCOPIQUE (OBESITE, COLON, PAROI ABDOMINALE) : - STAGE DE FORMATION : UNIVERSITE LIBRE DE BRUXELLES, HOPITAL SAINT –PIERRE Service de chirurgie digestive (Pr. CADIERE) 1/8/00- 1/02/01 - STAGE DE FORMATION :UNIVERSITE D’ATHENES, INSTITUT DES ETUDES MEDICOBIOLOGIQUES 16-18/10/06 - STAGE DE FORMATION : HOPITAL DE POISSY, Service de chirurgie viscerale (Dr. Elie Chouillard) 1/1/08- 20/06/08
Abstract: BACKGROUND: Tissue injury poses increased risk for postoperative thromboembolic complications. Laparoscopic surgery, by causing limited tissue injury, is associated with lower risk for thromboembolism than is open surgery. We conducted a prospective randomized study in order to detect potentially existing differences in activation of coagulation and fibrinolytic pathways between open and laparoscopic surgery. METHODS: Forty patients with chronic cholelithiasis were randomly assigned to undergo open (group A) or laparoscopic cholecystectomy (group B). Blood samples were taken preoperatively, at the end of the procedure, and at 24 and 72 h postoperatively. Prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), platelets (PLT), soluble fibrin monomer complexes (F.S. test), fibrin degradation products (FDP), D-dimers (D-D), and fibrinogen (FIB) were measured and compared within each group and between groups: Thrombin-antithrombin complexes (TAT) and prothrombin fragments (F1 + 2) were measured at 24 and 72 h postoperatively. RESULTS: Demographics were comparable between groups. Immediately postoperatively, TAT and F1 + 2 were significantly higher in group A (p < 0.05). They also increased significantly postoperatively as compared with preoperative levels within each group (p < 0.05). D-dimers were significantly higher in group A (p < 0.01) immediately postoperatively. D-dimers also increased significantly postoperatively in group B as compared with preoperative levels (p < 0.001). FIB decreased slightly in both groups at 24 h postoperatively but there was a significant increase in group A (p < 0.01). Soluble fibrin monomer complexes (SFMC) were detected twice in group A and only once in group B. FDP levels over 5 mug/ml were detected more often in group A (p < 0.05). There was not any case of thromboembolism or abnormal bleeding. CONCLUSIONS: Open surgery leads to higher activation of the clotting system than do laparoscopic procedures. Although of a lower degree, hypercoagulability is still observed in patients undergoing laparoscopic surgery and therefore routine thromboembolic prophylaxis should be considered.
Abstract: OBJECTIVE: Benign and malignant lesions of the breast may have similar appearances on fine-needle aspiration cytology. We report a case of fibroadenoma that was diagnosed as carcinoma by cytology. CASE STUDY: Breast fine-needle aspiration biopsy was highly cellular and composed of bland-appearing spindle/columnar cells that could represent either epithelial or stromal cells; the case was reported as positive and the patient had subsequent excisional biopsy taken. RESULTS: On microscopic examination, smears were hypercellular and had many single cells and clusters of columnar/ elongate cells No obvious bipolar cells of myoepithelial origin were seen. Significant atypia was noted. Immunocytochemistry for smooth muscle actin was not performed due to insufficient material. CONCLUSIONS: Some cases of fibroadenoma and carcinoma can be very difficult to distinguish on fine needle aspiration cytology smears. Immunocytochemistry may be of help if sufficient material is provided. To avoid false positive diagnosis on cytology, it is best to report such a case as intermediate (atypical/suspicious) with final interpretation pending excisional biopsy.
Abstract: AIM: Sentinel lymph node (SLN) biopsy has revolutionized lymph node staging in patients with malignant melanoma. Intraoperative evaluation is a new addition to the SLN procedure that allows for a one-step regional lymph node dissection to be performed when the SLN biopsy findings are positive. The discriminatory immunostaining pattern with the S-100 and HMB45 monoclonal antibodies allows intraoperative immunocytochemical evaluation of imprint smears of SLNs for melanoma metastases. METHODS: One hundred twenty eight SLNs from a cohort of 52 patient-cases that had been identified using sulfur colloid as a radioactive tracer and isosulfan blue were bisected for rapid Diff-Quick stained touch preparations. Intraopera-tive evaluation of sentinel node status by imprint cytology was correlated with the histopathological results of permanent sections. Tumor-negative nodes in routine paraffin sections were further investigated with the employment of the S-100 and HMB45 antibodies. RESULTS: Thirty-six of all SLNs harbored metastases in paraffin sections, from which 32 were identified by imprint cytology (sensitivity 88.8%). Three SLNs were positive by imprint cytology and negative by histopathology of paraffin sections. Comparison of the results of the touch preparations with the final histopathology (hematoxylin-eosin and S-100/ HMB45 stains) demonstrated a sensitivity of 83.3% and a negative predictive value of 92.5%. The specificity and positive predictive value were 100% respectively. CONCLUSION: Touch imprint cytology is potentially useful for intraoperative evaluation of SLNs in malignant melanoma patients. Results can be improved if the surface sampled is appropriately enlarged and a rapid immunohistochemical S-100/HMB45 stain on the imprints is utilized.
Abstract: OBJECTIVE: Endometriosis is defined as functioning endometrial tissue outside the uterine cavity. It occurs in up to 15% of menstruating females and in most cases is located within the pelvis. Endometrial implants, however have been described in soft tissues, particularly in the skin and subjacent tissues of surgical scars, and diagnosis might be problematic. CASE STUDY: A 32 aged female presented with a suprapubic abdominal mass, which appeared suddenly after exercise. Fine needle aspiration was performed. RESULTS: Epithelial sheets were shown in direct aspirates. No evident endometrial stromal cells were seen. CD10 immunostaining in additional cell block preparations using a commercial antibody gave positive results. The cell pattern and immunocytochemical profile suggested a cytodiagnosis of endometriosis. The patient was administered with leuprolide acetate. She experienced adverse effects related to estrogen deficiency. Medical treatment was discontinued and the patient underwent surgical excision. Histological sections revealed endometrial glands surrounded by stroma and embedded in fibrous connective tissue. CONCLUSION: With optimal preparations a confident cytological diagnosis of endometriosis may be established easily, allowing correct treatment of the disease and, in selected cases, planning of preoperative pharmacologic therapy.
Abstract: BACKGROUND: After tissue injury caused by trauma or surgery, alterations of hemostasis are observed and there is a risk for postoperative thromboembolic complications. Laparoscopic surgery, by causing limited tissue injury, appears to be associated with a lower risk for thromboembolism than open surgery. We conducted a prospective randomized study in order to detect potentially existing differences in activation of coagulation and fibrinolytic pathways between open and laparoscopic surgery. METHODS: Forty patients suffering from chronic cholelithiasis were randomly assigned to undergo open (group A n = 20) or laparoscopic cholecystectomy (group B n = 20) by the same surgical and anesthesiology team. Demographic data were comparable. Blood samples were taken (a) preoperatively, (b) at the end of the procedure, (c) 24 h postoperatively and (d) 72 h postoperatively. The following parameters were measured and compared within each group and between groups: platelets (PLT), soluble fibrin monomer complexes (SFMC), fibrin degradation products (FDP), D-dimers (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT). Thrombin-antithrombin III complexes (TAT) were measured at 24 and 72 h postoperatively. Prothrombin fragment 1 + 2 (F1 + 2) was measured at 24 and 72 h postoperatively in 11 patients of group A and 13 patients of group B, respectively. RESULTS: Demographics were comparable between groups. Immediately postoperatively, TAT and F1 + 2 were significantly higher in group A as compared to group B (p < 0.05). They also increased significantly postoperatively as compared to preoperative levels within each group (p < 0.05). D-dimers were significantly higher in group A as compared to group B (p < 0.01) immediately postoperatively. D-dimers also increased significantly postoperatively in group B as compared to preoperative levels (p < 0.001). FIB decreased slightly in both groups at 24 h postoperatively but there was a significant increase in group A as compared to group B (p < 0.01). SFMC were detected twice in group A and only once group B. FDP levels over 5 mug/ml were detected more often in group A than in group B (p < 0.05). No patient from either group suffered thromboembolism or abnormal bleeding as a postoperative complication. CONCLUSIONS: Open surgery as compared to laparoscopic procedures leads to activation of the clotting system of a higher degree. Although of a lower degree, hypercoagulability is still observed in patients undergoing laparoscopic surgery and, therefore, routine thromboembolic prophylaxis should be considered.
Abstract: Implantation of cancer cells from needle biopsy has been reported in a wide range of malignancies. Fine needle aspiration biopsy has become an accepted method for assessment of thyroid nodules. Local reappearance of thyroid cancer from needle track dissemination is a rare complication of thyroid aspiration. A 45-year-old female developed local recurrence of papillary thyroid carcinoma four years after aspiration biopsy and thyroidectomy. Metastatic deposits appeared in the skin and the sternocleidomastoid muscle. The linear array and the site of metastases implied that seeding most probably resulted from the needle biopsy.
Abstract: BACKGROUND: Poland's syndrome, a rare congenital anomaly characterized by a defect of the pectoralis muscles, has been reported in association with lymphoreticular malignancies and some solid tumors. CASE REPORT: We report the case of a 53-year-old woman with Poland's syndrome who developed breast cancer in the afflicted ipsilateral hypoplastic breast. FNA cytology revealed a moderately differentiated carcinoma and histology was consistent with a well differentiated invasive ductal carcinoma. CONCLUSION: Poland's syndrome can be associated with breast cancer so all females with the syndrome should be thoroughly examined for early detection of neoplasia.
