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Papers by Thomas Tsilalis

Telemedicine Journal and E-health, Sep 1, 2012

Σκοπός: Η παρούσα μελέτη διερευνά το ρόλο της τηλεκυτταρολογίας ως εργαλείου ελέγχου ποιότητας κα... more Σκοπός: Η παρούσα μελέτη διερευνά το ρόλο της τηλεκυτταρολογίας ως εργαλείου ελέγχου ποιότητας και βελτίωσης των διαγνώσεων σε κολποτραχηλικά επιχρίσματα, τα οποία παρασκευάστηκαν σύμφωνα με την τεχνική ThinPrep®. Μέθοδος: Η μελέτη διενεργήθηκε σε 404 δείγματα, τα οποία ελήφθησαν από εξεταζόμενες του Πανεπιστημιακού Νοσοκομείου «ΑΤΤΙΚΟΝ». Έξι διαγνωστικές κατηγορίες χρησιμοποιήθηκαν για την κατάταξη των κυτταρολογικών απαντήσεων. Από όλα τα περιστατικά ελήφθησαν 10 φωτογραφίες αντιπροσωπευτικές των αντίστοιχων μικροσκοπικών ευρημάτων. Οι ανωτέρω ψηφιακές φωτογραφίες απεστάλησαν μέσω ειδικού πρωτοκόλλου μεταφοράς αρχείων σε προστατευμένες ηλεκτρονικές διευθύνσεις 4 διαφορετικών Κυτταρολόγων, οι οποίοι ανασκόπησαν το σύνολο του ψηφιακού υλικού. Οι 4 Κυτταρολόγοι σχολίασαν επίσης την ποιότητα των φωτογραφιών. Οι αρχικές κυτταρολογικές διαγνώσεις καθώς και τα αποτελέσματα της ανασκόπησης συλλέχτηκαν, καταγράφηκαν, έτυχαν στατιστικής επεξεργασίας και συγκρίθηκαν με τις αντίστοιχες ιστολογικές διαγνώσεις. Αποτελέσματα: Σύμφωνα με τα ευρήματά μας, δεν παρατηρήθηκαν σημαντικές διαφορές όσον αφορά την ακρίβεια μεταξύ των διαγνώσεων που στηρίχθηκαν στην ανασκόπηση των ψηφιακών εικόνων και εκείνων που στηρίχθηκαν στην ανασκόπηση των αντίστοιχων επιχρισμάτων. Συμπεράσματα : Η Τηλεκυτταρολογία αποτελεί μια ταχεία και αξιόπιστη μέθοδο ελέγχου ποιότητας και εφαρμογής εξωτερικού ελέγχου επαγγελματικής επάρκειας στο κυτταρολογικό Εργαστήριο και πρέπει να εφαρμοστεί στην καθημερινή κλινική πράξη. Η εφαρμογή της Τηλεκυτταρολογίας στην καθημέρα εργαστηριακή πράξη θα εξασφαλίσει την αναπαραγωγιμότητα των κυτταρολογικών διαγνώσεων και θα καταστήσει εφικτή την παραγωγή ψηφιακού φωτογραφικού υλικού.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

We report a rare case of a primary melanoma of the lung initially presenting with haemoptysis, wh... more We report a rare case of a primary melanoma of the lung initially presenting with haemoptysis, which was diagnosed using 2 new immunohistochemistry markers and cytology with immunocytochemistry. A 67-year-old male underwent repeated major lung resections and died because of early recurrences of a primary pulmonary melanoma as detailed study excluded other primary foci. The diagnosis of the patient's last recurrence was achieved on a fine needle aspiration (FNA) specimen with immunocytochemistry. To the best of our knowledge this is the first case of primary pulmonary melanoma diagnosed by immunocytochemistry on FNA material.

Cytopathology : official journal of the British Society for Clinical Cytology, 1998

Gastroenterology, 1998

Hans Niedderer (Figure 1) has contributed a lot to German physics education research. His work in... more Hans Niedderer (Figure 1) has contributed a lot to German physics education research. His work includes quantitative and qualitative studies about topics like the learning of physics concepts or the history and philosophy of science in science teaching, he has worked on theoretical issues as well as on textbooks. But it is not only his work that is remarkable. He was one of the physics educators in Germany who believed, from the early days of science education research on, in the need to conduct empirical studies. A closer look at his career provides insights into the development of the discipline of science education and into its establishment as a subject at German universities. In this interview, Hans Niedderer talks about the "leaning pathway" of the discipline of science education in general-and about the value of researching learning pathways and learning progressions for science teaching. For more information and a bibliography of his work please visit his website: http://www.idn.uni-bremen.de/mitarbeiter_eng.php?id=27. The interview with Hans Niedderer was conducted by Christoph Kulgemeyer in 2013 at the University of Bremen.

Telemedicine and e-Health, 2012

Objective of this study is to investigate the potential of the learning vector quantizer neural n... more Objective of this study is to investigate the potential of the learning vector quantizer neural network (LVQ-NN) classifier on various diagnostic variables used in the modern cytopathology laboratory and to build an algorithm that may facilitate the classification of individual cases. From all women included in the study, a liquid-based cytology sample was obtained; this was tested via HPV DNA test, E6/E7 HPV mRNA test, and p16 immunostaining. The data were classified by the LVQ-NN into two groups: CIN-2 or worse and CIN-1 or less. Half of the cases were used to train the LVQ-NN; the remaining cases (test set) were used for validation. Out of the 1258 cases, cytology identified correctly 72.90% of the CIN-2 or worst cases and 97.37% of the CIN-1 or less cases, with overall accuracy 94.36%. The application of the LVQ-NN on the test set allowed correct classification for 84.62% of the cases with CIN-2 or worse and 97.64% of the cases with CIN-1 or less, with overall accuracy of 96.03%. The use of the LVQ-NN with cytology and the proposed biomarkers improves significantly the correct classification of cervical precancerous lesions and/or cancer and may facilitate diagnosis and patient management. of Hindawi Publishing Corporation

American Journal of Respiratory and Critical Care Medicine, 1997

Matrix metalloproteinases (MPs) constitute a family of proteolytic enzymes (proteases) that degra... more Matrix metalloproteinases (MPs) constitute a family of proteolytic enzymes (proteases) that degrade extracellular matrix (ECM) and promote the local or metastatic potential of carcinoma cells, and whose action is restrained by special inhibitors (metalloproteinase inhibitors; MIs). We assessed the role of the MPs stromelysin-3 (STR-3), putative metalloproteinase-1 (PUMP-I), and the gelatinases of molecular weights 72 kDa and 92 kDa, as well as the role of their inhibitors tissue inhibitor of metalloproteinase-1 (TIMP-1) and TIMP-2, as markers of metastatic potential in 25 fresh biopsies of squamous-cell lung carcinomas (SCLCs). We examined levels of messenger ribonucleic acid (mRNA) expression for these MPs and inhibitors through Northern blot analysis in 10 carcinomas of high-to-moderate differentiation without lymph-node involvement, and in 15 infiltrative carcinomas of moderate-to-low differentiation with lymph-node involvement. Five cases with significant epithelial atypia and five samples with normal mucosa were used as controls. Expression of STR-3 and TIMP-2 was also assessed immunohistochemically with the avidin-biotin-complex (ABC) technique. We noticed a progressive increase in the expression levels of MPs, especially of STR-3, and of TIMP-2, from the stage of epithelial atypia to the detection of carcinoma, finding the highest values of these substances among carcinomas of low differentiation with nodal metastases. These findings were also confirmed with immunohistochemical analysis. Our results suggest that there is a significant association of the expression of MPs and MIs with both the local and metastatic potential and the degree of cellular differentiation of SCLC, and that this association is clinically important because of its prognostic and therapeutic implications.

Telemedicine Journal and E-health, Sep 1, 2012

Σκοπός: Η παρούσα μελέτη διερευνά το ρόλο της τηλεκυτταρολογίας ως εργαλείου ελέγχου ποιότητας κα... more Σκοπός: Η παρούσα μελέτη διερευνά το ρόλο της τηλεκυτταρολογίας ως εργαλείου ελέγχου ποιότητας και βελτίωσης των διαγνώσεων σε κολποτραχηλικά επιχρίσματα, τα οποία παρασκευάστηκαν σύμφωνα με την τεχνική ThinPrep®. Μέθοδος: Η μελέτη διενεργήθηκε σε 404 δείγματα, τα οποία ελήφθησαν από εξεταζόμενες του Πανεπιστημιακού Νοσοκομείου «ΑΤΤΙΚΟΝ». Έξι διαγνωστικές κατηγορίες χρησιμοποιήθηκαν για την κατάταξη των κυτταρολογικών απαντήσεων. Από όλα τα περιστατικά ελήφθησαν 10 φωτογραφίες αντιπροσωπευτικές των αντίστοιχων μικροσκοπικών ευρημάτων. Οι ανωτέρω ψηφιακές φωτογραφίες απεστάλησαν μέσω ειδικού πρωτοκόλλου μεταφοράς αρχείων σε προστατευμένες ηλεκτρονικές διευθύνσεις 4 διαφορετικών Κυτταρολόγων, οι οποίοι ανασκόπησαν το σύνολο του ψηφιακού υλικού. Οι 4 Κυτταρολόγοι σχολίασαν επίσης την ποιότητα των φωτογραφιών. Οι αρχικές κυτταρολογικές διαγνώσεις καθώς και τα αποτελέσματα της ανασκόπησης συλλέχτηκαν, καταγράφηκαν, έτυχαν στατιστικής επεξεργασίας και συγκρίθηκαν με τις αντίστοιχες ιστολογικές διαγνώσεις. Αποτελέσματα: Σύμφωνα με τα ευρήματά μας, δεν παρατηρήθηκαν σημαντικές διαφορές όσον αφορά την ακρίβεια μεταξύ των διαγνώσεων που στηρίχθηκαν στην ανασκόπηση των ψηφιακών εικόνων και εκείνων που στηρίχθηκαν στην ανασκόπηση των αντίστοιχων επιχρισμάτων. Συμπεράσματα : Η Τηλεκυτταρολογία αποτελεί μια ταχεία και αξιόπιστη μέθοδο ελέγχου ποιότητας και εφαρμογής εξωτερικού ελέγχου επαγγελματικής επάρκειας στο κυτταρολογικό Εργαστήριο και πρέπει να εφαρμοστεί στην καθημερινή κλινική πράξη. Η εφαρμογή της Τηλεκυτταρολογίας στην καθημέρα εργαστηριακή πράξη θα εξασφαλίσει την αναπαραγωγιμότητα των κυτταρολογικών διαγνώσεων και θα καταστήσει εφικτή την παραγωγή ψηφιακού φωτογραφικού υλικού.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

We report a rare case of a primary melanoma of the lung initially presenting with haemoptysis, wh... more We report a rare case of a primary melanoma of the lung initially presenting with haemoptysis, which was diagnosed using 2 new immunohistochemistry markers and cytology with immunocytochemistry. A 67-year-old male underwent repeated major lung resections and died because of early recurrences of a primary pulmonary melanoma as detailed study excluded other primary foci. The diagnosis of the patient's last recurrence was achieved on a fine needle aspiration (FNA) specimen with immunocytochemistry. To the best of our knowledge this is the first case of primary pulmonary melanoma diagnosed by immunocytochemistry on FNA material.

Cytopathology : official journal of the British Society for Clinical Cytology, 1998

Gastroenterology, 1998

Hans Niedderer (Figure 1) has contributed a lot to German physics education research. His work in... more Hans Niedderer (Figure 1) has contributed a lot to German physics education research. His work includes quantitative and qualitative studies about topics like the learning of physics concepts or the history and philosophy of science in science teaching, he has worked on theoretical issues as well as on textbooks. But it is not only his work that is remarkable. He was one of the physics educators in Germany who believed, from the early days of science education research on, in the need to conduct empirical studies. A closer look at his career provides insights into the development of the discipline of science education and into its establishment as a subject at German universities. In this interview, Hans Niedderer talks about the "leaning pathway" of the discipline of science education in general-and about the value of researching learning pathways and learning progressions for science teaching. For more information and a bibliography of his work please visit his website: http://www.idn.uni-bremen.de/mitarbeiter_eng.php?id=27. The interview with Hans Niedderer was conducted by Christoph Kulgemeyer in 2013 at the University of Bremen.

Telemedicine and e-Health, 2012

Objective of this study is to investigate the potential of the learning vector quantizer neural n... more Objective of this study is to investigate the potential of the learning vector quantizer neural network (LVQ-NN) classifier on various diagnostic variables used in the modern cytopathology laboratory and to build an algorithm that may facilitate the classification of individual cases. From all women included in the study, a liquid-based cytology sample was obtained; this was tested via HPV DNA test, E6/E7 HPV mRNA test, and p16 immunostaining. The data were classified by the LVQ-NN into two groups: CIN-2 or worse and CIN-1 or less. Half of the cases were used to train the LVQ-NN; the remaining cases (test set) were used for validation. Out of the 1258 cases, cytology identified correctly 72.90% of the CIN-2 or worst cases and 97.37% of the CIN-1 or less cases, with overall accuracy 94.36%. The application of the LVQ-NN on the test set allowed correct classification for 84.62% of the cases with CIN-2 or worse and 97.64% of the cases with CIN-1 or less, with overall accuracy of 96.03%. The use of the LVQ-NN with cytology and the proposed biomarkers improves significantly the correct classification of cervical precancerous lesions and/or cancer and may facilitate diagnosis and patient management. of Hindawi Publishing Corporation

American Journal of Respiratory and Critical Care Medicine, 1997

Matrix metalloproteinases (MPs) constitute a family of proteolytic enzymes (proteases) that degra... more Matrix metalloproteinases (MPs) constitute a family of proteolytic enzymes (proteases) that degrade extracellular matrix (ECM) and promote the local or metastatic potential of carcinoma cells, and whose action is restrained by special inhibitors (metalloproteinase inhibitors; MIs). We assessed the role of the MPs stromelysin-3 (STR-3), putative metalloproteinase-1 (PUMP-I), and the gelatinases of molecular weights 72 kDa and 92 kDa, as well as the role of their inhibitors tissue inhibitor of metalloproteinase-1 (TIMP-1) and TIMP-2, as markers of metastatic potential in 25 fresh biopsies of squamous-cell lung carcinomas (SCLCs). We examined levels of messenger ribonucleic acid (mRNA) expression for these MPs and inhibitors through Northern blot analysis in 10 carcinomas of high-to-moderate differentiation without lymph-node involvement, and in 15 infiltrative carcinomas of moderate-to-low differentiation with lymph-node involvement. Five cases with significant epithelial atypia and five samples with normal mucosa were used as controls. Expression of STR-3 and TIMP-2 was also assessed immunohistochemically with the avidin-biotin-complex (ABC) technique. We noticed a progressive increase in the expression levels of MPs, especially of STR-3, and of TIMP-2, from the stage of epithelial atypia to the detection of carcinoma, finding the highest values of these substances among carcinomas of low differentiation with nodal metastases. These findings were also confirmed with immunohistochemical analysis. Our results suggest that there is a significant association of the expression of MPs and MIs with both the local and metastatic potential and the degree of cellular differentiation of SCLC, and that this association is clinically important because of its prognostic and therapeutic implications.