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Biomedical subjects

D Dimitrov

Publications and source records attributed to D Dimitrov.

At least 55 records · Page 3Linked to original sources

[Closed traumatic lesions of the bile ducts].

Three cases of traumatic rupture of the extrahepatic biliary passages are reported. One patient had complete rupture of the common bile duct, associated with retroperitoneal rupture of the duodenum and pancreatic injury. The other two patients had partial rupture of the common bile duct, associated in one with rupture of the duodenum. The diagnosis in all three patients was established during emergency operation for peritonitis. The operative intervention in one patient was performed late after a rather quiet interval of 30 days when signs of local biliary peritonitis persisted which did not necessitate immediate operative intervention after the trauma. The causes, pathophysiology, clinical manifestations and diagnosis of these lesions are discussed. The operative methods being applied were direct suture of the lesion, drainage by Kerr's technique and bypass biliodigestive anastomosis. Associated lesions were independently treated. One patient died. The remote results in the two survived a patients were considered very good.

Accidents, Traffic↗

[The pathology of Meckel's diverticulum].

Sixteen cases of Meckel's diverticulum are reported, 14 of them detected during emergency operative intervention for acute surgical abdomen and 2 during planned operation. The complicated forms of Meckel's diverticulum were 10: acute diverticulitis 4 (25 per cent), intestinal obstruction 4 (25 per cent), neoplastic process 1 (6.25 per cent), intestinal hemorrhage 1 (6.25 per cent). Symptom-free were 43.75 per cent of the diverticuli. The clinical symptoms of acute diverticulitis resembled much those of acute appendicitis. The method of choice for its surgical management is cuneiform resection of the intestinal wall at the site of the diverticulum and transverse reconstruction of the intestinal lumen. Cancer of the diverticulum requires extended intestinal resection.

Abdomen, Acute↗

[Changes in the serum biochemical indicators in healthy blood donors during cytapheresis].

In the serum of 33 healthy donors to whom 72 cytophereses (31 thrombo-, 25 leuko- and 16 leukothrombocytophereses) were performed by a cell separator "Haemonetix 30" the following indices were followed up by SMA before and after the cytophereses: total protein, albumin, calcium, inorganic phosphorus, cholesterol, glucose, urea, uric acid, creatinine: total and conjugated bilirubin and alkaline phosphatase. Several of the donors were followed up dynamically. Immediately following the cytopheresis a transitory decrease of total protein, albumin, inorganic phosphorus and cholesterol was found. At the following cytopheresis of the same donor (the time interval between two cytophereses varied from 72 hours up to several months) the levels of the total protein, albumin, calcium, inorganic phosphorus and cholesterol had reached their normal values. The glucose level increased transitory though in the reference ranges.

Alkaline Phosphatase↗

[Dynamic changes in the functional respiratory indices in chronic obstructive lung disease].

The basic functional respiratory indices were followed up in 50 patients suffering from various forms of chronic obstructive pulmonary disease before and after treatment. A decrease of the dynamic indices followed up was found: inspiration indices--FEV 1% (forced expiratory volume), FVC% (forced vital capacity), FEV 1/FVC%, FEV 1/VC%; flow indices--MEF 25% (maximal expiratory flow), MEF 50% MEF 75%, PEF% (peak expiratory flow), MEF/FVC%, MMEF 25-70% (maximal mean expiratory flow). A decrease of vital capacity and of diffusion capacity was also found. The ratio RV/TLC% (residual volume/total lung capacity) was increased and a general hyperventilation was established. Moderate hypoxemia and lowered saturation by normocapnia and normal pH were also established. The control examinations after treatment showed improvement of all indices followed up.

Blood Gas Analysis↗

[Adrenal function in patients with chronic obstructive lung diseases].

The hydrocortisone and ACTH blood levels, 17-hydroxycorticosteroids urine excretion and suprarenal function stimulation with Synacthen were studied in 22 patients with chronic obstructive pulmonary disease and 12 healthy persons as controls. The results show the presence of reliably higher hydrocortisone and 17-hydroxycorticosteroids levels in patients with low partial oxygen pressure as well as a higher ACTH plasma level and a strong Synacthen stimulation. After a comprehensive treatment including oxygen therapy the blood concentrations of hydrocortisone, ACTH, 17-hydroxycorticosteroids fell to levels found in healthy persons. The study shows that hypoxemia stimulates the suprarenal-cortex secretion.

17-Hydroxycorticosteroids↗

The influence of activating hormones on human platelet membrane Ca2+-ATPase activity.

Intact platelets were pretreated with hormones and thereafter membranes were prepared and Ca2+-ATPase activity determined. Thrombin decreased the Vmax of Ca2+-ATPase after pretreatment of intact platelets. Platelet activating factor, vasopressin and ADP also decreased Ca2+-ATPase activity. 12-O-tetradecanoylphorbol-13-acetate (TPA) or A23187 or ionomycin alone had no effect, whilst the simultaneous pretreatment with TPA and Ca2+-ionophore decreased Ca2+-ATPase activity. cAMP elevating agents prostaglandin E1 (PGE1) and forskolin had no influence per se on Ca2+-ATPase, but antagonized the inhibitory effect of thrombin. The data suggest a close connection between phosphoinositide metabolism and the Ca2+-ATPase system.

Adenosine Diphosphate↗

Abnormal cellular calcium regulation in essential hypertension.

The plasticity of cellular Ca2+ control and the events regulated by [Ca2+]i and other messengers make it difficult to assign causative or consequential roles to deranged platelet Ca2+-linked processes in the pathophysiology of essential hypertension. Our studies in human platelets support an underlying membrane pathology as being causative since observed derangements including partial membrane depolarization and enhanced calcium influx, enhanced hormone responsiveness and coupling to adenylate cyclase, increased phosphoinositide metabolism, as well as stimulated Ca2+-ATPase extrusion activity are membrane associated systems. Modification of phosphoinositide metabolism may be a key factor accounting for the multifaceted membrane abnormalities and eventually contribute to the elevated cytosolic [Ca2+]i concentration in essential hypertension. Whether these membrane abnormalities can also be found in human smooth muscle cells has yet to be determined.

Blood Platelets↗

Altered platelet phosphatidylinositol metabolism in essential hypertension.

The metabolism of phosphoinositides was investigated in platelet membranes from nine patients with essential hypertension (EHT) and from 10 age/sex-matched normotensive subjects. 32P-labelling or phosphatidic acid (PA), phosphatidylinositol (PI), phosphatidylinositol-4-phosphate (PIP) and phosphatidylinositol-4,5-bisphosphate (PIP2) was measured in lipid extracts prepared from resting 32P-prelabelled platelets. There were no differences in 32P-PA between subject groups. In platelets of hypertensive patients, 32P-incorporation into both PIP and PIP2 was greater (P at least less than 0.01). This increase apparently occurred at the expense of lower 32P-incorporation into PI (P less than 0.001). An alteration in the interconversion equilibrium between phosphoinositides which is directed towards polyphosphoinositide formation may lead to altered membrane ionic fluxes.

Adult↗

[Choreoathetosis syndrome in a female patient with systemic lupus erythematosus].

A case with choreoathetoid syndrome is described in a patient with advanced picture of systemic lupus erythematosus. The ineffective cerebroprotective therapy is associated with the grave affection of the deep cerebral structures by he lupus vascuitis. The adequate interpretation of the pathological deviations in the CNS in systemic lupus could contribute to their early diagnosis and timely treatment.

Adult↗