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Biomedical subjects

D Georgescu

Publications and source records attributed to D Georgescu.

At least 19 recordsLinked to original sources
PubMed2001

Galanin receptor 1 gene expression is regulated by cyclic AMP through a CREB-dependent mechanism.

The galanin receptor-1 (GalR1) protein belongs to a family of G protein-coupled receptors for the neuropeptide galanin (GalR1, GalR2 and GalR3) distributed throughout the central and peripheral nervous system. Activation of galanin receptors by their ligands results in increased feeding, impaired learning, enhanced opiate analgesia and decreased opiate place preference. We have shown that opiate withdrawal, which is known to increase levels of cAMP in the locus coeruleus (LC), results in an increase in the number of galanin binding sites and the level of GalR1 mRNA in the LC. We have isolated a 3.6-kb fragment 5' of the inititiation codon of the mouse GalR1 gene and generated a series of deletion mutations of this fragment driving expression of luciferase for use in transient transfection assays in PC12 and Cath.a cell lines. Treatment with forskolin, but not dideoxyforskolin, up-regulates GalR1 transcription, likely through elevation of cAMP levels. The region between - 1050 and - 700 base pairs upstream of exon one is necessary both for basal activity of the GalR1 promoter and for forskolin-mediated increases in transcription. The forskolin effect can be blocked by simultaneous mutation of a CRE-like site and a CRE/DRE-like site, but not mutation of either site alone. Gel shift and super-shift experiments demonstrate that the transcription factor CREB can bind to both sites and is likely to be responsible for the cAMP-mediated increase in GalR1 promoter activity. This study provides a molecular mechanism for the increased GalR1 expression in the LC seen following opiate withdrawal.

Animals↗
PubMed2001

Endoscopic classification and endourologic therapy in proximal incomplete ureteral duplication pathology.

OBJECTIVE: To assess whether patients with proximal incomplete ureteral duplication (PIUD) had functional or anatomical Y junction zone pathology. In such cases, stasis and infection, with or without associated renal scarring, are often found. The results after minimally invasive treatment (retrograde endoincision of ureteral stenosis, localized on one limb) can be evaluated. PATIENTS AND METHODS: In a retrospective analysis of 807 ureteroscopies, we found 29 cases with PIUD pathology dating from July 1996 to March 1999. The investigative protocol involved: intravenous pyelography (IVP) with delayed films, voiding cystourethrogram, and duplex Doppler renal ultrasonography (DDRU) for the resistive index. We used semirigid ureteroscopes (7.5 and 8.5 french) and the Storz cold knife/scissor. The mean follow-up period was 17 months (range 5-33 months). RESULTS: In 22 cases (76%) we found functional obstruction of the Y junction region and in 7 cases (24%) a ureteral stricture shorter than 1 cm of lower or upper limbs. We described four particular morphologies of the Y junction zone: double-barrelled (wide bifid limbs) with larger Y junction, lateral insertion, punctiform insertion and valvular insertion of one of the limbs. The first type is associated with functional obstruction and the others are characteristic of anatomic obstruction. After retrograde cold endoincision, normal PIUD was found in 85% of cases. CONCLUSIONS: Pathological aspects of PIUD may pose interesting problems in diagnosis and therapy. Endoscopic particularities of the Y junction zone could be correlated with IVP and DDRU. Retrograde endoureterotomy appears to be an effective minimally invasive procedure for treatment of anatomical obstruction where the ureteral stenosis of one limb is shorter than 1 cm.

Adult↗
PubMed2001

[Doppler ultrasonography in the function assessment of double J ureteral endoprosthesis in patients with extrinsic ureteral obstruction].

OBJECTIVES: The efficacy of internal urinary drainage by double J stent is relatively difficult to evaluate by classical methods. This prospective study evaluated variations of the resistance index (RI) in patients with unilateral extrinsic ureteric obstruction, requiring internal drainage by double J stent. MATERIAL AND METHODS: Variations of the resistance index (RI) and the correlations between RI and the results of other investigations were determined in a group of 48 patients with unilateral extrinsic ureteric obstruction, treated by ureteric stent. The presence of urine from the stented ureteric meatus was also assessed. RESULTS: The preoperative assessment demonstrated a sensitivity of 73% for RI (> 0.7) and 84.5% for DRI for the demonstration of obstruction. Following stenting, RI decreased by 11%, with a mean index of 0.66; the RI was less than 0.07 in 62.5% of cases. The mean index was 0.68 one month later and 0.71 three months later (an increase of 0.05 compared to the post-stent evaluation). CONCLUSIONS: The resistance index may represent a useful element in the assessment of the efficacy of internal drainage by double J stent, while the presence of urine in the ureteric orifice may not be helpful.

Adult↗
PubMedDate not supplied

[Idiopathic thrombocytopenic purpura in infants and small children (1 to 3 years old)].

In infant and young children (1-3 yrs), I.T.P. (idiopathic thrombocytopenic purpura) is an acute, self-limited disease in 6 months since the diagnosis. The treatment with intravenous immunoglobulins or corticosteroids will be administered in severe forms of disease(predicted by the severity of hemorrhage and thrombocytes less than 10 G./l). A retrospective study of 29 cases with I.T.P. in infants and young children shows that 22 out of 29 were acute I.T.P., 7 out of 29 were recurrent I.T.P., in which 3 cases were chronic I.T.P. Post-hemorrhage associated anemia was present in 10 out of 29 cases, in which 3 cases was severe. Prolonged bleeding time appears only in severe I.T.P. Values of thrombocytes less than 10 G/l were met in 6 cases of acute I.T.P. and in 3 cases with recurrent I.T.P., there was no predictable correlation between the very low value in the time of diagnosis and the following clinical course of the disease. Neonatal I.T.P. (history of maternal I.T.P) had a favourable clinical course after i.v. immunoglobulins treatment (1 case) and a trend to chronicity (1 case) probably due to platelet antiphospholipid antibodies. Postvaccinal I.T.P. is a rare and benign complication. Only 5 of 29 cases had spontaneous remission. The clinical course was towards complete remission in 22 out of 29 cases with i.v. immunoglobulins and/or corticosteroid therapy. In conclusion, view the natural history of disease and the unvariables responses to treatment, spontaneous bleeding cannot be predicted only by platelet count in I.T.P.-Infant-low age (1-3 yrs).

Acute Disease↗
PubMedDate not supplied

[Retrograde cold knife endo-pyelotomy in ureteropelvic junction stenosis].

Between September 1998 and July 2000 we performed a new procedure of ureteropelvic junction (UPJ) stenosis treatment: retrograde endopyelotomy (REP). So, 17 patients (7 males and 10 females) between 23 and 56 years old with hydronephrosis (IInd grade--3 cases, IIIrd grade--12 cases and IVth grade--2 cases) were evaluated with an unitary protocol: gray-scale and duplex Doppler (resistive index--RI measurement), IVP, ureteropyelography and renal scintigraphy in selected cases. The hydronephrosis was primitive in 12 cases and secondary in 5 cases (after previous open surgery). We excluded from our series of patients cases with aberrant vessels (polar inferior), associated renal stones, important hydronephrosis and young patients. Video assisted endoincision was realized at 6 and 3 o'clock position on the left side and at 6 and 9 o'clock position on the right side with Wolf semirigid ureteroscopes, Storz special knife/scissor. Double J indwelling catheter (8 Fr.) was removed after 6 weeks. The evaluation has been made at 3.6, 9 and 12 months demonstrating normal pyelocaliceal system in 10 cases (58.8%), a significative reduction of hydronephrosis grade in 3 cases (17.6%), mean RI = 0.63, with the presence in 15 cases (88.2%) of RI under 0.70. Stable good results were found in 14 cases (82.3%). After the failure of this technique (stenosis in 2 cases) the REP was practiced again. We didn't find intraoperative complications. Our conclusions despite the relative short follow-up period are very much in favor of this modality of treatment, minimally invasive, being an efficient technique in the modern therapy of hydronephrosis.

Adult↗
PubMedDate not supplied

[Duplex Doppler ultrasound value in upper urinary tract obstruction ].

UNLABELLED: Our prospective study aimed to establish the duplex Doppler ultrasonography (DDU) value in patient's investigative protocol with acute or chronic ureteral obstruction. A. DDU IN ACUTE URETERAL STONE OBSTRUCTION: Between October 1988 and January 2001 we applied DDU evaluation for 177 cases with ureteral lithiasis in which we also studied gray scale echography, resistive index (RI), the difference between affected kidney and contralateral kidney (delta RI) and the characteristics features (amplitude, velocity and frequency) of the ureteral jets (intravesical evaluation in color Doppler mode). a. For 65 cases with RI < 0.70, delta RI < or = 0.06 we didn't find obstruction and 95.4% of the patients had spontaneous passage of the stones. b. For 109 cases with RI > 0.70, delta RI > or = 0.06 the spontaneous passage of the stone was found in 40 cases (36.7%). DDU associated with ureteral jet evaluation increased the predictive value of this method. So, the presence of the ureteral jet on the obstructed side of the upper urinary tract was associated with 63% of spontaneous passage of the stone while the absence of the jet was followed by 5% of spontaneous passage of the stone. The RI was sensitive in 74% and specific in 81% and delta RI was sensitive in 85% and specific in 91%. B. DDU IN CHRONIC URETERAL OBSTRUCTION: Between October 1988 and January 2001 we evaluated the DDU value in chronical ureteral obstruction on 78 cases with operated and/or irradiated genital neoplasm's and retroperitoneal involvement. Our results found RI sensitive in 63% and specific in 70% and delta RI was sensitive in 72% and specific in 78%. After double J stenting (indwelling) RI varied from 0.74 to 0.66 (0.08), with a significative decrease (over 10%) in 61.5% of the cases in which preoperator RI was greater than 0.70. After 1 month we found an increase of RI with 0.02 and after 3 months with 0.05. IN CONCLUSION: We consider DDU a functional imagistic method with an important place in the investigative protocol of the obstructive uropathy.

Algorithms↗
PubMedDate not supplied

[Influence of changes in the vegetative tonus on the effects of succinylcholine on blood pressure (experimental data)].

Intravenous administration of small amounts (0,1 mg/kg of body weight) of succinyl-choline in dogs results in the increase of blood pressure through nicotine-like effects. The increase of succinyl-choline doses induces at first a lowering of the blood pressure through a muscarine-like effect, then its increase. Atropinization, as well as prealable vagotomy, prevents the lowering of the blood pressure but increases it through a nicotine-like effect. Neomistigmine increases both the nicotinic and the cholinergic (muscarinic) effects of succinyl-choline. The use of alpha-sympatico-mimetic drugs, followed by administration of succinyl-choline, generates hypertension and conjugation of alpha-sympatico-mimetic drugs with lepto-currarine induces hypotension, even when para-sympatic lysis has been performed in advance. Inhibition of the beta-sympatic components, followed by inhibition of the alpha-sympatic ones, prevents the development of the succinyl-cholinic hypotension. These facts indicate that the action of succinyl-choline on the blood pressure depends, to a considerable extent, on the condition of the central nervous system.

Animals↗
PubMedDate not supplied

[Laboratory studies of the effect of Pavulon on the blood pressure in induced autonomic dystonias].

In experimental studies performed in dogs Pavulon enhances the hypertensive effects of para- and orthosympathicomymetics (nicotinelike and liberation of cathecholamine respectively), parasympaticolytics lowering essentially the rise of the blood pressure induced by Pavulon, which sympathicolytics--depending on the dose administered--can decrease until zero. These facts have a significant role in the anesthesia and intensive care practice.

Animals↗
PubMedDate not supplied

[Topical immunotherapy with BCG in the adjuvant treatment of superficial bladder tumors--15-year-experience].

Between September 1984 and June 1999 we applied a long-term (3 years) protocol treatment (Pasteur strain produced by Cantacuzino Institute) in superficial bladder tumors (SBT) recurrence prophylaxis. In 1014 cases (pTa--11 cases, pT1G1--607 cases, pT1G2--149 cases, pT1G3--247 cases) our retrospective analysis used a personal protocol: 8 weekly intravesical instillations, then monthly instillations until 1 year, then 3 monthly instillations during the following 2 years. Pathologic bladder mucosa (simple, moderate and severe dysplasia, carcinoma in situ) was associated in over 80% of cases. Mean follow-up period was 118 months (range 174 to 6 months). Our results demonstrated the efficiency of this protocol (29.5% recurrences on 840 cases who had complete therapy). The importance of tumoral grading was clearly found: 13% recurrence rate for pT1G1, 39.5% for pT1G2 and 49% for pT1G3. Side-effects (local--78%, systemic--4%) and complications (3%) were treated by symptomatic or antituberculous drugs. Our significative study revealed that intravesical immunotherapy (with BCG vaccine) can be considered the first choice in the complementary treatment of SBT.

Adjuvants, Immunologic↗
PubMedDate not supplied

[New criteria for the diagnosis and endourological treatment of urethral strictures].

Between January 1994 and January 2000 we analyzed a series of 440 cases with urethral structures (US) in which we performed internal urethrotomy (IU). Bulbous site (76%), inflammatory etiology (84%) and primary disease (74%) were the characteristics of our series of patients. The diagnosis protocol was based on classical evaluation, urethral echography (7-10 MHz and endorectal Multiplan) and, in 37 cases, histopathological analysis of urethral callus. Based upon echographic description of the structural zone, the endo-incision was performed only at 12 o'clock position in 205 cases (46.8%), at 6 and 12 o'clock positions in 71 cases (16%), "star incision" in 141 cases (32%) and only at 6 o'clock position in 23 cases (5.2%). The recurrence rate was 15.7% (69 cases) after a follow-up period of 2 to 36 months. In 37 cases with urethral biopsy from structural zone, we described a high recurrence rate (62.5%) with "local active inflammation". Complementary treatment with anti-inflammatory drugs reduced this rate to 10% of cases. Our significative study revealed that echographic and histopathological evaluation of US could increase the efficiency of endourological treatment in this pathology; urethral ultrasound could be the first choice in the diagnostic of US and could establish the "perfect" site of endo-incision.

Adolescent↗