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Biomedical subjects

G Nikolov

Publications and source records attributed to G Nikolov.

At least 19 recordsLinked to original sources
PubMed2005

Antibodies against granulosa luteinized cells and their targets in women attending IVF program.

PROBLEM: The study was conducted to investigate the presence and the possible role of anti-granulosa luteinized cells (GLCs) antibodies in infertile patients, attending in vitro fertilization (IVF) cycles, as well as to attempt the identification of putative target antigens. METHOD OF STUDY: A total of 101 sera from infertile women (patient group) and 33 sera from fertile women (control group) were investigated. The patients were divided in subgroups according to: ovarian response to controlled ovarian hyperstimulation (COHS)--poor responders and good responders; fertilization rate--low fertilization rate and high fertilization rate. The relation between embryo transfer (ET) outcome and prevalence of anti-GLC antibodies was investigated too. NONIDET P-40 (NP-40) and whole-GLC lysates, as antigenic materials, were used in enzyme-linked immunosorbent assay (ELISA) and immunoblotting, respectively. RESULTS: Based on the cut-off value of 2 S.D. above the control mean value, the prevalence of patients positive for anti-GLC antibodies was found to be 28.7% (29/101) compared with 9.1% (3/33) in control fertile women (P < 0.05). Anti-GLC antibodies were detected in 54.8% (17/31) of women with low fertilization rate compared with 15.7% (11/70) of women with high fertilization rate (P = 0.003) and it was established that women positive for anti-GLC antibodies had lower fertilization rate, than those negative for anti-GLC antibodies. Immunoblotting has demonstrated a number of GLC proteins with molecular masses (MM) of 110, 70-80, 47 and 37 kDa, frequently reacting with anti-GLC antibodies in patient's sera, as possible targets. CONCLUSION: The presented results on the prevalence and role of anti-GLC antibodies, as well as the data on the target antigens confirmed our hypothesis about the potential involvement of GLC antigens in some cases of immunological infertility in IVF patients.

Adult↗
PubMed2003

Incremental diagnostic value of 99mTc methylene diphosphonate bone SPECT in patients with patellofemoral pain disorders.

Painful disorders of the patellofemoral joint are one of the most frequent complaints in orthopaedic and sports medicine. The purpose of this study was to assess the value of single photon emission computed tomography (SPECT) bone imaging compared with arthroscopy in the differential diagnosis of anterior knee pain. Twenty-seven patients with chronic anterior knee pain and 27 age matched control patients were examined prospectively. All patients underwent a detailed clinical history and a thorough physical examination of the knee. Planar and SPECT knee scintigraphy was performed using 99mTc methylene diphosphonate (99mTc-MDP). Subsequently, arthroscopic examination of all three compartments of the affected knee was performed. The association between the scintigraphic findings and arthroscopy was examined statistically. Planar and SPECT scintigrams were classified as follows: focal or diffuse uptake in the patella only (eight patients), uptake in the patella and a corresponding focus in the distal femur (12 patients), and uptake in the patella associated with linear increased activity along the distal femur (six patients). One patient had no patellofemoral SPECT abnormalities. Six of eight patients with isolated increased patellar activity were diagnosed with chondromalacia of the patella, while 2/8 patients had arthroscopic findings unrelated to patellofemoral abnormalities. Seven of 12 patients with corresponding uptake in the patella and distal femur were diagnosed with patellofemoral arthritis. Eleven other patients with corresponding patellar and femoral activity were diagnosed with increased lateral patellar compression syndrome. In these patients the patellar foci were always lateral, and they separated during flexion of the knee. Seven patients had further scintigraphic findings in addition to patellofemoral abnormalities, unsuspected clinically. Nine of 27 patients in the control group (33%) had either focal or diffuse increased patellar uptake. Compared to arthroscopy SPECT imaging had a sensitivity of 100% for patellofemoral abnormalities and a specificity of 64% (negative predictive value, 100%; and positive predictive value, 72%). The overall observed agreement between SPECT and arthroscopy was 81% (kappa=0.63). It is concluded that SPECT imaging of the knee is highly sensitive for the diagnosis of patellofemoral abnormalities. SPECT significantly improves the detection of maltracking of the patella and the ensuing increased lateral patellar compression syndrome. This information could be used to treat patellofemoral problems more effectively.

Adult↗
PubMed2000

The role of renal scintigraphy and unenhanced helical computerized tomography in patients with ureterolithiasis.

Unenhanced helical computerized tomography (UHCT) has recently evolved as an accurate imaging modality for determination of the presence or absence of ureterolithiasis in patients with acute flank pain. Functional renal scintigraphy is considered the gold standard for urinary tract obstruction. The objective of this study was to correlate the secondary signs of urinary obstruction on UHCT with findings of functional renal scintigraphy. UHCT was performed in 30 patients admitted to the emergency room with acute flank pain. All patients had a calcified urinary stone identified on UHCT. The location of each urinary stone was classified as ureteral or in the ureterovesical junction. The presence of secondary CT signs of ureteral obstruction was determined for each patient. After oral or intravenous hydration, a technetium-99m diethylene triamine penta-acetic acid renal scan was performed in all patients within 12 h of the CT scan. Follow-up delayed scintigraphic images were obtained at 2 h and 24 h in patients with evidence of ureteral obstruction. The sensitivity, specificity and predictive values of each possible combination of CT findings were determined by comparison with the scintigraphic results. The distal ureter was the most common location for a calculus on UHCT, followed in frequency by the ureterovesical junction, proximal ureter and mid-ureter. The renograms showed high-grade, unilateral obstruction in 12 patients, indeterminate scans in five patients and normal renograms in 13 patients. The sensitivities and specificities of individual CT findings ranged from 50% to 75% and from 8% to 69%, respectively. Perinephric stranding gave the highest positive predictive value (PPV) for obstruction (69% including indeterminate renograms). None of the individual CT findings showed a statistically significant correlation with scintigraphic findings. A combination of one or two positive CT findings had a PPV of only 25% for obstruction. A combination of three or four positive CT findings gave a PPV of 70% for obstruction. Our preliminary study shows that secondary CT signs of ureterolithiasis correlate poorly with the scintigraphic findings and that they do not permit evaluation of the functional status of obstructed kidneys. Even a combination of the most frequent CT findings has a low predictive value, i.e. does not allow a decision to be made as to the most suitable treatment. Therefore, renal scintigraphy should be performed in conjunction with UHCT in all patients with ureteral calculi.

Adult↗
PubMed1997

Splenogonadal fusion diagnosed by spleen scintigraphy.

Splenogonadal fusion (SGF) is a rare congenital malformation characterized by fusion of the spleen and a gonad (almost always the left one) frequently associated with orofacial and/or limb developmental abnormalities. Only 125 cases were reported between 1883 and 1994. This report concerns a case of SGF in a 20-yr-old woman with an accidental finding of a splenic space-occupying lesion protruding into the lower abdomen in ultrasound and CT. Radiocolloid spleen scintigraphy and SPECT proved to be the best procedure to establish the correct diagnosis of SGF. As SGF is often asymptomatic, more liberal use of splenic scintigraphy is suggested in patients with congenital limb and/or orofacial anomalies. SGF should be included among the differential diagnoses of left abdominal, pelvic or scrotal masses.

Adult↗
PubMed1996

Synthesis, gastroprotective, antisecretory and anti-Helicobacter effect of N-[3-(3-(1-piperidinylmethyl) phenoxy)propyl]-hydroxyacetamide 2-hydroxypropane-1,2,3-tricarboxylate bismuth (3+) complex (MX1)-MX1.

MX1 (N-[3-(3-(1-piperidinylmethyl)phenoxy)propyl]-hydroxyacetamide+ ++ 2-hydroxypropane-1,2,3-tricarboxylate bismuth (3+) complex) is a novel salt of the active metabolite of H2-antagonist roxatidine with a complex of bismuth with citric acid. In a model of ethanol-induced ulcers in male Wistar rats, both roxatidine and the bismuth salt reduced the number and the total length of lesions. Comparison of roxatidine and MX1 at equimolar doses of 160 mumol kg-1 showed a more potent cytoprotective effect of MX1. The potency of anti-secretory and antiacidic effects of MX1 was more than twice that of roxatidine on histamine-stimulated secretion in female Wistar pylorus-ligated rats. Microbiological tests with the reference bismuth preparation De-Nol showed prominent anti-Helicobacter properties of MX1 in-vitro. Both test compounds had similar range of MICs to Helicobacter pylori, from 4 to 64 microgram bismuth mL-1. The cytoprotective, antisecretory, anti-acidic and anti-Helicobacter properties of the new agent MX1 warrant further more extensive pharmacological and clinical trials.

Animals↗
PubMed1996

Computer design and syntheses of antiulcer compounds. 1st communication: N-[3-[3-(1-piperidinomethyl)phenoxy]propyl]amines and benzamides.

Aiming to develop new antiulcer agents, a quantitative structure-activity relationship (QSAR) study on in vitro (pA2) and in vivo histamine H2-receptor antagonistic activity of a series of N-[3-[3-(1-piperidinomethyl)phenoxy]propyl]amines was carried out using the OASIS computer system. The results showed that pA2 increases with the decrease (increase) of electron donor (acceptor) properties of molecules, particularly at the NH-reaction site. The finding is consistent with the assumption for an increase of histamine H2-receptor activity of the antagonists with their ability to form H-bonds with the receptor through NH groups. The correlations with hydrophobicity and related topological indices are consistent with the hypothesis that logP should indirectly reflect receptor interactions. In addition a series of N-[3-[3-(1-piperidinomethyl)phenoxy]propyl]benzamides are synthesized. The theoretically predicted in vitro activities of these compounds were found to be in accordance with in vivo tests (percent of inhibition of gastric juice and acid output [mEq/H+/3 h]).

Animals↗
PubMed1988

[The value of Wagner and Selvester's electrocardiographic point indices for assessing global and regional function of the left ventricle in patients with ischemic heart disease].

The study includes 45 patients with ischemic heart disease. The reproducibility of Selvester's QRS-point index was examined by two researchers (r = 0.98). Between the ejection fraction of the left ventricle and the ECG-pont indices there exists a reverse relation, the correlation coefficients being equal (r = -5.58). Between the segmental disturbances of the left ventricular wall movements, examined by the systolic shortening in percentage of the radial axes, and both ECG indices there is also an equal correlation (r = 0.59). The relation between the angiographically evaluated segmental disturbances and the ejection fraction is also reverse, r = -0.88. The results of the study prove the relatively great possibility for mistakes of only the routine rest ECG is analyzed. The ECG evaluation of the left ventricular function cannot disclose the compensatory reserves of the healthy myocardium.

Adult↗
PubMed1987

[Dissecting aortic aneurysm].

Twenty cases with aortic dissecting aneurysm (ADA) are presented, at an average age of 52.5 (from 14 to 75), 15 of them males and 5--females. Nineteen had acute form of the disease and 1--chronic. Etiology, clinical picture, diagnostic approach and treatment were analyzed. Pain as leading symptom was present in all patients with various intensity and predominantly antero-thoracal localization. Seventeen of the patients (70%) were in shock at admittance. Pulse asymmetry was established in 8 (40%) and in 4, out of 12 cases (33%) with ADA, complicated by cardiac tamponade, a freshly appeared diastolic murmur was present. Enlarged aortic shadow at X-ray investigation had 14 (70%) of the patients with a dynamics of the enlargement in 5 patients. The disease has been clinically diagnosed in 19 (95) of the patients. Five out of 20 patients underwent operation, two of them followed for two years after the surgical treatment. Only one patient out of the non-operated 15 patients, survived. The modes of therapeutic behaviour are discussed on the base of the authors' experience and literature data.

Adolescent↗
PubMed1986

[Diagnostic value of the Holter monitoring of ischemic heart disease patients].

Holter-monitoring, for 24 hours, has been performed to with 47 patients (12 females and 35 males), average age 59,05 +/- 10,98. All patients had ischemic heart disease, 13 with myocardial infarction in a subacute stage, 10--with postinfarction cicatrix, 7 with unstable angina pectoris, 4 with the syndrome of the morbid sinus node and 13--with myocardial sclerosis. Rhythm disorders were recorded in only 12 patients (25.5%). Ventricular extra systoles were recorded in 31 patients (65.9%), 70.97% being from class III-V according to Lown. Ventricular tachycardia was established in 8 patients (25.8%), with 3 paroxysms within 24 hours on the average. Transitory absolute arrhythmia was established in 4 cases and in 12-atrial extrasystoles. The incidence and class of ventricular activity, according to nosological entities were analyzed. Ventricular tachycardia in 87.5% was triggered by relatively late extra-systoles. The antiarrhythmic treatment, administered in the moment, proved not to be effective in the majority of the patients. The importance of holter-monitoring was stressed on both for registration and documentation of the various rhythm disorders and for the evaluation of the effectiveness of the treatment.

Aged↗
PubMed1986

[Treatment of light and moderate arterial hypertension with acebutolol].

The authors follow up the effectiveness and tolerance of monotherapy with acebutolol in 47 patients with light and moderate hypertension, in a dose of 400-1200 mg in the course of three months. Twenty two of the patients have been treatment with the original French drug of the firm "Specia" and the rest 25--with the Bulgarian preparation, produced by Pharmachim according to a licence of the French one. The following parameters were followed up: arterial pressure, pulse rate, ECG, eventual adverse effects on 30, 60, 90 day of the treatment. The indices of cardiac output and total peripheral vascular resistance were calculated in a group of 13 patients. The results obtained reveal that the monotherapy with acebutolol, in light and moderate arterial hypertension, leads to definite, lasting and progressive antihypertensive effect in over 75% of the patients. The preparation has no significant effect on pulse rate and induces no orthostatism. It affected the total peripheral vascular resistance with 26% from the initial with unchanged or lightly increased indices of cardiac output. The Bulgarian drug, produced by Pharmachim, gives no way in effectiveness to the original French preparation.

Acebutolol↗
PubMed1982

[Therapeutic and preventive effect of oral lidocaine in extrasystole].

Lidocaine, Egypt production, P. R. of Hungary, was perorally administered in an average dose of 1.8 +/- 0.38 gr daily for a period of 14.23 +/- 28.9 days to 52 patients with and average age of 61,52 +/- 12.8 with various organic cardiac diseases and ventricular extrasystolic arrhythmia. In 18 of them (47.38%) complete inhibition of arrhythmia was attained, in 10 (26.31%) a combination with another antirhythm preparation was necessary and in 10 (26.31%) the treatment had no effect. In 14 patients the peroral lidocaine form followed its intravenous infusion in acute myocardial infarction with a prophylactic aim and no rhythm disorders were observed. It was established that the unaffected cases were with proportional growth, depending on the severity of arrhythmia, classified according to the prognostic indices of Lown. In 13.46 per cent of the patients, adverse effects were observed, mainly from the gastrointestinal system. The authors think that lidocaine is a proper drug in the treatment of ventricular extrasystolic arrhythmia in the first two classes of Lown and in the prophylaxis of the patients with rhythm disorders after acute myocardial infarction.

Acute Disease↗
PubMed1982

[Treatment of chronic congestive failure with vasodilators (acute trial with prazosin and erythrityl tetranitrate)].

An acute clinical experiment was carried out with 34 patients with chronic refractory cardiac insufficiency with stasis and idiopathic dilating (stasis) cardiomyopathy so as to follow up the hemodynamic effect of the vasodilators prazosin and erythrityl tetranitrate. The values of the central and peripheral vascular hemodynamics were followed up before and one hour after the peroral intake of 2 mg prazosin and half an hour after the peroral intake of 40 mg erythrityl tetranitrate. The results indicate that a statistically significant decrease of the arterial pressure and the total peripheral vascular resistance developed after prazosin intake. The systolic arterial pressure was decreased from 121,80 +/- 3,52 to 102,40 +/- 3,71 (p less than 0,001) and the diastolic--from 80,20 +/- 2,41 to 68,20 +/- 2,56 (p less than 0,01). The values of the total peripheral vascular resistance were decreased from 2629,65 +/- 174 to 1865,53 +/- 153 (p less than 0,001). The indices of the pump function--Stl and SI were increased (Stl from 22,74 +/- 1,85 to 30,37 +/- 2,14 with p less than 0,025 and Sl--from 1,90 +/- 0,08 to 2,64 +/- 0,19; p less than 0,02). The indices of the pressure in the left ventricular filling had no statistically significant change. After the administration of erythrityl tetranitrate, a statistically significant improvement of the indices of the cardiac output was also observed as well as of the total peripheral vascular resistance. The systolic index grew from 1,74 +/- 0,20 to 2,70 +/- 0,16 (p less than 0,01); stroke index--from 18,35 +/- 2,82 to 32,99 +/- 2,88 (p less than 0,01), and the total peripheral vascular resistance was decreased from 2897,0 +/- 186,0 to 1556,0 +/- 154,0 (p less than 0,001). Prazosin and erythrityl tetranitrate led to a considerable decrease of the counter load of the heart and improvement of the pump function of left ventricle in an acute experiment in case of chronic cardiac insufficiency with stasis.

Adult↗
PubMed1981

[Vasodilator treatment of chronic heart failure: a chronic double-blind trial with prazosin and erythrityl tetranitrate].

A chronic double-blind experiment was carried out with 32 patients with severe chronic stasis cardiac insufficiency, with concomitant idiopathic congestive cardiomyopathy and ischemic heart disease, in assessing the effect of vasodilators prazosin or erythrityl tetranitrate upon the decompensation symptomatics and hemodynamic indices. The clinical indices of cardiac insufficiency with hemodynamic signs of pre-loading, myocardial contractility and postloading of left ventricle were followed up. Besides vasodilators the patients were administered the ordinary maintenance therapy with digoxin and diuretics. The experiment was a double blind one, controlled by placebo-periods and covered a 6 months follow-up period. The combined venous-arteriolar vasodilator prazosin was reduced pre and post-loading, it increased the cardiac output, without essential changes in functional capacity of the patients with chronic cardiac insufficiency. Erythrityl tetranitrate, however, has no substantial effect on the clinical and hemodynamic indices of statis cardiac insufficiency even in higher doses. That suggests the necessity of the chronic cardiac insufficiency treatment to be carried out with vasodilators with venous and arteriolar effect.

Chronic Disease↗
PubMed1978

[Clinical trial of the preparation clofazolin used intravenously].

The authors studied the hypotensive effect of the Bulgarian preparation Chlophazolin in ampoules of 0,15 mg, administered i. v. The study covered 50 patients, 44 of them with hypertonic disease II and III stage and the rest (6)--with renal and renovasal hypertension. The i. v. administration of chlophazolin was established to have a marked hypotensive effect and be expedient for the treatment of hypertonic crises and hypertension with high values. In a dose of 0,15 mg i. v. the preparation leads to a sharp decrease in the first 20 min, whereas during the following hours it is kept to lower values: systolic pressure-an average decrease of 30-40 mm Hb in a lying position, to 45-50 mm Hg in an erect position; the diastolic pressure-an average decrease of 10-15 mm Hg in a lying position to 20-25 mm Hg in an erect position. The hypotensive effect is better manifested in higher initial values of the pressure. It lasts approximately more than 13 hours but in 1/5 of the patients, with higher values of blood pressure, its effect is exhausted within 6-8 hours. Side effects of the preparation were registered in 26 per cent of the cases; orthostatic disturbances, sleepiness, dryness of the mouth, nausea. I. v. administration of chlopazolin does not change the excretion of urea and creatinine, diuresis and serum levels of sodium, potassium and chlorine.

Adolescent↗