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Biomedical subjects

I Papadopoulos

Publications and source records attributed to I Papadopoulos.

At least 19 recordsLinked to original sources
PubMed2001

Experiences with the entero-ureteral anastomosis via the extramural serous-lined tunnel: procedure of Abol-Enein.

OBJECTIVES: Ureteral reimplantation in any urinary diversion setting should be easy, reproducible, nonrefluxive, and without complications. In this study, we present our experiences with the entero-ureteral anastomosis via the extramural serous-lined tunnel, a technique introduced by Abol-Enein. METHODS: In the period between 1995 and 1998 we performed the Abol-Enein technique in 50 patients who underwent radical cystectomy and ileal neobladder construction. Preoperatively 10 patients had unilateral ureteral dilatation. RESULTS: The technique was performed easily, and any serious complications did not occur in the early postoperative period. Leakage of the urethral-intestinal anastomosis was seen in 2 patients and transient hydronephrosis in 2 patients. Among the most serious late complications were two strictures of the urethral-intestinal anastomosis and four unilateral strictures of the ureteral-intestinal anastomosis. Only 1 patient presented with unilateral grade IV urinary reflux. Four patients developed metabolic acidosis. In all cases, renal function was stabilized or improved, and preoperative dilatation of the ureters was alleviated. CONCLUSIONS: The low stricture rates of the uretero-intestinal anastomosis, as well as the low reflux rates of the procedure of Abol-Enein, render this procedure a safe method of uretero-intestinal anastomosis when an orthotopic ileal neobladder is formed. The method can be performed with equal or even greater ease in very dilated ureters that in many situations other techniques either cannot deal with or require ureteral tailoring. Although this technique seems to meet most of the criteria for an ideal uretero-intestinal anastomosis, further studies that involve longer follow-up periods are necessary to allow a definitive value of this method.

Cystectomy↗
PubMed2000

Primary adenosquamous and squamous cell carcinoma of the upper urinary tract. Report on three cases.

Three cases of adenosquamous cell carcinoma and squamous cell carcinoma of the upper urinary tract are presented. The fact that the urothelium normally has no glandular or squamous structures renders the pathogenesis of these tumours interesting. The process is assumed to begin with an urothelial metaplasia resulting from a reaction to chronic irritation, leading to dedifferentiation, dysplasias and, in the end, to a squamous cell carcinoma or adenocarcinoma. The relevant medical histories include chronic episodes of pyelonephritis or nephrolithiasis. Diagnosis, therapeutic approaches and prognosis of these rare tumours are discussed.

Aged↗
PubMed2000

Alterations in the fibrinolytic system components during acute myocardial infarction.

The purpose of this study was to evaluate the changes in tissue-plasminogen activator (t-PA), plasminogen activator inhibitor - type 1 (PAI-1) and D-dimer (DD) antigen plasma levels in acute myocardial infarction (AMI) patients after thrombolytic therapy with two different thrombolytic agents, rt-PA or acetyl-streptokinase and to find out any correlation between the plasma t-PA, PAI-1 and DD levels with the infarct size as it is estimated from the peak of serum CPK levels. The plasma antigen levels of t-PA, PAI-1 and DD were measured by the enzyme immunoassay method (Stago), in 57 consecutive patients (M = 46, F = 11, mean age 55.6 +/- 8.8 years) and in 25 normal subjects (M = 18, F = 7, mean age 54.0 +/- 5.5 years). In 47 out of the 57 patients who were treated successfully with 100 mg of rt-PA (26 patients) or with 1.5 MU 21 of acetyl-streptokinase, as well as in 10 patients who were not treated, samples were obtained again 4 and 24 hours after the end of thrombolytic therapy or admission, respectively. During the acute phase of myocardial infarction the t-PA, PAI-1 and DD antigen plasma levels were significantly higher than in healthy people. There were no significant changes in the t-PA, PAI-1 and DD plasma levels of the patients who were not treated with a thrombolytic agent. We found a significant elevation of t-PA (p < 0.001), PAI-1 (p < 0.05) and DD (p < 0.001) after 4 hours in comparison with the baseline (at presentation, before therapy). After 24 hours the t-PA and DD plasma levels remained significantly higher (p < 0.001) while the PAI-1 plasma levels returned to the pre-therapy levels. There were no significantly different changes in the t-PA, PAI-1 and DD plasma levels of either group of patients, treated with rt-PA or acetyl-streptokinase while the t-PA and PAI-1 levels were positively correlated with infarct size as estimated from peak serum CPK levels.

Clinical Enzyme Tests↗
PubMed1999

Health and illness beliefs of Greek Cypriots living in London.

This paper describes some of the findings of a qualitative study into the health and illness beliefs of Greek Cypriots living in London. Data were collected through group and individual in-depth interviews and were analysed using the grounded theory approach of constant comparison and saturation. Two of the six themes which were identified are discussed in this paper. The findings provide the reader with important insights into Greek Cypriots' beliefs of health and illness. The paper argues that the understanding of such beliefs from a cultural perspective is vitally important for all those involved in the provision of health care to this group.

Attitude to Health↗
PubMed1999

Primary renal malignant fibrous histiocytoma: case report.

We report on a case of primary renal malignant fibrous histiocytoma. Primary manifestation in the kidney is rare with only 22 cases reported in the literature. Preoperatively, a renal cell carcinoma cannot be distinguished from a malignant mesenchymal tumor with clinical or imaging techniques. We discuss the pathologic differential diagnosis, therapeutic strategies and prognosis of this infrequent tumor.

Histiocytoma, Benign Fibrous↗
PubMed1998

Barriers to evidence-based practice.

OBJECTIVES: This paper reports the findings of a study which aimed to identify the barriers to evidence-based practice in an acute National Health Service (NHS) trust. The study was carried out as part of an action research project designed to promote evidence-based practice. DESIGN: A rapid organizational appraisal design was used. This involved formal and informal interviews, focus groups, and observation of staff interactions at meetings and in clinical practice in an acute hospital NHS trust. Interviews were undertaken with key stakeholders within the organization and focus groups held with nurse managers, audit staff, staff nurses, and junior medical staff. Observation took place in meetings and in clinical areas. RESULTS: At an organizational level, the main issues identified were: (1) evidence-based practice was a low management priority, (2) problems with dissemination, (3) inadequate systems for personal and professional development, (4) difficulties in the management of innovations, (5) accessing evidence and resource constraints. At the individual practice level, the main issues were motivation, a lack of clarity about roles and practice, and a culture of practice which emphasizes 'routine' patient care. CONCLUSIONS: The results of this study demonstrate that structures and cultures within organizations can be important barriers to evidence-based practice. Factors which are external to individual trusts are also important. Existing hierarchical structures both in the NHS and within and between the different professional groups, are manifest in the existence of a largely deferential culture which emphasizes the routine in practice decision making. Given this reality, organizations will have to adopt multiple strategies to facilitate and promote the use of evidence in practice decision making.

Attitude of Health Personnel↗
PubMed1997

Correlation between DNA ploidy, proliferation marker Ki-67 and early tumor progression in renal cell carcinoma. A prospective study.

OBJECTIVE: The course of metastatic renal cell carcinoma shows a broad range of interindividual variation that cannot be sufficiently predicted by tumor stage and grade. The aim of this study was to establish the prognostic value of DNA ploidy and the proliferation marker Ki-67 in renal cell carcinoma. METHODS: Both parameters were measured simultaneously in 100 tumors and then correlated with the classic prognostic criteria pathologic stage and tumor differentiation grade as well as clinical course (early tumor progression). RESULTS: DNA ploidy correlated well with staging, grading and early progression. The proliferation index (Ki-67) correlated well with tumor stage and histopathological grade but not with the clinical course (early progression). CONCLUSION: Due to the diverse biological potential of renal cell carcinoma observation of further clinical course, including late tumor progression, will be necessary to determine whether one of these two indicators can provide additional information beyond what differentiation grade and tumor stage already tell us.

Aneuploidy↗
PubMed1997

Ureteral stenting using a combined antegrade/retrograde procedure. A technique for difficult cases.

Ureteral stenting is a procedure of daily routine. There are however cases in which cystoscopic placement of a stent fails despite various technical aids. Percutaneous nephrostomy is usually performed in those patients. In some cases however it is no reasonable alternative. For these special cases we used a combined antegrade/retrograde technique consisting in antegrade guide wire insertion followed by retrograde ureteral stenting. In 8 of 12 cases it was finally possible to insert a ureteral stent with this method. To our mind this technique should be applied when other attempts of stenting have failed and percutaneous nephrostomy is no reasonable alternative.

Cystoscopes↗
PubMed1997

Value of p53 expression, cellular proliferation, and DNA content as prognostic indicators in renal cell carcinoma.

OBJECTIVE: In renal cell carcinoma (RCC) little is known about the basic mechanisms of cell proliferation and differentiation leading to growth, invasion, and eventual metastasis. In the present study, the prognostic significance of proliferative activity, p53 activity, and ploidy is analyzed. METHODS: In 90 patients with RCC overexpression of the p53 protein. DNA ploidy and proliferation status as determined by the monoclonal antibodies Ki-67 and Ki-S5 were analyzed in addition to tumor malignancy grade and stage and correlated with the clinical course. RESULTS: During the follow-up period (average 38 months) 23% of the patients had a progressive course. Only the Ki-S5 index correlated with stage, grade, and clinical course. Ploidy, p53, and Ki-67 correlated neither with tumor stage and grade nor with the clinical course. CONCLUSION: The proliferation activity determined with the monoclonal antibody Ki-S5 represents the most promising prognostic factor of the pathological indicators considered for the clinical course of RCC.

Adult↗
PubMed1997

Epidemiology of adult rheumatoid arthritis in northwest Greece 1987-1995.

OBJECTIVE: Rheumatoid arthritis (RA) in Greece differs in its clinical, serological, and genetic aspects from that of Northern European countries. We investigated the incidence and prevalence of RA in the district of Ioannina in northwest Greece for the period 1987-1995. METHODS: We investigated records of patients at rheumatology clinics of university and general hospitals and private clinics in Ioannnina. Diagnosis was by 1987 ACR criteria, and the population data were based on the 1991 national census. Crude and age specific rates were calculated as number of cases per 1000 inhabitants. Age adjusted rates were obtained by the direct method using the European standard population. RESULTS: A total of 428 cases of RA were identified during the study period. Total prevalence of RA was for men 2.05 and for women 4.78 cases/1000 inhabitants, and the total women/men ratio was 2.33. Annual incidence rates fluctuated between 0.15 and 0.36/1000 inhabitants. CONCLUSION: Our findings suggest a low prevalence and low incidence of RA in northwest Greece. Environmental and/or genetic factors may explain this low frequency of the disease in the population studied.

Adolescent↗
PubMed1996

Prognostic indicators for response to therapy and survival in patients with metastatic renal cell cancer treated with interferon alpha-2 beta and vinblastine.

OBJECTIVES: Only one third of all patients with metastatic renal cell carcinoma respond to immunochemotherapy. Improved patient selection could render such treatment unnecessary in many cases. The goal of the study was to test various factors for their prognostic value as predictors of success of immunochemotherapy and patient survival in metastatic renal cell carcinoma. METHODS: Fifty patients with metastatic renal cell carcinoma were subjected to immunochemotherapy with interferon alpha-2 beta and vinblastine. Different variables such as age, sex, location of metastasis, primary or late metastasis, performance status, histologic status, overexpression of the p53 protein and cell proliferation as assessed by immunohistochemistry, and deoxyribonucleic acid-ploidy were considered as potential prognostic factors for response to immunochemotherapy and survival. RESULTS: Thirty percent (15) of the cases responded to therapy: 2 complete and 13 partial remissions. In univariate analysis, the proliferative activity (Ki-S5 labeling index) emerged as the statistically most significant prognostic factor (P = 0.0013) for prediction of successful immunochemotherapy in metastatic renal cell carcinoma. The second most significant factor was the location of metastases (P = 0.015), whereas all other parameters did not achieve statistical significance. As to overall survival, responsiveness to therapy was the most significant predictor (P = 0.0003), followed by Ki-S5 scores (P = 0.025). All other factors, including the sites of metastasic spread (P = 0.21), were not statistically relevant. CONCLUSIONS: Proliferation status in terms of Ki-S5 immunoreactive scores appears to be a valuable predictor of the responsiveness to immunochemotherapy. Overall survival appears to depend essentially on disease progression and tumor cell proliferation. Other alleged prognostic factors, such as performance status, sarcomatoid histology, and metastasis location, were not significant in this study.

Adult↗
PubMed1996

p53 expression, proliferation marker Ki-S5, DNA content and serum PSA: possible biopotential markers in human prostatic cancer.

OBJECTIVES: The biology of prostate cancer is poorly understood. Despite established prognostic criteria, a confident prediction of the clinical outcome is not always possible. Therefore, additional and more precise information is highly desirable. In the present study, we compared potential biologic markers with the laboratory, clinical, and histopathologic parameters of prostate-specific antigen (PSA) level, tumor stage, and tumor grade. METHODS: Paraffin-embedded material from 62 radical prostatectomies for prostate carcinoma was examined immunohistochemically using monoclonal antibody Ki-S5 to determine the tumor growth fraction and antibody DO-1 to assess p53 protein overexpression. Deoxyribonucleic acid-ploidy was analyzed by flow and image cytometry. Preoperative PSA levels were assessed by standard method. The tumors were categorized according to the Gleason grading system and staged postsurgery after the TNM classification. RESULTS: The p53 expression, proliferation rate (Ki-S5), and rate of aneuploidy correlated closely with stage (P < 0.05) and Gleason score (P < 0.01). However, divergences were occasionally observed. The ploidy status correlated closely with proliferative activity and p53 expression. Conversely, no correlation was seen between these parameters and serum PSA content, the latter being significantly associated with the tumor stage alone. CONCLUSIONS: The results characterize proliferation marker Ki-S5, p53 expression, and ploidy status as tumor biopotential markers, whereas PSA provides diagnostic information. Use of these investigative methods promises to provide additional information relevant in prognosis and therapy selection. Nonetheless, their precise prognostic value will have to be established in further studies.

Aged↗
PubMed1995

Non-synergistic relaxant effects of vasoactive intestinal polypeptide and SIN-1 in human isolated cavernous artery and corpus cavernosum.

Since vasoactive intestinal peptide (VIP) and nitric oxide (NO) are considered to be non-adrenergic, non-cholinergic (NANC) inhibitory mediators in human penile erectile tissue, the goal of this study was to discover possible synergistic effects of exogeneous VIP and the NO donor 3-morpholino-sydnonimine (SIN-1) in human isolated cavernous arteries and cavernosal smooth muscle. In contrast to VIP, SIN-1 elicited complete and reproducible relaxant actions. Combined administration of VIP and SIN-1 revealed non-synergistic, independent relaxant effects in both investigated tissues. The results do not favour a combined administration of VIP and SIN-1 as a new therapeutic approach in the treatment of erectile dysfunction.

Arteries↗
PubMed1995

The need for nursing and midwifery programmes of education to address the health care needs of minority ethnic groups.

The article reviews some of the more influential literature of the past decade on the health needs of ethnic groups, in an effort to identify what is being done by nursing and midwifery education to address the health care needs of these groups and to prepare practitioners who are able to respond to these needs. The article suggests that despite the relative lack of progress in this field of health care and education, there still exists much confusion, disagreement and lack of clarity around many issues, such as the identification of relevant content, the integration of this content into the curriculum and more importantly the delivery of this content. The literature seems to point to a lack of cultural knowledge, particularly for certain ethnic groups, which needs to be rectified. But even when knowledge is available, the evidence clearly indicates that both educators and practitioners are failing to translate this into effective and culturally sensitive care. The article suggests that nursing and midwifery education could and should play an important role in the development and dissemination of culturally sensitive care.

Curriculum↗
PubMed1995

Adult Wilms' tumor: case report, management, prognosis.

Wilms' tumor being a rare disease in adults, even large centers have had experience with isolated cases only. In our clinic, we have treated two cases of histologically confirmed Wilms' tumor in the last 3 years. On the basis of two case reports, we describe the staging, treatment and prognosis of this highly malignant tumor. To a large extent, diagnostics and treatment follow the recommendations for Wilms' tumor in children.

Adult↗
PubMed1995

Quantitative DNA analysis in renal cell carcinoma. Comparison of flow and image cytometry.

In 70 renal cell carcinomas, nuclear DNA content was determined by means of flow cytometry (FCM) and image cytometry (ICM). The two methods produced comparable results as to DNA tumor ploidy (DNA tumor stemlines, DNA index): 14 of the tumors were tetraploid or aneuploid and 56 diploid. Results with the two methods were also comparable in a comparison of DNA ploidy with degree of tumor malignancy (tumor grade G1-3) and local tumor spread stage (pT stage). As a consequence, both methods appear suitable as means of determining DNA tumor ploidy and thus of formulating a prognosis in renal cell carcinoma. Renal cell carcinomas with diploid stemlines tend to be characterized by local growth, whereas tetraploid or aneuploid tumors show a tendency toward perirenal spread and venous invasion.

Carcinoma, Renal Cell↗
PubMed1994

DNA content and the proliferation marker Ki-67 as prognostic indicators in renal cell carcinoma.

Patients suffering from renal cell carcinoma have a generally poor prognosis. Even cases that are clinically in comparable stages can, however, take quite different courses. The basic prognostic factors, histological grade and TNM stage do not do justice to the heterogeneous biological behavior of this tumor entity. In this study, the possible prognostic indicators, DNA content and proliferation rate, assessed with Ki-67, were compared with the histological grade and the TNM stage. Though there was no correlation between the proliferation rate (Ki-67) and the two, there was a significant correlation between DNA content and both histological grade and TNM stage.

Aneuploidy↗