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Biomedical subjects

S Raptis

Publications and source records attributed to S Raptis.

264 records · Page 15Linked to original sources
PubMedDate not supplied

Inhibition of pancreatic glucagon responses to arginine by human insulin (recombinant DNA) and purified porcine insulin in normal and diabetic subjects.

This study investigates and compares human insulin (recombinant DNA) and purified porcine insulin (PPI) in healthy volunteers and in type II diabetic patients, in terms of whether both these insulins were capable of influencing in a different manner pancreatic glucagon, C-peptide, and free fatty acids (FFA) concentrations. The findings reveal that the beta-cell of human pancreas apparently recognizes human insulin more readily than PPI, as assessed by the inhibition of C-peptide, and a similar conclusion follows for the alpha-cell; this conclusion is underscored by the inhibited glucagon values. The delayed increments of glucagon under human insulin following arginine stimulation may be the result of a more rapid insulin absorption from subcutaneous tissue and a greater biologic action of this insulin in comparison with the PPI. Finally, human insulin has additional properties as demonstrated by its stronger antilipolytic effects.

Absorption↗
PubMedDate not supplied

Plasma secretin, pancreozymin, and somatostatin-like hormone in chronic renal failure patients.

Twenty patients with chronic renal failure (CRF) and ten patients on hemodialysis were included in the study of plasma secretin and pancreozymin measurement. Plasma somatostatin-like hormone (SLH) was measured in seven patients with CRF, eight patients in continuous ambulatory peritoneal dialysis (CAPD), and ten patients on hemodialysis. Normal subjects were used as sex- and age-matched healthy controls. Plasma secretin, pancreozymin, and SLH were determined by radioimmunoassay. Basal plasma concentration of secretin and pancreozymin was found significantly increased in hemodialysis patients in comparison to controls. Also test meal induced a significant increase of both hormones in hemodialysis patients. Basal plasma SLH was found significantly increased in both predialysis and dialysis (hemodialysis, CAPD) patients in comparison to controls. Correlation between clinical gastrointestinal disturbances and elevated hormone levels was not found. We believe that more reliable plasma measurement of these hormones will help the clinical investigation of gastrointestinal pathophysiology in uremia for the future.

Adult↗
PubMedDate not supplied

New frontiers in liver surgery. Two-stage liver surgery for the management of advanced metastatic liver disease.

BACKGROUND/AIMS: To assess the value and the safety of main portal branch transection combined with transarterial targeting locoregional neo and adjuvant immunochemotherapy, 32 patients suffering from advanced metastatic liver disease underwent two-stage hepatectomy. METHODOLOGY: From September 1995 to June 1999, 32 consecutive patients underwent two-stage surgery for advanced metastatic liver disease. Firstly we performed ligation and transection of the main portal branch corresponding to the liver lobe occupied by the tumor and introduction of an arterial jet port catheter towards the hepatic artery. After a locoregional transarterial targeting immunochemotherapy regimen the patient had a 2nd laparotomy for hemihepatectomy. Following surgery, locoregional targeting immunochemotherapy was carried out in all patients via the arterial port of the gastroduodenal artery as an adjuvant treatment. RESULTS: There were no operative deaths. Mean survival was 27 +/- 8 months. CONCLUSIONS: Two-stage liver surgery is an appealing alternative that increases the resectability rate and overall survival in patients with advanced metastatic liver disease and is associated with excellent quality of post-operative life.

Adult↗
PubMedDate not supplied

Consecutive re-explorations for final resection of initially unresectable pancreatic head carcinoma.

BACKGROUND/AIMS: The lack of high surgical expertise and specialization of the practicing surgeon may lead some patients with pancreatic cancer to die. This study also investigates the role of combined neo and adjuvant locoregional immunochemotherapy in patients considered initially as non-amenable to resection. METHODOLOGY: 32 patients underwent re-exploration aiming at pancreatic resection. After the initial diagnostic work-up 22 of them underwent pancreatic resection during the first re-exploration. The remaining 10 patients were judged again as unresectable. All 32 patients had 2 catheters introduced into a side arterial branch of the jejunal artery and vein for locoregional immunochemotherapy. Seven out of 10, considered as unresectable initially, had pancreatic resection after immunochemotherapy regimen. RESULTS: All patients survived surgery. Early morbidity included wound infection in 3, bleeding in 1 and leakage of gastric stump in 1 patient. Treatment related toxicity included leukopenia in 4 patients, anemia in 3 and fever and chills in 21. Mean follow-up was 62 +/- 1.2 months. One-, 2-, 3- and 5-year survival was 100, 80, 70 and 48% respectively. CONCLUSIONS: Our results strongly support the necessity for neo and adjuvant locoregional immunochemotherapy and its contribution to prolongation of survival.

Adult↗
PubMedDate not supplied

Correlation of bone mineral density with the histological findings of renal osteodystrophy in patients on hemodialysis.

AIMS: To examine the distribution of bone mineral density (BMD) in different histological groups of renal osteodystrophy. PATIENTS: We prospectively studied 62 patients, 41 men and 21 women, aged 57+/-11.5 years, who had been on hemodialysis for 60+/-55 months. The women had been amenorrheic for 13+/-4 years and 7 patients (11%) had a positive fracture history. METHODS: A bone biopsy was taken after tetracycline labelling and BMD of the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry (DEXA); serum intact parathyroid hormone (iPTH), bone Gla protein (BGP), phosphorus, calcium and alkaline phosphatase (ALP) were also determined. RESULTS: Histologically, 40 patients showed secondary hyperparathyroidism (sHPT), 6 mixed bone disease, 14 adynamic bone disease (A) and 2 osteomalacia. BMD of the lumbar spine was decreased in 43 patients (69%) and in 9 (14.5%) it was lower than -2 Z score units. BMD of the femoral neck was low in 55 patients (89%) and in 22 (35.5%) it was lower than -2 Z scores. BMD was lower in patients with sHPT than in those with adynamic bone disease (p<0.05) in which it was close to normal. BMD in both these sites correlated inversely with the biochemical markers (serum iPTH, BGP and ALP) and the histomorphometric indices of bone turnover. CONCLUSIONS: Osteopenia is frequent in patients on hemodialysis, especially those with biochemical and histological findings of sHPT.

Absorptiometry, Photon↗
PubMedDate not supplied

Metastatic liver disease of colorectal origin: the value of locoregional immunochemotherapy combined with systemic chemotherapy following liver resection. Results of a prospective randomized study.

BACKGROUND/AIMS: Liver resection for metastatic liver disease of colorectal origin, although considered as the 'gold standard' of treatment, is associated with limited long-term survival. The aim of this study was to compare overall survival, disease-free survival and the incidence of intra- or extrahepatic recurrence between patients who were randomly assigned to have locoregional chemoimmunotherapy with systemic chemotherapy group A (n = 62 patients) versus those who were treated with systemic immunochemotherapy group B (n = 60 patients). METHODOLOGY: Group A included patients who, after liver resection, received locoregional immunochemotherapy combined with systemic chemotherapy, while group B included patients who had undergone systemic immunotherapy combined with systemic chemotherapy following liver resection. The two groups were matched in terms of sex, age and stage of the disease. Prognostic factors and their impact on disease-free survival were studied in both groups. RESULTS: Two-year survival was 92% for group A versus 75% for group B, 5-year survival was 73% for group A versus 60% for group B. During the two-year period, 34% of the group A patients versus 52% of those of group B developed either intrahepatic or extrahepatic recurrence of the disease (P < 0.00212). CONCLUSIONS: From the analysis of the above results it becomes clear that regional immunochemotherapy combined with systemic chemotherapy leads to a decrease in the incidence of disease recurrence and thus to a significant prolongation of the overall survival and of disease-free survival.

Adult↗
PubMedDate not supplied

Myelopathies during the course of multiple myeloma.

BACKGROUND: The development of acute non-lymphoblastic leukaemia (ANLL) or myelodysplastic syndromes (MDS) secondary to treatment of multiple myeloma (MM) is well known. In some cases the simultaneous appearance of MM and ANLL has been described. METHODS: In this series the simultaneous appearance of MM and various myelopathies in 91 untreated patients with MM, and the development of myelopathies during the course of the disease in 72 treated patients were studied. RESULTS: Simultaneous appearance of MM (IgA/lambda) and refractory anaemia with ring sideroblasts (RAS) was observed in one case (1.1%). Development of myelopathies in treated patients with MM was found in 4 out of 72 cases (cumulative risk at 8 years 28.3%). In one case (IgG/lambda MM) a myeloproliferative disorder (MPD) developed 6 years after the initial diagnosis. Cytogenetic analysis was normal. In the second patient (IgG/k MM) a similar MPD was observed 5 years after the initial diagnosis. The karyotype was 46, XX, -5 + t (20;?). The third patient with lambda light chain disease developed RAS 11 months after the initial diagnosis. The karyotype was 46, XY/hypodiploidy + M. Finally, the fourth case (IgG/k MM) developed ANLL (M4) 28 months after the initial diagnosis and the karyotype was 45, XX, -7, t(1;3). CONCLUSIONS: The simultaneous appearance of MM and various myelopathies is unusual and probably represents a neoplastic transformation of a single progenitor in both lymphoid and myeloid malignancies. On the contrary, the development of myelopathies during the course of treated patients is a common phenomenon. The time of development and the cytogenetic findings strongly suggest that they are related to treatment with cytostatics.

Adult↗
PubMedDate not supplied

The significance of tibial artery disease in the management of popliteal aneurysms.

The clinical, radiographic and histologic features of sixty-one popliteal aneurysms in 36 patients are reviewed. Twenty-seven aneurysms were thrombosed and presented with an acutely ischaemic limb or the sudden onset of severe claudication. Thirty-four patent aneurysms presented with either ischaemic ulceration or claudication due to tibial artery disease or were asymptomatic with normal distal pulses. Thrombosis made reconstruction difficult and at times required a femoro-tibial graft. In others reconstruction was not possible leading to amputation either as primary treatment or following failed revascularization. In patent aneurysms one or more tibial arteries were frequently occluded. It is postulated that obliterative atheromatous disease of the tibial vessels and the slow flow through the aneurysmal vessels is responsible for the high incidence of thrombosis, poor graft patency and a high amputation rate.

Aged↗
PubMedDate not supplied

Locoregional chemotherapy versus locoregional combined immuno-chemotherapy for patients with advanced metastatic liver disease of colorectal origin: a prospective randomized study.

BACKGROUND/AIMS: This reports presents the results of a prospective randomized controlled study of combined locoregional targeted immuno-chemotherapy for treatment of patients with liver metastasis from primary colorectal malignancies. MATERIALS AND METHODS: Forty eight patients were randomly assigned into one of two groups. Group A (n = 15) included patients who had post-operatively locoregional chemotherapy and Group B (n = 33) included patients who had combined locoregional immuno-chemotherapy. RESULTS: Statistical analysis shows a clear superiority in the survival and responses of patients treated with immuno-chemotherapy versus chemotherapy alone. Forty five percent of patients in Group B are alive with a mean survival of 20.3 months, ranging from 13 to 29 months, as opposed to no survivors from Group A and a mean survival of only 9.9 months, ranging from 3.6 to 22.5 months. Additionally, 64% of the immuno-chemotherapy group had a positive response while only 13% of the chemotherapy had such a response. CONCLUSIONS: Our data supports the value of combined immuno-chemotherapy as a treatment for advanced metastatic liver disease.

Adenocarcinoma↗