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Biomedical subjects

A Kostakis

Publications and source records attributed to A Kostakis.

At least 73 records · Page 4Linked to original sources

The effect of heparin upon fibrinopurulent peritonitis in rats.

The effect of heparin upon the clinical and pathologic course of experimentally induced peritonitis in the rat was studied. Peritonitis was induced in 40 rats by creating a closed ileal loop 4 centimeters long at a distance of 5 centimeters from the ileocecal valve. The rats were divided into two groups of 20 each. The first group served as the control group while each rat of the second group received 30 units of heparin subcutaneously per day postoperatively. Survival was drastically increased in the group receiving heparin (p = 0.001). Adhesion or abscess formation was considerably reduced in this group. The results of peritoneal cultures showed decreased incidence of Escherichia coli and clostridia in the heparin-treated group. Blood cultures also showed decreased incidence of both aerobes and anaerobes in the treated group. It is concluded from this that the administration of heparin significantly prolongs survival time of animals with peritonitis and reduces the development of adhesions and abscesses in the peritoneal cavity. This beneficial effect could be attributed to decreased fibrinogen deposits within the peritoneal cavity, thus rendering the bacteria more susceptible to cellular and noncellular clearing mechanisms.

Abscess↗

Cushing's syndrome. Analysis of 18 cases.

Eighteen patients with Cushing's syndrome were analyzed retrospectively. Eleven patients had diffuse or adenomatous hyperplasia, 5 an adenoma and 3 a carcinoma. Iodocholesterol scanning provides considerable help in localization of the disease. Surgical treatment, while curative for benign cases, affects only slightly the course of malignant disease.

Adenoma↗

Effect of beta-adrenergic blockade on physiologic growth in the Wistar rat.

The effect of propranolol (Pr) on body weight was studied in 144 Wistar rats of both sexes from weaning to 17 weeks of age. Pr was administered to 77 of these rats (chosen at random), in a dose of 100 mg/kg body weight daily. Body weights were monitored every third day throughout the study. During their 17th week of age, all the rats were weighed for the last time and then sacrificed. The following organs were carefully dissected and weighed: brain, thymus, lungs, heart, liver, kidneys, adrenals, testes and ovaries. Gain in body weight was significantly reduced in the propranolol treated animals compared to control in both sexes. Organ weights were also less in propranolol-treated rats except for the kidneys of both sexes and the heart and testes of the males. However, the ratio of most organ weights per body weight was greater, indicating that the inhibition of weight gain was less severe in those organs compared to that of total body weight.

Adrenergic beta-Antagonists↗

Lymphedema as the first manifestation of Hodgkin's disease.

Two cases of Hodgkin's disease are described, initially manifested with unilateral lymphedema of the lower extremity. The appearance of pronounced lymphedema of a lower extremity, as the first clinical manifestation and presenting sign of Hodgkin's disease is extremely rare. The surgical treatment of this condition consisted in removal of the involved lymph nodes of the inguinofemoral area and at the same time in omental transposition of a lymphatic communication of the afflicted area with the peritoneal cavity. The procedure was successful in ameliorating the lymphedema. No episodes of postoperative cellulitis occurred and good functional capacity of the extremity was achieved.

Female↗

Simple hypothermic preservation for transporting human livers long distances for transplantation. Report of 12 cases.

Since 1973, 12 patients in the Cambridge-King's College Hospital liver transplant programme have received livers from donors dying in hospitals considerable distances from the transplant centre in Cambridge. The method of preservation used to transport these livers from 35 to 110 miles was flush perfusion with plasma protein fraction and hypothermic storage in ice. The ischaemia times ranged from 2 hr and 42 min to 4 hr and 22 min. All of the recipients had good or excellent postoperative function of the grafts and 6 of the 12 recipients are alive, the longest survival being 29 months. The preservation technique is simple and easily portable and has given reliable 4-hr preservation of the human liver.

Adolescent↗

Cyclosporine levels at 2 hours after dose and body mass index in relation to graft function in renal transplant patients treated with azathioprine or mycophenolate mofetil.

The aim of this study was to evaluate the effect of C(2) levels on renal graft function in relation to body mass index (BMI). This retrospective study of 95 renal transplant patients included 53 on AZA and 42 on MMF at 3.1 years after transplantation. The cohort was divided into groups according to their C(2) levels, namely <600 ng/mL, 600 to 900 ng/mL, or >900 ng/mL, and according to BMI (>26 kg/m(2)). In every group, we evaluated the percentage of patients with an increase in creatinine by 1 mg/dL or >/=50% from the first year posttransplant. There was no difference in age, gender, graft source, and dose of corticosteroids or CsA between the groups. Patients on AZA with C(2) 600 to 900 ng/mL showed a lower prevalence of renal dysfunction (3.4%) than those with C(2) levels <600 ng/mL (14.3%) or >900 ng/mL (20%). Seventeen percent of the patients on AZA and 11.9% on MMF had BMI >26 kg/m(2) (P = NS). An increased serum creatinine was present in 22.2% of patients with BMI >26 kg/m(2) in the AZA group vs 20% in the cohort MMF (P = NS). These findings suggest that long-standing renal recipients on AZA with C(2) levels of between 600 and 900 ng/mL show better preservation of renal function. We did not identify differences on the basis of C(2) levels in MMF-treated recipients. The influence of BMI on long-term graft function seemed to be independent of AZA or MMF therapy.

Adult↗

Pre-operative Tc-99m-sestamibi scanning and intra-operative nuclear mapping: are they accurate in localizing parathyroid adenomas?

PURPOSE: Presentation of the results of Tc-99m-sestamibi imaging in the pre-operative localization of parathyroid adenomas and the intra-operative localization of those lesions using a gamma detector (prospective study). PATIENTS & METHODS: Eighteen consecutive patients aged 27-75 years with primary hyperparathyroidism (PHPT) underwent Tc-99m-sestamibi scanning 1-2 hours before the operation and the presence of a single adenoma was recognized. All our patients underwent bilateral neck exploration based on pre-operative scanning and intra-operative gamma detector guidance and the adenoma was detected in the positions shown by both methods. RESULTS: In 16 patients we found a single adenoma localized in the same position shown by pre-operative scanning, while the intra-operative method accurately revealed all abnormal glands. In one of the two patients where an inaccurate pre-operative localization technique had been carried out, we performed thyroid lobectomy (the adenoma proved to be intrathyroidal), while the other one had an adenoma which was not close to the site indicated by the pre-operative scintigraphy. Serum calcium reverted to normal within a few days postoperatively. CONCLUSION: Patients with true-positive scans for single parathyroid adenoma could be eligible for minimally invasive operations since the abnormal gland is easily identified by the above-mentioned methods.

Adenoma↗

Vincristine overdose: experience with 3 patients.

Vincristine overdose (7.5 mg/m2) was accidentally administered to 3 children with acute lymphoblastic leukemia. Treatment included double-volume exchange transfusion, phenobarbital administered prophylactically, and folinic acid rescue 18 mg every 3 hours for 16 doses. Vincristine levels were also assayed and showed a dramatic decline in postexchange levels in the 2 patients who survived and an almost unchanged value in the patient who succumbed. Early signs of toxicity in the 2 survivors were peripheral neuropathy (day 4), bone marrow toxicity (day 5), gastrointestinal toxicity (days 6 and 7), and hypertension (days 7 and 8). Marrow aplasia lasted for 4 and 10 days, peripheral neuropathy for 15 and 42 days, gastrointestinal toxicity for 3 and 5 days, and hypertension for 5 and 14 days. The 2 children were discharged on days 13 and 16 and cytostatic therapy was restarted on days 18 and 25. Both are alive without evidence of leukemia. The third patient developed liver and marrow toxicity on day 3 and died on day 9. Postmortem examination showed leukemia infiltration of the liver and spleen.

Bone Marrow Diseases↗