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Biomedical subjects

A Kostakopoulos

Publications and source records attributed to A Kostakopoulos.

At least 19 recordsLinked to original sources
PubMed2005

Combination of docetaxel, estramustine phosphate, and zoledronic acid in androgen-independent metastatic prostate cancer: efficacy, safety, and clinical benefit assessment.

OBJECTIVES: Docetaxel is an effective agent for the treatment of androgen-independent prostate cancer (AIPC). Its combination with estramustine phosphate (EMP) has shown promising results in AIPC but the toxicity remains considerable. In an effort to minimize toxicity, we designed an every-2-week docetaxel administration regimen with a 3-day low-dose EMP regimen. Patients with bone metastases also received zoledronic acid. METHODS: A total of 54 patients with AIPC received docetaxel at 45 mg/m2 and EMP (140 mg orally every 8 hours for nine doses) every 2 weeks. Zoledronic acid was administered at 4 mg every 28 days. RESULTS: Of the 49 assessable patients, 22 (45%, 95% confidence interval [CI] 31% to 60%) had a prostate-specific antigen response. Of 24 patients with measurable disease, 9 (38%, 95% CI 19% to 59%) had a response to therapy (one complete response and eight partial responses). The median time to progression was 4.4 months (95% CI 2.7 to 6), and overall survival was 13.3 months (95% CI 9 to 17.6). Toxicity was mild, with only 5 cases of grade 3 or 4 toxicity. The pain score improved by 1 point in 21 (54%) of 39 symptomatic patients, and 14 (40%) of 38 patients who used analgesics discontinued analgesic consumption by the end of treatment. CONCLUSIONS: The combination of an every-2-week regimen of docetaxel, EMP, and zoledronic acid is an effective, well-tolerated regimen that results in symptomatic improvement in a significant proportion of patients with AIPC.

Adenocarcinoma↗
PubMed2004

Colonoscopy effects on serum prostate specific antigen levels.

INTRODUCTION: To evaluate the colonoscopy effects on serum levels of prostate specific antigen (PSA) and PSA ratio. SUBJECTS AND METHODS: Thirty men were studied (median age 68 years, range 32-89). All of them had their serum PSA (total and free) measured 24 hours prior to colonoscopy and also 24 hours, 7 and 30 days after procedure. RESULTS: 14 of 30 (47%) patients, had significantly (p = 0.045) increased Total PSA levels 24 hours after the procedure, 14 (47%) patients had insignificantly (p = 0.139) increased levels 7 days after, while 13 (43%) of them had insignificantly (p = 0.061) increased levels 30 days after colonoscopy. In 7 patients (23%), with total PSA levels in the "gray zone" (4-10 ng/ml) before colonoscopy, a near significant (p = 0.063) raise in PSA ratio was also observed 24 hours after. CONCLUSION: Flexible colonoscopy affect serum PSA (free and total) levels in certain patients. Special attention must be given to those patients with PSA levels in the "gray zone" before colonoscopy.

Adult↗
PubMed2004

Extracorporeal shockwave lithotripsy for kidney stones reduces blood pressure: use of 24-hour ambulatory monitoring for study of blood-pressure changes induced by SWL.

PURPOSE: To investigate the effects of shockwave lithotripsy (SWL) on blood pressure with the use of 24-hour ambulatory blood-pressure monitoring (ABPM). PATIENTS AND METHODS: We studied three groups of patients. Group I consisted of 60 patients with kidney stones treated with SWL. Group II was formed by 30 patients with stones in the lower third of the ureter treated in situ with SWL, and group III consisted of 30 patients with ureteral stones treated with ureteroscopy (URS). The ABPM measurements were performed before stone treatment, immediately after, and then every 3 months through 1 year. RESULTS: There was no new onset of hypertension in any group. The prevalences of hypertension before stone treatment were 21 (35%), 12 (40%), and 9 (30%) for groups I, II, and III, respectively. One-year post treatment, the numbers of hypertensive patients found for groups I, II, and III were 15 (25%), 11 (33.3%), and 8 (22.2%), respectively. In group I, a statistically significant decrease in blood pressure values was noted 1 year post-treatment (p<0.05). This decrease was related (p<0.05) to the power (r=0.35), as well as to the product of the number and the power (r=0.25), of the shockwaves applied. CONCLUSION: Extracorporeal lithotripsy for kidney stone may be responsible for a drop in blood pressure possibly caused by alteration in intrarenal metabolism.

Adult↗
PubMed2003

Rupture of an aortic anastomotic aneurysm into a ureter.

A case of rupture of a false aneurysm of the distal aorta into the left ureter is reported. The patient presented with purulent hydronephrosis and hematuria. A left aorto-femoral graft had been inserted 3 years earlier, which became infected and was then removed. After 2 years a false distal aortic aneurysm developed, and in the last 6 months recurrent episodes of hematuria have occurred. An aorto-ureteric fistula was confirmed at surgery, and a left nephrostomy was performed with proximal and distal ligation of the ureter and then aneurysmectomy followed by aorto-bifemoral bypass.

Aorta, Abdominal↗
PubMed2002

DNA flow-cytometric, histological and hormonal analysis of sertoli cell only syndrome (SECOS).

Sertoli cell only syndrome (SECOS) was identified on histology in 21 cases (16,28%) among 129 testicular biopsies performed in our department for azoospermia over the last 5 years. In these patients history, clinical features, hormonal levels, and histological findings were analyzed. In addition DNA flow-cytometric analysis was performed and showed an almost complete absence of haploid cells. All patients presented with elevated serum FSH levels suggesting a Sertoli cell damage or reduced production of inhibin due to the absence of sermatogenic cells. An good correlation was found between histological findings and DNA histograms. In conclusion SECOS is a syndrome of unknown aetiology presenting in men with azoospermia. DNA flow-cytometric analysis is a reliable, rapid and easy method in the diagnosis of SECOS, and can replace histological examination.

Adult↗
PubMed1999

Extracorporeal shock wave lithotripsy for lower pole calculi: our experience.

INTRODUCTION: This study was performed in order to evaluate the immediate and long-term outcome of patients undergoing extracorporeal shock wave lithotripsy (ESWL) for isolated lower pole calculi. METHODS: Three hundred and seventy renal units of 350 patients (240 men and 110 women; mean age 55 years) with isolated lower pole renal stones of smaller than 2 cm2 were studied. Follow up ranged from 1 to 52 months (mean, 15 months) to time of censorship, significant period of secondary urologic evaluation. RESULTS: Out of 370 renal units in 350 patients, 212 (57, 29%) were stone-free 1 month after ESWL and 21 (5.67%) spontaneously became stone-free within another 1-52 months (mean, 15 months). Intervention was required after 1-52 months (mean, 17.5 months) and accomplished by ESWL alone (30/350 patients 8.57%) or combined with retrograde endoscopy (10/350 patients 2.85%) while retrograde manipulation was necessary in two of the 350 patients (0.57%). CONCLUSION: Extracorporeal shock wave lithotripsy is the initial treatment of choice in patients with lower pole stones < 2 cm2, because the overall stone-free rate is acceptable and because even in the residual calculi, the risk of suffering symptomatic episodes requiring secondary intervention is low.

Female↗
PubMed1998

Early repair of injury to the ureter or bladder after hysterectomy.

In the present study we investigated the effectiveness of early diagnosis, repair of injuries to the ureter and urinary bladder sustained during hysterectomy, as compared to the results of delayed intervention. There were 46 ureteral injuries and 20 vesicovaginal fistulas in 55 patients. In 14 cases of ureteral injury an endoscopic approach management was employed. There was complete healing in 18 vesicovaginal fistulas while there was a single case of a ureteral injury that required nephrectomy because of stenosis. This study shows that early repair of urological injuries after hysterectomy has considerable advantages and the results are equally comparable with those of delayed intervention. In most cases of ureteral injury an attempt of an endoscopic repair is warranted before proceeding to open surgery.

Adult↗
PubMed1998

Leiomyoma of the bladder: a case report.

A case of leiomyoma of the urinary bladder in a 20-year-old man is reported. The patient presented with severe frequency and perineal burning at the end of urination along with microscopic haematuria. Enucleation of the tumour was performed because transurethral biopsy revealed leiomyoma. The prognosis of these tumours is excellent.

Adult↗
PubMed1998

Tuberculosis of the prostate.

We present five cases of tuberculous prostatitis. In all cases this was an incidental histologic finding after transurethral prostatectomy. The patients were all treated with an antituberculous drug regimen. A literature review of this rare condition is included.

Aged↗