Biomedical subjects
Publications and source records attributed to C Dimopoulos.
Metabolic investigations were made in 21 cystinuric patients. The results showed a low output of urinary phosphorus and an increase of plasma IgG. These findings and the presence of uric acid in the urine, even in normal values, could play an important role in pathogenesis and stone formation, and also in cystinuria.
The effects of acute, rapid distention of the urinary bladder on the arterial pressure, blood flow and peripheral resistances were studied on dogs and an attempt was made to elucidate the mechanisms of cardiovascular responses observed. In 15 dogs with intact nervous system the arterial blood pressure and blood flow of the femoral, brachial and renal arteries were recorded and the vascular resistances were calculated during an increase of the intra-bladder pressure. Acute distention of the bladder, in the dog, increases arterial blood pressure by 10,25%, the vascular resistance of the femoral and renal vascular bed increases while that of the brachial artery is slightly reduced.
Three methods of preservation of the in situ temporarily ischaemic kidney were compared in dogs. The study was carried out in 24 dogs, divided in 4 groups. Each group included 4 dogs in which the ischaemic time was 60 minutes, and 3 dogs in which the ischaemic time was 90 minutes. The experimental animals of the first group served as controls (warm ischaemia); in the second group renal hypothermia was accomplished by an arterial infusion of Collins' solution at 4 degrees C; in the third group preservation of the kidney was attempted only by an arterial infusion of inosine (90-120 mg/kg); finally in the fourth group, the infusion of Collins' solution was combined with infusion of inosine (800-1 000 mg/l Collins' solution). The assessment of the damage of the ischaemic kidney was made by histo-enzymological analysis of renal tissue specimens received from each animal just before initiation of the ischaemia and on the 21st post-operative days. The enzymes examined in this analysis were: Alkaline Phosphatase, ATP-ase, Glutamate Dehydrogenase, Glucose-6-phosphatase, Hydroxybutyrate Dehydrogenase and gamma-GT. These studies have shown that the ischaemic kidney is best preserved by the arterial infusion of Collins' solution with simultaneous infusion of inosine.
beta 2 Microglobulin is a low molecular weight protein synthesised by lymphocytes and neoplastic cells. The authors measured levels of this substance in the plasma of 40 patients with carcinoma of the bladder and normal renal function. 26 subjects were used as controls. Plasma levels were markedly higher in the bladder carcinoma sufferers than in the normal controls. Levels were also higher in invasive carcinomas than in superficial lesions. beta 2 microglobulin may therefore not be considered to be a specific indicator of carcinoma of the bladder but rather as a factor offering the possibility of measurement of the secretory activity of tumour cells.
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The authors report the first results of the use of mercaptopropionyl-glycine (M.P.G.) in the solubilising and preventive treatment of cystine lithiasis. This substance results in the formation of a soluble cystine M.P.G. complex. It increases the solubility of cystine much more than D-penicillinamine. Twenty one cases of cystinuric cystine lithiasis were treated in this way, combined with forced diuresis, alkalinisation of the urine and uricolytic treatment. In 4 of their 21 patients, calculi disappeared completely, whilst in another 3 they decreased in size. Recurrence of lithiasis was avoided in 20 patients out of 21. These impressive results are similar to those in the brief literature concerned with the substance. Toxicity is virtually nil and its efficacy make this the drug par excellence for cystine lithiasis.
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The combination of juvenile diabetes mellitus, optic atrophy, perceptive hearing loss, diabetes insipidus and atonia of the urinary tract and bladder seems to constitute a distinct syndrome. In certain cases delayed puberty is also mentioned but this has not been considered as part of the syndrome.
41 dogs were subjected to percutaneous arterial embolization of branches or the main trunk of the renal artery with or without prior injury to the kidney. 8 materials were used: homologous blood clot, muscle, fat, fascia, barium sulfate, plain catgut, gelfoam and polyvinyl alcohol (Ivalon). From the angiographic investigation over a relatively long period, it was observed that complete recanalization of the embolized vessels occurred only with blood clot and gelfoam; partial recanalization, with muscle fat and plain catgut; and no recanalization at all with fat, barium sulfate and Ivalon.
Percutaneous venography of the internal spermatic vein was performed for the localization of unpalpable testicles in 5 patients varying from 4 to 45 years of age. The catheterization of the vein on the left side was successful in all 5 cases; and the testicle was localized and verified by surgery in all but one case in which a competent valve prevented the retrograde filling of the whole length of the vein down to the testicle. In the two patients with bilateral undescended testicles the right internal vein could not be identified in one patient, and in the other patient a semiselective injection was done into that vein which appeared to represent the spermatic vein, but the examination was not conclusive.
Carcinoma of the prostate, above all when accompanied by bone metastases, may be associated with a disseminated intravascular coagulation syndrome. The problem was to determine whether even in the absence of metastases the coagulation state of prostatic carcinoma patients predisposes them to disseminated intravascular coagulation. The authors compared coagulation equilibrium in 13 patients with a prostatic adenoma and 21 with carcinoma of the prostate free of metastases or infection. Fibrin breakdown product levels were abnormally high in 85.7 % of the carcinoma patients (as against 46.2 % of the adenoma sufferers). Clotting factor XIII was decreased in 70 % of carcinoma patients (as against 48.5 % of those with an adenoma). One prostatic carcinoma patient in four shows evidence of latent intravascular coagulation even in the absence of bone metastases. This prevalence justifies thorough coagulation studies in all patients with carcinoma of the prostate.
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