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Biomedical subjects

G Papadopoulos

Publications and source records attributed to G Papadopoulos.

At least 19 recordsLinked to original sources

Changes in the level of poly(Phe) synthesis in Escherichia coli ribosomes containing mutants of L4 ribosomal protein from Thermus thermophilus can be explained by structural changes in the peptidyltransferase center: a molecular dynamics simulation analysis.

Data from polyphenylalanine [poly(Phe)] synthesis determination in the presence and in the absence of erythromycin have been used in conjunction with Molecular Dynamics Simulation analysis, in order to localize the functional sites affected by mutations of Thermus thermophilus ribosomal protein L4 incorporated in Escherichia coli ribosomes. We observed that alterations in ribosome capability to synthesize poly(Phe) in the absence of erythromycin were mainly correlated to shifts of A2062 and C2612 of 23S rRNA, while in the presence of erythromycin they were correlated to shifts of A2060 and U2584 of 23S rRNA. Our results suggest a means of understanding the role of the extended loop of L4 ribosomal protein in ribosomal peptidyltransferase center.

Amino Acid Sequence↗

Expression of the glucocorticoid receptor in the human adrenal cortex.

Glucocorticoids produced in the adrenal cortex act by binding to a specific intracellular protein, the glucocorticoid receptor (GR), which then modulates gene transcription in target tissues. Whether the adrenal cortex itself is a glucocorticoid target tissue has not been analyzed as yet. Since the presence of GR would be a prerequisite for such "intracortical" glucocorticoid action, this study was designed to analyze GR expression in the normal human adrenal gland using RT-PCR, Western blot, and immunohistochemistry. RT-PCR revealed the presence of GR mRNA in adrenal cortex as well as in NCIh295 cells. These results were confirmed at the protein level by Western blot employing a specific anti-human GR antibody. Immunohistochemically, weak GR staining was observed in the adrenal medulla. In contrast, GR was strongly expressed in the adrenal cortex with the zona reticularis showing the most intense staining. Transfection of a GR-responsive luciferase reporter gene into NCIh295 cells resulted in dexamethasone-dependent induction of luciferase activity, indicating that GR is functional in this tissue. In this study, we show for the first time that GR is expressed in the human adrenal cortex. Its preferential expression in the zona reticularis may indicate a functional role in the regulation of adrenal androgen biosynthesis.

Adrenal Cortex↗

Cost-effectiveness of migraine prevention: the case of topiramate in the UK.

The aim of this study was to assess the cost-effectiveness of topiramate vs. no preventive treatment in the UK. Model inputs included baseline migraine frequency, treatment discontinuation and response, preventive and acute medical cost per attack [2005 GBP ( pound)] and gain in health utility. Outcomes included monthly migraines averted, acute and preventive treatment costs and cost per quality-adjusted life year (QALY). Topiramate was associated with 1.8 fewer monthly migraines and a QALY gain of 0.0384. The incremental cost of topiramate vs. no preventive treatment was about 10 UK pounds per migraine averted and 5700 UK pounds per QALY. Results are sensitive to baseline monthly migraine frequency, triptan use rate and the gain in utility. Incorporating savings from reduced work loss (about 36 UK pounds per month) suggests that topiramate would be cost saving compared with no preventive treatment. This analysis suggests that topiramate is a cost-effective treatment for migraine prevention compared with no preventive treatment.

Adult↗

Two cases of dysuria as a complication of single-session bilateral triple pelvic osteotomy.

Dysuria is a rare, but nevertheless severe postoperative complication associated with single-session bilateral triple pelvic osteotomy. Two cases are described in which contrast radiography of the lower urinary tract was used to diagnose urethral compression due to pelvic canal narrowing. Relief of the pressure on the urethra was achieved with an external fixation device, which distracted the acetabular fragments of the pelvis. In both cases the dysuria was resolved. The significance of this complication and its possible causes, especially regarding surgical technique, are discussed.

Animals↗

Comparison of the blood redox status between long-distance and short-distance runners.

Exercise increases the production of reactive oxygen species, which may damage a number of cell constituents. Organisms have developed a sophisticated antioxidant system for protection against reactive oxygen species. Our aim was to compare the adaptive responses of antioxidant mechanisms and the blood redox status of two groups of athletes, long-distance and short-distance runners. Thiobarbituric acid reactive substances, catalase activity and total antioxidant capacity was measured in the serum, while reduced and oxidized glutathione as well as their ratio were determined in blood hemolysates. Serum catalase activity (P<0.001) was found to be three times higher in long-distance compared to short-distance runners (25.4 vs. 8.9 micromol x min(-3) x ml(-1)), whereas the two groups did not differ in the other markers. Catalase activity also correlated significantly with maximal oxygen consumption in long-distance runners. In conclusion, we report here that long-distance and short-distance runners exhibit similar blood redox status judged by several oxidative stress indices, except for the much higher activity of catalase in long-distance runners. This different effect of the two training modules on catalase activity of long-distance runners might be partly due to the high oxygen load imposed during their repeated prolonged exercise bouts.

Adaptation, Physiological↗

Successful cardiac and cerebral resuscitation with extracorporeal circulation and mild hypothermia.

Extracorporeal circulation could be effective for cardiac resuscitation in patients who do not respond to ''Advanced cardiac life support'' (ACLS), but cannot guarantee brain survival. A case of successful cardiac and cerebral resuscitation with extracorporeal circulation and mild hypothermia, in a 48 year-old man with cardiac arrest due to cardiac tamponade, is reported. The good long term neurologic outcome of the patient is also described.

Cardiopulmonary Resuscitation↗

Collagen type IX and HNK-1 epitope in tears of patients with pseudoexfoliation syndrome.

Pseudoexfoliation syndrome (PEX) is an age-related condition, which may cause open-angle glaucoma and has increasing interest since it seems to affect additional human tissues, i.e., cardiovascular tissue, skin, and still lacks elucidated pathogenesis. Collagen type IX and HNK-1 epitope have been considered characteristic constituents of the aqueous humour of PEX patients, since their amounts were increased in PEX aqueous humour compared to normal eyes. Since it has been proposed that the initial manifestations of PEX syndrome occur in conjunctiva, the present study was undertaken to investigate the presence of the same antigens in tears of PEX patients and their possible use as the biochemical markers for early diagnosis. Tears of PEX patients and healthy individuals were subjected to western blotting analysis for various basement membrane components identified in aqueous humour. It was found that collagen type IX and HNK-1 epitope were present in tears, the amount of the former being increased 2.7 times compared to normal (P<0.05), surprisingly high as compared with total protein or lysozyme activity in tears, which were found to be increased in PEX patients about 25% with no statistical differences (P approximately 0.4). The results suggest the possible use of tears' collagen type IX for the diagnosis of PEX syndrome.

Aged↗

Diagnostic correlation of CT-MRI and histopathology in 10 dogs with brain neoplasms.

Ten dogs with primary (n = 8) and metastatic (n = 2) brain tumours were studied in an attempt to evaluate the diagnostic sensitivity of computed tomography (CT) or magnetic resonance imaging (MRI). Of the clinical signs noticed, seizures (seven of 10), behavioural abnormalities and cognition dysfunction (seven of 10), compulsive walking and circling (six of 10), sensorimotor (five of 10) and neuro-opthalmological (two of 10) dysfunction were the most common. In all 10 animals that finally died of the disease or were killed, the histopathological diagnosis that followed necropsy was taken as a golden standard in the CT or MRI prediction of the histological type of brain neoplasms. In every instance, tumour detection, morphology and histological differentiation were possible with the aid of either CT (seven of 10) or MRI (three of 10) imaging especially after contrast enhancement. Only one CT-evaluated dog, diagnosed as meningioma, was found to be astrocytoma on histopathology. Interestingly, a rare case of cerebellar medulloblastoma was correctly identified in MRI scans.

Animals↗

"Learning curves" of cardiac surgery in relation to risk stratification and hospital location.

AIM: The purpose of this study was to determine any significant differences in "learning curves" between private and public hospitals when the same senior surgeon was responsible during the initial phases of open-heart surgery programs development, in relation to risk stratification and hospital location. METHODS: A prospective review of 610 patients records was performed at a newly-opened cardiothoracic program in a public University Hospital (PUH) in the periphery of Greece, and a private institution (PI) with an experienced intensive care unit (ICU) in the capital city of Athens. Preoperative risk stratification, mortality and postoperative length of stay (LOS) were analysed between 1999 to 2001. RESULTS: At PUH 298 patients were operated and 312 patients at PI. There were 136 low risk (EuroSCORE 0-2) and 474 medium and high-risk patients (EuroSCORE > or =3). There was no significantly elevated mortality or learning curve in low risk surgery either at PUH (57 patients with 1 death) or PI (79 patients and 1 death). In medium and high-risk surgery at PI there was no mortality in 68 patients operated by the senior surgeon and no learning curve in all 233 such patients. In 240 medium and high-risk patients at PUH there was a learning curve despite the involvement of the same senior surgeon. In 1999 and 2000 the observed mortality (OM) in 150 patients was 15.33%, EuroSCORE 5.98, and in 2001 in 91 patients OM 3.29%, EuroSCORE 5.95 with p=0.00.8 when "experienced" ICU staff was employed. LOS was significantly reduced in 97 patients in 2001 at PUH (8.7 d +/- 2.81 vs 11.07 days +/- 7.9 in 1999 and 2000, p=0.046) confirming the existence of a learning curve at the PUH. No such change was observed at PI (8.2 days vs 7.8, p=0.45). CONCLUSION: No mortality differences or learning curve characteristics were detected for low risk operations either at PUH or PI. For medium and high risk surgery there appears to be a learning curve in PUH but not in PI despite senior surgeon involvement in both. The presence of an experienced ICU appears to play a critical role in the outcome of operations in newly opened cardiothoracic programs.

Analysis of Variance↗

Measuring Alzheimer's disease progression with transition probabilities: estimates from CERAD.

OBJECTIVES: To estimate annual transition probabilities (i.e., the likelihood that a patient will move from one disease stage to another in a given time period) for AD progression. Transition probabilities are estimated by disease stages (mild, moderate, severe) and settings of care (community, nursing home), accounting for differences in age, gender, and behavioral symptoms as well as the length of time a patient has been in a disease stage. METHODS: Using data from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the authors employed a modified survival analysis to estimate stage-to-stage and stage-to-nursing home transition probabilities. To account for individual variability, a Cox proportional hazards model was fit to the CERAD data to estimate hazard ratios for gender, age (50 to 64, 65 to 74, and more than 75 years), and level of behavioral symptoms (low/high, according to responses to the Behavioral Rating Scale for Dementia) for each of the key stage-to-stage and stage-to-nursing home transitions. RESULTS: The transition probabilities underscore the rapid progression of patients into more severe disease stages and into nursing homes and the differences among population subgroups. In general, male gender, age under 65, and high level of behavioral symptoms were associated with higher transition probabilities to more severe disease stages. Disease progression is roughly constant as a function of the time a patient has spent in a particular stage. CONCLUSIONS: Transition probabilities provide a useful means of characterizing AD progression. Economic models of interventions for AD should consider the varied course of progression for different population subgroups, particularly those defined by high levels of behavioral symptoms.

Aged↗

Childhood acute rheumatic fever in Greece: experience of the past 18 years.

UNLABELLED: This study reports on the authors' experience with acute rheumatic fever (ARF) during the years 1980-1997. The objectives were to estimate the incidence of the disease an area of Greece to characterize its epidemiology, to determine the frequency of the antecedent symptoms and to describe its clinical presentation. The medical records of 66 confirmed cases admitted to the First Department of Pediatrics, "Aghia Sophia" Children's Hospital, were reviewed. Two outbreaks occurred during this period. In contrast to the 3-4 cases seen every year, 14 cases were diagnosed during the 6 mo period from October 1989 to March 1990. An additional 10 cases were diagnosed in 1993. Most of the children (76%) were between 8 and 14 y old. The children were predominantly from middle-class families with ready access to medical care. Carditis, evident by auscultation, and arthritis were the dominant major manifestations in 70% and 68% of the cases, respectively. Mild carditis was present in 54% of children with valvular disease. CONCLUSION: ARF exists in the paediatric Greek population with exacerbations and remissions, but the cardiac manifestations appear mild or moderate.

Adolescent↗

[A voluminous vascular leiomyoma of the pancreas treated by personal technique of resection of the pancreatic head without duodenectomy].

A new technique variation of complete resection of the pancreatic head with preservation of the duodenum is described. The steps of this intervention are the partial mobilization of the duodenum, the mobilization of the gastric antrum, the section of the pancreatic neck and the complete resection of the pancreatic head with a meticulous dissection/section of the small blood vessels connecting the duodenum and the head of the pancreas. The terminal part of choledochus is removed with the specimen of the pancreas. The intervention is completed with cholecystectomy, end-to-side pancreaticojejunostomy, end-to-side choledocho-jejunostomy and side-to-side jejunojejunal anastomosis. The authors carried out this intervention on a 74-year old woman with a voluminous vascular leiomyoma of the pancreatic head. The patient, two years after the operation, is well with a normal clinical and laboratory follow-up.

Aged↗

Alterations in carbon dioxide release during abdominal aortic clamping for aneurysmal or occlusive repair.

BACKGROUND: Application and removal of an infrarenal aortic clamp is associated with changes in oxygen consumption, especially when collateral perfusion is limited. Carbon dioxide production during abdominal aortic clamping is expected also to change. The aim of this study was to evaluate the alterations of CO2 release during abdominal aortic surgery. METHODS DESIGN: prospective study. SETTING: University Hospital, Greece. PATIENTS: 17 patients undergoing abdominal aortic aneurismal (AAA) repair and 8 patients undergoing repair of aortoiliac occlusive disease. INTERVENTION: intraoperative record or calculation of PaCO2, PetCO2, PECO2, VD, VDalv, and VCO2. Patients with aneurysms were randomly divided to have constant ventilation (group AA) or modified ventilation to preserve normocapnia (group AB) during clamping. Ventilation was kept constant in the occlusive patients group (group OD). RESULTS: Patients with AAA showed a significant decrease of VCO2 during clamping and an elevation after unclamping in both groups (AA and AB), with no difference of statistical importance between them. During clamping, PetCO2/ PaCO2 ratio was decreased and VDalv was increased especially in group AA, while unclamping produced the opposite effect. Occlusive patients showed insignificant alterations. CONCLUSIONS: Our results suggest that, the calculated alveolar dead space is only an indicator of the true V/Q in patients with AAA, because it is strongly dependent on the CO2 load to the lungs, which is markedly altered in the same period. The modification of ventilation during clamping based only on PetCO2 and not on arterial sampling, could possibly lead to hypercarbia in these patients.

Aged↗

Distribution and synaptology of vasoactive intestinal polypeptide (VIP) immunoreactive structures in the rat periaqueductal grey.

Light microscopic analysis of the rat midbrain periaqueductal grey (PAG) showed vasoactive intestinal polypeptide immunoreactive (VIP-ir) neurons localized at the lateral and ventral walls of the aqueduct. Some varicose VIP-ir elements were detected closely associated with the ependyma. While several VIP-ir elements were encountered immediately under the ependyma, in a few cases, VIP-ir cell bodies were seen on the luminal surface of the ependymal cells lining the aqueduct. Electron microscopy revealed that most of these cells possessed the characteristics of a local circuit neuron. All VIP-ir cells had indented nuclei. Two types were distinguished: one with rounded cell body receiving numerous axo-somatic synapses established by VIP-negative axons. The other cell type was fusiform and its surface was almost fully isolated from axonal contacts by a glial sheath. The VIP-ir processes were interconnected with other periaqueductal cells by a variety of synaptic contacts. VIP-ir axon terminals formed asymmetric synapses with immunonegative dendritic shafts often in glomerulus-like assemblies. The postsynaptic immunonegative dendrites were of the aspinous, beaded type. We suggest that VIP-ir cells and processes in the midbrain PAG establish connections between the longitudinal functional columns of this region. On the basis of their morphology, VIP-ir cells in the PAG appear to be excitatory, terminating on inhibitory interneurons. Thus, a VIP-stimulated inhibition may be instrumental in the coordination of responses evoked by the stimulation of PAG columns.

Animals↗

Continuous monitoring of arterial blood gases and pH during intraoperative rapid blood administration using a Paratrend sensor.

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the effects of rapid transfusion of packed red cells on the arterial blood gases and acid-base status of the recipient. MATERIALS AND METHODS: We studied 16 patients (mean age 66.3+/-9.9 years) who received rapid transfusion of 632.8+/-287.2 g of packed red cells in CPDA-1, stored before use for a period of 15.2+/-4.4 days. During transfusion, monitoring of pH, PCO2 and PO2 was continuous using an intra-arterial multiparameter sensor (Paratrend 7, Biomedical Sensors, UK). RESULTS: The rate of the transfusion was 73.1+/-9.6 g/min and the duration of observation was 35.8+/-12.8 min. Arterial pH decreased from 7.446+/-0.023 to 7.385+/-0.034 (p<0.001) and PCO2 increased from 32.31+/-1.35 to 36.41+/-1.86 mmHg (p<0.001). Delta pH and delta PCO2 showed significant correlation to the weight and the age of the transfused blood (p<0.001 for both dependent variables). The rate of pH change was positively but insignificantly correlated to the rate of the transfusion. Base excess was significantly decreased and end-tidal CO2 (PetCO2) was increased from 25.8+/-2.0 to 28.1+/-2.3 mmHg (p<0.05), significantly correlating to the amount and age of the administered component (p<0.05). PetCO2 was not elevated when PCO2 changes were minimal. Alterations in PO2 were not specific and our clinical impression was that they were related to unmeasured parameters. CONCLUSION: Our findings suggest that the fall in pH and the elevation in PCO2 which occur during rapid transfusion of packed red cells may go undetected or be misinterpreted if the acid-base status of the recipient is not monitored continuously. These alterations are mainly of metabolic character and depend on the amount and age of the transfused component. Our data suggest that arterial sampling is essential during massive transfusions.

Aged↗