Adherence to an intensive antihypertensive follow-up programme.
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Adult↗
Biomedical subjects
P Papadopoulou
Publications and source records attributed to P Papadopoulou.
Oestrogen action on bone cells.
Sex steroids have an important impact on bone physiology. Oestrogen (E) appears to be the most important sex steroid in preventing osteoporosis in women. Despite the overwhelming evidence that oestrogens modulate bone growth and turnover in vivo, oestrogen receptors (ER) were detected only recently. Two forms of ER have been discovered so far, ERalpha and ERbeta. Both have been detected in osteoblasts and osteoclasts as well. A number of growth factors and cytokines appear to modulate bone resorption in vitro and in vivo. Among others, interleukin-1 and -6 and tumor necrosis factor alpha and beta were found to be extremely potent stimulators of bone resorption. Binding of different cytokines to their receptors in osteoblasts result in the release of soluble factors that act directly on osteoclasts to modulate their recruitment or activity. Thus, E, apart from the direct regulation of osteoclasts, which it achieves through its receptors, can inhibit the release of osteoclast stimulatory factors or enhance the release of osteoclast inhibitory factors. In general, E is an inhibitor of bone resorption that decreases both osteoclast numbers and activity. Recently, it has also been shown that it promotes apoptosis. Moreover, it also has anabolic effects on osteoblasts. However, E action on osteoclasts is superior in comparison with that on osteoblasts. Recent data have shown that transforming growth factor beta (TGFbeta) mediates the actions of E in bone. Following the example of raloxifene it may be proved that the role of TGFbeta in the actions of E in bone is central and has not only academic interest. More data are needed to elucidate this issue. Finally, recent data suggest the importance of E for bone maturation and development of peak bone mass in men. It seems likely that both E and androgens are required for the growth and maintenance of the adult male skeleton.
Journal Article↗
Disturbances of menstruation in hypothyroidism.
OBJECTIVES: Most thyroid textbooks describe hypothyroidism resulting in changes in the length of the menstrual cycle and in the amount of bleeding. Our experience at a busy thyroid clinic had given a picture which differs from that presented in the literature. The aim of this study was to determine the frequency and type of menstrual irregularities in premenopausal hypothyroid patients. DESIGN AND PATIENTS: We investigated the menstrual history, starting 6 months before the discovery of the disease, in 171 female premenopausal hypothyroid patients and 214 normal controls, with similar age and body mass index (BMI). MEASUREMENTS: TSH, TT4, TT3 and thyroid antibodies were measured by radioimmunoassay, while BMI was calculated from the ratio of body weight in kg to height in m2. RESULTS: Of the 171 hypothyroid patients, 131 (76.6%) had regular cycles and 40 (23.4%) irregular periods. Oligomenorrhoea and menorrhagia were the most common features in the latter group. No difference in BMI was found between the patients with or without menstrual abnormalities, or between patients and controls. TSH, TT4 and TT3 levels did not differ between patients with normal and abnormal menstruation. Forty-six (26.9%) out of 171 patients had subclinical hypothyroidism (group A), 42 (24.6%) mild hypothyroidism (group B) and 83 (48.5%) severe hypothyroidism (group C). Thirty-seven from group A (80.4%), 32 from group B (76.2%) and 62 from group C (74.7%) had normal periods. These differences were not statistically significant. Eighty-eight (88.9%) out of 99 patients in whom thyroid antibodies were measured had positive titres. Nineteen (21.6%) of the patients with positive thyroid antibodies had menstrual irregularities. This percentage did not differ from that found in the whole group of patients (23.4%). Out of 214 normal controls, 196 (91.6%) had normal menstruation and 19 (8.4%) irregular cycles. The latter group included mainly women with oligomenorrhoea. CONCLUSIONS: These data demonstrate that hypothyroidism in women is less frequently associated with menstrual disturbance than was previously described. Also, menstrual irregularities tend to be more frequent in sever hypothyroidism in comparison with mild cases, although this finding was not statistically significant. Oligomenorrhoea and menorrhagia are the most common menstrual disturbances.
Adult↗
Gastrointestinal leiomyosarcomas: experience of 14 cases and review of published reports.
OBJECTIVE: To present our experience of leiomyosarcoma of the gastrointestinal tract during a 10 year period and review similar publications. DESIGN: Retrospective study. SETTING: Teaching hospital, Greece. SUBJECTS: 14 patients who were treated for leiomyosarcoma between 1983 and 1993. INTERVENTIONS: Tumours were diagnosed by endoscopy, computed tomography, and contrast examination. All patients were treated by resection and no adjuvant treatment was given. MAIN OUTCOME MEASURES: Morbidity, mortality, and outcome. RESULTS: The diagnosis was made preoperatively in 10/14 patients: 4 of the tumours were locally advanced at the time of laparotomy, and two had liver metastases. Resection was potentially curative (all macroscopic tumour removed) in 12 patients (86%). Three patients died of recurrent disease at 5, 8 and 63 months, respectively. The mean follow up in the 11 survivors was 44 months (range 24-83). CONCLUSION: Resection is the treatment of choice for these tumours. A multicentre trial would be required to assess the effect of adjuvant chemotherapy.
Adult↗
Molecular and Supramolecular Architecture of the Salmo gairdneri Proteinaceous Eggshell during Development
A detailed developmental study of eggshell architecture of the fish Salmo gairdneri (rainbow trout) was performed using transmission and scanning electron microscopy. Thioglycollic acid treatment and freeze-fracturing reveal that fibrils ca. 5-10 nm in diameter constitute each lamella of the helicoidal eggshell. Freeze-fracturing also permits a direct visualization of the helicoidal architecture. Laser-Raman studies of the eggshell indicate abundant antiparallel beta-pleated-sheet conformation in the eggshell proteins of S. gairdneri during all developmental stages. Apparently, this conformation dictates formation of the helicoidal structure. Disulfide bonds, together with isopeptide bonds, cross-link S. gairdneri eggshell proteins throughout development.
Journal Article↗
Menstrual disturbances in thyrotoxicosis.
OBJECTIVES: In thyroid textbooks it is stated that hyperthyroidism in women may be associated in almost 50% of the cases with hypomenorrhoea, oligomenorrhoea or amenorrhoea and perhaps with reduced fertility. Our experience at a busy thyroid clinic has given a picture which differs from that described in the literature. Most of our female thyrotoxic patients had normal menstruation. This study was performed to define the menstrual abnormalities in hyperthyroidism. DESIGN AND PATIENTS: We investigated the menstrual history, starting 6 months before the discovery of the disease, the smoking habits and the body mass index (BMI), in 214 female, premenopausal thyrotoxic patients and a similar number of normal controls matched for age and weight. MEASUREMENTS: TT4 and TT3 were measured by radioimmunoassay, while BMI was calculated from the ratio of body weight in kg to height in m2. RESULTS: Of the 214 patients, 168 (78.5%) had regular menstrual cycles and 46 (21.5%) irregular cycles. No difference in BMI was found between the patients with or without menstrual abnormalities. Out of the 46 patients with irregular periods, 23 (50%) were smokers, while only 32 out of the 168 patients (19%) with normal periods were smokers (P < 0.001). TT4 levels were higher as a group in patients with menstrual disturbances (mean +/- SD 267.7 +/- 66.9 nmol/l) than in those with normal periods (240.6 +/- 47.6 nmol/l) (P < 0.05). The 23 smokers with irregular periods had higher TT4 levels (280.5 +/- 51.8 nmol/l) than the remaining non-smokers from the same group (241.9 +/- 43.7 nmol/l) (P < 0.01). No such differences were found for TT3 levels. Out of 214 normal controls, matched for age and weight, 196 (91.6%) had normal menstruation and 18 (8.4%) irregular cycles. The latter group included mainly women with oligomenorrhoea. Out of 18 normal controls with irregular periods, 6 (33.3%) were smokers, while 57 (29.1%) out of 196 with normal periods were smokers. CONCLUSIONS: These data demonstrate that hyperthyroidism in women is less frequently associated with menstrual abnormalities than was previously believed. Furthermore, no patient presented with amenorrhoea. Smoking and TT4 levels are strongly associated with the occurrence of menstrual disturbances in thyrotoxicosis.
Adult↗
[Otorhinolaryngologic aspects of Adamadiades-Behçet syndrome].
Behçet's syndrome is a rare, progressive and systemic disease. It causes scrotal ulcers, bilateral conjunctivitis and recurrent oral aphthous ulcers. Genetic factors, mechanisms of autoimmunity as well as environmental factors interact in the etiology of the syndrome, according to the most recently developed hypotheses. The diagnostic and therapeutic traps which might appear during the contemporary O.R.L. practice are presented here, considering the oral ulcers of a frequently common appearance and especially the dysphagia which might be confused with many other clinicopathological entities.
Adolescent↗
Intestinal obstruction due to sand in a dog.
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Animals↗
Pancreatic head carcinoma: is pancreatic resection indicated for patients with stage III pancreatic duct cancer?.
BACKGROUND/AIMS: This paper examines factors influencing the outcome of patients suffering from unresectable pancreatic carcinoma. MATERIALS AND METHODS: One hundred forty-three patients with pancreatic carcinoma were placed into three groups. Group A (n = 56) received pancreatic resection. Group B (n = 30) included patients deemed ineligible for pancreatic resection. Group C (n = 57) was made up of patients deemed ineligible for pancreatic resection who received combined locoregional immuno-chemotherapy. RESULTS: Twenty-two patients (36%) from Group A are still living. Average survival is 18.6 months. Survival was dependent on the stage of the disease, the site of origin, and the type of resection. All Group B patients are dead with an average survival of 4.5 months and poor quality of life. Thirty-two patients (56%) from Group C are alive. Average survival is 21 months and they have a much greater quality of life index compared to Group A or B. CONCLUSION: Based on the above results, we believe that for patients with Stage III Pancreatic Duct Carcinoma, pancreatic resection should not be the initial treatment option. These patients should be treated first with Locoregional Combined Immunochemotherapy. Then depending upon their response, should be assigned to a subsequent pancreatic resection.
Adult↗
Combined immunopharmaceutical therapy of patients with unresectable pancreatic carcinoma.
BACKGROUND/AIMS: This paper presents the results of a prospective randomized study of targeting locoregional chemotherapy and targeting locoregional immunostimulation therapy implemented in 36, out of 66, patients with a histological diagnosis of pancreatic duct carcinoma seen by our group from 1991 to Sept. 1994. METHOD AND MATERIALS: Sixty-six patients with unresectable pancreatic duct carcinoma were separated into two groups. The first group received laparotomy (n = 30), with palliative gastric bypass (n = 8) or with palliative biliary bypass (n = 18). The second group received laparotomy (n = 36), with palliative gastric bypass (n = 9) or with palliative biliary bypass (n = 20), supplemented with locoregional immunostimulation and locoregional chemotherapy. This therapy consisted of ten days of infusion with Proleukin (IL2) and Imukin (gamma-IFN), emulsified in Lipidiol-Urographin. This infusion was performed five days trans-splenically and five days trans-tumorally. Fifteen days later, targeting locoregional chemotherapy was administered, again emulsified in Lipidiol-Urographin. RESULTS: All the patients in the first group are dead, with a mean survival of 4.5 months, as of November 1995. Presently, 47% (n = 17) of the second group have achieved a positive objective response, with a mean survival of 14.1 months. During re-exploration, eight patients became tumor free after pancreatic resection, which became feasible after our therapy and six are alive and have remained tumor free to date. CONCLUSION: Targeting locoregional immunotherapy, combined with locoregional chemotherapy appears to be a promising therapy, meriting further consideration for clinical application in patients with unresectable pancreatic ductal carcinoma.
Antineoplastic Combined Chemotherapy Protocols↗