Biomedical subjects

S Giannakopoulos

Publications and source records attributed to S Giannakopoulos.

12 recordsLinked to original sources

PubMed2007

Semen and the diagnosis of infertility in Aristotle.

Aristotle (384-322bc) was one of the leading intellectual figures of all time. In his work he systematised a massive amount of knowledge on a diverse range of subjects, including medicine. This article discusses the observations and hypotheses of this great philosopher on semen and infertility, as they are presented in his work Generation of Animals. This is combined with an evaluation of his positions in relation to those of the Hippocratic Corpus on the same subject. An extensive review of Aristotle's work Generation of Animals was performed with particular focus on his perspectives about semen and infertility. Publications referring to this work were also reviewed. According to Aristotle, semen is that which contains the principles that come from both parents when they unite. He believed that semen was formed by the secretion of nutriments by the body, developing his theories of sterility on this basic principle. A lack of fertility is attributed to genetic or acquired causes. He proposed methods for diagnosing sterility, primarily the 'water test' for men and the 'pessary' method for women. Even if his observations contain clear mistakes, such as attributing only secondary functions to male testicles and the identification of menses as women's 'seed', Aristotle's views also contain keen observations and exceptional thinking, both on the characteristics of semen and the causes of sterility (infertility).

Female↗

PubMed2006

Urological management of indinavir-associated acute renal failure in HIV-positive patients.

INTRODUCTION: Indinavir, a protease inhibitor that is commonly used to treat HIV infection, may cause crystal formation within the renal tubules when urine pH is above 3.5. Crystallization in the urine may lead to intrarenal crystal deposition and acute renal failure (ARF). AIM: To establish the beneficial urological management of acute renal failure caused by indinavir treatment of HIV/AIDS patients. PATIENTS--METHODS: Five HIV positive patients (four men, one woman) with a mean age of 32 years (range 28-36 years) were referred to our Department of Urology from an AIDS outpatient Clinic, because of the development of postrenal acute renal failure with continuously elevated creatinine and urea plasma levels after indinavir therapy. Among the initial therapeutic maneuvers, indinavir administration was interrupted for 1 week while bilateral double-J ureteral stents were inserted in all the HIV/AIDS patients, during the first 24-72 h to secure upper-tract drainage. Concurrently urine has been acidified by oral administration of the amino acid L: -methionine and oral fluid intake was increased. RESULTS: All the patients responded well to the treatment and their renal function was effortlessly restored to normal within a few days. CONCLUSION: HIV-positive patients receiving indinavir therapy might be complicated by acute renal failure, mainly due to intrarenal crystal deposition (tubules) or urolithiasis (postrenal obstruction). This adverse effect may simply manage by the discontinuation of indinavir administration, urine acidification, as well as the possible early insertion of bilateral double-J ureteral stents.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Tension-free vaginal tape for the treatment of stress urinary incontinence in geriatric patients.

OBJECTIVE: To evaluate the safety and efficacy of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in geriatric patients. PATIENTS AND METHODS: Fifty-one women, aged 65-80 (mean 72.3) years, underwent a TVT procedure for genuine SUI from 2001 to 2004. A urodynamic test together with uroflowmetry were performed. The patients' SUI bother score was assessed using a visual analog scale (VAS). RESULTS: The mean operative time was 25 (range 14-29) min and mean hospitalization time was 1.2 (range 1-2) days. Bladder perforation occurred in 3 cases (5.8%) and was managed conservatively. Pre- and postoperative maximum flow rate were not significantly different (p > 0.05). The patients' SUI bother score estimated by the VAS was statistically significantly improved (p < 0.0001). After a mean follow-up of 35.6 (range 14-60) months, 49 patients (96%) had no SUI, while 2 patients (3.9%) had persistent SUI. Also, during the follow-up 5 patients (9.8%) were diagnosed with de novo urgency due to detrusor overactivity and 1 patient (1.9%) had persistent dysuria that was resolved with urethrolysis. CONCLUSIONS: SUI in elderly women can be safely treated with the TVT procedure in the vast majority of the patients. However, bladder perforation during surgery and de novo urgency postoperatively should be taken into account.

Aged↗

PubMed2001

Hepatitis B virus HBx protein activation of cyclin A-cyclin-dependent kinase 2 complexes and G1 transit via a Src kinase pathway.

Numerous studies have demonstrated that the hepatitis B virus HBx protein stimulates signal transduction pathways and may bind to certain transcription factors, particularly the cyclic AMP response element binding protein, CREB. HBx has also been shown to promote early cell cycle progression, possibly by functionally replacing the TATA-binding protein-associated factor 250 (TAF(II)250), a transcriptional coactivator, and/or by stimulating cytoplasmic signal transduction pathways. To understand the basis for early cell cycle progression mediated by HBx, we characterized the molecular mechanism by which HBx promotes deregulation of the G0 and G1 cell cycle checkpoints in growth-arrested cells. We demonstrate that TAF(II)250 is absolutely required for HBx activation of the cyclin A promoter and for promotion of early cell cycle transit from G0 through G1. Thus, HBx does not functionally replace TAF(II)250 for transcriptional activity or for cell cycle progression, in contrast to a previous report. Instead, HBx is shown to activate the cyclin A promoter, induce cyclin A-cyclin-dependent kinase 2 complexes, and promote cycling of growth-arrested cells into G1 through a pathway involving activation of Src tyrosine kinases. HBx stimulation of Src kinases and cyclin gene expression was found to force growth-arrested cells to transit through G1 but to stall at the junction with S phase, which may be important for viral replication.

CDC2-CDC28 Kinases↗

PubMed2001

Encrusted cystitis and pyelitis.

Encrusted cystitis (EC) and encrusted pyelitis (EP) are rare chronic inflammatory diseases of the bladder and renal pelvis, respectively, and are characterized by mucosal inflammation with deposits of ammonium magnesium phosphate on the urothelium. Corynebacterium urealyticum is the pathogen responsible in the vast majority of cases. We report 4 cases of EC and 1 case of EP. In 1 case of EC Ureaplasma urealyticum was isolated as the microorganism responsible. To the best of our knowledge, U. urealyticum-induced EC has never been reported previously.

Adult↗

PubMed1999

Influence of preoperative vesicle biopsy on the decision for radical prostatectomy.

PURPOSE: The presence of seminal vesicle invasion (SVI) by prostate cancer is difficult to detect clinically and is associated with poor prognosis. The aim of our study was to identify the efficacy of transrectal ultrasound-guided seminal vesicle biopsies in the detection of seminal vesicle invasion (SVI) in patients with prostate cancer. MATERIALS AND METHODS: One hundred transrectal ultrasound-guided seminal vesicle biopsies were performed in 50 patients with clinically localized prostate cancer. Every patient underwent two biopsies, one for each seminal vesicle. Radical retropubic prostatectomy was performed in all cases and the specimens with the attached seminal vesicles were examined for the presence of prostate cancer invasion. RESULTS: Of a total of 100 seminal vesical biopsies 87 were identified as seminal vesicle by characteristic epithelium. Cancer was found in 7 (8%) biopsies, confirmed in all cases by pathology in the surgical specimen. Eighty biopsies (40 patients) were normal. Pathological analysis of these 40 radical prostatectomy specimens revealed that 6 seminal vesicles (5 patients) were invaded by prostate cancer (6 false negative biopsies, 7.5%). Transrectal ultrasound images of 15 seminal vesicles were suspicious for invasion while 85 were normal. Of the 15 suspicious cases 11 were invaded by cancer (73.3%). Of the sonographically benign seminal vesicles 5 (5.88%) were invaded by cancer. Our data were analyzed by the ARCUS PRO-STAT statistical package. CONCLUSIONS: We suggest that transrectal ultrasound-guided seminal vesicle biopsy is useful and reliable for a more exact preoperative staging of prostate cancer, therefore helpful in correct decision making for radical prostatectomy.

Aged↗

PubMed1998

Malakoplakia of the testis. Case report.

Malakoplakia of the testis presenting as painless enlargement of the testis in an 80-year-old man is described. The literature is reviewed.

Aged↗

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

Efficacy of escalating doses of intravesical interferon alpha-2b in reducing recurrence rate and progression in superficial transitional cell carcinoma.

OBJECTIVE: To compare the efficacy of three different doses of intravesical interferon alpha-2b (IFN alpha-2b) in reducing recurrence and progression rates in superficial grade II, transitional cell carcinoma (TCC). PATIENTS AND METHODS: Eighty-nine patients with primary or recurrent TCC stage Ta/T1, grade II, were randomly allocated into four groups after transurethral resection (TUR) of the tumour. Group A (20 patients) received no further treatment, serving as the control group; group B (22 patients) received 40 MU of IFN alpha-2b, group C (24 patients) 60 MU and group D (23 patients) 80 MU. The instillations started within 48-72 h after TUR and were performed weekly for 2 months, bimonthly for the next 4 months and thereafter monthly for 6 months. The patients were followed for 36 months. The four groups were compared for the number of recurrences (simple recurrence rate), progression in stage, disease-free interval and recurrence rate per 100 patient-months. RESULTS: During the follow-up, 33 patients had recurrence (13, eight, seven and five in groups A to D, respectively). The simple recurrence rate was 65% for group A, compared with 36% (P = 0.06), 29% (P < 0.05) and 22% (P < 0.01) for groups B, C and D, respectively. The differences in simple recurrence rates between the groups treated with IFN alpha-2b were not statistically significant. Eleven patients experienced progression in stage, with six, there, one and one in groups A to D, respectively. The differences were statistically significant only between groups A and C (P < 0.05) and groups A and D (P < 0.05). The disease-free interval was 15 months for group A, compared with 21.4 (P < 0.05), 26.1 (P < 0.001) and 30 months (P < 0.001) for groups C to D, respectively. The disease-free intervals of the groups treated with IFN alpha-2b were significantly different between all patients in groups B and D (P < 0.01) and only for those with stage T1 between groups C and D (P < 0.01). Finally the recurrence rate per 100 patient-months was 2.91, 1.19, 0.88 and 0.63 for groups A to D, respectively (all P < 0.001). The results were always in favour of the patients treated with the high dose, the only exception being the difference between groups C and D (P = 0.026). No side-effects of the drug were noted, nor was any adverse reaction reported from any patient. CONCLUSION: These results show a significant advantage for adjuvant intravesical IFN alpha-2b treatment over TUR alone for the 36 months of follow up and indicate that IFN alpha-2b can modify the clinical course of superficial TCC at least in the short term. The appropriate dose was apparently 80 MU, for although 40 MU was better than TUR alone, it was less effective than 60 MU and 80 MU; the 80 MU dose was slightly better than 60 MU and thus this regimen is recommended.

Administration, Intravesical↗

PubMed1998

Evaluation of needle biopsy in the diagnosis of prostatic carcinoma in men with prostatic intraepithelial neoplasia.

Prostatic intraepithelial neoplasia (PIN) is considered a premalignant lesion of the prostate. It is often encountered in prostate needle biopsy in cases where no cancer is identified. In order to evaluate its importance 25 patients with PIN in a former prostate needle biopsy underwent a second ultrasound guided needle biopsy. The first biopsy was performed in all patients as a result of positive DRE. In 13 patients (52%), prostate cancer was identified in the second specimen. All presented with high or intermediate grade PIN in the first biopsy. PSA values were compared with PIN grade and cancer presentation in the second biopsy, although no statistically significant difference was proven. In conclusion, when PIN is discovered in prostate needle biopsy in patients with positive DRE, a second biopsy has to be performed in order to exclude the possibility of a prostate carcinoma.

Aged↗

PubMed1997

Malakoplakia of the testis.

Malakoplakia of the testis presenting as painless enlargement of the testis in an 80-year-old man is described. The literature is reviewed.

Aged↗

PubMed1996

Double-pigtail stents for distal ureteral calculi: an alternative form of definitive treatment.

In this study, we treated patients with a solitary distal ureteral stone of less than 10 mm in maximum diameter by placing a double-pigtail stent and subsequently removing it allowing the calculus to pass spontaneously. A total of 40 patients were enrolled in the study with a mean stone size of 5.1 x 3.5 mm (range 2-8 mm in length and 2-7 mm in width). The indication for intervention was intractable pain in 5 patients, infection due to obstruction in 2, highly obstructed urinary tract in 10, absence of progression for 30 days in 21 and desire of the patient to be free of stone in 2. A double-pigtail stent was inserted in the involved ureter under local anesthesia and left in place for 2 weeks. After stent removal, 34 patients succeeded in passing the stone within an average time of 5.8 days. The overall success rate was 85%. We suggest this method as an alternative form of treatment for distal ureteral calculi to extracorporeal shockwave lithotripsy of ureterolithotripsy under selected clinical circumstances.

Adult↗