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Biomedical subjects

A Fritjofsson

Publications and source records attributed to A Fritjofsson.

At least 19 recordsLinked to original sources
PubMed1993

Characterization of localized prostatic cancer: distribution, grading and pT-staging in radical prostatectomy specimens.

Ninety-one patients underwent radical retropubic prostatectomy. Forty-three specimens were examined after limited sectioning (series 1) and 48 underwent whole organ serial step-sectioning at 5 mm intervals (series 2) of the removed prostate gland. The latter allowed a more extensive assessment of tumour localization, multicentricity, extension, pT-stage and grade. Eighty-eight percent of specimens in series 1 had free surgical margins compared with only 41% in series 2 (p = 0.00001). Preoperative tumour grading by fine-needle aspiration biopsy, TUR-chips or 1.2 mm core biopsies was in agreement with postoperative grading in the prostatectomy specimens in 48% of the cases in series 1 and 67% in series 2, respectively. In series 2, preoperative localization of the tumours by palpation was accurately assessed in 75% of cases when compared to the findings at step-sectioning. Sixty-eight percent of 40 eligible glands in series 2 contained multiple tumours. 12/13 cases of unifocal tumours (92%) were classified as large single tumours. The sections were divided into four peripheral and four central parts/octants, and the tumour localization was marked within these octants. The apical and middle third of the prostate contained tumour in all cases, whereas the basal (cranial part) was engaged in 35%. Small tumours were localized mainly in the periphery of the gland, with no significant difference between dorsal and ventral octants. However, large tumours were situated mainly in the dorsal peripheral octants, concomitant with an increased involvement of the ventral and central octants.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Uptake of estramustine phosphate (estracyt) metabolites in prostatic cancer.

Plasma and tumour concentrations of estramustine, estromustine, estradiol and estrone, the major metabolites of estramustine phosphate (estracyt), were determined in patients with prostatic carcinoma treated between one and nine years with repeated oral doses of estracyt (560 to 840 mg./day). The last dose was given 12 to 16 hours before sampling. The binding of radioactive estramustine and estromustine was determined in the tumour tissue to examine the possible role of estramustine-binding protein for the accumulation of these metabolites into the tumour. Comparison was made with benign prostate hyperplastic tissue from untreated patients. Estromustine was the main metabolite in plasma as well as in the tumour (range 235 to 450 and 205 to 485 ng./gm., respectively), whereas estramustine (20 to 45; 95 to 370), estrone (62 to 140; 63 to 160) and estradiol (8 to 15; 7 to 36) were found in lower concentrations. Interestingly the concentration of estramustine was as an average six times higher in the tumour than in plasma contrasting with the other metabolites which were present in equal amounts of the two localities. Binding of 3H-estramustine and 3H-estromustine was two to three times higher in the tumour than in benign hyperplastic tissue and negligible in plasma samples. The present study is the first where substantial amounts of cytotoxically active estramustine and estromustine are demonstrated in tumour tissue from estracyt treated patients. Our findings suggest a mechanism for selective uptake of these metabolites in prostatic cancer (estramustine-binding protein). The uptake and binding of estramustine and estromustine in the tumour may account for the clinical effects of estracyt in prostatic carcinoma.

Aged↗
PubMed1988

The value of computed tomography and ultrasound in assessment of pelvic lymph node metastases in patients with clinically locally confined carcinoma of the prostate.

With the aim of detecting any metastases in pelvic lymph nodes, computed tomography (CT) was performed in 42 patients with clinically localized prostatic carcinoma, and ultrasound (US) examination in 35 of them, prior to pelvic lymphadenectomy. CT was positive in only one patient, and US was negative in all examined patients. At lymph node dissection macrometastases were found in four patients and histopathologic examination revealed micrometastases in a further ten patients. It is concluded that in clinically locally confined prostatic carcinoma CT and US are insensitive in diagnosing pelvic lymph node metastases, and that lymph node dissection remains the only method for staging of the regional lymph nodes.

Aged↗
PubMed1988

Anatomy of the prostate. Aspects of the secretory function in relation to lobar structure.

Anatomic studies have shown the prostate to be a heterogeneous organ in which at least three morphologically differing zones or lobes are identifiable. This indicates that the endocrinologic sensitivity of the prostate is not uniform, and that there may also be intraprostatic functional variations. Few studies have so far been done to prove such differences. Although interlobar differences in zinc content have been observed, their significance is not clear. The field is therefore open for further studies concerning both the anatomic and the functional heterogeneity of the human prostate.

Body Fluids↗
PubMed1987

Treatment of ulcer and nonulcer interstitial cystitis with sodium pentosanpolysulfate: a multicenter trial.

The effect of sodium pentosanpolysulfate (Elmiron) in the treatment of interstitial cystitis was observed in an open controlled multicenter trial. We studied 87 patients with symptoms for more than 2 years at 17 centers in Finland and Sweden. Patient selection was based on the typical chronic symptomatology but the material subsequently was stratified according to objective cystoscopic findings. The medication (400 mg. daily in 2 oral doses) was discontinued after 6 months. The response was evaluated every 4 weeks during treatment and every 3 months thereafter. Most patients responded favorably, many with diminution of pain within only 4 weeks from the start of treatment. The frequency of micturition decreased significantly and the mean volume per void per 24 hours increased in the patients without bladder ulceration but such changes were not found in the patients with ulcer. The bladder capacity was smaller in the ulcer group. In these patients the pre-treatment intensity of pain was somewhat greater than in those without bladder ulcer but the pain was alleviated in both groups and this effect was stable at the 3-month followup. The differences in responses in the 2 groups indicate a probable fundamental difference between ulcerative and nonulcerative interstitial cystitis. Side effects of the drug were few, slight and transient. Therefore, the study indicates that a significant number of patients with interstitial cystitis can be expected to benefit from treatment with sodium pentosanpolysulfate.

Adult↗
PubMed1987

Plasma concentrations of estradiol and testosterone in single-drug polyestradiol phosphate therapy for prostatic cancer.

To evaluate the appropriate dosage of polyestradiol phosphate (PEP, Estradurin) as single-drug therapy, patients with metastatic prostatic carcinoma were given 80, 160 or 240 mg PEP every 4 weeks for at least 6 months. Injection of PEP was followed by rising plasma concentrations of estradiol in the first 2 weeks and slight fall in the next 2 weeks. Testosterone levels fell rapidly in the first 7 days and rose slightly in the following 3 weeks. Steady-state levels were reached after 2 months at the two lowest doses and after 4 months at the highest dose. Steady-state estradiol values increased in linear proportion to the dose. The steady-state concentrations of testosterone were about 45, 25 and 15% of the pretreatment values in the respective groups. At least 160 mg PEP at 4-week intervals is appropriate when the drug is used alone.

Dose-Response Relationship, Drug↗
PubMed1985

Peroperative staging of renal carcinoma. A methodologic comparison.

Angiography, computed tomography and ultrasonography were compared with respect to staging of renal carcinoma in 41 patients with 46 renal tumours. Angiography and ultrasonography gave correct staging in 52% and 48%, respectively, while correct staging was achieved with computed tomography in 80% of the tumours.

Adenocarcinoma↗
PubMed1985

Surgery of renal cancer with extensive caval invasion. Suggestion for a new approach.

Radical surgery for renal cancer with invasion of the inferior vena cava can improve the patient's quality of life and, in some cases, offer longer survival or even cure. With a carefully planned surgical approach it is possible to remove renal tumours with thrombotic extension to the most proximal part of the inferior vena cava without necessity for cardiopulmonary bypass and without undue risk to the patient. In the operative procedure, good access and visual control of the proximal vena cava and all the contributing veins seem to be crucially important.

Aged↗
PubMed1985

Intravesical ethoglucid (Epodyl) for treatment of noninvasive bladder cancer (stage Ta).

Widespread, well differentiated (grade I) bladder tumours confined to the mucosa (stage Ta) were treated with regular intravesical instillations of ethoglucid (Epodyl) in 24 patients. The therapeutic schedule could be followed in all but one patient, in whom side effects necessitated cessation of treatment. Complete response was obtained in 75% of the patients, and during continued prophylactic therapy 90% remained tumour-free. After termination of the treatment, however, new tumours appeared in 60-80% of the patients.

Adult↗
PubMed1985

Biochemical and morphologic studies of the prostate gland in men subjected to radical cystectomy.

Whole human prostate glands obtained from patients undergoing radical cystectomy were dissected into three paired lobes and the various parts of the gland were subjected to biochemical and morphologic examination. No distinct differences were found between the prostate lobes in regard to content of divalent cations, acid phosphatase and ATPase. These findings were concordant with observations at light microscopy. Hence, despite discernible change in cellular appearance, no distinct border was observed between lobes indicating separate "compartments".

Aged↗
PubMed1984

Intravesical instillation of Adriamycin early after transurethral resection: measurements of plasma levels.

10 patients with frequently recurrent or wide-spread papillary tumors of the urinary bladder were treated by intravesical instillation of adriamycin (50-110 mg) within 3 h of transurethral resection of the tumors. The highest plasma concentration observed (73 ng/ml) was associated with the most extensive resection. In none of the other patients did the maximum plasma concentration exceed 30 ng/ml. Mostly, the intravesical instillation of adriamycin was given in immediate connection with the transurethral resection. Hence, the remaining effects from the epidural anesthesia eliminated all patients' discomfort related to the instillation therapy. In none of the patients was the combined therapy discontinued due to side effects.

Aged↗
PubMed1983

Experience with two-stage scrotal flap urethroplasty for stricture.

A series of 50 men with variously-caused stricture of the bulbar and/or membranous urethra is presented. The 2-stage scrotal flap urethroplasty described by Blandy was used. As a rule the operation was technically simple. Post-operative incontinence was not a problem. Recurrence or new stricture appeared in 7 cases, but 5 of these strictures were short and could be corrected with internal urethrotomy. Timed micturition showed improved voiding in all of the 18 patients studied before and after urethroplasty. Urodynamic studies in the last 8 cases of the series before and after urethroplasty showed significantly improved urinary flow and voiding post-operatively, with reduction of detrusor pressure and residual urine.

Adult↗
PubMed1983

Perspectives on serum acid phosphatase in prostatic disease. An evaluation of two methods.

Acid phosphatase in serum was measured in 116 patients with prostatic disease, benign in 59 and malignant in 57 cases. Comparisons were made between radioimmunoassay (RIA) and an enzymatic method. The correlation coefficient between the respective values was 0.96 in patients with untreated prostatic cancer, indicating that no significant difference between results with the two methods was to be expected. The correlation coefficient between RIA values and cancer stage was 0.48, and between catalytic activity and cancer stage it was 0.50. The validity of the two methods consequently was equal. RIA, however, was the more sensitive method, giving elevated values in 10 of 11 patients with untreated stage III or stage IV prostatic cancer, as compared with only 4 of the same 11 in the enzymatic assay. This seeming paradox most probably was attributable to differing intrinsic properties of the methods when the upper limits of normal range were established. Neither RIA nor enzymatic analysis discriminated early prostatic cancer (stages I and II) from benign lesions.

Acid Phosphatase↗