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Biomedical subjects

A Lewenhaupt

Publications and source records attributed to A Lewenhaupt.

17 recordsLinked to original sources
PubMed1991

Serum tumour markers in human prostatic carcinoma. The value of a marker panel for prognostic information.

Serum from 102 patients was analysed with regard to its content of prostatic acid phosphatase (PAP), prostate specific antigen (PSA), neopterin, osteocalcin, thymidine kinase, C-reactive protein, and of tissue polypeptide antigen (TPA). The levels were related to the short-term survival (death from cancer within 3 years) and compared by statistical means. A comparison was also made with tumour grade and stage and the presence or not of metastatic lesions. In this study neopterin was found to be most closely related to the clinical course followed by tumour grade, thymidine kinase and PSA. When all these four variables were in the equation no other parameter added any information of statistical significance. The importance of selecting appropriate cut off values ('normal' vs 'elevated') when using the serum marker as a prognostic indicator is also discussed.

Biomarkers, Tumor↗
PubMed1990

Tumour markers as prognostic aids in prostatic carcinoma.

Of 102 patients suffering from prostatic carcinoma, complete data on the serum concentration of 7 tumour markers were available from 90 patients, together with tumour grade, local stage and the presence or absence of skeletal metastases. The serum content of prostatic acid phosphatase, prostate specific antigen, neopterin, thymidine kinase, osteocalcin, C-reactive protein and tissue polypeptide antigen was measured. By means of Cox's regression and multivariate analysis the ability of these variables to predict prognosis, i.e. death from prostatic cancer, was studied. Neopterin appeared to be the most efficient marker, followed by tumour grade, thymidine kinase and prostate specific antigen. No other variable provided information of statistical significance. In multivariate analysis thymidine kinase performed best, followed by neopterin, tumour grade and prostate specific antigen. Several serum tumour markers reflect the biological activity of human prostate cancers and their value should be further explored. They may become useful in the management of individual patients.

Antigens, Neoplasm↗
PubMed1990

Tumor markers in human prostatic carcinoma. An optimation of reference values.

Serum concentrations of prostatic acid phosphatase, prostate-specific antigen, neopterin, osteocalcin, tissue polypeptide antigen, and CA-50 were measured before onset of treatment in 86 patients suffering from prostatic carcinoma. In an attempt to identify patients with a poor prognosis, the data were related to patient survival after 3 years. When the standard reference values, which are based on studies on healthy subjects, were used in the study on the deceased, the diagnostic sensitivity was acceptable, whereas the diagnostic specificity was low. A better relation to prognosis was obtained if higher discrimination values were employed. The increased specificity could be obtained with little loss of sensitivity. It is suggested that the discrimination value should be chosen after careful consideration of the expected performance of the test in differentiating between defined groups of patients. To indicate short-term prognosis in prostatic cancer, a higher than normally recommended discrimination value for the marker should be selected.

Aged↗
PubMed1988

Changes in intravesical pressure during irrigating fluid absorption in transurethral prostatic surgery.

Continuous recording of intravesical pressure (IVP) and incremental volumetric measurements of irrigating fluid absorption were performed during 37 transurethral resections of the prostate (TUR). Absorption which resulted in concomitant dilutional changes in peripheral blood, indicating intravascular absorption, was associated with prolongation of the time required to increase the IVP. There was an inverse relation between the change in maximum IVP and the rate of irrigating fluid absorption. Absorption that did not result in concomitant dilutional changes in peripheral blood, indicating extravascular absorption, was associated with similar changes in IVP parameters but the critical pressure for absorption was lower.

Absorption↗
PubMed1988

Irrigating fluid absorption and blood loss during transurethral resection of the prostate studied with a regular interval monitoring (RIM) method.

A method for the study of physiological events during transurethral resection of the prostate (TUR) is described. Measurements of volumetric irrigating fluid balance, blood loss, central venous pressure (CVP) as well as blood haemoglobin and serum levels of sodium and glycine were performed at 10-min intervals. This regular interval monitoring (RIM) method offers the possibility to retrospectively correlate changes that occur during TUR at discrete time intervals. In 20 patients undergoing TUR, irrigating fluid absorption occurred throughout the procedure although the risk of having an absorption increased 30 min after surgery commenced. Increase of blood loss coincided with intravascular but not with extravascular absorptions. If there was a rapid massive intravascular absorption of about 500 ml/10 min, the CVP increased greater than 2 mmHg. The total intraoperative blood loss was not greater in patients with large absorption volumes. RIM will detect absorption greater than the urine excretion in any given period of time. If absorption occurs during a limited time of the TUR, RIM allows a partial correction for the urinary excretion in the volumetric fluid balance.

Absorption↗
PubMed1988

Aspects on reference values for tumor markers in human prostatic carcinoma.

The efficiency of the tumor markers prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), neopterin, and osteocalcin was tested with regard to their ability to predict cancer death within 2 years plus survival beyond 2 years in a series of patients with newly diagnosed prostate cancer. For all markers, an elevated level suggested a tumor with a worse prognosis. Moreover, the extent to which the level was increased carried additional information. The prognostic efficiency was routinely improved by selecting cutoff levels higher than the standards suggested by the radioimmunoassay (RIA) kit manufacturers. Seventy-four percent of the patients with elevated levels of neopterin were still alive after 2 years when 8 nmol/L was selected as the upper normal value compared to only 43% at 12 nmol/L. At a cut-off value of 3 micrograms/L for osteocalcin, 79% of the patients with elevated levels were still alive after 2 years compared with only 20% when 7 micrograms/L was selected. Such adjustments to higher cutoff levels could be made without increasing the number of "false-negatives." The efficiency of PAP to predict short-term prognosis was poor at the standard cutoff level of 1.9 microgram/L. Not until 20 micrograms/L was selected did the efficiency exceed 80%. PSA was highly sensitive but little specific at any of the cutoff levels tested with regard to ability to indicate prognosis.

1-Carboxyglutamic Acid↗
PubMed1988

On reference values for tumor markers in prostatic carcinoma.

Serum contents of prostatic acid phosphatase, neopterin, osteocalcin, tissue polypeptide antigen and CA-50 were measured before onset of treatment in 83 patients suffering from prostatic carcinoma. In an attempt to identify patients with poor prognosis the data were related to patient survival after 2 years. It was found that the standard cut off values, obtained from the upper limits of normal, healthy subjects, were sensitive but had low specificity. A better relation to prognosis was usually found at a higher discrimination limit. The degree of elevation appears more important than the elevation of the markers as such in indicating a poor prognosis. By systematic adjustment of the discrimination levels, higher specificity can be obtained with little loss of sensitivity.

Acid Phosphatase↗
PubMed1987

Factors influencing the osmolality and the concentrations of blood haemoglobin and electrolytes during transurethral resection of the prostate.

Twenty patients undergoing transurethral resection of the prostate (TUR) were followed every 10 min intraoperatively as well as 1 and 2 h postoperatively with measurements of blood haemoglobin concentration (B-Hb), serum sodium (S-Na), serum potassium (S-K), serum osmolality (S-osmol), blood loss, central venous pressure and volumetric determination of the irrigating fluid absorption. Changes in B-Hb correlated well with the sum of acetated Ringer solution given and intravascular irrigating fluid absorption. A transient decrease in S-Na of 1-4 mmol/l followed absorptions less than 300 ml. With larger intravascular absorptions, three stages of dilutive changes in S-Na and B-Hb are described. Extravascular absorptions resulted in mild blood parameter changes at various times after their occurrence. Absorption of irrigating fluid was associated with an increase in S-K. S-osmol decreased in conjunction with some absorptions, although the irrigating fluid was isotonic. Postoperative analyses of blood parameters gave only limited information about intraoperative complications. The only consistent pattern was associated with intravascular irrigating fluid absorption.

Aged↗
PubMed1986

Serum levels of neopterin as related to the prognosis of human prostatic carcinoma.

In 93 patients suffering from prostatic cancer, serum levels of neopterin, a pteridine reflecting activation of the immune defence system, were measured at the time of diagnosis and 6 and 12 months after treatment with orchidectomy or estrogens. Neopterin levels were initially greater than 10 nM/l in 27% of the patients and in this group tumor recurrences occurred in 28% as compared to 7% in the group with neopterin less than 10 nM/l. No apparent correlation between tumor stage and grade and neopterin levels could be demonstrated. Neopterin levels decreased significantly after onset of treatment (p less than 0.001), which implicates a hormone dependence. But still patients with initially elevated serum neopterin levels, and thus an assumed activated immune defence system at the time of diagnosis, had lower survival rates than those without elevated neopterin levels (p less than 0.001). It is concluded that elevated levels of neopterin in serum is a sign of poor prognosis in human prostatic cancer.

Aged↗
PubMed1986

Rapid massive irrigating fluid absorption during transurethral resection of the prostate.

Absorption of irrigating fluid is common during transurethral resection (TUR) of the prostate. Eleven patients were monitored peroperatively during TUR with measurements of bladder pressure, arterial blood pressure, central venous pressure and determinations of serum sodium as well as fluid balance. A rapid massive irrigating fluid absorption occurred in one case. The clinical course and data from the patient monitoring makes it possible to study early manifestations of irrigating fluid absorption. The bladder pressure recordings show that maximum intravesical pressures were not higher during the phase of rapid massive absorption as compared to periods without absorption.

Absorption↗
PubMed1985

Tissue polypeptide antigen (TPA) as a prognostic aid in human prostatic carcinoma.

Serum levels of tissue polypeptide antigen (TPA) and prostatic acid phosphatase (PAP) in serum, the presence or absence of skeletal metastases, tumor grade, patient age, and erythrocyte sedimentation rate (ESR) were determined in 50 patients with prostatic adenocarcinoma before onset of any therapy. Crude survival rates were estimated for a 5-year period after the time of diagnosis. The prognostic value was estimated by means of the log rank test and multivariate life table analysis. The TPA, PAP, tumor stage, and ESR all appeared to be useful as prognostic markers. Tumor grade and patient age were not significantly related to crude survival. The TPA proved to be the most reliable prognostic marker in single test estimates as well as in a multivariate life table analysis (p less than 0.01).

Acid Phosphatase↗
PubMed1980

Plasma concentration of neurotensin-like immunoreactivity (NTLI) and lower esophageal sphincter (LES) pressure in man following infusion of (Gln4)-neurotensin.

(Gln4)-neurotensin was infused i.v. for 5 to 70 min at 3 different infusion rates (6, 12 and 18 pmol X kg-1 X min-1, respectively) in 19 male volunteers, aged 26-47. The plasma concentration of neurotensin-like immunoreactivity (NTLI), the lower esophageal sphincter (LES) pressure, blood pressure, heart rate. ECG and blood glucose concentration were measured. The volunteers did not report any subjective effects during the infusion. Following infusion periods of 30 min or more the volunteers often reported bowel movements starting 5 min or more after cessation of the infusion. Neither blood pressure nor heart rate changed significantly. No changes were noted in the continuous ECG or in the blood glucose concentration. Apparent steady state levels of about 300 pM NTLI were reached at about 40 min during infusion of 12 pmol X kg-1 X min-1 (Gln4)-neurotensin. In all volunteers the LES pressure was significantly reduced within 5 min of starting the infusion. In 6 volunteers 12 pmol X kg-1 X min-1 (Gln4)-neurotensin was infused i.v. for 5 min. The LES pressure decreased significantly (P less than 0.01) from 13.7 +/- 1.3 mmHg to 5.3 +/- 0.8 mmHg. The decrease in the LES pressure occurred at plasma NTLI concentrations of approximately 50 pM, i.e. at levels below those obtained in man after a meal or the ingestion of fat. The present data further support the hypothesis that in man plasma neurotensin, or a neurotensin metabolite is an endocrine hormone involved in the postprandial regulation of the motor functions of the gastrointestinal tract.

Adult↗
PubMed1979

Preferential utilization of newly synthesized cholesterol as substrate for bile acid biosynthesis. An in vivo study using 18O2-inhalation technique.

Incorporation of 18O in cholic anc chenodeoxycholic acid was determined after inhalation of 18O2 by rats with biliary fistula. After a 30-min inhalation, the maximal incorporation of 18O in the three hydroxyl groups of cholic acid was about 1.8 atoms, and in the two hydroxyl groups of chenodeoxycholic acid about 1.1 atoms. About 0.4 atom of 18O in the cholic and chenodeoxycholic acid isolated was present at C-3. It was calculated that at least 50% of the biosynthesized bile acids were derived from newly synthesized cholesterol. The time course for the incorporation of 18O at C-3 of chenodeoxycholic acid was slightly different from that of cholic acid, indicating that a small part of chenodeoxycholic acid might have been synthesized from a pool of cholesterol different from that utilized in the biosynthesis of cholic acid. Incorporation of 18O in biliary cholesterol was less than 0.05 atom, indicating that the major part of this cholesterol is derived from a pool different from that utilized in bile acid biosynthesis.

Animals↗