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B Glimelius

Publications and source records attributed to B Glimelius.

At least 19 recordsLinked to original sources
PubMed1992

Influence of 5-fluorouracil and folinic acid on colonic healing: an experimental study in the rat.

Male Wistar rats were subjected to colonic resection and randomized to one of four groups: control group (intraperitoneal NaCl, intravenous NaCl); 5-fluorouracil (5-FU) group (intraperitoneal 5-FU, intravenous NaCl); folinic acid group (intraperitoneal NaCl, intravenous folinic acid); and 5-FU-folinic acid group (intraperitoneal 5-FU, intravenous folinic acid). Treatment was started immediately after surgery and continued until the animals were killed at 3 or 7 days. Anastomotic complications (abscesses or dehiscence) occurred in four of 33 animals in the control group, 12 of 36 in the 5-FU group, one of 32 in the folinic acid group and nine of 36 in the 5-FU-folinic acid group. Anastomotic and skin breaking strength did not differ between groups on day 3 but by day 7 were significantly reduced in the 5-FU group. In rats given 5-FU-folinic acid, breaking strength was also reduced, but less so than in the 5-FU group. Breaking strength in animals receiving folinic acid was similar to that in the control group. In this model colonic healing was impaired after intraperitoneal 5-FU administration, but when folinic acid was added no further deterioration occurred.

Anastomosis, Surgical↗
PubMed1992

The value of endosonography in preoperative staging of rectal cancer.

Sixty-three patients with mobile rectal cancer were examined preoperatively with endorectal ultrasonography (EUS). The depth of infiltration and the presence of mesorectal lymph node metastases could be assessed in 53 patients. Doppler ultrasonography was performed in 16 cases with suspected lymph node enlargement in order to discriminate between lymph nodes and blood vessels. Tumour growth in the bowel wall was correctly estimated in 43 (81%) patients. The degree of spread was overestimated in five patients and underestimated in five. The evaluation of the mesorectal lymph node status was also accurate in 43 (81%) patients. Nine patients had one or several regional lymph node metastases, but the EUS revealed only some of the metastatic lymph nodes in each case. In the other 34, no lymph node metastases were found. In two patients the EUS was falsely positive since no lymph nodes could be demonstrated in the operative specimens. In eight patients the examination was falsely negative. EUS is considered to be an accurate method for preoperative assessment of tumour infiltration in the bowel wall as the risk of understaging was under 10%. Preoperative irradiation and surgery may be chosen based on the EUS-determined tumour extension into the rectal wall.

Arteries↗
PubMed1992

Sensitivity and specificity of CA242 in gastro-intestinal cancer. A comparison with CEA, CA50 and CA 19-9.

A serological assay for the quantitative determination of the novel tumour-associated epitope CA242 was developed and used for determination of sensitivity and specificity of CA242 in gastrointestinal cancer. The CA242 assay showed a better tumour specificity than CA50 (and CA 19-9). This was most noticeable in benign hepatobiliary disease. The sensitivity at 90% specificity cut-off level was approximately three times higher for CA242 compared to CA50 in colo-rectal cancer Dukes A, B and C, while in pancreatic cancer the sensitivity of CA242 and CA50 was similar. CA242 was expressed independently of CEA, and the combination of CEA and CA242 gave in colo-rectal cancer considerably higher sensitivity than the use of only one of the markers. This was most pronounced in Dukes A and Dukes B patients. CA242 is a novel tumour marker of potential clinical use, particularly in colo-rectal cancer.

Animals↗
PubMed1992

General condition of asymptomatic patients with advanced colorectal cancer receiving palliative chemotherapy. A longitudinal study.

A Nordic multicenter study in asymptomatic patients with advanced colorectal cancer compared initial chemotherapy with sequential methotrexate-5-FU with leucovorin rescue (MFL) for 6 months versus primary expectancy with chemotherapy only after the appearance of symptoms. The study (183 patients randomized between January 1985 and February 1990) showed that symptom-free survival, progression-free survival and survival respectively were about 6 months longer in the group of patients randomized to initial MFL. Whether these prolongations could be achieved without an impaired 'quality of life' was studied in an associated study. Between January 1985 and March 1987, 43 patients were randomized at one of the hospitals, 36 of which were interviewed with a questionnaire at randomization. Even if all these patients were considered, by the physician, to be 'free of symptoms from their disease', 16/36 (44%) had symptoms that could be referred to the disease. In spite of this, the patients were in a good general condition, and considerably better off than patients considered to have 'symptoms from the disease' who were interviewed with the same questionnaire when randomized in a parallel study of symptomatic patients. Patients randomized to initial chemotherapy and interviewed longitudinally maintained their good condition throughout treatment. Toxicity was mild, although the patients expressed more adverse effects than the physicians recorded. Since symptom-free survival, progression-free survival and survival were statistically significantly longer in the group of patients randomized to MFL also in this associated study, it is concluded that initial chemotherapy can prolong symptom-free survival and survival without reduced 'quality of life' during the treatment period.

Adult↗
PubMed1992

Trends in childhood and adolescent cancer survival in Sweden 1960 through 1984.

The temporal changes in childhood and adolescent cancer survival in Sweden 1960-1984 were analyzed. Complete follow-up through 1986 of 6,262 patients younger than 20 years at diagnosis revealed that the overall 5-year survival rates increased from 36.1 to 65.7% in males and from 43.6 to 73.6% in females. The temporal trends differed markedly between age groups and tumour sites and types. Over the study period, 5-years, survival for testicular cancer increased from 46.9 to 87.2%, kidney cancer, predominantly Wilms' tumour from 35.5 to 77.1% (with a higher rate of 89.1% in 1975-1979), Hodgkin's disease from 61.2 to 91.9%, non-Hodgkin's lymphoma from 32.5 to 76.6%, and all leukemias from 8.9 to 58.7%. Only a moderate improvement was noted for tumours of the bone, muscle and connective tissue, and survival rates for tumours of the nervous system remained largely unchanged. Our data reflect the remarkable therapeutic improvements that have occurred for cancer in the young and indicate that these improvements have rapidly become available in Sweden.

Adolescent↗
PubMed1992

Improved care of patients with small cell lung cancer. Nutritional and quality of life aspects.

A comprehensive cancer care project was carried out in Uppsala with the aim of improving the overall situation for patients treated with intensive chemotherapy with curative intent. This report gives the results in 58 patients with small cell lung cancer (SCLC), focusing on the nutritional aspects of the care and chemotherapy-related adverse effects. Responses, survival and simple nutritional parameters were compared with a historical control group (n = 81), and quality-of-life parameters with a pre-project group (n = 22). Groups were comparable with respect to pre-treatment characteristics. In contrast to the historical control group, weight, body mass index and S-albumin did not decrease during treatment in patients diagnosed during the project period. Yet, food intake in the study group was low, and for most patients below what is recommended. Survival, proportion of responses and response duration did not differ from those of the control group. Compared with the pre-project quality-of-life controls, a number of scores were more favourable for study patients (n = 36) interviewed in association with the 8th treatment course by a Swedish version of the Cancer Inventory of Problem Situations (CIPS). The global score was lower in the study group than in the pre-project group (0.80 vs 1.20, p < 0.001). Significant differences in a favourable direction were also seen in several higher order factors and miscellaneous subscales constituting the CIPS. On individual items, the study group expressed less problems with appetite/food taste in hospital, nervousness before chemotherapy and worry about adverse effects. The greatest differences in positive direction for the study group were seen within areas where the project focused on caring activities. We therefore conclude that a cancer care project with the present goals and means of intervention can improve the quality of life in patients with SCLC treated with intensive chemotherapy.

Adult↗
PubMed1992

Lymphoma incidence in a Swedish county during 1969-1987.

The incidence of lymphoid malignancies (acute leukemias and myelomatosis excluded) during 1969-1987 in the County of Uppsala was calculated on the basis of the regional cancer register and local registers from the only oncological, hematological, dermatological and pathological departments in this well-defined geographical area. Of the 774 patients included, 639 had histopathological specimens available, all of which were re-examined. Seventy-nine patients were diagnosed on the basis of bone marrow investigations (greater than 70% re-examined, all had a low-grade non-Hodgkin's lymphoma = NHL) and 54 on fine-needle aspiration biopsies (not re-examined). Seventy-nine of the lymphoma diagnoses were based on autopsy specimens. The overall age standardized incidence was 16.2/100,000/year (NHL: 13.6, Hodgkin's disease = HD: 1.5) according to the Swedish 1970 census (according to world standard population: 10.2); male: 20.9 (12.9) and female: 12.4 (7.9). The annual change in trend was +3.0% +/- 2.6 (NHL: +3.6% +/- 2.4, HD: no change). The omission of the 54 'fine needle cases' led to an overall incidence of 15.0 (9.7) and an annual change in trend of +3.5% +/- 1.9. Among the histopathological specimens, an NHL was found in 524 patients and HD in 69. In 46 registered patients, the diagnosis malignant lymphoma was wrong. The diagnosis changed to NHL in 43 patients registered as HD.

Adult↗
PubMed1992

The value of adjuvant therapy after radical surgery for colorectal cancer.

Extensive efforts to improve survival for patients with colorectal cancer using adjuvant treatments in addition to radical surgery have long been tried but without success. Recent data from several controlled trials have, however, shown positive results. The collected information from several trials using different chemotherapy schedules indicate that overall survival is improved. The extent of this improvement is not properly known although several centres have considered it to be sufficiently large to merit routine use in certain stages. Likewise, the collected information from several trials using perioperative radiotherapy indicates that the proportion of local recurrences are reduced by about 50% but without any major influence on survival. Most evidence favours additional radiotherapy before surgery rather than after. If proper dose planning is utilized, sufficiently high doses can be given preoperatively without increasing postoperative mortality.

Adenocarcinoma↗
PubMed1992

Nonresectable adenocarcinoma of the rectum assessed by MR imaging before and after chemotherapy and irradiation.

Thirty-four patients with nonresectable adenocarcinoma of the rectum, defined as tumor fixation at digital examination, were examined with MR. All 34 patients had, according to MR imaging, perirectal tumor growth. In 23 (68%) of the patients, the tumor has reached an adjacent organ. Eight of these patients had disturbances of the MR characteristics in the adjacent organ which proved to be due to overgrowth, i.e., to tumor invasion into these structures. In the remaining 15 patients, without disturbed MR characteristics, 7 had tumor overgrowth at laparotomy. When there was a visible space between the tumor and adjacent organs, there was no sign of tumor overgrowth at laparotomy, except in one case. In 24 patients, examined both before and after combined irradiation and drug therapy, tumor regression was registered after treatment. MR imaging seems to be useful in the assessment of resectability and to evaluate preoperative anticancer treatment in patients with nonresectable rectal carcinoma.

Adenocarcinoma↗
PubMed1992

Induction and quantification of hepatic metastases from a human colonic cancer in the nude rat.

Nude rats were injected with human colonic cancer cells (LS 174 T) in the superior mesenteric vein and the extent of hepatic metastases at sacrifice was estimated by visual inspection and computer-based area calculation. After 3 weeks, 5.0 x 10(6) cells caused hepatic metastases in 14/14 rats whereas 0.5 x 10(6) cells failed to produce liver metastases in 4/4 rats (P < 0.001). Injection of 1.0 x 10(7) cells caused portal vein occlusion in 3/5 rats. Extrahepatic tumour growth was rare; lung metastases were observed in four rats, and three rats had local tumour in the abdomen. The average extent of hepatic tumour replacement was 20.2 +/- 4.0%. Injection of embolies or single cells did not affect the incidence or extent of hepatic metastases. The incidence of hepatic metastases was similar in male and female rats, but the extent of hepatic tumour was larger in males (24.6%) than in females (3.2%) (P = 0.005). The pathophysiological similarities to human disease should make this model suitable for diagnostic and therapeutic studies with clinical application.

Animals↗
PubMed1992

Contrast-enhanced CT scanning in vivo for the quantification of hepatic metastases from a human colonic cancer in the nude rat.

Hepatic metastases were induced in nude rats by intraportal injection of 2.5-5.0 x 10(6) cells from the human colonic cancer cell line LS 174 T. Quantification of tumour burden, expressed as relative metastatic area, was performed by contrast-enhanced computed tomography (CT) scanning in vivo (n = 14), contrast enhanced CT scanning post mortem (n = 21) and computer-based area calculation (CBAC) (n = 21). To determine the false-positive contribution to the estimated tumour burden by the evaluation procedures themselves, six rats without metastases were assessed. The quantification in the three different assessment groups was in close accordance in animals with an intermediate or extensive metastatic burden, but not in rats with a minor (< 4%) tumour burden. The results indicate that contrast-enhanced CT scanning can be used in this model to quantify hepatic metastases, except in animals with few and small lesions. Furthermore, the results suggest a potential for the assessment of therapeutic response by repeated contrast-enhanced CT scanning in vivo, as well as prospects for a corresponding evaluation in man.

Animals↗
PubMed1991

Heterogeneity in ploidy and S-phase fraction in colorectal adenocarcinomas.

The heterogeneity in the DNA content was analysed in multiple biopsies from the surgical specimens in 77 cases of colonic and 46 cases of rectal adenocarcinomas. Frozen and unfixed tumour tissue was analysed with the flow cytometric technique. A total of 78/123 (63%) of all tumours displayed aneuploid stemlines in one or more pieces of tumour tissue; 45 were homogeneously aneuploid and 33 were heterogeneous, presenting both aneuploid and near-diploid samples. The remaining 45 tumours were homogeneously near-diploid. The heterogeneity in ploidy tended to be slightly higher if ten as compared with four samples from each tumour were analysed. Ploidy correlated to localization in the bowel and gender, but not to age, histopathological tumour stage, tumour differentiation or to the resectability rate for cure. The mean value of the S-phase fraction was 17% (range 7-31%) in the near-diploid and 14% (range 8-20%) in the aneuploid tumours. The range of the intratumoural variation was small for the DNA index (at most 5%) and high for the S-phase fraction (19% for near-diploid and 24% for aneuploid tumour pieces). Neither the mean value nor the heterogeneity in the DNA index and in the S-phase fraction displayed any correlation with the studied characteristics. In conclusion, the ploidy and the S-phase fraction varied considerably both within and between the tumours. As a consequence, multiple sampling is mandatory for a correct classification of colorectal adenocarcinomas based on the DNA content.

Adenocarcinoma↗
PubMed1991

Transanorectal ultrasonography in the staging of anal epidermoid carcinoma.

Fifty consecutive patients with anal canal epidermoid carcinoma were evaluated by transanorectal ultrasonography (TRUS) at diagnosis. Forty-six patients were treated with primary radiotherapy plus bleomycin. Twenty-eight of the last 30 patients underwent, in addition, planimetric volume determination. The ultrasound findings were compared with clinical stage as assessed by digital palpation. Tumours in clinical stages T1-2 showed evidence of penetration through the anorectal muscular wall at ultrasound (UT3-4) in two-thirds of the cases. This was the case in all tumours in clinical stages T3-4. A clear correlation between tumour size, depth of invasion, and tumour volume, respectively, and residual tumour after a "pre-operative" dose of 40 Gy plus bleomycin was found. When combining clinical stage with TRUS, all tumours classified as T1-2/UT1-2 had a complete response (CR) after the first radiotherapy period, whereas the corresponding figures for those with deep invasion ultrasonographically (T1-2/UT3-4 and T3-4/UT3-4) were 64 percent and 0 percent, respectively. It thus appears that TRUS could complement digital palpation in staging anal canal carcinoma.

Adult↗