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Biomedical subjects

E Nordman

Publications and source records attributed to E Nordman.

At least 37 records · Page 2Linked to original sources
PubMed1989

Ultrastructural effects of irradiation on squamous cell carcinoma of the head and neck.

Tissue samples taken before and during the radical irradiation of the squamous cell carcinoma of the head and neck region were studied by light and electron microscopic examination. Radiation-induced cellular changes of which nuclear atypia was most pronounced. The tumor invasion pattern remained unchanged but the number of mitoses decreased. The lymphocytic infiltration increased at the beginning of the therapy (from 10-30 Gy) but decreased at the end of radiotherapy. The amount of neutrofils and the keratinization pattern remained almost unchanged at the light microscopic level, but intracellular filaments and desmosomes slightly increased in electron microscopic study. The changes in nuclear morphologic features pointing in a more undifferentiated direction are considered to be due to cell damage rather than to the more aggressive behavior of the tumor cells. This is in agreement with the decrease of mitoses which is due to radiation-induced arrest of tumor cells to the G2 phase. These changes might be related to the disappearance of tumors during irradiation. The leukocyte compartment seen in the samples might take part in the destruction of the tumor cells and in the removal of the cell debris.

Adult↗
PubMed1989

Combined interferon and vinblastine treatment of advanced melanoma: evaluation of the treatment results and the effects of the treatment on immunological functions.

Thirteen patients with metastatic malignant melanoma received interferon alpha-2a (Roferon-A) and vinblastine. The interferon dosage was increased from 3 x 10(6) IU to 9 x 10(6) IU daily in 10 weeks and thereafter 9 x 10(6) IU was administered three times weekly intramuscularly. Vinblastine (0.075-0.15 mg/kg) was given every third week intravenously. One of the ten evaluable patients had partial remission (PR) (11%) for 10 months. The diseases was stabilized (NC) in three patients (30%) for 3, 6 and 9 months. Progression (PD) occurred in six patients. The treatment time varied from 5 weeks to 44 weeks. The median survival time from the beginning of this combination treatment was 5 months. The most common side-effects were fever, fatigue, loss of taste, weight loss and neutropenia. The mitogen response to phytohemagglutinin and purified protein derivative of tuberculin decreased in all patients. The response to concanavalin A decreased less and began to increase again in the patients with PR and NC. The natural killer cell activity in PD patients decreased more than in the patients with PR and NC. The ratio of T4/T8-positive cells was restored in PR + NC patients but rose in PD patients indicating a difference in the immunomodulatory effect of the combination or of the advanced disease itself on T-cell function in PD patients. This combination of daily interferon and vinblastine did not prove to be effective in melanoma. The depression of immunological functions, which was more marked in patients with PD, might indicate that vinblastine in this combination counteracts the immunostimulatory effect of interferon.

Adult↗
PubMed1989

Radiation-induced changes of fibroblasts in the squamous cell carcinoma of the head and neck.

The regrowth of mesenchymal tissue (stroma) surrounding the malignant epithelium is an important step in tissue remodelling during and after irradiation. The radiation-induced fibroblastic changes were studied on tissue samples taken before, during and after the radical irradiation of the squamous cell carcinoma of the head and neck. Elongated fibroblasts with large amount of rough endoplasmic reticulum were seen around the tumor epithelium before radiation. The fibrosis increased during irradiation and at the same time the shape of the fibroblasts changed so that they became more triangular and nuclear structures became more prominent together with hyperchromasia. The amount of cell organelles declined although there was a large amount collagen present. Epithelial cells invaded through the basal lamina. In most samples the basal lamina could not be seen at all and the tumor cells were dispersed between stromal elements. On the other hand there were close contacts between epithelial and mesenchymal cells throughout the study in places where the basal lamina was broken, which might indicate epithelio-mesenchymal interaction. Also the connective tissue formed by fibroblasts and collagen might be part of the radiation induced healing and destruction of the tumor cells.

Adult↗
PubMed1988

A flow cytometric analysis of 23 carcinoid tumors.

Twenty-three carcinoid tumors were investigated from paraffin-embedded tissue with flow cytometry (FCM) in order to correlate the DNA ploidy with clinical variables. DNA aneuploidy was found in ten tumors (45%) and one tumor was classified as tetraploid. Diurnal urinary excretion of 5-hydroxy indolic acetic acid (5-HIAA) was known to be elevated in seven of eight diploid tumors and in four of seven aneuploid carcinoids with distant metastases. Six (55%) of the diploid tumors had not given rise to metastases at the time of diagnosis, compared with three (30%) of the aneuploid tumors. Six of seven patients with an aneuploid tumor and three of five patients with a diploid tumor, observed for at least 10 years, died of the disease. It was concluded that, unlike in earlier studies with static DNA cytometry, DNA aneuploidy is common in human carcinoid tumors and may occur in tumors secreting biogenic amines.

Adult↗
PubMed1988

Toremifene, a new antiestrogenic compound, for treatment of advanced breast cancer. Phase II study.

Forty-six postmenopausal women with estrogen receptor positive advanced breast cancer were treated with the novel antiestrogen toremifene in this phase II study. The patients had no prior or concurrent hormonal or cytostatic treatment. Sixty milligrams of toremifene was given as a single daily dose for a minimum treatment period of 6 weeks. Eight patients (17%) achieved complete response, 17 (37%) partial response and 12 (26%) showed no change. The median durations of responses were 93, 66 and 24 weeks, respectively. Three patients still continue the treatment in complete response, four patients in partial response. No significant differences in response rates could be seen when related to different estrogen receptor concentrations. The treatment was well tolerated, only two patients had remarkable side-effects; one of the patients interrupted the treatment mainly because of tremor. Our conclusion is that toremifene is an effective, safe and in clinical practice easily applied choice of treatment in estrogen receptor positive advanced breast cancer.

Aged↗
PubMed1988

Inoperable non-small cell lung cancer: radiation with or without chemotherapy.

We report a randomized multicentre study of split-course radiotherapy (RT), with or without combination chemotherapy (CT), in 238 patients with inoperable non-small cell lung cancer (NSCLC), previously untreated, confined to one hemithorax and the mediastinal nodes. In both treatment groups RT consisted of 55 Gy in 20 F given over 7 weeks with a 3-week rest interval. CT consisted of the 3-drug regimen CAP: C = cyclophosphamide 400 mg/m2, A = adriamycin 40 mg/m2, P = cisplatin 40 mg/m2; 2 cycles of CAP given before RT, one during the rest interval and six after RT. Seventy per cent in the RT arm and 67% in the RT-CT arm had epidermoid carcinoma. No significant difference was apparent between the RT and the RT-CT arms with respect to objective response rates (CR + PR) (44 and 49%, respectively), median duration of response (278 and 320 days), local failure (31 and 20%), distant progression (23 and 20%) or median survival (311 and 322 days). The survival figures showed an almost significant (P = 0.05) therapeutic advantage of the combined regimen with stage IIIM0 disease. Progressive disease was the cause of death in 92% and 88%. We conclude that chemotherapy did not contribute significantly to either local control or survival as compared to radiotherapy alone.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Combined interferon and vinblastine treatment of advanced melanoma and renal cell cancer.

Thirteen patients with metastatic melanoma and ten patients with advanced renal cell cancer (RCC) received interferon alfa-2a (Roferon-A) and vinblastine. In melanoma the interferon dose was 3-9 million IU i.m., escalated daily for 10 weeks, and in RCC the dose was 18 million IU three times a week i.m. The dose of vinblastine was 0.075-0.15 mg/kg every third week i.v. One of the ten evaluable patients with melanoma had partial remission (PR; 11%) and three presented no change (NC). Three of seven evaluable patients with renal cell carcinoma had PR (43%) and three NC. Duration of the remission was 10 months in the melanoma patients and 7+, 10+, and 7+ in the RCC patients. The three times a week schedule was better tolerated. The most common side effects were fever, fatigue, loss of taste, weight loss, and neutropenia. On the basis of these results it can be concluded that in melanoma the combination of daily administration of interferon and vinblastine is not effective, whereas in renal cell cancer interferon and vinblastine treatment given three times a week seems to be favorable.

Adult↗
PubMed1987

Dental extractions in relation to radiation therapy of 224 patients.

The case histories of 224 patients treated with radiation therapy for head and neck malignancies at the Radiotherapy Clinic of the University Central Hospital in Turku during the years 1974-77 are reviewed. Of the 92 patients surviving for 5 years, 90 were available for re-examination. The median radiation dosage was 61 Gy in 6 to 8 weeks in patients with squamous cell carcinoma and other solid tumours and 43 Gy in 5 weeks in patients with lymphoma. The oral status of the patients was examined clinically and radiographically. From these patients, 45 teeth had been extracted before irradiation and 94 after irradiation. In no case had this resulted in osteoradionecrosis of the jaws. It is evident that the repairing of patient's teeth before radiation treatment, coupled with continuous preventive care of caries, will prevent serious complications from arising.

Adult↗
PubMed1987

Estimation of long-term salivary gland damage induced by radiotherapy.

A classification is proposed for estimating salivary gland damage induced by radiotherapy to the head and neck. The volume of salivary glands irradiated was evaluated, and their relative proportions of whole saliva output were calculated. Stimulated salivary flow rate was measured in 61 patients treated with radiotherapy for head and neck malignancies. A highly significant negative correlation was found between the classification of salivary gland damage and stimulated salivary flow rate. The volume of the major salivary glands irradiated seems to be the most important factor affecting the postirradiation salivary flow after a curative dose of radiotherapy. If possible, partial sparing of the salivary glands may help to keep the patient's salivary secretion at an acceptable level and promote protection against dental caries. Most patients irradiated to the head and neck, however, need an effective prophylactic programme for the rest of their lives in order to preserve their teeth.

Dose-Response Relationship, Radiation↗
PubMed1986

Long-term effect of levamisole on the immune functions in melanoma patients.

Thirty radically operated patients with a locally advanced malignant melanoma were given adjuvant levamisole orally 50 mg three times a day on two days a week for one to 40 months in order to prevent recurrence of melanoma. During levamisole treatment the number of E- and EAC-rosette forming cells, proliferative responses of lymphocytes to phytohemagglutinin, concanavalin A and to purified protein derivative of tuberculin were followed at two to four month intervals. All patients were clinically followed at least for five years or to the recurrence of melanoma. Only slight variations occurred in the number of E- and EAC-rosette forming cells and in the responses to mitogens during levamisole treatment. Five out of 30 patients were alive without a recurrence at five years after starting adjuvant levamisole treatment. We conclude that adjuvant levamisole treatment is of no benefit in radically operated melanoma with satellites or metastases in the regional lymph nodes.

B-Lymphocytes↗
PubMed1986

Effect of tamoxifen on immune functions.

Tamoxifen (20 mg twice daily) was given to ten patients with breast cancer whose immune functions were determined prior to and 3, 6, and 12 months after starting tamoxifen therapy. No consistent changes could be observed in erythrocyte rosette-forming cell counts, erythrocyte antibody rosette-forming cells, active erythrocyte rosette-forming cells, theophylline-resistant rosette-forming cells, surface immunoglobulin-positive cells, and responses to mitogens phytohemagglutinin and concanavalin A. Erythrocyte antibody rosette-forming cells decreased significantly, however, at 6 months and active erythrocyte rosette-forming cells at 12 months after starting tamoxifen. We conclude that no change in the immune capacity could be detected during tamoxifen treatment.

Breast Neoplasms↗
PubMed1985

Renal complications of mitomycin C therapy with special reference to the total dose.

One hundred forty-two patients with gastrointestinal cancer were treated with combination chemotherapy containing mitomycin C. The mitomycin C dose was less than or equal to 15 mg/m2 every 53rd day and the total cumulative dose was between 25 and 250 mg. Ten of the evaluable 118 patients (8.5%) developed renal toxicity due to mitomycin C. Five of these ten patients had microangiopathic hemolytic anemia, too. Six of them died 2 to 4.5 months after the last mitomycin C dose and four are alive 14 to 30 months after the last dose. Only 1 of the 63 patients (1.6%) who received less than 50 mg/m2 mitomycin C developed renal toxicity. Four of the 37 patients (10.8%) who received 50 to 69 mg/m2 and 5 of 18 (27.8%) who received more than 70 mg/m2 of mitomycin C developed nephrotoxicity. The toxicity of mitomycin C seems to be dose related, the safe total dose being less than 50 mg/m2 if delivered in doses of 10 to 15 mg/m2 at 8-week intervals.

Adult↗
PubMed1985

Immune functions and the prognosis of patients with solid tumours.

The immune competence of 169 patients with solid malignant tumours was assessed before initiation of radiotherapy or chemotherapy and followed during the course of the disease. The data of years 1974-1984 were collected and subjected to an analysis in order to evaluate their prognostic significance. The number of leucocytes and lymphocytes in the peripheral blood, the percentage or absolute number of E-rosette forming cells or EAC-rosette forming cells or serum immunoglobulin levels did not show any association with the prognosis. Lymphocyte proliferative responses to PHA, Con A and PPD as studied before initiation of the treatment did not correlate with recurrence or final prognosis of the disease, except that the responses to PPD were slightly lower in patients with recurrence of gynaecological cancer, melanoma or gastrointestinal cancer than in their respective control patients. In the values observed after the first treatment course a low response to PPD was associated with poor prognosis in patients with melanoma or gastrointestinal cancer. At the time of recurrent disease the PPD response showed an association with a poor final outcome in patients with gastrointestinal malignancy. Of the responses assessed less than 3 months before death due to cancer, only in patients with breast cancer were low Con A responses seen; in all patient groups the PHA responses decreased in the terminal patients. The results do not support the idea that the methods currently available should be routinely used in the follow-up of cancer patients; rather, they indicate the need to seek new methods for this purpose.

Adolescent↗