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Biomedical subjects

E Simonsen

Publications and source records attributed to E Simonsen.

At least 73 records · Page 4Linked to original sources

Plasma concentrations of complement split product C3d and immune complexes after procainamide induced production of antinuclear antibodies.

Seventeen patients treated with procainamide for cardiac ventricular arrhythmias were followed for up to 40 weeks. Immunological data as a clue to developing the systemic lupus erythematosus (SLE)-like syndrome was emphasized. Ten patients developed antinuclear antibodies (IgG or IgM), but no increase in the plasma concentration of the complement split product C3d or immune complexes, measured by two different methods, was demonstrated. This finding is in contrast to the high levels of both C3d and immune complexes in SLE. The discrepancy may be caused by a lack of immune complex mediated complement activation by the procainamide induced antibodies, or may be due to a difference in severity of disease. The acetylator phenotype of the patients was determined but due to the low frequency of fast acetylators no comparison of the immunological response of the two phenotypes could be done.

Aged↗

Superiority of multiprogrammable to nonprogrammable VVI pacing: a comparative study with special reference to management of pacing system malfunctions.

Analysis of pacing system malfunctions was performed in 374 patients at initial implantation or at pulse generator and lead replacement during a period of 55 months. A total of 150 nonprogrammable pacemakers were implanted in 148 patients, while 236 multiprogrammable pacemakers were implanted in 226 patients. The purpose of the analysis was to investigate the occurrence and management of malfunction unrelated to pacemaker/lead failure or lead dislodgement. The nonprogrammable group was followed for 3-53 months (median, 36). Malfunction occurred in 18 patients (12.0%): muscle stimulation in 14; exit block in three; sensing problem in one. Surgical correction was necessary in 14 of 18 cases. The multiprogrammable group was followed for 3-52 months (median, 12). Malfunction occurred in 30 cases (12.7%): muscle stimulation in 22; threshold increase in seven; sensing problem in one. Only seven of these patients required surgical correction as 23 cases were successfully managed by reprogramming alone. Malfunctions occurred during a period of several days to 36 months (median, 2.3 months). The difference in rate of secondary surgical intervention was significant (p less than 0.01). Measurements during reoperation in the nonprogrammable group showed that at least 40% of late malfunctions would have been correctable by reprogramming alone. Thus, multiprogrammability is of significant value for noninvasive correction of malfunctions unrelated to pacemaker and lead failures, predominantly muscle stimulation and threshold elevation.

Aged↗

Doxorubicin-cisplatin combination chemotherapy for recurrent carcinoma of the cervix.

A total of 31 patients with recurring or metastasizing squamous cell carcinoma of the cervix were treated with doxorubicin and cisplatin. Sixteen patients (Group 1) had previously been treated with external irradiation and two intracavitary radium applications, and 15 patients (Group 2) had been treated with radiotherapy plus chemotherapy with bleomycin plus mitomycin, peplomycin, or melphalan. The overall frequency of response was approximately 16% (five of 31 patients). In Group 1, two of 16 patients had complete remission for 14+ and 28 months, and survival for 36+ and 45+ months. One of 16 patients had partial remission for 8 months, and survival for 16+ months. In Group 2, two of 15 patients achieved partial remission for 16 and 18 months, and survival for 28 and 35 months. No serious side effects were noted in the two groups.

Adult↗

Frequent attacks of supraventricular tachycardia in a patient treated with an automatic scanning pacemaker (PASAR): Holter documentation of 554 episodes.

A 68-year-old woman suffering from frequent attacks of supraventricular tachycardia received an implantable, automatic scanning pacemaker for tachycardia termination (PASAR). Electrophysiological study had shown the mechanism to be atrioventricular reentry with retrograde conduction through a concealed bypass tract. During 1 year of follow-up, a total of twenty-one 24-hour Holter recordings documented 554 episodes of tachycardia. In spite of marked fluctuation in tachycardia rate from 135 to 195 bpm and a considerable variation in diurnal pattern of onset of episodes, a clinical improvement resulted. Previous episodes of tachycardia had been isolated and of longer duration. Following implantation, an unexpected observation was made of numerous episodes of supraventricular tachycardia confined to periods lasting up to several hours. This pattern seemed to result from the efficacy of tachycardia termination combined with a continued presence of factors responsible for initiation of tachycardia.

Aged↗

Basal cell carcinoma of the vulva.

A clinical and histopathologic study of material from a series of 21 patients with basal cell carcinoma treated from 1960 until 1979 are reviewed. In 3 patients 'mixed' tumor was recorded. The histopathologic diagnosis: basosquamous carcinoma and the behavior of this carcinoma are discussed. The mean age of the patients was 76 years. Presenting symptomatology consisted primarily of bleeding, burning or itching, and ulcerations. No case of pure basal cell carcinoma gave metastasis to the regional lymph nodes, in no case could the cause of death be attributed directly to this kind of lesion. A conservative approach consisting of wide local excision is suggested.

Aged↗

T wave inversion and ST segment depression in normally conducted beats in patients treated with ventricular demand pacing.

Changes of T waves and ST segments in normally conducted beats are frequently seen in patients treated with ventricular demand pacing. The alteration in the sequence of ventricular activation is accompanied by inversion of T waves and sometimes a depression of ST segments in several leads. These changes have a close resemblance to those often seen in ischaemic heart disease. Some of the clinical implications are illustrated in four case stories. The slow regression of changes after cessation of pacing is particularly emphasised. The time required for complete disappearance of changes was directly related to the duration of ventricular pacing. In contrast to this finding a quickly developed, though temporary, regression was observed during exercise. The development of repolarisation changes requires a certain duration and extent of pacing. Therefore changes are not present in all ventricular paced patients. Consequently, recording of the spontaneous rhythm is proposed as a routine in the pacemaker clinic. The recordings might prove valuable for future comparison in case of suspected myocardial disease.

Aged↗

Treatment of recurrent endometrial adenocarcinoma with a combination of doxorubicin and cisplatin.

Nineteen patients with recurrent endometrial carcinoma and one patient with Stage IV endometrial carcinoma not previously treated with chemotherapy were treated with a combination of doxorubicin and cisplatin. The dose schedule was doxorubicin, 50 mg/m2 on day 1, and cisplatin, 50 mg/m2 with hyperhydration on day 1, with a new course every 4 weeks. Objective response 60% was obtained in 12 out of 20 patients (two with complete remission and 10 with partial remission). Furthermore, four patients had stationary disease. The two patients with complete remission both had distal vaginal metastases, and they are still alive after greater than 21 and greater than 40 months. The median survival period for those with partial remission was greater than 11 months (range of 4 to 26); for those with stationary disease, 7 months (range of 4 to 10), and for those with progressive disease, 4 months (range of 3 to 7). The response rate was higher for well-differentiated tumors. No serious side effects were noticed. To our knowledge no other reports have been published so far with the use of the same regimen in patients with recurrent endometrial adenocarcinoma with no prior chemotherapy. We find the objective response rate, the survival time, and the quality of life for the responding patients in our study so encouraging that we shall continue with a larger trial.

Adenocarcinoma↗

Treatment of recurrent squamous cell carcinoma of the vulva.

Continuous follow-up of 244 patients treated for primary invasive squamous cell carcinoma of the vulva during a 20-year period (1960-1979) resulted in the detection of recurrent (or persistent) disease in 60 cases. Forty-one of these cases developed local or regional recurrence, or both, later than six months after treatment, and an analysis of the result of retreatment in this group is presented. Twenty-nine had local recurrences, nine regional metastases and three local recurrences and regional metastases. The treatment technique for local recurrences was surgery, in a few cases combined with irradiation and chemotherapy. In approximately one-third of the cases, this treatment resulted in long-term or permanent cure. In cases of regional metastases the prognosis was often extremely poor, but treatment normally gave good palliation although of short duration.

Actuarial Analysis↗

Radiation therapy and surgery in the treatment of regional lymph nodes in squamous cell carcinoma of the vulva.

A series of 244 patients with vulvar squamous cell carcinomas was analyzed with regard to treatment of the regional lymph nodes. In 144 patients, groin dissection was performed, supplemented in 24 cases by pelvic lymphadenectomy. Preoperative irradiation was given and in cases with positive nodes postoperative irradiation as well. Patients in whom lymph node dissection was not performed received irradiation. Treatment failures in the regional lymph node regions were analyzed and the policy concerning treatment of the regional lymph nodes is discussed.

Carcinoma, Squamous Cell↗

Stage I squamous cell carcinoma of the vulva.

Eighty-six patients with invasive squamous cell carcinoma of the vulva stage I were followed for 2 to 20 years after surgical treatment varying from local excision to radical vulvectomy with inguinal lymph node dissection. The results are presented and the prognosis discussed in relation to the radicality of the surgical intervention, the degree of tumour differentiation, the morphologic properties of tumour cell population, and the tumour host relationship. The most important prognostic factor seemed to be the radicality of the surgical intervention. To reduce patient morbidity in radical surgery while still achieving a comparable survival rate an operative approach with less than radical vulvectomy, inguinal dissections or pelvic lymphadenectomy, or both, is proposed for selected patients.

Actuarial Analysis↗