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Biomedical subjects

K Aabo

Publications and source records attributed to K Aabo.

At least 37 records · Page 2Linked to original sources
PubMed1986

Central nervous system complications by malignant lymphomas: radiation schedule and treatment results.

During a 10-year period, 28 patients with spinal cord compression due to epidural malignant lymphoma and 47 patients with cerebral involvement of lymphoma were treated with radiation at our institution. Fifty-four percent of the patients with spinal cord compression had this complication at the time of initial presentation of the disease, whereas only 4% with cerebral involvement presented with CNS symptoms. Only one patient had primary lymphoma solely located in the brain. Characteristically, a majority of the patients with spinal cord compression complained of back pain several months before developing neurological symptoms. Because only one-third of the patients had positive spine roentgenograms at the time of spinal cord compression, a CT scan is suggested in patients with malignant lymphoma suffering from back pain in order to verify a paraspinal lymphoma. Thus spinal cord compression may be avoided by early diagnosis and treatment. Among the patients with spinal cord compression, Hodgkin's and non-Hodgkin's histology were equally represented, whereas only 6% had Hodgkin's lymphoma among the patients with cerebral involvement of lymphoma. The response to treatment defined as improvement in neurological deficit in the patients with spinal cord compression was approximately 90% in both the Hodgkin's and the non-Hodgkin's group. No difference in response was found among patients who had laminectomy compared to patients who did not. Patients receiving high dose, short-term treatment (5 Gy X 5-6) responded equally to patients receiving low dose, long-term treatment (2 Gy X 18-20). The median survival from initiation of radiation therapy in patients developing spinal cord compression or cerebral involvement during relapse was 30 months. In patients with spinal cord compression at initial presentation of the disease, median survival had not been reached after 5 years. Among patients with cerebral involvement 50% had improvement of neurological symptoms with no difference between patients receiving high dose, short-term and patients receiving low dose, long-term treatment. It is concluded that high dose, short-term irradiation is as effective as low dose treatment. Especially in patients with neurological complications at relapse, this treatment schedule is preferred because of the extremely short survival of these patients.

Brain Neoplasms↗
PubMed1986

Lung abscess in small cell carcinoma of the lung during chemotherapy and corticosteroids: an analysis of 276 consecutive patients.

Two hundred and seventy-six consecutive patients with small cell carcinoma of the lung (SCCL) treated with combination chemotherapy and in 79 cases with "high-dose" steroids (greater than 40 mg of prednisone per day) were reviewed for the presence of lung abscess. This was diagnosed in 17 patients, in 4 (1.5%) at the time of their malignant diagnosis and 13 (4.9%) during chemotherapy. Five of 79 patients receiving "high-dose" glucocorticoid therapy and 8 of 184 patients not receiving steroids developed lung abscess (no statistical difference, P greater than 0.05). "High-dose" steroids do not facilitate the development of lung abscess. Eleven patients presented with a lung abscess within a month of initiation of chemotherapy. Median survival of these patients was 182 days and not significantly different from a median survival of 224 days (P greater than 0.05) observed in 31 compatible patients without lung abscess. Lung abscess per se in patients with SCCL should not prevent the use of intensive combination chemotherapy and "high-dose" steroid therapy.

Adult↗
PubMed1986

Clinical and non-invasive assessment of anthracycline cardiotoxicity: perspectives on myocardial protection.

A series of 38 patients with solid tumours (N=29) and haematological malignancies (N=9) and with suspicion of cardiotoxicity (CTX) due to antineoplastic drugs was studied. The series comprised 22 females and 16 males (mean age 52 years). The patients were examined clinically by ECG, chest X-ray and echocardiography. Seventeen patients were classified as having moderate or severe chronic CTX; 16 patients developed either arrhythmias shortly after the administration of chemotherapy (acute CTX) or arrhythmias and/or signs of myocardial dysfunction (without overt congestive heart failure) at a later date, after chemotherapy had been suspended (latent CTX). In 5 cases the suspicion of CTX could not be confirmed. Weak and non-specific symptoms such as unexplained tachycardia or coughing at night should alert the clinician and result in ECG control and further non-invasive cardiological investigations (including radionuclide angiocardiography) before additional anthracycline is administered. Chest X-ray is a very insensitive method with respect to early diagnosis of chronic CTX; in cases of doubt heart catheterization with endomyocardial biopsy should be carried out to obtain a reliable estimate of the extent of morphological damage. As anthracycline CTX may present without prominent clinical symptoms or as latent disease, one should be aware of potential precipitating factors such as volume load (during i.v. chemotherapy), surgical trauma and general anaesthesia and alcohol abuse. Further effects to lessen CTX should be made, using supposed cardio-protective substances in randomized clinical trials. Promising research on coenzyme Q10 and carnitine may usher in a new era in the prevention of anthracycline cardiotoxicity.

Adolescent↗
PubMed1985

Spleen irradiation in chronic lymphocytic leukemia (CLL): palliation in patients unfit for splenectomy.

In 22 patients with CLL given 30 courses of spleen irradiation, 23 responses were observed (77%, 95% confidence limits, 58-90%). Response was defined as reduction in palpable spleen size accompanied by relief of symptoms (pain, abdominal discomfort, and sweating) or improvement in hypersequestration or hemolytic anemia. Reduction in leukocyte count alone was not regarded as response. All responses were partial. The median response duration was 1 year. Subsequently, three patients underwent splenectomy. The median survival from the beginning of spleen irradiation was 2.5 years (range: 1 month-greater than 5 years). Only six patients had minor side effects from the gastrointestinal tract. The hematologic effect was most pronounced on the white blood cell count, but also the platelet count was affected. It is concluded that spleen irradiation is a gentle and effective alternative in CLL patients suffering from splenomegaly (pain and hypersplenism), refractory to chemotherapy and glucocorticosteroids and unfit for splenectomy. Splenic irradiation may also be used with benefit preoperatively before splenectomy in patients with excessive splenomegaly and hypersplenism.

Adult↗
PubMed1985

A randomized study of single agent vs combination chemotherapy in FIGO stages IIB, III and IV ovarian adenocarcinoma.

From 1977 until 1980, 179 patients with newly diagnosed FIGO stages IIB, III or IV ovarian adenocarcinoma were randomized in a two-armed clinical trial: dihydroxybusulfan (B) 600 mg/m2 p.o. for 4-6 weeks q 12 weeks or cyclophosphamide (C) 150 mg/m2 p.o. for 7 days q 4 weeks vs a combination of cyclophosphamide 400 mg/m2 i.v., doxorubicin 30 mg/m2 and 5-fluorouracil 400 mg/m2 i.v., days 1 and 8 q 4 weeks (CAF). In addition, stage IIB patients were randomised to +/- pelvic irradiation. The patients were stratified according to anatomic stage. The treatment groups were comparable with respect to performance status, age and histology. Twenty-three patients were excluded because of protocol violation, leaving 156 patients evaluable for survival with an observation period of 3-6 yr. Twenty patients were in stage IIB, while the remaining 136 patients were classified as stages III and IV. No statistically significant difference was found in survival or response between the two single agents. The overall median response rate (single drug: 27%; CAF: 47%) and the median response duration (single drug: 5 months; CAF: 10 months) were significantly superior for the CAF group compared to the single agent group. No statistical difference in median survival was observed between single-drug treatment (12 months) and CAF (14 months), despite the fact that responders lived significantly longer than nonresponders (17 vs 10 months). In stage IIB patients receiving chemotherapy no benefit of pelvic irradiation was found. Thirty patients (19%) underwent second-look laparotomy, with 15 (50%) being completely free of disease. So far only one patient (7%) has relapsed. Two additional patients, who had microscopic disease removed at second-look laparotomy, seem to have been rescued by this procedure.

Adenocarcinoma↗
PubMed1985

Cisplatin in the treatment of advanced gastric carcinoma: a phase II study.

Twenty-one patients with advanced local or metastatic gastric carcinoma were treated with 75 mg/m2 of cisplatin every 3 weeks. Six patients had received no prior chemotherapy. One patient achieved complete tumor regression lasting 5 months, while three patients had partial responses of 2, 4, and 11 months' duration, respectively, resulting in an overall response rate of 18% (95% confidence limits: 5%-40%). All four responding patients had improvement in performance status. Two of six patients who had had no prior chemotherapy responded, while only two of 16 patients previously treated with 5-FU and doxorubicin responded.

Adult↗
PubMed1984

Surgical management of intestinal obstruction in the late course of malignant disease.

Intra-abdominal and pelvic malignancies not infrequently are complicated by intestinal obstruction during their progressive course. How energetically this complication should be treated is a matter of controversy. An analysis of 41 such cases is presented. Small-bowel obstruction was most commonly caused by extensive serosal carcinomatosis, whereas obstruction of the large bowel usually was due to a single tumor. There was good concordance between the preoperative assessment of blockage level (small v. large bowel) and peroperative findings. All the patients with colonic obstruction obtained palliation from surgery, with median duration 6 months. Only 63% of the patients with small-bowel obstruction were relieved. This figure fell to 44%, with median duration of relief only 2 months, when carcinomatosis was the causal condition. The corresponding figures for patients with block caused by a single tumor were 89% and 6 months. Intestinal obstruction from non-malignant mechanisms was relieved in all cases. Surgical exploration should be attempted in these patients, as conservative measures are known to be of little benefit. In patients with extensive carcinomatosis, however, a favorable outcome in terms of symptom relief and prolonged survival is relatively unlikely.

Adolescent↗
PubMed1983

Pancreatic islet cell carcinoma associated with multiple hormone secretion and pancytopenia. Evidence of a serum factor suppressing hematopoiesis.

A case of metastatic islet cell carcinoma of the pancreas associated with the production of multiple polypeptide hormones (insulin, glucagon, and gastrin) is described. Three years prior to the histologic diagnosis the patient presented with a gastric ulcer and an androgen responsive pancytopenia with hypoplastic bone marrow. Discontinuation of androgen therapy resulted in relapse of pancytopenia. After the diagnosis of islet cell carcinoma of the pancreas was established, the patient was treated with 5-fluorouracil (5-FU) and streptozotocin and subsequently elevated serum polypeptide hormones returned toward normal levels. Concurrent with the normalization of peptide hormones another complete hematologic remission was achieved without use of androgens. Injection of the patient's serum into female rats produced a significant fall in leukocyte (P less than 0.02) and platelet counts (P less than 0.005), but no significant decrease in hematocrit. The clinical course and laboratory findings in this case suggest the presence of a previously undescribed serum factor released by an islet cell tumor capable of suppressing hematopoiesis.

Adenoma, Islet Cell↗
PubMed1983

Intermittent high-dose aclarubicin in patients with advanced cancer: a phase I study with special reference to cardiac toxicity.

Aclarubicin was given iv every 3 weeks to 21 patients with a variety of solid tumors. Four dose levels were tested: 80, 100, 120, and 140 mg/m2. The median cumulative dose was 270 mg/m2 (range, 80-900). No objective responses were observed. Hematologic toxicity was dose-limiting. All patients experienced moderate to severe gastrointestinal toxicity. Five of 13 patients evaluable for cardiac function showed clinical signs and ECG changes suggestive of cardiac dysfunction. The suggested maximum dose for phase II trials is 120-140 mg/m2 iv given in an intermittent 3-week schedule.

Aclarubicin↗
PubMed1982

cis-Dichlorodiammineplatinum (II) and hexamethylmelamine in advanced ovarian carcinoma: a phase II study.

Thirty-eight previously treated patients with ovarian carcinoma received a combination of cis-dichlorodiammineplatinum (II) (CDDP) and hexamethylmelamine (HMM). The schedule was CDDP 75 mg/m2 i.v. with forced diuresis on day 1, followed by HMM 200 mg/m2 p.o. on days 8-21, repeated every 4 weeks. In 29 evaluable patients an overall response rate (CR + PR) of 35% with a median response duration of 4.5 months was observed. The performance status seemed to be an important prognostic factor. The gastrointestinal- and neurotoxicities were severe and resulted in dose modification and/or drug discontinuation in half of the patients. In conclusion, CDDP and HMM is an active drug combination in advanced ovarian carcinoma resistant to conventional chemotherapy. A possible superiority of this combination compared with CDDP or HMM alone has to await randomized trials.

Adult↗
PubMed1982

Surface structure of intravasculary megakaryocytes. A scanning electron microscope study.

To elucidate the surface structure of intravasculary megakaryocytes, rabbit megakaryocytes were isolated from central venous blood and examined by scanning electron microscopy. The megakaryocytes were approximately 50 micrometers in diameter and had a spherical appearance. The surface was extremely folded with ridges and clefts, but pseudopods (budding) were never seen. Naked megakaryocyte nuclei appeared irregular in shape owing to varying amounts of residual cytoplasm often resembling buds (blebs). Their size were 15-20 micrometers.

Animals↗
PubMed1982

Phase II study of procarbazine in small cell carcinoma of the lung.

Thirty-nine patients with small cell anaplastic carcinoma of the lung were given oral doses of procarbazine ranging from 100 to 200 mg/m2 on Days 1-14 every 4 weeks. All patients had previously received combination chemotherapy. No responses were observed in the 24 evaluable patients. In reviewing the literature, we were unable to find evidence that the inclusion of procarbazine in combination chemotherapy is beneficial in small cell anaplastic carcinoma. Accordingly, it is concluded that procarbazine should not be considered as a useful drug in the management of this cell type of lung cancer.

Administration, Oral↗
PubMed1982

An implantable, externally powered radiotelemetric system for long-term ECG and heart-rate monitoring.

An externally inductive powered implantable ECG radiotelemetry unit has been developed for continuous long-term measurements of cardiophysiological changes following administration of cardiotoxic drugs. The power density distribution (320 kHz) inside the cage has been measured to be 3-11 mW/cm2. The implantable unit has a volume of 38 X 22 X 8 mm and a mass of 9 g, and has been tolerated by the animal (guinea pig) during a continuous registration period of 6 months.

Animals↗