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Biomedical subjects

M Onsrud

Publications and source records attributed to M Onsrud.

At least 19 recordsLinked to original sources
PubMed1992

CA125 in peritoneal fluid of ovarian cancer patients.

The presence of CA125 was assessed in peritoneal fluid from 70 patients with ovarian cancer and 32 control patients. The follow-up period ranged from 39 to 89 months (median, 56 months). The cutoff for normal peritoneal fluid CA125 levels was determined to be 250 U/ml. A positive correlation between the serum and peritoneal fluid CA125 levels was observed (P less than 0.001). Peritoneal fluid levels were higher than serum levels in all patients. Patients with evidence of active ovarian cancer showed higher peritoneal fluid CA125 levels than the control patients (P less than 0.001). Peritoneal fluid CA125 levels correlated inversely with survival (P = 0.004). The peritoneal fluid CA125 levels were higher in patients with bulky tumor than in those with small (less than 1 cm) tumors (P less than 0.001). Eight out of twenty-six patients with active cancer and available peritoneal cytology had a negative peritoneal cytology. Three of these patients showed elevated peritoneal fluid levels. Three patients out of twenty-four showed elevated peritoneal fluid CA125 levels at second-look laparotomy. These 3 patients had negative biopsies at second-look surgery, but relapsed during the observation period. At second-look laparotomy an elevated peritoneal fluid CA125 level may imply a bad prognosis, but a normal level does not exclude the presence of disease.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1992

Efficacy of orally administered ondansetron in the prevention of postoperative nausea and vomiting: a dose ranging study.

In a placebo-controlled, double-blind study, we have compared the efficacy of ondansetron 16 mg, 8 mg and 1 mg administered 8-hourly for prevention of postoperative nausea and vomiting. We studied 995 patients undergoing major gynaecological surgery; 982 were included in the analysis. Study medication was administered 1 h before induction of anaesthesia and second and third doses were given 8 and 16 h after the first. The treatment groups were similar for patient characteristics, surgical procedures, anaesthetics administered and opioids given. The frequency of nausea was 75%, 70%, 56% and 55% after placebo and ondansetron 1 mg, 8 mg and 16 mg, respectively; the corresponding frequencies of vomiting were 60%, 55%, 37% and 37%. Ondansetron 8 mg was as effective as 16 mg and both resulted in significant reductions in nausea and vomiting compared with placebo and ondansetron 1 mg (P less than 0.001).

Administration, Oral↗
PubMed1992

Lymphoid cell distribution as prognostic factor in carcinoma of the uterine cervix.

Pretreatment assessment of blood lymphoid cells was performed in 44 patients with carcinoma of the cervix and in 19 healthy controls. White blood cells were determined by routine differential counting, and T-lymphocyte subsets and monocytes were quantitated using monoclonal antibodies. Increase in monocyte numbers, as determined by the 1D5 antibody, was seen in the cancer patients, especially in the group with advanced disease. No change in T-lymphocyte subpopulations could be found. During the 5-year follow-up period, 17 patients had a recurrence or died of cancer. The best prognostic information was obtained from conventional clinical parameters, e.g. stage, tumor size and lymph node status. Increased numbers of granulocytes and monocytes were found in advanced stage disease but had no independent prognostic influence. In pelvic lymph node biopsies taken from patients undergoing Wertheim-Meigs operation the T-helper/T-suppressor ratio was higher and the monocyte number lower than in peripheral blood. No correlation could be detected between node cell distribution and the prognosis. It is concluded that immunological testing, as performed in this study, elicits very little new prognostic information.

Adenocarcinoma↗
PubMed1991

CA 125 in peritoneal fluid from patients with endometriosis.

This study was performed to evaluate CA 125 in peritoneal fluid as an indicator of endometriosis. Peritoneal fluid from patients with mostly minimal and mild endometriosis (n = 43) and normal controls (n = 17) was collected at laparoscopy or laparotomy. The median concentration of CA 125 in peritoneal fluid did not differ significantly between patients and controls (79 IU/ml versus 76 IU/ml). In patients with endometriosis, a significantly increasing concentration of CA 125 in peritoneal fluid was seen from the early follicular to the late luteal phase; a similar change was not observed in the controls. In 14 patients, peritoneal fluid was sampled again after treatment with danazol and a significant reduction in median CA 125 concentration (76.5 IU/ml versus 57 IU/ml), peritoneal fluid volume (17.5 ml versus 10.5 ml) as well as reduced endometriosis scores (4 versus 2) were found. In controls, the concentration of CA 125 was about 10 times higher in peritoneal fluid than in serum. As the peritoneal levels of CA 125 did not differ significantly between patients with endometriosis and controls and as the reduction seen after danazol treatment did not correlate with the decrease of endometriotic implants, it is concluded that the monitoring of CA 125 in peritoneal fluid will not be useful in the diagnosis or control of endometriosis.

Adult↗
PubMed1991

Oral magnetic particles in MR imaging of the abdomen and pelvis.

Two phase 2 clinical trials of an oral superparamagnetic contrast agent for enhancement on magnetic resonance images of the intestine were performed. In trial 1, 31 male patients with cancer of the testis underwent follow-up examinations of the abdomen at 0.5 and 1.5 T after oral administration of magnetic particles. In trial 2, 31 female patients with pelvic and lower abdominal disease were examined at 1.5 T after administration of the contrast material. The patients each ingested 800 mL of contrast material over approximately 2 hours. Concentrations of 0.25 and 0.5 g/L did not induce blurring or metallic artifacts. Distribution was homogeneous through the gastrointestinal tract. In all patients, a loss of signal intensity was observed on proton density-, T1-, and T2-weighted images. The diagnostic information from postcontrast images in trial 2 was greater in 16 patients (52%). Contrast enhancement was independent of field strength; no major side effects were observed. Artifacts from moving bowels were less troublesome, and delineation of intraabdominal and pelvic organs was better with the use of oral magnetic particles.

Abdominal Neoplasms↗
PubMed1991

Tumour markers in gynaecologic oncology.

Human chorionic gonadotropin is a highly sensitive and specific tumour marker for gestational trophoblastic disease and reflects accurately tumour volume and clinical course of the disease. Alpha-fetoprotein is usually a reliable marker for endodermal sinus tumours and embryonal carcinomas, and also predicts the presence of yolk sac elements in mixed germ cell tumours. Squamous cell carcinoma antigen can be useful in the detection of recurrent cervical carcinoma. Carcinoembryonic antigen determination can be of help to distinguish adenocarcinomas of the cervix from those of the endometrium. Thus far, CA125 is the most widely used tumour marker in gynaecologic oncology. Its main area of application is epithelial ovarian carcinomas where it is useful for disease monitoring during and after therapy. The specificity of the CA125 test is too low for use in preoperative diagnosis. The utility of CA125 for screening depends on combinations with other diagnostic methods, such as pelvic examination and ultrasound. No combination of tumour markers has so far proven superior to CA125 alone.

Antibodies, Monoclonal↗
PubMed1988

High-dose versus low-dose metoclopramide in the prevention of cisplatin-induced emesis. A randomized crossover study in patients with ovarian carcinoma.

Forty-six patients with ovarian carcinoma who received single drug cisplatin chemotherapy were evaluated for the antiemetic efficacy of two different doses of metoclopramide. Each patient received during the first two courses a 4-hour continuous infusion of either 8 or 0.8 mg/kg in a random order. Total protection from emesis was achieved in 12 (26%) of the high-dose courses and in three (7%) of the low-dose courses of metoclopramide. Major control (one or two emetic episodes) was achieved in seven (16%) and in four (9%) of the courses, respectively. The higher dose of metoclopramide significantly reduced the degree of nausea as recorded on a visual analogue scale. A significant difference between courses 1 and 2 could only be seen when the high-dose treatment was followed by low-dose metoclopramide. The duration of anorexia after the courses was not influenced by the metoclopramide dosage. Side effects were mild. It is concluded that there is a dose-response relationship for the antiemetic effect of metoclopramide.

Adult↗
PubMed1987

Cyclophosphamide versus ifosfamide: final report of a randomized phase II trial in adult soft tissue sarcomas.

Ifosfamide (IFOS) 5 g/m2 and its parent analog Cyclophosphamide (CYCLO) 1.5 g/m2 were studied in a randomized phase II study, accruing 171 patients with advanced soft tissue sarcoma. Both drugs were administered as 24 hr infusions, every 3 weeks, with comcomitant Mesna 400 mg/m2 i.v. bolus 4 hourly X 9 doses. Twenty-four patients were ineligible and 12 were not evaluable. The groups were well matched for age, previous chemotherapy (42% of the total) or radiotherapy, the presence of distant metastases and performance status, but there were more females (59% vs. 45%) in the IFOS arm. Among the 68 evaluable patients receiving IFOS, there were 2 CR, 10 PR (overall response 18%), 27 SD and 29 PD. For CYCLO, the corresponding results in 67 patients were 1 CR, 4 PR (overall response 8%), 23 SD and 39 PD. Using the chi-square test the P values for response rate and linear trend were 0.13 and 0.04 respectively. Response rates were higher for females (20% vs. 5%, P = 0.01) and patients who had not received previous chemotherapy (19% vs. 4%, P = 0.01). Fourteen of the 17 responses came from a group of 43 females, who had not received previous chemotherapy, for whom the overall response rate was 37.5%. Remissions were noted in only 4 histological subtypes (centrally reviewed material), i.e., 5 of 17 synovial sarcomas, 7 of 13 mixed mesodermal sarcomas and 2 of 7 fibrosarcomas. One of the 31 leiomyosarcomas responded to Cyclophosphamide. Durations of response did not differ significantly between the 2 arms--median 26, range 10-81+ weeks. Leucopenia was significantly more severe on CYCLO, particularly in patients who had received previous chemotherapy (P = 0.007). Serious infections occurred in approx. 7% of patients with no difference between the two drugs, although there was one toxic death on CYCLO. Nausea and vomiting were significantly worse on IFOS and alopecia, related in extent to dose, was seen in both arms. Other side-effects, such as hematuria or rises in serum creatinine and encephalopathy, were infrequent and mild. A higher response rate with less myelosuppression suggests that IFOS may have advantages over CYCLO in combination therapy.

Adolescent↗
PubMed1987

Placental alkaline phosphatase as a tumor marker in ovarian cancer.

The serum levels of placental alkaline phosphatase were determined with a radioimmunoassay using a polyclonal antibody on 1236 samples from 414 patients with ovarian cancer. The frequencies of elevated enzyme levels for patients with or without evidence of disease were 17.7 and 10.9%, respectively. The true positive rate was highest in serous cystadenocarcinoma, undifferentiated carcinoma, and dysgerminoma. A tendency to an inverse correlation with differentiation was found. Measurement of the enzyme did not give a useful index of stage of disease, tumor burden, or prognosis. The value of the enzyme as an index of successful therapy was limited because half of the patients lost this marker during progression. Further studies of the use of this enzyme as a tumor marker should evaluate the modulation of the placental alkaline phosphatase pattern during the course of the disease and should be based on monoclonal antibodies.

Alkaline Phosphatase↗
PubMed1986

Immunosuppressive effects of peritoneal fluids from ovarian cancer patients.

Peritoneal fluid samples from 42 patients with ovarian carcinomas were tested for their suppressive effects on in vitro responses of normal lymphocytes. Suppression was detected both in a natural killer cell assay against K562 cells and in an assay measuring phytohemagglutinin-induced lymphoproliferation. There was no correlation between the level of immunosuppression and the 1-year survival. The greatest suppression was seen in radically operated patients and in patients with normal amounts of peritoneal fluid. Complete suppression was also seen in two patients operated for benign diseases. The results indicate that immunosuppression is not restricted to malignant ascites, but may be a normal function of the peritoneal fluid.

Ascitic Fluid↗
PubMed1986

cis-Platinum as adjunctive to surgery in early stage ovarian carcinoma: effects on lymphoid cell subpopulations.

The effect of single-drug cis-diamminedichloroplatinum (CDDP) treatment on the distribution of T-lymphocyte subsets and monocytes was determined using monoclonal antibodies and a flow cytometry technique. Thirty-nine patients with radically operated ovarian carcinoma received postoperative treatment with six cycles of CDDP 50 mg/m2, and were examined either before, during, or after chemotherapy. During treatment, the number of OKT4+ (mainly T-helper) cells was reduced, whereas the number of OKT8+ (mainly T-suppressor/cytotoxic) cells was increased. Four to six months after the CDDP treatment was ended, these aberrations were no longer seen. The number of 1D5+ cells (monocytes) was not influenced by the treatment. It is concluded that no long-lasting change in the distribution of immunocompetent cells could be detected after this regimen of CDDP treatment.

Adult↗
PubMed1986

Suppressive effect of monocytes in vitro in patients with carcinoma of the uterine cervix.

The adherent cell fraction (AdC) of human peripheral blood mononuclear cells (PBM) contains two cell types of opposing function in vitro. Dendritic cells (DC) act as antigen-presenting cells (APC) in vitro, while monocytes (Mo) have a suppressive effect on antigen activation of T cells. In this report we show that patients with cervical carcinoma have a significantly increased number of suppressive Mo compared with healthy controls. The T cell response to Herpes Simplex Virus (HSV-1) and PPD was about the same in the two groups, but after removal of Mo by adherence a significantly higher T cell response was seen among the patients with advanced stage (Figo stage IIb-IVa) compared with patients in early stage (Figo stage Ia-IIa) and healthy controls. These observations indicate that patients with cervical carcinoma have an increased number of T cells reactive with HSV, and normal DC function. The relative suppression expressed on a per Mo basis was the same in all groups, which indicates that the increased suppression in the patients was caused by an increased number of Mo, and not by changes in their activation state.

Adenocarcinoma↗
PubMed1985

Squamous cell carcinoma of the cervix stage IB: numbers and reactivities of pelvic lymph node T cells.

Ten patients with squamous cell carcinoma of the cervix stage IB (FIGO) treated by radical hysterectomy and pelvic lymph node dissection had node biopsies taken for immunological studies. There was no evidence of metastases. Node biopsies from near the cervix (the obturator region) contained significantly more lymphoid cells per gram of tissue than biopsies from more distant (common iliac) nodes. The percentage of T cells was similar in the two nodes, but significantly lower than in mononuclear cell suspensions from peripheral blood. All patients responded to the mitogen phytohemagglutinin. Positive T-cell responses to herpes simplex virus antigen were found in seven patients. Six patients responded to stimulation by the chlamydial antigen LGV-2. Lymph node T cells gave responses higher than those from peripheral blood T cells. Obturator node T cells from patients pretreated with intracavitary radium had antigen-specific responses lower than those of the patients operated without prior irradiation. The results indicate that the pelvic lymph nodes are important reservoirs for sensitized T cells.

Adult↗
PubMed1985

Cell-mediated and humoral immune responses to chlamydial and herpesvirus antigens in patients with cervical carcinoma.

Herpes simplex virus (HSV) and Chlamydia trachomatis are both discussed in the etiology of cervical carcinoma. In this study the antibody titers and the T-cell proliferative responses to chlamydial and HSV antigens in patients with cervical intraepithelial neoplasia (CIN) and invasive cervical cancer, have been investigated and compared. The patients with CIN and invasive cancer showed approximately the same degree of immune responses to chlamydial and HSV antigens. Of the patients, 58% showed proliferative T-cell responses to C. trachomatis antigen, 87% to HSV antigens. Chlamydial antibodies were detected in 65% of the patients, while 81% had a positive HSV serology. Our results show a lack of correlation between levels of antibody titer and T-cell responses. It is concluded that patients with CIN and invasive cervical cancer have intact cellular immune responses to both chlamydial and HSV antigens. The eventual role of these infections in the etiology remains unclear.

Adenocarcinoma↗
PubMed1985

Serum-mediated immunosuppression: a possible tumor marker in patients with ovarian carcinoma.

Serum samples from 25 patients with ovarian carcinoma were tested for their suppressive effects on in vitro response of normal lymphocytes. Patients examined prior to primary surgery showed a significantly greater suppression than did patients examined after a radical operation. Suppression was detected both in a natural killer cell assay and in an assay of phytohemagglutinin-induced lymphoproliferation. Only the results of the later test showed a correlation to the clinical course: Those patients who died during the first year of follow-up presented the most marked suppression. Serial determinations performed in a few patients indicated a certain correlation between immunosuppression and tumor burden. It is concluded that this test may give additional prognostic information in patients with ovarian carcinoma.

Antilymphocyte Serum↗
PubMed1985

Serum lipids and lipoproteins in patients with endometrial carcinoma receiving adjuvant treatment with hydroxyprogesterone caproate.

Serum levels of triglycerides, total cholesterol, and HDL-cholesterol were determined in 57 patients who were undergoing treatment for stage I endometrial carcinoma. The patients belonged to a clinical trial where group A (control) was treated with surgery plus intravaginal irradiation, whereas group B in addition was treated with hydroxyprogesterone caproate (5000 mg i.m. as a loading dose followed by 1000 mg every 2 weeks for one year). In group B patients followed during the first 13 weeks of treatment, the level of serum triglycerides remained stable, whereas the level of total cholesterol and HDL-cholesterol increased significantly. This increase could not, however, have been caused by the progestogen treatment, as similar changes were seen in group A patients followed for the same period of time. Long-term effects were looked for in patient groups examined 3-12 months after the start of treatment and in groups examined 3-6 months after the hormone therapy was stopped. In neither group could any significant difference in cholesterol or HDL-cholesterol be found. It is concluded that this type of progestogen treatment causes no significant change in the levels of triglycerides, cholesterol, and HDL-cholesterol.

17 alpha-Hydroxyprogesterone Caproate↗