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O G Jørgensen

Publications and source records attributed to O G Jørgensen.

11 recordsLinked to original sources
PubMed1997

Systemic pneumococcal disease after staging splenectomy for Hodgkin's disease 1969-1980 without pneumococcal vaccine protection: a follow-up study 1994.

We surveyed, during 1994, all 325 patients who underwent staging laparotomy with splenectomy for Hodgkin's disease in Norway 1969-80, before pneumococcal vaccine was available in this country. The patients were thus not immunized preoperatively. Of 162 patients (49.8%) who died before 1994, 8 (2.4% of the total study) died from pneumococcal septicaemia and 16 (6.2%) from infections totally. Of 163 patients (50.2%) who were alive in 1994, 158 cooperated and filled in a questionnaire: 22 had been hospitalized for serious infections; 2 with pneumococcal septicaemia, and 6 with pneumonia, although lacking a specified microbiological diagnosis. We observed 325 patients representing 4420 patient-years, 3066 patient-years among survivors and 1354 patient-years among the dead. This resulted in an incidence rate of systemic pneumococcal disease of 226 per 100,000 patient-years, which is a relative risk of 20.5 compared to the general Norwegian population during 1994. Septicaemia for these patients most often had an abrupt clinical start even for relapse-free individuals and occurred from 2 to 17 yr after splenectomy (mean 10 yr). The risk of developing an overwhelming pneumococcal septicaemia with high case-fatality in asplenic patients seems to persist for these patients at about the same level even 15-20 yr after splenectomy. Only 12.7% of the survivors had been given pneumococcal vaccine in the autumn of 1993. Despite the fact that medical journals and media in Norway focused upon the problem of pneumococcal disease in asplenic individuals in the autumn of 1993 and spring of 1994, a substantial proportion of these patients (55.3%) still remained unimmunized when interviewed in the autumn of 1994. None of our systemic pneumococcal disease patients was vaccinated. Our data underline the need for prophylactic immunization with effective vaccines against pneumococcal infection in splenectomized Hodgkin's disease patients.

Adolescent↗
PubMed1994

[Medullary thyroid carcinoma--familial or sporadic disease?].

Medullary thyroid cancer may be autosomal dominantly inherited. Calcitonin is a very sensitive tumour marker in medullary thyroid cancer. It is essential to measure calcitonin in first grade relatives of these patients, in order to expose familial incidents of subclinical disease. In 55 patients with medullary thyroid cancer and no history of familial disease, nine close relatives with elevated calcitonin were identified in four different families. Eight of these nine have been thyroidectomized. Five were found to have medullary thyroid cancer, one had definite C-cell-hyperplasia, and two had equivocal C-cell hyperplasia. The last two, had elevated basal serum calcitonin-levels were increased, but with no further increase after intravenous pentagastrin bolus injection. Thyroidectomy did not modify these results and DNA-analysis may be necessary to draw a conclusion about the hereditary situation of these patients.

Adolescent↗
PubMed1993

Follow-up of breast cancer patients stage I-II: a baseline strategy.

In 430 stage I-II breast cancer patients the cost-benefit of investigations during follow-up have been studied. Median follow-up time was 8 years and 128 patients had relapsed, 91 with metastatic disease. High costs of routine chest X-ray, limited skeletal X-ray and bone scan examinations were associated with low incidence of diagnosed relapses not suspected otherwise. In the eight blood analyses examined, increases of more than 10 mm/h in erythrocyte sedimentation rate (ESR), 20 U/l in gamma-glutamyltransferase (GT) or 60 U/l in alkaline phosphatase (ALP) resulted in a combined sensitivity of 55% and specificity of 91% for relapses with distant metastases. Elevation of at least two blood tests gave a combined sensitivity of 31% and a specificity of 98%. The importance of using individual reference values in screening for recurrences is emphasised. Symptomatic relapse or relapse detected at interval visits were not independent prognostic factors. The blood tests ALP, ESR and GT were strong predictors of survival measured from relapse which increase their legitimacy in follow-up. A more frequent follow-up for patients with 4+ involved nodes is proposed: three visits annually the first 5 years vs. two visits annually for the others. We conclude that history, clinical examination, ALP, ESR and GT are sufficient as a baseline screening for relapse in breast cancer patients.

Aftercare↗
PubMed1990

[Thyroid carcinoma and the recurrent nerve. Recurrence fall-out, incidence and causal circumstances in a large case-load of patients with thyroid carcinoma].

Impairment of vocal cord function is a threat to patients with thyroid carcinoma; either due to the tumor having infiltrated the larynx or the recurrent nerve, or to accidental damage to the laryngeal nerves during thyroid surgery. We have reviewed 1,245 patients' records which were filed under the diagnosis of thyroid carcinoma at Det Norske Radiumhospital from 1956 to 1978. Pareses of vocal cords were noted in 465 patients (37.3%) during the course of their illness. In 135 patients (10.8%) the pareses were due to infiltration by the tumor, most commonly seen in anaplastic carcinoma. In 267 patients (21.4%) the pareses followed surgery; planned resections of the recurrent nerves were performed in 48 patients (3.9%). Transient pareses with normal vocal cord movements within months were experienced in 137 cases (11%). Permanent paralysis caused accidentally during surgery was seen in 82 patients, representing 6.6% of all patients and 4.7% of the surgically exposed nerves. We stress the need for pre- and postoperative evaluation of vocal cord movement as an aid to future diagnosis and optimal surgical planning.

Female↗
PubMed1989

Early liver metastases in patients with medullary carcinoma of the thyroid gland.

In 13 patients who had been thyroidectomized for medullary carcinoma (MCT), basal and pentagastrin-stimulated immunoreactive calcitonin (iCT) concentrations were measured in a peripheral vein and concomitantly in hepatic veins as well as in the superior and inferior caval veins. The basal concentrations of iCT in serum from the antecubital vein ranged from normal values (less than 0.50 micrograms/1) to grossly elevated (greater than 100 micrograms/1). Intravenous pentagastrin injections (0.5 micrograms/kg) stimulated transiently calcitonin secretion in all patients and peak concentrations occurred in peripheral venous blood and in the inferior caval vein after 3 to 5 minutes. In all patients peak iCT values in the hepatic vein occurred at 1 to 2 minutes and were much higher than in samples taken from other veins. Only three patients showed metastases to liver as judged by conventional clinical and laboratory examinations. Two patients with nonthyroid, malignant disease did not show an increase in serum iCT concentration of hepatic veins. The authors conclude that MCT may spread early to the liver. The presence of liver metastases is an important prognostic factor in patient evaluation and can be demonstrated by measuring iCT in hepatic veins before and during pentagastrin stimulation.

Adult↗
PubMed1989

Ultrastructural and electron immunohistochemical features of medullary thyroid carcinoma.

An ultrastructural study, both morphological and immunohistochemical, has been carried out on eight thyroglobulin-positive and nine thyroglobulin-negative medullary carcinomas of the thyroid. The morphometric analysis of granule size showed that all tumours contained cells with small granules and cells with medium size granules, whereas eight tumours had additional cells with large granules. The small granules had an electron dense core, while the medium and large sized granules were both pale-cored and dense-cored. The cells with small, medium or large secretory granules were all immunoreactive for calcitonin and CGRP. No ultrastructural differences were observed between thyroglobulin-positive and thyroglobulin-negative cases of medullary carcinoma of the thyroid.

Adult↗
PubMed1989

A spleen pregnancy.

Non-tubal ectopic pregnancy is very rare. We report a case of spleen pregnancy, difficult to recognize clinically. The tests and investigations which led to the diagnosis and treatment are described briefly.

Adult↗
PubMed1981

Cell-associated immunoglobulin in human non-Hodgkin lymphomas. A comparative study of surface immunoglobulin on cells in suspension and cytoplasmic immunoglobulin by immunohistochemistry.

Eighty-three non-Hodgkin lymphomas classified according to the Kiel classification have been studied with regard to surface immunoglobulin (sIg) on cells in suspension and cytoplasmic immunoglobulin (cIg) by the peroxidase anti-peroxidase method (PAP) on formaline-fixed tissue sections. Fifty-six out of 66 examined (i.e. 85%) revealed a monoclonal staining pattern for sIg, whereas 37/70 (53%) gave a monoclonal staining pattern for cIg by PAP. The methods combined gave a monoclonal staining pattern in 73/83, i.e. in 88%, of the biopsies tested. The discrepancies between the two methods were largest in centroblastic/centrocytic and lymphocytic lymphomas. With regard to the light chain staining patterns, complete agreement between the two methods was obtained in the 20 cases that allowed such analysis to be made. This suggests that the specificity of PAP, as carried out in this study with reagents purified by immunoabsorbent techniques, is satisfactory. On a basis of heavy chain isotypes centroblastic/centrocytic, lymphoplasmacytoid, and immunoblastic lymphomas could be divided into distinct immunological subgroups. In four biopsies the sIg heavy chains were mu + delta, whereas mu + gamma chains were detected by PAP. This finding may be relevant to the mu leads to gamma switch known to occur during normal B-cell differentiation. Immunoglobulin inclusions were found in 8 cases--3 belonging to the immunoblastic group, and 5 to the lymphoplasmacytoid group.

Adult↗
PubMed1980

Is staging laparotomy of therapeutic value in patients with supradiaphragmatic Hodgkins's disease, clinical stage IA-IIA?

Between 1968 and 1972, 123 patients with clinical stage (CS) IA and IIA Hodgkin's disease were seen. Staging laparotomy was introduced in June 1970. The impact of staging laparotomy on the prognosis has been evaluated by comparing the treatment results before and after the introduction of this procedure. The patients were treated only on the basis of CS before staging laparotomy, and mainly on the basis of pathological stage (PS) after the introduction of this procedure. Patients with stage IA to IIIA disease received radiotherapy alone with the extended field techniques, while patients with stage IVA disease had combination chemotherapy. After an observation time of 7 years there was no difference in survival between the two groups. The relapses occurred earlier in the patients treated after the introduction of staging laparotomy. It is known that the survival is unaffected by staging laparotomy in the patients with Hodgkin's disease CS IA and IIA.

Adolescent↗
PubMedDate not supplied

Medullary thyroid cancer in Norway. A 30-year experience.

Eighty-four cases of medullary thyroid carcinoma were notified to the Cancer Registry of Norway in 1956-1978, representing 3.6% of all notifications of thyroid cancer in Norway during that period. The annual incidence of medullary thyroid carcinoma for the whole period was 0.89/million (0.57 in 1956-1971 and 1.47 in 1972-1978). Probably some cases were unrecognized in the early years and 1.47/million more accurately reflects the true incidence. More than 80% of the medullary thyroid carcinomas were presumably of sporadic type. Survival was significantly poorer than in the general population, and slightly less than in papillary thyroid cancer. Serum calcitonin assay was useful for primary diagnosis, follow-up, location of distant spread and discrimination between sporadic and familial disease. Basal calcitonin greater than 25 micrograms/l was accompanied by clinically demonstrable tumor in all but one patient. Elevated levels were repeatedly found in some long-term survivors, but among those with postoperative basal calcitonin greater than 2 micrograms/l, the 5-year mortality rate exceeded 50%.

Adolescent↗