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Biomedical subjects

O Søreide

Publications and source records attributed to O Søreide.

At least 19 recordsLinked to original sources
PubMed1995

Vaccination with mutant ras peptides and induction of T-cell responsiveness in pancreatic carcinoma patients carrying the corresponding RAS mutation.

Mutations in codon 12 of K-RAS are frequently found in pancreatic adenocarcinomas. T-cell responses specific for individual RAS mutations can be elicited in vitro by stimulation of peripheral blood mononuclear cells with synthetic peptides. Mutant ras peptides are therefore a candidate vaccine for specific immunotherapy in pancreatic carcinoma patients. When vaccinated with a synthetic ras peptide representing the K-RAS mutation in their tumours, a transient ras-specific T-cell response was induced in two of five patients treated. The vaccination protocol involved multiple infusions of large amounts of peptide-pulsed antigen-presenting-cells obtained by leucapheresis. These results indicate that specific T-cell responses against mutations uniquely harboured in tumour cells can be induced in cancer patients by vaccination.

Adenocarcinoma↗
PubMed1995

Second primary cancers in patients with carcinoma in situ of the uterine cervix. The Norwegian experience 1970-1992.

Multiple primary cancers in the same individual occur rarely. Consequently, a large number of cancer patients have to be followed for long periods to obtain adequate information about their risk of subsequent tumour development. Studies of multiple malignancies are of interest, since they may provide information on common or opposite risk factors. In the present study, the risk of second primary cancers following carcinoma in situ of the uterine cervix diagnosed in Norway in the period 1970-1992 was examined and quantified. Altogether, 37,001 patients with carcinoma in situ were followed from the date of diagnosis until 31 December 1992. The follow-up period was divided into 5-year intervals. The results were expressed as standardized incidence ratios (SIR = O/E), and their 95% confidence intervals were given. A total of 1,037 second primary cancers in 989 individuals were identified. There was no overall excess of second primary cancers. However, there were differences depending on the site: cancers of the oesophagus, nose, nasal cavities, trachea, bronchus, lung, vulva, vagina, bladder and other urinary organs, and other skin cancers, excluding basal-cell carcinoma, occurred more frequently. A lower risk than expected was noted for cancer of the cervix uteri and cancer of the corpus uteri. There was a rising trend with time in the observed/expected ratio for cancer of urinary organs. In the group of patients evaluated, the likelihood of subsequent tumour development was no greater than in the general female population. Nevertheless, cancer sites of higher and of lower risk than expected were identified among the carcinoma-in situ patients.

Adolescent↗
PubMed1995

Incidence of perforated ulcer in western Norway, 1935-1990: cohort- or period-dependent time trends?

Previous reports have shown that peptic ulcer mortality follows birth cohorts. To the authors' knowledge, temporal variation in ulcer incidence has not been studied. Therefore, they present incidence data for a defined area of western Norway where 1,312 patients born between 1845 and 1975 were treated for ulcer perforation between 1935 and 1990. A rise and subsequent fall in incidence was observed in successive birth cohorts for both sexes, with the highest incidence observed for males born between 1900 and 1919 and females born between 1920 and 1929. Age-period-cohort analyses based on Poisson regression techniques were adapted to provide a statistical tool for testing specific cohort and period effects. Age-cohort models without period effects explained the variations in incidence for both sexes and all ulcer locations, suggesting cohort-dependent etiology. A cohort pattern in prevalence of smoking partly explained the cohort pattern in perforation risks for both sexes. No period effects were seen that could be attributed to the increase in the sale of non-steroidal anti-inflammatory drugs, to the introduction of antibiotics around 1950, or to World War II. Susceptibility to ulcer perforation seems to follow birth cohorts, and major etiologic factors should be sought in prenatal life, in childhood, or in life-style patterns that follow birth cohorts.

Adolescent↗
PubMed1995

Burst abdomen and incisional hernia after major gastrointestinal operations--comparison of three closure techniques.

OBJECTIVE: To compare the incidence of burst abdomen and incisional hernia after three different techniques of closure of the abdominal wall after major gastrointestinal operations. DESIGN: Prospective, randomised, controlled trial. SETTING: University hospital, Norway. SUBJECTS: 599 adults who underwent major operations for gastrointestinal conditions between December 1990 and February 1992. INTERVENTIONS: Patients were randomised in three groups for abdominal wall closure by continuous mass polyglyconate (Maxon) double suture with loop, continuous mass polyglactin 910 (Vicryl), and interrupted polyglactin 910 (Vicryl) (layered for transverse and mass for midline incisions). MAIN OUTCOME MEASURES: Burst abdomen during the postoperative period, and incisional hernia after one year follow up. RESULTS: The incidence of wound dehiscence was 2% and of incisional hernia at one year 7%. There were no differences in the rate of dehiscence among the groups, but there were significantly more hernias in the polyglyconate group (19/164, 12%) compared with the two in which polyglactin 910 was used (16/327, 5%). Wound infections developed in 84/583 of our patients (14%) and the incidence was closely associated with emergency operations and contamination. Wound complications were not associated with the closure technique. CONCLUSIONS: Wound infection is the most important single factor in the development of burst abdomen and incisional hernia. The continuous closure technique is quicker, cheaper, and as safe as the interrupted technique.

Aged↗
PubMed1992

[Conservative treatment of blunt liver injuries].

15 patients with blunt liver injuries were treated without operation. The extent of the injury was evaluated by computed tomography and median score was 3 (according to Mirvis and co-workers) (range 2-4). The mean lowest haemoglobin concentration was 10.4 g/100 ml (range 7.0-15.8). Two patients needed blood transfusion and two developed complications, one of which was related to the liver injury (cyst). No patient died, and mean hospitalization time was 11 days. This encouraging experience prompted the introduction of a treatment programme formalizing initial investigation and observation in such patients. Most patients with blunt liver injuries can be treated non-operatively. Surgery is indicated only if bleeding leads to haemodynamic instability or if other intraabdominal injuries are suspected.

Adolescent↗
PubMed1992

Is Lauren's histopathological classification of importance in patients with stomach cancer? A national experience. Norwegian Stomach Cancer Trial.

This study was performed to investigate the association between Lauren's histopathological classification system and different clinico-pathological characteristics in patients with gastric carcinoma. We revealed that the percentage of intestinal type tumour (ITT) increased with advancing age (52% in patients less than 60 years compared to 73% of octogenarians (P less than 0.001)). The male:female ratio was 1.7 for ITT versus 1.3 for diffuse type tumour (DTT (P = 0.12)). ITT was more common in proximally (fundus) localized tumours than in distal lesions (77% vs 65%; P less than 0.05). The proportion of patients with ITT decreased with advancing stages of the disease (70% in stage I and II vs 52% in stage IV (P less than 0.0001)). More patients with DTT had tumour infiltration in the resection margin (21% vs 9%; P less than 0.001). Intestinal metaplasia was found in 48% of those with ITT compared with 28% of those with DTT (P less than 0.001). No association was found between Lauren's classification and the ABO blood group or between the tumour types and infiltration in lymphatic or blood vessels. We conclude that gastric adenocarcinoma occurs in at least two different biological forms and that differentiation between the two is of relevance for treatment.

Adult↗
PubMed1992

Surgical treatment as a principle in patients with advanced abdominal carcinoid tumors.

Seventy-five patients with advanced abdominal carcinoid tumors (65 midgut, 10 others) have been examined retrospectively to evaluate the role of surgical treatment as a principle, irrespective of stage of disease. Eighteen of 52 patients (35%) exhibited the carcinoid syndrome. Two or more primaries were found in 39% of patients with midgut lesion, 81% of these patients had regional metastases, 5% of these patients had distant lymph node metastases, and 74% of the patients had liver secondaries. All patients underwent operation, an additional 34% of the patients had a further reoperation, 9% of the patients had a second reoperation, 3% of the patients had a third reoperation, and one patient (2%) had a fourth reoperation. Intraoperative debulking (liver excluded) was performed in 33% of the patients, and 48% of the patients had treatment (resection, hepatic artery ligation, embolization) directed at the liver. The postoperative mortality rate was 2% after the primary operation for midgut lesions. The median survival for midgut tumors was 92 months, compared to 40 months for other lesions (not significant). A significantly higher survival rate was revealed for those patients with midgut lesion who were undergoing intraabdominal debulking procedures (liver excluded); median survival was 139 months versus 69 months without debulking. For those patients with liver metastases, median survival after intervention was 216 months and 48 months without such treatment (p less than 0.001). It is concluded that resection of intraabdominal carcinoid tumor masses can be performed in a high proportion of patients. Despite the retrospective, uncontrolled nature of this study, the difference in survival probabilities in favor of aggressive surgical therapy is so marked that it is not unreasonable to conclude that surgery has played a role in prolonging life in these patients.

Adolescent↗
PubMed1991

[Content, function and structure of standardized hospital waiting lists in Norway].

Standardization of hospital waiting lists will improve the quality of information on waiting lists, allowing comparison between different hospitals and different counties, and a nationwide aggregation. Waiting lists must include all elective referrals, and will accordingly allow future planning and surveillance of the complete elective hospital activity. A current indication for evaluation/treatment in hospital is a prerequisite for waiting list registration. The registers must be continuously validated by erasing old referrals. Referrals are categorized in relation to hospital departments, sections and levels of care. Subgroups comprise medical specialties and diagnostic groups.

Diagnosis-Related Groups↗
PubMed1991

[Grouping and calculated measurements of standardized waiting lists in Norway. Definitions and interpretations of waiting lists].

Waiting list parameters calculated for defined dates and time periods allow studies to determine balance between new and completed referrals. The authors discuss various sub-groupings of the waiting lists. The main waiting time parameter is mean waiting time for the various levels of care in the case of the different medical specialties and diagnostic groups. Waiting time is defined as the difference between date of first admission to hospital and the date when the patient was referred. It is possible to calculate total waiting time for patients undergoing out-patient evaluation before in-patient or day-care treatment. Aggregated waiting times should exclude control admissions and admissions postponed at the wish of the patient.

Diagnosis-Related Groups↗
PubMed1991

[Reports of waiting list data from hospitals to the central registry--a database for reducing hospital waiting lists. Minimum dataset of waiting list parameters].

The governmental regulations concerning registration of waiting lists and priority of patients, laid down in July 1990, introduce a "waiting time guarantee" which ensures a waiting time not exceeding six months for patients suffering from diseases having severe impacts on health. Hospitals that are unable to treat these patients within six months are requested to refer them to other hospitals before the deadline. All hospitals have to make monthly reports of waiting list parameters to a Central Waiting List Register, enabling both a nationwide waiting list survey and comparisons between different hospitals and different counties. An online communication facility to the central register enables searches for and reporting of vacant treatment capacity.

Databases, Factual↗
PubMed1991

[Severe hemorrhage in pancreatic pseudocyst].

Pseudocysts in the pancreas occur in 10% of patients with pancreatitis and may lead to serious complications, i.e. infection, obstruction of the bile duct, rupture, and hemorrhage. The last complication is highly lethal. Two patients are described, with differing modes of presentation and therapy. In one patient hemostasis was obtained by surgical packing followed by percutaneous embolization. In the other patient embolization failed and surgical resection was necessary.

Adult↗
PubMed1991

Factors related to and consequences of weight loss in patients with stomach cancer. The Norwegian Multicenter experience. Norwegian Stomach Cancer Trial.

Of 1165 patients with stomach cancer included in a national, prospective multicenter study with 51 surgical units participating, information about weight loss before diagnosis was available for 855 patients (73%). Median weight loss was 5 kg; 259 patients (31%) experienced no weight loss. By logistic regression analysis the authors found that weight loss increased with age and advancing stages of disease (TNM Stage I-IV), with decreasing Karnofsky index, in Lauren's diffuse versus intestinal tumor type, and with tumors located at the cardia/esophagus. Increasing weight loss reduced the resectability rate significantly, but no association between weight loss and postoperative complication rate was found. The odds ratio for postoperative mortality was 2.5 to 1 for the weight loss group 5 to 10kg versus 0 kg. In conclusion, weight loss reflects a less favorable tumor status. Weight loss did not increase postoperative morbidity but did lead Weight to a higher death rate after surgery.

Adult↗
PubMed1991

Bile duct cysts in adults. Pitfalls in diagnosis and management.

Six women have been referred to us for treatment of bile duct cysts during the past 6 years. In three patients the disorder was misdiagnosed by the referring institution, and they were admitted because of continuing severe symptoms; two of them had been treated with internal drainage procedures which led to unnecessary treatment delay and complications. Two patients had developed cyst carcinoma, the most feared complication of cyst disease. It is concluded that clinical symptoms are nonspecific, and the diagnosis is only ascertained after complete cholangiographic imaging of the biliary tree. Primary cyst excision and hepaticojejunostomy is the treatment of choice.

Adult↗