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U Norming

Publications and source records attributed to U Norming.

32 records · Page 2Linked to original sources
PubMed1992

Diagnostic methods in the detection of prostate cancer: a study of a randomly selected population of 2,400 men.

We investigated the value of digital rectal examination, transrectal ultrasonography and prostatic specific antigen (PSA) analysis as aids in general clinical practice and in the early detection of prostate cancer. Of a randomly selected population of 2,400 men 55 to 70 years old who were offered examination with digital rectal examination, transrectal ultrasound and PSA analysis, 1,782 (74%) accepted and prostate cancer was detected in 65 (3.6%). When the transrectal ultrasound results were also considered the detection rate of digital rectal examination (2.3%) was increased by 50% and the number of stage T2A or less tumors was doubled. At reexamination due to markedly high PSA values (7 micrograms/l. or more) only a few additional cancers (5%) were detected. However, it is noteworthy that 80% of the detected cancers were found among the subgroup with abnormal PSA values (4 micrograms/l. or more) and comprising 17% of the study population, which suggests the possibility of selecting a risk group at mass screening. Moreover, the positive predictive value increased from 4% (when only digital rectal examination was positive) to 71% for the combination of positive digital rectal examination, positive transrectal ultrasound and an increased PSA concentration (that is 7 micrograms/l. or greater).

Aged↗
PubMed1992

Deoxyribonucleic acid profile and tumor progression in primary carcinoma in situ of the bladder: a study of 63 patients with grade 3 lesions.

In 63 patients with primary grade 3 carcinoma in situ of the bladder flow cytometric deoxyribonucleic acid (DNA) analysis was performed at diagnosis and during an average followup of 63 months. The results of DNA measurements were related to disease progression, that is invasive tumor and/or metastatic disease. The DNA histograms were classified as diploid (2 patients) or aneuploid (61). A total of 3 categories of aneuploid tumors with different prognostic significance could be defined: 1) carcinoma in situ with 1 aneuploid cell population at diagnosis and with no change to multiple aneuploid cell populations throughout observation, 2) carcinoma in situ with 1 aneuploid cell population at diagnosis but with a later change to multiple aneuploid cell populations and 3) carcinoma in situ with multiple aneuploid cell populations already at diagnosis. At 5 years the progression-free survival for the 3 categories was 94%, 43% and 20%, respectively. Over-all, of the patients with multiple aneuploid cell populations (categories 2 and 3) 76% had progression, in contrast to 19% of those in category 1 (p less than 0.0005). In category 2 development of multiple aneuploid cell populations preceded progression in 8 of 11 progressive cases by an average of 20 months. Therefore, the occurrence of multiple aneuploid cell populations must be considered as a sign of high aggressiveness. We conclude that flow cytometric DNA analysis is a potent predictor of prognosis in cases of primary carcinoma in situ of the bladder.

Aged↗
PubMed1991

Transanorectal ultrasonography in the staging of anal epidermoid carcinoma.

Fifty consecutive patients with anal canal epidermoid carcinoma were evaluated by transanorectal ultrasonography (TRUS) at diagnosis. Forty-six patients were treated with primary radiotherapy plus bleomycin. Twenty-eight of the last 30 patients underwent, in addition, planimetric volume determination. The ultrasound findings were compared with clinical stage as assessed by digital palpation. Tumours in clinical stages T1-2 showed evidence of penetration through the anorectal muscular wall at ultrasound (UT3-4) in two-thirds of the cases. This was the case in all tumours in clinical stages T3-4. A clear correlation between tumour size, depth of invasion, and tumour volume, respectively, and residual tumour after a "pre-operative" dose of 40 Gy plus bleomycin was found. When combining clinical stage with TRUS, all tumours classified as T1-2/UT1-2 had a complete response (CR) after the first radiotherapy period, whereas the corresponding figures for those with deep invasion ultrasonographically (T1-2/UT3-4 and T3-4/UT3-4) were 64 percent and 0 percent, respectively. It thus appears that TRUS could complement digital palpation in staging anal canal carcinoma.

Adult↗
PubMed1991

Transrectal ultrasound and computed tomography in preoperative staging of lower rectal adenocarcinoma.

A comparison of transrectal ultrasound (TRUS) and computed tomography (CT) for staging of rectal carcinoma was performed. Thirty-two patients were examined by TRUS and 30 by CT. The results of these preoperative examinations were compared with postoperative histopathological findings. TRUS had an accuracy of 81% and it predicted perirectal tumor growth with a sensitivity of 90% and a specificity of 67%, whereas the corresponding figures for CT were 52%, 67%, and 27%. These findings indicate that TRUS is more efficient than CT in staging local tumor growth in rectal cancer. Neither technique, however, can reliably identify lymph node metastases, since no correlation was found between lymph node size as observed on CT and TRUS and tumor involvement as evaluated histopathologically.

Adenocarcinoma↗
PubMed1991

Comparative histopathology and deoxyribonucleic acid flow cytometry of random mucosal biopsies in untreated bladder carcinoma.

In a study of 290 patients with untreated carcinoma of the bladder, histopathological studies of random mucosal biopsies were compared with the results of deoxyribonucleic acid (DNA) flow cytometry. By histopathology the findings were classified as severe atypia corresponding to primary grade 3 carcinoma in situ, atypia not fulfilling the criteria for carcinoma in situ and no atypia. The DNA histograms were classified as diploid or aneuploid. Aneuploid cell populations in mucosal biopsies were found mainly in cases with aneuploid tumors of grade 3. Of the biopsies classified as concomitant carcinoma in situ 76% were aneuploid. In biopsies exhibiting less severe or no atypia aneuploidy was found in 41 and 10%, respectively. For these 3 morphological categories the distributions of the aneuploid cell populations were similar irrespective of the histopathological findings and they were also the same as that found in primary carcinoma in situ. We concluded that gross chromosomal aberrations may appear at an early stage of the tumor development and before changes recognizable by morphology. The similarity of the DNA profiles of the aneuploid cell populations, regardless of morphological findings, indicates that apart from gross chromosomal aberrations changes of the phenotype are necessary for the expression of morphological changes.

Adult↗
PubMed1991

Short-term radiotherapy as palliative treatment in patients with transitional cell bladder cancer.

We report the results and complications of treatment with palliative, short-term radiotherapy in 162 elderly or disabled patients. Improvement in tumour-associated symptoms was noted in 75 of these patients and 72 survived for more than a year. Those who responded to radiotherapy had a 5-year cancer-free survival rate of 58% compared with 4% in patients who did not respond to treatment. Survival was also affected by stage and indications for radiotherapy. In 85 patients without severe symptoms, where the tumour was judged curable but the patient was unsuitable for a full course of radiotherapy, the 5-year cancer-free survival rate was 21%, which is in accordance with what can be achieved with full-course radiotherapy; 42% had various minor acute side effects. The 5-year late complication rate was 7%.

Aged↗
PubMed1991

Fine-needle aspiration biopsy with a new automatic fine-needle gun versus histological core in ultrasonically-guided transrectal biopsy for detection of prostate cancer.

In connection with a health control study of 2,400 men for early detection of prostate cancer the authors have compared fine-needle aspiration biopsy using a new automatic fine-needle gun with histological cores obtained by the Biopty gun. Both procedures were ultrasonically guided. Prostate cancer was found in 62 patients and in 46 of these both biopsy methods were used on the same occasion. There was no essential difference in sensitivity between the two methods. The authors recommend fine-needle aspiration biopsy as the primary method but regard the histological core technique as a valuable supplement.

Aged↗
PubMed1991

Digital rectal examination versus transrectal ultrasound in detection of prostate cancer. Preliminary results from a study of a randomly selected population.

In a study of 2,400 randomly selected men (age 55-70 years) for early detection of prostate cancer the authors have compared the diagnostic value of digital rectal examination (DRE), transrectal ultrasound (TRUS) and prostate specific antigen (PSA). Altogether 62 prostate cancers were detected, corresponding to a detection rate of 3.5% but by use of DRE the detection rate was only 2.3%. The study showed that TRUS added significantly to the detection rate. If radical surgery is restricted to stages T1 and T2A, the combined use of DRE and TRUS detected twice as many cases fit for this treatment than DRE alone. The authors advocate randomized studies for evaluation of early radical treatment of prostate cancer. Before results of such studies have appeared they recommend methodological studies aimed at development and enhancement of the accuracy of the diagnostic tools.

Aged↗
PubMed1990

Conventional heparin and semisynthetic heparin analogue (SSHA) alteration of blood coagulation after embolic occlusion of human renal circulation.

Blood coagulation and fibrinolytic variables were measured in a peripheral vein in a study of 21 consecutive patients before and after angio-embolization of renal carcinoma. The first ten patients received conventional heparin, 5000 IU twice daily, and the following eleven a semi-synthetic heparin analogue (SSHA), 50 mg twice daily, for 5 days. The first injection was given 2 hours before embolization and the last injection at least 12 hours before the last blood sampling. Both groups showed increased levels of FPA on day 5-7, indicating that the anticoagulant influence had ceased. F VII levels decreased only in the SSHA group from embolization to day 3, but were increased in both groups on day 5-7. Levels of thrombin-antithrombin complexes (TAT) were significantly increased in the heparin group 2 hours after embolization, indicating that thrombin activity had been formed. The corresponding TAT level in the SSHA group was not significantly increased. The differences could possibly indicate a different mechanism of action on blood coagulation of SSHA as compared with heparin, with involvement of extrinsic pathway and maybe by-passing antithrombin III inhibition.

Aged↗
PubMed1990

Blood coagulation alterations after embolic occlusion of the renal circulation.

Alterations in blood coagulation and fibrinolysis after embolic occlusion of renal adenocarcinoma were investigated in 11 patients. Peripheral vein blood was collected before, 2 hours after and on the first, third and fifth to seventh day after embolization. Five patients had renal vein blood sampling before and 2 hours after embolization. Increased levels of fibrinogen, plasminogen and antiplasmin were found on days 1-3. Antithrombin III showed a slight decrease between days 1 and 3 after embolization. All measured variables were lower in renal vein compared with simultaneous samples from peripheral vein. In renal vein samples, consumption of antiplasmin and antikallikrein was indicated. Fibrinopeptide A (FPA) was increased, with a mean maximum 2 hours after embolization. The findings seemed mainly to monitor acute phase reaction but also activation of blood coagulation and fibrinolysis. Embolization might be used as a human model of coagulation activation and acute phase reaction.

Acute-Phase Reaction↗
PubMed1990

Complications following combined transrectal aspiration and core biopsy of the prostate.

Ultrasound guided biopsy of the prostate with fine needle (22G) as well as trucut needle (18G) was performed in 145 patients with a suspicion of prostate cancer. After three weeks all patients were interviewed about complications associated with the biopsy. Hematuria and/or hemospermia occurred in 2/3 of the patients. None of the hemorrhages was severe and all ceased spontaneously. E. coli infection of the urinary tract occurred in 9 cases (6.2%). Five of the infections caused high fever and necessitated hospital care with parenteral antibiotics for 1 to 8 days. The patients with infection had no signs of immunological defects by which they might have been identified before the biopsy. As a consequence of these observations we now use prophylactic antibiotics when core biopsy of the prostate is performed transrectally.

Aged↗
PubMed1989

Comparative flow cytometric deoxyribonucleic acid studies on exophytic tumor and random mucosal biopsies in untreated carcinoma of the bladder.

In 290 patients with untreated carcinoma of the bladder the deoxyribonucleic acid properties, as measured by flow cytometry, of 3 random mucosal biopsies were studied and compared to those of the exophytic tumors. Mucosal aneuploidy was found with few exceptions in aneuploid tumors only, and in a significantly lower frequency in aneuploid tumors of grade 2 than grade 3. The individual specificity of bladder tumors is emphasized by the observation that the level of ploidy was mostly the same in aneuploid mucosal biopsies as in the exophytic tumor. This is underlined further by the occurrence of cell populations of the same ploidy in different parts of the bladder mucosa. However, S-phase values of the concomitant intraurothelial lesions were significantly lower than those of the exophytic tumors. Therefore, we concluded that the process of evolution from malignantly transformed lesions, confined to the urothelium, to an exophytic or invasive tumor is dependent on a further elevated proliferation of the urothelial lesions.

Adult↗
PubMedDate not supplied

Transanorectal ultrasonography in anal carcinoma. A prospective study of 21 patients.

Twenty-one consecutive patients with anal carcinoma of squamous cell type were evaluated by transanorectal ultrasonography (Brüel & Kjaeer) prior to radiation therapy. The normal anal anatomy, with three distinct layers, was easily demonstrated both in vitro and in vivo. The middle, low echogenic layer corresponded above the dentate line to the muscularis propria and more distally to the internal and external sphincters. A hypoechoic area, representing tumour, was detected in all patients. Using the ultrasound findings, it appeared possible to classify the depth of tumour invasion into four levels with respect to whether or not invasion had reached or penetrated beyond the muscular wall or into adjacent organs. Eighteen of 21 tumours had penetrated the muscular wall. In 3 cases low echogenic, rounded structures, interpreted as enlarged lymph nodes, were identified. The ultrasonographic findings were compared with digital staging. Tumour invasion had penetrated the muscular wall in 2 out of 3 stage T1 patients and in 10 out of 11 stage T2 patients. Prospective studies will show whether estimates of tumour size and depth of invasion in relation to various normal structures, as judged by ultrasonography, are of value prognostically and for the choice of therapy.

Adult↗