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Biomedical subjects

U Stendahl

Publications and source records attributed to U Stendahl.

At least 37 records · Page 2Linked to original sources
PubMed1991

Prognostic significance of proliferation in endometrial adenocarcinomas: a multivariate analysis of clinical and flow cytometric variables.

In a prospective study, the prognostic significance of clinical and flow cytometric variables was evaluated in univariate and multivariate analyses of 489 cases of endometrial adenocarcinoma. Age, uterine cavity depth, stage, histopathologic grade, myometrial invasion, ploidy level, and S-phase fraction were of prognostic value in the univariate analysis. In a multivariate analysis of clinical variables, age and uterine cavity depth were insignificant. When adding flow cytometric variables (DNA content and S-phase fraction) separately to the clinical variables, the significance of myometrial invasion was reduced, and histopathologic grade became nonsignificant when S-phase fraction was included. When adding both DNA content and S-phase fraction, the DNA content became prognostically insignificant. S-phase fraction was, next to clinical stages III and IV, found to be the strongest predictor of outcome. It is concluded that S-phase fraction is a new, objective parameter that can be used for the identification of prognostically different subgroups of patients within a given stage and grade.

Adenocarcinoma↗
PubMed1991

Chronic diarrhoea after radiotherapy for gynaecological cancer: occurrence and aetiology.

The occurrence of chronic diarrhoea was evaluated in 173 consecutive patients previously treated with radiation for gynaecological cancer. A survey of gastrointestinal symptoms showed a high frequency of diarrhoea; 13% of the patients had 21 or more bowel movements a week and 3% had 28 or more. Significantly more patients who had a cholecystectomy were in the group with diarrhoea (chi 2 = 6.26; p less than 0.02). Twenty patients with chronic or intermittent diarrhoea were subject to extended gastrointestinal investigation. Bile acid malabsorption was evaluated by the 75Selenahomocholic acid-taurine test (SeHCAT). Bile acid malabsorption was found in 13 (65%) of the 20 patients further investigated, of whom seven had extremely low whole body retention values, which is consistent with severe malabsorption. The results suggest that bile acid malabsorption is a common cause of diarrhoea after radiation treatment for gynaecological cancer. Bacterial contamination was diagnosed in nine patients (45%) by the [14C]-D-xylose breath test or by the cholyl-[14C]-glycine breath test in combination with a normal test for bile acid malabsorption. All patients with vitamin B-12 deficiency, who were tested for bile acid malabsorption, had low retention times for the SeHCAT (p = 0.05). A significant decline in the frequency of diarrhoea was found after treatment with antibiotics or bile acid sequestrants, or both, in combination with a reduced fat diet.

Adult↗
PubMed1991

Radioimmunoscintigraphy of gynecologic tumors with 131I-labeled anti-PLAP monoclonal antibodies.

Radioimmunoscintigraphy (RIS) was performed in 20 patients with gynecologic tumors, 14 ovarian, 5 cervical, and one endometrial carcinoma. One murine monoclonal antibody (mab) against placental alkaline phosphatase (H7) was used after radiolabeling with 131I. The labeling procedure yielded antibodies with specific activity varying between 60 and 73 MBq/mg mab. Each patient received 57 to 100 MBq of the preparation. RIS was performed 7 to 35 days later. Patients with ovarian adenocarcinoma had an accumulation of activity on RIS at tumor sites (79%, 11/14) verified by ultrasonography, CT, and clinical examination. A low or absent accumulation of activity was seen in patients with cervical tumors. The patient with an endometrial adenocarcinoma was seen to have an activity accumulation at RIS corresponding to tumor sites determined by ultrasound and/or CT. It is concluded that RIS using monoclonal antibodies against placental alkaline phosphatase can provide information which will supplement that gained from other investigations of patients with ovarian adenocarcinomas.

Adult↗
PubMed1991

Conservative surgery for vulvovaginal melanoma.

22 cases of vulvovaginal melanoma seen in Umeă between 1963 and 1989 were retrospectively reviewed. According to FIGO, 11 were in Stage I, 6 in Stage II, 3 in Stage IV and 2 in Stage VI. Most patients received only conservative surgery and/or radiotherapy. 8 patients (36%) were alive at 5 years and 4 survived more than 10 years. The longest survivor at 17 years is still alive without evidence of disease. Conservative surgery seems to give as good results as radical operation for vulvovaginal melanomas and FIGO clinical staging appears to be of limited prognostic value.

Adult↗
PubMed1990

Carcinoma of the cervix in the African setting.

Carcinoma of the cervix is the commonest female malignancy in sub-Saharan Africa today. A brief description of its prevalence and distribution is given. Kenyan data is then used to illustrate the predominance of advanced disease in mostly premenopausal women (70%) of high parity. Follow up is characteristically poor and treatment results, although difficult to calculate with accuracy, are also poor. These are compared to FIGO statistics. Against this background aspects peculiar to the tumor, patient and treatment facilities in Africa are cited and discussed with reference to current relevant literature.

Adult↗
PubMed1990

Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide antigen, and placental alkaline phosphatase, in patients with ovarian carcinoma, borderline tumors, or benign adnexal masses: relevance for differential diagnosis.

Pretreatment serum levels of the antigens CA-125, tissue polypeptide Antigen (TPA), carcinoembryonic antigen (CEA), and placental alkaline phosphatase (PLAP) were determined in samples from 295 women with adnexal masses. At laparotomy 48% of patients had epithelial ovarian carcinoma, 9% had tumors of low malignant potential, and 8% suffered from malignancies of other kinds. The sensitivity of CA-125 with 35 U/ml as the cutoff was 88% in women with ovarian carcinoma, but 74% among those with limited disease and 58% in borderline malignancy. Only 6 of 17 mucinous ovarian carcinomas were detected. Specificity was 83%. CEA was elevated above 5.0 micrograms/liter in 15 of 17 patients with mucinous ovarian cancer. TPA detected advanced stages of malignancy, but the sensitivity was low, 53%, in cases with limited disease. PLAP was elevated in 46% of ovarian carcinoma patients. For detecting malignancy overall, the use of a parallel combination of the CA-125 and CEA assays was more sensitive than use of CA-125 as a single marker. This test combination may be of value in the diagnosis of adnexal masses. The predictive value of a positive result was 90%, and that of a negative result, 76%.

Adnexal Diseases↗
PubMed1990

Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide antigen, and placental alkaline phosphatase in patients with ovarian carcinoma: influence of histological type, grade of differentiation, and clinical stage of disease.

Pretreatment serum levels of the tumor-associated antigens CA-125, tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), and placental alkaline phosphatase (PLAP) were analyzed in 142 patients with epithelial ovarian carcinoma, and related to clinical and histopathological parameters. In a linear multiple regression model CA-125 serum levels were profoundly influenced by the type of tumor, i.e., mucinous or nonmucinous. Clinical stage also had significant impact, whereas grade of differentiation did not, when the other two factors were taken into account. CEA levels were also dependent mainly on histological type. Mucinous tumor cases had high levels. Only clinical stage or tumor burden had a significant impact on TPA levels. PLAP levels were significantly influenced by histological type of tumor and by grade of differentiation but not by clinical stage. The dependence of CA-125 levels upon clinical stage was evident only in nonmucinous tumors. Furthermore, size of the primary tumor was not important for the CA-125 value, in contrast to FIGO stage. Thus CA-125 is primarily a sensitive indicator of disseminated disease in ovarian carcinoma patients. On the basis of the CA-125 level it was possible to predict the extent of disease with an overall accuracy of 55%. If TPA and CEA levels were also considered, the predictive accuracy was 63%.

Alkaline Phosphatase↗
PubMed1990

Prognostic factors in invasive squamous cell carcinoma of the vulva treated with surgery and irradiation.

From 1958 through 1980, 113 women with invasive squamous cell carcinoma of the vulva were treated with vulvectomy. Post-operative irradiation was given with cobalt-60 beam or 10 MV photons from a linear accelerator from anterior fields including the vulva and groins, with the intention of delivering 40-52 Gy with 2-4 Gy/day at a depth of 0.5 cm or 2 cm. The overall corrected five-year survival rate was 68%. The prognosis was shown to worsen significantly with advancing stages (I/96%, II/75%, III/62% and IV/19%), increasing grades (GI/78%, G2/70% and G3/22%) and increasing size of the tumor (T1/90%, T2/71% and T3/37%), as it also did when there were signs of vascular invasion, multifocal tumors or positive nodes in the inguinal regions. Recurrences were diagnoses in 32% of the patients. With the less aggressive surgical approach used, combined with radiation therapy to eradicate subclinical disease, the morbidity rate was acceptable and the survival rate comparable to that reported after more aggressive surgery.

Adult↗
PubMed1990

Placental alkaline phosphatase (PLAP)/PLAP-like alkaline phosphatase as tumour marker in relation to CA 125 and TPA for ovarian epithelial tumours.

The significance of the PLAP (Placental alkaline phosphatase)/PLAP-like isozyme as tumour marker in relation to CA 125 and TPA for the monitoring of patients with malignant ovarian epithelial tumours was evaluated. Of all patients (n = 85), 40% had all three markers elevated. CA 125 being the most sensitive (60%), and the PLAP/PLAP-like isozyme and TPA both 40%. A tendency to certain tumour marker patterns of these three antigens in serum can be seen with regard to histopathology. Serous and anaplastic adenocarcinomas usually have all three markers moderately elevated, mucinous and mesonephric adenocarcinomas both have low incidences and low average levels of all three markers. Endometrioid and non-mucinous adenocarcinomas are often associated with high levels of the PLAP/PLAP-like isozyme and CA 125, while TPA shows moderate elevation. The PLAP/PLAP-like isozyme is positively correlated to tumour burden and the outcome of the disease. It may provide additional information on CA 125 in the monitoring of patients with ovarian cancer.

Alkaline Phosphatase↗
PubMed1990

Beneficial effects of sucralphate in radiation induced diarrhea. An open randomized study in gynecological cancer patients.

In an open randomized study including 51 consecutive patients with gynaecological malignancies sucralphate was daily administered to patients receiving pelvic irradiation. Sucralphate, an aluminium hydroxide complex of sulphated sucrose used in the treatment of gastric ulcer, seems to be of value in preventing radiation-induced bowel discomfort. The most objective parameter, frequency of diarrhoea was almost 50% less in the sucralphate groups as compared to the controls. The patients receiving sucralphate in general displayed only minor alterations in bowel habits even at the end of the radiation treatment. The number of patients requiring symptomatic therapy with loperamide were markedly lower in the sucralphate group. Subjective discomfort such as nausea, vomiting, loss of appetite were also less common. A reduction in acute reactions to irradiation increases the possibility of carrying through planned treatment and avoids unfavourable intermissions, and thus curing the patient with cancer in the pelvis by means of radiotherapy.

Diarrhea↗
PubMed1990

Dysgerminoma of the ovary: treatment results in northern Sweden.

Thirteen patients with ovarian dysgerminoma were treated and followed up at the Department of Gynaecologic Oncology, University Hospital, Umeă between 1962 and June 1988. All except one had pure dysgerminoma. Ten patients had stage I, one stage II and two stage III disease. They underwent surgery, received radiotherapy, and have all been alive without evidence of disease, ten for more than 10 years, seven for over 20 years and four ever 25 years. One patient conceived and had two normal deliveries after conservative surgery and hemi-pelvic irradiation. The clinical presentation, treatment and outcome are discussed against the current shift in management of dysgerminoma towards increasingly conservative treatment.

Adolescent↗
PubMed1990

Purification and characterisation of the placental-like alkaline phosphatase from ovarian epithelial tumours.

The placental alkaline phosphatase was purified by immunoaffinity chromatography from ovarian epithelial tumours to homogeneity. Up to 40% of the catalytical phosphatase activity in these tumours was derived from this placental type alkaline phosphatase (PLAP). The purified enzyme were similar to those of PLAP, whereas the PLAP-like isozyme was more heat-stable and resistant to 8 M urea than PLAP. The amino terminal sequence of the PLAP-like enzyme demonstrated heterogeneity at position three in the N-terminal end compared with PLAP. Phenyl-Sepharose affinity chromatography and different lectin chromatographies demonstrated the tumour-derived enzyme to be microheterogeneous, both with regard to concanavalin A binding and hydrophobicity properties.

Alkaline Phosphatase↗
PubMed1989

Pharmacokinetics of 4' epi-adriamycin after morning and afternoon intravenous administration.

The chronopharmacokinetics of 4' epi-adriamycin (Epi) have been studied in ten patients with gynecological malignancies. The drug (45 mg m-2) was administered as a short time (5.0 min) intravenous infusion at 7 a.m. and 7 p.m., in a randomized cross-over design. The pharmacokinetics of Epi were evaluated according to the statistical moment theory. Morning and afternoon dosing of Epi was not bioequivalent. The area under the plasma concentration-time curve (AUC), the maximum plasma concentration (Cmax), mean residence time (MRT) and the terminal half-life time (t1/2) could differ by more than 35% after morning and afternoon dosing. The inter-individual variation of AUC and Cp,max were larger after morning dosing than after afternoon dosing (P less than 0.04). The morning dose of Epi resulted in higher values of AUC in seven of the ten treated patients as compared to the afternoon dose. The terminal half-life times were shorter in eight of the patients after the morning dose.

Aged↗
PubMed1989

Comparative study of demethoxydaunorubicin with other anthracyclines on generation of oxygen radicals and clonogenic survival of fibroblasts.

Demethoxydaunorubicin was compared to other anthracyclines (daunorubicin, doxorubicin, epirubicin) on its ability to generate free oxygen radicals when mixed with Fe2+ in solution and on its ability to reduce clonogenic survival of fibroblasts in culture. Oxygen electrode measurements of free radical generation showed that most of the consumed oxygen entered the monovalet oxygen reduction pathway. Catalase and superoxide dismutase additions inhibited oxygen consumption for all tested anthracyclines and diethylenetriaminepentacetic acid (DTPA) was also inhibitory except for demethoxydaunorubicin. Demethoxydaunorubicin and epirubicin dose-dependently reduced the clonogenic survival of fibroblasts. Addition of catalase or superoxide dismutase was without effect, whereas metal chelators DPTA, desferrioxamine and EDTA all protected against epirubicin-induced toxicity. Of the chelators, only desferrioxamine protected against demethoxydaunorubicin toxicity. Tests in vivo will further elucidate whether demethoxydaunorubicin also differs from the other anthracyclines in therapeutic effect as well as in side effects such as myocardial toxicity.

Animals↗
PubMed1989

Expression of placental alkaline phosphatase in epithelial ovarian tumours.

The expression of placental alkaline phosphatase in 116 ovarian epithelial tumours was examined in formalin-fixed tissues used for routine histopathologic examination. In the total material, 51% of the tumours displayed positive immunoreactivity, as described by the monoclonal anti-placental alkaline phosphatase antibody C2, with similar incidence (46-67%) in the four major groups of the adenocarcinomas, i.e., serous, mucinous, endometrioid and mesonephric tumours. By use of a histochemical staining index the mucinous and mesonephric tumours demonstrated a more intense staining (2.1 and 2.6) compared to the serous and endometrioid tumours (0.9 and 1.5). The relevance of the findings is discussed in relation to the use of monoclonal antibody technologies for radioimmunolocalization and radioimmunotherapy.

Alkaline Phosphatase↗