| 1. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Somatostatin receptors on neuroendocrine tumors--a way to intraoperative diagnosis and localization.
- 1994
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Ingår i: The Yale journal of biology and medicine. - 0044-0086. ; 67:3-4, s. 215-21
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Tidskriftsartikel (refereegranskat)abstract
- Intraoperative radionuclide detection using 111In-DTPA-D-Phe1-octreotide was evaluated in five patients with midgut carcinoids and in three patients with recurrent medullary thyroid carcinoma. Three different time intervals (24, 48 and 120 hr) from injection of the radiopharmaceutical to surgery were used. At surgery, suspect tumors were measured by probe in situ and ex vivo after excision. All tissue specimens and blood samples withdrawn during surgery were measured for 111In activity, and tissue/blood activity concentration ratios were calculated. In situ measurements were valuable especially in neck surgery, where the probe was helpful not only in localization of tumors but also in the control of tumor clearance. Ex vivo measurements were helpful in diagnosing tumor tissue. All five patients with midgut carcinoids were somatostatin receptor-positive, while only three out of seven patients with medullary thyroid carcinoma were receptor-positive. The tissue/blood activity concentration ratios and probe measurement ratios were in general higher in patients with midgut carcinoid than in patients with medullary thyroid carcinoma. Of particular interest were the high tissue/blood concentration ratios in all receptor-positive patients at all time intervals studied. This fact suggests a potential role for radiolabelled octreotide in radiotherapy of these tumor types.
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| 2. |
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| 3. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Clinical efficacy of octreotide scintigraphy in patients with midgut carcinoid tumours and evaluation of intraoperative scintillation detection.
- 1994
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Ingår i: The British journal of surgery. - 0007-1323. ; 81:8, s. 1144-9
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Tidskriftsartikel (refereegranskat)abstract
- 111In-diethylenetriamine penta-acetate-D-Phe1-octreotide scintigraphy was evaluated in a group of 27 patients with disseminated midgut carcinoid tumour. Additional information gained by the intraoperative use of a scintillation detector was studied in five patients with midgut carcinoid tumours and in two with endocrine pancreatic tumours. In 19 patients tumours not recognized by non-invasive radiological methods were visualized in 27 locations, most commonly in liver and para-aortic lymph nodes. Three false-negative tumour locations were noted (ovarian and peritoneal). With guidance from scintigraphic findings, nine patients underwent surgical tumour reduction, leading to complete remission in three. Clinically suspect tumour lesions were measured by the detector in situ, and ex vivo after excision. After excision the tissue:blood activity concentration ratios were calculated. In situ measurements were helpful in the localization of tumours and in the control of adequate clearance of tumour tissue. High tissue:blood activity concentration ratios at 1, 2 and 5 days in the five patients with midgut carcinoid tumour indicate a potential role for radiation therapy with radiolabelled octreotide in patients with somatostatin receptor-positive tumours.
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| 4. |
- Wadenvik, Hans, 1955, et al.
(författare)
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Peripheral and intrasplenic platelet kinetics and bone marrow megakaryopoiesis in alpha-2b-interferon treated hairy cell leukemia.
- 1994
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Ingår i: Leukemia research. - 0145-2126. ; 18:8, s. 569-75
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Tidskriftsartikel (refereegranskat)abstract
- In eight patients with previously untreated hairy cell leukemia (HCL), by using 111In-labelled platelets and megakaryocyte quantitation, the splenic platelet pooling and the platelet production rate (P) were evaluated before and during alpha-2b-interferon (IFN) treatment. Both before and after 8 months of IFN therapy the spleen was shown to pool a sizeable amount of the total body platelet mass. The average splenic platelet pools, prior to and after 8 months of IFN, were 58 +/- 17 and 47 +/- 11%, respectively. At the time when treatment was initiated, the patients were heterogeneous as regards the spleen size, platelet kinetics, and the bone marrow morphology. Three patients had values for P below the 95th percentile for a group of healthy control subjects; following IFN therapy they displayed a substantial increase in P. In three other HCL patients, with the largest spleens, the pre-treatment P was normal, or slightly above the values seen for the control subjects. In these patients, changes in splenic platelet pool size, blood volume, and platelet mean life-span accounted for the increase in platelet count observed in response to IFN. The mean megakaryocyte number and volume per microliter bone marrow increased during IFN therapy, while the mean P remained slightly reduced. It is concluded that splenic platelet pooling would explain the previously described difference in platelet counts between splenectomized and non-splenectomized patients treated with IFN.
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| 5. |
- Studahl, Marie, 1957, et al.
(författare)
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Septic arthritis of the knee: a 10-year review and long-term follow-up using a new scoring system.
- 1994
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Ingår i: Scandinavian journal of infectious diseases. - 0036-5548. ; 26:1, s. 85-93
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Tidskriftsartikel (refereegranskat)abstract
- The case records of 64 patients with 65 episodes of infectious gonarthritis during 1979-88 were reviewed regarding epidemiological, clinical and laboratory data of possible relevance to the course and outcome of the disease. Long-term healing results were evaluated by means of a new scoring system 2-11 years after the acute disease in 46 patients. The infection was acquired by inoculation in 37% and by the hematogenous route in 55%. The major risk factors were trauma to the joint and arthrosis. Staphylococcus aureus was the causative agent in 58% and Streptococci in 15%. Treatment consisted of suction irrigation (86%) or intermittent aspiration (5%) combined with systemic antibiotic treatment. At follow-up, the pain and ache scores of the arthritic joint had decreased by 21% and 16% respectively, compared with the scores of the contralateral control joints. Anatomy and motility were reduced by 9% and 8% respectively. Age < 45 was associated with a greater score loss than in older patients. Treatment delayed by > 5 days was associated with increased loss of motility. We estimate that 79% of the patients had excellent or good long-term results following treatment of infectious arthritis of the knee. Evaluation of healing after infectious gonarthritis by use of a scoring system is quite feasible and allows comparison of different treatment regimes with improved accuracy.
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| 6. |
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| 7. |
- Rossitti, S, et al.
(författare)
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Remodelling of the retinal arterioles in descending optic atrophy follows the principle of minimum work.
- 1994
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Ingår i: Acta physiologica Scandinavica. - : Wiley. - 0001-6772 .- 1365-201X. ; 152:3, s. 333-40
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Tidskriftsartikel (refereegranskat)abstract
- Mathematical modelling indicates that the minimum energy cost for blood flow is achieved when the arteries are arranged in a branching hierarchy such that the radii of the vessels are adjusted to the cube root of the volumetric flow (principle of minimum work). This is known to apply over several magnitudes of vessel calibres, and in many different organs, including the brain, in humans and in animals. This paper addresses the issue of remodelling of one and the same arterial network to long-term changes in blood flow. This has not been studied previously in humans. We measured the radius of parent (r0) and branch segments (r1 and r2) of the retinal arteriolar network in fundus photographs of six patients with blinding, non-vascular retrobulbar optic nerve lesions, mostly traumatic in origin, before and after the development of descending optic atrophy. Attenuation of retinal arterioles is a well-known phenomenon in descending optic atrophy, and is attributable to decreased metabolic demand secondary to loss of the retinal ganglion cells and their axons. On average, arteriolar diameters decreased by 15.2 +/- 17.7% (SD), with 95% confidence intervals of 18.7% and 11.7%; the radii decreased significantly (P = 0.0001) (n = 99). The area ratio of the bifurcations, defined as (r2(1) + r2(2))r-2(0), was 1.23 +/- 0.2 before, and 1.18 +/- 0.2 after optic atrophy (n = 36); the change of area ratio was not significant. The branching geometry of the retinal arteriolar network obeyed strictly the optimum branching rule of the principle of minimum work, or r3(0) = r3(1) + r3(2).(ABSTRACT TRUNCATED AT 250 WORDS)
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| 8. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Clinical management of gastric carcinoid tumors.
- 1994
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Ingår i: Digestion. - 0012-2823. ; 55 Suppl 3, s. 77-85
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Tidskriftsartikel (refereegranskat)abstract
- Four types of gastric carcinoids have been identified: (1) multiple small body-fundus carcinoids associated with chronic atrophic gastritis type A (A-CAG); (2) sporadic solitary lesions without specific pathogenetic background (non-A-CAG); (3) carcinoidosis associated with Zollinger-Ellison/MEN 1 syndrome, and (4) rare tumors, e.g. gastrin cell tumors, neuroendocrine carcinomas and mixed endocrine-exocrine tumors. In a retrospective study of 15 patients with gastric carcinoids (11 A-CAG, 3 non-A-CAG and 1 gastrin cell tumor) over a 10-year period, the histopathological and clinical features were assessed. The A-CAG-type carcinoids were clinically silent with lymph node metastases in 2/11 cases but no hepatic metastases. The non-A-CAG-type carcinoids were malignant with disseminated disease, hormonal symptoms and increased urinary excretion of the main histamine metabolite, MeImAA. Five patients with A-CAG tumors were subjected to antrectomy to remove hypergastrinemia, which is thought to be of pathogenetic importance for these tumors. During the observation period (1.5-8 years) 1 patient developed recurrent tumors, while the other 4 showed persistent argyrophil cell hyperplasia. A prospective treatment protocol of these tumors is suggested with endoscopic removal of less numerous, small lesions as first-step therapy, followed by antrectomy at recurrence. Larger lesions should be excised in combination with antrectomy. Gastrectomy is reserved for the rare cases of invasive tumors with lymph node metastases. As evident from the outcome of patients with non-A-CAG tumors radical surgery should be performed whenever practicable.
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| 10. |
- Kristjánsson, Sigurdur, 1955, et al.
(författare)
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Eosinophil cationic protein, myeloperoxidase and tryptase in children with asthma and atopic dermatitis.
- 1994
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - 0905-6157. ; 5:4, s. 223-9
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Tidskriftsartikel (refereegranskat)abstract
- Serum levels of eosinophil cationic protein (ECP), myeloperoxidase (MPO), tryptase, total IgE and differential blood cell counts were studied in atopic children with: 1) moderate to severe asthma using inhaled steroids and symptom-free for the last 3 weeks (n = 13), 2) mild asthma with sporadic symptoms, using only inhaled beta 2-agonists < 3 times/week (n = 15), 3) acute asthmatic attacks admitted to hospital (n = 12), 4) mild to moderate atopic dermatitis (n = 14). Fifteen children without any history of atopy served as controls. ECP, MPO, tryptase and IgE were measured in serum by radioimmunoassays (RIA). The symptom-free children with inhaled steroids had similar median ECP and MPO values as the controls, 8.0 and 360 micrograms/l, vs. 9.0 and 310 micrograms/l, while both ECP and MPO were significantly (p < 0.001) increased in the symptom-free children without anti-inflammatory treatment, 32 and 887 micrograms/l and in those with acute asthma, 28 and 860 micrograms/l. The children with atopic dermatitis had increased ECP but normal MPO levels, 16.0 and 455 micrograms/l. Tryptase in serum was not measurable in any patient. All groups except the control group had significantly elevated total IgE levels. The results indicate that in atopic children serum ECP is a good marker of ongoing asthma or atopic dermatitis. The normal levels of ECP and MPO in the children with asthma using inhaled steroids seem to reflect successful anti-inflammatory treatment. The increased levels of ECP and MPO in the children with mild asthma and no anti-inflammatory treatment may indirectly reflect airway inflammation.
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