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- Wallgren, Arne, 1940, et al.
(författare)
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Risk factors for locoregional recurrence among breast cancer patients: results from International Breast Cancer Study Group Trials I through VII.
- 2003
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Ingår i: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 0732-183X. ; 21:7, s. 1205-13
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore prognostic factors for locoregional failures (LRF) among women treated for invasive breast cancer within clinical trials of adjuvant therapies. PATIENTS AND METHODS: The study population consisted of 5,352 women who were treated with a modified radical mastectomy and enrolled in one of seven International Breast Cancer Study Group randomized trials. A total of 1,275 women with node-negative disease received either no adjuvant therapy or a single cycle of perioperative chemotherapy, and 4,077 women with node-positive disease received adjuvant chemotherapy of at least 3 months' duration and/or tamoxifen. Median follow-up is 12 to 15.5 years. RESULTS: In women with node-negative disease, factors associated with increased risk of LRF were vascular invasion (VI) and tumor size greater than 2 cm for premenopausal and VI for postmenopausal patients. Of the 1,275 patients, 345 (27%) met criteria for the highest risk groups, and the 10-year cumulative incidences of LRF with or without distant metastases were 16% for premenopausal and 19% for postmenopausal women. For the node-positive cohort, number of nodes and tumor grade were factors for both menopausal groups, with additional prediction provided by VI for premenopausal and tumor size for postmenopausal patients. Of the 4,077 patients, 815 (20%) met criteria for the highest risk groups, and 10-year cumulative incidences were 35% for premenopausal and 34% for postmenopausal women. CONCLUSION: LRFs are a significant problem after mastectomy alone even for some patients with node-negative breast cancer, as well as after mastectomy and adjuvant treatment for some subgroups of patients with node-positive disease. In addition to number of positive lymph nodes, predictors of LRF include tumor-related factors, such as vascular invasion, higher grade, and larger size.
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- Johansson, BL, et al.
(författare)
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Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus
- 2000
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 17:3, s. 181-189
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Recent studies have indicated that proinsulin C-peptide shows specific binding to cell membrane binding sites and may exert biological effects when administered to patients with Type 1 diabetes mellitus. This study was undertaken to determine if combined treatment with C-peptide and insulin might reduce the level of microalbuminuria in patients with Type 1 diabetes and incipient nephropathy. Methods: Twenty-one normotensive patients with microalbuminuria were studied for 6 months in a double-blind, randomized, cross-over design. The patients received s.c. injections of either human C-peptide (600 nmol/24 h) or placebo plus their regular insulin regimen for 3 months. Results: Glycaemic control improved slightly during the study and to a similar extent in both treatment groups. Blood pressure was unaltered throughout the study. During the C-peptide treatment period, urinary albumin excretion decreased progressively on average from 58 ╡g/min (basal) to 34 ╡g/min (3 months, P < 0.01) and it tended to increase, but not significantly so, during the placebo period. The difference between the two treatment periods was statistically significant (P < 0.01). In the 12 patients with signs of autonomic neuropathy prior to the study, respiratory heart rate variability increased by 21 ▒ 9% (P < 0.05) during treatment with C-peptide but was unaltered during placebo. Thermal thresholds were significantly improved during C-peptide treatment in comparison to placebo (n = 6, P < 0.05). Conclusion: These results indicate that combined treatment with C-peptide and insulin for 3 months may improve renal function by diminishing urinary albumin excretion and ameliorate autonomic and sensory nerve dysfunction in patients with Type 1 diabetes mellitus.
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- Josefson, A. B., et al.
(författare)
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Fate of phytodetritus in marine sediments: functional importance of macrofaunal community
- 2002
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Ingår i: Marine Ecology-Progress Series. - 0171-8630. ; 230, s. 71-85
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Tidskriftsartikel (refereegranskat)abstract
- A 54 d incubation of intact sediment box-cores from 2 different macrofaunal sediment communities from the Swedish west coast was performed under controlled laboratory conditions in April to June 1999. One community was dominated by passive suspension feeders the other by subsurface deposit feeders. The box-cores were seeded with C-14-labelled detritus of the diatom Skeletonema costatum in order to mimic a post-spring-bloom situation. In addition to the labelled diatom phytodetritus, the box-cosms initially contained chlorophyll a with concentrations between 1 and 1.5 mug ml(-1) in the top cm of the sediment. The experiment thus provided an opportunity to estimate degradation rates of the naturally occurring chlorophyll with a natural benthic fauna present over a ca, 2 mo period. Using a diagenetic model to describe the vertical distribution of chlorophyll a (chl a), and using the same, previously published, degradation rate constant in both communities (0,03 d(-1)), gave mixing coefficients (D-B, cm(2) d-1) that were on average > 2 times higher in the community (L18) dominated by deposit feeders than in the suspension-feeding community (S3): 2.5 +/- SD 1.7 and 0.86 +/- SD 0.50, respectively. This indicates a higher mixing rate at L18, This difference in mixing between the 2 communities was supported by changes in vertical distribution of C-14-labelled phytodetritus over the 54 d period. The mixing coefficients (D(B)s) were positively correlated with biomass of subsurface deposit feeders but not with total biomass. Background chl a was higher at L18 than at S3. A quantitative comparison of the total chl a inventories at the start and end of the experiment suggested a low overall degradation rate (no significant overall change) in the chl a, far from the reaction rate constant of 0.03 d(-1) often used in the literature. Similarly, the total C-14 activity in the cosms did not change significantly over the study period, suggesting a small loss Of (CO2)-C-14 from the cosms relative to the C-14-pool size. The labelled algal matter distributions showed clear mixing over the 2 months in both communities with a higher mixing rate in the deposit-feeding community than the suspension-feeding community. Mixing also occurred deeper in the deposit-feeding community. Uptake of labelled matter by macrofauna was similar in the 2 communities, but differed markedly between species and trophic groups. At the end of the incubation, surface deposit feeders had an order of magnitude higher weight-specific C-14 activity than suspension feeders and subsurface deposit feeders. The proportion of macrofaunal uptake of total C-14 activity in the cosms was small, on the order of 5 %. The results support the idea that community species composition is important for the fate of sedimented phytodetritus and that macrofaunal influence on degradation of sedimentary chlorophyll is small at this time of the year, The initial fate of the bloom material was burial in the sediment rather than consumption by heterotrophs. The findings are thus in accordance with the hypothesis that a part of the spring phytoplankton bloom may be buried for a while in the sediment before being remineralised.
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- Ståhl, H., et al.
(författare)
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Factors influencing organic carbon recycling and burial in Skagerrak sediments
- 2004
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Ingår i: Journal of Marine Research. - : Journal of Marine Research/Yale. - 0022-2402 .- 1543-9542. ; 62:6, s. 867-907
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Tidskriftsartikel (refereegranskat)abstract
- Different factors influencing recycling and burial rates of organic carbon (OC) were investigated in the continental margin sediments of the Skagerrak (NE North Sea). Two different areas, one in the southern and one in the northeastern part of the Skagerrak were visited shortly after a spring bloom (March 1999) and in late summer (August 2000). Results suggested that: (1) Organic carbon oxidation rates (C-ox) (2.2-18 mmol Cm-2 d(-1)) were generally larger than the O-2 uptake rates (1.9-25 mmol m(-2) d(-1)). Both rates were measured in situ using a benthic lander. A mean apparent respiration ratio (C-ox:O-2corr) of 1.3 +/- 0.5 was found, indicating some long-term burial of reduced inorganic substances in these sediments. Measured O-2, fluxes increased linearly with increasing C-ox rates during the late summer cruise but not on the, early spring cruise, indicating a temporal uncoupling of anaerobic mineralization and reoxidation of reduced substances. (2) Dissolved organic carbon (DOC) fluxes (0.2-1.0 mmol Cm-2 d(-1)) constituted 3-10% of the C-ox rates and were positively correlated with the latter, implying that net DOC production rates were proportional to the overall sediment OC remineralization rates. (3) Chlorophyll a (Chl-a) concentrations in the sediment were significantly higher in early spring compared to late summer. The measured C-ox rates, but not O-2 fluxes, showed a strong positive correlation with the Chl-a inventories in the top 3 cm of the sediment. (4) Although no relationship was found between the benthic fluxes and the macrofaunal biomass in the chambers, total in situ measured dissolved inorganic carbon (C-T) fluxes were 1-5.4 times higher than diffusive mediated C-T fluxes, indicating that macrofauna have a significant impact on benthic exchange rates of OC remineralization products in Skagerrak sediments. (5) OC burial fluxes were generally higher in northeastern Skagerrak than in the southern part. The same pattern was observed for burial efficiencies, with annual means of similar to62% and similar to43% for the two areas respectively. (6) On a basin-wide scale, there was a significant positive linear correlation between the burial efficiencies and sediment accumulation rates. (7) The calculated particulate organic carbon (POC) deposition, from benthic flux and burial measurements, was only 24-78% of the sediment trap measured POC deposition, indicating a strong near-bottom lateral transport and resuspension of POC. (8) A larger fraction of the laterally advected material of lower quality seemed to settle in the northeastern Skagerrak rather than in the southern Skagerrak. (9) Skagerrak sediments, especially in the northeastern part, act as an efficient net sink for organic carbon, even in a global continental margin context.
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