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| 2. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Cytotoxic treatment of adrenocortical carcinoma.
- 2001
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Ingår i: World journal of surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 25:7, s. 927-33
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Tidskriftsartikel (refereegranskat)abstract
- Adrenocortical carcinoma (ACC) is a rare, aggressive tumor that is often detected in an advanced stage. Medical treatment with the adrenotoxic drug mitotane has been used for decades, but critical prospective trials on its role in residual disease or as an adjuvant agent after surgical resection are still lacking. The concept of a critical threshold plasma level of the drug must be confirmed in controlled studies. Because individual responsiveness cannot be predicted, the use mitotane is still advised for nonresectable disease. In case of cortisol or other steroid overproduction, several drugs (e.g., ketoconazole or aminoglutethimide) may be used. Chemotherapy with single agents (e.g., doxorubicin or cisplatin) have been disappointing, with low response rates (< 30%) and a short response duration. Part of this refractoriness may be explained by the fact that ACC tumors express the multidrug-resistance gene MDR-1. Chemotherapy with multiple agents has been tested in smaller series and has resulted in significant side effects. The best results were achieved by the combination of etoposide, doxorubicin, and cisplatin associated with mitotane, achieving a response rate of 54%, including individual complete responses. To be able to make progress in treating advanced ACC disease, adjuvant multicenter trials must be encouraged. When mitotane-based therapies are used, monitored drug levels are mandatory.
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| 3. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Interventional treatment of gastrointestinal neuroendocrine tumours.
- 2000
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Ingår i: Digestion. - 0012-2823. ; 62 Suppl 1, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- Neuroendocrine (NE) tumours of the gastrointestinal tract (carcinoids and endocrine pancreatic tumours) are rare diseases. In the presence of liver metastases these patients may suffer from disabling symptoms due to hormone overproduction. Patients with localized disease can be resected for cure and also patients with liver metastases can undergo potentially curative tumour resection. However, long-term follow-up of the latter cases indicates frequent recurrence of tumour. Using close biochemical monitoring of tumour markers combined with newer techniques for tumour visualization, these recurrences can often be diagnosed at an early stage so that repeat surgical procedures can be performed. During the last years very active surgery has been recommended for NE tumours, many of which have a relatively slow growth. Even in patients not amenable to curative liver surgery, debulking can be considered if the main tumour burden can be safely excised. The primary aim of this type of treatment is palliation of hormonal symptoms. An important question is whether the aggressive treatment actually prolongs survival. No prospective studies have been performed. Such studies are hampered by the lack of strict surgical programs running over long periods and the relative rarity of NE tumours. Liver transplantation may be another treatment modality in selected cases.
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| 4. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Liver transplantation for treatment of metastatic neuroendocrine tumors
- 2004
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Ingår i: Annals of the New York Academy of Sciences. - 0077-8923. ; 1014, s. 265-9
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Tidskriftsartikel (refereegranskat)abstract
- Liver transplantation can be considered a therapeutic option for patients with neuroendocrine tumors only metastatic to the liver. Important selection criteria are well-differentiated tumors and a low proliferation rate (Ki67 <10%). In this series, orthopic liver transplantation offered good relief of symptoms and long disease-free intervals with initial survival of grafts and patients as in benign disease. The experience with multivisceral transplantation is still limited.
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| 5. |
- Bümming, Per, 1965, et al.
(författare)
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Neoadjuvant, adjuvant and palliative treatment of gastrointestinal stromal tumours (GIST) with imatinib: a centre-based study of 17 patients.
- 2003
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Ingår i: British journal of cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 89:3, s. 460-4
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Tidskriftsartikel (refereegranskat)abstract
- Malignant gastrointestinal stromal tumours (GIST) have a poor prognosis. Since these tumours are resistant to conventional radiation and chemotherapy, surgery has been the mainstay of treatment. However, surgery is usually inadequate for the treatment of malignant GIST. Imatinib, a KIT tyrosine kinase inhibitor, has recently been found to have a dramatic antitumour effect on GIST. In this centre-based study of 17 consecutive patients with high-risk or overtly malignant GIST, imatinib was used in three different settings - palliatively, adjuvantly, and neoadjuvantly. The treatment was found to be safe and particularly effective in tumours with activating mutations of exon 11 of the KIT gene. Clinical response to imatinib treatment correlated morphologically to tumour necrosis, hyalinisation, and reduced proliferative activity. The value of neoadjuvant imatinib treatment was illustrated in one case.
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| 7. |
- Eriksson, Håkan, et al.
(författare)
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Det är obalansen som är problemet
- 2004
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Ingår i: KommunAktuellt. ; :16, 6 maj
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Debatten har länge rasat om sjukskrivningarnas kostnader, men sett över en längretid är det arbetslöshetens kostnader som ökat. Det visar en forskarstudie om bruk av offentliga försörjningssystem som tagits fram på initiativ av de samverkande myndigheterna i Västmanland. Den redovisar hur de offentliga försörjningsinkomsterna har utvecklats efter 1990 och hur de är sammansatta och fördelade i befolkningen.
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| 8. |
- Hansson, Anders, et al.
(författare)
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On Methods for Gradient Estimation in IFT for MIMO Systems
- 2002
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Ingår i: Proceedings of 15th IFAC World Congress. - 9783902661746 ; , s. 1047-1047
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Konferensbidrag (refereegranskat)abstract
- Iterative feedback tuning (IFT) is a model free control tuning method using closed loop experiments. For single-input single-output (SISO) systems only 2 or 3, depending on the controller structure, closed loop experiments are required. However for multivariable systems the number of experiments increase to a maximum of 1 + m times p, where m times p is the dimension of the controller. In this contribution several methods are proposed to reduce the experimental time by approximating the gradient of the cost function. The local convergence for a method which uses the same technique as in IFT for SISO systems is analyzed. It is shown that even if there are commutation errors due to the approximation method, the numerical optimization may still converge to the true optimum.
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| 10. |
- Hugosson, Håkan Wilhelm, et al.
(författare)
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Phase stabilities and homogeneity ranges in 4d-transition-metal carbides : A theoretical study
- 2001
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Ingår i: Physical Review B Condensed Matter. - 0163-1829 .- 1095-3795. ; 6313:13
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Tidskriftsartikel (refereegranskat)abstract
- First-principles full-potential linear muffin-tin orbital calculations have been used to study the 4d-transition-metal cal bides ZrC, NbC, and MoC. The experimental phase diagrams at T = 0 of the refractory compounds ZrC, NbC, and MoC have been reproduced with great accuracy from first principles theory. The energy of for marion for these compounds has been calculated for several phases and stoichiometries in order to understand the differences in phase stabilities and the changes in homogeneity ranges found between these systems is explained. The results can be regarded as theoretical zero-temperature phase stability diagrams for the three compounds containing not only the experimentally verified but also hypothetical phases and many of the experimental properties and trends are reproduced and explained. A study of the changes and differences in electronic structure and bonding of the studied compounds, phases and stoichiometries is also presented. As a part of this study the hexagonal Me2C (Me being Zr, Nb, or Mo) phases were studied and the theoretical structures, with relaxed interlayer distances and lattice parameters, were obtained. The phase stabilities and electronic structure of the experimentally reported orthorhombic Nb2C and Mo2C phases were also studied.
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