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Biomedical subjects

A G Pedersen

Publications and source records attributed to A G Pedersen.

50 records · Page 3Linked to original sources
PubMed1985

Acute nonlymphocytic leukemia, preleukemia, and solid tumors following intensive chemotherapy of small cell carcinoma of the lung.

Six of 796 patients treated with intensive combination chemotherapy for small cell carcinoma of the lung developed overt acute nonlymphocytic leukemia (ANLL) (three patients) or preleukemia with severe refractory cytopenia and clonal cytogenetic abnormalities in bone marrow cells (three patients). The latent period to development of preleukemia or leukemia was less than two years in four of the six patients. The cumulative risk of preleukemia and leukemia according to a Kaplan-Meier estimate was 14.0% +/- 6.9% (mean +/- SE) four years after the start of treatment. The relative risk of overt ANLL was 77, since three cases were observed v 0.039 cases expected, based on the age- and sex-specific incidence of acute nonlymphocytic leukemia in the general Danish population. The risk of secondary solid tumors was not increased. The possible causes of the exceptionally early appearance and very high cumulative risk of leukemic complications found in the present study, as compared to previous experience in other malignant diseases, is discussed, including the implications for future therapy of patients with small cell lung cancer.

Acute Disease↗
PubMed1984

Misonidazole neuropathy.

Neurotoxic side effects of misonidazole with peripheral neuropathy was investigated in two series of patients. The first series consisted of eight patients with carcinoma of the pharynx, larynx or lung who, during treatment with misonidazole, developed peripheral neuropathy dominated by severe sensory symptoms and signs localized mainly to the lower extremities. Misonidazole was given for three to seven weeks in a total dose of 9.6 - 12.6 g/m2 (11 g/m2 or more in four of the patients). The symptoms subsided partially within a few months after cessation of the therapy. Electrophysiological and histological findings indicated axonal neuropathy with loss of large fibres and secondary demyelination. The second series consisted of 70 patients with carcinoma of the pharynx or larynx who, in addition to radiotherapy, were given either placebo or misonidazole over four weeks in a total dose of 11 g/m2. Fourteen patients out of 36 receiving misonidazole (38%) developed peripheral polyneuropathy, mostly in the feet, while this occurred in only two of the 34 patient placebo group.

Aged↗
PubMed1984

Phase II study of teniposide in small cell carcinoma of the lung.

Fifty-one patients with small cell bronchogenic carcinoma received 60 mg/m2 of teniposide iv on Days 1-5 every 3 weeks. All patients had received previous combination chemotherapy. Twenty patients with prior etoposide treatment and 20 without such prior treatment were evaluable. A partial response was observed in one of 20 and in five of 20 patients, respectively. The duration of responses was short (28-50 days). Sixty-one percent of patients experienced grade 3 or 4 toxicity on the World Health Organization scale. The activity in previously treated patients not exposed to etoposide was considerable, justifying further evaluation of teniposide in the treatment of small cell carcinoma of the lung.

Adult↗
PubMed1983

Brain CT-scanning and neurological examination in small cell bronchogenic carcinoma.

A brain CT-scan and a neurological examination were performed on forty-nine consecutive patients with small cell bronchogenic carcinoma before the start of chemotherapy and every three months thereafter. Contrast-enhancement was used in 90% of the CT-scans. Ninety percent of the neurologic examinations were performed by the same neurologist. No prophylactic cranial irradiation was given, and cranial irradiation was withheld if a CT-scan indicated metastases, unless the patient was symptomatic. Thirty-five patients are evaluable including 34 with a brain autopsy. CNS-metastases were found in 18 patients. Two of them had not been examined within three months of autopsy and are excluded from the calculations of diagnostic accuracy. Of the remaining 16 patients 10 had a correct diagnosis of cerebral metastases made by CT-scan, while the neurologist made 11 correct diagnoses of CNS-metastases. Seventeen patients did not have CNS-metastases including one patient alive and free of disease. Fifteen and 11 were judged to be free of metastases by the CT-scan and the neurologist, respectively. Two patients with negative autopsies had positive CT-scans turning negative at subsequent examinations. Two had positive CT-scans which became negative and at autopsy CNS-metastases were located at different sites from those initially indicated by CT. The positive predictive value of CT-scan was 71%, while the negative predictive value was 71%. In conclusion, routine CT-scan and neurological examination are equally sensitive but have low yields when there is no clinical suspicion of CNS-metastases. The predictive value of CT-scanning could possibly be higher with the newer generations of equipment.

Aged↗
PubMed1983

Peristalsis of the pyeloureter in pigs measured by videodensitometry.

The peristaltic activity of the upper urinary tract was investigated by means of a simple videodensitometric system. Through a transparenchymally placed catheter contrast medium was infused into the renal pelvis with perfusion rates increasing from 1 to 15 ml/min. Sequences of 3-5 min were recorded by means of a Siemens image amplifier on videotape for later analysis. Photodiodes were placed on the screen over the calyces, renal pelvis and ureter at a distance of 5 cm. An amplifying system and a UV recorder were used for registration. Peristaltic frequency, transmission velocity and average bolus volume were measurable in 8 out of 10 pyeloureteral units. Additionally, calyceal activity was detectable in one case. The tracings obtained by videodensitometry were reproducible and easy to analyse. Conversion of videorecordings to analogue signals for analysis might be a possible future clinical diagnostic method.

Absorptiometry, Photon↗
PubMed1982

Misonidazole Neuropathy: a clinical, electrophysiological, and histological study.

We studied eight patients with carcinoma of the pharynx and larynx (five cases) or lungs (three cases) who, during treatment with the radiosensitizing drug misonidazole, developed peripheral neuropathy dominated by severe sensory symptoms and signs mainly localized to the lower extremities. The symptoms partially subsided within months after cessation of therapy. Electrophysiological and histological findings indicated an axonal neuropathy with loss of large fibers and secondary demyelination. The neurotoxic property of misonidazole limits its therapeutic use.

Aged↗
PubMed1982

Phase II study of procarbazine in small cell carcinoma of the lung.

Thirty-nine patients with small cell anaplastic carcinoma of the lung were given oral doses of procarbazine ranging from 100 to 200 mg/m2 on Days 1-14 every 4 weeks. All patients had previously received combination chemotherapy. No responses were observed in the 24 evaluable patients. In reviewing the literature, we were unable to find evidence that the inclusion of procarbazine in combination chemotherapy is beneficial in small cell anaplastic carcinoma. Accordingly, it is concluded that procarbazine should not be considered as a useful drug in the management of this cell type of lung cancer.

Administration, Oral↗
PubMed1981

Adrenocortical function compared with computed tomography of the adrenals in small cell carcinoma of the lung.

Autopsy in patients with pulmonary small cell carcinoma frequently reveals metastases to the adrenal glands. In order to test the hypothesis that CT scanning might demonstrate such metastases at the time of clinical diagnosis of the pulmonary disease, the results of adrenal CT in 15 patients were correlated to adrenocortical function tests. No statistically significant relationship was found. It is concluded that no reliable non-invasive method exists to diagnose adrenal metastases in patients with pulmonary small cell carcinoma.

Adrenal Cortex↗
PubMed1980

The epipodophyllotoxin derivatives VM-26 and VP-16-213, 1976-1979, a review.

The epipodophyllotoxin derivatives VM 26 and VP 16-213 are currently entering phase III studies. The mechanism of their action is incompletely understood, but the greatest lethal effect is experienced in the late S and G2 phases. In transplanted tumors both drugs have shown marked schedule dependency and human studies also support this. As a single agent VP 16-213 is among the most active drugs in small-cell carcinoma of the lung. Significant clinical activity (> 20% response frequency) has been observed for both drugs in Hodgkin's disease, non-Hodgkin lymphomas and possibly in other more rare tumors (monocytic leukemia, hepatoma and teratoma). Although further clinical studies of both drugs would be ideal, it seems possible at present to justify a discontinuation of VM-26 in order to concentrate the efforts on VP 16-213. Further studies are needed to define optimal dose and schedule and place in combination chemotherapy.

Animals↗
PubMedDate not supplied

Cerebrospinal fluid cytology diagnosis of meningeal carcinomatosis in patients with small-cell carcinoma of the lung. A study of interobserver and intraobserver variability.

The interobserver and intraobserver variation in the cytologic diagnosis of malignancy was determined in 62 cerebrospinal fluid (CSF) specimens from 46 patients with small-cell carcinoma of the lung. In all patients, lumbar puncture was carried out because of suspected central nervous system metastases. Forty CSF specimens from 26 patients with meningeal carcinomatosis and thus with a high probability of a positive CSF cytology were mixed with 22 specimens from 20 patients without meningeal carcinomatosis. The slides were evaluated blindly by two observers, one of whom evaluated all specimens on two separate occasions; only positive, negative and suspicious conclusions were permitted. The consistency of the intraobserver and interobserver conclusions on the initial CSF specimen in each case was 87%. In 13% of the initial CSF specimens in each case, a suspicious conclusion was reached in one of the three evaluations. For all 62 CSFs, the intraobserver and interobserver disagreement was 2% and 3%, respectively. In the first and second evaluations by the one observer and the single evaluation by the other, 17 (65%), 15 (58%) and 12 (46%), respectively, of the 26 "high probability" patients were found to have malignant cells in the CSF. CSF cytology was negative in all 20 patients without meningeal carcinomatosis. Of 10 patients with autopsy-proven meningeal carcinomatosis, 40% were not diagnosed while alive. Multiple CSFs from repeated lumbar punctures increased the number of positive evaluations by 30%. At least 60% of those patients with a suspicious CSF cytology did in fact have meningeal carcinomatosis. On the other hand, 30% of the patients with a positive lumbar puncture had a subsequent negative one.

Carcinoma, Small Cell↗