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Biomedical subjects

B Sandstedt

Publications and source records attributed to B Sandstedt.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Increase of serum interleukin-2 and regression of myeloma after rhGM-CSF treatment of drug induced bone marrow aplasia.

Recombinant human granulocyte/macrophage colony-stimulating factor (rhGM-CSF) was administered to a patient with multiple myeloma (IgA, stage IIA) who had a chemotherapy-induced bone marrow aplasia with granulocytopenia complicated by severe pneumonia and septicemia. The rhGM-CSF was given as i.v. infusions, 300-400 micrograms daily, for three weeks. The patient responded both hematologically and clinically with improved granulocyte counts and clearance of massive pulmonary infiltrates. We also observed a partial remission of the myeloma with decreasing s-IgA levels and reduced plasma cell infiltration of the bone marrow during a period of up to four months after the rhGM-CSF treatment. Immunological studies performed during and after cytokine administration showed an increase in serum interleukin-2 (IL-2) levels and HLA-DR positive T-lymphocytes indicating an activation of the immune system. It is suggested that rhGM-CSF induced immunological changes which may have contributed to the partial regression of the myeloma.

Aged↗
PubMedDate not supplied

Chorioamnionitis in relation to gestational outcome in a Swedish population.

In a histopathological study, from a homogeneous Swedish population with a better than average socio-economic standard, placentas from 161 singleton infants small for gestational age (SGA) and 322 singleton infants appropriate for gestational age (AGA) were examined for the presence of inflammation in the placental parenchymal membranes, cord and decidua. Acute chorioamnionitis including funiculitis was found in 13.4% of the total material, in 17% of term AGA-infants (GA, greater than or equal to 38 weeks), in 13% of preterm AGA-infants (less than or equal to 37 weeks) and in 6.8% of SGA-infants (p less than 0.001, compared to term AGA). Acute chorioamnionitis was correlated to vaginal delivery (p less than 0.01), rupture of the membranes greater than 24 hours (p less than 0.01), nulliparity (p less than 0.05) and amniocentesis (RR = 1.7). In nulliparous, chorioamnionitis was related to duration of labor greater than 16 hours (p less than 0.01). Streptococcal (p less than 0.01) and anaerobic vaginal infections (p less than 0.05) were also related to chorioamnionitis. Of 17 infants with sepsis, 6 had chorioamnionitis (p less than 0.05). Decidual inflammation was chronic in type and found in 4.5% of the placentas and was not related to chorioamnionitis, but to parity (p less than 0.05) and term AGA-infants (p less than 0.001).

Amniocentesis↗
PubMedDate not supplied

Reduction of postoperative chemotherapy in children with stage I intermediate-risk and anaplastic Wilms' tumour (SIOP 93-01 trial): a randomised controlled trial.

BACKGROUND: Present treatment for Wilms' tumour is very successful. Now, efforts are aimed at reducing toxicity and burden of treatment by shortening schedules without loss of effectiveness. The objective of this randomised trial was to assess whether postoperative chemotherapy for patients with stage I intermediate-risk and anaplastic Wilms' tumour could be shortened to only 4 weeks from the standard 18 weeks, while maintaining equivalent event-free survival. METHODS: Between June, 1993, and June, 2000, 410 patients were randomly assigned after four doses of vincristine plus one course of dactinomycin postoperatively either to stop further adjuvant chemotherapy (no further chemotherapy group, n=200), or to receive a further two courses of the same chemotherapy (standard group, n=210). Previous treatment consisted of chemotherapy before nephrectomy of four doses of vincristine and two courses of dactinomycin followed by surgical resection of the tumour. Eligible patients were at least 6 months old and had stage I tumours with either intermediate-risk histology or anaplasia. The primary endpoint of this equivalence trial was 2-year event-free survival. Both per-protocol and intention-to-treat analyses were done. FINDINGS: By 2 years, 18 recurrences were reported in the standard group, and 22 in the no further chemotherapy group. Event-free survival was 91.4% (95% CI 87.5-95.2) for the no further chemotherapy group and 88.8% (84.3-93.2) for the standard group (difference=2.6%, upper 97.5% confidence limit 8.4%). The null hypothesis, that experimental treatment is less effective than standard treatment, could be rejected (p=0.008). CONCLUSIONS: Shortening duration of chemotherapy could reduce acute and late side-effects and inconvenience for patient and parents while maintaining effectiveness, and could be beneficial in terms of health costs.

Adolescent↗
PubMedDate not supplied

Suprarenal haematoma versus neuroblastoma complicated by haemorrhage. A diagnostic dilemma in the newborn.

Concomitant neonatal suprarenal haemorrhage and neuroblastoma is rare. The clinical and radiologic manifestations recorded in 11 patients with this entity are compared with the findings in 32 cases with simple adrenal haemorrhage. Because of the many similarities in presentation the combined lesion must always be considered when a neonate is found to have a retroperitoneal, extra-renal mass. Our present approach to the investigation includes conventional chest and abdominal radiography aimed to demonstrate possible paravertebral widening. Serial ultrasonographies are easy to carry out and indispensable. The low specificity of urography makes us refrain from this modality as a routine. Scintigraphy, in infants and children considered useful in demonstrating extent and spread of neuroblastoma, has hardly been employed in neonates. The true value of the modality in this particular age group remains to be settled. CT scanning does not seem to provide essential information additional to that of sonography and may therefore be excluded from the protocol. Determination of urinary excretion of catecholamine metabolites is of crucial significance and a compulsory part of the investigation.

Adrenal Gland Diseases↗
PubMedDate not supplied

Mesoblastic nephroma metastatic to the lungs and heart--another face of this peculiar lesion: case report and review of the literature.

A case of mesoblastic nephroma in a 14-month-old girl who developed consecutive metastases in the lung and the heart is presented. This tumor is considered to be benign and cured by surgery only. Recurrent cases are extremely rare and usually related to unclear surgical margins. Metastatic mesoblastic nephroma has been previously described in only two cases. The present case highlights a new, previously undescribed feature--the ability to metastasize to sites other than lung.

Combined Modality Therapy↗
PubMedDate not supplied

Nephrogenic rest associated with a mesoblastic nephroma--what does it tell us?

A 3-year-old girl presented with a tumor in the right kidney that was found to be a mesoblastic nephroma on histological examination. In addition, between the tumor and renal parenchyma there was a large perilobar sclerosing nephrogenic rest--a finding that has rarely been reported previously in non-Wilms renal tumors of childhood. We believe this supports the theory that both mesoblastic nephroma and Wilms tumor arise from the developing kidney but the key difference is the time point at which induction of neoplasm occurs.

Child, Preschool↗
PubMedDate not supplied

Infarction of the small bowel caused by giant cell arteritis. Case report.

A case with giant cell arteritis causing infarction of two segments of the small bowel is described in a 43-year-old woman. Subsequent angiography showed stenoses in both subclavian arteries and one common iliac artery, compatible with Takayasu's disease. The difficulties in distinguishing the different types of granulomatous giant cell arteries are discussed.

Adult↗
PubMedDate not supplied

Fine needle aspiration cytology of thymic tumors.

Cytologic material was reviewed from 23 mediastinal tumors clinically suspected as thymomas. The thymomas had a characteristic biphasic cell pattern in material obtained by fine needle aspiration biopsy that was easy to recognize and possible to differentiate from carcinoid tumors, malignant lymphomas and oat-cell carcinomas.

Adult↗