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Biomedical subjects

C Drott

Publications and source records attributed to C Drott.

48 records · Page 3Linked to original sources
PubMed1988

Increased urinary excretion of cortisol and catecholami-NES in malnourished cancer patients.

Excretion of cortisol and catecholamines were measured from 24-hour urine samples collected over a period of 3 days from hospitalized cancer patients suffering from malnutrition and were compared with those of control patients equally malnourished and having a similar degree of inflammation. Compared with control patients, cancer patients had a higher excretion of cortisol, adrenaline, and noradrenaline, although noradrenaline excretion reached statistical significance only when normalized to creatinine excretion. Plasma glycerol concentrations after an overnight fast were significantly higher in cancer patients as compared with control patients, in keeping with an increased adrenal and adrenergic activity. This study demonstrates evidence of simultaneously elevated catecholamine and cortisol excretion in cancer patients, which could not be ascribed to alteration in body composition. The results may, in part, explain the mechanisms behind ongoing tissue breakdown in progressive cancer disease.

Aged↗
PubMed1988

Monocytic production and plasma bioactivities of interleukin-1 and tumour necrosis factor in human cancer.

Plasma concentrations and in-vitro production of interleukin-1 and tumour necrosis factor were evaluated in 23 weight-losing patients with cancer, six bacterially infected patients without cancer and six healthy controls. Bioactivity of interleukin-1 was found in the plasma from five of six bacterially infected patients but only from one of 23 cancer patients. Tumour necrosis factor activity was not detected in the plasma of any patient. In four of 23 patients with cancer, in-vitro stimulation of peripheral blood monocytes by either endotoxin or heat-killed Staphylococcus albus resulted in no significant production of interleukin-1. Such a defect was not seen in any of the bacterially infected or control patients. Tumour necrosis factor production by endotoxin-stimulated blood monocytes was unaffected by the presence of cancer or bacterial infections and was normal in the four individuals with defective interleukin-1 production. We can therefore conclude that interleukin-1 bioactivity is not generally found in the plasma of weight-losing cancer patients. Furthermore, in a fraction of such cancer patients, monocytic production of interleukin-1 is markedly down-regulated. However, this defect appears to be specific for interleukin-1 since in-vitro tumour necrosis factor production is normal.

Aged↗
PubMed1988

Total parenteral nutrition as an adjuvant to patients undergoing chemotherapy for testicular carcinoma: protection of body composition--a randomized, prospective study.

The efficacy of total parenteral nutrition (TPN) in the protection of body composition, when given as an adjuvant to CVB (cisplatin-vinblastine-bleomycin) treatment to patients with testicular teratocarcinoma, was investigated. Twenty-three patients without previous malnutrition were randomized to receive either TPN or spontaneous oral intake only during their hospital stay, in the course of a total treatment period of 10 weeks. The patients spent weeks 1, 4, 7, and 10 in the hospital to undergo chemotherapy. Energy and nitrogen intakes were profoundly decreased in the spontaneous oral-intake group, whereas the intakes decreased in the TPN group only at home when they relied on oral intake. In spite of the cytotoxic drugs, the TPN group remained in nitrogen balance when undergoing TPN at the hospital. However, they lost substantial body weight and body nitrogen over 10 weeks when compared with the oral-intake group. This loss in body mass was mainly a result of the prolonged anorexia that all the patients had after weekly termination of chemotherapy. This study demonstrates that well-nourished patients can use intravenous nutrition even while receiving cytocidal and cytostatic drug administration. However, intermittent periods of adequate nutrition in the hospital had only a marginal impact, since the positive effects of nutrition were offset by the pronounced anorexia that occurred in all patients outside the hospital for a considerable time after cytostatic treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Cardiac sensitivity and responsiveness to beta-adrenergic stimulation in experimental cancer and undernutrition.

We have previously reported that the heart retains its pumping performance despite loss of contractile mass during tumor disease and malnutrition. This adaptation is associated with increased agonist affinity of the beta-receptor. The present study was undertaken to evaluate if increased beta-receptor agonist affinity has a physiologic counterpart which may contribute to the remained function in hypotrophic hearts. The isolated, perfused, working rat heart was used as a model. Hearts from tumor-bearing rats showed an increased sensitivity and reactivity to graded isoproterenol stimulation compared to freely-fed control animals. Starved and protein-calorie malnourished (PCM) control animals had a similar response of heart rate, left ventricular peak pressure and contractility as the tumor-bearing group. This increased response to beta-adrenergic stimulation thus seems to be a general adaptation to loss of contractile mass and not to a tumor-specific reaction. Tumor-bearing animals had lower myocardial content of norepinephrine and epinephrine compared to starved, PCM and freely-fed control rats. Oxygen consumption was higher in hearts from tumor-bearing animals compared to freely-fed controls during all experimental conditions. Starved and PCM rats, in contrast, had decreased oxygen consumption compared to the freely-fed controls. The heart might thus be one of the organs contributing to the increased energy expenditure seen in malignant tumor disease possibly due to a changed adrenergic regulation in the tumor state compared to uncomplicated undernutrition.

Animals↗
PubMed1987

Secondary aortoenteric fistulas--an analysis of 42 cases.

Secondary aortoenteric fistulas are seen with an increasing frequency which parallels the expansion of reconstructive vascular surgery. During a 12-year period 42 cases have been collected from the hospitals, which perform most of the vascular surgery in Sweden (0.7% of vascular operations). Twenty-five were seen after operation for aortic aneurysm, 15 for aortoiliac occlusive disease, one after renal artery ligation (as a part of reconstruction for renovascular hypertension) and one after operation for an iliac pseudoaneurysm. The frequency of complications during and after the primary operation was high. The interval between operation and onset of fistula symptoms was significantly shorter if there had been infectious complications, the median interval was 32 months, the longest being 10 years. The most important symptom was gastrointestinal haemorrhage, consisting of several small bleeds often combined with septic complications. A large number of negative investigations usually preceded the final diagnosis which was made at exploratory laparotomy. After surgery for the fistula the frequency of complications and mortality, were very high. Mortality was 58%, the most common cause of death being a blow out of the aortic stump. Of those leaving hospital, several further operations were performed with a high mortality. Recurrence of the fistula occurred in 16 out of 34 patients who survived surgery. At follow-up (12-74 months after fistula closure) seven patients were still alive.

Adolescent↗
PubMed1987

Role of insulin in development of cancer cachexia in nongrowing sarcoma-bearing mice: special reference to muscle wasting.

This study evaluated whether altered insulin metabolism is a key factor behind weight loss during sarcoma growth in nongrowing mice (C57BL/6J). Fasted sarcoma-bearing mice had decreased blood glucose concentrations but unchanged levels of insulin, compared with those in pair-weighed and freely fed controls. During refeeding, insulin levels were inappropriately low for the degree of glycemia in sarcoma-bearing mice compared with those of pair-weighed and freely fed controls. Injections ip of glucose to tumor-bearing animals resulted in insulin levels comparable to postabsorptive values in healthy control animals, indicating that hypoinsulinemia in freely eating tumor-bearing animals was due to a reduced glycemic sensitivity for pancreatic insulin release. Insulin supplementation at doses [4 IU/100 g (body wt)] that increase body fat in normal animals could not protect the tumor-bearing host from progressive loss of body fat or lean tissues. Exogenous insulin in excess of endogenous insulin production did not stimulate tumor growth. Nitrogen and RNA-DNA content were significantly decreased in the quadriceps muscle of tumor-bearing mice. This reduction was independent of altered insulin levels and could not be prevented by exogenous insulin. The depressed capacity of protein synthesis in extensor digitorum longus (EDL) muscle could be entirely attributed to the state of malnutrition in tumor-bearing animals. The sensitivity and responsiveness of protein synthesis in EDL muscles to insulin were normal in tumor-bearing mice, regardless of whether exogenous insulin exerted its effect in vivo or in vitro. This study confirms insulin resistance for glucose metabolism in an experimental sarcoma animal model. Such changes are concluded to be secondary to anorexia and necessary to counteract hypoglycemia. In non-growing sarcoma-bearing mice, malnutrition and anorexia account entirely for depressed muscle protein synthesis, which is not explained by insulin resistance at the translational level. Insulin metabolism is not a key factor behind progression of wasting in sarcoma-bearing mice, but anorexia is.

Animals↗
PubMed1986

Effects of tumor-load and malnutrition on myocardial function in the isolated working rat heart.

Marked differences in cardiac associated morbidity and mortality have been reported between patients with and without malnutrition. Tumor-associated cachexia may impair heart function, which further aggravate host wasting and thereby create a vicious circle. The aim of this study was to evaluate to what extent a malignant tumor may influence heart function under well-defined experimental conditions. The perfused working rat heart was used as a model. Study groups of freely-fed sarcoma-bearing rats, starved and protein-calorie malnourished (PCM) non-tumor rats were compared to freely-fed control animals. All groups of malnourished animals (tumor-bearing, starved and PCM) lost significant amounts of body and heart mass compared to freely-fed controls. Loss of heart contractile mass in tumor-bearing rats and malnourished animals did not lead to impaired heart function in any respect. The rate of oxygen uptake was significantly higher under all experimental conditions in perfused hearts from tumor-bearing rats compared with hearts from starved, PCM and freely-fed control rats. Oxygen uptake per left ventricular work was significantly higher in tumor-bearing rats but significantly lower in starved and PCM rats compared with control animals. Norepinephrine at various concentrations (10(-9)-10(-5) mol/l) in the perfusate stimulated the contractility and the left ventricular peak pressure significantly more in hearts from malnourished animals compared with that of freely-fed controls. The results show that adaptive functional changes can be recorded in the isolated perfused rat heart from sarcoma-bearing rats and after a period of comparatively acute undernutrition in non-tumor rats. A malignant tumor or the associated malnutrition does not induce impaired pumping performance despite a reduction in contractile heart mass. Increased oxygen consumption in hearts from tumor-bearing animals may contribute to elevated energy expenditure in a cancer-bearing host.

Animals↗
PubMed1981

Duplication cyst of the jejunum. Report of a case.

A 4-year-old boy presented with recurrent abdominal pain and melena. X-ray studies of the gastrointestinal tract and technetium scanning of the abdomen were normal. Laparotomy revealed a large duplication cyst in the proximal part of the jejunum. The cyst was intramesenteric and contained gastric mucosa with three peptic ulcers. The cyst was removed without bowel resection.

Child, Preschool↗
PubMed1978

Massive thrombosis of the superior mesenteric, splenic, and portal veins. Report of a case.

A 19-year-old previously healthy youth developed a deep venous thrombosis and a pulmonary embolism in connection with rupture of a ligament of the left ankle. Two months later, while on effective (thrombotest value 21%) oral anticoagulant therapy, the patient had massive thrombosis of the superior mesenteric splenic and portal veins and died. There was no known predisposition to thrombosis, such as tumour, infection, or trauma. A later examination of a 12-year-old brother revealed decreased fibrinolytic activity in the vessel wall as well as a decreased fibrinolytic response to venous occlusion. Since decreased fibrinolytic activity in the vessel wall is sometimes familial, it seems reasonable to suspect that the same defect might have occurred in the patient with the fatal massive thromboembolic disease.

Adult↗
PubMedDate not supplied

Optimal nutritional indexes in cancer patients.

This paper reviews various parameters that are used to assess the nutritional and functional status of cancer patients. Available information shows that the nutritional status of cancer patients is correlated with their overall prognosis and outcome. However, little information exists concerning the use of nutritional indexes to evaluate the effectiveness of nutritional rehabilitation of cancer patients. It is emphasized that we should concentrate on developing nutritional parameters to assess the functional improvement of patients rather than their body structure and composition.

Humans↗