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Biomedical subjects

E Simonsen

Publications and source records attributed to E Simonsen.

At least 37 records · Page 2Linked to original sources

Adenoid cystic carcinoma of Bartholin's gland: a report of five new cases treated with surgery and radiotherapy.

Adenoid cystic carcinoma (ACC) is a slow-growing tumor with a marked tendency for perineural and local invasion. The neoplasm occurs more frequently in the head and neck region and only 39 previously described cases of adenoid cystic carcinoma of Bartholin's gland are found in the world literature. Most authors advocate surgery as the primary treatment. Several cytostatic drugs have been tried but the results have been poor. The benefit of radiotherapy in the treatment of this type of tumor is not yet established. This is a report of five new cases all treated with surgery and postoperative radiotherapy. Three patients had histopathologically proven evidence of residual disease after surgery and were subsequently treated with radiotherapy. They are now living without evidence of disease after 28, 51, and 138 months.

Adult

Lymphocytic sodium and potassium pump function in Bartter's syndrome.

Bartter's syndrome is characterized by chronic hypokalaemia, activation of the renin-angiotensin system and normal blood pressure. To investigate whether a generalized disturbance of sodium-potassium pump function might be of pathogenetic importance, lymphocytic sodium-potassium homeostasis was examined in 5 patients suffering from Bartter's syndrome. Two of the patients were treated with potassium chloride supplementation, the others were without medical treatment when studied. All were severely hypokalemic (serum potassium 2.8 +/- 0.24 mmol/l, mean +/- SEM). Lymphocyte sodium and potassium concentration (14.4 +/- 0.37 and 94.4 +/- 7.7 mmol/l, respectively), ouabain sensitive 22Na-efflux rate constant (2.68 +/- 0.25 h), and absolute ouabain sensitive efflux rate (38.16 +/- 4.2 mmol l-1 h) did not differ from matched controls. Ouabain binding capacity was 126 900 +/- 23 500 sites/cell in patients vs 50 400 +/- 17 900 in controls (p less than 0.05). In conclusion, patients with Bartter's syndrome may have an intrinsic abnormal pump function, characterized by an increased pump density and a low cation turn-over rate per pump unit.

Adult

The prognosis in early endometrial carcinoma. The importance of uterine papillary serous carcinoma (UPSC), age, FIGO grade and nuclear grade.

278 patients with either stage I or II endometrial carcinoma treated between January 1979 and January 1982 were reviewed, particularly as regards certain prognostic factors. Uterine papillary serous carcinoma (UPSC), FIGO grade 3, nuclear grade 3, and age were the major independent prognostic factors. UPSC was diagnosed in 8% of the patients. The cancer mortality in the non-UPSC group was 7%, vs. 41% in the UPSC group. In the latter group all the deaths occurred within 2 1/2 years. Poorly differentiated non-UPSC had the same cancer death rate as UPSC, but usually had a completely different histological pattern. There was no significant difference in survival between stage I and stage II when corrected for FIGO grade and nuclear grade.

Age Factors

Primary invasive squamous cell carcinoma of the vagina.

Neoplastic lesions of the vagina account for 1% of all gynecologic malignancies. The overall 5-year survival rate for this disease is poor. This study comprised 58 patients with diagnosis of squamous cell carcinoma of the vagina treated between 1960 and 1984. Median age at diagnosis was 70 years. The lesions were staged according to FIGO. The numbers of patients in various stages were: I/13, II/24, III/12 and IV/9 and according to histologic differentiation: low grade/11, medium grade/17 and high grade/25; not recorded, 5. Twenty patients were treated with primary surgery and irradiation, 30 were treated with intracavitary and/or external irradiation only. The 5-year corrected survival rates were: St I/50%, St II/30%, St III/17% and St IV/10%; grade I/57%, grade 2/32% and grade 3/17%, younger than 70 years of age/43% and older than or 70 years of age/21%. The incidence of rectovaginal or vesicovaginal fistulas amounted to 17%. The treatment results of primary carcinoma of the vagina are poor. Prognostic factors for survival should be considered at treatment planning.

Aged

The use of chordotomy to treat pain from gynecologic cancer.

Tumor growth in the pelvis with nerve involvement causes severe pain which is notoriously resistant to pharmacological treatment. Chordotomy is a classical method for the relief of pain. This is a retrospective study of 24 chordotomy cases, operated on at the department of Neurosurgery, and independently evaluated at the department of Gynecologic Oncology. Initially 19 patients (79%) were painfree whereas 4 patients (17%) had only moderate or no relief following the operation (one not evaluable). 10 patients remained free of pain until death. There were no serious complications. Possible causes of pain relapse are analysed. We conclude that chordotomy is worth consideration when facing severe pelvic cancer pain.

Cordotomy

Plasma concentrations of complement split product C3d and immune complexes after procainamide induced production of antinuclear antibodies.

Seventeen patients treated with procainamide for cardiac ventricular arrhythmias were followed for up to 40 weeks. Immunological data as a clue to developing the systemic lupus erythematosus (SLE)-like syndrome was emphasized. Ten patients developed antinuclear antibodies (IgG or IgM), but no increase in the plasma concentration of the complement split product C3d or immune complexes, measured by two different methods, was demonstrated. This finding is in contrast to the high levels of both C3d and immune complexes in SLE. The discrepancy may be caused by a lack of immune complex mediated complement activation by the procainamide induced antibodies, or may be due to a difference in severity of disease. The acetylator phenotype of the patients was determined but due to the low frequency of fast acetylators no comparison of the immunological response of the two phenotypes could be done.

Aged

Superiority of multiprogrammable to nonprogrammable VVI pacing: a comparative study with special reference to management of pacing system malfunctions.

Analysis of pacing system malfunctions was performed in 374 patients at initial implantation or at pulse generator and lead replacement during a period of 55 months. A total of 150 nonprogrammable pacemakers were implanted in 148 patients, while 236 multiprogrammable pacemakers were implanted in 226 patients. The purpose of the analysis was to investigate the occurrence and management of malfunction unrelated to pacemaker/lead failure or lead dislodgement. The nonprogrammable group was followed for 3-53 months (median, 36). Malfunction occurred in 18 patients (12.0%): muscle stimulation in 14; exit block in three; sensing problem in one. Surgical correction was necessary in 14 of 18 cases. The multiprogrammable group was followed for 3-52 months (median, 12). Malfunction occurred in 30 cases (12.7%): muscle stimulation in 22; threshold increase in seven; sensing problem in one. Only seven of these patients required surgical correction as 23 cases were successfully managed by reprogramming alone. Malfunctions occurred during a period of several days to 36 months (median, 2.3 months). The difference in rate of secondary surgical intervention was significant (p less than 0.01). Measurements during reoperation in the nonprogrammable group showed that at least 40% of late malfunctions would have been correctable by reprogramming alone. Thus, multiprogrammability is of significant value for noninvasive correction of malfunctions unrelated to pacemaker and lead failures, predominantly muscle stimulation and threshold elevation.

Aged

Doxorubicin-cisplatin combination chemotherapy for recurrent carcinoma of the cervix.

A total of 31 patients with recurring or metastasizing squamous cell carcinoma of the cervix were treated with doxorubicin and cisplatin. Sixteen patients (Group 1) had previously been treated with external irradiation and two intracavitary radium applications, and 15 patients (Group 2) had been treated with radiotherapy plus chemotherapy with bleomycin plus mitomycin, peplomycin, or melphalan. The overall frequency of response was approximately 16% (five of 31 patients). In Group 1, two of 16 patients had complete remission for 14+ and 28 months, and survival for 36+ and 45+ months. One of 16 patients had partial remission for 8 months, and survival for 16+ months. In Group 2, two of 15 patients achieved partial remission for 16 and 18 months, and survival for 28 and 35 months. No serious side effects were noted in the two groups.

Adult