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Biomedical subjects

E Simonsen

Publications and source records attributed to E Simonsen.

At least 55 records · Page 3Linked to original sources
PubMed1985

Frequent attacks of supraventricular tachycardia in a patient treated with an automatic scanning pacemaker (PASAR): Holter documentation of 554 episodes.

A 68-year-old woman suffering from frequent attacks of supraventricular tachycardia received an implantable, automatic scanning pacemaker for tachycardia termination (PASAR). Electrophysiological study had shown the mechanism to be atrioventricular reentry with retrograde conduction through a concealed bypass tract. During 1 year of follow-up, a total of twenty-one 24-hour Holter recordings documented 554 episodes of tachycardia. In spite of marked fluctuation in tachycardia rate from 135 to 195 bpm and a considerable variation in diurnal pattern of onset of episodes, a clinical improvement resulted. Previous episodes of tachycardia had been isolated and of longer duration. Following implantation, an unexpected observation was made of numerous episodes of supraventricular tachycardia confined to periods lasting up to several hours. This pattern seemed to result from the efficacy of tachycardia termination combined with a continued presence of factors responsible for initiation of tachycardia.

Aged↗
PubMed1985

Basal cell carcinoma of the vulva.

A clinical and histopathologic study of material from a series of 21 patients with basal cell carcinoma treated from 1960 until 1979 are reviewed. In 3 patients 'mixed' tumor was recorded. The histopathologic diagnosis: basosquamous carcinoma and the behavior of this carcinoma are discussed. The mean age of the patients was 76 years. Presenting symptomatology consisted primarily of bleeding, burning or itching, and ulcerations. No case of pure basal cell carcinoma gave metastasis to the regional lymph nodes, in no case could the cause of death be attributed directly to this kind of lesion. A conservative approach consisting of wide local excision is suggested.

Aged↗
PubMed1985

T wave inversion and ST segment depression in normally conducted beats in patients treated with ventricular demand pacing.

Changes of T waves and ST segments in normally conducted beats are frequently seen in patients treated with ventricular demand pacing. The alteration in the sequence of ventricular activation is accompanied by inversion of T waves and sometimes a depression of ST segments in several leads. These changes have a close resemblance to those often seen in ischaemic heart disease. Some of the clinical implications are illustrated in four case stories. The slow regression of changes after cessation of pacing is particularly emphasised. The time required for complete disappearance of changes was directly related to the duration of ventricular pacing. In contrast to this finding a quickly developed, though temporary, regression was observed during exercise. The development of repolarisation changes requires a certain duration and extent of pacing. Therefore changes are not present in all ventricular paced patients. Consequently, recording of the spontaneous rhythm is proposed as a routine in the pacemaker clinic. The recordings might prove valuable for future comparison in case of suspected myocardial disease.

Aged↗
PubMed1984

Treatment of recurrent endometrial adenocarcinoma with a combination of doxorubicin and cisplatin.

Nineteen patients with recurrent endometrial carcinoma and one patient with Stage IV endometrial carcinoma not previously treated with chemotherapy were treated with a combination of doxorubicin and cisplatin. The dose schedule was doxorubicin, 50 mg/m2 on day 1, and cisplatin, 50 mg/m2 with hyperhydration on day 1, with a new course every 4 weeks. Objective response 60% was obtained in 12 out of 20 patients (two with complete remission and 10 with partial remission). Furthermore, four patients had stationary disease. The two patients with complete remission both had distal vaginal metastases, and they are still alive after greater than 21 and greater than 40 months. The median survival period for those with partial remission was greater than 11 months (range of 4 to 26); for those with stationary disease, 7 months (range of 4 to 10), and for those with progressive disease, 4 months (range of 3 to 7). The response rate was higher for well-differentiated tumors. No serious side effects were noticed. To our knowledge no other reports have been published so far with the use of the same regimen in patients with recurrent endometrial adenocarcinoma with no prior chemotherapy. We find the objective response rate, the survival time, and the quality of life for the responding patients in our study so encouraging that we shall continue with a larger trial.

Adenocarcinoma↗
PubMed1984

Treatment of recurrent squamous cell carcinoma of the vulva.

Continuous follow-up of 244 patients treated for primary invasive squamous cell carcinoma of the vulva during a 20-year period (1960-1979) resulted in the detection of recurrent (or persistent) disease in 60 cases. Forty-one of these cases developed local or regional recurrence, or both, later than six months after treatment, and an analysis of the result of retreatment in this group is presented. Twenty-nine had local recurrences, nine regional metastases and three local recurrences and regional metastases. The treatment technique for local recurrences was surgery, in a few cases combined with irradiation and chemotherapy. In approximately one-third of the cases, this treatment resulted in long-term or permanent cure. In cases of regional metastases the prognosis was often extremely poor, but treatment normally gave good palliation although of short duration.

Actuarial Analysis↗
PubMed1984

Radiation therapy and surgery in the treatment of regional lymph nodes in squamous cell carcinoma of the vulva.

A series of 244 patients with vulvar squamous cell carcinomas was analyzed with regard to treatment of the regional lymph nodes. In 144 patients, groin dissection was performed, supplemented in 24 cases by pelvic lymphadenectomy. Preoperative irradiation was given and in cases with positive nodes postoperative irradiation as well. Patients in whom lymph node dissection was not performed received irradiation. Treatment failures in the regional lymph node regions were analyzed and the policy concerning treatment of the regional lymph nodes is discussed.

Carcinoma, Squamous Cell↗
PubMed1984

Stage I squamous cell carcinoma of the vulva.

Eighty-six patients with invasive squamous cell carcinoma of the vulva stage I were followed for 2 to 20 years after surgical treatment varying from local excision to radical vulvectomy with inguinal lymph node dissection. The results are presented and the prognosis discussed in relation to the radicality of the surgical intervention, the degree of tumour differentiation, the morphologic properties of tumour cell population, and the tumour host relationship. The most important prognostic factor seemed to be the radicality of the surgical intervention. To reduce patient morbidity in radical surgery while still achieving a comparable survival rate an operative approach with less than radical vulvectomy, inguinal dissections or pelvic lymphadenectomy, or both, is proposed for selected patients.

Actuarial Analysis↗
PubMed1984

Spontaneous rotation of permanent pacemaker--a cause of muscle stimulation and myopotential inhibition.

In 5 of 192 patients who received their first pacemaker during a 17-month period, severe pectoral muscle stimulation was caused by spontaneous rotation of the pacemaker in the pocket, so that the uncoated side faced backwards. All five patients were women with abundant, loose subcutaneous tissue which allowed increased mobility of the pacemaker. This causal mechanism of muscle stimulation seems to be related to the reduced size and the coating of modern pacemakers. Reprogramming of the pacemaker to a lower output solved the problem in three cases, but reoperation was necessary in two. These cases stress the need to secure the pacemaker to the fascia during implantation, particularly in patients at enhanced risk. For such patients, use of a pacemaker equipped with suture holes may be advisable.

Aged↗
PubMed1984

Invasive squamous cell carcinoma of the vulva.

Clinical data on 266 patients with squamous cell carcinoma of the vulva seen between 1960 and 1979 are reported. Two-hundred and eleven of these patients were eligible for 5-year evaluation. The crude survival for these patients was 59%, and the 5-year crude survival for 195 patients treated with curative intention was 64%. Two-hundred-forty-four patients were treated with radical vulvectomy and in 122 patients lymphadenectomy was also performed. Fifty per cent of the patients treated with lymphadenectomy had lymph node metastases at the time of surgery. In 88% radiotherapy was included in the treatment of the regional lymph node regions. Treatment failures occurred in 25% of the patients. Prognosis was discussed in relation to tumour size, tumour site, and histological differentiation. The presence of lymphatic involvement and surgical radicality appeared to be the most significant prognostic factors.

Adult↗
PubMed1983

Bleomycin-mitomycin C in advanced carcinoma of the cervix. A third look.

Thirty-three patients with advanced cervical cancer (31 squamous cancer, two adenosquamous cancer) previously untreated with cytotoxic drugs, were treated with bleomycin, 5 mg daily, for seven days and mitomycin C, 10 mg, on day 8. This regimen was repeated four times at two-week intervals. All but one patient had previously been treated with radiotherapy; 36% of the patients had an objective response (five complete remission (CR), median duration 12 months; seven partial remission (PR), median duration six months). Severe myelosuppression occurred in nine patients. One drug-related death due to thrombocytopenia occurred. Three patients developed pulmonary fibrosis and one of them died of respiratory failure. The bleomycin-mitomycin C regimen has a definite but clearly limited effect in advanced cancer of the uterine cervix.

Adult↗
PubMed1983

CO2 laser for the treatment of invasive vulvar and vaginal cancer.

In a material of 21 patients including 7 primary and 6 recurrent vulvar carcinomas, 5 vaginal carcinomas, 1 urethral carcinoma and 2 preinvasive vulvar carcinomas operation was performed with a CO2-laser scalpel. In 9 radical and 3 partial vulvectomies no primary closing of the wounds was performed. In the remaining primary closing was performed. The operative bleeding and healing process with laser scalpel and electrosurgical scalpel using open wound technique were about the same. The surgical time was longer with the laser technique but the operative specimens were better preserved. Healing of the primary closed wounds were uncomplicated.

Carbon Dioxide↗