[A follow-up study of 167 patients after subtotal hysterectomy].
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Biomedical subjects
Publications and source records attributed to G Carlsson.
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The effect of general microwave hyperthermia and hepatic artery ligation (HAL) was tested on Wistar rats with a transplanted N-methyl-N-nitrosoguanidine-induced adenocarcinoma in the liver. Total body hyperthermia (41.5 degrees C for 1 hour, three times during 24 hours) was given on the same day as HAL, and 1, 2, and 3 days after. HAL induced a slower tumor growth than untreated controls. No additive effect was registered when total body microwave hyperthermia was added to HAL. When hyperthermia was added 2 days after HAL, there was a transient decrease in tumor volume as in the HAL series. Total body microwave hyperthermia added 3 days after HAL induced a faster tumor growth than after HAL alone. When hyperthermia was added the same day and 1 day after HAL, there was a 50% mortality.
Liver tumors, both primary and secondary, receive their main blood supply from the hepatic artery. Hepatic artery ligation (HAL) causes a reduction in tumor growth and tumor necrosis. In this experiment, three different experimental tumors were used to study the effect of hepatic artery ligation at different intervals after the occlusion of the arterial blood supply. Hepatic artery ligation causes a reduction in liver tumor growth for all three tumors but with some variation according to age and type of tumor.
Experimental solitary ellipsoid liver tumors in the rat can be induced by inoculation of a tumor-cell suspension of known potency into the liver parenchyma. During laparotomy, the largest (a) and the smallest (b) superficial diameters of the tumor were measured on the surface of the liver with vernier calipers. Four different formulas have been tested and compared with the actual volume from the extirpated tumor and tumor weight. Within the size range of 15-700 mm3, based on the calculation of the difference between logarithmic tumor volume from the different formulas versus logarithmic volume of extirpated and dissected tumors and regression analyses, volume of the unremoved liver tumor can be best calculated according to the formula V = a x b2/2.
In three different tumor systems (sarcoma, hepatoma and adenocarcinoma) in rats, hepatic artery ligation (HAL) 10 days after tumor cell inoculation in the liver caused liver tumors which when measured 7 days later were statistically significantly smaller than those found in untreated control animals. The day before the experimental procedure the animals were challenged with tumor cell suspensions subcutaneously on the back. In the rats with the adenocarcinoma these subcutaneous tumors were larger in the HAL-group than in the control groups. The same results were obtained in the animals with the sarcoma. No such differences were observed in the rats with the hepatoma. To extrapolate these findings in a rat tumor system to the clinical situation in man should be done with extreme caution. There are subjective clinical impressions in man of a similar type, which may indicate common mechanisms. These findings could indicate that HAL should not be performed in patients with manifest extrahepatic tumor growth and only in controlled studies in patients with occult extrahepatic growth.
The survival of patients with tumour growth in the liver is very restricted. Interruption of the arterial blood supply to the liver is one method used to control tumour growth. This method is based on the findings that liver tumours are mainly nourished by the hepatic artery. Different methods are used in order to interrupt the arterial blood supply to the liver. Hepatic artery ligation (HAL) has been found in animal experiments to be the most reproducible method to temporary retard tumour growth. Survival has been shown to be prolonged in animals with liver tumours subjected to HAL compared with untreated controls. In humans no effect on the survival time has been observed, but the quality of life of these patients has been claimed to be improved especially those with the carcinoid syndrome. Although interruption of the hepatic arterial blood supply has been used clinically for more than 15 years the method is still an experimental procedure. Further clinical research in this field requires properly designed randomized studies.
Tumour vascularity of a transplantable N-methyl-N-nitrosoguanidine induced adenocarcinoma of the colon in the liver was investigated by repeated hepatic arteriography and portography. The arterial vascularity was influenced by tumour size; a transient increase in vascularization was observed when tumour size increased. Portography revealed portal vessels concentrated to the peripheral parts but some portal vessels were also observed leading to the central part of the adenocarcinomas. The tumour volume of solitary adenocarcinoma in the liver could be estimated from measurements of the largest (a) and smallest (b) diameters on the angiogram according to the formula V = a x b2/2.
Liver tumors receive their main blood supply from the hepatic artery. Various types of interruption of arterial blood supply to the liver are considered to give a reduction in liver tumor growth. Inoculation of a tumor cell suspension of a transplanted benzpyrene-induced sarcoma was used to induce a tumor in the liver of Lister-hooded rats. The influence of hepatic artery ligation (HAL) and regular liver dearterialization, i.e. dividing of all structures to the liver except portal vein, common bile duct and hepatic veins, was tested against control and sham operation. Ligation of the hepatic artery gave a statistically significant temporary reduction of liver tumor growth. A continuous growth of the tumors was found after regular liver dearterialization, sham procedure and in the controls. Seven and 14 days after the procedures this difference between HAL and regular liver dearterialization was recognized statistically significant (p less than 0.001) in groups with only five animals.
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One hundred fifty-five patients, laparotomized because of colorectal cancer, were retrospectively evaluated with special attention given to the natural course of untreated synchronous liver metastases. The median survival time for patients with synchronous liver metastases was 4.5 months. The survival time was mainly influenced by the extent of tumor involvement in the liver. Patients with elevated levels of serum-alkaline phosphatase at the time of operation had a significantly shorter survival time than those with normal values. Serum alkaline phosphatase levels are a good indication of prognosis. The incidence of synchronous liver metastases was 16 percent. This low rate is partly explained by the development of metachronous liver metastases in five patients within 1 year. Comparison with previous reports, often more than 10 years old, reveals that the poor prognosis of patients with untreated liver metastases from colorectal cancer has remained unchanged.
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An investigation was carried out as a case-finding study to estimate the scale of heavy drug abuse in Sweden. Just over 8200 persons were reported as heavy drug abusers, 80% of these as injecting. For the majority of those reported more than one type of drug was indicated. There was concurrent abuse of alcohol by a majority of the heavy drug abusers. After correction of non-response with a modified capture-recapture technique and for erroneous classification, the scale of heavy drug abuse was estimated at 10000 - 14000 persons.
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Much more information is required on the distribution of blackflies in various parts of the world, and in many cases an adequate methodology for obtaining such information still has to be worked out. A detailed methodology for the collection of information about blackflies is given, which was developed for investigations mainly in the Holarctic regions but is basically applicable to other parts of the world. A brief survey of the population dynamics of various species of blackflies in various parts of the Holarctic regions is given, and the main factors influencing the population dynamics are discussed.Interspecific and intraspecific fluctuations in natural blackfly populations are attributed chiefly to abiotic environmental factors rather than to competition. Larval competition in a given microhabitat is mainly individual, though specimens belonging to a given species may have a slightly more favourable position than others.The use of parasites and in particular the replacement of one species by another are promising methods of blackfly control. Predators are not generally likely to prove useful for this purpose.