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Biomedical subjects

H Pape

Publications and source records attributed to H Pape.

At least 37 records · Page 2Linked to original sources
PubMed1999

Young, wet & wild? Associations between alcohol intoxication and violent behaviour in adolescence.

AIMS: To assess gender- and age-specific associations between alcohol intoxication and engagement in violent behaviours in young people. DESIGN, PARTICIPANTS AND MEASUREMENT: Cross-sectional study comprising a national sample of 12,000 Norwegian adolescents aged 12-20 years. Data on violent behaviour, alcohol intoxication and various confounders were obtained by self-administered questionnaires in school. FINDINGS: 2.8% had been in fight with a weapon and 32.6% had been beating or threatening to beat someone during the past year. Violent behaviours were more often reported among boys, in the younger age groups, with increasing frequency of alcohol intoxication, among users of other drugs, among those engaged in criminal activities and among those in wet environments (friends drinking regularly and parents often being intoxicated). The impact of intoxication frequency on number of times engaged in violent behaviours was of modest magnitude. It was greater in the youngest age group compared to those in the middle and late teens and greater for boys than for girls. However, when criminal activities were controlled for, the adjusted effect of intoxication on violent behaviour was significantly reduced, the effect was then of the same magnitude for both genders, whereas there was no longer any significant effect in the youngest age group. Controlling also for parents' and friends' drinking and parental monitoring did not alter these findings. CONCLUSIONS: A small direct effect of alcohol intoxication on violent behaviour appears to remain after controlling for various relevant confounders in middle and late teens. However, possible indirect effects of alcohol intoxication, mediated by own deviant life-style and wetness of environment, should also be taken into consideration.

Adolescent↗
PubMed1998

Hyperthermia for the treatment of patients with malignant germ cell tumors: a phase I/II study in ten children and adolescents with recurrent or refractory tumors.

BACKGROUND: Extracranial nontesticular germ cell tumors (GCTs) are rare malignancies in children and adolescents. Cisplatin-containing regimens and complete tumor resection are important determinants for a favorable outcome; however, patients with recurrent tumors that cannot be eradicated by surgical procedures and chemotherapy have a poor prognosis. Noninvasive electromagnetic technologies for superficial and regional deep hyperthermia (RHT) are under investigation to enhance local tumor control in various malignancies. The objectives of this Phase I/II study were to examine 1) whether RHT can be used in combination with platinum-based chemotherapy with acceptable toxicity in children and adolescents and 2) whether this combined regimen can induce objective tumor response in patients with malignant nontesticular GCT that persisted or recurred locoregionally after validated, intensive, cisplatin-based chemotherapy +/- surgery as unsuccessful first-line treatment. METHODS: The authors studied the effects of RHT induced by electromagnetic waves in combination with platinum-based chemotherapy in ten children and adolescents with recurrent or refractory GCTs. RESULTS: Seven of ten patients with recurrent or refractory GCTs had objective responses. Of these, two patients had a partial response and five patients had a complete response. CONCLUSIONS: The results of the current study found that combined RHT and platinum-based chemotherapy can be used in children and adolescents. This regimen was found to induce objective tumor response in 70% of study patients with recurrent or refractory GCTs. The results thus far are encouraging and the study has been extended to patients with a poor response to first-line treatment.

Adolescent↗
PubMed1998

Chondrosarcoma of the larynx: the role of radiotherapy revisited--a case report and review of the literature.

BACKGROUND: Experience in the treatment of laryngeal chondrosarcoma is based on about 250 cases reported to date. The standard therapy is conservative surgery. Radiotherapy has universally been regarded as ineffective in the treatment of this disease. METHODS: A patient with a laryngeal chondrosarcoma was observed for 11 years after radical radiotherapy. The literature on laryngeal chondrosarcoma was critically reviewed, with emphasis placed on radiotherapy. RESULTS: The review of the literature revealed that experience with radiotherapy of laryngeal chondrosarcoma has been lacking, with fewer than 10 cases with short follow-up documented up to now. Meanwhile, increasing evidence of the efficacy of radiotherapy in the treatment of skeletal chondrosarcoma has emerged. The authors report the first case of chondrosarcoma of the larynx in which radical radiotherapy resulted in a long term remission of more than 10 years. CONCLUSIONS: Radiotherapy should be considered when radical surgery is not feasible without severe mutilation. It should also be considered for the treatment of residual disease. Laryngectomy should be restricted to salvage treatment when radiotherapy fails. In this study, radiotherapy appeared to be an effective modality in the treatment of low grade laryngeal chondrosarcoma, and these results contrast with the current widespread disapproval of this treatment.

Aged↗
PubMed1997

[Victims of violence in the general youth population. A longitudinal study of risk factors].

This paper presents new knowledge on risk factors involving violent victimization. The data stem from a representative survey of youths living in the Oslo area (n 447, response rate 86%). Questions on victimization experiences, drinking habits, alcohol problems, violence towards others and conflict-provoking behavior were first asked between the ages of 18 and 20 years (1993), and were repeated in the follow-up two years later. More men than women had been victimized. In both sexes there was a significant connection between alcohol problems and experiences as a victim. However, the consumption of alcohol and frequency of intoxication were only slightly related to such experiences. In men, both cross-sectional and longitudinal analyses showed that violence towards others had a much greater statistical effect than any of the variables relating to drinking behavior. In fact, the effect was greater than that of any other variable in the study. In women, previous victimization was, without doubt, the most significant predictor for future victimization. Stability over time of such experiences was also much higher for women than for men. As regards preventive efforts targeted towards victimization among youths, our findings suggest that a specific programme for each of the sexes needs to be developed and implemented.

Adolescent↗
PubMed1996

[Bone marrow transplantation: role of radiation therapy].

Conditioning regimes before bone marrow transplantation serve a dual purpose. Firstly they have to destroy the host immune system sufficiently to allow permanent engraftment, secondly they have to eliminate the abnormal tumor cells. The special aim of total body irradiation is to eradicate those cells, which escape chemotherapy. The effectiveness of TBI is influenced by: delivered dose, fraction size and dose rate. Dose escalation improves the results of TBI. The seven year survival probability is 74%, if more than 9,9 Gy are administered and only 38% under 9,9 Gy. Combining TBI and chemotherapy promotes the outcome in patients with acute leukaemia and allogeneic bone marrow transplantation. The two year relapse rate is 16% with and 37% without TBI. Side effects are distinctly determined by fraction size and dose rate.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Interstitial pneumopathy after mantle field irradiation for Hodgkin's disease.

This retrospective analysis was undertaken to determine the incidence of interstitial pneumopathy and the clinical course after mantle field irradiation for Hodgkin's disease focusing on the role of radio- and chemotherapy. 136 patients were evaluable, 40 having received radiotherapy only and 96 patients having received combined radio-chemotherapy. The median follow-up time was 21.5 months. The overall incidence was 19%; 4 patients died of severe interstitial pneumopathy and 3 died of simultaneous severe complications. The radiation dose was correlated with the incidence of interstitial pneumopathy (P = 0.0021).

Adolescent↗
PubMed1996

Sober adolescence--predictor of psychosocial maladjustment in young adulthood?

We have explored how age at first intoxication with alcohol relates to mental health, social integration and adjustment to the adult role. The data stem from a longitudinal representative study of 2000 Norwegians. The sample was assessed at ages 19-22, 21-24 and 25-28. Among females, only early intoxication was related to young adult symptoms of poor mental health. A U-shaped association between intoxication debut and psychological problems was revealed among males, implying that both early and late beginners had more such problems than those who had followed the mainstream. These associations persisted without change over time. However, males who remained abstainers in adulthood were psychologically healthy, but they showed indications of a delayed entry into the adult role. Male late beginners were also somewhat reluctant to adopt adult role-behaviors. Thus, getting drunk for the first time in mid-adolescence seems to be an ingredient in the normal developmental process in young males.

Adolescent↗
PubMed1996

Formation of acarbose phosphate by a cell-free extract from the acarbose producer Actinoplanes sp.

The alpha-glucosidase inhibitor acarbose is modified during incubation with cell-free extract from the producing Actinoplanes strain. The formation of this product depends on the presence of ATP. Chromatographic and chemical properties of the purified transformation product indicate the presence of a phosphate ester. The structure is deduced by NMR analysis and shown to be acarbose-7-phosphate.

Acarbose↗
PubMed1996

Acarbose 7-phosphotransferase from Actinoplanes sp.: purification, properties, and possible physiological function.

A phosphotransferase which modifies the alpha-glucosidase inhibitor acarbose by phosphorylation at its 7-position was isolated from the acarbose producer Actinoplanes sp. and purified to homogeneity. The sequence of the first 20 amino acids of the enzyme was determined. The enzyme is an ATP-dependent kinase and shows high specificity for acarbose and some related compounds containing the pseudodisaccharide moiety (acarviosin). The product formed by the enzyme, acarbose-7-phosphate, shows a significant lower inhibitory activity towards disaccharidases than acarbose itself. The acarbose producing organism contains a maltase which is inhibited by acarbose, but to a much lesser extent by acarbose-7-phosphate. The possible role of acarbose 7-phospho-transferase as part of a self-defense mechanism against acarbose in the producing organism is discussed.

Actinomycetales↗
PubMed1996

How does young people's alcohol consumption change during the transition to early adulthood? A longitudinal study of changes at aggregate and individual level.

We have analysed data from a longitudinal representative study to explore aggregate and individual level changes in alcohol use from late adolescence to early adulthood. The sample, which consisted of 2000 Norwegians, was assessed at ages 19-22, 21-24 and 25-28 years. Only a bare majority of the respondents reduced their alcohol intake during the course of the study, whereas a substantial proportion showed an increase. The initial drinking level in individuals whose consumption declined was quite high, and the opposite was true for those who increased their consumption. The findings seemed to reflect true changes, implying that they only could be attributed to measurement errors to a limited extent. The stability in absolute alcohol intake was rather low, especially at the very high consumption levels. However, the respondents clearly tended to maintain their relative drinking position over time. Furthermore, the very high consumers were actually somewhat more apt than others to hold their position relative to the group. In contrast to previous research, these results thus suggest that there is a substantial stability in alcohol use over time. This in turn underscores the importance of implementing preventive programmes targeted towards factors that promote heavy drinking in adolescents.

Adolescent↗
PubMed1995

Radiation therapy in Ewing's sarcoma: an update of the CESS 86 trial.

PURPOSE: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. METHODS AND MATERIALS: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk (extremity tumors < 100 cm3), or vincristine, actinomycin D, ifosfamide, and adriamycin (VAIA) in high-risk tumors (central tumors and extremity tumors > or = 100 cm3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days after 22.4 Gy and 44.8 Gy, total dose and treatment time as for conventional fractionation). For quality assurance in radiotherapy, a central treatment planning program was part of the protocol. RESULTS: Forty-four patients (25%) received definitive radiotherapy; 39 (22%) had surgery, and 93 (53%) had resection plus postoperative irradiation. The overall 5-year survival was 69%. Thirty-one percent of the patients relapsed, 30% after radiotherapy, 26% after radical surgery, and 34% after combined local treatment. The better local control after radical surgery (100%) and resection plus radiotherapy (95%) as compared to definitive radiotherapy (86%) was not associated with an improvement in relapse-free or overall survival because of a higher frequency of distant metastases after surgery (26% vs. 29% vs. 16%). In irradiated patients, hyperfractionated split-course irradiation and conventional fractionation yielded the same results (5-year overall survival of definitively irradiated patients 63% after conventional fractionation and 65% after hyperfractionation; relapse-free survival 53% vs. 58%; local control 76% vs. 86%, not significant). The six local failures after radiotherapy did not correlate with tumor size or response to chemotherapy. Radiation treatment quality (target volume, technique, dosage) was evaluated retrospectively and was scored as unacceptable in only 1 out of 44 patients (2%) with definitive radiotherapy. Grade 3-4 complications developed in 4 out of 44 (9%) patients after definitive radiotherapy. CONCLUSIONS: Under the given selection criteria for local therapy, radiation therapy yielded relapse-free and overall survival figures comparable to radical surgery. Hyperfractionated split-course irradiation simultaneously with multidrug chemotherapy did not significantly improve local control or survival.

Adolescent↗
PubMed1995

Successful liver treatment of a juvenile granulosa cell tumor in a 4-year-old child by regional deep hyperthermia, systemic chemotherapy, and irradiation.

Juvenile granulosa cell tumors (JGCT) of the ovary are rare in children and adolescents. About 90% are diagnosed in early-stage FIGO I with favorable prognosis. More advanced stages (FIGO II-IV) have a poor clinical outcome and chemotherapy alone cannot avoid tumor progression. Regional deep hyperthermia (RHT) induced by microwave technique has been established as an additional modality for treatment of different tumors. However, in cases with liver involvement there are technical problems which have not yet been solved. We report on a 4-year-old child who suffered from diffuse liver metastases 10 months after JGCT of the left ovary. After chemotherapy including ifosfamide, etoposide, and carboplatin in combination with RHT and consolidation radiotherapy, the patient has been in complete remission for 1 year of follow-up. This Case Report indicates the feasibility of combining surgery, chemotherapy, hyperthermia, and radiation therapy (which can also be an effective treatment modality for advanced granulosa cell tumor) for the treatment of liver metastases of JGCT, but does not allow comparisons of these treatments.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

[The significance of clinical prodromes for dosage estimation after whole-body radiation exposure].

BACKGROUND: The triage of victims after radiation injury is complicated by missing dose values and the fact that most tissues react after a latency period. PATIENTS AND METHODS: We evaluated 63 patients undergoing total body irradiation as conditioning regime before bone marrow transplantation in order to find a relation between prodromal symptoms and dose. RESULTS: Emesis after radiation exposure hints to doses greater than 1.5 Gy. A rise of body temperature above 37 degrees C up to five hours after exposure is related to doses exceeding 2.5 Gy, while an acute onset of diarrhoea is an indicator of a severe accident with more than 9 Gy. CONCLUSION: Besides blood counts and chromosome analyses a careful evaluation of prodromal symptoms can help to classify the severity of radiation accidents.

Acute Disease↗
PubMed1994

The role of adjuvant treatment in endometrial cancer.

PURPOSE: Divergent opinions exist on the value of adjuvant treatment in endometrial cancer. This paper aims at clarifying the indications for adjuvant radiotherapy by reviewing the literature and presenting own data. METHODS: For endometrial cancer 5-year survival data are analysed with respect to the value of adjuvant radiotherapy and/or chemo-/hormone therapy. RESULTS: Adjuvant radiotherapy in FIGO stage I and II tumors reduces pelvic recurrence rates from 15 to 20% to 1 to 5%. In high risk stage I patients the 5-year survival rate is increased by 30 to 40% using pre-operative high dose endocavitary brachytherapy or postoperative external beam therapy. In stage II disease the 5-year survival rate is increased to 60 to 80% when applying 50 to 60 Gy post surgery. In stage III and IV tumors primary radiotherapy results in 5-year survival rates of 16 to 40%. CONCLUSIONS: In stage I and II endometrial cancer primary treatment consists of surgery followed by radiotherapy in eligible cases. In stage III and IV tumors primary radiotherapy is generally advocated. No properly randomized trials are available to date on the value of adjuvant treatment. There is a great demand for such trials in order to confirm the available data. According to the extent of the disease and the discrimination of certain risk groups these trials should include external beam pelvic irradiation, brachytherapy, para-aortic irradiation as well as systemic chemo-or hormone therapy.

Endometrial Neoplasms↗
PubMed1993

Analysis of the transfer region of the Streptomyces plasmid SCP2.

pIJ903, a bifunctional derivative of the 31.4 kb low-copy-number, conjugative Streptomyces plasmid SCP2*, was mutagenized in Streptomyces lividans using Tn4560. Mutant plasmids differing in their transfer frequencies, chromosome mobilization abilities, pock formation, and complementation properties were isolated. The mutations defined five transfer-related genes, traA, traB, traC, traD and spd, clustered in a region of 9 kb. The deduced sequences of the putative TraA and TraB proteins showed no overall similarity to known protein sequences, but the phenotype of traA mutant plasmids and sequence motifs in the putative TraA protein suggested that it might be a DNA helicase.

Amino Acid Sequence↗
PubMed1993

Myeloablative radiochemotherapy and hematopoietic stem-cell rescue in poor-prognosis Ewing's sarcoma.

PURPOSE: The prognosis of patients with multifocal primary and early or multiple relapsed Ewing's sarcoma is poor with conventional chemoradiotherapy and surgery. We evaluated the efficacy and feasibility of a myeloablative regimen administered as consolidation treatment for these patients. PATIENTS AND METHODS: The ablative regimens consisted of simultaneous radiochemotherapy: 12 Gy hyperfractionated total-body irradiation (TBI; two doses of 1.5 Gy for 4 days) plus fractionated high-dose melphalan (30 to 45 mg/m2 for 4 days) followed by high-dose etoposide (40 to 60 mg/kg) with or without carboplatin (900 to 1,500 mg/m2) (hyper-ME +/- C). These regimens were applied in a dose-escalation study that included 17 patients. All patients underwent remission induction chemotherapy and local treatment before myeloablative therapy. Seven patients had multifocal primary Ewing's sarcoma, and 10 had early or multiple relapse. We performed a matched-cohort analysis of the 17 grafted patients with 41 historic controls matched for sex, age, diagnosis, extent of disease, interval from diagnosis to transplant in the transplant group, and interval from diagnosis to relapse in the control group. RESULTS: The probability of relapse in the study patients is 52% at 6 years after the last event before transplantation. In the control group, the probability of relapse at 6 years was 98%. Eight of 17 treated patients are alive in complete remission at a median observation time of 49 months (range, 19 to 76) from the last event before transplantation. Probability of relapse-free survival in the study patients is 45% +/- 12% at 6 years after the last event before transplant, compared with 2% +/- 2% for the historic control group. CONCLUSION: Myeloblative therapy with hyper-ME +/- C radiochemotherapy can improve the prognosis of multifocal primary and early or multiple relapsing Ewing's sarcoma.

Adolescent↗