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Biomedical subjects

H Schraffordt Koops

Publications and source records attributed to H Schraffordt Koops.

At least 181 records · Page 10Linked to original sources
PubMed1984

Non-seminomatous germ cell tumors of the testis. Analysis of CEA production in primary tumors and in retroperitoneal lymph node metastases after PVB chemotherapy.

In the present investigation we compared CEA immunoperoxidase staining in testicular tumors (before PVB chemotherapy) and retroperitoneal tumors (after PVB chemotherapy) with CEA levels in the cyst fluid of retroperitoneal mature teratoma and in the patients' serum. CEA had no value as a serum tumor marker since serum CEA elevations were not associated with tumor activity. Only one elevated CEA level after chemotherapy was associated with bleomycin pneumonitis. Despite normal serum levels, CEA was localized immunohistochemically in yolk sac tumor and mature teratoma in the primary tumors and in retroperitoneal mature teratoma following PVB chemotherapy. The presence of CEA in cells lining cystic mature teratoma was associated with high CEA levels in the cyst fluid.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Phase I evaluation of SOAz (1,3,3,5,5 pentakis(aziridino)-1 lambda 6, 2,4,6,3 lambda 5, 5 lambda 5 thiatriaza-diphosphorine-1-oxide) in a weekly schedule.

Eleven patients with advanced cancer were treated with SOAz, the first aziridino substituted inorganic heterocyclic compound to undergo phase I clinical trials. The agent was administered as a rapid i.v. infusion once a week in a dose of 50, 75 or 100 mg/m2. Severe myelotoxicity, which was prolonged and delayed in onset, precluded continuing treatment for more than three courses in 9 of 11 patients. In two patients thrombocytopenia showed no signs of recovery 9 and 11 weeks after the last infusion. Two minor responses were noted and there was one therapy-related death. Because of severe myelotoxicity, which is cumulative and may be irreversible, this treatment schedule seems unsuitable for phase II studies.

Adult↗
PubMed1984

The pattern of gamma-glutamyl transpeptidase, alkaline phosphatase, serum glutamyl oxalate transaminase and serum glutamyl pyruvate transaminase in patients with disseminated non-seminomatous testicular tumors.

The serum enzyme activities of gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (AP), serum glutamyl oxalate transaminase (sGOT) and serum glutamyl pyruvate transaminase (sGPT) were determined longitudinally in 51 patients with a disseminated non-seminomatous testicular tumor. Elevated levels of one or more enzymes before chemotherapy were observed in 13 patients, all with stage III disease. If, after two cycles of chemotherapy, the established tumor markers alpha-fetoprotein (AFP), human chorionic-gonadotropin (HCG) and/or lactate dehydrogenase (LDH) were normalized, the initially increased enzyme activities were declined to normal values as well. Peaking concentrations of one or more of the tumor markers during induction chemotherapy, probably due to tumor cell lysis, were found in 34 of 45 marker-positive patients (76%). In addition, increases of one or more of the investigated enzyme activities were also noticed in 20 patients. In 76% of these patients the highest point of the tumor marker concentration coincided well with that of the enzyme activities. Indications are given that the peak activities were probably not caused by liver damage. Enzyme elevations were also found in 3 out of 7 patients with progressive disease. The behaviour of the enzyme activities of GGT, AP, sGOT and sGPT in patients with a disseminated non-seminomatous testicular tumor coincided with the known tumor markers. It favors the hypothesis that these enzymes are synthesized in the tumor. The mortality amongst stage III patients with or without initially raised GGT levels differed significantly (P less than 0.02). Finally, it is concluded that in patients with a non-seminomatous testicular tumor, sGOT, sGPT, GGT and AP cannot be used to diagnose liver function.

Alanine Transaminase↗
PubMed1984

Influence of platinum-induced renal toxicity on bleomycin-induced pulmonary toxicity in patients with disseminated testicular carcinoma.

Pulmonary function tests, including T1CO, and renal function tests were performed and GFR and ERPF measured in 18 patients with disseminated testicular non-seminoma before and after remission induction according to the Einhorn regimen. We found a significant positive correlation between delta GFR and delta T1CO (p less than 0.05). No significance could be demonstrated between delta ERPF and delta T1CO. It is concluded that caution should be exercised in administrating bleomycin to patients with severely impaired renal function.

Adult↗
PubMed1983

The effect of continuous enteral tube feeding on various nutritional parameters in patients with disseminated malignant melanoma during intensive chemotherapy.

In a prospective study the effect of continuous enteral tube feeding was evaluated on various nutritional parameters in patients with disseminated malignant melanoma during 13 chemotherapy courses employing bleomycin, DTIC, vindesine and actinomycin D. The patients received a quantity of calories according to their pretreatment intake, but complete metabolic equilibrium could not be obtained during chemotherapy. Although the weight/height index remained unchanged, a decrease of serum albumin and prealbumin level occurred during all 13 treatment courses. Transferrin level decreased during 11 of these courses and cholinesterase level during 12. Triceps skinfold thickness and arm muscle circumference diminished equally. Serum prealbumin was the first nutritional parameter to fall during chemotherapy and seems to be a very sensitive indicator of the occurrence of nutritional imbalance. The plasma vitamin C level was low before treatment while during treatment both vitamin C and vitamin A level fell quickly even though the nutritional intake of these vitamins was adequate. We conclude that continuous enteral tube feeding, which is a feasible method of feeding, can to some extent fulfill the nutritional needs of patients treated with intensive chemotherapy.

Journal Article↗
PubMed1983

Leydig cell function in patients with testicular cancer during and after chemotherapy.

In two groups of patients with disseminated testicular carcinoma the effect of combination chemotherapy on the pituitary-gonadal axis was evaluated, after unilateral orchiectomy: The two groups comprised 15 patients without hCG-producing metastases (group A), and 14 patients with hCG-producing metastases (group B). Seven patients who had received no chemotherapy were studied one year after unilateral orchiectomy as a control group (group C). In group A, serum levels of testosterone and oestradiol increased during chemotherapy, as did the levels of LH and FSH. The serum LH and FSH response to LHRH was increased following chemotherapy, whereas the serum testosterone increase after hCG stimulation remained unchanged. A rise of 316% in SHBG binding capacity was found after chemotherapy. This presumably accounted for the elevated steroid levels in the presence of high gonadotrophin levels, but unaltered Leydig cell response. The elevated serum levels of testosterone and oestradiol and the suppressed serum FSH levels normalized during disappearance of ectopic hCG production in group B patients. Leydig cell refractoriness to hCG and the FSH response to LHRH also reverted to normal. After chemotherapy, FSH, but not LH levels exceeded those of group C patients, presumably as a result of the azoospermia induced by chemotherapy. The hormonal changes associated with chemotherapy are best explained by an increase in serum binding proteins, notably SHBG.

Adolescent↗
PubMed1983

Effect of chemotherapy on taste sensation in patients with disseminated malignant melanoma.

The effect of combination chemotherapy (bleomycin, actinomycin D, vindesine and DTIC) on taste sensation in patients with malignant melanoma was evaluated. Five concentrations of 4 basic tastes (sweet, bitter, sour and salt) were tested. Lowest concentrations of all tastes were subjectively rated more intense after chemotherapy than before. This change was significant for sweet, sour and salt. The highest concentration of sweet was rated significantly less intense following chemotherapy. The discrimination between highest and lowest concentration was diminished for sweet, sour and bitter and marginally for salt. The changes in taste sensation following chemotherapy could attribute to anorexia in cancer patients treated with cytostatic agents.

Adult↗
PubMed1983

Influence of combination chemotherapy with cis-diamminedichloroplatinum on renal function: long-term effects.

Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were determined in 8 patients with disseminated testicular carcinoma before, during and 1 year after termination of a combination chemotherapy with cis-diamminedichloroplatinum (CDDP). The decrease in median GFR in comparison with the pretreatment value was 15.5% at the start of the maintenance therapy, 23% at the end of the maintenance therapy and 15.5% 1 year after termination of therapy. The comparable reduction in ERPF at those instants was 15.5, 19 and 23.5%, respectively. At all intervals the changes in GFR were significantly reduced in comparison with pretreatment values. No significant change in both GFR and ERPF was found either during or after discontinuation of maintenance treatment. The fall in ERPF was significant during the total period of treatment as well as during the total time of observation. Thus, no cumulative nephrotoxicity during therapy, nor improvement in renal function thereafter was found. Serum levels of creatinine and beta-2-microglobulin did not express the changes in renal function.

Adult↗
PubMed1983

Altered Leydig cell function in patients with testicular cancer: evidence for bilateral testicular defect.

In search of an abnormality in Leydig cell function in patients with testicular cancer, serum levels of testosterone, oestradiol, LH and FSH were compared in 3 groups of men. Group I comprised 26 patients studied after recent orchidectomy for a testicular carcinoma, group II 8 patients operated for benign testicular lesions and group III 8 normal controls. In group II normal testosterone values were found as a result of increased LH release. In group I patients, however, testosterone levels often were low, despite elevated LH levels and increased LH capacity. Evidently, in these patients a partial Leydig cell insufficiency may be present, which does not recover within one year of orchidectomy. After removal of one testis for benign disease, normal testosterone levels are maintained by increased LH levels. After orchidectomy for testicular carcinoma a partial Leydig cell insufficiency may be revealed, which seems to have a permanent character. A pre-existent Leydig cell insufficiency of the remaining testis in patients with testicular cancer indicates a bilateral testicular defect.

Adolescent↗
PubMed1983

Non-seminomatous germ cell tumors of the testis. Analysis of AFP and HCG production by primary tumors and retroperitoneal lymph node metastases after PVB combination chemotherapy.

Serum AFP and HCG values were correlated with AFP and HCG tissue staining in 27 non-seminomatous germ cell tumors (NSGCT) of the testis and their retroperitoneal lymph node metastases after PVB chemotherapy. We found a poor correlation between tissue and serum AFP positivity and a moderately good correlation between tissue and serum HCG positivity in the testicular tumor. The therapy-related differentiated teratomatous elements did occasionally produce AFP or HCG, but AFP or HCG were not detectable in the patients' sera. These serum markers have no value for the detection of mature residual tumor following chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

Lymphography in the diagnosis of non-seminoma tumours of the testis.

In a series of 86 lymphograms correlated to histological findings after retroperitoneal lymph node dissection or to laparotomy findings, reliability proved to be 78%. The reliability of lymphograms evaluated as positive was 88%, while that of negative lymphograms was 74%. Retroperitoneal lymph node metastases were detected with the aid of lymphography in 58% of the patients. It was impossible to establish a node size above which metastases could be demonstrated with certainty by lymphography.

Humans↗
PubMed1982

Nephrotoxicity of cis-diamminedichloride platinum (CDDP) during remission-induction and maintenance chemotherapy of testicular carcinoma.

We studied renal function in nine patients with disseminated testicular carcinoma before and after remission-induction and maintenance therapy with a drug combination containing cis-platinum. The median glomerular filtration rate (GFR) decreased during remission-induction therapy from 146 to 118 ml/min. No effect of cumulative toxicity on the median GFR was found during maintenance therapy, nor did the median GFR improve. The median effective renal plasma flow (ERPF) decreased during the total period from 705 to 514 ml/min. No significant changes in median filtration fraction (FF) and serum creatinine were observed. It is suggested that intrarenal hemodynamic effects are important in the nephrotoxicity of cis-diamminedichloride platinum (CDDP).

Adult↗