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Biomedical subjects

J Marrink

Publications and source records attributed to J Marrink.

At least 55 records · Page 3Linked to original sources

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↗

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↗

Pityriasis rubra pilaris, vitamin A and retinol-binding protein: a case study.

A patient with longstanding erythroderma and decreased sweat secretion due to the classical adult form of pityriasis rubra pilaris is described. The patient did not respond to oral megadoses of Vitamin A, even though a large increase of liver content of Vitamin A was demonstrated. Retinol-binding protein levels in serum of this patient and his relatives were normal. Danazol (Danatrol, Winthrop) therapy caused an increase of retinol-binding protein level, but clinical improvement did not occur.

Adult↗

Some effects of combination chemotherapy with cis-platinum on renal function in patients with nonseminomatous testicular carcinoma.

Renal function in 24 patients with disseminated nonseminomatous testicular carcinoma treated with combination chemotherapy including cis-platinum was examined prospectively. Renal function was monitored by several determinations of glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and serum creatinine, and beta-2-microglobulin. A reduction in GFR and ERPF was found at the end of the induction chemotherapy and at six weeks thereafter. Median GFR and ERPF decreased both 23% (P less than 0.01). Serum creatinine and beta-2-microglobulin concentrations however did not rise. It is suggested that under the influence of chemotherapy with platinum the production of creatinine and beta-2-microglobulin is decreased rendering their serum levels unsuitable as parameters of renal function.

Adult↗

Prostatic acid phosphatase: comparison of radioimmunoassay and enzyme activity assay.

Aspects of the clinical use of an enzymatic assay and a double antibody radioimmunoassay for prostatic acid phosphatase are compared. Standard blood sample collection and transport did not have a negative effect on the results of either assay. Our results show no substantial advantage in the use of a radioimmunoassay but emphasize the reliability of the enzymatic assay using alpha-naphthylphosphate as a substrate with respect to its predictive value and specificity in diagnosis and followup of patients with prostatic carcinoma.

Acid Phosphatase↗

Plasma spermidine concentrations as early indication of response to therapy in human myeloma.

Eighteen patients with melphalan refractory myeloma were treated with vindesine and prednisone. Plasma spermidine concentrations were measured by radioimmunoassay before and after a single vindesine injection. Seven patients showed a significant rise of plasma spermidine after vindesine and five of these showed a clinical response on further evaluation. Of the 11 patients who did not show raised spermidine concentrations, 10 did not respond to the therapy. The correlation between clinical response/rise of spermidine and between non-response/no rise of spermidine was statistically significant (p less than 0.05). Pretreatment spermidine concentrations did not distinguish those who responded to treatment nor did they differ in patients and controls.

Antineoplastic Agents↗

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↗

Evaluation of pregnancy-specific beta 1-glycoprotein in patients with non-seminomatous testicular germ cell tumors.

Serum SP-1 levels were measured serially in 94 patients with non-seminomatous germ cell tumors to evaluate its clinical significance as a tumor marker. In 12 out of 80 patients (15%) with active tumors serum SP-1 was found to be elevated, whereas serum HCG and AFP in the same sample were raised in 53 and 45% respectively. Elevation of serum SP-1 levels was always associated with raised HCG levels, and with AFP in 7 patients. During chemotherapy, serum SP-1 and HCG disappeared when a complete remission was obtained. In contrast to HCG, serum SP-1 failed to detect tumor progression in two patients. Serum HCG and AFP are superior as tumor markers to serum SP-1.

Chorionic Gonadotropin↗

Immunoglobulin allotypes and nonseminoma testicular cancer.

Gm, A2m, and Km allotypic markers were examined in 52 Dutch patients with nonseminoma testicular cancer. The distribution pattern of the immunoglobulin allotypes in different groups of patients, classified according to histological diagnosis, did not differ significantly from that in the normal population. These results indicate no relationship between nonseminoma testicular cancer and immunoglobulin allotypes.

Choriocarcinoma↗

Tumor markers in patients with non-seminomatous germ cell tumors of the testis.

In 82 patients with non-seminomatous germ cell tumors, the levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) were determined to find if there was a relation to clinical stage. Only two out of 34 patients could be restaged as a result of the presence of elevated marker levels. Markers were present in 12% of patients with stage IIA, 67% with stage IIB and 85% with stage III. In contrast to HCG, the initial levels of LDH and AFP were related to tumor stage. A return of marker levels to normal during chemotherapy always meant tumor regression and indicated complete remission in 42% of patients. Initial marker levels did not correlate with the eventual destructionn of all tumor by chemotherapy. A rise in marker levels always correlated with tumor progression. In conclusion, tumor markers have only a limited value in clinical staging. Disappearance of markers during chemotherapy does not always indicate destructio of all viable tumor, probably because non-producing cell lines such as mature teratoma may persist after chemotherapy.

Adolescent↗

The value of AFP and HCG half lives in predicting the efficacy of combination chemotherapy in patients with non-seminomatous germ cell tumors of the testis.

The decline of serum levels of AFP or HCG in 26 patients with disseminated non-seminomatous germ cell tumors during chemotherapy showed two different patterns: a linear decline or an increasing apparent half life (AHL). The initial AFP half life in 13 patients with a linear decline was 7.2 +/- 1.8 days, and did not differ from the initial half life in 5 patients with a curvi-linear pattern. HCG half life was 3.0 +/- 0.5 days in 10 patients with a linear AHL, and was not different from the initial half life in 6 patients with delayed marker disappearance. Based on the half life pattern of AFP or HCG the result of chemotherapy was predicted. When AFP or HCG showed a linear decline, all viable tumor appeared to be eliminated in 38 and 40% respectively of the patients. An increasing AHL indicated the presence of active tumor, mostly mature teratoma, in 60% of the patients with AFP and in 83% of the patients with HCG. Thus, the pattern of AFP or HCG half life does not predict the eventual outcome of chemotherapy with certainty.

Adolescent↗

An inherited restriction in the idiotypic variability as a possible explanation of a genetic predisposition for a monoclonal component.

Genetic factors have been proposed to play a role in the aetiology of a monoclonal proliferation of B lymphocytes. As an additional genetic factor we postulate that a restriction in the idiotypic variability of an individual contributes to a genetic predisposition to monoclonal gammopathy. To support our hypothesis, we have examined three families with multiple occurrence of M-components for sharing of idiotypic antigenicity between the related M-components and between the M-components and the sera of unaffected relatives. Idiotypic antisera against five isolated M-components were raised in guinea-pigs and used in a radiobinding inhibition assay. In none of the three families was idiotypic cross-reactivity observed between the familial M-components. However, in a family with three members with an M-component, sera of first-degree relatives showed a higher inhibitory capacity than sera of non-related individuals when an idiotypic antiserum, raised against the M-component of proposita, was employed. Within this particular family the observed restriction in the idiotypic variability could have contributed to the multiple occurrence of M-components.

Antibody Specificity↗