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K Lote

Publications and source records attributed to K Lote.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Prognosis in primary tumors of the central nervous system. A patient material from the Norwegian Radium Hospital 1960-94].

We present the results of a retrospective survey of 1,218 patients treated at the Norwegian Radium Hospital during the years 1980-94 for primary tumours of the central nervous system. Median survival for patients with glioblastoma (n = 492) was 12 months, for patients with anaplastic astrocytoma (n = 83) 25 months, astrocytoma (n = 260) 95 months, oligodendroglioma (n = 85) 74 months, mixed glioma (n = 68) 65 months, and medulloblastoma (n = 53) 109 months. Median survival for patients with brain stem tumours (n = 37) was nine months, while 74% of patients with tumours in the pineal region (n = 38) survived for five years. The histology and localisation of the tumour, as well as age and functional status, are important prognostic factors for survival in patients with primary CNS tumours.

Adolescent↗
PubMed1996

[Human T-cell lymphotrophic virus type I and T-cell lymphoma].

Human T-cell lymphotropic virus type I is an oncogenic retrovirus, endemic in Southwestern Japan, the Caribbean, some parts of Africa and Central and South America. The virus is etiologically associated with adult T-cell leukemia/lymphoma and a myelopathy called tropical spastic paraparesis or HTLV-I associated myelopathy. Transmission of the virus is almost identical to that of HIV. The latency period before onset of clinical symptoms can last from a few years (tropical spastic paraparesis) up to several decades (adult T-cell leukemia/lymphoma). Four different clinicopathological subtypes of the T-cell neoplasia are known, and in this article we describe two patients with the subtype lymphoma.

Adult↗
PubMed1996

[Press coverage of medical issues].

We assessed the coverage of medical issues in six Norwegian newspapers during the period January - March 1995. A majority of the articles and a minority of the letters presented neutral information about the national health system. 13% of the articles and 61% of the letters were, in our opinion, critical. Only 2% and 5%, respectively, conveyed unequivocally positive attitudes. In at least three out of 11 incidents, the journalists violated the ethical rules commonly accepted by members of the press for criticism of named health workers. In 503 major articles overall correctness of the medical information, as judged by the authors, was 85% and varied between newspapers (top 98%, bottom 70%). We conclude that health workers are more likely to be criticised than praised. The credibility of the medical information varied from one newspaper to another.

Ethics↗
PubMed1996

Prognostic factors for glioblastoma multiforme--development of a prognostic index.

The prognosis for glioblastoma multiforme is generally poor. However, it can be useful to identify groups of patients with varying prognosis. Based on data from 495 consecutive patients admitted to the Norwegian Radium Hospital during 1980-1994, multivariable methods were used to identify prognostic factors independently associated with length of survival. A prognostic index was derived in 384 randomly selected patients, and tested in 111 other patients. Performance status, dexamethasone dependency, age group, surgery and behavioural changes were prognostic discriminators. On this basis a prognostic index was made and three separate subsets with different survival prognoses could be identified. The prognostic index was then tested among 20% of the patients and shown to predict reliable survival curves. In the subset with the highest index (high risk subset) almost all patients in the main group as well as in the the test group were dead within 18 months.

Age Factors↗
PubMed1993

DNA synthesis and ploidy in non-Hodgkin's lymphomas demonstrate intrapatient variation depending on circadian stage of cell sampling.

Significant circadian cell cycle variations with a maximal number of cells in S-phase during the night have been found in a series of 24 patients (18 men and 6 women) with histologically established non-Hodgkin's lymphomas. Pathological lymph nodes of a total of 26 patients were punctured and aspirated by fine needle technique every 4 h during a single 24-h time span. Twenty-four patients (92.3%) had Stage III or IV disease. Twelve patients (46.1%) had low grade, 10 patients (38.5%) had intermediate grade, and 4 patients (15.4%) had high grade lymphomas according to the Working Formulation. The samples were analyzed by flow cytometry, and DNA synthesis (S-phase) and ploidy were determined according to circadian stage. The individual mean 24-h S-phase varied from 2.2 +/- 1.2% (mean +/- SD) to 24.0 +/- 3.3%. Within the group of patients with low grade lymphomas, a wide range in mean S-phase from 2.4 +/- 1.2% to 9.2 +/- 2.8% was observed. The percentage variation within each patient between the lowest and highest S-phase as compared to the lowest value (range of change) during the 24-h time span varied from 21 to 353%, with a mean range of change of 128 +/- 19%. When each individual S-phase series was converted to percent of mean and combined for analysis by one-way analysis of variance to test for time-effect across 2 12-h time spans (8 p.m.-8 a.m. versus 8 a.m.-8 p.m.), S-phase variation according to circadian stage was found to be statistically significant (P < 0.004), with higher values found in the 8 p.m.-8 a.m. time span. By single cosinor analysis, S-phase yielded a near significant P value of 0.069 for the least-squares fit of a 24-h cosine to all data as percent of mean, with the acrophase found to be near midnight (0.05 h). For those patients with low and intermediate grade lymphomas and with mean S-phase values < 10.0%, we found that mean S-phase was higher during winter (5.8 +/- 0.4%) than during spring (3.8 +/- 0.3%) or during fall (3.6 +/- 0.3%) (P < 0.001, analysis of variance). Twenty-one of the 26 patients (80.8%) had an aneuploid, hypodiploid, or near diploid population in one or several of the repeated samples. For the whole series, the DNA indices for the aneuploid populations varied from 1.09 to 1.96, the median DNA index being 1.20.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1993

Circadian variation in serum cortisol and circulating neutrophils are markers for circadian variation of bone marrow proliferation in cancer patients.

Serum cortisol, circulating white blood cells and DNA cell cycle distribution in bone marrow cells were measured during daytime (11.00) and at midnight (24.00) over single 24-hour periods in 15 cancer patients. The neutrophils and fraction of bone marrow cells in S-phase showed the same circadian variation as cortisol with higher values in daytime as compared to midnight in 11 patients with a normal cortisol rhythm (p < 0.05). The lymphocytes, eosinophils and basophils all had significantly higher values at midnight as compared to daytime. There were significant correlations between cortisol and neutrophils, lymphocytes, eosinophils and basophils. The correlation between neutrophils and fractions of bone marrow cells in S-phase and S + G2/M-phase were highly significant (r = 0.74, p = 0.0001 and r = 0.72, p = 0.0001, respectively). In 8 of 13 patients (61.5%) without bone marrow infiltration both cortisol and neutrophils showed identical circadian variation as bone marrow cells in S-phase and S + G2/M-phase. Furthermore, for the total series a significant correlation between S-phase, cortisol and neutrophils was found by multiple regression analysis (p < 0.0001). These findings strengthen the possibility of using the circadian variation in cortisol and neutrophils as marker rhythms for circadian variation in bone marrow proliferation, thus allowing optimization of cytotoxic therapy and individualization of chronotherapy.

Adult↗
PubMed1992

Colony-forming unit-granulocyte-macrophage and DNA synthesis of human bone marrow are circadian stage-dependent and show covariation.

Bone marrow samples from sternum and iliac crests were harvested every 4 hours during 19 24-hour periods from 16 healthy male volunteers, and myeloid progenitor cells were cultured by the colony-forming unit-granulocyte-macrophage (CFU-GM) assay. A large interindividual variation was observed in the mean number of colonies during each 24-hour period, with the highest 24-hour mean colony number being about 600% greater than the lowest (range: 16 +/- 2.3 to 100.3 +/- 4.5). For each individual the difference between the lowest and highest colony number throughout the day ranged from 47.4% to 256.3% of the mean colony number of each series. A circadian stage-dependent variation in the number of colony-forming units of myeloid progenitor cells (CFU-GM) of human bone marrow was demonstrated, with values 150% higher, on the average, during the day as compared with the night. The overall data (891 CFU-GM replicates) exhibited a significant 24-hour rhythm (P less than .001) with an acrophase at midday (12.09 hours with 95% confidence limits from 10.32 to 13.49 hours) and a trough at midnight. This 24-hour variation was found to covary with DNA synthesis in the total proliferating bone marrow cell population. A seasonal effect on CFU-GM numbers was detected by ANOVA (P = .014) and by the least squares fit of a 1-year cosine (P = .015), with the highest number found in summer. The potential relevance of these findings should be examined in relation to cytotoxic cancer therapy, use of hematopoietic growth factors, and bone marrow transplantation.

Adult↗
PubMed1992

DNA cell cycle distribution and glutathione (GSH) content according to circadian stage in bone marrow of cancer patients.

DNA cell cycle distribution and glutathione (GSH) content in bone marrow were measured both at daytime and midnight over single 24 h periods in 15 cancer patients. Between patients the S-phase demonstrated a difference from lowest to highest value of 700%, whereas the corresponding difference for the G2/M-phase was nearly 900%. The mean GSH content measured in the bone marrow at the two timepoints was 2.24 +/- 0.21 nmol mg-1 protein, range 0.91-4.19 nmol mg-1 protein. A statistically significant higher fraction of cells in S-phase and G2/M-phase was found at daytime as compared to midnight when excluding the four patients with an abnormal circadian variation in cortisol. No significant temporal variation in total bone marrow GSH content was found, although a weak correlation between S-phase and GSH content was demonstrated (r = 0.42; P less than 0.05). This correlation was strengthened when not including the six patients with an abnormal cortisol pattern (4) and bone marrow infiltration (2) (r = 0.66; P = 0.005). Cells in S-phase demonstrated a positive correlation with cells in G2/M-phase (r = 0.64; P less than 0.0001). A negative correlation was found between GSH content and age (r = 0.53; P less than 0.005). Finally, a statistically significant positive correlation was demonstrated between cortisol and both S-phase and G2/M-phase (r = 0.57; P less than 0.001 and r = 0.38; P less than 0.05, respectively). The present study suggests a possibility of optimising cancer therapy and use of hematopoietic growth factors by determining individual average values and circadian stage dependent variation in bone marrow DNA cell cycle distribution. Furthermore, GSH content in bone marrow may predict this tissue's sensitivity to cytotoxic agents.

Adult↗
PubMed1991

Glutathione content in human bone marrow and circadian stage relation to DNA synthesis.

DNA synthesis and contents of reduced glutathione (GSH) and oxidized glutathione were determined every 4 hours during a 24-hour period in 70 human bone marrow samples from 10 healthy males. The mean GSH contents during the sampling periods were low, varying from 1.94 to 3.27 nmol/mg protein between the subjects; the mean values for all samples were 2.54 +/- 0.06 nmol/mg protein. The GSH content varied markedly within the individual according to circadian stage (31.0% to 90.2%; mean, 51.4%). Between individuals the mean percentage of cells in DNA synthesis varied from 10.6% to 14.5%, but there was an intraindividual circadian stage-dependent variation, ranging from 48.9% to 274.0% (mean, 126.6%), relative to the lowest value. After adjustment for a slight phase difference between GSH content and DNA synthesis observed for some of the subjects, a statistically significant correlation was found between the GSH content and the fraction of cells in DNA synthesis. The myelosuppressive effect of many chemotherapeutic agents assumed to be detoxified by GSH-dependent mechanism(s) should be considered in the light of the low GSH content in human bone marrow, the circadian variation of DNA synthesis, and the circadian stage-dependent relationship of the GSH content and DNA synthesis.

Adult↗
PubMed1991

DNA synthesis in human bone marrow is circadian stage dependent.

Fraction of human bone marrow (BM) cells in DNA synthesis has been studied by sampling BM from the sternum or the iliac crests every 4 hours during one 24-hour period in 16 healthy male volunteers. Three of the subjects underwent the sampling procedure twice, resulting in 19 24-hour profiles. The percentage of cells in DNA synthesis measured by flow cytometry demonstrated a large variation along the circadian time scale for each 24-hour profile, with a range of variation from 29% to 339% from lowest to highest value. Seventeen profiles (89.5%) had the highest DNA synthesis during waking hours between 08:00 hours and 20:00 hours, and the lowest percentage of cells in DNA synthesis between 00:00 hours and 04:00 hours. The mean value of the lowest DNA synthesis for each 19 24-hour period was 8.7% +/- 0.6%, while the mean value of the highest DNA synthesis was 17.6% +/- 0.6%, ie, a twofold difference. There was no difference in DNA synthesis between winter and summer. A significantly higher DNA synthesis was demonstrated for samples obtained from sternum as compared with the iliac crests, but the same circadian pattern was demonstrated for both localizations. By taking circadian stage-dependent variations in DNA synthesis into account it may be possible to reduce BM sensitivity to cytotoxic chemotherapy, to increase the effect of hematopoietic growth factors as well as increase the fraction of proliferating cells with careful selection of time of day for harvesting BM cells for auto- or allografting.

Adult↗
PubMed1991

Anticipatory nausea and vomiting in cancer patients.

The present study reports on a mediating mechanism for anticipatory nausea and vomiting (ANV) in cancer chemotherapy. ANV is usually explained as a classically conditioned response. However, conditioning models have failed to explain individual variation in ANV susceptibility. On the basis of the positive correlation between degree of autonomic reactivity (AR) and conditionability, it is proposed that individual AR is predictive of ANV development. Of the 31 patients who participated in the study, 74% experienced postinfusion nausea and vomiting (PNV). Of the 23 patients who experienced PNV, 52% developed ANV. AR was recorded in a habituation paradigm before chemotherapy treatment was initiated. The patients in the ANV group showed significantly increased sympathetic reactivity as compared with the no-ANV group, implying that AR is a mediator of ANV development.

Adolescent↗
PubMed1991

Radical radiation treatment of invasive and locally advanced bladder carcinoma in elderly patients.

A total of 146 patients with invasive or locally advanced carcinoma of the bladder (T2-T4) underwent radiation treatment. A significantly higher complete response rate was observed with doses equal to or above 55 Gy and with doses corresponding to cumulative radiation effect (CRE) values of 1700 radiation effect units (reu) or more. In multivariate analysis, decreasing time from the first diagnosis of bladder carcinoma to radiation treatment and 1 or more transurethral resections was associated with a significant increase in survival; increases in T category and sedimentation rate were negative prognostic factors. Although both radiation dose and CRE levels had a significant effect on survival in univariate analysis, an increase in CRE levels alone was associated with a significant increase in survival in multivariate analysis. However, the most important predictor of survival was whether the patient showed a complete local response or not. This study emphasises the importance of treating patients with an adequate radiation dose over a short period of time in order to achieve the maximum radiobiological effect and thereby increase the possibility of cure.

Aged↗
PubMed1991

Resources and productivity in radiation oncology in Denmark, Finland, Iceland, Norway and Sweden during 1987.

Data concerning megavoltage equipment and use of megavoltage external beams in cancer management during 1987 in Denmark, Finland, Iceland, Norway, and Sweden were collected from all 37 centres serving a population of 23 million in these countries. Population per Linear Accelerator Equivalent (LAE) unit ranged from 0.30 million/LAE unit (Denmark) to 0.19 million/LAE unit (Sweden). The number of field treatments were 227,548 (Denmark), 259,917 (Finland), 10,426 (Iceland), 147,960 (Norway) and 490,126 (Sweden). The number of field treatments per million population per year ranged from 35,229 (Norway) to 58,438 (Sweden). The number of field treatments per LAE unit/year ranged from 13,192 (Denmark) to 9,546 (Norway). The fraction of cancer patients receiving megavoltage radiotherapy in 1987 out of all newly diagnosed cancer patients during 1987 was 24% in Denmark, 37% in Iceland, 25% in Norway, and 34% in Finland and Sweden. We conclude that Denmark and Norway probably did not provide adequate levels of radiotherapy for their cancer patients during 1987.

Denmark↗
PubMed1991

[Programmable and portable infusion pump for advanced cytostatic multidrug treatment].

A portable, battery-driven, programmable drug infusion system which administers up to four different drugs through a single i.v. line is described ("IntelliJect I.V. Drug Delivery System"). The IntelliJect System can be used for a wide range of simple and complex regimens, including cytostatic therapy, antibiotic therapy, antiemetic therapy or pain control. If the actual drugs are not compatible, one channel can be programmed for flushing with sodium chloride. The system assures infusion of the right drug at the right time, while allowing delivery of preferred regimens in all settings--hospital, outpatient and home. A central venous access is necessary when used in an outpatient setting. The system needs minimal nurse or patient manipulation. Chemical stability and questions concerning microbiological contamination must be clarified, because drugs will be in the pump from several hours to several days. Applications of the system for cancer treatment are described, and documentation of patient preference of such a system is demonstrated. "IntelliJect I.V. Drug Delivery System" has the potential of optimizing cancer therapy, with regard to both quality of life and scheduling of cytotoxic drugs which can reduce toxicity and thereby possibly allow dose escalation.

Antineoplastic Combined Chemotherapy Protocols↗