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Biomedical subjects

M Albertsson

Publications and source records attributed to M Albertsson.

At least 37 records · Page 2Linked to original sources
PubMed1994

Acute and delayed effects of radiotherapy in patients with oesophageal squamous cell carcinoma treated with chemotherapy, surgery and pre- and postoperative radiotherapy.

Among 73 patients with oesophageal squamous cell carcinoma treated with chemotherapy (cisplatin + 5-fluorouracil), surgery and pre- and postoperative radiotherapy, the 1-year survival rate was 68% and the 5-year rate 26%. The treatment was well tolerated, though there were 11 cases of pericardial or pleural effusion, in all of which the effusion was benign and could be successfully treated with pleural aspiration and/or pleurodesis, pericardiocentesis, or in one case pericardectomy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Scanning electron microscopy of human esophageal mucosa in patients with carcinoma of the esophagus.

Specimens taken at surgery from 15 patients with carcinoma of the esophagus were examined with scanning electron microscopy. Nine patients were treated with chemotherapy (cisplatin + 5-fluorouracil), surgery and radiotherapy; one received preoperative radiotherapy only; and the remaining five primary surgery only. Scanning electron microscopy was performed on specimens of both tumor tissue and the mucosa at least 5 cm from the tumor. In adjacent non-tumor tissue, damage due to treatment was observed in the form of changes in microridges and increased cell loss. In tumor tissue, the degree of damage was correlated to tumor response to treatment. For patients with no residual tumor after treatment, the ultrastructure was normalized with a low tumor score, while for patients with residual tumor, the score was high.

Adenocarcinoma↗
PubMed1992

Malignant melanoma of the nasal cavity and nasopharynx treated with cisplatin and accelerated hyperfractionated radiation.

Primary malignant melanoma of the nasal cavity and paranasal sinuses is an uncommon disease, accounting for only 0.5-2% of all malignant melanomas. The primary treatment has been surgery. The frequency of local recurrence is high and recurrence is also the major determinant of treatment failure. Here we report on six patients with locally advanced disease, four of whom were too advanced for surgery, who were treated with accelerated hyperfractionated radiation in combination with cis-platinum. Three of four patients treated for local recurrent disease achieved a local cure and died of disseminated disease after 9-21 months. One patient given preoperative cisplatin and radiation is still alive with no evidence of disease 34 months after the completion of treatment. The present protocol may be a useful approach to obtain local control with the possibility of long-term cure.

Aged↗
PubMed1992

Response of the esophageal epithelium to concomitant cis-dichlorodiammineplatinum(II) and radiation treatment. An electron microscopic study in rabbits.

The rabbit esophageal mucosa was irradiated with daily fractions of 2 Gy up to an accumulated dose of 20 Gy (total dose 2, 6, 10. 16 or 20 Gy). Fifteen to forty-five minutes before the start of each irradiation 0.3 mg Cis-dichlorodiammineplatinum (cis-DDP, cisplatinum) was given by intraperitoneal injection to each rabbit. Examinations were carried out 1-10 days after each fractionation schedule, when specimens were taken for morphological investigations. Scanning electron microscope (SEM) examination showed a gradual development of damage with cell loss and structural disarrangement of the microridges and whorls on the surface. However, with further treatment the esophageal mucosa exposed to cis-DDP and radiation normalized faster and more complete compared to the esophageal part exposed to cis-DDP alone. The difference may depend on an accelerated proliferation in the part of the trachea that is exposed to a combined treatment.

Animals↗
PubMed1991

Induction chemotherapy (cisplatin + 5-fluorouracil) and radiotherapy in advanced squamous cell carcinoma of the head and neck.

A phase II study was made of 58 consecutive patients with previously untreated locally advanced squamous cell carcinomas of the head and neck. The induction chemotherapy consisted of 3 courses of cisplatin (100 mg/m2) and a subsequent 120-h infusion of 5-fluorouracil (1,000 mg/m2/24 h) repeated every 3 weeks. It was followed by radiotherapy to a median target dose of 66 Gy and surgery for residual tumour. A total of 91 per cent received all 3 courses of chemotherapy, which was well tolerated. Complete response (CR) was obtained in 20 patients (35%) after chemotherapy and in 40 patients (69%) after subsequent radiotherapy. The median observation time was 28 months (range 15-57). The actuarial survival at 2 years for complete responders to chemotherapy was 83 per cent, implying a prolonged survival (p = 0.002) compared to those with less than CR. Complete responders after chemotherapy had also a significantly longer recurrence-free survival, though 19 out of 20 did not undergo surgery. Complete response after this induction therapy is thus an important prognostic predictor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Cisplatin and 5-FU combined with radiotherapy and surgery in the treatment of squamous cell carcinoma of the esophagus. Palliative effects and tumor response.

The combination of cisplatin (90-120 mg/m2) and 5-fluorouracil (5-FU) (1,000 mg/m2/day in continuous infusion for five days) was given for 2-3 cycles, prior to combined radiotherapy and surgery, to 73 patients with esophageal squamous cell carcinoma, 60 with limited disease (LD), and 13 with extensive disease (ED) (i.e. with metastasis) of whom 3 had recurrent disease. Before preoperative radiotherapy among 60 LD patients, 12 (20%) had complete response, 21 (35%) partial response, 25 (42%) had stable disease, and 2 (3%) progressive disease. Swallowing was improved in 35/73 (48%) of the cases. In the resected specimens, no tumor was found in 8/53 (15%) of the cases, microscopic tumor in 18/53 (34%) and macroscopic tumor in 27/53 (51%). In the ED group, complete response of distant metastases was obtained in 6/13 (48%) of the patients, one of whom is still alive with no evidence of disease 62 months after the start of treatment.

Aged↗
PubMed1991

The response of the tracheal epithelium to concomitant cis-diamminedichloroplatinum (II) and radiation. An electron microscopic study in rabbits.

The ciliated epithelium of the rabbit trachea was irradiated with daily fractions of 2 Gy up to an accumulated dose of 20 Gy (total dose: 2, 6, 10, 16, or 20 Gy). Fifteen to forty-five minutes before the start of each irradiation 0.3 mg Cis-diamminedichloroplatinum (cis-DDP) was given by intraperitoneal injection to each rabbit. Examinations were carried out 1-10 days after each fractionation schedule, when specimens were taken for morphological investigations. Scanning electron microscope (SEM) examination showed a gradual development of ciliary damage, from blebs on the cilia to swollen tips, broken and bent cilia and finally an epithelial injury with areas free from cilia, and a surface covered with microvilli-like structures. SEM also showed cell loss, and remnants of dead cells on the surface together with detritus. By transmission electron microscopy (TEM), ciliary damage, cell death and cell loss of the ciliated cell layer, as well as exfoliation of portions of goblet-like cells on the surface, could be confirmed. Scoring of SEM and TEM micrographs showed that for the tracheal part treated with cis-DDP and radiation, the maximal damage was expressed in the dose group 10 Gy, and above this no further increase in the average reaction occurred. For the part of the trachea only exposed to cis-DDP, the damage increased with the dose. The difference observed speaks for an accelerated proliferation exerted by the radiation.

Animals↗
PubMed1991

Effect of chemotherapy and radiotherapy on squamous cell carcinoma of the esophagus. A preoperative radiologic evaluation.

In a series of 82 patients with epidermoid carcinoma of the esophagus, 68 were available for review of barium examinations and 44 for review of CT examinations showing the effect of preoperative treatment. After 3 courses of chemotherapy--Cisplatinum and 5-fluorouracil, and 24 Gy of presurgical irradiation--over a total of 10.5 weeks, the patients were ready for surgery. The results of the presurgical radiographic examinations were compared with the findings of histopathologic studies after surgery. Where both the CT and the barium examination showed a complete response, none of the patients had remaining macroscopic cancer. When healing with stenosis was included, CT and barium studies in combination were necessary to exclude a residual macroscopic tumor. Therefore, a combination of barium esophagography and CT is recommended to estimate the preoperative effect of treatment.

Aged↗
PubMed1990

Failure of preventing 5-fluorouracil cardiotoxicity by prophylactic treatment with verapamil.

The most common cardiotoxic effects of 5-fluorouracil (5-FU) are chest pain and ischemic ECG abnormalities. Coronary vasospasm may be the underlying mechanism. If so, prophylactic treatment with calcium channel blockers might have a beneficial effect. In the present study, prophylaxis with verapamil (120 mg three times daily) was given to 58 patients with esophageal or advanced head and neck carcinoma during induction chemotherapy with cisplatin and continuous infusion with 5-FU. Signs of ischemia appeared in 12% of the patients as compared to 13% in a previously studied compatible group of patients not receiving prophylaxis. The study does not support the hypothesis that prophylactic treatment with verapamil reduces the incidence of ischemia in patients undergoing 5-FU treatment. Verapamil might, however, modify the adverse cardiac effects of 5-FU by preventing supraventricular tachyarrhythmia.

Adult↗
PubMed1990

Small cell carcinoma of the oesophagus: a clinical and immunohistopathological review.

Primary small cell carcinoma of the oesophagus (SCCO), histologically indistinguishable from its counterpart of the lung, is a rare tumour. Less than 100 cases are reported. A review of 558 consecutive patients with oesophageal carcinomas referred to our department revealed seven cases. These were studied and compared to a survey of 80 cases collected from 24 reports. The present results, as well as the survey, indicate a poor prognosis with rapid and widespread dissemination, and that death is attributed to distant metastases rather than local failure. Freedom from local symptoms was achieved in all seven patients, regardless of therapy modalities employed. A complete response of the primary lesion was observed in three patients after chemo- and subsequent radiotherapy. According to these findings the most suitable treatment approach seems to be the same as for small cell carcinoma of the lung. A detailed immunohistochemical analysis revealed more characteristics similar to small cell carcinoma of the lung than that of the skin, viz 'Merkel cell carcinoma'.

Adult↗
PubMed1990

Changes in the esophageal epithelium in rabbits treated by Cis-dichlorodiammineplatinum as studied by electron microscopy.

The esophageal mucosa of the rabbit was investigated after a single dose of 5 mg Cis-Dichlorodiammineplatinum (Cis-DDP). Specimens were taken for scanning electron microscopy, transmission electron microscopy, and light microscopy. Examination was performed daily for 20 consecutive days. A cytotoxic effect was observed already the first day after injection with an intracellular oedema. Thereafter the height of the esophageal epithelium and the basal cell layer steadily decreased to a minimum day 11. This parallels the damaged microridges and an increased cell loss as revealed by scanning electron microscopy. At the end of the observation period the esophageal mucosa had completely restituted.

Animals↗
PubMed1989

Evaluation of the palliative effect of radiotherapy for esophageal carcinoma.

149 patients with carcinoma of the esophagus treated with radiotherapy were evaluated. Eighty-one patients had treatment with palliative intent and 68 with curative intent. The 4-year actuarial survival was 1 and 5% respectively. The tumor size, Karnofsky index (KI) and radiation dose were prognostic factors. The duration of palliation of the patients dysphagia was dose-dependent.

Adenocarcinoma↗
PubMed1989

The effect of 10 and 20 Gy single dose irradiation on the esophageal mucosa of the rabbit. An electron microscopic study.

The mucosa of rabbit esophagus was irradiated with single doses of 10 and 20 Gy respectively. Specimens were taken for scanning electron microscopy (SEM), and light microscopy investigations. Examinations were made 1-14 days after 10 Gy and 1-17 days after 20 Gy. Irradiation resulted in edema during the first days. The thickness of the epithelium was at its lowest value around day 5 after the administration of 10 Gy, and on days eight to ten after the administration of 20 Gy. Damage of the epithelium surface, as scored on SEM micrographs, was most pronounced on days eight to eleven after irradiation, showing a clear dose dependency. The second week after irradiation repair was seen concluding in an overshoot of the mucosal height. The amount of bacteria on the surface increased during the period of edema, and decreased when the damage was most pronounced.

Animals↗
PubMed1989

X-ray microanalysis of mammalian salivary glands.

X-ray microanalysis was used to study the elemental composition of major salivary glands in rat and man. The elemental composition of the acinar cells is influenced by a variety of factors. Stimulation of fluid secretion by cholinergic, alpha-adrenergic or peptidergic agonists leads to a sustained increase of the Na/K ratio. The elemental composition and ultrastructure of the acinar cells of rat submandibular gland, as well as flow rate and composition of pilocarpinestimulated submandibular saliva are significantly affected by thyroxine, but less by the synthetic glucocorticoid dexamethasone. Hypercalcemia (induced by chronic vitamin D treatment) as well as hypocalcemia (induced by calcitonin) cause accumulation of intracellular mucus in the submandibular acinar cells, with concurrent increase in the cellular calcium concentration, and a significantly decreased flow rate after pilocarpine stimulation. Several animal models have been proposed for the generalized exocrinopathy cystic fibrosis (CF), which may be caused by a defective regulation of chloride transport in epithelial cells. A potential new model is proposed: the chronically furosemide-treated rat, which shows several abnormalities in salivary gland structure and function that parallel the abnormalities found in the human disease. Another experimental model of potential interest in the study of CF is short-term treatment of experimental animals with the adenylate-cyclase inhibitor alloxan.

Animals↗