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Biomedical subjects

M Hansen

Publications and source records attributed to M Hansen.

At least 217 records · Page 12Linked to original sources
PubMed1991

[Adjuvant chemotherapy in premenopausal and menopausal high-risk patients with breast cancer. 4. Results of the DBCG (Danish Breast Cancer Cooperative Group) 77B study].

From October 1977 to November 1982 premenopausal and menopausal high-risk breast cancer patients were included in a randomized trial (DBCG 77B). The primary surgical treatment was total mastectomy with axillary dissection. In the trial, a total of 1,034 patients were enrolled and received postoperative radiotherapy (RT) and were further randomized to 1) no systemic treatment, 2) cyclophosphamide, or 3) cyclophosphamide + methotrexate + 5-fluorouracil. The chemotherapy was given for one year. With a median observation time of ten years, the survival was 45, 60 and 62%, respectively. Retrospectively, the survival benefit was observed to be most pronounced in the age group less than 40 years, in patients with tumour size less than or equal to 5 cm or with less than or equal to 3 positive lymph nodes. In high-risk premenopausal and menopausal patients adjuvant chemotherapy combined with RT thus resulted in a more than 25% relative reduction in mortality at ten years of observation compared with RT alone.

Adult↗
PubMed1991

Calcium-dependent eicosanoid metabolism by concanavalin A-stimulated human monocytes in vitro. Synergism with phorbol ester indicates separate regulation of leukotriene B4 synthesis and release.

Human monocytes obtained by counter-current centrifugal elutriation released arachidonic acid when challenged in vitro with Con A, as well as with other soluble (PMA or ionomycin) or particulate stimuli (serum-treated zymosan). Cyclo-oxygenase metabolites were the principal eicosanoids detected in the supernatants of Con A-stimulated, [3H]arachidonate-labeled monocytes, 5-Lipoxygenase (5-LO) products, such as leukotriene B4 (LTB4), were conspicuously absent. Release of arachidonate and its metabolites in response to Con A was dependent on the presence of extracellular Ca2+, but not Mg2+. In contrast to serum-treated zymosan challenge, which resulted in increased inositol trisphosphate and LTB4 release, Con A-induced inositol phospholipid hydrolysis in monocytes was limited to phosphatidylinositol or phosphatidylinositol monophosphate. Despite an inability to augment LTB4 release, Con A or PMA induced a loss of 5-lipoxygenase from a cytosolic compartment that was similar to that achieved with a calcium ionophore (ionomycin), a potent stimulus for LTB4 generation. When cell-associated LTB4 was evaluated, evidence for increased LTB4 production was obtained in response to either stimulus (PMA greater than Con A). In combination, however, PMA and Con A treatment resulted in monocyte LTB4 release comparable with that observed with the calcium ionophore or STZ. LTB4 release in response to all stimuli tested was inhibited by MK-886, a drug that binds to 5-lipoxygenase-activating protein. These results indicate the following: 1) Phospholipase A2 activation and attendant arachidonic acid release induced by agents that increase intracellular Ca2+ and/or generate diacylglycerol results in increased synthesis and release of PG and increased synthesis of leukotrienes, but not necessarily leukotriene release. 2) 5-LO translocation, which may occur independently of increased intracellular Ca2+, may be necessary for LTB4 generation but is insufficient for its release. 3) 5-Lipoxygenase-activating protein activity is necessary for 5-LO activation and LTB4 release in response to all stimuli investigated here. 4) Phorbol ester, an activator of protein kinase C, may synergize with agents such as Con A (which by themselves induce a minimal intracellular Ca2+ rise), so as to result in the release of LTB4. Thus, Con A may represent a class of surface receptor-aggregating agents that initiates inflammatory changes or immunomodulation associated with liberation of PG and might predispose to release of other inflammatory mediators, such as leukotrienes, in the presence of additional signals including protein kinase activation.

Arachidonate 5-Lipoxygenase↗
PubMed1991

Theophylline and ethylenediamine pharmacokinetics following administration of aminophylline to septic patients with multiorgan failure.

The pharmacokinetics of theophylline and ethylenediamine were examined in 6 patients with septicaemia and multiorgan failure (MOF). The patients received a bolus injection of 4 mg/kg aminophylline. Aminophylline is the ethylenediamine salt of theophylline. The clearance of theophylline was reduced in all our patients ranging from 10-66% of the value obtained in healthy volunteers. The median t 1/2 beta was 18.8 h (range 5.8-25.5) compared to a normal value of 6 h. The median clearance of ethylenediamine was 54% of the normal value, while the peripheral volume of distribution was increased to 650%. Due to this t 1/2 beta was 2.3 (2.0-2.7) h, which is 5 times the normal value of 0.55 h. There was no correlation between clearance of theophylline and ethylenediamine. As theophylline has a narrow therapeutic range, routine monitoring with measurements of serum theophylline is mandatory in patients with MOF.

Adult↗
PubMed1991

[The methods and place of digital subtraction arthrography of the hip in detecting endoprosthesis loosening].

Digital subtraction arthrography (DSAr) of the operated hip is presented and compared to nuclide bone scan and plain radiograph. Surgical proof was obtained in 47 patients. In the evaluation DSAr proved to be superior to nuclide bone scan and plain radiograph. DSAr had the best predictive value in the diagnosis of loosening of a prosthesis. In contrast to conventional arthrography there is a better differentiation between the contrast medium, the prosthesis, the acrylic cement and the bone by using DSAr. In addition DSAr presents the advantage of postprocessing, especially pixel shift.

Aged↗
PubMed1991

Combination chemotherapy of limited-stage small-cell lung cancer. A controlled trial on 221 patients comparing two alternating regimens.

The outcome of two different alternating regimens of chemotherapy was investigated in a prospective controlled trial in limited-stage small-cell lung cancer (SCLC). Both regimens comprised cyclophosphamide, lomustine, vincristine, methotrexate, doxorubicin and etoposide administered in different schedules. The investigative regimen (B) included simultaneous administration of cyclophosphamide + lomustine alternating with cyclophosphamide + doxorubicin, and with doxorubicin + lomustine. The hypothetical superiority of this regimen was based on data from experimental animal tumors suggesting potentiated efficacy of the three specific combinations. A total of 234 patients were included, and 113 vs 108 patients were eligible. Median survival in both groups was 48 weeks (p = 0.89). Complete remissions were observed in 36/101 and in 42/99 patients evaluable for response. There was no significant difference in response duration. At restaging after 18 months of chemotherapy 27 patients (16%) and 22 patients (16%), respectively, were free of disease. Six patients, three in each arm, are still alive, 8+ to 10.5+ years after diagnosis. Scheduled doses of the six agents were the same in the two regimens except for a 30% reduction of every second dose of cyclophosphamide in regimen B. Nevertheless, regimen B resulted in significantly more leukopenic patients, septicemic episodes, and blood transfusions, and the dosage of etoposide was more often reduced in arm B than in arm A. The increased toxicity was not associated with improved treatment results.

Adult↗
PubMed1991

High-dose metoclopramide + lorazepam versus low-dose metoclopramide + lorazepam + dehydrobenzperidol in the treatment of cisplatin-induced nausea and vomiting.

In a randomized double-blind, cross-over trial of 34 patients receiving cisplatin-based chemotherapy (20-100 mg/m2), the antiemetic effect of high-dose metoclopramide (HDM) (10 mg/kg iv. loading dose + 7 hours continuous infusion) + lorazepam (L) (2.5 mg x 4 po) was compared with low-dose metoclopramide (LDM) (70 mg) + L (2.5 mg x 2 po) + dehydrobenzperidol (5 mg x 2 im). Among the 29 patients who completed the cross-over, HDM significantly reduced the number of vomiting episodes (p = 0.002) and the degree of nausea (p = 0.004). Seventeen patients preferred the HDM and 4 the LDM regimen (p = 0.01). Sedation was seen in all but 1 patient, and was graded as severe in 6 patients receiving the HDM and in 2 patients receiving the LDM regimen. No extrapyramidal adverse reactions were seen. We conclude that high-dose metoclopramide + lorazepam is a safe antiemetic regimen and significantly superior to low-dose metoclopramide + lorazepam + dehydrobenzperidol. Owing to the severe sedation which occurs in some patients, the dose of lorazepam should be individually adjusted.

Adult↗
PubMed1991

Teniposide and etoposide in previously untreated small-cell lung cancer: a randomized study.

A randomized study comparing teniposide (VM-26) and etoposide (VP-16) was performed to investigate whether there are any differences in the activity and toxicity of these two analogs in small-cell lung cancer (SCLC). Only previously untreated patients with SCLC were included; 46 and 48 patients receiving VP-16 and VM-26, respectively, are assessable for response. There were no differences between the two groups with respect to extent of disease, median age, and performance status (PS). The initial doses were for both compounds 70 mg/m2 intravenously (IV) daily for 5 days every 3 weeks. After inclusion of 25 patients in the study, the doses were increased to 80 mg/m2 for VM-26 and 90 mg/m2 for VP-16 because of differences in toxicity. VM-26 caused more hematologic toxicity than VP-16 throughout the study. The overall responses (complete response [CR] plus partial response [PR]) were 65% for VP-16 and 71% for VM-26, with CR occurring in 24% and 23%, respectively, for the two compounds. Median survival was 8.5 months for VP-16-treated patients versus 11.3 months for VM-26-treated patients (P = .58). It is concluded that both VP-16 and VM-26 are highly active single agents in SCLC.

Aged↗
PubMed1991

Clearance of xenon-133 from bone marrow in patients with small-cell lung cancer.

The aim of this study was to estimate bone-marrow blood flow (BMBF) in man and to correlate this with myelosuppression induced by cytostatic treatment dosed as a function of surface area. Twenty-four patients suffering from small-cell lung cancer participated in the study. Blood flow was measured with the xenon-133 washout technique. The 133Xe clearance measurement took place in conjunction with the pre-treatment bone-marrow staging procedure (ad modern Radner). Tissue samples were taken for microscopy and for the determination of the blood-to-tissue partition coefficient lambda. After the bone-marrow aspiration, 0.1-0.2 ml of 133Xe in saline was injected into the bone marrow and the cannula was removed. Following a hyperaemic phase of 12 min (7-16 min), monoexponential washouts were demonstrated. The median washout rate constant was 0.0063 min-1 (0.0038-0.0098 min-1). Lambda values of 0.3-3.5 ml g were found, but microscopy of the bone marrow showed a fairly large admixture of peripheral blood. Therefore, the lambda values should be taken with caution and absolute blood-flow values were not calculated. The results demonstrated no correlation between 133Xe clearance from crista iliaca and leucocyte or platelet suppression.

Aged↗
PubMed1991

Therapists' perceptions of severity in cases of family violence.

The incidence of relationship violence is a topic of increased concern (Koss, 1990). Family therapy theorists have been criticized for emphasizing shared responsibility and obscuring the seriousness of the violence (Bograd, 1989; Pressman, 1989). The current study surveyed 362 members of a national family therapy organization. Respondents were asked to conceptualize and provide interventions for one of two actual cases that involved family violence. Results indicate the therapists surveyed did not attend to the seriousness of the violence if they attended to the violence at all. Interventions frequently failed to address the crisis and the need for protection of the wife.

Diagnostic Errors↗
PubMed1991

Fixation characteristics in macular disease. Relationship between saccadic frequency, sequencing, and reading rate.

The relationship between reading rate and saccadic frequency in patients with macular degeneration was studied to determine if this simple measure of eye movements would be helpful in explaining the reduction in reading rates. Nineteen subjects and five controls were tested for visual acuity, reading rate, and saccadic frequency for intended stationary, simple left-to-right, and sequencing step tasks. Eye movements were recorded using an electro-oculography technique. Absolute eye position was not known. The results demonstrated that, using a 2 degree threshold for a stationary target, patients refixated a mean of 42.7 times per min, and controls refixated 0.00 times per min. For a two-letter left-to-right task, patients averaged 3.57 times more saccades than an ideal response, and controls had 1.14 times more saccades than ideal (P less than 0.01). For a five-letter left-to-right sequencing task, patients refixated a mean of 2.10 times more than ideal, and controls refixated 1.15 times more than ideal (P less than 0.05). Regression analysis demonstrated that sequencing task scores of saccadic frequency and visual acuity were the best predictors of reading rate (r2 = 0.705). These results indicate that higher saccadic frequencies are associated with lower reading rates and that there appears to be a relationship between the sequencing of visual information and reading rate.

Aged↗
PubMed1990

[Consensus on the treatment and control of border-line tumors of the ovary in Denmark].

In order to obtain an impression of the consensus in Denmark of the treatment and control of border-line tumours of the ovary (BTO), a questionnaire was sent to all 43 departments of gynaecology/obstetrics and of surgery with gynaecology/obstetrics. Thirty-seven (86%) departments replied. The results of the investigation are presented. It is concluded that about 75% (87% in stage Ia and 65% in stage Ib) perform restrictive surgery on younger patients in the early stages. Indication for chemotherapy is found only in patients with more advanced stages. Very few find an indication for radiotherapy. Treatment and control of BTO in Denmark are in agreement with current international principles.

Adult↗
PubMed1990

The involvement of protein kinase C in exocytosis in mast cells.

Diacylglycerol generated from inositolphospholipid hydrolysis and tumor-promoting phorbol esters stimulate protein kinase C. The synthetic diacylglycerol 1-oleoyl-2-acetyl-rac-glycerol and the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) have been used in pure rat peritoneal mast cells. Both caused histamine release associated with exocytosis. The release by the stimulation of protein kinase C alone in the absence of secretagogues was slow although up to 50% of the histamine content was released by TPA in 120 min. Remarkable potentiation of histamine release was observed when the mast cells were preincubated with TPA before exposure to the calcium ionophore A23187. The potentiation of histamine release corresponded with an intensification of exocytosis. The potentiation is consistent with a participation of protein kinase C in the secretory process. An inhibitory effect due to protein kinase C activity was also demonstrated using TPA and mast cells from sensitized rats. When sensitized mast cells preincubated with 50 nM TPA for 5 min were exposed to the antigen, the histamine release was substantially reduced compared to the sum of the release by the antigen and TPA or by the antigen alone. There was a corresponding decrease in exocytosis. The inhibition of exocytosis and histamine release seems to reflect a regulatory function of protein kinase C for the termination of the response, as demonstrated in other types of cells apparently acting through an inhibition of inositolphospholipid hydrolysis.

Animals↗
PubMed1990

A randomized study of sequential versus alternating combination chemotherapy in advanced ovarian carcinoma.

The concept of using either alternating or sequential combination chemotherapy with non-cross-resistant combinations was tested in a randomized trial including 301 previously untreated patients with advanced epithelial ovarian carcinoma. The sequential schedule consisted of CAF (cyclophosphamide, doxorubicin, 5-fluorouracil) followed by PH (cisplatin, hexamethylmelamine) in nonresponders, CAF- greater than PH (n = 157), and the alternating regimen consisted of CAF/PH (n = 144). With a median observation time of 54 months, no statistically significant differences were found between the pathologically complete response (PCR) rates of 17% and 16%, respectively, nor were there any statistical differences in median disease-free survival for PCR patients (CAF- greater than PH 34+ months and CAF/PH 26+ months), in overall survival (28 and 24 months, respectively), or in time to treatment failure (10 and 11 months). The overall estimated cure rate was 13%. An equal degree of myelosuppression was seen with the two regimens, whereas neuro- and nephrotoxicity were more pronounced when PH was given sequentially to CAF than with the alternating schedule. We conclude that the sequential and the alternated use of doxorubicin- and platinum-based regimens yield equivalent results and that other approaches should be investigated to improve treatment effects.

Adult↗
PubMed1990

Epirubicin or epirubicin and vindesine in advanced breast cancer. A phase III study.

One hundred thirty-three evaluable patients with advanced breast cancer entered a randomized trial comparing epirubicin 60 mg/m2 with a combination of epirubicin 45 mg/m2 and vindesine 3 mg/m2 day 1 and 8 every 4 weeks. In all 10 premenopausal women an oophorectomy was performed. Seventy-five patients had previously received cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) for advanced disease and 68 had received adjuvant chemotherapy (cyclophosphamide or CMF). Among evaluable patients (72 in the epirubicin group and 61 in the epirubicin + vindesine group) response rates were as follows: complete response--seven versus six; partial response--31 versus 22; no change--16 versus 17 (p greater than 0.40). Median time to disease progression was 6 months in both groups and median survival times were identical (12 months). Thrombocytopenia was less frequent in the epirubicin + vindesine group (p less than 0.01). In the epirubicin + vindesine group, mild to moderate peripheral neuropathy was observed in 40% of the patients. Congestive heart failure developed in one patient with a cumulative dose of epirubicin less than 1000 mg/m2 and in 7 of 15 patients who had greater than 1000 mg/m2. Four died of this cause. In conclusion, epirubicin is effective as a single agent for advanced breast cancer. The combination with vindesine does not increase its efficacy.

Adult↗
PubMed1990

Transport and assembly of gag proteins into Moloney murine leukemia virus.

We have studied the process of Moloney murine leukemia virus (M-MuLV) assembly by characterization of core (gag) protein mutants and analysis of wild-type (wt) gag proteins produced by cells in the presence of the ionophore monensin. Our genetic studies involved examination of linker insertion mutants of a Gag-beta-galactosidase (Gag-beta-gal) fusion protein, GBG2051, which is incorporated into virus particles when expressed in the presence of wt viral proteins. Analysis indicated that the amino-terminal two-thirds of the gag matrix domain is essential for targeting of proteins to the plasma membrane; mutant proteins localized to the cytoplasm or were trapped on intracellular membranes. Mutations through most of the coding region of the gag capsid domain generated proteins which were released from cells in membrane vesicles but not in virions. In contrast, linker insertions into p12gag or carboxy-terminal portions of the matrix or capsid coding regions did not affect assembly of fusion proteins into virus particles. Monensin, which blocks vesicular transport, inhibited gag protein intracellular transport and release from cells. Our results suggest that a significant proportion of M-MuLV myristylated gag proteins travel via vesicles to the cell surface. Specific matrix protein polypeptide regions and myristic acid modification are both necessary for appropriate gag protein transport, while capsid protein interactions appear to mediate the final phase of virion formation.

Acylation↗