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Biomedical subjects

N Wilking

Publications and source records attributed to N Wilking.

At least 73 records · Page 4Linked to original sources
PubMed1986

A comparison of the 25-cm rigid proctosigmoidoscope with the 65-cm flexible endoscope in the screening of patients for colorectal carcinoma.

A comparison of the rigid with the flexible sigmoidoscope was evaluated in 293 patients as part of a screening project for colorectal cancer at Roswell Park Memorial Institute. Patients with either a positive family history for colorectal cancer, a positive stool guaiac test result, a history of hematochezia, or a change in bowel habits were randomly assigned to either rigid or flexible sigmoidoscopy. The median distance of colon examined with the flexible instrument was significantly greater than with the rigid scope (55 versus 17 cm, respectively). A significantly greater number of malignant and premalignant lesions were found with the flexible instrument than with the rigid scope. It was concluded that the flexible sigmoidoscope is superior to the rigid scope in the process of screening for colorectal lesions.

Adolescent↗
PubMed1986

Squamous-cell carcinoma in a pilonidal sinus. Case report.

Squamous-cell carcinoma arising in a pilonidal sinus is a rare occasion. The present case stresses the importance of recognizing the condition. Malignancies of this location often has a more aggressive clinical course than squamous-cell carcinoma of other skin locations.

Adult↗
PubMed1986

Abdominal exploration for suspected recurrent carcinoma of the colon and rectum based upon elevated carcinoembryonic antigen alone or in combination with other diagnostic methods.

Thirty-six patients underwent abdominal exploration due to elevated carcinoembryonic antigen (CEA) levels after a curative resection for carcinoma of the colon and rectum. Three groups were evaluated. In group 1, CEA elevation alone was the indication for the exploration in 13 asymptomatic patients. In group 2, 13 other asymptomatic patients underwent exploration because of elevated CEA levels in combination with other findings. In group 3, ten patients were symptomatic with an elevated CEA level at the time of exploration. Five patients from groups 1 and 2 underwent a curative resection for recurrent tumor (14 per cent). Three of these patients are still alive more than five years after exploration. Nine patients had negative findings at exploration for tumor recurrence (25 per cent false-positive results). Six of these patients are alive while three have died of metastatic disease. Twenty-two of the 36 patients (61 per cent) had unresectable disease at the time of exploration. Four of these patients underwent some form of surgical palliative procedure. Considering the five patients who underwent a curative resection with the latter four patients, this results in 25 per cent of the patients benefitting from surgical exploration.

Adult↗
PubMed1985

Phase II study of combination bleomycin, vincristine and high-dose methotrexate (BOM) with leucovorin rescue in advanced squamous cell carcinoma of the anal canal.

Fifteen patients with advanced squamous cell carcinoma of the anal canal were treated with a combination of bleomycin, vincristine, and high-dose methotrexate (BOM) with leucovorin rescue. Three out of twelve patients with measurable disease had objective responses of 1, 2, and 5 months. Five of the fifteen patients had severe or life-threatening complications as a result of this treatment regimen. The narrow therapeutic index of the BOM therapy makes it a less than ideal drug combination for the treatment of advanced squamous cell carcinoma of the anal canal.

Aged↗
PubMed1985

Surgical resection of pulmonary metastases from colorectal adenocarcinoma.

From 1962 to 1982, 27 patients with pulmonary metastases as the only site of recurrent colorectal carcinoma underwent pulmonary resection at Roswell Park Memorial Institute. Only five of these patients had symptomatic pulmonary lesions. No postoperative mortality occurred. The median survival after pulmonary resection was 27 months. Five patients are alive presently without recurrent colorectal cancer and two patients are alive with recurrent pulmonary metastases. Patients with solitary lesions had a better survival than patients with multiple lesions. The major sites of recurrence following thoracotomy were the lungs and liver.

Adenocarcinoma↗
PubMed1985

Pelvic and perineal recurrences after abdominoperineal resection for adenocarcinoma of the rectum.

Pelvic and perineal recurrences were evaluated in 48 patients who underwent abdominoperineal resection at Roswell Park Memorial Institute for adenocarcinoma of the rectum. The duration of follow-up of these patients was at least 5 years or until death. There were 26 male and 22 female patients with a median age of 60 years. In 40 patients, the abdominoperineal resection was considered to be curative and in the remaining 8 patients, palliative abdominoperineal resection was performed. Only 2 of the 48 patients had a pelvic recurrence and in none of these patients was this recurrence the first site of relapse. One of the 48 patients had a local perineal recurrence; however, this was treated successfully with surgery. This represents a total of three pelvic or perineal recurrences in 48 patients, for a recurrence rate of 6 percent.

Abdomen↗
PubMed1984

Pregnancy-associated glycoprotein (alpha 2-PAG)--a possible marker in breast cancer?

Serum levels of pregnancy-associated alpha-glycoprotein (alpha 2-PAG) and estradiol-17 beta (E2) and the estrogen receptor content (ER) in the tumor cytosol were measured in 174 women aged 24 to 94 years with primary breast cancer and the values were related to patient age, tumor size and clinical stage. While E2 levels were significantly lower and ER values significantly higher in older women, no significant correlation was found between alpha 2-PAG on one hand and the patients' age, E2 or ER values or tumor size on the other. A significant positive correlation (p = 0.016, Pearson correlation test) was found between alpha 2-PAG values and the clinical stage of the tumor. The results suggest the possible use of alpha 2-PAG as a marker for the monitoring of disseminated breast cancer during systemic therapy.

Adult↗
PubMed1984

Inhibition of steroid sulfatase activity by danazol.

The hydrolysis of dehydroepiandrosterone sulfate (DHAS) by human liver cells in culture and the hydrolysis of and formation of estradiol-17 beta (E2) from estrone sulfate (E1S) by human breast tumor preparations in vitro were studies in the presence and absence of danazol. In the latter tissue the effects of medroxyprogesterone acetate (MPA), trilostane, aminoglutethimide (AG) and tamoxifen were tested for comparison. Danazol at concentrations of 10(-6) - 1.4 X 10(-4) M strongly inhibited the hydrolysis of DHAS as well as the hydrolysis of and formation of E2 from E1S. With the exception of a slight inhibitory effect of trilostane upon E1S hydrolysis, the other four drugs did not inhibit the metabolism of E1S. Danazol, at concentrations corresponding to those occurring in vivo during therapy, is a potent inhibitor of steroid sulfatase activity. This may be one of the ways in which the drug affects peripheral and target tissue levels of steroid hormones.

Aminoglutethimide↗
PubMed1982

The distribution and metabolism of 14C-labelled tamoxifen in spayed female mice.

The distribution and metabolism of 14C-tamoxifen (a non-steroidal triaryl ethylene anti-oestrogen) have been investigated in ovarieectomized mice. The autoradiograms showed accumulation of radioactivity in the liver and the bile as an indication of an excretory pathway, but a rapid and high accumulation was also seen in the lung and the adrenals, organs normally not considered as target organs for tamoxifen. The liver and sebaceous glands could be detected on the autoradiograms up to fourteen days after a single intravenous dose. However, in most organs the amount of retained radioactivity was very low after 24 hours. By using the autoradiograms as a guideline a metabolic study was performed. High concentrations of unmetabolized tamoxifen was detected in the lung and the adrenals as well as in the pancreas. Relatively high amounts of a compound tentatively identified as 4-hydroxy-tamoxifen were present in the pancreas and the liver and there were also indications for the presence of N-desmethyl-tamoxifen in these tissues. These metabolites are considered to possess anti-oestrogenic activity.

Animals↗
PubMed1982

A comparative study of the estrogenic effects of tamoxifen and 17 beta-estradiol in postmenopausal women.

The effects of tamoxifen and 17 beta-estradiol on the levels of FSH, PRL, and pregnancy zone protein were compared in two groups of postmenopausal women. Seventeen women with breast cancer were treated with tamoxifen (20 mg, twice a day). Fourteen women with climacteric complaints were given 17 beta-estradiol (2 mg, daily). A close parallelism between the effects of 17 beta-estradiol and the antiestrogen was obtained in all three markers studied. The percent decreases in FSH after 1 month were 29 and 44 and, after 3 months, 26 and 34 in the tamoxifen and estradiol groups, respectively. The decreases in PRL after 1 and 3 months of treatment with tamoxifen were 36% and 71%, and 19% and 31% after treatment with estradiol. Both treatments increased PZP serum levels, tamoxifen by 32% and 44% and estradiol by 55% and 70% after 1 and 3 months. Thus, tamoxifen was found to exert weak estrogenic effects in postmenopausal women.

Aged↗
PubMed1982

Effects of tamoxifen on the serum levels of oestrogens and adrenocortical steroids in postmenopausal breast cancer patients.

Peripheral serum levels of cortisol, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHA-S), oestradiol-17 beta and total oestrone were measured in 17 postmenopausal breast cancer patients and on age-matched healthy controls. In the breast cancer patients analyses were performed before and after 1, 2, 4, 8 and 12 weeks of treatment with tamoxifen. Basal DHA levels were significantly higher in breast cancer patients than in controls; otherwise no significant differences were noted. Treatment with tamoxifen resulted in significantly elevated levels of cortisol throughout the period of treatment; this effect was probably solely due to an increase in transcortin levels. A transient but significant elevation in total oestrone, probably related to liver function, was observed after one week of treatment. No significant effects of tamoxifen were noted on serum DHA, DHA-S or oestradiol-17 beta. The results indicate that tamoxifen does not affect the adrenocortical steroid biosynthesis in postmenopausal women. The oestrogenic effects of tamoxifen upon FSH, prolactin and the oestrogen induced Pregnancy Zone Protein (PZP) in postmenopausal women, described in a previous communication from this group, are probably not due to any increase in the serum oestrogens since this increase is transient and hardly impressive. The weak oestrogenic effect of the tamoxifen-receptor complex itself may thus be sufficient to produce net oestrogenic effects in subjects with low endogenous oestrogens such as postmenopausal women.

Adrenal Cortex Hormones↗
PubMed1982

Purification and partial characterization of a 17 beta-estradiol-binding macromolecule in the human pancreas.

Studies have been performed in order to investigate the presence of estrogen-binding proteins in the human pancreas that may provide the biochemical basis for tissue-specific treatment of pancreatic carcinoma with estrogen-based cytotoxic drugs. Using in vitro techniques, an estrogen-binding macromolecule has been purified from pancreatic cytosol. With estradiol a ligand, Kd was calculated to be 1.7 X 10(-7) M, and this protein was found to constitute about 4% of the total protein content in the cytosol. No metabolism of estradiol was detected under the in vitro conditions used. Competition experiments indicated that, besides estradiol, the protein also had some affinity for estrone and estriol but not for testosterone, progesterone, or dexamethasone. The protein was purified to homogeneity using chromatography on concanavalin A and hydroxylapatite followed by preparative polyacrylamide gel electrophoresis. The purified protein, still able to bind, [3H]-estradiol, gave one single protein-staining band when analyzed using different electrophoretic systems. The steroid-protein and did not bind to phosphocellulose or DNA-cellulose and did not show any similarities to steroid receptor proteins. The complex has a Strokes' radius of 52 A and a sedimentation coefficient of 3S. The biological significance of the macromolecule is known, but the protein is probably synthesized in the pancreas since no similar protein could be detected in serum. Studies are now being carried out to investigate whether this novel protein in the human pancreas may interact with complexes between cytotoxic agents and estrogens and provide the basis for tissue-specific treatment of pancreatic carcinoma.

Cell Membrane↗