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Biomedical subjects

S Nilsson

Publications and source records attributed to S Nilsson.

At least 307 records · Page 17Linked to original sources

Single-dose and fractionated irradiation of four human lung cancer cell lines in vitro.

Four established human lung cancer cell lines were exposed to single-dose irradiation. The survival curves of 2 small cell lung carcinomas (SCLC) were characterized by a limited capacity for repair with small and moderate shoulders with extrapolation numbers (n) of 1.05 and 1.60 respectively. Two non-small cell lung carcinoma (NSCLC) cell lines, one squamous cell (SQCLC) and one large cell (LCLC) had large shoulders with n-values of 73 and 15 respectively. The radiosensitivity when measured as D0 did not, however, differ as much from cell line to cell line, with values from 1.22 to 1.65. The surviving fraction after 2 Gy (SF2) was 0.24 and 0.42 respectively in the SCLC cell lines and 0.90 and 0.88 respectively in the NSCLC cell lines. Fractionated irradiation delivered according to 3 different schedules was also investigated. All the schedules delivered a total dose of 10 Gy in 5 days and were applied in 1, 2, and 5 Gy dose fractions respectively. Survival followed the pattern found after single-dose irradiation; it was lowest in the SCLC cell line with the lowest SF and highest in the two NSCLC cell lines. In the SCLC cell lines all schedules were approximately equally efficient. In the LCLC and in the SQCLC cell lines, the 5 Gy schedule killed more cells than the 1 and 2 Gy schedules. The results indicate that the size of the shoulder of the survival curve is essential when choosing the most tumoricidal fractionation schedule.

Carcinoma, Non-Small-Cell Lung↗

Expression of Ki-67--a proliferation-associated antigen--in prostatic cancer.

The expression of the proliferation-associated antigen Ki-67 was studied in human prostatic cancer. The antigen was analyzed with an immuno-histochemical technique in TUR specimens. A correlation was seen between Ki-67 positivity and differentiation grade. All TUR specimens (15/15) with poorly differentiated carcinomas expressed the antigen. Moderately differentiated carcinomas constituted an intermediate group and slightly less than half of the cancers (12/27) were positive for the antigen. Only one of the highly differentiated carcinomas (1/12) expressed the antigen. All TUR specimens from patients with benign prostatic hyperplasia (8/8) were negative. The effect on Ki-67 positivity was also investigated in a human prostatic cancer heterotransplanted to nude mice and subjected to ionizing irradiation with or without concomitant estramustine treatment. The antigen expression was compared with that seen in tumour tissues from untreated mice and from mice treated with estramustine alone. A pronounced effect was seen in the combination treatment group with an approximately 50% reduction of the Ki-67 positive cells. The results are discussed in relation to prognosis and follow-up after radiation therapy and the possible use of estramustine in combination with radiation therapy.

Animals↗

Modal DNA values and estramustine-binding protein (EMBP) as prognostic markers in prostatic cancer.

In this study, we have investigated the model DNA values and the expression of estramustine-binding protein (EMBP) in formalin-fixed and paraffin-embedded TUR specimens from 76 untreated patients with prostatic cancer. In addition, specimens from 13 patients were analyzed for tumour EMBP expression only. Ploidy was measured as diploid, tetraploid and non-tetraploid aneuploid or aneuploid in the near-diploid region. All patients had been referred during 1978-1981, and were subjected to TUR due to urinary obstruction. Survival data were obtained for all patients through March 1988. Statistical analyses were performed using a Cox's regression model with respect to survival and cause specific survival and correlated to the DNA pattern and the expression of EMBP. The existence of a near-diploid aneuploid cell population as well as poor differentiation grade were both statistically significantly correlated with poor survival. Near-diploid aneuploid cell lines were seen in 9/76 (12%) of the patients and were also seen in well differentiated cancers (4/17). The expression of EMBP was most abundant in the moderately differentiated cancers. However, all prostatic cancer specimens investigated were positive for the antigen. Patients with poorly differentiated carcinomas and high EMBP expression showed a tendency towards better prognosis than those with poorly differentiated carcinomas and low EMBP expression. The present patient material was, however, too small to show a statistically significant correlation between EMBP and survival.

Aged↗

Calcified leiomyosarcoma simulating uterine myoma in a patient with long-standing anaemia.

A case of small bowel leiomyosarcoma in a 75-year-old woman is reviewed. The patient had an unexplained anaemia with occult blood in the faeces for at least 15 years. The value of different radiological investigations in patients with suspected gastrointestinal bleeding is discussed. The possible significance of calcifications visible on plain abdominal films is emphasized.

Aged↗

Diabolic hiccups.

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History, Ancient↗

Adult idiopathic enteric intussusception in the postoperative period. Case report.

Enteric intussusception developed in a 43-year-old man 13 days after operation for mechanical intestinal obstruction. No leading point of the invagination was found. The case may thus be classified as idiopathic intussusception occurring in the postoperative period. To our knowledge this condition has not previously been described.

Adult↗

Atherosclerosis-related measures in digitized femoral arteriograms.

Atherosclerosis is reflected in the arteriogram as narrowing of the arterial lumen and irregularity of the arterial wall. We have quantified these changes in digitized femoral arteriograms from 107 hypercholesterolaemic patients and defined 10 different measures concerning arterial diameter, cross-sectional area, stenosis and edge irregularity. We examined the precision of these measures and the correlations between them. Lumen volume and mean diameter for defined arterial segments had the highest precision and may be useful for follow-up studies. The linear correlation between the mean diameter and the square root of the lumen volume was greater than 0.99, so these two measures seem to be equivalent for all practical purposes. The measured variables could be separated into 2 groups: the measures concerning arterial diameter and lumen volume and those concerning edge irregularity and localized stenosis. The measures within each group showed strong positive mutual correlations, while the correlations between measures from different groups were negative and small. It was concluded that if the results of one measure from each group, suitably those of lumen volume and edge roughness, are known, the other described measures will add no further information about the atherosclerotic process.

Arteriosclerosis↗

Clinical and serologic markers of stage and prognosis in small cell lung cancer. A multivariate analysis.

The respective pretreatment prognostic impacts of the following markers were evaluated in 125 patients with small cell lung cancer (SCLC): lactic dehydrogenase (LDH), serum thymidine kinase (S-TK), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and tissue polypeptide antigen (TPA). More traditional clinical and serologic markers were also evaluated. Univariate analysis showed that all of the biochemical markers mentioned above, the Karnofsky index (KI) and the patient's sex were related to both the stage of disease (limited/extensive disease: LD/ED) and to survival. The strongest marker for the clinical stage was S-TK, whereas TPA showed the strongest relationship with survival. Multivariate analyses produced a model consisting of S-TK, CEA, NSE, and the patient's sex for determining the clinical stage. To compare the prognostic capacity of easily determined biochemical and simple clinical variables to the more resource-demanding variable of the clinical stage, three multivariate analyses in relation to survival were performed: (1) biochemical markers and simple clinical variables; (2) LD/ED and simple clinical variables; and (3) all available variables. The model obtained from the first analysis included TPA, KI, age, and the patient's sex; the model from the second analyses included LD/ED, patient's age, and KI; and the model from the third analysis, TPA, KI, age, sex, and LD/ED. Indices based on these three multivariate models were calculated for each patient and the prognostic capacity of these indices was compared. Pretreatment serum marker levels also had the capacity to predict both the grade and the duration of the response to therapy.

Adult↗

20-year experience of follow-up of the abnormal smear with colposcopy and histology and treatment by conization or cryosurgery.

During the period 1967 to 1977, 1466 women with Pap smears suggesting cervical epithelial neoplasia (CIN) II or worse were evaluated by colposcopy, portio biopsy, and endocervical curettage. Women who had CIN III were treated first by conization and later by cryosurgery. Cytological diagnosis was inaccurate compared to colposcopical and histological diagnosis, with 27% having a worse histological diagnosis. In 22% of the cases histology was two degrees less or worse than suggested by cytology. Presence of atypical vessels was associated with invasive cancer in 17% of cases. A total of 635 patients were treated by conization. After an average follow-up of 10 years, the cure rate was 96% compared to 87% by cryosurgery (104 cases). Hysterectomy was, mainly because of old age, performed on 154 patients; the cure rate was 97%. Although most treatment failures occurred within the first 5 years, some were seen after as long as 15-20 years.

Adult↗

Perioperative risk assessment. The Project Perioperative Risk (PROPER).

Surgical operations are preceded by an assessment of the anticipated risks for the patient due to the operation. The present assessment procedure is not optimally organised and the scientific base is weak. In this project a new organisation was tested that provides more relevant data on the risk and more optimal timing if the risk has to be modified. All elective patients from a defined geographical area (n = 1361) were seen one week before the operation for risk assessment. They were then followed up during and after the operation. About 30% of the operations were followed by complications. More than half of them were mild. Severe complications were rare. Three risk assessment classifications were tested. They were all fairly good estimators of the risk but had different properties. The next step in this project is to systematically evaluate the main risk-affecting factors to improve the quality of risk assessment.

Follow-Up Studies↗

Radioimaging of human malignant gliomas using indium-labelled monoclonal antibodies.

A monoclonal antibody (MUC 2-63) was raised against a neuroectodermal antigen expressed on human malignant gliomas, neuroblastomas and melanomas. The mouse monoclonal antibody MUC 2-63 was of IgG1 isotype, it binds the antigenic determinants with the molecular weight of 32,000 Dalton present on the cell surface of native glioma cells. Seven patients with brain tumours, five with biopsy proven malignant gliomas, received an intravenous injection of the 111In-DTPA coupled monoclonal antibody MUC 2-63. Six patients had an uptake of 0.01-0.04% of the injected dose at the site of the tumour, which correlated to the computerized tomography (CT) images. The half-lives in the tumours of 111In were 38-259 h. The maximal uptake in the tumours were noticed between 40 and 67 h. One patient failed to demonstrate any intracranial uptake of the radioactivity. This patient had been treated with surgery and radiotherapy for a stage 2 testicular seminoma four years ago. He recently developed clinical signs of a primary brain tumour and the CT diagnosis was malignant glioma. All patients had nonspecific uptake in the liver, half-lives were between 60 and 84 h, the corresponding maximal uptake was detected between 22 and 45 h. No side effects were observed by administration of the mouse monoclonal antibody MUC 2-63.

Adult↗

A comparison of the ability of a sonographically measured biparietal diameter and the last menstrual period to predict the spontaneous onset of labor.

To study whether the estimated date of confinement (EDC) for women with optimal menstrual histories is predicted best from the last menstrual period (LMP) or biparietal diameter (BPD), 2320 women had the EDC estimated by both LMP and BPD measured sonographically in the second trimester. Those who delivered after the spontaneous onset of labor are reported here. Compared with the EDC calculated from the LMP, the EDC calculated from the BPD was postponed more than 1 week for 406 women (17.5%) and advanced more than 1 week for 56 (2.4%). For these women, the BPD estimate of EDC turned out to be closer to the day of delivery in 264 cases, whereas the LMP estimate was closer in 125 (P less than .001). For 73 women, the estimates were equally good. For 80.1% of the women, the two estimates of EDC differed by 1 week or less; in these cases, the estimates were equally good in predicting the day of delivery. We conclude that the BPD is a better predictor of the spontaneous onset of labor than is the LMP.

Clinical Trials as Topic↗

Changes in atheroma volume estimated from digitized femoral arteriograms.

To evaluate the effects of treatment in patients with cardiovascular risk factors, valid and reproducible methods for assessing changes in atheroma volume are required. We postulated that these changes could be accurately estimated by repeat measurement of the lumen volume of the artery to be studied. With a computer-based technique, the lumen volume of a 20 cm segment of the femoral artery was measured in arteriograms from 107 patients with hypercholesterolemia. Films were digitized with use of a high-resolution scanner, cross-sectional areas were calculated with a slice thickness of 150 microns and the lumen volume was obtained by their integration. The validity of the method was demonstrated in model experiments. An automatic algorithm to correct for changes due to patient positioning was developed and validated in a model experiment. With repeat measurement 10 min and 11 to 13 months apart the coefficients of variation were 2.9 per cent (N = 107) and 6.1 per cent (N = 29), respectively.

Algorithms↗

Arterial segmental vasoconstriction in hypercholesterolaemic patients.

Regular, wave-like constriction in medium-sized arteries, arterial segmental vasoconstriction (ASV), has been observed at arteriography and described by many authors. We found ASV in arteriograms of the superficial femoral artery in 13 of 107 hypercholesterolaemic patients, enrolled in the Probucol Quantitative Regression Swedish Trial (PQRST). The arteriograms were digitized and studied with a quantitative computer-assisted technique. The frequency of ASV was higher than has been reported earlier in clinical materials, possibly because of an increased vasoreactivity in hypercholesterolaemia, as recently observed experimentally. The ASV patients were, on average, younger, had lower blood pressure and less atherosclerosis, than the non-ASV patients. ASV was not found in any of the 19 patients in the material who either had symptoms of peripheral vascular disease or arteriographically verified arterial occlusions. No significant correlations with smoking habits or serum cholesterol levels were found. A computer-based index of ASV and measurement of ASV wavelength are discussed.

Adult↗