Search PubMed⌕ Search

Biomedical subjects

V Nikkanen

Publications and source records attributed to V Nikkanen.

At least 37 records · Page 2Linked to original sources
PubMed1993

Neonatal benign sacrococcygeal teratoma may recur in adulthood and give rise to malignancy.

BACKGROUND: The capacity of neonatal sacrococcygeal teratomas (SCT) to recur is a well-recognized phenomenon. However, only a few studies have reported recurrence of the tumors beyond childhood. METHODS: A follow-up of patients for the detection of late recurrent SCT was performed in 45 patients, ages 4-43 years (mean, 21.5 years). All of the patients had been operated on in infancy for a benign SCT. RESULTS: Three adults with persistent or recurrent SCT were found. The recurrent tumors were diagnosed 21-43 years after the initial diagnosis and operative treatment. Two recurrences were histologically benign, and one was malignant. In the patient with the malignant recurrence, the coccyx was not removed primarily. The malignant recurrence was a mucinous adenocarcinoma and probably originated from a preexisting benign epithelial component of the teratoma. CONCLUSIONS: The capacity of a benign SCT to recur may be retained into adulthood. Follow-up of patients after operation for a SCT, even when the tumor is benign, should extend far beyond infancy. Abdominal radiographs may help detect late recurrent tumors with intrapelvic calcifications. When any recurrence is found, malignancy should be suspected.

Adenocarcinoma, Mucinous↗
PubMed1992

The effect of luteal support with human chorionic gonadotrophin or progesterone on the daily progesterone profile after different types of ovarian stimulation.

Attempts have been made to increase the low pregnancy rate in in-vitro fertilization (IVF) cycles by luteal phase support with progesterone or human chorionic gonadotrophin (HCG). Previously, this practice has been inconsistent and the results unclear. The detailed effect of support on the progesterone profile in the luteal phase was assessed by daily salivary progesterone measurements in non-conception IVF cycles. The comparison of HCG and progesterone support in two different stimulation protocols showed that the profile of luteal progesterone concentrations was similar in control cycles and those supported with a vaginal progesterone suppository, showing an early decrease by the fourth luteal day. In cycles supported with multiple doses of HCG, the progesterone profile was normal but slightly increased up to the 9th luteal day subsequently falling to basal levels by the fourteenth luteal day.

Chorionic Gonadotropin↗
PubMed1992

Carboplatin and etoposide (CarE) combined with radiotherapy and vincristine, doxorubicin and cyclophosphamide (VAC) in limited small cell lung cancer. A phase II study.

Sixty-eight patients with limited small cell lung cancer were treated between April 1988 and October 1990 with combination carboplatin 450 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 i.v. on days 1-3 (CarE) for two courses, followed by thoracic radiotherapy (TRT) 50 Gy, and then vincristine 1 mg/m2, doxorubicin 50 mg/m2 and cyclophosphamide 750 mg/m2 on day one (VAC) for four courses. Prophylactic cranial irradiation (30 Gy) was given to patients with CR after completion of chemotherapy. Sixty patients (89%) achieved an objective response (40% complete responses). The median time to progression was 8.5 months and median survival time 12.1 months. Predicted one- and two-year survival was 50% and 12% respectively. Myelosuppression was the main toxicity, with WHO grade 3 and 4 leukopenia occurring in 32% of VAC courses. There were 5 (7%) treatment-related deaths, all of them during VAC. We conclude that the present combination is active in terms of response rate, but it did not demonstrate any superiority in survival. The frequency of haematological toxicity was substantial during VAC courses.

Adolescent↗
PubMed1992

The effect of postoperative radiotherapy on leukocyte zinc, serum trace elements and nutritional status of breast cancer patients.

Mononuclear (MNC) and polymorphonuclear cell (PMNC) zinc content was determined together with serum zinc, copper, selenium and iron concentrations in 24 operable breast cancer patients during and after postoperative radiotherapy. Anthropometric and biochemical indices of nutritional status were measured as background data. The measurements were carried out in the years 1987-1988. Nine patients used unconventional multivitamin or trace element preparations. A steady but statistically insignificant decrease in PMNC zinc was seen during treatment. No changes occurred in MNC zinc. Serum copper levels increased in five patients possibly due to tamoxifen treatment, but no other alterations occurred in serum trace element levels. Appetite was well maintained and nutritional status remained unaltered. Postoperative radiotherapy for breast carcinoma had thus no effect on either trace element or nutritional status. Patient-initiated alternative treatments did not significantly affect their trace element levels. This was probably due to small supplementation doses or irregular use of the preparations.

Breast Neoplasms↗
PubMed1991

Discordant levels of serum bioactive LH in man as measured in different in-vitro bioassay systems using rat and mouse interstitial cells and human granulosa-luteal cells.

Serum samples from healthy men (n = 6), perimenopausal women (n = 9) and patients with polycystic ovarian disease (n = 4) were analysed for LH bioactivity by the two widely used in-vitro bioassay systems: the mouse and rat interstitial cell testosterone-formation assays. The results were compared with an assay employing LH-stimulated cyclic AMP production by cultured human granulosa-luteal cells. Average bioactive LH levels in the mouse cell assay were 1.6-fold higher than those measured using the rat assay. A good correlation (r = 0.89, P less than 0.01) was observed between the bioactive LH levels measured by these two assays. No significant difference was found between the sensitivities of the two assays: 0.009 +/- 0.003 IU/l (mean +/- S.E.M., n = 10) with rat cells and 0.011 +/- 0.003 IU/l (n = 10) with mouse cells. The LH level resulting in half-maximal stimulation of testosterone production in the mouse model was twofold higher than that in the rat model (0.185 +/- 0.020 vs 0.083 +/- 0.022 IU/l, P less than 0.01). The bioactive LH levels measured by the human granulosa-luteal cell assay averaged 12% higher than those obtained with the rat assay (r = 0.84, P less than 0.01), but 58% lower than levels measured with the mouse assay (r = 0.86, P less than 0.01). The data indicate that the target cell model used in the in-vitro bioassay of LH contributes to the documented discrepancies in reports on serum levels of bioactive LH.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Carboplatin and etoposide in advanced lung cancer:--a phase I study.

This phase I study was carried out to determine the maximal tolerated dose of carboplatin (Car) together with a fixed dose of etoposide (E) and to recommend the optimal dose for a phase II study. The dose of E was 100 mg/m2 given i.v. on days 1-3, and the starting dose of Car was 200 mg/m2 given i.v. on day 1. The dose was escalated until WHO grade 4 toxicity developed after two treatment cycles in more than one-third of the patients. A total of 33 patients with advanced lung cancer entered the trial. The maximal tolerated toxicity of the combination was reached at a dose of 500 mg/m2 Car. Myelosuppression was moderate, and hematological toxicity of WHO grade 4 was encountered in one of five patients at 475 mg/m2 and in two out of five patients at 500 mg/m2. The main toxic effects were leucopenia and thrombocytopenia. The frequency of treatment-related infections was low and no deaths were caused by treatment. There was a significant overall correlation between the platelet nadir and creatinine clearance. One complete response and three partial responses were achieved after two treatment cycles. Based on the results of the present study, the dose of carboplatin (combined with 100 mg/m2 eposide given on days 1-3) recommended for phase II studies is 450 mg/m2.

Adult↗
PubMed1990

Vincristine, doxorubicin and cyclophosphamide with and without etoposide in limited small cell lung cancer.

A total of 80 patients with limited disease of small cell lung cancer were randomized to receive either vincristine 1 mg/m2 (max. 2 mg), doxorubicin 50 mg/m2 and cyclophosphamide 750 mg/m2 (VAC) i.v. on day 1, or the same drugs and etoposide 80 mg/m2 i.v. daily for 3 days (VACE) every 3 weeks for nine courses. Chest irradiation was given in both regimens after the second course. The response rate was 84% for VAC (41% complete responses) and 75% for VACE (46% complete responses). The median survival time was 10 months with VAC regimen, and 14 months with VACE (difference statistically not significant). The median duration of remission was 8 months with VAC and 14 months with VACE (p = 0.03), and the median survival for complete or partial responders was 12 months and 20 months respectively (p = 0.006). Myelosuppression was significantly greater in the VACE group, and there was one treatment related death in the group receiving VACE. In this study the addition of etoposide to VAC improved the duration of response, but did not lead to longer survival of patients with limited disease of small cell lung cancer.

Adult↗
PubMed1990

Survival and esophageal passage after radiotherapy of inoperable esophageal carcinoma. A retrospective study of 106 cases.

Survival and esophageal passage were studied retrospectively in 106 patients with inoperable esophageal carcinoma treated with radiotherapy during the years 1972 to 1983. The survival rates were 30%, 13% and 7% at one, two and three years respectively. The survival rate for the female patients was significantly better than for the males throughout these three years; 9% of the female patients lived for three years compared to only 3% of the male patients. Forty-two percent of the patients received 'radical' irradiation (greater than 50 Gy). The 3-year survival rate was 16% after a tumor dose of 50 Gy or more, and zero with a dose less than 50 Gy, but this difference might be explained by selection factors, such as patients in poor general condition not receiving 'radical' irradiation. Esophageal passage after radiotherapy could be evaluated in 62 patients, and 22 (35%) of them required feeding gastrostomy due to esophageal discontinuity, most often within one year after completion of radiotherapy. It is concluded that radiotherapy has only a slight effect on the prognosis of inoperable esophageal carcinoma.

Adenocarcinoma↗
PubMed1988

Inoperable non-small cell lung cancer: radiation with or without chemotherapy.

We report a randomized multicentre study of split-course radiotherapy (RT), with or without combination chemotherapy (CT), in 238 patients with inoperable non-small cell lung cancer (NSCLC), previously untreated, confined to one hemithorax and the mediastinal nodes. In both treatment groups RT consisted of 55 Gy in 20 F given over 7 weeks with a 3-week rest interval. CT consisted of the 3-drug regimen CAP: C = cyclophosphamide 400 mg/m2, A = adriamycin 40 mg/m2, P = cisplatin 40 mg/m2; 2 cycles of CAP given before RT, one during the rest interval and six after RT. Seventy per cent in the RT arm and 67% in the RT-CT arm had epidermoid carcinoma. No significant difference was apparent between the RT and the RT-CT arms with respect to objective response rates (CR + PR) (44 and 49%, respectively), median duration of response (278 and 320 days), local failure (31 and 20%), distant progression (23 and 20%) or median survival (311 and 322 days). The survival figures showed an almost significant (P = 0.05) therapeutic advantage of the combined regimen with stage IIIM0 disease. Progressive disease was the cause of death in 92% and 88%. We conclude that chemotherapy did not contribute significantly to either local control or survival as compared to radiotherapy alone.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Progesterone support of the luteal phase in in vitro fertilization program--a hazard?

To study the effect of progesterone support of the luteal phase in a stimulated cycle a subgroup of our IVF patients was treated with progesterone vaginal suppositoria. The treatment was initiated on the aspiration day. There was no significant difference in the pregnancy or abortion rate between the control group and the gestagen therapy group. However, it seems that progesterone support may increase the pregnancy rate but also the rate of spontaneous abortion. This suggests that the effective and early started progesterone supplementation of the luteal phase may cause the implantation of abnormal nonviable embryos.

Abortion, Spontaneous↗
PubMed1986

Fatal necrosis of the liver during ABVD chemotherapy for Hodgkin's disease. A case report.

A case of massive fatal liver necrosis during chemotherapy for stage IVA Hodgkin's disease is described. A previously healthy 50-year-old male was given doxorubicin 25 mg/m2, bleomycin 10 mg/m2 and vinblastine 6 mg/m2 on days 1 and 14 of the cycle combined with dacarbazine 150 mg/m2 on days 1-5 (ABVD) with 4-week intervals. During the fourth cycle of chemotherapy the patient developed fatal liver necrosis with anuria and uncontrolled bleeding. At autopsy, 80% of the liver was necrotic and viable cells were seen only in periportal areas. Dacarbazine may have caused the necrosis. Liver necrosis caused by drugs should be considered if unexplained hepatomegaly and a rise in serum liver enzyme levels is noted during ABVD treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Problems and benefits in early diagnosis of ectopic pregnancy.

A 5-yr retrospective study is presented of 168 consecutive patients operated on for ectopic pregnancy during 1977-1981, showing the prevalent features and trends of this disorder and its diagnosis. The overall incidence was 1.48% of deliveries, with a range of 1.00-2.34%. The number of unruptured cases (52.1%) in the series reflects the low gestational age. Some of the problems (and benefits) commonly associated with early diagnosis are surveyed. The presenting symptoms at arrival are compared between patients with an IUD in situ (33.3%) and those without, and between patients with a delay in diagnosis (47.6%) and those without. The use and the results of the diagnostic procedures are also compared between the latter two groups. An absence of clear amenorrhoea was significantly more common (P less than 0.005) in IUD-users than in non-users. Spotting was almost significantly more common (P less than 0.025) among patients with a delayed diagnosis than in those who underwent an operation on the first day seen. It is shown that patients whose diagnosis was delayed had had significantly more often either curettage (P less than 0.001) or an ultrasound examination which (in spite of a positive pregnancy test) did not show an intrauterine pregnancy (P less than 0.005) than those whose diagnosis was not delayed. It is emphasized that the physician should be on the alert in excluding the possibility of ectopic pregnancy in IUD patients and suspected spontaneous and threatened abortions, especially. In such cases an active laparoscopy is again recommended.

Abortion, Threatened↗
PubMed1984

Intrapleural endodermal sinus tumor arising from the diaphragm.

We report a primary endodermal sinus tumor (EST) of the right hemidiaphragm, presenting as a right-sided hemothorax in an 18-month-old female. Four operations were performed, the last three being indicated solely by an elevated level of serum alpha-fetoprotein (AFP). Cyclic chemotherapy with varying drug combinations together with irradiation therapy were not effective in controlling the disease. To our knowledge, this is the first instance of a primary EST arising from the diaphragm.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

External endometriosis in 801 operated patients.

Details of medical history, symptomatology, operative findings and certain other special features are reported for patients with external endometriosis treated operatively during the period 1969-76. The incidence of endometriosis in this survey was 19% of all gynecological laparotomies. The mean age of the patients at the time of the operation was 36.7 years. The most common sites of endometriosis were the retrocervix and the ovaries. Of the patients, 559 (70%) had complained of dysmenorrhea; the pain generally began before the bleeding. Also typical was the exacerbation of the pain with increasing age. Twenty-seven per cent of the patients also complained of infertility. Surgery was performed because of acute abdominal symptoms in 6% of cases. The incidence of endometriosis in postmenopausal women was 2.5% and that in young women, 1%. Endometriosis recurred in 15% of the cases during the follow-up period. Gestagen therapy after the operation had no effect on the recurrence rate.

Adult↗
PubMed1982

Ovarian function during and after curative intracavitary high dose-rate irradiation: steroidal output and morphology.

The endocrinological function of the ovary during and after curative intracavitary high dose-rate irradiation has been studied by determining the peripheral plasma levels of P, E1, E2, FSH, LH and PROL in 8 patients aged 37 +/- 7 yr (+/- SD). In addition, the concentrations of E1 and E2 in ovarian venous blood during the estimated ovulatory phase after irradiation were determined. The functional structure of the ovary was studied histochemically using 3 beta-hydroxysteroid dehydrogenase (HSD) and ultrastructurally and histologically with routine methods. The results during and after irradiation were compared to those before irradiation. In addition, 28 postmenopausal patients were used as controls. At the end of the irradiation course, which lasted from the premenstrual to the ovulatory phase, 3 out of 4 patients with cervical carcinoma had normal plasma P levels; the menstrual cycles of these patients was previously ovulatory. The normal P levels as well as a rise in E1 and E2 concentrations indicate ovulation. During the next menstrual cycle these values and the E2/E1 ratio in peripheral venous blood decreased and the levels of FSH and LH rose to the postmenopausal values. In patients with endometrial carcinoma, the menstrual cycle was anovulatory both before and after radiotherapy; in estrogen and gonadotrophin levels, similar changes were observed as in patients having ovulatory cycles. In ovarian venous blood, the E2 plasma levels and the E2/E1 ratios were in both groups significantly higher at the time of the second potential ovulatory phase than the corresponding postmenopausal values. As in the postmenopausal women, both E1 and E2 levels in irradiated patients were higher in ovarian effluent blood than peripherally. The ovarian/cubital E1 ratios did not differ between these groups. For E2, this ratio was, however, significantly higher in irradiated patients than in postmenopausal controls. The morphological findings--both by light and electron microscopy--as well as the enzyme-histochemical studies support the chemical results reflecting a decreased yet significant estrogen production in the ovaries after irradiation.

Adult↗