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Biomedical subjects

W Holtkamp

Publications and source records attributed to W Holtkamp.

31 records · Page 2Linked to original sources
PubMed1988

[Pathophysiology of hyperprolactinemia in breast cancer].

To characterize the prolactin secretion in human breast cancer, plasma prolactin levels were measured in 514 patients with breast cancer in long term follow-up studies. In hyperprolactinemic patients suppression and stimulation tests were performed and the 24-h secretion profile was recorded. Tissue extracts and sera of hyperprolactinemic breast cancer patients were incubated with cultured pituitary cells in vitro to detect a prolactin releasing activity in these specimens. 44% of breast cancer patients developed hyperprolactinemia in the course of the disease. In 35% of measurements hyperprolactinemia was induced by non tumor related causes, e.g. prolactin-stimulating drugs, surgery, uremia, prolactinoma. Excluding such influences on the prolactin level, hyperprolactinemia over 1,000 mU/l was almost only found in patients with progressive metastatic disease. In these patients hyperprolactinemia was associated with tumor load, but not correlated to BSR, CEA or prognostic factors. Hyperprolactinemia in breast cancer was not of paraneoplastic origin. No prolactin-releasing activity was detected in tumor tissue and sera of hyperprolactinemic breast cancer patients.

Breast↗
PubMed1988

[Bromocriptine in chemotherapy-resistant, metastatic breast cancer. Results of the GO-MC-BROMO 2/82 AIO Study].

In a case report a patient with metastatic breast cancer, who had chemotherapy resistance and hyperprolactinemia, showed a tumor remission following suppression of elevated prolactin levels with bromocriptine. Based on this observation, 18 patients with progressive metastatic breast cancer, chemotherapy resistance and hyperprolactinemia were treated with 10 mg bromocriptine/day in a prospective study. This treatment was in addition to chemotherapy, which was continued for 8 weeks in spite of progressive disease. In all patients, elevated prolactin levels (arithmetic mean 1388 +/- 201 mU/l before treatment) were suppressed to values under 100 mU/l. A partial remission was observed in one single patient which was not clearly attributed to suppression of plasma prolactin levels, but to delayed tumor remission. Side effects, mainly gastrointestinal disorders, were observed in all patients during therapy. In 6/18 patients treatment had to be stopped before end of study due to intolerable nausea and vomiting. It is concluded that suppression of elevated prolactin levels in progressive metastatic breast cancer patients is not effective in restoring tumor sensitivity to chemotherapy.

Breast Neoplasms↗
PubMed1988

[Stimulation of prolactin secretion with thyroliberin (TRH). In vivo and in vitro studies of metastatic breast cancer].

In 120 Patients with metastatic breast cancer prolactin stimulation tests with 200 mcg TRH i.v. were done. The mechanism of the TRH-induced prolactin release was characterized in vitro. Basal prolactin levels were stimulated in all patients with an average increase of 400% (means basal level 441 mU/l, after stimulation 1753 mU/l). Hyperprolactinemic patients showed the highest absolute prolactin levels following stimulation. Patients with basal prolactin levels under 500 mU/l showed the highest relative increase of prolactin levels (delta = 550%). The prolactin stimulation tests with TRH had no diagnostic advantage compared to the basal prolactin levels in predicting the activity of the disease (basal values: sensitivity 12%, specificity 100%, stimulated values: sensitivity 10%, specificity 99%). During inhibition of plasmaprolactin with bromocriptine, an 330% increase of plasmaprolactin following TRH was observed in vivo. The same was shown in vitro: Pituitary cells cultured in vitro with 10(-6) M dopamine showed an increase of prolactin secretion after coincubation with 10(-7) M TRH. There was a linear increase of the prolactin concentration during the incubation period in dopamine-free cell cultures. The increase of prolactin concentration in vitro was constant during the whole incubation period (5 h), not influenced by the basal prolactin concentration and was seen as early as 30 min in incubation. The in vivo and in vitro results are in agreement with the hypothesis of a rapid, dopamine-independent effect of TRH on the secretion of stored prolactin in the pituitary.

Breast Neoplasms↗
PubMed1986

[Metergoline in hyperprolactinemic breast cancer: a phase II study].

The prolactin release inhibiting action of the dopamine receptor agonist metergoline was investigated in 16 patients with metastatic breast cancer associated with hyperprolactinemia. At a daily dose of 12 mg p.o. for 30 days, the drug was highly effective in lowering prolactin levels (day 0: 1076 +/- 171, day 29: 249 +/- 46 mU/l) in these patients. Starting treatment with 4 mg/day, the side effects of the treatment were mild, including dizziness and nausea.

Breast Neoplasms↗
PubMed1984

Hyperprolactinemia is an indicator of progressive disease and poor prognosis in advanced breast cancer.

In a long-term follow-up study, prolactin levels were measured in 149 patients with advanced metastatic breast cancer. Control groups included 221 patients with primary operable breast cancer and 150 women with benign breast disease. Hyperprolactinemia (greater than 1,000 mIU/I; HYPRL) occurs in 44% of patients with metastatic breast cancer in the course of the disease (p less than 0.001 compared to patients with non-metastatic disease). HYPRL is associated with progressive breast cancer in 88% of cases. In patients experiencing several episodes of disease remission and relapse, incidence of HYPRL increases with each relapse. Prolactin blood levels return to normal if hyperprolactinemic patients experience remission after chemotherapy. Patients expressing HYPRL have a shorter survival time after mastectomy when compared to patients who never developed HYPRL (154/89 months, p = 0.01). It is concluded that HYPRL is of prognostic significance and a reliable indicator of progressive disease in advanced metastatic breast cancer.

Breast Diseases↗
PubMed1984

Resistance of tumour cells to chemotherapy: importance of host defence factors.

The arguments favouring the hypothesis that chemotherapeutic agents might act in cooperation with host defence mechanisms are reviewed briefly. In patients with far advanced solid tumours plasma factors blocking in vitro immune reactions have been identified and successfully removed by immune adsorption or plasma exchange. By plasmapheresis performed in patients with metastatic malignancies resistant to chemotherapy it was possible to induce tumour regressions. In 25/28 patients responding to the combined plasmapheresis/chemotherapy procedure a positive correlation was found to clinical results and patterns of plasma-blocking factor activities.

Adult↗
PubMed1983

[Plasma-prolactin concentrations in breast cancer at various stages, in mastopathy and other malignant tumors].

7% of 204 patients with metastatic breast cancer had hyperprolactinemia (greater than 1000 mIU/1 = 30.8 ng/ml) in the measurements of morning plasma prolactin basal levels. The incidence of hyperprolactinemia was significantly higher in patients with metastatic breast cancer than in 173 patients with non-metastatic breast cancer (p less than 0.001), in 151 patients with mastopathy (p = 0.01), in 63 patients with local (p = 0.001) and 56 patients with advanced solid tumors of different histology without prolactin stimulating medication (p = 0.001). After 5 measurements with a median interval of 2 months, elevated prolactin levels over 1000 mIU/l were found at least once in 35% of the patients with metastatic breast cancer. 93% of the women with hyperprolactinemic breast cancer were in progression at the time of the measurements, and none in remission; on the other hand, all patients with advanced breast cancer in remission had normal prolactin levels.

Adult↗
PubMedDate not supplied

[Gaucher disease and pregnancy].

Two pregnancies in a patient with Gaucher's disease type I are reported. Anemia and thrombocytopenia were augmented during pregnancy, but no effect on the spleen and liver was observed. The first delivery was associated with a severe post partum haemorrhagia (platelet count 56,000/mcl, hemoglobin before delivery 10.2 g/100 ml, postpartum 5.5 g/100ml). At the end of the second pregnancy the platelet count was 33,000/mcl. Platelet transfusions were given after induction of preterm labor and no bleeding complications were observed. The obstetric aspects of Gaucher's disease are reviewed. Post partum haemorrhagia is associated with thrombopenia and is observed in patients with platelet counts under 100,000/mcl. Platelet infusions are recommended before delivery in these patients. Thrombocytopenic patients should be carefully monitored during labor with crossmatched blood on standby.

Adult↗
PubMedDate not supplied

Mastectomy stimulates prolactin release in breast cancer patients.

Hyperprolactinaemia has been described to occur after mastectomy in breast cancer patients, but whether it may be the result of surgery or breast cancer is particularly unknown. Plasma prolactin levels were measured in 51 patients one day before, and 1, 7, 30, and 180 days after mastectomy (23 primary breast cancer patients), tumourectomy (10 patients with benign or malignant breast lesions), and cholecystectomy (18 patients with cholelithiasis). Elevated prolactin levels were found on the 7th and 30th postoperative day in mastectomized and laparotomized patients, but not in patients who underwent tumourectomy of benign or malignant breast lesions (p less than 0.01). The prolactin levels were in the normal range one day before and again 180 days after surgery in all patients. We conclude, therefore, that postoperative hyperprolactinaemia in breast cancer patients is a result of surgery rather than the disease.

Adult↗