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Biomedical subjects

H S Koops

Publications and source records attributed to H S Koops.

At least 55 records · Page 3Linked to original sources

FDG-PET to evaluate response to hyperthermic isolated limb perfusion for locally advanced soft-tissue sarcoma.

UNLABELLED: We investigated FDG-PET in patients undergoing hyperthermic isolated limb perfusion (HILP) with rTNF-alpha, rIFN-gamma and melphalan for locally advanced soft-tissue sarcoma of the extremities. METHODS: Twenty patients (11 women, 9 men; aged 18-80 yr, mean age 49 yr) were studied. FDG-PET studies were performed before, 2 and 8 wk after HILP. After the final PET study, the tumor was resected and pathologically graded. Patients with pathologically complete response (pCR) showed no viable tumor after treatment. Those with pathologically partial response (pPR) showed various amounts of viable tumor in the resected specimens. RESULTS: Seven patients showed a pCR (35%) and 12 patients showed a pPR (60%). In one patient, pathological examination was not performed (5%). The pre-perfusion glucose consumption in the pCR group was significantly higher than in the pPR group (p<0.05). Visual analysis of the PET images after perfusion showed a rim of increased FDG uptake around the core of absent FDG uptake in 12 patients. The rim signal contained a fibrous pseudocapsule with inflammatory tissue in the pCR group, viable tumor was seen in the pPR group. The glucose consumption in the pCR group at 2 and 8 wk after perfusion had decreased significantly (p<0.05) in comparison to the glucose consumption in the pPR. CONCLUSION: Based on the pretreatment glucose consumption in soft-tissue sarcomas, one could predict the probability of a patient achieving complete pathological response after HILP. FDG-PET indicated the pathological tumor response to HILP, although the lack of specificity of FDG, in terms of differentiation between an inflammatory response and viable tumor tissue, hampered the discrimination between pCR and pPR.

Adolescent↗

Aggressive fibromatosis (non-familial desmoid tumour): therapeutic problems and the role of adjuvant radiotherapy.

Aggressive fibromatosis is a rare soft tissue tumour with a high tendency to local recurrence, even after apparently adequate resection. Wide local excision with a margin of at least 3 cm, depending on the anatomical location, should be performed to improve rates of recurrent disease. There is no consensus concerning the role of radiotherapy in the treatment of these lesions. The clinical findings of 39 cases diagnosed between 1972 and 1991 were reviewed retrospectively. Local control was effected in 19 of 32 patients treated with surgery alone after a median (range) follow-up of 72 (18-236) months. There were 40 cases of recurrent fibromatosis in 15 patients. Local control was obtained in 13 of 14 patients who received radiotherapy using a wide-field technique and doses of more than 50 Gy over a period of 5 weeks after marginal or incomplete resection of primary or recurrent lesions (P < 0.001). The results suggest that in a selected group of patients with aggressive fibromatosis radiotherapy may effectively achieve control of residual disease after surgery without marked disfigurement and loss of function.

Adult↗

Dacarbazine (DTIC)-based chemotherapy or chemoimmunotherapy of patients with disseminated malignant melanoma.

Combinations of dacarbazine (DTIC) and other cytotoxic agents or alpha-interferon were given to 136 patients in five different regimens. The total response rate was 32% (95% confidence interval 24-40%); 13% had a complete remission. Female patients had a significantly higher chance of response than male patients: 46% vs 23%. There was also a difference in complete response rate: 25% vs 9%. The overall survival was 6 months; 8% of patients had a response of more than 6 months and 2% of more than 2 years. Although response rates vary among the various regimens described in the literature, the complete response rates are quite similar and the long-term disease-free survival of these combinations may be similar to that of dacarbazine alone.

Adolescent↗

Serum lactate dehydrogenase isoenzyme 1 activity in patients with testicular germ cell tumors correlates with the total number of copies of the short arm of chromosome 12 in the tumor.

The aim of our study was to assess the relationship between the serum lactate dehydrogenase isoenzyme 1 (S-LDH-1) activity in patients with testicular germ cell tumors and the number of copies of the short arm of chromosome 12 (12p) present in tumor. Twenty-seven adult patients with measurable tumor lesions were studied. Twenty-five had three or more copies of chromosome 12 per cell in the tumors. Nineteen had one or more copies of a specific chromosomal abnormality, an isochromosome of the short arm of chromosome 12, i(12p). Fourteen had increased S-LDH-1 levels. S-LDH-1 activity correlated significantly with the product of total tumor volume and the total number of copies of the short arm of chromosome 12 present per cell (total tumor 12p). We conclude that the total number of copies of the short arm of chromosome 12 in the tumors is most probably a factor contributing to the LDH-1 activity released from the tumors.

Adult↗

Chromosomal changes in human primary testicular nonseminomatous germ cell tumors.

A cytogenetic analysis of 14 primary testicular nonseminomatous germ cell tumors has been carried out after short term tissue culture. The modal chromosome numbers ranged from 53 to 113, in agreement with flow cytometric determination of the DNA content of the tumors. At least one copy of an i(12p) was present in 12 tumors. Two tumors, however, lacked that marker. Some chromosomes are apparently overrepresented, whereas others are underrepresented, although some differences between seminomas and nonseminomas were noticed.

Analysis of Variance↗

Malignant hemangiopericytoma in three kindred members of one family.

Three cases of malignant hemangiopericytoma in one family are reported. To our knowledge familial occurrence of malignant hemangiopericytoma has not been described before. Two of these lesions occurred in the head and neck region and one case presented as an intraabdominal tumor. Consanguinity of the parents seems to be likely, suggesting an autosomal recessive mode of inheritance in our family, whereas the similarity in age of onset in these three patients was apparent.

Adult↗

Chemotherapy with maximally tolerable doses of VP 16-213 and cyclophosphamide followed by autologous bone marrow transplantation for the treatment of relapsed or refractory germ cell tumors.

Eleven patients with advanced nonseminomatous germ cell tumors (NSGCT), who relapsed after or were refractory to standard dose cisplatin-based remission induction chemotherapy, were treated in a phase II clinical trial with VP 16-213 2500 mg/m2 and cyclophosphamide 7 g/m2. Both drugs were given in maximally tolerable doses regarding extramedullary toxicity. Urothelial damage due to cyclophosphamide was prevented by the administration of mesnum. Autologous bone marrow was infused on day 7 to prevent long lasting medullary toxicity. Because of the disappointing results in the first three patients, a second treatment step was added. The next eight patients were treated with 2500 mg/m2 VP 16-213 divided and given on days 1-2-3 and after full bone marrow recovery with total doses of VP 16-213 2000 mg/m2 plus cyclophosphamide 7 g/m2 divided and given on days 29-30-31, followed by autologous bone marrow transplantation (ABMT) on day 35. Toxicity to high-dose VP 16-213 plus cyclophosphamide followed by ABMT consisted of mucositis, nausea, vomiting and diarrhea. No cardiac toxicity or hemorrhagic cystitis occurred. The mean duration of leukopenia and thrombopenia was 14 and 13 days respectively. The additional, preceding treatment with VP 16-213 as a single agent caused mucositis, and leukopenia and thrombopenia for a mean number of 9 and 6 days respectively. Seven responses were obtained: two complete responses of 46 and 66+ weeks respectively and five partial responses with a median response duration of 12 weeks. The median survival time was 40 weeks. This regimen of one or two courses with maximally tolerable doses of VP 16-213 plus cyclophosphamide and ABMT is not sufficient to salvage a substantial number of patients with relapsing or refractory NSGCT.

Antineoplastic Combined Chemotherapy Protocols↗

Natural course of bleomycin-induced pneumonitis. A follow-up study.

In this study, long-term pulmonary complications of bleomycin were evaluated in 8 patients with bleomycin-induced pneumonitis (BIP). The lung function parameters: VC, alveolar volume, transfer factor for carbon monoxide of the lungs, diffusing capacity of the alveolocapillary membrane, and pulmonary capillary blood volume were studied in all patients for as long as 2 yr after the development of BIP. Perfusion scans with 133Xe and 99mTc were performed in these patients 2 yr after BIP developed. We concluded that if a patient survives the acute event of BIP, the pulmonary symptoms and the changes in these lung function parameters are completely reversible.

Adult↗

Treatment of retroperitoneal residual tumor after PVB chemotherapy of nonseminomatous testicular tumors.

Twenty-five patients with nonseminomatous testicular tumors stages IIB and IIC were treated at the Groningen University Hospital between January 1978 and April 1983. One patient died from his extensive tumor during chemotherapy. The remaining 24, treated by combination chemotherapy with cisplatin, vinblastine, and bleomycin as well as by surgery, are all alive after a mean follow-up period of 56 months. A laparotomy was performed after chemotherapy in each of the 24 cases. In four patients no residual tumor was found. Residual tumor was resected in 20 patients, in 13 the tumor contained only necrosis and fibrosis, 7 had mature teratoma. Comparison of the histologic features of the primary testicular tumor with those of the retroperitoneal residual tumor after chemotherapy, revealed that if the primary tumor did not contain a teratoma component the residual tumor showed only necrosis and/or fibrosis. When the primary tumor contained a teratoma component, mature teratoma was found in 50% (7/14) of the residual tumors.

Antineoplastic Combined Chemotherapy Protocols↗

Karyotyping and DNA flow cytometry of mature residual teratoma after intensive chemotherapy of disseminated nonseminomatous germ cell tumor of the testis: a report of two cases.

Karyotyping and DNA flow cytometry was performed on mature residual teratoma cells following intensive chemotherapy of disseminated nonseminomatous germ cell tumor of the testis to study its biology. We report herein a successful method for short-term tissue culture and karyotyping of retroperitoneal residual mature teratoma in two cases. In vitro morphology confirmed that the cultured cells were nonembryonal carcinoma cells. Both mature residual teratomas were highly aneuploid and possessed the i(12p) marker characteristic of testicular germ cell tumors. A clone in the retroperitoneal residual lesion of one of the patients showed a DNA-index different from the primary tumor and might represent a clone unmasked by chemotherapy. In view of these data, which are in agreement with recent reports on secondary non-germ cell malignancies arising in mature residual teratoma, aggressive surgery of mature residual lesions seems justified.

Adult↗

Phase II study of bleomycin, actinomycin D, DTIC and vindesine in disseminated malignant melanoma.

Twenty-seven patients with disseminated malignant melanoma were treated with combination chemotherapy consisting of bleomycin, actinomycin D, DTIC and vindesine. There were 4 complete responses in patients with pulmonary metastasis, 5 patients had a partial remission, 2 of them had mainly lung lesions. Toxicity consisted mainly of leuco- and thrombocytopenia of short duration and sporadic severe mucositis.

Adult↗

Eumelanin-related indolic compounds in the urine of treated melanoma patients.

A method was developed for the quantitation of six eumelanin-related indolic compounds in urine. The procedure employs methane ionization of the hexafluoroisopropyl and/or pentafluoropropionyl derivatives of 5,6-dihydroxyindole, 5-hydroxy-6-methoxyindole, 6-hydroxy-5-methoxyindole, 5-hydroxy-6-methoxyindolyl-2-carboxylic acid, 6-hydroxy-5-methoxyindolyl-2-carboxylic acid and 5,6-dimethoxyindolyl-2-carboxylic acid together with their deuterated analogues, and selected ion-monitoring. Deuterated analogues are added as internal standards to enzymatically hydrolysed urine before diethyl ether extraction. The method was used for monitoring urinary excretion in patients with malignant melanoma treated with cytostatics. In several cases, a decrease of the excretion of the eumelanin-related substances was recorded after the therapy. The usefulness of the individual indolic compounds for such follow-up studies is discussed.

Gas Chromatography-Mass Spectrometry↗

Improved tissue perfusion during pressure regulated hyperthermic regional isolated perfusion. A clinical study.

In previous studies on isolated hindlimb perfusions in dogs, the authors proved that the extracorporeal circuit should be regulated at a delta pressure (systemic mean arterial pressure minus hindlimb mean arterial pressure) of not more than 15 mmHg, to achieve adequate tissue perfusion. To confirm this in patients the authors performed clinical perfusions, divided into three groups. In group I and II the extracorporeal circuit was regulated at a delta pressure of 15 mmHg and 50 mmHg, respectively. In group III perfusions were performed using the common technique of a predetermined fixed flow. Tissue oxygenation, determined by means of a transcutaneous pO2 electrode, was adequate in group I and was severely impaired in group II and III. Although in group I high perfusion flows were needed, leakage was less than 10%. To achieve adequate tissue perfusion during clinical regional perfusions, the extracorporeal circuit must be regulated at a delta pressure of 15 mmHg.

Adult↗

Van Buchem's disease and aneurysmal bone cyst. A case history.

A patient suffering from Van Buchem's disease combined with an aneurysmal bone cyst in the para-acetabular region is described. The extreme rarity of both the primary disease and its combination with an aneurysmal bone cyst is discussed with respect to the clinical, radiological, and laboratory features.

Acetabulum↗

Serum ferritin determinations are of no value in the management of patients with disseminated non-seminomatous germ cell tumors.

In this study the clinical significance of serum ferritin (SF) determinations was evaluated in patients with disseminated non-seminomatous germ cell tumors (NSGCT). The SF levels during the presence of active tumor but before institution of combination chemotherapy (cis-platinum, vinblastine and bleomycin, PVB) were within the normal limits in 38/47 NSGCT patients. During PVB treatment peaking SF levels were observed in relationship to the drug administration, whereas alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) serum levels decreased continuously. Other drugs also caused temporary increases in SF levels. Tumor recurrence was not recognized by SF increases in all eight patients tested. Based on the results we conclude that serial SF determinations are of no value in monitoring patients with NSGCT.

Adult↗