Biomedical subjects

H Schraffordt Koops

Publications and source records attributed to H Schraffordt Koops.

At least 127 records · Page 7Linked to original sources

PubMed1989

Chromosomal changes in mature residual teratomas following polychemotherapy.

A cytogenetic analysis of 13 mature residual teratomas following chemotherapy revealed modal chromosome numbers ranging from 52 to 85, in agreement with the flow cytometric determination of the DNA content of the tumors. At least one copy of an i(12p) was present in 12 tumors. One tumor, however, lacked that marker. The comparison between the chromosomal abnormalities found in mature residual teratomas following chemotherapy and those from primary testicular nonseminomas suggests that residual teratomas result from selection of clones from the primary tumor with a less abnormal karyotype.

Adult↗

PubMed1989

Cytogenetic analysis of ten human seminomas.

A cytogenetic analysis of ten seminomas has been carried out after direct harvesting of the tumor cells. Modal chromosome numbers ranged from 63 to 112. These numbers were in agreement with flow cytometric determination of the DNA content of the tumors. Eight tumors had at least one copy of an i(12p) among other chromosomal abnormalities. Two seminomas lacked the i(12p).

Adult↗

PubMed1989

Hyperthermic isolated regional perfusion in the treatment of extremity melanoma in children and adolescents.

From 1973 to 1982 six children and eight adolescents with extremity melanomas were treated by local excision and adjuvant hyperthermic isolated regional perfusion with Melphalan (L-phenylalanine mustard, manufactured by Burroughs Wellcome Company, Research Triangle Park, NC). The median Breslow thickness of the melanomas was 2.7 mm (range, 1 to 15 mm). According to the M.D. Anderson classification, nine patients were in Stage IA and five were in Stage IIIB. The median follow-up period was approximately 10 years. Distant metastases developed in three patients (21%) (one patient was in Stage IA [11%] and two patients were in Stage IIIB [40%]). In two cases the development of distant metastases was preceded by local recurrence (14%). The 5-year survival rate was 93%. The 10-year survival rate was 81%. The high survival rate, even for patients with unfavorably thick melanomas, seems to be attributable to isolated regional perfusion.

Adolescent↗

PubMed1989

A combination of intraarterial chemotherapy, preoperative and postoperative radiotherapy, and surgery as limb-saving treatment of primarily unresectable high-grade soft tissue sarcomas of the extremities.

The localization and size of a high-grade soft tissue sarcoma of an extremity are generally the limiting factor in limb-saving surgery. Since 1982 nine patients with a high-grade soft tissue sarcoma of an extremity, which usually requires amputation, have been treated by intraarterial chemotherapy, preoperative and postoperative radiotherapy, and surgery. The limb was saved in eight patients (89%). During a median follow-up of 24 months (mean follow-up 32 months, range 12 to 64 months) one local recurrence and four distant metastases were diagnosed. Three patients developed complications due to the intraarterial chemotherapy, a motor and sensory neuropathy of the sciatic nerve was diagnosed in one patient, and two patients developed a flexion contracture of the knee. The results obtained in this small series show that the combination of intraarterial doxorubicin, preoperative and postoperative radiotherapy, and surgery is feasible in limb-saving treatment of primarily "unresectable" high-grade soft tissue sarcomas of the extremities without increasing the risk of a local recurrence.

Adult↗

PubMed1989

Isolated regional perfusion in the treatment of subungual melanoma.

Subungual melanoma is rare and represents only 1% to 3% of all diagnosed melanomas in Western countries. The tumor is frequently mistaken for a benign lesion and the delay in diagnosis and final treatment may be responsible for the high local recurrence rate and the low disease-free survival rate. From 1965 to 1982 the combined-modality therapy of amputation and adjuvant isolated regional perfusion with melphalan with or without dactinomycin was used in the treatment of 22 patients with subungual melanoma. Disease was staged according to the M. D. Anderson classification, as follows: stage I (primary melanoma), 11 patients; stage IIIA (in-transit metastases and/or satellitosis), three patients; stage IIIB (regional lymph nodes), seven patients; and stage IIIAB (in-transit metastases and/or satellitosis and regional lymph nodes), one patient. There were no cardiovascular complications and no treatment mortality. During a follow-up of at least 4.5 years, 12 patients (55%) developed distant metastases, including four patients with stage I disease (36%) and eight patients with stage III disease (73%). There were no locoregional recurrences. The median survival was three years (range, 0.5 to 12.5 years) and the overall five-year survival was 40%, with 56% of patients having stage I disease and 27% having stage III disease. The prognosis of subungual melanoma is determined by the stage of the disease. Isolated regional perfusion may prolong disease-free survival in patients with subungual melanoma compared with previously published data.

Adult↗

PubMed1989

Megaprostheses in the treatment of primary malignant and metastatic tumors in the hip region.

Twenty patients with malignant bone tumors of the hip region were treated surgically by resection and reconstruction with an endoprosthesis. Histologic types included five primary bone tumors and 15 metastatic lesions. At review four primary bone tumor patients are still alive without evidence of disease. The length of the observation period varied from 26 to 104 months. Eleven patients with metastatic bone disease died. The average postsurgical survival time was 23 months. All patients were able to walk with or without a cane. Failure of an endoprosthesis occurred in one case. According to the Enneking Evaluation System 11 patients had a good and 9 a fair result.

Adolescent↗

PubMed1989

Phase II study of bleomycin, dacarbazine (DTIC) and vindesine in disseminated malignant melanoma.

Thirty-one patients with disseminated malignant melanoma were treated with a combination chemotherapy of bleomycin, dacarbazine and vindesine. Five complete responses, and five partial remissions occurred. One patient survived for over 2 years without evidence of disease. This combination of drugs may give better results, as far as complete recovery and long-term survival are concerned, than single-agent therapy with dacarbazine.

Adult↗

PubMed1989

A malignant mixed gonadal stromal tumor of the testis with heterologous components and i(12p) in one of its metastases.

A malignant mixed gonadal stromal tumor with mesenchymal heterologous elements of the testis is presented. This entity has been described in the ovary, but not hitherto in the testis. Karyotyping and ploidy measurement was done of the primary tumor and of an inguinal and lung metastases. The DNA ploidy and modal chromosome numbers were in agreement with each other in all samples. The most significant cytogenetic finding was the presence of the metacentric germ cell tumor marker i(12p) in an inguinal metastasis. This marker has been demonstrated in testicular and ovarian germ cell tumors and in a mixed Müllerian tumor, which raises the question of a possible relationship between the pluripotency of these tumors and the presence of i(12p).

Chromosome Aberrations↗

PubMed1989

Epithelioid sarcoma in children and adolescents: a report of four cases.

Epithelioid sarcoma is an uncommon soft tissue tumor, most prevalent in the extremities of young adults. Youth has been described as a favorable prognostic factor. We describe four patients (two children aged 10 years and two adolescents aged 18 years) with extremity epithelioid sarcoma. Both 10-year-old children had rapid disease evolution and died 3 and 6 months after the diagnosis was made. Both tumors were strict diploid at DNA flow cytometry, but one had an abnormal karyotype (trisomy 2). Both adolescents are disease-free 18 months and 18 years after combined treatment consisting of local resection, regional lymph node dissection, and isolated regional perfusion with cytostatic agents.

Adolescent↗

PubMed1989

Two epithelioid malignant schwannomas in a patient with neurofibromatosis. Cytology, histology and DNA-flow-cytometry.

Cytological, histological and DNA-ploidy findings of 2 epithelioid malignant schwannomas arising in a patient with von Recklinghausen's neurofibromatosis are described. In both primary tumors, i.e. in the thigh and in the thoracic wall, origin from a neurofibromatous nerve could be established. Within 2 years after the manifestation of the first malignant tumor the patient died of widely metastasized disease. DNA-flow cytometry of several neurofibromas revealed diploid stemlines, but both malignant primary tumors and a lung metastasis appeared to be aneuploid. Presumably, the primary tumors also contained cell populations with a diploid stem line.

Adult↗

PubMed1989

Ten-year survival and late sequelae in testicular cancer patients treated with cisplatin, vinblastine, and bleomycin.

This 10-year follow-up study of 91 patients with disseminated testicular nonseminomatous cancer, treated with cisplatin, vinblastine, and bleomycin (PVB) induction chemotherapy and vinblastine plus bleomycin maintenance chemotherapy for a planned period of 2 years, shows a 63% cure rate. The predominant long-term sequelae are neurological and sexual dysfunction in 68% and 40% of patients, respectively. Two patients died of myocardial infarction. Sixteen percent of patients developed hypertension, 23% Raynaud's phenomenon, and 25% ototoxicity. Despite the long-term side effects, 90% of the patients who responded to a questionnaire are fully employed. This study shows that the maintenance chemotherapy has contributed to the incidence and/or degree of neurotoxicity, hypertension, and renal function disturbance.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1989

Design of a load cell for the Wagner distractor.

A leg length inequality can be treated by using a Wagner distractor. With this apparatus, it is possible to extend the upper or lower leg slowly. By analysing the measurements of the axial force acting on the femur or tibia the treatment can be optimized and soft tissue damage prevented. To measure the axial force, a load cell has been designed and constructed. This load cell is built into a Wagner distractor and connected with a specially designed measuring amplifier. The load cell and amplifier do not interfere with the lengthening procedure. They are safe for the patient and have an acceptable error of 7 per cent. So far, some test measurements were performed on two patients in the Rummelsberg Hospital in West Germany. The load cell proved to function in a clinical situation.

Adolescent↗

PubMed1989

Design of a lengthening element for a modular femur endoprosthetic system.

A malignant tumour may develop around the knee joint of a child. In the majority of cases it will then be necessary to resect the involved bone with adjacent tissue. A joint team of Groningen University Hospital and University of Twente is currently working on the project of developing a modular endoprosthetic system to bridge the defect resulting from the resection. Since the other, normal, leg continues to grow, the endoprosthetic system will have to include an element the length of which can be adjusted non-invasively. The main conditions to be met by the lengthening element are non-invasive continuous adjustability and a maximum total lengthening of 114 mm. This was achieved by using an external magnetic field. Animal experiments showed that the lengthening element worked well, although moisture infiltrated the telescopic tubes and the lengthening element was covered by proliferating bone at an early stage. Also, the necessary magnetic field proved to be larger than calculated. In a revised design, these problems are resolved. In vitro tests show that the new lengthening element meets all requirements.

Animals↗

PubMed1989

Ploidy of primary germ cell tumors of the testis. Pathogenetic and clinical relevance.

The ploidy of testicular germ cell tumors (GCT), a heterogeneous group of neoplasms, was studied by DNA flow cytometry. The DNA index for infantile yolk sac tumor (N = 10), seminomas (N = 20), and nonseminomas (N = 36), was: 1.91, 1.66, and 1.43, respectively. These values differed significantly one from another (p less than 0.01). The seminoma and nonseminoma components of combined tumors (N = 16) had a significantly different median DNA index of 1.61 and 1.40, respectively. Three of the 10 infantile yolk sac tumors, but only one of the 72 testicular GCT of adults were diploid. The consistent aneuploidy of testicular GCTs of adults might be helpful in the differential diagnosis of primary nongerm cell tumors of the testis, and in differentiating between metastases of testicular GCTs and primary extragonadal malignant GCTs. These data fit into a model of pathogenesis of testicular GCTs of adults in which all tumors, with the possible exception of spermatocytic seminoma, pass through a seminoma stage. Tumor evolution seems to result from net loss of chromosomes from a (near)tetraploid carcinoma in situ cell. The pathogenesis of infantile yolk sac tumor might be different from that of testicular GCTs of adults.

Aneuploidy↗

PubMed1989

Magnetic resonance imaging (MRI) in evaluating in vivo response to neoadjuvant chemotherapy for osteosarcomas of the extremities.

Limb-saving procedures for patients with osteosarcomas of the extremities are based on the anatomical localization and extent of the tumor. The effectiveness of neoadjuvant chemotherapy, high-dose methotrexate (HD MTX), was prospectively analyzed in patients using magnetic resonance imaging (MRI) and histologic evaluation of bone biopsies. Evaluation of in vivo response to neoadjuvant chemotherapy for osteosarcomas with MRI is a method which seems promising in predicting the histologic tumor reaction.

Adolescent↗

PubMed1988

Sexual function after surgery and combination chemotherapy in men with disseminated nonseminomatous testicular cancer.

Between 1978 and 1982 the sexual functions of 54 patients with a nonseminomatous testicular tumor stage II or III were assessed before and after treatment with surgery and combination chemotherapy. Two years after completing therapy 54% of the patients experienced sexual functional disorders. Greatly reduced or absent antegrade ejaculation was reported by 26 patients; 18 of them had been treated with more or less extensive retroperitoneal lymph node dissection, whereas 8 had not. This means that the chemotherapy might be responsible for ejaculatory disorders in 30% of the patients. Only two patients reported a change in the quality of erection; seven patients experienced a decidedly diminished libido, and five patients noticed their orgasm had changed in a negative sense. The appearance of the contralateral testis changed in 21 patients, who showed "atrophy" of this testis. The findings of this study indicate that sexual and ejaculatory disorders in particular are quite common in men treated for a disseminated nonseminomatous testicular tumor. Many of these disorders seem to be owing to causes other than surgical intervention.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1988

Results of adjuvant surgery in patients with stage III and IV nonseminomatous testicular tumors after cisplatin-vinblastine-bleomycin chemotherapy.

From January 1978 to April 1983, 53 patients were treated with cisplatin-vinblastine-bleomycin chemotherapy because of advanced nonseminomatous testicular tumor (NSTT). After the chemotherapy, the serum tumor markers were back to normal in 41 patients, of whom 35 were eligible for surgical removal of the residual tumor. In four patients, vital tumor tissue was found in the residual tumor. Salvage chemotherapy resulted in complete remission. Residual mature teratoma was encountered after the chemotherapy in 15 of the 25 patients with a teratomatous component and in one of the ten patients without a teratomatous component in the primary tumor. On completion of the study, 38 of the 53 patients (72%) are still alive, with a median follow-up of 65 months. Subdivided by tumor volume, survival is found to amount to 92% for small-volume disease, 67% for large-volume disease, and 64% for very-large-volume disease. Six patients (11%) developed a recurrence in the course of the follow-up. Exploratory laparotomy after remission induction chemotherapy is necessary in all patients with a teratomatous component in the primary testicular tumor who have become tumor marker negative, irrespective of the roentgenographic findings of the retroperitoneum. Patients without a teratomatous component in the primary tumor should have exploratory laparotomy only in case of roentgenographic evidence of retroperitoneal residual tumor. A thoracotomy is needed only in the presence of roentgenographic evidence of pulmonary residual lesions.

Adolescent↗

PubMed1988

Karyotyping and DNA flow cytometry of an orchidoblastoma.

The first karyotype of an orchidoblastoma is described. The most striking finding is the absence of the i(12p) marker chromosome, considered specific for testicular germ cell tumors of adults. Differences between infantile and adult testicular germ cell tumors are discussed, as are features that infantile testicular germ cell tumors have in common with extragonadal germ cell tumors.

Age Factors↗