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Biomedical subjects

H Schraffordt Koops

Publications and source records attributed to H Schraffordt Koops.

At least 163 records · Page 9Linked to original sources
PubMed1985

TNO-6-induced acute renal failure. A case report.

A case of fatal acute renal failure during treatment with 1,1-diaminomethyl cyclohexane sulphato platinum II (TNO-6) is reported. Pathologic investigation showed focal tubular necrosis with interstitial infiltration and edema. Despite the development of proteinuria no changes of the glomeruli were found, either by light or electron microscopic investigation. The pathologic changes caused by TNO-6 are similar to those found in renal failure caused by cisplatin (CDDP).

Acute Kidney Injury↗
PubMed1985

Treatment of malignant fibrous histiocytoma of bone. A plea for primary chemotherapy.

Seven patients have been treated for malignant fibrous histiocytoma (MFH) of bone since the end of 1977. One patient received no chemotherapy, and one did not complete attempted chemotherapy. Both died, 7 and 51 months after diagnosis, respectively. The remaining five patients completed chemotherapy. Two first underwent a primary amputation, whereas the other three received primary chemotherapy with histologic evaluation of the effect. These patients showed a complete remission. The five patients who completed chemotherapy are all still alive, without indications of metastases or local recurrence. Although the number of cases is small, a 25- to 58-months (mean, 45) survival, in five patients treated either with chemotherapy alone or chemotherapy and surgery, is surprisingly good in view of previous experience with this tumor. In some of these patients, the authors were able to document an absence of any viable tumor following chemotherapy.

Adolescent↗
PubMed1985

Dosimetry of cytostatics in hyperthermic regional isolated perfusion.

During the period from February to October 1983, 21 patients with malignant melanoma of the extremities were treated by hyperthermic regional isolated perfusion with L-phenylalanine mustard (melphalan). The melphalan dose for each patient was determined by the tissue volume of the perfused region, using a dose of 10 mg/l perfused tissue. Despite an average increase of melphalan dosage of 18% above the maximum for iliac perfusions recommended in the literature, no increase in toxic tissue reactions was observed after hyperthermic iliac perfusions. The same dose of 10 mg/l perfused tissue was used in hyperthermic axillary perfusions, resulting in an average decrease of melphalan dosage of 14% below the minimum recommended in the literature. By applying a constant dose per unit tissue volume, a standardization of treatment is achieved. This excludes variations like body weight, age, type of complexion, and hair color, which so far have determined dosimetry.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed1985

Significance of human chorionic gonadotropin, alpha-fetoprotein, and pregnancy-specific beta-1-glycoprotein in the detection of tumor relapse and partial remission in 126 patients with nonseminomatous testicular germ cell tumors.

After surgery and initial treatment, 126 patients with nonseminomatous germ cell tumors of the testis were followed by estimation of serum human chorionic gonadotropin (HCG), alpha-fetoprotein (AFP), and pregnancy-specific beta-1-glycoprotein (SP-1). The median follow-up time was 39 months (range, 12-69 months). An evaluation was made of the sensitivity, specificity, and predictive value of these markers to detect tumor relapse (TR) and partial remission (PR) rates. Five of the 35 (14%) Stage I patients had a TR, and in 4 the TR was recognized early by increasing serum levels of HCG (four times) and AFP (one time). In Stage II and III disease 17 of the 91 (18%) patients had a TR or PR. In 15 of the 17 patients TR and PR were associated with elevated serum levels of HCG (nine times), AFP (seven times), and SP-1 (five times). Rising levels of HCG and/or AFP preceded a clinical confirmation of TR and PR by 4 to 8 weeks. Serum SP-1 did not add useful information. The combined use of serum HCG and AFP gives a sensitive indicator for TR and PR: 19 of 22 (86%) of such patients were recognized. The specificity (98% and 100%, respectively) and the predictive value of positive tests (87% and 100%, respectively) were high for both HCG and AFP.

Chorionic Gonadotropin↗
PubMed1985

Identical chromosome translocations involving the region of the c-myb oncogene in four metastases of a mediastinal teratocarcinoma.

A 39-year-old white male presented with a disseminated mediastinal teratocarcinoma. Karyotyping was performed on two mature residual metastatic lesions in the lungs immediately following chemotherapy, on a recurring lung lesion after 5 months, and on a metastasis in the right thigh 5 months after salvage chemotherapy. All four lesions were pseudoeuploid and showed identical chromosomal abnormalities: a translocation with the two chromosomes #6 and one chromosome #11 involved, resulting in 46, XY, t (6;6;11) (q21;q23;q13). The breakpoint in chromosome #6 is in the region to which the oncogene c-myb has been localized, and the breakpoint in chromosome #11 is at a known fragile and possibly oncogenic site, suggesting that the translocations in this case may have played a crucial role in the development of the malignancy.

Adult↗
PubMed1985

Biopsy of bone tumours.

Bone biopsy is not only the most important step in the diagnosis of bone tumours, but since the introduction of chemotherapy, it has also become essential in the evaluation of treatment of highly malignant bone tumours. A total of 206 bone biopsies were performed on 136 patients seen between January 1, 1978 and August 1, 1982 (99 open and 107 drill biopsies). Complications during or after biopsy were relatively rare, and none were of a serious nature. Pathological fractures at sites of biopsies developed exclusively in patients given chemotherapy. In gaining adequate histologic material, the overall result of open bone biopsies (98%) was superior to that of drill biopsies (70%). The choice between both techniques was dependent on individual patient factors. Of the total of 206 bone biopsies, 10% proved not to be representative. It is concluded that, especially in patients given chemotherapy for a malignant tumour of a long bone, the possibility of a spontaneous fracture after a bone biopsy should be borne in mind.

Adolescent↗
PubMed1985

The treatment of primary tumors of the femur with chemotherapy (if indicated), resection and reconstruction with an endoprosthesis.

The treatment protocol of 15 patients with a primary tumor of the femur, including osteosarcoma, malignant fibrous histiocytoma and chondrosarcoma is presented. All patients had been selected for resection and reconstruction with an endoprosthesis. An endoprosthesis was implanted in 12 patients. The results of this type of treatment appear to be satisfactory. In eight osteosarcoma cases resection and reconstruction with an endoprosthesis combined with preoperative and postoperative chemotherapy, according to Rosen, were performed. Follow-up in all 15 patients, varying from 1.4 to 6.0 years, showed no evidence of disease in 12 patients. Three patients had died. Function of the involved leg was satisfactory in most cases. The advantage and disadvantages of the use of an endoprosthesis are discussed as well as complications in this series of patients.

Adolescent↗
PubMed1985

The effect of captopril on renal function in patients during the first cis-diamminedichloroplatinum II infusion.

On the assumption that hemodynamic changes in renal blood flow are the initial expression of cis-diamminedichloroplatinum (CDDP)-related nephrotoxicity, we treated patients with metastatic non-seminomatous testicular carcinoma during CDDP infusion with captopril. This angiotensin-converting enzyme inhibitor significantly attenuated the initial decrease in effective renal plasma flow and can probably be used to protect the kidneys against CDDP-induced nephrotoxicity.

Adolescent↗
PubMed1985

Changes in pulmonary function during and after bleomycin treatment in patients with testicular carcinoma.

Pulmonary function tests, including spirometry, transfer factor of the lungs for carbon monoxide (TlCO), and the two components of TlCO, the diffusing capacity of the alveolocapillary membrane (Dm) and pulmonary capillary blood volume (Vc), were carried out in a group of patients with testicular carcinoma during and after treatment with the Einhorn regimen. The lung function parameters of patients who developed bleomycin-induced pneumonitis were compared with those recorded in a group of patients who did not develop this syndrome. We suggest that bleomycin-induced damage to the pulmonary capillary vasculature can be monitored by measuring Vc and that ensuing fibrosis can be measured by recording Dm. The decrease in Dm is probably compensated for by an increase in Vc, leading to a smaller change in TlCO.

Bleomycin↗
PubMed1985

A reduction in pulmonary capillary blood volume in patients with disseminated testicular carcinoma.

Pulmonary function tests, including the transfer factor for carbon monoxide of the lungs (T1CO) and pulmonary capillary blood volume (Vc), were measured in 43 patients with disseminated testicular carcinoma and in eight patients with disseminated malignant melanoma before the start of a bleomycin-containing cytostatic combination. Their relation to the development of bleomycin-induced pulmonary toxicity was evaluated. We found two subgroups of patients, one group with and one group without an abnormal pretreatment T1CO and Vc. In the latter group the risk of bleomycin-induced pulmonary toxicity is not increased. Reduction in bleomycin dose during treatment is not necessary. The hypothesis is formulated that tumor embolism could be the explanation for this phenomenon.

Adolescent↗
PubMed1985

Fertility and hormonal function in patients with a nonseminomatous tumor of the testis.

Semen quality and serum testosterone, LH, and FSH levels were studied in 54 patients with a unilateral nonseminomatous tumor of the testis--14 before and 40 after orchiectomy. Semen analyses before and after orchiectomy gave essentially no different results: a poor semen quality was found in most men. The additional effect of a recent orchiectomy on semen quality was not demonstrable in the patients described here. Before orchiectomy, increased testosterone levels were found in patients with a beta-hCG-producing tumor. After orchiectomy serum testosterone levels were decreased, and LH and FSH levels increased. With beta-hCG-producing tumors FSH was suppressed after orchiectomy, and testosterone levels did not exceed those in patients with a tumor not producing beta-hCG. The results of semen analysis and of hormonal studies after orchiectomy suggest a dysfunction of the remaining "normal" testis. Diminished spermatogenesis and insufficient testosterone production by the Leydig cells clearly indicate anomalies already present before orchiectomy.

Adult↗
PubMed1985

The influence of verapamil on renal function in patients treated with cisplatin.

Nine patients with testicular cancer were treated with four platinum containing chemotherapy courses. In order to prevent cisplatin (CDDP)-induced nephrotoxicity, verapamil, a calcium entry blocker, was added to the chemotherapeutic regimen. Renal function studies, consisting of the measurement of the effective renal plasma flow (ERPF) and the glomerular filtration rate (GFR), were performed before, during and after the first dose of CDDP, at the end of the first course and at the end of the fourth course of chemotherapy. The results were compared with the results obtained previously in CDDP-treated patients not receiving verapamil. The initial decrease in ERPF during and after the first CDDP infusion was completely prevented by verapamil. Despite continuation of verapamil throughout all four courses, it failed to reduce the ultimate fall in GFR.

Adult↗
PubMed1985

Isolated hindlimb perfusion in dogs: the effect of perfusion pressures on the oxygen supply (ptO2 histogram) to the skeletal muscle.

During regional isolated perfusion, neoplasms in extremities are treated with high doses of chemotherapeutic drugs by means of an extracorporeal circuit. The question is whether optimal tissue perfusion, which is essential for the therapy, is obtained by regulation of the extracorporeal circuit on an adequate perfusion flow or on an adequate perfusion pressure. To determine which perfusion pressure is needed to maintain adequate tissue perfusion, hindlimbs of six dogs were perfused at perfusion pressures 0, 15, 25, and 50 mm Hg below systemic mean arterial pressure. A multiwire polarographic oxygen electrode placed on the sartorius muscle permitted quantitative evaluation of tissue oxygenation by means of ptO2 histograms. Our results indicated that the perfusion pressure must be equal to or within 15 mm Hg below systemic mean arterial pressure to obtain optimal tissue perfusion. To maintain this perfusion pressure, high perfusion flows of about five to 10 times control femoral flows were needed. At a perfusion pressure 50 mm Hg below systemic mean arterial pressure, perfusion flow was normal, but tissue perfusion was severely impaired.

Animals↗
PubMed1984

Five-year survival of patients with disseminated nonseminomatous testicular cancer treated with cisplatin, vinblastine, and bleomycin.

Ninety-one patients with disseminated testicular non-seminomas were treated with 3 to 4 cycles of cisplatin, vinblastine, and bleomycin (PVB) induction chemotherapy followed by cisplatin and vinblastine maintenance therapy for 1 year. The follow-up of these patients ranges from 24 to 66 months. Forty-nine (54%) patients achieved complete remission by chemotherapy alone and 14 (15%) were rendered free of tumor by surgery after chemotherapy, for a total complete remission rate of 69%. Three complete responders relapsed within 13 months, and two died. One additional complete responder died of a noncancer-related cause. One of the surgical complete responders relapsed and died. Overall, 58 (64%) patients remain free of disease. The 5-year survival is 95% for complete responders, 32% for partial responders, and 72% overall. This combination regimen has significantly improved the survival of disseminated testicular cancer patients, equaling that of Stage II patients in older literature.

Adolescent↗
PubMed1984

Epiphyseal fractures in children treated for osteosarcoma of the femur with chemotherapy, tumourresection, and endoprosthesis: report of four fractures in two children.

This paper reports on two patients, who both were under treatment for osteosarcoma of the femur. Treatment consisted of chemotherapy, resection of the tumour, and reconstruction with an endoprosthesis . Both patients sustained an epiphyseal fracture on two occasions after a minor trauma. Careful observations of the x-rays, including tomography, reveals that a metaphyseal anomaly could be the cause of these fractures. It is suggested that these metaphyseal changes are caused by chemotherapeutic agents. All fractures healed well after a conservative treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Improved tissue perfusion during pressure-regulated hyperthermic regional isolated perfusion in dogs.

To achieve adequate tissue perfusion during regional isolated perfusion, hind limbs of dogs were perfused for 60 min, regulating the extracorporeal circuit on pressure. The dogs were divided into three groups. In groups I and II perfusions were performed at a delta pressure (systemic mean arterial pressure minus hind limb mean arterial pressure) of respectively 50 and 15 mm Hg; in group III delta pressure was also 15 mm Hg but the cytostatic drug Melphalan was added. Tissue perfusion was determined by means of a multiwire polarographic oxygen electrode. Adequate tissue perfusion was obtained only at subnormal perfusion pressures (groups II and III), although in all groups perfusion flow was higher than preoperative flow. At low perfusion pressures (group I), tissue perfusion was severely impaired. In all groups leakage remained less than 10%. During regional isolated perfusion the extracorporeal circuit must be regulated at a delta pressure of 15 mm Hg to achieve adequate tissue perfusion.

Animals↗
PubMed1984

Dislocation of an artificial knee component due to extraordinary function.

A rare complication, namely dislocation of a knee component without fracture of the prosthesis and not caused by a trauma, is described in a patient who was treated for osteosarcoma of the femur. Probably the dislocation, which occurred 2 years postoperatively, was caused by an extraordinary function of this prosthesis. A partial revision of the prosthesis was performed. The newly designed knee component, which prevents dislocation, is described.

Child↗