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J Koutecky

Publications and source records attributed to J Koutecky.

9 recordsLinked to original sources
PubMed1999

Papillary cystic and solid tumor of the pancreas--surgical therapy with the use of CUSA, and a review of the pediatric literature.

Papillary cystic and solid tumor of the pancreas (PCSTP), so-called Frantz tumor, is a very rare tumor in children. Only 62 cases, 57 girls and 5 boys, have been reported in children since 1959. The tumor presents usually as a slowly growing abdominal mass with or without abdominal pain. Surgical resection of the tumor is an adequate mode of treatment, and the prognosis is excellent. The authors present 4 girls and 1 boy with PCSTP and demonstrate that the Cavitron Ultrasonic Surgical Aspirator (CUSA, Valleylab) is successfully used in surgical therapy.

Adolescent↗
PubMed1998

Pseudomembraneous clostridium after autologous bone marrow transplantation.

Clostridium difficile (C. difficile) pseudomembraneous colitis was diagnosed in a 13-year-old boy with Hodgkin's disease 3 months after autologous bone marrow transplantation. Hematopoiesis was fully reconstituted at the time. C. difficile infection occurred after gall bladder empyema had been treated conservatively with i.v. antibiotics and prophylactic 4-week administration of oral amoxicillin. C. difficile colitis was diagnosed early and intensive supportive therapy combined with administration of i.v. and subsequently oral vancomycin therapy failed. It is a phenomenon rarely seen and successful eradication of the clostridium infection was only achieved by a combination of higher dose vancomycin with metronidazole. During the post-colitis recovery the patient experienced a relapse of Hodgkin's disease and died following further surgical intervention 137 days post-transplantation.

Adolescent↗
PubMed1997

Treatment of spinal cord tumors in children.

BACKGROUND: A retrospective review was carried out of nine children under 17 years of age with a diagnosis of intramedullary tumor seen during the period 1989-1995. Six had astrocytomas; one each had an ependymoma, a PNET, and a choroid plexus papilloma. Five patients had back pain, 3 others had mild pareses and the ninth had incapacitating defects. Seven of the 9 were treated by subtotal extirpation of the lesion, and biopsy alone was performed in the other two. All tumors were low grade (grade I or II) and therefore radiation therapy (RT) was performed as the only postoperative treatment in 8 of the 9 children. RESULTS: In February 1996, seven (77.8%) children were alive and two (22.2%) died of recurrent tumor (7 months and 5 years after diagnosis, respectively). Median follow-up was 3 years 4 months (range: 1 year 6 months to 7 years 3 months). CONCLUSION: Surgical removal of intraspinal tumors provides the best hope of control, but spinal column deformity after laminectomy and irradiation is a serious long-term problem in children. Orthopedic supervision for the prevention of these deformities; e.g., by external immobilization, is mandatory.

Adolescent↗
PubMed1991

Is fetal cellular rhabdomyoma an entity or a differentiated rhabdomyosarcoma? A study of patients with rhabdomyoma of the tongue and sarcoma of the tongue enrolled in the intergroup rhabdomyosarcoma studies I, II, and III.

A tumor of the tongue with features consistent with the diagnosis of fetal cellular rhabdomyoma was seen in an 18-month-old infant. The tumor recurred 10 and 22 months after initial resection. The histologic condition of the first recurrence was similar to the original tumor except for some increased nuclear irregularities and mitotic activity. No adjunctive therapy was administered initially or after the first recurrence. The second recurrence showed mixed embryonal/alveolar rhabdomyosarcoma. This case represented a unique model of a highly differentiated striated muscle tumor converting to a moderately differentiated rhabdomyosarcoma, and illustrated differential diagnostic difficulties in distinguishing between fetal cellular rhabdomyoma and differentiated rhabdomyosarcoma. The patient was compared with eight children and adolescents with primary sarcomas of the tongue who entered the Intergroup Rhabdomyosarcoma Studies (IRS) I, II, and III protocols. The tumors of all eight arose at the base of the tongue. There were five embryonal, one alveolar, and one mixed embryonal/alveolar rhabdomyosarcomas, and one undifferentiated myxoid sarcoma. Five rhabdomyosarcomas were poorly differentiated, and two had a moderate degree of myogenesis. These sarcomas of the tongue represent approximately 0.34% of all cases entered in IRS studies.

Biopsy↗
PubMed1977

[Wilms' tumor].

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

Treatment of pediatric B-cell non-Hodgkin's lymphomas at the Motol Hospital in Prague, Czech Republic: results based on the NHL BFM 90 protocols.

Malignant non-Hodgkin's lymphomas (NHL) of childhood and adolescence are a heterogeneous group of diseases originating from the lymphoid cells. Unlike adults with non-Hodgkin's lymphoma, children typically have extranodal disseminated disease of high grade (Burkitt's lymphoma, large cell lymphoma, or lymphoblastic lymphoma). This study was conducted to determine the feasibility of treating children in the Czech Republic with B-cell non-Hodgkin's lymphomas according to very intensive protocols based on the German Berlin Frankfurt Munster (BFM) NHL 90 study. Treatments are divided in the BFM studies according to "B" and "non-B" immunophenotypes. The authors report only those treated according to the BFM B-cell protocol. From 1991 through 1997 eighty-two patients less than 18 years with NHL were admitted to the department. Seventy-three of them were classified as B-cell lymphoma and 54 were thus eligible for the BFM B-cell treatment. The entire group consisted of 38 males and 16 females (ratio 2.38). Median age was 11.6 years. Twelve had stage I disease, 3 stage II, 30 stage III, and 9 stage IV lymphoma. There were 21 patients with Burkitt's lymphoma, 29 with large cell lymphoma, of which 5 were patients with MALT lymphoma. In 3 cases B-cell NHL was not further classified and one child had a mediastinal B lymphoma. Patients were further stratified according to clinical stage and lactate dehydrogenase (LDH) level. Therapy consisted of a prephase and short (2, 4, or 6 courses), intensive 5-day therapy with 6 drugs. The probability of event-free survival (pEFS) for the entire group was 74% and overall survival at 5 years was 80%. There was a significantly better outcome for children classified as stage I. No difference was observed between the EFS of stage III and IV patients. Four patients died from treatment-related complications in complete remission. Treatment results were not identical between NHL subtypes, with large cell lymphoma patients doing significantly better (pEFS 90%, p = .008). The use of protocols based on BFM 90 study was feasible at this center. The treatment results are approximately 10% lower than those reported by BFM investigators, but comparable to results from other centers.

Adolescent↗
PubMedDate not supplied

Treatment of Hodgkin's disease in children with VAMP (vinblastine, adriamycin, methotrexate, prednisone) and VEPA (vinblastine, etoposide, prednisone, adriamycin).

Treatment of Hodgkin's disease in children should be directed at maximizing cures and minimizing the long-term effects of alkylating agents, anthracyclines, and bleomycin. In this study methotrexate and etoposide were used in the VAMP/VEPA regimens to treat 60 clinically staged pediatric patients with Hodgkin's disease. Twenty-nine patients with stages I-IIA received four courses of VAMP plus low-dose radiotherapy. Thirty-one IIA bulky disease and IIB-IVB patients received four or six courses of VEPA plus low-dose radiotherapy. There were 6 partial remissions after the completion of chemotherapy and all of these patients relapsed, but 4 were successfully salvaged with ABMT. Two patients have died. The 3.1-year overall survival rate is 97% (100% VAMP, 94% VEPA) and the event-free survival rate is 88% (97% VAMP, 77% VEPA). These results suggest that VAMP is a reasonable treatment for low stages of Hodgkin's disease, but more advanced disease is not adequately treated by VEPA and low-dose radiotherapy.

Adolescent↗
PubMedDate not supplied

History of pediatric hematology-oncology in the Czech Republic.

Specialized treatment for children with hematologic and oncologic diseases in the Czech Republic has a relatively short history. Dr. Josef Koutecky in 1964 was the first to organize the discipline of oncologic treatments and started a department that has since grown to include six other senior members. They treat over 250 new patients a year (approximately 150 malignant tumors) with an incidence similar to that in other European nations. Most are treated on cooperative group protocols with other centers in Europe and North America. Over 30 children also receive bone marrow transplants yearly from this group. Hematologic diseases including leukemia were first treated by D.r. O. Hrodek since the late 1950s in the Second Department of Pediatrics in Prague. Eight other centers in the Czech Republic besides Motol treat children with leukemia. Since 1985 they have followed the Berlin-Frankfurt-Münster (BFM) protocols for patients with acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML). The Motol Hematology Section does about 20 transplants a year. New molecular biology laboratories in both sections aid the diagnosis and follow-up of the patients.

Child↗