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Biomedical subjects

O Metz

Publications and source records attributed to O Metz.

At least 37 records · Page 2Linked to original sources

[Lung scintigraphy after tumor therapy in childhood].

Cytostatics- and radiation-induced alterations of the lung were investigated in 18 children after tumour-therapy by means of lung perfusion scintigraphy. 13 patients (Hodgkin- and non Hodgkin lymphoma, acute lymphocytic leukemia with mediastinal tumour, Ewing-sarcoma, and intrathoracal neuroblastoma) received epidiaphragmatical radiation and cytostatics. All 32 lung-scintigrams of these children 1-23 months after cessation of therapy were pathological. 5 patients (acute lymphocytic leukemia, Histiocytosis X) received cytostatics only. 1-6 months after cessation of therapy in these children 6 lung-scintigrams were pathological, one was normal. After cessation of tumour-treatment scintigraphical improvement of disturbed perfusion occurred in 9/18 patients only. In 6 children a deterioration of lung-perfusion was registered. Lung-scintigraphy is a method for testing pulmonary perfusion in diagnosis and therapy control in childhood malignancies. The results of this study indicate that prophylactic provisions against pulmonary damage during oncologic therapy are necessary.

Antineoplastic Agents↗

Meningosis prophylaxis with intrathecal 198Au-colloid and methotrexate in childhood acute lymphocytic leukemia.

Since 1972, telecobalt irradiation plus intrathecal methotrexate (ITMTX) has been successfully replaced in Jena by intrathecal colloidal radioactive gold (198Au) plus ITMTX for meningosis prophylaxis in leukemia. Seventy-three children with acute lymphocytic leukemia (ALL) were given 1.24-4.89 mCi (45.8-181 MBq) of colloidal 198Au IT after successful initiation of remission. During cytostatic therapy, the following relapses occurred: meningosis leucaemica, five patients (6.8%); bone-marrow relapse and the meningosis leucaemica, one patient; and bone-marrow relapse, 20 patients (27.4%). In 18 children, combination chemotherapy was terminated after two and a half or three years of treatment. After that time, one meningeal relapse and six bone-marrow relapses occurred. Within the first 24 hours after application of radioactive gold, headaches, vomiting, and fever occurred in less than 10% of the children. An apathy syndrome, leukecephalopathy, or severe infections, were not observed in a single case. Radioactive gold spreads in the subarachnoid space and is phagocytized by the arachnoidea. The tumoricide effect extends selectively over the space of distribution of the latent meningosis leucaemia. The cerebral parenchyma remains unaffected by radiation. Thus, radioactive gold may be preferable to telecobalt irradiation in preventing central nervous system leukemia.

Bone Neoplasms↗

[Ocular symptoms and leukemia in childhood].

Findings in a total of 200 children suffering from leukemia were evaluated. Ocular symptoms were found in 26% of the cases. Typically, fundus hemorrhages were found in the initial stage, leukemic infiltrates in the final stage and papilledema in the meningosis leucaemica stage. In patients with ophthalmologic changes the survival time was shorter than in patients with no ocular involvement. Ophthalmological "dispensaire" treatment is generally recommended.

Child↗

[Human nonspecific killer cells].

The NK and K-cell activity of human leukocytes was investigated as compared with those cells of the K 562 cell line and murine cells covered by xenoantibodies in Graffi erythroblast leukaemia by means of the 51Cr release test. NK and K-cells could be identified in the blood and bone-marrow. However, they could not be identified in the thymus, lymph-nodes, and tonsils. Attempts of cell fraction with the blood of healthy donors revealed that the K-cells must be attributed to non-T-lymphocytes. NK-cells may be found in the fraction of non-T-lymphocytes as well as in that of T-lymphocytes. Killer cell activity tests in children with acute leukaemia resulted in leukaemia cells having NK and K-cell activity only in very rare cases. ALL patients in remission had strongly lowered NK-cell values under chemotherapy. In comparison to that, chemotherapy had no influence on K-cell activity. On the one hand, NK-cell activities were induced in mixed cultures of allogenous lymphocytes of the blood and, on the other hand, in cells of lymph-nodes. Attempts of fractionation, investigations for determining the influence of chemotherapy and attempts of inducing killer cell activity in vitro lead to the conclusion that NK and K-cells may be regarded as similar cell populations, being, however, not identical.

Acute Disease↗

[Cessation of treatment in childhood acute lymphatic leukemia. Long-term observations after meningosis prevention with intrathecal gold colloid radioisotopes and methotrexate].

Cytostatic long-term treatment for about 36 months was administered to 18 children with acute lymphatic leukaemia who were in long-term remission (43-98 months). Prophylaxis of meningosis involved intrathecal 198Au colloid and methotrexate. Seven recurrences occurred during the long-term remissions: the bone marrow was involved six times, leukaemic meningosis occurred once. Five out of seven recurrences occurred within one year of cessation of treatment. There were no complications induced by intrathecal radio-gold, such as the apathy syndrome or leukoencephalopathy. Intrathecal methotrexate led to side effects before administration of radio-gold: encephalopathy twice, paraplegia once. Symptoms regressed completely in two children, one child with encephalopathy continues to have symptoms. All three children were given 198Au colloid intrathecally thereafter which was tolerated very well. 198Au colloid represents an alternative for prophylaxis of meningosis with 60Co telecobalt irradiation in leukaemias and non-Hodgkin lymphomas in childhood.

Adolescent↗

[Cerebral computed tomography in acute childhood leukemias].

It is suggested that cranial computerized (axial) tomography permits a more complete neurologic work-up for all children with acute leukemia. It also permits a better knowledge of the frequency and varieties of cerebral complications in leukemia. Endocranial complications in acute leukemia are essentially infiltrative, hemorrhagic, infectious or iatrogenic. Cranial computerized tomography can demonstrate cerebral changes in meningeal leukemia, hemorrhages, calcifications, brain atrophy or leukencephalopathy. The preliminary results of cranial computerized tomography in childhood leukemia suggest that the iatrogenic main lesion of the brain due to combined radiation-chemotherapy is atrophy whereas that of the intrathecal cytostatic therapy is demyelination. Accurate diagnostics and control of possible cerebral complications in therapy of leukemia is essentially for appropriate therapeutic management. For that cranial computerized tomography may be the best method to a effective exploration of the brain.

Acute Disease↗

[Lung-scintigraphy in the control of children with malignancies treated by radiochemotherapy (author's transl)].

Cytostatics- and radiation-induced alterations of the parenchyma of the lung were investigated in 30 children with malignomas before, during and after therapy by means of lung perfusion scintigraphy. Before the tumour-therapy (2 children) lung-scintigrams were regular. 16 children (Hodgkin- and non Hodgkin-lymphoma, acute lymphocytic leukemia with mediastinal tumour, intrathoracal neuroblastoma and Ewing-sarcoma) received epidiaphragmatical radiation and cytostatics. All 35 lung-scintigrams of these patients (1-60 months after beginning of therapy) were abnormal. Within 6 months after radiation obstructions to perfusion could be demonstrated in ray-treated parenchyma of the lung only. Subsequent to 6 months after radiation, during cytostatics, disturbances of perfusion were diffusely spreading in the lung parenchyma. 12 children (acute lymphocytic leukemia, Histiocytosis X and osteogenic sarcoma) received cytostatics only. All 18 lung-scintigrams of these patients (1-55 months after beginning of therapy) were pathological. After cessation of therapy (radiochemotherapy or chemotherapy only) scintigraphically improvement of perfusion occurred in the majority of patients. Obviously the diffusely spreading obstructions to perfusion represent alterations during the early phase of their development induced by chemotherapy.

Antineoplastic Agents↗

["Prophylactic" intrathecal radiogold (198au) in leukaemia in children (author's transl)].

198Au radiogold-colloid (Behring) was injected as "prophylactic" therapy against central nervous system leukaemia in 26 children with acute leukaemia (22 acute lymphatic and 4 myeloid). During the period of observation (1.3. 1972 to 1.9.1975), 23 children remained free of central nervous system recurrences: 16 children are alive 3 to 39 1/2 months later, seven died after 4 1/2 to 29 1/2 months from the underlying disease. In one child CNS leukaemia developed after about five months, in another one during a second haematological recurrence, while the third one developed retrobulbar infiltration in the optic nerve. In general, 2 mCi 198Au gold-colloid was injected intrathecally via a lumbar puncture. The method was well tolerated.

Child↗

[The cerebral sensitivity to "meningosis-prophylaxis" with 198Au radiogold according to EEG findings].

35 children (16 girls and 19 boys) at the age of 1 11/12 to 16 11/12 with acute leukaemia were injected intrathecally with 198Au-radiogold colloids (HOECHST-BEHRING) for "prophylaxis of meningosis". The colloid size of the isotope amounted to 5 or 30 nm, the applied activity lay between 1.4 and 3.12 mCi. According to a dosage estimation made with the help of LOEWINGERS formula 1 mCi of radiogold corresponds to approximately 1200 rad. Clinical observations, such as headaches, vomiting or fever up to 39 degrees C, could only be found in 6 children (17.1%) during the first 24 hours. All symptoms subsided quickly and without any sequels. Even retarded complications could not be detected. An electroencephalogram was made from all children before and after applying radiogold (1-8 d afterwards). After the injection of radiogold the majority of children had no change of findings in the electroencephalogram, 11 children even showed a tendency towards an improvement up to normalisation. Only 4 children had a deterioration of findings with unspecific disorders or appearances suspected of peak potential discharges. Simultaneously an accumulation of clinical complaints could be found. Judging from the clinical and electroencephalographic behaviour of our patients no absolute neurotoxity of radiogold could be ensured.

Adolescent↗