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Biomedical subjects

W Havers

Publications and source records attributed to W Havers.

At least 55 records · Page 3Linked to original sources
PubMed1986

Long-term results following surgical removal of pulmonary metastases in children with malignomas.

Between 1972 and June 1983, 21 children (mean age 9 years, range 20 months to 16.5 years) were operated on for pulmonary metastatic disease. Primary malignant tumors were Wilms-tumor (7 patients), osteogenic sarcoma (7 patients), Ewing's sarcoma (4 patients), hepatoblastoma (2 patients), and rhabdomyosarcoma (1 patient). The surgical intervention was part of a therapeutic pediatric oncological concept with curative purpose including chemotherapy and/or radiation in different combinations. Ten out of these 21 children survived disease-free 3 years and more after pulmonary metastasectomy. An aggressive surgical approach towards pulmonary metastatic disease in children thus appears to be justified.

Adolescent↗
PubMed1985

Persistent Epstein-Barr virus infection associated with monosomy 7 or chromosome 3 abnormality in childhood myeloproliferative disorders.

This report deals with myeloproliferative disorders associated with chronic, persistent Epstein-Barr virus (EBV) infection and with monosomy 7 and aberrations concerning chromosomes 3 and 5. Altogether five children were affected, their age ranging from 1 to 4 years at time of clinical diagnosis. Principal symptoms were: hepatomegaly, splenomegaly, recurring upper respiratory tract infection and anaemia. The serum IgG level remained persistently increased. Anti EBV antibody concentrations were measured over a period of 9 months to 6 years, demonstrating persistently increased concentrations of IgG antibodies to viral capsid antigen (VCA) and against early antigen (EA). In three patients IgA antibodies were also studied and were found to be elevated. Within 2-5 years two children developed chronic myelomonocytic leukaemia from the chronic myeloproliferative syndrome. A third patient who initially was diagnosed as chronic myelomonocytic leukaemia developed acute leukaemia within a period of 12 months. A fourth patient with myeloproliferative syndrome went into spontaneous remission after an observation period of 2 years. A fifth patient, the only one with translocation t(3;5)(q27;q33), displayed symptoms and a clinical course that can best be characterized as juvenile chronic myelocytic leukaemia. The clinical, haematological, serological and cytogenetic findings may be related.

Child, Preschool↗
PubMed1985

Preliminary results of the GPO-trial for treatment of non-testicular germ-cell tumors in children and adolescents.

Germ cell tumors account for a 3% mortality rate of childhood malignancies. The combined chemotherapy, vinblastine, bleomycin and cis-platinum, is probably associated with more toxicity and treatment-induced mortality in children. Based on pharmacokinetic findings concerning the renal elimination of bleomycin and the well known cis-platinum nephrotoxicity, these two drugs were given sequentially. In addition, the cumulative dose of bleomycin was limited to 180 mg/m2. 61 patients entered the trial whereby 42 of these are evaluable. The chemotherapeutic regimen was well tolerated and was completed in 19 patients without treatment induced mortality and without evidence of pulmonary fibrosis. The treatment regimen seems to be successful despite the relatively low cumulative doses of vinblastine and bleomycin, as only 4 of 19 patients relapsed after a median observation period of 12 months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Adjuvant chemotherapy in osteosarcoma - effects of cisplatinum, BCD, and fibroblast interferon in sequential combination with HD-MTX and adriamycin. Preliminary results of the COSS 80 study.

In a cooperative adjuvant chemotherapy study of osteosarcoma (COSS-80), 192 patients were registered from December 1979 to March 1982. Forty-one patients have been excluded from study because of their nonadjuvant situation, therapy-limiting clinical conditions, or inadequate diagnosis. One hundred and fifty-one patients have been randomized to receive either the drug combination bleomycin + cyclophosphamide + dactinomycin (BCD) or cisplatinum (CPL) within a course of sequential multidrug chemotherapy including adriamycin (ADR) and high dose methotrexate (HDMTX). After exclusion of 51 patients with some deviation in history and/or management 100 selected patients were randomized once more to receive in addition or not fibroblast interferon after preoperative chemotherapy and surgical removal of the primary tumor. Patients were stratified for age and sex and for site and extension of tumor as well in both randomizations. Median follow up is now 12 (1-16) months. The expected 2-year disease free survival (DFS) rate of the total doubly randomized group is 78% and of the single randomized group 76%. No difference could be discerned between recombined groups receiving BCD vs CPL or interferon vs no interferon. The effect of preoperative chemotherapy on the tumor was evaluated clinically and by histopathologic grading; 66/85 (78%) patients were judged clinically as responders with pathohistologic verification of this finding in 71% of these cases. No adverse effect arose from delaying definite surgery for preoperative chemotherapy, but initial application of chemotherapy as well as planning, preparing, and performing of the surgical procedure have been facilitated. The majority of patients received some kind of limb-salvage treatment without local recurrences so far. A statistically insignificant but intriguing tendency for a slightly higher incidence of pulmonary metastases after resection as opposed to amputation could be detected. Similar to observations in the previous study COSS-77.

Adult↗
PubMed1983

Interdisciplinary treatment of Wilms' tumour.

The results of treating the 51 children suffering from Wilms' tumour seen in the 10 years to January 1982 are described and the need of an interdisciplinary approach is stressed.

Child↗
PubMed1982

[Testicular yolk sac tumor in children. Current view on diagnosis and treatment].

5 children with yolk-sac tumor of the testis (= infantile embryonal carcinoma) were admitted to our hospital between 1973 and 1981. Evaluation of serum alpha-fetoprotein concentrations and ultrasonography of the retroperitoneal area proved to be extremely valuable to predict the tumor stage in these children. Therapy consisted of high inguinal orchiectomy, retroperitoneal lymphadenectomy and cytostatic chemotherapy in 3 children using the T2-protocol. All children are now between 1 1/2 and 8 years free of recurrence and metastases. Therapy of this tumor ought to be differentiated according to the individual tumor stage. Most patients with stage-I tumor require only radical orchiectomy for cure.

Antineoplastic Agents↗
PubMed1980

Anomalies of the kidneys and genitourinary tract in alcoholic embryopathy.

in addition to the well known major signs of growth retardation, microcephaly, mental retardation and typical craniofacial dysmorphism, malformations of the urinary tract were found in 9 of 110 patients with alcohol embryopathy. Of the 110 patients 21 have been examined adequately. An extensive urologic investigation of children with alcohol embryopathy and symptoms suggesting kidney or genitourinary tract disease is essential for early diagnosis and correction of malformations. Awarness of alcohol embryopathy in a child referred for correction of urinary tract anomalies may help to establish the diagnosis and prevent it in further offspring.

Child, Preschool↗
PubMed1980

[Treatment and prognosis of Wilms' tumor. Analysis of 30 patients (author's transl)].

The extraordinary results of treatment of Wilms' Tumor has made it a model for interdisciplinary treatment of malignancies in children. Grouping by pathological and clinical findings helps to estimate the prognosis and to establish an individual therapeutic protocol. Since 1972 the overall 5 years survival rate of our patients (n = 30) is 86%.

Child, Preschool↗
PubMed1980

[Familial partial pyruvic dehydrogenase deficiency (author's transl)].

Pyruvic dehydrogenase deficiency was found in two living children of a Turkish family, whereas lactate acidosis was found in a dead child. Two further children died with a pattern of a therapy-refractory metabolic acidosis without any recognisable cause. The prerequisites for the creation of lactate acidosis are demonstrated by the example of pyruvic dehydrogenase deficiency. The extent of remaining activity in case of peruvic dehydrogenase deficiency determines the pattern of clinical signs and the course of the disease which can be influenced to a varying degree by additional complications and different attempts at treatment.

Acidosis↗
PubMed1980

[Radiation-induced kidney diseases after treatment of juvenile neoplasms].

3 children with malignant tumors in one kidney were treated with radiation in doses of 30 (3 weeks), 35 (6 weeks), and 33 Gy (8 weeks). The clinical and histological findings of radiation-induced nephritis from 2 children are demonstrated. In the third case radiation was performed because of adrenocortical carcinoma. 10,5 years after radiation the child developed a renal cell carcinoma.

Adult↗
PubMed1979

Benign cystic nephroblastoma.

A benign cystic nephroblastoma in a 6-month-old boy is presented. Erroneous interpretation as malignant nephroblastoma led to unnecessarily aggressive therapy. There is no evidence of recurrence or metastatic disease 12 years after the initial resection. As shown in our case and in the others previously reported in the literature, benign cystic nephroblastoma represents a distinct clinicopathological entity which does not show malignant behavior.

Child↗
PubMed1979

[Multidisciplinary treatment of rhabdomyosarcoma in childhood].

From 1974 to 1978, 21 children with rhabdomyosarcoma were treated in a combined interdisciplinary protocol. All children received a polychemotherapy for 18 months. Radiotherapy and surgery were used according to the stage and localization of the tumor. The overall two-year survival rate is 86 +/- 9%, the tumor free survival rate is 78 +/- 11%. 7 patients have no evidence of disease after the end of treatment.

Adolescent↗
PubMed1978

[Fatal outcome of retinoblastoma. Retrospective study of 22 patients].

18 patients of 22 lethal cases of retinoblastoma died of recurrence or metastases of the primary tumor, which were mostly located in the head. Two clinical groups can be distinguished. In the patients with recurrence from the side of the enucleated eye, the mean survival time was 26 months, whereas the four children with a relaps originating in the conservatively treated eye survived 23 to 65 months. Two other children died of secondary tumors, and two of unrelated disease.

Child↗
PubMed1977

[BCG-osteomyelitis and BCG-arthritis after vaccination with BCG (author's transl)].

After vaccination with BCG (type Goeteborg) in the newborn period two children developed a BCG-osteomyelitis 12 and 19 months respectively later. The symptoms were only small. X-ray showed bone lesions in the distal metaphysis of the femur. The bacteriological examination demonstrated BCG-etiology. Disturbances of growth or of joint motility are seldom; they are possible, if the bone lesions are severe and if the diagnosis is late. In these cases the treatment must be intensive.

Animals↗