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Biomedical subjects

E Pichler

Publications and source records attributed to E Pichler.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Concept for the total care of families of children with leukemia and tumors based on conversations with the parents].

In order to create a foundation for prophylactic and therapeutic measures the problems of children with leucaemia and other malignancies and of their families were assessed in detail with parents of these children in single or group discussions. The necessity for integrated therapy including families of children with leucaemia or tumours became apparent. Care should include extensive talks with all family members and also with teachers of patients and of healthy siblings, the use of aids such a painting or puppet theatre for recognition of problems and needs, particularly in small children, home visits to explore problems of health siblings, involvement of social workers, aftercare for the whole family after the death of a child, and, finally the help for overcoming problems of the treating team. Care to such an extent has been found to be necessary and requires an increase in posts in oncological units. Lack of time for the patients as human beings is unacceptable even from an economical point of view. A psychotherapeutically versed medical doctor or a clinical psychologist and a social worker should be permanent members of any oncological team.

Adaptation, Psychological↗
PubMed1982

Embryonal rhabdomyosarcoma of the middle ear presenting as sarcoma botryoides. Favorable outcome in a 12-year-old boy.

A 12-year-old boy presented with a history of earache, fever and granuloma of the auditory canal. Biopsy revealed embryonal rhabdomyosarcoma. The patient was treated with chemotherapy and radiation therapy, which led to complete disappearance of the tumor without recurrence after three years. Diagnosis, staging and timing of the treatment plan is discussed for this rare but highly malignant tumor.

Child↗
PubMed1982

[Treatment of orbital rhabdomyosarcoma (author's transl)].

From March 1973 to December 1981 embryonal rhabdomyosarcoma of the orbit was diagnosed in 5 children. In two children exenteration was done after a previous local radiotherapy. In one child the exenteration of the orbit was done after a primary chemo- and radiotherapy because of local progression of the tumor. In two children the exenteration was avoidable by this therapy. In four of these five children this was followed by vincristine, actinomycin D and cyclophosphamide for 16 to 24 months. After the diagnosis these four children survived until now from 3 1/2 to more than 8 years. They are free of treatment and free of disease. Seven months after diagnosis one child died with an acute respiratory distress syndrome (at post mortem: hyaline membranes). In patients with rhabdomyosarcoma of the orbit it is justified to avoid the mutilating exenteration by primary chemotherapy followed by irradiation of the reduced manner. If exenteration becomes subsequently necessary the chance for survival is not diminished in our opinion.

Child↗
PubMed1981

[Treatment of Wilms' tumor (author's transl)].

Uniform treatment based on the therapeutic approach of the 1st and 2nd US National Wilms' Tumor Study was decided on in March 1976 by paediatricians, surgeons, urologists and radiotherapists in Austria. Wilms' tumour was diagnosed in 34 children between 1 january 1976 an 29 february 1980 (stage I: n = 11, stage II: n = 8, stage III: n = 8, stage IV: n = 7). Parents of two children refused treatments; both children have since died of metastases. Of the remaining 32 children 29 (90.6%) are alive, 10 for more than 4, 15 for more than 3 and 19 for more than 2 years after diagnosis. 21 children are without need of treatment. Three children have died, one due to postoperative complications, one due to haemorrhagic chickenpox, but free of tumour, and one after insufficient treatment. Two of the five children with a recurrence between 2 1/4 to 15 months after diagnosis had been treated inadequately in the initial phase. The tumour free survival rate in 74.2%. Two children with early occurring or recurrent lung metastases have survived for 53 1/2 and 54 months up to now.

Age Factors↗
PubMed1978

Preventive cranial irradiation in the treatment of acute lymphocytic leukemia in children.

From April 1971 to September 1977, 94 children with acute lymphocytic leukemia, in whom a complete clinical and hematologic remission had been obtained received preventive cranial irradiation at the University Clinic for Radiotherapy of Vienna. So far, only in 2 of the 94 patients an initial meningeal relapse occurred. After a minimum follow-up time of 3 years, the rate of primary CNS relapse is 8%. The combination of cranial irradiation and methotrexate intrathecally, beginning currently in the first month of the complete remission, seems to be the most effective and least hazardous regimen to prevent meningeal and CNS leukemia.

Adolescent↗
PubMed1978

[Systemic lupus erythematosus in twins (author's transl)].

A report is given of systemic lupus erythematosus (SLE) in monozygotic twins. One sister developed coombs-positive haemolytic anaemia at the age of 11 years and suffered from five haemolytic crises over a period of 8 months. SLE could not be proven at that time, but following a 3-year symptom-free period, characteristic clinical and immunological evidence of SLE became manifest. The second sister developed classical SLE at the age of 15 years. Clinical, immunological, etiological and therapeutical aspects of SLE are being discussed.

Adolescent↗
PubMed1977

[Polycythaemia as sole symptom of renal adenoma (author's transl)].

In two children, a 9 year-old boy and a 10 1/2 year-old girl, who presented with polycythaemia as the only symptom, the expected renal tumour was only found after exclusion of all other causes of polycythaemia. The delay in diagnosis was caused by technically inadequate intravenous urograms, which were erroneously passed as normal. In one child low kv X-ray exposition of the kidneys led to the diagnosis of a renal tumour. In the other child high-dose urography and tomography gave the indication for selective angiography. Normalization of the red blood count postoperatively verifies the connection between preoperative erythrocytosis and the renal tumour. Histologically both cases proved to be renal adenomas, which are extremely rare in childhood.

Adenoma↗
PubMed1977

[Diagnostic, therapeutic and prognostic aspects of wilms' tumour (author's transl)].

Within the last 20 years 43 children with Wilms' tumour were seen at the Paediatric Departments of the University Hospitals of Graz, Innsbruck and Vienna. Case histories, clinical details and diagnostic procedures are discussed. Since 1969 19 out of 21 children were treated according to the modern atandard regimen (operation, irradiation and cytostatic therapy for 2 years except in infants with stage I). Since 1969 the survival rate has been higher (17 out of 21 children: 81%) than in the period 1956 to 1968 (7 out of 22 children: 31.8%), when only one child (in stage I) was treated according to current concepts. The better prognosis noted in young infants of this series, as in the literature was due to the earlier stage of the disease in these infants. A further improvement in the survival rate of children with Wilms' tumour should be achieved by earlier diagnosis, thereby ensuring operability, and by cytostatic therapy during the following 2 years. This will only be possible when there is closer cooperation between surgeon, radiotherapist and oncologist. It should be possible to lower the long-term therapeutic complication rate with even more stringent observation measures and with increasing expertise of all doctors concerned.

Age Factors↗
PubMed1977

[Neuroblastoma: diagnosis, therapy and prognosis on the basis of 56 cases (author 's transl)].

Within the last 20 years 56 children with neuroblastoma were seen at the Paediatric Departments of the University Hospitals of Graz, Innsbruck and Vienna. Case histories, clinical details and diagnostic procedures are discussed. The poor prognosis (only 18 out of the 56 children i.e. 32% are still alive) is due to the high incidence of metastasis (55% of the patients were admitted in stage IV of the disease). Diagnosis within the first year of life, mediastinal localization and histological differentialtion to ganglioneuroblastoma are good prognostic features, whereas therapeutic measures are of less importance. Radical surgery still provides the patient with the best chance of survival, but is rarely feasible (complete primary removal was possible in only 7 out of the 56 patients; in futher 2 patients the tumour proved to be resectable at a 2nd look operation). Cytostatic therapy has not really increased the survival rate. At present improvement in prognosis can only be expected in case of early diagnosis of the tumour.

Adolescent↗
PubMed1977

[Congenital hepatic fibrosis and polycystic disease of the kidneys in two siblings (author's transl)].

Report of 2 siblings, aged 12 1/2 and 9 years, with congenital hepatic fibrosis and polycystic disease of the kidneys. Hepatosplenomegaly had been noted in both children at birth. The younger child had suffered from oliguria aged 2 1/2 years. At diagnosis both children had low platelet counts, one also had leucopenia. The cystic disease of the kidneys was verified by angiography. Coeliacography and splenopartography were diagnostically irrelevant. The diagnosis only became apparent from liver biopsy which was performed during splenectomy. After splenectomy there was an increase of platelets, white blood cells and the clotting factors II, V and X. The three years follow-up showed a constancy of renal impairment and of the minor oesophageal varices observed in the one patient who did not have a spontaneous spleno-renal anastomosis. So far no bleeding has been observed. Porto caval anastomosis was omitted in both children. Pros and cons are being discussed.

Child↗
PubMed1976

[Cytostatic therapy in a patient with histologically verified, but not irradiatied, brain stem glioma (author's transl)].

A boy, aged 8 1/2 years, was operated becuase of a brainstem tumor (polymorph mixed glioma) more than 4 years ago. Because of its dimension and location in the medulla oblongata the tumor was resected only partially. Radiotherapy was refused at that time. A combined cytostatic therapy proved to be successful. The marked neurological symptoms diminished considerably during treatment. The patient (with minor neurological symptoms) has been living a normal and active life for the last 4 years.

Brain Neoplasms↗
PubMed1976

[Differential diagnosis of chronic myeloic leucemia in infancy (author's transl)].

A 3 months old girl presented with significant enlargement of liver, spleen and lymphnodes, with moderate anemia, thrombopenia and leucocytosis. In the differential count there was a shift to the left and an increase of monocyte-like cells (35%). Differential diagnosis included leucemoid reaction, infectious mononucleosis, myelo-proliferative disorder with a missing C chromosome and chronic myeloid leucemia. Clinical symptoms, cytochemistry and caryotype of bone marrow cells suggested infantile chronic myeloic leucemia and normal ALP index and possibly normal HbF. Treatment with 6-mercaptopurine was followed by partial remission. The therapeutic consequences of exact differential diagnosis are discussed.

Anemia↗
PubMed1976

[Cerebellar vincristine toxicity (author's transl)].

The diagnosis of Wilms tumor stage IV was established in a girl of 5 1/2 years of age in July 1972. Nephrektomy was followed by radiotherapy of the tumorbed and the lung metastasis. Thereafter the child was treated with Vincristine (VCR) and Actinomycine D (AMD) for two years. The child has been off treatment for the last 14 months and is free of disease. An intention tremor of the right hand was noted 4 weeks after the 32nd application of VCR and 2 weeks after a viral infection of unknown etiology. The writing proved to be hypermetric. There was no loss of proprioception and thus the symptoms were localized into the right cerebellum. Having excluded other causes (hemorrhage, metastasis) as far as possible and considering unilateral cerebellar encephalitis as very unlikely the cerebellar symptoms were thought to be VCR toxicity.

Cerebellar Diseases↗
PubMed1976

[Announcement of an Austrian study group for the treatment of leukemia in children (author's transl)].

The formation of an Austrian study group for the treatment of leukemia in children with international cooperation is reported. An essential aim is the centralisation of treatment at the 3 Austrian University clinics, the St. Anna children's hospital in Vienna and other children's hospitals particularly interested in the treatment of leukemia. Secondly the group undertakes randomised therapeutic studies, at present on two new variants of the Pinkel treatment scheme. Within the first 9 months 33 cases were included in this study in cooperation with the Zagreb University children's clinic (Doz. TIEFENBACH).

Austria↗