Biomedical subjects
Publications and source records attributed to F Lampert.
Two cases of necrosis of caput femoris in children are reported. In both of them the lesion developed three years after diagnosis of acute lymphoblastic leukaemia, but during complete remission. Possible relations of the necrosis to ALL, Prednisone-therapy or constitutional factors are discussed.
1 1/2 years after diagnosis of acute lymphoblastic leukemia, Hodgkin's disease, stage IIA of cervical lymphnodes could be verified microscopically in a 7 year old girl in continuous complete remission (of leukemia) and was treated with regional irradiation and combination chemotherapy after exploratory laporotomy with splenectomy. The patient now is off therapy, healthy and without any signs of relapse of the two malignancies.
Scaling and subgingival curettage were performed on the upper and lower front teeth of 25 patients in the age of 25 to 35 years. Peripac was applied to the periodontal tissue of three of the six teeth treated per subject and Histoacryl to the periodontal tissue of the other three teeth. Prior to and three months after the beginning of therapy, pocket depth, sulcus bleeding tooth mobility were determined. It was found that the use of Histoacryl as a dressing material is not a disadvantage as compared to the conventional dressing Peripac as far as therapeutic success in terms of declining pocket depth and SBI is concerned.
The forameter is an instrument used for measuring the length of the root canal. Here the use of the principle of resistance measurement is refined. The position of the apical foramen is shown acoustically as well as visually. This investigation gives positive results for the measurements in the treatment of devitalised teeth. The inaccuracy of measurement in living teeth appears too great.
The technique of acid cauterisation is only effective in the area of the enamel. The technique of preparation has to be modified if fillings go beyond the area of the enamel. Those modifications and solutions are discussed which combine the anchoring possibilities of conventional preparations with the technique of acid cauterisation.
Only 40 out of 104 patients with neuroblastoma survived moronger than 5 years, and 7 longer than 10 years. This indicates a 2 year remission period of 38.4%. Of the 40 surviving children, only 11 (10,4%) showed no further complications, while 29 (72,5%) children suffered from severe later complications originating from the tumor or the therapy. The skeletal system was affected in 42.9%, the peripheral nervous system in 21.5%, and the central nervous system in 19.6%. In 4 patients, we observed a statomotoric retardation and intelligence deficiency, and in 3 other children, an Australian antigenemia. The possible reason of these later complications are discussed in the paper. The high number of such complications in patients with neuroblastoma raises the question whether or not a less radical therapeutic procedure would be more advisable for differentiated tumors.
Within a 2-year period, from March 1974 until May 1976 10 patients with anorexia nervosa were seen at the children's university hospitals of München (2 patients) and Giessen (8 patients). The patients were 10-16 years old, with one exception all girls, and had the typical cachexia, hypothermia, bradycardia, gray, hairy skin, and amenorrhea in those who had reached menarche. The blood counts at diagnosis revealed a leukopenia (below 5000/mm3) in 6 patients and a thrombocytopenia (below 150000/mm3) in 4 patients. The bone marrow was examined in 7 patients and showed marked hypocellularity with only few megakaryocytes present and abundant vacuolated hyaline material. Bone marrow erythroblasts were decreased (below 20%) in 5 patients, although peripheral blood hemoglobin and hematocrit were normal or even elevated in all 10 patients. In 7 patients blood urea nitrogen was elevated above 30 mg%, the highest value being 145 mg%. Blood and bone marrow alterations as well as the renal abnormalities disappeared within days to a few weeks after a regimen of strict fluid and caloric intake was initiated and a gain in body weight of up to 10 kg was achieved.
Fifteen cases of chronic lymphadenitis with massive hemophagocytic sinus histiocytosis were analyzed. Fourteen patients were whites, 13 were Europeans, and 11 were males; 10 patients were under 10, 4 were over 20, and 2 over 60 years old. The oldest patient died; all other either healed without therapy or are in excellent condition. We studied the cytologic features of lymph node imprints. A 5-year-old girl was examined more thoroughly. High antibody titers to Klebsiella antigens were found repeatedly. The patient also had a constant lymphocytopenia. Phytohemagglutinin-induced blast transformation and lymphotoxin production were within normal limits. No serum Epstein-Barr virus-antibodies could be detected.
In accordance with the recommendations of Pinkel, 147 children with acute lymphoblastic leukemia were treated by a combined cytostatic and radiation therapy during a joint study between May 1971 and Jan. 1, 1974. After a primary cytostatical treatment which brought about a remission of 94% of the patients within four to six weeks, the cranial irradiation was performed, depending on age, with a focal dose of 1500 up to 2400 rd in the course of three or four weeks. Simultaneously, the patients were given methotrexate intrathecally which was followed, later on, by a long-term therapy with cytostatics. By means of this combined treatment, a three-year survival was obtained in 50% (8 of 16) and a complete remission in 44% (7 of 16). The prognosis is the same for boys as for girls. A less favorable prognosis concerns the patients with an initial leukocytosisf more than 50 000 leukocytes/mm3 of blood, an age of more than ten years, and leukemic cells already demonstrable in the cerebrospinal fluid.
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The masticatory system has often proved very useful for the identification of unkown bodies. The technique of excising the mandible and the maxilla is explained. The evaluation and the preparation of models are described. For registration of the findings a new form has been developed. It is based on the old form "KP 16" as well as on the PA status.
The 5-year experiences of a center for pediatric oncology in a children's university hospital are reported. Currently (1-1-1975) 60 of 135 treated leukemic and 88 of 152 treated tumor patients are living. 1974, there were in the average 34 ambulatory complete blood counts per week, and in addition 263 bone marrow and 196 ambulatory lumbar punctures per year. The standardized routine of an outpatient visit is described. Advice for parents and family physicians are given. A standardized diagnostic approach for M. Hodgkin as a prototype is proposed, and a standardized therapy for Wilms' tumor. Of 24 thus treated children with Wilms' tumor 16 ("67 p.c.") survive, included 7 of 15 ("47 p.c.") with metastasized disease (observation time 21-71 months). Current treatment of 49 children with acute lymphoblastic leukemia resulted in continuous complete remission of 22 patients ("45 p.c.") (observation time 1-4 years), but 6 dead in complete remission due to infection. The need for specialized treatment centers with skilled persons is emphasized.
A cytogenetic investigation was performed in a family which included 2 individuals with congenital neuroblastomas of the suprarenal gland confirmed by autopsy and one with a ganglioneuroblastoma of the thoracic wall as well as 3 other individuals with tumors which probably were also neuroblastomas. The lymphocytes of the peripheral blood of 5 healthy relatives as well as of the child with the treated ganglioneuroblastoma failed to show a constant alteration of chromosomes. In this family, therefore, the suggestion could not be proofed that the very rare familial aggregation of neuroblastomas is caused by a hereditary chromosomal aberration.
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