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Biomedical subjects

H Reinhard

Publications and source records attributed to H Reinhard.

At least 19 recordsLinked to original sources

Two infants with life-threatening diffuse neonatal hemangiomatosis treated with cyclophosphamide.

Diffuse neonatal hemangiomatosis (DNH) is a rare, frequently fatal disorder characterized by multiple cutaneous and visceral hemangiomas. Complications include high-output cardiac failure, hemorrhage, hepatic failure, and consumption coagulopathy. We present two cases of neonates with DNH. We prescribed cyclophosphamide after failure of corticosteroids. Cyclophosphamide induced a fast regression of the lesions with no side effects in both infants. We were able to stop treatment after 3-4 courses of cyclophosphamide in both infants because of the excellent response. Cyclophosphamide seems to be a safe and effective treatment in patients suffering from life-threatening DNH unresponsive to corticosteroids.

Adrenal Cortex Hormones↗

Effects of short-term propofol administration on pancreatic enzymes and triglyceride levels in children.

This prospective, clinical trial evaluated the effects of short-term propofol administration on triglyceride levels and serum pancreatic enzymes in children undergoing sedation for magnetic resonance imaging. Laboratory parameters of 40 children, mean age (SD; range) 67 (66; 4-178) months undergoing short-term sedation were assessed before and 4 h after having received propofol. Mean (SD) propofol loading dose was 2.2 (1.1) mg.kg(-1) followed by continuous propofol infusion of 6.9 (0.9) mg.kg(-1).h(-1). Serum lipase levels (p = 0.035) and serum triglyceride levels (p = 0.003) were raised significantly after propofol administration but remained within normal limits. No significant changes in serum pancreatic-amylase levels were seen (p = 0.127). In two (5%) children, pancreatic enzymes and in four (10%) children triglyceride levels were raised above normal limits; however, no child showed clinical symptoms of pancreatitis. We conclude that even short-term propofol administration with standard doses of propofol may have a significant effect on serum triglyceride and pancreatic enzyme levels in children.

Adolescent↗

[Prognosis of Wilm's tumor in the course of the SIOP trials and studies].

Wilms' tumor is the most common malignant renal tumor in children. Dramatic improvements in survival have occurred as the result of advances in anesthetic and surgical management, irradiation, and chemotherapy. Today treatments are based on several multicenter trials and studies conducted by the SIOP in Europe and NWTS in the USA. The main objectives of these trials and studies are to treat patients according to well-defined risk groups in order to achieve the highest cure rates, to decrease the frequency and intensity of acute and late toxicity, and to minimize the cost of therapy. The SIOP trials and studies largely focus on the issue of preoperative therapy whereas patients treated according to NWTS are primarily operated.

Adolescent↗

[Stroke in childhood].

About 3% of cerebral infarcts occur in children and young individuals, and pediatric stroke is even less common. Cerebral infarcts in children have different etiologies compared to adults. The common causes are described, as well as sinus venous occlusions. Cerebral veno occlusive disease is an elusive, often underdiagnosed cause of acute neurologic deterioration.

Adolescent↗

[Supratentorial tumors in childhood].

In Germany about 400 children are diagnosed of having a brain tumour each year. About half of them are located in the supratentorial region. Despite the fact, that brain tumours are the most common solid tumour in childhood, they are very heterogeneous, regarding clinical symptoms, pathology, treatment and prognosis. Imaging studies play an important role for diagnosis and follow-up.

Adolescent↗

High-dose chemotherapy with autologous stem cell rescue in children with retinoblastoma.

Children with metastatic retinoblastoma are considered to have a poor prognosis after conventional chemotherapy. We used high-dose chemotherapy (HDC) with peripheral hematopoietic stem cell transplantation in such patients in an attempt to improve their survival. Four patients with bone marrow metastases and one child with extraorbital disease were treated with HDC after achieving complete remission by enucleation and conventional chemotherapy. The child with extraorbital tumor was the only one to receive local irradiation. The conditioning regimen included thiotepa (900 mg/m(2)), etoposide (40 mg/kg) and carboplatin (1.5 g/m(2)) in four patients, and BCNU (300 mg/m(2)), cyclophosphamide (6.8 g/m(2)) and etoposide (1.6 g/m(2)) in one child. Hematologic recovery occurred without delay in all patients. The main toxicities were diarrhea, mucositis and infectious complications. No toxic deaths or any major late toxicities were observed. The child treated with the BCNU regimen developed a meningeal relapse 10 months after HDC, which was partially resected and treated with conventional chemotherapy, but not with radiotherapy. He is in complete remission (CR) 105 months off treatment. The other patients are in CCR for 107, 57, 9 and 8 months after HDC. HDC with thiotepa, etoposide and carboplatin may represent a curative option for children with extrabulbar or disseminated retinoblastoma responsive to chemotherapy. It may control occult CNS disease. The necessity to irradiate these children and the curative potential of this strategy for patients with bulky CNS disease remain to be determined.

Antineoplastic Combined Chemotherapy Protocols↗

[Meningioangiomatosis with associated meningioma in a 4-year-old girl presenting with a focal seizure].

Meningioangiomatosis is regarded as a rare, benign, hamartomatous malformation. Histopathologically, the lesion is characterized by circumscribed transcortical and leptomeningeal meningovascular proliferation with focal calcifications. It may be classified into cases with predominant cellular or vascular features and may occur in association with neurofibromatosis, mostly of type 2, but sporadic cases are more frequently reported. Sporadic cases often present initially with seizures and can be treated surgically. However, a certain percentage of patients will need ongoing anticonvulsive therapy. The lesions are seldom associated with an overlying meningioma. These are usually benign lesions that must be strictly separated from an invasive anaplastic meningioma, which would warrant an adjuvant therapy. We report on a 4-year-old girl who presented with spontaneous, predominantly cellular meningioangiomatosis with associated fibrous meningioma. Focal immunopositivity of the meningioangiomatosis for CD34 was helpful in ruling out an invasive meningioma.

Antigens, CD34↗

Prenatal diagnosis of sacrococcygeal teratoma: a review of cases between 1993 and 2000.

Sacrococcygeal teratoma is the most common fetal neoplasm with a reported incidence of 1 in 30,000 to 40,000 births. Affected fetuses carry a high perinatal mortality and morbidity. The aim of this retrospective study was to assess prenatal sonographic aspects and pathological details of our cases with sacroccocygeal teratoma. Over the last seven years we identified six cases by retrospective chart review in our institution. Four fetuses were electively aborted, in two of these four fetuses the diagnosis was made before the 16th week of gestation. Two caesarean sections were performed at 35 + 5 and 37 + 0 weeks of gestation, respectively. In those two cases the diagnosis was only made in the late second and third trimester. No case of neonatal mortality occurred. In one of the two resected sacroccocygeal teratomas potential malignancy was diagnosed. A multidisciplinary approach seems advisible for optimal perinatal management.

Abortion, Induced↗

Primary mediastinal germ cell tumors in children and adolescents: results of the German cooperative protocols MAKEI 83/86, 89, and 96.

PURPOSE: To evaluate children and adolescents with primary mediastinal teratoma and malignant germ cell tumors (GCTs). PATIENTS AND METHODS: Forty-seven patients from the German nontesticular GCT studies were analyzed (median age, 2.5 years; range, neonate to 17 years). Teratoma (n = 21) were resected, and no adjuvant treatment was given. Malignant GCTs (n = 26) were treated with cisplatin-based chemotherapy and resection. Three of 26 patients underwent radiotherapy. RESULTS: In all patients with teratoma, tumor markers were normal. Surgery of teratoma was complete in 17 of 21 patients and microscopically incomplete in four of 21 patients, and we observed no relapse after a median follow-up of 29 months. In 23 of 26 patients with malignant GCTs, alpha-fetoprotein and/or beta-human chorionic gonadotropin were elevated. Twelve of 26 patients received adjuvant chemotherapy after initial resection, which was complete in six of 12 patients, whereas delayed resection after preoperative chemotherapy was complete in 10 of 11 patients (P =.03). Four of six patients underwent second-look thoracotomy after incomplete primary surgery. Three of 26 patients did not undergo tumor resection. The final completeness of resection was the strongest prognostic indicator (event-free survival ¿EFS, 0.94 +/- 0.06 v 0.42 +/- 0.33; P <.002). Local stage and distant metastases were not prognostically significant at the.05 level. For all malignant GCTs, the 5-year survival rate was 0.87 +/- 0.05 (median follow-up, 51 months), with an EFS of 0.83 +/- 0.05. CONCLUSION: The prognosis of mediastinal teratoma is excellent after complete or microscopically incomplete resection. In children with malignant GCT, the prognosis is favorable with a therapeutic strategy of delayed resection after preoperative chemotherapy. In most children, the diagnosis can be based on elevated tumor markers and imaging. Biopsy is indicated in nonsecreting GCT.

Adolescent↗

Reversed-phase liquid chromatographic behavior of the mycotoxins citrinin and ochratoxin A.

The reversed-phase (RP) chromatographic behavior of citrinin (CT) and ochratoxin A (OA), the latter introduced as reference substance, were studied as a function of hydrophobicity and silanophilic activities of the stationary phase, pH, type of acid in the eluent, its composition as well as of the column temperature. While OA's affinity to RP materials was not influenced by phase material properties, CT showed a high affinity to hydrophobic phase materials, and its elution order, compared to OA, depended strongly on the phase material chosen. In practice, all octadecyl stationary phases under investigation allowed proper conditions for CT and OA chromatography if judicious selection of influencing parameters, especially a low pH and applying an acid with a pKa<2.3, were chosen.

Acids↗

[Doppler ultrasound flow measurement of fetal and uteroplacental blood vessels. Study of a normal population in the 2d half of pregnancy].

Weekly Dopplersonography measurements were performed on the fetal aorta abdominalis, the umbilical artery, the fetal carotid artery and the uterine arcuate artery from the 20th to the 41st weeks of gestation, mean and maximum blood flow velocities were measured, as well as the resistance index. The mean values calculated from 20 cases per week were translated into standard graphical representations serving as a criterion for the assessment of pathological pregnancies. The vessels were examined as to their value for a screening programme of fetal circulation. A sample curve of a severe placental insufficiency showed significant deviations from the standard curves.

Arteries↗

Comparison of amino acid sequence analysis by electron ionization and negative-ion chemical ionization mass spectrometry.

The positive electron ionization and negative chemical ionization mass spectra of 15 different derivatives of the tripeptide Phe-Ala-Leu have been compared. Total ion currents and ion currents of sequence-characterizing ions have been measured and compared. The negative-ion spectra, using 10% carbon dioxide in argon as moderator gas, proved to be simpler and contained more abundant sequence ions than the positive electron ionization spectra.

Amino Acid Sequence↗

An effective morphometric method for electron microscopic studies on papillary muscles.

Morphometry was performed on the left ventricular posterior papillary muscles of seven Wistar rats. The volume densities of myocardial cells, interstitial space, myocardial nuclei, sarcoplasm, mitochondria, myofibrils, ground substance and T tubules, and the surface densities of myocardial cells, mitochondrial membranes and T tubules, were calculated. Though only 1 ultrathin section per animal was evaluated the low standard errors of the means indicate that the method described here will be adequate in most experimental studies. Due to the anisotropy of the surfaces within myocardial cells, the papillary muscles were cut at an angle of 32.4 degrees to their longitudinal axis. This angle is derived from an equation published by Whitehouse (1974). The procedure to correct the loss of cristal membrane images from oblique sectioning is discussed.

Animals↗