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Biomedical subjects

H Reinhard

Publications and source records attributed to H Reinhard.

31 records · Page 2Linked to original sources
PubMed1977

[Tryptic pancreatitis in small-cell bronchial carcinoma (author's transl)].

In two cases of typical small-cell bronchial carcinoma (one of them peripheral, small and clinically not diagnosed) destructive parenchylmal metastases in the pancreas, carcinomatous lymphoangiosis and infiltration of the larger excretory ducts by tumour cells were demonstrated. In both the clinical course was dominated by tryptic pancreatitis with treatment-refractory hypokalaemia. Since pancreatic metastases occur in about 10% of bronchial carcinomas, tryptic pancreatitis is, however, only rarely observed. It is, therefore, likely that autodigestion occurs only if in addition to parenchymal destruction by the metastases there are other factors. These may be blockage of lymphatic flow by carcinomatous lymphangiosis and duct stenosis by tumour infiltration of the walls. Hypercorticism due to ectopic ACTH production by the small-cell carcinoma may also be factor, but is without proof.

Carcinoma, Small Cell↗
PubMedDate not supplied

[Experimental visualization of the ventricular conduction system of the heart intra vitam (author's transl)].

The in-vivo tolerability of an in vitro in cow, calf and sheep hearts developed method for radiologic visualization of the left ventricular conduction system is tested in four animal experiments. The clinical in-vivo tolerability could be demonstrated on principle; however, it is to accent that hypertonic X-ray contrast dyes may be the cause of morphological changes in the micro- and ultrastructures of the specialised musculature of unknown dignity.

Animals↗
PubMedDate not supplied

[The importance of conventional radiographs in the diagnosis of osteosarcoma].

We report about a 12-year-old boy with a history of recurrent patella luxation. Due to persistent pain in the distal left femur a MRI examination was performed in another hospital which suggested a malignant bone tumor. Without validation of the MRI findings by conventional radiographs bone biopsy was performed. Histopathological examination yielded the diagnosis of a chondroblastic osteosarcoma. Before initiating polychemotherapy, plain radiographs for the first time, a nuclear imaging study and an additional MRI examination were performed in our hospital. The results of these studies made the diagnosis of an osteosarcoma unlikely. In particular, plain radiographs did not show any osseous lesion which was characteristic of an osteosarcoma. To establish a definite diagnosis biopsy was repeated with resection of the bone area which showed suspicious changes in MRI studies. An osteosarcoma was ruled out by histopathological examination. The pathologic changes detected in MRI were rated as bone bruise on plain radiographs and seemed to be of traumatic origin. Our case report emphasises the importance of conventional radiographs in establishing the diagnosis of an osteoarcoma respectively bone tumors and tumor-like lesions in general. They still remain the mainstay in diagnosing bone forming tumors. MRI imaging studies may show changes which mimick solid lesions but in deed can be of traumatic origin. Without informing the pathologist about the exact origin of the specimen, histopathological examination may lead to the misdiagnosis of a chondroblastic osteosarcoma if specimen, like in this case report, represents epiphyseal tissue showing cartilaginous areas with reactive bone formation.

Biopsy↗
PubMedDate not supplied

[Solid-pseudopapillary tumor of the pancreas in a 9-year-old girl].

Solid-pseudopapillary tumor of the pancreas constitutes a very rare benign or low-grade malignant lesion occurring most commonly in young women and girls. It was first described by Frantz. Local infiltration, distant metastasis and recurrence are very rare. Until today, the histogenetic origin of the tumor cell remains to be elucidated. In 1996, solid-pseudopapillary tumor of the pancreas was introduced in the World Health Organization (WHO) classification of tumors of the exocrine pancreas. Our case report--like a recently published work by Lange et al.--intends to underline the significance of solid-pseudopapillary tumor in the differential diagnosis of a pancreatic mass.

Biomarkers, Tumor↗
PubMedDate not supplied

Results of the SIOP 93-01/GPOH trial and study for the treatment of patients with unilateral nonmetastatic Wilms Tumor.

BACKGROUND: The treatment of Wilms Tumor is integrated into clinical trials since the 1970's. In contrast to the National Wilms Tumor Study Group (NWTSG) the SIOP trials and studies largely focus on the issue of preoperative therapy to facilitate surgery of a shrunken tumor and to treat metastasis as early as possible. PATIENTS AND METHODS: In the SIOP 93-01/GPOH trial and study 1 020 patients with a newly diagnosed renal tumor were registered. 847 of them had a histological proven Wilms Tumor, of whom 637 were unilateral localized, and 173 tumors had an other histology [40 congenital mesoblastic nephroma (CMN), 51 clear cell sarcoma (CCSK), 24 rhabdoid tumor (RTK) and 58 other tumors]. Preoperative chemotherapy in benign tumors was given to 1.3 % of the patients. The main objective of the trial was the randomized question, if the postoperative two drug chemotherapy for stage I in intermediate risk or anaplasia can be reduced from conventional 3 courses to an experimental 1 course without loss of efficacy. RESULTS: 519 patients with unilateral nonmetastatic Wilms did receive preoperative chemotherapy. The histology in this group of patients was of intermediate risk in 469 (90 %) patients, 14 (3 %) tumors were low risk and 36 (7 %) high risk. The stage distribution of the tumors was stage I in 315 (61 %), stage II N- in 126 (24 %), stage II N+ in 25 (5 %) and stage III in 36 (7 %) patients. In 17 (3 %) patients the tumor stage remained unclear. Tumor volume was measured in 487 patients before and in 402 after preoperative chemotherapy. The median tumor volume did shrink from 353 to 126 ml. The amount of volume reduction depends on the histological subtype. The event free survival (EFS) after 5 years was 91 % for all patients with unilateral Wilms tumor without distant metastasis. Randomisation was done in 43.7 % for stage I patients and there was no difference in EFS for both treatment arms (90 versus 91 %). The EFS is identical for patients with stage I and II N- (0.92), as well as for stage II N+ and III (0.82). The tumor volume after chemotherapy is a prognostic factor for intermediate risk tumors with the exception of epithelial and stromal predominant tumors. These two subtypes often present as large tumors, they do not shrink during preoperative chemotherapy but they still have an excellent prognosis. On the other hand the prognosis of patients with blastemal predominant subtype after preoperative chemotherapy is worse than in any other patient group of intermediate risk tumors. There are less blastemal predominant tumors compared to primary surgery, but they are chemotherapeutic resistant selected by the preoperative chemotherapy. CONCLUSION: Patients with unilateral Wilms tumor without metastasis have an excellent prognosis. The post-operative chemotherapy in stage I can be reduced to 4 weeks without worsening treatment outcome. The reduction of the tumor volume could be identified as a helpful marker for stratification of post-operative treatment. Post-chemotherapy blastemal predominant subtype of Wilms tumor has to be classified as high risk tumor. Focal anaplasia has a better prognosis than diffuse anaplasia and will be classified as intermediate risk tumor.

Adolescent↗
PubMedDate not supplied

[Churg-Strauss syndrome in a 15-year old boy].

A 15 year-old boy was admitted in our hospital with the clinical signs of cardiopulmonary deterioration. His history showed bronchial asthma since 3 years. Furthermore he revealed signs of polyneuropathy, exanthema and a transitory pulmonary infiltration. Elevation of eosinophilic granulocytes and IgE confirmed the diagnosis of a Churg-Strauss syndrome. A rapid improvement of the symptoms was achieved by high-dose steroids and symptomatic therapy. The impaired systolic and diastolic myocardial function improved, but a cardiomyopathy with a shortening fraction below 25% persisted. The Churg-Strauss syndrome is a rare disease in childhood and is classified as a systemic granulomatosis of the vessels. The marked perimyocarditis with consecutive restrictive cardiomyopathy is a rare manifestation in childhood and adolescence. The prognosis of this disease is mainly influenced by the cardiac involvement.

Adolescent↗
PubMedDate not supplied

Retinoids in the treatment of acute promyelocytic leukemia. Review of the literature.

Retinoids are derivates of vitamin A. They play an important role in embryogenesis and differentiation of normal cells. All-trans retinoic acid (ATRA, Tretinoin) and 13-cis retinoid acid (cRA, Isotretinoin) are the most important isomers. The first treatment with retinoids in a patient with an acute promyelocytic leukemia (APL) is reported in 1983. Since 1988 studies are done investigating the effect of retinoids in APL. These studies demonstrate, that retinoids can achieve a high remission rate in patients with APL but without curing patients. A combination with chemotherapy is always necessary. The main advantage of using retinoids in this disease is a rapid improvement of the hemostatic disorder and the absence of an aplastic phase. Side effects of retinoids are those of the hypervitaminosis A syndrome and have to be considered in every patient treated with this drug. The addition of alpha-Tocopherol seems to ameliorate the toxicity of retinoic acid (RA). The theoretical background of the treatment with retinoids in APL as well as the clinical studies done so far are explained in detail.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[The importance of pulsed Doppler sonography for prenatal diagnosis of placental insufficiency--studies of 198 patients].

Doppler sonographic measurements of the fetal aorta and the carotid artery were performed on 198 pregnant patients having been diagnosed with a placental insufficiency. A relationship between them and fetal as well as non-fetal factors was examined. For the fetal factors minus difference in weight of birth and perinatal morbidity there could be established a definite correlation with corresponding resistance-index (RI) of the examined vessels. The criteria for the fetal outcome Apgar-note and pH-value of the cord blood didn't show absolutely equal changes with a deteriorated blood perfusion, what might be due to the management of birth as well as it indicates the close correlation of these values with the course of birth. Among the non-fetal factors there could be shown close relationships between the duration of pregnancy as well as age and the values of resistance-indices. While the ones, mentioned first, decreased in an almost linear relationship with RI-deterioration, did the fetal circulatory situation ameliorate with an increasing maternal age. Possible factors of influence, especially on the duration of pregnancy as well as the relationship between the maternal age and the fetal condition of perfusion were discussed. Pulsed doppler sonographic measurement is an efficient step in diagnosing a suspected placental insufficiency and has an outstanding value in an early recognition of possible dangers for the fetus.

Aorta, Abdominal↗