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Biomedical subjects

I Meller

Publications and source records attributed to I Meller.

85 records · Page 5Linked to original sources
PubMed1989

Pediatric update #8. Acute hematogenous osteomyelitis in children. Long-term results of surgical treatment.

A retrospective review (1970-1982) of the clinical experience of 68 children with acute hematogenous osteomyelitis (AHO) is presented. Analysis of the epidemiologic, clinical, laboratory, radiologic and bacteriologic findings is made. Our series was treated mainly by an aggressive primary surgical protocol which is described in detail. Seventeen percent developed chronic osteomyelitis. The role of surgery in the treatment of AHO is discussed. It is our belief that surgical treatment has definite advantages over the conservative regime and it remains our treatment of choice.

Acute Disease↗
PubMed1986

Use of psychiatric facilities in the Upper Bavarian follow-up field study.

Utilization of psychiatric facilities by non-institutionalized persons aged 20 years and older was examined. Data were based on the representative community sample of the Upper Bavarian Follow-up Field Study, the original sample size being 1668 persons. In the 5-year follow-up 1384 (83.0%) subjects were interviewed; 80 subjects (4.8%) had died meanwhile. The follow-up sample contained 44 people who refused the first interview and agreed to participate at the follow-up. The 5-year prevalence of mental illness according to the definition used was 31.4%. The rate for psychiatric treatment (in- or outpatient) was 8.5%. We analyzed which people with mental illness seek help from professionals in psychiatric hospitals, from psychiatrists in private practices and psychosocial services, according to type of diagnosis, course of disorder (incidence, remission, chronic), sociodemographic data and psychosocial factors.

Adult↗
PubMed1983

The importance of artifactual factors in the relationship between sex and mental disorders.

This study is based on a representative sample of 1,536 subjects (15 years of age and older) in three communities of Upper Bavaria. The rate of refusal was 6.8%. Independent of the sex of the interviewer the rate of mental illness among women was higher than among men. However, male interviewers diagnosed mental disorders for women slightly more often than did the female interviewers. Using a self-rating scale, we found a tendency indicating that women report more symptoms than do men when psychiatric respectively somatic diagnoses are held constant. 28.9% of the women and 22.1% of the men who, in cross-section, demonstrated a mental disorder, had been treated psychiatrically before. Men were more often than women admitted to psychiatric hospitals. Voluntary help-seeking seems to be more prevalent among women with emotional problems.

Adolescent↗
PubMedDate not supplied

Effect of P-glycoprotein expression on outcome in the Ewing family of tumors.

This study was designed to determine the prognostic significance of multidrug resistance, mediated by P-glycoprotein (Pgp) expression, in Ewing sarcoma. The clinical and laboratory features, treatment protocol, and outcome of 75 patients with Ewing sarcoma or peripheral neuroectodermal tumor treated between 1972 and 1997 were reviewed. Pgp expression was tested with the monoclonal antibody JSB-1. Thirty-four (64%) of the 53 tissue samples from untreated patients stained positive for Pgp. Progression-free and overall survival were 44 and 59%, respectively, in patients with negative findings, and 28 and 41% in those with positive findings; neither difference was significant. Of the 12 relapsed patients, 6 (50%) expressed more Pgp after chemotherapy than at diagnosis and 4 (33%) expressed less. Within these subgroups, 5 out of 6 and 3 out of 4 died from the disease. No correlation was found between Pgp and known prognostic factors of Ewing tumors. Pgp expression is probably an intrinsic factor of Ewing tumors but has no correlation to prognosis.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

The role of chemotherapy in childhood soft tissue sarcomas other than rhabdomyosarcomas: experience of the Northern Israel Oncology Center.

Forty-three children with nonrhabdomyosarcomatous soft tissue sarcomas (NRSTS) were treated at the Northern Israel Oncology Center in Haifa, Israel, from 1971 to 1996. The male:female ratio was 1.5:1 and the median age of patient was 10 years (range, 3 months-18 years). The most common histopathologic diagnoses were fibrosarcoma (32.5%) and synovial sarcoma (16%). The sites of primary tumor were lower limb (35%), trunk (18%), upper limb (16%), head and neck (16%), and retroperitoneum (11%). By Intergroup Rhabdomyosarcoma Study classifications, 13 patients presented as group I, 15 patients as group II, 10 patients as group III, and 5 patients as group IV. Median follow-up time was 63 months (range, 6 months-18 years). The estimated survival after a 5-year period is 72% (SE +/- 17) for patients in group I, 75 +/- 15% in group II, 90 +/- 9% for patients in group III, and 40 +/- 21% for patients in group IV. Eleven patients relapsed; 4/6 who developed local relapse were cured and are alive with disease, while 4/5 who developed distant metastases are dead. For the 28 patients who underwent complete resection at diagnosis, the estimated survival after a 5-year period is 87 +/- 5% vs. 60 +/- 17% for the 15 patients who underwent partial excision or biopsy. Local radiotherapy was delivered after surgery to group III patients. Preoperative and postoperative chemotherapy was delivered to the patients of groups III and IV, and postoperative chemotherapy only to group II patients. Chemotherapy produced demonstrable gain in survival for group II and III patients but not for patients with metastases. The authors conclude that an aggressive surgical approach is needed in patients with NRSTS. Chemotherapy may help as a preoperative treatment in bulky disease or as a postoperative treatment for microscopic residual disease.

Adolescent↗
PubMedDate not supplied

Limb congenital fibrosarcoma: report of two cases and review of the literature.

Two cases of limb congenital fibrosarcoma are reported. The use of postsurgery chemotherapy allowed conservative surgery in one of them. Wide local excision appears to be the treatment of choice unless the size of the tumor and its anatomic location requires amputation. Additional chemotherapy could shift the surgical approach to one of less radical surgery.

Combined Modality Therapy↗
PubMedDate not supplied

Vascular invasion in high grade sarcoma of the extremity is associated with short overall survival.

Intravascular sarcoma thrombi were histologically evident in 2% of 470 patients with soft tissue or bone sarcoma treated during the last 3 years. Vascular invasion by sarcoma in our series was associated with an aggressive disease and short-term overall survival. In all the cases there was a large or locally advanced primary high grade sarcoma, and in all but one case, where preoperative chemotherapy was administered, the response was far from satisfactory. The post-operative course in 70% of the patients was characterized by early systemic spread, and a median overall survival of 9.5 months. The gloomy prognosis of our patients does not necessarily stem only from the presence of vascular invasion, but may also be related to other factors as histologic grade and tumor size. However, as compared to similar cases in our patient population, which did not show vascular invasion, the course here was more violent and short.

Adolescent↗
PubMedDate not supplied

Adriamycin-ifosfamide induction chemotherapy for extremity soft tissue sarcoma: comparison of two non-randomized protocols.

Chemotherapeutic cytoreduction of soft tissue sarcomas may permit less radical operation. In cases of large or multi-compartmental masses, deeply seated tumors or involvement of a neurovascular bundle, down-sizing of the mass is required before limb sparing surgery can be considered. We have applied a combination chemotherapy consisting of intravenous adriamycin and ifosfamide with intra-arterial cisplatin for patients with soft tissue sarcomas of the extremity as induction treatment, and switched to an intravenous-only protocol due to toxicity and management difficulties. Adjuvant chemotherapy and radiation therapy were given after limb-sparing surgery in both regimens. Fresh tumor specimens were obtained and were examined for tumor size, surgical margins, percent of necrosis, evidence of vascular or perineural invasion, and the presence of Pgp, Ki-67, p53, PCNA and bcl-2-oncoprotein. Our results in terms of percentage of tumor necrosis were comparable and even better in favor of the second regimen [38% good histological response with intravenous (i.v.)-only versus 12.5% for combined i.v. + intra-arterial (i.a.]. The clinical and radiological responses were also better for the second (i.v. only) regimen (45%) than for the first (i.v. + i.a.) regimen (12.5%). The toxicity and the inconvenience to the patients and to the treating staff were greater in the first regimen that combined intra-arterial and intravenous infusions. In the first group the failure rate is 75% within 32 months of follow-up, while it is 33% within 12 months follow-up in the second group. The immunohistochemical markers did not correlate with disease control nor with the patient outcome. Intravenous administration of ADR-IFX induction chemotherapy was more feasible than combined i.v. ADR-IFX plus i.a. cisplatin and achieved better results.

Adult↗
PubMedDate not supplied

Primary bone tumor resectability: the value of serial MRI studies in the determination of the feasibility, timing, and extent of tumor resection.

We report the prospective analysis of 119 magnetic resonance imaging (MRI) studies in 41 patients with primary bone tumors performed from January 1984 to December 1990 to evaluate the contribution of serial MRI studies in the determination of feasibility, timing, and extent of tumor resection. Long repetition time (TR)-long echo time (TE) T2-weighted (T2, second echo) imaging was the most useful in assessing soft-tissue involvement, and short TR-short TE T1-weighted (T1) imaging for documenting the bone marrow changes. The feasibility, timing, and extent of resection was determined with the help of MRI in 20 cases with only two local recurrences. One study falsely suggested active tumor. In four other cases, a treatment decision was made based on the MRI. The MRI added significantly to the evaluation by computed tomography, radiographs, and bone scans.

Adolescent↗