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Biomedical subjects

I Mutz

Publications and source records attributed to I Mutz.

At least 55 records · Page 3Linked to original sources

[Successful bleomycin treatment of bronchopulmonary papillomatosis in a child].

The patient suffered from recurrent stridor since the eighth month of life; during the seventh hospitalization at the age of 2 1/2 years laryngeal papillomas were found. Surgical removal of the papillomas was attempted several times. Despite this bronchopulmonary papillomas were seen on chest X-ray films at the age of seven years. After intravenous bleomycin therapy (7 mg/sqm twice weekly for nine weeks) the infiltrates disappeared and the patient has remained free of symptoms til now (18 months later).

Bleomycin↗

Results of LSA2-L2 therapy in 26 children with non-Hodgkin's lymphoma.

Twenty-six children with non-Hodgkin's lymphoma (NHL), 17 boys and nine girls, were treated with the LSA2-L2 protocol. Seven children had stage I or II, 16 Stage III and three Stage IV according to Murphy's staging system. Eight children had their primaries in peripheral lymph nodes, eight in the abdomen, six in the mediastinum and four in other sites. All tumors were classified histologically according to four different classifications. Overall disease-free actuarial survival is 53.6%. Complete responders show a disease-free survival of 77.8%. Fourteen children survived for 9-56 months. Included are all seven children with Stage I or II who survive irrespective of histologic type of the tumor. Of the remaining 12 children in Stage III or IV three children died in remission and nine of progressive disease. Eight of these nine patients did not attain complete remission. Whereas four of five children with the convoluted type of NHL survive, four of five patients with the Burkitt's type (small noncleaved follicle center cell lymphomas) died of progressive disease. According to Rappaport's classification, four of six children with diffuse undifferentiated lymphoma (DUL) are dead due to tumour progression. Considering the classification of lymphoblastic lymphomas introduced by Nathwani et al., 23 five of seven children suffering from lymphoblastic lymphomas but only two of eight children with nonlymphoblastic lymphomas belong to the survivors. Therefore histologic findings do hold prognostic significance in our series of children with NHL.

Adolescent↗

[Therapy of advanced neuroblastoma in children].

The success rate of treatment for advanced neuroblastoma in childhood is still unsatisfactory. The Austrian pediatric oncology working group since 1979 uses a chemotherapy protocol of Dimethyl-triazeno-imidazol-carboxamid, Adriamycin, N-Lost, Vincristin or modified for age and stage a combination of Dimethyl-triazeno-imidazol-carboxamid, Adriamycin, N-Lost, Vincristin, Cyclophosphamide and Cis-platinum. Over a 30 month period 27 children with neuroblastoma were registered, six had a stage III, twelve a stage IV tumor. Currently 15 patients have no evidence of disease, six patients are alive with tumor, one patient with stage III and five patients with stage IV are dead.

Abdominal Neoplasms↗

[Progress in the treatment of juvenile leukemias].

Between January 1979 and December 1980 64 children with acute lymphoblastic leukemia were treated in 9 pediatric clinics in austria according to the BFM study 76/790-protocol. For remission induction all patients received an 8 week multidrug regimen (West-Berlin ALL-protocol). High risk patients were defined according to a risk score at diagnosis and additionally treated with a 6 week reinforced reinduction protocol during the first half year after diagnosis. Maintenance therapy was stopped after about 22 months. The life table-analysis after 30 months showed a 75.5% disease free survival for the total group of patients. Compared with a control group of 228 patients treated between 1974 and 1980 in 9 different clinics in Austria according to 3 consecutive national treatment regimens (modifications of Memphis protocol VII and VIII), therapeutic results were markedly improved. After a follow-up of 36 to 90 months the overall oumulative remission rate was 37.7%. The results could be improved especially in the group of high risk patients for replase by 35% in contrast to the historical studies. A prognostic difference between low- and high risk-patients was not seen in the BFM study (84.3% vs. 69.9%). Without doubt, the marked improvement of prognosis is due to the intensification of therapy.

Antineoplastic Agents↗

[Immunothrombocytopenia of the newborn caused by platelet-specific antibodies (anti-P1A1) (author's transl)].

For the first time in the German speaking area 8 cases of neonatal immunothrombocytopenia caused by platelet-specific P1A1 antibodies could be ascertained. The disease is caused by fetomaternal incompatibility against platelet antigens. All mothers were healthy. The children showed a postnatal tendency for petechial haemorrhages. Cerebral haemorrhages occurred in two cases. Optimal treatment consists of administration of P1A1-negative platelets (perhaps of the mother). Demonstration of platelet antibodies is possible nowadays by adequate serological methods.

Adult↗

[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↗

[Intrapericardial rhabdomyosarcoma in infancy (author's transl)].

At the age of three months an infant rapidly developed signs of cardiac failure as well as in- and exspiratory stridor, caused by an intrathoracic tumor. Thoracotomy and biopsy revealed an intrapericardial tumor, histologically myxosarcoma. In spite of chemotherapy and radiation the infant died at the age of seven months due to multiple intracerebral metastases now histologically rhabdomyosarcoma. This is one of the rare cases of primarily malignant intrapericardial tumors in infancy, and also shows the possible pleomorphism of childhood rhabdomyosarcoma. We know only one further case of pericardial rhabdomyosarcoma where similar histologic changes have been observed.

Biopsy↗

[BCG-infection in chronic granulomatous disease (author's transl)].

A 7 year old boy developed in the newborn period a chronic suppurative process after routine BCG vaccination beginning at the site of the injection and spreading to the adjacent areas on neck and chin. A supraclavicular lymphadenopathy was also noted. Serial histological examinations revealed the typical histopathological pattern of tuberculosis and the boy received a tuberculostatic therapy for five years. During this time he suffered from multiple chronic bacterial infections which led to chronic granulomatous inflammations in different organs and to a fibrous pneumonitis with subsequent cor pulmonale. At the age of 6 years a negative NBT-test allowed the diagnosis of GCD. Consequently therapy with Sulfamethoxazol-Trimethoprim was started and the rate of infections diminished markedly.

BCG Vaccine↗

[(Management of acute toxicity after high dose methotrexate therapy)].

A 13-year-old girl with osteosarcoma and pulmonary metastases developed life-threatening renal toxicity, encephalopathy, and bone marrow failure following high dose methotrexate therapy. After successful treatment, high dose methotrexate therapy was continued without further problems. Recommendations for the prevention and the current management of methotrexate toxicity are discussed.

Adolescent↗

[Immunosuppressive treatment of endogenous uveitis in childhood (author's transl)].

This report is about a seven year old boy suffering from endogenous uveitis of unknown etiology in both eyes. A local and systemical steroid therapy did not stop the progressive course. Therefore an immunosuppressive treatment with methotrexate was begun. After the second intravenous application of this antifolate an amelioration could be noted and after 6 week a normalisation of the visual acuity on the left eye and an improvement from 0.4 to 0.8 on the right eye was obtained. Immunosuppressive treatment was discontinued after a duration of 14 months; now 2 years later, the inital success has been maintained. The advantages of methotrexate in comparison to other immunosuppressive agents are discussed.

Child↗

Leukemic nodules in the eye in immature-cellular infantile leukoses.

Two boys, aged 5 1/4 and 10 1/4, respectively, with acute immature-cell leukosis, died of massive cerebral haemorrhage. Their eyes showed extensive leukaemic involvement of the retina with development of numerous miliary leukaemic nodules; the vitreous of case 2 was also involved. The lesions were considered to have developed because of high circulating white cell counts, a tendency of blast cells to produce nodules, an oxygen poor avascular matrix in which to grow, and a physical environment which permitted growth without haemorrhage or distortion due to tissue pressures etc. Using histological methods, an attempt is made to trace the pattern of formation of the nodule, from an initial growing focus through "colonial" form resembling a bacterial colony to lysis. Necrotic blast cells are apparently a metabolic source for viable tumour cells. Their localization in the eye makes access by cytotoxic drugs difficult; thus they should be considered as blast cell pools.

Acute Disease↗

[Fatal cerebral apoplexy as the first manifestation of immature infantile leukemia (author's transl)].

Among 93 clinical cases of mature and immature leukemia among children in the last 10 years only 3 showed massive cerebral hemorrhage as the first manifestation. The children--aged 5 3/12 yr., m., 2 1/12 yr., f., and 10 3/12 yr., m. died within 40, 48 and 7 h, respectively. Characteristically, an extreme hyperleukocytosis of immature cells with 8999000, 585000, and 360000 cells/mm3, respectively was found. Morphologically the quantitatively varying occurrence of blasts in veins and arteries, basically of hemodynamic origin, is notable, while locally pronounced variations in the venous involvement apparently are strongly dependent upon endovasal growth periods of the blasts. The blasts penetrated extravasal areas not only via passive but also via active migration. The mainly round to oval shape of the perivascular infiltrates of blasts is determined especially by the Virchow-Robins' spaces. The abscence of growth disrupting hemodynamics and texture structures in the unhindered areas of the cerebral ventricle system and retinal detachement favors the formation of leukemic nodules. Neurological symptoms accompanying a high blast count point to a diagnosis of intracerebral hemorrhage.

Acute Disease↗