[Bohuslav Niederle, Czech surgeon].
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Biomedical subjects
Publications and source records attributed to J Koutecký.
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The authors give an account of contemporary problems of child ophthalmological oncology from the paediatrician's aspect. The most serious intraocular tumors are retinoblastomas, in the orbitopalpebral area rhabdomyosarcomas. The authors draw attention to the five main alarming symptoms typical for tumorous processes at these sites: red painful eye, leukokoria, acute visual failure, acute strabism and various rapidly developing protrusions of the bulbus. Subsequently they inform on possible ophthalmological complications of comprehensive oncological treatment.
During the period from March 31 1987 to April 30 1990 the authors operated 24 patients with pulmonary metastases. They performed 13 operations during which they removed 86 metastases, 54 of which were removed by a Nd:YAG laser, 32 by the classical technique. The results of evaluation of the group support a more active approach of the surgeon to these conditions. As far as the selected surgical technique is concerned, the authors recommend Nd:YAG lasers because of the qualitatively more favourable conditions of the performed operation.
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Antibody titres against Epstein-Barr virus (EBV) antigens in children suffering from non-Hodgkin's lymphoma (NHL) were determined. IgG antibody titres against the viral capsid antigen (VCA) and early antigen (EA) exceeded those found in healthy control subjects. On the other hand, antibody titres against EBV-determined nuclear antigen (EBNA complex) were generally lower than in the control group. The most striking phenomenon observed in the patient group was the frequent activation of latent virus infection as revealed by the periodical appearance of anti-EA and IgM class anti-VCA antibodies. Antibody titres against EBV antigens were generally lower among patients with progressing disease than in those with a more favourable course of the illness. The closest relation to EBV based on serological findings, was detected in lymphoblastic lymphomas of Burkitt-type histology, poorly differentiated lymphocytic lymphomas, and in lymphomas localized in the abdomen. The question whether EBV might be involved in a certain proportion of the cases examined is discussed and further approaches to elucidate this problem are suggested.
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The authors performed HLA typing in 18 patients affected by neurofibromatosis (NF) and in 13 of them they also typed all the available members of their families. In 9 families manifesting a kindred occurrence further 16 patients, in whom the disease had not yet been diagnosed, have been unveiled. In 8 families our of nine manifesting a familial load of the disease there was agreement in one HLA haplotype eventually HLA identity among the diseased sibling members. From this point of view it appears that HLA typing in NF might be a valuable contribution especially for the diagnosis of the complete cases in families manifesting a kindred type of NF occurrence. Since NF is a disease perilous through its life endangering complications of a malignant character the authors recommend its dispensation and a concentration of all the NF affected patients and their relatives into a limited number of clinical establishments endowed with a possibility of cooperation with some HLA laboratory.
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The results of a complex treatment of 93 patients with neuroblastoma treated at the Clinic of Pediatric Oncology in Prague during the period of 1965-1982 are presented. A group of 41 patients treated during 1965-1977 was compared to that of 52 patients treated during 1978-1982. The latter group received a more intense chemotherapy treatment. In Group A there survived 7 patients (16.28%), all of them without symptoms of neuroblastoma. In Group B did so 31 patients (59.61%), 25 of them (48.08%) without symptoms of the disease, however, the results obtained in this group are of rather recent origin. A comparison made by means of the log-rank test and by extrapolating the data from curves of survival rates revealed no statistically significant improvement.