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Biomedical subjects

J Oldhoff

Publications and source records attributed to J Oldhoff.

At least 91 records · Page 5Linked to original sources
PubMed1983

Some effects of combination chemotherapy with cis-platinum on renal function in patients with nonseminomatous testicular carcinoma.

Renal function in 24 patients with disseminated nonseminomatous testicular carcinoma treated with combination chemotherapy including cis-platinum was examined prospectively. Renal function was monitored by several determinations of glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and serum creatinine, and beta-2-microglobulin. A reduction in GFR and ERPF was found at the end of the induction chemotherapy and at six weeks thereafter. Median GFR and ERPF decreased both 23% (P less than 0.01). Serum creatinine and beta-2-microglobulin concentrations however did not rise. It is suggested that under the influence of chemotherapy with platinum the production of creatinine and beta-2-microglobulin is decreased rendering their serum levels unsuitable as parameters of renal function.

Adult↗
PubMed1983

Results of retroperitoneal lymph node dissection and postoperative adjuvant chemotherapy with dactinomycin in the treatment of retroperitoneal metastases of nonseminomatous testicular germ cell tumors.

This article discusses 103 patients with a nonseminomatous testicular germ cell tumor. Treatment of 87 patients in clinical Stages I, II-A, and II-B consisted of bilateral retroperitoneal lymph node dissection. In Stage I (54 patients), no further treatment was given. The three-year survival was 96%, while recurrence-free survival was 98%. Of 33 patients in Stages II-A and II-B, 26 received adjuvant chemotherapy with dactinomycin, and ten of these were given radiotherapy (peritoneum/mediastinum) as well. The three-year survival was 88% and recurrence-free survival was 85%. Seven patients in Stages II-A and II-B received no adjuvant chemotherapy; four of them died. Treatment of 14 patients in Stage II-C primarily consisted of dactinomycin therapy, subsequently combined with surgery and radiotherapy. The three-year survival was 28.5%. These findings raise the question whether adjuvant single-agent chemotherapy with dactinomycin for patients with a nonseminomatous testicular germ cell tumor should not be re-evaluated.

Adolescent↗
PubMed1983

Effects of multiple-drug chemotherapy (cis-diammine-dichloroplatinum, bleomycin, and vinblastine) on the maturation of retroperitoneal lymph node metastases of nonseminomatous germ cell tumors of the testis. No evidence for De Novo induction of differentiation.

Investigating the mechanisms underlying maturation of metastases of nonseminomatous germ cell tumors on administration of chemotherapy, the histologic characteristics of primary testis tumors was compared to the histologic characteristics of their retroperitoneal metastases in three historical patient groups. The metastases in Group I (20 patients) were not treated; those in Groups II (nine patients) and III (24 patients) were treated, respectively, with three cycles of dactinomycin and with four cycles of cis-diammine-dichloroplatinum, vinblastine, and bleomycin, before retroperitoneal lymph node dissection. In Group III there was a significant increase of metastases consisting of differentiated teratoma only, as compared to the metastases of Group I. However, both with and without chemotherapy, the metastases contained fewer areas of differentiated teratoma than the primary lesions. Metastases containing differentiated teratoma with and without other components, with one exception in Group III, were derived from primary tumors containing mature areas as well. Components other than mature teratoma were almost completely eradicated in Group III. These findings strongly suggest that selective destruction of components other than differentiated teratoma causes the mature histologic characteristics in the metastases upon administration of chemotherapy. The results do not support the hypothesis of induction of differentiation by the chemotherapeutic agents.

Bleomycin↗
PubMed1983

Hyperthermic regional perfusion in high-risk stage-I malignant melanomas of the extremities.

Local recurrence after conventional surgical treatment of malignant melanomas of the extremities has frequently been observed in our department in the past. As at other centers, this sometimes necessitated amputation, and on a few occasions amputations were performed exclusively for palliative reasons. In an effort to improve this situation, regional perfusion as local regional treatment was added to conventional therapy in 1965. We have since observed no further instances of massive local tumor growth, and since that time no amputations have had to be performed for this reason. Of course this complicated therapy caused new problems, particularly in the early years, but we have learned to reduce these to what we believe to be an acceptable minimum. In the last 2 years we have done nearly 100 perfusions and have had no major complications. A comparison of the results of regional perfusion plus local excision in the treatment of stage-I melanoma with those of other reported series (Cascinelli et al. 1978; Elder et al. 1979; Fortner et al. 1977; Goldsmith et al. 1970; Lee 1979; McCarthy et al. 1974; Veronesi et al. 1977; Wanebo et al. 1975) treated only by local excision is difficult, owing to the complexity of the known variables relating to survival and local recurrence. The 5-16 year determinate survival rate for our perfusion patients was 74%. The local recurrence rate in the perfused extremities was 9%, 14 patients, and nine of these 14 had distant metastases as well. The other five patients still show no evidence of disease after retreatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Amputation, Surgical↗
PubMed1982

The treatment of ejaculation disorders after retroperitoneal lymph node dissection.

In 14 patients by bilateral retroperitoneal lymph node dissection for nonseminoma tumors of the testes, several sexual functions before and after node dissection were compared. All patients had normal sexual function before the operation. After the operation, antegrade ejaculation was found to have disappeared completely in 12 patients, retrograde ejaculation was demonstrable in ten of these patients. In ten patients, antegrade ejaculation was restored after treatment with 25 mg imipramine twice daily by mouth. In the two patients who still showed antegrade ejaculation, albeit diminished, imipramine medication led to an increased number of spermatoza. During imipramine medication, the partners of five patients became pregnant. The preliminary conclusion from these findings is that ejaculation disorders, which most males develop after bilateral retroperitoneal lymph node dissection, can be successfully treated with daily oral doses of 25-50 mg imipramine in the majority of patients who still desire children.

Adolescent↗
PubMed1982

The viability of cells in the waste products of CO2-laser evaporation of Cloudman mouse melanomas.

The viability of cells present in waste products originating during CO2-laser evaporation of Cloudman S91 mouse melanomas was investigated. Cytologic smears showed mainly carbonized particles and thermally damaged cells but some morphologically intact cells as well. Viability was tested with the trypan blue test, by in vitro culture and intramuscular and intraperitoneal inoculations in syngeneic mice. No dye-excluding cells were found in the trypan blue test. Growth was noted neither in vitro nor in vivo in the 127 mice, intramuscularly or intraperitoneally injected with 10(5) x 10(5)/10 microliter smoke or debris particles, and killed four weeks after inoculation. Viable tumor cells, derived from a Cloudman melanoma cell line and added to the smoke and debris suspensions, remained viable. Thus, a toxic influence of smoke and debris particles in viable tumor cells, which would make the viability tests meaningless, was excluded. It is highly unlikely that viable tumor cells do occur in the waste products of CO2-laser tumor vaporization.

Animals↗
PubMed1982

Abdominal wall resection and reconstruction with the aid of Marlex mesh.

Treatment of malignant tumours of the abdominal wall is primarily surgical and should consist of ample excision with margin of 4-6 cm into the adjacent healthy tissue. When primary closure of the defect in the abdominal wall is not feasible, it can be repaired with the aid of Marlex mesh, combined if necessary with a pedicled omentum flap and free skin grafts. Major resections of the abdominal wall are thus made possible.

Abdominal Muscles↗
PubMed1982

Lymphography in the diagnosis of non-seminoma tumours of the testis.

In a series of 86 lymphograms correlated to histological findings after retroperitoneal lymph node dissection or to laparotomy findings, reliability proved to be 78%. The reliability of lymphograms evaluated as positive was 88%, while that of negative lymphograms was 74%. Retroperitoneal lymph node metastases were detected with the aid of lymphography in 58% of the patients. It was impossible to establish a node size above which metastases could be demonstrated with certainty by lymphography.

Humans↗
PubMed1982

Hyperthermic regional perfusion with melphalan and a combination of melphalan and actinomycin D in the treatment of locally metastasized malignant melanomas of the extremities.

From September 1969 through 1979, 68 patients with already locally metastasized malignant melanomas of the extremities were treated by hyperthermic regional perfusion and local excision(s). Of these, 53 patients could be evaluated after a follow-up of at least 2 years: 31 had been perfused with melphalan and 22 with melphalan in combination with actinomycin D. Local recurrence rates were about the same in both groups: 32 versus 33%. The same applied to the symptom-free interval between perfusion and local recurrence: about 12 versus about 13 months. Virtually all recurrences in both groups (90 versus 85%) were seen within 2 years. The interval between perfusion and systemic metastization was also roughly the same: about 25 versus about 23 months. These results indicate the need for better chemotherapeutics in order to achieve further improvement. The results of these perfusions were otherwise by no means disappointing, and hyperthermic regional perfusion is indicated in the treatment of patients with locally metastasized malignant melanomas.

Adult↗
PubMed1982

[Regional perfusion treatment in primary malignant melanomas of the extremities. (Microstage IV/V according to Clark and tumor thickness over 1.5 mm)].

During the period 1965-1976, 158 patients with stage I malignant melanoma of the extremities were treated by regional isolated perfusion with L-phenylalanine mustard (Melphalan) and local excision. In order to study local recurrence and survival, only patients with a primary melanoma Clark level IV or V and a tumor thickness of more than 1.5 mm were accepted in this study. The determinate survival in patients followed for 5-16 years is 74%; 20% developed positive regional lymph nodes. The local skin recurrence rate was 9% (14 patients); nine of these 14 patients simultaneously had distant metastases; the other five patients are alive with NED after retreatment. So far, this series of patients has shown no statistically significant difference in local recurrence after normothermic and hyperthermic perfusion: 2/19 (11%) and 12/132 (9%), respectively. However, mean tumor thickness in the patients treated by hyperthermic perfusion proved to exceed that in the normothermically perfused patients.

Antineoplastic Agents↗
PubMed1981

Local recurrence and survival in patients with (Clark Level IV/V and over 1.5-mm thickness) stage I malignant melanoma of the extremities after regional perfusion.

During the period 1965-1974, 110 patients with stage I malignant melanoma of the extremities were treated by regional isolated perfusion with L-phenylalanine mustard and local excision. In order to study local recurrence and survival, only patients with a primary melanoma Clark Level IV or V and a tumor thickness of more than 1.5 mm were accepted in this study. The determinate survival in patients followed for 5-14 years in 78%; 17% developed positive regional lymph nodes. The local skin recurrence rate was 9% (9 patients); four of these 9 patients simultaneously had distant metastases; the other five patients are alive with NED after retreatment. This series of patients, too, shows that tumor thickness determines the prognosis, both as to local recurrence and as to survival. The mean tumor thickness in the hyperthermically perfused patients was found to clearly exceed that in the normothermically perfused, the mean values being 4.85 mm and 3.87 mm, respectively. Yet local recurrence and regional lymph node metastases proved to be less frequent after hyperthermic than after normothermic perfusion, although the difference was not statistically significant.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed1981

The treatment of infantile embryonal carcinoma (Yolk-Sac Tumour) of the testis in children.

The case histories of five patients with an infantile embryonal carcinoma are presented. Personal observations and data from the literature indicate that treatment of this tumour is dependent on the patient's age. Non-operative staging is possible under age 1 (alpha 1-foetoprotein and CT-scan). Staging should include a laparotomy in patients aged between 1 and 2 years. Under age 2, retroperitoneal lymph node dissection is indicated only if metastases are demonstrable. From age 2 on, retroperitoneal lymph node dissection should be performed if possible: unilaterally in the absence, and bilaterally in the presence of retroperitoneal metastases. Chemotherapy is required only in cases with metastases. Radiotherapy is not indicated in the treatment of infantile embryonal carcinoma.

Bleomycin↗
PubMed1980

Improvement of hepatic dearterialization: a case report.

Dearterialization of the liver causes necrosis of primary liver tumors or metastases, because their blood supply is largely arterial. The normal liver tissue remains vital after a period of ischemia if the portal vein is intact. A patient with a carcinoid syndrome due to liver metastases is described. It was found that it is difficult to achieve complete dearterialization of the liver. Rather, preoperative and particularly peroperative angiograms are required to ensure the best possible degree of dearterialization.

Aged↗