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Biomedical subjects

J Oldhoff

Publications and source records attributed to J Oldhoff.

At least 109 records · Page 6Linked to original sources
PubMed1980

The relation between testicular tumours, undescended testes, and inguinal hernias.

A group of 230 patients with a malignant testicular tumour was found to include 12 patients with a history of an undescended testis (5.2%). Eight patients had a history of inguinal hernia (3.4%). The risk of malignant degeneration in an undescended testis proved to be 17 times greater than in the normal population. We found no increased risk for patients with a history of inguinal hernia. Nine patients with a history of orchiopexy developed a malignant testicular tumour; inguinal lymph node metastases were found in three of them. We advise the removal of all undescended testicles after puberty. In cases of malignant degeneration of a testis, which have been fixed in the scrotum, or in cases with a history of an operation in the inguinal region, the inguinal lymph nodes have to be treated. For seminoma, irradiation of these nodes is necessary; for non-seminoma tumours, hemiscrotectomy and inguinal lymph node dissection have to be performed.

Adolescent↗
PubMed1979

Two extensive giant-cell tumours of the proximal humerus treated by resection-reconstruction or excochleation-cryosurgery.

Giant-cell tumours of bone occur infrequently. Recurrence is often observed following excochleation. Due to the fact that most of these tumours are located in the epiphysis of long bones, treatment of extensive tumours with preservation of joint function usually is troublesome. Two patients are presented: one underwent resection and implantation of an endoprosthesis, the other one excochleation in combination with cryosurgery.

Adult↗
PubMed1978

Cryosurgical treatment of aneurysmal bone cysts.

An aneurysmal bone cyst is a benign, locally aggressive bone process which frequently recurs after excochleation. Exocochleation can be extended without loss of bone tissue by making use of cryosurgery. This combined technique was used in the treatment of 5 patients, without complications. None of the patients described had a demonstrable recurrence 12-60 (average 35) months after this combined therapy.

Adolescent↗
PubMed1977

Some aspects of the treatment of primary malignant melanoma of the extremities by isolated regional perfusion.

This paper reviews the changing concepts in the treatment of patients with malignant melanoma localized on the arm or leg. In addition to conventional surgical treatment, isolated regional perfusion of the extremities is discussed. An evaluation is presented of clinical and histological criteria applied to determine indications for conventional surgical treatment and for perfusion. It is maintained that isolated regional perfusion of arm or leg should be performed when the primary tumor meets one of the following criteria: (1) depth of tumor invasion beyond the papillary layer (Clark levels III, IV and V); (2) vascular invasion; (3) tumor diameter exceeding 1 cm; (4) ulceration. If none of these four criteria applies, conventional surgical treatment alone has proved to give very good results.

Adult↗
PubMed1977

Regional perfusion for recurrent malignant melanoma of the extremities.

Seventeen patients with a local recurrence or intransit metastases of a malignant melanoma of the arm or leg were treated by normothermic regional perfusion with phenylalanine mustard. Seven of these patients had regional lymph node metastases as well. The follow-up period was with five to eight years or until the time of death. Two years after treatment, eleven of the seventeen patients were still alive. After a five year follow-up, six patients were still alive without demonstrable recurrence or metastases. Only three patients had a recurrence in an extremity; two of these three patients simultaneously showed general metastization.

Adult↗
PubMed1977

Hepatic dearterialization for carcinoid syndrome due to liver metastases.

The cases are described of three patients with a carcinoid syndrome resulting from hepatic metastases of a carcinoid in the distal ileal tract. Treatment consisted in resection of the primary tumor and of the regional lymph-node metastases, combined with dearterialization of the liver. Apart from rapidly transient disorders of hepatic function, no postoperative complications occurred. Dearterialization should be regarded as a palliative operation and would appear to be beneficial. Optimally effective dearterialization may be achieved with the aid of peroperative angiography after the standard procedure. This will reveal any collaterals and anatomical variants that remain to be occluded. Postoperative mitigation of symptoms is the best parameter for evaluation of the efficacy of the dearterialization.

Aged↗
PubMed1976

Some thoughts about the treatment of patients suffering from cancer of the esophagus or cardia.

The treatment of patients suffering from carcinoma of the esophagus or the cardia is extremely difficult, and the results to date have not been encouraging. The authors are of the opinion that only relatively young patients in good general condition, with a tumor smaller than 5 cm, without metastases and without peri-esophageal infiltration, should be considered for curative ratiotherapy and/or surgery. However, apart from these tumor and patient elements, the physician's skill and the facilities for adequate nursing are also of decisive importance. When curative treatment is not possible, this does not imply the more or less automatic selection of some form of palliative radiotherapy or surgery. In certain circumstances, symptomatic treatment or the natural course of the disease will be best for the patient and his environment. More data should be collected regarding the natural course of the disease, especially in comparison with the results after palliative surgery or radiotherapy.

Aged↗
PubMed1975

Humoral and cell-mediated immune response in patients with malignant melanoma. I. In vitro lymphocyte reactivity to PHA and antigens following immunization.

In vitro lymphocyte function was evaluated in 61 patients with different clinical stages of malignant melanoma. Thirty-one of these patients had localized disease, 13 regional metastases, 10 distant lymph node or skin metastases, and 7 visceral metastases. Following immunization, in vitro lymphocyte reactivity to three antigens (diphtheria toxoid, tetanus toxoid and alpha-hemocyanin of Helix pomatia) was studied in the presence of autologous serum, in addition to lymphocyte reactivity to phytohemagglutinin (PHA). The relationship of these tests with the clinical stage and the subsequent course of the disease in a 6 months' observation period was determined. The patients with visceral metastases (7) had a lowered lymphocyte reactivity to PHA compared with controls and the patients with other stages, while they also had a low reactivity to the test antigens (only significantly lowered compared with patients with localized disease). All these patients showed tumor progression or died from metastatic disease. Between the other stages (54 patients) there was no difference in lymphocyte reactivity to the test antigens or PHA. No correlation between lymphocyte reactivity to PHA and the subsequent course of the disease could be demonstrated in these 54 patients. However, lymphocyte reactivity to the test antigens following immunization showed a definite correlation with the subsequent course. Sixty-four percent (9/14) of patients without any lymphocyte reactivity to the three antigens showed tumor recurrence or progression, against 3% (1/40) of patients with positive lymphocyte reactivity to one, two, or three antigens. A suppressive effect of autologous serum on lymphocyte reactivity could be found only in 1 of 20 patients with a low reactivity to PHA or antigens. It is concluded that defects in lymphocyte function are related to subsequent tumor growth in patients with malignant melanoma.

Adult↗
PubMed1975

Experimental surgery on the Cloudman S91 melanoma with the carbon-dioxide laser.

The continuous wave CO2 laser lacks a number of draw-backs of the pulsed Ruby laser, and seems attractive for tumor surgery. We compared the CO2 laser with conventional surgery in experiments on mice bearing the Cloudman S91 melanoma. We had the same rate of local recurrence and lung metastasis in both techniques.

Animals↗
PubMed1975

Penile cancer.

A retrospective study was made of the case histories of 91 patients with a penile tumor. The tumor histology of 56 patients could be re-evaluated, confirming the diagnosis: epidermoid cancer. Fifty three of these 56 patients were treated more than five years before the retrospective evaluation. Penile carcinoma has not increased in frequency during the last few decades. No correlation could be found between venereal diseases and penile carcinoma, nor between the duration of symptoms before treatment and the development of metastases. Amputation is the treatment of choice. Lymph node dissection must be performed when metastatic disease is suspected. When patients die of tumor, this is caused by metastatic disease, but in about 50 percent of cases the patients can be saved by dissection of positive nodes, preventing a further extension. More than 70 percent of 53 patients have survived for at least five years without evidence of recurrence or metastatic disease including six (out of 11) patients in whom the dissected inguinal lymph nodes showed involvement. In this series of patients cytostatic therapy was not used. Bleomycin is known to have a definite action on these tumors, but only the far future can show if better results are to be expected with a combination of the described therapy with cytostatic drugs.

Adult↗
PubMed1975

The carbon dioxide laser; some possibilities in surgery.

The CO2 laser emits an infra red beam with a wavelength of 10,6 mu. Focussing this beam gives a tremendous energy density. The strong absorption of this wavelength allows tissue evaporation at the focal point of the beam. The first surgical application is the use of this laser as a light knife. Satisfying haemostasis can be obtained. Vessels with an internal diameter up to 0,5 mm being sealed, haemostatic cutting is possible. Even cortical bone can easily be cut with this instrument. The ability to vaporize tissues can be used for tumor destruction. Special attachments for endoscopic surgery are available. Experimental work in the rectum and on vocal cords has been done in our laboratory. The important problem in laser surgery is the necrosis on the edges. Investigations about the viability of the margins, showed that the width of the necrosis is in linear relationship with the rate of the exposure time. For an exposure of 1/10th of a second this width was about 130 mu, for an exposure of 6 seconds about 600 mu. After one year of experimental work with the CO2 laser we are convinced that this instrument might prove to be a reliable tool in surgery.

Animals↗
PubMed1975

Isolated regional perfusion in the treatment of malignant melanomas of the extremities.

The authors present a survey of changed views on the treatment of patients with malignant melanoma of the extremities. In addition to conventional therapy, regional perfusion is discussed. Over the period 1964-1970, 115 perfusions were performed in 75 patients. The perfusions were confined to patients with a tumor infiltrating beyond the stratum papillare. The 4-year survival of 30 patients with a primary tumor, without demonstrable metastases at the moment of perfusion, was found to be 77%. The percentage of local recurrences was significantly lower after perfusion than after conventional surgery.

Adult↗
PubMed1975

A case of embryonal sarcoma (rhabdomyosarcoma) of the prostate treated with combined surgical and cytostatic therapy.

The case history of a 22-months old boy with a malignant embryonal tumor of the prostate is given. Five years after initiation and three years after termination of a combined therapy with cytostatic drugs (actinomycin D, vincristine sulfate and cyclophosphamide) and surgery he is in good health without any signs of recurrence or metastatic disease. On this moment it is still impossible to be certain whether this therapy is the key for treatment of these tumors, but the successes published and the result till now in this case can be an indication that we are going in the right direction. Perhaps we may even hope that in the future we will have cytostatic drugs and combinations of therapy which will enable us to avoid mutilating operations.

Child, Preschool↗