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  • 1
    Keywords: CANCER ; tumor ; Germany ; MODEL ; THERAPY ; INFORMATION ; LUNG-CANCER ; DISEASE ; EPIDEMIOLOGY ; HISTORY ; incidence ; MORTALITY ; POPULATION ; RISK ; TUMORS ; PATIENT ; FAMILY ; prognosis ; RISK-FACTORS ; SUSCEPTIBILITY ; BREAST ; DECREASE ; NUMBER ; AGE ; etiology ; risk factors ; RISK FACTOR ; RECURRENCE ; case-control studies ; CHILDREN ; PREDICTORS ; SARCOMA ; HEART-DISEASE ; AGENT ; ONCOLOGY ; PERSISTENT ; case-control study ; CHILDHOOD ; DISTRESS ; Ewing's sarcoma ; osteosarcoma
    Abstract: This case-control study investigates etiologically important factors for juvenile osteosarcomas and possible reasons for the relative scarcity of their incidence in the population. Information on a variety of risk factors, psychosocial factors, and factors possibly occurring in early childhood was obtained by interviewing 88 patients (ages 8-25 years) with osteosarcoma, Ewing's sarcomas and other bone tumors, and three age- and sex-matched control groups (hospital, neighbour and family controls), and their mothers. For both sexes, children's diseases in their history, which increased the risk were measles (RR = 1.56, not significant) and mumps (RR = 1.81, 95% Cl = 1.05-3.13), whereas clinically apparent chickenpox was associated with a significant decrease for bone tumors (RR = 0.46, 95% Cl = 0.26-0.8). Dermal and respiratory allergies (without hay fever) were also inversely associated with bone tumors. Breast feeding for longer than 2 months was associated with low risk for bone tumors for boys, whereas for girls, paternal age was a risk factor; remaining stable in a multivariate model (RR = 2.36, 95% CI = 0.90-6.21). A change in the presence of an emotionally significant person or changes of residence were risk factors both in univariate and multivariate analyses. The strongest and most persistent risk factor was difficulties in school, indicative of emotional disturbances (RR 2.58, 95% Q = 1.39-4.78). Considering such host factors as possibly . important modifiers of risk in addition to exogenous carcinogenic agents, these factors were consistent and statistically significant for both sexes and despite the small numbers recruited for this study, thus predicting susceptibility. The factors may become relevant for preventive psychotherapy applied to susceptible persons for improvement of prognosis after surgical therapy in preventing recurrences. (C) 2004 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 15225895
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  • 2
    ISSN: 1432-1076
    Keywords: Serum angiotensin converting enzyme activity ; Congenital heart disease ; Pulmonary blood flow ; Pulmonary arterial pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum angiotensin converting enzyme (ACE) activity was determined in 46 children with congenital heart disease with normal and abnormal lung perfusion: (1) congenital heart disease with normal pulmonary blood flow (12 patients); (2) congenital heart disease with increased pulmonary blood flow (18 patients); (3) congenital heart disease with decreased pulmonary blood flow (16 patients). There was no significant difference in serum ACE activity between the three groups. In group 2 serum ACE activity had a tendency to correlate inversely with both mean pulmonary arterial pressure (r=−0.43;P≤0.05) and pulmonary vascular resistance (r=−0.48;P=0.05). No further correlations between serum ACE activity and age, serum electrolytes, creatinine nor other haemodynamic data could be established.
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  • 3
    ISSN: 1432-1076
    Keywords: Indomethacin ; Patent ductus arteriosus ; Pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present pharmacokinetic data of prolonged, intra-arterial indomethacin treatment (i.e. induction plus maintenance dose) for symptomatic patent ductus arteriosus (sPDA) in 26 ventilated premature infants. sPDA was assessed by two-dimensional and pulsed Doppler echocardiography. Permanent ductal closure occurred in 20 (76%) infants. Plasma levels of indomethacin were 1.18±0.74; 1.8±1.0; 1.51±0.93 and 1.25±0.98 μg/ml (mean±SD) at 12, 24, 48 and 72 h after initial dose administration. All except one patient who responded with ductal closure, showed plasma levels above 0.25 μg/ml throughout the 3 day treatment period and no case of sPDA reopening was noted. Although target concentrations over time were not defined, the data indicate that the maintenance levels measured were within the therapeutic range. A negative correlation was found for plasma drug levels and postnatal age (r=0.52;P〈0.01). Volume of drug distribution was 0.23±0.18l/kg, total clearance 0.1±0.11 ml/min and elimination constant 0.06±0.05h−1 (mean±SD). The great variation in pharmacokinetic data reflects the heterogeneity of the population studied with respect to extracellular fluid space, cardiovascular status, serum protein and other parameters.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Report in literatur and 3 own cases serve in discussing the clinical picture, X-ray picture, morphological behavior, differential diagnosis of the benign chondroblastoma (Codmantumor). The knowledge of the tumor, which only seldom occurs, appears to be very important owing to the danger of its wrong interpretation especially of the morphological picture and the therapeutic consequence resulting thereform. With an exact conservativ surgical treatment the prognosis of the condition is a very good one. It is especially pointed to the problem of the atypical chondroblastoma.
    Abstract: Résumé On présente la clinique, l'aspect radiologique et morphologique ainsi que le diagnostic differentiel du chondroblastome benin (tumeur de Codman). Révue de litterature à laquelle trois nouveaux cas sont ajoutés. La conaissance de cette rare tumeur osseuse paraît importante en vue de fausse interpretation, surtout de l'aspect morphologique et des consequences therapeutiques qui en ressortent. L'exacte therapie chirurgicale conservatrice (excochleation, eventuellement resection) permet un bon prognostique de la maladie. Le probleme de chondroblastomes atypiques est demontré.
    Notes: Zusammenfassung An Hand von Literaturberichten und drei eigenen Fällen werden Klinik, Röntgenbild, morphologisches Verhalten und Differentialdiagnose desbenignen Chondroblastoms („Codmantumor“) besprochen. Die Kenntnis der selten vorkommenden Knochengeschwulst erscheint wegen der Gefahr einer Fehlinterpretation vor allem des morphologischen Bildes und der sich daraus ergebenden therapeutischen Konsequenzen wichtig. Bei exakter konservativ chirurgischer Therapie (Excochleation und evtl. Resektion) ist die Prognose der Erkrankung eine sehr gute. Auf die Problematik atypischer Chondroblastome wird hingewiesen.
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  • 5
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé A l'aide de 13 amputations d'ostéosarcomes on mène les recherches comparatives entre l'expansion radiologique de la tumeur et celle qui existe réellement du point de vue morphologique. Il en résulte que les limites supérieures de la tumeur sont données par l'angiographie qui montre d'une manière très exacte la partie extraossaire. Les limites sont également données par la saillie du périoste qui n'est pas envahie par la partie intraossaire de la tumeur. L'amputation doit être faite à peu près 5 cm au dessus des limites supérieures les plus avancées vues dans la radiographie. Si l'osteosarcome se trouve dans la partie inférieure d'un os long, on peut avec cette méthode, sans devoir craindre une recidive locale du moignon, préserver l'articulation supérieure dans sa fonction ce qui est essentiel pour la réadaption successive du membre.
    Abstract: Zusammenfassung An 13 Amputationspräparaten von Osteosarkomen werden vergleichende Untersuchungen über die röntgenologisch nachweisbare und die tatsächliche morphologische Tumorausdehnung durchgeführt. Daraus ergibt sich, daß die proximale Tumorgrenze mit Hilfe der Angiographie (die den extraossären Tumoranteil exakt darstellt) bzw. durch den Periostsporn (der vom intraossären Tumoranteil meist nicht überragt wird) gut zur Darstellung gelangt. Die Amputation soll ungefähr 5 cm oberhalb dieser am weitesten nach proximal reichenden röntgenologischen Verdachtszeichen erfolgen. Bei Lokalisation des Osteosarkoms im distalen Anteil eines langen Röhrenknochens kann mit diesem Vorgehen, ohne ein Stumpfrezidiv in Kauf nehmen zu müssen, das für die folgende Rehabilitation wichtige proximal gelegene Gelenk funktionsfähig erhalten werden.
    Notes: Summary Comparative research is being conducted on 13 amputation samples of osteosarcomas into the roentgenological provable and the actual morphological tumor extension. From this it can be seen, that with the help of the angiography (which shows the extraosseous tumor part very exact), respectively through the Codman triangle (above which the intraosseous tumor part usually does not extend) the proximal tumor boundary is shown very clearly. The amputation should be done approximately 2 inches above these farthest proximal extending roentgenological symptoms. In cases of localisation of the osteosarcoma in the distal part of a long bone, one can in this way keep the, for the following rehabilitation important proximal situated joint functioning, without causing a local recidiv.
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  • 6
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bericht über das operative Vorgehen bei 9 Kranken mit Metastasen der Brust- und Lendenwirbelsäule: Metastasenausräumung, Ersatz des Defektes durch Knochenzement und Stabilisierung des betroffenen Wirbelsäulenabschnittes mittels Metallplatte. Bei Durchführung des Eingriffes durch ein „Team der Spezialisten“ erscheint die Komplikationsrate gering. Bei strenger Indikation und adequater Nachbehandlung sind die Resultate ermutigend. Die Patienten bleiben meist bis knapp vor ihrem Tod beschwerdearm und gehfähig.
    Notes: Summary Critical report of the operative treatment in 9 patients with metastases of the thoracic or lumbar vertebral bodies: The tumor is evacuated, the defect filled with bone cement and the stabilisation established by metal-plate-fixation of the adjacent vertebral bodies. If the operation is done as a teamwork of thoracic and vascular surgeon, orthopedic surgeon and neurosurgeon the rate of complication is low. The patients loose their pains immediate after operation, mobilisation is possible after 1 week. Most of the patients remain mobile until short before their death.
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  • 7
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer interklinischen Studie werden 126 Fälle von kindlichen Osteosarkomen analysiert. Es findet sich eine zunehmende Häufigkeit bis zum 15. Lebensjahr bei geringem Überwiegen des männlichen Geschlechtes. Das kindliche Osteosarkom bevorzugt den distalen Femur, die proximale Tibia und den proximalen Humerus. Die Behandlung wurde — bedingt durch die verschiedenen Kooperationszentren — uneinheitlich durchgeführt. Überlebende finden sich in allen Altersgruppen. Multiple Metastasen — meist in den Lungen, aber auch im Skelet — treten gehäuft innerhalb des 1. Jahres und fast immer innerhalb der ersten 2 1/2 Jahre nach Diagnosestellung auf. Zur Prognosebeurteilung genügt daher die 21/2-Jahres-Grenze. Die anscheinend besseren Ergebnisse nach frühzeitiger Amputation lassen diese Methode beim kindlichen Osteosarkom empfehlenswert erscheinen. Mit der alleinigen Strahlentherapie konnten keine Heilungen erzielt werden. Zusätzlich zur frühzeitigen Radikalbehandlung läßt die intensive prophylaktische Chemotherapie bessere Resultate erwarten.
    Notes: Summary 126 osteosarcoma under the age of 15 years are followed up in an interclinical study. There is a steady increase of tumor incidence towards the 15th year with a slight male preponderance. The main sites of the tumor are the distal femur followed by the proximal tibia and humerus. Evidence of multiple metastases is most often present in the lungs, less often in the skeleton. Nearly always metastases became evident within 2 1/2 years after diagnosis (98%). Therefore the 2 1/2-year disease—free survival rate seems to be sufficient for prognostic evaluation. The over all 2 1/2-year survival rate was 17,5%. Though the different methods of treatment are not statistically valid, the best results can be expected after early amputation. By radiotherapy alone no cure has been achieved. Survivals were seen at any age and at any site of long bones (distal femur, proximal tibia, humerus, femur, distal radius). Prognosis of osteosarcoma in the childhood is similar to that of the adult group.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In this abstract, the authors are presenting three own cases under the title “ganglions affecting also the bones”, taking into account the medical literature on this matter. The anatomical caracteristics shows two groups of ganglions: 1. the ganglions which develop (themselves) in the soft tissue and are able to destroy the adjoining bones. 2. the ganglions which seem to be in the bone itself and for which it is not possible to prove with certitude that it exists a relation between them and the adjacent joint and the soft tissue. Particularly group I shows a typical radiograph. As link between group I and II, the authors relate a case where one ganglion destroyed a bone from the outside and then expanded in the internal bone. Such a case does not seem to be mentioned until now in the pertinent literature. The authors mention the morphological likeness between ganglions and the formation of cystes in bones in case of arthroses. For reason of practical therapy a separation of the two diseases would be desirable.
    Abstract: Résumé Dans ce memoire, les auteurs présentent trois cas traites par eux, sous le titre „ganglions avec affection conjointe de l'os“, en se rapportant a la littérature concernant de sujet. On distingue deux groupes de ganglions, classés d'après les caractères anatomiques: I. les ganglions qui se developpent dans les chairs et qui sont capables de détruiere les os situés à proximite. II. les ganglions qui paraissent être situes dans l'os même et pour lesquels is est difficile de prouver un contact avec les articulations ou chaires voisines. Le groupe I plus particulièrement présente une radiographie très caractéristique. Comme intermédiaire entre le groupe I et le groupe II les auteurs présentent un cas où le ganglion détruisit un os de l'extérieur et avant de s'étendre dans l'os même. A notre connaissance, nul cas similaire n'a encore été rélaté dans la littérature rélative ce genre d'affections. Les auteurs signalent la ressemblance morphologique de ces ganglions avec les kystes qui se developpent dans l'os dans les arthroses. Pour des considérations de pratique therapeutique, une séparation des deux maladies serait souhaitable.
    Notes: Zusammenfassung An Hand von drei eigenen Fällen und unter Berücksichtigung von Literaturangaben wird das Krankheitsbild des „Ganglion mit Knochenbeteiligung“ besprochen. Nach dem anatomischen Verhalten werden zwei Gangliengruppen unterschieden: Erstens solche, bei denen Ganglien in den Weichteilen entstehen und durch Druckusur den benachbarten Knochen zerstören können. Zweitens solche, die anscheinend primär rein intraossär gelegen sind, bei denen zumindest ein Zusammenhang mit dem benachbarten Gelenk oder anschließenden Weichteilen nicht sicher nachweisbar ist. Besonders Gruppe I zeigt ein typisches Röntgenbild. Beide Gruppen bevorzugen das mittlere und höhere Lebensalter. Als Bindeglied zwischen Gruppe I und II wird über einen Fall berichtet, bei dem ein Ganglion von außen den Knochen zerstörte und sich dann aber selbständig intraossär weiter ausbreitete. Ein derartiger Fall dürfte in der uns zugänglichen Literatur bisher nicht beschrieben worden sein. Auf die morphologische Ähnlichkeit zwischen diesen Ganglien und Cystenbildungen im Knochen bei Arthrosen wird hingewiesen und die Beziehung dieser beiden Läsionen zueinander diskutiert, wobei eine enge Verwandtschaft angenommen wird. Beide Veränderungen sind als Degenerationscysten anzusehen. Praktisch-therapeutische Gründe lassen eine Trennung der beiden Krankheitsbilder wünschenswert erscheinen.
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  • 9
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In 12 Fällen mit Osteosarkom wurde präoperativ die Tumorausdehnung röntgenologisch und szintigraphisch bestimmt und postoperativ mit den histologisch festgelegten Tumorgrenzen am Operationspräparat verglichen. Dabei zeigt sich, daß in jenen Fällen, bei denen der intraossäre Anteil des Tumors über den extraossären hinausgeht, die Szintigraphie den röntgenologischen Methoden überlegen ist. Zur präoperativen Feststellung der Tumorausdehnung bei Osteosarkomen wird zusätzlich zu Übersichtsröntgen, Angiographie und Tomographie die Verwendung der Knochenszintigraphie gefordert.
    Notes: Summary In 12 patients with osteogenic sarcoma tumour size was determined by X-ray and bone scintigraphy before surgery. After surgery this was compared with the actual tumour size as obtained by histological examination of the specimen. Scintigraphy was found to be superior to X-ray examinations if the intraosseous tumour exceeded the extraosseous tumour. Therefore scintigraphy is strongly recommended in addition to routine X-ray, tomographic and angiographic X-ray examination for preoperativ evaluation of osteogenic sarcoma.
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  • 10
    ISSN: 1432-1971
    Keywords: Coarctation of the aorta ; Postoperative systolic blood pressure ; Upper and lower limb gradient ; Exercise testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary After repair of coarctation, exercise testing was performed in 20 patients with an isolated coarctation (group I) and in 26 with additional congenital cardiac malformations (group II). Ages at time of operation were significantly different in both groups (7.9±6.0 years in group I; 4.6±3.8 years in group II;p≤0.01). Simultaneous blood pressures were obtained from upper and lower limbs at rest and after exercise. There was no significant difference regarding the systolic blood pressures at rest (122.5±15.6 mmHg in group I versus 119±15.8 mmHg in group II). Seven (14%) of the patients were hypertensive; five of them had blood pressure gradients between arms and legs of 15–45 mmHg. But the gradients at rest were found to be significantly different in both groups (9.0±10.5 mmHg in group I; 18.5±16.1 mmHg in group II;p≤0.05). Six patients, all in group II, had gradients ≥30 mmHg at rest. After exercise there were no significant differences in systolic blood pressure and gradients in both groups. Values for blood pressures and gradients at rest and after exercise showed a positive correlation (blood pressurer=0.76,p≤0.001; gradientr=0.44,p≤0.01). Thus exercise testing can provide valuable information about blood pressure and gradient changes during physical activity, but angiography is required to reveal restenosis or residual stenosis.
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