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  • 1
    ISSN: 1432-1076
    Keywords: Key words Growth regulation ; Leukaemia ; Radioimmunoassay ; Insulin-like growth factors ; Insulin-like growth factor-binding proteins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The insulin-like growth factor (IGF) signaling pathway may be of importance for the proliferation of different tumours (e.g. breast cancer and Wilms tumour). The bioavailability of both IGF-I and IGF-II is regulated by specific IGF-binding proteins (IGFBPs). IGFBP-2 is the predominant binding protein during fetal life, where it is expressed in most tissues. In contrast, postnatally it is mainly released by specific cell types (hepatocytes, astroglia, kidney cells, prostate cells) and a range of tumour cell lines. Furthermore, phytohaemagglutinin stimulated normal lymphoblasts and malignant lymphoblasts express IGFBP-2. In order to investigate the IGF regulatory pathway in leukaemia serum levels of IGF-I, IGF-II, IGFBP-2 and IGFBP-3 were determined in 28 leukaemic children. Whereas serum levels of IGF-I (mean/range:–2.7/–0.1 to –6.7 SDS), IGF-II (–3.6 SDS/–1.3 to -8.7) and IGFBP-3 (–2.0/+2.2 to –7.1 SDS) were significantly decreased comparable to levels in growth hormone deficiency, IGFBP-2 levels (+4.0/–0.45 to +7.4 SDS) were found to be markedly elevated and inversely correlated to IGF-I (r = –0.51, P = 0.013). After haematological remission upon chemotherapy all four parameters had normalized in the 16 re-investigated children. Similar findings have been observed in one boy with a relapse including CNS leukaemia. Conclusion This study demonstrates that the proliferation of malignant lymphoblasts (at diagnosis vs treatment) occurs in the presence of decreased serum levels of IGF-I, IGF-II and IGFBP-3 and that diminished production of these peptides may contribute to impaired growth. It further indicates that serum levels of IGFBP-2 may be directly related to the proliferation of lymphoblasts.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1076
    Keywords: Key words Growth  ;  Leukaemia  ;  Non-Hodgkin lymphoma  ;  Chemotherapy  ;  Cranial irradiation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endocrine dysfunction and damage of the epiphysial growth plates have been reported as late effects of antileukaemic treatment during childhood. It is a common opinion that cranial irradiation (CI) is the most important factor for blunted growth. Accordingly, recent therapeutic strategies in acute lymphoblastic leukaemia (ALL) avoid cranial irradiation. Here we analysed longitudinal data on growth and puberty of 54 children in first complete remission, who were treated with 18 Gy CI or not submitted to radiotherapy. Two chemotherapeutic protocols were compared which were similar during the induction period but differed in the intensity of maintenance therapy. In cranial irradiated patients both in males and females the pubertal growth spurt started at a mean age of 1.2 years (SD: 0.93 years) earlier than controls. Age at diagnosis and age at pubertal growth spurt were significantly correlated (r = 0.35, P = 0.017). Similarly, menarche occurred at a mean age (n = 22) of 12.1 years and was correlated with the age at start of therapy in girls who were treated with 18 Gy CI (r = 0.61, P = 0.01). Adult height was reached spontaneously in 30 patients treated during prepubertal age and in 10 treated shortly before or during puberty. In all prepubertal patients treated for 2–3 years with intensive maintenance therapy blunted growth resulted in a significant loss of −1.85 H-SDS (median, P = 0.0051) compared to height at diagnosis. However, if continuation treatment used only methotrexate and 6-mercaptopurine (i.e. BFM protocol) final height equalled projected adult height, despite 18 Gy CI. Conclusions (1) multiagent chemotherapy is of major impact for growth and puberty; (2) 18 Gy cranial irradiation is below the critical dosage responsible for blunted growth; (3) loss in potential growth might be prevented by current CT strategies; (4) onset of puberty depends on age when antileukaemic therapy is applied.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd.
    Journal of the European Academy of Dermatology and Venereology 17 (2003), S. 0 
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Most cases of urticaria pigmentosa are confined to the skin, but visceral involvement and/or haematological abnormalities have been observed. It is still a matter of debate whether all forms of mastocytosis are true neoplasias or reactive hyperplasias. Familial inheritance of urticaria pigmentosa is rare. We report on a fraternal set with urticaria pigmentosa as part of a systemic mastocytosis. The first patient additionally revealed persistent thrombocytosis and splenomegaly. His brother developed urticaria pigmentosa, intermittent diarrhoea, hepatomegaly and asthma bronchiale associated with trisomy 21 (Down's syndrome). The association of mastocytosis with thrombocytosis has seldom been described. In our patient it preceded the development of systemic mastocytosis. The association with Down's syndrome has not been reported until now.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2307
    Keywords: Multidrug resistance ; P-glycoprotein Neuroblastoma ; Nephroblastoma ; Reverse transcriptase polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the expression of MDR1/p-glycoprotein in paediatric tumours using reverse transcriptase polymerase chain reaction (RT-PCR), RNA dot blot analysis, and immunohistochemistry on formalin fixed paraffin-embedded material with JSB-1 and C-219 monoclonal antibodies, and compared these three techniques. The expression of multidrug resistance-associated protein (MRP) gene was examined by RT-PCR assay. We studied MDR1/p-glycoprotein and MRP expression in 13 samples from 10 neuroblastoma patients, 11 samples from 10 nephroblastoma patients, 2 rhabdomyosarcomas, 1 adrenocortical carcinoma and 10 benign tumours or tumour-like lesions. Eleven of 13 neuroblastomas, 7 of 11 nephroblastomas, 2 rhabdomyosarcomas, 1 adrenocortical carcinoma, and 7 of 10 benign tumours or tumour-like lesions showed MDR1 PCR products. By RNA dot blot analysis, MDR1 transcripts were detectable in 11 of 34 specimens. Immunohistochemically, we detected positive reaction products for JSB-1 in 26 of 36 samples. There was a significant correlation between the immunoreactivity for JSB-1 and the expression of MDR1 mRNA expression by RTPCR (P=0.0001). However, the presence of p-glycoprotein immunostaining does not correlate with the MDR1 expression shown by RT-PCR in every case. As for MRP mRNA expression, 9 of 13 neuroblastomas and 10 of 11 nephroblastomas revealed PCR products.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Akute demyelinisierende Enzephalomyelitis ; Multiple Sklerose ; Zerebrale Kernspintomographie ; Neuropathologie ; Key words Acute demyelinating encephalomyelitis ; Multiple sclerosis ; Cerebral MRI ; Neuropathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Multiple sclerosis is a rare disease in childhood. A 10 1/2 year old girl developed a rapidly ongoing paresis of the right leg accompanied by paresthesia, sphincter incompetence and retrobulbar neuritis. Results: Laboratory tests including examination of the cerebrospinal fluid were normal. Magnetic resonance imaging (MRI) of the brain revealed multiple circular lesions with central hypodensities in both hemispheres. A biopsy of the brain was performed. The histological picture showed changes of acute demyelinating encephalomyelitis also visible in early and subacute stages of multiple sclerosis. Discussion: Unusual findings especially of the MRI made it more difficult in this case to find the correct diagnosis.
    Notes: Zusammenfassung Die Multiple Sklerose ist eine seltene Erkrankung im Kindesalter. Bei einem 10jährigen Mädchen entwickelte sich eine rasch fortschreitende Parese des rechten Beins, begleitet von vegetativen und sensiblen neurologischen Ausfällen sowie einer Retrobulbärneuritis. Befund: Die Laboruntersuchungen einschließlich der Liquordiagnostik ergaben unauffällige Befunde. Mit Hilfe der Kernspintomographie waren mehrere, max. 3×3 cm2 große, zentral hypodense Rundherde in beiden Großhirnhemisphären erkennbar. Aus einer Läsion wurde stereotaktisch Hirngewebe entnommen. Histologisch ließen sich Veränderungen nachweisen, die sowohl in einer Frühform als auch im subakuten Stadium einer multiplen Sklerose beobachtet werden. Die klinisch vermutete Diagnose einer akuten demyelinisierenden Enzephalomyelitis wurde damit auch neuropathologisch bestätigt. Diskussion: Die ungewöhnlichen Befunde insbesondere der Kernspintomographie erschwerten in diesem Fall die Diagnosefindung.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 562-566 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Pigmentierter neuroektodermaler Tumor ; Melanotischer neuroektodermaler Tumor ; Tumoren des Kindesalters ; Key words Melanotic neuroectodermal tumor ; Tumors of infancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Melanotic neuroectodermal tumor of infancy is a rare neoplasm of neural crest origin. It almost always occurs in children younger than one year of age with a predilection for the anterior maxillary ridge. Although it usually follows a benign course, local destruction as well as metastasis and death may result from the tumor. Melanotic neuroectodermal tumor is most commonly treated by surgery. 10–15% of the lesions recur. We report the case of a 2-month-old infant suffering from melanotic neuroectodermal tumor of infancy of the premaxilla who was successfully treated with a combination of various chemotherapeutic agents in order to spare the child a mutilating operation or the late effects of radiation. Discussion: Chemotherapeutic management of melanotic neuroectodermal tumor of infancy can possibly spare the child a mutilating operation or at least reduce its extent.
    Notes: Zusammenfassung Der pigmentierte neuroektodermale Tumor des Kindesalters ist eine sehr seltene Geschwulst, die ihren Ursprung von der Neuralleiste nimmt. Fast immer sind Säuglinge von der Erkrankung betroffen. Prädilektionsort ist die vordere Maxilla. Obwohl der Tumor in der Regel eine sehr gute Prognose aufweist, besteht das Risiko einer lokalen Gewebedestruktion ebenso wie die Möglichkeit der malignen Entartung. Zumeist wird chirurgisch gegen die Geschwulst vorgegangen. In 10–15% der Fälle kommt es zum Rezidiv. Wir berichten über einen 2 Monate alten Säugling mit pigmentiertem neuroektodermalem Tumor der Prämaxilla, den wir erfolgreich mit einer Kombinationschemotherapie behandelten, um ihm eine Entstellung im Gesichtsbereich durch eine Operation oder die Spätfolgen einer Strahlentherapie zu ersparen. Diskussion: Die Chemotherapie eines pigmentierten neuroektodermalen Tumors des Kindesalters kann möglicherweise eine Operation mit ihren Komplikationen ersetzen oder zumindest das Ausmaß einer solchen mindern.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Der Pathologe 17 (1996), S. 6-17 
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Ewing-Sarkom ; Key words Ewing's sarcoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Ewing's sarcoma is a very rare tumor which has, however, attracted much oncological interest since the dramatic improvement of its prognosis under chemotherapy. Its histogenesis has been discussed controversially for a long time, including a possible origin in immature reticulum, myogenous, endothelial and undifferentiated mesenchymal cells. Repeated reports have also suggested a possible neuroectodermal genesis. Convincing arguments, however, have only been brought forward during recent years, since it was found that Ewing's sarcoma and malignant peripheral neuroectodermal tumor share a common chromosome translocation 11;22. In the meantime this hypothesis has been strengthened by numerous cell biological analyses. There seems to be no clear border between Ewing's sarcoma and malignant peripheral neuroectodermal tumors with definite neural differentiation. Histological differential diagnosis of Ewing's sarcoma has been improved by immunohistological methods. In most cases, they can be distinguished from lymphoma (leucocyte common antigen, B and T markers) and embryonal rhabdomyosarcoma (muscle specific actin, desmin) without problems. Apart from that, it is possible nowadays to obtain antibodies against the MIC 2-protein, which is preferably expressed in Ewing sarcoma. The diagnostics of Ewing's sarcoma and the malignant peripheral neuroectodermal tumor have considerably been enriched by the fact that the specific chromosome translocation t(11;22) can be proved molecular biologically. In contrast to the cytogenetic evidence, it is not necessary to establish cell cultures.
    Notes: Zusammenfassung Das Ewing-Sarkom ist ein sehr seltener Tumor, der jedoch in den Blickpunkt des onkologischen Interesses gelangt ist, seit seine Prognose unter Chemotherapie sich dramatisch verbessert hat. Die Ansichten zu seiner Histogenese waren lange Zeit strittig. Es wurde eine Herkunft von unreifen Retikulumzellen, myogenen Zellen, Endothelzellen und undifferenzierten Mesenchymzellen diskutiert. Auch auf eine mögliche neuroektodermale Genese ist immer wieder hingewiesen worden. Überzeugende Argumente hierfür wurden jedoch erst in den letzten Jahren vorgelegt, nachdem sich herausgestellt hat, daß das Ewing-Sarkom und der maligne periphere neuroektodermale Tumor eine gemeinsame Chromosomentranslokation aufweisen t(11;22). Mittlerweile wurde diese Hypothese durch zahlreiche zellbiologische Untersuchungen erhärtet. Offensichtlich gibt es fließende Übergänge von den Ewing-Sarkomen zu malignen peripheren neuroektodermalen Tumoren mit eindeutiger neuraler Differenzierung. Die histologische Differentialdiagnostik des Ewing-Sarkoms wurde durch immunhistologische Methoden verbessert. Eine Abgrenzung gegen Lymphome (Leucocyte common antigen, B- und T-Marker) und embryonale Rhabdomyosarkome (Muskelspezifisches Aktin, Desmin) ist so meist problemlos möglich. Darüber hinaus stehen jetzt Antikörper gegen das MIC 2-Protein zur Verfügung, das vorzugsweise im Ewing-Sarkom exprimiert wird. Eine wesentliche Bereicherung hat die Diagnostik des Ewing-Sarkoms und des malignen peripheren neuroektodermalen Tumors dadurch erfahren, daß die spezifische Chromosomentranslokation t(11;22) auch molekularbiologisch nachweisbar ist. Im Gegensatz zum zytogenetischen Nachweis ist es hierfür nicht erforderlich, Zellkulturen anzulegen.
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