Bone tumors in adolescents and young adults.

Bone tumors, particularly osteosarcomas and members of the Ewing Sarcoma Family of Tumors (ESFT), are typical malignancies of adolescents and young adults. Current diagnostic and therapeutic guidelines for patients of all ages were developed in this specific age group. The aim of bone sarcoma therapy should be to cure the patient from both the primary tumor and all (micro-)metastatic deposits while maintaining as much (extremity) function and causing as few treatment-specific late effects as possible.

Mesenchymal chondrosarcoma of soft tissues and bone in children, adolescents, and young adults: experiences of the CWS and COSS study groups.

Background: Mesenchymal chondrosarcoma (MCS) is a rare tumor with a strong tendency toward late recurrences leading to reported 10-year survival rates below 50%. The recommended treatment is resection with wide margins; the effectiveness of chemo- and radiotherapy remain poorly defined. As reports about MCS in young patients are scarce, treatment and outcomes of children/adolescents/young adults in the CWS and COSS studies were investigated.

Initial patient characteristics can predict pattern and risk of relapse in localized rhabdomyosarcoma.

Purpose: Evaluation of primary tumor-, treatment-, and patient-related factors predicting relapse pattern, risk, and survival after relapse with the aim to design a risk-adapted, tumor-directed surveillance program for patients with localized rhabdomyosarcoma (RMS).

Patients And Methods: One thousand one hundred sixty-four patients with nonmetastatic RMS achieved complete remission at the end of multimodal therapy in the consecutive trials of the Cooperative Weichteilsarkom Studiengruppe (CWS)-81, CWS-86, CWS-91, and CWS-96 between 1980 and 2002 (median follow-up, 5 years). Three hundred thirty-seven of these individuals developed either locoregional, metastatic, or combined relapses.

[Purpura Schoenlein-Henoch: results of the Wörlitz 2005 Consensus Conference focusing on diagnosis and therapy].

Henoch-Schoenlein Purpura (PSH) is the most frequent vasculitis in childhood. Skin, bowel and joints are characteristically involved. Although renal manifestations are common PSH-nephritis is infrequent but characterized by a poor prognosis.

[Results of ACL reconstruction with a periost-patella tendon-periost graft in growth age].

Aim: The results of 16 patients in growth age (mean age at surgery 13.7 years) with an ACL rupture that was treated with an ACL reconstruction using an periost-patella tendon-periost graft were reviewed.

Results: The follow-up was done 12 months postoperatively.

Cross pinning of supracondylar fractures from a lateral approach. Stabilization achieved with safety.

Purpose: Various pin configurations are possible to stabilize a supracondylar fracture. While cross pinning gives the best stabilty the disadvantage is the risk of iatrogenic ulnar nerve injury. We combine a cross pin fixation with a lateral approach.

[Emotional deprivation and narcissistic regulation--development and treatment of depressive crises in children and adolescents].

This paper outlines developmental and treatment issues of depression in childhood and adolescence. Impairment of parental empathy based on emotional disturbances of a parent leads to adaptive reactions as the child is confronted with threats of loss and separation. Hereditary vulnerability as well as insecure attachment patterns and the effects of explicit trauma must be viewed as further facilitating factors.

[Soft tissue sarcoma in children and adolescents: experiences of the cooperative Soft Tissue Sarcoma Group Studies (CWS-81 - 96)].

The very heterogeneous group of paediatric soft tissue sarcomas account for approximately 7 % of all malignant childhood tumours. More than one half of all cases are rhabdomyosarcomas, some of the over 20 entities are very rare. The prognosis and biology of soft tissue sarcomas in children and adolescents vary greatly depending on histological subtype, the age of the patient, the primary site, the tumour size, tumour invasiveness and the extent of disease at diagnosis.

Successful management of an extreme example of neonatal hyperprostaglandin-E syndrome (Bartter's syndrome) with the new cyclooxygenase-2 inhibitor rofecoxib.

Objective: To describe the successful treatment of an unusual case of severe neonatal Bartter's syndrome refractory to treatment with indomethacin.

Design: Case report, clinical.

Setting: Tertiary care intensive care unit.

[Ovarian hyperstimulation syndrome in preterm infants].

Ovarian cysts are a relatively frequent finding in fetuses and neonates. In preterm infants, a simultaneous occurrence of estradiol-producing ovarian cysts and edematous swelling of the vulva, the thighs and the lower abdominal wall was described by Sedin and co-workers in 1985 for the first time. This ovarian hyperstimulation syndrome occurred at a postconceptional age that slightly preceded the expected time of delivery.

Successful management of a resistant renal artery stenosis in a child using a 4 mm cutting balloon catheter.

Percutaneous transluminal renal angioplasty (PTRA) is a well-established method to treat renal artery stenosis (RAS) in children and adults. However, a significant number of stenoses might not be treated by interventional techniques due to the inability to dilate the RAS. Conventional balloon angioplasty with a high-pressure coronary angioplasty balloon at 20 atm was unable to dilate a significant RAS in a 12-year-old child with severe renovascular hypertension (RR 195/125 mm Hg).

Aneurysm of the inferior vena cava in a 5-year-old boy.

The authors present a case of an aneurysm of the inferior vena cava in a 5-year-old boy. The boy suffered from acute pulmonary and paradoxical cerebral embolism after a minor abdominal trauma. Magnetic resonance angiography was the key for correct diagnosis of the retroperitoneal process and helped develop a strategy for surgery.

[Radiation therapy in juvenile aggressive fibromatosis].

Background: In about one third of patients suffering from a desmoid tumor primary complete resection is not feasible. Furthermore in locally relapsing tumors reoperation alone does not result in cure in many cases. Radiotherapy can be applied in both groups of patients with curative intention.

[Chemotherapy in fibromatoses of childhood and adolescence: results from the Cooperative soft tissue sarcoma study (CWS) and the Italian Cooperative study group (ICG-AIEOP)].

Background: Fibromatoses are a group of semimalignant tumors which grow infiltratively without metastases. If radical surgery is not at all possible or only by mutilation the question of neoadjuvant concepts arises.

Patients: We report on therapy and outcome of 36 patients registered to the German CWS study group and the Italian ICG study group for soft tissue sarcoma who were between 0 and 23 years of age.

[Coxitis in the newborn infant and infant. Diagnosis and therapy].

From 198 o 1996 (12 years) we saw 24 neonates and small infants with septic arthritis of the hip joint. A minority of these infants was simultaneously affected by osteomyelitis of the femoral neck or the acetabulum. Clinical signs are a painful leg, pseudoparalysis, uneasiness and refusal to drink.

Coxitis in newborns and infants.

From 1985 to 1996 (12 years) we saw 24 neonates and small infants with septic arthritis of the hip joint. A minority of these infants was simultaneously affected by osteomyelitis of the femoral neck or the acetabulum. Clinical signs are a painful leg, pseudoparalysis, uneasiness and refusal to drink.