[To grow up with Crohn's disease]. / Felnoni Crohn-betegséggel.

OBJECTIVE: To assess the characteristics and course of childhood-onset Crohn's disease among Hungarian patients. METHODS: Records of 81 patients admitted between 1984 and 2006 and treated at least for one year until the 18th year of age were reviewed. RESULTS: There was a 62% male dominance and a rate of 12.5% of familial cases. The diagnostic lag was 11.36 (1-96) months. The mean age was 13.6 years (4-17), the activity index was 37.88 (5-80) at diagnosis and the initial frequencies were as follows: ileal affection 87%, stricturing and penetrating forms 27%, perianal manifestation 26%, giant cells or granuloma formation 47%, malnutrition 23,5%, growth failure 11%. Steroid therapy and azathioprin treatment were given in 84% and 62% of the patients, respectively. Biologic treatment was not possible during the study period. 31% of the patients underwent surgery (abdominal surgery 20%, perianal surgery 11%). When patients reached the 18th year of age the mean activity index decreased to 6.63 (0-35), the rate of malnutrition to 9.9% and that of growth failure to 2.5%. All these changes were statistically significant. CONCLUSIONS: Characteristics of childhood-onset Crohn's disease in Hungary are similar to those obtained in other European countries. The prolonged diagnostic lag, the high initial activity index, the granuloma formation and the stricturing/penetrating behavior may predict subsequent complications and need for surgery, and, therefore, justify intense initial therapy. The early introduction of immunomodulatory therapy affects favorably the course of illness.

[Response rates following neoadjuvant chemotherapy and breast preserving treatment in patients with locally advanced breast cancer]. / A neoadjuváns, avagy primer szisztémás kemoterápia eredményei es az ezt követo emlomegtartó mutétek aránya a loko- regionálisan elorehaladott emlorákos betegeknél.

INTRODUCTION: The neoadjuvant chemotherapy is increasingly being used in the treatment of patients with locally advanced breast cancer. We describe the hypothesis of the biological behaviour of breast cancer supporting the reason for the existence of this treatment. The improvement of neoadjuvant chemotherapy is being discussed as well as the advantages, disadvantages and problems of the treatment. THE AIM OF EXAMINATION: To study the results of neoadjuvant chemotherapy in patients with locally advanced breast cancer and the proportion of breast preserving surgery after the treatment. METHODS: Sixty seven patients were given neoadjuvant chemotherapy treatment between 01.01.1999 and 12.31.2003. Twenty three patients were stage III A while 35 stage III B and 9 stage III C. 63% of the patients received CEF chemotherapy and 19% were given MMM. 18% were given neoadjuvant Taxotere + Carboplatin and 4% were given Taxotere + Farmorubicin chemotherapy. RESULTS: After neoadjuvant chemotherapy 5 patients had SD (stable disease), 32 patients had MR (minor response) and in 28 cases patients had PR (partial response). Two patients showed pCR (complete pathologic response). Twenty patients (30%) had breast preserving surgery. CONCLUSIONS: On the basis of our own experience neoadjuvant therapy is justified in patients with locally advanced breast cancer as they have bigger chance for breast preserving surgery. If mastectomy and axillary block dissection has to be carried out they are easier to perform. Taxans must be introduced for neoadjuvant treatment in order to improve our results. A longer follow-up is necessary before drawing final conclusions.