[Characteristics of extracranial malignant germ cell tumours in two age groups of children (0-10 and 10-18 years). Multicentre experiences]. / Charakterystyka pozaczaszkowych zltosliwych guzów germinalnych u dzieci w dwóch grupach wiekowych 0-10 lat i 11-18 lat. Badania wieloosrodkowe.

UNLABELLED: In order to assess if any differences exist in children germ cell tumours depending on age, we compared some features of germ cell tumours in two age groups:younger than 10 and between 11 and 18 years. MATERIAL AND METHODS: Data of 146 patients with germ cell tumours treated in 15 Polish paediatric oncology departments between 1995 and 2005 were evaluated. They were divided into two groups: 76 children 0-10 years old (group I) and 70 patients 11-18 years old (group II). Tumour morphology, sex of patients, primary tumour and metastases localization, disease stage, biochemical markers, treatment response, disease relapse and long survival were analyzed. Every patient was treated according to the TGM 95 protocol. RESULTS: In group 1, 67 tumours were assessed histologically. 64%t tumours had homogenous structure with yolk sac tumour in predominance and 36% were mixed. Yolk sac tumour (YST) or teratoma as components of mixed tumours were the most commonly found. In older group 64 tumours were examined, 41% were homogenous, and seminoma/dysgerminoma predominated. In 59% mixed tumours the most common components were YST embryonal carcinoma and teratoma. The most common primary site in group I was the sacrococcygeal region while in group II - the gonads. Disseminated disease was recognized mostly in older children. Among two evaluated serum markers, AFP was increased mostly in younger patients (76% vs 44%), and 3HCG in older group (40% vs 9%). Treatment response was comparable in both groups. Two relapses were observed in each group. Poor outcome was noted in 17/140 analyzed patients: 9 (12%) in group I and 8 (11%) in group II. In 12 of patients with poor outcome the cause of death was progression and in 5 of them - treatment complications. CONCLUSIONS: 1. Germ cell tumours in younger and older children differ in histology, primary localization and serum level of biochemical markers. 2. In older patients germ cell tumours are recognized more frequently in advanced clinical stages. 3. Treatment response was comparable in both groups. 4. There is a need to analyze the intensity of chemotherapy to precise the adequate risk groups according to primary treatment response.

[Analysis of risk factor treatment failures in therapeutic programme for malignant germ cell tumours in children. Multicentre prospective study of Polish Pediatric Group for Solid Tumours 1998--2006]. / Analiza czynników ryzyka niepowodzenia terapii w programie leczenia dzieci ze zlosliwymi guzami terminalnymi. Wieloosrodkowe badania prospektywne Polskiej Pediatrycznej Grupy Guzów Litych (PPGGL) w Latach 1998--2006.

AIMS: The aim of the study was the analysis of risk factors of therapeutic failures in children with malignant germ cell tumours treated within the multicentre programme of PPGGL from 1999--2006. MATERIALS AND METHODS: The investigated group included 18 (14.3%) patients, of 123 who have finished the treatment of malignant germ cell tumour, in whom no remission was obtained or relapse occurred. All the patients were treated according to the TGM 95 programme. Both clinical and morphological data of the group have been analysed. RESULTS: Among 18 patients with therapeutic failures 12 died. Two patients from the high risk group died of complications of the treatment--sepsis during neutropenia after chemotherapy and one after haemorrhage to the central nervous system. The other 9 died from progression of malignancy, 6 of them belonged to the high risk group. 10 (82%) of 12 patients who died had extragonadal location and in 11 (92%) the tumour was in stage III or IV of the disease. The most frequent histology in this group was mixed germ cell tumour with component of yolk sac tumour or carcinoma embrionale. 92% patients had elevated AFP, in 4 it was above 15000 ng/ml. In 11 (92%) patients primary chemoresistance was observed, and radical surgery was not possible for the reason of advanced stage of the disease. In 6 patients relapse occurred. In 3 patients testis was the primary location (I and II stage), in 3 patients the tumour was localized in the sacrococcygeal region (III and IV stage). All the patients are alive in remission after second line therapy, with 78 months (median) of follow-up. CONCLUSIONS: 1. The main risk factor for therapeutic failures in malignant germ cell tumours was primary chemoresistance in inoperable tumours of the sacrococcygeal region. 2. The mortality of treatment complications was low. 3. The relapse of cancer was not a risk factor for therapeutic failure due to the high probability of second remission 4. Therapeutic failures are mainly observed in patients with mixed germ cell tumour with components of yolk sac tumour or carcinoma embrionale. 5. Tumour chemoresistance should be considered an essential factor in identifying high risk patients.

[Tryptase activity in colon mucosal samples of children with inflammatory bowel disease]. / Aktywnosc tryptazy w bioptatach blony sluzowej jelita grubego u dzieci z przewleklym nieswoistym zapaleniem jelit.

INTRODUCTION: mast cells are dispersed in many tissues, especially in the digestive and respiratory system mucosal membranes. Tryptase is the most important proteinase released from mast cells after degranulation. It influences strongly the cells and tissues by activating the inflammatory process. THE AIM OF THE STUDY: was to assess the activity of tryptase in colon mucosa samples in children with inflammatory bowel diseases (IBD) and in children with bleedings from lower part of gastrointestinal tract (GTB), without inflammation. MATERIAL AND METHODS: a group of 30 children with IBD was analyzed in the study. IBD is formed by three disease entities: ulcerative colitis (UC) - 14 patients, Crohn's disease (CD) - 9 patients and non-specific colitis (NSC) - 7 patients. Moreover, a group of 18 children with bleeding from lower part of gastrointestinal tract was studied. The activity of tryptase in homogenates of colon mucosal samples was estimated fluoroimmunoenzymatically. RESULTS: the results of our analysis showed no statistically important difference between the mean activity of tryptase in groups of children with IBD and GTB (31442 +/- 1304 vs 31868 +/- 775 ug/l). The study of tryptase activities in different disease entities of IBD group showed, that its value in ulcerative colitis group was 31382 +/- 1170 ug/l, in Crohn's disease group it was 31536 +/- 1120 ug/l; in non-specific colitis group the tryptase activity was 32277 +/- 498 ug/l. The analysis with Kruskal-Wallis Anova test revealed that the differences are statistically significant (p = 0.034). In post hoc test the outstanding value is the tryptase activity in children with NSC. Activity of tryptase in colon in much higher than its activity in plasma (normal range 1-19 ug/l). CONCLUSIONS: the activity of tryptase in mucosal membrane samples is much higher than in blood. The extent of mast cells degranulation may be dependent on the form of IBD.

[Bone mineral density in inflammatory bowel diseases in children]. / Mineralizacja kosci u dzieci z wrzodziejacym zapaleniem jelita gruego i choroba lesniowskiego-crohna.

OBJECTIVE: determination of bone mineral density in children treated because of inflammatory bowel diseases. MATERIAL AND METHODS: 42 patients were included: 21 with ulcerative colitis and 21 with Crohn's disease. The duration of illness was from 2.0-24.0 months. Glucocorticoid therapy was applied in 92.9% of patients with the duration from 4-1680 days. The cumulative doses of glucocorticoids were from 160 to 25900 mg. Bone mineral density (BMD) and z-score of L1-L4 were assessed by dual-energy X-ray absorptiometry (DEXA). The mean BMD of L1-L4 were measured in g/cm2 and compared with referential values for gender and age. Osteopenia (ope) mean z-score from -1 to -2 SD, osteoporosis (opo) < -2 SD were accepted. RESULTS: BMD values varied from 0.531 to 1.301 g/cm. Z-score values varied from 0.9 to -5.6 SD. Bone mineral disturbances occurred in 57.2% of cases and it was equally both in 28.6% of cases osteoporosis and osteopenia. In ulcerative colitis osteopenia was predominant (23.8%), while in Crohn's disease osteoporosis occurred more often (23.8%). There was no significance in the duration time of the disease and BMD and z-score. The significant difference was found in the duration of steroid therapy and z-score. No association was found among cumulative dose of steroids and z-score. No significant differences were found in BMD and z-score of lumbar spine in ulcerative colitis and Crohn's disease. CONCLUSIONS: 1. Bone mineral disturbances often complicate inflammatory bowel diseases in children. 2. The association among the duration time of steroid therapy and bone mineral density was confirmed. 3. No significant differences were found in bone mineral density among colitis ulcerasa and Crohn's disease cases.

[Mast cells, their adenosine receptors and reactive oxygen species in chronic inflammatory pathologies of childhood]. / Komórki tuczne i ich receptory adenozynowe oraz reaktywne formy tlenu w niektórych przewleklych stanach zapalnych wieku rozwojowego.

Mast cells were described by Erhlich at the end of XIX-th century. Their role was deeply investigated in asthma and allergy. The massive degranulation of mast cells in allergy can lead to anaphylactic shock. Recently, mast cells have been recognized again as a very interesting topic for investigation, due to their possible role in chronic inflammation. Moreover, through adenosine receptors, mast cells can be activated or inactivated. That is why these cells are regarded as a potential target of new drugs. It has been reported, that mast cells generate intracellular reactive oxygen species (ROS) in response to stimulation with divergent physiologically relevant stimulants. The intensification of ROS production may be measured by the level of carbonyl groups, as a marker of protein peroxidation. However, the role of mast cells in other than asthma diseases with chronic inflammation needs further investigation. It was found out that the information about mast cell distribution in colonic mucosa may serve as help in differentiation between inflammatory bowel disease and collagenous colitis. Moreover, its accumulation in focal active gastritis was confirmed in patients with Crohn's disease. An important role in regulation of inflammatory process seems to be reserved for adenosine receptors present on mastocytes. The activation of mast cells through the adenosine receptor is connected with 11-8 release, which stimulate the migration of leukocytes and oxidation reactions. The detection of mast cells in tissues should not be limited only to the simple histologic examination. It should be completed by the detection of products of degranulation, e.g. tryptase. This is the way to find out their actual function and state of activation.

[Assessment of angiogenesis in children' s osteosarcoma]. / Ocena stopnia angiogenezy w miesaku kosciopochodnym u dzieci.

INTRODUCTION: Tumour angiogenesis is one of the most important hallmarks of cancer, which enables its development, progression and metastasizing. The extent of angiogenesis seems to be an essential prognostic factor in many solid tumours of children and adults. There have also been reports on the significance of angiogenesis in osteosarcoma. The most common methods to estimate angiogenesis is assessment of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression. AIM: The aim of the study was assessment of angiogenesis in osteosarcoma patients treated in our centre on the basis of MVD and VEGF expression. PATIENTS AND METHODS: Histopathological specimens of 16 patients with osteosarcoma aged 9-18 years (median 13.5), treated in Department of Paediatrics, Paediatric Gastroenterology and Paediatric Oncology of Medical University in Gdansk, between 1997-2004, were studied retrospectively. Immunochemistry was performed using anti CD34 monoclonal antibody and chromogen to highlight vessels, which were counted at 200 x magnification on 3 microscopic fields. In the same specimens VEGF expression was evaluated semiquantitatively using immunohistochemical method. Patients were divided into two groups depending on presence of metastases. The two parameters were also compared in patients who died and the survivors. RESULTS: 11 of 16 patients are alive, with time of follow up 19-100 months (median 52). Five children died. Mean vascular density ranged from 25 to 87 (46 +/- 16.5). No significant statistical difference in microvessel density between metastatic and non-metastatic patients was observed. Microvessel density in these groups is 46.8 +/- 22.7 and 45.2 +/-7.0 respectively. In the group of survivors MVD was 44.3 +/- 5.9, inpatients who died it was 47.1 +/- 21.0 showing no significant statistical difference. In all patients positive VEGF expression was seen. Only one patient presented low expression of VEGF, the rest had high or medium degree of VEGF expression. MVD in the group with high expression of VEGF was higher than in the group with low and medium expression of VEGF. It was 51.8 +/- 18.7 and 39.2 +/- 14.2. The difference was not significant. CONCLUSIONS: In the presented group of patients no differences in the extent of angiogenesis were seen in relation to treatment outcome or presence of metastases.

[Ovarian malignant tumours. Efficacy of germ cell and sex cord tumour treatment protocol in Poland]. / Nowotwory zlosliwe zlokalizowane w obrebie jajników. Ocena skutecznosci programu leczenia zlosliwych guzów germinalnych i guzów sznurów plciowych u dzieci w Polsce.

UNLABELLED: Approximately 1% of all malignant tumours among children are localized in the ovary. The majority belongs to germ cell tumours and occurs in the peripubertal period. AIM of the study was the evaluation of the efficacy of malignant ovarian germ cell tumour treatment programme in children. MATERIAL AND METHODS: Since 1998, 40 girls with malignant ovarian tumours were enrolled in the multicentre trial. Mixed germ cell tumours with yolk sac elements and dysgerminoma occurred the most often. Alfa-fetoprotein (AFP) was increased in almost one half of patients. Tumour exceeded the ovary margin in more than half the patients and 25% were qualified as high risk group. 38 children completed the treatment. All but one patient with neuroblastoma received TGM protocol (Tumeurs Germinates Malignes). A VBP regimen (vinblastine, bleomycin, cisplatin) was applied in 19 girls, VIP regimen (etoposide, ifosfamide, cisplatin) in 16, two received no chemotherapy. Due to delayed remission after first-line chemotherapy it was prolonged with ABK (adriamycine, bleomycine, carboplatin) in 3 patients, 1 megachemotherapy regimen with autologous bone marrow transplantation was realized, one patient received a 1.5 year long oral chemotherapy. All the children underwent surgery, 34 primary (56% complete), 12 secondary (75% complete). 8 children were operated twice. RESULTS: Among 34 children with germ cell tumours and 3 with sex cord tumours who completed the treatment all are alive in the first remission. 1 child with neuroblastoma localised in the ovary died due to recurrence. A median follow-up period was 42 months. CONCLUSIONS: The TGM protocol appears to be highly efficient in treatment of germ cell tumours even in advanced stages.

[Testicular malignant tumours. Efficacy of germ cell and sex cord tumours treatment protocol in Poland]. / Zlosliwe nowotwory jader. Ocena skutecznosci programu leczenia zlosliwych guzów germinalnych i guzów sznurów plciowych u dzieci w Polsce.

UNLABELLED: Approximately 2% of of all malignant tumours in boys are localised in the testis. Among them 80% are germ cell tumours with the malignant elements of yolk sac tumour. AIM of the study was evaluation of the efficacy of malignant testicular tumour treatment programme in children. MATERIAL AND METHODS: Since 1998 31 boys aged 1 month to 18 years (median 14 years) with malignant testicular tumours were enrolled in the multicentre trial. Patomorphologically clear yolk sac tumour (33%) and mixed germ cell tumour (42%) with the majority of yolk sac tumour component or carcinoma embryonale, occurred most often. Alfa-feto-protein was increased in 63% and choriogonadotropin in 26 patients. 61% patients had local clinical stage and the tumour was localized in the testis. In 39% patients tumour exceeded the testis margin. 4 patients were excluded from analysis as 3 are actually treated and 1 died on the second day of admittance to hospital. All patients received TGM 95 regimen (Tumeurs Germinales Malignes). Surgery (orchidectomy) was applied in 27 boys, 26 were primary (81% complete), 3 secondary (100% complete). 33% received no chemotherapy after surgery, in 41% VBP protocol (vinblastine, bleomycin, cisplatin) was given and in 26%o VIP protocol (ethoposide, ifosphamide, cisplatin). Two patients received also ABK (adriamycine, bleomycin, carboplatin). RESULTS: Among 26 children with germ cell tumours, 25 (96%) are alive, 23 (88%) are in first remission after completion of treatment. One child died due to central nervous system metastases. 2 children had local recurrence treated with chemotherapy or surgery with good result. Median follow-up is 45 months. CONCLUSIONS: TGM regimen is highly efficient in the treatment of malignant testicular tumours. Problems occur in cases of disseminated disease.

[Does chemotherapy and radiotherapy influence the level of oxidative stress in children with malignant bone tumours?]. / Czy chemoterapia i radioterapia ma wplyw na poziom stresu oksydacyjnego u dzieci ze zlosliwymi guzami kosci?

UNLABELLED: Reactive oxygen species may play a role in initiation, promotion and progression of malignancies. Radiotherapy of neoplasms is a strong egzogenous source of reactive oxygen species. Chemotherapy with anthracyclines is also a source of reactive oxygen species. Protein carbonyl groups are a well known marker of protein peroxidation. THE AIM of the study was to analyse the carbonyl groups in children with malignant bone tumours, who underwent chemotherapy and radiotherapy or only chemotherapy with anthracyclines. PATIENTS AND METHODS: A group of 55 children aged from 6 to 18 years with malignant bone tumour was examined; osteosarcoma (n=35) and Ewing sarcoma (n=20). There were 30 children examined before the treatment was started, 19 with osteosarcoma after chemotherapy with anthracyclines (program EORTC) and 13 with Ewing sarcoma after chemotherapy with anthracyclines and radiotherapy with doses 45-55 Gy (program EICESS 92). The analysis of protein carbonyls' content was evaluated by colorimetric method with the use of 2,4 dinitrophenylhydrazine. RESULTS: It was found that plasma carbonyl groups in children before the treatment was 1.36 +/- 0.70 nmol/mg of protein (osteosarcoma--1.42 +/- 0.70, Ewing sarcoma--1.25 +/- 0.78). After chemotherapy, in osteosarcoma the carbonyl content diminished to 1.11 +/- 0.49, and after chemotherapy with radiotherapy, in Ewing sarcoma it grew to 1.39 +/- 0.55. The carbonyl level in the whole treated group (chemotherapy and radiotherapy) was 1.25 +/- 0.53. None of the differences reached statistical significance. CONCLUSION: In children with malignant bone tumours chemotherapy and radiotherapy did not influence the level of oxidative stress.

[Plasma protein peroxidation as a marker of oxidative stress intensity and antioxidant barrier activity in children who have completed treatment for neoplastic diseases]. / Poziom stresu oksydacyjnego na podstawie analizy utleniania bialek osocza oraz aktywnosc enzymatycznej bariery antyoksydacyjnej u dzieci po leczeniu chorób nowotworowych.

UNLABELLED: Reactive oxygen species are engaged in the process of carcinogenesis. It was found that oxidative stress level is significantly elevated in children with neoplasms. Moreover, their antioxidant barrier is deficient and does not control free radical reactions. Protein carbonyl groups are a well known marker of oxidative stress in organism. Glutathione peroxidase (GPx) and superoxide dismuthase (SOD) are the most important components of enzymatic antioxidant barrier in humans. THE AIM of the study was to analyze the protein carbonyl groups' content in plasma and evaluation of erythrocyte GPx and SOD activity in children who have completed the oncological treatment. PATIENTS: 60 children, aged from 6 to 16 years, who have completed the treatment at least a year before they were examined together with a group of 61 healthy children of 6 to 16 years of age. The diagnosis was as follows: leukemias and lymphomas--8, malignant bone tumours--23, malignant brain tumours--8, malignant germinal tumours--10, malignant soft tissue tumours--4, nephroblasoma--4, other neoplasms--3 cases. RESULTS showed the statistically important elevation of protein carbonyl groups' content in children after neoplastic diseases (0.98 +/- 0.31 vs 0.86 +/- 0.19 nmol/mg of protein, p<0.05). The activity of GPx in oncological patients was significantly diminished (20.8 +/- 12.3 vs 25.7 +/- 12,7 U/gHb, p = 0.01), activity of SOD did not differ significantly (2193 +/- 840 vs 1904 +/- 840) compared to the control group. CONCLUSION: Children, who have completed oncologic treatment, may have deficits of antioxidant barrier and elevated markers of protein oxidation.

[Pulmonary metastases in children with solid tumours--own experiences]. / Przerzuty do pluc w guzach litych u dzieci--obserwacje wlasne.

BACKGROUND: The most frequent reasons of relapses in solid tumours among children are lung metastases. AIM: Analysis of lung metastatic cases among children with solid tumours treated from 1995-2005. MATERIAL AND METHODS: 26 lung metastatic cases (17 males, 9 females) were analysed. At the moment of the diagnosis lung metastases were present in 19.2% of patients while in the rest (80.8%) occurred during and after treatment. The most often lung metastases were recognised in osteosarcoma (15-57.8%) and carcinoma embryonale (3-11.6%). Secondary metastases in lungs occurred within 4-48 months after the diagnosis. In 57.7% were bilateral. 36 thoracotomies (average 1.7/ a child) were performed. The after-surgery chemotherapy for tumour recurrence was introduced in each case. RESULTS: In the analysed group 14 (53.8%) children are alive with the overall survival time 8-120 months. The rest 12 (46.2%) are dead with the survival time 6-24 months. The statistically significant difference was found in comparison of complete surgery versus incomplete (p=0.02), no significance was found in primary or secondary metastases (p=0.27). Time of occurrence was statistically insignificant (p=0.26). CONCLUSIONS: The occurrence of metastases in children solid tumours worsened the prognosis. The active search for lung metastases at the moment of diagnosis, treatment and follow-up combined with complete surgery procedures may prolong survival. There is a need to find new methods of lung metastases treatment.

[Superoxide dismutase in children with juvenile idiopathic arthritis]. / Dysmutaza ponadtlenkowa u dzieci z mlodzienczym idiopatycznym zapaleniem stawów.

UNLABELLED: The use or antioxidants as drugs that may control the inflammatory process recently has become widely studied in adults. One of the most important components or antioxidant barrier in humans is enzyme superoxide dismutase. Experimental treatment with superoxide dismutase proved to be effective in animals. THE AIM of the present study was to estimate the activity of superoxide dismutase (SOD) in patients with rheumatoid disease of childhood -- juvenile idiopathic arthritis and to analyse it in different clinical aspects of the disease including its activity, course and time of duration. MATERIAL AND METHODS: A group of 70 children with juvenile idiopathic arthritis, age from 3 to 18 years, patients of Rheumatologic Hospital in Sopot was examined in years 1996-2001. Juvenile idiopathic arthritis was diagnosed according to the International League Against Rheumatism classification (Durban 1997). The control group consisted of 29 healthy children age from 3 to 18 years. Superoxide dismutase activity was determined in full, heparinised blood with the use of spectrophotometric method or Randox. The study was accepted by the Local Committee of Ethics. RESULTS: A statistically significant increase in superoxide dismutase activity was found in group of children with juvenile idiopathic arthritis compared to the control group. In the polyarticular form of disease the activity of superoxide dismutase was also significantly higher than in the control group. CONCLUSIONS: In course of juvenile idiopathic arthritis, differently from rheumatoid arthritis of adults, superoxide dismutase activity seems to be stimulated in the majority of cases, so the treatment with exogenous superoxide dismutase may not be effective.

[Assessment of treatment results in children with malignant liver tumours in own experience]. / Ocena wyników leczenia dzieci z nowotworami zlosliwymi watroby na podstawie badan wlasnych.

AIM: The assessment of malignant liver tumours in children treated in our centre between years 1985-2004 has been made in order to analyze the prognostic factors and improvement in survival rate. MATERIAL AND METHODS: 17 patients with malignant liver tumours were followed-up. There were 10 (58,8%) patients with hepatoblastomas, 5 (29,4%) hepatocarcinomas, 1 (5,9%) undifferentiated embryonal sarcoma and 1 (5,9%) rhabdomyosarcoma. Primary metastatic disease was recognized in 3 cases as: hepatic vascular involvement, lungs, femoral bone and lymph nodes of liver hilus metastases. All patients underwent preoperative chemotherapy. Tumour resection was attempted in 13 (76,5%) cases; it was complete within adequate resection margins in 11 (64 7%). In 3 cases biliary fistulas occurred after surgery. Secondary metastases appeared in lungs, lymph nodes of liver hilus and central nervous system in 4 cases. RESULTS: Twelve patients are alive with median follow-up 34,0 mths, five died with median survival time 16,0 mths. Total excision of liver tumour had no statistical significance in lifetime prolongation (p =0,12). Survival rate was statistically longer in patients without metastatic disease (p=0,028). CONCLUSIONS: Complete surgical excision had no statistical significance in increasing survival time in liver tumour patients. Metastatic disease had statistical significance in shortening overall survival of patients with liver tumours. Unsatisfactory results in hepatocarcinoma treatment in children dramatically demonstrate the need for new treatment approaches.

[The antioxidative-prooxidative balance in children with asthma treated with inhaled corticosteroids and long acting beta2-agonists]. / Równowaga antyoksydacyjno-prooksydacyjna u dzieci z astma leczonych kortykosteroidami wziewnymi i dlugo dzialajacymi beta2-mimetykami.

UNLABELLED: The aim of study was to analyze the effect of treatment with inhaled corticosteroids and long acting beta2-agonists on antioxidative-prooxidative balance in children with asthma. MATERIALS AND METHODS: Twenty children with newly diagnosed asthma before treatment (group 1), fourteen children with diagnosed asthma treated with inhaled corticosteroids and long acting beta2-agonists and 57 healthy children were ioncluded in the study. In all cases plasma protein carbonyls and activity of erythrocyte SOD was assayed. RESULTS: Plasma protein carbonyls in both group I (1,01 nmol/g of protein, SD=0,30) and group II (0,94; SD=0,15) was significantly higher than in group III (0,85; SD=0,24) (I vs III p<0,033; II vs III p<0,031). The highest SOD activity was found in group II (3156,4 U/gHb; SD=976,1) (II vs I p<0,02; II vs III p<0,0001). SOD activity n group I (2435,8, SD=730,2) was higher than in group III (1533,1, SD=703,8) (p<0,0001). CONCLUSIONS: The increase in SOD activity in children with asthma seems to be a response to intensification of oxidative stress. Treatment of asthma with inhaled corticosteroids and long acting beta2-agonists augments antioxidative defense by increase in superoxide dismutase activity.

[Free radical reactions and activity of antioxidant barrier in children with chronic hepatitis B]. / Ocena nasilenia reakcji wolnorodnikowych oraz aktywnosci bariery antyoksydacyjnej u dzieci z przewleklym zapaleniem watroby typy B.

UNLABELLED: Recent research has shown that highly reactive oxygen species may take part in pathogenesis of many diseases, in particular chronic inflammatory processes. It was demonstrated that the activation of the inflammatory process is linked with generation of significant quantities of free radicals. This may lead to uncontrolled free radical reactions, particularly in case of antioxidant barrier insufficiency. THE AIM OF THE STUDY: To assess the biochemical parameters of oxidative stress, activation of glutathione peroxidase (GPX) and superoxide dismutase (SOD1) in erythrocytes of children with chronic hepatitis B (CBH). MATERIALS AND METHODS: Group of 47 children aged from 7 to 18 years with histopathologically confirmed CBH was studied. The content of carbonyl groups in plasma proteins and activity of SOD1 and GPX in the erythrocytes was evaluated. The control group consisted of 61 healthy children aged from 7 to 18 years. RESULTS: Verified statistically with Mann-Whitney U test. Significantly higher content of plasma proteins' carbonyl groups was found in the study group (1.07 +/- 0.33 nmol/mg protein) than in the control group (0.86 +/- 0.2, p < 0,001). The activity of GPX [U/gHb] was lower in group of children with CBH (18.7 +/- 9.7) than in healthy children (26.1 +/- 0.2, p =0.005). A significantly higher activity or SOD1 [U/gHb] was found in children with CBH (2470+/- 714) as compared with healthy controls (1857+/- 782, p =0.006). CONCLUSIONS: In patients with CBH the intensification of free radicals' reactions can be observed, which confirms the role of ROS in its pathogenesis. One of the reasons for this phenomenon may be due to the inappropriate activity of antioxidant barrier enzymes. The elevation of SOD activity seems to be a response to increased oxidative stress.

[Malignant germ cell tumours. Multicenter prospective trial in Polish Pediatric Group for Solid Tumours (years 1998-2000)]. / Zlosliwe guzy germinalne u dzieci. Wieloosrodkowe badania prospektywne Polskiej Pediatrycznej Grupy Guzów Litych w latach 1998-2002.

UNLABELLED: Germ cell tumors constitute about 3% of all pediatric malignancies. Since 1998 the multicenter trial was initiated in Poland. MATERIAL AND METHODS: 95 children (aged from 1 month to 17 years--mean 9.2 years) were registered. There were 38 boys and 57 girls. Diagnosis was made on histopathological examination in 88% patients (pts) and in 12% was established on imaging and biochemical findings (elevated AFP). Mixed germ cell tumor and yolk sac tumor prevelaged. AFP was elevated in 72% pts; in 26% it was over 15.000. Primary tumor was localized in gonads (59%) and in sacrococcygeal region (30%). Following disease stages were identified: I and II--41% pts, III--34%, IV--25%. All patients were treated according to French TGM'95 protocol. 43 belonged to high risk and 52 to standard risk group. 77 children completed therapy, 15 continue treatment and 3 were lost from follow-up. RESULTS: Among children who were off therapy, 70 (91%) are alive in a complete remission (second remission in 3 cases). Survival in high risk group is 89%, while in standard risk group is 93%. Median time of follow-up is 31 months from the beginning of treatment and 25 months after completion of therapy. 7 children died; all had progressive disease. CONCLUSION: The outcome of malignant germ cell tumors treatment in Poland is favourable and comparable to results showed by other study groups in the world.

[Progress in the treatment of non-Hodgkin's lymphoma (NHL) in children. The report of Polish Pediatric Leukaemia/lymphoma Study Group (PPLLSG)]. / Postep w leczeniu nieziarniczych chloniaków zlosliwych (NHL) u dzieci. Raport Polskiej Pediatrycznej Grupy ds. Leczenia Bialaczek i Chloniaków u Dzieci (PPGLBC).

Treatment results of non-Hodgkin lymphoma (NHL) in children has been shown in this study. From 1979 to 2003 children were registered with the diagnosis of NHL in oncology centers of Polish Pediatric Leukaemia/Lymphoma Study Group, a group of 397 patients with NHL B, 222 pts with NHL T and 54 pts with anaplastic large cell lymphoma (ALCL). The pts with NHL T have been treated according to BFM-90 protocol. The predominant primary site of disease was mediastinum (59.3%). Complete remission (CR) was achieved by 87%. EFS for all NHL T pts was 65% and 56% for pts with extensive tumours and 73% for pts with tumours < 10 cm. Patients with NHL B were treated according to the adopted LMB-89 protocol. The majority were Burkitts type and presented abdominal location (50%). 80% with disseminated disease. CR was achieved by 89% patients, but 94% with LDH < 500 IU/L and 73% with LDH > 500 IU. The median time of follow up was 53 months. EFS was 73% for all patients. The patients with ALCL were treated according to several protocols. Peripheral nodes were the most often primary location (40%), than mediastinum (24%) and abdomen (21%). EFS for all pts was 63%. Despite great progress in the therapy of NHL in children during 20 years of observation, the results are not satisfactory in disseminated stages. It is necessary to look for new prognostic markers which make it possible to improve classification of patients. Major surgery in advanced stages is not recommended since it delays chemotherapy and fails to improve overall survival. Early detection of neoplasm is one of the most important efforts to improve therapy success.