Brainstem lesions in the course of chronic fetal asphyxia.

We present a neuropathological study of brainstem involvement during the neonatal period, under the influence of prolonged fetal asphyxia. The investigation was performed on 20 brains of premature and mature newborns, who died in the course of chronic asphyxia. Ischemic cell change, neuronal loss and gliosis were present in the brainstem of all infants. Two topographic patterns of brainstem lesions in chronic anoxic encephalopathy were distinguishable in the newborns. The neurons of the cranial nerve nuclei were more severely damaged in the group of premature newborns. More severe lesions of the reticular formation were found in the group of mature newborns. The topography of brainstem damage seems to be dependent on the maturity of CNS structures at the time of injury.

Endodermal sinus (yolk sac) tumors in pediatric oncology. Report on 14 cases.

Fourteen cases of the endodermal sinus tumors in children are reported. The most frequent localization was the vagina, next presacral region, ovary and testis. No ovarian case was observed under 3 years of age.

[The analysis of failures in therapy of osteosarcoma in children treated according to SFOP-94 protocol in the studies of Polish pediatric solid tumors treatment group]. / Analiza niepowodzen leczenia miesaka kosciopochodnego u dzieci wedlug protokolu SFOP-94 w materiale Polskiej Pediatrycznej Grupy ds. Leczenia Guzów Litych.

Between December 1989 and April 1998 twenty eight children aged from 5 to 20 years (18 female and 10 male) suffering from osteosarcoma were treated according to the OS-SFOP-94 protocol. Twenty four patients presented with localized tumor of extremities and four with pulmonary metastases. The majority of primary tumors exceeded 150 ml of volume. The primary preoperative chemotherapy consisted of adriamycin (70 mg/m2 every four weeks) and high-dose methotrexate (12 g/m2 every week). In 20 patients limb-salvage surgery was applied, in three children--amputation and in one child tibia resection with genu arthrodesis was applied. Five of 28 patients died, one because of treatment related infection, 2 non-responders with metastatic osteosarcoma due to progressive disease, and one because of local relapse with pulmonary metastasis non-responding to therapy, one because of treatment refusal. Twenty one from 25 children are alive from 5 to 51 months. Event frae survival of children with localized disease calculated according to Kaplan-Meier analysis was 64.17% in the 51st month. The main cause of failure in the treatment of osteosarcoma in children is primary and secondary progression of disease. The toleration and results of treatment for osteosarcoma in children according to the OS-SFOP-94 is satisfactory.

[The role of local surgical and radiological control in the treatment of soft tissue sarcoma sensitive to chemotherapy in children. Report of Polish Pediatric Solid Tumors Treatment Group]. / Udzial lokalnej kontroli chirurgicznej i radiologicznej w wynikach leczenia nowotworów tkanek miekkich wrazliwych na chemioterapie u dzieci. Raport PPG/GL.

In this paper the role local surgical and radiological control in the treatment of soft tissue sarcomas in children was analyzed. All children were treated according to CWS-91 and SIOP-IV protocols. Eighty three children with RMS A + E, EES/PNET, SS, UDS were included in the analysis. The primary surgery consisted of R0 (5%), R1 (18%) or R2 (16%) resection. In majority of cases (61%) primary surgical intervention was limited to diagnostic biopsy. Conventional or hyperfractionated radiotherapy was performed in 42.8%, 73.8% and 75% of children with disease stage II, III and IV, respectively. Delayed surgery was performed in 20 out of 53 (37.7%) children with stage III of the disease. In 5 patients without primary focus (urinary bladder in 3 and prostate in 2 cases) removed, progression of the disease occurred. In 5 children (stage IV) with progression of the disease no secondary surgery was performed. In 4 of them the primary tumor exceeded 10 cm in diameter. No delayed surgery was performed in 69% of relapsed children with stage III of the disease. Planned radiation therapy was not performed in 15.9% of cases. Primary local surgical control of primary tumor is of great importance for remission duration. In children who underwent delayed surgery the estimated EFS was of 0.7, in comparison with 0.5 EFS of those without secondary surgical treatment.

[Malignant neoplasms and potentially malignant hyperplasia in children and adolescents from material at the Department of Pathomorphology, Institute of Mother and Child during 1978/79-1983]. / Nowotwory zlosliwe i rozrosty potencjalnie zlosliwe u dzieci i mlodziezy w materiale Zakladu Patomorfologii IMD w okresie 1978/79-1983.

531 cases of malignant neoplasms and potentially malignant hyperplasia in children and adolescents diagnosed in the Department of Pathomorphology, Institute of Mother and Child between 1978/79 and 1983 are presented. Only patients treated in this hospital were included into the study. The most common diagnoses were neuroblastoma (68 cases), rhabdomyosarcoma (62 cases), nephroblastoma (56 cases), osteogenic sarcoma (47 cases), non-Hodgkin lymphoma (41 cases). Besides neoplasms most typical for childhood and adolescence the rare less typical cases were also seen.

[Prognostic factors in neuroblastoma in children]. / Czynniki rokownicze w neuroblastoma u dzieci.

The paper presents the review of prognostic factors which were investigated from the first interests of neuroblastoma, as a model for cancer biology in pediatric oncology. The authors on the basis of other authors experiences and on the own observations, as well stress the importance of basic sciences from the field of molecular biology, cytogenetics and biochemistry, leading to better understanding of the nature of neuroblastoma and to introduction of rational treatment. The stratification of neuroblastoma patients according to the known prognostic variables influenced favourably treatment results.