[Microflora of pharyngeal mucosa in children with solid tumors].

Microbiological study of pharyngeal mucosa in 43 children with solid tumors revealed that 77.2% of isolated microorganisms belonged to Gram-positive flora. It was shown that streptococci and Staphylococcus aureus were the main species. Species composition of streptococci included both pyogenic (S. pyogenes, S. agalactiae, S. dysgalactiae, S. equi) andviridans species (S. acidominimus, S. oralis and "S. milleri" group). Nocardioform actinomycetes, corynebacteria and other staphylococci were referred to additional microflora. Accidental microflora was represented by Neisseria spp., non-fermenting Gram-negative bacteria, enterobacteria and yeast-like fungi. Microbiologic study of pharyngeal mucosa biocenosis showed that monoculture was present only in 2.3% of cases; in other cases microorganisms formed both intra-genus and inter-species associations. 2-6-component associations were revealed with predominance of 3-4-component associations (37.2% and 32.6% respectively). Relationship of distribution of microorganisms belonging to main and additional microflora was revealed.

[Sociomedical service in the care system for children with oncological diseases]. / Mediko-sotsial'naia sluzhba v sisteme pomoshchi detiam s onkologicheskimi zabolevaniiami.

Children with oncological diseases and their families receive no adequate social and psychological support, which adversely affects the outcomes of treatment and prognosis in patients and in those who have been cured from malignant tumors and deteriorates their and their families' life quality. A concept of sociomedical measures, which has been worked out at the Research Institute of Pediatric Oncology and Hematology, N. Blokhin Russian Cancer Research Center, is built on the principle of interdisciplinary approach to providing care to children with malignant tumors and it implies the rendering the patient and his or her family various social and psychological supports at all stages of specialized care.

[Tyrosine metabolism, antioxidative system and free radical lipid oxidative processes in children with pigmented nevus and melanoma]. / Metabolism tirozina, sostoianie antioksidantnoi sistemy i protsessov svobodnoradikal'nogo okisleniia lipidov u detei, stradaiushchikh pigmentnym nevusom i melanomoi.

The plasma levels of tyrosine and the lipid peroxidation intermediate malonic dialdehyde (MDA) were measured in children with pigmental nevus and melanoma. They were found to have antioxidative protective failure. The presence of pigmental nevus predetermines the high incidence of tyrosine metabolic abnormalities. In children with pigmental nevus and melanoma, there was an impairment in the correlation of the parameters of tyrosine metabolism, the rate of free radical lipid peroxidation processes, and the status of the antioxidative system. The findings suggest that children with pigmental nevus may be referred to as a high cancer risk group and monitoring of these parameters should be recommended at follow-up of pigmental nevi.

[Prognostic significance of the glucocorticoid receptor level in the bone marrow blast cells of children with leukemias]. / Prognosticheskoe znachenie urovnia retseptorov gliukokortikoidov v blastnykh kletkakh kostnogo mozga detei, bol'nykh leikozami.

Glucocorticoid receptor (GR) levels of bone marrow blast cells were measured in 29 pediatric patients suffering different forms of acute leukemia. A decrease in GR level was registered immediately after prednisolone treatment. Differences in cell GR levels in patients with lymphoblastic and myeloblastic leukemia were not significant. The level of GR of bone marrow blast cells was found to be of prognostic significance in acute lymphoblastic leukemia: 4 out of 5 patients with GR levels under 3,000 sights per cell relapsed within 5-7 months of follow-up whereas all 7 cases with higher levels continue in remission. No correlation between GR level and prognosis was established in 5 patients with various forms of acute myeloblastic leukemia.

[Psychologic adjustment to therapy in children with cancer]. / Osobennosti psikhologicheskoi adaptatsii k lecheniiu detei s onkopatologoiei.

Peculiarities of adjustment of pediatric cancer patients and their perception of the disease were studied in a group of 29 including 12 cases of hematooncological diseases and 17 cases of different solid tumors. Projective psychological methods were used. Such menifestations of failure to adjust as lower selfesteem, feeling of guilt, helplessness, passivity, anxiety and fear were observed in nearly all the patients. Adequate adjustment was found to be determined by the formation of a similarly adequate perception of the disease which in turn becomes possible when the problems involved were discussed with the patient by competent medical staff and well-counseled parents in an open and trust-worthy manner.

[The role of parents in the psychological adjustment of children with cancer]. / Rol' roditelei v psikhologicheskoi adaptatsii detei s onkopatologiei.

The behavior of parents may have a decisive impact on the child's adjustment to treatment. Their positive attitudes have a calming effect, support the patient's emotionally and overcome problems and bear sufferings involved in the treatment. Conversely, negative attitude may ruin the adjustment and provoke pessimism, lack of cooperation and even aggressiveness. Although the nature and degree of parental behavior and attitude may vary, their impact on pediatric patient adaptation processes shows a general trend. Of particular importance is the pattern of parental attitude at stages of treatment which involve frustration, extrapunitive behavior of parents being a possible negative factor. Our experience suggests that psychologists employed at children's oncological clinics should provide more counseling for parents and more training professional for the medical staff to improve adjustment of patients to therapy.

[Preliminary results of the study of physical health parameters in people treated for retroperitoneal neoplasms in childhood]. / Pervye rezul'taty izucheniia pokazatelei fizicheskogo zdorov'ia u lits, v detstve izlechennykh ot zlokachestvennykh opukholei zabriushinnogo prostranstva.

Physical status of 172 former cases of retroperitoneal tumors was investigated. As a result of treatment for cancer, former patients revealed changes in the urinary (62.5%), cardiovascular (25%) systems and gastrointestinal tract (71.5%). These indices, however, stayed within the morbidity rates in the total population.

[High methotrexate doses in the treatment program for acute lymphoblastic leukemia and lymphosarcoma in children]. / Povyshennye dozy metotreksata v programme lecheniia ostrogo limfoblastnogo leikoza i limfosarkomy u detei.

Tolerability and efficacy of high-dose methotrexate was studied in 70 pediatric patients with lymphoblastic tumors (acute lymphoblastic leukemia and non-Hodgkin's lymphoma). Methotrexate was given by 24-hour infusion of 500-1000 mg/m2 (total dose-700-3000 mg) after remission had been achieved. An antidote--calcium folinate--was administered 24 hours postinfusion. Major adverse side-effects involved were stomatitis, hepatotoxicity and fever. Survival in the study group was higher than in controls.

[Clinical course and prognosis in T-cell lymphoblastic tumors in children typed with Soviet-produced monoclonal antibodies]. / Klinicheskoe techenie i prognoz T-kletochnykh limfoblastnykh opukholei u detei, tipirovannykh otechestvennymi monoklonal'nymi antitelami.

Correlation analysis of the clinical course and prognosis was made in 56 children with T-cell lymphoblastic tumors (acute lymphoblastic leukemia and lymphosarcoma) typed with the use of monoclonal antibodies obtained in this country. The frequency of T-cell marker detection among all immunological subvariants in acute lymphoid leukemia and lymphosarcoma proved to be similar (36.6 and 37%, respectively). In acute lymphoid leukemia type T1 of tumor cells prevailed (58%), while in lymphosarcoma type T3 (63%). T2 and T3-cell lymphoblastic tumors were characterized by the most severe clinical course.

[Glucocorticoid receptors in acute lymphoblastic leukemia in children]. / Retseptory gliukokortikoidov pri ostrom limfoblastnom leikoze u detei.

Glucocorticoid receptor (GR) levels were quantitated in leukemic blasts from bone marrow aspirates of 53 children with acute lymphoblastic leukemia (ALL) and compared to the clinical and immunological features of the disease and its prognosis. GR levels did not correlate with the patients' sex, peripheral white blood cell count and cellular immunophenotype, but depended on the patients' age and histological type of leukemia. 43 patients were monitored during 3 or more years. The relapse-free and overall survival of ALL patients receiving standard courses of polychemotherapy including glucocorticoids was highly dependent on the GR level in bone marrow blasts. The best prognosis (67% relapse-free and 73% overall 3-years' survival) was observed in patients with GR levels over 6,000 sites/cell and patients with GR levels under 3,000 sites/cell had poor prognosis (31% relapse-free and 50% overall survival; median 1st remission duration 12 months). These correlations were most pronounced in ALL patients with "common" antigen.

[Clinico-morphological characteristics of lymphogranulomatosis in young children]. / Kliniko-morfologicheskie osobennosti limfogranulematoza u detei rannego vozrasta.

Cases of lymphogranulomatosis underwent a clinico-morphological analysis in 67 children aged 1 year to 3 years 11 months. The morphological features of the process and distinctive traits of the clinical picture of the disease in infants were defined. The 5-year survival in patients undergoing the current treatment programs was estimated.

[Bioelectric activity of the brain of children with long-term remission of acute lymphoblastic leukemia receiving chemoradiation prevention of neuroleukemia]. / Bioélektricheskaia aktivnost' golovnogo mozga u detei s dlitel'noi remissiei ostrogo limfoblastnogo leikoza, poluchivshikh khimioluchevuiu profilaktiku neiroleikoza.

Investigation of the bioelectrical activity of the brain (EEG, echoEG) in 60 patients aged 8 to 20 years with a long relapse-free course of acute lymphoblastic leukemia (6-10 years) made it possible to distinguish 3 groups of patients in accordance with the changes seen on the EEG. A reverse relationship was noted between the characteristics of the leukemic process during disease diagnosis and neurophysiological disorders after intensive therapy including chemoradiation prophylaxis of neuroleukemia. It is recommended that the dose of radiation of the brain of children with acute lymphoblastic leukemia may be reduced, if there are no risk factors of the development of disease relapses.

[Results of neuroleukemia prevention in children with acute lymphoblastic leukemia]. / Rezul'taty profilaktiki neiroleikoza u detei s ostrym limfoblastnym leikozom.

The follow-up of 318 children with acute lymphoblastic leukemia given program therapy that included different treatments including chemo- and radioprevention of neuroleukemia demonstrated the high efficacy of the measures carried out, which reduced the incidence of neuroleukemia to 5.6%. No gross changes on the part of the neuropsychic status were revealed in the course of the follow-up of children who received the combined prophylaxis of neuroleukemia. The derangement of the CNS was recorded in 17 patients and ran its course in the form of leukemic meningitis and meningoencephalitis.