Choroidal involvement in lymphomatoid granulomatosis.

A 13-year-old boy with evidence of pulmonary lymphomatoid granulomatosis developed monocular diplopia. Fluorescein angiography revealed bilateral choroidal involvement. Following treatment with vincristine, cyclophosphamide, and prednisone his diplopia resolved and the angiographic appearances returned to normal.

Cognitive function after two doses of cranial irradiation for acute lymphoblastic leukaemia.

The cognitive function of 23 children given cranial irradiation in a dose of 24 Gy was compared with that of 41 given 18 Gy. No significant differences were found in intellectual function or in mean number of intelligence quotient points lost between patients in the two treatment groups. A reduction in the dose of cranial irradiation does not seem to alleviate long term neuropsychological deficits.

The influence of serum methotrexate concentrations and drug dosage on outcome in childhood acute lymphoblastic leukaemia.

Sequential methotrexate (Mtx) absorption studies were undertaken in 127 children undergoing treatment for childhood non-T acute lymphoblastic leukaemia (ALL) to determine whether serum drug concentration, clearance and dosage affect event free survival (EFS). Higher serum concentration and area under the plasma concentration curve (AUC) were not associated with an improved EFS. Methotrexate clearance was not found to be of prognostic significance.

Urinary retention--an unusual dystonic reaction to continuous metoclopramide infusion.

Vomiting is one of the most distressing adverse effects of cancer chemotherapy. Metoclopramide by continuous infusion (400 micrograms/kg/h after a loading dose of 2.5 mg/kg) is a novel administration method for optimizing efficacy.

Pulmonary function in survivors of Wilms' tumor.

The respiratory status of 47 patients surviving childhood Wilms' tumor was studied. The group that had received flank irradiation (which impinges on the lower lung) (n = 17) had a significantly lower mean percent predicted for forced expiratory volume in one second, residual volume, and total lung capacity when compared to those who had received no irradiation (n = 23). Those patients who had received whole-lung irradiation (n = 3) had significantly lower transfer factor for carbon monoxide and gas transfer per unit lung volume when compared to the nonirradiated group (n = 23).

Cytogenetic analysis of a congenital fibrosarcoma.

Congenital (infantile) fibrosarcoma is a rare soft tissue sarcoma occurring in children aged less than 5 years. We performed cytogenetic analysis on such a tumor, which had an abnormal karyotype: 48,XY, +11, +20. Three other reports of karyotypes in congenital fibrosarcoma describe similar cytogenetic changes, and a specific pattern of trisomies that may prove diagnostic for this tumor is beginning to emerge.

Assessment of chemotherapy-associated nephrotoxicity in children with cancer.

Assessment of the toxicity caused by chemotherapy in children with cancer has become more important as the number of long-term survivors has continued to increase. It is vital to monitor both acute life-threatening adverse effects and long-term toxicity that may impair the child's development and cause permanent morbidity. Renal damage may follow treatment with cytotoxic drugs, especially cisplatin or ifosfamide, and lead to glomerular, proximal tubular or distal tubular impairment or to any combination of these.

Sunscreen use on Queensland beaches.

The prevalence of use of sunscreens was assessed in an environment of high ultraviolet (UV) exposure by surveying 117 males and 126 females on two Queensland beaches. Using a questionnaire, information was obtained about their application of sunscreen on the day of participation in the study, thus eliminating recall error. It was found that 71% of the female and 68% of the male beach-goers sampled had applied sunscreen, 47% of which had the maximum Sun Protection Factor (15+) rating.

Lack of response of bone marrow, in vitro, to growth factors in congenital neutropenia.

Severe congenital neutropenia has a poor outlook. In vitro clonogenic assays using recombinant growth factors may improve understanding of the underlying pathogenetic mechanisms and identify those in whom growth factors might be clinically useful. Marrow from a boy with congenital neutropenia was cultured with a variety of recombinant growth factors.

Virus infections in bone marrow transplant recipients: a three year prospective study.

Over three years 81 consecutive bone marrow transplant recipients (32 allogeneic and 49 autologous) who received prophylaxis with acyclovir, were studied for symptomatic virus infection. Thirty nine infections were documented in a total of 28 patients. Thirty two infections were mild, five were moderately severe, and two were severe.

Short duration, high dose, alternating chemotherapy in metastatic neuroblastoma. (ENSG 3C induction regimen). The European Neuroblastoma Study Group.

Fifty-one children, aged from 15 months to 13 years 5 months with metastatic neuroblastoma presenting sequentially at the participating institutions received four 3 to 4 weekly courses of high dose multiagent chemotherapy. High dose cisplatin (200 mg m-2) combined with etoposide (500 mg m-2), HIPE, was alternated with ifosfamide (9 g m-2), vincristine (1.5 mg m-2), and adriamycin (60 mg m-1), IVAd.

Nephrotoxicity after ifosfamide.

Eleven children and adolescents with previously normal renal function who received ifosfamide for the treatment of extrarenal solid tumours underwent detailed investigation of glomerular and renal tubular function to assess the incidence and extent of renal damage. None had received cisplatin. Glomerular filtration rate (measured by plasma clearance of 51Cr labelled edetic acid) was reduced in six children.

Demonstration of Epstein-Barr viral DNA in formalin-fixed, paraffin-embedded samples of Hodgkin's disease.

The presence of Epstein-Barr virus (EBV) DNA in formalin-fixed, paraffin-embedded samples of Hodgkin's disease (HD) was investigated by Southern blot hybridization using a specific EBV Bam H1W fragment probe. DNA from 16 samples of HD in children and young adults was compared with that from ten samples in adults older than 45 years. A further eight cases of DNA extracted from fresh samples of HD were also studied, in order to compare the results obtained with fresh and fixed tissue samples.

Ototoxicity of cisplatinum in children and adolescents.

Twenty-two children and adolescents who had received cisplatinum for the treatment of solid tumours underwent audiometry to ascertain the extent of hearing damage. Five patients complained of hearing difficulties, causing difficulty at school in one child. Hearing loss greater than 20 decibels occurred in four patients at 1,000 Hz, seven at 2,000 Hz, 13 at 4,000 Hz and 21 at 8,000 Hz.

Local antibody production and respiratory syncytial virus infection in children with leukaemia.

Children undergoing therapy for acute lymphoblastic leukaemia (ALL) are at increased risk of severe viral respiratory infection, and some find it difficult to terminate virus secretion. This increased severity may result from a defect in the mucosal immune response. To test this hypothesis, nasal immunoglobulin secretion and specific antiviral antibody responses to infection with respiratory syncytial (RS) virus in children with ALL have been compared with those in a normal age-matched comparison group.

Gonadal function after 12-Gy testicular irradiation in childhood acute lymphoblastic leukaemia.

Gonadal function was assessed in 15 boys with acute lymphoblastic leukaemia (ALL) who had received testicular irradiation. The dose to the testes was 12 Gy in 12, 15 Gy in 1, and 24 Gy in 2 cases. All of those who had received 12 or 15 Gy had normal Leydig cell function, although high levels of gonadotropins suggest subclinical Leydig cell damage.

Low-dose methotrexate in systemic onset juvenile chronic arthritis.

Twelve children with severe systemic juvenile chronic arthritis, all requiring high dose corticosteroids, have been admitted to a pilot study to evaluate the effect of low-dose methotrexate (mean dose: 8.5 mg/M2) on disease activity over a 6 month period. Definite improvement occurred in 4 children, allowing reduction of the steroid dose in 2 cases.

Chromosome 22 abnormalities in Ewing's sarcoma.

A child with disseminated Ewing's sarcoma underwent cytogenetic investigations which showed different structural rearrangements of chromosome 22 at diagnosis (?ring22), and at relapse [t(10;22)], but the classic translocation t(11;22) was not detectable. This case provides further evidence of the importance of chromosome 22 in this disease, while raising some questions about the central importance of the translocation between chromosomes 11 and 22.