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Background: Internet information, now available in many different languages, can become a major source of information for patients and families in their own mother tongue. Chinese represent one of most frequently spoken language in the world. The aims of this study were to critically appraise the quantity and quality of Internet health information in childhood brain tumour in the Chinese language and to identify sufficient quality websites that can potentially be recommended to Chinese-speaking parents., Methods: Internet information on six common paediatric brain tumours was searched using six commonly used Chinese search engines. Websites were assessed systematically using two rating tools: DISCERN instrument and Checklist Rating System Instrument., Results: Out of 946 sites accessed, only 13 assessable Chinese websites, displaying Traditional Chinese characters and providing information on brain tumour, were identified. Only four sites included specific discussion on brain tumours in children. Ten websites failed to provide satisfactory information on brain tumour as rated by DISCERN instrument. Overall only 41% of the 13 specific items relevant to brain tumours were mentioned (Checklist Rating System Instrument)., Conclusion: Only a few satisfactory websites can be recommended to Chinese-speaking families for general information on brain tumour with caution from health care providers that such information may not apply to the child's individual condition.

Background: The fast growing internet offers easy access to medical information. So far there are limited data concerning the quality of this information. This study examined quality and readability of paediatric neuro-oncological information on the internet in german language., Method: Using the search terms "medulloblastoma", "ependymoma", "craniopharyngeoma", "brainstem glioma" and "low grade astrocytoma" in six different search engines, the first 30 universal/uniform resource locators (URLs) of each search engine were assessed. Appropriate Web sites were evaluated in regards to quality using DISCERN-Instrument and checklist rating system. Readability was rated by Flesch Reading Ease score., Results: Out of 889,56 web sites remained evaluable. Most of the sites rated as poor to very poor (49 %), 30 % rated as fair and 21 % as good to very good. Readability was scored as very difficult with complex vocabulary content limiting the usefulness of good web sites., Conclusions: Search-ing for childhood brain tumours via internet is time consuming and most often ineffective. There is a lack of high-quality and comprehensible information on childhood brain tumours on german web sites. Cooperation of scientific medical societies and the Federal Ministry of Health is essential to provide comprehensible and high-quality information on internet as an effective and supportive resource for patients and their relatives.

The continuing growth of the Internet has transformed the access to medical information. However, there are still little data on the quality of e-Health information available. This study examined the content and readability of paediatric neuro-oncology information on the Internet in the French language. The first 30 uniform/universal resource locators (URLs) from each of six search engines using the search terms "medulloblastoma", "ependymoma", "craniopharyngioma", "brainstem glioma" and "low grade glioma" were retrieved for accuracy and evaluation when appropriate. Eligible web sites were rated using the Discern instrument and a 13-items checklist. Readability was assessed using Flesch Reading Ease score. Out of 815 sites visited, only 22 fulfilled the evaluation criteria. Most sites rated either fair (25%), poor (59%) or very poor (13%). The mean readability score was 19.8 (6-32), indicative of poor accessibility by readability and complex vocabulary content. The poor quality of e-Health information is not specific of Web sites in French. The role of cooperative groups and the Health Care System in providing and disseminating clear and compelling medical information is essential., (Copyright John Libbey Eurotext 2003.)

Background and Objectives: We report a new real-time reverse transcription polymerase chain reaction (RT-PCR) method for quantification of TEL-AML1 transcripts. The method is based on hybridization probe (HybProbe) chemistry applied in LightCycler equipment. The study group comprised 44 successive cases of pediatric acute lymphoblastic leukemia (P-ALL)., Design and Methods: The quantitative estimation of TEL-AML1 transcripts was performed in 10 P-ALL TEL-AML1-positive patients. The PCR was performed in capillary tubes in 10 microL final volumes using two sets of primers: M1, which detects the long (L-form) and short (S-form) transcripts, and M2, specific for the L-form. The fluorescently labeled HybProbes (TEL 3FL and TEL 5LC) hybridize to the TEL region. TEL-AML1 expression was normalized relative to the levels of AML1 transcripts. Standard curves were prepared using serial dilutions of plasmids with TEL-AML1 or AML1 inserts., Results: The sensitivity attained allowed the detection of TEL-AML1 transcripts at a 10-4 dilution of a cDNA sample from a patient at diagnosis. The within-assay coefficient of variation (CV) for TEL-AML1 was 7.0% and the between-assay CV was 13%. Levels of TEL-AML1 transcript and the TEL-AML1/AML1 ratio decreased by more than four log units (p <0.001) during or after the course of initial treatment. Most of the patients who achieved complete remission after 5-6 months of initial treatment were TEL-AML1 negative, although some positive samples with negligible amounts of TEL-AML1 transcripts were still detected., Interpretation and Conclusions: This method has the sensitivity and reliability required to monitor the presence of minimal residual disease, and could be a powerful tool in monitoring the efficacy of the response to chemotherapy.

Common origin of sympathoblasts and pheochromoblasts from the neural crest cells is generally accepted. Neuroblastoma and pheochromocytoma result from an abnormal proliferation of these committed cells. They are included in the group of neuroendocrine neoplasms, formerly named Apudomas. Previous reports of mixed tumours of neuroblastoma and pheochromocytoma, and ganglioneuroma and pheochromocytoma, support this hypothesis. A case of extra-adrenal pheochromocytoma in an adolescent who 15 years before was successfully treated for a stage IV-S neuroblastoma without evidence of primitive tumour is reported. Two hypothesis are formulated: (1) the second neoplasm may have arisen from the unlocated primitive tumour, probably silent evolution could be due to its maturation into ganglioneuroma-pheochromocytoma; (2) taken into account a common origin of both neoplasms, the patient may have a genetic predisposition to develop neuroendocrine tumours. Whatever the mechanism, second neoplasms, as the case reported, late relapses, and late toxic effects may justify long follow-up of neuroblastoma survivors.

The use of recombinant human granulocyte-stimulating factor (G-CSF) has been shown to effectively accelerate granulocytic recovery after autologous bone marrow transplantation (BMT) in adults. The experience, however, is limited in children. We evaluated the hematopoietic reconstitution in 41 consecutive children undergoing autologous BMT for hematologic malignancies (21 acute lymphoblastic leukemia, five non-Hodgkin's lymphoma) and solid tumours (seven neuroblastoma, two brain tumor, three Ewing's sarcoma, two Wilms' tumor, one rhabdomyosarcoma). Their ages ranged from 2 to 16 years (mean 7.2 years). rhG-CSF was given at a dose of 10 micrograms/kg/day i.v. in a 2h infusion from day +1 until +28 or until the absolute neutrophil count (ANC) was > 1 x 10(9)/L. These patients were compared with a similar historical control group of 38 children who did not receive rhG-CSF after autologous BMT. The number of cells infused was similar in both groups. At the dose and schedule used in the present study, rhG-CSF was well tolerated and no side-effects were observed. The number of cell infused was similar in both groups. At the dose and schedule used in the present study, rhG-CSF was well tolerated and no side-effects were observed. Our data show that rhG-CSF accelerates engraftment and reduces the number of febrile days and antibiotic use. Furthermore, patients who were treated had less infections.

Some cases of conversion from acute lymphoblastic leukemia (ALL) to acute nonlymphoblastic leukemia (ANLL) at relapse have been reported recently. We report three cases initially diagnosed as having ALL and showing morphological, cytochemical, and immunophenotypic features of ANLL at relapse (lineage switch). Conversion was observed among 14 patients who developed bone marrow relapse while undergoing intensive treatment with our ALL protocol, which includes teniposide, and that had been administered to 62 patients. The three cases converted at first relapse, with a mean time of 20 months (13-29 months). Clinical and immunologic characteristics of T-cell leukemia were present in one patient. Changes documented in cytogenetic studies are discussed. The underlying mechanisms for the lineage switch remain unclear as does its relation with mixed lineage leukemias, but we believe that drugs employed in our therapy protocol could have had an influence on this conversion.

A study is made about the normal and abnormal gammagraphic patterns with 131-I-metaiodobenzylguanidine for the diagnosis of neuroblastoma in children. The authors find 100 per 100 positive results.

Results of 70 fine-needle aspiration biopsies (FNAB) were evaluated retrospectively in 61 pediatric patients. Over a period of 9 months all mass lesions suspected being malignant were aspirated. Twelve of the 70 aspirations were performed in children having known tumours, in order to exclude recurrence or metastasis. The others were carried out to obtain a diagnosis. Satisfactory specimens were obtained from 58 (83%). There were 21 benign diagnoses, 36 malignant diagnoses, and 1 with suspected malignancy. Correlation of histologic and cytologic diagnoses was possible in 45 cases. The diagnostic sensitivity and specificity were 95% and 80%, respectively. We have found FNAB more accurate in the diagnosis of malignancies than in benign lesions. The results suggest that this is a useful technique for obtaining a first diagnosis of malignancy, as well as for excluding recurrence or metastatic disease.

Ten patients with neuroblastoma were scintigraphed with I131-meta-iodobenzylguanidine (MIBG). Lugol solution was previously administered orally to all patients in order to avoid uptake of radioactive iodide by the thyroid gland. The compound was injected intravenously, 0.5 mCi/1.73 m2 of body surface. Scintigraphy was performed at 24, 48 and 72 hours and 6-7 days after administration of the radioactive preparation. Positive radiotracer uptake was demonstrated in all primitive tumors and metastases, showing a positivity of 100%. MIBG has proven to be the most useful technique in defining the stage of the disease. Mechanism of the tumoral uptake in relationship to catecholamine metabolism is discussed. Differences observed in MIBG radioactivity seen in the urinary bladder, heart and liver in children with or without. Neuroblastoma are discussed. MIBG has also been useful in the follow-up of patients with neuroblastoma.

Sixteen consecutive children diagnosed of "high risk" acute lymphoblastic leukemia were treated with a protocol including VM-26, ARC and intermediate-dose Mtx. Complete remission was obtained in 94 por 100 of patients. Actuarial haematologic remission rate at 36 months is 87% and continuous complete remission rate 58%. Twelve doses of Mtx (IV + IT) appear to be insufficient as SNC prophylaxis in these high risk children. Nevertheless hematologic relapse rate is very low. Mean follow-up time is 31 months and survival rate 87%.