The results of adjuvant therapy of juvenile recurring respiratory papillomatosis with the use of indole-3-carbinol

The authors analyse the efficacy of anti-relapse therapy of juvenile recurring respiratory papillomatosis in 87 children aged from 2 to 15 years with the use of indole-3-carbinol. Prior to inclusion into this study, the patients underwent from 2 to 86 (mean 12 +/- 14) surgical interventions for the ablation of papillomas. The average interval between successive relapses of papillomas ranged between 2 weeks and 12 months (mean 4.9 +/- 2.33 months). The patients remained under observation in the clinic during 2 years--6 years 5 months (mean 44.8 +/- 15.93 months). The duration of therapy with indole-3-carbinol varied from 12 weeks to 2 years (mean 8.9 +/- 4.72 months). The stable remission of pathology was documented in 28.7% of the patients within the 2 to 6 year follow-up period. A significant (1.5-10-fold) increase in the duration of interval between successive relapses occurred in 41.1% of the children. In 29.9% of the patients, therapy produced no apparent clinical effect; 18.4% of them showed an insignificant shortening of the interval between relapses that remained unaltered in the remaining 11.5%. No adverse effects of the treatment were recorded. It is concluded that treatment with indole-3-carbinol can be recommended as a starting therapeutic modality for the management of juvenile recurring respiratory papillomatosis and the reduction of the intervals between relapses of the disease.     

Clinical symptoms of vascular laryngeal tumors in children depending on their location

To study peculiarities of clinical symptoms of laryngeal angiomas in children, 71 case histories for children with vascular tumor aged 27 days to 14 years have been analysed. The cases were divided into two groups by location of the tumor: group 1--with hemangioma located in the subvocal larynx (45 children admitted to hospital at the age of 27 days to 2 years); group 2--with laryngeal vascular tumor located in the vocal or supravocal larynx (26 children admitted to hospital at the age of 3 months to 14 years). It was established that the age of the first angioma symptoms and the symptoms manifestation depend on the tumor location. Subvocal hemangioma should be considered an independent nosological unit of the disease.     

Efficacy of indinol in antirecurrence therapy of juvenile respiratory papillomatosis

The study of indinol efficacy in antirecurrence therapy of respiratory papillomatosis was performed in 46 children aged 2-14 years. The treatment lasted at least 12 weeks. Duration of a recurrence-free period before and after indinol administration was analysed. The response was observed in 30 (65.2%) patients. In 5 (10.9%) patients the remission continued from 2 to 3 years 10 months. In 25 (54.3%) patients recurrence-free period increased 1,5-6-fold. Side effects were not registered. Simple in use, cheap, well tolerated, usable with other treatments, indinol is recommended as a method of choice in antirecurrence treatment of recurrent respiratory papillomatosis.     

Combination therapy including mutamycin (mitomycin C) in the treatment of advanced colorectal and gastric cancer

The paper reports the data on treatment of 57 patients with disseminated gastric and colorectal carcinoma using a combination of mutamycin + 5-fluorouracil + leucovorin + cisplatin. Overall response was 26.3% including complete--7.01 and partial--19.29%. Mean duration of complete and partial remission was 10.88 +/- 5.65 and 5.18 +/- 0.82 months, respectively. Treatment as first-line chemotherapy was significantly more effective (36.1 and 9.5%). The regimens proved relatively low-toxic and therefore, can be recommended for out-patient application.     

Papillomatosis of the lower respiratory tracts in children

Papillomatosis of the trachea, bronchi and lungs was investigated in 40 children with papillomatosis of the lower airways in comparison with 408 children with laryngeal papullomatosis. All the patients were operated in 1988-2003 with histological verification of the diagnosis. Papillomas involved the lower airways because of tracheotomy (92.5%) or tracheal intubation (7.5%). Papillomatosis of the lower airways runs a more aggressive course than laryngeal papillomatosis, its treatment efficacy is worse. All the patients suffering from laryngeal papillomatosis with a history of tracheotomy need a regular endoscopic and x-ray control as papillomatosis of the trachea and/or lungs may develop in them several years after decanulation. Pulmonary papillomatosis has an invariably poor prognosis.     

Genetic polymorphism of clinical Mycobacterium tuberculosis strains circulating in the territory of Novosibirsk Region

Mycobacterium tuberculosis strains isolated from patients treated at TB dispensary branches in different districts of Novosibirsk were studied by genetic analysis. The below molecular methods were used: 1. PCR with random primers; 2. A method based on variable number of tandem repeats in loci; 3. IS6110 inverse PCR. Thirty-five samples of genome DNA of M. tuberculosis isolated were analyzed. Each of the 3 methods detected the main group of isolates, which comprised 61.8% of closely related strains revealed by method 1, 75.8%--by method 2, and 74.3%--by method 3. The remaining clusters were represented by 1 to 4 strains. The data obtained denote a relative homogeneity of M. tuberculosis strains circulating in Novosibirsk Region. No interplay was detected between the clustering of isolates and the presence or absence of mutation in genes conditioning the resistance to antibiotics.     

Gastroesophageal reflux disease and pharyngolaryngeal reflux in children with chronic laryngeal pathology

A prospective non-randomized trial was made to evaluate incidence of gastroesophageal reflux disease (GERD) and pharyngolaryngeal reflux (PLR) in children with chronic laryngeal pathology. A total of 46 children aged 6 to 15 years were examined including 16 patients with recurrent respiratory papillomatosis, 15 patients with acquired laryngotracheal scarry stenosis and 15 patients with vocal nodules and functional dysphonia. Combination of GERD with PLR is a factor of risk for scarry laryngostenosis in a child with recurrent respiratory papillomatosis. If it is impossible to perform 24-h pH-monitoring of the esophagus for detection of GERD or PLR in patients with chronic laryngeal pathology, antireflux therapy is prescribed empirically. It is necessary to establish significant diagnostic criteria of PLR.