The Hungarian Childhood Leukemia Working Group, later as the Hungarian Pediatric Oncology Group (HPOG) has systemized registration, diagnosis, treatment and follow-up of children with leukemia and solid tumors since 1971 and 1973, respectively. HPOG has developed a uniform, nation-wide pediatric oncology service in Hungary, a country with ten million inhabitants and limited economic resources characterized by a slowly but significantly growing annual cancer incidence of 132 per one million children (below the age of 15 years). The newly diagnosed about 250 patients are being treated in 7 centers, 2 hematopoietic stem cell transplantation units and in 2 rehabilitation facilities according to contemporary protocols and they are followed-up together with the enhancing numbers of children having cured from cancer. HPOG became an integral part of the international pediatric oncology community. As a result of the coordinated efforts of the members of HPOG, children with cancer in Hungary experience overall and event-free survival rates similar to that of other industrialized countries.

In the last decades therapeutic results significantly improved in the field of pediatric malignancies. For the new protocols not only the survival but also the quality of life is an important issue. Estimation, treatment or even prevention of the acute and late toxicity caused by the therapy are important routin clinical questions. However, to improve the survival there are only limited possibilities with the current cytostatic combinations. Besides the standard treatment protocols used for different patient groups nowadays more attention has been paid to individualise the treatment strategies. The broadening of our pharmacokinetic and pharmacogenetic knowledge, the usage of targeted- and immuntherapies might lead to future progress. In the present study we aim to summarise these therapeutic novelties supplemented with our own results.

Epigenetic changes are common alterations in cancer cells, contributing both to progression toward malignancy and tumor cell survival. There is an increasing variety of epigenetic antitumor drugs in the clinical practice or in various clinical trials. PML (promyelocytic leukemia) nuclear bodies are dynamic structures, composed of several epigenetic regulator proteins. Although the exact function of PML bodies is a matter of debate they play important roles in cell division, apoptosis, senescence and many more. Interestingly, most tumor cells have less PML bodies than the corresponding normal tissues. In response to differentiating antitumor drugs, such as retinoic acid in acute promyelocytic leukemia or neuroblastoma the number of PML bodies increase with differentiation. Here we discuss the possible role of PML bodies and epigenetic regulators in tumorigenesis and in antitumor therapeutical strategies.

Multilocular cystic renal tumors are rare entities. The authors presents these rare renal tumors through the history of two patients. In the authors institute two children were treated with multilocular cystic renal tumor in the past one and half years. The pathologic findings were cystic partially differentiated nephroblastoma in the first case, and cystic Wilms’ tumor in the second one. The authors present the nomenclature, the clinical, radiological signs, the pathological findings and the treatment of these tumors.

Summary: Authors from two institutes (Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis Medical University of Budapest and Outpatient Vaccination Consultation Unit of ”Szent László” Hospital for Infectious Diseases) cooperated in offering a vaccination program for patients waiting for cochlear implantation. Aims: Retrospective data evaluation was performed for implanted patients prior and after the introduction of the vaccination program. Demography, etiology and postoperative minor, major complications were evaluated for each patient group regarding the benefit of vaccination. Methods: Retrospective evaluation of patients charts implanted between 1985-2006 both at the clinic where the implantation has been performed and at the vaccination centre where immunisations took place. Vaccination was offered to all patients taken into the program after 2003. Results: Altogether 207 patients charts were evaluated. No vaccine preventable neuroinfection was documented in either group. Major and minor postoperative infectious complications occurred only in the unvaccinated – 33/68 – one out of these had meningeal signs, though meningitis was not found. The offered vaccination was accepted by only half of the patients – no vaccination related side effects or events have been reported. Conclusions: During the 22 study years a clear shift towards implanting patients in the prelingual ages can be demonstrated, while the majority of the cases had no clear estimated etiology throughout. No purulent meningitis was observed in either group, though major and minor infectious complications only occurred in the unvaccinated (33/68). Only half of the patients accepted the offered vaccination which underline the necessity of better communication of the benefits of the vaccination for these patients.

Approximately 60-80% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. Two genetic polymorphisms responsible for persistence have been identified for adult-type lactose intolerance, with their distribution concentrated in north Europeans. Primer autosome recessive inherited lactose intolerance is very rare, however, secondary type form caused by celiac disease or postenteritis syndrome are frequent in clinical practice. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoe. Diagnosis is most commonly based on lactose hydrogen breath test. Treatment options are lactose restriction diet or lactase enzyme supplementation.

The aim of our study was to examine the cases of suicide commited by children and adolescents, in the aspects of age, sex, method and time of committal. In Europe, the suicide rate among children and adolescents is the highest in Hungary. Matherials and methods: We used the Forensical Institute’s autopsy medical reports of the Semmelweis University. We examined suicide cases committed by children and adolescents highlighted from the extraordinary death cases in Budapest between 1995 and 2004. The casec were also processed by alcohol or drug consumption, previous attempts and psychiatric therapy. Results: We processed 101 suicide cases (81 males, 20 females). In the examined period, the cases of suicide showed decreasing tendency. Suicide was rare during the winter. The most common methods were poisoning, hanging and jumping from heights. The male:female rate was 4:1. 67% of the children were over the age of 16. Discussion: The risk factors of suicide were mental illnesses, bad social-economic environment, use of drugs and alcohol and negative life events. Studies of epidemiology and risk factors, analysis of the international data may provide a basis of development of a specific suicide prevention program including educational, health and welfare elements.

Authors assessed repeatedly the iodine nutrition of schoolchildren at three Hungarian settlements (Budapest, Csákvár, Szolnok) in a decade. The first study was carried out in the frame of a European survey („ThyroMobil study”) in 1994. This ThyroMobil model was repeated with the same methodology (determination of iodine excretion and thyroid volume) in 2005. The iodine deficiency detected by decreased iodine excretion in 1994 disappeared in these areas until 2005. The sonographic determination of thyroid volume was performed by the same expert to avoid the interobserver error. The goitre-frequency decreased significantly according to any proposed reference values. The physical examination confirmed this tendency.