Anemia can be defined as a lower than normal value for hemoglobin, hematocrit or number of red blood cells per cubic millimeter. Those who are aged 6~23 months with hemoglobin below 10 gm/dL, or aged 2~5 years with hemoglobin below 11 gm/dL, or aged 6~12 years with hemoglobin below 12 gm/dL need further examination to solve the problem. The importance of a good family history deserves emphasis because anemia often have a hereditary basis. The various causes of anemia have relative frequency in various ages of children. In early infancy, ABO incompatible hemolysis disease of newborn, hemorrhage either acute or chronic, anemia of prematurity, and iron deficiency anemia are the most common. While anemia of chronic disease, aplastic anemia, acquired immune hemolytic anemia, thalassemia, anemia of the red cell membrane abnormalities or enzymopathy are prevalent in later infancy and childhood. This article emphasizes the developmental changes in red cell production and function, the signs and symptoms of anemia, the morphologic changes of red cells in various disease, the skeletal changes in anemia, and lastly the importance of thalassemia in Taiwan. The treatment, such as: iron preparation, folic acid, vitamin B12, steroid, transfusion, iron chelation therapy, anti-thymocyt globulin, splenectomy and bone marrow transplantation, should be given according to the etiological diagnosis.
{"title":"教育演講：常見小兒疾病預防與處理－貧血症","authors":"林凱信","doi":"10.7097/APS.199511.0024","DOIUrl":"https://doi.org/10.7097/APS.199511.0024","url":null,"abstract":"Anemia can be defined as a lower than normal value for hemoglobin, hematocrit or number of red blood cells per cubic millimeter. Those who are aged 6~23 months with hemoglobin below 10 gm/dL, or aged 2~5 years with hemoglobin below 11 gm/dL, or aged 6~12 years with hemoglobin below 12 gm/dL need further examination to solve the problem. The importance of a good family history deserves emphasis because anemia often have a hereditary basis. The various causes of anemia have relative frequency in various ages of children. In early infancy, ABO incompatible hemolysis disease of newborn, hemorrhage either acute or chronic, anemia of prematurity, and iron deficiency anemia are the most common. While anemia of chronic disease, aplastic anemia, acquired immune hemolytic anemia, thalassemia, anemia of the red cell membrane abnormalities or enzymopathy are prevalent in later infancy and childhood. This article emphasizes the developmental changes in red cell production and function, the signs and symptoms of anemia, the morphologic changes of red cells in various disease, the skeletal changes in anemia, and lastly the importance of thalassemia in Taiwan. The treatment, such as: iron preparation, folic acid, vitamin B12, steroid, transfusion, iron chelation therapy, anti-thymocyt globulin, splenectomy and bone marrow transplantation, should be given according to the etiological diagnosis.","PeriodicalId":306859,"journal":{"name":"Acta paediatrica sinica","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1995-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125085688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Current chemotherapy will cure at least 65% of children with acute lymphoblastic leukemia (ALL). The major challenge in ALL is to develop effective risk-directed therapy. This approach seeks to improve outcome, through more intensive therapy, for children at high risk of relapse, while reducing the side effects and long-term complications of treatment for those with a high likelihood of cure. The prognosis remains poor for most children with acute myeloid leukemia (AML). Despite the use of intensive chemotherapy and bone marrow transplantation, only 30% to 40% of these patients are long-term survivors. However, research has identified subgroups of patients who will respond well to therapy that is targeted to their specific biologic subtype of AML. Allogeneic bone marrow transplantation remains the only curative treatment for patients with chronic myeloid leukemia. Current efforts focus on improving risk-directed and subtype-specific treatment for the childhood leukemias. Ultimately, it may be possible to target treatments to the specific genetic lesions of leukemic cells.
{"title":"Childhood leukemias--current status and future perspective.","authors":"Pui Ch","doi":"10.7097/APS.199510.0322","DOIUrl":"https://doi.org/10.7097/APS.199510.0322","url":null,"abstract":"Current chemotherapy will cure at least 65% of children with acute lymphoblastic leukemia (ALL). The major challenge in ALL is to develop effective risk-directed therapy. This approach seeks to improve outcome, through more intensive therapy, for children at high risk of relapse, while reducing the side effects and long-term complications of treatment for those with a high likelihood of cure. The prognosis remains poor for most children with acute myeloid leukemia (AML). Despite the use of intensive chemotherapy and bone marrow transplantation, only 30% to 40% of these patients are long-term survivors. However, research has identified subgroups of patients who will respond well to therapy that is targeted to their specific biologic subtype of AML. Allogeneic bone marrow transplantation remains the only curative treatment for patients with chronic myeloid leukemia. Current efforts focus on improving risk-directed and subtype-specific treatment for the childhood leukemias. Ultimately, it may be possible to target treatments to the specific genetic lesions of leukemic cells.","PeriodicalId":306859,"journal":{"name":"Acta paediatrica sinica","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1995-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128737686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selective IgG subclass (IgGSc) deficiencies are frequently found in association with recurrent infections in childhood. IgGi deficiency is the most severe and is associated with features typical of panhypogammaglobulinaemia. Immuno globulin replacement therapy is usually required. IgG2 deficiency is associated with recurrent infections with encapsulated bacteria such as Haemophilus influenzae and Streptococcus pneumoniae. IgG2 deficiency may be transient in children under five years of age and patients improve with antibiotics and immunisation. IgG3 and IgG4 deficiency are commonly found in children with recurrent infections and may indicate a disordered immune ystem since absence of these antibodies alone appears insufficient to cause symptoms. Children may also have selective IgGSc deficiencies in the absence of recurrent infections. This is explained by compensatory factors in other parts of the immune system. Measurement of IgGSc levels should be based on highly specific polyclonal antisera which show no IgGSc cross-reactivity. Most monoclonal antibodies are unsatisfactory since allotypes are detected variably, leading to excess reporting of IgGSc deficiencies and Mabs cannot be used for nephelometric or turbidimetric methods.
{"title":"IgG subclasses in childhood infections.","authors":"Bradwell Ar","doi":"10.7097/APS.199506.0164","DOIUrl":"https://doi.org/10.7097/APS.199506.0164","url":null,"abstract":"Selective IgG subclass (IgGSc) deficiencies are frequently found in association with recurrent infections in childhood. IgGi deficiency is the most severe and is associated with features typical of panhypogammaglobulinaemia. Immuno globulin replacement therapy is usually required. IgG2 deficiency is associated with recurrent infections with encapsulated bacteria such as Haemophilus influenzae and Streptococcus pneumoniae. IgG2 deficiency may be transient in children under five years of age and patients improve with antibiotics and immunisation. IgG3 and IgG4 deficiency are commonly found in children with recurrent infections and may indicate a disordered immune ystem since absence of these antibodies alone appears insufficient to cause symptoms. Children may also have selective IgGSc deficiencies in the absence of recurrent infections. This is explained by compensatory factors in other parts of the immune system. Measurement of IgGSc levels should be based on highly specific polyclonal antisera which show no IgGSc cross-reactivity. Most monoclonal antibodies are unsatisfactory since allotypes are detected variably, leading to excess reporting of IgGSc deficiencies and Mabs cannot be used for nephelometric or turbidimetric methods.","PeriodicalId":306859,"journal":{"name":"Acta paediatrica sinica","volume":"221 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1995-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132523849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thirty-three epileptic children who had epileptiform discharges in conventional 16 channel EEG study were enrolled in this study. The patients have never been treated with medication at first visit. Then patient were put on ambulatory monitoring EEG with the Oxford Medilog 9-channel cassette LEG system, which included six symmetrical scalp leads, one EOG, one Chin EMG and one channel for time signal. The LEG record was processed under the rule of the international standard method in terms of 10-20 system. The 24 hours EEG cassettes which recorded before and after antiepileptic drugs therapy were reviewed by an experienced electroencephalographer on a video play back unit. The number and duration of spikes or spike wave discharges were calculated. Among those 22 cases who had studied completed, there are 11 cases with generalized spike waves (5 with irregular spike waves, 3 with regular 3 hz spike waves, 1 with multiple spike waves, 1 with slow sharp waves and 1 with abortive spike waves), and 11 cases with focal spike activities (5 with bilateral central or centrotemporal spikes, 4 with temporal spikes and 2 with occipital spike discharges). After anticonvulsants therapy, 9 cases (82%) out of those 11 cases with generalized spike waves, the spike waves were disappeared; 2 cases (18%) revealed no significant change in spike rate and duration. In another 11 cases with focal spike discharges, 3 cases with centrotemporal spikes showed no significant change in spike rate, 2 cases with centrotemporal spikes and 4 cases with temporal spikes revealed significant decrease in spike rate; The occipital paroxysms of the last two cases were totally disappeared after medication. We found that most of generalized spike waves and occipital spike activities could be abolished totally by anticonvulsants, temporal spike discharges revealed marked decrease in spike rate after therapy, whereas, most of central or centrotemporal spike discharges showed no significant change in spike rate after antiepileptic drugs therapy.
{"title":"The Effects of Anticonvulsants on the Epileptiform Discharges-Study by 24-hour Ambulatory Cassette EEG System","authors":"劉文玉, 曹汶龍, 張民基, 朱夢麟","doi":"10.7097/APS.199412.0522","DOIUrl":"https://doi.org/10.7097/APS.199412.0522","url":null,"abstract":"Thirty-three epileptic children who had epileptiform discharges in conventional 16 channel EEG study were enrolled in this study. The patients have never been treated with medication at first visit. Then patient were put on ambulatory monitoring EEG with the Oxford Medilog 9-channel cassette LEG system, which included six symmetrical scalp leads, one EOG, one Chin EMG and one channel for time signal. The LEG record was processed under the rule of the international standard method in terms of 10-20 system. The 24 hours EEG cassettes which recorded before and after antiepileptic drugs therapy were reviewed by an experienced electroencephalographer on a video play back unit. The number and duration of spikes or spike wave discharges were calculated. Among those 22 cases who had studied completed, there are 11 cases with generalized spike waves (5 with irregular spike waves, 3 with regular 3 hz spike waves, 1 with multiple spike waves, 1 with slow sharp waves and 1 with abortive spike waves), and 11 cases with focal spike activities (5 with bilateral central or centrotemporal spikes, 4 with temporal spikes and 2 with occipital spike discharges). After anticonvulsants therapy, 9 cases (82%) out of those 11 cases with generalized spike waves, the spike waves were disappeared; 2 cases (18%) revealed no significant change in spike rate and duration. In another 11 cases with focal spike discharges, 3 cases with centrotemporal spikes showed no significant change in spike rate, 2 cases with centrotemporal spikes and 4 cases with temporal spikes revealed significant decrease in spike rate; The occipital paroxysms of the last two cases were totally disappeared after medication. We found that most of generalized spike waves and occipital spike activities could be abolished totally by anticonvulsants, temporal spike discharges revealed marked decrease in spike rate after therapy, whereas, most of central or centrotemporal spike discharges showed no significant change in spike rate after antiepileptic drugs therapy.","PeriodicalId":306859,"journal":{"name":"Acta paediatrica sinica","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1994-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115455242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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