ABSTRACT
Myelodysplastic syndrome is a heterogeneous disease complex which is basically a clonal disorder and has characteristics of cytopenia of one or more cell series in peripheral blood and of dyspoiesis of precursors in bone marrow. Since the nature of this disease in childhood is very different from that in adults, retrospective clinical study was performed with 17 confirmed patients who were admitted to the Department of Pediatrics, Seoul National University Children's Hospital from June 1986 till October 1992. The results were as follows: 1) Themost frequent occurrence was found in preschool age group (76.5%), and male predominance was noted. 2) Hepatosplenomegaly was the most frequent clinical finding, and in view of laboratory findings, anemia waas found in all cases, and leukopenia in 5 cases, thrombocytopenia in 13cases were observed. Bone marrow aspiration revealed dyspoiesis of 3 cell series in almost all cases. The percentage of myeloblasts more than 5% of total bone marrow nucleated cells was seen in 8 cases on bone marrow study. 3) Subtypes of the disease were found to be 3 cases of RA, 6 cases of RAEB, 3 cases of RAEB-T, 4 cases of JCML, and 1 case of monosomy 7 syndrome. Chromosomal study was performed in 8 cases, and 6 of them were detected to be abnormal. 4) Supportive management was performed for almost all cases, and combined therapy with prednisolone and one-alpha for 3 cases, combined chemotherapy with various anticancer drugs for 7 cases, and low dose cytarabine therapy (10 mg/m2/12 hr) for 6 cases were performed. 5) There were 3 cases of drop out, 8 cases followed up on not remitted state, 5 cases of death, and 2 cases followed up on complete remission state. Two cases in complete remission were one of RA patients, and one of JCML patients, to whom prednisolone with one-alpha, and combined chemotherapy with A-Triple-V regimen were applied as treatment modalities, respectively. 6) Average duration of follow up for 10 survival cases was 18.2 months and a significant difference of 2 year survival rate was found in between the group composed of RA, RAEB and the other group composed of remained subtypes.
Subject(s)
Adult , Child , Humans , Male , Anemia , Anemia, Refractory, with Excess of Blasts , Bone Marrow , Cytarabine , Drug Therapy , Follow-Up Studies , Granulocyte Precursor Cells , Leukemia, Myeloid, Acute , Leukopenia , Monosomy , Myelodysplastic Syndromes , Pediatrics , Prednisolone , Preleukemia , Retrospective Studies , Seoul , Survival Rate , ThrombocytopeniaABSTRACT
Since clinical significance of blood pressure level in childhood has been known, a several studies for the purpose of establishing normal blood pressure referece values in Korean school-aged children were performed. The author of this article measured normal blood pressure values for children in an elementary school, and two middle schools of Korean rural area using mercury sphygmomanometer. The results were as follows: 1) Systolic and diastolic blood pressure values increased according as age and height increased. Abrupt increase in systolic and diastolic blood pressure values at 11 years of age in both sexes was observed. 2) Average values of systolic/diastolic blood pressure in 6 year-old boys were 106/61 mmHg and these values increased with rates of 1.5 mmHg/yr (systolic blood pressure), 1.0 mmHg/yr (diastolic blood pressure). Similarily, the values in 6 year-old girls were 103/60 mmHg and they increased with the rate of 2.0 mmHg/yr (systolic blood pressure) and 1.5 mmHg/yr (diastolic blood pressure). 3) As the distribution of blood pressure level was observed in view of age and height reference, there were no biologically and statistically significant discrepancies in blood pressure level between boys and girls. 4) A strong positive correlationship with each parameters was observed in both sexes. 5) Blood pressure values for 50, 90, 95 percentile were presented in table and figure.