The Effect of Long-term Phenobarbital Administration on the Bone Mineral Density of Children

The long term administration of anti-convulsants on children with convulsive disorders may cause osteomalacia, depending on the dosage, duration, type and combination of anti-convulsants administred. Fifteen children, comprising 10 male and 5 female, dignosed with convulsive disorders and administered with phenobarbital for a long term period of more than 9 months but less than 84 months and 15 healthy children of a similar age-group were selected for the investigation the density of she spinal backbone of each individual was measured by means of the "QDR-2000 X-ray bone densitometer's (made by Hologic company) which uses the double energy X-ray absorption technique. The levels of serum calcium, phosphrus and alkaline phosphatase for each child were also measured for comparative analysis. The results were as follows: 1) The mean bone density for the healthy group of chlidren was 0.69+/-0.09g/cm(2) and that for the group of children administered with phenobarbital was 0.59+/-0.07cm(2) indicating a significant decrease in density for the latter group (p<0.05). 2) As for the relationship between the duration of phenonbarbital and the decrease in bone mineral density, 5 of 6 patients(83%) administered with phenobarbital for more than 4 years showed a decrease in bone mineral density and 5 of 9 patients (56%) administered with phenobarbital for less than 4 years showed a decrease in bone mineral density. 3) the mean vitamin D level for the healthy group of chlidren was 26.8+/-2.5pg/ml indicating a significant decrease in vitamin D3 level for this group(p<0.05). 4) The mean serum alkaline phospatase evel for the health group of children was 240+/-50u/L and 462+/-110u/L for those administered with phenobarbital. This indicate a significant increase in ALP for phenobarbital group(p<0.05). 5) The posphorus and calcium levels were within the normal range for all the groups of children.

Anemia due to prolonged breast feeding without weaning diet or supplement food

The paramount importance of breast feeding for the health of the infants has been recognized by untritionists and physicians. Although many advantages of the breast feedng, exclusive breast feeding without weaning diet or supplement food during prolonged perind in infants may produce iron deficiencyh anemia. This study was conducted to find out the hematologic state in exclusively prolonged breast-fed infants among these anemic patients and the way of thinking about their baby's feeding method in their mothers. Mothers of the anemic patients has been surveyed with questionare. The results and problems obtained from this study are summerized as follows. 1) Among 40 patients of this study, 27 were male (67.5%) and 13 were female (32.5%). Mean age was 12.6+/-2.7 month and 9 & 11 month of age were the most common, respectively (15.0%). 2) Mean age of mothers was 29.5 year. The 25 34 year-old group was most common. 3) Education levels of mothers were primary 10%, middle 10%, high 60%, and college graduate 20%. 4) In motivatins of breast feeding. Persuasion of husband or the parent of husband' 19(47.5%). 'Convenience for use' 12 (30.0%), and 'Through mass media or public information' 9 (22.5%). 5) In the causes of prolonged breast feeding, 'Think that satisfactory nutrition for baby is possible with breast milk alone' 4(10.0%), 'Due to persuasion of husband or the parents of husband' 11 (27.5%), 'Baby did no suck milk bottle or eat other diet except breast milk' 25 (62.5%). 6) In whether or not acknowledgment of the necessity of weaning diet, 'Know it but not consider so important 22 (55.0)%, 'Do not know at all) 15 (37.5%), and 'Breast milk, that will do' 3(7.5%). 7) Hb level in patient group, from 6 to 6.9g/dl was 2 (50.0%), from 7 to 7.9g/dl was 3 (7.5%), from 8 to 8.9%g/dl was 15 (37.5%), and from 9 to 10 g/dl was 20 (50.0%). From 9 to 10g/dl was the most common. Hematologic findings were Hb 8.8+/-0.9g/dl, Hct 28.8+/-3.0%, MCV 64.7+/-6.7 fl, MCH 20.0+/-2.5pg, MCHC 30.8+/-1.5g/dl. Platelet 452.5+/-142.9x103/mm3, Reticulocyte count 1.4+/-0.6%, Fe 28.6+/-14.1 g/dl, TIBC 446.7+/-66.2 g/dl, Ferritin 10.5+/-7.0ng/ml. Transferrin saturation 6.6+/-3.5%. 8) In association with duration of breast milk feeding and hematologic findings, as duration was prolonged, Hb, Hct, MCV & MCH were significantly decreased (p<0.01).

Clinical evaluation of reactive thrombocytosis in childhood

No abstract available.

Pineal Region Tumors : Clinical Analysis of 13 Cases

We reviewed 13 patients treated in the Department of Neurosurgery of the Presbyterian Medical Center from 1979 to 1982 who had tumors in the region of the pineal body. The treatment of such tumors has been in a state of flux between conservative therapy(cerebro-spinal fluid shunting and radiotherapy) and direct surgical removal. We compared both modes of treatment and analysed the patients in terms of clinical, pathological and radiological points of view. Good results were obtained by supracerebellar and infratentorial surgical approach.