ACUTE POISONINGS OF CHILDREN IN OSLO

ABSTRACT. A one year prospective study of all children under 15 years of age presenting for acute poisoning in Oslo is reported. There were 181 admissions in 179 children, of which 97 (54 %) were boys, giving an annual incidence of 2.3 %. All children survived without sequelae. Most poisonings were accidental and only two suicidal attempts were recorded. Of all poisonings 68 per cent occurred between the age of 1 and 2 years. The dominating toxic agents were drugs (44 %), tobacco (22 %) and petroleum products (9 %). Most poisonings were mild and only 7 (4 %) classified as severe. Seventy-two per cent of all children were admitted within the second hour after the ingestion of the toxic agent. Therapy should therefore be directed towards emptying the stomach with emetics or gastric lavage, unless corrosives or petroleum products are ingested. Childhood poisonings still call for better preventive measures since the toxic agent was found inappropriately stored in 86 % of the accidental poisonings.     

L-ASPARAGINASE TREATMENT OF ACUTE LEUKAEMIA IN CHILDREN

The results of asparaginase-prednisone therapy in children are reported. In 12 children with untreated acute lymphoblastic leukaemia 9 remissions were obtained, there were 2 failures and in one patient therapy had to be stopped because of an anaphylactic shock. One child with an acute myelocytic-granulocytic type of acute leukaemia did not respond. One child with an acute monocytic-monoblastic leukaemia was given asparaginase only. He responded very well. Four patients with a relapse of an acute myeloblastic leukaemia were treated: there were two failures, one child died too early from an infection to be evaluated. One child showed a very good reaction. Serious side-effects were few, the drugs gave many biochemical disturbances including a constant hypofibrino-genaemia, but these were well tolerated and reversible.     

ADRENAL GLUCOCORTICOID FUNCTION IN ACUTE VIRAL INFECTIONS IN CHILDREN

The hypothalamic pituitary adrenal system was studied in normal Egyptian children and in groups of children with some common viral infections including measles, chicken pox, mumps and poliomyelitis. Results showed a significant rise in plasma 17-OHCS levels in all acute viral infections. ACTH and metyrapone tests revealed that the hypothalamic-pituitary-adrenal axis was functioning adequately. The value of corticosteroids in the management of acute viral infections is discussed in the light of our clinical and laboratory findings.     

小儿急性造血功能停滞14例

急性造血功能停滞（又名急性红细胞再生障碍性贫血、急性再障危象等）,小儿少见。本文报道本单位十年来收治的１４例。男１２例女２例,最小年龄６月、最大１２岁,均有一定致病因素,以感染、药物毒性作用稍多。以中、重度贫血为多,网织红细胞明显减低。骨髓象：有核细胞增生活跃１３例,增生减低１例;但粒／红之比最低为１９：１,最高为１０１：１,多数介于３０～５６：１之间：重点讨论了病因、早诊线索及确诊。造血功能停滞恢复时间介于１０～３０天。     

ACUTE OTALGIA IN CHILDREN - FINDINGS AND DIAGNOSIS

ABSTRACT. One hundred and seventy-one children up to 15 years of age and with acute otalgia were examined to find out whether otalgia or any other symptoms were so closely related to acute otitis media (AOM) as to make otoscopic examination unnecessary. AOM was diagnosed in 46%, simplex otitis in 15%, serous otitis media (SOM) in 17%, and normal eardrums in 22%. Children with AOM had fever and spontaneous perforation of the eardrums in 78% and 30% of the cases, respectively. Of the children who had not AOM (54%), the otalgia could in most cases be classified as referred pain due to, for instance, discomfort when swallowing, nasal obstruction or throat pain. Other reasons were general irritability due to fever, teething or moderate hearing loss. The difficulties in diagnosing AOM simply on the basis of symptoms were demonstrated in the investigation. Symptoms such as otalgia, otorrhea, fever or upper respiratory tract infection (URI), possibly except for the combination of otorrhea and fever, can occur without AOM. A correct otoscopic examination and evaluation of the eardrums is necessary in children with otalgia, other symptoms of URI or in doubtful cases of acute illness. Physicians without possibilities to evaluate the eardrums properly should thus refer the patient to an otologist without delay.     

NEUTROPENIC ENTEROCOLITIS IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. During the period 1990-1995, 180 children were treated at the authors' center for acute lymphoblastic leukemia using a standard chemotherapy protocol. Among them, 11 children (6.1%) aged 4 to 12 years, were diagnosed clinically to have neutropenic enterocolitis. Eight had severe neutropenia (absolute neutrophil count < 10⁸/L and 5 had prolonged neutropenia (> 7 days duration). The symptoms included diffuse abdominal pain (10 children), oral mucositis (7), hematochezia (7), diarrhea (6), hematemesis (5), and right lower quadrant tenderness (4). Three children had radiological evidence of free intraperitoneal gas and an additional 3 children were found on surgical exploration to have cecal perforation. Laparotomy was performed on 8 children (73%), 4 of whom survived. Among the 3 children managed conservatively, 1 died awaiting surgical exploration, while the other 2 did well. The overall survival was 55%. The authors recommend an approach to management that respects the heterogeneity of the disease.     

PSYCHIATRIC MORBIDITY IN CHILDREN SUFFERING FROM ACUTE LYMPHOBLASTIC LEUKEMIA

The study aimed at assessing the frequency of psychiatric disorders in children with acute lymphoblastic leukemia. Thirty consecutive subjects in the age range of 6-12 years were interviewed with the help of a symptom checklist soon after they had achieved their first remission. The children were also administered the Children's Depression Rating Scale and the State Trait Anxiety Inventory for Children. One-third (n = 10) of the subjects received a diagnosis according to the International Classification of Diseases , 9th ed. Ninety percent (n = 9) had emotional disorders. All the disorders were mild to moderate in intensity and were perceived to be easily treatable.     

小儿急性白血病外周血NK细胞的变化

本文对20例小儿急性白血病进行了外用血NK细胞活性的测定。男13例、女7例，年龄4～13岁。其中急淋5例、急非淋15例。结果表明：急性白血病患儿NK细胞活性明显下降，与对照组（正常健康儿男12、女15，年龄为5～13岁）相比有显著差异，P＜0.05，并与文献报道相符。文中指出，在白血病的治疗过程中从其缓解、复发时NK细胞活性变化的检测，有益于对病情的了解、感染的存在等估评。例数偏少有待进一步阐明。     

RENAL FUNCTIONAL CHANGES IN ACUTE GLOMERULONEPHRITIS IN CHILDREN. A ONE-YEAR FOLLOW-UP

Abstract. Renal function was studied in three patients with post-streptococcal, four patients with IgA and one patient with non-streptococcal proliferative glomerulonephritis (GN) at the onset of the disease and two, six and 12 months later. Renal biopsies were performed at the onset of the disease and 12 months later. Standard clearance techniques were used for the functional studies. The latter were performed during hydropenia and continuous isotonic saline infusion. During hydropenia, the GFR was uniformly depressed shortly after the onset of the disease, but it normalized during the following two months. The filtration fraction was depressed in poststreptococcal GN at the onset and it normalized with the GFR. In IgA GN, the filtration fraction remained within normal limits during the entire course of the illness. The natriuretic response to isotonic saline volume expansion was low in all patients at the onset of the disease, but normalized in post-streptococcal and IgA GN during the one-year follow-up. In spite of normalized renal function, biopsy findings in IgA GN were unchanged 12 months later. An episode of macroscopic hematuria in one patient with IgA GN at the six-month investigation had no apparent effect on renal function.     

小儿急性白血病外周血白细胞介素Ⅱ活性的测定及临床意义

小儿急性白血病外周血白细胞介素Ⅱ活性的测定及临床意义郭承吉，王巍中国医科大学第一临床学院杨晓玲，周正任微生物教研组白细胞介素Ⅱ（ＩＬ－２）是免疫系统中重要的淋巴因子，在体内外具有许多免疫调节特性，在一些血液病的发生、发展及治疗中起一定作用。我们检测了...     

RUBIDOMYCIN IN BLASTIC PHASES OF ACUTE PROMYELOCYTIC AND MYELOBLASTIC LEUKEMIA IN CHILDREN

Rubidomycin was administered in doses of 1 mg/kg body weight, usually in combination with prednisone. The best results were obtained in promyelocytic leukemia. Promyelocy-tic leukemia in children seems to be characterized by sensitivity to rubidomycin even in late exacerbations.     

HbF与儿童急性白血病的预后

本文用抗硷血红蛋白法测定了３９例急性白血病患儿胎儿血红蛋白（ＨＢＦ）含量。结果示：２９例急性淋巴细胞白血病（Ａｌｌ）ＨｂＦ平均值为３．１５％，１０例急性非淋巴细胞白血病（ＡＮＬＬ）ＨｂＦ平均值为５．２１％，均有轻度增高，且经统计学处理，ＡＮＬＬ较ＡＬＬ为高，差异有显著性意义；相关分析示ＨｂＦ含量与缓解后初次复发的时间的负相关关系有显著意义；发病危险度的估计表明ＨｂＦ水平与急性白血病复发或死亡之间存在非常显著性关系。     

小儿急性白血病血清NO_2/NO_3和cGMP的变化

研究小儿性白血病血清NO_2／NO_3和cGMP的变化及其临床意义，为本文研究目的。应用镀铜镉还原法和放射免疫法检测患儿血清中NO的代谢产物NO_2／NO_3和cGMP含量。结果表明：小儿急性白血病急性期血清NO_2／NO_3和cGMP的含量明显高于正常对照组和完全缓解期组（P＜0．01）；急性淋巴细胞白血病与急性非淋巴细胞白血病相比无显著性差异（P＞0．05）。完全缓解期组与正常对照组相比，无显著性差异（P＞0．05）。结论：血清NO的检测可用于判断小儿急性白血的病情和监测化疗效果的指标之一，揭示了临床选用NO的细胞毒性作用可能为小儿急性白血病的治疗提供新的方法。