Pediatrics

In diagnoses of some rare conditions, such as bile acid synthetic defects, MS can also be utilized. Nowadays it is possible to screen and rapidly diagnose potential or real inborn errors in bile acid synthesis from urinary bile acid analysis by means of MS. Specific mutations in the genes that encode the enzymes responsible for bile acid synthesis can be identified by molecular techniques. Of the seven known genetic defects that cause progressive cholestatic Uver disease, syndromes of fat-soluble vitamin malabsorption, and neurological disease, six have been properly characterized [16]. 

(1-9) Organic acid disorders, (10-14) fatty acid oxidation disorders, (15-20) amino acid disorders, (21-23) hemoglobinopathies, (24 and 25) endocrinopathy, (26) other inborn error of metabolism, (27) carbohydrate disorders, (28) miscellaneous genetic conditions, and (29) infectious diseases. MS/MS tandem mass spectrometry, HPLC high pressure hquid chromatography, lEF isoelectrofocusing, RIA radioimmuno assay, and ELISA enzyme-linked immunosorbent assay. 

Thanks to proteomic applications in diagnosis of cancer, several research groups have identified proteomic patterns associated with ovarian, prostafic, colorectal, lung, and other cancers. While the sensitivity and specificity of these patterns are 

II and IV III and IV. Different stage groups could also be distinguished by two-dimensional scatter-plots. This method is applied in the preoperative phase [19]. 

Hb-oxaliplatin complexes indicates that an increased amount of Hb-oxahplatin complexes in patients closely correlates with an enhanced risk of cancer progression. The level of the Hh-oxaliplatin complexes in erythrocytes is therefore a potential hiomarker for indicating inter-patient variations in the treatment efficacy of oxahplatin [20], 

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The use of oxygen in pediatric incubators is an important factor in increasing the survival rate of premature infants who develop cyanosis. However, the use of oxygen is associated with risk of developing the visual defect known as retrolental fibroplasia (38). A careflil monitoring of arterial blood oxygen partial pressure is important. 

Fluoride produced from the biodegradation of halothane or the other agents has Htde effect on normal kidney function (59). Halothane usage has been declining because of the potential Hver effects, although the agent is used where inhalation induction is desired, especially in pediatrics. 

Vaccines are used in either the general population of children or adults or for special groups. Recommendations for vaccine usage are made by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control. The Committee on Infectious Diseases of the American Academy of Pediatrics (Redbook Committee) also makes recommendations for infants through adolescents, and the American Academy of Family Physicians makes recommendations for adults. An excellent review of vaccine history, development, usage, and related regulatory issues is available (2). 

The worldwide market is approximately 3.0 bHHon in sales, with the pediatric portion accounting for about 35%. Basic, required childhood vaccines (DTP, poHo, measles /MMR, BCG, and TT) account for 3640 x 10 doses of this global market. In the United States doses distributed in the pediatric sector have risen from around 45 x 10 in 1982, covering basic, childhood vaccines, to around 75 x 10 in 1993 due primarily to the addition of vaccines for Haemophilus disease, hepatitis B, and a second dose of MMR to the recommended childhood series (144). The majority of vaccines for the U.S. market are... 

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