Biomedical subjects

B Hwang

Publications and source records attributed to B Hwang.

172 records · Page 10Linked to original sources

PubMedDate not supplied

Direct tracheobronchial suction for massive post-extubation atelectasis in premature infants.

UNLABELLED: A prospective four-year study was done in a neonatal intensive care unit (NICU) to evaluate a technique, called direct tracheobronchial suction (DTBS), for rapidly removal of obstructive secretions from the tracheobronchial tree in newborn infants with massive post-extubation atelectasis (PEA). Selected cases who met the following criteria were enrolled: 1) developing new massive atelectasis within 48 hours after extubation; 2) no response to vigorous chest physiotherapy(CPT) and continuous deterioration; and 3) no air-bronchogram in the atelectatic lung field. DTBS was carried on at bedside by direct insertion a 6.5 Fr suction catheter into tracheobronchial tree and suctioning. Clinical and laboratory assessments were made in each case prior to and at two hours after DTBS for comparison. A total of 145 (19.7%, 145/736)) PEA occurred in a consecutive 736 postextubated newborn infants. Thirty-one atelectasis (4.2%, 31/736) that developed in 18 infants were managed with DTBS. There was a significant higher incidence of PEA developed, as well as a higher ratio of PEA been treated by DTBS, in the group of body weight < 1,500 g than the group of > or = 1,500 g. All except one infants weighed less than 1,500 g, with a mean of 1,043 +/- 269 g. Sixteen infants had been intubated for more than seven days with a mean of 14.1 +/- 5.0 days. Nine infants required more than one session of DTBS. DTBS was quite effective in immediate removal of retained secretions and improvement of pulmonary condition. By clinical assessment, respiratory distress improved with increased audible air entry on the affected lung, decreased chest retractions, and a significant fall in respiratory rate and heart rate. Arterial blood gases analysis showed significant improvement of pH, partial pressure of carbon dioxide and oxygenation ratio. By chest radiograph, DTBS resulted partial or nearly complete resolution of the atelectasis in all cases. DTBS procedures were well tolerated by all infants without significant sequelae. CONCLUSION: This study suggests that DTBS is a simple and effective therapeutic modality to rapidly correct the massive PEA which resist to vigorous CPT in small infants.

Humans↗

PubMedDate not supplied

Neonatal thyroid function is unaffected by single treatment with different preparations of povidone-iodine on a wide skin surface.

Povidone-iodine (PV-I) are commonly used for disinfection in hospitals. Previous investigators had proved that iodine can be absorbed from the skin. In an attempt to determine the effect of single treatment of various PV-I preparations on thyroid function in fullterm newborns, serial measurements of serum thyroxine (T4) and Thyroid stimulating hormone (TSH) were done in 48 neonates treated with one dose antiseptics (tincture PV-I, aqueous PV-I, tincture PV-I followed with 75% alcohol and no treatment in control group). The results revealed no significant change of thyroid function in any study group. In conclusion, PV-I with different preparations, aqueous or tincture, did not significantly influence neonatal thyroid function if they were used to a fullterm neonate only once and even to a wide skin surface.

Anti-Infective Agents, Local↗

PubMedDate not supplied

Complications of intra-cardial placement of silastic central venous catheter in pediatric patients.

UNLABELLED: A three-year prospective study was undertaken to determine the incidence and early complications from intra-cardiac placement of percutaneous central venous catheter (CVC). CVC was inserted by using "Catheter-through-needle" technique, and the insertion length was measured by body surface landmark. CVC course and tip location were routinely checked by roentgenography. Echocardiography was performed in case of arrhythmia. After analysis of 784 CVCs, 104 (13.3%) were proved to be intra-cardial, as located by either roentgenography or echocardiography. However, catheters passed via the upper trunk (14.5%) were significantly (p < 0.05) more intra-cardially located than those via the lower trunk (4.8%). Catheters which passed via the right upper trunk veins (basilic, cephalic, or external jugular veins) were also more intra-cardially located than those via their left veins counterparts, but the finding was not statistically significant (p > 0.05). The mean body weight (3.1 +/- 2.4 kg) in the intra-cardial placement group was significantly (p < 0.05) less than that in the non-intracardial placement group (7.9 +/- 4.5 kg). In intra-cardial placement patients, 32 cases (30.8%) had episode(s) of cardiac arrhythmia including 31 premature ventricular depolarization and 1 supra-ventricular tachycardia. All cases showed the presence of intra-ventricular catheter. All arrhythmias ceased abruptly after the catheters were pulled from the hearts. No other early complications were observed. CONCLUSIONS: the incidence of the intracardiac placement of CVC is high, especially in small infants or when the insertion via the upper trunk. Short term intra-cardiac catheter placement has a benign clinical course except that the intraventricular catheter may cause arrhythmia. However, this kind of arrhythmia can be resolved spontaneously by withdrawing the catheter.

Arrhythmias, Cardiac↗

PubMedDate not supplied

Clinical implication of transient hyperglycemia in childhood.

The incidence of insulin-dependent diabetes (IDDM) in Chinese is much lower than for Western persons. The study was designed to determine whether Chinese children with transient hyperglycemia would develop diabetes as frequently as Western children. Ten children presenting with transient hyperglycemia were investigated using glucagon stimulation test, oral glucose tolerance test (OGTT) and i.v. glucose tolerance test (IVGTT) to estimate pancreatic insulin secretory function. They were followed up for one to three years. Islet cell antibodies and insulin autoantibodies were also measured. During the follow-up period, 2 of the 10 children developed diabetes at 1 month and 1 year, respectively, after the occurrence of transient hyperglycemia. Both of them had lower C-peptide peak level to glucagon stimulation, decreased first phase insulin release to IVGTT and a diabetic sibling. Islet cell antibodies and insulin autoantibodies were all negative except in one of the two children who later developed diabetes. Although it is still premature owing to the small sample size to conclude that Chinese children with transient hyperglycemia are less likely to develop diabetes than Western children, it is advisable to closely follow up those with a family history of IDDM who seem to be at the greatest risk.

Adolescent↗

PubMedDate not supplied

Detachment of balloon in an infant: a rare complication of balloon pulmonary valvuloplasty.

A 3-month-old infant with severe tetralogy of Fallot underwent percutaneous balloon valvuloplasty. After the successful dilatation, the balloon could not be deflated completely and the partial deflated balloon was totally peeled off from the catheter at the junction of inferior vena cava and right common iliac vein when we attempted to move it out. The skin of the balloon was successfully retrieved with a snared guidewire without sequel.

Catheterization↗

PubMedDate not supplied

High-frequency oscillatory ventilation--a new management for respiratory distress syndrome and intractable respiratory failure.

High-frequency oscillatory ventilation (HFOV) has been proved to decrease the incidence of volutrauma and improve oxygenation and ventilation in severe pulmonary diseases by many investigators with animal studies and clinical reports, particularly in prematurities with severe respiratory distress syndrome. Patients with intractable respiratory failure or air-leak syndrome may be rescued by HFOV. During HFOV small volume, less than dead space, is delivered at high frequencies. Both inspiration and expiration are active. Oxygenation is mainly maintained by mean airway pressure to achieve optimal lung volume. Carbon dioxide elimination is mainly controlled by delivered volume. Mean airway pressure, fraction of inspiratory oxygen and amplitude are the only three items that need frequent adjustments after initial settings. The first two items determine the oxygenation and the last one determines ventilation. Careful monitoring of conditions the patients, discontinuous learning and cooperation of all coworkers are important to use the new therapy. Further studies with long-term follow-up are important to assess its appropriate role in different treatment methods and different degrees of respiratory diseases.

Adult↗

PubMedDate not supplied

Blood nutrient indices in breast and formula fed infants: amino acids metabolic responses.

Human milk is generally considered as nutritionally the best food for infants, infant formula are usually manufactured to be as similar to human milk as possible, it may appear logical to attempt a metabolic response of formula fed infants similar to that of breast fed infants. We conducted a 8 week growth and metabolic study in 90 healthy term infants fed either human milk, whey dominant formula or casein dominant formula, each group consisted of 30 infants. Results revealed no significant differences were observed among the groups with respect to growth and anthropometric measurements. Serum total protein, albumin were not differ among breast-fed and formula fed infants. BUN and many plasma essential, amino acid were significant higher in formula-fed groups. While plasma tryptophan concentration was lower in two formula fed groups, in addition, plasma taurine was lower in casein dominant group at 4 weeks of age. These results suggested a reevaluation of protein quantity and quality in infant formula is needed.

Amino Acids↗

PubMedDate not supplied

Germ cell tumor in infancy and childhood: experience at one institute compared to other studies.

To understand the difference in incidence and distribution of germ cell tumor (GCT) between cases seen in this institute and Western studies, 98 cases of GCTs collected from 1979 to 1996 were included 50 with gonadal GCTs, 9 with mediastinal GCTs; 9 with retroperitoneal GCTs, 10 with sacrococcygeal GCTs and 20 with intracranial GCTs; all were analyzed retrospectively by chart review. The incidences of testicular and intracranial GCT in all GCTs were higher in this study, i.e. 26.5%(26/98) and 20.4%(20/98) compared to 7% and 6% of American reports. But the incidence of sacrococcygeal GCT in all GCTs was lower in this study, i.e. 10.2%(10/98) compared to 41% of American reports. The incidences of testicular and ovarian GCT in all GCTs were about the same in this study, i.e. 26.5%(26/98) and 24.5%(24/98) compared to 7% and 29% of American reports; 51%(50/98) of all GCTs were gonadal in this study compared to 36% in the American reports.

Adolescent↗

PubMedDate not supplied

The effect of povidone-iodine on thyroid function of neonates with different birth sizes.

The aim of this study was to elucidate the role of povidone-iodine (PV-I) on thyroid function of newborns with different birth sizes in a high iodine-intake city. Serial measurements of serum thyroxine (T4) and thyrotropin (TSH) levels were done in 44 newborns locally treated with 10% PV-I for insertion of percutaneous central venous catheters. The results showed that the thyroid function was influenced prominently in very-low-birth weight (VLBW) babies. TSH went significantly higher after application of PV-I for 48 hours in VLBW babies. The smaller the babies were, the lower the T4 at birth and thereafter. In conclusion, PV-I is suggested to be avoided for single application on a wide skin surface in VLBW babies, even in an area with high iodine-intake population.

Anti-Infective Agents, Local↗

PubMedDate not supplied

The relationship between serum and saliva erythropoietin concentrations in adults, full-term and premature infants.

Simultaneous blood and saliva samples were collected for determination of the relationship between serum and saliva erythropoietin (EPO) concentrations in 12 adults (Group I), 15 full-term neonates (Group II), and 11 premature infants (Group III). Saliva was collected with a modified sputum-collecting tube combined with a vacuum suction pump. Serum and saliva EPO concentration was measured by enzyme-linked immunosorbent assay. The relationship between serum and saliva concentrations was explored using (1) regression analysis and (2) serum-to-saliva ratio. Salivary concentrations approximated 15 to 30% of the serum concentrations based on the serum-to-saliva ratios. Significant correlation was observed between serum and salivary concentrations in each group (p < 0.05). The regression analyses produced formulas for predicting serum EPO concentrations from saliva EPO concentrations which seemed to fit the data well. The resulting formula is surprisingly consistent with that derived from Group I. The ratio models seem to fit the data well as regression models. From the results it is concluded that the use of salivary samplings for serum EPO in adults, full term and premature infants may be a possible alternative method to blood samplings.

Adult↗