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Biomedical subjects

F Y Huang

Publications and source records attributed to F Y Huang.

At least 91 records · Page 5Linked to original sources
PubMed1991

Mini-dose intrathecal morphine for post-cesarean section analgesia.

Dose-response relationship of mini-dose intrathecal morphine (0.025-0.125 mg) for analgesia after Cesarean section was studied. Sixty-three patients were randomly divided into six groups by the following intrathecal morphine injection: group 1 (0 mg), group 2 (0.025 mg), group 3 (0.05 mg), group 4 (0.075 mg), group 5 (0.1 mg), and group 6 (0.125 mg). The selected dose of morphine mixed with 2 ml 0.5% hyperbaric bupivacaine (10 mg) was administered intrathecally to induce spinal anesthesia. The mean analgesia duration in each group was 3.6 +/- 2.0, 10.6 +/- 7.1, 17.3 +/- 13.8, 25.6 +/- 7.5, 33.9 +/- 10.1, and 39.5 +/- 11.9 h respectively (mean +/- SD). In morphine groups, duration of analgesia was significantly longer (p less than 0.05) than control group (0 mg), and the first 24 h pain scores were also lower (p less than 0.01). Furthermore, a significant linear dose-response relationship between analgesic duration and the dose of intrathecal morphine was revealed (y = 3.28 + 295.5x, r2 = 0.64, p less than 0.05). Among morphine groups, analgesic quality was significantly better in patients in groups 4-6 than those in group 2 and 3 (p less than 0.05), so as in the proportion of effective analgesia in the first 24 h (p less than 0.01). Neonatal condition was not adversely affected by such mini-dose of intrathecal morphine. The most common maternal adverse effect observed was pruritus, and its incidence was significantly greater in groups 3-6 than in the control group (p less than 0.05). However, no significant difference was observed among all morphine groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Chronological changes in genetic variance and heritability of anthropometric characteristics among Chinese twin infants.

In order to examine the chronologic changes in genetic variance and heritability of anthropometric characteristics of Chinese infants in Taiwan, a total of 521 pairs of same-sexed twin neonates given birth in four major general teaching hospitals in Taipei City were studied. Based on the placental pattern and 12 red blood cell antigens, 428 MZ and 93 DZ twin pairs were identified and followed up to the age of one year. There was no significant genetic variance for all anthropometric characteristics adjusted for sex and gestational week before the age of six months. After adjusting for sex and gestational week, a significant genetic variance was observed at the age of six months, with heritability values of 0.51 (weight), 0.63 (head circumference), 0.77 (chest circumference), and 0.53 (arm circumference), as well as at one year, although with considerably lower heritability values. This implies that growth is dynamically determined by both genetic and environmental factors during infancy.

Age Factors↗
PubMed1990

Genetic variance and heritability of temperament among Chinese twin infants.

In order to examine the genetic variance and heritability of temperament among Chinese infants in Taiwan, a total of 62 pairs of same-sexed twin infants given birth in four major general teaching hospitals in Taipei City were studied. Based on placentation and 12 red blood cell antigens, 44 MZ and 18 DZ pairs were identified. Temperament was assessed at the age of six months by the Chinese edition of Carey's Temperament scale. Significant genetic variance was observed for activity level, approach or withdrawal, intensity of reaction, quality of mood, and threshold of responsiveness, with a heritability of 0.64, 0.56, 0.74, 0.39, and 0.45, respectively. There was no significant intrapair difference in temperamental characteristics between monochorionic and dichorionic MZ twins.

Female↗
PubMed1990

Chronological changes in genetic variance and heritability of systolic and diastolic blood pressure among Chinese twin neonates.

In order to examine the chronological changes in genetic variance and heritability of arterial systolic and diastolic blood pressure (SBP and DBP of Chinese infants in Taiwan, a total of 339 same-sexed twin neonates born in four major general teaching hospitals in Taipei City were studied. Based on placentation and 12 red blood cell antigens, 274 monozygotic (MZ) and 65 dizygotic (DZ) twin pairs were identified and followed up to the age of one year. Both SBP and DBP were measured by Doppler blood pressure monitor. Within-pair mean squares of SBP and DBP were consistently smaller in MZ than DZ twins at ages one month and over. The findings remained unchanged after the adjustment for the effects of age, sex, gestational age, placentation and physical state during blood pressure measurement. Falconer's heritability indices for adjusted SBP and DBP at ages two months and over ranged from 0.29 to 0.55 and from 0.27 to 0.45, respectively. The study indicates an important genetic influence on blood pressure during infancy.

Blood Pressure↗
PubMed1990

Genetic variance and heritability of serum cholesterol and triglycerides among Chinese twin neonates.

In order to examine the genetic variance and heritability of serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides, a total of 349 pairs of same-sexed twin neonates born in four major general teaching hospitals in Taipei City were studied. Based on the placental pattern and 12 red blood cell antigens, 271 monozygotic (MZ) and 78 dizygotic (DZ) twin pairs were identified. There was a significant genetic variance for total cholesterol, HDL-C, LDL-C, and triglycerides both unadjusted and adjusted for sex, gestational age and placentation. The unadjusted heritability of total cholesterol, HDL-C, LDL-C, and triglycerides was 0.59, 0.30, 0.25 and 0.75, respectively; while the corresponding adjusted heritability was 0.74, 0.38, 0.31, and 0.49, respectively. Intrapair variance of serum lipids was not significantly different between monochorionic and dichorionic MZ twins.

China↗
PubMed1990

Hemolysis following correction of ventricular septal defect.

Hemolysis following repair of a ventricular septal defect (VSD) is an unusual complication. Three cases of patients who had simple VSD are described here. After repair of the VSD, the postoperative course was complicated by the intravascular hemolysis induced by the interaction between the red blood cells and the double velour Dacron patch. Thus the patients' hemodynamic status deteriorated. The first 2 patients had a course of hemoglobinuria, hyperamylasemia, hyperglycemia, malignant hypertension, hepatospenomegaly, acute renal failure and hypertensive encephalopathy. One patient, who did not undergo reoperation, died due to multiple organ failure; the other one, who underwent operation revision in order to arrest the hemolysis, died of sepsis. Early reoperation was performed in the remaining patient to replace the double velour Dacron patch with a pericardium-covered knitted Dacron patch, and he survived. Hemolysis ceased in both patients who had the double velour Dacron patch replaced with a pericardium-covered patch. A review of the literature failed to show previous reports concerned with hemolysis associated with repair of a simple VSD. We now report what we believe to be the first cases in the literature with this unique clinical course following hemolysis.

Blood Vessel Prosthesis↗
PubMed1990

Subpleural block in patients with multiple rib fractures.

Multiple rib fractures result in agonizing pain as well as impaired pulmonary functions. Mechanical ventilations are frequently indicated for those with poor respiratory reserves. Regional anesthesia has been advocated for easing pain and discomfort. We evaluate the efficacy of subpleural block in the treatment of multiple rib fractures. Ten patients who sustained multiple rib fractures were observed on the arrival of emergent service. One sustained flailed chest with respiratory distress which necessitated mechanical ventilation in intensive care unit. Subpleural block with 20 ml 0.5% bupivacaine was done to each patient. The location of catheter was identified by the injection of contrast medium. Serial visual analogue pain scale, arterial blood gas, and pulmonary function test were taken before and after subpleural block. Pulmonary function test significantly improved after subpleural block. Pain relief was immediate and desirable. The case in ICU weaned from ventilator 3 days later. There were no major complications after subpleural block. Inadvertent epidural spread and recurrent laryngeal nerve blocks were detected both clinically and radiologically without sequela noted. Subpleural block is effective both in pain relief and in improving pulmonary functions. Image intensifier is essential to subpleural block in order to prevent the misplacement of catheter. We recommend subpleural block to be an alternative approach of regional anesthesia in patients with multiple rib fractures.

Adult↗
PubMed1990

Microvascular perfusion and resistance in extracorporeal cardiopulmonary bypass under hypothermia with high-dose narcotic anesthesia--animal model.

Microvascular perfusion of the liver, kidney (cortex and medulla), pancreas and spleen was measured by laser-Doppler flowmetry under hypothermia in extracorporeal cardiopulmonary bypass, to determine the effectiveness of high-dose fentanyl in improving the microcirculation of these visceral organs. Twenty-four mongrel dogs in two groups were monitored by arterial catheter, Swan-Ganz catheter and laser-Doppler flowmeter. Cardiopulmonary bypass was carried out to induce hypothermia to 20 degrees C through the cannulation of inferior vena cava and aorta. Microvascular perfusion was measured by either needle or suturable probes of laser-Doppler flowmeter in liver, kidney (cortex and medulla), pancreas and spleen. With high-dose of fentanyl (100 micrograms/kg), decrease of microvascular perfusion in liver, pancreas and kidney (cortex and medulla) was less than the control group, especially at 20 degrees C. Notably, the trend of these changes had its unique pattern in each organ due to their own specific anatomical and physiological characteristics, while spleen did not show significant difference in both groups. In summary, high-dose of fentanyl improved the hepatic, renal and pancreatic microvascular perfusion, in agreement with our previous observation, might protect the function of these visceral organs from the damage of microvascular ischemia under hypothermia in the extracorporeal cardiopulmonary bypass.

Anesthesia↗
PubMed1990

[Chylous ascites in infancy].

Chylous ascites is a rare disease in infancy. Onset with acute manifestations should be managed surgically. However, congenital in nature or chronic cases many be treated conservatively with either medium-chain triglyceride feedings or total parenteral nutrition. Five cases of infantile chylous ascites are reported and discussed here.

Chylous Ascites↗
PubMed1990

[Propionic acidemia: report of a case that is successfully managed by peritoneal dialysis and sodium benzoate therapy].

Propionic acidemia is a rare hereditary disease which is an autosomal recessive disorder. Defect of propionyl CoA carboxylase results in abnormal accumulation of propionate and its metabolites which interfere the pathway of glycine cleavage and the urea cycle. This organic acidemia is characterized by a wide spectrum of clinical and biochemical findings, including recurrent vomiting, difficult feeding, lethargy, hypotonia, metabolic ketoacidosis, hyperglycinemia and hyperammonemia during the acute episodes. We present a male newborn infant who sustained this disorder and was managed successfully with blood exchange transfusion, peritoneal dialysis, supplemented with sodium benzoate and sodium bicarbonate therapy. Urine gas chromatography disclosed significant elevation of propionate and its metabolites which subsided 2 days after peritoneal dialysis. Special designed formula was then given with restriction of protein intake and supplement with sodium benzoate and sodium carbonate. Prenatal genetic counseling is necessary in further pregnancy. Diagnosis can be obtained when propionyl CoA carboxylase activity is low in cultured amniotic fluid cells or chorion villi sample or when there is abnormally high methylcitrate level in amniotic fluid.

Benzoates↗
PubMed1990

Intrauterine neuromuscular blockade in fetus.

Antenatal intrauterine fetal therapy has now become the target of numerous invasive diagnostic and therapeutic maneuvers. Fetal motion during intrauterine fetal therapy not only makes these procedures technically more difficult but also increases the likelihood of trauma to the umbilical vessels and the fetus. Combination of high doses of sedatives, tranquilizers, and narcotics rarely results in adequate suppression of fetal movement. Such medication puts the mother at risk of respiratory depression, regurgitation and aspiration. The use of pancuronium or atracurium to temporarily arrest fetal movement in ten fetus is reported. After an initial ultrasound assessment of fetal lie, placental location, and umbilical cord insertion site, the fetal weight was calculated by the ultrasound parameters of biparietal diameter and abdominal circumference. Under ultrasound guidance, we injected pancuronium 0.15 mg/kg or atracurium 1.0 mg/kg using a 23-gauge spinal needle into the fetal gluteal muscle. Short-term paralysis of the fetus was induced in all cases. Fetal movement stopped by sonographic observation within 5.8 +/- 2.3 min in the pancuronium group and 4.7 +/- 1.8 min in the atracurium group. Fetal movements returned both to maternal sensation or ultrasonic observation by 92 +/- 23 min in the first group and 36 +/- 11 min in the second group. No adverse effect of the relaxant has been observed in any of the mothers. There was no evidence of local soft tissue, nerve or muscle damage at the site of injection on initial examination of the neonates after delivery. The use of neuromuscular relaxant in fetus was a safe and useful method.

Atracurium↗
PubMed1990

Suppression of hemodynamic change before extubation--lidocaine through modified endotracheal tube.

Twenty females, aged 31 to 49 years, scheduled for abdominal total hysterectomy were randomly divided into two groups in this study. An epidural catheter was placed at T11-12 before general anesthesia. All patients receive the combination of epidural anesthesia and general anesthesia for the operation and relief of pain postoperatively. The modified endotracheal tube we used is shown in Fig. 1. For patients in group I (Lidocaine group), 2 mL 4% lidocaine solution was injected through the catheter to desensitize the tracheal mucosa around the cuff after the surgeon had removed the uterus. In group II (Control group), no special management was made. All patients were not extubated until they were considered to be awake. Systolic blood pressure at three and one minute before extubation and pulse rate recorded at one minute before extubation showed in patients of group I were statistically smoother than those recorded in group II (p less than 0.01). All patients had gag reflex just after awake extubation.

Adult↗
PubMed1990

General anesthesia with propofol (continuous intravenous infusion) supplemented with nitrous oxide: comparison with isoflurane.

Thirty adult surgical patients (ASA I-II) undergoing superficial operations of short duration (about 1h) were arbitrarily divided into two groups. In group A (n = 15), anesthesia was induced with propofol, 2 mg/kg, iv. After endotracheal intubation with the aid of succinylcholine (1 mg/kg, iv), anesthesia was maintained by continuous iv infusion of propofol (0.05-0.2 mg/kg/min) with nitrous oxide and oxygen (2:1). In group B (n = 15), induction and endotracheal intubation were accomplished using thiopental (4 mg/kg, iv) and succinylcholine (1 mg/kg). Anesthesia was maintained with isoflurane (0.5-2.0%), nitrous oxide and oxygen (2:1). Atracurium was used in both groups as muscle relaxant. Hemodynamic responses to laryngoscopy and endotracheal intubation and during operation were not significantly different between the two groups. However, recovery to verbal command and orientation was significantly more rapid in the propofol group (7.8 +/- 4.8 min and 11.2 +/- 5.1 min) than in the isoflurane group (15.6 +/- 4.9 min and 22.6 +/- 6.0 min). In conclusion, continuous propofol infusion combined with nitrous oxide and muscle relaxant is suggested as a better method compared with isoflurane for short operations because of more rapid complete recovery.

Adult↗
PubMed1990

Is it necessary to rotate the epidural needle to obtain successful sacral segment block?

The effect of rotating the level of touhy needle to obtain successful sacral blockade was controversial. During the rotation, dural puncture was reported by some studies. In our study, we divided forty patients into two groups randomly. They all belonged to ASA I-II, receiving epidural needle insertion at L 2-3 epidural space, before epidural catheter was inserted. Total of 10 mL of 2% xylocaine was injected into the epidural space. In group A, the level of Touhy needle was pointed upward, that is, parallel to the ligament flavum. In group B, the level was pointed caudally. We determined the cutaneous extension of loss of cold sensation by using a swab of cotton wool soaked with alcohol 15 min and 25 min after the test injection. Our result showed no different in loss of cold sensation in sacral area between these two groups. So we concluded that there is no need to rotate the epidural needle for sacral blockade.

Adult↗
PubMed1990

Evaluation of systemic hemodynamic effects on post-transplant perfusion to renal allograft.

Hemodynamic parameters and post-transplant renal perfusion were evaluated in 24 cadaver kidney transplantation. Cardiac output (CO), systemic vascular resistance (SVR) and mean arterial pressure (MAP), were continuously monitored in each patient via a transesophageal Doppler cardiac output monitor and radial arterial catheter. Seventeen were well perfused (Group 1) after releasing vascular clamps. Six among group 1 presented as the clinical picture of acute tubular necrosis. Seven were poorly perfused (Group 2). Post-anastomotic CO significantly increased in group 1, and decreased in group 2. SVR significantly decreased in group 1, and increased in group 2. MAP were not significantly different between group 1 and 2. Treatments based on hemodynamic derangement were initiated as soon as it was detected. Correction of CO was associated with the improvement of post-anastomotic renal perfusion, while SVR and MAP were not. Among the 7 poorly perfused kidneys, 5 became well perfused before leaving the operating room. The remaining 2 resumed their hemodynamic stability and renal function a few days later after oral captopril was administered. Two among the 6 acute tubular necrosis resumed renal function as long as hemodynamic stability was restored. Our study demonstrates that hemodynamic parameters are parallel to renal perfusion status. Restoration of hemodynamic derangement not only improves renal perfusion but also renal function. It is concluded that hemodynamic instability and graft ischemic time contribute to the variation of post-transplant perfusion to renal allograft. Non-invasive cardiac output monitor is a safe and reliable monitor which we recommend to be used during the operation of kidney transplantation.

Adult↗
PubMed1990

The application of pulse oximeter for supraclavicular brachial block.

The subclavian artery is the most important landmark of the supraclavicular brachial block. However, it is difficult to locate the artery by palpation in the patients with poor landmark. The present study was aimed to compare two localizing methods of the subclavian artery by a pulse oximeter or by palpation. One hundred patients were divided into three groups. Group A (Slim Group): 6 patients, Group B (Normal Weight Group): 75 and Group C (Obese Group): 19. All patients received both methods to locate the subclavian artery. The first method was by palpating the pulsation of the subclavian artery. The second was by observing the wave depression of the pulse oximeter while pressing supraclavicular area. It was found that the detection rate of the first method was 83.3% in Group A, 52.0% in Group B, 26.3% in Group C and 49.0% in overall patients. However, the detection rate of the second method was 100% in each group. It shows a significant difference between the two methods in Group B, Group C and all patients (P less than 0.001), but no difference in Group A (P = 0.68). There were 13 patients among the 100 patients undergoing surgery of the upper extremity. Seven of them whose pulsation was not clearly palpated but could be located exactly by pulse oximeter. Supraclavicular brachial block was still completed successfully in these 13 patients. No pneumothorax was found. Utilizing pulse oximeter in supraclavicular block provides a high detection rate of the pulsation of the subclavian artery and improves the reliability of the block, especially in the patients with poor landmark.

Adult↗
PubMed1990

Comparison of continuous epidural infusion of fentanyl and fentanyl-bupivacaine for post cholecystectomy pain control.

Epidural narcotics has been shown to produce profound and long-lasting analgesia. It has been suggested that lipid-soluble narcotics such as fentanyl, because of their short transit time in the CSF, are less likely to be associated with delayed respiratory depression and side effects. We tried to combine low concentrations of fentanyl with bupivacaine to minimize side effects and to see if synergistic effect existed. Forty ASA physical status I or II patients who present for cholecystectomy were included in the trial. Before surgery a thoracic epidural catheter was inserted and pain control began when patients became fully awake and complained of pain in the recovery room after surgery. Patients were randomized in a double-blind fashion to one of four groups. Patients in group I were given epidural infusions of fentanyl 0.001%; patients in group 2 received fentanyl 0.001% mixed with bupivacaine 0.1%; patients in group 3 received fentanyl 0.0005%; patients in group 4 received fentanyl 0.0005% mixed with bupivacaine 0.1%. A continuous epidural infusion of these drugs began at a rate of 10 mL/h after a 5-mL bolus of the solution. Pain relief was assessed with visual analogue pain scale. Respiratory rates, vital signs, and mental status were assessed hourly. Except the group 3, the degree of analgesia achieved was similarly satisfactory in all other groups. There was no respiratory depression developed in either group. Motor block was minimal or absent in all groups. The incidence of nausea and pruritus was significant less in group 3 and group 4. In conclusion, the continuous infusion of dilute bupivacaine with fentanyl provides synergistic analgesia with minimal side effects.

Analgesia, Epidural↗