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Biomedical subjects

Fu-Yuan Huang

Publications and source records attributed to Fu-Yuan Huang.

52 records · Page 3Linked to original sources
PubMed2003

Epstein-Barr virus-associated acute renal failure: diagnosis, treatment, and follow-up.

We retrospectively reviewed our experience of Epstein-Barr virus (EBV)-associated acute renal failure. Of 165 previously healthy children hospitalized with serologically proven primary EBV infection, 8 had acute renal failure, of whom 5 (group A) did not have virus-associated hemophagocytic syndrome (VAHS), while 3 (group B) did have VAHS. All had complications in four or more organ systems. Two patients in group A had renal biopsies showing acute tubulointerstitial nephritis, and the clinical and laboratory findings in the other 3 group A patients were consistent with acute tubulointerstitial nephritis. Acyclovir was used in 1 patient, but she died of hepatic failure and pulmonary hemorrhage. The other 4 spontaneously recovered renal function after supportive care, including hemodialysis in 1 patient. Our experience does not support the routine use of corticosteroids or antiviral agents in these patients. Children in group B had a relatively normal urinalysis. Renal biopsies were not performed, but their presentations were compatible with acute tubular necrosis. We conclude that EBV should be considered as a possible etiological agent in all children presenting with acute renal failure of unknown cause. The diagnosis depends on a high index of suspicion and careful serological evaluation in atypical cases.

Acute Kidney Injury↗
PubMed2003

Effect of nucleotides on diarrhea and immune responses in healthy term infants in Taiwan.

OBJECTIVES: The aim of this study was to compare the effects of an infant formula fortified with nucleotides (NF) with those of a control formula (CF) on the incidence of diarrhea, respiratory tract infections (RTIs), and immune responses in healthy term infants. METHODS: This 12-month, double-blind study was conducted on 1- to 7-day-old infants randomized to receive NF or CF exclusively until 12 weeks of age, and fed the assigned formula with solid food until 12 months. NF was supplemented with 72 mg/L of nucleotides, based on the total potentially available nucleotide content of human milk. Subjects were evaluated within 1 week of birth, at 4 weeks, and every 4 weeks thereafter until 48 weeks of age. The primary outcome variable was the incidence of diarrhea. Secondary variables included RTIs, serum immunoglobulin concentrations, and response to hepatitis B vaccine. RESULTS: Compared with subjects fed CF (n = 170), those fed NF (n = 166) had a trend toward reduced risk of diarrhea from 8 to 48 weeks of age and a significantly lower risk of 25.4% (P = 0.05) between 8 and 28 weeks. NF subjects had significantly higher serum immunoglobulin A concentrations ( P < 0.05) throughout the 48-week study. The NF group had an increased risk of upper RTIs, the same incidence of lower RTIs, and the same antibody response to hepatitis B vaccination as the CF group, based on one-sided tests. Growth was normal in both groups, and no adverse events were considered to be formula-related. CONCLUSIONS: Healthy term infants from 8 to 28 weeks of life are less likely to experience diarrhea and have higher serum immunoglobulin A concentrations with NF compared with formula without added nucleotides.

Bottle Feeding↗
PubMed2003

Etiology of acute pharyngitis in children: is antibiotic therapy needed?

Acute pharyngitis is a common upper respiratory tract disease in children. The aim of this study is to find the associated microorganisms and determinate whether antibiotics is needed. This study included a total of 416 children with a diagnosis of acute pharyngitis who were treated in an outpatient clinic In Taipei. Throat swabs for viral and bacterial cultures were taken. Antibiotics were prescribed when bacterial pharyngitis was suspected on the initial visit. The prescription was adjusted according to the results of bacterial culture and clinical manifestations on the second visit 3 to 4 days later. The mean age of the patients was 52.9 +/- 36.9 months. A total of 297 potential pathogens were isolated in 242 patients. Viruses were isolated in 123 (29.6%) patients. Bacteria were isolated in 73 (17.5%) patients, whereas group A streptococci were isolated in only 7 (1.7%) patients. Viruses mixed with bacteria were found in 46 (11.1%) patients. The mean age of patients with viral infections was lower than those with bacterial infections (47.5 +/- 30.4 vs 62.4 +/- 43.7 months, p = 0.01). There was a longer duration of fever in patients older than 2 years with viral isolates (p < 0.01). Antibiotics were prescribed for acute pharyngitis on the first visit in 43 (10.3%) patients, and on the second visit in 19 (4.6%) patients. In children with viral infection, mixed isolates, or no growth, there was significantly less prescription of antibiotics on the second visit. Given the low isolation rate of significant bacterial pathogens, routine throat cultures and antibiotics are not indicated in children with acute pharyngitis.

Acute Disease↗
PubMed2003

Acute epiglottitis caused by Haemophilus influenzae type b: a case report.

Acute epiglottitis is an inflammatory, edematous disease of the epiglottis and adjacent structures, usually caused by Haemophilus influenzae type b. It is a life-threatening condition, occurring mainly in childhood. There have never been any reports of this condition in Taiwan. We report a case of 4-year-old boy who presented with characteristics of systemic illness combined with respiratory distress on arrival at the emergency room. His mouth was open and his neck was hyperextended. The diagnosis of epiglottitis was established on the basis of physical examination, lateral neck x-ray, and the finding of an enlarged, swollen, erythematous epiglottis on flexible fiberoptic laryngoscopy. Urine latex agglutination test for H. influenzae type b was positive and a blood culture grew H. influenzae type b. He was treated with cefotaxime and did not require intubation.

Acute Disease↗
PubMed2003

Severe acute respiratory syndrome in a medical center in Taipei.

From April 18 to May 31, 2003, 46 patients with probable severe acute respiratory syndrome were admitted to the negative-pressure isolation rooms of Mackay Memorial Hospital in Taipei, Taiwan. Their demographic, clinical, laboratory, and radiologic characteristics and clinical outcomes were analyzed. There were 15 males and 31 females, in this cohort, 13 of whom were healthcare workers. The latter included 6 hospital staff and 7 medical personnel transferred from other hospitals. The most common symptoms were fever (100%, 46/46), cough (72%, 33/46), shortness of breath (46%, 21/46), and diarrhea (39%, 18/46). Other common findings were lymphopenia (57%, 26/46), thrombocytopenia (39%, 18/46), elevated lactate dehydrogenase (63%, 29/46), and elevated creatine kinase (24%, 11/46). A total of 7 patients (15%) required mechanical ventilation, and 8 (17%) died. Advanced age was an independent significant risk factor for death. Fever followed by rapidly progressive respiratory compromise led to significant morbidity and mortality in this cohort.

Adult↗
PubMed2002

A new measles mumps rubella (MMR) vaccine: a randomized comparative trial for assessing the reactogenicity and immunogenicity of three consecutive production lots and comparison with a widely used MMR vaccine in measles primed children.

OBJECTIVES: A multicenter, single-blind, randomized, controlled clinical study was conducted in healthy 15-18-month-old children in order to assess the immunogenicity and reactogenicity of three consecutive lots of a new measles- mumps-rubella (MMR) vaccine, GSK MMR. DESIGN: A total of 500 enrolled subjects were randomized into four groups to receive either a single dose of one of the three lots of GSK MMR (three groups--125 subjects in each group) or Merck MMR vaccine (125 subjects). Once clinical consistency had been demonstrated, the data were pooled and compared with the widely used Merck vaccine. Solicited local and general symptoms were recorded using diary cards, and antibody levels were determined using ELISA assays. RESULTS: No differences in the incidence of local and general symptoms or seroconversion rates were seen in the groups receiving different lots of GSK MMR. Compared with Merck MMR, there was a significantly lower incidence of local pain (P<0.001) and swelling (P=0.038) in infants receiving the GSK MMR vaccine. The incidences of all other solicited local and general symptoms were comparable between the two groups. No signs of suspected meningitis were reported. No serious adverse events were reported by the investigator to be related to vaccination. Equivalent seroconversion rates and postvaccination GMTs were observed in the groups receiving the two MMR vaccines. In conclusion, the new GSK MMR vaccine administered in measles-primed children demonstrated satisfactory immunogenicity and safety profiles as good as the Merck MMR vaccine.

Antibodies, Viral↗
PubMed2002

Acute suppurative thyroiditis in children.

BACKGROUND: Acute suppurative thyroiditis in children is rare and is often related to a pyriform sinus fistula or thyroglossal duct remnant, especially when it is recurrent. METHODS: From January, 1985, through December, 2000, 15 children with acute suppurative thyroiditis were treated. Their clinical, laboratory and radiologic findings were reviewed and analyzed. RESULTS: There were 8 girls and 7 boys, with a mean age at diagnosis of 6.1+/-2.9 years (range, 1.5 to 9.8). A thyroid mass was present on the left in 13 and on the right in 2 (P < 0.05). Fever, neck pain and swelling were the most common symptoms and signs. Seven patients (46.7%) had recurrent disease. Needle aspiration for Gram stain and bacterial cultures were done, and pathogenic organisms were identified on culture in 8 patients but were found only on Gram stain in 2 patients. In one-half of the patients with positive cultures, mixed pathogens were found. The most common organisms isolated were streptococcal species (50%). Barium esophagography was performed in all patients, and 5 (33.3%) had a pyriform sinus fistula on the left. Only 1 of the recurrent patients had a fistula. Thyroid scans were performed in 13 patients, of whom 12 (92.3%) had decreased radioactive uptake. Thyroid function tests were normal in all 15. CONCLUSIONS: Acute suppurative thyroiditis is usually caused by oropharyngeal flora, resulting in mixed pathogens on culture. Broad spectrum antibiotics should be given once cultures have been obtained. Imaging studies might be helpful in the diagnosis of acute suppurative thyroiditis.

Acute Disease↗
PubMedDate not supplied

Disseminated cutaneous bacille Calmette-Guérin infection identified by polymerase chain reaction in a patient with X-linked severe combined immunodeficiency.

An 8-month-old boy developed a disseminated cutaneous mycobacterial infection at 6 months of age that responded poorly to treatment. Further immunologic study and sequence analysis showed the presence of a missense mutation in the IL2RG gene, and X-linked severe combined immunodeficiency was diagnosed. To identify the strain of the microorganism causing the cutaneous infection, polymerase chain reaction with four pairs of primers was performed on skin biopsy specimens positive for acid-fast bacilli. Sequence analysis showed 99.36% homology with a bacilli Calmette-Guérin positive control. Disseminated bacilli Calmette-Guérin disease must be considered in any infant with cutaneous mycobacterial lesions, especially those with atypical histologic findings or who are immunocompromised. Testing by polymerase chain reaction using the proper primers may help in making a precise diagnosis.

BCG Vaccine↗
PubMedDate not supplied

A comparison of terbutaline and fenoterol unit dose vials in treating children with acute asthmatic attacks.

To compare the bronchodilation and adverse effects of two commercially marketed short-acting beta2-adrenergic agonists, terbutaline (Bricanyl, 5.0 mg/2ml) and fenoterol (Berotec,1.25 mg/2ml) unit dose vials (UDV), 108 acute asthmatic children, aged 5 to 14, were randomly enrolled into this study. Nebulization treatment for 10 minutes using an air compressor nebulizer was performed after measurements of baseline spirometry, SaO2, blood pressure and pulse rate. Same measurements were repeated at 0, 5, 15 and 30 minutes after the end of the nebulization treatment. The blood pressure was also monitored immediately and 30 minutes after treatment. Almost all the spirometric parameters of both treatments at various time points significantly improved. The pulse rate significantly increased at 15 and 30 min. The SaO2 significantly increased at 30 min. The systolic blood pressure significantly decreased immediately (terbutaline only) and at 30 min (fenoterol only). No significant change was found in diastolic blood pressure. When the laboratory parameters at the same time points were compared. Significant better results for fenoterol treatment were found in FEV, at 30 min (p = 0.048), PEF at 15 and 30 min (p = 0.049 and p = 0.027, respectively), FEF25-75% at 30 min (p = 0.033), mean absolute increase of PEF at 15 min (p = 0.034) and 30 min (p = 0.021), FEF25-75% at 30 min (p = 0.046), and in mean percent increase of FEF25-75% at 30 min (p = 0.047). The adverse effects for both groups were almost equal and around 21%. In conclusion, both terbutaline and fenoterol UDV nebulization treatments are effective in treating acute asthmatic children. The adverse effects are nearly equal. The fenoterol UDV nebulization treatment shows a little better result in improving pulmonary function than does terbutaline.

Acute Disease↗
PubMedDate not supplied

The function profile of compressed-air and ultrasonic nebulizers.

In order to study the detailed function of two kinds of nebulizers commonly used in clinical asthma treatment, compressed-air and ultrasonic, this study was conducted. At the beginning, various flow rates were adjusted, paired with different volumes of solutions in the container. The changes of temperature, pH, and osmolality during the course of nebulization were examined. Normal saline, terbutaline, and fenoterol solutions were used as the nebulized solutions. The study was performed in an environment in ambient temperature around 20 degrees C and relative humidity around 70%. The results showed a minimal 6 L/min flow rate was required to nebulize the solution when using the compressed-air nebulizer. The dead volume was about 0.8 ml for compressed-air and 8.5 ml for the ultrasonic nebulizer. When using the compressed-air nebulizer, the temperature, both in the solution and at the mouthpiece site, dropped gradually. On the contrary, the temperatures at both sites increased a little bit when using the ultrasonic nebulizer. The pH values of pure terbutaline and fenoterol nebulized solutions were acidic (3.58 and 3.00 respectively). The osmolality of terbutaline and fenoterol nebulized solutions were isotonic. The osmolality increased gradually during the course of nebulization, to a greater extent in the compressed-air nebulizer. In conclusion, both types of nebulizers have their special features. The ultrasonic nebulizer displays less extent in change of temperature and osmolality during nebulization and is expected to be a better device in treating asthmatic patients in terms of lesser effect on cooling and changing the osmolality of airway mucosa.

Air↗
PubMedDate not supplied

Efficacy of nebulized budesonide in hospitalized infants and children younger than 24 months with bronchiolitis.

To evaluate the effect of nebulized budesonide on acute, young, wheezing patients, a total of 73 patients, aged below 24 months, who were hospitalized due to bronchiolitis were randomly enrolled into this study according to age. They were divided into four groups and treated with four kinds of nebulized solutions. Group I consisted of 18 patients under 12 months old who were treated with budesonide (1 mg/2 ml) diluted with 2 ml isotonic sodium chloride. Group II consisted of 18 patients under 12 months old who were treated with 4 ml isotonic sodium chloride. Group III included 16 patients between 12 and 24 months old who were treated with terbutaline (5 mg/2 ml) diluted with 2 ml isotonic sodium chloride. Group IV included 21 patients between 12 and 24 months old who were treated with budesonide (1 mg/2 ml) and terbutaline (5 mg/2 ml). Clinical data on respiratory rate, wheezing score, cyanosis score and accessory respiratory muscle utilization score were recorded in all patients before and after treatment throughout the entire hospitalization. The results of this study showed no benefits from nebulized budesonide in infants with bronchiolitis either younger than 12 months old or between 12 and 24 months of age. The duration of admission also showed no significant differences among the groups.

Bronchiolitis↗
PubMedDate not supplied

Comparison of breath-actuated and conventional constant-flow jet nebulizers in treating acute asthmatic children.

To compare the therapeutic effects of two small-volume jet nebulization devices, a breath-actuated nebulizer (BAN) and a constant-flow nebulizer (CFN), this study was conducted. Seventy-two asthmatic patients, aged 5 to 15, were randomly enrolled into this study (39 to the CFN group, 33 to the BAN group). Nebulization treatment with terbutaline solution (5.0 mg /2 ml) diluted with 2 ml isotonic saline for 10 minutes was performed after measurements of baseline spirometry, SaO2, and pulse rate. Measurements of spirometry, SaO2 and pulse rate were repeated at 0, 5, 15 and 30 minutes after the end of the nebulization treatment. After treatment, for within-group comparison, all the spirometric parameters (including FEV1, PEF and FEF25-75%) and SaO2 at various time points of both groups significantly improved. The pulse rate also significantly increased (only at 15 and 30 min for the CFN group). For between-group comparison, the BAN group had greater improvement in all the data of spirometric parameters and SaO2 at various time points, but only reached statistical significance at some time points in PEF, FEF25-75% and SaO2. The pulse rate of the BAN group was significantly higher than that of the CFN group beginning 5 minutes after treatment. In conclusion, the BAN device is better than the CFN device in improving the spirometric parameters and oxygen saturation of asthmatic children during an equal 10-minute nebulization therapy. These results, associated with the higher pulse rate evoked in the BAN group, suggest a higher lung deposition ratio in the BAN device.

Acute Disease↗
PubMedDate not supplied

Infantile wheezing and bronchodilator treatment.

Wheezing is a symptom, not a diagnosis. Wheezing disorders are not equal to childhood asthma. Wheezing in the youngest children is often episodic, associated with upper respiratory infection. Early wheezing disorders, particularly in the first 2-3 years of life, should be considered as largely independent of later childhood asthma. It is difficult to distinguish an initial episode of asthma triggered by a viral respiratory infection from acute viral bronchiolitis. Most of the infants with wheezing have transient conditions associated with diminished airway function at birth and do not have increased risks of asthma or allergies later in life. There is no evidence for an overall beneficial clinical effect of nebulized a2-agonists in acute severe wheezing episodes or acute bronchiolitis in infants, although some may seem to respond.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Clinical analysis of chronic peritoneal dialysis related peritonitis in children.

In most countries, chronic peritoneal dialysis (PD) is the preferred dialysis mode for children and adolescents below the age of 15 years with end-stage renal disease. PD-related peritonitis is a serious complication that has a great impact on uremic patients'outcome. We retrospectively reviewed the charts of a total of 22 uremic children who underwent chronic peritoneal dialysis. The total peritonitis rate in our study was one episode every 23.7 patient-months, and there was no significant difference in the incidence of peritonitis between children with automated peritoneal dialysis and those with continuous ambulatory peritoneal dialysis (p=0.219). Staphylococcus aureus was the most common causative organism, accounting for 13.3% of the episodes of peritonitis. The combination therapy of vancomycin plus ceftazidime is effective for common pathogens in peritonitis. Rare microorganisms, e. g., fungus and mycobacterium, should be taken into consideration when the response to initial treatment is poor. Early diagnosis and treatment is important to prevent sequelae and mortality.

Adolescent↗