Biomedical subjects

J C Sheu

Publications and source records attributed to J C Sheu.

166 records · Page 10Linked to original sources

PubMedDate not supplied

Surgical management of complicated gastrointestinal salmonellosis in children.

From January 1984 to October 1991, 11 consecutive patients with complication of Salmonella infection received surgical intervention at our hospital. The age at operation ranged from 4 days to 8 years old, with a mean of 1 year and 8 months. Most of them (64%) were under the age of one year. Eight cases were male, 3 cases were female. The most common pathogen was Salmonella paratyphi Gr. B (73%); the most common presenting symptoms and signs were abdominal pain (82%), pyrexia (82%) and muscle guarding (82%). The indications for surgery included pneumoperitoneum (55%), peritonitis (36%) and intestinal obstruction (9%); 6 cases received one stage operation, 5 cases received staged operations (enterostomy). The most commonly involved organ was ileum (54%). Ceftriazone (rocephin) was the drug of choice for the first 2 weeks postoperatively. Total parenteral nutrition (TPN) was used for at least 2 weeks. The postoperative complications included adhesion ileus (9%), high output enterostomy (9%), reperforation (9%), and wound infection (18%); there was no surgical mortality. Prompt diagnosis, early resuscitation and operative management are mandatory to avoid mortality.

Child↗

PubMedDate not supplied

Torticollis: a long-term follow-up study.

To achieve better guidelines for the future management of torticollis, this study analyzed surgical and nonsurgical management of 253 torticollis patients who were treated in this hospital from 1971 to 1993. Of those, 37 cases received operation only, 78 cases were operated after failed physical therapy, and 138 cases were treated only at the Rehabilitation Department. If free neck movement was considered to be the primary goal of treatment, most parents were satisfied with the results. However, if facial and skull deformities were the serious sequelae of torticollis, then only less than half of the surgical and nonsurgical groups of patients were graded as normal. Further, 10.9% of physical therapy group and 7% of the surgical patients need further operation to release the fibrotic bundle which limited their neck movement. Therefore, it is suggested that torticollis treatment should include early interventions such as adjusting sleep position, careful planning of physical therapy and/or operation and a long term follow-up period as essential for better management of torticollis.

Child↗

PubMedDate not supplied

Effective reduction of Helicobacter pylori infection after upper gastrointestinal endoscopy by mechanical washing of the endoscope.

BACKGROUND/AIMS: To investigate the frequency of endoscopic transmission of Helicobacter pylori and the efficiency of disinfection in different washing methods of endoscopes. MATERIALS AND METHODS: IgG antibodies to H. pylori in patients prospectively followed who underwent first endoscopic examination at the National Taiwan University Hospital from 1982 to 1993 were measured. A total of 132 subjects who were negative for H. pylori IgG antibody test before examination and who were with negative endoscopic findings were enrolled. Among the 132 seronegative patients, 60 were examined before June 1989 when manual washing was adopted for endoscope cleaning and 72 received examination after mechanical washing were routinely used in our endoscopy unit. RESULTS: During a follow-up period of 6 months or more, 5 patients in the manual washing group sero-converted while none in the mechanical washing group seroconverted (5/60 vs 0/72. p = 0.02). CONCLUSION: The results suggested that the risk of endoscopic transmission of H. pylori is substantial and mechanical washing is efficient in preventing this iatrogenic spread.

Adult↗

PubMedDate not supplied

Conservative treatment of intra-abdominal abscess in children.

Fifty-three children under 18 years of age with sonogram-proved intra-abdominal abscess (IAA) were seen between July 1993 and June 1996 at the Department of Pediatrics of the Mackay Memorial Hospital, then were studied retrospectively. Following a course of conservative treatment and follow-up with serial sonographic studies, 42 (79.3%) patients responded favourably to antibiotics treatment without drainage procedure. The other 11 patients' condition deteriorated, and surgical intervention was performed. The gradual shrinkage and completely resolved periods of the abscesses averaged 27.9 days. The average duration of antibiotic treatment was 23.6 days, intravenously for average 12.2 days followed by oral treatment until the abscess was completely resolved (average 11.4 days). The intra-abdominal abscess recurred in 3 (5.7%) patients. The experience demonstrates that pediatric patients with an intra-abdominal abscess must be followed closely by sonography, and they can be managed successfully with appropriate antibiotics alone. Surgical intervention is still needed if symptoms and signs persist or deteriorate.

Abdominal Abscess↗