Biomedical subjects
K L Tan
Publications and source records attributed to K L Tan.
Effect of phototherapy on neonatal riboflavin status.
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Neonatal serum bilirubin levels in spontaneous and induced labour.
An investigation was made into the onset and severity of neonatal jaundice in 114 patients following spontaneous labour and labour induced by (a) amniotomy, (b) amniotomy and simultaenous infusion of oxytocin, (c) amniotomy and simultaneous administration of oral prostaglandin E2 (PGE2). No significant difference in serum bilirubin levels in the first five days of life was found in the four groups.
Simple methods in nursery care.
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Some aspects on management of neonatal jaundice in Singapore.
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The nature of the dose-response relationship of phototherapy for neonatal hyperbilirubinemia.
The nature of the dose response relationship of phototherapy for neonatal hyperbilirubinemia was studied in 110 infants divided into ten comparable groups; each group was subjected to phototherapy of different intensity. The response to phototherapy increases with increasing dose, but the rate of this response progressively decreases with increasing radiance till a "saturation point" is reached, beyond which no further increase in response occurs to further increase in radiance, i.e., an asymptotic regression was demonstrated. The minimal radiance at which phototherapy begins to be effective for neonatal hyperbilirubinemia was also determined. The rebound after cessation of phototherapy was similar in all groups of infants, despite the shorter duration of exposure required for the groups subjected to intense phototherapy.
The influence of gestational age and birth weight on the infant response to phototherapy for neonatal hyperbilirubinaemia.
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Phototherapy for neonatal jaundice in erythrocyte glucose-6-phosphate dehydrogenase-deficient infants.
The effectiveness of phototherapy in the management of neonatal hyperbilirubinemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient infants was studied. "Prophylactic" phototherapy for six continuous days commencing from the first day of life was effective in preventing a significant rise in bilirubin levels in 12 G6PD-deficient infants in the first three days, during which period a rapid rise was observed in a control group of G6PD-deficient infants. The hemoglobin levels on the first and eighth postnatal days were comparable in both groups. "Therapeutic" phototherapy proved equally effective in reducing bilirubin levels in 24 infants with nonhemolytic hyperbilirubinemia and an equal number of infnats with hyperbilirubinemia associated with G6PD deficiency. Phototherapy was efficacious in the prevention or treatment of neonatal hyperbilirubinemia associated with G6PD deficiency; even if its use is prolonged it does not cause hemolysis in such infants.
Neonatal jaundice in premature infants.
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Facial asymmetry and the sternomastoid tumour: a prospective study.
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Ulcerations of the upper alimentary tract in the newborn.
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Sex-linked recessive hydrocephalus.
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The mortality of exchange transfusions.
A prospective study of the effect and mortality of exchange transfusion was carried out in the Kandang Kerbau Hospital, Singapore. Altogether 140 exchange transfusions were performed on 122 infants. The exchanges were done for hyperbilirubinaemia due to "idiopathic" jaundice, ABO haemolytic disease, and glucose-6-phosphate dehydrogenase deficiency. Eight infants deteriorated during the exchange, in three of whom the procedure had to be terminated prematurely. Two deaths occurred two days after the exchange--the procedure being partly responsible in one case; necrotizing enterocolitis was present in addition to the kernicterus. Exchange transfusion is not without hazards, and should be performed carefully with close monitoring of the clinical status of the infant during and immediately after the procedure.
Wide sutures and large fontanels in the newborn.
Newborn infants with wide cranial sutures and large anterior fontanels, but having normal head circumferences, were prospectively studied and compared with a group of normal controls. The study group with wide sutures was composed of two different groups--one with good calcification of the calvaria, fairly large anterior fontanels, and no Wormian bones; and another with distinct parietal prominences, very large anterior and posterior fontanels with prolonged patency, poor initial calcification of the calvaria, and Wormian bones. Normal head growth and physical and mental development were observed in all the infants studied.
Neonatal brain tissue embolism in the lung.
A brain tissue embolus was observed in a major pulmonary artery in the right lung, in a neonate who died from intracranial haemorhage 36 hours after delivery. This is the fifth documented case in a neonate and the only one in whom survival had occurred beyond one hour. Brain tissue emboli in the pulmonary circulation occur very rarely; it has been described in adults and children with head injuries. In newborn infants with severe congenital malformations of the central nervous system, brain tissue has been found growing in the lungs; the possibility of this being the result of prenatal brain trauma with embolization has been raised. In newborn infants, pulmonary brain tissue embolism as a result of birth trauma has been reported only very rarely; as far as the authors are aware, only four such cases have been documented. In view of the rarity of this condition, it was thought that the present case merited reporting.
Phototherapy in the management of neonatal jaundice.
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Phototherapy for neonatal hyperbilirubinemia in "healthy" and "ill" infants.
The effectiveness of phototherapy for nonhemolytic hyperbilirubinemia was evaluated in two groups of closely matched newborns, one group consisting of "healthy" and the other "ill" infants. Phototherapy was equally effective in reducing bilirubin levels in both groups of infants. It would seem to be the treatment of choice in all infants with nonhemolytic hyperbilirubinemia, especially ill infants in whom its simplicity, safety, and effectiveness would make it an ideal form of therapy.