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K S Hsieh

Publications and source records attributed to K S Hsieh.

80 records · Page 5Linked to original sources
PubMedDate not supplied

Color flow mapping in ventricular septal defect: correlation of hemodynamic data and shunt flow area.

To evaluate the efficacy of two-dimensional Doppler echocardiography in assessing the severity of isolated ventricular septal defect, 31 children were studied within 24 hours of cardiac catheterization. The shunt flow area at peak systole (PSFA), diastole (DFA) and end-diastole (EDFA) and maximal shunt flow area (MSFA) were measured with frame-by-frame technique and corrected with body surface area and heart rate. The Qp/Qs ratio was calculated by the Fick's principle. Simultaneous pressures at peak systole (PSP), diastole (DP) and end-diastole (EDP) were recorded in the left (LV) and right ventricle (RV). The Qp/Qs ratio was correlated well with MFA (p = 0.05), MFA/BSA (p less than 0.001), PSFA/BSA (p less than 0.001), MFA/HR (p less than 0.05), MFA/BSA, HR (p less than 0.001), PSFA/BSA and HR (p,0.001). The PSP gradient between LV and RV was inversely correlated with MFA/BSA and PSFA/BSA (p less than 0.05) and HR (p less than 0.05). Two-dimensional Doppler echocardiography can provide a useful information of hemodynamic changes in children with isolated ventricular septal defect.

Adolescent↗
PubMedDate not supplied

High-dose intravenous gamma-globulin therapy in Kawasaki disease.

The efficacy for reduction of coronary aneurysm in Kawasaki disease was studied from 1984 to 1988 in Taiwan. One hundred and six children with Kawasaki disease were treated by one of the following regimens: regimen I: aspirin and 130-200 mg/kg/day of intravenous gamma-globulin (group I = 7), regimen II: 201-400 mg/kg/day of intravenous gamma-globulin with aspirin (group II = 49) and regimen III: aspirin alone (group III = 43) and no treatment (group IV = 7). By using two-dimensional echocardiography and aortography, the coronary arterial aneurysms noted in group I, II, III and IV were 42.9%, 49.0%, 44.2% and 16.7% respectively within 4 weeks of the illness and were 28.6%, 18.4%, 16.4% and 16.7% respectively during the follow-up period of 11.4 +/- 8.2 months. The incidence of coronary aneurysm was reduced significantly (p less than 0.005) in patients with high-dose gamma-globulin therapy and with aspirin therapy alone. However, there was no difference between group II and III, probably due to delays in the time of start of prophylactic gamma-globulin therapy. There was also significant lower incidence of the giant coronary aneurysm in children with high dose gamma-globulin therapy and with aspirin therapy. (p less than 0.05) The incidences of giant aneurysm in groups I, II, III and IV were 28.6%, 2.0%, 4.7% and 14.3% respectively. These results suggest that even with delay in the time of start of prophylactic gamma-globulin therapy, it still can reduce the formation of giant coronary aneurysm.

Adolescent↗
PubMedDate not supplied

[Hypoplastic left heart syndrome due to aortic and mitral atresias: report of one case].

A three-day-old female infant was transferred to the Pediatric Intensive Care Unit with chief presenting problems of progressive change of cyanosis and respiratory distress. Physical examination revealed tachypnea, acrocyanosis, hepatomegaly, undetectable pulse of extremities and oozing over the place of venous puncture. Chest roentgenograms revealed slight cardiomegaly; other X-rays were within normal limits. Complete electrocardiograms showed right axis deviation and right ventricular hypertrophy. Because of an impression of neonatal sepsis, the patient was put in an incubator with oxygen and antibiotics were given. Persistent anuria appeared associated with sighs of cardiac and renal failure; the ventilator was applied; dopamine and lasix were also given. Unfortunately, the cyanosis worsened progressive. Despite several attempts at resuscitations, the infant expired eight hours later. Pathology disclosed the heart size as normal; hypoplasia of ascending aorta as 0.4 cm in diameter; a PDA with 1 cm in diameter; a diminutive bean-sized left ventricle; hypertrophy of right ventricle and atresias of aortic and mitral valves. There was no evidence of septicemia.

Abnormalities, Multiple↗
PubMedDate not supplied

Detection of airway CO2 partial pressure to avoid esophageal intubation.

During endotracheal intubation, checking the position of endotracheal tube is important in order to avoid accidental esophageal intubation. Exhaled CO2 pressures of 50 emergent intubation attempts were recorded in our pediatric intensive unit to evaluate the efficacy of capnography in the early detection of esophageal intubation. Adjustment of the tube position was performed when indicated. In successful endotracheal intubation, the end-tidal CO2 pressures (PetCO2) ranged from 10 mmHg to 80 mmHg with typical respiratory phasic waveforms. In cases of inadvertent esophageal intubation, the PetCO2 values were less than 5 mmHg and revealed no typical respiratory pattern. It was also observed that PetCO2 decreased during one lung intubation or when the tip of endotracheal tube was pulled above the glottis. Capnographic monitoring end-tidal CO2 pressure continuously may be a reliable, time-saving tool for the detection of inadvertent esophageal intubation and the evaluation of proper positioning of the endotracheal tube.

Carbon Dioxide↗
PubMedDate not supplied

Dynamic three-dimensional display of common congenital cardiac defects from reconstruction of two-dimensional echocardiographic images.

BACKGROUND: Two-dimensional echocardiography had long been a standard diagnostic modality for congenital heart disease. Further attempts of three-dimensional reconstruction using two-dimensional echocardiographic images to visualize stereotypic structure of cardiac lesions have been successful only recently. So far only very few studies have been done to display three-dimensional anatomy of the heart through two-dimensional image acquisition because such complex procedures were involved. MATERIALS AND METHODS: This study introduced a recently developed image acquisition and processing system for dynamic three-dimensional visualization of various congenital cardiac lesions. From December 1994 to April 1995, 35 cases were selected in the Echo Laboratory here from about 3000 Echo examinations completed. Each image was acquired on-line with specially designed high resolution image grazmber with EKG and respiratory gating technique. Off-line image processing using a window-architectured interactive software package includes construction of 2-D ehcocardiographic pixel to 3-D "voxel" with conversion of orthogonal to rotatory axial system, interpolation, extraction of region of interest, segmentation, shading and, finally, 3D rendering. RESULTS: Three-dimensional anatomy of various congenital cardiac defects was shown, including four cases with ventricular septal defects, two cases with atrial septal defects, and two cases with aortic stenosis. Dynamic reconstruction of a "beating heart" is recorded as vedio tape with video interface. CONCLUSIONS: The potential application of 3D display of the reconstruction from 2D echocardiographic images for the diagnosis of various congenital heart defects has been shown. The 3D display was able to improve the diagnostic ability of echocardiography, and clear-cut display of the various congenital cardiac defects and vavular stenosis could be demonstrated. Reinforcement of current techniques will expand future application of 3D display of conventional 2D images.

Child, Preschool↗
PubMedDate not supplied

Serum HDL level at acute stage of Kawasaki disease.

Kawasaki disease is a disease of acute vascular inflammation of unknown etiology and HDL is a known risk factor of vascular damage. So far, there is no specific serum marker for KD. The previous study has shown a remarkable change of serum HDL in the patients with KD. To find whether changes in serum HDL level is a specific serum marker for early diagnosis of KD, we measured the concentration of HDL, LDL, TC, TG and CRP immediately after admission and one week later in three groups of patients (56 patients with KD, 38 patients with clinical viral infection, and 42 patients with bacterial infection). There was a significant decrease of HDL and increase of TG immediately after admission in three groups of patients. HDL and TG did not return to normal one week later. HDL level is more adversely affected in severe diseases than in mild diseases. Our results indicated that low HDL level is noted in various acute infection and is not a specific serum marker in the early stage of Kawasaki disease. It is interesting that low HDL is a universal phenomenon in this series. Further research is needed to explain the mechanism of lipid alterations and its consequences.

Acute Disease↗
PubMedDate not supplied

Left multicystic dysplastic kidney with contralateral ureteropelvic obstruction: report of one case.

Multicystic dysplastic kidney (MCDK) is a common cause of abdominal mass in neonates. It is frequently associated with malformation of the contralateral kidney, such as ureteropelvic obstruction, etc. Because MCDK is usually functionless, it is important to evaluate the condition of the contralateral kidney. The presence of severe obstruction in the contralateral ureteropelvic junction is life-threatening and prompt treatment should be made to preserve the remaining renal function. We report on a neonate with left MCDK and contralateral ureteropelvic obstruction, presenting as anuria after birth, and also we review the literature.

Anuria↗