Biomedical subjects

L Y Yang

Publications and source records attributed to L Y Yang.

95 records · Page 6Linked to original sources

PubMedDate not supplied

Peritonitis in children being treated with continuous ambulatory peritoneal dialysis. CAPD Team.

An eight-year retrospective study was performed to determine the incidence of peritonitis in a pediatric continuous ambulatory peritoneal dialysis (CAPD) population of 24 children, half of whom were boys and half, girls. All suffered from end stage renal disease (ESRD). When these children, aged 2 through 17 years (mean: 10.7 +/- 3.8), were examined, the incidence of peritonitis was one episode every 15.2 patient-months. Microbiologic evaluation showed that 76.4% of the 34 episodes were culture positive, with Staphylococci species (coagulase negative staphylococci 32.4%, Staphylococcus aureus 14.7%) causing most cases especially early in dialysis. Half the patients presented with a triad of symptoms (fever, abdominal pain and cloudy dialysate), with cloudy dialysate was the major presentation (88%). Peritonitis was treated with intraperitoneal administration of cefacin and/or netromycin when suspected, and 52.9% of the episodes needed hospitalization. Except for two patients who died of complications (sepsis, acute pancreatitis), all episodes of peritonitis were cured; in four episodes it was necessary to remove a catheter, and two of those cases came from fungal peritonitis. Peritonitis rates differed among disconnect systems. The manual spike had peritonitis rate of one episode per 4.6 patient-months which was higher than the O-set (one episode/22.2 patient-months), UV-XD and Y-set disconnect systems. Therefore, the major causes of peritonitis arose from contamination provoked by the technical aspect of the procedure. Nutrition status was stable in these patients. Serum albumin and total protein were adequate in all patients without relation to episode of peritonitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Plasma levels of atrial natriuretic factor in normal children and patients treated by hemodialysis and continuous ambulatory peritoneal dialysis.

In an attempt to establish the reference data of plasma levels of atrial natriuretic factor (ANF) in different age groups and to evaluate plasma ANF changes before and after hemodialysis (HD) and during continuous ambulatory peritoneal dialysis (CAPD), fifty normal healthy children and 20 children with end-stage renal disease (ESRD) were included. Ten ESRD children received HD and 15 received CAPD therapy. Five cases received HD in the earlier period and then CAPD. The results showed that in normal children, at the age of under one month, there were higher plasma ANF levels. As age increased, plasma ANF levels progressively decreased. During the ESRD before dialysis, there was a significantly increased plasma ANF level (434.1 +/- 80.1 vs 17.5 +/- 2.3 pg/ml, P < 0.0001). Both HD and CAPD reduced the plasma ANF of patients to a lower degree, but the result was still higher than that in normal controls. There were significantly decreased plasma ANF level in the patients with CAPD therapy than those with HD (71.8 +/- 13.7 vs 270.3 +/- 51.9 pg/ml, P < 0.0001). The change of ANF levels was positively correlated with the body weight change and creatinine change after HD.

Adolescent↗

PubMedDate not supplied

Early detection of neonatal adrenal hemorrhage by ultrasonography.

To investigate clinical features and course of neonatal adrenal hemorrhage (NAH) from July 1992 to August 1993, fifteen babies suffering from NAH born at Veterans General Hospital-Taipei were included. Portable ultrasound scanner was used for initial screening. The frequency of NAH was approximately 0.35% which is lower than other reports. The distribution of their birth weight was 3 cases lower than 3000 gm, 3 cases over 4000 gm and 9 cases within 3000 to 4000 gm. Only one was premature and another one post-term. Four of them had a history of either prenatal or perinatal asphyxia. Only one patient had a palpable abdominal mass. On the sonographic findings, eleven had bleeding in the right-side, two in the left-side and two in both sides. Only one had adrenal calcification. During their early life, no patient developed adrenal cortical insufficiency or secondary profuse bleeding. Two patients had pathologic jaundice. Two patients had severe anemia. After conservative treatment, none of them developed any severe complication. In conclusion, with the aid of renal sonoscreening in the newborn, we can discover NAH early and give adequate treatment at once. Severe complications also can be prevented.

Adrenal Gland Diseases↗

PubMedDate not supplied

A study of the relationship between IgG subclass/IgM and idiopathic nephrotic syndrome.

In an attempt to elucidate the relationship between serum IgG subclass/IgM ratio and prognosis in different types of idiopathic nephrotic syndrome (INS), 46 cases of treatment responders and 23 cases of either frequent relapse or non-responders were studied. All patients had received renal biopsy. Serum IgG subclass/IgM ratios were compared between the acute nephrotic phase and remission. The association between therapeutic effect and the parameters of INS were also investigated. There were 24 cases of minimal change nephrotic syndrome (MCNS), 32 cases of IgM nephropathy (IgMN) and 13 cases of focal segmental glomerular sclerosis (FSGS). All cases of MCNS were steroid-responders. Seventeen cases of IgMN experienced frequent relapses. The other 15 cases were responsive to the treatment. 6 cases of FSGS had poor response to any therapy; 7 cases were responsive to either triple therapy or cyclosporine A plus prednisolone. Both IgGI/IgM and IgG2/IgM were correlated with serum albumin and cholesterol levels at the acute nephrotic phase (p < 0.05). Longitudinal change of the immunologic parameters in patients with INS revealed significantly elevated serum IgM level decreased serum IgG level, IgG/IgM, IgG1/IgM, IgG2/IgM, IgG3/IgM, IgG4/IgM and IgG/IgE ratio during acute nephrotic phase. Correlation between therapy responses showed that, for serum IgG1/IgM ratio > 3.0, most of the cases were treatment-responders. For IgG1/IgM ratio > 1.0, all the cases were frequent relapsers or non-responders. These results suggest the immunologic changes in patients of INS may be caused by immune regulatory abnormality. Serum IgG1/IgM ratio may serve as one of the therapeutic and prognostic guides, especially if the patient refuses renal biopsy.

Child↗

PubMedDate not supplied

Clinical aspects of the hemolytic uremic syndrome.

Hemolytic uremic syndrome (HUS) can be clinically classified into two types: typical cases with a diarrheal prodrome of association with E. coli O157, and atypical cases without antecedent diarrhea. However, HUS is not common in Taiwan. To evaluate the clinical course, complications and outcome of HUS in children, and to identify the risk factors for mortality, retrospectively, seven cases of HUS in our hospital in the past 6 years were studied. Six of them were boys, and one was a girl. Their ages ranged from 0.67 to 3 years. None of them were preceded by diarrheal prodrome. Acute renal failure, hypertension and liver involvement were noted in all cases. Stroke and seizure developed in three of the cases with sequelae. Two cases progressed into end-stage renal disease (ESRD). One case developed acute respiratory distress syndrome (ARDS). Two cases (28.5%) expired. ESRD especially associated with ARDS was highly related to mortality.

Biopsy↗