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Biomedical subjects

M Y Ho

Publications and source records attributed to M Y Ho.

64 records · Page 4Linked to original sources
PubMedDate not supplied

[Pharmacological closure of symptomatic PDA in premature infants using indomethacin].

When left to right shunting through the ductus arteriosus is of a degree contributing to the cardiopulmonary problems in a premature infant, the condition is clinically termed symptomatic PDA. It is also generally agreed that symptomatic PDA if left untreated is a significant cause of increased morbidity and mortality. Studies have also concluded that all infants with symptomatic PDA who are prematurely born and/or ventilator dependent should be considered candidates for ductal closure by either pharmacological or surgical mean. Over a period of approximately 2 1/2 years, 22 premature infants with symptomatic PDA have been treated here with powder form indomethacin. The one course success rate was 68%. Thereafter, in another 2 1/2 years, 33 cases were selected for whom a liquid form was used instead. The success rate was 70%. Indomethacin is better given by an intravenous route. However, if the intravenous form is not available, using the liquid form by mouth or via the naso-gastric tube is a good substitute.

Ductus Arteriosus, Patent↗
PubMedDate not supplied

Periventricular leukomalacia in infancy: ultrasonic diagnosis and neurological outcome.

During the more than five years from January 1984 to June 1989, twenty-four patients with definite or probable cystic periventricular leukomalacia (PVL) were diagnosed by cranial ultrasonography at Mackay Memorial Hospital. The 24 patients were divided into two groups. Group A comprise two boys and four girls who received longitudinal sonographic follow-ups for leukomalacia. Of these six patients, five were premature and all suffered from severe perinatal insults. In each case, sequences of developmental cystic PVL were observed by serially scanning the brain. High echogenicity was discovered during the initial stages (2 to 7 days) in the periventricular area, and cystic formations were observed between the age of 18 and 60 days. Clinically, only one patient developed normally; four had severe motor dysfunction and poor motor development; and one was lost during follow-up, Group B was composed of 18 patients who visited the out-patient clinic for psychomotor retardation evaluation, and were found through ultrasound to have or possibly have cystic PVL formations at various stages. The clinical work-up revealed that 12 had spastic quadriplegia; 2 had hemiplegia; 3 had spastic displegia; and 1 case had hypotonic cerebral palsy. In infants, PVL is considered to be a much more reliable and important prognostic predictor than intraventricular hemorrhage. Consequently, it is crucial that physicians should screen patients at high risk for PVL, especially those with perinatal insults.

Cysts↗
PubMedDate not supplied

[Kawasaki disease complicated with hemorrhagic enteritis mimicking intestinal obstruction: report of one case].

A 6-month-old little boy presented with fever and cervical lymphadenopathy for four days. On admission, he was found to have conjunctival congestion of both eyes, reddened and fissured lips, straw-berry tongue, macular rash at the trunk and erythematous change on the BCG injection site. The diagnosis of Kawasaki disease was made and aspirin therapy (100 mg/kg/day) was started. On the 3rd hospital day, he developed abdominal distention, jaundice, poor activity and tachypnea. Bowel sound was silent on auscultation. Nasogastric tube was inserted for decompression and bilious material was drained out continuously. In addition, bloody, mucoid stool passage was noted. An abdominal radiography revealed dilatation of the small bowel and paucity of the colon gases. On the abdominal ultrasound, hydrops of gallbladder, marked ascites and silent and dilated bowel loops were found. Despite of supportive care, abdominal symptoms persisted and condition deteriorated. Laparotomy was done on the following day. At operation, it was found that the patient developed severe petechia on the long segment of small intestine from 15cm distal to the Treitz ligament to ileocecal valve and some fibrin plagues on the terminal ileum at 25cm proximal to the ileocecal valve were also found.

Enteritis↗
PubMedDate not supplied

The VATER association: analysis of forty six cases without karyotyping.

Forty-six patients with two or more features of the VATER association admitted to the Mackay Memorial Hospital from May, 1983 to Mar, 1992 were retrospectively enrolled in this study. We compared the incidence of major features with that reported in the literature. Imperforate anus, congenital heart disease, and renal anomalies were the three most common major features in our study. Thirteen patients died. Heart failure was the major cause of mortality. We noted many patients associated minor features, and among them there was a relatively high ratio of cleft lip, cleft palate, and hypospadius. The overall outcome and development were good among the survivals. We suggest that children who have any congenital anomaly included in the VATER association should get a careful examination and evaluation of their heart, genitourinary tract, limbs and vertebrae. Early correction if possible is indicated in such patients.

Abnormalities, Multiple↗
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Adult respiratory distress syndrome in full term neonates.

From July 1987 to October 1991, we experienced 10 full-term newborn infants with severe adult respiratory distress syndrome (ARDS). The triggering events were intrauterine/perinatal asphyxia in 6 and sepsis in 4. All had severe respiratory distress/failure and were mechanically ventilated with high concentration of inspired oxygen and positive end-expiratory pressure. Radiography of the chest all showed bilateral dense consolidation (white out lungs) and reduced lung volume. Persistent pulmonary hypertension (PPHN) was documented in 9 cases (90%). The concomittent occurrence of ARDS and PPHN rendered respiratory management extremely difficult. High-rate ventilation and tolazoline infusion were used in all these 9 PPHN cases. Acute complication of respiratory therapy (pneumothorax) was encountered in 5 patients. Only 3 cases survived, all belonging to the asphyxia group. Of these 3 survivors, 1 developed bronchopulmonary dysplasia, 1 had cerebral palsy on follow up and the other one was lost on follow up. The outcome of neonatal ARDS was generally poor.

Female↗
PubMedDate not supplied

[Clinical study of infants with birth weight less than 1500 grams].

One hundred and seventy-seven infants of birth weight less than 1500 grams admitted to the neonatal intensive care unit of Mackay Memorial Hospital in 1987 were studied. The sex distribution, male to female ratio was 100:77, inborn 78 cases, outborn 99 cases. At one year follow-up, the mortality rate of these weighed between 500 gm and 799 gm was 100%, between 800 gm and 999 gm 54%, between 1000 gm and 1249 gm 17%, between 1250 gm and 1499 gm 19% respectively. The mortality rate of outborns was higher than that of inborns (X2 = 6.03, P < .05). The most common cause of mortality of these infants was intracranial hemorrhage, it accounts for 55% of the mortality. Seventy-three percent of the deceased cases expired during the first three hospitalization days. Of these 177 cases, 94 were put on respirator with IPPB initially, another 47 cases were on nasal CPAP. Only 36 cases didn't require respiratory therapy. Complications of the extreme prematurity and management including intraventricular hemorrhage, pulmonary hemorrhage, sepsis, pneumothorax, persistent pulmonary hypertension, disseminated intravascular coagulopathy, electrolyte imbalance, bronchopulmonary dysplasia and retinopathy of prematurity were discussed. In order to improve survival and reduce complications of these extreme prematurity, advanced monitoring system, early detection and prevention of intracranial hemorrhage, establishment of the transport system are essential.

Bacteremia↗
PubMedDate not supplied

Pulmonary artery sling with tracheo-bronchial stenosis: report of one case.

This patient is a 6-month-old female baby with intermittent symptoms of air-way obstruction for two months. The diagnostic examinations performed included: esophagogram, two-dimensional echocardiography, cardiac catheterization with selective right pulmonary arteriography, magnetic resonance imaging (MRI) and tracheo-bronchogram. The esophagogram revealed anterior indentation of the esophagus. The echocardiogram, cardiac catheterization and MRI all demonstrated anomalous origin of the left pulmonary artery from the right pulmonary artery instead of the main pulmonary artery. The tracheo-bronchogram showed long-segment stenosis of the lower portion of the trachea. A final diagnosis of pulmonary artery sling with tracheo-bronchial stenosis was made. Since the parents refused surgery, the baby expired after several episodes of cyanosis & cardiac arrest.

Bronchial Diseases↗