Biomedical subjects

R J Teng

Publications and source records attributed to R J Teng.

At least 73 records · Page 4Linked to original sources

PubMedDate not supplied

Asymptomatic reopening of ductus arteriosus after successful closure by indomethacin in premature infants.

Indomethacin has been demonstrated to be effective for closure of hemodynamically symptomatic patent ductus arteriosus (PDA) in premature infants. The five cases in this study had acquired asymptomatic reopening of PDA a long time after successful closure by oral indomethacin. Providing adequate oxygen, giving another course of indomethacin, preventing excessive fluid intake and keeping hematocrit level greater than 40% had been tried to close the ducti but all in vain. However, most could be expected to close spontaneously later. Herein, the possible contributing factors and the treatment rationale are discussed.

Ductus Arteriosus, Patent↗

PubMedDate not supplied

Postnatal growth of low birthweight neonates in Taiwan.

The postnatal growth pattern of four hundred and twenty five Chinese low birth-weight neonates was assessed. All those whose birthweight were below 2500 grams and survived for more than 180 days during the study period were included. The gestational age was between 26 and 40 weeks, and the birthweights were between 766 and 2496 grams, respectively. Infants were grouped according to 250-gram birth-weight categories. The mean age of the lowest weight, mean age of weight regain, and percentage of weight loss were calculated for each weight group and demonstrated an inverse correlation to the birthweight. The mean age of the lowest weight ranged between 2.72 and 6.62 days, mean weight loss was between 4.06 and 14.56%, and age of weight regain was between 4.93 and 17.15 days, respectively.

Birth Weight↗

PubMedDate not supplied

Congenital ovarian cyst: report of one case.

The detection rate of ovarian cyst in neonates has been increased through use of prenatal and postnatal ultrasonography. A term female neonate, born to a G1P1 healthy mother, was found to have a cystic mass at the upper pole of the right kidney through prenatal sonographic evaluation. The cyst was also demonstrated to be located in the right pelvis by CT scan after birth. Because of the apparent floating nature of the cyst, laparotomy was performed at the age of seven days. A 4x3x3 cm3 cyst was found in the right ovary. Pathological examination of the cyst revealed a follicular cyst. The thyroid function was also checked before operation and revealed normal.

Adult↗

PubMedDate not supplied

Congenital chylothorax managed by partial pleurodesis: report of one case.

Congenital chylothorax, a rare cause of respiratory distress in neonate, presented here with respiratory distress from two days of age. Thoracocentesis was performed at six days, revealing a clear fluid with high protein content. Thoracotomy was performed at the age of 33 days because of a profuse amount of chest tube drainage. A leak of chyle was found near the esophageal hiatus of the costophrenic angle. Partial pleurodesis was performed because of difficulty in identifying the exact leakage point. Respiratory status improved very quickly after the operation, and oral intake was well-tolerated during follow-up.

Chylothorax↗

PubMedDate not supplied

Mesenteric arterial thrombosis complicating congenital nephrotic syndrome of Finnish type: report of one case.

A female, term neonate presented with generalized edema, heavy proteinuria, hypoalbuminemia and hyperlipidemia in the second week of life. The clinical and laboratory features were compatible with the diagnosis of congenital nephrotic syndrome. Treatment included albumin infusion, empirical penicillin, steroid and continuous arterio-venous hemofiltration. Intestinal perforation developed at the 19th day of age and led to a fatal outcome. At autopsy, thrombosis of the superior mesenteric artery and its branches was noted, and histology of the kidney was compatible with congenital nephrotic syndrome of the Finnish type. The risk of thromboembolism, arterial or venous, should be considered in patients with nephrotic syndrome, even in the neonatal period. Preventive measures, including avoiding volume depletion and femoral arterial/venous puncture, are essential in managing these patients. Prophylactic anticoagulation and infusion of fresh frozen plasma may be warranted to avoid such potentially lethal complications of thromboembolism.

Female↗

PubMedDate not supplied

Human herpesvirus-6 associated hemophagocytic syndrome in beta-thalassemia: report of one case.

An 8-month-old male infant with severe anemia and thrombocytopenia was brought to our hospital due to fever and pallor. The physical examination on admission showed pale conjunctivae, skin rash, lymphadenopathy and hepatosplenomegaly. Subsequent laboratory studies showed pancytopenia, impaired liver function, elevated lactate dehydrogenase level but without evidence of disseminated intravascular coagulation. Bone marrow aspiration demonstrated increased macrophages and prominent hemophagocytosis. The serological studies revealed a recent infection of human herpesvirus-6 which was confirmed by blood mononuclear cell culture and polymerase chain reaction. This infant was also found to have beta-thalassemia which was confirmed by hemoglobin electrophoresis performed before first transfusion. After treatment with intravenous immunoglobulin and other supportive therapies, the bone marrow abnormalities has completely recovered after 5 days, and the hemogram improved. This report demonstrates the human herpesvirus-6 as the etiology of hemophagocytic syndrome.

Herpesviridae Infections↗

PubMedDate not supplied

Risk factors of cholestasis in very low-birth-weight infants.

To evaluate the incidence, clinical course, and possible risk factors of cholestasis in very low-birth-weight infants. A retrospective study of 143 very low-birth-weight infants was performed. Cholestasis was defined as direct-reacting bilirubin > 2 mg/dL for more than 14 days. The clinical course of cholestasis was described, and perinatal risk factors were evaluated for associations with the development and severity of cholestasis. Cholestasis was present in 31 infants (21.7%). The mean (SD) age of onset was 30.3(15.3) days after birth or 26.0 (15.6) days after receiving parenteral nutrition, and the mean (SD) duration was 77.1 (33.8) days. In half of the cholestatic infants, bilirubin continued to rise after discontinuing parenteral nutrition. One infant developed signs of liver cirrhosis and died, two infants died with progressive cholestasis, while the other 28 patients recovered. Analysis of risk factors revealed that birthweight and duration of fasting significantly correlated with the development of cholestasis, and that sepsis significantly influenced the severity of cholestasis. Cholestasis is a common complication of extreme prematurity. The clinical course seems benign but long-term sequelae are unknown. Immature liver function and absence of stimuli for intestinal motility and hormonal secretion predispose to decreased bile flow, while sepsis further impairs hepatic ductular secretion and aggravates cholestasis.

Bile↗

PubMedDate not supplied

Group B streptococcal cellulitis of perineum and lower abdomen: report of one case.

This report describes a 4-week-old female baby with disseminated group B streptococcus (GBS) infection. The illness began as a swelling with violaceous hue of perineum and lower abdomen, a manifestation that may be falsely attributed to a traumatic injury. GBS septicemia, meningitis and cellulitis of lower abdomen was confirmed by cultures. This case illustrated an unusual presentation of GBS infection as cellulitis of lower abdomen. The presence of concurrent septicemia and meningitis in this case indicated that a more extensive diagnostic work-up and a more aggressive therapeutic approach are needed for young infants with cellulitis.

Ampicillin↗

PubMedDate not supplied

Liver laceration in premature neonate: report of a case with successful surgical treatment.

Neonatal liver laceration is a relatively rare but probably fatal condition without prompt diagnosis and treatment. It should be considered in newborn infants who are presented with sudden onset of symptoms and signs of hemoperitoneum such as shock, pallor, abdominal distension, abdominal bruising, or scrotal ecchymosis. Roentgenogram may show free peritoneal fluid. Abdominal sonography is helpful in the detection of intraabdominal bleeding. Paracentesis is the most effective diagnostic procedure for the confirmation of hemoperitoneum. The rupture of the liver is the first priority to be considered, though other abdominal organs including adrenals, kidneys, and spleen are also prone to injury. Once liver laceration is highly suspected, resuscitation with blood transfusion, correction of coagulopathy, and then emergency surgical intervention must be performed if conservative treatment fails. Here we present a 1,662 gm premature male neonate who underwent successful surgical repair of the liver laceration.

Birth Injuries↗

PubMedDate not supplied

Hepatic hemangioendothelioma: successful treatment with steroid in a very-low-birth-weight infant.

A female infant, born at the gestational age of 29 weeks with a birthweight of 1,350 gm, developed progressive hepatomegaly at 10 days of age. Congestive heart failure gradually developed, and hepatic hemangioendothelioma was diagnosed at 1 month of age by open biopsy. Due to rapid enlargement of the tumor and progressive heart failure, steroid therapy was given from 36 days of age, including methylprednisolone 15 mg/kg/day for 3 days and 10 mg/kg/day for 4 days, then prednisolone 4 mg/kg/day for 20 days followed by tapering till 74 days of age. The tumor regressed gradually and was not detectable by sonography at 33 months of age. We suggest that, even in very-low-birthweight infants, the prognosis of hepatic hemangioendothelioma may be improved with aggressive therapy when symptoms develop during tumor progression, and that steroid should be the initial treatment.

Dose-Response Relationship, Drug↗

PubMedDate not supplied

Impaired immune function in a premature infant with zinc deficiency after total parenteral nutrition.

The report describes a premature infant with necrotizing enterocolitis who developed symptoms of zinc (Zn) deficiency after three to four weeks of total parenteral nutrition (TPN). Clinical presentations included characteristic skin rash, alopecia, retarded growth, generalized edema and decreased serum alkaline phosphatase (ALP). Immune function studies revealed impaired neutrophil adhesion and mitogen-induced lymphoproliferation, whereas phagocytosis, chemotaxis and lymphocyte subsets remained normal. A high dose of elemental Zn (2.5 mg/kg/day), administered orally, improved the clinical symptoms and restored the immune function. In patients with Zn deficiency, impaired neutrophil adhesion and lymphocyte function may contribute to immunodeficiency which can be reversed with adequate Zn supplementation.

Humans↗

PubMedDate not supplied

Camptomelic dysplasia: report of one case.

A typical case of camptomelic dysplasia was noted to have only prenatally bowed legs. The infant showed the following characteristic features: dolichocephaly, flat-appearing small face, low nasal bridge, micrognathia, cleft palate, anterior bowing of tibia with skin dimpling over convex surface, mild bowing of femurs, talipes equinovarus, and tracheomalacia. Because of poor prognosis, the parents decided not to resuscitate the baby aggressively and the baby died of respiratory failure at six days old. Although this disease is rare, it does happen in ethnic Chinese and, because it may be an inherited disease, a correct diagnosis for camptomelic dysplasia is very important.

Abnormalities, Multiple↗

PubMedDate not supplied

Hydrops fetalis due to placental chorioangioma: report of one case.

Chorioangioma is the most common tumor of the placenta. However, a large one complicated with hydrops fetalis is rare. We report a patient who had hydrops fetalis associated with placental chorioangioma. The clinical manifestations included generalized edema, coagulopathy, thrombocytopenia, anemia, hypoproteinemia and hepatosplenomegaly. The hospital course was complicated with acute renal failure and repeated pneumonia. The patient died on the 54th day of life due to persistent lung atelectasis and hypovolemic shock. The pathophysiology and management of the complications of hydrops fetalis with chorioangioma are discussed.

Adult↗

PubMedDate not supplied

Lipomyelomeningocele associated with necrotizing enterocolitis in a term neonate.

A six-day-old full-term female infant with lipomyelomeningocele, confirmed by magnetic resonance imaging, suffered from necrotizing enterocolitis (NEC) when he was four-day-old. The clinical presentations were bloody stool and abdominal distension. A plain abdominal film demonstrated pneumatosis intestinalis and air in the portal vein. An emergent laparotomy was performed and revealed diffuse gangrenous change of both small and large bowels. A jejunostomy was done and strong antibiotics were given, but the baby died two days after the operation. In this paper report, the relation between lipomyelomeningocele and NEC is discussed.

Enterocolitis, Pseudomembranous↗

PubMedDate not supplied

Retroperitoneal cystic lymphangioma: report of one case.

Cystic lymphangioma is a developmental malformation of the lymphatic system. It is extremely rare for this type of tumor to arise from retroperitoneum in newborns. We present a male mature newborn infant with a retroperitoneal cystic lymphangioma proven by autopsy. The clinical manifestation of chylous ascites may mimic retroperitoneal cystic lymphangioma. The finding in supine abdomen X ray and abdominal sonography may help us to make some differential diagnosis.

Diagnosis, Differential↗

PubMedDate not supplied

Retinopathy of prematurity in very-low-birthweight neonates: epidemiology and risk factors.

A retrospective study of 143 very-low-birthweight infants cared in a level III neonatal intensive care unit who had survived for at least 28 days. Initial eye ground evaluation was done at the postnatal age between 4 and 6 weeks. Follow-up evaluation was done every one to two weeks at the discretion of the ophthalmologists. Thirty-four variables were reviewed for each case. Statistical analysis was done for each variable, with the development of retinopathy of prematurity (ROP), severity of ROP and development of threshold ROP as the dependent variables, by Mann-Whitney U test or X2 test when adequate. Variables with P-valu < 0.05 were included in multiple regression. One hundred and thirty-eight cases were survived for more than 28 days with their eyes been checked. Twenty-six (18.8%) of them developed ROP. The prevalence of stage I was 2.2% (3/138), stage II was 3.6% (5/138), stage III was 12.3% (17/138), and stage V was 0.7% (1/138). Threshold disease, stage 3 (+) and above, was found in 5 cases (3.6%). Seventeen variables were found to be correlated with the development of ROP. Only the duration of continuous positive airway pressure (CPAP) was significantly correlated to the development of ROP in multivariate logistic regression. Fifteen variables were correlated with the severity of ROP, but only peak direct bilirublin level, peak total bilirubin level and duration of CPAP could entered multiple stepwise linear regression. Thirteen variables were correlated with the development of threshold ROP, but only episodes of septicemia enter the multivariate logistic regression. We postulate that the longer duration of CPAP in ROP cases may reflect the severity of apnea and episodes of hypoxic attacks. Reducing episodes of apnea may prevent the development of ROP. The number of episodes of septicemia was the only significant variable for threshold ROP so that infection control is important for the prevention of threshold disease.

Humans↗

PubMedDate not supplied

Congenital short bowel syndrome with left acheiria: report of one case.

A case of congenital short bowel syndrome with left acheiria, hemivertebra and dextrocardia is described. Dilatation of the fetal bowel was observed at the 24th week of gestation during a routine ultrasonic scan of a healthy 23-year-old primigravida from a non-consanguineous marriage. Amniocentesis and chorionic villus sampling were denied. The baby was delivered at 38 weeks of gestational age. After delivery, multiple anomalies were noted: left acheiria, congenital short bowel syndrome (15 cm in length of the ileum), pseudo-obstruction of intestine, dextrocardia, and hemivertebrae. We suspected these abnormalities might be due to a vascular accident or failure of lateralization during the early gestational period. To our knowledge, these combinations have not been reported previously in English literature.

Adult↗

PubMedDate not supplied

Comparison of the outcome of extremely-low-birth-weight infants between two periods.

A comparison was made of the outcome of 73 neonates born with their birth weight of 500-999 gm in National Taiwan University Hospital during the period between January 1, 1993 and December 31, 1996 (Period II), with the outcome of 21 such neonates born between April 1, 1988 and October 31, 1992 (Period I). Exclusion criteria included parental refusal for resuscitation, and major anomalies. Data were collected via a predetermined record sheet. The incidences of the extremely-low-birth-weight infants were 23/10,173 (0.23%) and 81/13,835 (0.59%) in Periods I and II, respectively. Early neonatal mortality rate was significant decreased in Period II (43% versus 14%). The limit of viability was improved from gestational age of 26 weeks or 700 gm to gestational age of 24 weeks or 600 gm. The incidence of neonatal morbidity (80% versus 50%) and total survival rate (48% versus 60%) have not changed significantly as seen in this limited number of cases. This study concluded that, with the introduction of exogenous surfactant and modern neonatal care, early neonatal survival rate and the limit of viability were improved.

Female↗