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Biomedical subjects

T F Fok

Publications and source records attributed to T F Fok.

197 records · Page 11Linked to original sources
PubMed1986

Sciatic nerve palsy complicating umbilical arterial catheterization.

A term newborn infant developed a right sciatic nerve palsy after ischaemic necrosis of the gluteal region following umbilical arterial catheterization. The nerve lesion was believed to be caused by entrapment and compression by scar tissue. Recovery was slow and remained incomplete up to 6 months of age.

Buttocks↗
PubMed1986

Transcutaneous bilirubinometer: its use in Chinese term infants and the effect of haematocrit and phototherapy on the TcB index.

The application of the transcutaneous bilirubinometer in screening for neonatal jaundice was evaluated in 259 full-term Chinese infants: 202 who had not received any treatment and 57 who were receiving phototherapy. The transcutaneous bilirubin index correlated well with the serum bilirubin level (SB) of the untreated infants and the coefficient of correlation was slightly higher for TcB readings obtained over the mid-sternal area (r = 0.91; P less than 0.001) than those over the forehead (r = 0.85; P less than 0.001). Transcutaneous bilirubinometry was unreliable in predicting the SB level in infants receiving phototherapy even if the SB readings were obtained over shaded skin. The haematocrit of the infants, though having a statistically significant effect on the TcB index, contributed only minimally to the regression line and correlation coefficient between the TcB index and SB level.

Bilirubin↗
PubMed1986

Neonatal jaundice: its prevalence in Chinese babies and associating factors.

A prospective study of 1238 full-term Chinese newborn infants was conducted to determine the incidence of neonatal jaundice and associated factors. A significantly more severe degree of hyperbilirubinaemia was present in infants whose ABO blood group was incompatible with that of their mothers and those who were deficient in the enzyme glucose-6-phosphate dehydrogenase (G6PD). Among the remainder, clinical jaundice was present in 87% and 23.9% had a peak serum bilirubin (SB) concentration greater than 204 mumol/l. Factors that were found to have an association with a higher peak SB concentration included: male infants; elder siblings who had a history of neonatal jaundice; and breast-fed infants with or without supplementation with formula feed. Factors that were found to have no significant association with the peak SB concentration were: gestational age; birthweight; the mode of delivery of the infants; maternal consumption of Chinese herbs and syntocinon induction or augmentation of labour.

ABO Blood-Group System↗
PubMed1986

Perinatal colonization of group B streptococcus--an epidemiological study in a Chinese population.

An epidemiological study of perinatal colonization of group B streptococcus (GBS) was carried out prospectively in a Chinese population. One hundred and sixty-eight mother-infant pairs were studied. Maternal carriage rate from multiple sites was 19.0%, with an overall neonatal colonization rate of 19.6%. There was no neonatal sepsis due to GBS. No obstetrical risk factors that could influence material carriage could be identified. Neonatal colonization was associated with premature/prolonged rupture of membranes, increased duration of rupture of membranes and intrapartum pyrexia. The number of infected sites and the density of organism in each site in the infant were directly proportional to the number and density of organisms in the culture-positive sites in the mother. Serotypical study showed a complete absence of type II GBS in this population. Since the vertical transmission rate was only 37.5%, it is postulated that nosocomial spread of the organism contributed significantly towards colonization of the infants in our study population.

Carrier State↗
PubMed1985

Cord blood G-6-PD activity by quantitative enzyme assay and fluorescent spot test in Chinese neonates.

Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is a common X-linked recessive disorder among the Chinese population. Neonatal screening for this condition is important and with necessary precaution, enzyme deficient infants are less likely to develop severe haemolysis and subsequent kernicterus. Screening of G-6-PD deficiency by fluorescent spot test on cord blood samples of 1228 Chinese neonates revealed an incidence of 4.4% in males and 0.35% in females. Simultaneous direct enzyme assay confirmed the sensitivity and specificity of the spot test in the identification of male hemizygotes and female homozygotes. However, the spot test was unsatisfactory in detecting heterozygotes. Even quantitative enzyme assay could detect only 70% of the partially deficient subjects.

Clinical Enzyme Tests↗
PubMed1985

Development of cerebral palsy after ultrasonographic detection of periventricular cysts in the newborn.

Cysts in the periventricular region of the brain were demonstrated by ultrasound in eight of 102 preterm infants (birthweight less than 1501g or less than 34 weeks gestation) during a 14-month period. All eight babies survived, but developed serious neurological problems: five had spastic quadriplegia and three had spastic diplegia. Six had impaired vision and six had delayed speech development, but there was no evidence of impaired hearing. The cysts probably represent the infarcted lesions of periventricular leukomalacia.

Cerebral Hemorrhage↗
PubMed1985

Perinatal events which precede periventricular haemorrhage and leukomalacia in the newborn.

Ultrasound brain scans were obtained daily for the first 5 days after birth, on day 7 and then weekly until discharge from hospital in 86 babies during a 12-month period. The babies weighed less than 1501 g or were less than 34 weeks gestational age. Fifty-one (59%) had normal scans, 34 (40%) developed periventricular haemorrhage, and seven (8%) developed periventricular cysts (associated with periventricular haemorrhage in six). Factors associated with periventricular haemorrhage were perinatal hypoxia, acidosis, hypercapnia and hypoxia after birth. Babies who developed periventricular cysts (periventricular leukomalacia) were more likely to have been hypoxic at birth and in four of the seven there had been a maternal antepartum haemorrhage. The association of perinatal hypoxia with periventricular haemorrhage and leukomalacia suggests that intrapartum events may predispose to the onset of these lesions which then develop postnatally. Prevention of perinatal hypoxia may play an important role in diminishing the disability caused by these conditions.

Brain Diseases↗
PubMed1979

Salmonella gastroenteritis in Hong Kong--a clinical review of 200 patients.

A sudden increase in Salmonella gastroenteritis affecting infants and children in Hong Kong in 1971 prompted a clinical review of 200 such patients seen over a 6 year period. It showed unprecedented prevalence of Salmonella johannesburg infections and unusually protracted diarrhoea. Only 3.5 per cent of patients were breast fed. Factors causing this chronicity are discussed. All 8 fatal cases were under 7 1/2 months old, with protracted diarrhoea starting within 1 month after birth in 7. The invasiveness of Salmonella johannesburg is low although its infectivity high. Bacteraemia occurred in only 1 patient and focal infections other than gastroenteritis in none. Antibiotics did not improve diarrhoea nor eliminate faecal excretion in the majority of those treated. Prolonged and intermittent faecal excretion of Salmonella was common. Nineteen per cent of patients acquired diarrhoea in hospital; some after a course of antibiotics given for other infections. Experience from this series does not recommend administration of antibiotics to patients with uncomplicated Salmonella johannesburg gastroenteritis. As chronicity of diarrhoea seemed to be the major prognostic factor with regard to mortality and morbidity in this series, further search for causes and control measures of this chronicity is required.

Child, Preschool↗
PubMedDate not supplied

Pneumocystis carinii pneumonia in an immunocompetent infant with congenital cytomegalovirus infection.

The case of a term infant with congenital cytomegalovirus (CMV) infection who developed Pneumocystis carinii pneumonia (PCP) at 4 months of age is reported. Our patient suffered from severe malnutrition and zinc deficiency secondary to necrotizing enterocolitis since the age of 2 months. There was no evidence of human immunodeficiency virus infection. Qualitative and quantitative in vitro leukocyte functions were also normal. This case highlights the fact that PCP can occur in apparently immunocompetent term infants. Malnourished infants with zinc deficiency or congenital CMV infection are at increased risk of developing PCP.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Severe acute respiratory syndrome: 'SARS' or 'not SARS'.

Accurate clinical diagnosis of severe acute respiratory syndrome (SARS) based on the current World Health Organization definition is difficult and at times impossible at the early stage of the disease. Both false positive and false negative cases are commonly encountered and this could have far-reaching detrimental effects on the patients, their family and the clinicians alike. Contact history is particularly important in diagnosing SARS in children as their presenting features are often non-specific. The difficulty in making a correct diagnosis is further compounded by the lack of a sensitive rapid diagnostic test. Serology is not particularly helpful in the initial triaging of patients as it takes at least 3 weeks to become positive. Co-infection and other treatable conditions should not be missed and conventional antibiotics should remain as part of the first-line treatment regimen. We report five cases to illustrate the difficulties and dilemmas faced by clinicians in diagnosing SARS in children.

Adolescent↗