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Biomedical subjects

T Y Lin

Publications and source records attributed to T Y Lin.

286 records · Page 16Linked to original sources
PubMedDate not supplied

Comparison of an ELISA-based screening test with liquid chromatography for the determination of aflatoxins in corn.

An enzyme-linked immunosorbent assay (ELISA) screening test (CITE PROBE) was compared to liquid chromatography (LC) for the determination of aflatoxins in naturally contaminated corn samples. The CITE PROBE, with a positive/negative cutoff of 5 ng/g aflatoxin B1, was correct (based on LC results) on 47 of 51 samples. Two of the incorrect responses by the CITE PROBE were false positives on samples containing 4.4 ng/g and 4.1 ng/g aflatoxins by LC. Another incorrect response was a false negative on a sample containing 5.5 ng/g aflatoxins by LC. The fourth incorrect response was a false positive on a sample containing 1.9 ng/g aflatoxins by LC. On the basis of these results, the CITE PROBE was determined to be a reliable screening method for the detection of greater than or equal to 5 ng/g aflatoxins in corn.

Aflatoxins↗
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Pediatric flexible bronchoscopy: a three-year experience.

One hundred and forty-one flexible fiberoptic bronchoscopies were performed in 124 pediatric patients in Chang Gung Children's Hospital between October 1991 and September 1994. Eleven of these patients were younger than 1 month old; 52 patients were younger than 1 year old; 94 patients were younger than 6 years old. The bronchoscope used was Olympus BF 3C20; with a 3.5 mm outer diameter, it also has a build-in 1.2 mm working channel. Most of the procedures were done in the pediatric intensive care unit. Oral chloral hydrate and parenteral benadryl were given as pre-sedation medication 30 minutes before the procedures; for most cases intravenous midazolam and meperidine hydrochloride were given immediately before the examination. The most common diagnoses were laryngomalacia, airway foreign bodies, subglottic stenosis or tracheal stenosis. Six episodes of transient hypoxemia and one brief episode of apnea were encountered. It was concluded that flexible fiberoptic bronchoscopy, very useful and safe in pediatric patients, has been underused in Taiwan.

Adolescent↗
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Orbital cellulitis in children: clinical analysis of 16 cases.

Orbital cellulitis, defined as eyelid erythema and edema, proptosis and/or ophthalmoplegia, with or without visual acuity loss, is a rare, but severe infectious disease. The medical records were reviewed of 16 children, aged 18 years or under, who were admitted at Chang Gung Memorial Hospital with a diagnosis of orbital cellulitis during the period from January 1977 to June 1993. The 16 children included 13 males and 3 females. The mean age of the patients was 5.6 years. Sinusitis, diagnosed clinically and radiologically in eight cases, was the most common predisposing factor. From pus or blood in five patients, these pathogens were isolated: Staphylococcus aureus (2), viridans streptococci (1) and mixed bacterial flora (2). All of the patients were treated with systemic antibiotics. The mean duration of fever after initiation of antibiotic therapy was 2.9 days. Four patients subsequently developed complications: subperiosteal abscess (2), orbital abscess (1), and bacteremia (1). Five patients received surgical treatment. No mortality was reported. After a follow-up period of 1-2 months, no sequelae were found among any of these 16 patients.

Cellulitis↗
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Sinusitis and bronchial asthma in children.

Sinus disease has been assumed to exist in children with respiratory tract allergies. We consecutively evaluated 375 patients (245 male, 130 female) with childhood onset asthma, between 5 and 15 years of age (mean 7.8 years of age). Abnormal Waters radiographs were found in 205 patients (54.7%) which included mucosal wall thickening greater than 6 mm (67.3%), complete opacification (22.9%) and air-fluid levels (9.8%). The level of immunoglobulin (Ig) E was found to be much higher in non-sinusitis asthmatic children than in asthmatic children with sinusitis (1207 IU/mL vs. 644 IU/mL). The IgG, IgA, IgM and erythrocyte sedimentation rate (ESR) values were not significantly different in the two groups. All patients were treated with antibiotics for 3 to 6 weeks. Five patients required surgical intervention after antibiotic treatment had little success. Streptococcus viridans was isolated from 4 patients following surgical aspirates and Peptostreptococcus anaerobius was isolated in only one patient. In conclusion, sinusitis in children may be an aggravating factor for chronic reactive lower airway disease. Optimal treatment may decrease the need of asthmatic medication.

Adolescent↗
PubMedDate not supplied

Experience of intravenous immunoglobulin and acyclovir in neonates at risk for severe varicella infection--report of five cases.

Five cases of at-risk neonates for severe varicella infection were reported. Intravenous immunoglobulin (IVIG) was given soon after birth in different ways to four of them (Case 1 received 400 mg/kg/day for the first three days of life; Case 2 received a single dose of 200 mg/kg on day 2, and another dose of 160 mg/kg on day 7; Cases 3 and 4 received 400 mg/kg on day 2). All five patients were given acyclovir therapy, 40 to 45 mg/kg/day for five to nine days. (Case 1 for prophylaxis, Cases 2, 3, 4, 5 for treatment). Case 2, 3, 4, 5 developed vesicular rash, mild to moderate in degree, with rapid resolution without any constitutional symptoms. Case 1, who received both IVIG and acyclovir for prophylaxis, had no vesicle occurrence. IVIG, in combination with acyclovir, is a safe and probably effective regimen for preventing severe varicella in at-risk neonates. A multi-centered, collaborative study is mandatory to study the efficacy of prophylactic acyclovir with IVIG in these neonates.

Acyclovir↗
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Neonatal meningococcal meningitis: report of two cases.

Two neonates with meningococcal meningitis and meningococcemia are reported. The two, aged 28 and 16 days, respectively, presented similar symptoms of fever, poor appetite and poor activity. Both blood and cerebrospinal fluid cultures of each patient grew Neisseria meningitidis. The isolated bacteria were sensitive to penicillin, and both patients recovered completely after penicillin treatment for 22 and 15 days, respectively. In the antibiotic era, only 22 cases of neonatal meningococcal meningitis have been reported in the English literature. Among these reports, at least 7 patients survived without sequelae; 6 of those were treated with different combinations of antibiotics, including penicillin, for variable durations of 7-14 days. Therefore, effective antibiotic therapy for 14 days should be adequate in the treatment of uncomplicated neonatal meningococcal meningitis and meningococcemia.

Female↗
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Fever in infants less than 3 months of age.

A retrospective study of 207 febrile episodes by infants less than 3 months old was performed. Most infants had rectal temperatures ranging from 38 to 39.9 degrees C and only 6 (3%) infants had fever above 40 degrees C per rectum. One hundred and nine (53%) of 207 visits resulted in subsequent hospitalizations including most by infants under 1 month of age. Urinary tract infection was the most common bacterial infection and upper respiratory tract infection the most common viral infection observed. A total of 112 infants were assigned into high-risk or low-risk group for serious bacterial infection by the application of the criteria proposed by Dagan et al. in 1985. The overall incidence of serious bacterial infection was 20.5% (23 patients). Seven (9.2%) of the 76 infants in the low-risk group had serious bacterial infection, compared with 16 (44.4%) of the 36 in the high-risk group (p < 0.05). The negative predictive value of meeting the criteria was 90.8%, a value unacceptably lower than those of previous studies. For maximizing the negative predictive power of the criteria, the addition of another low-risk factor, a normal stool analysis, is suggested. Besides, urine cultures should be taken concomitantly with urinalyses in febrile infants, when considering nonpyuria in infants with urinary tract infections. We demonstrate the pitfalls and difficulties in the application of the criteria for excluding serious bacterial infection in febrile young infants and suggest prospective studies involving more patients should be undertaken before its wider application in clinical practice.

Bacterial Infections↗
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Evaluation of chronic atelectasis in children using chest computed tomography and bronchoscopy.

A heterogeneous group of 11 children with atelectasis persisting longer than one month were investigated for the causes using chest computed tomography and fiberoptic bronchoscope. Four young infants had right upper lobe (RUL) posterior segmental atelectasis simulating RUL lobar collapse in plain chest films; all had only two visible segmental bronchi by bronchoscopic examination. Intraluminal obstruction in the central airway was not a common cause of pediatric chronic atelectasis in this small series of patients. Only one obstructive atelectasis caused by dilated pulmonary arteries was detected in this study. Two patients with pre-existing neuromuscular diseases showed multiple atelectasis. The atelectatic lobes do not spontaneously re-inflate following flexible bronchoscopy. Investigations involving a larger number of cases are needed to substantiate the etiologies and to guide specific therapy for those children with chronic atelectasis.

Bronchoscopy↗
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Double-blind placebo-controlled study of oxatomide in the treatment of childhood asthma.

Oxatomide is an orally active H1-histamine receptor antagonist. It has been demonstrated to have therapeutic efficacy in the treatment of allergic diseases in adults. The aim of this study was to evaluate the efficacy and safety of oxatomide in the treatment of asthma in children. Sixty-four asthmatic children of both sexes, aged between 5 and 16 years, were enrolled in this double-blind, placebo-controlled trial with a duration of 4 months. Patients were randomized chosen to receive either oxatomide with a daily dose of 1 to 2 mg/kg body weight or a placebo twice daily. Clinical evaluations including pulmonary function tests and immunological studies. The patients' impression on the effect of treatment also were recorded during the study. The effects of bronchodilatation and normalizing pulmonary function were observed 2 months after oxatomide treatment. The levels of eosinophil cationic protein and total asthma symptom scores were significantly reduced during treatment with oxatomide. There was no significant change in total IgE or IgG4 before or after treatment in either the treatment or control groups. During the study, two (5.8%) oxatomide treated patients reported slight drowsiness and one (2.9%) reported body weight gain. Routine laboratory tests showed no significant alterations. In conclusion, oxatomide was generally well tolerated in this study and may have the potential of being an effective treatment for childhood asthma.

Adolescent↗
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Early echo-guided percutaneous aspiration of peripheral lung abscesses in children: report of two cases.

A 9 year-old boy and a 7 year-old girl suffered from fever and chest pains before they were brought to Chang Gung Children's Hospital. Chest radiographs and computed tomography scans showed lung abscesses with pleural attachment, and using echo-guidance, percutaneous aspirations were done which confirmed the growth of Fusobacterium sp, and Veillonella parvula respectively, both of which are susceptible to penicillin G. The fever and chest pains subsided within 24 hours after the procedure. We suggest using early percutaneous aspiration of peripheral located lung abscesses soon after admission, rather than after a 10-14 day trial of antibiotic therapy: it can be a safe and cost-effective procedure to shorten the duration of the parenteral antibiotic treatment and hospitalization.

Child↗
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Endocarditis due to Neisseria sicca: report of one case.

Many species of the Neisseria, which are respiratory commensals in humans, have been regarded as being nonpathogenic or as causing disease in only immunocompromised hosts. We report a case in which Neisseria sicca was the cause of infective endocarditis in a child with a ventricular septal defect and review the literature on endocarditis due to N. sicca infection. Most of these patients had an underlying heart disease. Dental caries and poor oral hygiene may be two factors that predispose patients to the infection. N. sicca endocarditis usually results in a subacute onset of symptoms and, if not diagnosed early and treated, is associated with a high rate of embolic complications.

Child↗
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Acetaminophen overdose in children and adolescents.

From 1982 to 1997, 12 Chinese children were admitted to Chang Gung Memorial Hospital with acetaminophen overdose. Six subjects (one young child, and five adolescents) developed liver damage which was severe in three cases (AST > 1000 IU/L). Acetaminophen-induced liver function abnormalities were characterized by elevation of transaminase levels with ALT higher than AST(6/6), coagulopathy(5/6), thrombocytopenia (1/6), but absence of jaundice(6/6). Fortunately, none of the six patients with liver damage developed fulminant liver failure, and all recovered completely. Acetaminophen overdose can cause significant morbidity in children and adolescents. Caretakers should be well instructed to give the drug correctly. So far, acetaminophen is still considered as the drug-of-choice for antipyresis in pediatric practice. However, multicentered collaborative study is necessary to determine whether acetaminophen intoxication causes less hepatic failure in Chinese children than in Western children.

Acetaminophen↗
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Pneumonia with pneumatocele formation caused by Mycobacterium tuberculosis: report of one case.

Pneumatoceles are usually characteristic of staphylococcal pneumonia. They are rarely formed as one of the complications of Mycobacterium tuberculosis pneumonia. We report a 1-year-and-5-month old male child with pneumonia who was confirmed to have the rare complication, pneumatocele formation, by chest radiography and computed tomography. Since the patient did not respond to empiric antibiotic therapy, gastric larvage through a nasogastric tube was performed on three consecutive mornings and, as a result, acid fast rods were found on the three specimens. The cultures subsequently yielded M. tuberculosis. He was finally cured with a 6-month course of antituberculous chemotherapy. We conclude that tuberculosis should be considered in infants or young children with pneumonia that presents radiologically as pneumatocele formation, especially in whom there has been no response to empiric antibiotic therapy.

Humans↗
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Spontaneous resolution of an intratracheal mass: report of one case.

A 14 year-old boy was investigated for a slowly resolving right upper lobe consolidation persisting for 3 months after a pneumonic episode. A flexible bronchoscopy showed a polypoid mass in the carina with extension to the right proximal bronchus. The bronchial washings study for fungus, acid-fast bacilli and polymerase chain reaction for mycobacterium were negative. A reported bronchoscopic examination 8 months later revealed no tracheal mass or subsequent stenosis. A tracheal mass in an asymptomatic and non-progressive child may be managed alternatively by repeated bronchoscopic examinations at intervals instead of immediate bronchoscopic excision or thoracotomy.

Adolescent↗
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Swyer James syndrome following Mycoplasma pneumoniae pneumonia: report of one case.

A previous healthy 5 year-old girl developed a right hyperlucent lung following Mycoplasma pneumoniae pneumonia 14 months before admission. Serial chest radiographs revealed a persistent right upper lobe atelectasis and gradual development of the right hyperlucent lung associated with frequent bouts of wheezing and exertional dyspnea. Physical examination showed markedly decreased breathing sounds in the right hemithorax with fine inspiratory crackles and expiratory wheezes. A diagnosis of Swyer James syndrome was confirmed by the exclusion of other causes of unilateral hyperlucent lung using computed tomographic scans of chest, fiberoptic bronchoscopy and lung perfusion scintigraphy. She has been followed up at our hospital using anti-asthmatic medication.

Child, Preschool↗