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Biomedical subjects

W Chen

Publications and source records attributed to W Chen.

At least 1,297 records · Page 72Linked to original sources
PubMedDate not supplied

Clinical trial of corticosteroid and beta-2 bronchodilator in acute wheezing infants.

To evaluate the effect of a combination of corticosteroid and beta-2 bronchodilator on acute, young, wheezing patients, a total of 80 patients, ages below 36 months who were hospitalized for this condition during the period November 1988 to March 1990 were studied. They were divided into three groups. Group A consisted of 29 cases, under 12 months old, and treated with hydrocortisone and procaterol; Group B included 23 cases, between 12 and 36 months old, treated as in Group A; Group C, of 28 cases younger than 12 months, received neither drug. The clinical severity scores for Group B were significantly more improved than Group A on days 4 and 5 (p less than 0.05 and p less than 0.05, respectively), and better than that of Group C on days 3, 4, and 5 (p less than 0.05, 0.005, and 0.05, respectively). No significant difference was found between Group A and C from days 1 to 5. The previous wheezy coughing episodes were significantly more frequent in Group B than in Groups A and C (p less than 0.05). Two-thirds of the quick responders to hydrocortisone and procaterol were 12 months old or older. The personal and family allergic history, serum IgE level, and total eosinophil count could not be used as parameter to predict responsiveness to the combined therapy of hydrocortisone and procaterol.

Acute Disease↗
PubMedDate not supplied

A protamine-mediated heparin sensing device.

A convenient, protamine mediated strip assay for heparin was developed. The assay is established on the specific interaction between heparin and protamine, and the metachromatic color change of methylene blue dye from blue to purple in the presence of heparin. The device consists of a fibrin cup fabricated with a cellulose paper strip containing immobilized protamine. To analyze plasma heparin levels, a fixed volume of the test sample is placed in the fibrin cup and allowed to migrate through the strip in a descending manner until exhaustion. The region to which heparin binds is then visualized as purple in color by spraying methylene blue dye onto the strip. The heparin level in the sample is estimated from the length of the purple region using a preconstructed standard curve. This device proved to be capable of detecting and differentiating heparin in clinically relevant concentrations.

Heparin↗
PubMedDate not supplied

[Amniotic band disruption complex: report of one case in twins].

Amniotic band disruption complex is a congenital disorder with the principal features vary from simple digital band constrictions to major craniofacial and visceral defects. Early amniotic rupture results in multiply affected infants who are frequently aborted or stillborn, whereas later rupture results primarily in limb involvement. Here we report a case of amniotic band disruption complex, a male infant (twin A) weighing 2350 gm with Apgar scores of 9 and 10 at one and five minutes. The second, third and fourth fingers on the left hand appeared to have ring constrictions, the distal part of the fourth finger had been amputated distally. There were amputations and ring constrictions of the distal parts of the second, third and fifth digits on the right hand, the fourth finger had only proximal third. All of the toes on the left foot had been amputated distally. The fifth toe on the right foot were absent, and the others had been partly amputated. Left cleft lip and palate were present with sunken left nasal flare. This baby underwent the cranial ultrasound examination, which demonstrated on structural anomalies, and both of the twins had the karyotype of 46XY. No other abnormalities was noted in the infant. The 890 gm placenta was delivered spontaneously. Two umbilical cords were present, each with normal vessels. The examination of the placenta revealed it to be dichorionic and diamniotic, and numerous fibrous strings extending form the fetal surface.

Amniotic Band Syndrome↗
PubMedDate not supplied

[Dandy-Walker complex with multiple anomalies: report of one case].

A 3570 gram male newborn was born to a 29-year-old mother at the gestational age of 40 weeks with gross abnormalities of flexion contracture of third and fifth fingers and fourth toes bilaterally. After birth, cyanotic spell while feeding was found, and a series of examinations were done. The abnormalities were focused on brain echogram, computed tomogram and magnetic resonance imaging examination, which showed a large posterior fossa cyst, cerebellar hypoplasia complicated with multiple severe supratentorial anomalies, including marked ventricular dilatation, cerebral agyria, agenesis of corpus callosum, absence of thalamus and basal ganglion, and optic nerve atrophy. Clinically, the patient had neonatal seizure and high fever. The diagnosis of Dandy-Walker complex type A was made according to the new classification presented by Barkovick et al. in 1989.

Abnormalities, Multiple↗
PubMedDate not supplied

[Artificial feeding practice in nursery: a new policy and maternal response].

While a single-bottle method is what mothers actually do in preparation of infant formula in their own home, in the hospital, each nursery makes its own rules about preparing formula. Early in 1988 a "self-service", artificial feeding practice was initiated in this 600-bed general hospital. Mothers who intended to bottle-feed were asked to purchase the powdered formula at their own expense. At feeding time, mothers prepare one bottle of formula at a time, and feed the infant immediately. Each mother's technique of formula preparation was observed by the nurses, and practical instructions were given if needed. Particular errors and hazards in the reconstitution of formula were emphasized with posters hung on the nursery wall and by the pamphlets distributed to the mothers. These practices avoid distribution of formula samples at the hospital, and provide repeated practice for mothers during their hospitalization. To explore the attitudes of mothers toward this new feeding practice, a questionnaire survey of 483 consecutive mothers who gave birth to healthy newborns was carried out. While 61.3% of the mothers thought that it was acceptable to purchase infant formula themselves, 85.1% thought preparing the formula themselves in hospital was acceptable. Furthermore, only 1.2% of the mothers said that this new practice was a great deal of trouble. Most mothers said that on-the-spot teaching by nurses was very helpful. Regarding overall attitudes, 5.4% and 2.1%, respectively, will not or may not return for the next delivery. After controlling for several socio-educational variables, only previous experience with bottle-feeding was associated with pro-and-con responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Hemolytic disease of the newborn caused by maternal irregular antibody anti-E: report of one case].

A 3390 gm male baby was born smoothly at 41 weeks' gestation to a 35-year-old, gravida 3, para 3, mother by spontaneous vaginal delivery at this hospital. The mother denied ever having received a blood transfusion. Her first two uneventful pregnancies had resulted in two healthy fullterm infants. Physical examination of the baby showed normal, until 15 hours of age, when apparent jaundice with serum total bilirubin concentration up to 21 mg/dl was noted. The blood types of both baby and mother were group A, Rh(D) positive. Compatibility testing for exchange blood transfusion with group A whole blood showed positive reaction due to the presence of an irregular antibody. Two exchange blood transfusions were performed in the same day with compatible blood. Thereafter, the patient's condition was much improved, he was discharged one week later. The irregular antibody--anti-E was identified in both baby and mother. The maternal RBC phenotyping was CCDee (R1R1), and the baby, CcDEe (R1R2).

Blood Group Antigens↗
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[Nebulizing terbutaline therapy in children with acute asthma].

To evaluate the therapeutic effect of nebulized terbutaline in children with acute asthma, 21 children, aged 1 year and 7 months to 10 years, with acute asthma, were enrolled into this study, during the period from July to December 1989. Each patient received nebulized terbutaline (Bricanyl) 5 mg/dose over 10 minutes. The respiratory rate, pulse rate, blood pressure, peak expiratory flow rate and clinical severity score were recorded before, and at 10 minutes after treatment. Comparing with the data before treatment, respiratory rate, peak expiratory flow rate and clinical severity score at 10 minutes after treatment showed significant improvement (p value less than 0.05; less than 0.0005; less than 0.0001, respectively), but pulse rate and blood pressure did not differ significantly. It was concluded that administration of nebulized terbutaline, at a dose of 5 mg, was both safe and effective in treating acute asthma, and may be used as the first line measure in treating acute asthma in children.

Acute Disease↗
PubMedDate not supplied

Breast-feeding counseling by a 24-hour telephone hot-line.

A 24-hour telephone hot-line functioning as a counseling service and case registry was included in a multi-faceted breast-feeding promotion program. The mothers could speak directly to especially trained staff members in a municipal hospital. All the questions were answered according to an "Answering Book" which included the anticipated question and the optimum answer. A total of 201 calls, which included 340 problems, were recorded from January 1, 1993 to October 31, 1993. Almost all the calls were made by the mothers (99%), and more than half (57.7%) of the mothers were primiparous. Most of the calls (79.6%) were made between 8 AM to 4 PM. The questions were frequently raised when the baby was aged 8 to 14 days (23.4%). The most frequently asked questions were: (1) insufficient milk? (14.1%), (2) frequent and loose stools? (13.2%), (3) weaning? (10.3%), (4) drugs? (6.8%), (5) additional formula or water? (6.2%), and (6) maternal contraindication? (6.2%). Although the impact of this telephone consultation could not be properly evaluated, the incidence of breast-feeding during hospital stay increased from 50% to 73.4%, and breast-feeding for more than 1 month increased from 22.7% to 42.2% before and after the whole promotion program. It is recommended that health care professionals provide more help when the mother leaves the hospital. A nation-wide toll-free telephone operated by the Department of Health to increase the chance of successful breast-feeding is also recommended.

Breast Feeding↗
PubMedDate not supplied

Falling cholecystectomy thresholds since the introduction of laparoscopic cholecystectomy.

OBJECTIVES: To determine whether cholecystectomy rates among the elderly increased following the introduction of laparoscopic cholecystectomy in 1989, and to assess whether changes in rates were accompanied by lower clinical thresholds for performing cholecystectomy. DESIGN: Time-series quasi-experimental design based on quarterly observations from 1986 to 1993. Data were obtained from Medicare hospital discharge files for Pennsylvania. PATIENTS: Medicare patients aged 65 years or older who resided in Pennsylvania, did not have end-stage renal disease, and underwent cholecystectomy in Pennsylvania from 1986 to 1993. MAIN OUTCOME MEASURES: Cholecystectomy rates per 1000 elderly Medicare beneficiaries, stage of gallstone disease (uncomplicated vs complicated) at cholecystectomy, type of admission (elective vs urgent/emergent), patient age and comorbidities, and 30-day postoperative mortality. RESULTS: Cholecystectomy rates increased 22% from 1989 to 1993. The proportions of cholecystectomy patients with uncomplicated gallstone disease and with elective admissions declined from 1986 to 1989 but then increased rapidly after laparoscopic cholecystectomy was introduced. In contrast, the age distribution and comorbidities of cholecystectomy patients did not change during the study period. Postoperative mortality rates were stable from 1986 to 1989 but decreased thereafter. CONCLUSIONS: Growth in cholecystectomy rates following the introduction of laparoscopic cholecystectomy was accompanied by evidence of lower clinical thresholds for performing surgery. The normative, or prescriptive, implications of lower cholecystectomy thresholds require further analyses that consider lower direct medical costs and indirect costs and reduced postoperative morbidity after laparoscopic cholecystectomy.

Age Distribution↗
PubMedDate not supplied

[Family environment of children with simple obesity].

Fifty obese children aged from 6 to 15 years and 50 non-obese controls paired on the basis of age and sex were evaluated by anthropometric measurements and a parents' questionnaire. Birth weight was comparable in obese and non-obese children. The majority (78%) of the cases in the study group were becoming obese during the age among 2 and 12 years. It was found that obese children were about five times as likely to have an obese parent as controls: 44% of the obese children had obese fathers and 12% had obese mothers. There also a significant difference in the chance of having an obese sibling between the obese and control groups. However, the difference of socioeconomic status between the two groups did not reach level of significance. The results indicated that there are likely to be more obese family members at home for every obese case identified in a weight control clinic. Identification, prevention, and control of childhood obesity in at-risk families are an important pediatric issue. Further research efforts are needed to unravel the multiple factors associated with childhood obesity.

Adolescent↗
PubMedDate not supplied

Effects of nebulized terbutaline on oxygen saturation in acute asthmatic children.

To evaluate the paradoxical effect of oxygen desaturation following beta-2 bronchodilator nebulization treatment in acute asthmatic children, a total of 47 patients, aged between 1.8 and 14 years, 27 males and 20 females, were studied. Twenty ml of nebulized normal saline (NS), followed by 10 mg (4 ml) of terbutaline sulphate solution (TSS) in 20 ml NS, were delivered by an ultrasonic nebulizer in 10 min to each patient through a connecting air tube placed in front of the nose and mouth. Oxygen saturation (SaO2) and pulse rate were monitored, using a pulse oximeter, before study and every two minutes until the end of the study. The clinical severity score and peak expiratory flow rate (PEFR) were checked before the study, at the end of inhalation of NS, and at the end of inhalation of TSS. SaO2 was increased both after nebulized NS and TSS when compared with the pre-study data (p < 0.05 and p < 0.0001, respectively). Twenty two cases (47%) during NS and 12 cases (25%) during TSS nebulization had SaO2 below the pre-study level. The mean decrease of SaO2 for the former was 1.62 +/- 0.95% (range: 1.00% to 4.26%), and 1.64 +/- 0.83% (range: 1.02% to 3.13%) for the latter (p > 0.9). No SaO2 decrease after nebulized TSS was observed in any of the seven severe asthmatic children with a prestudy SaO2 < or = 90%. The clinical severity score and PEFR were also significantly improved both after nebulized NS and TSS (p < 0.0001 and p < 0.001, respectively for NS, and both p < 0.0001 for TSS).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
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[Respiratory failure after nebulized terbutaline treatment in severely wheezy infants: report of three cases].

Subjective clinical observations have suggested that nebulized bronchodilators are helpful in the treatment of some wheezy infants. Although the role of beta 2-agonists in the management of acute asthma in infants and very young children remains controversial, the use of beta 2-adrenergic agents in this age group has been widespread. beta 2-agonists nebulization continues to be the first-line treatment for acute attack of asthma, irrespective of age, in some institutes, but their uses are not without side effect especially in young wheezy infants. We report three cases of respiratory failure occurred after treatment with nebulized beta 2 bronchodilator in infants with chronic lung disease and acute wheezing. All the 3 cases were victims of prematurity. Case 1 was a case of Wilson-Mikity syndrome; case 2 was a case of bronchopulmonary dysplasia; and case 3 was a case of repeatedly wheezing infant. All 3 cases had severely wheezy dyspnea with retraction before nebulized beta 2 bronchodilator treatment. Respiratory failure was found 5 to 10 minutes after the treatment. We suggest that it must be very careful in the treatment of severely wheezy infants with beta 2-agonist nebulization, especially in cases with histories of prematurity and chronic lung disease. It is necessary to carefully monitor the vital signs of the infants during beta 2 agonist nebulization.

Humans↗
PubMedDate not supplied

[Fetus in fetu: report of a single case].

A five-year-old girl had been noted, since birth to have abdominal distension. There was no history of twinning or teratoma in the family. Physical examination discovered a 15 x 10 cm mass in the abdomen. Roentgenologic examination demonstrated the presence of an axial skeleton and long bones within the mass. MRI showed a retroperitoneal mass with components of cystic, bony and fatty tissues. When the mass was surgically removed from the retroperitoneal cavity, pathologic examination disclosed a parasitic fetus measuring 15.3 x 6.3 x 6.0 cm in size and suspended by a peduncle within a capsule. The fetus was covered with skin, sebaceous materials and black hair. There were bilateral and symmetric upper extremities with a flapper-like, deformed hand. No obvious genital organ was noted. Dissection of the midline, revealed a vertebral column with spinal cord. An atrophic skull bone containing cephalized glial tissue was noted. A thoracic cavity and scapular bone were found in the thoracic cage; however, no heart was noted. Gastrointestinal tract and kidney-like organs were seen within the abdominal cavity. Microscopically, there were glial tissues within the skull bone, spinal cord and vertebra. The upper extremities revealed two long bones surrounded by myxomatous and fibrous tissue. A well developed intestine and an ovary containing follicles with nearby lympy nodes were seen. The capsule showed fibrous tissue with calcification and hairs. It was distinguished from the teratoma by the presence of a vertebral axis and by an appropriate arrangement of other organs or limbs with respect to the axis, and corresponding to the generally recognized diagnostic criteria of fetus in fetu.

Abdominal Neoplasms↗
PubMedDate not supplied

Intranasal lidocaine for treatment of migraine: a randomized, double-blind, controlled trial.

OBJECTIVE: To evaluate the effectiveness of intranasal lidocaine for treatment of acute migraine headache. DESIGN: Prospective, randomized, double-blind, placebo-controlled trial. SETTING: Community urgent care department. PATIENTS: A total of 81 patients (67 women and 14 men; median age, 42 years; range, 19-68 years) with a chief complaint of headache who fulfilled criteria of the International Headache Society for migraine participated. Patients were excluded if headache had lasted more than 3 days or if the frequency of severe headache was more than once per week. INTERVENTION: Patients were randomized in a 2:1 ratio to receive a 4 percent solution of intranasal lidocaine or saline placebo, respectively. MAIN OUTCOME MEASURES: The primary outcome measure was at least 50 percent reduction of headache within 15 minutes after treatment. Secondary measures include reduction in nausea and photophobia, use of rescue medication, relapse of headache, and change in headache disability scores. RESULTS: Of 53 patients who received intranasal lidocaine, 29 (55 percent) had at least a 50 percent reduction of headache compared with 6 (21 percent) of 28 controls (P=.004). Nausea and photophobia were significantly reduced (P=.03 and P=.001, respectively). Rescue medication for headache relief was needed in 15 (28 percent) of 53 patients in the lidocaine group vs 20 (71 percent) of 28 controls (P<.001). Among those with initial relief of headache, relapse of headache occurred in 10 (42 percent) of 24 in the lidocaine group vs 5 (83 percent) of 6 in the control group (P=.17), usually within the first hour after treatment. CONCLUSIONS: Intranasal lidocaine provides rapid relief of headache in approximately 55 percent of ambulatory patients with migraine. Relapse of headache is common and occurs early after treatment.

Acute Disease↗
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Colored striae in obese children and adolescents.

To document the characteristics of the striae in obese children and adolescents, 89 obese patients (56 males, 33 females) with a mean age of 9.6 +/- 3.0 years and range of 3 to 19 years who came to our pediatric nutrition clinic were studied. Obesity was defined as a weight-for-length index (WLI) above 1.2 (range 1.39 to 2.68). Striae were identified in 36 (40.4%) of the 89 patients. Generally, striae were present over both sides of the body symmetrically. Striae most prominently located on the thighs (73%), the arms (42%), and the abdomen (30%), less frequently on the back, buttocks, and over the knees. In about 40% of the patients, multiple sites were involved. There is no sex difference between striae and non-striae groups. Compared with the non-striae group, striae occurred in older age patients (11.5 vs 8.2 years, p = 0.0001), and more often in those with a longer duration of obesity (7.1 vs 5.0 years, p = 0.0002). A high prevalence of striae was found in more obese patients (WLI > 1.8). We conclude that striae might be associated with obesity, and the interpretation of striae as a cutaneous manifestation of obese children and adolescents should be considered.

Adolescent↗
PubMedDate not supplied

Effect of continuous positive airway pressure on cardiac output in neonates.

To determine the cardiac output change in neonates who were under nasal continuous positive airway pressure (CPAP) therapy, eleven newborn neonates, who were admitted to our neonatal intensive care unit with respiratory diseases, were enrolled in the study. Cardiac output was measured by pulsed Doppler echocardiogram at various pressures of 0, 2, 4, 6, 8, and 10 cm H2O and revealed 301 +/- 47, 300 +/- 49, 289 +/- 55, 275 +/- 64, 269 +/- 59 and 242 +/- 50 ml/min/kg, respectively. Cardiac output depressed significantly between 0 cm H2O and 8 cm H2O (P = 0.025), and between 0 cm H2O and 10 cm H2O (P = 0.004). We conclude that cardiac output may be depressed in neonates who are under high levels of nasal CPAP therapy, and suggest that high levels of nasal CPAP therapy must be used with caution, especially when the therapy is applied to the low birth weight neonates.

Cardiac Output↗