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Biomedical subjects

B Hwang

Publications and source records attributed to B Hwang.

At least 55 records · Page 3Linked to original sources
PubMed1998

Coxsackievirus B1 infection in infants less than 2 months of age.

Most of the neonatal enteroviral infections reported in the literature are associated with Coxsackievirus B2-B5 and echovirus 9 and 11. We report a retrospective Coxsackievirus B1 (CB1) infection in infants less than 2 months of age. Seventeen patients had aseptic meningitis and 8 had systemic sepsis (multi-organ involvement including meningitis, impaired liver function, and abnormality in coagulation). The symptoms and signs were nonspecific and could not be distinguished with bacterial infection on clinical grounds. Virus isolation was mandatory for diagnosis. Impaired liver function and coagulation profiles were noted in patients with systemic sepsis, but not in patients with meningitis only. CSF examination showed some uncommon features of viral meningitis: predominance of polymorphonuclear cells (PMN) was noted in 62.5% of patients and hypoglycorrhachia in 64% of patients. The patients with only meningitis recovered completely without any sequela. One of the eight patients with systemic sepsis died with case fatality rate 12.5%. Physicians should be aware of the possibility of CB1 virus infection in young infants during prevalent seasons. Specimens should be sent for viral culture in patients with meningitis and sepsis to make a definite diagnosis.

Age of Onset↗
PubMed1998

Assessing social integration in employment settings: current knowledge and future directions.

Based on a review of descriptive studies found in the employment literature from 1985 through 1995, we classified empirical measures that have been used to assess the social integration of employees with disabilities. In addition, we aggregated findings that described social interaction patterns in employment and summarized similarities and differences between the interactions of employees with and without disabilities. Ten categories of measures of social interaction were identified, and occurrence of social interaction was found to vary by environmental context and presence of disability. Findings were then compared to those of social skills interventions conducted in the workplace. Although aggregated findings revealed important information about social integration in work settings, critical gaps were found in current knowledge bases.

Adolescent↗
PubMed1998

Symptomatic patent ductus arteriosus in very low birth weight infants.

BACKGROUND: Premature neonatal survival rates have increased significantly. The diagnosis of patent ductus arteriosus (PDA) has also increased. In this paper, we present our experience of incidence, clinical features and outcome of the treatment of symptomatic PDA in very low birth weight infants. METHODS: From January 1990 to December 1995, 181 premature infants with birth weight less than 1,500 g were admitted to the Neonatal Intensive Care Unit (NICU) of Veterans General Hospital-Taipei. Thirty-seven were diagnosed to have symptomatic PDA. By reviewing hospital records, the clinical features and outcome of treatment of these infants were analyzed retrospectively. RESULTS: The incidence of symptomatic PDA was 20.9% and 21.4% in infants with birth weight less than or equal to 1,000 g, 1,001-1,500 g, respectively. The mean age at diagnosis of infants with symptomatic PDA was significantly less than those without symptoms (3.6 +/- 2.9 days vs 9.6 +/- 17.2 days, p = 0.044, 95% CI = 0.2-11.8). With fluid restriction and diuretic therapy, asymptomatic patients had a higher spontaneous ductal closure rate than symptomatic patients (58.3% vs 10.8%, p < 0.001, 95% CI = 17.9-77.1%). Thirty-two (97.0%) infants with symptomatic PDA responded to indomethacin therapy. However, four infants (12.1%) had recurrence. These four infants and a nonresponder received surgical ligation of the PDA and survived. There were four deaths. The reasons for death were respiratory failure in two, sepsis in one and necrotizing enterocolitis with intestinal perforation in one. CONCLUSIONS: Conservative medical management such as fluid restriction and diuretics are often adequate for asymptomatic PDA. However, since symptomatic PDA tends not to close spontaneously, patients should be treated with indomethacin if ductal shunting compromises cardiopulmonary function.

Ductus Arteriosus, Patent↗
PubMed1998

Neonatal myocardial infarction: a case report.

Neonatal myocardial infarction is a rare disorder. It occurs in association with congenital heart disease or coronary artery abnormalities. In the absence of structural heart disease, perinatal asphyxia and coronary artery thromboembolism have been reported as common etiologies. Whether the Coxsackie B viral group has a causal role in adult myocardial infarction remains controversial. We report herein a case of neonatal myocardial infarction without known congenital heart disease, in whom perinatal Coxsackie B viral infection was suspected to be the underlying cause. However, definite evidence indicating a causal relationship between neonatal myocardial infarction and Coxsackie B viral infection was lacking in this case.

Adult↗
PubMed1998

Metabolism of carvedilol in dogs, rats, and mice.

The excretion and biotransformation of carvedilol [1-[carbazolyl-(4)-oxy]-3-[(2-methoxyphenoxyethyl)amino]-2-p ropanol], a new, multiple-action, neurohormonal antagonist that exhibits the combined pharmacological activities of beta-adrenoreceptor antagonism, vasodilation, and antioxidation, were investigated in dogs, rats, and mice. Carvedilol was absorbed well, and biliary secretion was predominant in each species. Carvedilol was metabolized extensively in each species, and elimination of unchanged compound was minor in bile duct-catheterized rats and dogs. In dogs, glucuronidation of the parent compound and hydroxylation of the carbazolyl ring, with subsequent glucuronidation, were the major metabolic pathways. Rats showed the simplest metabolite profile; the primary metabolites were formed by hydroxylation of the carbazolyl ring, with subsequent glucuronidation. Mice displayed the most complicated metabolite profile; glucuronidation of the parent compound and hydroxylation of either the carbazolyl or phenyl ring, with subsequent glucuronidation, were the major metabolic routes. O-Dealkylation was a minor pathway in all species examined.

Adrenergic beta-Antagonists↗
PubMed1998

Experiences with high-frequency oscillatory ventilation in premature infants with respiratory distress syndrome.

BACKGROUND: High-frequency oscillatory ventilation (HFOV) has been used in treating premature infants with respiratory distress syndrome who have a low incidence of ventilation-associated lung injury. Herein, we report our initial clinical experience in using HFOV to treat such infants. METHODS: From October 1996 to February 1997, 10 premature infants with severe respiratory distress syndrome treated with HFOV were retrospectively evaluated. Clinical course and laboratory data collected during treatment were analyzed. Parameters evaluated included patient survival rate, incidence of chronic lung disease and morbidity associated with HFOV usage. RESULTS: The mean gestational age was 29 +/- 2 weeks; mean birth weight, 1,182 +/- 342 g; and mean period of HFOV treatment, 3.4 +/- 1.9 days. One patient died of sepsis due to infective pancarditis. Two patients developed moderate chronic lung disease at 30 days post delivery and in one of these patients, the disease persisted at 36 weeks' of age. The overall survival rate was 90%. No patient developed air-leak syndrome during the course of treatment. CONCLUSIONS: Our initial experience demonstrated that using HFOV in treating premature infants with severe respiratory distress syndrome was safe and effective. The incidence of moderate to severe chronic lung disease or air-leak syndrome following HFOV was low.

Female↗
PubMed1997

Structure and expression of two cDNAs encoding S-adenosyl-L-methionine synthetase of rice (Oryza sativa L.).

Two cDNAs encoding rice (Oryza sativa L.) S-adenosyl-L-methionine synthetase (SAMS) have been cloned, sequenced and identified. The deduced protein sequences share a high homology (90-94%) with those of other plant SAMS and are 60-62% identical to yeast, rat and human SAMS. The rice SAMS genes are differentially regulated in a tissue-specific manner and by a salt stress, while they are coordinately expressed during growth of the rice cell culture.

Amino Acid Sequence↗
PubMed1997

Changes in plasma levels of lipids and lipoprotein composition in patients with Kawasaki disease.

Studies on the response of plasma lipids and lipoproteins to Kawasaki disease are scarce so far. The purpose of this study was to investigate the changes in plasma levels of lipids and apolipoproteins as well as the composition of different lipoproteins in patients during the acute and convalescence phases of Kawasaki disease. The results showed that during the acute phase, the concentrations of plasma high density lipoprotein (HDL)-cholesterol, apolipoprotein A-I (apoA-I) and A-II (apoA-II) were significantly reduced. While the reduction of HDL-cholesterol was mainly related to the lowering of esterified and unesterified cholesterols in HDL2 during the acute stage of Kawasaki disease, most of which recovered during the subsequent convalescence phase. The plasma concentration of triglycerides was 46% higher in patients during the acute phase of Kawasaki disease than in the control subjects, which may be ascribed to the increase of triglycerides in very low density lipoprotein (VLDL), low density lipoprotein (LDL) and HDL2. The variables studied above did not appear to be independent parameters. The level of plasma apoA-I showed a stronger negative association with triglyceride concentration (r = -0.22) than apoA-II (r = -0.11) and HDL-cholesterol (r = -0.07). Furthermore, the levels of cholesterol, apoA-I and apoA-II in HDL2, but not in HDL3, were inversely correlated with the levels of triglyceride. We conclude that the temporary changes of lipid levels associated with Kawasaki disease results predominantly from alterations of lipoprotein composition.

Apolipoproteins↗
PubMed1997

XTT-colorimetric assay as a marker of viability in cryoprocessed cardiac valve.

This study sought to evaluate the use of tetrazolium salt XTT reduction as an indicator of valvular viability in a cryoprocessed porcine cardiac homograft model. The XTT tetrazolium assays was based on the metabolic reduction of Sodium 3'-[1-(phenylamino-carbonyl)-3,4-Tetrazolium]-bis(4-methoxy-6-nitro) benzene sulfonic acid hydrate. The relationship between XTT reduction and: (1) leaflet tissue with various weight (n = 24); (2) morphometric evaluation (n = 30); (3) cadaveric ischemic intervals (n = 30); (4) freeze-thawing (n = 30) has been studied. The measurement of XTT reduction were significantly correlated with the weight of cardiac leaflets, in the range of 30 to 180mg (y=0.015x-0.063; r=0.99). Compared to morphometry of valvular damage, the reduction of mitochondrial enzymatic activity in cardiac leaflets was correlated with matrix cells without irreversible damage (r=0.89, P<0.005). The depletion of XTT reduction occurred dependent of ischemic time intervals. In general, freeze-thawing reduced more than 20% activity of mitochondrial dehydrogenase. We concluded that XTT tetrazolium assay is highly sensitive to determine valvular injury. The study demonstrated its potential for testing of cryopreserved cardiac valve.

Animals↗
PubMed1997

Evaluation of the severity of illness in infants by the Baby Check Score.

BACKGROUND: The Baby Check Score System was developed for the measurement of severity of illness for infants less than six months of age. The purpose of this study was to evaluate the clinical application of the system in Chinese infants. METHODS: A prospective study was carried out in 134 of 495 babies who were brought to the emergency room of Veterans General Hospital (VGH)-Taipei from April 1992 to July 1992. The on-duty interns scored each baby, and the on-duty residents graded the severity of illness in ignorance of the score. Two senior pediatricians reviewed the medical records retrospectively, in ignorance of the score or the on-duty resident's gradings. RESULTS: The concordance between the score and the senior pediatricians' gradings was similar to that between the on-duty residents and senior pediatricians. The sensitivity of a score of 13 or more was as sensitive as the on-duty residents in identifying moderately or seriously ill babies. The specificity of a score of 0 to 12 was similar to that of the on-duty residents' gradings in identifying well or mildly ill babies. CONCLUSIONS: The Baby Check Score System is as reliable as a junior doctor in judgement of illness severity and it can be used as an adjunct assessment in the evaluation of the severity of illness in Chinese infants under six months of age.

Humans↗
PubMed1997

Aortic stenosis in children: 19-year experience.

BACKGROUND: In the Taiwanese literature, few articles describe the pertinent features of aortic stenosis (AS). This study explores the features of AS in Chinese children. METHODS: 3808 children with congenital heart diseases have undergone cardiac catheterization at our institution over the past 19 years. Among them, 51 (1.3%) cases were AS. The clinical, electrocardiographic, echocardiographic and catheterization findings, the methods of treatment and outcomes were reviewed. RESULTS: Valvular AS occurred in 39 children (76.5%), subvalvular AS in 5 (9.8%), and supravalvular AS in 7(13.7%). Male was predominant (M/F ratio, 2.6) except in supravalvular type. Forty-three patients had associated cardiovascular defects. Aortic regurgitation (AR) was the most common one. Most patients (56.9%) were asymptomatic. Classic symptoms included exertional dyspnea (17.6%), syncope (9.8%), and chest pain (7.8%), etc. Left ventricular hypertrophy was noted in 31.2% of cases. The mean duration of follow-up was 3.9 +/- 3.4 years. Ten patients received open-heart surgery and 2 received balloon dilation. The pressure gradients across the stenotic area dropped from 95.3 +/- 29.3 to 51.4 +/- 35.8 and 53.1 +/- 12.3 mm Hg in early and late Doppler follow-up studies, respectively (p < 0.05). The average gradient increased from 36.9 +/- 25.3 to 40.8 +/- 32.6 mm Hg in nonsurgical patients. The result was insignificant. No mortality occurred following open-heart surgery. One child expired due to heart failure after the ligation of the patent ductus arteriosus and dilation of the stenotic aortic valve on the surgical table under general anesthesia. Autopsy revealed valvular rupture. In the nonsurgical group, no mortality occurred, but one patient was brought home by parents in critical condition and later died. CONCLUSIONS: We found that some clinical features of AS in Chinese children were different from those in occidental populations. (1) The incidence of AS was relatively low. (2) Subvalvular AS was the least common type in contrast to supravalvular AS in western studies. (3) Male predominance was not present in the supravalvular type, which lacked sexual proclivity. (4) Williams syndrome was a more frequently associated anomaly. Turner syndrome was not present in our study. (5) Isolated AS was less frequent. (6) The unusual finding such as right ventricular hypertrophy on EKG was present due to associated cardiac anomalies. Open-heart surgery is effective and safe, but the efficacy of balloon dilation requires further investigation.

Adolescent↗
PubMed1997

Malignant epithelial neoplasm consistent with primitive cystic hepatic neoplasm with mesothelial differentiation: a case report.

Mesothelioma are primary tumors of the celiomic cavity and are seen more often in adults than in children: only an estimated 2-5% of all cases present within the first two decades of life. To best knowledge of the reviewing world literature reported to date, no more than 80 proved cases of this tumor have occurred in children. One-third of mesothelioma originate in the peritoneum and two-thirds arise in the pleural cavity. Mesothelioma of the liver are extremely rare; a review of the English literature shows only three adult cases that have been reported as fibrous mesothelioma of the liver; experience with these cases suggests a high potential for recurrence, but no progression to malignancy. Cystic mesothelioma occur mainly in adults and are considered to be benign and curable. We describe a case of malignant epithelial neoplasm consistent with primitive cystic hepatic neoplasm with mesothelial differentiation arising in a 3-year-old boy, a condition which has never before been reported in childhood. Malignant primitive cystic mesothelioma is possible that some cases of intraabdominal mesenchymoma or hamartoma with malignant differentiation may have been misdiagnosed in the past; future cases should be fully evaluated, to establish the true incidence of mesothelioma disease in children.

Child, Preschool↗
PubMed1996

Stomach rupture associated with physical struggle in a child.

A 5-year-old girl with spontaneous rupture of the stomach was treated successfully with excision of the ischemic edges of the perforation with primary repair. In this case, vigorous resistance against medical measurement resulted in rupture of the stomach, which was already distended with a large amount of fluid and air. The child survived following immediate surgical intervention and intensive postoperative care.

Child, Preschool↗
PubMed1996

The clinical evaluation of an outbreak of aseptic meningitis in children.

BACKGROUND: Aseptic meningitis is a common disease in children; The present report describes the clinical and laboratory studies of 62 children involved in an outbreak of aseptic meningitis. METHODS: Sixty-two children with aseptic meningitis having been hospitalized from February to June 1993 were evaluated. The clinical data were obtained by review of the medical records. Initial cerebrospinal fluid (CSF) laboratory values were recorded, and CSF specimens were submitted to determine the viral etiology. RESULTS: Thirty-three percent of the cases were aged 2-5 years. Echovirus 30 was isolated from CSF specimens in 17 children, this is the only virus isolated from CSF during this period. The illness was characterized by transient fever, headache and vomiting. There was wide variation in the number of leukocyte from 14 to 2333 cell/mm3 in the spinal fluid. CSF protein ranged from 19 mg/dL to 114 mg/dL, and CSF sugar was normal in all specimens. Virus isolation was related to the cell count in CSF. There was no significant relationship between CSF cell count and protein content (r = 0.162, p = 0.2237). Hospital stay ranged from 1 to 14 days with an average of 3.9 days. CONCLUSIONS. The disease was mild and self-limiting without death or complication. Enterovirus isolation from CSF can substantially establish the diagnosis and the subsequent management, therefore, early discharge is expectable.

Adolescent↗
PubMed1996

A clinical observation of term infants with critical cardiovascular disorders.

BACKGROUND: Cardiovascular disorders are known to be the major causes for infants requiring intensive care. The consequences of the treatment given to these infants suffering from congestive heart failure and/or cyanosis need to be evaluated. METHODS: A total of 210 infants both at term suffering from critical cardiovascular problems were hospitalized in the pediatric and neonatal ICU between July 1990 and December 1993. The etiology, clinical data, emergency procedures and outcomes of infants with or without congestive heart failure or cyanosis were analyzed. RESULTS: Congenital cardiac defects were the most common cause of critical cardiovascular disorders in infancy. These included ventricular septal defect in 42 (20%), Tetralogy of Fallot in 22 (10.5%), Dtransposition of the great arteries in 20 (9.5%) cases, etc. The most common symptoms and signs observed were congestive heart failure in 162 (77.1%) and cyanosis in 137 (65.2%) cases. In spite of aggressive medical and surgical treatments, the outcomes were still unsatisfactory. The mortality rate was found to be the same in infants with or without congestive heart failure, but was significantly higher in infants with cyanosis than in those without cyanosis, after operation (28.5% vs 5.5%, p < 0.05). CONCLUSIONS: Infants suffering from critical cardiovascular disorders need urgent medical and surgical treatments in intensive care units. In spite of treatment, the outcomes are still unsatisfactory.

Female↗
PubMed1996

Determination of the food specific IgE antibodies: comparison of MAST-CLA and CAP systems.

BACKGROUND: This study was carried out to compare two techniques used to determine the food specific IgE antibody. METHODS: Thirty-four allergic patients were evaluated for most common food IgE antibodies by multiple allergosorbent chemiluminescent assay (MAST-CLA). IgE antibodies to eight of these food allergens were also measured by Pharmacia CAP (CAP) test. RESULTS: The food specific IgE showed good agreement between MAST-CLA and CAP (kappa = 0.3-0.77). The sensitivity of MAST-CLA assay for food specific IgE antibody was variable comparing with that of CAP system. The accuracy ranged from 0.76 to 0.97. The agreement between the results of MAST-CLA and skin test was variable (kappa = 0.03-0.58). The agreement was poor in wheat, peanut and soybean (kappa = 0.03-0.12). Similar result between CAP and skin test was also obtained (kappa = 0.06-0.82). The agreement was poor in wheat (kappa = 0.06) and milk (kappa = 0.15). CONCLUSIONS: Different results might be related to quality of the extract, how they are performed in vitro test and difference of correspondent allergens employed in the tests.

Adolescent↗