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Biomedical subjects

B Hwang

Publications and source records attributed to B Hwang.

At least 91 records · Page 5Linked to original sources
PubMed1994

Hemophilia A presenting with intracranial hemorrhage in neonate: a case report.

Intracranial hemorrhage (ICH) in a neonate is an uncommon presentation of hemophilia. Its occurrence is invariably preceded by mild-to-moderate head injury, unlike adult hemophiliacs in whom ICH occurs without prior head injury in half the cases. The bleeding event may follow a minor injury of labor (eg, prolonged second stage of labor or the use of forceps). In a recent experience at our hospital, a 6 D/O male baby with hemophilia A presenting with ICH after traumatic delivery was later found to have factor VIII deficiency. We suggest that prenatal management for suspected cases should take family history of bleeding disorders and carrier testing into consideration. Any term neonate with ICH should eliminate the possibility of hemophilia until proved otherwise. Some specific diagnostic and therapeutic recommendations to assist the clinician to evaluate an infant with ICH and prolonged PTT are discussed.

Cerebral Hemorrhage↗
PubMed1993

Continuous positive airway pressure by nasal prongs in bronchiolitis.

Ten infants with evidence of impending respiratory failure from severe bronchiolitis were successfully treated with continuous positive airway pressure (NCPAP) with double nasal prongs. Their mean (SD) age was 6.7 (3.8) months and mean (SD) body weight was 7.1 (2.1) kg. Respiratory assessments were made immediately before and 2 hours after application of NCPAP. Clinical symptoms, signs, and arterial blood gases improved in all patients, with a significant fall in mean (SD) respiratory rate [71 (6) vs. 54 (9) per minute], mean (SD) heart rate (178(9) vs. 154(15) per minute], and mean (SD) partial pressure of arterial carbon dioxide [Paco2; 48.0 (13.9) vs. 42.4 (12.9) mmHg]. There was a significant rise in mean (SD) arterial blood pH [7.33 (0.05) vs. 7.37 (0.05)] and mean (SD) oxygenation ratio [Fio2/Pao2, 155 (25) vs. 175 (22)]. We believe NCPAP is an effective method, with numerous advantages in the treatment of severe bronchiolitis. Early application of NCPAP is suggested to avoid the need for mechanical ventilation.

Bronchiolitis↗
PubMed1993

Preirradiation chemotherapy for very young children with brain tumors.

Standard management of malignant brain tumors includes either surgical resection alone or surgery followed by irradiation. However, neuroaxis irradiation administered to very young children for primary intracranial tumors is often associated with major late side effects. To delay irradiation and evaluate the efficacy of preirradiation chemotherapy, we treated 9 young children (aged less than 3 years), who had newly diagnosed brain tumors and underwent total or subtotal resection, with a combination of chemotherapy including vinblastine, cisplatin, and etoposide every 3-4 weeks for 6-14 courses between 1988 and 1992. There were malignant gliomas in four patients, medulloblastomas in three, and ependymomas in two. A response to preirradiation chemotherapy (complete remission or partial remission) occurred in seven out of nine cases. Only one patient had progressive disease during the chemotherapy period. Preirradiation chemotherapy with vinblastine, cisplatin, and etoposide might be a highly effective combination allowing delay of radiation therapy in very young children with brain tumors. Acute and subacute toxicity of chemotherapy in this study was mild.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Cytokines predict coronary aneurysm formation in Kawasaki disease patients.

In this study, we measured serially the serum levels of cytokines including interleukin-6 (IL-6), IL-8, soluble IL-2 receptor (sIL-2R) and tumour necrosis factor alpha (TNF-alpha) in 60 patients with Kawasaki disease (KD) and evaluated the clinical significance of these cytokines in predicting coronary aneurysm formation. Of the 60 patients, 12 were complicated with coronary aneurysm. Blood samples were collected within the 1st week after onset of fever, then once a week for the 1st month, and once a month for another 5 months. The serum levels of IL-6, IL-8, sIL-2R and TNF alpha were measured using an ELISA or RIA method. Our results show that the changes in serum IL-6 and IL-8 were faster than those of sIL-2R and TNF alpha. Within the 1st week, the serum levels of IL-6 and IL-8 were significantly higher in the patients with than in those without coronary aneurysm (P < 0.001). In addition, the serum levels of IL-6 and IL-8 obtained in the 1st week were highly correlated (P < 0.001) with those of C-reactive protein and erythrocyte sedimentation rate, and the serum levels of sIL-2R and TNF alpha were also increased at the 1st week reaching the highest level in the 2nd week. In the 2nd week, the serum levels of sIL-2R and TNF alpha were significantly higher in the patients with than in those without coronary aneurysm (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1993

[Comparison of food specific IgE antibody test (RAST) and skin tests in children with atopic dermatitis].

Thirty children with atopic dermatitis were enrolled in our study to evaluate the food specific IgE antibody assay (RAST) and skin tests as a screening test for food hypersensitivity. Our results showed that eight food antigens (fish, shrimp, crab, soybean, milk, egg-white, peanut, wheat) frequently elicited positive hypersensitivity reactions. Twenty-four patients had at least a positive skin reaction to one of the foods tested. Of the 240 skin tests, 30% (72/240) yield positive reactions. Eighteen patients had at least a positive RAST reaction to one of the foods tested, 20.9% (50/240) yield positive reaction. The agreement between skin test and RAST was 79.6%. Crab and shrimp accounted for most frequent positive reaction in both tests. The skin tests produced more positive results in skin testing than RAST, but gave a higher frequency of false positive results. The diagnosis of food allergy may be suspected from the medical history or by food specific IgE antibodies together with skin test as a screening test. Furthermore, the double blind placebo controlled food challenge should be considered as standard for clinical investigations.

Adolescent↗
PubMed1993

Hemolytic impact of central venous catheters on fresh whole blood.

An in vitro study was conducted to determine the degree of hemolysis of fresh whole blood, transfused at rates of 10, 20, and 40 ml per hour through three different sizes of central venous catheters by using the same piston-type syringe pump. The catheter lengths were 20 cm, 30 cm and 30 cm; the intraluminal calibers were 0.18 mm, 0.30 mm and 0.51 mm, respectively. A total of 20 healthy volunteers were enrolled as blood donors. Nine 20-ml aliquots of fresh whole blood were obtained from each donor. These samples were assigned to infuse through nine infusion combinations of three different-gauge catheters with each of three different speeds. Three hemolysis parameters which included red blood cell counts, hematocrit and plasma potassium of the effluent were measured and compared with those of the controls (preinfusion). The results showed no significant hemolysis during passage through any infusion system. It was concluded that fresh whole blood may be transfused at regular rates through these three fine-bore central venous catheters without fear of hemolysis.

Blood Transfusion↗
PubMed1993

Acute pancreatitis in association with L-asparaginase therapy: report of one case.

L-asparaginase has been used clinically for treatment of a wide variety of pediatric neoplastic diseases (e.g. acute lymphocytic leukemia, malignant lymphoma, etc.) A 14-year-old female patient, is a victim of acute lymphocytic leukemia, Pre T type. She got acute pancreatitis after the L-asparaginase therapy. We reported her clinical course and our management. It is concluded that early diagnosis of pancreatitis is usually difficult, because the symptoms are vague, physical findings may be minimal, and laboratory studies are frequently inconclusive until the injury is severe. Therefore, physicians must be cautious to the patient's chief complaint before administering the next dose of L-asparaginase, because it may occur more earlier than the laboratory or image studies and thus could be used to predict pancreatitis.

Acute Disease↗
PubMed1993

[Maturation of ganglioneuroblastoma to ganglioneuroma: a case report].

A 1 year and 7 months old girl had suffered from chronic diarrhea for 6 weeks. A huge abdominal mass was found. She received subtotal resection of the tumor and the histological picture showed ganglioneuroblastoma. Then, 12 courses of chemotherapy (including cyclophosphamide, doxorubicin cisplatin and etoposide) were given for 8 months, but the residual tumor mass over the previous surgical area was still noted by CT scan. A second excision of the tumor was performed and histology showed a picture of ganglioneuroma incidentally. Chemotherapy was discontinued. The patient is still alive and well for more than one year.

Abdominal Neoplasms↗
PubMed1992

Virus-like particles with reverse transcriptase activity associated with Kawasaki disease.

To investigate the etiologic agent associated with Kawasaki disease (KD), we initially established a cocultivation system using concanavalin A (Con A)-stimulated lymphoblastoid cells obtained from each retrovirus-seronegative individual's peripheral blood mononuclear cells (MNCs) cocultivated with each of 1) 40 patients with KD, 2) 10 patients with other viral infection and skin rash, and 3) 10 age- and sex-matched normal controls. Five major findings suggested that virus-like particles with reverse transcriptase (RT) activity are associated with KD. First, RT activity appeared significantly higher on day 12 after the onset of fever in the KD patients than in those with other viral infections and normal controls (dTMP incorporation: 3,645 +/- 248 vs. 434 +/- 50 vs. 412 +/- 46 cpm, P < 0.0001). Second, the RT activity was not endogenous, because the Con A-stimulated lymphoblastoid cells were obtained from the individuals who were negative for retrovirus. Third, virus-like particles (80-100 nm in diameter) by electron microscopy were found in the concentrated pool supernatants of particulate fraction containing RT activity subjected to sucrose density gradient, obtained from KD patients. Fourth, the viral product, a 31.4 kilodalton molecule, was detected by SDS-PAGE after internal labelling (methionine-S35) and density gradient centrifugation. Fifth, using a "retrovirus universal pol gene region" as a primer and the RT-PCR method, a retrovirus-specific band was detected in the cocultivated supernatants obtained from four KD and one AIDS patients but not in patients with rubella or in healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Base Sequence↗
PubMed1992

Serial changes of serum interleukin-6, interleukin-8, and tumor necrosis factor alpha among patients with Kawasaki disease.

To determine the role of cytokines in Kawasaki disease, serial measurements of serum cytokine levels were done in 60 patients treated solely with aspirin. Coronary artery aneurysms later developed in 12 of them. The results suggest that elevated serum interleukin-6 and interleukin-8 levels during the first week of illness may be associated with a higher risk of coronary aneurysm formation.

Aspirin↗
PubMed1992

Preparation of monoclonal antibodies against acid alpha-D-glucosidase for study of Chinese glycogenosis type II patients.

Two monoclonal antibodies (Mabs), 8-23 and 4-6, against human acid alpha-D-glucosidase were generated to analyse the intracellular alpha-D-glucosidase from seven Chinese Pompe's disease families with the following study design: [1] Purified alpha-D-glucosidase from normal human urine was used as antigen for immunization of mice. [2] The splenic cells of immunized mice were isolated and fused with myeloma cells NS-1 for generation of hybridomas and production of anti-human alpha-D-glucosidase Mabs and detection of presence of the enzyme in skin fibroblasts obtained from the Pompe's disease families and normal controls. [3] Functional assay of acid alpha-D-glucosidase was done. Both generated Mabs were IgG1 with a kappa light chain. Mabs 8-23 and 4-6 can recognize 70 kd (kilodaltons) alpha-D-glucosidase evidenced by radioimmunoprecipitation (RIP). Our results showed that alpha-D-glucosidase did exist in the skin fibroblasts of all seven Pompe's disease patients by RIP and in the hepatic cells by immunohistological study. However, functional assay of alpha-D-glucosidase of the seven patients with Pompe's disease showed that the enzyme function of alpha-D-glucosidase was defective. This finding is at variance with the results of other workers which indicated that the amount of mature enzyme was reduced or totally absent in most of the juvenile and adult Caucasian and South African patients. The discordance may imply that the cause of alpha-D-glucosidase deficiency in Chinese patients is quite different from that in Caucasian and South African patients. This needs further study to clarify.

Animals↗
PubMed1992

Importance of spontaneous closure of the ventricular part in atrioventricular septal defect.

The clinical features, hemodynamic changes and prognosis of 21 children with simple atrioventricular septal defect (3 associated with patent ductus arteriosus) were studied during a follow-up period of 1 month to 13 3/12 years (median 3 years). Six patients had spontaneous closure of the ventricular part of the defect within 22.2 +/- 27.7 months (Group I). The symptoms and signs of failure to thrive, frequent respiratory tract infections and congestive heart failure were more common in patients without spontaneous closure of the ventricular part of atrioventricular septal defect (Group II) than in patients in Group I. The Qp/Qs ratio, pulmonary vascular resistance and pulmonary to systemic resistance ratio were also higher in Group II than in Group I. In spite of a higher postoperative mortality rate and a higher incidence of transient complete heart block, the children in Group II also had a significantly higher (p less than 0.005) preoperative mortality rate than those in Group I. In conclusion, if the ventricular part of the atrioventricular septal defect closed or was closing spontaneously, symptoms and signs were less severe and there was a better prognosis.

Child↗
PubMed1992

Evaluation of a once-a-day theophylline preparation in asthmatic children.

We conducted a study to evaluate the serum theophylline concentrations and dose interval of Theolan preparation in asthmatic children. A series of serum theophylline levels were measured both in 10 asthmatic children taking Theolan once a day and 9 children twice a day. In the once-a-day group, the peak serum theophylline level was greater than 20 micrograms/ml; whereas, in the twice-a-day group, it was mostly between 10 and 20 micrograms/ml. The difference of the peak-to-trough was more fluctuant in the once-a-day group than in the twice-a-day group. These results suggest that Theolan given once a day in the evening can be useful in the management of nocturnal asthma; however, it was difficult for once-a-day administration of Theolan to sustain rigid therapeutic serum theophylline levels. Because of rapid metabolism in children, they may require a more frequent interval than once-a-day dosing to suppress the symptoms of chronic asthma.

Asthma↗
PubMed1992

[The interrelationship between the O2-dependent bactericidal mechanism and hyperbilirubinemia of newborn].

In order to investigate the influence of indirect bilirubin to O2-dependent bactericidal mechanism in adult and newborn phagocytes we use the NBT reduction activity of granulocytes and monocytes as index, by infiltrated granulocytes and monocytes in different concentration of indirect bilirubin with or without latex stimulator. The NBT reduction activity of granulocytes infiltrated in 20 mg/dl indirect bilirubin will increase slightly, compared to uninfiltrated; but with latex stimulator, the increment will decrease significantly, this change is reversible, when indirect bilirubin be washed, the stimulating capacity by latex stimulator in granulocyte will be stronger; there were no such change pattern in monocytes. Since there were a big difference in NBT reduction activity of granulocytes and monocytes between newborns, with or without latex stimulator, we can't get a satisfied result. Indirect bilirubin in cells will increase NBT reduction activity of monocytes, but not in granulocytes.

Adult↗
PubMed1992

Superior vena cava syndrome in children with malignancy: analysis of seven cases.

Superior vena cava syndrome (SVCS) is rare in children. In Veterans General Hospital-Taipei, a total of 364 cases of SVC syndrome were diagnosed in the past 12 years. Of them only seven cases were younger than 18 years of age, ranging from 6 to 17 years, and they were all caused by mediastinal tumor. The underlying malignancy included malignant lymphoma in 4, teratocarcinoma in one and unknown in 2. The most common initial symptom was cough, followed in order of frequency by chest discomfort or neck mass. Dyspnea, orthopnea, swelling of head and neck, and venous engorgement might develop gradually within one to three weeks. Of the reported seven cases, two cases received immediate resuscitation upon arrival but expired in 1-2 hours. The other five cases received treatment with intravenous steroid as well as chemotherapy, and three cases also received committent emergent radiotherapy. Two of them expired 4 months and 2 years after treatment, respectively. Of the two surviving cases, one has received a complete course of chemotherapy and the other is still under regular chemotherapy in our hospital. Both of them are stable till now.

Adolescent↗
PubMed1991

The changes of interleukin-2, tumour necrotic factor and gamma-interferon production among patients with Kawasaki disease.

Included in this study were 43 cases of mucocutaneous lymph node syndrome (MCLS or Kawasaki disease) treated solely with aspirin. Of these, 19 developed coronary aneurysm. Mononuclear cells (MNC) of these MCLS patients were collected weekly and stimulated either with phytohaemagglutinin (PHA) or PHA plus phorbol myristic acetate. The production of interleukin-2 (IL-2), tumour necrotic factor (TNF) and gamma-interferon (IFN-r) was determined. In addition, IL-2, TNF, IFN-r from serial collections of serum samples of these patients were also measured. The results show that serum IL-2 and TNF were detected in the 1st week, reached maximal plateau in the 2nd and 3rd week and decreased 1 month later. The production of IL-2, TNF and IFN-r from MCLS patients' MNC increased from the 1st to the 3rd week, persisted at a high level for 1 month and then decreased. During the 2nd and 3rd weeks, there were significantly higher serum IL-2 levels and IL-2 production in patients with than in patients without coronary lesions. These observations suggest that the serum IL-2 level and IL-2 production during the 2nd week may serve as a predictive parameter for coronary aneurysm formation. It also suggests that the production of TNF, IL-2 and IFN-r from MNC may contribute to the development of vascular injury in acute MCLS.

Child↗
PubMed1991

Heparinization of blood decreases ionized calcium concentration.

To evaluate whether heparin in the plasma sample may affect the ionized calcium level, we compared the ionized calcium levels of blood samples of three different heparin concentrations in 25 normal healthy volunteers: Group A contained no heparin (control group); Group B contained 4.7 IU/ml heparin; and Group C contained 37.5 IU/ml heparin. The result showed ionized calcium to be 4.99 +/- 0.28 mg/dl (Mean +/- SEM) in group A; 4.64 +/- 0.26 mg/dl (Mean +/- SEM) in group B and 4.25 +/- 0.24 mg/dl (Mean +/- SEM) in group C. These three values were significantly different (p less than 0.001). So, heparin might artificially lower the plasma ionized calcium concentration. It is concluded that: (1) samples for accurate ionized calcium measurement should contain no heparin; and (2) in spite of the careful measurement by conventional technique, an introduction of an excessive amount of heparin into the deadspace of the syringe may significantly reduce the ionized calcium concentration.

Adult↗