Biomedical subjects

D Goh

Publications and source records attributed to D Goh.

21 records · Page 2Linked to original sources

PubMed1991

Transcranial Doppler (TCD) ultrasound as a noninvasive means of monitoring cerebrohaemodynamic change in hydrocephalus.

Cerebral blood flow velocity (CBFV) measurements by Transcranial Doppler (TCD) ultrasound were performed on 27 patients with hydrocephalus (Group I: neonates, Group II: children). Simultaneous measurements of direct ICP and CBFV were performed during ventricular taps in 16 patients. There was a significant correlation between ICP and Resistance Index (RI = peak systolic-end distolic/peak systolic velocity) overall in Group II patients (p less than 0.02) and in individual neonatal patients (p less than 0.001). After ventricular taps and ventriculo-peritoneal shunting (17 patients) there was a consistent significant decrease in RI due to increased end diastolic velocity in all patients (p less than 0.001). This suggests the RI is a reliable index of cerebrovascular resistance for serial monitoring in individual patients. There was an exponential pattern of decay in RI with CSF volume depletion (volume-flow velocity response) in 50/56 taps which allows calculation of a volume-buffering reserve before perfusion change occurred. Simultaneous ICP/CBFV monitoring during sleep may help to identify patients who are unable to compensate haemodynamically during episodic increase in ICP and are a greater risk of ischaemic insult. TCD is a useful noninvasive technique of monitoring cerebrohaemodynamic change for initial assessment and further management of children with hydrocephalus.

Adolescent↗

PubMed1991

Changes in psychosocial adjustment after renal transplantation.

The psychological aspects of transplantation were studied in 29 children and adolescents with functioning renal transplants. Most parents rated their child's physical health as considerably improved after transplantation. They also noted improvements in the child's behaviour and in the quality of family life. When compared with a sample of children being treated by hospital haemodialysis, children who had received transplants had more favourable parental views of behavioural and emotional adjustment, better parental psychiatric adjustment, and indications of superior child rated mood, self concept, and social functioning. Children who had received transplants did, however, show an increase in minor behavioural symptoms compared with healthy controls, and most parents required continuing psychological and social support as well as attention to physical aspects of the child's condition. Kidney transplantation is associated with improved psychosocial behaviour in children, but there is a continuing need for support for parents in dealing with minor psychological problems after the transplant.

Adaptation, Psychological↗

PubMed1989

Cavopulmonary anastomosis as long-term palliation for patients with tricuspid atresia.

Prior to 1970, most patients with tricuspid atresia (TA) and reduced pulmonary blood flow were palliated by means of a systemic to pulmonary artery shunt (SPAS). In Birmingham between 1967 and 1988, 19 patients with TA (aged 16 days to 23 years, mean 3.8 years) have undergone side-to-side cavopulmonary anastomosis (CPA) with preservation of pulmonary artery continuity. One had undergone a previous right Blalock-Taussig shunt and in 1 patient with left and right SVCs, bilateral CPAs were performed. Nine patients were less than 1 year old at the time of operation. There were no operative deaths. One late death occurred due to pneumonia. Immediate clinical improvement occurred in all cases. Six symptomatic patients subsequently required further surgery (mean interval between operations 8.9 years, range 4.6-14.2 years). The remaining 12 patients have recently been reviewed. Mean follow-up was 9.5 years (range 5 weeks to 21 years). Exercise tolerance remains good (9 in NY-HA Class 1 or 2) and resting transcutaneous oxygen saturations are higher (mean 85%, range 70%-89%) compared with preoperative values (P less than 0.01). In small children, CPA avoids the complications of SPAS and, in some patients, may itself achieve adequate long-term definitive palliation.

Adolescent↗