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Biomedical subjects

Donald Liu

Publications and source records attributed to Donald Liu.

9 recordsLinked to original sources
PubMed2006

A high prevalence of methicillin-resistant Staphylococcus aureus among surgically drained soft-tissue infections in pediatric patients.

Over the past decade, methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a global problem, prompting extensive surveillance efforts. A previous study of S. aureus isolates at our institution revealed alarming increases in the prevalence of MRSA with no sign of plateau. However, evidence of MRSA in pediatric surgical patients remains largely anecdotal, as there are no published reports of institutional MRSA surveillance in the pediatric surgical literature. We conducted a retrospective review of incision and drainage (I and D) procedures at our institution from 1998 through 2004. All I and D procedures performed at the University of Chicago Children's Hospital were identified and the patients' charts reviewed for pertinent information. A total of 99 I and D procedures were performed during the study period, ranging from 5 in 1998 to 32 in 2004. Among cultures with positive growth, 52 (65.8%) were MRSA, 14 (17.7%) were methicillin-sensitive S. aureus, and 13 (16.5%) were miscellaneous species. The number of MRSA isolates increases from 2 in 1998 to 20 in 2004, the largest increase occurring during the last 3 years of the study. A large proportion of MRSA isolates were resistant to antimicrobials from other classes, with over 70% being resistant to both erythromycin and cefazolin. A majority of MRSA isolates (71.4%) were obtained from patients with no record of prior hospitalization. Our analysis confirms a high prevalence of MRSA among soft-tissue infections requiring surgical drainage. In addition, a majority of MRSA isolates were resistant to multiple antimicrobials and were isolated from children without a previous documented exposure to the hospital milieu. Thus, pediatric surgeons should be aware of MRSA prevalence and resistance patterns in the local communities.

Abscess↗
PubMed2006

Discovery of a novel family of SARS-CoV protease inhibitors by virtual screening and 3D-QSAR studies.

The severe acute respiratory syndrome-associated coronavirus (SARS-CoV) 3C-like protease (3CL(pro) or M(pro)) is an attractive target for the development of anti-SARS drugs because of its crucial role in the viral life cycle. In this study, a compound database was screened by the structure-based virtual screening approach to identify initial hits as inhibitors of SARS-CoV 3CL(pro). Out of the 59,363 compounds docked, 93 were selected for the inhibition assay, and 21 showed inhibition against SARS-CoV 3CL(pro) (IC(50) <or= 30 microM), with three of them having common substructures. Furthermore, a search for analogues with common substructure in the Maybridge, ChemBridge, and SPECS_SC databases led to the identification of another 25 compounds that exhibited inhibition against SARS-CoV 3CL(pro) (IC(50) = 3-1,000 microM). These compounds, 28 in total, were subjected to 3D-QSAR studies to elucidate the pharmacophore of SARS-CoV 3CL(pro).

Binding Sites↗
PubMed2006

Pediatric pelvic fractures: a marker for injury severity.

Pelvic fractures comprise a small number of annual Level I pediatric trauma center admissions. This is a review of the University of Chicago Level I Pediatric Trauma Center experience with pediatric pelvic fractures. This is a retrospective review of the University of Chicago Level I Pediatric Trauma Center experience with pediatric pelvic fractures during the 12-year period from 1992 to 2004. From 1992 to 2004, there were 2850 pediatric trauma admissions. Thirteen patients were identified with pelvic fractures; seven were boys and six were girls. The average age was 8 years old. The mechanism of injury in all cases was motor vehicle related; 11 patients (87%) sustained pedestrian-motor vehicle crashes. According to the Torode and Zeig classification system, type III fractures occurred in eight patients (62%) and type IV fractures occurred in six patients (31%). Associated injuries occurred in eight patients (62%). Seven of these patients (88%) had associated injuries involving two or more organ systems. Of the associated injuries, additional orthopedic injuries were the most common, occurring in 62 per cent of our patients. Neurological injuries occurred in 54 per cent of patients, vascular injuries in 39 per cent, pulmonary injuries in 31 per cent, and genitourinary injuries in 15 per cent. Five patients (38%) were treated operatively; only two patients underwent operative management directly related to their pelvic fracture. The remaining three patients underwent operative management of associated injuries. The mortality rate was 0 per cent. Although pelvic fractures are an uncommon injury in pediatric trauma patients, the morbidity associated with these injuries can be profound. The majority of pelvic fractures in children are treated nonoperatively, however, more than one-half of these patients have concomitant injuries requiring operative management. When evaluating and treating pediatric pelvic fractures, a systematic multidisciplinary approach must be taken to evaluate and prioritize the pelvic fracture and the associated injuries.

Adolescent↗
PubMed2004

Endodontic working width: current concepts and techniques.

Root canal morphology is a critically important part of conventional and surgical endodontics (root canal therapy). Many in vitro studies have recorded the scales and average sizes of root canals, but there have been few clinical attempts to determine the working width. In the absence of a study that defines what the original width and optimally prepared horizontal dimensions of canals are, clinicians are making treatment decision without any support of scientific evidence. This article provides definitions and perspectives on the current concepts and techniques to handle working width-the horizontal dimension of the root canal system-and its clinical implications.

Dental Pulp↗
PubMed2004

C-Reactive protein-determined injury severity: length of stay predictor in surgical infants.

BACKGROUND/PURPOSE: Serum C-reactive protein (CRP) levels reflect the severity of the metabolic response to injury in critically ill children. During this period, caloric overfeeding can increase complications and delay recovery. The authors hypothesized that by avoiding excessive caloric delivery, the effect of injury severity would be the major factor determining clinical outcome. METHODS: Twenty-eight surgical infants who had indirect calorimetry measurements while in the Neonatal Intensive Care Unit between August 2000 and January 2002 were studied. Serum CRP concentrations, mean energy expenditure (MEE), respiratory quotient (RQ), length of hospital stay (LOS), and caloric intake (I) at the time of indirect calorimetry were recorded. Data were analyzed using the Pearson product-moment correlation. RESULTS: Peak serum CRP was significantly correlated to LOS in all patients (r = 0.79, P < .0001). When net caloric balance (I-MEE) did not exceed 5 kcal/kg/d (n = 9), peak serum CRP was correlated positively with RQ (r = 0.66, P = .05). When I-MEE exceeded 5 kcal/kg/d (n = 19), the positive correlation of serum CRP with RQ was diminished (r = 0.23, P = .33). CONCLUSIONS: CRP-measured injury severity is a major determinant of clinical outcome in surgical infants. In addition, overfeeding causes additional RQ elevation.

C-Reactive Protein↗
PubMed2004

Thoracic packing for uncontrolled bleeding in penetrating thoracic injuries.

We present a series of three patients who suffered penetrating thoracic injury, and in whom thoracic packing was used as a life-saving procedure. Survival among these patients paralleled the severity and extent of the original injuries. Restriction of cardiac filling and lung expansion are potential deterrents from using this technique; however, its use seems to be a valid adjunct, especially in the setting of chest wall bleeding coming from the intercostal arteries. Damage control surgery in pentrating thoracic trauma, including thoracic packing, is a sound alternative when uncontrollable bleeding, hypothermia and coagulopathy compromises the survival of a patient.

Adolescent↗
PubMed2004

Delayed hemopericardium after penetrating chest trauma: thoracoscopic pericardial window as a therapeutic option.

A 41-year-old male developed a hemothorax after sustaining a stab wound in the right chest. The patient was managed conservatively with thoracostomy tube drainage for 3 days and was subsequently discharged home. Two weeks later the patient returned to the hospital with pleuritic chest pain and shortness of breath. Imaging studies revealed a right-sided pleural effusion and an enlarged cardiac silhouette, which was consistent with pericardial effusion as per ultrasonography. Thoracoscopic exploration revealed an enlarged heart, that following pericardiotomy drained 400 mL of frank blood. Subsequently, cardiac contractility improved, and no further bleeding was evident.

Adult↗
PubMedDate not supplied

Laparoscopic pyloromyotomy: redefining the advantages of a novel technique.

OBJECTIVE: With recent advances in minimally invasive techniques, many surgeons are favoring laparoscopic over traditional "open" pyloromyotomy for hypertrophic pyloric stenosis. The results of few studies, however, exist in the literature adequately comparing surgical outcome. We present a retrospective analysis of 56 consecutive patients who underwent laparoscopic or open pyloromyotomy. METHODS: A retrospective chart review of 56 consecutive infants (ages: 2 to 9 weeks; weights: 2.2 to 5.4 kilograms) who underwent laparoscopic (Group A-28) vs open (Group B- 28) pyloromyotomy between January 2000 and May 2001 was performed. Preoperative (age, sex, weight, HCO3, and K values) and postoperative (operating time, time to full feedings, persistence of emesis, and hospital stay) parameters were compared. Statistical analysis was performed via the Student t test and chi-square/Fischer analysis where appropriate. A P value <0.05 was considered significant. RESULTS: Preoperative parameters of both groups were similar (P>0.05). In Group A, 26/28 (92.9%) were completed successfully with 2 open conversions. Group A versus Group B average operating times (36.1 vs 32.5 minutes), time to full feedings (24.1 vs 27.0 hours), and hospital stay (2.5 vs 2.6 days) were similar (P>0.05). Persistent vomiting was observed in Group A, 25.0% (day 1)/3.5% (day 2) vs Group B, 39.3% (day 1)/10.7% (day 2). One infant in Group B required operative drainage of a wound abscess 1 week after surgery. CONCLUSIONS: Laparoscopic pyloromyotomy can be performed with similar efficiency and surgical outcome as traditional open pyloromyotomy. Improved cosmesis and avoidance of wound complications are major benefits of this procedure, and a tendency towards less postoperative emesis is a potential benefit that deserves further investigation.

Case-Control Studies↗