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Biomedical subjects

H Y Hung

Publications and source records attributed to H Y Hung.

At least 37 records · Page 2Linked to original sources
PubMed1985

Nephrotic syndrome associated with varicella infection.

A 4-year-old boy developed nephrotic syndrome following varicella infection. Serologic studies during the early phase of the disease demonstrated a decrease in serum C3, C4, and properdin factor B. Renal biopsy revealed an acute proliferative glomerulonephritis with deposition of immunoglobulins A (IgA) and M, C3, C1q, and varicella virus antigen in the glomerulus, suggesting an immune complex deposition. Ultrastructurally, this suggested a postinfectious immune complex glomerulonephritis. These phenomena suggested that varicella virus antigen antibody complexes were deposited in the glomerulus and activated the classic and alternative pathway of complements, leading to an immune complex glomerulonephritis. During the nephrotic phase, an increase in OKT8 cells and decrease of the OKT4 cells were demonstrated. Two months later, this alteration returned to normal as the renal disease was in remission. This change of lymphocyte subsets during varicella infection may play a role in the pathogenesis of nephrotic syndrome.

Antigen-Antibody Complex↗
PubMedDate not supplied

Congenital rickets--a patient report.

We present a premature newborn with congenital rickets, born to a mother with untreated chronic renal insufficiency. X-ray films showed blurred metaphyseal ends and decreased bone density in the femurs and ribs. With treatment including calcium, phosphate, and vitamin D, her rickets healed and she grew normally.

Adult↗
PubMedDate not supplied

Thyroid function in the sick very low-birth-weight infants.

This study was undertaken to determine postnatal changes in thyroid function in very low-birth-weight (VLBW) infants. A total of one-hundred VLBW infants participated. Serial examination of serum levels of thyroxine (T4), free T4, triiodothyronine (T3), and thyroid-stimulating hormone (TSH) was performed in the neonatal period. A total of eighty-nine infants survived to discharge, while eleven died during hospitalization. Transient hypothyroxinemia was found in forty-one (46.1 percent) of the survivors. One of the surviving infants had primary hypothyroidism. His data was excluded from the analysis. In the other eighty-eight surviving infants, TSH levels were within normal limits throughout the six-week study period. T4 and free T4 values decreased after the first day of life, reaching a nadir at one week of age, followed by progressive increases. The mean cord blood T3 level was very low; the serum T3 value increased progressively in the postnatal period. We found a correlation between low T4 and free T4 values and mortality and neonatal illness. Hypothyroxinemia was associated with critical illness. In conclusion, the postnatal changes in thyroid function in VLBW infants were characteristic, with transient hypothyroxinemia being common in these infants. Further investigation of the relationship between thyroid function, death, neonatal illness, and developmental outcome is warranted.

Female↗
PubMedDate not supplied

Congenital varicella syndrome as an unusual cause of congenital malformation: report of one case.

Intrauterine infections with varicella-zoster virus following maternal varicella in early pregnancy and resulting in congenital malformations are rare. Herein we report a child with congenital varicella syndrome characterized by low birth weight, cicatricial scarring, hypoplasia of both lower extremities with joint contracture, congenital hip dislocation, corneal opacity, atresia of the sigmoid colon and a rarely associated cloaca anomaly. The varicella IgG remained positive after she was seven months old. Her mother developed chickenpox at the 14th week of gestation. The purpose of this article is to raise pediatricians' index of suspicion for congenital varicella syndrome when an infant is born with multiple congenital malformations with an apparent history of maternal varicella infection.

Abnormalities, Multiple↗
PubMedDate not supplied

Kawasaki disease with Reye syndrome: report of one case.

A seven-month-old girl was admitted to the Pediatrics Department of Mackay Memorial Hospital with the following symptoms and signs: (1) high fever for more than five days; (2) injection of bilateral conjunctiva; (3) bright red lips with strawberry tongue; (4) edematous change of palms and soles, followed by digit desquamation; (5) an ill-defined, erythematous plaque on the scar of the BCG. Kawasaki disease was diagnosed, and high dose aspirin (100 mg/kg/day) and intravenous gamma-globulin (IVIG) (400 mg/kg/day) were given for four days. The patient was afebrile on the second day after IVIG infusion, and was discharged six days after admission. A small single daily dose of aspirin (10 mg/kg/day) was given after the afebrile days. Unfortunately, vomiting and consciousness disturbance were noted one day after discharge. Laboratory data showed elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ammonia. Hypoglycemia and prolonged PT and PTT were also noted. Reye syndrome was suspected, and the patient was admitted to the intensive care unit for further management. A liver biopsy gave findings consistent with Reye syndrome. In spite of intensive treatment, the infant expired on the second day after admission. In a review of the literature, no correlation between these two syndromes was found. This rare case is presented to warn that Reye syndrome may follow Kawasaki disease when aspirin has been prescribed at a high dose.

Aspirin↗
PubMedDate not supplied

[Complications in the use of mechanical ventilator in newborns: one year's experience].

A retrospective study was undertaken of 175 patients (119 males, 56 females) admitted to the neonatal intensive care unit of Mackay Memorial Hospital during the period of July 1, 1985 to June 30, 1986 who received mechanical ventilation during their stay at the hospital. Upon reviewing the clinical histories of these patients, the complication rate of mechanical ventilation was 31.9%. The percentages of each complication were: pneumothorax 50.0%, pneumomediastinum 5.2%, pulmonary interstitial emphysema 1.7%, atelectasia 13.8%, pneumonia 13.8%, chronic lung disease 13.8%, nasopharyngeal infection 1.7%. Survival rate of these ventilated patients with or without complication was not significant statistically (69.2% vs 65.6%). However, with regard to the hospital course, cases with complication had a significantly longer duration of ventilator usage, hospital stay and oxygen usage than uncomplicated cases. In conclusion, experienced personnel are needed to supervise the use of mechanical ventilation in neonates, and a team of well-trained nurses working in the neonatal intensive care unit are essential to minimize complications.

Chi-Square Distribution↗
PubMedDate not supplied

Pulmonary hypoplasia associated with oligohydramnios: report of five cases.

From January 1986 to December 1988, 5 cases of oligohydramnios with pulmonary hypoplasia were experienced. Clinically, all of the newborn infants had unique faces and evidence of respiratory distress with tachypnea, cyanosis, intercostal retractions, nasal flaring and grunting respiration presented within minutes after birth. Usually, they had no response to respiratory therapy. Most of them showed small lung volume by chest roentgenogram and were prone to develop pneumothorax. All 5 cases did not survive more than a few hours. Autopsy findings disclosed pulmonary hypoplasia. Four of them had urinary tract malformation, and the other one had the history of prolonged leakage of amniotic fluid.

Female↗
PubMedDate not supplied

[Congenital cutaneous candidiasis: report of two cases].

Congenital cutaneous candidiasis is a very rare disease. We reported two newborn infants in whom generalized skin eruption was noted at birth, characteristics of erythematous papules and pustules. The eruption involved head, face, neck, trunk and extremities. Candida albicans was demonstrated on direct KOH smear, by surface fungal cultures and skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis which manifests as thrush, diaper dermatitis. The route of infection is ascending in congenital cutaneous candidiasis. The skin eruption is usually noted at birth or within 12 hours after delivery as a diffuse erythematous maculopapula, with pustules or vesicles distributed over head, face, neck, trunk and extremities. There is no fever; other constitutional signs are lacking. No evidence of impaired immunological responsiveness has been noted in previous study. Clinical features, direct smear examination of specimen and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Topical antifungal therapy is sufficient unless systemic candidiasis is present. Prognosis for congenital cutaneous candidiasis is good.

Candidiasis↗
PubMedDate not supplied

[Duplication of the alimentary tract: report of three cases].

Three cases of duplications of the alimentary tract are presented. Case 1 was a 5-month-old male baby. He was admitted due to copiously painless rectal bleeding. Tc-99m pertechnetate scanning revealed unusual tubular and spherical lesions. Laparotomy findings were that a tubular ileal duplication m assured 100cm or so in length and communicated with ileal lumen by its distal orifice. Moreover, there were 2 spherical duplications like ping-pong ball in morphology located in neighboring mesentery. Case 2 was a 2-day-old male newborn. He was admitted because of persistent bilious vomiting on his second day of life. Plain film x-ray revealed dilated stomach and scanty bowel gas. Laparotomy finding was that a cystic duplication measured 1.5cm in length which located in and obstructed the lumen of proximal jejunum. Also there was a distal orifice of duplication in communication with jejunal lumen. Case 3 was a 4-year-and-4-month-old boy who admitted after intermittently non-projectile vomiting for a period of 1 1/2 year. Sonography showed a calcification lesion at right upper quadrant of abdomen. Panendoscopy saw a refraction at second part of duodenum. The findings of laparotomy were that 2 tumor masses laid upon gastrocolic ligament. One was ossified soft tissue (gastrocolic ligament) with 1.5 x 1 x 0.8cm3 in size, and the other was cystic duplication of transverse colon in contact with beneath mesocolon. All duplications of 3 cases were lined with ectopic gastric and small intestinal mucosa, and ulcerative lesion was found in case 3 only. All lesions were resected and removed with good results.

Child, Preschool↗
PubMedDate not supplied

The VATER association: analysis of forty six cases without karyotyping.

Forty-six patients with two or more features of the VATER association admitted to the Mackay Memorial Hospital from May, 1983 to Mar, 1992 were retrospectively enrolled in this study. We compared the incidence of major features with that reported in the literature. Imperforate anus, congenital heart disease, and renal anomalies were the three most common major features in our study. Thirteen patients died. Heart failure was the major cause of mortality. We noted many patients associated minor features, and among them there was a relatively high ratio of cleft lip, cleft palate, and hypospadius. The overall outcome and development were good among the survivals. We suggest that children who have any congenital anomaly included in the VATER association should get a careful examination and evaluation of their heart, genitourinary tract, limbs and vertebrae. Early correction if possible is indicated in such patients.

Abnormalities, Multiple↗
PubMedDate not supplied

Urinary tract infection in infants less than 2 months of age.

Ninety-five infants, less than 2 months of age, diagnosed as urinary tract infections, from July 1984 to June 1991, were reviewed. Their urinary cultures, obtained either by suprapubic puncture or via catheterization, all had bacterial colony counts of over 10(5)/ml. In this survey, males predominated (91.6%). Fever and gastrointestinal problems were the two most prevalent signs. E. coli was the most common causative organism, and gentamicin was the most effective antibiotic. Vesicoureteral reflux (VUR), the most common anomaly, was found in one-third (25/76) of patients on voiding cystourethrography, with 20% being high grade (Gr. IV or Gr. V). Eleven cases (11%) had bacteremia, and one case had bacterial meningitis. Sixty-seven cases were followed up in our hospital and seven of them had second infections within a year of their first UTI. The mean period between episodes was less than two months. All these patients had urinary tract anomalies and received oral chemoprophylactic drugs for variable lengths of time. Five of the seven recurrences were caused by resistant bacilli. Continuous oral antibiotic prophylaxis and regular follow-up examinations were the rules of prevention for further infection and future renal impairment. These preventive methods are especially important in young infants with UTI.

Bacteremia↗
PubMedDate not supplied

Adult respiratory distress syndrome in full term neonates.

From July 1987 to October 1991, we experienced 10 full-term newborn infants with severe adult respiratory distress syndrome (ARDS). The triggering events were intrauterine/perinatal asphyxia in 6 and sepsis in 4. All had severe respiratory distress/failure and were mechanically ventilated with high concentration of inspired oxygen and positive end-expiratory pressure. Radiography of the chest all showed bilateral dense consolidation (white out lungs) and reduced lung volume. Persistent pulmonary hypertension (PPHN) was documented in 9 cases (90%). The concomittent occurrence of ARDS and PPHN rendered respiratory management extremely difficult. High-rate ventilation and tolazoline infusion were used in all these 9 PPHN cases. Acute complication of respiratory therapy (pneumothorax) was encountered in 5 patients. Only 3 cases survived, all belonging to the asphyxia group. Of these 3 survivors, 1 developed bronchopulmonary dysplasia, 1 had cerebral palsy on follow up and the other one was lost on follow up. The outcome of neonatal ARDS was generally poor.

Female↗
PubMedDate not supplied

Fatal enteroviral infection in a neonate.

Enterovirus infection has been recognized as one of the most common viral infections in the perinatal and neonatal periods. It frequently leads to significant mortality. One fatal case of neonatal enteroviral infection was experienced in last year. The patient was a one-day-old male, presenting with neonatal sepsis. He has a biphasic illness, first with a mild febrile prodrome then followed by severe systemic involvement, with meningitis, myocarditis, hepatosplenomegaly and disseminated intravascular coagulation. All bacterial cultures were negative, but the rectal swab isolated enterovirus. The echocardiogram revealed depressed cardiac function, and he finally expired at the age of 10 days. The autopsy findings supported the diagnosis of perinatal enteroviral infection (coxsackievirus B infection was highly suspected). Clinically, if a neonate presents as sepsis, but has the following conditions, enteroviral infection should be considered: (1) negative bacterial cultures; (2) multiple organ involvement; (3) proven enteroviral infection in the same nursery or ward; (4) a mild febrile illness in the mother within the last antepartum 10 days or the first postpartum 5 days; (5) any family members with fever or signs of upper respiratory infection within 15 days before delivery.

Bacteremia↗
PubMedDate not supplied

Transient hypertrophic cardiomyopathy with first degree atrioventricular block and QT prolongation. Report of one case.

Transient asymmetric hypertrophy of the interventricular septum was found by echocardiography in a 20-day-old infant whose mother was not diabetic. The electrocardiogram showed first-degree atrioventricular block and QT prolongation. Electrocardiograms on all first degree relatives were within normal limits. With the medication of propranolol, the infant did well. Both echocardiographic and electrocardiographic findings returned to normal two months later (Acta Paed Sin 1993; 34:38-44).

Cardiomyopathy, Hypertrophic↗
PubMedDate not supplied

Cutis marmorata telangiectatica congenita with cerebral and ophthalmic anomalies: report of one case.

A term male neonate had an uncommon congenital vascular disorder of the skin covering the whole body and extremities. These skin lesions were characterized by mottling and persistent telangiectasia. A skin biopsy showed nevus vascularis reticularis which was recognized as cutis marmorata telangiectatica congenita. In addition to the cutaneous involvement, the patient also had fetal ascites, pleural effusion, patent ductus arteriosus, glaucoma, retinal detachment in the left eye, and telangiectasia in the right eye. Neonatal focal seizure developed and expired on the 34th day of life. The cerebral image studies suggested vascular anomalies with secondary cerebral parenchymal damage. Cutis marmorata telangiectatica congenita may be solitary but is frequently associated with other developmental defects. However, the specific findings of cerebral and ophthalmic lesions in our case were rather unusual.

Abnormalities, Multiple↗