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Juine-Yih Ma

Publications and source records attributed to Juine-Yih Ma.

4 recordsLinked to original sources

Severe esophageal burn following chloral hydrate overdose in an infant.

Chloral hydrate is generally considered to be a safe hypnotic drug, and is commonly used for short-term sedation before diagnostic procedures. Its irritant actions to the mucous membranes are usually limited. We report a rare complication of chloral hydrate overdose in an infant. An 8-month-old male infant became unconscious and required ventilation support after an overdose of chloral hydrate was administered to provide sedation for an ophthalmologic examination. White plaques and sloughing of the oropharyngeal mucosa were observed on the next day. Esophagogastroscopy revealed severe corrosive lesions on the whole esophagus. The child recovered after supportive treatment and his oral intake remained well without dysphagia after 1 year. This report illustrates the potential corrosive effect of chloral hydrate. Strict attention should be paid to the dosing and administration protocol of chloral hydrate in infants. The condition of the oropharyngeal mucosa should be carefully monitored after chloral hydrate administration.

Burns, Chemical↗

Use of extracorporeal membrane oxygenation to rescue a newborn with early-onset group B streptococcal sepsis and cardiopulmonary failure.

Group B streptococcal (GBS) infection is an important cause of perinatal morbidity and mortality. We report the use of extracorporeal membrane oxygenation (ECMO) to rescue a newborn with refractory GBS sepsis and meningitis who developed cardiopulmonary failure. This 2-day-old infant weighed 2640 g and was born to a healthy mother at full term. Respiratory distress, hypotension, and persistent pulmonary hypertension developed on the second day of life. The clinical condition deteriorated rapidly despite conventional treatment, and venoarterial ECMO was established to rescue this moribund newborn. During ECMO, the patient regained stable hemodynamics and good oxygenation, and infection was controlled. ECMO was used for 90 hours and the baby was weaned smoothly. Neurologic assessment after ECMO revealed hydrocephalus, abnormal electroencephalogram, and increased brain auditory evoked potential threshold. This report emphasizes that ECMO may be considered to rescue neonatal patients with cardiopulmonary failure due to GBS sepsis. Possible neurologic complications after ECMO should be carefully monitored.

Extracorporeal Membrane Oxygenation↗

Intra-retroperitoneal duplication cyst.

Duplication cyst occupying the retro- and intra-peritoneal space is a rare condition. We describe a case of duplication cyst in a 13-year-old girl who presented with abdominal pain, vomiting, and a lower abdominal mass. Plain abdominal X-ray films revealed local ileus over the lower abdomen. Ultrasonography revealed 2 double-layered cystic masses over the lower abdomen with a suspicious communicating tract. Mild hydropelvis of the right kidney was also noted. Abdominal computed tomography revealed 2 cystic lesions. One was located at the pelvic cavity just above the urinary bladder and the other was in the left retroperitoneal space. Laparotomy revealed a dumbbell-shaped intra-retroperitoneal duplication cyst with a small communicating tract. The cyst was excised without disturbing bowel continuity and the vascular supply. The patient was doing well at 1-year follow-up.

Adolescent↗

Hybrid angioplasty for left pulmonary artery stenosis after total correction of tetralogy of Fallot: report of one case.

Pulmonary artery stenosis is common in tetralogy of Fallot. Surgical correction usually achieves good results. For those patients undergoing total correction with residual pulmonary artery stenosis, percutaneous transluminal angioplasty (PTA) plays an important role. However, this might not be possible for complex anatomies. We report a 19-month-old boy who underwent total correction of tetralogy of Fallot at 1 year of age. He developed main pulmonary artery (MPA) aneurysm and left pulmonary artery (LPA) stenosis 4 months after the operation. PTA was attempted, but the guidewire failed to thread into the LPA due to the dilated MPA and tiny LPA ostium. A hybrid approach consisting of left anterior small thoracotomy and balloon angioplasty via the introducer sheath in the MPA was proposed. Rapid access to the LPA and successful balloon angioplasty followed by stenting concluded the hybrid intervention. Such intervention is a good alternative to treat this complex anatomy.

Angioplasty, Balloon↗