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K S Hsieh

Publications and source records attributed to K S Hsieh.

At least 73 records · Page 4Linked to original sources
PubMed1986

Cardiac output estimates in the pediatric intensive care unit using a continuous-wave Doppler computer: validation and limitations of the technique.

We compared the cardiac index obtained by means of a continuous-wave Doppler computer with simultaneous thermodilution measurements in 25 children in the pediatric intensive care unit (40 observations). The aortic diameter was measured at various levels to determine which provided the best measure of cardiac index. The Doppler measurements were performed independently by a physician trained in Doppler cardiography and by a nurse with no experience in echocardiography. Both the nurse and physician obtained high-quality flow velocity recordings in all patients in a mean time of 5 minutes or less. Cardiac index and total systemic vascular resistance measured by means of Doppler and thermodilution techniques were highly correlated (r = 0.86 and r = 0.93, respectively). The highest correlation was obtained when Doppler cardiac index was computed by means of the internal diameter measured at the aortic anulus. There was no significant difference between the nurse's and physician's measurements. We conclude that cardiac index can be accurately determined in the pediatric intensive care unit by means of continuous-wave Doppler computer, even when operated by personnel not trained in Doppler cardiography.

Cardiac Output↗
PubMed1986

Right ventricular systolic time intervals: comparison of echocardiographic and Doppler-derived values.

Although the clinical utility of right ventricular (RV) systolic time intervals (STI) has been well documented, their use is at times limited by an inability to obtain adequate M-mode echocardiographic images of the pulmonary valve. Therefore the relationship between the pulmonary artery Doppler flow tracing and the timing of pulmonary valve opening and closure was investigated to determine if the more readily available Doppler recording could be utilized for determining RV STIs. We compared RV preejection period (PEP), ejection time (VET), and PEP/VET ratio derived from the pulsed Doppler frequency-time curve recorded in the main pulmonary artery with measurements from a simultaneously recorded M-mode pulmonary valve echocardiogram (Echo). The nadir of the late systolic flow reversal, rather than the point at which the frequency spectrum crosses the zero baseline, correlated best with the point of pulmonary valve closure. By the use of this method for determining end-systole, all three Doppler-derived measurements were highly correlated with the values from the pulmonary valve echocardiogram: PEPEcho = 1.01 PEPDoppler - 3.1 (r = 0.990, S.E.E. PEPEcho = 2.7 msec); VETEcho = 0.98 VETDoppler + 10.2 (r = 0.998, S.E.E. VETEcho = 3.3 msec); (PEP/VET)Echo = 0.95 (PEP/VET)Doppler + 0.007 (r = 0.980, S.E.E. (PEP/VET)Echo = 0.012 msec). The Doppler velocity-time curve provides accurate measurement of RV STIs that can be recorded with relative ease compared with the pulmonary valve echocardiogram. This expanded availability of RV STIs permits an improved ability to investigate the hemodynamic determinants of these indices and their relation to the status of the pulmonary vasculature and right ventricular performance.

Adolescent↗
PubMed1984

Campylobacter jejuni enteritis in children.

Campylobacter jejuni has been recently recognized as a frequent cause of diarrheal disease in infants and children. To assess its importance as an enteric pathogen in this area, in our pediatric laboratory, campylobacter jejuni was isolated by selective culture from 35 out of 623 (5.6%) patients with a history of acute diarrhea between March 1981 to December 1981. The peak incidence was in the summer (from May to August), age ranged from 10 days to 8 years, with the high incidence in the very young children. The sex ratio of male to female was four : one. In general, Campylobacter enteritis is not a severe disease and not associated with dehydration. The most common signs were fever & frequent diarrhea. Most of the children recovered spontaneously on conservative management. The antibiograms for 30 strains showed that the Aminoglycosides, Chloramphenicol, Ampicillin, Erythromycin were the most effective drugs. Resistance to erythromycin was found in 13.4% of our series. This study shows campylobacter is the common cause of bacterial diarrhea in Taiwan.

Age Factors↗
PubMedDate not supplied

Secondary erythrocytosis in distal renal tubular acidosis: report of one case.

The wide spectrum of distal renal tubular acidosis (RTA) has been reported. Children with distal RTA can present with failure to thrive, gastrointestinal symptoms, nephrocalcinosis, and renal failure, etc. So far, secondary erythrocytosis in pediatric patients with distal RTA has not been reported. Here we report a case of distal RTA with failure to thrive and nephrocalcinosis accompanied by secondary erythrocytosis in a 3-year-old boy. He has been followed up for 2 years and is under treatment with NaHCO3 and potassium citrate. The treatment contributes to the improvement of metabolic acidosis and his growth. There is normal renal function and constant erythrocytosis during the follow-up period. Further studies are needed to clarify the relationship between erythrocytosis and distal RTA.

Acidosis, Renal Tubular↗
PubMedDate not supplied

Kimura's disease in a teenage male: report of one case.

A 14-year-old boy gradually developed several subcutaneous masses over bilateral peri-auricular regions, neck, and both upper arms near the elbows over the past 2 years. The recent development of eyelid puffiness elicited his seeking medical attention. Hypereosinophilic syndrome was first considered due to the markedly elevated blood eosinophil count without other evidence of allergy or parasite infestation, but the absence of organ involvement made this diagnosis questionable. The histopathological investigation of the subcutaneous mass in the upper arm showed lymph node-like tissue with markedly reactive follicular hyperplasia and eosinophilic abscesses associated with granulomatous inflammation, thus leading to the final diagnosis of Kimura's disease. Oral prednisolone was prescribed successfully. This illness occurs mainly in young oriental males. We report this case to introduce it to pediatric clinicians as an important differential diagnostic entity in eosinophilia-associated diseases and reactive lymphadenopathy.

Adolescent↗
PubMedDate not supplied

The predisposing factors of coagulase negative staphylococcal bacteraemia in neonatal intensive care unit.

Coagulase negative staphylococci are the commonest blood culture isolate from infants on neonatal intensive care units. The differentiation of contaminants from isolates representing true infection remains a significant clinical problem. Data from two neonatal intensive care units were collected prospectively in order to find those parameters, which best correlated with actual sepsis. Each case was assessed using clinical parameters to categorise infants into infection and contaminant groups. Logistic regression was then performed to find significant correlates. Three correlates were found, namely the presence of a long line (P = 0.001), abnormal white cell count (P = 0.037) and abnormal white cell morphology (P = 0.027). Abnormal white cell morphology was assessed by two experienced hematologists. More than half the isolates were probable contaminants and true infection may occur in the absence of a long line in this patient group.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Haemophilus influenzae cellulitis of the hand: report of one case].

Cellulitis of extremities due to Haemophilus influenzae is rare in children. Only 60 cases of Haemophilus influenzae cellulitis of the extremities have been reported. It usually affects young children between the ages of six and 24 months. The lesion often presents with a red-to-bluish-purple discoloration overlying the involved area. High fever and leukocytosis are commonly found. Culture of needle aspirate and blood with appropriate media is necessary for diagnosis. Early diagnosis is especially important because of associated bacteremia and the subsequent possibility of life-threatening complications such as meningitis. We reported a 8-month-old female infant with Haemophilus influenzae type b cellulitis over the right hand. She was admitted due to high fever and painful swelling of the right hand. Edematous right hand with dusky erythematous skin over the dorsum and swelling of the palm with limitation of range of motion were noted on admission. Smear of needle aspirate revealed gram negative bacilli and beta-lactamase(-) Haemophilus influenzae type b was cultivated in the blood culture. She was successfully treated with ampicillin and discharged with stable condition.

Cellulitis↗
PubMedDate not supplied

Assessment of ventricular septal defect by echocardiography.

Both 2-D echocardiography and angiocardiography were performed preoperatively in 40 children with isolated ventricular septal defect (VSD). The diagnosis of VSD was confirmed and the size of VSD was measured during operation within on month of the study. There were 27 males and 13 females (age: 10mos-9 yrs). The VSD was classified into perimembranous type (24), supracristal type (14), and AV canal type (2) by surgery. The maximal VSD areas were calculated by 1/4 pi De2 (De = maximal defect diameter measured by 2D echo). The maximal shunt flow areas were measured by color Doppler echocardiography from frame by frame search of the video tape. The maximal shunt flow area was corrected by the body surface area to be the maximal shunt flow area index. A left ventriculogram (LVG) was performed from 4-chamber and left lateral views to measure the maximal diameter of the defect. The maximal defect area of VSD on angiocardiogram was also calculated by 1/4 pi Da2 (Da = maximal defect diameter measured by angiocardiography). The VSD areas measured by different methods were compared by the linear regression analysis. We found that: (1) there is good correlation of the maximal defect diameter and the area of ventricular septal defect by 2-DE and LVG (r = 0.80, p less than 0.0001 v.s. r = 0.78, p less than 0.0001). (2) the ventricular septal defect area by 2-DE had a better correlation with the surgical measurement than that by LVG (r = 0.93, p less than 0.0001, v.s. r = 0.80, p less than 0.0001). (3) the size of ventricular septal defect measured by two-dimensional echocardiography has a better correlation with the MSFAI than the LVG did (r = 0.81, p less than 0.0001, v.s. r = 0.64, p less than 0.0001). Therefore, by measuring the maximal defect diameter, maximal defect area and maximal shunt flow area index, the echocardiography can provide an accurate and non-invasive assessment of isolated VSD in children.

Child↗