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Biomedical subjects

K W So

Publications and source records attributed to K W So.

27 records · Page 2Linked to original sources

Lower gastrointestinal tract perforation in preterm infants treated with dexamethasone for bronchopulmonary dysplasia.

Two cases of ileal perforation in preterm infants treated with high-dose dexamethasone for bronchopulmonary dysplasia are described. Corticosteroid-induced gastroduodenal haemorrhage or perforation has been well documented, but less known to most clinicians is that the lower gastrointestinal tract can also be involved. Unlike previous reported cases in which affected infants deteriorated rapidly and became moribund within hours of onset of symptoms, "silent" perforations detected on routine radiograph or escaping clinical recognition until at an advanced stage can be the initial presentation. The need for greater vigilance and a low threshold for abdominal investigations are emphasised in preterm infants treated with dexamethasone.

Anti-Inflammatory Agents↗

Fatal haemorrhagic gastritis associated with oral sulindac treatment for patent ductus arteriosus.

We report the first case in a preterm infant given oral sulindac for treatment of symptomatic patent ductus arteriosus who subsequently developed severe acute haemorrhagic gastritis leading to disseminated intravascular coagulation, massive pulmonary haemorrhage and death. The postmortem examination suggested that the mechanism was likely a direct irritant insult causing ischaemia on the gastric mucosa. Although sulindac is supposed to be a renal-sparing non-steroidal anti-inflammatory prodrug associated with minimal renal and gastrointestinal adverse effects, clinicians should be alerted to this potential life-threatening complication in preterm infants. Until the question of safety could be adequately addressed, the use of sulindac for ductal closure should remain experimental.

Cyclooxygenase Inhibitors↗

The effect of transcutaneous electrical nerve stimulation (TENS) on autonomic cardiovascular reflexes.

Transcutaneous electrical nerve stimulation (TENS) has been shown to have an anti-ischaemic effect in patients with angina and peripheral vascular disease that appears to be additional to any analgesic action. The mechanism for this anti-ischaemic effect is not known but it is possible that TENS interferes with the autonomic responses to ischaemia. To determine if TENS has any direct action on autonomic reflexes we have assessed the effect of high frequency TENS on a variety of standard tests of autonomic cardiovascular reflexes in 10 normal subjects. Tests were done on four consecutive days at the same time and TENS therapy or placebo was randomly allocated on 2 days each. Results of the tests were assessed by one person 'blinded' to the randomization order. These showed that TENS was associated with a significant reduction in the rise of the diastolic blood pressure (21.8 +/- 2.3 v. 17.6 +/- 17 mmHg; p < 0.05) during isometric exercise, using sustained Handgrip. There was no significant effect discernible on the changes of heart rate and blood pressure during the Valsalva manoeuvre, cold face stimulus or head-up tilt. Transcutaneous electrical nerve stimulation appears, therefore, to have a mild inhibitory action on those reflexes mediated predominantly by the sympathetic nervous system and this is more apparent when the stimulation may be greater, as during isometric exercise.

Adult↗

Mutagenicity of peroxyacetyl nitrate (PAN) in vivo: tests for somatic mutations and chromosomal aberrations.

A series of experiments was conducted in which Chinese hamsters inhaled PAN, an ubiquitous pollutant that is present in the atmosphere at concentrations that are as high as, or higher than, other known genotoxic agents. The animals were exposed to PAN in air at concentrations of approximately 3 ppm for up to 1 month and then examined for somatic mutations and chromosomal aberrations. Mutations were assayed by measuring the frequency of thioguanine-resistant lung fibroblasts (isolated de novo and cultured). Chromosomal aberrations were assayed by measuring the frequency of micronuclei in either the bone marrow (polychromatic erythrocytes) or the lungs (binucleate lung fibroblasts cultured in the presence of cytochalasin B). The results for the test animals were compared to those from animals exposed similarly, but without PAN. Although in each experiment the mutation frequencies for the test animals were higher than the corresponding controls, the mutation frequencies were not significantly different from the concurrent negative controls (P > .05) or the historical controls, except for experiment C. In experiment C, there was a significant regression of mutation frequency versus dose (P < 0.001) if all of the historical controls for pooled animals are included at zero dose. No reproducible evidence of chromosomal breakage was found in either lung or bone marrow. Thus, although PAN has been found to be a bacterial mutagen, we did not find statistically significant evidence of mutagenicity in vivo. The toxicity of PAN limited the exposure concentration that could be used. When all of the PAN data were used, the best estimate of the mutagenic potency proved to be comparable to that of ethylene dibromide, a carcinogenic atmospheric pollutant.

Air Pollutants↗

Cochlear implant in Hong Kong Cantonese.

Cochlear implant surgery was performed in four Cantonese-speaking postlingually deaf Chinese adults, using the House/3M single channel device. This article outlines the methodology, including preoperative assessment and postoperative rehabilitation; and explains the necessary modifications in speech and audiologic work-up in Cantonese-speaking patients. Salient features of Cantonese phonetics, especially its tonal characteristics, are described. The findings of the study are presented. The results of the cochlear implant would suggest a performance superior to that of the hearing aid. Furthermore, the cochlear implant is able to detect tonal cues. This quality of the cochlear implant may prove to be a valuable asset to a tonal language-speaking cochlear implantee.

Adult↗

Material for Cantonese speech audiometry constructed by appropriate phonetic principles.

Cantonese is the common Chinese dialect spoken by the citizens in Hong Kong. It is difficult to construct a material for speech audiometry in the Chinese language in view of 3 facts: (1) all words are monosyllabic, (2) the language is tonal and (3) there are many homophones. Since well-documented Cantonese speech audiometry is not available, an attempt is made in this pilot study to construct short word lists which are equal in phonemic distribution.

Audiometry, Speech↗

Pneumocystis carinii pneumonia in an immunocompetent infant with congenital cytomegalovirus infection.

The case of a term infant with congenital cytomegalovirus (CMV) infection who developed Pneumocystis carinii pneumonia (PCP) at 4 months of age is reported. Our patient suffered from severe malnutrition and zinc deficiency secondary to necrotizing enterocolitis since the age of 2 months. There was no evidence of human immunodeficiency virus infection. Qualitative and quantitative in vitro leukocyte functions were also normal. This case highlights the fact that PCP can occur in apparently immunocompetent term infants. Malnourished infants with zinc deficiency or congenital CMV infection are at increased risk of developing PCP.

Bronchoalveolar Lavage Fluid↗