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Biomedical subjects

L H Lin

Publications and source records attributed to L H Lin.

85 records · Page 5Linked to original sources
PubMedDate not supplied

Oral bacterial therapy promotes recovery from acute diarrhea in children.

Lactobacilli in the intestines play an important role in developing natural defenses against both intestinal bacterial and viral infections. So a prospective clinical study was carried out at Cathay General Hospital to determine the effect of Lactobacillus acidophilus and Bifidobacterium infantis on the course of acute diarrhea in hospitalized children. Altogether 100 children between 6 and 60 months of age were collected and randomly allocated into 2 groups. Study group (n = 50) was given Infloran Berna, which contains 10(9) viable Lactobacillus acidophilus and 10(9) Bifidobacterium infantis, one capsule tid for 4 days and control group (n = 50) received parenteral rehydration only without any medication. Only 20 stool cultures in study group had positive culture results for Lactobacillus or Bifidobacterium. All children were evaluated for the degree of dehydration before rehydration. The clinical course of diarrhea was followed during the treatment period. Features on admission were similar between the study group and control group in age, duration of diarrhea at home, serum sodium & potassium and dehydration degree. The duration of diarrhea was defined as the time until the last appearance of watery stool. There was no difference between the study group and control group in the frequency of diarrhea stools on the day before admission (p > 0.05). However, the frequency of diarrhea for study group improved on the first and second day of hospitalization with statistical difference (p < 0.01). The duration of diarrhea during hospitalization in study group also decreased (3.1 vs. 3.6 days, p < 0.01). Oral bacterial therapy is an effective adjuvant therapy in rotavirus positive and negative children with diarrhea and can safely be administered during an episode of acute diarrhea.

Acute Disease↗
PubMedDate not supplied

Analysis and clinical correlates of the 14 and 6 Hz positive electroencephalographic spikes in Chinese children.

From January 1987 to March 1991, electroencephalographic (EEG) analysis and clinical correlates of the 14 and 6 Hz positive spikes were studied retrospectively in 2,026 Chinese patients, ranging in age from 1 to 18 years. All of them were the first-evaluation patients of Pediatric Neurology Clinics, National Taiwan University Hospital, each had had through EEG examinations (including waking and natural sleep records) and detailed medical records. The major findings of the present study are: (1) The overall incidence of the 14 and 6 Hz positive spikes in the series was 2.52% (51/2,026), and that in the age subgroup 1-5 years was significantly lower than those in the subgroups 6-10 years (p less than 0.0001) and 11-15 years (p less than 0.01). (2) 38 out of 51 cases (74.5%) with 14 and 6 Hz positive spikes presented normal EEG background activity. (3) 7 out of 51 cases (13.7%) had coincided negative spikes in frontal areas, and 12 out of 51 cases (23.5%) were associated with other focal or generalized paroxysmal discharges. (4) From the analysis of the clinical manifestations in the 51 cases with the 14 and 6 Hz positive spikes, the episodic attacks of headache, abdominal pain or other autonomic symptoms were most common (49%, 25/51 cases). Of the 25 cases, 19 cases (37.2%, 19/51 cases) were finally diagnosed as autonomic seizure or abdominal epilepsy and 3 cases were diagnosed as migraine. 3 of 10 cases with convulsive seizure or complex partial seizure were associated with autonomic symptom. (5) The etiology in 36 out of 51 cases (70.6%) remained unknown.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Epilepsia partialis continua (Kojewnikow's syndrome): report of one case.

We describe a 12-year-old boy with EPC (Epilepsia Partialis Continua) who showed well localized myoclonic jerks in the left toes continuing for more than 19 months. Preceding partial clonic or tonic convulsions of the left leg or body were initially noted. Neurological examination disclosed mild muscle weakness of the left leg. During the course, neither mental deterioration nor progressive evolution was noted. Since the EEG revealed well defined midline central spike focus which represent the sensorimotor area of left leg and foot, we postulate that the pathophysiological mechanism of the EPC may be evoked by the focal epileptogenic activation of the motor cortex. EEG-EMG polygraphy proved the well localized myoclonic action potential volleys in the M. extensor hallucis longus of the left great toe. According to the clinical and electrophysiological findings, we classified our case into the group I of Bancaud's definition but failed to find out any demonstrable brain lesion throughout brain CT, MRI and angiography. Neurosurgical intervention is not practical for our case, and medical treatment gave somewhat improvement.

Child↗
PubMedDate not supplied

Preclinical development and characterization of an intravenous dosage form for the ACE inhibitor RS-10029.

Preclinical development of an intravenous dosage form for the ACE inhibitor RS-10029 involved the formulation and characterization of the drug's chemical/physical stability in two prototype formulations (injectable solution and lyophilized powder). Included in these studies were quantitative evaluations of various processing and administration parameters (membrane qualification, terminal sterilization, compatibility/delivery of the drug with typical infusion fluids and administration sets) on finished product integrity and quality. Analytical methodology used in these studies consisted primarily of a stability specific HPLC assay and a light obscuration based sensor (HIAC) for particulate matter analysis. Results of these studies indicate that the drug is relatively stable at ambient temperature and under accelerated storage conditions (predicted T90 at 25 degrees C greater than 2 yr, and T90 at 50 degrees C greater than 2 mo). However, the ability of the product to withstand a full terminal sterilization cycle is limited, and therefore other approaches toward sterile processing were examined. With regard to the stability and compatibility of the drug in a variety of fluids and devices there appears to be no overt limitations in its use for either bolus or infusion delivery.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

Breast-feeding counseling by a 24-hour telephone hot-line.

A 24-hour telephone hot-line functioning as a counseling service and case registry was included in a multi-faceted breast-feeding promotion program. The mothers could speak directly to especially trained staff members in a municipal hospital. All the questions were answered according to an "Answering Book" which included the anticipated question and the optimum answer. A total of 201 calls, which included 340 problems, were recorded from January 1, 1993 to October 31, 1993. Almost all the calls were made by the mothers (99%), and more than half (57.7%) of the mothers were primiparous. Most of the calls (79.6%) were made between 8 AM to 4 PM. The questions were frequently raised when the baby was aged 8 to 14 days (23.4%). The most frequently asked questions were: (1) insufficient milk? (14.1%), (2) frequent and loose stools? (13.2%), (3) weaning? (10.3%), (4) drugs? (6.8%), (5) additional formula or water? (6.2%), and (6) maternal contraindication? (6.2%). Although the impact of this telephone consultation could not be properly evaluated, the incidence of breast-feeding during hospital stay increased from 50% to 73.4%, and breast-feeding for more than 1 month increased from 22.7% to 42.2% before and after the whole promotion program. It is recommended that health care professionals provide more help when the mother leaves the hospital. A nation-wide toll-free telephone operated by the Department of Health to increase the chance of successful breast-feeding is also recommended.

Breast Feeding↗
PubMedDate not supplied

Carcinoma of the colon in a child.

A 13-year-old boy presented with carcinoma of the ascending colon. He had had intermittent abdominal pain for about one year, with body weight loss, prior to admission. Physical examination showed diffuse abdominal tenderness, but no palpable mass. Lower GI barium study and colonofibroscopic examination showed a protruding mass over the proximal ascending colon. At operation, right hemicolectomy with ileotransversecolostomy was performed, the pathologic finding was adenocarcinoma, signet-ring cell type. Although chemotherapy with 5-fluorouracil, mitomycin, and levamisole were given subsequently, the patient expired one year after surgery because of multiple metastasis. Carcinoma of the colon is extremely rare in the young. Mucin-producing adenocarcinoma is the most predominant type of colon cancer, and most are of signet-ring cell carcinoma. While prognosis is relatively bright in adult, the prognosis is quite unfavorable in children because of the preponderance of the poor histological characteristics and the difficulty of diagnosis.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Fifteen-hour continuous esophageal pH monitoring: influence of position on gastroesophageal reflux among asymptomatic babies.

Using continuous esophageal pH monitoring, we examined 40 asymptomatic babies to evaluate the influence of different positions (prone, supine, right and left side lying position) on gastroesophageal reflux (GER). Several parameters including percent of time with a pH < 4, numbers of reflux episode, numbers of reflux episode lasting more than 5 min, average duration of longest reflux and average pH were studied. All babies were born fullterm and were 1 to 14 days old (average: 4 days). Male to female ratio was 1.7:1. For all parameters, except for average pH, we obtained more favorable results in prone position (p < 0.05). Continuous esophageal pH monitor is a suitable technique to evaluate GER under physiologic circumstances.

Esophagus↗
PubMedDate not supplied

[Choledochal cyst associated with dominant dorsal duct syndrome: report of two cases].

Two cases with choledochal cysts associated with dominant dorsal ducts were reported. The first patient, a male infant, presented with abdominal distention and vomiting for two days at the age of four months. The second patient, nine month-old male infant, presented with fever for one day, irritability, post-prandial vomiting and preference for lying in a left lateral decubitus position. Both cases were operated under the impression of choledochal cysts, and were found by intraoperative cholangiopancreatography to have dominant dorsal ducts. These two cases and the literature concerning choledochal cyst associated with dominant dorsal duct are reviewed.

Choledochal Cyst↗
PubMedDate not supplied

Laboratory aid and ultrasonography in the diagnosis of appendicitis in children.

Forty-seven consecutive patients with clinically suspected acute appendicitis were studied at this hospital from June, 1994 to March, 1995. All the patients had received a complete study protocol including: detailed history and physical examination; complete blood cell count with differential count; erythrocyte sedimentation rate; C-reactive protein and sonographic examination. The male to female ratio is 29: 18. The age range is from 4 to 14 years. Thirty patients received laparotomy and 27 were diagnosed as appendicitis by histologic findings including 6 cases of perforated appendicitis. The remaining 3 patients had no evidence of appendicitis histologically. The other 17 patients were observed clinically. In these, the abdominal pain resolved spontaneously, or it was proved due to other diseases. The sensitivity and specificity of these laboratory examinations are: leukocytosis (> 10,000/mm3): 85. 2%, 65%; leukocytosis with a shift-to-the-left (neutrophil > 75%): 81.5%, 70%; elevated ESR (> 20 mm/hr): 40.7%, 85%; elevated CRP (> 0.9 mg/dl): 70.4%, 65%; (> 5 mg/dl); 51.9%, 95%; sonography: 85.2%, 100%. There were 4 false-negative and no false-positive ultrasonographic results in our study. Five of the 6 case of perforated appendicitis had elevated CRP levels of more than 8 mg/dl. In conclusion, detailed history taking and physical examination are still the most reliable tools for diagnosis. For the doubtful cases, sonography can provide excellent specificity and good sensitivity for differential diagnosis. The classical tools of leukocytosis and shift-to-the-left can only provide a screening property but not for diagnosis. CRP was not a good predictor in our study, but it can be a useful parameter when perforated appendicitis is suspected.

Acute Disease↗
PubMedDate not supplied

Abdominal teratomas in children.

Seventeen cases of abdominal teratoma were studied retrospectively. These patients had been diagnosed at Cathay General Hospital from 1978 to 1993. The male to female ratio was 9:8, the range of age at diagnosis was from 2 days to 13 years. The chief complaints were palpable abdominal mass in 13 patients (76%) and abdominal distention in 7 (41%). Fifteen teratomas were located in the retroperitonium; also, 1 of the 17 had gastric teratoma and another, a tumor originating from an undescended testes. The tumors were resected in all patients. Postoperative courses were smooth except for one patient, who died suddenly on the day following surgery. No further specific management was needed because the pathologic findings were all benign in nature. Ultrasonography is of benefit in locating, as well as diagnosing, abdominal teratoma. Surgical excision is curative for the majority of cases. Long term follow-up is necessary, in consideration of the rare chance of recurrence.

Abdominal Neoplasms↗
PubMedDate not supplied

Perforated appendicitis in a 4-month-old infant.

A 4-month-old male infant was admitted to our hospital because of poor intake and mild abdominal distention for 1 day. Fever and watery diarrhea had occurred 4 days prior to admission, but subsided 2 days later after taking oral medications. A physical examination showed an acute ill-looking baby with a soft and mildly distended abdomen. The bowel sound was hypoactive and no obvious abdominal tenderness was found. Normal leukocyte and differential counts were noted in initial laboratory examinations; however, the serum level of C reactive protein was extremely high (31.4 mg/dL). Progressive abdominal distention and bilious vomiting occurred. Serial plain films of abdomen showed ileus with a fixed gas pattern and an abdominal echo revealed intraperitoneal fluid accumulation. Under the impression of intestinal perforation, an emergency laparotomy was performed. A perforated appendicitis with turbid fluid in the peritoneal cavity was noted during surgery. A pus culture grew Pseudomonas aeruginosa which was sensitive to Ceftazidime only. Triple antibiotics consisting of Prostaphlin, Metronidazole, and Ceftazidime were administered for 2 weeks. The patient was discharged 3 weeks later without any complications. Appendicitis in infancy is a rare condition and associated with a high frequency of perforation and peritonitis. Diagnosis is often difficult because of variable and nonspecific clinical manifestations.

Anti-Bacterial Agents↗
PubMedDate not supplied

Choledochal cyst in infancy: report of two cases.

Choledochal cysts are malformations of the biliary ductal system, which rarely occur in infancy. In neonates and infants, choledochal cysts are congenital, may be associated with distal biliary atresia and typically presents with cholestatic jaundice and acholic stools characteristic of biliary obstruction. In older children and adults, it may be acquired in association with an anomalous pancreaticobiliary union and presents with any combination of intermittent jaundice, abdominal pain, and a palpable abdominal mass. Early detection of choledochal cysts is important in the prevention of the fatal complications of biliary obstruction. Here, we present two cases of congenital choledochal cyst in which the patients were 9 weeks old and 7 weeks old respectively. Both of them presented with jaundice, acholic stools, and hepatomegaly. Combined use of sonography, computed tomography and hepatobiliary scintigraphy demonstrated the presence of choledochal cysts. Thereafter, they underwent surgical excision of the cysts with Roux-en-Y reconstruction of the biliary tree; the results were successful.

Choledochal Cyst↗