PubMed Health⌕ Search

Biomedical subjects

L L Fan

Publications and source records attributed to L L Fan.

At least 55 records · Page 3Linked to original sources
PubMed1992

The protective effect of puerarin against myocardial reperfusion injury. Study on cardiac function.

In order to find out if puerarin could protect the hearts from myocardial reperfusion injury after cardiac arrest, twelve dogs divided into two equal groups were placed on moderately hypothermic cardiopulmonary bypass and their hearts were subjected to 140 min of cold cardioplegic arrest and 60 min of reperfusion. In the control group, the hearts were perfused with a crystalloid cardioplegic solution (CPS) through the aortic root every 20 min during arrest. In the treated group, the hearts received CPS containing puerarin (2 mg/kg). Cardiac hemodynamic variables were monitored throughout the experiments. Left ventricular function curves were formed before ischemia and after 60 min of reperfusion. The results showed that the recovery of left ventricular function in the treated group was significantly better than that in the controls (81 +/- 11% versus 39 +/- 7%, P less than 0.01). Compared with preischemic values, the increase of coronary blood flow (CBF) at cardiac arrest in the puerarin-treated group was higher than that in the control group (214 +/- 11 versus 177 +/- 4 ml/min, P less than 0.01). The data indicate that puerarin has protective effects on the cardiac function after prolonged arrest and reperfusion.

Animals↗
PubMed1991

Effect of moniliformin on myocardial contractility in rats.

The present study was carried out on rat heart to in situ determine the myocardial toxicity of moniliformin, a synthesized compound, originally isolated from mouldy corn and soil samples in the Keshan disease prevalent area in China. Perfusion of moniliformin 10(-7) mol/liter in isolated heart decreased myocardial contractile force by 52 +/- 17%. Intravenous injection of moniliformin at 1/6 and 1/4 LD50 markedly inhibited cardiac hemodynamic variables relative to myocardial contractile function. Particularly, it decreased +/- LV dP/dt max by 52 +/- 6%, and induced ventricular arrhythmia. These data indicate that moniliformin is toxic to mammalian heart and might be an important factor relative to Keshan disease.

Animals↗
PubMed1990

The child with simultaneous stridor and wheezing.

We describe 25 patients with simultaneous stridor and wheezing. Twelve patients presented to the emergency department of The Children's Hospital of Denver over a two-year period; we found an additional 13 in a review of the literature. A combination of two disorders produced stridor and wheezing in six patients, with one condition in the extrathoracic airway and one in the intrathoracic airway. The remaining 19 patients had single lesions, nine with obstruction of the extrathoracic airway and 10 with obstruction of the intrathoracic airway. The causes of stridor and wheezing in these 19 patients fell into three general categories: (1) congenital lesion affecting the airway (eight patients); (2) foreign body in the airway or esophagus (nine patients); and (3) acquired lesion affecting the airway (two patients). All eight patients with congenital lesions developed symptoms by four months of age. All nine patients with an airway or esophageal foreign body were between five and 30 months of age. The history may be misleading, and the physical examination often cannot discriminate among the various likely diagnoses. However, the addition of four plain x-ray views (lateral neck, posteroanterior and lateral chest, and forced expiratory chest) located the site of obstruction in 18 of 25 patients. Barium swallow identified the two patients with vascular rings. Four patients underwent endoscopy to determine the site of obstruction. We make recommendations for evaluation of these patients.

Adolescent↗
PubMed1990

Diagnosis of tracheal injury in mechanically ventilated premature infants by flexible bronchoscopy. A pilot study.

Flexible bronchoscopy (FB) is uniquely suited for the study of large airway lesions in the ventilated premature infant. However, no standardized clinical scoring system of distal tracheal injury exists and the adverse consequences of FB in ventilated premature infants are not well described. Using a prototype Olympus fiberoptic ultrathin bronchoscope with a directable tip and an outer diameter of 2.2 mm, we serially scored distal tracheal injury in conventionally ventilated premature infants on the basis of mucosal and obstructive changes observed at bronchoscopy. In addition, we prospectively evaluated the incidence of adverse cardiovascular and pulmonary effects during, immediately after, and within 1 h of FB. We performed 21 FBs in eight conventionally ventilated premature infants with birth weight of 1,239 +/- 438 g and gestational age of 30 +/- 3 weeks. The carina and mainstem bronchi were easily visualized in all infants using the prototype bronchoscope. During the first several days of life, moderate-to-severe distal tracheal mucosal injury occurred frequently, while moderate-to-severe obstructive injury occurred infrequently. Distal mucosal injury appeared to improve during the fourth week of life. Mild distal obstructive injury began to appear during the second week of life. Adverse consequences of FB observed in our patient population included transient hypoxemia and bradycardia during FB, changes in systolic blood pressure immediately and within 1 h after FB, and emesis immediately after FB. Serious adverse cardiovascular or pulmonary effects were not observed. We conclude that FB can be performed safely with appropriate monitoring and is a useful tool in the clinical assessment and serial evaluation of distal tracheal injury in ventilated premature infants. We speculate that moderate-to-severe distal tracheal mucosal injury may be associated with the development of later obstructive injury. On the basis of this preliminary study, further prospective investigations of tracheal injury in ventilated premature infants appear to be warranted.

Blood Pressure↗
PubMed1989

Paralyzed left vocal cord associated with ligation of patent ductus arteriosus.

We reviewed the records of 167 neonates and older children undergoing ligation of a patent ductus arteriosus to determine the prevalence of recurrent laryngeal nerve injury and identify risk factors that might increase the likelihood of injury. Paralysis or paresis of the left vocal cord was identified by fiberoptic laryngoscopy in seven patients. All seven weighted less than 1500 gm at the time of operation and the ductus had been ligated with a metal clip. All had persistent symptoms when observed for 5 to 19 months. Injury to the left recurrent laryngeal nerve occurs infrequently but may have long-term consequences.

Child↗
PubMed1988

Necrotizing tracheobronchitis. An ischemic lesion.

Neonates with necrotizing tracheobronchitis present a diverse clinical spectrum from asymptomatic disease to severe airway obstruction. A retrospective clinicopathologic study of 206 neonatal autopsy reports spanning a three-year period yielded 122 cases of necrotizing tracheobronchitis with an incidence of 59%. All study patients received treatment prior to the development of high-frequency ventilator jet, oscillator, or interruption. The site and submucosal depth of airway involvement was variable. The most commonly affected anatomic site was the middle or thoracic trachea (56%). The common cause identified was severe ischemia to the airway mucosa and submucosa, occurring with profound birth asphyxia and/or shock. The presence of ischemia supports the concept that decreased tracheoperfusion may be an important factor in the development of tracheobronchial abnormalities.

Apgar Score↗
PubMed1988

Flexible fiberoptic endoscopy for airway problems in a pediatric intensive care unit.

We used flexible fiberoptic endoscopy to evaluate 87 patients with potential problems of the airway in a pediatric intensive care unit. Four different-sized bronchoscopes were used to perform 61 diagnostic laryngoscopic procedures, 35 diagnostic bronchoscopic procedures, and eight therapeutic bronchoscopic procedures. Diagnostic information was obtained in 91 of 96 procedures. Of the eight therapeutic procedures, seven were considered successful. Morbidity was minimal, and there was no death. Flexible fiberoptic endoscopy proved useful as a bedside technique for critically ill pediatric patients in whom evaluation of the airway in the operating room under general anesthesia would have been difficult.

Adolescent↗
PubMed1986

Applications of an ultrathin flexible bronchoscope for neonatal and pediatric airway problems.

A new 2.7 mm flexible fiberoptic bronchoscope with a directable tip was used to evaluate potential airway problems in 73 pediatric patients. Forty-eight laryngoscopies and 47 bronchoscopies were performed over an 18-month period. Persistent stridor was the most common indication for laryngoscopy; persistent wheezing, the most common indication for bronchoscopy. We obtained diagnostic information in 83 procedures, incidental findings in four, and normal results in eight. There were four complications and no deaths. This instrument enabled patients to be examined who were previously considered too small or who previously required rigid bronchoscopy under general anesthesia.

Bronchoscopes↗
PubMed1984

Emergency treatment of foreign-body obstruction of the upper airway in children.

Recently, the Committee of Accident and Poison Prevention of the American Academy of Pediatrics presented its recommendations regarding the emergency management of the choking child. Renewed interest was stimulated in the controversy regarding whether back blows, abdominal thrusts, or chest thrusts should be used in the initial treatment of foreign-body obstruction of the upper airway. Two cases exemplifying problems in patient management are presented as a basis of focusing on the current controversy. Review of the clinical and experimental data suggests that back blows, followed by either chest or abdominal thrusts, are a reasonable approach to emergency airway obstruction, but that this recommendation is based on limited evidence.

Airway Obstruction↗
PubMed1984

Transnasal fiberoptic endoscopy in children with obstructive apnea.

Eight children with obstructive apnea were evaluated by transnasal fiberoptic endoscopy. Three children had obstructive adenoids and tonsils, 2 had pharyngeal collapse, 1 had an obstructive tongue, and 1 had a subglottic cyst. The remaining patient had no abnormality. The results of transnasal endoscopy influenced therapeutic interventions.

Airway Obstruction↗
PubMed1984

Apnea of infancy and childhood.

Apnea of infancy and obstructive sleep apnea in older children are being more widely recognized as potential causes of morbidity and mortality in children. Much controversy exists surrounding the relationship of apnea of infancy to SIDS and the treatment of apnea in infancy, particularly home monitoring. Obstructive sleep apnea in older children is somewhat better defined, and therapy is generally more definitive.

Apnea↗