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Ling-Yu Yang

Publications and source records attributed to Ling-Yu Yang.

5 recordsLinked to original sources

Imperforate hymen complicated with pyocolpos and lobar nephronia.

An imperforate hymen is not a rare condition in female newborns, but is often ignored in a genital examination by physicians. Lobar nephronia is a rare condition in pediatric patients that can be screened by ultrasound or computed tomography to distinguish it from a renal abscess. Treatment for lobar nephronia requires at least 14 days of antimicrobial therapy and a follow-up assessment by renal ultrasonography or dimercaptosuccinic acid scan. We report an unusual case of a 2-year-old girl with an imperforate hymen and pyocolpos. The pyocolpos compressed the left lower ureter to cause hydroureter, hydronephrosis, and nephronia. Partial hymenotomy was performed to drain the pus, and antibiotics were administered for a total of 3 weeks. There was a good outcome. This case demonstrates the need to perform a full physical examination, particularly a genital examination, in newborns. Further, if gynecologic pathology is suspected, then urologic screening studies are recommended to rule out potential associated anomalies.

Bacterial Infections↗

Follow-up of linear growth of body height in children with nephrotic syndrome.

BACKGROUND AND PURPOSE: Steroid treatment is a mainstay in the management of nephrotic syndrome, but has the potential to impair growth and development of children. This study evaluated the effects of steroid regimens on linear growth of body height in children with nephrotic syndrome. METHODS: Hospital records of height measurements were reviewed for a selected cohort of 50 children with nephrotic syndrome. Patient data were obtained from disease onset until follow-up of at least 32 months. Information on dosage of prednisolone and immunosuppressive agents was also analyzed. RESULTS: The mean age at presentation was 6.8 years, and the mean age at final consultation was 10 years. Around one-half and one-third of children received the immunosuppressive agents cyclophosphamide and chlorambucil, respectively, in combination with prednisolone. Prednisolone treatment was associated with progressive reduction in height standard deviation score, which became statistically significant after 3 years (p<0.05). At year 3, patients receiving immunosuppressive agents in combination with prednisolone had significantly higher mean height standard deviation score values compared with prednisolone-only patients. There was a significant (p<0.05) inverse correlation between total prednisolone dose and percentile of body length during year 3 of treatment. CONCLUSIONS: Prednisolone was associated with impairment of growth in body height, in a dose-dependent fashion. Combined administration of immunosuppressive agents significantly reduced this effect and appears to have a therapeutic role in this setting, particularly when long-term treatment is required.

Adolescent↗

Xanthogranulomatous pyelonephritis treated by partial nephrectomy.

Xanthogranulomatous pyelonephritis is an uncommon disease in children. We report of a 2-month-old girl with urinary tract infection and with a renal mass detected by ultrasound scan. The preoperative differential diagnoses were Wilms tumor, multicystic dysplastic kidney, renal abscess, and mesoplastic nephroma. The subsequent histopathological findings allowed the diagnosis of xanthogranulomatous pyelonephritis (XGP). Although XGP is rare at this age, it must be considered in the differential diagnosis of a child presenting with renal mass, either with or without associated urolithiasis, anemia, and elevated inflammatory markers. The long-standing mainstay of therapy for diffuse XGP has been nephrectomy. However, we report the successful preservation of renal mass with partial nephrectomy for diffuse XGP. The affected kidney grew normally and preserved residual function after the operation. Hence we strongly suggest parenchymal saving in pediatric cases of XGP to preserve renal function.

Antihypertensive Agents↗

H1-A extracted from Cordyceps sinensis suppresses the proliferation of human mesangial cells and promotes apoptosis, probably by inhibiting the tyrosine phosphorylation of Bcl-2 and Bcl-XL.

H1-A, a pure compound used in traditional Chinese medicine, is effective in the treatment of autoimmune disorders of MRL lpr/lpr mice. We have previously reported that after 8 weeks of oral therapy with H1-A, 40 microg/kg/day, MRL lpr/lpr mice demonstrated significantly less proteinuria, lower serum creatinine levels, and less renal mesangial proliferation than mice in an untreated group. To clarify the pharmacologic properties of H1-A, we studied its cellular and subcellular effects in cultured human mesangial cells. Our results show that H1-A inhibits cell proliferation and promotes the apoptosis of interleukin (IL)-1- and platelet-derived growth factor (PDGF)-BB-activated human mesangial cells in vitro. Uptake of tritiated thymidine was nearly totally suppressed by the addition of 12.5 micromol/L H1-A (counts per minute decreased from 3905 +/- 70 to 141 +/- 5). The population of S-phase cells decreased from 15.5% +/- 1.7% to 10.0% +/- 0.3%, and G0 + G1 phase cells increased from 68.8% +/- 0.07% to 74.6% +/- 0.05%. This suppression was not a result of cytotoxicity. Apoptosis of human mesangial cells was detectable after treatment with 12.5 or 25 micromol/L H1-A. Using immunoprecipitation and immunoblotting, we found that H1-A inhibits tyrosine phosphorylation of human mesangial proteins and that Bcl-2 and Bcl-XL were probably among these proteins. These findings suggest that H1-A modulates some subcellular signal-transduction pathways and changes the balance between proliferation and apoptosis of mesangial cells in vitro or in vivo. H1-A may be effective in the management of autoimmune disorders, and the modulation of the signal transduction proteins Bcl-2 and Bcl-XL may represent a target for future pharmacologic interventions.

Apoptosis↗

Congenital nephrotic syndrome: report of an infant with diffuse mesangial sclerosis.

A case of congenital nephrotic syndrome (CNS) caused by diffuse mesangial sclerosis (DMS) is presented. A female baby weighting 2,680 gm was delivered at 35 weeks' gestation. She had early onset of generalized edema, heavy proteinuria, oligouria, uncorrectable hypoalbuminemia, and rapid progression to renal failure. Even after being treated with strong antibiotics (teicoplanin and ceftazidine), the infant died of septic shock with Enterobacter cloacea, only sensitive to imipenem, at the age of 7 days. The necropsy showed diffuse mesangial sclerosis. This case demonstrates that prematurity, low birth body weight and early onset of symptoms are not pathognomonic of the congenital nephrotic syndrome of the Finnish type (CNF). It can also occur in DMS. Besides, empirical antibiotics should be started promptly and should cover the major hospital strains of bacteria if the patient is not well.

Female↗