Biomedical subjects

M L Chu

Publications and source records attributed to M L Chu.

265 records · Page 15Linked to original sources

PubMedDate not supplied

[The effects of anticonvulsants on the epileptiform discharges--study by 24-hour ambulatory cassette EEG system].

Thirty-three epileptic children who had epileptiform discharges in conventional 16 channel EEG study were enrolled in this study. The patients have never been treated with medication at first visit. Then patient were put on ambulatory monitoring EEG with the Oxford Medilog 9-channel cassette EEG system, which included six symmetrical scalp leads, one EOG, one Chin EMG and one channel for time signal. The EEG record was processed under the rule of the international standard method in terms of 10-20 system. The 24 hours EEG cassettes which recorded before and after antiepileptic drugs therapy were reviewed by an experienced electroencephalographer on a video play back unit. The number and duration of spikes or spike wave discharges were calculated. Among those 22 cases who had studied completed, there are 11 cases with generalized spike waves (5 with irregular spike waves, 3 with regular 3 hz spike waves, 1 with multiple spike waves, 1 with slow sharp waves and 1 with abortive spike waves), and 11 cases with focal spike activities (5 with bilateral central or centrotemporal spikes, 4 with temporal spikes and 2 with occipital spike discharges). After anticonvulsants therapy, 9 cases (82%) out of those 11 cases with generalized spike waves, the spike waves were disappeared; 2 cases (18%) revealed no significant change in spike rate and duration.(ABSTRACT TRUNCATED AT 250 WORDS)

Anticonvulsants↗

PubMedDate not supplied

[The relationship between serum uric acid and the prognosis of children admitted to pediatric intensive care unit].

To investigate the relationship between hyperuricemia and the prognosis of acute ill children, we evaluated the usefulness of serum uric acid (SUa) and urinary uric acid concentration on admission as prognostic indices in 94 consecutive children admitted to a pediatric intensive care unit. Patients with hyperuricemia (13.1 +/- 5.6 mg/dl) had a higher mortality (13/26, 50% vs 7/68, 10%, P < 0.001), lower blood pH (7.20 +/- 0.18 vs 7.37 +/- 0.10, p < 0.05), lower systolic blood pressure (85 +/- 24 vs 102 +/- 28 mmHg, p < 0.05) and lower body temperature (36.6 +/- 0.8 vs 37.4 +/- 1.0 degrees C, p < 0.05) than did patients with normouricemia (5.0 +/- 1.5 mg/dl). There are no significant difference in uric acid and sodium excretion between hyperuricemic and normouricemic patients. We concluded that elevated serum uric acid on admission is associated with a higher mortality in pediatric ICU patients, therefore it may be used as an important prognostic index to evaluate patients' outcome in acute ill children. Hyperuricemia should also alert physicians to the possibility of profound cell injury caused by various etiology.

Child↗

PubMedDate not supplied

[Fulminating adenovirus pneumonia: report of one case].

Adenoviral pneumonia, while most common in infancy and young childhood, is rare in school childhood. Here, we report one case, a 13 years old otherwise healthy girl, suffered from fulminating pneumonia caused by adenovirus infection. She had dry cough, pharyngitis, lethargy, myalgia and fever in the beginning. Four days later, the patient became tachypneic, dyspneic and drowsy, and developed hypoxemia and diffuse bilateral infiltrates on chest radiographs. The laboratory data revealed elevated SGOT, CPK and LDH. Adenovirus was isolated from patient's endotracheal suction tube tips. Fortunately, weaning from mechanical ventilation was accomplished on the fifth day of hospitalization, despite of the high fatality rate of adenoviral pneumonia in this age group. The clinical characteristics and therapeutic management of our case are discussed and literatures reviewed.

Acute Disease↗

PubMedDate not supplied

[Effect of diuretics on renal sodium excretion of different ages (I)].

Ninety normal students including 30 cases in senior high, 30 cases in junior high and 30 cases in elementary schools were the subjects for diuretic test. Thirty cases in each age group were divided into three subgroups. Students in each subgroup were given one of three oral diuretic drugs (acetazolamide 10 mg/kg, furosemide 2 mg/kg, hydrochlorothiazide 2 mg/kg) for three consecutive days. Although there was an increased urinary sodium excretion among the three different age groups during the period of oral hydrochlorothiazide, it showed no significant difference among the three age groups (P > 0.05). There was more increased urinary sodium excretion for students of senior high school during the period of oral furosemide and acetazolamide than for students of junior high school and of elementary school. The largest, successive natriuretic action was observed in students of senior high school during the period of oral furosemide. It is suggested that there is more effective natriuretic action for students of senior high school during the period of oral acetazolamide and furosemide than for students of junior high and of elementary school.

Adolescent↗

PubMedDate not supplied

[Effect of furosemide on renal magnesium and calcium excretion of different ages (II)].

Thirty normal students, including senior high, junior high and elementary school, were the subject for furosemide test. Ten cases, in each age group, were given oral furosemide 2 mg/kg for three consecutive days. The result showed there were increasing urinary magnesium and calcium excretion among the three different age groups after oral furosemide (P < 0.05). Successive increase of urinary magnesium and calcium excretion of senior high school students is more obvious than those of junior high and elementary school students. It is suggested that there is more effective action on renal magnesium and calcium excretion for senior high school students after oral furosemide than that for the junior high and elementary school students. It is obvious that increasing dosage of furosemide would induce more calcium excretion than magnesium excretion among students of the three age groups. Therefore, it encouraged to drink the proper amount of water to decrease the incidence of hypercalciuric stone when furosemide should be used.

Adolescent↗

PubMedDate not supplied

[Effect of hydrochlorothiazide on renal calcium and sodium excretion of different ages (III)].

Thirty normal students, including students in senior high, junior high and elementary schools were the subjects for hydrochlorothiazide test. Ten cases, in each age group, were given oral hydrochlorothiazide 2 mg/kg for three consecutive days. The significant natriuretic action was only observed on the first day during the period of oral hydrochlorothiazide, there was no obvious difference among the three age groups. The urinary calcium excretion of elementary and junior high school students is less than that of senior high school students. It is suggested that there is more effective hypocalciuric action for elementary and junior high school students than for senior high school students during the period of oral hydrochlorothiazide.

Adolescent↗

PubMedDate not supplied

[Solitary diverticulum of ascending colon induced internal intestinal herniation: report of one case].

Colonic diverticula are generally multiple and occur most commonly in the descending and sigmoid colon. Solitary ascending colonic diverticulum is a rare pathology and presents several features which separate it from colonic diverticulosis. It is a true diverticulum. It is a congenital dysplasia that generally runs an asymptomatic course and becomes clinically important only when inflammatory, perforating, or hemorrhagic complications occurs and presents a difficult problem in diagnosis and management. An unusual case of 4 year old girl with solitary ascending colonic diverticulum was reported here. It caused internal intestinal herniation by forming an adhesion band with mesentery and the clinical course manifested as an acute intestinal obstruction.

Child, Preschool↗

PubMedDate not supplied

[Lowe syndrome: report of one case].

The Lowe syndrome, or oculocerebrorenal syndrome, is a rare X-linked recessive hereditary disease which typically involves three major systems including ocular defects (congenital cataracts, glaucoma, searching nystagmus), central nervous system defects (generalized hypotonia with decreased or absent deep tendon reflex and severe mental retardation), and renal dysfunction (progressive renal tubular dysfunction with acidosis and hyperaminoaciduria). Less than 200 cases have been reported in the English literatures since 1952. This article presents the first case of Lowe syndrome in Taiwan. Patient was a newborn who was born with congenital cataracts, glaucoma, generalized hypotonia with areflexia. In following laboratory studies showed early manifestations of renal tubular dysfunction with metabolic acidosis, proteinuria, glycosuria, phosphaturia and generalized hyperaminoaciduria (19 types). CT of brain showed an arachnoid cyst about 4.5 x 5 cm in size below the cerebellar tentorium. Large amount of copper, about 20-30 times above normal range, was detected in the urine. To our knowledge, Lowe syndrome associated with hypercupriuria and arachnoid cyst has not been reported in the past. Whether hypercupriuria is a part of the entity of this disease or prodromal stage of Wilson's disease is obscure. Further investigation and long-term observation are necessary to draw any conclusion.

Arachnoid Cysts↗

PubMedDate not supplied

[Heavy metals in traditional Chinese medicine: ba-pao-neu-hwang-san].

Heavy metal intoxication of newborn infants fed with "Ba-Pao-Neu-Hwang-San" has been reported every year by many hospitals in Taiwan. About nine years ago, the National Laboratories of Foods and Drugs of the Department of Health, Executive Yuan, received one case report of a five month old female infant who died as a result of long term feeding with "Ba-Pao-Neu-Hwang-San". The drug was found to have contained lead 44,000 ppm. Although this unfortunate incident was propagated by most newspapers, the prescription of this ancient Chinese medicinal preparation is still widely accepted by ordinary people. Herbal medicine doctors prefer complex mineral drugs as did their ancestors thousands of years ago. In the last two years, we have collected 5 samples of "Ba-Pao-Neu-Hwang-San" from different manufacturers and measured the concentration of 16 heavy metals (including Cadmium, Mercury, Arsenic, Lead, Chromium, Manganese, Selenium, Germanium, Nickel, Calcium, Magnesium, Aluminum, Iron, Copper, Zinc, and Vanadium) in these drugs with Inductively-Coupled Plasma Atomic Emission Spectrometry and Graphite Furnace Atomic Absorption Spectrometry. The result of our survey revealed that the first sample (from Tainan) contained mercury 52,800 ppm, the fourth (from Ping-tung) contained mercury 34,500 ppm, and the fifth (from Sin-chu) contained mercury 65,700 ppm. The mercurial contents of these samples were apparently too high to be a safe drug.

Humans↗

PubMedDate not supplied

Epididymo-orchitis in an infant resulting from Escherichia coli urinary tract infection.

Epididymo-orchitis (EO) is said to be extremely rare in infants and children. It is usually diagnosed after scrotal exploration for symptoms which mimic manifestations between EO and torsion of the cord and its appendage. The pathophysiologic mechanisms for the development of EO are not well known. Although some causative agents of EO have been reported, in most cases there was no clear etiology. We report a 3-month-old male infant who had been well until the day prior to admission when irritability, left testicular swelling, scrotal erythema with a hot sensation were noted by his mother. He was treated medically after excluding the possibility of an emergent surgical condition (such as torsion of the cord and its appendage, or incarcerated hernia) by means of physical examinations, abdominal and inguino-scrotal sonography, laboratory studies, and testicular radionuclide scintigraphy. A catheterized sample of urine for culture yielded Escherichia coli. There was the possibility that the EO was caused by hematogenous rather than local spread from an infection of the urinary tract. He was treated with a 10-day course of intravenous cefazolin and amikacin. Following this, he improved clinically and a repeat catheterized urine sample remained sterile on culture. In addition, a bilateral inguinal hernia and hydrocele were detected by inguino-scrotal sonography and were operated on the 11th hospital day. He was discharged on the 16th day of hospitalization and remained well 11 months after discharge.

Diagnostic Imaging↗

PubMedDate not supplied

Cat scratch disease in a child.

We report a case of a 9-year-old girl scratched on the right side of her neck by a kitten about one month prior to admission. She was well until three weeks later when she developed enlarged right neck masses, a pustula on the scratch site, right injected conjunctiva, headache, general malaise and fever, thus fulfilling the clinical criteria for CSD. Initially, she was treated by a practicing physician but the manifestations persisted for one week. After admission, leukocytosis and a mildly elevated erythrocyte sedimentary rate were noted. The serum IgG titer to Bartonella henselae was performed by means of indirect fluorescent antibody (IFA) test at the National Institute of Preventive Medicine. The serum titer of anti-B, henselae Ig G was 1:256 and greater (> or = 1:256). The positive serum titer(negative titer being < 1:64) to B, henselae, the organism thought to be responsible for CSD, also supports this diagnosis. She was treated with a 7-day course of intravenous gentamicin and the fever subsided within 24 hours. Following this, she improved clinically and was discharged one week later. One month after discharge, she remained well with no palpable neck masses.

Anti-Bacterial Agents↗

PubMedDate not supplied

Trichosporon beigelii causing oral mucositis and fungemia: report of one case.

A 23-month-old boy, a victim of acute myelomonocytic leukemia (AML), was admitted for chemotherapy. On the eighth hospital day, he started a one-week course of chemotherapy with agents of epirubicin and cytosine arabinoside. Unfortunately, persistent neutropenia, deteriorating diarrhea and intermittently spiking fever developed from the sixteenth hospital day. Initially, ceftazidime and amikacin were empirically utilized. Blood culture yielded Klebsiella pneumoniae and the fever subsided for one day. Unfortunately, oral mucositis and catheter-induced phlebitis developed subsequently. Subsequently, oral nystatin and intravenous oxacillin were added. The results of cultures from both blood and oral mucosal tissue yielded a fungus. Trichosporon beigelii. We changed from an oral antifungal agent to intravenous amphotericin B on the twenty-fourth hospital day. He presented signs of septic shock with disseminated intravascular coagulopathy and expired on the twenty-fifth hospital day after failure to respond to aggressive resuscitation. We report this case to emphasize that in cytotoxic chemotherapy-induced granulocytopenic AML patients who have compromised immune systems, and who may manifest some signs or symptoms of infection, and at the same time poorly respond to interventional antibiotic treatment, the possibility of T. beigelii infection can not be neglected.

Fungemia↗

PubMedDate not supplied

Renal abscess: report of two cases.

Renal abscess, a very uncommon renal disease in the pediatric patient is often complicated by irrelevant antibiotics treated urinary tract infection or due to other unknown reasons. In this paper, two cases of renal abscess were reported though they had been treated with antibiotics. The diagnosis had been made soon by sonography and computed tomography (CT). In addition, during the period of treatment, a series of sonography were performed to monitor resolution of abscess. In one, the lesion was resolved by antibiotics alone for 2 months duration, the other nearly disappeared 3 weeks later after antibiotics treatment combined with tube-drainage. These imaging techniques permit a prompt diagnosis as well as percutaneous drainage performed if antibiotic treatment dose not lead to resolution of the abscess.

Abscess↗