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Mei-Yung Chung

Publications and source records attributed to Mei-Yung Chung.

14 recordsLinked to original sources
PubMed2006

Retinopathy of prematurity in larger preterm infants.

Severe retinopathy of prematurity (ROP) usually occurs in preterm infants with birthweight<1500 g or gestational age<31 weeks. However, some exceptions occur in larger preterm infants. In southern Taiwan, six larger preterm infants with gestational age older than 31 weeks and birthweight>1500 g had stage III ROP in Chang Gung Memorial Hospital at Kaohsiung (Taiwan, Republic of China). All six infants were male and had received oxygen supplementation during hospitalization. Only one infant had received previous surgery and frequent packed red blood cell transfusions. Three infants received laser photocoagulation or cryotherapy, and all infants have good outcomes regardless of whether they received treatment. This report provides convincing evidence for expanding the screening criteria in our nursery and emphasizes the importance of assessing the risk of ROP for larger preterm infants.

Birth Weight↗
PubMed2006

Menhaden fish oil improves spatial memory in rat pups following recurrent pentylenetetrazole-induced seizures.

This study investigated the effects of two supplementary dietary oils (fish oil and corn oil) as parts of isocaloric/isoproteic diets on growth, brain fatty acid composition, and behavior in rat pups with recurrent seizures. Recurrent seizures were induced by injecting rat pups with pentylenetetrazole (PTZ) between P10 (10 days of age) and P14. Either menhaden fish oil (FO) or corn oil (CO) was given as supplemental dietary oil throughout the experiment from P3 to P40. We assessed the effects of the two supplemental dietary oils on spatial memory, histomorphology, and fatty acid composition of brain tissue at the end of the study on P40. Rats that received dietary FO performed significantly better in the Morris water maze, a test used to examine spatial performance in rats; the FO group had significantly shorter escape latencies (P=0.041) during the escape test. Compared with the CO group, the FO group stayed a longer time (P=0.015) and swam a longer distance (P=0.033) in the target quadrant in the spatial probe test. The FO group had significantly higher brain docosahexaenoic acid (P0.01) and significantly lower brain C20:3 n-6 and C20:4 n-6 (P<0.01 and P=0.031) levels compared with the CO group, but the two groups did not differ significantly with respect to neuronal cell loss in the histomorphology study. This study demonstrated that, compared with CO, FO is better in improving spatial memory in rats following recurrent PTZ-induced seizures.

Animals↗
PubMed2006

Alterations of postsynaptic density proteins in the hippocampus of rat offspring from the morphine-addicted mother: Beneficial effect of dextromethorphan.

Infants passively exposed to morphine or heroin through their addicted mothers usually develop characteristic withdrawal syndrome of morphine after birth. In such early life, the central nervous system exhibits significant plasticity and can be altered by various prenatal influences, including prenatal morphine exposure. Here we studied the effects of prenatal morphine exposure on postsynaptic density protein 95 (PSD-95), an important cytoskeletal specialization involved in the anchoring of the NMDAR and neuronal nitric oxide synthase (nNOS), of the hippocampal CA1 subregion from young offspring at postnatal day 14 (P14). We also evaluated the therapeutic efficacy of dextromethorphan, a widely used antitussive drug with noncompetitive antagonistic effects on NMDARs, for such offspring. The results revealed that prenatal morphine exposure caused a maximal decrease in PSD-95 expression at P14 followed by an age-dependent improvement. In addition, prenatal morphine exposure reduced not only the expression of nNOS and the phosphorylation of cAMP responsive element-binding protein at serine 133 (CREB(Serine-133)), but also the magnitude of long-term depression (LTD) at P14. Subsequently, the morphine-treated offspring exhibited impaired performance in long-term learning and memory at later ages (P28-29). Prenatal coadministration of dextromethorphan with morphine during pregnancy and throughout lactation could significantly attenuate the adverse effects as described above. Collectively, the study demonstrates that maternal exposure to morphine decreases the magnitude of PSD-95, nNOS, the phosphorylation of CREB(Serine-133), and LTD expression in hippocampal CA1 subregion of young offspring (e.g., P14). Such alterations within the developing brain may play a role for subsequent neurological impairments (e.g., impaired performance of long-term learning and memory). The results raise a possibility that postsynaptic density proteins could serve an important role, at least in part, for the neurobiological pathogenesis in offspring from the morphine-addicted mother and provide tentative therapeutic strategy.

Animals↗
PubMed2005

Risk factors of retinopathy of prematurity in premature infants weighing less than 1600 g.

There are many risk factors contributing to retinopathy of prematurity (ROP). Some are still controversial, including the use of glucocorticoid and intraventricular hemorrhage. Hence, a retrospective study was performed to evaluate the association between the suspected risk factors and ROP in a medical center in southern Taiwan. One hundred fifty-nine infants with birth body weight < 1600 g admitted to our neonatal intensive care unit before the 29th day of life were enrolled into this study. Clinical data were analyzed by means of logistic regression. The prevalence of ROP in all infants (birthweight < 1600 g) is 36.48% (58 of 159) and 59.46% (22 of 37) in extremely low birthweight infants (birthweight < or = 1000 g). One infant with gestational age 32 weeks and birthweight 1420 g developed stage III ROP. Logistic regression revealed six factors to be significant variables. Birthweight < or = 1000 g, intraventricular hemorrhage, sepsis, and use of glucocorticoid or dopamine were risk factors associated with higher incidence of ROP. Supplementation of vitamin E was shown to relate to lower incidence of ROP. This study confirms several risk factors recognized in previous statistical analyses. Sepsis is the most significant factor contributing to ROP. Vitamin E was proven to be effective in prophylaxis of development of ROP. The possibility of development of ROP could not be excluded in infants with gestational age > 32 weeks.

Blood Transfusion↗
PubMed2005

Tongue-lip adhesion in the management of Pierre Robin sequence with airway obstruction: technique and outcome.

BACKGROUND: Airway obstruction and feeding difficulty can occur in patients born with Pierre Robin sequence. In select patients with pronounced micrognathia, surgical intervention to relieve the airway obstruction is necessary. The surgical indications and appropriate surgical procedure continue to have a great deal of controversy. The purpose of this study was to evaluate our experience of tongue-lip adhesion in the management of upper airway obstruction associated with Pierre Robin sequence. METHODS: From March 1995 through May 2002, a total of 14 patients with Pierre Robin sequence, who were admitted to the pediatric neonatal intensive care unit either with prolong intubation, poor body weight gain, or repeated airway infection, underwent tongue-lip adhesion (TLA). The operation was performed by raising mucosa flaps and approximated the muscles between tongue and lower lip. Retention sutures were used. The patients were evaluated for clinical responses. RESULTS: Our successful rate with tongue-lip adhesion was 70%. Ten of the 14 patients showed clinical improvements including extubation of the endotraccheal tube, body weight gain, return for home care, reduced episodes of respiratory infection, and improvement in O2 saturation and blood gas. The surgical procedure was simple to perform without major complications. CONCLUSIONS: This retrospective review showed that with a thorough preoperative airway evaluation, TLA could be successfully used to treat select patients with Pierre Robin sequence suffering from severe upper airway obstruction. Thus, TLA should be first considered when surgical relief of airway obstruction is indicated and when obstruction is limited to the classic tongue base obstruction type.

Airway Obstruction↗
PubMed2005

Risk factors for hemodynamically-unrelated cystic periventricular leukomalacia in very low birth weight premature infants.

BACKGROUND AND PURPOSE: Periventricular leukomalacia (PVL) is one of the most important complications of prematurity, but its cause remains unclear. This study investigated the risk factors for hemodynamically-unrelated cystic PVL in very low birth weight (VLBW) premature infants. METHODS: VLBW premature infants admitted to the neonatal intensive care unit from 1998 through 2002 were included in this retrospective study. Infants who had congenital lethal anomalies or who died before a cranial scan could be done were excluded. All VLBW infants received serial cranial ultrasound examinations to screen for cystic PVL during hospitalization. Infants with cystic PVL were divided into those with or without a hemodynamic event of sufficient severity to potentially cause cystic PVL. The charts of all included infants were reviewed and relevant clinical parameters were analyzed. RESULTS: Cystic PVL occurred in 20 VLBW infants (6.9%) during the study period. Four of these infants (20%) had hemodynamic events before the development of cystic PVL and 16 (80%) had hemodynamically-unrelated cystic PVL. Univariate analysis showed that infants with hemodynamically-unrelated cystic PVL were more likely to have symptomatic patent ductus arteriosus (PDA) [p < 0.01] and bronchopulmonary dysplasia (BPD) [p < 0.01]. However, logistic regression indicated VLBW premature infants with BPD combined with symptomatic PDA (odds ratio, 8.92; 95% confidence interval, 2.55-31.20; p < 0.01) were at greatest risk for development of hemodynamically-unrelated cystic PVL. CONCLUSION: BPD and symptomatic PDA were more common in infants with hemodynamically-unrelated cystic PVL, although the reasons for these associations were unclear. Serial cranial scans are strongly suggested for VLBW premature infants with BPD and symptomatic PDA to screen for the development of cystic PVL.

Bronchopulmonary Dysplasia↗
PubMed2005

The effect of supplementation of docosahexaenoic acid and arachidonic acid on visual acuity and neurodevelopment in larger preterm infants.

BACKGROUND: Preterm infants may be born with deficits of both docosahexaenoic acid (DHA) and arachidonic acid (AA), but studies on supplementation of DHA and AA for preterm infants are limited. METHODS: Preterm infants with a gestational age between 30 and 37 weeks who met all the inclusion criteria were enrolled in this double blind, randomized, comparative study. Infants over 2000 g body weight, over 32 weeks of gestation and in full feeding status would enter into the active intervention period of 6 months. Sixteen infants received Neoangelac Plus with AA and DHA supplementation. Eleven infants received Neoangelac without AA and DHA supplementation. The babies had scheduled physical examinations and their cognitive development, visual acuity, and vital signs to be checked. Adverse events were also recorded. RESULTS: The mean Mental Development Index (MDI) scores for the supplementation and non-supplementation groups were 96.1 +/- 8.6 and 91.7 +/- 10.4 respectively at 6 months and 98.7 +/- 8.0 and 90.5 +/- 6.9 respectively at 1 year. The mean Physical Development Index (PDI) scores of these two groups were 102.2 +/- 10.5 and 95.4 +/- 13.2 respectively at 6 months and 98.0 +/- 5.8 and 86.7 +/- 11.1 respectively at 1 year. By repeated measures ANOVA, significant differences existed between groups for MDI and PDI (p = 0.020 and 0.008). However, there were no differences in visual acuity, physical examination variables or vital signs between these two groups. No obvious adverse effects were observed during the study period. CONCLUSION: These results showed possible benefits in the neurodevelopment of larger preterm infants given formula supplemented with DHA and AA.

Arachidonic Acid↗
PubMed2004

Periventricular echogenicity is related to delayed neurodevelopment of preterm infants.

Periventricular leukomalacia (PVL) is one of the most commonly seen neuropathologic lesions and is related to many neurodevelopmental handicaps in premature infants. Periventricular echogenicities (PVE) are considered to be at the milder end of the spectrum of PVL, and thus might affect the neurodevelopment of the preterm infants as well. In this retrospective cohort study medical records of 257 preterm infants who were discharged from our neonatal intensive care unit (NICU) during October 1996 to August 2000 were reviewed. A total of 114 records of preterm infants fulfilling our criteria were included in the survey. On the basis of the craniosonographic findings and birth history, the candidates were divided into three subgroups: group 1 (control) included infants with normal craniosonographic image during the neonatal period; group 2 included infants with PVEs for < 2 weeks during the neonatal period; group 3 included infants with PVEs> or = 2 weeks during the neonatal period. Neurodevelopmental assessment using the Bayley Scale of Infant Development II at 6, 12, and 18 months of corrected age of each group was compared. There were no significant differences among the three groups in gestational age, birth weight, and gender prevalence. Infants in group 3 had lower Mental Developmental Index and Psychomotor Developmental Index scores as compared with those in groups 1 and 2 at 6 ( p< 0.01), 12 ( p < 0.001), and 18 ( p < 0.01) months of corrected age, respectively. In conclusion, infants with PVEs that persisted for at least a 2-week period have significantly higher risk of delayed developmental outcomes as compared with infants with normal craniosonography or infants with PVEs that persisted for less than 2 weeks. It might be prudent to arrange therapeutic intervention for rehabilitation to these high-risk infants as early as possible to reduce the intensity of possible handicap in the future.

Cohort Studies↗
PubMed2004

Neonatal group B streptococcal infection: a 7-year experience.

BACKGROUND: This retrospective study was designed to determine the trend of neonatal group B streptococcal (GBS) infection during the past 7 years at the Chang Gung Memorial Hospital of Kaohsiung, as well as to assess the risk factors, clinical features and patient outcomes. METHODS: Medical records of infants with neonatal GBS infection identified by positive results of cultures of sterile body fluid in our hospital from January 1996 through December 2002 were reviewed for demographic and clinical data. RESULTS: There were 33 infants with neonatal GBS infections during the past 7 years in our hospital. The number of patients increased from 1996 to 2001. Sixteen infants had early onset infections and 17 infants had late onset infections. Of the nine patients with maternal risk factors in the early onset group, prolonged rupture of membranes (7, 44%) was most frequently encountered. Distressed respiratory sign (8, 50%) was the most common clinical presentation in early onset group, while fever >38 degrees C (17, 100%) was the most common presentation in late-onset group. The mortality rates were 13% and 6% in early and late onset groups, respectively. Gestational age (p = 0.05) and pneumonia (p = 0.015) were two most important factors influencing the mortality rate. CONCLUSIONS: The number of GBS-infected infants seemed to have increased during the past 7 years in our hospital. Because the incidence of neonatal GBS infection and maternal colonization in Taiwan has not been collected, we could not determine the necessity of intrapartum chemoprophylaxis. Setting a comprehensive surveillance in Taiwan should be considered.

Humans↗
PubMed2003

Branchial-cleft sinus presenting with a retropharyngeal abscess for a newborn: a case report.

A retropharyngeal abscess rarely occurs in the neonate. We report a neonate without apparent trauma who presented with a left neck mass and respiratory distress at the fourth day of age. A lateral neck X-ray revealed a widened retropharyngeal space. A neck computed tomography (CT) scan revealed a space-occupying lesion with air content in the left retropharyngeal area, although direct laryngoscopy, endoscopy, and a pharyngoesophagogram did not demonstrate the presence of any fistula tract. Due to the high index of suspicion for an aero-digestive tract fistula, diluted contrast medium was injected into the cyst while performing a CT-guided aspiration, and opacification was found in the oropharynx, thus a branchial-cleft sinus appeared to be most likely. The follow-up neck CT scan revealed no evidence of any recurrence. We suggest that CT-guided aspiration and cystography are useful for the diagnosis and treatment of some neonatal neck cystic lesions.

Anti-Infective Agents↗
PubMed2002

Transient hypothyroxinemia of prematurity is associated with abnormal cranial ultrasound and illness severity.

Transient hypothyroxinemia without elevated thyroid-stimulating hormone (TSH) levels is common in prematurity, especially in very-low-birth-weight (VLBW) infants. The transient hypothyroxinemia of prematurity (THOP) has been seen as a "benign" condition not requiring medical treatment. However, some recent large observational studies have revealed a relationship between THOP and abnormal neurodevelopment. Furthermore, one study showed THOP had twice the risk of brain echolucency, which was the best predictable neurodevelopmental dysfunction, than the premature infants with normal or higher thyroxine levels. The relationships among THOP, illness severity, and neurodevelopmental dysfunction remain unclear. We propose a hypothesis that THOP is associated with abnormal ultrasound and illness severity. We studied 54 infants who were admitted more than 14 days at our neonatal intensive care unit (NICU) with a birth weight <2000 g from March 1999 to March 2000. The infants received serum thyroxine (T4), free-T4, and TSH measurement during the first weeks of life. Most of them had serum thyroxine levels measured at approximately 2 weeks of age. The infants enrolled in the study were examined by at least 1 of 3 cranial ultrasounds during the first weeks of life, illness severity evaluation according to the neonatal therapeutic intervention scoring system (NTISS) score, as well as NICU hospital stay period. Infant were classified as THOP by T4 value <5.3 microg/dL (68 nmol/L), which is 2.6 SD below the mean for term infants in Massachusetts, without elevated TSH value (<20 microIU/mL). After adjusting for some confounding factors, such as gestational age, birth weight, duration of mechanical ventilation, infants with THOP were associated with abnormal cranial ultrasound, illness severity, and lower 1-minute Apgar score. In our studies, THOP was related with brain ultrasound anomaly, neonatal illness, and lower Apgar score at 1 minute. Does early thyroxine intervention improve the prognosis and neurodevelopmental dysfunction? This question requires further investigation.

Age Distribution↗
PubMedDate not supplied

Transient hyperammonemia in a neonate.

Neonatal hyperammonemia is a medical emergency requiring a multidisciplinary teamwork for early recognition and early treatment. The causes of neonatal hyperammonemia vary. The transient hyperammonemia of the neonate (THAN) occurs mostly in premature babies, and the prognosis is usually better than for urea cycle disorders. Here we present a near-term premature male infant with THAN. He exhibited the symptoms during the first 36 hours of life and survived after continuous arteriovenous hemodiafiltration (CAVHD). Nutritional support and sodium benzoate were also given. The diagnosis was based on laboratory tests. Long-term follow-up of neurodevelopment was suggested.

Anti-Infective Agents↗
PubMedDate not supplied

Biliary atresia associated with meconium peritonitis.

Biliary atresia, malrotation, meconium peritonitis and transient hypothyroidism are occasionally seen in neonatal infants. Biliary atresia associated with malrotation has been reported in some patients with polysplenia syndrome, but biliary atresia associated with meconium peritonitis has only been described by a few investigators. Here we present a case of meconium peritonitis due to malrotation with volvulus, followed by biliary atresia and transient hypothyroidism during early infancy.

Biliary Atresia↗