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Biomedical subjects

Shin-Nan Cheng

Publications and source records attributed to Shin-Nan Cheng.

At least 19 recordsLinked to original sources
PubMed2006

Hand abscess, phlebitis, and bacteremia due to Salmonella enterica serotype Augustenborg.

Soft tissue and superficial venous infections are uncommon extraintestinal manifestations of non-typhoidal Salmonella (NTS) infections. In contrast to affected adults, who usually show immunological impairment, the majority of children with extraintestinal NTS infections have no predisposing risk factors. Here, we report a previously healthy infant who developed hand abscess, phlebitis, bacteremia, and impending disseminated intravascular coagulation. Blood and abscess cultures showed Salmonella enterica serotype Augustenborg. This organism is an uncommon isolate in humans that can be highly pathogenic and induce rare manifestations of infection as in the present case.

Abscess↗
PubMed2005

Evaluation of the activity of tartrate-resistant acid phosphatase isoform 5b in normal Chinese children--a novel marker for bone growth.

BACKGROUND: Most parents are very concerned about the height of their children. Biochemical markers of bone formation and resorption may provide useful clinical predictors for bone growth. Tartrate-resistant acid phosphatase 5b (TRAcP 5b) has been advocated as a biomarker of osteoclast activity and bone resorption. However, the TRAcP 5b levels of children at different ages are still unknown. It is necessary to accumulate and analyze the data for healthy children at different ages. OBJECTIVES: We use an improved immunoassay for bone TRAcP 5b to examine sera from children to see whether it is a significant marker of bone growth. METHODS: Serum, including cord blood, was collected from 404 normal Chinese children (age range 0-17 years; 225 male, 179 female). The venous blood was withdrawn from the peripheral vein and stored at 4 degrees C before centrifugation for serum collection. All sera were stored at -70 degrees C and thawed at 37 degrees C immediately before TRAcP 5b levels were measured. Bone-specific alkaline phosphatase (BAP) was also used for comparison with TRAcP 5b levels at different ages. RESULTS: TRAcP 5b levels were extremely high in infants of both genders, gradually decreasing with age (p <0.001). A second peak in TRAcP 5b values occurred at 12-13 and 10-11 years in males and females, respectively (p <0.001). Age alone, as well as age-related changes between the male and female groups, were independent predictors of TRAcP 5b levels (p <0.001). There was no significant between-gender difference in serum TRAcP 5b levels for any age group (p = 0.682). BAP values did not show a significant second peak in females. Age and gender alone, as well as the age-related changes between male and female groups, were independent predictors of BAP values (p <0.001). CONCLUSION: Preliminary results were established for serum TRAcP 5b and BAP values of normal Chinese children of different ages. Elevated serum TRAcP 5b values were observed during infancy and puberty for both genders. The pattern of this age-related change in serum TRAcP 5b levels is similar to the shape of the standard height velocity curve for healthy children. Values of BAP were less specific than TRAcP 5b. These data may prove valuable as a normal reference in future research about bone markers.

Acid Phosphatase↗
PubMed2004

Identical twin brothers concordant for Langerhans' cell histiocytosis and discordant for Epstein-Barr virus-associated haemophagocytic syndrome.

UNLABELLED: We report on identical twin brothers, one of whom presented at 14 months of age with fever and clinical, laboratory and histological evidence of Epstein-Barr virus-associated haemophagocytic syndrome (EBV-AHS) and 4 months later with typical signs and symptoms of Langerhans' cell histiocytosis (LCH). The other twin, without previous symptoms, also displayed at that time LCH associated with signs of recent EBV infection, but without symptoms of haemophagocytic syndrome. No mutation in the SH2D1A gene, as observed in X-linked lymphoproliferative disease, or in the perforin gene as observed in some cases of hereditary haemophagocytic syndrome, was found. CONCLUSION: the occurrence of haemophagocytic syndrome and Langerhans' cell histiocytosis, although genetically based, can be triggered by environmental agents and viruses, in particular Epstein-Barr virus.

Diseases in Twins↗
PubMed2004

Osteoblast and osteoclast activity in a malignant infantile osteopetrosis patient following bone marrow transplantation.

The authors treated a 6-month-old boy with malignant infantile osteopetrosis using bone marrow transplantation. The patient's clinical response was compared with his biochemical response for bone metabolic markers such as tartrate-resistant acid phosphatase 5b (TRAcP 5b) and bone-specific alkaline phosphatase (BAP). Treatment was successful, resulting in a decrease in the serum TRAcP 5b level. These bone-specific markers may be useful for the early assessment of malignant infantile osteopetrosis patients with stem cell transplantation.

Acid Phosphatase↗
PubMed2004

Assessment of chemotherapy-induced oral complications in children with cancer.

OBJECTIVE: To assess children with cancer for oral complications using the oral assessment guide (OAG) and ascertain the efficacy of an oral hygiene care regimen in children undergoing chemotherapy and at 1 to 2 weeks postchemotherapy administration. METHODS: Thirty pediatric cancer patients with either leukemia or lymphoma were randomly selected from 3 medical centers. A quasi-experimental design was used to evaluate the difference between pre- and post-oral hygiene care. Descriptive and inferential statistical techniques were used to analyze the data. The interrater agreement between the nurse and the dentist was calculated using a Kappa score. A paired t test was to examine the difference between pre- and post-oral hygiene care regimen. RESULTS: The OAG scores ranged from 8 to 24. The higher the score, the more severe the oral complications. Ninety-six percent of the participants had a score > or = 9, on the pre-test, 26.7% had an OAG score > or = 12. Oral complications included ulcerated mucous membranes, dry lips, deeper or raspy voice, and oral debris. No scores were > or = 12 on the OAG following the posttest. The oral hygiene care regimen significantly improved oral assessment among patients (P < .05). CONCLUSIONS: The authors postulate that the OAG and oral hygiene care regimen may be clinically useful in improving oral assessment and hygiene in children with cancer during and after chemotherapy, thus decreasing associated infection and enhancing patient comfort.

Adolescent↗
PubMed2004

McCune-Albright syndrome associated with pituitary microadenoma: patient report.

McCune-Albright syndrome (MAS) is a rare disorder characterized by the classic triad of precocious puberty, polyostotic fibrous dysplasia and café-au-lait spots. Additional endocrine abnormalities may also be present, including hyperthyroidism, growth hormone excess and hyperprolactinemia. The most commonly encountered endocrine dysfunction is gonadal hyperfunction. Gonadotropin-independent precocious puberty is typically the initial manifestation of MAS in girls. Ovarian cysts may be detected on pelvic ultrasound. Our patient was also found to have pituitary microadenoma, evidenced by dynamic magnetic resonance imaging.

Adenoma↗
PubMed2004

Mycoplasma pneumoniae infection presenting as neutropenia, thrombocytopenia, and acute hepatitis in a child.

Extrapulmonary manifestations of Mycoplasma pneumoniae pneumonia are uncommon and include hematologic, gastrointestinal, musculoskeletal, dermatologic, and neurologic complications. We report a case of serologically-confirmed M. pneumoniae infection complicated by severe neutropenia, thrombocytopenia, and hepatitis. The presence of antiplatelet and antineutrophil antibodies suggested that these autoantibodies caused the cytopenias. The disease had an acute course and the patient recovered after steroid treatment. This case indicates that neutropenia, thrombocytopenia and hepatitis are possible clinical manifestations of M. pneumoniae infection.

Antibodies, Bacterial↗
PubMed2003

X-linked centronuclear myopathy.

We report the cases of two male preterm newborns with X-linked centronuclear myopathy (CNM). This is the most severe type of CNM. Each of them presented with generalized hypotonia, weakness, difficulty in swallowing, and respiratory distress at birth. Physical examination of both newborns revealed long thin face, high-arched palate, mild bilateral ptosis, frog-leg posture, and absence of deep tendon reflex. Diagnosis of the disease was made according to fetal history, family history, muscle histopathology, electron microscopy, and genetic analysis. Subdural hemorrhage of brain and subcapsular hematoma of the liver were found at autopsy of Case 1. The results of molecular analysis of Case 2 and his family favored the diagnosis of X-linked CNM. Molecular studies can be easily performed with only minute amount of DNA of patients, and may help the clinician to predict which patients may be at the risk for medical complications.

Fatal Outcome↗
PubMed2003

Leukemic infiltration of the urinary bladder presenting as uncontrollable gross hematuria in a child with acute lymphoblastic leukemia.

Acute leukemia can result in leukemic infiltration of many organs, but leukemic infiltration of the bladder is rare. The authors describe an 8-year-old girl with acute lymphoblastic leukemia who, during marrow relapse, had uncontrollable gross hematuria secondary to leukemic infiltration of the bladder. Cystoscopic biopsy confirmed the diagnosis. Literature review revealed 13 cases of acute leukemia with bladder involvement. Although leukemic infiltration of the bladder is rare, it should be considered in patients with acute leukemia and hematuria. Urine cytology might help detect bladder involvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Systemic lupus erythematosus-related acute pancreatitis: a case report.

Systemic lupus erythematosus presenting as acute pancreatitis is rare. We report a case of a 12-year-old girl with a 1-year history of systemic lupus erythematosus who developed active pancreatitis. The pancreatitis was first manifested by nausea, vomiting, fever, and abdominal pain. Elevated serum amylase (578 U/L) and lipase levels (5588 U/L), and pancreatic enlargement on ultrasound and computerized tomography confirmed the diagnosis. She responded well to high-dose corticosteroid. The high titer of antinuclear antibodies (1:1280) and low level of complement components (C3, 42.9 mg/dL; C4, 2.3 mg/dL) during the pancreatitis attack suggested that the pancreatitis may have been due to systemic lupus erythematosus exacerbation and not related to drug therapy.

Acute Disease↗
PubMed2002

Infected cephalohematoma associated with sepsis and scalp cellulitis: a case report.

Infected cephalohematoma is rarely complicated by sepsis. We report a case of an infected cephalohematoma caused by Escherichia coli sepsis in an otherwise healthy neonate. Skull X-ray revealed soft tissue swelling over parieto-temporal region but no osteolytic lesion. 99mTc bone scan showed scalp cellulitis. Blood culture and scalp wound culture identified E. coli. Treatment with surgical incision and drainage and administration of antibiotics resulted in prompt improvement. The relationship of scalp cellulitis, infected cephalohematoma, and sepsis are discussed.

Cellulitis↗
PubMedDate not supplied

The influence of pacifier sucking on mesenteric blood flow in infants.

Thirty-six neonates were randomly assigned to 2 groups of 18 neonates each. In the pacifier group, infants were given a pacifier before milk feeding. Newborns in the control group were fed without preprandial use of a pacifier. Doppler measurement of peak systolic velocity, end-diastolic velocity, and Pourcelot resistance index in the superior mesenteric artery was performed in both groups. Peak systolic and end-diastolic velocities were significantly increased after pacifier sucking in the preprandial stage. The resistance index decreased significantly after milk feeding but not after pacifier sucking. The feeding volume was not affected by preprandial pacifier sucking.

Humans↗
PubMedDate not supplied

Childhood Langerhans cell histiocytosis increased during El Niño 1997-98: a report from the Taiwan Pediatric Oncology Group.

From 1995-1999, a nation-wide study of Langerhans cell histiocytosis (LCH) in children less than 15 years old was conducted by the Taiwan Pediatric Oncology Group. The demographic and clinical data of 55 cases were analyzed. Thirty-two cases presented from the beginning of 1997 to the end of 1998, when the most severe El Niño in the century occurred. The incidence was higher than expected during this El Niño period (32 cases versus 22 cases, p = 0.003). During 1997-98, most LCH was diagnosed in summer (n = 15), autumn (n = 8), and winter (n = 8) but rarely in spring (n = 1); coincidentally, rainfall was least in winter but peaked in summer. During 1997-98, the most significant increase occurred in the polyostotic LCH subcategory (p = 0.017), with younger ages at diagnosis (p = 0.039). The incidence of LCH cytopenia, fever, and diseases of the skin, liver, spleen or other organs did not differ significantly. Local treatment modality, disseminated diseases and diagnosis during the El Niño of 1997-98 were independent risk factors predicting the recurrence or progression of LCH. Our findings suggest that particular infections or other environmental factors associated with El Niño might be related to the etiology of childhood LCH.

Adolescent↗
PubMedDate not supplied

Treatment of a pineal yolk sac tumor: report of one case.

Pineal yolk sac tumors are rare. We present a case of pineal yolk sac tumor in a 15-year-old boy with hydrocephalus and possible cerebrospinal dissemination. He was treated by surgical excision, craniospinal axis irradiation, PVBE (cisplatin, vinblastine, bleomycin, and etoposide) chemotherapy, and intrathecal methotrexate chemotherapy. There was no tumor recurrence at follow-up 2.5 years after treatment.

Adolescent↗
PubMedDate not supplied

Hyposensitization therapy reduced exhaled nitric oxide in asthmatic children with corticosteroid dependency.

Measurement of exhaled nitric oxide (FeNO) is a simple and noninvasive method for assessment of airway inflammation severity in asthmatic patients. The aim of this study was to investigate whether hyposensitization with extracts of Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) could decrease airway inflammation as determined by FeNO levels. Ten asthmatic children with corticosteroid dependency were recruited for the study. Eight subjects completed a ten months mite hyposensitization regimen. FeNO concentrations, asthma symptom scores and peak expiratory flow rates (PEFR) were measured monthly before and after treatment. FeNO levels from asthmatic patients were found to be higher before treatment (65.34+/-31.63 ppb). FeNO levels fell significantly after four months' treatment (39.89+/-21.13 ppb; p<0.05). PEFR increased significantly five months after hyposensitization treatment (214.38+/-49.38 vs 251.25+/-28.00; p<0.05). Asthma symptom scores decreased 5 months after hyposensitization treatment (6.84+/-1.22 vs 5.80+/-0.67, p<0.05). Hyposensitization with extracts of Der p and Der f appears to improve clinical symptoms and reduce airway inflammation as determined by FeNO concentrations in children with mite allergy asthma.

Adolescent↗
PubMedDate not supplied

Cellulitis resulting from infection by Haemophilus influenzae type b: report of two cases.

Cellulitis resulting from infection by Haemophilus influenzae type b (Hib) is uncommon but may be a characteristic of such infection. Especially in the post-Hib vaccine era, such infection represents a potentially life-threatening infectious process due to the relatively high incidence of accompanying bacteremia and meningitis. Here, we report on two apparently previously healthy children who developed Hib cellulitis, one of whom revealed lower-leg cellulitis while the other exhibited buccal cellulitis associated with an oral ulcer. To the best of our knowledge, there have been no formal reports pertaining to buccal cellulitis following infection by Hib yet published in Taiwan, and reports of Hib cellulitis of the extremities still appear to be rare, hence we report on these two cases.

Amoxicillin↗