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Biomedical subjects

T F Yeh

Publications and source records attributed to T F Yeh.

90 records · Page 5Linked to original sources
PubMed1977

Hydrocortisone therapy in meconium aspiration syndrome: a controlled study.

To evaluate the efficacy of glucocorticoids in the treatment of infants with meconium aspiration syndrome, a double-blind study using hydrocortisone or a lactose placebo was undertaken. Thirty-five infants were included in the study. No significant differences in arterial Po2, Pco2, pH, A-aDo2 gradients, in requirement for assisted ventilation, or in survival were domonstrated between the groups. In control infants, a significant decrease (p less than 0.01) in respiratory distress score was found at 48 to 72 hours of age; in treated infants, it was seen only after 72 hours. The infants in the treated group took a significantly longer (p less than 0.01) period of time to wean to room air than those in the control group (68.9 +/- 9.6 hours vs 36.6 +/- 6.9 hours). On the basis of these observations, hydrocortisone is not recommended for treatment of MAS.

Drug Evaluation↗
PubMedDate not supplied

Vallecular cyst: an uncommon cause of stridor in newborn infants.

UNLABELLED: Vallecular cyst, a rare but generally benign lesion in the larynx, may cause stridor and even life-threatening airway obstruction in early infancy. We retrospectively studied 14 cases of newborn infants with vallecular cyst. There was no gender predilection and most cases were full-term and appropriate for gestational age. The clinical presentations included stridor, chest wall retraction, feeding difficulties and failure to thrive. Laryngomalacia was the most common associated anomaly. Flexible laryngoscopy was sufficient for diagnosing the vallecular cyst and larygmalacia. Maintenance of airway patency, nutritional support, and de-roofing of the cyst were the mainstays of management. CONCLUSION: Vallecular cyst should be included in the differential diagnosis of stridor in newborn infants. Respiratory and feeding difficulties in these patients can be dramatically improved after appropriate surgical removal of the cyst.

Cysts↗
PubMedDate not supplied

Fuzzy oxygen control system for the indirect calorimeter of premature infants.

The indirect calorimetric system of measuring O2 consumption and CO2 production has been developed for energy expenditure estimation of premature infants. This apparatus requires an input room air mixing with pure oxygen to obtain a stable gas with definite oxygen concentration flowing into the hood for neonatal breath or supplemental oxygen treatments. In this paper, we propose an oxygen control system based on fuzzy control logic to automatically adjust the mixing ratio of room air to pure oxygen gas from the hospital's supply system, designed for premature infants. It is designed to reduce the risks of oxygenic toxicity and retinopathy of prematurity by lowering the overshoot of oxygen concentration. Its performance was evaluated and optimal membership functions were obtained. As a result, the system is quite robust with little effect caused by disturbance and has little or no overshoot when step changing the level of oxygen concentration in the mixed gas.

Calorimetry, Indirect↗
PubMedDate not supplied

Critical care problems of the newborn: insensible water loss in small premature infants.

During the control period in this study, small premature infants, 1500 g in birth weight, had insensible water loss (IWL) of 2.28 g/kg/hr (equivlaent to 54 ml/kg/day), which is considerably higher than in full term infants. Under phototherapy, there was a significant increase in IWL (3.14 g/kg/hr) associated with increase of skin and rectal temperature. The heart rate and respiratory rates were comparable. Full term infants in stress situations such as phototherapy can compensate for water losses by increasing oral intake. In small premature infants, reliance must be placed upon increased amounts of parenteral fluids when under phototherapy.

Body Temperature↗
PubMedDate not supplied

Acid-base balance in small premature infants (less than 1500 grams) with type II RDS.

Twenty-one small premature infants with clinical features and radiological findings of type II RDS were studied. Correction of blood pH, corresponding with the decrease of blood PaCO2, was usually seen in the first eight hours of age. Clinical inprovement, as judged by the RDS score, was noted only after 12 hours of age. Complete recovery was the rule although signs of respiratory distress in a few infants lasted for 48-72 hours. The calculated AaDO2 and total Qs/Qt weer slightly higher (27.8%) than reported in normal infants and remained unchanged until after 48 hours of age when it decreased to 24.5%.

Acid-Base Equilibrium↗
PubMedDate not supplied

Pulsed high-dose dexamethasone therapy in children with chronic idiopathic thrombocytopenic purpura.

PURPOSE: The effectiveness of pulsed high-dose oral dexamethasone therapy in children with refractory chronic idiopathic thrombocytopenic purpura (ITP) is evaluated. PATIENTS AND METHODS: Seven children (5 to 16 years old) who were refractory to 2 to 5 conventional standard therapies were included in the study. Dexamethasone was administered orally at a dosage of 40 mg/m2 per day (maximum 40 mg/day) for 4 consecutive days as a cycle. The cycle was repeated once a month for 6 months. RESULTS: One month after the first cycle, partial responses of platelet counts (> or = 50 x 10(9)/L and < 150 x 10(9)/L) were observed in three patients (43%). At the end of the sixth cycle, two patients (29%) had complete responses (> 150 x 10(9)/L) and one had a partial response. However, only one patient (14%) remained partially responsive 1 year after completion of therapy. CONCLUSIONS: In contrast to what was observed in adults, this preliminary study suggests that pulsed high-dose oral dexamethasone therapy was not uniformly effective in children with chronic ITP.

Administration, Oral↗
PubMedDate not supplied

Blunted serum erythropoietin response to anemia in patients polytransfused for beta-thalassemia major.

PURPOSE: To investigate the response of erythropoietin (EPO) to anemia in patients polytransfused for beta-thalassemia major. PATIENTS AND METHODS: We measured the serum EPO levels and the concurrent hemoglobin (Hb) concentrations in 40 patients polytransfused for beta-thalassemia major, in 18 patients with iron deficiency anemia (IDA), and 32 healthy subjects. Serum EPO levels were assayed by an enzyme immunoassay. RESULTS: In both groups with beta-thalassemia major and IDA, serum EPO levels were significantly elevated (114 +/- 71 and 239 +/- 217 mU/mL, respectively). There was a significant inverse correlation between log EPO values and Hb concentrations in patients with beta-thalassemia major (r = 0.61; p < 0.01) and IDA (r = 0.81; p < 0.01). In a semilogarithmic plot, the slope of the regression line obtained in patients with beta-thalassemia major was significantly lower than that of IDA (p < 0.01), suggesting a blunted EPO response to anemia in patients polytransfused for beta-thalassemia major. The elevation of serum EPO in patients with beta-thalassemia major was poorly related to clinical variables except serum ferritin. CONCLUSIONS: We conclude that a significant inverse relationship between serum EPO levels and Hb concentration exists in patients with beta-thalassemia major. However, this EPO response in patients with anemia caused by beta-thalassemia major may be blunted when compared to patients with IDA.

Adolescent↗
PubMedDate not supplied

Mortality, morbidity, length and cost of hospitalization in very-low-birth-weight infants in the era of National Health Insurance in Taiwan: a medical center's experience.

The impact of implementation of the National Health Insurance on the outcome, cost, and length of hospitalization of very-low-birth-weight (VLBW) infants is not clear in Taiwan. These data are important for the planning of medical care and regionalization in this area. This study was an attempt to examine these questions. We retrospectively collected mortality, morbidity, and length and cost of hospitalization data of VLBW (BW < 1500 g) infants between March 1995 and February 1998. There were totally 162 patients enrolled. The overall mortality rate was 21.6%; the birth weight (BW)-specific mortality rate was 72%, 31%, 19%, and 3% for infants with BWs of < 750 g, 750-999 g, 1000-1249 g, and 1250-1499 g, respectively. The incidence of morbidities were: respiratory distress syndrome (74%), patent ductus arteriosus (36%), necrotizing enterocolitis (9%), sepsis (42%), intraventricular hemorrhage (15%), retinopathy of prematurity (31%), failure to pass auditory brainstem response (ABR) (34%), and chronic lung disease (17%). The average length of hospitalization was 67.2 days, and the cost per infant was 62 x 10(4) NT dollars; 108 +/- 38 days, 73 +/- 32 x 10(4) NT dollars if BW < 750 g; 94 +/- 15 days, 99 +/- 35 x 10(4) NT dollars if BW 750-999 g; 66 +/- 23 days, 64 +/- 36 x 10(4) NT dollars if BW 1000-1249 g; and 43 +/- 14 days, 39 +/- 37 x 10(4) NT dollars if BW 1250-1499 g. In conclusion, VLBW infants are associated with high mortality and morbidity rates. They have long lengths and high costs of hospitalization, and therefore deserve attention in the implementation of the National Health Insurance and regionalization.

Hospital Costs↗
PubMedDate not supplied

Outcome and cost of intensive care for very low birth weight infants.

Very low birth weights (VLBW) remain the major factor contributing to neonatal mortality and morbidity. The development of Neonatal Intensive Care Units (NICU) has improved the outcome for the VLBW infants. However, outborn VLBW infants may have different outcomes, and different medical costs than those born intramurally. This study compared the mortality, morbidity and costs of inborn and outborn VLBW infants cared in the NICU of a tertiary care center. A total of 176 VLBW infants (inborn 83, outborn 93) were examined over the three years period June 1990 to May 1993. The birth weights (1131 +/- 244 g vs 1133 +/- 255 g) and gestational ages (29.0 +/- 4.0 wk vs 28.9 +/- 3.0 wk) were not different between the two groups. However, the age of admission to our wards was significantly different between the inborn infants (5.0 +/- 3.2 hr.) and outborn infants (53.6 +/- 26.8 hr.). There was no difference in mortality rates between the outborn infants (35.7%) and the inborn infants (32.9%), nor in the incidence of intraventricular hemorrhage, respiratory distress syndrome, sepsis, necrotizing enterocolitis, retinopathy of prematurity or abnormal auditory brainstem response. However the incidence of patent ductus arteriosus and chronic lung disease of the outborn infants was higher than those of the inborn (47% vs 32%, 51% vs 29% respectively). The mean duration of hospitalization and cost seemed to be longer and higher in the outborn VLBW infants. It was concluded that outborn VLBW infants have higher rates of morbidity, longer hospitalization and cost more than inborn infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Care Costs↗
PubMedDate not supplied

Renal effects and urinary excretion of prostaglandin following indomethacin therapy in premature infants with patent ductus arteriosus.

Renal side effects and urinary prostaglandin were evaluated in 10 premature infants (Mean +/- SD: BW 1245 +/- 290 gm, GA 32 +/- 2.2 wks, Postnatal age 7.7 +/- 3.8 days) with significant PDA who were given one dose of indomethacin (0.3 mg/kg intravenously). There was a significant decrease in urinary output, osmolal and free water clearance after therapy. The fractional excretion of sodium, chloride, potassium, glomerular filtration rate and urinary prostaglandin E2 also decreased but were not statistically different from the baseline values. In infants who responded to indomethacin with ductus closure, their renal functions appeared to be preserved even though they had higher plasma indomethacin levels than the non-responders in whom significant changes in renal function were observed following indomethacin therapy. This observation suggested that the improved renal hemodynamics following the closure of the ductus may minimize or attenuate the renal side effects of indomethacin.

Ductus Arteriosus, Patent↗
PubMedDate not supplied

Vital statistics of premature and low birthweight infants in Tainan area.

UNLABELLED: Birth weight and gestational age are strongly associated with perinatal mortality and morbidity. This study was conducted to survey the vital statistics of premature and low birthweight infants in the Tainan area. Between July 1991 and April 1992, fifteen medical institutions were included on a voluntary basis: eight from level I (obstetric specialty clinic), six from level II (regional hospital), and one from level III (tertiary care center). A total of 14,307 deliveries were enrolled, accounting for about 60% of the total delivery for that year in the area. The proportions of delivery among level I, II and III were 52%, 41% and 7%, respectively. The incidence of premature singleton live birth was 4.6%, and the percentages of gestation between 20-27 weeks, 28-31 weeks and 32-37 weeks were 0.2%, 0.6% and 3.8%, respectively. The premature births accounted for 3.5%, 4.8% and 11.3% of live births at the level I, II and III hospitals, respectively. The incidence of low birthweight and very low birthweight singleton live births was 4.4% and 0.5%, respectively. The low birthweight births accounted for 3.5%, 4.5% and 11.1% of live births at the level I, II and III hospitals, respectively. The data revealed that the higher the level of hospital, the higher incidences of premature and low birthweight infant. Teenage mothers (< 20 year of age) had higher low birthweight rate. The risk of having low birthweight infants decreased progressively in mothers of age < 20 (6.3%), 20-24 (5.4%), 25-29 (4.1%) and 30-34 (3.8%), whereas it became higher in mothers older than 35 (4.8%). CONCLUSION: The incidence of premature and low birthweight births in the Tainan area was low. Teenager or those with maternal age older than 35 year were high risk groups for producing these infants.

Adolescent↗