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Biomedical subjects

W C Yip

Publications and source records attributed to W C Yip.

At least 19 recordsLinked to original sources
PubMed1991

Social class distribution of obese Chinese children.

Four hundred and eighty four obese Chinese children who were defined obese by a relative weight of more than 120% of standard weight-for-height had their social status evaluated. The social class of each child was arbitrarily determined according to the father's occupation. The distribution of obese children in various social levels was compared with that of the working population in Singapore. Significantly greater proportions of children were in the upper and middle social classes compared with the general working population. Such trends may be related to the increased affluence of the society and the accompanying changes in life-styles and eating habits, and will influence measures in health education and control of childhood obesity in the future.

Child↗
PubMed1991

Assessment of ventricular septal defect by colour flow mapping.

The purpose of this study was to evaluate the usefulness of colour flow mapping (CFM) in the diagnosis and classification of congenital ventricular septal defect (VSD) and in the confirmation of spontaneous and surgical closure. Between August 1988 and March 1990, a total of 102 patients with isolated VSD (82 preoperative and 20 postoperative), age ranging from one day to 14 years, were subjected to 176 echocardiographic examinations. Sequential cross sectional imaging and CFM were the main modalities of assessment with conventional Doppler interrogation for quantitative measurements. In the preoperative group, there were 56 (68.3%) perimembranous (pm) VSD, 14 (17.1%) muscular (m) VSD and 12 (14.6%) doubly committed subarterial (dcsa) VSD. Ventricular septal defect was detected by CFM only in 88.9% of m/VSD, 57.6% of dcsa/VSD and 11.8% of pm/VSD (p less than 0.01). Spontaneous closure rate was highest in m/VSD (28.6%) followed by pm/VSD (8.9%) (p = 0.05). None of the dcsa/VSD closed as assessed by CFM. In the postoperative group, CFM served to quickly confirm complete closure without residual left to right shunt in 20 patients. In addition, CFM was useful in the assessment of haemodynamics and flow directed Doppler interrogation. Hence, CFM is a useful adjunct to cross sectional imaging in the assessment of children with isolated VSD.

Adolescent↗
PubMed1990

Sonographic screening for renal tract anomalies associated with congenital heart disease.

The incidence of structural renal tract abnormalities in 109 children with documented congenital heart disease (CHD) was studied using real-time sonography. In these children, 11.9% had associated urologic anomalies, which included hydronephrosis, duplication, ectopia, agenesis, and dysplasia of kidneys. Children with associated extracardiac anomalies had a significantly higher incidence of renal tract anomalies (39.1%) compared to those with isolated CHD (4.7%). Therefore, sonographic screening of the renal tract should be performed routinely in patients with CHD, especially in those with multiple congenital defects.

Abnormalities, Multiple↗
PubMed1990

Percutaneous transluminal balloon valvuloplasty: the treatment of choice for congenital valvar pulmonary stenosis.

Forty-eight children with suspected isolated pulmonary valvar stenosis were evaluated clinically and echocardiographically between January 1987 and December 1988. Fourteen patients with significant transpulmonary peak systolic pressure gradient greater than 30 mmHg on continuous-wave Doppler interrogation were subjected to right heart catheterisation. Percutaneous transluminal balloon valvuloplasty was performed in 11 of these patients with peak systolic pressure gradient than 40 mmHg across the pulmonary valve at cardiac catheterisation. Satisfactory reduction of systolic right ventricular pressure (110 +/- 43 to 46 +/- 17 mmHg, p less than 0.001) and peak systolic pressure gradient across pulmonary valve (92 +/- 44 to 27 +/- 16 mmHg, p less than 0.001), were achieved in all cases. The reduction of peak systolic pressure gradient (64 +/- 37 mmHg, range = 29-158 mmHg), was positively correlated with the initial right ventricular systolic pressure (r = 0.92, p less than 0.0002). There was no significant complication in this series and all patients were discharged the day after the procedure. Percutaneous transluminal balloon valvuloplasty is effective and safe. It should be the treatment of choice for significant valvar pulmonary stenosis in children.

Cardiac Catheterization↗
PubMed1989

Kawasaki syndrome in Chinese children.

A retrospective analysis of the clinical features and outcome of 39 Chinese children with Kawasaki syndrome was made. The mean age of onset was 2.7 years (range: 0.2-13 years). The male:female ratio was 2.9:1. One child presented with nephrotic syndrome. This renal manifestation has not been described in Kawasaki disease. Ten (32%) out of 31 patients were found to have coronary aneurysms by cross-sectional echocardiography. The only significant risk factor detected in this group of patients was anaemia (P less than 0.007). There was one (2.5%) death from acute myocardial infarction and the rest of the patients were clinically well with a mean follow-up period of 1 year (mean: 5-40 days). This study indicates that there is a high incidence of coronary aneurysm complicating Kawasaki syndrome in Chinese comparable with that reported in Japanese children.

Child, Preschool↗
PubMed1989

Detection of cardiac problems among school children by health screening.

A study was undertaken to assess the types of cardiac diseases and dysrhythmias in a healthy population of 651,794 school children who underwent general health screening between January 1981 to December 1986. Congenital heart lesions were diagnosed in 1159 (0.18 per cent), the majority being mitral valve prolapse (MVP; 0.08 per cent), small ventricular septal defects (VSD; 0.04 per cent), mild pulmonary stenosis (PS; 0.03 per cent), and small atrial septal defects (ASD; 0.02 per cent). Other lesions detected were patent ductus arteriosus (PDA), coarctation of aorta (CoA), Fallot's Tetralogy (FT) and total anomalous pulmonary venous drainage (TAPVD). Of these, five had surgical closure of ASD, eight and ligation of PDA, and one had correction for TAPVD. Cardiac dysrhythmias were seen in 350 patients; consisting of premature ventricular contractions (PVC) in 186, right bundle branch block (RBBB) in 132, atrial ectopics (AE) in 17, sinus node dysfunction in five, atrioventricular (AV) block in seven, Wolff-Parkinson-White (WPW) syndrome in two, and paroxysmal atrial tachycardia (PAT) in one boy. Associated congenital heart lesions were found in 110 patients. The cardiac screening programme has resulted in a significant detection of cardiac abnormalities among apparently healthy school children. Early detection of cardiac disease has resulted in early remedial measures to be taken and thus improved cardiological care.

Arrhythmias, Cardiac↗
PubMed1989

Nephrotic syndrome in Kawasaki disease.

Renal manifestations in Kawasaki disease are rare, and nephrotic syndrome in this disorder has not been described previously. We report a 3 month old infant with Kawasaki disease, presenting with nephrotic syndrome which responded to steroid therapy. The patient, however, developed coronary aneurysms and died of acute myocardial infarction.

Acute Disease↗
PubMed1989

Cardiac arrhythmias in paediatric practice.

Clinical data of patients with cardiac arrhythmias managed between May 1986 and March 1988 were reviewed to determine their mode of presentation and clinical course. Of the 5,768 admissions, 62 (1.07%) patients had arrhythmias. During the same period, 21 patients were managed as outpatients with 13 being new referrals. Thirty-eight patients had undergone corrective cardiac procedures, 8 others had congenital heart lesions, 3 were associated with acquired cardiac pathology and the remaining had isolated arrhythmias. The cardiac arrhythmias were: right bundle branch block 36, premature atrial and ventricular contractions 15, supraventricular tachycardia (SVT) 15, atrioventricular (AV) block 7, sinus bradycardia 3, atrial fibrillation 2, ventricular tachycardia and fibrillation 2, Wolff-Parkinson-White syndrome without SVT 2, bradytachyarrhythmia 1. There were 3 patients with foetal SVT, one persisting till day 1. High grade AV block occurred in 2 patients post-surgically and needed pacing. Only 2 others were symptomatic. Other than the 38 patients who underwent corrective procedures (2 had balloon valvuloplasty for pulmonary stenosis), 8 others had structural heart disease. There was 1 sudden death and 5 died from their primary heart disease.

Adolescent↗
PubMed1989

Infantile hypertrophic pyloric stenosis: evaluation of sonographic criteria.

Sonography has become an important diagnostic adjunct in the evaluation of vomiting infants who are suspected to have infantile hypertrophic pyloric stenosis (IHPS). Two commonly used sonographic criteria, viz. pyloric diameter (D) and pyloric muscle wall thickness (T) were evaluated in 14 consecutive vomiting infants. The D and T were significantly larger in the IHPS group compared to the non IHPS group (1.40 +/- 0.34 cm vs 0.95 +/- 0.19 cm, p = 0.04; 4.4 +/- 1.1 mm vs 2.5 +/- 0.6 mm, p less than 0.01). By a combination of sonographic criteria (D greater than or equal to 1.2 cm & T greater than or equal to 3 mm), all the 4 non IHPS patients and 9 out of 10 IHPS patients were correctly diagnosed. The positive and negative predictive values were 1.00 and 0.80, respectively. However, using reported diagnostic criteria of D greater than or equal to 1.5 cm or T greater than or equal to 4 mm would have missed 60% and 20% of the IHPS cases, respectively. With proper choice of diagnostic criteria, sonography is a useful diagnostic tool in the evaluation of vomiting infants for IHPS patients.

Humans↗
PubMed1989

Evaluation of lung function in Singapore obese children.

In this study, 65 obese children with a mean age of 12.1 years and mean relative weight (RW) of 156.1% had their lung function evaluated in comparison to predicted normal values. There were substantial changes in forced expiratory flow rates (FEF's) and maximum voluntary ventilation (MVV), with reductions to between 60% to 70% of predicted normal values. The more obese children (RVV greater than or equal to 150%) had significantly lower FEF's and MVV and a significantly greater proportion of the more obese children had FEF50 and MVV of less than 60% of predicted normal values. The results were suggestive of narrowing of small airways and increased respiratory inertance possibly due to excessive accumulation of fat in the chest wall and abdomen leading to respiratory limitation.

Adolescent↗
PubMed1988

An inexpensive spacer for use with metered-dose bronchodilators in young asthmatic children.

A 1-liter soft drink plastic bottle was modified as a spacer for use with a metered-dose bronchodilator. Its efficacy was tested on 22 children aged 3.9-7.5 years who had acute asthma. They were randomly selected to receive aerosolized salbutamol or placebo via the plastic bottle. Children who received the salbutamol showed significantly greater degree of bronchodilation than those who received the placebo. No significant adverse effects were observed. Cylindrical plastic bottles of 1-liter capacity may thus be used as a convenient and cheap spacer to effectively deliver metered-dose bronchodilators to children during acute asthma.

Administration, Inhalation↗
PubMed1988

Transluminal balloon dilation of resected coarcted segments of thoracic aorta: histological study and clinical implications.

The effect of experimental balloon dilation on seven excised specimens of classic coarctation was assessed histologically. Widening of the lumen was achieved in all specimens by tears in the vessel wall. The tears extended through the intima in one specimen and through both intimal and medial layers in six specimens. In view of the extent of wall damage, we postulate that there would be serious long-term complications following balloon dilation for the treatment of native coarctation.

Adult↗
PubMed1988

Limitations and dangers of gastrografin swallow after esophageal and upper gastric operations.

In a series of 135 patients who underwent esophageal and upper stomach surgery, the incidence of anastomotic leakage was 20.4 percent. One hundred four patients had either Gastrografin swallow or the methylene blue test to evaluate anastomotic integrity before resumption of oral feeding. Both tests were disappointing in that methylene blue failed to detect any case of leakage and Gastrografin swallow could only detect three cases of subclinical leakage. The high false-negative detection rate of Gastrografin swallow might be related to the inferior radiographic detail provided by this contrast medium. Aspiration of Gastrografin is potentially dangerous and could be fatal. We believe that barium sulfate, which provides better radiographic detail and is not so hazardous when aspirated, should be the contrast medium of choice.

Anastomosis, Surgical↗
PubMed1988

Influence of surgeons' experience on postoperative sepsis.

A prospective study was performed on 635 patients with appendicitis operated on by 7 trainees and 119 patients operated on by 6 senior surgeons with more than 8 years of surgical experience. In patients with normal appendices, postoperative sepsis was extremely low. For early and late appendicitis, the infection rates of the trainees decreased as experiences accumulated, but they were still higher than that of the senior surgeons. The difference in infection rates in acute appendicitis did not reach statistical significance between any of the training stages and between the various stages and the rate of the senior surgeons. The differences in infection rates in late appendicitis between stage 1 and stage 3 was significant, as was the difference in infection rates between stage 1 and the infection rate of the senior surgeons. Therefore, we have concluded that overall, the limited experience of trainees is related to the rate of postoperative sepsis in late appendicitis, although the infection rates of individual trainees vary a lot.

Appendectomy↗
PubMed1988

Optimal irrigation pressures in operative choledochoscopy.

A prospective study was conducted on 20 consecutive patients who underwent elective exploration of common bile-ducts for stones to determine the optimal irrigation pressures in choledochoscopy. Ten patients had rigid choledochoscopy and 10 patients had flexible choledochoscopy. Choledochoscopic views were assessed at low irrigation pressure (irrigant delivered at hydrostatic pressure of 1 m of water or 80 mmHg) and high irrigation pressure (irrigant delivered at cuff pressure of 300 mmHg plus hydrostatic pressure of 80 mmHg). Choledochoscopic views were better with high than low irrigation pressures for rigid choledochoscopy. However, there was little difference in the views for flexible choledochoscopy. Common bile-duct pressures were measured with irrigant delivered at pressures 80-380 mmHg at intervals of 50 mmHg. With increasing irrigation pressures, the common duct pressures rose and they were consistently higher in flexible than rigid choledochoscopy. The common duct pressures in rigid choledochoscopy never exceeded the recommended safety limit, even at the high irrigation pressure of 380 mmHg. With flexible choledochoscopy, the common duct pressure was below the recommended safety limit only with low irrigation pressure of 80 mmHg. Therefore, it is recommended that a high irrigation pressure of 380 mmHg for rigid choledochoscopy and a low irrigation pressure of 80 mmHg for flexible choledochoscopy be used.

Common Bile Duct↗