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Y T Lin

Publications and source records attributed to Y T Lin.

160 records · Page 9Linked to original sources

Use of a dynamic method in calibration of dye-dilution curves during cardiac surgery.

A simplified dynamic method of calibration for dye-dilution curves is described. The method involves appropriate matching of the fluid volume in the mixing chamber, the blood withdrawal rate, and the calibration dose of dye. It was used to compare the observed versus calibrated pump output of a heart-lung machine with individual dye-dilution curves obtained from 15 patients during total cardiopulmonary bypass. The results indicate that the difference (range+14% to-8%) between the two is statistically insignificant. The method is rapid and relatively simple. It is particularly useful for cardiac output determination during unsteady clinical conditions because of the ability to calibrate dye curves at the time they are recorded.

Adult↗

Intraoperative instability for developmental dysplasia of the hip in children 12 to 18 months of age as a guide to Salter osteotomy.

There is still debate on the necessity of Salter osteotomy for developmental dysplasia of hip (DDH) between 12 and 18 months of age. The goals of this study were to investigate the correlating factors of intraoperative instability as a guide to the additional Salter osteotomy and to evaluate the radiographic and clinical results. Stability could not be achieved in 63% of 84 hips with soft-tissue releases alone. The existence of three pathologic findings (grade of dislocation, inverted labrum, and excessive anteversion) and absence of two surgical procedures (transverse acetabular ligament incision and iliopsoas osteotomy) significantly correlates with instability. At follow-up, the acetabular remodeling with or without Salter osteotomy was similar. We conclude that the Salter osteotomy does not interfere with the acetabular remodeling and has no major disadvantages for children at that age but can help to improve the stability of the hip.

Age Factors↗

Clinical observations of erythema multiforme in children.

Erythema multiforme (EM), a cutaneous or mucocutaneous disorder, occurs primarily in young adults. To evaluate the precipitating factors, clinical courses, and treatment of this disease in children, 30 cases aged from 1 month old to 15 years of age were studied retrospectively from Jan 1988 to Aug 1998. Twenty-three cases were diagnosed as minor type; the other 7 were of major type (Stevens-Johnson syndrome). Mycoplasma infection was identified in 4 patients, and adenovirus in one patient with EM minor. Cytomegalovirus was found in one EM major patient. Anticonvulsant administration before the skin lesions were recorded in 5 EM major patients and 2 EM minor patients. All cases received supportive treatment during admission. Besides, 6 of 7 patients with EM major, and 11 of 23 EM minor (Group A) received systemic corticosteroid at a dose equal to prednisolone 1-2 mg/kg/day for 3-14 days. One EM major patient and 11 patients with EM minor (Group B) received supportive care only. One EM minor patient with acute idiopathic thrombocytopenia purpura was treated with intravenous immunoglobulin. The mean duration of course of EM minor was 11.8 +/- 2.9 days, and it was 25.1 +/- 9.8 days for EM major. No mortality and no sequelae were noted. The average disease course and hospitalization time were not significantly different between Group A and B: (11.4 +/- 3.1 days vs 12.4 +/- 2.9 days, p = 0.45); (5.4 +/- 2.0 days vs 6.3 +/- 3.1 days, p = 0.47). This study demonstrated that infections, especially mycoplasma, and anticonvulsants play important roles in childhood EM. The skin lesions of EM minor subsided within 2 weeks, and EM major recovered completely within 6 weeks. Systemic corticosteroid may be beneficial to EM major, but probably is unnecessary for patients with EM minor.

Adolescent↗

Primary intracavitary cardiac tumors: a review of 11 surgical cases.

During the past 14 years, 11 patients varying age from 27 to 68 years, had excision of primary intracavitary cardiac tumor: 7 had a left atrial myxoma, 1 a left ventricular myxoma, 1 a right ventricular myxoma, and 2 had a left atrial malignant mesenchymoma. Accurate diagnosis was made by angiocardiography in 8 patients. All patients underwent open heart excision of the tumor with the use of cardiopulmonary bypass. One of the 9 patients with a left atrial myxoma died postoperatively with recurrence of the tumor. The two patients with left atrial malignant mesenchymoma died 8 and 15 months after palliation. All surviving patients are asymptomatic without evidence of recurrence.

Adult↗

A follow-up study of annular pancreas in infants and children.

Fifteen pediatric patients undergoing surgery for annular pancreas from 1984 to 1996 were analyzed. Vomiting was the most common presenting symptom. Twelve patients (80%) had associated anomalies including malrotation (40%), intrinsic duodenal obstruction (33%), Down syndrome (27%) and duodenal bands (27%). Their ages at operation were between 5 hours and 8.5 years, with a median of 4 days. Surgical treatment included duodenojejunostomy in nine, duodenoduodenostomy in five and duodenotomy with duodenoplasty in one. The mean duration for reestablishment of bowel transit was 17.9 days, with 22.8 days for duodenojejunostomy and 12.3 days for duodenoduodenostomy. All cases received postoperative follow-up, but only 11 of them were long-term followed until April 1997, with a duration ranging from 1 year and 2 months to 11 years, with a median of 7 years and 5 months. The survival was 100%, but 12 cases (80%) developed postoperative complications including cholestatic jaundice (53%), upper gastrointestinal motility disorder (47%), failure to thrive (40%) and chronic diarrhea (33%). Annular pancreas divisum was noted in one case with chronic relapsing pancreatitis. At the end of follow-up (April 1997), when final ages ranged from 1 year and 2 months to 18 years and 9 months with a median of 7 years and 5 months, there were still problems: steatorrhea in 1, diarrhea after fatty diet in 3, malnutrition in 4, failure to thrive in 3 and lower concentration of stool trypsin in 3 cases. In conclusion, close long-term follow-up is essential for infants treated for annular pancreas because many of them can be expected to develop complications, even if the initial postoperative period is uncomplicated and survival is excellent.

Child↗