Biomedical subjects

Yu-Sheng Lee

Publications and source records attributed to Yu-Sheng Lee.

11 recordsLinked to original sources

PubMed2006

Esophageal atresia with tracheoesophageal fistula: ten years of experience in an institute.

BACKGROUND: Esophageal atresia (EA), tracheoesophageal fistula (TEF), or both is a complicated problem. The purpose of this study was to evaluate the outcomes and postoperative complications in patients with EA/TEF who were admitted to our hospital. METHODS: In total, 15 patients were enrolled from 1994 to 2003, including 8 males and 7 females. Patient demographics, associated anomalies, and outcomes were analyzed. RESULTS: The most common variant was EA with a distal TEF (type C), which occurred in 12 patients (80%). The latter had associated congenital anomalies, and cardiac anomalies were the most frequent, occurring in 8 patients (53.3%). Of the 6 cases who had life-threatening anomalies, 4 (66.7%) died, and of the 9 cases who had no life-threatening-anomalies, 2 (22.2%) died. Tracheomalacia and/or stenosis were diagnosed in 8 patients (66.7%) postoperatively. Though 3 of the 4 cases who suffered from dying spell received intratracheal stent implantation, 2 cases still died. CONCLUSION: The survival rate of the patients with EA/TEF is influenced mainly by associated life-threatening anomalies. TMS combined with a history of dying spell may be the major fatal complication.

Esophageal Atresia↗

PubMed2006

Effects of therapeutic bronchoalveolar lavage and partial liquid ventilation on meconium-aspirated newborn piglets.

OBJECTIVE: To investigate the therapeutic effects of bronchoalveolar lavage (BAL) with either diluted surfactant (SBAL) or perfluorochemical liquid (PBAL), followed by either conventional mechanical ventilation (CMV) or partial liquid ventilation (PLV), on lung injury and proinflammatory cytokine production induced by meconium aspiration in newborn piglets. DESIGN: A prospective, randomized, experimental study. SETTING: An animal research laboratory at a medical center. SUBJECTS: Anesthetized and mechanically ventilated newborn piglets (n = 27). INTERVENTIONS: The animals were instilled with 3-5 mL/kg 25% human meconium via an endotracheal tube to induce meconium aspiration syndrome (MAS). After stabilization, animals were randomly assigned to either CMV group (no BAL) or one of the treatment groups (SBAL-CMV, SBAL-PLV, PBAL-CMV, and PBAL-PLV). MEASUREMENTS AND MAIN RESULTS: Cardiopulmonary variables were monitored, and interleukin-1beta and interleukin-6 content of the serum and lung tissue was measured. The animals without any treatment (CMV group) displayed the worst outcome; the animals in the PBAL-PLV group had the best gas exchange, lung compliance, and least pulmonary damage; and the SBAL-CMV, PBAL-CMV, and SBAL-PLV groups had intermediate effects. The serum interleukin-1beta concentration of the CMV group was significantly higher than all other groups over time (p < .05), and interleukin-6 concentration was significantly higher than the PBAL-PLV group (p < .05). The tissue interleukin-1beta and interleukin-6 contents were also highest in the CMV group and lowest in the PBAL-PLV group. CONCLUSIONS: Initial therapeutic BAL and therapeutic BAL followed by PLV with the same perfluorochemical liquid provided significant therapeutic effects in treating an animal model with severe MAS and therefore warrant consideration in cases that are intractable to other therapies.

Animals↗

PubMed2004

Functional magnetic ventilation in dogs.

OBJECTIVE: To investigate the efficacy of the magnetic stimulation of inspiratory muscles as an alternative to mechanical ventilation and functional electric stimulation. DESIGN: A prospective before-after trial. SETTING: Functional magnetic stimulation laboratory in a Veterans Administration health care system. ANIMALS: Six male mongrel dogs, each weighing between 25 and 35 kg. INTERVENTIONS: Commercially available magnetic stimulators with a round magnetic coil were used. The center of the magnetic coil was placed posteriorly over the C5-7 vertebrae of the spinal cord transected dogs. Magnetic stimulation parameters were set at 80% intensity, 20 Hz, and a 1.2-second on and 3.8-second off pulse train. MAIN OUTCOME MEASURES: The major outcomes were changes in tidal volume (VT), tracheal pressure (Ptr), and arterial partial pressure of carbon dioxide (PaCO2) and oxygen sustained by magnetic stimulation over time. RESULTS: The average Vt and Ptr produced during functional magnetic ventilation (FMV) were.47+/-.07 L and -4.7+/-.51 cmH2O, respectively. Blood gas data showed that PaCO2 increased from a baseline of 33 to 75 mmHg, whereas pH decreased from 7.33 to 6.99 at the end of the 1-hour FMV period. CONCLUSIONS: FMV was achieved for 2 hours in dogs with C2 spinal cord transection. Additional refinements in magnetic stimulation are needed to improve ventilation in animals.

Analysis of Variance↗

PubMed2003

Flexible endoscopy of aerodigestive tract in small infants.

BACKGROUND: Flexible endoscopy (FE) is a useful method for diagnosing airway problems. Congenital or acquired airway lesions in infants may lead to respiratory distress that requires comprehensive investigation and management. This study was designed to evaluate the use of FE in small infants. METHODS: Infants who had symptoms of respiratory distress and received FE when they were less than 1-year-old were studied and their medical history, diagnoses, interventions, and complications from FE were investigated. RESULTS: The study population consisted of 568 small infants (334 boys and 234 girls) who weighed 5.1 +/- 2.4 kg, and received FE when they were 4.5 +/- 3.6 months of age. Most patients (91.2%) received diagnostic FE and the remainder (8.8%) received therapeutic procedures. Stridor (38.0%) was the most common indication for FE and laryngomalacia (33.3%) was the most frequent finding. Synchronous FE diagnosis was found in 351 (61.8%) cases. No major complications associated with FE were found. CONCLUSION: Flexible endoscopy allows direct visualization of dynamic motion of the small aerodigestive tract. Laryngomalacia was the most common FE finding of respiratory distress in small infants. Synchronous FE lesions were frequently found in this young age group and it necessitated a thorough investigation of the entire aerodigestive tract.

Endoscopy↗

PubMed2002

Effect of thermal and chemical pretreatments on anaerobic ammonium removal in treating septage using the UASB system.

This work investigated how thermal and chemical pretreatments influenced the anaerobic ammonium oxidation process in anaerobic digestion using biogranules that had been acclimated to septage. The digestion experiments were performed in serum vials using thermally and chemically pretreated septage as the substrate. The experimental results indicated that heat pretreatment reduced both dinitrogen production and ammonium removal. HCl and NaOH pretreatments increased both values by near 45% and 55% over the control. Alkali addition was more efficient than acid addition in enhancing dinitrogen production and ammonium removal.

Anaerobiosis↗

PubMed2002

Comparison of clinical characteristics of adenovirus and non-adenovirus pneumonia in children.

Forty-eight cases of adenovirus pneumonia in children were treated in the Department of Pediatrics of Taipei Veterans General Hospital from January 1998 through December 2000. The clinical characteristics of these patients were compared with those of a control group of 70 patients with non-adenovirus pneumonia mostly caused by Mycoplasma pneumoniae and other viruses during the same period. No difference was found between the adenovirus and non-adenovirus groups in age, sex, duration of fever, and hospitalization days. Chest retraction and extrapulmonary manifestations were significantly more common in the adenovirus group, especially conjunctivitis, gastroenteritis, lymphadenopathy, bleeding diathesis, and exanthema. C-reactive protein levels were significantly higher in the study group than in the control group. In the adenovirus group, 2 patients died and 5 had permanent lung damage after adenovirus infections. No mortality or long-term sequelae were found in the non-adenovirus group. Adenovirus may cause diseases manifesting predominantly as fever and lower respiratory tract infection that may require hospitalization. Extrapulmonary manifestations were observed in more than half of children with adenovirus infections. Adenoviral pneumonia can be fatal and permanent lung damage may be noted during the follow-up period.

Adenoviridae Infections↗

PubMed2002

Endotracheal tube position in pediatrics and neonates: comparison between flexible fiberoptic bronchoscopy and chest radiograph.

BACKGROUND: Correct tracheal intubation in critically ill patient is very important in intensive care medicine. The purpose of this study is to evaluate the value and accuracy of the flexible fiberoptic bronchoscopy (FFB) in confirming the endotracheal tube (ETT) position and to compare with the chest radiograph method in intubated pediatric and neonate patients. METHODS: We prospectively used the FFB to evaluate the ETT position in the pediatric and neonate intensive care units (ICUs) from January 2000 to December 2000. The distance between the ETT tip and the trachea carina measured by FFB (TC-FFB) was recorded and compared with that by the chest radiograph (TC-CR). The consuming time needed for checking the ETT position was also compared between these two methods. RESULTS: There were 74 cases enrolled. There was a significant correlation between TC-FFB and TC-CR (r = 0.898, p = 0.000). It took less time to confirm the ETT position by using the FFB than by the post-intubation chest radiograph (0.3 +/- 0.1 min vs. 103.8 +/- 45.2 min, p < 0.05). No major complication was noted in performing the FFB measurement. CONCLUSIONS: FFB is an accurate, convenient, timesaving and less traumatic technique in confirming the correct ETT position for the critical and emergent patients in the pediatric and neonate ICUs.

Adolescent↗

PubMedDate not supplied

Placental weight and birth characteristics of healthy singleton newborns.

To determine the relationship of placental weight and birth characteristics of healthy Chinese singleton newborns, 552 consecutive singleton near-term and uncomplicated pregnancies were enrolled in a retrospective study from October 2000 to April 2001. Maternal age, infants' gender, gestational age, placental weight (PW), birth weight (BW), birth length (BL), cord length, ponderal index, and appearance of meconium-stained amniotic fluid or a nuchal cord were recorded and analyzed. Our results show that the mean value of BW was 3235 +/- 17 g, birth length was 48.8 +/- 0.1 cm, PW was 646.2 +/- 0.3 g, BW/BL was 66.2 +/- 0.3, BW/PW was 5.1 +/- 0.1, and ponderal index was 2.8 +/- 0.0, respectively. Male neonates had significantly larger BWs (p<0.05) and BLs (p<0.01) than did female neonates. However, there was no significant difference in PW between male and female neonates. PW was positively correlated with BW (r=0.413, p<0.01), BL (r=0.305, p<0.01), BW/BL (r=0.397, p<0.01), and cord length (r=0.264, p<0.01). The PW of studied infants showed no significant difference when grouped by gestational age, maternal age, presence of meconium stained amniotic fluid, or presence of a nuchal cord. Of the studied healthy neonate, 81.9% and 69.4% had no meconium-stained amniotic fluid or nuchal cord, respectively. There were no significant differences in PW or BW/PW between neonates with the presence or absence of meconium-stained amniotic fluid or a nuchal cord. These results indicate that PW has a significant role in fetal growth in terms of weight, body length, and cord length. Furthermore, it has no significant role in the presence of meconium-stained fluid or a nuchal cord in healthy neonates.

Birth Weight↗

PubMedDate not supplied

Nasopharyngeal tract length measurement in infants.

UNLABELLED: Artificial nasopharyngeal (NP) airway is a common device used to secure upper airway patency. The proper length of its insertion is important, especially in infants. The purpose of this study is to measure and compare the endoscopic and the anthropometric measurements of NP length in infants. MATERIAL AND METHODS: We collected data from 413 infants who received flexible fiberoptic endoscopy. Endoscopic measurement length is from the nostril to the vocal cord (N-V distance). Anthropometric measurement length is from the nose tip to the earlobe. We stratified the infants into four groups by body weight and compared the difference between the two measurement methods. RESULTS: The mean length of the endoscopic measurement is compatible to the anthropometric measurement in all four groups. There is a statistically significant correlation between the N-V distance and the body length (p = 0.0001, r = 0.83), the body weight (p = 0.0001, r = 0.81), and the age (p = 0.0001, r = 0.64). CONCLUSION: The anthropometric measurement of nasopharyngeal airway length is nearly identical to the endoscopic measurement.

Body Height↗

PubMedDate not supplied

Total parenteral nutrition as a primary therapeutic modality for congenital chylous ascites: report of one case.

Congenital chylous ascites in the neonatal period is a rare entity. It is primarily related to congenital abnormalities of the lymphatics. We present a case in which ascites was detected by prenatal ultrasonogram. No evidence of congenital cytomegalovirus infection, intrauterine meconium peritonitis, or intestinal or genitourinary system abnormalities was found. Congenital chylous ascites was confirmed via an abdominal sonogram and diagnostic paracentesis. After 26 days of NPO and total parenteral nutrition, the newborn hadfully recovered.

Chylous Ascites↗

PubMedDate not supplied

Thoracic empyema in children: early surgical intervention hastens recovery.

The optimal management of thoracic empyema in children is still controversial. In this retrospective study, we analyze our six-year experience in the management of empyema. From April 1995 to December 2001, 39 patients under age 6 years were admitted with the diagnosis of empyema. These patients were assigned by the method of empyema management to one of two groups (either the conservatively treated or surgically treated group). The surgical patients were divided on the basis of the timing of surgical intervention into either the early (within 8 hospital days) or late (beyond 8 hospital days) surgical group. There was no difference in total hospital stay between those treated conservatively (24.3 +/- 11.6 days) and surgically (24.5 +/- 7.9 days). Among the surgically treated patients, recipients of early surgical intervention had significantly shorter hospital stay (20.2 +/- 5.9 days) than those receiving late surgical intervention (30.1 +/- 6.5 days). Early surgical intervention in cases of thoracic empyema in young children can shorten hospitalization. These children should undergo surgery if their clinical course does not improve within one week.

Child, Preschool↗