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Biomedical subjects

D Y Yu

Publications and source records attributed to D Y Yu.

124 records · Page 7Linked to original sources
PubMed1982

Catheter drainage of spontaneous pneumothorax: suction or no suction, early or late removal?

Twenty-three patients with primary spontaneous pneumothorax and 30 patients with secondary spontaneous pneumothorax treated by intercostal catheter drainage with underwater seal were divided randomly into two groups, one receiving suction drainage (up to 20 cm H2O pressure) and the other no suction. The success rate was 57% for the former and 50% for the latter. The suction group spent an average of five days in hospital, whereas the non-suction group averaged four days. Suction drainage therefore did not have any advantage. To determine how soon the catheter could be removed without complication, patients were also divided randomly into two subgroups--one had the catheter removed, without previous clamping, as soon as the lung was expanded; the other had the catheters left in situ for a further three days. The success rate was 52% for the former, and 53% for the latter. But most of the failure in the early removal group was caused by re-collapse of the lung rather than persistent air leakage; hence removal of the catheter too early was not recommended.

Adolescent↗
PubMed1976

Effect of acupuncture on bronchial asthma.

1. Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma. 2. In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated, and in five patients wheezing was abolished. 3. Stimulation at the correct site produced a significant increase in the mean FEV1-0 (58%) and FVC (29%) but not in maximal mid-expiratory flow rate (MMFR; 76%), when compared with the findings before acupuncture, along with a significant fall in the Pa,CO2 and an insignificant fall in Pa,O2. A mild tachycardia was also observed. 4. After acupuncture a greater improvement in FEV1-0, FVC and MMFR was produced by inhalation of isoprenaline. 5. No significant changes in FEV1-0, FVC, MMFR, pulse rate or arterial blood gas tensions occurred after acupuncture at control sites. 6. In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge, but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction. 7. It is concluded that acupunture probably reduced the reflex component of the bronchoconstriction, but failed to influence direct smooth muscle constriction caused by histamine.

Acupuncture Therapy↗
PubMed1975

Renal failure during intermittent rifampicin therapy.

Two patients who developed reversible renal failure during intermittent rifampicin therapy are described. Both had febrile reactions to rifampicin. The first was also found to have uraemia associated with swelling of the glomerular endothelial cells. The second developed tubular necrosis unassociated with haemolysis or shock. The pathogenesis of the renal lesion in these two patients, as revealed by light microscopy, immunofluorescence studies and electron microscopy, is discussed.

Acute Kidney Injury↗
PubMedDate not supplied

Terbutaline infusion in cardiogenic shock: acute hemodynamic effects and clinical response.

The effect of terbutaline infusion was studied in six patients with cardiogenic shock due to acute myocardial infarction. Terbutaline was initiated at 3 micrograms/kg/min, and the subsequent infusion rate was adjusted according to heart rate and blood pressure. At 3 hours after infusion arterial pressure increased from 62 +/- 13 mm Hg (mean +/- S.D.) to 89 +/- 13 mm Hg (P less than 0.001), cardiac index increased from 1.38 +/- 0.29 liter/min/m2 to 2.68 +/- 0.47 liter/min/m2 (P less than 0.001), and heart rate increased from 92 +/- 32 beats/min to 112 +/- 29 beats/min (P less than 0.005). Pulmonary artery wedge pressure fell from 24 +/- 7 mm Hg to 17 +/- 3 mm Hg (P less than 0.01), right atrial pressure fell from 12 +/- 4 mm Hg to 6 +/- 3 mm Hg (P less than 0.005), and systemic vascular resistance fell from 1880 +/- 641 dyn-sec/cm5 to 1515 +/- 418 dyn-sec/cm5 (P less than 0.05). In addition, urine flow increased from 4 +/- 6 ml/hr to 314 +/- 237 ml/hr (P less than 0.05), and subjective improvement was noted in all subjects. Undesirable effects observed were hypokalemia (all subjects), supraventricular tachycardia (one subject), and ventricular ectopic beats (three subjects), which responded to potassium replacement and other treatments. All patients required prolonged maintenance infusion to maintain adequate hemodynamic and clinical response. Four patients were weaned off from maintenance therapy after a mean duration of 4.8 days and eventually were discharged from the hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Myocardial metabolic effects of intravenous terbutaline in patients with severe heart failure due to coronary artery disease.

Intravenous terbutaline, 0.3 mg/kg/min for 30 minutes followed by 0.15 mg/min for 60 minutes, was studied in nine patients with severe heart failure due to documented coronary artery disease. Hemodynamic and myocardial metabolic effects were measured during terbutaline infusion. Cardiac index and stroke index increased, whereas mean pulmonary artery wedge pressure and pulmonary vascular resistance decreased significantly. No significant alterations in aortic oxygen content, coronary sinus oxygen content, myocardial oxygen extraction, and myocardial lactate extraction were observed during terbutaline infusion. No patient developed angina or electrocardiographic changes suggestive of ischemia. These results indicate that intravenous terbutaline infusion, at the dosage employed, produces beneficial hemodynamic effects without a deterioration of myocardial metabolism in patients with heart failure due to coronary artery disease.

Aged↗
PubMedDate not supplied

Developing laser-induced glaucoma in rabbits.

PURPOSE: An animal mode of glaucoma is necessary for the study of its pathogenesis and treatment. The purpose of this study was to create open-angle glaucoma using a laser in rabbits. METHODS: The trabecular meshwork of anaesthetized, adult, pigmented and albino rabbits was ablated internally using a diode laser via a gonioscopy lens, or externally through the limbus. In albino rabbits we used Chinese ink to pigment the angle and methylcellulose to open the iridocorneal angle. The eyes were examined weekly and histological assessment was performed. RESULTS: The success rate of intra-ocular hypertension was low (15%) and a result of synechial angle closure. A narrow angle prevented access of the laser beam to the trabecular meshwork and promoted damage to the ciliary processes located on the posterior iris. CONCLUSIONS: Due to the unique anatomy of the rabbit eye, laser-induced glaucoma is difficult to achieve. To create a successful model it is necessary to widen the iridocorneal angle, selectively damage the trabecular meshwork and reduce inflammation.

Animals↗
PubMedDate not supplied

Weekly dosing of carboplatin increases risk of allergy in children.

BACKGROUND: Carboplatin (CBDCA) has been used increasingly to treat pediatric low-grade gliomas. Allergic reactions to CBDCA have been reported in 2% to 30% of children. The reason for this high incidence of allergy is unclear. METHODS: To determine the risk factors for CBDCA allergy, an historic cohort study was conducted for all children who received the drug during a 6-year period at the Lucile Salter Packard Children's Hospital at Stanford. The patients' medical records were reviewed for data on age, tumor type, CBDCA dose schedule, total number of doses, cumulative dosage, dose per treatment, other chemotherapy administered, and allergic reaction. RESULTS: Fifty-four children (mean age 7.2 years, 35 boys) were identified. Six children (11.1%) had an allergic reaction to CBDCA. All reactors had low-grade gliomas treated with weekly CBDCA and vincristine, with a dosage per treatment <500 mg/m2. Overall, six (75%) of eight children administered weekly CBDCA, 6 (46.2%) of 13 children with brain tumors, and 6 (40%) of 15 administered CBDCA dosage <500 mg/m2 manifested allergic reactions. Patients receiving more than five doses had significant risk for CBDCA allergy (relative risk [RR] = 11.8; 95% confidence interval [CI]: 1.5-94.1). Using logistic regression with multiple variables, weekly dose schedule was the most predictive covariate for allergic reaction (P < 0.000 1), and other factors were unrelated or redundant. CONCLUSIONS: Children with low-grade gliomas receiving CBDCA weekly are at significantly increased risk for CBDCA allergy. The repetitive, weekly dosing schedule of CBDCA appears to be a key risk factor for allergic reaction in brain tumor patients. The high frequency of allergy with weekly CBDCA warrants further consideration when planning future trials.

Antineoplastic Agents↗
PubMedDate not supplied

Hepatic microvascular effects of terbutaline in experimental cardiogenic shock in rats.

1. Experimental myocardial infarction was produced in rats by direct electrical cauterization of the myocardium of left ventricle. This produced cardiogenic shock with the accompanying haemodynamic changes of low cardiac output, low mean arterial pressure, raised central venous pressure and an absence of cardiac arrhythmias. 2. The liver microcirculation was observed using in vivo television microscope method. The diameter and erythrocyte flow velocity in the liver sinusoids were measured quantitatively. 3. During experimental cardiogenic shock 80% of the liver sinusoids were constricted; the remaining 20% showed dilatation. In all these liver sinusoids the erythrocyte flow velocity was only 50% of the pre-shock level. 4. Intravenous injection of the selective beta 2-adrenoceptor agonist terbutaline (0.15 mg/kg) restored the systemic arterial pressure to pre-shcok levels and partially raised the cardiac output. In the liver microcirculation terbutaline restored both constricted and dilated liver sinusoids to pre-shock calibres, but only partially raised erythrocyte flow velocity. 5. It is proposed that during experimental cardiogenic shock, terbutaline produces dilatation in the terminal liver microcirculation by opening sphincters of liver sinusoids and restores sinusoid diameters to pre-shock calibres. Therefore, terbutaline has the capacity to decrease peripheral resistance and unload the circulation during cardiogenic shock.

Albuterol↗
PubMedDate not supplied

Diabetic retinopathy: early functional changes.

1. The present review reports some of the earliest physiological changes that occur in the diabetic retina prior to any clinical or anatomical changes in an animal model of diabetes. 2. Using chemically induced diabetes (by streptozotocin) in rats, retinal blood flow and vitreal and retinal oxygen tension were determined after 5 weeks of sustained hyperglycaemia. Blood flow was greater and was also redistributed in the diabetic group compared with values for the control group. At the same time, oxygen tension distribution was altered around retinal arterioles, implying an increase in retinal oxygen consumption in these early diabetic retinas. 3. The possibility that the blood flow changes could be due to altered control mechanisms in the retinal vasculature was confirmed using an isolated, perfused eye preparation. In diabetic eyes an altered reactivity to test pharmacological agents was demonstrated after 4 weeks of diabetes. 4. To further explore these vascular response changes we developed an isolated, perfused retinal arteriolar preparation in which individual segments of the vasculature can be tested. The possibility that insulin has a direct vasodilator effect on retinal arterioles was confirmed and was demonstrated to act via nitric oxide released from the vascular endothelial cells. These data may implicate the diabetic-induced insulin changes in early retinal changes. 5. Evidence is presented that although early glucose control may be vital in stopping the onset of diabetic retinopathy, there comes a stage in the induced diabetic cascade where if the retinopathy has commenced, good glucose control cannot stop the further progression of the retinopathy.

Animals↗
PubMedDate not supplied

Mesectodermal leiomyoma of the ciliary body: new evidence for neural crest origin.

An 8-year-old white boy had a mass of the ciliary body in his left eye. Both the translucent characteristics and the magnetic resonance imaging findings suggested that this lesion was cystic. Fluid aspiration biopsy and iridocyclectomy were performed. By light microscopy the neoplasm showed the characteristic appearance of a neuroid tumor; however, on electron microscopic examination, the tumor exhibited characteristic features of a smooth muscle neoplasm and was diagnosed as a mesectodermal leiomyoma. Observation of melanin granules in scattered tumor cells further confirmed that the tumor had the same origin as uveal melanocytes, which also derive from the neural crest.

Biopsy, Needle↗