Absorption and elimination kinetics of digoxin after multiple oral doses.
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Administration, Oral↗
Biomedical subjects
K L Hsu
Publications and source records attributed to K L Hsu.
Relationship of pulmonary venous flow pattern to mean left atrial pressure and phasic pressure change.
To assess the correlation of pulmonary venous flow pattern with the magnitude of the dynamic change in left atrial pressure (i.e. x and y descents) and to elucidate the way how pulmonary venous flow pattern reflects left atrial pressure, we studied 35 patients with normal sinus rhythm undergoing transesophageal echocardiography and cardiac catheterization. The ratio of peak systolic/diastolic flow correlated well with the ratio of x/y descent (r = 0.88) and the ratio of systolic/diastolic velocity-time integral (r = 0.89). The correlation between the ratio of systolic/diastolic flow or velocity-time integral and mean atrial pressure was less strong (r = -0.49 and -0.70, respectively). We conclude that the ratio of peak systolic/diastolic flow velocity, or the ratio of systolic/diastolic velocity-time integral of pulmonary venous flow reflects the phasic change in left atrial pressure more appropriately than the mean left atrial pressure. Due to the good correlation between the phasic change in left atrial pressure and pulmonary venous flow pattern, the flow pattern of pulmonary veins could be used to identify diseases with specific patterns of left atrial pressure.
Adult↗
Interference of mitral valve stenosis with left ventricular diastole and left atrial appendage flow.
Atrial fibrillation (AF) has been reported as an independent risk factor of systemic thromboembolism. Almost half of the left atrial thrombi are located in the left atrial appendage (LAA). LAA function, reflected by LAA flow, thus has an influence on the potential of distal embolic complications. To identify factors other than atrial contraction that influence LAA flow during AF, transthoracic and transesophageal echocardiographic studies were performed on 130 patients. Seventy patients with nonrheumatic AF were divided into two groups with higher peak LAA outflow velocity (group 1) and lower peak LAA outflow velocity (group 2) at the ventricular systolic phase. Sixty patients with rheumatic AF were classified as group 3. Group 1 had a higher peak LAA outflow velocity than group 2 at both the ventricular systolic and diastolic phases. Group 2 had a higher peak LAA outflow at the ventricular diastolic phase than group 3 (18.9 +/- 8.0 vs. 11.8 +/- 7.5 cm/s, p < 0.001), whereas there was no significant difference in the peak LAA outflow at the ventricular systolic phase between the two groups (9.6 +/- 4.0 vs. 10.8 +/- 6.8 cm/s, p = NS). Group 3 was subdivided according to mitral valve area. Patients with severe mitral stenosis (mitral valve area < 1 cm2) had a significantly lower diastolic augmentation of LAA outflow velocity (difference of LAA outflow velocity between ventricle systole and diastole) than patients with mild to moderate stenosis (0.5 +/- 3.2 vs. 2.6 +/- 4.9 cm/s, p < 0.05). In conclusion, patients with rheumatic AF, especially those with severe mitral stenosis, have a lower diastolic augmentation of LAA outflow velocity. The lower diastolic augmentation of the LAA outflow velocity at the ventricular diastolic phase might result from interference with the suction effect of the left ventricular diastole by the stenotic mitral valve.
Aged↗
Influence of left ventricular diastole on left atrial appendage blood flow in patients with nonrheumatic atrial fibrillation.
The function of the left atrial appendage (LAA) reflected by the Doppler flow velocity at the outlet of the left atrial appendage has been reported to be correlated with spontaneous echo contrast and thrombus formation. To evaluate the influence of left ventricular diastole on LAA flow during atrial fibrillation (AF), 81 patients with chronic nonrheumatic AF were studied by transesophageal echocardiography. The peak outflow velocity of LAA during ventricular diastole was higher than that during ventricular systole (0.23 +/- 0.14 vs. 0.15 +/- 0.13 m/s, p < 0.001). The peak inflow velocity of LAA during ventricular diastole was also higher than that during ventricular systole (0.22 +/- 0.15 vs. 0.18 +/- 0.11 m/s, p < 0.01). Patients with a good left ventricular ejection fraction have a significantly higher peak LAA outflow velocity and a larger diastolic augmentation of LAA outflow (defined by the difference of LAA outflow between systolic and diastolic phases) than patients with an impaired left ventricular function. Thus, left ventricular diastole might have an influence on LAA flow during AF. In addition, the left ventricular function might be considered a predictor of subsequent thromboembolism from the viewpoint of its effect on LAA flow in patients with nonrheumatic AF.
Adult↗
Hypoplastic right hepatic lobe with retrohepatic gallbladder complicated by hepatolithiasis and liver abscess: a case report.
A 37-year-old man with fever, jaundice, severe right upper quadrant abdominal pain and impending septic shock was pre-operatively diagnosed to have hypoplastic right lobe liver with retrohepatic gallbladder, left hepatolithiasis and liver abscess by computed tomography. An urgent operation with cholecystectomy, choledocholithotomy, operative choledochoscopy and T-tube drainage was performed. Postoperative cholangiograms depicted multiple residual stones behind the sharply angulated biliary strictures in the medial branches of the left intrahepatic duct, which could not be eradicated by biliary dilatation via the T-tube tract. The left hepatolithiasis might be coincidental, or secondary to the congenital anomaly of the liver, because of the distorted biliary architecture, and the hypoplastic right lobe liver was associated not only with the retrohepatic gallbladder, but also with the much more complicated left biliary strictures and the hepatolithiasis behind them.
Adult↗