PubMed HealthSearch

Biomedical subjects

W S Hsu

Publications and source records attributed to W S Hsu.

10 recordsLinked to original sources

Fully automated assay of blood D-3-hydroxybutyrate for ketosis.

Ketone bodies are derived from the accelerated beta-oxidation of fatty acids during prolonged starvation or severely impaired carbohydrate metabolism. D-3-hydroxybutyrate (3OHB) is the major ketone circulating in the blood. Fully automated assay of 3OHB using a centrifugal analyzer was developed. The within-run and between-run levels of precision were acceptable, with coefficients of variation of from 0.75% to 4.35%. The recovery was 101.00 +/- 3.71%. The linearity was up to 5 mmol/L. Delayed serum separation even after 24 hours had no effect. The stability of 3OHB at -20 degrees C was greater than that at 4 degrees C when the serum was stored. No significant interference was observed with hemoglobin, bilirubin or triacylglycerol. NaF-treated plasma gave a significant underestimation of 3OHB. There was no significant difference in blood 3OHB between normal (blood glucose < or = 110 mg/dL, n = 87) and hyperglycemic subjects (blood glucose 110-200 mg/dL, n = 42), but when the blood glucose concentration was greater than 200 mg/dL, the difference in blood 3OHB between normal subjects and hyperglycemic patients became significant. The blood 3OHB concentrations increased according to the degree of hyperglycemia. There were sensitive changes in blood 3OHB during the treatment of a patient with diabetic ketoacidosis. The monitoring of blood 3OHB can be used clinically as an index of ketosis and as a signal of metabolic control in diabetes.

3-Hydroxybutyric Acid

Causes of death in aged burn patients: analysis of 36 cases.

Over a 10-year period 110 patients over the age of 65 years were admitted to the Burn Center, Rui Jin Hospital and 36 (32.7 per cent) died. Significant differences between the survivors and non-survivors were related to the total burn surface area and full skin thickness burn size. Among the causes of death, pre-existing cardiopulmonary diseases and associated inhalation injury were particularly important since pneumonia was considered as a primary cause of death in 13 patients, myocardial disease in two, cor-pulmonale and heart failure in two. Care of the early fluid resuscitation, early excision of deep burn wounds and grafting, prevention or treatment of a variety of life-threatening complications, and nutritional supplementation appeared to decrease the mortality of aged burn patients.

Age Factors

Clinical significance of urinary N-acetyl-beta-D-glucosaminidase and alanine aminopeptidase.

The excretion of urinary N-acetyl-beta-D-glucosaminidase (NAG) and Alanine Aminopeptidase (AAP) increases with renal damage. The variation in enzyme activity due to the fluctuation of urine flow rate could almost be eliminated by expressing it as the ratio of enzyme activity to urinary creatinine concentration. The urinary enzyme activities increased not only by tubular damage but also by the reduced creatinine clearance due to glomerular injury. The normal reference values of NAG were 2.84 +/- 2.50U/g creatinine for 24-hour urine and 3.23 +/- 2.76U/g creatinine for random urine. The normal reference values of AAP were 9.71 +/- 6.68U/g creatinine for both 24-hour urine and random urine. Although 128 patients were with abnormal enzymuria, only 39.1%, 52.3%, 83.6%, and 86.7% of the patients were with abnormal serum creatinine, serum urea N, creatinine clearance, and urine protein, respectively. In view of the sensitivity, the determinations of urinary NAG and AAP are suitable for early detection of renal diseases.

Acetylglucosaminidase

Changes in lymphocyte response to phytohaemagglutinin and serum immunosuppressive activity after thermal injury.

The present study consisted of two parts. In part one, 14 cases were divided into an invasive infection group (4 cases) and a non-invasive infection group (10 cases). A total of 68 assays for lymphocyte responses to PHA stimulation were carried out. The invasive infection group showed a significantly suppressed lymphocyte response, which occurred during invasive infection but neither before nor after the infection. The extent of third-degree burns was statistically significant between these two groups (P less than 0.05), but no significance was found between the total body surface area burned. In part two, 18 burn patients were studied for serum immunosuppressive activity. Both invasive infection cases and non-invasive infection cases showed serum immunosuppression during the course of the study and no significant difference was found between these two groups (P greater than 0.05). It is concluded that the extent of third-degree burn and the complicated systemic infection contribute to the impairment of lymphocyte responses to PHA stimulation, while the post-burn serum immunosuppression is unrelated to the occurrence of systemic infection.

Adult

Changes of serum amino acids in severely burned patients.

The serum amino acids profile in ten severe burn patients was basically similar with the findings in major burns reported in our proceeding article, supporting the conclusion that burn patients might have a particular amino acid pattern. The larger was the burn size, the more severe was the nitrogen loss. Following a severe burn, the patient was faced with the challenge of acute protein malnutrition. After severe burns, the ratio of serum Phe/Tyr rose to a higher level than in the major burns. Moreover, the elevation of serum Met/Cys ratio indicated a more serious metabolic disturbance. During the first two weeks postburn, acute decrease of serum BCAA by 20-30 per cent of the normal value was associated with a striking increase of mortality. This fact indicated the level of BCAA might be of prognostic value. In severe burns, other than huge amount of calories and protein supplied, enriched BCAA, and perhaps, carnitine might be beneficial.

Adolescent

Serum and erythrocyte amino acid pattern: studies on major burn cases.

Venous serum amino acids were measured in 13 patients with major burns. Erythrocyte amino acids and plasma cortisol, blood sugar and urine catecholamine were measured in two representative subgroups respectively. After burn injury, serum proline, glycine, valine, isoleucine and arginine were significantly decreased; phenylalanine, cysteine, methionine, leucine, glutamate, alanine, aspartic acid and tyrosine were significantly increased. Histidine and lysine fluctuated. This serum amino acid profile is considered as a specific pattern for major burns. Serum phenylalanine was markedly elevated in the hypermetabolic burn patients, its fluctuation coincided with the burn course and was negatively correlated with serum albumin level (P less than 0.001). These findings suggest that the ratio of phenylalanine tyrosine is a useful clinical parameter for assessing the patient's nutritional condition. Twenty-three simultaneous determinations of both serum and erythrocyte amino acid concentrations show similar changes, suggesting that the serum amino acid profile might reflect the change of total free amino acid pool. After burn injury, plasma cortisol, blood sugar and urine catecholamine were elevated as well as urine urea nitrogen. However, although the first three returned to normal by the end of the second week post burn, urine urea nitrogen remained high. This indicates that there are other factors controlling nitrogen loss in patients with major burns, it is also postulated that, due to the abnormal amino acid pattern revealed after major burns, the constituents of commercially available amino acid solutions should be modified.

Adult