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Biomedical subjects

Y Y Hsieh

Publications and source records attributed to Y Y Hsieh.

At least 19 recordsLinked to original sources

Local dermal hypersensitivity from dobutamine hydrochloride (Dobutrex solution) injection.

Two patients had local dermal hypersensitivity at the site of dobutamine hydrochloride (Dobutrex solution) injection. Such local dermal lesions characterized by erythema, pruritus, and phlebitis with or without bullae formation have not been reported previously (to our knowledge). Hypersensitivity reaction to sulfites as a possible mechanism of the dermal lesions was substantiated further by skin tests and peripheral eosinophila. Oral antihistamine therapy can minimize such a minor but bothersome problem.

Aged

Separation and characterization of the metabolic products of lappaconitine in rat urine by high-performance liquid chromatography.

The separation and characterization of the metabolic products of lappaconitine in rat urine by high-performance liquid chromatography with electrochemical and ultraviolet detection are described. Urine samples from rats intravenously administered lappaconitine hydrobromide were extracted with chloroform and then purified on a Sep-Pak C18 cartridge. The subsequent resolution into individual compounds was achieved by high-performance liquid chromatography. Identification of these compounds was based on comparisons of the chromatographic behaviour and the detector response with those of authentic samples. Changes in the ratio of lappaconitine to its metabolites in rat urine with time after dosing led to a proposal for one of the probable metabolic pathways of lappaconitine in the rat.

Aconitine

Studies on the metabolism of lappaconitine in humans. Identification of the metabolites of lappaconitine in human urine by high performance liquid chromatography.

The metabolites of lappaconitine in the urine of humans having been previously administered intramuscularly with lappaconitine hydrobromide were studied using high performance liquid chromatography with electrochemical and ultraviolet detection. The urine was extracted by means of liquid- and solid-phase extractions. Each of the metabolites of lappaconitine was purified by high performance liquid chromatography on a reversed phase column and identified on the basis of the chromatographic behaviour and the detector response. It was proved that lappaconitine, N-deacetyl-16-O-demethyllappaconitine and N-deacetyllappaconitine were excreted in urine from humans receiving lappaconitine.

Aconitine

Retrospective analysis of 97 patients with infective endocarditis seen over the past 8 years.

The medical records of 97 consecutive patients (101 episodes) of infective endocarditis seen from January 1979 through January 1987 were reviewed. Only 30% of the patients were over 50 years of age and the majority (69%) of infecting organisms were streptococci (mainly of the viridans group), which were similar to those reported from the West in the early antibiotic era. Pseudomonas organisms and enterococci accounted for 6% and 5%, respectively. Fungal infections were noted in 2 patients. There was a high incidence (38%) of predisposing rheumatic valvular disease; approximately half of these patients had prosthetic valve infections. Mitral valve prolapse was also an important predisposing disease (11%). One-third (34%) of the patients had febrile illness for longer than 8 weeks before the diagnosis was established. The hospital morality rate was 22%; cerebral embolism and ruptured mycotic aneurysm, congestive heart failure, and sudden death were the major causes of death. Echocardiography disclosed vegetations on the cardiac valves and preexisting lesions in 75% of the episodes. Early recognition and proper treatment should be the focus of efforts to reduce mortality from infective endocarditis.

Adolescent

Probenecid interferes with the natriuretic action of furosemide.

The interaction between probenecid and furosemide was studied in eight hospital patients (ages 20-65 years) who had been treated with oral furosemide, 40 mg daily, and moderate salt restriction for 10 days or longer. After stabilization of drug therapy and diet for at least 3 days, probenecid, 0.5 g twice a day, was given for 3 days and then discontinued. The 24-h urinary sodium excretion (UNaV) significantly decreased from 56.3 +/- 7.2 to 35.9 +/- 7.1 mmol/day when probenecid was added to the treatment regimen (p less than 0.01), and then significantly increased to 61.7 +/- 10.3 mmol/day after probenecid was discontinued (p less than 0.01). Parallel with the changes in UNaV, there were also significant corresponding changes (p less than 0.01) in urinary excretion of uric acid (392.4 +/- 46.5, 600.9 +/- 102.1, and 345.0 +/- 33.2 mg/day, respectively), renal clearance of uric acid (3.7 +/- 0.3, 14.3 +/- 2.4, and 4.1 +/- 0.3 ml/h/kg, respectively), and serum uric acid concentration (7.7 +/- 0.5, 3.3 +/- 0.2, and 6.3 +/- 0.3 mg/dl, respectively). Before and after discontinuing probenecid therapy, there were no significant differences in these parameters (p greater than 0.05). In conclusion, the natriuretic action of furosemide was attenuated by concurrent probenecid therapy, probably owing to a reduction of furosemide delivery to the luminal side of renal tubules.

Adult

Frequency of various congenital heart diseases in Chinese adults: analysis of 926 consecutive patients over 13 years of age.

A retrospective analysis was performed in 926 consecutive Chinese persons, aged 14 to 68 years, in whom congenital heart disease had been diagnosed and catheterization had been performed over the past 24 years. The incidence of various congenital cardiac malformations was compared with that in other series reported world-wide. About 60% of the 926 patients underwent surgery, and anatomic details of the malformations were examined. Congenital aortic valvular stenosis and coarctation of the aorta were uncommon (2.4% and 1.2%, respectively) among the Chinese adults, and the ethnic differences with Western countries in the incidence of these 2 defects were apparent and real. In contrast, aneurysm of the sinus of Valsalva, either ruptured or nonruptured, was more common (4.3%) and the incidence of outlet muscular type (or type 1) of ventricular septal defect was 4 to 9 times as common as has been reported in the West. Genetic differences rather than environmental factors or dietary habits may explain these special features.

Adolescent