• Title/Summary/Keyword: Intravenous infusion

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Phase II Study on Voriconazole for Treatment of Chinese Patients with Malignant Hematological Disorders and Invasive Aspergillosis

  • Zhang, Xue-Zhong;Huang, Xin-En;Xu, Yan-Li;Zhang, Xiu-Qun;Su, Ai-ling;Shen, Zheng-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2415-2418
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    • 2012
  • Objective: To investigate the efficacy and safety of voriconazole in treating Chinese patients with hematological malignancies and invasive aspergillosis. Methods: From March 2007 to April 2012, patients with diagnoses confirmed by CT, GM test and/or PCR assays, were recruited into this study. Aspergillosis of all patients were treated with voriconazole 6 mg/kg intravenous infusion (iv) every 12 h for 1 day, followed by 4 mg/kg IV every 12 h for 10-15 days; Then, switch to oral administration that was 200mg every 12h for 4-12 weeks. Efficacy and safety were evaluated according to Practice Guideline of Infectious Diseases Society of America. Results: The overall response rate of 38 patients after voriconazole treatment was 81.6%. The median time to pyretolysis was 4.5 days. Treatment related side effects were mild and found in only 15.8% of cases. No treatment related deaths occurred. Conclusions: Voriconazole can considered to be a safe and effective front-line therapy to treat patients with hematological malignancies and invasive aspergillosis. Alternatively it could be used as a remedial treatment when other antifungal therapies are ineffective.

Is Early Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome Necessary? -A case report- (복합부위통증증후군 제I형 환자에서 조기 척수자극술이 필요한가? -증례보고-)

  • Min, Hyoung Ki;Han, Kyung Ream;Lee, Sang Eun;Kim, Kyoung Tae;Kim, Chan
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.223-227
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    • 2006
  • Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

Comparison of Vasodilator Effects of Platycodin D and $D_3$ in Rats

  • Lim, Dong-Yoon;Kim, Byeong-Cheol;Lee, Eun-Bang
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.3
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    • pp.149-155
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    • 2003
  • The aim of the present study was to examine the effects of platycodin D and $D_3$, which are active components derived from the roots of Platycodon grandiflorum A. DC., on the contractile force of the i3olated rat aorta and blood pressure of the anesthetized rat, and also to elucidate its mechanism of action. Both phenylephrine (an adrenergic ${\alpha}1$-receptor agonist) and high potassium (a membranedepolarizing agent) caused great contractile responses in the isolated aortic strips. Platycodin D at high concentration $(24{\mu}g/ml)$ inhibited contractile responses induced by phenylephrine $(10^{-5}\;M)$ and high potassium $(5.6{\times}10^{-2}\;M)$, while low concentrations of platycodin D $(4{\sim}8{\mu}g/ml$) did not affect those responses. However, platycodin $D_3\;(8{\sim}32{\mu}g/ml)$ did not alter the contractile responses evoked by phenylephrine and high $K^+$. Interestingly, the infusion of platycodin $D_3$ (1.0 mg/kg/30 min) significantly reduced the pressor responses induced by intravenous norepinephrine. However, platycodin $D_3$ (1.0 mg/kg/30 min) did not affect them. Taken together, these results show that intravenously administered platycodin D depresses norepinephrine-induced pressor responses in the anesthetized rat, at least partly through the blockade of adrenergic ${\alpha}1$-receptors. Platycodin D also caused vascular relaxation in the isolated aortic strips of the rat via the blockade of adrenergic ${\alpha}1$-receptors, in addition to an unknown direct mechanism. However, platycodin $D_3$ did not affect both norepinephrine-induced pressor responses and the isolated rat aortic contractile responses evoked by phenylephrine and high potassium. Based on these results, there seems to be much difference in the mode of action between platycodin D and platycodin $D_3$.

Blood Electrolytes and Metabolites in Rat Model of Acute Metabolic and Respiratory Alkalosis (흰쥐 급성 대사성 알칼리증과 호흡성 알칼리증 모델에서 혈액 전해질 및 대사산물)

  • Kim, Shang-Jin;Lee, Mun-Young;Kim, Jin-Shang;Kang, Hyung-Sub
    • Journal of Veterinary Clinics
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    • v.27 no.3
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    • pp.257-261
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    • 2010
  • The development of blood ionic changes could be precipitated in acid-base disorder and subsequent treatment. As technology for detecting circulating ionized $Mg^{2+}$ (the most interesting form with respect to physiological and biological properties) is now available in veterinary clinical medicine. This present study investigated the changes of whole blood ionized $Mg^{2+}$ correlated with acute metabolic and respiratory alkalosis in rodent model. Metabolic alkalosis was induced by intravenous infusion with $NaHCO_3$ and mechanical hyperventilation was applied for respiratory alkalosis. We founded that the blood ionized $Mg^{2+}$ could be reversibly decreased by the $NaHCO_3$-induced acute metabolic alkalosis but irreversibly increased by the mechanical hyperventilation-induced respiratory acidosis and respiratory acidosis. We suggested that the potential change in blood suggested that the potential change in blood ionized $Mg^{2+}$ should be counted in treatment of acid-base disorders.

Ethylacetate Fraction of Rubus coreanum Causes Vascular Relaxation and Hypotensive Action

  • Hong, Soon-Pyo;Choi, Mee-Sung;Lim, Dong-Yoon
    • Natural Product Sciences
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    • v.20 no.3
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    • pp.216-225
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    • 2014
  • The present study was designed to investigate whether ethylacetate (EtOAc) fraction extracted from Rubus coreanum affect the contractility of the isolated thoracic aortic strips and blood pressure of normotensive rats. The EtOAc fraction ($400{\mu}g/mL$) significantly depressed both phenylephrine (PE, $10{\mu}M$)- and high $K^+$ (56 mM)-induced contractile responses of the isolated thoracic aortic strips in a concentration-dependent fashion. In the simultaneous presence of L-NAME (an inhibitor of NO synthase, $300{\mu}M$) and EtOAc ($400{\mu}g/mL$), both PE- and high $K^+$-induced contractile responses were recovered to the corresponding control level in comparison with inhibition of EtOAc-treatment alone. Moreover, in the simultaneous presence of EtOAc after pretreatment with 0.4% CHAPS, both PE- and high $K^+$-induced contractile responses were recovered to the corresponding control level compared to the inhibitory response of EtOAc-treatment alone. Also, in anesthetized rats, EtOAc fraction (0.3~3.0 mg/kg) injected into a femoral vein dose-dependently produced depressor responses. This hypotensive action of EtOAc fraction was greatly inhibited after treatment with phentolamine (1 mg/kg), chlorisondamine (1 mg/kg), L-NAME (3 mg/kg/30 min) or sodium nitroprusside ($30{\mu}g/kg/30 min$). Intravenous infusion of EtOAc fraction (1.0~10.0 mg/kg/30 min) markedly inhibited norepinehrine-induced pressor responses. Taken together, these results demostrate that EtOAc causes vascular relaxation in the isolated rat thoracic aortic strips as well as hypotensive action in anesthetized rats. These vasorelaxation and hypotension of EtOAc seem to be mediated at least by the increased NO production through the activation of NO synthase of vascular endothelium, and the inhibitory adrenergic modulation.

A Study on Characteristics of Acid-Base Balance in Goats (염소의 산·염기 균형 특성에 관한 연구)

  • Yang, Il-suk;Sung, Ho-kyng
    • Korean Journal of Veterinary Research
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    • v.25 no.2
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    • pp.133-144
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    • 1985
  • The changes of acid-base status in vitro of the venous blood for 24 hours in ten Korean native goat were investigated. The acid-base parameters were measured within ten minutes after collection of the blood, and every hour during the first six hours and finally after twenty four hours of storage. Blood samples were stored at two different temperatures ($0-4^{\circ}C$ and $21-24^{\circ}C$). Twelve goats were induced acute acid-base disturbances by intravenous infusion of either hydrochloric acid or sodium bicarbonate and inhalated with $CO_2$ gas mixture (20% $CO_2$, 80% $O_2$) or hyperventilation were performed by means of respirator. The results were as follows; 1. Blood samples could be stored during the first two hours in ice water ($0-4^{\circ}C$) and one hour at room temperature without significant changes in pH. The magnitudes of changes were similar to those of cow, and lower than those of men and dogs. 2. The mean values of acid-base parameters in normal goat were arterial pH, 7.40; $P_{CO_2}$, 35.4mmHg; $HCO_3{^-}$, 21.8mEq/L. 3. Both the base excess and the bicarbonate showed high correlation (r=0.99) during the metabolic disturbance and were represented as $B.E.=1.38\;HCO^-{_3}-29.7$. 4. The slope of blood buffer curve obtained from the in vivo experiment was 16.3mEq/L/pH. 5. The magnitudes of changes in hydrogen ion concentration per unit change of $P_{CO_2}$ were 0.8nM/mmHg in hypercapnia and 1.0nM/mmHg in hypocapnia. 6. The ranges of acid-base parameters in normal goat urine were pH, 6.0-8.1; $P_{CO_2}$, 42-61mmHg; $HCO_3{^-}$, 2-110mEq/L. The concentration of potassium was higher (60-200mEq/L), and that of sodium was lower (8-70mEq/L) than those of human urine.

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Patient-Controlled Analgesia(PCA) for Pain Management after Gynecological Surgery (Baxter $Infusor^{(R)}$를 이용한 부인과 수술후의 통증 자가 조절)

  • Lee, Jung-Koo;Kim, Jin-Mo;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.49-54
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    • 1993
  • The use of intravenous patient-controlled analgesia is an effective and increasingly used means of providing postoperative pain relief. Recently a non-electric, disposable and portable infusor, the Baxter $Infusor^{(R)}$, has developed. This delivers not only a continuous drug infusion but can also deliver extradoses of medication on demand. The present study examined the benefits of two kinds of analgesics for pain management in 28 patients undergoing gynecological surgery. One group, 14 patients, received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA with meperidine 3 mg/kg/day for 3 days only(M group). In the other group, 14 patients, also received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA meperidine 3 mg/kg/day for 3 days and droperidol 5 mg(MD group). The PCA device used was the Baxter $Infusor^{(R)}$. This unit was fitted with patient control module which had a flow rate 0.5 ml/hr and the lockout time was 15 min. Resulting from the study, the MD patients in the first and second days post-operatively, reported less pain compared with the M group. VAPS(Visual Analogue Pain Scales) values were $3.52{\pm}l.61$ vs. $2.22{\pm}0.69$, $2.38{\pm}1.12$ vs. $1.45{\pm}0.48$ and $1.93{\pm}1.65$ vs. $0.98{\pm}0.36$, respectively pertaining to M and MD groups. In conclusion, the MD group with meperidine and droperidol(mixed regimen) provided more effective postoperative analgesia than M group(meperidine only).

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Symptomatic Hypocalcemia Associated with Dioscorea tokoro Toxicity (도코로(Tokoro)마 중독과 관련한 저 칼슘혈증)

  • Yoon, Jae Chol;Lee, Jae Baek;Jeong, Tae Oh;Jo, Si On;Jin, Young Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.42-45
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    • 2019
  • Dioscorea tokoro has long been used in Korean traditional medicine as a pain killer and anti-inflammatory agent. A 53-year-old male who consumed water that had been boiled with raw tubers of D. tokoro as tea presented with numbness and spasm of both hands and feet. Laboratory results showed hypocalcemia, hypoparathyroidism, and vitamin D insufficiency. During his hospital stay, colitis, acute kidney injury, and toxic encephalopathy developed. The patient received calcium gluconate intravenous infusion and oral calcium carbonate with alfacalcidol. His symptoms improved gradually, but hypocalcemia persisted despite the calcium supplementation. We suggest that ingestion of inappropriately prepared D. tokoro can cause symptomatic hypocalcemia in patients with unbalanced calcium homeostasis.

DENTAL MANAGEMENT UNDER GENERAL ANESTHESIA OF CHILDREN WITH HEMOPHILIA A AND HEMOPHILIA B (혈우병A와 혈우병B 환자의 전신마취 하 치과치료)

  • Kim, Ik-hwan;Park, Minji;Lee, Ko-Eun;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.2
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    • pp.102-105
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    • 2018
  • Hemophilia is an X-linked herediatry disorder. Hemophilia A is a defiency of factor VIII and hemophilia B (Christmas disease) is a deficiency of factor IX. The most widely used classification is based on plasma procoagulant levels, with people <1% factor defined as severe; 1 - 5% moderately severe; and >5% as mild. A 7 years old boy visited our clinic with chief complaint of impacted supernumerary tooth. This boy had severe hemophilia A. With the previous $ADVATE^{(R)}$ injection and factor VIII replacement, Extraction of supernumerary tooth was successfully done under General anesthesia. A 9 years old boy referred from local clinic for dental caries treatment. This boy had severe hemophilia B. With the preparation of $BeneFIX^{(R)}$ injection, dental treatment was done successfully under general anesthesia. It is often first detected by dental trauma. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. The treatment of the patients with either hemophilia A or hemophilia B involves the intravenous infusion to either control or prevent bleeding.

A Case of Isoniazid Intoxication in a Dog

  • Oh, Jimin;Kim, Hong-Seok;Kang, Ji-Houn;Kang, Byeong-Teck;Yang, Mhan-Pyo;Kim, Hakhyun
    • Journal of Veterinary Clinics
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    • v.38 no.4
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    • pp.204-209
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    • 2021
  • A seven-month-old castrated male Chihuahua weighing 1.6 kg presented with generalized tonic-clonic seizure following ingestion of isoniazid. Emergency treatment with three doses of diazepam (total 1.5 mg/kg, intravenous [IV]) and phenobarbital (15 mg/kg IV) was administered. The seizure stopped after administration of propofol (constant rate infusion [CRI]; 0.2 mg/kg/min). Blood analyses showed mildly increased serum blood glucose concentration, hyperkalemia, and hyperphosphatemia. On suspicion of isoniazid toxicity, activated charcoal (1 g/kg, orally), lipid emulsion (CRI; 9 mL/hr), and pyridoxine hydrochloride (70 mg/kg IV) were added to the treatment regimen. Twelve hours after presentation, the dog showed increased serum liver enzyme activities, serum blood urea nitrogen, and creatinine concentrations indicating hepatic and renal failure. Twenty-two hours after presentation, blood analysis still revealed increased liver enzyme activities, blood urea nitrogen, and creatinine concentrations with low blood glucose concentration. Twenty-six hours after presentation, the dog's vital signs deteriorated and the owner elected for the dog to be euthanized. This is the first report of the clinical course of isoniazid toxicosis in a dog in South Korea. Furthermore, to our best knowledge, this is the first report where secondary multiple organ failure was observed due to isoniazid toxicosis. Clinicians should be aware of the possibility of isoniazid toxicosis in dogs. Rapid initiation of treatment after clinical recognition is warranted in such cases.