• Title/Summary/Keyword: Respiratory Effects

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Clinical Experience of Continuous Epidural Analgesia Using Baxter $Infusor^{(R)}$ (Baxter $Infusor^{(R)}$를 이용한 경막외 진통제 지속 주입)

  • Bae, Sang-Chull;Lee, Jang-Won;Kim, Ill-Ho;Song, Hoo-Bin;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.127-132
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    • 1991
  • Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

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Reconstruction of Mainstem Bronchus Obstructed by Endobronchial Tuberculosis (결핵성 주기관지협착에 대한 주기관지재건술)

  • Kim Su Wan;Kim Jhingook;Shim Young Mog;Kim Kwhanmien;Choi Yong Soo;I Hoseok;Kim Hojoong;Chang Jee Won
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.622-626
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    • 2005
  • Background: Non-invasive interventional therapy has been performed for main bronchial obstruction by endobronchial tuberculosis because of the risk of main bronchial reconstruction regardless of the pulmonary function. But, effects of the inteeventional therapy are attacked by arguments. This study was aimed at interpreting the risk and effectiveness of bronchoplasty for benign bronchial stenosis over the last ten years in our hospital by reviewing the results based on clinical progression. Material and Method: We retrospectively reviewed the clinical records and out-patient medical records including 2f consecutive patients who underwent main bronchial reconstruction for obstruction by endobronchial tuberculosis. All of them had past medical history of anti-tuberculosis medication. They were preoperatively evaluated by bronchoscopy and chest computed tomography. Result: There were no incidences of postoperative mortality and signifcant morbidity. There were 2 cases of retained secretions but these problems were resolved by therapeutic bronchoscopy or intubation. All of the patients are still alive without obstructive airway problem. Conclusion: Bronchoplasty should be considered as one of the primary treatment modalities, if it is anatomically feasible.

Colchicine Derivatives Allows Prolonged Survival of Cardiac Allograft in the Rat (백서에서의 동종이형의 심장이식후 Colchicine 변형 물질 투여군의 장기 변존)

  • Kim Young-Hak;Lee Hyung-Chang;Chung Won-Sang;Kang Jung-Ho;Kim Hyuck;Chon Sun-Ho;Shin Sung-Ho
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.595-600
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    • 2005
  • Background: Colchicine with its immunosupressive properties has been used with benefcial effects in autoimmune disease, such as Gout, etc. Whether colchicine, by virtue of the above property, could attenuate the process of cardiac allograft rejection in the rats is investigated in this report. Material and Method: We compared the untreated group (Control, n=6), Cyclosporin A group (10 mg/kg, daily, n=20), and Colchicine derivative group (Colchicine 40 ${\mu}g$/kg, n=20) of cardiac allografts in the rats. Result: In the untreated control group (n=6), all of 6 rats showed rejection within 3 weeks after cardiac allograft. In the cyclosporin A group (n=20), cyclosporin A (10 mg daily oral dose) was administered at a 10 mg daily oral dose and promoted long-term survival (over 100 days). The cyclosporin A group had one mortality at the 18th post-operative day due to infection. Furthermore, in the Colchicine derivatives group (n=20) with a daily IP (Intra Peritoneum) dose (40 ug/kg/day), we observed long-term survival.(> 100 days), except for one rat that died of an anesthetic problem (respiratory failure) at the 9th post-operative day. Conclusion: Experiments have also been performed to evaluate whether the effect of colchicine derivatives allowed prolonged survival of cardiac allografts compared with the cyclosporin A administration group in the rats.

The Effects of Jungchun-tang and Jungchuntanggagambang on Immune Cell & Serum IgE in BALF in a Rat Asthma Model (정천탕과 정천탕가감방이 알레르기 천식모델 흰쥐의 BALF내 면역세포 및 혈청 IgE에 미치는 영향)

  • 염종훈;정희재;정승기;이형구
    • The Journal of Korean Medicine
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    • v.24 no.1
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    • pp.169-180
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    • 2003
  • Background : Allergic asthma is thought to be mediated by $CD4^{+}$ T lymphocytes producing the Th2-associated cytokines. According to investigations of lung biopsies and respiratory secretions from patients, $CD4^{+}$ T cells and eosinophils are the main features of the inflammatory process. Object : This study aimed to find an inhibition effect on allergens induced by JCT (Jungchun-tang) and JCTG (Jungchuntanggagambang) through the change of $CD4^{+}$ T cells and $CD8^{+}$ T cells in BALF of rat, and to see the change of IgE m serum. Materials and Methods : Laboratory rats were primary sensitized with OA (ovalbumin); on day 1, rats of a control group and a sample group (SBP group) were systemically immunized by subcutaneous injection of 1mg OA and 300mg of A1(OH)3 in a total volume of 2 ml saline. The rats of the sample group were orally administered with an SBP water extract for 14 days after primary immunization. On day 14 after the systemic immunization, rats received local immunization by inhaling 0.9% saline aerosol containing 2%(wt/vol) OA. A day after local immunization, BAL fluid and serum were collected from the rats. Total cells, lymphocytes, $CD4^{+}$ T cells, $CD8^{+}$ T cells, and $CD4^{+}$/$CD8^{+}$ ratio in the BALF, and IgE level in serum were measured and evaluated. Results : L Total cell in BALF of rat : JCT was observed to be significantly reduced but JCTG had no significant difference in comparison with the control group. 2. Lymphocytes in BALF of rat : JCT and JCTG were observed to be significantly reduced in comparison with the control group. 3. $CD4^{+}$T cells in BALF of rat : JCT was observed to be more significantly reducing than JCTG in comparison with the control group. 4. $CD8^{+}$T cells in BALF of rat : JCT and JCTG were observed not to be significantly different than in the control group. 5. $CD4^{+}/CD8^{+}$ ratio in BALF of rat : JCT and JCTG were observed not to be significantly different than in the control group. 6. The IgE level in serum : JCT and JCTG were observed to be significantly reduced in comparison with the control group. Conclusion : This study shows that JCT inhibits allergen-induced specially select $CD4^{+}$T cell channel in BALF of rat.

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Air Pollution and Daily Modality in Seoul (서울시의 대기오염과 일별 사망자 수의 관련성에 대한 시계열적 연구)

  • Cho, Soo-Hun;Kwon, Ho-Jang
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.191-199
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    • 1999
  • Objectives: To examine the relationship between air pollution exposure and mortality in Seoul for the years of 1991-1995, Methods: Daily counts of death were analyzed by general additive Poisson model, with adjustment for effects of secular trend, seasonal factor, day of the week, heat wave, temperature, and humidity. Pollution variables were ozone, nitrogen dioxide, total suspended particles(TSP), and sulfur dioxide. Results: Daily death counts were associated with ozone(1 day before), nitrogen dioxide(1 day before), TSP(2 days before), sulfur dioxide(2 days before). The association with ozone was most statisfically significant and independent of other air pollutants. Increase of 100 ppb in ozone was associated with 0%(95% Cl= 2%-10%) increase in the daily number of death, This effect was greater in persons aged 65 and older. The relative risks of death from respiratory disease and cardiovascular disease were greater than for all-cause mortality in each pollutant. After ozone level exceeds 25 ppb, the dose-response relationship between mortality and ozone was almost linear. However, the effect of TSP, sulfur dioxide, and nitrogen dioxide on mortality might be confounded with each other. Conclusion: Daily variations in air pollution within the range currently occurring in Seoul might have an adverse effect on daily mortality.

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Generation of Superoxide Radical from Rat Brain Mitochondria and Mechanism of Its Toxic Action to Mitochondrial and Extra-mitochondrial Components (흰쥐 뇌 미토콘드리아에 의한 superoxide radical의 생성과 이 radical이 미토콘드리아 및 미토콘드리아 외 물질에 대한 독작용과 그 기전에 관한 연구)

  • Roh, Jae-Kyu;Pyo, Jang-Geun;Chung, Myung-Hee;Lim, Jung-Kyoo;Myung, Ho-Jin
    • The Korean Journal of Pharmacology
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    • v.21 no.1
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    • pp.12-26
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    • 1985
  • The generation of $O^{-}_{2}{\cdot}$ and its toxic effects were studied with rat brain mitochondria. The production of $O^{-}_{2}{\cdot}$ from mitochondria in the presence of succinate and antimycin was demonstrated by SOD-inhibitable reduction of NBT. Although succinate can support the $O^{-}_{2}{\cdot}$ formation, the highest rate needs antimycin indicating that blockade of electron flow in the respiratory chain augments the univalent reduction of molecular oxygen. Under this condition, $H_2O_2$ was also observed to be produced. But its formation appears to be derived from the dismutation of the primary product, $O^{-}_{2}{\cdot}$ since the rate of $H_2O_2$ production was markedly decreased by NBT and ferricytochrome c. The $O^{-}_{2}{\cdot}$ and $H_2O_2$ produced were able to cause toxic actions to mitochondrial and extra-mitochondrial components as shown by lipid peroxidation of mitochondrial membrane, and inactivation and lysis of isocitrate dehydrogenase and erythrocytes added to the medium, respectively. In all the toxic actions observed, $Fe^{++}$ was required. It appears that in the toxic actions $OH{\cdot}$ generated from the iron-catalyzed Haber-Weiss reaction acts as a mediator. This was supported by the finding that mitochondria in the presence of succinate and antimycin produced ethylene from methional, and $Fe^{++}$ added increased the ethylene production. The observed toxic actions of mitochondrial $O^{-}_{2}{\cdot}$ may provide evidence supporting a potential role of mitochondria as a source of oxygen radicals to cause tissue damage.

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The Effect of Vitamin A Derivatives on the Activity of Drug-metabolizing Enzyme in Rat Liver (Vitamin A 유도체로 인한 간의 약물대사효소 변동)

  • Lee, H.W.;Ryu, K.Z.;Ro, J.Y.;Hong, S.S.
    • The Korean Journal of Pharmacology
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    • v.18 no.1
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    • pp.65-72
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    • 1982
  • It has been known that retinoids are intrinsically of critical importance for control of premalignant epithelial cell differentiation. In the absence of retinoids, normal cellular differentiation and growth does not occur in epithelia such as those of trachea and bronchi. Furthermore, it was also reported that retinoid deficiency enhanced susceptibility to chemical carcinogenesis in the respiratory system, in the bladder, and in the colon of the experimental animal. In 1974, Bollag examined the effects of synthetic retinoids in prevention of development of cancer and demonstrated synthetic retinoids to have more favorable therapeutic index than retinoic acid for causing regression of skin papilloma in mice. Therefore, it was assumed that this anticarcinogenic effect of vitamin A derivatives could be due to modification of the metabolism of the carcinogenic polycyclic hydrocarbon, which must first be activated to exert their effect. Hill and Shih reported that vitamin A compounds and analogs had inhibitory effect on drug metabolizing enzyme from liver and lung tissue of mouse and hamster. Lucy suggested that the chemoprevention effect of vitamin A derivatives is due to reaction with molecular oxygen, and it is possible that inhibition of hydroxybenzpyrene formation is a result of this property. On the other hand, butylated hydroxytoluene which is a potent antioxidant strongly inhibited the formation of mammary tumor induced by dimethylbenranthracene. Also, it was observed that this antioxidant inhibited cancer induction in rats by N-2-fluo-renylacetamide. The purpose of this experiment was to investigate the effect of vitamin A derivatives such as retinoic acid and retinoid on drug-metabolizing enzyme and to determine whether riboflavin tetrabutylate or vitamin E could prevent of modify any changes induced by vitamin A delivatives in the rats. The results obtained were as followings. 1) Body weight was significantly reduced by retinoic acid, but not by retinoid. 2) Retinoic acid markedly increased liver weight while retincid showed no effect on liver weight. Treatment of riboflavin tetrabutylate did not affect retinoic acid-induced change in both body weight and liver weight. 3) Both retinoic acid and retinoid remarkably decreased the activity of aminopyrine demethylase. Pretreatment of riboflavin tetrabutylate, however, prevented inhibitory effect of retinoic acid on the enzyme activity. 4) No significant effect of vitamin E on aminopyrine demethylase was observed in both groups treated with retinoic acid and retinoid.

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Post-operative Analgesic Effect of Epidural Midazolam Administered with Morphine (경막외강에 Morphine과 동반 투여한 Midazolam의 진통효과)

  • Yang, Nae-Yun;Moon, Dong-Eon;Shim, Jae-Yong;Park, Cheol-Joo;Kwon, Ou-Kyoung;Kim, Dae-Woo;Won, Chi-Hwan;Kim, Sun-Cheol;Chae, Hyeon;Kim, Wook-Sung
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.241-246
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    • 1998
  • Background: Opioids and local anesthetics have been administered epidurally for the purpose of the postoperative analgesia. However opioids have a serious risk of respiratory depression and local anesthetics have the risks of hypotension, sensory block, or motor one. In recent years, reports of spinal administration of midazolam for acute postoperative pain control have appeared in the literature. This study was performed to observe the effect of epidural midazolam in patient-controlled analgesia (PCA) device. Methods: Forty-five patients scheduled for the elective total hysterectomy were randomly selected; epidurally take morphine only (group I, n=15), morphine plus 0.1% bupivacaine (group II, n=15), or morphine plus midazolam (group III, n=15). The visual analogue scale (VAS) at rest and with movement, the sedation score, the degree of the satisfaction, the total amounts of a morphine usage, and the incidence of the side effects were observed. Rusults: The VAS at rest of group II and III were decreased significantly than that of group I. The VAS with movement of group III was significantly decreased than that of group I and II. The sadation score and the cumulative dose of a morphine were statistically insignificant within groups. Conclusion: Epidural morphine plus midazolam was proven to be clinically effective in the post-operative pain control especially for the pain with movement, compared with epidural morphine only and morphine plus 0.1% bupivacaine.

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Bioequivalence of Broadcef Capsule to Cefradine Yuhan Capsule (Cephradine 500 mg) (유한세프라딘 캅셀(세프라딘 500 mg)에 대한 브로드세프 캅셀의 생물학적 동등성)

  • Cho, Hea-Young;Lee, Suk;Kang, Hyun-Ah;Oh, In-Joon;Lim, Dong-Koo;Moon, Jai-Dong;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.32 no.3
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    • pp.215-221
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    • 2002
  • Cephradine is a first generation cephalosporin and has broad spectrum antibacterial activity against gram-positive and gram-negative microorganisms, through inhibition of bacterial cell wall synthesis. Cephradine is useful for treatment of infections of the urinary and respiratory tract, skin and soft tissues. The purpose of the present study was to evaluate the bioequivalence of two cephradine capsules, Cefradine Yuhan (YuHan Corporation) and Broadcef (Ilsung Pharmaceuticals Co. Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). The cephradine release from the two cephradine capsules in vitro was tested using KP VII Apparatus II method with various different kinds of dissolution media (pH 1.2, 4.0, 6.8 buffer solution and water). Twenty normal male volunteers, $23.10{\pm}2.90$ years in age and $67.69{\pm}8.04\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one capsule containing 500 mg as cephradine was orally administered, blood was taken at predetermined time intervals and the concentrations of cephradine in serum were determined using HPLC method with UV detector. The dissolution profiles of two cephradine capsules were very similar at all dissolution media. Besides, the pharmacokinetic parameters such as $AVC_t,\;C_{max}\;and\;T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AVC_t\;and\;C_{max}$ and untransformed $T_{max}$. The results showed that the differences in $AVC_t,\;C_{max}\;and\;T_{max}$ between two capsules based on the Cefradine Yuhan were -2.87%, -0.96% and -4.85%, respectively. There were no sequence effects between two capsules in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of 1og(0.8) to log(1.25) $(e.g.,\;log(0.93){\sim}log(1.02)\;and\;log(0.88){\sim}log(1.13)\;for \;AVC_t\;and\;C_{max},\;respectively)$. The 90% confidence interval using untransformed data was within ${\pm}20%$ $(e.g., \;-17.54{\sim}7.78\;for\;T_{max})$. All parameters met the criteria of KFDA guideline for bioequivalence, indicating that Broadcef capsule is bioequivalent to Cefradine Yuhan capsule.

Pain Control with Continuous Infusion of Epidural Morphine and Bupivacaine after Lumbar Spinal Surgery : A Prospective Study (요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과)

  • Shin, Moon Soo;Lee, Byung Hee;Choi, Hun Kyu;Noh, Jae Sub;Ahn, Jung Young;Sheen, Seung Hun;Lee, Byung Hee;Chung, Bong Sub
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.604-608
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    • 2000
  • Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n=20) and control group(n=15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.

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