• Title/Summary/Keyword: drug spread level

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A Comparison of the Spread Level of the Cervical Epidural Block in Terms of Volume (경부 경막외 차단 시 약물의 용량에 따른 분포 양상 비교)

  • Jo, Dae hyun;Kim, Myoung hee;Ahn, Sun Yeon;Park, Sa Hyun;Lee, Kang Chang
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.46-49
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    • 2007
  • Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were $4.88{\pm}0.78segments$ and $4.53{\pm}0.49segments$, respectively. Spread levels to the caudad for patients in the two groups were $4.59{\pm}0.93segments$ and $4.47{\pm}0.51segments$, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

Preliminary study on contrast flow analysis of thoracic transforaminal epidural block

  • Hong, Ji Hee;Noh, Kyoung Min;Park, Ki Bum
    • The Korean Journal of Pain
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    • v.31 no.2
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    • pp.125-131
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    • 2018
  • Background: The thoracic transforaminal epidural block (TTFEB) is usually performed to treat herpes zoster or postherpetic neuralgia (PHN). Especially, multiple segmental involvements and approximate contrast medium spread range, according to volume, help to choose the proper drug volume in the transforaminal epidural block. This study investigated the contrast medium spread patterns of 1-ml to 3-ml TTFEBs. Methods: A total of 26 patients with herpes zoster or PHN were enrolled in this study. All participants received 1 ml, 2 ml, or 3 ml of contrast medium. Results were divided into Groups A, B and C based on the volume (1, 2, or 3 ml), with n = 26 for each group. After the injection of contrast medium, the spread levels were estimated in both the lateral and anteroposterior (AP) images using fluoroscopy. Results: The cephalad spread of contrast medium in the lateral image as expressed by the median (interquartile range) was 2.00 levels (1.00-2.00) for Group A, 2.50 (2.00-3.00) for Group B, and 3.00 (2.00-4.00) for Group C. The caudal spread level of contrast medium was 1.00 (1.00-2.00) for Group A, 2.00 (2.00-3.00) for Group B, and 2.00 (2.00-3.00) for Group C. There was ventral and dorsal spread of the 3-ml contrast medium injection in 88% (23/26) of cases in the lateral image. Conclusions: Injection of 3 ml of contrast medium through the foramina spread 6 levels in a cephalocaudal direction. Spread patterns revealed a cephalad preference. TTFEB resulted in dorsal and ventral spread in a high percentage of cases. This procedure may be useful for transferring drugs to the dorsal and ventral roots.

Development of Anti-viral Agents from Natural Sources

  • Hattori, Masao
    • Plant Resources
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    • v.4 no.3
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    • pp.192-195
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    • 2001
  • Human immunodeficiency virus (HIV), the causative agent of AIDS, still continues to spread rapidly in the world population, especially in Africa and Southeast Asia. At present, two kinds of therapeutic approaches are used for treatment of AIDS. One is to target HIV reverse transcriptase, which is responsible for the viral genome transcription. The other is to inhibit HIV pretense PR, which is essential for the processing of viral proteins. Drug combinations based on these approaches can reduce the blood virus to an undetectable level. However, a small amount of virus may lurk inside the immune cells in a dormant state. Another major obstacle of long-term treatment of the disease is remarkable mutation in HIV. Most of the clinical chemotherapeutic agents have one or more of these problems. High cost and harmful side-effects further reduced the desirability of these drugs. In the course our studies on development of anti-HIV agents from natural products, we investigated various crude drugs for their inhibitory activity against HIV-induced cytopathic effects (CPE) in culture cells, HIV-pretense (PR), HIV-reverse transcriptase (RT) including ribonuclease H (RNase H), and HIV integrase (INT). In the present paper, some inhibitory substances relating to the development of anti-HIV agents are reported.

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Recent Advancements of Treatment for Leptomeningeal Carcinomatosis

  • Gwak, Ho-Shin;Lee, Sang Hyun;Park, Weon Seo;Shin, Sang Hoon;Yoo, Heon;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.1-8
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    • 2015
  • Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

Antibiotic Resistance Profiles of Staphylococcus pseudintermedius Isolates from Canine Patients in Korea

  • Yoon, Jang-Won;Lee, Ki-Jong;Lee, So-Young;Chae, Min-Joo;Park, Jae-Keun;Yoo, Jong-Hyun;Park, Hee-Myung
    • Journal of Microbiology and Biotechnology
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    • v.20 no.12
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    • pp.1764-1768
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    • 2010
  • In this study, the prevalence of antibiotic resistance was examined among 74 Staphylococcus pseudintermedius strains recently isolated from clinical cases of canine pyoderma and otitis externa at the veterinary teaching hospital at Konkuk University, Korea. Bacterial resistance to the nine commonly used antibiotics was evaluated by a standard disk diffusion technique based on the guidelines of the Clinical and Laboratory Standards Institute. The results demonstrated that most S. pseudintermedius isolates were resistant to penicillin (95.9%) or tetracycline (91.9%), but highly susceptible to amoxicillin/clavulanic acid (90.5%). Among the 74 isolates, 13 mecA-positive and methicillin-resistant S. pseudintermedius (MRSP) strains were identified, displaying a high level of resistance (84.6-100%) to each of the individual antibiotics evaluated, with the exception of amoxicillin/clavulanic acid (46.2% resistance). Notably, all of the MRSP isolates exhibited simultaneous resistance to four or more different antibiotics, indicating that they are multiple drug resistant (MDR) strains. Taken together, these results imply that more careful selection or prescription of antibiotics for canine pyoderma and otitis externa should be required for reducing the emergence and/or spread of MDR strains, especially MDR-MRSP isolates, in veterinary pet clinics in Korea.

Growth Factor Releasing Porous Poly (${\varepsilon}-caprolactone$)-Chitosan Matrices for Enhanced Bone Regenerative Therapy

  • Im, Su-Yeon;Cho, Seon-Hye;Hwang, Jeong-Hyo;Lee, Seung-Jin
    • Archives of Pharmacal Research
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    • v.26 no.1
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    • pp.76-82
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    • 2003
  • Drug releasing porous poly($\varepsilon$-caprolactone) (PCL)-chitosan matrices were fabricated for bone regenerative therapy. Porous matrices made of biodegradable polymers have been playing a crucial role as bone substitutes and as tissue-engineered scaffolds in bone regenerative therapy. The matrices provided mechanical support for the developing tissue and enhanced tissue formation by releasing active agent in controlled manner. Chitosan was employed to enhance hydrophilicity and biocompatibility of the PCL matrices. PDGF-BB was incorporated into PCL-chitosan matrices to induce enhanced bone regeneration efficacy. PCL-chitosan matrices retained a porous structure with a 100-200 $\mu$m pore diameter that was suitable for cellular migration and osteoid ingrowth. $NaHCO_3$ as a porogen was incorporated 5% ratio to polymer weight to form highly porous scaffolds. PDGF-BB was released from PCL-chitosan matrices maintaining therapeutic concentration for 4 week. High osteoblasts attachment level and proliferation was observed from PCL-chitosan matrices. Scanning electron microscopic examination indicated that cultured osteoblasts showed round form and spread pseudopods after 1 day and showed broad cytoplasmic extension after 14 days. PCL-chitosan matrices promoted bone regeneration and PDGF-BB loaded matrices obtained enhanced bone formation in rat calvarial defect. These results suggested that the PDGF-BB releasing PCL-chitosan porous matrices may be potentially used as tissue engineering scaffolds or bone substitutes with high bone regenerative efficacy.

Antibiotic Resistant Patterns and DNA Fingerprint Analysis of Acinetobacter baumannii from Clinical Isolates (임상에서 분리된 Acinetobacter baumannii의 항생제 내성 패턴과 유전학적 특징)

  • Kim, Min-Ji;Lee, Si-Won;Lee, Do-Kyung;Park, Jae-Eun;Kang, Joo-Yeon;Park, Il-Ho;Shin, Hae-Soon;Ha, Nam-Joo
    • YAKHAK HOEJI
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    • v.57 no.2
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    • pp.132-138
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    • 2013
  • Acinetobacter baumannii is gram-negative bacilli that can be widely found in environments. Recently, A. baumannii emerged as a serious nosocomial infection. A total of 92 A. baumannii were isolated from hospitalized patients in Seoul, Korea, between December 2010 and April 2011. Antimicrobial susceptibility testing was investigated using CLSI agar dilution methods. Tigecycline non-susceptible A. baumannii isolates were investigated by repetitive extragenic palindromic sequence-based PCR (rep-PCR). Pulsed-field gel electrophoresis was performed to determine the epidemiological relationships. All clinical isolates showed high-level resistance to the most commonly used antibiotics: Ciprofloxacin (87.0%), Ampicillin/sulbactam (82.6%), Cefotaxime (81.5%), Ceftazidime (80.4%). Moreover, 50.0% of these isolates were non-susceptible to tigecycline. When evaluated by RAPD analysis, generated distinct band ranging in size from 1kb to 8k band varying from 4 to 10 bands. Stricter surveillance and more rapid detection are essential to prevent the spread of multi drug resistant A. baumannii.

The Prognostic Factors of Selective Transforaminal Epidural Block in Patients with Low Back Pain (요하지통 환자에서 선택적 경추간공 경막외강 블록의 예후 인자)

  • Choi, Byung In;Han, Jeong Mi;Kweon, Tae Dong;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.54-59
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    • 2007
  • Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.

Interleukin-$32{\gamma}$ Transgenic Mice Resist LPS-Mediated Septic Shock

  • Kim, Sun Jong;Lee, Siyoung;Kwak, Areum;Kim, Eunsom;Jo, Seunghyun;Bae, Suyoung;Lee, Youngmin;Ryoo, Soyoon;Choi, Jida;Kim, Soohyun
    • Journal of Microbiology and Biotechnology
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    • v.24 no.8
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    • pp.1133-1142
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    • 2014
  • Interleukin-32 (IL-32) is a cytokine and inducer of various proinflammatory cytokines such as $TNF{\alpha}$, IL-$1{\beta}$, and IL-6 as well as chemokines. There are five splicing variants (${\alpha}$, ${\beta}$, ${\gamma}$, ${\delta}$, and ${\varepsilon}$) and IL-$32{\gamma}$ is the most active isoform. We generated human IL-$32{\gamma}$ transgenic (IL-$32{\gamma}$ TG) mice to express high level of IL-$32{\gamma}$ in various tissues, including immune cells. The pathology of sepsis is based on the systemic inflammatory response that is characterized by upregulating inflammatory cytokines in whole body, particularly in response to gram-negative bacteria. We investigated the role of IL-$32{\gamma}$ in a mouse model of experimental sepsis by using lipopolysaccharides (LPS). We found that IL-$32{\gamma}TG$ mice resisted LPS-induced lethal endotoxemia. IL-$32{\gamma}$ reduced systemic cytokines release after LPS administration but not the local immune response. IL-$32{\gamma}TG$ increased neutrophil influx into the initial foci of the primary injected site, and prolonged local cytokines and chemokines production. These results suggest that neutrophil recruitment in IL-$32{\gamma}TG$ occurred as a result of the local induction of chemokines but not the systemic inflammatory cytokine circulation. Together, our results suggest that IL-$32{\gamma}$ enhances an innate immune response against local infection but inhibits the spread of immune responses, leading to systemic immune disorder.

React-based Web System Providing Residual Material Information (잔류물질정보 제공을 위한 React 기반 웹 서비스)

  • Kim, Boseon;Lee, Min-Seong;Gang, MinGyu;Park, Jee-Tae
    • KNOM Review
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    • v.24 no.1
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    • pp.29-37
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    • 2021
  • With the spread of the Internet, users can easily receive various services and exchange information through the web. There are several requirements for building a web system, and it must be developed using a programming language or platform for user purposes. Residual material information refers to information on medicines and pesticides added to food, and residual material standards are used to measure the level of residues in food produced by companies and farmers to determine whether those levels meet domestic or international standards. Currently, the Ministry of Food and Drug Safety provides residual acceptance standards for food additives, including food, pesticides and animal medicines, in the form of documents, which must be serviced smoothly and conveniently by users through the establishment of a web system. It must also meet a variety of requirements, including user accessibility, such as scalability and compatibility. This paper proposes react-based residual material information web system that allows users to access more conveniently and receive residual material information smoothly. We measured the speed for the three inportant functions of information provision and compared them with existing residual material information web systems and qualitatively evaluated the seven essential requirements: scalability, compatibility, and accessibility.