Effect of Tetraethylammonium on the Contractile Reponse in the Isolated Rat Phrenic: Hemidiaphra / 대한마취과학회지

BACKGROUND: Recently, the phannacologic and therapeutic significance of various types of potassium channels are being realized. Thus it was attempted to delineate the role of voltage-gated K+ -channels on the excitation-contraction coupling in skeletal muscle. METHODS: The effects of tetraethylammonium, a well known K+ -channel blocker, on the electrically-evoked twitch response, train-of-four and tetanic stimulation, and the influence of various agents on the these effects were studied in the isolated rat hemi-diaphragm preparation. RESULTS: Tetraethylammonium (1 & 3 mM) increased the electrically-evoked twitch response, but the large dose (10 mM) decreased the twitch response. And tetraethylammonium decreased the TOF- and tetanus-ratio in a dose-related fashion. d-Tubocurarine(1 microM) decreased the twitch response, and tetraethylammonium recovered the d-tubocurarine-induced-depression of twitch response. When the Ca++(6x) and K+ (2x) concentration of the medium were increased, the twitch response caused by tetraethylammonium were slightly inhibited than that observed in the normal solution, but the fade phenomenon was potentiated. The tetraethylammonium (10 mM)-induced depression of twitch response were reduced by reducing the stimulus frequency to 0.01 Hz and choline (400 microM) treatment. And N-ethylmaleimide inhibited the tetraethylammonium-induced increment of twitch response and also potentiated the tetraethylammonium-induced fade phenomenon. However, it is noteworth the 4-aminopy- ridine, another K+ -channel bloker, potentiated the electrically-evoked twitch response but did not affect the TOF-and tetanusratio. CONCLUSION: These result indicate that tetraethylammonium elicited two districtive types of response in the rat phrenic-hemidiaphragm preparation. The potentiating effects of twitch response is mediated by blocking delayed K+ -rectifier channel and decreasing effects of twitch response, TOF-and tetanus-ratio is may be due to decreased the acetylcholine release from presynaptic nerve terminal.

Report on 7 Cases of Anisakiasis Involved the Upper Gastrointestinal Tract / 대한소화기내시경학회지

The anisakiasis disease that is infected through various kinds of larvae of the anisakis family when sea fish ia eaten uncooked or half-cooked. Sinee Van Thiel, a Netherlander, found in 1960 that anisakis larvae parasitize upon the human intestinal tract of the patients who suffer from ahdomieal pain after eating herrings, there have been a number of similar reports in North America and Japan, and the clinical importance of anisakis larvae for the acute gastrontestinal infection is rising. In general, as raw sea fish is not regarded as a source of parasite infestation, the patients who had eaten it and suffered from acute abdominal pain and vomiting are considered as and to be treated of food poisoning. But it is highly possible that some of them suffer from the acute gastrointestinal symptom caused by anisakis larvae. Thereby we report on 7 examples of anisakiasis taken through endoscopic diagnosis of the patients who have the acute upper abdominal pain after eating raw sea fish.

Effects of Morphine, Fentanyl and Ketorolac Tromethamine, Droperidol Intravenous Infusion for Postoperative Pain Control / 대한마취과학회지

Continuous intravenous infusions of opioids can provide better pain relief than intermittent injection but may be associated with increased incidence of undesirable side effects including respiratory depression, nausea, vomiting and urinary retention. Ketorolac tromethamine is a new, nonsteroidal anti-inflammatory agent. It has significant analgesic properties without respiratory and cardiovascular depression. Mixing of opioids and ketorolac may lessen these complications without reducing analgesic effect. In six groups, we assessed the effect of postoperative pain control using morphine or fentanyl, ketorolac and droperidol, Each group consists of 100 patients. Patients in group 1, group 2, and group 3 received 2 mg of morphine via intravenous injection following the induction of anesthesia. Patients in group 1 were then continuously infused with additional 48 mg of morphine, patients in group 2 received additional 18 mg of morphine plus 120 mg of ketorolac, and patients in the group 3 were treated with the same protocol as group 2 but 2.5 mg of droperidol was added. For patients in group 4, group 5, and group 6 initially received 20 ug of fentanyl after induction of anesthesia. The rest of dose were treated with similar protocols as group I, group 2, group 3, respectively. In group 4, group 5, and group 6, morphine was substituted to 500 ug, 200 ug, and 200 ug of fentanyl, respectively. In all patients, initial dose of drug was given by bolus of intravenous injection and the rest of dose was delivered via intravenous using a Baxter Two Day Infusor or a Paragon 100. Pain scores and side effects were recorded every twelve hours for three days. No significant difference was found between the groups although pain control effect was excellent in all groups. Untoward effects were least in morphine or fentanyl-ketorolac-droperidol(group 3, group 6). It could be concluded that mixing of opioids, ketorolac and dtoperidol would be better than opioids alone.

Effects of Lovastatin(Mevacor(R)) on Lowering Plasma Lipids in Patients with Hyperlipidemia

Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis was administered to 34 patients with primary hypertlipidemia, 20 mg once daily with the evening meal. Patients experienced mean total and LDL cholesterol reductions of 30.9% and 34.0% respectively. HDL cholesterol level was significantly increased by 15.4% and plasma triglyceride level was decreased by 11.2%. maximal hypocholesterolemic effects were evident at 8 weeks, after which the effects were stable. Adverse effects were noted in 2 patients who had mild gastrointestinal symptoms, that subsided after discontinuing the drug. We concluded that lovastatin is a well tolerated and effective agent for the treatment of primary hyperlipidemia.