Effects of Gabexate Mesilate (Foy(R)) on Endotoxin-Induced Acute Lung Injury in Rabbit / 대한마취과학회지

BACKGROUND: This study was to clarify the effects of gabexate mesilate (Foy(R)), a synthetic protease inhibitor, on endotoxin induced acute lung injury in rabbit. METHODS: Animals were randomly assigned to one of four groups: saline only (n = 7), saline and Escherichia coli endotoxin 5 mg/kg over 30 mins (n = 7), Foy(R) 1 mg/kg bolus, followed by infusion of Foy(R) at 1 mg/kg/h and endotoxin (n = 7), Foy(R) 2 mg/kg bolus, followed by infusion of Foy(R) at 2 mg/kg/h and endotoxin (n = 7). Infusion of saline or Foy(R) was started 0.5 hour before the start of infusion of saline or endotoxin and continued for 6.5 hours. At the end infusion animals were sacrificed, and the wet to dry (W/D) weight ratio of lung, lung injury score and leukocyte counts, percentage of polymorphonuclear leukocyte (PMNL), and concentrations of albumin and interleukin-8 (IL-8) in bronchoalveolar lavage fluid (BALF) were evaluated. RESULTS: Endotoxin decreased the PaO2 and peripheral blood leukocyte and platelet counts. And it increased the W/D weight ratio of lung, lung injury score and leukocyte counts, percentage of PMNL, and concentrations of albumin and IL-8 in BALF. Foy(R) attenuated all these changes except the decreased peripheral blood leukocyte count. CONCLUSIONS: These findings suggest that Foy(R) attenuates endotoxin-induced acute lung injury in rabbit by inhibiting neutrophil, IL-8 and platelet responses which may play a central role in sepsis related lung injury.

The Antinociceptive Effect of Intrathecal Anticholinesterase on the Formalin Test in Rats / 대한마취과학회지

BACKGROUND: Spinal anticholinesterase has been shown to have an antinociceptive action to acute noxious stimuli. The purpose of this study was to determine the effect of intrathecal anticholinesterase on the facilitated state developed after tissue injury evoked by formalin injection. METHODS: Rats were implanted with lumbar intrathecal catheters. For nociceptive test, 50 microliter of 5% formalin solution was injected into the hindpaw. The effect of pretreatment with intrathecal neostigmine, physostigmine and edrophonium, administered 10 min before formalin injection, was observed for 60 min. For the evaluation of the effect of posttreatment with intrathecal anticholinesterase, administered 9 min after formalin injection, the response was observed for 50 min. RESULTS: Formalin injection into the paw resulted in a biphasic incidence of flinching of the injected paw. Intrathecal pretreatment with neostigmine, physostigmine and edrophonium produced a dose- dependent suppression of the flinching during phase 1 and phase 2 on the formalin test. Posttreatment with three intrathecal anticholinesterases reduced the phase 2 flinching response. CONCLUSIONS: Both pretreatment and posttreatment with intrathecal anticholinesterase produced an antinociception on the formalin test. These results point out the usefulness of anticholinesterase to acute nociception and facilitated state.

Comparison of Propofol and Midazolam for Sedation of Mechanically Ventilated Patients / 대한마취과학회지

BACKGROUND: Mechanical ventilation is frequently used in the intensive care unit. Sedation is usually required to tolerate the presence of a tracheal tube and other unpleasant stimulus during mechanical ventilation. The ideal regimen for sedation has not yet been determined. This study was designed to compare the characteristics of safety and effectiveness of propofol to those of midazolam for sedation in patients undergoing mechanical ventilation in surgical intensive care unit. METHODS: 44 mechanically ventilated patients were randomized to receive either propofol (loading dose 20~40 mg, followed by 10~50 microgram/kg/min) or midazolam (loading dose 1~2 mg, followed by 0.2~0.8 microgram/kg/min). Infusion rates were titrated to 3~5 points of Ramsay scale. All patients also received morphine 0.5 microgram/kg/24 h without any muscle relaxants. Hemo-dynamic changes (SBP, DBP, HR), ventilatory parameters and recovery time were evaluated. Hepatic and renal functions were measured before start of infusion and after discontinuation of both drugs. RESULTS: The mean initial loading and maintenance dose were 0.35 mg/kg and 1.5 mg/kg/hr for the propofol, 29.2 microgram/kg and 29.1 microgram/kg/h for midazolam group, respectively. There was no difference between the two groups regarding the sedation score evaluated by Ramsay scale. Patients receiving propofol recovered more rapidly than those receiving midazolam (40.5+/-20.1 min vs. 88.2+/-29.5 min respectively; P30% of pre-injection value) or hepatic or renal function changes. CONCLUSIONS: Propofol is a sedative agent with shorter awakening time than midazolam but with the same safety and clinical effectiveness for the continuous sedation of mechanically ventilated patients.

Comparison of Propofol and Midazolam for Sedation of Mechanically Ventilated Patients / 대한마취과학회지

BACKGROUND: Mechanical ventilation is frequently used in the intensive care unit. Sedation is usually required to tolerate the presence of a tracheal tube and other unpleasant stimulus during mechanical ventilation. The ideal regimen for sedation has not yet been determined. This study was designed to compare the characteristics of safety and effectiveness of propofol to those of midazolam for sedation in patients undergoing mechanical ventilation in surgical intensive care unit. METHODS: 44 mechanically ventilated patients were randomized to receive either propofol (loading dose 20~40 mg, followed by 10~50 microgram/kg/min) or midazolam (loading dose 1~2 mg, followed by 0.2~0.8 microgram/kg/min). Infusion rates were titrated to 3~5 points of Ramsay scale. All patients also received morphine 0.5 microgram/kg/24 h without any muscle relaxants. Hemo-dynamic changes (SBP, DBP, HR), ventilatory parameters and recovery time were evaluated. Hepatic and renal functions were measured before start of infusion and after discontinuation of both drugs. RESULTS: The mean initial loading and maintenance dose were 0.35 mg/kg and 1.5 mg/kg/hr for the propofol, 29.2 microgram/kg and 29.1 microgram/kg/h for midazolam group, respectively. There was no difference between the two groups regarding the sedation score evaluated by Ramsay scale. Patients receiving propofol recovered more rapidly than those receiving midazolam (40.5+/-20.1 min vs. 88.2+/-29.5 min respectively; P30% of pre-injection value) or hepatic or renal function changes. CONCLUSIONS: Propofol is a sedative agent with shorter awakening time than midazolam but with the same safety and clinical effectiveness for the continuous sedation of mechanically ventilated patients.

An experimental study on the dynamic teeth movement of 3 types of the insertion method of Precision-TPA for derotating the posterior teeth / 대한치과교정학회지

Dr. Youn-Sic Chun and coworkers invented the new machine for getting information about the relative effectiveness of the orthodontic appliances and we named it Calorific machine. The author and colleagues used this machine to compare with tooth moving mechanism by 3 types of the insertion method of precision-TPA for derotating the posterior teeth. We measured the distance of tooth movement and found out the rotational center on the occlusal X-ray film and the tooth movement on the occlusogram and then processed paired t-test by SAS program. The results were as follow : 1. In the intermolar width, the mesial insertion method showed the loss of distance, and the other methods(-distal insertion method, mesial expansion method-) showed the increase of distance. 2. In the arch length, the distal insertion method was exhibited as most recommandable way for increasing the arch length. 3. The rotation center of the mesial insertion method for derotating the molar, was located between mesial pit and central pit of the lower 2nd molar. and, in the distal insertion method, it was located between distal pit and distolingual cusp, and in the mesial expansion method was located at distal pit.

A Clinical Study on the Antihypertensive Effect of Arotinolol

Arotinolol, a new alpha and beta receptor antagonist, was administered in 27 essential hypertensive patients for 8 weeks in order to evaluate the antihypertensive effect and side effects. The dose were 10mg to 15mg given twice a day. The results are as follows : 1) Before medication, systolic and diastolic blood pressure in sitting, supine and erect position were 173.1+/-3.2/105.8+/-1.8, 171.1+/-3.6/86.7+/-2.0 and 169.3+/-2.6/97.2+/-2.1mmHg. 2) After 8 weeks treatment moderated to marked antihypertensive effect was observed in 74.0%(in systolic blood pressure) and 81.4%(in diastolic blood pressure) respectively in sitting position. 3) There was a significant reduction of pulse rate from 73.0+/-2.5 beats per minute on the beginning of the treatment to 63.4+/-5.2 beats per minute after 8 weeks of medication. 4) There was no significant change in hematocrit, WBC, serum lipid, GOT, GPT, BUN and creatinine. But fasting blood sugar was reduced from 95.3mg% to 81.5mg% with treatment. 5) The side effects of arotinolol were gastrointestinal symptoms(15%), fatigue(11%), dizziness(7%) and insomnia(3%). But these side effects were not severe enough to discontinue medication. In summary, arotinolol seemed to be an effective antihypertensive drug in treating mild to moderate hypertension without significant side effects.