Clinical effect of Alesion (epinastine HCl) on mild to moderate persistent bronchial asthma / 천식및알레르기

BACKGROUND: Alesion, which is known as one of the second generation anti-histamine agents, has diverse anti-allergic effects. Some investigators have reported the clinical effects of Alesion as acting like an addictive agents to inhaled steroid in mild to moderate persistent bronchial asthma. METHODS: We evaluated the additive effects of daily administration of 20 mg of Alesion (epinastine HCl) in 30 mild to moderate persistent bronchial asthma patients. We estimated the clinical effects of Alesion with symptom scores, morning PEFR without bronchodilator, sputum eosinophil counts of induced sputum, spirometer parameters and frequency of short acting 2 agonist inhalation. RESULTS: With administration of Alesion for 4 weeks, the score of dyspnea, cough, nocturnal symptoms and limitation of daily activity were significantly improved. The mean value of morning PEFR without bronchodilator was also significantly improved by administration of Alesion. These improvements appeared after 1 week of administration. But, the frequencies of short acting 2 agonist inhalation, FEV1, FVC, peripheral blood eosinophil count, eosinophil percentage of induced sputum were not changed by the Alesion. About 64% of the enrolled patients expressed the clinical effects of Alesion. The patients complained of headache (1 case), drowsiness or sleepiness (3 cases), and weight gain (1 case) as adverse effects of Alesion. CONCLUSIONS: We suggest that Alesion can be effective as an the additive agent in mild to moderate persistent degree of bronchial asthma.

Delayed or Enlarged Lesions in Head Injury: An Analysis of Risk Factors

Delayed or enlarged lesions in head injury are potentially preventable events which worsen overall prognosis. We investigated the incidence and risk factors of these lesions in 240 head injured patients examined by repeated computerized tomographic(CT) scans from January 1989 to December 1990. Overall, delayed or enlarged lesions were found in 95 patients(39.6%) Intracerebral hemorrhage was the most common lesion(37 cases):Subdural(17 cases), epildural hematoma(16 cases), subdural hygroma(15 cases), cerebral swelling(6 cases), hydrocephalus(4 cases), and infarction(2 cases) followed in that order. These lesions occurred 3 days of initial scan in 64 patients(67.4%). Predictors were a low Glasgow Coma Scale score, abnormal papillary response, low or high blood pressure, hypoxia and previous infusion of large amounts of mannitol. Acute subdural hematoma was the most common initial lesion, heralding delayed or enlarged lesions in 50% of cases. Intracerebral hemtomas or contusion followed by next most common lesions. Incidence of delayed or enlarged lesions also differed according to therapy:decompressive craniectomy with these lesions in 82.8%. Mortality rate in patient who had delayed or enlarged lesions(35.5%) was 5.6 times higher than patient who did not have such lesions(6.3%). Delayed or enlarged lesions are relatively common. Patients with risk factors for delayed or enlarged lesions should be adequately monitored before overt clinical deterioration.