The effects of differences in the rate and composition of intravenous fluid replacement for urine loss on the pharmacokinetics and pharmacodynamics of torasemide were evaluated using rabbits as the animal model. Each rabbit received 2-h constant intravenous infusion of 1 mg/kg ∼ 1 of torasemide with 0% replacement (treatment I, n = 6), 50% replacement (treatment II, n = 9), and 100% replacement with lactated Ringer's solution (treatment III, n = 8) as well as with 100% replacement with 5% dextrose in water(D-5-W, treatment IV, n=6). (omitted)
A simple HPLC-UV method was developed and validated for the quantification of human serum isepamicin using phenylisocyanate as a derivatization agent. The linear calibration curve was obtained in the concentration range of $1{\sim}100{\mu}g/ml$ and LLOQ of $1{\mu}g/ml$. This method was validated with selectivity, linearity, precision and accuracy, leading to successful application for estimating the pharmacokinetic parameters of isepamicin in Korean healthy subjects following IV infusion of 800 mg isepamicin. The mean $t_{1/2}$ of isepamicin was $1.55{\pm}0.08hr$.
Background: About 75% of terminal cancer patients have severe pain. For the treatment of these patients, physicians usually use potent opioid analgesics. But many of the cancer patients were not controlled by IV or IM injection of opioids. In spite of the untreatable nature of the patient's illness, they should be hospitalized only for pain control. In that case, epidural opioid injection is one of the most effective methods in pain management. Methods: We retrospectively analyzed 126 terminal cancer patients who were treated with epidural morphine for pain management from 1993-97. In the routine procedure, an epidural catheter was inserted into the epidural space and tunnelled subcutaneously, exiting out from the anterior chest or abdomen. Morphine was used as the main analgesic and Multiday Infusor$^{(R)}$ (Baxter, 0.5 ml/h) as a continuous infusion system. Results: 1. Mean treatment time was 55 days (range; 3~373). 2. Mean daily epidural start mg dose of morphine was 8 mg (range; 2~20). 3. Mean daily dose at termination was 19 mg (range; 4~60) 4. 94 patients were controlled with continuous infusion but 32 patients needed additional bolus doses of morphine. 5. heter-associated subcutaneous infection occurred in 2 patients (1.6%). Conclusion: Terminal cancer pain management administered by a tunnelled epidural catheter is a simple, inexpensive method with a very small rate of infection.
Introduction: In this case report, we addressed the effects of a Korean medicine treatment on recurrent pyelonephritis in a female patient with a duplicated collecting system. Case report: A 22-year-old female with acute pyelonephritis was treated with Korean medicine, including herbal medication, Insampaedok-san plus Oryeong-san, and with antibiotic therapy. We evaluated the improvements in her symptoms by measuring C-reactive protein, WBC count, body temperature, and a numeric rating scale for nausea. The symptoms of fever and nausea improved after two days of hospitalization. From the 4th day of taking the herbal medicine, the antibiotic IV infusion was changed to oral agents. Conclusions: This clinical case study suggests that modified Insampaedok-san might have shortened the duration of intravenous antibiotic infusion and hospitalization for recurrent pyelonephritis in a female patient with a bifid ureter.
Kim, Kyung-Hwan;Moon, In-Sung;Park, Jang-Sang;Koh, Yong-Bok;Ahn, Hyuk
Journal of Chest Surgery
/
v.35
no.4
/
pp.267-273
/
2002
Background: We performed a phase IV clinical trial to examine the usefulness of a continuous infusion of nicardipine hydrochloride to control hypertension in patients with acute aortic dissection. material and Method: Systolic/diastolic blood pressure, and heart rate were monitored before and after the intravenous administration of nicardipine in 31 patients with aortic diseases. The period of nicardipine administration in each patient was from 3 to 14 days. Efficacy was evaluated by determining the average amount of blood pressure reduction on the 3rd day of drug administration. The dosage of another antihypertensive agent was slowly tapered down, and ultimately replaced by the test drug. Result: 28 patients were diagnosed as acute aortic dissection, 2 patients as rupture of the aortic arch aneurysm, and 1 patient as traumatic aortic rupture. Mean age was 53.9 $\pm$ 14.9(29~89) years, and 21 patients(67.7%) were male. 14 patients(32.3%) had complications associated with underlying aortic disease: aortic insufficiency in 7, hemopericardium in 6, acute renal failure in 1, paraplegia in 1, lower extremity ischemia in 1, and hemothorax in 1. The time needed to reach the target blood pressure was within 15 minutes in 16, from 15 to 30 minutes in 10, from 30 to 45 minutes in 3 and from 45 to 60 minutes in 2, and their baseline average systolic, diastolic, and mean arterial blood pressures(mmHg) were 147$\pm$23, 82.3$\pm$ 18.6, and 104 $\pm$ 18, respectively. Average systolic, diastolic, and mean arterial blood pressures(mmHg) on the third day of nicardipine infusion were 119$\pm$ 12, 69$\pm$9, and 86$\pm$8, and they all showed statistically significant decrease(p<0.05). The average systolic, diastolic, and mean arterial blood pressure(mmHg) after the discontinuation of the nicardipine infusion were 119 $\pm$ 15, 71 $\pm$ 14, and 86$\pm$ 13, respectively. No significant difference was observed between the average pressures measured on the third day and those measured after the discontinuation of the nicardipine infusion, and no definite side effects were observed during the study period. Conclusion: Nicardipine hydrochloride was both effective and safe at controlling blood pressure in patients with acute aortic dissection.
The combinations of alfaxalone and remifentanil constant rate infusion in dogs premedicated with xylazine or acepromazine were compared. Ten beagle dogs were used and assigned randomly into 2 groups (5 dogs for each group). In group AAR, dogs were premedicated with 0.02 mg/kg of intravenous acepromazine at 15 min before induction. In group XAR, 1.1 mg/kg of intravenous xylazine was premedicated at 5 min before induction. In both groups, anesthesia was induced with alfaxalone and maintained with the combination of alfaxalone (6 mg/kg/hr, IV) and remifentanil (0.05 ${\mu}g/kg/min$, IV). bispectral index score was decreased after induction of anesthesia compared with baseline in both groups and no steep increase was observed during anesthesia. Bispectral index scores and electromyographs in group XAR were significant decreased compared with those in group AAR. Although the pulmonary depression in group XAR and tachycardia in group AAR should be considered to use these regimes, the combinations of alfaxalone and remifentanil constant rate infusion in dogs premedicated with xylazine or acepromazine provided adequate analgesia and anesthesia in this study.
Effects of atrial natriuretic peptide (ANP) on the development of hypertension in 2-kidney, 1-clip (2-K, 1-C) rats were examined. In one group of rats, ANP infusion (500 ng/hr, iv) started immediately after clipping the renal artery. Another group of rats with one kidney-clipped was without ANP infusion and served as a control. Blood pressure was measured on days 4, 7, and 10 following clipping the renal artery. Upon the last blood pressure measurement finished, blood sample was collected by decapitation to measure plasma renin activity (PRA), and both kidneys were taken to weigh and to measure renin content. The ANP-infused group showed an attenuation of increases in blood pressure compared to the non-infused control group. PRA was lower in the ANP-infused group than in the non-infused group. Cortical renal renin content (RRC) of the clipped kidneys was not different between ANP-infused and non-infused groups. The clipped kidneys showed a higher RRC and weighed less than the non-clipped contralateral kidneys within each group. In contrast, sham-clipped rats did not show significant changes in any of the parameters examined regardless of whether ANP was infused or not. These results demonstrate that chronic ANP infusion does not prevent but does attenuate the development of hypertension in 2-K, 1-C rats. It is suggested that ANP plays a role in the long-term regulation of blood pressure, at least in part, by antagonizing the renin-angiotensin-system.
The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).
The effect of prostacyclin[PGI, ] on myocardial preservation during global ischemia was studied in the isolating working rabbit heart model. Forty hearts underwent a 15 minute period of retrograde nonworking perfusion with Krebs-Henseleit buffer solution [37*C] and were switched over to the working mode for 15 minutes. After baseline measurement of heart rate, peak aortic pressure, aortic flow, and coronary flow, all hearts were subjected to 60 minutes of ischemic arrest at 10*C induced with St. Thomas Hospital cardioplegic solution: Group I had single dose cardioplegia, Croup II double dose, Croup III oxygenated double dose, and Group IV single dose with PCI, infusion [10ng/min./gm heart weight]. Hearts were then revived with 15 minute period of nonworking reperfusion at normothermia, followed by 30 minutes of working perfusion. Repeat measurements of cardiac function were obtained and expressed as a percent of the preischemic baseline values. Oxygen content of arterial perfusate and coronary effluent was measured by designed time interval. Leakage of creatine kinase was determined during post-ischemic reperfusion period. Finally wet hearts were weighed and placed in 120*C oven for 36 hours for measurement of dry weight. In the PGI, treated group [IV], heart rate increased consistently throughout the period of reperfusion from 100*5.0% [p<0.001] to 107*6.2% [p<0.001]. The percent recovery of aortic flow showed 95*5.7% [p<0.001] at the first 3 minute and full recovery through the subsequent time. Coronary flow was augmented significantly in the 3 minute [96*6.2%, p<0.001] and then sustained above baseline values. Among the Croup I, II, and III, all hemodynamic values were significantly below preischemic levels. PGI2 relatively increased oxygen delivery [1.22*0.19ml/min, p<0.001] and myocardial oxygen consumption [0.90*0.13ml/min, p<0.001] during reperfusion period. Leakage of creatine kinase in the PGI2 group was 9.3*1.58IU/15min [p<0.001]. This was significantly lower than Group I [33.0*2.68 IU/15min]. The water content of PCI2 treated hearts [81*0.9%, p<0.001] was also lower than the other groups.
Objective: To investigate the efficacy and safety of voriconazole in treating Chinese patients with hematological malignancies and invasive aspergillosis. Methods: From March 2007 to April 2012, patients with diagnoses confirmed by CT, GM test and/or PCR assays, were recruited into this study. Aspergillosis of all patients were treated with voriconazole 6 mg/kg intravenous infusion (iv) every 12 h for 1 day, followed by 4 mg/kg IV every 12 h for 10-15 days; Then, switch to oral administration that was 200mg every 12h for 4-12 weeks. Efficacy and safety were evaluated according to Practice Guideline of Infectious Diseases Society of America. Results: The overall response rate of 38 patients after voriconazole treatment was 81.6%. The median time to pyretolysis was 4.5 days. Treatment related side effects were mild and found in only 15.8% of cases. No treatment related deaths occurred. Conclusions: Voriconazole can considered to be a safe and effective front-line therapy to treat patients with hematological malignancies and invasive aspergillosis. Alternatively it could be used as a remedial treatment when other antifungal therapies are ineffective.
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