• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.294-297
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• 2010

Although $Taxo^{(R)}$ is one of the most successful drugs in current cancer chemotherapy against solid tumors, a major problem is hypersensitivity reactions that arises as a consequence of activation of the complement (C) system, "C activation-related pseudo-allergy". Most severe hypersenstivity reactions occur within the first few minutes of $Taxo^{(R)}$ administration, usually after the first or second dose. Here we report a case of a severe hypersensitivity reaction in a 72-year-old man undergoing $Genexol-PM^{(R)}$ infusion. Hypotension and polymorphic pruritic skin rash appeared 2 hours after the start of $Genexol-PM^{(R)}$ infusion (with an appropriate premedication). Treating with methylprednisolone, epinephrine and inotropic agents, reduced the hypotension and the skin rash disappeared. We report this case with a review of the literature.

• Biomolecules & Therapeutics
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• v.3 no.2
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• pp.143-148
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• 1995

Recently, we reported that GS 389 has vasodilating action without cardiac inotropic action (Chang et al., Can. J. Physiol. Pharmacol. 72, 327-334, 1994). However the mechanism of action of GS 389 has not been thoroughly evaluated. In the present study, we performed functional study of GS 389 in rat trachealis, thoracic aorta, pig coronary artery by isometric tension and in human platelets by aggregation experiments. We also tested if GS 389 influences on $Ca^{2+}$movement and inositol phosphate metabolism. In rat trachealis, GS 389 concentration-dependently relaxed carbachol (0.1 $\mu$M)- and high $K^{+}$(65.4 mM)-induced contraction with p$IC_{50}$/ of 4.43$\pm$ 0.19 and 4.11$\pm$0.12, respectively. In $Ca^{2+}$-free media, GS 389 inhibited carbachol-induced phasic contraction. In rat thoracic aorta, GS 389 inhibited $^{45}$ Ca uptake due to norepinephrine and high $K^{+}$, indicating that GS 389 has direct inhibitory action of $Ca^{2+}$movement. Furthermore, GS 389 competitively inhibited U46619-induced contraction in rat thoracic aorta and pig coronary artery with K, values of 5.23$\pm$0.12 and 5.56$\pm$0.14, respectively, and inhibited U 46619-induced phosphatidylinositide (PI) turnover in rat aorta. GS 389 also concentration-dependently inhibited the human platelet aggregation against U 46619 with p$IC_{50}$/ 5.66$\pm$0.02. These results indicate that GS 389 has thromboxane $A_2$ antagonistic action in vascular and platelets as well as direct action on $Ca^{2+}$ movement, which may account, at least in part, for relaxing action of rat trachealis. trachealis.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.85-88
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• 2011

Purpose: Takotsubo cardiomyopathy is a relatively uncommon type of stress-induced cardiomyopathy characterized by transient left ventricular regional wall motion abnormalities. Emotional and physical stresses play a key role in this type of cardiomyopathy in postmenopausal women. The current hypothesis is that the syndrome represents a form of catecholamine surge due to stress or epinephrine-mediated acute myocardial stunning. Methods: A 44-year-old woman had suffered premature ventricular contraction following a cardiogenic shock during a breast augmentation surgery under enflurane anesthesia and tumescent solution infiltration. She was treated with cardiopulmonary resuscitation at a local clinic. Then she was brought to the Emergency Department of the authors' hospital. Results: The woman's echocardiogram showed an ejection fraction of 20~25% with associated basal hyperkinesis and left ventricular apical ballooning. The patient was admitted to the ICU and required inotropic support for two weeks. The patient's condition dramatically improved, and her ejection fraction returned to 70%. Conclusion: It is believed that there were multiple triggering factors of the onset of Takotsubo cardiomyopathy in the woman's social and family history, including infiltration of a large volume of the tumescent solution and VPCs induced by enflurane anesthesia without premedication. The importance of careful history-taking, careful pre-operative consultation on psychological suffering especially for breast surgery, premedication before surgery, patient reassurance, and post-operative psychosocial and emotional assistance was again seen in this case.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.69-72
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• 2006

Dicamba is a benzoic acid and classified as a chemically related chlorophenoxy herbicide which is widely used for the control of broad-leaved weeds. While the chlorophenoxy herbicide poisoning is known to be uncommon, its ingestion can result in serious or sometimes fatal outcome. A 65-year-old man ingested about 300 ml of dicamba in a suicidal attempt and three hours later he was admitted hospital, complaining abdominal pain, nausea and vomiting. On admission his vital signs were normal and laboratory findings were not remarkable except metabolic acidosis in arterial blood gas analysis. Shortly after the admission endotracheal tube was inserted due to altered mental state and activated charcoal was given after performing gastric lavage. However, his vital signs became unstable 6hrs after the ingestion and mechanical ventilation was started with administration of inotropic agents. In spite of urine alkalization for rapid elimination of the absorbed dicamba, the metabolic acidosis was aggravated with concomitant rhabdomyolysis and acute renal failure, and he died 24 hrs after the ingestion.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.2
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• pp.460-466
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• 2006

We wondered whether the mechanisms of antiplatelet aggregation of DJS-WE were through multiple pathways. Danggijakyak-san(DJS) consisting of 6 herbes of Paeoniae Radix, Poria Cocos, Angelicae Sinensis Radix, Cnidii Rhizoma, Atractylodis Macrocephalae Rhizoma and Alismatis Rhizoma, is a crude mixture of a commonly used Korean herbal medicine. The water extract (DJS-WE) of DJS has been known to have an anti-platelet aggregation activity. We have reported that DJS-WE inhibited ADP-induced aggregation as well as arachidonic acid-induced aggregation of human platelet. Clinical studies on the cardiovascular effects of DJS-WE have been done in Korea. The DJS has been used as a remedy for gastrointestinal disorders (abdominal pain, dysentery), headache, amenorrhea, and postpartum hemorrhage. It has also been claimed to have a remarkable central stimulant effect, a transient hypertensive effect, and positive inotropic and chronotropic effects. In this paper, we evaluated the possible mechanisms of the antiplatelet activity of DJS-WE using human platelets. On the other hand, the role of DJS-ethanol extract on the inhibition of platelet aggregation and hemolytic effect have not yet been investigated in detail. We also used the method of activated partial thromboplastin times (APTT) for the first time to study the inhibition on platelet aggregation activity of DJS-ethanol extract. The effect of DJS-WE on hemolysis was also investigated. DJS-WE showed a high hemolysis ability on human blood.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.203-206
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• 2012

Treatment for heart failure is directed to reduce atrial volume overload by diuretic agents, to lessen ventricular pressure overload by vasodilatory agents and to increase myocardial performance through inotropic agents. Of those cardiac therapeutics, diuretic agents are the most important to control heart failure in dogs, although long-term use often causes detrimental side-effects such as acute renal failure and electrolyte abnormalities. Thus, this study was designed to find a new diuretic agent from medicinal herbs which has better diuretic effect and less unfavorable complications in dogs. In a preliminary study performed with 5 normal healthy dogs, the extract from Akebia quinata Decaisne showed mild to moderate diuretic effect (0.3-0.5 potency of furosemide 2 mg/kg) and minimal changes in serum chemistry and electrolyte. Although the study population was not large enough and study period was not sufficient enough, this study found a good alternative diuretic agent which can replace or reduce the use of furosemide in dogs with heart failure.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1209-1217
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• 1992

Triiodothyronine[T3] is an important regulator of the tissue metabolism, and may have potential use as an inotropic agent. The change of serum T3 level was studied in the pediatric age patients after cardiopulmonary by pass. Thyroid function was tested pre-operatively in 33 patients and total triiodothyronine[TT3] levels were serially measured during and after cardiopulmonary bypass[CPB]. After correction of dilutional effect, effects of various factors on the TT3 levels were analyzed. Abrupt fall of TT3 level was demonstrated at 15 minutes after CPB[80.1$\pm$5.9ng/dL] from the initial level of 133.6$\pm$5.3ng/dL, with some recovery at 6 hours[115.4$\pm$6.7ng/dL]. After then, gradual decrease occured reaching to the level of 77.2$\pm$4.2ng /dL at 24 hours. These falls of the TT3 after CPB were statistically significant. [p<0.01 ANOVA] Statistically significant correlation were found between the degree of hemodilution and TT3 concentration at 15 and 30 minutes after CPB[p<0.05]. But, other factors were analyzed to have no effect on TT3 levels. As the degree of the hemodilution increases, TT3 decreased less. This observation probably supports the fact that decrease of TT3 during CPB may be a result of sequestration of T3 into peripheral tissue. Although it was not statistically significant[p=0.08], the fall of TT3 was greater in the group to which plasmanate was added, than those not added. This finding seemed to be due to the increase of albumin and other thyroid-hormone-binding-proteins in the serum. Increase of these binding proteins might potentiate the sequestration of T3 into the liver and the kidney from serum, and as a consequence, decrese the serum TT3 level further.

• Korean Journal of Clinical Pharmacy
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• v.30 no.3
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• pp.161-168
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• 2020

Background: Recently, a study comprising adult patients with sepsis admitted in the intensive care unit (ICU) was conducted. The patients were treated with high doses of intravenous ascorbic acid, thiamine, and hydrocortisone; the clinical outcomes demonstrated significant therapeutic benefits. The mortality rate in children with sepsis is approximately 25%. However, the effects of additional treatment with ascorbic acid and thiamine ("vitamin protocol") in children are rarely investigated. Methods: A retrospective analysis was performed using medical records of patients diagnosed with sepsis and admitted to the pediatric ICU (PICU) between September 2016 and June 2019. The control group received treatment only as per sepsis protocol, whereas the treated group received both sepsis protocol and the vitamin protocol. The primary endpoint was change in Vasoactive-Inotropic Score (VIS) for 5 days. The secondary endpoints included the length of stay in the PICU, duration of using mechanical ventilators and vasopressors, and mortality rate. Results: The number of patients in the treated and control groups was 33 and 24, respectively. The treated group showed greater decrease in their VIS for 5 days than the control group (44.4 vs 18.6); however, the difference was not statistically significant. The length of stay in the PICU was significantly longer for the treated group than for the control group [10.0 days (Interquartile range (IQR), 6-18) vs 4.5 days (IQR, 4-10.3); p=0.004]. Conclusions: No significant treatment benefits were observed following vitamin protocol administration to the pediatric patients with sepsis. Further studies are necessary for improving the efficacy and safety of the vitamin protocol.

• Clinical and Experimental Pediatrics
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• v.63 no.5
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• pp.184-188
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• 2020

Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

• Korean Journal of Pharmacognosy
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• v.13 no.4
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• pp.137-144
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• 1982

It was previously reported from our laboratory that the rate of deterioration of the force of contraction was slower in heart from Panax ginseng extract treated rats. The study carried out to elucidate its mechanism of the action on hearts. The cyclic AMP content in the rat hearts was measured by the method of radioimmunoassay techniques. Panax ginseng extract (100mg/kg/day) was administered orally to male Sprague-Dawley rats weighing 150g to 250g for 1 week and after 24 hrs the hearts were isolated and the cyclic AMP content in the fresh heart was assayed. The difference in cyclic AMP content between the rats treated with Panax ginseng extracts and normal rats was not significant. Panax ginseng extract(l00mg/kg/day) was administered orally to the rats for I week and after 24 hrs the hearts were isolated and perfused with Krebs-Henseleit buffer (pH7.4) for 90min. The cyclic AMP content in the both treated and normal rats was not also significantly different. On the other hand, when total ginseng saponin (50mg/kg/day) was administered orally to rats for 1 week and after 24 hrs, the isolated hearts were perfused with Krebs Henseleit solution for 32min, the cyclic AMP content in total ginseng soponin treated hearts was decreased by 18.7% compared to normal rats. It was also observed that when isolated hearts were perfused with total ginseng saponin $(10^{-4}g/ml)$ for 12 min after 30 min equilibration period, the cyclic AMP content in total ginseng saponin treated hearts was decreased by 23.7% compared to normal rats. Isolated hearts were perfused with ginseng saponins $(10^{-4}g/ml)$ or with Krebs-Henseleit solution alone for 10min and subsequently with dl-isoproterenol $(1/2{\times}10^{-6}M)$ until the positive inotropic effect of isoproterenol was initiated. The cyclic AMP content in each rat hearts treated with total ginseng saponin, or with ginsenoside $Rb_1$, or with Krebs-Henseleit solution alone were increased by 35.5%, 42.4%, 47.5%, respectively, compared to normal rats.