Earticle

Purpose: 본 연구는 토끼의 음경해면체 조직에 대한 인진쑥의 에탄올 추출물과 그 성분 중의 하나인 scoparone의 효능을 평가하고자 하였다. Methods: 체중이 2.5-3.0 Kg의 New Zealand백색 가토를 사용하여 음경 전체를 골반골로부터 분리하여 요도를 제거 한 후 백막을 보유한 음경해면체를 2 mL organ chamber 관류모형에 연결하고, 10-5 M의 phenylephrine을 관류하여 음경해면체를 수축시킨 후 0.1, 0.5, 1, 2 mg/mL의 에탄올 추출물 또는 10-7, 10-6, 10-5, 10-4 M의 scoparone을 녹 인 용액으로 관류시켜 음경의 장력 변화를 측정하였다. 기존의 발기부전 치료제로 사용되는 실데나필에 대한 인진쑥과 의 상호작용을 검토하기 위하여10-6 M의 scoparone과 10-8 M의 실데나필을 병용 사용 시 음경해면체 조직에 대한 효 과도 함께 검토하였다. Results: 인진쑥의 에탄올 추출물은 phenylephrine으로 전처리하여 수축시킨 음경해면체 평활근을 농도 의존적으로 효 과적으로 이완시켰으며 scoparone도 음경해면체 조직에 대한 이완작용 또한 농도 의존적으로 강한 효과를 나타내었다. 실데나필로 전처리한 음경해면체 조직에 대한 scoparone의 효과는 scoparone만을 단독으로 관류시킨 조직에서의 효과 보다 강하게 나타났으며 실데나필과 scoparone의 병용사용은 실데나필의 효능을 2배 이상 증가시켰다. Conclusions: Scoparone은 실데나필의 음경해면체평활근 작용을 증가시킴으로써 실데나필에 완전히 반응하지 않는 환 자들의 발기부전 치료효과 향상에 유용할 것으로 전망된다.

Bolus intravenous injection of adenosine resulted the temporal decrease of systemic blood pressure and heart rate in the anesthetized rats. Adenosine also resulted the persistent decrease of contractility and heart rate in the isolated spontaneously beating rat right atria. Both of the above inhibition effets of adenosine were increased by the pretreatment of NBI (nitrobenzylthioinosine), whitch is an adenosine transport inhibitor, but decreased by the pretreatment of 8- phenyltheophy1line, which is an adenosine antagonist. In isolated thoracic aorta ring segment of normotensive rats, intact rings were relaxed by adenosine (42.3±8.7%) and ATP (85.9±15.8%) in the concentration of 10-4 M, but rubbed rings were relaxed by adenosine (35.2±1.9%) and ATP (11.3±9.0%) in 10-4 M. After pretreatment of L-NAME (N-Nitro-Larginine methyl ester), which is an NO inhibitor, adenosine-induced relaxation was not affected, but ATP-induced relaxation was significantly inhibited (P<0.01). Meanwhile, adenosine resulted almost same as vasorelaxation in isolated thoracic aorta of SHR comparing to those of normotensive rats. But, vasodilation responses of ATP in intact rings of SHR are significantly inhibited comparing to those of normotensive rats. Adenosine-induced relaxation is attenuated after 8- phenyltheophylline pretreatment, but increased after NBI pretreatment. However, ATP-induced relaxations are not affected by 8-phenyltheophylline or NBI pretreatment. These results suggested that the hypotensive effects of adenosine was due to the decrease of contractile force and heart rate through the A1 receptor and vasodilation are mediated by A2 receptor of the vascular smooth muscle. And, the heart protective and vasodilation effects of adenosine might suggest that it would be useful in the acute treatment of coronary artery disease.

Drug Utilization Review (DUR) is known to play an important role to improve appropriateness of drug prescriptions. This retrospective, observational study was to compare prescription patterns after installation of Computerized DUR Program (Drug Information Framework-Korea™) (Jan-Mar 2008; After) to before DUR program (Jan-Mar 2007: Before). 8 physicians affiliated in the S University Hospital were enrolled in the study and their 3 months' prescription data were analysed for drug prescription trends and DUR conflict events per 7 DUR screening modules (drug-drug interaction, therapeutic duplication, allergy, dosing, disease contra-indication, geriatric contra-indication, pediatric contraindication). Average rate of DUR modules usage in 2008 (After) were 0.72. Average number of prescription drug per patient were reduced from 5.6 (Before) to 3.8 (After), and DUR program seemed to effect positively on physician's prescription related decision process. Overall DUR conflict events occurred by 8 physicians for 3 months were 17,923 Before and 20,057 After DUR program, and DUR conflict events per prescription were 2.8 Before and 2.9 After, respectively. Therapeutic duplication (37%), geriatric contra-indication (34%) and dosing (18%) were high ranked DUR conflicts. As the study was not sufficient to show a consistent trend to reduce DUR conflicts After, another study to confirm it's effectiveness would be recommended. This study would be of help to develop awareness of DUR program to healthcare providers.

Purpose: This study aims to investigate how gender-based differences are actually reflected on drug approval. Methods: Data on gender-based differences of drugs were analyzed by searching PDR (Physician’s Desk Reference) with the keyword, “GENDER”. Results: There were descriptions related to gender in product directions of 361 drugs in 2009 PDR, out of which 63 items actually showed gender-related differences. Drug categories showing comparatively high gender-based differences were nervous system, cardiovascular system, and alimentary tract and metabolism. Pharmacokinetic differences between genders were observed most frequently; compared to men, 32 drugs showed higher absorption while 18 drugs revealed lower clearance in women. There were 2 drugs which gender should be considered before prescribing, and 5 drugs which showed different severity of adverse effects according to gender. Conclusions: It is necessary to establish domestic policies for drug approval and use which reflects gender-based differences through sufficient researches.

The objective of this study was to find out drug use pattern of narcotic analgesics in university hospitals in Korea. A university hospital located in Kyungbuk province was chosen for this study. The drug use pattern was analyzed in terms of ingredient, administration route, patient type, and attending department. Amount of drug usage was counted by unit dose defined by the number of ampule or vial for injectable, tablet or capsule for oral, and each for patch preparations. Result showed that 11 narcotic analgesic ingredients were used during 2007-2009, and the drug usage was increased by about 20% annually during the period. Proportion of oral preparations used for pain management was about two third of all narcotic analgesics usage and kept increasing during the period. Proportion of the drug usage for outpatients was also steadily increased. Notably, the usage of oral preparations of oxycodone, morphine, and hydromorphone was rapidly increased for the management of cancer pain while the usage of codeine and codeine-containing composite preparations for cancer pain were minimal (<10%). About 90% of all narcotic analgesics were used by physicians in Internal Department, especially in Oncology Division of the Department. These findings suggest that pain management is becoming more aggressive and in agreement with WHO's guidelines regarding selection of administration route. However, in terms of 3-step ladder for cancer pain management, the drug use pattern was not congruent to WHO's guidelines. Therefore, in conclusion, it appears that physicians need to try to be congruent to the guidelines when using narcotic analgesics for cancer pain.

Idiopathic thrombocytopenic purpura is a potentially life-threatening condition characterised by thrombocytopenia and mediated by an autoimmune mechanism. Several recent studies have suggested that an association exists between H. pylori eradication and improvement in platelet count in a significant proportion of patients with idiopathic thrombocytopenic purpura. This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in steroid refractory idiopathic thrombocytopenic purpura patients. Eradication therapy is simple and inexpensive, with limited toxicity and the advantage of avoiding long-term immunosuppressive treatment.

We report an unusual case of respiratory depression and prolonged apnea after the second dose of 100-mg intravenous tramadol. Due to continuous pain at foley catheter keep site, intravenous tramadol was administered to the patient. Soon after the second dose of tramadol injection, the patient became apneic. The patient did not respond to verbal command and started exhibiting oxygen desaturation. The patient was quickly treated with 100% oxygen, and it took 4 hours for the spontaneous respiration to return to regular. This case report demonstrates that even two doses of tramadol administered intravenously may manifest as sudden and prolonged apnea. Respiratory depression with tramadol has been reported in patients with impaired renal functions and Cytochrome P(CYP) 2D6 gene duplication