PURPOSE: This study investigated the impact of subclinical borderline changes on the development of chronic allograft injury in patients using a modern immunosuppression protocol. METHODS: Seventy patients with stable renal allograft function and who underwent protocol biopsies at implantation, 10 days and 1 year after transplantation were included and classified based on biopsy findings at day 10. The no rejection (NR) group included 33 patients with no acute rejection. The treatment (Tx) group included 21 patients with borderline changes following steroid pulse therapy, and the nontreatment (NTx) group included 16 patients with borderline changes nontreated. RESULTS: The Banff Chronicity Score (BChS) and modified BChS (MBChS) were not different among the three groups at implantation (P = 0.48) or on day 10 (P = 0.96). Surprisingly, the NTx group had more prominent chronic scores at the 1-year biopsy, including BChS (3.07 +/- 1.33, P = 0.005) and MBChS (3.14 +/- 1.41, P = 0.008) than those in the Tx and NR group, and deterioration of BChS was more noticeable in the NTx group (P = 0.037), although renal function was stable (P = 0.66). No difference in chronic injury scores was observed between the Tx and NR groups at the 1-year biopsy. CONCLUSION: Subclinical borderline changes can be a risk factor for chronic allograft injury and should be considered for antirejection therapy.
Biopsy ; Cyclohexylamines ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Risk Factors ; Transplantation, Homologous ; Transplants

In the late 1950, Greifenstein and associates have studied the properties of phenylcyelohexylamine derivatives and reported that these chemicals produced amnesia, analgesia, catatonia and catalepsy. Phencyclidine was the first of these drugs used in clinical anesthesia, but convulsive movement as well as excitatory behavior discouraged the use of the agent in human beings. Continued research for a more suitable derivative of phencyclidine with similar analgesic action, but shorter duratoin and lesser psychotomimetic action led McCarthy and Chen to investigate the pharmacologic properties of a large series of compounds. One of these, 2-ochlorophenylcyclohexylamine, was shown to have some advantages. Ketamine hydrochloride, chemically related to both phencyclidine and cyclohexylamine, proved to be more satisfactory for clinical anesthesia. Clinical investigations were begun in 1965 by Dominos group who first termed it dissociative anesthesia. As noted by Pender, the clinical signs of anesthesia with ketamine are completely different from those seen with conventional intravenous agents and gaseous compounds. Ketamine acts rapidly on intravenous or intramuscular administration to produce a state chracterized by catalepsy, analgesia and amnesia. It is devoid of sedation, hypnotic or convulsive properties. Normal pharyngeal-laryngeal reflexes are maintained and skeletal tone remains normal or increased. Since the introduction of ketamine by Domino's group, numerous reports have appeared to explain various aspects of the cardiovascular response(increased cardiac output, hypertention, little or no change in peripheral resistance) and respiratory response. However there are few reports on the effect of ketamine on intestinal motility. Thus we have made a study to observe the effect of ketamine on the intestinal motility of chickens. Strips of isolated muscle, 1 cm long, from adult fowl weighing l.2-1.5 kg and isolated smooth muscle of a patient with stomach cancer, were suspended in a muscle chamber containing Tyrode's solution into which was bubbled oxygen gas. The solution was. kept constant at 38 degrees C and contraction of the preparations was recorded on a polygraph. After being washed several times with fresh solution, the muscle strips attained constant motility and tonus. Ketamine and other drugs were added in various concentrations to the chamber. The results are as follows: 1) Ketamine did not exert any effect on human intestinal motility. It relaxed fowl intestinal muscle strips and potentiated the effect of epinephrine, norepinephrine, and isoproterenol. 2) The relaxing effects of ketamine on fowl intestinal muscle strips were not abolished by adrenergic blocking agents. 3) Ketamine demonstrated anticholinergic effect on the intestinal motility of the human and fowl. From the above results, it may be concluded that ketamine exerts a anticholinergic effect and depressant effect on intestinal motility of fowl without relation to adrenergic receptors.
Adrenergic Antagonists ; Adult ; Amnesia ; Analgesia ; Anesthesia ; Cardiac Output ; Catalepsy ; Catatonia ; Chickens* ; Cyclohexylamines ; Epinephrine ; Gastrointestinal Motility* ; Humans ; Isoproterenol ; Ketamine* ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Phencyclidine ; Receptors, Adrenergic ; Reflex ; Stomach Neoplasms

This study was conducted to evaluate the effect of antenatal ambroxol administration to the mothers who were imminent preterm delivery on preventing the neonatal respiratory distress syndrome. Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, twenty-one ambroxol-treated group and twenty-one control group. Six cases of respiratory distress syndromes developed from 21 ambroxol-treated infants. but thirteen cases of RDS developed from 21 control infants. It indicated significant reduction of occurrence of RDS by antenatal administration of ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between two groups, ambroxol-treated and control groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndromes without significant adverse effects.
Ambroxol* ; Humans ; Infant ; Infant, Newborn ; Lung ; Mothers ; Respiratory Distress Syndrome, Newborn*

Administration, Inhalation ; Ambroxol ; administration & dosage ; Female ; Humans ; Infant, Newborn ; Male ; Pneumonia ; drug therapy ; physiopathology

PURPOSE: Antenatal dexamethasone administration is associated with a significant lowering respiratory distress syndrome (RDS) incidence, but can increase neonatal infection. Ambroxol has been accepted as an alternative treatment to dexamethasone and is of at least equal efficacy but without adverse reaction. The aim of this study was to evaluate the effectiveness of ambroxol versus dexamethasone in RDS incidence and neonatal infection. METHODS: In this study, 30 infants, who received prenatal dexamethasone therapy, were compared retrospectively to 19 infants who received prenatal ambroxol therapy and 45 infants who received placebo during 28 to 34 weeks' of gestation. RESULTS: RDS incidence was comparable in both the dexamethasone (10.0%) and ambroxol (10.5%) groups but higer in the control group (26.6%). The puerperal infection rate in the mothers of these infants was 33.3% in the dexamethasone group, 10.5% in the ambroxol group and 20.0% in the control group. Neonatal infection in the 28 days following delivery was 56.6% in the dexamethasone group, 26.3% in the ambroxol group and 26.6% in the control group. Neonatal infection rate of the dexamethasone group was higher than ambroxol and control groups (P<0.05). When premature rupture of membrane was controlled, the sepsis rate (<28 days) was significantly lower in the ambroxol group than in the dexamethasone group (P<0.05), but puerperal infection and sepsis (<7 days) were not significantly different. CONCLUSOIN: Ambroxol was as effective as the dexamethasone in reducing the RDS incidence. Neonatal and puerperal infection were significantly higher in the dexamethasone group than in the ambroxol group.
Ambroxol* ; Dexamethasone* ; Humans ; Incidence ; Infant ; Membranes ; Mothers ; Pregnancy ; Puerperal Infection ; Retrospective Studies ; Rupture ; Sepsis

This study was conducted to evaluate the effect of ambroxol on preventing the infantile respiratory distress syndrome (IRDS) in preterm birth at the Dept. of Obstetrics and Gynecology of Taegu Catholic Medical Center during the period from Jan. 1996 to Dec. 1996. Total of 68 cases were evaluated including 16 ambroxol group and 52 control group. The result were as follows : 1. In the comparison of preventing IRDS, there was 0 case of IRDS in ambroxol group and 7 cases of IRDS in control group (13.46 %). There was a significant difference between two groups (p<0.05). 2. The side effects of ambroxol after administration were nausea in 5 cases, headache in 3 cases, and chest discomfort in 4 cases, but these were not serious and self controlled. 3. There was no significant difference in neonatal morbidity between two groups (p > 0.05).
Ambroxol* ; Daegu ; Gynecology ; Headache ; Nausea ; Obstetrics ; Premature Birth ; Respiratory Distress Syndrome, Newborn* ; Thorax

OBJECTIVE: To establish a biofilm model of Haemophilus influenzae and observe the effect of ambroxol on biofilm of Haemophilus influenzae and bactericidal action. METHOD: Thirty strains of Haemophilus influenzae were isolated from adenoids of children with adenoidal hypertrophy. Two strains which could build stronger biofilms was selected in a 96-well plate. The effect of ambroxol on biofilms were determined by crystal violet, and the structure of biofilms were observed by scanning electron microscope (SEM). The numbers of viable bacterial in biofilm after ambroxol treatmented determined by plate culture count. RESULT: Through crystal violet assay, significant difference (P < 0.01) between the two group after treatment was found when ambroxol concentration reached at 0.25 mg/ml and 0.49 mg/ml. The biofilms was destroyed by SEM. Ambroxol had the positive effect on bacterial killing by plate culture count,and the effect was in a dose dependent. CONCLUSION Ambroxol could destroy the biofilm of Haemophilus influenzae, and had bactericidal function in vitro.
Ambroxol ; pharmacology ; Biofilms ; drug effects ; Child ; Child, Preschool ; Haemophilus influenzae ; drug effects ; Humans ; Microbial Sensitivity Tests

In the present study, we investigated whether ambroxol, S-carboxymethyl-L-cysteine, dextromethorphan and noscapine affect mucin release from airway goblet cells. Confluent primary hamster tracheal surface epithelial cells were metabolically radiolabeled and chased for 30 min in the presence of varying concentrations of the above agents to assess the effects on 3H-mucin release. Noscapine stimulated mucin release during 30 min of treatment period in a dose-dependent manner. However, ambroxol, S-carboxymethyl-L-cysteine and dextromethorphan showed no significant effect on mucin release during 30 min of treatment period. We conclude that noscapine can affect mucin release by acting on airway mucin-secreting cells.
Ambroxol* ; Animals ; Carbocysteine* ; Cricetinae ; Dextromethorphan* ; Epithelial Cells ; Goblet Cells* ; Mucins* ; Noscapine*

AIMTo develop a near-infrared diffuse reflectance analysis (NIRDRA) method for rapid noninvasive quantitative determination of ambroxol hydrochloride in half-finished product particles and non-blister-packed, blistered tablets.

METHODSAll spectra were measured with a Fourier transform spectrometer equipped with a PbS and a InGaAs detector, an external integrating sphere, a rotating sample cup, and a fibre-optic probe for reflectance measurements. All samples were scanned from 12,000 cm-1 to 4,000 cm-1, and each sample spectrum was obtained as an automatic mean of 64 scans. No spectrum pre-processing method was used, and spectral regions, 4,602-4,247, 12,000-7,498 and 6,102-5,446, 12,000-5,446 cm-1 were selected to develope mathematical models by partial least square method for half-finished product particles and non-blister-packed, blistered tablets samples, respectively.

RESULTSThe optimal rank and mean square error determined for half-finished product particles and non-blister-packed, blistered tablets samples by cross validation method all was 6 and 0.306, 0.972 and 1.492, respectively, the average recovery was 100%, 100% and 102% respectively; and the RSD was 1.17%, 1.70% and 1.78% respectively.

CONCLUSIONResults showed that the NIRDRA method was rapid, simple, noninvasive and sensitive, and it can be applied to assay the content of ambroxol hydrochloride in half-finished product particles non-blister-packed and blistered tablets.

Ambroxol ; administration & dosage ; analysis ; Expectorants ; administration & dosage ; analysis ; Quality Control ; Spectroscopy, Near-Infrared ; methods ; Tablets

Ambroxol ; administration & dosage ; therapeutic use ; Bronchitis, Chronic ; etiology ; therapy ; Bronchoalveolar Lavage ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; therapy ; Treatment Outcome