BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

No abstract available.
Glutathione Transferase* ; Glutathione* ; Schistosoma japonicum* ; Schistosoma*

No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Leptin* ; Rats* ; Receptors, Leptin*

No abstract available.
Alleles* ; Base Sequence* ; Clone Cells* ; Cloning, Organism* ; HLA-DR Antigens

PURPOSE: We conducted this study to compare the surface physical properties of four commercial preparations of artificial exogenous pulmonary surfactants in vitro which have been used in both the prevention and treatment of respiratory distress syndrome in newborn infants. METHODS: We tested four surfactants : a) Surfacten (Tokyo Tanabe, Japan) and Newfactan (Yuhan, Korea) : reconstituted bovine lung extract, b) Curosurf (Cheisi, Italy) : porcine lung mince; chloroform-methanol extract; liquid-gel chromatography, and c) Exosurf (Wellcome, USA), synthetic surfactant composed of colfosceril, palmitate, hexadecanol, and tyloxapol. We measured the surface adsorption rate, spreading rate, and surface tension(ST)-area diagram by using modified Wilhelmy balance and minimum(min-ST) and maximum ST(max-ST) by Pulsating Bubble Surfactometer. RESULTS: The adsorption rate of Surfacten is less than 30mN/m and those of Newfactan, Curosurf, and Exosurf are more than 30mN/m. The spreading rate of Surfaten and Newfactan are less than 30mN/m, and those of Curosurf and Exosurf are more than 30mN/m. The min-ST of Surfacten and Newfacten are less than 10mN/m, and those of Curosurf and Exosurf are more than 10mN/m. According to high performance of surface physical activities, which are compared with in vitro criteria of effective artificial surfactant, they are as follows; Surfacten>Newfactan>Curosurf>Exosurf. CONCLUSION: There are some differences between the surface physical properties of the four surfactant preparations. The natural surfactants appear to be superior to synthetic surfactant in vitro. Among the natural surfactants, Surfacten showed the best surface physical activities of spreading, adsorption and ST-lowering properties.
Adsorption ; Chromatography ; Humans ; Infant, Newborn ; Lung ; Motor Activity ; Pulmonary Surfactants* ; Surface-Active Agents

PURPOSE: To produce a new generation of artificial pulmonary surfactant(PS), surfactant protein (SP)-B from human PSwas isolated, and the amino acid sequences of these proteins were studied. Artificial peptides of human SP-B were synthesized. New artificial PS preparations which were cornposed of phospholopids and two artificial synthetic SP-B peptides were made, and the surface physical properties of these new PS preparations were tested. METHODS: The purities of SP-B were assessed by SDS-polyacrylamide gel and the amino acid sequences of these proteins were determined. We synthetized two peptides SP-1 and SP-2 and the amino acid sequences were as follows,' SP-1: RMLPQLVCRLVLRCSMD, SP-2: RMLP- QLVCRLVLRCSM. Surface physical properties of newly artificial PSs, which were composed of a mixture of phospholipid(PL) and SP-1 or SP-2(sample A; PL+SP-1, sample B; PL+SP-2), were measured by surface spreading, adsorption rate, and surface tension-area diagram. RESULTS: The amino acid sequence of human SP-B was obtained. We produced the artificial peptides of SP-B and prepared the new generation PS(sample A and sample B). The order of the superiority of spreading and adsorption rate was Surfacten Absorption ; Adsorption ; Amino Acid Sequence ; Humans ; Peptides* ; Pulmonary Surfactants

The constrained alpha-helical structure of a C-peptide is useful for enhancing anti-HIV-1 activity. The i and i+3 positions in an alpha-helical structure are located close together, therefore D-Cys (dC) and L-Cys (C) were introduced at the positions, respectively, to make a dC-C disulfide bond in 28mer C-peptides. Accordingly, this study tested whether a dC-C disulfide bond would increase the alpha-helicity and anti-HIV-1 activity of peptides. A C-peptide can be divided into three domains, the N-terminal hydrophobic domain (HPD), middle interface domain (IFD), and C-terminal hydrogen domain (HGD), based on the binding property with an N-peptide. In general, the dC-C modifications in HPD enhanced the anti-HIV-1 activity, while those in IFD and HGD resulted in no or much less activity. The modified peptides with no activity clearly showed much less alpha-helicity than the native peptides, while those with higher activity showed an almost similar or slightly increased alpha-helicity. Therefore, the present results suggest that the introduction of a dC-C bridge in the N-terminal hydrophobic domain of a C-peptide may be useful for enhancing the anti-HIV-1 activity.
Amino Acid Sequence ; Anti-HIV Agents/chemical synthesis/*chemistry/isolation & purification/*pharmacology ; Cell Line ; Circular Dichroism ; Cysteine/chemistry ; Disulfides/chemistry ; HIV Envelope Protein gp41/*chemistry ; HIV-1/*drug effects/growth & development ; Humans ; Inhibitory Concentration 50 ; Models, Molecular ; Molecular Sequence Data ; Peptides/chemical synthesis/*chemistry/isolation & purification/*pharmacology ; Protein Structure, Secondary ; Protein Structure, Tertiary ; Research Support, Non-U.S. Gov't ; Structure-Activity Relationship

OBJECTIVE: The purpose of this retrospective study is to review the clinical results, fusion rate, quality of reduction and stabilization and effects of cages in the intervertebral space in spondylolisthesis. METHODS: Authors reviewed retrospectively 30 patients who were treated with instrumentation and posterior lumbar interbody fusion(PLIF) between April 1996 to December 1997. RESULTS: Among 30 patients, 13 patients were degenerative type and 17 were isthmic types. The most commonly involved level was L4-5(16cases, 53.3%). Fusion was obtained in 29 patients(96.7%). Clinically, 14 of 17 patients(82.3%) showed excellent or good results in isthmic group, and 11 of 13 patients(84.6%) showed excellent or good results in degenerative group. Postoperative complications developed in three cases(10%), wound infection two cases(6.6%), cage retrodisplacement one case(3.3%). CONCLUSION: PLIF combined with transpedicular instrumentation in lumbar spondylolisthesis showed in all clinical results and fusion rate.
Humans ; Postoperative Complications ; Retrospective Studies ; Spondylolisthesis* ; Wound Infection

Although anterior cervical plate provide excellent fixation for anterior column, the potential risk for injury to spinal cord or soft tissue has been the reason why they have not gained universal acceptance. For this reason, anterior cervical locking plating systems were designed to avoid such surgical complications. The authors reviewed 98 patients who underwent anterior cervical fusion with anterior cervical locking unicortical system during the period of January 1995 to December 1997. Mean follow up period was 8.4months. Morscher plate placement was done in 24 and Orion plate was applied in 74. We compare the safety and efficacy of these tow plates. The two groups were comparable in demographic details, mean age(Morscher 41, Orion 47) average fusion level(Morscher 1.25, Orion 1.55) and fusion rate(Morscher 95.8%, Orion 100%). For comparison of hardware related complication, two patients(2.7%) showed screw loosening without without need for reoperation in Orion plate group. In Morscher plate group, 1 patient(4.1%) developed plate fracture and 1 patient (4.1%) developed screw loosening, but did not require delete(re) operation. Non-hardware related complications in Morscher group were seen in 2 patients(8.2%): one delete CSF leakage and the other being postoperative hematoma collection. In Orion plate group, complications were developed in 9 patients(12%): two nerve injuries(recurrent laryngeal and hypoglossal nerve), two CSF leakages, two wound infections, one postoperative hematoma collection, two donor graft site pains. Reoperations were done in two cases(2%) due to two postoperative hematoma collection one in Morscher plate group and one in Orion plate group. In one level fusion, longer operation time was required in Morscher plate group(217+/-93.7min) compared to Orion plate group(157+/-47min)(p<0.05). In this study two types of anterior cervical locking plate and screw system had good bony fusion and cervical stabilization with few instrument related complication. Moreover, allograft bone fusion with anterior cervical locking plate and screw system had good solid bony fusion without donor site morbidity. Instrument related complications were more common in Morscher locking plate and screw system.
Allografts ; Follow-Up Studies ; Hematoma ; Humans ; Reoperation ; Spinal Cord ; Spine* ; Tissue Donors ; Transplants ; Wound Infection

PURPOSE: In this study, natural pulmonary surfactant was extracted from bovine lung lavage and its surface activity was determined. To investigate the usefulness of synthetic peptides reconstituted with phospholipid as artificial surfactant, truncated peptides from surfactant protein (SP)-B were synthesized and restored the surface tension lowering activities when appropriately recombined with phospholipid. METHODS: Crude natural surfactant (CNS) was isolated from lung lavage by centrifugation and organic solvent for the extraction of pulmonary surfactant was selected to satisfy the in vitro physical properties. Two truncated peptides derived from C-terminal end of bovine SP-B hydrophobic protein were selected and synthesized. To prepare artificial surfactant, synthetic peptides was added to the phospholipid mixture. The various surfactant mixtures were assayed for in vitro physical activity with the Wilhemly plate method and were determined by surface spreading rate, surface adsorption rate and surface tension-area diagram. RESULTS: CNS-chloroform methanol (CM) displayed efficient surface activity compared with clinically used Surfacten but CNS-BuOH did not. The artificial surfactants containing phospholipid mixture and synthetic peptide were analyzed for their surface activities and displayed significant surfactant properties. CONCLUSION: 1-Butanol or CM (3:1) was used as an extraction solvent for CNS. CNS-CM showed more efficient surface activity than CNS-BuOH. Two synthetic peptides composing artificial pulmonary surfactant were designed and mixing ratio of peptide and phospholipid was established. Artificial surfactant dispalyed weaker surface activity than natural surfactant but significant surfactant activity.
1-Butanol ; Adsorption ; Bronchoalveolar Lavage ; Centrifugation ; Methanol ; Motor Activity* ; Peptides ; Pulmonary Surfactants* ; Surface Tension ; Surface-Active Agents