PURPOSE: Intratracheal pulmonary ventilation (ITPV) is developed to decrease dead space ventilation. A reverse thrust catheter (RTC) is introduced into an endotracheal tube through an adapter. Bias gas through the RTC exits from the catheter tip. The flow of gas is redirected outward away from the lung. Gas is intermittently introduced into the lung as tidal volume (VT) by an expiratory valve. ITPV can be combined with pressure control mode, resulting in hybrid ventilation (HV). We hypothesized that HV might decrease VT, compared with volume controlled ventilation (VCV) or pressure controlled ventilation (PCV) alone. METHODS: HV was compared with VCV and PCV in 7 tracheostomized rabbits. We aimed at maintaining PaCO2 levels normal as the respiratory rates (RR) were set at 20, 40, 80, and 120/min. Blood pressure and airway pressures were monitored and dead space ratio was calculated. RESULTS: The dead spaces (VD) of VCV are 30+/-4 mL, 18+/-4 mL, 14+/-4 mL, and 12+/-5 mL and the VD of PCV are 24+/-6 mL, 16+/-3 mL, 15+/-4 mL and 12+/-4 mL at the respiratory rates of 20/min, 40/min, 80/min, and 120/min, respectively. The VD of HV are 13+/-6 mL, 9+/-3 mL, 7+/-2 mL, and 5+/-1 mL, respectively. The VT and PIP of HV are significantly lower than those of VCV and PCV at the same RR. CONCLUSION: It can be concluded that HV can be applied to minimize the airway pressures and dead space ventilation of VCV and PCV.
Bias (Epidemiology) ; Blood Pressure ; Catheters ; Lung ; Pulmonary Ventilation ; Rabbits* ; Respiratory Rate ; Tidal Volume ; Ventilation*

Earlier work suggested that Ginseng saponin had an effect on healing of fracture and osteoporosis, hut there has heen no report on saponin effects on cultured osteoblast. The purpose of this study was to investigate the effect of saponin on cultured osteovlast of the mouse. Osteohlastic cells were isolated from periosteum-stripped parietal bones of neonatal rat calvaria, seeded at 4 x 10 4 cells/cm2 density, and cultured in standard medium and deficient medium, with addition of saponin (0(control), 10, 20, 50 microgram/ml concentration). Plating efficiency(adhesiveness), proliferation and the alkaline phosphatase activity of the osteohlasts were evaluated on 2 hours, days 2 and 7 of culture. Saponin was found to enhance the adhesiveness of seeded osteoblasts which were cultured with a deficient medium in comparison to the controls. It promoted cell proliferation of the osteoblasts cultured with a deficient medium in comparison to the controls. There was also a significantly enhanced increase of alkaline phosphatase levels in the presence of saponin during culture with deficient medium in comparison to the controls. In summary, the results showed that the saponin increased adhesiveness, proliferation and the alkaline phosphatase activity of the osteoblast cultured only in deficient medium.
Adhesiveness ; Alkaline Phosphatase ; Animals ; Cell Proliferation ; Mice ; Osteoblasts* ; Osteoporosis ; Panax* ; Parietal Bone ; Rats ; Saponins* ; Skull

BACKGROUND: To decrease homologuous transfusion and bleeding, Acute Normovolemic Hemodilution (ANH) may be combined with induced hypotension. Tissue oxygen balance may be in danger because of decreased tissue perfusion pressure by induced hypotension and reduced arterial oxygen content by ANH. Thus it is necessary to evaluate effects of induced hypotension combined with ANH on hemodynamics and systemic oxygen balance. METHODS: In 6 mongrel dogs anesthetized with N2O-O2-enflurane and paralyzed with vecuronium, ANH was performed up to half of initial level of hemoglobin with isovolemic pentastarch infusion, and then mean arterial pressure (MAP) was lowered by 30% of the initial value by intravenous administration of Sodium Nitroprusside (SNP). Various hemodynamic parameters were measured before and after ANH and 15, 30, 45 and 60 minutes after induction of hypotension and 15 minutes after the end of hypotension. RESULTS: Heart rate was not changed significantly throughout the study. Central venous pressure increased significantly after ANH but decreased to the initial value after induced hypotension. Systemic vascular resistance showed significant decrease after ANH, more significant decrease after induced hypotension and slight increase after discontinuation of SNP. Cardiac output increased markedly by ANH and maintained during induced hypotension. Oxygen flux decreased significantly after ANH but slightly increased after induced hypotension. Oxygen consumption and Oxygen extraction ratio were maintained throughout the study. There were no acidemia and hypoxemia throughout the study. CONCLUSION: The combined use of ANH and induced hypotension with SNP is safe in the aspect of cardiovascular system and systemic oxygen balance.
Administration, Intravenous ; Animals ; Anoxia ; Arterial Pressure ; Cardiac Output ; Cardiovascular System* ; Central Venous Pressure ; Dogs* ; Heart Rate ; Hemodilution* ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Hypotension* ; Nitroprusside ; Oxygen Consumption ; Oxygen* ; Perfusion ; Sodium* ; Vascular Resistance ; Vecuronium Bromide

To determine which HLA antigens are associated with rheumatoid arthritis in Korean, we studied the HLA class II genotypes in 40 patients with rheumatoid arthritis and 35 normal healthy persons by the two step polymerase chain reaction. At first we designed 20 pairs of group specific primers followed by the alleles which have the same nucleotide sequences in the exon 2 region. We performed amplification reaction with these 20 pairs of primers for 32 cycles. Reaction products were electrophoresed and only specifically amplified products were reamplified for 15 cycles with total 76 pairs of allele specific primers. We typed the HLA class II genotypes with specific band patterns of each allele. The genotypes in patients were compared with those of normals. HLA-DR4 gave the highest relative risk for rheumatoid arthritis (RR=4), which was statistically significant (P<0.01). The frequency of HLA-DR4 was 75.0% in patient group and 42.9% in normal control group. Relative risk was also associated with HLA-DQw4 of DQB1 gene (RR=3.82), which was statistically significant (P<0.05). The frequency of HLA-DQw4 was 38.9% in patient group and 14.3% in normal control group. HLA-DRI and DQw3 were not associated with rheumatoid arthritis (P>0.05). Among HLA-DR4 subtypes, the frequency of Dwl4(0404) in patient group was relatively higher (19.2%) than that in normal control group(7.7%). The relative risk was high (2.85), although it was not statistically significant (P>0.05). From this study, HLA-DR4 was found to be highly associated while DRI was not associated with rheumatoid arthritis patients in Koreans.
Alleles ; Arthritis, Rheumatoid* ; Base Sequence ; Exons ; Genotype* ; HLA Antigens ; HLA-DR4 Antigen ; Humans ; Polymerase Chain Reaction

Background/Aims: We examined the efficacy and safety of tegoprazan as a part of first-line triple therapy for Helicobacter pylori eradication. Methods: A randomized, double-blind, controlled, multicenter study was performed to evaluate whether tegoprazan (50 mg)-based triple therapy (TPZ) was noninferior to lansoprazole (30 mg)-based triple therapy (LPZ) (with amoxicillin 1 g and clarithromycin 500 mg; all administered twice daily for 7 days) for treating H. pylori. The primary endpoint was the H. pylori eradication rate. Subgroup analyses were performed according to the cytochrome P450 (CYP) 2C19 genotype, the minimum inhibitory concentration (MIC) of amoxicillin and clarithromycin, and underlying gastric diseases. Results: In total, 350 H. pylori-positive patients were randomly allocated to the TPZ or LPZ group. The H. pylori eradication rates in the TPZ and LPZ groups were 62.86% (110/175) and 60.57% (106/175) in an intention-to-treat analysis and 69.33% (104/150) and 67.33% (101/150) in a per-protocol analysis (non-inferiority test, p=0.009 and p=0.013), respectively. Subgroup analyses according to MICs or CYP2C19 did not show remarkable differences in eradication rate. Both first-line triple therapies were well-tolerated with no notable differences. Conclusions TPZ is as effective as proton pump inhibitor-based triple therapy and is as safe as first-line H. pylori eradication therapy but does not overcome the clarithromycin resistance of H. pylori in Korea

Background/Aims: The mucoprotective drug rebamipide is used to treat gastritis and peptic ulcers. We compared the efficacy of Mucosta Ⓡ (rebamipide 100 mg) and its new formulation, AD-203 (rebamipide 150 mg), in treating erosive gastritis. Methods: This double-blind, active control, noninferiority, multicenter, phase 3 clinical trial randomly assigned 475 patients with endoscopically proven erosive gastritis to two groups: AD-203 twice daily or Mucosta Ⓡ thrice daily for 2 weeks. The intention-to-treat (ITT) analysis included 454 patients (AD-203, n=229; Mucosta Ⓡ , n=225), and the per-protocol (PP) analysis included 439 patients (AD-203, n=224; Mucosta Ⓡ , n=215). The posttreatment assessments included the primary (erosion improvement rate) and secondary endpoints (erosion and edema cure rates; improvement rates of redness, hemorrhage, and gastrointestinal symptoms). Drug-related adverse events were evaluated. Results: According to the ITT analysis, the erosion improvement rates (posttreatment) in AD-203-treated and Mucosta Ⓡ -treated patients were 39.7% and 43.8%, respectively. According to the PP analysis, the erosion improvement rates (posttreatment) in AD-203-treated and Mucosta Ⓡ -treated patients were 39.3% and 43.7%, respectively. The one-sided 97.5% lower limit for the improvement rate difference between the study groups was −4.01% (95% confidence interval [CI], –13.09% to 5.06%) in the ITT analysis and −4.44% (95% CI, –13.65% to 4.78%) in the PP analysis. The groups did not significantly differ in the secondary endpoints in either analysis. Twenty-four AD-203-treated and 20 Mucosta Ⓡ -treated patients reported adverse events but no serious adverse drug reactions; both groups presented similar adverse event rates. Conclusions The new formulation of rebamipide 150 mg (AD-203) twice daily was not inferior to rebamipide 100 mg (Mucosta Ⓡ ) thrice daily. Both formulations showed a similar efficacy in treating erosive gastritis.