Nonsteroidal antiinflammatory drugs(NSAIDs) are known as clinically effective agents for treatment of inflammatory diseases. Inhibition of cyclooxygenase has been thought to be a major facet of the pharmacological mechanism of NSAIDs. However, it is difficult to ascribe the antiinflammatory effects of NSAIDs solely to the inhibition of prostaglandin synthesis. Human neutrophil elastase (HNElastase; HNE, EC 3.4.21.37) has been known as a causative factor in inflammatory diseases. To investigate the specific relationship between HNElastase inhibition and specificity of molecular structure of several NSAIDs, HNElastase was purified by Ultrogel AcA54 gel filtration, CM-Sephadex ion exchange, and HPLC (with TSK 250 column) chromatography. HNElastase was inhibited by aspirin and salicylate in a competitive manner and by naproxen, ketoprofen, phenylbutazone, and oxyphenbutazone in a partial competative manner, but not by ibuprofen and tolmetin. HNElastase-phenylbutazone-complex showed strong Raman shifts at 200, 440, 1124, 1194, 1384, 1506, and 1768 cm(-1). The Raman bands 1194, 1384, and 1768 cm(-1) may represent evidences of the conformational change at -N=N-phi radical, pyrazol ring, and -C=O radical of the elastase-drug complex, respectively. Phenylbutazone might be bound to HNElastase by ionic and hydrophobic interaction, and masked the active site. Inhibition of HNElastase could be another mechanism of action of NSAIDs besides cyclooxygenase inhibition in the treatment of inflammatory diseases. Different inhibition characteristics of HNE-lastase by NSAIDs such as aspirin, phenylbutazone-like drugs and ineffective drugs could be important points for drawing the criteria for appropriate drugs in clinical application.
Anti-Inflammatory Agents, Non-Steroidal/pharmacology* ; Chromatography, Affinity ; Computer Simulation ; Enzyme Inhibitors/pharmacology ; Human ; Isoenzymes/isolation & purification ; Isoenzymes/antagonists & inhibitors ; Ketoprofen/pharmacology ; Leukocyte Elastase/isolation & purification ; Leukocyte Elastase/antagonists & inhibitors* ; Models, Molecular ; Naproxen/pharmacology ; Phenylbutazone/analogs & derivatives ; Salicylates/pharmacology ; Spectrum Analysis, Raman

PURPOSE: The purpose of this study was to improve transportation and distribution of mass-casualty patients by reviewing the subway fire that occurred in Daegu on 18 February 2003. METHODS: We used the reports of the Daegu Emergency Medical Information Center and the medical records of each hospital to analyze retrospectively 199 patients who were transported to 22 initial receiving hospitals. We evaluated the appropriateness of transportation based on the distances of transportation, the capability of the receiving hospitals, and the severity of patients. Using the SAS program(version 6.12), the collected data was analyzed by frequency and x(2) test. RESULTS: The more severe the patients were, the nearer and larger the receiving hospitals were. There was no accurate triage at the scene, but the distribution of patients was good because members of Daegu Emergency Medical Information Center were dispatched to the scene and because communications between the scene and receiving hospitals were continuous. CONCLUSION: We do not expect disasters, but they happen. All we can do is plan and prepare appropriate responses for disasters. Appropriate transportation and distribution of patients based on triage is an important aspect of early disaster response.
Daegu* ; Disasters ; Emergencies ; Fires* ; Humans ; Information Centers ; Medical Records ; Railroads* ; Retrospective Studies ; Transportation* ; Triage