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( Chaiyoung Lee ),( Sun Hye Shin ),( Noeul Kang ),( Yeonseok Choi ),( Hyun Kyu Cho ),( Jun Hyeok Lim ),( Hye Yun Park ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background Vitamin D deficiency is prevalent in patients with chronic obstructive pulmonary disease (COPD). The relationship between vitamin D and clinical symptoms in stable COPD has not been fully investigated. We aimed to explore the association between vitamin D sufficiency and clinical symptoms in stable COPD patients. Methods We performed a cross-sectional study using data between October 2015 and March 2019 from the COPD Lung Evolution (CLUE) Registry in Samsung Medical Center. Serum 25-hydroxy (25-OH) vitamin D levels measured at diagnosis with concurrent spirometry. Vitamin D sufficiency was defined as serum level ≥ 30ng/mL of 25-OH vitamin D. Results Of the 330 COPD patients, mean age was 70.8±8.5 years and 305 (92.4%) were male. Current or ex-smokers were 296 (89.7%) and 281 (85.2%) did not have vitamin D sufficiency. Patients without vitamin D sufficiency showed higher COPD assessment test (CAT) score compared to those with vitamin D sufficiency (17.14±8.56 vs. 13.08±8.15, p = 0.002 and 80.4% vs. 63.3% for CAT ≥ 10, p =0.008). Among CAT items, the patients without vitamin D sufficiency showed higher scores in sputum (p = 0.005), chest tightness (p = 0.014), dyspnea (p = <0.001), activity (p = 0.006) and energy (p = 0.010) than those with vitamin D sufficiency. The modified Medical Research Council ≥2 was more common in patients without vitamin D sufficiency than those with vitamin D sufficiency (37.4% versus 22.4%, p = 0.044). Conclusions COPD patients without vitamin D sufficiency had worse clinical symptom than those with vitamin D sufficiency.
Crystallization of Local Anesthetics When Mixed With Corticosteroid Solutions
Hyeoncheol Hwang,Jihong Park,Won Kyung Lee,Woo Hyung Lee,이자호,Jin Joo Lee,Sun G. Chung,Chaiyoung Lim,Sang Jun Park,Keewon Kim 대한재활의학회 2016 Annals of Rehabilitation Medicine Vol.40 No.1
Objective To evaluate at which pH level various local anesthetics precipitate, and to confirm which combination of corticosteroid and local anesthetic crystallizes.Methods Each of ropivacaine-HCl, bupivacaine-HCl, and lidocaine-HCl was mixed with 4 different concentrations of NaOH solutions. Also, each of the three local anesthetics was mixed with the same volume of 3 corticosteroid solutions (triamcinolone acetonide, dexamethasone sodium phosphate, and betamethasone sodium phosphate). Precipitation of the local anesthetics (or not) was observed, by the naked eye and by microscope. The pH of each solution and the size of the precipitated crystal were measured.Results Alkalinized with NaOH to a certain value of pH, local anesthetics precipitated (ropivacaine pH 6.9, bupivacaine pH 7.7, and lidocaine pH 12.9). Precipitation was observed as a cloudy appearance by the naked eye and as the aggregation of small particles (<10 m) by microscope. The amount of particles and aggregation increased with increased pH. Mixed with betamethasone sodium phosphate, ropivacaine was precipitated in the form of numerous large crystals (>300 m, pH 7.5). Ropivacaine with dexamethasone sodium phosphate also precipitated, but it was only observable by microscope (a few crystals of 10–100 m, pH 7.0). Bupivacaine with betamethasone sodium phosphate formed precipitates of non-aggregated smaller particles (<10 m, pH 7.7). Lidocaine mixed with corticosteroids did not precipitate.Conclusion Ropivacaine and bupivacaine can precipitate by alkalinization at a physiological pH, and therefore also produce crystals at a physiological pH when they are mixed with betamethasone sodium phosphate. Thus, the potential risk should be noted for their use in interventions, such as epidural steroid injections.