Vecuronium is hydrolyzed in the body to 3-deacetyl (ORG 7268), 17-deacetyl (ORG NC58), and 3, 17-bis-deacetyl (ORG 7402) derivatives. Interactions of vecuronium and these metabolites were studied in phrenic nerve-hemidiaphragm preparations of rats. As already reported, ORG 7268 had a potent neuromuscular blocking action, and ORG NC58 and ORG 7402 had a weak neuromuscular blocking action. As expected, ORG 7268 increased the degree of neuromuscular block by vecuronium. However, a low concentration (10 microM) of ORG NC58 and ORG 7402 reversed the block by vecuronium. At a high concentration (50 microM), ORG NC58 and ORG 7402 increased the degree of block by vecuronium. Although we do not have enough data to explain these paradoxical reversal of neuromuscular block at this moment, we postulate that these results reflect the interaction between "slow" and "fast" competitive antagonists. Regardless of the mechanism, it should be emphasized that the concentrations of ORG NC58 and ORG 7402 which are necessary to reverse the block are much lower than those which facilitate the block. It is conceivable that this paradoxical reversal of the block occurs in experimental and clinical situations. Therefore, in determining the neuromuscular blocking action of a compound, the "antagonistic" effect of its metabolites should also be considered.
en-copyright= kn-copyright= en-aut-name=OhtaYoshio en-aut-sei=Ohta en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=Okayama University en-keyword=vecuronium kn-keyword=vecuronium en-keyword=neuromuscular trasmission kn-keyword=neuromuscular trasmission en-keyword=drug interaction kn-keyword=drug interaction en-keyword=competitive inhibition kn-keyword=competitive inhibition en-keyword=muscle relaxant kn-keyword=muscle relaxant END start-ver=1.4 cd-journal=joma no-vol=62 cd-vols= no-issue=1 article-no= start-page=15 end-page=20 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=200802 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Prototype Model Using Clinical Document Architecture (CDA) with a Japanese Local Standard : Designing and Implementing a Referral Letter System en-subtitle= kn-subtitle= en-abstract= kn-abstract=Since clinical document architecture (CDA) became an American National Standards Institute (ANSI)-approved health level seven (HL7) Standard, many countries have begun making an eff ort to make local standards conform to CDA. In order to make CDA compatible with the many diff erent local standards existing in diff erent countries, we designed a prototype model using HL7 CDA R2 with medical markup language (MML), a Japanese medical data exchange standard. Furthermore, a referral letter system based on this model was developed. Archetypes were used to express medical concepts in a formal manner and to make 2 diff erent standards work collaboratively. We share herein the experience gathered in designing and implementing a referral letter system based on HL7 CDA, Release 2 (CDA R2). We also outline the challenges encountered in our project and the opportunities to widen the scope of this approach to other clinical documents.
en-copyright= kn-copyright= en-aut-name=YongHuang en-aut-sei=Yong en-aut-mei=Huang kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=JinqiuGuo en-aut-sei=Jinqiu en-aut-mei=Guo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OhtaYoshio en-aut-sei=Ohta en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Dalian Medical University affil-num=3 en-affil= kn-affil=Okayama University en-keyword=health level seven kn-keyword=health level seven en-keyword=clinical document architecture kn-keyword=clinical document architecture en-keyword=medical markup language kn-keyword=medical markup language en-keyword=archetype kn-keyword=archetype END start-ver=1.4 cd-journal=joma no-vol=113 cd-vols= no-issue=3 article-no= start-page=295 end-page=297 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20011231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=電子カルテ en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=太田吉夫 kn-aut-sei=太田 kn-aut-mei=吉夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院医療情報部 en-keyword=電子カルテ kn-keyword=電子カルテ en-keyword=病院情報システム kn-keyword=病院情報システム END start-ver=1.4 cd-journal=joma no-vol=117 cd-vols= no-issue=3 article-no= start-page=225 end-page=234 dt-received= dt-revised= dt-accepted= dt-pub-year=2006 dt-pub=20060104 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=医療における個人情報保護法 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=太田吉夫 kn-aut-sei=太田 kn-aut-mei=吉夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院 医療情報部 en-keyword=個人情報 kn-keyword=個人情報 en-keyword=個人情報保護 kn-keyword=個人情報保護 en-keyword=プライバシー kn-keyword=プライバシー en-keyword=医療情報 kn-keyword=医療情報 END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=1985 dt-pub=19851231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=ベクロニウムの代謝物による筋弛緩拮抗作用 kn-title=PARADOXICAL ANTAGONISM OF NEUROMUSCULAR BLOCK BY VECURONIUM METABOLITES. en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=太田吉夫 kn-aut-sei=太田 kn-aut-mei=吉夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 END