• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.283-291
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• 2000

The purpose of this study was to compare the sedative effect of three routes of administration - intramuscular, intranasal drop-in, intranasal spray - with midazolam. The twenty two uncooperative children from 23 months to 76 months who required at least three dental appointment. Each patient was assigned randomly to receive intramuscular(Group I, 0.15mg/kg), intranasal drop-in(Group II, 0.20mg/kg), intranasal spray(Group III, 0.20mg/kg) administration at each visit. Sleep, crying, movement, and overall behavior response were evaluated, and the sedative effects were evaluated by Houpt's rating scale In order to monitor the sedated patients, pulse rate and peripheral oxygen saturation were measured by pulse oximeter during treatment procedures. The results were as follows 1. Pulse rate and peripheral oxygen saturation were stable through all the treatment procedures, and there were no statistically significant differences among three routes of administration(P>0.05). 2. The effect on sleep was, III, II, I, in order, III group was the most effective through all the treatment procedures, except rubber-dam placement and filling phase (P<0.0001). 3. The effects on crying, movement, overall behavior were II, III, I, in order, II group was the most effective through all treatment procedures(P<0.0001).

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.159-167
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• 2002

The purpose of this study was to evaluate the efficacy and safety depending on the route of flumazenil, as an antagonist against midazolam. The subjects of this study were 15 volunteers of $22{\sim}24$ years old. They were sedated with midazolam 0.2mg/Kg intranasal spray, and then 40 minutes after midazolam administration, they were given flumazenil 0.2mg intranasal spray for their reversal. For evaluation of the efficacy and safety of intranasal spray for flumazenil, they were monitored with pulse-oxymeter(Nellcor symphony N-3000, Nellcor Puritan CO. USA) and electric sphygmomanometer (Heartcare 200, National CO. Japan), and were assessed themselves using visual analogue scale(VAS) for tranquilization, sleep, fatigue and attitude. All of these subjects were reduced completely without any undesired situations. The results from this study can be summarized as follows ; 1. Nasaly administered flumazenil using spray device produced much more rapid reduction than intravenously administered flumazenil, but soon after fell in more deep sedated state than intravenously administered flumazenil. 2. There were no considerable side effects or bad influence on vital signs of both nasaly administered flumazenil and intravenously administered flumazenil. These results suggested that the flumazenil administered nasaly using spray device for reversal, we could treat patients safely and effectively under conscious sedation using midazolam administration. But, We will have to research about its optimal dosages for flumazenil, used as intranasal spray for reversal agents against the midazolam by evaluating the blood plasma concentration of midazolam and flumazenil.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.782-787
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• 1998

The treatment for pediatric dental patient has become more complex than the previous, because patients of pediatric dentistry, younger than the previous, and they were often combined with systemic disease. And, the importnace of conscious sedation has been increased by this time for this reason. In a variety of CNS depressants, newly developed imidazobenzodiazepine (midazolam) is well known as a safe and effective medicament. It has a rapid onset, minimized cardiovascular depression and various possible administering, route, so it is commonly used for the conscious sedation of pediatric dental patients. Recently, "intranasal drop-in method" draws attention for its safety, but discomfort during administration and posterior dripping through pharynx diminish its popularity. Now more advanced method for intranasal administration is introduced for conscious sedation for pediatric dental patients, it is "intranasal spray" with aerosol form of medicament. With this method, we can achieve some benefits as belows : 1. Diminished discomfort during intranasal spray than nitranasal drop-in. 2. Rapid osnet and reduction than intranasal drop-in. 3. Eliminatin of adverse reaction, such as rhinorrhea. 4. More improved behavior rating scale.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.427-436
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• 2008

Purpose. The objective of this study was to evaluate the behavioral response and assess the effectiveness of additional intranasal (IN) and submucosal (SM) administration of midazolam during pediatric sedation for dental procedure. Material and methods. Thirty-three cases of healthy (ASAⅠ), uncooperative children aged from 24 to 72 month old at pediatric dental clinic of Ewha Womans University Hospital were selected for this study. Children received oral chloral hydrate 50 mg/kg with hydroxyzine 1.0 mg/kg. After waiting for 45 minutes, midazolam 0.2 mg/kg was administrated via IN route and via SM route randomly maintaining 50% of $N_2O$. A pulse oximeter and a capnograph were used for measuring vital signs ($SpO_2$, PR, RR, $EtCO_2$) throughout the sedation. Behavioral response was evaluated as Quiet (Q), Crying (C), Movement (M) or Struggling (S) in every 2 minutes for 40 minutes. Results. There were also no statistically significant differences in vital signs of the two groups. The behavioral response for the first ten minutes during sedation was a statistically significant difference (P < 0.05) between the two groups. After the first ten minutes, it was revealed that there was no significant difference. Conclusion. This study demonstrated that the addition of IN midazolam to the combination of oral chloral hydrate with hydroxyzine and nitrous oxide/oxygen inhalation is as safe and effective as that of SM midazolam in pediatric sedation for dental procedure.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.15.2-15
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• 1982

Inverted papilloma arising from mucous membrane of the nasal cavity and paranasal sinuses is very rare benign neoplasm. Ward first described nasal papilloma in 1854, but its infrequent occurrence has delayed accurate understanding. This tumor was histologically benign neoplasm and clinically malignant, because it is locally invasive with extensive bone erosion at times and it shows a high incidence of local recurrence, and change of squamous cell carinoma was sometimes found. Recently, the authors have experienced a case of inverted pailloma with focal squamous cell carcinoma change which occupied the right side of the nsal cavity and maxillary sinus in a 48-year-old male. The tumor mass was removed surgically through intranasal and Caldwell-Luc's approach, and then was treated with systemic administration of Bleomycin, local spray of 5-FU and radiotherapy ($Co^{60}$). We report our case with review of current literatures.

• Korean Journal of Poultry Science
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• v.8 no.2
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• pp.69-75
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• 1981

The experiment was carried out to observe whether the route of administration of allantoic aminiotic fluid obtained from the chicken embryo infected with $B_1$ virus would affect the protectivity of brids against the challenge exposure of a virulent strain of ND virus. Four groups of birds of 30 days of age were immunized intranassally (0.1 $m\ell$), intramuscularly (1.0 $m\ell$), by spray administration (0.00015 $m\ell$/1㎤) or via drinking water(10.0 $m\ell$), with 1 in 100 dilution of th. fluid containing $B_1$ virus titre of 10$\^$8.5/ELD$\_$50/ per $m\ell$ and all the immunized birds, after 15 days of vaccination, were challenged intramuscularly with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. The results obtained are summerized as follows: 1. Good immunity was induced when 1 in 100 dilution of allantoaminiotic fluid with $B_1$ virus titre of 10$\^$8.5/ELD$\_$50/$m\ell$was applied to 30 day old chicks intramuscularly, intranasally and by spray application, but it was not the case when the allantomiotic fluid was diluted to 1 in 1,000. The ID$\_$50/ of birds immunized with 1 in 100 dilution of allantoaminiotic fluid by various routes of administration such as intramuscular Injection, spray application and intranasal instillation were 10$\^$2.8/＞10$\^$4.l and/＞10$\^$4.2/ 2. The high protectivity against the challenge exposure with a virulent Newcastle disease virus with 10,000 MLD/$m\ell$ were observed when the birds were immunized with a live vaccine of 10$\^$8.5/ ELD$\_$50/$m\ell$ by intramuscular injection, intranasal instillation or spray application, and the rates by different routes of application were 92.62%, 95.33% and 93.75%, respectively. On the contrary, no good immunity was induced in the groups of birds immunized via drinking water with the live vaccine, the rate of protection against the challenge exposure being 47.18%.