• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.499-508
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• 2005

The purpose of this study were to evaluate the effect on the reversion of sedation induced by midazolam with flumazenil and to determine the plasma concentration of flumazenil according to the method of administration. Intranasal and intravenous flumazenil were administered to sedated health volunteers aged from 23 to 25 years, in doses typical of those used clinically to induce sedation with midazolam and for reversal with flumazenil. Objective assessment for degree of sedation and vital signs, plasma concentration were made for 2 hours period. 1. Systolic and diastolic blood pressure, $SpO_2$ were not changed by adminstration of flumazenil in sedated subject with midazolam, but pulse rate was increased temporarily. 2. Flumazenil showed the reversal of the sedative effect induced by midazolam regardless of administration methods. But intravenous administration showed more effect on the degree and the duration of reversion than intranasal administration with the exception of on set time. 3. Peak plasma concentration of flumazenil administered by intranasal route reached after 2 min and that of flumazenil administered by intravenous route was 4 min. Thus uptake of flumazenil did not showed any difference in accordance with the adminstration route. 4. Administration of flumazenil resulted in the temporary increase of midazolam plasma concentration.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.285-285
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• 1994

Naproxen을 개의 정맥내 투여하였을때 뇨량의 감소와 더불어 삼투질제거율(Cosm), 뇨중 $Na^{+}$과 $K^{+}$의 배설율( $E_{Na}$ , $E_{k}$ )의 감소와 신세뇨관에서의 $Na^{+}$과 $K^{+}$의 재흡수율( $R_{Na}$ , $R_{k}$ )과 K/Na비의 증대를 나타내었으며 신혈류량(RPF)이 감소하였다. 한쪽 신동맥내에 naproxen을 투여하였을때 투여신(실험신)에서의 이뇨작용과 대조신에서의 항이뇨작용을 나타내었다. 경동맥에 naproxen을 투여하였을때도 뚜렷한 항이뇨작용을 나타내었다. 이와같은 두경우에서의 항이뇨 작용시의 신기능변화는 정맥내 naproxen의 경우와 같은 양상을 나타내었다. 경동맥내의 naproxen의 항이뇨작용은 신신경 제거에 의하여 영향을 받지 않았으나 정맥내로의 arachidonic acid나 indomethacin의 전처리에 의하여서는 나타나지 않았다. 경동맥내의 naproxen은 정맥내의 spironolactone의 이뇨작용을, 정맥내의 spironolactone은 경동맥내의 naproxen의 항이뇨작용을 억제하였다. 이상의 결과로 보아 naproxen은 중추성 항이뇨작용과 $Na^{+}$저류를 나타내며 이는 prostaglasdin의 합성억제와 aldosterone양 작용에 의하는 것으로 사료된다.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.201-201
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• 1994

항암 및 면역조절작용을 가지고 있으며 그자체가 서방성 prodrug으로서 약효를 나타낼것으로 기대되는 ara-C와 etherphospholipid의 conjugate인 ara-CDP-DL-PCA.2Na의 실험동물(rat)에서의 체내동태를 HPLC 정량법으로 시행 하였다. Ara-CDP-DL-PCA.2Na의 정맥내 투여(20mg/300g)의 경우 혈장중 반감기는 분포상에 있어서는 평균 20min, 소실상 에서는 4.42hr이었다. 분포 용적은 0.1635Lㆍkg$^{-1}$이었고, 전신 clearance 는 25.63ml.$hr^{-1}$.kg$^{-1}$이었다. 한편 AUC는 2601$\mu\textrm{g}$.hr.ml$^{-1}$이었다. 복강내 주사(1g/kg)의 경우 소실상의 반감기는 3.28hr, AUC는 439.3$\mu\textrm{g}$.hr.ml$^{-1}$이었다. 최고 혈중농도 도달시간은 4.4hr이었으며 그때의 농도는 33.19$\mu\textrm{g}$.ml$^{-1}$이었다. 한편 흡수속도 정수는 0.2493$hr^{-1}$이었다. 정맥내 투여에 대한 복강내 투여의 생체 이용율은 1.1252%로 복강내 투여시 흡수율이 좋지 않음을 시사하고 있다. 이는 투여 시료인 micellar solution이 일종의 약물저장 형태로 작용하여 활성물질을 서서히 방출 하기 때문인 것으로 사료된다. 한편 예비적 대사연구결과 TLC에서 뇨나 담즙으로 배설되는 유의한 농도수준의 ara-CDP-DL-PCA.2Na가 없는 것으로 평가되었다. 이는 생체내에서 enzyme등에 의한 대사과정을 거치는 것으로 사료되는바 방사성 동위원소 표지화합물을 이용한 충분한 대사연구가 필요한 것으로 사료된다.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.142-149
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• 2021

Purpose: This study examined the effectiveness of tranexamic acid in reducing postoperative blood loss in total knee arthroplasty by comparing the methods of administration between an intravenous group, topical group, and non-tranexamic acid group. Materials and Methods: This was a retrospective case series study of patients who underwent primary total knee arthroplasty from March 2017 to February 2019 performed by a single surgeon. The study population was divided into three groups according to the method of tranexamic acid administration (Group I: intravenous group, Group II: topical group, Group III: non-tranexamic acid group). To evaluate the effectiveness of tranexamic acids, the total amount of postoperative blood loss, postoperative hemoglobin loss, and volume of red blood cell transfusion in the three groups were compared. Results: The total amount of postoperative blood loss was lower in the tranexamic acid administered group than in the non-tranexamic acid group (1,366±866 ml). Among the administration methods, the intravenous group (987±449 ml) was significantly lower than the topical group (1,136±339 ml) (p=0.004). Postoperative hemoglobin loss was lower in the tranexamic acid group than the non-tranexamic acid group. Among the administration methods, the intravenous group was lower than the topical group. The transfusion rate was higher in the non-tranexamic acid group (5.7%) than the tranexamic administered group. The transfusion rate of the intravenous group was 1.4%, and no patient required a transfusion postoperatively in the topical group. The number of postoperative thromboembolic events, as a complication of tranexamic acid, was similar in the three groups. Conclusion: Tranexamic acid was effective in reducing postoperative blood loss after primary total knee arthroplasty compared to the non-tranexamic acid administered group. No significant difference in the complications induced by tranexamic acid was observed among the three groups.

• 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.32 no.3
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• pp.416-426
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• 2005

Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.169-169
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• 1994

항암 및 면역조절작용을 가지고 있으며 그 자체가 서방성 prodrug으로서 약효를 나타낼것으로 기대되는 ara-C와 etherphospholipid의 conjugate인 ara-CDP-DL-PCA.2Na, ara-CDP-DL-PBA.2Na, 및 ara-CDP-DL-PMA.2Na 3종의 BR-8702-2의 micellar soultion을 투여시료로 하여 제암력 평가를 실시하였다. DBA/2J 마우스(평균 체중 25g, 수컷)에 L$_{1210}$임파성 백혈병 세포를 이식한 후, 24시간 후 약물을 복강내에 투여하는 실험계 에서 400mg/kg/day, 단회투여 및 80 혹은 100mg/kg/day, 1~5일간 투여로 ILS%값이 229~543으로 우수한 제암력을 보였다. 또한 BDF$_1$ mice(15~20g)의 axillary region에 3㎣의 Lewis Lung Tumor를 피하로 이식한후 약물투여를 통한 제암효과를 관찰하였다. 100, 200, 300mg/kg/day의 단회 투여계 에서는 수명연장 효과가 없었다. 한편, 20, 40, 60mg/kg/day, 1~5일간의 투여계 에서는 ara-CDP-DL-PCA.2Na만이 효과가 있었는데 농도에 역순하여 저농도인 20mg/kg/day, 1~5일간의 투여계에서 가장 효과가 있었으며 그때의 ILS%는 32.3%였고 투여기간중의 체중변화는 거의 보이지 않았다. 한편 NICOM 370 Dynamic Light Scattering을 이용하여 투여시료로한 micellar solution의 입자도를 분석한 결과 ara-CDP-DL-PCA.2Na는 4.2nm size의 것이 99.48%를 차지하고 있었다. ara-CDP-DL-PCA.2Na의 ICR 마우스를 이용한 급성독성 시험에 있어서 경구투여에서의 LD$_{50}$값은 암,수컷 모두 5000mg/kg이상 이었고, 정맥내 투여 에서는 432mg/kg이었다. 실험과정중 생존동물의 일반적 이상소견등은 없었으나 정맥내 투여의 경우에서 체중증가 억제현상이 있었다.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.124-126
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• 1992

Interleukin-2 (IL-2)는 많은 immunoenhancing lymphokine의 한 종류로서 lymphokine activiated killer (LAK) cell의 생성을 자극시켜 흑종의 종양세포를 죽인다고 알려져 있다. 최근 간종양에서 비장동맥 또는 간동맥으로 투여한 IL-2가 비장의 임파계를 자극하여 LAK cell을 생성하여 어느정도효과가 있음이 밝혀지면서, 여러가지의 투여 방법이 시도되고 있다. 그러나 각종의 투여 방법에서 실제로 투여한 IL-2의 인체내 분포에 관한 연구는 없다. 저자들은 비정맥과 간문맥에 이상이 없는 증례의 비동맥에 IL-2와 $^{99m}Tc-phytate$ 혼합물을 투여하고, IL-2의 생체에서의 비장과 간에 어떻게 분포하는지 알아보기 위하여 $^{99m}Tc$의 radioactivity를 계측하여 보았다. 6예의 간세포암과 3예의 위암으로부터의 전이성간암에서 동맥조영술적방법을 이용하여 초선택적 비장동맥에 투여한 IL-2와 $^{99m}Tc-phytate$ 혼합물이 비장 27%, 간73%의 분포를 보여 비장을 거쳐온 $^{99m}Tc$의 방사능이 간에 많이 침착함을 확인하였고 간과 비장이외의 부위 즉 골수, 복수 또는 폐장이나 늑막에는 전혀 방사능 분포가 없음을 알 수 있었다. 따라서 비정맥이나 간문백에 이상이 없는 증례에서 IL-2의 비장동맥 투여는 목적하는 바 IL-2의 생체내 분포를 이룩할 수 있을 것으로 사료된다.

• Pediatric Infection and Vaccine
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• v.29 no.1
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• pp.46-53
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• 2022

It is challenging to treat ventriculitis with parenteral treatment alone in some cases because of the difficulty involved in maintaining an appropriate level of antibiotics in cerebrospinal fluid (CSF). We report two cases of ventriculitis who did not respond to intravenous (IV) antibiotics but were successfully treated with intraventricular antibiotics using IV agents. The first case was a four-month-old male patient with X-linked hydrocephalus. He showed ventriculitis due to Klebsiella pneumoniae not producing extended-spectrum β-lactamase and susceptible to third-generation cephalosporins and gentamicin, following ventriculoperitoneal (VP) shunt. His condition did not improve during the 47 days of treatment with IV cefotaxime and meropenem. We achieved improvement in clinical presentation and CSF profile after three times of intraventricular gentamicin injection. The patient was discharged from the hospital with antiepileptic drugs. The second case was a six-month-old female patient with a history of neonatal meningitis complicated with hydrocephalus at one month of age, VP shunt at two months of age, followed by a methicillin-resistant coagulase-negative staphylococci (CoNS) shunt infection with ventriculitis after the shunt operation. CoNS ventriculitis recurred four weeks later. We failed to treat intractable methicillin-resistant CoNS ventriculitis with IV vancomycin for ten days, and thus intraventricular antimicrobial treatment was considered. Five times of intraventricular vancomycin administration led to improvement in clinical parameters. There were only neurological sequelae of delayed language development but no other major complications. Patients in these two cases responded well to intraventricular antibiotics, with negative CSF culture results, and were successfully treated for ventriculitis without serious complications.

• Journal of Veterinary Clinics
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• v.32 no.6
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• pp.491-498
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• 2015

We investigated the effect of constant rate infusion (CRI) with doxapram on cardiopulmonary function during total intravenous anesthesia (TIVA) with remifentanil and propofol CRI in dogs. Fifteen male Beagle dogs were randomly divided into 3 groups. All groups were premedicated with medetomidine ($20{\mu}g/kg$, IV) and anesthetized by remifentanil/propofol CRI for one and half hour. At the initiating of the anesthesia, different doses of doxapram for each group were administrated as the followings; D1 group - doxapram 0.25 mg/kg bolus followed by doxapram $8.33{\mu}g/kg/min$, D2 group - doxapram 2 mg/kg bolus followed by doxapram $66.66{\mu}g/kg/min$, control group - normal saline. The anesthetic depth for surgery was well maintained in all groups throughout the anesthetic periods. The respiratory rate was significantly higher in D2 group than that of control group (p < 0.05). The values of $PaO_2$ and $SaO_2$ were significantly increased in both D1 and D2 groups compared with control group (p < 0.05). High dose of doxapram (D2 group) significantly decreased the level of $PaCO_2$ compared with control group (p < 0.05). The values of systolic, mean and diastolic arterial pressure were significantly increased in doxapram 2 group (p < 0.05). There were no significant differences in the values of heart rate and pH of arterial blood. Therefore, doxapram CRI may be useful to alleviate the suppression of cardiopulmonary function including hypoxia and hypotension during TIVA with remifentanil and propofol in dogs.