• Title/Summary/Keyword: Bolus

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Elliptical Centric Techniques and Tricks About the Usefulness of the Clinical Application (Elliptical Centric과 TRICKS 기법의 임상 적용에 관한 유용성 연구)

  • Kim, Sae-Ssak;Goo, Eun-Hoe;Dong, Kyung-Rae;Kweon, Dae-Chel;Lee, Jae-Seung;Cho, Jae-Hwan;Park, Chang-Hee
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.2
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    • pp.83-90
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    • 2011
  • To prospectively determine the diagnostic performance a combination of standard bolus-chase magnetic resonance (MR) angiography and MR angiography with time-resolved imaging of contrast kinetics (TRICKS) for depicting severity of the head and neck vascular diseases. Over a period of two months, A total of 100 patients(average ages : $50{\pm}8$, male : 60, female : 40) with head and neck vascular diseases were performed on the GE excite 3.0 T units with 8-channel head coil and 4-channel NV coil. Imaging parameters for a typical study were as follow: SBC(TR/ TE/ FA/ SliceThicken./ Slab/ Freq./ FOV/ BW/Scan Time) = 5.4/ min/ 30/ 2/ zip2/ 70/ $224{\times}448$/ 30/ 62.50/ 28, TRICKS(TR/ TE/ FA/ Slice Thicken/Slab/ Freq./ FOV/ BW/ Temp Res./ Scan Time = 3.6/ min/ 25/ 4/ 30/ $160{\pm}384$, zip512/ 30/ 100/ 1 to 1.5/ 23). The analysis of all MR images, which have respect-ively classified two techniques into some diseases. The results of the former were divided into two groups(SBC, TRICKS)with 4 grading of two reader, respectively. Wilcoxon signed rank test was used to determine if a significant difference between imaging techniques existed(p < 0.05). In 33 of 100 patients, arterio-venous malformation was 11% at TRICKS, subclavian vein stenosis : 8%, fistular sinus : 4%, jugular vein stenosis:6%, Middle Cerebral Artery bypass surgery : 4%, p < 0.05). The rest of 67 patients were considered as the results of SBC(14% in the basilar artery stenosis, carotid stenosis : 16%, vertebral stenosis : 17%, central neuro-cytoma : 5%, meningioma : 5%, Not appliable : 10%, p < 0.05). Sensitivity and specificity of TRICKS MR angiography in SVS, FS, JVS, MCABS were improved compared with those at standard MR angiography. In SBS MR angiography which were improved in BAS, CS, VS, CN, Meningioma. In conclusion, TRICKS MR angiography of the SVS, FS, JVS, MCABS is superior to standard MR angiography regarding the number of diagnostic grading. The SBS MR angiography were improved in BAS, CS, VS, CN, Meningioma. and assessment of the degree of luminal narrowing on both TRICKS and SBS.

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A Comparative Effect of Meperidine between Intravenous and Epidural Patient-Controlled Analgesia for the Postoperative Pain Relief after Cesarean Section (제왕절개 수술후 통증조절을 위해 PCA를 이용한 정맥과 경막외 Meperidine 투여효과의 비교)

  • Lee, Byung-Ho;Chea, Jun-Seuk;Chung, Mee-Young;Byun, Hyung-Jin
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.257-265
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    • 1995
  • Patient-Controlled Analgesia (PCA) has been widely used for postoperative pain relief. Meperidine is useful for PCA and has efficient analgesia, rapid onset, and low incidence of adverse effect. To compare the analgesic effect, total dose and hourly dose, side effect and neonatal status of breast feeding with meperidine via intravenous or epidural PCA for 48 hours after Cesarean Section, 40 parturient women undergoing elective Cesarean Section were randomly divided into two groups. Each respective group of 20 parturient women received meperidine via one of the intravenous PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after epidural block with 2% lidocaine 20ml combined with general anesthesia with only $N_2O$ and $O_2$ (EpiPCA group) when they first complained of pain in recovery room. Following the administration of analgesic initial dose, parturient women of IVPCA group were allowed intravenous meperidine 10 mg every 8 minutes when they felt pain. The EpiPCA group received additional bolus dose of meperidine 2 mg and bupivacaine 0.7 mg were administered every 8 minutes as requested the patients with hourly continuous infusion of meperidine 4 mg and bupivacaine 1.4 mg. Data was collected during the 48 hours observation period including visual analog scale (VAS) pain scores, total meperidine dose, hourly dose during 48 hours and each time interval, incidence of adverse effect, satisfaction, and neonatal status with breast feeding. VAS pain scores of analgesic effect in EpiPCA group was significantly lower than in IVPCA group at 2 hours after the initial pain after Cesarean Section. Total dose and hourly dose of meperidine significantly reduced in EpiPCA group. Hourly dose of meperidine at each time interval significantly reduced during first 6 hours and from 12 hours to 24 hours in EpiPCA group. The side effects in IVPCA group were mainly sedation, nausea, and local irritation of skin. And EpiPCA group experienced numbness and itching. The degree of satisfaction of parturient women was 88.2 % in IVPCA group and 85.7 % in EpiPCA group. We did not observe any sedation, abnormal behavior, or seizure like activity in any neonates of breast feeding. From the above results we conclude that epidural PCA was more efficiently analgesic, less sedative, and consumptional, and safer for neonate than intravenous PCA, and could be an alternative method to intravenous PCA.

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Pharmacokinetics of Anticancer Agent SB-31 in Rats & Rabbits and the Cardiovascular Effect on the Isolated Perfused Rat Heart & Blood Coagulation (SB-31의 Glycyrrhizin을 지표로 한 Rat과 Rabbit에서의 약물동태 및 심혈관계에 대한 효과 연구)

  • Kang, Won Ku;Park, Yong Soon;Lee, Dong Heum;Kwon, Kwang Il
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.2
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    • pp.122-132
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    • 1998
  • SB-31 which contains Pursatilla, Licoris and Ginseng extracts was recently proved as an anticancer agent. In a preclinical effort to be applied this drug to human, pharmacokinetics of SB-31 was carried out in rats and rabbits. Glycyrrhizin(GZ), a saponin of Licoris was used as a standard ingradient for the pharmacokinetics of SB-31. The rat's blood, bile and urine samples were serially collected in femoral vein, common bile duct and bladder, respectively, after bolus i.v. injection at a dose of 1 or 1/5 ampul/rat and rabbit's blood samples from the marginal ear vein at a dose of 1 or 3 amp./rabbit. GZ and glycyrrhetic acid(GA), a major metabolite of GZ in the physiological samples were analysed by HPLC with UV detection. The decline of GZ in plasma concentration was generally biexponential at each dose. GZ was almost completely recovered in bile within 18 hour. GA wasn't detected in the samples with UV detector. In the rat, Vss and Kel at a dose of 1 and 1/5 ampul of SB-31 were $98.06\pm6.07\;ml,\;0.33\pm0.05\;hr^{-1}\;and\;65.46\pm11.19\;ml,\;0.68\pm0.25\;hr^{-1}$, respectively. Those in rabbits at a dose of 3 and 1 ampul of SB-31 were $235.24\pm30.72\;ml,\;0.13\pm0.36\;hr^{-1}\;and\;341.32\pm28.58\;ml,\;0.27\pm0.04\;hr^{-1}$, respectively. 'WinNonlin' was utilized for the compartmental analysis. A two-compartment model was chosen as the most appropriate pbarmaco-kinetic model. The data were best described by using a weighting factor of $1/y^2$. To evaluate the effect of SB-31 on cardiovascular system, serially diluted SB-31 was directly injected into coronary artery in the isolated perfused rat heart and the effect of PSF, PSH, saponins of Pursatilla, and SB-31 on PT, APTT of healthy human plasma was examined. Except the positive inotropic effect of ten times diluted solution of SB-31, there was no significant effect on LVDP, (- dp/dt)/(+dp/dt), heart rate and coronary flow in comparision with that of vehicle. SB-31 had no effect on PT but slightly delayed APTT about $6.9{\sim}11.5\%$. There was no significant effect of PSF and PSH on PT & APTT. Conclusively, SB-31 did not show any notable toxic effects on cardiovascular system.

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A MULTICENTER RETROSPECTIVE STUDY OF OUTPATIENT INTRAVENOUS SEDATION FOR DENTAL TREATMENTS (치과 치료를 위한 외래 정주진정 법에 대한 다기관 후향적 임상연구)

  • Jung, Se-Hwa;Baik, Sang-Hyun;Roh, Hyun-Ki;Kang, Na-Ra;Im, Jae-Jung;Lee, Byung-Ha;Jeon, Jae-Yoon;Hwang, Kyung-Gyun;Shim, Kwang-Sup;Park, Chang-Joo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.394-400
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    • 2009
  • Purpose : On outpatient facilities, our sedation protocol focuses on the intermittent bolus injections of midazolam intravenously, according to patient's and operator's needs during the dental treatment. This multicenter retrospective study was aimed to prove the efficiency and safety of our sedation protocol. Patients and Methods : In three centers using the same outpatient sedation protocol for dental treatment (Division of Oral and Maxillofacial Surgery/Department of Dentistry in Hanyang University Medical Center, S-plant Dental Hospital. and Grand Oral and Maxillofacial Surgery), total 937 patients had various dental treatments under intravenous conscious sedations with independent patient monitoring from March 2006 to March 2009. By reviewing charts, we analyzed the results of sedation and dental treatment, retrospectively. Results : Our sedation protocol had no severe postoperative complications requiring admission. while showing good compatibility with almost all dental treatments, with acceptable satisfaction of both patients and operators. Conclusion : We assure that our sedation protocol can be used efficiently and safely on routine outpatient basis. We also hope that this study will provide the concrete concepts to common dental practitioners, who desire to perform sedation for dental treatment.

Clinical Pharmacokinetics of Vancomycin in Ovarian Cancer Patients (난소암 환자에서 반코마이신의 임상약물동태)

  • Kim, Yang Woo;Choi, Jun Shik;Lee, Jin Hwan;Park, Jae Young;Choi, Byong Chul;Burm, Jin Pil
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.13-18
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    • 1998
  • The purpose of this study was to determine pharmacokinetic parameters of vancomycin using the compartment model dependent and compartment model independent analysis in 6 Korean normal volunteers and 8 ovarian cancer patients. Vancomycin was administered 1.0 g bolus by IV infusion over 60 minutes. The elimination rate constant ($\beta$), volume of distribution (Vd), total body clearance (CLt), and area under the plasma level-time curve (AUC) of vancomycin in normal volunteers using the compartment model dependent analysis were $0.150\pm0.030\;hr^{-1},\;32.9\pm2.81\;L/kg,\;5.36\pm0.63\;L/hr,\;and\;186.5\pm20.5\;{\mu}g/ml{\cdot}hr$, respectively. The $\beta$, Vd, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model dependent analysis were $0.109\;0.008\;hr^{-1},\;41.5\pm3.01\;L/kg,\;4.58\pm0.57\;L/hr\;and\;218.3\pm22.9\;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05,\;p<0.01) in $\beta$, Vd, CLt, and AUC between normal volunteers and ovarian cancer patients. The elimination rate constant (Kel), CLt, and AUC of vancomycin in normal volunteers using the compartment model independent analysis were $0.152\pm0.022\;hr^{-1},\;5.77\pm0.75\;L/hr,\;and\;173.2\pm22.5;{\mu}g/ml{\cdot}hr$, respectively. The Kel, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model independent analysis were $0.126\pm0.012\;hr^{-1},\;4.96\pm0.55\;L/hr,\;and\;201.7\pm25.6;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05, p<0.01) in Kel, CLt, and AUC between normal volunteers and ovarian cancer patients. And also, there was significant difference (p<0.05) in Kel of vancomycin in ovarian cancer patients between the compartment model dependent and independen analysis. It is necessary for effective dosage regimen of vancomycin in ovarian cancer patient to use these population parameters.

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Patient Controlled Analgesia of Alfentanil after a Total Abdominal Hysterectomy: A Comparison of the Intravenous and Epidural Route (전자궁 적출술 후 자가통증조절장치를 이용하여 정맥과 경막외로 투여된 Alfentanil의 진통효과 비교)

  • Choi, Soo Kyeong;Yoon, Seok Hwa;Lee, Jun Hwa;Hwang, Jae Ha;Jung, Woo Suk;Kim, Yoon Hee;Lee, Won Hyung
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.169-173
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    • 2007
  • Background: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). Methods: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of $750{\mu}g$ alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. Results: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. Conclusions: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.

Pharmacokinetic/Pharmacodynamic Analysis of Metoprolol in Dogs (실험견에서 Metoprolol 약리효과의 약동/력학적 검토)

  • Oh, Dong-Jin;Jang, In-Jin;Lee, Kyung-Hun;Yim, Dong-Seok;Kim, Hyung-Kee;Shin, Sang-Goo;Park, Chan-Woong;Shin, Jae-Gook
    • The Korean Journal of Pharmacology
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    • v.31 no.2
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    • pp.251-259
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    • 1995
  • Pharmacokinetics and pharmacodynamics of metoprolol, a selective beta-l blocker, were examined for 360 minutes after intravenous bolus administration of metoprolol to 6 dogs. Plasma concentration and excreted amount in the urine metoprolol were measured by liquid chromatography with fluorescence detection. PR interval and heart rate were measured by ECG monitoring. Blood pressure was monitored through intraarterial catheter in femoral artery and cardiac output by thermodilution method using Swan-Ganz catheter. To analyze the effect site concentration-response relationship, plasma concentration and pharmacological effects were simultaneously fitted to a two pharmacokinetic compartment linked to pharmacodynamic model with NONLIN program. Results are as follows. 1) The plasma concentration of metoprolol after intrvenous injection decreased biexponentially. The terminal half-life estimated was $1.33{\pm}0.40$ hours and the volume of distribution at steady state (Vdss) and the total body clearance were $1.04{\pm}0.4\;L/kg,\;6.55{\pm}2.21\;L/hr$, respectively. The central compartment volume of distribution and peripheral compartment volume of distribution were $0.35{\pm}0.14L/kg\;and\;0.69{\pm}0.34L/kg$. The renal clearance and intercompartment clearance were $0.53{\pm}0.25\;L/min\;and\;0.35{\pm}0.19\;L/min$. 2) Simulated biophase concentration-response curve shows hyperbolic relationship and the estimated concentration-effect relationship was best explained by Emax model when the prolongation of PR interval and the reduction of the heart rate were used as pharmacodynamic parameters. Emax and EC50 were estimated to be $26.3{\pm}4.7\;msec\;and\;88.8{\pm}82.3\;g/ml$ for PR interval, and $48.7{\pm}18.8\;beats/min\;and\;113.5{\pm}78.7\;ng/ml$ for heart rate, respectively. 3) The changes of cardiac output-effect site concentration relationship was best fitted by a linear model and the slope of the relationship was $0.005{\pm}0.003$. Diastolic blood pressure-effect site concentration relationship was also explained by the linear model and the slope of the relationship was $0.038{\pm}0.034$.

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Tissue concentrations of quercitrin in spotted sea bass (Lateolabrax maculatus) after extended feeding with fish mint (Houttuynia cordata) extract (어성초 (Houttuynia cordata) 추출물을 장기간 투여한 점농어 (Lateolabrax maculatus)에서 조직내 quercitrin 잔류 농도)

  • Bak, Su-Jin;Bae, Jun Sung;Lee, Chae Won;Park, Kwan Ha
    • Journal of fish pathology
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    • v.31 no.2
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    • pp.115-122
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    • 2018
  • The Houttuynia cordata has been utilized for various beneficial purposes in humans mainly because of its potent antioxidant principle quercitrin present in this plant. This study examines the possibility of producing a functional sea food commodity containing active principle quercitrin by feeding H. cordata for a extended period. Spotted sea bass (Lateolabrax maculatus) were fed a diet containing H. cordata at 0.1-1.0% levels for 1 month and tissue concentrations of quercitrin were analyzed in serum, hepatopancreas and muscle. It was observed that quercitrin was found in the ranking order of hepatopancreas>muscle>serum. After a bolus administration of quercitrin (20 mg/kg, oral) to spotted sea bass and Nile tilapia (Oreochromis niloticus), idential rank order was observed after 48 hr. In contrast, the order was liver>serum>muscle in rat and mice, indicating that higher quercitrin distribution occurs to the muscle in fishes compared with in mammals tested. High residue concentration of qeurcitrin in the edible tissue can be an advantageous property in terms of functional food production. High level H. cordata extract inclusion of 1.0% seems to have detrimental effects in spotted sea bass leading to growth retardation and hepatic damage. It was concluded that incorporation of H. cordata extract into diet can be a way of producing healthy foods. However the level of active extract needs fine tuning to avoid toxicity to fishes.

Characteristics of the Oropharyngeal Swallowing Impairment in Stroke Patient using the Modified Barium Swallowing Impairment Profile (MBSImP에 따른 뇌졸중 환자의 삼킴 장애 양상 분석)

  • Im, Ikjae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.36-44
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    • 2019
  • Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

Effect of Saline Flush on the Enhancement of Vascular and Liver via Saphenous Vein for Abdominal CT in Dogs

  • Kim, Song Yeon;Hwang, Tae Sung;An, Soyon;Hwang, Gunha;Go, Woohyun;Lee, Jong Bong;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.135-142
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    • 2021
  • The aim of this study was to evaluate the contrast effect if a saline flush following low-volume contrast medium bolus improves vascular and parenchymal enhancement using a saphenous vein in abdominal CT for small animals. Six clinically healthy beagle dogs underwent abdominal contrast-enhanced CT. They were divided into nine groups (each group, n = 6), according to the volume of contrast medium 1, 2, and 3 mL/kg, and volume of the saline solution 0, 5, and 10 mL. Dynamic CT scanning was performed at the hepatic hilum level. The maximum contrast enhancement, time to maximum enhancement, and time to equilibrium phase were calculated from the time attenuation curves. Mean attenuation values for all groups were measured in the aorta, portal vein, and liver. After contrast enhancement, grading of image quality regarding surrounding artifacts and evaluation of the hepatic hilum structures was performed. For comparison of the effect of the contrast material and saline solution doses, differences in mean attenuation values between the contrast medium 2 mL/kg without saline flush group and the remaining groups, and between contrast medium 3 mL/kg without saline flush group and the remaining groups, were analyzed for statistical significance. There were no significant differences between with and without saline flushing at the same contrast medium dose groups. There were no significant differences in peak values between the 3 mL/kg dose of contrast medium alone and the 2 mL/kg dose of contrast medium with saline solution flush. However, there was a significant difference in peak values between the 3 mL/kg dose of the contrast medium without the saline flush group and the 2 mL/kg dose of the contrast medium alone group. Grades of the artifacts were not significantly different in the saline flush regardless of the dose of the contrast medium. Using 2 mL/kg of contrast medium with saline solution flush resulted in similar liver parenchyma attenuation, compared with using 3 mL/kg of contrast medium without saline solution flush. In CT evaluation of hepatic parenchymal diseases, using 2 mL/kg of contrast medium with saline solution flush may yield decreased risk of contrast nephropathy and cost-saving.