• 성인간호학회지
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• 제28권2호
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• pp.127-135
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• 2016

Purpose: The aim of this study was to identify the effect of dextrose intravenous fluid (IVF) on the blood glucose levels taken from both fingertips of patients with diabetes mellitus (DM) and those without DM. Methods: From October 2012 to February 2013, 21 DM and 25 non-DM patients were recruited. Blood glucose levels taken from the both fingertips of patients at 7AM while IVF was not infusing and at 11AM, 5PM, and 9PM while IVF was infusing. Results: The differences between the mean values of blood glucose from the fingertips at four different times was not statistically significant in DM patients as well as non-DM patients. Also intra-class correlation for blood glucose levels from the fingertips with and without IVF infusion in both groups was shown over about 0.95 at each time (p<.001). Conclusion: Blood glucose levels measured in the same fingertips of both arms were the same regardless of dextrose IVF infusion. The results indicated that IVF with dextrose may not have any significant effect on the fingertip results of blood glucose level. This study may suggest that patients' both arms and any fingertips can be used for blood glucose monitoring even when the patients are on dextrose IVF infusion.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.217-226
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• 2019

Background: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. Methods: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). Results: For all groups, the duration of dental treatments was $43{\pm}18$ minutes, total sedation time was $73{\pm}23$ minutes, and total BIS values was $57{\pm}12$. The propofol maintenance dosage values for each group were: mental retardation, $3{\pm}0.5(2-4){\mu}g/ml$; autism, $3.1{\pm}0.7(2-5){\mu}g/ml;$; brain lesion, $2.8{\pm}0.7(1.5-5){\mu}g/ml;$; genetic disease, $2.9{\pm}0.9(1-4){\mu}g/ml;$ and dementia $2.3{\pm}0.7(1-3.4){\mu}g/ml;$. Conclusions: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.

• The Korean Journal of Physiology and Pharmacology
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• 제28권2호
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• pp.121-127
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• 2024

Vancomycin is a frequently used antibiotic in intensive care units, and the patient's renal clearance affects the pharmacokinetic characteristics of vancomycin. Several advantages have been reported for vancomycin continuous intravenous infusion, but studies on continuous dosing regimens based on patients' renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient's renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin administration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomycin serum concentration. Vancomycin serum concentration was affected by vancomycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = -1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R² = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regimen for vancomycin.

• 대한임상독성학회지
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• 제9권2호
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• pp.56-60
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• 2011

Purpose: The optimal dose of oximes for use in the treatment of organophosphorus pesticide poisoning has not been conclusively established. In this retrospective study, we assessed the effectiveness of the use of high-dose pralidoxime infusion in treating organophosphorus pesticide poisoning. Methods: From January 1998 to December 2009, 71 patients visited the hospital Emergency Department (ED) as a result of organophosphate pesticide intoxication. All of these patients received an initial bolus of 2 g of pralidoxime as the first step of treatment. Patients who then received continuous infusion of pralidoxime at a dose of 500 mg/hr were entered into study group 1 (low dose), and those treated by continuous infusion of pralidoxime at a dose of 1000 mg/hr were entered into study group 2 (high-dose). Plasma cholinesterase activities for each patient were evaluated at ED arrival and re-evaluated 24 hours after pralidoxime infusion. The effectiveness of the two treatment modalities was gauged by comparing the required duration of mechanical ventilation, time spent in the intensive care unit (ICU) and total time spent in the hospital. Results: The mean duration of mechanical ventilation was $9.98{\pm}6.47$ days for group 1 and $4.39{\pm}6.44$ days for group 2. The respective mean duration of time spent in ICU and the total number of days in the hospital were $16.38{\pm}18.84$ days and $21.87{\pm}20.16$ days for group 1, and $7.83{\pm}9.99$ days and $11.71{\pm}13.53$ days for group 2. Highdose pralidoxime treatment was associated with shorter required durations for mechanical ventilation, ICU and hospital stay. In addition, plasma cholinesterase reactivation rates were higher for those patients receiving high-dose pralidoxime treatment. Conclusion: The results suggest that high-dose pralidoxime treatment has greater efficacy for patients suffering from organophosphorus pesticide poisoning.

• 한국약용작물학회지
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• 제19권4호
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• pp.276-286
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• 2011

Morus alba (Mulberry) leaves were exposed to fermentation for varying amounts of time: no fermentation (0 min, MANF), medial fermentation (10 h, MAMF), and full fermentation (24 h, MAFF). The chemical compositions of the teas were determined and compared with those of commercial Camellia sinensis teas. The results showed that mulberry leaf teas contained significantly higher amounts of ash and fat than Camellia sinensis tea. Compared with Camellia sinensis teas, all mulberry leaf teas contained significantly more total free amino acids (24.26~54.25mg L-glutamic acid equivalent $g^{-1}$), but the concentration of caffeine was relatively low for mulberry leaf teas. High thiamine, riboflavin, and niacin contents were found in all mulberry leaf teas, but ascorbic acid and pyridoxine were found at higher levels in Camellia sinensis teas than in mulberry leaf teas. Color measurements demonstrated that mulberry leaf tea infusions generally had lower $a^*$ (greenness) and $b^*$ (yellowness) values than Camellia sinensis tea infusions. All infusions exhibited low turbidity levels (less than 10%). The contents of total phenols were measured as 71.8 and 74.9mg 100 $ml^{-1}$ infusion in MANF and MAFF, respectively, but the MAMF tea infusion showed significantly lower total phenols (64.6mg 100$ml^{-1}$ infusion). The total flavonoid contents of mulberry leaf tea infusions were lower (8.9~20.6mg 100 $ml^{-1}$ infusion) than those of Camellia sinensis teas and thus had lower antioxidant capacities (DPPH: 326.8~526.9 ${\mu}M$ trolox equivalent $g^{-1}$ and FRAP: 364.6~387.6 ${\mu}M$ trolox equivalent $g^{-1}$) than Camellia sinensis teas. The amounts of ${\gamma}$-aminobutyric acid (GABA) and rutin were higher in fermented mulberry leaf teas; the level of GABA increased with increasing fermentation time and the content was highest in MAFF, but rutin content was highest in MAMF.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권1호
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• pp.19-28
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• 2023

Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

• Asian-Australasian Journal of Animal Sciences
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• 제19권7호
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• pp.1010-1018
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• 2006

A glucose clamp technique was used to investigate the effects of non-protein energy intake on tissue responsiveness and sensitivity to insulin for glucose metabolism in intact adults male goats. Three goats were fed diets at 1.0, 1.5 and 2.0 times of ME for maintenance, each for 21 d. Crude protein intake was 1.5 times of maintenance requirement in each treatment. Tissue responsiveness and sensitivity to insulin were evaluated using a hyperinsulinemic euglycemic clamp technique with four levels of insulin infusion, beginning at 13 h after feeding. Concentrations of plasma metabolites and insulin were also measured at 3, 6 and 13 h after feeding, for evaluating effects of non-protein energy intake on the metabolic status of the animals. Increasing non-protein energy intake prevented an increase in plasma NEFA concentration at 13 h after feeding (p = 0.03). Plasma urea-nitrogen and total amino-nitrogen concentrations decreased (p<0.01) and increased (p = 0.03), respectively, with increasing non-protein energy intake across time relating to feeding. Plasma insulin concentration was unaffected (p = 0.43) by non-protein energy intake regardless of time relating to feeding. In the glucose clamp experiment, increasing non-protein energy intake decreased numerically (p = 0.12) the plasma insulin concentration at half-maximal glucose infusion rate (insulin sensitivity), but did not affect (p = 0.60) maximal glucose infusion rate (tissue responsiveness to insulin). The present results suggest that an increase in non-protein energy intake may enhance insulin sensitivity for glucose metabolism, unlike responsiveness to insulin, in adult male goats. The possible enhancement in insulin sensitivity may play a role in establishing anabolic status in the body, when excess energy is supplied to the body.

• Korean Journal of Anesthesiology
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• 제71권6호
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• pp.459-466
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• 2018

Background: To compare the effects of intraoperative infusions of balanced electrolyte solution (BES)-based hydroxyethyl starch (HES) and saline-based albumin on metabolic acidosis and acid/base changes during major abdominal surgery conducted using Stewart's approach. Methods: Forty patients, aged 20-65 years, undergoing major abdominal surgery, were randomly assigned to the HES group (n = 20; received 500 ml of BES-based 6% HES 130/0.4) or the albumin group (n = 20; received 500 ml of normal saline-based 5% albumin). Acid-base parameters were measured and calculated using results obtained from arterial blood samples taken after anesthesia induction (T1), 2 hours after surgery commencement (T2), immediately after surgery (T3), and 1 hour after arriving at a postanesthetic care unit (T4). Results: Arterial pH in the HES group was significantly higher than that in the albumin group at T3 ($7.40{\pm}0.04$ vs. $7.38{\pm}0.04$, P = 0.043), and pH values exhibited significant intergroup difference over time (P = 0.002). Arterial pH was significantly lower at T3 and T4 in the HES group and at T2, T3, and T4 in the albumin group than at T1. Apparent strong ion difference (SIDa) was significantly lower at T2, T3, and T4 than at T1 in both groups. Total plasma weak nonvolatile acid ($A_{TOT}$) was significantly lower in the HES group than in the albumin group at T2, T3 and T4 and exhibited a significant intergroup difference over time (P < 0.001). Conclusions: BES-based 6% HES infusion was associated with lower arterial pH values at the end of surgery than saline-based 5% albumin infusion, but neither colloid caused clinically significant metabolic acidosis (defined as an arterial pH < 7.35).

• Journal of Acupuncture Research
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• 제17권1호
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• pp.189-219
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• 2000

To study the effects of anti-cancer, anti-metastasis and immune response improvement effects of aqua-acupuncture with Rubi Fructus infusion solution, we used Rubi Fructus infusion solution(taken by water-alcohol method) put into Chung-wan (CV12) and Chok-Samni(ST36) of BALB/c or C57BL/6 which are corresponding to humanbody. We observed the cytotoxicity, the effect on the expression of MMP-9 gene, the ability to control cancer cell proliferation, change of body weight, surviving number, median surviving time, increase of life span, changes in amount of leukocyte, erythrocyte, platelet, total protein, creatinine, glucose and LDH, weight of spleen, number of pulmonary colony, histological analysis on tissue metastasis of lung and liver, splenic cell proliferation, the expression of cytokine gene, the number of $CD4^+$, $CD8^+$, $CD19^+$ and NK cell, and concluded like this. The results were obtained as follows : 1. Effects of Anti-cancer 1) The cytotoxicity about B16-F10 cell line of $2^0$, $2^{-1}$, $2^{-2}$, $2^{-3}$, $2^{-5}$, $2^{-6}$, $2^{-7}$, $2^{-8}$ diluent groups in Rubi Fructus infusion solution treatment was inhibited significantly, compared with control group. 2) The cytotoxicity about HT1080 cell line of $2^0{\sim}2^{-8}$ diluent groups in Rubi Fructus infusion solution treatment was inhibited significantly, compared with control group. 3) The effect on expression of MMP-9 gene was inhibited significantly in all the sample groups, compared with control group. 4) The effect on the control-ability on the cancer cell proliferation showed cytotoxicity significantly in $2^0$, $2^{-1}$, $2^{-2}$, $2^{-3}$, $2^{-4}$, $2^{-5}$, $2^{-6}$, $2^{-7}$, diluent groups. 2. Effects of Anti-metastasis 1) S-180 cancer cell line transplants in BALB/c mice were inhibited significantly in weight increase in all the sample groups, compared with control group. The surviving number increased in almost sample groups, except one group put into Chok-Samni(ST36) with 20% Rubi Fructus infusion solution treatment group that showed same number of the control group. 2) S-180 cancer cell line transplants in BALB/c mice showed high MST significantly in almost sample groups, compared with control group. But one group put into Chok-Samni(ST36) with 20% Rubi Fructus infusion solution showed low MST than control group. 3) The group injected in vein with B16-F10 cancer cell line in C57BL/6 mice showed increased ILS than control group significantly in anti-metastasis test. 3. Effects of Immune response improvement 1) The group injected in vein with B16-F10 cancer cell line in C57BL/6 mice were increased significantly in the number of leukocyte and glucose, and decreased significantly in the amount of platelet and LDH, compared with control group. However, there's no significant increase or decrease in number of erythrocyte, total protein and creatinine. 2) We couldn't find any significant relation in spleen weight of the sample group. 3) In pulmonary colony, sample group was decreased significantly, compared with control group. 4) Histological analysis of sample group inhivited compared with that of control group in both of lung and liver. 5) In immune system, all the sample groups showed having more relevancy to the effect on splenic cell proliferation than normal group. 6) Cytokine gene increased in almost sample groups, except one group treated with $50{\mu}g/m{\ell}$ Rubi Fructus infusion solution on IL-12. 7) In flow cytometry there's no significant relation in number of $CD8^+$ cell, however, the number of $CD4^+$, $CD19^+$ cell and NK cell in sample group had more relation than in control group. Above the results showed that aqua-acupuncture of Rubi Fructus solution has effects of anti-cancer, and-metastasis and immune response improvement.

• Archives of Pharmacal Research
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• 제25권6호
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• pp.932-939
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• 2002

The aim of the present study was to determine the characteristics of cytisine on the secretion of catecholamines (CA) in isolated perfused rat adrenal glands, and to clarify its mechanism of action. The release of CA evoked by the continuous infusion of cytisine ($1.5{\times}10^{-5} M$) was time-dependently reduced from 15 min following the initiation of cytisine infusion. Furthermore, upon the repeated injection of cytisine ($5{\times}10^{-5}$), at 30 min intervals into an adrenal vein, the secretion of CA was rapidly decreased following the second injection. Tachyphylaxis to the release of CA was observed by the repeated administration of cytisine. The cytisine-induced secretion of CA was markedly inhibited by pretreatment with chlorisondamine, nicardipine, TMB-8, and the perfusion of $Ca^{2+}$-free Krebs solution, while it was not affected by pirenzepine or diphenhydramine. Moreover, the secretion of CA evoked by ACh was time-dependently inhibited by the prior perfusion of cytisine ($5{\times}10^{-6} M$). Taken together, these experimental data suggest that cytisine causes secretion of catecholamines from the perfused rat adrenal glands in a calcium-dependent fashion through the activation of neuronal nicotinic ACh receptors located in adrenomedullary chromaffin cells. It also seems that the cytisine-evoked release of catecholamine is not relevant to the activation of cholinergic M$_1$-muscarinic or histaminergic receptors.