• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.772-781
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• 1998

The purpose of this study was to assess the sedative effect of intranasal spray with midazolam for management of the uncooperative 20 children aged from 24 months to 92 months who required extensive treatment. The patients were given randomly a dose of 0.2mg/kg of intranasal placebo, intranasal spray with midazolam, and intranasal drop with midazolam. All the children were restrained in a pediwrap and were monitored with pulse oximeter for assessing the pulse rate and peripheral oxygen saturation. According to Fukuta's behavior rating scale, behavior was checked for evaluation of the clinical sedative effect. The obtained results were as follows: 1. Behavior score of intranasal spray with midazolam was lower than intranasal drop with midazolam(P<0.01). 2. Pulse rate was a significant change as a function of dental procedure(P<0.001), however the peripheral oxygen saturation was not influenced significantly by either adiministration route of drug or dental procedure. Clinically, intranasal spray with midazolam were safe and effective sedation in young children undergoing pediatric dental procedures.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.4
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• pp.223-227
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• 2012

Autism patients in general have bad oral hygiene. It is hard for autism patients to get dental treatment as poor communication. Therefore, they may have to be treated by deep sedation or general anesthesia in numerous cases. However, this process requires induction with mask, so it is not easy to do for disobliging autism patient. Midazolam is a water-soluble benzodiazepine, has been used in pediatric dentistry or dentistry for the handicapped because of rapid onset. Midazolam can be administered through oral, rectal, intramuscular,intravenous, and intranasal (IN) routes. IN route of midazolam may be considered as effective way to allay for uncooperative autism patients before general anesthesia. In this case report, two autism patients required dental treatment. Intranasal spray of midazolam before general anesthesia was safe and effective procedure of behavioral management.

• 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.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.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 Chest Surgery
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• v.19 no.2
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• pp.325-330
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• 1986

Eosinophilic granuloma is one of the histiocytosis X. It may occur in any bone and tissues, but the one originated from the sternum was rarely reported. Recently, we experienced an eosinophilic granuloma at the manubrium sterni, associated with diabetes insipidus, which was surgically resected. Although intranasal spray of DDAVP has been used for the control of diabetes insipidus, the bony lesion was remitted. With the brief review of the literatures, we report the case.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1998.11a
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• pp.137-137
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• 1998

Stability, efficacy, absorption and toxicity of a new nasal spray formulation including salmon calcitonin were studied in the laboratory animals. After the effects of many excipients on the stability of salmon calcitonin were evaluated using HPLC system, we selected taurine. Our experimental composition of salmon calcitonin contains taurine as a stabilizer and HPMC (hydroxypropylmethyl cellulose) as an adhesive polymer. After intranasal administration of salmon calcitonin formulations, Mia$\^$(R)/, Men$\^$(R)/ and experimental composition, 22 IU to rats, the reduction percentages of calcium concentration in plasma (ΔD%) were 16.3%, 12.9% and 20.8%, respectively. After intranasal administration of Mia$\^$(R)/, Men$\^$(R)/ and experimental composition to rats, C$\sub$MAX/ (205${\pm}$161, 244${\pm}$117, and 330${\pm}$202 pg/$m\ell$, respectively) and AUC (41585${\pm}$22070, 41191${\pm}$19125, and 63357${\pm}$43126 pg. min/$m\ell$, respectively) were calculated. The permeation coefficients 10$\^$-7/,cm/sec) of salmon calcitonin in Mia$\^$(R)/, Men$\^$(R)/ and experimental composition using Ussing chamber with rabbit nasal mucosa were 4.7${\pm}$1.5, 0.75${\pm}$0.4 and 5.3${\pm}$1.1, respectively. The experimental composition with taurine and HPMC was proved to be excellent because it improved the stability of salmon calcitonin and inhanced the absorption of salmon calcitonin and was not irritative to the nasal mucosa.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.6
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• pp.303-315
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• 2023

Painless treatment determines the quality of pediatric dental care. Although local anesthesia has been used to manage pain in dentistry, children often cite traditional aspirating syringes as a symbol of fear and pain. Adequate pain control during dental procedures may help alleviate fear and anxiety and instill positive oral health attitudes in children. Newer approaches such as intranasal spray, centbucridine, jet injectors, buzzy devices, and acupressure have been developed to help dentists provide near-painless injections while reducing dental anxiety. This review aims to summarize newer approaches to alleviate pain and anxiety in children.

• 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%.

• Korean Journal of Poultry Science
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• v.8 no.2
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• pp.77-89
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• 1981

The experimental study was undertaken to confirm the effect of vaccination of birds with Newcastle disease (ND) vaccines on the Market by use of th. various vaccination programs. Sixteen groups of birds varying from 2 to f days of age, which were originated from hyper-immunised hens against ND were immunised by three different ways, a live vaccine only, a killed vaccine only, and the combination of a live and killed vaccine according to the each schedule of employed programs. In the administration of a live vaccine only, birds were immunized by one of following methods, the combination of intranasal and intraocular inoculation, intramuscular inoculation, via drinking water and the double inoculation by spray and drinking water application. Except for the double application, all the birds were vaccinated 2,3 or 4 times with two volumes of the virus dose (drinking water application) instructed by the commercial vaccine laboratory, until 21, 28 or 30 days of age, and all the immunized birds 19, 21 or 28 days postvaccination were challenged intramuscularly with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. In the administration of the combination of a live and killed vaccine, birds were immunized 2 or 3 times intranasally at first until 14 or 28 days of age with the same dose of the above experiment of a live vaccine, and then inoculated intramuscularly 1 or 2 times until 60 days of age with 1.0 $m\ell$ of a killed vaccine. And all immunized birds 11 days postvaccination were challenged with the same procedure of the above experiment. In the administration of a killed vaccine only, birds were immunized 3 times intramuscularly until 28 days of age with varied dose (0.2-0.5 $m\ell$) of a killed vaccine and all immunized birds 33 days postvaccination were challenged with the same procedure of the above experiment. The results obtained are summerised as follows: All birds vaccinated by using the combination of a live and killed vaccine program or a killed vaccin only appeared to be refractory. without any sign of illness, to the challenge exposure with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. On the other hand, the survival rates of birds of live vaccine groups immunized by a number of vaccine program such as Salsbury's day old program, 3-3-3 program, the Institute of Veterinary Reserch program and Multiple inoculation program, were 39.58%, 43.7%, 43.75% and 47.80%, respectively. And the survival rates of birds vaccinated with a live vaccine by 4 different ways of administration, i.e., double inoculation by water and aerosol application, intramuscular injection, intranasal instillation and via 4.inking water were 87.50%, 64.06%, 42.18% and 25.00%, respectively.