• Journal of Chest Surgery
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• 제56권6호
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• pp.452-455
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• 2023

Patients who have undergone mechanical valve replacement require anticoagulation therapy with warfarin to prevent thromboembolism. However, administering warfarin to pregnant patients increases their risk of warfarin embryopathy or central nervous system disorders. Consequently, safer alternatives, such as heparin or low-molecular-weight heparin injection, are substituted for warfarin. However, limited research has been conducted on this subject, with no large-scale studies and particularly few investigations involving multiparous patients. A patient who had previously undergone mechanical mitral valve replacement for atrial septal defect and mitral stenosis received anticoagulant therapy with enoxaparin during 2 pregnancies. Upon confirmation of pregnancy, warfarin was replaced with subcutaneously injected enoxaparin with a dosage of 1 mg/kg at 12-hour intervals. The enoxaparin dosage was controlled using an anti-factor Xa assay, with a target range of 0.3-0.7 IU/mL. Intravenous heparin injections were administered starting 3 days prior to the expected delivery date and were continued until delivery, after which warfarin was resumed. No complications were observed during the deliveries.

• Journal of Radiation Protection and Research
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• 제19권3호
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• pp.230-234
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• 1994

본 연구에서는 마우스에 이미 오염된 방사성스트론들(Sr-85)을 제거하는데 수용성카이토산이 어느정도 효과가 있는지 알아보고자 하였다. Sr-85를 정맥주사한 경우 주사후 1일째의 체내 잔류량은 $72.9{\pm}5.7%$, 5일째는 $57.7{\pm}1.9%$, 7일째는 $54.2{\pm}1.4%$로 서서히 감소하였으며, Sr-85를 복강내 주사한 경우는 주사후 5일째 $54.4{\pm}1.2%$, 15일째 $50.6{\pm}0.8%$로 정맥주사에 비해 낮은 잔류량을 보였다(5일째 잔류량의 비교, P<0.05). 0.3% 수용성카이토산을 1회 정맥주사해준 제2군 및 10% 수용성카이토산을 식이중에 섞어 먹인 제5군은 각각의 대조군에 비해 체내 잔류방사능의 차이가 없었으나(P>0.05), 0.3% 수용성카이토산을 3일간 정맥주사 한 제3군과 3% 수용성카이토산을 이틀 간격으로 15일간 복강내 주사한 계6군에서는 각각의 대조군에 비해 낮은 잔류방사능을 보였다(P<0.01). 결론적으로 수용성카이토산을 연속적으로 정맥투여하거나 복강내 투여하는 경우에는 스트론튬의 골대사촉진 또는 골중의 스트론튬과의 반응등을 통해 그 배출을 촉진시킬 것으로 사료되었다.

• 폴리머
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• 제38권3호
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• pp.333-337
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• 2014

PVC 재질로 만들어진 기존의 수액백과 튜브는 가소제인 DEHP(diethylhexyl phthalate)를 함유하고 있어 정맥 주사 시에 가소제의 용출과 약물 흡착이라는 심각한 취약점을 내재하고 있다. 본 연구에서는 폴리올레핀 재질로 만들어진 non-PVC 수액튜브(가소제 미포함)를 개발하고, 이들 튜브 내면에서의 약물 흡착 거동을 기존의 PVC 및 PU 재질의 수액 튜브와 비교 검토하므로써, 수액 주사 시 약물 흡착으로 인한 약효 감소 효과를 최소화 가능한 방안을 도출하고자 한다. 4가지의 non-PVC 수액튜브는 폴리에틸렌(PE), 폴리프로필렌(PP), syndiotactic 1,2-폴리부타 다이엔(PB)과 스타이렌-에틸렌(SE)의 공중합 탄성체를 사용하여 압출하여 제조하였으며, 이들은 기존의 PVC 수액튜브의 기계적 특성과 동등한 물성을 나타내었다. 아울러 제조된 폴리올레핀 재질의 4가지 수액튜브들은 기존의 PVC 및 PU 재질의 수액튜브 대비 우수한 약물흡착 방지 효과를 나타내었다. 따라서 이들은 약물흡착 방지용 수액튜브뿐 아니라 DEHP의 용출 위험이 배제된 안전한 수액튜브로서 임상 적용 가능할 것이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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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.

• Journal of Ginseng Research
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• 제26권3호
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• pp.132-138
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• 2002

본 연구에서는 혈류량의 변화를 실시간으로 측정할 수 있는 레이져 도플러 혈류량측정장치를 이용하여 피부혈류 및 뇌혈류량에 미치는 고려홍삼의 사포닌과 비사포닌의 효능을 연구하고자 고려홍삼의 정맥내 복강내 및 구강내로 주입하고 혈류의 변화를 관찰하여 다음과 같은 결론을 얻었다. 고려 홍삼의 사포닌 성분은 피부혈류량에는 영향을 주지 않으나 뇌혈류량을 증가시키는 효능이 있다. 고려 홍삼의 비사포닌 성분은 피부혈류량 및 뇌혈류량에 거의 영향을 주지 않았다. 고려홍삼사포닌에 의한 뇌혈류량의 증가는 복강내 및 경구로 투여할 경우는 관찰할 수 있으나 정맥내로 직접 투여할 경우는 관찰되지 않았다. 이상의 결과를 종합해 볼 때 고려홍삼의 사포닌 성분은 뇌혈류량을 증가시키는 혈류개선작용이 있는 것으로 사료된다.

• The Korean Journal of Pain
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• 제20권1호
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• pp.15-20
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• 2007

Background: Lipo-prostaglandin E1 (Lipo-$PGE_1$) has vasodilating and platelet aggregation inhibitory characteristics and it has been used as a treatment for patients with blood flow dysfunction disease. Based on the mechanisms of lumbar spinal stenosis, including veno congestion, neuro-ischemia and mechanical compression, we aimed to study whether intravenous Lipo-$PGE_1$ injection has any therapeutic effect on hyperalgesia in a rat foraminal stenosis model. Methods: In this study, twenty male Sprague-Dawley rats were divided into the control (n = 10) and Lipo-$PGE_1$ (n = 10) groups. A small stainless steel rod was inserted into the L5-6 intervertebral foramen to induce intervertebral foramen stenosis and chronic DRG compression. In the Lipo-$PGE_1$ group, $0.15{\mu}g/kg$ of Lipo-$PGE_1$ were injected intravenously via a tail vein for 10 days starting from the $3^{rd}$ day after operation. Behavioral testing for mechanical and thermal hyperalgesia was performed for 3 weeks after the injections. Results: From the $10^{th}$ day after Lipo-$PGE_1$ injection, the rats in the experimental group showed significant recovery of their mechanical threshold, and this effect was maintained for 3 weeks. No significant differences of the thermal hyperalgesia were observed between the two groups. Conclusions: These findings suggest that intravenously injected Lipo-$PGE_1$ may be effective for alleviating neuropathic pain, which isthe main symptom of spinal stenosis, by improving the blood flow dysfunction.

• 대한의용생체공학회:의공학회지
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• 제29권1호
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• pp.66-72
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• 2008

The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of computed tomography (CT) contrast media can produce the compartment syndrome. The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The extravasation detection accessory (EDA) system was composed of a strain gage, an amplifier and a computer based system. A strain gage pliable adhesive patch was applied to the skin aver the intravenous catheter and the catheter was connected to the power injector with a cable to monitor the resolution data. If the programmed monitoring, which was developed with MS Visual C++, at the extravasation occurred, then the injection was interrupted the auto injector. CT was used to demonstrate the clinically important extravasation. This study was a prospective, observational study in which the EDA system was used to monitor the automated mechanical injection of contrast material in 7 dogs. There were two true-positive cases (range of extravasation volumes: $18{\sim}22ml$), twenty three true-negative cases, three false-positive cases and no false-negative cases. The EDA system had a sensitivity of 100% and a specificity of 88% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors. The EDA system is easy to use safe and accurate for the monitoring extravasation of the intravenous injections, and this system may prove especially useful in CT applications.

• The Korean Journal of Pain
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• 제11권1호
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• pp.1-6
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• 1998

Background: The role of nitric oxide(NO) in analgesia from opioids is controversial. On the one hand, IV morphine analgesia is enhanced by IV injection of NO synthase inhibitors. On the other hand, IV morphine results in increased release of NO in the spinal cord. There have been no behavioral studies examining the interaction between IV morphine and intrathecal injection of drugs which affect NO synthesis. Method: Rats were prepared with chronic lumbar intrathecal catheters and were tested withdrawal latency on the hot plate after 3~5 days of surgery. Antinociception was determinined in response to a heat stimulus to the hind paw before and after IV injection of morphine, 2.5 mg/kg. Twenty minutes after morphine injection, rats received intrathecal injection of saline or the NO synthase inhibitors, L-NMMA or TRIM, the NO scavenger, PTIO, or the NO synthase substrate, L-Arginine. Intrathecal injections, separated by 15 min, were made in each rats and measurements were obtained every 5 min. Result: Mophine produced a 60~70% maximal antinociceptive response to a heat stimulus in all animals for 60 min in control experiments. Intrathecal injection of idazoxane decreased antinociception of IV morphine. The NO synthase inhibitors and the NO scavenger produced dose-dependent decreases in antinociceptive effect of morphine, whereas saline as a control group and L-Arginine as the NO substrate had no effect on antinociception of morphine. Conclusion: The present study supports the evidences that systemic morphine increase the nitrite in cerebrospinal fluid and dorsal horn. These data suggest that the synthesis of NO in the spinal cord may be important to the analgesic effect of IV morphine and increased NO in spinal cord has different action from the supraspinal NO.

• The Korean Journal of Pain
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• 제31권3호
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• pp.155-173
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• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

• International Journal of Oral Biology
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• 제41권4호
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• pp.191-197
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• 2016

The present study was to evaluate effects of vitamin E on intravenous administration of lidocaine-induced antinociception. Experiments were carried out using male Sprague-Dawley rats. Orofacial formalin-induced nociceptive behavioral responses were used as the orofacial animal pain model. Subcutaneous injection of formalin produced significant nociceptive scratching behavior. Intraperitoneal injection of 5 and 10 mg/kg of lidocaine attenuated formalin-induced nociceptive behavior in the 2nd phase, compared to the vehicle-treated group. Intraperitoneal injection of 1 g/kg of vitamin E also attenuated the formalin-induced nociceptive behavior in the 2nd phase, compared to the vehicle-treated group. However, low dose of vitamin E (0.5 g/kg) did not affect the nociceptive behavioral responses produced by subcutaneous injection of formalin. The present study also investigated effects of intraperitoneal injection of both vitamin E and lidocaine on orofacial formalin-induced behavioral responses. Vehicle treatment affected neither formalin-induced behavioral responses nor lidocaine-induced antinociceptive effects. However, intraperitoneal injection of 0.5 g/kg of vitamin E enhanced the lidocaine-induced antinociceptive effects in the 2nd phase compared to the vehicle-treated group. Intraperitoneal injection of naloxone, an opioid receptor antagonist, did not affect antinociception produced by intraperitoneal injections of both vitamin E and lidocaine. These results suggest that treatment with vitamin E enhances the systemic treatment with lidocaine-induced antinociception and reduces side effects when systemically treated with lidocaine. Therefore, the combined treatment with vitamin E and lidocaine is a potential therapeutic for chronic orofacial pain.