• Title/Summary/Keyword: Korean healthy volunteers

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Prevention of thromboembolism with ticlopidine and aspirin after cardiac valve replacement (심장변막치환후 Ticlopidine과 Aspirin의 혈전방지 효과)

  • Kim, Gwang-Taek;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.35-42
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    • 1986
  • Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

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Functional MRI Study of Changes in Brain Activity by Manual Acupuncture at LI11 or ST36 (곡지, 족삼리 침자극이 뇌활성화에 미치는 영향에 대한 뇌기능적 자기공명영상을 이용한 연구)

  • Cho, Seung-Yeon;Jahng, Geon-Ho;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Gho, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Park, Jung-Mi
    • The Journal of Korean Medicine
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    • v.31 no.1
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    • pp.81-92
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    • 2010
  • Objectives: The objective of this study was to assess bra in activation and difference by LI11 or ST36 acupuncture stimulation using functional MRI (fMRI). Methods: A total of 10 healthy right-handed volunteers were studied. LI11 acupuncture and ST36 acupuncture stimulations were applied in order on the left. The block design paradigm of RARARA was used for the task, with R representing rest and A representing stimulation, and each period lasted 30 seconds. fMRI data were analyzed using SPM2. Results: The left LI11 acupuncture stimulation activated both sides of the inferior parietal lobule, the left side of the extra-nuclear, culmen and inferior semi-lunar lobules. On the right side, the nodule and midbrain regions were activated by the left LI11 acupuncture stimulation. The left ST36 acupuncture stimulation activated the right side of the superior frontal gyrus, middle frontal gyrus, superior parietal lobule, inferior semi-lunar lobule and pyramis. On the left side, the sub-gyral, middle temporal gyrus, fusiform gyrus, supramarginal gyrus, extra-nuclear, cingulate gyrus and fastigium regions were activated by the left ST36 acupuncture stimulation. Besides, both sides of the paracentral lobule, inferior parietal lobule, culmen, cerebellar tonsil and midbrain regions were activated. Conclusions: In conclusion, brain signal activation patterns according to acupoints were observed to differ, and ST36 acupuncture stimulation activated more regions than LI11. It is supposed that LI11 and ST36 acupuncture stimulations have an influence on motor function and sensory aphasia, and these stimulations thus represent potential for ocular motor dysfunction, discriminative touch or position sense disorder. Moreover, ST36 acupuncture stimulation activated the cingulate gyrus of the limbic system, so it seems to have an influence over autonomic functions.

Effects of Korean Ginseng, Korean Red Ginseng and Fermented Korean Red Ginseng on Cerebral Blood Flow, Cerebrovascular Reactivity, Systemic Blood Pressure and Pulse Rate in Humans (인삼, 홍삼 및 발효 홍삼이 정상인의 뇌혈류, 평균혈압, 맥박수에 미치는 영향)

  • Jeong, Dong-Won;Hong, Jin-Woo;Shin, Won-Jun;Park, Young-Min;Jung, Jae-Han;Kim, Chang-Hyun;Min, In-Kyu;Park, Seong-Uk;Jung, Woo-Sang;Park, Jung-Mi;Go, Chang-Nam;Cho, Ki-Ho;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.38-50
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    • 2006
  • Objectives: The aim of this study was to evaluate the effects of Korean ginseng (KG), Korean red ginseng (KRG) and fermented Korean red ginseng (FKRG) extracts on cerebral hemodynamics and to compare distinction of each extract. Methods: Ten healthy male volunteers $(26.0{\pm}1.8yrs)$ participated in the study according to double-blind and cross-over protocols. Each volunteer was blindly administered 500mg of KG, KRG, FKRG extract or placebo (Dextrin). Blinded researchers measured changes of hyperventilation-induced cerebrovascular reactivity (CVR), mean blood flow velocity (MBFV) of middle cerebral arteries (MCAs) and corrected blood flow velocity at $P_{ETCO2}=40mmHg$ (CV40) using transcranial Doppler ultrasound (DWL Co., Germany). Researchers also observed changes of mean blood pressure (MBP), pulse rate (PR) and expiratory $CO_2$ using S/5 Collector (Datex-Ohmeda Co., Finland). The evaluation was performed at basal condition, and repeated at 1, 2, 3, 4 and 5 hours after administration. Results: MBFV and CV40 in the KRG group tended to rise at I hour after administration, while those of the FKRG group tended to rise at 2 hours after administration. CVR increased significantly after 1 hour in the KRG group (p=0.009) and after 2 hours in the FKRG group (p=0.035), respectively. The KG group showed increasing tendency at 4 hours after administration. No group showed significant difference from the placebo in changes of MBP and PR. Conclusions: It is suggested that KG, KRG and FKRG extracts have effects of enhancing CVR and thus of increasing cerebral blood flow in human subjects.

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Alterations of Cerebral Blood Flow and Cerebrovascular Reserve in Patients with Chronic Traumatic Brain Injury Accompanying Deteriorated Intelligence (지능 저하를 동반한 두부외상 환자에서 뇌혈류 및 혈류예비능의 변화)

  • Song, Ho-Chun;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.183-198
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    • 2000
  • Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

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Comparison of Algorithms for Generating Parametric Image of Cerebral Blood Flow Using ${H_2}^{15}O$ PET Positron Emission Tomography (${H_2}^{15}O$ PET을 이용한 뇌혈류 파라메트릭 영상 구성을 위한 알고리즘 비교)

  • Lee, Jae-Sung;Lee, Dong-Soo;Park, Kwang-Suk;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.288-300
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    • 2003
  • Purpose: To obtain regional blood flow and tissue-blood partition coefficient with time-activity curves from ${H_2}^{15}O$ PET, fitting of some parameters in the Kety model is conventionally accomplished by nonlinear least squares (NLS) analysis. However, NLS requires considerable compuation time then is impractical for pixel-by-pixel analysis to generate parametric images of these parameters. In this study, we investigated several fast parameter estimation methods for the parametric image generation and compared their statistical reliability and computational efficiency. Materials and Methods: These methods included linear least squres (LLS), linear weighted least squares (LWLS), linear generalized least squares (GLS), linear generalized weighted least squares (GWLS), weighted Integration (WI), and model-based clustering method (CAKS). ${H_2}^{15}O$ dynamic brain PET with Poisson noise component was simulated using numerical Zubal brain phantom. Error and bias in the estimation of rCBF and partition coefficient, and computation time in various noise environments was estimated and compared. In audition, parametric images from ${H_2}^{15}O$ dynamic brain PET data peformed on 16 healthy volunteers under various physiological conditions was compared to examine the utility of these methods for real human data. Results: These fast algorithms produced parametric images with similar image qualify and statistical reliability. When CAKS and LLS methods were used combinedly, computation time was significantly reduced and less than 30 seconds for $128{\times}128{\times}46$ images on Pentium III processor. Conclusion: Parametric images of rCBF and partition coefficient with good statistical properties can be generated with short computation time which is acceptable in clinical situation.

Studies on Radiation Protection Effect of the Beer (맥주의 방사선방어효과에 관한 연구)

  • Sohn, Jong-Gi;Ha, Tae-Young;Hwang, Chul-Hyan;Lee, Young-Hwa
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.83-90
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    • 2007
  • Purpose: In this study, it was investigated whether commercially produced beer is able to prevent a lymphocyte from radiation induced apoptosis. Materials and Methods: Whole blood samples were acquired from 5 healthy volunteers (male, 26$\sim$38 years old) and the lymphocyte were isolated by density gradient centrifugation. Radiation induced apoptosis of the lymphocyte were investigated by 0.5 Gy, 1.0 Gy, 2.0 Gy, 3.0 Gy to 5.0 Gy irradiation. In some experiments, the donor drunk beer and then blood samples were collected. In other experiments, melatonin or glycine betain was added to lymphocyte culture medium. Treated or untreated lymphocytes were cultured for 60 hours and radiation induced apoptosis of the lymphocyte was analyzed by annexin-V staining through flow cytometery. Results: Relative radiation induced apoptosis ratio of the untreated lymphocytes is 1.22$\pm$1.1, 1.22$\pm$1.1, 1.38$\pm$1.0, 1.47$\pm$1.1, 1.50$\pm$1.2 by radiation dose of 0.5 Gy, 1.0 Gy, 2.0 Gy, 3.0 Gy and 5.0 Gy respectively. Relative radiation induced apoptosis ratio of lymphocytes is isolated from beer drunken donors is 0.97$\pm$1.0, 0.99$\pm$1.0, 1.11$\pm$0.9, 1.29$\pm$1.1, 1.15$\pm$1.1 by radiation doses respectively which are reduced 21.5% compared with untreated lymphocyte. Relative radiation induced apoptosis ratio of the lymphocytes is isolated from non-alcohol beer drunken donors is 1.22$\pm$1.1, 1.17$\pm$1.1, 1.13$\pm$1.3, 1.38$\pm$1.2, 1.32$\pm$1.1 by radiation dose of 0.5 Gy, 1.0 Gy, 2.0 Gy, 3.0 Gy and 5.0 Gy respectively which are reduced 10.8% compared with the untreated lymphocyte. Conclusion: As a result, it is suggested that beer may protect the lymphocyte from radiation damage and inhibit apoptosis.

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Evaluation of Hemodynamic Failure with Acetazolamide Challenged $^{123}I-IMP$ Brain SEPCT and PET (PET과 Acetazolamide 부하 $^{123}I-IMP$ 뇌혈류 SPECT를 이용한 혈역학적 부전의 평가)

  • Chun, Kyung-Ah;Cho, In-Ho;Won, Kyu-Jang;Lee, Hyung-Woo;Hayashida, Kohei
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.94-102
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    • 2003
  • Purpose : Cerebral blood flow (CBF) reactivity to acetazolamide (ACZ) is useful to select patients with hemodynamic failure. However, it is still a matter of speculation that varying degrees of regional CBF increases after ACZ administration represent the severity or stage of regional hemodynamic failure as assessed by positron emission tomography (PET). We studied to elucidate whether ACZ challenge $^{123}I-IMP$ brain single photon emission tomography (SPECT) can accurately grade the seventy of regional hemodynamic failure. Materials and Methods: Eighteen patients (M: 16, F: 2, average age: 61 years) with unilateral occlusive disease of the internal carotid artery or the trunk of the middle cerebral artery (MCA). Patients undewent $^{123}I-IMP$ brain SPECT study with acetazolamide challenge and PET study was carried out within 2 weeks before and after SPECT study. Five healthy volunteers with a mean age of 48 years (range: 28-73 yr, M: 3, F: 2) underwent PET studies to determine normal values. In SPECT study, an asymmetry index (Al)-the percentage of radioactivity of region of interest (ROI) in the occlusive cerebrovascular lesion to the contralateral homologous ROI-was used for numerical evaluation of relative $^{123}I-IMP$ distribution. In PET study, regional CBF, oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen ($CMRO_2$) and cerebral blood volume (CBV) values were measured with $^{15}O-labeled$ gas inhalation method and the values were used for comparison with Al (Al during acetazolamide challenge-Al of basal study) on the SPECT study. ROls were classified by severity into three groups (normal, stage I and stage II). Results: Mean values of Al in areas with normal, stage I and stage II hemodynamic failure were $6.25{\pm}7.77%\;(n=107),\;-10.38{\pm}10.41%\:(n=117)\;and\;13.30{\pm}10.51%\;(n=140)$, respectively. Al significantly differed with each groups (p<0.05). Correlation between Al and CBF, OEF and CBV/CBF in hemisphere with occlusive cerebrovascular lesion was 0.20 (p<0.01), -0.28 (p<0.01) and -0.28 (p<0.01), respectively. Conclusion: We concluded that $^{123}I-IMP$ brain SPECT with acetazolamide challenge could determine the severity ad stage of regional hemodynamic failure as assessed by PET.

The Influence of Iteration and Subset on True X Method in F-18-FPCIT Brain Imaging (F-18-FPCIP 뇌 영상에서 True-X 재구성 기법을 기반으로 했을 때의 Iteration과 Subset의 영향)

  • Choi, Jae-Min;Kim, Kyung-Sik;NamGung, Chang-Kyeong;Nam, Ki-Pyo;Im, Ki-Cheon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.122-126
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    • 2010
  • Purpose: F-18-FPCIT that shows strong familiarity with DAT located at a neural terminal site offers diagnostic information about DAT density state in the region of the striatum especially Parkinson's disease. In this study, we altered the iteration and subset and measured SUV${\pm}$SD and Contrasts from phantom images which set up to specific iteration and subset. So, we are going to suggest the appropriate range of the iteration and subset. Materials and Methods: This study has been performed with 10 normal volunteers who don't have any history of Parkinson's disease or cerebral disease and Flangeless Esser PET Phantom from Data Spectrum Corporation. $5.3{\pm}0.2$ mCi of F-18-FPCIT was injected to the normal group and PET Phantom was assembled by ACR PET Phantom Instructions and it's actual ratio between hot spheres and background was 2.35 to 1. Brain and Phantom images were acquired after 3 hours from the time of the injection and images were acquired for ten minutes. Basically, SIEMENS Bio graph 40 True-point was used and True-X method was applied for image reconstruction method. The iteration and Subset were set to 2 iterations, 8 subsets, 3 iterations, 16 subsets, 6 iterations, 16 subsets, 8 iterations, 16 subsets and 8 iterations, 21 subsets respectively. To measure SUVs on the brain images, ROIs were drawn on the right Putamen. Also, Coefficient of variance (CV) was calculated to indicate the uniformity at each iteration and subset combinations. On the phantom study, we measured the actual ratio between hot spheres and back ground at each combinations. Same size's ROIs were drawn on the same slide and location. Results: Mean SUVs were 10.60, 12.83, 13.87, 13.98 and 13.5 at each combination. The range of fluctuation by sets were 22.36%, 10.34%, 1.1%, and 4.8% respectively. The range of fluctuation of mean SUV was lowest between 6 iterations 16 subsets and 8 iterations 16 subsets. CV showed 9.07%, 11.46%, 13.56%, 14.91% and 19.47% respectively. This means that the numerical value of the iteration and subset gets higher the image's uniformity gets worse. The range of fluctuation of CV by sets were 2.39, 2.1, 1.35, and 4.56. The range of fluctuation of uniformity was lowest between 6 iterations, 16 subsets and 8 iterations, 16 subsets. In the contrast test, it showed 1.92:1, 2.12:1, 2.10:1, 2.13:1 and 2.11:1 at each iteration and subset combinations. A Setting of 8 iterations and 16 subsets reappeared most close ratio between hot spheres and background. Conclusion: Findings on this study, SUVs and uniformity might be calculated differently caused by variable reconstruction parameters like filter or FWHM. Mean SUV and uniformity showed the lowest range of fluctuation at 6 iterations 16 subsets and 8 iterations 16 subsets. Also, 8 iterations 16 subsets showed the nearest hot sphere to background ratio compared with others. But it can not be concluded that only 6 iterations 16 subsets and 8 iterations 16 subsets can make right images for the clinical diagnosis. There might be more factors that can make better images. For more exact clinical diagnosis through the quantitative analysis of DAT density in the region of striatum we need to secure healthy people's quantitative values.

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A Study of Sex-related Problems of Old Women in Kyeonggi Province, Korea (경기도 여성노인의 성의식에 관한 조사연구)

  • Park, Young-Soo;Choi, In-Sook
    • The Journal of Korean Society for School & Community Health Education
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    • v.5
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    • pp.71-84
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    • 2004
  • The sexual discourse has been frequent, but the subjects of it have been limited to the young, and the sex of women and that of the old people, until now, have been overlooked. According to the data in 2,000 of the Korea Statistic Service, the older-than-sixty-five-year people consist of 37.4% men and 62.6% women. Of them, the older-than-seventy-year people consist of 33.8% men and 55.2% women. The data show the fact that as the age of the old people is higher, the number of old women is enlarging. Paying attention to the above-mentioned tendency, this study conducted a survey about the aspects of the sexual consciousness of old women. The purpose of study was focused, through the survey, on discovering the ways of old women's recognization about their sexual desire, and on presenting basic data to developing the programs which could solve the problems derived from the discovery. That is to say, the purpose of it was to prevent the sexual desire's distortion and suppression of old women, if they had any, and to present basic data to developing the programs which could convert their recognization of sex. The objects of the survey were the sample group of 301 people inhabiting in Hwaseong City, Seongnam City, Yongin City, and Suwon City, chosen out of 375,298 old women of 614,316 older-than-sixty-five-year people in Kyeonggi Province (Kyeonggi Province homepage, 2002). The data were collected by the questionnairers' interviews in the fields of old men's resting house, churches, temples, old men's niversities and so like, from September 19th to September 31th in 2003. The questionnairers as volunteers were taught the prior education, being prepared for the survey about old women's sexual consciousness. The contents of education were composed of the understanding of old women, the ways of questionnairing, and the items of questionnaire. The outcomes of the survey are following; First, concerning general items, the old women of the sample group answered that they felt greatly the difficulties of health(36.5%), economy(12.0%), and loneliness(11.3%) in turn. The 48.2% of them answered that they were healthy, but the 62.3% answered that they were suffering various illnesses. The 24.4% answered they were economically rich, and the 23.9% answered they were working. The 53.5% were living alone due to divorce or death. The 71.1% had been living for more than ten years. The 83.1% believed in their own religion. Second, the 43.8% of the sample group admitted the necessity of a heterosexual friend and sexuality The 39.0% felt sexual desire, and the 33.9% were experiencing sexuality. As the obstructing factors in performing sexuality, the objects of sample group pointed out shamefulness or morality(28.7%), anxiety that such deeds might afflict their health or the problem of health itself(20.2%), weakening of sexual potency(16.9%). This outcome shows that they have ambiguous notions about their sexual alienation and manner. Third, the 33.7% of the sample group admitted sexual education and sexual counsel, and of those that admitted them, the 85.2% said that they would take part in sexual education if it were held. It shows that the demand of sexual education and sexual counsel need be fulfilled. Therefore, through this study, the following two important suggestions can be drawn: First, systematic sexual education programs should be developed, considering old people's developing steps containing their rights of health and sex. Also those should be educated through kindergartens, primary, middle and higher education institutions. Second, sexual education and sexual counsel on prospective old people and present old people should be performed.

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Clinical Trial of Nasal Flumazenil Administration (플루마제닐의 경비 투여)

  • Hong, Soo-Jin;Kim, Hyun-Jung;Yum, Kwang-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.441-446
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    • 2001
  • Flumazenil is a competitive antagonist of benzodiazepines. It is usually administered intravenously. However, if the intravenous route is not available then other routes of drug administration should be considered. This study was designed to evaluate the reversal effects of flumazenil after nasal administration. Twenty-five young, healthy adult volunteers participated in this clinical trial. The dosage of 0.08mg/kg midazolam was administered intravenously to induce deep sedation. Ten minutes after midazolam administration, 0.5mg of flumazenil was dropped nasally, over a period of one minute. Blood samples were taken to measure the concentration of midazolam and flumazenil at 0, 5, 10, and 20min after nasal administration of flumazenil, using High Performance Liquid Chromatography. The degree of sedation was evaluated with sedation score and bispectral index (BIS), Statistical analysis was performed by multivariate ANOVA and correlation analysis (P<0.05). Peak serum flumazenil concentration was reached in 10min. Sedation score decreased after midazolam administration and showed a significant increase after flumazenil administration. However, BIS decreased during the first 10min after midazolam administration and then no significant changes after flumazenil administration. There were two instances representing rapid and complete reversal of midazolam after intranasal administration of flumazenil. In conclusion, intranasal flumazenil administration may be effective in some patients when intravenous route is not available in condition of benzodiazepine overdose.

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