• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.408-412
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• 2010

Introduction: This study examined the depth of sedation and the usefulness of the monitoring tool in determining the level of sedation in patients undergoing third molars extraction under conscious sedation with midazolam. Materials and Methods: Twenty two patients undergoing third molars extraction at the department of Oral and Maxillofacial surgery, Ewha Womans Mokdong Hospital from February 2010 to April 2010 were analyzed. All patients were classified as American Society of Anesthesiologist (ASA) class I and had no contraindications tosedation. The bispectral index was recorded continually during surgery using a bispectral monitor. The initial sedation was accomplished using a 3 mg bolus of midazolam followed by a 2 mg bolus of midazolam until the level of sedation, at which the patient’s eyes were closed or the subject was responsive only to loud or repeated calling of their name, was reached. All subjects were surveyed with a postoperative questionnaire to evaluate the level of sedation. Results: The bispectral index (BIS) decreased approximately 5 minutes after midazolam administration, but increased at the local anesthesia injection and odontomy procedure. The amnestic effect was shown effectively in the early stages of surgery. Conclusion: Conscious sedation with intravenous midazolam is effective in achieving the effect of anxiolysis, analgesia and amnesia. The BIS is an objective and useful means of assessing the depth of sedation.

• Journal of Oriental Neuropsychiatry
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• v.19 no.3
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• pp.129-142
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• 2008

Objective: The purpose of this study was to evaluate the antioxidative effects of the extract of Scolopendra subspinipes which has been used mainly for detoxication in the oriental medicine and reported to have sedative action, antiinflammatory effect, antihypertensive property and immunity enhancing activity. Method: Inhibitory activities on oxygen radical generating enzymes (aldehyde oxidase and xanthine oxidase) and increasing activities on oxygen radical scavenging enzymes (superoxide dismutase, glutathione peroxidase, glutathione-S-transferase) were investigated. Furthermore, the content of glutathione in the mouse brain, DPPH radical scavenging activity and also anti-lipid peroxidative effects in vivo and in vitro were estimated. Results: The extract showed weak inhibitory effects on the activities of aldehyde oxidase and xanthine oxidase which are oxygen radical generating enzymes. The extract inhibited lipid peroxidation with 26.1% against control group at 500 mg/kg in vivo and with 11.2% against control group at 10 mg/kg in vitro in a dose-dependent manner, which means this drug may protect radical-induced cell damages. The extract showed dose-dependently the scavenging effect on DPPH radical with 24.8% activity at 10 mg/ml in vitro. The extract enhanced the activities of superoxide dismutase, glutathione peroxidase and glutathione-S-transferase, which are oxygen radical scavenging enzymes, with 28.9%, 22.3% and 23.1%, respectively at 500mg/kg in vivo. Finally, this extract strongly increased the glutathione content in the mouse barin. Conclusion: Above results indicated that Scolopendra subspinipes can be useful for the protection or treatment of some diseases caused by reactive oxygen species.

• Journal of Oriental Neuropsychiatry
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• v.15 no.1
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• pp.77-86
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• 2004

Objective : This study was performed to investigate the agonistic activity of Chunmajeongal-tang extract to the $GABA_A/benzodiazepine$ receptor complex. Methods : Male mice and Sprague-Dawley rats were used for this experiment. Chunmajeongal-tang Prescription was extracted with 80% methanol, evaporated in vacuo and dried with freeze dryer. The agonistic activity to the GABA/ benzodiazepine receptor complex and GABA transaminase activity were measured in vitro. Results : Chunmajeongal-tang extract inhibited dose-dependently the binding of [3H]Ro15-1788, an antagonist on GABA/benzodiazepine receptor complex, in rat cerebral cortices, showing $82.4{\pm}4.12%$ inhibition at a dose of 5.0 mg/kg. This extract inhibited dose-dependently the binding of [3H]flunitrazepam, an agonist on GABA/benzodiazepine receptor complex, in rat cerebral cortices, showing $5.6{\pm}1.24%$ inhibition. Furthermore, Chunmajeongal-tang extract inhibited the binding of [3H]flunitrazepam in the presence of GABA/NaCI with $13.2{\pm}0.44%$ inhibition, its inhibitory effect exhibited a positive GABA shift, which means that this extract activates a GABAergic neurotransmission.

• YAKHAK HOEJI
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• v.41 no.6
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• pp.817-828
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• 1997

In order to investigate pharmacological properties of New Woohwangchungsimwon Pill (NWCH) and Woohwangchungsimwon Pill(WCH), effects of NWCH and WCH on cerebral ischemia and central nervous system were compared. Cerebral ischemia insult was performed using unilateral carotid artery occlusion in Mongolian gerbils. The histological observations showed preventive effect of NWCH and WCH treatments with ischemia-induced brain damage. The ATP in brain tissue was decreased in vehicle-treated ischemic gerbils. This decrease was prevented by NWCH and WCH treatment. In contrast to what was seen with ATP, the lactate and lipid peroxide were both elevated in vehicle-treated ischemic gerbils. This elevation was inhibited by NWCH and WCH treatments. In central nervous system, NWCH and WCH had sedative effect in rotarod and spontaneous activity test, but no effects on the hexobarbital-induced sleeping time. And, NWCH and WCH had weak anticonvulsion effects in electric shock- and pentetrazol-induced convulsion test. NWCH and WCH increased the respiration rate, but decreased the respiration depth in rats. Furthermore, NWCH and WCH showed antistress effect. Our findings suggest that the pharmacological profiles of NWCH on cerebral ischemia and central nervous system are similar to that of WCH.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.505-516
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• 2000

Chloral hydrate is one of the most widely used sedative agents to control the difficult-to-treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time of Chloral hydrate. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This study was designed to test the efficacy of one sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with mixed gas of Enflurane(2vol%) and $N_2O(50%)-O_2(50%)$ for $60\sim120$ seconds to 35 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The Result of this regimen was compare to those of two oral regimen of Chloral hydrate/Hydroxyzine and Chloral hydrate only Analyses of result on vital signs and behavior pattern were performed. The outcome of the study suggest that sleep induction by a short inhalation of low dose of $Enflurane/N_2O-O_2$ provide dentist with suitable condition for the completion of scheduled treatment in the patient who failed to oral Chloral hydrate. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.304-312
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• 2002

The purpose of this study was to assess the sedative effects of four kinds of medication for management in the uncooperative 64 children aged from 18 to 92 months(ASA class I) and weighting between 10 and 32 kg. They were given randomly a dose of chloral hydrate 75mg/kg and hydroxyzine 25mg orally(group 1), midazolam 0.1mg/kg intramuscularly and $N_2O$(group 2), group 1 with additional $N_2O$(group 3) and group 1 with additional midazolam 0.5cc intranasally(group 4), respectively. According to rating scale, sleep, crying, movement and overall behavior were checked for evaluation of the clinical sedative effects. They were restraind with Pediwrap and were monitored by pulse oximeter for safety during treatment period. The results were as follows : 1. In the evaluation of sleep, rating scale of chloral hydrate and hydroyzine combination group was superior to midazolam and $N_2O$ combination group(p<0.001), but there was no significant difference between chloral hydrate, hydroxyzine and $N_2O$ combination group and chloral hydrate, hydroxyzine and midazolam combination group. 2. In the evaluation of crying, movement and overall behavior, there were significant differences between chloral hydrate and hydroxyzine combination group and midazolam and $N_2O$ combination group(p<0.05), but no significant difference between chloral hydrate, hydroxyzine and $N_2O$ combination group and chloral hydrate, hydroxyzine and midazolam combination group. 3. In the evaluation of overall behavior, the mean score of chloral hydrate and hydroyzine combination group was 2.94, midazolam and $N_2O$ combination group 2.07, chloral hydrate, hydroxyzine and $N_2O$ combination group 2.47 and chloral hydrate, hydroxyzine and midazolam combination group 2.24, respectively. 4. Evidence of adverse effect was not detected or reported during and/or after dental treatment.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.86-90
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• 1998

Background: There are no controlled studies assessing the effect of metoclopramide and droperidol administered epidurally for the prevention of nausea and vomiting associated with epidural morphine. This study was undertaken to compare the effectiveness of continuous epidural metoclopramide and droperidol in reducing nausea and vomiting associated with epidural morphine. Methods: Ninty patients undergoing elective gynecologic surgery were randomly assigned to one of three study groups; Group A(n=30) patients received continuous infusion of epidural morphine(6.0 mg/day) following a bolus loading dose of 3.0 mg; Group B(n=30), epidural mixture of morphine and droperidol(5.0 mg/day) following a bolus loading dose(morphine 3.0 mg, droperidol 1.5 mg); Group C, (n=30), epidural mixture of morphine and metoclopramide(20 mg/day) following a bolus loading dose(morphine 3.0 mg, metoclopramide 10 mg). For the 24 postoperative hours, the incidence of nausea and vomiting, degree of pain, level of sedation and other adverse effects were evaluated. Results: Incidence of nausea and vomiting, and number of patients who required antiemetic therapy were significantly less in Group B and C than in Group A(P<0.05). Patients in Group A and C were less sedated than those in Group B. Conclusions: We conclude metoclopramide is more effective than droperidol for postoperative nausea and vomiting due to its lower of sedative effect.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.245-254
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• 2018

Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

• Natural Product Sciences
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• v.14 no.1
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• pp.21-26
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• 2008

The leaves of Acanthopanax species have traditionally been used as a tonic and a sedative as well as in the treatment of rheumatism and diabetes. Chiisanoside is the major active lupane triterpenoid of Acanthopanax leaves. To investigate the bioactivities of chiisanoside, which act on bone metabolism, the effects of chiisanoside on the function of osteoblastic MC3T3-E1 cells were studied. Chiisanoside $(0.02{\sim}20\;{\mu}M)$ significantly increased the growth of MC3T3-E1 cells and caused a significant elevation of alkaline phosphatase (ALP) activity, collagen content, and nodules mineralization in the cells (P < 0.05). The effect of chiisanoside (2 ${\mu}M$) in increasing ALP activity was completely prevented by the presence of tamoxifen, suggesting that the effect of chiisanoside might be partly estrogen receptor mediated. Moreover, cotreatment of p38 inhibitor SB203580 or JNK inhibitor SP600125 inhibited chiisanoside-mediated ALP upregulation, suggesting that the induction of differentiation by chiisanoside is associated with increased activation of p38 and JNK mitogen-activated protein kinases. Our data indicate that the enhancement of osteoblast function by chiisanoside may result in the prevention for osteoporosis.

• YAKHAK HOEJI
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• v.40 no.3
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• pp.251-261
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• 1996

Acanthopanax divaricatus Seem. is a medicinal plant growing widely through out Korea, Japan and China. The plant material of Acanthopanax spp. is used as analgesic , tonic, sedative drug as well as for the treatment of hypertension, rheumatism and diabetes. From the stem barks and root barks of A. divaricatus, diterpenoid compound was isolated and identified as pamaric acid ($C_{20}H_{30}O_2,\;mp\;164^{\circ}C$), lignan compounds were isolated and identified as d-sesamin ($C_{20}H_{18}O_6,\;mp\;123{\sim}124^{\circ}C$), eletheroside E ($C_{34}H_{46}O_{18},\;mp\;257{\sim}259^{\circ}C$), three sterol compounds were identified as ${\beta}$-sitosterol, campesterol, stigmasterol, and six fatty acid compounds were identified as stearic acid, palmitic acid, oleic acid, linolenic acid, arachidonic acid and behenic acid. And also leaves of A. divaricatus, chiisanoside were identified, one of secotriterpenoidal compound(white amorphorous powder crystal, mp $228^{\circ}C$). Anticancer activity and nephrotoxicity were tested by MTT assay. Anticancer effect of chiisanoside was much lower than that of cisplatin.