• Title/Summary/Keyword: Time to Sleep

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Identification of an effective and safe bolus dose and lockout time for patient-controlled sedation (PCS) using dexmedetomidine in dental treatments: a randomized clinical trial

  • Seung-Hyun Rhee;Young-Seok Kweon;Dong-Ok Won;Seong-Whan Lee;Kwang-Suk Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.1
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    • pp.19-35
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    • 2024
  • Background: This study investigated a safe and effective bolus dose and lockout time for patient-controlled sedation (PCS) with dexmedetomidine for dental treatments. The depth of sedation, vital signs, and patient satisfaction were investigated to demonstrate safety. Methods: Thirty patients requiring dental scaling were enrolled and randomly divided into three groups based on bolus doses and lockout times: group 1 (low dose group, bolus dose 0.05 ㎍/kg, 1-minute lockout time), group 2 (middle dose group, 0.1 ㎍/kg, 1-minute), and group 3 (high dose group, 0.2 ㎍/kg, 3-minute) (n = 10 each). ECG, pulse, oxygen saturation, blood pressure, end-tidal CO2, respiratory rate, and bispectral index scores (BIS) were measured and recorded. The study was conducted in two stages: the first involved sedation without dental treatment and the second included sedation with dental scaling. Patients were instructed to press the drug demand button every 10 s, and the process of falling asleep and waking up was repeated 1-5 times. In the second stage, during dental scaling, patients were instructed to press the drug demand button. Loss of responsiveness (LOR) was defined as failure to respond to auditory stimuli six times, determining sleep onset. Patient and dentist satisfaction were assessed before and after experimentation. Results: Thirty patients (22 males) participated in the study. Scaling was performed in 29 patients after excluding one who experienced dizziness during the first stage. The average number of drug administrations until first LOR was significantly lower in group 3 (2.8 times) than groups 1 and 2 (8.0 and 6.5 times, respectively). The time taken to reach the LOR showed no difference between groups. During the second stage, the average time required to reach the LOR during scaling was 583.4 seconds. The effect site concentrations (Ce) was significantly lower in group 1 than groups 2 and 3. In the participant survey on PCS, 8/10 in group 3 reported partial memory loss, whereas 17/20 in groups 1 and 2 recalled the procedure fully or partially. Conclusion: PCS with dexmedetomidine can provide a rapid onset of sedation, safe vital sign management, and minimal side effects, thus facilitating smooth dental sedation.

THE EFFECTIVENESS OF TWO SEDATIVE REGIMEN USED FOR CHILD PATIENT WHO FAILED TO ORAL CHLORAL HYDRATE (Chloral hydrate 경구 진정에 실패한 소아환자를 대상으로 사용한 두 가지 진정요법의 효과)

  • Lee, Sang-Min;Kim, Jong-Soo;Kim, Yong-Kee
    • 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.

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Design and Performance Analysis of a new MAC Protocol for Providing Real-time Traffic Information using USN (USN 기반 실시간 주행 상황 정보 제공을 위한 MAC 설계 및 성능 분석)

  • Park, Man-Kyu;So, Sang-Ho;Lee, Jae-Yong;Lim, Jae-Han;Son, Myung-Hee;Kim, Byung-Chul
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.44 no.5
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    • pp.38-48
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    • 2007
  • In ubiquitous environment, sensor networks that sense and transmit surrounding data without human intervention will become more important. If sensors are installed for detecting vehicles and measuring their speed in the road and that real-time information is given to drivers, it will be very effective for enhancing safety and controlling traffic in the road. In this paper, we proposed a new reliable and real-time sensor MAC protocol between AP and sensor nodes in order to provide real-time traffic flow information based on ubiquitous sensor networks. The proposed MAC allocates one TDMA slot for each sensor node on the IEEE 802.15.4 based channel structure, introduces relayed communication for distant sensors, and adopts a frame structure that supports retransmission for the case of errors. In addition, the proposed MAC synchronizes with AP by using beacon and adopts a hybrid tracking mode that supports economic power consumption according to various traffic situations, We implemented a simulator for the proposed MAC by using sim++ and evaluated various performances. The simulation results show that the proposed MAC reduces the power consumption and reveals excellent performance in real-time application systems.

Individual Exposure Characteristics to Humidifier Disinfectant according to Exposure Classification Groups - Focusing on 4-1 and 4-2 Applicants - (가습기살균제 환경노출 판정등급에 따른 개인 노출 특성 분포 - 4-1차와 4-2차 신청자를 중심으로 -)

  • Lee, Seula;Yoon, Jeonggyo;Ock, Jeongwon;Jo, Eun-Kyung;Ryu, Hyeonsu;Yang, Wonho;Choi, Yoon-Hyeong
    • Journal of Environmental Health Sciences
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    • v.45 no.4
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    • pp.370-380
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    • 2019
  • Objective: This study was performed to investigate the distribution of individual exposure characteristics according to an exposure assessment classification for humidifier disinfectant and to identify the factors that influence assessment classification. Methods: We examined the exposure characteristics of 4,482 subjects who applied for the 4-1 and 4-2 assessments of environmental exposure to humidifier disinfectant conducted by the Korea Environmental Industry & Technology Institute (KEITI). Environmental exposure assessment classification was assessed using the following seven criteria: 1) Distance from humidifier to face; 2) Spray direction; 3) Time used, daytime 4) Time used, during sleep; 5) Time used, cumulative; 6) Exposure intensity; and 7) Cumulative exposure level. Each criteria was then classified as 'high' or low'. When participants answered for more than four criteria, exposure assessment was determined as 'definite,' 'probable,' or 'possible' depending on the ratio of 'high' responses. If participants' responses were inconsistent, exposure assessment was listed as 'unlikely.' If participants answered for less than four criteria, exposure assessment was considered 'indeterminate.' Results: For the exposure assessment classes, definite was assigned to 38.5% (1,725 subjects), probable assigned to 32.9% (1,474 subjects), 25.0% (1,122 subjects) were assigned to as possible, unlikely assigned to 0.1% (3 subjects), and indeterminate assigned to 3.5% (158 subjects). Overall, participants who used 'Oxy Ssakssak New Gaseupgi Dangbun,' 'Aekyung Gaseupgi Mate,' 'Homeplus Gaseupgi Chungjungje,' and 'E-Mart Gaseupgi Salgyunje' totaled 2,996, 557, 176, and 162 subjects, respectively. There was a statistical difference in the type of humidifier disinfectant products between high-exposed and low-exposed participants. Based on the assessment criteria of humidifier disinfectant exposure, subjects were likely to be in the highly exposed classes (definite and probable) when the subjects were exposed 1) for more than ten hours per day and 2) for more than four hours at night 3) when the total cumulative exposure time was higher than the average, 4) when the direction of humidifier spray was toward the face, 5) when the respiratory position was less than 1 meter of distance from the humidifier, 6) when the concentration of indoor contaminants (ug/m3) was higher than the average exposure intensity, and 7) when overall exposure level ($ug/m3^*hr$) was higher than the average exposure level. Conclusion: This study suggests that each exposure assessment criteria was able to appropriately estimate cumulative exposure levels.

Determination of Appropriate Sampling Time for Job Stress Assessment: the Salivary Chromogranin A and Cortisol in Adult Females

  • Hong, Ran-Hi;Yang, Yun-Jung;Kim, Sang-Yon;Lee, Won-Young;Hong, Yeon-Pyo
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.4
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    • pp.231-236
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    • 2009
  • Objectives : This study was conducted to determine the appropriate sampling time of the salivary stress markers, chromogranin A (CgA) and cortisol as objective indices of job stress assessment in adult females. Methods : The subjects were 20${\sim}$39-year-old women (13 office workers, 11 sales-service workers, and 11 college students) who were eligible for the study and free of acute and chronic medical conditions. Salivary CgA and cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA). Saliva samples were collected (2 $m{\ell}$ each) at 7:00, 8:00, 10:30, 12:00, 17:30, and 22:30 on a typical day. Salivary CgA and cortisol levels, according to sampling time, were compared among the three groups using general linear model. The full version of the Korean Occupational Stress Scale (KOSS), which includes socioeconomic characteristics, health behavior, workrelated characteristics, and BMI, was used to access the subjects' job stress. Multiple regression analysis of the job stressors identified by the KOSS was performed on salivary CgA and cortisol levels. Results : The salivary CgA level peaked at 7:00 (time of awakening), then decreased and were maintained at a low level throughout the day, and increased slightly at 17:30. The salivary cortisol level increased steeply within the 1st hour after awakening, followed by a gradual decrease by 12:00, and was then maintained at a low level throughout the day. The salivary cortisol levels of subjects who worked ${\leq}$5 days per week and graduated from the university were significantly lower at 8:00 (p=0.006). The salivary cortisol levels of non-smokers were significantly lower at 7:00 p=0.040) and 8:00 (p=0.003) compared to smokers. There were no significant differences in salivary CgA and cortisol levels at 10:30 and 12:00 in general characteristics. The regression coefficients on salivary CgA level were significant with interpersonal conflict at 17:30 and job insecurity at 22:30. Regression coefficients on salivary cortisol level were significant with organizational system and total job stressors at 17:30. Conclusions : We suggest that the appropriate sampling times for the salivary stress markers, CgA and cortisol, are at 7:00 (time of awakening), 8:00 (1 hour after awakening), 17:30 (early evening), and 22:30 (before sleep).

Comparison between adverse effects of low and usual doses of intravenous aminophylline (정주 아미노필린의 투여 농도에 따른 부작용에 관한 연구)

  • Kim, Bok Ki;Lim, Dae Hyun;Ahn, So Hyun;Kwak, Jong Hoon;Kim, Jeong Hee;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.441-445
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    • 2009
  • Purpose : Some patients develop side effects from theophylline even at low serum concentrations. We designed a prospective study to evaluate the side effects of theophylline. Methods : A Prospective, controlled trial study was conducted. The low-dose group received an intravenous continuous aminophylline dose of 5 mg/kg/day on the first day and subsequently 10 mg/kg/day on the following two days. The usual-dose group received 10 mg/kg/day for three days and the control group received normal saline for three days. Heart rate, respiratory rate, serum concentration of theophylline, and four adverse events (irritability, sleep disturbance, jitter, and vomiting) were checked at the time of admission and at 2, 12, 24, 48, and 72 h after the start of aminophylline infusions. Results : Nine patients out of 37 in the low-dose group and six of 21 in the usual-dose group dropped out because of uncontrolled irritability. The serum concentrations of theophylline in dropouts ($3.68{\pm}1.93$ ig/mL) and participants ($4.47{\pm}2.45$ ig/mL) were not significantly different. Irritability was a more frequent side effect in the usual-dose group at 12 h, but there was no difference between the low-dose and usual-dose groups in terms of vomiting, sleep disturbance, and jitter. Most of the severe adverse effects were observed in children below two years of age. Conclusion : Some patients dropped out regardless of the initiating aminophylline dose, especially patients under the age of two years.

Control Method of Adaptive Duty-cycling for Monitoring System in Excavations (굴착현장 모니터링 시스템을 위한 적응적인 듀티사이클링 제어 기법)

  • Kim, Taesik;Min, Hong;Jung, Jinman
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.16 no.6
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    • pp.141-146
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    • 2016
  • Geotechnial engineering projects that requires excavation activity can cause massive ground deformation and this can damage adjacent structures. Depending on the engineering characteristics of ground material and the excavation depth, the ground movement is various. To overcome this issue, the ground deformation is monitored by multiple sensors. Typically, an inclinometer is installed behind the support wall. In this paper, we present an adaptive duty-cycling control mechanism using wireless sensors for monitoring ground deformation in excavations. The proposed mechanism dynamically adjusts the sleep time based on the urgency degree of sensed data from inclinometer. Through analytical evaluation of expected latency time, we confirm our adaptive duty-cycling mechanism has lower latency compared with periodic duty-cycling mechanism under variable conditions.

The study of Polygalae Radix & Acori Graminei Rhizoma in Bang-Yak-Hap-Pyun ("방약합편(方藥合編)"중(中) 원지(遠志) 및 석창포(石菖蒲)를 포함한 처방(處方)에 대한 고찰(考察))

  • Sin, Hong-Jung;Jo, Yun-Hang;Jo, Chang-Hwan;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.15 no.2
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    • pp.231-238
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    • 2006
  • In oriental medicine, Polygalae Radix & Acori Graminei Rhizoma are frequently used materials for the cardiac disorder(palpitaion), brain disorder(sleep disorder, forgetfulness, confused mind, dizziness). Bang-Yak-Hap-Pyun(方藥合編) is widely used for clinical herbal prescription book. In Bang-Yak-Hap-Pyun(方藥合編), Polygalae Radix is usually used 1don(錢)(4g) and Acori Graminei Rhizoma is used 1don(錢)(4g). The most important fact is that, in contrast to most people know that Polygalae Radix & Acori Graminei Rhizoma are used most prescription at the same time, the prescription used Polygalae Radix & Acori Graminei Rhizoma at the same time is merely 3. (Bang-Yak-Hap-Pyun percentage of Polygalae Radix & Acori Graminei Rhizoma is 0.64%). The number of prescription Polygalae Radix & Acori Graminei Rhizoma in Bang-Yak-Hap-Pyun is total 16. 10 in sang-tong(上統), 4 in jung-tong(中統), 2 in ha-tong(下統). The ratio of Polygalae Radix in Bang-Yak-Hap-Pyun is 0.41%~14.28%. And the ratio of Acori Graminei Rhizoma is 4%~16.66%. The mostly quoted medical literature what prescription included Polygalae Radix & Acori Graminei Rhizoma in Bang-Yak-Hap-Pyun is Tae-Pypng-Ha-Jae-Guk-Bang.

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Effects of School Attendance Policy on Breakfast Eating, Sleep, and Physical Activity in Middle School Students (9시 등교정책이 중학생의 아침식사, 수면 및 신체활동에 미치는 영향)

  • Kim, Ha Na;Kim, Seong Yeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.11
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    • pp.1397-1407
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    • 2017
  • The aim of a school attendance policy (SAP) is to ensure breakfast time for school-aged adolescents. Therefore, this study investigated the effects of SAP on dietary behavior, particularly breakfast consumption, among adolescent middle school students (n=426) in the Ansan area of Gyeonggi-do. After implementation of the SAP, the response rates for eating breakfast every-day among boys (P>0.05) and girls (P<0.05) slightly increased by 44.6% and 35.8%, respectively, compared to before the SAP. Further, the degree of satisfaction with breakfast increased among both boys ('satisfied' and 'strongly satisfied'; 32.4% and 21.6%, respectively) (P<0.01) and girls ('satisfied' and 'strongly satisfied'; 32.8% and 14.2%, respectively) (P<0.001) compared to before the SAP. Moreover, boys (56.8%) and girls (53.9%) were aware that the SAP increased breakfast-eating frequency. Increases in deep sleep as a result of the SAP were high in both boys (39.2%) and girls (47.1%), and sleeping hours among boys (P<0.05) and girls (P<0.01) increased compared to before the SAP. The respondents were aware of the positive effects on physical function such as reduction of physical fatigue (boys 40.1%, girls 38.2%) and improvement of physical health (boys 36.5%, girls 32.8%). Thus, systematic and sustained political support at the national level is required to encourage healthy breakfast eating and physical activity in middle school students.

A Study on Activation device of 119 Emergency Care (119구급대의 활성화 방안에 관한 연구)

  • Koh, Jae-Moon;Kim, Gyoung-Wan;Chung, Yong-Tai
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.27-40
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    • 2007
  • Even now, 119 rescue services have dissatisfactory aspects in operation, system and equipments as discussed above, It is the most urgent subject to systemize rescue services so that they can be suitable for our status, for we will make 21C welfare state come true before long. So, this author suggest that the followings have to be raised to activate 119 rescue service. 1) Bring up experts and offer high-quality rescue service 2) Prepare more up-to-date equipments 3) Operate transfer joint organizations 4) Promote the ability to meet with a press at the time of rescue service activities 5) Adjust regulations related to rescue services 6) Make up for a countermeasure to traffic accidents of ambulances 7) Adjust regulations making it mandatory to establish heliport at the target on hospitals more than a defined scale 8) Install more rescue service teams 9) Educate and train officials belonging to briefing rooms, where the officials with long experiences are arranged 10) Minimize the time for rescue team to reach fields 11) Establish legal protection system for rescue the team Nowadays, our country operates the department of fire fighting and rescue services without great difficulty, even though the circumstances are bad - insufficient members and the inferior circumstances. All of the fire fighting officials are given heavy duties in bad circumstances, and so are the team of rescue service. The rescue service team, taking charge of some emergency medical system, do a fire fighting inspection as a non-duty service, though they are scanty of sleep due to prevention and protection services of the fire fighting service team. But, they can not engage in rescue services completely and have to deal with miscellaneous duties. So they can not offer professional emergency medical services. But now, almost every fire fighting organization, belonging to National Emergency Management Agency, are separating rescue services, which shows a lot of good results. People recognize rescue services to get better and better gradually and the demands for this rescue services increase. So, this is the best time when rescue service teams should offer qualitative services rather than quantitative services. The people will recognize this rescue service team to be an organization sacrificing and serving for them. However well institutes and operation systems should be established, the rescue service team can not come true their aim without strong wills that they will serve and sacrifice themselves for people from their hearts. In addition, it is essential for the officials in charge of policies about emergency medical services to have a concernment on and practice the policy without failure.

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