• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.331-341
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• 2022

This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

• 한국식품영양학회지
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• 제30권6호
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• pp.1364-1369
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• 2017

There is a growing demand for natural sleep aids due to various side effects of long-term administration of pharmacological treatments for insomnia. Honey has been reported to exhibit numerous potential health benefits, and it is hypothesized that honey may favorably affect insomnia treatment. Therefore, this study was performed to investigate the possible hypnotic effect of clover honey (CH) and to determine its in vivo mechanism. The total flavonoid content (TFC) of CH and fractions extracted with ethylacetate (EtOAc) and $H_2O$ was measured. The pentobarbital-induced sleep test using $GABA_A$-benzodiazepine (BZD) agonists and antagonists was conducted to evaluate the potential mechanism of action behind the sedative-hypnotic activity of CH in mice. The results showed that administration of 500 and 1,000 mg/kg of CH significantly (p<0.01) reduced the sleep latency to a level similar to that of diazepam (DZP, 2 mg/kg), and 1,000 mg/kg of CH significantly (p<0.01) prolonged the sleep duration, which was comparable to that of DZP (2 mg/kg). Administration of the EtOAc fraction with a higher TFC significantly reduced the sleep latency at 50 to 200 mg/kg and prolonged the sleep duration at 100 to 200 mg/kg, which were comparable to those after administration of DZP (2 mg/kg). However, co-administration of CH and EtOAc with flumazenil, a specific $GABA_A-BZD$ receptor antagonist, blocked the hypnotic effect. Our findings suggest that the hypnotic activity of CH may be attributed to allosteric modulation of $GABA_A-BZD$ receptors. The TFC of CH is expected to be a key factor that contributes to its hypnotic effect.

• Molecules and Cells
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• 제25권2호
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• pp.216-223
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• 2008

It has been reported that bone marrow (BM)-side population (SP) cells, with hematopoietic stem cell activity, can transdifferentiate into cardiomyocytes and contribute to myocardial repair. However, this has been questioned by recent studies showing that hematopoietic stem cells (HSCs) adopt a hematopoietic cell lineage in the ischemic myocardium. The present study was designed to investigate whether BM-SP cells can in fact transdifferentiate into functional cardiomyocytes. Phenotypically, BM-SP cells were $19.59%{\pm}9.00\;CD14^+$, $8.22%{\pm}2.72\;CD34^+$, $92.93%{\pm}2.68\;CD44^+$, $91.86%{\pm}4.07\;CD45^+$, $28.48%{\pm}2.24\;c-kit^+$, $71.09%{\pm}3.67\;Sca-1^+$. Expression of endothelial cell markers (CD31, Flk-1, Tie-2 and VEGF-A) was higher in BM-SP cells than whole BM cells. After five days of co-culture with neonatal cardiomyocytes, $7.2%{\pm}1.2$ of the BM-SP cells expressed sarcomeric ${\alpha}$-actinin as measured by flow cytometry. Moreover, BM-SP cells co-cultured on neonatal cardiomyocytes fixed to inhibit cell fusion also expressed sarcomeric ${\alpha}$-actinin. The co-cultured BM-SP cells showed neonatal cardiomyocyte-like action potentials of relatively long duration and shallow resting membrane potential. They also generated calcium transients with amplitude and duration similar to those of neonatal cardiomyocytes. These results show that BM-SP cells are capable of functional cardiomyogenic differentiation when co-cultured with neonatal cardiomyocytes.

• 대한치과마취과학회지
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• 제1권1호
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• pp.26-31
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• 2001

The wide deep penetrating wound of maxillofacial region should be early closed under emergency general anesthesia for the prevention of complications of bleeding, infection, shock & residual scars. But, if the emergency general anesthesia wound be impossible because of pneumoconiosis, obstructive pulmonary disease & hypovolemic shock, early primary closure should be done under local anesthesia by use of much amount of the anesthetic solution. The maximum dose of dental lidocaine (2% lidocaine with 1 : 100,000 epinephrine) is reported to 7 mg/kg under 500 mg (13.8 ampules) in normal adult. But the maximum permissible dose of dental lidocaine can be changed owing to the general health, rapidity of injection, resorption, distribution & excretion of the drug. The blood level of overdose toxicity is above $4.0{\mu}g/ml$ in central nervous & cardiovascular system. The injection of dental lidocaine 1-4 ampules is attained to the blood level of $1{\mu}g/ml$ in normal healthy adult. The duration of anesthetic action in the dental 2% lidocaine hydrochloride with 1 : 100.000 epinephrine is 45 to 75 minutes and the period to elimination is about 2 to 4 hours. Therefore, authors selected the following anesthetic methods that the first injection of 6 ampules is applied into the deeper periosteal layer for anesthetic action during 1 hour, the second injection into the deeper muscle & fascial layer, the third injection into the superficial muscle and fascial layer, the fourth injection into the proximal skin & subcutaneous tissue and the fifth final injection into the distal skin & subcutaneous tissue. The total 26-28 ampules of dental lidocaine were injected into the wound as the regular time interval during 5-6 hours, but there were no systemic complications, such as, agitation, talkativeness, convulsion and specific change of vital signs and consciousness.

• The Korean Journal of Physiology and Pharmacology
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• 제3권3호
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• pp.237-244
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• 1999

Magnesium ion is known to selectively block the N-methyl-D-aspartate (NMDA)-induced responses and to have anticonvulsive action, neuroprotective effect and antinociceptive action in the behavioral test. In this study, we investigated the effect of $Mg^{2+}$ on the responses of dorsal horn neurons to cutaneous thermal stimulation and graded electrical stimulation of afferent nerves as well as to excitatory amino acids and also elucidated whether the actions of $Ca^{2+}$ and $Mg^{2+}$ are additive or antagonistic. $Mg^{2+}$ suppressed the thermal and C-fiber responses of wide dynamic range (WDR) cell without any effect on the A-fiber responses. When $Mg^{2+}$ was directly applied onto the spinal cord, its inhibitory effect was dependent on the concentration of $Mg^{2+}$ and duration of application. The NMDA- and kainate-induced responses of WDR cell were suppressed by $Mg^{2+}$, the NMDA-induced responses being inhibited more strongly. $Ca^{2+}$ also inhibited the NMDA-induced responses current-dependently. Both inhibitory actions of $Mg^{2+}$ and $Ca^{2+}$ were additive, while $Mg^{2+}$ suppressed the EGTA-induced augmentation of WDR cell responses to NMDA and C-fiber stimulation. Magnesium had dual effects on the spontaneous activities of WDR cell. These experimental findings suggest that $Mg^{2+}$ is implicated in the modulation of pain in the rat spinal cord by inhibiting the responses of WDR cell to noxious stimuli more strongly than innocuous stimuli.

• 동의신경정신과학회지
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• 제19권1호
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• pp.43-54
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• 2008

Objective: The aim of this study is to evaluate the anticonvulsive effects of Gamiheichumhwan extract and to explain its action in GABAergic neuromodulation of the rat brain. Method: The extracts of Gamiheichumhwan were investigated for their inhibitory effect on GABA transaminase activity, their influence on brain GABA and glutamate levels, their agonistic activity on GABA/benzodiazepine receptor and anticonvulsive action using in vitro and in vivo assays. Results: 1. The extract inhibited dose-dependently GABA transaminase (GABA-T) activity by 4.6% and 18.9%, respectively at dosages of 250 mg/kg and 500mg/kg mouse (p.o.). 2. Brian GABA level was increased to 72.0% and brain glutamate level was decreased to 9.6% at a dosage of 500 mg/kg mouse (p.o.). 3. The extract suppressed [3H]Ro15-1788 binding to rat cerebral cortical membrane by $81.4{\pm}0.8%$ at a dosage of 3.2 mg, suggesting its agonistic activity on GABA/benzodiazepin receptor. 4. The extract showed anticonvulsive effect by lengthening the onset time of convulsion, shortening the convulsion duration and diminishing the lethality. Conclusion : It is suggested that Gamiheichumhwan can be used to somnipathy and adapted to treatment and prevention of epilepsy or convulsion.

• Clinical Pain
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• 제18권2호
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• pp.70-75
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• 2019

Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.

• The Korean Journal of Physiology
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• 제10권1호
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• pp.41-48
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• 1976

Tetrodotoxin (TTX) is the purified active principle responsible for tetrodon (Puffer-fish) poisoning which has long been known in the Orient. The pharmacological actions of TTX have been rather extensively investigated. Two of the most prominent effects of intravenousely administered TTX are severe hypotension and respiratory paralysis resulting from its depressant actions on tissues. This depressant actions of TTX in turn result from the selective inhibition of sodium-carrying mechanism which is essential to generation of the action potential. TTX differs from local anesthetics in that it does not affect potassium conductance. Although the mechanism of the hypotensive action of TTX remains a subject of controversy, most investigator agree that TTX-induced hypotension is caused by alteration in the blood vessels rather than the heart. Not only the study on the effects of TTX on cardiac function is meager but the results of reported works are often contradictory. The present study was undertaken to investigate the effect of TTX on the electrocardiogram of the rabbit and to compare them with well known electrocardiographical characteristics found in digitalis and quinidine intoxicated animals. The results obtained from the present study are summarized as follows. 1. No changes were found in P-R interval and QRS duration after i.v. administration of $1.0\;{\mu}g/kg\;to\;1.5\;{\mu}g/kg$ TTX to the animals. It is obvious that there were no conduction disturbance between atria and ventricles as well as in the ventricular tissue. 2. In $1.0\;{\mu}g/kg$ TTX group, S-T interval and T-P segment were not changed whereas marked changes were observed in $1.5\;{\mu}g/kg$ TTX group. 3. The first and second degree A-V blocks appeared in the $2.0\;{\mu}g/kg$ TTX group. 4. TTX differs from digitalis and quinidine in that it does not cause S-T interval depression and T-wave inversion. In contrast with digitalis, TTX caused Q-T interval prolongation.

• 한국잠사곤충학회지
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• 제34권1호
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• pp.15-20
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• 1992

누에의 5령유충 섭식기 동안 절식, 두흉부 결찰, 재섭식 및 methoprene 등의 처리가 JHE 활성도의 조절에 미치는 영향을 실험한 바 그 결과는 다음과 같다. 1. 누에의 절식 및 결찰처리를 하면 혈림프 JHE 활성도가 감소하였다. 2. 절식누에는 재섭식에 의해 JHE 활성도가 증가하였으며, 재섭식에 의한 JHE 활성도의 증가시기는 절식기간에 따라 다르게 나타났다. 3. 절식누에에 methoprene을 투여하면 JHE 활성도는 5령 기잠과 1일에서는 변화가 없었으나 2일부터 5일에서 절식누에에 비해 1.3-1.4배 증가하였다. 4. 결찰누에에 methoprene을 처리하면 JHE 활성도는 5령 기잠에 변화가 없었고 1일부터 5일에서는 결찰누에에 비해 1.9-2.3배 증가하였다. 5. 이상의 결과에서 5령누에의 섭식기 동안 JHE 활성도의 조절에는 두부요인, JH 및 영양 등이 중요한 요인으로 작용하였다 .특히 섭식기에 있어서 JHE는 두부요인과 JH의 공동작용에 의해 조절되지만, 령의 초기에는 두부요인이 그 후에는 JH가 보다 중요한 역할을 하는 것으로 생각된다.

• 수면정신생리
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• 제5권2호
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• pp.170-176
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• 1998

Nowadays light therapy is accepted practice in the treatment for Seasonal Affective Disorder. The author reviewed the practical aspects of light therapy, latest treatment research on optimal parameters of light therapy and the mechanisms of action of light therapy. Therapeutic efficacy of light therapy using light visors & dawn simulators has been suggested but further studies are needed to clarify the efficacy. The treatment most strongly supported by research studies is light therapy using a light box to administer bright white light (2500 lux for 2 hours or 10000 lux for 30 minutes). Although some patients may be selective responders to morning light exposure, the optimal timing of light exposure still remains controversial. In practice, generally the duration of exposure can be increased or decreased as necessary and also the timing of exposure can be splitted (e.g. AM/PM usage) if optimal response is obtained. For most, a positive response of light therapy is usually noted within $4{\sim}5\;days$ and optimal response is obtained within 2 weeks. Generally the relapse of symptom occurs within days of discontinuation of light therapy, so to prevent relapse, light therapy should be continued throughout the winter season for typical seasonal affective disorder. Side effects of light therapy appear to be mild and well tolerated. Several theories for the mechanisms of action of light therapy at the basis of seasonal affective disorder had been suggested but remain still controversial. Further studies on the optimal parameters and the mechanisms of light therapy help us to better understand and treat not only seasonal affective disorders but also chronobiological disorders and nonseasonal affective disorders.