• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.481-486
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• 2008

목 적 : 신생아에서 냉각 분사와 30% 포도당액의 경구투여의 통증 감소 효과를 비교하여, 신생아 집중치료실에서 행해지는 처치 중, 통증 감소를 위한 방법으로 냉각 분사의 유용성을 알아보고자 하였다. 방 법 : 2006년 6월부터 2006년 12월까지 인제대학교 부산백병원 신생아실에 입원한 60명의 신생아들을 대상으로 발뒤꿈치 천자와 근육 주사 시 다음 3가지 방법으로 통증 정도를 측정하였다. 제 1군(30명)은 발뒤꿈치천자군, 제 2군(30명)은 근육주사군이며, A군(10명)은 아무것도 처치하지 않은 군(대조군), B군(10명)은 30% 포도당액을 먹인 군, C군(10명)은 냉각스프레이를 분사한 군으로 나누어서 통증의 정도를 비교하였다. 통증의 평가 지표는 PIPP(Premature Infant Pain Profiles) 점수를 사용하였고, 심장 박동수와 산소포화도는 pulse oxymeter로 측정하였다. 결 과 : 발뒤꿈치천자군과 근육주사군에서 대조군의 PIPP 점수를 비교해보면 근육주사군에서 PIPP 점수가 높게 측정되었다(P=0.07). 그러나 통계적으로 유의하지 않았다. 평균 PIPP 점수를 보면 발뒤꿈치 천자시 대조군 $10.6{\pm}2.4$, 포도당군 $5.5{\pm}2.0$, 냉각 분사군 $5.2{\pm}1.8$로 대조군에 비해 냉각분사 및 포도당군들이 유의하게 낮았다(포도당군 P<0.001, 냉각 분사군 P<0.001). 근육 주사시 대조군 $12.5{\pm}1.4$, 포도당군 $7.0{\pm}1.7$, 냉각분사군 $6.4{\pm}1.6$으로 대조군에 비해 역시 실험군에서 유의하게 낮았다.(포도당군 P<0.001, 냉각 분사군 P<0.001). 통증을 느끼는 PIPP 6점 이상의 비율을 비교해보면 발뒤꿈치 천자시 대조군 100%, 포도당군 40%, 냉각분사군 40%, 근육주사시 대조군 100%, 포도당군 90%, 냉각분사군 60%으로 냉각분사군에서 낮았다. 심한 통증을 느끼는 PIPP 12점 이상의 비율을 비교해보면 발뒤꿈치천자시 대조군 60%, 포도당군 0%, 냉각분사군 0%, 근육주사시 대조군 70%, 포도당군 0%, 냉각분사군 0%로 대조군에 비해 포도당군과 냉각분사군에서 낮았다. 결 론 : 신생아에서 발뒤꿈치 천자나 근육 주사 시 냉각 분사는 경구 포도당액 만큼 통증감소에 효과가 있었다. 따라서 통증을 줄일 수 있는 새로운 방법으로 냉각 분사가 고려될 수 있다.

• 한국어병학회지
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• 제22권1호
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• pp.91-95
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• 2009

옥시테트라사이클린 (OTC)을 넙치 (평균체중 600 g)에 1회 근육 주사 (12.5, 25 및 50 ㎎/㎏ body weight)한 다음, 경시적 (3시간-360시간) 인 혈장내 OTC의 잔류농도를 분석하였다. 25 및 50 ㎎/㎏ 시험구에서 투여 5시간째 각각 0.99 및 1.49 $\mu{g}/m\ell$로 최대혈중농도를 나타내었으나, 12.5 ㎎/㎏ 시험구는 투여 10시간째 0.35 $\mu{g}/m\ell$로 최대혈중농도를 나타내었다. 모든 시험구는 투여 360시간째 혈중에서 OTC가 검출되지 않 았다. OTC의 넙치 체내 약물 혈중농도 측정결과를 바탕으로 1- compartment model로 Win-Nonlin program을 이용하여 OTC의 흡수, 배설,반감기 등 약물동태학적 매개변수 (parameter)를 조사하였다. 12.5, 25 및 50 ㎎/㎏을 근육 주사한 경우, 혈장농도-시간곡선하 면적 (AUC)은 각각 24.9, 44.67 및 50.45 $\mu{g}$ $h/m\ell$, 약물의 반감기 ($T_{1/2}$)는 각각 0.42, 0.59 및 0.41 h, 혈중최고농도의 도달시간 ($T_{max}$)은 8.46, 6.34 및 2.66 h, 혈중 최고농도 ($C_{max}$)는 0.30, 0.63 및 1.13 $\mu{g}/m\ell$로 계산되었다.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.412-420
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• 2016

본 연구는 실습실 개방 자율실습이 간호학생의 근육주사법에 대한 지식, 자신감 및 수행능력에 대해 미치는 효과를 확인하기 위해 실시되었다. 연구 설계는 비동등성 대조군 사전 사후 설계를 이용한 유사실험 연구로 G광역시 소재 일 간호대학의 기본간호학실습 과목을 수강하는 2학년 학생을 대상으로 하였으며 실험군 32명, 대조군 30명으로 총 62명이었다. 지식과 자신감은 설문지를 이용하였고 수행능력은 체크리스트를 사용하여 측정하였으며 사전, 사후 동일하게 측정하였다. 실험군은 전통적 학습과 실습실 개방 자율실습을 하였고 대조군은 전통적 학습만을 실시하였으며 수집된 자료는 SPSS 19.0 program 을 이용하여 paired t-test, t-test, ANCOVA로 분석하였다. 연구 결과 대조군의 지식(F=3.59, p=.019)이 실험군보다 유의하게 높게 나타났고, 실험군의 자신감(F=2.26, p=.016)과 수행능력(F=9.08, p<.001)이 대조군보다 유의하게 더 높게 나타났다. 따라서 실습실 개방 자율실습이 근육주사 간호술기에 대한 자신감 및 수행능력을 높이는 효과적인 방법으로 확인되었다. 앞으로 간호학생이 자율실습에 적극적으로 참여할 수 있고 실습실 개방 자율실습을 효과적으로 운영하는 방안이 마련되어야 할 것이다.

• Neonatal Medicine
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• 제18권2호
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• pp.353-358
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• 2011

목적: 건강한 신생아를 대상으로 B형 간염 예방접종 시 25% 경구 포도당과 인공젖꼭지의 진통효과를 알아보고자 전향적 부분적 무작위 임상실험을 시행하였다. 방법: 132명의 신생아를 대상으로, 출생 6시간 이후 B형 간염 예방접종을 근육 내 주사하여 비약물적 통증조절 방법을 비교하였다. 4가지 번호가 담긴 성별에 따라 구분된 상자를 통해 무작위 추첨으로 각 실험군을 정하였고, 주사 투여 2분 전에 증류수를 먹인 군을 대조군으로 25% 경구 포도당을 먹인 군(포도당 처치군), 주사 투여 전 2분 동안 인공젖꼭지만 물린 군(인공젖꼭지 처치군) 및 25% 경구 포도당을 인공젖꼭지에 묻혀 물린 군(포도당+인공젖꼭지 처치군)으로 총 4개의 군으로 구분하여 진행되었다. 모든 군에서 접종 전, 접종 시, 회복 시의 Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System (NFCS), Premature Infant Pain Profile (PIPP) 점수를 구하여 비교하였다. 결과: 산모와 대상아의 임상적 특징은 4개의 군 사이에 차이가 없었고, 대조군과 비교하여 포도당 처치군에서 NIPS 점수상 접종 시(6.4${\pm}$0.9 vs. 5.5${\pm}$1.7, P=0.01)와 회복 시(1.6${\pm}$2.0 vs. 0.6${\pm}$0.9, P=0.01), NFCS 점수상 회복 시(1.5${\pm}$2.3 vs. 0.7${\pm}$0.8, P=0.04)에 통증점수가 유의하게 낮음을 확인하였다. 또한 각 통증평가 점수상 통증이 있는 것으로 판단되는 대상(NIPS점수${\geq}$ 4점, NFCS점수${\geq}$3점)의 숫자가 의미 있게 감소하였다(9명 (23.1%) vs. 0명(0%), P=0.04 via NIPS, 7명(17.9%) vs. 0명(0%), P=0.02 via NFCS). 반면 모든 군 사이 PIPP 점수 혹은 중등도 혹은 심한 통증 PIPP 점수 대상수(PIPP점수${\geq}$7점)의 비교에서는 통계상 의미가 없었다. 그러나 대조군과 비교하여 인공젖꼭지 처치군에서 오히려 NIPS와 NFCS 점수가 각각 회복 시 통계상 유의하게 증가하였고(1.6${\pm}$2.0 vs. 2.7${\pm}$2.6, P=0.003 via NIPS, 1.5${\pm}$2.3 vs. 2.9${\pm}$2.6, P=0.023 via NFCS), 포도당+인공젖꼭지 처치군에서는 통계상 유의하지 않았다. 결론: 25% 경구 포도당을 이용한 통증조절은 효과가 있어 보이나 인공젖꼭지 혹은 25% 포도당을 묻힌 인공젖꼭지의 경우에는 효과가 없었다. 저자들은 본 연구 결과를 바탕으로 향후 신생아의 비약물적 통증조절에 대한 추가적 연구가 필요할 것으로 생각한다.

• 대한약침학회지
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• 제16권4호
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• pp.22-29
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• 2013

Objectives: This study was performed to analyze the toxicity of the test substance, anti-inflammatory pharmacopuncture (AIP), when used as a single intramuscular-dose in 6-week-old, male and female Sprague-Dawley rats and to find the lethal dose. Methods: The experiment was conducted at Biotoxtech according to Good Laboratory Practices. Twenty (20) female and 20 male Spague-Dawley rats were divided into 4 groups of five 5 female and 5 male animals per group. The rats in the three experimental groups received single intramuscular injections with 0.1-$m{\ell}$, 0.5-$m{\ell}$ and 1.0-$m{\ell}$/animal doses of AIP, Groups 2, 3, and 4, respectively, and the control group, Group 1, received a single intramuscular injection with a 1.0-$m{\ell}$ dose of normal saline. Clinical signs were observed and body weight measurements were carried out for 14 days following the injections. At the end of the observation period, hematology, clinical chemistry, histopathological tests and necropsy were performed on the injected parts. Results: No deaths occurred in any of the groups. Also, histopathological tests showed that AIP had no effect on the injected parts in terms of clinical signs, body weight, hematology, clinical chemistry, and necropsy. Conclusions: As a result of single intramuscular-dose tests of the test substance AIP in 4 groups of rats, the lethal dose for both males and females exceeded $1.0m{\ell}$/animal. Therefore, AIP is a relatively safe pharmacopuncture that can be used for treatment, but further studies should be performed.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.742-747
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• 2006

Purpose: The purpose of this study was to evaluate the role of mast cell and histamine as typical product of mast cell in ischemia-reperfusion injury of muscle flap using H2 receptor blocker and mast cell stabilizer. Methods: Thirty-five Sprague-Dawley rats weighing 250-300 gm were divided into four groups; Group I: Control group without ischemia, Group II: Normal saline injection group with ischemia, Group III: Cimetidine injection group with ischemia, Group IV: Sodium cromoglycate injection group with ischemia. Well established single pedicled transverse rectus abdominis musculocutaneous(TRAM) flap was designed in all rats and were rendered ischemia by clamping the artery for 150 minutes. All injections were applied intramuscular around gluteal area 30 minutes before reperfusion. The flap survival was evaluated at 7 days after operation. Neutrophil counts and mast cell counts were evaluated 24 hours after reperfusion. Results: The difference of skin flap survival between control group and cimetidine injection group was not significant. In the normal saline injection group flap survival was markedly decreased compared to that of control group. The muscle flap survival was similar to the results of skin flap survival. The neutrophil counts were significantly decreased in control group and sodium cromoglycate injection group than normal saline injection group. The mast cell counts were significantly decreased in cimetidine injection group and control group than both normal saline injection and sodium cromoglycate injection groups. The protective effect of sodium cromoglycate was not seen in the skin flap, but the muscle flaps showed protective effects of sodium cromoglycate compared to normal saline injection group. Conclusions: It is suggests that commonly used antihistamine(H2 receptor blocker) has protective effect against ischemia-reperfusion injury to skin and muscle flaps by reducing neutrophil and mast cell. The mast cell stabilizer was not effective for skin flap but, possibly, for muscle flap.

• Archives of Pharmacal Research
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• 제26권6호
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• pp.493-498
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• 2003

In this study we have investigated the pharmacokinetics and tissue distribution of GX-12, a multiple plasmid DNA vaccine for the treatment of HIV-1 infection. Plasmid DNA was rapidly degraded in blood with a half-life of 1.34 min and was no longer detectable at 90 min after intravenous injection in mice. After intramuscular injection, plasmid DNA concentration in the injection site rapidly declined to less than 1 ％ of the initial concentration by 90 min post-injection. However, sub-picogram levels (per mg tissue) were occasionally detected for several days after injection. The relative proportions of the individual plasm ids of GX-12 remained relatively constant at the injection site until 90 min post-injection. The concentration of plasmid DNA in tissues other than the injection site peaked at 90 min post-injection and decreased to undetectable levels at 8 h post-injection. The rapid in vivo degradation of GX-12 and absence of persistence in non-target tissues suggest that the risk of potential gene-related toxicities by GX-12 administration, such as expression in non-target tissues, insertional mutagenesis and germline transmission, is minimal.

• Neonatal Medicine
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• 제25권2호
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• pp.72-77
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• 2018

Purpose: Glucose has been recommended as an analgesic for mild to moderately painful procedures in neonates. The goal of this study was to assess the optimal dextrose concentration for pain control in newborns. Methods: This prospective, randomized, blinded clinical trial included 116 healthy full-term newborns. The neonates were randomly assigned to the following four groups by drawing straws: groups receiving sterile water or a 10%, 20%, or 40% dextrose solution orally. Each group was treated with the assigned solution prior to hepatitis B vaccination. The Neonatal Facial Coding System (NFCS) and the Neonatal Infant Pain Scale (NIPS) scores were evaluated before, immediately after, and 2 minutes after the injection in all neonates. Premature Infant Pain Profile (PIPP) scores were evaluated during the injection. All procedures were video-recorded, and pain scores were assessed by two independent observers who were not involved in the care of the newborns studied. The pain scores were compared among the four groups. Results: The 40% dextrose solution significantly reduced the NFCS (P=0.002) and the PIPP scores (P=0.001) compared with sterile water. No hyperglycemic events were noted in the study subjects 2 hours after the injection. Conclusion: The 40% dextrose solution effectively relieved pain due to intramuscular injection in full-term newborns without causing hyperglycemic events. However, the 10% and 20% dextrose solutions did not affect neonatal pain scores.

• 대한유전성대사질환학회지
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• 제5권1호
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• pp.9-17
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• 2005

Homocystinuria is a metabolic disorder caused by a deficiency of cystathionine ${\beta}$-synthase (CBS). Patients with homocystinuria show clinical symptoms such as mental retardation, lens dislocation, vascular disease with life-threatening thromboembolisms and skeletal deformities. Generally, the major treatments for CBS deficiency include pharmacologic doses of pyridoxine or dietary restriction of methionine. However, there is no effective treatment for this disease up till today and gene therapy can be an attractive novel approach to treatment of the disease. We investigated whether a recombinant adeno-associated virus could be used as a CBS gene transfer vector to reduce the excessive homocysteine level in the homocystinuria mouse model. Recombinant adeno-associated virus vector encoding the human CBS gene (rAAV-hCBS), driven by EF1-a promoter, was infused into CBS-deficient mice ($CBS^{-/-}$) via intramuscular (IM) and intraperitoneal (IP) injection. IP injection was more efficient than IM injection for prolongation of lives and reduction of plasma homocysteine levels. After 2 weeks of gene transfer by IP injection, serum homocysteine level was significantly decreased in treated mice compared with the age-matched controls and the life span was extended about 1.5 times. Also, increased expression of CBS gene was observed by immunohistochemical staining in livers of treated $CBS^{-/-}$ mice and microvesicular lipid droplets was decreased in cytoplasm of liver. These results demonstrate the possibility and efficacy of gene therapy by AAV gene transfer in homocystinuria mice.

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.135-141
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• 1997

The early studies demonstrated that the relative amount of FSH was important for stimulating normal ovarian activity and demonstrated the existence of a threshold level for FSH, above which follicular growth was activated. It was found that only a modest increase in circulating FSH level above the threshold (between 10 and 30%) was required to stimulate folliculogenesis. In addition, FSH is primary responsible for initiating estradiol production through the activation of the aromatase enzyme system in granulosa cells, follicular secretion and growth. LH on the other hand, plays a supportive role in ovarian steroidogenesis, stimulating the ovarian thecal cells to produce androgen, the precursor for estradiol synthesis. But there is now an increasing number of reports in the literature demonstrating an adverse effect of LH on fertility and miscarriage in infertile and fertile women. So HP-FSH is the drug of a highly purified FSH preparation which has a higher specific activity and far fewer impurities than FSH. This study was performed to evaluate the efficacy and safety of HP-FSH administered (SC; subcutaneous) versus FSH(IM; intramuscular) for ovulation induction. 20 candidates patients for ovulation induction were participated. All patients underwent pituitary desensitizing with a long gonadotropin-releasing hormone (GnRH) agonist protocol and ovulation induction was started with HP-FSH SC (10 patients; group I) or FSH IM (10 patients; group II). After ovulation, outcome of ovulation induction and local reaction of injection site were compared. There were no difference of outcome of ovulation in two groups except pregnancy rate/embryo transfer. Group I had a higher pregnancy rate/ embryo transfer than Group II (44.4% Vs 28.6%). Pain, redness, tenderness, bruising and itching when the injection received on the first 5 days of treated (50 SC and 50 IM injections) were assessed. There were no significant difference (P>0.05) in the incidence of tenderness, bruising and itching between the IM and SC injection. But IM injection (FSH) had a tendency of higher above incidence. The number of reports of pain, redness were significantly increased in IM injection group (P<0.05). These results indicate that SC administration of HP-FSH has been shown to be as effect for superovulation as traditional gonadotropins, with an improved safety profile due to the removal of extaneous proteins.