• 약학회지
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• 제55권2호
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• pp.145-153
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• 2011

A simultaneous detection and quantification method for determining the Phenylalkylamine derivatives, such as methamphetamine (MA), amphetamine (AM), 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), ketamine (KT), norketamine (NKT), phentermine (PT), fenfluramine (FFA) and phenmetrazine (PM), in oral fluid was developed and validated according to international guidelines. The validated method was applied to actual oral fluid samples collected from drug abuse suspects. The recovery of phenylalkylamines from oral fluid collection devices was also assessed. Oral fluid specimens from 20 drug abuse suspects submitted by the police were collected using Salivette$^{TM}$, Quantisal$^{TM}$ or direct expectoration. The samples were screened using a biochip array analyzer. For confirmation, the samples were analyzed by GC-MS in selected-ion monitoring (SIM) mode after extraction using automated SPE with a mixed-mode cation exchange cartridge and derivatization with trifluoroacetic anhydride (TFAA). The results from the immunoassay were consistent with those from GC-MS. All the oral fluid samples gave positive results for MA, AM, PT and/or PM. The detection of phenylalkylamines in oral fluid can provide a better indication of recent use than urine or hair. Therefore, the oral fluid specimen was useful for demonstrating phenylalkylamines abuse in the driving under the influence of drug (DUID) as an alternative specimen for urine.

• 대한임상독성학회지
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• 제11권1호
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• pp.23-27
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• 2013

Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.

• 대한수의학회지
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• 제45권1호
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• pp.131-137
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• 2005

To assess anesthetic depth using quantitative electroencephalography (q-EEG), we recorded processed EEG (raw EEG) till 100 minutes in beagle dogs anesthetized for 60 minutes with tiletamine/zolazepam (n=5, TZ group), xylazine/ketamine (n=5, XK group) and propofol (n=5, PI group) by intermittent bolus injection. Raw EEG was converted into 95% spectral edge frequency (SEF) and median frequency (MF) through fast fourier transformation (FFT) method. 95% SEF value of TZ group was significantly higher (p<0.05) than the XK group from 10 minutes to 100 minutes. 95% SEF value of PI group was significantly higher (p<0.05) than the XK group from 10 minutes to 40 minutes, and significantly low (p<0.05) than XK group at 90 and 100 minutes. MF was significantly higher (p<0.05) in TZ group from 60 minutes to 100 minutes. Based on these results, using dissociative agent with ${\alpha}_2$-adrenergic agent is more potent in CNS depressed than using dissociative agent alone, and low doses of propofol has a disinhibitory effect on CNS.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.22-32
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• 2000

Purpose : Histopathologic observation was performed in order to determine which type of suture material is superior in microvascular anastomoses. Materials & Methods : The interrupted end to end anastomosis of the transected carotid arteries of 105 Sprague-Dawley rats, weighing 180 to 200g, were performed using 9-0 polypropylene ($Prolene^{TM}$, Ethicon, U.K.), 9-0 polyglactin 910 monofilament($Vicryl^{TM}$, Ethicon, U.K.), and 9-0 polyamide($Ethilon^{TM}$, Ethicon, U.K.) under intramuscular Ketamine and Xylazine anesthesia(5mg/100g). In all cases, 10 to 12 sutures were placed to complete the anastomoses. The specimens were obtained at 1, 2, 3 days, and 1, 2, 4 and 6 weeks after the surgery and prepared with H&E and Van-Gieson stains and investigated the histologic changes in anastomotic sites under light microscope. The histologic changes we were concerned about were followings- thrombus formation, intimal edema, infiltration of inflammatory cells in media and adventitia, proliferation of endothelial cells and subintimal hyperplasia. Results : 1. All of the anastomosed arteries were patent when they were exposed for examination. 2. Thrombus formation and intimal edema were most severe in Vicryl group, followed by Ethilon, Prolene group in order. 3. The inflammatory cells infiltrated to the media and the adventitia most severely in Ethilon group, followed by Vicryl, Prolene group in order. 4. There was little difference in proliferation of endothelial cells in each group. 5. Subintimal hyperplasia was greater in Vicryl group than the others, but there was no significant difference between the Prolene and Ethilon groups. Conclusions : On the basis of these observations, we could conclude that Prolene may be the better suture material for microvascular anastomoses regarding the tissue responses than Ethilon and Vicryl.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.543-547
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• 2009

Purpose: Adhesion is the most common and troublesome complication after repair of flexor tendon injury. Recently, use of sodium hyaluronate derivatives for adhesion prevention is increasing. A commercial product, Guardix$^{(R)}$, sodium hyaluronate(NaHe) combined with carboxymethylcellulose(CMC) has been newly developed as a preventive material for adhesion. We have investigated its effect in rabbits. Methods: Twenty seven male New Zealand white rabbits were operated under ketamine anesthesia. After tendon repair in zone II of the hind paw, Guardix$^{(R)}$(experimental group) or normal saline(control group) was administered. Biomechanical tests were performed to estimate adhesion formation at 2, 4, 8, and 12 weeks after the operation. Maximum tensile load to flex the distal interphalangeal joint 50 degree from its resting state(MTL50) was measured, depicting the amount of adhesion formed. Subsequently, breaking strength was assessed. Results: There were no postoperative complications such as infection, wound dehiscence, or hematoma. MTL50 was significantly lower in the experimental group than in the control group at 4, 8, 12 weeks (p<0.05). Mean value of MTL50 was 6.64N in the experimental group and 28.53N in the control group at 12 weeks after surgery. There were no significant differences in breaking strength. Conclusion: Our results indicate that Guardix$^{(R)}$ is helpful in reducing adhesion formation and does not interfere with normal healing processes of the tendon.

• Restorative Dentistry and Endodontics
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• 제21권2호
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• pp.677-687
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• 1996

This study was conducted to evaluate the tissue responses histologically to three root canal cements : Sealapex, AH-26, and zinc oxide-eugenol cement. Twelve white female Sprague-Dawley rats, weighing between 350 and 400 gm, were anesthetized with an intraperitoneal injection of Ketamine hydrochloride(0.4 ml). After shaving the sites selected(left and right scapular areas, left and right pelvic areas), the animal's backs were scrubed with soap and water, and sterilized with absolute alcohol. Each material was mixed to a thin consistency to flow out easily through a 24-guage needle, and loaded into a sterile, disposable plastic 1-ml syringe. All of the rats were injected subcutaneously with 0.1 ml of the three test sealers. Normal saline was used as a control. Animals were sacrificed after 48hr, 1, 4, and 12 weeks by overanesthetization using jars containing anesthetic ether. The tested sites were surgically removed with the surrounding tissue and fixed with 10% formalin. After 48 hours specimens were embedded in paraffin, sectioned to an average thickness of $6{\mu}m$ thick, stained with hematoxylin-eosin. The slides were examined under the light microscope. The results were obtained as follows 1. All material except the control showed various degree of inflammation on 48 hr. 2. Sealapex : In early stage, severe inflammatory cell infiltration was observed. At the 4th weeks observation, graunlomatous tissue with macrophage and foreing body giant cells containing many dark particles in their cytoplasm was observed. 3. AH-26 : Mild inflammatoy reaction was observed with AH-26 throughout the experimental period. 4. Zinc oxide-eugenol cement : Severe inflammatory cell infiltration, necrosis along the material, edema could be seen in early stage. Zinc oxide-eugenol cement maintained a moderate/severe reaction throughout the experimental period.

• 대한본초학회지
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• 제28권3호
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• pp.7-15
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• 2013

Objectives : Interruption and subsequent restoration of blood flow into the kidney result in renal injury. As an approach to preventing the renal injury, we determined the optimal conditions and the underlying mechanisms by which supernatant of hot water extract of ground Triticum aestivum L. (extract) attenuated ischemia/reperfusion (I/R) injury. Methods : One hour after administration of the extract (400 mg/kg) by intraperitoneal injection, renal I/R injury was generated by clamping the left renal artery in rats after surgical removal of the right kidney, followed by reperfusion. The maximal difference between the vehicle-treated and the extract-treated group under ketamine/xylazine or enflurane anesthetization was assessed at varying periods of ischemia (30-45 min) and reperfusion (3-48 hr), based on the renal function assessed with serum creatinine levels, tissue injury with hematoxylin/eosin staining, and apoptosis with terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling staining. Results : Enflurane anesthetization with 40 min of ischemia and 24 hr of reperfusion was identified to be the optimal condition, under which condition serum creatinine levels and tubular damage in the extract-treated group were significantly reduced compared with those in the vehicle-treated group ($1.3{\pm}0.2$ versus $2.7{\pm}0.3$ mg/dL, P < 0.01, and average score $1.8{\pm}0.1$ versus $3.5{\pm}0.3$, P < 0.01, respectively). These beneficial effects were mediated by inhibition of apoptotic cascades through attenuation of renal tissue malondialdehyde levels, Bax/Bcl-2 ratio and caspase-3 levels. Conclusions : The extract conferred renal protection against ischemia/reperfusion injury in rats by scavenging reactive oxygen species and consequently blocking apoptotic cascades, plausibly augmented by enflurane protection.

• 한국임상수의학회지
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• 제40권1호
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• pp.25-30
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• 2023

The ventral midline approach (VMA) and right flank approach (RFA) are common procedures for the sterilization of bitches. This study compared the different parameters viz. total duration of surgery, recovery time, and length of the incision as well as body temperature, heart rate, respiration rate, and SpO2 in each approach. Twenty (20) bitches were divided randomly for the RFA and VMA. Meloxicam (0.2 mg/kg) was administered subcutaneously half an hour before the induction to provide preemptive analgesia. Diazepam and ketamine were administered intravenously at dose rates of 0.25 mg/kg and 2.5 mg/kg, and 0.17 mg/kg and 3.33 mg/kg, respectively to produce and maintain anesthesia. Each parameter was recorded at the pre-operative, operative and post-operative times. The average duration of surgery and length of incision of RFA (16.1 ± 5.13 min and 2.44 ± 0.83 cm) were significantly lower (p < 0.05) than the VMA (21.3 ± 5.48 min and 3.53 ± 0.7 cm). The operated bitches showed hypothermia (p < 0.05) at 1 hour compared to baseline and 24 hours of surgery. Heart and respiration rates increased significantly (p < 0.05) during traction and severing of ovarian ligaments in bitches within the RFA group, but there was no significant difference within VMA approaches. The sedation score was significantly higher (p < 0.05) at 1 hour after surgery in both approaches. Based on the duration of surgery and length of incision RFA approach was quick and minimal skin wound. Further studies on bitches considering molecular investigations of surgical stress are imperative.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권2호
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• pp.83-89
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• 2023

Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania. Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic. Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office. Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.79-87
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• 2023

Purpose: Gastrointestinal (GI) endoscopy is an important tool for diagnosing and treating GI diseases in children. This study aimed to analyze the current GI endoscopy practice patterns among South Korean pediatric endoscopists. Methods: Twelve members of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition developed a questionnaire. The questionnaire was emailed to pediatric gastroenterologists attending general and tertiary hospitals in South Korea. Results: The response rate was 86.7% (52/60), and 49 of the respondents (94.2%) were currently performing endoscopy. All respondents were performing esophagogastroduodenoscopy, and 43 (87.8%) were performing colonoscopy. Relatively rare procedures for children, such as double-balloon enteroscopy (DBE) (4.1%), endoscopic retrograde cholangiopancreatography (ERCP) (2.0%), and endoscopic ultrasound (EUS) (2.0%), were only performed by pediatric gastroenterologists at very few centers, but were performed by adult endoscopists in most of the centers; of all the respondents, 83.7% (41/49) performed emergency endoscopy. In most centers, the majority of the endoscopies were performed under sedation, with midazolam (100.0%) and ketamine (67.3%) as the most frequently used sedatives. Conclusion: While most pediatric GI endoscopists perform common GI endoscopic procedures, rare procedures, such as DBE, ERCP, and EUS, are only performed by pediatric gastroenterologists at very few centers, and by adult GI endoscopists at most of the centers. For such rare procedures, close communication and cooperation with adult GI endoscopists are required.