• 생물정신의학
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• 제27권1호
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• pp.27-35
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• 2020

Objectives Ketamine has been reported to have antidepressant effects or psychotomimetic effects. The aim of this study was to investigate the behavioral effects of ketamine treatment at various sub-anesthetic doses in adolescent and adult naïve mice. Methods In each experiment for adolescent and adult mice, a total of 60 male Institute of Cancer Research mice were randomly divided into 6 groups, which were intraperitoneally treated with physiological saline, 10, 20, 30, 40, and 50 mg/kg ketamine for consecutive 3 days. At 1 day after last injection, the locomotor and depressive-like behaviors were evaluated in mice, using open field test (OFT) and forced swim test (FST), respectively. Results In case of adolescent mice, ketamine dose was negatively correlated with total distance traveled in the OFT (Spearman's rho = -0.27, p = 0.039). In case of adult mice, we found significant positive correlation between ketamine dose and duration of immobility in the FST (Spearman's rho = 0.45, p < 0.001). Immobility time in the 50 mg/kg ketamine-treated mice was significantly higher compared to the saline-treated mice (Dunnett's post-hoc test, p = 0.012). Conclusions We found that the repeated treatment with ketamine could decrease the locomotor or prolong the duration of immobility in mice as the dose of ketamine increased. Our findings suggest that sub-anesthetic doses of ketamine might induce schizophrenia-like negative symptoms but not antidepressant effects in naïve laboratory animals.

• 생물정신의학
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• 제22권4호
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• pp.149-154
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• 2015

Mood disorder is a common psychiatric illness with a high lifetime prevalence in the general population. Many prescribed antidepressants modulate monoamine neurotransmitters including serotonin, norepinephrine and dopamine. There has been greater focus on the major excitatory neurotransmitter in the human brain, glutamate, in the pathophysiology and treatment of major depressive disorder (MDD). Recently, ketamine, an N-methyl-D-aspartate receptor antagonist, has received attention and has been investigated for clinical trials and neurobiological studies. In this article, we will review the clinical evidence for glutamatergic dysfunction in MDD, the progress with ketamine as a rapidly acting antidepressant, and other N-methyl-D-aspartate receptor antagonist for treatment-resistant depression.

• 분석과학
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• 제22권3호
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• pp.210-218
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• 2009

GC-MS/MS를 이용하여 모발 중 암페타민계 마약류 4종과 노르케타민의 동시 분석법을 확립하였으며 결과의 신뢰도를 높이기 위해 분석법 검정을 실시하였다. 모발 시료의 전처리 과정은 증류수와 아세톤을 이용하여 세척, 자동분쇄기를 이용한 세절, 메탄올 용매를 이용한 추출 및 배양 그리고 HFBA로 유도체화하는 단계를 거쳐 GC-MS/MS를 이용하여 분석하였다. 그 결과 모든 분석물질에 대해 정량범위 내에서 우수한 직선성을 나타내었으며, 실제 마약 복용자의 모발감정에 이용될 수 있는 충분한 감도와 선택성, 정밀도와 정확도를 확인하였다. 검정곡선의 결정계수($r^2$)는 0.998 이상을 나타내었고 검출 한계는 0.007 ng/mg 이하였으며 회수율은 75.9-100.9%이었다. 일내 (intra-day) 및 일간 (inter-day) 정확도는 -2.6-17.0%의 범위를 나타내었으며 정밀도는 10.7%이하로 모두 기준값(20% 이하)이내의 값을 나타내었다. 확립된 분석법을 마약 복용자의 모발에 적용한 결과 메스암페타민의 농도 분포는 0.97-19.30 ng/mg이었으며 암페타민은 0.14-2.56 ng/mg이었다.

• Restorative Dentistry and Endodontics
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• 제24권1호
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• pp.116-128
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• 1999

치근흡수 연구에서 치아재식을 위한 적당한 동물모델을 찾는일은 대단히 중요하다. 본 실험에서는 쥐 대구치의 발치 및 재식을 통해서 치근흡수가 발현되는 모양을 관찰했다. 모두 20마리의 쥐(30일생)에게 0.4% ${\beta}$-APN(aminoproprionitrile)가 포함된 분말용쥐사료를 5일간 먹인후 케타민 마취후 상악좌우측 제일대구치를 손상을 최소화하여 발치 하였다. 발거된 쥐치아는 0.02M Tris-HCl로 표면처리하여 부착치근막을 제거한후 파라핀팍스로 치근단을 밀폐 하여 재식하였다. 재식후 1, 2, 4, 6, 8 및 12일이 경과된 후 심장관혈을 통하여 쥐를 희생시킨후 3% glutaraldehyde가 포함된 EDTA에서 탈회한후 Epon 포매 하였다. 모든 시편은 유리칼을 사용하여 1미크론 두께로 절편한후 veronal acetate buffer에 녹인 1% toluidine blue로 염색하였다. 파치세포양 세포에 의한 치근흡수는 재식 5-7일후 처음 관찰되었다. 재식 12일후에는 치근 전체에 걸친 광범위한 치근흡수가 관찰되었다. 이상의 결과 ${\beta}$-APN을 포함한 쥐사료 식이요법은 쥐 상악제일대구치의 발치와 재식을 용이하게 하여 일정한 치근흡수를 발현시키는데 많은 도움이 된 것으로 판단되었다.

• 생물정신의학
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• 제23권1호
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• pp.18-23
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• 2016

Depression is a complicated psychiatric illness with severe consequences. Despite recent advanced achievements of molecular neurobiology, pathophysiology of depression has not been well elucidated. Among new findings of pathophysiology of depression, the possible fast antidepressant effect by N-methyl-D-asparate receptor antagonist, such as ketamine, is regarded as a promising treatment target of depression. Ketamine stimulates the mammalian target of rapamycin (mTOR) signaling pathway and activation of mTOR signaling pathway may be a key mechanism of the antidepressant effect of ketamine. Thus, this review describes the role of mTOR signaling in the pathophysiology of depression and developing a new treatment target of depression.

• The Korean Journal of Pain
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• 제12권1호
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• pp.123-127
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• 1999

Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

• The Korean Journal of Pain
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• 제1권1호
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• pp.87-90
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• 1988

In recent years the use of epidural opiates has increased and although this method of pain relief has shown good results in clinical practice It is still subject to certain drawbacks, the most serious of which appears to be delayed respiratory depression. Since ketamine administered systemically is unlikely to produce respiratory depression it seemed worthwhile to investigate the possibility of exploiting the potent analgesic property to ketamine by its epidural administration. The analgesic effect of ketamine 4 mg, administered epidural space, was evaluated. The duration of pain relief varied from less than 3 hours in 20% to over 24 hours in 30% of the cases. In 62.5% of the cases pain relief exceeded 6 hours. There was no evidence of respiratory depression, and there no postoperative neurologic sequelae. The present results indicated the need for further studies to compare the efficacy and safety of epidural ketamine with the response to epidural opioids for the relief of postoperative pain.

• The Korean Journal of Pain
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• 제19권1호
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• pp.87-90
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• 2006

Background: There are many ways to provide superior analgesia for postoperative pain after abdominal surgery of which epidural analgesics with opioids and local analgesics are the most useful. In an effort to maximize the level of analgesia and to minimize the side effects, ketamine, midazolam, clonidine, and adrenalin can be co-administrated as an adjuvant. This study examined the analgesic effect and side effects of midazolam compared with those given an epidural injection of bupivacaine, fentanyl and ketamine. Methods: In a double blind randomized controlled trial, 50 patients received either fentanyl $0.3{\mu}g/kg/h$ and ketamine 0.1 mg/kg/h (Group FK) or fentanyl $0.3{\mu}g/kg/h$, ketamine 0.1 mg/kg/h and midazolam 0.4 mg/h (Group FKM), added to 0.125% of bupivacaine at a rate of as much as 2 ml/h, for patient controlled epidural analgesia (PCEA) after low abdominal surgery. Ten minutes before surgery, the patients received either 10 ml of 0.125% bupivacaine with 0.5 mg/kg of ketamine or 10 ml of 0.125% bupivacaine with the same amount of normal saline, added to fentanyl $50{\mu}g$. The pain score and the side effects were recorded at 1, 3, 6, and 24 hours after surgery. Results: There was no difference in the pain score except for the VAS on coughing 1 hour after surgery. FKM group had fewer side effects. Conclusions: There was a better analgesic effect and fewer side effects with the addition of epidural midazolam to bupivacaine and fentanyl with ketamine formula. However, more study on the dose and route of administration will be needed.

• Advances in pediatric surgery
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• 제19권2호
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• pp.73-80
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• 2013

Ketamine is a safe and effective drug for pediatric anesthesia, sedation and analgesia. We hoped to identify that surgeons could operate a pediatric hernia with the ketamine anesthesia without general anesthesia. The study was a consecutive case series of 2230 inguinal hernia patients aged 1 months to 17 years in a Joo's day-surgical clinic during 11-year period. The patients had pediatric inguinal hernia surgery without general anesthesia under the day-surgery system. We retrospectively analyzed the medical record of patients who were registered with the Diagnosis Related Group (DRG) system. All patients received ketamine (5mg/kg) and atropine (0.01mg/kg) intramuscularly before surgery. After anesthesia, we injected 1~2% lidocaine (Less than 5ml) subcutaneously at the site of incision and started operation. The surgical method was the high ligation method of the hernia sac.) In total 2230 patients, male were 1756 and female were 474. 2076 patients were a unilateral inguinal hernia at the time of surgery and 154 were bilateral hernia patients. Less than three months, depending on the age of the patients was 391, and less than 12 months the patient was 592 people (26.5%). After surgery, there were no accidents or long term complications associated with ketamine anesthesia. We think the surgeon can safely do the pediatric inguinal hernia surgery using ketamine and lidocaine without anesthesiologist through 11 years of our surgical experiences.

• 대한치과마취과학회지
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• 제12권2호
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• pp.111-114
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• 2012

Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity, and hyperactivity. Given high incidence of ADHD, many children with ADHD is likely to present for anesthesia. This case report suggests intramuscular premedication as an alternative method for anesthetic induction. A 9-year-old male patient with ADHD was transferred for dental treatment under general anesthesia. The patient refused to go into dental clinic office. Oral midazolam was given to the patient, however, he was resistant to take midazolam via oral route. Instead, we administer midazolam and ketamine via intramuscular route. After less than 10 miniutes, the patient became drowsy and was transferred to dental chair. Intravenous access and mask inhalation was possible. The patient received dental treatment under general anesthesia and recovered in a non-complicated way. In this case, intramuscular sedation with midazolam and ketamine was used as a premedication in highly uncoopearive patient refused to take oral sedative medication.