• 제목/요약/키워드: Analog Test

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Orthodontic pain control following arch wire placement; a comparison between pre-emptive tenoxicam and chewing gum: a randomized clinical trial

  • Basam, Lakshman Chowdary;Singaraju, Gowri Sankar;Obili, Sobitha;Keerthipati, Thejasree;Basam, Ram Chowdary;Prasad, Mandava
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권2호
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    • pp.107-116
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    • 2022
  • Background: Pain during fixed orthodontic treatment can have a detrimental effect on patient treatment compliance. To overcome this, there is a definite need to establish the best pain-relieving methods suitable for orthodontic patients in terms of efficacy and use. The objective of this study was to compare the effect of chewing gum and pre-emptive tenoxicam on pain after initial archwire placement and to evaluate the pain perceptions of orthodontic patients in the two groups while performing various functions at specific time intervals. Methods: Forty-two patients were selected and randomly divided into two groups: group A (chewing gum) and group B (pre-emptive tenoxicam). Pain perception was documented by patients immediately; at 4 h; at bedtime on the day of archwire placement; the next morning; at 24 h; and at bedtime on the 2nd, 3rd, and 7th day after the initial archwire placement. Pain scores were noted during fitting of the posterior teeth, biting, and chewing using a visual analog scale. The data obtained were subjected to statistical analysis. Results: Group A showed a significant increase in pain until the next morning while fitting the posterior teeth, biting, and chewing [36.2, 52.0, 33.4, respectively]], followed by a gradual decrease by the 7th day. Group B showed a significant increase in pain at bedtime on biting, with a peak value of 47.5. Pain on chewing, fitting posterior teeth, peaked the morning of the next day (100.0, 45.0). The Freidman test showed a statistically significant difference with a p-value of < 0.01. Higher pain scores were observed while chewing and biting compared with that while fitting the posterior teeth in both groups. The overall comparison of pain control between the two groups was not statistically significant [P > 0.05] between the two groups. Conclusions: Chewing gum was not inferior to pre-emptive tenoxicam. Thus, chewing gum is a non-pharmacological alternative to analgesics for orthodontic pain control that eliminates the chance of adverse reactions and can be used in the absence of adult observation.

신경병성 통증이 있는 당뇨 환자에서 반복 경두개 자기자극치료의 효과 및 피질 탈억제 현상: 환자 대조군 연구 (Effects of Repetitive High Frequency Motor Cortex Transcranial Magnetic Stimulation and Cortical Disinhibition in Diabetic Patients with Neuropathic Pain: A Case Control Study)

  • 한용;이찬호;민경완;한경아;최효선;강윤주
    • Clinical Pain
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    • 제18권1호
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    • pp.1-7
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    • 2019
  • Objective: To investigate the cortical disinhibition in diabetic patients with neuropathic pain and without pain. In addition, we assessed the cortical disinhibition and pain relief after repetitive transcranial magnetic stimulation (rTMS). Method: We recruited diabetic patients with neuropathic pain (n = 15) and without pain (n = 15). We compared the TMS parameters such as motor evoked potential (MEP) amplitude, cortical silent period (CSP), intracortical inhibition (ICI %) and intracortical facilitation (ICF %) between two groups. Moreover, we evaluated the changes of pain and TMS parameters after five consecutive high frequency (10 Hz) rTMS sessions in diabetic patients with neuropathic pain. The neuropathic pain intensity (visual analog scale) and TMS parameters were assessed on pre-rTMS, post-rTMS 1day, and post-rTMS 5 day. Results: The comparison of the CSP, ICI % revealed significant differences between two groups (p<0.01). After rTMS sessions, the decrease in pain intensity across the three time points revealed a pattern of significant differences (p<0.01). The change of CSP and ICI % across the three test points revealed a pattern of significant differences (p<0.01). The ICI % revealed immediate increase after first rTMS application and significant increase after five rTMS application (p<0.01) in diabetic patients with neuropathic pain. The MEP amplitude and ICF % did not reveal any significant changes. Conclusion: Our findings demonstrate that cortical inhibition was decreased in diabetic patients with neuropathic pain compared with patients without pain. Furthermore, we also identified that five daily rTMS sessions restored the defective intracortical inhibition which related to improvement of neuropathic pain in diabetic patients.

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

  • Troy Li;Kenneth H. Levy;Akiro H. Duey;Akshar V. Patel;Christopher A. White;Carl M. Cirino;Alexis Williams;Kathryn Whitelaw;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.245-251
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    • 2023
  • Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

호스피스 자원봉사자의 발마사지와 지지적 의사소통이 외래 항암화학요법 환자의 우울, 불안 및 기분에 미치는 효과 (Effects of Foot Massage and Supportive Communication by Hospice Volunteers on Depression, Anxiety, and Mood of Cancer Patients Who Undergo Intravenous Chemotherapy at Out-patient Department)

  • 허혜경;송희영
    • Journal of Hospice and Palliative Care
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    • 제13권4호
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    • pp.232-242
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    • 2010
  • 목적: 종합병원 외래 주사실에서 항암화학요법을 받는 암환자를 대상으로 발마사지와 지지적 의사소통 제공 후 우울, 불안, 긍정적 및 부정적 기분의 변화를 확인하기 위함이다. 방법: 비동등대조군 전후 시차 유사 실험설계로 연구의 대상은 원주시의 일 3차 종합병원 외래 주사실에 항암화학요법을 받는 암환자를 편의표집하여 대조군 34명 실험군 30명 총 64명이었다. 연구도구는 일반적 특성과 질병특성, 최근에 경험하는 신체적 증상 측정 문항, 그리고 각각 10 cm 시각상사척도를 이용하여 우울, 불안, 활기, 의욕, 희망, 긴장 및 무기력을 측정하였다. 결과: 제 1 가설인 '발마사지와 지지적 의사소통을 받은 실험군은 대조군보다 처치 후에 우울과 불안이 더 많이 감소될 것이다'는 처치 후 실험군에서 우울(t=5.26, P<0.001)과 불안(t=5.07, P<0.001)이 유의하게 감소되어 지지되었다. 제 2 가설인 '실험군은 대조군 보다 처치 후에 활기, 의욕 및 희망이 더 증가될 것이다'는 두 군에서 활기, 의욕 및 희망의 처치 전후의 변화를 비교한 결과 실험군에서 유의한 변화가 없어 기각되었다. 제 3 가설인 '실험군은 대조군보다 처치 후에 긴장과 무기력이 더 감소될 것이다'는 처치 후 두 군 모두에서 긴장과 무기력이 유의한 감소를 나타냈으므로, 중재 전후 변화의 정도에 차이가 있는지를 확인하기 위해 두 변수의 중재 전과 후의 차이값의 평균을 비교하였다. 검정결과 대조군에 비해 실험군에서 긴장(t=5.64, P<0.001)과 무기력(t=5.38, P<0.001)이 더 큰 감소를 보여 제 3 가설은 지지되었다. 결론: 본 연구의 결과는 외래 주사실에서 항암화학요법을 받는 동안 호스피스 자원봉사자가 제공한 발마사지와 지지적 의사소통이 암환자의 우울, 불안, 긴장, 무기력을 감소에 유용함을 제시하였다. 연구 결과의 타당성을 높이기 위해 대상자 수를 확대하고 좀 더 정련화된 중재의 개발과 효과검증을 위한 추후 연구가 필요하다.

Variability in Drug Interaction According to Genetic Polymorphisms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • 한국환경성돌연변이발암원학회지
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    • 제24권1호
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    • pp.15-18
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    • 2004
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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디지털 보청기 알고리즘 평가를 위한 감음신경성 난청의 모델링 (Modeling of Sensorineural Hearing Loss for the Evaluation of Digital Hearing Aid Algorithms)

  • 김동욱;박영철
    • 대한의용생체공학회:의공학회지
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    • 제19권1호
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    • pp.59-68
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    • 1998
  • 디지털 보청기는 기존의 아날로그 보청기에 비하여 많은 장점이 있다. 디지털 신호처리 프로세서의 발달과 더불어 최근에 다양한 디지털 보청 알고리즘과 완전한 디지털 보청기가 선보였다. 디지털 보청기의 알고리즘을 개발하거나 디지털 보청기를 새로이 평가하려는 사람들에게 난청자를 대상으로 하는 임상연구는 필수적으로 거쳐야 하는 과정이다. 그러나 이러한 임상연구는 실제 난청자를 대상으로 하여야 하기 때문에 난청자와 검사자 간에 통상적으로 많은 시간과 노력이 필요하며 원활한 의사 소통이 때로는 어려울 수 있다. 왜냐하면 난청자들의 연령이 너무 어리거나 많아서 의사소통에 지장을 주거나 검사자가 필요로 하는 시간에 비슷한 난청 유형을 가진 대상자를 모으기 어렵다. 본고에서는 임상연구를 보조하여 디지털 보청기 또는 알고리즘이 개발되기까지 수행되어야 할 많은 임상연구의 결과를 예측하고 평가할 수 있는 디지털 난청 시뮬레이션 방법을 제안하고, 실제 환자의 데이터를 사용한 시뮬레이션과 그에 대한 임상 실험을 통하여 시스템의 성능을 평가하였다. 실험 결과, 정상인으로부터 모델링된 환자 데이터와 매우 유사한 측정 결과를 얻어냄으로써, 제안된 시스템이 목적하고자 하는 바를 이룰 수 있음을 검증하였다. 또한 난청 시뮬레이터의 목적인 디지털 보청기 알고리즘을 개발하기 위한 평가 툴로서, 개발 초기에 다양한 디지털 보청기용 알고리즘을 구현하여 실제 난청 시뮬레이터와 연계하여 실험함으로써 보청기 알고리즘의 평가 및 새로운 보청기 알고리즘을 개발하고 평가하거나 향후 난청자를 대상으로 하는 임상연구에서 사용할 수 있는 유용성을 입증하였다.로 우유 교육 프로그램이 향후보다 체계적이고 확대되어 지속적으로 실시된다면, 우유에 대한 의미는 물론 인식 그리고 지식 정도에 있어 효과적인 결과를 유도할 수 있을 것이다.니하였다. 6) Dibutyryl cyclic AMP 및 8-bromo cyclic GMP 모두 혈소판응집률(血小板凝集率)을 감소시켰고, 후자(後者)는 전자(前者)에 비(比)하여 월등(越等)히 현저(顯著)하였다. sodium nitroprusside에 의한 항응집률(抗凝集率)은 methylene blue 전처치(前處置)에 의하여 길항(拮抗)되었으나, bovine hemoglobin전처치에 의하여는 영향(影響)을 받지 아니하였다. 이상(以上)의 성적(成績)을 종합(綜合)하면, 뇌졸중증(腦卒中症)때, 특히 뇌혈전증(腦血栓症)의 응급치료시(應急治療時) sodium nitroprusside의 응용(應用)이 가능(可能)하다고 사료(思料)되며, 이에 대(對)하여 임상적(臨床的) 치료(治療)가 기대되는 바이다.다시 상승(上昇)하는 경향(傾向)이었다. 중성지질(中性脂質) 중(中) climacteric rise 및 숙도(熟度)와 관련하여 변화(變化)한 것은 diglyceride 및 sterol ester의 2종(種)이었으며 glyceride가 중성지질(中性脂質) 전량(全量)의 변화(變化)와 동일(同一)한 경향(傾向)인데 반(反)하여 sterol ester은 climactric onset까지 증가(增加)하다가 기후(其後) 감소(減少)하였다. 인지질(燐脂質)도 저장기간(貯藏期間) 중(中) 처리구(處理區)에 관계(關係)없이 다같이 감소(減少)되었는데, 그 정도(程度)

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지질매체내에서의 $^{241}Am,\;^{152}Eu,\;^{160}Tb,\;^{60}Co$의 흡착특성비교: 지표지질내에서의 Am의 거동특성을 위한 최적 유사체로서의 Eu (Sorption Behavior of $^{241}Am,\;^{152}Eu,\;^{160}Tb\;and\;^{60}Co$ in the Geological Materials: Eu as an Optimum Analogue for Fate and Transport of Am Behavior in Subsurface Environment)

  • 이승구;이길용;조수영;윤윤열;김용제
    • 자원환경지질
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    • 제40권4호
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    • pp.361-374
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    • 2007
  • 희토류원소는 지각의 진화, 분화작용 등을 포함한 여러 가지 지질학적 역사를 이해하는 매우 유용한 도구로서 활용되어 왔다. 뿐만 아니라, 이 희토류원소는 방사성폐기물의 처분과 관련된 물-암석반응연구에 있어서 액티나이드 원소의 유사체로서 사용되어져 왔다. 본 논문에서는 희토류원소인 Eu와 액티나이드 원소인 Am의 유사한 물리적/화학적 특성을 토대로 지질매체의 종류에 관계없이 희토류원소와 액티나이드 원소의 거동이 매우 유사하다는 가설을 설정하고 이를 검증하기 위한 회분식(batch experiment) 실험을 수행하였다. 회분식 실험에는 4종류의 암석(화강암, 화강암질 편마암, 앰피볼라이트, 응회암)을 지질매체로 선택하였고, 고준위 방사성 핵종으로는 액티나이드계열인 $^{241}Am$, 희토류원소 계열인 $^{152}Eu,\;^{160}Tb$을 선택하였고, 중저준위 핵종으로는 $^{60}Co$를 사용하였다. 특히 $^{160}Tb$$^{60}Co$$^{241}Am-^{152}Eu$의 흡착능과 다른 방사성핵종의 흡착능을 비교하는데 사용되었다. 핵종과 혼합한 흡착실험용 용액의 pH는 5.5전후로 조절하였다. 실험결과, $^{241}Am,\;^{152}Eu,\;^{160}Tb$의 흡착 특성은 암상의 변화에 관계없이 매우 유사하게 나타났지만, $^{60}Co$는 다르게 나타났다. 이는 $^{60}Co$의 흡착특성은 암상의 종류에 따라 큰 차이가 있음을 지시해주는 것이다. 이와 같은 실험결과는 1) 희토류원소 중 Eu이 지표지질하에서의 Am의 거동을 추적하고 예측하기 위한 최적 유사체이고, 2) 비록 암석가루의 비표면적 혹은 양이온교환능과 같은 물리적/화학적 특성에 의한 영향을 배제할 수는 없지만, $SiO_2,\;TiO_2,\;P_2O_5$같은 화학조성 및 Eu의 이상과 같은 희토류원소의 분포도의 차이가 지표지질하에서의 방사성 핵종의 흡착거동에 중요한 역할을 하고 있음을 지시해주는 것이다.

Variability in Drug Interaction According to Genetic Polymorph isms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • 한국환경성돌연변이발암원학회지
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    • 제23권4호
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    • pp.131-134
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    • 2003
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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