• Journal of Pharmaceutical Investigation
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• v.35 no.6
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• pp.417-422
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• 2005

This study was aimed to design and formulate the moisture-activated patches containing ofloxacin and lidocaine for antibacterial and local anesthetic action. The solubility of lidocaine at $32^{\circ}C$ in various vehicles decreased in the rank order of PG $759.5{\pm}44.5\;mg/mL$ > PGL > IPM > PEG 300 > PEG 400 > Ethanol > PGMC > DGME > PGML > OA > $Captex^{\circledR}\;300$ > $Captex^{\circledR}\;200$ > water $(4.0{\pm}0.1\;mg/mL)$. Ofloxacin revealed very low solubility, which the highest solubility was obtained from PEG 400 $(18.7{\pm}6.3\;mg/mL)$ among the vehicles used. The addition of lactic acid increased the solubility of ofloxacin dramatically; the solubility at 5% lactic acid was $133.7{\pm}9.7\;mg/mL$. As $2-hydroxypropyl-{\beta}-cyclodextrin$ was added at the concentrations of 40, 80, 120, 160 and 200 mM, the solubilities of lidocaine and ofloxacin were enhanced up to three and two times, respectively, with concentration-dependent pattern. Gel intermediates for filmtype patches were prepared with mucoadhesive polymer, viscosity builders, lidocaine or ofloxacin at pH values from 5 to 7. Gels were cast onto a release liner and dried at room temperature. Dried patch was attached onto an adhesive backing layer, thus forming a patch system. Patches containing a single drug component were characterized by in vitro measurement of drug release rates through a cellulose barrier membrane. The release study was carried out at $37^{\circ}C$ using a Franz-type cell. Receptor solutions were isotonic phosphate buffers (pH 7.4). Samples $(100\;{\mu}L)$ were taken over 24 hours and quantitated by a verified HPLC method. The releases from all tested were proportional to the square root of time. The release rates were 0.9, 157.3 and $281.7\;{\mu}g/cm^{2}/min^{1/2}$ for the lidocaine patches and 19.8,37.2 and $50.7\;{\mu}g/cm^{2}/min^{1/2}$ for the ofloxacin patches at the concentrations of 0.3, 0.5 and 1 %, respectively. The release rates were dose dependent in both drug patches $(R^{2}\;=\;0.9077\;for\;lidocaine;\;R^{2}\;=\;0.9949\;for\;ofloxacin)$ and those were also thickness-dependent $(R^{2}\;=\;0.9246\;for\;lidocaine;\;R^{2}\;=\;0.9512\;for\;ofloxacin)$.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.3
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• pp.243-251
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• 2000

In order to provide a basis for studying the molecular mechanism of pharmacological action of local anesthetics and to develop a fluorescence spectroscopic method which can detect the microviscosity of native and model membranes using intramolecular excimerization of 1,3-di(l-pyrenyl)propane (Py-3-Py), we examined the effect of lidocaine HCl on the microviscosity of model membranes of phosphatidylcholine fraction extracted from synaptosomal plasma membrane vesicles (SPMVPC). The excimer to monomer fluorescence intensity ratio (I'/I) of Py-3-Py in liquid paraffin was a simple linear function of $T/{\eta}.$ Based on this calibration curve, the microviscosity values of the direct probe environment in SPMVPC model membranes ranged from $234.97{\pm}48.85$ cP at $4^{\circ}C$ to %19.21{\pm}1.11$ cP at $45^{\circ}C.$ At $37^{\circ}C,$ a value of $27.25{\pm}0.44$ cP was obtained. The lidocaine HCl decreased the microviscosity of SPMVPC model membranes in a concentration-dependent manner, with a significant decrease in microviscosity value by injecting the local anesthetic even at the concentration of 0.5 mM. These results indicate that the direct environment of Py-3-Py in the SPMVPC model membranes is significantly fluidized by the lidocaine HCl. Also, the present study explicitly shows that an interaction between local anesthetics and membrane lipids is of importance in the molecular mechanism of pharmacological action of lidocaine HCl.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.162-169
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• 1994

Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.468-478
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• 2009

This research was performed to provide basic data for the development of infection related dental hygiene studies by surveying the current condition of recognition among students in the department of dental hygiene toward hospital infection management while receiving the following results by using a personal self-administered survey method targeting 303 students in the department of dental hygiene from certain areas. 1. With the current condition of recognition on the sanitization and sterilization of instruments among students in the department of dental hygiene(study), the rate at which surgical instruments are to be sterilized with autoclaves was 79.9% which was relatively higher than other instruments while it was shown that prosthetic instruments for treatment was 56.4%, conservative instruments for treatment was 51.8%, and ultrasonic scaler tip was 51.1% while the way syringe tips(36.1%) and the dental anesthetic apparatus(27.9%) were revealed to require sanitization by alcohol. 2. The 'hand wash' area was the highest with 4.71 while the 'materials and environment management' area and 'equipment management' area appeared high respectively with 4.43 and 4.41. 3. With the current condition of recognition on equipment management, 'equipments used for contagious patients are separately washed after a one-time use and must be sterilized or separated-and-discarded' was the highest with 4.82 while 'sterilization equipments with humidity or water on it are considered contaminated and are not used' showed the lowest recognition level with 3.90. 4. Regarding the current condition of materials and environment management, 'contagious and general trash are separated and discarded' was the highest with 4.70 while 'the refrigerator for medicine storage is cleaned on a regular basis once a month' was revealed as the lowest with 4.11. 5. With the current condition of recognition on hand washing, 'one must wash their hands after coming in contact with contagious patients, was the highest with 4.90 while washing hands after taking off gloves' appeared as the lowest with 4.51 point. To conclude department of dental hygiene there is to infection management and necessary about organization disinfecting and pasteurization to strengthen an education in order raising a stamp helping practical ratio about the infection management which whole, is from presence at a sickbed and connection does and about the infection management which is substantial and educational program development leads feed with the fact that deepening studying which is continuous must become accomplished becomes.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.1
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• pp.69-75
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• 2002

A number of techniques may be employed to reduce the discomfort of syringe or needle for dental care. The use of topical anesthesia is one such method. Topical anesthetics are applied to alleviate pain during many clinical procedures, such as injection of local infiltration anesthetics, primary tooth extraction, X-ray taking of sensitive patients, reducing gag reflex prior to impression taking. In children, placement of a rubber dam clamp, however, may cause significant discomfort for purpose of pit and fissure sealant and preventive resin restoration(PRR). A topical anesthetic would be beneficial to aid in rubber dam placement for this purpose. It has been suggested that all intra-oral topical anesthetics are equally effective on reflected mucosa, however EMLA(an acronym for eutectic mixture of local anesthetics), which was developed in the 1980s and produces surface anesthesia of skin, has been shown to be more effective than conventional topical anesthetics when used on attached gingivae. This report is topical anesthesized 4 case by EMLA cream, who showed better effect in reducing the pain of infiltration anesthesia, extraction of deciduous teeth, rubber dam clamp placement and reducing the pain of preformed crown adaptation.

• The Korean Journal of Pharmacology
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• v.22 no.2
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• pp.88-95
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• 1986

Clinically, subhypnotic doses of barbiturates have been known to elicit hyperalgesia. In this experiment, effect of acute or chronic phenobarital treatment on the response to pain in rat was reevaluated by hot-plate method. To elucidate its mechanism, changes of ${\beta}-endorphin$ contents and [3H]-morphine binding of the rat midbrain as well as functional opiate receptor in vas deferens were also measured. Intraperitoneal injection of sub anesthetic dose phenobarbital induced initial hyperalgesia followed by successive analgesia, while chronic phenobarbital-treatment decreased reactivity to pain. Naloxone (10mg/kg, i.p.) markedly shortened hot plate latency period, and significantly inhibited the analgesic action of phenobarbital. Single dose of phenobarbital did not affect ${\beta}-endorphin$ contents and [3H]-morphine binding in rat mid brain, but in the chronic phenobarbital-treated groups, ${\beta}-endorphin$ contents was increased, while Bmax of opiate receptor binding was decreased. Moreover, very significant correlations among responses to pain, changes of ${\beta}-endorphin$ contents and opiate receptor binding were observed. However, Kd values of opiate receptor bindings were not changed in all preparations. In the chronic phenobarbital-treated vas deferens preparations, ID50 of morphine was increased witb concomittant decrease of maximum effect. But $pA_2 $, value for naloxone was not changed. From these results, it is suggested that phenobarbital can produce analgesia due to changes of ${\beta}-endorphin$ contents as well as functional opiate receptors by receptor regulation.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.212-219
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• 2009

Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.115-119
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• 2012

Double outlet of right ventricle (DORV) refers to a congenital heart disease in which pulmonary and systemic circulation originates from the right ventricle. In the patient with DORV, it is important to maintain the balance between pulmonary and systemic circulation in anesthetic management. A 4-year-old boy with DORV, who underwent a Blalock-Taussig shunt operation, was transferred to the clinic with a chief complaint of multiple caries. Due to poor cooperability, it was impossible to treat the caries without sedation or general anesthesia. We planned to sedate him with consideration with detrimental effects associated with positive pressure ventilation for dental treatment. After a prophylactic administration of antibiotics, sevoflurane was administered through T-cannula site. Throughout the treatment, His blood remained stable around 80/40 mmHg, oxygen saturation remained around 91%. After 3 hour of sedation with sevoflurane (end-tidal sevoflurane con 1-1.8 vol%), he fully regained consciousness, and discharged from hospital without complications. In case of DORV patient, deep sedation with sevoflurane may be used as effective method of behavioral management during dental treatment.

• Journal of the Korean Society of Radiology
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• v.79 no.6
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• pp.323-331
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• 2018

Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.229-236
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• 2023

Background: Local anesthesia has been reliably used to control pain during dental procedures and is important in pediatric dentistry. However, children occasionally complain of prolonged numbness after dental treatment, leading to several problems. Studies conducted to reverse the effect of local anesthesia using phentolamine mesylate and photobiomodulation therapy (PBM) are encouraging but limited. PBM is a type of light therapy that utilizes visible and near-infrared non-ionizing electromagnetic spectral light sources. Hence, this study used this modality to compare the reversal of local anesthesia at two different wavelengths. This study compared the effect of PBM at 660 and 810 nm wavelengths on the reversal of soft tissue local anesthesia using a diode LASER in pediatric dentistry. Method: Informed consent and assent were obtained, and the participants were then divided randomly into three groups of 20 children each: control group-without LASER irradiation, LASER irradiation at 660 nm, and LASER irradiation at 810 nm. Sixty children aged 4-8 years with deciduous mandibular molars indicated for pulp therapy were administered an inferior alveolar nerve block. After 45 min of injection, a duration that was similar to the approximate duration of treatment, they were exposed to 660- and 810-nm LASER irradiation according to their groups until reversal of local anesthesia was achieved. The control group did not undergo LASER irradiation. The reversal of the soft tissue local anesthetic effect was evaluated using palpation and pin prick tests every 15 min, and the LASER irradiation cycle continued until reversal of the soft tissue local anesthesia was achieved. Results: A significant reduction of 55.5 min (27.6%) in the mean soft tissue local anesthesia reversal time was observed after the application of 810 nm wavelength PBM and 69 min (34.7%) after 660 nm wavelength LASER irradiation. Conclusion: PBM with a 660 nm wavelength was more effective in reducing the mean soft tissue local anesthesia reversal duration, and thus can be used as a reversal agent for soft tissue local anesthesia in pediatric dentistry.