• Biomolecules & Therapeutics
• /
• 제29권4호
• /
• pp.384-391
• /
• 2021

Currently, the expanding recreational use of synthetic cannabinoids (SCBs) threatens public health. SCBs produce psychoactive effects similar to those of tetrahydrocannabinol, the main component of cannabis, and additionally induce unexpected pharmacological side effects. SCBs are falsely advertised as legal and safe, but in reality, SCB abuse has been reported to cause acute intoxication and addictive disorders. However, because of the lack of scientific evidence to elucidate their dangerous pharmacological effects, SCBs are weakly regulated and continue to circulate in illegal drug markets. In the present study, the intravenous self-administration (IVSA) paradigm was used to evaluate the abuse potential of three SCBs (AM-1248, CB-13, and PB-22) in rats. All three SCBs maintained IVSA with a large number of infusions and active lever presses, demonstrating their reinforcing effects. The increase of active lever presses was particularly significant during the early IVSA sessions, indicating the reinforcement-enhancing effects of the SCBs (AM-1248 and CB-13). The number of inactive lever presses was significantly higher in the SCB groups (AM-1248 and CB-13) than that in the vehicle group, indicating their impulsive effects. In summary, these results demonstrated that SCBs have distinct pharmacological properties and abuse potential.

• 셀메드
• /
• 제11권3호
• /
• pp.15.1-15.9
• /
• 2021

The chemical constitution of a drug has been accepted as an important basis for pharmacological action in Unani medicine. Various dosage forms have been developed on this concept, such as decoctions (Joshanda), infusions (Khesanda), extract (Rub / Usara), and syrup. Zarawand Mudaharaj (ZM.) / Aristolochia rotunda L. root was subjected to extraction process using Soxhlet's apparatus by using Response Surface Methodology (RSM) to design the number of random runs of the extracts with variation in the factors of temperature, the concentration of ethanol in water, time for extraction, for optimizing and maximizing the yield concentration. The data obtained, was analyzed with regression equation and ANOVA two-way summary to interpret the interaction of the factors for yield maximization. Minitab version 18 was used to design and analyze data. Validation of the optimum conditions for maximum yield of the whole extract of ZM. Root was carried out by re-run of the extract using the optimized conditions. The maximum yield percentage thus obtained using RSM was 20.87% whereas using these optimum conditions 21.35 % yield was obtained thereby validating the method. The association between the response functions and the process variables was identified by a three-factor recorded Box-Behnken design. In the present study RSM is used because itis a cheap and affordable method to optimize maximum yield percentage which may be reliably used by researchers. The study set in the surface conditions for ZM. root extraction by the Soxhlet apparatus for maximizing the yield percentage.

• Journal of Veterinary Science
• /
• 제21권1호
• /
• pp.8.1-8.11
• /
• 2020

This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10-70) vs. 19.63 (10-25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.

• 대한본초학회지
• /
• 제27권6호
• /
• pp.63-69
• /
• 2012

Objectives : Decoction, in Korean Medicine, is a pharmacological method of extraction, by boiling, of dissolved chemicals, or herbal prescriptions, which may include stems, roots, bark and rhizomes. Decoctions differ from most teas, infusions, in that they are usually boiled. This study was performed to compare the difference of water decoctions extracted by different decoction extractor and extraction time and to analyze the reason of decoctions extracted by each decoction extractor have different taste. Methods : With water decoction samples by Pressure extractor, Non-pressure extractor and Ultrasonic waves merge extractor for 1 hr, 2 hr and 3 hr were investigated the yield and the concentration of hesperidin and glycyrrhizin by HPLC/DAD system in Pyungwi-san decoction. Results : The samples of each extractor were gradually increased the yield and the concentration of hesperidin and glycyrrhizin. The HPLC pattern of samples is similar. The yield and the concentration of hesperidin and glycyrrhizin of Ultrasonic waves merge extractor was most highest of the three. The rate of increase of the yield and the hesperidin concentration of between 1 hr and 2 hr in Pressure extractor was the most highest of the three. But the concentration of glycyrrhizin in Pressure extractor was relatively similar to Non-pressure extractor. Conclusions : The yield and the concentration of reference compounds in Pyungwi-san water decoction was influenced by extracting method and extracting time. For scientific movement and standardization of extracting medicinal herbs method need to study of extractor validation and to study in vitro and in vivo.

• 임상간호연구
• /
• 제29권1호
• /
• pp.42-55
• /
• 2023

Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

• The Korean Journal of Physiology and Pharmacology
• /
• 제28권2호
• /
• pp.121-127
• /
• 2024

Vancomycin is a frequently used antibiotic in intensive care units, and the patient's renal clearance affects the pharmacokinetic characteristics of vancomycin. Several advantages have been reported for vancomycin continuous intravenous infusion, but studies on continuous dosing regimens based on patients' renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient's renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin administration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomycin serum concentration. Vancomycin serum concentration was affected by vancomycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = -1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R² = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regimen for vancomycin.

• 한국간담췌외과학회지
• /
• 제27권4호
• /
• pp.394-402
• /
• 2023

Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

• Clinical and Experimental Pediatrics
• /
• 제50권12호
• /
• pp.1225-1230
• /
• 2007

목 적 : 만성 빈혈로 대량 수혈을 받아야 하는 환아들에서는 조직과 장기에 철이 축적될 수 있다. 이러한 환아들에서 효과적인 철킬레이트 치료의 목적은 충분한 양의 철을 제거하여 체내에서 철로 인한 장기 손상이 나타나지 않도록 하는데 있다. 본 연구는 후향적으로 대량 수혈을 받은 환아들에서 정맥 투여한 deferoxamine의 효과를 알아보고자 하였다. 방 법 : 2005년 3월부터 2007년 1월까지 15명의 대량 수혈을 받았던 환아들을 대상으로 하였으며 이들 중 수혈 의존성 환아들은 한 달에 1단위 이상의 농축 적혈구 수혈을 최근 6개월 이상 계속 받고 있는 환아들로 정의하였다. 7일 동안 deferoxamine을 10-30 mg/kg/day로 24시간 지속 정맥주입하였으며 투여 전, 후 그리고 3개월 후의 혈청 철, 총철결합능, ferritin을 수혈 의존성 환아들과 수혈 비의존성 환아들로 나누어 비교하였다. 결 과 : 6명의 남아와 9명의 여아가 있었으며 이들의 나이는 5.6-21.3(중앙값 8.3)세였고 수혈 의존성 환아들은 7명, 수혈 비의존성 환아들은 8명이었다. 수혈 의존성 환아들의 ferritin은 deferoxamine 투여 전과 후, 3개월 후에 의미 있는 차이를 보이지 않았으나 수혈 비의존성 환아들에서는 투여 전과 비교 시 투여 3개월 후에는 의미 있는 감소를 보였다(P=0.046). Deferoxamine 정맥주입과 연관된 이상 반응은 경미하였으며 1-2일 내에 소실되었다. 결 론 : 7일 동안 정맥주입하는 deferoxamine은 수혈 비의존성 환아들에서 단기간의 효과적인 치료로 사용될 수 있을 것으로 생각되지만 수혈 의존성 환아들의 경우에는 철의 축적을 막기 위해 유지 요법이 필요할 것으로 생각된다.

• 한국임상수의학회지
• /
• 제31권1호
• /
• pp.25-30
• /
• 2014

본 연구의 목적은 외인성 Estradiol(E)에 의해 발현되는 LH surge가 다른 농도의 Progesterone (P)에 억제되고, 그 기전이 E의 존재에 의해 더욱 강화된다는 것을 증명하는 것이다. 선행된 연구에서 E의 존재하에 LH surge는 P의 농도에 의해 LH surge 발현 시간은 점진적/유의성 있게 억제된다는 것을 확인했다. 이런 결과를 토대로 난소가 제거된 Shiba 염소를 이용하여 인위적으로 난포기(Non-P), 아황체기(Low-P), 기능성황체기(High-P)의 P 농도 및 Estradiol (E) 농도를 유도하였다 (Day 0: P와 E 이식일). 스테로이드 호르몬의 농도를 알아보기 위해 매일 혈액을 채혈하였으며, Day 7에 각 그룹의 P 농도를 유지하기 위한 packet과 E 처치용 capsule를 동시에 제거하였다. 또한 Day 7에 P와 E의 농도변화를 세밀하게 조사하기 위해 12시간 동안 1시간 간격으로 채혈 후 검사하였다. LH surge 분비패턴은 P packet 제거 후 13시간부터 E를 3-6 ${\mu}g/h$ 농도로 36시간 동안 주입하고, 52시간 동안(E 주입 4시간 전부터 주입 후 48시간) 2시간 간격으로 채혈을 실시했다. 그 결과, 모든 3그룹의 염소는 LH surge가 발현되었지만 그 발현시간은 Low-P와 High-P 그룹에서 유의성 없는 발현시간 차를 나타내었다. 즉, 각각의 선행된 P 농도 (Non-P, Low-P, High-p) 그룹은 외인성 Estradiol에 의한 LH surge 발현을 조절하는데 있어서 E의 존재가 중요하며, E는 GnRH/LH surge-generating 시스템에 작용하는 P의 억제적 효과를 더욱 강화시키는 것으로 생각되었다.

• Journal of Hospice and Palliative Care
• /
• 제6권1호
• /
• pp.51-57
• /
• 2003

배경 : Anorexia-cachexia syndrome은 말기 암 환자에서 흔한 증상이며, 암 환자의 주린 사망 원인이 되기도 한다. 이들 증상들은 주로 암 세포 성장과 암세포에서 분비되는 cytokines이 중요한 역할을 한다고 한다. 일부 의사들은 비타민 C가 선택적인 항암 효과를 가지고 있을 뿐만 아니라 여러 가지 말기 암 환자에서 임상 증상을 호전시키는 데 도움이 된다고 보고하였다. 이에 저자 등은 비타민 C가 anorexia-cachexia syndrome을 유발시키는 기전 중의 하나인 사이토카인에 어떤 영향을 주는 지를 알아보고자 한다. 방법 : 2002년 3월 1일부터 2002년 8월 31일까지 국민건강보험공단 일산병원 가정의학과에 입원한 환자 49명을 대상으로 22명은 비타민 C를 1주일동안 지속적으로 10 g을 정맥 주사하였고, 나머지 27명은 비타민 C를 주사하지 않았다. 대상이 된 환자의 비타민 C를 주기 전과 주고 1주일 지난 후의 혈액을 채취하여 cytokine의 변화가 있는 지를 wilcoxon rank sum test를 이용하여 비교분석하였다. 결과 : 대상이 된 총 49명의 환자 중 22명(남자 12명, 여자 10명)이 비타민 C를 사용하였고, 27명(남자18명, 여자 9명)이 비타민 C를 사용하지 않았다. 비타민 C를 사용한 환자에서 $IL-1{\beta}$는 사용 전에는 $6.19{\pm}5.47$이고, 사용 1주일 후에는 $8.76{\pm}5.72$로 $2.94{\pm}7.29$만큼 증가하였고, IL-6는 사용 전에는 $3.07{\pm}8.09$이고 사용 1주일 후라는 $1.31{\pm}2.36$로 $-1.57{\pm}7.96$만큼 감소하였으며, $TNF-{\alpha}$는 사용 전에는 $2.74{\pm}14.24$이고 사용 1주일 후에는 $0.50{\pm}2.00$로 $-4.13{\pm}18.74$만큼 감소하였다. 비타민 C를 사용하지 않은 환자에서는 $IL-1{\beta}$는 사용 전에는 $1.00{\pm}2.19$이고, 사용 1주일 전에는 $17.16{\pm}81.55$로 $16.50{\pm}81.71$만큼 증가하였고, IL-6는 사용 전에는 $2.50{\pm}3.58$이고, 사용 1주일 후에는 $6.49{\pm}12.01$로 $4.11{\pm}12.14$만큼 증가하였으며, $TNF-{\alpha}$는 사용 전에는 $1.19{\pm}2.98$이고, 사용 1주일 후에는 $1.27{\pm}1.52$로 $-0.07{\pm}4.36$만큼 감소하였다. 비타민 C를 사용한 환자와 사용하지 않은 환자에서 사이토카인 변화는 모두 비타민 C를 사용한 환자가 사용하지 않은 환자보다 감소하거나 더 적게 증가하였지만 각각 통계학적인 의미는 없었다($IL-1{\beta}$에서는 P=0.06, IL-6에서는 P=0.166, $TNF-{\alpha}$에서는 P=0.54). 결론 : 비타민 C 사용여부에 따른 cytokines의 변화는 비록 통계학적인 차이는 없지만 비타민 C를 사용한 환자의 cytokines이 모두 사용하지 않은 환자에 비해 감소하였음을 보였다. 비타민 C는 부작용이 거의 없는 안전한 약으로서 말기 암 환자에서 비타민 C사용은 임상 증상을 호전시키는 데 도움이 될 것이라 생각된다.