BACKGROUND: Fentanyl-induced cough (FIC) is a transient condition with a reported incidence of 18% to 65% depending on the dose and route of administration of fentanyl. Nonpharmacological methods to prevent FIC are more cost-effective than medications. Dilution of fentanyl has a proven role in the prevention of FIC. Acupressure can also prevent FIC because it has a proven role in the treatment of cough. METHODS: This study included 225 female patients with an American Society of Anesthesiologists physical status of I or II who were randomly divided into 3 groups of 75 patients each. Patients in the control group received undiluted fentanyl at 3 µg/kg, patients in the acupressure group received undiluted fentanyl at 3 µg/kg with acupressure, and patients in the dilution group received diluted fentanyl at 3 µg/kg. Coughing was noted within 2 min of fentanyl administration. The severity of FIC was graded as mild (1-2 coughs), moderate (3-4 coughs), or severe (≥5 coughs). The timing of coughs was also noted. RESULTS: The incidence of FIC was 12.7% in the control group, 6.8% in the dilution group, and 1.3% in the acupressure group. The difference in the incidence of cough was statistically significant (P = 0.008) between the control and acupressure groups. The difference in the severity of cough among the groups was not statistically significant. The median onset time of cough among all groups was 9 to 12 seconds. CONCLUSIONS: The application of acupressure prior to administration of fentanyl significantly reduces the incidence of FIC. Dilution of fentanyl also reduces the incidence of FIC, but the difference is not statistically significant.
Acupressure* ; Cough* ; Female* ; Fentanyl* ; Humans ; Incidence* ; Indicator Dilution Techniques ; Prospective Studies*

The object of this paper is to determine the clearance of amphotericin B from the rabbit vitreous. In vitro susceptability of Candida guilliermondi to amphotericin B in antibiotic medium 20(Difco) provided the lowest values of the minimal inhibitory concentration(MIC) among several Candida strains and showed the same MIC afteir incubation at either 30 degrees C or 35 degrees C for 48 hours. A volume of 0.05 ml of solution containing 5 microgram of amphotericin B was injected into the rabbit vitreous, and animals were killed at various intervals. Both eyes were immediately enucleated and frozen to prevent further diffusion of the amphotericin B out of the vitreous. The vitreous was removed intact while it was still frozen. After the vitreous had thawed, its volume was measured. Sterile saline was added and total volume was adjust to 2 ml. The mixture was homogenized and then centrifuged at 2,000 rpm for 20 minutes. One ml of supernatant was removed from the sediment, and the concentration of amphotericin B was determined by broth dilution technique with Candida guilliermondi. The clearance studies indicated that 5 microgram of amphotericin B injected intravititreally, maintained an antibiotic level of greater than 1 microgram/ml for longer than 96 hours, with a half-life of 12 hours. If all factors are considered equal, presumed clearance data for intravitreal injection of 10 microgram of amphotericin B in humans may be calculated from the result in rabbit vitreous. Therapeutic levels of amphotericin B(1 microgram/ml) may be maintained at least 48 hours after the initial intravitreal injection of antibiotic in human eyes.
Amphotericin B* ; Animals ; Candida ; Diffusion ; Half-Life ; Humans ; Indicator Dilution Techniques ; Intravitreal Injections

Econazole is one of the new imidazole derivatives displaying antifungal and antibacterial properties in vitro and in vivo. The present study was undertaken to evaluate the therapeutic efficacy of Econazole in patients with dermatomycoses anl to determine the minimal inhibitory concentration in vitro. A total of 48 patients with various forrns of dermatomycoses(25 patienta with T. cruris, 13 with T. pedis, l with T. corporis, 4 with T. versicolor and 5 with candidiasis) entered this study at the Departement of Dermatology, University Hospital, College of Medicine, Seoul National University during 3 months period. from July to September, 1976. Dia,gnosis was established clinically as well as microscopically by direct KOH mount. All patients were instructed to apply 1:o Econazole solution two to three times daily on the affected area for four to seven weeks and weekly examination of the clinical lesions and direct KOH mount were performed. In addition, minimal inhibitory concentration for Trichophyton mentagrophy tes was determined by the modified dilution technique in vitro. The results were as follows. 1. Thirty five patients (72. 9F) were cured clinically and microscopieally and thc remainders showed marked clinical improvement but positive KOH mount at 4 th week of treatment. At 7th week, nine (18.8io) of the remainders were cured clinically and microscopically and the overall cure rate at 7th week was 91. 7%. Five patients with tinea cruris experienced trar.sient irritation derrnatitis on their crural regions. 2. The minimal inhibitory coriceritration of Econazole for Trichophyton mentagrophytes was 25 pg per ml. of medium. The authors concluded that the 1 i Econazole was highly effective in the treatment of superficial rnycoses and the side effects were rninimal and only transient.
Dermatology ; Dermatomycoses* ; Dronabinol ; Econazole* ; Humans ; Indicator Dilution Techniques ; Seoul ; Tinea ; Trichophyton

No abstract available.
*Algorithms ; Automation ; Clinical Laboratory Information Systems/*standards ; Humans ; Immunoassay/*methods ; Indicator Dilution Techniques ; alpha-Fetoproteins/*analysis

BACKGROUND: Prophylactic stenosis correction is important in the durability of the vascular access, and routine surveillance for the detection of stenosis has been widely recommended to allow preemptive intervention before thrombotic occlusion. The ultrasound dilution technique has been considering not only a popular and validated in vascular access surveillance, but also useful in the measurement of access recirculation and cardiac output. METHODS: Access flow, recirculation, and cardiac output of seventy-six hemodialysis patients with arteriovenous fistulae were measured by ultrasound dilution technique, followed by access flow measurement by color doppler ultrasound in sixty-four patients. Access stenosis was defined as 50% and more reduction in the diameter of vessels by color doppler ultrasound. Cardiac output of thirty-seven patients by echocardiography within a year was also analyzed. RESULTS: Access stenosis was diagnosed in six of sixty-four patients by color doppler ultrasound (9.4%). Access flow in the group with stenosis (621+/-322 mL/min) was lower than the group without stenosis (1, 005+/-633 mL/min), but no statistical significance was found. The access flow measured by ultrasound dilution technique was significantly correlated with color doppler ultrasound (r=0.436, p= 0.01). The cardiac output measured by ultrasound dilution technique was also significantly correlated with echocardiography (r=0.660, p=0.01). CONCLUSION: The data did not provide statistical significances for the detection of stenosis by ultrasound dilution technique. But this study suggests that ultrasound dilution technique is a useful method in the measurement of access flow, cardiac output and recirculation. We hope further prospective studies based on our data will be performed.
Arteriovenous Fistula ; Cardiac Output ; Constriction, Pathologic ; Echocardiography ; Hope ; Humans ; Indicator Dilution Techniques ; Renal Dialysis* ; Ultrasonography*

PURPOSE: Vascular access flow (Qa) measurements are important in the surveillance protocol of hemodialysis vascular access stenosis. The glucose pump technique (GPT) is a technique for Qa measurement based on the dilution technique of a constant glucose infusion that was introduced in 1995. The aim of this study is to verify the clinical efficacy of GPT in vascular access surveillance compared with ultrasound dilution technique. METHODS: In 31 chronic hemodialysis patients with a AV fistula, we compared Qa measurements performed with GPT in pre-dialysis and the ultrasound dilution technique (Transonic HD01, Transonic System Inc., Ithaca, NY) during hemodialysis. RESULTS: Mean Qa was 1171 ml/min by GPT versus 1028 ml/min by HD01 (p=0.262). There was a strong linear correlation between the two methods (r=0.61; p<0.01). Ultrasound dilution technique HD01 yielded 6 cases of high risk Qa measurements and GPT yielded 4 cases of high risk Qa measurements. The diagnostic accuracy of GPT tested with the ROC curve was similar with ultrasound dilution technique HD01. The specificity and sensitivity was 80% and 66.7% according to Qa=600 ml/min. But sensitivity was 83.3% according to Qa=750 ml/min. CONCLUSION: GPT offers the advantage of a simple and economic bedside procedure easily performed before dialysis and had a similar diagnostic accuracy and efficiency compared with ultrasound dilution technique HD01.
Constriction, Pathologic ; Dialysis ; Fistula ; Glucose* ; Humans ; Indicator Dilution Techniques* ; Renal Dialysis* ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography*

Several approaches have been introduced to detect allo-antibodies in the presence of warm auto-antibodies, and these methods include warm autoadsorption, cysteine-activated papain and dithiothreitol (ZZAP), and polyethylene glycol (PEG) and dilution of the patient's serum. Among them, the dilution technique is a simple and rapid method. During pretransfusion testing of a 33 year-old systemic lupus erythematosus (SLE) patient with warm auto-antibodies, antibody identification was done by the dilution technique with using serum diluted 1-in-8. The patient demonstrated an anti-Fy(b) pattern of reactivity in his sera. Contrary to our expectations, the phenotype of the erythrocytes was Fy(a+/b+) and the genotype, as assessed by performing PCR-restriction fragment length polymorphism (RFLP), was FY*A/FY*B. These results suggest that the antibody is an autoantibody showing anti-Fy(b) specificities. An antibody identification test using undiluted serum showed the same result when 40 days had passed. We report here on a case with auto-anti-Fy(b) proven by the dilution method in the presence of warm autoantibodies.
Autoantibodies ; Dithiothreitol ; Erythrocytes ; Genotype ; Humans ; Indicator Dilution Techniques ; Lupus Erythematosus, Systemic ; Papain ; Phenotype ; Polyethylene Glycols ; Sensitivity and Specificity*

A high affinity polyclonal antibody-based enzyme linked immunosorbent assay (ELISA) was developed for the quantification of zeranol in bovine urine. On the basis of urine matrix studies, the optimized dilution factors producing insignificant matrix interference were selected as 1:5 in pretreatment. In the improved ELISA, the linear response range was between 0.02 and 1 microg/ml, and the detection limit was 0.02 microg/ml for the assay. The overall recoveries and the coefficients of variation (CVs) were in the range of 82% to approximately 127% and 3.5% to approximately 8.8%, respectively. Thirty-six bovine urine samples spiked with zeranol (ranging from 0.2 to 10 microg/ml) were detected by the ELISA and liquid chromatography (LC) method, and good correlations were obtained between the two methods (R(2)=0.9643). We conclude that this improved ELISA is suitable tool for a mass zeranol screening and can be an alternative for the conventional LC method for zeranol in bovine urine.
Animals ; Calibration ; Cattle ; Chromatography, High Pressure Liquid ; Enzyme-Linked Immunosorbent Assay ; methods ; Indicator Dilution Techniques ; Zeranol ; immunology ; urine

A simple, reliable and sensitive liquid chromatography-isotope dilution mass spectrometry (LC-ID/MS) was developed and validated for quantification of olanzapine in human plasma. Plasma samples (50 microL) were extracted with tert-butyl methyl ether and isotope-labeled internal standard (olanzapine-D3) was used. The chromatographic separation was performed on XBridge Shield RP 18 (100 mm x 2.1 mm, 3.5 microm, Waters). An isocratic program was used at a flow rate of 0.4 m x min(-1) with mobile phase consisting of acetonitrile and ammonium buffer (pH 8). The protonated ions of analytes were detected in positive ionization by multiple reactions monitoring (MRM) mode. The plasma method, with a lower limit of quantification (LLOQ) of 0.1 ng x mL(-1), demonstrated good linearity over a range of 0.1 - 30 ng x mL(-1) of olanzapine. Specificity, linearity, accuracy, precision, recovery, matrix effect and stability were evaluated during method validation. The validated method was successfully applied to analyzing human plasma samples in bioavailability study.
Antipsychotic Agents ; blood ; pharmacokinetics ; Benzodiazepines ; blood ; pharmacokinetics ; Biological Availability ; Chromatography, Liquid ; methods ; Humans ; Indicator Dilution Techniques ; Isotope Labeling ; Reproducibility of Results ; Sensitivity and Specificity ; Tandem Mass Spectrometry ; methods

To study reliability and reliable indices of quantitative assessment of right ventricular systolic function by time-intensity curve (TIC) with right ventricular contrast, 5% sonicated human albumin was injected intravenously at a does of 0.08 ml/kg into 10 dogs at baseline status and cardiac insufficiency. Apical four-chamber view was observed for washin and washout of contrast agent from right ventricle. The parameters of TIC were obtained by curve fitting. The differences of parameters were analyzed in different states of cardiac functions. Among the parameters derived from TIC, the time constant (k) was decreased significantly with decline of cardiac function (P<0.001). But half-time of decent of peak intensity (HT) and mean-transit-time (MTT) of washout were increased significantly (P<0.001). The k was strongly related to cardiac output of right ventricle (CO) and ejection fraction (EF) of left ventricle and fractional shortening (FS) of left ventricle. Right ventricular systolic function could be assessed reliably by the parameters derived from TIC with right ventricular contrast echocardiography. The k, HT and MTT are reliable indices for quantitative assessment of right ventricular systolic function.
Animals ; Blood Flow Velocity ; physiology ; Cardiac Output ; Contrast Media ; Dogs ; Echocardiography ; Image Processing, Computer-Assisted ; Indicator Dilution Techniques ; Reproducibility of Results ; Systole ; Ventricular Function, Right ; physiology