Animals ; Endothelium, Vascular ; injuries ; Female ; Hemodynamics ; Infusions, Intravenous ; methods ; Injections ; methods ; Male ; Rabbits ; Syringes

Postoperative muscle pain is well known to occur in man following intravenous administration of succinylcholine. The mechanism of muscle pain is yet unknown. A number of methods for preventing muscle pains or decreasing their severity have been suggested, including nondepolarizing relaxants prior to succinylcholine (Churchill-Davidson, 1954: Cullen, 1971: Wig and Bali, 1979) or lidocaine(Usubiaga et al., 1967: Haldia et al., 1973: Fry, 1975), use of vitamin C (Gupte & Savant, 1971), procaine chloride(Morris & Dunn, 1957), thiopental sodium (Craign, 1964) or diazepam (Verma et al., 1978) and the use of a "self-taming" method of succinylcholine by prior injection of a small dose(Baraka, 1977). To investigate methods of preventing muscle pains or decreasing their severity after intravenous injection of succinylcholine, we studied four groups, a control group and three experimental groups (a lidocaine group, a d- Tubocurarine group and a succinylcholine self-taming group). The following results were obtained: 1) In the lidocaine group, the incidence of muscle pain was lower than in the control group, but there was no significant difference between the two groups. However the incidence of muscle pain in the d-Tubocurarine group or the succinylcholine self-taming group were lower than in the control group and there were statistically significant differences(p<0.0005). 2) In most of the patients of each group, the degree of postoperative muscle pain was mild and a difference of degree of muscle pain was not found in each group (p>0.05).3) The muscle pain usually appeared in the first day after operation and disappeared usually within three days. 4) The degree of muscle fasciculation showed a significant decrease with lidocaine, d-Tubocurarine or the succinylcholine self-taming group over the control group(p<0.0005), but there was no significant relationship between the degree of muscle fasciculation and the incidence of postoperative muscle pain(p>0.05). 5) The degree of muscle relaxation during intubation in the d-Tubocurarine group was less complete than in the other 3 groups and it was statistically significant(Zi>1.96). It is suggested from the above results that d-Tubocurarine(0.05~0.06mg/kg) prior to succinylcholine or the method of self-taming of succinylcholine(prior use of succinylcholine 0.15mg/kg) can be used as methods to prevent muscle pain after intravenous administration of succinylcholine, but lidocaine(2mg/kg) prior to succinylcholine is not effective in preventing muscle pain following succinylcholine administration.
Administration, Intravenous ; Ascorbic Acid ; Diazepam ; Fasciculation ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Lidocaine ; Methods ; Muscle Relaxation ; Myalgia* ; Procaine ; Succinylcholine ; Thiopental ; Tubocurarine

In recent years there has been an increase in the number of outpatient surgical procedures performed using local anesthesia with intravenous sedation. However, many patients are reluctant to undergo surgery because of their concerns about pain and pain-awareness during the operation. We performed a study to evaluate the effectiveness and safety of midazolam during outpatient surgical procedures. Between March 1997 and December 1998, 50 patients were anesthetized with bolus intravenous injection of 0.1mg/kg of midazolam, followed by local anesthesia. The blood pressure, pulse and oximeter values were monitored. There was no significant change of arterial oxygen saturation. Midazolam induced antegrade amnesia in most cases. All patients except three (94%) said they would willingly choose this anesthetic technique again. Major complications were not noted. We concluded that midazolam is a good sedative agent in providing favorable antegrade amnesia, as well as reduced anxiety and fear of pain during surgical procedures. This suggests that midazolam may be used routinely in outpatient surgical procedures. Monitoring of oxygen saturation, however is essential in preventing severe hypoxia during procedures.
Amnesia ; Anesthesia, Local* ; Anoxia ; Anxiety ; Blood Pressure ; Humans ; Injections, Intravenous ; Methods ; Midazolam* ; Outpatients ; Oxygen

PURPOSE: In the present study, we evaluated the validity of intravenous neostigmine administration combined with alternate prism cover test (APCT) measurement as a confirmatory diagnostic method for confusing cases of myasthenia gravis with ocular involvement. METHODS: Neostigmine was administered intravenously in 26 suspicious myasthenic diplopia patients under electrocardiographic monitoring. Distance deviation at primary position was evaluated with APCT at 5, 10, 15, 20, and 30 minutes after intravenous injection of neostigmine. Margin reflex distance was also evaluated at each time point. RESULTS: Seven of 26 patients were diagnosed as myasthenic diplopia based on a positive neostigmine test. Among these patients, 6 had strabismus at the primary position and 5 patients had ptosis. In patients who showed positive results, all 6 patients showed improvement of strabismus. However, ptosis was not improved in 1 patient. The improvement of strabismus and ptosis reached a peak at 10 to 15 minutes after neostigmine administration. CONCLUSIONS: Intravenous neostigmine administration combined with APCT is a rapid, objective and safe method in hard-to-diagnose cases of myasthenia gravis with ocular involvement. When performing the neostigmine test for myasthenia gravis with ocular involvement, not only the lid position but also strabismus should be evaluated quantitatively to avoid a false negative results.
Diagnosis* ; Diplopia ; Electrocardiography ; Humans ; Injections, Intravenous ; Methods ; Myasthenia Gravis* ; Neostigmine* ; Reflex ; Strabismus

Methods for imaging the molecular or cellular profile of tissue are being developed for all forms of non-invasive cardiovascular imaging. It is thought that these technologies will potentially improve patient outcomes by allowing diagnosis of disease at an early-stage, monitoring disease progression, providing important information on patient risk, and for tailoring therapy to the molecular basis of disease. Molecular imaging is also already assuming an important role in science by providing a better understanding of the molecular basis of cardiovascular pathology, for assessing response to new therapies, and for rapidly optimizing new or established therapies. Ultrasound-based molecular imaging is one of these new approaches. Contrast-enhanced ultrasound molecular imaging relies on the detection of novel site-targeted microbubbles (MB) or other acoustically active particles which are administered by intravenous injection, circulate throughout the vascular compartment, and are then retained and imaged within regions of disease by ligand-directed binding. The technique is thought to be advantageous in practical terms of cost, time, and ease of use. The aim of this review is to discuss the molecular participants of cardiovascular disease that have been targeted for ultrasound imaging, general features of site-targeted MB, imaging protocols, and potential roles of ultrasound molecular imaging in cardiovascular research and clinical medicine.
Cardiovascular Diseases ; Clinical Medicine ; Diagnosis ; Disease Progression ; Humans ; Injections, Intravenous ; Methods ; Microbubbles ; Molecular Imaging* ; Pathology ; Ultrasonography*

The history of muscle relaxants is fascinating, and their use for clinical applications has been accepted. Depolarizing drugs can produce a non-depolarizing type of neuromuscular block. Decamethonium produces a nondepolarizing block in the isolated rabbit lumbrical muscle. Electromyographic studies of the hand muscles in man have demonstrated that a dual block will be produced with doses of succinylcholine varying from 500 to 1,500 mg (initially a delpolarizing block and subsequently a non-depolarizing block exists). The common peroneal nerve in the rabbit knee was stimulated by a "train of four" method (Ali et al) repeated intermittently. The muscle response with the "train of four" method to intravenous succinylcholine chloride (1 mg/kg) in the rabbit was recorded and analysed after a single injection and repeated intravenous injections of succinylcholine chloride 1 mg/kg. Result were as follows: 1) Time after the "train of four" to depression of muscle twiteh of 25, 50, 75 & 100% was 128. 2, 135. 3, 142. 8 and 159 seconds respectively. 2) Recovery index of a single intravenous injection of succinylcholine chloride 1 mg/kg was observed as 3 minutes and 14 seconds. 3) A depolarizing form of "train of four" response to the first succinylcholine chloride injection 1 mg/kg was observed and, a non-depolarizing form of "train of four" response to the second dose of succinylcholine chloride 1 mg/kg was observed definitely.
Depression ; Hand ; Injections, Intravenous ; Knee ; Methods ; Muscles ; Neuromuscular Blockade ; Peroneal Nerve ; Rabbits* ; Succinylcholine

Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of (99m)Tc-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using (99m)Tc-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GRF calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of (99m)Tc-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GRF. In conclusion, the determination of GFR according to Gates' formula shows good and reproducible of GRF with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.
Creatinine ; Filtration* ; Glomerular Filtration Rate ; Injections, Intravenous ; Kidney ; Methods ; Nuclear Medicine

OBJECTIVETo develop animal models and methodologies for assay of pseudoallergy induced by injectable drugs.

METHODMouse anaphylactoid reaction model was developed by intravenous injection of test substance solutions containing Evans blue (EB). Scores of ear blue staining and quantitation of ear EB exudation were the parameters for the pseudoallergy reaction.

RESULTMouse anaphylactoid reaction was characterized as vascular hyperpermeability which was detectable in ears by quantitation of blue staining score and EB exudation. Compound 48/80 and histamine caused severe ear bluing and EB exudation by inducing obvious vascular hyperpermeability which indicated that they can induce mouse pseudoallergy. Intravenous injection of either normal saline or 5% glucose injection showed no ear bluing. The mouse pseudoallergy model was validated by intravenous injections of western drugs and Chinese medicine.

CONCLUSIONMice could be developed into pseudoallergy model for preclinical safety evaluation of injectable drugs. The pseudoallergy reaction in this model is of high clinic consistency, sensitivity, reproducibility, and maneuverability. The model is suitable for the evaluation for pseudoallergy induced by injectable products prepared from Chinese materia medica This model can also be used for safety assay and quality control in manufacturing process, spot checking of marketed products, screening of allergen as well as studying of pseudoallergy mechanism.

Anesthesiology ; methods ; Catheterization ; Equipment Failure ; Humans ; Infusions, Intravenous ; instrumentation ; Injections, Spinal ; instrumentation ; Needles ; Plastics

BACKGROUND: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. METHODS: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. RESULTS: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment (SCr₀ vs. SCr₁; 0.85±0.80 vs. 1.00±0.82 mg/dL, n=48, p<0.001), but the changes were in normal range according to the standards at Yonsei university health system(a). Among 48 patients, 38 patients were in the non-AKI group (79.2%), and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Risk group (80%). CONCLUSION: There was no significant difference in age, dosage and duration of treatment between AKI group and non-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. (a): SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL
Acute Kidney Injury ; Adult ; Creatinine ; Electronic Health Records ; Female ; Humans ; Injections, Intravenous ; Lung ; Male ; Methods ; Reference Values ; Retrospective Studies