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Sample records for young ketamine injectors

  1. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

    Science.gov (United States)

    Sheehy, Kathy A; Lippold, Caroline; Rice, Amy L; Nobrega, Raissa; Finkel, Julia C; Quezado, Zenaide MN

    2017-01-01

    Background Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. Purpose We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting. Methods This is a longitudinal cohort study of patients treated with subanesthetic ketamine infusions in regular patient care units in a tertiary pediatric hospital. Primary outcomes included changes in pain scores and morphine-equivalent intake. Results The study cohort included 230 different patients who during 360 separate hospital admissions received subanesthetic ketamine infusions for pain management. Overall, ketamine infusions were associated with significant reductions in mean pain scores from baseline (mean pain scores 6.64 [95% CI: 6.38–6.90]) to those recorded on the day after discontinuation of ketamine (mean pain scores 4.38 [95% CI: 4.06–4.69]), pketamine on pain scores varied according to clinical diagnosis (p=0.011), infusion duration (p=0.004), and pain location (p=0.004). Interestingly, greater reductions in pain scores were observed in patients with cancer pain and patients with pain associated with pancreatitis and Crohn’s disease. There were no records of psychotomimetic side effects requiring therapy. Conclusion These data suggest that administration of subanesthetic ketamine for pain management is feasible and safe in regular inpatient care units and may benefit children, adolescents, and young adults with acute and chronic pain. This study is informative and can be helpful in determining sample and effect sizes when planning clinical trials to

  2. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

    Directory of Open Access Journals (Sweden)

    Sheehy KA

    2017-04-01

    Full Text Available Kathy A Sheehy,1,* Caroline Lippold,1,* Amy L Rice,1 Raissa Nobrega,1 Julia C Finkel,1 Zenaide MN Quezado1,2 1Division of Anesthesiology, Pain, and Perioperative Medicine, The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s Research Institute, Children’s National Health System, George Washington University School of Medicine and Health Sciences, 2Center for Neuroscience Research, Children’s Research Institute, Children’s National Health System, Washington, DC, USA *These authors contributed equally to this work Background: Subanesthetic doses of ketamine, an N-methyl-D-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. Purpose: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting. Methods: This is a longitudinal cohort study of patients treated with subanesthetic ketamine infusions in regular patient care units in a tertiary pediatric hospital. Primary outcomes included changes in pain scores and morphine-equivalent intake. Results: The study cohort included 230 different patients who during 360 separate hospital admissions received subanesthetic ketamine infusions for pain management. Overall, ketamine infusions were associated with significant reductions in mean pain scores from baseline (mean pain scores 6.64 [95% CI: 6.38–6.90] to those recorded on the day after discontinuation of ketamine (mean pain scores 4.38 [95% CI: 4.06–4.69], p<0.001. Importantly, the effect of ketamine on pain scores varied according to clinical diagnosis (p=0.011, infusion duration (p=0.004, and pain location (p=0

  3. Ketamine cystitis: Its urological impact and management

    Directory of Open Access Journals (Sweden)

    Yao Chou Tsai

    2015-09-01

    Full Text Available Ketamine, an n-methyl-d-aspartic acid receptor complex antagonist, has been used as an anesthetic and/or analgesic. However, in the past decade, ketamine has been illegally available as a recreational drug in Asian countries and Taiwan. Due to the characteristic of being short-acting, youngsters widely assume that ketamine is not as harmful as other drugs, such as heroin. Consequently, many young patients used this drug for a longer duration before they presented with severe urinary frequency and urgency symptoms. Subsequently, other cases have been reported in Taiwan, Hong Kong, Singapore, Malaysia, and Europe. Ketamine abuse is increasing, with rates of 0.30% in 2006 to 0.40% in 2007 among those in the 16–59 year age group. In general, affected patients tend to be young with a peak age range of 16–35 years. The incidence of lower urinary tract symptoms in ketamine abuse patients is around 30%. The actual underlying pathomechanism of ketamine cystitis (KC and associated pelvic pain remains unclear. It is speculated that chronic contact and stimulation to the bladder or ureteral mucosa due to metabolites of ketamine will result in submucosal edema, vascular ectasia, fibrosis, detrusor muscle inflammation, and fibrosis. Presentations of KC include remarkable dysuria, urinary frequency/urgency, urge incontinence, and bladder pain. Urine culture usually fails to yield any microbiology in KC with bladder pain alone. The majority of patients can enjoy clinical improvement after cessation of ketamine and urological treatment similar to interstitial cystitis/bladder pain syndrome (IC/BPS. However, patients who are still abusing ketamine and/or who have a longer duration of ketamine abuse might suffer from severe bladder pain, which does not respond to empirical oral or intravesical treatments such as hyaluronic acid. Among these patients, most have a remarkably impaired quality of life and are at risk of developing upper urinary tract damage

  4. Bilateral Hydronephrosis and Cystitis Resulting from Chronic Ketamine Abuse

    Directory of Open Access Journals (Sweden)

    Vu Huy Tran

    2014-07-01

    Full Text Available Ketamine associated urinary dysfunction has become increasingly more common worldwide. Point-of-care ultrasound (POCUS is an established modality for diagnosing hydronephrosis in the emergency department. We describe a case of a young male ketamine abuser with severe urinary urgency and frequency in which POCUS performed by the emergency physician demonstrated bilateral hydronephrosis and a focally thickened irregular shaped bladder. Emergency physicians should consider using POCUS evaluate for hydronephrosis and bladder changes in ketamine abusers with lower urinary tract symptoms. The mainstay of treatment is discontinuing ketamine abuse. [West J Emerg Med. 2014;15(4:382-384.

  5. Intramuscular ketamine to facilitate pediatric central vascular access.

    Science.gov (United States)

    Denmark, T Kent; Hargrove, Jenny R; Brown, Lance

    2004-07-01

    Obtaining prompt vascular access in young children presenting to the emergency department (ED) is frequently both necessary and technically challenging. The objective of our study was to describe our experience using intramuscular (IM) ketamine to facilitate the placement of central venous catheters in children presenting to our ED needing vascular access in a timely fashion. We performed a retrospective medical record review of all pediatric patients central venous catheter facilitated by the use of IM ketamine. Eleven children met our inclusion criteria. Most of the children were young and medically complicated. The children ranged in age from 6 months to 8 years. The only complication identified was vomiting experienced by an 8-year-old boy. Emergency physicians successfully obtained central venous access in all subjects in the case series. The use of IM ketamine to facilitate the placement of central venous catheters in children who do not have peripheral venous access appears to be helpful. Emergency physicians may find it useful to be familiar with this use of IM ketamine.

  6. Ketamine-snorting associated cystitis.

    Science.gov (United States)

    Chen, Chung-Hsien; Lee, Ming-Huei; Chen, Yi-Chang; Lin, Ming-Fong

    2011-12-01

    Ketamine hydrochloride, commonly used as a pediatric anesthetic agent, is an N-methyl-D-aspartic (NMDA) acid receptor antagonist with rapid onset and short duration of action. It produces a cataleptic-like state where the patient is dissociated from the surrounding environment by direct action on the cortex and limbic system. It has emerged as an increasingly popular choice among young drug users, especially within dance club venues. Cases of bladder dysfunction among recreational ketamine users were reported since Shahani et al first reported nine cases of ketamine-associated ulcerative cystitis in 2007. We report on four patients who had history of ketamine abuse, presenting with dysuria, fluctuating lower urinary tract symptoms (LUTS), lower abdominal or perineal pain, and impaired functional bladder capacities. Urinalysis showed pyuria and microhematuria. Urine culture was sterile. Bladder ulceration with severe diffuse hemorrhage and low bladder capacity were noted under anesthetized cystoscopic examination. Transurethral bladder mucosa biopsy was consistent with chronic cystitis. Cessation of ketamine abuse was the milestone of treatment, followed by the administration of mucosal protective agents, such as pentosan polysulphate or hyaluronic acid. Suprapubic pain was improved in three patients during follow-up. However, the outcome of treatment depends on the severity of the disease process, similar to that of interstitial cystitis (IC). Copyright © 2011. Published by Elsevier B.V.

  7. Prevalence and Perception of Ketamine Use among Young Danish Night Clubbers:

    DEFF Research Database (Denmark)

    Ravn, Signe; Demant, Jakob

    2012-01-01

    AIMS – This article describes the prevalence of ketamine use among Danish recreational drug users and provides a contextual understanding of ketamine use within this group. METHODS AND DATA – The analysis is based on a mixed-methods night club study combining a survey among guests in night clubs (N...

  8. Ketamine

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Ketamine KidsHealth / For Teens / Ketamine Print en español Ketamina What It Is: Ketamine hydrochloride is a quick-acting anesthetic that is ...

  9. Clinical pattern and prevalence of upper gastrointestinal toxicity in patients abusing ketamine.

    Science.gov (United States)

    Liu, Shirley Yuk Wah; Ng, Stephen Ka Kei; Tam, Yuk Him; Yee, Samuel Chi Hang; Lai, Franco Pui Tak; Hong, Cindy Yuek Lam; Chiu, Philip Wai Yan; Ng, Enders Kwok Wai; Ng, Chi Fai

    2017-09-01

    Evaluations of upper gastrointestinal toxicity from ketamine abuse are uncommon. This study investigated the clinical pattern of upper gastrointestinal symptoms in patients inhaling ketamine. In a cross-sectional study of 611 consecutive patients who were seeking treatment for ketamine uropathy in a tertiary hospital setting between August 2008 and June 2016, their clinical pattern of upper gastrointestinal symptoms was evaluated and compared with a control population of 804 non-users. A total of 168 (27.5%) patients abusing ketamine (mean age 26.3 years, 58.9% female) reported the presence of upper gastrointestinal symptoms. These symptoms were significantly more prevalent in patients inhaling ketamine than in those who were not (27.5% vs 5.2%, P ketamine abuse before symptom presentation was 5.0 ± 3.1 years. The presenting symptoms included epigastric pain (n = 155, 25.4%), recurrent vomiting (n = 48, 7.9%), anemia (n = 36, 5.9%) and gastrointestinal bleeding (n = 20, 3.3%). Uropathy symptoms were preceded by upper gastrointestinal symptoms for 4.4 ± 3.0 years in 141 (83.9%) patients. Logistic regression showed that elder age (odds ratio [OR] 1.06, P = 0.04), active abuser status (OR 1.60, P = 0.04) and longer duration of ketamine abuse (OR 1.00, P = 0.04) were independent factors associated with upper gastrointestinal toxicity. Although epigastric symptoms are unusual in the young population, upper gastrointestinal toxicity was highly prevalent in those inhaling ketamine. Enquiries about ketamine abuse are recommended when assessing young patients with epigastric symptoms. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  10. Anesthetic efficacy of ketamine-diazepam, ketamine-xylazine, and ketamine-acepromazine in Caspian Pond turtles (Mauremys caspica).

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    Adel, Milad; Sadegh, Amin Bigham; Arizza, Vincenzo; Abbasi, Hossein; Inguglia, Luigi; Saravi, Hasan Nasrollahzadeh

    2017-01-01

    The objective of this study was to assess the efficacy of different anesthetic drug combinations on the Caspian Pond turtles ( Mauremys caspica ). Three groups of the Caspian Pond turtles ( n = 6) were anesthetized with three different drug combinations. Initially, a pilot study was conducted to determine the best drug doses for the anesthetization of the turtles, and according to these results, ketamine-diazepam (120 mg/kg ketamine hydrochloride [5%] and 2 mg/kg diazepam [5%]), ketamine-acepromazine (120 mg/kg ketamine hydrochloride [5%] and 1 mg/kg acepromazine [1%]), and ketamine-xylazine (120 mg/kg ketamine hydrochloride [5%] and 1 mg/kg xylazine [2%]) were injected intramuscularly. The onset times of anesthetization and the recovery time were measured. Statistical analysis of the data was performed using one-way analysis of variance followed by t -tests, and P turtles, respectively, compared to that obtained with the ketamine-acepromazine combination and 64% (male turtles) and 50% (female turtles) shorter than that obtained with the ketamine-xylazine combination. Further, the recovery time, in male turtles, was 17% shorter in animals treated with the first drug combination than those treated with the ketamine-acepromazine combination and 37% shorter than those treated with the ketamine-xylazine combination. The recovery time, in female turtles, did not seem to be significantly different among treatments. The study showed that the ketamine-diazepam drug combination is the anesthetic combination with the fastest onset time and shortest recovery time.

  11. A Case Report: Subanesthetic Ketamine Infusion for Treatment of Cancer-Related Pain Produces Urinary Urge Incontinence.

    Science.gov (United States)

    Vickers, Barbara A; Lee, Wayne; Hunsberger, Joann

    2017-05-01

    Oncology patients undergoing treatment can experience substantial pain related to their disease or prescribed therapy. Ketamine infusions at subanesthetic doses have been used at our institution to supplement the pain management regimens of 262 patients. We present 2 cases in which young adult patients being treated with subanesthetic ketamine for cancer-related pain experienced urinary urgency and incontinence after initiation or increase of the ketamine infusion. This adverse effect has not been reported previously at this dosing range. These case reports suggest that subanesthetic ketamine infusions may cause side effects that previously have been reported only at anesthetic or abuse doses.

  12. Ketamine and international regulations.

    Science.gov (United States)

    Liao, Yanhui; Tang, Yi-Lang; Hao, Wei

    2017-09-01

    Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries. To review the nonmedical use of ketamine in selected countries and its regulatory control. We conducted a review of literature identified from searches of the China National Knowledge Infrastructure (CNKI) (1979-2016) and PubMed databases, supplemented by additional references identified by the authors. Special attention was given to the regulation of ketamine. Illicit manufacturing, trafficking, and use of ketamine appear to have begun on a large scale in several Asian nations, and it has subsequently spread to other regions. Regulations governing availability of ketamine vary across countries, but there is a clear trend toward tighter regulations. As nonmedical use of ketamine and its harmful consequences have worsened globally, stricter controls are necessary. Appropriate regulation of ketamine is important for international efforts to control ketamine's cross-border trafficking and its nonmedical use.

  13. Oral Ketamine

    African Journals Online (AJOL)

    Oral Ketamine: A Four-years Experience in ... Key words: Oral Ketamine, Premedication and Oncology. .... form of a letter published in 19835. .... Acta. Anaesthesiol Scandinavica, 1998; 42: 750-758. 4. Murray P. Substitution of another opioid ...

  14. Late preconditioning is blocked by racemic ketamine, but not by S(+)-ketamine

    NARCIS (Netherlands)

    Müllenheim, J.; Rulands, R.; Wietschorke, T.; Frässdorf, J.; Preckel, B.; Schlack, W.

    2001-01-01

    Racemic ketamine blocks K(ATP) channels in isolated cells and abolishes short-term cardioprotection against prolonged ischemia. We investigated the effects of racemic ketamine and S(+)-ketamine on ischemic late preconditioning (LPC) in the rabbit heart in vivo. A coronary occluder was chronically

  15. Repeated ketamine administration alters N-methyl-d-aspartic acid receptor subunit gene expression: Implication of genetic vulnerability for ketamine abuse and ketamine psychosis in humans

    Science.gov (United States)

    Lipsky, Robert H

    2015-01-01

    For more than 40 years following its approval by the Food and Drug Administration (FDA) as an anesthetic, ketamine, a non-competitive N-methyl-d-aspartic acid (NMDA) receptor antagonist, has been used as a tool of psychiatric research. As a psychedelic drug, ketamine induces psychotic symptoms, cognitive impairment, and mood elevation, which resemble some symptoms of schizophrenia. Recreational use of ketamine has been increasing in recent years. However, little is known of the underlying molecular mechanisms responsible for ketamine-associated psychosis. Recent animal studies have shown that repeated ketamine administration significantly increases NMDA receptor subunit gene expression, in particular subunit 1 (NR1 or GluN1) levels. This results in neurodegeneration, supporting a potential mechanism where up-regulation of NMDA receptors could produce cognitive deficits in chronic ketamine abuse patients. In other studies, NMDA receptor gene variants are associated with addictive behavior. Here, we focus on the roles of NMDA receptor gene subunits in ketamine abuse and ketamine psychosis and propose that full sequencing of NMDA receptor genes may help explain individual vulnerability to ketamine abuse and ketamine-associated psychosis. PMID:25245072

  16. Repeated ketamine administration alters N-methyl-D-aspartic acid receptor subunit gene expression: implication of genetic vulnerability for ketamine abuse and ketamine psychosis in humans.

    Science.gov (United States)

    Xu, Ke; Lipsky, Robert H

    2015-02-01

    For more than 40 years following its approval by the Food and Drug Administration (FDA) as an anesthetic, ketamine, a non-competitive N-methyl-D-aspartic acid (NMDA) receptor antagonist, has been used as a tool of psychiatric research. As a psychedelic drug, ketamine induces psychotic symptoms, cognitive impairment, and mood elevation, which resemble some symptoms of schizophrenia. Recreational use of ketamine has been increasing in recent years. However, little is known of the underlying molecular mechanisms responsible for ketamine-associated psychosis. Recent animal studies have shown that repeated ketamine administration significantly increases NMDA receptor subunit gene expression, in particular subunit 1 (NR1 or GluN1) levels. This results in neurodegeneration, supporting a potential mechanism where up-regulation of NMDA receptors could produce cognitive deficits in chronic ketamine abuse patients. In other studies, NMDA receptor gene variants are associated with addictive behavior. Here, we focus on the roles of NMDA receptor gene subunits in ketamine abuse and ketamine psychosis and propose that full sequencing of NMDA receptor genes may help explain individual vulnerability to ketamine abuse and ketamine-associated psychosis. © 2014 by the Society for Experimental Biology and Medicine.

  17. Ketamine, but not S(+)-ketamine, blocks ischemic preconditioning in rabbit hearts in vivo

    NARCIS (Netherlands)

    Müllenheim, J.; Frässdorf, J.; Preckel, B.; Thämer, V.; Schlack, W.

    2001-01-01

    BACKGROUND: Ketamine blocks KATP channels in isolated cells and abolishes the cardioprotective effect of ischemic preconditioning in vitro. The authors investigated the effects of ketamine and S(+)-ketamine on ischemic preconditioning in the rabbit heart in vivo. METHODS: In 46

  18. Ketamine for pain

    Science.gov (United States)

    Jonkman, Kelly; Dahan, Albert; van de Donk, Tine; Aarts, Leon; Niesters, Marieke; van Velzen, Monique

    2017-01-01

    The efficacy of the N-methyl-D-aspartate receptor antagonist ketamine as an analgesic agent is still under debate, especially for indications such as chronic pain. To understand the efficacy of ketamine for relief of pain, we performed a literature search for relevant narrative and systematic reviews and meta-analyses. We retrieved 189 unique articles, of which 29 were deemed appropriate for use in this review. Ketamine treatment is most effective for relief of postoperative pain, causing reduced opioid consumption. In contrast, for most other indications (that is, acute pain in the emergency department, prevention of persistent postoperative pain, cancer pain, and chronic non-cancer pain), the efficacy of ketamine is limited. Ketamine’s lack of analgesic effect was associated with an increase in side effects, including schizotypical effects. PMID:28979762

  19. Ketamine - A Multifaceted Drug.

    Science.gov (United States)

    Meng, Lingzhong; Li, Jian; Lu, Yi; Sun, Dajin; Tao, Yuan-Xiang; Liu, Renyu; Luo, Jin Jun

    There is a petition for tight control of ketamine from the Chinese government to classify ketamine as a Schedule I drug, which is defined as a drug with no currently accepted medical use but a high potential for abuse. However, ketamine has unique properties that can benefit different patient populations. Scholars from the Translational Perioperative and Pain Medicine and the International Chinese Academy of Anesthesiology WeChat groups had an interactive discussion on ketamine, including its current medical applications, future research priorities, and benefits versus risks. The discussion is summarized in this manuscript with some minor edits.

  20. Ketamine-propofol sedation in circumcision

    Directory of Open Access Journals (Sweden)

    Handan Gulec

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVE: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.METHODS: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05 mg/kg + ketamine 3 mg/kg + atropine 0.02 mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.RESULTS: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p > 0.050. Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20th min, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p < 0.050.CONCLUSION: Propofol-ketamine (Ketofol provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

  1. Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

    Science.gov (United States)

    Klaess, Cynthia C; Jungquist, Carla R

    2018-06-01

    Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  2. Cost-Effectiveness of Postoperative Ketamine in Chiari Decompression.

    Science.gov (United States)

    McDowell, Michael M; Alhourani, Ahmad; Pearce-Smith, Beverly A; Mazurkiewicz, Anna; Friedlander, Robert M

    2018-02-01

    In Chiari I patients, postoperative pain and discomfort frequently slow the transition back to the home setting. We sought to determine the effect of standardized ketamine infusion protocols on hospital length of stay (LOS). This retrospective cohort study reviewed 100 consecutive adult patients undergoing Chiari I decompression. Fifty-nine patients were placed on a 2-3 mg/hr ketamine drip until postoperative day 1. This group was compared with a group who received 2-3 mg/hr of ketamine until postoperative day 2 (19 patients) and patients who did not receive ketamine at all (22 patients). Clinical characteristics, opioid use, LOS, and relative hospitalization costs were assessed. All narcotic amounts were converted into milligram equivalents of morphine. LOS of the short-ketamine group was 46.5 hours when compared with the long-ketamine group (66.8 hours) and no-ketamine group (56.9 hours). There was a statistically significant difference when comparing the short-ketamine group with the long-ketamine group and no-ketamine group together (P ketamine protocol was used (P ketamine group, 196 mg in the long-ketamine group, and 187 mg in the no-ketamine group (P = 0.65). No adverse events from ketamine were noted. Ketamine at subanesthetic levels may be an effective tool to facilitate early return home postoperatively and may significantly reduce medical costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. [Ketamine as a party drug

    NARCIS (Netherlands)

    Vroegop, M.P.; Dongen, R.T.M. van; Vantroyen, B.; Kramers, C.

    2007-01-01

    Ketamine is a new party drug, which is easy to obtain. For this reason, it is possible that physicians will be increasingly confronted with users that have medical problems. Relatively few cases of ketamine intoxication with a fatal outcome have been reported thus far. Ketamine is very

  4. Effects of Ketamine and Ketamine Metabolites on Evoked Striatal Dopamine Release, Dopamine Receptors, and Monoamine Transporters

    Science.gov (United States)

    Can, Adem; Zanos, Panos; Moaddel, Ruin; Kang, Hye Jin; Dossou, Katinia S. S.; Wainer, Irving W.; Cheer, Joseph F.; Frost, Douglas O.; Huang, Xi-Ping

    2016-01-01

    Following administration at subanesthetic doses, (R,S)-ketamine (ketamine) induces rapid and robust relief from symptoms of depression in treatment-refractory depressed patients. Previous studies suggest that ketamine’s antidepressant properties involve enhancement of dopamine (DA) neurotransmission. Ketamine is rapidly metabolized to (2S,6S)- and (2R,6R)-hydroxynorketamine (HNK), which have antidepressant actions independent of N-methyl-d-aspartate glutamate receptor inhibition. These antidepressant actions of (2S,6S;2R,6R)-HNK, or other metabolites, as well as ketamine’s side effects, including abuse potential, may be related to direct effects on components of the dopaminergic (DAergic) system. Here, brain and blood distribution/clearance and pharmacodynamic analyses at DA receptors (D1–D5) and the DA, norepinephrine, and serotonin transporters were assessed for ketamine and its major metabolites (norketamine, dehydronorketamine, and HNKs). Additionally, we measured electrically evoked mesolimbic DA release and decay using fast-scan cyclic voltammetry following acute administration of subanesthetic doses of ketamine (2, 10, and 50 mg/kg, i.p.). Following ketamine injection, ketamine, norketamine, and multiple hydroxynorketamines were detected in the plasma and brain of mice. Dehydronorketamine was detectable in plasma, but concentrations were below detectable limits in the brain. Ketamine did not alter the magnitude or kinetics of evoked DA release in the nucleus accumbens in anesthetized mice. Neither ketamine’s enantiomers nor its metabolites had affinity for DA receptors or the DA, noradrenaline, and serotonin transporters (up to 10 μM). These results suggest that neither the side effects nor antidepressant actions of ketamine or ketamine metabolites are associated with direct effects on mesolimbic DAergic neurotransmission. Previously observed in vivo changes in DAergic neurotransmission following ketamine administration are likely indirect. PMID

  5. Suppressive effects of ketamine on macrophage functions

    International Nuclear Information System (INIS)

    Chang Yi; Chen, T.-L.; Sheu, J.-R.; Chen, R.-M.

    2005-01-01

    Ketamine is an intravenous anesthetic agent. Clinically, induction of anesthesia with ketamine can cause immunosuppression. Macrophages play important roles in host defense. In this study, we attempted to evaluate the effects of ketamine on macrophage functions and its possible mechanism using mouse macrophage-like Raw 264.7 cells as the experimental model. Exposure of macrophages to 10 and 100 μM ketamine, which correspond to 0.1 and 1 times the clinically relevant concentration, for 1, 6, and 24 h had no effect on cell viability or lactate dehydrogenase release. When the administered concentration reached 1000 μM, ketamine caused a release of lactate dehydrogenase and cell death. Ketamine, at 10 and 100 μM, did not affect the chemotactic activity of macrophages. Administration of 1000 μM ketamine in macrophages resulted in a decrease in cell migration. Treatment of macrophages with ketamine reduced phagocytic activities. The oxidative ability of macrophages was suppressed by ketamine. Treatment with lipopolysaccharide induced TNF-α, IL-1β, and IL-6 mRNA in macrophages. Administration of ketamine alone did not influence TNF-α, IL-1β, or IL-6 mRNA production. Meanwhile, cotreatment with ketamine and lipopolysaccharide significantly inhibited lipopolysaccharide-induced TNF-α, IL-1β, and IL-6 mRNA levels. Exposure to ketamine led to a decrease in the mitochondrial membrane potential. However, the activity of mitochondrial complex I NADH dehydrogenase was not affected by ketamine. This study shows that a clinically relevant concentration of ketamine (100 μM) can suppress macrophage function of phagocytosis, its oxidative ability, and inflammatory cytokine production possibly via reduction of the mitochondrial membrane potential instead of direct cellular toxicity

  6. Synthesis of isotopically labeled ketamine

    OpenAIRE

    Stuchlíková, Lucie

    2011-01-01

    In this work were synthesized ketamine isotopomers. Ketamine is used in human medicine and veterinary sectors. It has very broad spectrum of pharmacological effects: anesthetic, analgesic, hallucinogenic, bronchodilator, cardiovascular and antidepressive, which is currently in the research. At first was synthesized precursor of ketamine, N- desmethylketamine which was subsequently labeled the deuterium, tritium and carbon- 14. For the determination of purity and identity mass spectrometry and...

  7. Ketamine-induced apoptosis in cultured rat cortical neurons

    International Nuclear Information System (INIS)

    Takadera, Tsuneo; Ishida, Akira; Ohyashiki, Takao

    2006-01-01

    Recent data suggest that anesthetic drugs cause neurodegeneration during development. Ketamine is frequently used in infants and toddlers for elective surgeries. The purpose of this study is to determine whether glycogen synthase kinase-3 (GSK-3) is involved in ketamine-induced apoptosis. Ketamine increased apoptotic cell death with morphological changes which were characterized by cell shrinkage, nuclear condensation or fragmentation. In addition, insulin growth factor-1 completely blocked the ketamine-induced apoptotic cell death. Ketamine decreased Akt phosphorylation. GSK-3 is known as a downstream target of Akt. The selective inhibitors of GSK-3 prevented the ketamine-induced apoptosis. Moreover, caspase-3 activation was accompanied by the ketamine-induced cell death and inhibited by the GSK-3 inhibitors. These results suggest that activation of GSK-3 is involved in ketamine-induced apoptosis in rat cortical neurons

  8. 21 CFR 522.1222a - Ketamine.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Ketamine. 522.1222a Section 522.1222a Food and..., FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.1222a Ketamine. (a) Specifications. Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams (mg...

  9. Ketamine for Treatment-Resistant Unipolar Depression

    Science.gov (United States)

    Mathew, Sanjay J.; Shah, Asim; Lapidus, Kyle; Clark, Crystal; Jarun, Noor; Ostermeyer, Britta; Murrough, James W.

    2013-01-01

    Currently available drugs for unipolar major depressive disorder (MDD), which target monoaminergic systems, have a delayed onset of action and significant limitations in efficacy. Antidepressants with primary pharmacological targets outside the monoamine system may offer the potential for more rapid activity with improved therapeutic benefit. The glutamate system has been scrutinized as a target for antidepressant drug discovery. The purpose of this article is to review emerging literature on the potential rapid-onset antidepressant properties of the glutamate NMDA receptor antagonist ketamine, an established anaesthetic agent. The pharmacology of ketamine and its enantiomer S-ketamine is reviewed, followed by examples of its clinical application in chronic, refractory pain conditions, which are commonly co-morbid with depression. The first generation of studies in patients with treatment-resistant depression (TRD) reported the safety and acute efficacy of a single subanaesthetic dose (0.5 mg/kg) of intravenous ketamine. A second generation of ketamine studies is focused on testing alternate routes of drug delivery, identifying methods to prevent relapse following resolution of depressive symptoms and understanding the neural basis for the putative antidepressant actions of ketamine. In addition to traditional depression rating endpoints, ongoing research is examining the impact of ketamine on neurocognition. Although the first clinical report in MDD was published in 2000, there is a paucity of adequately controlled double-blind trials, and limited clinical experience outside of research settings. Given the potential risks of ketamine, safety considerations will ultimately determine whether this old drug is successfully repositioned as a new therapy for TRD. PMID:22303887

  10. Ketamine

    African Journals Online (AJOL)

    MJZ

    anesthesia in extremely critical conditions (e.g., ... treatment. Some animal studies have shown that ketamine may produce a marked neuroprotective effect mediated ... IM) for pediatric surgery. .... prior personality disorders, excessive noise.

  11. [Safety and efficacy of ketamine for pain relief].

    Science.gov (United States)

    Niesters, Marieke; Dahan, Albert; van Kleef, Maarten

    2016-01-01

    Intravenous ketamine treatment is frequently used for the management of chronic pain, especially in those patients who do not benefit from other therapies. In this commentary we discuss the efficacy of ketamine for relief of chronic pain and ketamine's safety profile. A review of the literature indicates that only a few studies show that intravenous ketamine has analgesic effects that persist beyond the infusion period, an effect that occurs in about two-thirds of patients. Ketamine has multiple safety issues, ranging from psychotomimetic and schizotypal symptoms, sympathetic stimulation, tachycardia and hypertension, and damage to the liver and the urogenital tract. Damage to the urogenital tract seems to be restricted to individuals who chronically abuse ketamine. We indicate the need for large randomized trials in which ketamine is compared with an 'active' placebo.

  12. Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial.

    Science.gov (United States)

    Azizkhani, Reza; Bahadori, Azadeh; Shariati, Mohammadreza; Golshani, Keyhan; Ahmadi, Omid; Masoumi, Babak

    2018-01-01

    The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO 4 ) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures. In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO 4 or ketamine alone. Train of four (TOF) stimulation pattern was assessed using nerve stimulator machine and compared between groups. The mean age of studied patients was 46.9 ± 9.3 years old. 48% were male and 52% were female. No significant differences were noted between groups in demographic variables. The status of TOF, 2 min after the injection of ketamine (1.5 mg/kg), in both groups was similar. After the injection of the second dose of ketamine (1 mg/kg) the status of TOF in four patients in ketamine plus MgSO 4 (0.45 mg/kg) group changed, it was three quarters but in ketamine group, the status of TOF in all patients was four quarters. The difference between groups was not statistically significant ( P = 0.12). The findings revealed that for muscle relaxation during medical procedures in the emergency department, ketamine in combination with MgSO 4 with this dose was not effective for muscle relaxation during procedures.

  13. Ketamine for chronic pain: risks and benefits

    Science.gov (United States)

    Niesters, Marieke; Martini, Christian; Dahan, Albert

    2014-01-01

    The anaesthetic ketamine is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Low dose ketamine produces strong analgesia in neuropathic pain states, presumably by inhibition of the N-methyl-D-aspartate receptor although other mechanisms are possibly involved, including enhancement of descending inhibition and anti-inflammatory effects at central sites. Current data on short term infusions indicate that ketamine produces potent analgesia during administration only, while three studies on the effect of prolonged infusion (4–14 days) show long-term analgesic effects up to 3 months following infusion. The side effects of ketamine noted in clinical studies include psychedelic symptoms (hallucinations, memory defects, panic attacks), nausea/vomiting, somnolence, cardiovascular stimulation and, in a minority of patients, hepatoxicity. The recreational use of ketamine is increasing and comes with a variety of additional risks ranging from bladder and renal complications to persistent psychotypical behaviour and memory defects. Blind extrapolation of these risks to clinical patients is difficult because of the variable, high and recurrent exposure to the drug in ketamine abusers and the high frequency of abuse of other illicit substances in this population. In clinical settings, ketamine is well tolerated, especially when benzodiazepines are used to tame the psychotropic side effects. Irrespective, close monitoring of patients receiving ketamine is mandatory, particularly aimed at CNS, haemodynamic, renal and hepatic symptoms as well as abuse. Further research is required to assess whether the benefits outweigh the risks and costs. Until definite proof is obtained ketamine administration should be restricted to patients with therapy-resistant severe neuropathic pain. PMID:23432384

  14. Ketamine in the treatment of acute pain.

    Science.gov (United States)

    Brinck, Elina; Kontinen, Vesa

    2017-01-01

    Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system. This is advantageous for patients suffering from severe pain prior to surgery or are using a strong opioid. The S enantiomer of ketamine used for anesthesia is more powerful than racemic ketamine. The ideal dose of ketamine for pain relief is not yet known, and its adverse effects on the central nervous system, including hallucinations, sedation, and diplopia have limited its use in pain management. The significance of these effects at low doses is probably less than expected, particularly if benzodiazepines or an alpha-2 agonist, such as dexmedetomidine, are administered in addition to ketamine.

  15. Ketamine: A New Antidepressant?

    Directory of Open Access Journals (Sweden)

    Feride Karacaer

    2015-03-01

    Full Text Available Standart antidepressants are needed for the many individuals with major depressive disorder. However they do not respond adequately to treatment and because of a delay of weeks before the emergence of therapeutic effects. Recent studies show that subanesthetic dose of ketamine is efficacy and safety for the treatment of depression. Antidepressant effects of ketamine have been found to be short-lived and its psychotomimetic properties may limit the use of ketamine to depressive patients. Future research studies should focus on identifying predictors of response (pharmalogical and clinical , investigating application of different doses and routes of administration and maintaining antidepressant effect. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 30-40

  16. Ketamine and ketamine metabolites as novel estrogen receptor ligands: Induction of cytochrome P450 and AMPA glutamate receptor gene expression.

    Science.gov (United States)

    Ho, Ming-Fen; Correia, Cristina; Ingle, James N; Kaddurah-Daouk, Rima; Wang, Liewei; Kaufmann, Scott H; Weinshilboum, Richard M

    2018-04-03

    Major depressive disorder (MDD) is the most common psychiatric illness worldwide, and it displays a striking sex-dependent difference in incidence, with two thirds of MDD patients being women. Ketamine treatment can produce rapid antidepressant effects in MDD patients, effects that are mediated-at least partially-through glutamatergic neurotransmission. Two active metabolites of ketamine, (2R,6R)-hydroxynorketamine (HNK) and (2S,6S)-HNK, also appear to play a key role in ketamine's rapid antidepressant effects through the activation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptors. In the present study, we demonstrated that estrogen plus ketamine or estrogen plus active ketamine metabolites displayed additive effects on the induction of the expression of AMPA receptor subunits. In parallel, the expression of estrogen receptor alpha (ERα) was also significantly upregulated. Even more striking, radioligand binding assays demonstrated that [ 3 H]-ketamine can directly bind to ERα (K D : 344.5 ± 13 nM). Furthermore, ketamine and its (2R,6R)-HNK and (2S,6S)-HNK metabolites displayed similar affinity for ERα (IC 50 : 2.31 ± 0.1, 3.40 ± 0.2, and 3.53 ± 0.2 µM, respectively) as determined by [ 3 H]-ketamine displacement assays. Finally, induction of AMPA receptors by either estrogens or ketamine and its metabolites was lost when ERα was knocked down or silenced pharmacologically. These results suggest a positive feedback loop by which estrogens can augment the effects of ketamine and its (2R,6R)-HNK and (2S,6S)-HNK metabolites on the ERα-induced transcription of CYP2A6 and CYP2B6, estrogen inducible enzymes that catalyze ketamine's biotransformation to form the two active metabolites. These observations provide novel insight into ketamine's molecular mechanism(s) of action and have potential implications for the treatment of MDD. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Something new about ketamine for pediatric anesthesia?

    Science.gov (United States)

    Lois, Fernande; De Kock, Marc

    2008-06-01

    This review discusses the place of the old anesthetic ketamine in pediatric anesthesia. Despite the availability of modern alternatives, ketamine remains a frequently used drug particularly for anesthesia in high-risk children and for procedures outside the operating room. In adult patients undergoing surgery, a renewed interest in this drug is noted. It is the consequence of recent demonstrations of the following effects. First, ketamine is highly effective against surgery and opiate-induced hyperalgesia. Second, it has original antiproinflammatory properties. In other words, it promotes self-limitation of the inflammatory response that follows surgery. In the pediatric population, these benefits wait to be confirmed. Finally, questions arise about the safety of ketamine anesthesia. Ketamine is a potent proapoptotic drug. In rodents treated during the critical period for central nervous system development, long-term behavioral deficits were noted after an anesthetic dose of ketamine. The exact consequences of these proapoptotic properties on human brain tissue development have to be exactly determined and are still debatable. Ketamine has not yet revealed all its interactions in humans. Recent discoveries indicate interesting properties on the one hand and potentially deleterious effects on the other.

  18. Perioperative Ketamine Administration for Thoracotomy Pain.

    Science.gov (United States)

    Moyse, Daniel W; Kaye, Alan D; Diaz, James H; Qadri, Muhammad Y; Lindsay, David; Pyati, Srinivas

    2017-03-01

    Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia. We reviewed the evidence for the efficacy of intravenous and epidural administration of ketamine in acute post-thoracotomy pain management, and its effectiveness in reducing chronic post-thoracotomy pain. Systematic literature review and an analytic study of a data subset were performed. We searched PubMed, Embase, and Cochrane reviews using the key terms "ketamine," "neuropathic pain," "postoperative," and "post-thoracotomy pain syndrome." The search was limited to human trials and included all studies published before January 2015. Data from animal studies, abstracts, and letters were excluded. All studies not available in the English language were excluded. The manuscript bibliographies were reviewed for additional related articles. We included randomized controlled trials and retrospective studies, while excluding individual case reports. This systematic literature search yielded 15 randomized control trials evaluating the efficacy of ketamine in the treatment of acute post-thoracotomy pain; fewer studies assessed its effect on attenuating chronic post-thoracotomy pain. The majority of reviewed studies demonstrated that ketamine has efficacy in reduction of acute pain, but the evidence is limited on the long-term benefits of ketamine to prevent post-thoracotomy pain syndrome, regardless of the route of administration. A nested analytical study found there is a statistically significant reduction in acute post-thoracotomy pain with IV or

  19. Ketamine for chronic pain: risks and benefits.

    Science.gov (United States)

    Niesters, Marieke; Martini, Christian; Dahan, Albert

    2014-02-01

    The anaesthetic ketamine is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Low dose ketamine produces strong analgesia in neuropathic pain states, presumably by inhibition of the N-methyl-D-aspartate receptor although other mechanisms are possibly involved, including enhancement of descending inhibition and anti-inflammatory effects at central sites. Current data on short term infusions indicate that ketamine produces potent analgesia during administration only, while three studies on the effect of prolonged infusion (4-14 days) show long-term analgesic effects up to 3 months following infusion. The side effects of ketamine noted in clinical studies include psychedelic symptoms (hallucinations, memory defects, panic attacks), nausea/vomiting, somnolence, cardiovascular stimulation and, in a minority of patients, hepatoxicity. The recreational use of ketamine is increasing and comes with a variety of additional risks ranging from bladder and renal complications to persistent psychotypical behaviour and memory defects. Blind extrapolation of these risks to clinical patients is difficult because of the variable, high and recurrent exposure to the drug in ketamine abusers and the high frequency of abuse of other illicit substances in this population. In clinical settings, ketamine is well tolerated, especially when benzodiazepines are used to tame the psychotropic side effects. Irrespective, close monitoring of patients receiving ketamine is mandatory, particularly aimed at CNS, haemodynamic, renal and hepatic symptoms as well as abuse. Further research is required to assess whether the benefits outweigh the risks and costs. Until definite proof is obtained ketamine administration should be restricted to patients with therapy-resistant severe neuropathic pain. © 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.

  20. Ketamine use in current clinical practice

    Science.gov (United States)

    Gao, Mei; Rejaei, Damoon; Liu, Hong

    2016-01-01

    After nearly half a century on the market, ketamine still occupies a unique corner in the medical armamentarium of anesthesiologists or clinicians treating pain. Over the last two decades, much research has been conducted highlighting the drug's mechanisms of action, specifically those of its enantiomers. Nowadays, ketamine is also being utilized for pediatric pain control in emergency department, with its anti-hyperalgesic and anti-inflammatory effects being revealed in acute and chronic pain management. Recently, new insights have been gained on ketamine's potential anti-depressive and antisuicidal effects. This article provides an overview of the drug's pharmacokinetics and pharmacodynamics while also discussing the potential benefits and risks of ketamine administration in various clinical settings. PMID:27018176

  1. Ketamine for cancer pain: what is the evidence?

    Science.gov (United States)

    Jonkman, Kelly; van de Donk, Tine; Dahan, Albert

    2017-06-01

    In this review, we assess the benefit of ketamine in the treatment of terminal cancer pain that is refractory to opioid treatment and/or complicated by neuropathy. While randomized controlled trials consistently show lack of clinical efficacy of ketamine in treating cancer pain, a large number of open-label studies and case series show benefit. Ketamine is an N-methyl-D-aspartate receptor antagonist that at low-dose has effective analgesic properties. In cancer pain, ketamine is usually prescribed as adjuvant to opioid therapy when pain becomes opioid resistant or when neuropathic pain symptoms dominate the clinical picture. A literature search revealed four randomized controlled trials that examined the benefit of oral, subcutaneous or intravenous ketamine in opioid refractory cancer pain. None showed clinically relevant benefit in relieving pain or reducing opioid consumption. This suggests absence of evidence of benefit for ketamine as adjuvant analgesic in cancer pain. These findings contrast the benefit from ketamine observed in a large number of open-label studies and (retrospective) case series. We relate the opposite outcomes to methodological issues. The complete picture is such that there is still insufficient evidence to state with certainty that ketamine is not effective in cancer pain.

  2. Ketamine produces lasting disruptions in encoding of sensory stimuli.

    Science.gov (United States)

    Maxwell, Christina R; Ehrlichman, Richard S; Liang, Yuling; Trief, Danielle; Kanes, Stephen J; Karp, Jonathan; Siegel, Steven J

    2006-01-01

    The current study analyzed the acute, chronic, and lasting effects of ketamine administration in four inbred mouse strains (C3H/HeHsd, C57BL/6Hsd, FVB/Hsd, and DBA/2Hsd) to evaluate vulnerability to ketamine as a drug of abuse and as a model of schizophrenia. Serum half-life of ketamine was similar between all strains (approximately 13 min). Also, the ratio of brain-to-serum ketamine levels was 3:1. Examination of multiple phases of auditory processing using auditory-evoked potentials (AEPs) following acute ketamine (0, 5, and 20 mg/kg) treatment revealed C3H/HeHsd mice to be most vulnerable to ketamine-induced alterations in AEPs, whereas FVB/Hsd mice exhibited the least electrophysiological sensitivity to ketamine. Overall, the precortical P1-evoked potential component increased in amplitude and latency, whereas the cortically generated N1 and P2 components decreased in amplitude and latency following acute ketamine across all strains. Brain catecholamine analyses indicated that ketamine decreased hippocampus epinephrine levels in C3H/HeHsd but elevated hippocampus epinephrine levels in FVB/Hsd, suggesting one potential mechanism for AEP vulnerability to ketamine. Based on results of the acute study, the immediate and lasting effects of chronic low-dose ketamine on AEPs were examined among C3H/HeHsd (sensitive) and FVB/Hsd (insensitive) mice. We observed a decrement of the N1 amplitude that persisted at least 1 week after the last exposure to ketamine across both strains. This lasting deficit in information processing occurred in the absence of acute changes among the FVB/Hsd mice. Implications for both ketamine abuse and N-methyl-D-aspartate hypofunction models of schizophrenia are discussed.

  3. Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing.

    Science.gov (United States)

    Abulebda, Kamal; Patel, Vinit J; Ahmed, Sheikh S; Tori, Alvaro J; Lutfi, Riad; Abu-Sultaneh, Samer

    2017-10-28

    The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed. 73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia. Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Injecting behaviour and service use among young injectors in Albania, Moldova, Romania and Serbia.

    Science.gov (United States)

    Busza, Joanna; Douthwaite, Megan; Bani, Roland; Scutelniciuc, Otilia; Preda, Marian; Simic, Danijela

    2013-09-01

    This study examines socio-demographic profiles, injecting risk and use of health services among young injectors (15-24) in Albania, Moldova, Romania and Serbia. The objective was to provide age-disaggregated data to identify differences between adolescents (Romania, surveys were conducted in the capitals, respectively, Bucharest and Tirana. Respondents were recruited from 3 cities in Moldova (Chisinau, Balti and Tiraspol) and Serbia (Belgrade, Novi Sad and Nis). Data were collected on risk behaviours, service use and contact with police and other authorities. Analysis focused on associations between unsafe injecting behaviour and key determinants including demographic background, source of needles/syringes, use of harm reduction services and interactions with law enforcement. Although drug use and health-seeking varied across settings, sources of injecting equipment were significantly associated with sharing needles and syringes in Moldova, Romania and Serbia. Obtaining equipment from formal sources (pharmacies, needle-exchange programmes) reduced likelihood of sharing significantly, while being stopped by the police or incarcerated increased it. Adolescents relied on pharmacies more than public sector services to obtain equipment. Adolescents comprise a small proportion of PWID in this region, but have poorer access to harm reduction services than older peers. Engaging young PWID through private and public sector outlets might reduce unsafe practices, while use of the justice system to address drug use complicates efforts to reach this population. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Spinal conduction block by intrathecal ketamine in dogs.

    Science.gov (United States)

    Iida, H; Dohi, S; Tanahashi, T; Watanabe, Y; Takenaka, M

    1997-07-01

    In addition to its use for intravenous (I.V.) anesthesia, ketamine can provide pain relief in humans when administered spinally. To elucidate the mechanisms of intrathecal (I.T.) ketamine analgesia, we observed differences in the effects of I.V. and I.T. ketamine on intraspinal evoked potentials (ISEPs) in 28 dogs anesthetized with pentobarbital. Bipolar extradural electrodes were inserted at the cervical and lumbar regions of the spinal cord for recording descending ISEPs represented by the two negative deflections, Waves I and II. I.V. ketamine 2 and 10 mg/ kg did not affect the amplitude and latency of Wave I, whereas the large dose (10 mg/kg) significantly decreased the amplitude but not the latency of Wave II. I.T. ketamine 1 and 5 mg/kg caused significant dose-dependent decreases in both Wave I and II amplitudes and prolongations of both Wave I and II latencies. These I.T. effects on ISEPs are consistent with previous in vitro observations that ketamine blocks axonal conduction. We conclude that axonal conduction block may contribute to the analgesic mechanism of I.T. ketamine.

  6. Ketamine and the Obstetric Patient

    African Journals Online (AJOL)

    1974-04-13

    Apr 13, 1974 ... Dream recall was more frequent in the ketamine series, but most dreams seemed to be pleasant in nature (Table ID. Total No. of cases. Definite 1Painful factual recall. Painless. Doubtful recall. Ketamine anaesthesia was administered to 135 mothers undergoing Caesarean section. The incidence of aware-.

  7. Oral ketamine for radiotherapy in children with cancer

    International Nuclear Information System (INIS)

    Shewale, S.; Saxena, Abha; Trikha, Anjan; Singh, Manorama; Sharief, Abeda

    2000-01-01

    Children coming for radiotherapy under sedation usually get repeated injections, which cause distress to both the child and the parents. A prospective study was conducted to evaluate the efficacy of oral ketamine for sedation for radiotherapy (RT) in children with cancer. Ten children who received 49 sittings of RT were given 8-15 mg/kg body weight of oral ketamine. The onset time, recovery time, efficacy of sedation and incidence of abnormal movements were compared with another group of 8 children, who received intramuscular ketamine in the dose of 6 mg/kg for a total of 28 sittings of RT. Onset time and recovery time were significantly longer in oral ketamine group as compared to the intramuscular group (p<0.001). Limb movements in patients receiving oral ketamine necessitated further supplement of sedation and interruption of RT. These drawbacks discourage use of oral ketamine as a good sedative for radiotherapy treatment in paediatric oncology patients. (author)

  8. Peripheral analgesic effects of ketamine in acute inflammatory pain

    DEFF Research Database (Denmark)

    Pedersen, J L; Galle, T S; Kehlet, H

    1998-01-01

    BACKGROUND. This study examined the analgesic effect of local ketamine infiltration, compared with placebo and systemic ketamine, in a human model of inflammatory pain. METHODS: Inflammatory pain was induced by a burn (at 47 degrees C for 7 min; wound size, 2.5 x 5 cm) on the calf in 15 volunteers...... on 3 separate days with 7-day intervals. They received either (1) subcutaneous infiltration with ketamine in the burn area (local treatment) and contralateral placebo injections, or (2) subcutaneous ketamine contralateral to the burn (systemic treatment) and placebo in the burn area, or (3) placebo...... hyperalgesia. Local ketamine infiltration reduced pain during the burn injury compared with systemic treatment and placebo (P ketamine treatment compared with placebo immediately after injection (P

  9. The Effects of Different Doses of Ketamine on Quality of Normal Ejaculated Sperm

    Directory of Open Access Journals (Sweden)

    Forouzan Absalan

    2014-07-01

    Full Text Available Background: Ketamine, an injectable anesthetic in human and animal medicine, is also a recreational drug used by young adults. The aim of this study is to evaluate the effects of ketamine on membrane integrity, DNA fragmentation and sperm parameters in humans. Materials and Methods: This prospective study was conducted on 40 males with normal semen samples over one month (August 2012. Subjects were randomly allocated to four groups (Control and case I, II and III whose semen samples were adjusted to different concentrations of ketamine (1, 3, 5 μL for one hour. Sperm analysis was performed for routine parameters, motility and morphology. Evaluation of membrane integrity and DNA fragmentation was done by eosin-Y staining and the sperm chromatin dispersion (SCD test, respectively. The results were analyzed by ANOVA and Tukey’s tests. P≤0.05 was considered statistically significant. Results: Total sperm motility in all case groups were significantly lower compared with the control group. In case group III, progressive motility showed significant difference with case group II. After addition of ketamine, sperm had evidence of coiled tails in all case groups compared to the control group however this observation was not significant. Evaluation of membrane integrity showed the rate of necrospermia increased in all case groups. However, ketamine only significantly affected membrane integrity in case group III. SCD staining showed that in the control group nucleoids with medium halos (63.44 ± 1.2 were significantly different compared to the case groups I (15.44 ± 0.45, II (9.05±1.16 and III (10.55 ± 1.14, respectively. Between case groups, nucleoids with large and medium halos showed significant differences in case groups II and III compared with case group I. Nucleoids with medium halos were significantly different between case groups II and III. Conclusion: Ketamine, through its effect on membrane integrity and DNA fragmentation, decreased

  10. Cognitive impairments in poly-drug ketamine users.

    Science.gov (United States)

    Liang, H J; Lau, C G; Tang, A; Chan, F; Ungvari, G S; Tang, W K

    2013-11-01

    Cognitive impairment has been found to be reversible in people with substance abuse, particularly those using ketamine. Ketamine users are often poly-substance users. This study compared the cognitive functions of current and former ketamine users who were also abusing other psychoactive substances with those of non-users of illicit drugs as controls. One hundred ketamine poly-drug users and 100 controls were recruited. Drug users were divided into current (n = 32) and ex-users (n = 64) according to the duration of abstinence from ketamine (>30 days). The Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scale (HADSA) and the Severity of Dependence Scale (SDS) were used to evaluate depression and anxiety symptoms and the severity of drug use, respectively. The cognitive test battery comprised verbal memory (Wechsler Memory Scale III: Logic Memory and Word List), visual memory (Rey-Osterrieth Complex Figure, ROCF), executive function (Stroop, Wisconsin Card Sorting Test, and Modified Verbal Fluency Test), working memory (Digit Span Backward), and general intelligence (Information, Arithmetic and Digit-Symbol Coding) tests. Current users had higher BDI and HADSA scores than ex-users (p recognition than controls (p = 0.002). No difference was found between the cognitive functions of current and ex-users. Ketamine poly-drug users displayed predominantly verbal and visual memory impairments, which persisted in ex-users. The interactive effect of ketamine and poly-drug use on memory needs further investigation. © 2013 Elsevier Ltd. All rights reserved.

  11. The effect of ketamine on intraspinal acetylcholine release

    DEFF Research Database (Denmark)

    Abelson, Klas S P; Goldkuhl, Renée Röstlinger; Nylund, Anders

    2006-01-01

    The general anaesthetic ketamine affects the central cholinergic system in several manners, but its effect on spinal acetylcholine release, which may be an important transmitter in spinal antinociception, is unknown. This study aimed to investigate the effect of ketamine on spinal acetylcholine...... release. Microdialysis probes were placed intraspinally in male rats, and acetylcholine was quantified with HPLC. Anaesthesia was switched from isoflurane (1.3%) to ketamine (150 mg/kg h), which resulted in a 500% increased acetylcholine release. The increase was attenuated during nicotinic receptor...... blockade (50 microM mecamylamine). The nicotinic receptor agonist epibatidine (175 microM) produced a ten-fold higher relative increase of acetylcholine release during isoflurane anaesthesia compared to ketamine anaesthesia (270% to 27%). Intraspinal administration of ketamine and norketamine both...

  12. Involvement of adenosine in the antiinflammatory action of ketamine.

    Science.gov (United States)

    Mazar, Julia; Rogachev, Boris; Shaked, Gad; Ziv, Nadav Y; Czeiger, David; Chaimovitz, Cidio; Zlotnik, Moshe; Mukmenev, Igor; Byk, Gerardo; Douvdevani, Amos

    2005-06-01

    Ketamine is an anesthetic drug. Subanesthetic doses of ketamine have been shown to reduce interleukin-6 concentrations after surgery and to reduce mortality and the production of tumor necrosis factor alpha and interleukin 6 in septic animals. Similarly, adenosine was shown to reduce tumor necrosis factor alpha and mortality of septic animals. The aim of this study was to determine whether adenosine mediates the antiinflammatory effects of ketamine. Sepsis was induced in mice by lipopolysaccharide or Escherichia coli inoculation. Leukocyte recruitment and cytokine concentrations were used as inflammation markers. Adenosine concentrations were assayed by high-performance liquid chromatography, and the involvement of adenosine in the effects of ketamine was demonstrated by adenosine receptor agonists and antagonists. Ketamine markedly reduced mortality from sepsis, leukocyte recruitment, and tumor necrosis factor-alpha and interleukin-6 concentrations. Ketamine administration in mice and rats was associated with a surge at 20-35 min of adenosine in serum (up to 5 microm) and peritoneal fluid. The adenosine A2A receptor agonist CGS-21680 mimicked the effect of ketamine in peritonitis, whereas the A2A receptor antagonists DMPX and ZM 241385 blocked its antiinflammatory effects. In contrast, A1 and A3 receptor antagonists had no effect. ZM 241385 reversed the beneficial effect of ketamine on survival from bacterial sepsis. The current data suggest that the sepsis-protective antiinflammatory effects of ketamine are mediated by the release of adenosine acting through the A2A receptor.

  13. Radiographic assessment of laryngeal reflexes in ketamine-anesthetized cats

    International Nuclear Information System (INIS)

    Robinson, E.P.; Johnston, G.R.

    1986-01-01

    The competence of the laryngeal closure reflexes of cats anesthetized with ketamine was assessed. Radiographic evaluations of the respiratory and digestive tracts were made after colloidal barium suspension was instilled into the pharynges of conscious and ketamine-anesthetized cats. There was a significant ketamine dose-related response of spread of contrast medium into the supraglottic laryngeal area and into the stomach 2 minutes after contrast medium was instilled into the pharynx (P less than 0.05). Cats did not aspirate contrast medium into the lower respiratory tract. Three ketamine-anesthetized cats aspirated contrast medium into the subglottic area of the larynx, and 2 of these cats also aspirated the material into the cranial part of the trachea. This material was coughed up and swallowed within 5 minutes. Transit time of contrast medium into the stomach seemed to be increased in 11 of the 15 cats given the larger dosages of ketamine (24, 36, 48 mg/kg of body weight), compared with that in conscious cats and those given ketamine at 12 mg/kg. Competent laryngeal protective reflexes in cats can be maintained with ketamine anesthesia. Contrast radiography could be used as a diagnostic aid in ketamine-anesthetized cats suspected of laryngeal reflex abnormalities

  14. Comparison Of Oral Premedication With Combination Of Midazolam With Ketamine Vs Midazolam Ketamine Alone In Children Children Medical Center (year 2000

    Directory of Open Access Journals (Sweden)

    Hasani M

    2002-09-01

    Full Text Available Anxiolysis and sedation with oral midazolam are common practice in pediatric anesthesia. Good or excellent results are seen in only 50% to 80% of cases, so we decided to investigate if addition of a low dose of oral ketamine to midazolam (ketamine2.5 mg /kg ^midazolam 0.25 mg/kg resulted in better premedication compared with oral midazolam 0.5 mg/kg or ketamine 6 mg/kg alone."nMethods and Materials: in a prospective, randomized ,double -blind study we study 105 children (mean age 6 ,range 2-10 yr. undergoing non thoracic and non cardiac surgery of more than 30 min duration. The patients were in ASA 1, 2. After oral premedication the child's condition was evaluated by assigning 1-4 point to the quality of anxiolysis, sedation, and separation from parents in the induction room .The groups were similar in sex, age, weight, intervention and duration of anaesthesia."nResults: The score of sedation before transfer to the operation room was significantly better in the ketamine, midazolam combination group than in the ketamine or midazolam group. Success rates for anxiolysis and behavior at separation were grater than 90%with the combination, approximately 80% with midazolam and 70% with ketamine alone .The incidence of salivation, excitation, nausea and vomiting was grater in the ketamine group but were very low in other groups. During recovery there were no difference in sedation or time of possible discharge."nConclusion: In summery, significantly better anxiolysis and separation were observed with a combination of ketamine and midazolam, even in awake children than with midazolam or ketamine alone. Duration of action and side effects of the combination was similar to those of midazolam.

  15. Use of Ketamine in Elderly Patients with Treatment-Resistant Depression.

    Science.gov (United States)

    Medeiros da Frota Ribeiro, Carolina; Riva-Posse, Patricio

    2017-11-15

    The purpose of this paper is to provide a review of the use of ketamine as an antidepressant for treatment-resistant depression (TRD) in the geriatric population. Available treatment options for late-life treatment-resistant depression are limited and include electroconvulsive therapy and transcranial magnetic stimulation as well as possible pharmacologic augmentation. Ketamine has been shown to be a promising treatment in TRD; however, data regarding the use of ketamine in the elderly includes only five case reports. We discuss the use of ketamine for late-life TRD and present two cases where ketamine led to a significant and sustained improvement in depressive symptoms. Ketamine is a promising treatment for geriatric patients with TRD. Further studies in the elderly will provide valuable insights into the use of ketamine for a population much in need of safe and effective treatments for TRD.

  16. Intravenous sub-anesthetic ketamine for perioperative analgesia

    Directory of Open Access Journals (Sweden)

    Andrew W Gorlin

    2016-01-01

    Full Text Available Ketamine, an N-methyl-d-aspartate antagonist, blunts central pain sensitization at sub-anesthetic doses (0.3 mg/kg or less and has been studied extensively as an adjunct for perioperative analgesia. At sub-anesthetic doses, ketamine has a minimal physiologic impact though it is associated with a low incidence of mild psychomimetic symptoms as well as nystagmus and double vision. Contraindications to its use do exist and due to ketamine′s metabolism, caution should be exercised in patients with renal or hepatic dysfunction. Sub-anesthetic ketamine improves pain scores and reduces perioperative opioid consumption in a broad range of surgical procedures. In addition, there is evidence that ketamine may be useful in patients with opioid tolerance and for preventing chronic postsurgical pain.

  17. Ketamine Infusion Associated with Improved Neurology in a Patient with NMDA Receptor Encephalitis

    Directory of Open Access Journals (Sweden)

    Michael MacMahon

    2013-01-01

    Full Text Available A young lady was ventilated on intensive care for a prolonged period with NMDA receptor encephalitis. She had undergone steroid, immunoglobulin, and plasmapheresis with no evidence of recovery. Her main management issue was the control of severe orofacial and limb dyskinesia. Large doses of sedating agents had been used to control the dystonia but were ineffective, unless she was fully anaesthetised. The introduction of a ketamine infusion was associated with a dramatic improvement in her symptoms such that it was possible to remove her tracheostomy two days after commencement. She was discharged shortly after that and is making a good recovery. The successful use of ketamine has not previously been described in this context, and we hope this case report will provide some insight into the management of this rare but serious condition.

  18. A PK-PD model of ketamine-induced high-frequency oscillations

    Science.gov (United States)

    Flores, Francisco J.; Ching, ShiNung; Hartnack, Katharine; Fath, Amanda B.; Purdon, Patrick L.; Wilson, Matthew A.; Brown, Emery N.

    2015-10-01

    Objective. Ketamine is a widely used drug with clinical and research applications, and also known to be used as a recreational drug. Ketamine produces conspicuous changes in the electrocorticographic (ECoG) signals observed both in humans and rodents. In rodents, the intracranial ECoG displays a high-frequency oscillation (HFO) which power is modulated nonlinearly by ketamine dose. Despite the widespread use of ketamine there is no model description of the relationship between the pharmacokinetic-pharmacodynamics (PK-PDs) of ketamine and the observed HFO power. Approach. In the present study, we developed a PK-PD model based on estimated ketamine concentration, its known pharmacological actions, and observed ECoG effects. The main pharmacological action of ketamine is antagonism of the NMDA receptor (NMDAR), which in rodents is accompanied by an HFO observed in the ECoG. At high doses, however, ketamine also acts at non-NMDAR sites, produces loss of consciousness, and the transient disappearance of the HFO. We propose a two-compartment PK model that represents the concentration of ketamine, and a PD model based in opposing effects of the NMDAR and non-NMDAR actions on the HFO power. Main results. We recorded ECoG from the cortex of rats after two doses of ketamine, and extracted the HFO power from the ECoG spectrograms. We fit the PK-PD model to the time course of the HFO power, and showed that the model reproduces the dose-dependent profile of the HFO power. The model provides good fits even in the presence of high variability in HFO power across animals. As expected, the model does not provide good fits to the HFO power after dosing the pure NMDAR antagonist MK-801. Significance. Our study provides a simple model to relate the observed electrophysiological effects of ketamine to its actions at the molecular level at different concentrations. This will improve the study of ketamine and rodent models of schizophrenia to better understand the wide and divergent

  19. Oral ketamine for the treatment of pain and treatment-resistant depression†.

    Science.gov (United States)

    Schoevers, Robert A; Chaves, Tharcila V; Balukova, Sonya M; Rot, Marije Aan Het; Kortekaas, Rudie

    2016-02-01

    Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. Searches in PubMed with the terms 'oral ketamine', 'depression', 'chronic pain', 'neuropathic pain', 'intravenous ketamine', 'intranasal ketamine' and 'subcutaneous ketamine' yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. © The Royal College of Psychiatrists 2016.

  20. R-ketamine: a rapid-onset and sustained antidepressant without psychotomimetic side effects

    Science.gov (United States)

    Yang, C; Shirayama, Y; Zhang, J-c; Ren, Q; Yao, W; Ma, M; Dong, C; Hashimoto, K

    2015-01-01

    Although the efficacy of racemate ketamine, a rapid onset and sustained antidepressant, for patients with treatment-resistant depression was a serendipitous finding, clinical use of ketamine is limited, due to psychotomimetic side effects and abuse liability. Behavioral and side-effect evaluation tests were applied to compare the two stereoisomers of ketamine. To elucidate their potential therapeutic mechanisms, we examined the effects of these stereoisomers on brain-derived neurotrophic factor (BDNF)–TrkB signaling, and synaptogenesis in selected brain regions. In the social defeat stress and learned helplessness models of depression, R-ketamine showed a greater potency and longer-lasting antidepressant effect than S-ketamine (esketamine). Furthermore, R-ketamine induced a more potent beneficial effect on decreased dendritic spine density, BDNF–TrkB signaling and synaptogenesis in the prefrontal cortex (PFC), CA3 and dentate gyrus (DG) of the hippocampus from depressed mice compared with S-ketamine. However, neither stereoisomer affected these alterations in the nucleus accumbens of depressed mice. In behavioral tests for side effects, S-ketamine, but not R-ketamine, precipitated behavioral abnormalities, such as hyperlocomotion, prepulse inhibition deficits and rewarding effects. In addition, a single dose of S-ketamine, but not R-ketamine, caused a loss of parvalbumin (PV)-positive cells in the prelimbic region of the medial PFC and DG. These findings suggest that, unlike S-ketamine, R-ketamine can elicit a sustained antidepressant effect, mediated by increased BDNF–TrkB signaling and synaptogenesis in the PFC, DG and CA3. R-ketamine appears to be a potent, long-lasting and safe antidepressant, relative to S-ketamine, as R-ketamine appears to be free of psychotomimetic side effects and abuse liability. PMID:26327690

  1. Failure of Ketamine Anesthesia in a Patient with Lamotrigine Overdose

    Directory of Open Access Journals (Sweden)

    Daniel Kornhall

    2014-01-01

    Full Text Available Introduction. It is important to know which clinical situations prevent ketamine from working. Case Report. We present the case of the psychiatric inpatient who was admitted to our emergency department after ingesting a toxic dose of lamotrigine, unknown at that time. On admission, she was clearly in distress, displaying extreme agitation and violent ataxic movements. We opted to achieve sedation using intravenous ketamine boluses. Unexpectedly, after being injected with a total of 250 mg ketamine, our patient displayed no signs of dissociative anaesthesia. Discussion. There was no apparent reason for why ketamine failed, but an interaction between lamotrigine and ketamine was suspected. A literature search was performed. Very few articles describe interactions between lamotrigine and ketamine. Experimental studies, however, demonstrate how lamotrigine attenuates the neuropsychiatric effects of ketamine. Ketamine is classically described as an NMDA antagonist. Ketamine’s dissociative effects, however, are thought to be mediated by increased glutamate release via a pathway not dependent on NMDA receptors. Lamotrigine, on the other hand, is known to reduce cortical glutamate release. Conclusion. Lamotrigine reduces the glutamate release needed to mediate ketamine’s dissociative anaesthesia. This is important knowledge for anaesthesiologists in the emergency room where ketamine is often administered to unstable patients.

  2. Brain damages in ketamine addicts as revealed by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Chunmei eWang

    2013-07-01

    Full Text Available Ketamine, a known antagonist of N-methyl-D-aspartic (NMDA glutamate receptors, had been used as an anesthetic particularly for pediatric or for cardiac patients. Unfortunately, ketamine has become an abusive drug in many parts of the world while chronic and prolonged usage led to damages of many organs including the brain. However, no studies on possible damages in the brains induced by chronic ketamine abuse have been documented in the human via neuroimaging. This paper described for the first time via employing magnetic resonance imaging (MRI the changes in ketamine addicts of 0.5 to 12 years and illustrated the possible brain regions susceptible to ketamine abuse. Twenty-one ketamine addicts were recruited and the results showed that the lesions in the brains of ketamine addicts were located in many regions which appeared 2-4 years after ketamine addiction. Cortical atrophy was usually evident in the frontal, parietal or occipital cortices of addicts. Such study confirmed that many brain regions in the human were susceptible to chronic ketamine injury and presented a diffuse effect of ketamine on the brain which might differ from other central nervous system (CNS drugs, such as cocaine, heroin and methamphetamine.

  3. A consideration of ketamine dreams.

    Science.gov (United States)

    Hejja, P; Galloon, S

    1975-01-01

    This study was designed to see whether covering of the eyes during and after ketamine anaesthesia would reduce the incidence of dreams. One hundred and fifty patients, randomly divided into three groups, underwent therapeutic abortion with ketamine as the sole anaesthesia. One hundred patients had their eyes completely covered, 50 in the operating room only and 50 in the operating room and in the recovery room. The third 50 were controls, with their eyes uncovered. All patients were questioned post-operatively about dreams, nausea and vomiting, headache, dizziness and experiences, and also how frequently they dreamed at home. Although covering the eyes in the recovery room only reduced the incidence of dreams marginally, it became obvious that the patients who dreamed after ketamine (in all 3 groups) were those who normally dreamed at home. There were 82 patients who were recorded as not being home-dreamers, and only two of these dreamed after ketamine. In contrast, of the 68 home-dreamers, 50 dreamed after ketamine, and 17 of these had unpleasant dreams. In the home-dreamers, covering the eyes reduced the incidence of dreams from 86 per cent in Group 1 to 72 per cent in Group 2 and 64 per cent in Group 3. It is suggested that goggles may be advantageous when dealing with home-dreamers, and a question about the patient's tendency to dream should be included in the preoperative questioning. Alterations in premedication and the use of a quiet dark room during recovery may even further reduce unpleasant dreams in this group.

  4. Ketamine for Pain Management-Side Effects & Potential Adverse Events.

    Science.gov (United States)

    Allen, Cheryl A; Ivester, Julius R

    2017-12-01

    An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. The doses used for analgesic purposes are much lower than those used for anesthesia purposes. A literature review was performed to ascertain potential side effects and/or adverse events when using ketamine for analgesia purposes. The search included CINAHL, PubMed, and Ovid using the search terms "ketamine," "ketamine infusion," "pain," "adverse events," "practice guideline," and "randomized controlled trial." Searches were limited to full-text, peer-reviewed articles and systematic reviews. Initially 1,068 articles were retrieved. The search was then narrowed by using the Boolean connector AND with various search term combinations. After adjusting for duplication, article titles and abstracts were reviewed, leaving 25 articles for an in-depth analysis. Specific exclusion criteria were then applied. The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  5. Redirecting by Injector

    Science.gov (United States)

    Filman, Robert E.; Lee, Diana D.; Norvig, Peter (Technical Monitor)

    2000-01-01

    We describe the Object Infrastructure Framework, a system that seeks to simplify the creation of distributed applications by injecting behavior on the communication paths between components. We touch on some of the ilities and services that can be achieved with injector technology, and then focus on the uses of redirecting injectors, injectors that take requests directed at a particular server and generate requests directed at others. We close by noting that OIF is an Aspect-Oriented Programming system, and comparing OIF to related work.

  6. Subanesthetic, Subcutaneous Ketamine Infusion Therapy in the Treatment of Chronic Nonmalignant Pain.

    Science.gov (United States)

    Zekry, Olfat; Gibson, Stephen B; Aggarwal, Arun

    2016-06-01

    This study was designed to describe the efficacy and toxicity of subcutaneous ketamine infusions and sublingual ketamine lozenges for the treatment of chronic nonmalignant pain. Data were collected prospectively on 70 subjects managed in an academic, tertiary care hospital between 2007 and 2012 who received between 3 and 7 days of subanesthetic, subcutaneous ketamine infusion. Data were analyzed for efficacy, adverse effects, and reduction in use of opioid medication. We also analyzed whether subsequent treatment with sublingual ketamine lozenges resulted in longer-term efficacy of the beneficial effects of the initial ketamine infusion. There was a significant reduction in pain intensity measured by numerical rating scale (NRS) from mean of 6.38 before ketamine to 4.60 after ketamine (P ketamine infusion from a mean morphine equivalent dose (MMED) of 216 mg/day before ketamine to 89 mg/day after ketamine (P ketamine infusion was 59%. No subjects increased their use of opioids during their hospitalization for the ketamine infusion. A small proportion of subjects who responded to the infusion were continued on ketamine lozenges. This group was followed for between 3 months and 2 years. The use of ketamine lozenges after the infusion resulted in 31% of these subjects being able to cease their use of opioids compared with only 6% who did not receive ketamine lozenges. Eleven percent of subjects who received lozenges subsequently increased their opioid usage. Adverse effects were fairly common, but only mild, with 46% of patients experiencing light-headedness and dizziness, 25% tiredness and sedation, 12% headaches, 12% hallucinations, and 8% vivid dreams. Adverse effects were easily managed by reducing the rate of the ketamine infusion. The administration of subanesthetic, subcutaneous ketamine infusion was well tolerated, with mostly mild adverse effects and no serious adverse effects. The infusion provided significant pain relief in subjects who had failed a wide

  7. Ketamine Dependence in an Anesthesiologist: An Occupational Hazard?

    OpenAIRE

    Goyal, Shrigopal; Ambekar, Atul; Ray, Rajat

    2014-01-01

    Substance abuse among medical professionals is a cause for concern. Certain psychotropic substances such as ketamine are at easy dispense to anesthesiologists increasing the likelihood of misuse and dependence and raise several issues including safety of patients. We discuss a case demonstrating ketamine dependence in an anesthesiologist from India. The reported psychotropic effects of ketamine ranged from dissociation and depersonalization to psychotic experiences. There was also development...

  8. Abnormalities in white matter microstructure associated with chronic ketamine use.

    Science.gov (United States)

    Edward Roberts, R; Curran, H Valerie; Friston, Karl J; Morgan, Celia J A

    2014-01-01

    Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has been found to induce schizophrenia-type symptoms in humans and is a potent and fast-acting antidepressant. It is also a relatively widespread drug of abuse, particularly in China and the UK. Acute administration has been well characterized, but the effect of extended periods of ketamine use-on brain structure in humans-remains poorly understood. We measured indices of white matter microstructural integrity and connectivity in the brain of 16 ketamine users and 16 poly-drug-using controls, and we used probabilistic tractography to quantify changes in corticosubcortical connectivity associated with ketamine use. We found a reduction in the axial diffusivity profile of white matter in a right hemisphere network of white matter regions in ketamine users compared with controls. Within the ketamine-user group, we found a significant positive association between the connectivity profile between the caudate nucleus and the lateral prefrontal cortex and dissociative experiences. These findings suggest that chronic ketamine use may be associated with widespread disruption of white matter integrity, and white matter pathways between subcortical and prefrontal cortical areas may in part predict individual differences in dissociative experiences due to ketamine use.

  9. Revealing past memories: proactive interference and ketamine-induced memory deficits.

    Science.gov (United States)

    Chrobak, James J; Hinman, James R; Sabolek, Helen R

    2008-04-23

    Memories of events that occur often are sensitive to interference from memories of similar events. Proactive interference plays an important and often unexamined role in memory testing for spatially and temporally unique events ("episodes"). Ketamine (NMDA receptor antagonist) treatment in humans and other mammals induces a constellation of cognitive deficits, including impairments in working and episodic memory. We examined the effects of the ketamine (2.5-100 mg/kg) on the acquisition, retrieval, and retention of memory in a delayed-match-to-place radial water maze task that can be used to assess proactive interference. Ketamine (2.5-25 mg/kg, i.p.) given 20 min before the sample trial, impaired encoding. The first errors made during the test trial were predominantly to arms located spatially adjacent to the goal arm, suggesting an established albeit weakened representation. Ketamine (25-100 mg/kg) given immediately after the sample trial had no effect on retention. Ketamine given before the test trial impaired retrieval. First errors under the influence of ketamine were predominantly to the goal location of the previous session. Thus, ketamine treatment promoted proactive interference. These memory deficits were not state dependent, because ketamine treatment at both encoding and retrieval only increased the number of errors during the test session. These data demonstrate the competing influence of distinct memory representations during the performance of a memory task in the rat. Furthermore, they demonstrate the subtle disruptive effects of the NMDA antagonist ketamine on both encoding and retrieval. Specifically, ketamine treatment disrupted retrieval by promoting proactive interference from previous episodic representations.

  10. Versatility of Ketamine

    Directory of Open Access Journals (Sweden)

    MC Rajesh

    2017-07-01

    Full Text Available In the present day anaesthesia practice, ketamine is not routinely used as an induction agent. But it is a popular pharmacological agent in variety of pain conditions from nociceptive to neuropathic pains and for paediatric procedural sedation outside operation theatre complex. Of late, there is a renewed enthusiasm with regard to use of Ketamine for variety of indications like pain relief in pre hospital trauma victims, as an antidepressant, anticonvulsant, to prevent post operative sore throat and even in renal colic. Following text is a narrative review on the recent evidences with regard to pharmacology of the agent for its extended indications other than in day to day anaesthesia practice.

  11. A review of the use of ketamine in pain management.

    Science.gov (United States)

    Tawfic, Qutaiba A

    2013-01-01

    Ketamine is a noncompetitive antagonist of N-methyl-d-aspartate receptor. It has been widely used in anesthesia and pain management. Ketamine has been administered via the intravenous, intramuscular, subcutaneous, oral, rectal, topical, intranasal, sublingual, epidural, and caudal routes. Ketamine improves postoperative and posttrauma pain scores and reduces opioid consumption. It has special indication for patients with opioid tolerance, acute hyperalgesia, and neuropathic pain. It also has a role in the management of chronic pain including both cancer and noncancer pain. Recreational use of ketamine is increasing as well through different routes of administration like inhalation, smoking, or intravenous injection. Long-time exposure to ketamine, especially in the abusers, may lead to serious side effects. This review is trying to define the role of ketamine in pain management.

  12. Ketamine for Analgosedation in the Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Patanwala, Asad E; Martin, Jennifer R; Erstad, Brian L

    2017-07-01

    To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients. One trial evaluated opioid consumption as an outcome in postoperative critically ill patients who were randomized to ketamine or saline infusions. The mean cumulative morphine consumption at 48 hours was significantly lower in the ketamine group (58 ± 35 mg) compared to the morphine-only group (80 ± 37 mg; P ketamine in terms of cerebral hemodynamics in patients with traumatic brain injury, improved gastrointestinal motility, and decreased vasopressor requirements. The observational study and case reports suggest that ketamine is safe and effective and may have a role in patients who are refractory to other therapies. Ketamine use may decrease analgesic consumption in the intensive care unit. Additional trials are needed to further delineate the role of ketamine for analgosedation.

  13. The prevalence and natural history of urinary symptoms among recreational ketamine users.

    Science.gov (United States)

    Winstock, Adam R; Mitcheson, Luke; Gillatt, David A; Cottrell, Angela M

    2012-12-01

    Study Type--Symptom prevalence (prospective cohort) Level of Evidence 1b. What's known on the subject? and What does the study add? Case series have described lower urinary tract symptoms associated with ketamine use including severe pain, frequency, haematuria and dysuria. Little is known regarding the frequency of symptoms, relationship of symptoms with dose and frequency of use and natural history of symptoms once the ketamine user has stopped. This study describes the prevalence of ketamine use in a population of recreational drug users in a dance music setting. It shows a dose-frequency relationship with ketamine use. It shows that urinary symptoms associated with recreational ketamine use may lead to a considerable demand on health resources in the primary-, secondary- and emergency-care settings. It shows that symptoms may improve once ketamine use is decreased. • To investigate the prevalence and natural history of urinary symptoms in a cohort of recreational ketamine users. • A purposeful sampling technique was used. • Between November 2009 and January 2010 participants were invited to undertake an on-line questionnaire promoted by a national dance music magazine and website. • Data regarding demographics and illicit drug-use were collected. • Among respondents reporting recent ketamine use, additional information detailing their ketamine use, experience of urinary symptoms and use of related healthcare services was obtained. • In all, 3806 surveys were completed, of which 1285 (33.8%) participants reported ketamine use within the last year. • Of the ketamine users, 17% were found to be dependent on the drug; 26.6% (340) of recent ketamine users reported experiencing urinary symptoms. • Urinary symptoms were significantly related to both dose of ketamine used and frequency of ketamine use. • Of 251 users reporting their experience of symptoms over time in relationship to their use of ketamine, 51% reported improvement in urinary symptoms

  14. Comparison of three Ketamine drug combinations for short term ...

    African Journals Online (AJOL)

    Ketamine (XK) at a dose of 0.05/25mg/kg, acepromazine/ketamine (AK) at a dose of 0.05/25mg/kg and diazepam/ketamine (DK) at a dose of 0.5/25mg/kg were evaluated and compared in five non-fasted West African Dwarf (WAD) goats. The mean ...

  15. Ketamine for pain [version 1; referees: 2 approved

    OpenAIRE

    Kelly Jonkman; Albert Dahan; Tine van de Donk; Leon Aarts; Marieke Niesters; Monique van Velzen

    2017-01-01

    The efficacy of the N-methyl-D-aspartate receptor antagonist ketamine as an analgesic agent is still under debate, especially for indications such as chronic pain. To understand the efficacy of ketamine for relief of pain, we performed a literature search for relevant narrative and systematic reviews and meta-analyses. We retrieved 189 unique articles, of which 29 were deemed appropriate for use in this review. Ketamine treatment is most effective for relief of postoperative pain, causing red...

  16. Other drug use does not impact cognitive impairments in chronic ketamine users.

    Science.gov (United States)

    Zhang, Chenxi; Tang, Wai Kwong; Liang, Hua Jun; Ungvari, Gabor Sandor; Lin, Shih-Ku

    2018-05-01

    Ketamine abuse causes cognitive impairments, which negatively impact on users' abstinence, prognosis, and quality of life. of cognitive impairments in chronic ketamine users have been inconsistent across studies, possibly due to the small sample sizes and the confounding effects of concomitant use of other illicit drugs. This study investigated the cognitive impairment and its related factors in chronic ketamine users with a large sample size and explored the impact of another drug use on cognitive functions. Cognitive functions, including working, verbal and visual memory and executive functions were assessed in ketamine users: 286 non-heavy other drug users and 279 heavy other drug users, and 261 healthy controls. Correlations between cognitive impairment and patterns of ketamine use were analysed. Verbal and visual memory were impaired, but working memory and executive functions were intact for all ketamine users. No significant cognitive differences were found between the two ketamine groups. Greater number of days of ketamine use in the past month was associated with worse visual memory performance in non-heavy other drug users. Higher dose of ketamine use was associated with worse short-term verbal memory in heavy other drug users. Verbal and visual memory are impaired in chronic ketamine users. Other drug use appears to have no impact on ketamine users' cognitive performance. Copyright © 2018. Published by Elsevier B.V.

  17. Gargling with Ketamine Attenuates the Postoperative Sore Throat

    Directory of Open Access Journals (Sweden)

    A Rudra

    2009-01-01

    Full Text Available Postoperative sore throat (POST is a common complication of anaesthesia with endotracheal tube that affects patient satisfaction after surgery. Therefore, this complication remains to be resolved in patients undergoing endotra-cheal intubation. The aim of the study was to compare the effectiveness of ketamine gargles with placebo in prevent-ing POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anaesthesia were randomized into: Group C, water 30 ml; Group K, ketamine 50 mg in water 29 ml. Patients were asked to gargle this mixture for 40 seconds, 5 minutes before induction of anaesthesia. POST was graded at 4, 8 and 24 hours after operation on a four-point scale (0-3. In the Control group POST occurred more frequently, when compared with patients belonging to Ketamine group, at 4, 8, and 24 hours and significantly more patients suffered severe POST in Control group at 8 and 24 hours compared with Ketamine group (P< 0.05. We demonstrated that gargling with ketamine significantly attenuated POST, with no drug-related side effects were observed.

  18. Effects of ketamine on pro-inflammatory mediators in equine models

    NARCIS (Netherlands)

    Lankveld, D.P.K.

    2007-01-01

    Ketamine is frequently used in both human and veterinary anaesthesia. Beside its anaesthetic and analgesic effects, ketamine has been demonstrated to possess anti-inflammatory properties in rodents and humans. To date, no data are available on the anti-inflammatory effects of ketamine in horses.

  19. Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy.

    Science.gov (United States)

    Peltoniemi, Marko A; Hagelberg, Nora M; Olkkola, Klaus T; Saari, Teijo I

    2016-09-01

    Ketamine is a phencyclidine derivative, which functions primarily as an antagonist of the N-methyl-D-aspartate receptor. It has no affinity for gamma-aminobutyric acid receptors in the central nervous system. Ketamine shows a chiral structure consisting of two optical isomers. It undergoes oxidative metabolism, mainly to norketamine by cytochrome P450 (CYP) 3A and CYP2B6 enzymes. The use of S-ketamine is increasing worldwide, since the S(+)-enantiomer has been postulated to be a four times more potent anesthetic and analgesic than the R(-)-enantiomer and approximately two times more effective than the racemic mixture of ketamine. Because of extensive first-pass metabolism, oral bioavailability is poor and ketamine is vulnerable to pharmacokinetic drug interactions. Sublingual and nasal formulations of ketamine are being developed, and especially nasal administration produces rapid maximum plasma ketamine concentrations with relatively high bioavailability. Ketamine produces hemodynamically stable anesthesia via central sympathetic stimulation without affecting respiratory function. Animal studies have shown that ketamine has neuroprotective properties, and there is no evidence of elevated intracranial pressure after ketamine dosing in humans. Low-dose perioperative ketamine may reduce opioid consumption and chronic postsurgical pain after specific surgical procedures. However, long-term analgesic effects of ketamine in chronic pain patients have not been demonstrated. Besides analgesic properties, ketamine has rapid-acting antidepressant effects, which may be useful in treating therapy-resistant depressive patients. Well-known psychotomimetic and cognitive adverse effects restrict the clinical usefulness of ketamine, even though fewer psychomimetic adverse effects have been reported with S-ketamine in comparison with the racemate. Safety issues in long-term use are yet to be resolved.

  20. Ketamine induced renal fibrosis in a ketamine addition rat model

    Directory of Open Access Journals (Sweden)

    Mei-Yu Jang

    2017-09-01

    Conclusion: Ketamine treatment not only induced cystitis-like syndrome, but also renal fibrosis. These renal interstitial fibrosis changes may be induced by the TGF-β pathway. These preliminary results can provide valuable information from a clinical perspective.

  1. Chronic postthoracotomy pain and perioperative ketamine infusion.

    Science.gov (United States)

    Hu, Jie; Liao, Qin; Zhang, Fan; Tong, Jianbin; Ouyang, Wen

    2014-06-01

    The objectives of this study were to investigate whether continuous intravenous ketamine during the first 72 hours after thoracotomy could reduce the incidence and intensity of chronic postthoracotomy pain (CPTP) and to define the incidence and risk factors of CPTP. Seventy-eight patients receiving thoracotomy for lung tumor (benign or malignant) were randomly divided into two groups: ketamine group (n = 31) and control groups (n = 47). Patients in the ketamine group received intravenous ketamine 1 mg/kg before incision, followed by 2 μg/kg/minute infusion for 72 hours plus sufentanil patient-controlled intravenous analgesia after thoracotomy. Patients in the control group received intravenous a 0.9% normal saline and infusion plus sufentanil patient-controlled intravenous analgesia. The solutions patients received were blinded. The numerical rating scale (NRS) pain scores and the incidence and risk factors of CPTP were recorded during the first 6 months after surgery. Compared with control group, the incidence of chronic pain in the ketamine group did not decrease at 2 months (χ(2) = 1.599, P = .206) and 6 months (χ(2) = 0.368, P = .544) after surgery. Postoperative pain scores in the ketamine group were not significantly different from those of the control group patients at 2 months (U = 677.5, P = .593) and 6 months (U = 690.5, P = .680). The incidence of CPTP was 78.2% (61/78) at 2 months and 53.8% (42/78) at 6 months after surgery. Retractor used time (OR = 5.811, P = .002), inadequate acute pain control (NRS ≥ 5) (OR = 5.425, P = .048), and chemotherapy (OR = 3.784, P = .056) were independent risk factors for chronic postthoracotomy pain. The authors conclude that continuous intravenous ketamine (2 μg/kg/min) during the first 72 hours after thoracotomy was not beneficial to prevent chronic postthoracotomy pain. The independent risk factors for chronic postthoracotomy pain were retractor used time, inadequate acute pain control, and chemotherapy.

  2. Ketamine for pain management in France, an observational survey.

    Science.gov (United States)

    Martinez, Valeria; Derivaux, Benoit; Beloeil, Helene

    2015-12-01

    Before updating the French guidelines on postoperative pain treatment in 2015, the Pain Committee of the French Society of Anaesthesiology and Intensive Care (SFAR) conducted a survey on the medical use of ketamine in France. An online questionnaire was nationally distributed to members of SFAR, the French Pain Society (SFETD) and the French Society of Emergency Medicine (SFMU). The questionnaire included questions on demographic data, the type of patients for whom ketamine was prescribed, the doses used, the side effects and safety measures associated with the administration of ketamine. A total of 1388 questionnaires were analysed. Ninety-two percent of the responders declared that they used ketamine. Ketamine was widely used as anti-hyperalgesic medication but the modalities of administration and the doses varied greatly and were not in accordance with the guidelines. Despite the lack of evidence and guidelines, ketamine has also been used to treat acute and chronic pain. Doses, duration and localization of the patients during administration have varied greatly. Psychedelic effects and hallucinations are the most feared side effects. In terms of monitoring during ketamine infusion, 15% of physicians declared that no monitoring was necessary while 59%, 55%, 59% and 77% monitored heart rate, SpO2, blood pressure and level of consciousness, respectively. Anaesthesiologists have integrated the benefit of ketamine in preventing hyperalgesia but there is no consensus on doses and duration. For other indications (acute and chronic pain treatment), toxicity and the absence of significant benefit call for guidelines from scientific societies. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  3. Role of ketamine in acute postoperative pain management: a narrative review.

    Science.gov (United States)

    Radvansky, Brian M; Shah, Khushbu; Parikh, Anant; Sifonios, Anthony N; Le, Vanny; Eloy, Jean D

    2015-01-01

    The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. A literature search was performed using the phrases "ketamine" and "postoperative pain." The authors analyzed the studies that involved testing ketamine's effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for.

  4. Suppressed neural complexity during ketamine- and propofol-induced unconsciousness.

    Science.gov (United States)

    Wang, Jisung; Noh, Gyu-Jeong; Choi, Byung-Moon; Ku, Seung-Woo; Joo, Pangyu; Jung, Woo-Sung; Kim, Seunghwan; Lee, Heonsoo

    2017-07-13

    Ketamine and propofol have distinctively different molecular mechanisms of action and neurophysiological features, although both induce loss of consciousness. Therefore, identifying a common feature of ketamine- and propofol-induced unconsciousness would provide insight into the underlying mechanism of losing consciousness. In this study we search for a common feature by applying the concept of type-II complexity, and argue that neural complexity is essential for a brain to maintain consciousness. To test this hypothesis, we show that complexity is suppressed during loss of consciousness induced by ketamine or propofol. We analyzed the randomness (type-I complexity) and complexity (type-II complexity) of electroencephalogram (EEG) signals before and after bolus injection of ketamine or propofol. For the analysis, we use Mean Information Gain (MIG) and Fluctuation Complexity (FC), which are information-theory-based measures that quantify disorder and complexity of dynamics respectively. Both ketamine and propofol reduced the complexity of the EEG signal, but ketamine increased the randomness of the signal and propofol decreased it. The finding supports our claim and suggests EEG complexity as a candidate for a consciousness indicator. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Ketamine for pain [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Kelly Jonkman

    2017-09-01

    Full Text Available The efficacy of the N-methyl-D-aspartate receptor antagonist ketamine as an analgesic agent is still under debate, especially for indications such as chronic pain. To understand the efficacy of ketamine for relief of pain, we performed a literature search for relevant narrative and systematic reviews and meta-analyses. We retrieved 189 unique articles, of which 29 were deemed appropriate for use in this review. Ketamine treatment is most effective for relief of postoperative pain, causing reduced opioid consumption. In contrast, for most other indications (that is, acute pain in the emergency department, prevention of persistent postoperative pain, cancer pain, and chronic non-cancer pain, the efficacy of ketamine is limited. Ketamine’s lack of analgesic effect was associated with an increase in side effects, including schizotypical effects.

  6. CFD simulation of coaxial injectors

    Science.gov (United States)

    Landrum, D. Brian

    1993-01-01

    The development of improved performance models for the Space Shuttle Main Engine (SSME) is an important, ongoing program at NASA MSFC. These models allow prediction of overall system performance, as well as analysis of run-time anomalies which might adversely affect engine performance or safety. Due to the complexity of the flow fields associated with the SSME, NASA has increasingly turned to Computational Fluid Dynamics (CFD) techniques as modeling tools. An important component of the SSME system is the fuel preburner, which consists of a cylindrical chamber with a plate containing 264 coaxial injector elements at one end. A fuel rich mixture of gaseous hydrogen and liquid oxygen is injected and combusted in the chamber. This process preheats the hydrogen fuel before it enters the main combustion chamber, powers the hydrogen turbo-pump, and provides a heat dump for nozzle cooling. Issues of interest include the temperature and pressure fields at the turbine inlet and the thermal compatibility between the preburner chamber and injector plate. Performance anomalies can occur due to incomplete combustion, blocked injector ports, etc. The performance model should include the capability to simulate the effects of these anomalies. The current approach to the numerical simulation of the SSME fuel preburner flow field is to use a global model based on the MSFC sponsored FNDS code. This code does not have the capabilities of modeling several aspects of the problem such as detailed modeling of the coaxial injectors. Therefore, an effort has been initiated to develop a detailed simulation of the preburner coaxial injectors and provide gas phase boundary conditions just downstream of the injector face as input to the FDNS code. This simulation should include three-dimensional geometric effects such as proximity of injectors to baffles and chamber walls and interaction between injectors. This report describes an investigation into the numerical simulation of GH2/LOX coaxial

  7. Effects of Chloramphenicol Pretreatment on Xylazine/ketamine ...

    African Journals Online (AJOL)

    Keyword: Chloramphenicol, xylazine, ketamine, anaesthesia, cats. The effect of pretreatment with a single intramuscular (im) dose of chloramphenicol (10mg/kg) on the anaethesia induced with im injection of ketamine (25mg/kg) was investigated in five cats premedicated with im xylazine (1.0mg/kg) and atropine ...

  8. COMPARATIVE EFFICACY (SEDATIVE AND ANAESTHETIC OF DETOMIDINE, KETAMINE AND DETOMIDINE-KETAMINE COCKTAIL IN PIGEONS (COLUMBA LIVIA

    Directory of Open Access Journals (Sweden)

    UZMA F. DURRANI, M. ARIF KHAN1 AND S. SALEEM AHMAD

    2008-07-01

    Full Text Available A study was conducted to compare the synergistic efficacy of detomidine, ketamine and their cocktail in pigeons (Columba livia. For this study, 15 adult and healthy pigeons were divided into three equal groups A, B and C. Birds of groups A and B were intramuscularly administered detomidine and ketamine @ 1.4 and 60 mg/kg b. wt., respectively. Pigeons of group C received detomidine + Ketamine cocktail @ 0.7 and 30 mg/kg b. wt. Induction of sedation and anaesthesia was smooth in all groups. Mean duration of induction was 11.1 + 2.03, 11.0 + 1.49 and 1.6 + 0.48 minutes in groups A, B, C, respectively. In groups A and B, smooth but light sedation and anaesthesia were observed accompanied by superficial analgesia, while in group C, birds showed deep anaesthesia alongwith deep analgesia. Birds in groups A and C elicited hypothermia, respiratory depression and bradycardia till complete recovery, while group B showed hyperthermia and tachycardia with rapid respiration. In group A, sedation persisted for 54.2 + 21.82 minutes and mean recovery period was 49.9 + 5.91 minutes, while groups B and C had anaesthesia for 47.7 + 8.06 and 103.5 + 27.52 minutes, and recovery periods were 52.6 + 9.64 and 61.3 + 17.26 minutes, respectively. Recovery was rough in group B and smooth in groups A and C. It was concluded that in pigeons, detomidine (alone is safe for handling and for least painful procedures, while detomidine-ketamine cocktail is safe as intramuscular anaesthetic for major surgical procedures. However, ketamine is not a good anaesthetic to be used alone in pigeons.

  9. COMPARISON OF INTRAMUSCULAR FENTANYL-MIDAZOLAM, FENTANYL-MIDAZOLAM-KETAMINE, AND KETAMINE-MEDETOMIDINE FOR IMMOBILIZATION OF JAPANESE MACAQUES ( MACACA FUSCATA).

    Science.gov (United States)

    Ølberg, Rolf-Arne; Sinclair, Melissa; Barker, Ian K; Crawshaw, Graham

    2018-03-01

    The combination of fentanyl and midazolam is commonly used as a sedative in humans. The objective of this study was to evaluate the sedative properties and physiological effects of fentanyl-midazolam and fentanyl-midazolam-ketamine compared with medetomidine-ketamine given intramuscularly in Japanese macaques ( Macaca fuscata). In a randomized crossover design, eight Japanese macaques were hand-injected with either 30 μg/kg fentanyl + 0.3 mg/kg midazolam (FM), 15 μg/kg fentanyl + 0.3 mg/kg midazolam + 5.0 mg/kg ketamine (FMK), or 0.05 mg/kg medetomidine + 5.0 mg/kg ketamine (MedK). Heart rate; indirect systolic, mean, and diastolic arterial pressure; respiratory rate; blood gas concentrations; rectal temperature; and duration of immobilization were recorded. Mixed linear models were used to evaluate the effects of drug treatment on all continuous variables, with a significance level of P < 0.05. Only three of seven animals receiving FM were successfully immobilized. All eight animals in both the FMK and MedK treatment groups had a rapid, smooth induction and were successfully immobilized. Both FMK and MedK treatments resulted in significant hypoxia and the animals required supplemental oxygen via face mask. The mean duration of FMK immobilization was 42 ± 10 min, significantly shorter than the 65 ± 14 min for the animals receiving MedK. Immobilization with MedK resulted in significantly lower heart rates, and significantly higher arterial pressure compared with FMK. Hypoventilation was significantly more pronounced in FMK-treated animals compared with MedK treatments. Immobilization with FMK resulted in a gradual, slow recovery whereas MedK-treated animals woke up more rapidly. Fentanyl-midazolam alone is not a useful sedative in Japanese macaques. A combination of fentanyl and midazolam with ketamine can be used as an alternative to medetomidine-ketamine in this species.

  10. Ketamine as an adjuvant to opioids for cancer pain.

    Science.gov (United States)

    Bell, Rae F; Eccleston, Christopher; Kalso, Eija A

    2017-06-28

    This is an update of a review first published in 2003 and updated in 2012.Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of refractory cancer pain, when opioids alone or in combination with appropriate adjuvant analgesics prove to be ineffective. Ketamine is known to have psychomimetic (including hallucinogenic), urological, and hepatic adverse effects. To determine the effectiveness and adverse effects of ketamine as an adjuvant to opioids for refractory cancer pain in adults. For this update, we searched MEDLINE (OVID) to December 2016. We searched CENTRAL (CRSO), Embase (OVID) and two clinical trial registries to January 2017. The intervention considered by this review was the addition of ketamine, given by any route of administration, in any dose, to pre-existing opioid treatment given by any route and in any dose, compared with placebo or active control. We included studies with a group size of at least 10 participants who completed the trial. Two review authors independently assessed the search results and performed 'Risk of bias' assessments. We aimed to extract data on patient-reported pain intensity, total opioid consumption over the study period; use of rescue medication; adverse events; measures of patient satisfaction/preference; function; and distress. We also assessed participant withdrawal (dropout) from trial. We assessed the quality of the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). One new study (185 participants) was identified by the updated search and included in the review. We included a total of three studies in this update.Two small studies, both with cross-over design, with 20 and 10 participants respectively, were eligible for inclusion in the original review. One study with 20 participants examined the addition of intrathecal ketamine to intrathecal morphine, compared with intrathecal morphine alone. The

  11. Injector of the Utrecht EN tandem

    Energy Technology Data Exchange (ETDEWEB)

    Borg, K. van der; Haas, A.P. de; Hoogenboom, A.M.; Strasters, B.A.; Vermeer, A.; Zwol, N.A. van (Rijksuniversiteit Utrecht (Netherlands). Fysisch Lab.)

    1984-02-15

    An injector has been built to obtain improved beam transmission through the EN tandem. The injector has been provided with a 90/sup 0/ analysing magnet, m/..delta..m=300, and 130 kV preacceleration. Beam optics calculations have been made for the injector and tandem. The injector has been equipped with a fiber optics control and data acquisition system.

  12. Steady state neutral beam injector

    International Nuclear Information System (INIS)

    Mattoo, S.K.; Bandyopadhyay, M.; Baruah, U.K.; Bisai, N.; Chakbraborty, A.K.; Chakrapani, Ch.; Jana, M.R.; Bajpai, M.; Jaykumar, P.K.; Patel, D.; Patel, G.; Patel, P.J.; Prahlad, V.; Rao, N.V.M.; Rotti, C.; Singh, N.P.; Sridhar, B.

    2000-01-01

    Learning from operational reliability of neutral beam injectors in particular and various heating schemes including RF in general on TFTR, JET, JT-60, it has become clear that neutral beam injectors may find a greater role assigned to them for maintaining the plasma in steady state devices under construction. Many technological solutions, integrated in the present day generation of injectors have given rise to capability of producing multimegawatt power at many tens of kV. They have already operated for integrated time >10 5 S without deterioration in the performance. However, a new generation of injectors for steady state devices have to address to some basic issues. They stem from material erosion under particle bombardment, heat transfer > 10 MW/m 2 , frequent regeneration of cryopanels, inertial power supplies, data acquisition and control of large volume of data. Some of these engineering issues have been addressed to in the proposed neutral beam injector for SST-1 at our institute; the remaining shall have to wait for the inputs of the database generated from the actual experience with steady state injectors. (author)

  13. Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric; Cammilleri, Serge; Colavolpe, Cecile; Taieb, David; Laforte, Catherine de; Mundler, Olivier [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Assistance Publique des Hopitaux de Marseille, Marseille Cedex 5 (France); Niboyet, Jean [Clinique La Phoceanne, Unite d' Etude et de Traitement de la Douleur, Marseille (France)

    2007-08-15

    Ketamine has been used successfully in various proportions of fibromyalgia (FM) patients. However, the response to this specific treatment remains largely unpredictable. We evaluated brain SPECT perfusion before treatment with ketamine, using voxel-based analysis. The objective was to determine the predictive value of brain SPECT for ketamine response. Seventeen women with FM (48 {+-} 11 years; ACR criteria) were enrolled in the study. Brain SPECT was performed before any change was made in therapy in the pain care unit. We considered that a patient was a good responder to ketamine if the VAS score for pain decreased by at least 50% after treatment. A voxel-by-voxel group analysis was performed using SPM2, in comparison to a group of ten healthy women matched for age. The VAS score for pain was 81.8 {+-} 4.2 before ketamine and 31.8 {+-} 27.1 after ketamine. Eleven patients were considered ''good responders'' to ketamine. Responder and non-responder subgroups were similar in terms of pain intensity before ketamine. In comparison to responding patients and healthy subjects, non-responding patients exhibited a significant reduction in bilateral perfusion of the medial frontal gyrus. This cluster of hypoperfusion was highly predictive of non-response to ketamine (positive predictive value 100%, negative predictive value 91%). Brain perfusion SPECT may predict response to ketamine in hyperalgesic FM patients. (orig.)

  14. Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Cammilleri, Serge; Colavolpe, Cecile; Taieb, David; Laforte, Catherine de; Mundler, Olivier; Niboyet, Jean

    2007-01-01

    Ketamine has been used successfully in various proportions of fibromyalgia (FM) patients. However, the response to this specific treatment remains largely unpredictable. We evaluated brain SPECT perfusion before treatment with ketamine, using voxel-based analysis. The objective was to determine the predictive value of brain SPECT for ketamine response. Seventeen women with FM (48 ± 11 years; ACR criteria) were enrolled in the study. Brain SPECT was performed before any change was made in therapy in the pain care unit. We considered that a patient was a good responder to ketamine if the VAS score for pain decreased by at least 50% after treatment. A voxel-by-voxel group analysis was performed using SPM2, in comparison to a group of ten healthy women matched for age. The VAS score for pain was 81.8 ± 4.2 before ketamine and 31.8 ± 27.1 after ketamine. Eleven patients were considered ''good responders'' to ketamine. Responder and non-responder subgroups were similar in terms of pain intensity before ketamine. In comparison to responding patients and healthy subjects, non-responding patients exhibited a significant reduction in bilateral perfusion of the medial frontal gyrus. This cluster of hypoperfusion was highly predictive of non-response to ketamine (positive predictive value 100%, negative predictive value 91%). Brain perfusion SPECT may predict response to ketamine in hyperalgesic FM patients. (orig.)

  15. Ketamine Causes Mitochondrial Dysfunction in Human Induced Pluripotent Stem Cell-Derived Neurons

    Science.gov (United States)

    Ito, Hiroyuki; Uchida, Tokujiro; Makita, Koshi

    2015-01-01

    Purpose Ketamine toxicity has been demonstrated in nonhuman mammalian neurons. To study the toxic effect of ketamine on human neurons, an experimental model of cultured neurons from human induced pluripotent stem cells (iPSCs) was examined, and the mechanism of its toxicity was investigated. Methods Human iPSC-derived dopaminergic neurons were treated with 0, 20, 100 or 500 μM ketamine for 6 and 24 h. Ketamine toxicity was evaluated by quantification of caspase 3/7 activity, reactive oxygen species (ROS) production, mitochondrial membrane potential, ATP concentration, neurotransmitter reuptake activity and NADH/NAD+ ratio. Mitochondrial morphological change was analyzed by transmission electron microscopy and confocal microscopy. Results Twenty-four-hour exposure of iPSC-derived neurons to 500 μM ketamine resulted in a 40% increase in caspase 3/7 activity (P ketamine (100 μM) decreased the ATP level (22%, P ketamine concentration, which suggests that mitochondrial dysfunction preceded ROS generation and caspase activation. Conclusions We established an in vitro model for assessing the neurotoxicity of ketamine in iPSC-derived neurons. The present data indicate that the initial mitochondrial dysfunction and autophagy may be related to its inhibitory effect on the mitochondrial electron transport system, which underlies ketamine-induced neural toxicity. Higher ketamine concentration can induce ROS generation and apoptosis in human neurons. PMID:26020236

  16. Mutual enhancement of central neurotoxicity induced by ketamine followed by methamphetamine

    International Nuclear Information System (INIS)

    Ke, J.-J.; Chen, H.-I.; Jen, C.J.; Kuo, Y.-M.; Cherng, C.G.; Tsai, Y.-P.N.; Ho, M.-C.; Tsai, C.-W.; Lung Yu

    2008-01-01

    We hereby report that repeated administration of ketamine (350 mg/kg in total) and methamphetamine (30 mg/kg in total) causes specific glutamatergic and dopaminergic neuron deficits, respectively, in adult mouse brain. Acute ketamine did not affect basal body temperature or the later methamphetamine-induced hyperthermia. However, pretreatment with repeated doses of ketamine aggravated methamphetamine-induced dopaminergic terminal loss as evidenced by a drastic decrease in the levels of dopamine, 3,4-dihydroxyphenylacetic acid, and dopamine transporter density as well as poor gait balance performance. In contrast, methamphetamine-induced serotonergic depletion was not altered by ketamine pretreatment. Likewise, the subsequent treatment with methamphetamine exacerbated the ketamine-induced glutamatergic damage as indicated by reduced levels of the vesicular glutamate transporter in hippocampus and striatum and poor memory performance in the Morris water maze. Finally, since activation of the D1 and AMPA/kainate receptors has been known to be involved in the release of glutamate and dopamine, we examined the effects of co-administration of SCH23390, a D1 antagonist, and CNQX, an AMPA/kainate antagonist. Intraventricular CNQX infusion abolished ketamine's potentiation of methamphetamine-induced dopamine neurotoxicity, while systemic SCH23390 mitigated methamphetamine's potentiation of ketamine-induced glutamatergic toxicity. We conclude that repeated doses of ketamine potentiate methamphetamine-induced dopamine neurotoxicity via AMPA/kainate activation and that conjunctive use of methamphetamine aggravates ketamine-induced glutamatergic neurotoxicity possibly via D1 receptor activation

  17. Differential regulation of GluA1 expression by ketamine and memantine.

    Science.gov (United States)

    Zhang, Ke; Yamaki, Vitor Nagai; Wei, Zhisheng; Zheng, Yu; Cai, Xiang

    2017-01-01

    Evidence from preclinical and clinical studies shows that ketamine, a noncompetitive NMDA receptor antagonist, exerts rapid and sustained antidepressant responses. However, ketamine's psychotomimetic side effects and abuse liability limit the clinical use of the compound. Interestingly, memantine, another NMDA receptor channel blocker, processes no defined antidepressant property but is much safer and clinical tolerated. Understanding why ketamine but not memantine exhibits rapid antidepressant responses is important to elucidate the cellular signaling underlying the fast antidepressant actions of ketamine and to design a new safer generation of fast-acting antidepressants. Here we show that ketamine but memantine caused a rapid and sustained antidepressant-like responses in forced swim test (FST). Both drugs enhanced GluA1 S845 phosphorylation and potentiated Schaffer collateral-CA1 synaptic transmission. However, ketamine but not memantine elevated the expression of GluA1. Incubating acutely prepared hippocampal slices with ketamine but not memantine enhanced mTOR phosphorylation in a time course parallel to the time course of GluA1 elevation. Our results suggest that distinct properties in regulation of mTOR phosphorylation and synaptic protein expression may underlie the differential effectiveness of ketamine and memantine in their antidepressant responses. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. High-brightness electron injectors

    International Nuclear Information System (INIS)

    Sheffield, R.L.

    1987-01-01

    Free-electron laser (FEL) oscillators and synchrotron light sources require pulse trains of high peak brightness and, in some applications, high-average power. Recent developments in the technology of photoemissive and thermionic electron sources in rf cavities for electron-linac injector applications offer promising advances over conventional electron injectors. Reduced emittance growth in high peak-current electron injectors may be achieved by using high field strengths and by linearizing the radial component of the cavity electric field at the expense of lower shunt impedance

  19. Effect of ketamine on endogenous pain modulation in healthy volunteers.

    Science.gov (United States)

    Niesters, Marieke; Dahan, Albert; Swartjes, Maarten; Noppers, Ingeborg; Fillingim, Roger B; Aarts, Leon; Sarton, Elise Y

    2011-03-01

    Inhibitory and facilitatory descending pathways, originating at higher central nervous system sites, modulate activity of dorsal horn nociceptive neurons, and thereby influence pain perception. Dysfunction of inhibitory pain pathways or a shift in the balance between pain facilitation and pain inhibition has been associated with the development of chronic pain. The N-methyl-d-aspartate receptor antagonist ketamine has a prolonged analgesic effect in chronic pain patients. This effect is due to desensitization of sensitized N-methyl-d-aspartate receptors. Additionally, ketamine may modulate or enhance endogenous inhibitory control of pain perception. Diffuse noxious inhibitory control (DNIC) and offset analgesia (OA) are 2 mechanisms involved in descending inhibition. The present study investigates the effect of a ketamine infusion on subsequent DNIC and OA responses to determine whether ketamine has an influence on descending pain control. Ten healthy subjects (4 men/6 women) received a 1-hour placebo or S(+)-ketamine (40mg per 70kg) infusion on 2 separate occasions in random order. Upon the termination of the infusion, DNIC and OA responses were obtained. After placebo treatment, significant descending inhibition of pain responses was present for DNIC and OA. In contrast, after ketamine infusion, no DNIC was observed, but rather a significant facilitatory pain response (Ppain inhibition and pain facilitation was shifted by ketamine towards pain facilitation. The absence of an effect of ketamine on OA indicates differences in the mechanisms and neurotransmitter influences between OA and DNIC. Diffuse noxious inhibitory control responses following a 1-hour low-dose ketamine treatment displayed facilitation of pain in response to experimental noxious thermal stimulation. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  20. The effects of ketamine on sexual behavior, anxiety, and locomotion in female rats.

    Science.gov (United States)

    Guarraci, Fay A; Gonzalez, Chantal M F; Lucero, Devon; Womble, Paige D; Abdel-Rahim, Heba; DeVore, Jennie; Kunkel, Marcela Nicole; Quadlander, Emma; Stinnett, Morgan; Boyette-Davis, Jessica

    2018-02-01

    The present study characterized the effects of ketamine on sexual behavior and anxiety in female rats. In Experiment 1, female subjects received an injection of ketamine (10.0mg/kg) or saline 30min prior to a sexual partner-preference test during which each female subject was given the opportunity to interact with a female stimulus or a sexually vigorous male stimulus. Immediately afterwards, female subjects were tested for locomotion in an open field test. Ketamine-treated subjects spent significantly more time with the male stimulus than saline-treated subjects. No other measures of mating behavior (i.e., paced mating behavior, lordosis) were affected by ketamine. Ketamine also had no effect on locomotion. In Experiment 2, female subjects received an injection of ketamine (10.0mg/kg), or saline daily for 10days to investigate the possibility that sexual dysfunction emerges only after repeated exposure. Similar to the results of Experiment 1, ketamine-treated subjects spent significantly more time with the male stimulus than saline-treated subjects. Chronic ketamine treatment also decreased the likelihood of leaving the male after mounts, without affecting any other measures of sexual behavior. Chronic ketamine had no effect on locomotion. In Experiment 3, female subjects received an injection of ketamine (10.0mg/kg) or saline and were tested for anxiety in an elevated plus maze test and for locomotion in an open field test. Acute ketamine had no effect on anxiety or locomotion. In Experiment 4, female subjects received an injection of ketamine (10.0mg/kg) or saline daily for 10days to investigate the possibility that anxiety emerges only after repeated exposure. Chronic ketamine exposure had no effect on any measure of anxiety. However, chronic ketamine exposure increased locomotion. The results from these experiments indicate that unlike other medications prescribed for depression, neither acute nor chronic ketamine treatment causes anxiety or disruption of

  1. High-brightness injector modeling

    International Nuclear Information System (INIS)

    Lewellen, J.W.

    2004-01-01

    There are many aspects to the successful conception, design, fabrication, and operation of high-brightness electron beam sources. Accurate and efficient modeling of the injector are critical to all phases of the process, from evaluating initial ideas to successful diagnosis of problems during routine operation. The basic modeling tasks will vary from design to design, according to the basic nature of the injector (dc, rf, hybrid, etc.), the type of cathode used (thermionic, photo, field emitter, etc.), and 'macro' factors such as average beam current and duty factor, as well as the usual list of desired beam properties. The injector designer must be at least aware of, if not proficient at addressing, the multitude of issues that arise from these considerations; and, as high-brightness injectors continue to move out of the laboratory, the number of such issues will continue to expand.

  2. Molecular recognition of ketamine by a subset of olfactory G protein–coupled receptors

    Science.gov (United States)

    Saven, Jeffery G.; Matsunami, Hiroaki; Eckenhoff, Roderic G.

    2015-01-01

    Ketamine elicits various neuropharmacological effects, including sedation, analgesia, general anesthesia, and antidepressant activity. Through an in vitro screen, we identified four mouse olfactory receptors (ORs) that responded to ketamine. In addition to their presence in the olfactory epithelium, these G protein (heterotrimeric guanine nucleotide–binding protein)–coupled receptors (GPCRs) are distributed throughout the central nervous system. To better understand the molecular basis of the interactions between ketamine and ORs, we used sequence comparison and molecular modeling to design mutations that (i) increased, reduced, or abolished ketamine responsiveness in responding receptors, and (ii) rendered non-responding receptors responsive to ketamine. We showed that olfactory sensory neurons (OSNs) that expressed distinct ORs responded to ketamine in vivo, suggesting that ORs may serve as functional targets for ketamine. The ability to both abolish and introduce responsiveness to ketamine in GPCRs enabled us to identify and confirm distinct interaction loci in the binding site, which suggested a signature ketamine-binding pocket that may guide exploration of additional receptors for this general anesthetic drug. PMID:25829447

  3. Triaxial Swirl Injector Element for Liquid-Fueled Engines

    Science.gov (United States)

    Muss, Jeff

    2010-01-01

    A triaxial injector is a single bi-propellant injection element located at the center of the injector body. The injector element consists of three nested, hydraulic swirl injectors. A small portion of the total fuel is injected through the central hydraulic injector, all of the oxidizer is injected through the middle concentric hydraulic swirl injector, and the balance of the fuel is injected through an outer concentric injection system. The configuration has been shown to provide good flame stabilization and the desired fuel-rich wall boundary condition. The injector design is well suited for preburner applications. Preburner injectors operate at extreme oxygen-to-fuel mass ratios, either very rich or very lean. The goal of a preburner is to create a uniform drive gas for the turbomachinery, while carefully controlling the temperature so as not to stress or damage turbine blades. The triaxial injector concept permits the lean propellant to be sandwiched between two layers of the rich propellant, while the hydraulic atomization characteristics of the swirl injectors promote interpropellant mixing and, ultimately, good combustion efficiency. This innovation is suited to a wide range of liquid oxidizer and liquid fuels, including hydrogen, methane, and kerosene. Prototype testing with the triaxial swirl injector demonstrated excellent injector and combustion chamber thermal compatibility and good combustion performance, both at levels far superior to a pintle injector. Initial testing with the prototype injector demonstrated over 96-percent combustion efficiency. The design showed excellent high -frequency combustion stability characteristics with oxygen and kerosene propellants. Unlike the more conventional pintle injector, there is not a large bluff body that must be cooled. The absence of a protruding center body enhances the thermal durability of the triaxial swirl injector. The hydraulic atomization characteristics of the innovation allow the design to be

  4. NLC electron injector beam dynamics

    International Nuclear Information System (INIS)

    Yeremian, A.D.; Miller, R.H.

    1995-10-01

    The Next Linear Collider (NLC) being designed at SLAC requires a train of 90 electron bunches 1.4 ns apart at 120 Hz. The intensity and emittance required at the interaction point, and the various machine systems between the injector and the IP determine the beam requirements from the injector. The style of injector chosen for the NLC is driven by the fact that the production of polarized electrons at the IP is a must. Based on the successful operation of the SLC polarized electron source a similar type of injector with a DC gun and subharmonic bunching system is chosen for the NLC

  5. Ketamine for acute neuropathic pain in patients with spinal cord injury.

    Science.gov (United States)

    Kim, Kyongsong; Mishina, Masahiro; Kokubo, Rinko; Nakajima, Takao; Morimoto, Daijiro; Isu, Toyohiko; Kobayashi, Shiro; Teramoto, Akira

    2013-06-01

    Ketamine, an N-methyl-d-aspartic acid (NMDA) receptor antagonist, may be useful for treating neuropathic pain, which is often difficult to control. We report a prospective study of 13 patients with acute neuropathic pain due to spinal cord injury (SCI) treated with ketamine. All underwent a test challenge with 5mg ketamine. Patients with satisfactory responses were then treated intravenously and subsequently perorally with ketamine. Pre- and post-treatment pain was recorded on a visual analogue scale. All 13 patients responded positively to the ketamine test challenge and underwent continued ketamine administration. At the cessation of treatment and alter at final follow up, pain was decreased by 74.7% and 96.8%, respectively. The average administration period was 17.2 days; it was longer (59 days) in one patient treated in the subacute phase. All patients suffered allodynia-type pain and experienced 30% or less of their original pain intensity upon test challenge. Side effects were noted in five patients, although their severity did not require treatment cessation. In patients with SCI, ketamine reduced allodynia. Particularly good results were obtained in patients treated in the acute phase and these patients did not experience post-treatment symptom recurrence. Our results suggest that in patients with SCI, ketamine is useful for treating neuropathic pain in the acute phase. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Rectal premedication in pediatric anesthesia: midazolam versus ketamine

    Directory of Open Access Journals (Sweden)

    Moshirian N

    2008-06-01

    Full Text Available Background: Premedication is widely used in pediatric anesthesia to reduce emotional trauma and ensure smooth induction. The rectal route is one of the most commonly accepted means of drug administration. The aim of our study was to investigate and compare the efficacy of rectally administered midazolam versus that of ketamine as a premedication in pediatric patients.Methods: We performed a prospective randomized double-blinded clinical trial in 64 children, 1 to 10 years of age, randomly allocated into two groups. The midazolam group received 0.5 mg/kg rectal midazolam and the ketamine group received 5 mg/kg rectal ketamine. The preoperative sedation scores were evaluated on a three-point scale. The anxiolysis and mask acceptance scores were evaluated separately on a four-point scale, with ease of parental separation, based on the presence or lack of crying, evaluated on a two-point scale. Results: Neither medication showed acceptable sedation (>75%, with no significant difference in sedation score between the two groups (P=0.725. Anxiolysis and mask acceptance using either midazolam or ketamine were acceptable, with  midazolam performing significantly better than ketamine (P=0.00 and P=0.042, respectively. Ease of parental separation was seen in both groups without significant difference (P=0.288 and no major adverse effects, such as apnea, occurred in either group.Conclusions: Rectal midazolam is more effective than ketamine in anxiolysis and mask acceptance. Although they both can ease separation anxiety in children before surgery, we found neither drug to be acceptable for sedation.

  7. Inhibitory Effects of Ketamine on Lipopolysaccharide-Induced Microglial Activation

    Directory of Open Access Journals (Sweden)

    Yi Chang

    2009-01-01

    Full Text Available Microglia activated in response to brain injury release neurotoxic factors including nitric oxide (NO and proinflammatory cytokines such as tumor necrosis factor-α (TNF-α and interleukin-1β (IL-1β. Ketamine, an anesthetic induction agent, is generally reserved for use in patients with severe hypotension or respiratory depression. In this study, we found that ketamine (100 and 250 μM concentration-dependently inhibited lipopolysaccharide (LPS-induced NO and IL-1β release in primary cultured microglia. However, ketamine (100 and 250 μM did not significantly inhibit the LPS-induced TNF-α production in microglia, except at the higher concentration (500 μM. Further study of the molecular mechanisms revealed that ketamine markedly inhibited extracellular signal-regulated kinase (ERK1/2 phosphorylation but not c-Jun N-terminal kinase or p38 mitogen-activated protein kinase stimulated by LPS in microglia. These results suggest that microglial inactivation by ketamine is at least partially due to inhibition of ERK1/2 phosphorylation.

  8. Evaluation of cardiorespiratory and biochemical effects of ketamine-propofol and guaifenesin-ketamine-xylazine anesthesia in donkeys (Equus asinus).

    Science.gov (United States)

    Molinaro Coelho, Cássia M; Duque Moreno, Juan C; Goulart, Daniel da S; Caetano, Leandro B; Soares, Lorena K; Coutinho, Gustavo H; Alves, Geraldo Es; da Silva, Luiz Antonio F

    2014-11-01

    To evaluate the cardiorespiratory and biochemical effects of ketamine-propofol (KP) or guaifenesin-ketamine-xylazine (GKX) anesthesia in donkeys. Prospective crossover trial. Eight healthy, standard donkeys, aged 10 ± 5 years and weighing 153 ± 23 kg. Donkeys were premedicated with 1.0 mg kg(-1) of xylazine (IV) in both treatments. Eight donkeys were administered ketamine (1.5 mg kg(-1)) and propofol (0.5 mg kg(-1) for induction, and anesthesia was maintained by constant rate infusion (CRI) of ketamine (0.05 mg kg(-1) minute(-1)) and propofol (0.15 mg kg(-1) minute(-1)) in the KP treatment. After 10 days, diazepam (0.05 mg kg(-1)) and ketamine (2.2 mg kg(-1)) were administered for induction, and anesthesia was maintained by a CRI (2.0 mL kg(-1) hour(-1)) of ketamine (2.0 mg mL(-1), xylazine (0.5 mg mL(-1)) and guaifenesin (50 mg mL(-1)) solution. Quality of anesthesia was assessed along with cardiorespiratory and biochemical measurements. Anesthetic induction took longer in GKX than in KP. The induction was considered good in 7/8 with KP and in 6/8 in GKX. Anesthetic recovery was classified as good in 7/8 animals in both treatments. Xylazine administration decreased heart rate (HR) in both treatments, but in KP the HR increased and was higher than GKX throughout the anesthetic period. Respiratory rate was higher in GKX than in KP. PaO(2) decreased significantly in both groups during the anesthetic period. Glucose concentrations [GLU] increased and rectal temperature and PCV decreased in both treatments. Arterial lactate [LAC] increased at recovery compared with all time points in KP. [GLU] and calcium were higher in GKX than in KP at recovery. These protocols induced significant hypoxemia but no other cardiorespiratory or metabolic changes. These protocols could be used to maintain anesthesia in donkeys, however, they were not tested in animals undergoing surgery. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia

  9. Ketamine changes the local resting-state functional properties of anesthetized-monkey brain.

    Science.gov (United States)

    Rao, Jia-Sheng; Liu, Zuxiang; Zhao, Can; Wei, Rui-Han; Zhao, Wen; Tian, Peng-Yu; Zhou, Xia; Yang, Zhao-Yang; Li, Xiao-Guang

    2017-11-01

    Ketamine is a well-known anesthetic. 'Recreational' use of ketamine common induces psychosis-like symptoms and cognitive impairments. The acute and chronic effects of ketamine on relevant brain circuits have been studied, but the effects of single-dose ketamine administration on the local resting-state functional properties of the brain remain unknown. In this study, we aimed to assess the effects of single-dose ketamine administration on the brain local intrinsic properties. We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the ketamine-induced alterations of brain intrinsic properties. Seven adult rhesus monkeys were imaged with rs-fMRI to examine the fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) in the brain before and after ketamine injection. Paired comparisons were used to detect the significantly altered regions. Results showed that the fALFF of the prefrontal cortex (p=0.046), caudate nucleus (left side, p=0.018; right side, p=0.025), and putamen (p=0.020) in post-injection stage significantly increased compared with those in pre-injection period. The ReHo of nucleus accumbens (p=0.049), caudate nucleus (p=0.037), and hippocampus (p=0.025) increased after ketamine injection, but that of prefrontal cortex decreased (pketamine administration can change the regional intensity and synchronism of brain activity, thereby providing evidence of ketamine-induced abnormal resting-state functional properties in primates. This evidence may help further elucidate the effects of ketamine on the cerebral resting status. Copyright © 2017. Published by Elsevier Inc.

  10. Ketamin genopdaget af både læger og misbrugere

    DEFF Research Database (Denmark)

    Sørensen, Anne; Barnung, Steen; Rasmussen, Lars Simon

    2011-01-01

    Ketamine is a unique anaesthetic because it has both hypnotic and analgesic effects and also potential hallucinogenic side effects. Lack of cardiopulmonary depression makes the drug a popular choice for anaesthesia in the prehospital setting. In recent years ketamine has been found to have anti......-hyperalgesic and opioid saving effects, opening to new ways of managing post-operative and chronic pain states. Recreational use of ketamine among night clubbers is increasing and makes acute and chronic symptoms of ketamine abuse a new challenge in emergency departments....

  11. Ketamin genopdaget af både læger og misbrugere

    DEFF Research Database (Denmark)

    Sørensen, Anne; Barnung, Steen; Rasmussen, Lars Simon

    2011-01-01

    -hyperalgesic and opioid saving effects, opening to new ways of managing post-operative and chronic pain states. Recreational use of ketamine among night clubbers is increasing and makes acute and chronic symptoms of ketamine abuse a new challenge in emergency departments.......Ketamine is a unique anaesthetic because it has both hypnotic and analgesic effects and also potential hallucinogenic side effects. Lack of cardiopulmonary depression makes the drug a popular choice for anaesthesia in the prehospital setting. In recent years ketamine has been found to have anti...

  12. Ketamin genopdaget af både læger og misbrugere

    DEFF Research Database (Denmark)

    Sørensen, Anne; Barnung, Steen; Rasmussen, Lars Simon

    2011-01-01

    Ketamine is a unique anaesthetic because it has both hypnotic and analgesic effects and also potential hallucinogenic side effects. Lack of cardiopulmonary depression makes the drug a popular choice for anaesthesia in the prehospital setting. In recent years ketamine has been found to have anti-h......-hyperalgesic and opioid saving effects, opening to new ways of managing post-operative and chronic pain states. Recreational use of ketamine among night clubbers is increasing and makes acute and chronic symptoms of ketamine abuse a new challenge in emergency departments....

  13. Ketamine. A solution to procedural pain in burned children.

    Science.gov (United States)

    Groeneveld, A; Inkson, T

    1992-09-01

    Our experience has shown ketamine to be a safe and effective method of providing pain relief during specific procedures in burned children. It renders high doses of narcotics unnecessary and offers children the benefit of general anesthesia without the requirement of endotracheal intubation and a trip to the operating room. The response of parents and staff to the use of ketamine has been positive. Parents often experience feelings of guilt following injury to a child and are eager to employ methods that reduce their child's pain. So far, no parent has refused the administration of ketamine; some have even asked that it be used during subsequent procedures on their child. With adequate pre-procedure teaching, parents are prepared for the possible occurrence of emergent reactions and can assist in reorienting the child during recovery. Staff have found that the stress of doing painful procedures on children is reduced when ketamine is used. The procedures tend to be quicker and the predicament of working on a screaming, agitated child is eliminated. At the same time, nursing staff have had to get used to the nystagmic gaze of the children and accept that these patients are truly anesthetized even though they might move and talk. Despite the success we and others have had with ketamine, several questions about its use in burn patients remain unanswered. The literature does not answer such questions as: Which nursing measures reduce the incidence of emergent reactions? How many ketamine anesthetics can safely be administered to one individual? How does the frequency of administration relate to tolerance in a burn patient? Are there detrimental effects of frequent or long-term use? Clearly, an understanding of these questions is necessary to determine the safe boundaries of ketamine use in burn patients. Ketamine is not a panacea for the problem of pain in burned children. But it is one means of managing procedural pain, which is, after all, a significant clinical

  14. Previous Ketamine Produces an Enduring Blockade of Neurochemical and Behavioral Effects of Uncontrollable Stress

    Science.gov (United States)

    Dolzani, Samuel D.; Tilden, Scott; Christianson, John P.; Kubala, Kenneth H.; Bartholomay, Kristi; Sperr, Katherine; Ciancio, Nicholas; Watkins, Linda R.; Maier, Steven F.

    2016-01-01

    Recent interest in the antidepressant and anti-stress effects of subanesthetic doses of ketamine, an NMDA receptor antagonist, has identified mechanisms whereby ketamine reverses the effect of stress, but little is known regarding the prophylactic effect ketamine might have on future stressors. Here we investigate the prophylactic effect of ketamine against neurochemical and behavioral changes that follow inescapable, uncontrollable tail shocks (ISs) in Sprague Dawley rats. IS induces increased anxiety, which is dependent on activation of serotonergic (5-HT) dorsal raphe nucleus (DRN) neurons that project to the basolateral amygdala (BLA). Ketamine (10 mg/kg, i.p.) administered 2 h, 1 week, or 2 weeks before IS prevented the increased extracellular levels of 5-HT in the BLA typically produced by IS. In addition, ketamine administered at these time points blocked the decreased juvenile social investigation produced by IS. Microinjection of ketamine into the prelimbic (PL) region of the medial prefrontal cortex duplicated the effects of systemic ketamine, and, conversely, systemic ketamine effects were prevented by pharmacological inhibition of the PL. Although IS does not activate DRN-projecting neurons from the PL, IS did so after ketamine, suggesting that the prophylactic effect of ketamine is a result of altered functioning of this projection. SIGNIFICANCE STATEMENT The reported data show that systemic ketamine, given up to 2 weeks before a stressor, blunts behavioral and neurochemical effects of the stressor. The study also advances understanding of the mechanisms involved and suggests that ketamine acts at the prelimbic cortex to sensitize neurons that project to and inhibit the DRN. PMID:26740657

  15. Electron linac injector developments

    International Nuclear Information System (INIS)

    Fraser, J.S.

    1986-01-01

    There is a continuing demand for improved injectors for electron linacs. Free-electron laser (FEL) oscillators require pulse trains of high brightness and, in some applications, high average power at the same time. Wakefield-accelerator and laser-acceleration experiments require isolated bunches of high peak brightness. Experiments with alkali-halide photoemissive and thermionic electron sources in rf cavities for injector applications are described. For isolated pulses, metal photocathodes (illuminated by intense laser pulses) are being employed. Reduced emittance growth in high-peak-current electron injectors may be achieved by linearizing the cavity electric field's radial component and by using high field strengths at the expense of lower shunt impedance. Harmonically excited cavities have been proposed for enlarging the phase acceptance of linac cavities and thereby reducing the energy spread produced in the acceleration process. Operation of injector linacs at a subharmonic of the main linac frequency is also proposed for enlarging the phase acceptance

  16. Swirl Coaxial Injector Testing with LOX/RP-J

    Science.gov (United States)

    Greene, Sandra Elam; Casiano, Matt

    2013-01-01

    Testing was conducted at NASA fs Marshall Space Flight Center (MSFC) in the fall of 2012 to evaluate the operation and performance of liquid oxygen (LOX) and kerosene (RP ]1) in an existing swirl coaxial injector. While selected Russian engines use variations of swirl coaxial injectors, component level performance data has not been readily available, and all previously documented component testing at MSFC with LOX/RP ]1 had been performed using a variety of impinging injector designs. Impinging injectors have been adequate for specific LOX/RP ]1 engine applications, yet swirl coaxial injectors offer easier fabrication efforts, providing cost and schedule savings for hardware development. Swirl coaxial elements also offer more flexibility for design changes. Furthermore, testing with LOX and liquid methane propellants at MSFC showed that a swirl coaxial injector offered improved performance compared to an impinging injector. So, technical interest was generated to see if similar performance gains could be achieved with LOX/RP ]1 using a swirl coaxial injector. Results would allow such injectors to be considered for future engine concepts that require LOX/RP ]1 propellants. Existing injector and chamber hardware was used in the test assemblies. The injector had been tested in previous programs at MSFC using LOX/methane and LOX/hydrogen propellants. Minor modifications were made to the injector to accommodate the required LOX/RP ]1 flows. Mainstage tests were performed over a range of chamber pressures and mixture ratios. Additional testing included detonated gbombs h for stability data. Test results suggested characteristic velocity, C*, efficiencies for the injector were 95 ]97%. The injector also appeared dynamically stable with quick recovery from the pressure perturbations generated in the bomb tests.

  17. Ketamine infusion for refractory status epilepticus: A case report of cardiac arrest.

    Science.gov (United States)

    Koffman, Lauren; Yan Yiu, Ho; Farrokh, Salia; Lewin, John; Geocadin, Romergryko; Ziai, Wendy

    2018-01-01

    Refractory status epilepticus (RSE) has a high mortality rate and is often difficult to treat. When traditional therapies fail ketamine may be considered. There are limited reports of adverse cardiac events with the use of ketamine for RSE and no reports of cardiac arrest in this context. Evaluate the occurrence of cardiac arrhythmias associated with the use of ketamine for RSE. Retrospective chart review of nine patients who underwent ketamine infusion for RSE. Etiology of refractory status epilepticus included autoimmune/infectious process (Zeiler et al., 2014), ischemic stroke (Bleck, 2005) and subarachnoid hemorrhage (Bleck, 2005). Of the nine patients who received ketamine, two had documented cardiac events; one remained clinically stable and the other developed multiple arrhythmias, including recurrent episodes of asystole. Once ketamine was discontinued the latter patient stabilized with the addition of anti arrhythmic therapy. Ketamine is utilized to treat refractory status epilepticus, but should be used with caution in patients with subarachnoid hemorrhage, as there may be an increased risk of life threatening arrhythmias and cardiac arrest. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

    Science.gov (United States)

    Radvansky, Brian M.; Shah, Khushbu; Parikh, Anant; Sifonios, Anthony N.; Eloy, Jean D.

    2015-01-01

    Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine's effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for. PMID:26495312

  19. Pharmacokinetics of S-ketamine during prolonged sedation at the pediatric intensive care unit.

    Science.gov (United States)

    Flint, Robert B; Brouwer, Carole N M; Kränzlin, Anne S C; Lie-A-Huen, Loraine; Bos, Albert P; Mathôt, Ron A A

    2017-11-01

    S-ketamine is the S(+)-enantiomer of the racemic mixture ketamine, an anesthetic drug providing both sedation and analgesia. In clinical practice, significant interpatient variability in drug effect of S-ketamine is observed during long-term sedation. The aim of this study was to evaluate the pharmacokinetic variability of S-ketamine in children aged 0-18 years during long-term sedation. Twenty-five children (median age: 0.42 years, range: 0.02-12.5) received continuous intravenous administrations of 0.3-3.6 mg/kg/h S-ketamine for sedation during mechanical ventilation. Infusion rates were adjusted to the desired level of sedation and analgesia based on the COMFORT-B score and Visual Analog Scale. Blood samples were drawn once daily at random time-points, and at 1 and 4 hours after discontinuation of S-ketamine infusion. Time profiles of plasma concentrations of S-ketamine and active metabolite S-norketamine were analyzed using nonlinear mixed-effects modeling software. Clearance and volume of distribution were allometrically scaled using the ¾ power model. A total of 86 blood samples were collected. A 2-compartment and 1-compartment model adequately described the PK of S-ketamine and S-norketamine, respectively. The typical parameter estimates for clearance and central and peripheral volumes of distribution were: CL S - KETAMINE =112 L/h/70 kg, V1 S- KETAMINE =7.7 L/70 kg, V2 S- KETAMINE =545L/70 kg, Q S - kETAMINE =196 L/h/70 kg, and CL S - NORKETAMINE =53 L/h/70 kg. Interpatient variability of CL S - KETAMINE and CL S - NORKETAMINE was considerable with values of 40% and 104%, respectively, leading to marked variability in steady-state plasma concentrations. Substantial interpatient variability in pharmacokinetics in children complicates the development of adequate dosage regimen for continuous sedation. © 2017 John Wiley & Sons Ltd.

  20. Antidepressant effects of ketamine: mechanisms underlying fast-acting novel antidepressants

    Directory of Open Access Journals (Sweden)

    Caroline Ann Browne

    2013-12-01

    Full Text Available Newer antidepressants are needed for the many individuals with major depressive disorder that do not respond adequately to treatment and because of a delay of weeks before the emergence of therapeutic effects. Recent evidence from clinical trials shows that the NMDA antagonist ketamine is a revolutionary novel antidepressant because it acts rapidly and is effective for treatment-resistant patients. A single infusion of ketamine alleviates depressive symptoms in treatment-resistant depressed patients within hours and these effects may be sustained for up to 2 weeks. Although the discovery of ketamine’s effects has reshaped drug discovery for antidepressants, the psychotomimetic properties of this compound limit the use of this therapy to the most severely ill patients. In order to develop additional antidepressants like ketamine, adequate preclinical behavioral screening paradigms for fast-acting antidepressants need to be established and used to identify the underlying neural mechanisms. This review examines the preclinical literature attempting to model the antidepressant-like effects of ketamine. Acute administration of ketamine has produced effects in behavioral screens for antidepressants like the forced swim test, novelty suppression of feeding and in rodent models for depression. Protracted behavioral effects of ketamine have been reported to appear after a single treatment that last for days. This temporal pattern is similar to its clinical effects and may serve as a new animal paradigm for rapid antidepressant effects in humans. In addition, protracted changes in molecules mediating synaptic plasticity have been implicated in mediating the antidepressant-like behavioral effects of ketamine. Current preclinical studies are examining compounds with more specific pharmacological effects at glutamate receptors and synapses in order to develop additional rapidly acting antidepressants without the hallucinogenic side effects or abuse

  1. The injector of the Utrecht EN tandem

    International Nuclear Information System (INIS)

    Borg, K. van der; Haas, A.P. de; Hoogenboom, A.M.; Strasters, B.A.; Vermeer, A.; Zwol, N.A. van

    1984-01-01

    An injector has been built to obtain improved beam transmission through the EN tandem. The injector has been provided with a 90 0 analysing magnet, m/Δm=300, and 130 kV preacceleration. Beam optics calculations have been made for the injector and tandem. The injector has been equipped with a fiber optics control and data acquisition system. (orig.)

  2. Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial.

    Science.gov (United States)

    Taylor, Jerome H; Landeros-Weisenberger, Angeli; Coughlin, Catherine; Mulqueen, Jilian; Johnson, Jessica A; Gabriel, Daniel; Reed, Margot O; Jakubovski, Ewgeni; Bloch, Michael H

    2018-01-01

    Many patients with social anxiety disorder (SAD) experience inadequate symptom relief from available treatments. Ketamine is a potent N-methyl-D-aspartate receptor antagonist with a potentially novel mechanism of action for the treatment of anxiety disorders. Therefore, we conducted a double-blind, randomized, placebo-controlled crossover trial in 18 adults with DSM-5 SAD and compared the effects between intravenous ketamine (0.5 mg/kg over 40 min) and placebo (normal saline) on social phobia symptoms. Ketamine and placebo infusions were administered in a random order with a 28-day washout period between infusions. Ratings of anxiety were assessed 3-h post-infusion and followed for 14 days. We used linear mixed models to assess the impact of ketamine and placebo on anxiety symptoms. Outcomes were blinded ratings on the Liebowitz Social Anxiety Scale (LSAS) and self-reported anxiety on a visual analog scale (VAS-Anxiety). We also used the Wilcoxon signed-rank test to compare the proportion of treatment responders. Based on prior studies, we defined response as a greater than 35% LSAS reduction and 50% VAS-Anxiety reduction. We found ketamine resulted in a significantly greater reduction in anxiety relative to placebo on the LSAS (Time × Treatment: F 9,115 =2.6, p=0.01) but not the VAS-Anxiety (Time × Treatment: F 10,141 =0.4, p=0.95). Participants were significantly more likely to exhibit a treatment response after ketamine infusion relative to placebo in the first 2 weeks following infusion measured on the LSAS (33.33% response ketamine vs 0% response placebo, Wilcoxon signed-rank test z=2.24, p=0.025) and VAS (88.89% response ketamine vs 52.94% response placebo, Wilcoxon signed-rank test z=2.12, p=0.034). In conclusion, this proof-of-concept trial provides initial evidence that ketamine may be effective in reducing anxiety.

  3. Injector of solid indicator

    Energy Technology Data Exchange (ETDEWEB)

    Chernyshev, G.I.; Luk' yanov, E.P.; Pruslin, Y.A.; Zabrodin, P.I.

    1981-04-25

    The injector can be used with remote introduction of indicators into a borehole for study in an oil well of the parameters of movement of fluid currents, control of the state of the equipment, and study of the properties of the rocks. Proposed is a method of increasing the reliability of operation of the injector by stabilizing the rate of its dispersing. Introduced to the injector of a solid indicator are auxiliary brackets and a cathode made from nonmetallic electrical conducting material and reinforced at the end by an elastic bracket. The auxillary cathode is attached to the end surface of the anode and cathode.

  4. Urine metabolomics in rats after administration of ketamine

    Directory of Open Access Journals (Sweden)

    Wen C

    2015-02-01

    Full Text Available Congcong Wen,1 Meiling Zhang,2 Jianshe Ma,2 Lufeng Hu,3 Xianqin Wang,2 Guanyang Lin31Laboratory Animal Centre, 2Analytical and Testing Center, 3First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of ChinaAbstract: In this study, we developed a urine metabonomic method, based on gas chromatography–mass spectrometry (GC-MS, to evaluate the effect of ketamine on rats. Pattern recognition analysis, including both principal component analysis and partial least squares discriminate analysis revealed that ketamine (50 mg/kg induced metabolic perturbations. Compared with the control group, at day 7, the level of alanine, butanoic acid, glutamine, butanedioic, trimethylsiloxy, L-aspartic acid, D-glucose, cholesterol, acetamide, and oleic acid of the ketamine group was increased, while the level of 2,3,4-trihydroxybutyric acid, benzene­acetic acid, threitol, ribitol, xylitol, and glycine decreased. At day 14, the level of alanine, ethanedioic acid, L-proline, glycerol, tetradecanoic acid, l-serine, l-phenylalanine, L-aspartic acid, d-glucose, cholesterol, heptadecanoic acid, and acetamide in rat urine of the ketamine group was increased, while the 2,3,4-trihydroxybutyric acid, benzeneacetic acid, d-ribose, threitol, ribitol, glycine, pyrazine, and oleic acid levels decreased. Our results indicate that metabonomic methods based on GC-MS may be useful to elucidate ketamine abuse, through the exploration of biomarkers.Keywords: GC-MS, abuse, biomarker, metabolite

  5. Case report: efficacy and tolerability of ketamine in opioid-refractory cancer pain.

    Science.gov (United States)

    Amin, Priya; Roeland, Eric; Atayee, Rabia

    2014-09-01

    A 36-year-old female with metastatic breast cancer involving bones, liver, lung, and pleura/chest wall with worsening back pain received weight-based intravenous (IV) ketamine and was transitioned to oral ketamine for cancer-related neuropathic pain. She had responded poorly to outpatient pain regimen of oxycodone sustained and immediate release, hydromorphone, gabapentin, and duloxetine (approximate 480 mg total oral morphine equivalents [OME]), reporting an initial pain score of 10/10. She was started on hydromorphone parenteral patient-controlled analgesia (PCA) bolus dose in addition to her outpatient regimen. Despite escalating doses of opioids and the addition of a lidocaine 5% patch, the patient's pain remained uncontrolled 6 days after admission. On hospital day 7, utilizing a hospital weight-based ketamine protocol, the patient was started on subanesthetic doses of ketamine at 0.2 mg/kg/h (288 mg/24 h) and titrated over 2 days to 0.4 mg/kg/h (576 mg/24 h). Then, a 3-day rotation from intravenous to oral ketamine was initiated, and the patient was discharged on ketamine oral solution, 75 mg every 8 hours. When the patient's dose was increased to 0.4 mg/kg/h, adequate pain relief was charted by the nurse within 120 minutes, "patient pain free and resting comfortably." Her pain continued to be well managed, with an average pain score of 5/10 with the ketamine continuous infusion and sustained with conversion to oral ketamine without any report of side effects. This was a 37% reduction in pain scores. With the patient's stabilized dose of ketamine, opioid requirements decreased by 61.4% (1017.5 mg reduction in total OME). The use of weight-based dosing of IV continuous infusion and transition to oral ketamine was effective and tolerable in the management of opioid-refractory, neuropathic cancer pain. It is hoped that this case report promotes a discussion regarding ketamine dosing in refractory neuropathic cancer pain.

  6. N,N-dimethylglycine differentially modulates psychotomimetic and antidepressant-like effects of ketamine in mice.

    Science.gov (United States)

    Lin, Jen-Cheng; Chan, Ming-Huan; Lee, Mei-Yi; Chen, Yi-Chyan; Chen, Hwei-Hsien

    2016-11-03

    Ketamine, a dissociative anesthetic, produces rapid and sustained antidepressant effects at subanesthtic doses. However, it still inevitably induces psychotomimetic side effects. N,N-dimethylglycine (DMG) is a derivative of the amino acid glycine and is used as a dietary supplement. Recently, DMG has been found acting at glycine binding site of the N-methyl-d-aspartate receptor (NMDAR). As blockade of NMDARs is one of the main mechanisms responsible for the action of ketamine on central nervous system, DMG might modulate the behavioral responses to ketamine. The present study determined the effects of DMG on the ketamine-induced psychotomimetic, anesthetic and antidepressant-like effects in mice. DMG pretreatment reversed the ketamine-induced locomotor hyperactivity and impairment in the rotarod performance, novel location and novel object recognition tests, and prepulse inhibition. In addition, DMG alone exhibited antidepressant-like effects in the forced swim test and produced additive effects when combined with ketamine. However, DMG did not affect ketamine-induced anesthesia. These results reveal that DMG could antagonize ketamine's psychotomimetic effects, yet produce additive antidepressant-like effects with ketamine, suggesting that DMG might have antipsychotic potential and be suitable as an add-on therapy to ketamine for patients with treatment-resistant depression. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. DIAGNOSTICS AND REGENERATION OF COMMON RAIL INJECTORS

    Directory of Open Access Journals (Sweden)

    Łukasz KONIECZNY

    2015-03-01

    Full Text Available The article presents the methodology of Common Rail injector diagnostic, regeneration and regulation with use of professional test stands. The EPS 815 machine can be used to test and repair all BOSCH injectors fully satisfying the producer requirements and standards. The article describes an example injector diagnosis with use of such test stand and additionally presents appropriate injector regeneration and encoding techniques

  8. Psychological effects of ketamine in healthy volunteers - Phenomenological study

    NARCIS (Netherlands)

    Pomarol-Clotet, E.; Honey, G. D.; Murray, G. K.; Corlett, P. R.; Absalom, A. R.; Lee, M.; McKenna, P. J.; Bullmore, E. T.; Fletcher, P. C.

    Background: The psychosis-inducing effect of ketamine is important evidence supporting the glutamate hypothesis of schizophrenia. However, the symptoms the drug produces have not been described systematically. Aim: To examine the effects of ketamine in healthy people using a structured psychiatric

  9. Mechanistic Target of Rapamycin-Independent Antidepressant Effects of (R)-Ketamine in a Social Defeat Stress Model.

    Science.gov (United States)

    Yang, Chun; Ren, Qian; Qu, Youge; Zhang, Ji-Chun; Ma, Min; Dong, Chao; Hashimoto, Kenji

    2018-01-01

    The role of the mechanistic target of rapamycin (mTOR) signaling in the antidepressant effects of ketamine is controversial. In addition to mTOR, extracellular signal-regulated kinase (ERK) is a key signaling molecule in prominent pathways that regulate protein synthesis. (R)-Ketamine has a greater potency and longer-lasting antidepressant effects than (S)-ketamine. Here we investigated whether mTOR signaling and ERK signaling play a role in the antidepressant effects of two enantiomers. The effects of mTOR inhibitors (rapamycin and AZD8055) and an ERK inhibitor (SL327) on the antidepressant effects of ketamine enantiomers in the chronic social defeat stress (CSDS) model (n = 7 or 8) and on those of ketamine enantiomers in these signaling pathways in mouse brain regions were examined. The intracerebroventricular infusion of rapamycin or AZD8055 blocked the antidepressant effects of (S)-ketamine, but not (R)-ketamine, in the CSDS model. Furthermore, (S)-ketamine, but not (R)-ketamine, significantly attenuated the decreased phosphorylation of mTOR and its downstream effector, ribosomal protein S6 kinase, in the prefrontal cortex of susceptible mice after CSDS. Pretreatment with SL327 blocked the antidepressant effects of (R)-ketamine but not (S)-ketamine. Moreover, (R)-ketamine, but not (S)-ketamine, significantly attenuated the decreased phosphorylation of ERK and its upstream effector, mitogen-activated protein kinase/ERK kinase, in the prefrontal cortex and hippocampal dentate gyrus of susceptible mice after CSDS. This study suggests that mTOR plays a role in the antidepressant effects of (S)-ketamine, but not (R)-ketamine, and that ERK plays a role in (R)-ketamine's antidepressant effects. Thus, it is unlikely that the activation of mTOR signaling is necessary for antidepressant actions of (R)-ketamine. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Oral ketamine for children with chronic pain: a pilot phase 1 study

    Science.gov (United States)

    Bredlau, Amy-Lee; McDermott, Michael P.; Adams, Heather; Dworkin, Robert H; Venuto, Charles; Fisher, Susan; Dolan, James G; Korones, David N

    2013-01-01

    Objective To assess whether oral ketamine aids is is safe at higher dosages for sedating children and whether it may be an option for control of chronic pain in children. Study design A prospective study was performed on 12 children with chronic pain to identify the maximum tolerated dosage of oral ketamine. Participants were given 14 days of oral ketamine, three times daily, at dosages ranging from 0.25–1.5 mg/kg/dose. Participants were assessed for toxicity and for pain severity at baseline and on day 14 of treatment. Results Two participants, both treated at 1.5 mg/kg/dose, experienced dose-limiting toxicities (sedation and anorexia). One participant, treated at 1 mg/kg/dose, opted to stop ketamine treatment due to new pain on treatment. Nine participants completed their course of ketamine treatment. Of these 12 children, 5 experienced improvement in their pain scores, two with complete resolution of pain, lasting for more than 4 weeks off ketamine treatment. Conclusion Oral ketamine at dosages of 0.25–1 mg/kg/dose appears to be safe when given for 14 days to children with chronic pain. PMID:23403253

  11. Single i.v. ketamine augmentation of newly initiated escitalopram for major depression: results from a randomized, placebo-controlled 4-week study.

    Science.gov (United States)

    Hu, Y-D; Xiang, Y-T; Fang, J-X; Zu, S; Sha, S; Shi, H; Ungvari, G S; Correll, C U; Chiu, H F K; Xue, Y; Tian, T-F; Wu, A-S; Ma, X; Wang, G

    2016-02-01

    While oral antidepressants reach efficacy after weeks, single-dose intravenous (i.v.) ketamine has rapid, yet time-limited antidepressant effects. We aimed to determine the efficacy and safety of single-dose i.v. ketamine augmentation of escitalopram in major depressive disorder (MDD). Thirty outpatients with severe MDD (17-item Hamilton Rating Scale for Depression total score ⩾ 24) were randomized to 4 weeks double-blind treatment with escitalopram 10 mg/day+single-dose i.v. ketamine (0.5 mg/kg over 40 min) or escitalopram 10 mg/day + placebo (0.9% i.v. saline). Depressive symptoms were measured using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR). Suicidal ideation was evaluated with the QIDS-SR item 12. Adverse psychopathological effects were measured with the Brief Psychiatric Rating Scale (BPRS)-positive symptoms, Young Mania Rating Scale (YMRS) and Clinician Administered Dissociative States Scale (CADSS). Patients were assessed at baseline, 1, 2, 4, 24 and 72 h and 7, 14, 21 and 28 days. Time to response (⩾ 50% MADRS score reduction) was the primary outcome. By 4 weeks, more escitalopram + ketamine-treated than escitalopram + placebo-treated patients responded (92.3% v. 57.1%, p = 0.04) and remitted (76.9% v. 14.3%, p = 0.001), with significantly shorter time to response [hazard ratio (HR) 0.04, 95% confidence interval (CI) 0.01-0.22, p escitalopram + placebo, escitalopram + ketamine was associated with significantly lower MADRS scores from 2 h to 2 weeks [(peak = 3 days-2 weeks; effect size (ES) = 1.08-1.18)], QIDS-SR scores from 2 h to 2 weeks (maximum ES = 1.27), and QIDS-SR suicidality from 2 to 72 h (maximum ES = 2.24). Only YMRS scores increased significantly with ketamine augmentation (1 and 2 h), without significant BPRS or CADSS elevation. Single-dose i.v. ketamine augmentation of escitalopram was safe and effective in severe MDD, holding promise for speeding up

  12. Ketamine PCA for treatment of end-of-life neuropathic pain in pediatrics.

    Science.gov (United States)

    Taylor, Matthew; Jakacki, Regina; May, Carol; Howrie, Denise; Maurer, Scott

    2015-12-01

    Control of neuropathic pain (NP) for children at end of life is challenging. Ketamine improves control of NP, but its use in children is not well described. We describe a retrospective case review of 14 children with terminal prognoses treated with ketamine patient-controlled analgesia (PCA) for management of opioid-refractory NP at the end of life. Median ketamine dose was 0.06 mg/kg/h (range 0.014-0.308 mg/kg/h) with a 0.05 mg/kg (range 0.03-0.5mg/kg) demand dose available every 15 minutes (range 10-60 minutes). All patients noted subjective pain relief with ketamine, and 79% had no adverse effects. Benzodiazepines limited neuropsychiatric side effects. Ketamine treatment arrested dose escalation of opioids in 64% of patients, and 79% were discharged to home hospice. Ketamine PCA is an effective, well-tolerated therapy for opioid-refractory NP in pediatric end-of-life care. © The Author(s) 2014.

  13. CNG INJECTOR RESEARCH FOR DUAL FUEL ENGINE

    Directory of Open Access Journals (Sweden)

    Adam Majczak

    2017-03-01

    Full Text Available The article presents the tests results of the prototype design of hydraulically assisted injector, that is designed for gas supply into diesel engines. The construction of the injector allows for it positioning in the glow plug socket, so that the gas is injected directly into the combustion chamber. The cycle analysis of the four-cylinder Andoria ADCR engine with a capacity of 2.6 dm3 for different crankshaft rotational speeds allowed to determine the necessary time for fuel injection. Because of that, it was possible to determine the required mass flow rate of the injector, for replacing as much of the original fuel by gaseous fuel. To ensure a high value of flow inside the injector, supply pressure equal to 1 MPa was applied. High gas supply pressure requires high value of valve opening forces. For this purpose a injector with hydraulic control system, using a liquid under pressure for the opening process was designed. On the basis of air pressure measurements in the flow line after the injector, the analysis of opening and closing of the valve was made. Measurements of outflow mass of the injector were also carried out. The results showed that the designed injector meets the requirements necessary to supply ADCR engine by the CNG fuel.

  14. Ketamine for Depression: Where Do We Go from Here?

    Science.gov (United States)

    aan het Rot, Marije; Zarate, Carlos A.; Charney, Dennis S.; Mathew, Sanjay J.

    2012-01-01

    Since publication of the first randomized controlled trial describing rapid antidepressant effects of ketamine, several reports have confirmed the potential utility of this dissociative anesthetic medication for treatment of major depressive episodes, including those associated with bipolar disorder and resistant to other medications and electroconvulsive therapy. These reports have generated several questions with respect to who might respond to ketamine, how, and for how long. To start answering these questions. We used PubMed.gov and ClinicalTrials.gov to perform a systematic review of all available published data on the antidepressant effects of ketamine and of all recently completed, ongoing, and planned studies. To date, 163 patients, primarily with treatment-resistant depression, have participated in case studies, open-label investigations, or controlled trials. All controlled trials have used a within-subject, crossover design with an inactive placebo as the control. Ketamine administration has usually involved an anaesthesiologist infusing a single, subanesthetic, intravenous dose, and required hospitalization for at least 24 hours postinfusion. Response rates in the open-label investigations and controlled trials have ranged from 25% to 85% at 24 hours postinfusion and from 14% to 70% at 72 hours postinfusion. Although adverse effects have generally been mild, some patients have experienced brief changes in blood pressure, heart rate, or respiratory rate. Risk–benefit analyses support further research of ketamine for individuals with severe mood disorders. However, given the paucity of randomized controlled trials, lack of an active placebo, limited data on long-term outcomes, and potential risks, ketamine administration is not recommended outside of the hospital setting. PMID:22705040

  15. To use or not to use: an update on licit and illicit ketamine use

    Directory of Open Access Journals (Sweden)

    Yuet-wah Cheung

    2011-03-01

    Full Text Available Jih-Heng Li1, Balasingam Vicknasingam2, Yuet-wah Cheung3, Wang Zhou4, Adhi Wibowo Nurhidayat5, Don C Des Jarlais6, Richard Schottenfeld71College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; 2National Centre for Drug Research, Universiti Sains Malaysia, Malaysia; 3Department of Sociology, The Chinese University of Hong Kong, Hong Kong, China; 4Wuhan Center for Disease Control and Prevention, Wuhan, China; 5Drug Dependence Hospital RSKO, Jakarta, Indonesia; 6Beth Israel Medical Center, New York, NY; 7School of Psychiatry, Yale University, CT, USAAbstract: Ketamine, a derivative of phencyclidine that was developed in the 1960s, is an anesthetic and analgesic with hallucinogenic effects. In this paper, the pharmacological and toxicological effects of ketamine are briefly reviewed. Ketamine possesses a wide safety margin but such a therapeutic benefit is somewhat offset by its emergence phenomenon (mind-body dissociation and delirium and hallucinogenic effects. The increasing abuse of ketamine, initially predominantly in recreational scenes to experience a “k-hole” and other hallucinatory effects but more recently also as a drug abused during the workday or at home, has further pushed governments to confine its usage in many countries. Recently, urinary tract dysfunction has been associated with long-term ketamine use. In some long-term ketamine users, such damage can be irreversible and could result in renal failure and dialysis. Although ketamine has not yet been scheduled in the United Nations Conventions, previous studies using different assessment parameters to score the overall harms of drugs indicated that ketamine may cause more harm than some of the United Nations scheduled drugs. Some countries in Southeast and East Asia have reported an escalating situation of ketamine abuse. Dependence, lower urinary tract dysfunction, and sexual impulse or violence were the most notable among the ketamine-associated symptoms in these

  16. Adjunct Ketamine Use in the Management of Severe Ethanol Withdrawal.

    Science.gov (United States)

    Pizon, Anthony F; Lynch, Michael J; Benedict, Neal J; Yanta, Joseph H; Frisch, Adam; Menke, Nathan B; Swartzentruber, Greg S; King, Andrew M; Abesamis, Michael G; Kane-Gill, Sandra L

    2018-05-08

    Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. Retrospective observational cohort study. Academic tertiary care hospital. Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria. Pre and post guideline, all patients were treated in a symptom-triggered fashion with benzodiazepines and/or phenobarbital. Postguideline, standard symptom-triggered dosing continued as preguideline, plus, the patient was initiated on an IV ketamine infusion at 0.15-0.3 mg/kg/hr continuously until delirium resolved. Based upon withdrawal severity and degree of agitation, a ketamine bolus (0.3 mg/kg) was provided prior to continuous infusion in some patients. A total of 63 patients were included (29 preguideline; 34 postguideline). Patients treated with ketamine were less likely to be intubated (odds ratio, 0.14; p trend toward a shorter hospitalization.

  17. 21 CFR 522.1222 - Ketamine hydrochloride injectable dosage forms.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Ketamine hydrochloride injectable dosage forms. 522.1222 Section 522.1222 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... ANIMAL DRUGS § 522.1222 Ketamine hydrochloride injectable dosage forms. ...

  18. Studies of the biotransformation and pharmacology of ketamine and its metabolites

    International Nuclear Information System (INIS)

    Leung, Y.

    1986-01-01

    The first part of the research is concerned with the synthesis, resolution and metabolism of norketamine, the primary metabolite of ketamine. Incubations of racemic norketamine, individual enantiomers of norketamine and the pseudoracemates in rat liver microsomes revealed stereoselectivity and enantiomeric interactions during the metabolism of norketamine. The second part of the research describes the synthesis of 6-OH-norketamine, the major secondary metabolite of ketamine, and reports on its pharmacological activity and cerebral distribution in the rat. Primary deuterium isotope effects associated with the metabolism and pharmacological activity of ketamine-N-CD 3 were examined in the third part of this research. The last part of the research deals with the effect of diazepam on the metabolic transformation of ketamine to norketamine in the rat. The fractions of ketamine metabolized to norketamine were found not to be different in the presence or the absence of diazepam

  19. Influence of ketamine on regional brain glucose use

    International Nuclear Information System (INIS)

    Davis, D.W.; Mans, A.M.; Biebuyck, J.F.; Hawkins, R.A.

    1988-01-01

    The purpose of this study was to determine the effect of different doses of ketamine on cerebral function at the level of individual brain structures as reflected by glucose use. Rats received either 5 or 30 mg/kg ketamine intravenously as a loading dose, followed by an infusion to maintain a steady-state level of the drug. An additional group received 30 mg/kg as a single injection only, and was studied 20 min later, by which time they were recovering consciousness (withdrawal group). Regional brain energy metabolism was evaluated with [6- 14 C]glucose and quantitative autoradiography during a 5-min experimental period. A subhypnotic, steady-state dose (5 mg/kg) of ketamine caused a stimulation of glucose use in most brain areas, with an average increase of 20%. At the larger steady-state dose (30 mg/kg, which is sufficient to cause anesthesia), there was no significant effect on most brain regions; some sensory nuclei were depressed (inferior colliculus, -29%; cerebellar dentate nucleus, -18%; vestibular nucleus, -16%), but glucose use in the ventral posterior hippocampus was increased by 33%. In contrast, during withdrawal from a 30-mg/kg bolus, there was a stimulation of glucose use throughout the brain (21-78%), at a time when plasma ketamine levels were similar to the levels in the 5 mg/kg group. At each steady-state dose, as well as during withdrawal, ketamine caused a notable stimulation of glucose use by the hippocampus

  20. Efficacy of ketamine in improving pain after tonsillectomy in children: meta-analysis.

    Science.gov (United States)

    Cho, Hye Kyung; Kim, Kyu Won; Jeong, Yeon Min; Lee, Ho Seok; Lee, Yeon Ji; Hwang, Se Hwan

    2014-01-01

    The goal of this meta-analysis study was to perform a systematic review of the literature on the effects of ketamine on postoperative pain following tonsillectomy and adverse effects in children. Two authors independently searched three databases (MEDLINE, SCOPUS, Cochrane) from their inception of article collection to February 2014. Studies that compared preoperative ketamine administration (ketamine groups) with no treatment (control group) or opioid administration (opioid group) where the outcomes of interest were postoperative pain intensity, rescue analgesic consumption, or adverse effects (sedation, nausea and vomiting, bad dream, worsening sleep pattern, and hallucination) 0-24 hours after leaving the operation room were included in the analysis. The pain score reported by the physician during first 4 hours and need for analgesics during 24 hours postoperatively was significantly decreased in the ketamine group versus control group and was similar with the opioid group. In addition, there was no significant difference between ketamine and control groups for adverse effects during 24 hours postoperatively. In the subgroup analyses (systemic and local administration) regarding pain related measurements, peritonsillar infiltration of ketamine was more effective in reducing the postoperative pain severity and need for analgesics. Preoperative administration of ketamine systemically or locally could provide pain relief without side-effects in children undergoing tonsillectomy. However, considering the insufficient evaluation of efficacy of ketamine according to the administration methods and high heterogeneity in some parameters, further clinical trials with robust research methodology should be conducted to confirm the results of this study.

  1. Distinct effects of ketamine and acetyl l-carnitine on the dopamine system in zebrafish

    Science.gov (United States)

    Robinson, Bonnie L.; Dumas, Melanie; Cuevas, Elvis; Gu, Qiang; Paule, Merle G.; Ali, Syed F.; Kanungo, Jyotshna

    2016-01-01

    Ketamine, a noncompetitive N-methyl-d-aspartic acid (NMDA) receptor antagonist is commonly used as a pediatric anesthetic. We have previously shown that acetyl L-carnitine (ALCAR) prevents ketamine toxicity in zebrafish embryos. In mammals, ketamine is known to modulate the dopaminergic system. NMDA receptor antagonists are considered as promising anti-depressants, but the exact mechanism of their function is unclear. Here, we measured the levels of dopamine (DA) and its metabolites, 3, 4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), in the zebrafish embryos exposed to ketamine in the presence and absence of 0.5 mM ALCAR. Ketamine, at lower doses (0.1–0.3 mM), did not produce significant changes in DA, DOPAC or HVA levels in 52 h post-fertilization embryos treated for 24 h. In these embryos, tyrosine hydroxylase (TH) mRNA expression remained unchanged. However, 2 mM ketamine (internal embryo exposure levels equivalent to human anesthetic plasma concentration) significantly reduced DA level and TH mRNA indicating that DA synthesis was adversely affected. In the presence or absence of 2 mM ketamine, ALCAR showed similar effects on DA level and TH mRNA, but increased DOPAC level compared to control. ALCAR reversed 2 mM ketamine-induced reduction in HVA levels. With ALCAR alone, the expression of genes encoding the DA metabolizing enzymes, MAO (monoamine oxidase) and catechol-O-methyltransferase (COMT), was not affected. However, ketamine altered MAO mRNA expression, except at the 0.1 mM dose. COMT transcripts were reduced in the 2 mM ketamine-treated group. These distinct effects of ketamine and ALCAR on the DA system may shed some light on the mechanism on how ketamine can work as an anti-depressant, especially at sub-anesthetic doses that do not affect DA metabolism and suppress MAO gene expression. PMID:26898327

  2. FERMILAB: Main Injector

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The Fermilab Main Injector (FMI) project is the centerpiece of the Laboratory's Fermilab III programme for the 1990s. Designed to support a luminosity of at least 5x10 31 cm -2 s -1 in the Tevatron collider, it will also provide new capabilities for rare neutral kaon decay and neutrino oscillation studies. The Fermilab Main Injector 8-150 GeV synchrotron is designed to replace the existing Main Ring which seriously limits beam intensities for the Tevatron and the antiproton production target. The project has passed several significant milestones and is now proceeding rapidly towards construction. The project received a $11.65M appropriation in 1992 and has been given $15M for the current fiscal year. Through the Energy Systems Acquisition Advisory Board (ESAAB) process, the US Department of Energy (DoE) has authorized funds for construction of the underground enclosure and service building where the Main Injector will touch the Tevatron, and to the preparation of bids for remaining project construction

  3. Involvement of posterior cingulate cortex in ketamine-induced psychosis relevant behaviors in rats.

    Science.gov (United States)

    Ma, Jingyi; Leung, L Stan

    2018-02-15

    The involvement of posterior cingulate cortex (PCC) on ketamine-induced psychosis relevant behaviors was investigated in rats. Bilateral infusion of muscimol, a GABA A receptor agonist, into the PCC significantly antagonized ketamine-induced deficit in prepulse inhibition of a startle reflex (PPI), deficit in gating of hippocampal auditory evoked potentials, and behavioral hyperlocomotion in a dose dependent manner. Local infusion of ketamine directly into the PCC also induced a PPI deficit. Systemic injection of ketamine (3mg/kg,s.c.) induced an increase in power of electrographic activity in the gamma band (30-100Hz) in both the PCC and the hippocampus; peak theta (4-10Hz) power was not significantly altered, but peak theta frequency was increased by ketamine. In order to exclude volume conduction from the hippocampus to PCC, inactivation of the hippocampus was made by local infusion of muscimol into the hippocampus prior to ketamine administration. Muscimol in the hippocampus effectively blocked ketamine-induced increase of gamma power in the hippocampus but not in the PCC, suggesting independent generation of gamma waves in PCC and hippocampus. It is suggested that the PCC is part of the brain network mediating ketamine-induced psychosis related behaviors. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Ketamine attenuates the glutamatergic neurotransmission in the ventral posteromedial nucleus slices of rats.

    Science.gov (United States)

    Fu, Bao; Liu, Chengxi; Zhang, Yajun; Fu, Xiaoyun; Zhang, Lin; Yu, Tian

    2017-08-23

    Ketamine is a frequently used intravenous anesthetic, which can reversibly induce loss of consciousness (LOC). Previous studies have demonstrated that thalamocortical system is critical for information transmission and integration in the brain. The ventral posteromedial nucleus (VPM) is a critical component of thalamocortical system. Glutamate is an important excitatory neurotransmitter in the brain and may be involved in ketamine-induced LOC. The study used whole-cell patch-clamp to observe the effect of ketamine (30 μM-1000 μM) on glutamatergic neurotransmission in VPM slices. Ketamine significantly decreased the amplitude of glutamatergic spontaneous excitatory postsynaptic currents (sEPSCs), but only higher concentration of ketamine (300 μM and 1000 μM) suppressed the frequency of sEPSCs. Ketamine (100 μM-1000 μM) also decreased the amplitude of glutamatergic miniature excitatory postsynaptic currents (mEPSCs), without altering the frequency. In VPM neurons, ketamine attenuates the glutamatergic neurotransmission mainly through postsynaptic mechanism and action potential may be involved in the process.

  5. Preemptive Analgesic Effect of Ketamine in Children with Lower Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Serbülent Gökhan Beyaz

    2011-06-01

    Full Text Available Objective: Preemptive analgesic effect of low dose ketamine has been supported by clinical studies in adults. The aim of this study was to evaluate the analgesic effect of ketamine applied at different times in children who underwent lower abdominal surgery.Material and Methods: A total of 90 children having ASAI-II physical status between 3 and 12 was randomly divided into three groups as pre, int and post groups. Ketamine were given to these groups in the following manner respectively; 1mg/kg intravenous ketamine before incision (pre-incisional; the same dose ketamine 10 minutes following the first incision (intraoperative; and ketamine at the end of the surgical operation (postoperative. The pain of patients was assessed by postoperative pain scale (CHIPPS in children and infants; the sedation status of children was assessed by Ramsey’s sedation scale. The first analgesic requirement time was recorded.Results: No significant difference was found in demographic characteristics of the three groups (p>0.05. Lower CHIPPS scores were found in Group Post throughout all measurement periods (p<0.05. Group Post was found to have significantly higher sedation levels compared with the other two groups (p=0.003. Conclusion: No analgesic effect was obtained using by pre-incisional and intraoperative i.v.1mg/kg ketamine, during lower abdominal surgery in children. Further studies with different drugs are needed to clarify this topic.

  6. 49 CFR 230.57 - Injectors and feedwater pumps.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Injectors and feedwater pumps. 230.57 Section 230... Appurtenances Injectors, Feedwater Pumps, and Flue Plugs § 230.57 Injectors and feedwater pumps. (a) Water.... Injectors and feedwater pumps must be kept in good condition, free from scale, and must be tested at the...

  7. Respiratory complications associated with ketamine anesthesia for ophthalmic procedures following intraocular pressure measurement in children

    Directory of Open Access Journals (Sweden)

    Lei Wu

    2014-01-01

    Full Text Available Background: We compared respiratory complications (RCs in children who received intramuscular (IM versus intravenous (IV or no ketamine for intraocular pressure (IOP measurement to test our observation that IM ketamine is associated with higher incidence of RCs. Materials and Methods: We analyzed 149 eye examinations under anesthesia with ketamine in 27 patients and 263 non-ketamine examinations under anesthesia in 81 patients using a mixed effects logistic regression model. Results: IM ketamine was strongly associated with increased odds of RCs compared to no ketamine (odds ratio (OR: 20.23, P < 0.0001 and to IV ketamine (OR: 6.78, P = 0.02, as were higher American Society of Anesthesiologists (ASA classification (OR: 2.60, P = 0.04, and the use of volatile agents (OR: 3.32, P = 0.02. Conclusion: Further studies should be conducted to confirm our observation of increased RCs with IM ketamine.

  8. Pellet injector research and development at ORNL

    International Nuclear Information System (INIS)

    Combs, S.K.; Barber, G.C.; Baylor, L.R.

    1994-01-01

    Oak Ridge National Laboratory has been developing pellet injectors for plasma fueling experiments on magnetic confinement devices for more than 15 years. Recent major applications of the ORNL development program include (1) a tritium-compatible four-shot pneumatic injector for the Tokamak Fusion Test Reactor, (2) a centrifuge pellet injector for the Tore Supra tokamak, and most recently (3) a three-barrel repeating pneumatic injector for the DIII-D tokamak. In addition to applications, ORNL is developing advanced technologies, including high-speed pellet injectors, tritium injectors, and long-pulse pellet feed systems. The high-speed research involves a collaboration between ORNL and ENEA-Frascati in the development of a repeating two-stage light gas gun based on an extrusion-type pellet feed system. Construction of a new tritium-compatible, extruder-based repeating pneumatic injector (8-mm-diam) is complete and will replace the pipe gun in the original tritium proof-of-principle experiment. The development of a steady-state feed system in which three standard extruders operate in tandem is under way. These research and development activities are relevant to the International Thermonuclear Experimental Reactor and are briefly described in this paper

  9. Rapid and sensitive detection of ketamine in blood using novel fluorescence genosensor.

    Science.gov (United States)

    Ding, Yanjun; Li, Xingmei; Guo, Yadong; Yan, Jie; Ling, Jiang; Li, Weichen; Lan, Lingmei; Chang, Yunfeng; Cai, Jifeng; Zha, Lagabaiyla

    2017-12-01

    In recent years, drug abuse has been considered as a most challenging social problem that aroused public attention. Ketamine has increased in unregulated use as a 'recreational drug' in teenagers. However, there is no suitable and maneuverable detection method for ketamine in situ at the moment. Fluorescence sensor technique, with predominant recognition and simple operation, is a good potential application in drug detection. Here, we first reported a highly sensitive and selective fluorescence genosensor for rapid detection of ketamine based on DNA-templated silver nanoclusters (DNA-AgNCs) probes, in which the DNA sequence could specially recognize ketamine with high affinity. Parameters affecting detection efficiency were investigated and optimized. Under optimum conditions, the as-prepared genosensor can allow for the determination of ketamine in the concentration range of 0.0001-20 μg/mL with two linear equations: one is y = 2.84x-7.139 (R 2 = 0.987) for 0.0001-0.1 μg/mL, and the other is y = 1.87x-0.091 (R 2 = 0.962) for 0.1-20 μg/mL, and the estimated detection limit of ketamine is 0.06 ng/mL. Moreover, the feasibility of this proposed method was also demonstrated by analyzing forensic blood samples. Compared with official gas chromatography/mass spectrometry (GC/MS), this fluorescence genosensor is simple, rapid, and accurate for quantitative determination of ketamine in blood for pharmaceutical and forensic analysis. Overall, it is the first report on a fluorescence genosensor for detecting ketamine directly in blood. This research may provide a new insight for the analyst to band fluorescence genosensor technology together with drug monitoring in the battle against drug abuse and forensic examination. Graphical abstract High selectively detection of ketamine using a novel fluorescence genosensor based on DNA-AgNCs probe.

  10. Population pharmacokinetic-pharmacodynamic modeling of ketamine-induced pain relief of chronic pain.

    Science.gov (United States)

    Dahan, Albert; Olofsen, Erik; Sigtermans, Marnix; Noppers, Ingeborg; Niesters, Marieke; Aarts, Leon; Bauer, Martin; Sarton, Elise

    2011-03-01

    Pharmacological treatment of chronic (neuropathic) pain is often disappointing. In order to enhance our insight in the complex interaction between analgesic drug and chronic pain relief, we performed a pharmacokinetic-pharmacodynamic (PK-PD) modeling study on the effect of S(+)-ketamine on pain scores in Complex Regional Pain Syndrome type 1 (CRPS-1) patients. Sixty CRPS-1 patients were randomly allocated to received a 100-h infusion of S(+)-ketamine or placebo. The drug infusion rate was slowly increased from 5 mg/h (per 70 kg) to 20 mg/h based upon the effect/side effect profile. Pain scores and drug blood samples were obtained during the treatment phase and pain scores were further obtained weekly for another 11 weeks. A population PK-PD model was developed to analyze the S(+)-ketamine-pain data. Plasma concentrations of S(+)-ketamine and its metabolite decreased rapidly upon the termination of S(+)-ketamine infusion. The chance for an analgesic effect from ketamine and placebo treatment was 67±10% and 23±9% (population value±SE), respectively. The pain data were well described by the PK-PD model with parameters C(50)=10.5±4.8 ng/ml (95% ci 4.37-21.2 ng/ml) and t½ for onset/offset=10.9±4.0 days (5.3-20.5 days). Long-term S(+)-ketamine treatment is effective in causing pain relief in CRPS-1 patients with analgesia outlasting the treatment period by 50 days. These data suggest that ketamine initiated a cascade of events, including desensitization of excitatory receptor systems in the central nervous system, which persisted but slowly abated when ketamine molecules were no longer present. Copyright © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  11. Numerical Simulation of Twin Nozzle Injectors

    OpenAIRE

    Milak, Dino

    2015-01-01

    Fuel injectors for marine applications have traditionally utilized nozzles with symmetric equispaced orifice configuration. But in light of the new marine emission legislations the twin nozzle concept has arisen. The twin nozzle differs from the conventional configuration by utilizing two closely spaced orifices to substitute each orifice in the conventional nozzle. Injector manufacturers regard twin nozzle injectors as a promising approach to facilitate stable spray patterns independent of t...

  12. Detailed Measurement of ORSC Main Chamber Injector Dynamics

    Science.gov (United States)

    Bedard, Michael J.

    Improving fidelity in simulation of combustion dynamics in rocket combustors requires an increase in experimental measurement fidelity for validation. In a model rocket combustor, a chemiluminescence based spectroscopy technique was used to capture flame light emissions for direct comparison to a computational simulation of the production of chemiluminescent species. The comparison indicated that high fidelity models of rocket combustors can predict spatio-temporal distribution of chemiluminescent species with trend-wise accuracy. The comparison also indicated the limited ability of OH* and CH* emission to indicate flame heat release. Based on initial spectroscopy experiments, a photomultiplier based chemiluminescence sensor was designed to increase the temporal resolution of flame emission measurements. To apply developed methodologies, an experiment was designed to investigate the flow and combustion dynamics associated with main chamber injector elements typical of the RD-170 rocket engine. A unique feature of the RD-170 injector element is the beveled expansion between the injector recess and combustion chamber. To investigate effects of this geometry, a scaling methodology was applied to increase the physical scale of a single injector element while maintaining traceability to the RD-170 design. Two injector configurations were tested, one including a beveled injector face and the other a flat injector face. This design enabled improved spatial resolution of pressure and light emission measurements densely arranged in the injector recess and near-injector region of the chamber. Experimental boundary conditions were designed to closely replicate boundary conditions in simulations. Experimental results showed that the beveled injector face had a damping effect on pressure fluctuations occurring near the longitudinal resonant acoustic modes of the chamber, implying a mechanism for improved overall combustion stability. Near the injector, the beveled geometry

  13. Efficacy of Ketamine in Pediatric Sedation Dentistry: A Systematic Review.

    Science.gov (United States)

    Oh, Samuel; Kingsley, Karl

    2018-05-01

    Ketamine has been used as a safe and effective sedative to treat adults and children exhibiting high levels of anxiety or fear during dental treatment. Pediatric dentistry often involves patients with high levels of anxiety and fear and possibly few positive dental experiences. Patient management can involve behavioral approaches, as well as the use of sedation or general anesthesia with a variety of agents, including midazolam, diazepam, hydroxyzine, meperidine, and ketamine. The aim of this study was to investigate the clinical efficacy of ketamine use in pediatric sedation dentistry through systematic review and analysis. A systematic review of publications between 1990 and 2015 was conducted using PubMed and MEDLINE databases maintained by the US National Library of Medicine and the National Institutes of Health. The keywords used were (ketamine) AND (dental OR dentistry) AND (sedation). The abstract and title of all potential publications were then screened for clinical trials and to remove non-English articles, non-human or animal trials, and other non-dental or non-relevant studies. A total of 1,657 citations were initially identified, reviewed, and screened, eventually resulting in inclusion of 25 clinical trials in this systematic review. Nineteen studies evaluated ketamine effects in pediatric dental sedation using oral (non-invasive) administration, three involved subcutaneous or intramuscular injection, and three were completed intravenously. Evidence analysis of these trials revealed the majority (n = 22/25) provided strong, positive evidence for the use of ketamine (alone or in combination) to reduce dental anxiety and behavioral non-compliance with the remainder suggesting equivocal results. Additional endpoints evaluated in some studies involved dosage, as well as time to achieve sedation effect. The use of ketamine (alone or in combination) can provide safe, effective, and timely sedation in pediatric patients regardless of the route of

  14. Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Brian M. Radvansky

    2015-01-01

    Full Text Available Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural that ketamine is best suited for.

  15. Pellet injector development and experiments at ORNL

    International Nuclear Information System (INIS)

    Baylor, L.R.; Argo, B.E.; Barber, G.C.; Combs, S.K.; Cole, M.J.; Dyer, G.R.; Fehling, D.T.; Fisher, P.W.; Foster, C.A.; Foust, C.R.; Gouge, M.J.; Jernigan, T.C.; Langley, R.A.; Milora, S.L.; Qualls, A.L.; Schechter, D.E.; Sparks, D.O.; Tsai, C.C.; Wilgen, J.B.; Whealton, J.H.

    1993-01-01

    The development of pellet injectors for plasma fueling of magnetic confinement fusion experiments has been under way at Oak Ridge National Laboratory (ORNL) for the past 15 years. Recently, ORNL provided a tritium-compatible four-shot pneumatic injector for the Tokamak Fusion Test Reactor (TFTR) based on the in situ condensation technique that features three single-stage gas guns and an advanced two-stage light gas gun driver. In another application, ORNL supplied the Tore Supra tokamak with a centrifuge pellet injector in 1989 for pellet fueling experiments that has achieved record numbers of injected pellets into a discharge. Work is progressing on an upgrade to that injector to extend the number of pellets to 400 and improve pellet repeatability. In a new application, the ORNL three barrel repeating pneumatic injector has been returned from JET and is being readied for installation on the DIII-D device for fueling and enhanced plasma performance experiments. In addition to these experimental applications, ORNL is developing advanced injector technologies, including high-velocity pellet injectors, tritium pellet injectors, and long-pulse feed systems. The two-stage light gas gun and electron-beam-driven rocket are the acceleration techniques under investigation for achieving high velocity. A tritium proof-of-principle (TPOP) experiment has demonstrated the feasibility of tritium pellet production and acceleration. A new tritium-compatible, extruder-based, repeating pneumatic injector is being fabricated to replace the pipe gun in the TPOP experiment and will explore issues related to the extrudability of tritium and acceleration of large tritium pellets. The tritium pellet formation experiments and development of long-pulse pellet feed systems are especially relevant to the International Tokamak Engineering Reactor (ITER)

  16. Ketamine and the metabolite norketamine: persistence and phototransformation toxicity in hospital wastewater and surface water.

    Science.gov (United States)

    Lin, Angela Yu-Chen; Lee, Wan-Ning; Wang, Xiao-Huan

    2014-04-15

    Ketamine has been increasingly used both recreationally and medicinally around the world. Although the metabolic pathways to form its metabolite norketamine have been carefully investigated in humans and animals, knowledge of their environmental occurrence and fate is limited. In this study, we investigated the occurrence of ketamine and norketamine in 20 natural bodies of water, effluents from 13 hospitals, two wastewater treatment plants and one water supply plant. Ketamine was found at concentrations as high as 10 μg/L. Ketamine and norketamine were consistently found in similar concentrations (ketamine/norketamine ratio: 0.3-4.6) in the collected water samples, and this ratio similar to that found in urine samples. Dark incubation experiments have shown that ketamine is not susceptible to microbial degradation or hydrolysis. Phototransformation was demonstrated to significantly reduce the concentration of ketamine and norketamine in river waters (t(1/2) = 12.6 ± 0.4 and 10.1 ± 0.4 h, respectively) and resulted in byproducts that are similar to human metabolites. Both direct and indirect photolysis led to the N-demethylation of ketamine to form norketamine and other byproducts, including hydroxy-norketamine (HNK), dehydronorketamine (DNK), hydroxy-ketamine (HK) and isomer forms of ketamine and norketamine. Irradiated solutions exhibited higher toxicity (via the Microtox test). Although a final risk assessment could not be made due to a lack of studies on the chronic effects on aquatic organisms, the high and persistent environmental occurrences of ketamine and norketamine as well as the increasingly acute toxicity of the photo byproducts demonstrate the importance of including metabolites in evaluation of the overall risk of ketamine. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Ecotoxicological effect of ketamine: Evidence of acute, chronic and photolysis toxicity to Daphnia magna.

    Science.gov (United States)

    Li, Shih-Wei; Wang, Yu-Hsiang; Lin, Angela Yu-Chen

    2017-09-01

    Ketamine has been increasingly used in medicine and has the potential for abuse or illicit use around the world. Ketamine cannot be removed by conventional wastewater treatment plants. Although ketamine and its metabolite norketamine have been detected to a significant degree in effluents and aquatic environments, their ecotoxicity effects in aquatic organisms remain undefined. In this study, we investigated the acute toxicity of ketamine and its metabolite, along with the chronic reproductive toxicity of ketamine (5-100μg/L) to Daphnia magna. Multiple environmental scenarios were also evaluated, including drug mixtures and sunlight irradiation toxicity. Ketamine and norketamine caused acute toxicity to D. magna, with half lethal concentration (LC 50 ) values of 30.93 and 25.35mg/L, respectively, after 48h of exposure. Irradiated solutions of ketamine (20mg/L) significantly increased the mortality of D. magna; pre-irradiation durations up to 2h rapidly increased the death rate to 100%. A new photolysis byproduct (M.W. 241) of norketamine that accumulates during irradiation was identified for the first time. The relevant environmental concentration of ketamine produced significant reproductive toxicity effects in D. magna, as revealed by the reduction of the number of total live offspring by 33.6-49.8% (p ketamine concentration cannot be ignored and warrant further examination. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Intravenous S-Ketamine Does Not Inhibit Alveolar Fluid Clearance in a Septic Rat Model

    Science.gov (United States)

    Weber, Nina C.; van der Sluijs, Koen; Hackl, Florian; Hotz, Lorenz; Dahan, Albert; Hollmann, Markus W.; Berger, Marc M.

    2014-01-01

    We previously demonstrated that intratracheally administered S-ketamine inhibits alveolar fluid clearance (AFC), whereas an intravenous (IV) bolus injection had no effect. The aim of the present study was to characterize whether continuous IV infusion of S-ketamine, yielding clinically relevant plasma concentrations, inhibits AFC and whether its effect is enhanced in acute lung injury (ALI) which might favor the appearance of IV S-ketamine at the alveolar surface. AFC was measured in fluid-instilled rat lungs. S-ketamine was administered IV over 6 h (loading dose: 20 mg/kg, followed by 20 mg/kg/h), or intratracheally by addition to the instillate (75 µg/ml). ALI was induced by IV lipopolysaccharide (LPS; 7 mg/kg). Interleukin (IL)-6 and cytokine-induced neutrophil chemoattractant (CINC)-3 were measured by ELISA in plasma and bronchoalveolar lavage fluid. Isolated rat alveolar type-II cells were exposed to S-ketamine (75 µg/ml) and/or LPS (1 mg/ml) for 6 h, and transepithelial ion transport was measured as short circuit current (ISC). AFC was 27±5% (mean±SD) over 60 min in control rats and was unaffected by IV S-ketamine. Tracheal S-ketamine reduced AFC to 18±9%. In LPS-treated rats, AFC decreased to 16±6%. This effect was not enhanced by IV S-ketamine. LPS increased IL-6 and CINC-3 in plasma and bronchoalveolar lavage fluid. In alveolar type-II cells, S-ketamine reduced ISC by 37% via a decrease in amiloride-inhibitable sodium transport. Continuous administration of IV S-ketamine does not affect rat AFC even in endotoxin-induced ALI. Tracheal application with direct exposure of alveolar epithelial cells to S-ketamine decreases AFC by inhibition of amiloride-inhibitable sodium transport. PMID:25386677

  19. COMPARISON OF THREE SHORT-TERM IMMOBILIZATION REGIMES IN WILD VERREAUX'S SIFAKAS (PROPITHECUS VERREAUXI): KETAMINE-XYLAZINE, KETAMINE-XYLAZINE-ATROPINE, AND TILETAMINE-ZOLAZEPAM.

    Science.gov (United States)

    Springer, Andrea; Razafimanantsoa, Léonard; Fichtel, Claudia; Kappeler, Peter M

    2015-09-01

    Although research on lemurid primates in Madagascar has been ongoing for several decades, reports on different drug regimes to immobilize wild lemurs are limited. This study compares the efficacy, reliability, and side effects of ketamine-xylazine, ketamine-xylazine-atropine, and tiletamine-zolazepam immobilization in wild Verreaux's sifakas (Propithecus verreauxi). In the course of a long-term study in Kirindy Forest, western Madagascar, eight animals each received a mixture of ketamine (5.32±1.71 mg/kg) and xylazine (0.56±0.19 mg/kg) (KX; 7 males, 1 female) and ketamine (6.58±1.36 mg/kg), xylazine (1.28±0.28 mg/kg), and atropine (0.013±0.003 mg/kg) (KXA; 5 males, 3 females), respectively, and 14 individuals received tiletamine-zolazepam (7.73±1.37 mg/kg) (TZ; 9 males, 5 females). Induction was smooth in all protocols, but showed considerable variation in duration when animals had received KXA. Immobilization as well as recovery lasted significantly longer with TZ than with KX (Pimmobilized with TZ. Heart rate measurement at 10 min after onset of complete immobilization yielded significantly higher values if the animals had been immobilized with TZ compared to KX (Pimmobilized animals, whereas immobilization with TZ resulted in an increase in heart rate. The results suggest that KX produces good, but short, immobilization in Verreaux's sifakas at approximately 5 mg/kg ketamine and 0.5 mg/kg xylazine and a smoother and shorter recovery phase than 5 to 10 mg/kg TZ, whereas adding atropine to KX did not provide any benefits.

  20. FERMILAB: Main Injector

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1993-06-15

    The Fermilab Main Injector (FMI) project is the centerpiece of the Laboratory's Fermilab III programme for the 1990s. Designed to support a luminosity of at least 5x10{sup 31} cm{sup -2} s{sup -1} in the Tevatron collider, it will also provide new capabilities for rare neutral kaon decay and neutrino oscillation studies. The Fermilab Main Injector 8-150 GeV synchrotron is designed to replace the existing Main Ring which seriously limits beam intensities for the Tevatron and the antiproton production target. The project has passed several significant milestones and is now proceeding rapidly towards construction. The project received a $11.65M appropriation in 1992 and has been given $15M for the current fiscal year. Through the Energy Systems Acquisition Advisory Board (ESAAB) process, the US Department of Energy (DoE) has authorized funds for construction of the underground enclosure and service building where the Main Injector will touch the Tevatron, and to the preparation of bids for remaining project construction.

  1. Paliperidone for the treatment of ketamine-induced psychosis: a case report.

    Science.gov (United States)

    Zuccoli, M L; Muscella, A; Fucile, C; Carrozzino, R; Mattioli, F; Martelli, A; Orengo, S

    2014-01-01

    Ketamine is an anaesthetic and analgesic drug synthesized in the 1960s from phencyclidine. The recreational use of ketamine increased among the dance culture of techno and house music, in particular in clubs, discotheques, and rave parties. The psychotropic effects of ketamine are now well known and they range from dissociation to positive, negative, and cognitive schizophrenia-like symptoms. We report a case of a chronic oral consumption of ketamine which induced agitation, behavioral abnormalities, and loss of contact with reality in a poly-drug abuser; these symptoms persisted more than two weeks after the drug consumption had stopped. Antipsychotic treatment with paliperidone led to a successful management of the psychosis, getting a complete resolution of the clinical picture. Paliperidone has proven to be very effective in the treatment of ketamine-induced disorders. Moreover, the pharmacological action and metabolism of paliperidone are poorly dependent from the activity of liver enzymes, so that it seems to be one of the best second generation antipsychotics for the treatment of smokers and alcohol abusers.

  2. KETAMINE ABREACTION : A NEW APPROACH TO NARCOANALYSIS

    OpenAIRE

    Golechha, G.R.; Sethi, I.C.; Misra, S.L.; Jayaprakash, N.P.

    1986-01-01

    SUMMARY Ketamine is a parenterally administered non barbiturate anaesthetic agent, in use for more than a decade. It is a safer than Na Pentothal. Administered intramuscularly, in dose of 6 to 15 mgm/Kg body wt. it produces dissociative anaesthesia. But, in smaller sub anaesthetic doses it may act as an abreactant. We report in this study the abreaction effect of Ketamine in dose of .5 to 1.5 mgm/kg body wt. given intramuscularly in 30 selected psychiatric cases requiring narcoanalysis for di...

  3. Long-term heavy ketamine use is associated with spatial memory impairment and altered hippocampal activation

    Directory of Open Access Journals (Sweden)

    Celia J A Morgan

    2014-12-01

    Full Text Available Ketamine, a non-competitive N-methyl-D-aspartate receptor antagonist, is rising in popularity as a drug of abuse. Preliminary evidence suggests that chronic, heavy ketamine use may have profound effects on spatial memory but the mechanism of these deficits is as yet unclear. This study aimed to examine the neural mechanism by which heavy ketamine use impairs spatial memory processing. In a sample of 11 frequent ketamine users and 15 polydrug controls, matched for IQ, age and years in education. We used fMRI utilising an ROI approach to examine the neural activity of three regions known to support successful navigation; the hippocampus, parahippocampal gyrus and the caudate nucleus during a virtual reality task of spatial memory. Frequent ketamine users displayed spatial memory deficits, accompanied by and related to, reduced activation in both the right hippocampus and left parahippocampal gyrus during navigation from memory, and in the left caudate during memory updating, compared to controls. Ketamine users also exhibited schizotypal and dissociative symptoms that were related to hippocampal activation. Impairments in spatial memory observed in ketamine users are related to changes in medial temporal lobe activation. Disrupted medial temporal lobe function may be a consequence of chronic ketamine abuse and may relate to schizophrenia-like symptomatology observed in ketamine users.

  4. Adverse Events During a Randomized Trial of Ketamine Versus Co-Administration of Ketamine and Propofol for Procedural Sedation in a Pediatric Emergency Department.

    Science.gov (United States)

    Weisz, Keith; Bajaj, Lalit; Deakyne, Sara J; Brou, Lina; Brent, Alison; Wathen, Joseph; Roosevelt, Genie E

    2017-07-01

    The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). This was a prospective, randomized, single-blinded, controlled trial of KM vs. CoKP in patients between 3 and 21 years of age. The attending physician administered either ketamine 1 mg/kg i.v. or ketamine 0.5 mg/kg and propofol 0.5 mg/kg i.v. The physician could administer up to three additional doses of ketamine (0.5 mg/kg/dose) or ketamine/propofol (0.25 mg/kg/dose of each). Adverse events (e.g., respiratory events, cardiovascular events, unpleasant emergence reactions) were recorded. Secondary outcomes included efficacy, recovery time, and satisfaction scores. Ninety-six patients were randomized to KM and 87 patients were randomized to CoKP. There was no difference in adverse events or type of adverse event, except nausea was more common in the KM group. Efficacy of PSA was higher in the KM group (99%) compared to the CoKP group (90%). Median recovery time was the same. Satisfaction scores by providers, including nurses, were higher for KM, although parents were equally satisfied with both sedation regimens. We found no significant differences in adverse events between the KM and CoKP groups. While CoKP is a reasonable choice for pediatric PSA, our study did not demonstrate an advantage of this combination over KM. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. NMDAR inhibition-independent antidepressant actions of ketamine metabolites

    Science.gov (United States)

    Zanos, Panos; Moaddel, Ruin; Morris, Patrick J.; Georgiou, Polymnia; Fischell, Jonathan; Elmer, Greg I.; Alkondon, Manickavasagom; Yuan, Peixiong; Pribut, Heather J.; Singh, Nagendra S.; Dossou, Katina S.S.; Fang, Yuhong; Huang, Xi-Ping; Mayo, Cheryl L.; Wainer, Irving W.; Albuquerque, Edson X.; Thompson, Scott M.; Thomas, Craig J.; Zarate, Carlos A.; Gould, Todd D.

    2016-01-01

    Major depressive disorder afflicts ~16 percent of the world population at some point in their lives. Despite a number of available monoaminergic-based antidepressants, most patients require many weeks, if not months, to respond to these treatments, and many patients never attain sustained remission of their symptoms. The non-competitive glutamatergic N-methyl-D-aspartate receptor (NMDAR) antagonist, (R,S)-ketamine (ketamine), exerts rapid and sustained antidepressant effects following a single dose in depressed patients. Here we show that the metabolism of ketamine to (2S,6S;2R,6R)-hydroxynorketamine (HNK) is essential for its antidepressant effects, and that the (2R,6R)-HNK enantiomer exerts behavioural, electroencephalographic, electrophysiological and cellular antidepressant actions in vivo. Notably, we demonstrate that these antidepressant actions are NMDAR inhibition-independent but they involve early and sustained α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor activation. We also establish that (2R,6R)-HNK lacks ketamine-related side-effects. Our results indicate a novel mechanism underlying ketamine’s unique antidepressant properties, which involves the required activity of a distinct metabolite and is independent of NMDAR inhibition. These findings have relevance for the development of next generation, rapid-acting antidepressants. PMID:27144355

  6. Depression in chronic ketamine users: Sex differences and neural bases.

    Science.gov (United States)

    Li, Chiang-Shan R; Zhang, Sheng; Hung, Chia-Chun; Chen, Chun-Ming; Duann, Jeng-Ren; Lin, Ching-Po; Lee, Tony Szu-Hsien

    2017-11-30

    Chronic ketamine use leads to cognitive and affective deficits including depression. Here, we examined sex differences and neural bases of depression in chronic ketamine users. Compared to non-drug using healthy controls (HC), ketamine-using females but not males showed increased depression score as assessed by the Center of Epidemiological Studies Depression Scale (CES-D). We evaluated resting state functional connectivity (rsFC) of the subgenual anterior cingulate cortex (sgACC), a prefrontal structure consistently implicated in the pathogenesis of depression. Compared to HC, ketamine users (KU) did not demonstrate significant changes in sgACC connectivities at a corrected threshold. However, in KU, a linear regression against CES-D score showed less sgACC connectivity to the orbitofrontal cortex (OFC) with increasing depression severity. Examined separately, male and female KU showed higher sgACC connectivity to bilateral superior temporal gyrus and dorsomedial prefrontal cortex (dmPFC), respectively, in correlation with depression. The linear correlation of sgACC-OFC and sgACC-dmPFC connectivity with depression was significantly different in slope between KU and HC. These findings highlighted changes in rsFC of the sgACC as associated with depression and sex differences in these changes in chronic ketamine users. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Status of the positive-ion injector for ATLAS

    International Nuclear Information System (INIS)

    Bollinger, L.M.; Pardo, R.C.; Shepard, K.W.

    1986-01-01

    The planned positive-ion injector for ATLAS consists of an ECR ion source on a 350-kV platfrom and a superconducting injector linac of a new kind. The objective is to replace the present tandem injector with a system that can increase beam intensities by two orders of magnitude and extend the mass range up to uranium. In the first, developmental stage of the work, now in progress, the ECR source will be built, the technology of superconducting accelerating structures for low-velocity ions will be developed, and these structures will be used to form a 3-MV prototype injector linac. Even this small system, designed for ions with A < 130, will be superior to the present FN tandem as a heavy-ion injector. In later phases of the work, the injector linac will be enlarged enough to allow ATLAS to effectively accelerate uranium ions. The injector system is expected to provide exceptional beam quality. The status of the work, expected performance of the accelerator system, and the technical issues involved are summarized

  8. Sympathetic activity of S-(+-ketamine low doses in the epidural space

    Directory of Open Access Journals (Sweden)

    Slobodan Mihaljevic

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: S-(+-ketamine is an intravenous anaesthetic and sympathomimetic with properties of local anaesthetic. It has an effect of an analgetic and local anaesthetic when administered epidurally, but there are no data whether low doses of S-(+-ketamine have sympathomimetic effects. The aim of this study was to determine whether low doses of S-(+-ketamine, given epidurally together with local anaesthetic, have any effect on sympathetic nervous system, both systemic and below the level of anaesthetic block. METHODS: The study was conducted on two groups of patients to whom epidural anaesthesia was administered to. Local anaesthesia (0.5% bupivacaine was given to one group (control group while local anaesthesia and S-(+-ketamine were given to other group. Age, height, weight, systolic, diastolic and mean arterial blood pressure were measured. Non-competitive enzyme immunochemistry method (Cat Combi ELISA was used to determine the concentrations of catecholamines (adrenaline and noradrenaline. Immunoenzymometric determination with luminescent substrate on a machine called Vitros Eci was used to determine the concentration of cortisol. Pulse transit time was measured using photoplethysmography. Mann-Whitney U-test, Wilcoxon test and Friedman ANOVA were the statistical tests. Blood pressure, pulse, adrenaline, noradrenaline and cortisol concentrations were measured in order to estimate systemic sympathetic effects. RESULTS: 40 patients in the control group were given 0.5% bupivacaine and 40 patients in the test group were given 0.5% bupivacaine with S-(+-ketamine. Value p < 0.05 has been taken as a limit of statistical significance. CONCLUSIONS: Low dose of S-(+-ketamine administered epidurally had no sympathomimetic effects; it did not change blood pressure, pulse, serum hormones or pulse transit time. Low dose of S-(+-ketamine administered epidurally did not deepen sympathetic block. Adding 25 mg of S-(+-ketamine to 0

  9. Ion Sources and Injectors for HIF Induction Linacs

    International Nuclear Information System (INIS)

    Kwan, J.W.; Ahle, L.; Beck, D.N.; Bieniosek, F. M.; Faltens, A.; Grote, D.P.; Halaxa, E.; Henestroza, E.; Herrmannsfeldt, W.B.; Karpenko, V.; Sangster, T.C.

    2000-01-01

    Ion source and injector development is one of the major parts of the HIF program in the USA. Our challenge is to design a cost effective driver-scale injector and to build a multiple beam module within the next couple of years. In this paper, several current-voltage scaling laws are summarized for guiding the injector design. Following the traditional way of building injectors for HIF induction linac, we have produced a preliminary design for a multiple beam driver-scale injector. We also developed an alternate option for a high current density injector that is much smaller in size. One of the changes following this new option is the possibility of using other kinds of ion sources than the surface ionization sources. So far, we are still looking for an ideal ion source candidate that can readily meet all the essential requirements

  10. Morphological and behavioral responses of zebrafish after 24 h of ketamine embryonic exposure

    Energy Technology Data Exchange (ETDEWEB)

    Félix, Luís M., E-mail: lfelix@utad.pt [Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real (Portugal); Institute for Research and Innovation in Health (i3S), University of Porto (UP), Porto (Portugal); Laboratory Animal Science (LAS), Institute for Molecular and Cell Biology (IBMC), University of Porto - UP, Porto (Portugal); Serafim, Cindy; Martins, Maria J. [Life Sciences and Environment School (ECVA), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real (Portugal); Valentim, Ana M. [Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real (Portugal); Institute for Research and Innovation in Health (i3S), University of Porto (UP), Porto (Portugal); Laboratory Animal Science (LAS), Institute for Molecular and Cell Biology (IBMC), University of Porto - UP, Porto (Portugal); Antunes, Luís M. [Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real (Portugal); Institute for Research and Innovation in Health (i3S), University of Porto (UP), Porto (Portugal); Laboratory Animal Science (LAS), Institute for Molecular and Cell Biology (IBMC), University of Porto - UP, Porto (Portugal); School of Agrarian and Veterinary Sciences (ECAV), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real (Portugal); and others

    2017-04-15

    Ketamine, one anesthetic used as an illicit drug, has been detected both in freshwater and marine ecosystems. However, knowledge of its impact on aquatic life is still limited. This study aimed to test its effects in zebrafish embryos by analyzing its time- and dose-dependent developmental toxicity and long-term behavioral changes. The 24 h-LC{sub 50} was calculated from percent survival using probit analysis. Based on the 24 h-LC{sub 50} (94.4 mg L{sup −1}), embryos (2 hour post-fertilization - hpf) were divided into four groups, including control, and exposed for 24 h to ketamine concentrations of 50, 70 or 90 mg L{sup −1}. Developmental parameters were evaluated on the course of the experimental period, and anatomical abnormalities and locomotor deficits were analyzed at 144 hpf. Although the portion of ketamine transferred into the embryo was higher in the lowest exposed group (about 0.056 ± 0.020 pmol per embryo), the results showed that endpoints such as increased mortality, edema, heart rate alterations, malformation and abnormal growth rates were significantly affected. At 144 hpf, the developmental abnormalities included thoracic and trunk abnormalities in the groups exposed to 70 and 90 mg L{sup −1}. Defects in cartilage (alcian blue) and bone (calcein) elements also corroborated the craniofacial anomalies observed. A significant up-regulation of the development-related gene nog3 was detected by qRT-PCR at 8 hpf. Early exposure to ketamine also resulted in long-term behavioral changes, such as an increase in thigmotaxis and disruption of avoidance behavior at 144 hpf. Altogether, this study provides new evidence on the ketamine teratogenic potential, indicating a possible pharmacological impact of ketamine in aquatic environments. - Highlights: • 24 h exposure to ketamine increases mortality. • Morphological changes were observed after exposure. • Exposure to ketamine leads to severe craniofacial anomalies. • Developmental gene expression

  11. Morphological and behavioral responses of zebrafish after 24 h of ketamine embryonic exposure

    International Nuclear Information System (INIS)

    Félix, Luís M.; Serafim, Cindy; Martins, Maria J.; Valentim, Ana M.; Antunes, Luís M.

    2017-01-01

    Ketamine, one anesthetic used as an illicit drug, has been detected both in freshwater and marine ecosystems. However, knowledge of its impact on aquatic life is still limited. This study aimed to test its effects in zebrafish embryos by analyzing its time- and dose-dependent developmental toxicity and long-term behavioral changes. The 24 h-LC 50 was calculated from percent survival using probit analysis. Based on the 24 h-LC 50 (94.4 mg L −1 ), embryos (2 hour post-fertilization - hpf) were divided into four groups, including control, and exposed for 24 h to ketamine concentrations of 50, 70 or 90 mg L −1 . Developmental parameters were evaluated on the course of the experimental period, and anatomical abnormalities and locomotor deficits were analyzed at 144 hpf. Although the portion of ketamine transferred into the embryo was higher in the lowest exposed group (about 0.056 ± 0.020 pmol per embryo), the results showed that endpoints such as increased mortality, edema, heart rate alterations, malformation and abnormal growth rates were significantly affected. At 144 hpf, the developmental abnormalities included thoracic and trunk abnormalities in the groups exposed to 70 and 90 mg L −1 . Defects in cartilage (alcian blue) and bone (calcein) elements also corroborated the craniofacial anomalies observed. A significant up-regulation of the development-related gene nog3 was detected by qRT-PCR at 8 hpf. Early exposure to ketamine also resulted in long-term behavioral changes, such as an increase in thigmotaxis and disruption of avoidance behavior at 144 hpf. Altogether, this study provides new evidence on the ketamine teratogenic potential, indicating a possible pharmacological impact of ketamine in aquatic environments. - Highlights: • 24 h exposure to ketamine increases mortality. • Morphological changes were observed after exposure. • Exposure to ketamine leads to severe craniofacial anomalies. • Developmental gene expression changes in response to

  12. Effects caused by the spinal administration of ketamine S (+) 5% with no preservatives, using a single puncture, and located on the spinal cord and meninges in rabbits.

    Science.gov (United States)

    Lima Filho, José Admirço; Fin, Natalia Castro; Valerini, Felipe Gilberto; Machado, Vania Maria; Marques, Mariangela Ester; Miot, Hélio; Lima, Lais Helena Navarro E; Ganen, Eliana Marisa

    2014-07-01

    To evaluate the effect of ketamine S (+) 5% with no preservatives and administered as a subarachnoid single puncture on the spinal cord and meninges of rabbits. Twenty young adult female rabbits, each weighing 3500-5000 g and having a spine length between 34 and 38 cm, were divided by lot into two groups (G): 0.9% saline in G1 and ketamine S (+) 5% in G2, by volume of 5 μg per cm column (0.18 mL). After intravenous anaesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance, and a random solution was injected. The animals remained in captivity for 21 days under medical observation and were sacrificed by decapitation. The lumbosacral spinal cord portion was removed for immunohistochemistry to assess the glial fibrillary acidic protein (GFAP), and histology was assessed using hematoxylin and eosin (HE) stain. No histological lesions were found in the nervous tissue (roots and cord) or meninges in either group. The ketamine S (+) 5% unpreserved triggered no neurological or histological lesions in the spinal cord or meninges of rabbits.

  13. Inhibition of a Descending Prefrontal Circuit Prevents Ketamine-Induced Stress Resilience in Females

    DEFF Research Database (Denmark)

    Dolzani, S. D.; Baratta, M. V.; Moss, J. M.

    2018-01-01

    . The NMDA receptor antagonist ketamine has recently emerged as a prophylactic capable of preventing neurochemical and behavioral outcomes of a future stressor. Despite promising results of preclinical studies performed in male rats, the effects of proactive ketamine in female rats remains unknown....... This is alarming given that stress-related disorders affect females at nearly twice the rate of males. Here we explore the prophylactic effects of ketamine on stress-induced anxiety-like behavior and the neural circuit-level processes that mediate these effects in female rats. Ketamine given one week prior...... to an uncontrollable stressor (inescapable tailshock; IS) reduced typical stress-induced activation of the serotonergic (5-HT) dorsal raphe nucleus (DRN) and eliminated DRN-dependent juvenile social exploration (JSE) deficits 24 h after the stressor. Proactive ketamine altered prelimbic cortex (PL) neural ensembles so...

  14. Effects of Nicotine on the Neurophysiological and Behavioral Effects of Ketamine in Humans

    Directory of Open Access Journals (Sweden)

    Daniel H Mathalon

    2014-01-01

    Full Text Available Background: N-methyl-D-aspartate (NMDA receptor hypofunction has been implicated in the pathophysiology of schizophrenia and its associated neurocognitive impairments. The high rate of cigarette smoking in schizophrenia raises questions about how nicotine modulates putative NMDA receptor hypofunction in the illness. Accordingly, we examined the modulatory effects of brain nicotinic acetylcholine receptor (nAChR stimulation on NMDA receptor hypofunction by examining the interactive effects of nicotine, a nAChR agonist, and ketamine, a noncompetitive NMDA receptor antagonist, on behavioral and neurophysiological measures in healthy human volunteers.Methods: From an initial sample of 17 subjects (age range 18 - 55 years, 8 subjects successfully completed 4 test sessions, each separated by at least 3 days, during which they received ketamine or placebo and two injections of nicotine or placebo in a double-blind, counterbalanced manner. Schizophrenia-like effects (PANSS, perceptual alterations (CADSS, subjective effects (VAS and auditory event-related brain potentials (mismatch negativity, P300 were assessed during each test session.Results: Consistent with existing studies, ketamine induced transient schizophrenia-like behavioral effects. P300 was reduced and delayed by ketamine regardless of whether it was elicited by a target or novel stimulus, while nicotine only reduced the amplitude of P3a. Nicotine did not rescue P300 from the effects of ketamine; the interactions of ketamine and nicotine were not significant. While nicotine significantly reduced MMN amplitude, ketamine did not. Conclusion: Nicotine failed to modulate ketamine-induced schizophrenia-like effects in this preliminary study. Interestingly, ketamine reduced P3b amplitude and nicotine reduced P3a amplitude, suggesting independent roles of NMDA receptor and nAChR in the generation of P3b and P3a, respectively.

  15. IV paracetamol effect on propofol-ketamine consumption in paediatric patients undergoing ESWL.

    Science.gov (United States)

    Eker, H Evren; Cok, Oya Yalçin; Ergenoğlu, Pınar; Ariboğan, Anış; Arslan, Gülnaz

    2012-06-01

    Electroshock wave lithotripsy (ESWL) is a painful procedure performed with sedoanalgesia in paediatric patients. The propofol-ketamine combination may be the preferable anaesthesia for this procedure, and propofol-ketamine consumption may be decreased with the administration of intravenous (IV) paracetamol. In this study we investigated the effect of IV paracetamol administration on propofol-ketamine consumption, recovery time and frequency of adverse events in paediatric patients undergoing ESWL. Sixty children, ranging in age from 1 to 10 years and with American Society of Anesthesiologists Physical Status 1-2, were included in this prospective, randomized, double-blinded study. Thirty minutes prior to the procedure children randomly assigned to Group I received IV 15 mg/kg paracetamol, and those randomly assigned to Group II received 1.5 mL/kg IV saline infusion 30 min. The propofol-ketamine combination was prepared by mixing 25 mg propofol and 25 mg ketamine in a total 10 mL solution in the same syringe. After the administration of 0.1 mg/kg midazolam and 10 μg/kg atropine to both groups and during the procedure, the propofol-ketamine combination was administered at 0.5 mg/kg doses to achieve a Wisconsin sedation score of 1 or 2. Oxygen saturation and heart rate were recorded at 5-min intervals. Propofol-ketamine consumption, recovery times and adverse events were also recorded. Demographic data were similar between groups. Propofol-ketamine consumption (Group I, 25.2 ± 17.7 mg; Group II, 35.4 ± 20.1 mg; p = 0.04) and recovery times (Group I, 19.4 ± 7.9 min; Group II, 29.6 ± 11.4 min; p ESWL procedures in paediatric patients and shortens recovery time.

  16. Deuterium pellet injector gun design

    International Nuclear Information System (INIS)

    Lunsford, R.V.; Wysor, R.B.; Bryan, W.E.; Shipley, W.D.; Combs, S.K.; Foust, C.R.; Milora, S.L.; Fisher, P.W.

    1985-01-01

    The Deuterium Pellet Injector (DPI), an eight-pellet pneumatic injector, is being designed and fabricated for the Tokamak Fusion Test Reactor (TFTR). It will accelerate eight pellets, 4 by 4 mm maximum, to greater than 1500 m/s. It utilizes a unique pellet-forming mechanism, a cooled pellet storage wheel, and improved propellant gas scavenging

  17. Psychiatric side effects of ketamine in hospitalized medical patients administered subanesthetic doses for pain control.

    Science.gov (United States)

    Rasmussen, Keith G

    2014-08-01

    To assess the psychiatric side effects of ketamine when administered in subanesthetic doses to hospitalized patients. It is hypothesized that such effects occur frequently. In this retrospective study, the medical records of 50 patients hospitalized on medical and surgical units at our facility who had continuous intravenous infusions of ketamine for pain or mild sedation were reviewed. Patient progress in the days following the start of ketamine infusion was reviewed and response to ketamine was noted. Twenty-two percent of the patients were noted to have some type of psychiatric reaction to ketamine, including agitation, confusion, and hallucinations. These reactions were relatively short lived, namely, occurring during or shortly after the infusions. No association was found between patient response to ketamine and gender, age, or infusion rate. Awareness of the psychiatric side effects of ketamine is an important consideration for clinicians administering this medication either for pain control or for depressive illness.

  18. Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion

    International Nuclear Information System (INIS)

    Knobloch, M.; Portier, C.J.; Levionnois, O.L.; Theurillat, R.; Thormann, W.; Spadavecchia, C.; Mevissen, M.

    2006-01-01

    Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 μg/ml S-ketamine over 120 min under isoflurane anesthesia was performed in Shetland ponies. A quantitative electromyographic assessment of the NWR was done before, during and after the TCI. Plasma levels of R-/S-ketamine and R-/S-norketamine were determined by enantioselective capillary electrophoresis. These data and two additional data sets from bolus studies were used to build a PBPk model for ketamine in ponies. The peak-to-peak amplitude and the duration of the NWR decreased significantly during TCI and returned slowly toward baseline values after the end of TCI. The PBPk model provides reliable prediction of plasma and tissue levels of R- and S-ketamine and R- and S-norketamine. Furthermore, biotransformation of ketamine takes place in the liver and in the lung via first-pass metabolism. Plasma concentrations of S-norketamine were higher compared to R-norketamine during TCI at all time points. Analysis of the data suggested identical biotransformation rates from the parent compounds to the principle metabolites (R- and S-norketamine) but different downstream metabolism to further metabolites. The PBPk model can provide predictions of R- and S-ketamine and norketamine concentrations in other clinical settings (e.g. horses)

  19. Intravenous Ketamine Infusions for Neuropathic Pain Management: A Promising Therapy in Need of Optimization.

    Science.gov (United States)

    Maher, Dermot P; Chen, Lucy; Mao, Jianren

    2017-02-01

    Intravenous ketamine infusions have been used extensively to treat often-intractable neuropathic pain conditions. Because there are many widely divergent ketamine infusion protocols described in the literature, the variation in these protocols presents a challenge for direct comparison of one protocol with another and in discerning an optimal protocol. Careful examination of the published literature suggests that ketamine infusions can be useful to treat neuropathic pain and that certain characteristics of ketamine infusions may be associated with better clinical outcomes. Increased duration of relief from neuropathic pain is associated with (1) higher total infused doses of ketamine; (2) prolonged infusion durations, although the rate of infusion does not appear to be a factor; and (3) coadministration of adjunct medications such as midazolam and/or clonidine that mitigate some of the unpleasant psychomimetic side effects. However, there are few studies designed to optimize ketamine infusion protocols by defining what an effective infusion protocol entails with regard to a respective neuropathic pain condition. Therefore, despite common clinical practice, the current state of the literature leaves the use of ketamine infusions without meaningful guidance from high-quality comparative evidence. The objectives of this topical review are to (1) analyze the available clinical evidence related to ketamine infusion protocols and (2) call for clinical studies to identify optimal ketamine infusion protocols tailored for individual neuropathic pain conditions. The Oxford Center for Evidence-Based Medicine classification for levels of evidence was used to stratify the grades of clinical recommendation for each infusion variable studied.

  20. Modeling of classical swirl injector dynamics

    Science.gov (United States)

    Ismailov, Maksud M.

    The knowledge of the dynamics of a swirl injector is crucial in designing a stable liquid rocket engine. Since the swirl injector is a complex fluid flow device in itself, not much work has been conducted to describe its dynamics either analytically or by using computational fluid dynamics techniques. Even the experimental observation is limited up to date. Thus far, there exists an analytical linear theory by Bazarov [1], which is based on long-wave disturbances traveling on the free surface of the injector core. This theory does not account for variation of the nozzle reflection coefficient as a function of disturbance frequency, and yields a response function which is strongly dependent on the so called artificial viscosity factor. This causes an uncertainty in designing an injector for the given operational combustion instability frequencies in the rocket engine. In this work, the author has studied alternative techniques to describe the swirl injector response, both analytically and computationally. In the analytical part, by using the linear small perturbation analysis, the entire phenomenon of unsteady flow in swirl injectors is dissected into fundamental components, which are the phenomena of disturbance wave refraction and reflection, and vortex chamber resonance. This reveals the nature of flow instability and the driving factors leading to maximum injector response. In the computational part, by employing the nonlinear boundary element method (BEM), the author sets the boundary conditions such that they closely simulate those in the analytical part. The simulation results then show distinct peak responses at frequencies that are coincident with those resonant frequencies predicted in the analytical part. Moreover, a cold flow test of the injector related to this study also shows a clear growth of instability with its maximum amplitude at the first fundamental frequency predicted both by analytical methods and BEM. It shall be noted however that Bazarov

  1. Spray Modeling for Outwardly-Opening Hollow-Cone Injector

    KAUST Repository

    Sim, Jaeheon

    2016-04-05

    The outwardly-opening piezoelectric injector is gaining popularity as a high efficient spray injector due to its precise control of the spray. However, few modeling studies have been reported on these promising injectors. Furthermore, traditional linear instability sheet atomization (LISA) model was originally developed for pressure swirl hollow-cone injectors with moderate spray angle and toroidal ligament breakups. Therefore, it is not appropriate for the outwardly-opening injectors having wide spray angles and string-like film structures. In this study, a new spray injection modeling was proposed for outwardly-opening hollow-cone injector. The injection velocities are computed from the given mass flow rate and injection pressure instead of ambiguous annular nozzle geometry. The modified Kelvin-Helmholtz and Rayleigh-Taylor (KH-RT) breakup model is used with adjusted initial Sauter mean diameter (SMD) for modeling breakup of string-like structure. Spray injection was modeled using a Lagrangian discrete parcel method within the framework of commercial CFD software CONVERGE, and the new model was implemented through the user-defined functions. A Siemens outwardly-opening hollow-cone spray injector was characterized and validated with existing experimental data at the injection pressure of 100 bar. It was found that the collision modeling becomes important in the current injector because of dense spray near nozzle. The injection distribution model showed insignificant effects on spray due to small initial droplets. It was demonstrated that the new model can predict the liquid penetration length and local SMD with improved accuracy for the injector under study.

  2. Ketamine coadministration attenuates morphine tolerance and leads to increased brain concentrations of both drugs in the rat

    Science.gov (United States)

    Lilius, T O; Jokinen, V; Neuvonen, M S; Niemi, M; Kalso, E A; Rauhala, P V

    2015-01-01

    Background and Purpose The effects of ketamine in attenuating morphine tolerance have been suggested to result from a pharmacodynamic interaction. We studied whether ketamine might increase brain morphine concentrations in acute coadministration, in morphine tolerance and morphine withdrawal. Experimental Approach Morphine minipumps (6 mg·day–1) induced tolerance during 5 days in Sprague–Dawley rats, after which s.c. ketamine (10 mg·kg–1) was administered. Tail flick, hot plate and rotarod tests were used for behavioural testing. Serum levels and whole tissue brain and liver concentrations of morphine, morphine-3-glucuronide, ketamine and norketamine were measured using HPLC-tandem mass spectrometry. Key Results In morphine-naïve rats, ketamine caused no antinociception whereas in morphine-tolerant rats there was significant antinociception (57% maximum possible effect in the tail flick test 90 min after administration) lasting up to 150 min. In the brain of morphine-tolerant ketamine-treated rats, the morphine, ketamine and norketamine concentrations were 2.1-, 1.4- and 3.4-fold, respectively, compared with the rats treated with morphine or ketamine only. In the liver of morphine-tolerant ketamine-treated rats, ketamine concentration was sixfold compared with morphine-naïve rats. After a 2 day morphine withdrawal period, smaller but parallel concentration changes were observed. In acute coadministration, ketamine increased the brain morphine concentration by 20%, but no increase in ketamine concentrations or increased antinociception was observed. Conclusions and Implications The ability of ketamine to induce antinociception in rats made tolerant to morphine may also be due to increased brain concentrations of morphine, ketamine and norketamine. The relevance of these findings needs to be assessed in humans. PMID:25297798

  3. Pellet injectors for steady state plasma fuelling

    International Nuclear Information System (INIS)

    Vinyar, I.; Geraud, A.; Yamada, H.; Lukin, A.; Sakamoto, R.; Skoblikov, S.; Umov, A.; Oda, Y.; Gros, G.; Krasilnikov, I.; Reznichenko, P.; Panchenko, V.

    2005-01-01

    Successful steady state operation of a fusion reactor should be supported by repetitive pellet injection of solidified hydrogen isotopes in order to produce high performance plasmas. This paper presents pneumatic pellet injectors and its implementation for long discharge on the LHD and TORE SUPRA, and a new centrifuge pellet injector test results. All injectors are fitted with screw extruders well suited for steady state operation

  4. Ketamine analgesia for inflammatory pain in neonatal rats: a factorial randomized trial examining long-term effects

    Directory of Open Access Journals (Sweden)

    Bhutta Adnan T

    2008-08-01

    Full Text Available Abstract Background Neonatal rats exposed to repetitive inflammatory pain have altered behaviors in young adulthood, partly ameliorated by Ketamine analgesia. We examined the relationships between protein expression, neuronal survival and plasticity in the neonatal rat brain, and correlated these changes with adult cognitive behavior. Methods Using Western immunoblot techniques, homogenates of cortical tissue were analyzed from neonatal rats 18–20 hours following repeated exposure to 4% formalin injections (F, N = 9, Ketamine (K, 2.5 mg/kg × 2, N = 9, Ketamine prior to formalin (KF, N = 9, or undisturbed controls (C, N = 9. Brain tissues from another cohort of rat pups (F = 11, K = 12, KF = 10, C = 15 were used for cellular staining with Fos immunohistochemistry or FluoroJade-B (FJB, followed by cell counting in eleven cortical and three hippocampal areas. Long-term cognitive testing using a delayed non-match to sample (DNMS paradigm in the 8-arm radial maze was performed in adult rats receiving the same treatments (F = 20, K = 24, KF = 21, C = 27 in the neonatal period. Results Greater cell death occurred in F vs. C, K, KF in parietal and retrosplenial areas, vs. K, KF in piriform, temporal, and occipital areas, vs. C, K in frontal and hindlimb areas. In retrosplenial cortex, less Fos expression occurred in F vs. C, KF. Cell death correlated inversely with Fos expression in piriform, retrosplenial, and occipital areas, but only in F. Cortical expression of glial fibrillary acidic protein (GFAP was elevated in F, K and KF vs. C. No significant differences occurred in Caspase-3, Bax, and Bcl-2 expression between groups, but cellular changes in cortical areas were significantly correlated with protein expression patterns. Cluster analysis of the frequencies and durations of behaviors grouped them as exploratory, learning, preparatory, consumptive, and foraging behaviors. Neonatal inflammatory pain exposure reduced exploratory behaviors in adult

  5. Eletrocardiografia em cães anestesiados com cetamina-s ou cetamina Electrocardiography in dogs anesthetized with s-ketamine or ketamine

    Directory of Open Access Journals (Sweden)

    Almir Pereira de Souza

    2002-10-01

    Full Text Available A cetamina, fármaco derivado da fenciclidina, há muito é usada na anestesia veterinária, sendo que o seu isômero (+, a cetamina S, recém-lançada no mercado, tem tido emprego principalmente na anestesia humana. Em vista disso, objetivou-se, com este experimento avaliar comparativamente, as possíveis alterações eletrocardiográficas em cães anestesiados com cetamina S ou cetamina e avaliar as freqüências respiratória e cardíaca, saturação de oxihemoglobina e pressão arterial. Para tanto, foram utilizados 10 cães adultos, machos e fêmeas, sem raça definida e hígidos. Os animais foram distribuídos em dois grupos (G1 e G2 de igual número. Ao G1 administrou-se, por via intramuscular, cetamina S na dose de 20mg/kg, e ao G2, cetamina na mesma dose e via de administração empregados no G1. As observações das variáveis tiveram início imediatamente antes da aplicação dos fármacos (M1 e a cada 10 minutos (M2, M3 e M4, respectivamente. Os dados numéricos foram submetidos ao teste de Tukey, para análises repetidas no grupo, a fim de verificar significado estatístico ou não entre as médias, nos vários momentos, sendo considerado o nível de significância de 5% (pKetamine is a drug derived of the phenciclidine and has been used in veterinary anaesthesia for a long time. Its (+ isomers, s-ketamine, was recently introduced in the clinical practice and has been used mainly in human anaesthesia. So, this experiment was performed to evaluate comparatively possible electrocardiographic changes in dogs anesthetized with S-ketamine or ketamine and also evaluate heart rate, respiratory rate, oxihemoglobine saturation and arterial pressure. Ten adult male and female dogs were used in this study. All dogs were healthy and mix breed. The animals were divided in two equal number groups (G1 and G2. The G1 received 20mg/kg of S-ketamine intra-muscularly and G2 received the same dose of ketamine with the injection protocol. The

  6. Peripheral lidocaine, but not ketamine inhibit capsaicin-induced hyperalgesia in humans

    DEFF Research Database (Denmark)

    Gottrup, Hanne; Bach, Flemming Winther; Arendt-Nielsen, Lars

    2000-01-01

    We examined the effect of the subcutaneous infiltration of ketamine, lidocaine and saline before injury on capsaicin-induced pain and hyperalgesia. Twelve healthy volunteers participated in two separate, randomized, double-blind, placebo-controlled crossover experiments. In experiment 1, 100...... micrograms capsaicin was injected intradermally in one volar forearm 10 min after the skin had been pretreated with lidocaine 20.0 mg in 2.0 ml or 0.9% saline 2.0 ml at the capsaicin injection site. In experiment 2, a similar capsaicin test was given 10 min after the skin had been pretreated with ketamine 5...... and brush stimuli, and areas of brush-evoked and punctate-evoked hyperalgesia. Lidocaine reduced all measures compared with placebo (P ketamine failed to change any measures. Pain scores and areas of hyperalgesia were not affected when the contralateral site was infiltrated with ketamine...

  7. Low concentrations of ketamine initiate dendritic atrophy of differentiated GABAergic neurons in culture

    International Nuclear Information System (INIS)

    Vutskits, Laszlo; Gascon, Eduardo; Potter, Gael; Tassonyi, Edomer; Kiss, Jozsef Z.

    2007-01-01

    Administration of subanesthetic concentrations of ketamine, a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) type of glutamate receptors, is a widely accepted therapeutic modality in perioperative and chronic pain management. Although extensive clinical use has demonstrated its safety, recent human histopathological observations as well as laboratory data suggest that ketamine can exert adverse effects on central nervous system neurons. To further investigate this issue, the present study was designed to evaluate the effects of ketamine on the survival and dendritic arbor architecture of differentiated γ-aminobutyric acidergic (GABAergic) interneurons in vitro. We show that short-term exposure of cultures to ketamine at concentrations of ≥20 μg/ml leads to a significant cell loss of differentiated cells and that non-cell death-inducing concentrations of ketamine (10 μg/ml) can still initiate long-term alterations of dendritic arbor in differentiated neurons, including dendritic retraction and branching point elimination. Most importantly, we also demonstrate that chronic (>24 h) administration of ketamine at concentrations as low as 0.01 μg/ml can interfere with the maintenance of dendritic arbor architecture. These results raise the possibility that chronic exposure to low, subanesthetic concentrations of ketamine, while not affecting cell survival, could still impair neuronal morphology and thus might lead to dysfunctions of neural networks

  8. Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials.

    Science.gov (United States)

    Ballard, Elizabeth D; Wills, Kathleen; Lally, Níall; Richards, Erica M; Luckenbaugh, David A; Walls, Tessa; Ameli, Rezvan; Niciu, Mark J; Brutsche, Nancy E; Park, Lawrence; Zarate, Carlos A

    2017-08-15

    Identifying clinical correlates associated with reduced suicidal ideation may highlight new avenues for the treatment of suicidal thoughts. Anhedonia occurs across psychiatric diagnoses and has been associated with specific neural circuits in response to rapid-acting treatments, such as ketamine. This analysis sought to evaluate whether reductions in suicidal ideation after ketamine administration were related to reduced levels of anhedonia, independent of depressive symptoms. This post-hoc analysis included treatment-resistant patients with either major depressive disorder (MDD) or bipolar disorder (BD) from several clinical trials of ketamine. Anhedonia was assessed using a subscale of the Beck Depression Inventory (BDI) and the Snaith-Hamilton Pleasure Scale (SHAPS). The outcome of interest was suicidal ideation, as measured by a subscale of the Scale for Suicide Ideation (SSI5), one day post-ketamine administration. Anhedonia, as measured by the SHAPS, was associated with suicidal thoughts independent of depressive symptoms both before and after ketamine administration. One day post-ketamine administration, improvements on the SHAPS accounted for an additional 13% of the variance in suicidal thought reduction, beyond the influence of depressive symptoms. The BDI anhedonia subscale was not significantly associated with suicidal thoughts after adjusting for depressive symptoms. Data were limited to patients experiencing a major depressive episode and may not be generalizable to patients experiencing an active suicidal crisis. Suicidal thoughts may be related to symptoms of anhedonia independent of other depressive symptoms. These results have implications for the potential mechanisms of action of ketamine on suicidal thoughts. Published by Elsevier B.V.

  9. Imaging diagnosis of ketamine-induced uropathy

    Directory of Open Access Journals (Sweden)

    Shu-Huei Shen

    2015-09-01

    Full Text Available With growing ketamine abuse, ketamine-induced uropathy (KIU has become a vital health issue in recent years. Although the lower urinary tract is the primary affected site, involvement of the upper urinary tract is common, and KIU may progress rapidly. The main objective of a baseline imaging study is evaluating the extent and complications of KIU after excluding other causes of uropathy. A comprehensive strategy for KIU evaluation through imaging is essential for effectively managing complications and preventing further renal function deterioration. In this study, we describe the imaging presentation of KIU and examine the role of various imaging modalities, such as ultrasound, intravenous urography, and computed tomography, in diagnosing patients with KIU.

  10. Pneumatic pellet injectors for TFTR and JET

    International Nuclear Information System (INIS)

    Combs, S.K.; Milora, S.L.

    1986-01-01

    This paper describes the development of pneumatic hydrogen pellet injectors for plasma fueling applications on the Tokamak Fusion Test Reactor (TFTR) and the Joint European Torus (JET). The performance parameters of these injectors represent an extension of previous experience and include pellet sizes in the range 2-6 mm in diameter and speeds approaching 2 km/s. Design features and operating characteristics of these pneumatic injectors are presented

  11. Immobilization of swift foxes with ketamine hydrochloride-xylazine hydrochloride

    Science.gov (United States)

    Telesco, R.L.; Sovada, Marsha A.

    2002-01-01

    There is an increasing need to develop field immobilization techniques that allow researchers to handle safely swift foxes (Vulpes velox) with minimal risk of stress or injury. We immobilized captive swift foxes to determine the safety and effectiveness of ketamine hydrochloride and xylazine hydrochloride at different dosages. We attempted to determine appropriate dosages to immobilize swift foxes for an adequate field-handling period based on three anesthesia intervals (induction period, immobilization period, and recovery period) and physiologic responses (rectal temperature, respiration rate, and heart rate). Between October 1998–July 1999, we conducted four trials, evaluating three different dosage ratios of ketamine and xylazine (2.27:1.2, 5.68:1.2, and 11.4:1.2 mg/kg ketamine:mg/kg xylazine, respectively), followed by a fourth trial with a higher dosage at the median ratio (11.4 mg/kg ketamine:2.4 mg/kg xylazine). We found little difference in induction and recovery periods among trials 1–3, but immobilization time increased with increasing dosage (Pimmobilization period and recovery period increased in trial 4 compared with trials 1–3 (P≤0.03). There was a high variation in responses of individual foxes across trials, making it difficult to identify an appropriate dosage for field handling. Heart rate and respiration rates were depressed but all physiologic measures remained within normal parameters established for domestic canids. We recommend a dosage ratio of 10 mg/kg ketamine to 1 mg/kg xylazine to immobilize swift foxes for field handling.

  12. Ketamin genopdaget af både læger og misbrugere

    DEFF Research Database (Denmark)

    Sørensen, Anne; Barnung, Steen; Rasmussen, Lars Simon

    2011-01-01

    -hyperalgesic and opioid saving effects, opening to new ways of managing post-operative and chronic pain states. Recreational use of ketamine among night clubbers is increasing and makes acute and chronic symptoms of ketamine abuse a new challenge in emergency departments....

  13. Three-phase Bone Scintigraphy Can Predict the Analgesic Efficacy of Ketamine Therapy in CRPS.

    Science.gov (United States)

    Sorel, Marc; Beatrix, Jacques-Christian; Locko, Blanche; Armessen, Catherine; Domec, Anne-Marie; Lecompte, Otilia; Boucheneb, Sofiane; Harache, Benoit; Robert, Jacques; Lefaucheur, Jean-Pascal

    2018-03-13

    The efficacy of ketamine in relieving complex regional pain syndrome (CRPS) lacks predictive factors. The value of three-phase bone scintigraphy (TPBS) was assessed or this purpose. TPBS was performed in 105 patients with unilateral, focal CRPS of type 1 before 5 days of ketamine infusions. Tracer uptake was measured in the region of interest concerned by CRPS and the contralateral homologous region. For the three scintigraphic phases (vascular, tissular, and bone phases), an asymmetry ratio of fixation was calculated between the affected and the unaffected sides (VPr, TPr, and BPr). Ketamine efficacy was assessed on pain intensity scores. Ketamine-induced pain relief did not correlate with VPr, TPr, and BPr, but with the ratios of these ratios: BPr/TPr (r=0.32, P=0.009), BPr/VPr (r=0.34, P=0.005), and TPr/VPr (r=0.23, P=0.02). The optimum cut-off value for predicting the response to ketamine therapy was >1.125 for BPr/TPr, >1.075 for BPr/VPr, and >0.935 for TPr/VPr. The combination of increased values of BPr/TPr, BPr/VPr, and TPr/VPr was extremely significantly associated with ketamine therapy outcome. The relative hyperfixation of the radioactive tracer in the limb region concerned by CRPS in phases 2 and 3 versus phase 1 of TPBS correlated positively to the analgesic efficacy of ketamine. This study shows for the first time the potential predictive value of TPBS regarding ketamine therapy outcome. In addition, these results suggest that the analgesic action of ketamine is not restricted to "central" mechanisms, but may also involve "peripheral" mechanisms related to tissue inflammation and bone remodeling.

  14. Apoptosis-related genes induced in response to ketamine during early life stages of zebrafish.

    Science.gov (United States)

    Félix, Luís M; Serafim, Cindy; Valentim, Ana M; Antunes, Luís M; Matos, Manuela; Coimbra, Ana M

    2017-09-05

    Increasing evidence supports that ketamine, a widely used anaesthetic, potentiates apoptosis during development through the mitochondrial pathway of apoptosis. Defects in the apoptotic machinery can cause or contribute to the developmental abnormalities previously described in ketamine-exposed zebrafish. The involvement of the apoptotic machinery in ketamine-induced teratogenicity was addressed by assessing the apoptotic signals at 8 and 24 hpf following 20min exposure to ketamine at three stages of early zebrafish embryo development (256 cell, 50% epiboly and 1-4 somites stages). Exposure at the 256-cell stage to ketamine induced an up-regulation of casp8 and pcna at 8 hpf while changes in pcna at the mRNA level were observed at 24 hpf. After the 50% epiboly stage exposure, the mRNA levels of casp9 were increased at 8 and 24 hpf while aifm1 was affected at 24 hpf. Both tp53 and pcna expressions were increased at 8 hpf. After exposure during the 1-4 somites stage, no meaningful changes on transcript levels were observed. The distribution of apoptotic cells and the caspase-like enzymatic activities of caspase-3 and -9 were not affected by ketamine exposure. It is proposed that ketamine exposure at the 256-cell stage induced a cooperative mechanism between proliferation and cellular death while following exposure at the 50% epiboly, a p53-dependent and -independent caspase activation may occur. Finally, at the 1-4 somites stage, the defence mechanisms are already fully in place to protect against ketamine-insult. Thus, ketamine teratogenicity seems to be dependent on the functional mechanisms present in each developmental stage. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Mazindol attenuates ketamine-induced cognitive deficit in the attentional set shifting task in rats.

    Science.gov (United States)

    Nikiforuk, Agnieszka; Gołembiowska, Krystyna; Popik, Piotr

    2010-01-01

    Cognitive impairments associated with schizophrenia await an effective treatment. In order to model schizophrenia-like cognitive deficits in rats, we evaluated the effects of ketamine, a dissociative anesthetic NMDA/glutamate receptor channel blocker in the attentional set-shifting task (ASST). Acute administration of ketamine (10 but not 3mg/kg) selectively impaired solving of the extradimensional (ED) set-shifting component. Next, we investigated whether the co-administration of mazindol, a dopamine and norepinephrine reuptake inhibitor would protect rats from ketamine-induced deficits. Mazindol dose-dependently and selectively alleviated ketamine-induced ED deficit with a minimal effective dose of 0.5mg/kg. The ED component improvement was noted primarily in ketamine - but not in vehicle co-treated rats, in which the drug facilitated ED shift solving at the dose as high as 5mg/kg. A "positive control", sertindole (2.5mg/kg) also ameliorated ketamine-induced ED deficit. Microdialysis of the prefrontal cortex in a separate group of animals revealed that 2-3h after the administration of 5mg/kg of mazindol and ketamine (i.e., at the time of ED component solving), the extracellular concentrations of dopamine were enhanced by ~300% as compared to the baseline and were intermediate between the mazindol- and ketamine-treated reference groups. However, at that time the levels of norepinephrine, serotonin and glutamate appeared unaffected. We conclude that ketamine may be useful in mimicking deficits specifically related to cognitive inflexibility observed in schizophrenia, and suggest that these anomalies could be ameliorated by mazindol. The beneficial effects of mazindol on ASST performance may have therapeutic implications for the treatment of schizophrenia.

  16. Preemptive effects of epidural s (+ - ketamine or ketamine in the horse's postincisional pain

    Directory of Open Access Journals (Sweden)

    Nilson Oleskovicz

    2006-02-01

    Full Text Available The aim of this study was to evaluate the pre-emptive effect of epidural ketamine S (+ (SK or racemic ketamine (RK administration, in post-incisional pain in horses. Were used in a blinded, randomized experimental study, sixteen mixed breed mares, 6±2 years old, weighting 273.2±42.0 kg. An epidural catheter was inserted 24 hours before the trials. The thigh region was shaved bilaterally, and mechanical cutaneous sensibility was measured using von Frey filaments (T-30. Using the left side as the control one, local anesthesia was performed at the right side. Twenty-five minutes later, SK was injected in G1 or RK in G2 through the epidural catheter. Five minutes after the ketamine injection, a 10 cm skin incision was made on the right side, and then sutured. Mechanical post-incisional pain was measured using von Frey filaments, at 1, 3 and 5 cm around the incision at 15 minutes intervals, for 2 hours, then 4, 6 and 8 hours after suturing. No changes were observed in the heart and respiratory rate and rectal temperature among groups or times of each group. Hind limb ataxia was observed in 62.5% and 12.5% of G1 and G2 respectively. SK and RK reduced cutaneous sensibility in the right and the left sides to mechanical postincisional pain during all time of experiment. Epidural SK and RK produce similar post-incisional analgesic effects, did not interfere in the cardio-respiratory parameters. The SK induces more intense ataxia in mares and presents a larger analgesic potency in the first 60 minutes after the administration.

  17. Preventive Treatment with Ketamine Attenuates the Ischaemia-Reperfusion Response in a Chronic Postischaemia Pain Model

    Directory of Open Access Journals (Sweden)

    Suryamin Liman

    2015-01-01

    Full Text Available Ischemia and inflammation may be pathophysiological mechanisms of complex regional pain syndrome (CRPS. Ketamine has proposed anti-inflammatory effects and has been used for treating CRPS. This study aimed to evaluate anti-inflammatory and analgesic effects of ketamine after ischaemia-reperfusion injury in a chronic postischaemia pain (CPIP model of CRPS-I. Using this model, ischemia was induced in the hindlimbs of male Sprague-Dawley rats. Ketamine, methylprednisolone, or saline was administered immediately after reperfusion. Physical effects, (oedema, temperature, and mechanical and cold allodynia in the bilateral hindpaws, were assessed from 48 hours after reperfusion. Fewer (56% rats in the ketamine group developed CPIP at the 48th hour after reperfusion (nonsignificant. Ketamine treated rats showed a significantly lower temperature in the ischaemic hindpaw compared to saline (P<0.01 and methylprednisolone (P<0.05 groups. Mechanical and cold allodynia were significantly lower in the ischaemic side in the ketamine group (P<0.05. Proinflammatory cytokines TNF-α and IL-2 were significantly lower at the 48th hour after reperfusion in ketamine and methylprednisolone groups, compared to saline (all P<0.05. In conclusion, immediate administration of ketamine after an ischaemia-reperfusion injury can alleviate pain and inflammation in the CPIP model and has potential to treat postischaemic pain.

  18. Ketamine induces brain-derived neurotrophic factor expression via phosphorylation of histone deacetylase 5 in rats.

    Science.gov (United States)

    Choi, Miyeon; Lee, Seung Hoon; Park, Min Hyeop; Kim, Yong-Seok; Son, Hyeon

    2017-08-05

    Ketamine shows promise as a therapeutic agent for the treatment of depression. The increased expression of brain-derived neurotrophic factor (BDNF) has been associated with the antidepressant-like effects of ketamine, but the mechanism of BDNF induction is not well understood. In the current study, we demonstrate that the treatment of rats with ketamine results in the dose-dependent rapid upregulation of Bdnf promoter IV activity and expression of Bdnf exon IV mRNAs in rat hippocampal neurons. Transfection of histone deacetylase 5 (HDAC5) into rat hippocampal neurons similarly induces Bdnf mRNA expression in response to ketamine, whereas transfection of a HDAC5 phosphorylation-defective mutant (Ser259 and Ser498 replaced by Ala259 and Ala498), results in the suppression of ketamine-mediated BDNF promoter IV transcriptional activity. Viral-mediated hippocampal knockdown of HDAC5 induces Bdnf mRNA and protein expression, and blocks the enhancing effects of ketamine on BDNF expression in both unstressed and stressed rats, and thereby providing evidence for the role of HDAC5 in the regulation of Bdnf expression. Taken together, our findings implicate HDAC5 in the ketamine-induced transcriptional regulation of Bdnf, and suggest that the phosphorylation of HDAC5 regulates the therapeutic actions of ketamine. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The promise of ketamine for treatment-resistant depression: current evidence and future directions

    Science.gov (United States)

    DeWilde, Kaitlin E.; Levitch, Cara F.; Murrough, James W.; Mathew, Sanjay J.; Iosifescu, Dan V.

    2014-01-01

    Major depressive disorder (MDD) is one of the most disabling diseases worldwide and is a significant public health threat. Current treatments for MDD primarily consist of monoamine-targeting agents and have limited efficacy. However, the glutamate neurotransmitter system has recently come into focus as a promising alternative for novel antidepressant treatments. We review the current data on the glutamate NMDA receptor antagonist ketamine, which has been shown in clinical trials to act as a rapid antidepressant in MDD. We also examine ketamine efficacy on dimensions of psychopathology, including anhedonia, cognition, and suicidality, consistent with the NIMH Research Domain Criteria (RDoC) initiative. Other aspects of ketamine reviewed in this paper include safety and efficacy, different administration methods, and the risks of misuse of ketamine outside of medical settings. Finally, we conclude with a discussion of other glutamatergic agents other than ketamine currently being tested as novel antidepressants. PMID:25649308

  20. Ketamine sedation for patients with acute agitation and psychiatric illness requiring aeromedical retrieval.

    Science.gov (United States)

    Le Cong, Minh; Gynther, Bruce; Hunter, Ernest; Schuller, Peter

    2012-04-01

    Aeromedical retrieval services face the difficult problem of appropriate levels of sedation for transport of acutely agitated patients to definitive care. This paper describes a technique using ketamine, which is titratable and avoids problems associated with airway management. A 3-year review of a new technique of ketamine sedation by aeromedical retrieval teams from the Cairns base of the Queensland section of the Royal Flying Doctor Service of Australia. Clinical records were systematically reviewed for ketamine administration and signs of adverse events during transport and in the subsequent 72 h. 18 patients were sedated during retrieval with intravenous ketamine. Effective sedation was achieved in all cases, with no significant adverse events noted during retrieval or 72 h afterwards. Ketamine sedation is effective and safe in agitated patients with a psychiatric illness in the aeromedical setting and does not lead to worsening agitation in the subsequent 72-h period.

  1. Estimation of the contribution of norketamine to ketamine-induced acute pain relief and neurocognitive impairment in healthy volunteers

    Science.gov (United States)

    Olofsen, Erik; Noppers, Ingeborg; Niesters, Marieke; Kharasch, Evan; Aarts, Leon; Sarton, Elise; Dahan, Albert

    2012-01-01

    Background The N-methyl-D-receptor antagonist ketamine is metabolized in the liver into its active metabolite norketamine. No human data are available on the relative contribution of norketamine to ketamine-induced analgesia and side effects. One approach to assess the ketamine and norketamine contributions is by measuring ketamine-effect at varying ketamine and norketamine plasma concentrations using the CYP450 inducer rifampicin. Methods In 12 healthy male volunteers the effect of rifampicin versus placebo pretreatment on S-ketamine (a 2-h infusion of 20 mg/h)-induced analgesia and cognition was quantified. The relative ketamine and norketamine contribution to effect was estimated using a linear additive population pharmacokinetic-pharmacodynamic model. Results S-ketamine produced significant analgesia, psychotropic effects (drug high), and cognitive impairment (including memory impairment, reduced psychomotor speed, reduced reaction time, reduced cognitive flexibility). Modeling revealed a negative contribution of S-norketamine to S-ketamine-induced analgesia and absence of contribution to cognitive impairment. At ketamine and norketamine effect concentrations of 100 ng/ml and 50 ng/ml, respectievly, the ketamine contribution to analgesia is −3.8 cm (visual analogue pain score) versus a contribution of norketamine of +1.5 cm, causing an overall effect −2.3 cm. The blood-effect-site equilibration half-life ranged from 0 (cognitive flexibility) to 11.8 (pain intensity) min, and averaged across all end-points was 6.1 min. Conclusions This first observation that norketamine produces effects in the opposite direction of ketamine requires further proof. It can explain the observation of ketamine-related excitatory phenomena (such as hyperalgesia and allodynia) upon the termination of ketamine infusions. PMID:22692377

  2. Ketamine-induced bladder fibrosis involves epithelial-to-mesenchymal transition mediated by transforming growth factor-β1.

    Science.gov (United States)

    Wang, Junpeng; Chen, Yang; Gu, Di; Zhang, Guihao; Chen, Jiawei; Zhao, Jie; Wu, Peng

    2017-10-01

    Bladder wall fibrosis is a major complication of ketamine-induced cystitis (KC), but the underlying pathogenesis is poorly understood. The aim of the present study was to elucidate the mechanism of ketamine-induced fibrosis in association with epithelial-to-mesenchymal transition (EMT) mediated by transforming growth factor-β1 (TGF-β1). Sprague-Dawley rats were randomly distributed into four groups, which received saline, ketamine, ketamine combined with a TGF-β receptor inhibitor (SB-505124) for 16 wk, or 12 wk of ketamine and 4 wk of abstinence. In addition, the profibrotic effect of ketamine was confirmed in SV-40 immortalized human uroepithelial (SV-HUC-1) cells. The ketamine-treated rats displayed voiding dysfunction and decreased bladder compliance. Bladder fibrosis was accompanied by the appearance of a certain number of cells expressing both epithelial and mesenchymal markers, indicating that epithelial cells might undergo EMT upon ketamine administration. Meanwhile, the expression level of TGF-β1 was significantly upregulated in the urothelium of bladders in ketamine-treated rats. Treatment of SV-HUC-1 cells with ketamine increased the expression of TGF-β1 and EMT-inducing transcription factors, resulting in the downregulation of E-cadherin and upregulation of fibronectin and α-smooth muscle actin. Administration of SB-505124 inhibited EMT and fibrosis both in vitro and vivo. In addition, withdrawal from ketamine did not lead to recovery of bladder urinary function or decreased fibrosis. Taken together, our study shows for the first time that EMT might contribute to bladder fibrosis in KC. TGF-β1 may have an important role in bladder fibrogenesis via an EMT mechanism. Copyright © 2017 the American Physiological Society.

  3. Ketamine-induced inhibition of glycogen synthase kinase-3 contributes to the augmentation of AMPA receptor signaling

    Science.gov (United States)

    Beurel, Eléonore; Grieco, Steven F; Amadei, Celeste; Downey, Kimberlee; Jope, Richard S

    2016-01-01

    Objectives Sub-anesthetic doses of ketamine have been found to provide rapid antidepressant actions, indicating that the cellular signaling systems targeted by ketamine are potential sites for therapeutic intervention. Ketamine acts as an antagonist of N-methyl-D-aspartate (NMDA) receptors, and animal studies indicate that subsequent augmentation of signaling by α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors is critical for the antidepressant outcome. Methods In this study, we tested if the inhibitory effect of ketamine on glycogen synthase kinase-3 (GSK3) affected hippocampal cell-surface AMPA receptors using immunoblotting of membrane and synaptosomal extracts from wild-type and GSK3 knockin mice. Results Treatment with an antidepressant dose of ketamine increased the hippocampal membrane level of the AMPA glutamate receptor (GluA)1 subunit, but did not alter the localization of GluA2, GluA3, or GluA4. This effect of ketamine was abrogated in GSK3 knockin mice expressing mutant GSK3 that cannot be inhibited by ketamine, demonstrating that ketamine-induced inhibition of GSK3 is necessary for up-regulation of cell surface AMPA GluA1 subunits. AMPA receptor trafficking is regulated by post-synaptic density-95 (PSD-95), a substrate for GSK3. Ketamine treatment decreased the hippocampal membrane level of phosphorylated PSD-95 on Thr-19, the target of GSK3 that promotes AMPA receptor internalization. Conclusions These results demonstrate that ketamine-induced inhibition of GSK3 causes reduced phosphorylation of PSD-95, diminishing the internalization of AMPA GluA1 subunits to allow for augmented signaling through AMPA receptors following ketamine treatment. PMID:27687706

  4. A novel coated silver ketamine(I electrode for potentiometric determination of ketamine hydrochloride in ampoules and urine samples

    Directory of Open Access Journals (Sweden)

    Hazem M. Abu Shawish

    2014-11-01

    Full Text Available A new ketamine coated silver electrode (KCSE based on ketamine hydrochloride with sodium tetraphenylborate (KT-TPB as electroactive material has been described. The influence of membrane composition, type of solvent mediators, kind of electroactive materials and interfering ions on the sensor was investigated. The sensor displays Nernstian response of 55.8 ± 0.3 mV/decade over the concentration range of 2.5 × 10−6 to 1.0 × 10−2 M with limit of detection of 8.5 × 10−7 M. The coated wire electrode has short response time ∼8 s and it can be used in pH range of 2.6–6.4. The selective coefficients were determined in relation to several inorganic, organic ions, sugars and some common drug excipients. The KCSE electrode was successfully used for the determination of the ketamine content in ampoule and urine samples with satisfactory results. Statistical student’s t-test and F test showed insignificant systematic error between proposed and official methods.

  5. Oral ketamine for the treatment of pain and treatment-resistant depression

    NARCIS (Netherlands)

    Schoevers, Robert A.; Chaves, Tharcila V.; Balukova, Sonya M.; Rot, Marije Aan Het; Kortekaas, Rudie

    Background Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications.

  6. Modelling the High-speed Injector for Diesel ICE

    Science.gov (United States)

    Buryuk, V. V.; Kayukov, S. S.; Gorshkalev, A. A.; Belousov, A. V.; Gallyamov, R. E.; Zvyagintsev, V. A.

    2018-01-01

    The article describes the results of research on the option of improving the operation speed of the electro-hydraulically driven injectors (Common Rail) for diesel ICE. The injector investigated in this article is a modified serial injector Common Rail-type with solenoid. The model and the injector parameters are represented in the package LMS Imagine. Lab AMESim with the detailed description of the substantiation and background for the research. Following the research results, the advantages of the proposed approach to analysing the operation speed were detected with outlining the direction of future studies.

  7. Application of advanced diagnostics to airblast injector flows

    Science.gov (United States)

    Mcvey, John B.; Kennedy, Jan B.; Russell, Sid

    1987-01-01

    This effort is concerned with the application of both conventional laser velocimetry and phase Doppler anemometry to the flow produced by an airblast nozzle. The emphasis is placed on the acquisition of data using actual engine injector/swirler components at (noncombusting) conditions simulating those encountered in the engine. The objective of the effort was to test the applicability of the instrumentation to real injector flows, to develop information on the behavior of injectors at high flow, and to provide data useful in the development of physical models of injector flows.

  8. Design status of heavy ion injector program

    International Nuclear Information System (INIS)

    Ballard, E.O.; Meyer, E.A.; Rutkowski, H.L.; Shurter, R.P.; Van Haaften, F.W.; Riepe, K.B.

    1985-01-01

    Design and development of a sixteen beam, heavy ion injector is in progress at Los Alamos National Laboratory (LANL) to demonstrate the injector technology for the High Temperature Experiment (HTE) proposed by Lawrence Livermore Laboratory (LBL). The injector design provides for individual ion sources mounted to a support plate defining the sixteen beam array. The beamlets are electrostatically accelerated through a series of electrodes inside an evacuated (10 -7 torr) high voltage (HV) accelerating column

  9. Direct Fuel Injector Power Drive System Optimization

    Science.gov (United States)

    2014-04-01

    solenoid coil to create magnetic field in the stator. Then, the stator pulls the pintle to open the injector nozzle . This pintle movement occurs when the...that typically deal with power strategies to the injector solenoid coil. Numerical simulation codes for diesel injection systems were developed by...Laboratory) for providing the JP-8 test fuel. REFERENCES 1. Digesu, P. and Laforgia D., “ Diesel electro- injector : A numerical simulation code”. Journal of

  10. Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression

    NARCIS (Netherlands)

    Murrough, James W.; Perez, Andrew M.; Pillemer, Sarah; Stern, Jessica; Parides, Michael K.; aan het Rot, Marije; Collins, Katherine A.; Mathew, Sanjay J.; Charney, Dennis S.; Iosifescu, Dan V.

    2013-01-01

    Background: Ketamine is reported to have rapid antidepressant effects; however, there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine

  11. Economic evaluation of epinephrine auto-injectors for peanut allergy.

    Science.gov (United States)

    Shaker, Marcus; Bean, Katherine; Verdi, Marylee

    2017-08-01

    Three commercial epinephrine auto-injectors were available in the United States in the summer of 2016: EpiPen, Adrenaclick, and epinephrine injection, USP auto-injector. To describe the variation in pharmacy costs among epinephrine auto-injector devices in New England and evaluate the additional expense associated with incremental auto-injector costs. Decision analysis software was used to evaluate costs of the most and least expensive epinephrine auto-injector devices for children with peanut allergy. To evaluate regional variation in epinephrine auto-injector costs, a random sample of New England national and corporate pharmacies was compared with a convenience sample of pharmacies from 10 Canadian provinces. Assuming prescriptions written for 2 double epinephrine packs each year (home and school), the mean costs of food allergy over the 20-year model horizon totaled $58,667 (95% confidence interval [CI] $57,745-$59,588) when EpiPen was prescribed and $45,588 (95% CI $44,873-$46,304) when epinephrine injection, USP auto-injector was prescribed. No effectiveness differences were evident between groups, with 17.19 (95% CI 17.11-17.27) quality-adjusted life years accruing for each subject. The incremental cost per episode of anaphylaxis treated with epinephrine over the model horizon was $12,576 for EpiPen vs epinephrine injection, USP auto-injector. EpiPen costs were lowest at Canadian pharmacies ($96, 95% CI $85-$107). There was price consistency between corporate and independent pharmacies throughout New England by device brand, with the epinephrine injection, USP auto-injector being the most affordable device. Cost differences among epinephrine auto-injectors were significant. More expensive auto-injector brands did not appear to provide incremental benefit. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Understanding the spectrum of diesel injector deposits

    Energy Technology Data Exchange (ETDEWEB)

    Quigley, Robert; Barbour, Robert [Lubrizol Limited, Derby (United Kingdom); Arters, David; Bush, Jim [Lubrizol Corporation, Wickliffe, OH (United States)

    2013-06-01

    Understanding the origin of diesel fuel injector deposits used to be relatively simple; for the most part they were caused by the decomposition of fuel during the combustion process, were generally organic in nature and typically only affected the nozzle orifices. However, modem fuel injector designs appear to be both more severe in terms of generating conditions conducive to creating new and different types of deposits and more likely to have their operation affected by those deposits. Changes to fuel composition and type have in some cases increased the potential pool of reactive species or provided new potential deposit precursors. As a result, the universe of diesel injector deposits now range from the traditional organic to partially or fully inorganic in nature and from nozzle coking deposits to deposits which can seize the internal components of the injector; so called internal diesel injector deposits. Frequently, combinations of inorganic and organic deposits are found. While power loss is one well known issue associated with nozzle deposits, other field problems resulting from these new deposits include severe issues with drivability, emissions, fuel consumption and even engine failure. Conventional deposit control additive chemistries were developed to be effective against organic nozzle coking deposits. These conventional additives in many cases may prove ineffective against this wide range of deposit types. This paper discusses the range of deposits that have been found to adversely impact modem diesel fuel injectors and compares the performance of conventional and new, advanced deposit control additives against these various challenges to proper fuel injector functioning. (orig.)

  13. Fast screening of ketamine in biological samples based on molecularly imprinted photonic hydrogels

    International Nuclear Information System (INIS)

    Meng, Liang; Meng, Pinjia; Zhang, Qingqing; Wang, Yanji

    2013-01-01

    Graphical abstract: A novel label-free colorimetric chemosensor: with the increase in the concentration of ketamine, the Bragg diffraction peak of MIPHs gradually shifted to the longer wavelength region. Accompanying the peak shift, the color change of MIPHs was also observed obviously: from green to red. Highlights: ► We developed the label-free colorimetric MIPHs for handy and fast screening of ketamine. ► The obvious color change of MIPHs was observed upon ketamine. ► The MIPHs exhibited good sensing abilities in an aqueous environment. ► The sensing mechanisms of the water-compatible MIPHs were investigated. ► The MIPHs were employed to screening ketamine in real biological samples. -- Abstract: A novel label-free colorimetric chemosensor was developed for handy and fast screening of ketamine with high sensitivity and specificity based on molecularly imprinted photonic hydrogels (MIPHs) that combined the colloidal-crystal with molecular imprinting technique. The unique inverse opal arrays with a thin polymer wall in which the imprinted nanocavities of ketamine moleculars distributed allowed high sensitive, quick responsive, specific detection of the target analyte, and good regenerating ability in an aqueous environment. Due to the hierarchical inverse opal structural characteristics, the specific ketamine molecular recognition process can induce obvious swelling of the MIPHs to be directly transferred into visually perceptible optical signal (change in color) which can be detected by the naked eye through Bragg diffractive shifts of ordered macroporous arrays. In order to enhance the recognition ability in aqueous environments, the MIPHs were designed as water-compatible and synthesized in a water–methanol system. The molecular recognition mechanisms were investigated. The proposed MIPHs were successfully employed to screen trace level ketamine in human urine and saliva samples, exhibiting high sensitivity, rapid response, and specificity in the

  14. Fast screening of ketamine in biological samples based on molecularly imprinted photonic hydrogels

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Liang [Department of Forensic Science, People' s Public Security University of China, Beijing (China); Meng, Pinjia, E-mail: mengpinjia@163.com [Department of Forensic Science, People' s Public Security University of China, Beijing (China); Zhang, Qingqing; Wang, Yanji [Department of Forensic Science, People' s Public Security University of China, Beijing (China)

    2013-04-10

    Graphical abstract: A novel label-free colorimetric chemosensor: with the increase in the concentration of ketamine, the Bragg diffraction peak of MIPHs gradually shifted to the longer wavelength region. Accompanying the peak shift, the color change of MIPHs was also observed obviously: from green to red. Highlights: ► We developed the label-free colorimetric MIPHs for handy and fast screening of ketamine. ► The obvious color change of MIPHs was observed upon ketamine. ► The MIPHs exhibited good sensing abilities in an aqueous environment. ► The sensing mechanisms of the water-compatible MIPHs were investigated. ► The MIPHs were employed to screening ketamine in real biological samples. -- Abstract: A novel label-free colorimetric chemosensor was developed for handy and fast screening of ketamine with high sensitivity and specificity based on molecularly imprinted photonic hydrogels (MIPHs) that combined the colloidal-crystal with molecular imprinting technique. The unique inverse opal arrays with a thin polymer wall in which the imprinted nanocavities of ketamine moleculars distributed allowed high sensitive, quick responsive, specific detection of the target analyte, and good regenerating ability in an aqueous environment. Due to the hierarchical inverse opal structural characteristics, the specific ketamine molecular recognition process can induce obvious swelling of the MIPHs to be directly transferred into visually perceptible optical signal (change in color) which can be detected by the naked eye through Bragg diffractive shifts of ordered macroporous arrays. In order to enhance the recognition ability in aqueous environments, the MIPHs were designed as water-compatible and synthesized in a water–methanol system. The molecular recognition mechanisms were investigated. The proposed MIPHs were successfully employed to screen trace level ketamine in human urine and saliva samples, exhibiting high sensitivity, rapid response, and specificity in the

  15. Ultrastructure of canine meninges after repeated epidural injection of S(+)-ketamine.

    Science.gov (United States)

    Acosta, Alinne; Gomar, Carmen; Bombí, Josep A; Graça, Dominguita L; Garrido, Marta; Krauspenhar, Cristina

    2006-01-01

    The safety of ketamine when administered by the spinal route must be confirmed in various animal species before it is approved for use in humans. This study evaluates the ultrastructure of canine meninges after repeated doses of epidural S(+)-ketamine. Five dogs received S(+)-ketamine 5%, 1 mg/kg, twice a day for 10 days through an epidural catheter with its tip located at the L5 level. One dog received the same volume of normal saline at the same times. The spinal cord and meninges were processed for histopathological and ultrastructural studies. Clinical effects were assessed after each injection. Motor and sensory block appeared after each injection of S(+)-ketamine, but not in the dog receiving saline. No signs of clinical or neurologic alterations were observed. Using light microscopy, no meningeal layer showed alterations except focal infiltration at the catheter tip level by macrophages, lymphocytes, and a few mast cells. The cells of different layers were studied by electron microscopy and interpreted according to data from human and other animal species because no ultrastructural description of the canine meninges is currently available. There were no cellular signs of inflammation, phagocytosis, or degeneration in meningeal layers and no signs of atrophy, compression, or demyelinization in the areas of dorsal root ganglia and spinal cord around the arachnoid. These findings were common for dogs receiving S(+)-ketamine and the dog receiving saline. Repeated doses of epidural S(+)-ketamine 5%, 1 mg/kg, twice a day for 10 days was not associated to cellular alterations in canine meninges.

  16. Haloperidol counteracts the ketamine-induced disruption of processing negativity, but not that of the P300 amplitude

    DEFF Research Database (Denmark)

    Oranje, Bob; Gispen-de Wied, Christine C; Westenberg, Herman G M

    2009-01-01

    . Besides exerting an antagonistic effect on NMDA receptors, they have agonistic effects on dopamine D2 receptors. Can haloperidol (D2 antagonist) counteract the disruptive effects of ketamine on psychophysiological parameters of human attention? In a randomized, double-blind, placebo-controlled experiment...... 18 healthy male volunteers received placebo/placebo, placebo/ketamine (0.3 mg/kg i.v.) and haloperidol (2 mg)/ketamine (0.3 mg/kg i.v.) on three separate test days, after which they were tested in an auditory selective-attention paradigm. Haloperidol/ketamine reduced task performance compared...... to placebo/placebo, while the task performance in these two treatments did not differ from placebo/ketamine. Furthermore, placebo/ketamine reduced processing negativity compared to both placebo/placebo and haloperidol/ketamine, while processing negativity did not differ between placebo...

  17. Tritium pellet injector for TFTR

    International Nuclear Information System (INIS)

    Gouge, M.J.; Baylor, L.R.; Cole, M.J.; Combs, S.K.; Dyer, G.R.; Fehling, D.T.; Fisher, P.W.; Foust, C.R.; Langley, R.A.; Milora, S.L.; Qualls, A.L.; Wilgen, J.B.; Schmidt, G.L.; Barnes, G.W.; Persing, R.G.

    1992-01-01

    The tritium pellet injector (TPI) for the Tokamak Fusion Test Reactor (TFTR) will provide a tritium pellet fueling capability with pellet speeds in the 1- to 3-km/s range for the TFTR deuterium-tritium (D-T) phase. The existing TFTR deuterium pellet injector (DPI) has been modified at Oak Ridge National Laboratory (ORNL) to provide a four-shot, tritium-compatible, pipe-gun configuration with three upgraded single-stage pneumatic guns and a two-stage light gas gun driver. The TPI was designed to provide pellets ranging from 3.3 to 4.5 mm in diameter in arbitrarily programmable firing sequences at speeds up to approximately 1.5 km/s for the three single-stage drivers and 2.5 to 3 km/s for the two-stage driver. Injector operation is controlled by a programmable logic controller. The new pipe-gun injector assembly was installed in the modified DPI guard vacuum box, and modifications were made to the internals of the DPI vacuum injection line, including a new pellet diagnostics package. Assembly of these modified parts with existing DPI components was then completed, and the TPI was tested at ORNL with deuterium pellet. Results of the limited testing program at ORNL are described. The TPI is being installed on TFTR to support the D-D run period in 1992. In 1993, the tritium pellet injector will be retrofitted with a D-T fuel manifold and secondary tritium containment systems and integrated into TFTR tritium processing systems to provide full tritium pellet capability

  18. Ketamine and phencyclidine: the good, the bad and the unexpected

    Science.gov (United States)

    Lodge, D; Mercier, M S

    2015-01-01

    The history of ketamine and phencyclidine from their development as potential clinical anaesthetics through drugs of abuse and animal models of schizophrenia to potential rapidly acting antidepressants is reviewed. The discovery in 1983 of the NMDA receptor antagonist property of ketamine and phencyclidine was a key step to understanding their pharmacology, including their psychotomimetic effects in man. This review describes the historical context and the course of that discovery and its expansion into other hallucinatory drugs. The relevance of these findings to modern hypotheses of schizophrenia and the implications for drug discovery are reviewed. The findings of the rapidly acting antidepressant effects of ketamine in man are discussed in relation to other glutamatergic mechanisms. PMID:26075331

  19. 21 CFR 522.1222b - Ketamine hydrochloride with promazine hydrochloride and aminopentamide hydrogen sulfate injection.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Ketamine hydrochloride with promazine... RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.1222b Ketamine.... Ketamine hydrochloride, (±),-2-(o-chlorophenyl)-2-(methylamino) cyclohexanone hydrochloride, with promazine...

  20. Modulation of NMDA receptor function by ketamine and magnesium: Part I

    NARCIS (Netherlands)

    Liu, H. T.; Hollmann, M. W.; Liu, W. H.; Hoenemann, C. W.; Durieux, M. E.

    2001-01-01

    N-methyl-D-aspartate (NMDA) receptors are important components of pain processing. Ketamine and Mg2+ block NMDA receptors and might therefore be useful analgesics, and combinations of Mg2+ and ketamine provide more effective analgesia. We investigated their interactions at NMDA receptors. Xenopus

  1. Short- and long-term antidepressant effects of ketamine in a rat chronic unpredictable stress model.

    Science.gov (United States)

    Jiang, Yinghong; Wang, Yiqiang; Sun, Xiaoran; Lian, Bo; Sun, Hongwei; Wang, Gang; Du, Zhongde; Li, Qi; Sun, Lin

    2017-08-01

    This research was aimed to evaluate the behaviors of short- or long-term antidepressant effects of ketamine in rats exposed to chronic unpredictable stress (CUS). Ketamine, a glutamate noncompetitive NMDA receptor antagonist, regulates excitatory amino acid functions, such as anxiety disorders and major depression, and plays an important role in synaptic plasticity and learning and memory. After 42 days of CUS model, male rats received either a single injection of ketamine (10 mg/kg; day 43) or 15 daily injections (days 43-75). The influence of ketamine on behavioral reactivity was assessed 24 hr (short-term) or 7 weeks after ketamine treatment (long-term). Behavioral tests used to assess the effects of these treatments included the sucrose preference (SP), open field (OF), elevated plus maze (EPM), forced swimming (FS), and water maze (WM) to detect anxiety-like behavior (OF and EPM), forced swimming (FS), and water maze (WM). Results: Short-term ketamine administration resulted in increases of body weight gain, higher sensitivity to sucrose, augmented locomotor activity in the OF, more entries into the open arms of the EPM, along increased activity in the FS test; all responses indicative of reductions in depression/despair in anxiety-eliciting situations. No significant differences in these behaviors were obtained under conditions of long-term ketamine administration ( p  > .05). The CUS + Ketamine group showed significantly increased activity as compared with the CUS + Vehicle group for analysis of the long-term effects of ketamine (* p   .05). Taken together these findings demonstrate that a short-term administration of ketamine induced rapid antidepressant-like effects in adult male rats exposed to CUS conditions, effects that were not observed in response to the long-term treatment regime.

  2. S -ketamine compared to etomidate during electroconvulsive therapy in major depression.

    Science.gov (United States)

    Zavorotnyy, Maxim; Kluge, Ina; Ahrens, Kathrin; Wohltmann, Thomas; Köhnlein, Benjamin; Dietsche, Patricia; Dannlowski, Udo; Kircher, Tilo; Konrad, Carsten

    2017-12-01

    Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0.96 (0.26) mg/kg. Right unilateral brief pulse ECTs were performed. The number of ECTs was individually adjusted to clinical needs, mean (SD) = 13.0 (4.3). Seizure characteristics, adverse events, and the clinical global impression (CGI) scores were compared between the both groups during ECT series. In the S-ketamine group, a lower initial seizure threshold (p = 0.014), stimulation charge (p ketamine might hold a potential to become a clinically favorable anesthetic agent during ECT. However, the current findings should be interpreted with caution, and further prospective randomized clinical trials are required. Also, specific adverse effects profile of S-ketamine, especially with regard to the cardiovascular risk, needs to be taken into account.

  3. Ketamine as a Rapid Treatment for Post-Traumatic Stress Disorder

    Science.gov (United States)

    2011-10-01

    Post - traumatic stress disorder ( PTSD ) is a debilitating anxiety disorder characterized by intrusive re-experiences of the traumatic events...08-1-0602 TITLE: Ketamine as a Rapid Treatment for Post - Traumatic Stress Disorder PRINCIPAL INVESTIGATOR: Dennis Charney...dissociative effects of ketamine but not have any sustained anxiolytic and antidepressant effects. Forty individuals diagnosed with post - traumatic

  4. Operation of the repeating pneumatic injector on TFTR and design of an 8-shot deuterium pellet injector

    International Nuclear Information System (INIS)

    Combs, S.K.; Milora, S.L.; Foust, C.R.

    1985-01-01

    The repeating pneumatic hydrogen pellet injector, which was developed at the Oak Ridge National Laboratory (ORNL), has been installed and operated on the Tokamak Fusion Test Reactor (TFTR). The injector combines high-speed extruder and pneumatic acceleration technologies to propel frozen hydrogen isotope pellets repetitively at high speeds. The pellets are transported to the plasma in an injection line that also serves to minimize the gas loading on the torus; the injection line incorporates a fast shutter valve and two stages of guide tubes with intermediate vacuum pumping stations. A remote, stand-alone control and data acquisition system is used for injector and vacuum system operation. In early pellet fueling experiments on TFTR, the injector has been used to deliver deuterium pellets at speeds ranging from 1.0 to 1.5 km/s into plasma discharges. First, single large (nominal 4-mm-dia) pellets provided high densities in TFTR (1.8 x 10 14 cm -3 on axis); after conversion to smaller (nominal 2.7-mm-dia) pellets, up to five pellets were injected at 0.25-s intervals into a plasma discharge, giving a line-averaged density of 1 x 10 14 cm -3 . Operating characteristics and performance of the injector in initial tests on TFTR are presented

  5. N-acetylcysteine prevents ketamine-induced adverse effects on development, heart rate and monoaminergic neurons in zebrafish.

    Science.gov (United States)

    Robinson, Bonnie; Dumas, Melanie; Gu, Qiang; Kanungo, Jyotshna

    2018-06-08

    N-acetylcysteine, a precursor molecule of glutathione, is an antioxidant. Ketamine, a pediatric anesthetic, has been implicated in cardiotoxicity and neurotoxicity including modulation of monoaminergic systems in mammals and zebrafish. Here, we show that N-acetylcysteine prevents ketamine's adverse effects on development and monoaminergic neurons in zebrafish embryos. The effects of ketamine and N-acetylcysteine alone or in combination were measured on the heart rate, body length, brain serotonergic neurons and tyrosine hydroxylase-immunoreactive (TH-IR) neurons. In the absence of N-acetylcysteine, a concentration of ketamine that produces an internal embryo exposure level comparable to human anesthetic plasma concentrations significantly reduced heart rate and body length and those effects were prevented by N-acetylcysteine co-treatment. Ketamine also reduced the areas occupied by serotonergic neurons in the brain, whereas N-acetylcysteine co-exposure counteracted this effect. TH-IR neurons in the embryo brain and TH-IR cells in the trunk were significantly reduced with ketamine treatment, but not in the presence of N-acetylcysteine. In our continued search for compounds that can prevent ketamine toxicity, this study using specific endpoints of developmental toxicity, cardiotoxicity and neurotoxicity, demonstrates protective effects of N-acetylcysteine against ketamine's adverse effects. This is the first study that shows the protective effects of N-acetylcysteine on ketamine-induced developmental defects of monoaminergic neurons as observed in a whole organism. Published by Elsevier B.V.

  6. Longitudinal Effects of Ketamine on Dendritic Architecture In Vivo in the Mouse Medial Frontal Cortex123

    Science.gov (United States)

    Phoumthipphavong, Victoria; Barthas, Florent; Hassett, Samantha

    2016-01-01

    Abstract A single subanesthetic dose of ketamine, an NMDA receptor antagonist, leads to fast-acting antidepressant effects. In rodent models, systemic ketamine is associated with higher dendritic spine density in the prefrontal cortex, reflecting structural remodeling that may underlie the behavioral changes. However, turnover of dendritic spines is a dynamic process in vivo, and the longitudinal effects of ketamine on structural plasticity remain unclear. The purpose of the current study is to use subcellular resolution optical imaging to determine the time course of dendritic alterations in vivo following systemic ketamine administration in mice. We used two-photon microscopy to visualize repeatedly the same set of dendritic branches in the mouse medial frontal cortex (MFC) before and after a single injection of ketamine or saline. Compared to controls, ketamine-injected mice had higher dendritic spine density in MFC for up to 2 weeks. This prolonged increase in spine density was driven by an elevated spine formation rate, and not by changes in the spine elimination rate. A fraction of the new spines following ketamine injection was persistent, which is indicative of functional synapses. In a few cases, we also observed retraction of distal apical tuft branches on the day immediately after ketamine administration. These results indicate that following systemic ketamine administration, certain dendritic inputs in MFC are removed immediately, while others are added gradually. These dynamic structural modifications are consistent with a model of ketamine action in which the net effect is a rebalancing of synaptic inputs received by frontal cortical neurons. PMID:27066532

  7. Meta-analysis of short- and mid-term efficacy of ketamine in unipolar and bipolar depression.

    Science.gov (United States)

    Romeo, Bruno; Choucha, Walid; Fossati, Philippe; Rotge, Jean-Yves

    2015-12-15

    Among treatments currently assessed in major depression, ketamine, has been proposed of great interest, especially because of its very rapid action. However, the time-course of the antidepressive action of ketamine remained unclear. In the present meta-analysis, we provided a clear and objective view regarding the putative antidepressive effect of ketamine and its time-course. We searched the MEDLINE and PsycINFO databases through December 2013, without limits on year of publication, using the key words ketamine and synonyms for mood disorder or episode. Six randomized, double-blind and placebo-controlled trials of ketamine in major depression (n=103 patients) were thus identified. Authors were contacted and they all provided original data necessary for this meta-analysis. Standardized mean differences (SMD) were calculated between the depression scores in ketamine and placebo groups at days 1, 2, 3-4, 7 and 14. Ketamine showed an overall antidepressive efficacy from day 1 to day 7. However, the maintenance of its efficacy over time failed to reach significance in bipolar depression after day 3-4. Significant SMDs were not explained by demographic or clinical characteristics of included samples. The present meta-analysis provides a high level of evidence that ketamine has a rapid antidepressive action during one week, especially in unipolar disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Comparison of nasal Midazolam with Ketamine versus nasal Midazolam as a premedication in children

    Directory of Open Access Journals (Sweden)

    Sonal S Khatavkar

    2014-01-01

    Full Text Available Background: T his study was done to compare effects of intranasal midazolam and intranasal midazolam with ketamine for premedication of children aged 1-12 yrs undergoing intermediate and major surgeries. Aims: Midazolam and Ketamine have already been used as premedicants in children. Our aim was to find out advantage of combination of midazolam with ketamine over midazolam by nasal route. Methods: Sixty children of age group 1-12 yrs of American Society of Anesthesiologists (ASA grade 1 and 2 were selected. Group A- midazolam (0.2 mg/kg, Group B- midazolam (0.15 mg/kg + ketamine 1 mg/kg. Both groups received drug intranasally 30 min before surgery in recovery room with monitored anesthesia care. Onset of sedation, sedation score, emotional reaction, intravenous cannula acceptance, and mask acceptance were studied. Statistical Analysis: Unpaired t test and chi square test. Results: Sedation score, anxiolysis, attitude, reaction to intravenous cannulation, face mask acceptance, and emotional reaction were significantly better in midazolam with ketamine group. Intra operatively, in both groups, pulse rate, oxygen saturation, and respiratory rate had no significant difference; also, post operatively, no significant difference was observed in above parameters, post operative analgesia was significantly better in midazolam with ketamine group. Conclusions: Intra nasal premedication allows rapid and predictable sedation in children. Midazolam as well as combination of Midazolam with ketamine gives good level of sedation and comfort. But quality of sedation, analgesia, and comfort is significantly better in midazolam with ketamine group. No significant side effects were observed in both groups.

  9. Ketamine displaces the novel NMDA receptor SPET probe [123I]CNS-1261 in humans in vivo

    International Nuclear Information System (INIS)

    Stone, James M.; Erlandsson, Kjell; Arstad, Erik; Bressan, Rodrigo A.; Squassante, Lisa; Teneggi, Vincenza; Ell, Peter J.; Pilowsky, Lyn S.

    2006-01-01

    [ 123 I]CNS-1261 [N-(1-naphthyl)-N'-(3-iodophenyl)-N-methylguanidine] is a high-affinity SPET ligand with selectivity for the intrachannel PCP/ketamine/MK-801 site of the N-methyl-D-aspartate (NMDA) receptor. This study evaluated the effects of ketamine (a specific competitor for the intrachannel PCP/ketamine/MK-801 site) on [ 123 I]CNS-1261 binding to NMDA receptors in vivo. Ten healthy volunteers underwent 2 bolus-plus-infusion [ 123 I]CNS-1261 scans, one during placebo and the other during a ketamine challenge. Ketamine administration led to a significant decrease in [ 123 I]CNS-1261 V T in most of the brain regions examined (P 123 I]CNS-1261 appears to be a specific ligand in vivo for the intrachannel PCP/ketamine/MK-801 NMDA binding site

  10. Ketamine versus propofol for strabismus surgery in children

    Directory of Open Access Journals (Sweden)

    Ayse Mizrak

    2010-07-01

    Full Text Available Ayse Mizrak1, Ibrahim Erbagci2, Tulin Arici1, Ibrahim Ozcan1, Gurkan Tatar2, Unsal Oner11Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep, Turkey; 2The Department of Ophthalmology, Gaziantep University School of Medicine, Gaziantep, TurkeyPurpose: To compare the effects of intravenous infusion of ketamine and propofol anesthesia in children undergoing strabismus surgery. Methods: Sixty pediatric patients aged 4–11 years were enrolled for the study. Patients in Group K were infused ketamine 1–3 mg/kg/hr (n = 30 and patients in Group P were infused with propofol6–9 mg/kg/hr (n = 30. After giving fentanyl 1 µg/kg and rocuronium bromide 0.5 mg/kg, patients were intubated.Results: The consumption of anesthetics (P = 0.0001 and antiemetics (P = 0.004, the incidence of ­oculocardiac reflex (P = 0.02 in Group K were significantly lower than in Group P. The recovery time (P = 0.008, postoperative agitation score (P = 0.005, Face Pain Scale (P = 0.001, Ramsay Sedation Score (P = 0.01 during awakening and at postoperative 30th min (P = 0.02 in Group K were significantly lower than in Group P. The postoperative agitation score ­during awakening was significantly lower than the preoperative values in Group K (P = 0.0001.Conclusions: The infusion of ketamine is more advantageous than the infusion of propofol in children for use in strabismus surgery.Keywords: ketamine, propofol, pediatrics, strabismus, surgery

  11. Ketamine alters lateral prefrontal oscillations in a rule-based working memory task.

    Science.gov (United States)

    Ma, Liya; Skoblenick, Kevin; Johnston, Kevin; Everling, Stefan

    2018-02-02

    Acute administration of N-methyl-D-aspartate receptor (NMDAR) antagonists in healthy humans and animals produces working memory deficits similar to those observed in schizophrenia. However, it is unclear whether they also lead to altered low-frequency (rule-based prosaccade and antisaccade working memory task, both before and after systemic injections of a subanesthetic dose (delay periods and inter-trial intervals. It also increased task-related alpha-band activities, likely reflecting compromised attention. Beta-band oscillations may be especially relevant to working memory processes, as stronger beta power weakly but significantly predicted shorter saccadic reaction time. Also in beta band, ketamine reduced the performance-related oscillation as well as the rule information encoded in the spectral power. Ketamine also reduced rule information in the spike-field phase consistency in almost all frequencies up to 60Hz. Our findings support NMDAR antagonists in non-human primates as a meaningful model for altered neural oscillations and synchrony, which reflect a disorganized network underlying the working memory deficits in schizophrenia. SIGNIFICANCE STATEMENT Low doses of ketamine-an NMDA receptor blocker-produce working memory deficits similar to those observed in schizophrenia. In the LPFC, a key brain region for working memory, we found that ketamine altered neural oscillatory activities in similar ways that differentiate schizophrenic patients and healthy subjects, during both task and non-task periods. Ketamine induced stronger gamma (30-60Hz) and weaker beta (13-30Hz) oscillations, reflecting local hyperactivity and reduced long-range communications. Furthermore, ketamine reduced performance-related oscillatory activities, as well as the rule information encoded in the oscillations and in the synchrony between single cell activities and oscillations. The ketamine model helps link the molecular and cellular basis of neural oscillatory changes to the working

  12. Preliminary evidence that ketamine inhibits spreading depolarizations in acute human brain injury

    DEFF Research Database (Denmark)

    Sakowitz, Oliver W; Kiening, Karl L; Krajewski, Kara L

    2009-01-01

    by the noncompetitive N-methyl-d-aspartate receptor antagonist ketamine. This restored electrocorticographic activity. CONCLUSIONS: These anecdotal electrocorticographic findings suggest that ketamine has an inhibitory effect on spreading depolarizations in humans. This is of potential interest for future...

  13. Comparison between intravenous and intramuscular administration of ketamine in children sedation referred to emergency department

    Directory of Open Access Journals (Sweden)

    Behnaz Boroumand Rezazadeh

    2014-12-01

    Full Text Available Ketamine, among wide variety of sedative drugs, has shown beneficial effects when using during the procedural sedation, specifically in pediatrics. Various parameters should be considered in order to perform a safe and effective procedural sedation including optimum dosage of the sedative, administration methods of sedation, and need for applying any adjuvant drug. In this study, we aimed to review the studies, which have compared the efficacy of the different ways of the injection of ketamine such as intravenous or intramuscular ketamine application. Based on data obtained from the related articles, efficacy and safety of these two methods of ketamine usage in the pediatric procedural sedation were widely similar, but the intravenously administration of the ketamine can be proposed as the preferable mode.

  14. New developments of HIF injector

    Directory of Open Access Journals (Sweden)

    Liang Lu

    2018-01-01

    Full Text Available The ultra-high intensity heavy-ion beam is highly pursued for heavy-ion researches and applications. However, it is limited by heavy-ion production of ion source and space-charge-effect in the low energy region. The Heavy-ion Inertial Fusion (HIF facilities were proposed in 1970s. The HIF injectors have large cavity number and long total length, e.g., there are 27 injectors in HIDIF and HIBLIC is 30 km in length, and the corresponding HIF facilities are too large and too expensive to be constructed. Recently, ion acceleration technologies have been developing rapidly, especially in the low energy region, where the acceleration of high intensity heavy-ions is realized. Meanwhile, superconducting (SC acceleration matures and increases the acceleration gradient in medium and high energy regions. The length of HIF injectors can be shortened to a buildable length of 2.5 km. This paper will present a review of a renewed HIF injector, which adopts multi-beam linac-based cavities. Keywords: Heavy-ion inertial fusion (HIF, Radio frequency quadrupole (RFQ, IH cavity, Heavy-ion, Multi-beam accelerator, PACS Codes: 52.58.Hm, 28.52.Av, 29.20.Ej, 29.27.-a, 29.27.Ac, 41.75.Lx

  15. Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature.

    Science.gov (United States)

    Bredlau, Amy Lee; Thakur, Rajbala; Korones, David Nathan; Dworkin, Robert H

    2013-10-01

    Chronic cancer pain is often refractory and difficult to treat. Ketamine is a medication with evidence of efficacy in the treatment of chronic pain. This article presents a synthesis of the data on ketamine for refractory cancer pain in adults and children. There are five randomized, double-blind, controlled trials of ketamine use in cancer pain that demonstrate improvement in pain for some patients. There are six prospective, uncontrolled trials in cancer pain that also demonstrate improvement in pain scores for some patients. There are no randomized, controlled trials in children with cancer pain, although there are a few studies reflecting improved pain control with ketamine for children with cancer pain. Adverse events for adults on ketamine are most commonly somnolence, feelings of insobriety, nausea/vomiting, hallucinations, depersonalization/derealization, and drowsiness. However, when ketamine is combined with benzodiazepines, feelings of insobriety, hallucinations, and depersonalization/derealization are not reported. Children on ketamine have had few reported adverse effects, which include sedation, anorexia, urinary retention, and myoclonic movements. Recommended ketamine infusion dosages are from 0.05 to 0.5 mg/kg/h (intravenous or subcutaneous). Recommended oral dosages of ketamine are 0.2-0.5 mg/kg/dose two to three times daily with a maximum of 50 mg/dose three times daily. Despite limitations in the breadth and depth of data available, there is evidence that ketamine may be a viable option for treatment-refractory cancer pain. Wiley Periodicals, Inc.

  16. Preemptive analgesia by peritonsillar ketamine versus ropivacaine for post-tonsillectomy pain in children

    Directory of Open Access Journals (Sweden)

    Manal S. Farmawy

    2014-01-01

    Conclusion: Perincisional peritonsillar infiltration of both ropivacaine and ketamine was effective in reduction of post-tonsillectomy pain. Ropivacaine was superior to ketamine in reduction of time to first analgesic demand.

  17. Compact 250-kV injector system for PIGMI

    International Nuclear Information System (INIS)

    Hamm, R.W.; Stevens, R.R. Jr.; Mueller, D.W.; Lederer, H.M.

    1978-01-01

    A 250-kV proton injector to be used in the development of a linac suitable for medical applications has been constructed. This injector utilizes a spherical Pierce geometry to produce a converging beam. A gas insulated accelerating column is cantilevered on a grounded vacuum system, with a separate high voltage equipment dome connected to a 300-kV Cockcroft-Walton power supply. The injector can be operated locally or remotely, with the remote control accomplished by a microprocessor system linked to a central control minicomputer. This injector has been designed as a low-cost compact system. The design details and the data obtained during initial operation are presented

  18. Severe toxic damage to the rabbit spinal cord after intrathecal administration of preservative-free S(+)-ketamine

    NARCIS (Netherlands)

    Vranken, Jan H.; Troost, Dirk; de Haan, Peter; Pennings, Fritz A.; van der Vegt, Marinus H.; Dijkgraaf, Marcel G. W.; Hollmann, Markus W.

    2006-01-01

    BACKGROUND: Ketamine and S(+)-ketamine have been advocated for neuraxial use in the management of postoperative pain and severe intractable pain syndromes unresponsive to opioid escalation. Although clinical experience has accumulated with S(+)-ketamine, safety data on toxicity in the central

  19. Molecular Imaging on the Cerebral Pathological Damage Target of Ketamine Dependence

    Directory of Open Access Journals (Sweden)

    YANG Hong-jie1,2;HU Shu1;JIA Shao-wei1;GAO Zhou1;WANG Tong3;ZHAO Zheng-qin1

    2014-02-01

    Full Text Available To study the cerebral pathological damage target which result from abusing ketamine through molecular imaging techniques, 20 cases of ketamine dependent patients looking for treatment at the Peking University Shenzhen Hospital and 31 healthy volunteers were included in this study, all of them got brain SPECT DAT imaging. The results were analyzed by SPSS 16.0. The bilateral caudate nucleus and putamen of healthy volunteers were roughly equally large, and the radioactive distribution of DAT in healthy volunteers were uniform and symmetrical. The bilateral corpora striatum showed typical “panda eyes” pattern. But the bilateral corpora striatum of ketamine dependent patients got smaller in shape, got disorders in pattern, and the radioactive distribution of DAT reduced or defected or even got disturbance and with much more non-specific radioactive. The V, m and Ra of bilateral corpora striatum in ketamine dependent patients were (21.03±3.15) cm3, (22.08±3.31) g and (5.37±1.08) %, respectively, which were significantly lower than the healthy volunteers (p<0.01. The cerebral pathological damage target which resulted from abusing ketamine was similar to those of compound codeine phosphate antitussive solution dependence, heroin dependence and MDMA dependence, all of these psychoactive substances damaged the function of DAT.

  20. Low-Dose Ketamine Infusion for Emergency Department Patients with Severe Pain.

    Science.gov (United States)

    Ahern, Terence L; Herring, Andrew A; Miller, Steve; Frazee, Bradley W

    2015-07-01

    Use of low-dose ketamine infusions in the emergency department (ED) has not previously been described, despite routine use in perioperative and other settings. Our hypothesis was that a low-dose ketamine bolus followed by continuous infusion would 1) provide clinically significant and sustained pain relief; 2) be well tolerated; and 3) be feasible in the ED. We prospectively administered 15 mg intravenous ketamine followed immediately by continuous ketamine infusion at 20 mg/h for 1 hour. Optional morphine (4 mg) was offered at 20, 40, and 60 minutes. Pain intensity, vitals signs, level of sedation, and adverse reactions were assessed for 120 minutes. A total of 38 patients were included with a median initial numerical rating scale (NRS) pain score of 9. At 10 minutes, the median reduction in pain score was 4, with 7 patients reporting a score of 0. At 60 and 120 minutes, 25 and 26 patients, respectively, reported clinically significant pain reduction (decrease NRS score > 3). Heart rate, blood pressure, respiratory rate, and oxygen saturation remained stable. Mild or moderate side effects including dizziness, fatigue, and headache were common. Patient satisfaction was high; 85% reported they would have this medication again for similar pain. A low-dose ketamine infusion protocol provided significant pain relief with mostly mild side effects and no severe adverse events. Wiley Periodicals, Inc.

  1. STREET KETAMINE-ASSOCIATED BLADDER DYSFUNCTION: AN EMERGING HEALTH PROBLEM

    Directory of Open Access Journals (Sweden)

    TEH GC

    2009-08-01

    Full Text Available Introduction: Ketamine is frequently abused nowadays as a recreational drug. Case reports are emerging since 2007 to describe a new clinical entity of severe bladder dysfunction associated with chronic abuse of street ketamine. Clinical presentation: Severe lower urinary tract symptoms of urinary frequency and urgency which are refractory to conventional treatment. Quality of life is adversely affected as a consequence. Chronic kidney disease will develop in advanced cases. Investigation findings: The urine is sterile on culture. Ultrasound will show reduced bladder capacity with thickened bladder wall. In advanced stage, hydronephrosis and renal impairment will develop. Treatment: Patients should be advised to stop street ketamine use immediately. Anticholinergic medication could be tried to alleviate the symptoms. Refractory cases with dilatation of the upper urinary tract might need urinary diversion. Conclusion: Awareness of this new condition is essential in diagnosis. Early intervention offers better treatment outcome.

  2. The SSRL injector beam position monitoring systems

    International Nuclear Information System (INIS)

    Lavender, W.; Baird, S.; Brennan, S.; Borland, M.; Hettel, R.; Nuhn, H.D.; Ortiz, R.; Safranek, J.; Sebek, J.; Wermelskirchen, C.; Yang, J.

    1991-01-01

    The beam position monitoring system of the SSRL injector forms a vital component of its operation. Several different types of instrumentation are used to measure the position or intensity of the electron beam in the injector. These include current toroids, fluorescent screens, Faraday cups, the 'Q' meter, a synchrotron light monitor, and electron beam position monitors. This paper focuses on the use of the electron beam position monitors to measure electron trajectories in the injector transport lines and the booster ring. The design of the beam position monitors is described in another paper to be presented at this conference. There are three different beam position monitor systems in the injector. One system consists of a set of five BPMs located on the injection transport line from the linac to the booster (known as the LTB line). There is a second system of six BPMs located on the ejection transport line (known as the BTS line). Finally, there is an array of 40 BPMs installed on the main booster ring itself. This article describes the software and processing electronics of the systems used to measure electron beam trajectories for the new SSRL injector for SPEAR

  3. Ignition Delay Properties of Alternative Fuels with Navy-Relevant Diesel Injectors

    Science.gov (United States)

    2014-06-01

    nozzle tip. 8 Figure 3 EMD injector cross-sectional view, after [15]. c. Sturman Injector A Sturman research diesel injector was used to validate...PROPERTIES OF ALTERNATIVE FUELS WITH NAVY-RELEVANT DIESEL INJECTORS by Andrew J. Rydalch June 2014 Thesis Advisor: Christopher M. Brophy...Navy’s Green Fleet Initiative, this thesis researched the ignition characteristics for diesel replacement fuels used with Navy-relevant fuel injectors

  4. Assembly process of the ITER neutral beam injectors

    Energy Technology Data Exchange (ETDEWEB)

    Graceffa, J., E-mail: joseph.graceffa@iter.org [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul lez Durance (France); Boilson, D.; Hemsworth, R.; Petrov, V.; Schunke, B.; Urbani, M. [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul lez Durance (France); Pilard, V. [Fusion for Energy, C/ Josep Pla, n°2, Torres Diagonal Litoral, Edificio B3, 08019 Barcelona (Spain)

    2013-10-15

    The ITER neutral beam (NB) injectors are used for heating and diagnostics operations. There are 4 injectors in total, 3 heating neutral beam injectors (HNBs) and one diagnostic neutral beam injector (DNB). Two HNBs and the DNB will start injection into ITER during the hydrogen/helium phase of ITER operations. A third HNB is considered as an upgrade to the ITER heating systems, and the impact of the later installation and use of that injector have to be taken into account when considering the installation and assembly of the whole NB system. It is assumed that if a third HNB is to be installed, it will be installed before the nuclear phase of the ITER project. The total weight of one injector is around 1200 t and it is composed of 18 main components and 36 sets of shielding plates. The overall dimensions are length 20 m, height 10 m and width 5 m. Assembly of the first two HNBs and the DNB will start before the first plasma is produced in ITER, but as the time required to assemble one injector is estimated at around 1.5 year, the assembly will be divided into 2 steps, one prior to first plasma, and the second during the machine second assembly phase. To comply with this challenging schedule the assembly sequence has been defined to allow assembly of three first injectors in parallel. Due to the similar design between the DNB and HNBs it has been decided to use the same tools, which will be designed to accommodate the differences between the two sets of components. This reduces the global cost of the assembly and the overall assembly time for the injector system. The alignment and positioning of the injectors is a major consideration for the injector assembly as the alignment of the beamline components and the beam source are critical if good injector performance is to be achieved. The theoretical axes of the beams are defined relative to the duct liners which are installed in the NB ports. The concept adopted to achieve the required alignment accuracy is to use the

  5. High-Average, High-Peak Current Injector Design

    CERN Document Server

    Biedron, S G; Virgo, M

    2005-01-01

    There is increasing interest in high-average-power (>100 kW), um-range FELs. These machines require high peak current (~1 kA), modest transverse emittance, and beam energies of ~100 MeV. High average currents (~1 A) place additional constraints on the design of the injector. We present a design for an injector intended to produce the required peak currents at the injector, eliminating the need for magnetic compression within the linac. This reduces the potential for beam quality degradation due to CSR and space charge effects within magnetic chicanes.

  6. Cocaine potentiates ketamine-induced loss of the righting reflex and sleeping time in mice. Role of catecholamines.

    Science.gov (United States)

    Vanderwende, C; Spoerlein, M T; Lapollo, J

    1982-07-01

    Cocaine in graded doses potentiated ketamine-induced loss of the righting reflex and sleeping time. Potentiation of drug-induced sleep with cocaine was not a generalized phenomenon inasmuch as it had no effect on sleep induced by pentobarbital or hexobarbital and decreased sleep induced by phenobarbital. Pentylenetetrazole reduced ketamine sleep but d-amphetamine had a potentiative action. dl-alpha-Methyl-p-tyrosine methyl ester itself increased both the number losing the righting reflex and the sleeping time induced by ketamine. However, the effect cocaine on sleeping time was blocked 3 h after the dl-alpha-methyl-p-tyrosine methyl ester was given. The alpha and beta adrenergic blocking drugs, phenoxybenzamine and propranolol, increased the number of animals losing the righting reflex with ketamine, and phenoxybenzamine lengthened the sleeping time. Alpha and beta adrenergic agonists, l-phenylephrine and isoproterenol, increased the number of animals going to sleep with ketamine but did not significantly alter how long they would sleep. The agonists had no effect on the cocaine interaction with ketamine, whereas the antagonists blocked the effect of cocaine. Both stimulation and blockade of dopamine receptors led to increased loss of the righting reflex and sleeping time with ketamine but only receptor blockade antagonized the effect of cocaine on ketamine-induced sleep. Thus, both the noradrenergic and dopaminergic systems appear to be involved in the ability of cocaine to potentiate ketamine-induced sleep.

  7. Commissioning of the RFQ1 injector

    International Nuclear Information System (INIS)

    Arbique, G.M.; Sheikh, J.Y.; Taylor, T.; Birney, L.F.; Davidson, A.D.; Wills, J.S.C.

    1987-01-01

    The RFQ1 accelerator is being developed at Chalk River to test the limits of the cw RFQ technology. A 50 kV injector has been built and is now being commissioned as the first phase of the program. This paper describes some of the innovative features of the RFQ1 injector and reports on initial operating experience

  8. First operational tests of the positive-ion injector for ATLAS

    International Nuclear Information System (INIS)

    Bollinger, L.M.; Den Hartog, P.K.; Pardo, R.C.

    1989-01-01

    This paper summarizes the status and first operational experience with the positive-ion injector for ATLAS. The new injector consists of an ECR ion source on a 350-kV platform, followed by a superconducting injector linac of a new kind. In Phase I of this project, the ECR source, voltage platform, bunching system, beam-transport system, and a 3-MV injector linac were completed and tested in early 1989 by a successful acceleration of an 40 Ar 12+ beam. Most of the new system operated as planned, and the longitudinal emittance of the 36-MeV beam out of the injector was measured to be only 5 π keV-ns, much smaller than the emittance for the present tandem injector. When completed in 1990, the final injector linac will be enlarged to 12 MV, enough to allow the original ATLAS linac to accelerate uranium ions up to 8 MeV/u. 8 refs., 2 figs

  9. First operational tests of the positive-ion injector for ATLAS

    Energy Technology Data Exchange (ETDEWEB)

    Bollinger, L.M.; Den Hartog, P.K.; Pardo, R.C.; Shepard, K.W.; Benaroya, R.; Billquist, P.J.; Clifft, B.E.; Markovich, P.; Munson, F.H. Jr.; Nixon, J.M.

    1989-01-01

    This paper summarizes the status and first operational experience with the positive-ion injector for ATLAS. The new injector consists of an ECR ion source on a 350-kV platform, followed by a superconducting injector linac of a new kind. In Phase I of this project, the ECR source, voltage platform, bunching system, beam-transport system, and a 3-MV injector linac were completed and tested in early 1989 by a successful acceleration of an /sup 40/Ar/sup 12 +/ beam. Most of the new system operated as planned, and the longitudinal emittance of the 36-MeV beam out of the injector was measured to be only 5 ..pi.. keV-ns, much smaller than the emittance for the present tandem injector. When completed in 1990, the final injector linac will be enlarged to 12 MV, enough to allow the original ATLAS linac to accelerate uranium ions up to 8 MeV/u. 8 refs., 2 figs.

  10. SLC injector simulation and tuning for high charge transport

    International Nuclear Information System (INIS)

    Yeremian, A.D.; Miller, R.H.; Clendenin, J.E.; Early, R.A.; Ross, M.C.; Turner, J.L.; Wang, J.W.

    1992-01-01

    We have simulated the SLC injector from the thermionic gun through the first accelerating section and used the resulting parameters to tune the injector for optimum performance and high charge transport. Simulations are conducted using PARMELA, a three-dimensional space-charge model. The magnetic field profile due to the existing magnetic optics is calculated using POISSON, while SUPERFISH is used to calculate the space harmonics of the various bunchers and the accelerator cavities. The initial beam conditions in the PARMELA code are derived from the EGUN model of the gun. The resulting injector parameters from the PARMELA simulation are used to prescribe experimental settings of the injector components. The experimental results are in agreement with the results of the integrated injector model. (Author) 5 figs., 7 refs

  11. Inhibition by ketamine and amphetamine analogs of the neurogenic nitrergic vasodilations in porcine basilar arteries

    International Nuclear Information System (INIS)

    Chen, Mei-Fang; Lai, Su-Yu; Kung, Po-Cheng; Lin, Yo-Cheng; Yang, Hui-I; Chen, Po-Yi; Liu, Ingrid Y.; Lua, Ahai Chang; Lee, Tony Jer-Fu

    2016-01-01

    The abuse of ketamine and amphetamine analogs is associated with incidence of hypertension and strokes involving activation of sympathetic activities. Large cerebral arteries at the base of the brain from several species receive dense sympathetic innervation which upon activation causes parasympathetic-nitrergic vasodilation with increased regional blood flow via axo-axonal interaction mechanism, serving as a protective mechanism to meet O 2 demand in an acutely stressful situation. The present study was designed to examine effects of ketamine and amphetamine analogs on axo-axonal interaction-mediated neurogenic nitrergic vasodilation in porcine basilar arteries using techniques of blood-vessel myography, patch clamp and two-electrode voltage clamp, and calcium imaging. In U46619-contracted basilar arterial rings, nicotine (100 μM) and electrical depolarization of nitrergic nerves by transmural nerve stimulation (TNS, 8 Hz) elicited neurogenic nitrergic vasodilations. Ketamine and amphetamine analogs concentration-dependently inhibited nicotine-induced parasympathetic-nitrergic vasodilation without affecting that induced by TNS, nitroprusside or isoproterenol. Ketamine and amphetamine analogs also concentration-dependently blocked nicotine-induced inward currents in Xenopus oocytes expressing α3β2-nicotinic acetylcholine receptors (nAChRs), and nicotine-induced inward currents as well as calcium influxes in rat superior cervical ganglion neurons. The potency in inhibiting both inward-currents and calcium influxes is ketamine > methamphetamine > hydroxyamphetamine. These results indicate that ketamine and amphetamine analogs, by blocking nAChRs located on cerebral perivascular sympathetic nerves, reduce nicotine-induced, axo-axonal interaction mechanism-mediated neurogenic dilation of the basilar arteries. Chronic abuse of these drugs, therefore, may interfere with normal sympathetic-parasympathetic interaction mechanism resulting in diminished neurogenic

  12. Inhibition by ketamine and amphetamine analogs of the neurogenic nitrergic vasodilations in porcine basilar arteries

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Mei-Fang [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Tzu Chi Center for Vascular Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Tzu Chi University of Science and Technology, Hualien, Taiwan (China); Lai, Su-Yu; Kung, Po-Cheng; Lin, Yo-Cheng [Department of Pharmacology and Toxicology, College of Medicine, Tzu Chi University, Hualien, Taiwan (China); Yang, Hui-I [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Chen, Po-Yi [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Department of Pharmacology and Toxicology, College of Medicine, Tzu Chi University, Hualien, Taiwan (China); Liu, Ingrid Y. [Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan (China); Lua, Ahai Chang [Department of Laboratory Medicine and Biotechnology & Graduate Institute of Medical Biotechnology, Tzu Chi University, Hualien, Taiwan (China); Lee, Tony Jer-Fu, E-mail: tlee@mail.tcu.edu.tw [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Tzu Chi Center for Vascular Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Department of Life Sciences, College of Life Sciences, Tzu Chi University, Hualien, Taiwan (China); Department of Pharmacology and Toxicology, College of Medicine, Tzu Chi University, Hualien, Taiwan (China); Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL (United States)

    2016-08-15

    The abuse of ketamine and amphetamine analogs is associated with incidence of hypertension and strokes involving activation of sympathetic activities. Large cerebral arteries at the base of the brain from several species receive dense sympathetic innervation which upon activation causes parasympathetic-nitrergic vasodilation with increased regional blood flow via axo-axonal interaction mechanism, serving as a protective mechanism to meet O{sub 2} demand in an acutely stressful situation. The present study was designed to examine effects of ketamine and amphetamine analogs on axo-axonal interaction-mediated neurogenic nitrergic vasodilation in porcine basilar arteries using techniques of blood-vessel myography, patch clamp and two-electrode voltage clamp, and calcium imaging. In U46619-contracted basilar arterial rings, nicotine (100 μM) and electrical depolarization of nitrergic nerves by transmural nerve stimulation (TNS, 8 Hz) elicited neurogenic nitrergic vasodilations. Ketamine and amphetamine analogs concentration-dependently inhibited nicotine-induced parasympathetic-nitrergic vasodilation without affecting that induced by TNS, nitroprusside or isoproterenol. Ketamine and amphetamine analogs also concentration-dependently blocked nicotine-induced inward currents in Xenopus oocytes expressing α3β2-nicotinic acetylcholine receptors (nAChRs), and nicotine-induced inward currents as well as calcium influxes in rat superior cervical ganglion neurons. The potency in inhibiting both inward-currents and calcium influxes is ketamine > methamphetamine > hydroxyamphetamine. These results indicate that ketamine and amphetamine analogs, by blocking nAChRs located on cerebral perivascular sympathetic nerves, reduce nicotine-induced, axo-axonal interaction mechanism-mediated neurogenic dilation of the basilar arteries. Chronic abuse of these drugs, therefore, may interfere with normal sympathetic-parasympathetic interaction mechanism resulting in diminished neurogenic

  13. 5-Hydroxytryptamine-Independent Antidepressant Actions of (R)-Ketamine in a Chronic Social Defeat Stress Model.

    Science.gov (United States)

    Zhang, Kai; Dong, Chao; Fujita, Yuko; Fujita, Atsuhiro; Hashimoto, Kenji

    2018-02-01

    Previous reports suggest that 5-hydroxytryptamine might play a role in the antidepressant actions of (R,S)-ketamine. However, its role in the antidepressant actions of (R)-ketamine, which is more potent than (S)-ketamine, is unknown. This study was conducted to examine whether 5-hydroxytryptamine depletion affects the antidepressant actions of (R)-ketamine in a chronic social defeat stress model. An inhibitor of 5-hydroxytryptamine synthesis, para-chlorophenylalanine methyl ester hydrochloride (300 mg/kg, twice daily for 3 consecutive days), or vehicle was administered to control and chronic social defeat stress-susceptible mice. Levels of 5-hydroxytryptamine and its metabolite, 5-hydroxyindoleacetic acid, in mouse brain regions were measured using high-performance liquid chromatography. Furthermore, antidepressant effects of (R)-ketamine (10 mg/kg) in the vehicle- and para-chlorophenylalanine methyl ester hydrochloride-treated susceptible mice were assessed using tail suspension test and 1% sucrose preference test. para-Chlorophenylalanine methyl ester hydrochloride treatment caused marked reductions of 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in the brain regions of control and chronic social defeat stress susceptible mice. In the tail suspension test, (R)-ketamine significantly attenuated the increased immobility time in the chronic social defeat stress-susceptible mice with or without 5-hydroxytryptamine depletion. In the sucrose preference test (2 and 5 days after a single dose), (R)-ketamine significantly enhanced reduced sucrose consumption in the chronic social defeat stress-susceptible mice with or without 5-hydroxytryptamine depletion. These findings show that 5-hydroxytryptamine depletion did not affect the antidepressant effects of (R)-ketamine in a chronic social defeat stress model. Therefore, it is unlikely that 5-hydroxytryptamine plays a major role in the antidepressant actions of (R)-ketamine. © The Author 2017. Published by Oxford

  14. Locomotor sensitization to intermittent ketamine administration is associated with nucleus accumbens plasticity in male and female rats.

    Science.gov (United States)

    Strong, C E; Schoepfer, K J; Dossat, A M; Saland, S K; Wright, K N; Kabbaj, M

    2017-07-15

    Clinical evidence suggests superior antidepressant response over time with a repeated, intermittent ketamine treatment regimen as compared to a single infusion. However, the club drug ketamine is commonly abused. Therefore, the abuse potential of repeated ketamine injections at low doses needs to be investigated. In this study, we investigated the abuse potential of repeated exposure to either 0, 2.5, or 5 mg/kg ketamine administered once weekly for seven weeks. Locomotor activity and conditioned place preference (CPP) were assayed to evaluate behavioral sensitization to the locomotor activating effects of ketamine and its rewarding properties, respectively. Our results show that while neither males nor females developed CPP, males treated with 5 mg/kg and females treated with either 2.5 or 5 mg/kg ketamine behaviorally sensitized. Furthermore, dendritic spine density was increased in the NAc of both males and females administered 5 mg/kg ketamine, an effect specific to the NAc shell (NAcSh) in males but to both the NAc core (NAcC) and NAcSh in females. Additionally, males administered 5 mg/kg ketamine displayed increased protein expression of ΔfosB, calcium calmodulin kinase II alpha (CaMKIIα), and brain-derived neurotrophic factor (BDNF), an effect not observed in females administered either dose of ketamine. However, males and females administered 5 mg/kg ketamine displayed increased protein expression of AMPA receptors (GluA1). Taken together, low-dose ketamine, when administered intermittently, induces behavioral sensitization at a lower dose in females than males, accompanied by an increase in spine density in the NAc and protein expression changes in pathways commonly implicated in addiction. Copyright © 2017. Published by Elsevier Ltd.

  15. Effects of ketamine and alfaxalone on application of a feline pain assessment scale.

    Science.gov (United States)

    Buisman, Mandy; Wagner, Marika C; Hasiuk, Michelle Mm; Prebble, Melanie; Law, Laura; Pang, Daniel Sj

    2016-08-01

    The objective of this study was to compare the effects of ketamine and alfaxalone on the application of a validated feline-specific multidimensional composite pain scale (UNESP-Botucatu MCPS). In a prospective, randomized, blinded, crossover trial, 11 adult cats (weight 4.4 ± 0.6 kg) were given dexmedetomidine (15 μg/kg) and hydromorphone (0.05 mg/kg) with either alfaxalone (2 mg/kg) or ketamine (5 mg/kg) as a single intramuscular injection for the induction of general anesthesia. After orotracheal intubation, general anesthesia (without surgery) was maintained for 32 mins with isoflurane, followed by atipamezole. The following parameters were recorded at baseline, 1-8 h and 24 h post-extubation: pain (pain expression and psychomotor subscales) and sedation scale scores. Alfaxalone treatment injection sites were examined for inflammation at baseline, postinjection, and 8 h and 24 h post-extubation. Psychomotor scores were higher with ketamine at hours 1 (3.5 [0-5.0], P ketamine group crossed the analgesic intervention threshold. In contrast, pain expression scores did not differ significantly between treatments at any time (P >0.05); one cat from each group crossed the analgesic intervention threshold. Sedation was greater with ketamine (1 [0-3], P = 0.02) than alfaxalone (0 [0-1]) 1 h post-extubation. No cats had visible inflammation at the injection sites at any time. Ketamine has a confounding effect on the psychomotor subscale of the pain scale studied, which may lead to erroneous administration of rescue analgesia. In contrast, alfaxalone was not associated with significant increases in either pain subscale. These effects of ketamine should be considered when evaluating acute postoperative pain in cats. © The Author(s) 2015.

  16. Clonidine versus ketamine to prevent tourniquet pain during intravenous regional anesthesia with lidocaine.

    Science.gov (United States)

    Gorgias, N K; Maidatsi, P G; Kyriakidis, A M; Karakoulas, K A; Alvanos, D N; Giala, M M

    2001-01-01

    Both clonidine and ketamine have been found to prolong the action of local anesthetics through a peripheral mechanism. Our study compares the efficacy of a low dose of clonidine or ketamine separately added to intravenous regional anesthesia (IVRA) with lidocaine to prevent tourniquet pain. We conducted a prospective randomized double-blinded study in 45 patients undergoing hand or forearm surgery, with anticipated duration exceeding 1 hour under IVRA. Proximal cuff inflation of a double tourniquet was followed by administration of 40 mL of lidocaine 0.5% and either saline, 1 microg/kg clonidine, or 0.1 mg/kg ketamine. When anesthesia was established, the inflation of the proximal and distal cuff was interchanged. Thereafter, tourniquet pain was rated on a visual analog scale (VAS) every 10 minutes. Intraoperatively, boluses of 25 microg fentanyl were provided for tourniquet pain treatment when required, and total fentanyl consumption was recorded. Patients receiving plain lidocaine persistently reported the highest pain scores among groups (P <.001) 20 minutes after distal cuff inflation. Differences between the groups with additional treatment were noted 50 minutes after distal cuff inflation and until the end of the observation, with significantly lower VAS ratings (P <.001 to P <.01) in ketamine-treated patients. Total fentanyl consumption was significantly decreased by ketamine (70.00 +/- 25.35 microg) or clonidine (136.67 +/- 39.94 microg) compared with the plain lidocaine group (215.33 +/- 52.33 microg) (P <.001 between all groups). The addition of clonidine 1 microg/kg or ketamine 0.1 mg/kg to lidocaine for IVRA delays the onset of unbearable tourniquet pain and decreases analgesic consumption for tourniquet pain relief, although ketamine has a more potent effect.

  17. Opposite effects of ketamine and deep brain stimulation on rat thalamocortical information processing.

    Science.gov (United States)

    Kulikova, Sofya P; Tolmacheva, Elena A; Anderson, Paul; Gaudias, Julien; Adams, Brendan E; Zheng, Thomas; Pinault, Didier

    2012-11-01

    Sensory and cognitive deficits are common in schizophrenia. They are associated with abnormal brain rhythms, including disturbances in γ frequency (30-80 Hz) oscillations (GFO) in cortex-related networks. However, the underlying anatomofunctional mechanisms remain elusive. Clinical and experimental evidence suggests that these deficits result from a hyporegulation of glutamate N-methyl-D-aspartate receptors. Here we modeled these deficits in rats with ketamine, a non-competitive N-methyl-D-aspartate receptor antagonist and a translational psychotomimetic substance at subanesthetic doses. We tested the hypothesis that ketamine-induced sensory deficits involve an impairment of the ability of the thalamocortical (TC) system to discriminate the relevant information from the baseline activity. Furthermore, we wanted to assess whether ketamine disrupts synaptic plasticity in TC systems. We conducted multisite network recordings in the rat somatosensory TC system, natural stimulation of the vibrissae and high-frequency electrical stimulation (HFS) of the thalamus. A single systemic injection of ketamine increased the amount of baseline GFO, reduced the amplitude of the sensory-evoked TC response and decreased the power of the sensory-evoked GFO. Furthermore, cortical application of ketamine elicited local and distant increases in baseline GFO. The ketamine effects were transient. Unexpectedly, HFS of the TC pathway had opposite actions. In conclusion, ketamine and thalamic HFS have opposite effects on the ability of the somatosensory TC system to discriminate the sensory-evoked response from the baseline GFO during information processing. Investigating the link between the state and function of the TC system may conceptually be a key strategy to design innovative therapies against neuropsychiatric disorders. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

  18. Long-Term Stability of Tramadol and Ketamine Solutions for Patient-Controlled Analgesia Delivery.

    Science.gov (United States)

    Gu, Junfeng; Qin, Wengang; Chen, Fuchao; Xia, Zhongyuan

    2015-08-26

    Subanesthetic doses of ketamine as an adjuvant to tramadol in patient-controlled analgesia (PCA) for postoperative pain have been shown to improve the quality of analgesia. However, there are no such commercially available drug mixtures, and the stability of the combination has rarely been assessed. Admixtures were assessed for periods of up to 14 days at 4°C and 25°C. Three different mixtures of tramadol and ketamine (tramadol 5.0 mg/mL + ketamine 0.5 mg/mL, tramadol 5.0 mg/mL + ketamine 1.0 mg/mL, and tramadol 5.0 mg/mL + ketamine 2.0 mg/mL) were prepared in polyolefin bags by combining these 2 drugs with 0.9% sodium chloride (normal saline [NS]). The chemical stability of the admixtures was evaluated by a validated high-performance liquid chromatography (HPLC) method and by measurement of pH values. Solution appearance and color were assessed by observing the samples against black and white backgrounds. Solutions were considered stable if they maintained 90% of the initial concentration of each drug. The percentages of initial concentration of tramadol and ketamine in the various solutions remained above 98% when stored at 4°C or 25°C over the testing period. No changes in color or turbidity were observed in any of the prepared solutions. Throughout this period, pH values remained stable. The results indicate that the drug mixtures of tramadol with ketamine in NS for PCA delivery systems were stable for 14 days when stored in polyolefin bags at 4°C or 25°C.

  19. Designing Liquid Rocket Engine Injectors for Performance, Stability, and Cost

    Science.gov (United States)

    Westra, Douglas G.; West, Jeffrey S.

    2014-01-01

    NASA is developing the Space Launch System (SLS) for crewed exploration missions beyond low Earth orbit. Marshall Space Flight Center (MSFC) is designing rocket engines for the SLS Advanced Booster (AB) concepts being developed to replace the Shuttle-derived solid rocket boosters. One AB concept uses large, Rocket-Propellant (RP)-fueled engines that pose significant design challenges. The injectors for these engines require high performance and stable operation while still meeting aggressive cost reduction goals for access to space. Historically, combustion stability problems have been a critical issue for such injector designs. Traditional, empirical injector design tools and methodologies, however, lack the ability to reliably predict complex injector dynamics that often lead to combustion stability. Reliance on these tools alone would likely result in an unaffordable test-fail-fix cycle for injector development. Recently at MSFC, a massively parallel computational fluid dynamics (CFD) program was successfully applied in the SLS AB injector design process. High-fidelity reacting flow simulations were conducted for both single-element and seven-element representations of the full-scale injector. Data from the CFD simulations was then used to significantly augment and improve the empirical design tools, resulting in a high-performance, stable injector design.

  20. Management of Neuropathic Chronic Pain with Methadone Combined with Ketamine: A Randomized, Double Blind, Active-Controlled Clinical Trial.

    Science.gov (United States)

    Rigo, Flavia Karine; Trevisan, Gabriela; Godoy, Maria C; Rossato, Mateus Fortes; Dalmolin, Gerusa D; Silva, Mariane A; Menezes, Mirian S; Caumo, Wolnei; Ferreira, Juliano

    2017-03-01

    Methadone and ketamine are used in neuropathic pain management. However, the benefits of both drugs association are uncertain in the treatment of neuropathic pain. Our primary objective was test the hypothesis that oral methadone combined with oral ketamine is more effective than oral methadone or ketamine alone in reducing neuropathic pain. We conducted a randomized, double blind, active-controlled parallel-group clinical trial. Forty-two patients with neuropathic pain refractory to conventional therapy were randomly assigned to receive oral methadone (n = 14), ketamine (n = 14), or methadone plus ketamine (n = 14) over a 3-month period. During these 90 days, we observed pain scores using a visual analogical scale (VAS), allodynia, burning/shooting pain, and some side effects. All treatments were effective in reducing pain scores by at least 40%. However, a significant improvement in pain was observed only in the ketamine alone group compared with both the methadone or methadone/ketamine groups. No significant differences were observed among the treatment groups for the reduction of burning or shooting pain, while ketamine alone was more effective than methadone or methadone/ketamine for the reduction of allodynia. Formal assessment for awareness of the allocation was not performed, some co-intervention bias may have occurred, our results could be only relevant to the patient population investigated and the use of VAS as the primary outcome detect changes in pain intensity but not to assess neuropathic pain symptoms. This study indicates that ketamine was better than methadone or methadone/ketamine for treating neuropathic pain.Key words: Multimodal analgesia, refractory pain, NMDA receptor, opioid.

  1. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department.

    Science.gov (United States)

    Jamal, S M; Fathil, S M; Nidzwani, M M; Ismail, A K; Yatim, F M

    2011-08-01

    The study compared the effectiveness of ketamine and midazolam/fentanyl as procedural sedation and analgesia agents for reduction of fractures and dislocated joints. Forty-one adult patients were enrolled by convenience sampling. They were randomized to receive ketamine or midazolam/fentanyl. Depth of sedation, pain score, procedural outcome and memory of the procedure were documented. The ketamine group had deeper sedation, but there was no statistical difference in other variables between the two groups. Three patients in the midazolam/fentanyl group had oxygen desaturation. More adverse effects were associated with ketamine. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation.

  2. Neuropathological findings after continuous intrathecal administration of S(+)-ketamine for the management of neuropathic cancer pain

    NARCIS (Netherlands)

    Vranken, J. H.; Troost, D.; Wegener, J. T.; Kruis, M. R.; van der Vegt, M. H.

    2005-01-01

    Questions have been raised about the potential neurotoxicity of the neuraxial use of ketamine although ketamine and its active enantiomer S(+)-ketamine have been used intrathecally and epidurally (caudally) for the management of perioperative pain and in a variety of chronic pain syndromes. Clinical

  3. 21 CFR 870.1670 - Syringe actuator for an injector.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Syringe actuator for an injector. 870.1670 Section 870.1670 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... actuator for an injector. (a) Identification. A syringe actuator for an injector is an electrical device...

  4. Role of NMDA receptor GluN2D subunit in the antidepressant effects of enantiomers of ketamine

    Directory of Open Access Journals (Sweden)

    Soichiro Ide

    2017-11-01

    Full Text Available We investigated the rapid and sustained antidepressant effects of enantiomers of ketamine in N-methyl-d-aspartate (NMDA receptor GluN2D subunit knockout (GluN2D-KO mice. Intraperitoneal administration of ketamine or its enantiomers 10 min before the tail-suspension test exerted significant antidepressant effects on restraint stress-induced depression in both wildtype and GluN2D-KO mice. The antidepressant effects of (RS-ketamine and (S-ketamine were sustained 96 h after the injection in both wildtype and GluN2D-KO mice, but such sustained antidepressant effects of (R-ketamine were only observed in wildtype mice. These data suggest that the GluN2D subunit is critical for the sustained antidepressant effects of (R-ketamine.

  5. Ketamine blocks bursting in the lateral habenula to rapidly relieve depression.

    Science.gov (United States)

    Yang, Yan; Cui, Yihui; Sang, Kangning; Dong, Yiyan; Ni, Zheyi; Ma, Shuangshuang; Hu, Hailan

    2018-02-14

    The N-methyl-d-aspartate receptor (NMDAR) antagonist ketamine has attracted enormous interest in mental health research owing to its rapid antidepressant actions, but its mechanism of action has remained elusive. Here we show that blockade of NMDAR-dependent bursting activity in the 'anti-reward center', the lateral habenula (LHb), mediates the rapid antidepressant actions of ketamine in rat and mouse models of depression. LHb neurons show a significant increase in burst activity and theta-band synchronization in depressive-like animals, which is reversed by ketamine. Burst-evoking photostimulation of LHb drives behavioural despair and anhedonia. Pharmacology and modelling experiments reveal that LHb bursting requires both NMDARs and low-voltage-sensitive T-type calcium channels (T-VSCCs). Furthermore, local blockade of NMDAR or T-VSCCs in the LHb is sufficient to induce rapid antidepressant effects. Our results suggest a simple model whereby ketamine quickly elevates mood by blocking NMDAR-dependent bursting activity of LHb neurons to disinhibit downstream monoaminergic reward centres, and provide a framework for developing new rapid-acting antidepressants.

  6. Is nitric oxide signalling involved in the antidepressant action of ketamine?

    DEFF Research Database (Denmark)

    Liebenberg, Nico; Müller, Heidi Kaastrup; Elfving, Betina

    2012-01-01

    Background and Aim: Stress-induced excessive glutamate transmission at N-methyl-D-aspartate (NMDA) receptors may underlie a major mechanism in the pathophysiology that leads to depression, while ketamine, an NMDA receptor antagonist, has been shown to induce a rapid antidepressant effect in depre......Background and Aim: Stress-induced excessive glutamate transmission at N-methyl-D-aspartate (NMDA) receptors may underlie a major mechanism in the pathophysiology that leads to depression, while ketamine, an NMDA receptor antagonist, has been shown to induce a rapid antidepressant effect...... in depressed patients following a single intravenous administration that is sustained for ± 7 days. A number of downstream cellular mechanisms appear to mediate the antidepressant action of ketamine, and the majority of evidence point to a rapid activation of protein translation leading to increased synaptic...... receptors, while the uncoupling of the nNOS-NMDA receptor complex prevents NMDA-induced excitotoxicity. Thus, it is possible that the inhibition of nitric oxide (NO) signalling underlies a key upstream mechanism in the antidepressant action of ketamine. Methods: We used a genetic rat model of depression...

  7. Development of Technologies on Innovative-Simplified Nuclear Power Plant Using High-Efficiency Steam Injectors (11) Visualization Study on the Start-Up of the Steam Injector

    International Nuclear Information System (INIS)

    Koji Okamoto; Tadashi Narabayashi; Chikako Iwaki; Shuichi Ohmori; Michitsugu Mori

    2006-01-01

    The Steam Injector is the superior system to pump the fluid without rotating machine. Because the water column is surrounded by the saturated steam, very high heat transfer is also expected with direct condensation. The inside of the Steam Injector is very complicated. To improve the efficiency of the Steam Injector, the water column behavior inside the Injector is visualized using the Dynamic PIV system. Dynamic PIV system consists of the high-speed camera and lasers. In this study, 384 x 180 pixel resolution with 30,000 fps camera is used to visualize the flow. For the illumination CW green laser with 300 mW is applied. To view inside the Injector, relay lens system is set at the Injector wall. Very high speed water column during the starting up of Steam Injector had been clearly visualized with 30,000 fps. The wave velocity on the water column had been analyzed using PIV technique. The instability of the water column is also detected. (authors)

  8. Up-regulation of insulin-like growth factor 2 by ketamine requires glycogen synthase kinase-3 inhibition

    Science.gov (United States)

    Grieco, Steven F.; Cheng, Yuyan; Eldar-Finkelman, Hagit; Jope, Richard S.; Beurel, Eléonore

    2016-01-01

    An antidepressant dose of the rapidly-acting ketamine inhibits glycogen synthase kinase-3 (GSK3) in mouse hippocampus, and this inhibition is required for the antidepressant effect of ketamine in learned helplessness depression-like behavior. Here we report that treatment with an antidepressant dose of ketamine (10 mg/kg) increased expression of insulin-like growth factor 2 (IGF2) in mouse hippocampus, an effect that required ketamine-induced inhibition of GSK3. Ketamine also inhibited hippocampal GSK3 and increased expression of hippocampal IGF2 in mice when administered after the induction of learned helplessness. Treatment with the specific GSK3 inhibitor L803-mts was sufficient to up-regulate hippocampal IGF2 expression. Administration of IGF2 siRNA reduced ketamine's antidepressant effect in the learned helplessness paradigm. Mice subjected to the learned helplessness paradigm were separated into two groups, those that were resilient (non-depressed) and those that were susceptible (depressed). Non-depressed resilient mice displayed higher expression of IGF2 than susceptible mice. These results indicate that IGF2 contributes to ketamine's antidepressant effect and that IGF2 may confer resilience to depression-like behavior. PMID:27542584

  9. Distinct retrosplenial cortex cell populations and their spike dynamics during ketamine-induced unconscious state.

    Directory of Open Access Journals (Sweden)

    Grace E Fox

    Full Text Available Ketamine is known to induce psychotic-like symptoms, including delirium and visual hallucinations. It also causes neuronal damage and cell death in the retrosplenial cortex (RSC, an area that is thought to be a part of high visual cortical pathways and at least partially responsible for ketamine's psychotomimetic activities. However, the basic physiological properties of RSC cells as well as their response to ketamine in vivo remained largely unexplored. Here, we combine a computational method, the Inter-Spike Interval Classification Analysis (ISICA, and in vivo recordings to uncover and profile excitatory cell subtypes within layers 2&3 and 5&6 of the RSC in mice within both conscious, sleep, and ketamine-induced unconscious states. We demonstrate two distinct excitatory principal cell sub-populations, namely, high-bursting excitatory principal cells and low-bursting excitatory principal cells, within layers 2&3, and show that this classification is robust over the conscious states, namely quiet awake, and natural unconscious sleep periods. Similarly, we provide evidence of high-bursting and low-bursting excitatory principal cell sub-populations within layers 5&6 that remained distinct during quiet awake and sleep states. We further examined how these subtypes are dynamically altered by ketamine. During ketamine-induced unconscious state, these distinct excitatory principal cell subtypes in both layer 2&3 and layer 5&6 exhibited distinct dynamics. We also uncovered different dynamics of local field potential under various brain states in layer 2&3 and layer 5&6. Interestingly, ketamine administration induced high gamma oscillations in layer 2&3 of the RSC, but not layer 5&6. Our results show that excitatory principal cells within RSC layers 2&3 and 5&6 contain multiple physiologically distinct sub-populations, and they are differentially affected by ketamine.

  10. Ketamine produces antidepressant-like effects through phosphorylation-dependent nuclear export of histone deacetylase 5 (HDAC5) in rats

    Science.gov (United States)

    Choi, Miyeon; Lee, Seung Hoon; Wang, Sung Eun; Ko, Seung Yeon; Song, Mihee; Choi, June-Seek; Duman, Ronald S.; Son, Hyeon

    2015-01-01

    Ketamine produces rapid antidepressant-like effects in animal assays for depression, although the molecular mechanisms underlying these behavioral actions remain incomplete. Here, we demonstrate that ketamine rapidly stimulates histone deacetylase 5 (HDAC5) phosphorylation and nuclear export in rat hippocampal neurons through calcium/calmodulin kinase II- and protein kinase D-dependent pathways. Consequently, ketamine enhanced the transcriptional activity of myocyte enhancer factor 2 (MEF2), which leads to regulation of MEF2 target genes. Transfection of a HDAC5 phosphorylation-defective mutant (Ser259/Ser498 replaced by Ala259/Ala498, HDAC5-S/A), resulted in resistance to ketamine-induced nuclear export, suppression of ketamine-mediated MEF2 transcriptional activity, and decreased expression of MEF2 target genes. Behaviorally, viral-mediated hippocampal knockdown of HDAC5 blocked or occluded the antidepressant effects of ketamine both in unstressed and stressed animals. Taken together, our results reveal a novel role of HDAC5 in the actions of ketamine and suggest that HDAC5 could be a potential mechanism contributing to the therapeutic actions of ketamine. PMID:26647181

  11. Upper urinary tract damage caused by ketamine snorting—A report of nine cases

    Directory of Open Access Journals (Sweden)

    Hsiang-Ying Lee

    2015-09-01

    Conclusion: To the best of our knowledge, currently there is no standard therapy for ketamine-induced nephropathy, we therefore supplied a therapeutic choice for those ketamine abuser combined with hydronephrosis and/or acute kidney injury.

  12. [Ketamine--anticonvulsive and proconvulsive actions].

    Science.gov (United States)

    Kugler, J; Doenicke, A

    1994-11-01

    Animal experimentation has revealed that ketamine has anticonvulsive properties. Changes in the EEG have also been reported in animals; these have been designated non-convulsive generalized electrographic seizures because of their similarities to epileptiform potentials, even though there are no recognizable signs of seizures. The cataleptic condition of the cats in which these changes were observed led to the conclusion that ketamine could cause petit mal seizures, which took the course of petit mal status. Ketamine was therefore also seen as a dangerous anaesthetic agent predisposing to convulsions, the use of which could lead to status epilepticus and irreversible brain damage. These conflicts of opinion should be resolved, as they are based on various misconceptions. (1) The terminology used for epilepsy by specialized clinicians is not always correctly applied in the context of animal experimentation. (2) The activation of epileptiform potentials in the EEG of animals cannot be interpreted as a reliable sign of epileptogenic efficiency in humans. (3) Too little regard is paid to the different actions of anaesthetic agents in various sites of the brain, at different doses and with different routes of administration. (4) The statistical significance and biological relevance of the study results are inadequate because the numbers of observations are too small. Epileptologists regret the insufficiency of animal models as paradigma for the study of efficiency of antiepileptic drugs in humans. The degree by which extensor spasms in the front paw of Gerbils of rats induced by pentylentetrazol or electric current are reduced after application of an anticonvulsive drug is no reliable measure of its anticonvulsive effect in humans.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Ameliorating treatment-refractory depression with intranasal ketamine: potential NMDA receptor actions in the pain circuitry representing mental anguish.

    Science.gov (United States)

    Opler, Lewis A; Opler, Mark G A; Arnsten, Amy F T

    2016-02-01

    This article reviews the antidepressant actions of ketamine, an N-methyl-D-aspartame glutamate receptor (NMDAR) antagonist, and offers a potential neural mechanism for intranasal ketamine's ultra-rapid actions based on the key role of NMDAR in the nonhuman primate prefrontal cortex (PFC). Although intravenous ketamine infusions can lift mood within hours, the current review describes how intranasal ketamine administration can have ultra-rapid antidepressant effects, beginning within minutes (5-40 minutes) and lasting hours, but with repeated treatments needed for sustained antidepressant actions. Research in rodents suggests that increased synaptogenesis in PFC may contribute to the prolonged benefit of ketamine administration, beginning hours after administration. However, these data cannot explain the relief that occurs within minutes of intranasal ketamine delivery. We hypothesize that the ultra-rapid effects of intranasal administration in humans may be due to ketamine blocking the NMDAR circuits that generate the emotional representations of pain (eg, Brodmann Areas 24 and 25, insular cortex), cortical areas that can be overactive in depression and which sit above the nasal epithelium. In contrast, NMDAR blockade in the dorsolateral PFC following systemic administration of ketamine may contribute to cognitive deficits. This novel view may help to explain how intravenous ketamine can treat the symptoms of depression yet worsen the symptoms of schizophrenia.

  14. SLC injector simulation and tuning for high charge transport

    International Nuclear Information System (INIS)

    Yeremian, A.D.; Miller, R.H.; Clendenin, J.E.; Early, R.A.; Ross, M.C.; Turner, J.L.; Wang, J.W.

    1992-08-01

    We have simulated the SLC injector from the thermionic gun through the first accelerating section and used the resulting parameters to tune the injector for optimum performance and high charge transport. Simulations are conducted using PARMELA, a three-dimensional ray-trace code with a two-dimensional space-charge model. The magnetic field profile due to the existing magnetic optics is calculated using POISSON, while SUPERFISH is used to calculate the space harmonics of the various bunchers and the accelerator cavities. The initial beam conditions in the PARMELA code are derived from the EGUN model of the gun. The resulting injector parameters from the PARMELA simulation are used to prescribe experimental settings of the injector components. The experimental results are in agreement with the results of the integrated injector model

  15. LTP fibre injector qualification and status

    International Nuclear Information System (INIS)

    Bogenstahl, J; Cunningham, L; Fitzsimons, E D; Hough, J; Killow, C J; Perreur-Lloyd, M; Robertson, D; Rowan, S; Ward, H

    2009-01-01

    This paper presents the current state of the LISA Technology Package (LTP) fibre injector qualification project in terms of vibration and shock tests. The fibre injector is a custom built part and therefore must undergo a full space qualification process. The mounting structure and method for sinusoidal vibration and random vibration tests as well as shock tests will be presented. Furthermore a proposal will be presented to use the fibre injector pair qualification model to build an optical prototype bench. The optical prototype bench is a full-scale model of the flight model. It will be used for development and rehearsal of all the assembly stages of the flight model and will provide an on-ground simulator for investigation as an updated engineering model.

  16. Demonstration of analgesic effect of intranasal ketamine and intranasal fentanyl for postoperative pain after pediatric tonsillectomy.

    Science.gov (United States)

    Yenigun, Alper; Yilmaz, Sinan; Dogan, Remzi; Goktas, Seda Sezen; Calim, Muhittin; Ozturan, Orhan

    2018-01-01

    Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children. This randomized-controlled study was conducted to evaluate the effects of intranasal ketamine and intranasal fentanyl in children undergoing tonsillectomy. Tonsillectomy performed in 63 children were randomized into three groups. Group I received: Intravenous paracetamol (10 mg/kg), Group II received intranasal ketamine (1.5 mg/kg ketamine), Group III received intranasal fentanyl (1.5 mcg/kg). The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wilson sedation scale scores were recorded at 15, 30, 60 min, 2 h, 6hr, 12 h and 24 h postoperatively. Patients were interviewed on the day after surgery to assess the postoperative pain, nightmares, hallucinations, nausea, vomiting and bleeding. Intranasal ketamine and intranasal fentanyl provided significantly stronger analgesic affects compared to intravenous paracetamol administration at postoperative 15, 30, 60 min and at 2, 6, 12 and 24 h in CHEOPS (p ketamine administration group. No such sedative effect was seen in the groups that received intranasal fentanyl and intravenous paracetamol in Wilson Sedation Scale (p ketamine and intranasal fentanyl were more effective than paracetamol for postoperative analgesia after pediatric tonsillectomy. Sedative effects were observed in three patients with the group of intranasal ketamine. There was no significant difference in the efficacy of IN Ketamine and IN Fentanyl for post-tonsillectomy pain. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Role of NMDA receptor GluN2D subunit in the antidepressant effects of enantiomers of ketamine.

    Science.gov (United States)

    Ide, Soichiro; Ikekubo, Yuiko; Mishina, Masayoshi; Hashimoto, Kenji; Ikeda, Kazutaka

    2017-11-01

    We investigated the rapid and sustained antidepressant effects of enantiomers of ketamine in N-methyl-d-aspartate (NMDA) receptor GluN2D subunit knockout (GluN2D-KO) mice. Intraperitoneal administration of ketamine or its enantiomers 10 min before the tail-suspension test exerted significant antidepressant effects on restraint stress-induced depression in both wildtype and GluN2D-KO mice. The antidepressant effects of (RS)-ketamine and (S)-ketamine were sustained 96 h after the injection in both wildtype and GluN2D-KO mice, but such sustained antidepressant effects of (R)-ketamine were only observed in wildtype mice. These data suggest that the GluN2D subunit is critical for the sustained antidepressant effects of (R)-ketamine. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  18. Ketamine displaces the novel NMDA receptor SPET probe [{sup 123}I]CNS-1261 in humans in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Stone, James M. [Institute of Psychiatry, King' s College London, De Crespigny Park London, SE5 8AF (United Kingdom)]. E-mail: j.stone@iop.kcl.ac.uk; Erlandsson, Kjell [Institute of Nuclear Medicine, University College London, London, W1N 8AA (United Kingdom); Arstad, Erik [Institute of Psychiatry, King' s College London, De Crespigny Park London, SE5 8AF (United Kingdom); Bressan, Rodrigo A. [Institute of Psychiatry, King' s College London, De Crespigny Park London, SE5 8AF (United Kingdom); Squassante, Lisa [GlaxoSmithKline (GSK), Verona 37135 (Italy); Teneggi, Vincenza [GlaxoSmithKline (GSK), Verona 37135 (Italy); Ell, Peter J. [Institute of Nuclear Medicine, University College London, London, W1N 8AA (United Kingdom); Pilowsky, Lyn S. [Institute of Psychiatry, King' s College London, De Crespigny Park London, SE5 8AF (United Kingdom); Institute of Nuclear Medicine, University College London, London, W1N 8AA (United Kingdom)

    2006-02-15

    [{sup 123}I]CNS-1261 [N-(1-naphthyl)-N'-(3-iodophenyl)-N-methylguanidine] is a high-affinity SPET ligand with selectivity for the intrachannel PCP/ketamine/MK-801 site of the N-methyl-D-aspartate (NMDA) receptor. This study evaluated the effects of ketamine (a specific competitor for the intrachannel PCP/ketamine/MK-801 site) on [{sup 123}I]CNS-1261 binding to NMDA receptors in vivo. Ten healthy volunteers underwent 2 bolus-plus-infusion [{sup 123}I]CNS-1261 scans, one during placebo and the other during a ketamine challenge. Ketamine administration led to a significant decrease in [{sup 123}I]CNS-1261 V {sub T} in most of the brain regions examined (P<.05). [{sup 123}I]CNS-1261 appears to be a specific ligand in vivo for the intrachannel PCP/ketamine/MK-801 NMDA binding site.

  19. Adverse Events With Ketamine Versus Ketofol for Procedural Sedation on Adults: A Double-blind, Randomized Controlled Trial.

    Science.gov (United States)

    Lemoel, Fabien; Contenti, Julie; Giolito, Didier; Boiffier, Mathieu; Rapp, Jocelyn; Istria, Jacques; Fournier, Marc; Ageron, François-Xavier; Levraut, Jacques

    2017-12-01

    The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol"). We performed a multicentric, randomized, double-blind trial in which adult patients received emergency procedural sedations with ketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Other outcomes were frequency of interventions required by these recovery reactions, rates of respiratory or hemodynamic events, emesis, and satisfaction of patients as well as providers. A total of 152 patients completed the study, 76 in each arm. Compared with ketamine, ketofol determined a 22% reduction in recovery reactions incidence (p ketamine. We found a significant reduction in recovery reactions and emesis frequencies among adult patients receiving emergency procedural sedations with ketofol, compared with ketamine. © 2017 by the Society for Academic Emergency Medicine.

  20. Ketamine-associated lower urinary tract destruction: a new radiological challenge

    Energy Technology Data Exchange (ETDEWEB)

    Mason, K., E-mail: k.mason@doctors.org.u [Bristol Royal Infirmary, Bristol (United Kingdom); Cottrell, A.M. [North Bristol NHS Trust, Bristol (United Kingdom); Corrigan, A.G. [Bristol Royal Infirmary, Bristol (United Kingdom); Gillatt, D.A.; Mitchelmore, A.E. [North Bristol NHS Trust, Bristol (United Kingdom)

    2010-10-15

    Aim: Ketamine is a short-acting dissociative anaesthetic whose hallucinogenic side effects have led to an increase in its illicit use amongst club and party goers. There is a general misconception amongst users that it is a safe drug with few long term side effects, however ketamine abuse is associated with severe urinary tract dysfunction. Presenting symptoms include urinary frequency, nocturia, dysuria, haematuria and incontinence. Materials and methods: We describe the radiological findings found in a series of 23 patients, all with a history of ketamine abuse, who presented with severe lower urinary tract symptoms (LUTS). Imaging techniques used included ultrasonography (US), intravenous urography (IVU), and computed tomography (CT). These examinations were reviewed to identify common imaging findings. All patients with positive imaging findings had also undergone cystoscopy and bladder wall biopsies, which confirmed the diagnosis. The patients in this series have consented to the use of their data in the ongoing research into ketamine-induced bladder pathology. Results: Ultrasound demonstrated small bladder volume and wall thickening. CT revealed marked, generalized bladder wall thickening, mucosal enhancement, and perivesical inflammation. Ureteric wall thickening and enhancement were also observed. In advanced cases ureteric narrowing and strictures were identified using both CT and IVU. Correlation of clinical history, radiological and pathological findings was performed to confirm the diagnosis. Conclusion: This case series illustrates the harmful effects of ketamine on the urinary tract and the associated radiological findings. Delayed diagnosis can result in irreversible renal tract damage requiring surgical intervention. It is important that radiologists are aware of this emerging clinical entity as early diagnosis and treatment are essential for successful management.

  1. High Brightness Injectors Based On Photocathode DC Gun

    International Nuclear Information System (INIS)

    B. Yunn

    2001-01-01

    Sample results of new injector design method based on a photocathode dc gun are presented, based on other work analytically proving the validity of the emittance compensation scheme for the case even when beam bunching is involved. We have designed several new injectors appropriate for different bunch charge ranges accordingly. Excellent beam quality produced by these injectors clearly shows that a photocathode dc gun can compete with a rf gun on an equal footing as the source of an electron beam for the bunch charge ranging up to 2 nano Coulomb (nC). This work therefore elevates a dc gun based injector to the preferred choice for many ongoing high brightness accelerator projects considering the proven operational stability and high average power capability of the dc gun

  2. The positive-ion injector of ATLAS: design and operating experience

    Energy Technology Data Exchange (ETDEWEB)

    Bollinger, L M [Physics Div., Argonne National Lab., IL (United States); Pardo, R C [Physics Div., Argonne National Lab., IL (United States); Shepard, K W [Physics Div., Argonne National Lab., IL (United States); Billquist, P J [Physics Div., Argonne National Lab., IL (United States); Bogaty, J M [Physics Div., Argonne National Lab., IL (United States); Clifft, B E [Physics Div., Argonne National Lab., IL (United States); Harkewicz, R [Physics Div., Argonne National Lab., IL (United States); Munson, F H [Physics Div., Argonne National Lab., IL (United States); Nolen, J A [Physics Div., Argonne National Lab., IL (United States); Zinkann, G P [Physics Div., Argonne National Lab., IL (United States)

    1993-06-01

    The recently completed positive-ion injector for the heavy-ion accelerator ATLAS is a replacement for the tandem injector of the present tandem-linac system. Unlike the tandem, the new injector provides ions from the full range of the periodic table. The concept for the new injector, which consists of an ECR ion source on a voltage platform coupled to a very-low-velocity superconducting linac, introduces technical problems and uncertainties that are well beyond those encountered previously for superconducting linacs. The solution to these problems and their relationship to performance are outlined, and experience in the operation of ATLAS with its new injector is discussed. (orig.)

  3. The positive-ion injector of ATLAS: Design and operating experience

    International Nuclear Information System (INIS)

    Bollinger, L.M.; Pardo, R.C.; Shepard, K.W.; Billquist, P.J.; Bogaty, J.M.; Clifft, B.E.; Harkewicz, R.; Munson, F.H.; Nolen, J.A.; Zinkann, G.P.

    1992-01-01

    The recently completed Positive-Ion Injector for the heavy-ion accelerator ATLAS is a replacement for the tandem injector of the present tandem-linac system. Unlike the tandem, the new injector provides ions from the full range of the periodic table. The concept for the new injector, which consists of an ECR ion source on a voltage platform coupled to a very-low-velocity superconducting linac, introduces technical problems and uncertainties that are well beyond those encountered previously for superconducting linacs. The solution to these problems and their relationship to performance are outlined, and experience in the operation of ATLAS with its new injector is discussed

  4. The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy

    Directory of Open Access Journals (Sweden)

    Chi-Hang Yee

    2017-06-01

    Full Text Available Purpose The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF symptom score, uroflowmetry (UFM parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2% had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8% in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012, functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029, serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006. Conclusions Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.

  5. Effects of combined ketamine/xylazine anesthesia on light induced retinal degeneration in rats.

    Directory of Open Access Journals (Sweden)

    Blanca Arango-Gonzalez

    Full Text Available OBJECTIVES: To explore the effect of ketamine-xylazine anesthesia on light-induced retinal degeneration in rats. METHODS: Rats were anesthetized with ketamine and xylazine (100 and 5 mg, respectively for 1 h, followed by a recovery phase of 2 h before exposure to 16,000 lux of environmental illumination for 2 h. Functional assessment by electroretinography (ERG and morphological assessment by in vivo imaging (optical coherence tomography, histology (hematoxylin/eosin staining, TUNEL assay and immunohistochemistry (GFAP and rhodopsin staining were performed at baseline (ERG, 36 h, 7 d and 14 d post-treatment. Non-anesthetized animals treated with light damage served as controls. RESULTS: Ketamine-xylazine pre-treatment preserved retinal function and protected against light-induced retinal degeneration. In vivo retinal imaging demonstrated a significant increase of outer nuclear layer (ONL thickness in the non-anesthetized group at 36 h (p0.05, indicating a stabilizing and/or protective effect with regard to phototoxicity. Histology confirmed light-induced photoreceptor cell death and Müller cells gliosis in non-anesthetized rats, especially in the superior hemiretina, while ketamine-xylazine treated rats showed reduced photoreceptor cell death (TUNEL staining: p<0.001 after 7 d, thicker ONL and longer IS/OS. Fourteen days after light damage, a reduction of standard flash induced a-wave amplitudes and a-wave slopes (p = 0.01 and significant alterations in parameters of the scotopic sensitivity function (e.g. Vmax of the Naka Rushton fit p = 0.03 were observed in non-treated vs. ketamine-xylazine treated animals. CONCLUSIONS: Our results suggest that pre-treatment with ketamine-xylazine anesthesia protects retinas against light damage, reducing photoreceptor cell death. These data support the notion that anesthesia with ketamine-xylazine provides neuroprotective effects in light-induced cell damage.

  6. Comparison of pregabalin versus ketamine in postoperative pain management in breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Essam Mahran

    2015-01-01

    Full Text Available Background: Breast surgery compromises one of the most common cancer surgeries in females and commonly followed by acute postoperative pain. Pregabalin and ketamine have been used in many previous studies and was found to have a good analgesic profile. We assumed that pregabalin and ketamine can be used in control of postoperative pain in female patients undergoing breast cancer surgery. Material and Methods: Ninety female patients scheduled for cancer breast surgery were allocated in three groups (30 patients each, control group (group c received preoperative placebo, pregabalin group (group p received oral 150 mg pregabalin 1 h before surgery, ketamine group (group k received intravenous (IV 0.5 mg/kg ketamine with induction of anesthesia followed by 0.25 mg/kg/h IV throughout the surgery. All patients received general anesthesia and after recovery, the three groups were assessed in the first postoperative 24 h for postoperative visual analog scale (VAS , total 24 h morphine consumption, incidence of postoperative nausea and vomiting (PONV, sedation score >2 and any complications from the drugs used in the study. Results: The use of pregabalin or ketamine was found to reduce total postoperative morphine consumption with P 2. Conclusion: The use of preoperative oral 150 mg pregabalin 1 h before surgery or IV 0.5 mg ketamine with induction of anesthesia can reduce postoperative opioid consumption in breast cancer surgery without change in sedation or PONV and with a good safety profile.

  7. Analysis of print news media framing of ketamine treatment in the United States and Canada from 2000 to 2015.

    Directory of Open Access Journals (Sweden)

    Melvyn W B Zhang

    Full Text Available There are multifaceted views on the use of ketamine, a potentially addictive substance, to treat mental health problems. The past 15 years have seen growing media coverage of ketamine for medical and other purposes. This study examined the print news media coverage of medical and other uses of ketamine in North America to determine orientations and trends over time.Print newspaper coverage of ketamine from 2000 to 2015 was reviewed, resulting in 43 print news articles from 28 North American newspapers. A 55-item structured coding instrument was applied to assess news reports of ketamine. Items captured negative and positive aspects, therapeutic use of ketamine, and adverse side effects. Chi-squares tested for changes in trends over time.In the 15-year reviewed period, the three most frequent themes related to ketamine were: abuse (68.2%, legal status (34.1%, and clinical use in anesthesia (31.8%. There was significant change in trends during two periods (2000-2007 and 2008-2015. In 2008-2015, print news media articles were significantly more likely to encourage clinical use of ketamine to treat depression (p = 0.002, to treat treatment resistant depression (p = 0.043, and to claim that ketamine is more effective than conventional antidepressants (p = 0.043.Our review found consistent positive changes in the portrayals of ketamine by the print news media as a therapeutic antidepressant that mirror the recent scientific publications. These changes in news media reporting might influence the popularity of ketamine use to treat clinical depression. Guidance is required for journalists on objective reporting of medical research findings, including limitations of current research evidence and potential risks of ketamine.

  8. Analysis of print news media framing of ketamine treatment in the United States and Canada from 2000 to 2015.

    Science.gov (United States)

    Zhang, Melvyn W B; Hong, Ying X; Husain, Syeda F; Harris, Keith M; Ho, Roger C M

    2017-01-01

    There are multifaceted views on the use of ketamine, a potentially addictive substance, to treat mental health problems. The past 15 years have seen growing media coverage of ketamine for medical and other purposes. This study examined the print news media coverage of medical and other uses of ketamine in North America to determine orientations and trends over time. Print newspaper coverage of ketamine from 2000 to 2015 was reviewed, resulting in 43 print news articles from 28 North American newspapers. A 55-item structured coding instrument was applied to assess news reports of ketamine. Items captured negative and positive aspects, therapeutic use of ketamine, and adverse side effects. Chi-squares tested for changes in trends over time. In the 15-year reviewed period, the three most frequent themes related to ketamine were: abuse (68.2%), legal status (34.1%), and clinical use in anesthesia (31.8%). There was significant change in trends during two periods (2000-2007 and 2008-2015). In 2008-2015, print news media articles were significantly more likely to encourage clinical use of ketamine to treat depression (p = 0.002), to treat treatment resistant depression (p = 0.043), and to claim that ketamine is more effective than conventional antidepressants (p = 0.043). Our review found consistent positive changes in the portrayals of ketamine by the print news media as a therapeutic antidepressant that mirror the recent scientific publications. These changes in news media reporting might influence the popularity of ketamine use to treat clinical depression. Guidance is required for journalists on objective reporting of medical research findings, including limitations of current research evidence and potential risks of ketamine.

  9. COMPARATIVE EFFICACY OF DETOMIDINE AND DETOMIDINE - KETAMINE COCKTAIL IN QUAILS

    Directory of Open Access Journals (Sweden)

    U. F. Durrani, M. Ashraf and A. Khalid¹

    2005-10-01

    Full Text Available Twenty adult healthy quails (Coturnix coturnix were divided into two equal groups. One group was administered detomidine (2.4 mg/kg, I/M and other group was administered detomidine-ketamine cocktail (1.2 mg/kg + 30 mg/kg, I/M. Detomidine slowly and smoothly induced a light sedation accompanied by superficial analgesia, hypoventilation, hypothermia and bradycardia in all birds. Detomidine-ketamine cocktail rapidly and smoothly induced a deep anaesthesia accompanied by deep analgesia, hypoventilation, hypothermia and bradycardia and complete loss of all reflexes in all birds. In both groups, recovery from sedation and anaesthesia was smooth and of short duration. From this study it was concluded that for minor and least painful procedures in quails detomidine can be used alone, while for major and painful surgical procedures detomidine-ketamine combination should be preferred.

  10. Ketamine administration in depressive disorders: a systematic review and meta-analysis.

    Science.gov (United States)

    Fond, Guillaume; Loundou, Anderson; Rabu, Corentin; Macgregor, Alexandra; Lançon, Christophe; Brittner, Marie; Micoulaud-Franchi, Jean-Arthur; Richieri, Raphaelle; Courtet, Philippe; Abbar, Mocrane; Roger, Matthieu; Leboyer, Marion; Boyer, Laurent

    2014-09-01

    Ketamine's efficacy in depressive disorders has been established in several controlled trials. The aim of the present study was to determine whether or not ketamine administration significantly improves depressive symptomatology in depression and more specifically in major depressive disorder (MDD), bipolar depression, resistant depression (non-ECT studies), and as an anesthetic agent in electroconvulsive therapy (ECT) for resistant depression (ECT studies). Secondary outcomes were the duration of ketamine's effect, the efficacy on suicidal ideations, the existence of a dose effect, and the safety/tolerance of the treatment. Studies were included if they met the following criteria (without any language or date restriction): design: randomized controlled trials, intervention: ketamine administration, participants: diagnosis of depression, and evaluation of severity based on a validated scale. We calculated standardized mean differences (SMDs) with 95 % confidence intervals (CIs) for each study. We used fixed and random effects models. Heterogeneity was assessed using the I2 statistic. We included nine non-ECT studies in our quantitative analysis (192 patients with major depressive disorder and 34 patients with bipolar depression). Overall, depression scores were significantly decreased in the ketamine groups compared to those in the control groups (SMD = -0.99; 95 % CI -1.23, -0.75; p depression (SMD = -1.34; 95 % CI -1.94, -0.75), and in drug-free patients as well as patients under medication. Four ECT trials (118 patients) were included in our quantitative analysis. One hundred and three patients were diagnosed with major depressive disorder and 15 with bipolar depression. Overall, depression scores were significantly improved in the 58 patients receiving ketamine in ECT anesthesia induction compared to the 60 patients (SMD = -0.56; 95 % CI -1.10, -0.02; p = 0.04; I2 = 52.4 %). The duration of ketamine's effects was assessed in only two non

  11. Ketamine and other glutamate receptor modulators for depression in adults.

    Science.gov (United States)

    Caddy, Caroline; Amit, Ben H; McCloud, Tayla L; Rendell, Jennifer M; Furukawa, Toshi A; McShane, Rupert; Hawton, Keith; Cipriani, Andrea

    2015-09-23

    Considering the ample evidence of involvement of the glutamate system in the pathophysiology of depression, pre-clinical and clinical studies have been conducted to assess the antidepressant efficacy of glutamate inhibition, and glutamate receptor modulators in particular. This review focuses on the use of glutamate receptor modulators in unipolar depression. To assess the effects - and review the acceptability - of ketamine and other glutamate receptor modulators in comparison to placebo (or saline placebo), other pharmacologically active agents, or electroconvulsive therapy (ECT) in alleviating the acute symptoms of depression in people with unipolar major depressive disorder. We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR, to 9 January 2015). This register includes relevant randomised controlled trials (RCTs) from: the Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). We did not apply any restrictions to date, language or publication status. Double- or single-blind RCTs comparing ketamine, memantine, or other glutamate receptor modulators with placebo (or saline placebo), other active psychotropic drugs, or electroconvulsive therapy (ECT) in adults with unipolar major depression. Three review authors independently identified studies, assessed trial quality and extracted data. The primary outcomes for this review were response rate and adverse events. We included 25 studies (1242 participants) on ketamine (9 trials), memantine (3), AZD6765 (3), D-cycloserine (2), Org26576 (2), atomoxetine (1), CP-101,606 (1), MK-0657 (1), N-acetylcysteine (1), riluzole (1) and sarcosine (1). Twenty-one studies were placebo-controlled and the majority were two-arm studies (23 out of 25). Twenty-two studies defined an inclusion criteria specifying the severity of depression; 11 specified at least moderate depression; eight, severe depression; and the remaining three

  12. Pellet injector research and development at ORNL

    International Nuclear Information System (INIS)

    Combs, S.K.; Argo, B.E.; Baylor, L.R.; Cole, M.J.; Dyer, G.R.; Fehling, D.T.; Fisher, P.W.; Foster, C.A.; Foust, C.R.; Gouge, M.J.; Jernigan, T.C.; Langley, R.A.; Milora, S.L.; Qualls, A.L.; Schechter, E.; Sparks, D.O.; Tsai, C.C.; Wilgen, J.B.; Whealton, J.W.

    1993-01-01

    A variety of pellet injector designs have been developed at ORNL including single-shot guns that inject one pellet, multiple-shot guns that inject four and eight pellets, machine gun-types (single- and multiple-barrel) that can inject up to >100 pellets, and centrifugal accelerators (mechanical devices that are inherently capable of high repetition rates and long-pulse operation). With these devices, macroscopic pellets (1--6 mm in diameter) composed of hydrogen isotopes are typically accelerated to speeds of ∼1.0 to 2.0 km/s for injection into plasmas of experimental fusion devices. In the past few years, steady progress has been made at ORNL in the development and application of pellet injectors for fueling present-day and future fusion devices. In this paper, we briefly describe some research and development activities at ORNL, including: (1) two recent applications and a new one on large experimental fusion devices, (2) high-velocity pellet injector development, and (3) tritium injector research

  13. Low-dose ketamine infusion for labor analgesia: A double-blind, randomized, placebo controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Sam Joel

    2014-01-01

    Full Text Available Background: Most primary and secondary level hospitals in developing countries provide inadequate labor analgesia due to various medical, technical and economic reasons. This clinical trial was an effort to study the efficacy, safety and feasibility of intravenous (IV ketamine to provide labor analgesia. Materials and Methods: A total of 70 parturients were consented and randomly assigned to receive either IV ketamine or 0.9% saline. A loading dose of ketamine (0.2 mg/kg was followed-by an infusion (0.2 mg/kg/h until the delivery of the neonate. Similar volume of saline was infused in the placebo-group. Intramuscular meperidine was the rescue analgesic in both groups. The pain score, hemodynamic parameters of mother and fetus and the anticipated side-effects of ketamine were observed for. The newborn was assessed by the Neonatologist. Results: The pain score showed a decreasing trend in the ketamine group and after the 1 st h more than 60% of women in the ketamine group had pain relief, which was statistically significant. There was no significant clinical change in the maternal hemodynamics and fetal heart rate. However, 17 (48.5% of them had transient light headedness in the ketamine group. All the neonates were breast fed and the umbilical cord blood pH was between 7.1 and 7.2. The overall satisfaction was significantly high in the intervention group (P = 0.028. Conclusion: A low-dose ketamine infusion (loading dose of 0.2 mg/kg delivered over 30 min, followed-by an infusion at 0.2 mg/kg/h could provide acceptable analgesia during labor and delivery.

  14. Ketamine as an Adjunct to Opioids for Acute Pain in the Emergency Department: A Randomized Controlled Trial.

    Science.gov (United States)

    Bowers, Karen J; McAllister, Kelly B; Ray, Meredith; Heitz, Corey

    2017-06-01

    This study had five objectives: 1) to measure and compare total opioid use and number of opioid doses in patients treated with opioids versus ketamine in conjunction with opioids; 2) to measure pain scores up to 2 hours after presentation in the ED patient with pain, comparing standard opioid pain control to ketamine in conjunction with opioids; 3) to compare patient satisfaction with pain control using opioids alone versus ketamine in conjunction with opioids; 4) to monitor and compare side effects in patients treated with opioids versus ketamine in conjunction with opioids; and 5) to identify effect variation between different subgroups of patients, with the purpose of focusing future research. We hypothesized that low-dose ketamine, compared to placebo, as an adjunctive treatment to opioids would result in better pain control over 2 hours and greater patient satisfaction with pain control; further, this protocol will result in a lower opioid dosage over 2 hours. This was a randomized, double-blinded, placebo-controlled trial at a single academic emergency department evaluating the use of ketamine versus placebo in conjunction with opioids for moderate to severe pain. Subjects with a continued high level of pain after an initial dose of opioid analgesia were randomized to receive either 0.1 mg/kg ketamine or placebo prior to protocol-based dosing of additional opioid analgesia, if required. Over 120 minutes, subjects were assessed for pain level (0-10), satisfaction with pain control (0-4), side effects, sedation level, and need for additional pain medication. Total opioid dose, including the initial dose, was compared between groups. Sixty-three subjects were randomized to the placebo group and 53 to the ketamine group. No significant differences were found in demographics between the groups. Patients receiving ketamine reported lower pain scores over 120 minutes than patients receiving placebo (p = 0.015). Total opioid dose was lower in the ketamine group

  15. Ketamine as an Analgesic Adjuvant in Adult Trauma Intensive Care Unit Patients With Rib Fracture.

    Science.gov (United States)

    Walters, Mary K; Farhat, Joseph; Bischoff, James; Foss, Mary; Evans, Cory

    2018-03-01

    Rib fracture associated pain is difficult to control. There are no published studies that use ketamine as a therapeutic modality to reduce the amount of opioid to control rib fracture pain. To examine the analgesic effects of adjuvant ketamine on pain scale scores in trauma intensive care unit (ICU) rib fracture. This retrospective, case-control cohort chart review evaluated ICU adult patients with a diagnosis of ≥1 rib fracture and an Injury Severity Score >15 during 2016. Patients received standard-of-care pain management with the physician's choice analgesics with or without ketamine as a continuous, fixed, intravenous infusion at 0.1 mg/kg/h. A total of 15 ketamine treatment patients were matched with 15 control standard-of-care patients. Efficacy was measured via Numeric Pain Scale (NPS)/Behavioral Pain Scale (BPS) scores, opioid use, and ICU and hospital length of stay. Safety of ketamine was measured by changes in vital signs, adverse effects, and mortality. Average NPS/BPS, severest NPS/BPS, and opioid use were lower in the ketamine group than in controls (NPS: 4.1 vs 5.8, P rib fracture.

  16. Review on pressure swirl injector in liquid rocket engine

    Science.gov (United States)

    Kang, Zhongtao; Wang, Zhen-guo; Li, Qinglian; Cheng, Peng

    2018-04-01

    The pressure swirl injector with tangential inlet ports is widely used in liquid rocket engine. Commonly, this type of pressure swirl injector consists of tangential inlet ports, a swirl chamber, a converging spin chamber, and a discharge orifice. The atomization of the liquid propellants includes the formation of liquid film, primary breakup and secondary atomization. And the back pressure and temperature in the combustion chamber could have great influence on the atomization of the injector. What's more, when the combustion instability occurs, the pressure oscillation could further affects the atomization process. This paper reviewed the primary atomization and the performance of the pressure swirl injector, which include the formation of the conical liquid film, the breakup and atomization characteristics of the conical liquid film, the effects of the rocket engine environment, and the response of the injector and atomization on the pressure oscillation.

  17. COMPARATIVE EFFICACY OF DETOMIDINE AND DETOMIDINE - KETAMINE COCKTAIL IN QUAILS

    OpenAIRE

    U. F. Durrani, M. Ashraf and A. Khalid¹

    2005-01-01

    Twenty adult healthy quails (Coturnix coturnix) were divided into two equal groups. One group was administered detomidine (2.4 mg/kg, I/M) and other group was administered detomidine-ketamine cocktail (1.2 mg/kg + 30 mg/kg, I/M). Detomidine slowly and smoothly induced a light sedation accompanied by superficial analgesia, hypoventilation, hypothermia and bradycardia in all birds. Detomidine-ketamine cocktail rapidly and smoothly induced a deep anaesthesia accompanied by deep analgesia, hypove...

  18. Ketamine infusion was effective for severe pain of Non-Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Tomoki Nishiyama

    2017-10-01

    Full Text Available A 52 years old man with a Non-Hodgkin lymphoma had severe pain at right buttock and lower leg. Sustained-release tablet of morphine 90 mg/day, intravenous morphine 40 mg/day, granisetron 9 mg/day, metoclopramide 30 mg/day, domperidone suppository 60 mg/day, intravenous hydroxyzine 25 mg/day, and haloperidol 20 mg/day did not decrease pain and side effects. Intravenous ketamine 10 mg in 15 min was quite effective for analgesia. Then infusion of ketamine started with 7 mg/h and increased to 10 mg/h with morphine 20 mg/day, which could control pain well with no side effects until his death. Keywords: Ketamine, Morphine, Cancer pain, Terminal

  19. Anestesi Infus Gravimetrik Ketamin dan Propofol pada Anjing (THE GRAVIMETRIC INFUSION ANAESTHESIA WITH KETAMINE AND PROPOFOL IN DOGS

    Directory of Open Access Journals (Sweden)

    I Gusti Ngurah Sudisma

    2014-08-01

    Full Text Available This study aim was to evaluate quality of anaesthesia by using gravimetric infusion anaesthesia withketamine and propofol in dogs. The quality of anaesthesia, duration of actions, and the physiological responsseof anaesthesia were evaluated in twenty domestic dogs. Anaesthesia was induced intramuscularly withatropine (0.03 mg/kg-xylazine (2 mg/kg (AX, intravenously ketamine-propofol (KP (4 mg/kg, andmaintained with continuous intravenous infusion with pre-mixed propofol (P and normal saline containing2 mg/ml of propofol and 2 mg/ml of ketamine (K. Domestic stray dogs were randomly divided into fivegroups. Groups AXKP-K2P2, AXKP-K4P4, and AXKP-K6P6 were treated with ketamine-propofol the dose0.2 mg/kg/minute, 0.4 and 0.6 mg/kg/minute respectively, while group AXKP-P4 was given propofol 0.4 mg/kg/minute and group AXKP-I was given isoflurane 1-2%. Heart rate (HR, respiratory rate (RR,electrocardiogram (ECG, blood oxygen saturation (SpO2, end tidal CO2 (ET CO2, and capillary refill time(CRT were measured. No significant difference (P>0.05 found between the groups in anaesthetion times.All groups showed rapid and smooth inductions, prolonged surgical stage, and rapid recovery. Groups AXKPK2P2and AXKP-K4P4 showed minimal physiological effect on the dogs. The HR, RR, ET CO2, SpO2, CRT,and ECG wave were stabl. Combination of AXKP-K6P6 induced SpO2 depression, increased and instabilityof HR, RR and ET CO2. Groups AXKP-P4 showed decreased of HR and respiratory depression. All anaestheticcombinations showed no significant influence (P>0.05 on the electricity of the dog’s heart. The combinationof ketamine-propofol at dose 0.2 and 0.4 mg/kg/minute were found to be better as an application formaintaining anaesthesia by gravimetric continuous intravenous infusion. The method is a suitablealternative for inhalation anaesthesia in dogs.

  20. Ketamine Use for Successful Resolution of Post-ERCP Acute Pancreatitis Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Suneel M. Agerwala

    2017-01-01

    Full Text Available We report a case in which a patient with intractable pain secondary to post-endoscopic retrograde cholangiopancreatography (ERCP acute pancreatitis is successfully treated with a subanesthetic ketamine infusion. Shortly after ERCP, the patient reported severe stabbing epigastric pain. She exhibited voluntary guarding and tenderness without distension. Amylase and lipase levels were elevated. Pain persisted for hours despite hydromorphone PCA, hydromorphone boluses, fentanyl boluses, and postprocedure anxiolytics. Pain management was consulted and a ketamine infusion was trialed, leading to a dramatic reduction in pain. This case suggests that ketamine may be a promising option in treating intractable pain associated with ERCP acute pancreatitis.

  1. Effects of ketamine on glucose uptake by glucose transporter type 3 expressed in Xenopus oocytes: The role of protein kinase C

    Energy Technology Data Exchange (ETDEWEB)

    Tomioka, Shigemasa, E-mail: tomioka@dent.tokushima-u.ac.jp [Department of Dental Anesthesiology, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho 18-15, Tokushima City, Tokushima 770-8504 (Japan); Kaneko, Miyuki [Department of Dental Anesthesiology, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho 18-15, Tokushima City, Tokushima 770-8504 (Japan); Satomura, Kazuhito [First Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho 18-15, Tokushima City, Tokushima 770-8504 (Japan); Mikyu, Tomiko; Nakajo, Nobuyoshi [Department of Dental Anesthesiology, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho 18-15, Tokushima City, Tokushima 770-8504 (Japan)

    2009-10-09

    We investigated the effects of ketamine on the type 3 facilitative glucose transporter (GLUT3), which plays a major role in glucose transport across the plasma membrane of neurons. Human-cloned GLUT3 was expressed in Xenopus oocytes by injection of GLUT3 mRNA. GLUT3-mediated glucose uptake was examined by measuring oocyte radioactivity following incubation with 2-deoxy-D-[1,2-{sup 3}H]glucose. While ketamine and S(+)-ketamine significantly increased GLUT3-mediated glucose uptake, this effect was biphasic such that higher concentrations of ketamine inhibited glucose uptake. Ketamine (10 {mu}M) significantly increased V{sub max} but not K{sub m} of GLUT3 for 2-deoxy-D-glucose. Although staurosporine (a protein kinase C inhibitor) increased glucose uptake, no additive or synergistic interactions were observed between staurosporine and racemic ketamine or S(+)-ketamine. Treatment with ketamine or S(+)-ketamine partially prevented GLUT3 inhibition by the protein kinase C activator phorbol-12-myrisate-13-acetate. Our results indicate that ketamine increases GLUT3 activity at clinically relevant doses through a mechanism involving PKC inhibition.

  2. Effects of ketamine on glucose uptake by glucose transporter type 3 expressed in Xenopus oocytes: The role of protein kinase C

    International Nuclear Information System (INIS)

    Tomioka, Shigemasa; Kaneko, Miyuki; Satomura, Kazuhito; Mikyu, Tomiko; Nakajo, Nobuyoshi

    2009-01-01

    We investigated the effects of ketamine on the type 3 facilitative glucose transporter (GLUT3), which plays a major role in glucose transport across the plasma membrane of neurons. Human-cloned GLUT3 was expressed in Xenopus oocytes by injection of GLUT3 mRNA. GLUT3-mediated glucose uptake was examined by measuring oocyte radioactivity following incubation with 2-deoxy-D-[1,2- 3 H]glucose. While ketamine and S(+)-ketamine significantly increased GLUT3-mediated glucose uptake, this effect was biphasic such that higher concentrations of ketamine inhibited glucose uptake. Ketamine (10 μM) significantly increased V max but not K m of GLUT3 for 2-deoxy-D-glucose. Although staurosporine (a protein kinase C inhibitor) increased glucose uptake, no additive or synergistic interactions were observed between staurosporine and racemic ketamine or S(+)-ketamine. Treatment with ketamine or S(+)-ketamine partially prevented GLUT3 inhibition by the protein kinase C activator phorbol-12-myrisate-13-acetate. Our results indicate that ketamine increases GLUT3 activity at clinically relevant doses through a mechanism involving PKC inhibition.

  3. Pellet injectors for the tokamak fusion test reactor

    International Nuclear Information System (INIS)

    Combs, S.K.

    1986-01-01

    The repeating pneumatic injector is a device from the ORNL development program. A new eight-shot deuterium pellet injector has been designed and constructed specifically for the TFTR application and is scheduled to replace the repeating injector this year. The new device combines a cryogenic extruder and a cold wheel rotary mechanism to form and chamber eight pellets in a batch operation; the eight pellets can then be delivered in any time sequence. Another unique feature of the device is the variable pellet size with three pellets each of 3.0 and 3.5 mm diam and two each of 4.0 mm diam. The experience and technology that have been developed on previous injectors at ORNL have been utilized in the design of this latest pellet injection system

  4. Spray Modeling for Outwardly-Opening Hollow-Cone Injector

    KAUST Repository

    Sim, Jaeheon; Badra, Jihad; Elwardani, Ahmed Elsaid; Im, Hong G.

    2016-01-01

    linear instability sheet atomization (LISA) model was originally developed for pressure swirl hollow-cone injectors with moderate spray angle and toroidal ligament breakups. Therefore, it is not appropriate for the outwardly-opening injectors having wide

  5. Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia.

    Science.gov (United States)

    Xu, Ke; Krystal, John H; Ning, Yuping; Chen, Da Chun; He, Hongbo; Wang, Daping; Ke, Xiaoyin; Zhang, Xifan; Ding, Yi; Liu, Yuping; Gueorguieva, Ralitza; Wang, Zuoheng; Limoncelli, Diana; Pietrzak, Robert H; Petrakis, Ismene L; Zhang, Xiangyang; Fan, Ni

    2015-02-01

    Studies of the effects of the N-methyl-d-aspartate (NMDA) glutamate receptor antagonist, ketamine, have suggested similarities to the symptoms of schizophrenia. Our primary goal was to evaluate the dimensions of the Positive and Negative Syndrome Scale (PANSS) in ketamine users (acute and chronic) compared to schizophrenia patients (early and chronic stages). We conducted exploratory factor analysis for the PANSS from four groups: 135 healthy subject administrated ketamine or saline, 187 inpatients of ketamine abuse; 154 inpatients of early course schizophrenia and 522 inpatients of chronic schizophrenia. Principal component factor analyses were conducted to identify the factor structure of the PANSS. Factor analysis yielded five factors for each group: positive, negative, cognitive, depressed, excitement or dissociation symptoms. The symptom dimensions in two schizophrenia groups were consistent with the established five-factor model (Wallwork et al., 2012). The factor structures across four groups were similar, with 19 of 30 symptoms loading on the same factor in at least 3 of 4 groups. The factors in the chronic ketamine group were more similar to the factors in the two schizophrenia groups rather than to the factors in the acute ketamine group. Symptom severities were significantly different across the groups (Kruskal-Wallis χ(2)(4) = 540.6, p Symptoms in the two ketamine groups were milder than in the two schizophrenia groups (Cohen's d = 0.7). Our results provide the evidence of similarity in symptom dimensions between ketamine psychosis and schizophrenia psychosis. The interpretations should be cautious because of potential confounding factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Safety-efficacy balance of S-ketamine and S-norketamine in acute and chronic pain

    OpenAIRE

    Noppers, Ingeborg Marieke

    2011-01-01

    The balance between safety and efficacy is important in pharmacotherapy. When the indication of a registered drug shifts to another disease or a different patient population, studies on safety and efficacy need to be performed. Ketamine is a relatively ‘old’ drug and used for almost 50 years as an anesthetic. Recently there has been a renewed interest for the treatment of therapy-resistant chronic pain with subanesthetic doses of ketamine. This thesis describes the effects of S-ketamine in pa...

  7. Comparison of the preventive analgesic effect of rectal ketamine and rectal acetaminophen after pediatric tonsillectomy

    Directory of Open Access Journals (Sweden)

    S Morteza Heidari

    2012-01-01

    Full Text Available Objectives: There is a little data about rectal administration of Ketamine as a postoperative analgesic, so we compared the efficacy of rectal ketamine with rectal acetaminophen, which is applied routinely for analgesia after painful surgeries like tonsillectomy. Methods: In this single-blinded comparative trial, we enrolled 70 children undergoing elective tonsillectomy, and divided them randomly in two groups. Patients received rectal ketamine (2 mg / kg or rectal acetaminophen (20 mg / kg at the end of surgery. The children′s Hospital of Eastern Ontario Pain scale was used to estimate pain in children. Also the vital signs, Wilson sedation scale, and side effects in each group were noted and compared for 24 hours. Results: The ketamine group had a lower pain score at 15 minutes and 60 minutes after surgery in Recovery (6.4 ± 0.8, 7.4 ± 1 vs. 7.1 ± 1.2, 7.8 ± 1.2 in the acetaminophen group, P < 0.05 and one hour and two hours in the ward (7.2 ± 0.7, 7 ± 0.5 vs. 7.9 ± 1.2, 7.5 ± 1.2 in the acetaminophen group, P < 0.05, with no significant differences till 24 hours. Dreams and hallucinations were not reported in the ketamine group. Systolic blood pressure was seen to be higher in the ketamine group (104.4 ± 7.9 vs. 99.8 ± 7.7 in the acetaminophen group and nystagmus was reported only in the ketamine group (14.2%. Other side effects were equivalent in both the groups. Conclusions: With low complications, rectal ketamine has analgesic effects, especially in the first hours after surgery in comparison with acetaminophen, and it can be an alternative analgesic with easy administration in children after tonsillectomy.

  8. Immediate ketamine treatment does not prevent posttraumatic stress responses in an animal model for PTSD.

    Science.gov (United States)

    Juven-Wetzler, Alzbeta; Cohen, Hagit; Kaplan, Zeev; Kohen, Avi; Porat, Oren; Zohar, Joseph

    2014-03-01

    Clinical studies suggest that administration of ketamine hydrochloride-an antagonist at the N-methyl-d-aspartate ionophore-provides short-term amelioration for depressive symptoms. The effects of a brief course of ketamine given immediately following exposure to psychogenic stress on the behavioral stress responses were assessed in an animal model of posttraumatic stress disorder. Animals exposed to stress were treated 1h later with ketamine (0.5, 5, and 15 mg/kg) or vehicle for three days (N = 107). Outcome measures included behavior in the elevated plus maze (EPM) and acoustic startle response (ASR) tests 30 days after initial exposure and freezing behavior upon exposure to a trauma-cue on day 31. Pre-set cut-off behavioral criteria classified exposed animals according to their EPM and ASR response-patterns into "extreme," "minimal," or "partial" behavioral response for analysis of prevalence rates of "PTSD-like behavior." Circulating corticosterone levels were assessed 20 min after injection of ketamine in exposed and unexposed animals (N = 62). The dexamethasone suppression test was used to assess negative feedback inhibition of the HPA axis. Prevalence rates of extremely-, partially-, or minimally-disrupted behavior demonstrated that ketamine administered immediately following stress exposure was ineffective in alleviating "PTSD-like behavior" at day 30 after exposure. Administration of ketamine was associated with increase in freezing behavior after exposure to a trauma-cue on day 31. Corticosterone levels were significantly suppressed by ketamine only in the exposed animals. Administration of ketamine immediately following trauma-exposure may not only be ineffective but actually detrimental in the long term. A disruption of the post-stress HPA-response has been raised as a contributing factor. © 2013 Published by Elsevier B.V. and ECNP.

  9. S-ketamine influences strategic allocation of attention but not exogenous capture of attention.

    Science.gov (United States)

    Fuchs, Isabella; Ansorge, Ulrich; Huber-Huber, Christoph; Höflich, Anna; Lanzenberger, Rupert

    2015-09-01

    We investigated whether s-ketamine differentially affects strategic allocation of attention. In Experiment 1, (1) a less visible cue was weakly masked by the onsets of competing placeholders or (2) a better visible cue was not masked because it was presented in isolation. Both types of cue appeared more often opposite of the target (75%) than at target position (25%). With this setup, we tested for strategic attention shifts to the opposite side of the cues and for exogenous attentional capture toward the cue's side in a short cue-target interval, as well as for (reverse) cueing effects in a long cue-target interval after s-ketamine and after placebo treatment in a double-blind within-participant design. We found reduced strategic attention shifts after cues presented without placeholders for the s-ketamine compared to the placebo treatment in the short interval, indicating an early effect on the strategic allocation of attention. No differences between the two treatments were found for exogenous attentional capture by less visible cues, suggesting that s-ketamine does not affect exogenous attentional capture in the presence of competing distractors. Experiment 2 confirmed that the competing onsets of the placeholders prevented the strategic cueing effect. Taken together, the results indicate that s-ketamine affects strategic attentional capture, but not exogenous attentional capture. The findings point to a more prominent role of s-ketamine during top-down controlled forms of attention that require suppression of automatic capture than during automatic capture itself. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Engineering problems of future neutral beam injectors

    International Nuclear Information System (INIS)

    Fink, J.

    1977-01-01

    Because there is no limit to the energy or power that can be delivered by a neutral-beam injector, its use will be restricted by either its cost, size, or reliability. Studies show that these factors can be improved by the injector design, and several examples, taken from mirror reactor studies, are given

  11. Biochemical Effects of Xylazine, Propofol, and Ketamine in West African Dwarf Goats

    Directory of Open Access Journals (Sweden)

    Ukwueze Celestine Okwudili

    2014-01-01

    Full Text Available Anaesthesia was induced in West African Dwarf (WAD goats using different combinations of propofol (P, xylazine (X, and ketamine (K, and the biochemical effect of the drugs determined. Twenty male (WAD goats were randomly assigned to five treatment groups viz. Control (C (2.5 mL IV normal saline; group K + X (5 mg/kg IV ketamine + 0.05 mg/kg IV xylazine, group P + X (5 mg/kg IV propofol + 0.05 mg/kg IV xylazine, group P + K (propofol 5 mg/kg IV + ketamine 5 mg/kg IV, and group P + K + X (propofol 2.5 mg/kg IV + ketamine 2.5 mg/kg IV + xylazine 0.05 mg/kg IV, respectively. There was increase (P0.05 in serum creatinine. These biochemical changes were transient. P + K + X would be the best drug combinations considering the biochemical parameter measured. However, data on blood glucose, ALT, BUN, and cortisol levels in an anaesthsized goat should be interpreted with caution in order to avoid erroneous interpretation in these animals.

  12. Effect of ketamine dose on self-rated dissociation in patients with treatment refractory anxiety disorders.

    Science.gov (United States)

    Castle, Cameron; Gray, Andrew; Neehoff, Shona; Glue, Paul

    2017-10-01

    Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25-1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety. Dissociation ratings were increased by ketamine in a dose-dependent manner. In contrast, midazolam showed no effect on ratings of dissociation. For individual CADSS items, the magnitude of change and the ketamine dose at which changes were observed were not homogenous. The Cronbach alpha for the total scale was high (0.937), with acceptable item-rest correlations for almost all individual items. Purposefully removing items to maximise alpha did not lead to meaningful improvements. Acceptable internal consistency was still observed after removing items which lacked evidence of responsiveness at lower doses. The high Cronbach alpha values identified in this study suggests that the CADSS is an internally consistent instrument for evaluating ketamine-induced dissociation in clinical trials in anxiety, although it does not capture symptoms such as thought disorder.

  13. Necessary LIU studies in the injectors during 2012

    International Nuclear Information System (INIS)

    Rumolo, G.; Bartosik, H.; Papaphilippou, Y.

    2012-01-01

    A significant fraction of the Machine Development (MD) time in the LHC injectors in 2011 was devoted to the study of the intensity limitations in the injectors (e.g. space charge effects in PS and SPS, electron cloud effects in the PS and SPS, single bunch and multi-bunch instabilities in PS and SPS, emittance preservation across the injector chain, etc.). The main results achieved in 2011 are presented as well as the questions that still remain unresolved and are of relevance for the LHC Injector Upgrade (LIU) project. 2012 MD will also continue exploring the potential of scenarios that might become operational in the future, like the development of a low gamma transition optics in the SPS or alternative production schemes for the LHC beams in the PS. A tentative prioritized list of studies is provided. (authors)

  14. Geometrical characterization and performance optimization of monopropellant thruster injector

    Directory of Open Access Journals (Sweden)

    T.R. Nada

    2012-12-01

    Full Text Available The function of the injector in a monopropellant thruster is to atomize the liquid hydrazine and to distribute it over the catalyst bed as uniformly as possible. A second objective is to place the maximum amount of catalyst in contact with the propellant in as short time as possible to minimize the starting transient time. Coverage by the spray is controlled mainly by cone angle and diameter of the catalyst bed, while atomization quality is measured by the Sauter Mean Diameter, SMD. These parameters are evaluated using empirical formulae. In this paper, two main types of injectors are investigated; plain orifice and full cone pressure swirl injectors. The performance of these two types is examined for use with blow down monopropellant propulsion system. A comprehensive characterization is given and design charts are introduced to facilitate optimizing the performance of the injector. Full-cone injector is a more suitable choice for monopropellant thruster and it might be available commercially.

  15. Heavy ion fusion 2 MV injector

    International Nuclear Information System (INIS)

    Yu, S.; Eylon, S.; Henestroza, E.

    1995-04-01

    A heavy-ion-fusion driver-scale injector has been constructed and operated at Lawrence Berkeley Laboratory. The injector has produced 2.3 MV and 950 mA of K + , 15% above original design goals in energy and current. Normalized edge emittance of less than 1 π mm-mr was measured over a broad range of parameters. The head-to-tail energy flatness is less than ± 0.2% over the 1 micros pulse

  16. ELECTRON BEAM ION SOURCE PRE-INJECTOR DIGNOSTICS

    International Nuclear Information System (INIS)

    WILINSKI, M.; ALESSI, J.; BEEBE, E.; BELLAVIA, S.; PIKIN, A.

    2006-01-01

    A new ion pre-injector line is currently under design at Brookhaven National Laboratory (BNL) for the Relativistic Heavy Ion Collider (RHIC) and the NASA Space Radiation Laboratory (NSRL,). Collectively, this new line is referred to as the EBIS project. This pre-injector is based on an Electron Beam Ion Source (EBIS), a Radio Frequency Quadrupole (R-FQ) accelerator, and a linear accelerator. The new EBIS will be able to produce a wide range of heavy ion species as well as rapidly switching between species. To aid in operation of the pre-injector line, a suite of diagnostics is currently proposed which includes faraday cups, current transformers, profile monitors, and a pepperpot emittance measurement device

  17. Pilot Randomized Controlled Trial of Titrated Subcutaneous Ketamine in Older Patients with Treatment-Resistant Depression.

    Science.gov (United States)

    George, Duncan; Gálvez, Verònica; Martin, Donel; Kumar, Divya; Leyden, John; Hadzi-Pavlovic, Dusan; Harper, Simon; Brodaty, Henry; Glue, Paul; Taylor, Rohan; Mitchell, Philip B; Loo, Colleen K

    2017-11-01

    To assess the efficacy and safety of subcutaneous ketamine for geriatric treatment-resistant depression. Secondary aims were to examine if repeated treatments were safe and more effective in inducing or prolonging remission than a single treatment. In this double-blind, controlled, multiple-crossover study with a 6-month follow-up (randomized controlled trial [RCT] phase), 16 participants (≥60 years) with treatment-resistant depression who relapsed after remission or did not remit in the RCT were administered an open-label phase. Up to five subcutaneous doses of ketamine (0.1, 0.2, 0.3, 0.4, and 0.5 mg/kg) were administered in separate sessions (≥1 week apart), with one active control (midazolam) randomly inserted (RCT phase). Twelve ketamine treatments were given in the open-label phase. Mood, hemodynamic, and psychotomimetic outcomes were assessed by blinded raters. Remitters in each phase were followed for 6 months. Seven of 14 RCT-phase completers remitted with ketamine treatment. Five remitted at doses below 0.5 mg/kg. Doses ≥ 0.2 mg/kg were significantly more effective than midazolam. Ketamine was well tolerated. Repeated treatments resulted in higher likelihood of remission or longer time to relapse. Results provide preliminary evidence for the efficacy and safety of ketamine in treating elderly depressed. Dose titration is recommended for optimizing antidepressant and safety outcomes on an individual basis. Subcutaneous injection is a practical method for giving ketamine. Repeated treatments may improve remission rates (clinicaltrials.gov; NCT01441505). Copyright © 2017 American Association for Geriatric Psychiatry. All rights reserved.

  18. Improved methods for thermal rearrangement of alicyclic α-hydroxyimines to α-aminoketones: synthesis of ketamine analogues as antisepsis candidates.

    Science.gov (United States)

    Elhawi, Hagit; Eini, Hadar; Douvdevani, Amos; Byk, Gerardo

    2012-06-04

    Ketamine is an analgesic/anesthetic drug, which, in combination with other drugs, has been used as anesthetic for over 40 years. Ketamine induces its analgesic activities by blocking the N-methyl-D-aspartate (NMDA) receptor in the central nervous system (CNS). We have reported that low doses of ketamine administrated to patients before incision significantly reduced post-operative inflammation as reflected by reduced interleukin-6 (IL-6) sera-levels. Our data demonstrated in a rat model of Gram-negative bacterial-sepsis that if we inject a low dose of ketamine following bacterial inoculation we reduce mortality from approximately 75% to 25%. Similar to what we have observed in operated patients, the levels of TNF-α and IL-6 in ketamine-treated rats were significantly lower than in septic animals not treated with ketamine. On the base of these results, we have designed and synthesized series of new analogues of ketamine applying a thermal rearrangement of alicyclic α-hydroxyimines to a-aminoketones in parallel arrays. One of the analogues (compound 6e) displayed high activity in down-regulating the levels of IL-6 and TNF-α in vivo as compared to ketamine.

  19. Long-Term Intravenous Ketamine for Analgesia in a Child with Severe Chronic Intestinal Graft versus Host Disease

    Directory of Open Access Journals (Sweden)

    Jennifer Busse

    2015-01-01

    Full Text Available Ketamine is reported to be an effective adjuvant to opioids in the treatment of refractory cancer pain; however, the use of high doses of ketamine for extended periods in pediatric patients has not been described. We present a five-year-old male with grade IV intestinal GVHD whose abdominal pain required both hydromorphone and ketamine for a period of over four months. There was no evidence of hepatotoxicity, hemorrhagic cystitis, or other adverse effects. Possible withdrawal symptoms were mild and were readily mitigated by gradually weaning ketamine.

  20. Development of a checklist of short-term and long-term psychological symptoms associated with ketamine use.

    Science.gov (United States)

    Fan, Ni; Xu, Ke; Ning, Yuping; Wang, Daping; Ke, Xiaoyin; Ding, Yi; Sun, Bin; Zhou, Chao; Deng, Xuefeng; Rosenheck, Robert; He, Hongbo

    2015-06-25

    Ketamine is an increasingly popular drug of abuse in China but there is currently no method for classifying the psychological effects of ketamine in individuals with ketamine dependence. Develop a scale that characterizes the acute and long-term psychological effects of ketamine use among persons with ketamine dependence. We developed a preliminary symptom checklist with 35 dichotomous ('yes' or 'no') items about subjective feelings immediately after ketamine use and about perceived long-term effects of ketamine use that was administered to 187 inpatients with ketamine dependence recruited from two large hospitals in Guangzhou, China. Exploratory factor analysis (EFA) was conducted on a randomly selected half of thesample to reduce the items and to identify underlying constructs. Confirmatory factor analysis (CFA) was conducted on the second half of the sample to assess the robustness of the identified factor structure. Among the 35 symptoms, the most-reported acute effects were 'floating or circling' (94%), 'euphoric when listening to rousing music' (86%), and 'feeling excited, talkative, and full of energy' (67%). The mostreported long-term symptoms were 'memory impairment' (93%), 'personality changes' (86%), and 'slowed reactions' (81%). EFA resulted in a final 22-item scale best modelled by a four-factor model: two factors representing chronic symptoms (social withdrawal and sleep disturbances), one about acute psychoticlike symptoms, and one that combined acute drug-related euphoria and longer-term decreased libido. CFA showed that these 4 factors accounted for 50% of the total variance of the final 22-item scale and that the model fit was fair (Goodness of Fit Index, GIF=83.3%; Root Mean Square Error of Approximation, RMSEA=0.072). A four-factor model including social withdrawal, sleep disturbance, psychotic-like symptoms, and euphoria at the time of drug use provides a fair description of the short-term and long-term psychological symptoms associated with

  1. Status and performance of PF injector linac

    International Nuclear Information System (INIS)

    Sato, Isamu

    1994-01-01

    PF injector linac has been improved on a buncher section for accelerating of intense electron beam, and reinforced a focusing system of the positron generator linac for the expansion of phase space. In this presentation, I shall report present status and performance of PF injector linac, and discuss its upgrade program for B-factory project. (author)

  2. Anorectal manometry with and without ketamine for evaluation of defecation disorders in children.

    Science.gov (United States)

    Keshtgar, A S; Choudhry, M S; Kufeji, D; Ward, H C; Clayden, G S

    2015-03-01

    Anorectal manometry (ARCM) provides valuable information in children with chronic constipation and fecal incontinence but may not be tolerated in the awake child. This study aimed to evaluate the effect of ketamine anesthesia on the assessment of anorectal function by manometry and to evaluate defecation dynamics and anal sphincter resting pressure in the context of pathophysiology of chronic functional (idiopathic) constipation and soiling in children. This was a prospective study of children who were investigated for symptoms of chronic constipation and soiling between April 2001 and April 2004. We studied 52 consecutive children who had awake ARCM, biofeedback training and endosonography (awake group) and 64 children who had ketamine anesthesia for ARCM and endosonography (ketamine group). We age matched 31 children who had awake anorectal studies with 27 who had ketamine anesthesia. The children in awake and ketamine groups were comparable for age, duration of bowel symptoms and duration of laxative treatments. ARCM profile was comparable between the awake and the ketamine groups with regard to anal sphincter resting pressure, rectal capacity, amplitude of rectal contractions, frequency of rectal and IAS contractions and functional length of anal canal. Of 52 children who had awake ARCM, dyssynergia of the EAS muscles was observed in 22 (42%) and median squeeze pressure was 87mm Hg (range 25-134). The anal sphincter resting pressure was non-obstructive and comparable to healthy normal children. Rectoanal inhibitory reflex was seen in all children excluding diagnosis of Hirschsprung disease. Ketamine anesthesia does not affect quantitative or qualitative measurements of autonomic anorectal function and can be used reliably in children who will not tolerate the manometry while awake. Paradoxical contraction of the EAS can only be evaluated in the awake children and should be investigated further as the underlying cause of obstructive defecation in patients with

  3. Digital Measuring Devices Used for Injector Hydraulic Test

    Directory of Open Access Journals (Sweden)

    S. N. Leontiev

    2015-01-01

    Full Text Available To ensure a high specific impulse of the LRE (liquid-propellant engine chamber it is necessary to have optimally organized combustion of the fuel components. This can be ensured by choosing the optimum geometry of gas-dynamic contour of the LRE combustor, as well as by improving the sputtering processes and mixing the fuel components, for example, by selection of the optimum type, characteristics, and location of injectors on the mixing unit of the chamber.These particular reasons arise the interest in the injector characteristics in terms of science, and technological aspects determine the need for control of underlying design parameters in their manufacture.The objective of this work is to give an experimental justification on used digital measurement instrumentation and research the hydraulic characteristics of injectors.To determine injector parameters most widely were used the units with sectional collectors. A technique to control injector parameters using the sectional collectors involves spraying the liquid by injector at a given pressure drop on it for a certain time (the longer, the higher the accuracy and reliability of the results and then determining the amount of liquid in each section to calculate the required parameters of injector.In this work the liquid flow through the injector was determined by high-precision flowmeters FLONET FN2024.1 of electromagnetic type, which have very high metrological characteristics, in particular a flow rate error does not exceed 0.5% in a range of water flow from Qmin= 0.0028 l/s to Qmax Qmax = 0.28 l/s. To determine the coefficient of uneven spray were used differential pressure sensors DMD 331-ASLX of company "DB Sensors RUS", which have an error of 0.075% with a range of differential pressure 0 ... 5 kPa. Measuring complex MIC-200 of company "NPP Measure" and WinPos software for processing array information provided entry, recording, and processing of all the data of the experiment.In this

  4. The use of sub-anesthetic intravenous ketamine and adjuvant dexmedetomidine when treating acute pain from CRPS.

    Science.gov (United States)

    Nama, Sharanya; Meenan, Daniel R; Fritz, William T

    2010-01-01

    Complex regional pain syndrome (CRPS) is a pain condition of the extremities that presents with pain and allodynia, decreased range of motion, swelling and skin changes. There are 2 forms of CRPS - Type I which does not have demonstrable nerve lesions and Type 2, which has evidence of obvious nerve damage. Management of refractory CRPS has been challenging. Some studies have revealed that the N-methyl-D-aspartic acid receptor (NMDAR) may be involved in the etiology of the pain in CRPS and perhaps that a NMDA receptor antagonist like ketamine is a potential treatment for CRPS. However, the side effect profile of ketamine is concerning, and limiting the adverse effects of the drug is beneficial. Dexmedetomidine is an alpha 2 agonist similar to clonidine with analgesic properties that can be used in combination with ketamine to provide additional analgesia in CRPS. This case describes the treatment of acute pain symptoms from Chronic Regional Pain Syndrome-Type 1 (CRPS-1) with sub-anesthetic intravenous infusion of ketamine with adjunct dexmedetomidine. A 47-year-old female patient presented with severe pain, burning and allodynia from CRPS-1 refractory to conventional therapy. She was then admitted to a monitored bed, received a sub-anesthetic intravenous infusion of ketamine with adjunct dexmedetomidine for 19 hours and subsequently discharged with complete resolution of her pain and associated symptoms. Here, the synergistic effect of the ketamine and dexmedetomidine together is shown to provide excellent symptom relief while decreasing the total ketamine administered. The combination minimized unwanted side effects and eliminated the need for intensive care unit admission secondary to anesthetic doses of ketamine.

  5. An effective dose of ketamine for eliminating pain during injection of propofol: a dose response study.

    Science.gov (United States)

    Wang, M; Wang, Q; Yu, Y Y; Wang, W S

    2013-09-01

    Ketamine can completely eliminate pain associated with propofol injection. However, the effective dose of ketamine to eliminate propofol injection pain has not been determined. The purpose of this study was to determine the effective dose of ketamine needed to eliminate pain in 50% and 95% of patients (ED50 and ED95, respectively) during propofol injections. This study was conducted in a double-blinded fashion and included 50 patients scheduled for elective gynecological laparoscopy under general anesthesia. The initial dose of ketamine used in the first patient was 0.25mg/kg. The dosing modifications were in increments or decrements of 0.025 mg/kg. Ketamine was administered 15 seconds before injecting propofol (2.5mg/kg), which was injected at a rate of 1mL/s. Patients were asked to rate their pain during propofol injection every 5s econds using a 0-3 pain scale. The highest pain score was recorded. The ED50, ED95 and 95% confidence intervals (CI) were determined by probit analyses. The dose of ketamine ranged from 0.175 to 0.275 mg/kg. The ED50 and ED95 of ketamine for eliminating pain during propofol injection were 0.227 mg/kg and 0.283 mg/kg, respectively (95%CI: 0.211-0.243 mg/kg and 0.26-0.364 mg/kg, respectively). Ketamine at an approximate dose of 0.3mg/kg was effective in eliminating pain during propofol injection. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  6. A systematic review and meta-analysis of ketamine for the prevention of persistent post-surgical pain.

    Science.gov (United States)

    McNicol, E D; Schumann, R; Haroutounian, S

    2014-11-01

    While post-operative pain routinely resolves, persistent post-surgical pain (PPSP) is common in certain surgeries; it causes disability, lowers quality of life and has economic consequences. The objectives of this systematic review and meta-analysis were to evaluate the effectiveness of ketamine in reducing the prevalence and severity of PPSP and to assess safety associated with its use. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE through December 2012 for articles in any language. We included randomized, controlled trials in adults in which ketamine was administered perioperatively via any route. Seventeen studies, the majority of which administered ketamine intravenously, met all inclusion criteria. The overall risk of developing PPSP was not significantly reduced at any time point in the ketamine group vs. placebo, nor did comparisons of pain severity scores reach statistical significance. Sensitivity analysis of exclusively intravenous ketamine studies included in this meta-analysis demonstrated statistically significant reductions in risk of developing PPSP at 3 and 6 months (P = 0.01 and P = 0.04, respectively). Adverse event rates were similar between ketamine and placebo groups. The study data from our review are heterogeneous and demonstrate efficacy of intravenously administered ketamine only in comparison with placebo. Highly variable timing and dosing of ketamine in these studies suggest that no unifying effective regimen has emerged. Future research should focus on clinically relevant outcomes, should stratify patients with pre-existing pain and possible central sensitization and should enroll sufficiently large numbers to account for loss to follow-up in long-term studies. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Glycine Transporter Inhibitor Attenuates the Psychotomimetic Effects of Ketamine in Healthy Males: Preliminary Evidence

    Science.gov (United States)

    D'Souza, Deepak Cyril; Singh, Nagendra; Elander, Jacqueline; Carbuto, Michelle; Pittman, Brian; de Haes, Joanna Udo; Sjogren, Magnus; Peeters, Pierre; Ranganathan, Mohini; Schipper, Jacques

    2012-01-01

    Enhancing glutamate function by stimulating the glycine site of the NMDA receptor with glycine, -serine, or with drugs that inhibit glycine reuptake may have therapeutic potential in schizophrenia. The effects of a single oral dose of cis-N-methyl-N-(6-methoxy-1-phenyl-1,2,3,4-tetrahydronaphthalen-2-ylmethyl) amino-methylcarboxylic acid hydrochloride (Org 25935), a glycine transporter-1 (GlyT1) inhibitor, and placebo pretreatment on ketamine-induced schizophrenia-like psychotic symptoms, perceptual alterations, and subjective effects were evaluated in 12 healthy male subjects in a randomized, counter-balanced, within-subjects, crossover design. At 2.5 h after administration of the Org 25935 or placebo, subjects received a ketamine bolus and constant infusion lasting 100 min. Psychotic symptoms, perceptual, and a number of subjective effects were assessed repeatedly before, several times during, and after completion of ketamine administration. A cognitive battery was administered once per test day. Ketamine produced behavioral, subjective, and cognitive effects consistent with its known effects. Org 25935 reduced the ketamine-induced increases in measures of psychosis (Positive and Negative Syndrome Scale (PANSS)) and perceptual alterations (Clinician Administered Dissociative Symptoms Scale (CADSS)). The magnitude of the effect of Org 25935 on ketamine-induced increases in Total PANSS and CADSS Clinician-rated scores was 0.71 and 0.98 (SD units), respectively. None of the behavioral effects of ketamine were increased by Org 25935 pretreatment. Org 25935 worsened some aspects of learning and delayed recall, and trended to improve choice reaction time. This study demonstrates for the first time in humans that a GlyT1 inhibitor reduces the effects induced by NMDA receptor antagonism. These findings provide preliminary support for further study of the antipsychotic potential of GlyT1 inhibitors. PMID:22113087

  8. Comparison of efficacy of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort

    Directory of Open Access Journals (Sweden)

    Başak Akça

    2016-01-01

    Full Text Available Objectives: To compare the effects of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort/pain in patients undergoing cystoscopy. Methods: This prospective study was conducted on 75 American Society of Anesthesiologists (ASA I-II patients between 18-75 years of age and undergoing cystoscopy between November 2011 and June 2012 at Hacettepe University Hospital, Ankara, Turkey. Patients were randomly assigned to one of the 3 groups to receive 1 μ/kg dexmedetomidine, 250 μ/kg intravenous ketamine, or normal saline. All patients were questioned regarding probe-related discomfort, patient satisfaction, and pain at the end of the operation 0 (t0 and 15 (t1, 60 (t2, 120 (t3, and 360 (t4 minutes postoperatively. Evaluations were performed in person at the post-anesthesia care unit, or in ambulatory surgery rooms, or by phone calls. Results: Pain incidence in the dexmedetomidine and ketamine groups (p=0.042 was significantly lower than that in the control group (p=0.044.The sedation scores recorded at t0 in the dexmedetomidine and ketamine groups (p=0.004 were significantly higher than that of the control group (p=0.017. Patient groups were similar regarding the rate of hallucinations experienced at t1, no patients experienced hallucinations at t2, t3, or t4. Significantly more patients experienced hallucinations at t0 in the ketamine group than in the dexmedetomidine group (p=0.034 and the control group (p=0.005. Conclusion: Dexmedetomidine and ketamine had similar analgesic effects in preventing catheter-related pain; however, dexmedetomidine had a more acceptable side effect profile. To identify the optimal doses of dexmedetomidine and ketamine, more large-scale interventional studies are needed.

  9. Performance on a probabilistic inference task in healthy subjects receiving ketamine compared with patients with schizophrenia

    Science.gov (United States)

    Almahdi, Basil; Sultan, Pervez; Sohanpal, Imrat; Brandner, Brigitta; Collier, Tracey; Shergill, Sukhi S; Cregg, Roman; Averbeck, Bruno B

    2012-01-01

    Evidence suggests that some aspects of schizophrenia can be induced in healthy volunteers through acute administration of the non-competitive NMDA-receptor antagonist, ketamine. In probabilistic inference tasks, patients with schizophrenia have been shown to ‘jump to conclusions’ (JTC) when asked to make a decision. We aimed to test whether healthy participants receiving ketamine would adopt a JTC response pattern resembling that of patients. The paradigmatic task used to investigate JTC has been the ‘urn’ task, where participants are shown a sequence of beads drawn from one of two ‘urns’, each containing coloured beads in different proportions. Participants make a decision when they think they know the urn from which beads are being drawn. We compared performance on the urn task between controls receiving acute ketamine or placebo with that of patients with schizophrenia and another group of controls matched to the patient group. Patients were shown to exhibit a JTC response pattern relative to their matched controls, whereas JTC was not evident in controls receiving ketamine relative to placebo. Ketamine does not appear to promote JTC in healthy controls, suggesting that ketamine does not affect probabilistic inferences. PMID:22389244

  10. Linac pre-injector

    CERN Multimedia

    CERN PhotoLab

    1965-01-01

    New accelerating column of the linac pre-injector, supporting frame and pumping system. This new system uses two mercury diffusion pumps (in the centre) and forms part of the modifications intended to increase the intensity of the linac. View taken during assembly in the workshop.

  11. Effects of subanesthetic doses of ketamine in cats with induced experimental endotoxemia

    Directory of Open Access Journals (Sweden)

    Felipe Hertzing Farias

    2015-12-01

    Full Text Available ABSTRACT. Farias F.H., Gehrcke M.I., Padilha V.S., Volpato J., Tochetto R., Comassetto F. & Oleskovicz N. [Effects of subanesthetic doses of ketamine in cats with induced experimental endotoxemia.] Efeitos da cetamina em doses subanestésicas em gatos submetidos à endotoxemia experimental. Revista Brasileira de Medicina Veterinária, 37(4:297-302, 2015. Programa de Pós-Graduação em Ciência Animal, Centro de Ciências Agroveterinárias, Universidade do Estado de Santa Catarina, Avenida Luís de Camões, 2090, Bairro Conta Dinheiro, Lages, SC 88520-000, Brasil. E-mail: noleskovicz@yahoo.com.br The clinical endotoxemia is difficult to diagnosis and treatment because of the involvement of multiple organs. This study aimed to evaluate the clinical effects of subanesthetic doses of ketamine, before or after the induction of endotoxemia in cats. Were used nine healthy cats, with 4.3±0.59 kg, autocontroles, placed into three groups: lipopolysaccharide (LPS, n=9 received a bolus of NaCl 0,9 % followed by a continuous infusion (CI of LPS for two hours and; bolus of NaCl 0,9 % followed by CI of LPS for two hours; ketamine/LPS (C/ LPS, n=9 received a bolus of ketamine followed by ketamine CI and LPS for two hours and, after, bolus of saline followed by CI of LPS for another two hours; LPS/ketamine (LPS/C, n=9 received bolus of saline followed by a CI LPS for two hours and then after bolus of ketamine followed by the same CI associated with LPS for two hours. The heart rate was higher for 5 to 120 minutes after initiation of the CI LPS in C/LPS and less than 150 to 240 minutes and from 600 to 720 minutes in LPS compared to the other groups. Five minutes after CI LPS initiation in C/LPS, 60 minutes in LPS/C and 90 minutes to 720 minutes in LPS, FC was higher than at baseline. The PAS was lower in all groups from 360 to 720 minutes compared to baseline. All treatments showed increased TR from 60 to 600 minutes compared to baseline. The levels of glucose

  12. First operational experience with the positive-ion injector of ATLAS

    Energy Technology Data Exchange (ETDEWEB)

    Bollinger, L M; Pardo, R C; Shepard, K W; Bogaty, J M; Clifft, B E; Munson, F H; Zinkann, G [Argonne National Lab., IL (United States)

    1993-04-15

    The recently completed positive-ion injector for the heavy-ion accelerator ATLAS was designed as a replacement for the tandem injector of the present tandem-linac system and, unlike the tandem, the positive-ion injector is required to provide ions from the full range of the periodic table. The concept for the new injector, which consists of an ECR ion source on a voltage platform coupled to a very-low-velocity superconducting linac, introduces technical problems and uncertainties that are well beyond those encountered previously for superconducting linacs. The solution to these problems and their relationship to performance are outlined, and initial experience in the acceleration of heavy-ion beams through the entire ATLAS system is discussed. The unusually good longitudinal beam quality of ATLAS with its new injector is emphasized. (orig.).

  13. First operational experience with the positive-ion injector of ATLAS

    International Nuclear Information System (INIS)

    Bollinger, L.M.; Pardo, R.C.; Shepard, K.W.; Bogaty, J.M.; Clifft, B.E.; Munson, F.H.; Zinkann, G.

    1992-01-01

    The recently completed positive-ion injector for the heavy-ion accelerator ATLAS was designed as a replacement for the tandem injector of the present tandem-linac system and, unlike the tandem, the positive-ion injector is required to provide ions from the full range of the periodic table. The concept for the new injector, which consists of an ECR ion source on a voltage platform coupled to a very-low-velocity superconducting linac, introduces technical problems and uncertainties that are well beyond those encountered previously for superconducting linacs. The solution to these problems and their relationship to performance are outlined, and initial experience in the acceleration of heavy-ion beams through the entire ATLAS system is discussed. The unusually good longitudinal beam quality of ATLAS with its new injector is emphasized

  14. First operational experience with the positive-ion injector of ATLAS

    Energy Technology Data Exchange (ETDEWEB)

    Bollinger, L.M.; Pardo, R.C.; Shepard, K.W.; Bogaty, J.M.; Clifft, B.E.; Munson, F.H.; Zinkann, G.

    1992-08-01

    The recently completed positive-ion injector for the heavy-ion accelerator ATLAS was designed as a replacement for the tandem injector of the present tandem-linac system and, unlike the tandem, the positive-ion injector is required to provide ions from the full range of the periodic table. The concept for the new injector, which consists of an ECR ion source on a voltage platform coupled to a very-low-velocity superconducting linac, introduces technical problems and uncertainties that are well beyond those encountered previously for superconducting linacs. The solution to these problems and their relationship to performance are outlined, and initial experience in the acceleration of heavy-ion beams through the entire ATLAS system is discussed. The unusually good longitudinal beam quality of ATLAS with its new injector is emphasized.

  15. First operational experience with the positive-ion injector of ATLAS

    Energy Technology Data Exchange (ETDEWEB)

    Bollinger, L.M.; Pardo, R.C.; Shepard, K.W.; Bogaty, J.M.; Clifft, B.E.; Munson, F.H.; Zinkann, G.

    1992-01-01

    The recently completed positive-ion injector for the heavy-ion accelerator ATLAS was designed as a replacement for the tandem injector of the present tandem-linac system and, unlike the tandem, the positive-ion injector is required to provide ions from the full range of the periodic table. The concept for the new injector, which consists of an ECR ion source on a voltage platform coupled to a very-low-velocity superconducting linac, introduces technical problems and uncertainties that are well beyond those encountered previously for superconducting linacs. The solution to these problems and their relationship to performance are outlined, and initial experience in the acceleration of heavy-ion beams through the entire ATLAS system is discussed. The unusually good longitudinal beam quality of ATLAS with its new injector is emphasized.

  16. NMDA receptor antagonist ketamine impairs feature integration in visual perception.

    Science.gov (United States)

    Meuwese, Julia D I; van Loon, Anouk M; Scholte, H Steven; Lirk, Philipp B; Vulink, Nienke C C; Hollmann, Markus W; Lamme, Victor A F

    2013-01-01

    Recurrent interactions between neurons in the visual cortex are crucial for the integration of image elements into coherent objects, such as in figure-ground segregation of textured images. Blocking N-methyl-D-aspartate (NMDA) receptors in monkeys can abolish neural signals related to figure-ground segregation and feature integration. However, it is unknown whether this also affects perceptual integration itself. Therefore, we tested whether ketamine, a non-competitive NMDA receptor antagonist, reduces feature integration in humans. We administered a subanesthetic dose of ketamine to healthy subjects who performed a texture discrimination task in a placebo-controlled double blind within-subject design. We found that ketamine significantly impaired performance on the texture discrimination task compared to the placebo condition, while performance on a control fixation task was much less impaired. This effect is not merely due to task difficulty or a difference in sedation levels. We are the first to show a behavioral effect on feature integration by manipulating the NMDA receptor in humans.

  17. NMDA receptor antagonist ketamine impairs feature integration in visual perception.

    Directory of Open Access Journals (Sweden)

    Julia D I Meuwese

    Full Text Available Recurrent interactions between neurons in the visual cortex are crucial for the integration of image elements into coherent objects, such as in figure-ground segregation of textured images. Blocking N-methyl-D-aspartate (NMDA receptors in monkeys can abolish neural signals related to figure-ground segregation and feature integration. However, it is unknown whether this also affects perceptual integration itself. Therefore, we tested whether ketamine, a non-competitive NMDA receptor antagonist, reduces feature integration in humans. We administered a subanesthetic dose of ketamine to healthy subjects who performed a texture discrimination task in a placebo-controlled double blind within-subject design. We found that ketamine significantly impaired performance on the texture discrimination task compared to the placebo condition, while performance on a control fixation task was much less impaired. This effect is not merely due to task difficulty or a difference in sedation levels. We are the first to show a behavioral effect on feature integration by manipulating the NMDA receptor in humans.

  18. Memantine reverses social withdrawal induced by ketamine in rats.

    Science.gov (United States)

    Uribe, Ezequiel; Landaeta, José; Wix, Richard; Eblen, Antonio

    2013-03-01

    The objective of this study was to determine the effect of memantine on schizophrenia-like symptoms in a ketamine-induced social withdrawal model in rats. We examined therapeutic effects of memantine, an NMDA antagonist, and haloperidol, a classic antipsychotic drug, on this behavioral model. Administration of memantine (10 or 15 mg·kg(-1)) significantly reduced ketamine-induced social withdrawal, and this effect was more effective than that of haloperidol (0.25 mg·kg(-1)) by restoring the social interaction between rats with no modification in general motor activity. These results suggest that memantine could have a therapeutic potential for schizophrenia.

  19. Lack of Antidepressant Effects of (2R,6R)-Hydroxynorketamine in a Rat Learned Helplessness Model: Comparison with (R)-Ketamine.

    Science.gov (United States)

    Shirayama, Yukihiko; Hashimoto, Kenji

    2018-01-01

    (R)-Ketamine exhibits rapid and sustained antidepressant effects in animal models of depression. It is stereoselectively metabolized to (R)-norketamine and subsequently to (2R,6R)-hydroxynorketamine in the liver. The metabolism of ketamine to hydroxynorketamine was recently demonstrated to be essential for ketamine's antidepressant actions. However, no study has compared the antidepressant effects of these 3 compounds in animal models of depression. The effects of a single i.p. injection of (R)-ketamine, (R)-norketamine, and (2R,6R)-hydroxynorketamine in a rat learned helplessness model were examined. A single dose of (R)-ketamine (20 mg/kg) showed an antidepressant effect in the rat learned helplessness model. In contrast, neither (R)-norketamine (20 mg/kg) nor (2R,6R)-hydroxynorketamine (20 and 40 mg/kg) did so. Unlike (R)-ketamine, its metabolite (2R,6R)-hydroxynorketamine did not show antidepressant actions in the rat learned helplessness model. Therefore, it is unlikely that the metabolism of ketamine to hydroxynorketamine is essential for ketamine's antidepressant actions. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  20. New features of the MAX IV thermionic pre-injector

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, J., E-mail: joel.andersson@maxiv.lu.se; Olsson, D., E-mail: david.olsson@maxiv.lu.se; Curbis, F.; Malmgren, L.; Werin, S.

    2017-05-21

    The MAX IV facility in Lund, Sweden consists of two storage rings for production of synchrotron radiation. The smaller 1.5 GeV ring is presently under construction, while the larger 3 GeV ring is being commissioned. Both rings will be operating with top-up injections from a full-energy injector. During injection, the electron beam is first delivered to the main injector from a thermionic pre-injector which consists of a thermionic RF gun, a chopper system, and an energy filter. In order to reduce losses of high-energy electrons along the injector and in the rings, the electron beam provided by the thermionic pre-injector should have the correct time structure and energy distribution. In this paper, the design of the MAX IV thermionic pre-injector with all its sub components is presented. The electron beam delivered by the pre-injector and its dependence on parameters such as optics, cathode temperature, and RF power are studied. Measurements are here compared with simulation results obtained by particle tracking and electromagnetic codes. The chopper system is described in detail, and different driving schemes that optimize the injection efficiency for the two storage rings are investigated. During operation, it was discovered that the structure of the beam delivered by the gun is affected by mode beating between the accelerating and a low-order mode. This mode beating is also studied in detail. Finally, initial measurements of the electron beam delivered to the 3 GeV ring during commissioning are presented.

  1. Integrated numerical modeling of a laser gun injector

    International Nuclear Information System (INIS)

    Liu, H.; Benson, S.; Bisognano, J.; Liger, P.; Neil, G.; Neuffer, D.; Sinclair, C.; Yunn, B.

    1993-06-01

    CEBAF is planning to incorporate a laser gun injector into the linac front end as a high-charge cw source for a high-power free electron laser and nuclear physics. This injector consists of a DC laser gun, a buncher, a cryounit and a chicane. The performance of the injector is predicted based on integrated numerical modeling using POISSON, SUPERFISH and PARMELA. The point-by-point method incorporated into PARMELA by McDonald is chosen for space charge treatment. The concept of ''conditioning for final bunching'' is employed to vary several crucial parameters of the system for achieving highest peak current while maintaining low emittance and low energy spread. Extensive parameter variation studies show that the design will perform beyond the specifications for FEL operations aimed at industrial applications and fundamental scientific research. The calculation also shows that the injector will perform as an extremely bright cw electron source

  2. Design considerations for single-stage and two-stage pneumatic pellet injectors

    International Nuclear Information System (INIS)

    Gouge, M.J.; Combs, S.K.; Fisher, P.W.; Milora, S.L.

    1988-09-01

    Performance of single-stage pneumatic pellet injectors is compared with several models for one-dimensional, compressible fluid flow. Agreement is quite good for models that reflect actual breech chamber geometry and incorporate nonideal effects such as gas friction. Several methods of improving the performance of single-stage pneumatic pellet injectors in the near term are outlined. The design and performance of two-stage pneumatic pellet injectors are discussed, and initial data from the two-stage pneumatic pellet injector test facility at Oak Ridge National Laboratory are presented. Finally, a concept for a repeating two-stage pneumatic pellet injector is described. 27 refs., 8 figs., 3 tabs

  3. AMELIORATING TREATMENT-REFRACTORY DEPRESSION WITH INTRANASAL KETAMINE: POTENTIAL NMDA RECEPTOR ACTIONS IN THE PAIN CIRCUITRY REPRESENTING MENTAL ANGUISH

    Science.gov (United States)

    Opler, Lewis A.; Opler, Mark G.; Arnsten, Amy F.T.

    2014-01-01

    This paper reviews the anti-depressant actions of the N-methyl-D-aspartame glutamate receptor (NMDAR) antagonist, ketamine, and offers a potential neural mechanism for intranasal ketamine’s ultra-rapid actions based on the key role of NMDAR in the nonhuman primate prefrontal cortex (PFC). Although intravenous ketamine infusions can lift mood within hours, the current review describes how intranasal ketamine administration can have ultra-rapid antidepressant effects, beginning within minutes (5–40 minutes) and lasting hours, but with repeated treatments needed for sustained antidepressant actions. Research in rodents suggests that increased synaptogenesis in PFC may contribute to the prolonged benefit of ketamine administration, beginning hours after administration. However, these data cannot explain the relief that occurs within minutes of intranasal ketamine delivery. We hypothesize that the ultra-rapid effects of intranasal administration in humans may be due to ketamine blocking the NMDAR circuits that generate the emotional representations of pain (e.g. Brodmann Areas 24 and 25, insular cortex), cortical areas that can be overactive in depression and which sit above the nasal epithelium. In contrast, NMDAR blockade in the dorsolateral PFC following systemic administration of ketamine may contribute to cognitive deficits. This novel view may help to explain how intravenous ketamine can treat the symptoms of depression yet worsen the symptoms of schizophrenia. PMID:25619798

  4. An introduction to photo-injector design

    International Nuclear Information System (INIS)

    Travier, C.

    1993-07-01

    A quick overview is given of the RF gun basic theory for photo-injectors and of the presently achievable technical parameters thus providing some guidelines to help the designer in his choices. Simple scaling laws and formulas for both beam dynamics and technical parameters are proposed and compared to corresponding values for existing photo-injectors. Various sophisticated schemes used to improve the performances beyond those given by a straightforward approach are reviewed. (author) 65 refs., 11 figs., 3 tabs

  5. Subanesthetic ketamine infusions for the treatment of children and adolescents with chronic pain: a longitudinal study.

    Science.gov (United States)

    Sheehy, Kathy A; Muller, Elena A; Lippold, Caroline; Nouraie, Mehdi; Finkel, Julia C; Quezado, Zenaide M N

    2015-12-01

    Chronic pain is common in children and adolescents and is often associated with severe functional disability and mood disorders. The pharmacological treatment of chronic pain in children and adolescents can be challenging, ineffective, and is mostly based on expert opinions and consensus. Ketamine, an N-methyl-D-aspartate receptor antagonist, has been used as an adjuvant for treatment of adult chronic pain and has been shown, in some instances, to improve pain and decrease opioid-requirement. We examined the effects of subanesthetic ketamine infusions on pain intensity and opioid use in children and adolescents with chronic pain syndromes treated in an outpatient setting. Longitudinal cohort study of consecutive pediatric patients treated with subanesthetic ketamine infusions in a tertiary outpatient center. Outcome measurements included self-reported pain scores (numeric rating scale) and morphine-equivalent intake. Over a 15-month period, 63 children and adolescents (median age 15, interquartile range 12-17 years) with chronic pain received 277 ketamine infusions. Intravenous administration of subanesthetic doses of ketamine to children and adolescents on an outpatient basis was safe and not associated with psychotropic effects or hemodynamic perturbations. Overall, ketamine significantly reduced pain intensity (p pain reduction in patients with complex regional pain syndrome (CRPS) than in patients with other chronic pain syndromes (p = 0.029). Ketamine-associated reductions in pain scores were the largest in postural orthostatic tachycardia syndrome (POTS) and trauma patients and the smallest in patients with chronic headache (p = 0.007). In 37% of infusions, patients had a greater than 20 % reduction in pain score. Conversely, ketamine infusions did not change overall morphine-equivalent intake (p = 0.3). These data suggest that subanesthetic ketamine infusion is feasible in an outpatient setting and may benefit children and adolescents with chronic pain

  6. Fundamental rocket injector/spray programs at the Phillips Laboratory

    Science.gov (United States)

    Talley, D. G.

    1993-11-01

    The performance and stability of liquid rocket engines is determined to a large degree by atomization, mixing, and combustion processes. Control over these processes is exerted through the design of the injector. Injectors in liquid rocket engines are called upon to perform many functions. They must first of all mix the propellants to provide suitable performance in the shortest possible length. For main injectors, this is driven by the tradeoff between the combustion chamber performance, stability, efficiency, and its weight and cost. In gas generators and preburners, however, it is also driven by the possibility of damage to downstream components, for example piping and turbine blades. This can occur if unburned fuel and oxidant later react to create hot spots. Weight and cost considerations require that the injector design be simple and lightweight. For reusable engines, the injectors must also be durable and easily maintained. Suitable atomization and mixing must be produced with as small a pressure drop as possible, so that the size and weight of pressure vessels and turbomachinery can be minimized. However, the pressure drop must not be so small as to promote feed system coupled instabilities. Another important function of the injectors is to ensure that the injector face plate and the chamber and nozzle walls are not damaged. Typically this requires reducing the heat transfer to an acceptable level and also keeping unburned oxygen from chemically attacking the walls, particularly in reusable engines. Therefore the mixing distribution is often tailored to be fuel-rich near the walls. Wall heat transfer can become catastrophically damaging in the presence of acoustic instabilities, so the injector must prevent these from occurring at all costs. In addition to acoustic stability (but coupled with it), injectors must also be kinetically stable. That is, the flame itself must maintain ignition in the combustion chamber. This is not typically a problem with main

  7. Investigating nitric oxide signalling involvement in the antidepressant action of ketamine

    DEFF Research Database (Denmark)

    Liebenberg, Nico; Müller, Heidi Kaastrup; Elfving, Betina

    2012-01-01

    Stress-induced excessive glutamate transmission at N-methyl-D-aspartate receptors (NMDA-R’s) may underlie a primary mechanism in the physiology that leads to depression, and ketamine, an NMDA-R antagonist, has been shown to rapidly relieve depression in humans. A number of downstream mechanisms...... have been suggested to mediate the antidepressant action of ketamine, including the activation of extracellular-signal-regulated kinases 1/2 (ERK1/2), protein kinase B (or Akt) and the mammalian target of rapamycin (mTOR). However, the mechanism(s) that are affected immediately downstream of NMDA......-R’s remain unclear. Neuronal nitric oxide synthase (nNOS) is directly coupled to and activated by NMDA-R’s, and the uncoupling of the nNOS-NMDA-R complex prevents NMDA-R-mediated excitotoxicity. Therefore, we investigated whether the antidepressant mechanism of ketamine involves the inhibition of nitric...

  8. Ketamine is a potent antidepressant in two rodent models of depression

    DEFF Research Database (Denmark)

    Mathe, A.; Sousa, V.; Fischer, C. W.

    2013-01-01

    pathophysiological factor and converging evidence indicates that other systems, such as the glutamatergic are of paramount importance. Indeed, work at the Yale University, NIMH, and Icahn School of Medicine at Mount Sinai demonstrated the marked antidepressant effects of intravenously infused ketamine to treatment...... resistant patients diagnosed with major depressive disorder. In order to better understand the mechanisms of ketamine effects we decided to test it on animal models. Methods: All experiments were approved by the Karolinska Institutet's Committee for Animal Protection. Two rat models, bred at the Karolinska...... Institutet, the Flinders Sensitive Line (FSL) and their controls, the Flinders Resistant Line (FRL), and the SERT KO (homozygous, heterozygous, and the wild type rats) were used. Male animals were injected 10 mg ketamine/kg body weight or vehicle and the Open Field Test (OF) and Forced Swim Test (FST...

  9. Dopamine Attenuates Ketamine-Induced Neuronal Apoptosis in the Developing Rat Retina Independent of Early Synchronized Spontaneous Network Activity.

    Science.gov (United States)

    Dong, Jing; Gao, Lingqi; Han, Junde; Zhang, Junjie; Zheng, Jijian

    2017-07-01

    Deprivation of spontaneous rhythmic electrical activity in early development by anesthesia administration, among other interventions, induces neuronal apoptosis. However, it is unclear whether enhancement of neuronal electrical activity attenuates neuronal apoptosis in either normal development or after anesthesia exposure. The present study investigated the effects of dopamine, an enhancer of spontaneous rhythmic electrical activity, on ketamine-induced neuronal apoptosis in the developing rat retina. TUNEL and immunohistochemical assays indicated that ketamine time- and dose-dependently aggravated physiological and ketamine-induced apoptosis and inhibited early-synchronized spontaneous network activity. Dopamine administration reversed ketamine-induced neuronal apoptosis, but did not reverse the inhibitory effects of ketamine on early synchronized spontaneous network activity despite enhancing it in controls. Blockade of D1, D2, and A2A receptors and inhibition of cAMP/PKA signaling partially antagonized the protective effect of dopamine against ketamine-induced apoptosis. Together, these data indicate that dopamine attenuates ketamine-induced neuronal apoptosis in the developing rat retina by activating the D1, D2, and A2A receptors, and upregulating cAMP/PKA signaling, rather than through modulation of early synchronized spontaneous network activity.

  10. The role of ketamine in the treatment of chronic cancer pain

    OpenAIRE

    ZGAIA, ARMEANA OLIMPIA; IRIMIE, ALEXANDRU; SANDESC, DOREL; VLAD, CATALIN; LISENCU, COSMIN; ROGOBETE, ALEXANDRU; ACHIMAS-CADARIU, PATRICIU

    2015-01-01

    Background and aim Ketamine is a drug used for the induction and maintenance of general anesthesia, for the treatment of postoperative and posttraumatic acute pain, and more recently, for the reduction of postoperative opioid requirements. The main mechanism of action of ketamine is the antagonization of N-methyl-D-aspartate (NMDA) receptors that are associated with central sensitization. In the pathogenesis of chronic pain and particularly in neuropathic pain, an important role is played by ...

  11. A light ion four rod RFQ injector

    International Nuclear Information System (INIS)

    Schempp, A.; Ferch, M.; Klein, H.

    1987-01-01

    The four-rod RFQ has been developed in Frankfurt as an alternative solution for ion injectors. A 202 MHz resonator has been built with design parameters taken from the HERA injector (18keV-750keV, 20mA H - ). Properties of this structure are described and applications as light ion accelerator for particles from an EBIS ion source are discussed

  12. Initial use of the positive-ion injector of ATLAS

    International Nuclear Information System (INIS)

    Bollinger, L.M.; Billquist, P.J.; Bogaty, J.M.; Clifft, B.E.; Den Hartog, P.K.; Munson, F.H. Jr.; Pardo, R.C.; Shepard, K.W.; Zinkann, G.P.

    1989-01-01

    The positive-ion injector of ATLAS consists of an ECR heavy-ion source coupled to a 12-MV superconducting injector linac. The ECR source and a 3-MV version of the partially completed linac have been used to accelerate successfully several species of heavy ions. The operating experience is summarized, with emphasis on the excellent beam quality of beams from the new injector. Two new fast-timing detectors are described. 9 refs., 5 figs., 1 tab

  13. Efficacy and safety of ketamine for the management of refractory status epilepticus (RSE) in adults

    International Nuclear Information System (INIS)

    Liaqat, J.; Raja, W.; Wali, W.

    2018-01-01

    Objective: To determine the efficacy and safety of ketamine (KE) in the management of refractory status epilepticus (RSE) in adults. Study Design: Open Label, unblinded prospective case series. Place and Duration of Study: The study was conducted at Neurology Department Military Hospital Rawalpindi, from Jan 2014 to Dec 2014. Material and Methods: All the patients with status epilepticus, from Jan 2014 to Dec 2014 were treated with ketamine in addition to benzodiazepines, phenytoin and levitricetam. Ketamine was the last drug added and if seizures were still not controlled then anesthetic agents like thiopental and propofol were used. Results: Between Jan 2014 and Dec 2014, twenty patients received IV Ketamine. In 18 patients RSE lasted for more than 24 hours, with a median of 4 days (range 1-8 days). Mean duration of seizures in the study group was 4.45 days (SD 2.01). Ketamine was successful in terminating seizure activity in 40% (n=8) patients while it failed in 15% (n=3) patients. There was additional 15% (n=3) partial response in the form of initial control but these patients had later breakthrough or with drawl seizures. Twenty five percent (n=5) of the patients died during the treatment while in one patient ketamine had to be stopped because of intolerable side effects. In our patients the adverse effects of ketamine included sepsis (35%, 5, n=7), shock (10%, n=2) and pneumonia (10%, n=2). Conclusion: In this small, open-label, unblinded study KE appears effective and safe in treating RSE in adults. Larger, randomized studies will help to confirm data emerging from this preliminary study. (author)

  14. Cue-Induced Brain Activation in Chronic Ketamine-Dependent Subjects, Cigarette Smokers, and Healthy Controls: A Task Functional Magnetic Resonance Imaging Study

    Directory of Open Access Journals (Sweden)

    Yanhui Liao

    2018-03-01

    Full Text Available BackgroundObservations of drug-related cues may induce craving in drug-dependent patients, prompting compulsive drug-seeking behavior. Sexual dysfunction is common in drug users. The aim of the study was to examine regional brain activation to drug (ketamine, cigarette smoking associated cues and natural (sexual rewards.MethodsA sample of 129 [40 ketamine use smokers (KUS, 45 non-ketamine use smokers (NKUS and 44 non-ketamine use non-smoking healthy controls (HC] participants underwent functional magnetic resonance imaging (fMRI while viewing ketamine use related, smoking and sexual films.ResultsWe found that KUS showed significant increased activation in anterior cingulate cortex and precuneus in response to ketamine cues. Ketamine users (KUS showed lower activation in cerebellum and middle temporal cortex compared with non-ketamine users (NKUS and HC in response to sexual cues. Smokers (KUS and NKUS showed higher activation in the right precentral frontal cortex in response to smoking cues. Non-ketamine users (NKUS and HC showed significantly increased activation of cerebellum and middle temporal cortex while viewing sexual cues.ConclusionThese findings clearly show the engagement of distinct neural circuitry for drug-related stimuli in chronic ketamine users. While smokers (both KUS and NKUS showed overlapping differences in activation for smoking cues, the former group showed a specific neural response to relevant (i.e., ketamine-related cues. In particular, the heightened response in anterior cingulate cortex may have important implications for how attentionally salient such cues are in this group. Ketamine users (KUS showed lower activation in response to sexual cues may partly reflect the neural basis of sexual dysfunction.

  15. Improved Methods for Thermal Rearrangement of Alicyclic α-Hydroxyimines to α-Aminoketones: Synthesis of Ketamine Analogues as Antisepsis Candidates

    Directory of Open Access Journals (Sweden)

    Gerardo Byk

    2012-06-01

    Full Text Available Ketamine is an analgesic/anesthetic drug, which, in combination with other drugs, has been used as anesthetic for over 40 years. Ketamine induces its analgesic activities by blocking the N-methyl-D-aspartate (NMDA receptor in the central nervous system (CNS. We have reported that low doses of ketamine administrated to patients before incision significantly reduced post-operative inflammation as reflected by reduced interleukin-6 (IL-6 sera-levels. Our data demonstrated in a rat model of Gram-negative bacterial-sepsis that if we inject a low dose of ketamine following bacterial inoculation we reduce mortality from approximately 75% to 25%. Similar to what we have observed in operated patients, the levels of TNF-α and IL-6 in ketamine-treated rats were significantly lower than in septic animals not treated with ketamine. On the base of these results, we have designed and synthesized series of new analogues of ketamine applying a thermal rearrangement of alicyclic α-hydroxyimines to a-aminoketones in parallel arrays. One of the analogues (compound 6e displayed high activity in down-regulating the levels of IL-6 and TNF-α in vivo as compared to ketamine.

  16. Design of injector section for SPring-8 linac

    International Nuclear Information System (INIS)

    Yoshikawa, Hiroshi; Nakamura, Naoki; Mizuno, Akihiko; Suzuki, Shinsuke; Hori, Toshihiko; Yanagida, Kenichi; Mashiko, Katsuo; Yokomizo, Hideaki

    1993-07-01

    In the SPring-8, we are planning to use positrons in order to increase the beam life time in the storage-ring. For the injector linac, though high current beam production to yield positrons is alternative with accurate low current beam production for commissioning, we designed the injector section to achieve both of the high current mode and the low current mode. In this paper, overview of some simulation codes for the design of electron accelerators are described and the calculation results by TRACE for the injector section of the linac are shown. That is useful not only for the design of machines but for the selection of sensitive parameters to establish the good beam quality. Now the injector section, which is settled at Tokai Establishment, is arranged for the case of the performance check of the electron gun. And we present that the layout of this section is needed to be rearranged for the high current mode operation. (author)

  17. Design of deuterium and tritium pellet injector systems for Tokamak Fusion Test Reactor

    International Nuclear Information System (INIS)

    Wysor, R.B.; Baylor, L.R.; Bryan, W.E.

    1985-01-01

    Three pellet injector designs developed by the Oak Ridge National Laboratory (ORNL) are planned for the Tokamak Fusion Test Reactor (TFTR) to reach the goal of a tritium pellet injector by 1988. These are the Repeating Pneumatic Injector (RPI), the Deuterium Pellet Injector (DPI) and the Tritium Pellet Injector (TPI). Each of the pellet injector designs have similar performance characteristics in that they deliver up to 4-mm-dia pellets at velocities up to 1500 m/s with a dsign goal to 2000 m/s. Similar techniques are utilized to freeze and extrude the pellet material. The injector systems incorporate three gun concepts which differ in the number of gun barrels and the method of forming and chambering the pellets. The RPI, a single barrel repeating design, has been operational on TFTR since April 1985. Fabrication and assembly are essentially complete for DPI, and TPI is presently on hold after completing about 80% of the design. The TFTR pellet injector program is described, and each of the injector systems is described briefly. Design details are discussed in other papers at this symposium

  18. Differential psychopathology and patterns of cerebral glucose utilisation produced by (S)- and (R)-ketamine in healthy volunteers using positron emission tomography (PET)

    NARCIS (Netherlands)

    Vollenweider, FX; Leenders, KL; Oye, [No Value; Hell, D; Angst, J

    Until recently, racemic ketamine (S-ketamine/R-ketamine=50:50) has been used to study NMDA receptor hypofunction in relation to pathophysiological models of schizophrenia. Ketamine given to normal humans in subanesthetic doses produces a model psychosis including both positive and negative symptoms

  19. CTF3 Drive Beam Injector Optimisation

    CERN Document Server

    AUTHOR|(CDS)2082899; Doebert, S

    2015-01-01

    In the Compact Linear Collider (CLIC) the RF power for the acceleration of the Main Beam is extracted from a high-current Drive Beam that runs parallel to the main linac. The main feasibility issues of the two-beam acceleration scheme are being demonstrated at CLIC Test Facility 3 (CTF3). The CTF3 Drive Beam injector consists of a thermionic gun followed by the bunching system and two accelerating structures all embedded in solenoidal magnetic field and a magnetic chicane. Three sub-harmonic bunchers (SHB), a prebuncher and a travelling wave buncher constitute the bunching system. The phase coding process done by the sub-harmonic bunching system produces unwanted satellite bunches between the successive main bunches. The beam dynamics of the CTF3 Drive Beam injector is reoptimised with the goal of improving the injector performance and in particular decreasing the satellite population, the beam loss in the magnetic chicane and the beam emittance in transverse plane compare to the original model based on P. Ur...

  20. Ketamine as a first-line treatment for severely agitated emergency department patients.

    Science.gov (United States)

    Riddell, Jeff; Tran, Alexander; Bengiamin, Rimon; Hendey, Gregory W; Armenian, Patil

    2017-07-01

    Emergency physicians often need to control agitated patients who present a danger to themselves and hospital personnel. Commonly used medications have limitations. Our primary objective was to compare the time to a defined reduction in agitation scores for ketamine versus benzodiazepines and haloperidol, alone or in combination. Our secondary objectives were to compare rates of medication redosing, vital sign changes, and adverse events in the different treatment groups. We conducted a single-center, prospective, observational study examining agitation levels in acutely agitated emergency department patients between the ages of 18 and 65 who required sedation medication for acute agitation. Providers measured agitation levels on a previously validated 6-point sedation scale at 0-, 5-, 10-, and 15-min after receiving sedation. We also assessed the incidence of adverse events, repeat or rescue medication dosing, and changes in vital signs. 106 patients were enrolled and 98 met eligibility criteria. There was no significant difference between groups in initial agitation scores. Based on agitation scores, more patients in the ketamine group were no longer agitated than the other medication groups at 5-, 10-, and 15-min after receiving medication. Patients receiving ketamine had similar rates of redosing, changes in vital signs, and adverse events to the other groups. In highly agitated and violent emergency department patients, significantly fewer patients receiving ketamine as a first line sedating agent were agitated at 5-, 10-, and 15-min. Ketamine appears to be faster at controlling agitation than standard emergency department medications. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. NLCTA injector experimental results

    International Nuclear Information System (INIS)

    Yeremian, A.D.; Adolphsen, C.; Miller, R.H.; Nantista, C.D.; Wang, J.W.

    1997-04-01

    The purpose of the Next Linear Collider Test Accelerator (NLCTA) at SLAC is to integrate the new technologies of X-band accelerator structures and RF systems for the Next Linear Collider (NLC), demonstrate multibunch beam-loading energy compensation and suppression of high-order deflecting modes, measure the transverse components of the accelerating field, and measure the dark current generated by RF field emission in the accelerator. For beam loading R and D, an average current of about 1 A in a 120 ns long bunch train is required. The initial commissioning of the NLCTA injector, as well as the rest of the accelerator have been progressing very well. The initial beam parameters are very close to the requirement and they expect that injector will meet the specified requirements by the end of this summer

  2. On the prediction of spray angle of liquid-liquid pintle injectors

    Science.gov (United States)

    Cheng, Peng; Li, Qinglian; Xu, Shun; Kang, Zhongtao

    2017-09-01

    The pintle injector is famous for its capability of deep throttling and low cost. However, the pintle injector has been seldom investigated. To get a good prediction of the spray angle of liquid-liquid pintle injectors, theoretical analysis, numerical simulations and experiments were conducted. Under the hypothesis of incompressible and inviscid flow, a spray angle formula was deduced from the continuity and momentum equations based on a control volume analysis. The formula was then validated by numerical and experimental data. The results indicates that both geometric and injection parameters affect the total momentum ratio (TMR) and then influence the spray angle formed by liquid-liquid pintle injectors. TMR is the pivotal non-dimensional number that dominates the spray angle. Compared with gas-gas pintle injectors, spray angle formed by liquid-liquid injectors is larger, which benefits from the local high pressure zone near the pintle wall caused by the impingement of radial and axial sheets.

  3. Effects of Subanesthetic Ketamine on Pain and Cognitive Functions in TIVA

    Directory of Open Access Journals (Sweden)

    Yeliz Ozhan

    2014-03-01

    Full Text Available Aim: It was aimed to compare the effects of subanesthetic dose ketamine on analgesic consumption, cognitive functions, perioperative hemodynamics and postoperative recovery in patients scheduled for laparoscopic cholecystectomy under total intravenous anesthesia (TIVA. Material and Method: The study was approved by Institutional Ethics Committee and all patients gave written informed consent. Sixty ASA I-III patients aged 20-70 years scheduled for elective laparoscopic cholecystectomy were randomly assigned into 2 groups [group 1 (TIVA-ketamine and group 2 (TIVA]. Both groups underwent Mini Mental Test (MMT before the operation. In the group 1, 0.25 mg.kg-1 ketamine was given 2 minutes before induction via intravenous route. Anesthesia was induced by using 2mg.kg-1 propofol, 1µg.kg-1fentanyl (iv and 0.6 mg.kg-1 rocuronium (iv in both groups. Anesthesia was maintained by 5-8mg.kg-1.h-1 propofol, 0,15µg kg-1 remifentanil (iv and 50:50 mixtures of O2 and air. Postoperative pain management was achieved by tramadol HCl via patient-controlled analgesia (PCA device. Total dose within 24 hours was recorded. Hemodynamic parameters during surgery and times to extubation, eye opening, receiving verbal commands and orientation time were recorded. Ramsey sedation score (RSS and Aldrete recovery score (ARS were recorded after extubation. MMT was repeated on the postoperative hour 24. Results: Hemodynamic parameters were found to be similar in both groups. Total analgesic consumption was found to be significantly lower in patients received ketamine (p0.05. Discussion: Addition of subanesthetic dose ketamine to total intravenous anesthesia had no adverse effect on intraoperative hemodynamic parameters; it provided more effective postoperative analgesia; however, we think that a meticulous monitoring is required during early postoperative period as it prolonged awakening and recovery times.

  4. Rationale and design of a multicenter randomized clinical trial with memantine and dextromethorphan in ketamine-responder patients.

    Science.gov (United States)

    Pickering, Gisèle; Pereira, Bruno; Morel, Véronique; Tiberghien, Florence; Martin, Elodie; Marcaillou, Fabienne; Picard, Pascale; Delage, Noémie; de Montgazon, Géraldine; Sorel, Marc; Roux, Delphine; Dubray, Claude

    2014-07-01

    The N-methyl-D-aspartate receptor plays an important role in central sensitization of neuropathic pain and N-methyl-D-aspartate receptor antagonists, such as ketamine, memantine and dextromethorphan may be used for persistent pain. However, ketamine cannot be repeated too often because of its adverse events. A drug relay would be helpful in the outpatient to postpone or even cancel the next ketamine infusion. This clinical trial evaluates if memantine and/or dextromethorphan given as a relay to ketamine responders may maintain or induce a decrease of pain intensity and have a beneficial impact on cognition and quality of life. This trial is a multi-center, randomized, controlled and single-blind clinical study (NCT01602185). It includes 60 ketamine responder patients suffering from neuropathic pain. They are randomly allocated to memantine, dextromethorphan or placebo. After ketamine infusion, 60 patients received either memantine (maximal dose 20 mg/day), or dextromethorphan (maximal dose 90 mg/day), or placebo for 12 weeks. The primary endpoint is pain measured on a (0-10) Numeric Rating Scale 1 month after inclusion. Secondary outcomes include assessment of neuropathic pain, sleep, quality of life, anxiety/depression and cognitive function at 2 and 3 months. Data analysis is performed using mixed models and the tests are two-sided, with a type I error set at α=0.05. This study will explore if oral memantine and/or dextromethorphan may be a beneficial relay in ketamine responders and may diminish ketamine infusion frequency. Preservation of cognitive function and quality of life is also a central issue that will be analyzed in these vulnerable patients. Copyright © 2014. Published by Elsevier Inc.

  5. Acute administration of ketamine in rats increases hippocampal BDNF and mTOR levels during forced swimming test.

    Science.gov (United States)

    Yang, Chun; Hu, Yi-Min; Zhou, Zhi-Qiang; Zhang, Guang-Fen; Yang, Jian-Jun

    2013-03-01

    Previous studies have shown that a single sub-anesthetic dose of ketamine exerts fast-acting antidepressant effects in patients and in animal models of depression. However, the underlying mechanisms are not totally understood. This study aims to investigate the effects of acute administration of different doses of ketamine on the immobility time of rats in the forced swimming test (FST) and to determine levels of hippocampal brain-derived neurotrophic factor (BDNF) and mammalian target of rapamycin (mTOR). Forty male Wistar rats weighing 180-220 g were randomly divided into four groups (n = 10 each): group saline and groups ketamine 5, 10, and 15 mg/kg. On the first day, all animals were forced to swim for 15 min. On the second day ketamine (5, 10, and 15 mg/kg, respectively) was given intraperitoneally, at 30 min before the second episode of the forced swimming test. Immobility times of the rats during the forced swimming test were recorded. The animals were then decapitated. The hippocampus was harvested for determination of BDNF and mTOR levels. Compared with group saline, administration of ketamine at a dose of 5, 10, and 15 mg/kg decreased the duration of immobility (P < 0.05 for all doses). Ketamine at doses of both 10 and 15 mg/kg showed a significant increase in the expression of hippocampal BDNF (P < 0.05 for both doses). Ketamine given at doses of 5, 10, and 15 mg/kg showed significant increases in relative levels of hippocampal p-mTOR (P < 0.05 for all doses) The antidepressant effect of ketamine might be related to the increased expression of BDNF and mTOR in the hippocampus of rats.

  6. Temporal dynamics of distinct CA1 cell populations during unconscious state induced by ketamine.

    Directory of Open Access Journals (Sweden)

    Hui Kuang

    2010-12-01

    Full Text Available Ketamine is a widely used dissociative anesthetic which can induce some psychotic-like symptoms and memory deficits in some patients during the post-operative period. To understand its effects on neural population dynamics in the brain, we employed large-scale in vivo ensemble recording techniques to monitor the activity patterns of simultaneously recorded hippocampal CA1 pyramidal cells and various interneurons during several conscious and unconscious states such as awake rest, running, slow wave sleep, and ketamine-induced anesthesia. Our analyses reveal that ketamine induces distinct oscillatory dynamics not only in pyramidal cells but also in at least seven different types of CA1 interneurons including putative basket cells, chandelier cells, bistratified cells, and O-LM cells. These emergent unique oscillatory dynamics may very well reflect the intrinsic temporal relationships within the CA1 circuit. It is conceivable that systematic characterization of network dynamics may eventually lead to better understanding of how ketamine induces unconsciousness and consequently alters the conscious mind.

  7. Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients.

    Science.gov (United States)

    Yeaman, Fiona; Meek, Robert; Egerton-Warburton, Diana; Rosengarten, Pamela; Graudins, Andis

    2014-06-01

    There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in the ED. The study aims to examine the effectiveness of sub-dissociative IN ketamine as a primary analgesic agent for adult patients in the ED. This is a prospective, observational study of adult ED patients presenting with severe pain (≥6 on 11-point scale at triage). IN ketamine dose was 0.7 mg/kg, with secondary dose of 0.5 mg/kg at 15 min if pain did not improve. After 6 months, initial dose was increased to 1.0 mg/kg with the same optional secondary dose. The primary outcomes are change in VAS rating at 30 min; percentage of patients reporting clinically significant reduction in VAS (≥20 mm) at 30 min; dose resulting in clinically significant pain reduction. Of the 72 patients available for analysis, median age was 34.5 years and 64% were men. Median initial VAS rating was 76 mm (interquartile range [IQR]: 65-82). Median total dose of IN ketamine for all patients was 0.98 mg/kg (IQR: 0.75-1.15, range: 0.59-1.57). Median reduction in VAS rating at 30 min was 24 mm (IQR: 2-45). Forty (56%, 95% CI: 44.0-66.7) reported VAS reduction ≥20 mm, these patients having had a total median ketamine dose of 0.94 mg/kg (IQR: 0.72-1.04). IN ketamine, at a dose of about 1 mg/kg, was an effective analgesic agent in 56% of study patients. The place of IN ketamine in analgesic guidelines for adults requires further investigation. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  8. Effect of ketamine on exploratory behaviour in BALB/C and C57BL/6 mice.

    Science.gov (United States)

    Akillioglu, Kubra; Melik, Emine Babar; Melik, Enver; Boga, Ayper

    2012-01-01

    In this study, we evaluated the effect of ketamine on exploratory locomotion behaviours in the Balb/c and C57BL/6 strains of mice, which differ in their locomotion behaviours. Intraperitoneal administration of ketamine at three different doses (1, 5 or 10 mg/kg, 0.1 ml/10 gr body weight) was performed on adult male Balb/c and C57BL/6 mice. The same volume of saline was applied to the control group. The open-field and elevated plus maze apparatus were used to evaluate exploratory locomotion. In the open-field test, Balb/c mice less spend time in the centre of the field and was decreased locomotor activity compared to C57BL/6 mice (pmice at 10 mg/kg dose caused an increase in locomotor activity and an increase in the amount of time spent in the centre in the open-field test, compared to the control group (pmice, ketamine treatment (1 and 10 mg/kg) decreased locomotor activity (pmice, the three different doses of ketamine application each caused a decrease in the frequency of centre crossing (pmice compared to C57BL/6 mice (pmice at 10 mg/kg dose caused an increase in the open-arm activity (pmice (pmice. In contrast, a subanaesthetic dose of ketamine decreased exploratory locomotion in C57BL/6 mice. In conclusion, hereditary factors may play an important role in ketamine-induced responses. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Comparison of ketorolac and low-dose ketamine in preventing tourniquet-induced increase in arterial pressure

    Directory of Open Access Journals (Sweden)

    Raza Zaidi

    2015-01-01

    Full Text Available Background and Aims: Application of tourniquet during orthopaedic procedures causes pain and increase in blood pressure despite adequate anaesthesia and analgesia. In this study, we compared ketorolac with ketamine in patients undergoing elective lower limb surgery with tourniquet in order to discover if ketorolac was equally effective or better than ketamine in preventing tourniquet-induced hypertension. Methods: Approval was granted by the Institutional Ethics Review Committee and informed consent was obtained from all participants. A randomised double-blinded controlled trial with 38 patients each in the ketamine and ketorolac groups undergoing elective knee surgery for anterior cruciate ligament repair or reconstruction was conducted. Induction and maintenance of anaesthesia were standardised in all patients, and the minimum alveolar concentration of isoflurane was maintained at 1.2 throughout the study period. One group received ketamine in a dose of 0.25 mg/kg and the other group received 30 mg ketorolac 10 min before tourniquet inflation. Blood pressure was recorded before induction of anaesthesia (baseline and at 0, 10, 20, 30, 40, 50, and 60 min after tourniquet inflation. Results: The demographic and anaesthetic characteristics were similar in the two groups. At 0 and 10 min, tourniquet-induced rise in blood pressure was not observed in both groups. From 20 min onward, both systolic and diastolic blood pressures were significantly higher in ketorolac group compared to ketamine group. Conclusion: We conclude that ketamine is superior to ketorolac in preventing tourniquet-induced increases in blood pressure.

  10. Ketamine Therapy for Treatment-resistant Depression in a Patient with Multiple Sclerosis: A Case Report.

    Science.gov (United States)

    Messer, Michael M; Haller, Irina V

    2017-01-01

    Objective: Depression is a common condition among patients with multiple sclerosis and often becomes resistant to oral antidepressants. We report a patient with multiple sclerosis who developed severe treatment-resistant depression and who was successfully treated with intravenous ketamine over the period of two years. Methods: Ketamine treatment protocol included an initial series of six treatments administered every other day, followed by a maintenance schedule. Ketamine was administered intravenously at 0.5mg/kg of ideal body weight over 40 minutes. Depression symptoms were measured using Beck Depression Index. Results: The patient's Beck Depression Index score prior to initiating ketamine treatment was 38, corresponding to severe depression. Response to treatment, defined as 50-percent reduction in Beck Depression Index score, was observed after five treatments. For this patient, the maintenance schedule ranged from a weekly treatment to one treatment every three weeks. During the two-year observation period, this patient was able to maintain a stable non-depressed mood and had no worsening of her MS symptoms. Conclusion: Ketamine may be an alternative treatment for resistant depression and may have a special use in patients with multiple sclerosis.

  11. Acute S-ketamine application does not alter cerebral [18F]altanserin binding: a pilot PET study in humans

    International Nuclear Information System (INIS)

    Matusch, A.; Rota Kops, E.; Winz, O.H.; Elmenhorst, D.; Herzog, H.; Hurlemann, R.; Zilles, K.; Bauer, A.

    2007-01-01

    Modeling short-term psychotic states with subanaesthetic doses of ketamine provides substantial experimental evidence in support of the glutamate hypothesis of schizophrenia. Ketamine exerts its pharmacological effects both directly via interactions with glutamate receptors and indirectly by stimulating presynaptic release of endogenous serotonin (5-HT). The aim of this feasibility study was to examine whether acute ketamine-induced 5-HT release interferes with the binding of the 5-HT 2A receptor (5-HT 2A R) radioligand [ 18 F]altanserin and positron emission tomography (PET). Two subjects treated with ketamine and one subject treated with placebo underwent [ 18 F]altanserin PET at distribution equilibrium conditions. Robust physiological, psychopathological and cognitive effects were present at ketamine plasma concentrations exceeding 100 μg/l during >70 min. Notwithstanding, we observed stable radioligand binding (changes ±95 % CI of -1.0 ± 1.6 % and +4.1 ± 1.8 % versus -1.2 ± 2.6 %) in large cortical regions presenting high basal uptake of both, [ 18 F]altanserin and ketamine. Marginal decreases of 4 % of radioligand binding were observed in the frontal lobe, and 8 % in a posteriorly specified frontomesial subregion. This finding is not compatible with a specific radioligand displacement from 5-HT2 AR which should occur proportionally throughout the whole brain. Instead, the spatial pattern of these minor reductions was congruent with ketamine-induced increases in cerebral blood flow observed in a previous study using [ 15 O]butanol PET. This may caused by accelerated clearance of unspecifically bound [ 18 F]altanserin from cerebral tissue with increased perfusion. In conclusion, this study suggests that [ 18 F]altanserin PET is not sensitive to acute neurotransmitter fluctuations under ketamine. Advantageously, the stability of [ 18 F]altanserin PET towards acute influences is a prerequisite for its future use to detect sub-acute and chronic effects of

  12. Development of technologies on innovative-simplified nuclear power plant using high-efficiency steam injectors (5) operating characteristics of center water jet type supersonic steam injector

    International Nuclear Information System (INIS)

    Abe, Y.; Kawamoto, Y.; Iwaki, C.; Narabayashi, T.; Mori, M.; Ohmori, S.

    2005-01-01

    Next-generation reactor systems have been under development aiming at simplified system and improvement of safety and credibility. A steam injector has a function of a passive pump without large motor or turbo-machinery, and has been investigated as one of the most important component of the next-generation reactor. Its performance as a pump depends on direct contact condensation phenomena between a supersonic steam and a sub-cooled water jet. As previous studies of the steam injector, there are studies about formulation of operating characteristic of steam injector and analysis of jet structure in steam injector by Narabayashi etc. And as previous studies of the direct contact condensation, there is the study about the direct contact condensation in steam atmosphere. However the study about the turbulent heat transfer under the great shear stress is not enough investigated. Therefore it is necessary to examine in detail about the operating characteristic of the steam injector. The present paper reports the observation results of the water jet behavior in the super sonic steam injector by using the video camera and the high-speed video camera. And the measuring results of the temperature and the pressure distribution in the steam injector are reported. From observation results by video camera, it is cleared that the water jet is established at the center of the steam injector right after steam supplied and the operation of the steam injector depends on the throat diameter. And from observation results by high-speed video camera, it is supposed that the columned water jet surface is established in the mixing nozzle and the water jet surface movement exists. And from temperature measuring results, it is supposed that the steam temperature at the mixing nozzle is changed between about 80 degree centigrade and about 60 degree centigrade. Then from the pressure measuring results, it is confirmed that the pressure at the diffuser depends on each the throat diameter and

  13. Impact of palm biodiesel blend on injector deposit formation

    International Nuclear Information System (INIS)

    Liaquat, A.M.; Masjuki, H.H.; Kalam, M.A.; Fazal, M.A.; Khan, Abdul Faheem; Fayaz, H.; Varman, M.

    2013-01-01

    Highlights: • 250 h Endurance test on 2 fuel samples; diesel fuel and PB20. • Visual inspection of injectors running on DF and PB20 showed deposit accumulation. • SEM and EDS analysis showed less injector deposits for DF compared to PB20 blend. • Engine oil analysis showed higher value of wear particles for PB20 compared to DF. - Abstract: During short term engine operation, renewable fuels derived from vegetable oils, are capable of providing good engine performance. In more extended operations, some of the same fuels can cause degradation of engine performance, excessive carbon and lacquer deposits and actual damage to the engine. Moreover, temperatures in the area of the injector tip due to advanced diesel injection systems may lead to particularly stubborn deposits at and around the injector tip. In this research, an endurance test was carried out for 250 h on 2 fuel samples; DF (diesel fuel) as baseline and PB20 (20% palm biodiesel and 80% DF) in a single cylinder CI engine. The effects of DF and PB20 on injector nozzle deposits, engine lubricating oil, and fuel economy and exhaust emissions were investigated. According to the results of the investigation, visual inspection showed some deposit accumulation on injectors during running on both fuels. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis showed greater carbon deposits on and around the injector tip for PB20 compared to the engine running with DF. Similarly, lubricating oil analysis presented excessive wear metal concentrations, decreased viscosity and increased density values when the engine was fuelled with PB20. Finally, fuel economy and emission results during the endurance test showed higher brake specific fuel consumption (bsfc) and NO x emissions, and lower HC and CO emissions, for the PB20 blend compared to DF

  14. Prevention of propofol-induced pain in children: pretreatment with small doses of ketamine.

    Science.gov (United States)

    Zhao, Guang-yi; Guo, Yao; Bao, Shu-min; Meng, Ling-xin; Zhang, Li-hong

    2012-06-01

    To evaluate the efficacy of ketamine in preventing propofol injection pain in children. Prospective, randomized, double-blinded, placebo-controlled study. University-affiliated hospital. 192 ASA physical status 1 and 2 pediatric patients. Patients were randomly assigned to 4 groups. Group S (control) received normal saline as a placebo; Group K1, Group K3, and Group K5 received 0.1 mg/kg, 0.3 mg/kg, and 0.5 mg/kg of ketamine, respectively. Fifteen seconds after the ketamine injection, patients were injected with propofol at a rate of 12 mL/min until loss-of-eyelash reflex. Pain was evaluated blindly at the time of induction using a 4-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain. Adverse effects were recorded. Characteristics of induction of anesthesia, such as dose of propofol and time from propofol injection to loss of consciousness (induction duration), were noted. 39 (84.8%) Group S (control) patients had pain. Pretreatment with ketamine reduced the frequency of pain significantly to 56.5%, 17.0%, and 14.9% in Groups K1, K3, and K5, respectively. Furthermore, the frequency of moderate and severe pain in Group K1 (21.8%), Group K3 (6.4%), and Group K5 (4.3%) was significantly (P ketamine (0.3 mg/kg) reduced the frequency and intensity of propofol injection pain without severe adverse effects. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Ketamine Protects Gamma Oscillations by Inhibiting Hippocampal LTD

    Science.gov (United States)

    Huang, Lanting; Yang, Xiu-Juan; Huang, Ying; Sun, Eve Y.

    2016-01-01

    NMDA receptors have been widely reported to be involved in the regulation of synaptic plasticity through effects on long-term potentiation (LTP) and long-term depression (LTD). LTP and LTD have been implicated in learning and memory processes. Besides synaptic plasticity, it is known that the phenomenon of gamma oscillations is critical in cognitive functions. Synaptic plasticity has been widely studied, however it is still not clear, to what degree synaptic plasticity regulates the oscillations of neuronal networks. Two NMDA receptor antagonists, ketamine and memantine, have been shown to regulate LTP and LTD, to promote cognitive functions, and have even been reported to bring therapeutic effects in major depression and Alzheimer’s disease respectively. These compounds allow us to investigate the putative interrelationship between network oscillations and synaptic plasticity and to learn more about the mechanisms of their therapeutic effects. In the present study, we have identified that ketamine and memantine could inhibit LTD, without impairing LTP in the CA1 region of mouse hippocampus, which may underlie the mechanism of these drugs’ therapeutic effects. Our results suggest that NMDA-induced LTD caused a marked loss in the gamma power, and pretreatment with 10 μM ketamine prevented the oscillatory loss via its inhibitory effect on LTD. Our study provides a new understanding of the role of NMDA receptors on hippocampal plasticity and oscillations. PMID:27467732

  16. Penggunaan zoletil dan ketamine untuk anestesia pada Felidae

    Directory of Open Access Journals (Sweden)

    I Komang Wiarsa Sardjana

    2003-06-01

    Full Text Available Zoletil and ketamine as a non barbiturat anaesthetic can be administered by the intramuscular route in Felidae a specially in thewild animals and pets. Seven Felidaeof the wild animals there were five the Lions (Panthera leo and two the White tigers (Pantheratigris tigris of the Surabaya Zoological Garden have of Zoletil with dose 5 mg/kg body weight and seven Cats of Veterinary Hospitalof Faculty of Veterinary Medicine of airlangga was used Ketamine as anaesthetic with dose 20 mg/Kg body weight. All the animalshave injected Atropin sulfate with dose 0.1 mg/Kg body weight intramuscular as a premedication.The result of this study of Zoletil in Felidae are shown that the animals have not in respiratory depression and during anaesthesiahave done the body temperature means about 36.9 º C, Pulsus rate is 100.8 times/minutes and Respiration rate is 21.7times/minutes.The studi of Ketamine the data shown during anaesthesia the means of the body temperature of the cats is 38.4 º C with pulsus rate is85.1 times/minutes and respiration rate is 41.1 time/minutes.We have assumed that study of the drug have a great effect of the animals in practice look like in cats or the wild animals forrestraint or anaesthesia of short duration.

  17. Experience of the use of Ketamine to manage opioid withdrawal in an addicted woman: a case report.

    Science.gov (United States)

    Lalanne, Laurence; Nicot, Chloe; Lang, Jean-Philippe; Bertschy, Gilles; Salvat, Eric

    2016-11-10

    Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain. She presented a severe opioid addiction, and her physicians refused to prescribe such high doses of opioid treatment (oxycontin® extended-release 120 mg daily, oxycodone 60 mg daily, and acetaminophen/codeine 300 mg/25 mg 6 times per day). To assist her with her opioid withdrawal which risked increasing her existing pain, she received 1 mg/kg ketamine oral solution, and two days after ketamine initiation her opioid treatment was gradually reduced. The patient dramatically reduced the dosage of opioid painkillers and ketamine was withdrawn without any withdrawal symptoms. Ketamine displays many interesting qualities for dealing with all symptoms relating to opioid withdrawal. Accordingly, it could be used instead of many psychotropic treatments, which interact with each other, to help with opioid withdrawal. However, the literature describes addiction to ketamine. All in all, although potentially addictive, ketamine could be a good candidate for the pharmacological management of opioid withdrawal.

  18. The effects of subarachnoid administration of preservative-free S(+)-ketamine on spinal cord and meninges in dogs.

    Science.gov (United States)

    Rojas, Alfredo Cury; Alves, Juliana Gaiotto; Moreira E Lima, Rodrigo; Esther Alencar Marques, Mariângela; Moreira de Barros, Guilherme Antônio; Fukushima, Fernanda Bono; Modolo, Norma Sueli Pinheiro; Ganem, Eliana Marisa

    2012-02-01

    The N-methyl-d-aspartate receptor antagonist ketamine and its active enantiomer, S(+)-ketamine, have been injected in the epidural and subarachnoid spaces to treat acute postoperative pain and relieve neuropathic pain syndrome. In this study we evaluated the effects of a single dose of preservative-free S(+)-ketamine, in doses usually used in clinical practice, in the spinal cord and meninges of dogs. Under anesthesia (IV etomidate (2 mg/kg) and fentanyl (0.005 mg/kg), 16 dogs (6 to 15 kg) were randomized to receive a lumbar intrathecal injection (L5/6) of saline solution of 0.9% (control group) or S(+)-ketamine 1 mg/kg(-1) (ketamine group). All doses were administered in a volume of 1 mL over a 10-second interval. Accordingly, injection solution ranged from 0.6% to 1.5%. After 21 days of clinical observation, the animals were killed; spinal cord, cauda equina root, and meninges were removed for histological examination with light microscopy. Tissues were examined for demyelination (Masson trichrome), neuronal death (hematoxylin and eosin) and astrocyte activation (glial fibrillary acidic protein). No clinical or histological alterations of spinal tissue or meninges were found in animals from either control or ketamine groups. A single intrathecal injection of preservative-free S(+)-ketamine, at 1 mg/kg(-1) dosage, over a concentration range of 6 to 15 mg/mL injected in the subarachnoid space in a single puncture, did not produce histological alterations in this experimental model.

  19. Ketamine inhibits 45Ca influx and catecholamine secretion by inhibiting 22Na influx in cultured bovine adrenal medullary cells

    International Nuclear Information System (INIS)

    Takara, Hiroshi; Wada, Akihiko; Arita, Masahide; Izumi, Futoshi; Sumikawa, Koji

    1986-01-01

    The effects of ketamine, an intravenous anesthetic, on 22 Na influx, 45 Ca influx and catecholamine secretion were investigated in cultured bovine adrenal medullary cells. Ketamine inhibited carbachol-induced 45 Ca influx and catecholamine secretion in a concentration-dependent manner with a similar potency. Ketamine also reduced veratridine-induced 45 Ca influx and catecholamine secretion. The influx of 22 Na caused by carbachol or by veratridine was suppressed by ketamine with a concentration-inhibition curve similar to that of 45 Ca influx and catecholamine secretion. Inhibition by ketamine of the carbachol-induced influx of 22 Na, 45 Ca and secretion of catecholamines was not reversed by the increased concentrations of carbachol. These observations indicate that ketamine, at clinical concentrations, can inhibit nicotinic receptor-associated ionic channels and that the inhibition of Na influx via the receptor-associated ionic channels is responsible for the inhibition of carbachol-induced Ca influx and catecholamine secretion. (Auth.)

  20. What factors affect the carriage of epinephrine auto-injectors by teenagers?

    Science.gov (United States)

    Macadam, Clare; Barnett, Julie; Roberts, Graham; Stiefel, Gary; King, Rosemary; Erlewyn-Lajeunesse, Michel; Holloway, Judith A; Lucas, Jane S

    2012-02-02

    Teenagers with allergies are at particular risk of severe and fatal reactions, but epinephrine auto-injectors are not always carried as prescribed. We investigated barriers to carriage. Patients aged 12-18 years old under a specialist allergy clinic, who had previously been prescribed an auto-injector were invited to participate. Semi-structured interviews explored the factors that positively or negatively impacted on carriage. Twenty teenagers with food or venom allergies were interviewed. Only two patients had used their auto-injector in the community, although several had been treated for severe reactions in hospital. Most teenagers made complex risk assessments to determine whether to carry the auto-injector. Most but not all decisions were rational and were at least partially informed by knowledge. Factors affecting carriage included location, who else would be present, the attitudes of others and physical features of the auto-injector. Teenagers made frequent risk assessments when deciding whether to carry their auto-injectors, and generally wanted to remain safe. Their decisions were complex, multi-faceted and highly individualised. Rather than aiming for 100% carriage of auto-injectors, which remains an ambitious ideal, personalised education packages should aim to empower teenagers to make and act upon informed risk assessments.

  1. What factors affect the carriage of epinephrine auto-injectors by teenagers?

    Directory of Open Access Journals (Sweden)

    Macadam Clare

    2012-02-01

    Full Text Available Abstract Background Teenagers with allergies are at particular risk of severe and fatal reactions, but epinephrine auto-injectors are not always carried as prescribed. We investigated barriers to carriage. Methods Patients aged 12-18 years old under a specialist allergy clinic, who had previously been prescribed an auto-injector were invited to participate. Semi-structured interviews explored the factors that positively or negatively impacted on carriage. Results Twenty teenagers with food or venom allergies were interviewed. Only two patients had used their auto-injector in the community, although several had been treated for severe reactions in hospital. Most teenagers made complex risk assessments to determine whether to carry the auto-injector. Most but not all decisions were rational and were at least partially informed by knowledge. Factors affecting carriage included location, who else would be present, the attitudes of others and physical features of the auto-injector. Teenagers made frequent risk assessments when deciding whether to carry their auto-injectors, and generally wanted to remain safe. Their decisions were complex, multi-faceted and highly individualised. Conclusions Rather than aiming for 100% carriage of auto-injectors, which remains an ambitious ideal, personalised education packages should aim to empower teenagers to make and act upon informed risk assessments.

  2. Water jet behavior in center water jet type supersonic steam injector

    International Nuclear Information System (INIS)

    Kawamoto, Y.; Abe, Y.

    2005-01-01

    Next-generation reactor systems have been under development aiming at simplified system and improvement of safety and credibility. A steam injector has a function of a passive pump without large motor or turbo-machinery, and has been investigated as one of the most important component of the next-generation reactor. Its performance as a pump depends on direct contact condensation phenomena between a supersonic steam and a sub-cooled water jet. As previous studies of the steam injector, there are studies about formulation of operating characteristic of steam injector and analysis of jet structure in steam injector by Narabayashi etc. And as previous studies of the direct contact condensation, there is the study about the direct contact condensation in steam atmosphere. However the study about the turbulent heat transfer under the great shear stress is not enough investigated. Therefore it is necessary to examine in detail about the operating characteristic of the steam injector. The present paper reports the observation results of the water jet behavior in the super sonic steam injector by using the video camera and the high-speed video camera. And the measuring results of the temperature and the pressure distribution in the steam injector are reported. From observation results by video camera, it is cleared that the water jet is established at the center of the steam injector right after steam supplied and the operation of the steam injector depends on the throat diameter. And from observation results by high-speed video camera, it is supposed that the columned water jet surface is established in the mixing nozzle and the water jet surface movement exists. Furthermore and effect of the non-condensable gas on the steam injector is investigated by measuring the radial temperature distributions in the water jet. From measuring results, it is supposed the more the air included in the steam, the more the temperature fluctuation of both steam and discharge water

  3. Repeating pneumatic pellet injector in JAERI

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Satoshi; Hasegawa, Kouichi; Suzuki, Sadaaki; Miura, Yukitoshi (Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment); Oda, Yasushi; Onozuka, Masanori; Tsujimura, Seiichi.

    1992-09-01

    A repeating pneumatic pellet injector has been developed and constructed at Japan Atomic Energy Research Institute. This injector can provide repetitive pellet injection to fuel tokamak plasmas for an extended period of time, aiming at the improvement of plasma performance. The pellets with nearly identical speed and mass can be repeatedly injected with a repetition rate of 2-3.3 Hz and a speed of up to 1.7 km/s by controlling the temperature of the cryogenic system, the piston speed and the pressure of the propellant gas. (author).

  4. Mechanical design for TMX injector system

    International Nuclear Information System (INIS)

    Calderon, M.O.; Chen, F.F.K.; Denhoy, B.S.

    1977-01-01

    The injector system for the Tandem Mirror Experiment (TMX) contains the components required to create and maintain a high-temperature, high-density plasma. These components include a streaming-plasma gun in each of the plug tanks to form the target-plasma, 24 neutral-beam source modules for injecting neutral deuterium atoms to heat and replace losses from the plasma, and a gas box system that applies a streaming cold gas to the plasma to stabilize it. This paper discusses the mechanical design problems and solutions for this injector system

  5. Repeating pneumatic pellet injector in JAERI

    International Nuclear Information System (INIS)

    Kasai, Satoshi; Hasegawa, Kouichi; Suzuki, Sadaaki; Miura, Yukitoshi; Oda, Yasushi; Onozuka, Masanori; Tsujimura, Seiichi.

    1992-09-01

    A repeating pneumatic pellet injector has been developed and constructed at Japan Atomic Energy Research Institute. This injector can provide repetitive pellet injection to fuel tokamak plasmas for an extended period of time, aiming at the improvement of plasma performance. The pellets with nearly identical speed and mass can be repeatedly injected with a repetition rate of 2-3.3 Hz and a speed of up to 1.7 km/s by controlling the temperature of the cryogenic system, the piston speed and the pressure of the propellant gas. (author)

  6. DARHT-II Injector Transients and the Ferrite Damper

    Energy Technology Data Exchange (ETDEWEB)

    Waldron, Will; Reginato, Lou; Chow, Ken; Houck, Tim; Henestroza, Enrique; Yu, Simon; Kang, Michael; Briggs, Richard

    2006-08-04

    This report summarizes the transient response of the DARHT-II Injector and the design of the ferrite damper. Initial commissioning of the injector revealed a rise time excited 7.8 MHz oscillation on the diode voltage and stalk current leading to a 7.8 MHz modulation of the beam current, position, and energy. Commissioning also revealed that the use of the crowbar to decrease the voltage fall time excited a spectrum of radio frequency modes which caused concern that there might be significant transient RF electric field stresses imposed on the high voltage column insulators. Based on the experience of damping the induction cell RF modes with ferrite, the concept of a ferrite damper was developed to address the crowbar-excited oscillations as well as the rise-time-excited 7.8 MHz oscillations. After the Project decided to discontinue the use of the crowbar, further development of the concept focused exclusively on damping the oscillations excited by the rise time. The design was completed and the ferrite damper was installed in the DARHT-II Injector in February 2006. The organization of this report is as follows. The suite of injector diagnostics are described in Section 2. The data and modeling of the injector transients excited on the rise-time and also by the crowbar are discussed in Section 3; the objective is a concise summary of the present state of understanding. The design of the ferrite damper, and the small scale circuit simulations used to evaluate the ferrite material options and select the key design parameters like the cross sectional area and the optimum gap width, are presented in Section 4. The details of the mechanical design and the installation of the ferrite damper are covered in Section 5. A brief summary of the performance of the ferrite damper following its installation in the injector is presented in Section 6.

  7. Effect of injector geometry on the performance of an internally mixed liquid atomizer

    Energy Technology Data Exchange (ETDEWEB)

    Kushari, A.

    2010-11-15

    This paper presents the results of an experimental study of the effect of injector's geometry on the performance of an internally mixed, air-assisted, liquid injector. In this type of injector a small amount of air is injected into a liquid stream within the injector. The interaction of the liquid with the atomizing air inside the injector induces atomization. The results presented in this paper show that the size of the droplets produced by the investigated injector decreases with a decrease in the air injection area. This is due to the increase in atomizing air injection velocity that accompanies the decrease in the air injection area, which improves atomization. This study also shows that the droplet sizes decrease with an increase in the injector's length, which is attributed to the increase in total interactive force. (author)

  8. Rectal Thiopental versus Intramuscular Ketamine in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Reza Azizkhani

    2015-01-01

    Full Text Available Introduction: Physicians frequently deal with procedures which require sedation of pediatric patients. Laceration repair is one of them. No study has been performed regarding the comparison between induction of sedation with sodium thiopental and ketamine in laceration repair. Therefore, the present study was aimed to comparison of induced sedation by rectal sodium thiopental and muscular injection of hydrochloride ketamine in pediatric patients need laceration repair. Methods: The presented study is a single-blinded clinical trial performed through 2013 to 2014 in Ayatollah Kashani and Alzahra Hospitals, Isfahan, Iran. Patients from 3 months to 14 years, needed sedation for laceration repair, were entered. Patients were sequentially evaluated and randomly categorized in two groups of hydrochloride ketamine with dose of 2-4 milligram per kilogram and sodium thiopental with dose of 25 milligram per kilogram. Demographic data and vital signs before drug administration and after induction of sedation, Ramsey score, time to onset of action, and sedation recovery time were evaluated. Chi-squared, Mann-Whitney, and Non-parametric analysis of covariance tests were used. P<0.05 was considered as a significant level. Results: In this study 60 pediatric patients were entered. 30 patients with mean age of 42.8±18.82 months were received sodium thiopental and the rest with mean age of 30.08±16.88 months given ketamine. Mann-Whitney test was showed that time to onset of action in sodium thiopental group (28.23±5.18 minutes was significantly higher than ketamine (7.77±4.13 minutes, (p<0.001. The sedation recovery time in ketamine group (29.83±7.70 was higher than sodium thiopental. Depth of sedation had no significant difference between two groups based on Ramsey score (p=0.87. No significant difference was seen between two groups in the respiratory rate (df=1, 58; F=0.002; P=0.96 and heart rate (df=1, 58; F=0.98; P=0.33. However, arterial oxygen

  9. Case Reports Showing a Long-Term Effect of Subanesthetic Ketamine Infusion in Reducing L-DOPA-Induced Dyskinesias

    Directory of Open Access Journals (Sweden)

    Scott J. Sherman

    2016-02-01

    Full Text Available Ketamine is an FDA-approved drug with a known safety profile. Low-dose subanesthetic intravenous ketamine infusion treatment has led to long-term reduction of treatment-resistant depression and of chronic pain states. We report on low-dose subanesthetic intravenous ketamine infusion treatment in Parkinson's disease (PD patients by 5 case studies and show a long-lasting therapeutic benefit to reduce L-DOPA-induced dyskinesia (LID, improve on time, and reduce depression. Based on the literature we hypothesize that low-dose ketamine may act as a ‘chemical deep brain stimulation', by desynchronizing hypersynchronous oscillatory brain activity, including in the basal ganglia and the motor cortex. The presented PD case reports indicate tolerability, safety and long-term beneficial effects of low-dose ketamine infusion that should be further investigated in a properly controlled prospective clinical trial for treatment of LID, as well as the prevalent nonmotor features pain and depression in PD patients.

  10. Commissioning of the 123 MeV injector for 12 GeV CEBAF

    International Nuclear Information System (INIS)

    Wang, Yan; Hofler, Alicia S.; Kazimi, Reza

    2015-09-01

    The upgrade of CEBAF to 12GeV included modifications to the injector portion of the accelerator. These changes included the doubling of the injection energy and relocation of the final transport elements to accommodate changes in the CEBAF recirculation arcs. This paper will describe the design changes and the modelling of the new 12GeV CEBAF injector. Stray magnetic fields have been a known issue for the 6 GeV CEBAF injector, the results of modelling the new 12GeV injector and the resulting changes implemented to mitigate this issue are described in this paper. The results of beam commissioning of the injector are also presented.

  11. Initial operation of the new bevatron local injector

    International Nuclear Information System (INIS)

    Staples, J.; Dwinell, R.; Gough, R.

    1985-01-01

    Initial operational characteristics of a new Bevatron injector system are described. It is capable of providing an independent source of ions to the Bevatron through mass 40. The new injector consists of a sputter ion PIG source, operating on a 60 kV DC platform, an RFQ linac, and two Alvarez linacs, all operating at 199 MHz. Beams with q/A greater than or equal to 0.14 are accelerated to 200 keV/n in the RFQ and to 800 keV/n in the first Alvarez tank. Each Alvarez operates in the 2βlambda mode, and each is followed by a foil stripper. Beams with a q/A greater than or equal to 0.32 are accelerated through the second Alvarez to 5 MeV/n, fully stripped, and injected into the Bevatron. Because the Bevatron can be efficiently switched between this injector and the Super HILAC injector, a more efficient operations schedule is made possible to meet the increasingly diverse needs of the Biomedical and Nuclear Science research programs

  12. Design of a tritium pellet injector for TFTR

    International Nuclear Information System (INIS)

    Milora, S.L.; Gouge, M.J.; Fisher, P.W.; Combs, S.K.; Cole, M.J.; Wysor, R.B.; Fehling, D.T.; Foust, C.R.; Baylor, L.R.; Schmidt, G.L.; Barnes, G.W.; Persing, R.G.

    1991-01-01

    The TFTR tritium pellet injector (TPI) is designed to provide a tritium pellet fueling capability with pellet speeds in the 1- to 3 km/s-range for the TFTR D-T phase. The existing TFTR deuterium pellet injector is being modified at Oak Ridge National Laboratory to provide a fourshot, tritium-compatible, pipe-gun configuration with three upgraded single-stage pneumatic guns a two -stage light gas gun driver. The pipe gun concept has been qualified for tritium operation by the tritium proof-of-principle injector experiments conducted on the Tritium Systems Test Assembly at Los Alamos National Laboratory. In these experiments, tritium and D-T pellets were accelerated to speeds near 1.5 km/s. The TPI is being designed for pellet sizes in the range from 3.43 to 4.0 mm in diameter in arbitrarily programmable firing sequences at speeds up to approximately 1.5 km/s for the three single-stage drivers and 2.5 to 3 km/s for the two-stage driver. Injector operation will be controlled by a programmable logic controller. 7 refs., 4 figs

  13. Initial operation of the new Bevatron local injector

    International Nuclear Information System (INIS)

    Staples, J.; Dwinell, R.; Gough, R.

    1985-05-01

    Initial operational characteristics of a new Bevatron injector system are described. It is capable of providing an independent source of ions to the Bevatron through mass 40. The new injector consists of a sputter ion PIG source, operating on a 60 kV dc platform, an RFQ linac, and two Alvarez linacs, all operating at 199 MHz. Beams with q/A greater than or equal to 0.14 are accelerated to 200 keV/n in the RFQ and to 800 keV/n in the first Alvarez tank. Each Alvarez operates in the 2βlambda mode, and each is followed by a foil stripper. Beams with a q/A greater than or equal to 0.32 are accelerated through the second Alvarez to 5 MeV/n, fully stripped, and injected into the Bevatron. Because the Bevatron can be efficiently switched between this injector and the SuperHILAC injector, a more efficient operations schedule is made possible to meet the increasingly diverse needs of the Biomedical and Nuclear Science research programs. 5 refs

  14. The Effect of Ketamine on Posttonsillectomy Pain in Children: A Clinical Trial

    Directory of Open Access Journals (Sweden)

    Akbar Pirzadeh

    2012-01-01

    Full Text Available Introduction: Tonsillectomy is one of the most common surgical operations and has such complications as pain, hemorrhage and laryngospasm. Pain management is of vital importance in order to reduce the suffering and restlessness in children having undergone tonsillectomy. Different studies differ in their findings as to the use of ketamine for postoperative analgesia. The aim of this study was to investigate the effect of peritonsillar injection of ketamine preoperatively on postoperative pain relief.  Materials and Methods: This was a randomized controlled trial (RCT on sixty 3-12-year-old children. Children were randomly assigned to the intervention and control groups. Peritonsillar injection consisted of 1 mg/kg ketamine in the intervention group and of normal saline in the control group. An injection of 1 cc was administered on each side five minutes prior to tonsillectomy. Pain assessment was performed using the self-report Oucher Scale and CHEOPS (Children's Hospital of Eastern Ontario Pain Scale and sedative state assessment was performed using the Wilson Sedation Scale. Pain, medication and complications were studied for 24 hours. Data analysis was performed using chi-squared test and t-test. Results: The ketamine group had a lower pain score compared with the control group (1.40±1.003 compared with 1.53±1.074. The average pain was less in the control group two hours after the surgery. The difference was statistically significant. There was no difference between the two groups in terms of nausea and vomiting incidence.  Conclusion: The peritonsillar injection of ketamine five minutes prior to the surgery reduces the post-tonsillectomy pain without causing any complications.

  15. Comparison of propofol effect with Ketamine for sedation induction in pediatric patients who underwent cardiol catheterization

    Directory of Open Access Journals (Sweden)

    Houshang Shahryari

    2010-04-01

    Full Text Available Background: The goals for sedation in pediatric patients scheduled to undergo cardiac catheterization include immobility, analgesia, cardiovascular and respiratory stability. We investigated the effects of Propofol and Ketamine on hemodynamic, respiratory status, sedation level, pain score and recovery period in pediatric patients undergoing cardiac catheterization. Methods: We preformed a randomized clinical trial study on 40 pediatric patients. The patients were randomly assigned to two groups, so that 20 patients received Ketamine and 20 patients received Propofol. In all patients, sedation was started with Midazolam (0.03mg/kg, then followed by Propofol in the first group and Ketamine in the second one. The hemodynamic responses, respiratory parameters, recovery characteristics (Ramsey scale, pain score VAS and relevant adverse effects of the two groups were recorded. Data was analyzed using Paired T Test, ANOVA and Stearman correlation coefficient. Results: Five patients in the Propofol group andon patients in the Ketamine group experienced a transient decrease in mean systolic blood pressure greater than 10% of baseline(p=0.034. Time to full recovery (mean ± SD was not significantly different in the Propofol group and Ketamine group (1.8 min vs. 2.9 min, P > 0.05. Pain scores were significantly different in both groups (P= 0.010. Patients’ heart rates were significantly higher in Ketamine group(P=0.029. No significant difference in respiratory rate was recorded in both groups(p›0.05. Conclusion: Both Ketamine and Propofol are useful and safe in pediatric patients undergoing cardiac catheterization but it seems that it is better to use Propofol in stable hemodynamic pediatric patients under continuous blood pressure monitoring.

  16. Extraction septum magnet for the SSRL SPEAR injector

    International Nuclear Information System (INIS)

    Cerino, J.; Baltay, M.; Boyce, R.; Harris, S.; Hettel, R.; Horton, M.; Zuo, K.

    1991-01-01

    The Stanford Synchrotron Radiation Laboratory (SSRL) successfully commissioned a 3-3.5 GeV electron injector for the SPEAR Storage Ring during 1990. The Injector operates at a 10 Hz repetition rate and accelerates ∼ 10 10 electrons per second for extraction and transport to SPEAR. The extraction septum magnet is a pulsed Lambertson type which, for reasons of economy, was constructed from the same laminations which form 1/2 of an Injector booster synchrotron dipole magnet core block. The excitation coil also utilizes a design in common with the pulse chokes of the booster magnet circuit. The septum magnet is pulsed by an SCR controlled resonant LC circuit with a resonant frequency of 30 Hz

  17. Hollow-Wall Heat Shield for Fuel Injector Component

    Science.gov (United States)

    Hanson, Russell B. (Inventor)

    2018-01-01

    A fuel injector component includes a body, an elongate void and a plurality of bores. The body has a first surface and a second surface. The elongate void is enclosed by the body and is integrally formed between portions of the body defining the first surface and the second surface. The plurality of bores extends into the second surface to intersect the elongate void. A process for making a fuel injector component includes building an injector component body having a void and a plurality of ports connected to the void using an additive manufacturing process that utilizes a powdered building material, and removing residual powdered building material from void through the plurality of ports.

  18. Effects of ketamine on the unconditioned and conditioned locomotor activity of preadolescent and adolescent rats: impact of age, sex, and drug dose.

    Science.gov (United States)

    McDougall, Sanders A; Moran, Andrea E; Baum, Timothy J; Apodaca, Matthew G; Real, Vanessa

    2017-09-01

    Ketamine is used by preadolescent and adolescent humans for licit and illicit purposes. The goal of the present study was to determine the effects of acute and repeated ketamine treatment on the unconditioned behaviors and conditioned locomotor activity of preadolescent and adolescent rats. To assess unconditioned behaviors, female and male rats were injected with ketamine (5-40 mg/kg), and distance traveled was measured on postnatal day (PD) 21-25 or PD 41-45. To assess conditioned activity, male and female rats were injected with saline or ketamine in either a novel test chamber or the home cage on PD 21-24 or PD 41-44. One day later, rats were injected with saline and conditioned activity was assessed. Ketamine produced a dose-dependent increase in the locomotor activity of preadolescent and adolescent rats. Preadolescent rats did not exhibit sex differences, but ketamine-induced locomotor activity was substantially stronger in adolescent females than males. Repeated ketamine treatment neither caused a day-dependent increase in locomotor activity nor produced conditioned activity in preadolescent or adolescent rats. The activity-enhancing effects of ketamine are consistent with the actions of an indirect dopamine agonist, while the inability of ketamine to induce conditioned activity is unlike what is observed after repeated cocaine or amphetamine treatment. This dichotomy could be due to ketamine's ability to both enhance DA neurotransmission and antagonize N-methyl-D-aspartate (NMDA) receptors. Additional research will be necessary to parse out the relative contributions of DA and NMDA system functioning when assessing the behavioral effects of ketamine during early ontogeny.

  19. Development of 4-shot pellet injector for JET-2M

    International Nuclear Information System (INIS)

    Noda, O.; Kuribayashi, S.; Uchikawa, T.; Onozuka, M.; Kasaki, S.; Hasegawa, K.

    1987-01-01

    A pneumatic 4 pellet injector has been constructed for JFT-2M. The performance tests have proved high performance and reliability of the injector. The maximum pellet velocity obtained in hydrogen pellet tests is 1.4km sec. The device is now in use for JFT-2M in a place of a previous single pellet injector, contributing to plasma studies. In this paper the outline of features and performance of the device is presented

  20. Ketamine Exhibits Different Neuroanatomical Profile After Mammalian Target of Rapamycin Inhibition in the Prefrontal Cortex: the Role of Inflammation and Oxidative Stress.

    Science.gov (United States)

    Abelaira, Helena M; Réus, Gislaine Z; Ignácio, Zuleide M; Dos Santos, Maria Augusta B; de Moura, Airam B; Matos, Danyela; Demo, Júlia P; da Silva, Júlia B I; Danielski, Lucineia G; Petronilho, Fabricia; Carvalho, André F; Quevedo, João

    2017-09-01

    Studies indicated that mammalian target of rapamycin (mTOR), oxidative stress, and inflammation are involved in the pathophysiology of major depressive disorder (MDD). Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has been identified as a novel MDD therapy; however, the antidepressant mechanism is not fully understood. In addition, the effects of ketamine after mTOR inhibition have not been fully investigated. In the present study, we examined the behavioral and biochemical effects of ketamine in the prefrontal cortex (PFC), hippocampus, amygdala, and nucleus accumbens after inhibition of mTOR signaling in the PFC. Male adult Wistar rats received pharmacological mTOR inhibitor, rapamycin (0.2 nmol) or vehicle into the PFC and then a single dose of ketamine (15 mg/kg, i.p.). Immobility was assessed in forced swimming tests, and then oxidative stress parameters and inflammatory markers were evaluated in the brain and periphery. mTOR activation in the PFC was essential to ketamine's antidepressant-like effects. Ketamine increased lipid damage in the PFC, hippocampus, and amygdala. Protein carbonyl was elevated in the PFC, amygdala, and NAc after ketamine administration. Ketamine also increased nitrite/nitrate in the PFC, hippocampus, amygdala, and NAc. Myeloperoxidase activity increased in the hippocampus and NAc after ketamine administration. The activities of superoxide dismutase and catalase were reduced after ketamine administration in all brain areas studied. Inhibition of mTOR signaling pathways by rapamycin in the PFC was required to protect against oxidative stress by reducing damage and increasing antioxidant enzymes. Finally, the TNF-α level was increased in serum by ketamine; however, the rapamycin plus treatment group was not able to block this increase. Activation of mTOR in the PFC is involved in the antidepressant-like effects of ketamine; however, the inhibition of this pathway was able to protect certain brain areas against

  1. [The Analgesic Sparing Effect of Ketamine for Postoperative Pain Management after Pediatric Surgery on the Body Surface].

    Science.gov (United States)

    Urabe, Tomoaki; Nakanuno, Ryuichi; Hayase, Kazuma; Sasada, Shogo; Iwamitsu, Reimi; Senami, Masaki

    2016-04-01

    It is reported that ketamine, a N-methyl-D-aspertate (NMDA) receptor antagonist, can provide analgesic effect improving postoperative pain management and decrease the supplementary analgesic requirement. We investigated the analgesic sparing effect of ketamine for postoperative pain in children undergoing surgery of body surface. Fifty eight patients (0-9 yrs) who had surgery of body surface were divided into two groups (ketamine : n = 27, Group K or control : n = 31, Group N). Postoperative analgesia extracted from charts was retrospectively evaluated by the times patients used analgesics until discharge after the operations. Chi-square and Mann-Whitney U tests were used for statistical analysis. Results : The ketamine group received an intrave- nous bolus of ketamine (1 mg - kg-1) before surgical skin incision. However, there were no significant differ- ences of usage (Group K vs Group N : 4/27 vs 7/31, P=0.45) and frequency of supplementary analgesic us- ages (P=0.85) among groups. In addition, there were also no significant demographic differences between the two groups. Conclusions : Our investigation suggests that the intravenous bolus of ketamine (1 mg - kg-1) before surgical skin incision does not decrease the supple- mentary analgesic requirements on postoperative pain management in pediatric surgery of the body surface.

  2. Lithium Pellet Injector Development for NSTX

    International Nuclear Information System (INIS)

    Gettelfinger, G.; Dong, J.; Gernhardt, R.; Kugel, H.; Sichta, P.; Timberlake, J.

    2003-01-01

    A pellet injector suitable for the injection of lithium and other low-Z pellets of varying mass into plasmas at precise velocities from 5 to 500 m/s is being developed for use on NSTX (National Spherical Torus Experiment). The ability to inject low-Z impurities will significantly expand NSTX experimental capability for a broad range of diagnostic and operational applications. The architecture employs a pellet-carrying cartridge propelled through a guide tube by deuterium gas. Abrupt deceleration of the cartridge at the end of the guide tube results in the pellet continuing along its intended path, thereby giving controlled reproducible velocities for a variety of pellets materials and a reduced gas load to the torus. The planned injector assembly has four hundred guide tubes contained in a rotating magazine with eight tubes provided for injection into plasmas. A PC-based control system is being developed as well and will be described elsewhere in these Proceedings. The development path and mechanical performance of the injector will be described

  3. Effect of ketamine on aquaporin-4 expression and neuronal apoptosis in brain tissues following brain injury in rats

    Institute of Scientific and Technical Information of China (English)

    Zangong Zhou; Xiangyu Ji; Li Song; Jianfang Song; Shiduan Wang; Yanwei Yin

    2006-01-01

    BACKGROUND: Aquaporin-4 (AQP-4) is closely related to the formation of brain edema. Neuronal apoptosis plays an important part in the conversion of swelled neuron following traumatic brain injury. At present, the studies on the protective effect of ketamine on brain have involved in its effect on aquaporin-4 expression and neuronal apoptosis in the brain tissues following brain injury in rats.OBJECTIVE: To observe the effect of ketamine on AQP-4 expression and neuronal apoptosis in the brain tissue following rat brain injury, and analyze the time-dependence of ketamine in the treatment of brain injury.DESIGN: Randomized grouping design, controlled animal trial.SETTING: Department of Anesthesiology, the Medical School Hospital of Qingdao University.MATERIALS: Totally 150 rats of clean grade, aged 3 months, were involved and randomized into control group and ketamine-treated group, with 75 rats in each. Each group was divided into 5 subgroups separately at 6,12, 24, 48 and 72 hours after injury, with 15 rats at each time point. Main instruments and reagents:homemade beat machine, ketamine hydrochloride (Hengrui Pharmaceutical Factory, Jiangsu), rabbit anti-rat AQP-4 polyclonal antibody, SABC immunohistochemical reagent kit and TUNEL reagent kit (Boster Co.,Ltd.,Wuhan).METHODS: This trial was carried out in the Institute of Cerebrovascular Disease, Medical College of Qingdao University during March 2005 to February 2006. A weight-dropping rat model of brain injury was created with Feeney method. The rats in the ketamine-treated group were intraperitoneally administered with 50 g/L ketamine (120 mg/kg) one hour after injury, but ketamine was replaced by normal saline in the control group. In each subgroup, the water content of cerebral hemisphere was measured in 5 rats chosen randomly. The left 10 rats in each subgroup were transcardiacally perfused with ketamine, then the brain tissue was made into paraffin sections and stained by haematoxylin and eosin. Neuronal

  4. Can gradual dose titration of ketamine for management of neuropathic pain prevent psychotomimetic effects in patients with advanced cancer?

    Science.gov (United States)

    Okamoto, Yoshiaki; Tsuneto, Satoru; Tanimukai, Hitoshi; Matsuda, Yoichi; Ohno, Yumiko; Tsugane, Mamiko; Uejima, Etsuko

    2013-08-01

    Ketamine is often used to manage neuropathic pain in patients with cancer. However, it occasionally causes psychotomimetic effects such as vivid dreams, nightmares, illusions, hallucinations, and altered body image. To examine whether gradual dose titration of ketamine for management of neuropathic pain prevents psychotomimetic effects in patients with advanced cancer. This was a retrospective chart review. We administered ketamine when neuropathic pain in patients with advanced cancer became refractory to opioids and oral adjuvant analgesics. The starting dose of ketamine was 10 mg/d by continuous intravenous infusion. The dose was gradually increased by 10 mg/d every 4 to 6 hours to 50 mg/d or until the pain was relieved. It was subsequently increased by 25 mg/d every 12 to 24 hours until the pain was relieved. For this study, we enrolled 46 patients with advanced cancer. The mean age was 52.2 ± 16.9 years. The mean dose at onset of action and maximum dose of ketamine were 56 ± 58 and 272 ± 214 mg/d, respectively. The mean pain intensity (numerical rating scale) decreased significantly from 7.3 ± 2.0 to 3.5 ± 2.2 after the administration of ketamine (P ketamine for management of neuropathic pain can prevent psychotomimetic effects in patients with advanced cancer.

  5. Circulatory responses to propofol-ketamine combination compared ...

    African Journals Online (AJOL)

    propofol-ketamine infusion in maintaining hemodynamic stability when used for sedation as compared to propofol alone during spinal anesthesia. Sixty adult patients of either sex, belonging to ASA physical status I and II undergoing urological procedures were studied in a randomized manner. After administering spinal ...

  6. Metabolic hyperfrontality and psychopathology in the ketamine model of psychosis using positron emission tomography (PET) and [F-18]fluorodeoxyglucose (FDG)

    NARCIS (Netherlands)

    Vollenweider, FX; Leenders, KL; Scharfetter, C; Antonini, A; Maguire, P; Missimer, J; Angst, J

    To date, the ketamine/PCP model of psychosis has been proposed to be one of the best pharmacological models to mimic schizophrenic psychosis in healthy volunteers, since ketamine can induce both positive and negative symptoms of schizophrenia. At subanesthetic doses, ketamine has been reported to

  7. Total Intravenous Anesthesia Including Ketamine versus Volatile Gas Anesthesia for Combat-related Operative Traumatic Brain Injury

    Science.gov (United States)

    2008-07-01

    Pediatric Critical Care, Connecticut Children’s Medical Center, Hartford, Connecticut. § Assistant Chief, Anesthesiology, Elmendorf Air Force Base...increases in cerebral blood volume.20 Regional oxygen extraction fraction decreases with ketamine alone.20 Furthermore, ketamine possesses anticonvulsant

  8. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain

    DEFF Research Database (Denmark)

    Carstensen, M; Møller, A M

    2010-01-01

    In experimental trials, ketamine has been shown to reduce hyperalgesia, prevent opioid tolerance, and lower morphine consumption. Clinical trials have found contradictory results. We performed a review of randomized, double-blinded clinical trials of ketamine added to opioid in i.v. patient-contr...... heterogeneity of studies and small sample sizes, larger double-blinded randomized studies showing greater degree of homogeneity are required to confirm these findings...

  9. Low dose ketamine use in the emergency department, a new direction in pain management.

    Science.gov (United States)

    Pourmand, A; Mazer-Amirshahi, M; Royall, C; Alhawas, R; Shesser, R

    2017-06-01

    There is a need for alternative non-opioid analgesics for the treatment of acute, chronic, and refractory pain in the emergency department (ED). Ketamine is a fast acting N-methyl-d-aspartate (NMDA) receptor antagonist that provides safe and effective analgesia. The use of low dose ketamine (LDK) (Ketamine was shown to be efficacious at treating a variety of painful conditions. It has a favorable adverse effect profile when given at sub-dissociative doses. Studies have also compared LDK to opioids in the ED. Although ketamine's analgesic effects were not shown to be superior, they were comparable to opioids. LDK has the benefit of causing less respiratory depression. It likely has less wide spread potential for abuse. Nursing protocols for the administration of LDK have been studied. We believe that LDK has the potential to be a safe and effective alternative and/or adjunct to opioid analgesics in the ED. Additional studies are needed to expand upon and determine the optimal use of LDK in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Synthesis of deuterium labeled ketamine metabolite dehydronorketamine-d₄.

    Science.gov (United States)

    Sulake, Rohidas S; Chen, Chinpiao; Lin, Huei-Ru; Lua, Ahai-Chang

    2011-10-01

    A convenient synthesis of ketamine metabolite dehydronorketamine-d(4), starting from commercially available deuterium labeled bromochlorobenzene, was achieved. Key steps include Grignard reaction, regioselective hydroxybromination, Staudinger reduction, and dehydrohalogenation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Tritium pellet injector results

    International Nuclear Information System (INIS)

    Fisher, P.W.; Bauer, M.L.; Baylor, L.R.; Deleanu, L.E.; Fehling, D.T.; Milora, S.L.; Whitson, J.C.

    1988-01-01

    Injection of solid tritium pellets is considered to be the most promising way of fueling fusion reactors. The Tritium Proof-of- Principle (TPOP) experiment has demonstrated the feasibility of forming and accelerating tritium pellets. This injector is based on the pneumatic pipe-gun concept, in which pellets are formed in situ in the barrel and accelerated with high-pressure gas. This injector is ideal for tritium service because there are no moving parts inside the gun and because no excess tritium is required in the pellet production process. Removal of 3 He from tritium to prevent blocking of the cryopumping action by the noncondensible gas has been demonstrated with a cryogenic separator. Pellet velocities of 1280 m/s have been achieved for 4-mm-diam by 4-mm-long cylindrical tritium pellets with hydrogen propellant at 6.96 MPa (1000 psi). 10 refs., 10 figs

  12. ATA injector-gun calculations

    International Nuclear Information System (INIS)

    Paul, A.C.

    1981-01-01

    ATA is a pulsed, 50 ns 10 KA, 50 MeV linear induction electron accelerator at LLNL. The ETA could be used as an injector for ATA. However the possibility of building a new injector gun for ATA, raised the question as to what changes from the ETA gun in electrode dimensions or potentials, if any, should be considered. In this report the EBQ code results for the four electrode configurations are reviewed and an attempt is made to determine the geometrical scaling laws appropriate to these ETA type gun geometries. Comparison of these scaling laws will be made to ETA operation. The characteristic operating curves for these geometries will also be presented and the effect of washer position determined. It will be shown that emittance growth will impose a limitation on beam current for a given anode potential before the virtual cathode limit is reached

  13. Injector MD Days 2017

    CERN Document Server

    Rumolo, G

    2017-01-01

    The Injector Machine Development (MD) days 2017 were held on 23-24 March, 2017, at CERN with thefollowing main goals:Give a chance to the MD users to present their results and show the relevant progress made in 2016 onseveral fronts.Provide the MD users and the Operation (OP) crews with a general overview on the outcome and theimpact of all ongoing MD activities.Identify the open questions and consequently define - with priorities - a list of machine studies in theinjectors for 2017 (covering the operational beams, LHC Injectors Upgrade, High Luminosity LHC,Physics Beyond Colliders, other projects).Create the opportunity to collect and document the highlights of the 2016 MDs and define the perspectivesfor 2017.Discuss how to make best use of the MD time, in particular let the main MD user express their wishesand see whether/how OP teams can contribute to their fulfilment.

  14. First operation of the ATLAS Positive-Ion Injector

    International Nuclear Information System (INIS)

    Pardo, R.C.; Bollinger, L.M.; Shepard, K.W.; Billquist, P.J.; Bogaty, J.M.; Clifft, B.E.; Harkewicz, R.; Munson, F.H.; Nolen, J.A.; Zinkann, G.P.

    1992-01-01

    The construction of the ATLAS Positive-Ion Injector (PII) is complete and beam acceleration tests are underway. The PII consists of an ECR ion source, on a high-voltage platform, providing beam to a low-velocity-acceptance, independently-phased, superconducting linac. This injector enables the ATLAS facility to accelerate any heavy ion, including uranium, to energies in excess of the Coulomb barrier. The design accelerating field performance has been exceeded, with an average accelerating field of approximately 3.2 MV/m achieved in early tests. Initial beam tests of the entire injector indicate tat all important performance goals have been met. This paper describes the results of these early tests and discusses our initial operating experience with the whole ATLAS system

  15. First operation of the ATLAS positive-ion injector

    International Nuclear Information System (INIS)

    Pardo, R.C.; Bollinger, L.M.; Shephard, K.W.; Billquist, P.J.; Bogaty, J.M.; Clifft, B.E.; Harkewicz, R.; Munson, F.H.; Nolen, J.A.; Zinkann, G.P.

    1992-01-01

    The construction of the ATLAS Positive-Ion Injector (PII) is complete and beam acceleration tests are underway. The PII consists of an ECR ion source, on a high-voltage platform, providing beam to a low-velocity-acceptance, independently-phased, superconducting linac. This injector enables the ATLAS facility to accelerate any heavy ion, including uranium, to energies in excess of the Coulomb barrier. The design accelerating field performance has been exceeded, with an average accelerating field of approximately 3.2 MV/m achieved in early tests. Initial beam tests of the entire injector indicate that all important performance goals have been met. This paper describes the results of these early tests and discusses our initial operating experience with the whole ATLAS system. (Author) 5 refs., tab., fig

  16. Platelet injectors for Space Shuttle orbit maneuvering engine

    Science.gov (United States)

    Kahl, R. C.; Labotz, R. J.; Bassham, L. B.

    1974-01-01

    The Space Shuttle Orbit Maneuvering Subsystem Rocket Engine employs a platelet element injector concept. This injector has demonstrated 316-sec vacuum specific impulse performance under simulated altitude conditions when tested with a milled slot/electroformed nickel close-out regenerative chamber and a full 71 area ratio nozzle. To date, over 300 altitude engine tests and 300 stability bomb tests have demonstrated stable, erosion free operation with this concept to test durations of 150 seconds. The injector and chamber also meet the reusable requirements of the shuttle with a cycle life capability in excess of 1000 cycles. An extensive altitude restart program has also demonstrated OMS-engine operation over large variations in the burn and coast times with helium saturated propellants.

  17. Isoflurane and ketamine:xylazine differentially affect intraocular pressure-associated scotopic threshold responses in Sprague-Dawley rats.

    Science.gov (United States)

    Choh, Vivian; Gurdita, Akshay; Tan, Bingyao; Feng, Yunwei; Bizheva, Kostadinka; McCulloch, Daphne L; Joos, Karen M

    2017-10-01

    Amplitudes of electroretinograms (ERG) are enhanced during acute, moderate elevation of intraocular pressure (IOP) in rats anaesthetised with isoflurane. As anaesthetics alone are known to affect ERG amplitudes, the present study compares the effects of inhalant isoflurane and injected ketamine:xylazine on the scotopic threshold response (STR) in rats with moderate IOP elevation. Isoflurane-anaesthetised (n = 9) and ketamine:xylazine-anaesthetised (n = 6) rats underwent acute unilateral IOP elevation using a vascular loop anterior to the equator of the right eye. STRs to a luminance series (subthreshold to -3.04 log scotopic cd s/m 2 ) were recorded from each eye of Sprague-Dawley rats before, during, and after IOP elevation. Positive STR (pSTR) amplitudes for all conditions were significantly smaller (p = 0.0001) for isoflurane- than for ketamine:xylazine-anaesthetised rats. In addition, ketamine:xylazine was associated with a progressive increase in pSTR amplitudes over time (p = 0.0028). IOP elevation was associated with an increase in pSTR amplitude (both anaesthetics p ketamine:xylazine and isoflurane were similar (66.3 ± 35.5 vs. 54.2 ± 24.1 µV, respectively). However, the fold increase in amplitude during IOP elevation was significantly higher in the isoflurane- than in the ketamine:xylazine-anaesthetised rats (16.8 ± 29.7x vs. 2.1 ± 2.7x, respectively, p = 0.0004). The anaesthetics differentially affect the STRs in the rat model with markedly reduced amplitudes with isoflurane compared to ketamine:xylazine. However, the IOP-associated enhancement is of similar absolute magnitude for the two anaesthetics, suggesting that IOP stress and anaesthetic effects operate on separate retinal mechanisms.

  18. Ketamine increases the frequency of electroencephalographic bicoherence peak on the alpha spindle area induced with propofol.

    Science.gov (United States)

    Hayashi, K; Tsuda, N; Sawa, T; Hagihira, S

    2007-09-01

    The reticular and thalamocortical system is known to play a prominent role in spindle wave activity, and the spindle wave is related to the sedative effects of anaesthetics. Recently, bispectral analysis of the EEG has been developed as a better method to indicate nonlinear regulation including the thalamocortical system linking to the cortical area. In the present study, in order to explore the interference of ketamine with the nonlinear regulation of the sub-cortical system, we examined the effect of ketamine on spindle alpha waves through the bispectral analysis. The study included 21 patients. Anaesthesia was induced and maintained using a propofol-TCI system (target-controlled infusion, with target concentration 3.5 microg ml(-1)). An A-2000 BIS monitor was used and the raw EEG signals were collected via an RS232 interface on a personal computer. Bicoherence, the normalized bispectrum, and power spectrum were analysed before and after i.v. administration of 1 mg kg(-1) racemic ketamine. Propofol caused alpha peaks in both power and bicoherence spectra, with average frequencies of 10.6 (SD 0.9) Hz and 10.7 (1.0) Hz, respectively. The addition of ketamine significantly shifted each peak to frequencies of 14.4 (1.4) Hz and 13.6 (1.5) Hz, respectively [P < 0.05, mean (SD)]. Ketamine shifted the alpha peaks of bicoherence induced by propofol to higher frequencies. This suggests that ketamine changes the alpha spindle rhythms through the modulation of the nonlinear sub-cortical reverberating network.

  19. Psychotic-like symptomatology and reward responsivity in chronic ketamine and cannabis users

    OpenAIRE

    Joye, A. M.

    2015-01-01

    This thesis assesses psychotic-like symptomatology and reward responsivity in chronic users of two illicit drugs, cannabis and ketamine. As use of these drugs is steadily increasing, with cannabis being the most widely used drug worldwide (following alcohol, caffeine and tobacco) and the recent proliferation of ketamine misuse in parts of Asia, Europe and the United States, it is important to examine the effects of their habitual use. While research has linked cannabis use to sub-clinical psy...

  20. Morphine sparing effect of low dose ketamine during patient ...

    African Journals Online (AJOL)

    Adele

    2003-09-12

    Sep 12, 2003 ... KEY WORDS: Ketamine, morphine sparing effect, patient controlled intravenous analgesia. ... Measurements: Morphine consumption, visual analogue pain score (VAPS), pulse ..... Brain Research, 1990; 518: 218-222. 7.

  1. Injector for the University of Maryland Electron Ring (UMER)

    Energy Technology Data Exchange (ETDEWEB)

    Kehne, D. E-mail: dkehne@gmu.edu; Godlove, T.; Haldemann, P.; Bernal, S.; Guharay, S.; Kishek, R.; Li, Y.; O' Shea, P.; Reiser, M.; Yun, V.; Zou, Y.; Haber, I

    2001-05-21

    The electron beam injector constructed by FM technologies for the University of Maryland Electron Ring (UMER) program is described. The program will use an electron beam to model space-charge-dominated ion beams in a recirculating linac for heavy ion inertial fusion, as well as for high-current muon colliders. The injector consists of a 10 keV, 100 mA electron gun with 50-100 nsec pulse width and a repetition rate of 120 Hz. The e-gun system includes a 6-mask, rotatable aperture plate, a Rogowski current monitor, an ion pump, and a gate valve. The injector beamline consists of a solenoid, a five-quadrupole matching section, two diagnostic chambers, and a fast current monitor. An independent diagnostic chamber also built for UMER will be used to measure horizontal and vertical emittance, current, energy, energy spread, and the evolution of the beam envelope and profile along the injector beamline.

  2. Injector for the University of Maryland Electron Ring (UMER)

    Science.gov (United States)

    Kehne, D.; Godlove, T.; Haldemann, P.; Bernal, S.; Guharay, S.; Kishek, R.; Li, Y.; O'Shea, P.; Reiser, M.; Yun, V.; Zou, Y.; Haber, I.

    2001-05-01

    The electron beam injector constructed by FM technologies for the University of Maryland Electron Ring (UMER) program is described. The program will use an electron beam to model space-charge-dominated ion beams in a recirculating linac for heavy ion inertial fusion, as well as for high-current muon colliders. The injector consists of a 10 keV, 100 mA electron gun with 50-100 nsec pulse width and a repetition rate of 120 Hz. The e-gun system includes a 6-mask, rotatable aperture plate, a Rogowski current monitor, an ion pump, and a gate valve. The injector beamline consists of a solenoid, a five-quadrupole matching section, two diagnostic chambers, and a fast current monitor. An independent diagnostic chamber also built for UMER will be used to measure horizontal and vertical emittance, current, energy, energy spread, and the evolution of the beam envelope and profile along the injector beamline.

  3. Injector design for liner-on-target gas-puff experiments

    Science.gov (United States)

    Valenzuela, J. C.; Krasheninnikov, I.; Conti, F.; Wessel, F.; Fadeev, V.; Narkis, J.; Ross, M. P.; Rahman, H. U.; Ruskov, E.; Beg, F. N.

    2017-11-01

    We present the design of a gas-puff injector for liner-on-target experiments. The injector is composed of an annular high atomic number (e.g., Ar and Kr) gas and an on-axis plasma gun that delivers an ionized deuterium target. The annular supersonic nozzle injector has been studied using Computational Fluid Dynamics (CFD) simulations to produce a highly collimated (M > 5), ˜1 cm radius gas profile that satisfies the theoretical requirement for best performance on ˜1-MA current generators. The CFD simulations allowed us to study output density profiles as a function of the nozzle shape, gas pressure, and gas composition. We have performed line-integrated density measurements using a continuous wave (CW) He-Ne laser to characterize the liner gas density. The measurements agree well with the CFD values. We have used a simple snowplow model to study the plasma sheath acceleration in a coaxial plasma gun to help us properly design the target injector.

  4. Numerical determination of injector design for high beam quality

    International Nuclear Information System (INIS)

    Boyd, J.K.

    1985-01-01

    The performance of a free electron laser strongly depends on the electron beam quality or brightness. The electron beam is transported into the free electron laser after it has been accelerated to the desired energy. Typically the maximum beam brightness produced by an accelerator is constrained by the beam brightness deliverd by the accelerator injector. Thus it is important to design the accelerator injector to yield the required electron beam brightness. The DPC (Darwin Particle Code) computer code has been written to numerically model accelerator injectors. DPC solves for the transport of a beam from emission through acceleration up to the full energy of the injector. The relativistic force equation is solved to determine particle orbits. Field equations are solved for self consistent electric and magnetic fields in the Darwin approximation. DPC has been used to investigate the beam quality consequences of A-K gap, accelerating stress, electrode configuration and axial magnetic field profile

  5. Ketamine appears associated with better word recall than etomidate after a course of 6 electroconvulsive therapies.

    Science.gov (United States)

    McDaniel, William W; Sahota, Anupinder K; Vyas, Barin V; Laguerta, Nena; Hategan, Liana; Oswald, Jessica

    2006-06-01

    Ten patients treated with electroconvulsive therapy (ECT) for depressive illness received anesthesia with either etomidate or ketamine. Three patients received both etomidate and ketamine anesthesia for ECT during separate episodes of depression. Patients anesthetized with ketamine for ECT had significantly less impairment of short-term memory function than did patients who received ECT with etomidate anesthesia. All patients who received both anesthetics for ECT during 2 different episodes had less memory loss during ECT with ketamine than with etomidate. These results show the importance of studying the effects of all anesthetic agents used during ECT on cognitive functions. The results imply that the effect of ECT on memory may be largely caused by effects mediated by glutamate at N-methyl-d-aspartate receptors and suggest that N-methyl-d-aspartate antagonists may offer protection from memory dysfunction during ECT.

  6. Behavioral and biochemical effects of ketamine and dextromethorphan relative to its antidepressant-like effects in Swiss Webster mice.

    Science.gov (United States)

    Nguyen, Linda; Lucke-Wold, Brandon P; Logsdon, Aric F; Scandinaro, Anna L; Huber, Jason D; Matsumoto, Rae R

    2016-09-28

    Ketamine has been shown to produce rapid and robust antidepressant effects in depressed individuals; however, its abuse potential and adverse psychotomimetic effects limit its widespread use. Dextromethorphan (DM) may serve as a safer alternative on the basis of pharmacodynamic similarities to ketamine. In this proof-of-concept study, behavioral and biochemical analyses were carried out to evaluate the potential involvement of brain-derived neurotrophic factor (BDNF) in the antidepressant-like effects of DM in mice, with comparisons to ketamine and imipramine. Male Swiss, Webster mice were injected with DM, ketamine, or imipramine and their behaviors were evaluated in the forced-swim test and the open-field test. Western blots were used to measure BDNF and its precursor, pro-BDNF, protein expression in the hippocampus and the frontal cortex of these mice. Our results show that both DM and imipramine reduced immobility time in the forced-swim test without affecting locomotor activity, whereas ketamine reduced immobility time and increased locomotor activity. Ketamine also rapidly (within 40 min) increased pro-BDNF expression in an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor-dependent manner in the hippocampus, whereas DM and imipramine did not alter pro-BDNF or BDNF levels in either the hippocampus or the frontal cortex within this timeframe. These data show that DM shares some features with both ketamine and imipramine. Additional studies examining DM may aid in the development of more rapid, safe, and efficacious antidepressant treatments.

  7. Suppression of Methamphetamine Self-Administration by Ketamine Pre-treatment Is Absent in the Methylazoxymethanol (MAM) Rat Model of Schizophrenia.

    Science.gov (United States)

    Ruda-Kucerova, Jana; Babinska, Zuzana; Stark, Tibor; Micale, Vincenzo

    2017-07-01

    Ketamine may prove to be a potential candidate in treating the widespread drug addiction/substance abuse epidemic among patients with schizophrenia. Clinical studies have shown ketamine to reduce cocaine and heroin cravings. However, the use of ketamine remains controversial as it may exacerbate the symptoms of schizophrenia. Therefore, the aim of this study is to characterize the effects of ketamine on drug addiction in schizophrenia using the methylazoxymethanol (MAM) acetate rat model on operant IV methamphetamine (METH) self-administration. MAM was administered intraperitoneally (22 mg/kg) on gestational day 17. Locomotor activity test and later IV self-administration (IVSA) were then performed in the male offspring followed by a period of forced abstinence and relapse of METH taking. After reaching stable intakes in the relapse phase, ketamine (5 mg/kg) was administered intraperitoneally 30 min prior to the self-administration session. As documented previously, the MAM rats showed a lack of habituation in the locomotor activity test but developed stable maintenance of METH self-administration with no difference in operant behaviour to control animals. Results show that ketamine treatment significantly reduced the METH intake in the control animals but not in MAM animals. Ketamine effect on METH self-administration may be explained by increased glutamatergic signalling in the prefrontal cortex caused by the N-methyl-D-aspartate antagonism and disinhibition of GABA interneurons which was shown to be impaired in the MAM rats. This mechanism may at least partly explain the clinically proven anti-craving potential of ketamine and allow development of more specific anti-craving medications with fewer risks.

  8. Preparation and assessment of ketamine hydrogels for prolonged ...

    African Journals Online (AJOL)

    : 1596-5996 (print); ..... 15(11): 1249–1253. 16. Mahoney JM, Topical ketamine cream in the treatment of ... Transdermal drug delivery system of aceclofenac for rheumatoid arthritis and the effect of permeation enhancers: Invitro and in vivo ...

  9. Atlas positive-ion injector project

    Energy Technology Data Exchange (ETDEWEB)

    Pardo, R C; Bollinger, L M; Shepard, K W

    1987-04-01

    The goal of the Argonne Positive Ion Injector project is to replace the ATLAS tandem injector with a facility which will increase the beam currents presently available by a factor of 100 and to make beams of essentially all elements including uranium available at ATLAS. The beam quality expected from the facility will be at least as good as that of the tandem based ATLAS. The project combines two relatively new technologies - the electron cyclotron resonance ion source, which provides ions of high charge states at microampere currents, and rf superconductivity which has been shown to be capable of generating accelerating fields as high as 10 MV/m resulting in an essentially new method of acceleration for low-energy heavy ions.

  10. Beam dynamics studies of the Heavy Ion Fusion Accelerator injector

    International Nuclear Information System (INIS)

    Henestroza, E.; Yu, S.S.; Eylon, S.

    1995-04-01

    A driver-scale injector for the Heavy Ion Fusion Accelerator project has been built at LBL. This machine has exceeded the design goals of high voltage (> 2 MV), high current (> 0.8 A of K + ) and low normalized emittance (< 1 π mm-mr). The injector consists of a 750 keV diode pre-injector followed by an electrostatic quadrupole accelerator (ESQ) which provides strong (alternating gradient) focusing for the space-charge dominated beam and simultaneously accelerates the ions to 2 MeV. The fully 3-D PIC code WARP together with EGUN and POISSON were used to design the machine and analyze measurements of voltage, current and phase space distributions. A comparison between beam dynamics characteristics as measured for the injector and corresponding computer calculations will be presented

  11. Microwave proton source development for a high-current linac injector

    International Nuclear Information System (INIS)

    Sherman, J.; Bolme, G.; Geisik, C.

    1995-01-01

    Powerful CW proton linear accelerators (100-mA at 0.5--1.0 GeV) are being proposed for spallation neutron-source applications. A 75-keV, 110-mA dc proton injector using a microwave ion source is being tested for these applications. It has achieved 80-keV, 110-mA hydrogen-ion-beam operation. Video and dc beam-current toroid diagnostics are operational, and an EPICS control system is also operational on the 75-keV injector. A technical base development program has also been carried out on a 50-keV injector obtained from Chalk River Laboratories, and it includes low-energy beam transport studies, ion source lifetime tests, and proton-fraction enhancement studies. Technical base results and the present status of the 75-keV injector will be presented

  12. Feasibility and application on steam injector for next-generation reactor

    International Nuclear Information System (INIS)

    Narabayashi, Tadashi; Ishiyama, Takenori; Miyano, Hiroshi; Nei, Hiromichi; Shioiri, Akio

    1991-01-01

    A feasibility study has been conducted on steam injector for a next generation reactor. The steam injector is a simple, compact passive device for water injection, such as Passive Core Injection System (PCIS) of Passive Containment Cooling System (PCCS), because of easy start-up without an AC power. An analysis model for a steam injector characteristics has been developed, and investigated with a visualized fundamental test for a two-stage Steam Injector System (SIS) for PCIS and a one-stage low pressure SIS for PCCS. The test results showed good agreement with the analysis results. The analysis and the test results showed the SIS could work over a very wide range of the steam pressure, and is applicable for PCIS or PCCS in the next generation reactors. (author)

  13. Transient Tolerant Automated Control System for the LEDA 75kV Injector

    International Nuclear Information System (INIS)

    Thuot, M.E.; Dalesio, L.R.; Harrington, M.; Hodgkins, D.; Kerstiens, D.M.; Stettler, M.W.; Warren, D.S.; Zaugg, T.; Arvin, A.; Bolt, S.; Richards, M.

    1999-01-01

    The Low-Energy Demonstration Accelerator (LEDA) injector is designed to inject 75-keV, 110-mA, proton beams into the LEDA RFQ. The injector operation has been automated to provide long term, high availability operation using the Experimental Physics and Industrial Control System (EPICS). Automated recovery from spark-downs demands reliable spark detection and sequence execution by the injector controller. Reliable computer control in the high-energy transient environment required transient suppression and isolation of hundreds of analog and binary data lines connecting the EPICS computer controller to the injector and it's power supplies and diagnostics. A transient suppression design based on measured and modeled spark transient parameters provides robust injector operation. This paper describes the control system hardware and software design, implementation and operational performance

  14. Does intravenous ketamine enhance analgesia after arthroscopic shoulder surgery with ultrasound guided single-injection interscalene block?: a randomized, prospective, double-blind trial.

    Science.gov (United States)

    Woo, Jae Hee; Kim, Youn Jin; Baik, Hee Jung; Han, Jong In; Chung, Rack Kyung

    2014-07-01

    Ketamine has anti-inflammatory, analgesic and antihyperalgesic effect and prevents pain associated with wind-up. We investigated whether low doses of ketamine infusion during general anesthesia combined with single-shot interscalene nerve block (SSISB) would potentiate analgesic effect of SSISB. Forty adult patients scheduled for elective arthroscopic shoulder surgery were enrolled and randomized to either the control group or the ketamine group. All patients underwent SSISB and followed by general anesthesia. During an operation, intravenous ketamine was infused to the patients of ketamine group continuously. In control group, patients received normal saline in volumes equivalent to ketamine infusions. Pain score by numeric rating scale was similar between groups at 1, 6, 12, 24, 36, and 48 hr following surgery, which was maintained lower than 3 in both groups. The time to first analgesic request after admission on post-anesthesia care unit was also not significantly different between groups. Intraoperative low dose ketamine did not decrease acute postoperative pain after arthroscopic shoulder surgery with a preincisional ultrasound guided SSISB. The preventive analgesic effect of ketamine could be mitigated by SSISB, which remains one of the most effective methods of pain relief after arthroscopic shoulder surgery.

  15. Evaluating the Use of Ketamine for Pain Control With Sickle Cell Crisis in Pregnancy: A Report of 2 Cases.

    Science.gov (United States)

    Gimovsky, Alexis C; Fritton, Kate; Viscusi, Eugene; Roman, Amanda

    2018-01-01

    Sickle cell crises occur frequently during pregnancy and are difficult to treat, even with high-dose opioids. Analgesia with ketamine has been suggested as an alternative, but its use during pregnancy is underreported. Two pregnant patients with uncontrolled sickle cell pain were treated with ketamine. Patient A reported no decrease in her pain, but her opioid requirements decreased. Patient B's pain resolved during ketamine administration. No serious maternal or neonatal adverse effects occurred. Ketamine may be considered as an adjunct analgesic in pregnant patients with sickle cell pain, although prospective clinical data are needed to fully assess its efficacy.

  16. A Preliminary Urinary Metabolomics Study of Sprague-Dawley Rats after Short-term Ketamine Administration by Proton Nuclear Magnetic Resonance Spectroscopy

    Directory of Open Access Journals (Sweden)

    Xiang Lu

    2016-01-01

    Full Text Available Drug abuse has become a global problem. The mass spectrometry-based metabolic consequences of ketamine administration in anesthesia and therapy have been well studied, but to the best of our knowledge, metabolomic studies of ketamine abuse based on nuclear magnetic resonance (NMR spectroscopy are still lacking. In this study, twenty Sprague–Dawley rats were randomly assigned into two groups: a control group (n = 10 and a ketamine group (n = 10. The animals in the ketamine group received intraperitoneal injections of ketamine twice daily at 12-h intervals at progressively increasing doses over a period of 9 days, while the control group received an equal volume of saline. The urine samples were collected for 24 h at days 0, 1, 3, 5, 7, and 9 for the metabolomics study. The metabolic changes in urine after short-term ketamine administration were analyzed by proton NMR coupled with multivariate statistical analysis. The results indicated that short-term ketamine exposure led to significant alterations of the metabolites in the urine of the rats. Specifically, 1,3,7-trimethyluric acid, 1,3-dimethyluric acid, acetoacetic acid, acetylglycine, creatine, sarcosine, dimethylglycine, glycine, and theobromine were significantly increased in the urine. Significant changes were also found in metabolites related to antioxidant and energy metabolism, including acetoacetic acid, succinate, 1,3,7-trimethyluric acid, 1,3-dimethyluric acid, creatine, and taurine. Our findings indicated that short-term ketamine administration leads to disorder of energy metabolism and oxidative stress. In addition, the modified metabolites identified could serve as the new biological markers and potential biological indices reflecting the underlying mechanism of ketamine abuse.

  17. Long-term heavy ketamine use is associated with spatial memory impairment and altered hippocampal activation

    NARCIS (Netherlands)

    Morgan, C.J.A.; Dodds, C.M.; Furby, H.; Pepper, F.; Johnson, F.; Freeman, T.P.; Hughes, E.; Doeller, C.F.; King, J.; Howes, O.; Stone, J.M.

    2014-01-01

    Ketamine, a non-competitive N-methyl-d-aspartate receptor antagonist, is rising in popularity as a drug of abuse. Preliminary evidence suggests that chronic, heavy ketamine use may have profound effects on spatial memory but the mechanism of these deficits is as yet unclear. This study aimed to

  18. Ketamine alleviates bradykinin-induced disruption of the mouse cerebrovascular endothelial cell-constructed tight junction barrier via a calcium-mediated redistribution of occludin polymerization

    International Nuclear Information System (INIS)

    Chen, Jui-Tai; Lin, Yi-Ling; Chen, Ta-Liang; Tai, Yu-Ting; Chen, Cheng-Yu; Chen, Ruei-Ming

    2016-01-01

    Highlights: • Ketamine could suppress bradykinin-induced intracellular calcium mobilization. • Ketamine induced B1R protein and mRNA expressions but did not change B2R protein levels. • Ketamine attenuated bradykinin-induced redistribution of occludin tight junctions. • Ketamine prevented bradykinin-induced breakage of the MCEC-constructed tight junction barrier. - Abstract: Following brain injury, a sequence of mechanisms leads to disruption of the blood-brain barrier (BBB) and subsequent cerebral edema, which is thought to begin with activation of bradykinin. Our previous studies showed that ketamine, a widely used intravenous anesthetic agent, can suppress bradykinin-induced cell dysfunction. This study further aimed to evaluate the protective effects of ketamine against bradykinin-induced disruption of the mouse cerebrovascular endothelial cell (MCEC)-constructed tight junction barrier and the possible mechanisms. Exposure of MCECs to bradykinin increased intracellular calcium (Ca 2+ ) concentrations in a time-dependent manner. However, pretreatment of MCECs with ketamine time- and concentration-dependently lowered the bradykinin-induced calcium influx. As to the mechanisms, although exposure of MCECs to ketamine induced bradykinin R1 receptor protein and mRNA expression, this anesthetic did not change levels of the bradykinin R2 receptor, a major receptor that responds to bradykinin stimulation. Bradykinin increased amounts of soluble occludin in MCECs, but pretreatment with ketamine alleviated this disturbance in occludin polymerization. Consequently, exposure to bradykinin decreased the transendothelial electronic resistance in the MCEC-constructed tight junction barrier. However, pretreatment with ketamine attenuated the bradykinin-induced disruption of the tight junction barrier. Taken together, this study shows that ketamine at a therapeutic concentration can protect against bradykinin-induced breakage of the BBB via suppressing calcium

  19. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: a qualitative review of randomized trials

    DEFF Research Database (Denmark)

    Carstensen, M; Møller, A M

    2010-01-01

    In experimental trials, ketamine has been shown to reduce hyperalgesia, prevent opioid tolerance, and lower morphine consumption. Clinical trials have found contradictory results. We performed a review of randomized, double-blinded clinical trials of ketamine added to opioid in i.v. patient......-controlled analgesia (PCA) for postoperative pain in order to clarify this controversy. Our primary aim was to compare the effectiveness and safety of postoperative administered ketamine in addition to opioid for i.v. PCA compared with i.v. PCA with opioid alone. Studies were identified from the Cochrane Library 2003...... of 4.5. Pain was assessed using visual analogue scales or verbal rating scales. Six studies showed significant improved postoperative analgesia with the addition of ketamine to opioids. Five studies showed no significant clinical improvement. For thoracic surgery, the addition of ketamine to opioid...

  20. CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: impact on adverse effects.

    Science.gov (United States)

    Li, Yibai; Jackson, Kate A; Slon, Barry; Hardy, Janet R; Franco, Michael; William, Leeroy; Poon, Peter; Coller, Janet K; Hutchinson, Mark R; Currow, David C; Somogyi, Andrew A

    2015-08-01

    Ketamine analgesia is limited by low intrinsic efficacy compounded by large interindividual variability in drug responses, possibly due to the heterogeneity in drug concentration. The CYP2B6*6 allele is associated with substantially reduced ketamine metabolism in vitro and, therefore, may affect ketamine clearance. Our aims were to examine the impact of the CYP2B6*6 allele on ketamine plasma clearance and on adverse effects in chronic pain patients. CYP2B6 genotypes were identified in 49 chronic pain patients who received 24 h continuous subcutaneous infusions of ketamine. Steady-state plasma concentrations of ketamine (Css,k ) and norketamine (Css,nk ) were determined using HPLC. The median plasma clearance of ketamine after 100 mg 24 h(-1) dose was significantly lower in patients with the CYP2B6*6/*6 (21.6 l h(-1) ) and CYP2B6*1/*6 (40.6 l h(-1) ) genotypes compared with patients with the CYP2B6*1/*1 genotype (68.1 l h(-1) , P ketamine : norketamine plasma metabolic ratio was significantly higher in patients with the CYP2B6*6/*6 genotype than in those with the CYP2B6*1/*6 and the CYP2B6*1/*1 genotypes (P ketamine plasma clearance in chronic pain patients. The decreased clearance and resultant higher plasma concentrations may be associated with a higher incidence of ketamine adverse effects. © 2015 The British Pharmacological Society.

  1. Voluntary running enhances glymphatic influx in awake behaving, young mice

    DEFF Research Database (Denmark)

    von Holstein-Rathlou, Stephanie; Petersen, Nicolas Caesar; Nedergaard, Maiken

    2018-01-01

    that exercise would also stimulate glymphatic activity in awake, young mice with higher baseline glymphatic function. Therefore, we assessed glymphatic function in young female C57BL/6J mice following five weeks voluntary wheel running and in sedentary mice. The active mice ran a mean distance of 6km daily. We...... of the cortex, but also in the middle cerebral artery territory. While glymphatic activity was higher under ketamine/xylazine anesthesia, we saw a decrease in glymphatic function during running in awake mice after five weeks of wheel running. In summary, daily running increases CSF flux in widespread areas...

  2. Narrow electron injector for ballistic electron spectroscopy

    International Nuclear Information System (INIS)

    Kast, M.; Pacher, C.; Strasser, G.; Gornik, E.

    2001-01-01

    A three-terminal hot electron transistor is used to measure the normal energy distribution of ballistic electrons generated by an electron injector utilizing an improved injector design. A triple barrier resonant tunneling diode with a rectangular transmission function acts as a narrow (1 meV) energy filter. An asymmetric energy distribution with its maximum on the high-energy side with a full width at half maximum of ΔE inj =10 meV is derived. [copyright] 2001 American Institute of Physics

  3. The therapeutic effect of crocin on ketamine-induced retrograde amnesia in rats

    Directory of Open Access Journals (Sweden)

    Namdar Yousefvand

    2016-09-01

    Full Text Available Introduction: The glutamatergic system plays an important role in learning and memory. Administration of crocus sativus (Saffron or its constituent, crocin, facilitates the formation of memory. This research investigated the effect of crocin on antagonizing retrograde amnesia induced by ketamine, a glutamatergic receptor antagonist, in rats by shuttle box. Methods: Male Wistar rats were tested to measure their learning behavior in the passive avoidance task. All animals were trained by a 1 mA shock. The drugs were injected immediately after the training was successfully performed. The animals were tested 24h after training to measure Step Through Latency (STL. Results: On the test day, administration of ketamine (12 mg/kg, ip impaired the memory after training. Different doses of crocin (2, 5 or 10 mg/kg, ip were injected 30 min after ketamine, but only 2 mg/kg crocin could improve retrograde amnesia and 5 and 10 mg/kg doses did not have any significant effect on retrograde amnesia. Moreover, administration of crocin (2, 5 or 10 mg/kg, ip after training had no significant impact on passive avoidance memory by itself. Conclusion: Considering the therapeutic effect of post-training administration of crocin on ketamine-induced retrograde amnesia, it can be argued that crocin has an interaction with glutamatergic system in formation of passive avoidance memory in rats.

  4. Administration of Ketamine Causes Autophagy and Apoptosis in the Rat Fetal Hippocampus and in PC12 Cells

    Directory of Open Access Journals (Sweden)

    Xinran Li

    2018-02-01

    Full Text Available Drug abuse during pregnancy is a serious problem. Like alcohol, anticonvulsants, sedatives, and anesthetics, such as ketamine, can pass through the placental barrier and affect the growing fetus. However, the mechanism by which ketamine causes damage to fetal rats is not well understood. Therefore, in this study, we anesthetized pregnant rats with ketamine and evaluated the Total Antioxidant Capacity (T-AOC, Reactive Oxygen Species (ROS, and Malondialdehyde (MDA. Moreover, we determined changes in the levels of Cleaved-Caspase-3 (C-Caspase-3, Beclin-1, B-cell lymphoma-2 (Bcl-2, Bcl-2 Associated X Protein (Bax, Autophagy-related gene 4 (Atg4, Atg5, p62 (SQSTM1, and marker of autophagy Light Chain 3 (LC3. In addition, we cultured PC12 cells in vitro to determine the relationship between ROS, autophagy, and apoptosis following ketamine treatment. The results showed that ketamine induced changes in autophagy- and apoptosis-related proteins, reduced T-AOC, and generated excessive levels of ROS and MDA. In vitro experiments showed similar results, indicating that apoptosis levels can be inhibited by 3-MA. We also found that autophagy and apoptosis can be inhibited by N-acetyl-L-cysteine (Nac. Thus, anesthesia with ketamine in pregnant rats may increase the rate of autophagy and apoptosis in the fetal hippocampus and the mechanism may be through inhibition of antioxidant activity and ROS accumulation.

  5. Impact of biodiesel blend on injector deposit formation

    International Nuclear Information System (INIS)

    Liaquat, A.M.; Masjuki, H.H.; Kalam, M.A.; Rizwanul Fattah, I.M.

    2014-01-01

    Continued legislative pressure to reduce exhaust emissions from CI (compression ignition) has resulted in the development of advanced fuel injection equipment. This advanced injection system produces higher temperatures and pressures at the injector tip, where deposit formation is initiated. In this research, an endurance test was carried out for 250 h on 2 fuel samples; DF (diesel fuel) as baseline fuel and JB20 (20% jatropha biodiesel and 80% DF) in a single-cylinder CI engine. The effects of JB20 on injector nozzle deposits, engine lubricating oil, and fuel economy and exhaust emissions were investigated during the endurance test. According to the results of the investigation, visual inspection showed some deposit accumulation on injectors for both fuel samples. SEM (scanning electron microscopy) and EDX (energy dispersive X-ray spectroscopy) analysis showed greater carbon deposits on and around the injector tip for JB20 compared to the engine running with DF. Similarly, lubricating oil analysis presented excessive wear metal concentrations and decreased viscosity values when the engine was fueled with JB20. Finally, fuel economy and emission results during the endurance test showed higher BSFC (brake specific fuel consumption) and NO x emissions, and lower HC (hydrocarbons) and CO (carbon monoxide) emissions, for the JB20 blend compared to DF. - Highlights: • Endurance test for 250 h on 2 fuel samples; diesel fuel and JB20. • Investigation on effects of JB20 on the injector deposits and exhaust emissions. • Lubricating oil analysis during endurance test. • SEM (scanning electron microscopy) analysis. • EDX (energy dispersive X-ray spectroscopy) analysis

  6. Neutral beam injector performance on the PLT and PDX tokamaks

    International Nuclear Information System (INIS)

    Schilling, G.; Ashcroft, D.L.; Eubank, H.P.; Grisham, L.R.; Kozub, T.A.; Kugel, H.W.; Rossmassler, J.; Williams, M.D.

    1981-02-01

    An overall injector system description is presented first, and this will be followed by a detailed discussion of those problems unique to multiple injector operation on the tokamaks, i.e., power transmission, conditioning, reliability, and failures

  7. Upper urinary tract damage caused by ketamine snorting—A report of nine cases

    OpenAIRE

    Hsiang-Ying Lee; Yu-Chao Hsu; Chao-Yu Hsu; Eric Chieh-Lung Chou; Ching-Chia Li; Yung-Shun Juan; Mei-Yu Jang

    2015-01-01

    Objective: The toxicity of ketamine to genitourinary system not only involved in lower urinary tract, which include urinary frequency, urgency, suprapubic pain, dysuria and hematuria, but also upper urinary tracts. However, the reports of ketmaine-induced upper urinary tract damage were rare. Materials and methods: Herein, we reported nine ketamine abusers presented with moderate flank pain with hydronephrosis and lower urinary tract symptoms from three medical centers located around Taiwa...

  8. Power supplies for the injector synchrotron quadrupoles and sextupoles

    International Nuclear Information System (INIS)

    Fathizadeh, M.

    1995-01-01

    This light source note will describe the power supplies for the injector synchrotron quadrupole and sextupole magnets. The injector synchrotron has two families of quadrupole magnets. Each family consists of 40 quadrupole magnets connected in series. These magnets are energized by two phase-controlled, 12-pulse power supplies. Therefore, each power supply will be rated to deliver the necessary power to only 40 quadrupole magnets. The two families of sextupole magnets in the injector synchrotron each consists of 32 sextupole magnets connected in series, powered by a phase-controlled power supply. Thus, each power supply shall be capable of delivering power to only 32 sextupole magnets

  9. A proposed injector for the LCLS linac

    International Nuclear Information System (INIS)

    Yeremian, A.D.; Bharadwaj, V.K.; Emma, P.; Miller, R.H.; Palmer, D.T.; Woodley, M.D.

    1996-11-01

    The Linac Coherent Light Source (LCLS) will use the last portion of the SLAC accelerator as a driver for a short wavelength FEL. The injector must produce 1-nC, 3-ps rms electron bunches at a repetition rate of up to 120 Hz with a normalized rms emittance of about 1 mm-mrad. The injector design takes advantage of the photocathode rf gun technology developed since its conception in the mid 1980's, in particular the S-band rf gun developed by the SLAC/BNL/UCLA collaboration, and emittance compensation techniques developed in the last decade. The injector beamline has been designed using the SUPERFISH, POISSON, PARMELA, and TRANSPORT codes in a consistent way to simulate the beam from the gun up to the entrance of the main accelerator linac where the beam energy is 150 MeV. PARMELA simulations indicate that at 150 MeV, space charge effects are negligible

  10. The JET high frequency pellet injector project

    International Nuclear Information System (INIS)

    Geraud, Alain; Dentan, M.; Whitehead, A.; Butcher, P.; Communal, D.; Faisse, F.; Gedney, J.; Gros, G.; Guillaume, D.; Hackett, L.; Hennion, V.; Homfray, D.; Lucock, R.; McKivitt, J.; Sibbald, M.; Portafaix, C.; Perin, J.P.; Reade, M.; Sands, D.; Saille, A.

    2007-01-01

    A new deuterium ice pellet injector is in preparation for JET. It is designed to inject both small pellets (variable volume within 1-2 mm 3 ) at high frequency (up to 60 Hz) for ELM mitigation experiments and large pellets (volume within 35-70 mm 3 ) at moderate frequency (up to 15 Hz) for plasma fuelling. It is based on the screw extruder technology developed by PELIN and pneumatic acceleration. An injection line will connect the injector to the flight tubes already in place to convey the pellets toward the plasma either from the low field side or from the high field side of the torus. This injection line enables: (i) the pumping of the propellant gas, (ii) the provision of the vacuum interface with the torus and (iii) the selection of the flight tube to be used via a fast selector. All the interfaces have been designed and a prototype injector is being built, to demonstrate that the required performance is achievable

  11. Status of the SPIRAL2 injector commissioning

    Energy Technology Data Exchange (ETDEWEB)

    Thuillier, T., E-mail: thuillier@lpsc.in2p3.fr; Angot, J.; Jacob, J.; Lamy, T.; Sole, P. [LPSC, Université Grenoble Alpes, CNRS/IN2P3, 53 rue des Martyrs, 38026 Grenoble Cedex (France); Barué, C.; Bertrand, P.; Canet, C.; Ferdinand, R.; Flambard, J.-L.; Jardin, P.; Lemagnen, F.; Maunoury, L.; Osmond, B. [GANIL, CNRS/IN2P3, Bvd Henri Becquerel, BP 55027, 14076 Caen Cedex 5 (France); Biarrotte, J. L. [IPN Orsay, Université Paris Sud, CNRS/IN2P3, 15 rue Georges Clémenceau, 91406 Orsay Cedex (France); Denis, J.-F.; Roger, A.; Touzery, R.; Tuske, O.; Uriot, D. [Irfu, CEA Saclay, DSM/Irfu/SACM, 91191 Gif Sur Yvette (France); and others

    2016-02-15

    The SPIRAL2 injector, installed in its tunnel, is currently under commissioning at GANIL, Caen, France. The injector is composed of two low energy beam transport lines: one is dedicated to the light ion beam production, the other to the heavy ions. The first light ion beam, created by a 2.45 GHz electron cyclotron resonance ion source, has been successfully produced in December 2014. The first beam of the PHOENIX V2 18 GHz heavy ion source was analyzed on 10 July 2015. A status of the SPIRAL2 injector commissioning is given. An upgrade of the heavy ion source, named PHOENIX V3 aimed to replace the V2, is presented. The new version features a doubled plasma chamber volume and the high charge state beam intensity is expected to increase by a factor of 1.5 to 2 up to the mass ∼50. A status of its assembly is proposed.

  12. Design of the ITER Neutral Beam injectors

    International Nuclear Information System (INIS)

    Hemsworth, R.S.; Feist, J.; Hanada, M.; Heinemann, B.; Inoue, T.; Kuessel, E.; Kulygin, V.; Krylov, A.; Lotte, P.; Miyamoto, K.; Miyamoto, N.; Murdoch, D.; Nagase, A.; Ohara, Y.; Okumura, Y.; Pamela, J.; Panasenkov, A.; Shibata, K.; Tanii, M.

    1996-01-01

    This paper describes the Neutral Beam Injection system which is presently being designed in Europe, Japan and Russia, with co-ordination by the Joint Central Team of ITER at Naka, Japan. The proposed system consists of three negative ion based neutral injectors, delivering a total of 50 MW of 1 MeV D 0 to the ITER plasma for pulse length of ≥1000 s. The injectors each use a single caesiated volume arc discharge negative ion source, and a multi-grid, multi-aperture accelerator, to produce about 40 A of 1 MeV D - . This will be neutralized in a sub-divided gas neutralizer, which has a conversion efficiency of about 60%. The charged fraction of the beam emerging from the neutralizer is dumped in an electrostatic residual ion dump. A water cooled calorimeter can be moved into the beam path to intercept the neutral beam, allowing commissioning of the injector independent of ITER. copyright 1996 American Institute of Physics

  13. Inhibition of spinal astrocytic c-Jun N-terminal kinase (JNK activation correlates with the analgesic effects of ketamine in neuropathic pain

    Directory of Open Access Journals (Sweden)

    Wang Wen

    2011-01-01

    Full Text Available Abstract Background We have previously reported that inhibition of astrocytic activation contributes to the analgesic effects of intrathecal ketamine on spinal nerve ligation (SNL-induced neuropathic pain. However, the underlying mechanisms are still unclear. c-Jun N-terminal kinase (JNK, a member of mitogen-activated protein kinase (MAPK family, has been reported to be critical for spinal astrocytic activation and neuropathic pain development after SNL. Ketamine can decrease lipopolysaccharide (LPS-induced phosphorylated JNK (pJNK expression and could thus exert its anti-inflammatory effect. We hypothesized that inhibition of astrocytic JNK activation might be involved in the suppressive effect of ketamine on SNL-induced spinal astrocytic activation. Methods Immunofluorescence histochemical staining was used to detect SNL-induced spinal pJNK expression and localization. The effects of ketamine on SNL-induced mechanical allodynia were confirmed by behavioral testing. Immunofluorescence histochemistry and Western blot were used to quantify the SNL-induced spinal pJNK expression after ketamine administration. Results The present study showed that SNL induced ipsilateral pJNK up-regulation in astrocytes but not microglia or neurons within the spinal dorsal horn. Intrathecal ketamine relieved SNL-induced mechanical allodynia without interfering with motor performance. Additionally, intrathecal administration of ketamine attenuated SNL-induced spinal astrocytic JNK activation in a dose-dependent manner, but not JNK protein expression. Conclusions The present results suggest that inhibition of JNK activation may be involved in the suppressive effects of ketamine on SNL-induced spinal astrocyte activation. Therefore, inhibition of spinal JNK activation may be involved in the analgesic effects of ketamine on SNL-induced neuropathic pain.

  14. Inhibition of spinal astrocytic c-Jun N-terminal kinase (JNK) activation correlates with the analgesic effects of ketamine in neuropathic pain

    Science.gov (United States)

    2011-01-01

    Background We have previously reported that inhibition of astrocytic activation contributes to the analgesic effects of intrathecal ketamine on spinal nerve ligation (SNL)-induced neuropathic pain. However, the underlying mechanisms are still unclear. c-Jun N-terminal kinase (JNK), a member of mitogen-activated protein kinase (MAPK) family, has been reported to be critical for spinal astrocytic activation and neuropathic pain development after SNL. Ketamine can decrease lipopolysaccharide (LPS)-induced phosphorylated JNK (pJNK) expression and could thus exert its anti-inflammatory effect. We hypothesized that inhibition of astrocytic JNK activation might be involved in the suppressive effect of ketamine on SNL-induced spinal astrocytic activation. Methods Immunofluorescence histochemical staining was used to detect SNL-induced spinal pJNK expression and localization. The effects of ketamine on SNL-induced mechanical allodynia were confirmed by behavioral testing. Immunofluorescence histochemistry and Western blot were used to quantify the SNL-induced spinal pJNK expression after ketamine administration. Results The present study showed that SNL induced ipsilateral pJNK up-regulation in astrocytes but not microglia or neurons within the spinal dorsal horn. Intrathecal ketamine relieved SNL-induced mechanical allodynia without interfering with motor performance. Additionally, intrathecal administration of ketamine attenuated SNL-induced spinal astrocytic JNK activation in a dose-dependent manner, but not JNK protein expression. Conclusions The present results suggest that inhibition of JNK activation may be involved in the suppressive effects of ketamine on SNL-induced spinal astrocyte activation. Therefore, inhibition of spinal JNK activation may be involved in the analgesic effects of ketamine on SNL-induced neuropathic pain. PMID:21255465

  15. Influence of injector technology on injection and combustion development - Part 1: Hydraulic characterization

    Energy Technology Data Exchange (ETDEWEB)

    Payri, R.; Salvador, F.J.; Gimeno, J.; Morena, J. de la [CMT-Motores Termicos, Universidad Politecnica de Valencia, Camino de Vera s/n, E-46022 (Spain)

    2011-04-15

    An experimental study of two real multi-hole Diesel injectors is performed under current DI Diesel engine operating conditions. The aim of the investigation is to study the influence of injector technology on the flow at the nozzle exit and to analyse its effect on the spray in evaporative conditions and combustion development. The injectors used are two of the most common technologies used nowadays: solenoid and piezoelectric. The nozzles for both injectors are very similar since the objective of the work is the understanding of the influence of the injector technology on spray characteristics for a given nozzle geometry. In the first part of the study, experimental measurements of hydraulic characterization have been analyzed for both systems. Analysis of spray behaviour in evaporative conditions and combustion development will be carried out in the second part of the work. Important differences between both injectors have been observed, especially in their transient opening and closing of the needle, leading to a more efficient air-fuel mixing and combustion processes for the piezoelectric actuated injector. (author)

  16. Analgesic Effects of Preincision Ketamine on Postspinal Caesarean Delivery in Uganda’s Tertiary Hospital: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Richard Mwase

    2017-01-01

    Full Text Available Background. Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative pain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit. We determined ketamine’s postoperative analgesic effects. Materials and Methods. We did an RCT among consenting parturients that were randomized to receive either intravenous ketamine (0.25 mg/kg or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24 hours postoperatively using the numerical rating scale. The first complaint of pain requiring treatment was noted as “time to first breakthrough pain.” Results. We screened 100 patients and recruited 88 that were randomized into two arms of 44 patients that received either ketamine or placebo. Ketamine group had 30-minute longer time to first breakthrough pain and lower 24-hour pain scores. Postoperative diclofenac consumption was lesser in the ketamine group compared to placebo and Kaplan-Meier graphs showed a higher probability of experiencing breakthrough pain earlier in the placebo group. Conclusion. Preincision intravenous ketamine (0.25 mg/kg offered 30-minute prolongation to postoperative analgesia requirement with reduced 24-hour pain scores. We recommend larger studies to explore this benefit. This trial is registered with Pan African Clinical Trial Registry number PACTR201404000807178.

  17. Necessary LIU studies in the injectors during 2012

    CERN Document Server

    Rumolo, G; Papaphilippou, Y

    2012-01-01

    A significant fraction of the Machine Development (MD) time in the LHC injectors in 2011 was devoted to the study of the intensity limitations in the injectors (e.g. space charge effects in PS and SPS, electron cloud effects in the PS and SPS, single bunch and multi-bunch instabilities in PS and SPS, emittance preservation across the injector chain, etc.). The main results achieved in 2011 will be presented as well as the questions that still remain unresolved and are of relevance for the LIU project. 2012 MDs will also continue exploring the potential of scenarios that might become operational in the future, like the development of a low gamma transition optics in the SPS or alternative production schemes for the LHC beams in the PS. A tentative prioritized list of studies is provided.

  18. Ketamine and rapid-acting antidepressants: a new era in the battle against depression and suicide [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Ronald S. Duman

    2018-05-01

    Full Text Available Therapeutic medications for the treatment of depression have serious limitations, particularly delayed onset and low rates of efficacy. However, the discovery that a single subanesthetic dose of ketamine, a glutamate NMDA receptor channel blocker, can produce a rapid (within hours antidepressant response that is sustained (about 1 week, even in patients considered treatment-resistant, has invigorated the field. In addition to these remarkable actions, ketamine has proven effective for the treatment of suicidal ideation. Efforts are under way to develop ketamine-like drugs with fewer side effects as well as agents that act at other sites within the glutamate neurotransmitter system. This includes ketamine metabolites and stereoisomers, drugs that act as NMDA allosteric modulators or that block mGluR2/3 autoreceptors. In addition, targets that enhance glutamate neurotransmission or synaptic function (or both, which are essential for the rapid and sustained antidepressant actions of ketamine in rodent models, are being investigated; examples are the muscarinic cholinergic antagonist scopolamine and activators of mechanistic target of rapamycin complex 1 (mTORC1 signaling, which is required for the actions of ketamine. The discovery of ketamine and its unique mechanisms heralds a new era with tremendous promise for the development of novel, rapid, and efficacious antidepressant medications.

  19. Low-dose ketamine for treatment resistant depression in an academic clinical practice setting.

    Science.gov (United States)

    Feifel, David; Malcolm, Benjamin; Boggie, Danielle; Lee, Kelly

    2017-10-15

    Recent studies demonstrating a rapid, robust improvement in treatment resistant depression (TRD) following a single sub-anesthetic infusion of ketamine have generated much excitement. However, these studies are limited in their generalizability to the broader TRD population due to their subject exclusion criteria which typically limit psychiatric comorbidity, concurrent medication, and level of suicide risk. This paper describes the safety and efficacy of sub-anesthetic ketamine infusions in a naturalistic TRD patient sample participating in a real-world TRD treatment program within a major university health system. The effects of a sub-anesthetic dose (0.5mg/kg) of ketamine infused IV over forty minutes on TRD patients participating in a treatment program at the University of California, San Diego was investigated by retrospectively analyzing the medical charts of 41 adult TRD patients with a diagnosis of Major Depressive Disorder (MDD) or Bipolar Disorder (BD). Subjects were aged 48.6, 78% white, 36.6% female, and 82.9% had MDD. Significant psychiatric comorbidity existed in 73%. Average pre-infusion BDI score was 32.6 ± 8.4 (S.D) and dropped to 16.8 ± 3.1 at 24-h post-infusion (p Ketamine infusions were well tolerated with occasional nausea or anxiety and mild hemodynamic effects during the infusion. Retrospective nature of this study, lack of control group and use of self-report depression ratings scales. This is the first published study of sub-anesthetic ketamine infusions in a real-world TRD population. The results suggest that this treatment is effective and well tolerated in this population. Copyright © 2017. Published by Elsevier B.V.

  20. Study on biodiesel heat transfer through self-temperature limit injector during vehicle cold start

    Directory of Open Access Journals (Sweden)

    Wang Jun

    2015-01-01

    Full Text Available A type of Self-Temperature Limit-Injector (STL- injector is proposed to reduce the biodiesel consumption and emission in vehicle cold start process. The STL-injector is capable of fast raising fuel temperature, which helps improve the quality of diesel spray and its combustion efficiency. A STL-injector model is established with consideration of electro-mechanic coupling and fluid-structure interaction. A transient simulation is conducted using dynamic grid technology. The results show that STL-injector can effectively raise biodiesel temperature to 350K from 300K in 32 seconds. That is to say, adding STL-injector to existing biodiesel combustion system is an environment-friendly solution due to improving atomization and spray quality quickly.

  1. Early Use of the NMDA Receptor Antagonist Ketamine in Refractory and Superrefractory Status Epilepticus

    Directory of Open Access Journals (Sweden)

    F. A. Zeiler

    2015-01-01

    Full Text Available Refractory status epilepticus (RSE and superrefractory status epilepticus (SRSE pose a difficult clinical challenge. Multiple cerebral receptor and transporter changes occur with prolonged status epilepticus leading to pharmacoresistance patterns unfavorable for conventional antiepileptics. In particular, n-methyl-d-aspartate (NMDA receptor upregulation leads to glutamate mediated excitotoxicity. Targeting these NMDA receptors may provide a novel approach to otherwise refractory seizures. Ketamine has been utilized in RSE. Recent systematic review indicates 56.5% and 63.5% cessation in seizures in adults and pediatrics, respectively. No complications were described. We should consider earlier implementation of ketamine or other NMDA receptor antagonists, for RSE. Prospective study of early implementation of ketamine should shed light on the role of such medications in RSE.

  2. Comparison of different administration of ketamine and intravenous tramadol hydrochloride for postoperative pain relief and sedation after pediatric tonsillectomy.

    Science.gov (United States)

    Yenigun, Alper; Et, Tayfun; Aytac, Sirin; Olcay, Betul

    2015-01-01

    Tonsillectomy is the oldest and most frequently performed surgical procedure practiced by ear, nose, and throat physicians. In this study, our aim was to compare the analgesic effects of peritonsillar, rectal, as well as intravenous infiltration of ketamine and intravenous tramadol hydrochloride infiltration for postoperative pain relief and sedation after tonsillectomy in children. This randomized controlled study evaluated the effects of peritonsillar, intravenous, and rectal infiltration of ketamine in children undergoing adenotonsillectomy. One hundred twenty children who were categorized under American Society of Anesthesiologists classes I to II were randomized to 4 groups of 30 members each. Group 1 received intravenous (IV) ketamine (0.5 mg/kg), group 2 received rectal ketamine (0.5 mg/kg), group 3 received local peritonsillar ketamine (2 mg/kg), and the control group received IV tramadol hydrochloride infiltration (2 mg/kg). Children's Hospital of Eastern Ontario Pain Scale scores and Wilson sedation scale were recorded at minutes 1, 15, 30, 60 as well as hours 2, 12, and 24 postoperatively. The patients were interviewed on the day after the surgery to assess the postoperative pain and sedation. All the routes of infiltration of ketamine were as effective as those of tramadol hydrochloride (P > 0.05). A statistically significant difference was observed between IV infiltrations and all groups during the assessments at hours 6 and 24. The analgesic efficacy of IV ketamine was found especially higher at hours 6 and 24 (P(6) = 0.045, P(24) = 0.011). Perioperative, low-dose IV, rectal, or peritonsillar ketamine infiltration provides efficient pain relief without any adverse effects in children who would undergo adenotonsillectomy.

  3. Ketamine as an adjunct to postoperative pain management in opioid tolerant patients after spinal fusions: a prospective randomized trial.

    Science.gov (United States)

    Urban, Michael K; Ya Deau, Jacques T; Wukovits, Barbara; Lipnitsky, Jane Y

    2008-02-01

    Management of acute postoperative pain is challenging, particularly in patients with preexisting narcotic dependency. Ketamine has been used at subanesthetic doses as a N-methyl D-aspartate (NMDA) receptor antagonist to block the processing of nociceptive input in chronic pain syndromes. This prospective randomized study was designed to assess the use of ketamine as an adjunct to acute pain management in narcotic tolerant patients after spinal fusions. Twenty-six patients for 1-2 level posterior lumbar fusions with segmental instrumentation were randomly assigned to receive ketamine or act as a control. Patients in the ketamine group received 0.2 mg/kg on induction of general anesthesia and then 2 mcg kg(-1) hour(-1) for the next 24 hours. Patients were extubated in the operating room and within 15 minutes of arriving in the Post Anesthesia Care Unit (PACU) were started on intravenous patient-controlled analgesia (PCA) hydromorphone without a basal infusion. Patients were assessed for pain (numerical rating scale [NRS]), narcotic use, level of sedation, delirium, and physical therapy milestones until discharge. The ketamine group had significantly less pain during their first postoperative hour in the PACU (NRS 4.8 vs 8.7) and continued to have less pain during the first postoperative day at rest (3.6 vs 5.5) and with physical therapy (5.6 vs 8.0). Three patients in the control group failed PCA pain management and were converted to intravenous ketamine infusions when their pain scores improved. Patients in the ketamine group required less hydromorphone than the control group, but the differences were not significant. Subanesthetic doses of ketamine reduced postoperative pain in narcotic tolerant patients undergoing posterior spine fusions.

  4. Ketamine effects on memory reconsolidation favor a learning model of delusions.

    Directory of Open Access Journals (Sweden)

    Philip R Corlett

    Full Text Available Delusions are the persistent and often bizarre beliefs that characterise psychosis. Previous studies have suggested that their emergence may be explained by disturbances in prediction error-dependent learning. Here we set up complementary studies in order to examine whether such a disturbance also modulates memory reconsolidation and hence explains their remarkable persistence. First, we quantified individual brain responses to prediction error in a causal learning task in 18 human subjects (8 female. Next, a placebo-controlled within-subjects study of the impact of ketamine was set up on the same individuals. We determined the influence of this NMDA receptor antagonist (previously shown to induce aberrant prediction error signal and lead to transient alterations in perception and belief on the evolution of a fear memory over a 72 hour period: they initially underwent Pavlovian fear conditioning; 24 hours later, during ketamine or placebo administration, the conditioned stimulus (CS was presented once, without reinforcement; memory strength was then tested again 24 hours later. Re-presentation of the CS under ketamine led to a stronger subsequent memory than under placebo. Moreover, the degree of strengthening correlated with individual vulnerability to ketamine's psychotogenic effects and with prediction error brain signal. This finding was partially replicated in an independent sample with an appetitive learning procedure (in 8 human subjects, 4 female. These results suggest a link between altered prediction error, memory strength and psychosis. They point to a core disruption that may explain not only the emergence of delusional beliefs but also their persistence.

  5. Development of Technologies on Innovative-Simplified Nuclear Power Plant Using High-Efficiency Steam Injectors (12) Evaluations of Spatial Distributions of Flow and Heat Transfer in Steam Injector

    International Nuclear Information System (INIS)

    Yutaka Abe; Yujiro Kawamoto; Chikako Iwaki; Tadashi Narabayashi; Michitsugu Mori; Shuichi Ohmori

    2006-01-01

    Next-generation nuclear reactor systems have been under development aiming at simplified system and improvement of safety and credibility. One of the innovative technologies is the supersonic steam injector, which has been investigated as one of the most important component of the next-generation nuclear reactor. The steam injector has functions of a passive pump without large motor or turbo-machinery and a high efficiency heat exchanger. The performances of the supersonic steam injector as a pump and a heat exchanger are dependent on direct contact condensation phenomena between a supersonic steam and a sub-cooled water jet. In previous studies of the steam injector, there are studies about the operating characteristics of steam injector and about the direct contact condensation between static water pool and steam in atmosphere. However, there is a little study about the turbulent heat transfer and flow behavior under the great shear stress. In order to examine the heat transfer and flow behavior in supersonic steam injector, it is necessary to measure the spatial temperature distribution and velocity in detail. The present study, visible transparent supersonic steam injector is used to obtain the axial pressure distributions in the supersonic steam injector, as well as high speed visual observation of water jet and steam interface. The experiments are conducted with and without non-condensable gas. The experimental results of the interfacial flow behavior between steam and water jet are obtained. It is experimentally clarified that an entrainment exists on the water jet surface. It is also clarified that discharge pressure is depended on the steam supply pressure, the inlet water flow rate, the throat diameter and non-condensable flow rate. Finally a heat flux is estimated about 19 MW/m 2 without non-condensable gas condition in steam. (authors)

  6. The Effects of Low-Dose Ketamine on Acute Pain in an Emergency Setting: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lee, Eun Nam; Lee, Jae Hoon

    2016-01-01

    Currently ketamine is not used often as an analgesic in the emergency department (ED). Nonetheless, it can increase the efficiency of opioids and decrease their side effects. The purpose of this systematic review and meta-analysis was to evaluate whether low-dose ketamine in the ED provides better analgesia with fewer adverse effects. The PubMed, EMBASE, and Cochrane Library databases were searched by two reviewers independently (last search performed on January 2016). Data were also extracted independently. A total of 6 trials involving 438 patients were included in the current analysis. Our subgroup analysis of pain reduction indicates that the favorable effects of ketamine were similar or superior to those of placebo or opioids, although these effects were heterogeneous. However, low-dose ketamine was associated with a higher risk of neurological (relative risk [RR] = 2.17, 95% confidence interval [CI] = 1.37-3.42, P ketamine varies depending on the pain site, but low-dose ketamine may be a key agent for pain control in the ED, as it has no side effects. It may also help to reduce the side effects of opioids.

  7. Complete recovery from intractable complex regional pain syndrome, CRPS-type I, following anesthetic ketamine and midazolam.

    Science.gov (United States)

    Kiefer, Ralph-Thomas; Rohr, Peter; Ploppa, Annette; Altemeyer, Karl-Heinz; Schwartzman, Robert Jay

    2007-06-01

    To describe the treatment of an intractable complex regional pain syndrome I (CRPS-I) patient with anesthetic doses of ketamine supplemented with midazolam. A patient presented with a rapidly progressing contiguous spread of CRPS from a severe ligamentous wrist injury. Standard pharmacological and interventional therapy successively failed to halt the spread of CRPS from the wrist to the entire right arm. Her pain was unmanageable with all standard therapy. As a last treatment option, the patient was transferred to the intensive care unit and treated on a compassionate care basis with anesthetic doses of ketamine in gradually increasing (3-5 mg/kg/h) doses in conjunction with midazolam over a period of 5 days. On the second day of the ketamine and midazolam infusion, edema, and discoloration began to resolve and increased spontaneous movement was noted. On day 6, symptoms completely resolved and infusions were tapered. The patient emerged from anesthesia completely free of pain and associated CRPS signs and symptoms. The patient has maintained this complete remission from CRPS for 8 years now. In a patient with severe spreading and refractory CRPS, a complete and long-term remission from CRPS has been obtained utilizing ketamine and midazolam in anesthetic doses. This intensive care procedure has very serious risks but no severe complications occurred. The psychiatric side effects of ketamine were successfully managed with the concomitant use of midazolam and resolved within 1 month of treatment. This case report illustrates the effectiveness and safety of high-dose ketamine in a patient with generalized, refractory CRPS.

  8. Present status of the negative ion sources and injectors at JAERI tandem accelerator facility

    International Nuclear Information System (INIS)

    Minehara, E.; Yoshida, T.; Abe, S.

    1988-01-01

    The JAERI tandem accelerator began regular operation with the 350 kV negative ion jnjector and 3 kinds of nagative ion sources (Direct Extraction Duoplasmatron Ion Source, Heinickie Penning Ion Source, Negative Ion Sputter Source (Refocus-UNIS)) since 1982. An extension with the injector was constructed in 1984, (1) to increase reliability of all devices in the injector, (2) to exclude completely any unsafe operation in the injector, and (3) to tune several ion sources simultaneously, while a certain ion source is in operation. After the extended injector became available, we have been able to run the whole injector system very safely, steadily and effectively, and have had few troubles. Currently, the second injector has been constructed in order to obtain a full strength of resistance against any sudden troubles in the injector. Several other operational and developmental items will be discussed in the text briefly. (author)

  9. The Effect of Low‑Dose Ketamine (Preemptive Dose) on ...

    African Journals Online (AJOL)

    Reproductive Health Research Center, Alzahra Hospital, School of Medicine, 1Guilan University of Medical Sciences, .... pregnancy), who referred to the Alzahra Hospital, were ... Petidine consumption “during 24 “ was lesser in ketamine.

  10. Is magnesium sulfate effective for pain in chronic postherpetic neuralgia patients comparing with ketamine infusion therapy?

    Science.gov (United States)

    Kim, Yang Hyun; Lee, Pyung Bok; Oh, Tak Kyu

    2015-06-01

    Postherpetic neuralgia (PHN) is a frequent debilitating complication and one of the most intractable pain disorders, particularly in elderly patients. Although tricyclic antidepressants, topical capsaicin, gabapentin, and oxycodone are effective for alleviating PHN, many patients remain refractory to current therapies. Here, the analgesic effects of ketamine or magnesium for PHN were assessed in an open prospective study. Thirty patients with severe, intractable PHN who were unresponsive to conservative therapy participated. The effects of ketamine hydrochloride (Ketara, Parke Davis) 1 mg/kg and magnesium sulfate (Magnesin) 30 mg/kg were investigated. The patients were randomly divided into 2 groups of 15 patients each, and ketamine 1 mg/kg or magnesium 30 mg/kg was administered intravenously for 1 hour after midazolam sedation. Pain was rated on a visual analog scale (VAS) during a 2-week follow-up. All patients also completed the Doleur Neuropathique 4 questionnaire at baseline and final visits. Response to treatment, defined as a 50% reduction in VAS score 2 weeks after, was recorded in 10 of 15 patients in the ketamine group and 7 of 15 patients in the magnesium group. The difference in VAS reduction was not significant between the 2 groups. Ketamine and magnesium showed significant analgesic effects in patients with PHN. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Is Subdissociative Ketamine As Safe and Effective As Morphine for Pain Management in the Emergency Department?

    Science.gov (United States)

    Howard, Patricia Kunz; Gisness, Christine M

    : Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial." This prospective, randomized controlled inquiry enrolled 90 patients into 2 groups (ketamine vs. morphine) for patients seeking care in an emergency department with acute pain. Data regarding pain scores were collected at baseline, 15, 30, 60, 90, and 120 min. Study subjects reporting persistent pain could receive rescue analgesia with fentanyl. Initial pain scores for the subjects in each of the groups were comparable (ketamine: 8.6; morphine: 8.5). Pain management for the 2 groups revealed similar average doses (ketamine: 21.8 mg; morphine: 7.7 mg). Although subjects in both groups reported reduction in pain scores at 15 and 30 min, no clinical significance was found. Subjects experienced greater pain relief (pain score = 0) in the ketamine group at 15 min (percentage difference 31%; 95% confidence interval [13, 49]), yet this was not sustained at the 30-min interval. There were no serious or life-threatening adverse effects in either group. This study highlights the important role of the APN in providing quality care, communication about pain management, and related follow-up care.

  12. Developing the Model of Fuel Injection Process Efficiency Analysis for Injector for Diesel Engines

    Science.gov (United States)

    Anisimov, M. Yu; Kayukov, S. S.; Gorshkalev, A. A.; Belousov, A. V.; Gallyamov, R. E.; Lysenko, Yu D.

    2018-01-01

    The article proposes an assessment option for analysing the quality of fuel injection by the injector constituting the development of calculation blocks in a common injector model within LMS Imagine.Lab AMESim. The parameters of the injector model in the article correspond to the serial injector Common Rail-type with solenoid. The possibilities of this approach are demonstrated with providing the results using the example of modelling the modified injector. Following the research results, the advantages of the proposed approach to analysing assessing the fuel injection quality were detected.

  13. Intranasal ketamine for acute traumatic pain in the Emergency Department: a prospective, randomized clinical trial of efficacy and safety.

    Science.gov (United States)

    Shimonovich, Shachar; Gigi, Roy; Shapira, Amir; Sarig-Meth, Tal; Nadav, Danielle; Rozenek, Mattan; West, Debra; Halpern, Pinchas

    2016-11-09

    Ketamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study was to elucidate the efficacy and adverse effects of a sub-dissociative dose of IN Ketamine compared to IV and IM morphine. A single-center, randomized, prospective, parallel clinical trial of efficacy and safety of IN ketamine compared to IV and IM morphine for analgesia in the emergency department (ED). A convenience sample of 90 patients aged 18-70 experiencing moderate-severe acute traumatic pain (≥80 mm on 100 mm Visual Analog Scale [VAS]) were randomized to receive either 1.0 mg/kg IN ketamine, 0.1 mg/kg IV MO or 0.15 mg/kg IM MO. Pain relief and adverse effects were recorded for 1 h post-administration. The primary outcome was efficacy of IN ketamine compared to IV and IM MO, measured by "time-to-onset" (defined as a ≥15 mm pain decrease on VAS), as well as time to and degree of maximal pain reduction. The 3 study groups showed a highly significant, similar maximal pain reduction of 56 ± 26 mm for IN Ketamine, and 59 ± 22 and 48 ± 30 for IV MO and IM MO, respectively. IN Ketamine provided clinically-comparable results to those of IV MO with regards to time to onset (14.3 ± 11.2 v. 8.9 ± 5.6 min, respectively) as well as in time to maximal pain reduction (40.4 ± 16.3) versus (33.4 ± 18), respectively. IN ketamine shows efficacy and safety comparable to IV and IM MO. Given the benefits of this mode of analgesia in emergencies, it should be further studied for potential clinical applications. Retrospectively registered on 27 June 2016. ClinicalTrials.gov ID: NCT02817477.

  14. Study on thermal-hydraulic behavior in supersonic steam injector

    International Nuclear Information System (INIS)

    Abe, Yutaka; Fukuichi, Akira; Kawamoto, Yujiro; Iwaki, Chikako; Narabayashi, Tadashi; Mori, Michitsugu; Ohmori, Shuichi

    2007-01-01

    Supersonic steam injector is the one of the most possible devices aiming at simplifying system and improving the safety and the credibility for next-generation nuclear reactor systems. The supersonic steam injector has dual functions of a passive jet pump without rotating machine and a compact and high efficiency heat exchanger, because it is operated by the direct contact condensation between supersonic steam and subcooled water jet. It is necessary to clarify the flow behavior in the supersonic steam injector which is governed by the complicated turbulent flow with a great shear stress of supersonic steam. However, in previous study, there is little study about the turbulent heat transfer and flow behavior under such a great shear stress at the gas-liquid interface. In the present study, turbulent flow behavior including the effect of the interface between water jet and supersonic steam is developed based on the eddy viscosity model. Radial velocity distributions and the turbulent heat transfer are calculated with the model. The calculation results are compared with the experimental results done with the transparent steam injector. (author)

  15. Characteristics of modified CT injector for JFT-2M

    Energy Technology Data Exchange (ETDEWEB)

    Fukumoto, N. [Himeji Institute of Technology, 2167 Shosha, Himeji, Hyogo 671-2201 (Japan)]. E-mail: fukumoto@elct.eng.himeji-tech.ac.jp; Ogawa, H. [Japan Atomic Energy Research Institute (JAERI), 2-4 Shirakatashirane, Tokai-mura, Naka-gun, Ibaraki 311-0193 (Japan); Nagata, M. [Himeji Institute of Technology, 2167 Shosha, Himeji, Hyogo 671-2201 (Japan); Uyama, T. [Himeji Institute of Technology, 2167 Shosha, Himeji, Hyogo 671-2201 (Japan); Shibata, T. [Japan Atomic Energy Research Institute (JAERI), 2-4 Shirakatashirane, Tokai-mura, Naka-gun, Ibaraki 311-0193 (Japan); Kashiwa, Y. [Japan Atomic Energy Research Institute (JAERI), 2-4 Shirakatashirane, Tokai-mura, Naka-gun, Ibaraki 311-0193 (Japan); Kusama, Y. [Japan Atomic Energy Research Institute (JAERI), 2-4 Shirakatashirane, Tokai-mura, Naka-gun, Ibaraki 311-0193 (Japan)

    2004-10-01

    The HIT-CTI mark II compact toroid (CT) injector employed for the JFT-2M tokamak facility at the Japan Atomic Energy Research Institute (JAERI) has been upgraded to improve injection performance. The nozzle of the mark III injector now has a linear tube in place of the original focus cone to avoid rapid focus and deceleration, and the tapered outer electrode has been replaced with more gentle taper in the compression section in order to facilitate gradual compression. The dependence of CT velocity and electron density on poloidal bias flux and trigger time of CT acceleration have been investigated in the operable range of 70-230 km/s average CT velocity and electron density of 0.1-1.0 x 10{sup 22} m{sup -3} at an accelerator bank voltage of 25 kV. The operation window is broader than that of the mark II injector. Emission of a CT plasmoid from the injector, and transport to the flux conserver as a high-density spheromak magnetic structure have also been confirmed.

  16. Beam dynamics simulation of the S-DALINAC injector section

    Energy Technology Data Exchange (ETDEWEB)

    Franke, Sylvain; Ackermann, Wolfgang; Weiland, Thomas [Institut fuer Theorie Elektromagnetischer Felder, Technische Universitaet Darmstadt, Darmstadt (Germany)

    2013-07-01

    In order to extend the experimental possibilities at the superconducting electron linear accelerator S-DALINAC a new polarized gun has recently been installed in addition to the well-established thermionic electron source. Beside the two electron sources the injector section consists of several short quadrupole triplets, an alpha magnet, a Wien filter and a chopper/prebuncher system. The setup of these components differs depending on whether bunched polarized electrons with kinetic energy in the 100 keV range are supplied by the polarized source or whether a continuous unpolarized 250 keV electron beam is extracted from the thermionic gun. The electrons pass through the injector at a relatively low energy and therefore are very sensitive to the beam forming elements in this section. Thus, a proper knowledge of the particle distribution at the exit of the injector section is essential for the quality of any simulation of the subsequent accelerator parts. In this contribution first numerical beam dynamics simulation results of the S-DALINAC injector setup are discussed.

  17. Low-Dose Ketamine Infusion for Adjunct Management during Vaso-occlusive Episodes in Adults with Sickle Cell Disease: A Case Series.

    Science.gov (United States)

    Palm, Nicole; Floroff, Catherine; Hassig, Tanna B; Boylan, Alice; Kanter, Julie

    2018-05-23

    The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs). Patients were treated with a continuous-infusion of low-dose ketamine (up to 5 µg/kg/min) after insufficient pain control with opioid analgesic therapy. Outcomes studied included impact on opioid analgesic use, a description of ketamine dosing strategy, and an analysis of adverse events due to opioid or ketamine analgesia. Descriptive statistics are provided. During ketamine infusion, patients experienced a lower reported pain score (mean numeric rating scale [NRS] score 7.2 vs. 6.4), reduced opioid-induced adverse effects, and decreased opioid dosing requirements (median reduction of 90 mg morphine equivalents per patient). The average duration of severe pain during admission prior to ketamine therapy was 8 days. Only one of five patients reported an adverse effect (vivid dreams) secondary to ketamine infusion. The Richmond Agitation Sedation Scale (RASS) was assessed throughout therapy, with only one patient experiencing light drowsiness. Low-dose ketamine infusion may be considered as an adjunct analgesic agent in patients with vaso-occlusive episodes who report continued severe pain despite high-dose opioid therapy, particularly those experiencing opioid-induced adverse effects.

  18. Comparison of intranasal ketamine versus IV morphine in reducing pain in patients with renal colic.

    Science.gov (United States)

    Farnia, Mohammad Reza; Jalali, Alireza; Vahidi, Elnaz; Momeni, Mehdi; Seyedhosseini, Javad; Saeedi, Morteza

    2017-03-01

    Various drugs have been used to relieve abdominal pain in patients with renal colic. Ketamine is a popular choice as an analgesic. To compare the effectiveness of intranasal (IN) ketamine versus intravenous (IV) morphine in reducing pain in patients with renal colic. A randomized double-blind controlled trial was performed in 53 patients with renal colic recruited from the emergency department (ED) in 2015. Finally, 40 patients were enrolled in this study. Patients in the ketamine group received IN ketamine 1 mg/kg and IV placebo while patients in the control group received IV morphine 0.1mg/kg and IN placebo. Our goal was to assess visual analogue scale (VAS) changes between the 2 groups. Patients' VAS scores were reported before and 5, 15, 30min after drug injection. Before drug administration, the mean±SD VAS score was 7.40±1.18 in the morphine group (group A) and 8.35±1.30 in the ketamine group (group B) (P-value=0.021). After adjustment by the appropriate analysis, the mean±SD VAS score in group (A) and (B) at 5min were (6.07±0.47 vs 6.87±0.47; mean difference -0.79, 95% confidence interval (CI) -1.48 to -1.04) (P-value=0.025), at 15 and 30min, the mean±SD VAS score in group (A) and (B) were (5.24±0.49 vs 5.60±0.49; mean difference -0.36, 95% CI -1.08 to 0.34) and (4.02±0.59 vs 4.17±0.59; mean difference -0.15, 95% CI -1.02 to 0.71) (P-value=0.304 and 0.719) respectively. IN ketamine may be effective in decreasing pain in renal colic. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A Single Sub-anesthetic Dose of Ketamine Relieves Depression-like Behaviors Induced by Neuropathic Pain in Rats

    Science.gov (United States)

    Wang, Jing; Goffer, Yossef; Xu, Duo; Tukey, David S.; Shamir, D. B.; Eberle, Sarah E.; Zou, Anthony H.; Blanck, Thomas J.J.; Ziff, Edward B.

    2011-01-01

    Background Chronic pain is associated with depression. In rodents, pain is often assessed by sensory hypersensitivity, which does not sufficiently measure affective responses. Low-dose ketamine has been used to treat both pain and depression, but it is not clear whether ketamine can relieve depression associated with chronic pain and whether this antidepressant effect depends on its anti-nociceptive properties. Methods We examined whether the spared nerve injury (SNI) model of neuropathic pain induces depressive behavior in rats, using sucrose preference test and forced swim test, and tested whether a subanesthetic dose of ketamine treats SNI-induced depression. Results SNI-treated rats, compared with control, showed decreased sucrose preference (0.719 ± 0.068 (mean ± SEM) vs. 0.946 ± 0.010) and enhanced immobility in the forced swim test (107.3 ± 14.6s vs. 56.2 ± 12.5s). Further, sham-operated rats demonstrated depressive behaviors in the acute postoperative period (0.790 ± 0.062 on postoperative day 2). A single subanesthetic dose of ketamine (10mg/kg) did not alter SNI-induced hypersensitivity; however, it treated SNI-associated depression-like behaviors (0.896 ± 0.020 for ketamine vs. 0.663 ± 0.080 for control 1 day after administration; 0.858 ± 0.017 for ketamine vs. 0.683 ± 0.077 for control 5 days after administration). Conclusions Chronic neuropathic pain leads to depression-like behaviors. The postoperative period also confers vulnerability to depression, possibly due to acute pain. Sucrose preference test and forced swim test may be used to compliment sensory tests for assessment of pain in animal studies. Low-dose ketamine can treat depression-like behaviors induced by chronic neuropathic pain. PMID:21934410

  20. Ketamine infusion for sickle cell pain crisis refractory to opioids: a case report and review of literature.

    Science.gov (United States)

    Uprety, Dipesh; Baber, Aurangzeb; Foy, Maria

    2014-05-01

    This article reports a rare case of the use of low-dose ketamine infusion as an adjuvant to opioids to treat pain in sickle cell disease. A 31-year-old African-American male with history of sickle cell disease presented to the emergency department with complaints of chest tightness, multiple joint pain, and headache for 1 week. His vital signs and physical examination were unremarkable. His admission lab included hemoglobin of 8.4 g/dl, reticulocyte count of 16.3%, bilirubin of 1.7 mg/dl, and LDH of 1,267 U/l. Chest X-ray showed middle and lower lobe opacity and interstitial thickening. He was treated for acute pain crisis and community-acquired pneumonia with intravenous fluids, supplemental oxygen, and intravenous levofloxacin. He was placed on fentanyl patient-controlled analgesia (PCA), oxycodone, ketorolac, and methadone with co-analgesic gabapentin and venlafaxine. Over the course of his hospitalization, his chest pain resolved, but the joint pains continued. He was then transferred to the ICU and was discharged a day later after 7 days of ketamine infusion. Ketamine is a noncompetitive antagonist at the N-methyl-D-aspartate (NMDA) receptor. This property has been shown to modulate opioid tolerance and opioid-induced hyperalgesia. There have been a very few published reports on the use of low-dose ketamine in sickle cell pain management. A PubMed search revealed four published articles (Table 1). Fourteen out of the 17 cases (82.35%) who received ketamine infusion showed improvement in self-reported pain intensity and significant reduction in opioid dosage. Only one patient (5.9%) developed serious side effect leading to discontinuation of the drug. A low-dose ketamine can be an option for pain control in sickle cell disease. Randomized trial is required to establish this benefit of ketamine over currently available therapies.

  1. Hyperphosphorylated tau in the brains of mice and monkeys with long-term administration of ketamine.

    Science.gov (United States)

    Yeung, L Y; Wai, Maria S M; Fan, Ming; Mak, Y T; Lam, W P; Li, Zhen; Lu, Gang; Yew, David T

    2010-03-15

    Ketamine, a non-competitive antagonist at the glutamatergic N-methyl-d-aspartate (NMDA) receptor, might impair memory function of the brain. Loss of memory is also a characteristic of aging and Alzheimer's disease. Hyperphosphorylation of tau is an early event in the aging process and Alzheimer's disease. Therefore, we aimed to find out whether long-term ketmaine administration is related to hyperphosphorylation of tau or not in the brains of mice and monkeys. Results showed that after 6 months' administration of ketamine, in the prefrontal and entorhinal cortical sections of mouse and monkey brains, there were significant increases of positive sites for the hyperphosphorylated tau protein as compared to the control animals receiving no ketamine administration. Furthermore, about 15% of hyperphosphorylated tau positive cells were also positively labeled by terminal dUTP nick end labeling (TUNEL) indicating there might be a relationship between hyperphosphorylation of tau and apoptosis. Therefore, the long-term ketamine toxicity might involve neurodegenerative process similar to that of aging and/or Alzheimer's disease. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Neuroprotective and antioxidant effects of curcumin in a ketamine-induced model of mania in rats.

    Science.gov (United States)

    Gazal, Marta; Valente, Matheus R; Acosta, Bruna A; Kaufmann, Fernanda N; Braganhol, Elizandra; Lencina, Claiton L; Stefanello, Francieli M; Ghisleni, Gabriele; Kaster, Manuella P

    2014-02-05

    Bipolar disorder (BD) is a chronic and debilitating illness characterized by recurrent manic and depressive episodes. Our research investigates the protective effects of curcumin, the main curcuminoid of the Indian spice turmeric, in a model of mania induced by ketamine administration in rats. Our results indicated that ketamine treatment (25 mg/kg, for 8 days) induced hyperlocomotion in the open-field test and oxidative damage in prefrontal cortex (PFC) and hippocampus (HP), evaluated by increased lipid peroxidation and decreased total thiol content. Moreover, ketamine treatment reduced the activity of the antioxidant enzymes superoxide dismutase and catalase in the HP. Pretreatment of rats with curcumin (20 and 50 mg/kg, for 14 days) or with lithium chloride (45 mg/kg, positive control) prevented behavioral and pro-oxidant effects induced by ketamine. These findings suggest that curcumin might be a good compound for preventive intervention in BD, reducing the episode relapse and the oxidative damage associated with the manic phase of this disorder. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Technological Challenges for High-Brightness Photo-Injectors

    CERN Multimedia

    Suberlucq, Guy

    2004-01-01

    Many applications, from linear colliders to free-electron lasers, passing through light sources and many other electron sources, require high brightness electron beams, usually produced by photo-injectors. Because certain parameters of these applications differ by several orders of magnitude, various solutions were implemented for the design and construction of the three main parts of the photo-injectors: lasers, photocathodes and guns. This paper summarizes the different requirements, how they lead to technological challenges and how R&D programs try to overcome these challenges. Some examples of state-of-the-art parts are presented.

  4. Intranasal ketamine for the management of incidental pain during wound dressing in cancer patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Nivedita Page

    2018-01-01

    Full Text Available Introduction: Cancer wounds need regular dressing; else they develop infection, foul odor, and in extreme cases, maggots. Patients resist dressing due to the severe incidental pain during dressing. Intranasal ketamine was tried as an analgesic to reduce this incidental pain. Materials and Methods: Twenty patients with wounds requiring regular dressing were selected; these patients had a basal pain score of 4/10 and incidental pain score of 7/10 during four consecutive dressings. Ketamine 0.5 mg/kg was administered transmucosally 10 min before dressing, and pain scores, hemodynamic parameters, and sedation were recorded for up to 2 h in six consecutive dressings. Results: Ketamine produced a significant reduction in incidental pain without any hemodynamic changes or sedation. Conclusion: Ketamine appears to be a safe and effective analgesic when used intranasally for incidental pain.

  5. Heavy-Ion Injector for the High Current Experiment

    Science.gov (United States)

    Bieniosek, F. M.; Henestroza, E.; Kwan, J. W.; Prost, L.; Seidl, P.

    2001-10-01

    We report on progress in development of the Heavy-Ion Injector at LBNL, which is being prepared for use as an injector for the High Current Experiment (HCX). It is composed of a 10-cm-diameter surface ionization source, an extraction diode, and an electrostatic quadrupole (ESQ) accelerator, with a typical operating current of 0.6 A of potassium ions at 1.8 MeV, and a beam pulse length of 4.5 microsecs. We have improved the Injector equipment and diagnostics, and have characterized the source emission and radial beam profiles at the diode and ESQ regions. We find improved agreement with EGUN predictions, and improved compatibility with the downstream matching section. Plans are to attach the matching section and the initial ESQ transport section of HCX. Results will be presented and compared with EGUN and WARP simulations.

  6. [Clinical and biological predictors of ketamine response in treatment-resistant major depression: Review].

    Science.gov (United States)

    Romeo, B; Choucha, W; Fossati, P; Rotge, J-Y

    2017-08-01

    The aim of this review was to determine the clinical and biological predictors of the ketamine response. A systematic research on PubMed and PsycINFO database was performed without limits on year of publication. The main predictive factors of ketamine response, which were found in different studies, were (i) a family history of alcohol dependence, (ii) unipolar depressive disorder, and (iii) neurocognitive impairments, especially a slower processing speed. Many other predictive factors were identified, but not replicated, such as personal history of alcohol dependence, no antecedent of suicide attempt, anxiety symptoms. Some biological factors were also found such as markers of neural plasticity (slow wave activity, brain-derived neurotrophic factor Val66Met polymorphism, expression of Shank 3 protein), other neurologic factors (anterior cingulate activity, concentration of glutamine/glutamate), inflammatory factors (IL-6 concentration) or metabolic factors (concentration of B12 vitamin, D- and L-serine, alterations in the mitochondrial β-oxidation of fatty acids). This review had several limits: (i) patients had exclusively resistant major depressive episodes which represent a sub-type of depression and not all depression, (ii) response criteria were more frequently assessed than remission criteria, it was therefore difficult to conclude that these predictors were similar, and finally (iii) many studies used a very small number of patients. In conclusion, this review found that some predictors of ketamine response, like basal activity of anterior cingulate or vitamin B12 concentration, were identical to other therapeutics used in major depressive episode. These factors could be more specific to the major depressive episode and not to the ketamine response. Others, like family history of alcohol dependence, body mass index, or D- and L-serine were different from the other therapeutics. Neurocognitive impairments like slower speed processing or alterations in

  7. GLYX-13, a NMDA receptor glycine-site functional partial agonist, induces antidepressant-like effects without ketamine-like side effects.

    Science.gov (United States)

    Burgdorf, Jeffrey; Zhang, Xiao-lei; Nicholson, Katherine L; Balster, Robert L; Leander, J David; Stanton, Patric K; Gross, Amanda L; Kroes, Roger A; Moskal, Joseph R

    2013-04-01

    Recent human clinical studies with the NMDA receptor (NMDAR) antagonist ketamine have revealed profound and long-lasting antidepressant effects with rapid onset in several clinical trials, but antidepressant effects were preceded by dissociative side effects. Here we show that GLYX-13, a novel NMDAR glycine-site functional partial agonist, produces an antidepressant-like effect in the Porsolt, novelty induced hypophagia, and learned helplessness tests in rats without exhibiting substance abuse-related, gating, and sedative side effects of ketamine in the drug discrimination, conditioned place preference, pre-pulse inhibition and open-field tests. Like ketamine, the GLYX-13-induced antidepressant-like effects required AMPA/kainate receptor activation, as evidenced by the ability of NBQX to abolish the antidepressant-like effect. Both GLYX-13 and ketamine persistently (24 h) enhanced the induction of long-term potentiation of synaptic transmission and the magnitude of NMDAR-NR2B conductance at rat Schaffer collateral-CA1 synapses in vitro. Cell surface biotinylation studies showed that both GLYX-13 and ketamine led to increases in both NR2B and GluR1 protein levels, as measured by Western analysis, whereas no changes were seen in mRNA expression (microarray and qRT-PCR). GLYX-13, unlike ketamine, produced its antidepressant-like effect when injected directly into the medial prefrontal cortex (MPFC). These results suggest that GLYX-13 produces an antidepressant-like effect without the side effects seen with ketamine at least in part by directly modulating NR2B-containing NMDARs in the MPFC. Furthermore, the enhancement of 'metaplasticity' by both GLYX-13 and ketamine may help explain the long-lasting antidepressant effects of these NMDAR modulators. GLYX-13 is currently in a Phase II clinical development program for treatment-resistant depression.

  8. Effects of ketamine and N-methyl-D-aspartate on fluoxetine-induced antidepressant-related behavior using the forced swimming test.

    Science.gov (United States)

    Owolabi, Rotimi Adegbenga; Akanmu, Moses Atanda; Adeyemi, Oluwole Isaac

    2014-04-30

    This study investigated the effects of ketamine on fluoxetine-induced antidepressant behavior using the forced swimming test (FST) in mice. In order to understand the possible role of N-methyl-d-aspartate (NMDA) neurotransmission in the antidepressant effect of fluoxetine, different groups of mice (n=10) were administered with acute ketamine (3mg/kg, i.p.), acute NMDA (75mg/kg and 150mg/kg, i.p.) and a 21-day chronic ketamine (15mg/kg, i.p./day) were administered prior to the administration of fluoxetine (20mg/kg, i.p.) in the mice. Antidepressant related behavior (immobility score) was measured using the forced swimming test. The results showed that the acute ketamine and fluoxetine alone treatments elicited a significant (pfluoxetine-induced decrease in immobility score. In contrast, pre-treatment with NMDA (150mg/kg) significantly (pfluoxetine-induced decrease in immobility score. On the other hand, chronic administration of ketamine significantly elicited an increase in immobility score as well as reversed the reduction induced by fluoxetine. Similarly, NMDA administration at both 75mg/kg and 150mg/kg increased immobility score in chronically administered ketamine groups. Furthermore, chronic administration of ketamine, followed by NMDA (75mg/kg) and fluoxetine significantly elevated the immobility score when compared with the group that received NMDA and fluoxetine but not chronically treated with ketamine. It can be suggested) that facilitation of NMDA transmission blocked fluoxetine-induced reduction in immobility score, while down-regulation of NMDA transmission is associated with increase in fluoxetine-induced antidepressant-related behavior in mice. Down-regulation of the NMDA transmission is proposed as an essential component of mechanism of suppression of depression related behaviors by fluoxetine. Modulation of NMDA transmission is suggested to be relevant in the mechanism of action of fluoxetine. Copyright © 2014 Elsevier Ireland Ltd. All rights

  9. Differential interaction with the serotonin system by S-ketamine, vortioxetine, and fluoxetine in a genetic rat model of depression.

    Science.gov (United States)

    du Jardin, Kristian Gaarn; Liebenberg, Nico; Müller, Heidi Kaastrup; Elfving, Betina; Sanchez, Connie; Wegener, Gregers

    2016-07-01

    The mechanisms mediating ketamine's antidepressant effect have only been partly resolved. Recent preclinical reports implicate serotonin (5-hydroxytryptamine; 5-HT) in the antidepressant-like action of ketamine. Vortioxetine is a multimodal-acting antidepressant that is hypothesized to exert its therapeutic activity through 5-HT reuptake inhibition and modulation of several 5-HT receptors. The objective of this study was to evaluate the therapeutic-like profiles of S-ketamine, vortioxetine, and the serotonin reuptake inhibitor fluoxetine in response to manipulation of 5-HT tone. Flinders Sensitive Line (FSL) rats, a genetic model of depression, were depleted of 5-HT by repeated administration of 4-chloro-DL-phenylalanine methyl ester HCl (pCPA). Using pCPA-pretreated and control FSL rats, we investigated the acute and sustained effects of S-ketamine (15 mg/kg), fluoxetine (10 mg/kg), or vortioxetine (10 mg/kg) on recognition memory and depression-like behavior in the object recognition task (ORT) and forced swim test (FST), respectively. The behavioral phenotype of FSL rats was unaffected by 5-HT depletion. Vortioxetine, but not fluoxetine or S-ketamine, acutely ameliorated the memory deficits of FSL rats in the ORT irrespective of 5-HT tone. No sustained effects were observed in the ORT. In the FST, all three drugs demonstrated acute antidepressant-like activity but only S-ketamine had sustained effects. Unlike vortioxetine, the antidepressant-like responses of fluoxetine and S-ketamine were abolished by 5-HT depletion. These observations suggest that the acute and sustained antidepressant-like effects of S-ketamine depend on endogenous stimulation of 5-HT receptors. In contrast, the acute therapeutic-like effects of vortioxetine on memory and depression-like behavior may be mediated by direct activity at 5-HT receptors.

  10. COMPARISON OF INTRAOPERATIVE KETAMINE VS. FENTANYL USE DECREASES POSTOPERATIVE OPIOID REQUIREMENTS IN TRAUMA PATIENTS UNDERGOING CERVICAL SPINE SURGERY.

    Science.gov (United States)

    Berkowitz, Aviva C; Ginsburg, Aryeh M; Pesso, Raymond M; Angus, George L D; Kang, Amiee; Ginsburg, Dov B

    2016-02-01

    Postoperative airway compromise following cervical spine surgery is a potentially serious adverse event. Residual effects of anesthesia and perioperative opioids that can cause both sedation and respiratory depression further increase this risk. Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that provides potent analgesia without noticeable respiratory depression. We investigated whether intraoperative ketamine administration could decrease perioperative opioid requirements in trauma patients undergoing cervical spine surgery. We retrospectively reviewed anesthesia records identifying cervical spine surgeries performed between March 2014 and February 2015. All patients received a balanced anesthetic technique utilizing sevoflurane 0.5 minimum alveolar concentration (MAC) and propofol infusion (50-100 mcg/kg/min). For intraoperative analgesia, one group of patients received ketamine (N=25) and a second group received fentanyl (N=27). Cumulative opioid doses in the recovery room and until 24 hours postoperatively were recorded. Fewer patients in the ketamine group (11/25 [44%] vs. 20/27 [74%], respectively; p = 0.03) required analgesics in the recovery room. Additionally, the total cumulative opioid requirements in the ketamine group decreased postoperatively at both 3 and 6 hours (p = 0.01). Ketamine use during cervical spine surgery decreased opioid requirements in both the recovery room and in the first 6 hours postoperatively. This may have the potential to minimize opioid induced respiratory depression in a population at increased risk of airway complications related to the surgical procedure.

  11. Simulation of transient effects in the heavy ion fusion injectors

    International Nuclear Information System (INIS)

    Chen, Y.J.; Hewett, D.

    1993-01-01

    The authors have used the 2-D PIC code, GYMNOS, to study the transient behaviors in the Heavy Ion Fusion (HIF) injectors. GYMNOS simulations accurately provide the steady state Child-Langmuir current and the beam transient behavior within a planar diode. The simulations of the LBL HIF ESAC injector experiments agree well with the experimental data and EGUN steady state results. Simulations of the nominal HIF injectors have revealed the need to design the accelerating electrodes carefully to control the ion beam current, particularly the ion loss at the end of the bunch as the extraction voltage is reduced

  12. Simulation of transient effects in the heavy ion fusion injectors

    Science.gov (United States)

    Chen, Yu-Jiuan; Hewett, D. W.

    1993-05-01

    We have used the 2-D PIC code, GYMNOS, to study the transient behaviors in the Heavy Ion Fusion (HIF) injectors. GYMNOS simulations accurately provide the steady state Child-Langmuir current and the beam transient behavior within a planar diode. The simulations of the LBL HIF ESAC injector experiments agree well with the experimental data and EGUN steady state results. Simulations of the nominal HIF injectors have revealed the need to design the accelerating electrodes carefully to control the ion beam current, particularly the ion loss at the end of the bunch as the extraction voltage is reduced.

  13. Chemical immobilization of chimpanzees (Pan troglodytes) using a combination of detomidine and ketamine.

    Science.gov (United States)

    Melis, Sanne; Schauvliege, Stijn; van Bolhuis, Hester; Hoyer, Mark; Gasthuys, Frank

    2012-09-01

    To determine if a combination of detomidine and ketamine can be used for effective chemical immobilization of chimpanzees. Observational study. Twenty-one adult captive chimpanzees (12 males, nine females), age 8-46 years, weighing 40.4-68.4 kg. The chimpanzees were immobilized with intramuscular (IM) detomidine and ketamine by a darting system. Based on estimated weights, doses administered were 50 μg kg(-1) detomidine and 4 mg kg(-1) ketamine in groups 1 and 2, and 60 μg kg(-1) and 5 mg kg(-1) respectively in group 3. Eight minutes in group 1 and 15 minutes in groups 2 and 3 were allowed from the time of apparent immobilization before removing the animals from their enclosures. Body temperature, arterial haemoglobin saturation and pulse rate were measured. The time from injection to induction (recumbency and absence of voluntary movement), total anaesthetic and recovery times (with or without atipamezole) were recorded. Immobilization occurred within 5 minutes after darting in most animals. Early handling of the chimpanzees often resulted in arousal and required further doses of ketamine IM. Most animals were hypoxaemic and hypothermic. Occasionally, bradycardia was observed. Atipamezole resulted in an acceptable quality of recovery 10 minutes after IM injection. The duration of immobilization varied widely when no antagonist was administered. The combination detomidine (60 μg kg(-1) ) and ketamine (5-6 mg kg(-1) ) can be used for the immobilization of chimpanzees for non- to minimally invasive procedures. A period of 15 minutes should be allowed before handling to avoid unwanted arousal. Oxygen administration is recommended to reduce hypoxaemia. Administration of atipamezole is justified to hasten recovery. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  14. First operational experience with the positive-ion injector of ATLAS

    Energy Technology Data Exchange (ETDEWEB)

    Bollinger, L M; Pardo, R C; Shepard, K W; Billquist, P J; Bogaty, J M; Clifft, B E; Harkewicz, R; Joh, K; Markovich, P K; Munson, F H; Zinkann, G; Nolen, J A [Physics Div., Argonne National Lab., IL (United States)

    1993-03-01

    A Positive-Ion Injector (PII) designed to enable ATLAS to accelerate all stable nuclei has been completed and successfully tested. This new injector system consists of an ECR source on a 350-kV platform coupled to a 12-MV superconducting injector linac formed with four different types of independently-phased 4-gap accelerating structure. The injector linac is configured to be optimum for the acceleration of uranium ions from 0.029 to [approx equal] 1.1 MeV/u. When ions with q/A>0.1 are accelerated by PII and injected into the main ATLAS linac, CW beams with energies over 6 MeV/u can be delivered to the experimental areas. Since its completion in March 1992, PII has been tested by accelerating [sup 30]Si[sup 7+], [sup 40]Ar[sup 11+], [sup 132]Xe[sup 13+], and [sup 208]Pb[sup 24+]. For all of these, transmission through the injector linac was [approx equal] 100% of the pre-bunched beam, which corresponds to [approx equal] 60% of the DC beam from the source. The accelerating fields of the superconducting resonators were somewhat greater than the design goals, and the whole system ran stably for long periods of time. (orig.).

  15. Evaluation of the use of midazolam as a co-induction agent with ketamine for anaesthesia in sedated ponies undergoing field castration.

    Science.gov (United States)

    Allison, A; Robinson, R; Jolliffe, C; Taylor, P M

    2018-05-01

    There are limited investigations comparing ketamine to a ketamine-midazolam co-induction. To compare quality and safety of general anaesthesia induced using ketamine alone with anaesthesia co-induced using ketamine and midazolam. Randomised, double blinded, placebo controlled trial. After i.v. detomidine (20 μg/kg) thirty-eight ponies undergoing field castration received either 0.06 mg/kg (0.6 mL/50 kg) midazolam (group M) or 0.6 mL/50 kg placebo (group P) with 2.2 mg/kg ketamine i.v. for anaesthetic induction. Quality of anaesthetic induction, endotracheal intubation, surgical relaxation and recovery were scored using combinations of simple descriptive and visual analogue scales. Time of sedation, induction, start of endotracheal intubation, first movement, sternal recumbency and standing were recorded, as were time, number and total quantity of additional i.v. detomidine and ketamine injections. Cardiorespiratory variables were assessed every 5 min. Adverse effects were documented. Data were tested for normality and analysed with a mixed model ANOVA, Fisher's exact test, unpaired Students' t test and Wilcoxon Rank-sum as appropriate; Pketamine (P = 0.04). Time (minutes) from induction to first movement (PKetamine-midazolam co-induction compared to ketamine alone improved quality of induction, ease of intubation and muscle relaxation without impacting recovery quality. © 2017 EVJ Ltd.

  16. Voluntary running enhances glymphatic influx in awake behaving, young mice.

    Science.gov (United States)

    von Holstein-Rathlou, Stephanie; Petersen, Nicolas Caesar; Nedergaard, Maiken

    2018-01-01

    Vascular pathology and protein accumulation contribute to cognitive decline, whereas exercise can slow vascular degeneration and improve cognitive function. Recent investigations suggest that glymphatic clearance measured in aged mice while anesthetized is enhanced following exercise. We predicted that exercise would also stimulate glymphatic activity in awake, young mice with higher baseline glymphatic function. Therefore, we assessed glymphatic function in young female C57BL/6J mice following five weeks voluntary wheel running and in sedentary mice. The active mice ran a mean distance of 6km daily. We injected fluorescent tracers in cisterna magna of awake behaving mice and in ketamine/xylazine anesthetized mice, and later assessed tracer distribution in coronal brain sections. Voluntary exercise consistently increased CSF influx during wakefulness, primarily in the hypothalamus and ventral parts of the cortex, but also in the middle cerebral artery territory. While glymphatic activity was higher under ketamine/xylazine anesthesia, we saw a decrease in glymphatic function during running in awake mice after five weeks of wheel running. In summary, daily running increases CSF flux in widespread areas of the mouse brain, which may contribute to the pro-cognitive effects of exercise. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Tramadol Pretreatment Enhances Ketamine-Induced Antidepressant Effects and Increases Mammalian Target of Rapamycin in Rat Hippocampus and Prefrontal Cortex

    Directory of Open Access Journals (Sweden)

    Chun Yang

    2012-01-01

    Full Text Available Several lines of evidence have demonstrated that acute administration of ketamine elicits fast-acting antidepressant effects. Moreover, tramadol also has potential antidepressant effects. The aim of this study was to investigate the effects of pretreatment with tramadol on ketamine-induced antidepressant activity and was to determine the expression of mammalian target of rapamycin (mTOR in rat hippocampus and prefrontal cortex. Rats were intraperitoneally administrated with ketamine at the dose of 10 mg/kg or saline 1 h before the second episode of the forced swimming test (FST. Tramadol or saline was intraperitoneally pretreated 30 min before the former administration of ketamine or saline. The locomotor activity and the immobility time of FST were both measured. After that, rats were sacrificed to determine the expression of mTOR in hippocampus and prefrontal cortex. Tramadol at the dose of 5 mg/kg administrated alone did not elicit the antidepressant effects. More importantly, pretreatment with tramadol enhanced the ketamine-induced antidepressant effects and upregulated the expression of mTOR in rat hippocampus and prefrontal cortex. Pretreatment with tramadol enhances the ketamine-induced antidepressant effects, which is associated with the increased expression of mTOR in rat hippocampus and prefrontal cortex.

  18. The ATLAS positive ion injector

    International Nuclear Information System (INIS)

    Shepard, K.W.; Bollinger, L.M.; Pardo, R.C.

    1990-01-01

    This paper reviews the design, construction status, and beam tests to date of the positive ion injector (PII) which is replacing the tandem injector for the ATLAS heavy-ion facility. PII consists of an ECR ion source on a 350 KV platform injecting a very low velocity superconducting linac. The linac is composed of an independently-phased array of superconducting four-gap interdigital resonators which accelerate over a velocity range of .006 to .05c. In finished form, PII will be able to inject ions as heavy as uranium into the existing ATLAS linac. Although at the present time little more than 50% of the linac is operational, the indenpently-phased array is sufficiently flexible that ions in the lower half of the periodic table can be accelerated and injected into ATLAS. Results of recent operational experience will be discussed. 5 refs

  19. The ATLAS positive ion injector

    Energy Technology Data Exchange (ETDEWEB)

    Shepard, K.W.; Bollinger, L.M.; Pardo, R.C.

    1990-01-01

    This paper reviews the design, construction status, and beam tests to date of the positive ion injector (PII) which is replacing the tandem injector for the ATLAS heavy-ion facility. PII consists of an ECR ion source on a 350 KV platform injecting a very low velocity superconducting linac. The linac is composed of an independently-phased array of superconducting four-gap interdigital resonators which accelerate over a velocity range of .006 to .05c. In finished form, PII will be able to inject ions as heavy as uranium into the existing ATLAS linac. Although at the present time little more than 50% of the linac is operational, the indenpently-phased array is sufficiently flexible that ions in the lower half of the periodic table can be accelerated and injected into ATLAS. Results of recent operational experience will be discussed. 5 refs.

  20. Differential effect of ketamine and lidocaine on spontaneous and mechanical evoked pain in patients with nerve injury pain

    DEFF Research Database (Denmark)

    Gottrup, Hanne; Bach, Flemming Winther; Juhl, Gitte Irene

    2006-01-01

    ketamine, an N-methyl-D-aspartate receptor antagonist and lidocaine, a sodium channel blocker, on spontaneous pain, brush-evoked pain, and pinprick-evoked pain in patients with nerve injury pain. METHODS: Twenty patients participated in two randomized, double-blinded, placebo-controlled, crossover...... experiments in which they, on four different days, received a 30-minute intravenous infusion of ketamine (0.24 mg/kg), lidocaine (5 mg/kg), or saline. Ongoing pain, pain evoked by brush and repetitive pinprick stimuli, and acetone was measured before, during, and after infusion. RESULTS: Ketamine...... significantly reduced ongoing pain and evoked pain to brush and pinprick, whereas lidocaine only reduced evoked pain to repetitive pinprick stimuli. In individual patients, there was no correlation between the pain-relieving effect of lidocaine and ketamine on ongoing or mechanically evoked pains. CONCLUSIONS...