Objective: Herbal and natural supplements have gained popularity as alternative treatments to insomnia and sleep disorders due to their perceived safety and potential effectiveness. This literature review summarizes the current evidence on the efficacy, safety, and mechanisms of action of commonly used supplements for sleep, including valerian, hops, kava, German chamomile, cherry, tryptophan, theanine, melatonin, magnesium, and zinc. Methods: We conducted literature review of clinical research on herbal and supplements for sleep reported to date. We summarized key findings and reviewed outcomes related to clinical efficacy and side effects. Results: Findings suggest that certain supplements, particularly valerian, hops, and melatonin, could be effective in improving sleep quality and reducing insomnia symptoms through modulation of neurotransmitter systems and regulation of sleep-wake cycles. However, the strength of the evidence varies with unestablished optimal dosages, formulations, and treatment durations. Although generally considered safe, these supplements are not without risks, such as rare but serious adverse effects associated with kava and potential interactions with prescription medications. The quality and purity of supplements also vary widely due to a lack of strict regulations. Conclusion Healthcare providers should remain informed about the latest research and work closely with patients to develop personalized treatment plans. Herbal and natural supplements may offer promising alternatives or adjunct treatments for insomnia and sleep disorders, but their use should be guided by the best available evidence and individual patient requirements. Larger, well-designed clinical trials are needed to establish the efficacy and safety of these supplements for clinical decision-making.

Diabetic gastroparesis is a common gastrointestinal complication which develops in about 20-30% of patients with longstanding diabetes mellitus. Recent studies have shown that erythromycin stimulates gastrointestinal motor activity by binding on motilin receptors of gastrointestinal smooth muscles and that it improves gastric emptying in patients with diabetic gastroparesis. In this respect, we present a 35-year-old patient with diabetic gastroparesis, complicated with a gastric bezoar, who was successfully treated with endoscopic bezoar fragmentation and oral erythromycin for 3 weeks.
Adult ; Bezoars* ; Diabetes Mellitus ; Erythromycin ; Gastric Emptying ; Gastroparesis* ; Humans ; Motilin ; Motor Activity ; Muscle, Smooth

PURPOSE: Intestinal atresia is a common cause of neonatal intestinal obstruction. Recently, the survival rate has been increasing from development of prenatal diagnosis, total parenteral nutrition (TPN) and neonatal intensive care. We evaluated the complication rate and cause of mortality after operative management for jejunoileal atresia. METHODS: We reviewed 62 patients (36 males, 26 females) with jejuno-ileal atresia who underwent operation from 1998 to 2007. RESULTS: There were 37 patients with jejunal atresia and 25 with ileal atresia. The average gestational age was 256+/-16.6 days and birth weight was 2,824+/-620 g. Prenatal diagnosis was performed in 45 patients (72.6%) around gestational age 27 weeks. Within 2nd day after birth, 44 patients (71%) underwent operation. Half of the jejunoileal atresia was type IIIa and type I was in 8, type II was in 3, type IIIb was in 12, and type IV was in 8. The operative treatment was resection & anastomosis in 59 patients and enterotomy & web excision in 3. They started feeding at 12.4+/-11.5 days after operation on average. The average duration of TPN was 26.7+/-23.5 days, and the incidence of cholestasis was 30.6%. Hospital days averaged 36.8+/-26 days. Early complication occurred in 14 patients (intestinal obstruction in 5, sepsis in 4, wound problem in 3, anastomosis leakage in 1, and intraabdominal abscess in 1). Late complication occurred in 7 patients (anastomosis stricture in 4 and intestinal obstruction in 3). There was only one case of mortality due to short bowel syndrome after re-operation for adhesive ileus. CONCLUSION: The operation for intestinal atresia was successful and aggressive management contributed to a low mortality rate.
Abscess ; Adhesives ; Birth Weight ; Cholestasis ; Constriction, Pathologic ; Gestational Age ; Humans ; Ileus ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intestinal Atresia ; Intestinal Obstruction ; Male ; Parenteral Nutrition, Total ; Parturition ; Prenatal Diagnosis ; Sepsis ; Short Bowel Syndrome ; Survival Rate

AIMTo avoid the limitation of the use of cationic polyethlenimine (PEI)-complexed plasmid DNA use for in vitro or in vivo gene delivery due to its cytotoxicity and lower efficiency in the presence of serum.

METHODSA polyplex with decreased positive charge on the complex surface was designed. The PEI/DNA (PD) complexes coated with an anionic biodegradable polymer, alginate were prepared and their gene delivery behavior with PD was compared.

RESULTSThe alginate-coated PD polyplex, where alginate : PEI : DNA [alginate : DNA, 0.15 (w/w); PEI : DNA, N : P = 10] showed about 10 - 30 fold-increased transfection efficiency compared to corresponding non-coated complexes to C3 cells in the presence of 50% serum. The surface charge of the alginate-coated complex was approximately half of that of the alginate-lacking complex. The size of alginate-coated complex was slightly smaller than that of the corresponding complex without alginate. The former complex also showed a reduced erythrocyte aggregation activity and decreased cytotoxicities to C3 cells in comparison with PD complex.

CONCLUSIONThe alginate-coated PD polyplexes as a new gene delivery system can improve transfection efficiency in high serum concentration with low cytotoxicity to C3 cells.

Alginates ; administration & dosage ; metabolism ; Animals ; Cell Line, Transformed ; Cell Survival ; Culture Media ; DNA ; administration & dosage ; genetics ; metabolism ; Erythrocyte Aggregation ; Fibroblasts ; cytology ; metabolism ; Gene Transfer Techniques ; Genetic Vectors ; Glucuronic Acid ; administration & dosage ; metabolism ; Hexuronic Acids ; administration & dosage ; metabolism ; Mice ; Mice, Inbred C57BL ; Plasmids ; Polyethyleneimine ; administration & dosage ; metabolism ; Serum ; Transfection

Objective: Previous studies have suggested various causes of restless legs syndrome (RLS), including iron and dopamine concentrations in the brain. Genetic influences have also been reported in many studies. There is also a possibility that circadian clock genes may be involved because symptoms of RLS worsen at night. We investigated whether CLOCK and NPAS2 gene polymorphisms were associated with RLS. Methods: A total of 227 patients with RLS and 229 non-RLS matched controls were assessed according to the International Restless Legs Syndrome Study Group diagnostic criteria. Genotyping was performed using reverse transcription polymerase chain reaction and high-resolution melting curve analyses. Results: Although the genotype distributions of the CLOCK variants (rs1801260 and rs2412646) were not significantly different between patients with RLS and non-RLS controls, the allele frequencies of CLOCK rs1801260 showed marginally significant differences between the two groups (X2 =2.98, p=0.085). Furthermore, there was a significant difference in the distribution of CLOCK haplotypes (rs1801260-rs2412646) between patients with RLS and non-RLS controls (p=0.013). The distributions of allelic, genotypic, and haplotypic variants of NPAS2 (rs2305160 and rs6725296) were not significantly different between the two groups. Conclusion Our results suggest that CLOCK variants may be associated with decreased susceptibility to RLS.

Background: and Purpose The purpose of this study was to describe the clinical presentation and features in electrodiagnostic and imaging investigations of young South Korean males diagnosed with Hirayama disease (HD). Methods: We reviewed the electronic medical records of South Korean enlisted soldiers who were diagnosed with HD and discharged from military service during 2011–2021. We investigated the clinical characteristics and results of electrodiagnostic and magnetic resonance imaging (MRI) investigations. We analyzed laterality and identified the involved muscles using needle electromyography (EMG). Loss of lordosis, localized cervical cord atrophy, loss of attachment between the posterior dura and subjacent lamina, asymmetric flattening of the cord, crescent-shaped mass in the posterior epidural space, and noncompressive intramedullary T2-weighted high signal intensity were investigated using neutral- or flexion-position MRI. Results: Forty-two male patients aged 20.2±0.8 years (mean±standard deviation) were identified. All patients complained of hand weakness, and 10 complained of hand tremor (23.8%).Four patients (9.5%) had symptoms in both upper limbs, and five (11.9%) had sensory disturbances. Needle EMG revealed that muscles in the C7–T1 myotome were commonly involved, and C5–C6 involvement of the deltoid (10.5%) and biceps brachii (12.5%) was also observed.In cervical MRI, localized cord atrophy (90.0%) was the most characteristic finding, and cord atrophy was most severe at the C5–C6 level (58.3%). Conclusions This is the first description of a large number of patients with HD in South Korea.The clinical presentation and features found in electrodiagnostic and imaging investigations will improve the understanding of HD in the young South Korean male population.

BACKGROUNDS/AIMS: The purpose of this study was to evaluate the role of peripheral eosinophilia as a predictable factor associated with Eosinophilic cholecystitis (EC) compared with other forms of cholecystitis in patients who underwent a cholecystectomy. METHODS: Between January 2001 and May 2011, the histopathologic features of 3,539 cholecystectomy specimens were reviewed retrospectively. EC was diagnosed in 30 specimens (0.84%). Data from 30 consecutive patients with EC (eosinophilic cholecystitis group [E-group]) were compared with a retrospective control group of 60 patients (other cholecystitis group [O-group]) during the same period. The two groups were matched for age, gender, and the presence of cholelithiasis. RESULTS: The median absolute eosinophil count 1 day post-operatively was 144 cells/mm3 (range: 9-801 cells/mm3) in the E-group and 93 cells/mm3 (range: 0-490 cells/mm3) in the O-group (p=0.036). Pre-operative peripheral eosinophilia was more common in the E-group than the O-group (20% vs. 3.3%, p=0.015). Multivariate analysis revealed that pre-operative peripheral eosinophilia was an independent significant predictable factor associated with EC (odds ratio=7.250, 1.365 <95% confidence interval<38.494, p=0.020). CONCLUSIONS: In the present study, pre-operative peripheral eosinophilia was shown to be an independent predictable factor associated with EC. Further researches seem to be necessary to confirm this finding.
Cholecystectomy ; Cholecystitis ; Eosinophilia ; Eosinophils ; Humans ; Multivariate Analysis ; Retrospective Studies

Paraganglioma is a generic term applied to tumors of paraganglia, regardless of location, and composed largely of paraganglionic chief cells. It is a rare tumor, especially in the spinal region. When it appears in the craniospinal axis, it is restricted to the cauda equina or filum terminale, and less commonly, the spinal nerve root. We report a case of oncocytic paraganglioma in the spinal nerve root of 13-year-old girl. The tumor was located in intradural and extramedullary areas from the 12th thoracic to the 1st lumbar vertebra. Histologically, the tumor cells with abundant eosinophilic cytoplasms show diffuse compact clusters, which are surrounded by fibers in a reticulin stain, like a nested pattern. The nuclei are round to ovoid in shape with mild atypia. Immunohistochemically, the tumor cells are positive for synaptophysin, neuron-specific enolase and vimentin but are negative for cytokeratin, chromogranin and glial fibrillary acidic protein. Some cells are positive for S-100 protein. The MIB-1 labeling index is low. Ultrastructurally, dense core neurosecretory granules are not found but mitochondrias are commonly noted.
Adolescent ; Axis, Cervical Vertebra ; Cauda Equina ; Cytoplasm ; Eosinophils ; Female ; Glial Fibrillary Acidic Protein ; Humans ; Keratins ; Mitochondria ; Paraganglioma* ; Phosphopyruvate Hydratase ; Reticulin ; S100 Proteins ; Spinal Canal ; Spinal Nerve Roots ; Spine ; Synaptophysin ; Vimentin

BACKGROUND: The purpose of this study was to analyze biomechanical properties of a novel wedge locking plate in medial open wedge high tibial osteotomy (OWHTO) in a porcine tibial model. METHODS: A uniform 8-mm OWHTO was performed in 12 porcine tibiae. Six of them were subsequently fixed with the plate without a wedge, whereas the other 6 were additionally reinforced with a metal wedge of 8 mm. Biomechanical properties (stiffness, displacement of the osteotomy gap, and failure load) were evaluated under axial load. The different modes of failure were also investigated. RESULTS: The plate showed an axial stiffness of 2,457 ± 450 N/mm with a wedge and 1,969 ± 874 N/mm without a wedge. The maximum failure load was 5,380 ± 952 N with a wedge and 4,354 ± 607 N without a wedge. The plate with a wedge had a significantly greater failure load and significantly less displacement of medial gap at failure than that without a wedge (p = 0.041 and p = 0.002, respectively). The axial stiffness was not different between the two types of fixation. Most failures were caused by lateral cortex breakage and there was no implant failure. CONCLUSIONS: The novel wedge locking plate showed excellent biomechanical properties and an additional wedge provided significant improvement. This plate can be a good fixation method for OWHTO.
Knee ; Methods ; Osteotomy ; Tibia

OBJECTIVE: Classical markers of infection cannot differentiate reliably between inflammation and infection after neurosurgery. This study investigated the dynamics of serum procalcitonin (PCT) in patients who had elective spine surgeries without complications. METHODS: Participants were 103 patients (47 women, 56 men) who underwent elective spinal surgery. Clinical variables relevant to the study included age, sex, medical history, body mass index (BMI), site and type of surgery, and surgery duration. Clinical and laboratory data were body temperature, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and PCT, all measured preoperatively and postoperatively on days 1, 3, and 5. RESULTS: PCT concentrations remained at <0.25 ng/mL during the postoperative course except in 2 patients. PCT concentrations did not correlate with age, sex, DM, hypertension, BMI, operation time, operation site, or use of instrumentation. In contrast, CRP concentrations were significantly higher with older age, male, DM, hypertension, longer operation time, cervical operation, and use of instrumentation. CONCLUSION: PCT may be useful in the diagnosing neurosurgical patients with postoperative fever of unknown origin.
Blood Sedimentation ; Body Mass Index ; Body Temperature ; C-Reactive Protein ; Calcitonin ; Female ; Fever of Unknown Origin ; Humans ; Hypertension ; Inflammation ; Leukocyte Count ; Leukocytes ; Male ; Neurosurgery ; Protein Precursors ; Spine