OBJECTS: Sanjoin, the seeds of Zizyphus vulgaris var. spinosus has been used as the most important hypnotic agent in chinese medicine to treat insomnia. This research was performed in order to examine the effect of betulinic acid and sanjoinine-A which are components of Sanjoin. METHOD: Sleeping time, sleep recordings of EEG, serum serotonin level, and locomotor activity were measured in rats which received betulinic acid and sanjoinine-A as sleep induction material extracted from Sanjoin. RESULTS: 1) Groups received betulinic acid, sanjoinine-A, and lorazepam showed increased sleep time than control group with saline. 2) Groups with betulinic acid, sanjoinine-A, lorazepam and saline recorded beta-wave in sleep recording of EEG. In there was no significant difference among all groups. 3) No significant difference in serum serotonin level among all groups was found. 4) In autonomic activity testing, groups of betulinic acid, sanjoinine-A, and lorazepam showed significantly more decreased in activity than saline group. In comparison of groups of betulinic acid and sanjoinine-A with a group of lorazepam, there was no significant difference. CONCLUSION: These results suggests that betulinic acid and sanjoinine-A have the sedative effect like lorazepam rather than sleep effect.
Animals ; Asian Continental Ancestry Group ; Brain* ; Electroencephalography* ; Humans ; Hypnotics and Sedatives ; Lorazepam ; Motor Activity ; Rats* ; Serotonin* ; Sleep Initiation and Maintenance Disorders ; Ziziphus

PURPOSE: Atypical femoral fracture (AFF), periprosthetic femoral fracture (PPFF) and femoral nonunion (FNU) are recalcitrant challenges for orthopedic surgeons. Teriparatide (TPTD) had been demonstrated to have anabolic effects on bone in various studies. We postulated that adjuvant TPTD after operation would enhance biologic stimulation for bone formation. We investigated (1) whether the adjuvant TPTD could achieve satisfactory union rate of surgically challenging cases such as displaced AFF, PPFF and FNU; (2) whether the adjuvant TPTD could promote development of abundant callus after surgical fixation; (3) whether the adjuvant TPTD had medically serious adverse effects. MATERIALS AND METHODS: Thirteen patients who agreed to off label use of TPTD in combination of operation were included in this retrospective case series. Median patients' age was 68.7 years, and there were three male and ten female patients. Their diagnoses were nonunion in six patients and acute fracture in seven. Medical records and radiographic images were reviewed. RESULTS: Twelve of thirteen fractures were united both clinically and radiologically within a year after adjuvant TPTD. Union completed radiologically median 5.4 months and clinically 5.7 months after the medication, respectively. Callus appeared abundantly showing median 1.4 of fracture healing response postoperatively. There was no serious adverse reaction of medication other than itching, muscle cramp, or nausea. CONCLUSION: Even appropriate surgical treatment is a mainstay of treatment for AFF, PPFF, and FNU, the current report suggested that adjuvant TPTD combined with stable fixation results in satisfactory outcome for the challenging fractures of femur.
Anabolic Agents ; Bony Callus ; Diagnosis ; Female ; Femoral Fractures* ; Femur ; Fracture Healing ; Humans ; Male ; Medical Records ; Muscle Cramp ; Nausea ; Off-Label Use ; Orthopedics ; Osteogenesis ; Periprosthetic Fractures ; Pruritus ; Retrospective Studies ; Surgeons ; Teriparatide*

When performing cementless hip arthroplasty, it is critical to achieve firm primary mechanical stability followed by biological fixation. In order to achieve this, it is essential to fully understand characteristics of implant design. In this review, the authors review fixation principles for a variety of implants used for cementless hip replacement and considerations for making an optimal selection.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Hip*

Routine use of the IVP in preoperative evaluation of patients with obstructive bladder outlet symptoms has been questioned on the basis of the chance of incidental finding in the upper tract and the implication of such findings to management. We studied 220 patients who underwent intravenous pyelography before prostatectomy at Department of Urology, Sanggye Paik Hospital from Oct. 1989 to Jun 1992. Of 220 patients, 183( 83.2% ) showed normal upper tract with cystogram compatible with benign prostatic hyperplasia. Abnormalities were found in 37( 16.8% ) patients but treatment plan was altered in only 5(2.25% ) cases. Most of these abnormalities could be detected on KUB or cystoscopy. Only one(0.45% ) malignancy would have been missed without routine IVP. We conclude that IVP in our opinion should not be performed as a routine procedure in patients with benign prostatic hypertrophy, but only in selected cases.
Cystoscopy ; Humans ; Incidental Findings ; Prostatectomy ; Prostatic Hyperplasia ; Urinary Bladder ; Urography ; Urology

In the thyroid tissue, thyrotrophin(TSH) and IGF-I played major role of the goitrogen. But the evidences and precise mechanism of these two factors were not known so much. Actually local secretion of thyroid IGF-I was originated from its fibroblasts mainly. We guessed major roles of IGFs in the thyroid tissue were local paracrine effect of thyroid cells proliferation and differentiation which concert with TSH. Recently, some reporters described the source of thyroid IGF-I were partly from thyroid follicular cells and its action were synergistic with TSH. We measured TSH, IGF-I and IGFBP-3 from sera and thyroid cystic fluids in 36 patients with simple thyroid cyst and examined into correlation between TSH, IGF-I and IGFBP-3.1) According to cyst/serum TSH ratio, we classified two groups(Group I; c/s TSH <1, n=19. Group II; c/s TSH >1, n=17). This classification criteria means that cystic TSH level were increased than that of serum or not.2) The serum TSH, IGF-I and IGFBP-3 levels are not difference between group I and II.3) Cystic TSH were dependent on the serum TSH in Group I, but negative correlation in Group II. In Group II, cystic TSH was significant increased.4) Serum IGF-I were positive correlation in each Group5) In Group II, cystic IGF-I was not exceed than those of serum IGF-I, but some cystic IGFBP-3 were more increased than those of serum.6) In Group II, cystic IGFBP-3 increased than serum TSH, and cystic IGFBP-3 was positive correlation with cystic TSH and cystic IGF-I.As these data suggested that cystic TSH and cystic IGF-I levels may influence cystic IGFBP-3 level. The main effect for maintenance of cyst was mediated by cystic TSH and cystic IGFBP-3. But the cystic IGFBP-3 has major role for thyroid cyst than cyst TSH.
Classification ; Fibroblasts ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Thyroid Gland

No abstract available.
Pregnancy*

PURPOSE: Peritoneal dialysis related peritonitis remains one of the most common causes of hospitalization and discontinuation of peritoneal dialysis. Patient education and the individual environment play a significant role in improving the clinical outcomes. Therefore, this study focused on the preventive effects of practical training on the spot for peritoneal dialysis related peritonitis in continous ambulatory peritoneal dialysis (CAPD) patients. METHODS: Fifty-eight patients who were started on CAPD were as the primary intended treatment modality. The patients were given to a questionnaire regarding their gender, age, place of residence, level of education, economic status, sterile technique, knowledge of personal hygiene, placing a correct region for exchanging a fluid bag, and their duration of CAPD. During a home visit, the patients were instructed in how to sterilize the region of dialysis and maintain sterility in dialysis. RESULTS: Seventy four cases of peritonitis from 35 patients were identified over the 2 year's period. In the rural residences where there is a lower socio-economic status, the rates of peritonitis decreased in those patients who had received training on the spot within 6 months from the start of peritoneal dialysis compared with the patients after the 6 month period. Lower rates of peritonitis were noted in the patients who received training earlier (r=0.19, p=0.03). CONCLUSION: Ongoing and repetitive individualized education is needed to prevent peritoneal dialysis related peritonitis. The incidence of peritoneal dialysis related peritonitis can be reduced by educating these patients individually.
Dialysis ; Education ; Hospitalization ; House Calls ; Humans ; Hygiene ; Incidence ; Infertility ; Patient Education as Topic ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Surveys and Questionnaires

BACKGROUND: Venous thromboembolism (VTE) is a relatively common and potentially life threatening complication after major hip surgery. There are two main types of prophylaxis: chemical and mechanical. Chemical prophylaxis is very effective but causes bleeding complications in surgical wounds and remote organs. On the other hand, mechanical methods are free of hemorrhagic complications but are less effective. We hypothesized that mechanical prophylaxis is effective enough for Asians in whom VTE occurs less frequently. This study evaluated the effect of intermittent pneumatic compression (IPC) in the prevention of VTE after major hip surgery. METHODS: Incidences of symptomatic VTE after primary total hip arthroplasty with and without application of IPC were compared. A total of 379 patients were included in the final analysis. The IPC group included 233 patients (106 men and 127 women) with a mean age of 54 years. The control group included 146 patients (80 men and 66 women) with a mean age of 53 years. All patients took low-dose aspirin for 6 weeks after surgery. IPC was applied to both legs just after surgery and maintained all day until discharge. When a symptom or a sign suspicious of VTE, such as swelling or redness of the foot and ankle, Homans' sign, and dyspnea was detected, computed tomography (CT) angiogram or duplex ultrasonogram was performed. RESULTS: Until 3 months after surgery, symptomatic VTE occurred in three patients in the IPC group and in 6 patients in the control group. The incidence of VTE was much lower in the IPC group (1.3%) than in the control group (4.1%), but the difference was not statistically significant. Complications associated with the application of IPC were not detected in any patient. Patients affected by VTE were older and hospitalized longer than the unaffected patients. CONCLUSIONS: The results of this study suggest that IPC might be an effective and safe method for the prevention of postoperative VTE.
Ankle ; Arthroplasty, Replacement, Hip* ; Asian Continental Ancestry Group ; Aspirin ; Dyspnea ; Foot ; Hand ; Hemorrhage ; Hip ; Humans ; Incidence ; Leg ; Male ; Methods ; Ultrasonography ; Venous Thromboembolism* ; Wounds and Injuries

No abstract available.
Pneumoconiosis* ; Welding*

Transurethral resection of Prostate(TURP) is the current optimal therapy for benign prostatic hypertrophy. But in some cases of BPH patients, TURP cannot be performed because the patients have medical disorders not to be operated. Thus several alternatives have been used in the management of BPH patients, especially who had anesthetic contraindications to an operation. We experienced 12 cases of BPH patients applied with Intraurethral Cath(IUC) from April 1991 to September 1995. Eleven patients became able to void after IUC insertion. The maximal flow rates were 5.1 to 15.7 ml/sec and average value was 11.8 ml/sec. Almost all patients showed irritative voiding symptoms such as urgency, urge incontinence, frequency, and dysuria at first. In 7 patients, these symptoms disappeared spontaneously within 2 to 5 days and oxybutynin chloride was used orally in 2 patients. Suprapubic cystostomy was done in three patients because two patients had severe irritative voiding symptoms and one patient had persistent urinary retention. The stent was changed every 3 to 6 months. Stone formation around the device was noted in 2 patients and migration of device into the bladder was found in 2 patients. In 4 patients, TURP was performed when the patient's condition improved enough to be operated under epidural anesthesia. In conclusion, the use of IUC is thought to be a valid, cost effective and safe alternative to TURP in the treatment of highly operative risk patients with benign prostatic hypertrophy.
Anesthesia, Epidural ; Cystostomy ; Dysuria ; Humans ; Prostatic Hyperplasia* ; Stents* ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Incontinence, Urge ; Urinary Retention