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

No abstract available.
Failed Back Surgery Syndrome*

Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia.
Allografts ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Hypotension ; Critical Care ; Operating Rooms ; Respiratory System ; Resuscitation

No abstract available.
Humans

No abstract available.
Arteriovenous Fistula*

We performed a retrospective study on evisceration and enucleation operated at Chosun University hospital and Chonnam University hospital during the period of 10 years from January 1982 to December 1991. The total number of cases was 550. The incidence was mow common in male. The male and female ratio was 1.85: 1(Male 64.9%, Female 35.1%). The frequency of enucleation and evisceration was as follows trauma; 281 cases(51.1%), glaucoma; 76 cases(13.8%), corneal ulcer; 69 cases(12.6%), panophthalmitis; 43 cases(7.8%), tumor; 33 cases(6.0%), phthisis bulbi, 26 cases(4.7%), others; 22 cases(4.0%). The most frequent cause of the trauma whitch had been eviscerated or enucleated was traffic accident; 129 cases(45.9%), followed by violence; 73 cases(25.9%), industrial accident, 37 cases(13.2%), toy and pencil; 19 cases(6.8%), sports; 12 cases(4.3%), unknown; 11 cases(3.9%). The age-related incidence was peak in the third decades 86 cases(15.6%), followed by fifth decades 85 cases(15.5%) and fourth and sixth decades 82 cases(14.9%), respectively. The mean annual incidince rate was significantly greater among males than females: 2.33 per 100,000 population and 1.93 per 100,000 population, respectively. The overall mean annual rate was 2.13.
Accidents, Occupational ; Accidents, Traffic ; Corneal Ulcer ; Female ; Glaucoma ; Gwangju* ; Humans ; Incidence ; Jeollanam-do* ; Male ; Panophthalmitis ; Play and Playthings ; Retrospective Studies ; Sports ; Violence

We performed a retrospective study on evisceration and enucleation operated at Chosun University hospital and Chonnam University hospital during the period of 10 years from January 1982 to December 1991. The total number of cases was 550. The incidence was mow common in male. The male and female ratio was 1.85: 1(Male 64.9%, Female 35.1%). The frequency of enucleation and evisceration was as follows trauma; 281 cases(51.1%), glaucoma; 76 cases(13.8%), corneal ulcer; 69 cases(12.6%), panophthalmitis; 43 cases(7.8%), tumor; 33 cases(6.0%), phthisis bulbi, 26 cases(4.7%), others; 22 cases(4.0%). The most frequent cause of the trauma whitch had been eviscerated or enucleated was traffic accident; 129 cases(45.9%), followed by violence; 73 cases(25.9%), industrial accident, 37 cases(13.2%), toy and pencil; 19 cases(6.8%), sports; 12 cases(4.3%), unknown; 11 cases(3.9%). The age-related incidence was peak in the third decades 86 cases(15.6%), followed by fifth decades 85 cases(15.5%) and fourth and sixth decades 82 cases(14.9%), respectively. The mean annual incidince rate was significantly greater among males than females: 2.33 per 100,000 population and 1.93 per 100,000 population, respectively. The overall mean annual rate was 2.13.
Accidents, Occupational ; Accidents, Traffic ; Corneal Ulcer ; Female ; Glaucoma ; Gwangju* ; Humans ; Incidence ; Jeollanam-do* ; Male ; Panophthalmitis ; Play and Playthings ; Retrospective Studies ; Sports ; Violence

PURPOSE: To evaluate the clinical and radiographic results of acetabular reconstruction in severe acetabular bony defect using acetabular roof reinforcement ring with hook. MATERIALS AND METHODS: Thirty-five acetabular reconstructions using acetabular roof reinforcement ring with hook were performed between 1993 and 1997 and were followed up for more than two years. Bony defect was classified according to AAOS classification system. The clinical function was evaluated by Harris hip score and radiographical evaluation was focused on the osseous union of the grafted bone, reconstruction of center of rotation and any signs of socket loosening. RESULTS: The mean Harris hip score improved from 49 points preoperatively to 85 points at the final follow up. The bone graft was incorporated in 33 cases as shown by radiographic remodelling and had a homogenous trabecular appearance. In all cases, the center of rotation was repositioned within three milimeters from the anatomical position. One case was rerevised due to hook failure and postoperative deep infection. Another hook failure without infection was found in one case, but this patient had no radiographic or clinical instability because of bony consolidation after the grafted bone initially settled down at final follow up. Postoperative complications were hip dislocation in 3 hips, nonunion of the greater trochanter in one hip and discomfort at autograft donor site in 3 hips. CONCLUSION: Acetabular reconstruction using acetabular roof reinforcement ring with hook combined with morcellised bone graft was considered to be an useful methods especially in severe acetabular bone deficiency.
Acetabulum* ; Autografts ; Classification ; Femur ; Follow-Up Studies ; Hip ; Hip Dislocation ; Humans ; Postoperative Complications ; Tissue Donors ; Transplants

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*

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