Abstract The study of the use of active substances in the raw materials of drugs used in traditional medicine by modern medical methods, especially the relationship between their secondary metabolites and their biological activity, has become a topic of great interest. The purpose of this study is to clarify the taste, potency, and chemical composition of some medicinal herbs used in traditional Mongolian medicine to treat arthritis. The main methods used in the research are analysis of ancient source materials and checklist. Four herbs were selected for the study: Linari buriatica Turcz, Veronica incana, Inula Britannica, and Ledum palustre L. According to the theory of traditional medicine, the taste, potency and general use of these four herbs are different, but the medicinal herbs have the ability to cure arthritis. In addition, the active substances in the chemical composition of these four herbs has been shown to be effective against a variety of diseases, including: Linari buriatica Turcz, used in large doses has purgative action and in small doses, it has the effect of stimulating gastrointestinal peristalsis and secretory function, Veronica incana contains cardiac glycosides and saponins while Inula Britannica contains inulin, and Ledum palustre L have been shown to suppress inflammation and promote apoptosis, or programmed cell death, which is essential for healthy living. However, the use of these four herbs in the treatment of arthritis in traditional medicine is noteworthy and needs to be studied in more depth.

Objectives: . This study aimed to investigate whether optical coherence tomography (OCT) provides useful information about the microstructures of the middle and inner ear via extratympanic approach and thereby could be utilized as an alternative diagnostic technology in ear imaging. Methods: . Five rats and mice were included, and the swept-source OCT system was applied to confirm the extent of visibility of the middle and inner ear and measure the length or thickness of the microstructures in the ear. The cochlea was subsequently dissected following OCT and histologically evaluated to compare with the OCT images. Results: . The middle ear microstructures such as ossicles, stapedial artery and oval window through the tympanic membrane with the OCT could be confirmed in both rats and mice. It was also possible to obtain the inner ear images such as each compartment of the cochlea in the mice, but the bone covering bulla needed to be removed to visualize the inner ear structures in the rats which had thicker bulla. The bony thickness covering the cochlea could be measured, which showed no significant differences between OCT and histologic image at all turns of cochlea. Conclusion . OCT has been shown a promising technology to assess real-time middle and inner ear microstructures noninvasively with a high-resolution in the animal model. Therefore, OCT could be utilized to provide additional diagnostic information about the diseases of the middle and inner ear.

BACKGROUND AND OBJECTIVES: The aims of this study were to evaluate the rate and risk factors involved in bilateral central lymph node metastasis in patients with papillary thyroid cancer (PTC) found in the isthmus and compared them to tumors located in other thyroid regions, using those findings to establish a surgical strategy for treating these tumors. SUBJECTS AND METHOD: We compared the clinical and pathological data of 48 patients with isthmic PTC and 141 patients with PTC found in other thyroid regions, all of whom underwent total thyroidectomy and bilateral central neck dissection. RESULTS: The rates of bilateral central lymph node metastasis were higher in the isthmus group than in the non-isthmus group (29.2% vs. 9.9%; p=0.001). On multivariate analysis, the isthmic location of the tumor was an independent risk factor for bilateral central lymph node metastasis (OR=3.458; p=0.005). But the positional relationship between the tracheal midline and the nodule was not clear in lymph node metastasis in the isthmus group. CONCLUSION: Bilateral central neck dissection should be considered for isthmic PTC regardless of the relation between nodule and tracheal midline because of the high rate of bilateral central lymph node metastasis.
Humans ; Lymph Nodes* ; Lymphatic Metastasis ; Methods ; Multivariate Analysis ; Neck Dissection ; Neoplasm Metastasis* ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Despite a low risk of liver failure and preserved liver function, non-cirrhotic hepatocellular carcinoma (HCC) has a poor prognosis. In the current study, we evaluated an active regulator of SIRT1 (AROS) as a prognostic biomarker in non-cirrhotic HCC. mRNA levels of AROS were measured in tumor and non-tumor tissues obtained from 283 non-cirrhotic HCC patients. AROS expression was exclusively up-regulated in recurrent tissues from the non-cirrhotic HCC patients (P=0.015) and also in tumor tissues irrespective of tumor stage (P<0.001) or BCLC stage (P<0.001). High mRNA levels of AROS were statistically significantly associated with tumor stage (P<0.001), BCLC stage (P=0.007), alpha fetoprotein (AFP) level (P=0.013), microvascular invasion (P=0.001), tumor size (P=0.036), and portal vein invasion (P=0.005). Kaplan-Meir curve analysis demonstrated that HCC patients with higher AROS levels had shorter disease-free survival (DFS) in both the short-term (P<0.001) and long-term (P=0.005) compared to those with low AROS. Cox regression analysis demonstrated that AROS is a significant predictor for DFS along with large tumor size, tumor multiplicity, vascular invasion, and poor tumor differentiation, which are the known prognostic factors. In conclusion, AROS is a significant biomarker for tumor aggressiveness in non-cirrhotic hepatocellular carcinoma.
Adult ; Age Distribution ; Aged ; Biomarkers, Tumor/*metabolism ; Carcinoma, Hepatocellular/*epidemiology/*metabolism/pathology ; Disease-Free Survival ; Female ; Humans ; Liver Cirrhosis/epidemiology/metabolism/pathology ; Liver Neoplasms/*epidemiology/*metabolism/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Nuclear Proteins/*metabolism ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Sex Distribution ; Transcription Factors/*metabolism ; Young Adult

No abstract available.
Aged, 80 and over ; Cholecystitis/*complications/diagnosis ; Hemobilia/diagnosis/*etiology ; Humans ; Jaundice, Obstructive/etiology ; Male

OBJECTIVE: This study was conducted to investigate anger in elderly patients with depressive disorders. METHODS: The subjects included 216 elderly patients with depression and 198 controls. All subjects were assessed by the State and Trait Anger Inventory (STAXI), Aggression Questionnaire (AQ), Reaction Inventory (RI). RESULTS: Elderly patients with depressive disorder showed lower levels of trait anger and anger expression on the STAXI, lower levels of verbal aggression and hostility on the AQ, and lower levels of anger reaction to the unpredictable disruption and disturbances factor, the embarrassing circumstances factor, and the personal disrespect factor on the RI than the controls. In the depression group, the severity of their depression was positively correlated with the trait anger, state anger, anger expression (except 'anger control') scores on the STAXI; the physical aggression, anger, and hostility scores on the AQ; and the anger reaction to unpredictable disruption and disturbances factor, the embarrassing circumstances factor, and the personal disrespect factor scores on the RI. However, the severity of depression negatively correlated with only anger control on the STAXI. In the linear logistic regression analysis, as there were higher levels of state anger seen in the STAXI, anger on the AQ, anger reaction to unpleasant factors on the RI, and therefore the likelihood of depression would be higher. CONCLUSION: Elderly depressive patients are less likely to have anger traits and to express anger than normal elderly. However, in elderly depressive patients, the higher they have severity of depressive symptoms, the higher they reported anger experience and anger expression.
Aged ; Aggression ; Anger ; Depression ; Depressive Disorder ; Hostility ; Humans ; Logistic Models ; Surveys and Questionnaires

OBJECTIVE: This study is intended to identify predictive factors of delirium, including risk factors and prodromal symptoms. METHODS: This study included sixty-five patients aged 65 years or older who had undergone hip surgery. Baseline assessments included age; gender; admission type (acute/elective); reason for surgery (fracture/replacement); C-reactive protein (CRP); Acute Physiology, Age, Chronic Health Evaluation (APACHE III); and the Mini-Mental State Examination (MMSE). The Korean version of the Delirium Rating Scale-Revised-98 (K-DRS-98) was used to assess prodromal symptoms daily before the onset of delirium. RESULTS: Almost 28% (n=18) of the 65 patients developed delirium after surgery. Delirium in elderly patients after hip surgery was observed more often in older patients and those with acute admission, hip fracture, higher APACHE III score, lower MMSE score, and higher CRP levels within early days after the operation. Sleep-wake cycle disturbances, thought process abnormalities, orientation, and long-term memory in symptom items of K-DRS-98 were showed significant difference on 4 days before delirium, lability of affect on 3 days before, perceptual disturbances and hallucination, and visuo-spatial ability on 2 days before, and delusion, motor agitation, and short-term memory on the day before the occurrence of delirium. CRP levels within 24 hours and 72 hours after hospitalization were significantly higher in the delirium group. CONCLUSION: Medical professionals must pay attention to behavioral, cognitive changes and risk factors in elderly patients undergoing hip surgery and to the prodromal phase of delirium. K-DRS-98 may help in identifying the prodromal symptoms of delirium in elderly patients after hip surgery.
Aged ; APACHE ; C-Reactive Protein ; Delirium ; Delusions ; Dihydroergotamine ; Hallucinations ; Hip ; Hospitalization ; Humans ; Memory, Long-Term ; Memory, Short-Term ; Orientation ; Prodromal Symptoms ; Risk Factors

PURPOSE: To evaluate functions of the elbow joint according to surgical approach, time to exercise, and type of fracture after surgical treatment for the intra-articular comminuted fracture of the distal humerus. MATERIALS AND METHODS: 27 patients with the intra-articular comminuted fractures of the distal humerus underwent surgery from March, 2000 to January, 2007. We investigated the surgical approach, time for union, time to exercise and age. We also evaluated postoperative functions of the elbow joint according to the flexion contracture, the range of motion and the Mayo elbow performance score. RESULTS: The average follow-up period was 37 months and the average time for union was 14 weeks. The average range of flexion was 115 degrees, the average flexion contracture was 10 degrees, and the Mayo elbow performance score with average value of 85 point showed good clinical results. There were no statistically significant differences in functions of the elbow joint according to the operative method and age. However, patients with early postoperative exercise within 6 days showed statistically better outcomes than patients with postoperative exercise after 7 days. Type C1, 2 fractures showed statistically better results than the type C3 fracture. CONCLUSION: Stable fixation and early exercise are required to prevent postoperative complications and restore functions of the elbow joint with an intra-articular comminuted fracture of the distal humerus.
Contracture ; Elbow ; Elbow Joint ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Humerus ; Intra-Articular Fractures ; Postoperative Complications ; Range of Motion, Articular

PURPOSE: To document the incidence and analyze the causes of anterior knee pain following closed intramedullary nailing for tibial fractures. MATERIALS AND METHODS: Between January 2005 and February 2007, 50 tibial fractures (48 patients) were treated using locked intramedullary nails. We examined the relationship between postoperative anterior knee pain and age, gender distribution, mechanism of injury, cause and type of fracture, method of patellar tendon incision, and position of the nails on radiography. Anterior knee pain was assessed using a visual analogue scale (VAS). Pearson chi-square test was used to assess the incidence of knee pain. RESULTS: At a mean follow-up period of 16 months (range 13-30 months), 23 cases (46%) had developed anterior knee pain. Knee pain was more common in woman (p=0.000), but there was no statistically significant difference with regard to age, cause or type of fracture, reaming or incision technique. If the knee apex distance was below -30 mm on radiological analysis, there was no statistically significant increase in postoperative knee pain (p=0.000). Nail removal resolved or improved the symptoms in 77% of patients with anterior knee pain. CONCLUSION: Based on these data, nail prominence correlated with increased knee pain. We believe surgeons can decrease the severity of knee pain after tibial nailing by burying the tip of the nail as reflected on lateral radiographs.
Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Incidence ; Knee ; Nails ; Patellar Ligament ; Tibial Fractures

PURPOSE: To analyze the factors affecting the nonunion of extraarticular proximal tibial fracture and the outcome of nonunion treatment. MATERIALS AND METHODS: We investigated 51 cases of extraarticular proximal tibial fractures from June 2002 to May 2006. The nonunion rate was assessed in relation to several risk factors and the treatment outcome of nonunion using plate fixation with bone graft was assessed by Klemm and BOrner functional rating system. RESULTS: 6 cases of nonunion (11.8%) was noted among 51 cases, and the risk factors examined, OTA A3 comminuted fracture was associated with a high nonunion rate with statistical significance and initial bone graft had a significant effect in bone healing. Excellent and good results were obtained in 5 cases (83.3%) and bone union was achieved in all nonunion cases. CONCLUSION: Comminution was found to be an important factor affecting the nonunion in extraarticular proximal tibial fracture, and bone graft in primary operation could reduce the chance of nonunion. Accurate plate fixation with bone graft is a reliable option in nonunion treatment.
Fractures, Comminuted ; Risk Factors ; Tibial Fractures ; Transplants ; Treatment Outcome