The extraction characteristics and physiological properties of Viscum album var. coloratum (mistletoe) were monitored by response surface methodology (RSM). The maximum electron donating ability 88.05% was obtained at 42.10 W of microwave power, 36.99% of ethanol concentration, and 7.17 min of extraction time. The maximum inhibition effect on tyrosinase was 62.88% at microwave power, and its condition was 84.02 W, 92.46%, and 7.07 min of ethanol concentration, and extraction time, respectively. Superoxide dismutase (SOD) showed a maximum pseudo-activity of 53.55% at microwave power, 142.69 W, ethanol concentration, 32.69%, and extraction time, 3.58 min. The maximum total polyphenol content was 72.82% and it was under 122.57 W, 16.81%, and 2.94 min of microwave power, ethanol concentration, and extraction time, respectively. Based on superimposition of four-dimensional RSM regarding electron-donating ability, inhibition effect on tyrosinase, pseudo-activity of SOD, and total polyphenol content, the optimum ranges of extraction conditions are as follows; microwave power, 0-135 W, ethanol concentration, 64-70%, and extraction time, 4.15 min.

Astragals membranaceus (A. membranaceus) has been widely used as food material as well as medicinal ingredients for therapeutic effects. The objective of this study was to determine physiological activities such as polyphenol content, SOD-like activity, tyrosinase activity, nitrite scavenging activity and EDA (electron donating ability) of 2-and 6 -year root A. membranaceus extracts. SOD-like activities of all samples were shown the high effects (over 86.63%), and 6-year root A. membranaceus was higher (1.90–5.52%) than 2-year root A. membranaceus. Nitrite Scavenging activity (pH1.2) of 6 year root A. membranaceus were higher (9.08–13.42%) than 2 year root A. membranaceus extracts, and 50% ethanol extracts of samples were highest. EDAs of 2-year root A. membranaceus extracts were higher (26.76–44.46%) than 6-year root extracts, while those extracts were lower (42.66–74.05%) than 1.0% and 0.1% L-ascorbate solutions. Tyrosinase inhibitory effects and total polyphenol contents of 6 year root A. membranaceus extracts were higher than 2 year root A. membranace (1.90–5.52%), while both samples were lower than 1.0% and 0.1% L-ascorbate solutions. 6-year root A. membranaceus tended to have higher antioxidant effects of these antioxidant experiments than 2-year root A. membranaceus. Therefore, these suggest that the extracts of A. membranaceus can be used as a data to develop more efficient material in functional food.

Purpose:The study aimed to investigate the complications accompanying stoma take-down and to elucidate the significant factors associated with complications.Methods: We recruited 341 patients who underwent stoma take-down in our hospital between January 2000 and December 2005.Data on various complications during this procedure, i.e., wound infection, prolonged ileus, and anastomotic leakage, were collected with respect to patient-and operation-associated parameters.Results: Complications of stoma take-down developed in 72 (21.1%) patients: 53 (20.3%) patients in a loop ileosotmy, 10 (21.3%) patients in a loop colostomy, and 9 (27.3%)patients in a Hartmann colostomy, The overall complication rate was significantly associated with the urgency of the primary operation (elective vs. emergent, 17.8% vs. 29%, P=0.017), and with the operation time (≤80 min vs. ＞80 min, 16.5% vs. 29.3%,P=0.005).Among the complications, ileus developed in 46 (13.5%) patients, wound infection in 17 (5.0%)patients, and anastomotic leakage in 5 (1.5%) patients.Wound infection was related to the type of stoma between a loop ileostomy and a Hartmann colostomy (3.5% vs. 12.1%; P=0.014), but no other factors were associated with other complications.Conclusions: There were significant differences in overall complications in relation to urgency of the primary operation and the operation time, but there was no statistical difference in complications between a loop ileostomy and a loop colostomy takedown groups.The significance of these factors appears to be reduced with accurate surgical technique and patient care.

BACKGROUND:Parenteral administration of opioids and NSAIDs has been the mainstay for postoperative pain control in patients undergoing laparoscopic adjustable gastric banding (LAGB). Both classes of drugs, however, are associated with serious adverse effects. An addition of complimentary analgesic techniques may decrease requirement for traditional analgesics, thus reducing the incidence of side-effects. We designed the study to evaluate the effectiveness of Lavender aromatherapy in reducing opioid requirements after LAGB.METHODS:A prospective randomized placebo controlled study was carried out on 54 patients undergoing LAGB. Upon arrival to the post-anesthesia care unit (PACU), patients in the study group were treated with lavender oil, which was applied to the oxygen face mask; the control group patients received nonscented baby oil. Postoperative pain was treated with morphine. Numerical rating scores (0-10) were used to measure the level of pain at 5, 30, and 60 min. Sedation was evaluated using the Observer Assessment of Alertness/Sedation scale (0-5). Data analyzed included the amount of opioids, NRS, OAA/S, PACU discharge time, as well as the incidence of side-effects.RESULTS:The two groups were comparable with regard to patient characteristics, intraoperative drug use, and surgical time. Significantly more patients in the Placebo group (PL) required analgesics for postoperative pain (22/27, 82%) than patients in the Lavender group (LAV) (12/26, 46%) (P = .007). Moreover, the LAV patients required significantly less morphine postoperatively than PL patients: 2.38 mg vs 4.26 mg, respectively (P = .04). There were no differences in the requirements for post-operative antiemetics, antihypertensives, or PACU discharge time.CONCLUSIONS:Our results suggest that lavender aromatherapy can be used to reduce the demand for opioids in the immediate postoperative period. Further studies are required to assess the effect of this therapy on clinically meaningful outcomes, such as the incidence of respiratory complications, delayed gastric emptying, length of hospital stay, or whether this therapy is applicable to other operations.

El síndrome de Rett (SR) es un trastorno neurológico que afecta principalmente a las mujeres. Se caracteriza por un retraso mental severo después de un periodo de desarrollo aparentemente normal en la infancia temprana. Las principales características incluyen autismo, espasticidad, microcefalia, escoliosis, estereotipias, control anormal de la respiración y convulsiones. Se ha notificado que son muy sensibles a sedantes y tienen una lenta recuperación luego de una anestesia. Nosotros describimos y discutimos el manejo anestésico de una mujer de 26 años con SR y fractura distal del húmero, tratada con reducción y fijación con agujas de Kirschner bajo anestesia regional y sedación; quien tuvo depresión respiratoria luego de administrar 1 mg de midazolam i.v. intraoperatorio. Nuestra experiencia con este caso nos hace concluir y sugerir que no se deben usar benzodiacepinas en SR, y si no existe contraindicación, la anestesia regional es la técnica de elección.Rett Syndrome (RS) is a neurological disorder that almost exclusively affects females. RS is characterized by severe mental retardation following a period of apparent normal development in early childhood. The main clinical features include autism, spasticity, microcephaly, scoliosis, stereotyping, abnormal respiratory control and seizures. Patients with RS have been reported to be extremely sensitive to sedatives and exhibit a slow recovery from anesthesia. We describe and discuss the anesthetic management of a 26-year-old woman with RS and distal fracture of the humerus that underwent reduction and fixation with Kirschner'swires under regional anesthesia and sedation. Intraoperatively, the patient experienced respiratory depression following the administration of 1 mg of I.V. midazolam. Our experience in this case led us to conclude and suggest that benzodiazepines should not be used in RS and in the absence of contraindications the technique of choice should be regional anesthesia.

This study compared the analgesic efficacy of postoperative lavender oil aromatherapy in 50 patients undergoing breast biopsy surgery. Twenty-five patients received supplemental oxygen through a face mask with two drops of 2% lavender oil postoperatively. The remainder of the patients received supplemental oxygen through a face mask with no lavender oil. Outcome variables included pain scores (a numeric rating scale from 0 to 10) at 5, 30, and 60 minutes postoperatively, narcotic requirements in the postanesthesia care unit (PACU), patient satisfaction with pain control, as well as time to discharge from the PACU. There were no significant differences in narcotic requirements and recovery room discharge times between the two groups. Postoperative lavender oil aromatherapy did not significantly affect pain scores. However, patients in the lavender group reported a higher satisfaction rate with pain control than patients in the control group (P = 0.0001).

Study Objective: The aim of this study was to compare the analgesic efficacy of premedication with rofecoxib vs intravenous (IV) ketorolac in reducing postoperative pain after arthroscopic knee surgery.Study Design: This is a prospective, randomized, double-blinded study.Setting: This study was set at a university hospital.Subjects: The subjects include 54 patients with American Society of Anesthesiologists physical statuses I, II, and III undergoing knee arthroscopy.Interventions: Group 1 received 50 mg oral rofecoxib preoperatively with IV placebo injection, which was administered 20 minutes before the end of the operation. Group 2 received a preoperative placebo and 30 mg IV ketorolac 20 minutes before the end of surgery.Measurements: The primary outcome measure was the proportion of patients reporting pain in the postoperative anesthesia care unit, 6 hours and 24 hours after discharge. Additional end points included the use of 5:325 mg oxycodone-acetaminophen (O/A) tablets, pain scores, patient's satisfaction survey, and comparison of side effects. Data were analyzed using independent samples t tests for continuous variables or chi(2) tests for categorical variables. P <.05 was considered significant.Results: The 2 groups were comparable with regard to patient characteristics, intraoperative medication use, and duration of surgery. There was no difference either in pain scores or O/A use in the postoperative anesthesia care unit. At 24 hours after discharge, significantly more patients in the ketorolac group (91%) reported pain than the rofecoxib group (63%) (P =.02). Sixty-one percent of patients in the ketorolac group used O/A during the first 24 hours vs 38% in the rofecoxib group. The difference, however, was not statistically significant.Conclusion: Preoperative rofecoxib is as effective as ketorolac for the treatment of pain after knee arthroscopy. Higher frequency of pain reporting at 24 hours by patients in ketorolac group is explained by the longer analgesic effect of rofecoxib. Future studies should directly compare gastrointestinal injury of these drugs, as well as cost-effectiveness of rofecoxib vs ketorolac. (c) 2005 Elsevier Inc. All rights reserved.