OBJECTIVES: To investigate the therapeutic effect of cranial electrotherapy stimulation (CES) with sleep hygiene in patients with chronic insomnia. METHODS: This study was designed as a prospective, double-blinded, and randomized controlled trial. Twenty-seven patients with chronic insomnia were recruited and randomly allocated to two groups; cranial microcurrent therapy (MC) group and sham group. All patients received sleep hygiene education. Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were measured at baseline (pre-treatment), and 2 weeks and 4 weeks of treatment. RESULTS: In MC group, the PSQI and ISI showed a tendency to decrease consistently until 4 weeks of treatment. In sham group, PSQI and ISI initially decreased during the first 2 weeks, but it increased after 2 weeks of treatment. CONCLUSIONS: This study showed that combination treatment of CES and sleep hygiene is more effective in treating chronic insomnia than sleep hygiene only as demonstrated by improvement and maintenance of sleep score for 1 month.
Education ; Electric Stimulation Therapy ; Humans ; Hygiene ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

Since the occlusal loading is transmitted to the surrounding bone, the success of an implant treatment is closely related to the distribution of the stress on the implant. The finite element analysis method is often used in order to produce a model for dispersion of stress. Assessment of the success of the implant is usually based on the degree of osseointegration which is a bone and implant surface interface. Implant used in this research was designed through the method of shape optimization after the stress on implant was anaylzed by the finite element analysis method. This study was pertinently assessed by a clinical, histologic, histomorphometric analysis after the shape optimized implant was installed on beagle dog tibia. The results are as follows 1. It clinically showed a good result without mobility and imflammatory reaction. 2. Implant was supported by dense bone and bone remodeling showed on the surrounding area of the implant 3. The average percentage of bone-implant contact was 58.1%.The percentage of bone density was 57.6%. Having above results, shape optimized implant showed the pertinence through clinical and histologic aspects. However, to use the shape optimized implant, the further experiment is required for finding problems, improvement.
Animals ; Bone Density ; Bone Remodeling ; Dogs ; Finite Element Analysis ; Osseointegration ; Tibia

PURPOSE: To assess the suitability of multidetector row CT angiogram (MDCTA) as the sole preoperative imaging for infrainguinal arterial surgery. METHOD: From March 2002 to September 2003, 75 patients (24 claudicants, 41 limb-threatening ischemia) were studied with MDCTA preoperatively. We compared the surgical inflow and outflow site changes between preoperative planning based on MDCTA and the results of final operation. MDCTA was interpreted by the same vascular surgeon, and arterial segments from the renal artery to foot were reviewed. Surgery plans were formulated based on arterial anatomic and hemodynamic characteristics. Additional diagnostic value and test related complications were also studied. RESULT: Twenty- one patients had conventional angiogram after MDCTA scan - 9 for interventional treatment at inflow site and 12 patients for complement of MDCTA, although the operation plan was not changed. The agreement between preoperative plan based on MDCTA and final operation was 100% even in critical limb ischemia. In 11 patients tortuous calcified iliac artery was ambiguous in routine image but it could be solved using the other specific functional option of MDCTA. There were no serious complications related to the test. CONCLUSION: These findings suggest that MDCTA is an adequate preoperative imaging study of infrainguinal arterial surgery and that it may be substituted for conventional angiogram without any serious complication. The particular functional options of MDCTA help resolve its defect.
Complement System Proteins ; Extremities ; Foot ; Hemodynamics ; Humans ; Iliac Artery ; Ischemia ; Renal Artery

PURPOSE: To determine the activity and the toxicity associated with a low dose regimen of leucovorin (LV) plus 5-fluorouracil (5-FU) combined with oxaliplatin every two weeks (modified FOLFOX 4) as a salvage therapy for advanced gastric cancer patients. MATERIALS AND METHODS: Between December 2003 and December 2004, 33 patients were enrolled in this study. The patients were treated with oxaliplatin 85 mg/m2 as a 2-hour infusion on the first day plus LV 20 mg/m2 over 10 minutes. Subsequently, the patients were given a 5-FU bolus 400 mg/m2 followed by a 22-hour continuous infusion of 600 mg/m2 on days 1~2. The treatment was repeated at 2 week intervals. RESULTS: The median age of the patients was 50 years (range: 31~74), 82% (27/33) had the Eastern Cooperative Oncology Group performance status was 0 and 1. Of the 30 patients who could be evaluated for their tumor response, 8 achieved a partial response, with an overall response rate of 26.7% (95% confidence interval (CI): 20.5~32.7%). Fifteen patients (50%) showed stable disease and 7 patients (23.3%) progressed during the course of treatment. The median time from the start of chemotherapy to progression was 3.5 months (95% CI: 2.6~4.4 months) and the median overall survival time was 7.9 months (95% CI: 5.9~9.9 months). The major grade 3/4 hematological toxicity encountered included neutropenia (45.4%) and thrombocytopenia (3.0%). Neutropenic fever occurred during only 2 of the 178 cycles. The most common non-hematological toxicity encountered was grade 1/2 nausea/vomiting, which occurred in 18.2% of patients, diarrhea in 12.1% and neuropathy in 15.2%. There were no treatment related deaths. CONCLUSIONS: The modified FOLFOX 4 regimen appears to be a safe and effective salvage therapy for advanced gastric cancer patients.
Diarrhea ; Drug Therapy ; Fever ; Fluorouracil* ; Humans ; Leucovorin* ; Neutropenia ; Salvage Therapy* ; Stomach Neoplasms* ; Thrombocytopenia

Laparoscopic splenectomy (LS) has become the treatment of choice for patients with idiopathic thrombocytopenic purpura (ITP) who do not respond to medical treatment. The aim of this study was to identify factors predictive of outcome after LS for ITP. From May 1997 to December 2002, we performed 30 LS on patients with ITP. A positive response was defined as a postoperative platelet count greater than 50,000/microliter and no requirement for maintenance therapy. Chi-square testing was performed to determine the predictive effects of the following variables: age, sex, preoperative response to steroids or immunoglobulin, duration of disease, antiplatelet antibody, platelet associated antibody, and antinuclear antibody. LS was successfully performed in all patients. For a mean follow-up interval of 24.3 months, response to LS was 73.3%. Splenectomy for steroid nonresponders resulted in an inferior complete response rate (10 of 18, 55.6%) as compared with those that experienced relapse after steroid treatment (11 of 12, 91.7%) (p=0.042). The other significant predictor of outcome by univariate analysis was the time between diagnosis and surgery (p=0.049). The other variables showed no significant correlation with successful splenectomy. We conclude that LS can be performed safely with a satisfactory remission rate in patients with ITP who do not respond to medical treatment, and that the factors most frequently associated with surgical success are a response to steroid and disease duration.
Adolescent ; Adult ; Aged ; Analysis of Variance ; Chi-Square Distribution ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Platelet Count ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic/*surgery ; Splenectomy/*methods ; Time Factors ; Treatment Outcome

The auricle, which has a subtle structure, is an element that conveys signs of age or sex and decides the facial characteristic. The anatomy of the auricle differs in each individual as well as in each race. Therefore, the anatomy of the auricle can be useful for physical anthropologist to classify the race of a person or for a forensic anthropologist to identify the body of dead person. Also, a standard measurement of a normal ear is required for plastic surgeons to reconstruct an ear or artists to express the ear. Studies on the auricle of Caucasians and Koreans have been reported. However, further study on the classification of the location and shape of the auricle is necessary. The authors investigated the metric and non-metric characteristics to obtain basic data that display physical anthropologic features. Seven hundreds and thirty three Koreans under 39 years old and over 18 years old were examined. Metric items investigated were the length of the auricle, width of the auricle, morphological width of the ear, physiognomic ear length, physiognomic ear breadth, morphologic ear breadth, length of the ear cartilage, length of the ear lobule, and the height of the tragus. Non-metric items investigated were the location of the ear, shape of the helix and antihelix, and the attaching shape of the lobule. According to the metric results, all measured values were significantly greater in males than females, and there was a sexual difference except the width of the auricle, length of the ear lobule, and the height of the tragus. In non-metric results of the auricle, cases where the superaurale was located at the upper area of the eyebrow line and cases where the superaurale was between the eyebrow line and the upper eyelid showed similar rates among males. However, in 87.5% of the female group, the superaurale was located between the eyebrow line and the upper eyelid. The major shape of the helix were oval type (32.6%) and quadrilateral type (30.5%) in males, but oval type (32.7%) and triangular type (33.0%) in females. We believe that the data obtained in this study have generated standard measurements for ear reconstruction and can be used as basic data that show physical anthropologic characteristics of the Korean auricle.
Adolescent ; Adult ; Anthropology ; Classification ; Continental Population Groups ; Ear ; Ear Cartilage ; Eyebrows ; Eyelids ; Female ; Head ; Humans ; Male ; Young Adult*

PURPOSE: The matrix metalloproteinases (MMPs) are a family of proteolytic enzymes. MMPs are known to be involved in tumor invasion, and several have been implicated in tumor prognosis. The aim of this study was to evaluate the prognostic significances of the expressions of MMP-7 and -9 in rectal cancer. MATERIALS AND METHODS: The tumor tissues of 87 patients with stage II or III rectal carcinoma that underwent potentially curative resection followed by postoperative adjuvant chemoradiation and 5-fluorouracil based chemotherapy, were investigated immunohistochemically using monoclonal antibodies against MMP-7 and MMP-9. Clinical information, including tumor grades, carcinoembryonic antigen (CEA) levels, and disease-free survival and overall survival were evaluated with respect to the expressions of MMP-7 and -9. RESULTS: Median follow-up duration was 53.2 months, and median patient age was 55+/-11 years (range 32~75). MMP-7 expression in tumor tissue was found to be significantly correlated with the presence of nodal metastasis (p=0.029), whilst MMP-9 expression correlated with depth of tumor invasion (p=0.019). No relatio- nships were found between the expressions of MMP-7 or -9 and age, sex, tumor size, tumor grade, or CEA level. Univariate analysis showed that MMP-7 expression was associated with poor 5-year overall survival (12.8 months vs. 65.3 months, p=0.0405). Multivariate analysis confirmed that MMP-7 was independently associated with an adverse outcome (Relative risk: 1.415, p=0.027). However, MMP-9 expression was not found to be related to clinical outcome. CONCLUSION: MMP-7 expression in tumor tissue is associated with lymph node metastasis and a poor 5-year overall survival in rectal cancer patients.
Antibodies, Monoclonal ; Carcinoembryonic Antigen ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Matrix Metalloproteinase 7* ; Matrix Metalloproteinases ; Multivariate Analysis ; Neoplasm Metastasis ; Peptide Hydrolases ; Prognosis ; Rectal Neoplasms*

PURPOSE: Testosterone replacement therapy is an effective treatment for late-onset hypogonadism (LOH) despite a few contraindications and side-effects. The aim of this study was to determine whether modified Ojayeonjonghwan (KH-204, Korean herbal formula) improved LOH. KH-204 is a strong antioxidant herbal formula. We evaluated the effect of Korean herbal prescription on androgen receptor (AR) expression in an aged rat model of LOH. MATERIALS AND METHODS: Eighteen-month-old rats were used as aged LOH rat models. Eighteen Sprague-Dawley rats were randomly divided into three equal groups of six animals each and treated with one of the following: 1) normal control group (oral administration with distilled water, n=6), 2) KH-204 200 group (oral administration with 200 mg/kg of KH-204, n=6), and 3) KH-204 400 group (oral administration with 400 mg/kg of KH-204, n=6). After four weeks of treatment (once daily, distilled water or KH-204), serum testosterone levels, changes in testicular and epididymal weight, Western blotting analysis of AR expression and measurement of oxidative stress were examined. RESULTS: Treatment with the herbal formulation KH-204 200 mg/kg and 400 mg/kg (1) increased the weights of testis and epididymis; (2) increased the level of serum testosterone; (3) increased the level of superoxide dismutase and reduced the level of 8-hydroxy-20-deoxyguanosine; and (4) upregulated AR expression in testicular tissue. CONCLUSIONS: KH-204 might be an effective alternative for LOH. It improves antioxidant mechanisms and increases testicular AR expression without side-effects.
Aging* ; Animals ; Blotting, Western ; Epididymis ; Hypogonadism* ; Male ; Models, Animal* ; Oxidative Stress ; Phytotherapy ; Prescriptions ; Rats* ; Rats, Sprague-Dawley ; Receptors, Androgen* ; Superoxide Dismutase ; Testis ; Testosterone ; Water ; Weights and Measures