OBJECTIVES: "Internet-addiction" came into common use not only in clinical setting but also in everyday life. But, pathophysiology and diagnostic criteria of the internet addiction remain unknown. Because adolescents are in developing period, they might be vulnerable to the internet addiction, depression and sleep-related problem. The objectives of this study were to investigate the characteristics of internet addiction and its association with sleep pattern and depression in Korean adolescence. METHODS: Subjects were 799 middle and high school students in Seoul, Korea. We administered a self-reported questionnaire including socio-demographic data, Korean versions of Young's Internet Addiction Scale (YIAS), Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies for Depression Scale (CES-D) and questions about internet using patterns. Data of 696 subjects were included in analysis. Chi-square tests were used to analyze proportional differences, and ANOVA with post-hoc tests were used to analyze differences among groups. Partial correlation analyses were performed to analyze the correlation of internet addiction with other variables (two-tailed, p<0.05). RESULTS: Of the 696 participants (grade 2 of middle school;M2 135 vs. grade 1 of high school;H1 238 vs. grade 2 of high school;H2 323), 2.0% (n=14) were internet-addicted (IA), 27.7% (n=193) were over-using (OU) and 70.3% (n=489) were not-addicted (NA). The mean scores of YIAS, PSQI and CES-D scores were 35.24+/-12.78, 5.53+/-3.04 and 16.72+/-8.69, respectively. In higher grade students, average total sleep time was shorter (M2 426.20+/-67.68 min. vs. H1 380.47+/-62.57 min. vs. H2 354.67+/-73.37 min., F=51.909, p<0.001), and PSQI (4.69+/-3.14 vs. 5.42+/-3.15 vs. 5.97+/-2.83, F=8.871, p<0.001) CES-D (13.53+/-8.37 vs. 16.96+/-8.24 vs. 17.87+/-8.84, F=12.373, p<0.001) scores were higher than those of lower grade students. Comparing variables among IA, OU and NA groups, computer using time not for study (96.36+/-63.31 min. vs. 134.92+/-86.79 min. vs. 213.57+/-136.87 min., F=34.287, p<0.001) and portable device using time not for study (84.22+/-79.11 min. vs. 96.97+/-91.89 min. vs. 152.31+/- 93.64 min., F=5.400, p=0.005) were different among groups. PSQI (5.26+/-2.97 vs. 6.08+/-2.97 vs. 7.50+/-4.41, F=8.218, p<0.001) and CES-D scores (15.40+/-8.08 vs. 19.05+/-8.42 vs. 30.43+/-13.69, F=32.692, p<0.001) were also different among groups. YIAS score were correlated with computer using time not for study (r=0.356, p<0.001) and portable device using time not for study (r=0.136, p<0.001). PSQI score (r=0.237, p<0.001) and CES-D score (r=0.332, p<0.001). YIAS score and PSQI score (r=0.131, p=0.001), YIAS and CES-D score (r=0.265, p<0.001), PSQI score and CES-D score (r=0.357, p<0.001) were correlated each other. CONCLUSION: These results suggested that adolescents' internet-addiction was correlated with not only computer and portable device using time not for study but also depression and sleep-related problems. We should pay attention to depression and sleep-related problems, when evaluating internet-addiction in adolescents.
Adolescent ; Depression ; Epidemiologic Studies ; Humans ; Internet ; Korea ; Porphyrins ; Surveys and Questionnaires

OBJECTIVE: The aim of this study is to evaluate the clinical usefulness of cervicogram as primary screening test of cervical intraepithelial neoplasia. METHODS: Total 294 women who had undergone cervicogram and pathologically diagnosed at YUMC between January and July 2003, were selected. Diagnostic accuracy of Pap smear, cervicogram and Pap smear combined with cervicogram were compared with pathologic diagnosis. Statistical analysis was performed by chi-square test (SPSS version 11.0). RESULTS: 1. Among 294 women, Pap smears were normal in 130 cases (44.2%) and abnormal in 164 cases (55.8%). The diagnostic accuracy between Pap smear and histology was as follows; sensitivity 72.0%, specificity 64.6%, positive predictive value 72.0%, negative predictive value 64.6%, false positive rate 28.0%, false negative rate 35.4%. 2. Cervicogram were normal in 202 cases (68.7%) and abnormal in 92 cases (31.3%). The diagnostic accuracy between cervicogram and histology was as follows; sensitivity 39.6%, specificity 79.2%, positive predictive value 70.7%, negative predictive value 31.0%, false positive rate 29.3%, false negative rate 49.0%. 3. Among 130 women with normal Pap smear, cervicogram were normal in 101 cases (77.7%) and abnormal in 29 cases (22.3%). The diagnostic accuracy between cervicogram with normal Pap smear and histology was as follows; sensitivity 26.1%, specificity 79.8%, positive predictive value 41.4%, negative predictive value 66.3%, false positive rate 58.6%, false negative rate 33.7%. 4. Among 164 women with abnormal Pap smear, Cervicograms were normal in 101 cases (61.6%) and abnormal in 63 cases (38.4%). The diagnostic accuracy between cervicogram with abnormal Pap smear and histology was as follows; sensitivity 44.9%, specificity 78.3%, positive predictive value 84.1%, negative predictive value 32.7%, false positive rate 15.9%, false negative rate 67.3%. CONCLUSION: Although adjunctive use of cervicogram to Pap smear in initial screening of cervical intraepithelial neoplasia showed higher specificity, higher negative predictive value and lower false negative rate compared to Pap smear alone, but, consideration in terms of lower sensitivity, lower positive predictive value, higher false positive rate and cost-effectiveness should be given in lieu of clinically applicating cervicogram with Pap smear as initial screening test.
Cervical Intraepithelial Neoplasia* ; Diagnosis ; Female ; Humans ; Mass Screening* ; Sensitivity and Specificity

OBJECTIVES: People at ultra-high risk for psychosis have heterogenous character and different long-term outcomes. We divided ultra-high risk subjects into two subgroups by presence of familial history and tried to find different pattern of functional connectivity of the default mode network (DMN) between the two groups in order to examine the effects familial loading. METHODS: Eleven subjects at clinical-high risk (CHR) group with familial history of psychiatric illness and nineteen subjects of CHR group without familial history were recruited. All the subjects were scanned using resting-state functional magnetic resonance imaging. A posterior cingulate cortex was the seed region of the analysis, and the DMN of the both high risk group were analyzed with voxel-wise two sample T test. RESULTS: The CHR group with familial history showed greater functional connectivity in the precuneus area in contrast with the other high risk subjects (peak-level t=5.49, p<0.001). There were no significant differences in total score on the Positive and Negative Syndrome Scale and Scales of Psychosis-risk Syndrome between the two groups. CONCLUSION: The study suggests that the abnormalities of functional connectivity between precuneus and posterior cingulate area may be associated with the genetic vulnerability of high risk trait.
Gyrus Cinguli ; Magnetic Resonance Imaging ; Pilot Projects ; Psychotic Disorders ; Seeds ; Weights and Measures

The purpose of this study was to evaluate on nutrient intake status and diet quality of middle and old aged vegetarian women in Korea. The research group was composed of vegetarian women (n = 91), all of them were Seven Day Adventists, who had been on vegetarian diets, over 20 yrs. Their anthropometric measurements, dietary intakes, and diet quality indices were compared to omnivores (n = 122). The average age of vegetarians and omnivores were 61.8 yrs and 60.3 yrs, respectively. The mean daily energy intakes of vegetarians and omnivores were 1428.8 kcal and 1424.5 kcal, respectively and there was no significant difference. The vegetarians consumed significantly lower intakes of protein (p<0.05), zinc (p<0.001) and vitamin B2 (p<0.05) compared to omnivores. In the diet quality, zinc and vitamin B2 nutrient adequacy ratio (NAR) of vegetarians were significantly lower than those of omnivores. Mean adequacy ratio (MAR) of vegetarians and omnivores were 0.80 and 0.77, respectively and there was no significant difference. The KDDS (Korean's Dietary Diversity Score) of vegetarians and omnivores were 3.7 and 4.0, respectively, and there was significant difference (p<0.01). The KDQI (Korean's Diet Quality Index) of vegetarians (1.5) was significantly lower than that (2.1) of omnivores (p<0.001). In conclusion, vegetarian women have low intake status of protein, zinc and vitamin B2, and partly low diet quality. Therefore it was needed that well planed diets to replace the nutrients supplied from excluded food groups in middle and old aged vegetarian women.
Diet* ; Diet, Vegetarian ; Female ; Humans ; Korea* ; Riboflavin ; Zinc

Malignant mixed mullerain tumors (MMMT) are rare neoplasms of the female genital tract that histolotically consist of malignant epithelial and stromal components, arising in the endometirum, followed in decreasing order by the vagina, cervix, and ovary. Tubal origin is extremely rare and accounts for less than 4% of all MMMTs. Most of the patients present with nonspecific abdominal pain or abnormal vaginal bleeding. Nonspecific findings on imaging studies also make exact preoperative diagnosis very difficult, mostly mistaken as ovarian malignancies. The primary goal of treatment is removal of tumor mass by cytoreductive surgery. Postoperatively, chemotherapy or radiotherapy is added, but prognosis is very poor. The best form of postoperative adjuvant therapy is not yet established due to the rarity of this disease entity. We report a case of a malignant mixed mullerian tumor of the fallopian tube that we have experienced recently with a brief review of the literature.
Abdominal Pain ; Cervix Uteri ; Diagnosis ; Drug Therapy ; Fallopian Tubes* ; Female ; Humans ; Ovary ; Prognosis ; Radiotherapy ; Uterine Hemorrhage ; Vagina

OBJECTIVE: To examine the cardiorespiratory responses of patients with spinal cord injury (SCI) paraplegia using a motor driven rowing machine. METHOD: Ten SCI patients with paraplegia [A (n=6), B (n=1), and C (n=3) by the American Spinal Injury Association impairment scale] were selected. Two rowing techniques were used. The first used a fixed seat with rowing achieved using only upper extremity movement (fixed rowing). The second used an automatically moving seat, facilitating active upper extremity movement and passive lower extremity movement via the motorized seat (motor rowing). Each patient performed two randomly assigned rowing exercise stress tests 1-3 days apart. The work rate (WR), time, respiratory exchange ratio (R), oxygen consumption (VO2), heart rate (HR), metabolic equivalents (METs), and rating of perceived exertion (RPE) were recorded. RESULTS: WR, time, VO2, and METs were significantly higher after the motor rowing test than after fixed motor rowing test (p<0.05). HR after motor rowing was significantly lower than fixed rowing (p<0.05). CONCLUSION: Cardiorespiratory responses as VO2, HR and METs can be elicited by the motor rowing for people with paraplegic SCI.
Electric Stimulation ; Exercise Test ; Heart Rate ; Humans ; Lower Extremity ; Metabolic Equivalent ; Oxygen Consumption ; Paraplegia ; Spinal Cord Injuries ; Spinal Injuries ; Upper Extremity

PURPOSE: To describe the prevalence and severity of postneonatal epilepsy after neonatal seizures in term neonates as well as to evaluate the predictive factors of postneonatal epilepsy. METHODS: Retrospective analysis of 50 children who experienced neonatal seizures. In children with at least 12 months of follow-up data, the univariate and multivariate logistic regression analysis was applied in order to determine the predictive factors of postneonatal epilepsy. Electroencephalography (EEG), neuroimaging studies, and other clinical variables were systematically analyzed. Infants with abnormal EEG recordings in the initial studies underwent a follow-up EEG examination at 1 or 3 months later. RESULTS: Twelve of 50 neonates with neonatal seizures (24%) developed postneonatal epilepsy. Seventy-five percent (9 of 12) of the children with postneonatal epilepsy were eventually seizure-free without AED (antiepileptic drug), and 25% (3 of 12) had seizures at the last follow-up (modified angel classification 2 or 3, mean follow-up period; 52 months). On the univariate logistic regression analysis, abnormal EEG, Magnetic resonance imaging (MRI) findings, combined with encephalopathy and the number of AEDs were correlated with postneonatal epilepsy (P<0.05). On the multivariate analysis, the persistent abnormality on the follow-up EEG was correlated with postneonatal epilepsy (adjusted odds ratio=20.78; P=0.016). CONCLUSION: The number of intractable cases was relatively low, indicating good prognosis in postneonatal epilepsy. Abnormal EEG, MRI findings, combined with encephalopathy, and the number of AEDs were very good predictors of postneonatal epilepsy. The persistent abnormality in the follow-up EEG was more frequently seen in postneonatal epilepsy patients.
Child ; Classification ; Electroencephalography* ; Epilepsy* ; Follow-Up Studies* ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Magnetic Resonance Imaging ; Multivariate Analysis ; Neuroimaging ; Prevalence ; Prognosis ; Retrospective Studies ; Seizures

PURPOSE: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors??modification to overcome this problem, using artificial collagen membrane. METHODS: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. RESULTS: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. CONCLUSION: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.
Bandages ; Collagen ; Forehead ; Humans ; Membranes ; Membranes, Artificial ; Nose Deformities, Acquired ; Nylons ; Outpatients ; Silicones ; Skin ; Surgical Flaps ; Sutures ; Tissue Donors

PURPOSE: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors??modification to overcome this problem, using artificial collagen membrane. METHODS: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. RESULTS: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. CONCLUSION: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.
Bandages ; Collagen ; Forehead ; Humans ; Membranes ; Membranes, Artificial ; Nose Deformities, Acquired ; Nylons ; Outpatients ; Silicones ; Skin ; Surgical Flaps ; Sutures ; Tissue Donors

Background: It remains unclear whether a combination of glycemic variability and glycated hemoglobin (HbA1c) status leads to a higher incidence of cardiovascular disease (CVD).Therefore, to investigate CVD risk according to the glucose control status during early diabetes, we examined visit-to-visit HbA1c variability among patients with type 2 diabetes (T2DM). Methods: In this 9-year retrospective study, we measured HbA1c levels at each visit and tracked the change in HbA1c levels for 3 years after the first presentation (observation window) in newly diagnosed T2DM patients. We later assessed the occurrence of CVD in the last 3 years (target outcome window) of the study period after allowing a 3-year buffering window. The HbA1c variability score (HVS; divided into quartiles, HVS_Q1–4) was used to determine visit-to-visit HbA1c variability. Results: Among 4,817 enrolled T2DM patients, the mean HbA1c level was < 7% for the first 3 years. The group with the lowest HVS had the lowest rate of CVD (9.4%; 104/1,109 patients).The highest incidence of CVD of 26.7% (8/30 patients) was found in HVS [≥ 9.0%]_Q3, which was significantly higher than that in HVS [6.0–6.9%]_Q1 (P = 0.006), HVS [6.0–6.9%]_Q2 (P = 0.013), HVS [6.0–6.9%]_Q3 (P = 0.018), and HVS [7.0–7.9%]_Q3 (P = 0.040). Conclusion To our knowledge, this is the first long-term study to analyze the importance of both HbA1c change and visit-to-visit HbA1c variability during outpatient visits within the first 3 years. Lowering glucose levels during early diabetes may be more critical than reducing visit-to-visit HbA1c variability.