OBJECTIVES: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. METHODS: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. RESULTS: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. CONCLUSIONS: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Adolescent ; Adult ; Aggression ; Anxiety ; Checklist ; Depression ; Humans ; Internet ; Logistic Models ; Mass Screening ; Parents ; Risk Factors ; Risk-Taking ; Suicide ; Violence

Three cases of intestinal lipoma near the ileocecal valve are described. In patients of cecal and ileocecal valve lipoma, they had right lower quadrant abdominal pain secondary to partial intestinal obstruction. In rarely developed segmental lipomatosis of the ileum, the patient had right abdominal mass and pain to fecal impaction of the diverticula. Diagnosis may be made by an abnormal roentgenographic pattern and confirmed by colonoscopy. Surgical removal of the affected segment results in cure in symptomatic patients.
Abdominal Pain ; Colonoscopy ; Diagnosis ; Diverticulum ; Fecal Impaction ; Humans ; Ileocecal Valve ; Ileum ; Intestinal Obstruction ; Lipoma* ; Lipomatosis

OBJECTIVES: We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. METHODS: 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. RESULTS: 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. CONCLUSIONS: In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.
Comorbidity ; Delivery of Health Care ; Depression ; Female ; Humans ; Korea ; Life Style ; Logistic Models ; Mass Screening ; Mental Health ; Questionnaires ; Risk Factors ; Smoke ; Smoking

Tunica albuginea cyst is a rare disease and the most of which are benign lesion unlike most testicular mass. We report a 65-year-old man was admitted with testicular pain, tenderness and palpable mass. Preoperative ultrasonography demonstrated well marginated, cystic lesion in right testis, about 2.0 x 2.8 x 3.3 cm in size with partially thin walls. Orchiectomy was done and diagnosis was made by patho-histologic findings.
Aged ; Diagnosis ; Humans ; Orchiectomy ; Rare Diseases ; Testis ; Ultrasonography

Purple urine bag syndrome (PUBS) was first reported in 1978, and is a rare phenomenon in which purple staining of the bags occurs, with a violet discoloration of the plastic of the catheter bag due to fine blue crystals of indigo in the urine. PUBS occurs predominantly in chronically catheterized constipated women, and is associated with urinary tract infections due to bacteria that produce sulphatase/phosphatase. A 70-year old male patient, who as used a suprapubic cystocatheter for almost 12 months, due to acute urinary retention, visited to our department with a purple colored urine bag. PUBS has previously been reported to be observed mostly in female patients. Herein, we report a rare case of PUBS in male patient.
Aged ; Bacteria ; Catheters ; Female ; Humans ; Indigo Carmine ; Male* ; Plastics ; Urinary Retention ; Urinary Tract Infections ; Viola

PURPOSE: To prospectively evaluate the clinical results of iris-fixed phakic intraocular lens (IOL) implantation (Artisan(R) implantation) in patients with high myopia. METHODS: Eighteen eyes of 10 patients underwent Artisan(R) implantation between December 2001 and February 2003 and were followed up for more than 6 months. The study prospectively analyzed the efficacy, safety and predictability of Artisan(R) implantation based on visual acuity and refractive errors. RESULTS: The preoperative mean uncorrected visual acuity (UCVA) was 0.02, and mean spherical equivalent refraction was -9.98D. Postoperative uncorrected vision was more than 0.5 in 83.3% of the eyes at 1 month and in 100% after 3 months. Also it was more than 0.9 in 22.2% of the eyes at 1 month, in 50.0% at 3 months and in 88.9% at 6 months. The spherical equivalent refraction after surgery was within 0.5D of emmetropia in 77.8% of eyes at 1 month, in 94.4% at 3 months and in 100% at 6 months. Also it was within 1.0D of emmetropia in 94.4% at 1 month and in 100% after 3 months. Complications included temporary glare or halo in 3 eyes, transient elevation of intraocular pressure in 1 eye, and decentration of IOL due to incomplete iris-fixation in 1 eye. CONCLUSIONS: Because of its good visual results and rare complications, the Artisan(R) implantation may be an effective surgical procedure for patients who cannot undergo laser in situ keratomileusis (LASIK).
Emmetropia ; Glare ; Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ ; Myopia ; Phakic Intraocular Lenses ; Prospective Studies ; Refractive Errors ; Visual Acuity

Acute peripheral vestibulopathy, of which the chief complaint is positional vertigo, comprises benign paroxysmal positional vertigo (BPPV), labyrinthitis, labyrinthine fistula, and cerebellopontine angle tumors. Since the typical presentation of labyrinthine fistulas may be sensorineural hearing loss, positional vertigo, or disequilibrium, it is often difficult to distinguish from BPPV or Meniere's disease. Herein we report a 61-year-old female patient with typical symptoms and signs attributable to geotropic type variant of the lateral semicircular canal BPPV on the left side, who eventually was confirmed as having a labyrinthine fistula from chronic otitis media with cholesteatoma on the left side. This is another case where, even in the presence of isolated vertigo showing typical findings of acute peripheral vestibulopathy, other otologic symptoms and signs must not be overlooked.
Cholesteatoma* ; Ear, Inner ; Female ; Fistula* ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Meniere Disease ; Middle Aged ; Neuroma, Acoustic ; Otitis Media ; Semicircular Canals ; Vertigo* ; Vestibular Neuronitis

Pseudo-vestibular neuritis is a central pathology of acute vestibular syndrome, characterized by unidirectional nystagmus mimicking acute peripheral vestibulophaty. We report a 39-year-old female patient who developed cerebellar infarction with isolated vertigo, spontaneous nystagmus, a positive head thrust test, and unilateral canal paresis in the contralesional side. The patient had no vascular risk factors. A diffusion-weighted image of the brain showed infarction of medial branch of posterior inferior and superior cerebellar artery on the left side. A magnetic resonance angiography of neck disclosed a wide range of diffused severe stenosis and narrowing of right and left vertebral arteries, respectively. This case suggests the possibility of vestibular ischemia masking the central pathology in isolated vertigo.
Adult ; Arteries ; Brain ; Constriction, Pathologic ; Embolism ; Female ; Head Impulse Test ; Humans ; Infarction ; Ischemia ; Magnetic Resonance Angiography ; Masks ; Neck ; Neuritis* ; Nystagmus, Pathologic ; Paresis* ; Pathology ; Risk Factors ; Vertebral Artery ; Vertebral Artery Dissection* ; Vertigo ; Vestibular Neuronitis

OBJECTIVE: To examine if amniotic fluid (AF) monocyte chemotactic protein-1 (MCP-1) concentrations are useful in the identification of intrauterine infection and pregnancy outcomes in preterm labor with intact membranes. METHODS: The study population consists of 65 patients who received amniocentesis for preterm labor with intact membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. MCP-1 was determined by a sensitive and specific immunoassay. Fisher's exact test, Mann-Whitney U test, receiver operating characteristic curve, survival techniques, logistic regression, and Spearman correlation were used for statistical analysis. RESULTS: (1) Patients with a positive amniotic fluid culture had a significantly higher median AF MCP-1 concentration than those with negative results (median, 9.0 ng/mL; range, 0.45-40.5 ng/mL; vs median, 0.82 ng/mL; range, 0.06-30.1 ng/mL; P<.01). (2) Patients with AF MCP-1 concentration of >1.9 ng/mL had a significantly shorter median interval to delivery, the higher rate of histologic chorioamnionitis, preterm delivery within 2 and 5 days, and the occurrence of congenital proven or suspected sepsis than did those with AF MCP-1 concentration of <1.9 ng/mL after adjustment for gestational age (P<.05). (3) There was strong correlation between AF MCP-1 concentrations and AF interleukin-6 concentrations (r=.881, P<.001). CONCLUSION: AF MCP-1 determinations are useful in the identification of intrauterine infection, preterm delivery, and neonatal infectious complication in preterm labor with intact membranes.
Amniocentesis ; Amniotic Fluid* ; Bacteria, Anaerobic ; Chemokine CCL2* ; Chorioamnionitis ; Female ; Gestational Age ; Humans ; Immunoassay ; Interleukin-6 ; Logistic Models ; Membranes ; Monocytes* ; Mycoplasma ; Obstetric Labor, Premature* ; Pregnancy ; Pregnancy Outcome ; ROC Curve ; Sepsis

OBJECTIVE: We undertook this study to find out clinical characteristics and prognostic factors of neonatal survival in nonimmune hydrops fetalis (NIHF). METHODS: From Oct. 1988 to Feb. 2001, 54 cases of nonimmune hydrops fetalis diagnosed at Seoul National University Hospital (SNUH) were included in our study. The incidence and perinatal mortality were investigated. The diagnostic work-up for associated conditions (or etiology) included detailed ultrasonography, karyotyping, fetal echocardiography, infection work-up (TORCH, parvovirus), and autopsy (if fetus was dead). Among 54 cases, 20 cases of liveborns were divided into two groups. Group I survived beyond neonatal period (survived>28 days) and group II did not (expired3 (OR=21, CI 1.77, 248.1; p<0.05), and 5-min AS>3 (p<0.01). CONCLUSION: Over 3 of 1-min and 5-min AS were meaningful factors for neonatal survival in NIHF.
Apgar Score ; Autopsy ; Echocardiography ; Female ; Fetofetal Transfusion ; Fetus ; Gestational Age ; Hydrops Fetalis* ; Incidence ; Karyotyping ; Parturition ; Perinatal Mortality ; Pleural Effusion ; Polyhydramnios ; Pregnancy ; Seoul ; Ultrasonography