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

PURPOSE: To report the first case of Waardenburg syndrome type 4 in Korea. CASE SUMMARY: A 3-year-old boy visited our clinic to have his abnormal right eye iris color checked. The patient had a previous operation Hirschsprung's disease. In addition, his older sister and aunt showed similar ocular findings. A general physical examination, hearing test, and fundus examination were performed. On examination, hypochromic heterochromic iridum, albinism of the posterior pole upon ipsilateral fundus, and dystopia canthorum were found. There was no abnormal finding in the hearing test. CONCLUSIONS: The patient showed hypochromic heterochromic iridum, dystopia canthorum, and albinism of ipsilateral fundus. He also had a family history of Waardenburg syndrome and had surgery associated with congenital megacolon. The patient was diagnosed with Waardenburg syndrome type 4.
Albinism ; Child, Preschool ; Hearing Tests ; Hirschsprung Disease ; Humans ; Iris ; Korea ; Male ; Physical Examination ; Siblings ; Waardenburg Syndrome*

OBJECTIVE: The objective of this study were to clarify the significance of PCNA and DNA ploidy as a possible parameter of the prognosis in squamous cell carcinoma of the uterine cervix. STUDY DESIGN: Women with the diagnosis of cervical cancer operated between January 1987, and July 1991, composed the study group(n=35) in this case-control group. Among these 35 patients.In theese patients we chose the patients with complete follow up treatment. Also we employed 7 control paraffin-embedded cervical specimens without any specific pathologic lesions for the comparison. Immunohistochemical staining to identify PCNA was applied to case of paraffin section and PCNA indices was obtained. DNA analysis was done by using flow cytometry and S-phase fraction and DNA ploidy were obtained. RESULT: The results were summarized as follows. 1. S-phase fraction were 20+/-7% in cervical cancer and 16+/-11% in control group. There were no statistical difference. Aneuploid ratio were 26%(9/35) in cervical cancer and 0%(0/7) in control group. There were statistical difference. PCNA indices were 45+/-6% in cervical cancer and 5+/-4% in control group. There were statistical difference. 2. There were no statistical difference in PCNA indices between large cell keratinizing type, and large cell nonkratinizing type of cervical cancer. 3. According to lymph node metastasis, there were no statistical difference in PCNA indices between positive group and negative group.4. According with various pathologic parameters, recurrence rate was hihger in cases of parametrial involvement. 5. The correlation of coefficient was 0.747 between PCNA indices and S-phasd fraction that is a significant relationship.6. According to recurrence, there were no statistical difference in S-phase fraction, aneuploidy and PCNA indices between group of recurrence and no recurrence.7. There were no statistical difference between <20% group nad>20%, group of S-phase, aneuploid and <60%, group and >60%, group of PCNA index in view of recurrence rate. conclusion: That is a significant relationship between S-phase fraction and PCNA indices, But, there are no statictical significance of PCNA indices, DNA ploid and a prognostic factor. So, that is a limitation in PCNA index DNA ploid when it was used as as prognostic parameter of nterine cervical cancer.
Aneuploidy ; Carcinoma, Squamous Cell ; Case-Control Studies ; Cervix Uteri ; Diagnosis ; DNA* ; Female ; Flow Cytometry ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen ; Recurrence ; Uterine Cervical Neoplasms*

OBJECTIVE: The present study assessed the difference in the brain activity of professional gamers (excessive players, but not addicts) in response to playing a 3-dimensional online game with an improved interface. METHODS: Twenty-three StarCraft I pro gamers and 16 StarCraft II pro gamers were recruited at Chung Ang University Medical Center. Brain activity in response to StarCraft I or II cues was assessed with a 1.5 Tesla Espree MRI scanner. RESULTS: StarCraft I pro gamers showed significantly greater activity in 4 clusters in response to the video game cues compared to StarCraft II pro gamers: right superior frontal gyrus, right medial frontal gyrus, right occipital lobe, and left medial frontal gyrus. StarCraft II pro gamers showed significantly greater activity in 3 clusters in response to the video game cues compared to StarCraft I pro gamers: left middle frontal gyrus, left temporal fusiform gyrus and left cerebellum. DISCUSSION: This is the first study to show the difference in brain activity between gamers playing either a 2-dimensional or 3-dimensional online game. Current brain imaging studies may confirm the pro gamers' experience when playing StarCraft II, a 3-dimensional game with an improved interface, relative to playing StarCraft I.
Academic Medical Centers ; Brain ; Cues ; Neuroimaging ; Occipital Lobe ; Video Games

Acute megakaryoblastic leukemia is a rare and rapidly fatal disease characterized by proliferation of megakaryocyte series and atypical megakaryocytes in the bone marrow. Acute megakaryoblastic leukemia is suspicious when 1) megakaryocyte in peripheral blood, mixture of large and small mononuclear megakaryoblast in the bone marrow 2) cytoplasmic budding in blast 3) myelofibrosis (dense medullary overgrowth of reticulin fibers) 4) PAS (+), ANAE (+), SBB (−), peroxidase (−) and which is confirmed by platelet peroxidase oxidation on electron microscope or monoclonal antibody. A case of acute megakaryoblastic leukemia was studied morphologically and monoclonal antibody.
Blood Platelets ; Bone Marrow ; Cytoplasm ; Leukemia, Megakaryoblastic, Acute* ; Megakaryocyte Progenitor Cells ; Megakaryocytes ; Naphthol AS D Esterase ; Peroxidase ; Primary Myelofibrosis ; Reticulin

Pigmented squamous cell carcinoma is a very rare malignant, pigmented, epidermal tumor. The rarity of pigmented squamous cell carcinomas may reflect in part their misdiagnosis as other pigmented neoplasms, particularly malignant melanoma. To our knowledge, only five cases have been reported in literature. We recently experienced a case of pigmented squamous cell carcinoma arising from pigmented actinic keratosis in a 77 years old female. Physical examination showed a 0.8 0.6 cm, smooth, dark brown pigmented patch with irregular but sharply defined borders located on the upper left chest. The biopsy specimen showed histologic findings of pigmented actinic keratosis with abundant melanin pigments, which became pigmented squamous cell carcinoma. Most of pigments in the squamous cell carcinoma were contained within the melanocytes along with the neoplastic squamous cells.
Actins* ; Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnostic Errors ; Female ; Humans ; Keratosis, Actinic* ; Melanins ; Melanocytes ; Melanoma ; Physical Examination ; Skin ; Thorax

Adenocarcinoma of the ciliary epithelium is a rare tumor, usually occuring in elderly patients who have a history of severe ocular trauma or chronic inflammation. We report an adenocarcinoma of the nonpigmented ciliary epithelium found within the phthisical globe of a 36-year-old female whose eye had been loss of vision since infancy. The mass, measured 4.0 x 4.0 cm, was relatively limited by sclera but had invasion to posterior portion. Histologically, the tumor was a compact mass which consisted of tubular and papillary structures with foci of the pleomorphic area. Strands of cells and individual cells were invested with thick basement membrane that have positivity for periodic acid-Schiff stain. Immunohistochemical staining showed strong reactivity for cytokeratin and epithelial membrane antigen, and focal for neuron-specific enolase and S-100 protein.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Adult ; Aged ; Basement Membrane ; Epithelium* ; Female ; Humans ; Inflammation ; Keratins ; Mucin-1 ; Phosphopyruvate Hydratase ; S100 Proteins ; Sclera

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12+1 (9+3 to 27+1) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.

BACKGROUND: Quyyumi et al described circadian variation of ischemic eletrocardio-graphic changes and heart rate in patients with and without significant coronary disease in 1985. Rocco et al also described circadian variation of transient myocaldial ischemia in patients with coronary artery disease. They also noted an increse in ischemic eletrocardiographic abnormalities in the morning hours.In recent years the important of circadian variation of cardiovascular phenomena has generated a great deal of interest. Such phonomena include the occurrence of ischemia in patients with both chronic stable angina and variant angina, myocaldial infarction, sudden cardiac death, ventricular arrhythmia and platelet aggregability. METHOD: To examine whether a significant circadain variation of transient myocardial ischemia exists and to better understand the character of such variation, 35 patients with againa pectoris(15 patients treated with nitrate and/or caclcum channel blocker and 20 patients without treatment) underwent 24 hours ambulatory monitoring of ischemic ST segment changes during daily life. RESULT: Only 21% of the episodes of ST depression were accompanied by chest pain. While 79% were asymptomatic. A significant circadian increase in ischemic activity was found with 44% of episodes and 40% of total ischemic time in not treated group, and 52% of episodes and 56% of total ischemic time in treated group, occuring between 6 A.M. to 12 P.M.(P<0.05 respectively) When the distribution of ischemic episodes was corrected for the variable time of waking, the peak ischemic activity was occuring in the 1st and 2nd hours after rising. There were no significant differences in heart rate at onset and heart rate at 1 min before onset. CONCLUSION: Is summary, transient myocardial ischemia in the absence of pain was more common and there were a significant circadian variation of transient myocardial ischemia with peak activity in the morning. In addition most of transient myocardial were not preceded by a rise in heart rate.
Angina, Stable ; Arrhythmias, Cardiac ; Blood Platelets ; Chest Pain ; Coronary Artery Disease ; Coronary Disease ; Death, Sudden, Cardiac ; Depression ; Heart Rate ; Humans ; Infarction ; Ischemia ; Monitoring, Ambulatory ; Myocardial Ischemia*

BACKGROUND: The immune thrombocytopenia (ITP) criteria were newly standardized by the International Working Group. Thus, we analyzed the natural course of childhood chronic ITP to predict the prognosis based on the revised criteria. METHODS: The medical records of children with chronic ITP from May 2000 to February 2013 in our institute were reviewed. RESULTS: Forty-seven children with chronic ITP who were not undergoing corticosteroid therapy were included. Their initial platelet count was 23+/-25x10(9)/L, and age at diagnosis was 6.3+/-4.1 years. The follow-up period was 5.4+/-3.7 years. Among them, 44.7% (21/47) showed spontaneous remission and maintained a platelet count > or =100x10(9)/L. And 66.0% (31/47) maintained a platelet count > or =50x10(9)/L until the last follow-up date. The time periods required for the platelet count to be maintained > or =50x10(9)/L and > or =100 x10(9)/L were 3.1+/-2.7 and 3.6+/-2.7 years. Age at diagnosis in the > or =50x10(9)/L group (5.7+/-4.4 years) was significantly lower than the age at diagnosis in the <50x10(9)/L group (7.4+/-3.3 years) (P=0.040). And follow-up period was the factor influencing prognosis between the > or =100x10(9)/L group and <50x10(9)/L group (P=0.022). CONCLUSION: Approximately 45% of children with chronic ITP recovered spontaneously about 3-4 years after the diagnosis and 2/3 of patients maintained a platelet count > or =50x10(9)/L, relatively safe state. Age at diagnosis of ITP and follow-up period were the factors influencing prognosis in this study.
Child ; Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Platelet Count ; Prognosis ; Remission, Spontaneous ; Thrombocytopenia*