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

No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

A ruptured cerebral aneurysm in a term parturient requires a consideration of several factors important to the survival of both the mother and infant. A 39-week pregnant patient with a subarachnoid hemorrhage, secondary to a ruptured anterior communicating artery aneurysm, presented emergently for clipping of a cerebral aneurysm under general anesthesia. Anesthetic goals for this patient included maintenance of maternal well-being, uteroplacental perfusion, and fetal well-being. Fetal monitoring consisted of fetal heart rate by external Doppler and uterine activity by external tocodynamometer. The aneurysm was well clipped, and the patient was in a good neurological grade after surgery. A healthy baby was delivered 7 days postoperatively via the vaginal route under epidural analgesia. The anesthetic management of the case is described and discussed.
Analgesia, Epidural ; Anesthesia, General ; Aneurysm ; Female ; Fetal Monitoring ; Heart Rate, Fetal ; Humans ; Infant ; Intracranial Aneurysm* ; Mothers ; Perfusion ; Pregnancy ; Subarachnoid Hemorrhage

We have experienced a 14 year old female patient who had suffered from headache, dizziness, exertional dyspnea and chest pain during 6 months. She was diagnosed as primary pulmonary hypertension by ultrasonogram and cardiac cathererization. On the cardiac catheterization, there was elevated pulmonary artery pressure and normal pulmonary wedge pressure. We report this case with related literature review.
Adolescent ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dizziness ; Dyspnea ; Female ; Headache ; Humans ; Hypertension, Pulmonary* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Ultrasonography

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

The effects of 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) on movement and tyrosine hydroxylase (TH)-immunoreactive (ir) neuronal changes in young (5~6 weeks) and aged (10~12 months) C57BL/6 mice were studied. Locomotor activity was measured during 180 minutes after a single injection of 30 mg/kg of MPTP. For immunohistochemistry both young and aged mice were injected four repeated dosages of 10 mg/kg of MPTP 12 hours apart. We counted the numbers of TH-ir cell bodies using immunohistochemical technique in substantia nigra (SN), ventral tegmental area (VTA) and locus ceruleus (LC) 7 days after the last injection of MPTP. There was a marked decrease of locomotor activity in MPTP-treated young and aged mice, and a delay in recovery of locomotor activity in MPTP-treated aged mice. In young mice, there was a decrease in the number of TH-ir cell bodies in the SN of young mice, but not in VTA or LC. In aged mice, there was a significant decrease in the number of TH-ir cell bodies in VTA as well as SN. It was concluded that aged mice were more sensitive to MPTP than young mice, and MPTP-treated aged mice a more useful animal model for studing the characteristics of Parkinson's disease.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine* ; Aging* ; Animals ; Immunohistochemistry ; Locus Coeruleus ; Mice* ; Models, Animal ; Motor Activity ; Neurons* ; Parkinson Disease ; Substantia Nigra ; Tyrosine 3-Monooxygenase ; Ventral Tegmental Area

No abstract available.
Spine*

The lack of specificity of an abnormal findings visualized on a conventional radiocolloid liver imaging remains a significant limitation of the examination. The purpose of this investigation is to clarify an equivocal abnormal finding visualized on a conventional liver and spleen imaging by using combination of scintiangiography and histogram as a quantiative assessment. Histo-analysis of peak colloidal distribution in the liver and spleen was undertaken as a complement of conventional liver imaging. The following useful patterns was emerged: 1. In hepatitis, the splenic uptake was slightly higher than in normal group. This change was usually not recognized in conventional imaging. 2. In liver cirrhosis, the liver uptake was markedly low whilst splenic uptake was very high, resulting in splenic shift and very low liver-spleen uptake ratio. 3. In hepatoma, the liver uptake was not definitely changed but splenic uptake was considerably high, so that the liver-spleen uptake ratio was very low. 4. In liver metastasis, both liver and splenic uptakes were within normallimits and the liver-spleen uptake ratio was not changed.
Carcinoma, Hepatocellular ; Colloids ; Complement System Proteins ; Evaluation Studies as Topic ; Hepatitis ; Liver ; Liver Cirrhosis ; Neoplasm Metastasis ; Radionuclide Imaging ; Sensitivity and Specificity ; Spleen

The first purpose of this study was to compare the mean Knowledge, Attitude & Practice(KAP) scores concerning major occupational Health between two types of occupational health management in small & medium-scale textile factories. Sample number was 1,138 workers. In small & medium factories with 300 workers or less, they have two alternatives for occupational health management; Individual Health Management or Vicarious Health Management. The second purpose was to determine if there was a relationship between duration of Vicarious health management and mean kap scores for 694 workers from the Vicarious Health Management group. We used self-administered questionnaires for measuring KAP. The results of this study were; 1. There was significant difference concerning all socioeconomic & occupational variables(gender, age education level, marital status, Blue/White collar, working duration of present factory, working duration of total factories) except for shift. 2. There was no significant difference of mean scores of Knowledge and attitude between the Individual Health Management Group and the Vicarious Health Management. But, the mean score of Practice was significantly different. 3. According to multiple regression analysis, the mean score of Knowledge significantly increased with age, education level, working duration of all factories increased. The mean score of Attitude significantly increased with age, education level and married. The mean score of Practice significantly increased with age, education level, working duration of all factories, married and men. 4. In conclusion, The type of Health management did not significantly affect the mean KAP scores concerning major occupational Health problems. 5. But, the Duration of Vicarious Health management significantly increased the mean KAP scores.
Education ; Humans ; Male ; Marital Status ; Occupational Health* ; Surveys and Questionnaires ; Textiles

No abstract available.
Carcinoma, Transitional Cell* ; Cytochrome P-450 CYP1A1* ; Genetic Predisposition to Disease* ; Urinary Bladder*