PURPOSE: This study was done to identify the state of internet addiction and to investigate the relationships among internet addiction, depression and suicidal ideation in adolescents. METHOD: Participants were 1,670 high school students in an urban city. The Internet Addiction Scale was used to measure internet addiction, the DISC-MDD-SQ was used to measure depression, and the Suicidal Ideation Questionnaire-JR was used to measure suicidal ideation. RESULT: 38.1% of participants were perceived to be in the early stages of internet addiction and 1.5% reported heavy addiction. Overall the internet addiction scale score was 37.57(+/-12.52). The differences of internet addiction in sample characteristics were found to be significant in rank in class. The differences in DISC-MDD-SQ and IAS scores among the states of internet addiction were statistically significant. The level of internet addiction correlated positively to the level of depression and suicidal ideation. CONCLUSION: Based upon these findings, there were significant positive correlations among Internet addiction, depression, and suicidal ideation in adolescents. As schools are often the first line for the identification of potential life-threatening behaviors, nurses, especially school-based health professionals, need to be cognizant of measures and procedures for the assessment of Internet addiction, depression, and suicidal ideation.
Adolescent ; *Adolescent Psychology ; Behavior, Addictive/diagnosis/*psychology ; Depression/diagnosis/*psychology ; Female ; Humans ; *Internet ; Male ; Suicide/*psychology

Sjogren syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth and eyes. Approximately one-third of patients present with systemic manifestations, but respiratory muscle involvements have been rarely reported. We report a case of acute respiratory failure complicated by primary Sjogren syndrome. Muscle biopsy revealed perivascular lymphocytic infiltrations. Corticosteroid therapy improved respiratory muscle weakness. Sjogren syndrome should be considered as one of the underlying diseases causing acute respiratory failure.
Autoimmune Diseases ; Biopsy ; Exocrine Glands ; Humans ; Mouth ; Muscular Diseases ; Respiratory Insufficiency ; Respiratory Muscles* ; Respiratory Paralysis ; Sjogren's Syndrome*

OBJECTIVES: To assess the relationship between ST segment elevation during exercise testing and coronary artery disease. METHODS: Treadmill exercise electrocardiography and coronary angiography were performed in 137 patients with angina with no Q waves. The J point elevation of > 0.03mV(0.3mm) measured from baseline, the elevation of ST segment at 80msec. from J point(ST80) measured larger in lead V1than in aV1, or both the elevation of ST segment at J point and at ST80 developed earlier than or concomitantly with ST depression were considered as abnormal responses. RESULTS: 1) There was no clinical significance of ST elevation in lead aV1. 2) Exercise-induced ST elevation in lead V1occurred in 29 of 137 patients with angina. 3) Abnormal St elevation in V1was detected in 26 of 86 patients with coronary artery disease, for a specificity of 98%. The patients with left anterior descending coronary artery or left main coronary artery stenosis were observed in 3 of 5(60%) patients with single-vessel disease, in 7 of 9(79%) with two-vessel disease, and in 9 of 10(90%) with three-vessel disease. 4) The standard ST depression yielded a specificity of 55% in the patients with isolated or predominant ST depression in inferior leads(II. III, and aVF) and of 81% in the patients with isolated or predominat ST depressin in precordial leads(p<0.001). 5) Abnormal exercise-induced ST elevation in V1was detected in 13 of 39(33%) patients with isolated or predominat ST depression in inferior leads and yielded a specificity of 94% for coronary artery disease. CONCLUSION: Abnormal ST segment elevation in V1may increase the specificity in isolated or predominat ST segment depression in inferior leads and may predict left anterior descending or left main coronary artery disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test* ; Hexamethonium ; Humans ; Sensitivity and Specificity

We report 3 cases of recurrent acute disseminated encephalomyelitis (ADEM) known as multiphasic disseminated encephalomyelitis (MDEM). The 3 cases presented with fever, headache, neck stiffness, abdominal pain, seizure and decreased mentality as well as focal neurologic deficits, which showed relatively good steroid responsiveness. Brain MRI revealed variable sized, multifocal, subcortical white matter lesions with gray matter involvement. The CSF study showed mild pleocytosis with negative oligoclonal band.
Abdominal Pain ; Brain ; Encephalomyelitis* ; Encephalomyelitis, Acute Disseminated ; Fever ; Headache ; Leukocytosis ; Magnetic Resonance Imaging ; Neck ; Neurologic Manifestations ; Seizures

BACKGROUND: We evaluated the pharmacodynamic and pharmacokinetic properties of rapacuronium, a new non-depolarizing muscle relaxant. METHODS: The EC50 and EC95 values of rapacuronium, vecuronium, and rocuronium were determined on rat hemidiaphragm, and reversal effects were determined using edrophonium or pyridostigmine. In 57 healthy adults, neuromuscular transmission was monitored at the adductor pollicis. Patients received a single dose of succinylcholine (1.0 mg/kg), rapacuronium (1.5 mg/kg), rocuronium (0.6 mg/kg), or mivacurium (0.16 mg/kg). Onset time, clinical duration, recovery index (RI), total duration (TD), train of four (TOF) ratio at over 95% recovery of control first twitch height, cardiovascular effect, and intubation scores were measured. RESULTS: By in vitro study, the EC50 and EC95 of rapacuronium were 4 to 10 fold larger than those of vecuronium and rocuronium, and by clinical study, the onset time of rapacuronium was similar to those of succinylcholine. The clinical duration of rapacuronium was not different from those of succinylcholine and mivacurium. RI and TD of rapacuronium (9.6 +/- 3.5 min and 30.9 +/- 10.7 min) were longer than those of succinylcholine (3.5 +/- 1.1 min and 18.1 +/- 4.4 min) and mivacurium (6.5 +/- 0.9 min and 23.0 +/- 4.4 min) for spontaneous recovery, but not different during reversal by pyridostigmine (5.0microgram/kg). The TOF ratio was increased after pyridostigmine than during spontaneous recovery. Intubation conditions of rapacuronium were similar to those of succinylcholine. Heart rates were significantly increased (15% of control) within 2 min, but not mean arterial pressure after rapacuronium was administration. CONCLUSIONS: Rapacuronium can be considered a valid alternative to succinylcholine and had no observed cardiovascular effect.
Adult ; Animals ; Arterial Pressure ; Edrophonium ; Heart Rate ; Humans ; Intubation ; Neuromuscular Blockade* ; Pyridostigmine Bromide ; Rats ; Succinylcholine ; Vecuronium Bromide

BACKGROUND: Charcot-Marie-Tooth (CMT) disease is pathologically divided into the following two types: demyelinating type and axonal type. This study aimed to analyze the results of the electrophysiological studies of CMT1A and to reevaluate the clinical significance of nerve conduction studies (NCS). METHODS: The subjects of the study were 18 patients with genetically confirmed CMT1A during the period of 1995. 1.-2004. 8. The NCS data from 22 family members of the patients were also included. The nerve conduction velocities, conduction blocks and compound muscle action potentials were analyzed. RESULTS: The subjects were composed of 19 males and 21 females. The mean NCV was 21.70 m/s in the median nerve, and the conduction block was observed in 13 patients (32.5%). The NCV was uniformly slow. The intrafamilial variation of NCVs between parents and their children were analyzed in 30 patients from 11 families. The mean velocity was 24.44+/-3.67 m/s in parents and 19.53+/-5.37m/s in their children. CONCLUSIONS: The CMT1A showed the slowness in NCV, one of the characteristics of demyelinating neuropathy, and this slowing had a uniform pattern. Nerve conduction block was also frequently observed, the pattern of which was diffuse without dispersion, and non segmental. Because the NCV of the children tended to be slower than that of the parents, CMT1A may not be a simple progressive disease. The onset and progression of CMT1A may be determined by other genetic and environmental factors.
Action Potentials ; Axons ; Child ; Female ; Humans ; Male ; Median Nerve ; Neural Conduction ; Parents

BACKGROUND: Occipital neuralgia (ON) is a condition characterized by a paroxysmal stabbing pain in the area of the greater or lesser occipital nerves; it is usually regarded by clinicians as idiopathic. Some have suggested that ON can be induced by trauma or injury of the occipital nerves or their roots, but tumor has rarely been reported as a cause of ON. CASE REPORT: We report herein a case of foramen magnum meningioma in a 55-year-old woman who presented with ON triggered by head motion as the only symptom without any signs of myelopathy. CONCLUSIONS: This case indicates that it is important to consider the underlying causes of ON. Precise neurologic and radiological evaluations such as cervical spine magnetic resonance imaging are needed.
Female ; Foramen Magnum ; Head ; Humans ; Magnetic Resonance Imaging ; Meningioma ; Middle Aged ; Neuralgia ; Spinal Cord Diseases ; Spine

OBJECTIVE: The purpose of this follow-up study was to evaluate the status of standing and gait for the paraplegics at their home after discharge. METHOD: A medical doctor interviewed 93 paraplegics by spinal cord injury, who visited the outpatient clinic of the National Rehabilitation Hospital, or who were admitted for the follow up urologic evaluation. RESULTS: Out of 93 paraplegics, 90 patients had done a standing exercise in hospitals, but 42 patients continued a standing exercise after discharge. Seventy-nine patients had done a gait exercise in hospitals, but only 24 patients continued a gait exercise after discharge. Seventy-five patients were prescribed KAFO (Knee-Ankle-Foot orthosis), but only 11 patients used the KAFO continuously after discharge. The reasons to stop using KAFO were loss of motivation, lack of time, no helper, difficulties with wearing orthoses, and etc. The continuous using rates of other standing or exercise equipments were higher than that of KAFO. CONCLUSION: Many paraplegics had done gait training and had been prescribed KAFO in hospitals. But only 14.7% of them had used KAFO for any purpose after discharge. We believe that more careful consideration and explanation are needed to each patient. We think that standing or exercise equipments are good alternatives.
Ambulatory Care Facilities ; Follow-Up Studies ; Gait* ; Humans ; Motivation ; Orthotic Devices ; Paraplegia ; Rehabilitation ; Spinal Cord Injuries* ; Spinal Cord*

Subchondral cyst is a benign cystic lesion, and it is often found in patients with rheumatoid arthritis or osteoarthritis. However, its occurrence in those joints without preexisted disease is rare. Furthermore, there has been no report in the medical literature regarding pathologic fracture in the bony plate of a subchondral cyst at the superior acetabulum. We report here on a case of the 44-year-old woman for whom a pathologic fracture was found in the bony plate of a subchondral cyst at the superior acetabulum.
Acetabulum ; Adult ; Arthritis, Rheumatoid ; Bone Cysts ; Female ; Fractures, Spontaneous ; Humans ; Joints ; Osteoarthritis