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

The antiphospholipid antibody syndrome is cha- racterized by antibodies directed against either phos-pholipids or plasma proteins bound to anionic phos- pholipids. These antibodies have been characterized by lupus anticoagulants and anticardiolipin antibodies. Patients with the antiphospholipid antibody syndrome may display a constellation of clinical features including venous and arterial thrombosis, recurrent fetal losses, and thrombocytopenia. Although the majority of patients reported have a thrombotic microangiopathy, some have also seen membranous nephopathy as well as IgA nephropathy in a patient with anti-phospholipid antibody syndrome accompanying glo-merulonephritis. Authors experienced a 37-year-old male patient who presented with generalized edema at the moment of follow-up for primary antiphos-pholipid syndrome accampanying systemic thrombotic events. Anticardiolipin antibody-IgM positivity was detected by seroligic test but no evidence for systemic lupus erythematosus was found. Kidney biopsy showed mesangial IgA deposition without th throm-botic microangiopathy of gomerular capillaries and was diagnosed finally as primary antiphospholipid syndrome with IgA nephropathy. Patient's symptom was relieved with steroids and anti platelete agents and now he is being follow-up to out patient department. This case suggests some possibility that anticardiolipin antibody may induce the IgA nephropathy. Therefore clinician should have concern about the relationship between antiphospholipid antibody and immune mediate glomerulonephritis.
Adult ; Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid* ; Anticoagulants ; Antiphospholipid Syndrome* ; Biopsy ; Blood Platelets ; Blood Proteins ; Capillaries ; Edema ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Kidney ; Lupus Erythematosus, Systemic ; Male ; Steroids ; Thrombocytopenia ; Thrombosis ; Thrombotic Microangiopathies

Twin-twin transfusion syndrome(TTTS) is a serious complication of monozygotic mu-ltiple pregnancy. TTTS is associated with high perinatal mortality rate. The acute form has been attributed to rapid transfer of blood through superficial artery-to-artery or vein-to- vein anastomoses during labor and delivery, resulting in a hypovolemic, anemic donor twin and a hypervolemic, plethoric recipient twin of similar birth weight. The authors present a case of acute twin-twin transfusion syndrome with a review of literature.
Birth Weight ; Humans ; Hypovolemia ; Perinatal Mortality ; Pregnancy ; Tissue Donors ; Veins

Several reports have described the usefulness of tumor markers detected in pancreatic juice for diagnosis of pancreatic cancer. We performed this study to evaluate the usefulness of tumor markers in pure pancreatic juice collected by duodenoscopic cannulation of pancreatic duct before and after injection of secretin. From April 1993 to July 1995, 8 cases of pancreatic cancer, 5 cases of benign pancreatic lesions, and 5 cases of benign biliary diseases without pancreatic lesion were involved. CEA and CA 19-9 immunoreactivity were measured by radioimmunoassay. Concentrations of CA 19-9 in pure pancreatic juice were significantly higher in patients with pancreatic cancer(median value; 3582, range 88.4-10410 IU/ml) than in control patients(median value 231, range 30.4-682 IU/ml)(p<0.05). Concentrations of CEA in pure pancreatic juice were not significantly different between patients with pancreatic cancer(median value: 6,5, range 1.0-152ng/ml) and control patients(median value: 4.0, range 1-17.2 ng/ml)(p>0.05). There was no significant correlation between levels of CA19-9, CEA in pancreatic juice and those levels in serum. The amounts of juice collected by duodenoscopic cannulation in patients with pancreatic cancer were 1.5+/- 0.9ml during 5 minutes before infusion of secretin, 11.3+/- 3.9ml, 10.8+/- 4.0ml, 10.6+/- 4.0ml in 5 minute interval after infusion of secretin. These results indicated that measurement of CA19-9 in pure pancreatic juice may be used as a marker for pancreatic cancer. Adequate amount of pancreatic juice was collected by duodenoscopic cannulation for evaluation of tumor marker, enzyme studies and cytology.
Catheterization ; Diagnosis ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice* ; Pancreatic Neoplasms ; Radioimmunoassay ; Secretin ; Biomarkers, Tumor

No abstract available.
Dysgerminoma*

A 57-year-old female with jaundice and right upper quadrant abdominal pain, was found on exploration to have squamous cell carcinoma of the common bile duct. Squamous cell carcinoma of the common bile duct is a very rare tumor, simulating adenocarcinoma in its clinical presentation and aggressiveness. Although no consistent causative factors for this tumor has been demonstrated, it has been theorized that the normal columnar epithelium of the bile duct under the influence of an inflammatory stimulus, can develop into squamous epithelium with the ongoing process leading to squamous metaplasia, and eventually carcinoma. Cholelithiasis has been implicated as a cause for bile duct cancer, which was manifested in this patient. The prognosis of this carcinoma was grave, despite all forms of surgical and medical management. A case of squamous cell carcinoma of the common bile duct is reported with a review of relevant literature.
Abdominal Pain ; Adenocarcinoma ; Bile Duct Neoplasms ; Bile Ducts ; Carcinoma, Squamous Cell* ; Cholelithiasis ; Common Bile Duct* ; Epithelium ; Female ; Humans ; Jaundice ; Metaplasia ; Middle Aged ; Prognosis

BACKGROUND/AIMS: This study was undertaken to evaluate the usefulness of ERCP in patients with pyogenic liver abscess. METHODS: An endoscopic retrograde cholangiographic study of 70 consecutive cases of pyogenic liver abscess was conducted during the period from January, 1993 to December, 1997. Among 70 cases of pyogenic liver abscess, the male to female ratio was 1.69 :1, and the peak incidence was in the sixth decade. RESULTS: The common associated diseases were liver cirrhosis (11.4%), diabetes mellitus (8.5%), and malignancy (5.7%). The most common origins of the abscess in decreasing order of frequency were, transbiliary infection (51%), hematogenous spread, and trauma-associated causes. The ascending infection through the biliary tract as the etiology of liver abscess, has been common since the 1970's. The positive rate of abdominal US, CT, and ERCP in the diagnosis of the etiology of the liver abscess was 68, 82, 84% respectively. The treatments of the pyogenic liver abscess were, surgical drainage in 15 cases (21%) and percutaneous drainage in 51 cases (73%). Among 70 patients treated for pyogenic liver abscess, 12 patients had CBD stones and 11 patients were cured by EST. CONCLUSIONS: The most common origin of liver abscess is ascending infection through the biliary tract and ERCP may be a effective tool in the assessment and management of the etiology of pyogenic liver abscess.
Abscess ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Diabetes Mellitus ; Diagnosis ; Drainage ; Female ; Humans ; Incidence ; Liver Abscess ; Liver Abscess, Pyogenic* ; Liver Cirrhosis ; Male

PURPOSE: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. METHODS: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. RESULTS: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. CONCLUSION: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.
Adult ; Aged ; Cerebrovascular Disorders/*complications ; *Exercise Therapy ; Female ; Hemiplegia/complications/*therapy ; Humans ; Male ; Middle Aged ; *Muscle Spasticity ; *Muscle Strength ; *Range of Motion, Articular ; Shoulder Joint/physiology ; Wrist Joint/physiology

Agenesis of the dorsal pancreas is a rare congenital anomaly that arises from the failure of the dorsal pancreatic bud of endodermal cells to form the body and tail of the pancreas and can manifest as diabetes. A 24-year-old man, who had been treated with insulin for 7 years, presented with epigastric pain, vomiting, and watery diarrhea. Abdominal computed tomography showed only the head of the pancreas without visualization of the pancreatic body and tail. Left renal agenesis and absence of the left vertebral pedicle in T12 were also observed. The duct of Santorini and the duct in the body and tail were not visible in magnetic resonance cholangiopancreatography. The associated anomalies reported here are very rare globally. We report a case of complete agenesis of the dorsal pancreas with multiple congenital abnormalities and diabetes mellitus.
Cholangiopancreatography, Magnetic Resonance ; Congenital Abnormalities ; Diabetes Mellitus ; Diarrhea ; Endoderm ; Head ; Humans ; Insulin ; Kidney ; Kidney Diseases ; Pancreas ; Pancreatic Ducts ; Vomiting ; Young Adult

STUDY DESIGN: A comparative in vivo study between ceramics with different compositions. OBJECTIVES: To compare the biodegradation and osteoconduction properties of CaO-SiO2- P2O5- B2O3 glass-ceramics and Cerabone(R)-AW. Summary of Literature Review: Bioglass ceramics can be used as bone graft substitutes. However, no study has been undertaken to investigate the possibility of CaO-S i O2-P2O5-B2O3 glass-ceramics as a bone graft substitute. MATERIALS AND METHODS: Porous CSPB2 implants (44.07% CaO, 40.28% SiO2, 8.1% P2O5 and 5.0% B2O3), porous CSPB3 implants (43.76% CaO, 43.41% SiO2, 4.05% P2O5 and 7.5% B2O3) and porous Cerabone(R)-AW were prepared by the polymer sponge method. Single-level posterolateral spinal fusions were performed on sixty New Zealand white male rabbits. The animals were divided into four groups (9 of autograft, 17 per 3 kind of porous implant group) according to the implant material used: autograft, CSPB2, CSPB3 and Cerabone(R)-AW. Radiographs were performed every two weeks. All animals were sacrificed 12 weeks after surgery. Manual palpation and uniaxial tensile strength were determined. The proportion of the area occupied by the ceramics in the final compared to the initial radiographs was calculated. Decalcified and undecalcified histological sections were evaluated by light microscopy. RESULTS: Fifty one rabbits were evaluated. The union rates were 100 (9 out of 9), 80 (8 out of 8), 81.1 (9 out of 11) and 90.9% (10 out of 11) in the autograft, Cerabone(R)-AW, CSPB2 and CSPB3 groups, respectively. The proportion of the area occupied by Cerabone(R)-AW (90.8 % +/- 14.0) was significantly higher than for CSPB2 (73.1% +/- 11.5) and CSPB3 (73.5% +/- 10.0)(p=0.0011). The mean values of the tensile strengths of Cerabone(R)-AW (214. +/- 57.3N), CSPB2 (214. +/- 57.3 N) and CSPB3 (217 +/- 70.1 N) were not significantly different (p>0.05). CONCLUSION: CSPB2 and CSPB3 had similar tensile strengths and fusion rates of the fusion masses as those of Cerabone(R)-AW; however, they degraded more rapidly than Cerabone(R)-AW. These findings suggest that CSPB2 and CSPB3 grafts can be used as a more ideal new bone graft substitutes than Cerabone(R)-AW.
Animals ; Autografts ; Bone Regeneration ; Ceramics ; Humans ; Lumbar Vertebrae* ; Male ; Microscopy ; New Zealand ; Palpation ; Polymers ; Porifera ; Rabbits ; Spinal Fusion ; Tensile Strength ; Transplants