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*

Ulcerative colitis is associated with various extra-intestinal manifestations, including rheumatic, dermatologic, ophthalmologic, biliary, and hematologic manifestations. Cutaneous findings are common extra-intestinal manifestations of ulcerative colitis, occurring in 10-20% of patients. Cutaneous manifestations include erythema nodosum, pyoderma gangrenosum, aphthous stomatitis, and acute febrile neutrophilic dermatosis. Treatments for these cutaneous manifestations include corticosteroids, cyclosporine, tacrolimus, mycophenolate mofetil, azathioprine, and infliximab. A 48-year-old male presented with an acute exacerbation of ulcerative colitis associated with multiple skin lesions on his face, thumbs, thighs, and feet. The final impression was neutrophilic folliculitis, which is an early form of pyoderma gangrenosum. The patient's skin lesions and colitis both improved with corticosteroids. There are rare published case reports of ulcerative colitis exacerbations associated with pyoderma gangrenosum that initiated as neutrophilic folliculitis of the face. This case report includes a review of the literature.
Adrenal Cortex Hormones ; Antibodies, Monoclonal ; Azathioprine ; Colitis ; Colitis, Ulcerative ; Cyclosporine ; Erythema Nodosum ; Folliculitis ; Foot ; Humans ; Infliximab ; Male ; Middle Aged ; Mycophenolic Acid ; Neutrophils ; Pyoderma ; Pyoderma Gangrenosum ; Skin ; Skin Manifestations ; Stomatitis, Aphthous ; Sweet Syndrome ; Tacrolimus ; Thigh ; Thumb ; Ulcer

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

BACKGROUND: The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. MATERIAL AND METHOD: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001. The records of the patients except six patients who were lost from follow up were analyzed retrospectively. Mean age and male:female ratio were 52+/-15 years (range, 17~79 years) and 80:60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09+/-3.68 mg/dL (range, 2.55~20.09 mg/dL) and 4.7+/-0.9 mmol/L (range, 2.3~8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. RESULT: Mean follow up period of the patients was 41.8+/-31.0 months (range, 0.2~108.8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8+/-10.1 months (range, 0.1~40.4 months). The patency rates of 1 month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. CONCLUSION: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.
Arteriovenous Fistula* ; Arteriovenous Shunt, Surgical ; Constriction, Pathologic ; Creatinine ; Diabetes Mellitus ; Fistula ; Follow-Up Studies ; Hand ; Humans ; Hyperplasia ; Hypertension ; Kidney Failure, Chronic ; Postoperative Complications ; Potassium ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis ; Veins

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

Cap polyposis is a rare disorder with characteristic endoscopic and histological features; its etiology is still unknown, and no specific treatment has been established. We report a case of cap polyposis that improved remarkably after infliximab infusion and had no recurrence for 3 years.
Antibodies, Monoclonal ; Recurrence ; Infliximab