OBJECTIVES: The goals of the study are how to establish the cohort systems for the children and adolescents victims with sexual abuse in Korea and to identify the risk and protective factors that influence mental health in child sexual abuse (CSA). This is initial assessment data based on the analysis of cohort variables for baseline evaluation of subjects. METHODS: We constructed the cohort systems for CSA victims recruited by Seoul Sunflower Children Center, CSA victims protection center. The initial assessment data which consisted of demographic and psychological inventories of CSA victims and their parents/families, psychiatric diagnoses were the results of statistical analysis of 65 subjects under 19 years old for 3 years 7 months. RESULTS: The initial data were followings : female participants, N=56; mean age, 11.6 (SD=4.5); the most sexual assault, molestation 71.8%; victims, family and acquaintance 87.1%; 61.5% of the subjects diagnosed with psychiatric disorder; 29.2% diagnosed with PTSD and 23.1% diagnosed with depression. Mean duration for abuse to report is 1.5 years. Mean score of IES-R-K, TSCYC-avoidant and CBCL-problematic behavior were increased above clinical cut-off. CONCLUSIONS: CSA victims tend to have high risks in mental health problem. The cohort study could provide the risk and protective factors of CSA in mental health, and construct the predictive model for mental illness in Korea.
Adolescent ; Child Abuse, Sexual ; Child ; Cohort Studies ; Depression ; Diagnosis ; Equipment and Supplies ; Female ; Helianthus ; Humans ; Korea ; Mental Health ; Protective Factors ; Seoul ; Sex Offenses ; Stress Disorders, Post-Traumatic

PURPOSE: Effective management of pediatric hand burn is a considerable challenge for clinicians. Traditional dressings may result in significant pain, wound dryness, weak adhesive strength, and increase necessity for dressing change. Versiva(R)XC is combined dressing materials of hydrocolloid, hydrofiber, a polyurethane foam. Authors have used Versiva(R)XC in treatment of pediatric hand burns, and we experienced that maintenance of dressing is comfortable and decrease patient's discomfort. METHODS: Study enrolled 9 patients of mean age 3.6 years with second degree pediatric hand burn, Versiva(R)XC dressing initially applied after bullae aspiration and saline gauze dressing. After admission, we daily changed the dressing in first two or three days and had an interval of two or three days depending on the degree of exudate from the wound. RESULTS: The mean day of application was 6.3 days. None of patients required surgery and healed with no other complication of scar contracture and hypertrophic scar formation. CONCLUSION: The dressing with Versiva(R)XC was effective method because of decreased pain, easy dressing change, more comfort, and decreased hospital day.
Adhesives ; Bandages ; Blister ; Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Colloids ; Contracture ; Exudates and Transudates ; Hand ; Humans ; Polyurethanes

The variant of squamous carcinoma of the scrotum known as verrucous carcinoma is very rare, but has a distinct clinical and pathological condition which has a significantly better prognosis than the more common infiltrative type. We report one case of verrucous carcinoma of the scrotum that was treated by wide local excision with placing the bilateral testes subcutaneously in the thigh and a split-thickness skin graft to cover the scrotum. And we tried to detect human Papillomavirus (HPV) type 6, 11, 16 and 18 with DNA in situ hybridization method.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; DNA ; Humans ; In Situ Hybridization ; Prognosis ; Scrotum* ; Skin ; Testis ; Thigh ; Transplants

PURPOSE: It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. METHODS: We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillin-resistance. RESULTS: Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. CONCLUSION: Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.
Colon ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Jaundice, Neonatal ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Sprains and Strains ; Staphylococcus aureus

MRSA strains cause serious nosocomial infections. The rate of MRSA among Staphylococcus aureus isolated in Korea is about 70 - 80%. The treatment for MRSA infection is vancomycin. But vancomycin has several side effects and its therapeutic rate is 60 - 75%. Therefore the disinfectants play an important role in preventing and treating MRSA infection. In this study, 44 MRSA isolates were obtained from Wonkwang University Hospital, and examined for the efficacy of disinfectants commonly used in hospital. The tested disinfectants were chlorohexidine (Hibitan(R)), H2O2, tego, Gentian Violet, potadine, chlorohexidine gluconate (Microshield(R)), boric acid, alcohol, zepanon, acetic acid, and combinations of these disinfectants. MRSA studied were killed after exposure to chlorohexidine gluconate (Microshield (R)), alcohol, zepanon, alcohol+potadine, and alcohol+Gentian Violet within 30 seconds. But, tego, boric acid, and Gentian Violet+acetic acid could not kill MRSA after 30 minutes. Agar dilution minimal inhibitory concentration test was done with cephalothin, ciprofloxacin, clindamycin, erythromycin, fusidic acid, gentamicin, mupirocin, oxacillin, penicillin G, rifampin, tetracycline, and vancomycin. We found that bactericidal activity of vancomycin, fusidic acid, and mupirocin were good. In conclusion, this study provided useful information: 75% alcohol is the best disinfectant for wound dressing, 4% chlorohexidine gluconate(Microshield(R)) is useful for hand washing, and zepanon is useful for ward cleansing. Vancomycin-resistant Staphylococcus aureus was not found in our study.
Acetic Acid ; Agar ; Anti-Bacterial Agents* ; Bandages ; Cephalothin ; Ciprofloxacin ; Clindamycin ; Cross Infection ; Disinfectants* ; Erythromycin ; Fusidic Acid ; Gentamicins ; Gentian Violet ; Gentiana ; Hand Disinfection ; Korea ; Methicillin-Resistant Staphylococcus aureus* ; Mupirocin ; Oxacillin ; Penicillin G ; Rifampin ; Staphylococcus aureus ; Tetracycline ; Vancomycin ; Viola ; Wounds and Injuries

It is now generally accepted that most, if not all, colon cancers originate within previously benign adenomas. Endoscopic polyp resection and regular follow up endoscopic examination are essential for prevention of carcinoma fro benign adenoma. However, small colorectal polyps are difficult to recognize during follow up endoscopic examinations because of the lack of reliable endoscopic landmarkers. Endoscopic Indiaink marking of the colon was first described by Ponsky and King in l975. The method has subsequently been advocated by expert as the best available means to mark the site of a colonic lesion. We prospectively studied the effectiveness of India ink as a long term colonic mucosal marker. Twelve patients who were diagnosed as colorectal polyp had a India ink marking with standard sclerotherapy needle. All patients who were followed at 6 months interval (mean duration 13 months) continue to display intensely stained mucosa at the original sites. No side effects or complications were encountered. India ink appears to be a safe and effective long term marker for colonic mucosal lesions.
Adenoma ; Colon* ; Colonic Neoplasms ; Follow-Up Studies ; Humans ; India* ; Ink* ; Mucous Membrane* ; Needles ; Polyps ; Prospective Studies ; Sclerotherapy

Objective: The victims and their families of child sexual abuse (CSA) may confront persistent psychological sequela. We aimed to investigate the psychological symptoms, diagnosis, and family functions in children and adolescents with CSA. Methods: We assessed the symptom scales at 6-month intervals, and conducted diagnostic re-assessments at 1-year intervals. Trauma Symptom Checklist for Children (TSCC), Trauma Symptom Checklist for Young Children (TSCYC), Family Adaptability and Cohesion Evaluation Scales IV (FACES-IV), and Family Communication Scale (FCS) scores were reported by children or parents. Results: We found in parent-reported TSCYC, that posttraumatic stress symptoms domain scores significantly decreased with time progression. The scores decreased more in the evidence-based treatment group over time in anxiety and posttraumatic stress symptom domains of TSCC. In FACES-IV and FCS scores, indices of family function have been gradually increasing both after 6 months and after 1 year compared to the initial evaluation. Further, about 64% of the children diagnosed with psychiatric diseases, including posttraumatic stress disorder (PTSD) at the initial assessment maintained the same diagnosis at follow-up. Conclusion We observed changes in psychological symptoms and family functioning in sexually abused children with time progression during 1 year. It is postulated that PTSD may be a persistent major mental illness in the victims of CSA.

To evaluate oxygenation and metabolic state of the non-brainstem stroke patients after the moderate intensity exercise using arterial blood gas analysis (ABGA). Fifty-two stroke patients were recruited. All the subjects were to follow the instructions for the exercise, not suffered cardiopulmonary diseases before, and not diagnosed with brainstem disorders. They were ordered to maintain 70% heart rate of maximal heart rate during exercise and checked blood pressure, pulse rate, respiratory rate (RR), and ABGA before and after the exercise, respectively. O² saturation, PaO², PaCO², O² content, HCO³⁻, pH, and anion gap were compared between the exercise, and those data changes were performed correlation analysis into age and the time after stroke onset. The data comparison was also done into the subgroup of the severity of stroke using National Institutes of Health Stroke Scale (NIHSS). The statistically significant results were observed in the change of O² saturation, PaO², PaCO², O² content, HCO3⁻, pH, and anion gap after the exercise. The decrease of HCO³⁻ and increase of RR were proportional to age, however the data showed no correlation with the NIHSS. These results suggest relatively preserved respiratory compensation mechanism and homeostatic effect to maintain metabolic balance among the non-brainstem stroke patients.
Acid-Base Equilibrium ; Bicycling ; Blood Gas Analysis ; Blood Pressure ; Brain Stem ; Compensation and Redress ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; National Institutes of Health (U.S.) ; Oxygen ; Oxygen Consumption ; Respiratory Rate ; Stroke*

A 63-year-old man visited outpatient clinic complaining of dysphagia due to left jugular foramen meningioma. The patient underwent conventional dysphagia rehabilitation programs but functional improvement was not enough. A videofluoroscopic swallowing study (VFSS) revealed decreased laryngeal elevation and a lot of residue in pyriform sinus and vallecula. We noticed that enhancing laryngeal elevation like mendelshon maneuver promotes functional compensation, so we developed a therapeutic band for promoting laryngeal elevation. In follow-up VFSS, swallowing function was improved on the band. Persistent dysphagia due to decreased laryngeal elevation is very common and this case showed the possibility of improvement of symptom using therapeutic band we devleoped with conventional dysphagia rehabilitation programs.
Ambulatory Care Facilities ; Compensation and Redress ; Deglutition ; Deglutition Disorders* ; Follow-Up Studies ; Humans ; Meningioma ; Middle Aged ; Pyriform Sinus ; Rehabilitation

BACKGROUND: Recent evidence demonstrates that high doses of epoetin-alpha (EPO-alpha) can be administrated at extended intervals, despite its relatively short serum half-life. However, no prospective randomized trials on the effects of extended dosing intervals of EPO-alpha compared with darbepoetin-alpha (DA-alpha) have been performed. This study was designed to investigate whether a single biweekly (Q2W) administration of a high dose of EPO-alpha is as effective as DA-alpha for anemia in chronic kidney disease (CKD) patients not receiving dialysis. METHODS: Sixty non-dialysis CKD patients were equally randomized to either Q2W subcutaneous EPO-alpha (10,000 unit) or DA-alpha (50microg) therapy groups for the first 6 weeks. After a 6-week washout period, the participants of the EPO-alpha and DA-alpha treatment groups switched to the alternate regimen for 6 weeks. The mean hemoglobin (Hb) levels after erythropoiesis stimulating agent (ESA) therapy and percentage change in Hb levels from baseline to the end of the study were analyzed. RESULTS: The mean Hb levels of postESA therapy increased significantly compared with those of preESA therapy in both ESA regimens. The percentage increase in Hb levels and erythropoietin resistance index did not show a significant difference between the different ESA regimens. No difference was observed between the regimens regarding mean Hb levels after ESA therapy. Additionally, there were no serious adverse effects leading to withdrawal from treatment. CONCLUSION: Biweekly high doses of EPO-alpha therapy may be equally as effective as Q2W DA-alpha therapy in maintaining target Hb levels in non-dialysis CKD patients.
Anemia ; Cross-Over Studies* ; Dialysis* ; Erythropoiesis ; Erythropoietin ; Half-Life ; Humans ; Renal Insufficiency, Chronic*