Research about Inappropriate Sexual Behavior (ISB) among patients with dementia is not abundant although its impact on patients and carers can be significant. There are many reasons for this relative neglect. In particular, notable is a problem encountered in the inconsistency of definition and assessment of ISB as well as stigma of sexuality in patients with dementia. This article reviews the literature concerning sexually inappropriate behavior in demented patients. Behavioral and pharmacological treatment approaches are explored and the recommendations and guidelines offered by other researchers are described.
Caregivers ; Dementia ; Humans ; Sexual Behavior ; Sexuality

Research about Inappropriate Sexual Behavior (ISB) among patients with dementia is not abundant although its impact on patients and carers can be significant. There are many reasons for this relative neglect. In particular, notable is a problem encountered in the inconsistency of definition and assessment of ISB as well as stigma of sexuality in patients with dementia. This article reviews the literature concerning sexually inappropriate behavior in demented patients. Behavioral and pharmacological treatment approaches are explored and the recommendations and guidelines offered by other researchers are described.
Caregivers ; Dementia ; Humans ; Sexual Behavior ; Sexuality

Sleep, which was previously not a topic for discussion in clinical practice, is now a problem that cannot be disregarded in people with diabetes mellitus. Instead, the importance of sleep has increased for the management and prevention of diabetes mellitus. Diabetes mellitus and dyssomnias are both chronic conditions that have a significant effect on the quality of life and health. Numerous research has shown that the relationship between diabetes mellitus and sleep is bidirectional rather than linear. In this review, not only the effects of diabetes mellitus on sleep, but also the effects of sleep on diabetes mellitus are investigated, and the biological mechanisms are summarized as well.

OBJECTIVES: The purpose of this study was to examine the prevalence and clinical characteristics of nonsuicidal self-injury (NSSI), and its association with suicide attempts among clinically depressed adolescents in Korea. METHODS: In total, 113 depressed adolescents aged 12– 18 years in South Korea were enrolled in this study. We assessed sociodemographic and clinical characteristics including suicidality and non-suicidal self-injury (NSSI) using various self-reported scales and semi-structured interview for diagnosis of psychiatric disorders. Demographic and clinical characteristics of the subjects were compared between NSSI and non-NSSI groups. We examined significant predictors of suicide attempts using logistic regression analysis. RESULTS: Among 113 depressed participants, 48 (42.1%) adolescents were classified into the NSSI group. In the NSSI group, there were significantly more females, showed higher depression, higher state-anxiety, and more suicide ideation. The most predictive factors of suicide attempts were history of NSSI, observed suicide/NSSI behaviors of their family or friends, and total state anxiety score. CONCLUSIONS: NSSI is more common problem among clinically depressed adolescents and history of NSSI is a significant predictor of present suicide attempts. To include the assessment of NSSI for clinically depressed adolescent may be crucial for intervention programs for high risk adolescents of suicide in Korea.
Adolescent ; Anxiety ; Depression ; Diagnosis ; Female ; Friends ; Humans ; Korea ; Logistic Models ; Prevalence ; Suicide ; Weights and Measures

For quality assurance purposes, the authors correlated aspiration cytology and subsequent tissue findings and examined the reasons for discrepancies. In three months from Jan. to Mar. 1996, 1,383 aspirations were performed, of which 285 (20.6%) had subsequent tissue diagnoses within two months. The aspiration sites were thyroid (483), lymph node (LN) (290), breast (250), soft tissue (154), liver (89), lung (49), salivary gland (26), pancreas (22), gallbladder (3), bone (3), joint (2), adrenal gland (2), scrotum (2), mediastinum (2), omentum (2), oral cavity (1), chest wall (1), and intraabdominal (1) and pelvic cavities (1). A total of 68 discrepancies were identified, and biopsies and smears from these cases were reviewed monthly. In 27 cases (40%), the discrepancy was attributed to sampling error. In five cases (9%), aspiration gave superior results with better sampling and preservation than biopsy. Thirty six cases (53% of discrepant cases) were errors in cytologic diagnosis. We categorized these discrepancies into "A", "B", and "C" ("A": minor disagreement with no affect on patient care, "B": minimal affect on patient care, "C": major affect on patient care), which were 9 (13%), 14 (21%) and 13 (19%) cases, respectively. In thirteen cases of category "C", there were eleven false negative and two false positive diagnoses. Eleven false negative cases included thyroid (3), lymph node (2), breast (2), bone (1), salivary gland (1), lung (1), and liver (1). Three cases of thyroid were papillary carcinomas diagnosed as nodular hyperplasia (1), occasional pleomorphic cells (1), and cystic change (1). Two breast cases of invasive ductal carcinomas were diagnosed as ductal hyperplasia. A malignant lymphoma was diagnosed as reactive hyperplasia and a metastatic carcinoma of LN was diagnosed as tuberculosis. Other cases were malignant tumors of bone, salivary gland, lung, and liver those were misinterpreted as benign lesion or normal. Of two false positive cases, one was nodular hyperplasia of thyroid diagnosed as papillary carcinoma and the other was normal islet cell of pancreas diagnosed as islet cell tumor. A continuous monitoring of laboratory performance is an essential component of the quality control and assurance, and the review of discrepant cases provides useful information for improvement of diagnosis.
Adenoma, Islet Cell ; Adrenal Glands ; Aspirations (Psychology) ; Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Papillary ; Diagnosis ; Gallbladder ; Humans ; Hyperplasia ; Islets of Langerhans ; Joints ; Liver ; Lung ; Lymph Nodes ; Lymphoma ; Mediastinum ; Mouth ; Omentum ; Pancreas ; Patient Care ; Quality Control ; Salivary Glands ; Scrotum ; Selection Bias ; Thoracic Wall ; Thyroid Gland ; Tuberculosis

This study examined the normal ranges and the determinants for various parameters of the short-term heart rate variability (HRV) measurements in a large Korean sample of healthy people. HRV measurements were obtained in 2,748 healthy men and 735 healthy women 18-65 yr of age. The mean total power (TP), low frequency (LF), high frequency (HF), and LF/HF ratio were 1,358.9 +/- 1,840.8 ms2, 417.3 +/- 807.6 ms2, 254.1 +/- 414.1 ms2, and 2.4 +/- 20.9 ms2 in the frequency-domain spectral analysis. The mean standard deviation of the normal-to-normal (NN) interval (SDNN) and the square root of the mean squared differences of successive NN intervals (RMSSD) were 39.6 +/- 22.1 ms and 29.7 +/- 18.1 ms in the time-domain analysis. The female subjects had significantly higher SDNN, RMSSD, and HF values than the male subjects. After controlling for age, there was no statistically significant difference in the SDNN. Quantile regression analysis showed that age and mean heart rate had a significant impact on short-term HRV measurement. Given that both clinicians and researchers are increasingly relying on short-term HRV assessment in measuring stress, our work suggests that age and gender should be considered as independent determinants for HRV.
Adolescent ; Adult ; Aged ; Alcohol Drinking ; Autonomic Nervous System/*physiology ; Body Weights and Measures ; Caffeine ; Exercise ; Female ; Heart/*physiology ; Heart Rate/*physiology ; Humans ; Male ; Middle Aged ; Republic of Korea ; Smoking

Objective: To investigate whether serum 25-hydroxyvitamin D [25(OH)D] level is associated with ovarian reserve markers in secondary amenorrhea (SA) patients. Methods: Sixty-three women diagnosed with SA were recruited during 12 months from the initiation of this prospective observational study. Serum 25(OH)D levels, serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) were estimated in study participants and ovarian reserve markers were compared between participants with vitamin D deficiency and those with normal vitamin D levels. Results: Of the 63 participants, 27 (42.9%) were vitamin D deficient (<20 ng/mL) and 36 (57.1%) had normal vitamin D levels. The mean AMH levels and AFC were 10.86±8.94 µ/L and 15.23±7.65 in the vitamin D deficient group, and 7.24±5.62 µ/L and 12.30±6.95 in the normal vitamin D group. Univariate and multivariate linear regression analysis of log10 transformed AMH and AFC with serum 25(OH)D adjusted for age and body mass index confirmed no association between vitamin D levels and AMH levels or AFC. There was also no correlation between serum 25(OH)D and AMH levels or AFC in all participants. However, participants with vitamin D deficiency had an increased chance of having polycystic ovarian syndrome (PCOS) as cause of SA than those with normal vitamin D levels (adjusted odds ratio, 7.559; 95% confidence interval, 1.28–44.65; P=0.026) after adjustment for clinical factors by logistic regression model. Conclusion There was no correlation between serum 25(OH)D levels and ovarian reserve markers in SA patients, but vitamin D deficiency may be linked to PCOS patients.

Objective: To investigate whether serum 25-hydroxyvitamin D [25(OH)D] level is associated with ovarian reserve markers in secondary amenorrhea (SA) patients. Methods: Sixty-three women diagnosed with SA were recruited during 12 months from the initiation of this prospective observational study. Serum 25(OH)D levels, serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) were estimated in study participants and ovarian reserve markers were compared between participants with vitamin D deficiency and those with normal vitamin D levels. Results: Of the 63 participants, 27 (42.9%) were vitamin D deficient (<20 ng/mL) and 36 (57.1%) had normal vitamin D levels. The mean AMH levels and AFC were 10.86±8.94 µ/L and 15.23±7.65 in the vitamin D deficient group, and 7.24±5.62 µ/L and 12.30±6.95 in the normal vitamin D group. Univariate and multivariate linear regression analysis of log10 transformed AMH and AFC with serum 25(OH)D adjusted for age and body mass index confirmed no association between vitamin D levels and AMH levels or AFC. There was also no correlation between serum 25(OH)D and AMH levels or AFC in all participants. However, participants with vitamin D deficiency had an increased chance of having polycystic ovarian syndrome (PCOS) as cause of SA than those with normal vitamin D levels (adjusted odds ratio, 7.559; 95% confidence interval, 1.28–44.65; P=0.026) after adjustment for clinical factors by logistic regression model. Conclusion There was no correlation between serum 25(OH)D levels and ovarian reserve markers in SA patients, but vitamin D deficiency may be linked to PCOS patients.

Suicide has dramatically increased in recent years, and South Korea is the highest rate among the Organization for Economic Cooperation and Development member countries. Noteably, suicide is the leading cause of death in South Korea in youths aged 15-24. Approximately 70-90% of youth suicides are related to a preexisting psychiatric disorder such as depressive disorder, conduct disorder, or substance abuse. Recently, some studies have proposed nationwide suicide prevention programs, but there have been no systematic studies about suicide and suicide prevention programs particularly for adolescents. In South Korea, to establish an evaluation system of mental health screening services and to develop a case management program, a mental health promotion model for adolescents and a few programs for depression and suicide prevention for adolescents are currently being developed. Developmental considerations and a multidisciplinary approach in the treatment and prevention of suicidal adolescents are very important. In addition it is necessary to conduct a systematized nationwide survey of depression and suicide in adolescents.
Adolescent ; Aged ; Case Management ; Cause of Death ; Conduct Disorder ; Depression ; Depressive Disorder ; Humans ; Korea ; Mass Screening ; Mental Health ; Republic of Korea ; Substance-Related Disorders ; Suicide

An analysis presented 86 cases of intussuscetion in Korean infants and children, treated at the Department of Pediatrics and the Surgery, Ewha Woman's University Hospital from January 1, 1967 to August, 1977, The following findings were noted. 1) The male outnumbered the females nearly 2.1/1. 2) In our survey, 82.5% of 86 patients were 1year or gounger and the peak incidence was between the 3 rd and 6th month of life (40.8%). 3) Seasonal distribution revealed as the highest in spring.(34.9%). 4) Thirity-seven cases(55.2%) of the intussusception were idipoathic. In 30 cases, a local cause was demonstrated. A wandering cecum was pesonted in 14 patients(20.9%) and proved to be the most common local cause. 5) It is significant that 58 cases(67.4%) of the patients were treated within 24 hours after onset of symptoms. However, seven patients(8.1%) had symptoms for more than 72 hours prior to hospital admission. 6) Vomiting and bloody stool were most common clinical signs(87.2% and 75.6%). Others were colicky abdominal pain (72.1%) and abdominal mass(50.0%). The positive results on the rectal exmination was 91.9 percent. 7) The demonstrable anatomic type of intussusception was ileocecal (38.4%) and proved to be the most common type. In addition to this type, there ileoclic(33.7%), ileocecocolic(11.6%), ileoileocolic(7.0%), ileoileal (5.8%), ileoileocecal(2.2%) in orders. 8) Simple abdomen X-ray on admission showed gaseous distension(45.5%). No specific findings were noted in 8 cases(12.1%) of the patients. 9) Nineteen (22.2%) of the patients underwent barium reduction and remainder were treated by surgical reduction. There were 58 patients(67.4%) who required manual reduction lreduction and 9 cases(10.4%) by intestinal resection for definitive therapy. 10) There were complications in 11.7 percents of the patients. The recurrence was 5 cases(5.8%) and proved to be the common complication. No deaths was encountered in our small series.
Abdomen ; Abdominal Pain ; Barium ; Cecum ; Child ; Female ; Humans ; Incidence ; Infant ; Intussusception* ; Male ; Pediatrics ; Recurrence ; Seasons ; Vomiting