PURPOSE: It is important for the physician and a rape counselor to understand epidemiology studies of the incidence, prevalence, spread, prevention, and control of sexual assault in a local community or a specific group of individuals. We did this study in order to find an effective treatment for the sexual assault victims and to establish a data base on them. METHODS: We prospectively evaluated sexually assaulted patients who visited the Medical Supportive Center for Women at the National Police Hospital from Oct. 11, 2001, to Oct. 10, 2002. The data were obtained from the records of the ER (emergency room) and OB & GY (obstetric & gynecologic) clinic; a total of 169 patients were evaluated. RESULTS: The mean age was 20.1 years old. The age distribution of sexual assault victims was divided into four: 14 cases under 7 years of age (8.3%), 26 cases between ages 7 and 13 years (15%), 43 cases between ages 14 and 19 years (26.3%), and 86 cases over 20 years of age (52.6%). Of the patients, 157 (92.9%) were unmarried and 117 (69.2%) were examined within 1 hour after visiting the hospital. The physical injuries were 15 vaginal injuries (26.9%), 34 ruptures of the hymen (16.9%), 1 sexually transmitted disease (0.6%), 57 abnormal sensations of the genital organ (28.3%), and 55 minor injuries including abrasions, contusions, and lacerations (27.3%). The psychological injuries were 105 phobias (21.4%), 92 anxieties (18.8%), 68 angers (13.9), 51 guilts (10.4%), and the like. Eighty-eight patients (52.1%) were acquainted with the assailant. CONCLUSION: Optimal management of sexual assault victims should involve continuous epidemiologic analysis and the estalishment of an assault-victim data base.
Age Distribution ; Anger ; Anxiety ; Contusions ; Counseling ; Epidemiology ; Female ; Genitalia ; Guilt ; Humans ; Hymen ; Incidence ; Lacerations ; Phobic Disorders ; Police ; Prevalence ; Prospective Studies ; Rape ; Rupture ; Sensation ; Sexually Transmitted Diseases ; Single Person

Dysphagia is a relatively rare symptom of neurovascular compression of the lower cranial nerve (CN). Many case reviews of neurovascular compression required surgical treatment to improve the neurological symptoms. This report presents a 75-year-old female patient who complained of dysphagia due to neurovascular compression of CNs IX-XI at the left side after the onset period. The symptom was improved by treating with balloon swallowing rehabilitation (BSR). In a video fluoroscopic swallowing study (VFSS), no significant manifestations were observed in the oral phase. On the other hand, profuse post-swallow residue decreased pharyngeal propulsion were observed without aspiration or penetration during the semisolid portion of the swallowing test. To reduce the pharyngeal remnant and improve pharyngeal propulsion, the BSR protocol was performed and the patient recovered quickly.Follow-up VFSS showed improvement in the post-swallow residue from 42.6 to 7.3%. After discharge, the patient could resume a normal diet without complications. Based on this observed result, it is advantageous to consider the option of a prescribed rehabilitation program over surgical treatment.

PURPOSE: Low urinary pH is a risk factor for uric acid stones, and acidic urine has been described as a renal manifestation of the metabolic syndrome. We evaluated the association between metabolic syndrome and urinary pH in adult Korean men who visited a health promotion center. MATERIALS AND METHODS: From 2004 to 2008, a total of 18,513 adult men who visited our health promotion center were enrolled in this study. The relation between urinary pH and various parameters associated with the metabolic syndrome were evaluated. RESULTS: The average age was 45.6 years (range, 18-95 years), and 4987 men (26.9%) were classified as having the metabolic syndrome. The mean urinary pH of the metabolic syndrome group was 5.91, which was significantly lower than that of the normal group (6.08). In univariate and multivariate analysis, body mass index, serum triglyceride, and blood sugar were negatively correlated with urinary pH (p<0.05). In multivariate logistic regression analysis, obesity (body mass index > or =25 kg/m2), hypertriglyceridemia (> or =150 mg/dl), high fasting glucose (> or =110 mg/dl), and low high-density lipoprotein cholesterol (<45 mg/dl) were the significant factors that predicted low urinary pH (< or =5.5). CONCLUSIONS: Metabolic syndrome was related to lower urinary pH in ostensively healthy adult Korean men. Further studies are needed to elucidate the exact mechanism responsible for the lower urinary pH in individuals with the metabolic syndrome.
Adult ; Blood Glucose ; Body Mass Index ; Cholesterol ; Fasting ; Glucose ; Health Promotion ; Humans ; Hydrogen-Ion Concentration ; Hypertriglyceridemia ; Lipoproteins ; Logistic Models ; Male ; Metabolic Syndrome X ; Multivariate Analysis ; Obesity ; Risk Factors ; Uric Acid ; Urinalysis

Cases of sexual assault are often difficult to investigate and prosecute. The collection of evidence is a crutial factor when determining if such a case will go forward. Evidence contained in a rape kit plays a significant role in whether or not a crime of sexual assault can be prosecuted. It is important not only that the evidence be collected properly but also that the kit itself provide for the proper collection of evidence and materials. Because most hospital emergency departments throughout the country use their own kits, or none at all, there is a vast inconsistency in evidence collection. Different kits collect different amounts of evidence. For this reason, we established a kit committee to evaluate the contents of victim evidence collection kits. We propose that most hospital emergency departments and some clinics across the country be provided with rape kits to be used during forensic medical examinations of sexual assault victims and that those kits should be supplied the Sexual Assault Evience Collection (SAEC) Program, commonly referred to as the Rape Kit Program.
Crime ; Emergency Service, Hospital ; Rape

Cilostazol is used for the treatment of intermittent claudication, ulceration and pain. This study was conducted to develop a population pharmacodynamic (PD) model for cilostazol's closure time (CT) prolongation effect in healthy Korean subjects based on a pharmacokinetic (PK) model previously developed. PD data were obtained from 29 healthy subjects who participated in a study conducted in 2009 at Severance Hospital. The PK model used was a two-compartment model with first order absorption. CT data were best described by a turnover model with a fractional turnover rate constant (K(out)) inhibited by drug effects (Eff), which were represented by a sigmoid E(max) model [Eff = E(max) · C(γ) / (EC₅₀(γ)+C(γ))] with E(max) being maximum drug effect, EC₅₀ drug plasma concentration at 50% of E(max), C drug plasma concentrations, and γ the Hill coefficient. For the selected PD model, parameter estimates were 0.613 hr⁻¹ for K(out), 0.192 for E(max), 730 ng/ml for EC₅₀ and 5.137 for γ. Sex and caffeine drinking status significantly influenced the baseline CT, which was 85.36 seconds in male non-caffeine drinkers and increased by 15.5% and 16.4% in females and caffeine drinkers, respectively. The model adequately described the time course of CT. This was the first population PD study for cilostazol's CT prolongation effect in a Korean population.
Absorption ; Caffeine ; Colon, Sigmoid ; Drinking ; Female ; Healthy Volunteers ; Humans ; Intermittent Claudication ; Male ; Plasma ; Ulcer

No abstract available.
Antibodies* ; Egg Yolk* ; Humans* ; Ovum* ; Rotavirus*

Behcet's disease is a recurrent and multisystemic disorder which usually persists over many years. In 1937 Behcet described a chronic relapsing triple symptom complex of recurrent oral ulceration, genital ulceration and ocular inflammation. Other manifestations of the syndrome include arthritis, cutaneous vasculitis, thrombophlebitis, epididymitis, ulcers of gastrointestinal tract and meningoencephalitis. Recently, a case was experienced involving intestinal Behcet's syndrome with duodenal ulcer bleeding. A 32-year-old male patient was admitted due to hematemesis, and epigastric pain. The patient had ulcers on the oral mucosa, soft palate, external genitalia, and anus. An irregularly marginated ulcer with bleeding was found on the anterior of the duodenal bulb through esophago- gastroduodenoscopic examination. The patient was diagnosed with Behcet's disease and was treated with steroids. In this paper, the case of duodenal bulb involvement of Behcet's disease is reported with a review of relevant literature.
Adult ; Anal Canal ; Arthritis ; Behcet Syndrome ; Duodenal Ulcer* ; Epididymitis ; Gastrointestinal Tract ; Genitalia ; Hematemesis ; Hemorrhage ; Humans ; Inflammation ; Male ; Meningoencephalitis ; Mouth Mucosa ; Oral Ulcer ; Palate, Soft ; Steroids ; Thrombophlebitis ; Ulcer ; Vasculitis

PURPOSE: Although subintimal angioplasty (SIA) has been advocated to treat chronic lower extremity arterial occlusions, numerous reports have described differences in its results. We evaluated the effect of SIA in a group of patients with severe lower extremity arterial occlusive disease. METHOD: During a 5-month period, 6 limbs in 4 patients with arterial occlusions (mean length, 17.7 cm; range, 9 to 27 cm) were treated with SIA. Three limbs had gangrene, and all patients had resting pain. There were two external iliac-superficial femoral, two superficial femoral-popliteal and two femoral-popliteal-tibial artery lesions. With fluoroscopic guidance, via an antegrade common femoral artery puncture, a subintimal dissection plane was created across the occlusion with standard hydrophilic guidewire and catheter. The arterial lumen was reentered distal to the occlusion, and the recanalized segment was balloon (3 to 6 mm) dilated. RESULT: SIA was technically successful in all 6 limbs (100%). Pain was completely resolved and all areas of gangrene were healed. The mean increase in ankle-brachial index after SIA was 0.51 (range, 0.25 to 0.71). There was no significant complication related with SIA and all arteries were patent during 3.6-months mean follow-up period. CONCLUSION: SIA for long occlusions of the crural arteries is safe and effective and can be an excellent alternative to reconstructive surgery in elderly and frail patients.
Aged ; Angioplasty* ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Catheters ; Extremities ; Femoral Artery ; Follow-Up Studies ; Gangrene ; Humans ; Lower Extremity* ; Punctures

PURPOSE: Alfuzosin XL (Sanofi-Aventis, UroXatral(R)) has to be taken just after a meal for the best efficacy due to its specific pharmacokinetics. We studied patient compliance and associated factors with regard to the correct instructions for taking alfuzosin XL. MATERIALS AND METHODS: Alfuzosin XL was prescribed to 62 patients from February to May 2008. At the first visit, we provided a prescription for alfuzosin XL with the instructions to "take one tablet just after dinner once a day". At the second visit, we evaluated patient compliance and the factors that influenced the patient compliance for taking the alfuzosin XL. The physician explained the instructions to the patients. At the third visit, we compared the compliance and associated factors with the results from the first visit. RESULTS: A total of 50 patients completed the study. After the first visit, twenty one patients (42.0%) were not taking the alfuzosin XL according to the prescription, that is, 20 patients took alfuzosin XL before going to bed, and one patient before meals. (p<0.05) After direct instructions by a physician, 49 patients (98.0%) took the alfuzosin XL correctly. (p<0.001) CONCLUSIONS: Taking alfuzosin XL as prescribed was accomplished in only 58% of patients. When alfuzosin XL is prescribed, the physicians should be aware of the importance of providing instructions directly to patients.
Compliance ; Humans ; Meals ; Patient Compliance ; Prescriptions ; Quinazolines

The seminiferous tubules merge and connect with the tubuli recti that form the spaces known as the rete testis. Cystic ectasia of the rete testis is a rare benign testicular lesion. We report the cystic ectasia of the rete testis in a 66-year-old man.
Aged ; Dilatation, Pathologic ; Humans ; Rete Testis ; Seminiferous Tubules ; Testis