A Gynecologic Aspects of Child Sexual Abuse / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate victims of child sexual abuse and assess the similarities and differences between them. METHODS: The authors studied retrospectively 55 patients among 230 sexual abuse victims between the ages 2 and 13 who visited and were treated at the Department of Obstetrics and Gynecology, National Police Hospital between the dates Oct, 13, 2001 and Mar, 25, 2003 were followed and observed. RESULTS: Female infants and children composed 94.5% instances of sexual abuse were most common between 4 and 7 o'clock in the afternoon. Unlike adult cases, assailants were in most cases acquaintances (55.5%), and the crimes were committed most often at the homes of either victim or assailant (50.9%). 38.2% of victims had been directed to the National Police Hospital from police stations, 21.8% from other hospitals. Diagnosis resulted in 5.5% of cases with no observable symptoms, 18.2% with lacerations, among these cases 1 instance (1.8%) requiring surgical repair. 1 case each of Gonorrhea and genital herpes were found, with no instances of pregnancy. CONCLUSION: Child sexual abuse results in life-long bodily and psychological stress for both the victim and his/her family. Witnesses are in some cases unable to testify in legal proceedings, and the gathering of evidence is more difficult than in adult cases. This could lead to frequent social and legal negligence. Cooperation among such numerous and various professional institutions as hospitals, child guidance clinics, child psychiatrists, police, prosecutory offices and the courts is requisite to the settlement of these cases. Since the gynecologist plays the leading role in the identification and treatment of child and infant sexual abuse victims, and is often the first to come in contact with these cases, careful attention is required in the processes of inspection, inquiry, evidence collection, treatment and diagnosis.

A Case of Pelvic Actinomycosis / 대한산부인과학회잡지

Actinomycosis is a chronic, progressive, suppurative disease which present some difficulty in establishing a correct preoperative diagnosis. Because pelvic actinomycosis has variable nonspecific clinical manifestations. Actinomyces species are gram-positive, non-acid fast, anaerobic bacteria that exhibit branching filamentous growth. After trauma, surgery, or other infection that alter the host's mucosal barriers, these organism advance to invade surrounding tissues and organs. Recent reports have demonstrated an increased incidence in women using Intrauterine device (IUD). It is accounted that IUD cause chronic intrauterine infection, tissue injury, and act as nucleus for parasitic infestation. We have experienced a cause of pelvic actinomycosis in a 37-year-old woman using IUD and report it with brief review of literature.

Clinical study of Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: Ectopic pregnancy can still cause maternal death, though we have undergone it frequently. So, we survey 80 cases ectopic pregnancies treated our hospital for early detection and proper management. METHODS: In this study, the authors studied retrospectively 80 cases which had been admitted and treated at the department of Obstetrics and Gynecology, National Police Hospital from Jan. 1, 1991 to Dec. 31, 2000. RESULTS: Incidence of ectopic pregnancy was one in 68 normal deliveries for 10 years, 63.7% of cases occurred in 25~34 years-old age group, and 52.6% of patients had previous abdominal surgery including cesarean section. Average interval of tubal ligation was 6.5 years between the onset of ectopic pregnancy and tubal ligation. Lower abdominal pain was the most common clinical symptom developed in 91.3% of the patients. Average interval between the onset of symptom and LMP was 7.6 weeks. Most ectopic pregnancies were tubal pregnancies and salpingectomy was done in 56.3% of the patients. CONCLUSION: According to our study, ectopic pregnancy occurred most frequently in women in their reproductive age and one of most important prognostic factors is time between onset of symptom and arrival of patient at hospital. We must make our efforts to preserve utero-ovarian function in treatment of patients with ectopic pregnancy.