PURPOSE: The purpose of this retrospective study was to identify factors predictive of survival in rectal cancer patients who received surgery with curative intent after preoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: Between July 1996 and June 2010, 104 patients underwent surgery for rectal cancer after preoperative CRT. The median dose of radiotherapy was 50.4 Gy (range, 43.2 to 54.4 Gy) for 6 weeks. Chemotherapy was a bolus injection of 5-fluorouracil and leucovorin for the first and last week of radiotherapy (n=84, 77.1%) or capecitabine administered daily during radiotherapy (n=17, 16.3%). Low anterior resection (n=86, 82.7%) or abdominoperineal resection (n=18, 17.3%) was performed at a median 47 days from the end of radiotherapy, and four cycles of adjuvant chemotherapy was administered. The serum carcinoembryonic antigen (CEA) level was checked at initial diagnosis and just before surgery. RESULTS: After a median follow-up of 48 months (range, 9 to 174 months), 5-year disease free survival (DFS) was 74.5% and 5-year overall survival (OS) was 86.4%. Down staging of T diagnoses occurred in 32 patients (30.8%) and of N diagnoses in 40 patients (38.5%). The CEA change from initial diagnosis to pre-surgery (high-high vs. high-normal vs. normal-normal) was a statistically significant prognostic factor for DFS (p=0.012), OS (p=0.002), and distant metastasis free survival (p=0.018) in a multivariate analysis. CONCLUSION: Patients who achieve normal CEA level by the time of surgery have a more favorable outcome than those who retain a high CEA level after preoperative CRT. The normalization of CEA levels can provide important information about the prognosis in rectal cancer treatment.
Carcinoembryonic Antigen ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Deoxycytidine ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Leucovorin ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Retrospective Studies ; Capecitabine

PURPOSE: This study investigates the effect of pregnant women's growth mindset on the stress of pregnancy through ego-resilience. METHODS: The subjects included 551 pregnant women in Seoul and Gyeonggi area. Data were collected using a structured questionnaire; statistical, frequency, correlation, and structural equation analyses were performed using SPSS21 and M-plus 7.0. RESULTS: First, pregnant women's growth mindset had a direct effect on pregnancy stress. Second, the mediating pathway that influenced pregnancy stress through the ego-resilience of growth mindset was significant. CONCLUSION: These results suggest that it is important to devise and practice a method to improve the growth mindset of pregnant women, enhance ego-resilience, and reduce the negative effects of stress by reducing pregnancy stress.
Female ; Gyeonggi-do ; Humans ; Methods ; Negotiating ; Pregnancy ; Pregnant Women ; Seoul

No abstract available.
Dinoprostone* ; Suppositories*

Purpose: Despite advances in neonatal care, extrauterine growth restriction (EUGR) remains common in preterm infants. This retrospective single-center study aimed to determine the incidence and risk factors of EUGR in very low birth weight (VLBW) infants. Methods: Data were collected concerning VLBW infants with gestational age (GA) <32 weeks between 2011 and 2020. EUGR was defined as a decline in weight z-score >1.2 from birth to discharge, using Fenton growth charts. Results: Among 331 eligible preterm infants, the prevalence of EUGR at discharge was 71.6%. Infants with EUGR had lower GA and birth weight than those without EUGR. They also underwent prolonged durations of parenteral nutrition, invasive ventilation, and hospitalization. Neonatal morbidities, such as bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, gastrointestinal surgery, sepsis, and parenteral nutrition-associated cholestasis were more prevalent in the EUGR group. Multivariate analysis identified lower GA and longer time to reach full enteral feeding as independent risk factors, whereas maternal use of antenatal steroids and history of gestational diabetes mellitus were independent protective factors for EUGR. Conclusion As VLBW infants are at a high risk of EUGR, continuous attention and efforts to achieve early full enteral nutrition are required to decrease the incidence of EUGR.

The purpose of this study was to examine to what extent teenagers accepted sexual relations, and to determine in which way that was affected by their disposition of stimuli, one of the psychological factors, and by their adjustment to school life, one of the environmental factors, as those factors seemed to have impact on that. This study was of descriptive correlational approach, and the subjects were 962 boy and girl students randomly selected from regular and business high schools. The data were collected from May through July 2002, and SPSS win 10.0 program was employed for data analysis. The major findings of this study were as follows; First, the students investigated got a mean of 44.49 marks on school adjustment. Their sensation seeking got an average of 130.10 marks. Their sexual allowance got a mean of 38.90 marks. Second is to regard the influence of their general characteristics on school adjustment, sensation seeking and sexual allowance. school adjustment was significant on gender, grade, career track, religion, school record, economic state, sexual intercourse. Sensation seeking was significant on all of their general characteristics. Sexual allowance was significant on all except economic state. Third, concerning correlation among sexual allowance, school adjustment and sensation seeking, sexual allowance was positively correlated to sensation seeking and negatively to school adjustment. The above-mentioned findings suggested that school adjustment and stimuli pursuit was associated with sexual attitude, and the findings of this study are expected to make any contribution to creating an ideal sexual culture for the youth.
Adolescent* ; Coitus ; Commerce ; Female ; Humans ; Male ; Psychology ; Sensation* ; Statistics as Topic ; Child Health

Candida albicans infections of the spine are relatively uncommon in spite of the increasing frequency of predisposing factors. Moreover, late onset spondylodiscitis after bloodstream candidiasis is extremely rare. A 66-year-old woman to have been underwent chemotherapy was diagnosed with candidemia. Antifungal agent was administrated until two weeks after no detection of fungus in the blood culture. The chemotherapy was continued. But, she was hospitalized due to abdominal pain and diarrhea. Pseudomembranous colitis was diagnosed. After metronidazole administration, she was improved and discharged. However, she revisited because of back pain and fever. Spondylitis and discitis on the 10th~11th thoracic spine was shown in magnetic resonance images. Open curettage and spinal stabilization was performed. C. albicans was identified. Antifungal agent was administrated and the patient improved well postoperatively. We present a rare case of late onset Candida spondylodiscitis after candidemia with review of the literatures.

No abstract available.
Case-Control Studies* ; Health Promotion* ; Risk Factors*

BACKGROUND/AIMS: The present study aimed to determine the role of cystatin C as a prognostic factor for acute kidney injury and survival in cirrhotic patients. METHODS: The study investigated 53 liver cirrhosis patients. The renal function was evaluated by serum creatinine, serum and urine cystatin C, and 24-hour creatinine clearance on admission. Acute kidney injury was defined as a serum creatinine level exceeding the normal range (>1.2 mg/dl) and an increase of at least 50% from the baseline value. Multivariate analysis, receiver operating characteristic curve, and survival analysis were used to investigate prognostic factors for acute kidney injury and survival. RESULTS: Nine of the 53 cirrhotic patients (17.0%) developed acute kidney injury within 3 months. Both serum creatinine and cystatin C were predictive factors for acute kidney injury in univariate analysis, with a diagnostic accuracy of 0.735 (95% confidence interval (CI), 0.525-0.945; p=0.028) for serum cystatin C and 0.698 (95% CI, 0.495-0.901, p=0.063) for creatinine. In multivariate analysis, only serum cystatin C was an independent risk factor for acute kidney injury. The sensitivity and specificity of a serum cystatin C level of >1.23 mg/L to acute kidney injury were 66% and 86%, respectively. Serum cystatin C was positively correlated with the Model for End-Stage Liver Disease (MELD) and MELD-Na scores (r=0.346 and p=0.011, and r=0.427 and p=0.001, respectively). Comparison of the survival rates over the observation period revealed that a serum cystatin C level of >1.23 mg/L was a useful marker for short-term mortality (p<0.001). CONCLUSIONS: The accuracy in predicting acute kidney injury and short-term mortality was higher for a serum cystatin C level of >1.23 mg/L than for the serum creatinine concentration in patients with cirrhosis.
Acute Kidney Injury/complications/*diagnosis/mortality ; Adult ; Aged ; Creatinine/blood ; Cystatin C/*analysis/blood/urine ; Female ; Humans ; Liver Cirrhosis/blood/*complications ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; ROC Curve ; Risk Factors ; Severity of Illness Index ; Survival Rate

PURPOSE: This study was done to examine the relationship between sexual permissiveness, family function and parent-adolescent communication among adolescents. METHOD: A descriptive correlation approach was used and the participants were 956 male and female students. Data were collected by questionnaire survey using convenience sampling. The instruments were the Family APGAR Questionnaire by Smilkstein(1978), PAC by Olson and Barnes(1982), and the Premarital Sexual Permissiveness Questionnaire by Reiss(1967). Data were analyzed using the SPSS 10.0 program with descriptive statistics, Pearson correlation coefficients, t-test, and ANOVA. RESULTS: Family function was significant according to school record, economic status, living arrangement of parent. Parent-Adolescent Communication was significant according to religion, economic status, having a boy/girl friend, and experience of sexual intercourse. Sexual permissiveness was significant for all except economic status. Correlation among the variables showed that parent-adolescent communication was negatively correlated to sexual permissiveness(r=-.127, p=.000) and positively to family function(r=.368, p=.000). CONCLUSION: The findings suggest that parent-adolescent communication and family function are associated with sexual permissiveness, and the findings of this study are expected to make a contribution to creating an ideal sexual culture for youth.
Adolescent* ; Coitus ; Female ; Friends ; Humans ; Male ; Parents ; Permissiveness* ; Residence Characteristics ; Child Health ; Surveys and Questionnaires

"Background: In using the Double-lumen tube (DLT), knowing the minimum bronchial cuff volume (MCV) for an effective air-tight seal will be useful; to provide a collapse of the lung; and to avoid pressure damage. The aims of the present study are thus three-fold: to measure the MCV; to measure the diameter of left main bronchus (LMBD); and to prove any relationships between two parameters. METHODS: One hundred men and forty women who needed intubation of left-sided DLT were enrolled in this study. 37 Fr DLTs were used in male patients, and 35 Fr DLTs were used in female patients. We evaluated the MCV by air bubble method and measured the LMBD in chest PA. We also evaluated the pressure/volume characteristics of the bronchial cuffs by control inflator. RESULTS: 29 patients of 100 patients (29%) exhibited persistent air leakage in 2.5 ml cuff volume in male patients (group of MCV >2.5). On the contrary, 18 patients of 40 patients (45%) did not require any cuff volume in female patients (group of MCV 0). The mean LMBD were 13.23 1.45 mm in male and 11.09 0.96 mm in female. There were significant positive correlations between MCV and LMBD in both sex and their respective correlation coefficients were 0.264 (P=0.008) in male and 0.484 (P=0.002) in female. The equations of linear regression were: LMBD = 12.394 0.429xMCV in male, LMBD = 10.725 0.438xMCV in female. CONCLUSIONS: The MCV of the brochial cuffs in left-sided DLTs has significant relationships with the LMBD measured in chest PA.
Bronchi ; Female ; Humans ; Intubation ; Linear Models ; Lung ; Male ; Thorax