BACKGROUND/OBJECTIVES: Although globally the numbers of children diagnosed with failure to thrive (FTT) have decreased, FTT is still a serious pediatric problem. We aimed to investigate the effects of zinc supplementation for 6 months on growth parameters of infants and children with FTT. SUBJECTS/METHODS: In this retrospective study, of the 114 participants aged between 4 months and 6 years, 89 were included in the zinc supplementation group and were provided with nutrition counseling plus an oral zinc supplement for 6 months. The caregivers of the 25 participants in the control group received nutrition counseling alone. Medical data of these children, including sex, age, height, weight, serum zinc level, and serum insulin-like growth factor 1 (IGF1) level were analyzed. RESULTS: Zinc supplementation for 6 months increased weight-for-age Z-score and serum zinc levels (5.5%) in the zinc supplementation group of underweight category children. As for stunting category, height-for-age Z-score of the participants in the zinc supplementation group increased when compared with the baseline, and serum zinc levels increased in the normal or mild stunting group. Serum IGF1 levels did not change significantly in any group. Thus, zinc supplementation was more effective in children in the underweight category than those in the stunted category; this effect differed according to the degree of the FTT. CONCLUSION: These findings suggest that zinc supplementation may have beneficial effects for growth of infants and children with FTT, and zinc supplementation would be required according to degree of FTT.
Caregivers ; Child* ; Counseling ; Failure to Thrive* ; Growth Disorders ; Humans ; Infant ; Retrospective Studies ; Thinness ; Zinc*

PURPOSE: This study analyzed the prognostic factors affecting admission in acute alcohol-intoxicated traumatic brain injury (TBI) patients visiting the emergency room. METHODS: A multicenter, retrospective observational study was conducted on 821 acute alcohol-intoxicated adult trauma patients, who visited 10 university hospital emergency centers from April to November 2016. The primary outcome was hospital admission. The secondary outcome was in-hospital mortality. RESULTS: One hundred sixty-eight patients diagnosed with acute alcohol-intoxicated TBI were analyzed. The increase in blood alcohol concentration was associated significantly with a mild decrease in admission (adjusted odds ratio, 0.993; 95% confidence interval, 0.989 to 0.998; p=0.01). Moderate to severe TBI patients showed a significant increase in admission compared to mild TBI patients (adjusted odds ratio, 12.449; 95% confidence interval, 3.316 to 46.743; p < 0.001). CONCLUSION: This study showed that the admission was inversely correlated with the blood alcohol concentration and is correlated directly with the increase in the severity in TBI. Therefore, emergency physicians may be required to identify the severity of TBI rapidly and accurately in acute alcohol-intoxicated trauma patients visiting the emergency room.
Adult ; Alcohol Drinking ; Blood Alcohol Content ; Brain Injuries* ; Emergencies* ; Emergency Service, Hospital* ; Hospital Mortality ; Humans ; Observational Study ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies

BACKGROUND: Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories. METHODS: Each participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors. RESULTS: A total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity. CONCLUSIONS: Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.
Hand ; Hospitals, General ; Mass Screening* ; Methods ; Papanicolaou Test ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010. RESULTS: We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081). CONCLUSION: PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Radiotherapy* ; Recurrence ; Retrospective Studies*

PURPOSE: The purpose of this study is to evaluate the treatment outcomes of adjuvant radiotherapy using vaginal brachytherapy (VB) with a lower dose per fraction and/or external beam radiotherapy (EBRT) following surgery for patients with stage I endometrial carcinoma. MATERIALS AND METHODS: The subjects were 43 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer who underwent adjuvant radiotherapy following surgery between March 2000 and April 2014. Of these, 25 received postoperative VB alone, while 18 received postoperative EBRT to the whole pelvis; 3 of these were treated with EBRT plus VB. The median EBRT dose was 50.0 Gy (45.0–50.4 Gy) and the VB dose was 24 Gy in 6 fractions. Tumor dose was prescribed at a depth of 5 mm from the cylinder surface and delivered twice per week. RESULTS: The median follow-up period for all patients was 57 months (range, 9 to 188 months). Five-year disease-free survival (DFS) and overall survival (OS) for all patients were 92.5% and 95.3%, respectively. Adjuvant radiotherapy was performed according to risk factors and stage IB, grade 3 and lymphovascular invasion were observed more frequently in the EBRT group. Five-year DFS for EBRT and VB alone were 88.1% and 96.0%, respectively (p = 0.42), and 5-year OS for EBRT and VB alone were 94.4% and 96%, respectively (p = 0.38). There was no locoregional recurrence in any patient. Two patients who received EBRT and 1 patient who received VB alone developed distant metastatic disease. Two patients who received EBRT had severe complications, one each of grade 3 gastrointestinal complication and pelvic bone insufficiency fracture. CONCLUSION: Adjuvant radiotherapy achieved high DFS and OS with acceptable toxicity in stage I endometrial cancer. VB (with a lower dose per fraction) may be a viable option for selected patients with early-stage endometrial cancer following surgery.
Brachytherapy ; Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Follow-Up Studies ; Fractures, Stress ; Gynecology ; Humans ; Obstetrics ; Pelvic Bones ; Pelvis ; Radiotherapy ; Radiotherapy, Adjuvant* ; Radiotherapy, Conformal ; Recurrence ; Risk Factors

PURPOSE: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. METHODS: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. RESULTS: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. CONCLUSION: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.
Adult ; Assertiveness ; Cerebral Infarction ; Health Promotion ; Humans ; Myocardial Infarction ; Smoke* ; Tobacco Smoke Pollution ; Vascular Diseases*

No abstract available.
Adult* ; Cellulitis* ; Humans ; Sporotrichosis*

PURPOSE: This study was conducted to explore the influence of academic institutional interest, open parent-adolescent communication, social (friend) support, and existential spiritual well-being on suicidal ideation of college students. METHODS: The research design was descriptive survey research involving 285 college students in city G. Data was collected from May 18, 2011 to November 2, 2011 and analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical regression analysis. RESULTS: The findings reveal that suicidal ideation of college students was low, i.e., average score was 9.2+/-3.65 (possible range 5~25). This study determined that suicidal ideation is negatively correlated with interest on the part of the academic institution, open parent-adolescent communication, social support from friends, and existential spiritual well-being. The extent of existential spiritual well-being was a significant predictor of suicidal ideation, controlling for general characteristics variables (gender, number of close friends, first supporter) and institutional interest, open parent-adolescent communication, and social support. Existential spiritual well-being accounted for 50% of the explanation of suicidal ideation of college students. CONCLUSION: Based on the outcomes of this study, designing an intervention program that emphasizes existential spiritual well-being in order to decrease suicidal ideation of tertiary education students is strongly recommended.
Education ; Friends ; Humans ; Research Design ; Suicidal Ideation*

Young radish (Raphanus sativus L), a member of the mustard family (Cruciferae), is a common ingredient of Kimchi. Although few reports have described anaphylaxis to cruciferous vegetables, we report the case of anaphylaxis induced by contact with young radish. A 46-year-old female with a history of contact allergy to metal presented to our emergency room (ER) with dizziness, generalized eruption and gastrointestinal upset. Her symptoms developed after re-exposure to young radish while chopping it. Hypotensive blood pressures were noted. Three days prior, the patient had experienced generalized urticaria with pruritus immediately after chopping the fresh young radish, which resolved spontaneously. In the ER, her symptoms improved by the administration of epinephrine (0.3 mL), antihistamine (chlorpheniramine) and isotonic saline hydration. A skin prick test with young radish extract showed positive reactivity. The same skin test was negative in five adult controls. IgE-mediated hypersensitivity could be an important immunologic mechanism in the development of young radish-induced anaphylaxis.
Adult ; Anaphylaxis* ; Dizziness ; Emergency Service, Hospital ; Epinephrine ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Middle Aged ; Mustard Plant ; Pruritus ; Raphanus* ; Skin ; Skin Tests ; Urticaria ; Vegetables

BACKGROUND/AIMS: Second-look endoscopy is performed to check for the possibility of post-endoscopic submucosal dissection (ESD) bleeding and to perform prophylactic hemostasis in most hospitals; however, there is little evidence about the efficacy of second-look endoscopy. We investigated whether second-look endoscopy after ESD is useful in the prevention of post-ESD bleeding. METHODS: A total of 550 lesions with gastric epithelial neoplasms in 502 patients (372 men and 130 women) were treated with ESD between August 18, 2009 and August 18, 2010. After the exclusion of three lesions of post-ESD bleeding within 24 hours, 547 lesions (335 early gastric cancers and 212 gastric adenomas) were included for the final analysis. RESULTS: The occurrence rate of delayed post-ESD bleeding was not significantly different between the second-look group and the no second-look group (1% vs 2.5%, p>0.05). The only predictor of delayed bleeding was tumor size, regardless of second-look endoscopy after ESD (22.8+/-9.87 vs 15.1+/-10.47, p<0.05). There was no difference between the prophylactic hemostasis and nonprophylactic hemostasis groups, including the occurrence rate of delayed bleeding. In the second-look group with prophylactic hemostasis, the hospital stay was more prolonged than in the second-look group without prophylactic hemostasis, but there was no significant difference (p=0.08). CONCLUSIONS: Second-look endoscopy to prevent delayed bleeding after ESD provides no significant medical benefits.
Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy/adverse effects ; Gastric Mucosa/surgery ; *Gastroscopy ; Humans ; Length of Stay ; Male ; Middle Aged ; Postoperative Hemorrhage/*diagnosis/etiology ; Retrospective Studies ; Risk Factors ; Second-Look Surgery ; Stomach/pathology/surgery ; Stomach Neoplasms/pathology/*surgery ; Time Factors