PURPOSE: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. METHODS: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. RESULTS: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. CONCLUSION: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.
Counseling ; Delivery of Health Care ; Humans ; Leadership ; Learning ; Lectures ; Multimedia ; Program Development ; Smoke ; Smoking ; Smoking Cessation ; Tobacco

In Korea, skipping breakfast is of concern as an unhealthy dietary habit. While the relationship between skipping breakfast and overweight and obesity has been established in children and adolescents in Europe, studies on this topic in Korean adolescents are scarce. Therefore, we investigated the relationship between body mass index (BMI) and skipping breakfast in Korean adolescents. Data from the 13th Korea Youth Risk Behavior Web-based Survey (2017) were analyzed. This anonymous, self-administered online questionnaire examined health behaviors including smoking, drinking, obesity, eating habits, sleep duration, and physical activity in Korean youth. Questions included those on general characteristics, such as economic status, parental education level, etc. This study included data from 56,933 adolescents aged 12–18 years. Skipping breakfast was defined as consuming breakfast fewer than five times per week. BMI, health behaviors, and general characteristics were compared between the breakfast-skipping and control groups. The skipping-breakfast and control groups comprised 25,836 (45.4%) and 31,097 (54.6%) subjects, respectively. BMI was significantly higher in the breakfast-skipping group than that in the control group (21.6 ± 3.24 kg/m2 vs. 21.4 ± 3.26 kg/m2, p < 0.001). Among the normal-weight and overweight groups, 44.9% and 47.3% skipped breakfast, respectively (p < 0.001). After adjusting for health behaviors and general characteristics, the risk of overweight was higher in those who skipped breakfast than that in the control group (odds ratio; 1.125, 95% confidence interval; 1.077–1.176).Skipping breakfast was related to overweight in Korean adolescents. Therefore, longitudinal research is needed to determine whether skipping breakfast is associated with overweight.

PURPOSE: This study investigated the recurrence rate after performing hallux valgus correction using scarf and Akin osteotomy, and also identified the correlation and cut-off values of both the preoperative and postoperative radiographic parameters as risk factors for the recurrence of hallux valgus. MATERIALS AND METHODS: We reviewed 87 hallux valgus patients (122 feet) who received scarf and Akin osteotomy from January 2007 to August 2015. The clinical outcomes were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. The radiological outcome measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) as determined on the serial weight bearing radiographs. Recurrence was defined as more than 20 degrees of HVA noted on the final follow-up radiograph. Those radiological factors associated with recurrence were evaluated and analyzed. RESULTS: The mean follow-up duration was 20.6 months (12.0∼46.5 months) and the mean age was 44 years (13∼80 years). The VAS and AOFAS scores were significantly improved at the time of the final follow-up (7.0 to 2.0, p<0.001; 78.0 to 92.0, p<0.001; respectively). Significant corrections in the HVA, IMA, and DMAA were obtained (p<0.001). Eleven (9.0%: 11/122) cases experienced recurrent hallux valgus deformity. The postoperative IMA, DMAA and HVA showed significant moderate to strong correlation with HVA at the final follow-up (Pearson correlation coefficient: 0.44, 0.70, and 0.88, respectively; p<0.001). Postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees showed statistically significant correlation with radiological recurrence at the last follow-up, and the odds ratio of each variable was high in order. CONCLUSION Our radiographic results indicated that postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees can be risk factors for hallux valgus recurrence. These risk factors may be helpful for modifying surgical procedures and preventing the recurrence of hallux valgus.

Central obesity carries more metabolic risks compared with total obesity assessed by Body mass index (BMI). Also, there’s paradoxical relationship between BMI and all-cause mortality in overweight group (23 kg/㎡ ≤ BMI < 25 kg/㎡). The aim of this study is to assess relationship between waist-to-height ratio (WHtR) and lifestyle-related diseases such as metabolic syndrome, hypertension, and type 2 diabetes in overweight group, and to find the most predictable and useful obesity index for screening lifestyle-related diseases.A total of 3,994 overweight (23 kg/㎡ ≤ BMI < 25 kg/㎡) adults from the Korea National Health and Nutrition Examination Survey, 2013-2015 (KNHANES VI) were included. We assessed the relationship between WHtR and metabolic syndrome components using multiple regression analysis, and assessed the relationship between abdominal obesity (WHtR ≥ 0.5) and lifestyle-related diseases using complex samples logistic regression analysis. Also, to find the most useful index to predict lifestyle-related diseases, we calculated the areas under the Receiver operating characteristic (ROC) curves.WHtR was significantly related to metabolic syndrome components. Odds ratios of metabolic syndrome, hypertension and type 2 diabetes were 2.187, 1.445, 2.463 in abdominal obese group (WHtR ≥ 0.5), respectively. Area under the curve of WHtR was the most significantly highest among those of obesity indices.WHtR is a simple and useful obesity index to predict lifestyle-related diseases in overweight Korean adults. Further investigations for other obesity indices are needed to predict lifestyle-related diseases better.

Central obesity carries more metabolic risks compared with total obesity assessed by Body mass index (BMI). Also, there’s paradoxical relationship between BMI and all-cause mortality in overweight group (23 kg/㎡ ≤ BMI < 25 kg/㎡). The aim of this study is to assess relationship between waist-to-height ratio (WHtR) and lifestyle-related diseases such as metabolic syndrome, hypertension, and type 2 diabetes in overweight group, and to find the most predictable and useful obesity index for screening lifestyle-related diseases.A total of 3,994 overweight (23 kg/㎡ ≤ BMI < 25 kg/㎡) adults from the Korea National Health and Nutrition Examination Survey, 2013-2015 (KNHANES VI) were included. We assessed the relationship between WHtR and metabolic syndrome components using multiple regression analysis, and assessed the relationship between abdominal obesity (WHtR ≥ 0.5) and lifestyle-related diseases using complex samples logistic regression analysis. Also, to find the most useful index to predict lifestyle-related diseases, we calculated the areas under the Receiver operating characteristic (ROC) curves.WHtR was significantly related to metabolic syndrome components. Odds ratios of metabolic syndrome, hypertension and type 2 diabetes were 2.187, 1.445, 2.463 in abdominal obese group (WHtR ≥ 0.5), respectively. Area under the curve of WHtR was the most significantly highest among those of obesity indices.WHtR is a simple and useful obesity index to predict lifestyle-related diseases in overweight Korean adults. Further investigations for other obesity indices are needed to predict lifestyle-related diseases better.

BACKGROUND: Water is essential to body homeostasis. But there are little attention to basic impact or attribute of response to drinking water. We investigated the factors related to drinking water through the ‘5th Korea National Health and Nutrition Examination Survey’ (KNHANESV). METHODS: From the database of the 5th KNHANESV conducted in 2010 to 2012, data of 15,716 adults who aged 19 or above, and responded to all the questionnaires of health interview, nutrition survey and had health examination were included in this analysis. SPSS 21.0 was used for statistical analysis with complex sample survey modules. RESULTS: The study subjects drink 5.2 ± 0.48 cups of water for a day. The elderly (>65 yrs) drink less water (p < 0.000), and male drink more than female (p < 0.000). And obesity is significantly associated with higher water intake (p < 0.000). Calorie and sodium intake, HbA1c, low-density lipoprotein, triglyceride, feritin, Fe, creatinine are significantly associated with higher water intake. Physical activity and serum vitamin D level are also associated with higher water intake (p < 0.000). CONCLUSION: Older people drink less water and several disease is related with water intake amount. Further studies need to be done about the value of water intake in healthy life style, and measuring the effect of water intake.
Adult* ; Aged ; Creatinine ; Drinking Water ; Drinking* ; Female ; Homeostasis ; Humans ; Korea* ; Life Style ; Lipoproteins ; Male ; Motor Activity ; Nutrition Surveys* ; Obesity ; Sodium ; Triglycerides ; Vitamin D ; Water*

Chopart joint fracture and dislocation are rare injuries compared with other joint injuries with various clinical manifestations. Moreover, there is a lack of knowledge of the radiological findings of the joints, and thus, the extent of joint ligament damage may be underestimated, leading to improper treatment. This paper reports three cases of Chopart joint injury and seeks to reconsider the importance of Chopart joint evaluation and treatment.
Dislocations* ; Foot Injuries ; Joints* ; Ligaments ; Tarsal Joints

Gastrocelic fistula of malignant origin is a rare complication, usually due to gastric or colon cancer. Possible other etiologic factors resulting in gastrocolic fistula are peptic ulcer, trauma, carcinoid tumor, intestinal tuberculosis, Crohn's disease, lymphoma, intraabdominal abscess, diverticulitis and etc. At the present, earlier diagnosis and treatment of gastric and colon cancer may explain the low frequency of malignant gastrocolic fistula than the past but the review of Korean literatures revealed only two reports of gastrocolic fistula secondary to gastric cancer and another from benign gastric ulcer. Yet, there has been no report of fistula due to colon cancer. We experienced a case of colon cancer with postural dizziness, fecal eructation who was diagnosed as gastrocolic fistula by endoscopy, barium enema, UGI series and finally underwent operation. Therefore, we report this case with the review of literatures.
Abscess ; Barium ; Carcinoid Tumor ; Colon* ; Colonic Neoplasms* ; Crohn Disease ; Diagnosis ; Diverticulitis ; Dizziness ; Endoscopy ; Enema ; Eructation ; Fistula* ; Lymphoma ; Peptic Ulcer ; Stomach Neoplasms ; Stomach Ulcer ; Tuberculosis

Purpose: The current treatment option of bimalleolar equivalent fractures is open reduction and internal fixation of lateral malleolus followed by syndesmotic screw fixation of syndesmosis or deltoid ligament augmentation. On the other hand, there is still debate using deltoid ligament augmentation technique. This study compared the clinical results of deltoid ligament augmentation and syndesmosis screw fixation in bimalleolar equivalent fractures. Materials and Methods: From 2007 to 2022, this study retrospectively compared 31 patients who underwent deltoid ligament augmentation with fibula fixation with 12 patients who underwent syndesmosis fixation for bimalleolar equivalent fractures. The clinical results were compared by measuring visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and ankle range of motion 12 months after surgery. The radiological results were compared by measuring medial clear space, tibiofibular overlap, and tibiofibular clear space before and after surgery. The postoperative complications were compared. Results: The post-operative AOFAS score, the VAS score, and the ankle range of motion were similar in the two groups. The radiological results showed a similar medial clear space, tibiofibular overlap, and tibiofibular clear space in the two groups before and after surgery. In addition, there were no postoperative complications in the group that underwent deltoid ligament augmentation, and one screw break and superficial infection were observed in each of the patient groups that had undergone trans-syndesmosis screw fixation. Conclusion Clinically good results could be obtained despite only deltoid ligament augmentation being performed alone after fibular fracture fixation in bimalleolar equivalent fractures. In addition, if only deltoid ligament augmentation is performed alone rather than transsyndesmosis screw fixation, there is little possibility of misalignment and no risk of screw breakage or the need for additional procedures to remove the screws. In conclusion, deltoid ligament repair without syndesmosis screw fixation could be viable for treating bimalleolar equivalent fractures.

PURPOSE: This study was designed to investigate the significance of preoperative serum CA 19-9 level as a prognostic factor and postoperative serum CA 19-9 level as an indicator for recurrence in gastric adenocarcinoma patients. MATERIALS AND METHODS: 328 patients, who received curative resection of stomach for gastric cancer from 1989 to 1996 and followed up successfully, were analyzed retrospec- tively. Median follow-up period was 24 months (range: 11-38 months). The cut off level of serum CA 19-9 was 37 U/ml. The relationships between preoperative serum CA 19-9 status and prognostic parameters, recurrence and survival rate were analyzed. Multivariate analysis using Cox proportional hazards regression analysis was performed to evaluate as an independent prognostic factor. The relationship between postoperative serum CA 19-9 level and recurrence was investigated. RESULTS: Out of 328 cases, 29 cases (8.8%) showed elevated preoperative serum CA 19-9 level. The preoperative serum CA 19-9 level was correlated with the degree of depth of invasion and the status of lymph node metastasis (p<0.05). Patients with positive pre- operative serum CA 19-9 status showed higher incidence of recurrence (p<0.05) and poorer survival rate (p=0.00003) than patients with negative status. Preoperative serum CA 19-9 status (risk ratio: 3.4464, p=0.0039) revealed as an independent prognostic factor in multivariate analysis. Postoperative serum CA 19-9 status revealed as a useful predictor for recurrence in patients with positive preoperative serum CA 19-9 status. CONCLUSION: Preoperative serum CA 19-9 determination in patients with gastric cancer was valuable for predicting tumor progression and prognosis. Preoperative serum CA 19-9 status may be helpful to predict recurrence earlier than other diagnostic tools, especially in the patients with positive preoperative serum CA 19-9 status.
Adenocarcinoma* ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach ; Stomach Neoplasms ; Survival Rate