OBJECTIVES: This study was designed to investigate factors affecting the discordance between body image and body mass index amongst Korean adults aged 19–39 years. METHODS: Data (N = 59,361) from the 2014 Korean Community Health Survey was analyzed using descriptive analysis, chi-square test, and logistic regression analysis. RESULTS: To examine the factors affecting body image discordance as observed in 43.1% of participants, the group was subdivided into underestimation and overestimation. There were 36.0% of participants that were body image discordant underestimators and 7.1% were overestimators. Multivariate logistic regression analysis showed that the underestimators tended to be men, graduated from high school, married, current/ex-smokers, ex-drinkers, had between 5 to 9 hours sleep (inclusive), had fair to good self-rated health, and demonstrated healthy weight control behavior, relative to the reference group. In comparison, overestimators tended to be in the 19–29 year group and had signs of depression. The OR of individuals who were men, married, and had healthy weight control behavior was significantly lower in the overestimators group. CONCLUSION: These findings show that tailored interventions to promote accurate body awareness should be based on the type of body image discordance. In addition, it is necessary to develop and implement a program of body image improvement that considers the factors affecting body weight discordance.
Adult* ; Body Image* ; Body Mass Index ; Body Weight ; Depression ; Health Surveys ; Humans ; Logistic Models ; Male ; Overweight

PURPOSE: The purpose of this research was to develop and evaluate the effect of a mind map for relief of emotional labor and burnout among nurses in outpatient departments in cancer hospitals. METHODS: We developed a mind map to reduce emotional labor and burnout. A quasi-experimental study was used with a nonequivalent control group pretest-posttest design. Data were collected from December 2012 to April 2013. Participants were 35 nurses working in the outpatient department of a cancer hospital. The experimental group participated in the mind map program biweekly for 10 weeks. Data were analyzed using chi2-test, Mann-Whitney U test, paired t-test, and Wilcoxon sign rank test with the SPSS 21.0 program. RESULTS: The physical burnout and total burnout scores decreased significantly in the intervention group which took the mind map program. CONCLUSION: Findings indicate that the mind map is an effective intervention to reduce burnout in outpatient department nurses.
Cancer Care Facilities* ; Humans ; Outpatients*

Bronchogenic cyst has been recognized as remnants of foregut which abnormally were developed tracheobronchial tree during embryonic period. The anomaly was found in the lung or mediastinum but rarely in the neck. Histologic diagnosis can be made by the identification of the airway tissue lined by ciliated pseudostratified columnar or cuboid epithelium. A 4-year-old patient was admitted due to increase in the size of right neck mass which was incidentally found 2 years ago. In anterior triangle of neck, soft, non-tender and movable mass was presented in right lymph node measured by 1.2X0.7 cm in size. On admission, soft and non-tender mass was palpated at the right neck between right thyroid gland and right sternocleidomastoid muscle measured by 2.0x1.0 cm in size. After the excisional operation, histopathologic examination revealed the smooth muscle and muco-serous gland lined by ciliated pseudostratified columnar epithelium, and was diagnosed of bronchogenic cyst surrounded by enlarged lymph nodes which were reflecting reactive hyperplasia. We are reporting a case of bronchogenic cyst presenting as neck mass with brief review of the literature.
Bronchogenic Cyst* ; Child ; Child, Preschool* ; Diagnosis ; Epithelium ; Humans ; Hyperplasia ; Lung ; Lymph Nodes ; Male* ; Mediastinum ; Muscle, Smooth ; Neck* ; Thyroid Gland

PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

PURPOSE: Non-alcoholic fatty liver disease (NAFLD) has been recognized as an important childhood liver disease, especially where the prevalence of childhood obesity is increasing. The purpose of this study is to clarify the usefulness of elevated serum aminotransferase activities and their ratio for predicting the presence of fatty liver and its severity in obese children. METHODS: Forty-four children (M/F 29/15, age 4 to 16 years) with obesity (weight excess>20%) were analyzed retrospectively with medical records based on degree of obesity, bioelectrical impedence, serum aminotransferase activities, lipid profiles and ultrasonography. RESULTS: 1) Ultrasonography was carried out in 34 cases. Elevated serum ALT was found in 89.7% (26/29) of the patients diagnosed as fatty liver by ultrasonography and decreased AST/ALT ratio (<1) was found in 96.6% (28/29). There was a strong correlation between elevated serum ALT (>45 IU/L) or decreased AST/ALT ratio (<1) and the fatty liver in obese children (p<0.05). 2) There was no significant correlation between the serum ALT or AST/ALT ratio and the degree of fatty liver (p>0.05). 3) There was a significant correlation between total cholesterol, triglyceride and fatty liver (p<0.05). CONCLUSION: Serum ALT activity and AST/ALT ratio were useful to predict the presence of fatty liver diagnosed by ultrasonography in obese children, whereas they were not useful to predict the degree of fatty liver. Therefore, to prevent fatty liver progressing to advanced liver disease, it is necessary to manage and monitor the obese children continuously, especially those who have predicting factors of fatty liver.
Child* ; Cholesterol ; Fatty Liver* ; Humans ; Liver Diseases ; Medical Records ; Obesity ; Pediatric Obesity ; Prevalence ; Retrospective Studies ; Triglycerides ; Ultrasonography

Objective: Recent studies have raised concerns about the cardiovascular safety of dipeptidyl peptidase-4 (DPP4) inhibitors. We performed a systematic review and meta-analysis to compare the cardiovascular outcomes of sulfonylureas (SUs) versus DPP4 inhibitors in combination with metformin. Methods: After searching for trials using combination therapy of metformin with an SU or DPP4 inhibitor in PubMed, Cochrane Library, and Embase, 1 prospective observational study and 15 randomized controlled studies were selected. Results: Regarding the primary analysis endpoint, no significant differences were found in the risk of all-cause mortality between SUs and DPP4 inhibitors as add-on therapies to metformin (random-effect relative risk [RR], 1.14; 95% confidence interval [CI], 0.98–1.33;I2 =0%; p=0.097). Cardiovascular death was also similar between SUs and DPP4 inhibitors in the 5 studies that reported outcomes (random-effect RR, 1.03; 95% CI, 0.83–1.27; I2 =0%; p=0.817). Furthermore, there were no significant differences in major adverse cardiac events, coronary heart disease, myocardial infarction, and heart failure. However, the SU group showed a higher risk of ischemic stroke, more hypoglycemic events, and more weight gain than the DPP4 inhibitor group (ischemic stroke, random-effect RR, 2.78; 95% CI, 1.06–7.30; I2 =51.9%; p=0.039; hypoglycemia, random-effect RR, 3.79; 95% CI, 1.53–9.39; I2 =98.2; p=0.004; weight gain, weighted mean difference, 1.68; 95% CI, 1.07–2.29; I2 =94.7; p<0.001). Conclusion As add-on therapies to metformin, SUs and DPP4 inhibitors showed no significant differences in all-cause mortality and cardiovascular mortality. However, some of the favorable results of DPP4 inhibitors suggest good safety and feasibility of the drugs.

Objective: Recent studies have raised concern about the cardiovascular safety of dipeptidyl peptidase-4 (DPP4) inhibitors. We performed a systematic review through meta-analysis to compare cardiovascular outcomes of sulfonylurea (SU) versus DPP4 inhibitors when used in combination with metformin. Methods: After searching for trials using combination therapy of metformin with DPP4 inhibitor or SU in PubMed, Cochrane Library, and Embase, one prospective observation study and 15 randomized controlled studies were selected. Results: Regarding the primary analysis endpoint, there were no significant differences in the risk of all-cause mortality between SU and DPP4 inhibitors as an add-on therapy to metformin (random-effect relative risk [RR], 1.14; 95% confidence interval [CI], 0.98–1.33;p=0.811; I2 =0%). Cardiovascular death was also similar between the two drug classes in the five studies which reported outcomes (random-effect RR, 1.03; 95% CI, 0.83–1.27; p=0.517; I2 =0%). Furthermore, there were no significant differences in major adverse cardiac events (MACE), coronary heart disease, myocardial infarction, ischemic stroke and heart failure. However, there were less hypoglycemic events and weight gain in the DPP4 inhibitor group as compared with the SU group (random-effect RR, 3.79; 95% CI, 1.53–9.39; p<0.001; I2 =98.2 and weighted mean difference, 1.68; 95% CI, 1.07–2.29; p<0.001; I2 =94.7, respectively). Conclusion As add-on therapy to metformin, there were no significant differences in allcause mortality and cardiovascular mortality between DPP4 inhibitors and SUs.

Objective: Recent studies have raised concern about the cardiovascular safety of dipeptidyl peptidase-4 (DPP4) inhibitors. We performed a systematic review through meta-analysis to compare cardiovascular outcomes of sulfonylurea (SU) versus DPP4 inhibitors when used in combination with metformin. Methods: After searching for trials using combination therapy of metformin with DPP4 inhibitor or SU in PubMed, Cochrane Library, and Embase, one prospective observation study and 15 randomized controlled studies were selected. Results: Regarding the primary analysis endpoint, there were no significant differences in the risk of all-cause mortality between SU and DPP4 inhibitors as an add-on therapy to metformin (random-effect relative risk [RR], 1.14; 95% confidence interval [CI], 0.98–1.33;p=0.811; I2 =0%). Cardiovascular death was also similar between the two drug classes in the five studies which reported outcomes (random-effect RR, 1.03; 95% CI, 0.83–1.27; p=0.517; I2 =0%). Furthermore, there were no significant differences in major adverse cardiac events (MACE), coronary heart disease, myocardial infarction, ischemic stroke and heart failure. However, there were less hypoglycemic events and weight gain in the DPP4 inhibitor group as compared with the SU group (random-effect RR, 3.79; 95% CI, 1.53–9.39; p<0.001; I2 =98.2 and weighted mean difference, 1.68; 95% CI, 1.07–2.29; p<0.001; I2 =94.7, respectively). Conclusion As add-on therapy to metformin, there were no significant differences in allcause mortality and cardiovascular mortality between DPP4 inhibitors and SUs.

PURPOSE: The purpose of this study was to validate the Korean version of Partners In Health scale (PIH-K) which is used to measure the self-management of patients with chronic illnesses in Korea.METHODS: Translation of the 12-item PIH-K was conducted according to the World Health Organization guidelines. Data from 306 participants who took medicines over 3 months by doctor's prescription were collected from October to November 2017. Validity such as content validity, construct validity, and concurrent validity were conducted using content validity index (CVI), exploratory and confirmatory factor analyses (CFA). To evaluate concurrent validity, the correlation coefficients between the PIH-K and concurrent scales (Self-As-Carer Inventory) were calculated. The reliability of the PIH-K was examined using the internal consistency and test-retest reliability tests.RESULTS: The CVI of the PIH-K was 0.91. According to the CFA, factor loadings for four factors ranged from .64 to .97, which explained 67.5% of the total variance. The PIH-K was significantly correlated with concurrent variables such as those on the Self-As-Carer Inventory. The Cronbach's α was .86 and the intraclass correlation coefficient for the two-week test-retest reliability was .88.CONCLUSION: Findings show that the PIH-K is reliable and valid in measuring self-management of patients with chronic illnesses.
Chronic Disease ; Health Behavior ; Humans ; Korea ; Prescriptions ; Reproducibility of Results ; Self Care ; Weights and Measures ; World Health Organization

Purpose: We aimed to evaluate the influence of technological advances on ablation outcomes in patients with persistent atrial fibrillation (AF) (PeAF). Radiofrequency ablation for patients with AF has advanced, including contact force (CF)-sensing catheters and the ablation index (AI). Methods: Between 2009 and 2018, we analyzed 173 patients with PeAF who underwent catheter ablation. We cat‑ egorized them into three groups: AF ablation without CF and AI information (no-CF group, n = 63), with CF without AI (CF-only group, n = 49), and with optimal AI-guided ablation (AI group, n = 61). Early (within 3 months, ER) and late (from 3 months to 1 year, LR) AF recurrence after ablation was assessed. Procedure-related complications were also evaluated. Results: The baseline characteristics were similar among the 3 groups, excluding the baseline antiarrhythmic drug history. Additional substrate modification after pulmonary vein isolation was significantly low in frequency in the AI group (71.4%, no-CF; 69.4%, CF-only; 41.0%, AI, p = 0.001). The AI group had a shorter mean procedure-related time than the other groups. Both ER and LR of PeAF showed a trend of reduction with technological advances. With a short experience (less than 1 year), the CF-only group showed more ER and LR than that shown by the AI group. However, with a long experience (more than 1 year), ER and LR occurred similarly in the two groups. Procedure-related compli‑ cations improved with technological advances. Conclusion As ablation technology advanced, favorable clinical outcomes with short procedural times were observed. However, prospective, large multicenter studies are needed to verify these results.