The mental health of medical students in Daegu during the 2020 COVID-19 pandemic / 한국의학교육

Purpose@#In February 2020, the first outbreak of coronavirus disease 2019 (COVID-19) occurred in Daegu, South Korea, and confirmed cases increased sharply, sparking intense anxiety among residents. This study analyzed the data of a mental health survey on students enrolled at a medical school located in Daegu in 2020. @*Methods@#An online survey was administered to 654 medical school students (pre-medical course: 220 students, medical course: 434 students) from August to October 2020, with 61.16% (n=400) valid responses. The questionnaire included items about COVID-19-related experiences, stress, stress resilience, anxiety, and depression. @*Results@#Of the survey participants, 15.5% had experienced unbearable stress, with the most significant stress factors (in descending order) being limited leisure activities, unusual experiences related to COVID-19, and limited social activities. Approximately 28.8% reported psychological distress, and their most experienced negative emotions were helplessness, depression, and anxiety (in descending order). The mean Beck Anxiety Inventory and Beck Depression Inventory-II scores were 2.44 and 6.08, respectively, both within normal ranges. Approximately 8.3% had mild or greater anxiety, and 15% had mild or greater depression. For students under psychological distress, the experience of unbearable stress before COVID-19 affected anxiety (odds ratio [OR], 0.198; p<0.05), and having an underlying condition affected depression (OR, 0.190; p<0.05). With respect to their psychological distress during August–October 2020 compared with that during February–March 2020 (2 months from the initial outbreak), anxiety stayed the same while depression increased and resilience decreased at a statistically significant level. @*Conclusion@#It was found that some medical students were suffering from psychological difficulties related to COVID-19, and there were several risk factors for them. This finding suggests that medical schools need to not only develop academic management systems but also provide programs that can help students manage their mental health and emotions in preparation for an infectious disease pandemic.

Mature Defense Mechanisms Affect Successful Adjustment in Young Adulthood-Adjustment to Military Service in South Korea

OBJECTIVE: A defense mechanism is an automatic psychological process necessary for successful adaptation. It reflects adaptive capacity. The purpose of this study is to explore the relationship between the adaptation ability of individuals who face mandatory military service and the pattern of defense mechanisms. METHODS: The subjects were 69 men (21.4±2.2 years) who expressed psychological difficulties in three military service situations. Control group was 36 men (24.0±1.4 years) who had successfully completed military service. We examined psychiatric history, the pattern of defense mechanisms, and depression and anxiety levels. Defense mechanisms were compared between two groups. RESULTS: The maladjusted group used immature defenses more frequently than the control group did. There were no differences in the defense patterns according to diagnosis. The control group used more identification and rationalization, classified as immature defenses. The temporarily maladjusted group used more somatization, regression, and avoidance. CONCLUSION: Using mature defense mechanisms helped young adults to adapt to a particular situation. The maturity of the defense is more valuable than the psychiatric diagnosis. Some immature defenses are also helpful to adapt. We cautiously assume that some defenses can be protective or risk factors in adapting to stressful situations by young adults.

Psychiatric Symptoms after Taking Oseltamivir in a Child and Its Causality Assessment

Oseltamivir is an antiviral medication prescribed to prevent and treat influenza A and B. A case from a community pharmacy in Korea was reported for an adverse event associated with oseltamivir administration. A 20-month-old boy had psychiatric symptoms after receiving 2 doses of oseltamivir. Therefore, an evaluation of whether the psychiatric symptoms were caused by oseltamivir was required. To determine whether the adverse event resulted from the administrated medication or other factors, three tools were used: the Naranjo scale, the Korean causality assessment algorithm (Ver.2), and the World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria. The psychiatric symptoms occurred after oseltamivir administration, and were attenuated after oseltamivir termination. A possible cause of the psychiatric symptoms is high fever, but information on the body temperature of the patient was not sufficient. Therefore, it was unclear whether there were other nonpharmacological causes of adverse drug reaction. For these reasons, in terms of causality, the results evaluated by the three tools represented, “possible”, “probable”, and “probable/likely”, respectively.

The Severity of Sleep Disordered Breathing Induces Different Decrease in the Oxygen Saturation During Rapid Eye Movement and Non-Rapid Eye Movement Sleep

OBJECTIVE: To investigate how differences in oxygen saturation between non-REM (NREM) and REM sleep in patients according to the severity of sleep apnea. METHODS: We studied 396 male patients diagnosed with simple snoring or obstructive sleep apnea syndrome (OSAS) on nocturnal polysomnography. Patients were divided into groups by the OSAS severity. We compared the average oxygen saturation between REM and NREM sleep in each group. RESULTS: In the simple snoring group, average oxygen saturation was significantly greater during REM than during NREM sleep. In the severe OSA group alone, average oxygen saturation was greater in NREM than in REM sleep. The difference of NREM-REM average oxygen saturation correlated significantly with AHI in the severe OSA group. CONCLUSION: More severe hypoxemia was seen in REM than NREM sleep in the severe OSAS group. The differential oxygen decrease between REM and NREM sleep is likely due to the differentially occurring sleep breathing events in each sleep stage according to the SDB severity. The more AHI increases in the severe OSAS patients, the more prominent the hypoxemia of REM sleep compared with NREM sleep is likely to appear. This suggests that the pressure of continuous positive airway pressure should be increased to control the hypoxemia of REM sleep in extremely severe OSAS.

Physical Aspect of The Gamma Knife and Its Clinical Application / 대한치료방사선과학회지

The first Leksell Gamma Knife unit(LGU-type B) for radiosurgery in Asia was installed in Asan Medical Center. Mechanical accuracy, output, dose profiles for each collimators were measure during acceptance test. Sixty eight patients (sixty nine cases) had undergone radiosurgery from May 1990 to September 1990. AVM cases were 24 cases (35%), acoustic tumor 10 (14%), pituitary adenoma 4 (6%), metastatic tumor 18 (26%), meningioma 6 (9%) and others 18 (26%). Dose of 25 Gy-100 Gy was delivered at one time according to disease, location and sizes.

Modified Five Field Technique for Primary and Postop Breast Cancer Irradiation / 대한치료방사선과학회지

In breast cancer, the treatment volume presents a relatively complex three dimensional structure. Effective radiation therapy requires the delivery of adequate dose to a large target volume using complex beam arrangements. The technique proposed here is our department's method using asymmetric jaw with appropriate couch, collimator and gantry rotation. This technique has the following advantages: 1) all treatments are given in a single clinical set up 2) it dose not require half beam blocks 3) it produces exact geometric match 4) it is very convenient and easy to use 5) it has daily reproducibility.