Effects of Depression and Resilience of Public Workers on Work-related Stress and Anxiety in Response to the COVID-19 Pandemic

Background@#This study explored the clinical variables related to public workers' stress and anxiety regarding the viral epidemic, and the mediating effect of resilience on the relationship between their depression and anxiety in response to coronavirus disease 2019 (COVID-19) pandemic. @*Methods@#A total of 938 public workers answered anonymous questionnaires in May 2020.The survey included rating scales such as the Stress and Anxiety to Viral Epidemics-9 (SAVE-9), Patients Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Connor-Davidson Resilience Scale 2 items (CD-RISC 2), and subjects also answered whether they were employed in COVID-19 related fields. @*Results@#Married, female, junior, public workers reported a higher level of stress and anxiety in response to the viral epidemic. Furthermore, high levels of stress and anxiety toward the epidemic are defined by high PHQ-9, high GAD-7, and low CD-RISC 2 scores. It could also be seen that resilience mediated the effect of depression in public workers and their stress and anxiety levels toward the epidemic. @*Conclusion@#It is important to reduce the psychological burden of public workers and manage their mental health to help them cope with the epidemic wisely and efficiently. Among many mental health factors, psychological resilience represents an essential target for psychological intervention among public workers.

Lomens-P0 (mixed extracts of Hordeum vulgare and Chrysanthemum zawadskii) regulate the expression of factors affecting premenstrual syndrome symptoms

BACKGROUND/OBJECTIVES@#Premenstrual syndrome (PMS) is a disorder characterized by repeated emotional, behavioral, and physical symptoms before menstruation, and the exact cause and mechanism are uncertain. Hyperprolactinemia interferes with the normal production of estrogen and progesterone, leading to PMS symptoms. Thus, we judged that the inhibition of prolactin hypersecretion could mitigate PMS symptoms.MATERIALS/METHODS: Hordeum vulgare L. extract (HVE), Chrysanthemum zawadskii var. latilobum extract (CZE), and Lomens-P0 the mixture of these extracts were tested in subsequent experiments. The effect of extracts on prolactin secretion at the in vitro level was measured in GH3 cells. Nitric oxide and pro-inflammatory mediator expression were measured in RAW 264.7 cells to confirm the anti-inflammatory effect. Also, the hyperprolactinemic Institute for Cancer Research (ICR) mice model was used to measure extract effects on prolactin and hormone secretion and uterine inflammation. @*RESULTS@#Anti-inflammatory effects of and prolactin secretion suppress by HVE and CZE were confirmed through in vitro experiments (P < 0.05). Treatment with Lomens-P0 inhibited prolactin secretion (P < 0.05) and restored normal sex hormone secretion in the hyperprolactinemia mice model. In addition, extracts significantly inhibited the expression of pro-inflammatory biomarkers, including interleukin-1β, and -6, tumor necrosis factor-α, inducible nitric oxide synthase, and cyclooxygenase-2 (P < 0.01). We used high-performance liquid chromatography analyses to identify tricin and chlorogenic acid as the respective components of HVE and CZE that inhibit prolactin secretion. The Lomens-P0, which includes tricin and chlorogenic acid, is expected to be effective in improving PMS symptoms in the human body. @*CONCLUSIONS@#The Lomens-P0 suppressed the prolactin secretion in hyperprolactinemia mice, normalized the sex hormone imbalance, and significantly suppressed the expression of inflammatory markers in uterine tissue. This study suggests that Lomens-P0 may have the potential to prevent or remedy materials to PMS symptoms.

Effects of Depression and Resilience of Public Workers on Work-related Stress and Anxiety in Response to the COVID-19 Pandemic

Background@#This study explored the clinical variables related to public workers' stress and anxiety regarding the viral epidemic, and the mediating effect of resilience on the relationship between their depression and anxiety in response to coronavirus disease 2019 (COVID-19) pandemic. @*Methods@#A total of 938 public workers answered anonymous questionnaires in May 2020.The survey included rating scales such as the Stress and Anxiety to Viral Epidemics-9 (SAVE-9), Patients Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Connor-Davidson Resilience Scale 2 items (CD-RISC 2), and subjects also answered whether they were employed in COVID-19 related fields. @*Results@#Married, female, junior, public workers reported a higher level of stress and anxiety in response to the viral epidemic. Furthermore, high levels of stress and anxiety toward the epidemic are defined by high PHQ-9, high GAD-7, and low CD-RISC 2 scores. It could also be seen that resilience mediated the effect of depression in public workers and their stress and anxiety levels toward the epidemic. @*Conclusion@#It is important to reduce the psychological burden of public workers and manage their mental health to help them cope with the epidemic wisely and efficiently. Among many mental health factors, psychological resilience represents an essential target for psychological intervention among public workers.

Oral health status of Korean adults with implants according to their use of oral hygiene products: results from a nationwide population-based study (2013–2015)

Purpose@#Many home care treatments can be used to promote the health and longevity of dental implants; however, few studies are available to support the concept that selfperformed oral hygiene behaviors are an essential tool for improving and maintaining oral health. We investigated age-stratified associations between dental health behaviors related to tooth brushing (TB) and oral hygiene product use in Korean adults with implants. @*Methods@#A total of 1,911 subjects over 19 years of age who had 1 or more implants and who participated in the 2013 to 2015 Korea National Health and Nutrition Examination Survey were reviewed. Periodontal status was assessed using Community Periodontal Index (CPI) scores, and periodontitis was defined as a CPI greater than or equal to 3. The complex sampling design of the survey was utilized to obtain the variance and individual weight of each analyzed factor. A high CPI was the outcome variable, and the main explanatory variables were oral hygiene behaviors, such as TB, dental floss (DF), interproximal brushing, and mouth rinsing. @*Results@#Almost all individuals with a lower CPI brushed their teeth twice or more per day, in contrast to those with a higher CPI, and were likely to use DF. The adjusted odds ratio of not using DF for a higher CPI was 1.83 (95% confidence interval, 1.35–2.49). @*Conclusions@#TB was implemented more than twice a day by patients with good oral health, and the combination of TB and DF significantly reduced the prevalence of a higher CPI. Selfperformed oral hygiene practices combining TB and DF were significantly related to a low prevalence of periodontitis in implant patients.

Cancer-related Fatigue of Breast Cancer Survivors: Qualitative Research

Purpose@#Cancer-related fatigue (CRF) is an important health concern among breast cancer survivors. However, CRF is apt to be dismissed as a minor discomfort by medical professionals. This study aimed to understand the experience of CRF in breast cancer survivors. @*Methods@#We conducted a qualitative study using in-depth interviews and thematic analysis. The 14 participants were over the age of 40, complained of fatigue, and had been battling breast cancer for at least eight months to up to 16 years. @*Results@#The analysis revealed four themes: traces of fighting cancer, inseparable part of the self, difficulty in daily life, and the body’s signals for care.Chronic fatigue initially disrupted the daily lives of the participants. As time passed, fatigue made it difficult for patients to fulfill their roles within their families, and gradually alienated friends and neighbors. Nevertheless, they tried to overcome the symptoms of fatigue by responding sensitively to the warning signs or changes in their bodies. @*Conclusion@#Breast cancer survivors often worry about relapse due to persistent fatigue after treatment completion. Therefore, the results of this study may be useful in developing strategies tailored for managing CRF using a multifaceted approach.

Oral health status of Korean adults with implants according to their use of oral hygiene products: results from a nationwide population-based study (2013–2015)

Purpose@#Many home care treatments can be used to promote the health and longevity of dental implants; however, few studies are available to support the concept that selfperformed oral hygiene behaviors are an essential tool for improving and maintaining oral health. We investigated age-stratified associations between dental health behaviors related to tooth brushing (TB) and oral hygiene product use in Korean adults with implants. @*Methods@#A total of 1,911 subjects over 19 years of age who had 1 or more implants and who participated in the 2013 to 2015 Korea National Health and Nutrition Examination Survey were reviewed. Periodontal status was assessed using Community Periodontal Index (CPI) scores, and periodontitis was defined as a CPI greater than or equal to 3. The complex sampling design of the survey was utilized to obtain the variance and individual weight of each analyzed factor. A high CPI was the outcome variable, and the main explanatory variables were oral hygiene behaviors, such as TB, dental floss (DF), interproximal brushing, and mouth rinsing. @*Results@#Almost all individuals with a lower CPI brushed their teeth twice or more per day, in contrast to those with a higher CPI, and were likely to use DF. The adjusted odds ratio of not using DF for a higher CPI was 1.83 (95% confidence interval, 1.35–2.49). @*Conclusions@#TB was implemented more than twice a day by patients with good oral health, and the combination of TB and DF significantly reduced the prevalence of a higher CPI. Selfperformed oral hygiene practices combining TB and DF were significantly related to a low prevalence of periodontitis in implant patients.

Cancer-related Fatigue of Breast Cancer Survivors: Qualitative Research

Purpose@#Cancer-related fatigue (CRF) is an important health concern among breast cancer survivors. However, CRF is apt to be dismissed as a minor discomfort by medical professionals. This study aimed to understand the experience of CRF in breast cancer survivors. @*Methods@#We conducted a qualitative study using in-depth interviews and thematic analysis. The 14 participants were over the age of 40, complained of fatigue, and had been battling breast cancer for at least eight months to up to 16 years. @*Results@#The analysis revealed four themes: traces of fighting cancer, inseparable part of the self, difficulty in daily life, and the body’s signals for care.Chronic fatigue initially disrupted the daily lives of the participants. As time passed, fatigue made it difficult for patients to fulfill their roles within their families, and gradually alienated friends and neighbors. Nevertheless, they tried to overcome the symptoms of fatigue by responding sensitively to the warning signs or changes in their bodies. @*Conclusion@#Breast cancer survivors often worry about relapse due to persistent fatigue after treatment completion. Therefore, the results of this study may be useful in developing strategies tailored for managing CRF using a multifaceted approach.

Antibacterial effect of different concentrations of Galla Chinensis extract on cariogenic bacteria in a biofilm model / 대한구강보건학회지

OBJECTIVES: Galla chinensis inhibited the adherence of planktonic oral bacteria and acid production by cariogenic bacteria. However, little is known about the relevant conditions of Galla Chinensis extract (GCE) exposure time and concentration and the effect of GCE on the structural and functional activity of cariogenic bacteria. The antibacterial effects of natural G. Chinensis extract on S. mutans , S. sanguinis, and S. oralis biofilms were evaluated in vitro.METHODS: Biofilms formed on glass surfaces were treated with different concentrations of GCE at different exposure times. The effects were assessed by examining the bactericidal activity, acidogenesis, minimum inhibitory concentration, and morphology.RESULTS: There was a statistically significant difference in the bacterial growth inhibition depending on the concentration of the GCE, with bacterial growth being inhibited as the concentration of GCE increased. A concentration of 1.0 mg/ml GCE had similar bactericidal effects against S. mutans and S. oralis biofilms to those produced by 2.0 mg/ml CHX. In the 1.0 mg/ml GCE group, incomplete septa were also observed in the outline of the cell wall, together with disruption of the cell membrane. In addition, there was also a slight exudation of the intracellular content from the bacteria in the 1.0 mg/ml GCE and 2 mg/ml CHX groups.CONCLUSIONS: These results indicate that GCE inhibits the growth of S. mutans, S. sanguinis, and S. oralis with increasing concentrations. It alters the microstructure of S. mutans biofilms. These results suggest that GCE might be a useful anti-bacterial agent for preventing dental caries.

Differences in Oral Health Status between Rural and Urban Populations of Korean Elders: A Population-Based Study from the Korean National Health and Nutrition Examination Survey VI (2013~2015) / 치위생과학회지

BACKGROUND: Edentulism is associated with socioeconomic status, rural residence, and chronic disease, but no studies have investigated edentulism and residence factors together. All information that drives a better understanding of the factors related to edentulism plays an important role in the planning and delivery of appropriate dental services for the elderly by national and oral health professionals. This study was designed to investigate the prevalence of edentulism in adults aged over 60 years in Korea and to examine whether there are differences in dentate status between people living in urban and rural areas after controlling for sociodemographic and other related factors. METHODS: The data for this study were collected from 2013 to 2015 as part of the Korea National Health and Nutrition Examination Survey VI, those individuals aged over 60 years and who had complete datasets were included (5,071). The number of teeth and residence status were categorized into two groups: edentate and dentate (1 or more); urban and rural. Multiple multivariate logistic regression analyses were sequentially applied to assess the association between dentate status and residence status after adjusting for potential confounders. RESULTS: Rural areas, lower household income, and lower education levels were associated with a higher edentate rate. The number of teeth was lower in rural areas than in urban areas. After adjusting for various factors, statistically significant associations were present for women, low household income, low education level, poor perceived health status, and alcohol consumption in participants. CONCLUSION: Elders living in rural areas had poorer oral health than elders living in urban areas. The government will need to provide effective systems for promoting oral health for elders living in rural areas.

Effects of Titratable Acidity and Organic Acids on Enamel Erosion In Vitro / 치위생과학회지

BACKGROUND: Erosion is a gradual process that occurs fairly quickly, and the full extent of the erosive effects of acidic beverages is not yet clear. The present study aimed to determine the differences in the erosive potentials among four naturally acidic fruit nectars within the same range of titratable acidity and to determine the influence of the components of organic acids on tooth erosion. METHODS: Diluted fruit nectars (mandarin 1:1.1, orange 1:1.7, lemon 1:15, grapefruit 1:20) with the same range of titratable acidity (7.9 ml) and their corresponding organic acids (0.05%, 0.1%, 0.3%, and 0.5% citric acid, malic acid, and a citric and malic acid mixture [pH 2.8], respectively) were used. Specimens were placed in conical tubes with 50 ml of each of the test solutions for 1 hour. A microhardness test and scanning electron microscopy were used to measure enamel erosion. Acid separation was carried out using high-performance liquid chromatography to analyze the composition of each test solution. RESULTS: Similar decreases in the Vickers hardness number (VHN) were observed among the groups treated with the following diluted fruit nectars: diluted mandarin nectar (75.9 ΔVHN), diluted lemon nectar (89.1 ΔVHN), diluted grapefruit nectar (91.7 ΔVHN), and diluted orange nectar (92.5 ΔVHN). No statistically significant differences were found in the enamel surface hardness after erosion (p>0.05). Citric and malic acids were the major organic acids in the test fruits. The lemon and orange groups had the highest malic acid concentrations, and the mandarin group had the lowest malic acid concentration. CONCLUSION: The titratable acidity and the citric and malic acid contents of the fruits could be crucial factors responsible for enamel erosion. Therefore, fruit-based drinks should be regarded as potentially erosive.

Awareness of Dementia National Responsibility of Elders: Oral Health Items / 치위생과학회지

BACKGROUND: Dementia is a condition in which a person who has been living a normal life suffers from various cognitive impairments in memory, words, and judgment that considerably disrupt daily life. The oral care ability and subjective oral status of elderly individuals with dementia are lower than those of a healthy person. The oral health care of individuals admitted to nursing homes inevitably falls to nursing assistants and nursing care staff. This study aimed to investigate the need for oral health management items of and to provide basic direction for the future of the Dementia National Responsibility System. METHODS: Elders aged 65 years and over were selected from a comprehensive welfare center. A total of 155 questionnaires were analyzed. The questionnaire consisted of 15 items about general status, 9 items about recognition of the Dementia National Responsibility System, 5 items of the subjective recognition of oral health, and 6 items of the correlation between oral health and dementia. RESULTS: Among our subjects, 71.0% answered that they did not know about the Dementia National Responsibility System, 78.7% answered that they think they need the system, and 81.9% think that they should add dental health items to the Dementia National Responsibility System. The response to the need for dementia national responsibility, oral health items in the Dementia National Responsibility System, and oral specialists all showed scores of >4 points. The need for the Dementia National Responsibility System, oral health items, and specialists were found. CONCLUSION: It is necessary to include oral health care items in the Dementia National Responsibility System so that elderly individuals with dementia can receive the needed oral health care.

Nonalcoholic fatty liver disease in obese and nonobese pediatric patients / 소아과

PURPOSE: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. METHODS: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10–18 years of age. Body mass index ≥95th percentile for age and sex was defined as obesity. Abdominal ultrasonography and laboratory, anthropometrics measurements were evaluated. RESULTS: Among the 68, 26 (38.2%) were nonobese patients. The ratio of male to female was 5.8:1, and the median age at diagnosis was 13 years (range, 10–17 years). Significant higher triglyceride (223.0 mg/dL vs. 145.9 mg/dL, P=0.047) and total cholesterol levels (211.6 mg/dL vs. 173.2 mg/dL, P=0.011) were shown in nonobese than obese patients. High-density lipoprotein cholesterol level 200mg/dL (HR, 5.6; 95% CI, 1.23–15.31; P=0.038) and abdominal obesity (HR, 2.53; 95% CI, 1.22–4.68; P=0.013) were significant risk factors for NAFLD in nonobese patients. CONCLUSION: Nonobese patients present a substantial proportion of pediatric NAFLD cases. Significant abnormal lipid concentrations were found in nonobese and abdominal obesity was important risk factor for nonobese NAFLD.

Association between Sleep Patterns and Health Indicators and Diseases in Adults Over 19 Years of Age in Korea: Based on the Korea National Health and Nutrition Examination Survey 2016–2017

BACKGROUND: The purpose of this study was to investigate the relationship between sleep patterns and health in Korea, using data from the Korea National Health and Nutrition Examination Survey 2016–2017.METHODS: In total, 12,646 individuals were divided into those who sleep more than 5 hours and less than 5 hours per day during the week. In addition, 512 people who slept less than 5 hours a day on weekdays were further classified into those sleeping on average less than 5 hours a day and those sleeping more than 5 hours a day on weekends.RESULTS: People who slept on average for more than 5 hours on weekdays were taller, had lower body mass index, and lower fasting blood sugar and glycated hemoglobin levels than those who slept less than 5 hours on weekdays. In addition, the percentage of people with osteoporosis, cervical cancer, and depression was lower in the group that slept on average 5 hours or more on weekdays than in the group that slept less than 5 hours on weekdays. Among those who slept on average less than 5 hours a day on weekdays, individuals who slept more than 5 hours a day on weekends were taller and had lower fasting blood glucose and glycated hemoglobin than those who slept less than 5 hours a day on weekends. The prevalence of patients with angina, arthritis, osteoporosis, colon cancer, and depression was higher in the group who slept less than 5 hours a day on weekends.CONCLUSION: There are differences in height, body mass index, fasting blood sugar level and glycated hemoglobin level and in the prevalence of angina, arthritis, osteoporosis, colon cancer, and depression according to weekday and weekend sleep times.

196G/A of the Brain-Derived Neurotrophic Factor Gene Polymorphisms Predicts Suicidal Behavior in Schizophrenia Patients

OBJECTIVE: Brain-derived neurotrophic factor (BDNF) has possible neurobiologic impact on etiology of schizophrenia. We hypothesized that the specific allele or the genotype such as two single nucleotide polymorphisms (SNPs) , 196G/A (rs6265), 11757G/C(rs16917204) is associated with schizophrenia or its clinical features. METHODS: 241 normal controls and 157 schizophrenia patients are included. The differences in allele or genotype distribution for the patients and normal controls were analyzed. We also analyzed clinical variables among patients. RESULTS: We found no significant difference in genotype or allele distributions of two studied SNPs between the patient group and the control group. However, history of suicide attempt was relatively higher in patients with genotype with A allele, compared to patients with genotype G/G for 196G/A (p-value=0.045). CONCLUSION: Our results suggest that it is possible to use BDNF gene allele and genotype as a predictor for suicide attempt in schizophrenia patients. It can help manage the schizophrenia patients regarding suicidal behavior and furthermore, mortality.

The Effects of Therapeutic Climbing on Shoulder Muscle Activity according to the Inclination of the Climbing Wall

PURPOSE: Therapeutic climbing has become very popular today, with it being reported as a new method for preventing and treating orthopedic trauma to the shoulder joint. However, objective studies on its effects on the musculoskeletal system are still lacking. The objective of the present study was to investigate the effects of wall inclination during therapeutic climbing on the muscle activity around the shoulder joint. METHODS: In this study, the participants performed movements at three different inclination angles of 0°, +15°, and −15°. sEMG was performed to measure the activities of five different muscles around the shoulder joint (biceps brachii, serratus anterior, upper trapezius, middle trapezius, and lower trapezius muscles). RESULTS: Biceps brachii muscle showed a significant increase at −15°, as compared to 0° (p 0.05). CONCLUSION: Therapeutic climbing may be a new therapeutic approach that can increase muscle strength and coordination in the sensory nervous system, since it can be used as a tool that promotes active movement by altering wall inclination and causing the user to generate movements according to the existing situation.

A Case of Spontaneous Intracranial Hypotension Accompanied by Acute Kidney Injury in a Child / 대한소아신경학회지

Spontaneous intracranial hypotension in childhood is rare, and a few cases have been reported as a cause of headache in children. A 9-year-old boy was admitted to our hospital with a 3-day history of new-onset headache that worsened upon standing or walking, and aggravating low back pain. No medical history of injury, connective tissue disorder or migraine was detected. A neurological examination revealed neck stiffness. His initial blood tests suggested acute kidney injury by increased blood urea nitrogen (BUN) and creatinine. Brain computed tomography (CT) and cerebral spinal fluid (CSF) analysis were normal: however, opening pressure was low (< 60 mm H₂O). Magnetic resonance imaging (MRI) of the spine showed a collection of cerebral spinal fluid in the dorsal extradural space throughout the entire thoracic and lumbar spine level. The patient was diagnosed as having spontaneous intracranial hypotension accompanied by acute kidney injury. Magnetic resonance myelography and spinal MRI performed 14 days later did not show any cerebrospinal fluid leak. The headache and back pain were alleviated with strict bed rest and hydration. He remained free of headache and back pain at the 2-month follow-up. Here, we report a case of a 9-year-old boy with spontaneous intracranial hypotension.

Galla chinensis extracts and calcium induce remineralization and antibacterial effects of enamel in a Streptococcus mutans biofilm model / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate the combined effects of Galla chinensis extract (GCE) and calcium (CA) on enamel remineralization. The antibacterial effect of G. chinensis on Streptococcus mutans biofilm was also evaluated by examining the bacterial growth, acidogenesis, and morphology of the biofilm in vitro. METHODS: S. mutans biofilm was formed on bovine enamel specimens over a 72-h period and treated for 10 min with 1.0 mol CA, 4,000 ppm aqueous solution of GCE, or a combination of the two (GCE+CA). The enamel specimens were analyzed for enamel surface microhardness after remineralization. We tested the anti-cariogenic effects of GCE based on the inhibition of acid production, antibacterial activity, and morphological changes in S. mutans. The differences between the groups and antibacterial effects were analyzed using one-way analysis of variance. RESULTS: GCE+CA group showed the highest efficacy in enhancing remineralization. The GCE group showed the highest antibacterial activity against S. mutans biofilm. Although the GCE+CA group showed significant antibacterial activity, it was less than that of the GCE group (P < 0.05). Both GCE and GCE+CA groups maintained a pH of approximately 7.0 for 1 h whereas the pH of the control group decreased rapidly from pH 7.3 to pH 6.1. SEM imaging revealed that S. mutans treated with GCE and GCE+CA showed irregular cell wall structure and showed fewer cells in the chain than the typical long chains observed in the control group. CONCLUSIONS: This study found that natural G. chinensis significantly enhances enamel remineralization, and exerts synergistic effects with calcium. It also exerts strong bactericidal activity and inhibits acid production and changes in the microstructure of S. mutans biofilm.

Evaluation of an extracurricular program for students interested in rural and public health / 한국의학교육

PURPOSE: The problem regarding the geographic imbalance of the physician workforce has been a long-standing problem in South Korea. Additionally, rural medicine and public health have been marginalized across whole undergraduate curriculums. The aim of this study was to evaluate the effectiveness of an extracurricular program targeting medical students interested in rural and public health. METHODS: A 2-day extracurricular program was held twice in 2015 and 2016. A total of 53 students were selected among eighty students who voluntarily applied to participate in the program. The effectiveness of the program was evaluated by pre- and post-program surveys. RESULTS: The overall satisfaction for the program was 5.35 out of 6. The participants showed a significant improvement in perception of the clerkship experience in a rural and public health care setting as well as the importance of rural medicine and public health in South Korea. CONCLUSION: In conclusion, this study showed the acceptability of a short-term extracurricular program for medical students interested in rural and public health.

The influence of gonadotropin releasing hormone agonist treatment on the body weight and body mass index in girls with idiopathic precocious puberty and early puberty

PURPOSE: This study aimed to investigate the influence of gonadotropin releasing hormone agonist (GnRHa) treatment on the weight and body mass index (BMI) of girls who were diagnosed with idiopathic central precocious puberty (CPP) or early puberty (EP). METHODS: Patients who were younger than 8 years of age at diagnosis were classified as CPP and patients aged between 8 and 9 years at diagnosis were classified as EP. Of 129 patients, 34 were diagnosed with CPP and 95 were diagnosed with EP. The patients were divided according to pretreatment weight status into normal weight group, an overweight group, or an obese group. RESULTS: No significant changes were observed with respect to the weight standard deviation score (SDS) before and after 1 year, 2 years of treatment, respectively (P>0.05, P>0.05) in all patient groups. No significant changes were observed in relation to the BMI SDS before and after 1 year, 2 years of treatment, respectively (P>0.05, P>0.05) in all patient group. Depending on the degree of obesity, differences with respect to the weight SDS and BMI SDS were observed. CONCLUSION: BMI SDS increased in the GnRHa-treated patients as a whole group, but was not statistically significant. But BMI SDS increased significantly in the normal weight group after 2 years of GnRHa treatment. So, GnRHa treatment may affect the change of BMI SDS depending on degree of obesity.

2 Cases of Beta-thalassemia Minor in Korea / 임상소아혈액종양

In Korea, recent epidemiologic studies show that the incidence of β-thalassemia is increasing as the influx of South-East Asian population increases and molecular technologies develop. However, many patients are still misdiagnosed as iron deficiency anemia (IDA). All patients with microcytic anemia need to perform evaluation including reticulocyte index, Mentzer index, and iron studies. Considering the increasing incidence of β-thalassemia, hemoglobin beta globulin (HBB) gene sequencing should be performed if suspicious. In our cases, patients whose parents were both Koreans were confirmed to have β-thalassemia with a substitution in c1, ATG>GTG, and deletion of the HBB gene. In Korea, initiation condon ATG>AGG (20.9%) is most common mutation, followed by codon 17 (A>T) (17.6%), codon 121 (G>T) (12.1%), and so on. We report two cases of β-thalassemia diagnosed by genetic testing for microcytic anemia.