The Effects of Economic Deterioration Due to COVID-19 to Alcohol and Tobacco Consumption Behaviors of Adolescents in South Korea: A Nationwide Analysis

Background@#Coronavirus disease 2019 (COVID-19) pandemic has greatly impacted health, culture, and the economy. Although it has had little direct effect on children and adolescents, its indirect effect on them has been significant. In this study, we aim to evaluate the alcohol and tobacco consumption behaviors of adolescents and the economic determination of their families due to COVID-19. Methods: We collected data from the Korea Youth Risk Behavior Survey, which is an annual cross-sectional national representative survey published by the Korea Disease Control and Prevention Agency in South Korea. We considered, in particular, the survey conducted in middle and high school students in 2020. Results: The number of subjects was 54,948 with 28,353 male students and 26,595 female students. The drinking rate was higher in male students and female students in the group with severe economic deterioration compared to the group without deterioration (odd ratio [OR], 1.355; 95% confidence interval [95% CI], 1.175-1.563; OR, 1.199; 95% CI, 0.987-1.457). The smoking rate was higher in male students and female students in the group with severe economic deterioration (OR, 1.435; 95% CI, 1.180-1.745; OR, 1.809; 95% CI, 1.331-2.457). The secondhand smoking rate at home was higher in male students and female students in the group with severe economic deterioration (OR, 1.397; 95% CI, 1.239-1.574; OR, 1.440; 95% CI, 1.263-1.641). @*Conclusions@#The economic deterioration due to COVID-19 is a risk factor for alcohol drinking, smoking, and secondhand smoking among adolescents. Our study results suggest the need to pay more attention to youth health management in the event of sudden economic impacts.

Association between Skipping Breakfast and Overweight in Korean Adolescents: Analysis of the 13th Korea Youth Risk Behavior Web-based Survey / 계명의대학술지

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.

The Effect of Changes in Family Developmental Stage According to Child Independence on the Incidence of Depression in South Korean Middle-Aged Adults

Background@#The incidence of depression in middle-aged adults is increasing and has been affected by physiological changes and various sociodemographic factors. The present study aimed to examine the longitudinal relationship between depression and changes in the family developmental stage based on child independence in South Korean middle-aged adults living with children. @*Methods@#This study included 1,593 people in the age group of 45-64 years who participated in the first survey of the Korean longitudinal study of aging in 2006. Participants did not have depression, lived with unmarried children, and responded to Center for Epidemiologic Studies Depression 10 scale and child-related questions in the 7th survey (2018). The chi-squared test, t-test, and Mann-Whitney U test were used to compare differences in depression according to general characteristics and family developmental stage. The generalized estimating equation model was used to longitudinally examine the effect of changes in the family developmental stage on the incidence of depression from the 1st to the 7th survey. @*Results@#Changes in the family developmental stage based on child independence have a significant effect on the incidence of depression in middle-aged adults (P=0.000). In addition, in the generalized estimating equation model, the longitudinal association between changes in the family developmental stage and the incidence of depression was confirmed. @*Conclusions@#Therefore, confirming the independence of children as an important factor is essential in the management of depression in middle-aged adults.

Waist-to-Height Ratio as an Index for Screening Lifestyle-Related Diseases in Overweight Adults / 계명의대학술지

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.

Dorsal root ganglion stimulation combined with spinal cord stimulation for effective treatment of postherpetic neuralgia - A case report -

Background@#Although spinal cord stimulation (SCS) can be a treatment option for intractable postherpetic neuralgia (PHN), obtaining proper stimulation at the thoracic dermatome is difficult. Dorsal root ganglion (DRG) stimulation may be an effective treatment for patients with insufficient efficacy in SCS only.Case: A 54-year-old man with intractable PHN was referred to our clinic. Pain was localized to the distribution of the T1–3 dermatomes. SCS trial was conducted, and lead was placed within the epidural space over the C6–T1 level; however, the stimulation was inadequate for his pain site. Therefore, another lead was placed within the left T1 and T2 DRG for trial, and T1 DRG stimulation provided adequate stimulation. T1 DRG stimulation and SCS could cover the entire pain site with paresthesia, and his pain was decreased by over 50%. @*Conclusions@#DRG stimulation combined with SCS may be a good treatment option for intractable thoracic PHN.

Waist-to-Height Ratio as an Index for Screening Lifestyle-Related Diseases in Overweight Adults / 계명의대학술지

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.

Clinical Characteristics of Mild Coronavirus Disease 2019 Inpatients / 계명의대학술지

About 30~50% COVID-19 hospital inpatients is reported to have mild clinical presentation, and the clinical course is known to be good even in the older population. In order to compare the clinical symptoms of mild patients with COVID-19 infection by age, the clinical symptoms and laboratory results were analyzed by dividing mild patients admitted to a dedicated hospital into three groups: under the age of 64, 65-84, and above 85 years of age.There was no difference in gender ratio by age among 555 mild cases. Concomitant diseases with significant differences by age were hypertension, diabetes, stroke, and coronary artery disease.Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age. Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age.The white blood cell count (WBC), neutrophil count, monocyte, blood sugar, procalcitonin, and creatinine were significantly higher in the 85 years old or older group, and the hemoglobin, albumin, and glomerular filtration rate (GFR) were significantly lower in the 85 years old or older group.

The Effect of Housing Unaffordability on the Incidence of Depression in Korean Adults: Focusingon Korean Longitudinal Study of Aging

Background@#This study examined the effect of housing affordability on the incidence of depression in Korean adults aged 45 years and above usingthe Korean Longitudinal Study of Aging (KLoSA). @*Methods@#Five-year data from wave two to wave six of the KLoSA provided by the Ministry of Labor were used. In the first year of KLoSA in 2006, amongthose who did not suffer from depression, ones who had one or more of the survey data from the second to the sixth were analyzed. generalizedestimating equation (GEE) regression analysis and chi-square test were used as data processing methods. @*Results@#According to the 2010 data, out of 4,606 people, 3,558 (77.3%) were in the affordable group, and 1,048 (22.8%) in the experienced overburdengroup. The result of regression analysis with controlling general characteristics as covariates showed that the experienced overburden group had ahigher incidence of depression than the affordable group. A longitudinal analysis of housing affordability and incidence of depression for five yearsrevealed no significant difference in the incidence of depression. However, the overall share of overburden experience increased steadily. Acomparison of the incidence of depression between the affordable and experienced overburden groups in each year showed that the incidence ofdepression was statistically higher each year. @*Conclusion@#Housing affordability increases the incidence of depression, and eight years of data indicated depression in the experienced overburdengroup to be higher than the affordable group.

Clinical Characteristics of Mild Coronavirus Disease 2019 Inpatients / 계명의대학술지

About 30~50% COVID-19 hospital inpatients is reported to have mild clinical presentation, and the clinical course is known to be good even in the older population. In order to compare the clinical symptoms of mild patients with COVID-19 infection by age, the clinical symptoms and laboratory results were analyzed by dividing mild patients admitted to a dedicated hospital into three groups: under the age of 64, 65-84, and above 85 years of age.There was no difference in gender ratio by age among 555 mild cases. Concomitant diseases with significant differences by age were hypertension, diabetes, stroke, and coronary artery disease.Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age. Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age.The white blood cell count (WBC), neutrophil count, monocyte, blood sugar, procalcitonin, and creatinine were significantly higher in the 85 years old or older group, and the hemoglobin, albumin, and glomerular filtration rate (GFR) were significantly lower in the 85 years old or older group.

Association between Raising Grandchildren and Depression in Korean Adults

BACKGROUND: Several contradictory studies exist on the relationship between raising grandchildren and the grandparent's health. The present study identified the association between raising grandchildren and depression among Korean grandparents.METHODS: The wave 1 (2006) and wave 2 (2008) databases of the Korean longitudinal study on aging (KLoSA) were analyzed. T-test and chi-square test were used to compare the demographics and health condition variable between the two groups based on the presence or absence of raising grandchildren. Logistic regression analysis, including demographics and health conditions, was conducted to identify the relationship between depression and raising grandchildren. Depression was assessed using the Center for Epidemiologic Studies Depression scale (CES-D-10).RESULTS: In all, 4,784 participants (4,636: not raising grandchildren; 148: raising grandchildren) were examined. Significantly lower CES-D-10 scores (3.34 vs. 4.35, P<0.001), and therefore, lower depression (25% vs. 39.9%, P<0.001) was found among grandparents raising grandchildren than those who did not raise grandchildren. After adjusting the confounding variables through logistic regression analysis, the odds ratio of depression when raising grandchildren was 0.57 (95% confidence interval=0.37–0.89), which indicates significant relevance.CONCLUSION: The results show lower depressive symptoms among grandparents raising grandchildren. Even after adjusting the variables, the results presented a lower risk of depression among them.

The Association between the Body Mass Index and the Incidence of Depression in Korean Adults: Result from the Korean Longitudinal Study

BACKGROUND: Several conflicting studies exist on the relationship between body mass index (BMI) and depression. We investigated the effect of BMI on the development of depression in adults aged 45 years and older using the Korean Longitudinal Study of Aging Study (KLoSA).METHODS: The data from the wave 1 (2006), wave 2 (2008), wave 3 (2010), wave 4 (2012), and wave 5 (2014) database of the Korean Longitudinal Study on Aging (KLoSA) were analyzed. Depression was assessed using the Center for Epidemiologic Studies Depression Scale-10. To investigate the relationship between BMI and depression, ANOVA and chi-square test was used. Kaplan-Meier survival curves were generated, and Cox proportional hazard regression modeling was used to estimate the risk of depression according to obesity status, by controlling for age, sex, and health-related, lifestyle, and socioeconomic variables.RESULTS: This study included 6,811 individuals who were not found to have depression in the first survey. The incidence of depression was the highest in the underweight group (underweight, 74.3%; normal, 63.1%; overweight, 59.5%; obese, 63.0%; severe obese, 59.9%, P < 0.001). The risk of depression was significantly lower in the overweight and severe obese groups than in the underweight group after adjusting for age, sex, and demographic, social, and physical factors (overweight: hazard ratio [HR]=0.872, 95% confidence interval [CI]=0.775–0.981; severe obese: HR=0.791, 95% CI=0.648–0.966).CONCLUSION: The incidence of depression was the highest in the underweight group. The risk of depression was higher in the underweight group than in the overweight and severe obese groups.

Medical Students' Perception of Family Medicine and Career Choice

BACKGROUND: The role of family medicine specializing in primary care is important. This study examined medical students' perception of family medicine and their career choice, and provides policy and educational implications for family medicine.METHODS: The study used data collected from the 111 medical students from Keimyung University. The questionnaire comprised items pertaining to respondents' demographic information, career plan, and perceptions about family medicine.RESULTS: The most common mode of learning about family medicine was class or clinical practice (68.5%). Further, 73 students (65.8%) reported an intention to select family medicine as their major. These students were most likely to be employed (34 persons). Among the 111 students, 3 (2.8%) choose family medicine as their preferred major. Before receiving clinical practice experience, the most common reason for not choosing family medicine was “does not fit into the reality in Korea” (32.1%). After clinical practice, “lack of professionalism” (44.6%) was the most commonly cited reason.CONCLUSION: Medical students' perception about family medicine was strongly influenced by their experiences during class and clinical practice. Students also reported the need to improve professionalism in family medicine. Building public relations could help improve medical students' awareness about family medicine, and it is also necessary to improve social awareness of family medicine through the support of government such as th family doctor system.

The Relationship of Water Intake and Health Status in Korean Adult: 5th Korea National Health and Nutrition Examination Survey / 계명의대학술지

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.

The radiation safety education and the pain physicians' efforts to reduce radiation exposure

BACKGROUND: C-arm fluoroscopy equipment is important for interventional pain management and can cause radiation injury to physicians and patients. We compared radiation safety education and efforts to reduce the radiation exposure of pain specialists. METHODS: A survey of 49 pain specialists was conducted anonymously in 2016. The questionnaire had 16 questions. That questionnaire was about radiation safety knowledge and efforts to reduce exposure. We investigated the correlation between radiation safety education and efforts of radiation protection. We compared the results from 2016 and a published survey from 2011. RESULTS: According to the 2016 survey, all respondents used C-arm fluoroscopy in pain interventions. Nineteen respondents (39%) had received radiation safety education. Physicians had insufficient knowledge about radiation safety. When the radiation safety education group and the non-education group are compared, there was no significant difference in efforts to reduce radiation exposure and radiation safety knowledge. When the 2011 and 2016 surveys were compared, the use of low dose mode (P = 0.000) and pulsed mode had increased significantly (P = 0.001). The number checking for damage to radiation protective garments (P = 0.000) and use of the dosimeter had also increased significantly (P = 0.009). But there was no significant difference in other efforts to reduce radiation exposure. CONCLUSIONS: Pain physicians seem to lack knowledge of radiation safety and the number of physicians receiving radiation safety education is low. According to this study, education does not lead to practice. Therefore, pain physicians should receive regular radiation safety education and the education should be mandatory.

Does acute normovolemic hemodilution affect intraoperative value of serum-creatinine concentration in patients undergoing cardiac surgery

BACKGROUND: The possible impact of hemodilution during acute normovolemic hemodilution (ANH) using hydroxyethyl starch (HES) on intraoperative serum concentration of creatinine (s-Cr) has not been well investigated. METHODS: Patients undergoing cardiac surgery were randomly allocated into Group-ANH (n = 15) or Group-C (control; n = 17). In Group-ANH, 5 ml/kg whole blood was collected, and they were administered 5 ml/kg of HES 130/0.4 after anesthesia induction and before initiating cardiopulmonary bypass (CPB). In both groups, moderate hypothermic CPB was initiated using 1,600–1,800 ml of bloodless priming solution. The changes of s-Cr, blood urea nitrogen, hematocrit (Hct), electrolytes, and osmolality were determined before ANH administration (T1), after administering ANH 5 ml/kg (T2), 30 and 60 s after the initiation of CPB (T3, T4), and at the end of surgery (T5). RESULTS: In Group-ANH, the s-Cr values at T2 (median [IQR25–75%], 0.83 [0.71–1.00] mg/dl) were not significantly different compared to those at T1 (0.84 [0.64–1.00] mg/dl), while those at T3 and T4 (0.68 [0.61–0.80] and 0.76 [0.59–0.92] mg/dl, respectively) were significantly lower than those at T2 (0.83 [0.71–1.00] mg/dl, P < 0.001). Hct at T3, T4 and T5 were significantly lower than those of T1 in both groups, and those at T2 and T4 of Group-ANH were significantly lower than those of Group-C (P < 0.001). There was no significant inter-group difference in all other parameters. CONCLUSIONS: Intraoperative s-Cr was not affected by the administration of ANH 5 ml/kg, although it reduced transiently at the beginning of CPB. Further study is needed to determine the clinical relevancy of our results.

Beneficial Effect of Diet Intervention on School Children with Atopic Dermatitis

BACKGROUND: Atopic dermatitis (AD) is one of the most common skin disorders affecting infants and children. Food allergy is a strong risk factor for the development of AD. This study was designed to evaluate the improvement of symptoms among AD patients in the late childhood while they take the customized (organic, balanced, non-allergic, diverse vegetable, little saturated fat and trans fat free) diet. METHODS: Nineteen children with AD who agreed to the written consent were enrolled in the study from October to December, 2014. We supplied them with the customized diet for 8 weeks. Clinical evaluations, blood tests and nutritional status were conducted at baseline, at 4th and at 8th week. Eczema area and severity index (EASI) and Scoring atopic dermatitis (SCORAD) were used to determine the severity of AD. RESULTS: The mean age of 19 patients was 8.5±1.54 years. EASI and SCORD index were decreased after diet intervention (2.6±3.06 [standard deviation] vs. 2.0±2.93 P=0.026, 24.9±10.76 vs. 20.0±12.65 P=0.009). Pruritus scores using visual analogue scale, rated by patients and hemoglobin revealed statistically significant improvement after diet intervention. CONCLUSIONS: The customized diet helps to improve the symptoms of atopic dermatitis and the nutritional indicators. Additional long-term and large-scale studies are required as well as the development of various diets.