OBJECTIVES: This study investigated recent trends in the prevalence of obesity among Korean adolescents and explored socioeconomic disparities in obesity. METHODS: This study used annual self-reported data on height, weight, and socioeconomic information from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2020. With a 95.8% response rate, the sample consisted of 818,210 adolescents. Obesity prevalence was calculated according to 4 socioeconomic indicators (household income, father’s educational attainment, mother’s educational attainment, and urbanicity). Socioeconomic inequality was quantified using the relative index of inequality (RII). RESULTS: The overall prevalence of obesity increased, doubling from 5.9% in 2006 to 11.7% in 2020. Boys and high school students showed a higher prevalence. The RIIs in household income and parental educational attainments significantly increased with time, indicating a growing inequality in obesity. Socioeconomic disadvantages had a greater influence on obesity among girls. The most recent RII values for boys were 1.25 for income, 1.79 for the father’s education, and 1.45 for the mother’s education, whereas the corresponding values for girls were 2.49, 3.17, and 2.62, respectively. CONCLUSIONS These findings highlight growing inequalities in adolescent obesity according to household income and parental educational attainments, especially for girls and middle schoolers.

BACKGROUND AND OBJECTIVES: Cigarette smoking has been reported to be associated with arterial stiffness. However, the clinical relevance of smoking cessation on arterial stiffness is debatable. Thus, we evaluated whether smoking cessation is associated with arterial stiffness.METHODS: A total of 1,169 male participants aged 30–64 years with absence of cardiovascular diseases in 2013–2017 were selected from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study. The subjects were classified into the following 5 groups based on self-reporting: non-smokers, former smokers (<1, 1 to <10, and ≥10, years after cessation), and current smokers. Arterial stiffness was assessed using the augmentation index (AIx). The radial artery AIx was obtained from the peripheral artery waveform. The association was explored cross-sectionally.RESULTS: The AIx of former smokers did not differ from that of non-smokers (p=0.089). However, after former smokers were stratified by duration of smoking cessation, we noted a linear trend according to the smoking status (p<0.001). Men who quit smoking <1 year ago showed an elevated AIx (β=3.94, standard error=1.54, p=0.011) as much as ones of current smokers (β=4.39, standard error=0.74, p<0.001), while those who quit more than a decade ago showed an AIx similar to that of non-smokers (β=0.35, standard error=0.82, p=0.670) after controlling covariates.CONCLUSIONS: A dose-response association between smoking cessation and AIx was revealed, which implies the possibility of a reversible effect of smoking cessation on arterial stiffness. Therefore, our findings may motivate current smokers to modify their smoking habits to delay or reverse disease progression.
Arteries ; Cardiovascular Diseases ; Cohort Studies ; Disease Progression ; Health Behavior ; Humans ; Male ; Metabolic Diseases ; Radial Artery ; Smoke ; Smoking Cessation ; Smoking ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Cigarette smoking has been reported to be associated with arterial stiffness. However, the clinical relevance of smoking cessation on arterial stiffness is debatable. Thus, we evaluated whether smoking cessation is associated with arterial stiffness. METHODS: A total of 1,169 male participants aged 30–64 years with absence of cardiovascular diseases in 2013–2017 were selected from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study. The subjects were classified into the following 5 groups based on self-reporting: non-smokers, former smokers (<1, 1 to <10, and ≥10, years after cessation), and current smokers. Arterial stiffness was assessed using the augmentation index (AIx). The radial artery AIx was obtained from the peripheral artery waveform. The association was explored cross-sectionally. RESULTS: The AIx of former smokers did not differ from that of non-smokers (p=0.089). However, after former smokers were stratified by duration of smoking cessation, we noted a linear trend according to the smoking status (p<0.001). Men who quit smoking <1 year ago showed an elevated AIx (β=3.94, standard error=1.54, p=0.011) as much as ones of current smokers (β=4.39, standard error=0.74, p<0.001), while those who quit more than a decade ago showed an AIx similar to that of non-smokers (β=0.35, standard error=0.82, p=0.670) after controlling covariates. CONCLUSIONS A dose-response association between smoking cessation and AIx was revealed, which implies the possibility of a reversible effect of smoking cessation on arterial stiffness. Therefore, our findings may motivate current smokers to modify their smoking habits to delay or reverse disease progression.

Cutaneous adverse events associated with intravenous immunoglobulin (IVIG) have a relatively low significance, ranging from 0.4% to 6%. In Korean dermatology literature, eczematous reactions associated with the use of IVIG have been underestimated. A 34-year-old male presented with a 2-week history of multiple vesicles on both hands and diffuse eczematous lesions on the trunk and both arms. He had been diagnosed with Guillain-Barré syndrome and had received IVIG at a dosage of 0.4 g/kg/d for 5 days during hospitalization. One week after discharge, cutaneous manifestations developed, starting with tiny blisters on both hands and progressing to eczematous patches on the trunk and arms.Histopathologic examination revealed spongiotic dermatitis with intracorneal bullae formation. A diagnosis of palmar pompholyx and systemic eczematous reaction associated with the administration of IVIG was made. Treatment with systemic corticosteroid, antihistamines and topical steroid was initiated. At a 2-week follow-up, significant improvement was observed.

BACKGROUND AND OBJECTIVES: Sleep disordered breathing (SDB) is a common problem in otolaryngology and comprises a spectrum of airway disorders that ranges from simple snoring to obstructive sleep apnea. SDB can exhibit problems of behavioral regulation such as inattention, hyperactivity and impulsivity. We aim to assess the effect of adenotonsillectomy on inattention and hyperactivity before and after adenotonsillectomy in children with SDB. SUBJECTS AND METHOD: We selected 19 pediatric patients with SDB, whose tonsils are of grade III or greater and the adenoid-nasopharyngeal ratio was 70% or more. The degree of inattentiveness and hyperactivity was evaluated by ADHD diagnostic system (ADS), trail making test, Wisconsin card sorting test (WCST) and SNAP-IV rating scale. RESULTS: There was significant improvement after adenotonsillectomy in the score of auditory ADS, trail making test, WCST, SNAP-IV rating scale. However, no improvement in postoperative visual ADS was observed. CONCLUSION: Adenotonsillectomy could be recommended to improve inattentiveness and hyperactivity in children with SDB.
Adenoidectomy ; Attention Deficit Disorder with Hyperactivity ; Child* ; Humans ; Impulsive Behavior ; Otolaryngology ; Palatine Tonsil ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Snoring ; Tonsillectomy ; Trail Making Test ; Wisconsin

Frequent screening for thyroid cancer has been suggested as a probable explanation for the observed high risk of thyroid cancer in nuclear power plant (NPP) areas. We aimed to compare thyroid cancer screening rates of residents living near NPPs to those of the general population. This study utilized data from two national survey-based studies in 2016 and in 2014, respectively, for residents (n = 1,200) living in administrative districts within 5 km of NPP sites as the interest group, and the general population (n = 228,712) including distantliving residents (n = 19,100) in administrative districts within 30 km of NPP sites as reference groups. We observed an increase in screening rates in residents near NPPs, which may lead to a higher possibility of thyroid cancer detection. Therefore, further epidemiological studies investigating radiation-induced thyroid cancer risk among residents near NPPs should be carefully designed and interpreted considering possible detection bias.

OBJECTIVES: We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population. METHODS: Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment). RESULTS: Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively). CONCLUSIONS An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.

OBJECTIVES: This study examined socioeconomic inequalities in compliance with precautions and health behavior changes during the coronavirus disease 2019 (COVID-19) outbreak using a representative Korean sample. METHODS: This exploratory study utilized around 210,000 participants aged ≥25 years in the Korean Community Health Survey 2020. Socioeconomic status was measured with educational attainment and household income. Outcomes included non-compliance with 8 precaution measures and deterioration in 6 health behaviors. The relative inequality index (RII) was calculated to quantify the degree of inequality by education and income level. RII values >1.0 indicate that deprived people have a higher frequency of health problems, and RII values <1.0 conversely indicate a higher frequency of health problems in more advantaged groups. RESULTS: People with lower education or income levels tended to have higher rates of non-compliance with COVID-19 safety precautions (RII range, 1.20 to 3.05). Lower education and income levels were associated with an increased smoking amount (RII=2.10 and 1.67, respectively) and sleep duration changes (RII=1.21 and 1.36, respectively). On the contrary, higher education and income levels were associated with decreased physical activity (RII=0.59 and 0.77, respectively) and increased delivery food consumption (RII=0.27 and 0.37, respectively). However, increased alcohol drinking was associated with lower education and income levels in younger men (RII=1.73 and 1.31, respectively), but with higher levels in younger women (RII=0.73 and 0.68, respectively). CONCLUSIONS Our findings suggest the need to develop customized strategies, considering the characteristics of the target population, to decrease the burden and impact of the COVID-19 outbreak.

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1–S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion Spinal FF may help assess both AS disease activity and chronicity.