Considering that health inequalities derive from socioeconomic inequalities, fair policies and strategies to tackle health inequalities must focus on socioeconomic conditions. What is needed here is Health in All Policies, a comprehensive and intersectoral approach beyond health and healthcare sectors. However, based on a review of policies and programs of the Ministry of Health and Welfare and the 3rd National Health Promotion Strategies (Health Plan 2020) in Korea, we conclude that they totally lacked in perspective on health equity and social determinants of health. In fact, even most programs under the name of health equity include only supplementary health services targeted for low-income groups. As socioeconomic inequalities are worsening in Korea, health inequalities are more likely to be further aggravated if timely actions are not taken.
Health Care Sector ; Health Impact Assessment ; Health Promotion ; Health Services ; Korea ; Policy Making ; Republic of Korea ; Socioeconomic Factors

Objective: We investigated the sleep parameters and clinical factors related to short sleep onset latency (SL) in cancer patients. Methods: We retrospectively reviewed the medical records of 235 cancer patients. Patient Health Questionnaire-9, State and Trait Anxiety Inventory (State subcategory), Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs about Sleep, and Fear of Progression scale scores and sleep related parameters including sleeping pill ingestion time, bedtime, sleep onset time, and wake-up time were collected. We also calculated the duration from sleeping pill ingestion to bedtime, sleep onset time, and wake-up time; duration from wake-up time to bedtime and sleep onset time; and time spent in bed over a 24 hours period. Results: Among patients not taking sleeping pills (n = 145), early wake-up time (adjusted odds ratio [OR]: 0.39, 95% confidence interval [CI] 0.19−0.78), early sleep onset time (OR: 0.50, 95% CI 0.27−0.93), and low ISI score (OR: 0.82, 95% CI 0.71−0.93) were identified as expecting variables for SL ≤ 30 minutes. Longer duration from wake-up time to bedtime (OR: 2.49, 95% CI 1.48−4.18) predicted SL ≤ 30 minutes. Among those taking sleeping pills (n = 90), early sleep onset time (OR: 0.54, 95% CI 0.39−0.76) and short duration from pill ingestion to sleep onset time (OR: 0.05, 95% CI 0.02−0.16) predicted SL ≤ 30 minutes. Conclusion Cancer patients who fell asleep quickly spent less time in bed during the day. Thus, before cancer patients with insomnia are prescribed sleeping pills, their sleep parameters should be examined to improve their SL.

Additional dentition images are needed because the dentitions are distorted in cone-beam computed tomography (CBCT) due to streak artifacts and non-uniformity of the x-ray beam.
The purpose of this study is to evaluate the feasibility of improving the dentition image of CBCT scan with intraoral scanner instead of plaster models.
Maxilla images from plaster models, two intraoral scanners, and CBCT of 20 patients aged 12 to 18 were used in this study. With one of the intraoral scanners, the full arch was scanned by three segments and combined into a complete full arch. Virtual skull-dentition hybrid images from intraoral scanners were superimposed with the images from plaster models to evaluate the coordinate value difference and distance at reference points.
The results showed that the coordinate value difference and distance were smallest with segmented intraoral scan, which showed only 2 ㎛ distance. Intraoral scan may provide good dentition images for virtual skull-dentition images.

Purpose: Fractional microneedle radiofrequency (FMR) systems are used to treat inflammatory acne and scarring. Nonetheless, few controlled studies have combined this treatment with the traditional ablative fractional laser (AFL). We aimed to assess the safety and efficacy of the combination of FMR and AFL versus AFL alone in treating acne and acne scars. Materials and Methods: In this 20-week, randomized, split-face study, 23 Korean patients with facial acne and acne scars underwent FMR and AFL treatments. One half of each patient’s face was randomly assigned to receive FMR+AFL, whereas the other half received AFL alone. Treatments were administered in three consecutive sessions at 4-week intervals. This study investigated the severity of inflammatory acne, acne scars, individual lesion counts, depressed scar volumes, as well as patient and physician satisfaction. In addition, five patients underwent skin biopsy, and sebum output was measured. Results: The FMR+AFL treatment demonstrated superior efficacy compared to AFL alone in terms of inflammatory acne and acne scar grading, lesion counts, and subjective satisfaction. The side effects were minimal and well-tolerated in both groups. Immunohistochemical findings from skin biopsy samples revealed that the application of FMR+AFL could induce an inhibitory effect on sebum secretion at the molecular level. Conclusion FMR combined with AFL is a well-tolerated and effective treatment modality for inflammatory acne and acne scarring.

Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.
Adipocytes ; Bone Marrow ; Diagnosis ; Gelatin ; Hematologic Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Positron-Emission Tomography ; Spine

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.

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.

Background: This study explores whether the intolerance of uncertainty among healthcare workers prompts viral anxiety, and whether this association is mediated by their reassuranceseeking behavior and preoccupation with the coronavirus disease 2019 (COVID-19) in Korea. Methods: An online survey was conducted among healthcare workers in Asan Medical Center, on November 29, 2021. Demographic characteristics and responses to items from rating scales were collected, including Stress and Anxiety to Viral Epidemics-9, Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Obsession with COVID-19 Scale (OCS), Patient Health Questionnaire-9, Insomnia Severity Scale, and Intolerance of Uncertainty-12 (IUS-12). Results: Among the 329 participants, viral anxiety of healthcare workers was predicted by being female (β = 0.14, P = 0.002), CRBS (β = 0.30, P < 0.001), OCS (β = 0.32, P < 0.001), and IUS-12 (β = 0.15, P = 0.002) scores (adjusted R2 = 0.43, F = 31.1, P < 0.001). Mediation analysis showed that the intolerance of uncertainty directly influenced viral anxiety, and reassuranceseeking behavior and obsession with COVID-19 partially mediated the association. Conclusion The intolerance of uncertainty among healthcare workers directly influenced their viral anxiety, and reassurance-seeking behavior and obsession with COVID-19 mediated this association in this era of “living with coronavirus” in Korea.

Mucinous adenocarcinoma arising from a chronic anorectal fistula is a rare condition. It is often confused with a hemorrhoid or perineal abscess, which consequently delays accurate diagnosis. Here, we report the case of a 58-year-old man with blood-tinged stool who reported a rectal mass, which was diagnosed as mucinous adenocarcinoma arising from an anal fistula. After initial computed tomography-guided needle aspiration biopsy had failed to provide an accurate diagnosis, transrectal punch biopsy was performed to obtained adequate tissue sample for confirmative histological diagnosis. The patient was successfully treated with neoadjuvant concurrent chemoradiotherapy followed by surgical intervention.
Abscess ; Adenocarcinoma, Mucinous* ; Biopsy* ; Biopsy, Needle ; Chemoradiotherapy* ; Fistula* ; Hemorrhoids ; Humans ; Middle Aged ; Mucins* ; Needles ; Neoadjuvant Therapy ; Rectal Fistula

PURPOSE: In order to suggest optimal anticancer drugs for patient-tailored chemotherapy, we developed a colorectal cancer (CRC)-liver metastasis patient-derived tumor xenograft (PDTX) model. METHODS: Tissue obtained from a patient with CRC-liver metastasis (F0) was transplanted in a nonobese female mouse with diabetic/severe combined immune deficiency (F1) and the tumor tissue was retransplanted into nude mice (F2). When tumor volumes reached ~500 mm³, the F2 mice were randomly divided into 4 groups (n = 4/group) of doxorubicin, cisplatin, docetaxel, and nontreated control groups. The tumor tissues were investigated using H&E staining, terminal deoxynucleotidyl transferase dUTP nick end labeling assays, and immunohistochemistry. To determine where the mutant allele frequencies varied across the different passages, we isolated genomic DNA from the primary tumor, liver metastasis, and PDTX models (F1/F2). RESULTS: The physiological properties of the tumor were in accord with those of the patient's tumors. Anticancer drugs delayed tumor growth, inhibited proliferation, and caused apoptosis. Histological assessments revealed no observable heterogeneity among the intragenerational PDTX models. Target exon sequencing analysis without high-quality filter conditions revealed some genetic variations in the 83 cancer-related genes across the generations. However, when de novo mutations were defined as a total count of zero in F0 and ≥5 in F2, exactly prognostic impact of clone cancer profiling (EGFR, KRAS, BRAF, PIK3CA, NRAS, APC and TP53) were detected in the paired. CONCLUSION: A CRC liver metastasis PDTX model was established for the evaluation of chemotherapeutic efficacy. This model retained the physiological characters of the patient tumors and potentially provides a powerful means of assessing chemotherapeutic efficacy.
Animals ; Apoptosis ; Cisplatin ; Clone Cells ; Colorectal Neoplasms* ; DNA ; DNA Nucleotidylexotransferase ; Doxorubicin ; Drug Therapy* ; Exons ; Family Characteristics ; Female ; Gene Frequency ; Genetic Variation ; Heterografts* ; Humans ; Immunohistochemistry ; Liver* ; Mice ; Mice, Nude ; Neoplasm Metastasis* ; Population Characteristics ; Sequence Analysis ; Xenograft Model Antitumor Assays