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      • The COVID-19 Pandemic Response System at University Level : The Case of Safe Campus Model at Ewha Womans University

        Kyunghee Jung-Choi,Nackmoon Sung,Sun Hwa Lee,Misun Chang,Hee Jung Choi,Chung-Jong Kim,Nam-Kyong Choi,Hanna Kim,Yi-Jun Kim,Whanhee Lee,Hyesook Park,Eunhee Ha Ewha Womans University School of Medicine 2022 EMJ (Ewha medical journal) Vol.45 No.4

        In response to the changes in the Coronavirus disease 2019 (COVID-19) epidemic situation, Ewha Womans University established Ewha Safe Campus (ESC), an on-campus infection outbreak management system, to allow students and faculty members to safely resume face-to face classes in 2022. The COVID-19 testing station, Ewha Safe Station, is the core element of ESC. Symptomatic students and faculty members perform a combo swab self-PCR test or receive a nasopharyngeal swab PCR test from experts to prevent the spread of COVID-19 through early detection and management. ESC is significant in that it detects infection risks and proactively implements preemptive measures in a university. The COVID-19 health response system model at the university level was applied for the first time in South Korea, reaching a milestone in the history of university health in South Korea. In particular, it is highly valuable that the test was free of charge, as it enabled all of the examinees to have easy access to the test through joint cooperation with the Seegene Medical Foundation. This is a successful example of cooperation between schools and private institutions for public health improvement. In the future, the direct and indirect effects of the establishment and implementation of ESC need to be evaluated and confirmed, and areas requiring improvements need to be identified in preparation for another infectious disease outbreak in the future.

      • Effect of body mass index on gastric cancer risk according to sex in Korea: a nationwide cohort study and literature review

        Yonghoon Choi,Jieun Jang,Nayoung Kim Ewha Womans University School of Medicine 2024 EMJ (Ewha medical journal) Vol.47 No.2

        Objectives: Gastric cancer (GC) demonstrates a sex disparity that may also be associated with body mass index (BMI). This study explored whether the effect of BMI on the risk of GC varies by sex. Methods: The study cohort included 341,999 Koreans aged 40 years or older from the National Health Insurance Service–Health Screening Cohort, with a median follow-up period of 10 years. Participants were categorized into five groups based on their BMI. The effect of BMI was evaluated using Cox proportional hazard regression. Additionally, stratification analysis was performed according to waist circumference. Results: An increased risk of developing GC was observed across the study population among those with obesity (BMI 25.0–29.9 kg/m2; hazard ratio [HR], 1.11; 95% CI , 1.03–1.20) and severe obesity (BMI ≥30.0 kg/m2; HR, 1.22; 95% CI, 1.01–1.47), considering a 2-year latency period. Notably, the rise in GC risk was particularly pronounced among women with obesity and men with severe obesity. In the age-stratified analysis, severe obesity (BMI ≥30.0 kg/m2) was associated with an increased risk of GC in men under 50 years old (HR, 1.83; 95% CI, 0.99–3.37). For individuals aged ≥50 years, obesity was linked to a heightened risk of GC in both sexes. Furthermore, normal BMI (18.5–22.9 kg/m2) was associated with an increased GC risk in women. Conclusion: These findings indicate a positive association between excess body weight and the risk of GC in Koreans, particularly among men with severe obesity.

      • Treatment of Hemorrhoid in Unusual Condition- Pregnancy

        Hyo Seon Ryu Ewha Womans University School of Medicine 2022 EMJ (Ewha medical journal) Vol.45 No.4

        Hemorrhoids are varicose veins of the rectum that are located in or near the anal canal and are covered by mucosa. They can occur at any age, are generally symptomless, and affect both sexes equally. Hemorrhoids are a common complaint among younger women and are more likely to occur during pregnancy and the menstrual cycle. In this article, we discuss the many approaches in the treatment of hemorrhoids. Laxatives, stool softeners, and fiber supplements are all considered safe for use by pregnant women. Moderate use of laxatives is also acceptable. Since there is a lack of sufficient evidence to support the safety and efficiency of topical medicines or oral phlebotomies during pregnancy, these treatments must to be utilized with an increased degree of extreme caution. In the case that considerable bleeding occurs, anal packing may be a straight forward and helpful operation to implement. A hemorhoidectomy is the treatment option for hemorrhoids that have become strangulated, badly thrombosed, or have bleeding that cannot be controlled.

      • Sex differences in coronary atherogenesis: a narrative review

        Hack-Lyoung Kim Ewha Womans University School of Medicine 2024 EMJ (Ewha medical journal) Vol.47 No.2

        Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven primarily by atherogenesis. Recent efforts to understand sex differences in CAD have revealed distinct patterns in disease burden, risk factors, and clinical presentations. This review examines these sex differences in CAD, underscoring the importance of customized diagnostic and management strategies. Although men typically have higher rates of CAD prevalence and incidence, women face unique challenges, such as delayed diagnosis, atypical symptoms, and lower rates of medication prescription. Hormonal, genetic, and lifestyle factors all play a role in these disparities, with estrogen notably reducing CAD risk in women. Nontraditional risk factors, including chronic inflammation, psychological stress, socioeconomic status, and reproductive history, also contribute to CAD development and are often neglected in clinical settings. Addressing these differences requires increased awareness, more accurate diagnosis, and equitable healthcare access for both sexes. Furthermore, greater inclusion of women in CAD research is essential to better understand sex-specific mechanisms and optimize treatment outcomes. Personalizing CAD management based on sex-specific knowledge has the potential to improve prognosis and decrease disease incidence for both men and women.

      • A Proactive Testing Strategy to COVID-19 for Reopening University Campus during Omicron Wave in Korea : Ewha Safe Campus (ESC) Project

        Whanhee Lee,Kyunghee Jung-Choi,Hyunjin Park,Seunghee Jun,Nackmoon Sung,Sun-Hwa Lee,Misun Chang,Hee Jung Cho,Chung-Jong Kim,Hyesook Park,Eunhee Ha Ewha Womans University School of Medicine 2023 EMJ (Ewha medical journal) Vol.46 No.3

        Objectives: Ewha Womans University launched an on-campus Coronavirus disease-19 (COVID-19) response system called Ewha Safety Campus (ESC) Project in collaboration with the Seegene Inc. RTPCR diagnostic tests for COVID-19 were proactively provided to the participants. This study examines the effectiveness of the on-campus testing strategy in controlling the reproduction number (R t) and identifying student groups vulnerable to infection. Methods: The ESC project was launched on March 2, 2022, with a pilot period from Feb 22 to March 1, 2022—the peak of the Omicron variant wave. We collected daily data on the RT-PCR test results of the students of Ewha Womans University from Mar 2 to Apr 30, 2022. We daily calculated R t and compared it with that of the general population of Korea (women, people aged 20–29 years, and Seoul residents). We also examined the students vulnerable to the infection based on the group-specific R t and positivity rate. Results: A lower R t was observed about 2 weeks after the implementation of the ESC Project than that of the general population. The lower R t persisted during the entire study period. Dormitory residents had a higher R t. The positivity rate was higher in students who did not comply with quarantine guidelines and did not receive the second dose of the vaccine. Conclusion: The study provides scientific evidence for the effectiveness of the on-campus testing strategy and different infection vulnerabilities of students, depending on dormitory residence, compliance with the quarantine guidelines, and vaccination.

      • Ultrasound-guided sciatic nerve block in a patient with sciatic neuropathy associated with uterine myoma: a case report

        Bo Kyung Kang,Min Hyouk Beak,Won-joong Kim Ewha Womans University School of Medicine 2024 EMJ (Ewha medical journal) Vol.47 No.2

        Although sciatica is commonly associated with lumbar spinal issues, it is important to acknowledge that non-spinal factors can also play a significant role in this condition. This is particularly relevant for female patients, in whom gynecologic conditions can lead to secondary sciatic neuropathy. Herein, we report the case of a 66-year-old woman who experienced posterolateral right lower extremity radiating pain. We initially performed a lumbar transforaminal epidural steroid injection, but the pain persisted. Subsequently, hip MRI revealed sciatic neuropathy adjacent to the pedunculated portions of a uterine myoma. We then performed a sub-gluteal sciatic nerve block under ultrasound guidance, resulting in significant relief of her pain. In conclusion, hip MRI can be helpful for the differential diagnosis of sciatica, and ultrasound-guided sciatic nerve block can be considered an appropriate and effective treatment option.

      • Epidemiology and Etiology of Elbow Pain Based on the Healthcare Bigdata Hub in Korea: A Longitudinal Observational Study

        Hyungsuk Kim,Taeyang Jang Ewha Womans University School of Medicine 2023 EMJ (Ewha medical journal) Vol.46 No.4

        Objectives: This study investigated the epidemiological and etiological trends associated with elbow pain over the past decade in South Korea. Methods: Nationwide health statistics data from 2011 to 2020 pertaining to elbow pain-related diseases and soft tissue damages were sourced from the Healthcare Bigdata Hub with disease codes M771 (lateral epicondylitis), M770 (medial epicondylitis), S53 (elbow injury, dislocation, sprain), and G56 (mononeuropathies of the upper limb). The study assessed the annual fluctuations in the total medical cost and the number of patients associated with these codes. Trends over time were characterized by evaluating the crude and age-standardized prevalence rates and the annual percentage change. Changes in the proportion of medical expenses based on age distribution were also investigated. Results: A significant surge in medical costs was observed across all four codes. The M771, M770, and G56 codes experienced a pronounced increase in crude and age-standardized prevalence. Conversely, only S53 registered a significant drop in age-standardized prevalence. Moreover, within the total medical expenditures for the M771 code, the age bracket of 50 to 59 represented the largest proportion. Conclusion: The data suggest that the average age of patients reporting elbow pain is rising. Given this shifting trend in South Korea's health statistics concerning elbow pain, there will be an increasing need for socioeconomic support, which will in turn necessitate improving health policies that address allocating medical expenses and resources for elbow pain.

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