Journal Of Korean Medical Science[JOURNAL]
Sun
200 papers
EGFR and Its Ligands in Idiopathic Pulmonary Fibrosis: Predicting Clinical Outcomes and Molecular Endotyping Through In-Depth Analysis.
Lee JU, Park SL, Kim MK … +8 more , Seo EJ, Hwang HG, Son B, Kim TR, Park HO, Park JY, Chang HS, Park CS
J Korean Med Sci · 2026 Jun · PMID 42381528 · Full text
BACKGROUND: The dysregulation of alveolar epithelial cells has been proposed as the cause of idiopathic pulmonary fibrosis (IPF) due to abnormal activation of epidermal growth factor receptor (EGFR). However, the ways of...
BACKGROUND: The dysregulation of alveolar epithelial cells has been proposed as the cause of idiopathic pulmonary fibrosis (IPF) due to abnormal activation of epidermal growth factor receptor (EGFR). However, the ways of interaction with EGFR ligands including amphiregulin (AREG), epidermal growth factor (EGF), transforming growth factor (TGF)-α and heparin-binding EGF have not been revealed. The aim of the present study was to investigate the diagnostic and prognostic significance of EGFR and its ligands in IPF. METHODS: EGFR and its ligands were quantified by enzyme-linked immunosorbent assay in bronchoalveolar lavage (BAL) fluids and serum from 131 patients with IPF and 52 normal controls (NCs). Mortality risk was evaluated using Cox proportional hazards models. Cluster analysis based on EGFR and its ligands was conducted using both hierarchical and K-means clustering methods. RESULTS: The patients exhibited significantly higher levels of EGFR, AREG, EGF, and TGF-α compared to NCs. The threshold values for AREG, EGF and TGF-α were determined to be 12.2 pg/mL, 6.3 pg/mL and 5.2 pg/mL, respectively, for the two groups. The sensitivities were 79.83%, 88.24%, and 56.30%, and the specificities were 81.82%, 31.82%, and 63.64% to diagnose IPF, respectively. The mortality rate was significantly higher in IPF patients with low levels compared to those with high levels of EGFR and EGF on Cox analysis. Four distinct clusters were identified based on the levels of EGFR and its ligands in BAL fluids. C3 group (n = 7), which exhibited the highest levels of TGF-α, AREG and EGFR, showed the highest risk of mortality, whereas the C2 group (n = 40), with the highest level of EGF and the intermediate levels of AREG, EGFR, and TGF-α, had the lowest risk. CONCLUSION: The diverse effects of EGFR on mortality may depend on balance of TGF-α and EGF. Therefore, a comprehensive analysis of EGFR and its ligands could help predict molecular endotypes and clinical outcomes for IPF patients.
Genotype Modifies the Predictive Performance of Plasma Biomarkers for Amyloid Plaque Burden in Subjective Cognitive Decline.
Lee HJ, Yoon B, Hong YJ … +8 more , Jeong JH, Kim S, Wang MJ, Choi SH, Ryu JS, Kang S, Park KH, Yang DW
J Korean Med Sci · 2026 Jun · PMID 42381527 · Full text
BACKGROUND: Apolipoprotein E () ε4 is a well-known risk factor for Alzheimer's disease (AD), with ε4 carriers exhibiting distinct clinical and biological characteristics compared to non-carriers. This study investigated...
BACKGROUND: Apolipoprotein E () ε4 is a well-known risk factor for Alzheimer's disease (AD), with ε4 carriers exhibiting distinct clinical and biological characteristics compared to non-carriers. This study investigated whether the predictive performance of plasma biomarkers for amyloid positron emission tomography (PET) outcomes varies by ε4 carrier status in individuals with subjective cognitive decline (SCD). METHODS: We retrospectively analyzed baseline data from the Cohort Study to Identify Predictors for the Clinical Progression to Mild Cognitive Impairment or Dementia from Subjective Cognitive Decline. Plasma levels of the amyloid beta (Aβ) 42/40 ratio, glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and phosphorylated tau (pTau) 181 were quantified using Single Molecule Array technology. We assessed predictive performance of plasma biomarkers for amyloid PET outcomes using receiver operating characteristic analysis and linear regression models. RESULTS: The study included 104 participants, with 20 ε4 carriers and 84 non-carriers. Among ε4 carriers, NfL (area under the curve [AUC] = 0.909), GFAP (AUC = 0.904), and pTau181 (AUC = 0.828) showed the highest predictive accuracy. For non-carriers, the most predictive biomarkers were pTau181/Aβ42 (AUC = 0.872), Aβ42/Aβ40 (AUC = 0.794), and pTau181 (AUC = 0.761). Significant interactions between and biomarkers were noted for GFAP ( = 0.005) and NfL ( = 0.010) in predicting amyloid plaque burden. CONCLUSION: Plasma biomarkers exhibit differential predictive performance for amyloid pathology based on genotype, with GFAP and NfL showing interaction with genotype. These findings suggest the importance of considering genotype when interpreting plasma biomarker results for AD diagnosis in individuals with SCD. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003397.
Two-Year Outcomes of a Randomized Controlled Trial of Nonintervention Versus Oral Ibuprofen for Patent Ductus Arteriosus in Premature Infants.
Sung SI, Yang M, Ahn SY … +2 more , Chang YS, Park WS
J Korean Med Sci · 2026 Jun · PMID 42381526 · Full text
BACKGROUND: Optimal management of patent ductus arteriosus (PDA) in premature infants remains debated, and the long-term impact of different strategies has not been well studied. We previously conducted a randomized clin...
BACKGROUND: Optimal management of patent ductus arteriosus (PDA) in premature infants remains debated, and the long-term impact of different strategies has not been well studied. We previously conducted a randomized clinical trial comparing nonintervention (NI) and oral ibuprofen (IBU) for hemodynamically significant PDA in preterm infants, which showed no significant difference in bronchopulmonary dysplasia or death during hospitalization. In this study, we aimed to present a prespecified longitudinal follow-up investigation to assess the outcomes of persistently open PDA at discharge, as well as growth and neurodevelopmental outcomes at 2 years' corrected age (CA), based on PDA management strategy. METHODS: Surviving infants from the original trial were evaluated at 2 years' CA. Examiners blinded to the management group assessed spontaneous ductal closure after hospital discharge, growth parameters, and neurodevelopmental outcomes. RESULTS: Among 130 survivors, open PDA at discharge was present in 7/66 (11%) NI and 2/64 (3%) IBU infants; spontaneous closure occurred in 3/7 NI infants but 0/2 IBU infants. Device closure occurred in 6% (4/66) of the NI group and 3% (2/64) of the IBU group ( = 0.680) by 2 years' CA. Growth parameters-height, weight, and head circumference-did not differ significantly between groups. Neurodevelopmental impairment-defined as cerebral palsy, hearing or visual loss, or a Bayley Scales of Infant Development II mental or psychomotor development index below 70-was present in 15% (10/66) of the NI group and 22% (14/64) of the IBU group ( = 0.371). CONCLUSION: This follow-up study demonstrated that NI for hemodynamically significant PDA in preterm infants resulted in growth and neurodevelopmental outcomes at 2 years' CA similar to those seen with IBU treatment. The high rate of spontaneous PDA closure and lack of significant differences in long-term morbidities support the safety of NI and raise questions about the benefit of routine pharmacologic closure.
Technology-Dependent Children Living at Home in Korea: A Population-Based Analysis Using NHIS Claims Data.
Lee JW, Kim CH, Lim NG … +2 more , Kim MS, Lee SY
J Korean Med Sci · 2026 Jun · PMID 42381525 · Full text
BACKGROUND: Advances in medical technology have improved the survival of critically ill children, resulting in a growing population of technology-dependent children (TDC). Given their substantial healthcare needs and oft...
BACKGROUND: Advances in medical technology have improved the survival of critically ill children, resulting in a growing population of technology-dependent children (TDC). Given their substantial healthcare needs and often complex care, understanding the prevalence and healthcare utilization of TDC is crucial for informed decision-making for healthcare professionals and policymakers. This study aimed to investigate the prevalence, incidence, and healthcare utilization of TDC in Republic of Korea (South Korea). METHODS: This retrospective, population-level study analyzed the National Insurance Service claims data in Korea from 2018 to 2019. Children and adolescents aged 0-18 years living at home with technology dependence for respiratory (invasive/non-invasive ventilation, tracheostomy, or oxygen therapy) or nutritional support (nasoenteric or gastrostomy tube feeding) were included. We estimated 2-year prevalence, 1-year incidence, and healthcare utilization, including subgroup comparisons by complex chronic condition (CCC) status. RESULTS: In total, 3,306 children were identified as TDC: 1,889 required respiratory support (21.5 per 100,000), and 2,036 required tube feeding (23.2 per 100,000). The mean age was 4.4 ± 5.4 years for respiratory-dependent and 6.2 ± 5.8 years for nutritional-dependent children. Most of the children had ≥ 1 CCC. Compared with non-CCC counterparts, children with CCC had longer hospital stays (125 vs. 35.8 days), more intensive care unit days (74.6 vs. 35.8), and higher annual healthcare costs per patient ($49,870 vs. $10,430). The overall 1-year mortality was 17.0%, with higher rates among patients with CCC. CONCLUSION: TDC represent a relatively small but medically complex population with high healthcare needs and utilization. These findings highlight the importance of coordinated and multidisciplinary home-based care. Further studies are warranted to guide interventions and policies that support improved outcomes for TDC and their families.
Retracted Publications Related to Statistics: A Scopus-Based Bibliometric Analysis.
Oralbek A, Yessirkepov M, Zimba O … +2 more , Qumar AB, Kocyigit BF
J Korean Med Sci · 2026 Jun · PMID 42381524 · Full text
BACKGROUND: Statistics is a field that provides the methodological basis for modern scientific research, including data collection, analysis, and interpretation. The retraction procedure involves the official removal of...
BACKGROUND: Statistics is a field that provides the methodological basis for modern scientific research, including data collection, analysis, and interpretation. The retraction procedure involves the official removal of a work from the literature due to substantial scientific concerns. Analysis of retracted publications is critical for identifying ethical violations and structural flaws in scientific publishing. METHODS: This study performed a bibliometric and descriptive analysis of publications labeled as "retracted" in the Scopus database, retrieved via a search utilizing the term "statistics" on August 18, 2025. The analysis of documents was conducted based on year, country, journal, keyword, and reasons for retraction. Collaboration networks of countries and authors were displayed with VOSviewer software, and reasons for retraction were confirmed using the Retraction Watch Database. Temporal trends were assessed by linear regression analysis. RESULTS: A total of 680 retracted papers were examined. Retractions occurred between 2006 and 2025. A statistically significant upward trend was found in the number of retracted articles over time ( = 0.030). The most retracted publications came from China (n = 426), followed by India (n = 67), and the United States (n = 49). The Journal of Healthcare Engineering (n = 35) and Journal of Sensors (n = 25) stood out among the journals with the most retracted publications. The most common retraction reasons were investigation by journal/publisher (n = 297), unreliable results and/or conclusions (n = 189), and concerns/issues about referencing/attributions (n = 153). CONCLUSION: The number of retracted publications tagged with the keyword "statistics" has increased significantly over the years. This increase can be attributed to strengthening scientific oversight mechanisms and increased awareness of publication ethics. Increasing the involvement of statistical experts in the peer-review process, improving the statistical literacy of authors, and developing training and mentoring mechanisms to prevent ethical violations are crucial.
Tuberculosis Development in Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Study.
Jeong H, Lee E, Oh JH … +3 more , Choi WI, Park B, Park JH
J Korean Med Sci · 2026 Jun · PMID 42381523 · Full text
BACKGROUND: Pulmonary tuberculosis is a major comorbidity of chronic obstructive pulmonary disease (COPD). However, the risk factors for tuberculosis development in patients with COPD have not been thoroughly studied. Th...
BACKGROUND: Pulmonary tuberculosis is a major comorbidity of chronic obstructive pulmonary disease (COPD). However, the risk factors for tuberculosis development in patients with COPD have not been thoroughly studied. Thus, this study investigated the development of tuberculosis according to comorbidities and inhaler prescriptions for COPD. METHODS: A retrospective cohort study was conducted using data from the Korean Health Insurance Review and Assessment Service database from January 1, 2015 to December 31, 2020. This cohort included 139,589 COPD patients (≥ 40 years) with a new prescription of inhalers. Cox proportional hazards regression models were used to identify significant risk factors for predicting the development of tuberculosis. RESULTS: Multivariate analysis demonstrated that a history of tuberculosis (hazard ratio [HR], 18.14; 95% confidence interval [CI], 16.44-20.02) and hospitalization during the screening period (HR for one hospitalization, 1.30; 95% CI, 1.17-1.44; HR for two or more hospitalizations, 1.54; 95% CI, 1.39-1.70), along with older age and male sex, were associated with the development of pulmonary tuberculosis. CONCLUSION: Our data indicate that a history of tuberculosis and hospitalization during the screening period, along with old age and male sex, are independent risk factors for the development of pulmonary tuberculosis in patients with COPD.
Characteristics of Adolescents and Young Adults Visiting an Emergency Department Due to Self-Harm or Suicide Attempts: Risk Factors for Severe Medical Outcome and Short-Term Revisits.
Park K, Kim TH, Song KJ … +5 more , Shin J, Jung JH, Lee HJ, Kim YH, Lee SGW
J Korean Med Sci · 2026 Jun · PMID 42333398 · Full text
BACKGROUND: Suicide and self-harm among adolescents or young adults represent major public health issues, characterized by high recurrence rates and significant social burdens. This study aimed to identify demographic an...
BACKGROUND: Suicide and self-harm among adolescents or young adults represent major public health issues, characterized by high recurrence rates and significant social burdens. This study aimed to identify demographic and clinical characteristics, as well as risk factors associated with severe medical outcomes and short-term revisits among this population. METHODS: A retrospective analysis was performed on 1,445 adolescents or young adults (≤ 24 years old) who visited an emergency department (ED) designated as a regional psychiatric emergency center in Seoul, Korea, for suicide attempts or self-harm from January 2015 to December 2022. Data collected included demographics, medical and psychiatric histories, details of the incidents, and clinical outcomes. Severe medical outcomes were defined as admissions to non-psychiatric wards, intensive care units, surgical hospitalization, or transfers. Short-term ED revisits within 60 days were analyzed. Multivariable logistic regression was employed to identify independent factors associated with severe medical outcomes and ED revisits. RESULTS: Among the study participants, 1,090 (75.4%) were female, and most incidents were impulsive and non-lethal. Severe medical outcomes occurred in 8.7% of visits and were significantly associated with planned suicide attempts (adjusted odds ratio [aOR], 1.92; 95% confidence interval [CI], 1.02-3.62) and the use of high-lethality methods such as pesticides, chemicals, inhalation, hanging, and falls. Short-term revisits within 60 days occurred in 7.1% of patients, with significant factors associated with revisits including female gender (aOR, 1.93; 95% CI, 1.04-3.55), living alone (aOR, 1.57; 95% CI, 1.00-2.44), expressed requests for help (aOR, 1.68; 95% CI, 1.04-2.74), and history of psychiatric treatment (aOR, 2.41; 95% CI, 1.15-5.04). CONCLUSION: Targeted ED-based and community interventions, along with timely psychiatric care, tailored to the specific characteristics and risk profiles of adolescents or young adults may help reduce severe outcomes and prevent repeat self-harm and suicide attempts.
Effect of Socioeconomic Status on Lung Function in the Korean General Population.
Joo H, Jo YS, Rhee CK … +1 more , Choi JY
J Korean Med Sci · 2026 Jun · PMID 42333397 · Full text
BACKGROUND: Socioeconomic status (SES) significantly influences the incidence and severity of chronic obstructive pulmonary disease. This study investigated the impact of SES on incidence of airflow obstruction and lung...
BACKGROUND: Socioeconomic status (SES) significantly influences the incidence and severity of chronic obstructive pulmonary disease. This study investigated the impact of SES on incidence of airflow obstruction and lung function decline within a general population cohort in Republic of Korea (South Korea). METHODS: We utilized data from the Korean Genome and Epidemiology Study Ansan-Ansung Cohort, collected between 2001 and 2014. A total of 10,030 participants were included in the longitudinal analysis. Socioeconomic status was classified using four key indicators: area of residence (urban, n = 5,012; rural, n = 5,018), marital status (single, n = 974; married, n = 8,987), education level (elementary school, n = 3,355; middle or high school, n = 5,287; college or above, n = 1,305), and income (< $1,460, n = 6,413; $1,460-2,920, n = 2,705; > $2,920, n = 729), among participants with available data. RESULTS: Over a 12-year follow-up period, individuals living in rural areas experienced a more rapid decline in both mean forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) compared to those in urban areas ( < 0.001). Participants with the lowest levels of education and income experienced significantly faster declines in both FVC and FEV₁ (all < 0.001, except for medium vs. high income). The risk of developing airflow obstruction was significantly higher for participants from rural areas, with lower education levels, and lower income. CONCLUSION: This study demonstrated a significant association between lower SES and incidence of airflow obstruction and progression in Korea. Lower SES, characterized by rural residence, lower educational status, and lower income, was associated with poorer baseline health, higher comorbidity rates, and more rapid lung function decline over a 12-year period.
Predictors of Treatment Outcomes in Pediatric Graves' Disease.
Shin DY, Kang E, Nam HK … +2 more , Lee KH, Rhie YJ
J Korean Med Sci · 2026 Jun · PMID 42333396 · Full text
BACKGROUND: Graves' disease (GD), the most common cause of hyperthyroidism in children, is primarily treated with antithyroid drugs (ATDs). The aim of this study was to evaluate factors that could predict remission, rela...
BACKGROUND: Graves' disease (GD), the most common cause of hyperthyroidism in children, is primarily treated with antithyroid drugs (ATDs). The aim of this study was to evaluate factors that could predict remission, relapse, and the need for persistent high doses of methimazole (MMI) in pediatric GD. METHODS: This was a retrospective study of medical records that included GD diagnosed before 19 years of age from January 2004 to December 2023. Remission was defined as maintaining the euthyroid state for more than 6 months after stopping ATDs. The high-dose group was defined as those receiving MMI doses of more than 5 mg/day at last follow-up, regardless of euthyroid status. RESULTS: Of the 113 patients (95 girls and 18 boys), 47 (41.6%) achieved remission at a mean of 37.17 ± 29.01 months after treatment. Compared to the non-remission group, the remission group showed significant differences in T3, fT4 and thyroid-stimulating hormone-binding inhibitor immunoglobulin (TBII) at diagnosis (330.92 ± 177.72 vs. 413.75 ± 179.09 ng/dL, = 0.017; 3.31 ± 1.39 vs. 4.12 ± 1.34 ng/dL, = 0.002; 15.68 ± 14.37 vs. 23.37 ± 16.61 IU/L, = 0.012, respectively); time to TBII normalization (25.26 ± 29.88 vs. 45.33 ± 37.17 months, = 0.003); and ratio of 6-month to initial TBII (54.98 ± 42.04 vs. 87.92 ± 55.94%, < 0.001). Eleven patients (11/47, 23.4%) experienced relapse at a mean of 17.91 ± 16.81 months after remission. Compared to the non-relapse group, the relapse group was predominantly male (5.6 vs. 45.5%, < 0.001) and exhibited a higher ratio of 12-month to initial TBII (36.64 ± 33.78 vs. 87.18 ± 78.14%, = 0.025). In the non-remission group, 38/66 patients (57.6%) received persistent high doses of MMI, with a mean dose of 0.39 ± 0.17 mg/kg/day at the last follow-up. Compared to the low-dose group, the high-dose group showed significant differences in time to T3, fT4 and TBII normalization (1.21 ± 0.69 vs. 2.39 ± 1.76 months, < 0.001; 1.50 ± 0.84 vs. 2.61 ± 2.47 months, = 0.013; 7.00 ± 2.61vs. 9.55 ± 5.14 months, = 0.011, respectively) and ratio of 6-month to initial TBII (61.57 ± 36.96 vs. 107.34 ± 59.90%, < 0.001). Based on the receiver-operating characteristic curve for the ratio of 6-month to initial TBII, the cut-off value for remission was 62.5%, and the cut-off value for persistent high doses of MMI was 82.5%. CONCLUSION: Thyroid hormone and TBII levels at diagnosis, time to thyroid hormone and TBII normalization, and the TBII ratio after ATD treatment can be used to predict remission, relapse, and the persistent need for high-dose MMI in pediatric GD patients.
Evaluating Large Language Models for Post-Publication Promotion: A Blinded Comparative Study of Social Media Posts in Public Health.
Doskaliuk B, Mukhamediyarov M, Yessirkepov M … +1 more , Zimba O
J Korean Med Sci · 2026 Jun · PMID 42333395 · Full text
BACKGROUND: Social media platforms such as X (formerly Twitter) are increasingly used by journals, authors, and institutions to promote newly published research. Well-designed posts can enhance visibility, accelerate kno...
BACKGROUND: Social media platforms such as X (formerly Twitter) are increasingly used by journals, authors, and institutions to promote newly published research. Well-designed posts can enhance visibility, accelerate knowledge translation, and increase altmetric attention. However, creating accurate and policy-compliant content is time-intensive. Large language models (LLMs) offer a potential solution, yet systematic evaluations of their performance in post-publication promotion remain limited. METHODS: We conducted a blinded, crossed, offline evaluation of four LLMs: GPT-5 (OpenAI), Gemini 2.5 Pro (Google DeepMind), Grok-3 (xAI), and Perplexity Pro (Perplexity AI), tasked with generating X-style posts (≤ 260 characters) for 36 open access articles from The Lancet Public Health, The Lancet Planetary Health, and Annual Review of Public Health. Posts were generated using a standardized system and user prompt. A single blinded rater scored outputs using a five-domain rubric (factual accuracy, clarity, policy compliance, call-to-action quality, structure/metadata; maximum score 10). Secondary measures included character count, hashtag use, and readability (Flesch-Kincaid Grade Level). General linear models with Bonferroni-adjusted post hoc tests and non-parametric analyses were applied. RESULTS: All four models achieved perfect factual accuracy and no policy violations. Mean total quality scores differed significantly by model, < 0.001. GPT-5 (9.60) and Perplexity Pro (9.60) performed best, followed by Gemini 2.5 Pro (9.47), while Grok-3 scored lower (8.80). Domain analyses showed Grok-3 underperformed in call-to-action quality (1.40 vs. ≥1.97 in other models, < 0.001) and produced significantly shorter posts (median 194 characters, < 0.001). Perplexity Pro scored highest for policy compliance, while GPT-5 and Gemini 2.5 Pro achieved superior structural scores. Readability varied: GPT-5 8.9 (7.3-9.2) and Perplexity Pro 7.3 (6.5-8.8) generated more complex outputs, whereas Gemini 2.5 Pro 5.1 (4.8-6.5) and Grok-3 4.5 (3.6-6.3) produced more accessible posts. CONCLUSION: LLMs can reliably generate accurate and policy-compliant social media posts for research promotion, with differences in style and readability that may inform audience targeting. GPT-5, Gemini 2.5 Pro, and Perplexity Pro produced high-quality outputs, while Grok-3 underperformed across several domains. These findings highlight the potential of LLMs as scalable first-draft tools for post-publication promotion, capable of improving the reach and accessibility of scientific research. Careful model selection, tailored to audience and communication goals, together with human oversight, remains essential.
Values and Preferences of Korean Patients With Facial Palsy: A Cross-Sectional Survey.
Joo HA, Kim J, Kwak MY … +14 more , Yoo MC, Cho YS, Lee SA, Jeong J, Kim S, Shin JY, Han J, Chung JH, Hong JB, Kim BK, Kim M, Kim HJ, Lee HY, Lee JD
J Korean Med Sci · 2026 Jun · PMID 42333394 · Full text
BACKGROUND: Facial palsy is a debilitating condition that can lead to significant functional, aesthetic, and psychosocial impairments. Thus, this study aimed to systematically explore treatment preferences and values amo...
BACKGROUND: Facial palsy is a debilitating condition that can lead to significant functional, aesthetic, and psychosocial impairments. Thus, this study aimed to systematically explore treatment preferences and values among Korean patients with facial palsy and develop clinically applicable recommendations to enhance patient-centered care. METHODS: A cross-sectional questionnaire survey was conducted between June and July 2025 at a facial palsy clinic in a secondary referral hospital. A total of 51 patients with peripheral facial palsy completed a structured 21-item survey addressing preferences related to assessment and diagnosis, treatment modalities, multidisciplinary care, communication, information sources, and recovery concerns. The internal consistency of the questionnaire was evaluated using Cronbach's alpha (α). RESULTS: Participants (mean age 43.1 ± 12.4 years; 68.6% female) prioritized objective assessment methods and accurate prognostic information, favoring standardized tools and electrophysiological testing. Regarding treatment preferences, 82.4% supported active steroid therapy and 74.5% preferred combined steroid-antiviral treatment. Surgery was generally viewed as a last resort, with 51.0% favoring non-surgical rehabilitation even in chronic cases-those persisting for more than six months. Multidisciplinary care and clear, detailed communication were highly valued. The primary recovery concern was permanent facial sequelae (64.7%). Meanwhile, the internal consistency of the survey, which covered diverse and independent domains, was rather poor (Cronbach's α = 0.548), reflecting the multidimensional nature of the patient preferences. CONCLUSION: Korean patients with facial palsy express a strong fear of permanent sequelae, which shapes the preferences of patients toward objective information and treatments with high efficacy. Moreover, the patients were found to favor comprehensive multidisciplinary care, clear and transparent communication, and collaborative relationships with healthcare providers. These findings provide important insights for developing patient-centered clinical guidelines tailored to Korean patients with facial palsy.
Publication and Retraction Activity in the Field of Extracorporeal Membrane Oxygenation: Origins, Concerns, and Perspectives.
Permenov BA, Zimba O, Suigenbayev D … +1 more , Kocyigit BF
J Korean Med Sci · 2026 Jun · PMID 42333393 · Full text
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has become a vital life-support tool in critical care, particularly during the COVID-19 pandemic. The rapid growth of ECMO research necessitates bibliometric analysi...
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has become a vital life-support tool in critical care, particularly during the COVID-19 pandemic. The rapid growth of ECMO research necessitates bibliometric analysis to identify trends, key contributors, and obstacles, including concerns regarding scientific integrity, such as retractions. METHODS: A bibliometric analysis was conducted using the Scopus database (search date: August 25, 2025), with the phrase "extracorporeal membrane oxygenation" searched in the title, abstract, or keywords. All English-language publications from 1958 and 2025 were covered. Data on publication trends, prominent countries, institutions, journals, authors, keywords, and citation/Altmetric Attention Scores were obtained. Retractions were detected using standardized queries on PubMed, and data on publication year, retraction year, country, and reasons were obtained. RESULTS: A total of 26,786 ECMO-related publications were examined. The number of publications showed a significant upward trend ( < 0.001), peaking in 2022 with 240 articles. The United States was the leading country (n = 11,261), followed by Germany (n = 2,349), Italy (n = 1,756), China (n = 1,660), and the United Kingdom (n = 1,642). The ASAIO Journal was the most prolific source (n = 1,204). Harvard Medical School (n = 585) ranked first among institutions. Coronavirus disease 2019 (COVID-19)-related papers dominated citation and altmetric impact, with the 2020 JAMA Wuhan cohort publication receiving the most citations (n = 17,423). Between 2012 and 2024, nine ECMO-related articles were retracted. CONCLUSION: This analysis highlights the significant global growth of ECMO research, demonstrating considerable academic and social impact, particularly during the COVID-19 pandemic. The results offer valuable insights into publication trends, major contributors, and research visibility, potentially informing future research and partnerships in this field.
Risk-Based Survival Outcomes in Early-Stage Endometrial Cancer: Impact of Radiation Therapy.
Han KH, Kim MK, Suh DH … +3 more , Kim K, Kim YB, No JH
J Korean Med Sci · 2026 Jun · PMID 42299140 · Full text
BACKGROUND: Although a new paradigm incorporating molecular and histological classifications has emerged, molecular classification is not routinely performed for all patients in real-world practice. Therefore, evaluating...
BACKGROUND: Although a new paradigm incorporating molecular and histological classifications has emerged, molecular classification is not routinely performed for all patients in real-world practice. Therefore, evaluating the impact of adjuvant radiation in early-stage endometrial cancer according to risk grouping without molecular classification remains important. This study aims to assess the prognostic impact of adjuvant radiation in intermediate-risk (IR) and high-intermediate-risk (HIR) groups, as defined by the 2021 European Society of Gynaecological Oncology (ESGO) guidelines. METHODS: We retrospectively reviewed the medical records of 131 patients with stage I or II endometrial cancer classified as IR or HIR. All patients underwent staging surgery between July 2004 and April 2020 and were followed until December 2023. The prognostic impact of adjuvant radiation on survival outcomes was evaluated using multivariable analysis with a Cox proportional hazards model. RESULTS: The median age of patients was 59 years, and the median follow-up duration was 73.4 months. Of the 131 patients, 72 (55.0%) were classified as IR and 59 (45.0%) as HIR. Adjuvant radiation was administered to 98 patients, including 45 (62.5%) in the IR group and 53 (89.8%) in the HIR group. Tumor recurrence occurred in 12.5% of IR patients and 8.5% of HIR patients ( = 0.574). In the HIR group, adjuvant radiation was associated with significantly improved progression-free survival (PFS) ( = 0.015). Multivariable analysis further identified older age (> 60 years) and receipt of adjuvant radiation as independent prognostic factors for PFS in the HIR group ( = 0.046 and = 0.023, respectively). CONCLUSION: According to the 2021 ESGO risk classification without molecular profiling, adjuvant radiation was associated with a significant improvement in PFS in the HIR group, but not in the IR group.
Sex Differences in the Effect of Long-Term Blood Pressure Trajectories and Variability on the Atrial Fibrillation Risk in a Korean Cohort.
Kwon HJ, Jin SA, Park JH … +1 more , Ahn SK
J Korean Med Sci · 2026 Jun · PMID 42299139 · Full text
BACKGROUND: Long-term blood pressure (BP) patterns and variability may influence atrial fibrillation (AF) risk. However, whether these associations differ according to sex is unclear. METHODS: We analyzed 45,663 adults (...
BACKGROUND: Long-term blood pressure (BP) patterns and variability may influence atrial fibrillation (AF) risk. However, whether these associations differ according to sex is unclear. METHODS: We analyzed 45,663 adults (age ≥ 40 years) from a Korean National Health Insurance cohort. Over the past decade, systolic BP (SBP) trajectories have been classified into two distinct trajectory classes: Class 1 (stable-low BP) and Class 2 (sustained-elevated BP). Visit-to-visit SBP variability, quantified as variability independent of the mean (VIM), was stratified into quartiles. The participants were followed up for incident AF between 2012 and 2019. Using sex-stratified Cox proportional hazards models, we assessed the association of SBP trajectory class and VIM with AF risk. RESULTS: Male sex (adjusted hazard ratio [HR], 1.43; < 0.001), elevated SBP trajectory (Class 2, adjusted HR, 1.42; = 0.015), and VIM 4Q (adjusted HR, 1.25; = 0.007) were associated with a higher risk of AF. Additionally, older age, higher body mass index, alcohol consumption, diabetes, congestive heart failure, and myocardial infarction were independently associated with a higher risk of AF. In men, SBP trajectory Class 2 (adjusted HR, 1.47; = 0.025) and VIM 4Q (adjusted HR, 1.25; = 0.038) were significantly associated with an increased incidence of AF, whereas these associations were not significant in women. CONCLUSION: Long-term SBP trajectories and variability demonstrated sex-specific effects on AF risk. An elevated SBP trajectory and high variability conferred an increased risk of AF in men, but not in women. This novel finding may provide new insights into sex-specific differences in the pathogenesis of AF.
Teleophthalmology in the Korean Military: An 8-Year Review of Patients Admitted to the Military Telemedicine Team.
Yoon JS, Kwon S, Moon JH … +3 more , Hwang S, Maeng KJ, Kim M
J Korean Med Sci · 2026 Jun · PMID 42299138 · Full text
BACKGROUND: In 2015, the Republic of Korea Armed Forces implemented a telemedicine pilot program that included teleophthalmology services provided through booths in remote and medically underserved military units linked...
BACKGROUND: In 2015, the Republic of Korea Armed Forces implemented a telemedicine pilot program that included teleophthalmology services provided through booths in remote and medically underserved military units linked to the Medical Emergency Operation Center. This study aimed to evaluate the epidemiology, distribution, and injury patterns of eye diseases managed using this military telemedicine program. METHODS: Teleophthalmology consultations conducted between January 1, 2016, and December 31, 2023 were retrospectively reviewed. Diagnoses, causes of trauma, seasonal distributions, and evacuation trends were analyzed. RESULTS: Among the 47,701 telemedicine patients, 3,167 were ophthalmology patients. The most common diagnoses were hordeolum/chalazion (39.3%) and viral conjunctivitis (20.3%). Ocular trauma and injury occurred in 384 cases, most of which were caused by task-related activities (47.1%), particularly welding and exposure to metal fragments. Seasonal variation was significant, with the highest trauma incidence observed in summer ( = 0.014). Evacuation was required in 19.4% of ophthalmology patients and 49.9% of trauma and injury cases. CONCLUSION: This was the first long-term analysis of a military teleophthalmology program in South Korea. The study findings demonstrate the effectiveness of telemedicine in remote military environments, and underscore the need for protective equipment and task-specific safety training. Further development of remote diagnostic tools and targeted preventive strategies is warranted to reduce injury-related evacuations and to support combat readiness.
A Nationwide Study on Pretransfusion Testing for 10 Years in Korea Using Health Insurance Review and Assessment Claims Data.
Park JH, Chung Y, Ko DH … +1 more , Kim H
J Korean Med Sci · 2026 Jun · PMID 42299137 · Full text
BACKGROUND: Assessing pretransfusion testing utilization at medical institutions on a nationwide scale can be challenging. This study aimed to evaluate the status of pretransfusion testing in Korea by analyzing insurance...
BACKGROUND: Assessing pretransfusion testing utilization at medical institutions on a nationwide scale can be challenging. This study aimed to evaluate the status of pretransfusion testing in Korea by analyzing insurance claims data. METHODS: We identified all claims including pretransfusion testing or blood transfusion made between January 2011 and December 2020 from the Korean Health Insurance Review and Assessment Service database. ABO/RhD typing, antibody screening and identification, and crossmatching were analyzed according to the hospital type. RESULTS: A total of 42,968,177 claims from 20,088,744 patients were analyzed. The median ratios of ABO serum typing to cell typing were 1.000 for tertiary hospitals, 0.998 for secondary hospitals, 0.000 for primary hospitals, and 0.000 for clinics ( < 0.001). Between 2016 and 2020, there was a 10.3-32.3 percentage-point increase in the proportion of automated ABO typing in tertiary hospitals, secondary hospitals, and clinics, while there was only a 1.9 percentage-point increase in primary hospitals. The median ratios of antibody identification to screening were 0.459% for tertiary hospitals, 0.359% for secondary hospitals, 0.198% for primary hospitals, and 0.139% for clinics ( < 0.001). For the first red blood cell (RBC) transfusion for each patient at each hospital, 71.5% of the patients from primary hospitals and 68.3% of the patients from clinics received RBC transfusion after only crossmatching without antibody screening. CONCLUSION: The application of pretransfusion testing considerably differs according to the type of hospital in Korea. Primary hospitals and clinics need education and improvement in practice to pursue safe blood transfusion.
Association of Social Support With Complicated Grief and Post-Traumatic Stress Symptoms Among Student Survivors of the Sewol Ferry Disaster: An Observational Longitudinal Study.
Chon MW, Noh JW, Kim KB … +2 more , Lee SH, Kim EJ
J Korean Med Sci · 2026 Jun · PMID 42299136 · Full text
BACKGROUND: This longitudinal study examined how social support has interacted with complicated grief and post-traumatic stress disorder (PTSD) symptoms among student survivors of the Sewol ferry disaster. METHODS: Sixty...
BACKGROUND: This longitudinal study examined how social support has interacted with complicated grief and post-traumatic stress disorder (PTSD) symptoms among student survivors of the Sewol ferry disaster. METHODS: Sixty-six student survivors were recruited and evaluated biannually from 2016 to 2021. Duke-UNC Functional Social Support Questionnaire, PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Inventory of Complicated Grief were used for data collection. Demographic data were treated as covariates. Group-based trajectory modeling delineated longitudinal trajectories of social support, and a series of generalized estimating equation models compared elevated PTSD symptoms and probable complicated grief among the identified trajectory groups. RESULTS: A four-group solution for trajectories of social support was the optimal model (group 1, low baseline social support; group 2, moderate baseline support increasing over time; group 3, high baseline support; group 4, highest baseline support). Compared to trajectory group 4, trajectory group 2 had a significantly higher risk for elevated PTSD symptoms, while trajectory groups 1 and 2 had a significantly higher risk for probable complicated grief. CONCLUSION: Our study highlights the importance of social support and its changes relating to psychopathology including complicated grief and PTSD symptoms after disaster exposure. Individuals sensitive to changes in the level of social support who also have relatively low initial support may be particularly vulnerable.
Use of Mendelian Randomization to Unveil Metabolic Markers in Infection.
Hoang T, Kim J
J Korean Med Sci · 2026 Jun · PMID 42299135 · Full text
BACKGROUND: Enzymes encoded by are involved in various metabolic processes. Using a Mendelian randomization (MR) framework, we investigated the metabolites associated with six antibodies against and explored the potent...
BACKGROUND: Enzymes encoded by are involved in various metabolic processes. Using a Mendelian randomization (MR) framework, we investigated the metabolites associated with six antibodies against and explored the potential underlying biological pathways. METHODS: A meta-analysis of 65 genome-wide association studies was conducted to assess the genetic predisposition to approximately 3,550 metabolites. Summary-level data for > 10 million genetic variants associated with antibodies were extracted from the UK Biobank. MR analysis was performed using inverse-variance weighting, weighted median, and Egger regression to ensure robust findings. Significant metabolites were further analyzed using enrichment analysis to identify the relevant biological pathways. RESULTS: A total of 100 metabolites were positively associated with antibodies (cytotoxin-associated gene A [CagA], 16; catalase, 25; GroEL, 16; outer membrane protein [OMP], 22; urease [UREA], 15; and vacuolating cytotoxin [VacA], 6). These metabolites were linked to pathways involving the metabolism of alanine, aspartate, glutamate, glycine, serine, threonine, purine, and tryptophan in four antibodies. Additionally, 67 metabolites were negatively associated with antibodies (CagA, 11; catalase, 6; GroEL, 13; OMP, 11; UREA, 11; and VacA, 15). These metabolites were primarily involved in pyrimidine metabolism in the three antibodies. CONCLUSION: Our study identified numerous metabolites linked to antibody levels, indicating that metabolic alterations are associated with infection. These changes were particularly enriched in pathways involved in amino acid, nucleotide, and coenzyme metabolism and biosynthesis. These findings highlight the systemic metabolic impact of infection and offer insights into the biological mechanisms underlying host-pathogen interactions.
Travel Time to Healthcare and Type 2 Diabetes Mellitus Management in Korea: A Nationwide Retrospective Study.
Ha R, Kim CY, Hwang SS … +1 more , Jung-Choi K
J Korean Med Sci · 2026 Jun · PMID 42261575 · Full text
BACKGROUND: This study aimed to investigate the relationship between average travel time to healthcare facilities and management of type 2 diabetes mellitus (T2DM). In addition, we examined how average travel time and th...
BACKGROUND: This study aimed to investigate the relationship between average travel time to healthcare facilities and management of type 2 diabetes mellitus (T2DM). In addition, we examined how average travel time and the presence of a usual source of care (USC) interact to influence T2DM management. METHODS: We analyzed National Health Insurance data from 2015 to 2019 for a cohort of 81,588 patients newly diagnosed with T2DM in 2014. Geographic Information System-based road network data were used to calculate travel time. Outcome variables for T2DM management included regular visits, medication adherence, and monitoring tests: hemoglobin testing, lipid panel testing, and fundus examination. Generalized Estimating Equations models were used to assess the effects of travel time on T2DM management. RESULTS: Patients traveling ≤ 15 minutes to their healthcare facilities had higher rates of regular visits (risk ratio [RR], 1.04; 95% confidence interval [CI], 1.03-1.05), but showed no significant difference in medication adherence (RR, 1.00; 95% CI, 1.00-1.01) relative to patients with longer travel times. The presence of a USC was associated with higher levels of medication adherence (RR, 1.16; 95% CI, 1.15-1.16) and regular visits (RR, 1.38; 95% CI, 1.37-1.40). Patients with both a USC and short travel time had the highest medication adherence and visit rates (RR, 1.14 and 1.42) compared to those without a USC and with longer travel times, reflecting significant interaction effects. Shorter travel time was, however, associated with lower uptake of diabetes monitoring tests. Patients who most frequently visited tertiary or general hospitals had lower regularity of visits and medication adherence but higher rates of diabetes monitoring tests. CONCLUSION: This study highlights the importance of the combined effect of travel time and the presence of a USC in promoting regular visits to healthcare facilities among T2DM patients, rather than the effect of either factor alone. These findings underscore the need to consider both proximity and continuity of care when planning healthcare access strategies for T2DM management. In addition, measures are needed to promote the implementation of diabetes monitoring tests in clinics.
Impact of Tailored Interventions on Suicidal Ideation Recovery: Addressing Hopelessness Among Economically Vulnerable Populations During COVID-19 Period.
Kim NY, Han DH, Hwang H … +2 more , Lee HJ, Kim SM
J Korean Med Sci · 2026 Jun · PMID 42261574 · Full text
BACKGROUND: Public health crises-most recently exemplified by the coronavirus disease 2019 (COVID-19) pandemic-cause widespread psychological, social, and economic disruptions, contributing to increased depression, anxie...
BACKGROUND: Public health crises-most recently exemplified by the coronavirus disease 2019 (COVID-19) pandemic-cause widespread psychological, social, and economic disruptions, contributing to increased depression, anxiety, and suicidal ideation rates. This study aims to examine the clinical characteristics and treatment outcomes of individuals who attempted suicide during the COVID-19 pandemic, focusing on the effectiveness of tailored interventions for economically vulnerable individuals. METHODS: This study was conducted as part of the "Post-management Service for Suicide Attempters in the Emergency Room" project. Overall, 93 individuals who had attempted suicide were recruited, with 49 completing the study. Participants were categorized based on economic status (vulnerable vs. general) and suicide attempt timing (during vs. after COVID-19). The intervention included structured counseling sessions (six and four sessions for the vulnerable and general group, respectively). The vulnerable group received two additional sessions tailored to individual needs, choosing from family counseling, mental health education, social skills training, or vocational rehabilitation. Clinical assessments-Beck Scale for Suicidal ideation (BSS), Beck Hopelessness Scale (BHS), Beck Depression Inventory-II, and Beck Anxiety Inventory-were conducted at baseline and follow-up, with statistical analyses using linear regression, mixed-effects analysis of variance, and Pearson correlation. RESULTS: Changes in BSS scores negatively correlated with baseline BHS scores (B = -0.841, β = -0.593, = 0.009) and intervention type (B = -4.596, β = -0.296, = 0.040). During the COVID-19 intervention period, BSS scores improved greatly in the vulnerable group than in the general population group (F = 4.324, = 0.049). Post-COVID-19, no significant group differences were observed in outcome measures. Changes in BSS scores positively correlated with changes in BHS scores across the total study population ( = 0.567, < 0.001), general population group ( = 0.485, = 0.016), and vulnerable population group ( = 0.641, = 0.001). CONCLUSION: Tailored interventions were associated with reduced suicidal ideation, particularly among economically vulnerable individuals during the COVID-19 pandemic. Addressing hopelessness emerged as a key mechanism in suicide prevention. The observed enhancement during the pandemic highlights the importance of context-sensitive strategies in public health crises. Further research using larger, randomized controlled trials is warranted. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0009463.
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