Journal Of Korean Medical Science[JOURNAL]
Sun
200 papers
Evaluating and Refining Claims-Based Algorithms for Pregnancy Outcomes and Gestational Age Estimation in Korea.
Kim HJ, Cho H, Jung SY … +3 more , Shin JY, Choe SA, Choi NK
J Korean Med Sci · 2026 May · PMID 42153229 · Full text
BACKGROUND: A recently developed claims-based algorithm, originally designed using data from pregnancies with systemic lupus erythematosus, may enhance the identification of pregnancy episodes in Korean observational res...
BACKGROUND: A recently developed claims-based algorithm, originally designed using data from pregnancies with systemic lupus erythematosus, may enhance the identification of pregnancy episodes in Korean observational research. However, its applicability for estimating gestational age (GA) has not yet been validated in the general pregnant population. This study aimed to evaluate and refine the algorithm's performance. METHODS: We utilized nationwide claims data from the Korean National Health Insurance Service between February 27, 2021, and December 31, 2022, to identify pregnancy episodes, including deliveries, stillbirths (SBs), and abortive outcomes (ABs). GA for each episode was estimated using both the original and modified algorithms, which prioritized second-to-third trimester target scan (TS) codes and first-trimester TS codes, respectively. Identified episodes with GA outside clinically plausible ranges for each pregnancy outcome were either reclassified into different outcomes or excluded. Algorithm performance was evaluated based on the following three criteria: first, the agreement between the estimated GA and the specified GA range in delivery episodes with a preterm birth (PB) code; second, comparison of estimated preterm birth (ePB) rates with national statistics reported by the Korean Statistical Information Service (KOSIS); third, sensitivity analysis of ultrasound code prioritization on the ePB rate. RESULTS: Among 581,740 pregnancy episodes, 456,157 were deliveries, 3,050 were SB, and 122,533 were AB. Deliveries with a GA of less than 37 weeks were classified as ePB, with rates of 39.7% in the original algorithm and 11.9% in the modified algorithm. In delivery episodes with PB codes that included specified GA ranges, the modified algorithm demonstrated higher agreement with the specified GA compared to the original algorithm (96.4% vs. 75.2%). The ePB rate estimated by the modified algorithm was also more consistent with the 9.4% reported by KOSIS, compared to the original algorithm (12.0% vs. 39.8%). CONCLUSION: The modified algorithm, which prioritized first-trimester TS codes, improved the accuracy of GA estimation and reduced the underestimation observed in the original algorithm.
Standard-Dose Ursodeoxycholic Acid Improves Biochemical Liver Function and Fibrosis in Chronic Liver Disease: Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.
Chang Y, Cho YK, Kim YS … +20 more , Kim SE, Cheon GJ, Kim JH, Yang H, Kim W, Ahn SB, Yoon EL, Cheong JY, Lee JW, Kim MY, Kim HJ, Lee SH, Cho EY, Choi NR, Lee HW, Kim KM, Choe WH, Yu JM, Kim SY, Jang JY
J Korean Med Sci · 2026 May · PMID 42153228 · Full text
BACKGROUND: This study evaluated the efficacy and safety of standard-dose ursodeoxycholic acid (UDCA; fixed daily dose of 300 mg/day) compared with placebo, in patients with chronic liver disease. METHODS: A multicenter,...
BACKGROUND: This study evaluated the efficacy and safety of standard-dose ursodeoxycholic acid (UDCA; fixed daily dose of 300 mg/day) compared with placebo, in patients with chronic liver disease. METHODS: A multicenter, randomized, double-blind, placebo-controlled phase IV clinical trial was conducted in academic hospitals in South Korea. Patients with chronic liver disease and abnormal serum alanine aminotransferase (ALT) levels in at least two consecutive results prior to screening, persisting for at least 6 months, were randomly assigned to receive 100 mg UDCA or placebo three times daily for 8 weeks. The primary endpoint was the mean relative change in ALT levels from baseline. The secondary endpoints included changes in fibrosis and drug-related adverse events. RESULTS: A total of 262 patients were analyzed (132 in the UDCA group and 130 in the placebo group). By week 8, there was a significantly greater reduction in serum ALT levels from baseline in the UDCA-treated patients than in the placebo group (-14.70 vs. -5.51 U/L; = 0.010). The ALT normalization rates were higher in the UDCA group (26.52% vs. 13.08%; odds ratio, 2.60; = 0.005). Fibrosis reduction, as assessed by the FibroTest score, was greater in the UDCA group (-0.03 vs. -0.00; = 0.016). The frequency of adverse events in the two groups was similar, with no serious adverse events reported in the UDCA group. CONCLUSION: In patients with chronic liver disease, 100 mg UDCA three times daily for 8 weeks improved ALT levels and fibrosis, and had a favorable safety profile. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06272630.
Surgeons' Burnout During the Medical Crisis in Korea.
Choi J, Kim J, Lee JE … +3 more , Choi YS, Suh SW, Lee SE
J Korean Med Sci · 2026 May · PMID 42153227 · Full text
BACKGROUND: In February 2024, more than 80% of medical residents resigned, and more than 70% of medical students took a leave of absence to protest the South Korean government's new health care policies. This study exami...
BACKGROUND: In February 2024, more than 80% of medical residents resigned, and more than 70% of medical students took a leave of absence to protest the South Korean government's new health care policies. This study examines the existing level of burnout based on a reliable measure and compares burnout levels before and after the onset of the current medical crisis through a comprehensive survey of surgeons in Korea. METHODS: We conducted a survey targeting all members of the Korean Surgical Society, and 457 responses were analyzed. Burnout was measured using the full version of the Maslach Burnout Inventory-Human Service Survey for Medical Personnel (MBI-HSS-MP). We compared the burnout levels of Korean surgeons in 2024 with the result of a survey of surgeons conducted in 2019, both of which used 2 short-form single-item measures from the MBI-HSS-MP. Moreover, we conducted a group comparison analysis and performed multiple linear and binary logistic regressions to explore the factors influencing burnout. RESULTS: The overall burnout rate among Korean surgeons is considerably high at 70.5% on the full MBI-HSS-MP. Weekly working hours are significant predictors of burnout. Compared to 2019, before the coronavirus disease 2019 pandemic, burnout levels measured with a 2 single-item measures of burnout increased from 34.9% to 50.8% in 2024 during the medical crisis in South Korea. The prevalence of full MBI-HSS-MP-defined burnout by rank was as follows; academic tenure, 70.2%; academic other,79.2%; hospital-employed, 60.7%; and private practice,72.1%. An increase in burnout measured with a 2 single-item measures is particularly noticeable among surgeons in the academic field. CONCLUSION: This study confirms a high level of burnout among Korean surgeons, underscoring the need for efforts to improve workplace conditions and the healthcare system to alleviate this issue.
Case 23: A 26-Year-Old Man Presenting With Right-Eye Visual Disturbances.
Yun J, Lee JS, Jun Y … +3 more , Kim YJ, Kim SH, Jeong YJ
J Korean Med Sci · 2026 May · PMID 42117150 · Full text
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Proposal for Modified Alpha Fetoprotein Use in Hepatocellular Carcinoma Surveillance: Analysis of the 2018-2020 National Cancer Screening Program.
Yu S, Kim S, Kim H … +2 more , Lee HR, Choi J
J Korean Med Sci · 2026 May · PMID 42117149 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) is a major health concern, highlighting the need for effective surveillance. Republic of Korea's (South Korea's) National Cancer Screening Program (NCSP) uses ultrasound and ser...
BACKGROUND: Hepatocellular carcinoma (HCC) is a major health concern, highlighting the need for effective surveillance. Republic of Korea's (South Korea's) National Cancer Screening Program (NCSP) uses ultrasound and serum alpha fetoprotein (AFP) tests for high-risk populations, but its performance remains unevaluated. The AFP result is only used when a mass under 1 cm is detected on ultrasound, raising concerns about its appropriateness. METHODS: We analyzed data from 820,380 participants in Korea's NCSP for HCC between 2018 and 2020, comparing the ultrasound-alone protocol, current criteria, and the modified criteria newly proposed in this study. The current criteria define surveillance positivity as positive ultrasound findings or equivocal findings with elevated AFP, while the modified criteria consider either positive ultrasound findings or elevated AFP. Sensitivity, specificity, and area under the receiver operating characteristic (AUROC) curve for detecting HCC with various AFP cutoffs were evaluated. RESULTS: Ultrasound alone had a sensitivity of 44.26% and a specificity of 97.38%. The current criteria achieved a sensitivity of 44.82-46.51% and a specificity of 97.18-97.38% for detecting HCC with various AFP cutoffs ranging from 5 to 100 ng/mL. The AUROC for the modified criteria was 0.8728, significantly higher than that of the current criteria (0.7209, < 0.001). An AFP cutoff of 7 ng/mL was identified as the optimal threshold based on Youden's index. An AFP cutoff of 7 ng/mL slightly reduced specificity from 97.28% to 92.24%, whereas sensitivity markedly increased from 46.22% to 76.72%. Additionally, an AFP cutoff of 20 ng/mL yielded an increased sensitivity of 63.25% with maintaining specificity of 96.71%. CONCLUSION: The modified NCSP criteria we proposed, which incorporate AFP more proactively, identified an optimal cutoff for the Korean NCSP by balancing both sensitivity and specificity. This approach may contribute to improving the effectiveness HCC surveillance in the future.
Time Frame Analysis of Medical Device Approval, New Health Technology Assessment, and Reimbursement Decision-Making in Korea.
Kim JH
J Korean Med Sci · 2026 May · PMID 42117148 · Full text
BACKGROUND: The time required for the health insurance listing, including health technology assessment (HTA) after medical device approval, has a significant impact on the medical device industry, clinical practice, and...
BACKGROUND: The time required for the health insurance listing, including health technology assessment (HTA) after medical device approval, has a significant impact on the medical device industry, clinical practice, and patient access to treatment. The aim of this study is to analyze the total time frame from device approval to health insurance listing via HTA and to examine the duration of each procedural step. METHODS: Using publicly available data, the study identified 34 medical technologies submitted for HTA and subsequently listed for health insurance coverage between 2021 and 2023. The study analyzed the time frame from device approval to health insurance listing, including evaluation periods for existing coverage category determination, HTA, and listing. RESULTS: The median time from device approval to health insurance listing was 6.0 years for all technologies (n = 34) and 2.4 years for moderate- to high-risk or novel devices requiring pre-market approval (n = 15). For technologies that utilized the parallel review track (n = 8), the median time was 1.5 years. Median durations for existing coverage category determination, HTA, and health insurance listing for all technologies were 64.0, 244.5, and 346.0 days, respectively, and for moderate- to high-risk or novel devices, 65.0, 240.0, and 339.0 days, respectively. CONCLUSION: The process from device approval to health insurance listing in Korea takes a considerable amount of time. Streamlining evaluation and reimbursement processes is essential to accelerating patient access to novel treatments. To support the timely adoption of new technologies, policymakers should prioritize efficiency while maintaining safety and effectiveness standards.
Aerosolized Pentamidine Is an Effective Prophylaxis for Pneumonia in Adults Undergoing Allogeneic Hematopoietic Cell Transplantation.
Song GY, Ahn SY, Jang HC … +6 more , Kim M, Ahn JS, Yang DH, Kim HJ, Jung SH, Lee JJ
J Korean Med Sci · 2026 May · PMID 42117147 · Full text
BACKGROUND: pneumonia (PJP) is a common but serious opportunistic infection after allogeneic hematopoietic cell transplantation (HCT). The preferred regimen for PJP prophylaxis is trimethoprim-sulfamethoxazole (TMP-SMX)...
BACKGROUND: pneumonia (PJP) is a common but serious opportunistic infection after allogeneic hematopoietic cell transplantation (HCT). The preferred regimen for PJP prophylaxis is trimethoprim-sulfamethoxazole (TMP-SMX), but TMP-SMX can delay engraftment and has some toxicities. This study retrospectively analyzed the efficacy and safety of aerosolized pentamidine (AP) as an alternative to TMP-SMX for PJP prophylaxis after allogeneic HCT. METHODS: One hundred and fifty-five patients received AP and 86 patients received TMP-SMX. Pentamidine isethionate 300 mg was nebulized every 4 weeks and double-strength TMP-SMX was administrated once-daily and 2 days per week. RESULTS: Incidences of suspicious PJP and confirmed PJP were not statistically different between two groups (suspicious PJP, 4.5% vs. 3.5%, = 1.000; confirmed PJP, 0.6% vs. 0.0%, = 1.000). There were fewer adverse reaction in AP group than TMP-SMX group (10.3% vs. 26.7%, < 0.001). Only 1 patient (0.6%) discontinued prophylaxis due to adverse reaction in AP group, while 17 patients (19.8%) in TMP-SMX group discontinued prophylaxis due to adverse reaction ( < 0.001). There was more incidence of graft failure in TMP-SMX group and the incidence of prolonged thrombocytopenia was significantly higher in TMP-SMX group. There was no deterioration of lung function in patients received AP prophylaxis. CONCLUSION: In conclusion, AP is well tolerated without severe adverse events and effective in preventing PJP after allogeneic HCT.
Risk of Mortality Associated With Substance Use Disorder in Korea: A National Population-Based Study.
Kim S, Sohn JH, Hwang SS
J Korean Med Sci · 2026 May · PMID 42117146 · Full text
BACKGROUND: Substance use disorder (SUD) is a major public health issue, contributing to high morbidity and mortality worldwide. In Korea, despite ongoing public health initiatives, SUD remains a significant concern, wit...
BACKGROUND: Substance use disorder (SUD) is a major public health issue, contributing to high morbidity and mortality worldwide. In Korea, despite ongoing public health initiatives, SUD remains a significant concern, with diverse trends and risks linked to different substance types. This study investigates the mortality risk associated with SUD in South Korea using national, population-based data. METHODS: We performed a retrospective cohort analysis using data from the National Health Insurance Service (NHIS) database spanning 2008 to 2022. Three groups of incident SUD patients were identified-those with alcohol use disorder (AUD), drug use disorder (DUD), and nicotine use disorder-and tracked over time. The study evaluated incidence rates, mortality characteristics, and risk factors for each disorder group. RESULTS: Among 3,413,297 individuals, 1,114,550 were diagnosed with SUD. The mortality rate for SUD patients was significantly higher (16.8%) compared to that of non-SUD patients (10.9%). Among SUD patients who died, AUD accounted for 89.7%, representing the highest proportion. Mortality risk was especially high among lower-income individuals, those with disabilities, and those with psychiatric comorbidities. An increasing incidence of AUD and DUD was observed among women and younger adults (15-29 years), raising particular concern for these demographics. CONCLUSION: This study showed that while the incidence trends of SUD varied by sex and age, mortality risk was notably disparate across socioeconomic and demographic groups. Specifically, we observed a rising incidence of AUD among young women and significantly elevated mortality risk in this demographic, as well as in vulnerable populations. These findings suggest the need for targeted public health interventions for high-risk groups, particularly young women, and underscore the importance of improving access to treatment and support services to reduce mortality in individuals with SUD.
Limited Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Appetite and Body Weight: Evidence From Clinical and Rodent Studies.
Lee J, Park S, Kim E … +6 more , Park JY, Rhee M, Hughes JW, Ko SH, Kwon O, Lee EY
J Korean Med Sci · 2026 May · PMID 42117145 · Full text
BACKGROUND: The effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors on appetite and food intake remains unclear. This study investigated the effects of SGLT2 inhibitors on appetite, food craving, and body weight...
BACKGROUND: The effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors on appetite and food intake remains unclear. This study investigated the effects of SGLT2 inhibitors on appetite, food craving, and body weight in patients with type 2 diabetes and diabetic rat models. METHODS: Thirty-four participants were randomized to receive either dapagliflozin or sitagliptin for 24 weeks. The primary endpoint was body weight changes from baseline; secondary outcomes included food intake, appetite and related hormone changes, and glycemic control. For rodent study, Otsuka Long-Evans Tokushima Fatty (OLETF) rats treated with empagliflozin for 12 weeks to evaluate chronic effect on food intake and appetite-related gene expression. RESULTS: Weight reduction in the dapagliflozin group was lower than expected, with a 1.99 kg difference at 24 weeks ( < 0.001). Leptin levels significantly decreased in the dapagliflozin group, but food intake and appetite scores showed no differences between the groups. Consistent with the human study, food intake at 12 weeks of empagliflozin treatment in OLETF rats showed no difference from the controls, while increased intake during the first 3 weeks in the empagliflozin group. CONCLUSION: Sustained SGLT2 inhibitor treatment does not cause compensatory appetite increase after weight stabilization. Furthermore, it does not stimulate appetite or affect appetite-regulating molecules, thereby supporting its metabolic safety with respect to energy intake. This finding suggests that less-than-expected weight loss with SGLT2 inhibitors may result from mechanisms other than sustained changes in appetite or food intake. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0009925.
Cardiovascular Risk Stratification in Youth-Onset Type 2 Diabetes Using Machine Learning.
Joo EY, Lee YS, Shin EJ … +2 more , Kim SJ, Lee JE
J Korean Med Sci · 2026 May · PMID 42117144 · Full text
BACKGROUND: The rising incidence of youth-onset type 2 diabetes mellitus (T2DM), along with the risk of early cardiovascular complications, is concerning. Brachial-ankle pulse wave velocity (baPWV) and carotid intima-med...
BACKGROUND: The rising incidence of youth-onset type 2 diabetes mellitus (T2DM), along with the risk of early cardiovascular complications, is concerning. Brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (cIMT) are noninvasive markers of arterial stiffness and atherosclerosis. They serve as important markers for cardiovascular risk assessment. This study aimed to apply machine learning models to identify high-risk individuals who may benefit from early and targeted cardiovascular screening. METHODS: This retrospective study included 129 patients with youth-onset T2DM who underwent baPWV and cIMT measurements between January 2018 and July 2024. High-risk groups were defined as having values of ≥ mean + 1 standard deviation for baPWV (arterial stiffness) and cIMT (atherosclerosis). Clinical predictors were evaluated using linear, logistic regression, and machine learning analyses. Multiple machine learning models were trained using oversampling and cross-validation techniques to enhance prediction performance. RESULTS: Among the models tested, the gradient boosting model with adaptive synthetic sampling oversampling achieved the best performance in predicting both arterial stiffness (accuracy 0.81) and atherosclerosis prediction (accuracy 0.92). Age and hypertension were consistently identified as the most important factors for arterial stiffness. For atherosclerosis risk, traditional analysis identified dyslipidemia, male sex, and duration of illness as relevant factors; machine learning more clearly emphasized low-density lipoprotein cholesterol and triglyceride levels as key predictors of increased cIMT. CONCLUSION: Hypertension and age were consistent predictors of arterial stiffness, while atherosclerosis risk factors were further clarified with lipid parameters by machine learning analysis. These findings suggest that conventional and machine learning analyses offer complementary strengths. Their combined use may enable earlier to detect nuanced cardiovascular risk patterns and support early and targeted vascular screening in youth-onset T2DM.
Letter to the Editor: Citations of Retracted Publications Should Be Discounted From One's Bibliometric Indicator.
Tang BL
J Korean Med Sci · 2026 May · PMID 42089138 · Full text
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Association Between the Korean Healthy Eating Index and Hyperuricemia Among Korean Adults.
Son H, Lee HS, Lee SY … +1 more , Lee W
J Korean Med Sci · 2026 May · PMID 42089137 · Full text
BACKGROUND: Hyperuricemia is an emerging public health concern associated with gout and metabolic diseases. While numerous studies have examined associations between individual dietary factors and hyperuricemia, comprehe...
BACKGROUND: Hyperuricemia is an emerging public health concern associated with gout and metabolic diseases. While numerous studies have examined associations between individual dietary factors and hyperuricemia, comprehensive assessments of overall diet quality and their impact on hyperuricemia are lacking. This study aimed to investigate the association between overall diet quality, as measured by the Korean Healthy Eating Index (KHEI), and the prevalence of hyperuricemia among Korean adults using nationally representative data. METHODS: We analyzed data from 27,149 Korean adults aged ≥ 20 years from the Korea National Health and Nutrition Examination Survey (2016-2021). The KHEI assesses dietary quality based on adherence to Korean dietary guidelines, encompassing adequacy, moderation, and balance of intake. Hyperuricemia was defined as serum uric acid ≥ 7.0 mg/dL in men and ≥ 6.0 mg/dL in women. Logistic regression was performed, adjusting for sociodemographic, lifestyle, and health-related factors. RESULTS: Higher total KHEI scores were significantly associated with a lower prevalence of hyperuricemia (10.6% vs. 15.5%; < 0.001). After adjustment, participants with high KHEI scores exhibited 22% lower odds of hyperuricemia compared to those with low scores (odds ratio, 0.78; 95% confidence interval, 0.72-0.84). Specifically, higher consumption of breakfast, whole grains, fruits, vegetables, and balanced energy intake were inversely associated with hyperuricemia risk. However, higher intake of purine-rich foods (meat, fish, eggs, beans) was positively associated with hyperuricemia. An unexpected finding was observed regarding sodium: lower sodium intake correlated with increased hyperuricemia risk, possibly related to renal uric acid reabsorption mechanisms or confounding by medications. CONCLUSION: Our findings demonstrate a significant inverse relationship between overall dietary quality, assessed using the KHEI, and hyperuricemia risk among Korean adults. The results emphasize the protective effects of balanced dietary habits, highlighting the benefits of regular breakfast consumption, increased fruit and vegetable intake, and balanced energy distribution. These insights underscore the importance of adopting holistic dietary strategies for the prevention and management of hyperuricemia, moving beyond traditional recommendations focused on individual nutrients. Further longitudinal studies are required to clarify causality and mechanisms underlying these associations.
Nutritional Risk Assessed by Royal Free Hospital-Nutritional Prioritizing Tool Predicts Survival in Cirrhosis With or Without Hepatocellular Carcinoma.
Park HJ, Jung JK, Noh J … +6 more , Kim Y, Lee SU, Yun BC, Lee JW, Kim HJ, Seo KI
J Korean Med Sci · 2026 May · PMID 42089136 · Full text
BACKGROUND: Nutritional status is an independent factor that affects clinical outcomes in patients with liver cirrhosis (LC). This study aimed to investigate the prognosis of patients with LC according to their nutrition...
BACKGROUND: Nutritional status is an independent factor that affects clinical outcomes in patients with liver cirrhosis (LC). This study aimed to investigate the prognosis of patients with LC according to their nutritional risk. METHODS: From January 2020 to April 2021, the medical records of patients with LC with/without hepatocellular carcinoma (HCC) who underwent abdominal computed tomography and nutritional risk evaluation using the Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) were retrospectively reviewed. RESULTS: In total, 243 patients were analyzed, 92: LC without HCC and 151: LC with HCC. Nutritional risk analysis using RFH-NPT revealed that 121 (49.8%) patients were low-risk, 35 (14.4%) moderate-risk, and 87 (35.8%) high-risk. Child-Pugh class ( < 0.001), albumin-bilirubin score ( < 0.001), and psoas muscle index ( < 0.001) significantly correlated with nutritional risk in all patients. Serum sodium levels were significantly different based on the nutritional risk in LC without HCC ( = 0.008) and with HCC ( = 0.001). Total cholesterol levels were significantly correlated with nutritional risk in all patients ( < 0.001) and in patients with LC with HCC ( < 0.001). Survival rates differed significantly according to nutritional risk in all patients ( < 0.001), patients with LC without HCC ( = 0.017), and patients with LC with HCC ( < 0.001). RFH-NPT high risk (hazard ratio [HR], 3.115; 95% confidence interval [CI], 1.396-6.950; = 0.006), Child-Pugh C (HR, 12.802; 95% CI, 5.062-32.372; < 0.001) and HCC (HR, 9.078; 95% CI, 3.657-22.535; < 0.001) were significant factors affecting the survival rate of all patients. CONCLUSION: RFH-NPT is a useful method for evaluating nutritional risk and predicting the survival rate of patients with LC with/without HCC.
Hypertension Care Quality and Incidence of Complications Among Hypertensive Patients With Disabilities in Korea: An Analysis of a Cohort Study Using National Health Insurance Data.
Lee HY, Kim K, Shin DW … +3 more , Han K, Jung JH, Park JH
J Korean Med Sci · 2026 May · PMID 42089135 · Full text
BACKGROUND: Hypertension is more prevalent among individuals with disabilities than in the general population. This study analyzed long-term trends in disparities in hypertension care quality and the incidence of hyperte...
BACKGROUND: Hypertension is more prevalent among individuals with disabilities than in the general population. This study analyzed long-term trends in disparities in hypertension care quality and the incidence of hypertensive complications among individuals with and without disabilities. METHODS: This retrospective cohort study followed 52,743 hypertensive patients aged 20 or older with disabilities newly diagnosed in 2010, along with 47,564 age- and sex-matched patients without disabilities, from 2011 to 2019. Hypertension care quality was assessed using indicators of medication adherence and the completion of three complication-monitoring tests at recommended frequency: blood test, urine test, and electrocardiogram (ECG). Hypertensive complications included major cardiovascular and cerebrovascular events, kidney diseases, and all-cause mortality. Logistic regression was repeated annually to assess hypertension care quality, and Cox-proportional model was used to estimate the risk of hypertension-related complications. RESULTS: Hypertensive patients with disabilities consistently demonstrated lower medication adherence throughout the study period (adjusted odds ratio [aOR], 0.90-0.96, depending on the year), but a higher likelihood of undergoing screenings at recommended frequency (e.g., aOR for blood test, 1.31-1.39, for urine test, 1.24-1.33, and for ECG, 1.30-1.37). The risk of complications remained significantly higher among hypertensive patients with disabilities, even after adjusting for care quality indicators (e.g., adjusted hazard ratio for cardiovascular events: 1.36, 95% confidence interval: 1.31-1.41). Subgroup analyses revealed that the excess risks for complications varied across different sociodemographic groups. CONCLUSION: These findings underscore the need for comprehensive strategies to enhance medication adherence among hypertensive patients with disabilities. Additionally, other factors beyond medication adherence and monitoring test completion that contribute to the increased risk of complications require further exploration.
Sero-Epidemiologic Study of Respiratory Syncytial Virus Infection in Korea.
Na SH, Jo HJ, Park JJ … +7 more , Seo YB, Lee J, Lee CM, Kang CK, Choe PG, Park WB, Kim NJ
J Korean Med Sci · 2026 May · PMID 42089134 · Full text
BACKGROUND: Despite the recent introduction of a respiratory syncytial virus (RSV) vaccine, there is no sero-epidemiologic study of RSV infection among old adults in Korea. This study aimed to assess humoral immune respo...
BACKGROUND: Despite the recent introduction of a respiratory syncytial virus (RSV) vaccine, there is no sero-epidemiologic study of RSV infection among old adults in Korea. This study aimed to assess humoral immune responses to RSV among different age groups in Korea. METHODS: A total of 400 serum samples (100 samples from each of the following age groups: 10-20, 21-40, 41-60, and 61-80 years) were selected randomly from a general population cohort used for health status evaluation in Korea (the Korea National Health and Nutrition Examination Survey 2019-2020 cohort). Anti-RSV IgM and IgG levels, along with total IgM and IgG levels, were measured in enzyme-linked immunosorbent assays. RESULTS: Anti-RSV IgM levels were higher in individuals aged 10-20 and 21-40 years than in the other age groups (121.43 U/mL vs. 102.33 U/mL vs. 76.71 U/mL vs. 64.89 U/mL, < 0.05), whereas anti-RSV IgG levels were similar across all age groups. Although the proportion of anti-RSV IgM relative to total IgM, respectively, was higher in the 10-20 age group than in the other groups (16.05% vs. 13.26% vs. 10.95% vs. 11.06%, < 0.001), there was no significant difference among the 21-40, 41-60, and 61-80 age groups. Finally, there was no significant difference in anti-RSV IgG positivity rate among the age groups; however, the rate of anti-RSV IgM positivity was higher in the groups aged 10-20 and 21-40 years (73% vs. 54% vs. 28% vs. 28%, < 0.001). CONCLUSION: RSV infections are recurrent in people over the age of 40 in Korea, but at a lower rate than in those aged 10-40. Therefore, more attention should be paid to RSV infections in the adult population in Korea.
Enhanced Early Stabilization and Improved Clinical Outcomes by Transforaminal Lumbar Interbody Fusion With Contralateral Facet Fusion Compared With Conventional Posterior Lumbar Interbody Fusion.
Kang TH, Jang SI, Cho M … +1 more , Lee JH
J Korean Med Sci · 2026 May · PMID 42089133 · Full text
BACKGROUND: This study introduces and evaluates the transforaminal lumbar interbody fusion technique with contralateral facet fusion (TLIFcFF), aiming to improve fusion rates and clinical outcomes compared to conventiona...
BACKGROUND: This study introduces and evaluates the transforaminal lumbar interbody fusion technique with contralateral facet fusion (TLIFcFF), aiming to improve fusion rates and clinical outcomes compared to conventional posterior lumbar interbody fusion (PLIF). METHODS: A retrospective case-control study was conducted on patients undergoing TLIFcFF or PLIF between July 2009 and November 2020. Patients with one- or two-level lumbar fusion were included, excluding cases involving long-level fusions, revision surgeries, or other diseases. Perioperative parameters, radiological outcomes, fusion rates, and clinical outcomes were analyzed. RESULTS: The study included 101 patients in the TLIFcFF group and 89 in the PLIF group, with a mean follow-up of 57 months. TLIFcFF demonstrated higher fusion rates at six months (84.9% vs. 66.4%, < 0.001) but comparable fusion rates at one year. TLIFcFF showed significant improvements in low back pain and radiating pain scores at 3, 6, and 12 months postoperatively ( < 0.05). There were no significant differences in complications, operation time, or functional outcomes (Oswestry Disability Index, Functional Rating Index) between groups. CONCLUSION: TLIF with contralateral facet fusion represents a viable alternative to conventional PLIF, demonstrating advantages in early fusion rates and reduced pain within the first year. Further prospective studies are warranted to validate these findings.
Trends in Cardiac Rehabilitation Participation in Patients With Acute Myocardial Infarction: A 5-Year Nationwide Study in Korea.
Kim H, Yun RY, Kim C … +7 more , Shin YI, Bang HJ, Uhm KE, Kim SH, Bae JW, Lee K, Kim Y
J Korean Med Sci · 2026 May · PMID 42089132 · Full text
BACKGROUND: Cardiac rehabilitation (CR) is a critical secondary prevention strategy for patients with acute myocardial infarction (AMI). Although CR has been covered by the National Health Insurance in Korea since 2017,...
BACKGROUND: Cardiac rehabilitation (CR) is a critical secondary prevention strategy for patients with acute myocardial infarction (AMI). Although CR has been covered by the National Health Insurance in Korea since 2017, real-world participation remains suboptimal. We assessed trends in CR participation over the past 5 years and identified factors associated with non-participation in treatment. METHODS: This retrospective observational study analyzed data from the National Health Insurance Service claims database between 2018 and 2022. Patients aged ≥ 40 years who were hospitalized for AMI and received acute-phase interventions, such as thrombolysis, percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG), were included. CR participation was defined as having at least one claim for education, assessment, or treatment services. Multivariable logistic regression was conducted to identify factors associated with non-participation in CR treatment, focusing on patients who received care at CR-providing institutions, to minimize confounding related to institutional availability. RESULTS: In total, 109,436 patients were included. Overall participation rates in CR education, assessment, and treatment increased from 2018 to 2022. However, sustained participation in outpatient treatment remained low, with only 5.7% of patients in 2022 completing ≥ 11 treatment sessions. Factors associated with lower treatment participation included the absence of prior education and assessment, lower socioeconomic status, undergoing PCI rather than CABG, and receiving care at non-tertiary hospitals. Regional disparities and inadequate institutional infrastructure further contributed to reduced access to CR services. CONCLUSION: Although CR participation among patients with AMI in Korea has gradually increased, treatment continuity remains suboptimal. To enhance CR utilization, policy efforts should prioritize reducing patient burden, addressing provider-level barriers, and promoting equitable access through financial support mechanisms and infrastructure expansion.
Correction: Funding in "It Is Time for Physician-Scientists to Lead Their Own Development".
Lee DH, Kim JI
J Korean Med Sci · 2026 Apr · PMID 42046524 · Full text
This corrects the article on p. e257 in vol. 40.
This corrects the article on p. e257 in vol. 40.
Medical Photography for Scientific Publishing (MedPhotoPubl) in Rheumatology and Rehabilitation.
Benlidayi IC
J Korean Med Sci · 2026 Apr · PMID 42046523 · Full text
Medical photography is an essential component of scientific publishing in rheumatology and rehabilitation. Besides, challenges in daily clinical practice such as disease monitoring can be addressed with the support of me...
Medical photography is an essential component of scientific publishing in rheumatology and rehabilitation. Besides, challenges in daily clinical practice such as disease monitoring can be addressed with the support of medical photography. Although recommendations exist for medical photography in diverse areas of medicine, there is a lack of comprehensive literature addressing this point in rheumatology and rehabilitation. In this regard, the current article aimed to provide standards and recommendations for Medical Photography for Scientific Publishing (MedPhotoPubl) in rheumatology and rehabilitation. The adopted measures during medical photographing should be given in detail in publications. The details to be mentioned are 1) image acquisition protocol, 2) patient position, 3) anatomical region specification (e.g., laterality, reference landmarks), 4) photographic view, 5) task definition, 6) phase specification, 7) timepoint labeling, 8) image editing procedures, 9) image metadata documentation, 10) image storage, and 11) patient informed consent statement. Accordingly, a reporting checklist was developed based on the recommendations for MedPhotoPubl in rheumatology and rehabilitation.
Patient-Centric Approach to Improve the Quality of Life and Healing Efficacy for Patients With Fabry Disease: A Grounded Theory-Based Analysis.
Gwak SY, Lim HJ, Cho I … +5 more , Shim CY, Kim K, Lee HJ, Son JW, Hong GR
J Korean Med Sci · 2026 Apr · PMID 42046522 · Full text
BACKGROUND: Fabry disease (FD) poses multifaceted challenges for patients in Republic of Korea (South Korea), but an in-depth qualitative understanding of their experiences and support needs is still lacking. This study...
BACKGROUND: Fabry disease (FD) poses multifaceted challenges for patients in Republic of Korea (South Korea), but an in-depth qualitative understanding of their experiences and support needs is still lacking. This study aimed to qualitatively explore the experiences and coping strategies of Korean patients with FD who reported dissatisfaction with their well-being and faced social, occupational, or personal difficulties, to inform patient-centered care and healthcare policy. METHODS: We conducted a qualitative study using a grounded theory approach to explore the experiences of individuals with FD in Korea. Eligible participants were aged 19-70 years, had been diagnosed for more than three years or treated for at least one year, and reported dissatisfaction with their well-being alongside social or personal disadvantages. Each participant completed three in-depth interviews. Data were collected iteratively and analyzed through open and axial coding until theoretical saturation was reached. RESULTS: Theoretical saturation was achieved after conducting three in-depth interviews with each of the 10 participants (5 males, 5 females; age range: 34-66 years). A total of 273 initial concepts were generated and refined into 21 categories across six conceptual domains: causal conditions, contextual conditions, central phenomenon, intervening conditions, actions/interactions, and consequences. Patients reported persistent physical and emotional burdens, financial strain, limited systemic support, and stigma. However, they developed adaptive coping strategies, including lifestyle modifications, medical engagement, and meaning-making. The coping process followed five progressive stages: diagnostic odyssey, treatment entry, life reconstruction, symptom management, and hope, highlighting dynamic psychological adaptation. Three distinct coping styles emerged: religious will, optimistic acceptance, and altruistic solidarity. CONCLUSION: Fabry patients experience physical pain, emotional and socioeconomic burdens, and limited systemic and social support, yet they develop adaptive coping strategies and resilience. These findings highlight the importance of developing patient-centered, context-sensitive care approaches in Korea.
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