Journal Of Korean Medical Science[JOURNAL]
Sun
200 papers
Evaluation of Clinical, Laboratory and Immunological Characteristics in the Early Onset (Diagnosed Age < 30 Years Old) Patients With Type 2 Diabetes.
Lee DH, Jeon HJ, Oh TK
J Korean Med Sci · 2026 Feb · PMID 41732045 · Full text
BACKGROUND: The classification of early onset (< 30 years old) patients with diabetes mellitus (DM) as either type 1 diabetes (T1D) or type 2 diabetes (T2D) can be a challenge due to their similar overlapping phenotypes....
BACKGROUND: The classification of early onset (< 30 years old) patients with diabetes mellitus (DM) as either type 1 diabetes (T1D) or type 2 diabetes (T2D) can be a challenge due to their similar overlapping phenotypes. In this study, we attempted to utilize various clinical and laboratory characteristics in combination with immunological factors in the blood to determine whether it would be possible to distinguish and more accurately characterize our patients as T2D. METHODS: Electronic medical records were evaluated to obtain information categorized as either early onset patients with DM (n = 102) and patients with T1D (n = 89). Using the stored serum from these patients, autoantibodies of anti-insulinoma associated 2 (IA2), anti-zinc transporter 8 (ZnT8) and anti-glutamic acid decarboxylase antibody (GAD) were measured. RESULTS: In the clinical characteristics, early onset patients with DM (n = 102) were younger (31.7 ± 7.0 years old, < 0.01), more overweight (28.1 ± 5.5 kg/m², < 0.05), shorter duration of diabetes (10.4 ± 7.3 years, < 0.01) and a more prevalent family history of diabetes (81%, < 0.01) than patients with T1D. The laboratory values from early onset patients with DM exhibited lower glycated hemoglobin A1c (8.0 ± 2.1%, < 0.01) and glucose levels (165 ± 73 mg/dL, < 0.01) with conversely higher C-peptide levels (2.2 ± 1.2 ng/mL, < 0.01). Measurements of immunological factors, demonstrated that the prevalence of anti-ZnT8 (2%) and anti-GAD antibody (2%) in early onset patients with DM was significantly lower ( < 0.01) compared to patients with T1D (13% for anti-ZnT8 and 38% for anti-GAD). The prevalence of anti-IA2 was not significantly different between early onset patients with DM (13%) versus patients with T1D (11%). In the multivariate logistic regression analysis, C-peptide level (B, 4.453; standard error [SE], 0.844; Wald, 27.808; < 0.001) was the strongest independent factor to distinguish early onset patients with DM as T2D. After adjusting C-peptide level, family history of diabetes (B, 0.830; SE, 0.420; Wald, 3.909; = 0.048), body mass index (BMI) (B, 0.111; SE, 0.039; Wald, 8.167; = 0.004) and the relative negative status of anti-GAD (B, -2.041; SE, 0.597; Wald, 11.670; < 0.001) were determining factors in our analyses. CONCLUSION: In this study, our findings suggested that early onset patients with DM may be more accurately diagnosed as T2D if they have a compilation of elevated C-peptide levels, higher BMI, more prevalent history of familial diabetes and the absence of detecting anti-GAD antibodies.
Single-Fraction Stereotactic Radiosurgery for Benign Perioptic Meningiomas: A Strategy for Long-Term Tumor Control and Radiation-Induced Optic Neuropathy Avoidance With a 10-Year Follow-up.
Lee EJ, Chung HT, Kim JW … +2 more , Kim DG, Paek SH
J Korean Med Sci · 2026 Feb · PMID 41732044 · Full text
BACKGROUND: Lower doses of single-fraction stereotactic radiosurgery (SF-SRS) are typically prescribed for perioptic meningiomas (POMs) due to concerns about radiation-induced optic neuropathy (RION). However, comprehens...
BACKGROUND: Lower doses of single-fraction stereotactic radiosurgery (SF-SRS) are typically prescribed for perioptic meningiomas (POMs) due to concerns about radiation-induced optic neuropathy (RION). However, comprehensive long-term follow-up data on both tumor control and RION occurrence are currently lacking. This study endeavored to formulate safe and practical strategies for the implementation of SF-SRS in POMs, utilizing extensive ten-year follow-up data. METHODS: We retrospectively analyzed patients who underwent SF-SRS for POMs (< 2 mm from the optic apparatus [OA]) and who were followed up for more than ten years at our institution. Correlations between diverse dosimetric factors irradiated to the tumor and the OA and their respective impacts on tumor control and RION were examined. RESULTS: Thirty patients were included (a median follow-up: 152 months). A dose of 12.7 ± 3.1 Gy was delivered to the gross tumor volume of 4.8 ± 5.1 cm³ with a coverage rate of 76.7 ± 19.1%, yielding a D of 7.0 ± 4.7 Gy. The actuarial 5- and 10-year progression-free survival rates were 90% and 70%, respectively (overall tumor control in 57%). Treatment failure occurred in a delayed fashion at 107 ± 55 (20-200) months after stereotactic radiosurgery (SRS). Coverage was associated with long-term tumor control ( = 0.004, cutoff value: 81%). Among patients who retained valid vision, the maximum dose to the OA was 7.2 ± 1.6 Gy (4.8-12.9) Gy, and visual decline attributed to tumor progression manifested in two patients at 116 months and 103 months post-SRS, with no occurrence of RION. CONCLUSION: Inadequate tumor coverage near the OA during SF-SRS for POMs, driven by concerns about RION, resulted in a significant incidence of long-term tumor progression and subsequent visual deterioration. Clarifying the optimal dose range is crucial for achieving sustained tumor control and preventing RION following SF-SRS.
Delays in Diagnosing Pediatric Inflammatory Bowel Disease in Korea: Impact on Disease Severity and the Need for Early Recognition.
Choi SY, Choi S, Kang B … +17 more , Choe BH, Lee YJ, Park JH, Kim YB, Kim JY, Lee K, Lee KJ, Kang KS, Lee YM, Kim HJ, Kang Y, Jang HJ, Yi DY, Hong SJ, Choi YJ, Hong J, Kim SC
J Korean Med Sci · 2026 Feb · PMID 41732043 · Full text
BACKGROUND: A delayed diagnosis of pediatric inflammatory bowel disease (IBD) can lead to adverse outcomes. This study aimed to analyze the diagnostic delay among pediatric patients with IBD, focusing on associations wit...
BACKGROUND: A delayed diagnosis of pediatric inflammatory bowel disease (IBD) can lead to adverse outcomes. This study aimed to analyze the diagnostic delay among pediatric patients with IBD, focusing on associations with disease classification, disease activity, and initial management. METHODS: This multicenter retrospective study included pediatric patients who had been diagnosed with IBD across 17 Korean medical centers. Clinical and demographic data were extracted from their medical records. RESULTS: Overall, 486 patients, 362 with Crohn's disease (CD) and 124 with ulcerative colitis (UC), were included in the study. The median diagnostic delay, defined as the interval between initial symptom onset and final diagnosis of IBD, was not significantly different between CD and UC ( = 0.154); however, the interval from symptom onset to the first physician visit was significantly longer than that from the physician visit to diagnosis for both CD and UC ( = 0.004). Regarding CD, a long diagnostic delay was associated with fewer extraintestinal symptoms, lower C-reactive protein levels, and lower symptom scores. CONCLUSION: Significant diagnostic delays are primarily due to prolonged intervals between symptom onset and the first physician visit. Public awareness campaigns about IBD symptoms tailored to the growing number of pediatric IBD patients in Korea could be a crucial factor for early diagnosis.
Clinical Impact of in Otology: Prevalence and Surgical Outcomes From a Single-Center Study in Korea.
Han JS, Lee DG, Yoo IY … +4 more , Park YJ, Park SN, Park KH, Seo JH
J Korean Med Sci · 2026 Feb · PMID 41732042 · Full text
BACKGROUND: is an emerging pathogenic yeast of increasing global concern. This study aimed to explore recent epidemiological trends in at a single center and evaluate its impact on otologic surgery outcomes. METHODS: A...
BACKGROUND: is an emerging pathogenic yeast of increasing global concern. This study aimed to explore recent epidemiological trends in at a single center and evaluate its impact on otologic surgery outcomes. METHODS: An epidemiological review was conducted for patients with positive fungal culture results at Seoul St. Mary's Hospital between January 2018 and December 2023. Medical records of patients with were retrospectively analyzed, focusing on surgical outcomes and comparing them with those of patients infected with other fungi. RESULTS: Of 3,430 fungal cultures from ear discharge, was identified in 104 cases (3.0%). Among 89 patients with isolated from ear discharge, 53 (59.6%) had mixed infections, with species being the most common co-pathogen. Of 207 patients with fungal infections who underwent otologic surgery, 39 had . The postoperative complication rate was significantly higher in the group (34.2%) compared to that with other fungal infections (16.1%) ( = 0.011). CONCLUSION: is widely distributed in the community and is particularly prevalent in patients requiring surgical treatment. Its presence in otologic surgery cases is linked to a higher risk of postoperative complications. Enhanced vigilance and proactive management by otolaryngologists are crucial to minimize nosocomial transmission and improving surgical outcomes.
Heterogeneous Kidney Patterns in Diabetic Patients Following SGLT2 Inhibitor Use.
Bae S, Yun D, Kim J … +7 more , Park S, Kim YC, Kim DK, Oh KH, Joo KW, Kim YS, Han SS
J Korean Med Sci · 2026 Feb · PMID 41732041 · Full text
BACKGROUND: Although sodium-glucose cotransporter 2 inhibitors (SGLT2is) slow the progression of kidney disease in diabetic patients, whether certain subsets of diabetic patients present heterogeneous phenotypes, such as...
BACKGROUND: Although sodium-glucose cotransporter 2 inhibitors (SGLT2is) slow the progression of kidney disease in diabetic patients, whether certain subsets of diabetic patients present heterogeneous phenotypes, such as a rapid deterioration of kidney function, following SGLT2i use remains unclear. This study aimed to clarify these heterogeneous responses and identify the factors contributing to them through a kidney function trajectory analysis. METHODS: This retrospective cohort study included 66,375 patients who visited the diabetes clinic for type 2 diabetes management, 5,209 of whom were prescribed SGLT2is. The median duration of SGLT2i prescription was 29.0 months (interquartile range, 16.3 to 49.0 months). Patterns of estimated glomerular filtration rate (eGFR) trajectories were analyzed using a latent class linear mixed model for 4,185 patients, with a median follow-up duration of 29.7 months (interquartile range, 17.1 to 34.1 months) and factors associated with these patterns were evaluated via multinomial logistic regression analysis. RESULTS: Four distinct eGFR trajectory patterns were identified: 3,636 (86.9%) in class 1 (high baseline, stable eGFR), 440 (10.5%) in class 2 (low baseline, stable eGFR), 73 (1.7%) in class 3 (high baseline, rapidly declining eGFR), and 36 (0.9%) in class 4 (low baseline, rapidly declining eGFR). A rapid eGFR decline was more common in younger patients with substantial albuminuria, and hypoalbuminemia. Patients in the rapidly declining eGFR classes had higher risks of hospitalization and death than those in stable eGFR classes did. CONCLUSION: The heterogeneity in eGFR trajectories following SGLT2i use suggests that not all patients benefit equally from this therapy. Identifying patients at risk of a rapid eGFR decline is critical for providing timely warnings and optimizing treatment strategies.
Epidemiological Trends of Herpes Zoster in Korea, 2010-2022: A Nationwide Study Using National Health Insurance Data.
Lee KS, Moon J, Kim MK
J Korean Med Sci · 2026 Feb · PMID 41664576 · Full text
Herpes zoster (HZ) poses a growing public health burden, particularly in aging populations. This study investigated long-term trends in the incidence, hospitalization, and recurrence of HZ in Korea. We analyzed National...
Herpes zoster (HZ) poses a growing public health burden, particularly in aging populations. This study investigated long-term trends in the incidence, hospitalization, and recurrence of HZ in Korea. We analyzed National Health Insurance Service data covering adults aged ≥ 20 years from 2010 to 2022. HZ cases were defined using International Classification of Diseases-10 codes and antiviral treatment criteria. Rates were stratified by age, sex, and income level. The incidence of HZ increased until 2018 and then stabilized. Women and older adults consistently showed higher incidence, hospitalization, and recurrence rates. The medical aid beneficiaries had significantly higher hospitalization rates. Despite recent stabilization, the burden of HZ remains substantial among older adults, women, and medical aid beneficiaries. Targeted vaccination and ongoing surveillance are essential to mitigate disease burden and reduce disparities.
Current Practices and Challenges in Pediatric Obesity Management (POM): A Nationwide Survey of Physicians in Korea.
Lee Y, Shin M, Chung S … +3 more , Jung J, Sul AR, Hong YH
J Korean Med Sci · 2026 Feb · PMID 41664575 · Full text
BACKGROUND: Childhood obesity is a critical public health issue that often persists into adulthood, posing significant treatment challenges. Establishing long-term healthy habits is essential, and South Korea has impleme...
BACKGROUND: Childhood obesity is a critical public health issue that often persists into adulthood, posing significant treatment challenges. Establishing long-term healthy habits is essential, and South Korea has implemented various policies to manage pediatric obesity. However, a gap remains between policy, medical efforts, and actual outcomes. This study aimed to explore physicians' perspectives on clinical practices, awareness of governmental policies, and the key barriers and facilitators in pediatric obesity management (POM). METHODS: The questionnaire was developed through a comprehensive literature review and expert feedback, followed by a validity assessment and pilot study, resulting in a finalized 42-question version. Using a convenience sampling approach, 200 physicians specializing in pediatric obesity were recruited via academic societies and online channels. Data analysis involved descriptive statistics, presenting categorical data as frequencies and percentages, and continuous variables as averages. RESULTS: Among the 200 participating physicians, 87.5% were pediatricians. Most had over five years of experience, and more than half were affiliated with primary clinics. Counseling was the primary treatment approach, with liraglutide being the most commonly used medication. However, POM effectiveness was largely unsatisfactory, with 42.0% considering their efforts a "failure." Only 46.0% reported having institutional protocols, and training experiences varied by institution and region. Awareness and satisfaction with governmental policies were low, with limited recognition of national programs. Physicians emphasized the need for early childhood interventions and stronger medical involvement. Key priorities for improvement included better insurance reimbursement and stronger school partnerships. CONCLUSION: This study lays the groundwork for developing targeted strategies and policies to address the complex challenges of POM, ultimately improving health outcomes across all age groups, particularly children and adolescents.
Drug Resistance in Extrapulmonary Tuberculosis in Korea, 2010-2019: A Comparison With Pulmonary Tuberculosis.
Kim S, Jeon D, Lee T … +4 more , Lee SJ, Lee HY, Kang BH, Mok J
J Korean Med Sci · 2026 Feb · PMID 41664574 · Full text
BACKGROUND: This study investigated drug resistance status and trends in patients with extrapulmonary tuberculosis (EPTB) and compared them with those in patients with pulmonary tuberculosis (PTB). METHODS: The phenotypi...
BACKGROUND: This study investigated drug resistance status and trends in patients with extrapulmonary tuberculosis (EPTB) and compared them with those in patients with pulmonary tuberculosis (PTB). METHODS: The phenotypic drug susceptibility test (DST) results of patients with culture-confirmed tuberculosis (TB) diagnosed at seven hospitals in South Korea between 2010 and 2019 were retrospectively analyzed. RESULTS: Overall, 10,557 patients were included in the analysis (747 and 9,810 patients in the EPTB and PTB groups, respectively). The proportion of EPTB among all patients with TB demonstrated an increasing trend over the study period. In the EPTB group, the pleura was the most commonly involved site (n = 246, 32.9%), followed by the lymph nodes (n = 152, 20.3%) and bones and joints (n = 138, 18.5%). Among 706 new patients with EPTB, the resistance rates to isoniazid (INH) and rifampicin (RIF) were 8.5% and 2.4%, respectively. The proportions of RIF-susceptible, INH-resistant TB, multidrug/rifampicin-resistant tuberculosis (MDR/RR-TB), and pre-extensively drug-resistant TB were 6.7%, 2.4%, and 0.7%, respectively. When comparing new patients in the EPTB group with those in the PTB group (8,607 patients), the resistance rates to RIF, ethambutol, and rifabutin and the proportion of MDR/RR-TB were significantly lower in the EPTB group. During the study period, the proportion of MDR/RR-TB among new patients showed a decreasing trend in both the EPTB and PTB groups. CONCLUSION: This study provides important information on the resistance status and trends among patients with EPTB in South Korea. To improve the management of patients with EPTB, efforts to identify drug resistance and regular updates to the DST database are essential.
Quantitative Cardiac MRI in COVID-19 Vaccine-Related Versus Other Types of Myocarditis: A Korean Multicenter Study.
Chang S, Kim JY, Hong YJ … +1 more , Chun EJ
J Korean Med Sci · 2026 Feb · PMID 41664573 · Full text
BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccine-related myocarditis (C-VRM) is a potential adverse event following mRNA-based vaccination. Cardiac magnetic resonance imaging (CMR) is pivotal for diagnosing and mo...
BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccine-related myocarditis (C-VRM) is a potential adverse event following mRNA-based vaccination. Cardiac magnetic resonance imaging (CMR) is pivotal for diagnosing and monitoring myocarditis. This study compared quantitative CMR findings among C-VRM, COVID-19 myocarditis, and other myocarditis in the Korean population, and identified prognostic factors associated with adverse outcomes. METHODS: This retrospective multicenter study included patients diagnosed with various types of myocarditis who underwent CMR in four tertiary-care hospitals between October 2018 and January 2023. Clinical data and CMR findings, including cine, native T1, T2, extracellular volume (ECV), and late gadolinium enhancement (LGE) were analyzed. Differences in CMR parameters among myocarditis types were analyzed using linear regression. Predictors of adverse outcomes, defined as a composite of left ventricular ejection fraction (LVEF) of < 40% at follow-up and all-cause mortality, were assessed using logistic regression analysis. RESULTS: A total of 82 patients (mean age, 42.8 ± 19.2 years; 40 men) were included: 29 with C-VRM, 7 with COVID-19 myocarditis, and 46 with other myocarditis. C-VRM showed significantly lower native T1, T2, and ECV than other myocarditis ( = 0.001, 0.022, and 0.001, respectively), after adjustment for age, sex, and time from symptom onset to CMR. Among the 74 patients with follow-up LVEF data, seven (9.5%) experienced adverse outcomes. Maximum ECV z-score (odds ratio [OR], 1.457; 95% confidence interval [CI], 1.062-1.998; = 0.020) and LGE extent (OR, 1.109; 95% CI, 1.029-1.194; = 0.007) remained independent predictors after adjusting for age and initial LVEF, while myocarditis type was not associated with prognosis. CONCLUSION: In this Korean multicenter cohort, CMR markers of myocardial injury were lower in C-VRM than in other myocarditis types, whereas prognosis was more strongly associated with injury severity than with disease subtype.
Pertussis Outbreak Investigation in a Korean Middle School: Insights on Tdap and Td Vaccination.
Park S, Chang K, Lee SY … +2 more , Ju YJ, Heo JY
J Korean Med Sci · 2026 Feb · PMID 41664572 · Full text
BACKGROUND: Pertussis was considered a neglected respiratory infection for decades in Korea due to the national immunization program, which includes six doses of vaccination. The final dose is administered between 11 and...
BACKGROUND: Pertussis was considered a neglected respiratory infection for decades in Korea due to the national immunization program, which includes six doses of vaccination. The final dose is administered between 11 and 12 years of age. In recent years, the number of reported pertussis cases has risen, with a rapid surge observed in 2024. This study investigates a pertussis outbreak in a middle school and explores potential reasons for the resurgence, particularly in relation to completion of the final Tdap booster dose. METHODS: All 22 confirmed cases were investigated descriptively, and a case-control study was conducted involving 22 cases and 44 controls. Participant information, including vaccination history, was obtained through a field epidemiological investigation. RESULTS: The epidemic curve of the 22 cases indicated a human-to-human transmission, with 16 transmission routes identified through the investigation. The average time from symptom onset to diagnosis was 8 days (3 to 30 days). Eight cases (36.4%) had completed all six doses of vaccination, including the final Tdap booster. In the control group, 28 out of 44 individuals (63.6%) had received the Tdap booster. A marginal statistical difference was observed between the groups ( = 0.065). Among the eight cases, the mean interval between Tdap vaccination and symptom onset was 23.1 ± 11.1 months, compared to 13.3 ± 9.0 months until the end of the outbreak for the 28 controls ( = 0.014). CONCLUSION: These findings suggest that individuals who did not receive the Tdap booster may be more susceptible to pertussis infection. It is necessary to consider standardizing the final adolescent booster as Tdap within Korea's National Immunization Program. Health authorities should use nationwide data to address the implications of permitting both Tdap and Td as the final booster dose and resolve the inconsistencies in current guidelines. While this manuscript was under review, the guideline was updated in March 2025 to recommend Tdap, not Td, as the booster at 11-12 years of age.
Trends in Atypical Antipsychotic Use Among Children and Adolescents With Depressive Disorders in Korea.
Park KJ, Kim YJ, Jung E … +5 more , Kim JY, Moon DS, Park J, Lee MS, Kim HW
J Korean Med Sci · 2026 Feb · PMID 41664571 · Full text
BACKGROUND: Atypical antipsychotics (AAPs) are increasingly prescribed to children and adolescents. Most AAPs are prescribed off-label for children and adolescents with depressive disorders. We investigated the longitudi...
BACKGROUND: Atypical antipsychotics (AAPs) are increasingly prescribed to children and adolescents. Most AAPs are prescribed off-label for children and adolescents with depressive disorders. We investigated the longitudinal trends and patterns of AAP prescription in Korean children and adolescents with depressive disorders. METHODS: We conducted a population-based study using data from the Korean National Health Insurance Review and Assessment Service to assess AAP prescriptions among Koreans aged 0-18 years with depressive disorders between 2010 and 2022. An annual cross-sectional assessment was used to analyze longitudinal trends. Additionally, we focused on the most recent year (2022) to assess the current prescription patterns of AAP. RESULTS: The annual proportion of AAP prescriptions among children and adolescents with depressive disorders will increase from 10.4% in 2010 to 40.0% in 2022 (average annual percentage change: 14.9; 95% confidence interval, 14.3 to 16.3). This trend was more pronounced in patients with depressive disorders with psychiatric comorbidities than in those without psychiatric comorbidities. Over the last 13 years, the predominantly prescribed AAPs have shifted from risperidone to aripiprazole. According to recent data (2022), the most-prescribed AAP for children and adolescents with depressive disorders was aripiprazole, followed by risperidone, quetiapine, and olanzapine. Children and adolescents with depressive disorders and psychiatric comorbidities, particularly Attention-Deficit Hyperactivity Disorder, were more frequently prescribed AAPs ( < 0.001). CONCLUSION: The use of AAPs has progressively increased among Korean children and adolescents with depressive disorders, particularly among those with psychiatric comorbidities. Further studies are needed to establish safer and more evidence-based AAP treatments for depressive disorders in children and adolescents.
Complementary Roles of Next-Generation Flow and Next-Generation Sequencing for Measurable Residual Disease Assessment in Multiple Myeloma.
Park MS, Lim DJ, Kim HJ … +5 more , Cho D, Yoon SE, Kim SJ, Kim K, Kim HY
J Korean Med Sci · 2026 Feb · PMID 41664570 · Full text
BACKGROUND: Highly sensitive measurable residual disease (MRD) assays play a crucial role in predicting prognosis and guiding further treatment in multiple myeloma (MM). This study aimed to compare the diagnostic perform...
BACKGROUND: Highly sensitive measurable residual disease (MRD) assays play a crucial role in predicting prognosis and guiding further treatment in multiple myeloma (MM). This study aimed to compare the diagnostic performance and clinical utility of next-generation flow (NGF)- and next-generation sequencing (NGS)-based MRD assays in patients with MM. METHODS: We evaluated 55 bone marrow (BM) aspirate samples from 41 MM patients for MRD. NGF-MRD was performed on fresh BM specimens in accordance with EuroFlow standard operating procedures, whereas NGS-MRD was conducted on archived BM DNA using the LymphoTrack IGH FR1 assay. RESULTS: The MRD detection rates were 43.6% (24/55) for NGF-MRD and 29.1% (16/55) for NGS-MRD with 67.3% (37/55) concordance rate between two MRD assays, and correlation coefficient () was 0.506. The 3-year progression-free survival (PFS) estimates were 37.5% and 71.6% for the NGF-MRD-positive and -negative groups, respectively ( = 0.056), and 40.4% and 69.1% for the NGS-MRD-positive and -negative groups ( = 0.167). In patients who MRD-positive by either NGF or NGS, the 3-year PFS was 40.0%, whereas those negative by both assays exhibited 75.9% ( = 0.035). Revised International Staging System stage III (hazard ratio [HR], 3.30) and combined MRD positivity (HR, 3.01) were most strongly associated with PFS in univariate analysis. CONCLUSION: Both NGF-MRD and NGS-MRD play critical and complementary roles in monitoring MRD in MM. Notably, even isolated MRD positivity detected by either method was associated with disease progression in certain cases, underscoring the importance of both MRD assays.
Airway Quantification Using Ultra-Low-Dose Computed Tomography Correlates With Pulmonary Function Indices in Patients With Asthma.
Kim SH, Yang Z, Chang SW … +8 more , Sim JK, Oh JY, Min KH, Hur GY, Lee SY, Shim JJ, Choi J, Yong HS
J Korean Med Sci · 2026 Feb · PMID 41633329 · Full text
This prospective cohort study evaluated ultra-low-dose computed tomography (ULDCT) as a tool for quantifying airway and parenchymal abnormalities in 24 patients with asthma. Quantitative indices included the percentage o...
This prospective cohort study evaluated ultra-low-dose computed tomography (ULDCT) as a tool for quantifying airway and parenchymal abnormalities in 24 patients with asthma. Quantitative indices included the percentage of low-attenuation area (LAA%) for emphysema, parametric response mapping for functional small airway disease (PRM), and Pi10 for airway thickening, assessed against spirometric parameters at baseline and 1-year follow-up. PRM showed the strongest and most consistent associations with forced expiratory volume in 1 second (FEV₁) %pred, forced expiratory flow between 25% and 75% (FEF25-75) %pred, and the ratio of FEV₁ to forced vital capacity (FVC). The LAA% correlated mainly with the ratio of FEV₁ to FVC. Pi10 showed significant association only with FEF25-75%pred in the multivariable model. Despite dose-related variability in raw values, correlations with lung function parameters remained stable over time. These findings suggest that indices derived from ULDCT, particularly PRM, provide practical low-radiation biomarkers of lung function abnormalities in asthma.
Evaluation of Post-Acute Sequelae of SARS-CoV-2 (PASC) Index and a Recent Long COVID Criteria in Korean Long COVID-19 Cohort.
Kwon K, Jang CY, Kim W … +3 more , Son J, Chang E, Kim SH
J Korean Med Sci · 2026 Feb · PMID 41633328 · Full text
BACKGROUND: To compare the post-acute sequelae of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection (PASC) index and the National Academies of Sciences, Engineering, and Medicine (NASEM) criteria in...
BACKGROUND: To compare the post-acute sequelae of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection (PASC) index and the National Academies of Sciences, Engineering, and Medicine (NASEM) criteria in identifying long coronavirus disease (COVID) among adults with confirmed coronavirus disease 2019. METHODS: A prospective cohort study was conducted from November 2022 to February 2025 at a single tertiary care hospital in Seoul, Korea. Adults aged 18 years or older with confirmed SARS-CoV-2 infection were enrolled, yielding a total of 183 participants. Follow-up assessments took place at 1-, 3-, 6-, and 12-months post-infection. The primary outcome was the prevalence of long COVID at 12 months, measured using the PASC index (≥ 12 points across specified symptoms) and the NASEM criteria (≥ 1 symptom persisting for at least 3 months). RESULTS: Of 183 participants, 26.2% (48/183) met the PASC index, whereas 47.5% (87/183) fulfilled the NASEM criteria. Of the 48 patients who met the PASC index, 44 (91.7%) also met the NASEM criteria. CONCLUSION: The NASEM criteria classified nearly half of participants with long COVID and covered those with PASC index, while the PASC index identified about one quarter. Although the NASEM criteria capture a broader range of persistent symptoms, the PASC index may offer a more stringent threshold, potentially informing targeted research and clinical decision-making.
Minimally Invasive Lateral Lumbar Interbody Fusion Shows a Lower Incidence of Radiologic Adjacent Segment Pathology Than Conventional Posterior Lumbar Interbody Fusion.
Soh J, Ahn J, Lee JC … +2 more , Song MG, Shin BJ
J Korean Med Sci · 2026 Feb · PMID 41633327 · Full text
BACKGROUND: Radiologic adjacent segment pathology (R-ASP) is a significant consequence following lumbar spinal fusion, potentially resulting from compromised integrity of posterior structures. Few studies have directly c...
BACKGROUND: Radiologic adjacent segment pathology (R-ASP) is a significant consequence following lumbar spinal fusion, potentially resulting from compromised integrity of posterior structures. Few studies have directly compared the incidence of R-ASP between minimally invasive lateral lumbar interbody fusion (LLIF) and conventional posterior lumbar interbody fusion (PLIF). Thus, the objective of this study was to analyze risk factors for R-ASP and compare clinical outcomes between minimally invasive LLIF supplemented with percutaneous pedicle screw fixation and open conventional PLIF. METHODS: This study included 107 patients who underwent one- or two-segment spinal fusion for degenerative lumbar disease. Fifty-one patients underwent minimally invasive LLIF and 56 received conventional PLIF. Factors related to occurrence of R-ASP were investigated by analyzing demographic profiles, radiological results, and clinical outcomes. Correlations between clinical results were determined based on fusion methods and the presence of R-ASP. Patient-related factors, preoperative spinal diagnosis, number of fused segments, and radiologic findings were analyzed. Clinical outcomes were also assessed. Cox regression survival analysis was performed to determine risk factors for R-ASP. Annual incidence and cumulative survival rate of R-ASP were calculated using the life-table method and Kaplan-Meier survival curve. RESULTS: Cox proportional hazards regression analysis identified three significant risk factors for R-ASP: PLIF over LLIF ( = 0.028; hazard ratio [HR], 2.321; 95% confidence interval [CI], 1.096-4.913), postoperative pelvic incidence-lumbar lordotic angle mismatch ≥ 10° ( = 0.022; HR, 2.280; 95% CI, 1.126-4.617), and preoperative facet arthropathy grade ≥ 2 ( = 0.016; HR, 3.491; 95% CI, 1.266-9.629). The predicted incidence of R-ASP was 48.7% (95% CI, 42.1-55.2%) at 5 years post-fusion and 80.7% (95% CI, 73.0-88.5%) at 8 years. Clinical outcomes showed that the final visual analog scale for lower back pain was significantly lower in patients who underwent LLIF and in patients who did not develop R-ASP. CONCLUSION: Minimally invasive fusion techniques that preserve posterior structures might slow the progression of degenerative changes in adjacent segments. To reduce R-ASP, preoperative assessment of facet degeneration and adequate restoration of sagittal balance during surgery are crucial considerations.
Correlation Between Small Dense Low-Density Lipoprotein and Tissue Perfusion in Diabetic Foot.
Lee KI, Choi YW, Han SK … +2 more , Jeong SH, Dhong ES
J Korean Med Sci · 2026 Feb · PMID 41633326 · Full text
BACKGROUND: Small dense low-density lipoprotein (sdLDL) is recognized as a reliable predictor of atherosclerotic vascular diseases and is also associated with the severity of diabetes. Vascular status directly affects ti...
BACKGROUND: Small dense low-density lipoprotein (sdLDL) is recognized as a reliable predictor of atherosclerotic vascular diseases and is also associated with the severity of diabetes. Vascular status directly affects tissue perfusion, indicating that sdLDL could serve as a potential marker for tissue perfusion in diabetic feet. However, an alternative possibility exists. In patients with diabetes, discrepancies can occur between vascular status and actual tissue perfusion due to complications related to diabetes such as neuropathy and hematologic changes in red blood cells. In such instances, sdLDL may not consistently correlate with tissue perfusion. Tissue perfusion is a crucial element in managing diabetic foot conditions. Despite acknowledging its importance, no studies to date have explored the relationship between sdLDL levels and tissue perfusion in diabetic feet. This prospective study seeks to explore this correlation. METHODS: Fifty patients with diabetes were enrolled in the study. Tissue perfusion was assessed by measuring the foot's transcutaneous oxygen pressure (TcPO₂). SdLDL levels were determined based on the mean low-density lipoprotein (LDL) particle size, proportion of sdLDL as a percentage of total LDL, and LDL subfraction score. Correlations between TcPO₂ and each variable were evaluated through scatter plots, and correlation coefficients () with corresponding values were calculated. Statistical analyses were conducted for all participants and further stratified into two subgroups based on a TcPO₂ threshold of ≥ 40 mmHg and < 40 mmHg. RESULTS: In the overall analysis (n = 50), no statistically significant relationships were detected between TcPO₂ and sdLDL size, sdLDL percentage, or LDL subfraction score. Nevertheless, in the TcPO₂ ≥ 40 mmHg subgroup (n = 29), a statistically significant positive correlation was found between mean LDL particle size and TcPO₂ ( = 0.414, = 0.026). In contrast, statistically significant negative correlations emerged between sdLDL percentage and TcPO₂ ( = -0.415, = 0.025), as well as between LDL subfraction score and TcPO₂ ( = -0.419, = 0.024). CONCLUSION: This study identified a significant correlation between sdLDL levels and tissue perfusion in diabetic feet with TcPO₂ ≥ 40 mmHg, but no significant correlation in those with TcPO₂ < 40 mmHg.
Evaluation of the Medical Utilization of the Telemedicine Pilot Project for Patients With Diabetes Based on Korean National Health Insurance Claims Data.
Jung Y, Kim JY, Seo S … +3 more , Kim Y, Ko MJ, Kim HS
J Korean Med Sci · 2026 Feb · PMID 41633325 · Full text
BACKGROUND: Numerous studies have explored blood sugar management in patients with diabetes through telemedicine. However, since the implementation of the telemedicine pilot project, no studies have assessed changes in h...
BACKGROUND: Numerous studies have explored blood sugar management in patients with diabetes through telemedicine. However, since the implementation of the telemedicine pilot project, no studies have assessed changes in healthcare utilization for diabetes. This study examined medical outcomes and utilization among diabetes patients comparing telemedicine to traditional in-person care, focusing on medical utilization, care continuity, prescription adherence, and safety. METHODS: This study used data from the National Health Insurance Service to identify patients with diabetes who did or did not receive telemedicine. We analyzed medical utilization, medical sustainability, prescription continuity, and safety through propensity score matching (PSM). To evaluate the telemedicine pilot project's impact, changes and differences in outcome indicators were calculated using a Difference-in-Differences (DID) approach. RESULTS: After PSM, the total number of patients in the telemedicine group (Tele_G) and the face-to-face treatment group (Control_G) was 59,954 each. Medical utilization of telemedicine decreased in both groups, but the DID was 0.16 (-0.04 in Tele_G vs. -0.20 in Control_G, < 0.001). Medical continuity also differed significantly between the Tele_G and Control_G (all < 0.001). The DIDs for the ratio of diabetes medication prescription days and appropriate prescription continuation rate were 0.95 (-0.72 vs. -1.67, < 0.001) and 1.26 (-1.80 vs. -3.07, < 0.001), respectively, with statistically significant differences. There were no significant differences in hospitalization experience for safety assessment (DID = -0.14, = 0.139) or emergency room visits (DID = 0.00, = 0.950). CONCLUSION: DID analysis revealed the potential of the telemedicine pilot project, with slightly lower continuity than face-to-face care; hence, it is acceptable as a supplementary service. To improve this, a telemedicine system specializing in diabetes and blood glucose management is needed, along with a clear protocol that allows patient blood glucose data to be integrated into the telemedicine platform.
Long-Term Mortality After Tuberculosis Among People With Disabilities in Korea.
Min J, Kim SY, Park JE … +8 more , Kim YY, Yang HS, Park BH, Jeon SW, Kim YJ, Yang B, Yeob KE, Park JH
J Korean Med Sci · 2026 Feb · PMID 41633324 · Full text
BACKGROUND: Given the increased vulnerability of people with disabilities to poor health outcomes, we evaluated the impact of disability on long-term mortality among tuberculosis (TB) survivors. METHODS: We conducted a n...
BACKGROUND: Given the increased vulnerability of people with disabilities to poor health outcomes, we evaluated the impact of disability on long-term mortality among tuberculosis (TB) survivors. METHODS: We conducted a nationwide population-based cohort study using the linked national registry databases in the Republic of Korea. The study included 305,055 TB patients diagnosed between 2008 and 2016 who survived at least 1 year. The primary outcome was to compare long-term mortality after TB diagnosis between people with and without disabilities. Long-term mortality was defined as all-cause mortality at least 1 year after TB diagnosis. Cox proportional hazard models were used to evaluate the risk of long-term mortality. Subgroup and sensitivity analyses were performed based on disability type, severity, and cause of death. RESULTS: Disabilities were present in 10.1% of survivors and were associated with higher mortality rates (46.3 vs. 16.3 per 1,000 person-years, < 0.001). Cox analysis revealed that disabilities increased long-term mortality risk, with severe disabilities posing the highest risk. Respiratory disabilities were strongly linked to deaths both related and unrelated to TB. CONCLUSION: Long-term mortality risk is significantly higher in TB survivors with disabilities.
Trends in Sedative-Hypnotic Prescription Among Insomnia Patients: A Nationwide Cohort Study From 2010 to 2022 in Korea.
Shin J, Jun SY, Won D … +5 more , Kim M, Lee SY, Seo M, Shin A, Lee YJ
J Korean Med Sci · 2026 Feb · PMID 41633323 · Full text
BACKGROUND: Global insomnia prevalence increased during the coronavirus disease 2019 (COVID-19) pandemic, driving higher demand for sedative-hypnotics. The objective of this study was to compare sedative-hypnotic prescri...
BACKGROUND: Global insomnia prevalence increased during the coronavirus disease 2019 (COVID-19) pandemic, driving higher demand for sedative-hypnotics. The objective of this study was to compare sedative-hypnotic prescription patterns in South Korea from 2010 to 2022 and assess the potential impact of the COVID-19 pandemic. METHODS: This population-based cohort study from January 1, 2010, to December 31, 2022, used the Korean National Health Insurance's Health Insurance Sharing Service database of 8,136,437 (60.4% female) unique insomnia patients aged 18 and older. Prescriptions for sedative-hypnotic groups (benzodiazepines, non-benzodiazepines, antidepressants, and antipsychotics), number of patients prescribed sedative-hypnotics, and predicted and observed prescription rates by sex, age, and sedative-hypnotic group were analyzed. RESULTS: The number of prescriptions per 1,000 population increased across all sedative-hypnotic groups before and during the pandemic. Women and the elderly had higher prescriptions for all sedative-hypnotic groups compared to men and other age groups. Antidepressant prescriptions saw the highest percentage increase (men 38.6%; women 37.1%) in 1st half of 2020 compared to 2019, followed by antipsychotics (men 28.9%; women 25.7%). Antidepressant prescriptions showed the largest increase relative to predicted levels across all age groups from 2020 to 2021, while non-benzodiazepines exhibited the smallest increase (men 5.6%; women 4.5%). In the 18-29 age group, prescriptions for all sedative-hypnotic groups exceeded predicted numbers in 2021. CONCLUSION: This study found that sedative-hypnotic prescriptions steadily increased from 2010 to 2022, with the trend becoming more pronounced during the COVID-19 pandemic, when prescription rates tended to exceed predicted levels in Korea. Monitoring the use of sedative-hypnotics for insomnia in women, the elderly, and young adults is essential for potential adverse effects and associated mental problems.
Shared Decision-Making for Determining Treatment Strategies in Low-Risk Thyroid Cancer: Protocol of a Multicenter Cluster-Randomized Trial (MAeSTro-SDM).
Lee EK, Kim MJ, Hwangbo Y … +31 more , Moon JH, Cho SW, Chai YJ, Choi JY, Jung YS, Lee KE, Chung EJ, Kim K, Kim SJ, Kim W, Kim YH, Lee YK, Jang J, Song YS, Yi KH, Yu HW, Moon S, Jung KY, Kim HJ, Ryu CH, Ryu J, Seok J, Kang SH, Lee S, Chu AJ, Lee CY, Lee JY, Lim H, Kim JH, Park SK, Park YJ
J Korean Med Sci · 2026 Jan · PMID 41589080 · Full text
Active surveillance (AS) is recommended for low-risk papillary thyroid microcarcinoma (PTMC) in many guidelines. However, while its clinical application requires incorporation of patient values, implementing shared decis...
Active surveillance (AS) is recommended for low-risk papillary thyroid microcarcinoma (PTMC) in many guidelines. However, while its clinical application requires incorporation of patient values, implementing shared decision-making (SDM) in practice remains challenging. To generate reliable evidence, facilitate the integration of SDM into routine PTMC managements and improve patient satisfaction, this study developed a PTMC-specific SDM model (SM group) and aims to evaluate whether it improves patient-reported outcomes (PROs) compared to usual care (UC group) in patients with low-risk PTMC. This multicenter, parallel-group, cluster-randomized controlled trial will enroll 310 patients with low-risk PTMC across seven academic hospitals in Korea. Participants will be assigned to either the SM group (model) or the UC group (control) through cluster randomization of 26 clinicians, stratified by specialty and AS experience. The SM group will receive structured counseling using a newly developed PTMC-specific SDM model, supported by decision aids such as educational videos, web-based card news, and illustrated leaflets regarding disease-information and patients' values. The UC group will receive standard counseling. The primary outcome is the Decisional Conflict Scale score. Secondary outcomes include satisfaction with decision-making process, decision regret, anxiety, and thyroid-specific quality of life. Data will be collected via the iCReaT v2.0 electronic Case Report Form, supplemented by electronic and paper-based PRO surveys. Assessments will be conducted at baseline, 1-4 weeks, and 6 months after the treatment decision. ClinicalTrials.gov Identifier: NCT06730893.
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