Journal of Korean Medical Science最新文献

{"title":"Informed Consent in Radiation Oncology: A Nationwide Survey of Institutions in Korea.","authors":"Jin-Kyu Kang, Kyubo Kim, Hae Jin Park, Won Il Jang, Byoung Hyuck Kim, Kyung Su Kim","doi":"10.3346/jkms.2025.40.e246","DOIUrl":"10.3346/jkms.2025.40.e246","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the current radiotherapy (RT) consent forms in Korea and present inter-institutional variations in the content, format, and level of detail provided to patients across major cancer types.</p><p><strong>Methods: </strong>Between June and October 2022, the Informatics Committee and Clinical Practice Guidelines Committee of the Korean Society for Radiation Oncology collected RT consent forms from board-certified radiation oncologists. The consent forms for six cancer types were analyzed, including the five most common cancers treated with RT in Korea (breast, lung, prostate, colorectal, and liver cancer) as well as head and neck cancers.</p><p><strong>Results: </strong>Forty-nine institutions (49% of 101 institutions) submitted their consent forms, including all 13 Regional Cancer Centers. Of these, 46 provided complete site- or cancer-specific forms for analysis, whereas one provided partial information and two used free-text forms. Seventy percent of institutions (33/47) clearly documented the purpose for RT. Seventy percent of institutions (33/47) categorized side effects as acute and chronic, whereas 30% (14/47) did not make this distinction. In addition to variations in categorizing acute and chronic side effects, a wide range of variations was observed in reporting the side effects of each cancer type. Most forms did not specify the probability of having side effects.</p><p><strong>Conclusion: </strong>This study uncovered notable inter-institutional variations in RT consent forms across Korea, especially in specifying side effects. These findings establish a basis for developing standardized consent forms, which could enhance patient-centered care, strengthen legal clarity, and promote ethical practices in radiation oncology.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 40","pages":"e246"},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Mycoplasma pneumoniae</i> Infections Among Children and Adolescents in Korea, 2014-2024.","authors":"Byung Wook Eun, Unyeong Go, Gayoung Chun, Mi-Sun Park, You La Jeon, Sungwook Song, Eun Hee Lee, Sang Gon Lee","doi":"10.3346/jkms.2025.40.e253","DOIUrl":"10.3346/jkms.2025.40.e253","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma pneumoniae</i> (MP) is the most common cause of community-acquired bacterial pneumonia in children. Macrolides are used as the first-line treatment for MP infection, but resistance has increased significantly over the past few decades, making treatment difficult. This study examines the prevalence of <i>M. pneumoniae</i> infections and macrolide-resistant <i>M. pneumoniae</i> (MRMP) rates in Korean children across three recent epidemics in Korea between 2014 and 2024.</p><p><strong>Methods: </strong>Data from Green Cross Laboratories on <i>M. pneumoniae</i> polymerase chain reaction (PCR) and macrolide-resistance tests were analyzed from January 2014 to March 2024, including 425,079 MP PCR tests and 11,206 resistance tests (macrolide-resistance testing began in 2019). We examined <i>M. pneumoniae</i>-positive rates by age and compared age composition to the epidemic and non-epidemic periods using Cochran-Armitage trend tests and also examined differences in MRMP positive rates by year, epidemic status, sex, age group, and region using the χ² test.</p><p><strong>Results: </strong>Three epidemics of <i>M. pneumoniae</i> infection were identified in 2015/16, 2019/20, and 2023/24, with seasonal peaks between the third and fourth quarter of each starting epidemic year and the highest <i>M. pneumoniae</i>-positive rates in children aged 7 to 9 years. There were significant differences in the proportion of children aged 12 years or younger between epidemic and non-epidemic periods (<i>P</i> < 0.001 for two epidemics and 0.027 for one). MRMP PCR positive rates for A2063G and A2064G mutations were 76.6% and 0.7%, respectively, with a notable increase in A2063G rates from 2019/20 to 2023/24, along with a significant decrease as age increased.</p><p><strong>Conclusion: </strong>The findings indicate a significant rise in <i>M. pneumoniae</i> infections among Korean children, especially those aged 12 years or younger, suggesting a nationwide epidemic. The increase in A2063G mutation rates underscores the need for monitoring antibiotic resistance and further research into resistance factors for future epidemic responses.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 40","pages":"e253"},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Cardiac Events and Survival Between Asymptomatic Diabetic and Nondiabetic Patients: Coronary CT Study.","authors":"Jin Young Yoo, Se Ri Kang, Yun Jung Bae, Eun Ju Chun","doi":"10.3346/jkms.2025.40.e251","DOIUrl":"10.3346/jkms.2025.40.e251","url":null,"abstract":"<p><strong>Background: </strong>Although coronary computed tomography angiography (CCTA) is useful for risk stratification in patients with diabetes, limited data is available regarding its prognostic value in asymptomatic patients with type 2 diabetes mellitus (T2DMs). Therefore, we aimed to evaluate the utility of CCTA in coronary artery disease (CAD) risk stratification in T2DMs compared to that in patients without diabetes mellitus (non-DMs).</p><p><strong>Methods: </strong>We selected 565 T2DMs and 1,130 non-DMs using propensity score matching from the Evaluation of Subclinical Coronary atherosclerosis for Risk Stratification Using the Coronary Computed Tomography Angiography (ESCORT) study of 5,142 asymptomatic individuals. We evaluated CCTA findings and confirmed the occurrence of major adverse cardiac events (MACE; cardiac death, non-fatal myocardial infarction, and unstable angina) and total cardiac events (TCE; MACE plus coronary revascularization) during follow-up using Cox proportional hazards analysis and Kaplan-Meier survival curves.</p><p><strong>Results: </strong>Over a median follow-up of 47 months, MACE and TCE occurred significantly more in T2DMs than in non-DMs (4.2% vs. 1.7% and 7.8% vs. 4.3%, respectively, all <i>P</i> < 0.001). The Cox regression model identified T2DMs, obstructive stenosis, and proximally located plaques as independent predictors of MACE and TCE (all <i>P</i> < 0.05). Kaplan-Meier curve analysis revealed that survival rate was dependent on stenosis grade (log-rank <i>P</i> < 0.001) and differed significantly in the presence of T2DMs among patients with obstructive stenosis (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>While diabetes is an independent risk factor for CAD, its impact on survival rate varies with the severity of CAD, highlighting the value of CCTA as a prognostic tool for CAD risk stratification in asymptomatic T2DMs.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT01416532.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 40","pages":"e251"},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Adverse Events and Associated Safety Profiles of Doxepin: A Pharmacovigilance Study Using VigiBase.","authors":"Chae-Young Lee, Dongwon Yoon, Minyoung Ha, Mo-Se Lee, Young-Wook Kim, Jungmin Lee, Ju-Young Shin","doi":"10.3346/jkms.2025.40.e260","DOIUrl":"10.3346/jkms.2025.40.e260","url":null,"abstract":"<p><strong>Background: </strong>Doxepin, an antidepressant commonly prescribed for the management of depression and insomnia, has been insufficiently explored regarding its safety. We aimed to determine the overall safety profile of doxepin and evaluate relevant adverse events of special interest (AESIs).</p><p><strong>Methods: </strong>Utilizing the World Health Organization's VigiBase from 1967 to 2022, we conducted a disproportionality analysis for AESIs associated with doxepin compared with other tricyclic antidepressants. Reporting odds ratios (RORs) with 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis. Signals were regarded significant when they met the following criteria: cases ≥ 3, and lower end of the 95% CI of ROR ≥ 1.</p><p><strong>Results: </strong>Of the 6,827 doxepin-related reports, 3,869 (56.67%) were predominantly reported in women, with a substantial proportion from the middle-aged population. Overall, none of the predefined AESIs met the safety criteria for this analysis. However, among the frequently reported adverse events (AEs) following doxepin administration, safety signal was identified for drug abuse (adjusted ROR, 2.41; 95% CI, 2.06-2.83).</p><p><strong>Conclusion: </strong>Although no definitive safety signals were detected in our AESI analyses, we identified safety signal for drug abuse. Clinicians should carefully weigh the risks and benefits when prescribing doxepin and emphasize the need for vigilant monitoring of AEs.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 40","pages":"e260"},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital-Based Surveillance of Pediatric Invasive Pneumococcal Diseases, 2016-2023 in Korea: Serotype Trends and Vaccination Policy.","authors":"Dayun Kang, Ki Wook Yun, Hyunju Lee, Eun Song Song, Jong Gyun Ahn, Su Eun Park, Taekjin Lee, Hye-Kyung Cho, Jina Lee, Yae-Jean Kim, Dae Sun Jo, Hyun Mi Kang, Joon Kee Lee, Chun Soo Kim, Dong Hyun Kim, Jae Hong Choi, Byung Wook Eun, Nam Hee Kim, Eun Young Cho, Yun-Kyung Kim, Han Wool Kim, Eun Hwa Choi","doi":"10.3346/jkms.2025.40.e250","DOIUrl":"10.3346/jkms.2025.40.e250","url":null,"abstract":"<p><strong>Background: </strong>In Korea, the 10-valent and 13-valent pneumococcal conjugate vaccines (PCVs) were introduced into the national immunization program (NIP) in 2014 for the protection in children. A decade later, in 2024, PCV15 replaced PCV10 and was included in the NIP in April, while PCV20 was licensed for use in October. To inform optimal vaccination policy, this study aimed to analyze the current distribution of serotypes responsible for invasive pneumococcal diseases (IPDs) in children.</p><p><strong>Methods: </strong>IPD cases from children under 19 years of age were collected from a prospective hospital-based surveillance study conducted at 20 hospitals between 2016 and 2023. Data on the changes in IPD case number and serotype distribution were compared between the pre- coronavirus disease 2019 (COVID-19) period (2016-2019) and the during/post-COVID-19 period (2020-2023).</p><p><strong>Results: </strong>Of the 187 cases with a determined serotype, the most frequent serotypes identified were 10A (21.9%), 15C (11.8%), 15A (9.1%), 15B (8.0%), and 19A (7.5%), and 23B (5.9%). Compared to the pre-COVID-19 period, the proportion of serotype 10A decreased (27.4% vs. 12.9%), while serotypes 23B (0.9% vs. 14.3%) and 6C (0.9% vs. 7.1%) increased. In regard to the vaccine serotype, PCV13 serotypes accounted for 12.3%, PCV15/PCV20 common serotypes for 3.2%, and PCV20 unique serotypes for 35.3% of IPD cases. Serotype 15C, cross protected by the 15B conjugate vaccines, accounted for 11.8%, and non-PCV20 serotypes for 36.4%.</p><p><strong>Conclusion: </strong>Given the approval of two new PCVs, the study results identified the substantial contribution of non-PCV13 serotypes to pediatric IPD and provide critical insights for optimal vaccination strategies to protect children against pneumococcal diseases.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 40","pages":"e250"},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Safety of Tofacitinib for Treatment of Moderate-to-Severe Ulcerative Colitis: Three Years of Korean National Data.","authors":"Eun Mi Song, Gi Hyeon Seo, Sung Hoon Jung","doi":"10.3346/jkms.2025.40.e259","DOIUrl":"10.3346/jkms.2025.40.e259","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) requires long-term treatment. Tofacitinib, a JAK inhibitor approved for UC, raises safety concerns regarding serious adverse events (SAEs) such as thromboembolism, major adverse cardiovascular events (MACEs), and opportunistic infections. This study aimed to evaluate the long-term safety of tofacitinib versus anti-tumor necrosis factor (TNF) inhibitors in Korean patients with UC using a nationwide population-based cohort.</p><p><strong>Methods: </strong>We analyzed data from the National Health Insurance Service database from May 2019 to April 2022. Patients with UC were identified using the International Classification of Diseases, 10th revision and rare intractable disease codes. We compared the incidence of SAEs, including MACE, thromboembolic events, herpes zoster, tuberculosis, and malignancy, between the tofacitinib and anti-TNF inhibitor groups. The risk factors for SAEs in all patients with UC and tofacitinib users were also analyzed.</p><p><strong>Results: </strong>A total of 1,816 patients with UC were included (521 treated with tofacitinib and 1,295 treated with anti-TNF inhibitors). The overall incidence of SAEs was similar between the tofacitinib and anti-TNF inhibitor groups (4.41/100 person-years vs. 5.33/100 person-years, <i>P</i> = 0.332). Thromboembolic events, including MACE, pulmonary thromboembolism, and deep vein thrombosis, were comparable between the two groups (<i>P</i> = 0.151). The incidence of opportunistic infections (herpes zoster and tuberculosis) and malignancy did not differ significantly between the two groups. Among tofacitinib users, older age (≥ 60 years) and concomitant hypertension were significant risk factors for SAEs.</p><p><strong>Conclusion: </strong>Tofacitinib demonstrates a safety profile comparable to that of anti-TNF inhibitors in Korean patients with UC. Despite safety concerns, tofacitinib can be safely used in this population with caution in older patients and those with comorbidities.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 39","pages":"e259"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Clinical Practice Guideline of Korean Society for Research on Nicotine and Tobacco (KSRNT) and National Evidence-based Healthcare Collaborating Agency (NECA) on Treatment of Tobacco Use 2024.","authors":"Yoo-Bin Seo, Haine Lee, Yu-Jin Paek, Hyeon-Jeong Lee, Cheol Min Lee, Eon Sook Lee, Heejin Kimm, Hye-Ji An, Eun-Jung Bae, Ji Soo Kim, Sungwon Roh, Yoo Suk An, Sang-Ho Jo, Seo Young Kang, Yun Hee Kim, Kyung Hyun Suh, Sang Hwa Shin, Jin-Kyoung Oh, Dong Won Park, Kiheon Lee, Hye Seon Kang, Wonyoung Jung, Hyeon Jeong Lim, Miyoung Choi, Jimin Kim, Hyo-Weon Suh, Jinyoung Chang, Hwa Yeong Oh, Soo Young Kim","doi":"10.3346/jkms.2025.40.e299","DOIUrl":"10.3346/jkms.2025.40.e299","url":null,"abstract":"<p><p>Tobacco use is a leading cause of preventable death, disease, and disability worldwide. Thus, smoking cessation is a critical public health intervention globally. This clinical practice guideline was developed to provide recommendations on pharmacological and non-pharmacological treatments for smoking cessation, tailored strategies for smoking cessation in special populations, and interventions for users of electronic cigarettes and multiple tobacco products. Thirty key questions and corresponding evidence-based recommendations were derived from systematic reviews, meta-analyses, and de novo development. A multidisciplinary panel of experts participated in the development of this guideline, incorporating evaluation of evidence quality, benefit-risk balance, patient values and preferences, resource use, and feasibility in the development process. This guideline reflects the latest research on smoking cessation treatments and provides practical and adaptable strategies for clinical and policy implementation. In addition, this guideline is expected to support healthcare providers in improving cessation success rates and contribute to the reduction of smoking-related morbidity and mortality rates in Korea. This guideline will be updated periodically in response to emerging evidence and clinical needs.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 39","pages":"e299"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Stroke in COVID-19 Survivors With Asthma: A Nationwide, Population-Based Cohort Study.","authors":"Sungmin Zo, Youlim Kim, Jong Seung Kim, Min Gu Kang, Ji-Yong Moon, Jongkyu Park, Sang-Heon Kim, Kwang Ha Yoo, Ho Joo Yoon, Kyung Hoon Min, Hyun Lee","doi":"10.3346/jkms.2025.40.e247","DOIUrl":"10.3346/jkms.2025.40.e247","url":null,"abstract":"<p><strong>Background: </strong>The impact of coronavirus disease 2019 (COVID-19) on stroke risk in adult individuals with asthma post-recovery remains unclear.</p><p><strong>Methods: </strong>Using a longitudinal retrospective cohort design based on the Korean National Health Insurance Service claims database, we analyzed stroke risk in two parts. Study 1 examined stroke risk in individuals with asthma according to COVID-19 severity, and Study 2 compared stroke risk between individuals with asthma (asthma cohort) and the general population without asthma (general population cohort), considering COVID-19 severity. Both studies used propensity score matching and Cox proportional hazards regression models for risk estimation.</p><p><strong>Results: </strong>In Study 1, which evaluated stroke risk in the asthma cohort, the risk of stroke was significantly higher in the asthma cohort with severe COVID-19 compared to the asthma cohort without COVID-19 (adjusted hazard ratio [aHR], 1.88; 95% confidence interval [CI], 1.02-3.46). In Study 2, which evaluated stroke risk across six groups stratified by asthma status (asthma cohort and general population cohort) and COVID-19 severity (no, non-severe, and severe COVID-19), stroke risk was highest in the asthma cohort with severe COVID-19 (aHR, 3.42; 95% CI, 1.72-6.79, referring to the general population group without COVID-19), suggesting that severe COVID-19 has a more substantial effect on stroke risk in individuals with asthma.</p><p><strong>Conclusion: </strong>This study highlights a significant association between severe COVID-19 and stroke occurrence in adults with asthma, emphasizing the need for ongoing stroke monitoring to improve long-term asthma outcomes during the COVID-19 endemic period.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 39","pages":"e247"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Pathologic Complete Response Using Breast MRI After Completion of Neoadjuvant Chemotherapy in Breast Cancer Patients With Residual Calcifications on Mammography.","authors":"Ga Eun Park, Seungsoo Lee, Eun Jeong Min, Sung Hun Kim","doi":"10.3346/jkms.2025.40.e248","DOIUrl":"10.3346/jkms.2025.40.e248","url":null,"abstract":"<p><strong>Background: </strong>Determining an appropriate surgical strategy for breast cancer patients with residual suspicious calcifications following neoadjuvant chemotherapy (NAC) remains challenging. Suspicious calcifications often persist on post-treatment mammography, irrespective of tumor viability. This study aimed to identify key predictors of pathologic complete response (pCR) and evaluate the optimal surgical approach for this specific patient cohort.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on breast cancer patients who presented with residual suspicious calcifications on mammography after NAC but demonstrated a radiologic response on magnetic resonance imaging (MRI), classified as complete (CR) or partial (PR) response. Two radiologists, blinded to pathology results, assessed mammography and MRI findings. Molecular subtypes were classified based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status as HR+/HER2-, HR+/HER2+, HR-/HER2+, and triple-negative breast cancer (TNBC). Multivariable regression analysis with an Elastic Net penalty was performed to identify independent predictors of pCR. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were analyzed by molecular subtypes.</p><p><strong>Results: </strong>A total of 243 patients, with a mean age of 50.7 years, were included. The overall pCR rate was 33.7%, with HR-/HER2+ demonstrating the highest pCR rate (59.1%) and HR+/HER2- the lowest (3.8%). Multivariable regression analysis identified CR on MRI (compared to PR; odds ratio [OR], 3.13; <i>P</i> = 0.015) and HR-/HER2+ subtype (compared to HR+/HER2-; OR, 29.7; <i>P</i> = 0.005) as significant predictors of pCR. Diagnostic performance metrics of MRI varied by molecular subtype: sensitivity was highest in TNBC (87%) and lowest in HR-/HER2+ (70.4%), while specificity was highest in HR+/HER2- (100%) and lowest in HR-/HER2+ (48.7%). Accuracy was highest in HR+/HER2- (80.8%) and TNBC (78.9%), with lower accuracy in HR+/HER2+ (72.4%) and HR-/HER2+ (57.6%).</p><p><strong>Conclusion: </strong>Post-treatment MRI response and molecular subtypes are significant predictors of pCR in breast cancer patients with suspicious calcifications after NAC. Nevertheless, complete surgical excision of the calcifications remains advised, particularly for the HR+/HER2- due to the lowest pCR rate and for the HR-/HER2+ due to suboptimal MRI accuracy, despite its highest pCR rate.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 39","pages":"e248"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of Urinary Catheterization in Korea From 2010 to 2021: Population Based Data Analysis.","authors":"Jae Yen Song, Eunjae Kim, Kang Sup Kim, Hong Chung, Chang Hee Han, Sangrak Bae","doi":"10.3346/jkms.2025.40.e266","DOIUrl":"10.3346/jkms.2025.40.e266","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate temporal changes in urinary catheterization practices by analyzing prescription patterns over the past decade.</p><p><strong>Methods: </strong>Using nationwide claims data from the Health Insurance Review & Assessment Service between 2010 and 2021, we examined the total number of prescriptions and their distribution by catheterization method (Foley catheterization, Nelaton catheterization, and suprapubic cystostomy), sex, type of medical institution, and age group (5-year intervals).</p><p><strong>Results: </strong>The overall number of catheterization prescriptions steadily increased during the study period. Foley catheterization was most frequently performed, followed by Nelaton catheterization, while percutaneous and open cystostomy accounted for a negligible proportion. The relative distribution remained stable over 12 years, with Foley catheterization comprising ~70%, Nelaton catheterization ~30%, and cystostomy ~0.2%. Catheterization rates rose sharply after age 60 in both sexes, with an additional modest increase among females aged 24-44. Most procedures were performed in tertiary and general hospitals, with minimal use in primary care. On a per-patient basis, Foley catheterization was more common in females, whereas Nelaton catheterization predominated in males. Cystostomy was prescribed over four times more frequently in males than in females.</p><p><strong>Conclusions: </strong>Despite evolving recommendations and clinical guidelines, the relative proportions of catheterization methods have remained largely unchanged over the past 12 years. Age and sex exert significant influence on catheterization patterns. Strategies to expand the use of intermittent catheterization relative to indwelling catheters appear warranted.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 39","pages":"e266"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}