Journal of Korean Medical Science最新文献

{"title":"Relationship Between Aortic Valve and Mitral Annular Calcification With Coronary Artery Calcification in Asymptomatic Individuals: Cross-Sectional and Longitudinal Analyses.","authors":"Kyung An Kim, Mi-Jeong Kim, Hae-Ok Jung, So-Young Lee, Yuran Ahn, Mi-Hyang Jung, Woo-Baek Chung, Dong-Hyeon Lee, Ho-Joong Youn","doi":"10.3346/jkms.2025.40.e209","DOIUrl":"10.3346/jkms.2025.40.e209","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve calcification (AVC), mitral annular calcification (MAC), and coronary artery calcification (CAC) all share common atherosclerotic origins. However, the relationship between these entities is not fully understood.</p><p><strong>Methods: </strong>A total of 722 asymptomatic individuals who underwent health screening with serial cardiac computed tomography (CT) were retrospectively selected for analysis. AVC, MAC, and CAC were identified on CT, and the severity was quantified using Agatston units (AU). Multivariable regression models were used to identify the association between the severity of CAC and the probability of prevalent AVC and MAC, and the relation between annualized progression rates of AVC, MAC and CAC.</p><p><strong>Results: </strong>On initial CT, the prevalence of AVC, MAC, and CAC was 11.4%, 6.5%, and 46.3%, respectively. Increasing baseline CAC severity was associated with a higher probability of both prevalent AVC (odds ratio [OR] per 100 AU increase, 1.03; 95% confidence interval [CI], 1.02-1.04; <i>P</i> < 0.001) and MAC (OR per 100 AU increase, 1.06; 95% CI, 1.05-1.07; <i>P</i> < 0.001), even after correction for other risk factors. On follow-up CT, the interval changes of MAC and CAC scores were also highly correlated (<i>P</i> < 0.001). However, no significant relationship was found between the interval changes of AVC and MAC scores, or between AVC and CAC.</p><p><strong>Conclusion: </strong>We observed a close correlation between AVC, MAC, and CAC, which is in accord with their common atherosclerotic origin. However, the correlation between MAC and CAC progression but not with AVC suggests that other factors such as hemodynamics may have an important role in the further development of calcification.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 34","pages":"e209"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957450","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 the Need for Cardiopulmonary Resuscitation in Preterm Infants in the Delivery Room Using Machine Learning Models: Analysis of a Korean Neonatal Network Database.","authors":"Hyun Ho Kim","doi":"10.3346/jkms.2025.40.e208","DOIUrl":"10.3346/jkms.2025.40.e208","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a specialized model for predicting the stages of neonatal resuscitation for preterm infants using prospectively collected data on very-low-birth-weight infants in South Korea.</p><p><strong>Methods: </strong>A prospective cohort study was conducted using the Korean Neonatal Network database, including neonates weighing < 1,500 g. Overall, 9,684 infants were included, and external validation was performed using data of 71 infants collected from Jeonbuk National University Hospital. Logistic regression, random forest, and eXtreme Gradient Boosting (XGB) were the machine learning models employed.</p><p><strong>Results: </strong>The final models particularly in predicting the need for \"endotracheal intubation or higher\" performed well, with the XGB ensemble algorithm showing the best performance (area under the receiver operating characteristic curve, 0.91; area under the precision-recall curve, 0.86; and accuracy, 0.85). The most influential variables affecting the performance of the predictive models in the ensemble algorithm were gestational age and birth weight.</p><p><strong>Conclusion: </strong>The developed predictive model enabled the early identification of the need for neonatal resuscitation in preterm infants. When used as a clinical decision support system in neonatal intensive care units and delivery rooms, it is expected to not only facilitate efficient staffing by healthcare professionals but also increase resuscitation procedure success rates.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 34","pages":"e208"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957474","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":"Development of a Prediction Model for Acute Exacerbation in Idiopathic Pulmonary Fibrosis: A Study of the Korea IPF Cohort Registry.","authors":"Jae Ha Lee, Ji Hoon Jang, Song Yee Kim, Moo Suk Park, Man Pyo Chung, Hongseok Yoo, Sung Hwan Jeong, Hong Lyeol Lee, Sun Mi Choi, Young Whan Kim, Yong Hyun Kim, Sung Woo Park, Jong Sun Park, Yangjin Jegal, Yong Suk Jo, Hee-Young Yoon, Tae-Hyung Kim, Yee Hyung Kim, Beomsu Shin, Hyun-Kyung Lee, Sei-Hoon Yang, Hyun Lee, Sang-Heon Kim, Eun Joo Lee, Hye Sook Choi, Hyung Koo Kang, Eun Young Heo, Won-Yeon Lee, Jin Woo Song","doi":"10.3346/jkms.2025.40.e212","DOIUrl":"10.3346/jkms.2025.40.e212","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) has the most disastrous impact on prognosis as a major cause of morbidity and mortality. However, there is no proven treatment, and the occurrence of AE is unpredictable. This study aimed to develop a prediction model for AE in patients with IPF using the nationwide Korea IPF Cohort (KICO) registry.</p><p><strong>Methods: </strong>This is a retrospective study of Korean patients with IPF who were enrolled from June 2016 to February 2022 in the KICO registry. We developed a prediction model for AE based on risk factors found in the multivariable logistic regression model.</p><p><strong>Results: </strong>Of 678 patients with IPF, the mean age was 69.4 years, and 82.0% were male. AE occurred in 165 patients (24.3%) during follow-up (median: 40.7 months). The median time from IPF diagnosis to AE was 11.6 (interquartile range: 3.6-23.5) months. Lower forced vital capacity (FVC), shorter six-minute walking distance (6MWD), and the use of home oxygen were independently associated with AE in the multivariable logistic analysis. In a risk-predicting model using variables of FVC, 6MWD, and the use of home oxygen, there was a significant predictive power for AE in both score (area under the curve [AUC], 0.746; 95% confidence interval [CI], 0.705-0.783; <i>P</i> < 0.001) and stage (AUC, 0.696; 95% CI, 0.654-0.736; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Our results suggest that a model using FVC, 6MWD, and home oxygen use may be useful in predicting AE in patients with IPF.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 34","pages":"e212"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957476","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":"Profiling Cytokines According to the Presence or Absence of Small-for-Gestational Age Using Amniotic Fluid Retrieved During Cesarean Section From Pregnant Women With Early-Onset Preeclampsia.","authors":"Soyoung Shin, Shin Kim, Gisu Lee, Jingon Bae, Junho Kang, Jaehyun Park","doi":"10.3346/jkms.2025.40.e213","DOIUrl":"10.3346/jkms.2025.40.e213","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia (PE) is a hypertensive disorder and a major cause of maternal and fetal mortality. We aimed to investigate the molecular properties of early-onset PE, which requires delivery before 34 weeks' gestation by analyzing the molecular cytokine profile of amniotic fluid obtained during cesarean section from pregnant women with early-onset PE, based on the presence or absence of small-for-gestational age (SGA).</p><p><strong>Methods: </strong>This study included 73 pregnant women with early-onset PE among which 21 women had SGA infants, whose birth weight was less than the 10th percentile of the gestational age-specific birth weight. Amniocentesis was performed after exposing the amniotic sac during cesarean delivery. Twenty-five cases of appropriate-for-gestational age (AGA) infants, who had birth weights between the 25th and 75th percentile of the gestational age-specific birth weight, were arbitrarily selected as a control group. Potential protein biomarkers were analyzed using the Olink® Explore 384 Inflammation panel with a Proximity Extension Assay technique. The biological implications of the differentially expressed proteins (DEPs) were assessed using the web-based tool Database for Annotation, Visualization, and Integrated Discovery 2021. Enrichment analysis of hub genes was performed using the Metascape Database.</p><p><strong>Results: </strong>Although the mean birth weight was significantly lower in the SGA group than that in the AGA group (945.2 ± 302.3 vs. 1,590.0 ± 393.2, respectively; <i>P</i> < 0.001), no difference was observed in the mean gestational age at delivery (<i>P</i> > 0.05). Sixteen DEPs (EPO, WFIKKN2, CLSTN2, CSF3, COL9A1, SCG3, CCL23, SKAP2, CCL20, GZMB, TIMP3, FIS1, IL17C, PON3, VEGFA, and CXCL8) were found to be upregulated in the SGA group compared with the AGA group. Six hub genes (<i>CCL20</i>, <i>CSF3</i>, <i>EPO</i>, <i>VEGFA</i>, <i>IL17C</i>, and <i>GZMB</i>), which are mainly involved in cytokine-cytokine receptor interactions, were overexpressed in the SGA group.</p><p><strong>Conclusion: </strong>We found six upregulated hub genes with potential as novel biomarkers for early-onset PE with SGA. Although further investigation is warranted to validate our results, our findings may contribute to a better understanding of the pathogenesis of early-onset PE with SGA.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 34","pages":"e213"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957416","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":"Novel Bone Scan Features for Predicting Prognosis in Men With Bone Metastatic Prostate Cancer: A Retrospective Study.","authors":"Byung Woo Kim, Jang Hee Han, Sang Hyun Yoo, Minh-Tung Do, Minho Kang, Seung-Bo Lee, Dongkyu Oh, Gi Jeong Cheon, Ja Hyeon Ku, Cheol Kwak, Young-Gon Kim, Chang Wook Jeong","doi":"10.3346/jkms.2025.40.e206","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e206","url":null,"abstract":"<p><strong>Background: </strong>Bone metastasis frequently occurs in patients with prostate cancer, however, a consensus has not been reached regarding bone scan image analysis. We aimed to analyse various bone scan imaging features of metastatic prostate cancer and to assess their impact on prognosis.</p><p><strong>Methods: </strong>One thousand five hundred sixty-three paired sets of bone scan images (anterior and posterior) were obtained from patients with metastatic prostate cancer at Seoul National University Hospital. U-Net architecture was used for the segmentation of metastatic bone lesions. Imaging features describing the overall metastatic burden (n = 18) and largest metastatic burden (n = 32) were extracted using computer vision techniques. Kaplan-Meier survival analysis and Cox proportional risk model were used to analyse the prognostic impact of each feature.</p><p><strong>Results: </strong>The correlation coefficient between the actual number of lesions and that predicted by the deep learning model was 0.87, indicating a strong correlation. Multivariate Cox regression showed that metastasis intensity difference (hazard ratio [HR], 0.53; <i>P</i> = 0.002) and the largest metastasis percentage (HR, 0.62; <i>P</i> = 0.038) were independently associated with disease progression and were even more strongly associated with the number of metastases (current standard). The Kaplan-Meier curves revealed that a higher total metastasis ratio (<i>P</i> < 0.001), a lower total metastasis intensity difference (<i>P</i> = 0.030), a lower largest metastatic lesion percentage (<i>P</i> < 0.001), higher compactness (<i>P</i> = 0.028), and lower eccentricity (<i>P</i> = 0.070) were associated with shorter progression-free survival.</p><p><strong>Conclusion: </strong>Although the number of bone metastases is a standardised prognostic factor, additional consideration of morphological or intensity-related novel features may be useful to more accurately predict the prognosis of patients with metastatic prostate cancer.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 33","pages":"e206"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957306","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":"Valproic Acid Inhibits RhoA-Mediated Vascular Smooth Muscle Cell Contraction.","authors":"Ji-Kwang Park, Seo-Hyeon Kim, Hansol Lee, Yun-Jin Hwang, Du-Hyong Cho","doi":"10.3346/jkms.2025.40.e199","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e199","url":null,"abstract":"<p><strong>Background: </strong>Vascular smooth muscle cells (VSMCs) play an important role in regulating vessel diameter and blood pressure. Dysregulation of VSMC contraction contributes to the development of coronary and post-subarachnoid hemorrhagic (SAH) vasospasms. We investigated the molecular mechanisms by which valproic acid (VPA) inhibits Ras homolog family member A (RhoA)-mediated VSMC contraction in rat VSMCs and isolated aortas.</p><p><strong>Methods: </strong>In rat VSMCs, western blot analyses, quantitative real-time reverse transcription-polymerase chain reaction, ectopic expression of the constitutively active (CA)-RhoA gene or wild-type (WT)-histone deacetylase (HDAC) 5 gene, and inhibitor studies were performed. Active RhoA-GTP levels and Rho-associated protein kinase activity in VSMCs were also measured. We performed a phenylephrine (PE)-induced aortic contraction assay using isolated rat aortas, as well as post hoc analyses of an endothelium-dependent aortic relaxation assay using aortas from VPA-administered mice.</p><p><strong>Results: </strong>VPA decreased the phosphorylation of the myosin light chain at Ser19 (p-MLC-Ser¹⁹) in a dose- and time-dependent manner. Interestingly, VPA significantly decreased RhoA mRNA and protein expression, as well as the active RhoA-GTP level. Furthermore, ectopic expression of CA-RhoA gene almost completely reversed VPA-inhibited p-MLC-Ser¹⁹. VPA markedly increased the acetylation levels of histone 3 (H3K9ac/K14ac). VPA and sodium butyrate but not valpromide significantly decreased the expression levels of both RhoA and p-MLC-Ser¹⁹ in VSMCs. However, this decrease was not reversed by overexpression of the WT-HDAC5 gene, indicating that HDAC5 was not responsible for this decrease. Consistent with the <i>in vitro</i> results, VPA attenuated PE-induced aortic contraction, decreased RhoA and p-MLC-Ser¹⁹ expression, and increased H3K9ac/K14ac levels in isolated rat aortas. The post hoc analysis revealed that the VPA-inhibited RhoA pathway accounted for 30% of the total aortic relaxation induced by VPA.</p><p><strong>Conclusion: </strong>This study showed that VPA inhibits RhoA-mediated VSMC and vessel contraction by decreasing RhoA expression, which is mediated by the inhibitory action of VPA on HDACs. These results suggest that VPA may be useful in the treatment and prevention of spastic vascular diseases, including coronary and post-SAH vasospasms.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 33","pages":"e199"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957471","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 Clinical Indicators for Non-Suicidal Self-Injury and Suicide Attempts in the Emergency Department.","authors":"Eun Kim, Doug Hyun Han, Hyunchan Hwang, Na Yeon Kim, Sung Ah Chung, Leah Han, Sun Mi Kim","doi":"10.3346/jkms.2025.40.e205","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e205","url":null,"abstract":"<p><strong>Background: </strong>While differentiating non-suicidal self-injury (NSSI) from minor intent suicide attempts (MSAs) and serious intent suicide attempts (SSAs) is crucial for providing effective crisis interventions in emergency departments (EDs), existing research on this distinction remains limited. Therefore, this study aims to identify clinical indicators differentiating NSSI, MSA, and SSA among ED patients.</p><p><strong>Methods: </strong>Data were collected from 587 patients who presented with self-injurious behaviors at Chung-Ang University Hospital ED in Seoul from June 2018 to December 2023. The study assessed patients' suicide attempt intentionality, demographic and historical factors, characteristics of self-injury, status at self-injury, as well as suicidal ideation and suicide planning upon presentation to the ED. Patients were classified into NSSI, MSA, or SSA groups based on the intentionality of their self-injury. Hierarchical logistic regression analyses were performed to identify clinical indicators distinguishing these groups.</p><p><strong>Results: </strong>Among all self-injury patients, sex (odds ratio [OR], 0.45; <i>P</i> = 0.029), higher lethality of injury (OR, 5.34; <i>P</i> < 0.001), and sustained suicidal ideation (OR, 2.83; <i>P</i> = 0.002) were clinical indicators that distinguished intentional suicide attempts (MSA and SSA) from NSSI. Among patients with NSSI and MSA, those with a higher lethality of injury (OR, 2.88; <i>P</i> = 0.002) and sustained suicidal ideation (OR, 2.87; <i>P</i> = 0.005) were more likely to have MSA. By contrast, for patients with intentional suicide attempts (MSA and SSA), the following factors were significant predictors of SSA: method of cutting (OR, 0.17; <i>P</i> < 0.001), higher lethality of injury (OR, 6.01; <i>P</i> < 0.001), self-injury under the influence of alcohol (OR, 1.76; <i>P</i> = 0.041), and help-seeking at the time of self-injury (OR, 0.48; <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>Being male, higher injury lethality, and sustained suicidal ideation are significant clinical indicators predicting suicidal attempt rather than NSSI. Among patients attempting suicide, methods other than cutting, high-lethality attempts, self-injury under the influence of alcohol, or not seeking help may indicate serious suicidal intentions, necessitating thorough evaluation and possible emergency hospitalization.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 33","pages":"e205"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957295","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":"Endocrine Disorders in Patients With Inborn Errors of Immunity.","authors":"Eu-Seon Noh, Doo Ri Kim, Minji Im, Insung Kim, Juyoung Sung, Yoon Ji Ahn, Areum Shin, Kyung-Ran Kim, Hwanhee Park, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Jihyun Kim, Kangmo Ahn, Keon Hee Yoo, Sung Yoon Cho, Yae-Jean Kim","doi":"10.3346/jkms.2025.40.e204","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e204","url":null,"abstract":"<p><strong>Background: </strong>Human inborn errors of immunity (IEIs) include disorders characterized by aberrant function or development of the immune system. Recently, interest in the immune and endocrine systems has increased. We aimed to investigate endocrine disorders in patients with IEIs.</p><p><strong>Methods: </strong>Data on patients with IEIs diagnosed from 1994 to 2021 at Samsung Medical Center, Seoul, Korea were reviewed. Each IEI was classified according to the International Union of Immunological Societies classification, and endocrine issues were reviewed.</p><p><strong>Results: </strong>Of the 169 patients with IEIs, an endocrine evaluation was performed in 130 (76.9%). Thirty-five of the 130 patients (27% of the evaluated group) were diagnosed with at least one endocrine disorder, representing approximately 20% of all IEI patients with cumulative incidence of 32.3% at 20 years and 39.8% at 40 years. Patients with 'diseases of immune dysregulation' showed the highest proportion of endocrine disorders. Additionally, six of these 35 patients had two distinct endocrine conditions. Thyroid involvement was most commonly observed (n = 15), followed by hypogonadism (n = 8), adrenal insufficiency (n = 7), growth hormone deficiency (n = 6), hypoparathyroidism (n = 3), and diabetes (n = 2).</p><p><strong>Conclusion: </strong>We described endocrine disorders in patients with IEIs in Korea. About 20% of IEI patients had endocrine problems. Endocrine evaluations should be considered in IEI patients.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 33","pages":"e204"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957358","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":"Association Between Intraocular Pressure and Risk Factors for Metabolic Syndrome in Korea.","authors":"Jun Young Lee, Myung Ho Cho, Jiwoong Lee, Jong Soo Lee","doi":"10.3346/jkms.2025.40.e202","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e202","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma, the second leading cause of blindness worldwide, is associated with elevated intraocular pressure (IOP). Metabolic syndrome, a cluster of conditions that includes obesity, hypertension, hyperglycemia, and dyslipidemia, has been linked to increased IOP. This study investigated the relationship between IOP and metabolic syndrome risk factors in an adult Korean population.</p><p><strong>Methods: </strong>Data from 1,896 adults (aged 19-59 years) from the 2021 Korea National Health and Nutrition Examination Survey were analyzed. The exclusion criteria were age < 19 years; use of anti-glaucoma medications or anti-inflammatory eye drops; history of glaucoma, retinal, or refractive surgery; and a diagnosis of glaucoma. Metabolic syndrome risk factors, including blood pressure, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance, body mass index, abdominal obesity, triglycerides, and high-density lipoprotein cholesterol were examined for their association with ocular hypertension (OHT) using multivariate logistic regression.</p><p><strong>Results: </strong>Participants with metabolic syndrome (n = 383, 20.3%) demonstrated a higher mean IOP (16.05 ± 0.15 mmHg) compared with the normal group (15.33 ± 0.09 mmHg; <i>P</i> < 0.001). OHT was present in 33 patients (1.2%), and its prevalence did not differ significantly between the normal and metabolic syndrome groups. In multiple linear regression, risk factors, including hyperglycemia (<i>P</i> = 0.037) and hypertriglyceridemia (<i>P</i> = 0.027), were significantly associated with IOP. Abdominal obesity showed a strong association with OHT in multivariate analysis (odds ratio, 2.90; 95% confidence interval, 1.35-6.23; <i>P</i> = 0.007).</p><p><strong>Conclusion: </strong>Risk factors for metabolic syndrome, particularly abdominal obesity, were strongly associated with OHT. These findings emphasize the importance of regular IOP screening to prevent glaucoma progression in individuals with metabolic syndrome.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 33","pages":"e202"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957352","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":"Greater White Matter Hyperintensities and More Severe Cognitive Dysfunction in Mild Cognitive Impairment With Motoric Cognitive Risk Syndrome.","authors":"Joon Hyuk Park, Hyun Ju Yang, Suyeon Park, Bong Soo Kim","doi":"10.3346/jkms.2025.40.e200","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e200","url":null,"abstract":"<p><strong>Background: </strong>The motoric cognitive risk syndrome (MCRS) is characterized by slow gait and cognitive complaints. A motor-based approach to MCRS provides a clinical strategy for identifying individuals at high risk for dementia.</p><p><strong>Methods: </strong>This study included 81 outpatients with mild cognitive impairment (MCI). All participants underwent clinical evaluations, including volumetric brain magnetic resonance imaging (MRI) and neuropsychological testing with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet. White matter hyperintensities (WMH) volume was calculated using automated segmentation analysis from three-dimensional MRI images. MCRS was defined by the presence of cognitive complaints and slow gait defined as gait speed at least one standard deviation below age- and sex-specific means.</p><p><strong>Results: </strong>A total of 31 subjects with MCRS and 50 subjects without slow gait participated in this study. The linear regression analysis revealed a significant negative relationship between WMH volume and gait speed in both the MCI group with MCRS (β = -1.010, <i>P</i> < 0.001) and the MCI group without slow gait (β = -0.427, <i>P</i> = 0.016). Both age (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.02-1.34) and WMH volume (OR, 1.11; 95% CI, 1.01-1.22) were significantly associated with MCRS, even after adjusting for confounding factors. After applying Bonferroni correction (<i>P</i> < 0.0036), the MCRS group exhibited significantly worse performance on word list memory, word list recall, and MMSE-KC compared to the MCI group without slow gait.</p><p><strong>Conclusion: </strong>MCRS represents a distinct and more severe clinical entity within the MCI population, characterized by greater cognitive impairment and increased WMH burden.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 33","pages":"e200"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957293","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}