Journal of Korean Medical Science最新文献

{"title":"Incidence and Characteristics of Adverse Events: The 2024 Patient Safety Incidents Inquiry in Korea.","authors":"Dan Bi Cho, Won Lee, Seung Gyeong Jang, Jeehee Pyo, Eun Young Choi, Minsu Ock","doi":"10.3346/jkms.2026.41.e301","DOIUrl":"10.3346/jkms.2026.41.e301","url":null,"abstract":"<p><strong>Background: </strong>In accordance with Article 7-2 of the Patient Safety Act, the Ministry of Health and Welfare conducts a Patient Safety Incident Inquiry every 5 years to support patient safety policy. This study aimed to describe the methodology and main findings of the 2024 Patient Safety Incident Inquiry.</p><p><strong>Methods: </strong>Ten Accountable Care Hospitals (five tertiary and five general hospitals) participated. From each hospital, 500 patients discharged in 2021 were randomly selected. A standardized three-stage retrospective medical record review was conducted: first-stage screening by nurses or health information managers, second-stage review and reporting of suspected adverse events by physicians or nurses, and final adjudication by a central expert committee.</p><p><strong>Results: </strong>Of 5,000 patients, 2,208 (44.2%) met one or more the screening criteria. Following adjudication in the third review stage, confirmed adverse events were identified in 565 patients (11.3%), resulting in 612 confirmed adverse events. The most common type was patient care-related events (37.3%), followed by medication-/fluid-/blood-related (36.1%) and surgery-/procedure-related (26.8%) events. Temporary harm requiring intervention accounted for 62.4% of adverse events, and 3.6% of patients died. Prolonged hospitalization was associated with 36.3% confirmed adverse events, and 28.3% were classified as preventable. Variation in the incidence of confirmed adverse events across institutions was observed.</p><p><strong>Conclusion: </strong>Using a standardized three-stage medical record review, the 2024 Patient Safety Incident Inquiry provides updated descriptive baseline data on confirmed adverse events across tertiary and general hospitals in Korea. These findings may support institutional patient safety improvement efforts and inform national patient safety planning.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 39","pages":"e301"},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166820","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":"Publishing Quality Statistics Videos on YouTube: Analysis of Sources and Publishing Formats.","authors":"Aizhan Oralbek, Olena Zimba, Ainur B Qumar, Nurlan Aukenov, Ramazan Azim Okyay, Burhan Fatih Kocyigit","doi":"10.3346/jkms.2026.41.e249","DOIUrl":"10.3346/jkms.2026.41.e249","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the content quality, presentation characteristics, and viewer engagement of YouTube videos on statistics, and to compare video quality categories based on fundamental video parameters, interaction metrics, presentation formats, and content sources.</p><p><strong>Methods: </strong>YouTube videos were searched for on November 17, 2025, using the search terms \"statistical analysis,\" \"data analysis,\" \"statistics,\" and \"statistical methods.\" The top 50 most relevant videos for each search term were assessed; after applying exclusion criteria, 114 videos were reviewed. The Global Quality Scale was used to measure video quality, and reliability was determined using a modified DISCERN tool. Videos were divided into low-, intermediate-, and high-quality categories. Engagement metrics and presentation methods were compared among quality groups.</p><p><strong>Results: </strong>Eighty-seven (76.3%) of the videos were categorized as high quality. Statistically significant differences were observed among video quality groups in daily views, likes, and comments (<i>P</i> < 0.001 for all comparisons); these differences were attributed to the disparity between the low- and high-quality groups. Videos produced by academic institutions, nonprofit associations, and professional experts had higher percentages classified in the high-quality category (n = 1; 100%, n = 5; 83.3%, and n = 32; 80%, respectively). Presentation formats differed significantly across quality categories, with greater diversity observed in high-quality videos. Within this group, slide-based presentations accounted for 33.3%, animated content for 32.2%, and demonstration-based (software-centric) videos for 18.4% (<i>P</i> = 0.020).</p><p><strong>Conclusion: </strong>A substantial proportion of YouTube videos on statistics were rated high quality, and significant differences were observed in engagement metrics across quality groups. The quality distribution varied by video source and presentation format. These findings emphasize the need for educators and content developers to integrate accurate statistical content with engaging presentation formats to improve the educational value of YouTube videos.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 39","pages":"e249"},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164629","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":"Drug Use Patterns and Characteristics by Drug Type Among Drug Abusers: Findings From the Survey of Drug Abusers in Korea 2021.","authors":"Hae-Ryoung Chun, Na-Rae Lee, Hyeon Woo Yim, Hyunsuk Jeong, Younghoon Chon, Seung-Yup Lee, Hae Kook Lee","doi":"10.3346/jkms.2026.41.e261","DOIUrl":"10.3346/jkms.2026.41.e261","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although substance use disorders are increasingly recognized in the Republic of Korea (South Korea), empirical data on the prevalence and characteristics of drug use among treatment-seeking populations remain limited. This study examined the rate and temporal patterns of major psychoactive substance use-specifically sedatives/hypnotics/tranquilizers (sedatives), amphetamines, and marijuana/cannabis (cannabis)-across three timeframes and explored the associated sociodemographic and clinical factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were obtained from 540 adults with a history of substance use, recruited from medical and rehabilitation institutions as part of the 2021 Survey of Drug Abusers in Korea. Sociodemographic and clinical factors-including Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)-based substance use disorder (SUD) diagnosis, self-recognition of addiction, depression, anxiety, and Addiction Severity Index (ASI) scores-were assessed. Group comparisons were conducted using χ² and &lt;i&gt;t&lt;/i&gt;-tests. Multivariable logistic regression identified factors associated with sedative, amphetamine, and cannabis use across past 30-day, past-year, and lifetime periods. Multiple linear regression examined associations between each substance and ASI composite domains. Statistical significance was set at &lt;i&gt;P&lt;/i&gt; &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 540 individuals with a history of substance use, the lifetime rate of use was highest for amphetamines (71.9%), followed by cannabis (52.8%) and sedatives (38.1%). Sedative use remained relatively consistent across timeframes (30-day: 21.9%; 1-year: 28.9%; lifetime: 38.1%), suggesting patterns of chronic or concurrent use. Across all three substance groups, participants exhibited poorer mental health, including elevated levels of depression, anxiety, or psychiatric severity. Amphetamine and sedative users were more likely to be female, older, and of lower socioeconomic and educational status, with greater impairment in psychiatric, family, and social functioning, as well as higher self-recognition of addiction. In contrast, cannabis users were predominantly younger males with higher socioeconomic status but elevated anxiety levels. Institutional affiliation also differed by substance type: cannabis users were more frequently associated with rehabilitation centers, whereas amphetamine users were more often treated in medical institutions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Findings highlight the coexistence of shared psychosocial vulnerabilities and substance-specific risk profiles in Korea. Integrated, multidimensional interventions-linking psychiatric care, social support, and economic protection-are needed for amphetamine and sedative users. For younger cannabis users, early intervention and relapse prevention are essential. Strengthening coordination between medical and rehabilitation systems under Korea's Judicial-Treatment-Rehabi","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 39","pages":"e261"},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169638","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":"Screening for Left Ventricular Dysfunction in Sepsis Using a Smartphone ECG Analysis Application: A Multicenter Validation Study.","authors":"Yun Seong Park, Joonghee Kim, You Hwan Jo, Woon Yong Kwon, Kyoung Jun Song, Hui Jai Lee, Youngjin Cho, Ji Eun Hwang","doi":"10.3346/jkms.2026.41.e217","DOIUrl":"10.3346/jkms.2026.41.e217","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-induced left ventricular (LV) dysfunction complicates fluid resuscitation, increasing the risk of pulmonary edema and worsening outcomes. Echocardiographic assessment is often delayed, and natriuretic peptides such as N-terminal pro-B-type natriuretic peptide (NT-proBNP) have limited diagnostic accuracy in this setting. We evaluated a smartphone-based electrocardiogram (ECG) analysis application for screening LV dysfunction in patients with sepsis.</p><p><strong>Methods: </strong>In this multicenter retrospective observational study, we included 425 adult sepsis patients from three university hospitals who underwent both a 12-lead ECG and transthoracic echocardiography within 72 hours of emergency department admission. ECG images displayed on a monitor were photographed and analyzed using an artificial intelligence (AI)-based smartphone application (ECG Buddy™), which generated a quantitative digital biomarker for LV dysfunction (quantitative electrocardiogram scores for LV dysfunction [QCG-LVDys]). LV dysfunction was defined as a left ventricular ejection fraction ≤ 40%. The diagnostic performance of QCG-LVDys for detecting LV dysfunction was evaluated using area under the receiver operating characteristic curve (ROC-AUC). A predefined comparison with NT-proBNP was performed in the single center where NT-proBNP was routinely measured.</p><p><strong>Results: </strong>In the overall multicenter cohort, QCG-LVDys showed high diagnostic performance for LV dysfunction, with an ROC-AUC of 0.901. Using an optimized threshold (37.35), QCG-LVDys achieved a sensitivity of 89.6%, specificity of 75.1%, and negative predictive value (NPV) of 97.5%. In the NT-proBNP subset, QCG-LVDys outperformed NT-proBNP (ROC-AUC 0.911 vs. 0.637, <i>P</i> < 0.001). Higher QCG-LVDys values were associated with increased lactate levels (<i>P</i> = 0.002) and 28-day in-hospital mortality (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>AI-driven ECG analysis via a smartphone app provided a rapid, accessible, and accurate screening tool for LV dysfunction in sepsis and outperformed NT-proBNP. Its high NPV suggests potential utility for early risk stratification and for informing cautious hemodynamic management, although prospective studies are needed to define its role in sepsis treatment protocols.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 39","pages":"e217"},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166911","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":"Superior Efficacy of Besifovir in Reducing Hepatocellular Carcinoma Risk Compared to Tenofovir in Chronic Hepatitis B Patients: A Nationwide Cohort Study.","authors":"Yoon E Shin, Jae Young Kim, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim","doi":"10.3346/jkms.2026.41.e251","DOIUrl":"10.3346/jkms.2026.41.e251","url":null,"abstract":"<p><strong>Background: </strong>Besifovir dipivoxil maleate (BSV) is a novel therapeutic option for the treatment of chronic hepatitis B (CHB). However, its long-term effectiveness in reducing the risk of hepatocellular carcinoma (HCC) remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Korean Health Insurance Review and Assessment Service database from 2018 to 2022. A total of 32,383 patients with CHB were included (BSV, n = 2,358; tenofovir disoproxil fumarate [TDF], n = 30,025). Propensity score matching was conducted at a 1:3 ratio to minimize selection bias. The primary outcome was the incidence of HCC, with cirrhosis development as the secondary endpoint.</p><p><strong>Results: </strong>In the overall population, 57 cases of HCC were reported in the BSV group (2,358 individuals, 5,918 person-years), while 1,268 cases of HCC were reported in the TDF group (30,025 individuals, 83,587 person-years). After propensity score matching, the incidence of HCC was significantly lower in the BSV group (9.63 per 1,000 person-years; 95% confidence interval [CI], 7.43-12.49) than in the TDF group (15.36 per 1,000 person-years; 95% CI, 13.72-17.18), with an incidence rate ratio of 1.59 (<i>P</i> = 0.001). This protective effect remained consistent in both cirrhotic (hazard ratio [HR], 1.609; <i>P</i> = 0.028) and non-cirrhotic subgroups (HR, 1.831; <i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>BSV treatment demonstrated superior efficacy in reducing the risk of HCC compared to TDF, regardless of baseline cirrhosis status. These findings suggest that BSV may provide enhanced protection against HCC in patients with CHB.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 39","pages":"e251"},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170126","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":"Systolic Blood Pressure Variability and Outcomes in Atrial Fibrillation: A Nationwide Population Study in Korea.","authors":"Jaechan Park, So-Ryoung Lee, Jungmin Choi, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Bongsung Kim, Kyung-Do Han, Seil Oh, Gregory Y H Lip, Eue-Keun Choi","doi":"10.3346/jkms.2026.41.e277","DOIUrl":"10.3346/jkms.2026.41.e277","url":null,"abstract":"<p><strong>Background: </strong>The relationship between systolic blood pressure variability (SBP-V) and clinical outcomes in patients with atrial fibrillation (AF) remains unclear.</p><p><strong>Methods: </strong>Using the Korean National Health Insurance database, we included patients with prevalent AF who received health checkups in 2013-2014, with at least three checkups in total (n = 235,091). SBP-V was defined as the standard deviation of SBP. The outcomes, including stroke, major bleeding, and all-cause death, were assessed during follow-up.</p><p><strong>Results: </strong>During the follow-up period (median, 4.9 years; interquartile range, 4.3-5.3), 5,339 strokes (0.5/100 person-years [PYs]), 3,432 major bleeding incidents (0.3/100 PYs), and 16,755 all-cause mortality (1.5/100 PYs) occurred. Compared to patients with SBP 120 to < 130 mmHg at the index health checkup, those with SBP ≥ 130 mmHg had a significantly higher risks of stroke and major bleeding. All-cause mortality was elevated at both high (≥ 150 mmHg) and low (< 120 mmHg) SBP levels. Compared to the lowest SBP-V group, the highest SBP-V group had significantly higher risks of stroke (adjusted hazard ratio [aHR], 1.211; 95% confidence interval [CI], 1.125-1.304), major bleeding (aHR, 1.125; 95% CI, 1.025-1.234), and all-cause death (aHR, 1.189; 95% CI, 1.141-1.239). No significant interactions were observed between oral anticoagulation use and SBP-V for any of the clinical outcomes.</p><p><strong>Conclusion: </strong>SBP and SBP-V were independently associated with higher risks of stroke, major bleeding, and all-cause death in patients with AF. These findings highlight the importance of not only achieving target blood pressure levels but also minimizing SBP variability through optimal hypertension management to improve outcomes in this population.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 38","pages":"e277"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126680","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 and Causes of Hospitalization Among People With HIV in Korea: A 20-Year Observational Study.","authors":"Young Rong Kim, Ji Hyun Park, Eun Jin Kim, Hakjun Hyun, Young Hwa Choi, Jung Yeon Heo","doi":"10.3346/jkms.2026.41.e121","DOIUrl":"10.3346/jkms.2026.41.e121","url":null,"abstract":"<p><strong>Background: </strong>The widespread use of antiretroviral therapy (ART) has shifted a change in hospitalization patterns among people with HIV. However, long term trends and causes of hospitalization among people with HIV (PWH) in Korea remain underexplored. This study aimed to investigate 20-year trends in hospitalization rates and causes among PWH.</p><p><strong>Methods: </strong>We retrospectively analyzed hospitalization data from 803 PWH aged ≥ 18 years who received care at the university-affiliated hospital from 2001 to 2020. Hospitalization data were examined across five 4-year intervals. Hospitalization rates per 100 person-years (PY) were estimated using generalized estimating equation models with a Poisson distribution, adjusting first for sex and age and then baseline CD4 T cell count and HIV viral load. Cox regression identified predictors of first hospitalization.</p><p><strong>Results: </strong>Over 3,998 PY, 593 hospitalizations occurred among 322 patients. Unadjusted all-cause hospitalization rates declined from 92.3 to 8.6 per 100 PY, driven by significant reductions in AIDS-defining illnesses (-79.0% per period; 95% confidence interval [CI], -94.8 to -63.1) and non-AIDS infections (-48.4% per period; 95% CI, -63.3 to -33.5). Maternal conditions increased from 0 to 0.67 per 100 PY, with a mean change of 91.3.% per period (95% CI, 41.3-141.2), whereas most of the other chronic conditions and trauma/injury remained stable. Fully adjusted models demonstrated similar trends in most of the categories. Anal condyloma emerged as a leading causes of hospitalization in the later periods. Multivariate analysis revealed that age ≥ 50 years (adjusted hazard ratio [aHR], 1.42; 95% CI, 1.05-1.92), CD4 counts < 100 cells/mm³ (aHR, 2.48; 95% CI, 1.74-3.53), and HIV RNA > 100,000 copies/mL (aHR, 1.61; 95% CI, 1.13-2.30) at enrollment were associated with a higher hospitalization risk.</p><p><strong>Conclusion: </strong>Hospitalization rates among Korean PWH have declined substantially over two decades, primarily driven by a decline in opportunistic infections, attributable to earlier diagnosis and expanded ART access. However, persistent AIDS-related illnesses and the high proportion of non-AIDS-defining cancers diagnosed at advanced stage highlight the ongoing need for earlier HIV detection and a stigma-free healthcare environment that promotes care engagement for PWH.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 38","pages":"e121"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127375","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":"Annular Enlargement: Can It Be Effective for Patients With a Small Left Ventricular Outflow Tract?","authors":"Soo Jin Park, Kitae Kim, Hong Rae Kim, Jae Suk Yoo, Joon Bum Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee, Ho Jin Kim","doi":"10.3346/jkms.2026.41.e250","DOIUrl":"10.3346/jkms.2026.41.e250","url":null,"abstract":"<p><strong>Background: </strong>Aortic annular enlargement (AAE) has been suggested as a surgical technique to facilitate the implantation of a larger prosthetic valve in patients with a small aortic annulus. We investigated the differences in clinical and echocardiographic parameters between patient undergoing aortic valve replacement (AVR) with and without AAE, focusing on the impact of left ventricular outflow tract (LVOT) geometry.</p><p><strong>Methods: </strong>A total of 899 patients (age, 65.5 ± 9.6 years; 414 female) who underwent AVR from 1996 to 2023 were evaluated. The primary outcomes were all-cause mortality and the trends in echocardiographic parameters, analyzed using a linear mixed-effects model. The secondary outcomes included early complications and valve-related adverse events comprising stroke, congestive heart failure, reoperation and infective endocarditis. Propensity score matching was employed for baseline adjustment.</p><p><strong>Results: </strong>In the entire cohort, 75 underwent AVR with AAE, and 824 received AVR-only. After pair matching, 274 patients were included in the final analysis (72 vs. 202). Larger-sized valves were implanted in the AVR-AAE group (22.0 ± 2.2 mm vs. 20.9 ± 1.6 mm, <i>P</i> < 0.001). Early complications, survival rates, and valve-related adverse events showed no significant differences. Echocardiography revealed similar left ventricular mass index (LVMI) regression in both groups (<i>P</i> = 0.057). In patients with a larger LVOT than the annulus (13.9%), the AVR-AAE group showed a rapid LVMI regression trend, while in those with a smaller LVOT than the annulus (86.1%), the AVR-only group demonstrated faster LVMI regression (<i>P</i> = 0.021).</p><p><strong>Conclusion: </strong>While AAE enables larger prosthetic valve implantation without affecting clinical outcomes, its impact on LVMI regression varies based on the LVOT-annulus relationship. AAE may not have long-term benefits in patients with a smaller LVOT compared to the annulus. For optimal surgical planning, evaluation of both annulus and LVOT sizes is crucial.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 38","pages":"e250"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127800","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":"Fecal Microbiota Transplantation Beyond <i>Clostridioides difficile</i> Infection: Expanding Indications, Mechanisms, and Future Directions.","authors":"Md Hasanuzzaman, Chang Seok Bang, Jae Jun Lee, Eun Jeong Gong","doi":"10.3346/jkms.2026.41.e335","DOIUrl":"10.3346/jkms.2026.41.e335","url":null,"abstract":"<p><p>Fecal microbiota transplantation (FMT) has emerged as a transformative therapeutic approach to restore gut microbial homeostasis. The most established indication is recurrent <i>Clostridioides difficile</i> infection (CDI), demonstrating that restoring ecosystem-level microbiota has substantial clinical benefits. Building on this success, FMT is now being investigated across a broader range of indications associated with gut dysbiosis and altered microbiome-host signaling, including inflammatory bowel disease, irritable bowel syndrome, metabolic, and neurological disorders. Mechanistic insights into the gut-organ axes provide biological plausibility for this expansion; gut dysbiosis can function as a modifiable upstream driver of host metabolism, immune-neural signaling, and barrier function. However, the clinical benefits beyond CDI remain heterogeneous and often modest, highlighting the need for further research on patient stratification, standardized protocols, and mechanistic biomarkers. Furthermore, regulatory frameworks remain heterogeneous worldwide, and recent approvals of standardized microbiota-based products for recurrent CDI represent a transition toward treating microbiome therapeutics as regulated biologics. This review synthesizes the mechanistic rationale and current evidence for FMT beyond CDI and outlines future directions for personalized and next-generation microbiome therapeutics.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 38","pages":"e335"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127770","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":"Research Participation During a National Educational Disruption: Insights From a Natural Experiment in Medical Education.","authors":"Joon Sung Shin, Yeon-Ju Huh, Narae Yoon, Hyun Bae Yoon, Joo Youn Oh, Sun Jung Myung","doi":"10.3346/jkms.2026.41.e154","DOIUrl":"10.3346/jkms.2026.41.e154","url":null,"abstract":"<p><strong>Background: </strong>Immersive research experiences are widely recognized as valuable for medical students. However, opportunities for extended research are often constrained by dense curricula. In 2024, the Republic of Korea experienced an inevitable nationwide suspension of medical education for about one year, allowing some students to engage in full-time research. From this unique situation, the present study aimed to explore the medical students' motivations for research participation, their self-perceived outcomes, and the types of institutional support they have identified as necessary to ensure equitable engagement.</p><p><strong>Methods: </strong>A mixed-methods design was employed. Survey 1 collected data from the entire student body during the leave of absence to investigate research participation rates and support needs. Survey 2 examined the research experiences of students who conducted full-time research. Focus group interviews were conducted with purposively selected student representatives, and the integrated results were analyzed thematically.</p><p><strong>Results: </strong>A total of 99 students responded to the survey (response rate: 16.9%), and 25 (25.3%) reported participating in research during their leave of absence. Students motivated by intrinsic interest engaged for longer periods and reported greater self-perceived competency gains, particularly in data analysis and communication, whereas non-participants most often cited barriers to access and a need for more structured information. Thematic analysis of focus group interviews underscored the pivotal role of mentorship, early curricular exposure, and faculty role modeling.</p><p><strong>Conclusion: </strong>Full-time, faculty-supervised research during an educational disruption provided transformative learning opportunities across motivation types. Embedding structured, early research exposure into the curriculum and ensuring transparent access to opportunities may enhance equity, strengthen professional identity formation, and support the sustainability of the clinician-scientist pipeline.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 38","pages":"e154"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127924","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}