Journal of Korean Medical Science最新文献

{"title":"A Novel Mouse Model of Mixed Dementia Using Chronic Cerebral Hypoperfusion Induced by Bilateral Carotid Artery Stenosis.","authors":"Jang Hun Kim, Ho-Young Kang, Sung Young Park, Yoo Mi Yang, Sang-Kyung Jo, Dongho Geum, Jong-Hoon Kim, Dong-Hyuk Park","doi":"10.3346/jkms.2025.40.e236","DOIUrl":"10.3346/jkms.2025.40.e236","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) and vascular dementia (VaD) have distinct pathognomonic features, but they frequently co-occur as mixed dementia (MD) in elderly adults. This study aimed to develop a novel MD mouse model using bilateral carotid artery stenosis (BCAS) in 5 times familial Alzheimer's disease (5xFAD) transgenic mice and characterize its behavioral and histological features.</p><p><strong>Methods: </strong>Thirteen C57BL/6 and sixteen 5xFAD transgenic mice were prepared. Six C57BL/6 and seven 5xFAD transgenic mice underwent BCAS surgery, and all mice were housed for 3 months. Mice were divided into wild-type (n = 7), VaD (n = 6), AD (n = 9), and MD (n = 7) groups. Neurobehavioral tests, including the Y-maze test (YMT) and passive avoidance test (PAT), along with immunohistochemical analysis of amyloid β plaque (6E10) and myelin basic protein, were performed.</p><p><strong>Results: </strong>MD mice exhibited similar deficits in YMT as AD and VaD groups but had significantly worse performance in PAT compared to all other groups. Histologically, MD mice showed amyloid-β accumulation in the cortex/hippocampus and axonal degeneration in the corpus callosum.</p><p><strong>Conclusion: </strong>This novel MD model demonstrates key features of both AD and VaD, providing a valuable tool for studying the pathophysiology of mixed dementia and testing potential therapeutic interventions.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e236"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023513","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":"Letter to the Editor: Defining the Boundaries of AI Use in Scientific Writing: A Comparative Review of Editorial Policies.","authors":"Shigeki Matsubara","doi":"10.3346/jkms.2025.40.e272","DOIUrl":"10.3346/jkms.2025.40.e272","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e272"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023485","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":"Evidence of Overlapping Roles Between Clinics and Hospitals in Primary Care.","authors":"Boram Sim, Jihye Shin, Hyun Woo Kim, Jin Yong Lee, Min-Woo Jo","doi":"10.3346/jkms.2025.40.e219","DOIUrl":"10.3346/jkms.2025.40.e219","url":null,"abstract":"<p><strong>Background: </strong>Clinics and hospitals in South Korea are often perceived as competitors to each other. This study examines the overlapping roles in providing primary care provision between clinics and hospitals by analyzing the healthcare facility type where patients first receive diagnoses of hypertension (HTN) or diabetes mellitus (DM). We also explore the characteristics of patients that influence their choice of healthcare facility and compare healthcare utilization patterns in the first year post-diagnosis by facility type.</p><p><strong>Methods: </strong>Using 2021 claims data from the Health Insurance Review and Assessment Service, we included data from 599,955 patients with newly diagnosed HTN and 195,668 patients with newly diagnosed DM. We analyzed the distribution of new diagnoses by facility type, characteristics of patients who chose hospitals, average number of facility visits and medical expenses in the first year following the initial diagnosis, and continuity of care index.</p><p><strong>Results: </strong>Among the newly diagnosed patients, 82.5% of HTN and 66.6% of DM cases were diagnosed in clinics, whereas 17.5% and 33.4%, respectively, occurred in hospitals. Younger patients, those with comorbidities, and those residing outside Seoul were more likely to receive care at hospitals. Compared to those diagnosed in hospitals, patients diagnosed in clinics visited healthcare facilities more frequently and incurred greater total medical expenses but demonstrated higher continuity of care.</p><p><strong>Conclusion: </strong>These findings indicate that both clinics and hospital-level healthcare facilities, excluding general hospitals, play significant roles in providing primary care. Strengthening the clinic-based primary care system and ensuring the quality of primary care provided by hospitals are crucial. Policies that promote transparency in the quality assessments of healthcare facilities can help patients make informed decisions when choosing between clinics and hospitals.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e219"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023516","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":"It Is Time for Physician-Scientists to Lead Their Own Development.","authors":"Dong Hyeon Lee, Jong-Il Kim","doi":"10.3346/jkms.2025.40.e257","DOIUrl":"10.3346/jkms.2025.40.e257","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e257"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023498","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":"Adherence of Anti-Dementia Medications in Alzheimer's Disease and Related Dementia: A Nationwide Cohort Study in Korea.","authors":"Eunyoung Lee, Sungwoo Kang, Byoung Seok Ye, Young-Gun Lee","doi":"10.3346/jkms.2025.40.e226","DOIUrl":"10.3346/jkms.2025.40.e226","url":null,"abstract":"<p><strong>Background: </strong>Readily available treatments for Alzheimer's disease and related dementia (ADRD) include acetylcholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists. Non-adherence and early discontinuation of anti-dementia medications are prevalent issues. We aimed to investigate factors associated with suboptimal usage of anti-dementia medications in ADRD.</p><p><strong>Methods: </strong>Based on data extracted from a claim database in South Korea, 508,958 patients with ADRD who began taking anti-dementia medication between 2018 and 2020 were included. The mean possession ratio is the ratio of the sum of prescribed medication supply over one year and non-adherence is defined as mean possession ratio < 80%. Discontinuation is defined as no prescription of anti-dementia medications, or no switch to other anti-dementia medications, within 45 days after the run-out date. The cumulative incidence of discontinuation of anti-dementia medication was estimated using the Kaplan-Meier method. Factors associated with non-adherence were evaluated using logistic regression analyses.</p><p><strong>Results: </strong>Within the first year, the non-adherence ratio was 40.8%, while the discontinuation ratio was 43.6%, and approximately 30% of patients discontinued medication within 90 days after initiation. Younger age at diagnosis, female sex, and prescription at non-tertiary hospitals or clinics other than neurology/psychiatry were associated with increased risk of non-adherence. Compared with Seoul, a prescription issued by neurology/psychiatry departments at a tertiary hospital in other provinces was associated with a 75% higher risk of non-adherence.</p><p><strong>Conclusion: </strong>Strategies targeting non-adherence are warranted to minimize disparities in the management of patients with dementia.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e226"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023422","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":"Letter to the Editor: Fimasartan-Induced Liver Injury and Update on Hepatotoxicity Risks.","authors":"Jisoo Lee, Susie Chin, Sang Gyune Kim, Young Seok Kim, Jeong-Ju Yoo","doi":"10.3346/jkms.2025.40.e271","DOIUrl":"10.3346/jkms.2025.40.e271","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e271"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023454","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":"Validation of ReadSmart4U: An Automated Tool for Neuropsychological Assessment Reporting.","authors":"Jeongbin Park, Chae Hyun Kim, Sungjin Park, Hae In Kim, Ji Won Han, Ki Woong Kim","doi":"10.3346/jkms.2025.40.e225","DOIUrl":"10.3346/jkms.2025.40.e225","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychological assessments are critical to cognitive care, but are time-consuming and often of variable quality. Automated tools, such as ReadSmart4U, improve report quality and consistency while meeting the growing demand for cognitive assessments.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analysed 150 neuropsychological assessments stratified by cognitive diagnosis (normal cognition, mild cognitive impairment and Alzheimer's disease) from the Clinical Data Warehouse of a university-affiliated referral hospital (2010-2020). Reports were generated for each assessment by ReadSmart4U and certified clinical psychologists (CCPs). Three blinded CCPs assessed report quality using the Integrated Scoring for Quality Assessment of Structure (ISQAS) for absolute quality and the Integrated Scoring for Quality Comparison of Superiority (ISQCS) for paired comparisons. Domains assessed included terminology accuracy, interpretation accuracy, usefulness and writing quality.</p><p><strong>Results: </strong>ReadSmart4U-generated reports outperformed CCP reports in all ISQAS domains, with mean overall quality scores of 87.3 ± 3.4 vs. 74.5 ± 6.7 (<i>P</i> < 0.001). Domain-specific scores were higher for terminology accuracy (31.4 ± 1.5 vs. 26.8 ± 2.1), interpretation accuracy (32.2 ± 1.7 vs. 27.3 ± 2.4), usefulness (10.8 ± 0.9 vs. 9.2 ± 1.2) and writing quality (14.5 ± 0.6 vs. 12.7 ± 1.1; all <i>P</i> < 0.001). In the ISQCS evaluations, ReadSmart4U reports were judged superior in 80.2% of cases for overall quality and 58.0-88.2% for domains (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>ReadSmart4U significantly improves the quality and consistency of neuropsychological assessment reports compared to CCPs, reducing workload and supporting the integration of automated tools into clinical workflows to improve cognitive care.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e225"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023452","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":"Large-Scale Dermatopathology Dataset for Lesion Segmentation: Model Development and Analysis.","authors":"Yosep Chong, Daseul Park, Youngbin Ahn, Yoonjin Kwak, Seyeon Park, Seung Wan Back, Changwoo Lee, Gyeongsin Park, Mohammad Rizwan Alam, Binna Kim, Kee-Taek Jang, Nayoung Han, Chong Woo Yoo, Jonghyuck Lee, Cheol Lee, Young-Gon Kim","doi":"10.3346/jkms.2025.40.e220","DOIUrl":"10.3346/jkms.2025.40.e220","url":null,"abstract":"<p><strong>Background: </strong>With the increasing incidence of skin cancer, the workload for pathologists has surged. The diagnosis of skin samples, especially for complex lesions such as malignant melanomas and melanocytic lesions, has shown higher diagnostic variability compared to other organ samples. Consequently, artificial intelligence (AI)-based diagnostic assistance programs are increasingly needed to support dermatopathologists in achieving more consistent diagnoses. However, large-scale skin pathology image datasets for AI learning are often insufficient or limited to specific diseases. This study aimed to build and assess a large-scale dermatopathology image dataset for an AI model.</p><p><strong>Methods: </strong>We trained and evaluated a lesion segmentation model based on this dataset, which consisted of over 34,376 histopathology slide images collected from four institutions, including normal skin and six types of common skin lesion: epidermal cysts, seborrheic keratosis, Bowen disease/squamous cell carcinoma, basal cell carcinoma, melanocytic nevus, and malignant melanoma. Each image was accompanied by labeled data consisting of lesion area annotations and clinical information. To ensure the high quality and accuracy of the dataset, we employed data quality management methods, including syntactic accuracy, semantic accuracy, statistical diversity, and validity evaluation.</p><p><strong>Results: </strong>The results of the dataset quality assessment confirmed high quality, with syntactic accuracy and semantic accuracy at 0.99 and 0.95, respectively. Statistical diversity was verified to follow a natural distribution. The validity evaluation verified the strong performance of the segmentation model for each group of data, with a Dice score ranging from 80% to 91%.</p><p><strong>Conclusion: </strong>The results demonstrated that our constructed dataset provides a well-suited resource for deep learning training, offering a large-scale multi-institutional dermatopathology dataset that can drive advancements in AI-driven dermatopathology diagnosis.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 35","pages":"e220"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023489","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":"Weekday-to-Weekend Sleep Differences and Poor Mental Health in Young Adulthood.","authors":"Minjae Choi, Joshua Kirabo Sempungu, Joon Hee Han, Mi-Hyui Kim, Yo Han Lee","doi":"10.3346/jkms.2025.40.e211","DOIUrl":"10.3346/jkms.2025.40.e211","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate associations between weekday-to-weekend sleep differences and mental health and examine whether the association varies by weekday sleep duration among young adults in South Korea.</p><p><strong>Methods: </strong>We used the Survey of Korean Youths' Lives, a nationally representative data for young adults aged 19-34 years in South Korea. Weekday-to-weekend sleep differences were calculated by the difference between sleep durations on weekends (or free days) and those on weekdays (or working days). Indicators of mental health included unhappiness, life dissatisfaction, burnout, depression, and suicide ideation. A logistic regression analysis was conducted to investigate associations between weekday-to-weekend sleep differences and mental health. We stratified respondents by weekday sleep duration (i.e., < 7 hours and ≥ 7 hours) and examined the difference in associations of weekday-to-weekend sleep differences with mental health.</p><p><strong>Results: </strong>Among the 14,931 respondents, 49.4% and 17.1% reported having 1-2 hours and more than 2 hours more sleep during weekends compared to their weekday sleep, respectively. Moreover, 38.5% of respondents had less than the recommended hours (≥ 7 hours) of sleep on weekdays and they were more likely to have additional hours of sleep on weekends. Larger weekday-to-weekend sleep differences were associated with poor mental health. Specifically, young adults who slept more than two additional hours on weekends were more likely to experience poor mental health conditions, including unhappiness, life dissatisfaction, burnout, depression, and suicide ideation. Furthermore, the associations between weekday-to-weekend sleep differences and poor mental health were more pronounced among those who slept less than the recommended hours on weekdays.</p><p><strong>Conclusion: </strong>This study suggests that large differences in sleep duration between weekdays and weekends could be a useful indicator for detecting poor mental health status. However, further research is needed to better understand the mechanisms underlying factors contributing to weekday-to-weekend sleep differences among young adults.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 34","pages":"e211"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957392","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":"Longitudinal Analysis of Growth and Neurodevelopmental Outcomes in Very Low Birth Weight Infants With Congenital Anomalies Over Three Years.","authors":"Tae Hyeong Kim, Song Ee Youn, Sung-Hoon Chung","doi":"10.3346/jkms.2025.40.e254","DOIUrl":"10.3346/jkms.2025.40.e254","url":null,"abstract":"<p><strong>Background: </strong>Very low birth weight infants (VLBWIs) are vulnerable to growth restrictions and neurodevelopmental impairments. Congenital anomalies further complicate these risks; however, their long-term effects remain unclear. This study examined the impact of congenital anomalies on the growth and neurodevelopment of VLBWIs.</p><p><strong>Methods: </strong>This prospective cohort study analyzed data from the Korean Neonatal Network (2013-2017). A total of 172 VLBWIs with congenital anomalies were matched by gestational age to 516 without anomalies at 18-24 months corrected age, and 136 were matched to 408 at 3 years of age. Growth was assessed using WHO standards, and neurodevelopment was evaluated using the Bayley Scales of Infant Development (II/III) and Korean Developmental Screening Test. Logistic regression analyses were used to identify factors associated with adverse outcomes, with statistical significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>VLBWIs with congenital anomalies had significantly lower weight, height, and head circumference z-scores at both time points. Growth restriction persisted, and neurodevelopmental delays, particularly in motor function, were more prevalent. Infants with multiple congenital anomalies had the highest risk of severe growth restriction and developmental impairment.</p><p><strong>Conclusion: </strong>Congenital anomalies pose significant challenges to the growth and neurodevelopment of VLBWIs. Early and individualized interventions, structured neurodevelopmental follow-up, and multidisciplinary care are essential for improving long-term outcomes.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 34","pages":"e254"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957427","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}