Journal of Korean Medical Science最新文献

{"title":"Temporal Radiographic Trajectory and Clinical Outcomes in COVID-19 Pneumonia: A Longitudinal Study.","authors":"Dong-Won Ahn, Yeonju Seo, Taewan Goo, Ji Bong Jeong, Taesung Park, Soon Ho Yoon","doi":"10.3346/jkms.2025.40.e25","DOIUrl":"10.3346/jkms.2025.40.e25","url":null,"abstract":"<p><strong>Background: </strong>Currently, little is known about the relationship between the temporal radiographic latent trajectories, which are based on the extent of coronavirus disease 2019 (COVID-19) pneumonia and clinical outcomes. This study aimed to elucidate the differences in the temporal trends of critical laboratory biomarkers, utilization of critical care support, and clinical outcomes according to temporal radiographic latent trajectories.</p><p><strong>Methods: </strong>We enrolled 2,385 patients who were hospitalized with COVID-19 and underwent serial chest radiographs from December 2019 to March 2022. The extent of radiographic pneumonia was quantified as a percentage using a previously developed deep-learning algorithm. A latent class growth model was used to identify the trajectories of the longitudinal changes of COVID-19 pneumonia extents during hospitalization. We investigated the differences in the temporal trends of critical laboratory biomarkers among the temporal radiographic trajectory groups. Cox regression analyses were conducted to investigate differences in the utilization of critical care supports and clinical outcomes among the temporal radiographic trajectory groups.</p><p><strong>Results: </strong>The mean age of the enrolled patients was 58.0 ± 16.9 years old, with 1,149 (48.2%) being male. Radiographic pneumonia trajectories were classified into three groups: The steady group (n = 1,925, 80.7%) exhibited stable minimal pneumonia, the downhill group (n = 135, 5.7%) exhibited initial worsening followed by improving pneumonia, and the uphill group (n = 325, 13.6%) exhibited progressive deterioration of pneumonia. There were distinct differences in the patterns of temporal blood urea nitrogen (BUN) and C-reactive protein (CRP) levels between the uphill group and the other two groups. Cox regression analyses revealed that the hazard ratios (HRs) for the need for critical care support and the risk of intensive care unit admission were significantly higher in both the downhill and uphill groups compared to the steady group. However, regarding in-hospital mortality, only the uphill group demonstrated a significantly higher risk than the steady group (HR, 8.2; 95% confidence interval, 3.08-21.98).</p><p><strong>Conclusion: </strong>Stratified pneumonia trajectories, identified through serial chest radiographs, are linked to different patterns of temporal changes in BUN and CRP levels. These changes can predict the need for critical care support and clinical outcomes in COVID-19 pneumonia. Appropriate therapeutic strategies should be tailored based on these disease trajectories.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 9","pages":"e25"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597124","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":"In This Issue on 10-March-2025.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e103","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e103","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 9","pages":"e103"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Crisis in Korea and Its Impact on Medical Research: A PubMed Analysis (2022-2024).","authors":"Soo Ick Cho, Jeong-Moo Lee, Hyung Jun Park, Jungyo Suh, Ro Woon Lee","doi":"10.3346/jkms.2025.40.e112","DOIUrl":"10.3346/jkms.2025.40.e112","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 9","pages":"e112"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597111","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":"Emerging Innovations in Acne Management: A Focus on Non-Pharmacological Therapeutic Devices.","authors":"Ji Yeon Hong, Joon Seok, Hye Sung Han, Kui Young Park","doi":"10.3346/jkms.2025.40.e118","DOIUrl":"10.3346/jkms.2025.40.e118","url":null,"abstract":"<p><p>Acne is a chronic inflammatory condition affecting the sebaceous glands, with approximately 80% of individuals experiencing it at some point in their lives. Among adolescents, the incidence is reported to exceed 85%. The disease can significantly impact both physical and emotional aspects of a person's quality of life, leading to permanent scarring, poor self-image, depression, and anxiety. The standard first-line treatment for acne vulgaris includes conventional pharmacological approaches such as keratolytics, topical or oral antibiotics, retinoids, and hormonal agents. However, these treatments are not universally effective due to patient noncompliance, adverse drug effects, and the emergence of antibiotic resistance in <i>Cutibacterium acnes</i>, often resulting in high rates of recurrence. Consequently, non-pharmacological therapies have been developed as safe and effective alternatives or supplements to pharmacological treatment. These non-pharmacological approaches can serve as standalone treatment modalities, adjuncts to pharmacological therapy, or maintenance treatments. Current literature lacks comprehensive data on the classification of these non-pharmacological treatment options. This paper aims to provide a brief overview of recent research on the practical applications and potential mechanisms of non-pharmacological therapies for both acne and acne scars. Through elucidating the distinct mechanisms and therapeutic roles of these treatments, we aim to assist dermatologists and other healthcare providers in formulating more effective disease management strategies, thereby encouraging further research in this area.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 9","pages":"e118"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597088","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":"Neutralizing Activity and T-Cell Responses Against Wild Type SARS-CoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count.","authors":"Na Young Ha, Ah-Ra Kim, Hyeongseok Jeong, Shinhye Cheon, Cho Rong Park, Jin Ho Choe, Hyo Jung Kim, Jae Won Yoon, Miryoung Kim, Mi Yeong An, Sukyoung Jung, Hyeon Nam Do, Junewoo Lee, Yeon-Sook Kim","doi":"10.3346/jkms.2025.40.e28","DOIUrl":"10.3346/jkms.2025.40.e28","url":null,"abstract":"<p><strong>Background: </strong>We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19.</p><p><strong>Methods: </strong>Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose.</p><p><strong>Results: </strong>At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm³. The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm³ (high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm³ (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm³ significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (<i>P</i> = 0.017) and interferon-γ-producing T-cell responses (<i>P</i> = 0.049 for CD T-cell; <i>P</i> = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 9","pages":"e28"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597116","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":"Urine Leukocyte Counts for Differentiating Asymptomatic Bacteriuria From Urinary Tract Infection and Predicting Secondary Bacteremia.","authors":"Yongseop Lee, JongHoon Hyun, Je Eun Song, Hyo Won Park, I Ji Yun, Yee Gyung Kwak, Yong Chan Kim","doi":"10.3346/jkms.2025.40.e30","DOIUrl":"10.3346/jkms.2025.40.e30","url":null,"abstract":"<p><strong>Background: </strong>Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is difficult in patients who have difficulty communicating their symptoms. This study aimed to evaluate the diagnostic accuracy of urine leukocytes in distinguishing between UTI and ASB, and the clinical outcomes of patients with UTI according to the degree of pyuria.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with positive urine cultures between July 2022 and June 2023 at two hospitals. UTI and ASB were diagnosed through a comprehensive review of medical records. We evaluated the differences in urine leukocyte counts between patients with UTI and ASB. The diagnostic performance of urine leukocytes to differentiate between UTI and ASB was evaluated. To investigate the clinical outcomes based on the degree of pyuria, we classified patients with upper UTI according to their urine leukocyte counts.</p><p><strong>Results: </strong>Of the 1,793 eligible patients with bacteriuria included, 1,464 had UTI and 329 had ASB. Patients with UTI had higher urinary leukocytes than patients with ASB did (490.4 vs. 123.5 cells/µL; <i>P</i> < 0.001). The area under the receiver operating characteristic curve was 0.702 for discriminating between ASB and UTI. The optimal urine leukocyte cutoff was 195.35 cells/µL, with a sensitivity and specificity of 0.70 and 0.60, respectively. A sequential rise in secondary bacteremia rate was observed according to an increase in urine leukocytes in patients with upper UTI, whereas in-hospital mortality showed no corresponding trend.</p><p><strong>Conclusion: </strong>Urine leukocyte counts could be used to predict UTI occurrence and bacteremia secondary to UTI. Higher degrees of pyuria were associated with bacteremia but not with mortality. Urine leukocyte counts can provide additive information for patients with bacteriuria with vague symptoms.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 9","pages":"e30"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597052","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":"Reinforcing Primary Care in Korea: Policy Implications, Data Sources, and Research Methods.","authors":"Chung-Nyun Kim, Seok-Jun Yoon","doi":"10.3346/jkms.2025.40.e109","DOIUrl":"10.3346/jkms.2025.40.e109","url":null,"abstract":"<p><p>Korea has undergone rapid transformation, achieving significant advancements in both economic development and social security. Notably, the country achieved universal health coverage within a remarkably short period, representing a significant institutional milestone in healthcare. However, the healthcare system faces substantial challenges due to limited resources, a reliance on private healthcare providers, and a rapidly aging population which threatens its sustainability. Various efforts have been made to strengthen Korea's primary care environment. This study aims to examine the multifaceted healthcare landscape surrounding primary care in Korea, analyze associated systems to identify institutional limitations, and propose strategies to enhance primary care in the future. Additionally, it seeks to raise awareness of the current state of primary care in Korea and serves as an example for other countries striving to improve their primary care systems. Furthermore, this review provides a comprehensive overview of key data sources relevant to primary care research in Korea, such as the National Health Insurance Service claims data and the Korea Health Panel Survey. It also outlines practical research methodologies-from epidemiological studies to policy analyses-serving as a valuable reference for both domestic and international scholars seeking to enhance primary care systems.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 8","pages":"e109"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542256","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":"Advancing Korean Medical Research Through Comprehensive Data Resources.","authors":"Jaehun Jung","doi":"10.3346/jkms.2025.40.e104","DOIUrl":"10.3346/jkms.2025.40.e104","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 8","pages":"e104"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542252","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":"Statistical Methods for Baseline Adjustment and Cohort Analysis in Korean National Health Insurance Claims Data: A Review of PSM, IPTW, and Survival Analysis With Future Directions.","authors":"Dong Wook Kim","doi":"10.3346/jkms.2025.40.e110","DOIUrl":"10.3346/jkms.2025.40.e110","url":null,"abstract":"<p><p>The utilization of health insurance claims data has expanded significantly, enabling researchers to conduct epidemiological studies on a large scale. This review examines key statistical methods for addressing baseline differences and conducting cohort analyses using Korean National Health Insurance claims data. Propensity score matching and inverse probability of treatment weighting are widely used to mitigate selection bias and enhance causal inference in observational studies. These methods help improve study validity by balancing covariates between treatment and control groups. Additionally, survival analysis techniques, such as the Cox proportional hazards model, are essential for assessing time-to-event outcomes and estimating hazard ratios while accounting for censoring. However, the application of these statistical methods is accompanied by challenges, including unmeasured confounding, instability in weight estimation, and violations of model assumptions. To address these limitations, emerging approaches, such as Doubly robust estimation, machine learning-based causal inference, and the marginal structural model, have gained prominence. These techniques offer greater flexibility and robustness in real-world data analysis. Future research should focus on refining methodologies for integrating high-dimensional health datasets and leveraging artificial intelligence to enhance predictive modeling and causal inference. Furthermore, the expansion of international collaborations and the adoption of standardized data models will facilitate large-scale multi-center studies. Ethical considerations, including data privacy and algorithmic transparency, should also be prioritized to ensure responsible data use. Maximizing the utility of health insurance claims data requires interdisciplinary collaboration, methodological advancements, and the implementation of rigorous statistical techniques to support evidence-based healthcare policy and improve public health outcomes.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 8","pages":"e110"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542258","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":"Surveillance System for Infectious Disease Prevention and Management: Direction of Korea's Infectious Disease Surveillance System.","authors":"Yumi Jang, Hyungmin Lee, Hyekyung Park","doi":"10.3346/jkms.2025.40.e108","DOIUrl":"10.3346/jkms.2025.40.e108","url":null,"abstract":"<p><p>Emerging infectious diseases have risen sharply due to population growth, urbanization, travel, trade, and environmental changes, with outbreaks like severe acute respiratory syndrome, Middle East respiratory syndrome, and coronavirus disease 2019 highlighting the global need for effective surveillance systems. Various infectious disease surveillance systems are applied depending on the surveillance objectives, target populations, and geographical scope. While Korea has a robust surveillance system, challenges remain in integrating data, enhancing coordination, and improving response efficiency. This article reviews the types and roles of infectious disease surveillance systems through a literature review and proposes strategies for improving Korea's surveillance system by comparing it with those of other countries, including the World Health Organization (WHO). To strengthen Korea's surveillance framework, a comprehensive strategy should be implemented to interconnect multiple surveillance mechanisms and enhance real-time data sharing. A centralized data platform must integrate these systems, leveraging artificial intelligence and big data analytics for faster outbreak analysis. International collaboration through data-sharing networks with the WHO, European Center for Disease Prevention and Control, and U.S Centers for Disease Control and Prevention is essential, along with standardized reporting formats to improve interoperability.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 8","pages":"e108"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542260","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}