Journal of Korean Medical Science最新文献

{"title":"Compression Rate Progression of Osteoporotic Vertebral Compression Fracture in Conservative Treatments.","authors":"Jaewan Soh, Joonghyun Ahn, Hyun-Jun Kim, Jun-Seok Oh, Young Seok Lee, Ye-Soo Park","doi":"10.3346/jkms.2025.40.e191","DOIUrl":"10.3346/jkms.2025.40.e191","url":null,"abstract":"<p><strong>Background: </strong>The treatment of osteoporotic vertebral compression fracture (OVCF) aims to alleviate pain and prevent further compression; however, compression often progresses during conservative treatments. Furthermore, studies on the factors affecting compression rate progression and the timing at which compression progresses the most are limited.</p><p><strong>Methods: </strong>A total of 122 patients with OVCF, who were follow-up duration > 6 months, were included. Factors, such as age, sex, fracture levels, bone mineral density, body mass index, medications for osteoporosis, initial compression rate, fracture locations, and pelvic incidence were assessed. The compression rates were measured initially and at 1, 2, 3, and 6 months. The correlation between these factors and compression rate progression of > 50% was analyzed using univariate and multivariate Cox regression analyses. The compression rate progression over time was evaluated using a repeated-measures general linear model, and clinical outcomes were assessed using a paired <i>t</i>-test.</p><p><strong>Results: </strong>Univariate analysis showed that an initial compression rate of < 30% was significantly associated with progression (<i>P</i> = 0.001). Multivariate Cox regression confirmed this association (<i>P</i> = 0.013; hazard ratio, 3.018; 95% confidence interval, 1.265-7.200). The most significant compression rate progression occurred within the first month of follow-up (<i>P</i> = 0.038). At the final follow-up, the visual analog scale for back pain (<i>P</i> = 0.009) and Oswestry Disability Index (<i>P</i> = 0.026) were significantly higher in the compression rate progression group.</p><p><strong>Conclusion: </strong>An initial compression rate of < 30% was highly correlated with compression rate progression, particularly within the first month after injury. Compression rate progression correlated with clinical outcomes in terms of pain and quality of life.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e191"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873605","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":"Fractionated Gamma Knife Radiosurgery as a Primary Treatment for Large Brain Metastases.","authors":"Ho Sung Myeong, Hye Ran Park, Sang Soon Jeong, Jung Hoon Kim, Jae Meen Lee, Kwang Hyon Park, Kawngwoo Park, Hyun Joo Park, Byung Woo Yoon, Eun Jung Lee, Jin Wook Kim, Hyun Tai Chung, Dong Gyu Kim, Sun Ha Paek","doi":"10.3346/jkms.2025.40.e195","DOIUrl":"10.3346/jkms.2025.40.e195","url":null,"abstract":"<p><strong>Background: </strong>To assess the effectiveness of fractionated Gamma Knife radiosurgery (fGKS) as a primary treatment for newly diagnosed large (> 10 cm³) brain metastases.</p><p><strong>Methods: </strong>Ninety-three patients with newly diagnosed large brain metastases, comprising 99 lesions, who underwent fGKS were included in this retrospective study. Tumor and edema volumes were measured using follow-up magnetic resonance imaging for longitudinal analysis. Local or distant progression-free survival (PFS) rate in the brain, and overall survival (OS) rates were analyzed. Cox regression analysis was used to assess prognostic factors for local progression. Radiation toxicity was evaluated based on RTOG CNS toxicity grades.</p><p><strong>Results: </strong>Median local PFS was 15.5 months, distant PFS was 13.2 months, overall PFS was 8.2 months, and OS was 15.2 months. Both tumor and edema volumes were significantly reduced by 78% and 82%, respectively, over 6-9 months after fGKS. Tumor volume decreased by ≥ 50% in 80.8% (n = 80) of lesions, with a median maximal reduction time of 3.3 months. Radiation necrosis occurred in 5.4% (n = 5) of patients. Within 6 months after fGKS, 45 patients showed neurological improvement, 36 remained stable, and 12 experienced neurological worsening. Systemic therapy was a significant prognostic factor for local PFS.</p><p><strong>Conclusion: </strong>fGKS could be recommended as an effective and safe primary treatment for large brain metastases.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e195"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873607","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":"The Validity and Reliability of the Mini-Mental State Examination-2 for Detecting Vascular Mild Cognitive Impairment and Vascular Dementia in a Korean Population.","authors":"Min Jae Baek, Young Ho Park, SangYun Kim","doi":"10.3346/jkms.2025.40.e207","DOIUrl":"10.3346/jkms.2025.40.e207","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the validity and reliability of the Mini-Mental State Examination, 2nd Edition (MMSE-2), as a cognitive screening tool for patients with vascular mild cognitive impairment (VaMCI) and vascular dementia (VD) in a Korean population. Specifically, we investigated whether the MMSE-2 effectively detects early cognitive changes associated with vascular cognitive impairment (VCI) that might be overlooked by the original Mini-Mental State Examination (MMSE).</p><p><strong>Methods: </strong>A total of 66 patients with VaMCI, 46 patients with VD, and 75 cognitively healthy older adults participated in this study. All participants provided informed consent and underwent assessments using the MMSE-2, the original MMSE, and a comprehensive neuropsychological test battery.</p><p><strong>Results: </strong>The MMSE-2 demonstrated robust performance in differentiating participants across Clinical Dementia Rating (CDR) stages and CDR-Sum of Boxes scores. It exhibited excellent internal consistency, high test-retest reliability, and strong interrater reliability. Concurrent validity with the original MMSE and other neuropsychological measures was also high. The MMSE-2 showed relatively high sensitivity and specificity in distinguishing normal cognitive aging, VaMCI, and VD.</p><p><strong>Conclusion: </strong>The MMSE-2 is a valid and reliable tool for assessing cognitive impairment in patients with VCI in a Korean population. While its specificity in differentiating VaMCI from healthy aging remains relatively modest, the MMSE-2 demonstrates superior sensitivity in detecting VaMCI compared to the original MMSE. These findings suggest that the MMSE-2 is a valuable screening instrument for identifying early cognitive changes associated with VCI.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e207"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873609","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":"A Medical Error of Saints Cosmas and Damian: Reflections on Fallibility and Medical Education From a Medieval Miracle.","authors":"Minso Kim, Ju-Hong Jeon","doi":"10.3346/jkms.2025.40.e229","DOIUrl":"10.3346/jkms.2025.40.e229","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e229"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873603","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":"Impact of Qualified Trauma Center Implementation on Mortality From Severe Trauma in Korea: A Retrospective Cohort Study.","authors":"Junsik Kwon, Myeonggyun Lee, Seoyoung Song, Sora Kim, Jonghwan Moon, Yo Huh, Kyoungwon Jung","doi":"10.3346/jkms.2025.40.e196","DOIUrl":"10.3346/jkms.2025.40.e196","url":null,"abstract":"<p><strong>Background: </strong>The Korean government and experts initiated a national trauma system development project in 2012. Its first major initiative was establishing and operating regional trauma centers across the country. We assessed whether the severity-adjusted mortality rates were lower in trauma centers compared with non-trauma centers and the specific benefits of trauma centers for patients with trauma.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed the data of patients with trauma registered in the National Emergency Department Information System from 2015 to 2019. Additionally, we used the Korean Trauma Data Bank and trauma center status data provided by the Ministry of Health and Welfare. We focused on patients with survival probabilities of < 0.5 according to the International Classification of Diseases Injury Severity Score, 9th Edition. The severity-adjusted mortality rates between the trauma centers and non-trauma centers were compared.</p><p><strong>Results: </strong>The 7 qualified trauma centers had notably more younger patients with penetrating injuries than the non-trauma centers. Patients admitted to the trauma centers had more critical vital signs and a higher incidence of reduced consciousness than those admitted to the non-trauma centers. After adjusting for severity, the in-hospital mortality rates were significantly lower in the trauma centers than in the non-trauma centers (16.9% vs. 18.2%; relative risk, 0.933; 95% confidence interval, 0.874-0.997). Patients in shock conditions had significantly lower mortality rates when treated in trauma centers. The disparity in cumulative mortality rates between the trauma centers and non-trauma centers was most pronounced 2 days post-admission.</p><p><strong>Conclusion: </strong>This study confirmed that the national project for establishing regional trauma centers effectively reduced mortality rates among severely injured patients.</p><p><strong>Trial registration: </strong>Clinical Research Information Service Identifier: KCT0009684.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e196"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873608","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 of Serum Vascular Endothelial Growth Factor-A With Pubertal Stage by Sex and Its Relationship With Precocious Puberty in Girls.","authors":"Hyo-Kyoung Nam, Young Jun Rhie, Kee-Hyoung Lee","doi":"10.3346/jkms.2025.40.e193","DOIUrl":"10.3346/jkms.2025.40.e193","url":null,"abstract":"<p><strong>Background: </strong>Vascular endothelial growth factor-A (VEGF-A) is essential for normal growth plate morphogenesis, including blood vessel invasion and cartilage remodeling. We assessed serum VEGF-A levels according to pubertal stage by sex and investigated their relationship with precocious puberty.</p><p><strong>Methods: </strong>Our study included 180 children aged 6-15 years (153 children with normal puberty [92 boys and 61 girls] and 27 girls with precocious puberty). Clinical and biochemical characteristics according to prepubertal stages were compared in boys and girls, respectively. Serum VEGF-A and leptin levels were performed across Tanner stages.</p><p><strong>Results: </strong>Mean VEGF-A levels were similar among boys and girls with normal puberty (433.7 ± 326.1 pg/mL vs. 483.9 ± 390.5 pg/mL). There was no significant difference in the VEGF-A levels between prepubertal and pubertal boys. VEGF-A levels were significantly higher in pubertal girls than in prepubertal girls (595.9 ± 405.4 pg/mL vs. 264.2 ± 138.0 pg/mL, <i>P</i> < 0.001) and were positively correlated with bone age advancement, Tanner stage, and estradiol level. There was no association between the VEGF-A levels and the body mass index standard deviation scores in either sex. VEGF-A levels were significantly higher in girls with precocious puberty than in prepubertal girls of the same age.</p><p><strong>Conclusion: </strong>Our study showed sex-related differences in VEGF-A levels according to the pubertal stage. Therefore, VEGF-A may be involved in the progression of precocious puberty.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e193"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873604","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":"Developing a Prediction Model for Suicidality Among COVID-19 Patients in Korea Using Timely Data From the National Center for Disaster and Trauma.","authors":"Hyejin Kim, Youngrong Lee, Euihyun Kwak, Dongkyu Lee, So Yeon Hyun, Kyungmin Kang, Minjae Son, Myungjae Baik, Jong-Woo Paik, Minyoung Sim, Sun Jae Jung","doi":"10.3346/jkms.2025.40.e192","DOIUrl":"10.3346/jkms.2025.40.e192","url":null,"abstract":"<p><strong>Background: </strong>To date, no study has developed a predictive model based on the timely data (diagnosed within a month) of patients with coronavirus disease 2019 (COVID-19). This study aimed to develop screening tools and a model for predicting suicidality based on data from patients diagnosed with COVID-19 within the past month.</p><p><strong>Methods: </strong>We analyzed data from 96,694 COVID-19 patients collected by the Korean National Center for Disaster and Trauma. Using classification and regression tree (CART) and random forest models, we predicted suicidality based on 39 features, including demographic information, COVID-19-related factors, and psychological symptoms such as depression, anxiety, somatic, and post-traumatic stress symptoms. Based on the final model with the highest performance index, we presented the results with a scorecard that includes multiple cut-off scores.</p><p><strong>Results: </strong>The area under curve was 0.71 for the CART model and 0.85 for the random forest model, with the sensitivity and specificity of the random forest model being 73.4% and 83.9%, respectively. The suicidality of COVID-19 patients was most strongly associated with suicidal ideation, fatigue, anticipatory anxiety, uncontrollable worrying, depressive mood, generalized worry, restlessness, changes in appetite, concentration problems, and feeling nervous.</p><p><strong>Conclusion: </strong>We developed a well-performing prediction model for suicidality among Korean COVID-19 patients and developed a scorecard to expand the feasibility of the model in public mental health practice.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e192"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>AKT1</i> Functional Polymorphism (rs2494750) Influences Clinical Outcomes in Patients With Advanced Lung Cancer Treated With EGFR Inhibitors.","authors":"Sun Ha Choi, Jin Eun Choi, Mi Jeong Hong, Jang Hyuck Lee, Hyo-Gyoung Kang, Sook Kyung Do, Won Kee Lee, Ji Eun Park, Yong Hoon Lee, Hyewon Seo, Jaehee Lee, Shin Yup Lee, Seung Ick Cha, Chang Ho Kim, Jae Yong Park, Seung Soo Yoo","doi":"10.3346/jkms.2025.40.e184","DOIUrl":"10.3346/jkms.2025.40.e184","url":null,"abstract":"<p><strong>Background: </strong>Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are the standard first-line treatment for patients with advanced lung cancer harboring activating <i>EGFR</i> mutations. This study aimed to investigate the association between genetic polymorphisms in the EGFR signaling pathway and clinical outcomes in patients receiving EGFR-TKI therapy.</p><p><strong>Methods: </strong>We enrolled 266 patients with advanced lung cancer treated with EGFR-TKIs and examined 30 putative functional polymorphisms across 11 genes involved in the EGFR signaling pathway. Associations between these polymorphisms and clinical outcomes were assessed.</p><p><strong>Results: </strong>Among the polymorphisms analyzed, <i>AKT1</i> rs2494750G>C was significantly associated with improved chemotherapy response (codominant model: odds ratio, 1.78; 95% confidence interval [CI], 1.05-2.99; <i>P</i> = 0.031) and prolonged progression-free survival (recessive model: hazard ratio, 0.62; 95% CI, 0.39-0.97; <i>P</i> = 0.037). In the luciferase reporter assays, the rs2494750C allele exhibited significantly lower promoter activity than the rs2494750G allele in H522 and A549 lung cancer cell lines (<i>P</i> = 0.033 and <i>P</i> < 0.001, respectively). AKT1 expression levels were also significantly reduced in individuals with the CC genotype compared to those with GG or GC genotypes (<i>P</i> = 0.034).</p><p><strong>Conclusion: </strong>The <i>AKT1</i> rs2494750G>C polymorphism reduces promoter activity and gene expression of AKT1, potentially contributing to improved clinical outcomes in patients with advanced lung cancer treated with EGFR-TKIs.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 31","pages":"e184"},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835321","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 11-August-2025.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e228","DOIUrl":"10.3346/jkms.2025.40.e228","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 31","pages":"e228"},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835325","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":"Occupational Risk Factors for Kidney Disease: A Comprehensive Review.","authors":"Min Young Park, Mo-Yeol Kang","doi":"10.3346/jkms.2025.40.e224","DOIUrl":"10.3346/jkms.2025.40.e224","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a major global health concern, with traditional risk factors such as diabetes and hypertension well established. However, emerging evidence suggests that occupational exposures could play a significant role in CKD development. This review comprehensively summarizes the current evidence concerning occupational risk factors contributing to kidney disease, including exposure to heavy metals (lead, cadmium, mercury, chromium), organic solvents (trichloroethylene, methanol, ethylene glycol), heat stress, and job-related stress factors (occupational stress, long working hours, shift work). Epidemiological studies indicate that nephrotoxic agents contribute to renal dysfunction through oxidative stress, mitochondrial damage, and impaired ion transport. Industries such as manufacturing, agriculture, and mining pose particularly high risks due to hazardous exposures. While strong evidence links nephrotoxic metals and solvents to early renal dysfunction, the long-term effects of chronic low-dose exposure remain unclear. Additionally, heat stress-related CKD, particularly Meso-American nephropathy, highlights the growing concern of climate-related occupational risks. Job-related stress factors, including long working hours and shift work, may further accelerate CKD progression through stress-induced hypertension and metabolic disturbances. Given the substantial public health implications, preventive strategies should focus on reducing workplace exposures, implementing heat stress management programs, and addressing the impact of job-related stress factors.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 31","pages":"e224"},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835326","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}