Journal of Korean Medical Science最新文献

{"title":"National Wastewater Surveillance of SARS-CoV-2 Across Provinces and Regions in the Republic of Korea From January to August 2023.","authors":"You-Jung Choi, Lan Hee Kim, Jinhwa Jang, Shin Young Park, Sejin Jeong, Sungpyo Kim, Sangwon Lee, Seong-Sun Kim","doi":"10.3346/jkms.2025.40.e94","DOIUrl":"10.3346/jkms.2025.40.e94","url":null,"abstract":"<p><strong>Background: </strong>Wastewater surveillance (WS) technology has gained significant attention in many countries due to its role in the monitoring of infectious diseases within communities and complementing clinical testing to prevent coronavirus disease 2019 (COVID-19) outbreaks. In 2023, the Korea Disease Control and Prevention Agency (KDCA) launched the Korea Wastewater Surveillance (KOWAS) project in collaboration with 17 cities and provinces to track COVID-19 outbreaks.</p><p><strong>Methods: </strong>From January to August 2023, the concentrations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) E gene in wastewater were monitored in 19 institutes of health and environmental research, all within local governments. Influent samples were collected from 62 wastewater treatment plants (WWTPs) and weekly trends in SARS-CoV-2 E gene concentrations in wastewater were compared to those of new COVID-19 cases.</p><p><strong>Results: </strong>During 34 weeks, the concentration of SARS-CoV-2 in wastewater samples closely mirrored the trends in new COVID-19 cases, showing the effectiveness of WS in detecting the presence of the virus. However, the efficacy of the WS method varied between provinces. Although some provinces showed a significant positive correlation between new COVID-19 cases and SARS-CoV-2 E gene concentrations in wastewater, this correlation was inconsistent between all locations. However, when data were analyzed on a broader regional scale, defined as a grouping of multiple provinces, a higher proportion of regions showed significant correlations. This suggests that analyzing WS data on a broader scale, with larger aggregated populations and higher coverage rates, reduces the influence of local variabilities, such as the proportion of combined sewer types, WWTPs coverage rate, and foot traffic, which may affect alignment at the provincial level.</p><p><strong>Conclusion: </strong>The synchrony between trends in SARS-CoV-2 E gene concentrations in wastewater and new COVID-19 cases highlights the effectiveness of KOWAS in tracking new clinical cases. However, measured SARS-CoV-2 RNA concentrations can be affected by socioenvironmental factors (e.g., WWTP treatment capacity, sewer pipeline distances, and coverage populations). Further refinement will involve expanding the surveillance network to include additional WWTPs and a more comprehensive range of monitoring targets.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 30","pages":"e94"},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784541","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":"Global, Regional, and National Burden of Pharyngeal Cancer and Projections to 2050 in 185 Countries: A Population-Based Systematic Analysis of GLOBOCAN 2022.","authors":"Wonwoo Jang, Seokjun Kim, Yejun Son, Soeun Kim, Sooji Lee, Hyeon Jin Kim, Hyesu Jo, Jaeyu Park, Kyeongmin Lee, Hayeon Lee, Masoud Rahmati, Selin Woo, Jiyoung Hwang, Jiseung Kang, Lee Smith, Dong Keon Yon","doi":"10.3346/jkms.2025.40.e177","DOIUrl":"10.3346/jkms.2025.40.e177","url":null,"abstract":"<p><strong>Background: </strong>Pharyngeal cancer has resulted in 3.23 million disability-adjusted life years as of 2019. Based on anatomical site, pharyngeal cancers are categorized into oropharyngeal cancers (OPCs), nasopharyngeal cancers (NPCs), and hypopharyngeal cancers (HPCs). The spatiotemporal distribution of each pharyngeal cancer is related to their respective risk factors.</p><p><strong>Methods: </strong>Using the latest updated GLOBOCAN 2022 and Cancer Incidence in Five Continents database, global, regional, and national age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) of pharyngeal cancer by anatomical site, as well as longitudinal trends since 1998 and future projections to 2050 were investigated across 185 countries and territories. We employed joinpoint regression to assess the average annual percentage change to quantify trends in the ASIR of pharyngeal cancer. We additionally present the mortality-to-incidence ratio as an indicator of disease fatality.</p><p><strong>Results: </strong>In 2022, an estimated 313,091 people were diagnosed with pharyngeal cancer (ASIR, 3.3 per 100,000 person-years) and 166,689 people died from pharyngeal cancer worldwide (ASMR, 1.7 per 100,000 person-years). Regardless of an individual's age and anatomical site, pharyngeal cancer exhibits significantly higher incidence and mortality rates in old males, and the highest number of cases and deaths occur in individuals aged 45-59 years in both sexes. The highest ASIRs per 100,000 person-years were found in Western Europe (2.6) and Northern America (2.6) for OPC, South-Eastern Asia (4.7) for NPCs, South Central Asia (2.1) and Eastern Europe (1.5) for HPC. ASMR per 100,000 person-years were higher for OPC and HPC in Eastern Europe (OPC, 1.1; HPC, 1.0), South Central Asia (OPC, 0.9; HPC, 0.8), and for NPC in South-Eastern Asia (3.1), and Micronesia (2.1). In most countries, the incidence of OPC either increased or remained at a similar level, and NPC remained stable in most countries and HPC decreased or remained unchanged in both sexes. If the ASIR and ASMR of 2022 are maintained, in 2050, the projected number of cases will increase by 63.64% for OPC, 46.40% for NPC, and 64.23% for HPC.</p><p><strong>Conclusion: </strong>Pharyngeal cancer represents a significant burden on global public health, with its disease burden varying across different demographic variables. These variations were closely associated with risk factors such as tobacco and alcohol use, high-risk human papillomavirus, and Epstein-Barr virus infections. To effectively manage the current and future global burden, tailored interventions aligned with unique epidemiological profiles of pharyngeal cancer in diverse populations are required.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 30","pages":"e177"},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784539","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":"Using a Graft Arrival Time Estimation Formula Decreases Operation Time in Transplantation From Deceased Donor.","authors":"Dae Kyun Ryu, Ja Eun Lee, SoRa Cha, Gaab Soo Kim","doi":"10.3346/jkms.2025.40.e175","DOIUrl":"10.3346/jkms.2025.40.e175","url":null,"abstract":"<p><strong>Background: </strong>Prolonged operation time is a risk factor for negative clinical outcomes in deceased donor transplantation. Implementing a graft arrival time estimation formula to facilitate communication among the transplantation team and to determine the start time for deceased donor liver transplantation (LT) or kidney transplantation (KT) may help reduce operation time.</p><p><strong>Methods: </strong>This was a single-center retrospective study reviewing adult deceased donor LT or KT recipients. Cases between January 2017 and August 2018 were categorized as the pre-formula group, while those between September 2019 and July 2021 were categorized as the formula group. The operation time and the cold ischemic time were compared between the two groups.</p><p><strong>Results: </strong>Out of 336 recipients reviewed, 227 cases were included in the analysis. In LT, the operation time and the time from anesthesia induction to the start of the anhepatic phase were significantly shorter in the formula group than in the pre-formula group. In KT, the operation time and the time from anesthesia induction to graft insertion were significantly shorter in the formula group than in the pre-formula group. Cold ischemic time in both LT and KT did not differ between the two groups.</p><p><strong>Conclusion: </strong>Using a graft arrival time estimation formula to facilitate communication may reduce operation time for deceased donor LT and KT.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 30","pages":"e175"},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784544","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 in Preventable Trauma Death Rates in Korea: A Follow-up Study of the Trauma System's Performance.","authors":"Byung Hee Kang, Kyoungwon Jung, Jonghwan Moon, Junsik Kwon, Yo Huh, Seoyoung Song, Sora Kim, Yo Han Lee, Eun Hae Lee, Won Pyo Hong, Borami Lim, Seunghyeon Yoo, Chan Yong Park, Byungchul Yu, Hangjoo Cho, Younghwan Kim, Young Sun Ro, Jeong Ho Park, Tae Seok Jeong","doi":"10.3346/jkms.2025.40.e165","DOIUrl":"10.3346/jkms.2025.40.e165","url":null,"abstract":"<p><strong>Background: </strong>The preventable trauma death rate (PTDR) is a key measure of trauma system performance. This study, the fourth follow-up since the implementation of trauma centers in South Korea, aimed to evaluate trends in PTDR and assess the mid-term performance of the trauma system. The study utilized consistent methods with previous analyses to ensure comparability and continuity.</p><p><strong>Methods: </strong>A total of 8,490 trauma deaths occurred in 2021, and 1,688 patients from 265 medical institutions were included in the study. A multidisciplinary panel review was conducted to assess the preventability of mortality and identify opportunities for improvement. The results were compared with those from previous studies on the PTDR.</p><p><strong>Results: </strong>Of the 1,688 sampled patients, the PTDR was calculated for 929. The overall PTDR was estimated at 13.9%, with a definitive preventable death rate of 2.9% and a potentially preventable death rate of 12.7%. The reduction in PTDR was not statistically significant compared to the 2019 study, which reported a rate of 15.7% (<i>P</i> = 0.261). Significant differences were observed between the preventable and non-preventable groups in terms of age, timing of death, level of medical institution, inter-hospital transfer, means of hospital admission, and time from accident to death.</p><p><strong>Conclusion: </strong>In 2021, the PTDR was 13.9%, showing a slight reduction compared to the 2019 study. This study primarily evaluated the performance of Korea's trauma system, with findings highlighting both progress and persistent challenges. Although the study was conducted during the coronavirus disease 2019 pandemic, its potential indirect impact on trauma care is acknowledged as an area for further research. Addressing systemic limitations remains essential for further reducing preventable trauma deaths.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e165"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731760","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":"Interpersonal Constructs in the Mediation of Early Maladaptive Schemas and Suicidal Ideation Among Outpatients With Major Depressive Disorder.","authors":"Jong Yoon Ko, C Hyung Keun Park","doi":"10.3346/jkms.2025.40.e173","DOIUrl":"10.3346/jkms.2025.40.e173","url":null,"abstract":"<p><strong>Background: </strong>Four early maladaptive schemas (EMSs) are known to increase suicidal ideation: defectiveness/shame, social isolation/alienation, failure, and dependence/incompetence. However, no mechanisms through which EMSs may increase suicidal ideation have been studied. We aimed to examine important mechanisms that may underlie the association between specific EMSs related to heightened suicidal ideation (defectiveness/shame, social isolation/alienation, failure, and dependence/incompetence) and present suicidal ideation in outpatients with major depressive disorder (MDD) through 2 interpersonal constructs: perceived burdensomeness and thwarted belongingness.</p><p><strong>Methods: </strong>We conducted parallel mediation analysis for 247 outpatients with MDD to test the hypothesis that each of the four EMSs would exhibit positive correlations with suicidal ideation, while perceived burdensomeness and thwarted belongingness would concurrently mediate these associations.</p><p><strong>Results: </strong>Perceived burdensomeness and thwarted belongingness fully mediated the associations between early maladaptive schemas and suicidal ideation, with significant total indirect effects for defectiveness/shame schema (95% confidence interval [CI], 0.28-0.47; B = 0.38), social isolation schema (95% CI, 0.27-0.48; B = 0.37), failure schema (95% CI, 0.25-0.41; B = 0.33), and dependence/incompetence schema (95% CI, 0.23-0.40; B = 0.31), after controlling for age and sex.</p><p><strong>Conclusion: </strong>Through greater perceived burdensomeness and thwarted belongingness, outpatients with MDD with higher levels of the schemas previously known to be associated with elevated suicidal ideation were likely to exhibit a more severe level of current suicidal ideation. These findings highlight the potential benefits of including components that can reduce the severity of both interpersonal constructs in antisuicidal strategies.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e173"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731758","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 in Incidences, Treatments and Outcomes of Spontaneous Subarachnoid Hemorrhage in Korea Between 2002 and 2022.","authors":"Jinju Park, Ji Yoon Baek, Sung Ho Lee, Keun-Hwa Jung, Hae-Young Lee, Aesun Shin, Won-Sang Cho","doi":"10.3346/jkms.2025.40.e171","DOIUrl":"10.3346/jkms.2025.40.e171","url":null,"abstract":"<p><strong>Background: </strong>Access to equitable care for severely emergent diseases serves as a key indicator for evaluating the performance of a country's health care system. The aim of this study was to examine trends in the incidence, treatment and outcomes of patients with spontaneous subarachnoid hemorrhage (SAH) using Korean national claims data.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a cohort of inpatients with spontaneous SAH from 2002 to 2022, utilizing data from the Korean National Health Insurance Service. The primary outcomes assessed were fatalities within 30 and 90 days from the index date of hospitalization.</p><p><strong>Results: </strong>While the crude incidence rate has remained constant, the age-standardized incidence rate (ASR) has decreased from 22.0 per 100,000 in 2002 to 12.5 per 100,000 in 2022. The regions with the highest incidence rates were Gyeonggi (29,833 cases, 21.0%) and Seoul (26,484, 18.7%). In 2002, 59.6% of all patients received major treatments within 48 hours of admission, with a distribution of 68.4% in tertiary hospitals and 30.7% in secondary hospitals. By 2022, the proportion of patients receiving major treatment had increased to 71.9%, with 42.3% in tertiary hospitals and 57.5% in secondary hospitals. Endovascular coiling surpassed surgical clipping as the predominant treatment modality between 2013 and 2014. On average, 70.1% of treated patients received care within their area of residence, with the highest rates in Daegu (92.9%), Gwangju (91.4%) and Busan (90.1%) and the lowest in Jeonnam (14.2%). From 2002 to 2019, the 30-day and 90-day fatality rates declined from 21.2% to 19.2% and from 24.4% to 21.3%, respectively, whereas these rates gradually increased after 2020.</p><p><strong>Conclusion: </strong>The total number of patients with spontaneous SAH remained relatively constant, whereas both the ASR and overall crude fatality rate declined. A national shift in treatment modalities was observed, with coiling surpassing clipping and admissions to secondary hospitals exceeding those to tertiary hospitals. Regional disparities in health care utilization were identified, highlighting the need for a locally accountable health care system in health care policy.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e171"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731759","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":"Global Cost of Silencing Science: Editors and Publishers Have a Duty to Resist.","authors":"Frank Frizelle, Kamran Abbasi, Vivienne Bachelet, Christopher Baethge, Sabine Kleinbert, Jin-Hong Yoo, Lilia Zakhama","doi":"10.3346/jkms.2025.40.e216","DOIUrl":"10.3346/jkms.2025.40.e216","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e216"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731757","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":"Difference in Lymphocyte Subset Counts According to Disease Severity and SARS-CoV-2 Variants of Hospitalized COVID-19 Patients in Korea.","authors":"Heayeon Lee, Bora Lee, Sei Won Kim, Chang Dong Yeo, Sang Haak Lee, Jihyang Lim","doi":"10.3346/jkms.2025.40.e172","DOIUrl":"10.3346/jkms.2025.40.e172","url":null,"abstract":"<p><strong>Background: </strong>The studies about the characteristics of immune systems and lymphocyte subset counts regarding coronavirus disease 2019 (COVID-19) have been conducted in a number of ways, however studies on the difference of lymphocyte subset counts according to each severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant are rare. As each country has a different quarantine system, it is necessary to investigate the characteristics in places such as South Korea where the vaccination rate is high and a thorough national quarantine system is being operated. The aim of this study was to investigate the difference in peripheral blood lymphocyte subset counts in COVID-19 patients in South Korea according to their disease severity and SARS-CoV-2 variants.</p><p><strong>Methods: </strong>A total of 148 hospitalized COVID-19 patients enrolled in this study at Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea. SARS-CoV-2 infection was confirmed using real-time quantitative polymerase chain reaction and COVID-19 severity was divided into three groups (mild, moderate, and severe) at the time of admission, according to the treatment types of oxygen support. Laboratory tests were performed for evaluation of inflammatory status. The peripheral lymphocyte subset counts were analyzed using flow cytometry at the time of admission in all 148 patients and after treatment in 65 patients with moderate or severe severity. We analyzed the changes of peripheral lymphocyte subset counts according to three COVID-19 severity groups and three SARS-CoV-2 variants (wild and alpha, delta and omicron variants).</p><p><strong>Results: </strong>At admission, total T, CD4+ T, CD8+ T, natural killer (NK), and NKT cell counts decreased, but B cells did not change significantly depending on severity. There were markedly decreased in total T, CD4+ T, CD8+ T, and NK cells in the delta and omicron variants and not in the wild and alpha variant. After treatment in patients with moderate or severe severity, most lymphocyte subset counts were increased except the NK cells. Lower total lymphocyte counts, especially total T lymphocyte counts were associated with a higher occurrence of severe COVID-19.</p><p><strong>Conclusion: </strong>The peripheral lymphocyte subset counts decreased according to disease severity and the types of SARS-CoV-2 variants in hospitalized COVID-19 patients. Despite the efficient operation of the national quarantine system and high vaccination rates in South Korea, it suggests that viral mutations evolve in a direction that further weakens the immune system. This is the only study on the difference in peripheral lymphocyte subset counts according to COVID-19 severity and SARS-CoV-2 variants conducted in South Korea, and therefore our data could be used as an important reference for another pandemic situation in the future.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e172"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731812","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":"Voxel-Based Morphometric Analysis of the Mini-Mental State Examination and the Mini-Mental State Examination-2 in Patients With Mild Cognitive Impairment and Alzheimer's Disease in Korea.","authors":"Min Jae Baek, Jae-Won Jang, Young Ho Park, SangYun Kim","doi":"10.3346/jkms.2025.40.e167","DOIUrl":"10.3346/jkms.2025.40.e167","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association between the Mini-Mental State Examination-2 (MMSE-2) and the Korean version of the Mini-Mental State Examination (K-MMSE) scores with global cortical gray matter volume changes in healthy older adults, patients with mild cognitive impairment (MCI), and Alzheimer's Disease (AD) in Korea. Using voxel-based morphometry analysis of structural magnetic resonance imaging (MRI), we explored how these correlations evolve with the progression of cognitive impairment. Additionally, we identified brain regions linked to the newly added components of MMSE-2, such as story memory and processing speed.</p><p><strong>Methods: </strong>A total of 22 patients with MCI, 11 patients with AD, and 10 healthy controls were enrolled based on a comprehensive neuropsychological assessment. All participants underwent brain MRI within six months of completing both the MMSE-2 and K-MMSE. MRI data were acquired using T1-weighted three-dimensional spoiled gradient echo sequences on a Philips Intera Achieva 3.0T scanner. Image preprocessing and analysis were conducted using MATLAB and Statistical Parametric Mapping (SPM5). Multiple regression analysis was performed to compare gray matter volumes across groups, with adjustments for age and education. Statistical significance was set at <i>P</i> = 0.005 with a voxel threshold of 100, and brain atrophy regions were identified using Talairach Client 2.4.2.</p><p><strong>Results: </strong>MMSE-2 scores demonstrated stronger and more extensive correlations with gray matter volume than K-MMSE scores. Specifically, MMSE-2: Brief Version was associated with the left fusiform gyrus and left inferior temporal gyri, while MMSE-2: Standard Version extended its correlations to include regions such as the hippocampus. Notably, MMSE-2: Expanded Version (EV) exhibited the most robust and widespread associations, involving frontal, temporal, and occipital regions. In contrast, K-MMSE scores showed more limited regional correlations, primarily focusing on the fusiform gyrus, hippocampus, and cuneus.</p><p><strong>Conclusion: </strong>The MMSE-2 demonstrated broader and stronger associations with cortical gray matter volume compared to the K-MMSE. In particular, MMSE-2:EV emerged as a more effective cognitive screening tool in clinical settings due to its widespread correlations across key brain regions, including the frontal lobe-a region inadequately assessed by the K-MMSE. These findings highlight the enhanced sensitivity of MMSE-2 in detecting structural brain changes associated with cognitive decline.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e167"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731761","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":"Exploring Strategies to Improve Outcomes in Patients With Giant Cell Myocarditis: A Case Series of Five Biopsy-Proven Cases.","authors":"Minjung Bak, Jinyoung Lee, Minseok Hong, Darae Kim, Jin-Oh Choi, Jung-Sun Kim, Jeong Hoon Yang","doi":"10.3346/jkms.2025.40.e221","DOIUrl":"10.3346/jkms.2025.40.e221","url":null,"abstract":"<p><p>Giant cell myocarditis (GCM) is a rare but severe disease with high morbidity and mortality, often requiring heart transplantation (HT). While immunosuppressive therapy has improved outcomes, recurrence after HT remains high, and long-term survival without transplantation is also limited. This case series presents five biopsy-confirmed GCM cases, highlighting clinical characteristics and strategies to improve prognosis. A retrospective analysis was conducted on five GCM patients at Samsung Medical Center (2004-2024). The median age was 57.8 years, and 40% had underlying autoimmune diseases. All patients presented with fulminant heart failure, requiring vasopressor support or mechanical circulatory support (MCS). Early diagnosis facilitated targeted therapy, improving outcomes in select cases. Two patients achieved long-term survival without recurrence. One patient recovered cardiac function and avoided in-hospital mortality but was later readmitted due to infection and subsequently died. The remaining two patients underwent HT but died during hospitalization due to post HT complications. Timely histologic confirmation, early immunosuppressive therapy, and appropriate MCS bridging are critical in GCM management. Larger studies are needed to validate these findings.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 29","pages":"e221"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731756","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}