Yonsei Medical Journal最新文献

A Novel Sarcopenia Screening Approach Using an Osteoporosis-Inspired T-Score Method. 一种使用骨质疏松启发t评分法筛查骨骼肌减少症的新方法。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0537

Hyun Sik Kim, Choon Hee Chung, Jung Woo Lee

{"title":"A Novel Sarcopenia Screening Approach Using an Osteoporosis-Inspired T-Score Method.","authors":"Hyun Sik Kim, Choon Hee Chung, Jung Woo Lee","doi":"10.3349/ymj.2024.0537","DOIUrl":"10.3349/ymj.2024.0537","url":null,"abstract":"Purpose: Sarcopenia is characterized by reduced muscle mass, strength, and impaired physical function, and it requires effective indicators for early detection. This study introduces a novel screening method using the expected muscle functionality (eMF) indicator and an osteoporosis-inspired T-score.Materials and methods: The model was developed using 4052 individuals from the Korea National Health and Nutrition Examination Survey (KNHANES) and validated with 888 individuals from the Korean Genome and Epidemiology Study (KoGES). eMF was calculated using logistic regression based on grip strength, body mass index (BMI), waist circumference, and age. The T-score was derived by standardizing eMF against the mean and standard deviation of young adults (aged 20-29 years). The T-score cut-off values were determined at the intersection of kernel density estimation plots, set at -1.1 for men and -1.8 for women. Sarcopenia was diagnosed in individuals below these cutoffs.Results: Performance metrics were calculated based on sarcopenia defined using cutoff values of grip strength and muscle mass. The model demonstrated reliable performance, with sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve of 0.900, 0.889, 0.890, and 0.932, respectively. False negatives exhibited clinical characteristics similar to sarcopenic obesity, while false positives resembled possible sarcopenia.Conclusion: The eMF-based indicator offers a significant improvement in sarcopenia screening, enabling more accurate identification and supporting early detection and management of the condition, ultimately enhancing patient outcomes and healthcare delivery.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"647-656"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Influencing Indoor Xylene Concentrations and Biomarkers in the General Population Based on the 2020-2021 KNHANES. 基于2020-2021年KNHANES的普通人群室内二甲苯浓度和生物标志物的影响因素

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0456

Mi-Ji Kim, SangJin Park, Ahra Kim, Joo Hyun Sung

{"title":"Factors Influencing Indoor Xylene Concentrations and Biomarkers in the General Population Based on the 2020-2021 KNHANES.","authors":"Mi-Ji Kim, SangJin Park, Ahra Kim, Joo Hyun Sung","doi":"10.3349/ymj.2024.0456","DOIUrl":"10.3349/ymj.2024.0456","url":null,"abstract":"Purpose: Xylene, a widely used aromatic hydrocarbon, is associated with various health concerns due to its industrial and environmental exposure. While recent studies have raised concerns about its health effects on the general population, research on factors influencing xylene exposure in non-industrial settings remains limited. In this study, we aimed to analyze factors affecting indoor xylene concentrations and biomarkers in the general population using data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES).Materials and methods: We analyzed the data of 1098 participants who completed indoor air quality and biomarker testing within 1 month and had no liver or kidney disease. Environmental and individual factors were analyzed, and logistic regression was performed to identify determinants of indoor xylene concentrations and xylene biomarkers.Results: Environmental factors such as building age within 5 years, recent house repairs within 6 months, and the use of air cleaners or air fresheners were significantly associated with higher indoor xylene concentrations. Among individual factors, high-risk occupations for xylene exposure, such as agricultural or fishery workers, machine operators, functional or assembly workers, and simple laborers, were associated with increased biomarker levels. Additionally, smoking status and body mass index were associated with xylene biomarkers.Conclusion: This study identified key environmental and individual factors influencing xylene exposure in the general population. These findings highlight the importance of mitigating exposure risks through targeted interventions and the need for further research to reduce the potential health effects of xylene exposure.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"703-712"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Foveal Serous Retinal Detachment with Inferior Staphyloma: Long-Term Treatment Response to Anti-VEGF and Photodynamic Therapy. 中央凹浆液性视网膜脱离伴下葡萄肿：抗vegf和光动力疗法的长期治疗反应。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0220

Jae Won Jun, Soyoung Jeon, Goeun Park, Hyun Goo Kang, Christopher Seungkyu Lee, Min Kim, Sung Soo Kim, Suk Ho Byeon, Junwon Lee

{"title":"Foveal Serous Retinal Detachment with Inferior Staphyloma: Long-Term Treatment Response to Anti-VEGF and Photodynamic Therapy.","authors":"Jae Won Jun, Soyoung Jeon, Goeun Park, Hyun Goo Kang, Christopher Seungkyu Lee, Min Kim, Sung Soo Kim, Suk Ho Byeon, Junwon Lee","doi":"10.3349/ymj.2024.0220","DOIUrl":"10.3349/ymj.2024.0220","url":null,"abstract":"Purpose: To evaluate the treatment response and long-term prognosis of foveal serous retinal detachment (SRD) associated with inferior staphyloma to anti-vascular endothelial growth factor (anti-VEGF) treatment and photodynamic therapy (PDT).Materials and methods: Treatment-naïve patients who underwent >24 months of follow-up were included. We analyzed inter-visit changes in the foveal subretinal fluid (SRF) height after anti-VEGF treatment or PDT compared to no treatment and long-term prognosis of best-corrected visual acuity in choroidal neovascularization (CNV)-free patients.Results: Nineteen patients were enrolled, and the mean follow-up duration was 4.81 years. In 14 CNV-free patients, 11 received anti-VEGF injections, three patients underwent PDT, and two patients had both treatments. During the follow-up period, there were a total of 243 inter-visit events (88 injections and 155 observations without treatment). At the last visit of patients who received the treatment, complete resolution was more significantly achieved in the CNV group than in the CNV-free group (p=0.028). In CNV-free patients, visual acuity improved when complete resolution was achieved; otherwise, it generally decreased. After adjusting for confounding factors, analyses showed no statistically significant differences in inter-visit changes of foveal SRF height between the anti-VEGF treatment and no treatment cases (absolute value, rate, subgroup categorized as ±20% of change; p=0.733, p=0.916, p=0.277; respectively). All patients who underwent PDT did not show complete resolution or maintained improvement of SRF.Conclusion: Treatment with anti-VEGF and PDT do not seem to be effective for foveal SRD of CNV-free inferior staphyloma.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"666-674"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Usefulness of a Multigene Testing in Patients with Special Histologic Type Breast Cancer. 多基因检测在特殊组织学类型乳腺癌患者中的临床应用

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0408

Suk Jun Lee, Jung Min Park, Jee Hyun Ahn, Chan Seok Yoon, Seho Park

{"title":"Clinical Usefulness of a Multigene Testing in Patients with Special Histologic Type Breast Cancer.","authors":"Suk Jun Lee, Jung Min Park, Jee Hyun Ahn, Chan Seok Yoon, Seho Park","doi":"10.3349/ymj.2024.0408","DOIUrl":"10.3349/ymj.2024.0408","url":null,"abstract":"Purpose: Rare special histologic types of breast cancer usually show a favorable prognosis but often has atypical features. Multigene tests (MGTs) in patients with special types of breast cancer have not been well studied. Therefore, we aimed to examine the association between MGTs and histopathology and to evaluate the prognosis of MGTs in patients with special types of breast cancer.Materials and methods: A total of 133 patients with special histologic types of breast cancer who underwent MGTs were selected from two institutions from 2013 to 2022. Special types were divided into favorable and unfavorable groups. The patients' clinicopathological characteristics and MGT results were compared, and disease-free survival (DFS) was analyzed.Results: The unfavorable group consisted of 76 (57.1%) patients and included more older patients, multiple tumors, grade II/III tumors, high-risk MGT results, and chemotherapy administration. High-risk MGTs were found in 16.5% of the total cohort. The unfavorable type tended to have high-risk MGTs, but multivariate analysis demonstrated that grade II/III tumors, low progesterone receptor expression, and high Ki-67 levels were associated with high-risk MGTs in special type breast carcinomas. MGTs were significantly associated with DFS, particularly in the unfavorable subgroup, in which no recurrence occurred among patients with low-risk MGTs.Conclusion: Unfavorable special types of breast cancer were more likely to have high-risk MGTs. The MGT result was a significant prognostic factor and could support decision-making for adjuvant therapies in patients with special histologic types of breast cancer.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"630-636"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tinnitus Subtyping and Personalized Treatment via Audiometric and Psychometric Clustering. 耳鸣分型与个体化治疗。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2025.0088

Su Jin Kim, Seung-Ho Shin, Sung Wan Byun, Ho Yun Lee

{"title":"Tinnitus Subtyping and Personalized Treatment via Audiometric and Psychometric Clustering.","authors":"Su Jin Kim, Seung-Ho Shin, Sung Wan Byun, Ho Yun Lee","doi":"10.3349/ymj.2025.0088","DOIUrl":"10.3349/ymj.2025.0088","url":null,"abstract":"Purpose: We aimed to identify distinct tinnitus subtypes and determine optimal treatment approaches based on comprehensive audiometric and psychometric assessments.Materials and methods: Cluster analysis was performed on data from 311 tinnitus patients. Assessments included pure tone average (PTA), uncomfortable loudness levels, Tinnitus Handicap Inventory (THI), visual analog scales for subjective symptoms, Beck Depression Inventory (BDI), and Beck Anxiety Inventory. K-means clustering identified three distinct tinnitus subtypes. Multiple regression analyses were conducted to identify predictors of treatment response.Results: Three distinct subtypes were identified: Cluster 1 (41.8%, n=130): severe tinnitus with normal hearing (THI=61.2±20.6, PTA_R=14.7±8.1 dB); Cluster 2 (20.9%, n=65): hearing loss-dominant tinnitus (THI=53.6±22.4, PTA_R=35.4±15.9 dB); Cluster 3 (37.3%, n=116): mild psychosomatic tinnitus (THI=30.1±18.5, PTA_R=13.8±9.1 dB). Treatment efficacy varied significantly by cluster (p<0.01), with diuretics most effective for Cluster 1 (36.2±38.8% improvement), baclofen for Cluster 2 (41.4±39.7%), and Indenol for Cluster 3 (39.5±35.8%). Hearing aids benefited Cluster 2 (26.0±35.7%) but were detrimental in Clusters 1 and 3. Initial THI score predicted improvement in Cluster 1 (β=1.45, p<0.001) and approached significance in Cluster 2 (β=1.67, p=0.081), while BDI was significant in Cluster 3 (β=-7.76, p=0.030).Conclusion: We confirmed tinnitus heterogeneity with three distinct subtypes showing differential treatment responses. Audiometric testing provides objective criteria for patient classification and treatment selection. A precision medicine approach with cluster-specific strategies may improve tinnitus management.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"685-694"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hearing Rehabilitation with Osia^®2 in Patients with Bonebridge^® Failure. Osia®2在骨桥失败患者中的听力康复

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0437

Ji Min Yun, Yunbin Nam, Gerard Lapina, In Seok Moon

{"title":"Hearing Rehabilitation with Osia®2 in Patients with Bonebridge® Failure.","authors":"Ji Min Yun, Yunbin Nam, Gerard Lapina, In Seok Moon","doi":"10.3349/ymj.2024.0437","DOIUrl":"10.3349/ymj.2024.0437","url":null,"abstract":"Purpose: This study aimed to compare the clinical performance and patient satisfaction of the Osia®2 system with the Bonebridge® system in patients requiring reimplantation owing to Bonebridge® device malfunction.Materials and methods: A retrospective chart review was conducted on seven patients who initially received Bonebridge® and subsequently underwent reimplantation with Osia®2 following device failure. Audiological outcomes were evaluated using pure tone audiometry and the Korean Hearing in Noise Test. Subjective outcomes were assessed with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Speech, Spatial and Qualities of Hearing Scale (SSQ).Results: Osia®2 provided greater low-frequency gain and comparable high-frequency gain compared to Bonebridge®. The median hearing gain with Osia®2 was 60.0 dB (interquartile range, 48.75-83.0), consistent with previous findings for this model and higher than those reported for the earlier Osia® model. Patient questionnaires indicated significant improvements in APHAB and SSQ scores with Osia®2 compared to both unaided and Bonebridge®-aided conditions.Conclusion: The Osia®2 system demonstrated audiological outcomes and patient satisfaction comparable to the Bonebridge® system in this reimplantation cohort. Osia®2 may be a favorable option for patients with conductive or mixed hearing loss or single-sided deafness, pending further studies on long-term device reliability.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"695-702"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Positive Relationships between Intraocular Pressure and Thyroid Function in Graves' Ophthalmopathy: A Three-Aspect Evidence Analysis. Graves眼病患者眼压与甲状腺功能正相关：三方面证据分析。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0468

Wenhua Zhang, Feng Zhang, Ziyi Zhu, Jiamin Cao, Wei Xiong

{"title":"Positive Relationships between Intraocular Pressure and Thyroid Function in Graves' Ophthalmopathy: A Three-Aspect Evidence Analysis.","authors":"Wenhua Zhang, Feng Zhang, Ziyi Zhu, Jiamin Cao, Wei Xiong","doi":"10.3349/ymj.2024.0468","DOIUrl":"10.3349/ymj.2024.0468","url":null,"abstract":"Purpose: High intraocular pressure (IOP) is a frequent clinical manifestation of Graves' ophthalmopathy (GO), but little is known about the mechanism by which thyroid function alters IOP in GO.Materials and methods: The relationships between IOP and clinical manifestations of GO were determined by simple linear correlation analysis and the Kruskal-Wallis test. Factors significantly associated with changes in IOP were evaluated by multiple linear regression analysis. The relationships between IOP and thyroid function were verified using data from the National Health and Nutrition Examination Survey, and causative relationships between thyroid function and IOP were assessed using summary-data-based Mendelian randomization analysis. Gene expression was compared in patients with and without GO using analysis of a Gene Expression Omnibus dataset, and associated GO pathways were identified.Results: Clinical data were obtained from 392 hospitalizations of 270 patients, including 142 hospitalizations with increased IOP and 250 with normal IOP. IOP was linearly associated with GO duration, clinical activity score (CAS), and concentrations of free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin receptor antibodies. Multiple linear regression analysis yielded a model including CAS, FT3 concentration, and sex (r=0.46). Analysis of 3848 samples from the dataset showed that FT3 and FT4 levels differed between the increased and normal IOP groups. Increased expression of the LOXL-AS1 gene was identified as a contributor to increased IOP, with LOXL-AS1 expression increased in GO.Conclusion: Increased thyroid function is a risk factor for elevated IOP in patients with GO, with higher expression of LOXL-AS1 in GO contributing to this effect.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"675-684"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Significant Improvement in Long-Term Survival after Liver Resection for Hepatocellular Carcinoma: Evolving Outcomes over 20 Years. 肝切除术后肝细胞癌长期生存率的显著改善：20年来的发展结果。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0087

Na Reum Kim, Gi Hong Choi, Dai Hoon Han, Kyung Sik Kim, Jin Sub Choi

{"title":"Significant Improvement in Long-Term Survival after Liver Resection for Hepatocellular Carcinoma: Evolving Outcomes over 20 Years.","authors":"Na Reum Kim, Gi Hong Choi, Dai Hoon Han, Kyung Sik Kim, Jin Sub Choi","doi":"10.3349/ymj.2024.0087","DOIUrl":"10.3349/ymj.2024.0087","url":null,"abstract":"Purpose: Advanced techniques and multidisciplinary approaches have improved hepatocellular carcinoma (HCC) surgical outcomes. This study updates the long-term survival after liver resection (LR) for HCC based on over 20 years of experience.Materials and methods: Between 1996 and 2017, 1963 patients with HCC underwent LR. After excluding 185 patients who received preoperative therapy, 1778 treatment-naïve HCC patients were included. Clinicopathological characteristics and surgical outcomes were compared across three periods: 1 (1996-2007), 2 (2008-2012), and 3 (2013-2017). Prognostic factors for overall survival (OS) and disease-free survival (DFS) were analyzed using Cox regression analysis.Results: Recent trends indicate increased diagnoses at older ages, number of non-B and non-C HCC cases and decreased incidence of cirrhosis. Minor, non-anatomical, and minimally invasive LR have become more prevalent. In period 3, short-term outcomes improved, as 90-day mortality decreased to 0.3% and major complications to 5.0%. Long-term outcomes improved (5-year OS: 68.1% vs. 80.7% vs. 90.5%, p<0.001; 5-year DFS: 41.4% vs. 50.7% vs. 61.1%, p<0.001), and early recurrence rates decreased in period 3 (34.0% vs. 34.0% vs. 25.8%, p<0.001). Factors such as smaller tumor size, decreased incidence of cirrhosis, fewer intraoperative transfusions, and fewer major complications have contributed to improved OS and DFS.Conclusion: Remarkable improvements in 5-year OS and DFS were observed after curative LR for HCC, particularly in period 3. Advancements in surgical outcomes, including very low short-term mortality, along with improved surgical techniques, early detection, and refined patient selection, are likely key factors in this progress.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"637-646"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Adherence to Digital Cognitive Behavioral Therapy for Insomnia Effectiveness. 坚持数字认知行为疗法对失眠疗效的影响。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0398

Suonaa Lee, Kyung Mee Park, Do Hyun Lee, Eun Chae Choi, Yujin Lee, Eun Lee

{"title":"Impact of Adherence to Digital Cognitive Behavioral Therapy for Insomnia Effectiveness.","authors":"Suonaa Lee, Kyung Mee Park, Do Hyun Lee, Eun Chae Choi, Yujin Lee, Eun Lee","doi":"10.3349/ymj.2024.0398","DOIUrl":"10.3349/ymj.2024.0398","url":null,"abstract":"Purpose: Although digital cognitive behavioral therapy for insomnia (dCBT-I) offers a promising solution to the accessibility limitations of traditional face-to-face CBT-I, few studies have examined dCBT-I against a sham app and adherence issues remain. This study assessed the efficacy of dCBT-I compared with a sham app and investigated whether adherence predicts sleep outcomes.Materials and methods: In this combined analysis of two multicenter, double-blind, sham-controlled randomized controlled trials, 120 patients with insomnia were randomized to use the dCBT-I app (n=60) or a sham app (n=60). The primary outcome was the change in sleep efficiency (SE) from baseline after the 6-week intervention. The relationship between adherence to sleep restriction therapy (SRT) and sleep outcomes post-intervention was assessed.Results: After adjusting for age, sex, sleep medication use, and baseline levels of each outcome variable, the dCBT-I group demonstrated better treatment outcomes than the sham app group, with significant improvements of 7.69% in SE [95% confidence interval (CI), 3.09% to 12.30%; p=0.001], -16.77 minutes in sleep onset latency (95% CI, -31.48 to -2.06 minutes; p=0.026), and -0.97 in dysfunctional beliefs about sleep (95% CI, -1.46 to -0.48; p<0.001) from baseline. Poorer adherence to SRT was associated with reduced SE (p=0.006) and increased nighttime wakefulness (p=0.002) after controlling for age, sex, years of education, and the baseline value of each outcome variable.Conclusion: This combined analysis demonstrates the efficacy of dCBT-I in improving sleep outcomes compared with a sham app and highlights the role of adherence to SRT in enhancing treatment efficacy. The two studies were registered with ClinicalTrials.gov (NCT05822999, NCT05809544).","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"657-665"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acidic Tumor Microenvironments and Emerging Therapeutic Strategies for Cancer Therapy. 酸性肿瘤微环境和新兴的癌症治疗策略。

IF 2.8 4区医学

Yonsei Medical Journal Pub Date : 2025-10-01 DOI: 10.3349/ymj.2024.0210

Yongzhi Zhuang, Liquan Tong, Xueying Sun

{"title":"Acidic Tumor Microenvironments and Emerging Therapeutic Strategies for Cancer Therapy.","authors":"Yongzhi Zhuang, Liquan Tong, Xueying Sun","doi":"10.3349/ymj.2024.0210","DOIUrl":"10.3349/ymj.2024.0210","url":null,"abstract":"Hypoxia and acidity represent two distinct properties of tumor microenvironments (TMEs). Tumor acidity was initially proposed to be a \"by-product\" of hypoxia, which results from abnormal vasculature and excessive oxygen demands. It is now recognized that acidity has its unique function in TMEs, as it can exacerbate abnormal cellular energy metabolism, inhibit cellular carcinogen metabolism, impede DNA damage repair mechanisms, and suppress immune cell activation, all of which play crucial roles during carcinogenesis. Acidic TMEs are also major contributors to the invasion and metastasis of tumor cells, and participate in the mechanisms underlying resistance to cancer treatments including immunotherapy. Therefore, the development of novel anti-cancer agents that target acidic TMEs may have considerable clinical benefits. This article reviews the updated information in this rapidly growing field, including the influence of acidic TMEs on cancer progression, resistance to current treatments and anti-cancer immunity, and their association with hypoxia and aerobic glycolysis. It also summarizes the key molecules that contribute to acidic TMEs and highlights the development of anti-cancer agents targeting tumor acidity, primarily inhibitors of carbonic anhydrases, monocarboxylic acid transporters, vacuolar-type adenosine triphosphatase (V-ATPase), and Na+/H+ exchangers. At present, none of the inhibitors targeting acidic TMEs have been approved for clinical use in cancer treatment, except for proton pump inhibitors that target V-ATPase. Development of highly specific agents and the discovery of more sensitive and precise biomarkers may help improve the effectiveness of these inhibitors for cancer therapy.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"619-629"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0