Ewha Medical Journal最新文献

{"title":"Ewha, where medical education for women began in Korea, is now leading global healthcare through innovative research networks and education: the inaugural address of the 28th Dean of the College of Medicine.","authors":"Duk-Hee Kang","doi":"10.12771/emj.2025.00129","DOIUrl":"https://doi.org/10.12771/emj.2025.00129","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e19"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feature-based ensemble modeling for addressing diabetes data imbalance using the SMOTE, RUS, and random forest methods: a prediction study.","authors":"Younseo Jang","doi":"10.12771/emj.2025.00353","DOIUrl":"https://doi.org/10.12771/emj.2025.00353","url":null,"abstract":"<p><strong>Purpose: </strong>This study developed and evaluated a feature-based ensemble model integrating the synthetic minority oversampling technique (SMOTE) and random undersampling (RUS) methods with a random forest approach to address class imbalance in machine learning for early diabetes detection, aiming to improve predictive performance.</p><p><strong>Methods: </strong>Using the Scikit-learn diabetes dataset (442 samples, 10 features), we binarized the target variable (diabetes progression) at the 75th percentile and split it 80:20 using stratified sampling. The training set was balanced to a 1:2 minority-to-majority ratio via SMOTE (0.6) and RUS (0.66). A feature-based ensemble model was constructed by training random forest classifiers on 10 two-feature subsets, selected based on feature importance, and combining their outputs using soft voting. Performance was compared against 13 baseline models, using accuracy and area under the curve (AUC) as metrics on the imbalanced test set.</p><p><strong>Results: </strong>The feature-based ensemble model and balanced random forest both achieved the highest accuracy (0.8764), followed by the fully connected neural network (0.8700). The ensemble model had an excellent AUC (0.9227), while k-nearest neighbors had the lowest accuracy (0.8427). Visualizations confirmed its superior discriminative ability, especially for the minority (high-risk) class, which is a critical factor in medical contexts.</p><p><strong>Conclusion: </strong>Integrating SMOTE, RUS, and feature-based ensemble learning improved classification performance in imbalanced diabetes datasets by delivering robust accuracy and high recall for the minority class. This approach outperforms traditional resampling techniques and deep learning models, offering a scalable and interpretable solution for early diabetes prediction and potentially other medical applications.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e32"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of <i>Anisakis</i> larvae molting membrane against human eosinophilia sera.","authors":"Sooji Hong, Bong-Kwang Jung, Hyun-Jong Yang","doi":"10.12771/emj.2025.00311","DOIUrl":"10.12771/emj.2025.00311","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate whether proteins present in the molting membranes of third-stage (L3) <i>Anisakis</i> larvae could serve as potential risk factors for allergic reactions.</p><p><strong>Methods: </strong>Third-stage larvae (L3) of <i>Anisakis</i> spp. were primarily collected from mackerels and cultured in vitro to yield both molting membranes and fourth-stage (L4) larvae. Major soluble proteins in the molting membranes were identified using SDS-PAGE (sodium dodecyl sulfate-polyacrylamide gel electrophoresis). Crude antigens extracted from L3, L4, and the molting membranes were subsequently evaluated by western blotting using sera from <i>Anisakis</i>-infected rabbits and patients with eosinophilia.</p><p><strong>Results: </strong>Antigens derived from the molting membranes reacted with sera from <i>Anisakis</i>-infected rabbits as well as with sera from 7 patients with eosinophilia of unknown origin. These findings suggest that unidentified proteins in the molting membranes of <i>Anisakis</i> L3 may contribute to early allergic reactions, particularly in patients sensitized by specific molecular components.</p><p><strong>Conclusion: </strong>Our results indicate that proteins present in the molting membranes of third-stage <i>Anisakis</i> spp. larvae may be associated with allergic responses. Further studies are required to confirm the correlation between these membranes and <i>Anisakis</i>-induced allergies.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e29"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving appendix cancer prediction with SHAP-based feature engineering for machine learning models: a prediction study.","authors":"Ji Yoon Kim","doi":"10.12771/emj.2025.00297","DOIUrl":"10.12771/emj.2025.00297","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to leverage Shapley additive explanation (SHAP)-based feature engineering to predict appendix cancer. Traditional models often lack transparency, hindering clinical adoption. We propose a framework that integrates SHAP for feature selection, construction, and weighting to enhance accuracy and clinical relevance.</p><p><strong>Methods: </strong>Data from the Kaggle Appendix Cancer Prediction dataset (260,000 samples, 21 features) were used in this prediction study conducted from January through March 2025, in accordance with TRIPOD-AI guidelines. Preprocessing involved label encoding, SMOTE (synthetic minority over-sampling technique) to address class imbalance, and an 80:20 train-test split. Baseline models (random forest, XGBoost, LightGBM) were compared; LightGBM was selected for its superior performance (accuracy=0.8794). SHAP analysis identified key features and guided 3 engineering steps: selection of the top 15 features, construction of interaction-based features (e.g., chronic severity), and feature weighting based on SHAP values. Performance was evaluated using accuracy, precision, recall, and F1-score.</p><p><strong>Results: </strong>Four LightGBM model configurations were evaluated: baseline (accuracy=0.8794, F1-score=0.8691), feature selection (accuracy=0.8968, F1-score=0.8860), feature construction (accuracy=0.8980, F1-score=0.8872), and feature weighting (accuracy=0.8986, F1-score=0.8877). SHAP-based engineering yielded performance improvements, with feature weighting achieving the highest precision (0.9940). Key features (e.g., red blood cell count and chronic severity) contributed to predictions while maintaining interpretability.</p><p><strong>Conclusion: </strong>The SHAP-based framework substantially improved the accuracy and transparency of appendix cancer predictions using LightGBM (F1-score=0.8877). This approach bridges the gap between predictive power and clinical interpretability, offering a scalable model for rare disease prediction. Future validation with real-world data is recommended to ensure generalizability.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e31"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of human rights violations and trauma among North Korean defectors: a cross-sectional study.","authors":"So Hee Lee, Won Woong Lee, Haewoo Lee, Jin Yong Jun, Jin-Won Noh","doi":"10.12771/emj.2025.00367","DOIUrl":"10.12771/emj.2025.00367","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors' interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements.</p><p><strong>Methods: </strong>A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression.</p><p><strong>Results: </strong>The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being.</p><p><strong>Conclusion: </strong>An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e28"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between periodontitis and systemic health conditions: a narrative review.","authors":"Min-Young Kim, Eun-Kyoung Pang","doi":"10.12771/emj.2025.00101","DOIUrl":"10.12771/emj.2025.00101","url":null,"abstract":"<p><p>This review examines the bidirectional relationship between periodontitis and systemic health conditions, offering an integrated perspective based on current evidence. It synthesizes epidemiological data, biological mechanisms, and clinical implications to support collaborative care strategies recognizing oral health as a key component of overall wellness. Periodontitis affects 7.4% to 11.2% of adults worldwide, and its prevalence increases with age. Beyond its local effects, including gingival inflammation, periodontal pocket formation, and alveolar bone loss, periodontitis is associated with various systemic conditions. Emerging evidence has established links with obesity, diabetes mellitus, cardiovascular disease, chronic kidney disease, inflammatory bowel disease, rheumatoid arthritis, respiratory diseases, adverse pregnancy outcomes, certain malignancies, neurodegenerative diseases, psychological disorders, and autoimmune conditions. These associations are mediated by 3 primary mechanisms: dysbiotic oral biofilms, chronic low-grade systemic inflammation, and the dissemination of periodontal pathogens throughout the body. The pathophysiology involves elevated levels of pro-inflammatory cytokines (including interleukin 6, tumor necrosis factor alpha, and C-reactive protein), impaired immune function, oxidative stress, and molecular mimicry. Periodontal pathogens, particularly <i>Porphyromonas gingivalis</i>, are crucial in initiating and sustaining systemic inflammatory responses. Treatment of periodontitis has demonstrated measurable improvements in numerous systemic conditions, emphasizing the clinical significance of these interconnections. Periodontitis should be understood as more than just a localized oral disease; it significantly contributes to the overall systemic inflammatory burden, with implications for general health. An integrated, multidisciplinary approach to prevention, early detection, and comprehensive treatment is vital for optimal patient outcomes. Healthcare providers should acknowledge oral health as an essential element of systemic well-being.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e27"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korea's 2024 reduction in medical research output amid physician residents' resignation.","authors":"Jeong-Ju Yoo, Hyun Bin Choi, Young-Seok Kim, Sang Gyune Kim","doi":"10.12771/emj.2025.00381","DOIUrl":"10.12771/emj.2025.00381","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e36"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role and prospects of telemedicine in the treatment of heart failure patients: a narrative review.","authors":"Dong-Ju Choi","doi":"10.12771/emj.2025.00360","DOIUrl":"10.12771/emj.2025.00360","url":null,"abstract":"<p><p>Heart failure (HF) represents a significant global health burden characterized by high morbidity, mortality, and healthcare utilization. Traditional in-person care models face considerable limitations in providing continuous monitoring and timely interventions for HF patients. Telemedicine-defined as the remote delivery of healthcare via information and communication technologies-has emerged as a promising solution to these challenges. This review examines the evolution, current applications, clinical evidence, limitations, and future directions of telemedicine in HF management. Evidence from randomized controlled trials and meta-analyses indicates that telemedicine interventions can improve guideline-directed medical therapy implementation, reduce hospitalization rates, improve patient engagement, and potentially decrease mortality among HF patients. Remote monitoring systems that track vital signs, symptoms, and medication adherence allow for the early detection of clinical deterioration, enabling timely interventions before decompensation occurs. Despite these benefits, telemedicine implementation faces several barriers, including technological limitations, reimbursement issues, digital literacy gaps, and challenges in integrating workflows. Future directions include developing standardized guidelines, designing patient-centered technologies, and establishing hybrid care models that combine virtual and in-person approaches. As healthcare systems worldwide seek more efficient and effective strategies for managing the growing population of individuals with HF, telemedicine offers a solution that may significantly improve patient outcomes and quality of life.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 2","pages":"e26"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental disease monitoring by regional Environmental Health Centers in Korea: a narrative review.","authors":"Myung-Sook Park, Hwan-Cheol Kim, Woo Jin Kim, Yun-Chul Hong, Won-Jun Choi, Seock-Yeon Hwang, Jiho Lee, Young-Seoub Hong, Yong-Dae Kim, Seong-Chul Hong, Joo Hyun Sung, Inchul Jeong, Kwan Lee, Won-Ju Park, Hyun-Joo Bae, Seong-Yong Yoon, Cheolmin Lee, Kyoung Sook Jeong, Sanghyuk Bae, Jinhee Choi, Ho-Hyun Kim","doi":"10.12771/emj.2025.e3","DOIUrl":"10.12771/emj.2025.e3","url":null,"abstract":"<p><p>This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children's Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007-February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 1","pages":"e3"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea.","authors":"Maria Florencia Deslivia, Hyun-Joo Lee, In-Ho Jeon, Hemanshu Kochhar, Hyo-Jin Kim, Poong-Taek Kim","doi":"10.12771/emj.2024.e77","DOIUrl":"10.12771/emj.2024.e77","url":null,"abstract":"<p><p>Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 1","pages":"e77"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}