Ewha Medical Journal最新文献

{"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":"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":"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":"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":0.9,"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":"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}

{"title":"A day in the life of a public health center director in a rural area, Korea.","authors":"Chanbyoung Park","doi":"10.12771/emj.2025.e13","DOIUrl":"10.12771/emj.2025.e13","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 1","pages":"e13"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699940","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":"Application of deep learning for diagnosis of shoulder diseases in older adults: a narrative review.","authors":"Sung Min Rhee","doi":"10.12771/emj.2025.e6","DOIUrl":"10.12771/emj.2025.e6","url":null,"abstract":"<p><p>Shoulder diseases pose a significant health challenge for older adults, often causing pain, functional decline, and decreased independence. This narrative review explores how deep learning (DL) can address diagnostic challenges by automating tasks such as image segmentation, disease detection, and motion analysis. Recent research highlights the effectiveness of DL-based convolutional neural networks and machine learning frameworks in diagnosing various shoulder pathologies. Automated image analysis facilitates the accurate assessment of rotator cuff tear size, muscle degeneration, and fatty infiltration in MRI or CT scans, frequently matching or surpassing the accuracy of human experts. Convolutional neural network-based systems are also adept at classifying fractures and joint conditions, enabling the rapid identification of common causes of shoulder pain from plain radiographs. Furthermore, advanced techniques like pose estimation provide precise measurements of the shoulder joint's range of motion and support personalized rehabilitation plans. These automated approaches have also been successful in quantifying local osteoporosis, utilizing machine learning-derived indices to classify bone density status. DL has demonstrated significant potential to improve diagnostic accuracy, efficiency, and consistency in the management of shoulder diseases in older patients. Machine learning-based assessments of imaging data and motion parameters can help clinicians optimize treatment plans and improve patient outcomes. However, to ensure their generalizability, reproducibility, and effective integration into routine clinical workflows, large-scale, prospective validation studies are necessary. As data availability and computational resources increase, the ongoing development of DL-driven applications is expected to further advance and personalize musculoskeletal care, benefiting both healthcare providers and the aging population.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 1","pages":"e6"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699941","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":"Conservative treatment of older adult patients with shoulder diseases: a narrative review.","authors":"Kook Jong Kim, Ho-Seung Jeong","doi":"10.12771/emj.2025.e1","DOIUrl":"10.12771/emj.2025.e1","url":null,"abstract":"<p><p>The purpose of this review is to provide a comprehensive guide for managing older adult patients with shoulder diseases, specifically rotator cuff tears and osteoarthritis, and to explore effective nonsurgical treatment options. Chronic rotator cuff tears are typically degenerative, whereas acute tears result from trauma. A key feature of these tears is tendon degeneration accompanied by type III collagen predominance, predisposing tears to progression. Osteoarthritis in the glenohumeral joint arises from wear-and-tear changes that compromise cartilage integrity, leading to pain and restricted motion. Accurate clinical assessment and imaging, including plain radiographs, ultrasonography, and MRI, facilitate diagnosis and guide treatment. The physic-al examination emphasizes range of motion, rotator cuff strength, and scapular stability. Management strategies prioritize pain relief, function preservation, and improving mobility. Nonsurgical modalities, including exercise, manual therapy, and activity modification, constitute first-line treatments, especially for older adults. Pharmacological approaches involve NSAIDs, corticosteroid injections, and neuropathic pain medications. Steroid injections have short-term benefits, but repeated treatments may compromise tissue integrity. Platelet-rich plasma is a regenerative option that may improve tendon healing, but mixed findings highlight the need for further investigation. A structured physical therapy program focusing on range of motion and strengthening is essential, with alternative interventions used judiciously. Patients should be counseled regarding the potential progression of tears and the possible need for future surgical intervention if nonsurgical methods are unsuccessful. Multimodal approaches, including joint mobilization and personalized exercise regimens, hold potential for optimizing functional outcomes and supporting independence in older adults.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 1","pages":"e1"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699888","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":"Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review.","authors":"Dong-Wook Lee, Inah Kim, Jungho Hwang, Sunhaeng Choi, Tae-Won Jang, Insung Chung, Hwan-Cheol Kim, Jaebum Park, Jungwon Kim, Kyoung Sook Jeong, Youngki Kim, Eun-Soo Lee, Yangwoo Kim, Inchul Jeong, Hyunjeong Oh, Hyeoncheol Oh, Jea Chul Ha, Jeehee Min, Chul Gab Lee, Heon Kim, Jaechul Song","doi":"10.12771/emj.2025.e9","DOIUrl":"10.12771/emj.2025.e9","url":null,"abstract":"<p><p>This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"48 1","pages":"e9"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699909","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}