Korean Journal of Internal Medicine最新文献

Pulsed field ablation: focused on atrial fibrillation ablation. 脉冲场消融：主要研究心房颤动消融。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 Epub Date: 2025-12-04 DOI: 10.3904/kjim.2025.193

Hong-Ju Kim, Chan-Hee Lee

引用次数: 0

Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021. 1990年至2021年全球医疗不良反应负担：2021年全球疾病负担研究。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.278

{"title":"Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021.","authors":"","doi":"10.3904/kjim.2025.278","DOIUrl":"10.3904/kjim.2025.278","url":null,"abstract":"Background/aims: This study aims to evaluate the global burden of adverse effects of medical treatment (AEMT) using data from the Global Burden of Disease Study (GBD) 2021.Methods: Data were extracted from the GBD 2021, covering 204 countries/territories from 1990 to 2021. AEMT was defined using ICD-9 and ICD-10 codes, encompassing complications from medical procedures, treatments, or healthcare exposures. Estimates were categorized into fatal and non-fatal outcomes and stratified by age, sex, year, and covariates, including the Socio-demographic Index (SDI). Mortality-incidence ratios (MIRs), defined as the ratio of mortality calculated by dividing the number of deaths by the total incident cases, were analyzed.Results: In 2021, the global age-standardized prevalence, incidence, disability-adjusted life years (DALYs), and mortality rates of AEMT were 11.48 (95% uncertainty interval [UI], 8.86-14.13), 150.44 (131.19-171.81), 64.19 (51.06-73.11), and 1.53 (1.29-1.68) per 100,000 population, respectively. DALY rates were highest in the early neonatal group (4,789.47 per 100,000 population [95% UI, 3,682.00-5,963.30]), while mortality rates followed a U-shaped pattern across age groups. In 2021, MIRs were highest at both ends of the age range: the early neonatal group (0.58 [95% UI, 0.55-0.58]) and the 95+ age group (0.05 [0.04-0.06]). This pattern was consistent across all SDI quintiles, with higher MIRs observed in lower SDI quintiles.Conclusion: The significantly higher prevalence and incidence rates of AEMT among the older population in high SDI quintiles, compared to lower SDI quintiles, could be attributed to the healthcare overutilization, highlighting the need for policy adjustments.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 2","pages":"350-366"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481819","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

From bench to bedside: adipose tissue fibrosis in obesity, anti-diabetic therapies, and bariatric surgery. 从实验室到床边：肥胖、抗糖尿病治疗和减肥手术中的脂肪组织纤维化。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.3904/kjim.2025.363

Mihye Seo, Kyoil Suh, Hyeong Kyu Park, Kae Won Cho

{"title":"From bench to bedside: adipose tissue fibrosis in obesity, anti-diabetic therapies, and bariatric surgery.","authors":"Mihye Seo, Kyoil Suh, Hyeong Kyu Park, Kae Won Cho","doi":"10.3904/kjim.2025.363","DOIUrl":"10.3904/kjim.2025.363","url":null,"abstract":"This review provides a comprehensive examination of the recent research findings concerning the pathophysiology and clinical implications of adipose tissue fibrosis in obesity and metabolic diseases. Recent large-scale studies, including a longitudinal study spanning 24 years (Swedish Obese Subjects), have demonstrated that weight loss in obese patients is directly correlated with reduced metabolic complications and mortality. Nonetheless, instances of weight regain and subsequent loss of metabolic improvements have been observed in some patients, with adipose tissue dysfunction and fibrosis identified as significant contributing factors. Adipose tissue fibrosis is increasingly recognized as a critical pathological mechanism that influences weight loss responsiveness and long-term prognosis, extending beyond the previously predominant focus on inflammatory responses. Recent advancements in spatial transcriptomics and single-cell omics have elucidated the interactions and molecular networks among various cell types (e.g., fibroblasts and macrophages), revealing the involvement of miRNAs, among other factors, in metabolic plasticity and weight maintenance. Anti-diabetic therapies (such as GLP-1 receptor agonists, SGLT2 inhibitors, and thiazolidinediones) and bariatric surgery have been shown to contribute to tissue remodeling and the mitigation of fibrosis. However, the issue of weight regain upon drug discontinuation persists, underscoring the necessity for integrated strategies that simultaneously target adipose tissue set-point regulation and fibrosis improvement. In conclusion, adipose tissue fibrosis is proposed as a novel predictive and therapeutic target for metabolic health prognosis and treatment selection in patients with obesity. This study is anticipated to lay the groundwork for personalized management from a precision medicine perspective.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"210-229"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811707","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 features of NAAT-positive, toxin-negative Clostridioides difficile infections in South Korea. 韩国naat阳性、毒素阴性艰难梭菌感染的临床特征

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.207

In Hyoung Choi, Chang Kyo Oh, Young Wook Cho, Young-Seok Cho

{"title":"Clinical features of NAAT-positive, toxin-negative Clostridioides difficile infections in South Korea.","authors":"In Hyoung Choi, Chang Kyo Oh, Young Wook Cho, Young-Seok Cho","doi":"10.3904/kjim.2025.207","DOIUrl":"10.3904/kjim.2025.207","url":null,"abstract":"Background/aims: The clinical characteristics of Clostridioides difficile infection (CDI) in patients within the Asia-Pacific region who test positive on the nucleic acid amplification test (NAAT) and negative on the toxin enzyme immunoassay (EIA, hereafter referred to as \"Toxin\") are unclear. We evaluated the clinical significance and associated factors of NAAT+/Toxinpatients whose diagnosis of CDI was confirmed by toxigenic C. difficile culture.Methods: This retrospective cohort study enrolled adult patients admitted to Seoul St. Mary's Hospital between January 2015 and December 2015 with a diagnosis of active CDI.Results: In total, 3,311 stool samples were subjected to C. difficile culture, NAAT, and toxin EIA. Among them, 298 culture- positive patients fulfilled the criteria for CDI, and 3 NAAT-/Toxin- patients were excluded. The risk factors for a negative EIA and positive NAAT and culture results were evaluated in 295 patients. Among them, 128 patients were Toxin- and 167 were Toxin+. No clinical or laboratory parameters (fever, white blood cell count of < 1,000/mm3, eosinophils, C-reactive protein, creatinine, or albumin) differed significantly between NAAT+/Toxin+ and NAAT+/Toxin- patients. In addition, the clinical outcomes did not differ between the two groups. In the multivariable analysis, previous use of antibiotics was inversely associated with negative EIA results, whereas high-dose corticosteroid use was positively associated.Conclusion: Clinical outcomes related to CDI are not different between NAAT+/Toxin+ and NAAT+/Toxin- patients, emphasizing the need for individual clinical evaluation.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 2","pages":"255-264"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481538","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

The epidemiology of inflammatory bowel disease: exploring the impacts of environmental factors. 炎症性肠病的流行病学：探讨环境因素的影响。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 Epub Date: 2025-12-04 DOI: 10.3904/kjim.2025.083

Jihye Park, Jae Hee Cheon

引用次数: 0

The effect of HFE gene mutation and iron overload on sustained virological response in Egyptian chronic hepatitis C patients treated with daclatasvir and sofosbuvir. HFE基因突变和铁超载对使用daclatasvir和sofosbuvir治疗的埃及慢性丙型肝炎患者持续病毒学反应的影响

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.156

Emad M Kodsi, Hisham Ismail, Randa Issa, Ahmed Elshaarawy, Moustafa A Sakr, Eman L Shehata, Emad R Issak

{"title":"The effect of HFE gene mutation and iron overload on sustained virological response in Egyptian chronic hepatitis C patients treated with daclatasvir and sofosbuvir.","authors":"Emad M Kodsi, Hisham Ismail, Randa Issa, Ahmed Elshaarawy, Moustafa A Sakr, Eman L Shehata, Emad R Issak","doi":"10.3904/kjim.2025.156","DOIUrl":"10.3904/kjim.2025.156","url":null,"abstract":"Background/aims: This matched case-control study investigated the impact of HFE gene mutations on sustained virological response (SVR) in Egyptian patients with chronic hepatitis C (CHC) treated with daclatasvir and sofosbuvir.Methods: A total of 150 CHC patients were enrolled (75 responders and 75 non-responders) based on HCV RNA levels 12 weeks post-treatment. HFE gene mutations (C282Y, H63D, S65C) were detected by PCR-restriction fragment length polymorphism. Liver function and iron parameters were assessed.Results: Among responders, 86.67% had wild-type HFE alleles, compared to 72.00% of non-responders (p = 0.027). Heterozygous mutant alleles were more common in non-responders (28.00%) than in responders (13.33%). Wild-type carriers had 2.59 times higher odds of achieving SVR (OR, 2.59; 95% CI, 1.10-5.83). HFE mutations were significantly associated with elevated serum iron (p = 0.031) and ferritin (p = 0.044) levels, the with C282Y mutation linked to increased iron. However, after multivariate adjustment using principal component analysis, only iron overload remained a significant predictor of non-response (p < 0.001), while the association with HFE mutations was no longer significant (p = 0.647).Conclusion: HFE mutations are associated with lower SVR rates and iron overload, but their impact appears mediated through disrupted iron metabolism. Iron overload emerged as the key independent predictor of treatment failure. These findings underscore the importance of evaluating iron status in conjunction with genetic factors to more accurately predict treatment outcomes in CHC patients receiving direct-acting antivirals.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 2","pages":"265-276"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482139","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

High diffuse bone marrow uptake in 18F-FDG PET/CT may reflect the diverse mutational characteristics of multiple myeloma. 18F-FDG PET/CT高弥漫性骨髓摄取可能反映多发性骨髓瘤的多种突变特征。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.224

Hee Jeong Cho, Donghyeon Lee, Tan Minh Le, Hong Duc Thi Nguyen, Juhyung Kim, Jung Min Lee, Dong Won Baek, Ha-Jeong Kim, Hyung Soo Han, Sang Kyun Sohn, Chae Moon Hong, Joon Ho Moon

{"title":"High diffuse bone marrow uptake in 18F-FDG PET/CT may reflect the diverse mutational characteristics of multiple myeloma.","authors":"Hee Jeong Cho, Donghyeon Lee, Tan Minh Le, Hong Duc Thi Nguyen, Juhyung Kim, Jung Min Lee, Dong Won Baek, Ha-Jeong Kim, Hyung Soo Han, Sang Kyun Sohn, Chae Moon Hong, Joon Ho Moon","doi":"10.3904/kjim.2025.224","DOIUrl":"10.3904/kjim.2025.224","url":null,"abstract":"Background/aims: To explore the biological implications of positron emission tomography/computed tomography (PET/CT) findings in multiple myeloma (MM), we investigated the mutational characteristics relevant to PET/CT findings using targeted DNA sequencing.Methods: Fourteen newly diagnosed patients with MM who underwent 18F-fluorodeoxyglucose (FDG) PET/CT at diagnosis were retrospectively reviewed. Targeted sequencing was performed on their bone marrow samples using a customized panel covering 80 genes relevant to MM biology. In seven patients, serial PET/CT and sequencing were also conducted after firstline treatment.Results: The most frequently identified mutant gene was ATM, followed by HUWE1, PABPC1, and TP53. Patients with high diffuse FDG uptake (high DU) in their bone marrow showed a higher tumor burden than those with low diffuse uptake (low DU), and they were likely to have an inferior overall survival. Mutations detected in high DU were associated with various oncogenic pathways relevant to the disease progression of MM. Notably, pathways involving epigenetic regulators were predominantly enriched in patients with high DU. In serial follow-ups, a patient with residual PET/CT findings showed the emergence of new mutations; however, those with complete resolution of PET/CT abnormalities demonstrated improved mutational characteristics.Conclusion: Patients with high DU showed diverse mutational characteristics, which may reflect the heterogeneous nature of MM and contribute to inferior survival outcomes.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 2","pages":"307-316"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481922","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

Too much synchrony? Left bundle branch area pacing-induced systolic anterior motion and left ventricular outflow tract obstruction managed by intentional atrioventricular dyssynchrony. 太多的同步？故意房室非同步化处理左束支区起搏诱导的收缩前运动和左室流出道阻塞。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.244

Hyung Ki Jeong, Sung Soo Kim, Hyun Kuk Kim, Young Jae Ki, Dong Hyun Choi, Keun Ho Park

引用次数: 0

A bridge, not a destination: clarifying the role of polatuzumab vedotin plus bendamustine and rituximab in relapsed/refractory diffuse large B-cell lymphoma. 一个桥梁，而不是终点：澄清polatuzumab vedotin联合苯达莫司汀和利妥昔单抗在复发/难治性弥漫性大b细胞淋巴瘤中的作用

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.054

Ho-Young Yhim

引用次数: 0

Development of Simple Assessment tool for predict imminent risk of Fracture in Elderly women. 预测老年妇女即将发生骨折风险的简单评估工具的开发。

IF 2.4 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-03-01 DOI: 10.3904/kjim.2025.227

So Young Park, Sujin Kwon, Kyoung Jin Kim, Seong Hee Ahn, Ha Young Kim, Kyoung Min Kim

{"title":"Development of Simple Assessment tool for predict imminent risk of Fracture in Elderly women.","authors":"So Young Park, Sujin Kwon, Kyoung Jin Kim, Seong Hee Ahn, Ha Young Kim, Kyoung Min Kim","doi":"10.3904/kjim.2025.227","DOIUrl":"10.3904/kjim.2025.227","url":null,"abstract":"Background/aims: Previously developed fracture risk prediction models primarily estimate long-term risk and are limited in their ability to predict imminent fractures. We developed a simplified and practical model to predict the short-term fracture risk (1- to 3-year risk) in elderly Korean women.Methods: We included 1,440,988 women who underwent a national life-transition health examination at age 66 between 2011 and 2017. The participants were followed-up for 3 years to identify major osteoporotic fractures (MOFs) and hip fractures. Clinical risk factors such as body mass index, bone mineral density, fall history within 6 months, prior fractures within 3 years, recent fractures within 1 year, and recurrent fractures were analyzed. Multivariate logistic regression was used to estimate the odds ratios (ORs) for these risk factors. Each OR was converted into a risk score, and the total scores were stratified into five groups: 0-4, 5-7, 8-10, 11-14, and 15-18 points.Results: Higher scores were associated with a significantly increased risk of fractures. At 3 years, the incidences of MOF were 3.4%, 5.8%, 12.0%, 21.3%, and 36.6%, and the hip fracture incidences were 0.13%, 0.26%, 0.59%, 0.73%, and 1.82% across the five groups, respectively.Conclusion: This simplified scoring model is a practical tool for predicting the 1- to 3-year fracture risk in elderly Korean women. By stratifying patients into risk groups based on routine clinical data, it enables the early identification of high-risk individuals and facilitates timely preventive care.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 2","pages":"277-285"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481804","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