Korean Journal of Internal Medicine最新文献

Epidemiological and clinical trends of malignant small-bowel tumors in Asia. 亚洲恶性小肠肿瘤的流行病学和临床趋势。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-08-26 DOI: 10.3904/kjim.2025.422

Jung Rock Moon, Seong Ran Jeon

{"title":"Epidemiological and clinical trends of malignant small-bowel tumors in Asia.","authors":"Jung Rock Moon, Seong Ran Jeon","doi":"10.3904/kjim.2025.422","DOIUrl":"https://doi.org/10.3904/kjim.2025.422","url":null,"abstract":"Malignant small-bowel tumors are uncommon, accounting for < 5% of all gastrointestinal cancers, yet their incidence has exhibited a steady rise in both Western and Asian populations. This increase is attributed to expanded use of advanced diagnostic modalities and improved registry completeness. Malignant small-bowel tumors encompass a heterogeneous group-adenocarcinoma, neuroendocrine tumors, gastrointestinal stromal tumors, and lymphoma-each with distinct anatomic predilections, molecular characteristics, and clinical behavior. In Asia, sporadic adenocarcinoma remains the predominant subtype, whereas Crohn's disease-associated lesions and small-bowel neuroendocrine tumors are relatively less common than in Western cohorts. Early detection continues to be limited by diagnostic delays caused by nonspecific symptoms and the anatomic inaccessibility of the small-bowel. Prognosis varies substantially across subtypes, with adenocarcinoma demonstrating the poorest survival rate despite advances in systemic therapy. Recent nationwide and multicenter studies from Asian countries have highlighted evolving temporal trends, improvements in diagnostic performance, and emerging regional differences in etiology, stage distribution, and outcomes. A clearer understanding of the epidemiologic patterns and clinical charimacteristics of malignant small-bowel tumors in Asia is essential for developing region-specific diagnostic strategies, optimizing treatment pathways, and prioritizing areas for future collaborative research.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Castleman disease-like mesenteric lymphadenopathy in a Korean adult ultimately diagnosed with familial Mediterranean fever. 一例韩国成人的Castleman病样肠系膜淋巴结病最终被诊断为家族性地中海热。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-08-26 DOI: 10.3904/kjim.2025.415

Hee Won Park, Seo Yeon Youn, Gyeongsin Park, Youngjae Park

引用次数: 0

Hepatitis B core-related antigen as a multifaceted biomarker in chronic hepatitis B: implications for immune activity and hepatocellular carcinoma prediction. 乙型肝炎核心相关抗原作为慢性乙型肝炎的多方面生物标志物：对免疫活性和肝细胞癌预测的影响

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2025.408

Kwon Yong Tak, Seok Hwan Kim, Myeong Jun Song

{"title":"Hepatitis B core-related antigen as a multifaceted biomarker in chronic hepatitis B: implications for immune activity and hepatocellular carcinoma prediction.","authors":"Kwon Yong Tak, Seok Hwan Kim, Myeong Jun Song","doi":"10.3904/kjim.2025.408","DOIUrl":"10.3904/kjim.2025.408","url":null,"abstract":"Background/aims: Hepatitis B core-related antigen (HBcrAg) reflects both serum hepatitis B virus (HBV) DNA and intrahepatic covalently closed circular DNA activity, offering potential advantages over conventional biomarkers in monitoring chronic hepatitis B (CHB). This study evaluated the clinical utility of HBcrAg across immune phases and its prognostic value for hepatocellular carcinoma (HCC).Methods: In this retrospective study, 281 CHB patients from Daejeon St. Mary's Hospital (September 2022-July 2024) were classified into HBV phases. HBcrAg was quantified using the ultrasensitive iTACT-HBcrAg assay. HBcrAg level was compared across HBV phases, HCC presence, and patient characteristics.Results: HBcrAg levels varied significantly across immune phases, with an AUC of 0.97 for HBeAg(+) IA vs. IT, and 0.83 for HBeAg(-) IA vs. II. In HBeAg(-) IA, HBcrAg ≥ 3.8 LogU/mL was associated with higher HCC prevalence at AUC 0.69, while in HBeAg(+) IA, ≥ 4.9 LogU/mL was the optimal cut-off at AUC 0.71. In HBeAg(-) II, HBcrAg < 3.8 LogU/mL was linked to the absence of HCC. HBcrAg correlated inversely with age (r = -0.31, p < 0.0001), while the relationship with fibrosis severity differed according to HBeAg status. In multivariate analysis, HBcrAg remained independently associated with HCC (OR 1.64, p = 0.002). Residual HBcrAg positivity was observed in patients with HBsAg loss.Conclusion: HBcrAg is a robust biomarker capturing both virologic and immunologic activity in CHB, with additional prognostic value for HCC, particularly in IA phases. It may complement or surpass conventional markers in phase classification and risk stratification.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 4","pages":"636-648"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431291","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

Restrictive lung function and smoking increase lung cancer risk in tuberculosis survivors: a cohort study. 限制性肺功能和吸烟增加结核病幸存者患肺癌的风险：一项队列研究

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2025.289

Yun-Gyoo Lee, Hyun-Il Gil, Dayeon Seo, Bo-Guen Kim, Hyunjoo Lee, Young Hwan Kim, Heerim Nam, Soo-Youn Ham, Du-Young Kang, Jae-Uk Song

{"title":"Restrictive lung function and smoking increase lung cancer risk in tuberculosis survivors: a cohort study.","authors":"Yun-Gyoo Lee, Hyun-Il Gil, Dayeon Seo, Bo-Guen Kim, Hyunjoo Lee, Young Hwan Kim, Heerim Nam, Soo-Youn Ham, Du-Young Kang, Jae-Uk Song","doi":"10.3904/kjim.2025.289","DOIUrl":"10.3904/kjim.2025.289","url":null,"abstract":"Background/aims: Individuals with prior tuberculosis (TB) infection represent a high-risk group for lung cancer due to chronic pulmonary damage. Although associations between TB and lung cancer have been established, this study aimed to explore specific risk factors of lung cancer development in TB survivors.Methods: Data from 9,734 TB survivors within the Kangbuk Samsung Cohort Study (2011-2021) were analyzed. Pulmonary function was assessed by spirometry and classified as normal, restrictive, or obstructive. Multivariable Cox proportional hazard models were used to evaluate the relationships among lung function, smoking, alcohol consumption, comorbidities, and lung cancer incidence.Results: Participants were mostly male (65.4%), with an average age of 41.2 years. Over a median follow-up of 12.3 years, 22 lung cancer cases were identified. Univariate analysis revealed significant associations with restrictive (hazard ratio [HR] 2.58, 95% CI 1.00-6.65; p = 0.050) and obstructive (HR 6.48, 95% CI 2.05-20.43; p < 0.001) lung function, age (HR 2.35 per 5-year; p < 0.001), heavy smoking (HR 6.62; p < 0.001), alcohol (HR 3.05; p = 0.019), and diabetes (HR 6.40; p = 0.003). In multivariable models, restrictive lung function (HR 2.94, 95% CI 1.00-8.65; p = 0.050), age (HR 1.73; p < 0.001), and heavy smoking (HR 4.09; p = 0.010) persisted as independent risk factors. Obstructive lung function initially showed a strong association but was not significant after adjusting for covariates, indicating confounding.Conclusion: Restrictive lung function, likely indicative of post-TB fibrotic changes, heavy smoking, and older age significantly predict lung cancer development in TB survivors. These results highlight the need for surveillance using spirometry for TB survivors.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 4","pages":"721-730"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430280","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

Sigmoid colon metastasis from esophageal squamous cell carcinoma presenting as a colon polyp. 食管鳞状细胞癌乙状结肠转移，表现为结肠息肉。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2026.012

Tae Un Kim, Su Jin Kim, Hwaseong Ryu

引用次数: 0

Financial burden of glycemic control: a single-center retrospective study of diabetes costs in South Korean patients. 血糖控制的经济负担：韩国糖尿病患者成本的单中心回顾性研究。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2025.247

Han-Sang Baek, Sungju Kim, Dong-Jun Lim, Chul-Min Kim, Tae Seo Sohn, Sungrae Kim

{"title":"Financial burden of glycemic control: a single-center retrospective study of diabetes costs in South Korean patients.","authors":"Han-Sang Baek, Sungju Kim, Dong-Jun Lim, Chul-Min Kim, Tae Seo Sohn, Sungrae Kim","doi":"10.3904/kjim.2025.247","DOIUrl":"10.3904/kjim.2025.247","url":null,"abstract":"Background/aims: The impact of glycemic control on healthcare costs is a critical research area. In this study, we aimed to evaluate the relationship between hemoglobin A1c (HbA1c) levels and healthcare costs, including out-of-pocket (OOP) expenses and insurance expenditures (IEs), over 5 years (2019-2023).Methods: This retrospective cohort study was conducted using data from Uijeongbu St. Mary's Hospital of patients who underwent HbA1c testing between January 1, 2019 and December 31, 2023. Patients were categorized as normal glycemic group (NG, HbA1c < 6.5%), moderately hyperglycemic group (MG, 6.5-8%), and highly hyperglycemic group (HG, ≥ 8%). Univariate linear regression was used for evaluating associations between HbA1c levels and healthcare costs.Results: Of 86,417 patients, 61,961, 15,065, and 9,391 were NG, MG, and HG, respectively. The HG group had the highest 75th percentile cost at 9,339 USD, compared with 7,673 and 8,741 USD in the NG and MG groups, respectively. Each 1% increase in HbA1c level was associated with an additional 236.11 USD in total costs, including 55.58 and 180.53 USD in OOP expenses and IEs, respectively. Patients with worsened glycemic control had the highest total healthcare costs (up to 12,742 USD), whereas those with improved glycemic control showed consistently lower total and inpatient costs. Higher costs were also observed among patients with diabetes, chronic kidney disease, serious disease exemption status (particularly those with poorly controlled diabetes), and those receiving medical aid.Conclusion: Elevated HbA1c levels were associated with increased healthcare costs. Effective glycemic control might help reduce financial burdens.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 4","pages":"706-720"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431239","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

Pigmented villonodular synovitis in the thoracic spine: a rare and under-recognized condition. 胸椎色素绒毛结节性滑膜炎：一种罕见且未被充分认识的疾病。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2024.323

Jacob A Schroeder, Márcio Luís Duarte, Leonardo Furtado Freitas

引用次数: 0

Beyond airway obstruction: restrictive lung physiology as an independent risk factor for lung cancer in tuberculosis survivors. 超越气道阻塞：限制性肺生理是结核病幸存者肺癌的独立危险因素。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2025.268

Sang Hoon Chun

引用次数: 0

Recent advances in the management of small bowel Crohn's disease. 小肠克罗恩病治疗的最新进展

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2025.401

Kwangwoo Nam, Hee Seok Moon

引用次数: 0

The 2020 disease burden and economic implications of digestive diseases in Korea: a nation-wide comprehensive study. 2020年韩国消化系统疾病的疾病负担和经济影响：一项全国性的综合研究。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-07-01 DOI: 10.3904/kjim.2025.376

Eui Sun Jeong, Hye-Kyung Jung, Younhee Kim, Hyung Seok Lim

{"title":"The 2020 disease burden and economic implications of digestive diseases in Korea: a nation-wide comprehensive study.","authors":"Eui Sun Jeong, Hye-Kyung Jung, Younhee Kim, Hyung Seok Lim","doi":"10.3904/kjim.2025.376","DOIUrl":"10.3904/kjim.2025.376","url":null,"abstract":"Background/aims: Digestive diseases are highly prevalent and contribute substantially to healthcare utilization and costs. However, national-level data on digestive diseases burden in Korea are limited. This study aimed to estimate the healthcare burden of digestive diseases in Korea via a national database analysis.Methods: We analyzed the 2020 National Patient Sample data from the Health Insurance Review and Assessment Service, covering the entire Korean population. Digestive diseases were grouped into seven categories. Medical utilization and expenditures were assessed using two criteria: the principal estimate (primary diagnosis only) and the extended estimate (primary plus first-listed secondary diagnosis).Results: Approximately 18.5 million individuals (39.2% of all patients) received care for digestive diseases, according to the principal estimate, and 30.1 million (63.8%) received care, according to the extended estimate. Corresponding medical exdigespenditures were $8.5 billion (11.6% of total national healthcare costs) based on the principal estimate and $14.4 billion (19.6%) based on the extended estimate. Although only 7.4% of patients were hospitalized, they accounted for 51.4% of the total expenditure for digestive diseases. Colorectal cancer incurred the highest inpatient costs. Gastroesophageal reflux disease was the most common and expensive diagnosis in outpatients. Intestinal infectious diseases were the leading causes of hospitalization and emergency department visits; foreign body ingestion was a key driver in pediatric emergency cases.Conclusion: Digestive diseases impose significant clinical and economic burdens in Korea. Their frequent occurrence as primary and comorbid diseases highlights the need for comprehensive healthcare strategies and informed policy planning.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 4","pages":"649-662"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430268","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