Korean Journal of Internal Medicine最新文献

{"title":"Physical activity for prevention of cardiovascular disease: consensus statement of Korean Society of Cardio-cerebrovascular Disease Prevention.","authors":"Ye Seul Yang, Eu Jeong Ku, Seung-Hyun Ko, Eun-Jung Rhee, Sang-Hyun Ihm, Sung Hee Choi, Won-Young Lee","doi":"10.3904/kjim.2025.206","DOIUrl":"10.3904/kjim.2025.206","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, highlighting the need for effective preventive strategies. This consensus statement emphasizes the critical role of regular physical activity, including aerobic and muscle-strengthening exercises, in reducing key CVD risk factors such as hypertension, dyslipidemia, obesity, and insulin resistance. Recommendations are provided for the general adult population as well as specific subgroups, including older adults, pregnant and postpartum women, individuals with CVD, and those with physical limitations. The importance of reducing sedentary behavior and integrating physical activity into daily life is also addressed. Recommendations should focus on tailored interventions, supportive environments, and evidence-based policies that encourage active lifestyles. Further research specific to the Korean population will enhance the development of evidence-based, population-tailored guidelines for more effective CVD prevention in Korea.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 5","pages":"696-709"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016422","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}

{"title":"Impact of guideline-directed medical therapy on the cardiac or non-cardiac death in acute myocardial infarction.","authors":"Jin-Ho Choi, Dahee Hyun, Seung Ho Hur, Seung Woon Rha, Seung Jae Joo, Hyo-Soo Kim, Myung Ho Jeong","doi":"10.3904/kjim.2025.068","DOIUrl":"10.3904/kjim.2025.068","url":null,"abstract":"<p><strong>Background/aims: </strong>While the clinical effectiveness of guideline-directed medical therapy (GDMT) is well established in patients with acute myocardial infarction (AMI), its specific impact on cause-specific mortality remains unclear. This study aimed to investigate the impact of GDMT on both cardiac and non-cardiac mortality in AMI patients.</p><p><strong>Methods: </strong>Data of the KAMIR-NIH, a multicenter prospective registry of AMI in Korea between 2011 and 2015, were included. The competing risks of cardiac and non-cardiac death in patients who received GDMT were compared with those who did not, using a multivariable-adjusted cumulative incidence analysis of propensity score-matched patients. Primary endpoint of interest was 3-year cardiac and non-cardiac mortality.</p><p><strong>Results: </strong>Of the 12,815 patients enrolled, 2,700 matched pairs with a mean age of 64.9 ± 12.2 years were analyzed. The cumulative incidence of cardiac death (5.0% vs. 8.6%; subdistribution hazard ratio [sHR] 0.53; 95% CI 0.43-0.67) and non-cardiac death (3.2% vs. 4.5%; sHR 0.69; 95% CI 0.52-0.92) was significantly lower in patients receiving GDMT compared to those who did not (all p < 0.05). These results were also consistent in 30-day landmark analyses.</p><p><strong>Conclusion: </strong>In patients with AMI, the use of GDMT was linked to a reduced risk of both cardiac and non-cardiac death over a period of 3 years. These findings support the continued adoption of GDMT in clinical practice.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 5","pages":"780-789"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016509","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}

{"title":"Leiomyosarcoma at popliteal vein presented as unilateral leg edema in a patient with kidney transplantation.","authors":"Sang Heon Song","doi":"10.3904/kjim.2025.097","DOIUrl":"10.3904/kjim.2025.097","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"858-859"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975323","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}

{"title":"The early impact of COVID-19 vaccines on major events in cardiac, pulmonary, and thromboembolic disease: a population-based study.","authors":"Myeong Geun Choi, Min-Ho Kim, Eun Mi Chun","doi":"10.3904/kjim.2025.056","DOIUrl":"10.3904/kjim.2025.056","url":null,"abstract":"<p><strong>Background/aims: </strong>Although COVID-19 vaccines reduce COVID-19 severity, various safety concerns have emerged. This study, involving a population-based cohort, used health insurance data to investigate potential vaccine-related major outcomes, including cardiac, pulmonary, and thromboembolic diseases.</p><p><strong>Methods: </strong>This retrospective cohort study involved data from 2,017,884 vaccinated (at least two doses) individuals and 334,583 unvaccinated individuals. The incidences of myocarditis, myocardial infarction, atrial fibrillation, interstitial lung disease, pulmonary thromboembolism, deep vein thrombosis, and cerebrovascular disease were compared between the vaccinated and the unvaccinated groups at 1 week to 3 months after vaccination.</p><p><strong>Results: </strong>The study population had a mean age of 54 years (male: 44.6%). Among the vaccinated, 57.7% received the mRNA vaccine only, whereas 35.5% received the adenoviral vector vaccine alone. Multivariate logistic analysis revealed that vaccination was significantly associated with the early development of myocarditis. The mRNA vaccine, a younger age, and retrohyperlipidemia were independent indicators of poor myocarditis prognosis after vaccination. However, the incidence of myocardial infarction at 1-2 weeks post-vaccination, as well as pulmonary thromboembolism and cerebrovascular disease (both at 3 months post-vaccination), were significantly lower in the vaccinated group when compared with the unvaccinated one. However, there was no significant association between vaccination and interstitial lung disease, atrial fibrillation, or deep vein thrombosis.</p><p><strong>Conclusion: </strong>The younger male population (age: < 45 years) should be cautious about receiving the COVID-19 mRNA vaccine and should be closely monitored for myocarditis after vaccination. Vaccination was associated with short-term protection against venous and arterial thrombotic events, as well as hemorrhagic events.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"801-812"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975266","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}

{"title":"Association of kidney function and proteinuria with lower-extremity dysfunction in older Korean adults: a cross-sectional study.","authors":"Bongjo Kim, Eun-Bin Lim, Young Sang Lyu, Minkook Son, Youngmin Yoon","doi":"10.3904/kjim.2025.088","DOIUrl":"10.3904/kjim.2025.088","url":null,"abstract":"<p><strong>Background/aims: </strong>Chronic kidney disease (CKD) is associated with complications that affect physical function and mobility. This study investigated the associations between kidney function, proteinuria, and lower-extremity dysfunction.</p><p><strong>Methods: </strong>Data were obtained from the Korean National Health Insurance Service Health Screening Program, including individuals aged 66 years who participated in the National Screening Program for Transitional Ages in Korea. Participants were stratified based on estimated glomerular filtration rate (eGFR) into four groups: Group 1 (eGFR ≥ 90 mL/min/1.73 m2), Group 2 (60 ≤ eGFR < 90 mL/min/1.73 m2), Group 3 (30 ≤ eGFR < 60 mL/min/1.73 m2), and Group 4 (eGFR < 30 mL/min/1.73 m2). Lower-extremity dysfunction was assessed using two physical tests measuring function and balance. Multivariable logistic regression was performed to examine the associations between kidney function, proteinuria, and lower-extremity dysfunction.</p><p><strong>Results: </strong>Group 2 served as the reference. Both decreased (Groups 3 and 4) and elevated (Group 1) eGFR levels were significantly associated with an increased risk of lower-extremity dysfunction (Group 4: adjusted OR 1.40, 95% CI 1.10-1.78; Group 1: adjusted OR 1.19, 95% CI 1.12-1.25). Similar patterns were observed for balance dysfunction. A U-shaped relationship was identified between eGFR and lower-extremity dysfunction. Proteinuria was independently associated with balance dysfunction (adjusted OR 1.35, 95% CI 1.20-1.51) but not with lower-extremity dysfunction.</p><p><strong>Conclusion: </strong>A U-shaped relationship was identified between renal function and lower-extremity dysfunction, with both lower and elevated eGFR linked to increased risks of impairment, underscoring the need for regular assessment of lower-extremity function and appropriate interventions in patients with CKD, elevated eGFR, or proteinuria.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"823-834"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700142","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}

{"title":"Factors influencing delayed attainment of low disease activity in rheumatoid arthritis patients continuing targeted therapy.","authors":"Yeo-Jin Song, Soo-Kyung Cho, Se Rim Choi, Shin-Seok Lee, Hye-Soon Lee, Sung-Hoon Park, Yeon-Ah Lee, Min-Chan Park, Hyoun-Ah Kim, Soo-Bin Lee, Ha-Rim Park, Eunwoo Nam, Yoon-Kyoung Sung","doi":"10.3904/kjim.2024.344","DOIUrl":"10.3904/kjim.2024.344","url":null,"abstract":"<p><strong>Background/aims: </strong>To identify factors associated with achieving low disease activity (LDA) after 48 weeks of targeted therapy in patients with rheumatoid arthritis (RA) despite not meeting treat-to-target (T2T) criteria at week 24.</p><p><strong>Methods: </strong>Data were collected from a multicenter, prospective observational cohort of Korea patients with RA receiving targeted therapy between April 2020 and July 2023. Patients who continued their initial targeted therapy despite not achieving LDA at week 24 were assigned to the LDA and non-LDA groups at week 48. Multivariable logistic regression was employed to identify factors associated with achieving delayed LDA at week 48.</p><p><strong>Results: </strong>Among 456 patients with RA receiving targeted therapy, 213 were included in the analysis: 96 and 117 in the LDA and non-LDA groups, respectively. Patients with more comorbidities (HR 0.40, 95% CI 0.22-0.73) and those with seropositive RA (HR 0.15, 95% CI 0.03-0.70) were less likely to achieve LDA at week 48. Conversely, significant reductions in DAS28-ESR (HR 2.42, 95% CI 1.27-4.60) and HAQ-DI (HR 2.70, 95% CI 1.46-5.01) from enrolment to week 24, along with the absence of non-steroidal anti-inflammatory drug (NSAID) use at week 24 (HR 2.15, 95% CI 1.06-4.38), were associated with a greater likelihood of achieving delayed LDA at week 48.</p><p><strong>Conclusion: </strong>Many patients with RA can achieve delayed LDA with continued targeted therapy without adhering to the T2T strategy. Key factors include fewer comorbidities, seronegative RA, substantial disease activity reduction in the first 24 weeks, and stopping NSAID at week 24.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 5","pages":"835-844"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016416","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}

{"title":"Hidden benefits beyond herpes zoster: a potential preventive strategy against hepatobiliary diseases.","authors":"Dong Wook Kim, Tae Jun Song","doi":"10.3904/kjim.2025.262","DOIUrl":"10.3904/kjim.2025.262","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 5","pages":"691-692"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016469","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}

{"title":"Predicted pro-inflammatory high-sensitivity C-reactive protein score and inflammatory bowel disease: a cross-sectional study.","authors":"Dong Hyun Kim, Akinkunmi Paul Okekunle, Jioh Kang, Hyun-Soo Kim, Sang Hoon Kim, Min Kyu Jung, Jae Ho Park, Soo Young Na, Hoonjai Chun, Jung Eun Lee, Yun Jeong Lim","doi":"10.3904/kjim.2025.038","DOIUrl":"10.3904/kjim.2025.038","url":null,"abstract":"<p><strong>Background/aims: </strong>The role of pro-inflammatory factors in the pathogenesis of inflammatory bowel diseases (IBD), is not well understood. This study investigated the association between the predicted pro-inflammatory high-sensitivity C-reactive protein (hs-CRP) score and IBD.</p><p><strong>Methods: </strong>This study involved 127 case/non-case pairs matched by age and sex of participants who underwent gastrointestinal endoscopy in Korea. Participants provided comprehensive sociodemographic, lifestyle, and dietary data. We obtained odds ratio (OR) and 95% confidence interval (CI) for IBD prevalence by tertiles of the predicted pro-inflammatory hs-CRP score using multivariable-adjusted logistic regression models at a two-sided p < 0.05.</p><p><strong>Results: </strong>Higher predicted pro-inflammatory hs-CRP score was associated with a higher IBD prevalence; OR (95% CI): 1.00, 0.88 (0.38, 2.07) and 8.11 (2.07, 31.81; p for trend = 0.006). Similar increased trends of IBD prevalence with score increase were observed for men and women. The association was more pronounced for UC prevalence when we separated UC and CD. Compared to the low category, OR (95% CI) were 5.78 (1.29, 25.89) for UC but 1.44 (0.31, 6.69) for CD in the dichotomized higher category. The area under the curve for predicted pro-inflammatory hs-CRP score was 0.72 (95% CI: 0.64, 0.81) for UC and 0.68 (95% CI: 0.58, 0.77) for CD, indicating moderate predictive ability.</p><p><strong>Conclusion: </strong>Higher predicted pro-inflammatory hs-CRP score was significantly associated with an increased prevalence of IBD, particularly UC, and could be a valuable indicator for discriminating people at risk of IBD, offering insights into disease aetiology and opportunities for targeted interventions.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"734-746"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643926","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}

{"title":"Automatic quantitative analysis of atherosclerotic aortic plaques in patients with embolic cerebral infarction using deep learning.","authors":"Hye Jin Bang, Jae-Hyeong Park, Sun Geu Chae, Suk Joo Bae, Ji-Hoon Jung, You Hee Cho, Jong Won Park, Dae-Won Kim, Jung Sun Cho","doi":"10.3904/kjim.2024.360","DOIUrl":"10.3904/kjim.2024.360","url":null,"abstract":"<p><strong>Background/aims: </strong>Transesophageal echocardiography (TEE) is a commonly used imaging modality for assessing embolic stroke of undetermined source (ESUS) in clinical practice. We aimed to develop an automatic plaque segmentation model based on U-net and evaluate its clinical usefulness in patients with ESUS.</p><p><strong>Methods: </strong>We used two aorta image sets. TEE aortic images of 711 patients visiting two cardiovascular centers for various causes were randomly divided into training, validation, and test sets to automatically segment plaques and estimate the aortic plaque area (APA) and aortic plaque ratio (APR) using U-net. The model was tested in a clinical data set of patients with ESUS who attended three cardiovascular centers to determine whether it could predict a composite cardiovascular event in those patients.</p><p><strong>Results: </strong>The mean intersection of over union to assess the accuracy of the U-net model was 0.997 ± 0.002 and 0.997 ± 0.001 for the model development and clinical application data sets, respectively. When using the U-net-based model, the APA and APR significantly differed between complex and simple aortic plaques (p < 0.001). However, unlike complex aortic plaques measured in clinical practice, APA or APR estimated by U-net models or manual segmentation did not show additional value in predicting major adverse cardiovascular and cerebrovascular events.</p><p><strong>Conclusion: </strong>The estimation of APA and APR by the U-net model could be helpful in predicting complex aortic plaques. Additional comprehensive quantitative image analysis of plaque characteristics using artificial intelligence, such as movability and morphology, may be needed to predict prognosis.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"767-779"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975299","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}

{"title":"Comprehensive analysis of patients with rheumatoid arthritis associated interstitial lung disease.","authors":"Ji-Won Kim, Ju-Yang Jung, Chang-Hee Suh, Hyoun-Ah Kim","doi":"10.3904/kjim.2024.377","DOIUrl":"10.3904/kjim.2024.377","url":null,"abstract":"<p><strong>Background/aims: </strong>To investigate the demographics, disease characteristics, and treatment modalities of patients with rheumatoid arthritis (RA) associated interstitial lung disease (ILD), focusing on ILD exacerbation and mortality.</p><p><strong>Methods: </strong>This retrospective study included individuals aged ≥ 18 years diagnosed with RA-ILD at Ajou University Hospital from January 1999 to March 2022. Diagnosis was based on chest computed tomography (CT) scans; progression was monitored based on available follow-up pulmonary function tests (PFTs) and chest CTs. Logistic regression analysis identified factors associated with ILD progression and mortality.</p><p><strong>Results: </strong>The study included participants with a mean age of 64.3 years, 48.3% of whom were male. Smoking status: 13.2% ex-smokers, 25.2% current smokers, 61.6% non-smokers. Mean RA and ILD duration were 134.0 and 87.5 months, respectively. Mean Disease Activity Score in 28 joints was 4.9. The usual interstitial pneumonia (UIP) pattern was seen in 60.3%. Baseline PFT showed a mean FVC of 81.9 L, diffusing capacity for carbon monoxide (DLco) of 58.7 mL/min/mm, and DLco corrected for alveolar volume of 83.4 mL/min. With a mean follow-up of 4 years, ILD progressed in 58.3% of patients, with a mortality rate of 21.2%. ILD progression and UIP pattern significantly influenced mortality. Methotrexate use did not impact progression or mortality.</p><p><strong>Conclusion: </strong>RA-ILD patients showed diverse clinical profiles, with ILD duration and UIP pattern significantly affecting prognosis. Personalized management and vigilant monitoring are essential to improve outcomes for RA-ILD patients.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"845-855"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975301","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}