Korean Journal of Internal Medicine最新文献

{"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":"https://doi.org/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>Conclusions: </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":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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>Conclusions: </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":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Findings suggestive of fanconi syndrome and multiple myeloma.","authors":"Hwa-Young Lee, Sung Gyul Lim, Han Sang Lee, Won-Ae Lee, So Mi Kim","doi":"10.3904/kjim.2025.004","DOIUrl":"https://doi.org/10.3904/kjim.2025.004","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643925","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}

{"title":"Submucosal saline injection and mini-probe endoscopic ultrasound to assess endoscopic resectability of colorectal subepithelial tumors.","authors":"Jung-Bin Park, Ji Eun Baek, June Hwa Bae, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang","doi":"10.3904/kjim.2024.384","DOIUrl":"10.3904/kjim.2024.384","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aimed to evaluate the feasibility and outcomes of mini-probe endoscopic ultrasound (mEUS) followed by submucosal saline injection (SSI-mEUS) for assessing the endoscopic resectability of colorectal subepithelial lesions (SELs).</p><p><strong>Methods: </strong>From January 2020 to December 2023, the medical records of 391 SELs (364 patients) were retrospectively reviewed and categorized into no EUS, mEUS-only, and SSI-mEUS groups according to the procedure used. To compare variables between the SSI-mEUS and other groups, the no EUS and mEUS-only groups were combined into the non-SSI-mEUS group. In the SSI-mEUS group, submucosal cushion thickness was endosonographically measured after the saline injection. Treatment outcomes and histological diagnosis were retrospectively reviewed.</p><p><strong>Results: </strong>A total of 210 lesions in the no EUS group, 23 in the mEUS-only group, and 125 in the SSI-mEUS group were endoscopically resected. The mean SEL size was larger in the SSI-mEUS than in the non-SSI-mEUS group (6.8 ± 2.6 mm vs. 4.9 ± 2.6 mm, p < 0.001). R0 resection was achieved in 107 of 110 neoplastic lesions (97.3%) in the SSI-mEUS group vs. 159 of 176 neoplastic lesions (90.3%) in the non-SSI-mEUS group (p = 0.046). Not using SSI-mEUS was the only factor associated with indeterminate or positive deep resection margins (odds ratio 3.45, 95% confidence interval 1.19-13.40, p = 0.021).</p><p><strong>Conclusion: </strong>For colorectal SELs, including those that appear insufficiently elevated during conventional endoscopy, SSI-mEUS enables an objective assessment of the feasibility of endoscopic resection and can predict a high likelihood of achieving a safe and complete resection.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"592-605"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601975","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 body mass index on clinical outcomes in intestinal Behçet's disease.","authors":"Daye Park, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon","doi":"10.3904/kjim.2024.349","DOIUrl":"10.3904/kjim.2024.349","url":null,"abstract":"<p><strong>Background/aims: </strong>The impact of body mass index (BMI) on the clinical outcomes of intestinal Behçet's disease (BD) remains unclear. This study assessed the association between BMI and disease progression.</p><p><strong>Methods: </strong>A retrospective analysis of 760 patients with intestinal BD was conducted. Patients were classified by BMI as underweight (< 18.5 kg/m2), normal (18.5-22.9), overweight (23.0-24.9), or obese (≥ 25.0). The association between BMI and clinical outcomes-biologics, surgery, hospitalization, and emergency visits-was examined.</p><p><strong>Results: </strong>Among 760 patients, 130 (17.1%) were underweight, 384 (50.5%) normal, 152 (20.0%) overweight, and 94 (12.4%) obese. Higher BMI linked to lower cumulative rates of biologics use (p trend = 0.002), surgery (p trend = 0.004), hospitalization (p trend = 0.004), and emergency visits (p trend = 0.008). Compared with the underweight group, the normal (HR 0.667, 95% CI 0.483-0.922, p = 0.014), overweight (HR 0.589, 95% CI 0.394-0.879, p = 0.010), and obese groups (HR 0.515, 95% CI 0.321-0.828, p = 0.006) had lower hospitalization risks. The overweight (HR 0.490, 95% CI 0.241-0.996, p = 0.049) and obese (HR 0.312, 95% CI 0.116-0.840, p = 0.021) groups were negatively associated with future biologics use. The normal (HR 0.705, 95% CI 0.480-1.036, p = 0.075) and obese (HR 0.510, 95% CI 0.272-0.953, p = 0.035) groups were negatively associated with future surgery in multivariable analysis.</p><p><strong>Conclusion: </strong>Lower BMI was linked to poorer clinical outcomes in intestinal BD, emphasizing the need to optimize nutritional status.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"606-615"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602043","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":"Role of catheter ablation in patients with heart failure and atrial fibrillation.","authors":"Min-Su Jung, Hyoung-Seob Park","doi":"10.3904/kjim.2024.284","DOIUrl":"10.3904/kjim.2024.284","url":null,"abstract":"<p><p>Atrial fibrillation (AF) and heart failure (HF) frequently coexist with other cardiovascular conditions and adversely affect each other. Over the past few decades, there have been therapeutic advances in AF and HF; however, whether rate-control or rhythm-control is the superior approach for these patients remains controversial. Additionally, there is debate regarding whether antiarrhythmic drug therapy or ablation is the optimal strategy for rhythm-control. The outcomes of AF ablation have improved, and several studies have assessed the potential benefits of AF ablation in patients with HF. The positive impact of catheter ablation in patients with AF and impaired left ventricular (LV) systolic function extends beyond rhythmic outcomes and may result in LV function improvement. This review provides a brief overview of this topic and summarizes several prospective randomized trials that have shown important clinical outcomes comparing AF ablation and non-ablation treatment options in patients with AF and HF so as to provide improved treatment guidance.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"533-545"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601974","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":"Beat-to-beat alternans.","authors":"Chan-Hee Lee, Melvin M Scheinman","doi":"10.3904/kjim.2024.372","DOIUrl":"10.3904/kjim.2024.372","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"687-688"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112481","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":"Generalized edema with acute renal failure in a patient with diabetes.","authors":"Yujin Shin, Chang-Hoon Lee, Kyoung Min Kim, Yong Gon Cho, Kyung Pyo Kang","doi":"10.3904/kjim.2024.428","DOIUrl":"10.3904/kjim.2024.428","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"689-690"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602042","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 between body mass index and survival after hematopoietic stem cell transplantation.","authors":"Han-Sang Baek, Jong Hyuk Lee, Joonyub Lee, Seung-Hwan Lee, Gi June Min, Sung-Soo Park, Silvia Park, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Seok-Goo Cho, Jong Wook Lee, Jae-Ho Yoon","doi":"10.3904/kjim.2024.246","DOIUrl":"10.3904/kjim.2024.246","url":null,"abstract":"<p><strong>Background/aims: </strong>The unclear relationship between body mass index (BMI) and post-hematopoietic stem cell transplantation (HSCT) mortality was investigated, including the impact of metabolic diseases.</p><p><strong>Methods: </strong>This retrospective study conducted at a Korean tertiary hospital (2009-2021) included patients who underwent HSCT. Patients were categorized as underweight (BMI < 18.5 kg/m2, n = 106), normal (BMI 18.5-22.9 kg/m2, n = 1,345), overweight (BMI 23.0-24.9 kg/m2, n = 980), or obese (BMI ≥ 25.0 kg/m2, n = 1,471). Diabetes mellitus (DM), hypertension, and dyslipidemia were identified by disease codes or medication prescriptions. A Cox proportional hazards model was used to analyze mortality risks.</p><p><strong>Results: </strong>Over 108 months, 29.8% (1,164/3,902) of the participants died. Patients with underweight had significantly higher mortality (adjusted HR 1.76, 95% CI 1.29-2.40, p < 0.001) than in those with normal BMI. Patients with overweight and obesity did not show increased mortality. Post-HSCT, DM significantly raised mortality risk (HR 3.36, 95% CI 2.86-3.94, p < 0.001), whereas newly diagnosed dyslipidemia was associated with lower mortality (HR 0.27, 95% CI 0.23-0.33, p < 0.001). Post-transplant hypertension had no significant impact on mortality (HR 1.10, 95% CI 0.95-1.28, p = 0.184).</p><p><strong>Conclusion: </strong>Post-HSCT, obesity is not a prognostic factor for poor survival; however, certain metabolic diseases have diverse effects on mortality.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"645-656"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602023","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":"Cytokine profiles associated with persisting symptoms of post-acute sequelae of COVID-19.","authors":"Ji-Soo Kwon, Euijin Chang, Hyeon Mu Jang, Ji Yeun Kim, Woori Kim, Ju Yeon Son, Junho Cha, Choi Young Jang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim","doi":"10.3904/kjim.2024.217","DOIUrl":"10.3904/kjim.2024.217","url":null,"abstract":"<p><strong>Background/aims: </strong>Post-acute sequelae of COVID-19 (PASC) are highly heterogeneous; therefore, the pathophysiological mechanisms for PASC remain unclear. In this study, we aimed to examine the immunologic aspects of various PASC symptoms.</p><p><strong>Methods: </strong>We prospectively enrolled adults aged ≥ 18 years who were diagnosed with COVID-19 between August 2022 and September 2023. Blood samples were collected from all participants, who were interviewed using a questionnaire for PASC symptoms at least once between 1 and 6 months after the COVID-19 diagnosis. For immunological evaluation, plasma concentrations of SARS-CoV-2 spike subunit 1-specific IgG and 33 cytokines were measured using enzyme-linked immunosorbent assays and multiplex-based immunoassay, respectively.</p><p><strong>Results: </strong>In total, 156 pairs of blood samples and symptom reports from 79 participants were eligible for analysis. The most frequent symptom was fatigue, followed by post exertional malaise, chronic cough, thirst, and brain fog. Gastrointestinal symptoms, chest pain, post exertional malaise, smell/taste change, fatigue, brain fog, abnormal movement, and palpitation were accompanied by significant increases in IL-10, VEGF, and inflammatory cytokines like MIP-1α, IL-1β, IL-6, IL-8, MIG, granzyme A, and CX3CL1 levels, while chronic cough, dizziness, dyspnea, and hair loss were not accompanied by significant differences in cytokine levels.</p><p><strong>Conclusion: </strong>Symptoms classified into different categories based on the dysfunctional organs may share a common pathophysiology regarding elevation of certain cytokines. Although PASC symptoms are heterogeneous, our findings suggest that T-cell recruitment, thrombosis, and increased vascular permeability might contribute to various symptom clusters sharing common pathophysiological mechanisms.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"667-675"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602037","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}