Korean Journal of Internal Medicine最新文献_第3页

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 : 2026-09-01 Epub 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

Clinical feasibility of deep learning-assisted classification of Helicobacter pylori infection in endoscopic imagery: a reader study. 内镜图像中幽门螺杆菌感染的深度学习辅助分类的临床可行性：一项读者研究。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2024.245

Jun-Young Seo, Jiseon Kang, Do Hoon Kim, Namkug Kim

{"title":"Clinical feasibility of deep learning-assisted classification of Helicobacter pylori infection in endoscopic imagery: a reader study.","authors":"Jun-Young Seo, Jiseon Kang, Do Hoon Kim, Namkug Kim","doi":"10.3904/kjim.2024.245","DOIUrl":"10.3904/kjim.2024.245","url":null,"abstract":"Background/aims: Detecting Helicobacter pylori infection through endoscopic imaging is a preferred method to address the limitations of invasive diagnostics. We have developed a deep learning (DL) model to classify these images based on their H. pylori infection status and to evaluate its potential as a diagnostic aid.Methods: We retrospectively enrolled H. pylori-positive patients (by rapid urease test and serum IgG) at Asan Medical Center between January 2015 and December 2020, establishing development and test datasets to evaluate model utility. We developed a DL model and assessed its performance at both the image and patient levels using metrics such as accuracy, sensitivity, specificity, and F1-score. Fourteen readers of varying experience levels interpreted the endoscopic images in two apsessions, before and after the integration of the DL model results. The diagnostic accuracy of the readers was analyzed using the McNemar test and generalized estimating equations.Results: In the utility test set, the image-level accuracy, sensitivity, specificity, and F1-score of our DL model were 84.2%, 74.4%, 93.9%, and 82.5%, respectively. At the patient level, the corresponding values were 97.0%, 100%, 94.0%, and 97.1%. Endoscopists utilizing the DL model demonstrated significantly improved accuracy in classifying H. pylori infections, with classification rates of 83.2% versus 72.4% (p < 0.001).Conclusion: Our DL model shows exceptional predictive capabilities for identifying H. pylori infections in gastroscopy images, suggesting the potential of DL-based tools to enhance clinical decision-making in endoscopy. Future research should focus on multicenter prospective studies to validate these findings.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"862-872"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991904","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

Beyond susceptibility: do population-specific rare variants shape age at diagnosis in Korean inflammatory bowel disease? 除了易感性：人群特异性罕见变异是否影响韩国炎症性肠病的诊断年龄？

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2026.430

Soo-Kyung 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