Korean Journal of Internal Medicine最新文献

{"title":"Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease.","authors":"Noeul Kang, Su-Young Kim, Dae Hun Kim, Byung Woo Jhun","doi":"10.3904/kjim.2024.209","DOIUrl":"10.3904/kjim.2024.209","url":null,"abstract":"<p><strong>Background/aims: </strong>To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status.</p><p><strong>Methods: </strong>Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3-V4 region of the 16S rRNA gene.</p><p><strong>Results: </strong>Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05).</p><p><strong>Conclusion: </strong>In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"449-457"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701825","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":"Altered polyunsaturated fatty acids and oxylipins profile in Behçet's disease.","authors":"Mohamed Kacem Ben-Fradj, Ines Naceur, Emna Talbi, Rahma Wada, Omar Feki, Monia Smiti-Khanfir, Moncef Feki","doi":"10.3904/kjim.2024.033","DOIUrl":"10.3904/kjim.2024.033","url":null,"abstract":"<p><strong>Background/aims: </strong>Behçet's disease (BD) is an autoinflammatory disease of unknown etiopathogenesis. Oxylipins i.e., prostaglandins, leukotrienes, lipoxins, resolvins, and protectins are bioactive polyunsaturated fatty acids (PUFAs) derivatives involved in inflammatory response induction and resolution. The study aimed to determine the profile of selected PUFAs and oxylipins and to define a lipidomic signature for BD.</p><p><strong>Methods: </strong>A case-control study was conducted involving thirty-five patients with BD and thirty-five age and sex-matched healthy individuals as a control group. Selected plasma PUFAs and oxylipins were analyzed using a targeted LC-MS/MS method.</p><p><strong>Results: </strong>The lipidomic profile was different between the two groups. BD patients showed higher levels of oxylipins deriving from either the n-6-arachidonic acid (i.e., prostaglandin D2, E2, F2α, and 6-keto-F1α, thromboxane B2, leukotriene B4, E4 and F4, and 6-epi and 15-epi-lipoxin A4) or n-3 PUFAs (i.e., 18-hydroxyeicosapentaenoic acid, 7,17-dihydroxy docosapentaenoic acid, protectin X, and resolvin D5), but decreased levels of both n-3 and n-6 PUFAs. Multivariate analyses selected the combination of four mediators, i.e., docosapentaenoic acid, prostaglandin E2, thromboxane B2, and lipoxin A4 as an accurate lipidomic signature for BD.</p><p><strong>Conclusion: </strong>The profile of PUFAs/oxylipins is altered in BD patients, characterized by increased pro-inflammatory and pro-resolving oxylipins. The findings suggest that oxylipin metabolism might be involved in BD pathophysiology and may represent a therapeutic target for the disease. Further research is required to examine the role of lipid mediators in BD.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"502-511"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484481","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":"Hematologic malignancy detected on sacroiliac magnetic resonance imaging in a patient with inflammatory back pain.","authors":"Jiwon Yang, Hyoo Jeong Lim, Seul Ki Lee, Seung Min Jung","doi":"10.3904/kjim.2024.243","DOIUrl":"10.3904/kjim.2024.243","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"526-527"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701764","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":"Polymyxin B-hemoperfusion in acute exacerbation of idiopathic pulmonary fibrosis: a feasibility step forward.","authors":"Won-Il Choi","doi":"10.3904/kjim.2025.111","DOIUrl":"10.3904/kjim.2025.111","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 3","pages":"345-346"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054683","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":"Unusual polypoid mass in the colon.","authors":"Seung-Woo Lee, Jong Ok Kim","doi":"10.3904/kjim.2024.327","DOIUrl":"10.3904/kjim.2024.327","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"524-525"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434130","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":"Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients.","authors":"Yuri Kim, Do Hoon Kim, Myeongsook Seo, Hee Kyong Na, Kee Wook Jung, Ji Yong Ahn, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung","doi":"10.3904/kjim.2024.250","DOIUrl":"10.3904/kjim.2024.250","url":null,"abstract":"<p><strong>Background/aims: </strong>Cytomegalovirus (CMV) disease in the upper gastrointestinal (UGI) tract frequently occurs in immunocompromised patients. However, data regarding UGI CMV disease in non-transplant patients compared with those in transplant recipients are limited. Therefore, we compared the clinical characteristics, endoscopic findings, and outcomes of UGI CMV disease in non-transplant patients with those in transplant recipients.</p><p><strong>Methods: </strong>We reviewed the medical records of patients diagnosed with UGI CMV disease between May 1999 and January 2022. UGI CMV disease was defined as symptoms or signs of gastrointestinal disease with typical findings of CMV inclusion body and positive immunochemistry stain or CMV polymerase chain reaction from the endoscopic biopsy specimen.</p><p><strong>Results: </strong>Among the 219 eligible patients, 132 (60.3%) were transplant patients. Age, male sex, and Charlson Comorbidity Index were significantly higher in the non-transplant group than in the transplant group. The most common symptoms were pain and odynophagia (43.8%). Transplant recipients more frequently experienced UGI CMV disease in the stomach than non-transplant patients, typically presenting as erosions or mucosal hyperemia. However, non-transplant patients more commonly experienced UGI CMV disease in the esophagus than transplant recipients, typically presenting as ulcers. The transplant group had a significantly higher clinical response than the non-transplant group.</p><p><strong>Conclusion: </strong>UGI CMV disease in transplant patients can be present in the stomach in various forms, including ulcers or erosions. In transplant patients suspected of UGI CMV disease, conducting an esophagogastroduodenoscopy with tissue biopsy in any area where even the slightest mucosal abnormality is observed is essential to facilitate a prompt diagnosis.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"394-403"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701740","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":"Follicular lymphoma: contemporary clinical management with a focus on recent therapeutic advances.","authors":"Robert Kridel","doi":"10.3904/kjim.2024.279","DOIUrl":"10.3904/kjim.2024.279","url":null,"abstract":"<p><p>Follicular lymphoma (FL) is the most common type of indolent lymphoma, and the prognosis is favorable for most patients. However, FL remains generally incurable, and relapse is common. Patients are at risk of developing treatment-resistant lymphoma, particularly when early disease progression occurs or transformation to aggressive lymphoma takes place. Furthermore, lymphoma is the leading cause of death among patients with FL, emphasizing the need for more effective treatment strategies. This review summarizes therapeutic approaches for FL, with a focus on therapies currently in development. Recent biological insights have driven the emergence of highly effective treatments, including novel immune and targeted therapies. Clinical trials are assessing the efficacy of these novel approaches, which are increasingly used in earlier line settings. In the future, FL therapy is expected to rely less on chemotherapeutic methods, extend remission, and potentially enable cures for a growing number of patients.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"371-393"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484442","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":"Tissue-invasive upper gastrointestinal cytomegalovirus disease in transplant and non-transplant patients.","authors":"Seokin Kang","doi":"10.3904/kjim.2025.096","DOIUrl":"10.3904/kjim.2025.096","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 3","pages":"343-344"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020392","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":"Clinical perspective on serum periostin in antineutrophil-cytoplasmic antibody-associated vasculitis.","authors":"Taejun Yoon, Jiyeol Yoon, Eunhee Ko, Yong-Beom Park, Sang-Won Lee","doi":"10.3904/kjim.2024.254","DOIUrl":"10.3904/kjim.2024.254","url":null,"abstract":"<p><strong>Background/aims: </strong>This study evaluated the clinical utility of serum periostin measured at diagnosis in reflecting activity at diagnosis and predicting all-cause mortality during follow-up in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).</p><p><strong>Methods: </strong>This study included 76 patients with AAV whose serum periostin was measured from sera collected and stored at diagnosis. The correlation of either serum periostin or the Birmingham Vasculitis Activity Score (BVAS) with other variables was evaluated. Cumulative survival rates were compared using Kaplan-Meier survival analysis. The variables at diagnosis were compared between deceased and surviving patients. Hazard ratios were obtained by Cox proportional hazard analysis.</p><p><strong>Results: </strong>The median age of the 76 patients was 64.0 years and 60.5% were female. The median BVAS and serum periostin were 5.0 and 10.9 ng/mL, respectively. Five of the 76 patients (6.6%) died. Serum periostin was independently correlated with cross-sectional BVAS, the Vasculitis Damage Index (VDI), white blood cell count, and serum albumin. Patients with serum periostin ≥ 15.9 ng/mL at diagnosis had a significantly lower cumulative survival rate than those without. In addition to high VDI, dyslipidaemia frequency, and C-reactive protein, deceased patients showed higher serum periostin than surviving patients. In multivariable Cox analysis, however, only dyslipidaemia rather than serum periostin was identified as an independent predictor of all-cause mortality.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate that serum periostin at diagnosis could independently reflect cross-sectional BVAS and further partially contribute to all-cause mortality prediction in patients with AAV.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 3","pages":"512-523"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033592","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":"Clinical approach to sexually transmitted infections and pelvic inflammatory disease in women with acute pyelonephritis.","authors":"Mi-Hee Kim, Hyojin Ahn, Soyeon Kang, Ahra Lee, Seong-Heon Wie","doi":"10.3904/kjim.2024.213","DOIUrl":"10.3904/kjim.2024.213","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aimed to investigate co-occurrence and clinical characteristics of sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) in women hospitalized for acute pyelonephritis (APN).</p><p><strong>Methods: </strong>This single-center retrospective study reviewed medical records of inpatients with APN from January 2019 to February 2023 and identified records of 142 patients who were referred to a gynecologist to evaluate gynecological diseases including STIs.</p><p><strong>Results: </strong>Of the 142 patients, 47 were tested positive for sexually transmitted pathogens in nucleic acid amplification testing, confirming the presence of STIs. In patients with APN, those with STIs were more likely to have lower abdominal pain or cervical motion tenderness (CMT) on pelvic examination and leukocytosis (> 14.5 × 109/L) than those without STIs. Of the 93 patients who underwent pelvic examination, 34 had CMT with one or more of additional criteria for the clinical diagnosis of PID, such as abnormal vaginal discharge and leukorrhea confirmed by microscopic examination, which could be clinically diagnosed as PID.</p><p><strong>Conclusion: </strong>In sexually active women with APN, it is important to evaluate the possibility of STIs and PID, considering several risk factors such as lower abdominal pain, abnormal vaginal discharge, CMT, and leukocytosis.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 3","pages":"482-490"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042242","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}