Korean Journal of Internal Medicine最新文献

{"title":"Fecal microbiota transplantation for marked colonic dilatation.","authors":"Eunseo Cho, Jung-Hwan Lee, Ji-Taek Hong, Kye Sook Kwon, Yong Woon Shin","doi":"10.3904/kjim.2025.253","DOIUrl":"10.3904/kjim.2025.253","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"560-562"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934908","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":"Comparison of the efficacy and safety of endoscopic and fluoroscopic balloon dilatation in benign esophageal strictures.","authors":"Kwangbeom Park, Chang Hoon Oh, Do Hoon Kim, Ji Hoon Shin, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung","doi":"10.3904/kjim.2023.525","DOIUrl":"10.3904/kjim.2023.525","url":null,"abstract":"<p><strong>Background/aims: </strong>Balloon dilatation under endoscopic or fluoroscopic guidance is regarded as the gold standard for treating benign esophageal strictures. However, no prior studies have compared endoscopic balloon dilatation (EBD) with fluoroscopic balloon dilatation (FBD). We aimed to compare the efficacy and safety of the two methods.</p><p><strong>Methods: </strong>Subjects who underwent balloon dilatation under endoscopic or fluoroscopic guidance for benign esophageal strictures between 2001 and 2018 were eligible. Their medical records were retrospectively reviewed, and clinical characteristics were investigated.</p><p><strong>Results: </strong>From 201 patients, 60 patients underwent EBD, and the remaining 141 underwent FBD. The mean age was higher in the FBD group than in the EBD group (69.77 vs. 58.63 yr, p < 0.001). The most frequent etiology of the strictures was surgery in both groups. Longer procedure times, cervical esophageal location, and short stricture length were significantly associated with the FBD group. Multivariable analysis showed that old age (HR 1.028), higher dysphagia grade (HR 1.561 for grade II and HR 3.518 for grade III), and long stricture length (HR 1.943) were significantly associated with the short dilatation-free period. There were no significant differences in dilatation-free periods or adverse events between the groups.</p><p><strong>Conclusion: </strong>Both EBD and FBD are safe and effective primary treatment modalities for treating benign esophageal strictures. Choosing an appropriate method depending on the location and length of the stricture and the institution's capacity and resources would produce more effective results.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"462-473"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934891","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":"Eperisone-induced immediate hypersensitivity reactions.","authors":"Gyu-Young Hur, Jung-Won Park","doi":"10.3904/kjim.2025.341","DOIUrl":"10.3904/kjim.2025.341","url":null,"abstract":"<p><p>Eperisone hydrochloride is a centrally acting muscle relaxant commonly prescribed for musculoskeletal pain, particularly in Korea and Japan. It induces relaxation of skeletal and vascular smooth muscle through central nervous system modulation and peripheral mechanisms, although its precise biochemical pathway remains unclear. While generally well tolerated, eperisone has been reported to cause immediate hypersensitivity reactions, including anaphylaxis. Because eperisone is frequently co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs), these reactions are often misdiagnosed as NSAID hypersensitivity, leading to unnecessary drug discontinuation and suboptimal pain management. A review of published case reports and pharmacovigilance data indicates that most eperisone-associated reactions are immediate-type, with anaphylaxis being clinically significant yet underrecognized. Skin prick tests and intradermal tests show variable diagnostic reliability, whereas drug provocation tests (DPTs) demonstrate the highest diagnostic accuracy and remain the gold standard. Basophil activation tests and serum tryptase measurement during DPT may serve as complementary diagnostic tools. Accurate identification of eperisone hypersensitivity is essential for preventing recurrent anaphylaxis and avoiding unnecessary NSAID discontinuation. This review summarizes the epidemiology, clinical features, and diagnostic strategies of eperisone hypersensitivity and emphasizes the importance of enhancing clinical awareness and referring affected patients to allergy specialists for proper evaluation.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"411-417"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934894","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":"Subacute respiratory symptoms in a patient with Crohn's disease and ankylosing spondylitis.","authors":"Doohyuck Lee, Kwangwoo Nam, Ho Jin Yong, Juntae Kim, Miil Kang","doi":"10.3904/kjim.2025.270","DOIUrl":"10.3904/kjim.2025.270","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"557-559"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311442","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":"Beyond technique: toward strategy-based endoscopic resection for rectal neuroendocrine tumors.","authors":"Seong-Jung Kim","doi":"10.3904/kjim.2026.204","DOIUrl":"10.3904/kjim.2026.204","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"441-442"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934958","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":"Cross-neutralizing antibody responses among individuals with or without bivalent vaccine: a six-month prospective cohort study.","authors":"Hye Hee Cha, Ji Yeun Kim, Seung Beom Kim, Junho Cha, Ji-Soo Kwon, Woori Kim, Ju Yeon Son, Choi Young Jang, Min-Chul Kim, So Yun Lim, Sung-Han Kim","doi":"10.3904/kjim.2025.246","DOIUrl":"10.3904/kjim.2025.246","url":null,"abstract":"<p><strong>Background/aims: </strong>Although the COVID-19 pandemic has officially ended, SARS-CoV-2 continues to circulate with periodic surges and may exhibit seasonal patterns. Understanding the importance of prompt immunization, particularly in individuals with prior infection, is crucial for developing future vaccination protocols. This study aimed to assess the durability and breadth of neutralizing antibody (nAb) responses against Omicron subvariants based on infection and bivalent vaccination status.</p><p><strong>Methods: </strong>In this six-month prospective cohort study, we evaluated nAb responses to the original SARS-CoV-2 strain (D614G), as well as Omicron subvariants BA.4/5 and XBB.1.5 variants, in 79 healthcare workers stratified by prior Omicron infection and bivalent vaccination status. Blood samples were collected at baseline, 3 months, and 6 months, and nAb titers were measured using an optimized pseudovirus neutralization assay.</p><p><strong>Results: </strong>At 3 months, individuals with prior Omicron infection followed by bivalent vaccination showed significantly higher nAb titers against BA.4/5 and XBB.1.5 compared to those with infection alone or vaccination alone. At 6 months, the highest titers persisted in the group with both prior infection and bivalent vaccination, while titers declined in previously infected but unvaccinated individuals. Notably, individuals with prior infection alone exhibited comparable nAb titers to infection-naïve vaccinated individuals, suggesting limited durability of infection-induced immunity without vaccine-induced boosting.</p><p><strong>Conclusion: </strong>These findings underscore the importance of timely vaccination, even among previously infected individuals, to ensure sustained humoral immunity and broader cross-nAb responses against emerging SARS-CoV-2 variants.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"516-523"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934935","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":"Does physical activity reduce cardiovascular risk associated with knee osteoarthritis in type 2 diabetes? A nationwide cohort study.","authors":"Dojoon Park, Kyuho Kim, Hae-Seok Koh, Kyungdo Han, Youn-Ho Choi","doi":"10.3904/kjim.2025.143","DOIUrl":"10.3904/kjim.2025.143","url":null,"abstract":"<p><strong>Background/aims: </strong>Knee osteoarthritis (OA), type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) share overlapping mechanisms but are often managed independently. We evaluated whether knee OA increases CVD risk in Korean T2DM patients and whether physical activity (PA) modifies this risk.</p><p><strong>Methods: </strong>We conducted a nationwide cohort study using data from the Korean National Health Insurance Service. A total of 1,068,215 adults with T2DM screened between 2009-2012 were followed until CVD events or end of follow-up in 2018. Knee OA was identified by ICD-10 codes and radiographic imaging. PA was classified as none, intermittent (≥ 1 session/week), or regular (≥ 3 sessions/week). Cox models were used to estimate hazard ratios (HRs) for myocardial infarction (MI), stroke, heart failure (HF), and cardiovascular mortality, adjusting for demographics, BMI, eGFR, lifestyle factors, hypertension, dyslipidemia, insulin use, and antidiabetic medication.</p><p><strong>Results: </strong>Knee OA independently increased risks for overall CVD (HR 1.13, 95% CI 1.11-1.16), MI (1.07, 1.02-1.13), stroke (1.14, 1.10-1.18), and HF (1.13, 1.09-1.17). Cardiovascular mortality was not significantly increased (HR 0.99, 95% CI 0.92-1.07). The association was stronger among non-insulin users and patients with diabetes duration < 5 years. Even intermittent PA significantly reduced cardiovascular mortality among OA patients (HR 0.69, 95% CI 0.61-0.78).</p><p><strong>Conclusion: </strong>Knee OA substantially elevates CVD risk in Korean T2DM patients, particularly early in disease progression. Even modest PA confers meaningful cardiovascular protection. Early cardiovascular assessment and tailored PA recommendations are essential for comprehensive diabetes management in patients with OA.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"485-500"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934955","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":"LncRNA as a diagnostic marker for rheumatoid arthritis: a systematic review and meta-analysis.","authors":"Lin-Ling Luo, Yu-Tong Chen, Yi-Ning Xu, Miao Lu, Xi-de Liu","doi":"10.3904/kjim.2025.079","DOIUrl":"10.3904/kjim.2025.079","url":null,"abstract":"<p><strong>Background/aims: </strong>Rheumatoid arthritis (RA) is categorized as an autoimmune disorder characterized by the absence of a definitive cure. In this investigation, we executed a systematic review and diagnostic meta-analysis to ascertain the diagnostic efficacy of long non-coding RNAs (lncRNAs) in the identification of RA.</p><p><strong>Methods: </strong>Our survey involved relevant studies published in PubMed, Web of Science, Embase, Cochrane library search engines. Specificity and sensitivity were calculated, as well as positive likelihood ratios (PLRs), negative likelihood ratios (NLRs), and diagnostic odds ratios (DORs). The operating characteristics of the overall receiver were plotted, and the area under the curve (AUC) was evaluated.</p><p><strong>Results: </strong>This systematic review and meta-analysis incorporated 34 studies involving a total of 1,535 participants-comprising 853 individuals diagnosed with RA and 682 control subjects without the disease. The pooled specificity, sensitivity, NLR, PLR, and DOR were 0.88 (95% CI: 0.84-0.92), 0.86 (95% CI: 0.81-0.91), 0.15 (95% CI: 0.11-0.22), 7.51 (95% CI: 5.39-10.46), and 49.06 (95% CI: 30.31-79.41), respectively, and the AUC = 0.94 (95% CI: 0.91-0.96). Subgroup analysis was performed according to lncRNA expression in RA, sample size, sample type, RNA extraction, and control group type.</p><p><strong>Conclusion: </strong>This meta-analysis reveals that lncRNAs may serve as powerful biomarkers for RA. This systematic review and meta-analysis provides the first evidence showing the potential value of using lncRNAs as a diagnostic tool for RA.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"524-536"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934889","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":"Transcatheter aortic valve implantation for symptomatic severe aortic stenosis and its expanding clinical indications.","authors":"Hyungdon Kook, Young-Hyo Lim","doi":"10.3904/kjim.2025.256","DOIUrl":"10.3904/kjim.2025.256","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for symptomatic severe aortic stenosis (AS) that was initially developed for patients with prohibitive surgical risk. Since the first-in-human procedure in 2002, TAVI has gained global acceptance owing to its favorable clinical outcomes and faster recovery than those associated with surgical aortic valve replacement. Landmark trials have demonstrated the noninferiority or superiority of TAVI across high-, intermediate-, and low-surgical risk populations, leading to guideline endorsement as a recommended option for appropriately selected patients across all surgical risk groups. Furthermore, long-term follow-up data support the durability of contemporary TAVI devices. Beyond its current established indications, TAVI is being explored for broader applications such as asymptomatic severe AS, moderate AS with heart failure, and pure aortic regurgitation; however, these uses remain investigational and are not yet part of formal guidelines. This review summarizes TAVI's historical evolution, pivotal clinical trial evidence, and procedural innovations that have enabled its widespread use. We explore Korea-specific experiences with TAVI implementation, highlighting national registry data, healthcare policy considerations, and institutional adoption. Future perspectives include long-term device performance, lifetime valve management strategies, and the integration of artificial intelligence into transcatheter valve therapy.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"373-383"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277366","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 outcomes of heart failure with improved ejection fraction in patients treated with angiotensin receptor-neprilysin inhibitor.","authors":"Dong-Eon Kim, Min Gyu Kong, Saerom Kim, Inki Moon, Hyun Woo Park, Hyung-Oh Choi, Hye Sun Seo, Yoon Haeng Cho, Nae-Hee Lee, Kwan Yong Lee, Ho-Jun Jang, Je Sang Kim, Ik Jun Choi, Jon Suh","doi":"10.3904/kjim.2025.309","DOIUrl":"10.3904/kjim.2025.309","url":null,"abstract":"<p><strong>Background/aims: </strong>Improvement of left ventricular ejection fraction (LVEF) in heart failure with reduced ejection fraction (HFrEF) has been associated with favorable outcomes; however, corresponding data in patients treated with angiotensin receptor- neprilysin inhibitors (ARNIs) remain limited. This study aimed to examine the characteristics, predictors, and outcomes of HF with improved ejection fraction (HFimpEF) compared with persistent HFrEF in the RECORD-SV registry.</p><p><strong>Methods: </strong>Patients with LVEF ≤ 40% in the RECORD-SV registry were classified based on echocardiographic assessments at baseline and 1-year follow-up. Patients with HFimpEF were defined as those with follow-up LVEF of > 40% with an absolute improvement of ≥ 10%, whereas the persistent HFrEF group included those who did not meet these criteria. Baseline characteristics, predictive factors, and clinical outcomes of the patients were analyzed. The primary composite outcome was allcause mortality and hospitalization for HF management, with secondary outcomes including each component of the primary outcome and frequency of urgent emergency room visits.</p><p><strong>Results: </strong>Among 198 patients with HFrEF, 60 patients (30.3%) achieved HFimpEF after one year of ARNI-based therapy. Independent predictors of HFimpEF included female sex, non-ischemic etiology, and de novo HF. HFimpEF patients exhibited significantly lower risks in the primary composite outcome (HR 0.382, 95% CI 0.148-0.985) compared to those with persistent HFrEF, with a similar trend observed for secondary outcomes.</p><p><strong>Conclusion: </strong>Patients achieving HFimpEF with ARNIs exhibited distinct clinical features and significantly lower risk of cardiovascular events compared to those with persistent HFrEF, highlighting the prognostic benefit of EF recovery with ARNI therapy.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 3","pages":"474-484"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934871","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}