JOURNAL OF KOREAN MEDICAL SCIENCE

Risk Factors for Multiple Suicide Attempts in Adolescents From 10 Years Suicide Repository
Kim S, Yang EY, Choi KH, Lee HK, Kweon YS and Lee KU
While there are many studies on adolescents' suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts.
In This Issue on 02-December-2024
Yoo JH
Using Large Language Models to Extract Core Injury Information From Emergency Department Notes
Choi DH, Kim Y, Choi SW, Kim KH, Choi Y and Shin SD
Injuries pose a significant global health challenge due to their high incidence and mortality rates. Although injury surveillance is essential for prevention, it is resource-intensive. This study aimed to develop and validate locally deployable large language models (LLMs) to extract core injury-related information from Emergency Department (ED) clinical notes.
Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050: Comprehensive Analysis of the WHO Mortality Database
Hahn JW, Woo S, Park J, Lee H, Kim HJ, Ko JS, Moon JS, Rahmati M, Smith L, Kang J, Pizzol D, Tully MA, Dragioti E, Sánchez GFL, Lee K, Ha Y, Lee J, Lee H, Rhee SY, Son Y, Kim S and Yon DK
Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.
Letter to the Editor: Clarification of Evidence and Consensus on Strengthening Pharmacovigilance for Vaccine Safety
Kim HY
Similar but Distinct Comorbidity Patterns Between Polycystic Ovary Syndrome and Endometriosis in Korean Women: A Nationwide Cohort Study
Jeong HG, Jeon M, Ryu KJ, Kim J, Choe BY, Joo YY and Park H
Polycystic ovary syndrome (PCOS) and endometriosis are widely recognized as significant risk factors affecting the reproductive health of women. The underlying mechanisms impacting fertility may vary, potentially leading to divergent outcomes. We aimed to examine and contrast the prevalence patterns of diseases coexisting with PCOS and endometriosis, using a large-scale nationwide insurance claims data from Asian women of reproductive age.
Current Status of Co-Ordering of C-Reactive Protein and Erythrocyte Sedimentation Rate Testing in Korea
Koo SE, Kim J, Hong J and Park K
We retrospectively examined current trends in ordering for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) testing. All claims corresponding to ESR and CRP testing for hospital visits in 2022 were obtained from a platform operated by the Health Insurance and Review Agency. The annual (2018-2022) utilization and cost of ESR and CRP, total inpatient days, and patient encounters with outpatients were retrieved. The number of ESR and CRP tests gradually increased over 5 years, except a slight decrease in 2020. The proportion of claims with co-ordering of ESR and CRP tests was 46.64%. More than 60% co-ordering claims were observed in orthopedic surgery, neurosurgery, and plastic surgery departments. The proportion of co-orders was relatively high in inpatient setting and primary hospitals. This study indicated frequent co-ordering patterns of ESR and CRP tests, highlighting an urgent need for diagnostic stewardship programs on ESR and CRP testing in Korea.
Risk Adjustment in Medical Research: A Bird's Eye View
Habibzadeh P and Habibzadeh F
Making correct decisions is of paramount importance in clinical medicine and health-related disciplines. Randomized clinical trials are considered the gold-standard type of study for the assessment of the efficacy of a treatment. However, conducting a randomized clinical trial is not always possible; observational studies should be conducted, instead. For lack of randomization in observational studies, there may be differences in the distributions of certain variables (, age, race, and quality of health care services) between the study groups that may result in a biased estimate of the outcome of interest. Risk adjustment methods are used to account for these differences and find an unbiased measure of the treatment effect. The method involves several steps including defining the outcome of interest and identifying its potential outcome predictors. Then, we need to operationalize the selected risk factors and construct a statistical model or other methods of adjustment. This will result in a more accurate (less biased) estimate of the treatment effect.
Letter to the Editor: Before Characterising Post-Acute Sequelae of SARS-CoV-2 Infection by Viral and Immunologic Parameters, Alternative Causes of Their Increase Must Be Ruled Out
Finsterer J
Cutaneous Manifestations in Patients on Hemodialysis and Assessment of the Changes in Quality of Life After 12 Weeks of Treatment by a Dermatologist
Jeong JS, Lee Y, Lee S, Baek H, Choi MJ, Her Y and Park JI
Cutaneous manifestations are frequently observed in end-stage kidney disease (ESKD) and affect the quality of life (QoL) of patients undergoing maintenance hemodialysis (HD). Even patients undergoing HD who frequently visit hospitals do not receive active dermatological care. The aims of this study were to assess the cutaneous manifestations of patients undergoing HD and investigate changes in their QoL before and after active treatment by dermatologists.
FGFR Inhibitors in Urothelial Cancer: From Scientific Rationale to Clinical Development
Kwon WA
In the past decade, the treatment of metastatic urothelial cancer (mUC), including bladder cancer (BC), has transformed significantly with the introduction of diverse therapies, such as immune checkpoint inhibitors, targeted therapies, and antibody-drug conjugates. This change is partly due to advancements in genomic understanding, particularly next-generation sequencing, which has identified numerous mutations in UC. Among these therapies, erdafitinib, a pan-fibroblast growth factor receptor (FGFR) inhibitor for specific FGFR2 and FGFR3 alterations, is the only targeted therapy approved till now. In 2019, erdafitinib became pivotal for the treatment of mUC, particularly in patients with specific FGFR alterations. Recent studies have highlighted the benefits of combining erdafitinib with immunotherapy, thereby broadening the treatment options. Ongoing investigations exist on its use in non-muscle-invasive BC and in combination with drugs such as enfortumab vedotin in mUC. Other FGFR-targeted agents are under development; however, overcoming FGFR resistance and ensuring the safety of combination therapies remain major hurdles. FGFR3 mutations are particularly prevalent in BC, a heterogeneous form of UC, and account for a considerable proportion of new cancer diagnoses annually. Approximately half of these cancers have mutations, with gene rearrangements being a common feature. These FGFR3 genomic alterations often occur independently of mutations in other BC oncogenes, such as and . This review emphasizes the importance of FGFR inhibition in UC and the optimization of its use in clinical practice. Moreover, it underscores the ongoing efforts to evaluate combination strategies and early treatment testing to enhance the effectiveness of targeted therapies for UC.
Normative Parameters of Olfactory Bulbs Based on Magnetic Resonance Imaging and Olfactory Function
Kim M, Lee JY, Kim YH, Choi SH, Won TB and Han DH
Olfactory dysfunction is a frequently encountered sensory disorder that increases with aging, assessed magnetic resonance imaging (MRI); however, reference quantitative values for associated anatomical structures have rarely been suggested. The aim of this study was to assess the parameters of the olfactory bulbs (OBs) and olfactory sulcus (OS) in Korean adults according to age, along with their olfactory function.
In This Issue on 25-November-2024
Yoo JH
Tobacco Use in Korea: Current Epidemiology and Public Health Issues
Park JE, Jeong WM, Choi YJ, Kim SY, Yeob KE and Park JH
Tobacco control efforts in Korea began nearly three decades ago with the enactment of the National Health Promotion Act in 1995. Monitoring smoking prevalence is crucial for evaluating the effectiveness of tobacco control measures, as reductions in smoking rates reflect the impact of anti-smoking policies. This review aims to provide an updated overview of the epidemiology of tobacco use in Korea, outline the nation's advancements in tobacco control, and emphasize emerging challenges in tobacco use. The data sources included statistics and reports from the World Health Organization (WHO) and the Organization for Economic Co-operation and Development (OECD), the Korea National Health and Nutrition Examination Survey, as well as various national statistics and reports on tobacco use and control in Korea. Over the past quarter-century, there was a notable 49.6% reduction in the prevalence of cigarette smoking among Korean adults, with a particularly pronounced decline among men (1998: 66.3% vs. 2022: 30.0%; a 54.8% decrease). However, the reduction among women was more modest, with only a 1.5 percentage point decrease (1998: 6.5% vs. 2022: 5.0%; a 23.1% decrease), and an increase in smoking prevalence was observed among women in their 20s and 30s. Overall use of any tobacco product, including cigarettes, heated tobacco products, electronic nicotine delivery systems, and others, was 6.6 percentage points higher among males and 2.2 percentage points higher among females compared to cigarette smoking alone. In 2019, there were 58,036 deaths attributed to direct smoking in Korea, with an estimated socioeconomic cost of smoking amounting to 12,191.3 billion Korean won. Furthermore, critical issues in tobacco use persist in Korea, including significant disparities in tobacco use related to age, gender, and disability, the growing use of novel tobacco and nicotine products among adolescents and younger adults, and regulatory blind spots. The reduction in smoking rates in Korea reflects the impact of expanded tobacco control policies and public health initiatives. However, for Korea to advance to the next level in tobacco control policies, it is essential to implement the WHO Framework Convention on Tobacco Control's MPOWER measures more thoroughly.
Happiness and Its Association With Suicide Ideation and Attempt in Korea: The Roles of Socio-Environmental, Psychological, and Health-Related Factors
Choi M, Sempungu JK, Kim MH, Han J and Lee YH
The association between happiness and suicide behaviour across different gender and age groups remains unclear, with few studies identifying potential confounding or mediating factors that explain this association. We aimed 1) to examine the association of happiness with suicide ideation/attempt and 2) to assess the relative contribution of potential factors in explaining the associations in South Korea.
Diagnostic Value of Sternocleidomastoid Muscle Hemorrhage on Clavicular Periosteum in Hanging Deaths
Lim S, Chun HR, Kim MK, Son MJ, Kim C and Yoo SH
Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths.
Sites of Metastasis and Survival in Metastatic Renal Cell Carcinoma: Results From the Korean Renal Cancer Study Group Database
Lee CH, Kang M, Kwak C, Ko YH, Kim JK, Park JY, Bang S, Seo SI, Suh J, Song W, Song C, Lee HH, Chung J, Jeong CW, Jo JK, Choi SH, Choi J, Choi C, Choo SH, Han JH, Hong SH and Hwang EC
In patients with metastatic renal cell carcinoma (mRCC), sites of metastatic involvement have been reported to be associated with a difference in survival. However, the frequency and survival according to different sites of metastases in Korean patients with mRCC remain unclear. Therefore, this study aimed to assess the frequency of metastatic site involvement and the association between sites of metastatic involvement and survival in Korean patients with mRCC.
Active Surveillance for Safety Monitoring of XBB.1.5-Containing COVID-19 mRNA Vaccines in Korea
Park B, Lee HA, Kim Y, Kim CH, Park H, Jun S, Lee H, Kwon SL, Heo Y, , Lee H and Park H
The emergence of the omicron variant and its sub-lineages has necessitated vaccine updates for coronavirus disease 2019. In September 2023, the U.S. Food and Drug Administration approved an updated BNT162b2 vaccine targeting the omicron XBB.1.5 variant, which was initiated in Korea in October 2024. This study demonstrates the adverse events reported through active nationwide surveillance after XBB.1.5 vaccination in Korea. Since October 19, 2023, the Korea Disease Control and Prevention Agency has conducted daily Short Message Service surveys to collect data on health issues, fever, vaccination site reactions, systemic symptoms, impact on daily life, and healthcare visits. Among 20,180 respondents, 27.9% reported health issues. Adverse reactions peaked on day 1 (28.7%), including pain at the vaccination site, muscle pain, fatigue, and fever. These findings elucidate the short-term safety of the XBB.1.5 vaccine and support its co-administration with the influenza vaccine, reducing vaccine hesitancy and achieving herd immunity.
Impact of Mass Screening Using Chest X-Ray on Mortality Reduction and Treatment Adherence Among Pulmonary Tuberculosis Patients
Baek JY, Kazmi SZ, Lee H, Hwang Y, Park SJ, Shin MH, Lee J, Choi H and Shin A
Evaluate the impact of chest X-ray (CXR) screening on mortality and treatment adherence by comparing pulmonary tuberculosis (PTB) cases detected through screening and those routinely diagnosed at healthcare facilities.
Impact of Palivizumab in Preventing Severe Acute Lower Respiratory Infection in Moderate-to-Late Preterm Infants: A Nationwide Cohort Study
Kim S, Choe YJ, Lee S and Heo JS
Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants.
Obstetric and Perinatal Outcomes in 44,118 Singleton Pregnancies: Endometrial Preparation Methods for Frozen-Thawed Embryo Transfer
Yu EH, Lee HJ, Lee S, Kim J, Kim SC, Joo JK and Na YJ
This study aimed to investigate the obstetric and perinatal outcomes of singleton deliveries following frozen embryo transfer (FET) cycles using different endometrial preparation methods.