1.Development of automatic organ segmentation based on positron-emission tomography analysis system using Swin UNETR in breast cancer patients in Korea
Dong Hyeok CHOI ; Joonil HWANG ; Hai-Jeon YOON ; So Hyun AHN
The Ewha Medical Journal 2025;48(2):e30-
Purpose:
The standardized uptake value (SUV) is a key quantitative index in nuclear medicine imaging; however, variations in region‐of‐interest (ROI) determination exist across institutions. This study aims to standardize SUV evaluation by introducing a deep learning‐based quantitative analysis method that enhances diagnostic and prognostic accuracy.
Methods:
We used the Swin UNETR model to automatically segment key organs (breast, liver, spleen, and bone marrow) critical for breast cancer prognosis. Tumor segmentation was performed iteratively based on predefined SUV thresholds, and prognostic information was extracted from the liver, spleen, and bone marrow (reticuloendothelial system). The artificial intelligence training process employed 3 datasets: a test dataset (40 patients), a validation dataset (10 patients), and an independent test dataset (10 patients). To validate our approach, we compared the SUV values obtained using our method with those produced by commercial software.
Results:
In a dataset of 10 patients, our method achieved an auto‐segmentation accuracy of 0.9311 for all target organs. Comparison of maximum SUV and mean SUV values from our automated segmentation with those from traditional single‐ROI methods revealed differences of 0.19 and 0.16, respectively, demonstrating improved reliability and accuracy in whole‐organ SUV analysis.
Conclusion
This study successfully standardized SUV calculation in nuclear medicine imaging through deep learning‐based automated organ segmentation and SUV analysis, significantly enhancing accuracy in predicting breast cancer prognosis.
2.Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
Dong-Wook LEE ; Inah KIM ; Jungho HWANG ; Sunhaeng CHOI ; Tae-Won JANG ; Insung CHUNG ; Hwan-Cheol KIM ; Jaebum PARK ; Jungwon KIM ; Kyoung Sook JEONG ; Youngki KIM ; Eun-Soo LEE ; Yangwoo KIM ; Inchul JEONG ; Hyunjeong OH ; Hyeoncheol OH ; Jea Chul HA ; Jeehee MIN ; Chul Gab LEE ; Heon KIM ; Jaechul SONG
The Ewha Medical Journal 2025;48(1):e9-
This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
3.Environmental disease monitoring by regional Environmental Health Centers in Korea: a narrative review
Myung-Sook PARK ; Hwan-Cheol KIM ; Woo Jin KIM ; Yun-Chul HONG ; Won-Jun CHOI ; Seock-Yeon HWANG ; Jiho LEE ; Young-Seoub HONG ; Yong-Dae KIM ; Seong-Chul HONG ; Joo Hyun SUNG ; Inchul JEONG ; Kwan LEE ; Won-Ju PARK ; Hyun-Joo BAE ; Seong-Yong YOON ; Cheolmin LEE ; Kyoung Sook JEONG ; Sanghyuk BAE ; Jinhee CHOI ; Ho-Hyun KIM
The Ewha Medical Journal 2025;48(1):e3-
This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.
4.Effects of dental implant surface treated with sandblasting large grit acid-etching and femtosecond laser on implant stability, marginal bone volume, and histological results in a rabbit model
Young-Tak SON ; KeunBaDa SON ; Hoseong CHO ; Jae-Mok LEE ; Sm Abu SALEAH ; JunHo HWANG ; JongHoon LEE ; HyunDeok KIM ; Myoung-Uk JIN ; Jeehyun KIM ; Mansik JEON ; Kyu-Bok LEE
The Journal of Advanced Prosthodontics 2025;17(2):101-114
PURPOSE:
The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser.
MATERIALS AND METHODS:
A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05).
RESULTS:
No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05).
CONCLUSION
Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.
5.Rehabilitation of patient with hybrid telescopic denture using remaining teeth and implants after failure of implants: a case report
The Journal of Korean Academy of Prosthodontics 2025;63(2):122-129
Telescopic denture has freedom in the positioning of abutments, ease of repair for abutment loss, and a simple structure. In this case, the patient initially treated with fixed prosthesis, but had to remove some implants due to diabetes. Given the number and location of remaining teeth and implants, the possibility of further tooth loss, and ease of cleansing, a decision was made to fabricate a telescopic denture. The telescopic copings were made with zirconia for aesthetic appearance. In patients with uncertain prognosis of additional implant placement, converting to a telescopic denture can provide successful outcome aesthetically and functionally.
6.Implant-assisted removable partial denture (IARPD) rehabilitation in a patient exhibiting mandibular prognathism due to decreased vertical dimension: a case report
Hye-Kyoung HWANG ; Young-Jun LIM ; Ho-Beom KWON ; Myung-Joo KIM
The Journal of Korean Academy of Prosthodontics 2025;63(1):82-91
The loss of occlusal vertical dimension due to multiple tooth loss and wear can lead to a collapsed occlusion, resulting in both functional and aesthetic problems.This case report describes a patient exhibiting mandibular prognathism as a result of vertical dimension loss. A comprehensive oral rehabilitation involving an increase in vertical dimension was required. A minimal number of implants were placed, and implant-supported surveyed crowns were fabricated, allowing for the design of a stable and retentive implant-assisted removable partial denture. The treatment resulted in both functional and aesthetic improvements. The anterior rotational pattern of the mandible was alleviated, and the implant-assisted partial denture provided clinically high levels of patient satisfaction. This case report details the diagnostic and therapeutic processes involved in this treatment.
7.The Enhancement of Line Operations Safety Audit for Safe Flight Operation
Korean Journal of Aerospace and Environmental Medicine 2025;35(1):4-7
Purpose:
Line Operations Safety Audit (LOSA) has reduced errors by detecting and managing threats and errors of flight deck crew in the cockpit during normal flight operations. Airlines can understand the countermeasures and competencies of the crew and the success of error management. This paper introduces the advantages of LOSA and how LOSA data collection can be enhanced for the safety of flight operations.
Methods:
It analyzed the components of data collection tool in the International Civil Aviation Organization Doc 9803, LOSA manual to find out the deficiencies for enhancement.
Results:
Five suggestions are proposed in this study, codes for positive activities and the development of a form, the development of proactive strategies that predict threats in advance and manage the threats and management of errors, to describe the coding and narrative for successful briefings that manage threats and errors and codes for positive culture are required for successful LOSA data collection flight operations.
Conclusion
Safety Management System, Threat and Error Management, LOSA, and other conventional safety tools manage safety based on risk or failure, so if we change the paradigm, we can train more safety-resilient pilots. The tragic outcomes such as accidents or incidents have the problem of low occurrence probability, but if we supplement and utilize LOSA data of normal flights, we can prevent accidents or nearaccidents in advance.
8.Predictive value and optimal cut-off level of high-sensitivity troponin T in patients with acute pulmonary embolism
Moojun KIM ; Chang-Ok SEO ; Yong-Lee KIM ; Hangyul KIM ; Hye Ree KIM ; Yun Ho CHO ; Jeong Yoon JANG ; Jong-Hwa AHN ; Min Gyu KANG ; Kyehwan KIM ; Jin-Sin KOH ; Seok-Jae HWANG ; Jin Yong HWANG ; Jeong Rang PARK
The Korean Journal of Internal Medicine 2025;40(1):65-77
Background/Aims:
Elevated troponin levels predict in-hospital mortality and influence decisions regarding thrombolytic therapy in patients with acute pulmonary embolism (PE). However, the usefulness of high-sensitivity troponin T (hsTnT) regarding PE remains uncertain. We aimed to establish the optimal cut-off level and compare its performance for precise risk stratification.
Methods:
374 patients diagnosed with acute PE were reviewed. PE-related adverse outcomes, a composite of PE-related deaths, cardiopulmonary resuscitation incidents, systolic blood pressure < 90 mmHg, and all-cause mortality within 30 days were evaluated. The optimal hsTnT cut-off for all-cause mortality, and the net reclassification index (NRI) was used to assess the incremental value in risk stratification.
Results:
Among 343 normotensive patients, 17 (5.0%) experienced all-cause mortality, while 40 (10.7%) had PE-related adverse outcomes. An optimal hsTnT cut-off value of 60 ng/L for all-cause mortality (AUC 0.74, 95% CI 0.61–0.85, p < 0.001) was identified, which was significantly associated with PE-related adverse outcomes (OR 4.07, 95% CI 2.06–8.06, p < 0.001). Patients with hsTnT ≥ 60 ng/L were older, hypotensive, had higher creatinine levels, and right ventricular dysfunction signs. Combining hsTnT ≥ 60 ng/L with simplified pulmonary embolism severity index ≥1 provided additional prognostic information. Reclassification analysis showed a significant shift in risk categories, with an NRI of 1.016 ± 0.201 (p < 0.001).
Conclusions
We refined troponin’s predictive value in patients with acute PE, proposing a new cut-off value of hsTnT ≥ 60 ng/L. Validation through large-scale studies is essential to offer clinically useful guidance for managing patient population.
9.The characteristics of Korean elderly multiple myeloma patients aged 80 years or over
Sang Hwan LEE ; Hee-Jeong CHO ; Joon Ho MOON ; Ji Yoon JUNG ; Min Kyoung KIM ; Mi Hwa HEO ; Young Rok DO ; Yunhwi HWANG ; Sung Hwa BAE
The Korean Journal of Internal Medicine 2025;40(1):115-123
Background/Aims:
Multiple myeloma (MM) predominantly affects elderly individuals, but studies on older patients with MM are limited. The clinical characteristics and survival outcomes of patients with MM aged 80 years or over were retrospectively analyzed.
Methods:
This retrospective multicenter study was conducted to investigate the clinical characteristics, treatment patterns, and survival outcomes of patients aged 80 years or over who were newly diagnosed with MM at five academic hospitals in Daegu, Korea, between 2010 and 2019.
Results:
A total of 127 patients with a median age of 83 years (range, 80–93 yr) were enrolled: 52 (40.9%) with Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, 84 (66.1%) with International Staging System (ISS) stage III disease, and 93 (73.2%) with a Charlson comorbidity index (CCI) > 4. Chemotherapy was administered to 86 patients (67.7%). The median overall survival was 9.3 months. Overall survival was significantly associated with ECOG PS > 2 (HR 2.26, 95% CI 1.43–3.59), ISS stage III (HR 1.99, 95% CI 1.18–3.34), and chemotherapy (HR 0.34, 95% CI 0.21–0.55). There was no statistically significant difference in event-free survival according to the type of anti-myeloma chemotherapy administered. The early mortality (EM) rate was 28.3%.
Conclusions
Even in patients with MM aged 80 years or over, chemotherapy can result in better survival outcomes than supportive care. Patients aged ≥ 80 years should not be excluded from chemotherapy based on age alone. However, reducing EM in elderly patients with newly diagnosed MM remains challenging.
10.Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea
Ki Jin KIM ; Su-Bin SONG ; Jung-Bin PARK ; June Hwa BAE ; Ji Eun BAEK ; Ga Hee KIM ; Min-Jun KIM ; Seung Wook HONG ; Sung Wook HWANG ; Dong-Hoon YANG ; Byong Duk YE ; Jeong-Sik BYEON ; Seung-Jae MYUNG ; Suk-Kyun YANG ; Chang Sik YU ; Yong-Sik YOON ; Jong-Lyul LEE ; Min Hyun KIM ; Ho-Su LEE ; Sang Hyoung PARK
The Korean Journal of Internal Medicine 2025;40(2):243-250
Background/Aims:
Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia. This research aimed to evaluate the clinical features and outcomes of PVT in patients with IBD at a leading hospital in South Korea.
Methods:
This retrospective analysis reviewed adult patients diagnosed with both IBD and PVT from 1989 to 2021 at a renowned South Korean medical center. The study focused on patient characteristics, specifics of PVT, administered treatments, and outcomes, all confirmed through enhanced CT scans.
Results:
A total of 78 patients met the study’s criteria. Notably, only 20.5% (16/78) were treated with oral anticoagulants; however, a vast majority (96.2%; 75/78) achieved complete radiographic resolution (CRR). When comparing patients receiving anticoagulants to those who did not, a significant preference for anticoagulant use was observed in cases where the main portal vein was affected, as opposed to just the left or right veins (p = 0.006). However, multivariable analysis indicated that neither anticoagulant use nor previous surgeries significantly impacted CRR.
Conclusions
Patients with IBD and PVT generally had favorable outcomes, regardless of anticoagulant use.

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