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Mechanisms of ceftolozane/tazobactam resistance in Pseudomonas aeruginosa isolates from South Korea: A diagrostic study

Precision and Future Medicine.2024;8(4):166-169. doi:10.23838/pfm.2024.00149

Purpose: To identify ceftolozane/tazobactam (C/T)-resistant Pseudomonas aeruginosa isolates in Korea and to investigate the resistance mechanism. Methods: We performed antibiotic susceptibility testing for 42 carbapenem-resistant, non-carbapenemase-producing P. aeruginosa isolates from Korea. Multilocus sequence typing was performed for all isolates. Whole-genome sequencing was performed for four carbapenem-resistant P. aeruginosa isolates, including two C/T-resistant isolates and two C/T-susceptible isolates. Results: We identified two C/T-resistant P. aeruginosa isolates (P70 and P112) among 42 carbapenem-resistant, non-carbapenemase-producing P. aeruginosa isolates. We found multiple amino acid substitutions in AmpC, AmpR, efflux pump systems, and a porin protein in C/T-resistant P. aeruginosa isolates. These were not reported previously in C/T-resistant P. aeruginosa isolates. Conclusion C/T-resistant P. aeruginosa isolates with multiple amino acid alterations were identified, implying that resistance to this novel antibiotics should be constantly monitored.

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Bibliometric analysis of literature on stem cells in regenerative medicine and their clinical applications (2010 to 2024): A scoping review

Meerim K. NURBAEVA ; Gulnara DZHUNUSHALIEVA

Precision and Future Medicine.2024;8(4):137-155. doi:10.23838/pfm.2024.00121

Stem cells in regenerative medicine are advancing rapidly, with significant progress made in recent years. Our bibliometric review is a significant contribution to the field and is essential for advancing research. However, there is a noticeable lack of reviews that focus on stem cells and their clinical applications in regenerative medicine. Our study addressed this gap using advanced tools such as R-Studio and VOSviewer to explore publication volumes, intellectual structures, and emerging trends in the field, ensuring the validity and reliability of our findings. We utilized Scopus and Web of Science to extract 1,274 relevant articles and employed rigorous descriptive analysis, co-occurrence analysis, and text-mining techniques. Our study identified the most influential journals based on productivity and citation volume. These journals are: International Journal of Molecular Sciences, Stem Cell Reviews and Reports, Biomaterials, Stem Cell Research and Therapy, Regenerative Therapy, Stem Cells Translational Medicine, and Cytotherapy. The top-cited articles highlight mRNA, stem cell reprogramming, and innovative therapeutic techniques. Our analysis of the links between stem cells and disease underscores the significant focus on mesenchymal stem cells and pluripotent stem cells, with the most frequently treated conditions being knee osteoarthritis, various types of cancer, and cardiovascular diseases. We also identified emerging areas classified as materials, methods, and technologies such as biopolymers, nanotechnology, deep learning, Kyoto Encyclopedia of Genes and Genomes, three-dimensional printers, and bioprinting. By investigating this focused area, this study provides valuable insights into the current landscape and future directions of stem cell-based regenerative medicine with a clear clinical translation pathway.

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A novel Gly436Glu variant in the LPL gene identified in a Saudi Arabian patient with severe hypertriglyceridemia and recurrent pancreatitis

Dena A. NUWAYLATI ; Hussam DAGHISTANI ; Noor Ahmad SHAIK ; Zuhier A. AWAN

Precision and Future Medicine.2024;8(4):178-183. doi:10.23838/pfm.2024.00163

Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive disorder characterized by severe hypertriglyceridemia and recurrent pancreatitis, often manifesting in childhood. The condition results from variants in the lipoprotein lipase (LPL<) gene, which lead to impaired fat metabolism. We report the case of an 18-year-old Saudi male with a lifelong history of hypertriglyceridemia and recurrent episodes of pancreatitis. Laboratory investigations revealed severe hypertriglyceridemia and low high-density lipoprotein cholesterol, consistent with FCS. A comprehensive evaluation excluded secondary causes of hyperlipidemia, suggesting a potential genetic basis for the condition. Whole-exome sequencing identified a novel homozygous missense variant (c.1307G> A; p.Gly436Glu) in the LPL< gene. Bioinformatics analysis predicted this variant to be deleterious, potentially disrupting the structure and stability of the LPL enzyme and impairing its ability to hydrolyze dietary fats. This finding suggested a causal link between the variant and the patient’s FCS phenotype. This case highlights the importance of molecular diagnosis in FCS, enabling the identification of causative genetic alterations and improving our understanding of the link between LPL dysfunction and severe metabolic disorders.

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Investigation of potential relationship between glucagon-like peptide 1 receptor agonists with suicide/self-injury: disproportionality analysis using WHO-VigiBase: Disproportionality analysis

Ye Young KIM ; Ju Hwan KIM ; Ju-Young SHIN

Precision and Future Medicine.2024;8(4):170-177. doi:10.23838/pfm.2024.00170

Purpose: As global interest in glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has increased owing to weight loss effect, concerns regarding the risk of suicide/self-injury associated with GLP-1 RAs have garnered considerable attention. Given the limited evidence, in this study, we aimed to investigate the potential relationship between GLP-1 RAs and suicide/self-injury, stratified by therapeutic indications, using VigiBase, the largest global database. Methods: Disproportionality analysis was conducted to detect signals of disproportionate reporting using VigiBase data from April 28, 2005, to August 31, 2023. Subgroup analyses by indication were conducted, comparing against drugs that have different mechanisms but are used for similar indications (type 2 diabetes mellitus [T2DM] treatment: glucose-lowering agents; weight loss: orlistat). Reporting odds ratio (ROR) and information component (IC) were used as signal detection indicators. Results: A total of 485 reports of suicide/self-injury associated with GLP-1 RAs were identified. Indication-integrated analyses did not indicate a potential relationship between any GLP-1 RA and suicide/self-injury. In subgroup analyses by indication, signals of disproportionate reporting were not detected in patients using GLP-1 RAs for T2DM treatment but were detected in patients using GLP-1 RAs for weight loss: total (ROR, 2.01; 95% confidence interval [CI], 1.34 to 3.01; IC025, 0.01), liraglutide (ROR, 2.26; 95% CI, 1.47 to 3.49; IC025, 0.14), semaglutide (ROR, 2.33; 95% CI, 1.31 to 4.14; IC025, 0.22). Conclusion Given the differences in results by indication, this study highlights the need for post-marketing surveillance of the suicide/self-injury risk in non-T2DM populations using GLP-1 RAs for simple weight loss.

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Epidemiology of Marfan syndrome: a retrospective cohort study based on the Korean population: A retrospective cohort study

Shin Yi JANG ; June HUH ; Duk-Kyung KIM ; Taek Kyu PARK

Precision and Future Medicine.2024;8(4):156-165. doi:10.23838/pfm.2024.00142

Purpose: To determine the risk of incidence, prevalence, survival, and death risk for Marfan syndrome (MFS) in Korea. Methods: MFS (10th revision of the International Statistical Classification of Diseases [ICD-10] code: Q87.4) data were collected from the Korea National Health Insurance Service between 2006 and 2017. Simple and multiple Cox proportional hazards analyses were performed. The death data of Koreans from 2006 to 2018 were used. Results: The mean age of patients with MFS was 27.2± 16.8 years, 26.5± 15.9 years for males and 28.2± 18.1 years for females (P < 0.01), and the proportion of males was 59.5%. The age-standardized incidence and prevalence in 2017 were 0.51 and 5.70 per 100,000 persons, respectively. The 10-year survival rate was 92.7%. Adjusted hazard ratio increased significantly with age, male sex, heart failure, ischemic stroke, hemorrhagic stroke, chronic kidney disease, malignant neoplasm, aortic dissection, and abdominal aortic aneurysm. Conclusion Although the overall 10-year survival rate of MFS was over 90%, the adjusted hazard ratio was significantly higher in the older age group, male sex, and individuals with heart failure, stroke, chronic kidney disease, malignant neoplasm, aortic dissection, and abdominal aortic aneurysm. These results suggest the need for meticulous surveillance of aortopathy in patients with MFS, as it may portend a worse prognosis in aortic dissection and aneurysm, and in older age groups with MFS.

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Message from the Precision and Future Medicine editors to our ad hoc reviewers

Hong Jin JEON

Precision and Future Medicine.2025;9(1):1-1. doi:10.23838/pfm.2025.00114

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Statins: a tale of two pathways—cardiovascular savior, renal ineffectual

Jihyun YANG

Precision and Future Medicine.2025;9(1):43-52. doi:10.23838/pfm.2025.00065

Statins are effective in improving outcomes in the general population. However, in patients with chronic kidney disease (CKD), clinical outcomes and therapeutic approaches require careful interpretation from multiple perspectives. Managing dyslipidemia in CKD presents unique challenges requiring a comprehensive understanding of alterations in lipid metabolism in renal dysfunction. This review explored the key factors influencing statin efficacy, safety, and guideline recommendations in the CKD population, with a focus on lipid-lowering strategies tailored to renal function.

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Clinical implications of idiopathic pulmonary fibrosis and lung cancer

Hongseok YOO ; Man Pyo CHUNG

Precision and Future Medicine.2025;9(1):35-42. doi:10.23838/pfm.2025.00030

Idiopathic pulmonary fibrosis (IPF) is characterized by chronic progressive fibrosis of the lungs of unknown etiology. The prognosis of IPF is poor, with a median survival of 3 to 5 years. Lung cancer is one of the most frequently associated comorbidities of IPF, often resulting in grave outcomes. Patients with IPF have a higher risk for lung cancer than the general population. Lung cancer frequently develops in older male IPF patients with smoking history. Squamous cell carcinoma is the most common histological type, followed by adenocarcinoma. Such cancers typically develop abutting or within fibrosis. One of the major obstacles in making therapeutic decisions for these patients is the complications after treatment and subsequent poor prognosis. Numerous studies have reported post-treatment complications, such as acute exacerbation of IPF, pneumonia, and persistent air leakage, and their impact on survival. Higher mortality rates have consistently been reported among patients diagnosed with both IPF and lung cancer compared to those with either IPF or lung cancer alone. Thorough risk assessment for complications, selection of appropriate therapeutic modality, and use of antifibrotic agents, such as pirfenidone or nintedanib, may help prevent complications and improve survival. Nevertheless, further research is necessary to establish optimal treatment strategies for patients diagnosed with IPF and lung cancer.

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How to use new transrectal ultrasound in prostate cancer detection and biopsy for beginners and experts

Byung Kwan PARK

Precision and Future Medicine.2025;9(1):25-34. doi:10.23838/pfm.2025.00016

Many radiologists and urologists believe that many prostate cancers are invisible under transrectal ultrasound (TRUS) imaging. Frequently, they use TRUS only as a guiding tool or fuse TRUS images with magnetic resonance images for prostate biopsy in men with high prostate specific antigen. However, TRUS software and hardware have been developed and have potential to depict many prostate cancers. Currently, there are only a few papers dealing with how to use TRUS for detection and biopsy of prostate cancers. The aim of this review is to describe the new TRUS techniques, imaging features, and biopsy techniques.

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Efficacy and adverse events of immune checkpoint inhibitors: evidence from non-small cell lung cancer and gastric cancer in Korea and Japan

Mc Neil VALENCIA ; Zeeshan ABBAS ; Seung Won LEE

Precision and Future Medicine.2025;9(1):15-24. doi:10.23838/pfm.2025.00009

In recent years, immune checkpoint inhibitors (ICIs) have changed the landscape of cancer treatment by harnessing their efficacy in treating malignancies. These cancer therapies have shown remarkable result and efficacy across multiple cancer types. However, this review specifically focuses on non-small cell lung cancer (NSCLC) and gastric cancer (GC) due to their high incidence rates in Korea and Japan, ranking first to second in both sexes, as well as the availability of real-world data assessing ICI efficacy in these populations. In NSCLC, ICI treatment demonstrated better objective response rate and disease control rate, with overall survival (OS) ranging from 8.4 to 12.6 months in different studies. Nivolumab and atezolizumab exhibited efficacy in disease management in lung lesions. In GC, ICI showed promising efficacy in biomarker-positive patients, including those with programmed death-ligand 1 positive tumors, human epidermal growth factor receptor 2 (HER2) positive tumors, and microsatellite instability-high/mismatch repair (MSI-H/MMR)-deficient tumors, indicating that ICIs are beneficial for patients with favorable biomarker profiles. The median OS was significantly longer in patients with GC who were treated with ICI (16.9 months vs. 13.9 months). Immunotherapy leads to a durable response and improves the survival rates of patients with advanced or metastatic cancers. However, the success of ICI is affected by mild to severe immune-related adverse events, which are potentially life-threatening. Given the expanding ICIs application across different cancer, further studies are warranted to explores its broader implications and limitations. Therefore, this review explored the impacts of ICIs and their potential drawbacks in cancer treatment in Korea and Japan using real-world data and clinical trials.

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