1.Citizen-Led Integrated Care in Rural Depopulation Areas: Addressing Depression and Frailty in Older Adults
Suhyeon CHOI ; Susan PARK ; Eunhee CHOI ; Jihee CHOI ; Minkyoung KIM ; Seok-gyu KIM ; Sunyoung PARK ; Soong-nang JANG
Annals of Geriatric Medicine and Research 2026;30(1):51-61
Background:
Rural areas in Korea are experiencing both super-aging and depopulation, creating critical gaps in health and social care. Using a citizen participatory approach, we sought to address the care gaps for older adults in rural areas. This study examined the changes in frailty and depressive symptoms observed during a citizen-led intervention.
Methods:
This study is a single- arm pre–post quasi-experimental design. A 12-week intervention was implemented using local citizens as care providers. Intervention components included identifying and planning individual care needs, providing health education, organizing tailored community activities, and conducting AI-assisted weekly check-up calls to monitor health status.
Results:
Changes appeared more pronounced among vulnerable subgroups. Older adults with frailty showed an observed decrease in depressive symptoms compared to those with prefrailty or robust status. Conversely, among those with depressive symptoms, frailty levels appeared to increase more slowly than those without depressive symptoms. These patterns are consistent with the previously reported bidirectional associations between frailty and depression and may reflect the tendency for changes in one domain to coincide with changes in the other, rather than indicating a causal influence.
Conclusion
This citizen-led care intervention showed more noticeable short-term changes among older adults with higher vulnerability, particularly those with frailty or depressive symptoms. These findings indicate potential roles for citizen participation in enhancing social support and supporting ongoing monitoring in rural depopulation areas. The results suggest that citizen participation is a potentially feasible and sustainable approach to care systems in aging, resource-limited communities.
2.Amyloid-Related Imaging Abnormalities in Anti-Amyloid Monoclonal Antibody Therapy for Alzheimer’s Disease:Expert Recommendation for Standard MRI Protocol
Jimin KIM ; Eunhee KIM ; Mina PARK ; Yun Jung BAE ; Chong Hyun SUH ; Sung-Hye YOU ; Younghee YIM ; Ho-Joon LEE ; Jin Wook CHOI ; Se Won OH ; Won-Jin MOON ;
Journal of the Korean Society of Radiology 2025;86(1):34-44
The introduction of anti-amyloid therapies for Alzheimer’s disease (AD), such as lecanemab (Lequembi®), which was recently approved in Korea, necessitates careful monitoring for amyloid-related imaging abnormalities (ARIA) using brain MRI. To optimize ARIA monitoring in Korean clinical settings, the Korean Society of Neuroradiology (KSNR) and the Age and Neurodegeneration Imaging (ANDI) Study Group proposed MRI protocol recommendations on essential MR sequences, MRI acquisition parameters, timing and condition of MRI examinations, and essential details to provide a scientific basis for maximizing the safety and efficacy of AD treatment. A customized, standardized MRI protocol focusing on Korea’s healthcare environment can improve ARIA management and ensure patient safety through early detection of potential anti-amyloid therapy side effects, thereby enhancing treatment quality.
3.Amyloid-Related Imaging Abnormalities in Anti-Amyloid Monoclonal Antibody Therapy for Alzheimer’s Disease:Expert Recommendation for Standard MRI Protocol
Jimin KIM ; Eunhee KIM ; Mina PARK ; Yun Jung BAE ; Chong Hyun SUH ; Sung-Hye YOU ; Younghee YIM ; Ho-Joon LEE ; Jin Wook CHOI ; Se Won OH ; Won-Jin MOON ;
Journal of the Korean Society of Radiology 2025;86(1):34-44
The introduction of anti-amyloid therapies for Alzheimer’s disease (AD), such as lecanemab (Lequembi®), which was recently approved in Korea, necessitates careful monitoring for amyloid-related imaging abnormalities (ARIA) using brain MRI. To optimize ARIA monitoring in Korean clinical settings, the Korean Society of Neuroradiology (KSNR) and the Age and Neurodegeneration Imaging (ANDI) Study Group proposed MRI protocol recommendations on essential MR sequences, MRI acquisition parameters, timing and condition of MRI examinations, and essential details to provide a scientific basis for maximizing the safety and efficacy of AD treatment. A customized, standardized MRI protocol focusing on Korea’s healthcare environment can improve ARIA management and ensure patient safety through early detection of potential anti-amyloid therapy side effects, thereby enhancing treatment quality.
4.Amyloid-Related Imaging Abnormalities in Anti-Amyloid Monoclonal Antibody Therapy for Alzheimer’s Disease:Expert Recommendation for Standard MRI Protocol
Jimin KIM ; Eunhee KIM ; Mina PARK ; Yun Jung BAE ; Chong Hyun SUH ; Sung-Hye YOU ; Younghee YIM ; Ho-Joon LEE ; Jin Wook CHOI ; Se Won OH ; Won-Jin MOON ;
Journal of the Korean Society of Radiology 2025;86(1):34-44
The introduction of anti-amyloid therapies for Alzheimer’s disease (AD), such as lecanemab (Lequembi®), which was recently approved in Korea, necessitates careful monitoring for amyloid-related imaging abnormalities (ARIA) using brain MRI. To optimize ARIA monitoring in Korean clinical settings, the Korean Society of Neuroradiology (KSNR) and the Age and Neurodegeneration Imaging (ANDI) Study Group proposed MRI protocol recommendations on essential MR sequences, MRI acquisition parameters, timing and condition of MRI examinations, and essential details to provide a scientific basis for maximizing the safety and efficacy of AD treatment. A customized, standardized MRI protocol focusing on Korea’s healthcare environment can improve ARIA management and ensure patient safety through early detection of potential anti-amyloid therapy side effects, thereby enhancing treatment quality.
5.Development of Reimbursement Models for the Deployment of Advanced Practice Nurses in Korea: Focusing on General Wards and Intensive Care Units
Min Young KIM ; Su Jung CHOI ; Eunhee LEE ; Jae Won HYUN ; Young-Ah KANG ; Jeong-Hee PARK
Journal of Korean Clinical Nursing Research 2025;31(3):220-233
Purpose:
This study aimed to develop reimbursement models for advanced practice nurses (APNs) in Korea by analyzing APN workload, estimating optimal patient-to-APN ratios, and calculating APN employment costs.
Methods:
A descriptive study was conducted with 116 APNs working from general wards and intensive care units (ICUs) at three tertiary hospitals. Data were collected from March to May 2025 using structured questionnaires and activity diaries. APN workload was classified into 15 task categories comprising 79 sub-activities and additionally unclassified miscellaneous activities. Time spent per patient was used to estimate optimal patient loads, and employment costs were calculated using salary and administrative expense data. Daily reimbursement per patient was derived by dividing operating costs by the optimal caseload.
Results:
Participants were predominantly female (99.1%), with a mean age of 38.9 years and an average of 15.9 years of clinical experience.APNs devoted the greatest share of their time to patient assessment and prescription-related activities. The optimal patient load was 10~15 per APN in general wards and 5~10 in ICUs. Based on these workload-derived ratios, the estimated reimbursement ranged from KRW 12,333 to 114,659 per patient per day in general wards and KRW 49,330 to 229,318 per patient per day in ICUs.
Conclusion
By linking workload, staffing needs, and employment costs, this study offers an empirical foundation for designing equitable APN reimbursement models.These findings support policy efforts to secure appropriate APN compensation, enhance workforce stability, and strengthen team-based care. Implementation through pilot reimbursement programs is recommended to evaluate their feasibility and economic impact.
6.Exposure to air pollution and precocious puberty:a systematic review
Rosie LEE ; Jongmin OH ; Eunji MUN ; Jung Eun CHOI ; Kyung Hee KIM ; Ji Hyen LEE ; Hae Soon KIM ; Eunhee HA
The Ewha Medical Journal 2024;47(2):e20-
The worldwide incidence of precocious puberty, which is associated with negative health outcomes, is increasing. Several studies have suggested that environmental factors contribute to the development of precocious puberty alongside genetic factors. Some epidemiological studies have provided limited evidence suggesting an association between exposure to air pollution and changes in pubertal development. This systematic review aimed to summarize existing evidence on the association between air pollution exposure and precocious puberty. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science) until August 2023. The included studies assessed the association between air pollutant exposure and the risk of precocious puberty, early menarche, or pubertal development. Two authors independently performed study selection and data extraction. A meta-analysis and analysis of the risk of bias were infeasible due to the limited number of studies and the heterogeneity among them. The literature search resulted in 184 studies, from which we included six studies with sample sizes ranging from 437 to 4,074 participants. The studies reported heterogeneous outcomes. Four studies found that increased exposure to air pollution was related to earlier pubertal onset. One study was inconclusive, and another suggested that air pollutant exposure may delay the onset of thelarche. Most studies suggest that exposure to air pollutants accelerates pubertal development; however, the results from the available studies are inconsistent. More extensive and well-designed longitudinal studies are required for a comprehensive understanding of the association between air pollution and precocious puberty.
7.Characteristics of Diverse Verbal Pain Descriptors in South Korean Patients With Peripheral Neuropathic Pain:‘Jeorim’ (Tingling) and ‘Sirim’ (Cold) as Key Neuropathic Pain Descriptors
Kyomin CHOI ; Ohyun KWON ; Bum Chun SUH ; Jeeyoung OH ; Sungkun CHO ; Eunhee SOHN ; In Soo JOO
Journal of Clinical Neurology 2023;19(3):296-303
Background:
and Purpose The description of pain is the most-important indicator leading to the adequate treatment of patients with neuropathic pain (NeP). The purpose of this study was to identify and characterize the unique features of Korean verbal descriptions in patients with peripheral NeP.
Methods:
This study included 400 patients (167 males and 233 females) and their 1,387 paindescription responses. Patients with peripheral NeP freely described their symptoms in Korean. Collected verbal descriptions were grouped according to terminologies with similar meanings. Participants completed validated patient-reported outcome scales including the neuropathic pain symptom inventory (NPSI) and painDETECT questionnaire (PD-Q). The frequencies of each verbal pain descriptor were compared between the NPSI and PD-Q scores.
Results:
‘Jeorim’ (tingling) was the most common among 17 types of organized verbal pain descriptors, and the ‘Sirim’ (cold) symptom had a significantly higher rate of use in the 2 highseverity groups when participants were classified by their total scores on the NPSI and PD-Q.
Conclusions
Korean verbal NeP descriptors were significantly diverse. The Jeorim (tingling) and Sirim (cold) descriptors can be utilized in evaluations of Korean patients with NeP.
8.A Proactive Testing Strategy to COVID-19 for Reopening University Campus during Omicron Wave in Korea: Ewha Safe Campus (ESC) Project
Whanhee LEE ; Kyunghee JUNG-CHOI ; Hyunjin PARK ; Seunghee JUN ; Nackmoon SUNG ; Sun-Hwa LEE ; Misun CHANG ; Hee Jung CHOI ; Chung-Jong KIM ; Hyesook PARK ; Eunhee HA
The Ewha Medical Journal 2023;46(3):e7-
Objectives:
Ewha Womans University launched an on-campus Coronavirus disease-19 (COVID-19) response system called Ewha Safety Campus (ESC) Project in collaboration with the Seegene Inc. RTPCR diagnostic tests for COVID-19 were proactively provided to the participants. This study examines the effectiveness of the on-campus testing strategy in controlling the reproduction number (Rt ) and identifying student groups vulnerable to infection.
Methods:
The ESC project was launched on March 2, 2022, with a pilot period from Feb 22 to March 1, 2022—the peak of the Omicron variant wave. We collected daily data on the RT-PCR test results of the students of Ewha Womans University from Mar 2 to Apr 30, 2022. We daily calculated Rt and compared it with that of the general population of Korea (women, people aged 20–29 years, and Seoul residents). We also examined the students vulnerable to the infection based on the group-specific Rt and positivity rate.
Results:
A lower Rt was observed about 2 weeks after the implementation of the ESC Project than that of the general population. The lower Rt persisted during the entire study period. Dormitory residents had a higher Rt . The positivity rate was higher in students who did not comply with quarantine guidelines and did not receive the second dose of the vaccine.
Conclusion
The study provides scientific evidence for the effectiveness of the on-campus testing strategy and different infection vulnerabilities of students, depending on dormitory residence, compliance with the quarantine guidelines, and vaccination.
9.Subgrouping of Peripheral Neuropathic Pain Patients According to Sensory Symptom Profile Using the Korean Version of the PainDETECT Questionnaire
Kyomin CHOI ; Ohyun KWON ; Bum Chun SUH ; Eunhee SOHN ; In Soo JOO ; Jeeyoung OH
Journal of Korean Medical Science 2022;37(3):e8-
Background:
A culturally validated Korean version of the PainDETECT Questionnaire (PD-Q) was used to identify neuropathic pain components (NeP) in patients suffering from chronic pain. The purpose of this study was to determine if the Korean PD-Q can be used to subgroup patients with peripheral NeP according to sensory symptom profiles.
Methods:
This study included 400 Korean patients with peripheral neuropathic pain diagnosed as probable or definite NeP. The total scores and subscores for each item in PD-Q were transformed into a Z-score for standardization. Hierarchical cluster analysis was performed to identify clusters of subjects by PD-Q scores.
Results:
The mean total PD-Q score of the study participants was 14.57 ± 6.46. A hierarchical cluster analysis identified 5 clusters with distinct pain characteristic profiles. Cluster 1 had relatively severe burning and tingling sensations. The mean total PD-Q score for cluster 2 was the lowest of the 5 clusters. Cluster 3 tended to be vulnerable to pain in response to cold/heat stimulation. Cluster 4 showed relatively severe pain induced by physical stimuli, such as light touch or slight pressure. Cluster 5 had high scores for all NeP symptoms.
Conclusion
This study demonstrates the ability of patients to cluster by symptoms using the Korean PD-Q. Subgrouping of peripheral neuropathic pain by sensory symptom profile may be useful in making effective drug treatment decisions.
10.Radiation Dose Reduction in Digital Mammography by Deep-Learning Algorithm Image Reconstruction: A Preliminary Study
Su Min HA ; Hak Hee KIM ; Eunhee KANG ; Bo Kyoung SEO ; Nami CHOI ; Tae Hee KIM ; You Jin KU ; Jong Chul YE
Journal of the Korean Radiological Society 2022;83(2):344-359
Purpose:
To develop a denoising convolutional neural network-based image processing technique and investigate its efficacy in diagnosing breast cancer using low-dose mammography imaging.
Materials and Methods:
A total of 6 breast radiologists were included in this prospective study. All radiologists independently evaluated low-dose images for lesion detection and rated them for diagnostic quality using a qualitative scale. After application of the denoising network, the same radiologists evaluated lesion detectability and image quality. For clinical application, a consensus on lesion type and localization on preoperative mammographic examinations of breast cancer patients was reached after discussion. Thereafter, coded low-dose, reconstructed full-dose, and full-dose images were presented and assessed in a random order.
Results:
Lesions on 40% reconstructed full-dose images were better perceived when compared with low-dose images of mastectomy specimens as a reference. In clinical application, as compared to 40% reconstructed images, higher values were given on full-dose images for resolution (p < 0.001); diagnostic quality for calcifications (p < 0.001); and for masses, asymmetry, or architectural distortion (p = 0.037). The 40% reconstructed images showed comparable values to 100% full-dose images for overall quality (p = 0.547), lesion visibility (p = 0.120), and contrast (p = 0.083), without significant differences.
Conclusion
Effective denoising and image reconstruction processing techniques can enable breast cancer diagnosis with substantial radiation dose reduction.

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