1.Part 1. Current Status of Hearing Loss Patients in Korea Using National Data: National Health Insurance Service- Database, 2010 to 2020
Junhun LEE ; Chul Young YOON ; Jiwon KIM ; In-Ki JIN ; Michelle J. SUH ; Wan-Ho CHO ; Hyo-Jeong LEE ; Seong Jun CHOI ; Dongchul CHA ; Kyung Ho PARK ; Soo Hee OH ; Young Joon SEO ; Tae Hoon KONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(1):7-18
Background and Objectives:
Hearing loss significantly affects communication, psychosocial well-being, and quality of life. This study analyzes the National Health Insurance Service database to assess the trends and characteristics of hearing loss in South Korea from 2010 to 2020.Subjects and Method The database encompasses 97% of the Korean population, providing comprehensive data on medical history, prescriptions, and health examinations. The analysis used the World Health Organization’s ICD-10 definitions to categorize hearing loss types and examine their prevalence and incidence across various demographics over 11 years.
Results:
There was an overall annual increase of 4.62% in diagnosed cases of hearing loss, with the most significant rise among the elderly. The rate of increase accelerated from 3.32% between 2010 and 2014 to 6.49% between 2014 and 2020, corresponding with the improved hearing aid access facilitated by policy changes. Women showed a slightly higher increase than men. The data also indicated a consistent rise in abnormal hearing test results during health examinations, especially in older adults.
Conclusion
The study highlights an increasing trend in hearing loss diagnoses, driven by an aging population and enhanced detection facilitated by policy changes. These findings emphasize the need for continuous monitoring and targeted health policies to manage hearing loss effectively, offering valuable insights for global health management and policy development.
2.Part 2. Current Status of Hearing Disability and Hearing Rehabilitation Devices in Korea Using National Data: NHIS-Database, 2010 to 2020
Junhun LEE ; Chul Young YOON ; Jiwon KIM ; In-Ki JIN ; Michelle J. SUH ; Wan-Ho CHO ; Hyo-Jeong LEE ; Seong Jun CHOI ; Dongchul CHA ; Kyung Ho PARK ; Soo Hee OH ; Young Joon SEO ; Tae Hoon KONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(3):94-104
Background and Objectives:
This study aims to analyze trends in hearing disability and the use of hearing rehabilitation devices (hearing aids and cochlear implants) in South Korea over the past 11 years (2010-2020) using data from the National Health Insurance Service (NHIS).Subjects and Method Data were extracted from the NHIS database, covering approximately 97% of the South Korean population. Patients diagnosed with hearing loss were classified using ICD-10 codes. The data were analyzed to determine trends in hearing disability, hearing aid prescriptions, and cochlear implant usage by age, gender, and types and causes of hearing loss.
Results:
The number of hearing disability patients increased from 170900 in 2010 to 362738 in 2020, with an annual growth rate of 7.95%. The highest increase was observed in the ≥60 age group, with an annual growth rate of 11.04%. Hearing aid prescriptions rose from 4966 in 2010 to 11974 in 2020, showing a 10.45% annual increase. Females showed a higher growth rate in both hearing disability and hearing aid prescriptions compared to males. Cochlear implant prescriptions also increased, particularly among older adults.
Conclusion
The study highlights a significant rise in hearing disability and the use of hearing aids and cochlear implants in South Korea, especially among the elderly. The findings underscore the importance of early diagnosis and intervention for hearing loss and the need for policy improvements to enhance accessibility and affordability of hearing rehabilitation services. Additional strategies are needed to ensure appropriate hearing rehabilitation for those not yet receiving adequate care.
3.18F‑FDG PET/CT in Inflammation and Infection: Procedural Guidelineby the Korean Society of Nuclear Medicine
Joon Ho CHOI ; Yong‑Jin PARK ; Hyunjong LEE ; Hye Ryeong KWON ; Jinkyoung OH ; Chae Hong LIM ; Eun Ji HAN ; Joon Young CHOI ;
Nuclear Medicine and Molecular Imaging 2025;59(1):27-40
This guideline outlines the use of 18F-fluoro-2-deoxyglucose positron emission tomography / computed tomography for the diagnosis and management of infectious and inflammatory diseases. It provides detailed recommendations for healthcare providers on patient preparation, imaging procedures, and the interpretation of results. Adapted from international standards and tailored to local clinical practices, the guideline emphasizes safety, quality control, and effective use of the technology in various conditions, including spinal infections, diabetic foot, osteomyelitis, vasculitis, and cardiac inflammation. The aim is to assist nuclear medicine professionals in delivering accurate diagnoses and improving patient outcomes while allowing flexibility to adapt to individual patient needs, technological advancements, and evolving medical knowledge. This document is a comprehensive resource for enhancing the quality and safety of 18F-fluoro-2-deoxyglucose positron emission tomography / computed tomography for the evaluation of infectious and inflammatory diseases.Preamble The Korean Society of Nuclear Medicine (KSNM) was established in 1961 to promote the clinical and technological advancement of nuclear medicine in South Korea, with members that include nuclear medicine physicians and associated scientists. The KSNM regularly formulates and revises procedural guidelines for nuclear medicine examinations to enhance the field and improve the quality of patient care. These guidelines are designed to support healthcare professionals in providing appropriate medical care to patients. However, they are not immutable rules or mandatory requirements for conducting examinations.Therefore, KSNM states that these guidelines should not be used in legal actions challenging a healthcare professional’s medical decisions. The ultimate judgment regarding specific procedures or appropriate measures should be made by nuclear medicine physicians, considering the unique circumstances of each case. Deviation from these guidelines does not imply substandard medical practice. Rather, reasonable judgments differing from the guidelines can be made based on the patient’s condition, available resources, and advancements in knowledge or technology. Due to the diversity and complexity of patients, it is often challenging to predict the most appropriate diagnostic and accurate therapeutic responses. Thus, adherence to these guidelines does not always guarantee an exact diagnosis or successful outcomes.The purpose of this guideline is to assist healthcare providers in making reasonable decisions and conducting effective and safe examinations based on current medical knowledge, available resources, and patient needs when performing 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) examinations for infectious/ inflammatory diseases.
4.Factors influencing satisfaction with medical services in medically underserved populations: an analytical cross-sectional study at a free medical clinic in the Republic of Korea
Joo Hyun KIM ; Yeon Jeong HEO ; Jae Bok KWAK ; Samil PARK ; Curie AHN ; So Hee AHN ; Bumjo OH ; Jung Sik LEE ; Jun Hyun LEE ; Ho Young LEE
Osong Public Health and Research Perspectives 2025;16(2):181-191
Objectives:
This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations.
Methods:
We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction.
Results:
Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction.
Conclusion
These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.
5.Machine Learning Prediction of Attachment Type From Bio-Psychological Factors in Patients With Depression
Yoon Jae CHO ; Jin Sun RYU ; Jeong-Ho SEOK ; Eunjoo KIM ; Jooyoung OH ; Byung-Hoon KIM
Psychiatry Investigation 2025;22(4):412-423
Objective:
Adult attachment style is linked to how an individual responds to threats or stress and is known to be related to the onset of psychiatric symptoms such as depression. However, as the current assessment of attachment type mainly relies on self-report questionnaires and can be prone to bias, there is a need to incorporate physiological factors along with psychological symptoms and history in this process. We aimed to predict the measurement of two important types of adult attachment with heart rate variability (HRV), early life stress experience, and subjective psychiatric symptoms.
Methods:
Five hundred eighty-two subjects with depressive disorder were recruited retrospectively from January 2015 to June 2021. The experience of early life stress and psychiatric symptoms were collected, and HRV measures were obtained as input for an ensembled Voting Regressor model of machine learning-based regression models, including linear regression, ElasticNet, Support Vector Machine (SVM), Random Forest, and Extreme Gradient Boosting (XGBoost).
Results:
Model performances evaluated with R-squared score averaged across 30 seeds were 0.377 and 0.188 for anxious- and avoidant-attachment, respectively. Mean absolute error averaged to 13.251 and 12.083, respectively. Shapley value importance analysis indicated that for both attachment types, the most important feature was the trait-anxiety, followed by emotional abuse, state-anxiety or self-reported depressive symptoms, and fear or helplessness felt in the moment of an early life stressor.
Conclusion
Our results provide the evidence base that may be utilized in clinical settings to predict the degree of attachment type using bio-psychological factors.
7.Initial and peak serum levels of Krebs von den Lungen-6 for predicting the prognosis of patients with COVID-19
Geonui KIM ; Hyeonwoo KWON ; Sang Hyun RA ; Euijin CHANG ; Seongman BAE ; Jiwon JUNG ; Min Jae KIM ; Yong Pil CHONG ; Sang-Oh LEE ; Sang-Ho CHOI ; Yang Soo KIM ; Sung-Han KIM
The Korean Journal of Internal Medicine 2025;40(2):321-329
Background/Aims:
Krebs von den Lungen-6 (KL-6) is associated with prognosis in patients with COVID-19. However, there is limited data on the correlation between the prognosis of COVID-19 and varying KL-6 levels at different time points. We investigated the optimal cutoff values of the initial and peak serum KL-6 levels to predict mortality and evaluated their correlation with mortality.
Methods:
This retrospective cohort study collected data on serially collected serum KL-6 levels in patients hospitalized with COVID-19 between October 2020 and January 2022 at a single tertiary hospital in South Korea. The area under the receiver operating characteristic curve and Youden index were used to determine the cutoff points for the initial and peak KL-6 levels that best predicted 30-day mortality. The association between the initial and peak KL-6 values was assessed by univariate and multivariate logistic regression models.
Results:
A total of 349 patients were included in this study. The mean initial and peak KL-6 levels were significantly higher in the non-survivor group than in the survivor group. The initial and peak KL-6 values that best predicted 30-day mortality were 491.85 U/mL and 660.05 U/mL, respectively. An initial KL-6 level greater than 491.85 U/mL and a peak KL-6 level greater than 660.05 U/mL were significantly associated with 30-day mortality.
Conclusions
The initial and peak levels of KL-6 were significantly associated with 30-day mortality in hospitalized patients with COVID-19. These findings suggest that serially monitoring blood KL-6 levels could be a valuable prognostic indicator for COVID-19.
8.Prevalence and characteristics of impacted teeth in Korean orthodontic patients at ten university dental hospitals
Youn-Kyung CHOI ; Sung-Hun KIM ; Yong-Il KIM ; Seong-Sik KIM ; Soo-Byung PARK ; Dong-Soon CHOI ; Ho-Jin KIM ; Kyung-A KIM ; Mo-Hyeon LEE ; Sung-Hwan CHOI ; Sung-Kwon CHOI ; Kyungmin Clara LEE ; Young-Mi JEON ; Sewoong OH ; Seorin JEONG
The Korean Journal of Orthodontics 2025;55(3):234-241
Objective:
This study aimed to investigate the prevalence and characteristics of impacted teeth (ITs) in orthodontic patients at university dental hospitals in Korea.
Methods:
This study included 14,774 patients who visited the Department of Orthodontics at 10 university dental hospitals in Korea between 2020 and 2022 and underwent orthodontic diagnosis. The prevalence and characteristics of ITs were investigated using orthodontic diagnostic records, radiographs, and diagnostic casts.
Results:
The prevalence of ITs, excluding third molar impaction, in Korean orthodontic patients was 13.6% (n = 2,014).The prevalence of ITs in pediatric orthodontic patients was 24.5% (n = 1,614).Of these patients, 68.2% had one IT, 27.5% had two ITs, 24.3% had bilateral IT, and 75.7% had unilateral IT. The most frequent IT was the maxillary canine (50.1%), followed by the mandibular second molar (11.7%), and maxillary second premolar (9.6%). An abnormal eruption path (46.5%) was the most frequent etiology. Orthodontic traction after surgical exposure (70.6%) was the most frequent treatment option. Among the patients with ITs, 29.8% had other dental anomalies, such as tooth agenesis (8.7%), microdontia (8.0%), and supernumerary teeth (5.1%). Furthermore, 50.8% had complications such as cystic lesions (18.3%), transposition (17.7%), and root resorption (14.8%).Among the patients with maxillary canine impaction, 62.2% had labial maxillary canine impaction and 21.1% had palatal maxillary canine impaction.
Conclusions
The prevalence of ITs in Korean orthodontic patients at university dental hospitals was high, particularly in pediatric orthodontic patients.
9.The Application of L-Serine-Incorporated Gelatin Sponge into the Calvarial Defect of the Ovariectomized Rats
Yoon-Jo LEE ; Ji-Hyeon OH ; Suyeon PARK ; Jongho CHOI ; Min-Ho HONG ; HaeYong KWEON ; Weon-Sik CHAE ; Xiangguo CHE ; Je-Yong CHOI ; Seong-Gon KIM
Tissue Engineering and Regenerative Medicine 2025;22(1):91-104
BACKGROUND:
Osteoporosis, characterized by decreased bone mineral density due to an imbalance between osteoblast and osteoclast activity, poses significant challenges in bone healing, particularly in postmenopausal women. Current treatments, such as bisphosphonates, are effective but associated with adverse effects like medication-related osteonecrosis of the jaw, necessitating safer alternatives.
METHODS:
This study investigated the use of L-serine-incorporated gelatin sponges for bone regeneration in calvarial defects in an ovariectomized rat model of osteoporosis. Thirty rats were divided into three groups: a control group, a group treated with a gelatin sponge containing an amino acid mixture, and a group treated with a gelatin sponge containing L-serine. Bone regeneration was assessed using micro-computed tomography (micro-CT) and histological analyses.
RESULTS:
The L-serine group showed a significant increase in bone volume (BV) and bone area compared to the control and amino acid groups. The bone volume to total volume (BV/TV) ratio was also significantly higher in the L-serine group.Immunohistochemical analysis demonstrated that L-serine treatment suppressed the expression of cathepsin K, a marker of osteoclast activity, while increasing serine racemase activity.
CONCLUSION
These findings suggest that L-serine-incorporated gelatin sponges not only enhance bone formation but also inhibit osteoclast-mediated bone resorption, providing a promising and safer alternative to current therapies for osteoporosis-related bone defects. Further research is needed to explore its clinical applications in human patients.
10.Virtual Reality-Based Cognitive Behavior Therapy for Major Depressive Disorder: An Alternative to Pharmacotherapy for Reducing Suicidality
Miwoo LEE ; Sooah JANG ; Hyun Kyung SHIN ; Sun-Woo CHOI ; Hyung Taek KIM ; Jihee OH ; Ji Hye KWON ; Youngjun CHOI ; Suzi KANG ; In-Seong BACK ; Jae-Ki KIM ; San LEE ; Jeong-Ho SEOK
Yonsei Medical Journal 2025;66(1):25-36
Purpose:
Cognitive behavioral therapy (CBT) has long been recognized as an effective treatment for depression and suicidality.Virtual reality (VR) technology is widely used for cognitive training for conditions such as anxiety disorder and post-traumatic stress disorder, but little research has considered VR-based CBT for depressive symptoms and suicidality. We tested the effectiveness and safety of a VR-based CBT program for depressive disorders.
Materials and Methods:
We recruited 57 participants from May 2022 through February 2023 using online advertisements. This multi-center, assessor-blinded, randomized, controlled exploratory trial used two groups: VR treatment group and treat as usual (TAU) group. VR treatment group received a VR mental health training/education program. TAU group received standard pharmacotherapy. Assessments were conducted at baseline, immediately after the 6-week treatment period, and 4 weeks after the end of the treatment period in each group.
Results:
Depression scores decreased significantly over time in both VR treatment and TAU groups, with no differences between the two groups. The suicidality score decreased significantly only in VR group. No group differences were found in the remission or response rate for depression, perceived stress, or clinical severity. No adverse events or motion sickness occurred during the VR treatment program.
Conclusion
VR CBT treatment for major depressive disorder has the potential to be equivalent to the gold-standard pharmacotherapy in reducing depressive symptoms, suicidality, and related clinical symptoms, with no difference in improvement found in this study. Thus, VR-based CBT might be an effective alternative to pharmacotherapy for depressive disorders.

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