1.Association between outdoor clothing use and serum perfluoroalkyl substances (PFAS): Korean National Environmental Health Survey cycle 4
Keon Woo KIM ; Jisoo KANG ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK
Annals of Occupational and Environmental Medicine 2026;38(1):e4-
Background:
Perfluoroalkyl substances (PFAS) are used in various products, and PFAS have been detected in outdoor clothing. PFAS can be absorbed into the human body via oral ingestion, inhalation, and dermal contact. In this study, we examined the association between the frequency of using outdoor clothing and serum PFAS concentrations in the Korean population using data from cycle 4 (2018–2020) of the Korean National Environmental Health Survey.
Methods:
Data from 2,993 adult participants were analyzed. The participants were classified into low-concentration and high-concentration groups based on the 75th percentile concentration of serum PFAS. The use of outdoor clothing was categorized into three groups: non-use, <4 times a week, and ≥4 times a week. The odds ratio (OR) for serum PFAS levels associated with use of outdoor clothing was determined through logistic regression analysis, adjusted for demographic characteristics, health-related factors, PFAS-treated items, dietary factors, and ventilation time.
Results:
ORs for high serum PFAS were higher in groups using outdoor clothing compared to the non-user group. In males, the adjusted ORs for the < 4 times a week and ≥ 4 times a week outdoor clothing usage group were as follows: perfluorooctanoic acid (PFOA), 1.26 (95% confidence interval [CI]: 1.10–1.44) and 1.70 (1.40–2.07); perfluorohexanesulfonic acid (PFHxS), 1.49 (1.16–1.92) and 1.70 (1.22–2.37); and perfluorononanoic acid (PFNA), 1.34 (1.19–1.51) and 1.68 (1.38–2.05), respectively. In females, the respective ORs were as follows: PFOA 1.32 (95% CI: 1.19–1.46) and 1.53 (1.01–2.32); PFHxS, 1.46 (1.08–1.96) and 2.63 (2.10–3.29); PFNA, 1.38 (1.22–1.55) and 1.45 (1.07–1.96).
Conclusions
In adults, elevated serum PFAS levels were associated with increased frequency of using outdoor clothing.
2.Clinical Application of Pharmacogenomics in Stroke Management: Current Evidence and Future Directions
Keon-Joo LEE ; Minkyung KANG ; Eung Joon LEE ; Jaeseong OH ; Na-Young HAN ; Jeong-Yoon LEE ; Joo-Yeon LEE ; Soo Ji LEE ; Stéphanie DEBETTE ; Guillaume PARÉ ; Daniel WOO ; Andrew ELDEIRY ; Young Seo KIM ; Jinkwon KIM ; Jong-Moo PARK ; Juneyoung LEE ; Joohon SUNG ; Jay Chol CHOI ; Hee-Joon BAE
Journal of Stroke 2026;28(1):58-75
Pharmacogenomic variations may significantly influence responses to commonly prescribed stroke medications. Despite accumulating evidence, genetic testing has not yet been widely integrated into stroke care. This review summarizes current evidence and provides practical guidance for clinical implementation. Pharmacogenomic studies and clinical guidelines related to antiplatelet agents, anticoagulants, and statins were reviewed, with particular emphasis on East Asian populations. Substantial evidence supports genotype-guided use of clopidogrel (CYP2C19), warfarin (CYP2C9, VKORC1, CYP4F2), and statins (SLCO1B1, ABCG2). For aspirin, PTGS1/2 and PEAR1 variants have been investigated; however, current data remain insufficient for clinical application. Regarding direct oral anticoagulants (DOACs), candidate genes such as ABCB1 and CES1 demonstrate pharmacokinetic associations, though robust clinical outcome data are lacking. Distinct allele frequencies in East Asians—such as higher prevalence of CYP2C19 and ABCG2 variants—underscore the need for population-specific strategies. Beyond single-gene approaches, polygenic risk scores, pharmacogenomic panels, and integration with multi-omics data and artificial intelligence represent promising directions for personalized therapy. Pharmacogenomic testing can enhance stroke pharmacotherapy, particularly in populations with high frequencies of actionable variants. Broader implementation requires rapid testing platforms, clinician education, tailored clinical guidelines, and real-world validation of aspirin, DOACs, and multi-gene approaches. Future research should expand population-specific studies and integrate pharmacogenomics within the broader framework of precision medicine to ensure equitable clinical benefit.
3.National Trends in the Prevalence of Suicide Attempts Among Adolescents by Self-Perceived Weight, 2005–2023: A Nationwide Representative Study in South Korea
Jinyoung JEONG ; Hyunjee KIM ; Hyesu JO ; Hyeon Jin KIM ; Jaeyu PARK ; Jaehyeong CHO ; Jiyoung HWANG ; Seoyoung PARK ; Damiano PIZZOL ; Lee SMITH ; Sang Youl RHEE ; Selin WOO ; Dong Keon YON
Psychiatry Investigation 2026;23(1):48-62
Objective:
Suicide is a leading cause of death among adolescents, and despite the need to distinguish between suicidal consideration and suicide attempts, research focused on suicide attempts remains insufficient. Therefore, this study aims to investigate the influence of self-perceived weight on suicide attempts.
Methods:
This study utilized data from the Korea Youth Risk Behavior Web-based Survey for its analysis from 2005 to 2023, including a total of 1,156,728 participants. This study utilized various analytical methods to examine the influence of self-perceived weight on suicide attempts. We estimated weighted prevalence and used linear regression to assess temporal trend β coefficients and their differences (βdiff) with 95% confidence intervals (CIs), and survey-weighted logistic regression to estimate weighted odds ratios (wORs) and 95% CIs for the association between self-perceived weight and suicide attempts.
Results:
A comparison of suicide attempts based on self-perceived weight suggested that individuals who perceived themselves as overweight (weighted prevalence, 3.97% [95% CI, 3.89 to 4.04]) had the highest rate of suicide attempts, followed by those who perceived themselves as underweight (3.36% [95% CI, 3.28 to 3.44]), while those who perceived themselves as having a normal weight (3.20% [95% CI, 3.14 to 3.27]) had the lowest rate. Additionally, females (underweight: 4.47% [95% CI, 4.32 to 4.62]; normal weight: 3.91% [95% CI, 3.81 to 4.01]; overweight: 5.23% [5.11 to 5.35]) experienced more suicide attempts than males (underweight: 2.73% [95% CI, 2.65 to 2.82]; normal weight: 2.43% [95% CI, 2.35 to 2.51]; overweight: 2.60% [95% CI, 2.52 to 2.69]).
Conclusion
Findings from the present study suggest that self-perceived weight was associated with suicide attempts and interaction analyses indicated a potential sex-based difference in the impact of body image distortion. Therefore, this study suggests the introduction of programs and campaigns aimed at correcting distorted self-perceived weight.
4.Global Burden of Vaccine-Associated Cerebrovascular Venous Sinus Thrombosis, 1968–2024: A Critical Analysis From the WHO Global Pharmacovigilance Database
Jaehyeong CHO ; Hyesu JO ; Hyunjee KIM ; Jaeyu PARK ; Damiano PIZZOL ; Min Seo KIM ; Ho Geol WOO ; Dong Keon YON
Journal of Korean Medical Science 2025;40(11):e101-
Despite widespread coronavirus disease 2019 (COVID-19) vaccine use, research on the association between vaccines and cerebrovascular venous sinus thrombosis (CVST) in diverse populations is limited. This study aimed to address this gap. Data from the World Health Organization pharmacovigilance database (1968–2024; total reports = 8,909,484) were used.Reporting odds ratios (RORs) and information components (ICs) were calculated to assess the association between each drug and CVST. In total, 851 cases were identified as vaccineassociated CVST, of which 527 (61.93%) occurred in female patients. Only Ad5-vectored COVID-19 vaccines had the highest ROR and IC value with CVST (ROR, 4.78; 95% confidence interval, 4.34–5.28; IC, 2.15). The risk of CVST increased with age, with the 45–64-years age group having an IC of 1.35, while the 65 years and older group had a higher IC of 2.08.The findings highlight the need for clinicians to recognize the potential risks of CVST and prioritize rigorous monitoring and research to ensure patient safety.
5.Global Burden of Vaccine-Associated Cerebrovascular Venous Sinus Thrombosis, 1968–2024: A Critical Analysis From the WHO Global Pharmacovigilance Database
Jaehyeong CHO ; Hyesu JO ; Hyunjee KIM ; Jaeyu PARK ; Damiano PIZZOL ; Min Seo KIM ; Ho Geol WOO ; Dong Keon YON
Journal of Korean Medical Science 2025;40(11):e101-
Despite widespread coronavirus disease 2019 (COVID-19) vaccine use, research on the association between vaccines and cerebrovascular venous sinus thrombosis (CVST) in diverse populations is limited. This study aimed to address this gap. Data from the World Health Organization pharmacovigilance database (1968–2024; total reports = 8,909,484) were used.Reporting odds ratios (RORs) and information components (ICs) were calculated to assess the association between each drug and CVST. In total, 851 cases were identified as vaccineassociated CVST, of which 527 (61.93%) occurred in female patients. Only Ad5-vectored COVID-19 vaccines had the highest ROR and IC value with CVST (ROR, 4.78; 95% confidence interval, 4.34–5.28; IC, 2.15). The risk of CVST increased with age, with the 45–64-years age group having an IC of 1.35, while the 65 years and older group had a higher IC of 2.08.The findings highlight the need for clinicians to recognize the potential risks of CVST and prioritize rigorous monitoring and research to ensure patient safety.
6.Global Burden of Vaccine-Associated Cerebrovascular Venous Sinus Thrombosis, 1968–2024: A Critical Analysis From the WHO Global Pharmacovigilance Database
Jaehyeong CHO ; Hyesu JO ; Hyunjee KIM ; Jaeyu PARK ; Damiano PIZZOL ; Min Seo KIM ; Ho Geol WOO ; Dong Keon YON
Journal of Korean Medical Science 2025;40(11):e101-
Despite widespread coronavirus disease 2019 (COVID-19) vaccine use, research on the association between vaccines and cerebrovascular venous sinus thrombosis (CVST) in diverse populations is limited. This study aimed to address this gap. Data from the World Health Organization pharmacovigilance database (1968–2024; total reports = 8,909,484) were used.Reporting odds ratios (RORs) and information components (ICs) were calculated to assess the association between each drug and CVST. In total, 851 cases were identified as vaccineassociated CVST, of which 527 (61.93%) occurred in female patients. Only Ad5-vectored COVID-19 vaccines had the highest ROR and IC value with CVST (ROR, 4.78; 95% confidence interval, 4.34–5.28; IC, 2.15). The risk of CVST increased with age, with the 45–64-years age group having an IC of 1.35, while the 65 years and older group had a higher IC of 2.08.The findings highlight the need for clinicians to recognize the potential risks of CVST and prioritize rigorous monitoring and research to ensure patient safety.
7.Global Burden of Vaccine-Associated Cerebrovascular Venous Sinus Thrombosis, 1968–2024: A Critical Analysis From the WHO Global Pharmacovigilance Database
Jaehyeong CHO ; Hyesu JO ; Hyunjee KIM ; Jaeyu PARK ; Damiano PIZZOL ; Min Seo KIM ; Ho Geol WOO ; Dong Keon YON
Journal of Korean Medical Science 2025;40(11):e101-
Despite widespread coronavirus disease 2019 (COVID-19) vaccine use, research on the association between vaccines and cerebrovascular venous sinus thrombosis (CVST) in diverse populations is limited. This study aimed to address this gap. Data from the World Health Organization pharmacovigilance database (1968–2024; total reports = 8,909,484) were used.Reporting odds ratios (RORs) and information components (ICs) were calculated to assess the association between each drug and CVST. In total, 851 cases were identified as vaccineassociated CVST, of which 527 (61.93%) occurred in female patients. Only Ad5-vectored COVID-19 vaccines had the highest ROR and IC value with CVST (ROR, 4.78; 95% confidence interval, 4.34–5.28; IC, 2.15). The risk of CVST increased with age, with the 45–64-years age group having an IC of 1.35, while the 65 years and older group had a higher IC of 2.08.The findings highlight the need for clinicians to recognize the potential risks of CVST and prioritize rigorous monitoring and research to ensure patient safety.
8.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
Jong Woo HAHN ; Selin WOO ; Jaeyu PARK ; Hyeri LEE ; Hyeon Jin KIM ; Jae Sung KO ; Jin Soo MOON ; Masoud RAHMATI ; Lee SMITH ; Jiseung KANG ; Damiano PIZZOL ; Mark A TULLY ; Elena DRAGIOTI ; Guillermo F. LÓPEZ SÁNCHEZ ; Kwanjoo LEE ; Yeonjung HA ; Jinseok LEE ; Hayeon LEE ; Sang Youl RHEE ; Yejun SON ; Soeun KIM ; Dong Keon YON
Journal of Korean Medical Science 2024;39(46):e292-
Background:
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.
Methods:
This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.
Results:
The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.
Conclusion
Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.
9.Associations between weight-control methods and depression among Korean adolescents: a study based on a national dataset
Jaehyun KONG ; Kyeongmin LEE ; Sooji LEE ; Soeun KIM ; Jinyoung JEONG ; Yejun SON ; Hayeon LEE ; Louis JACOB ; Masoud RAHMATI ; Guillaume FOND ; Laurent BOYER ; Lee SMITH ; Elena DRAGIOTI ; Selin WOO ; Jiyoung HWANG ; Dong Keon YON
Nutrition Research and Practice 2024;18(6):818-828
BACKGROUND/OBJECTIVES:
The increasing prevalence of overweight and obesity has become a significant global burden, with more than 40% of the global adult population attempting to lose weight. Previous studies on the impact of weight-control methods on mental health, especially among adolescents, are limited. Thus, this study aimed to investigate the association between various weight-control methods and depression among adolescents, with the goal of informing healthier weight management decisions and promoting effective methods.
SUBJECTS/METHODS:
This nationwide study utilized data from the Korea Youth Risk Behavior Web-based Survey, including a sample of 418,254 adolescents collected over 12yrs (2007–2019). We conducted a weighted complex sample analysis to compare depression rates associated with specific weight-control methods, including exercise, fasting (≥ 24 h), eating less, taking prescriptionon-prescription weight-loss medication, taking laxatives or diuretics, vomiting, one-food diet, taking oriental medicine, and diet foods.
RESULTS:
Of the 418,254 participants, 45.96% (192,246) were male. Among male participants, fasting (≥ 24 h; weighted odds ratio [wOR], 1.43; 95% confidence interval [CI], 1.36–1.51) and vomiting (wOR, 1.49; 95% CI, 1.35–1.66) were associated with an increased risk of depression. Among female participants, prescribed (wOR, 0.82; 95% CI, 0.74–0.90) and non-prescribed (wOR, 0.89; 95% CI, 0.82–0.97) weight-loss medication reduced the risk of depression. However, fasting (≥ 24 h; wOR, 1.47; 95% CI, 1.41–1.52) vomiting (wOR, 1.45;95% CI, 1.36–1.55) significantly increased the risk of depression.
CONCLUSION
The risk of depression varies depending on the weight-control method, with a consistent trend observed across both sexes. Methods such as vomiting, fasting, taking oriental medicine for weight loss, and consuming diet foods increased the risk of depression, while weight-loss medications were associated with reduced depression symptoms in females. These findings highlight the need for further research on weightcontrol medications and policies that support effective weight management while reducing depressive effects.
10.Relationship between crustacean consumption and serum perfluoroalkyl substances (PFAS): the Korean National Environmental Health Survey (KoNEHS) cycle 4
Sung Woo HUH ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Keon Woo KIM
Annals of Occupational and Environmental Medicine 2024;36(1):e12-
Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs. Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ2 test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage. The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females. This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.

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