1.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
2.Persistent influence of past obesity on current adiponectin levels and mortality in patients with type 2 diabetes
Min-Ji KIM ; Sung-Woo KIM ; Bitna HA ; Hyang Sook KIM ; So-Hee KWON ; Jonghwa JIN ; Yeon-Kyung CHOI ; Keun-Gyu PARK ; Jung Guk KIM ; In-Kyu LEE ; Jae-Han JEON
The Korean Journal of Internal Medicine 2025;40(2):299-309
Background/Aims:
Adiponectin, a hormone primarily produced by adipocytes, typically shows an inverse relationship with body mass index (BMI). However, some studies have reported a positive correlation between the two. Thus, this study aimed to examine the relationship between adiponectin level and BMI in diabetic patients, focusing on the impact of past obesity on current adiponectin levels.
Methods:
We conducted an observational study analyzing data from 323 diabetic patients at Kyungpook National University Hospital. Based on past and current BMIs, participants were categorized into never-obese (nn, n = 106), previously obese (on, n = 43), and persistently obese (oo, n = 73) groups based on a BMI threshold of 25 kg/m2. Adiponectin level and BMI were key variables. Kaplan–Meier analysis assessed their impact on all-cause mortality up to August 2023, with survival differences based on adiponectin quartiles and follow-up starting from patient enrollment (2010–2015).
Results:
The analysis revealed a significant inverse correlation between adiponectin level and past maximum BMI. The on group exhibited approximately 10% lower adiponectin levels compared to the nn group. This association remained significant after adjusting for current BMI, age, and sex, highlighting the lasting influence of previous obesity on adiponectin levels. Furthermore, survival analysis indicated that patients in the lowest adiponectin quartile had reduced survival, with a statistically significant trend (p = 0.062).
Conclusions
Findings of this study suggest that lower adiponectin levels, potentially reflecting past obesity, are associated with decreased survival in diabetic patients, underscoring a critical role of adiponectin in long-term health outcomes.
3.Korean Guidelines for the Management and Antibiotic Therapy in Adult Patients with Hospital-Acquired Pneumonia
Hayoung CHOI ; Kyung Hoon MIN ; Young Seok LEE ; Youjin CHANG ; Bo Young LEE ; Jee Youn OH ; Ae-Rin BAEK ; Jongmin LEE ; Kyeongman JEON
Tuberculosis and Respiratory Diseases 2025;88(1):69-89
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are correlated with high morbidity and mortality rates. Guidelines that consider local epidemiologic data are fundamental for identifying optimal treatment strategies. However, Korea has no HAP/VAP guidelines. This study was conducted by a committee of nine experts from the Korean Academy of Tuberculosis and Respiratory Diseases Respiratory Infection Study Group using the results of Korean HAP/VAP epidemiologic studies. Eleven key questions for HAP/VAP diagnosis and treatment were addressed. The Convergence of Opinion on Suggestions and Evidence (CORE) process was used to derive suggestions, and evidence levels and recommendation grades were in accordance with the Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology. Suggestions were made for the 11 key questions pertinent to diagnosis, biomarkers, antibiotics, and treatment strategies for adult patients with HAP/VAP. Using the CORE process and GRADE methodology, the committee generated a series of recommendations for HAP/VAP diagnosis and treatment in the Korean context.
4.Spatiotemporal Gait Parameters During Turning and Imbalance in Parkinson’s Disease: Video-Based Analysis From a Single Camera
HoYoung JEON ; Jung Hwan SHIN ; Ri YU ; Min Kyung KANG ; Seungmin LEE ; Seoyeon KIM ; Bora JIN ; Kyung Ah WOO ; Han-Joon KIM ; Beomseok JEON
Journal of Movement Disorders 2025;18(1):87-92
Objective:
This study aims to objectively evaluate turning gait parameters in Parkinson’s disease (PD) patients using 2D-RGB video-based analysis and explore their relationships with imbalance.
Methods:
We prospectively enrolled PD patients for clinical assessment, balance analysis and gait with 180º turning. Spatiotemporal gait parameters during turning were derived using video-based analysis and correlated with modified Hoehn and Yahr (mHY) stages and center of pressure (COP) oscillations.
Results:
A total of 64 PD patients were enrolled. The PD patients with higher mHY stages (≥2.5) had significantly longer turning times, greater numbers of steps, wider step bases and less variability in step length during turns. COP oscillations were positively correlated with the mean turning time on both the anterior-posterior and right-left axes.
Conclusion
Spatiotemporal gait parameter during turning, derived from video-based gait analysis, may represent apromising biomarker for monitoring postural instability in PD patients.
5.Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young HAM ; Seungjae LEE ; Min-Kyung KIM ; Jaehyun JEON ; Eunyoung LEE ; Subin KIM ; Jae-Phil CHOI ; Hee-Chang JANG ; Sang-Won PARK
Journal of Korean Medical Science 2025;40(11):e38-
Background:
Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines.
Methods:
We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed.
Results:
A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%).
Conclusion
Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA.
6.Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young HAM ; Seungjae LEE ; Min-Kyung KIM ; Jaehyun JEON ; Eunyoung LEE ; Subin KIM ; Jae-Phil CHOI ; Hee-Chang JANG ; Sang-Won PARK
Journal of Korean Medical Science 2025;40(11):e38-
Background:
Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines.
Methods:
We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed.
Results:
A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%).
Conclusion
Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA.
7.The Incidence of Occult Malignancy in Contralateral Risk Reducing Mastectomy Among Affected Breast Cancer Gene Mutation Carriers in South Korea
Cho Eun LEE ; Dong Seung SHIN ; Ki Jo KIM ; Seok Jin NAM ; Seok Won KIM ; Jonghan YU ; Byung Joo CHAE ; Se Kyung LEE ; Jai Min RYU ; Goo-Hyun MUN ; Jai-Kyong PYON ; Byung-Joon JEON ; Kyongje WOO ; Jeong Eon LEE
Journal of Breast Cancer 2025;28(1):1-10
Purpose:
Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM.
Methods:
Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated.
Results:
In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations.
Conclusion
The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.
8.Psychosocial and Clinical Characteristics of Temporomandibular Disorder Patients Attributing Symptoms to Dental Treatment
Hee-Won KIM ; Yong-Woo AHN ; Sung-Hee JEONG ; Hye-Min JU ; Kyung-Hee KIM ; Hye-Mi JEON ; Soo-Min OK
Journal of Oral Medicine and Pain 2025;50(1):16-24
Purpose:
Temporomandibular disorder (TMD) is a multifactorial condition influenced by biological, psychological, and social factors. Some patients perceive dental treatment as the cause of their TMD, which may impact symptom perception and treatment response.This study aims to compare the psychosocial and clinical characteristics of patients who attribute their TMD onset to prior dental treatment (DT group) with those who do not (NT group).
Methods:
A total of 250 patients diagnosed with TMD at Pusan National University Dental Hospital between January and October 2024 were included. Patients were classified into the DT group (n=92) if they attributed their symptoms to previous dental procedures, while the remaining NT group (n=158) consisted of patients with other primary complaints. Patients were additionally categorized into Generation X (1965-1980), Generation Y (1981-1999), and Generation Z (2000-2012). Clinical assessments were conducted following the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and psychosocial factors were evaluated using the Oral Behaviors Checklist (OBC), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15).
Results:
The DT group had a significantly higher mean age (54.16±16.87 years) compared to the NT group (39.71±19.12 years, p<0.001). Psychological distress scores (PHQ-9, GAD-7, and PHQ-15) were significantly higher in the DT group, particularly among Generation X patients (p<0.05). Muscle-related pain was more prevalent in the DT group (75%) than in the NT group. Interestingly, OBC scores were higher in the NT group (p<0.05).
Conclusions
Patients who attributed their TMD onset to dental treatment reported higher psychological distress and a greater prevalence of muscle-related pain, underscoring the need for a biopsychosocial approach to TMD management. Clinicians should consider the impact of patient perception on TMD symptoms and integrate psychological assessment and counseling to enhance treatment efficacy and patient adherence.
9.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
10.Persistent influence of past obesity on current adiponectin levels and mortality in patients with type 2 diabetes
Min-Ji KIM ; Sung-Woo KIM ; Bitna HA ; Hyang Sook KIM ; So-Hee KWON ; Jonghwa JIN ; Yeon-Kyung CHOI ; Keun-Gyu PARK ; Jung Guk KIM ; In-Kyu LEE ; Jae-Han JEON
The Korean Journal of Internal Medicine 2025;40(2):299-309
Background/Aims:
Adiponectin, a hormone primarily produced by adipocytes, typically shows an inverse relationship with body mass index (BMI). However, some studies have reported a positive correlation between the two. Thus, this study aimed to examine the relationship between adiponectin level and BMI in diabetic patients, focusing on the impact of past obesity on current adiponectin levels.
Methods:
We conducted an observational study analyzing data from 323 diabetic patients at Kyungpook National University Hospital. Based on past and current BMIs, participants were categorized into never-obese (nn, n = 106), previously obese (on, n = 43), and persistently obese (oo, n = 73) groups based on a BMI threshold of 25 kg/m2. Adiponectin level and BMI were key variables. Kaplan–Meier analysis assessed their impact on all-cause mortality up to August 2023, with survival differences based on adiponectin quartiles and follow-up starting from patient enrollment (2010–2015).
Results:
The analysis revealed a significant inverse correlation between adiponectin level and past maximum BMI. The on group exhibited approximately 10% lower adiponectin levels compared to the nn group. This association remained significant after adjusting for current BMI, age, and sex, highlighting the lasting influence of previous obesity on adiponectin levels. Furthermore, survival analysis indicated that patients in the lowest adiponectin quartile had reduced survival, with a statistically significant trend (p = 0.062).
Conclusions
Findings of this study suggest that lower adiponectin levels, potentially reflecting past obesity, are associated with decreased survival in diabetic patients, underscoring a critical role of adiponectin in long-term health outcomes.

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