1.Repeated Health Screening Measures and Incident Ischemic Stroke: Evidence From a Korean Population Study
Inhyeok YIM ; Heui Sug JO ; Seongheon KIM ; Su Kyoung KIM ; Gyoung-Min LEE ; Yu Seong HWANG
Journal of Preventive Medicine and Public Health 2026;59(3):318-327
Objectives:
Ischemic stroke is influenced by long-term metabolic and renal deterioration; however, many risk prediction frameworks rely on single time-point measurements. We examined whether multi-period patterns in national health screening indicators are associated with incident ischemic stroke in Korea.
Methods:
Using customized National Health Insurance Service data with 3 biennial screenings (P1: 2013–2014; P2: 2015–2016; P3: 2017–2018), we identified incident ischemic stroke during 2019–2023 (Korean Standard Classification of Diseases-7 I63). After applying eligibility criteria and excluding individuals with missing screening values, we performed 1:1 propensity score matching on sex, 1-year age strata, and insurance type (97 454 matched pairs; n=194 908). Multi-period indicators included waist circumference increase ≥10%, sustained blood pressure ≥130/80 mmHg, sustained fasting glucose ≥126 mg/dL, proteinuria progression, and creatinine elevation in ≥2 periods (sex-specific thresholds). Associations were evaluated using conditional logistic regression; a comparator model used P3-only indicators.
Results:
In the multi-period model, stroke was associated with waist circumference increase ≥10% (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01 to 1.08), sustained blood pressure ≥130/80 mmHg (OR, 1.34; 95% CI, 1.31 to 1.37), sustained fasting glucose ≥126 mg/dL (OR, 1.66; 95% CI, 1.60 to 1.73), creatinine elevation in ≥2 periods (OR, 1.08; 95% CI, 1.06 to 1.10), and proteinuria progression (OR, 1.36; 95% CI, 1.32 to 1.39). In the P3-only model, all single-time-point indicators were associated with incident stroke (ORs, 1.08 to 1.47).
Conclusions
Multi-year patterns in metabolic screening indicators were associated with incident ischemic stroke. Repeated health screening measurements may complement single time-point assessments and support continuous risk-factor monitoring and patient-centered prevention.
2.Pain Lateralization in Cluster Headache and Associated Clinical Factors
Soohyun CHO ; Mi Ji LEE ; Min Kyung CHU ; Jeong Wook PARK ; Heui-Soo MOON ; Pil-Wook CHUNG ; Jong-Hee SOHN ; Byung-Su KIM ; Daeyoung KIM ; Kyungmi OH ; Byung-Kun KIM ; Soo-Jin CHO
Journal of Clinical Neurology 2025;21(3):220-229
Background:
and Purpose The pain lateralization in cluster headache (CH) may be related to the asymmetry in the functions of the brain hemispheres. The right-sided dominance of pain in CH has been found inconsistently across studies, and so we aimed to characterize this and identify the factors influencing pain lateralization during current and previous bouts.
Methods:
This study enrolled 227 patients from the Korean Cluster Headache Registry between October 2018 and December 2020. We evaluated the side of pain during current and previous bouts, demographic features, and clinical characteristics, including handedness. Multivariable logistic regression analyses were performed to identify factors associated with the side of pain.
Results:
The 227 patients with CH included 131 (57.7%) with right-sided pain and 86 (37.9%) with left-sided pain during the current bout (p<0.001). The 189 patients with previous bouts of CH included 86.8% who consistently reported the same side of pain throughout multiple bouts (side-locked pain), with a higher prevalence of pain on the right than the left side (55.0% vs. 31.7%, p<0.001). Multivariable analyses revealed that higher age at diagnosis (odds ratio [OR]=1.045, p=0.031) and shorter CH attacks (OR=0.992, p=0.017) were associated with left-side-locked pain. However, handedness was not associated with the lateralization of leftside-locked pain.
Conclusions
This study has confirmed the predominance of right-sided pain throughout multiple CH bouts. We found that higher age at diagnosis and shorter CH attacks were associated with left-side-locked pain, suggesting that certain clinical factors are associated with the pain laterality. However, the underlying mechanisms linking these factors to lateralized pain remain unclear and therefore require further investigation.
3.Pain Lateralization in Cluster Headache and Associated Clinical Factors
Soohyun CHO ; Mi Ji LEE ; Min Kyung CHU ; Jeong Wook PARK ; Heui-Soo MOON ; Pil-Wook CHUNG ; Jong-Hee SOHN ; Byung-Su KIM ; Daeyoung KIM ; Kyungmi OH ; Byung-Kun KIM ; Soo-Jin CHO
Journal of Clinical Neurology 2025;21(3):220-229
Background:
and Purpose The pain lateralization in cluster headache (CH) may be related to the asymmetry in the functions of the brain hemispheres. The right-sided dominance of pain in CH has been found inconsistently across studies, and so we aimed to characterize this and identify the factors influencing pain lateralization during current and previous bouts.
Methods:
This study enrolled 227 patients from the Korean Cluster Headache Registry between October 2018 and December 2020. We evaluated the side of pain during current and previous bouts, demographic features, and clinical characteristics, including handedness. Multivariable logistic regression analyses were performed to identify factors associated with the side of pain.
Results:
The 227 patients with CH included 131 (57.7%) with right-sided pain and 86 (37.9%) with left-sided pain during the current bout (p<0.001). The 189 patients with previous bouts of CH included 86.8% who consistently reported the same side of pain throughout multiple bouts (side-locked pain), with a higher prevalence of pain on the right than the left side (55.0% vs. 31.7%, p<0.001). Multivariable analyses revealed that higher age at diagnosis (odds ratio [OR]=1.045, p=0.031) and shorter CH attacks (OR=0.992, p=0.017) were associated with left-side-locked pain. However, handedness was not associated with the lateralization of leftside-locked pain.
Conclusions
This study has confirmed the predominance of right-sided pain throughout multiple CH bouts. We found that higher age at diagnosis and shorter CH attacks were associated with left-side-locked pain, suggesting that certain clinical factors are associated with the pain laterality. However, the underlying mechanisms linking these factors to lateralized pain remain unclear and therefore require further investigation.
4.Pain Lateralization in Cluster Headache and Associated Clinical Factors
Soohyun CHO ; Mi Ji LEE ; Min Kyung CHU ; Jeong Wook PARK ; Heui-Soo MOON ; Pil-Wook CHUNG ; Jong-Hee SOHN ; Byung-Su KIM ; Daeyoung KIM ; Kyungmi OH ; Byung-Kun KIM ; Soo-Jin CHO
Journal of Clinical Neurology 2025;21(3):220-229
Background:
and Purpose The pain lateralization in cluster headache (CH) may be related to the asymmetry in the functions of the brain hemispheres. The right-sided dominance of pain in CH has been found inconsistently across studies, and so we aimed to characterize this and identify the factors influencing pain lateralization during current and previous bouts.
Methods:
This study enrolled 227 patients from the Korean Cluster Headache Registry between October 2018 and December 2020. We evaluated the side of pain during current and previous bouts, demographic features, and clinical characteristics, including handedness. Multivariable logistic regression analyses were performed to identify factors associated with the side of pain.
Results:
The 227 patients with CH included 131 (57.7%) with right-sided pain and 86 (37.9%) with left-sided pain during the current bout (p<0.001). The 189 patients with previous bouts of CH included 86.8% who consistently reported the same side of pain throughout multiple bouts (side-locked pain), with a higher prevalence of pain on the right than the left side (55.0% vs. 31.7%, p<0.001). Multivariable analyses revealed that higher age at diagnosis (odds ratio [OR]=1.045, p=0.031) and shorter CH attacks (OR=0.992, p=0.017) were associated with left-side-locked pain. However, handedness was not associated with the lateralization of leftside-locked pain.
Conclusions
This study has confirmed the predominance of right-sided pain throughout multiple CH bouts. We found that higher age at diagnosis and shorter CH attacks were associated with left-side-locked pain, suggesting that certain clinical factors are associated with the pain laterality. However, the underlying mechanisms linking these factors to lateralized pain remain unclear and therefore require further investigation.
5.Effects of Interprofessional Education (IPE) Program in Nursing and Health and Welfare Students
Pan Heui KIM ; Su Kyung KIM ; Sang Soon LEE
Health Communication 2024;19(1):61-69
Purpose:
: This study aimed to analyze the effectiveness of the interprofessional education (IPE) program for nursing and Health and Welfare students.
Methods:
: This study used a quasi-experimental method (single group, before and after). The participants were 45 students from the nursing and Health and Welfare departments. Data were collected using a self-report questionnaire. Data were then analyzed using descriptive statistics, paired t-test using SPSS/WIN Statistics version 19.0.
Results:
: After completing the IPE program, students’ readiness for interprofessional learning (t=4.76, p<.001), self-efficacy for interprofessional experimental learning (t=16.05, p<.001) and teamwork attitudes (t=5.59, p<.001) scores were significantly higher than before the program.
Conclusion
: The study results indicate that the IPE program for nursing and Health and Welfare students is effective in increasing their readiness for interprofessional learning, self-efficacy for interprofessional experimental learning and teamwork attitudes.
6.An Analysis of the Determinants of the Health-Related Quality of Life in Asian Patients With Cluster Headaches During Cluster Periods Using the Time Trade-Off Method
Soo-Kyoung KIM ; Min Kyung CHU ; Byung-Kun KIM ; Pil-Wook CHUNG ; Heui-Soo MOON ; Mi Ji LEE ; Yun-Ju CHOI ; Jeong Wook PARK ; Byung-Su KIM ; Tae-Jin SONG ; Kyungmi OH ; Jin-Young AHN ; Jong-Hee SOHN ; Kwang-Soo LEE ; Kwang-Yeol PARK ; Jae Myun CHUNG ; Chin-Sang CHUNG ; Soo-Jin CHO
Journal of Clinical Neurology 2024;20(1):86-93
Background:
and Purpose Patients with cluster headache (CH) exhibit impaired health-related quality of life (HRQoL). However, there have been few studies related to the HRQoL of patients with CH from Asian backgrounds. This study aimed to determine the impact of CH on HRQoL and to identify the factors affecting HRQoL in patients with CH during cluster periods.
Methods:
This prospective study enrolled patients with CH from 17 headache clinics in South Korea between September 2016 and February 2021. The study aimed to determine HRQoL in patients with CH using the EuroQol 5 Dimensions (EQ-5D) index and the time trade-off (TTO) method. Age- and sex-matched headache-free participants were recruited as a control group.
Results:
The study included 423 patients with CH who experienced a cluster period at the time. EQ-5D scores were lower in patients with CH (0.88±0.43, mean±standard deviation) than in the controls (0.99±0.33, p<0.001). The TTO method indicated that 58 (13.6%) patients with CH exhibited moderate-to-severe HRQoL deterioration. The HRQoL states in patients with CH were associated with current smoking patterns, headache severity, frequency, and duration, and scores on the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire 9-item scale (PHQ-9), 6-item Headache Impact Test, and 12-item Allodynia Symptom Checklist. Multivariable logistic regression analyses demonstrated that the HRQoL states in patients with CH were negatively correlated with the daily frequency of headaches, cluster period duration, and GAD-7 and PHQ-9 scores.
Conclusions
Patients with CH experienced a worse quality of life during cluster periods compared with the headache-free controls, but the degree of HRQoL deterioration varied among them. The daily frequency of headaches, cluster period duration, anxiety, and depression were factors associated with HRQoL deterioration severity in patients with CH.
7.Effects of Interprofessional Education (IPE) Program in Nursing and Health and Welfare Students
Pan Heui KIM ; Su Kyung KIM ; Sang Soon LEE
Health Communication 2024;19(1):61-69
Purpose:
: This study aimed to analyze the effectiveness of the interprofessional education (IPE) program for nursing and Health and Welfare students.
Methods:
: This study used a quasi-experimental method (single group, before and after). The participants were 45 students from the nursing and Health and Welfare departments. Data were collected using a self-report questionnaire. Data were then analyzed using descriptive statistics, paired t-test using SPSS/WIN Statistics version 19.0.
Results:
: After completing the IPE program, students’ readiness for interprofessional learning (t=4.76, p<.001), self-efficacy for interprofessional experimental learning (t=16.05, p<.001) and teamwork attitudes (t=5.59, p<.001) scores were significantly higher than before the program.
Conclusion
: The study results indicate that the IPE program for nursing and Health and Welfare students is effective in increasing their readiness for interprofessional learning, self-efficacy for interprofessional experimental learning and teamwork attitudes.
8.Effects of Interprofessional Education (IPE) Program in Nursing and Health and Welfare Students
Pan Heui KIM ; Su Kyung KIM ; Sang Soon LEE
Health Communication 2024;19(1):61-69
Purpose:
: This study aimed to analyze the effectiveness of the interprofessional education (IPE) program for nursing and Health and Welfare students.
Methods:
: This study used a quasi-experimental method (single group, before and after). The participants were 45 students from the nursing and Health and Welfare departments. Data were collected using a self-report questionnaire. Data were then analyzed using descriptive statistics, paired t-test using SPSS/WIN Statistics version 19.0.
Results:
: After completing the IPE program, students’ readiness for interprofessional learning (t=4.76, p<.001), self-efficacy for interprofessional experimental learning (t=16.05, p<.001) and teamwork attitudes (t=5.59, p<.001) scores were significantly higher than before the program.
Conclusion
: The study results indicate that the IPE program for nursing and Health and Welfare students is effective in increasing their readiness for interprofessional learning, self-efficacy for interprofessional experimental learning and teamwork attitudes.
9.Intranasal Immunization WithNanoparticles Containing an Orientia tsutsugamushi Protein Vaccine Candidate and a Polysorbitol Transporter Adjuvant E
Cheol Gyun KIM ; Won Kyong KIM ; Narae KIM ; Young Jin PYUNG ; Da-Jeong PARK ; Jeong-Cheol LEE ; Chong-Su CHO ; Hyuk CHU ; Cheol-Heui YUN
Immune Network 2023;23(6):e47-
Scrub typhus, a mite-borne infectious disease, is caused by Orientia tsutsugamushi. Despite many attempts to develop a protective strategy, an effective preventive vaccine has not been developed. The identification of appropriate Ags that cover diverse antigenic strains and provide long-lasting immunity is a fundamental challenge in the development of a scrub typhus vaccine. We investigated whether this limitation could be overcome by harnessing the nanoparticle-forming polysorbitol transporter (PST) for an O. tsutsugamushi vaccine strategy.Two target proteins, 56-kDa type-specific Ag (TSA56) and surface cell Ag A (ScaA) were used as vaccine candidates. PST formed stable nano-size complexes with TSA56 (TSA56-PST) and ScaA (ScaA-PST); neither exhibited cytotoxicity. The formation of Ag-specific IgG2a, IgG2b, and IgA in mice was enhanced by intranasal vaccination with TSA56-PST or ScaA-PST. The vaccines containing PST induced Ag-specific proliferation of CD8 + and CD4 +T cells. Furthermore, the vaccines containing PST improved the mouse survival against O.tsutsugamushi infection. Collectively, the present study indicated that PST could enhance both Ag-specific humoral immunity and T cell response, which are essential to effectively confer protective immunity against O. tsutsugamushi infection. These findings suggest that PST has potential for use in an intranasal vaccination strategy.
10.Enhancement of Immune Responses Elicited by Nanovaccines through a Cross-Presentation Pathway
Cheol-Gyun KIM ; Jeong-Cheol LEE ; Do-Bin JU ; Seo-Kyung KIM ; Cheol-Heui YUN ; Chong-Su CHO
Tissue Engineering and Regenerative Medicine 2023;20(3):355-370
Numerous studies have aimed to develop novel advanced vaccines, in part because traditional vaccines have been unsuccessful in preventing rapidly emerging and reemerging viral and bacterial infections. There is a need for an advanced vaccine delivery system to ensure the successful induction of humoral and cellular immune responses. In particular, the ability of nanovaccines to modulate intracellular antigen delivery by inducing exogenous antigens (loaded onto major histocompatibility complex class 1 molecules) in CD8+ T cells, the so-called cross-presentation pathway, has attracted a great deal of attention. Protection against viral and intracellular bacterial infections relies on cross-presentation.This review discusses the advantages, requirements, and preparation of nanovaccines, the cross-presentation mechanism, the several parameters affecting cross-presentation by nanovaccines, and future perspectives.

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