1.Latest Insights into Long COVID Diagnosis and Treatment
Jun-Won SEO ; Seong Eun KIM ; Yoonjung KIM ; Eun Jung KIM ; Tark KIM ; Tae Hwa KIM ; So Hee LEE ; Eunjung LEE ; Jacob LEE ; Yu Bin SEO ; Young-Hoon JEONG ; Young Hee JUNG ; Yu Jung CHOI ; Joon Young SONG
Korean Journal of Medicine 2025;100(2):45-53
Long coronavirus disease (COVID) is a condition in which coronavirus disease 2019 (COVID-19) symptoms persist for over 3 months, and currently poses a global public health challenge. Due to varying manifestations and lack of standardized definitions, diagnostic methods, and treatments, comprehensive clinical guidelines are required. This review article, summarizing research and expert consensus up to June 2023, provides recommendations for diagnosis and long-term management of long COVID symptoms. It emphasizes thorough patient evaluation, including medical history, physical examinations, and tests, and advocates vaccination and antiviral treatments to reduce risk. Guidelines for long COVID will be updated as new knowledge emerges.
2.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2025;100(1):44-
3.Therapeutic Effects of Intravitreal Methotrexate Injection for Intraocular Lymphoma Diagnosed Using Immunocytochemical Staining
Yong Jin NA ; Kun Young KWON ; Kook Young KIM ; Young Suk CHANG ; Jung Tae KIM
Journal of the Korean Ophthalmological Society 2025;66(2):101-113
Purpose:
This study evaluated the therapeutic efficacy of intravitreal methotrexate (MTX) injections in patients diagnosed with intraocular lymphoma via vitrectomy and immunocytochemical staining.
Methods:
In a retrospective analysis of medical records, we reviewed data from four patients (six eyes) diagnosed with intraocular lymphoma cytologically after undergoing vitrectomy at our hospital between December 2021 and December 2023. Each case was followed for a minimum of 6 months after treatment, with comparisons made between pre- and post-treatment observations
Results:
The mean age of the patients was 63.5 ± 9.8 years, with an average interval of 29.3 ± 32.0 months from initial symptom onset to intraocular lymphoma diagnosis. Diagnosis was confirmed through cytological and immunocytochemical analysis of vitreous specimens, identifying diffuse large B-cell lymphoma in four eyes and atypical lymphoid cells in two eyes. On average, 14.0 ± 1.7 intravitreal MTX injections were administered per eye. The mean best-corrected visual acuity improved from 1.18 ± 0.90 pre-treatment to 0.37 ± 0.70 post-treatment. Ophthalmic complications included toxic keratopathy in three eyes and retinal hemorrhage in one eye. Additionally, nasal cavity lymphoma was diagnosed in two patients.
Conclusions
Diagnostic vitrectomy combined with cytology and immunocytochemical staining is essential for the early diagnosis of intraocular lymphoma and differentiation from inflammatory diseases, such as uveitis. Intravitreal MTX injections can induce clinical remission in intraocular lymphoma cases.
4.Genetic Characteristics of 63 Patients with Non-syndromic Retinitis Pigmentosa at a Single Korean Institution
Sa Ra KIM ; Jae Hui KIM ; Won Tae YOON ; Young Ju LEW
Journal of the Korean Ophthalmological Society 2025;66(1):36-44
Purpose:
To investigate the genetic characteristics of patients with non-syndromic retinitis pigmentosa (RP) analyzed at a single institution.
Methods:
We conducted a retrospective analysis of 63 patients clinically diagnosed with non-syndromic RP who underwent genetic testing. The clinical features of patients exhibiting the most common mutations, EYS and USH2A, were further assessed through routine ophthalmic examinations.
Results:
Of the 63 patients, 22 (34.9%) exhibited significant mutations. Notably, EYS and USH2A mutations were each found in 5 patients (7.9%); RP1 mutations were found in 4 patients (6.3%). The average ages at diagnosis were 38.8 years for EYS mutations and 41.8 years for USH2A mutations. The average best-corrected visual acuities were logMAR 0.08 for EYS mutations and logMAR 0.51 for USH2A mutations. Both mutation types showed a decrease in the normal macular area in fundus photographs with increasing age. In USH2A mutations, optical coherence tomography revealed a more pronounced reduction in central macular thickness and central foveal ellipsoid length compared with EYS mutations. Visual field tests indicated a reduction within the central 10° in 40% of EYS mutations and 60% of USH2A mutations. Electroretinography showed non-detectable responses in 2 individuals with EYS mutations and 4 individuals with USH2A mutations (40% and 80%, respectively).
Conclusions
EYS and USH2A mutations represented 45% of the genetically identified cases; affected patients typically were diagnosed in their 40s. EYS mutations tended to preserve retinal function and central foveal structure better than USH2A mutations.
6.Effect of regional COVID-19 outbreak to emergency department response on acute myocardial infarction: a multicenter retrospective study
Young Wook KIM ; Sungbae MOON ; Hyun Wook RYOO ; Jae Yun AHN ; Jung Bae PARK ; Dong Eun LEE ; Sang Hun LEE ; Sangchan JIN ; You Ho MUN ; Jung Ho KIM ; Tae Chang JANG
Journal of the Korean Society of Emergency Medicine 2025;36(2):72-82
Objective:
The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments.
Methods:
A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison.
Results:
The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups.
Conclusion
The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.
7.Comparison of complications in patients with NSTEMI according to the timing of invasive intervention: early versus delayed
Chang Wan SEO ; Ha Young PARK ; Han Byeol KIM ; Jai Woog KO ; Jun Bae LEE ; Yoon Jung HWANG ; Tae Sik HWANG
Journal of the Korean Society of Emergency Medicine 2025;36(2):54-62
Objective:
Acute coronary syndrome often requires urgent intervention. The 2023 European Society of Cardiology guidelines recommend invasive procedures within 24 hours for high-risk cases. Nevertheless, there have been limited studies on non-ST-segment elevation myocardial infarction (NSTEMI) in South Korea. This study compared the risk of complications based on the timing of intervention.
Methods:
A retrospective observational study was conducted on patients with chest pain and elevated high-sensitivity troponin T from January to December 2021 in the emergency department. Patients were categorized into early (≤24 hr) and late (>24 hr) intervention groups. Primary outcomes (death, restenosis, or stroke) at 12 months were compared. Survival and subgroup analyses were performed to examine the factors affecting the outcomes in the two groups.
Results:
Three hundred seventy six patients were enrolled in the study, and 115 patients were excluded. Among 261 patients, 106 and 155 patients were in the early intervention group (≤24 hr), and late intervention group (>24 hr), respectively. The primary outcome (death or restenosis) showed no significant difference (hazard ratio [HR] in the early intervention group at 12 mo; 1.03; 95% confidence interval [CI], 0.63-1.70; P=0.905). However, risk of stroke was lower in the early intervention group (HR in the early, 0.08; 95% CI, 0.00-0.66; P=0.013). Subgroup analysis showed no significant advantage for early intervention.
Conclusion
In NSTEMI patients, early intervention does not reduce death or restenosis but lowers stroke incidence. No specific risk factors favored early intervention.
8.Incidence of complicated appendicitis before and after the COVID-19 pandemic: a comparative analysis
Haksoo KIM ; Dongkil JEONG ; Young Soon CHO ; Geum Jong SONG ; Hyung Jun MOON ; Tae Yong SHIN ; Dong Wook LEE ; Hyun Joon KIM ; Hyun Jung LEE ; Sun In HONG
Journal of the Korean Society of Emergency Medicine 2025;36(1):12-19
Objective:
It has been 1 year since the start of the worldwide coronavirus disease-19 (COVID-19) pandemic. This study analyzed the indirect effects of COVID-19 on treating patients with non-infectious diseases by comparing the incidence of complicated appendicitis before and after the pandemic.
Methods:
The target group included patients aged at least 16 years diagnosed with acute appendicitis between February 23 and July 31, 2020. Patients diagnosed during the same period in 2019 were selected as the control group. The differences in the incidence of complicated appendicitis before and after COVID-19 were investigated, and the association with various variables was analyzed using the odds ratios and 95% confidence intervals (CIs).
Results:
The study included 120 subjects in 2019 (pre-COVID group) and 119 cases in 2020 (post-COVID group). The pre-COVID group included 25 cases (20.8%) of complicated appendicitis, while the post-COVID group included 48 cases (40.3%). The median time from symptom onset to visit (pre-hospital time) increased from 15 to 22 hours, and the median time from the visit to surgery (in-hospital time) increased from 7 to 11 hours. Multivariate regression analysis of the three variables revealed odds ratios (95% CIs) of pre-hospital time, erythrocyte sedimentation rate, and inclusion in the post-COVID group of 1.02 (1.01-1.02), 2.07 (1.11-3.86), and 2.15 (1.12-4.11), respectively.
Conclusion
The incidence of complicated appendicitis increased after the COVID-19 pandemic. Therefore, a healthcare system that can minimize the delay in treating non-infectious emergency patients is needed.
9.Isolated Perihepatic Peritoneal Leiomyoma: A Case Report
Journal of the Korean Society of Radiology 2025;86(1):148-153
Peritoneal leiomyomas are extremely rare. Most reported cases are that of disseminated peritoneal leiomyomatosis, making isolated leiomyoma an uncommon occurrence. Given that isolated leiomyoma is rare, the preoperative diagnosis of isolated leiomyoma is challenging. To date, very few reports have described the radiological findings of isolated peritoneal leiomyoma. This study aimed to present a rare case of isolated peritoneal leiomyoma in the perihepatic region of a 54-year-old female, and present the US, CT, and MRI based radiological findings of the case.
10.Splenic Duplication, a Rare Cause of Gastric Varices:A Case Report
Journal of the Korean Society of Radiology 2025;86(2):298-303
Splenic duplication, also known as polysplenia syndrome, is a condition occasionally observed in which the spleen is divided into segments of similar size. However, gastric fundic varices arising from a duplicated spleen are exceedingly rare, and this medical anomaly has been infrequently reported in the literature. This case report presents a 40-year-old male with a rare instance of gastric fundic varices secondary to splenic duplication. Comprehensive imaging studies, including endoscopy, CT, Doppler US, and radioisotope splenic scans, were performed to confirm the diagnosis. This case contributes to valuable information in the medical literature, shedding light on a seldom-discussed condition.

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