1.Divergent Propagation Networks Define Two Pathophysiologically Distinct Electroclinical Phenotypes in Mesial Temporal Lobe Epilepsy
Heewon BAE ; Dae Won SEO ; Seung Bong HONG ; Hea Ree PARK ; Young-Min SHON
Journal of Clinical Neurology 2026;22(2):203-211
Background:
and Purpose Temporal dissociation between electrographic and clinical seizure onset in mesial temporal lobe epilepsy (MTLE) implies network heterogeneity. We hypothesized that MTLE consists of distinct electroclinical phenotypes defined by divergent seizure propagation dynamics.
Methods:
We retrospectively analyzed 167 seizures from 13 patients with drug-resistant MTLE who achieved Engel Class I surgical outcomes. Based on the predominant relationship between scalp electroencephalography (EEG) and clinical onset, patients were classified as EEG-first (n=7) or Clinical-first (n=6). Seizure onset patterns, propagation pathways, and temporal dynamics were assessed using scalp and stereoelectroencephalography (SEEG).
Results:
The cohort included 83 scalp and 84 SEEG seizures. By definition, onset order differed: in EEG-first seizures, scalp changes preceded clinical signs in 70.5%, whereas the reverse occurred in 65.8% of Clinical-first seizures (p<0.001). EEG-first seizures demonstrated longer SEEG-to-clinical latency (28.8±7.7 s vs. 13.0±7.7 s; p=0.004) and rhythmic theta onset on scalp EEG with focal SEEG low-voltage fast activity or preictal spikes. In contrast, Clinical-first seizures showed heterogeneous scalp patterns (theta, delta–theta, or delta slowing). Propagation tended to differ, with anterior pathways more common in EEG-first (69.6%) and posterior pathways in Clinical-first (26.3%), though with partial overlap (p=0.138).
Conclusions
MTLE comprises two pathophysiologically distinct phenotypes: EEG-first, reflecting a slowly propagating anterior mesial network, and Clinical-first, involving a rapidly spreading posterior network. This classification offers a mechanistic framework for understanding electroclinical dissociation and may refine presurgical evaluation.
2.The Association of Smoking Status with Diabetic Microvascular Complications in Korean Patients with Type 2 Diabetes
Yongin CHO ; Hye-Sun PARK ; Da Hea SEO ; Seong Hee AHN ; Seongbin HONG ; Young Ju SUH ; Suk CHON ; Jeong-Taek WOO ; Sei Hyun BAIK ; Kwan Woo LEE ; So Hun KIM
Yonsei Medical Journal 2024;65(8):427-433
Purpose:
Few studies have investigated the association between smoking and microvascular complications in the Asian population with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between smoking status and microvascular complications in Korean patients with T2DM.
Materials and Methods:
From the Korean National Diabetes Program cohort, we included 2316 Korean male with T2DM who had baseline clinical information available, including their smoking status, and underwent diabetic complication studies.
Results:
Compared to non-smokers, current smokers had higher odds of any-microvascular complications [adjusted odds ratio (aOR) 1.45, 95% confidence interval (CI) 1.07–1.97, p=0.016]. The odds of neuropathy were significantly higher; however, the odds of retinopathy were significantly lower in current smokers than in nonsmokers (all p<0.05). Among those who underwent repeated complication tests after 3 years, the risk of newly developed retinopathy was significantly increased in ex-smokers [aOR 3.77 (95% CI 1.61–8.87), p=0.002]. Within ex-smokers, long smoking duration and smoking cessation within the recent 5 years were associated with an increased risk of newly developed retinopathy (all p<0.05).
Conclusion
Male smokers had higher odds of having overall diabetic microvascular complications, including neuropathy. However, the odds of having retinopathy were significantly lower among current smokers. More attention and research are needed regarding the increased risk of retinopathy development in ex-smokers who have recently stopped smoking after a long history of smoking.
3.Cancer Patients' and Caregivers' Experiences Admitted to Comprehensive Nursing Care Service Wards: An Exploratory Qualitative Research
Sarah LIM ; Mee Young CHO ; Hyun Joo SHIN ; Ki Yeon SONG ; Soo Kyoung SHIM ; Yoon Jung LEE ; Hea Jin KWON ; Ji Eun KIM ; Hui Ean KIM ; Hyun Ja PARK ; Han Wool AN ; So Jeong HYEON ; Sue KIM
Asian Oncology Nursing 2024;24(4):173-183
Purpose:
The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards.
Methods:
Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt.
Results:
Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: ‘Wishing for precise operating systems based on patient severity,’ ‘Anticipating active caregiver participation in treatment process,’ ‘Requiring a countermeasure for safety accidents,’ 2) Professional nursing service which provides relief: ‘Patient-centered professional nursing service,’ ‘Inpatient service that provides relief for patients and caregivers,’ 3) Anticipating continuous use of the service: ‘Inpatient service which users are willing to reuse,’ ‘Wishing for expansion and reinforcement of the service.’
Conclusion
Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers.
4.Differentiation between Hypovolemic Shock and Septic Shock in Patients with Unstable Vital Signs after Cesarean Section: A Case Report
Jae Young JI ; Da Hyung KIM ; Yong Han SEO ; Ho Soon JUNG ; Hea Rim CHUN ; Hyung Youn GONG ; Jin Soo PARK ; Ye Eun SHIN
Soonchunhyang Medical Science 2024;30(2):56-59
Hypovolemic shock and septic shock present similar symptoms, such as increased heart rate and decreased blood pressure. However, the two conditions have different causes, mechanisms, and treatment approaches. Early differentiation between the two conditions can have a positive impact on patient prognosis. In this case, the patient underwent a right ovarian cystectomy due to a teratoma torsion during a previous pregnancy, followed by treatment for a postoperative infection. While recovering, the patient underwent an emergency cesarean section due to sudden severe abdominal pain. After the surgery, unstable vital signs were suggestive of hypovolemia due to massive bleeding from the cesarean section. Therefore, fluid infusion and blood transfusion were initiated. The vital signs did not improve. So, the patient was reassessed. Body temperature and the previously elevated C-reactive protein levels were remeasured. The results of the reassessment indicated a septic condition due to previous infection. The patient was prescribed additional vasopressors and antibiotics for the following week. Subsequently, the patient’s vital signs stabilized, and the treatment was discontinued.
5.Differentiation between Hypovolemic Shock and Septic Shock in Patients with Unstable Vital Signs after Cesarean Section: A Case Report
Jae Young JI ; Da Hyung KIM ; Yong Han SEO ; Ho Soon JUNG ; Hea Rim CHUN ; Hyung Youn GONG ; Jin Soo PARK ; Ye Eun SHIN
Soonchunhyang Medical Science 2024;30(2):56-59
Hypovolemic shock and septic shock present similar symptoms, such as increased heart rate and decreased blood pressure. However, the two conditions have different causes, mechanisms, and treatment approaches. Early differentiation between the two conditions can have a positive impact on patient prognosis. In this case, the patient underwent a right ovarian cystectomy due to a teratoma torsion during a previous pregnancy, followed by treatment for a postoperative infection. While recovering, the patient underwent an emergency cesarean section due to sudden severe abdominal pain. After the surgery, unstable vital signs were suggestive of hypovolemia due to massive bleeding from the cesarean section. Therefore, fluid infusion and blood transfusion were initiated. The vital signs did not improve. So, the patient was reassessed. Body temperature and the previously elevated C-reactive protein levels were remeasured. The results of the reassessment indicated a septic condition due to previous infection. The patient was prescribed additional vasopressors and antibiotics for the following week. Subsequently, the patient’s vital signs stabilized, and the treatment was discontinued.
6.Cancer Patients' and Caregivers' Experiences Admitted to Comprehensive Nursing Care Service Wards: An Exploratory Qualitative Research
Sarah LIM ; Mee Young CHO ; Hyun Joo SHIN ; Ki Yeon SONG ; Soo Kyoung SHIM ; Yoon Jung LEE ; Hea Jin KWON ; Ji Eun KIM ; Hui Ean KIM ; Hyun Ja PARK ; Han Wool AN ; So Jeong HYEON ; Sue KIM
Asian Oncology Nursing 2024;24(4):173-183
Purpose:
The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards.
Methods:
Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt.
Results:
Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: ‘Wishing for precise operating systems based on patient severity,’ ‘Anticipating active caregiver participation in treatment process,’ ‘Requiring a countermeasure for safety accidents,’ 2) Professional nursing service which provides relief: ‘Patient-centered professional nursing service,’ ‘Inpatient service that provides relief for patients and caregivers,’ 3) Anticipating continuous use of the service: ‘Inpatient service which users are willing to reuse,’ ‘Wishing for expansion and reinforcement of the service.’
Conclusion
Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers.
7.Cancer Patients' and Caregivers' Experiences Admitted to Comprehensive Nursing Care Service Wards: An Exploratory Qualitative Research
Sarah LIM ; Mee Young CHO ; Hyun Joo SHIN ; Ki Yeon SONG ; Soo Kyoung SHIM ; Yoon Jung LEE ; Hea Jin KWON ; Ji Eun KIM ; Hui Ean KIM ; Hyun Ja PARK ; Han Wool AN ; So Jeong HYEON ; Sue KIM
Asian Oncology Nursing 2024;24(4):173-183
Purpose:
The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards.
Methods:
Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt.
Results:
Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: ‘Wishing for precise operating systems based on patient severity,’ ‘Anticipating active caregiver participation in treatment process,’ ‘Requiring a countermeasure for safety accidents,’ 2) Professional nursing service which provides relief: ‘Patient-centered professional nursing service,’ ‘Inpatient service that provides relief for patients and caregivers,’ 3) Anticipating continuous use of the service: ‘Inpatient service which users are willing to reuse,’ ‘Wishing for expansion and reinforcement of the service.’
Conclusion
Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers.
8.Differentiation between Hypovolemic Shock and Septic Shock in Patients with Unstable Vital Signs after Cesarean Section: A Case Report
Jae Young JI ; Da Hyung KIM ; Yong Han SEO ; Ho Soon JUNG ; Hea Rim CHUN ; Hyung Youn GONG ; Jin Soo PARK ; Ye Eun SHIN
Soonchunhyang Medical Science 2024;30(2):56-59
Hypovolemic shock and septic shock present similar symptoms, such as increased heart rate and decreased blood pressure. However, the two conditions have different causes, mechanisms, and treatment approaches. Early differentiation between the two conditions can have a positive impact on patient prognosis. In this case, the patient underwent a right ovarian cystectomy due to a teratoma torsion during a previous pregnancy, followed by treatment for a postoperative infection. While recovering, the patient underwent an emergency cesarean section due to sudden severe abdominal pain. After the surgery, unstable vital signs were suggestive of hypovolemia due to massive bleeding from the cesarean section. Therefore, fluid infusion and blood transfusion were initiated. The vital signs did not improve. So, the patient was reassessed. Body temperature and the previously elevated C-reactive protein levels were remeasured. The results of the reassessment indicated a septic condition due to previous infection. The patient was prescribed additional vasopressors and antibiotics for the following week. Subsequently, the patient’s vital signs stabilized, and the treatment was discontinued.
9.Differentiation between Hypovolemic Shock and Septic Shock in Patients with Unstable Vital Signs after Cesarean Section: A Case Report
Jae Young JI ; Da Hyung KIM ; Yong Han SEO ; Ho Soon JUNG ; Hea Rim CHUN ; Hyung Youn GONG ; Jin Soo PARK ; Ye Eun SHIN
Soonchunhyang Medical Science 2024;30(2):56-59
Hypovolemic shock and septic shock present similar symptoms, such as increased heart rate and decreased blood pressure. However, the two conditions have different causes, mechanisms, and treatment approaches. Early differentiation between the two conditions can have a positive impact on patient prognosis. In this case, the patient underwent a right ovarian cystectomy due to a teratoma torsion during a previous pregnancy, followed by treatment for a postoperative infection. While recovering, the patient underwent an emergency cesarean section due to sudden severe abdominal pain. After the surgery, unstable vital signs were suggestive of hypovolemia due to massive bleeding from the cesarean section. Therefore, fluid infusion and blood transfusion were initiated. The vital signs did not improve. So, the patient was reassessed. Body temperature and the previously elevated C-reactive protein levels were remeasured. The results of the reassessment indicated a septic condition due to previous infection. The patient was prescribed additional vasopressors and antibiotics for the following week. Subsequently, the patient’s vital signs stabilized, and the treatment was discontinued.
10.Differentiation between Hypovolemic Shock and Septic Shock in Patients with Unstable Vital Signs after Cesarean Section: A Case Report
Jae Young JI ; Da Hyung KIM ; Yong Han SEO ; Ho Soon JUNG ; Hea Rim CHUN ; Hyung Youn GONG ; Jin Soo PARK ; Ye Eun SHIN
Soonchunhyang Medical Science 2024;30(2):56-59
Hypovolemic shock and septic shock present similar symptoms, such as increased heart rate and decreased blood pressure. However, the two conditions have different causes, mechanisms, and treatment approaches. Early differentiation between the two conditions can have a positive impact on patient prognosis. In this case, the patient underwent a right ovarian cystectomy due to a teratoma torsion during a previous pregnancy, followed by treatment for a postoperative infection. While recovering, the patient underwent an emergency cesarean section due to sudden severe abdominal pain. After the surgery, unstable vital signs were suggestive of hypovolemia due to massive bleeding from the cesarean section. Therefore, fluid infusion and blood transfusion were initiated. The vital signs did not improve. So, the patient was reassessed. Body temperature and the previously elevated C-reactive protein levels were remeasured. The results of the reassessment indicated a septic condition due to previous infection. The patient was prescribed additional vasopressors and antibiotics for the following week. Subsequently, the patient’s vital signs stabilized, and the treatment was discontinued.

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