1.Research on the Correlation between Balance Function and Core Muscles in Patients With Adolescent Idiopathic Scoliosis
Si-Jia LI ; Qing YUE ; Qian-Jin LIU ; Yan-Hua LIANG ; Tian-Tian ZHOU ; Xiao-Song LI ; Tian-Yang FENG ; Tong ZHANG
Neurospine 2025;22(1):264-275
		                        		
		                        			 Objective:
		                        			This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. 
		                        		
		                        			Methods:
		                        			A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. 
		                        		
		                        			Results:
		                        			AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). 
		                        		
		                        			Conclusion
		                        			These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population. 
		                        		
		                        		
		                        		
		                        	
2.Dietary isoflavone intake among breast cancer survivors and cancer-free women
Sihan SONG ; Hyeong-Gon MOON ; Dong-Young NOH ; So-Youn JUNG ; Eun Sook LEE ; Zisun KIM ; Hyun Jo YOUN ; Jihyoung CHO ; Young Bum YOO ; Se Kyung LEE ; Jeong Eon LEE ; Seok Jin NAM ; Yoo Seok KIM ; Jun Won MIN ; Shinyoung JUN ; Hyojee JOUNG ; Jung Eun LEE
Nutrition Research and Practice 2025;19(1):80-95
		                        		
		                        			 BACKGROUND/OBJECTIVES:
		                        			Isoflavones are estrogen-like compounds found in plants and their health effects remain equivocal. We investigated dietary isoflavone intake and its associated factors in Korean breast cancer survivors, with a comparison to cancer-free women. 
		                        		
		                        			SUBJECTS/METHODS:
		                        			The usual dietary intake of breast cancer survivors (n = 981, mean age 52 yrs) in 9 hospitals between 2012 and 2019 was assessed using 3-day food records or food frequency questionnaires (FFQs). They were age-matched to 2,943 cancer-free women who completed FFQs as part of a nationwide study conducted between 2012 and 2016. We used the flavonoid database of common Korean foods and the Phenol-Explorer database to estimate isoflavone intake. The contribution of each food or food group to the total isoflavone intake was calculated. The adjusted least-squares means of dietary isoflavone intake according to lifestyle and clinical factors were calculated using generalized linear models. 
		                        		
		                        			RESULTS:
		                        			Breast cancer survivors had a higher mean dietary isoflavone intake (23.59 mg/day) than cancer-free women (17.81 mg/day). Major food sources, including tofu, soybeans, and doenjang, contributed to over 70% of the isoflavone intake in both groups. When we estimated dietary isoflavone intake according to lifestyle characteristics, isoflavone intake increased with higher scores of adherence to the American Cancer Society dietary guidelines but decreased with increasing body mass index in both groups. Among cancer-free women, dietary isoflavone intake was higher among those who had never smoked and among dietary supplement users. Among breast cancer survivors, dietary isoflavone intakes did not vary with clinical characteristics, including time since surgery and estrogen receptor status. 
		                        		
		                        			CONCLUSION
		                        			Breast cancer survivors were more likely to consume isoflavones than agematched cancer-free women. Dietary isoflavone intake was associated with healthy lifestyle characteristics in women both with and without breast cancer. Further research is needed to understand the role of the higher isoflavone intake among breast cancer survivors compared to cancer-free women on their prognosis. 
		                        		
		                        		
		                        		
		                        	
3.Research on the Correlation between Balance Function and Core Muscles in Patients With Adolescent Idiopathic Scoliosis
Si-Jia LI ; Qing YUE ; Qian-Jin LIU ; Yan-Hua LIANG ; Tian-Tian ZHOU ; Xiao-Song LI ; Tian-Yang FENG ; Tong ZHANG
Neurospine 2025;22(1):264-275
		                        		
		                        			 Objective:
		                        			This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. 
		                        		
		                        			Methods:
		                        			A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. 
		                        		
		                        			Results:
		                        			AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). 
		                        		
		                        			Conclusion
		                        			These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population. 
		                        		
		                        		
		                        		
		                        	
4.Dietary isoflavone intake among breast cancer survivors and cancer-free women
Sihan SONG ; Hyeong-Gon MOON ; Dong-Young NOH ; So-Youn JUNG ; Eun Sook LEE ; Zisun KIM ; Hyun Jo YOUN ; Jihyoung CHO ; Young Bum YOO ; Se Kyung LEE ; Jeong Eon LEE ; Seok Jin NAM ; Yoo Seok KIM ; Jun Won MIN ; Shinyoung JUN ; Hyojee JOUNG ; Jung Eun LEE
Nutrition Research and Practice 2025;19(1):80-95
		                        		
		                        			 BACKGROUND/OBJECTIVES:
		                        			Isoflavones are estrogen-like compounds found in plants and their health effects remain equivocal. We investigated dietary isoflavone intake and its associated factors in Korean breast cancer survivors, with a comparison to cancer-free women. 
		                        		
		                        			SUBJECTS/METHODS:
		                        			The usual dietary intake of breast cancer survivors (n = 981, mean age 52 yrs) in 9 hospitals between 2012 and 2019 was assessed using 3-day food records or food frequency questionnaires (FFQs). They were age-matched to 2,943 cancer-free women who completed FFQs as part of a nationwide study conducted between 2012 and 2016. We used the flavonoid database of common Korean foods and the Phenol-Explorer database to estimate isoflavone intake. The contribution of each food or food group to the total isoflavone intake was calculated. The adjusted least-squares means of dietary isoflavone intake according to lifestyle and clinical factors were calculated using generalized linear models. 
		                        		
		                        			RESULTS:
		                        			Breast cancer survivors had a higher mean dietary isoflavone intake (23.59 mg/day) than cancer-free women (17.81 mg/day). Major food sources, including tofu, soybeans, and doenjang, contributed to over 70% of the isoflavone intake in both groups. When we estimated dietary isoflavone intake according to lifestyle characteristics, isoflavone intake increased with higher scores of adherence to the American Cancer Society dietary guidelines but decreased with increasing body mass index in both groups. Among cancer-free women, dietary isoflavone intake was higher among those who had never smoked and among dietary supplement users. Among breast cancer survivors, dietary isoflavone intakes did not vary with clinical characteristics, including time since surgery and estrogen receptor status. 
		                        		
		                        			CONCLUSION
		                        			Breast cancer survivors were more likely to consume isoflavones than agematched cancer-free women. Dietary isoflavone intake was associated with healthy lifestyle characteristics in women both with and without breast cancer. Further research is needed to understand the role of the higher isoflavone intake among breast cancer survivors compared to cancer-free women on their prognosis. 
		                        		
		                        		
		                        		
		                        	
5.Sentinel Safety Monitoring System for Adverse Events of Special Interest Associated With Non-NIP Vaccines in Korea
Hakjun HYUN ; Jung Yeon HEO ; Yu Jung CHOI ; Eliel NHAM ; Jin Gu YOON ; Ji Yun NOH ; Joon Young SONG ; Woo Joo KIM ; Won Suk CHOI ; Min Joo CHOI ; Yu Bin SEO ; Jacob LEE ; Hee Jin CHEONG
Journal of Korean Medical Science 2025;40(16):e152-
		                        		
		                        			
		                        			 South Korea’s current vaccination policies leave a surveillance gap for non-National Immunization Program (NIP) vaccines. In this study, we proposed a sentinel surveillance approach for monitoring the safety of non-NIP vaccines. Vaccination data were collected retrospectively among patients hospitalized with pre-defined adverse events of special interest (AESI) by reviewing electronic medical records in five university hospitals. This approach incorporates expert assessment to determine the causal relationship. We confirmed that 16 patients had received non-NIP vaccines among 860 patients diagnosed with AESI.We concluded one case of preeclampsia was possibly related to tetanus-diphtheria-pertussis vaccination. We propose a multi-hospital-based, retrospective assessment system for predefined AESIs as an alternative to active vaccine safety monitoring method. These efforts are expected to enhance both the accuracy and timeliness of safety monitoring in South Korea. 
		                        		
		                        		
		                        		
		                        	
6.Clinical Exome-Based Redefinition and Reclassification of Retinitis Pigmentosa
Hyo Song PARK ; Kyung KIM ; Dongwook LEE ; Jong-Young LEE ; Jeong Nam CHOI ; Jin Ha KIM ; Jung Woo HAN ; Tae Kwann PARK
Journal of Korean Medical Science 2025;40(16):e54-
		                        		
		                        			 Background:
		                        			Because of the low prevalence of inherited retinal diseases, reports on the distribution of retinitis pigmentosa (RP)-related genes in Korean patients are scarce. The aim of this study was to determine the mutation spectrum and allele frequency and observe the final diagnoses in a Korean cohort clinically diagnosed with RP. 
		                        		
		                        			Methods:
		                        			We used whole-exome sequencing (WES) to analyze a Korean cohort of 100 unrelated patients clinically diagnosed with RP. The possible pathogenicity of each variant was assessed based on the guidelines of the American College of Medical Genetics and Genomics and Association for Molecular Pathology, in-silico prediction tools, known clinical phenotypes, and inheritance patterns. 
		                        		
		                        			Results:
		                        			Definite causative genes were detected in 60/100 patients (60.0%). Of these 60 cases, USH2A was the most common causative gene (14/60, 23.3%), followed by EYS (13/60, 21.7%) and RP1 (6/60, 10.0%). The clinical diagnosis was redefined in 9 of the 60 probands (15.0%) with causative genes after WES. Five of the 60 patients (8.3%) carried a causative variant in CHM, and the clinical diagnosis was redefined as choroideremia. Leber congenital amaurosis was diagnosed in 2/60 probands (3.3%), and RDH12 and RPGRIP1 were the causative genes in each patient. One patient (1/60, 1.7%) was diagnosed with Bietti’s crystalline dystrophy, with CYP4V2 identified as the causative gene. In another patient (1/60, 1.7%), ABCA4 variants were detected with clinical findings suggestive of cone-rod dystrophy. 
		                        		
		                        			Conclusion
		                        			This study reports the mutational spectrum of a cohort of Korean patients with a clinical diagnosis of RP who were referred for genetic testing. This study adds valuable data regarding the frequency of genes as well as their relation to the age of symptom onset and relation to other inherited retinal degenerations. 
		                        		
		                        		
		                        		
		                        	
7.A Nationwide Survey on Infection Prevention and Control in Acute Care Hospitals of Korea
Sun Hee NA ; Yubin SEO ; Hye Jin SHI ; In Sun HWANG ; Kyong A SHIN ; Kwang Yul SON ; Sung Ran KIM ; Myoungjin SHIN ; Hee-jung SON ; Ji Youn CHOI ; Heekyung CHUN ; Sook-Kyung PARK ; Jeongsuk SONG ; Namyi KIM ; Jacob LEE ; Joong Sik EOM
Journal of Korean Medical Science 2025;40(4):e41-
		                        		
		                        			 Background:
		                        			Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. 
		                        		
		                        			Methods:
		                        			From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. 
		                        		
		                        			Results:
		                        			Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. 
		                        		
		                        			Conclusion
		                        			This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities. 
		                        		
		                        		
		                        		
		                        	
8.Consensus Statements on Tinnitus Assessment and Treatment Outcome Evaluation: A Delphi Study by the Korean Tinnitus Study Group
Oak-Sung CHOO ; Jung Mee PARK ; Euyhyun PARK ; Jiwon CHANG ; Min Young LEE ; Ho Yun LEE ; In Seok MOON ; Jae-Jun SONG ; Kyu-Yup LEE ; Jae-Jin SONG ; Eui-Cheol NAM ; Shi Nae PARK ; Hyun Joon SHIM ; Yoon Chan RAH ; Jae-Hyun SEO
Journal of Korean Medical Science 2025;40(7):e93-
		                        		
		                        			 Background:
		                        			Tinnitus is a multifactorial condition with no universally accepted assessment guidelines. The Korean Tinnitus Study Group previously established consensus statements on the definition, classification, and diagnostic tests for tinnitus. As a continuation of this effort, this study aims to establish expert consensus on tinnitus assessment and treatment outcome evaluation, specifically tailored to the Korean clinical context. 
		                        		
		                        			Methods:
		                        			A modified Delphi method involving 26 otology experts from across Korea was used. A two-round Delphi survey was conducted to evaluate statements related to tinnitus assessment before and after treatment. Statements were rated on a scale of 1 to 9 for the level of agreement. Consensus was defined as ≥ 70% agreement (score of 7–9) and ≤ 15% disagreement (score of 1–3). Statistical measures such as content validity ratio and Kendall’s coefficient of concordance (W) were calculated to assess agreement levels. 
		                        		
		                        			Results:
		                        			Of the 46 assessment-related statements, 17 (37%) reached consensus, though overall pre-treatment assessments showed weak agreement (Kendall’s W = 0.319). Key areas of agreement included the use of the visual analogue scale, numeric rating scale, and validated questionnaires for pre-treatment evaluation. Five statements, such as the use of computed tomography, magnetic resonance imaging, and angiography for diagnosing pulsatile tinnitus, achieved over 90% agreement. For treatment outcome measurements, 8 of 12 statements (67%) reached a consensus, with moderate agreement (Kendall’s W = 0.513). Validated questionnaires and psychoacoustic tests were recommended for evaluating treatment effects within 12 weeks. While standardized imaging for pulsatile tinnitus and additional clinical tests were strongly recommended, full consensus was not achieved across all imaging modalities. 
		                        		
		                        			Conclusion
		                        			This study provides actionable recommendations for tinnitus assessment and treatment evaluation, emphasizing the use of standardized tools and individualized approaches based on patient needs. These findings offer a practical framework to enhance consistency and effectiveness in tinnitus management within Korean clinical settings. 
		                        		
		                        		
		                        		
		                        	
9.Explainability Enhanced Machine Learning Model for Classifying Intellectual Disability and AttentionDeficit/Hyperactivity Disorder With Psychological Test Reports
Tong Min KIM ; Young-Hoon KIM ; Sung-Hee SONG ; In-Young CHOI ; Dai-Jin KIM ; Taehoon KO
Journal of Korean Medical Science 2025;40(11):e26-
		                        		
		                        			 Background:
		                        			Psychological test reports are essential in assessing intellectual functioning, aiding in diagnosing and treating intellectual disability (ID) and attention-deficit/ hyperactivity disorder (ADHD). However, these reports can have several problems because they are diverse, unstructured, subjective, and involve human errors. Additionally, physicians often do not read the entire report, and the number of reports is lower than that of diagnoses. 
		                        		
		                        			Methods:
		                        			We developed explainable predictive models for classifying IDs and ADHDs based on written reports to address these issues. The reports of 1,475 patients with IDs and ADHDs who underwent intelligence tests were used for the models. These models were developed by analyzing reports using natural language processing (NLP) and incorporating the physician’s diagnosis for each report. We selected n-gram features from the models’ results by extracting important features using SHapley Additive exPlanations and permutation importance to make the models explainable. Developing the n-gram feature-based original text search system compensated for the lack of human readability caused by NLP and enabled the reconstruction of human-readable texts from the selected n-gram features. 
		                        		
		                        			Results:
		                        			The maximum model accuracy was 0.92, and the 80 human-readable texts were restored from four models. 
		                        		
		                        			Conclusion
		                        			The results showed that the models could accurately classify IDs and ADHDs, even with a few reports. The models were also able to explain their predictions. The explainability-enhanced model can help physicians understand the classification process of IDs and ADHDs and provide evidence-based insights. 
		                        		
		                        		
		                        		
		                        	
10.Consensus Statements on Tinnitus Treatment: A Delphi Study by the Korean Tinnitus Study Group
Junhui JEONG ; Ho Yun LEE ; Oak-Sung CHOO ; Hantai KIM ; Kyu-Yup LEE ; Jae-Jin SONG ; Jae-Hyun SEO ; Yoon Chan RAH ; Jae-Jun SONG ; Eui-Cheol NAM ; Shi Nae PARK ; In Seok MOON ; Hyun Joon SHIM
Journal of Korean Medical Science 2025;40(18):e75-
		                        		
		                        			 Background:
		                        			Tinnitus is a bothersome condition associated with various mechanisms of action. Although treatment methods vary according to these mechanisms, standardized guidelines would benefit both patients and clinicians. We conducted a Delphi study, a method that collects expert opinions through multiple rounds of questionnaires, to reach a consensus on tinnitus treatment with professional experts. 
		                        		
		                        			Methods:
		                        			A two-round modified Delphi survey was conducted to develop a clinical consensus on tinnitus treatment. The experts scored each statement on a scale of 1 (highest disagreement) to 9 (highest agreement) for their level of agreement on tinnitus treatment.Consensus was defined when 75% or more of the participants scored 7–9, and 15% or less scored 1–3. To ensure reliability of the responses, the content validity ratio and Kendall’s coefficient of concordance were evaluated. 
		                        		
		                        			Results:
		                        			Approximately 19 of 31 statements reached a consensus. All 3 statements reached a consensus regarding the candidates for treatment. Regarding treatment, 3 of 8 statements on medication, 2 of 2 statements on tinnitus retraining therapy/cognitive behavioral therapy, and 5 of 7 statements on auditory rehabilitation reached a positive consensus. Although all 6 statements regarding miscellaneous treatment reached a consensus, most were negatively agreed. For treatment with neuromodulation, none of the 5 statements reached a consensus. 
		                        		
		                        			Conclusion
		                        			The experts reached a high level of consensus on treatment candidates, tinnitus retraining therapy/cognitive behavioral therapy, and auditory rehabilitation in this modified Delphi study. The results of this study can provide beneficial and practical information for clinicians regarding the treatment of tinnitus. 
		                        		
		                        		
		                        		
		                        	
            
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