1.Similar but Distinct Comorbidity Patterns Between Polycystic Ovary Syndrome and Endometriosis in Korean Women: A Nationwide Cohort Study
Hye Gyeong JEONG ; Minhyek JEON ; Ki-Jin RYU ; Jina KIM ; Byeol Yi CHOE ; Yoonjung Yoonie JOO ; Hyuntae PARK
Journal of Korean Medical Science 2024;39(44):e284-
		                        		
		                        			 Background:
		                        			Polycystic ovary syndrome (PCOS) and endometriosis are widely recognized as significant risk factors affecting the reproductive health of women. The underlying mechanisms impacting fertility may vary, potentially leading to divergent outcomes. We aimed to examine and contrast the prevalence patterns of diseases coexisting with PCOS and endometriosis, using a large-scale nationwide insurance claims data from Asian women of reproductive age. 
		                        		
		                        			Methods:
		                        			We analyzed health insurance and examination data of 157,662 Korean women aged 15–45 years, drawn from the Korea National Health Insurance Service-National Sample Cohort database. International Classification of Disease, Tenth Revision codes were mapped to phenome-wide association study codes (phecodes). Subsequently, multivariate logistic regression was performed to assess the comorbidity patterns among patients diagnosed with PCOS and endometriosis and healthy control groups. 
		                        		
		                        			Results:
		                        			Our analysis revealed that PCOS was correlated with a wider range of metabolic disorders and symptoms, such as hyperlipidemia, type 2 diabetes, various gastrointestinal (GI) issues, and an array of pregnancy-related complications. Conversely, endometriosis was more prevalent among benign neoplasms of female reproductive and digestive organs, endometrial hyperplasia, and angina pectoris. Notably, infertility and glaucoma demonstrated significant associations with both conditions. Furthermore, a comparison of symptom-related codes in women with endometriosis revealed a predominance of painrelated symptoms, whereas those with PCOS exhibited a broader spectrum, encompassing pain, pruritus, GI problems, cough, fever, menstrual cycle disorders, edema, and dizziness. 
		                        		
		                        			Conclusion
		                        			PCOS and endometriosis, which are prevalent gynecological disorders affecting similar age groups of women, rarely co-occur and exhibit unique comorbidity profiles.Tailored healthcare strategies that take into account these distinct patterns have the potential to enhance long-term healthcare outcomes of affected patients. Further research is required to elucidate the underlying mechanisms and contrasting comorbidity profiles between PCOS and endometriosis. 
		                        		
		                        		
		                        		
		                        	
2.Similar but Distinct Comorbidity Patterns Between Polycystic Ovary Syndrome and Endometriosis in Korean Women: A Nationwide Cohort Study
Hye Gyeong JEONG ; Minhyek JEON ; Ki-Jin RYU ; Jina KIM ; Byeol Yi CHOE ; Yoonjung Yoonie JOO ; Hyuntae PARK
Journal of Korean Medical Science 2024;39(44):e284-
		                        		
		                        			 Background:
		                        			Polycystic ovary syndrome (PCOS) and endometriosis are widely recognized as significant risk factors affecting the reproductive health of women. The underlying mechanisms impacting fertility may vary, potentially leading to divergent outcomes. We aimed to examine and contrast the prevalence patterns of diseases coexisting with PCOS and endometriosis, using a large-scale nationwide insurance claims data from Asian women of reproductive age. 
		                        		
		                        			Methods:
		                        			We analyzed health insurance and examination data of 157,662 Korean women aged 15–45 years, drawn from the Korea National Health Insurance Service-National Sample Cohort database. International Classification of Disease, Tenth Revision codes were mapped to phenome-wide association study codes (phecodes). Subsequently, multivariate logistic regression was performed to assess the comorbidity patterns among patients diagnosed with PCOS and endometriosis and healthy control groups. 
		                        		
		                        			Results:
		                        			Our analysis revealed that PCOS was correlated with a wider range of metabolic disorders and symptoms, such as hyperlipidemia, type 2 diabetes, various gastrointestinal (GI) issues, and an array of pregnancy-related complications. Conversely, endometriosis was more prevalent among benign neoplasms of female reproductive and digestive organs, endometrial hyperplasia, and angina pectoris. Notably, infertility and glaucoma demonstrated significant associations with both conditions. Furthermore, a comparison of symptom-related codes in women with endometriosis revealed a predominance of painrelated symptoms, whereas those with PCOS exhibited a broader spectrum, encompassing pain, pruritus, GI problems, cough, fever, menstrual cycle disorders, edema, and dizziness. 
		                        		
		                        			Conclusion
		                        			PCOS and endometriosis, which are prevalent gynecological disorders affecting similar age groups of women, rarely co-occur and exhibit unique comorbidity profiles.Tailored healthcare strategies that take into account these distinct patterns have the potential to enhance long-term healthcare outcomes of affected patients. Further research is required to elucidate the underlying mechanisms and contrasting comorbidity profiles between PCOS and endometriosis. 
		                        		
		                        		
		                        		
		                        	
3.Similar but Distinct Comorbidity Patterns Between Polycystic Ovary Syndrome and Endometriosis in Korean Women: A Nationwide Cohort Study
Hye Gyeong JEONG ; Minhyek JEON ; Ki-Jin RYU ; Jina KIM ; Byeol Yi CHOE ; Yoonjung Yoonie JOO ; Hyuntae PARK
Journal of Korean Medical Science 2024;39(44):e284-
		                        		
		                        			 Background:
		                        			Polycystic ovary syndrome (PCOS) and endometriosis are widely recognized as significant risk factors affecting the reproductive health of women. The underlying mechanisms impacting fertility may vary, potentially leading to divergent outcomes. We aimed to examine and contrast the prevalence patterns of diseases coexisting with PCOS and endometriosis, using a large-scale nationwide insurance claims data from Asian women of reproductive age. 
		                        		
		                        			Methods:
		                        			We analyzed health insurance and examination data of 157,662 Korean women aged 15–45 years, drawn from the Korea National Health Insurance Service-National Sample Cohort database. International Classification of Disease, Tenth Revision codes were mapped to phenome-wide association study codes (phecodes). Subsequently, multivariate logistic regression was performed to assess the comorbidity patterns among patients diagnosed with PCOS and endometriosis and healthy control groups. 
		                        		
		                        			Results:
		                        			Our analysis revealed that PCOS was correlated with a wider range of metabolic disorders and symptoms, such as hyperlipidemia, type 2 diabetes, various gastrointestinal (GI) issues, and an array of pregnancy-related complications. Conversely, endometriosis was more prevalent among benign neoplasms of female reproductive and digestive organs, endometrial hyperplasia, and angina pectoris. Notably, infertility and glaucoma demonstrated significant associations with both conditions. Furthermore, a comparison of symptom-related codes in women with endometriosis revealed a predominance of painrelated symptoms, whereas those with PCOS exhibited a broader spectrum, encompassing pain, pruritus, GI problems, cough, fever, menstrual cycle disorders, edema, and dizziness. 
		                        		
		                        			Conclusion
		                        			PCOS and endometriosis, which are prevalent gynecological disorders affecting similar age groups of women, rarely co-occur and exhibit unique comorbidity profiles.Tailored healthcare strategies that take into account these distinct patterns have the potential to enhance long-term healthcare outcomes of affected patients. Further research is required to elucidate the underlying mechanisms and contrasting comorbidity profiles between PCOS and endometriosis. 
		                        		
		                        		
		                        		
		                        	
4.Similar but Distinct Comorbidity Patterns Between Polycystic Ovary Syndrome and Endometriosis in Korean Women: A Nationwide Cohort Study
Hye Gyeong JEONG ; Minhyek JEON ; Ki-Jin RYU ; Jina KIM ; Byeol Yi CHOE ; Yoonjung Yoonie JOO ; Hyuntae PARK
Journal of Korean Medical Science 2024;39(44):e284-
		                        		
		                        			 Background:
		                        			Polycystic ovary syndrome (PCOS) and endometriosis are widely recognized as significant risk factors affecting the reproductive health of women. The underlying mechanisms impacting fertility may vary, potentially leading to divergent outcomes. We aimed to examine and contrast the prevalence patterns of diseases coexisting with PCOS and endometriosis, using a large-scale nationwide insurance claims data from Asian women of reproductive age. 
		                        		
		                        			Methods:
		                        			We analyzed health insurance and examination data of 157,662 Korean women aged 15–45 years, drawn from the Korea National Health Insurance Service-National Sample Cohort database. International Classification of Disease, Tenth Revision codes were mapped to phenome-wide association study codes (phecodes). Subsequently, multivariate logistic regression was performed to assess the comorbidity patterns among patients diagnosed with PCOS and endometriosis and healthy control groups. 
		                        		
		                        			Results:
		                        			Our analysis revealed that PCOS was correlated with a wider range of metabolic disorders and symptoms, such as hyperlipidemia, type 2 diabetes, various gastrointestinal (GI) issues, and an array of pregnancy-related complications. Conversely, endometriosis was more prevalent among benign neoplasms of female reproductive and digestive organs, endometrial hyperplasia, and angina pectoris. Notably, infertility and glaucoma demonstrated significant associations with both conditions. Furthermore, a comparison of symptom-related codes in women with endometriosis revealed a predominance of painrelated symptoms, whereas those with PCOS exhibited a broader spectrum, encompassing pain, pruritus, GI problems, cough, fever, menstrual cycle disorders, edema, and dizziness. 
		                        		
		                        			Conclusion
		                        			PCOS and endometriosis, which are prevalent gynecological disorders affecting similar age groups of women, rarely co-occur and exhibit unique comorbidity profiles.Tailored healthcare strategies that take into account these distinct patterns have the potential to enhance long-term healthcare outcomes of affected patients. Further research is required to elucidate the underlying mechanisms and contrasting comorbidity profiles between PCOS and endometriosis. 
		                        		
		                        		
		                        		
		                        	
5.Ursane-type Triterpene Glycosides from Rubus cochinchinensis Exhibited Insulin-Mimetic Activities in Differentiated 3T3-L1 Adipocytes
Jin Pyo AN ; Eun Jin PARK ; Thi Phuong DOAN ; Byeol RYU ; Ha Thanh TUNG PHAM ; Won Keun OH
Natural Product Sciences 2024;30(1):14-19
		                        		
		                        			
		                        			 Diabetes mellitus is characterized by hyperglycemic due to impaired insulin secretion or resistance. In our search for anti-diabetic agents, we found that a 70% EtOH extract of Rubus cochinchinensis(Tratt) enhances glucose  uptake  in  3T3-L1  adipocytes.  R.  cochinchinensis  is  predominantly  found  in  East  Asia,  particularly  in Vietnam,  Laos,  Cambodia,  and  southern  in  China.  Despite  its  widespread  distribution,  there  have  been  few studies  on  its  bioactivity  or  chemical  constituents.  In  this  study,  activity-guided  fractionation  of  70%  EtOH extract from the leaves of R. cochinchinensis resulted in the isolation of one new ursane-type glycoside, 3-O-β-acetyl-28-O-β-D-glucopyranosyl-rotundioic acid (1), along with four known compounds (2–5). The structures of these  compounds  were  elucidated  using  1D  and  2D  NMR  and  HRESIMS  data.  Notably,  compound  4 significantly  increased  the  uptake  level  of  2-deoxy-2-[(7-nitro-2,1,3-benzoxadiazol-4-yl)amino]-D-glucose  (2-NBDG)  in  differentiated  3T3-L1  adipocytes.  This  study  suggests  the  potential  of  R.  cochinchinensis  as  a promising medicinal plant for treating diabetes via glucose uptake.  
		                        		
		                        		
		                        		
		                        	
6.Validation of high-sensitivity troponin I levels for major adverse cardiac events in low risk chest pain patients
Hyun Jin RYU ; Ha Young PARK ; Tae Sik HWANG ; Han Byeol KIM ; Ju Hong LEE
Journal of the Korean Society of Emergency Medicine 2023;34(6):586-598
		                        		
		                        			 Objective:
		                        			This study examined whether the efficiency of the level of detection (LOD) and upper reference limit (URL) for high-sensitivity cardiac troponin I (hs-cTnI) is increased when major adverse cardiovascular events (MACEs) occur in patients with low-risk chest pain who visit the emergency department (ED) and how long they stay in the ED. 
		                        		
		                        			Methods:
		                        			The URL for hs-cTnI used in the hospital improved from 0.04 ng/mL (LOD <0.0041 ng/mL) in 2018 to 19.8 pg/mL (LOD <2.3 pg/mL) in 2019. In these two years, the occurrence of MACEs, frequency of hs-cTnI follow-up in the ER, and the length of stay in the ER were compared. In addition, the three calculated risk assessment scores for the safety level of early discharge were compared. 
		                        		
		                        			Results:
		                        			In 2018, there were six MACEs out of 120 patients (5.0%), no cardiac deaths, one acute myocardial infarction (AMI), and five unplanned coronary revascularizations. In 2019, six MACEs out of 105 patients (5.7%) were all unplanned coronary revascularizations without any cardiac deaths or AMIs. 
		                        		
		                        			Conclusion
		                        			Although the level of hs-cTnI measurement was improved, there was no difference in the incidence of MACEs in patients with low-risk chest pain who were discharged from the ED, and the number of hs-cTnI follow-ups and time in the ED increased. Interestingly, there were only short-term MACEs and no medium-term MACEs. In addition, there was little to no coronary artery occlusion disease. The risk assessment score combined with hs-cTnI improved the predictive performance for MACEs. 
		                        		
		                        		
		                        		
		                        	
7.The Comparison of Emergency Medical Service Responses to and Outcomes of Out-of-hospital Cardiac Arrest before and during the COVID-19 Pandemic in an Area of Korea
Daesung LIM ; Song Yi PARK ; Byungho CHOI ; Sun Hyu KIM ; Ji Ho RYU ; Yong Hwan KIM ; Ae Jin SUNG ; Byung Kwan BAE ; Han Byeol KIM
Journal of Korean Medical Science 2021;36(36):e255-
		                        		
		                        			Background:
		                        			Since the declaration of the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 has affected the responses of emergency medical service (EMS) systems to cases of out-of-hospital cardiac arrest (OHCA). The purpose of this study was to identify the impact of the COVID-19 pandemic on EMS responses to and outcomes of adult OHCA in an area of South Korea. 
		                        		
		                        			Methods:
		                        			This was a retrospective observational study of adult OHCA patients attended by EMS providers comparing the EMS responses to and outcomes of adult OHCA during the COVID-19 pandemic to those during the pre-COVID-19 period. Propensity score matching was used to compare the survival rates, and logistic regression analysis was used to assess the impact of the COVID-19 pandemic on the survival of OHCA patients. 
		                        		
		                        			Results:
		                        			A total of 891 patients in the pre-COVID-19 group and 1,063 patients in the COVID-19 group were included in the final analysis. During the COVID-19 period, the EMS call time was shifted to a later time period (16:00–24:00, P < 0.001), and the presence of an initial shockable rhythm was increased (pre-COVID-19 vs. COVID-19, 7.97% vs. 11.95%, P = 0.004). The number of tracheal intubations decreased (5.27% vs. 1.22%, P < 0.001), and the use of mechanical chest compression devices (30.53% vs. 44.59%, P < 0.001) and EMS response time (median [quartile 1-quartile 3], 7 [5–10] vs. 8 [6–11], P < 0.001) increased. After propensity score matching, the survival at admission rate (22.52% vs. 18.24%, P = 0.025), survival to discharge rate (7.77% vs. 5.52%, P = 0.056), and favorable neurological outcome (5.97% vs. 3.49%, P < 0.001) decreased. In the propensity score matching analysis of the impact of COVID-19, odds ratios of 0.768 (95% confidence interval [CI], 0.592–0.995) for survival at admission and 0.693 (95% CI, 0.446–1.077) for survival to discharge were found. 
		                        		
		                        			Conclusion
		                        			During the COVID-19 period, there were significant changes in the EMS responses to OHCA. These changes are considered to be partly due to social distancing measures. As a result, the proportion of patients with an initial shockable rhythm in the COVID-19 period was greater than that in the pre-COVID-19 period, but the final survival rate and favorable neurological outcome were lower.
		                        		
		                        		
		                        		
		                        	
8.The Comparison of Emergency Medical Service Responses to and Outcomes of Out-of-hospital Cardiac Arrest before and during the COVID-19 Pandemic in an Area of Korea
Daesung LIM ; Song Yi PARK ; Byungho CHOI ; Sun Hyu KIM ; Ji Ho RYU ; Yong Hwan KIM ; Ae Jin SUNG ; Byung Kwan BAE ; Han Byeol KIM
Journal of Korean Medical Science 2021;36(36):e255-
		                        		
		                        			Background:
		                        			Since the declaration of the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 has affected the responses of emergency medical service (EMS) systems to cases of out-of-hospital cardiac arrest (OHCA). The purpose of this study was to identify the impact of the COVID-19 pandemic on EMS responses to and outcomes of adult OHCA in an area of South Korea. 
		                        		
		                        			Methods:
		                        			This was a retrospective observational study of adult OHCA patients attended by EMS providers comparing the EMS responses to and outcomes of adult OHCA during the COVID-19 pandemic to those during the pre-COVID-19 period. Propensity score matching was used to compare the survival rates, and logistic regression analysis was used to assess the impact of the COVID-19 pandemic on the survival of OHCA patients. 
		                        		
		                        			Results:
		                        			A total of 891 patients in the pre-COVID-19 group and 1,063 patients in the COVID-19 group were included in the final analysis. During the COVID-19 period, the EMS call time was shifted to a later time period (16:00–24:00, P < 0.001), and the presence of an initial shockable rhythm was increased (pre-COVID-19 vs. COVID-19, 7.97% vs. 11.95%, P = 0.004). The number of tracheal intubations decreased (5.27% vs. 1.22%, P < 0.001), and the use of mechanical chest compression devices (30.53% vs. 44.59%, P < 0.001) and EMS response time (median [quartile 1-quartile 3], 7 [5–10] vs. 8 [6–11], P < 0.001) increased. After propensity score matching, the survival at admission rate (22.52% vs. 18.24%, P = 0.025), survival to discharge rate (7.77% vs. 5.52%, P = 0.056), and favorable neurological outcome (5.97% vs. 3.49%, P < 0.001) decreased. In the propensity score matching analysis of the impact of COVID-19, odds ratios of 0.768 (95% confidence interval [CI], 0.592–0.995) for survival at admission and 0.693 (95% CI, 0.446–1.077) for survival to discharge were found. 
		                        		
		                        			Conclusion
		                        			During the COVID-19 period, there were significant changes in the EMS responses to OHCA. These changes are considered to be partly due to social distancing measures. As a result, the proportion of patients with an initial shockable rhythm in the COVID-19 period was greater than that in the pre-COVID-19 period, but the final survival rate and favorable neurological outcome were lower.
		                        		
		                        		
		                        		
		                        	
9.Pattern of Extraocular Muscle Involvements in Miller Fisher Syndrome
Won Yeol RYU ; Yoo Hwan KIM ; Byeol A YOON ; Hwan Tae PARK ; Jong Seok BAE ; Jong Kuk KIM
Journal of Clinical Neurology 2019;15(3):308-312
		                        		
		                        			
		                        			BACKGROUND AND PURPOSE: The most-common initial manifestation of Miller Fisher syndrome (MFS) is diplopia due to acute ophthalmoplegia. However, few studies have focused on ocular motility findings in MFS. This study aimed to determine the pattern of extraocular muscle (EOM) paresis in MFS patients. METHODS: We consecutively recruited MFS patients who presented with ophthalmoplegia between 2010 and 2015. The involved EOMs and the strabismus pattern in the primary position were analyzed. Antecedent infections, other involved cranial nerves, and laboratory findings were also reviewed. We compared the characteristics of the patients according to the severity of ophthalmoplegia between complete ophthalmoplegia (CO) and incomplete ophthalmoplegia (IO). RESULTS: Twenty-five patients (15 males and 10 females) with bilateral ophthalmoplegia were included in the study. The most-involved and last-to-recover EOM was the lateral rectus muscle. CO and IO were observed in 11 and 14 patients, respectively. The patients were aged 59.0±18.4 years (mean±SD) in the CO group and 24.9±7.4 years in the IO group (p<0.01), and comprised 63.6% and 21.4% females, respectively (p=0.049). Elevated cerebrospinal fluid protein was identified in 60.0% of patients with CO and 7.7% of patients with IO (p=0.019) for a mean follow-up time from the initial symptom onset of 3.7 days. CONCLUSIONS: The lateral rectus muscle is the most-involved and last-to-recover EOM in ophthalmoplegia. The CO patients were much older and were more likely to be female and have an elevation of cerebrospinal fluid protein than the IO patients.
		                        		
		                        		
		                        		
		                        			Cerebrospinal Fluid
		                        			;
		                        		
		                        			Cranial Nerves
		                        			;
		                        		
		                        			Diplopia
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Guillain-Barre Syndrome
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Jupiter
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Miller Fisher Syndrome
		                        			;
		                        		
		                        			Ophthalmoplegia
		                        			;
		                        		
		                        			Paresis
		                        			;
		                        		
		                        			Strabismus
		                        			
		                        		
		                        	
10.Biflorin Ameliorates Memory Impairments Induced by Cholinergic Blockade in Mice.
Se Jin JEON ; Boseong KIM ; Byeol RYU ; Eunji KIM ; Sunhee LEE ; Dae Sik JANG ; Jong Hoon RYU
Biomolecules & Therapeutics 2017;25(3):249-258
		                        		
		                        			
		                        			To examine the effect of biflorin, a component of Syzygium aromaticum, on memory deficit, we introduced a scopolamine-induced cognitive deficit mouse model. A single administration of biflorin increased latency time in the passive avoidance task, ameliorated alternation behavior in the Y-maze, and increased exploration time in the Morris water maze task, indicating the improvement of cognitive behaviors against cholinergic dysfunction. The biflorin-induced reverse of latency in the scopolamine-treated group was attenuated by MK-801, an NMDA receptor antagonist. Biflorin also enhanced cognitive function in a naïve mouse model. To understand the mechanism of biflorin for memory amelioration, we performed Western blot. Biflorin increased the activation of protein kinase C-ζ and its downstream signaling molecules in the hippocampus. These results suggest that biflorin ameliorates drug-induced memory impairment by modulation of protein kinase C-ζ signaling in mice, implying that biflorin could function as a possible therapeutic agent for the treatment of cognitive problems.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Blotting, Western
		                        			;
		                        		
		                        			Cognition
		                        			;
		                        		
		                        			Cognition Disorders
		                        			;
		                        		
		                        			Dizocilpine Maleate
		                        			;
		                        		
		                        			Hippocampus
		                        			;
		                        		
		                        			Memory Disorders
		                        			;
		                        		
		                        			Memory*
		                        			;
		                        		
		                        			Mice*
		                        			;
		                        		
		                        			N-Methylaspartate
		                        			;
		                        		
		                        			Protein Kinases
		                        			;
		                        		
		                        			Syzygium
		                        			;
		                        		
		                        			Water
		                        			
		                        		
		                        	
            
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