1.Obesity and heart failure with preserved ejection fraction: focus on new drugs and future direction in medical treatment
The Korean Journal of Internal Medicine 2025;40(3):357-370
Obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and contributes through multiple pathophysiological pathways, including systemic inflammation, neurohormonal activation, and mechanical inhibition. The treatment of obesity has shown significant potential for improving HFpEF outcomes. Sodium-glucose cotransporter 2 inhibitors have emerged as effective treatments for improving symptoms and quality of life in patients with HFpEF while aiding in weight control. Furthermore, a recent demonstration of the clinical benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF showed promising results in reducing weight loss, and improving symptoms and clinical outcomes. In this review article, we discuss the association between HFpEF and obesity, the emerging role of GLP-1 RAs, and future directions for medical therapies targeting obesity-associated HFpEF.
2.Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease
Noeul KANG ; Su-Young KIM ; Dae Hun KIM ; Byung Woo JHUN
The Korean Journal of Internal Medicine 2025;40(3):449-457
Background/Aims:
To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status.
Methods:
Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3–V4 region of the 16S rRNA gene.
Results:
Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05).
Conclusions
In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.
3.Obesity and heart failure with preserved ejection fraction: focus on new drugs and future direction in medical treatment
The Korean Journal of Internal Medicine 2025;40(3):357-370
Obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and contributes through multiple pathophysiological pathways, including systemic inflammation, neurohormonal activation, and mechanical inhibition. The treatment of obesity has shown significant potential for improving HFpEF outcomes. Sodium-glucose cotransporter 2 inhibitors have emerged as effective treatments for improving symptoms and quality of life in patients with HFpEF while aiding in weight control. Furthermore, a recent demonstration of the clinical benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF showed promising results in reducing weight loss, and improving symptoms and clinical outcomes. In this review article, we discuss the association between HFpEF and obesity, the emerging role of GLP-1 RAs, and future directions for medical therapies targeting obesity-associated HFpEF.
4.Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease
Noeul KANG ; Su-Young KIM ; Dae Hun KIM ; Byung Woo JHUN
The Korean Journal of Internal Medicine 2025;40(3):449-457
Background/Aims:
To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status.
Methods:
Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3–V4 region of the 16S rRNA gene.
Results:
Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05).
Conclusions
In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.
5.Accuracy evaluation of preoperative indocyanine green tattooing and intraoperative colonoscopy in determining surgical resection margins for left-sided colorectal cancer: a retrospective study in Korea
Byung-Soo PARK ; Sung Hwan CHO ; Gyung Mo SON ; Hyun Sung KIM ; Jin Ook JANG ; Dae Gon RYU ; Su Jin KIM ; Su Bum PARK ; Hyung Wook KIM
Journal of Minimally Invasive Surgery 2025;28(1):19-24
Purpose:
We aimed to evaluate the precision of preoperative colonoscopic tattooing and intraoperative colonoscopic tumor localization in determining distal surgical margins for leftsided colorectal cancer surgery.
Methods:
This retrospective study included 30 patients who underwent laparoscopic colorectal surgery, preoperative colonoscopic tattooing, and intraoperative colonoscopic localization for colorectal cancer at our center between July 2020 and March 2024. Clinical data were collected, and the precision of these methods was assessed by measuring the differences between the target resection margin and the actual pathological resection margin.
Results:
In four patient cases, the indocyanine green tattoo was not visible in the laparoscopic surgical field. The average stained length of the tattoo was 2.89 cm, with a mean distance of 1.18 cm between the low margin of the tattoo and the cancer. The difference between the target distal resection margin by intraoperative colonoscopic localization and the actual pathological resection margin was 0.88 cm. No complications related to the intraoperative colonoscopy were observed.
Conclusion
Preoperative tattooing showed limitations, such as spreading and occasional invisibility. Intraoperative colonoscopic localization proved to be an effective method for achieving more precise distal surgical margins in left-sided colorectal cancer surgery.
6.Combination of Aβ40, Aβ42, and Tau Plasma Levels to Distinguish Amyloid-PET Positive Alzheimer Patients from Normal Controls
Seungyeop BAEK ; Jinny Claire LEE ; Byung Hyun BYUN ; Su Yeon PARK ; Jeong Ho HA ; Kyo Chul LEE ; Seung-Hoon YANG ; Jun-Seok LEE ; Seungpyo HONG ; Gyoonhee HAN ; Sang Moo LIM ; YoungSoo KIM ; Hye Yun KIM
Experimental Neurobiology 2025;34(1):1-8
Alzheimer disease (AD) diagnosis is confirmed using a medley of modalities, such as the detection of amyloid-β (Aβ) neuritic plaques and neurofibrillary tangles with positron electron tomography (PET) or the appraisal of irregularities in cognitive function with examinations. Although these methods have been efficient in confirming AD pathology, the rising demand for earlier intervention during pathogenesis has led researchers to explore the diagnostic potential of fluid biomarkers in cerebrospinal fluid (CSF) and plasma. Since CSF sample collection is invasive and limited in quantity, biomarker detection in plasma has become more attractive and modern advancements in technology has permitted more efficient and accurate analysis of plasma biomolecules. In this study, we found that a composite of standard factors, Aβ40 and total tau levels in plasma, divided by the variation factor, plasma Aβ42 level, provide better correlation with amyloid neuroimaging and neuropsychological test results than a level comparison between total tau and Aβ42 in plasma. We collected EDTA-treated blood plasma samples of 53 subjects, of randomly selected 27 AD patients and 26 normal cognition (NC) individuals, who received amyloid-PET scans for plaque quantification, and measured plasma levels of Aβ40, Aβ42, and total tau with digital enzyme-linked immunosorbent assay (ELISA) in a blinded manner. There was difficulty distinguishing AD patients from controls when analyzing biomarkers independently. However, significant differentiation was observed between the two groups when comparing individual ratios of total-tau×Aβ40/Aβ42. Our results indicate that collectively comparing fluctuations of these fluid biomarkers could aid in monitoring AD pathogenesis.
7.Obesity and heart failure with preserved ejection fraction: focus on new drugs and future direction in medical treatment
The Korean Journal of Internal Medicine 2025;40(3):357-370
Obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and contributes through multiple pathophysiological pathways, including systemic inflammation, neurohormonal activation, and mechanical inhibition. The treatment of obesity has shown significant potential for improving HFpEF outcomes. Sodium-glucose cotransporter 2 inhibitors have emerged as effective treatments for improving symptoms and quality of life in patients with HFpEF while aiding in weight control. Furthermore, a recent demonstration of the clinical benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF showed promising results in reducing weight loss, and improving symptoms and clinical outcomes. In this review article, we discuss the association between HFpEF and obesity, the emerging role of GLP-1 RAs, and future directions for medical therapies targeting obesity-associated HFpEF.
8.Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease
Noeul KANG ; Su-Young KIM ; Dae Hun KIM ; Byung Woo JHUN
The Korean Journal of Internal Medicine 2025;40(3):449-457
Background/Aims:
To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status.
Methods:
Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3–V4 region of the 16S rRNA gene.
Results:
Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05).
Conclusions
In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.
9.Obesity and heart failure with preserved ejection fraction: focus on new drugs and future direction in medical treatment
The Korean Journal of Internal Medicine 2025;40(3):357-370
Obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and contributes through multiple pathophysiological pathways, including systemic inflammation, neurohormonal activation, and mechanical inhibition. The treatment of obesity has shown significant potential for improving HFpEF outcomes. Sodium-glucose cotransporter 2 inhibitors have emerged as effective treatments for improving symptoms and quality of life in patients with HFpEF while aiding in weight control. Furthermore, a recent demonstration of the clinical benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF showed promising results in reducing weight loss, and improving symptoms and clinical outcomes. In this review article, we discuss the association between HFpEF and obesity, the emerging role of GLP-1 RAs, and future directions for medical therapies targeting obesity-associated HFpEF.
10.Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease
Noeul KANG ; Su-Young KIM ; Dae Hun KIM ; Byung Woo JHUN
The Korean Journal of Internal Medicine 2025;40(3):449-457
Background/Aims:
To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status.
Methods:
Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3–V4 region of the 16S rRNA gene.
Results:
Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05).
Conclusions
In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.

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