1.Validation of the London Classification for Rectal Hyposensitivity in an Anorectal Manometry Database of 2540 Patients With Functional Defecatory Disorder
Jeongkuk SEO ; Kee Wook JUNG ; Sehee KIM ; Seung Wook HONG ; Sung Wook HWANG ; Sang Hyoung PARK ; Dong-Hoon YANG ; Byong Duk YE ; Jeong-Sik BYEON ; Seung-Jae MYUNG ; Suk-Kyun YANG
Journal of Neurogastroenterology and Motility 2025;31(2):276-284
Background/Aims:
Rectal hyposensitivity (RH), as defined by the London Classification, has been linked to sensory dysfunction caused by diabetes mellitus and Parkinson’s disease (PD); however, its clinical interpretation has not been sufficiently validated. In this study, we aim to explore the correlations between rectal sensory thresholds and the clinical characteristics of patients with functional defecatory disorders.
Methods:
We reviewed data from patients who underwent high-resolution anorectal manometry and acquired their clinical characteristics using a standardized questionnaire. The associations between RH based on either 1 (borderline RH) or 2 (RH) abnormal rectal sensory thresholds and patients’ clinical and demographic characteristics were analyzed using linear and logistic regression models in the overall sex-stratified populations.
Results:
We enrolled 2540 patients, of whom 1046 (41.2%) were men. Overall, 150 (5.9%) patients were diagnosed with RH, whereas 422 (16.6%) had borderline RH. Multivariate linear regression analysis revealed that the Cleveland Clinic Constipation Score (CCCS) increased linearly with the increase in the number of abnormal rectal sensory thresholds (effect per threshold: 0.900 [standard deviation: 0.188]). Upon stratification by sex, borderline RH was positively associated with diabetes mellitus, PD, and CCCS (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [1.08, 4.15]; aOR = 1.49 [1.03, 2.14]; aOR = 1.03 [1.01, 1.05], respectively) in women. However, RH was positively associated with only the CCCS.
Conclusions
Defining RH based on 1 or more abnormal sensory thresholds showed better clinical correlation with patient characteristics. However, further prospective studies are needed to validate these findings before proposing revisions to the current London classification criteria.
2.Association of weight and dietary habits with high blood mercury levels in Korean adolescents: data from the KoNEHS cycle 4, 2018-2020
Ji Hoon KIM ; Minju JUNG ; Jaewon MUN ; Dong-Jae SEO ; Jong-Han LEEM ; Shin-Goo PARK ; Dong-Wook LEE ; Hyung Doo KIM ; Hwan-Cheol KIM
Annals of Occupational and Environmental Medicine 2025;37(1):e5-
Background:
Humans are exposed to mercury primarily in its highly toxic form, methyl mercury, which is known to have adverse effects on various organs and systems. The negative impact of mercury exposure on the growth, development, and mental health of children, from infancy to adolescence, is well-documented. However, there are no internationally standardized safe limits for mercury exposure. This study investigated the impact of dietary habits and higher body mass index (BMI) on blood mercury levels in adolescents.
Methods:
This study analyzed the data from the 4th Korean National Environmental Health Survey (KoNEHS) 2018–2020. The focus was on 825 middle and high school students aged 13–18 years, whose blood mercury levels were measured. A survey on dietary and lifestyle habits was also conducted. Blood mercury levels were categorized by geometric median values, and associations with overweight status and seafood consumption were examined using a generalized linear model.
Results:
The geometric mean blood mercury level for the entire sample was 1.37 μg/L, with levels of 1.31 μg/L in normal-weight individuals and 1.43 μg/L in overweight individuals, showing a statistically significant difference between the two groups. After adjusting for other variables, blood mercury levels were significantly associated with overweight status (estimate: 0.084; p = 0.018; 95% confidence interval [CI]: 0.015–0.153), consumption of large fish and tuna more than once a week (estimate: 0.18; p = 0.001; 95% CI: 0.077–0.284), and consumption of fish once a week or more (estimate: 0.147; p = 0.004; 95% CI: 0.043–0.250).
Conclusions
In adolescents, a higher BMI and an increased consumption of large fish, tuna, and fish were associated with higher blood mercury levels. Notably, a stronger association was found between large fish consumption and blood mercury levels in the overweight group. These findings suggest the need to moderate seafood consumption and establish more proactive mercury exposure standards for adolescents.
3.Association of weight and dietary habits with high blood mercury levels in Korean adolescents: data from the KoNEHS cycle 4, 2018-2020
Ji Hoon KIM ; Minju JUNG ; Jaewon MUN ; Dong-Jae SEO ; Jong-Han LEEM ; Shin-Goo PARK ; Dong-Wook LEE ; Hyung Doo KIM ; Hwan-Cheol KIM
Annals of Occupational and Environmental Medicine 2025;37(1):e5-
Background:
Humans are exposed to mercury primarily in its highly toxic form, methyl mercury, which is known to have adverse effects on various organs and systems. The negative impact of mercury exposure on the growth, development, and mental health of children, from infancy to adolescence, is well-documented. However, there are no internationally standardized safe limits for mercury exposure. This study investigated the impact of dietary habits and higher body mass index (BMI) on blood mercury levels in adolescents.
Methods:
This study analyzed the data from the 4th Korean National Environmental Health Survey (KoNEHS) 2018–2020. The focus was on 825 middle and high school students aged 13–18 years, whose blood mercury levels were measured. A survey on dietary and lifestyle habits was also conducted. Blood mercury levels were categorized by geometric median values, and associations with overweight status and seafood consumption were examined using a generalized linear model.
Results:
The geometric mean blood mercury level for the entire sample was 1.37 μg/L, with levels of 1.31 μg/L in normal-weight individuals and 1.43 μg/L in overweight individuals, showing a statistically significant difference between the two groups. After adjusting for other variables, blood mercury levels were significantly associated with overweight status (estimate: 0.084; p = 0.018; 95% confidence interval [CI]: 0.015–0.153), consumption of large fish and tuna more than once a week (estimate: 0.18; p = 0.001; 95% CI: 0.077–0.284), and consumption of fish once a week or more (estimate: 0.147; p = 0.004; 95% CI: 0.043–0.250).
Conclusions
In adolescents, a higher BMI and an increased consumption of large fish, tuna, and fish were associated with higher blood mercury levels. Notably, a stronger association was found between large fish consumption and blood mercury levels in the overweight group. These findings suggest the need to moderate seafood consumption and establish more proactive mercury exposure standards for adolescents.
4.Validation of the London Classification for Rectal Hyposensitivity in an Anorectal Manometry Database of 2540 Patients With Functional Defecatory Disorder
Jeongkuk SEO ; Kee Wook JUNG ; Sehee KIM ; Seung Wook HONG ; Sung Wook HWANG ; Sang Hyoung PARK ; Dong-Hoon YANG ; Byong Duk YE ; Jeong-Sik BYEON ; Seung-Jae MYUNG ; Suk-Kyun YANG
Journal of Neurogastroenterology and Motility 2025;31(2):276-284
Background/Aims:
Rectal hyposensitivity (RH), as defined by the London Classification, has been linked to sensory dysfunction caused by diabetes mellitus and Parkinson’s disease (PD); however, its clinical interpretation has not been sufficiently validated. In this study, we aim to explore the correlations between rectal sensory thresholds and the clinical characteristics of patients with functional defecatory disorders.
Methods:
We reviewed data from patients who underwent high-resolution anorectal manometry and acquired their clinical characteristics using a standardized questionnaire. The associations between RH based on either 1 (borderline RH) or 2 (RH) abnormal rectal sensory thresholds and patients’ clinical and demographic characteristics were analyzed using linear and logistic regression models in the overall sex-stratified populations.
Results:
We enrolled 2540 patients, of whom 1046 (41.2%) were men. Overall, 150 (5.9%) patients were diagnosed with RH, whereas 422 (16.6%) had borderline RH. Multivariate linear regression analysis revealed that the Cleveland Clinic Constipation Score (CCCS) increased linearly with the increase in the number of abnormal rectal sensory thresholds (effect per threshold: 0.900 [standard deviation: 0.188]). Upon stratification by sex, borderline RH was positively associated with diabetes mellitus, PD, and CCCS (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [1.08, 4.15]; aOR = 1.49 [1.03, 2.14]; aOR = 1.03 [1.01, 1.05], respectively) in women. However, RH was positively associated with only the CCCS.
Conclusions
Defining RH based on 1 or more abnormal sensory thresholds showed better clinical correlation with patient characteristics. However, further prospective studies are needed to validate these findings before proposing revisions to the current London classification criteria.
5.Association of weight and dietary habits with high blood mercury levels in Korean adolescents: data from the KoNEHS cycle 4, 2018-2020
Ji Hoon KIM ; Minju JUNG ; Jaewon MUN ; Dong-Jae SEO ; Jong-Han LEEM ; Shin-Goo PARK ; Dong-Wook LEE ; Hyung Doo KIM ; Hwan-Cheol KIM
Annals of Occupational and Environmental Medicine 2025;37(1):e5-
Background:
Humans are exposed to mercury primarily in its highly toxic form, methyl mercury, which is known to have adverse effects on various organs and systems. The negative impact of mercury exposure on the growth, development, and mental health of children, from infancy to adolescence, is well-documented. However, there are no internationally standardized safe limits for mercury exposure. This study investigated the impact of dietary habits and higher body mass index (BMI) on blood mercury levels in adolescents.
Methods:
This study analyzed the data from the 4th Korean National Environmental Health Survey (KoNEHS) 2018–2020. The focus was on 825 middle and high school students aged 13–18 years, whose blood mercury levels were measured. A survey on dietary and lifestyle habits was also conducted. Blood mercury levels were categorized by geometric median values, and associations with overweight status and seafood consumption were examined using a generalized linear model.
Results:
The geometric mean blood mercury level for the entire sample was 1.37 μg/L, with levels of 1.31 μg/L in normal-weight individuals and 1.43 μg/L in overweight individuals, showing a statistically significant difference between the two groups. After adjusting for other variables, blood mercury levels were significantly associated with overweight status (estimate: 0.084; p = 0.018; 95% confidence interval [CI]: 0.015–0.153), consumption of large fish and tuna more than once a week (estimate: 0.18; p = 0.001; 95% CI: 0.077–0.284), and consumption of fish once a week or more (estimate: 0.147; p = 0.004; 95% CI: 0.043–0.250).
Conclusions
In adolescents, a higher BMI and an increased consumption of large fish, tuna, and fish were associated with higher blood mercury levels. Notably, a stronger association was found between large fish consumption and blood mercury levels in the overweight group. These findings suggest the need to moderate seafood consumption and establish more proactive mercury exposure standards for adolescents.
6.Validation of the London Classification for Rectal Hyposensitivity in an Anorectal Manometry Database of 2540 Patients With Functional Defecatory Disorder
Jeongkuk SEO ; Kee Wook JUNG ; Sehee KIM ; Seung Wook HONG ; Sung Wook HWANG ; Sang Hyoung PARK ; Dong-Hoon YANG ; Byong Duk YE ; Jeong-Sik BYEON ; Seung-Jae MYUNG ; Suk-Kyun YANG
Journal of Neurogastroenterology and Motility 2025;31(2):276-284
Background/Aims:
Rectal hyposensitivity (RH), as defined by the London Classification, has been linked to sensory dysfunction caused by diabetes mellitus and Parkinson’s disease (PD); however, its clinical interpretation has not been sufficiently validated. In this study, we aim to explore the correlations between rectal sensory thresholds and the clinical characteristics of patients with functional defecatory disorders.
Methods:
We reviewed data from patients who underwent high-resolution anorectal manometry and acquired their clinical characteristics using a standardized questionnaire. The associations between RH based on either 1 (borderline RH) or 2 (RH) abnormal rectal sensory thresholds and patients’ clinical and demographic characteristics were analyzed using linear and logistic regression models in the overall sex-stratified populations.
Results:
We enrolled 2540 patients, of whom 1046 (41.2%) were men. Overall, 150 (5.9%) patients were diagnosed with RH, whereas 422 (16.6%) had borderline RH. Multivariate linear regression analysis revealed that the Cleveland Clinic Constipation Score (CCCS) increased linearly with the increase in the number of abnormal rectal sensory thresholds (effect per threshold: 0.900 [standard deviation: 0.188]). Upon stratification by sex, borderline RH was positively associated with diabetes mellitus, PD, and CCCS (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [1.08, 4.15]; aOR = 1.49 [1.03, 2.14]; aOR = 1.03 [1.01, 1.05], respectively) in women. However, RH was positively associated with only the CCCS.
Conclusions
Defining RH based on 1 or more abnormal sensory thresholds showed better clinical correlation with patient characteristics. However, further prospective studies are needed to validate these findings before proposing revisions to the current London classification criteria.
7.Erratum to: Corrigendum: 2023 Korean Society of Menopause -Osteoporosis Guidelines Part I
Dong Ock LEE ; Yeon Hee HONG ; Moon Kyoung CHO ; Young Sik CHOI ; Sungwook CHUN ; Youn-Jee CHUNG ; Seung Hwa HONG ; Kyu Ri HWANG ; Jinju KIM ; Hoon KIM ; Dong-Yun LEE ; Sa Ra LEE ; Hyun-Tae PARK ; Seok Kyo SEO ; Jung-Ho SHIN ; Jae Yen SONG ; Kyong Wook YI ; Haerin PAIK ; Ji Young LEE
Journal of Menopausal Medicine 2024;30(3):179-179
8.Machine Learning for Movement Pattern Changes during Kinect-Based Mixed Reality Exercise Programs in Women with Possible Sarcopenia: Pilot Study
Yunho SUNG ; Ji-won SEO ; Byunggul LIM ; Shu JIANG ; Xinxing LI ; Parivash JAMRASI ; So Young AHN ; Seohyun AHN ; Yuseon KANG ; Hyejung SHIN ; Donghyun KIM ; Dong Hyun YOON ; Wook SONG
Annals of Geriatric Medicine and Research 2024;28(4):427-436
Background:
Sarcopenia is a muscle-wasting condition that affects older individuals. It can lead to changes in movement patterns, which can increase the risk of falls and other injuries.
Methods:
Older women participants aged ≥65 years who could walk independently were recruited and classified into two groups based on knee extension strength (KES). Participants with low KES scores were assigned to the possible sarcopenia group (PSG; n=7) and an 8-week exercise intervention was implemented. Healthy seniors with high KES scores were classified as the reference group (RG; n=4), and a 3-week exercise intervention was conducted. Kinematic movement data were recorded during the intervention period. All participants' exercise repetitions were used in the data analysis (number of data points=1,128).
Results:
The PSG showed significantly larger movement patterns in knee rotation during wide squats compared to the RG, attributed to weakened lower limb strength. The voting classifier, trained on the movement patterns from wide squats, determined that significant differences in overall movement patterns between the two groups persisted until the end of the exercise intervention. However, after the exercise intervention, significant improvements in lower limb strength in the PSG resulted in reduced knee rotation range of motion and max, thereby stabilizing movements and eliminating significant differences with the RG.
Conclusion
This study suggests that exercise interventions can modify the movement patterns in older individuals with possible sarcopenia. These findings provide fundamental data for developing an exercise management system that remotely tracks and monitors the movement patterns of older adults during exercise activities.
9.Exploring the impact of age and socioeconomic factors on health-related unemployment using propensity score matching: results from Korea National Health and Nutrition Examination Survey (2015–2017)
Ye-Seo LEE ; Dong-Wook LEE ; Mo-Yeol KANG
Annals of Occupational and Environmental Medicine 2024;36(1):e16-
Previous reports showed that age and socioeconomic factors mediated health-related unemployment. However, those studies had limitations controlling for confounding factors. This study examines age and socioeconomic factors contributing to health-related unemployment using propensity score matching (PSM) to control for various confounding variables. Data were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2015–2017. We applied a 1:1 PSM to align health factors, and examined the association between health-related unemployment and age or socioeconomic factors through conditional logistic regression. The health-related unemployment group was compared with the employment group. Among the 9,917 participants (5,817 women, 4,100 men), 1,182 (853 women, 329 men) were in the health-related unemployment group. Total 911 pairs (629 women pairs and 282 men pairs) were retained after PSM for health factors. The results of conditional logistic regression showed that older age, low individual and household income levels, low education level, receipt of the Basic Livelihood Security Program benefits and longest-held job characteristics were linked to health-related unemployment, despite having similar health levels. Older age and low socioeconomic status can increase the risk of health-related unemployment, highlighting the presence of age discrimination and socioeconomic inequality. These findings underscore the importance of proactive management strategies aimed at addressing these disparities, which are crucial for reducing the heightened risk of health-related unemployment.
10.Machine Learning for Movement Pattern Changes during Kinect-Based Mixed Reality Exercise Programs in Women with Possible Sarcopenia: Pilot Study
Yunho SUNG ; Ji-won SEO ; Byunggul LIM ; Shu JIANG ; Xinxing LI ; Parivash JAMRASI ; So Young AHN ; Seohyun AHN ; Yuseon KANG ; Hyejung SHIN ; Donghyun KIM ; Dong Hyun YOON ; Wook SONG
Annals of Geriatric Medicine and Research 2024;28(4):427-436
Background:
Sarcopenia is a muscle-wasting condition that affects older individuals. It can lead to changes in movement patterns, which can increase the risk of falls and other injuries.
Methods:
Older women participants aged ≥65 years who could walk independently were recruited and classified into two groups based on knee extension strength (KES). Participants with low KES scores were assigned to the possible sarcopenia group (PSG; n=7) and an 8-week exercise intervention was implemented. Healthy seniors with high KES scores were classified as the reference group (RG; n=4), and a 3-week exercise intervention was conducted. Kinematic movement data were recorded during the intervention period. All participants' exercise repetitions were used in the data analysis (number of data points=1,128).
Results:
The PSG showed significantly larger movement patterns in knee rotation during wide squats compared to the RG, attributed to weakened lower limb strength. The voting classifier, trained on the movement patterns from wide squats, determined that significant differences in overall movement patterns between the two groups persisted until the end of the exercise intervention. However, after the exercise intervention, significant improvements in lower limb strength in the PSG resulted in reduced knee rotation range of motion and max, thereby stabilizing movements and eliminating significant differences with the RG.
Conclusion
This study suggests that exercise interventions can modify the movement patterns in older individuals with possible sarcopenia. These findings provide fundamental data for developing an exercise management system that remotely tracks and monitors the movement patterns of older adults during exercise activities.

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