1.Impact of Early Continuous Kidney Replacement Therapy in Patients With Sepsis-Associated Acute Kidney Injury:An Analysis of the MIMIC-IV Database
Yongseop LEE ; Jun Hye SEO ; Jaeeun SEONG ; Sang Min AHN ; Min HAN ; Jung Ah LEE ; Jung Ho KIM ; Jin Young AHN ; Su Jin JEONG ; Jun Yong CHOI ; Joon-Sup YEOM ; Hyung Jung OH ; Nam Su KU
Journal of Korean Medical Science 2024;39(43):e276-
Background:
Renal replacement therapy (RRT) is an important treatment option for sepsisassociated acute kidney injury (AKI); however, the optimal timing for its initiation remains controversial. Herein, we investigated the clinical outcomes of early continuous kidney replacement therapy (CKRT), defined as CKRT initiation within 6 hours of sepsis-associated AKI onset, which was earlier than the initiation time defined in previous studies.
Methods:
We used clinical data sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. This study included patients aged ≥ 18 years who met the sepsis diagnostic criteria and received CKRT because of stage 2 or 3 AKI. Early and late CKRTs were defined as CKRT initiation within 6 hours and after 6 hours of the development of sepsisassociated AKI, respectively.
Results:
Of the 33,236 patients diagnosed with sepsis, 553 underwent CKRT for sepsisassociated AKI. After excluding cases of early mortality and patients with a dialysis history, 45 and 334 patients were included in the early and late CKRT groups, respectively. After propensity score matching, the 28-day mortality rate was significantly lower in the early CKRT group than in the late CKRT group (26.7% vs. 43.9%, P = 0.035). The early CKRT group also had a significantly greater number of days free of mechanical ventilation (median, 19; interquartile range [IQR], 3–25) and vasopressor administration (median, 21; IQR, 5–26) than the late CKRT group did (median, 10.5; IQR, 0–23; P = 0.037 and median, 13.5;IQR, 0–25; P = 0.028, respectively). The Kaplan–Meier curve also showed that early CKRT initiation was associated with an improved 28-day mortality rate (log-rank test, P = 0.040).In contrast, there was no significant difference in the 28-day mortality between patients who started CKRT within 12 hours and those who did not (log-rank test, P = 0.237).
Conclusion
Early CKRT initiation improved the survival of patients with sepsis-associated AKI. Initiation of CKRT should be considered as early as possible after sepsis-associated AKI onset, preferably within 6 hours.
2.Impact of Early Continuous Kidney Replacement Therapy in Patients With Sepsis-Associated Acute Kidney Injury:An Analysis of the MIMIC-IV Database
Yongseop LEE ; Jun Hye SEO ; Jaeeun SEONG ; Sang Min AHN ; Min HAN ; Jung Ah LEE ; Jung Ho KIM ; Jin Young AHN ; Su Jin JEONG ; Jun Yong CHOI ; Joon-Sup YEOM ; Hyung Jung OH ; Nam Su KU
Journal of Korean Medical Science 2024;39(43):e276-
Background:
Renal replacement therapy (RRT) is an important treatment option for sepsisassociated acute kidney injury (AKI); however, the optimal timing for its initiation remains controversial. Herein, we investigated the clinical outcomes of early continuous kidney replacement therapy (CKRT), defined as CKRT initiation within 6 hours of sepsis-associated AKI onset, which was earlier than the initiation time defined in previous studies.
Methods:
We used clinical data sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. This study included patients aged ≥ 18 years who met the sepsis diagnostic criteria and received CKRT because of stage 2 or 3 AKI. Early and late CKRTs were defined as CKRT initiation within 6 hours and after 6 hours of the development of sepsisassociated AKI, respectively.
Results:
Of the 33,236 patients diagnosed with sepsis, 553 underwent CKRT for sepsisassociated AKI. After excluding cases of early mortality and patients with a dialysis history, 45 and 334 patients were included in the early and late CKRT groups, respectively. After propensity score matching, the 28-day mortality rate was significantly lower in the early CKRT group than in the late CKRT group (26.7% vs. 43.9%, P = 0.035). The early CKRT group also had a significantly greater number of days free of mechanical ventilation (median, 19; interquartile range [IQR], 3–25) and vasopressor administration (median, 21; IQR, 5–26) than the late CKRT group did (median, 10.5; IQR, 0–23; P = 0.037 and median, 13.5;IQR, 0–25; P = 0.028, respectively). The Kaplan–Meier curve also showed that early CKRT initiation was associated with an improved 28-day mortality rate (log-rank test, P = 0.040).In contrast, there was no significant difference in the 28-day mortality between patients who started CKRT within 12 hours and those who did not (log-rank test, P = 0.237).
Conclusion
Early CKRT initiation improved the survival of patients with sepsis-associated AKI. Initiation of CKRT should be considered as early as possible after sepsis-associated AKI onset, preferably within 6 hours.
3.Impact of Early Continuous Kidney Replacement Therapy in Patients With Sepsis-Associated Acute Kidney Injury:An Analysis of the MIMIC-IV Database
Yongseop LEE ; Jun Hye SEO ; Jaeeun SEONG ; Sang Min AHN ; Min HAN ; Jung Ah LEE ; Jung Ho KIM ; Jin Young AHN ; Su Jin JEONG ; Jun Yong CHOI ; Joon-Sup YEOM ; Hyung Jung OH ; Nam Su KU
Journal of Korean Medical Science 2024;39(43):e276-
Background:
Renal replacement therapy (RRT) is an important treatment option for sepsisassociated acute kidney injury (AKI); however, the optimal timing for its initiation remains controversial. Herein, we investigated the clinical outcomes of early continuous kidney replacement therapy (CKRT), defined as CKRT initiation within 6 hours of sepsis-associated AKI onset, which was earlier than the initiation time defined in previous studies.
Methods:
We used clinical data sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. This study included patients aged ≥ 18 years who met the sepsis diagnostic criteria and received CKRT because of stage 2 or 3 AKI. Early and late CKRTs were defined as CKRT initiation within 6 hours and after 6 hours of the development of sepsisassociated AKI, respectively.
Results:
Of the 33,236 patients diagnosed with sepsis, 553 underwent CKRT for sepsisassociated AKI. After excluding cases of early mortality and patients with a dialysis history, 45 and 334 patients were included in the early and late CKRT groups, respectively. After propensity score matching, the 28-day mortality rate was significantly lower in the early CKRT group than in the late CKRT group (26.7% vs. 43.9%, P = 0.035). The early CKRT group also had a significantly greater number of days free of mechanical ventilation (median, 19; interquartile range [IQR], 3–25) and vasopressor administration (median, 21; IQR, 5–26) than the late CKRT group did (median, 10.5; IQR, 0–23; P = 0.037 and median, 13.5;IQR, 0–25; P = 0.028, respectively). The Kaplan–Meier curve also showed that early CKRT initiation was associated with an improved 28-day mortality rate (log-rank test, P = 0.040).In contrast, there was no significant difference in the 28-day mortality between patients who started CKRT within 12 hours and those who did not (log-rank test, P = 0.237).
Conclusion
Early CKRT initiation improved the survival of patients with sepsis-associated AKI. Initiation of CKRT should be considered as early as possible after sepsis-associated AKI onset, preferably within 6 hours.
4.Impact of Early Continuous Kidney Replacement Therapy in Patients With Sepsis-Associated Acute Kidney Injury:An Analysis of the MIMIC-IV Database
Yongseop LEE ; Jun Hye SEO ; Jaeeun SEONG ; Sang Min AHN ; Min HAN ; Jung Ah LEE ; Jung Ho KIM ; Jin Young AHN ; Su Jin JEONG ; Jun Yong CHOI ; Joon-Sup YEOM ; Hyung Jung OH ; Nam Su KU
Journal of Korean Medical Science 2024;39(43):e276-
Background:
Renal replacement therapy (RRT) is an important treatment option for sepsisassociated acute kidney injury (AKI); however, the optimal timing for its initiation remains controversial. Herein, we investigated the clinical outcomes of early continuous kidney replacement therapy (CKRT), defined as CKRT initiation within 6 hours of sepsis-associated AKI onset, which was earlier than the initiation time defined in previous studies.
Methods:
We used clinical data sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. This study included patients aged ≥ 18 years who met the sepsis diagnostic criteria and received CKRT because of stage 2 or 3 AKI. Early and late CKRTs were defined as CKRT initiation within 6 hours and after 6 hours of the development of sepsisassociated AKI, respectively.
Results:
Of the 33,236 patients diagnosed with sepsis, 553 underwent CKRT for sepsisassociated AKI. After excluding cases of early mortality and patients with a dialysis history, 45 and 334 patients were included in the early and late CKRT groups, respectively. After propensity score matching, the 28-day mortality rate was significantly lower in the early CKRT group than in the late CKRT group (26.7% vs. 43.9%, P = 0.035). The early CKRT group also had a significantly greater number of days free of mechanical ventilation (median, 19; interquartile range [IQR], 3–25) and vasopressor administration (median, 21; IQR, 5–26) than the late CKRT group did (median, 10.5; IQR, 0–23; P = 0.037 and median, 13.5;IQR, 0–25; P = 0.028, respectively). The Kaplan–Meier curve also showed that early CKRT initiation was associated with an improved 28-day mortality rate (log-rank test, P = 0.040).In contrast, there was no significant difference in the 28-day mortality between patients who started CKRT within 12 hours and those who did not (log-rank test, P = 0.237).
Conclusion
Early CKRT initiation improved the survival of patients with sepsis-associated AKI. Initiation of CKRT should be considered as early as possible after sepsis-associated AKI onset, preferably within 6 hours.
5.Clinical Practice Recommendations for the Use of Next-Generation Sequencing in Patients with Solid Cancer: A Joint Report from KSMO and KSP
Miso KIM ; Hyo Sup SHIM ; Sheehyun KIM ; In Hee LEE ; Jihun KIM ; Shinkyo YOON ; Hyung-Don KIM ; Inkeun PARK ; Jae Ho JEONG ; Changhoon YOO ; Jaekyung CHEON ; In-Ho KIM ; Jieun LEE ; Sook Hee HONG ; Sehhoon PARK ; Hyun Ae JUNG ; Jin Won KIM ; Han Jo KIM ; Yongjun CHA ; Sun Min LIM ; Han Sang KIM ; Choong-kun LEE ; Jee Hung KIM ; Sang Hoon CHUN ; Jina YUN ; So Yeon PARK ; Hye Seung LEE ; Yong Mee CHO ; Soo Jeong NAM ; Kiyong NA ; Sun Och YOON ; Ahwon LEE ; Kee-Taek JANG ; Hongseok YUN ; Sungyoung LEE ; Jee Hyun KIM ; Wan-Seop KIM
Cancer Research and Treatment 2024;56(3):721-742
In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.
6.Clinical practice recommendations for the use of next-generation sequencing in patients with solid cancer: a joint report from KSMO and KSP
Miso KIM ; Hyo Sup SHIM ; Sheehyun KIM ; In Hee LEE ; Jihun KIM ; Shinkyo YOON ; Hyung-Don KIM ; Inkeun PARK ; Jae Ho JEONG ; Changhoon YOO ; Jaekyung CHEON ; In-Ho KIM ; Jieun LEE ; Sook Hee HONG ; Sehhoon PARK ; Hyun Ae JUNG ; Jin Won KIM ; Han Jo KIM ; Yongjun CHA ; Sun Min LIM ; Han Sang KIM ; Choong-Kun LEE ; Jee Hung KIM ; Sang Hoon CHUN ; Jina YUN ; So Yeon PARK ; Hye Seung LEE ; Yong Mee CHO ; Soo Jeong NAM ; Kiyong NA ; Sun Och YOON ; Ahwon LEE ; Kee-Taek JANG ; Hongseok YUN ; Sungyoung LEE ; Jee Hyun KIM ; Wan-Seop KIM
Journal of Pathology and Translational Medicine 2024;58(4):147-164
In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.
7.Psychometric Properties of the Korean Version of Functioning Assessment Short Test in Bipolar Disorder
Hangoeunbi KANG ; Bo-Hyun YOON ; Won-Myong BAHK ; Young Sup WOO ; Won KIM ; Jonghun LEE ; InKi SOHN ; Sung-Yong PARK ; Duk-In JON ; Myung Hun JUNG ; Moon-Doo KIM ; Young-Eun JUNG ; Hyung-Mo SUNG ; Young-Min PARK ; Jung Goo LEE ; Sang-Yeol LEE ; Seung-Ho JANG ; Eun-Sung LIM ; In Hee SHIM ; Kwanghun LEE ; Sae-Heon JANG
Clinical Psychopharmacology and Neuroscience 2023;21(1):188-196
Objective:
The Functioning Assessment Short Test (FAST) is a relatively specific test for bipolar disorders designed to assess the main functioning problems experienced by patients. This brief instrument includes 24 items assessing impairment or disability in 6 domains of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time. It has already been translated into standardized versions in several languages. The aim of this study is to measure the validity and reliability of the Korean version of FAST (K-FAST).
Methods:
A total of 209 bipolar disorder patients were recruited from 14 centers in Korea. K-FAST, Young Mania Rating Scale (YMRS), Bipolar Depression Rating Scale (BDRS), Global Assessment of Functioning (GAF) and the World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were administered, and psychometric analysis of the K-FAST was conducted.
Results:
The internal consistency (Cronbach’s alpha) of the K-FAST was 0.95. Test-retest reliability analysis showed a strong correlation between the two measures assessed at a 1-week interval (ICC = 0.97; p < 0.001). The K-FAST exhibited significant correlations with GAF (r = −0.771), WHOQOL-BREF (r = −0.326), YMRS (r = 0.509) and BDRS (r = 0.598). A strong negative correlation with GAF pointed to a reasonable degree of concurrent validity. Although the exploratory factor analysis showed four factors, the confirmatory factor analysis of questionnaires had a good fit for a six factors model (CFI = 0.925; TLI = 0.912; RMSEA = 0.078).
Conclusion
The K-FAST has good psychometric properties, good internal consistency, and can be applicable and acceptable to the Korean context.
8.The Essential Function of miR-5739 in Embryonic Muscle Development
Ji-Heon LEE ; Min Sup KIM ; Jin-seop LEE ; Dong Hyun LEE ; Chansol PARK ; Dong Hyuk LEE ; Eun-Young KIM ; Hyung Min CHUNG
International Journal of Stem Cells 2023;16(2):145-155
Background and Objectives:
Embryologically, mesodermal development is closely related to the development of various organs such as muscles, blood vessels, and hearts, which are the main organs that make up the body. However, treatment for mesoderm developmental disorders caused by congenital or acquired factors has so far relied on surgery and drug treatment for symptom relief, and more fundamentally, treatment for mesoderm developmental disorders is needed.
Methods:
and Results: In our study, microRNA (miRNA), which plays an important role in the mesoderm development process, was identified and the developmental function was evaluated. miRNAs consist of small nucleotides, which act as transcription factors that bind to the 3’ untranslated region and suppressed target gene expression. We constructed the human embryonic stem cell (hESC) knockout cell line and analyzed the function and characteristics of miR-5739, which plays an important role in mesoderm lineage. miR-5739 acts as a transcription factor targeting SMA, Brachyury T, Hand1, which controls muscle proliferation and differentiation, and KDR gene, which regulates vessel formation in vitro. In vivo results suggest a role in regulating muscle proliferation and differentiation. Gene ontology analysis confirmed that the miR-5739 is closely related to genes that regulate muscle and vessel proliferation and differentiation. Importantly, abnormal expression of miR-5739 was detected in somatic cells derived from patients with congenital muscle disease.
Conclusions
Our study demonstrate that miR-5739 gene function significantly affects transcriptional circuits that regu-late muscle and vascular differentiation during embryonic development.
9.Prevalence and Comorbidities of Adult Attention-deficit/ hyperactivity Disorder in a Community Sample from Korea
Young Sup WOO ; Jung Wan HONG ; Se-Hoon SHIM ; Hyung Mo SUNG ; Jeong Seok SEO ; Sung-Yong PARK ; Jung Goo LEE ; Bo-Hyun YOON ; Won-Myong BAHK
Clinical Psychopharmacology and Neuroscience 2023;21(4):798-807
Objective:
Attention-deficit/hyperactivity disorder (ADHD) is prevalent in adults, and psychiatric comorbidities are common in adults with ADHD. We aimed to examine the prevalence of adult ADHD with several common psychiatric conditions in a community sample in Korea and the association between adult ADHD and risk of psychiatric comorbidities.
Methods:
This study used a cross-sectional survey design. We provided supplementary and optional self-report questionnaires, including the Korean version of the World Health Organization Adult ADHD Self-Report Scale (ASRS) short screening scale, Patient Health Questionnaire-9 for screening for depression, Alcohol Use Disorders Identification Test alcohol consumption questions, and the Korean version of the Mood Disorders Questionnaire, to Korean adults who visited one of six centers of a large private healthcare company for the National General Health Examination.
Results:
A total of 17,799 subjects included in this study, and 430 (2.4%) were positive on the ASRS screen. ADHD was significantly associated with the 19−30-year-old age group (odds ratio [OR] = 3.938), lower income (OR = 1.298), depression (OR = 11.563), and bipolar disorder (OR = 3.162).
Conclusion
Adult ADHD was highly associated with depression and bipolar disorder, suggesting that clinicians should carefully evaluate and treat such psychiatric disorders in adults with ADHD symptoms.
10.Comparison between Atomoxetine and OROS Methylphenidate as an Adjunctive to SSRIs in Attention-deficit/Hyperactivity Disorder Adults with Comorbid Partially Responsive Major Depressive Disorder: A Head-to-head, 12-week, Randomized, Rater-blinded Clinical Trial
Se-hoon SHIM ; Young Sup WOO ; Ji Sun KIM ; In Soo HEO ; Hee-jung YOON ; Hyung Mo SUNG ; Jonghun LEE ; Won-Myong BAHK
Clinical Psychopharmacology and Neuroscience 2022;20(1):143-153
Objective:
This study aimed to compare the efficacy and safety of atomoxetine (ATX) and OROS methylphenidate (MPH) as adjunctive to selective serotonin reuptake inhibitors (SSRIs) in adults with attention-deficit hyperactivity disorder (ADHD) with comorbid partially responsive major depressive disorder (MDD).
Methods:
Sixty Korean adults with ADHD and comorbid partially responsive MDD were recruited in a 12-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to ATX or OROS MPH treatment.
Results:
Depressive symptoms measured using the Hamilton Depression Rating Scale and Clinically Useful Depression Outcome Scale, and ADHD symptoms measured using the Adult ADHD Self-Report Scale, as well as the Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and the Sheehan Disability Scale scores were significantly improved in both groups during the 12 weeks of treatment. The changes in all outcome measures during the 12-week treatment were not significantly different between the two groups (all p > 0.05). No serious adverse events were reported and there were no significant differences in systolic and diastolic blood pressure, pulse rate, weight, or body mass index between the ATX and MPH groups.
Conclusion
Our findings suggest that ATX and MPH can be used as adjunctive treatments in adults with ADHD and comorbid partially responsive MDD. The efficacy and tolerability of ATX and MPH in adults with ADHD did not differ significantly. Further studies should be conducted to draw a definitive conclusion.

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