Dong Wook Kim

Objectives: Cardiovascular disease (CVD) co-occurs with multiple chronic conditions, but their structural relationships remain underexplored. This study aimed to explore the comorbidity patterns and disease network structures of CVD patients using nationwide claims data, with attention to differences by sex.Methods: Using National Health Insurance Service claims data from 2002 to 2019, adults diagnosed with CVD (KCD: I20-25) were identified, and comorbidities recorded before the first CVD diagnosis were extracted. Sex-specific odds ratios with 95% confidence intervals were calculated, and disease networks were constructed for the CVD, myocardial infarction (MI), and ischemic heart disease (IHD) groups, with each disease as the central node and the top 10 comorbidities as surrounding nodes.Results: Essential hypertension and type 2 diabetes showed positive associations with CVD and were prominently represented in the disease networks in both sexes. Both associations were stronger in women, with odds ratios for hypertension of 1.379 in men and 1.887 in women, and for diabetes of 1.885 and 2.454, respectively. Similar patterns were observed in the MI and IHD groups, with hypertension and type 2 diabetes showing consistently positive associations in both sexes. Sex-specific differences were also evident: knee osteoarthritis and dyslipidemia were more prominent in women, with odds ratios of 1.796 and 1.296, whereas benign prostatic hyperplasia showed the highest association in men, with an odds ratio of 2.271.Conclusions: Comorbidity structures in CVD patients differed by sex. These findings suggest the importance of early detection and continuous management of hypertension and diabetes, and support sex-specific approaches to chronic disease management in CVD patients.

Objectives: To assess age-specific effectiveness of dual-focus soft contact lenses (MiSight) and orthokeratology (Ortho-K) in slowing myopia progression over 18 months in pediatric patients, emphasizing axial length (AL) changes. Methods: Retrospective analysis of 239 eyes from 123 myopic pediatric patients (aged 8–18 years) (MiSight: 137 eyes; Ortho-K: 102 eyes), stratified by age (younger: ≤10 vs. older: >10 years). Primary outcome was AL elongation measured by IOL Master. Secondary outcomes included spherical equivalent (SE), keratometry, and cylinder power (CYL) through autorefraction. Orthokeratology measurements were taken during treatment without washout, limiting direct refractive comparisons. Linear mixed models were used for intragroup changes, and general linear model adjustment was applied for baseline imbalances in AL and CYL. Results: Despite significant baseline imbalances (MiSight group had longer AL and more myopic SE), GLM-adjusted analysis showed modestly lower overall annualized AL elongation with MiSight (0.20 mm/year) compared with Ortho-K (0.24 mm/year). In older children (older than 10 years), MiSight was associated with lower AL progression, particularly between 6 to 12 months (0.07 vs. 0.11 mm/6–months, P =0.012). In younger children (10 years and younger), adjusted AL elongation rates were comparable between groups. MiSight maintained relatively stable refractive parameters, while Ortho-K induced corneal flattening but progressive worsening of CYL. Conclusions: This age-stratified retrospective comparison demonstrated modestly lower axial elongation with MiSight after adjustment for baseline differences, particularly in older children (older than 10 years). These findings suggest potential age-dependent differences in treatment response between the two modalities and highlight the importance of individualized myopia management strategies.

Purpose: To evaluate the short-term efficacy and optical performance of the ZEISS CT LUCIA 621P intraocular lens (IOL) in cataract patients using a diopter (D)-stratified approach. Patients and Methods: This retrospective study included 304 eyes of 216 patients who underwent phacoemulsification with CT LUCIA 621P implantation. Eyes were stratified into four groups by implanted IOL power: Group 1 (< 20.0 D, n=49), Group 2 (20.0– 21.5 D, n=137), Group 3 (22.0– 23.5 D, n=60), and Group 4 (≥ 24.0 D, n=58). Primary outcomes were monocular and binocular photopic/mesopic defocus curves and internal higher-order aberrations (HOAs) at 1 and 3 months because these directly evaluate the optical quality and depth of focus delivered by the non-constant aspheric ZEISS Optic design—the core innovative feature of the CT LUCIA 621P IOL—across the full spectrum of implanted powers. Secondary outcomes provide complementary clinical efficacy data; uncorrected and corrected distance visual acuity (UDVA/CDVA), uncorrected intermediate (UIVA) and near (UNVA), refractive predictability, and contrast sensitivity (CS). Analyses used generalized estimating equations (GEE) with an exchangeable correlation structure. Results: All groups achieved excellent refractive predictability with convergence of spherical equivalent (SE) toward emmetropia (p=0.398). Mean monocular UDVA at 3 months was comparable across groups (p=0.498). Monocular and binocular UIVA and UNVA were also comparable (all p> 0.23). Photopic and mesopic defocus curves showed similar depth of focus across groups (p> 0.05 at most levels). Postoperative spherical aberration (SA) and coma remained low with no significant inter-group differences after generalized GEE adjustment (p> 0.17). Photopic CS was comparable across IOL power groups at most spatial frequencies. Conclusion: The CT LUCIA 621P IOL demonstrated consistent refractive predictability, VA across distances, and optical quality across a wide range of implanted powers, supporting its reliable use in contemporary cataract surgery.

Purpose: Cataracts and presbyopia affect millions worldwide, driving demand for advanced intraocular lenses (IOLs) to restore vision and reduce spectacle dependence. Extended depth of focus (EDoF) IOLs, such as Clareon Vivity and TECNIS PureSee, provide continuous vision with minimal disturbances. Given limited direct clinical comparisons, this research offers a head-to-head analysis of their visual performance and optical stability in cataract patients. Patients and Methods: This retrospective cohort study analyzed 106 eyes from 72 patients who underwent phacoemulsification with Clareon Vivity or TECNIS PureSee IOL implantation. Primary outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected intermediate VA (UIVA) at 66/80 cm, uncorrected near VA (UNVA) at 40 cm, and longitudinal internal higher-order aberrations (HOAs), specifically total coma. Refractive error (spherical/cylindrical powers [SPH/CYL], spherical equivalent [SE]) and defocus curve (+1.5 D to – 3.5 D under mesopic/photopic conditions) were measured at 1 and 3 months postoperatively; HOAs (spherical aberration [SA], coma) and pupil size were assessed at 1 week, 1 month, and 3 months, and contrast sensitivity (CS; 1.5– 18 cpd) at 1 month using standardized equipment. Results: Both IOLs significantly improved UDVA (p < 0.05). Clareon Vivity showed superior monocular UIVA at 80 cm at 1 and 3 months (p = 0.0042 and p = 0.0711, respectively), comparable UIVA at 66 cm and UNVA at 40 cm, a broader defocus range (+0.5 D to – 2.0 D), and lower total coma at 1 and 3 months (p = 0.001 and p = 0.0097) with reduced variability, emphasizing mid-range vision and optical stability advantages. TECNIS PureSee exhibited comparable refractive outcomes and CS, with initial superiority in monocular UNVA at 40 cm at 1 month (p < 0.05), providing robust early near vision. Conclusion: Clareon Vivity excels in intermediate vision, defocus tolerance, and coma stability, while TECNIS PureSee offers strong initial near focus. These differences suggest Clareon Vivity may be particularly suitable for patients prioritizing mid-range stability, while both IOLs provide excellent overall visual performance.

Impact of Socioeconomic Status on the Risk of Disability Registration and Cognitive Decline in Patients with Parkinson’s Disease: A Nationwide Cohort Study

Objectives: Adolescents’ dietary habits significantly affect both physical and mental health. This study aims to develop a total dietary score based on key eating behaviors and to examine its association with mental health among Korean adolescents. Methods: Data from the 2022-2024 Korea Youth Risk Behavior Survey were analyzed. Five dietary behaviors were scored using a nomogram derived from logistic regression predicting subjective health awareness. The total score was used to assess associations with mental health via complex-sample logistic regression. Results: Higher total dietary scores were significantly associated with lower risks of subjective stress (OR=0.986, 95% CI: 0.985-0.987) and sleep deprivation (OR=0.985, 95% CI: 0.984-0.986). Increased scored were also linked to reduced risks for other mental health, including sleep disturbance and suicidal ideation. Conclusions: A nomogrambased total dietary score showed significant associations with various mental health problems among adolescents. This score may be a useful tool for a early identification of high-risk groups and could inform future intervention for adolescents mental health promotion.

Cancer Public Library Database (CPLD) links data from four major population-based public sources: the Korea National Cancer Incidence Database in the Korea Central Cancer Registry, cause-of-death data in Statistics Korea, the National Health Information Database in the National Health Insurance Service, and the National Health Insurance Research Database in the Health Insurance Review & Assessment Service. The National Cancer Data Center has developed a new nationally representative sample cohort dataset from Korean Clinical Data Utilization for Research Excellence project (K-CURE) CPLD: Stomach Cancer Sample Cohort, Breast Cancer Sample Cohort, Colorectal Cancer Sample Cohort, and Liver Cancer Sample Cohort. The sample populations consisted of approximately 21% of all cancer patients from 2012 to 2019. The populations of the Stomach Cancer Sample Cohort, Breast Cancer Sample Cohort, Colorectal Cancer Sample Cohort, and Liver Cancer Sample Cohort were 51,951, 39,586, 53,485, and 27,375 patients, respectively. The dataset included cancer incidence information, demographics, socioeconomic variables, health utilization data (procedures, diagnoses, and medications), general health checkup data, cancer screening data before and after the cancer incidence, as well as death information. These cohorts could help researchers analyze time-to-event data on mortality, treatment outcomes, comorbid conditions following a cancer diagnosis, and cancer incidence risk factors. The data can be accessed through the K-CURE portal (https://k-cure.mohw.go.kr/).

SD, standard deviation; BMI, body mass index.

Kim DW. J Korean Med Sci. 2025 Feb;40:e110. https://doi.org/10.3346/jkms.2025.40.e110

Purpose: This study investigates the impact of varying degrees of immunosuppression on the clinical outcomes of immunocompromised individuals, particularly those with autoimmune diseases or post-solid organ transplant statuses, in the context of COVID-19. By focusing on these highly vulnerable populations, the study underscores the significant health inequalities faced by immunocompromised patients, who experience disproportionately worse outcomes in comparison to the general population. Methods: A retrospective cohort analysis of the K-COV-N dataset was conducted, comparing the effects of immunosuppression in autoimmune and transplant groups with matched control groups. Propensity score matching was employed to minimize inequalities in baseline characteristics, ensuring a more equitable comparison between immunocompromised and non-immunocompromised individuals. Outcomes included COVID-19-related in-hospital mortality, 28-day mortality, ICU admissions, and the need for respiratory support among 323,890 adults in the Republic of Korea. Patients with cancer or other immunosuppressive conditions, such as HIV, were excluded. Subgroup analyses assessed the influence of specific immunosuppressive medications and vaccination extent. Results: Significantly elevated in-hospital mortality was found for patients with autoimmune diseases (adjusted Odds Ratio [aOR] 2.749) and transplant recipients (aOR 7.567), with similar patterns in other outcomes. High-dose steroid use and a greater number of immunosuppressant medications markedly increased the risk of poor outcomes. Vaccination emerged as a protective factor, with a single dose substantially improving outcomes for autoimmune patients and at least two doses necessary for transplant recipients. Conclusions: Immunocompromised patients, particularly those with autoimmune diseases and transplant recipients, are highly vulnerable to severe COVID-19 outcomes. High-dose steroid use and multiple immunosuppressants further increase risks. Vaccination significantly improves outcomes, with at least one dose benefiting autoimmune patients and two doses necessary for transplant recipients. Personalized vaccination schedules based on immunosuppression levels are essential to mitigate healthcare inequalities and improve outcomes, particularly in underserved populations, informing both clinical and public health strategies.