Hae-Rim Kim

Background: We investigated the roles of heated tobacco products (HTPs) and electronic cigarettes (ECs) in combustible cigarette (CCs) smoking initiation, relapse and cessation, as well as in all tobacco product discontinuation and transition of dual and triple use of CCs, HTPs and ECs. Method: Researchers analysed data from Korea National Health Insurance Service including 7 260 125 Korean adults who participated in three biennial health screenings between 2019 and 2023. Multivariable logistic regression analyses were performed to investigate the associations of HTPs and ECs use with initiation, relapse and cessation of CCs smoking and discontinuing all tobacco products, and transition probabilities were estimated to characterise changes in tobacco-use patterns. Results: Compared with participants who reported never using, those who reported current HTPs and ECs use had higher odds of initiation, relapse and cessation of CCs smoking, but lower odds of discontinuing all tobacco products. Among participants who reported dual use of CCs and HTPs, more than 70% transitioned to CCs’ use. Complete cessation of all tobacco products was less common among dual and triple users of HTPs, ECs and CCs than among exclusive CC users. Conclusion: Although HTPs and ECs use was associated with increased CCs smoking cessation, these products drive higher rates of CC initiation and relapse and lower rates of complete tobacco cessation. Most users of multiple tobacco products revert to CCs smoking and are less likely to successfully quit all tobacco use. The net public health impact of these evolving tobacco use patterns in Korea remains uncertain.

Background: People with disabilities (PWDs) have higher incidence and mortality rates of cardiovascular disease than non-PWDs. Considering the mutual influence of cardiovascular diseases and disabilities, careful observation and complementary management beyond standard treatments are essential when ischemic heart disease (IHD) occurs in PWDs. This study investigated the association between acupuncture treatment and reduced mortality in PWDs diagnosed with IHD. Methods: Using a database from the National Health Insurance Service of Korea, PWDs newly diagnosed with IHD were included in this study. Exposure to acupuncture treatment within one year after diagnosis was used to classify participants into the exposure and non-exposure groups, with follow-up for three years or until death. Propensity score matching (PSM) was used to adjust for group imbalances, and survival analysis was conducted using the Cox proportional hazards model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Dose-response and subgroup analyses were also performed. Results: After PSM, 38,157 PWDs were included in each group. The acupuncture group showed a significantly lower hazard of mortality, approximately 22% lower than that of the control group (adjusted HR 0.78, 95% CI 0.74–0.81). In the dose-response analysis, the group receiving the highest dose of acupuncture demonstrated the lowest hazard of mortality (adjusted HR 0.67, 95% CI 0.62–0.72). Most subgroups also showed a reduced mortality hazard in the acupuncture-treated groups, with the highest dose group exhibiting the lowest hazard. Conclusion: This study is a foundational investigation suggesting that acupuncture treatment is associated with reduced mortality in PWDs diagnosed with IHD. Although future research is needed to establish causality, acupuncture should be considered a beneficial option for managing IHD in PWDs.

Background/Objectives: The treatment options for endometriosis vary depending on individual needs and clinical circumstances. To preserve ovarian reserve, ethanol catheter-directed sclerotherapy may be considered as a treatment option. We compared the efficacy of catheter-directed sclerotherapy with that of surgical removal for the treatment of large ovarian endometriomas. Methods: This retrospective, single-center study was conducted at a tertiary care center. Patients diagnosed with ovarian endometriomas of >10 cm between 1 January 2019 and 5 December 2024 were included. Fifteen patients underwent catheter-directed sclerotherapy, and 69 underwent laparoscopic ovarian cystectomy or oophorectomy. The changes in ovarian cyst size, anti-Müllerian hormone levels, and cancer antigen 125 levels after six months of treatment were determined. Results: Before matched comparison, anti-Müllerian hormone levels decreased from 2.48 ng/mL to 1.11 ng/mL 6 months after surgical treatment. In the catheter-directed sclerotherapy group, anti-Müllerian hormone levels decreased from 1.33 ng/mL to 1.19 ng/mL. In the 1:1 matched comparison between the catheter-directed sclerotherapy and surgical groups, the anti-Müllerian hormone levels decreased by approximately −0.13 and −0.59 in the catheter-directed sclerotherapy and surgical groups, respectively. The relative reduction in the anti-Müllerian hormone levels was approximately −0.25 and −0.78 in the unilateral and bilateral ovarian surgery groups, respectively. In the surgical group, cyst size decreased to 0 cm six months after treatment, whereas CA-125 levels decreased from 62.10 U/mL to 11.20 U/mL. In the CDS group, cyst size reduced to 3.30 cm, whereas CA-125 levels decreased from 74.20 U/mL to 17.60 U/mL. Conclusions: Catheter-directed sclerotherapy preserves ovarian reserve more effectively than surgical treatment, even in cases of large endometriomas. It may be a promising treatment option for individuals with low anti-Müllerian hormone levels who are planning to conceive.

Nafamostat mesylate, an anticoagulant with a short half-life, is useful during hemodialysis for patients at high risk of bleeding. Research on the appropriate dosage of nafamostat has been insufficient. This study aimed to investigate the optimal dosage of nafamostat using a dosage prediction model. We retrospectively analyzed medical records from 12 centers affiliated with Yeolin Medical Foundation over an 8-month period. Candidate predictor variables were evaluated using bootstrapping and stepwise regression to determine feature importance. Predictive models were compared based on performance metrics. In total, 308 sessions from 88 patients without dialyzer clotting were selected. The average nafamostat dose was 21.90 ± 6.82 mg/h. The top four important features were oral anticoagulant use, dry body weight, age, and hemoglobin level. The best-performing model using 12 variables showed a root mean squared error of 4.11 mg/h and an adjusted R² value of 0.49. Multivariable linear regression showed that oral anticoagulant use (coefficient − 14.20, 95% confidence interval [CI] -18.28 to -10.12, P < 0.001) and age (-0.13, 95% CI -0.19 to -0.08, P < 0.001) were associated with a lower nafamostat dose, whereas dry body weight (coefficient 0.15, 95% CI 0.09 to 0.22, P < 0.001) and hemoglobin level (1.13, 95% CI 0.51 to 1.76, P < 0.001) were associated with a higher dose. The nafamostat dosage prediction model can be used to calculate the dose required for individual patients. However, further studies for model improvement and external validation are required. Not applicable.

Wonsock Kim, Hae-rim Kim, Woo-young Shin, Seo Young Kang, Sanghoon Oh, Youn Huh, Young Sik Kim. Korean J Fam Pract 2025;15:96-101. https://doi.org/10.21215/kjfp.2025.15.2.96

Background/Objectives: The prognosis of endometriosis-related ovarian clear cell carcinoma (OCCC) versus non-endometriosis-associated OCCC remains unclear. We examined the impact of endometriosis on OCCC diagnosis and progression and assessed whether prior surgical intervention for endometriotic ovarian cysts affects prognosis. Methods: In this retrospective study (2006–2024), OCCC patients were classified as non-endometriosis-associated or endometriosis-related. A subgroup analysis compared endometriosis-related OCCC patients with and without a history of endometriotic ovarian cyst surgery. Results: The average CA-125 level was 104.20 (29.90, 347.70) in the non-endometriosis-associated OCCC group and 80.70 (32.40, 247.90) in the endometriosis-related OCCC group (p = 0.32). Early-stage diagnosis occurred in 62.77% and 75.21% of these groups, respectively (p = 0.046). The average age at diagnosis was 53.95 ± 9.71 years for the non-endometriosis-associated group and 45.68 ± 7.98 years for the endometriosis-related group (p < 0.001). Mortality or poor prognosis was observed in 24.11% and 17.80% of these groups, respectively (p = 0.226). In endometriosis-related OCCC, comparisons were made between patients with and without a history of endometriotic ovarian cyst surgery. The average age at diagnosis was 45.84 ± 8.24 years for those without a surgical history and 44.71 ± 6.35 years for those with a surgical history (p = 0.59). Early-stage diagnosis was observed in 77.23% and 62.50%, respectively (p = 0.339). Mortality or poor prognosis occurred in 14.85% of those without a surgical history and 35.29% of those with a surgical history (p = 0.008). The hazard ratio for women with a surgical history was 3.48 (1.29–8.69) (p = 0.008). The incidence rate was 3.17 per 1000 person-years (PYRs) for individuals without surgery and 13.36 per 1000 PYRs for those with a history of surgical intervention (p = 0.008). Conclusions: Endometriosis did not impact the prognosis of women with OCCC. However, women with endometriosis-related OCCC were diagnosed at earlier stages and at younger ages. A history of endometriotic ovarian cyst surgery did not influence OCCC detection but was linked to poorer survival outcomes.