Kosin Medical Journal

Volume 40(2); June 2025

Editorial

Oral contraceptives: balancing intended use with metabolic syndrome risk: Bukyung Kim; Kosin Med J. 2025;40(2):85-87. Published online June 30, 2025; DOI: https://doi.org/10.7180/kmj.25.117

164 View
5 Download

PDF PubReader ePub

Review articles

The role of the interatrial shunt device in the treatment of patients with heart failure with preserved ejection fraction: experience from the REDUCE LAP-HF studies: Bong-Joon Kim; Kosin Med J. 2025;40(2):88-95. Published online February 17, 2025; DOI: https://doi.org/10.7180/kmj.24.150

780 View
13 Download

Abstract PDF PubReader ePub: Heart failure with preserved ejection fraction (HFpEF) is characterized by increased left ventricular filling pressure and elevated left atrial pressure. Despite advances in medical treatments, the management of HFpEF patients is often challenging due to multiple comorbidities, leading to polypharmacy and associated side effects. Consequently, there is an increasing demand for procedural or device-based therapies in HFpEF management. Over the past decade, the transcatheter interatrial shunt device (IASD), designed to create a passage between the left atrium and the right atrium, has emerged as a novel therapeutic option. The IASD offers potential benefits by reducing left atrial pressure at rest and during exercise. The efficacy and safety of the IASD were demonstrated in the REDUCE LAP-HF (Reduce Left Atrial Pressure in Patients with Heart Failure) study series. Furthermore, IASD has been shown to support positive cardiac remodeling. With the availability of more data, appropriate indications for the use of IASDs are becoming more evident, and criteria for patient selection in future studies are needed.

Postoperative scar management: Jinyong Shin, Yoonsoo Kim, Hongil Kim, Jinhyung Park, Hyungsuk Yi; Kosin Med J. 2025;40(2):96-105. Published online June 20, 2025; DOI: https://doi.org/10.7180/kmj.25.107

467 View
8 Download

Abstract PDF PubReader ePub: Postoperative scars inevitably occur after surgical procedures and can impact both aesthetic and functional aspects of healing. With advancements in medical research, various strategies have been developed to prevent and manage surgical scars. This review explores mechanisms of wound healing, the classification of postoperative scars, and the latest approaches in scar prevention and treatment. The wound healing process consists of the following phases: hemostasis, inflammation, proliferation, and maturation. Understanding this process is essential for effective scar management. Factors such as tension, infection, and individual patient characteristics can influence scar formation. Preventive strategies, including optimal suture techniques, taping methods, silicone therapy, and corticosteroid injections, have demonstrated significant benefits in minimizing scar severity. Additionally, advanced treatments such as laser therapy and surgical scar revision techniques, including Z-plasty and W-plasty, offer effective solutions for improving established scars. Relaxed skin tension lines in surgical planning also play a crucial role in minimizing scar prominence. Evidence suggests that a multidisciplinary approach that integrates prevention and treatment modalities can optimize wound healing and improve patient outcomes. Implementing these evidence-based strategies can significantly improve postoperative scar management, ultimately enhancing both functional and cosmetic results for patients.

Clinical applications and advancements in noninvasive prenatal diagnosis: Sul Lee, Jin Hyuk Choi, Jong Hyouk Yun, Su Hwan Kang, Jesang Yu, Jihun Kang, Chang Zoo Kim, Taek Yong Ko, Hanggoo Yun; Kosin Med J. 2025;40(2):106-115. Published online June 30, 2025; DOI: https://doi.org/10.7180/kmj.25.118

274 View
2 Download

Abstract PDF PubReader ePub: Noninvasive prenatal testing (NIPT) is widely performed and enables the detection of fetal chromosomal abnormalities through the analysis of cell-free fetal DNA in maternal blood. Since its introduction in 2011, NIPT has demonstrated high sensitivity and specificity for common trisomies (trisomy 21, trisomy 18, trisomy 13), and its scope has rapidly expanded to include sex chromosome aneuploidies, microdeletion syndromes, and single-gene disorders. However, the widespread adoption of NIPT has brought new challenges, including technical limitations (e.g., low fetal fraction, placental mosaicism), interpretation of variants of uncertain significance, and ethical concerns related to over-screening and patient anxiety. This review summarizes the historical evolution, technical advances, clinical applications, limitations, and future perspectives of NIPT, emphasizing the need for balanced clinical implementation and ongoing innovation.

Original articles

The conservative management of ovarian endometrioma using cyst aspiration followed by dienogest medication: a pilot study: Ha Eun Jung, Eun Hee Yu, Hyun Joo Lee, Jong Kil Joo, Yong Jin Na; Kosin Med J. 2025;40(2):116-121. Published online March 27, 2025; DOI: https://doi.org/10.7180/kmj.24.149

378 View
5 Download

Abstract PDF PubReader ePub: Background
The aim of this study was to evaluate the efficacy of ultrasonography-guided cyst aspiration followed by dienogest medication in the management of endometriomas in selected patients.
Methods
This study included 38 female patients diagnosed with endometrioma via transvaginal ultrasonography or pelvic magnetic resonance imaging. We performed needle aspiration of the contents of endometrioma followed by the administration of dienogest (2 mg) daily orally, and assessed changes in endometrioma size, cancer antigen 125, anti-Müllerian hormone, and a visual analog scale score for dysmenorrhea before and 3 months after the procedure.
Results
The diameter of the ovarian cysts decreased from a maximum of 4.35 cm before the procedure to 2.37 cm on follow-up ultrasonography, and seven of 56 endometriomas in 38 patients resolved completely as evaluated on transvaginal ultrasonography. Malignant cells were not found in any of the cases upon a cytologic examination of endometriotic cyst fluid. The mean cancer antigen 125 level decreased from 86.69 U/mL before the procedure to approximately 37.28 U/mL. There was no statistically significant difference in anti-Müllerian hormone before and after the procedure. The visual analog scale score decreased from 3.58 to 0.97 after aspiration.
Conclusions
Ultrasonography-guided cyst aspiration followed by dienogest administration allows cytological confirmation through relatively low-burden procedures and may increase patient compliance due to the reduction in ovarian cyst size.

Resurgence of multidrug-resistant tuberculosis during the COVID-19 pandemic in Korea: Tae Hoon Kim, I Re Heo, Ho Cheol Kim; Kosin Med J. 2025;40(2):122-127. Published online June 23, 2025; DOI: https://doi.org/10.7180/kmj.25.105

198 View
3 Download

Abstract PDF PubReader ePub: Background
The coronavirus disease 2019 pandemic, which emerged in 2020, disrupted healthcare systems globally, affecting tuberculosis (TB) diagnosis and reporting. This study assessed the impact of the pandemic on the incidence of TB, multidrug-resistant TB (MDR-TB), and TB-related deaths in Korea between 2016 and 2023.
Methods
Data from annual reports from 2016 to 2023 were used to analyze the incidence of TB and MDR-TB, as well as TB-related deaths. Trends before and after the pandemic were compared to assess the pandemic’s impact on TB management. Key variables included age and sex-based TB incidence, MDR-TB incidence, and number of TB-related deaths.
Results
From 2016 to 2023, the total number of TB cases declined from 39,245 to 19,540, while new TB cases dropped from 30,892 to 15,640, representing reductions of 50.2% and 49.4%, respectively. The most pronounced decline occurred between 2020 and 2023. Individuals ≥65 years of age consistently had the highest TB burden, although the number of cases decreased by 28.6%. MDR-TB cases declined to 399 in 2020 but subsequently rose to 551 in 2023. TB-related deaths decreased from 2,186 in 2016 to 1,322 in 2022, with most deaths occurring in individuals ≥65 years of age.
Conclusions
While the incidence of TB and TB-related deaths decreased during the study period, MDR-TB exhibited an upward trend after 2020. Continued monitoring is needed to understand whether these changes were driven by pandemic-related disruptions or healthcare improvements.

The association between oral contraceptive use and the risk of metabolic syndrome in Korean women: a national population-based study: Hong Kyu Park, Taehong Kim; Kosin Med J. 2025;40(2):128-135. Published online June 10, 2025; DOI: https://doi.org/10.7180/kmj.24.161

262 View
5 Download
1 Citations

Abstract PDF PubReader ePub

Background
This study aimed to evaluate the association between oral contraceptive (OC) use and the incidence of metabolic syndrome (MetS) and its components in Korean women.
Methods
We conducted a cross-sectional study including 11,084 Korean women between 2012 and 2020 based on nationally representative data from the Korea National Health and Nutrition Examination Survey. Multivariate logistic regression analysis was conducted to examine the relationships between OC use, MetS, and its components.
Results
In total, 11,084 women were included in the study, of whom 1,117 (10.1%) used OCs and 8.5% had MetS. The prevalence of MetS was higher in the OC users (11.5%) than in the non-OC users (8.1%) (p<0.001). The OC users had an increased risk of MetS (odds ratio [OR], 1.480; 95% confidence interval [CI], 1.215‒1.802; p<0.001). Additionally, OC users had higher risks of abdominal obesity (OR, 1.319; 95% CI, 1.119‒1.555), hypertension (OR, 1.557; 95% CI, 1.302‒1.863), and hypertriglyceridemia (OR, 1.521; 95% CI, 1.287‒1.797).
Conclusions
The incidence of MetS was higher among OC users, with waist circumference, hypertension, and hypertriglyceridemia being significantly more prevalent components of MetS. These findings can provide valuable evidence to support the development of evidence-based health policies related to women’s health.

Citations

Citations to this article as recorded by

Oral contraceptives: balancing intended use with metabolic syndrome risk
Bukyung Kim
Kosin Medical Journal.2025; 40(2): 85. CrossRef

Case reports

Complete response in borderline resectable pancreatic cancer after modified FOLFIRINOX chemotherapy followed by surgical resection: a case report: Seong Hyun Koh, Jung Wook Lee; Kosin Med J. 2025;40(2):136-141. Published online June 18, 2025; DOI: https://doi.org/10.7180/kmj.24.158

142 View
2 Download

Abstract PDF PubReader ePub: Borderline resectable pancreatic cancer (BRPC) constitutes a challenging subset of cases that fall between clearly resectable and unresectable disease. Pancreatic cancer has a poor prognosis, with a 5-year survival rate of 4.2%. In patients who underwent surgical resection, the 5-year survival rate rose from 1.5% to 17.4%, whereas in those who did not undergo resection, it remained unchanged. Here, we present the case of a patient with BRPC who had no residual tumor during surgery after receiving neoadjuvant FOLFIRINOX chemotherapy. A 57-year-old male patient was hospitalized for abdominal pain and was referred to our hospital for recurrent pancreatitis due to persistent alcohol consumption. Tumor marker testing showed a carbohydrate antigen 19-9 level <2.00 U/mL and a carcinoembryonic antigen level of 4.32 ng/mL. Computed tomography and magnetic resonance cholangiopancreatography revealed signs suggestive of pancreatic cancer, including diffuse gallbladder wall thickening and pancreatic duct dilatation. Endoscopic ultrasound-guided fine needle aspiration biopsy was performed to obtain a tissue sample, and pathological examination confirmed pancreatic ductal adenocarcinoma. Positron emission tomography-computed tomography found no abnormal F-18 fluorodeoxyglucose uptake that would suggest metastasis. Pylorus-preserving pancreaticoduodenectomy was performed, and no visible tumor cells were detected in the resected pancreas after chemotherapy. The patient was followed up for >2 months after surgery without recurrence. The absence of a residual tumor during surgery after upfront chemotherapy in patients with pancreatic cancer is extremely rare and is reported here along with a review of the literature.

Incidental findings of isolated colonic varices at the hepatic flexure due to pancreatic head and uncinate process cancer: a case report: Inmo Kang; Kosin Med J. 2025;40(2):142-144. Published online June 24, 2025; DOI: https://doi.org/10.7180/kmj.25.109

175 View
4 Download

Abstract PDF PubReader ePub: In cases of portal hypertension, collateral pathways may form to bypass the obstruction or resistance. These pathways can create ectopic varices at various sites along the gastrointestinal tract in addition to the common gastroesophageal region. Among these, colonic varices are a particularly rare subtype. Colonic varices can develop owing to conditions such as portal hypertension, splenic or portal vein thrombosis, and mesenteric vein obstruction. This report presents a case of incidental colonic varices at the hepatic flexure, which led to the diagnosis of cancer in the pancreatic head and uncinate process.

Spinal subarachnoid hematoma following lumbar puncture in a patient without coagulopathy: a case report: Kyung Ryeol Lee; Kosin Med J. 2025;40(2):145-149. Published online June 30, 2025; DOI: https://doi.org/10.7180/kmj.25.110

152 View
1 Download

Abstract PDF PubReader ePub: Spinal subarachnoid hematoma (SSAH) following lumbar puncture (LP) in patients without coagulopathy is exceedingly rare, but can lead to severe neurologic complications, such as paraplegia. Although LP has been identified as a cause of SSAH in certain cases, its rarity underscores the need for a prompt diagnosis. Here, we present the case of a young patient who developed SSAH after LP and presented with headache and back pain. The patient was diagnosed accurately and rapidly using magnetic resonance imaging and was successfully managed with conservative treatment.

Brain hemorrhage in patients with advanced hepatocellular carcinoma treated with atezolizumab and bevacizumab: two case reports: Bangju Kim, Hyun Joon Park, Sang Uk Lee, Kwang Il Seo, Jung Wook Lee, Sumin Jo, Jun Yeb Nam; Kosin Med J. 2025;40(2):150-156. Published online June 30, 2025; DOI: https://doi.org/10.7180/kmj.25.114

197 View
10 Download

Abstract PDF PubReader ePub: A combination of atezolizumab and bevacizumab is currently recommended for treating unresectable advanced-stage hepatocellular carcinoma (HCC), as it has demonstrated superior overall survival and progression-free survival compared to sorafenib. However, concerns have been raised regarding serious adverse events associated with bevacizumab, such as gastrointestinal perforation, fistula, hemorrhage, and arterial thromboembolism. In particular, patients with liver cirrhosis (LC) show an increased risk of variceal bleeding. However, brain hemorrhage associated with the use of bevacizumab in patients with HCC and LC is extremely rare. We encountered two cases of brain hemorrhage in patients with HCC and LC who underwent treatment with atezolizumab and bevacizumab. One patient had no history of hypertension, while the other patient had hypertension that was well-controlled with medication and an unruptured brain aneurysm located on the right side of the anterior communicating artery. Both patients experienced brain hemorrhage after two treatment cycles of atezolizumab with bevacizumab. One patient died due to brain hemorrhage, while the other patient recovered from subarachnoid hemorrhage with successful coil embolization. This case report suggests that if a patient has any high-risk factors associated with brain hemorrhage, physicians should thoroughly consider alternative treatment options for advanced HCC, as brain hemorrhage could be fatal.

First
Prev
Page of 1
Next
Last

Current issue