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[English]
Core principles and structures of geriatric rehabilitation: a narrative review
Jae-Young Lim
Ewha Med J 2025;48(4):e57.   Published online October 14, 2025
DOI: https://doi.org/10.12771/emj.2025.00829
Funded: Ministry of Health and Welfare
Globally, rapid population aging—particularly in Korea—has extended life expectancy but not proportionally extended healthy life expectancy, resulting in longer periods of illness or disability and a higher demand for complex medical and social care. Therefore, prolonging healthy life and improving health-related quality of life have become primary objectives in geriatric medicine and rehabilitation. Geriatric rehabilitation is a critical intervention aimed at optimizing the functioning of older adults and pre-morbidly frail individuals who have lost independence due to acute illness or injury. For many older patients, the goal shifts from complete recovery to achieving a new equilibrium, maximizing autonomy despite greater dependency. Geriatric rehabilitation also targets key geriatric syndromes such as frailty, recognizing it as a dynamic and potentially reversible state that provides a crucial “time window” for intervention. This review summarizes the core principles and structural elements essential for geriatric rehabilitation, emphasizing the implementation challenges within the Korean healthcare system. Unlike the European consensus, which supports structured inpatient and outpatient services with seamless transitions of care guided by Comprehensive Geriatric Assessment, the Korean healthcare system remains fragmented and heavily centered on acute hospitals. This highlights the urgent need for a systematic model to integrate care facilities and strengthen interprofessional collaboration to support community-based “aging in place.” Effective geriatric rehabilitation requires multidisciplinary teams and multifaceted approaches to optimize quality of life, social participation, and independent living. Despite its importance, substantial awareness gaps and policy barriers persist, underscoring an urgent call to action.
  • 163 View
  • 18 Download
[English]
Aging with disability in polio survivors: a narrative review
Ju-Hee Hwang, Ga-Yang Shim
Ewha Med J 2025;48(4):e58.   Published online October 20, 2025
DOI: https://doi.org/10.12771/emj.2025.00843
Funded: Ministry of Health and Welfare
This study aimed to provide a comprehensive understanding of aging with disability among polio survivors who continue to live with long-term sequelae. Although poliomyelitis has been eradicated in most regions, survivors entering older age face a dual challenge, as age-related decline overlaps with pre-existing impairments, creating a need for integrated management strategies. This narrative review examined the epidemiology, clinical manifestations, and late effects of polio, with particular attention to post-polio syndrome, secondary musculoskeletal disorders, and other systemic conditions. International and Korean studies were compared to highlight similarities and contextual differences. Polio survivors frequently experience accelerated functional decline due to post-polio syndrome, fatigue, pain, musculoskeletal disorders (e.g., arthritis, osteoporosis, fractures), and cardiopulmonary dysfunction. Approximately 64% report major falls, with 35% sustaining fractures, often at vulnerable sites such as the hip or distal femur. Psychological distress, sleep disturbances, metabolic syndrome, and cardiovascular disease are also prevalent, further compounding frailty. In Korea, where most survivors are now over 60 years of age, epidemiological patterns differ from those of Western cohorts; however, systematic investigations remain limited. Polio survivors exemplify the dual burden of aging and long-term disability, underscoring the need to move beyond fragmented, symptom-focused care toward integrated, life course–oriented approaches. Anticipating and managing late effects, strengthening preventive strategies, and ensuring equitable healthcare access are essential for maintaining function, independence, and quality of life. Lessons drawn from polio survivors offer valuable insights for understanding aging with disability more broadly.
  • 347 View
  • 23 Download
[English]
Hip fracture and cognitive impairment in older adults–integrated approaches to rehabilitation: a narrative review
Seung-Kyu Lim, Jae-Young Lim
Ewha Med J 2025;48(4):e59.   Published online October 20, 2025
DOI: https://doi.org/10.12771/emj.2025.00801
Funded: Ministry of Health and Welfare
Fragility fractures, particularly hip fractures, represent a major public health concern among older adults and are associated with high morbidity, mortality, functional decline, and socioeconomic burden. Cognitive impairment is common in older adults with hip fractures and contributes to increased fracture risk, poor postoperative outcomes, delayed recovery, and higher rates of institutionalization. This review aimed to examine rehabilitation strategies for older adults with hip fractures, with a specific focus on considerations for those with cognitive impairment. Evidence suggests that individuals with mild-to-moderate cognitive impairment can achieve meaningful functional gains through structured, intensive, multidisciplinary rehabilitation programs incorporating progressive resistance training, balance and mobility exercises, and individualized approaches tailored to cognitive and physical abilities. However, the implementation of such programs is often hindered by insufficient staff training and awareness in dementia-specific rehabilitation, limited resources, and the lack of standardized protocols defining eligibility, intensity, and adaptation. Optimizing outcomes requires structured, tailored rehabilitation protocols, enhanced staff education, interprofessional collaboration, and proactive management of delirium and secondary fracture prevention through fracture liaison services, while concurrently addressing systemic barriers such as resource constraints. Integrated, coordinated care across the continuum is essential to maximize recovery, independence, and quality of life in older adults with hip fractures and cognitive impairment.
  • 198 View
  • 10 Download
[English]
Bridging science and policy in tuberculosis treatment through innovations in precision medicine, drug development, and cohort research: a narrative review
Jinsoo Min, Bruno B. Andrade, Ju Sang Kim, Yoolwon Jeong
Ewha Med J 2025;48(2):e22.   Published online April 2, 2025
DOI: https://doi.org/10.12771/emj.2025.00115
Funded: Korea National Institute of Health
Recent advancements in tuberculosis treatment research emphasize innovative strategies that enhance treatment efficacy, reduce adverse effects, and adhere to patient-centered care principles. As tuberculosis remains a significant global health challenge, integrating new and repurposed drugs presents promising avenues for more effective management, particularly against drug-resistant strains. Recently, the spectrum concept in tuberculosis infection and disease has emerged, underscoring the need for research aimed at developing treatment plans specific to each stage of the disease. The application of precision medicine to tailor treatments to individual patient profiles is crucial for addressing the diverse and complex nature of tuberculosis infections. Such personalized approaches are essential for optimizing therapeutic outcomes and improving patient adherence—both of which are vital for global tuberculosis eradication efforts. The role of tuberculosis cohort studies is also emphasized, as they provide critical data to support the development of these tailored treatment plans and deepen our understanding of disease progression and treatment response. To advance these innovations, a robust tuberculosis policy framework is required to foster the integration of research findings into practice, ensuring that treatment innovations are effectively translated into improved health outcomes worldwide.

Citations

Citations to this article as recorded by  
  • Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
    Hae-Sun Chung
    Ewha Medical Journal.2025; 48(2): e16.     CrossRef
  • 3,177 View
  • 89 Download
  • 1 Web of Science
  • 1 Crossref

Original articles

[English]
Development of automatic organ segmentation based on positron-emission tomography analysis system using Swin UNETR in breast cancer patients in Korea
Dong Hyeok Choi, Joonil Hwang, Hai-Jeon Yoon, So Hyun Ahn
Ewha Med J 2025;48(2):e30.   Published online April 2, 2025
DOI: https://doi.org/10.12771/emj.2025.00094
Funded: National Research Foundation of Korea, National Research Foundation of Korea
Purpose
The standardized uptake value (SUV) is a key quantitative index in nuclear medicine imaging; however, variations in region‐of‐interest (ROI) determination exist across institutions. This study aims to standardize SUV evaluation by introducing a deep learning‐based quantitative analysis method that enhances diagnostic and prognostic accuracy.
Methods
We used the Swin UNETR model to automatically segment key organs (breast, liver, spleen, and bone marrow) critical for breast cancer prognosis. Tumor segmentation was performed iteratively based on predefined SUV thresholds, and prognostic information was extracted from the liver, spleen, and bone marrow (reticuloendothelial system). The artificial intelligence training process employed 3 datasets: a test dataset (40 patients), a validation dataset (10 patients), and an independent test dataset (10 patients). To validate our approach, we compared the SUV values obtained using our method with those produced by commercial software.
Results
In a dataset of 10 patients, our method achieved an auto‐segmentation accuracy of 0.9311 for all target organs. Comparison of maximum SUV and mean SUV values from our automated segmentation with those from traditional single‐ROI methods revealed differences of 0.19 and 0.16, respectively, demonstrating improved reliability and accuracy in whole‐organ SUV analysis.
Conclusion
This study successfully standardized SUV calculation in nuclear medicine imaging through deep learning‐based automated organ segmentation and SUV analysis, significantly enhancing accuracy in predicting breast cancer prognosis.
  • 1,129 View
  • 41 Download
[English]
Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
So Hee Lee, Won Woong Lee, Haewoo Lee, Jin Yong Jun, Jin-Won Noh
Ewha Med J 2025;48(2):e28.   Published online April 10, 2025
DOI: https://doi.org/10.12771/emj.2025.00367
Funded: National Human Rights Commission of Korea
Purpose
This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements.
Methods
A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression.
Results
The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being.
Conclusion
An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.

Citations

Citations to this article as recorded by  
  • Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
    Hae-Sun Chung
    Ewha Medical Journal.2025; 48(2): e16.     CrossRef
  • 5,373 View
  • 73 Download
  • 1 Web of Science
  • 1 Crossref
Correspondence
[English]
Korea’s 2024 reduction in medical research output amid physician residents’ resignation
Jeong-Ju Yoo, Hyun Bin Choi, Young-Seok Kim, Sang Gyune Kim
Ewha Med J 2025;48(2):e36.   Published online April 17, 2025
DOI: https://doi.org/10.12771/emj.2025.00381
Funded: Soonchunhyang University

Citations

Citations to this article as recorded by  
  • Current challenges in Korean medical research and highlights from this issue of Annals of Clinical Microbiology
    Hae-Sun Chung
    Annals of Clinical Microbiology.2025; 28(2): 11.     CrossRef
  • 2,566 View
  • 26 Download
  • 1 Crossref
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