Most-read are based on citations from 2023 ~ 2025.
의학 연구의 대부분은 관찰 연구이다. 관찰 연구의 보고는 종종 불충분한 품질을 보이기도 한다. 부실한 보고는 연구의 강점과 약점을 평가하고 연구
결과의 일반화 가능성을 평가하는 데 방해가 된다. 방법론 전문가, 연구자, 편집자 그룹은 경험적 근거와 이론적 고려 사항을 고려하여 관찰 연구
보고의 질을 개선하기 위한 역학 STROBE 권고안을 개발했다. STROBE statement은 논문의 제목, 초록, 서론, 방법, 결과 및
토론 부분에 대한 22개 항목의 체크리스트로 구성되어 있다. 18개 항목은 코호트연구, 환자 대조군 연구, 단면연구에 공통으로 적용되며, 4개
항목은 세 가지 연구설계 각각에 따라 다르다. STROBE statement는 저자에게 관찰 연구에 대한 보고를 개선하는 방법에 대한 지침을
제공하고 심사자, 편집자 및 독자가 연구를 비판적으로 평가하고 해석하는 데 도움이 된다. 이 설명 문서는 STROBE statement의 사용,
이해 및 보급을 향상 시키는 것이 목적이다. 각 체크리스트 항목의 의미와 근거가 제시되어 있다. 각 항목에 대해 하나 또는 여러 개의 출판된
예시 논문과 가능한 경우 관련 경험적 연구 및 방법론 문헌에 대한 내용이 참고사항으로 제공된다. 유용한 흐름도의 예도 포함되어 있다. 본 문서
및 관련 웹사이트(
The Republic of Korea’s potential role in the peacebuilding process on the Korean Peninsula is explored, with the Democratic People’s Republic of Korea’s earnest efforts to denuclearize and become a normal country. The paper focuses on the United Nations (UN) agencies in the peacebuilding process, considering the UN’s engagement in the Democratic People’s Republic of Korea during the sanction years with humanitarian assistance, the UN’s legitimacy as an impartial international organization for assisting developing countries in forging peace and prosperity, and recently-adopted resolutions on sustaining peace and the Sustainable Development Goals. Policy recommendations are for the Republic of Korea to actively cooperate with the UN’s development and humanitarian agencies, conduct a thorough preparatory review and conduct research, and work towards expanding its engagement and role within key UN agencies.
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Sexually transmitted infections (STIs) continue to pose significant public health
challenges in Korea, with syphilis, gonorrhea, chlamydia,
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Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven primarily by atherogenesis. Recent efforts to understand sex differences in CAD have revealed distinct patterns in disease burden, risk factors, and clinical presentations. This review examines these sex differences in CAD, underscoring the importance of customized diagnostic and management strategies. Although men typically have higher rates of CAD prevalence and incidence, women face unique challenges, such as delayed diagnosis, atypical symptoms, and lower rates of medication prescription. Hormonal, genetic, and lifestyle factors all play a role in these disparities, with estrogen notably reducing CAD risk in women. Nontraditional risk factors, including chronic inflammation, psychological stress, socioeconomic status, and reproductive history, also contribute to CAD development and are often neglected in clinical settings. Addressing these differences requires increased awareness, more accurate diagnosis, and equitable healthcare access for both sexes. Furthermore, greater inclusion of women in CAD research is essential to better understand sex-specific mechanisms and optimize treatment outcomes. Personalizing CAD management based on sex-specific knowledge has the potential to improve prognosis and decrease disease incidence for both men and women.
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Shoulder diseases, including adhesive capsulitis, rotator cuff tear, and osteoarthritis of the glenohumeral joint, can significantly impair daily activities in older adult patients. This review aims to examine the radiologic findings associated with these shoulder conditions in older patients, providing insights for accurate diagnosis and effective treatment. Adhesive capsulitis, commonly known as frozen shoulder, leads to pain and restricted movement, thereby causing shoulder dysfunction. Recent advances in diagnostic technology have greatly enhanced the sensitivity and accuracy of diagnosing this condition through radiologic evaluations, including MRI, magnetic resonance arthrography (MRA), and high-resolution ultrasound. Rotator cuff disease is another frequent issue in older adults, with full-thickness tears occurring in 50%–80% of cases. Both MRI and MRA are highly sensitive and specific in identifying rotator cuff tears. Additionally, ultrasonography is recognized for its high sensitivity and specificity in detecting tears of the supraspinatus tendon. Although osteoarthritis of the glenohumeral joint is less commonly prevalent, its advanced stages can severely affect the function of the upper extremity. Plain radiography is typically the first imaging technique used to assess this type of osteoarthritis. As the condition worsens, CT is utilized to measure glenoid bone loss, glenoid version, and inclination, which are crucial for accurate surgical planning. Each imaging modality provides distinct benefits: plain radiographs for initial structural assessment, ultrasonography for real-time evaluation of soft tissues, MRI/MRA for detailed visualization of capsular and tendinous lesions, and CT for precise bony analysis.
This paper discusses the implications of South Korea's birth notification system and Protected Birth Act, which is set to take effect on July 19, 2024. The legislation aims to prevent infanticide and child abandonment by mandating birth reporting and allowing anonymous births for women in crisis. However, concerns have been raised about the Act's effectiveness in protecting both women and children, particularly regarding issues of disability and migrant families. This paper focuses on gender and healthcare issues, highlighting how the Act perpetuates discrimination against out-of-wedlock pregnancies and upholds normal family ideologies. It notes the absence of critical discussions on women's autonomy, safe pregnancy termination, and paternal responsibility. The importance of healthcare providers understanding and preparing for the Act's implementation is emphasized. The paper calls for strengthening social safety nets to improve healthcare access for vulnerable populations and eliminate discrimination against non-traditional families. Additionally, it addresses the need for comprehensive support systems for crisis pregnancies, including financial assistance, psychological support, parenting education, housing solutions, and expanded healthcare services. This paper acknowledges the Act's significance in providing a systematic state-level approach to protecting pregnant women in crisis, replacing the previous reliance on private organizations. Nonetheless, it also emphasizes the importance of continually reviewing and supplementing the system to address potential rights infringements and ensure its effectiveness. In conclusion, this paper advocates for ongoing discussions on gender and healthcare issues, and for future amendments to the law that reflect real-world circumstances and provide genuine protection for crisis pregnancies and infants.
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This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.
Heart failure (HF) represents a serious public health concern, characterized by substantial morbidity and mortality. Despite advances in pharmacological management, a gap persists in understanding and accounting for sex-related differences in HF treatment. This review was performed to clarify the impact of sex on the clinical outcomes of HF medications. Insights from various clinical trials and studies have highlighted differences between men and women in drug responses and adverse effects, indicating the need for a more nuanced approach to HF management. Promoting greater representation of women in clinical trials and the development of research methodologies that consider sex differences are crucial steps in advancing precision medicine. Such efforts ensure that therapeutic strategies are optimally tailored to the unique biological and genetic profiles of each person. Ultimately, this review emphasizes the vital need for a more inclusive and personalized approach to HF pharmacotherapy, underscoring the critical role of sex-related differences in shaping effective and individualized treatment pathways.
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This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
Shoulder pain is a common complaint in primary care settings. The prevalence of shoulder pain is on the rise, especially in societies with aging populations. Like other joint-related conditions, shoulder pain is predominantly caused by degenerative diseases. These degenerative changes typically affect bones, tendons, and cartilage, with common conditions including degenerative rotator cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these degenerative diseases in older adults requires a thorough understanding of basic anatomy, general physical examination techniques, and specific diagnostic tests. This review aims to outline the fundamental physical examination methods for diagnosing shoulder pain in older adult patients in primary care. The shoulder's complex anatomy and its broad range of motion underscore the need for a systematic approach to evaluation. Routine inspection and palpation can identify signs such as muscle atrophy, bony protrusions, or indications of degenerative changes. Assessing range of motion, and distinguishing between active and passive deficits, is crucial for differentiating conditions like frozen shoulder from rotator cuff tears. Targeted strength tests, such as the empty can, external rotation lag, liftoff, and belly press tests, are instrumental in isolating specific rotator cuff muscles. Additionally, impingement tests, including Neer’s and Hawkins’ signs, are useful for detecting subacromial impingement. A comprehensive understanding of shoulder anatomy and a systematic physical examination are vital for accurately diagnosing shoulder pain in older adults. When properly executed and interpreted in the clinical context, these maneuvers help differentiate between various conditions, ranging from degenerative changes to rotator cuff pathology.
FLASH radiotherapy (FLASH-RT) is an innovative approach that delivers ultra-high dose rates exceeding 40 Gy in less than a second, aiming to widen the therapeutic window by minimizing damage to normal tissue while maintaining tumor control. This review explores the advancements, mechanisms, and clinical applications of FLASH-RT across various radiation sources. Electrons have been predominantly used due to technical feasibility, but their limited penetration depth restricts clinical application. Protons, offering deeper tissue penetration, are considered promising for treating deep-seated tumors despite challenges in beam delivery. Preclinical studies demonstrate that FLASH-RT reduces normal tissue toxicity in the lung, brain, skin, intestine, and heart without compromising antitumor efficacy. The mechanisms underlying the FLASH effect may involve oxygen depletion leading to transient hypoxia, reduced DNA damage in normal tissues, and modulation of immune and inflammatory responses. However, these mechanisms are incompletely understood, and inconsistent results across studies highlight the need for further research. Initial clinical studies, including treatment of cutaneous lymphoma and bone metastases, indicate the feasibility and potential benefits of FLASH-RT in patients. Challenges for clinical implementation include technical issues in dosimetry accuracy at ultra-high dose rates, adaptations in treatment planning systems, beam delivery methods, and economic considerations due to specialized equipment requirements. Future directions will involve comprehensive preclinical studies to optimize irradiation parameters, large-scale clinical trials to establish standardized protocols, and technological advancements to overcome limitations. FLASH-RT holds the potential to revolutionize radiotherapy by reducing normal tissue toxicity and improving therapeutic outcomes, but significant research is required for real-world clinical applications.
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Understanding the effects of sex and sex differences on liver health and disease is crucial for individualized healthcare and informed decision-making for patients with liver disease. The impact of sex on liver disease varies according to its etiology. Women have a lower prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) than men. However, postmenopausal women face a higher risk of advanced liver fibrosis due to hormonal influences. Sex differences affect the pathogenesis of MASLD, which involves a complex process involving several factors such as hormones, obesity, and the gut microbiome. Furthermore, sex-related differences in the development of MASLDrelated hepatocellular carcinoma have been observed. The sex-specific characteristics of MASLD necessitate an individualized management approach based on scientific evidence. However, research in this area has been lacking. This article reviews the current understanding of sex differences in MASLD.
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This review classifies and summarizes the major shoulder diseases affecting older adults, focusing on rotator cuff disease, frozen shoulder, osteoarthritis, and shoulder instability. It explores each condition's pathophysiology, risk factors, clinical presentation, diagnostic approaches, and treatment strategies to guide clinicians in optimizing patient outcomes and enhancing quality of life. Age-related degenerative changes, comorbidities, and distinct etiological factors contribute to the presentation of shoulder disorders in older adults. Rotator cuff disease ranges from tendinopathy to full-thickness tears and is influenced by genetic predispositions, inflammatory cytokines, and muscle quality. Frozen shoulder results from fibroproliferative changes in the capsule, leading to significant pain and restricted motion. Osteoarthritis involves cartilage degeneration and bony remodeling, often necessitating surgical interventions such as arthroplasty. Shoulder instability, though less frequent, is complicated by associated injuries like rotator cuff tears and fractures, requiring tailored management strategies. Advances in imaging techniques, biologic treatments, and surgical procedures, particularly arthroscopic and arthroplasty options, have improved diagnostic accuracy and therapeutic outcomes. A thorough classification of shoulder diseases in older adult patients highlights the complexity of managing these conditions. Effective treatment requires individualized approaches that integrate conservative measures with emerging biologic or surgical therapies. Future research should focus on targeted interventions, standardized diagnostic criteria, and multidisciplinary collaboration to minimize disability, optimize function, and improve overall quality of life in this growing patient population. Multimodal strategies, including patient education, structured rehabilitation, and psychosocial support, further enhance long-term adherence and outcomes. Ongoing vigilance for comorbidities, such as osteoporosis or metabolic disorders, is necessary for comprehensive care.
성별(sex)과 젠더(gender)의 차이를 이해하는 것은 질병 관련 병태생리학 연구, 사회인구학적 건강결정요인, 의학적 또는 사회적 중재의
긍정적 영향 및 위해성 등을 막론하고 엄밀하고 포용적연구에 있어 필수적이다. 다양한 젠더를 포함한 연구가 활발해졌지만 성별과 젠더를 변수로
명시하는 연구는 여전히 부족하다. 2016년에 발표된 성별과 젠더 형평성(Sex and Gender Equity in Research,
SAGER) 지침은 널리 지지되고 있지만, 소수의 과학 학술지와 기관들에서만 이를 공식적인 편집 및 출판 정책에 반영하고 있다.
The capabilities of artificial intelligence (AI) have recently surged, largely due to advancements in deep learning inspired by the structure and function of the neural networks of the human brain. In the medical field, the impact of AI spans from diagnostics and treatment recommendations to patient engagement and monitoring, considerably improving efficiency and outcomes. The clinical integration of AI has also been examined in specialties, including pathology, radiology, and oncology. General surgery primarily involves manual manipulation and includes preoperative, intraoperative, and postoperative care, all of which are critical for saving lives. Other fields have strived to utilize and adopt AI; nonetheless, general surgery appears to have retrogressed. In this review, we analyzed the published research, to understand how the application of AI in general surgery differs from that in other medical fields. Based on previous research in other fields, the application of AI in the preoperative stage is nearing feasibility. Ongoing research efforts aim to utilize AI to improve and predict operative outcomes, enhance performance, and improve patient care. However, the use of AI in the operating room remains significantly understudied. Moreover, ethical responsibilities are associated with such research, necessitating extensive work to gather evidence. By fostering interdisciplinary collaboration and leveraging lessons from AI success stories in other fields, AI tools could be specifically tailored for general surgery. Surgeons should be prepared for the integration of AI into clinical practice to achieve better outcomes; therefore, the time has come to consider ethical and legal implications.
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This study analyzed drug-induced death statistics in Korea between 2011 and 2021.
Cause-of-death statistics data from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death and the International Statistical Classification of Diseases and Related Health Problems, 10th revision.
In 2021, there were 559 drug-induced deaths, marking a 172.7% increase compared to 2011, which recorded 205 deaths. The rate of drug-induced deaths per 100,000 people was 1.1 in 2021, up 153.6% from 0.4 in 2011. The mortality rate for men aged 25−34 years and women aged 35−44 years each increased fourfold from 2011 to 2021: from 0.3 to 1.2 for the former and 0.3 to 1.3 for the latter. Of the drug-induced deaths in 2021, 75.0% (419/559) were due to intentional self-harm, and 10.4% (58/559) were accidental. The number of deaths attributed to medical narcotics in 2021 was 169, a 5.5-fold increase from 2011. The most commonly implicated drugs in these deaths were sedative-hypnotic drugs, benzodiazepines, and opioids. Sedative-hypnotic drugs and benzodiazepines were frequently involved in cases of intentional self-harm, while opioids and psychostimulants were more often associated with accidental deaths.
The death rate from drug-induced causes is considerably lower in Korea than in the United States (1.1 vs. 29.2). However, the number of such deaths has increased recently. Since these deaths occur predominantly among younger age groups and are often the result of intentional self-harm, there is a clear need for systematic management and the implementation of targeted policies.
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This study reviewed quantitative research on the health of sexual and gender minorities (SGMs) in Korea and aimed to propose a role for healthcare professionals in improving their health and access to medical care. We searched PubMed through February 29, 2024 for articles published since 2000, using terms related to SGMs and the keyword “Korea.” This process yielded 33 quantitative studies on Korean SGMs. Of these, 17 focused on sexual minorities and 16 on gender minorities. The findings indicate that Korean SGMs experience many symptoms of depression and anxiety, as well as high rates of suicidal ideation, planning, and attempts. They also report diminished health-related quality of life. SGM individuals who have faced discrimination or pressure to change their sexual or gender identity face an elevated risk of mental health issues. To improve the health of Korean SGMs and improve their access to healthcare, we recommend several approaches. First, more research on the health of Korean SGMs is necessary. Second, education and training programs for health professionals are essential to promote their understanding of SGM health issues and their advocacy for SGM health. Third, strategies are required to develop and implement program interventions that improve SGM health, such as increasing the availability of gender-affirming care, which is known to benefit the health of transgender and gender-diverse individuals. Finally, healthcare professionals should actively advocate for SGM health and call for shifts in public perception and institutional change, grounded in a broad understanding of SGMs and their health needs.
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Health and safety issues in micro and small enterprises (MSEs) are recognized as a global challenge. This study aimed to examine Workers' Health Centers (WHCs) as a representative public organization providing occupational health services to MSEs in Korea. WHCs were established in 2011 after a trial period aimed at addressing occupational diseases in MSEs with limited resources. As of 2024, there are 24 WHCs, 22 branch offices, and 23 trauma counseling centers for workers. These health centers are managed by the Korea Occupational Safety and Health Agency, with their actual operation delegated to private organizations. Each WHC employs an average of 13 staff members and is organized into four specialized teams: cardiovascular disease prevention, workplace environment improvement, musculoskeletal disease prevention, and occupational stress management. These centers also offer common basic programs along with region-specific specialized initiatives. In 2023, the total cumulative number of users reached 203,877, with employees from MSEs comprising approximately 88.5% of the total. WHCs can thus be seen as playing a pivotal role as case managers of health requirements in the workplace by fostering strong relationships with MSEs and linking them to other relevant programs through a problem-solving-oriented approach. Given the limited resources of these enterprises, proactive policies and the equitable application of safety and health regulations are essential. A balanced strategy that combines regulatory enforcement with practical assistance is critical to ensure the success of WHCs in improving health and safety conditions in MSEs.
The purpose of this review is to provide a comprehensive guide for managing older adult patients with shoulder diseases, specifically rotator cuff tears and osteoarthritis, and to explore effective nonsurgical treatment options. Chronic rotator cuff tears are typically degenerative, whereas acute tears result from trauma. A key feature of these tears is tendon degeneration accompanied by type III collagen predominance, predisposing tears to progression. Osteoarthritis in the glenohumeral joint arises from wear-and-tear changes that compromise cartilage integrity, leading to pain and restricted motion. Accurate clinical assessment and imaging, including plain radiographs, ultrasonography, and MRI, facilitate diagnosis and guide treatment. The physic-al examination emphasizes range of motion, rotator cuff strength, and scapular stability. Management strategies prioritize pain relief, function preservation, and improving mobility. Nonsurgical modalities, including exercise, manual therapy, and activity modification, constitute first-line treatments, especially for older adults. Pharmacological approaches involve NSAIDs, corticosteroid injections, and neuropathic pain medications. Steroid injections have short-term benefits, but repeated treatments may compromise tissue integrity. Platelet-rich plasma is a regenerative option that may improve tendon healing, but mixed findings highlight the need for further investigation. A structured physical therapy program focusing on range of motion and strengthening is essential, with alternative interventions used judiciously. Patients should be counseled regarding the potential progression of tears and the possible need for future surgical intervention if nonsurgical methods are unsuccessful. Multimodal approaches, including joint mobilization and personalized exercise regimens, hold potential for optimizing functional outcomes and supporting independence in older adults.
Artificial intelligence (AI) is rapidly transforming various medical fields, including radiation oncology. This review explores the integration of AI into radiation oncology, highlighting both challenges and opportunities. AI can improve the precision, efficiency, and outcomes of radiation therapy by optimizing treatment planning, enhancing image analysis, facilitating adaptive radiation therapy, and enabling predictive analytics. Through the analysis of large datasets to identify optimal treatment parameters, AI can automate complex tasks, reduce planning time, and improve accuracy. In image analysis, AI-driven techniques enhance tumor detection and segmentation by processing data from CT, MRI, and PET scans to enable precise tumor delineation. In adaptive radiation therapy, AI is beneficial because it allows real-time adjustments to treatment plans based on changes in patient anatomy and tumor size, thereby improving treatment accuracy and effectiveness. Predictive analytics using historical patient data can predict treatment outcomes and potential complications, guiding clinical decision-making and enabling more personalized treatment strategies. Challenges to AI adoption in radiation oncology include ensuring data quality and quantity, achieving interoperability and standardization, addressing regulatory and ethical considerations, and overcoming resistance to clinical implementation. Collaboration among researchers, clinicians, data scientists, and industry stakeholders is crucial to overcoming these obstacles. By addressing these challenges, AI can drive advancements in radiation therapy, improving patient care and operational efficiencies. This review presents an overview of the current state of AI integration in radiation oncology and insights into future directions for research and clinical practice.
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