https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/274 2026-07-21T10:23:35Z 2026-07-21T10:23:35Z Yoon, Jiyoung Yoon, Jai Hoon Lee, Heajung Lee, Jun Su Moon, Seong Mi Choi, Hayoung Yang, Bumhee Lee, Hyun https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/210380 2026-01-20T05:00:17Z 2026-12-01T00:00:00Z

Title: Association between gastroesophageal reflux disease and incident bronchiectasis: a nationwide representative population-based study in Korea Authors: Yoon, Jiyoung; Yoon, Jai Hoon; Lee, Heajung; Lee, Jun Su; Moon, Seong Mi; Choi, Hayoung; Yang, Bumhee; Lee, Hyun Abstract: Introduction: A close association between gastroesophageal reflux disease (GERD) and chronic respiratory diseases has been suggested. However, limited information is available on whether GERD is associated with an increased incidence of bronchiectasis. Methods: Using a nationwide representative claims database, we identified adults with GERD (GERD cohort) and propensity score-matched controls without GERD (matched controls) between 2004 and 2012. Both cohorts were followed until the date of bronchiectasis diagnosis, date of death, or December 31, 2015. Cox proportional hazard regression analyses were used to evaluate the risk of bronchiectasis between groups. Using the GERD cohort, we also evaluated factors associated with bronchiectasis. Results: During the median follow-up of 9.5 years (interquartile range: 6.33–12.17 years), the cumulative incidence of bronchiectasis was significantly higher in the GERD cohort than in matched controls (418.59 person-years vs. 291.68 person-years; P < 0.01), with a hazard ratio (HR) of 1.43 (95% confidence interval [CI] = 1.13–1.55). Besides, the risk of bronchiectasis increased as GERD severity increased (HR = 1.24, 95% CI = 1.12–1.38 for mild GERD group and HR = 1.48, 95% CI = 1.35–1.62 for severe GERD group). Among the GERD cohort, factors associated with increased risk bronchiectasis were older age (the highest adjusted hazard ratio [aHR] = 8.46, 95% CI = 4.84–14.80 for individuals aged 70 years or older versus individuals aged 20–29), underweight (aHR = 1.79, 95% CI = 1.35–2.37), chronic obstructive pulmonary disease (aHR = 1.33, 95% CI = 1.06–1.67), asthma (aHR = 1.51, 95% CI = 1.25–1.82), and peptic ulcer disease (aHR = 1.26, 95% CI = 1.09–1.46). Conclusion: GERD is associated with an increased risk of bronchiectasis. Older age, underweight, coexisting airway diseases, and peptic ulcer disease were risk factors for developing bronchiectasis in GERD.

2026-12-01T00:00:00Z Kim, Moinay Jung, Hyunchul Kim, Seung Bin Jeon, Hanwool Chung, Yeongu Shim, Youngbo Kwon, Sae Min Kim, Jae Hyun Chung, Jaewoo Choi, Kyu-Sun Lee, Heui Seung Byun, Joonho Lee, Si Un Park, Wonhyoung Park, Jung Cheol Ahn, Jae Sung Lee, Seungjoo https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/212314 2026-04-23T02:30:16Z 2026-12-01T00:00:00Z

Title: Critical illness-related corticosteroid insufficiency after acute brain hemorrhage surgery: a prospective cohort study with a randomized trial of hydrocortisone : HYdrocortisone theraPy in nEurocRitical illness; HYPER study Authors: Kim, Moinay; Jung, Hyunchul; Kim, Seung Bin; Jeon, Hanwool; Chung, Yeongu; Shim, Youngbo; Kwon, Sae Min; Kim, Jae Hyun; Chung, Jaewoo; Choi, Kyu-Sun; Lee, Heui Seung; Byun, Joonho; Lee, Si Un; Park, Wonhyoung; Park, Jung Cheol; Ahn, Jae Sung; Lee, Seungjoo Abstract: Background Critical illness-related corticosteroid insufficiency (CIRCI) is a potentially underrecognized complication in postoperative patients with acute brain hemorrhage. Its incidence, associated risk factors, and the therapeutic role of corticosteroids in this population remain unclear. Method This multicenter study combined a prospective observational cohort with a single-blinded randomized controlled trial. Adult patients aged 18-80 years who underwent neurological surgery for acute brain hemorrhage within 48 h of admission at tertiary care hospitals were eligible for inclusion. Acute brain hemorrhage was confirmed by computed tomography or magnetic resonance imaging and included both traumatic (e.g., epidural or subdural hematoma) and non-traumatic etiologies (e.g., aneurysmal subarachnoid hemorrhage). Among 497 screened patients, 255 eligible postoperative patients underwent adrenal function testing using a high-dose corticotropin stimulation test (HDST) on postoperative day (POD) 2 or 3. Patients diagnosed with CIRCI (n = 64, 25.1%) were randomized in a 1:1 ratio to receive intravenous hydrocortisone or placebo. The primary outcome was neurological improvement at 30 days assessed using the modified Rankin Scale (mRS). Results CIRCI was diagnosed in 25.1% of patients. Independent predictors of CIRCI included traumatic subdural hematoma, epidural hematoma, mechanical ventilation, and fresh frozen plasma transfusion. While hydrocortisone did not significantly improve the primary outcome of 30-day neurological function, it significantly reduced mechanical ventilation duration (median [IQR], 5 [3-7] vs. 10 [6-16] days; p = 0.032) and ICU length of stay (5 [2-13] vs. 13 [3-18] days; p = 0.038). No increase in serious adverse events was observed. Conclusion CIRCI is common in postoperative patients with acute brain hemorrhage and is associated with specific clinical risk factors. Although targeted hydrocortisone therapy did not significantly improve functional outcomes at 30 days, it yielded significant improvements in short-term ICU parameters. These findings warrant further adequately powered studies to evaluate the role of corticosteroid therapy in patients with acute brain hemorrhage diagnosed with CIRCI. Clinical trial registration This study was registered with the Clinical Research Information Service (CRIS), a primary registry of the WHO International Clinical Trials Registry Platform, under the identifier KCT0004425. The trial was prospectively registered on 5 November 2019.

2026-12-01T00:00:00Z Bae, Go Eun Lee, Jinyoung Yoo, Sang-Ho Jang, Sou Hyun https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/212533 2026-05-16T09:00:17Z 2026-12-01T00:00:00Z

Title: Multilevel barriers and facilitators of shared decision-making in chronic illness management: a social ecological model approach Authors: Bae, Go Eun; Lee, Jinyoung; Yoo, Sang-Ho; Jang, Sou Hyun Abstract: Background: Shared decision-making is central to patient-centered chronic illness care, yet patients’ participation often remains constrained in physician-driven systems. Therefore, this study applied the Social Ecological Model to explore how multilevel barriers and facilitators influence patient–doctor communication and shared decision-making among patients with chronic illnesses. Methods: We conducted an interpretive qualitative study in South Korea using semi-structured, in-depth interviews guided by the Social Ecological Model. Sixteen adults diagnosed with hypertension, diabetes mellitus, chronic kidney disease, or heart disease for more than 12 months were purposively sampled. Interviews (75–115 min) were transcribed verbatim and analyzed using qualitative content analysis informed by grounded theory approaches. Codes were inductively developed through open coding and organized across multiple ecological levels (individual, interpersonal, institutional, societal). Analytical rigor was enhanced through independent coding, iterative discussions, and triangulation. Results: Twelve themes were identified across multiple levels. At the individual level, patients’ illness-specific perceptions, health literacy, and psychological distress strongly influenced engagement. At the interpersonal level, physician authority, limited and selective information provision, and patients’ own communication styles shaped relational dynamics, which together determined trust and willingness to participate. The institutional level was marked by hospital capacity and continuity challenges, outdated or inaccessible educational resources, and rigid scheduling and coordination processes that constrained dialogue. Cultural expectations of deference to physicians, entrenched hierarchical medical culture, and financial uncertainty (including lack of transparent cost information) further limited autonomy at the societal level. Across levels, empathetic provider communication and supportive information environments functioned as key facilitators. Conclusions: Shared decision-making in chronic illness care is not solely a patient–provider exchange but the product of interacting personal, relational, organizational, and societal forces. Effective promotion of shared decision-making requires multilevel interventions: strengthening patients’ knowledge and self-efficacy, fostering empathetic two-way communication, ensuring institutional continuity and educational support, and addressing structural and cultural barriers. By aligning strategies across these levels, health systems can enable patients to participate as informed and autonomous partners in decision-making, ultimately improving care quality and outcomes. Clinical trial registration: Not applicable.

2026-12-01T00:00:00Z Kent, Joanna Xu, Xiaomeng Ramnarain, Arushi Louthrenoo, Worawit Golder, Vera Hamijoyo, Laniyati Luo, Shue-Fen Wu, Yeong-Jian Jan Chen, Yi-Hsing Bae, Sang-Cheol Cho, Jiacai Lateef, Aisha Chan, Shirley Lau, Chak Sing Navarra, Sandra Zamora, Leonid Yao, Haihong Sockalingam, Sargunan Basnayake, B.M.D.B. Hao, Yanjie Zhang, Zhuoli Chan, Madelynn Xu, Chuanhui Katsumata, Yasuhiro Kikuchi, Jun Kaneko, Yuko Takeuchi, Tsutomu Oon, Shereen O’Neill, Sean Hassett, Geraldine Goldblatt, Fiona Poh, Yih Jia Sapsford, Mark Tugnet, Nicola Ng, Kristine Pek Ling Tee, Cherica Tee, Michael Miyazaki, Yusuke Ohkubo, Naoaki Tanaka, Yoshiya Nikpour, Mandana Hoi, Alberta Rojas, Aldo A Navarro Morand, Eric Kandane-Rathnayake, Rangi https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/212760 2026-05-20T01:30:31Z 2026-12-01T00:00:00Z

Title: Treatment patterns, treat-to-target goals and clinical outcomes of patients with active lupus nephritis: real-world evidence from a multicentre cohort study Authors: Kent, Joanna; Xu, Xiaomeng; Ramnarain, Arushi; Louthrenoo, Worawit; Golder, Vera; Hamijoyo, Laniyati; Luo, Shue-Fen; Wu, Yeong-Jian Jan; Chen, Yi-Hsing; Bae, Sang-Cheol; Cho, Jiacai; Lateef, Aisha; Chan, Shirley; Lau, Chak Sing; Navarra, Sandra; Zamora, Leonid; Yao, Haihong; Sockalingam, Sargunan; Basnayake, B.M.D.B.; Hao, Yanjie; Zhang, Zhuoli; Chan, Madelynn; Xu, Chuanhui; Katsumata, Yasuhiro; Kikuchi, Jun; Kaneko, Yuko; Takeuchi, Tsutomu; Oon, Shereen; O’Neill, Sean; Hassett, Geraldine; Goldblatt, Fiona; Poh, Yih Jia; Sapsford, Mark; Tugnet, Nicola; Ng, Kristine Pek Ling; Tee, Cherica; Tee, Michael; Miyazaki, Yusuke; Ohkubo, Naoaki; Tanaka, Yoshiya; Nikpour, Mandana; Hoi, Alberta; Rojas, Aldo A Navarro; Morand, Eric; Kandane-Rathnayake, Rangi Abstract: Background: Lupus nephritis (LN) is a common and severe manifestation of systemic lupus erythematosus (SLE). We sought to evaluate treatment patterns, treat-to-target state attainment, and outcomes of patients with active LN on non-biologic, conventional therapy, in a large real-world cohort from the Asia–Pacific region. Methods: Adult patients enrolled in a multinational lupus cohort were studied for evidence of active LN, defined based on the SLE Disease Activity Index-2000 (SLEDAI-2K)-proteinuria threshold (> 0.5 g/24 h or > 0.05g/mmol), ≥ 2 visits of data, and no exposure to biologics. The subset of these patients who had kidney biopsy-confirmed LN was retrospectively determined. Attainment of treatment goals, including modified versions of complete renal response (mCRR) and primary efficacy renal response (mPERR), lupus low disease activity state (LLDAS) and DORIS remission (REM), and organ damage accrual, were assessed over time following the first visit with proteinuria. Results: One thousand one hundred eighty patients were studied for a median 2.7 [IQR 1.0, 5.0] years, 435 (37%) of whom had biopsies (Class III/IV = 242 (56%)). mCRR, mPERR, LLDAS, and REM were attained at least once during follow-up by 46%, 55%, 60%, and 46% of patients, respectively. mCRR and mPERR attainment was highest at year 2, while LLDAS and REM attainment gradually increased over time. New organ damage accrued in 11% of patients by year 1, increasing to 33% by year 5. Conclusion: In a multinational cohort of patients with active LN receiving non-biologic conventional therapy, the attainment of renal responses, LLDAS, and REM was low, while damage accrual was prevalent.

2026-12-01T00:00:00Z