Background: Adolescent unintended pregnancies can have detrimental effects on maternal and fetal health, impacting the social lives of young parents. Globally, there is an emphasis on preventing unintended pregnancies in adolescents through comprehensive contraceptive education. This study examined contraception practices and determinants among sexually active Korean adolescents. Methods: This study analyzed raw data from the 2018 and 2021 Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency. The cohort consisted of 6,042 adolescents who reported sexual experience, categorized into those always practicing contraception and those not. We scrutinized factors related to sexual behavior, such as contraception and sex education, as well as other social and behavioral factors. Results: Among sexually active adolescents, 47.9% of males and 48.1% of females consistently used contraception. The most prevalent contraceptive method was condoms (male 58.1%; female 59.6%). However, a significant portion of adolescents were not using contraception (male 29.4%; female 21.7%). Females who did not consistently use contraception exhibited higher pregnancy rates (2.4% vs. 11.3%). Consistent contraceptive users tended to live with their families and reported less sexual experience after drinking alcohol. Despite a decline in sexual education in schools from 2018 to 2021, the proportion of adolescents consistently using contraception increased. Conclusion To prevent unintended pregnancies among sexually active adolescents, consistent use of appropriate contraceptive methods is crucial.Comprehensive education on contraception should be extended beyond schools to include homes and primary healthcare settings. Policymakers and healthcare providers should consider these consequences when devising strategies to reduce unintended pregnancies among adolescents.

Background: Adolescent unintended pregnancies can have detrimental effects on maternal and fetal health, impacting the social lives of young parents. Globally, there is an emphasis on preventing unintended pregnancies in adolescents through comprehensive contraceptive education. This study examined contraception practices and determinants among sexually active Korean adolescents. Methods: This study analyzed raw data from the 2018 and 2021 Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency. The cohort consisted of 6,042 adolescents who reported sexual experience, categorized into those always practicing contraception and those not. We scrutinized factors related to sexual behavior, such as contraception and sex education, as well as other social and behavioral factors. Results: Among sexually active adolescents, 47.9% of males and 48.1% of females consistently used contraception. The most prevalent contraceptive method was condoms (male 58.1%; female 59.6%). However, a significant portion of adolescents were not using contraception (male 29.4%; female 21.7%). Females who did not consistently use contraception exhibited higher pregnancy rates (2.4% vs. 11.3%). Consistent contraceptive users tended to live with their families and reported less sexual experience after drinking alcohol. Despite a decline in sexual education in schools from 2018 to 2021, the proportion of adolescents consistently using contraception increased. Conclusion To prevent unintended pregnancies among sexually active adolescents, consistent use of appropriate contraceptive methods is crucial.Comprehensive education on contraception should be extended beyond schools to include homes and primary healthcare settings. Policymakers and healthcare providers should consider these consequences when devising strategies to reduce unintended pregnancies among adolescents.

Background: Adolescent unintended pregnancies can have detrimental effects on maternal and fetal health, impacting the social lives of young parents. Globally, there is an emphasis on preventing unintended pregnancies in adolescents through comprehensive contraceptive education. This study examined contraception practices and determinants among sexually active Korean adolescents. Methods: This study analyzed raw data from the 2018 and 2021 Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency. The cohort consisted of 6,042 adolescents who reported sexual experience, categorized into those always practicing contraception and those not. We scrutinized factors related to sexual behavior, such as contraception and sex education, as well as other social and behavioral factors. Results: Among sexually active adolescents, 47.9% of males and 48.1% of females consistently used contraception. The most prevalent contraceptive method was condoms (male 58.1%; female 59.6%). However, a significant portion of adolescents were not using contraception (male 29.4%; female 21.7%). Females who did not consistently use contraception exhibited higher pregnancy rates (2.4% vs. 11.3%). Consistent contraceptive users tended to live with their families and reported less sexual experience after drinking alcohol. Despite a decline in sexual education in schools from 2018 to 2021, the proportion of adolescents consistently using contraception increased. Conclusion To prevent unintended pregnancies among sexually active adolescents, consistent use of appropriate contraceptive methods is crucial.Comprehensive education on contraception should be extended beyond schools to include homes and primary healthcare settings. Policymakers and healthcare providers should consider these consequences when devising strategies to reduce unintended pregnancies among adolescents.

Background: Adolescent unintended pregnancies can have detrimental effects on maternal and fetal health, impacting the social lives of young parents. Globally, there is an emphasis on preventing unintended pregnancies in adolescents through comprehensive contraceptive education. This study examined contraception practices and determinants among sexually active Korean adolescents. Methods: This study analyzed raw data from the 2018 and 2021 Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency. The cohort consisted of 6,042 adolescents who reported sexual experience, categorized into those always practicing contraception and those not. We scrutinized factors related to sexual behavior, such as contraception and sex education, as well as other social and behavioral factors. Results: Among sexually active adolescents, 47.9% of males and 48.1% of females consistently used contraception. The most prevalent contraceptive method was condoms (male 58.1%; female 59.6%). However, a significant portion of adolescents were not using contraception (male 29.4%; female 21.7%). Females who did not consistently use contraception exhibited higher pregnancy rates (2.4% vs. 11.3%). Consistent contraceptive users tended to live with their families and reported less sexual experience after drinking alcohol. Despite a decline in sexual education in schools from 2018 to 2021, the proportion of adolescents consistently using contraception increased. Conclusion To prevent unintended pregnancies among sexually active adolescents, consistent use of appropriate contraceptive methods is crucial.Comprehensive education on contraception should be extended beyond schools to include homes and primary healthcare settings. Policymakers and healthcare providers should consider these consequences when devising strategies to reduce unintended pregnancies among adolescents.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Coffin-Lowry syndrome (CLS, OMIM # 303600) is a rare X-linked disorder caused by mutations in RPS6KA3. CLS is characterized by facial dysmorphism, digit abnormalities, developmental delays, growth retardation, and progressive skeletal changes in male patients. Females with CLS are variably affected, complicating diagnosis. Here, we describe the clinical and molecular findings in a female Korean child with CLS and review the associated literature. A 5-year-old girl presented with short stature and developmental delays. She had a coarse facial appearance characterized by a prominent forehead, hypertelorism, thick lips, and hypodontia. She also had puffy tapering fingers and pectus excavatum. We performed exome sequencing and identified a novel, likely pathogenic, heterozygous variant, c.326_338delinsCTCGAGAC (p.Val109Alafs*10), in RPS6KA3 (NM_004586.2). This is the first Korean female genetically diagnosed with CLS. In contrast to the delayed bone age reported in previous studies, our patient showed advanced bone age and central precocious puberty. CLS should be considered as a differential diagnosis of short stature, tapering fingers, and developmental delay. We suggest that molecular techniques can be a useful tool for diagnosis of rare disorders such as CLS because such conditions are not simple, and the associated spectrum of phenotypes can vary.

Background/Aims: As the characteristics of inflammatory bowel disease (IBD) differ between Asians and Westerners, it is necessary to determine adequate therapeutic strategy for Asian IBD patients. We evaluated the current treatment of IBD in Asian countries/regions using a web-based survey. Methods: The Korean Association for the Study of Intestinal Diseases conducted a multinational web-based survey for current IBD care in Asia between September 16, 2020, and November 13, 2020. Results: A total of 384 doctors treating IBD patients from 24 Asian countries/regions responded to the survey. Anti-tumor necrosis factor (TNF) agents, anti-integrins, and anti-interleukin-12/23 agents were available for use by 93.8%, 72.1%, and 70.1% of respondents in Asian countries/regions. Compared with a previous survey performed in 2014, an increased tendency for treatment with biologics, including anti-TNF agents, was observed. In the treatment of corticosteroid-refractory acute severe ulcerative colitis, 72.1% of respondents chose anti-TNF agents, followed by tacrolimus (11.7%). In the treatment of corticosteroid-refractory Crohn’s disease, 90.4% chose anti-TNF agents, followed by thiopurines (53.1%), anti-interleukin-12/23 agents (39.3%), and anti-integrin agents (35.7%). In the treatment of Crohn’s disease patients refractory to anti-TNF agents, the most preferred strategy was to measure serum levels of anti-TNF and anti-drug antibodies (40.9%), followed by empiric dose escalation or shortening of dosing intervals (25.3%). Conclusions Although there were some differences, treatment strategies for patients with IBD were mostly similar among Asian doctors. Based on the therapeutic outcomes, it is necessary to identify the most appropriate therapeutic strategy for Asian IBD patients.

Background: Thiazolidinediones (TZDs) have been associated with various safety concerns including weight gain, bladder cancer, and congestive heart failure (CHF). This study evaluated the efficacy and safety of lobeglitazone, a novel TZD in patients with type 2 diabetes mellitus (T2DM) in real practice. Methods: In this non-interventional, multi-center, retrospective, and observational study conducted at 15 tertiary or secondary referral hospitals in Korea, a total of 2,228 patients with T2DM who received lobeglitazone 0.5 mg for more than 1 year were enrolled. Results: Overall adverse events (AEs) occurred in 381 patients (17.10%) including edema in 1.97% (n=44). Cerebrovascular and cardiovascular diseases were identified in 0.81% (n=18) and 0.81% (n=18), respectively. One case of CHF was reported as an AE. Edema occurred in 1.97% (n=44) of patients. Hypoglycemia occurred in 2.47% (n=55) of patients. Fracture occurred in 1.17% (n=26) of all patients. Lobeglitazone significantly decreased HbA1c level, resulting in a mean treatment difference of -1.05%± 1.35% (P<0.001), and decreased total cholesterol, triglyceride, and low-density lipoprotein cholesterol. However, it increased high-density lipoprotein cholesterol, regardless of statin administration. The patients who received lobeglitazone 0.5 mg showed an apparent reduction in glycosylated hemoglobin (HbA1c) from baseline during the first 6 months of treatment. The HbA1c levels remained stable between months 6 and 42. Conclusion Lobeglitazone has long-term safety profile, good glycemic-lowering effect and long-term durability of glycemic control in real-world clinical settings.

Background/Aims: Our study aimed to evaluate the long-term outcomes and risk factors forrelapse after anti-tumor necrosis factor (TNF)-α cessation in inflammatory bowel disease (IBD) patients because they are not well established. Methods: A retrospective multicenter cohort study was conducted involving patients with Crohn’s disease (CD) or ulcerative colitis (UC) from 10 referral hospitals in Korea who discontinued firstline anti-TNF therapy after achieving clinical remission. Results: A total of 109 IBD patients (71 CD and 38 UC) with a median follow-up duration of 56months were analyzed. The cumulative relapse rates at 1, 3, and 5 years were 11.3%, 46.7%, and 62.5% for CD patients and 28.9%, 45.3%, and 60.9% for UC patients. Multivariable Coxanalysis revealed that discontinuation owing to the clinician’s decision was associated with lower risk of relapse (vs patient’s preference: hazard ratio [HR], 0.13; 95% confidence interval [CI], 0.04 to 0.48; p=0.002) and adalimumab use was associated with higher risk of relapse (vs infliximab: HR, 4.42; 95% CI, 1.24 to 17.74; p=0.022) in CD patients. Mucosal healing was associated with lower risk of relapse (vs nonmucosal healing: HR, 0.12; 95% CI, 0.02 to 0.83; p=0.031) in UC patients. Anti-TNF re-induction was provided to 52 patients, and a response was obtained in 50 patients. However, 25 of them discontinued retreatment owing to a loss of response (n=15), the patient’s preference (n=6), and other factors (n=4). Conclusions More than 60% of IBD patients in remission under anti-TNF therapy relapsed within 5 years of treatment cessation. Anti-TNF re-induction was effective. However, half of the patients discontinued anti-TNF therapy, and 50% of these patients discontinued treatment owing to loss of response.

Purpose: To find biomarkers for disease, there have been constant attempts to investigate the genes that differ from those in the disease groups. However, the values that lie outside the overall pattern of a distribution, the outliers, are frequently excluded in traditional analytical methods as they are considered to be ‘some sort of problem.’ Such outliers may have a biologic role in the disease group. Thus, this study explored new biomarker using outlier analysis, and verified the suitability of therapeutic potential of two genes (TM4SF4 and LRRK2). Materials and Methods: Modified Tukey’s fences outlier analysis was carried out to identify new biomarkers using the public gene expression datasets. And we verified the presence of the selected biomarkers in other clinical samples via customized gene expression panels and tissue microarrays. Moreover, a siRNA-based knockdown test was performed to evaluate the impact of the biomarkers on oncogenic phenotypes. Results: TM4SF4 in lung cancer and LRRK2 in breast cancer were chosen as candidates among the genes derived from the analysis. TM4SF4 and LRRK2 were overexpressed in the small number of samples with lung cancer (4.20%) and breast cancer (2.42%), respectively. Knockdown of TM4SF4 and LRRK2 suppressed the growth of lung and breast cancer cell lines. The LRRK2 overexpressing cell lines were more sensitive to LRRK2-IN-1 than the LRRK2 under-expressing cell lines Conclusion Our modified outlier-based analysis method has proved to rescue biomarkers previously missed or unnoticed by traditional analysis showing TM4SF4 and LRRK2 are novel target candidates for lung and breast cancer, respectively.