Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Allergen immunotherapy (AIT) has been used for over a century and has been demonstrated to be effective in treating patients with various allergic diseases. AIT allergens can be administered through various routes, including subcutaneous, sublingual, intralymphatic, oral, or epicutaneous routes. Sublingual immunotherapy (SLIT) has recently gained clinical interest, and it is considered an alternative treatment for allergic rhinitis (AR) and asthma. This review provides an overview of the current evidence-based studies that address the use of SLIT for treating AR, including (1) mechanisms of action, (2) appropriate patient selection for SLIT, (3) the current available SLIT products in Korea, and (4) updated information on its efficacy and safety. Finally, this guideline aims to provide the clinician with practical considerations for SLIT.

Allergen immunotherapy (AIT) is a causative treatment of allergic diseases in which allergen extracts are regularly administered in a gradually escalated doses, leading to immune tolerance and consequent alleviation of allergic diseases. The need for uniform practice guidelines in AIT is continuously growing as the number of potential candidates for AIT increases and new therapeutic approaches are tried. This updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT, published in 2010, proposes an expert opinion by specialists in allergy, pediatrics, and otorhinolaryngology. This guideline deals with the basic knowledge of AIT, including mechanisms, clinical efficacy, allergen standardization, important allergens in Korea, and special consideration in pediatrics. The article also covers the methodological aspects of AIT, including patient selection, allergen selection, schedule and doses, follow-up care, efficacy measurements, and management of adverse reactions. Although this guideline suggests the optimal dosing schedule, an individualized approach and modifications are recommended considering the situation for each patient and clinic.

Background: Over the last decade, extracorporeal membrane oxygenation (ECMO) use in critically ill children has increased and is associated with favorable outcomes. Our study aims to evaluate the current status of pediatric ECMO in Korea, with a specific focus on its volume and changes in survival rates based on diagnostic indications. Methods: This multicenter study retrospectively analyzed the indications and outcomes of pediatric ECMO over 10 years in patients at 14 hospitals in Korea from January 2012 to December 2021. Four diagnostic categories (neonatal respiratory, pediatric respiratory, postcardiotomy, and cardiac-medical) and trends were compared between periods 1 (2012–2016) and 2 (2017–2021). Results: Overall, 1065 ECMO runs were performed on 1032 patients, with the annual number of cases remaining unchanged over the 10 years. ECMO was most frequently used for post-cardiotomy (42.4%), cardiac-medical (31.8%), pediatric respiratory (17.5%), and neonatal respiratory (8.2%) cases. A 3.7% increase and 6.1% decrease in pediatric respiratory and post-cardiotomy cases, respectively, were noted between periods 1 and 2.Among the four groups, the cardiac-medical group had the highest survival rate (51.2%), followed by the pediatric respiratory (46.4%), post-cardiotomy (36.5%), and neonatal respiratory (29.4%) groups. A consistent improvement was noted in patient survival over the 10 years, with a significant increase between the two periods from 38.2% to 47.1% (P = 0.004). Improvement in survival was evident in post-cardiotomy cases (30–45%, P = 0.002).Significant associations with mortality were observed in neonates, patients requiring dialysis, and those treated with extracorporeal cardiopulmonary resuscitation (P < 0.001). In pediatric respiratory ECMO, immunocompromised patients also showed a significant correlation with mortality (P < 0.001). Conclusion Pediatric ECMO demonstrated a steady increase in overall survival in Korea;however, further efforts are needed since the outcomes remain suboptimal compared with global outcomes.

Background: Coronary artery disease patients undergoing percutaneous coronary intervention (PCI) often exhibit reduced left ventricular ejection fraction (LVEF). However, the impact of LV dysfunction status in conjunction with platelet reactivity on clinical outcomes has not been previously investigated. Methods: From the multicenter PTRG-DES (Platelet function and genoType-Related long-term prognosis in DES-treated patients) consortium, the patients were classified as preserved-EF (PEF: LVEF ≥ 50%) and reduced-EF (REF: LVEF< 5 0%) group by echocardiography. Platelet reactivity was measured using VerifyNow P2Y 12 assay and high platelet reactivity (HPR) was defined as PRU ≥ 252. The major adverse cardiac and cerebrovascular events (MACCEs) were a composite of death, myocardial infarction, stent thrombosis and stroke at 5 years after PCI. Major bleeding was defined as Bleeding Academic Research Consortium bleeding types 3–5. Results: A total of 13,160 patients from PTRG-DES, 9,319 (79.6%) patients with the results of both PRU and LVEF were analyzed. The incidence of MACCE and major bleeding was higher in REF group as compared with PEF group (MACCEs: hazard ratio [HR] 2.17, P < 0.001, 95% confidence interval [CI] 1.85–2.55; major bleeding: HR 1.78, P < 0.001, 95% CI 1.39–2.78).The highest rate of MACCEs was found in patients with REF and HPR, and the difference between the groups was statistically significant (HR 3.14 in REF(+)/HPR(+) vs. PEF(+)/HPR(-) group,P <0.01, 95% CI 2.51–3.91). The frequency of major bleeding was not associated with the HPR in either group. Conclusion LV dysfunction was associated with an increased incidence of MACCEs and major bleeding in patients who underwent PCI. The HPR status further exhibited significant increase of MACCEs in patients with LV dysfunction in a large, real-world registry.Trial Registration: ClinicalTrials.gov Identifier: NCT04734028

The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.

The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.

The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.

The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.