Background/Aims: Potassium-competitive acid blockers (P-CABs) have emerged as promising alternatives to proton pump inhibitors (PPIs) to treat erosive esophagitis (EE). This study aims to compare the efficacy and safety of P-CABs and PPIs in patients with mild to severe EE stratified by treatment phase. Methods: A systematic literature search was conducted using PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials comparing the efficacy of P-CABs and PPIs for EE were included. The pooled risk ratios (RRs) and risk differences with 95% confidence intervals (CIs) were calculated. A frequentist network meta-analysis was performed, and treatment ranking was assessed using P-scores. Results: Nineteen studies evaluating 5 P-CABs (vonoprazan, tegoprazan, keverprazan, fexuprazan, and zastaprazan) and 2 PPIs (lansoprazole and esomeprazole) were included. P-CABs demonstrated superior efficacy in healing EE during the initial phase, particularly in patients with severe EE (RR = 1.10; 95% CI, 1.00-1.20) and were also associated with a lower EE recurrence risk during maintenance treatment (RR = 0.59; 95% CI, 0.41-0.85). The efficacy was notably greater in patients with higher EE severity and among cytochrome P450 2C19 extensive metabolizers. The safety profiles of the P-CABs and PPIs were comparable. Vonoprazan consistently ranked the highest for both initial treatment (P-score = 0.68) and maintenance (P-score = 0.94). Conclusions P-CABs, especially vonoprazan, showed superior efficacy compared to PPIs in both the initial and maintenance treatment of EE. These findings support the use of P-CABs as a potent and reliable first-line option for EE management, particularly in high-risk populations, with acceptable safety outcomes.

Gastroesophageal reflux disease (GERD) is a chronic and relapsing gastrointestinal disorder characterized by the reflux of gastric contents into the esophagus, leading to troublesome symptoms and/or complications. Since the publication of the 2020 Seoul Consensus on GERD, significant new evidence has emerged, particularly regarding acid-suppressive therapies and diagnostic approaches. This 2025 focused update aims to refine GERD management strategies by incorporating the latest evidence on acid suppressive therapies and regional considerations in Asian populations. This study builds on the 2020 Seoul Consensus by integrating systematic reviews, meta-analyses, and expert consensuses to offer updated recommendations for the definition and medical treatment of GERD. These guidelines incorporate recent advances in acid-suppressive therapies, particularly potassium-competitive acid blockers, and adopt updated diagnostic frameworks in accordance with the Lyon Consensus 2.0. Key clinical questions were identified and structured using the following format: Population, Intervention, Comparator, Outcome. The resulting recommendations address the initial treatment, long-term maintenance strategies, and role of personalized therapy based on disease severity, such as the grade of reflux esophagitis. Six key statements are presented: updated definition and classification of GERD (Statement 1); initial and long-term treatment strategies tailored to GERD phenotypes, such as non-erosive reflux disease, mild erosive esophagitis, and severe erosive esophagitis (Statements 2-5); and dose optimization strategies for long-term safety (Statement 6). These guidelines aim to support gastroenterologists and general healthcare providers in making individualized evidence-based decisions for GERD management.

The trend toward miniaturization and multi-functionalization of implantable medical devices is shifting the paradigm of medicine from treatment to prevention and precision management; however, it faces a bottleneck due to the energy density limits of batteries. Existing power transfer technologies based on electromagnetic induction or radio frequency cause rapid efficiency degradation and electromagnetic interference issues in micro-scale devices. This paper reviews laser-based optical wireless power transfer technology as an innovative alternative to these issues, with particular emphasis on its potential medical applications. We provide an in-depth analysis of strategies to maximize penetration depth using near-infrared windows and light propagation characteristics within biological tissue, optimization of conversion efficiency through bandgap engineering of silicon (Si) and gallium arsenide (GaAs) based photovoltaic cells, and the latest wavefront shaping and optical phased array technologies to overcome dynamic scattering. Furthermore, by chronologically organizing research trends over the past 20 years, we discuss the paradigm shift from passive devices to active intelligent systems and present the technical and regulatory challenges for clinical adoption based on international safety standards (IEC 60825-1, ISO 14708-1), ultimately providing a technical roadmap for the energy autonomy of next-generation bio-electronic medicine.

Purpose: While MRI-based tumor regression grade (mrTRG) has shown promise in evaluating pathologic response to concurrent chemoradiotherapy (CCRT) in rectal cancer, its ability to predict pathologic complete response remains limited.This study aimed to enhance mrTRG’s diagnostic performance in predicting ypT0–1N0 status, a key factor in considering non-radical management after CCRT for locally advanced rectal cancer (LARC). Methods: This retrospective study included 430 patients with LARC who underwent radical resection following CCRT at a single referral hospital between April 2018 and September 2024. Multivariable logistic regression was used to identify predictive factors associated with achieving ypT0–1N0 status. The diagnostic performances of mrTRG1–2 alone and in combination with other factors were assessed by comparing sensitivity, specificity, positive-predictive value (PPV), negative-predictive value, and area under the curve (AUC). Results: Ninety-three patients (21.6%) achieved ypT0–1N0. In the multivariable analysis, fungating type, cT1–2, and mrTRG1–2 were independent predictors for ypT0–1N0. Integrating mrTRG with gross tumor type yielded the highest AUC of 0.689 among the combined models. For predicting ypT0–1N0, the combination of mrTRG and gross tumor type improved PPV (79.2% vs. 41.5% for mrTRG alone) while also demonstrating enhanced sensitivity compared with ycT0–1N0, the conventional MRI-based predictor (40.9% vs. 22.6%). Conclusion This study demonstrated that combining mrTRG and gross tumor type improved the PPV of mrTRG in predicting ypT0–1N0 after CCRT in LARC. Further studies are warranted to validate the role of gross tumor type in refining predictive systems for selecting candidates for non-radical treatment.

Recent technological advancements and environmental shifts have reshaped the therapeutic landscape of human diseases, driving a transition from merely understanding pathogenesis to developing precise and targeted therapeutic solutions. While the 2025 Special Issue focused on identifying emerging risk factors, the 2026 Special Issue (Vol. 34, No. 1) pivots toward concrete methodological innovations and advanced therapeutic interventions. This issue presents a curated collection of ten distinguished articles organized around three core themes. First, in the field of oncology and drug resistance, studies investigate transglutaminase 2 (TG2)-mediated autophagy and ferroptosis as strategies to overcome therapeutic resistance, alongside advances in CAR-T cell engineering and the integration of artificial intelligence (AI) with robotic surgery to enable precision medicine. Second, addressing degenerative and metabolic diseases, contributions elucidate the role of Wnt/β-catenin signaling in osteoporosis, recent therapeutic advances in knee osteoarthritis, mechanisms underlying drug-induced senescence, and the application of gene-editing technologies in iPSC-derived hepatic models. Finally, investigations into the neuro–immune axis highlight the dual roles of adaptive immunity in Alzheimer’s disease and evaluate novel pharmacological modulators targeting the kynurenine–aryl hydrocarbon receptor (AhR) axis. Collectively, this Special Issue delivers groundbreaking insights and innovative strategies aimed at restoring biological homeostasis and overcoming intractable diseases.

Purpose: The male predominance in the incidence of gastric cancer (GC) is established; however, sex differences in the prognosis of GC remain controversial. As such, this study analyzed the prognosis of patients with GC based on age and sex. Materials and Methods: Data from 14,739 patients diagnosed with GC at Seoul National University Bundang Hospital between 2003 and 2023 were analyzed. Baseline characteristics, histological types of GC, overall and GC-specific survival rates (age and stage stratification), and associated risk factors were analyzed. Results: Females were significantly younger (p < 0.001) and exhibited more gastric body cancers (p < 0.001) and tumors with diffuse-type or poorly differentiated histology (p < 0.001) than males. Females exhibited an advantage over males in terms of overall survival (p=0.004), but not in GC-specific survival. However, age stratification revealed significant sex differences, that females < 50 years of age exhibited survival disadvantages (p < 0.001); however, this trend was reversed with age, and females > 60 years exhibited survival advantages (p < 0.001) for both overall and GC-specific survival. This may be explained by the lower ratio of diffuse-type GC as females age. Furthermore, in the analysis according to stage, females with stage IV disease exhibited significant survival disadvantages, with significantly younger age and a higher proportion of diffuse-type GC which exhibits aggressive features, resulting in poorer survival than in males. Conclusion Age and stage stratification revealed significant differences in survival between the sexes, which can be helpful for public health strategies.

Subglottic stenosis (SGS) and tracheal stenosis (TS) are rare conditions that can cause significant breathing difficulties and, if not properly managed, may lead to life-threatening complications. Despite their clinical importance, debate continues regarding the optimal management of adult SGS and TS, and no comprehensive guidelines have been established to date. The Korean Bronchoesophagological Society appointed a task force to develop clinical practice guidelines with the goal of providing evidence-based recommendations for managing SGS and TS in adults. The task force conducted a systematic review of the relevant literature by searching PubMed, Embase, and the Cochrane Library using predefined search terms aligned with key clinical questions. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, which also informed the formulation and reporting of the recommendations. The strength of each recommendation reflects the guideline panel’s confidence that the benefits of an intervention outweigh its risks for eligible patients. After drafting the guidelines, feedback was obtained through Delphi questionnaires completed by members of the Korean Bronchoesophagological Society. Ultimately, the committee developed 17 evidence-based recommendations across four categories: initial evaluation, medical management, surgical treatment, and postoperative management and rehabilitation. These guidelines aim to support clinicians in delivering optimal care to adult patients with SGS and TS.

Background: Programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) inhibitors are effective treatments for non-small cell lung cancer (NSCLC), but their use can lead to severe pneumonitis. This study aims to evaluate the utility of Krebs von den Lungen-6 (KL-6) for predicting and diagnosing PD-1/PD-L1 inhibitor-related pneumonitis in NSCLC patients. Methods: We conducted a prospective observational study at a university-affiliated tertiary hospital in Korea from February 2022 to June 2023. Baseline KL-6 levels were measured immediately before initiating PD-1/PD-L1 inhibitor therapy. In patients who developed pneumonitis, KL-6 levels were monitored every 1–2 weeks from the onset of pneumonitis. For patients without pneumonitis, KL-6 levels were measured every 6 weeks. We compared clinical characteristics and serial KL-6 levels between the pneumonitis and non-pneumonitis groups. Results: Eighteen patients were enrolled, with 11 developing pneumonitis. Baseline KL-6 levels did not significantly differ between the two groups (261 U/mL in the pneumonitis group vs. 373 U/mL in the non-pneumonitis group, p=0.375). In the pneumonitis group, KL-6 levels generally showed an upward trend, with a median of 412 U/mL at pneumonitis onset. Conversely, KL-6 levels in the non-pneumonitis group showed no clear overall change. Conclusion In this pilot study, baseline KL-6 was not clearly linked to PD-1/PD-L1 inhibitor-related pneumonitis in NSCLC patients. However, increases in KL-6 levels post-baseline were more frequently observed in patients who developed pneumonitis, including cases of all-cause pneumonitis.