1.Effectiveness of low-dose mepolizumab in refractory eosinophilic granulomatosis with polyangiitis: systemic steroid use and remission
Mi-Ae KIM ; Ji-Hyun LEE ; Eun-Kyung KIM ; Jung-Hyun KIM ; Jisoo PARK ; Se Hee LEE ; Tae-Bum KIM
The Korean Journal of Internal Medicine 2026;41(1):163-174
Background/Aims:
This study investigated the clinical efficacy of low-dose mepolizumab (100 mg) in controlling severe eosinophilic asthma, aiming to induce eosinophilic granulomatosis with polyangiitis (EGPA) remission and reduce systemic steroid usage. Additionally, we constructed a basic frame for our longitudinal EGPA cohort by collecting serial blood samples before, during, and after mepolizumab treatment in EGPA patients.
Methods:
We conducted a 2-year prospective observational cohort study in patients with uncontrolled severe eosinophilic asthma and refractory EGPA who used systemic steroids (≥ 7.5 mg/day of prednisolone) or other immunosuppressant drugs for at least 6 months. All patients were treated with 100 mg of mepolizumab every 4 weeks for 1 year to control severe eosinophilic asthma and then were followed for an additional 1 year to monitor their disease course. We analyzed total systemic steroid use and EGPA remission/relapse during the study period.
Results:
Three EGPA patients were included in this study and completed 16 study visits over a 2-year period. After 1 year of treatment with mepolizumab (100 mg monthly), all 3 patients were able to reduce their maintenance dose of systemic steroids, with 2 patients completely discontinuing use. These 2 patients achieved EGPA remission during mepolizumab treatment, and their remission status remained stable for 1 year after they stopped receiving the medication.
Conclusions
Low-dose mepolizumab treatment demonstrated clinical efficacy in reducing the maintenance dose of systemic steroids required for severe refractory EGPA. While not all patients achieved EGPA remission with low-dose mepolizumab, some did, and their remission persisted even after treatment discontinuation.
2.Applying National Whole-genome Sequencing Findings for Rare Diseases in Clinical Practice: The Imperative of a Multidisciplinary Approach
Kyung Sun PARK ; Sunghwan SHIN ; Jong-Ho PARK ; Young-Eun KIM ; Won Kyung KWON ; Min-Kyung SO ; Changhee HA ; Ja-Hyun JANG ; Taeheon LEE ; Chang-Seok KI ; Yoonjung KIM ; Kyung-A LEE ; Inho PARK ; Sejoon LEE ; Hong-Hee WON ; ; Jong-Won KIM
Annals of Laboratory Medicine 2026;46(1):94-103
Background:
As nationwide government-led whole-genome sequencing (WGS) projects progress, optimizing the clinical integration of large-scale WGS results is crucial. We explored how the initial analysis from Korea’s First WGS Pilot Study for Rare Diseases was applied in clinical practice, and then we reanalyzed the data comprehensively at Samsung Medical Center (SMC) Seoul, Korea.
Methods:
A prospective cohort study designed to collect WGS data under a Korean national initiative was conducted from August 2020 to December 2021. We focused on patients with rare diseases recruited from 16 university hospitals. The participants included 5,000 individuals (2,200 probands and 2,800 family members). The initial WGS data and diagnostic reference reports (from 682 probands and 484 family members), generated based on the First Korean WGS Pilot Study for Rare Diseases, were subsequently reanalyzed by SMC.
Results:
The initial analysis of the First Korean WGS Pilot Study data revealed a diagnostic rate of 17%. Upon receiving these results, the SMC conducted two rounds of reanalysis, increasing the diagnostic rate from 15% in the first analysis, to 18% in the second, and finally to 24% in the third (P = 1.6 × 10 −5 ). Key factors in improving the genetic diagnosis included increased detection of novel (likely) pathogenic variants (P = 1.0 × 10 −4 ), improved diagnostic rates with larger family recruitment (P = 0.004), and refined clinical information for more precise genotype–phenotype correlation analysis (40%).
Conclusions
Although national WGS projects lay a foundation for rare disease diagnosis, hospital-level reanalysis and multidisciplinary collaborations are crucial for optimizing diagnostic outcomes.
3.Diagnostic Accuracy of Serological Tests for Mycoplasma pneumoniae Infections in Children with Pneumonia, Based on Symptom Onset
Gahee KIM ; Ki Wook YUN ; Dayun KANG ; Taek Jin LEE ; Byung Wook EUN ; Hyunju LEE ; Yae-Jean KIM ; Doo Ri KIM ; Areum SHIN ; Hyun Mi KANG ; Ye Ji KIM ; Byung Ok KWAK ; Younghee LEE ; Ye Kyung KIM ; Young June CHOE ; Woosuck SUH ; Kyo Jin JO ; Kyung-Ran KIM ; Eun Young CHO ; Kyung Min KIM ; Joon Kee LEE ; Su Eun PARK
Annals of Laboratory Medicine 2026;46(2):162-170
Background:
Mycoplasma pneumoniae is a major cause of community-acquired pneumonia (CAP) in children, with a rising incidence of macrolide resistance. Early diagnosis is crucial for reducing the disease burden; however, current diagnostic tools have limitations.We evaluated the diagnostic accuracy of serological assays and their performance based on symptom onset in children with CAP.
Methods:
From September 2023 to September 2024, we prospectively enrolled children with CAP, classified as M. pneumoniae pneumonia (MPP) or non-MPP, from 16 hospitals in Korea. Serological testing included chemiluminescence immunoassay (CLIA) and ELISA for detecting IgM and IgG, along with particle agglutination (PA) for total antibody measurements. Serological responses were analyzed at different times after symptom onset (0–4, 5–9, and 10–21 days).
Results:
Among 472 children with CAP (362 MPP, 110 non-MPP), 138 (29.2%) underwent PA testing, and 334 (70.8%) underwent IgM testing. PA at a 1:640 cutoff showed 48.0% sensitivity and 100% specificity. CLIA and ELISA showed comparable sensitivities (69.1% vs. 69.2%) and specificities (76.9% vs. 66.7%) for IgM testing. Seropositivity increased significantly with time since symptom onset (P for trend < 0.001), reaching 97.9% for IgM, 62.5% for IgG, and 94.7% for PA at 10–21 days.
Conclusions
The time post-symptom onset significantly influenced the diagnostic utility of serological tests for pediatric MPP, which showed limited value during the early stage of illness. These findings emphasize the importance of symptom onset-based interpretation of serological test results and their utility in complementing PCR when optimizing MPP diagnosis in children.
4.Final adult height in male patients with central precocious puberty after gonadotropin-releasing hormone agonist treatment
Kyoung Won CHO ; Youn Kyoung KIM ; Ji Eun YOO ; Joon Young KIM ; Seo Jung KIM ; Sujin KIM ; Youngha CHOI ; Kyungchul SONG ; Eun Byeol LEE ; Hyun Wook CHAE ; Junghwan SUH
Annals of Pediatric Endocrinology & Metabolism 2026;31(1):30-37
Purpose:
We aimed to compare the final adult height (FAH) of male patients with central precocious puberty (CPP) after treatment with a gonadotropin-releasing hormone agonist (GnRHa). Specifically, we compared FAH with the target height (TH) and the predicted adult height (PAH) before and after GnRHa treatment to quantify height gain and identify predictive factors.
Methods:
We retrospectively reviewed the medical records of 92 male patients with CPP and known FAH after GnRHa treatment at the Department of Pediatrics of Severance Children’s Hospital between January 2000 and June 2024.
Results:
The mean duration of GnRHa treatment was 2.7±1.3 years. A significant 1.1±0.9 years narrowing was observed in the difference between bone age (BA) and chronological age (CA) during treatment (P<0.001). TH was 172.4±3.4 cm. FAH was 173.6±6.4 cm. FAH was greater than TH by 1.2±5.9 cm (P=0.047). PAH before and after treatment was 179.9±8.1 and 181.2±7.4 cm, respectively. PAH was increased by 1.3±4.9 cm (P=0.012) after treatment. As the PAH standard deviation score (SDS) before GnRHa treatment increased, FAH tended to exceed TH. In contrast, higher testosterone levels before treatment are associated with FAH falling below TH. A longer duration of treatment and taller TH are associated with an FAH SDS greater than height SDS before treatment. Conversely, a greater weight SDS, BA–CA difference, and testis size before treatment are associated with FAH SDS being less than height SDS before GnRHa treatment.
Conclusion
GnRHa treatment improved FAH and inhibited bone maturation in male patients with CPP.
5.Nationwide Survey on Endoscopic Submucosal Dissection for Early Gastric Cancer in Korea: Results From the Korean College of Helicobacter and Upper Gastrointestinal Research (KCHUGR) 2023 Survey
Jae Yong PARK ; Jeong Hoon LEE ; Tae-Se KIM ; Da Hyun JUNG ; Bong Eun LEE ; Yonghoon CHOI ; Wan-Sik LEE ; Young-Il KIM ; Sun Hyung KANG ; Hyunsoo CHUNG ; Su Jin KIM ; Joon Sung KIM ; Donghoon KANG ; Su Youn NAM ; Seung Han KIM ; Hyo-Joon YANG ; Hyun LIM ; Jin LEE ; Seon-Young PARK ; Seung-Woo LEE ; Sun Moon KIM ; Sam Ryong JEE ; Dae Young CHEUNG ; Chung Hyun TAE ; Seokin KANG ; Sung Chul PARK ; Seung In SEO ; Cheol Min SHIN ; Kee Don CHOI ; Jong Yeul LEE ;
Journal of Gastric Cancer 2026;26(2):169-183
Purpose:
Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research.
Materials and Methods:
Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes.Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes.
Results:
Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days.
Conclusions
This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.
6.Optimizing Healthspan in Women: A New Paradigm for Successful Aging through the Menopausal Transition
Hyun Joo LEE ; Eun Hee YU ; Jong Kil JOO ; Yong Jin NA
Journal of Menopausal Medicine 2026;32(1):1-11
Menopause is a normative midlife transition characterized by profound endocrine remodeling and a high burden of symptoms and functional change. Accumulating epidemiologic and translational evidence links menopausal transition with shifts in cardiometabolic risk, musculoskeletal health, sleep, mood, and perceived cognitive function. However, most data support association rather than definitive causal acceleration of aging independent of chronological time. This narrative review proposes a menopause-centered healthspan framework that integrates biological, neurocognitive, and psychosocial domains and translates evidence into pragmatic clinical pathway tools. To inform topic selection and prioritize higher-level evidence, including guidelines, randomized trials, meta-analyses, and large cohort studies, a structured evidence scan utilizing PubMed and targeted citation tracking was performed. The evidence scan identified 256 citations. After duplicate removal, titles/abstracts of 162 unique records were reviewed, of which 102 citations informed the final narrative synthesis. The results emphasize that menopausal hormone therapy remains the most effective treatment for vasomotor symptoms and an evidence-based option for reducing fracture risk in appropriate candidates. However, it is not indicated for the primary prevention of cardiovascular disease or dementia. Absolute risks and benefits vary by age, time since menopause, and formulation/route. The neurocognitive section distinguishes common, often transient midlife cognitive complaints from long-term neurodegenerative outcomes, highlighting that menopause is not established as an independent dementia risk factor in the general population. Overall, the framework aims to support individualized, equity-informed care during menopausal transition.
7.Clinical Outcomes of Endoscopic Radiofrequency Stretta Therapy for Gastroesophageal Reflux Disease Treatment: A Retrospective Analysis From2 Tertiary Centers in Korea
Hyun LIM ; Yuri KIM ; Jin Hee NOH ; Jung In LEE ; Eun Jeong GONG ; Boram CHA ; Chan Hyuk PARK ; Da Hyun JUNG ; Ju Yup LEE ; Sun Hyung KANG ; In Kyung YOO ; Joo Young CHO ; Do Hoon KIM ;
Journal of Neurogastroenterology and Motility 2026;32(2):290-297
Background/Aims:
Endoscopic anti-reflux therapy is a therapeutic option for gastroesophageal reflux disease (GERD), providing durable effects. However, clinical data from Korea remain limited. This study evaluates the clinical outcomes of endoscopic radiofrequency Stretta therapy in Korean patients.
Methods:
A retrospective analysis was conducted on 71 patients with GERD who underwent Stretta therapy at 2 tertiary hospitals in Korea between November 2015 and July 2021. Clinical outcomes, including patient satisfaction, medication cessation or reduction, and complications, were evaluated. Pre- and post-procedural esophageal manometry and 24-hour pH monitoring test results were also analyzed.
Results:
Patient satisfaction rates at 1, 6, and 12 months post-procedure were 54.7% (35/64), 70.0% (28/40), and 75.0% (21/28), respectively. Medication cessation or reduction was achieved in 31.2% (20/64) at 1 month, 70.0% (28/40) at 6 months, and 67.9% (19/28) at 12 months. Esophageal manometry (n = 21) showed no significant changes in mean lower esophageal sphincter pressure (18.7 mmHg [2.5-52.9] vs 17.4 mmHg [0.0-43.0], P = 0.702) or mean integrated relaxation pressure (8.2 mmHg [0.0-28.0] vs 10.1 mmHg [0.0-31.0], P = 0.840). The 24-hour pH monitoring (n = 18) demonstrated a nonsignificant decrease in acid exposure time (pH < 4) from 2.3% (0.0-8.4) to 1.6% (0.0-7.3) (P = 0.182). Similarly, the DeMeester score decreased non-significantly from 8.4 (0.8-27.7) to 6.6 (0.8-21.8) (P = 0.352). No procedure-related complications occurred.
Conclusion
Endoscopic radiofrequency Stretta therapy appears to be a safe treatment option for GERD and may provide favorable patient satisfaction and medication reduction.
8.Spatiotemporal Remodeling of Enteric Neural Pathways Underlies ColonicDysmotility Following Spinal Cord Injury in Rats
Min Seob KIM ; Sei KIM ; Se Eun HA ; Hyun Seok CHOI ; Myeong Hwan YU ; Jisong YOU ; Dahyun SEON ; Do Hee LEE ; Min Cheol JOO ; Yong Sung KIM ; Suck Chei CHOI ; Joong Goo KWON ; Kyung Sik PARK ; Hyun Jin KIM ; Seungil RO ; Moon Young LEE
Journal of Neurogastroenterology and Motility 2026;32(1):86-98
Background/Aims:
Spinal cord injury (SCI) frequently impairs defecation, severely affecting the quality of life. This study examines compensatory neural remodeling after SCI, focusing on basal colonic contractility, neural responses to electrical field stimulation, and alterations in excitatory cholinergic and inhibitory nitrergic pathways.
Methods:
Female Sprague–Dawley rats underwent either sham surgery or T10 spinal cord transection and were categorized into 3 groups: sham, 1-week post-SCI (acute), and 4-week post-SCI (chronic). Colonic contractility was assessed in an organ bath using electrical field stimulation in the presence of a nitric oxide synthase inhibitor. Neural protein expression was analyzed by immunofluorescence and Western blotting.
Results:
SCI produced region- and time-dependent impairments in colonic contractility, with distinct alterations in the proximal circular and longitudinal muscles across acute and chronic phases. Neural excitability shifted dynamically, showing enhanced excitatory activity in the proximal longitudinal muscle at 1-week and the distal circular muscle at 4-week post-SCI. Protein analysis revealed increased neuronal nitric oxide synthase in the proximal colon, decreasedsoluble guanylyl cyclase in the distal colon, upregulated muscarinic M3 receptor in the proximal colon, and reduced vaso-active intestinal peptide receptor 1 in both proximal and distal regions.
Conclusion
SCI induces spatiotemporal remodeling of excitatory and inhibitory neural pathways, contributing to colonic dysmotility and revealing potential targets for therapeutic intervention.
9.Myopia Management Consensus Statement in South Korean Children 2025 by the Korean Myopia Society for the Korean Association for Pediatric Ophthalmology and Strabismus
Yeon-Hee LEE ; Jae Yun SUNG ; Sun Young SHIN ; Young-Woo SUH ; Ungsoo Samuel KIM ; Hyunkyung KIM ; Kyung-Ah PARK ; Su Jin KIM ; MiRae KIM ; Hyun Jin SHIN ; Kyeong Wook LEE ; Haeng-Jin LEE ; So Young HAN ; Jinu HAN ; Eun Hee HONG ; Seung-Hee Hannah BAEK ; Hae Jung PAIK ;
Korean Journal of Ophthalmology 2026;40(2):185-205
Myopia, particularly high myopia, is a significant risk factor for several ocular pathologies including cataract, glaucoma, and retinal detachment. Excessive axial elongation associated with high myopia can induce biomechanical stretching, increasing the risk of serious complications like posterior staphyloma and myopic maculopathy. Global meta-analyses estimate that approximately 10 million people were visually impaired due to myopic maculopathy in 2015, with 3 million being blind. Recent nationwide surveys in South Korea revealed a prevalence of 65.4% for myopia and 6.9% for high myopia in children and adolescents, highlighting the urgent need for effective management. Delaying the onset and slowing the progression of myopia during childhood and adolescence is crucial for reducing the potential lifetime risk of these complications. This consensus statement, prepared by the Korean Myopia Society for the Korean Association for Pediatric Ophthalmology and Strabismus (KAPOS), reviews the current evidence for myopia control interventions and provides management strategies applicable to the South Korean clinical setting. Key interventions covered include lifestyle modifications (outdoor time, near work adjustment), optical methods (myopia-control spectacle lenses, dual-focus soft contact lenses, orthokeratology), and pharmacologic treatment (low-concentration atropine), as well as combination therapies. The statement also addresses patient selection, treatment outcome evaluation using spherical equivalent and axial length changes, and the crucial aspects related to treatment cessation and the rebound effect.
10.Misinterpreted Recurrence of Autoimmune Pancreatitis as Malignant Transformation of Branch-Duct Intraductal Papillary Mucinous Neoplasm
Eun Jeong KIM ; Chang Hyun KIM ; Tae Seung LEE ; Jin Ho CHOI ; In Rae CHO ; Sang Hyub LEE ; Ji Kon RYU ; Woo Hyun PAIK
Korean Journal of Pancreas and Biliary Tract 2026;31(1):13-18
This case describes a male with a history of type 1 autoimmune pancreatitis (AIP) who had a concomitant branch-duct intraductal papillary mucinous neoplasm under long-term surveillance. During follow-up, new high-risk radiologic features developed within the pancreatic cyst, raising concern for malignant transformation and ultimately leading to surgical resection. However, final histopathologic examination revealed recurrent type 1 AIP rather than malignant progression of branch-duct intraductal papillary mucinous neoplasm, a finding that represents an uncommon and diagnostically challenging manifestation. This case suggests that when new imaging changes are observed during surveillance of pancreatic cystic lesions, clinicians should consider not only malignant transformation but also the possibility of recurrence or coexistence of underlying diseases such as AIP.

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