1.Muscle Loss Driven by Extracellular Signal-Regulated Kinase Suppression via β-Adrenergic Activation in High-Normal Catecholamine Status
Jieun LEE ; Ju Yeon KWAK ; Ho Yeop LEE ; Ji Sun MOON ; Hyo Ju JANG ; Ha Thi NGA ; Thi Linh NGUYEN ; Alfin Mohammad ABDILLAH ; Junglyun KIM ; Sihwan KIM ; Yong Ryoul YANG ; Jeong Eun LEE ; Hyon-Seung YI
Endocrinology and Metabolism 2026;41(2):319-332
Background:
Catecholamines play a crucial role in muscle biogenesis, but their persistent elevation is linked to muscle wasting, which is poorly understood. This study aimed to investigate the association between catecholamine levels and age-related muscle loss.
Methods:
This retrospective study evaluated the plasma levels of two catecholamines, metanephrine and normetanephrine, and the clinical characteristics of 830 patients with adrenal incidentaloma on computed tomography (CT). Cross-sectional CT data at the L3 lumbar vertebrae were used to measure muscle areas. In vitro studies on C2C12 myotubes were conducted to examine β-adrenergic receptor signaling pathways and their role in myogenesis.
Results:
Men had significantly higher mean metanephrine levels of 0.17 nmol/L and normetanephrine levels of 0.63 nmol/L than women (P<0.05). Total abdominal muscle area was negatively correlated with catecholamine levels in both men and women, with the strongest negative correlation between normetanephrine levels and total abdominal muscle area in men (r=–0.31, P<0.001). Similarly, the strongest negative correlation between visceral fat area and metanephrine was observed in men (r=–0.25, P=0.004). Clenbuterol, a β-adrenergic receptor agonist, inhibited myogenesis, including myotube formation by extracellular signal-regulated kinase (ERK) suppression in C2C12 myoblasts. Conversely, β-blockers increased myogenesis via increasing ERK phosphorylation in C2C12 cells. These findings suggest that β-adrenergic modulation influences skeletal muscle differentiation, with ERK phosphorylation.
Conclusion
Catecholamine levels are associated with age, sex, muscle mass, and fat mass. Monitoring catecholamine levels, particularly in older men and in individuals with reduced muscle mass, may help manage age-related muscle loss and lead to individualized treatment strategies.
2.Parental Roles and Challenges in Managing Pediatric Obesity: Insights from Focus Group Interviews in Korea
Jieun JU ; Jahye JUNG ; Yong Hee HONG ; Minsoo SHIN ; Yoon LEE ; Ah-Ram SUL
Journal of Obesity & Metabolic Syndrome 2025;34(1):75-83
Background:
Pediatric obesity is a global public health concern. South Korea is witnessing a notable increase in obesity rates among children and adolescents, despite various governmental interventions. Parents play a crucial role in preventing and managing pediatric obesity, as they are typically the primary observers of their child’s weight and daily habits.
Methods:
This study involved 10 parents of overweight or obese children and adolescents in South Korea, identified from a 2023 Student Health Examination. Focus group interviews were conducted to explore participants’ experiences, followed by a rigorous qualitative content analysis of the data.
Results:
The analysis revealed one main theme, parental roles and challenges in managing pediatric obesity, that encompassed five categories: parental awareness and perception of pediatric obesity; causes of pediatric obesity; parental strategies for managing obesity; barriers to management; and support systems and resources.Parental recognition of their child’s obesity was predominantly initiated through student health examinations at school, and the cause of obesity was multifactorial. Parents use various strategies, such as dietary changes and exercise promotion, but face barriers, including stigma and resource constraints. Parents demand comprehensive support from schools, healthcare providers, and community programs to effectively manage obesity.
Conclusion
These findings highlight the need for tailored interventions to address parents’ specific obstacles in managing pediatric obesity. Enhancing parental awareness, providing clear information, and strengthening support systems are essential for preventing and managing pediatric obesity in South Korea.
3.The role of large language models in the peer-review process: opportunities and challenges for medical journal reviewers and editors
Jisoo LEE ; Jieun LEE ; Jeong-Ju YOO
Journal of Educational Evaluation for Health Professions 2025;22(1):4-
The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.
4.Parental Roles and Challenges in Managing Pediatric Obesity: Insights from Focus Group Interviews in Korea
Jieun JU ; Jahye JUNG ; Yong Hee HONG ; Minsoo SHIN ; Yoon LEE ; Ah-Ram SUL
Journal of Obesity & Metabolic Syndrome 2025;34(1):75-83
Background:
Pediatric obesity is a global public health concern. South Korea is witnessing a notable increase in obesity rates among children and adolescents, despite various governmental interventions. Parents play a crucial role in preventing and managing pediatric obesity, as they are typically the primary observers of their child’s weight and daily habits.
Methods:
This study involved 10 parents of overweight or obese children and adolescents in South Korea, identified from a 2023 Student Health Examination. Focus group interviews were conducted to explore participants’ experiences, followed by a rigorous qualitative content analysis of the data.
Results:
The analysis revealed one main theme, parental roles and challenges in managing pediatric obesity, that encompassed five categories: parental awareness and perception of pediatric obesity; causes of pediatric obesity; parental strategies for managing obesity; barriers to management; and support systems and resources.Parental recognition of their child’s obesity was predominantly initiated through student health examinations at school, and the cause of obesity was multifactorial. Parents use various strategies, such as dietary changes and exercise promotion, but face barriers, including stigma and resource constraints. Parents demand comprehensive support from schools, healthcare providers, and community programs to effectively manage obesity.
Conclusion
These findings highlight the need for tailored interventions to address parents’ specific obstacles in managing pediatric obesity. Enhancing parental awareness, providing clear information, and strengthening support systems are essential for preventing and managing pediatric obesity in South Korea.
5.The role of large language models in the peer-review process: opportunities and challenges for medical journal reviewers and editors
Jisoo LEE ; Jieun LEE ; Jeong-Ju YOO
Journal of Educational Evaluation for Health Professions 2025;22(1):4-
The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.
6.Progressive tooth pattern changes in Cilk1-deficient mice depending on Hedgehog signaling.
Minjae KYEONG ; Ju-Kyung JEONG ; Dinuka ADASOORIYA ; Shiqi KAN ; Jiwoo KIM ; Jieun SONG ; Sihyeon PARK ; Suyeon JE ; Seok Jun MOON ; Young-Bum PARK ; Hyuk Wan KO ; Eui-Sic CHO ; Sung-Won CHO
International Journal of Oral Science 2025;17(1):71-71
Primary cilia function as critical sensory organelles that mediate multiple signaling pathways, including the Hedgehog (Hh) pathway, which is essential for organ patterning and morphogenesis. Disruptions in Hh signaling have been implicated in supernumerary tooth formation and molar fusion in mutant mice. Cilk1, a highly conserved serine/threonine-protein kinase localized within primary cilia, plays a critical role in ciliary transport. Loss of Cilk1 results in severe ciliopathy phenotypes, including polydactyly, edema, and cleft palate. However, the role of Cilk1 in tooth development remains unexplored. In this study, we investigated the role of Cilk1 in tooth development. Cilk1 was found to be expressed in both the epithelial and mesenchymal compartments of developing molars. Cilk1 deficiency resulted in altered ciliary dynamics, characterized by reduced frequency and increased length, accompanied by downregulation of Hh target genes, such as Ptch1 and Sostdc1, leading to the formation of diastemal supernumerary teeth. Furthermore, in Cilk1-/-;PCS1-MRCS1△/△ mice, which exhibit a compounded suppression of Hh signaling, we uncovered a novel phenomenon: diastemal supernumerary teeth can be larger than first molars. Based on these findings, we propose a progressive model linking Hh signaling levels to sequential changes in tooth patterning: initially inducing diastemal supernumerary teeth, then enlarging them, and ultimately leading to molar fusion. This study reveals a previously unrecognized role of Cilk1 in controlling tooth morphology via Hh signaling and highlights how Hh signaling levels shape tooth patterning in a gradient-dependent manner.
Animals
;
Hedgehog Proteins/physiology*
;
Mice
;
Signal Transduction/physiology*
;
Tooth, Supernumerary
;
Molar
;
Cilia/physiology*
;
Odontogenesis/physiology*
;
Patched-1 Receptor
;
Protein Serine-Threonine Kinases/physiology*
;
Mice, Knockout
;
Adaptor Proteins, Signal Transducing
7.The role of large language models in the peer-review process: opportunities and challenges for medical journal reviewers and editors
Jisoo LEE ; Jieun LEE ; Jeong-Ju YOO
Journal of Educational Evaluation for Health Professions 2025;22(1):4-
The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.
8.Parental Roles and Challenges in Managing Pediatric Obesity: Insights from Focus Group Interviews in Korea
Jieun JU ; Jahye JUNG ; Yong Hee HONG ; Minsoo SHIN ; Yoon LEE ; Ah-Ram SUL
Journal of Obesity & Metabolic Syndrome 2025;34(1):75-83
Background:
Pediatric obesity is a global public health concern. South Korea is witnessing a notable increase in obesity rates among children and adolescents, despite various governmental interventions. Parents play a crucial role in preventing and managing pediatric obesity, as they are typically the primary observers of their child’s weight and daily habits.
Methods:
This study involved 10 parents of overweight or obese children and adolescents in South Korea, identified from a 2023 Student Health Examination. Focus group interviews were conducted to explore participants’ experiences, followed by a rigorous qualitative content analysis of the data.
Results:
The analysis revealed one main theme, parental roles and challenges in managing pediatric obesity, that encompassed five categories: parental awareness and perception of pediatric obesity; causes of pediatric obesity; parental strategies for managing obesity; barriers to management; and support systems and resources.Parental recognition of their child’s obesity was predominantly initiated through student health examinations at school, and the cause of obesity was multifactorial. Parents use various strategies, such as dietary changes and exercise promotion, but face barriers, including stigma and resource constraints. Parents demand comprehensive support from schools, healthcare providers, and community programs to effectively manage obesity.
Conclusion
These findings highlight the need for tailored interventions to address parents’ specific obstacles in managing pediatric obesity. Enhancing parental awareness, providing clear information, and strengthening support systems are essential for preventing and managing pediatric obesity in South Korea.
9.Lessons for Future Vaccination Policies: COVID-19 Vaccination Intention in People With and Without Chronic Diseases
Jieun JU ; Kihye HAN ; Jieun KIM ; Yunhyung KWON
Asian Nursing Research 2024;18(3):288-295
Purpose:
This study compared COVID-19 vaccination intentions in those with and without chronic diseases (CDs and non-CDs) in South Korea. We hypothesized that the factors associated with COVID-19 vaccination intentions would differ between CDs and non-CDs in South Korea.
Methods:
Using survey data collected through a Korean online panel in June 2021, we conducted a crosssectional secondary data analysis. Of the 2292 participants, 411 had at least one chronic disease. To construct a comparable dataset, we selected non-CDs via a 1:1 case-control matching for age and gender.We then utilized a multivariable binary logistic regression model to explore the factors contributing to COVID-19 vaccination intentions in CDs and non-CDs.
Results:
All told, over 75% of participants in both groups indicated that they intended to vaccinate against COVID-19. In both groups, those who mistrusted general vaccine benefits reported significantly lower COVID-19 vaccination intentions. Regarding factors associated with vaccination intentions, CDs identified anxiety regarding coronavirus and exposure to COVID-19 vaccination promotions at the community level, while non-CDs highlighted hesitancy regarding vaccines and confidence in government/health services.
Conclusion
Improving vaccination acceptance will require the development and implementation of tailored approaches for CDs and non-CDs and efforts to minimize general vaccine mistrust.
10.Rationale, Design, and Interim Observations of the Steady Movement With Innovating Leadership for Heart Failure (SMILE HF) Registry: A Multicenter Prospective Cohort Registry for Patients With Acute Heart Failure
Jah Yeon CHOI ; Mi-Na KIM ; Seongwoo HAN ; Sunki LEE ; Myung Soo PARK ; Min Gyu KONG ; Sung-Hea KIM ; Yong-Hyun KIM ; Sang-Ho JO ; Sungeun KIM ; Seonghoon CHOI ; Jinsung JEON ; Jieun LEE ; Byambakhand BATTUMUR ; Seong-Mi PARK ; Eung Ju KIM ;
International Journal of Heart Failure 2024;6(3):129-136
Background and Objectives:
Heart failure (HF) is a leading cause of hospitalization and death worldwide. The Steady Movement with Innovating Leadership for Heart Failure (SMILE HF) aims to evaluate the clinical characteristics, management, hospital course, and long-term outcomes of patients hospitalized for acute HF in South Korea.
Methods:
This prospective, observational multicenter cohort study was conducted on consecutive patients hospitalized for acute HF in nine university hospitals since September 2019. Enrolment of 2000 patients should be completed in 2024, and follow-up is planned through 2025.
Results:
Interim analysis of 1,052 consecutive patients was performed to understand the baseline characteristics. The mean age was 69±15 years; 57.6% were male. The mean left ventricular ejection fraction was 39±15%. The prevalences of HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction were 50.9%, 15.3%, and 29.2%. Ischemic cardiomyopathy (CMP) was the most common etiology (32%), followed by tachycardia-induced CMP (12.8%) and idiopathic dilated CMP (9.5%). The prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin receptor/ neprilysin inhibitor, beta-blockers, spironolactone, and sodium-glucose cotransporter-2 inhibitors at discharge were 76.8%, 66.5%, 50.0%, and 17.5%, respectively. The post-discharge 90-day mortality and readmission rates due to HF aggravation were 2.0% and 6.4%, respectively. Our analysis reveals the current state of acute HF in South Korea.
Conclusions
Our interim analysis provides valuable insights into the clinical characteristics, management, and early outcomes of acute HF patients in South Korea, highlighting the current state and treatment patterns in this population.

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