1.The Recommendation of the Neuropathic Pain Special Interesting Group of the International Association for the Study of Pain: A Comparison of Systematic Reviews and Meta-analyses between 2015 and 2025
Kyomin CHOI ; Kyung Min KIM ; Byung-Su KIM ; Hee-Jin KIM ; Seung Woo KIM ; Kyoungwon BAIK ; Jin Myoung SEOK ; Jun-Sang SUNWOO ; In-Uk SONG ; Ho Geol WOO ; Eek-Sung LEE ; Jin-Man JUNG ; Yun Ho CHOI ; Kwang Ik YANG ;
Journal of the Korean Neurological Association 2026;44(1):1-7
Neuropathic pain markedly impairs quality of life and imposes a substantial socioeconomic burden, while available treatments often provide only partial relief and are limited by safety concerns. The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG-IASP) first published pharmacologic recommendations in 2007, followed by a major update in 2015 and a new guideline in 2025. This narrative review specifically compares the 2015 and 2025 NeuPSIG-IASP guidelines, outlining key methodological changes and therapeutic shifts. The 2025 guideline is based on a larger, more rigorous meta-analysis, maintains α2δ-ligands (adds mirogabalin), serotonin-noradrenaline reuptake inhibitors, and tricyclic antidepressants as first-line drugs, downgrades tramadol into the opioid third-line group. It also introduces high-frequency motor-cortex repetitive transcranial magnetic stimulation as a weakly recommended third-line option and discusses implications for Korean clinical practice.
2.Exploring LEPR-Linked Metabolic Diversity through Gut Microbiome-Metabolome Network Analysis in Non-Obese Adults
Kyeong-Seog KIM ; Joo-Youn CHO ; Ye Chan PARK ; Jang Hee HONG ; Jin-Gyu JUNG ; Jung SUNWOO
Biomolecules & Therapeutics 2026;34(2):448-460
Genetic variation in the leptin receptor (LEPR) gene has been implicated in metabolic regulation, while the gut microbiome and circulating metabolites are increasingly recognized as mediators of host metabolic phenotype. However, the systems-level interactions among LEPR genotypes, gut microbial composition, and serum metabolomic profiles remain poorly understood, particularly in healthy individuals. We conducted a cross-sectional study involving 37 healthy Korean adults. Three LEPR single nucleotide polymorphisms (rs1137101, rs1173100, rs790419) were genotyped. Untargeted metabolomics of fasting serum was performed using gas chromatography–time-of-flight mass spectrometry, and gut microbiome composition was profiled by 16S rRNA gene sequencing. Statistical analysis included principal component analysis, Mann–Whitney U tests, and Spearman correlations. Network analysis integrating microbiome, metabolomic, and clinical phenotype data was conducted using Cytoscape. A total of 54 serum metabolites were identified. LEPR genotypes, particularly rs1137101 and rs1173100, were associated with differences in metabolites such as pimelic acid, malonic acid, and 2,4-dihydroxybutyric acid. Firmicutes negatively correlated with saturated fatty acids and organic acids, whereas Actinobacteria positively correlated with cholesterol and amino acids. Network analysis revealed indole-3-acetate and cholesterol as central nodes linking microbial taxa with body mass index and leptin levels. However, no direct molecular pathways connecting leptin or its receptor were identified. LEPR genetic variation is associated with distinct serum metabolomic patterns and microbiome–host networks in healthy adults. Although no direct leptin signaling links were found, network-level associations suggest indirect genetic influences on metabolic states through microbiome–metabolome interactions.These findings advance understanding of personalized metabolic regulation and gene–microbiome interplay.
3.Uncovering Putative Causal Non-coding RNAs in Acute and Chronic Myeloid Leukemia: A Genome-Wide Mendelian Randomization Study
Sunwoo JUNG ; Ji-Won KIM ; Buhm HAN
Cancer Research and Treatment 2026;58(2):664-676
Purpose:
Although non-coding RNAs (ncRNAs) have often been implicated in various cancers, their causal roles in acute (AML) and chronic myeloid leukemia (CML) remain unclear. Here, we conducted a genome-wide two-sample Mendelian randomization (MR) study to investigate the causal effects of a comprehensive set of ncRNAs on AML and CML.
Materials and Methods:
We used summary statistics of blood expression quantitative trait loci (eQTL) from the eQTLGen consortium (31,684 European participants) as exposure data. Genome-wide association study summary statistics from the FinnGen study (AML, 322 cases; CML, 303 cases) and UK Biobank (UKBB) (AML, 318 cases; CML, 153 cases) served as outcome data. The generalized inverse-variance weighted (GIVW) method was used as the primary MR method. Two additional MR methods (generalized MR-Egger and weighted median), sensitivity analyses, and the HEIDI test were further employed to support our findings.
Results:
Upregulated HCG22 and RP11-42I10.1 were causally linked to increased AML risk, while the GMDS-AS1 locus was positively associated with increased CML risk. We highlight these ncRNAs for their consistent significance across all three MR methods, with no evidence of bias in sensitivity analyses (F-test, Cochran’s Q-test, MR-Egger intercept, MR-PRESSO global test) and no indication of confounding from the HEIDI test. These findings were primarily discovered in FinnGen (FDRGIVW < 0.05), their significance was validated in UKBB (pGIVW < 0.05). Upon validation with an independent linkage disequilibrium reference panel, they remained robust.
Conclusion
This study provides evidence of causal relationships between ncRNAs and the subtypes of AML and CML, notably highlighting HCG22 and RP11-42I10.1 in AML and the GMDS-AS1 locus in CML.
4.The Association between Self-Rated Health and Body Weight Image among Korean Adolescents
Yoonsoo SUNG ; Jung Ah LEE ; Sung SUNWOO
Korean Journal of Health Promotion 2025;25(4):138-146
Background:
Self-rated health (SRH) is crucial for predicting morbidity and mortality across age groups, including adolescents and adults. Body image dissatisfaction, measured by difference between current and ideal weight, surpasses body mass index (BMI) in predicting health outcomes. We evaluated the correlation between body image perception and SRH among middle and high school students in Korea.
Methods:
This study comprised of 51,850 students aged 12–18 years who participated in the 2022 Korea Youth Risk Behavior Survey. Subjective health status was categorized into ‘good’ or ‘poor’ groups. Body image was classified into ‘underweight,’ ‘normal,’ or ‘overweight.’ BMI was determined using age-specific percentiles: underweight (<5th percentiles), overweight (85th–95th percentiles), and obese (>95th percentiles). Data analysis was performed by multivariable logistic analysis and adjusted for depressive mood, stress, and socioeconomic status.
Results:
The total participants (N=50,455) included 59.4% with normal weight according to BMI, only 36.4% perceived themselves as normal. Students who perceived themselves as having a normal weight had higher rates of good SRH compared to others. Excluding females with BMI ≥25 kg/m2, both sex showed higher odds ratios [ORs] for poor SRH when perceiving themselves overweight (male: OR=2.57, 95% confidence interval [95% CI]=2.367–2.782; female: OR=1.36, 95% CI=1.270–1.452) or underweight (male: OR=1.64, 95% CI=1.507–1.791; female: OR=1.36, 95% CI=1.256–1.472).
Conclusions
More than half of the students responded negatively to their body image, associated with poor subjective health status. Therefore, promoting accurate body weight perceptions will play a positive role in overall health of adolescents.
5.Guidelines for an alcohol clinic in primary healthcare clinics
Jin-Gyu JUNG ; Jong-Sung KIM ; Seok-Joon YOON ; Jang-Hee HONG ; Jung SUNWOO
Journal of the Korean Medical Association 2024;67(4):256-264
In clinical practice, primary healthcare physicians commonly encounter patients with alcohol-related problems. This review article introduces the concept of an alcohol clinic for treating patients with these issues at primary healthcare clinics.Current Concepts: Alcohol-related problems often give rise to health problems, which prompts primary healthcare physicians to be required to develop screening, treatment, and counseling skills. Primary healthcare clinics should actively screen for alcohol-related problems. Screening involves questions regarding the frequency, quantity, and maximum consumption of alcohol to determine risk levels. For Koreans, moderate alcohol consumption is defined as ≤8 drinks per week (1 drink=14 g of alcohol) for men aged up to 65 years, and ≤4 drinks per week for men over 65 years; consumption for women is set at half of the amount defined for men. Individuals experiencing facial flushing after alcohol consumption are advised to limit their alcohol intake to half the amount consumed by those who do not experience flushing.Discussion and Conclusion: The focus for these patients should be on their environment, particularly when implementing a family-oriented approach. The decision to initiate drug treatment should be based on the symptoms of the patient, with follow-up evaluations performed at appropriate time points. The “FRAMES Motivational Enhancement Interview” and “Insight Enhancement Counseling” are recommended for an effective counseling of patients.
6.The Effect of Psychological Resilience on Cognitive Decline in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study
Sunwoo KIM ; Chang Won WON ; Sunyoung KIM ; Jung Ha PARK ; Miji KIM ; Byungsung KIM ; Jihae RYU
Korean Journal of Family Medicine 2024;45(6):331-336
Background:
Chronic stress is associated with an increased risk of cognitive impairment and Alzheimer’s disease. This study aimed to assess whether better coping with stress, as assessed using the Brief Resilience Scale (BRS), is associated with slower cognitive decline in community-dwelling older adults.
Methods:
This study used 2018/2019 data and 2-year follow-up data from the Korean Frailty and Aging Cohort Study. Of the 3,014 total participants, we included 1,826 participants (mean age, 77.6±3.7 years, 51.9% female) who completed BRS and Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Battery and the Korean version of the Frontal Assessment Battery (FAB).
Results:
Higher BRS score at baseline was associated with a lesser decline in the Mini-Mental State Examination score over 2 years after adjusting for age, sex, years of education, smoking status, hypertension, diabetes, and depression (B, 0.175; 95% confidence interval, 0.025–0.325) for 2 years, which represents global cognitive function. Other cognitive function measurements (Word List Memory, Word List Recall, Word List Recognition, Digit Span, Trail Making Test-A, and FAB) did not change significantly with the BRS score at baseline.
Conclusion
These findings suggest that better stress-coping ability, meaning faster termination of the stress response, may limit the decline in cognitive function.
7.A Lung Cancer Risk Prediction Model from Healthy Korean Adults: A Single Center Cohort Study
Yong Ho LEE ; Taewon HWANG ; Sunwoo CHO ; Hyungseok OH ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(2):90-97
Background:
Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model.
Methods:
This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments.
Results:
Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878).
Conclusion
Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.
8.The Influence of Coronavirus Disease 2019 Pandemic-Related Daily Life Restrictions on Daily Life Satisfaction
Inwook LEE ; Sung SUNWOO ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(3):126-132
Background:
The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction.
Methods:
2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic.
Results:
The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried.
Conclusion
The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.
9.The Effect of Psychological Resilience on Cognitive Decline in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study
Sunwoo KIM ; Chang Won WON ; Sunyoung KIM ; Jung Ha PARK ; Miji KIM ; Byungsung KIM ; Jihae RYU
Korean Journal of Family Medicine 2024;45(6):331-336
Background:
Chronic stress is associated with an increased risk of cognitive impairment and Alzheimer’s disease. This study aimed to assess whether better coping with stress, as assessed using the Brief Resilience Scale (BRS), is associated with slower cognitive decline in community-dwelling older adults.
Methods:
This study used 2018/2019 data and 2-year follow-up data from the Korean Frailty and Aging Cohort Study. Of the 3,014 total participants, we included 1,826 participants (mean age, 77.6±3.7 years, 51.9% female) who completed BRS and Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Battery and the Korean version of the Frontal Assessment Battery (FAB).
Results:
Higher BRS score at baseline was associated with a lesser decline in the Mini-Mental State Examination score over 2 years after adjusting for age, sex, years of education, smoking status, hypertension, diabetes, and depression (B, 0.175; 95% confidence interval, 0.025–0.325) for 2 years, which represents global cognitive function. Other cognitive function measurements (Word List Memory, Word List Recall, Word List Recognition, Digit Span, Trail Making Test-A, and FAB) did not change significantly with the BRS score at baseline.
Conclusion
These findings suggest that better stress-coping ability, meaning faster termination of the stress response, may limit the decline in cognitive function.
10.A Lung Cancer Risk Prediction Model from Healthy Korean Adults: A Single Center Cohort Study
Yong Ho LEE ; Taewon HWANG ; Sunwoo CHO ; Hyungseok OH ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(2):90-97
Background:
Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model.
Methods:
This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments.
Results:
Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878).
Conclusion
Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

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