Dementia is a neuropsychiatric disorder that primarily affects the elderly, leading to a widespread decline in cognitive function and significant impairment of occupational, social, and personal functioning. In addition to cognitive deficits, dementia is frequently comorbid with behavioral and psychological symptoms of dementia (BPSD), such as agitation.When present, these secondary symptoms can exacerbate the clinical course of the disease, reduced treatment responsiveness, increased rates of admission to long-term care facilities, extended hospitalization, higher risk of personal injury and a substantial socioeconomic burden. Given these consequences, early management of BPSD—particularly agitation—is critical to mitigating these risks. Although antipsychotics are commonly prescribed to manage agitation, risperidone remains the only agent approved by regulatory authorities for this indication. Recently, however, brexpiprazole, a medication with a pharmacological profile distinct from that of risperidone, received U.S. FDA approval (on May 11, 2023) for the treatment of agitation associated with Alzheimer’s disease. Agitation is among the most prevalent BPSD manifestations, with symptoms ranging from verbal to physical aggression. Given its recent approval and unique pharmacodynamic properties, brexpiprazole may have strong potential as a therapeutic option for this population. This paper aims to review the pharmacological mechanisms, clinical evidence, and future perspectives of brexpiprazole as a novel therapeutic option for managing agitation in patients with Alzheimer’s disease.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

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.