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.Analysis of Chronic Disease Comorbidity Rate and Related Factors in Korean Adult Cancer Patients
Korean Journal of Family Practice 2025;15(4):217-222
Background:
In Korea, the number of patients with chronic diseases and cancer is increasing. This study aims to analyze the prevalence and associated factors with chronic diseases among adult cancer patients in Korea.
Methods:
We used data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2015 and 2020. In all, 1,842 adults aged 19 years or older diagnosed with cancer were included in the case group, and 34,975 people who had never been diagnosed with cancer were included in the control group. The main chronic diseases analyzed were hypertension, diabetes mellitus, dyslipidemia, stroke, cardiovascular disease, chronic liver disease, and chronic kidney disease.
Results:
Approximately 54.7% of the patients with cancer had chronic diseases. Logistic regression analysis revealed that patients with cancer had a significantly higher incidence of chronic diseases such as hypertension (odds ratio [OR], 1.49; 95% confidence interval [CI],1.33–1.66), diabetes mellitus (1.40; 95% CI, 1.22–1.61), dyslipidemia (1.41; 95% CI, 1.26–1.59), cardiovascular disease (1.31; 95% CI, 1.05–1.64), and chronic liver disease (2.30; 95% CI, 1.76–3.00) compared to the control group. Additionally, older age (OR. 2.99; 95% CI, 2.44–3.68), female sex (1.45; 95% CI, 1.19–1.76), high body mass index (1.14; 95% CI, 1.01–1.24), smoking (1.29; 95% CI, 1.06–1.56), and drinking (1.20; 95% CI, 1.09–1.33) were significantly associated with chronic diseases.
Conclusion
A significant proportion of adult cancer patients in Korea suffer from chronic diseases at a higher frequency, which requires an integrated approach to treatment and health management.
3.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.
4.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.
5.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.
6.Association of Geriatric Depressive Symptoms and Government-Initiated Senior Employment Program: A Population-Based Study
Soyeon PARK ; Yeojin KIM ; Sunwoo YOON ; You Jin NAM ; Sunhwa HONG ; Yong Hyuk CHO ; Sang Joon SON ; Chang Hyung HONG ; Jai Sung NOH ; Hyun Woong ROH
Psychiatry Investigation 2024;21(3):284-293
Objective:
The impact of the government-initiated senior employment program (GSEP) on geriatric depressive symptoms is underexplored. Unearthing this connection could facilitate the planning of future senior employment programs and geriatric depression interventions. In the present study, we aimed to elucidate the possible association between geriatric depressive symptoms and GSEP in older adults.
Methods:
This study employed data from 9,287 participants aged 65 or older, obtained from the 2020 Living Profiles of Older People Survey. We measured depressive symptoms using the Korean version of the 15-item Geriatric Depression Scale. The principal exposure of interest was employment status and GSEP involvement. Data analysis involved multiple linear regression.
Results:
Employment, independent of income level, showed association with decreased depressive symptoms compared to unemployment (p<0.001). After adjustments for confounding variables, participation in GSEP jobs showed more significant reduction in depressive symptoms than non-GSEP jobs (β=-0.968, 95% confidence interval [CI]=-1.197 to -0.739, p<0.001 for GSEP jobs, β=-0.541, 95% CI=-0.681 to -0.401, p<0.001 for non-GSEP jobs). Notably, the lower income tertile in GSEP jobs showed a substantial reduction in depressive symptoms compared to all income tertiles in non-GSEP jobs.
Conclusion
The lower-income GSEP group experienced lower depressive symptoms and life dissatisfaction compared to non-GSEP groups regardless of income. These findings may provide essential insights for the implementation of government policies and community-based interventions.
7.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.
8.Effects of Cetrorelix on Ovary and Endometrium Prior to AntiPD-L1 Antibody in Murine Model
Soo Jin PARK ; Yoon Young KIM ; Wonhyoung PARK ; Sunwoo PARK ; Ji Yeon HAN ; Sung Woo KIM ; Hoon KIM ; Seung-Yup KU
Tissue Engineering and Regenerative Medicine 2024;21(2):319-328
BACKGROUND:
Recent anti-cancer agents, immune checkpoint inhibitors (ICIs), have emerged as effective agents targeting the programmed cell death protein-1 (PD-1)/programmed death-ligand 1 (PD-L1) pathway. While the administration of gonadotropin-releasing hormone (GnRH) analogs before cytotoxic agents is known to preserve female reproductive organ function, the potential effects of ICIs and the protective impact of GnRH analogs on female reproductive organs, especially concerning ovarian reserve and endometrial receptivity, remain unknown. In this study, we attempted to elucidate the protective or regenerative effect on the female reproductive organ of cetrorelix prior to anti-PD-L1 antibody administration.METHOD: Using a murine model, we examined the effects of Anti-PD-L1 antibody treatment on ovarian and uterine morphology, compared them with controls, and further assessed any potential protective effect of cetrorelix, a GnRH analog. Histological examinations and quantitative reverse transcription polymerase chain reaction were employed to study the morphological changes and associated gene expression patterns.
RESULTS:
Anti-PD-L1 treatment led to a significant depletion of primordial/primary ovarian follicles and impaired decidualization in uterine stromal cells. However, while pretreatment with cetrorelix could restore normal decidualization patterns in the uterus, it did not significantly ameliorate ovarian follicular reductions. Gene expression analysis reflected these observations, particularly with marked changes in the expression of key genes like Prl and Igfbp1, pivotal in uterine decidualization.
CONCLUSION
Our study underscores the potential reproductive implications of cetrorelix treatment prior to Anti-PDL1 therapy, shedding light on its short-term protective effects on the uterus. Further studies are necessary to understand long-term and clinical implications.
9.Deep Learning-Based Automatic Classification of Ischemic Stroke Subtype Using Diffusion-Weighted Images
Wi-Sun RYU ; Dawid SCHELLINGERHOUT ; Hoyoun LEE ; Keon-Joo LEE ; Chi Kyung KIM ; Beom Joon KIM ; Jong-Won CHUNG ; Jae-Sung LIM ; Joon-Tae KIM ; Dae-Hyun KIM ; Jae-Kwan CHA ; Leonard SUNWOO ; Dongmin KIM ; Sang-Il SUH ; Oh Young BANG ; Hee-Joon BAE ; Dong-Eog KIM
Journal of Stroke 2024;26(2):300-311
Background:
and Purpose Accurate classification of ischemic stroke subtype is important for effective secondary prevention of stroke. We used diffusion-weighted image (DWI) and atrial fibrillation (AF) data to train a deep learning algorithm to classify stroke subtype.
Methods:
Model development was done in 2,988 patients with ischemic stroke from three centers by using U-net for infarct segmentation and EfficientNetV2 for subtype classification. Experienced neurologists (n=5) determined subtypes for external test datasets, while establishing a consensus for clinical trial datasets. Automatically segmented infarcts were fed into the model (DWI-only algorithm). Subsequently, another model was trained, with AF included as a categorical variable (DWI+AF algorithm). These models were tested: (1) internally against the opinion of the labeling experts, (2) against fresh external DWI data, and (3) against clinical trial dataset.
Results:
In the training-and-validation datasets, the mean (±standard deviation) age was 68.0±12.5 (61.1% male). In internal testing, compared with the experts, the DWI-only and the DWI+AF algorithms respectively achieved moderate (65.3%) and near-strong (79.1%) agreement. In external testing, both algorithms again showed good agreements (59.3%–60.7% and 73.7%–74.0%, respectively). In the clinical trial dataset, compared with the expert consensus, percentage agreements and Cohen’s kappa were respectively 58.1% and 0.34 for the DWI-only vs. 72.9% and 0.57 for the DWI+AF algorithms. The corresponding values between experts were comparable (76.0% and 0.61) to the DWI+AF algorithm.
Conclusion
Our model trained on a large dataset of DWI (both with or without AF information) was able to classify ischemic stroke subtypes comparable to a consensus of stroke experts.
10.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.

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