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.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.
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.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.
9.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.
10.Influence of Depression and Subjective Health Status on COVID-19 Vaccine Acceptance: Based on the 2021 Community Health Survey
Yong Ho LEE ; Seong-Eon PARK ; Sung SUNWOO
Korean Journal of Health Promotion 2024;24(3):127-133
Background:
Coronavirus Disease 2019 (COVID-19) is a novel coronavirus identified in 2019 that exhibited an exceptionally rapid spread. Although the development and administration of COVID-19 vaccines progressed quickly, concerns about side effects and safety persisted. This study utilized data from the 2021 Community Health Survey to analyze the relationship between COVID-19 vaccination and psychosocial factors, including depression and subjective health status.
Methods:
Analysis included 203,449 individuals, excluding those who had not received or were ineligible for the COVID-19 vaccine, based on the 2021 Community Health Survey. The chi-square tests assessed sociodemographic and health status differences related to vaccination status. Subjective health status was categorized based on survey responses as ‘good’ or ‘poor,’ and depression was assessed using the self-reported Patient Health Questionnaire-9. The association between depression, subjective health status, and vaccination status was examined using chi-square tests, followed by multiple logistic regression to determine independent effects.
Results:
Vaccination rates were higher among the elderly, those with lower education, higher income, healthcare workers, and individuals with lower depression, higher subjective health, and chronic conditions like hypertension or diabetes. Significantly lower vaccination rates were observed in those with lower subjective health and Patient Health Questionnaire-9 scores ≥5 or ≥10. Among individuals with chronic illnesses, those with good subjective health had the lowest odds for non-vaccination (odds ratio=0.42; 95% confidence interval, 0.39-0.45), while those without chronic illnesses and poor subjective health had the highest odds (odds ratio=1.89; 95% confidence interval, 1.76-2.02).
Conclusions
This study found significantly higher odds ratios for vaccine non-receipt among individuals with lower levels of depression and subjective health status. Incorporating psychosocial factors such as depression and subjective health status may be crucial in developing strategies to enhance vaccination rates during future outbreaks of novel infectious diseases.

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