Purpose: This study aimed to identify the academic stress experienced by medical students in basic medical science courses and analyze its underlying factors. Methods: A survey was conducted among 228 students from a medical school in Seoul, South Korea, of whom 204 who had completed at least one basic science course were included in the final analysis. A modified stress scale for medical students and a newly developed subject-specific academic stress scale, validated through literature review, student feedback, and expert review, were employed. Data were analyzed using IBM SPSS ver. 25.0 with descriptive statistics, t-tests, chi-square tests, and one-way analysis of variance. Results: The overall academic stress among students was relatively high. The highest stress levels were observed in cell biology (mean=7.15), followed by bioinformatics (mean=5.97), molecular biology (mean=5.47), and organic chemistry (mean=5.20). Key stress factors included a lack of connectivity with clinical subjects, excessive learning volume, and inappropriate difficulty levels. Conclusion Academic stress varied significantly across courses, underscoring the need for curriculum improvements in basic medical science education. Faculty should consider adjusting course difficulty, enhancing clinical integration, motivating students, and managing workloads to reduce stress and support learning outcomes.

The efficacy of clarithromycin-containing triple therapy (TT) against Helicobacter pylori has declined in Korea, with recent first-line eradication rates falling below 70%. Clarithromycin resistance exceeded 30%, undermining the standard regimen for H. pylori. These trends necessitate a change in the treatment strategy. This review analyzed the shift proposed in the draft of the 2025 Korean H. pylori guidelines. We examined the rationale for abandoning TT as a first-line empirical therapy and the establishment of a new dual-pillar strategy: 1) the declining role of clarithromycin-containing TT as a first-line treatment and 2) polymerase chain reaction (PCR)-based tailored therapy as the recommended precision approach. We explored the 1) emergence of new empirical regimen options, 2) application of tailored therapy, and 3) adoption of potassium-competitive acid blockers (P-CABs). Empirical regimens have shifted toward four-drug combinations to achieve higher cure rates. Concomitant therapy (proton-pump inhibitor [PPI] or P-CAB+amoxicillin+clarithromycin+metronidazole) offers high efficacy but raises concerns about antibiotic overuse. As a compromise, bismuth-augmented triple regimens (adding bismuth to TT) are now recommended; these modified quadruple therapies (e.g., PACB: PPI+amoxicillin+clarithromycin+bismuth, or PAMB: PPI+amoxicillin+metronidazole+bismuth) significantly improve eradication rates without requiring a third antibiotic class. Regarding tailored therapy, PCR-based domestic clinical research data consistently achieves ≥90% cure rates in first-line treatment—markedly higher than empirical TT in Korea. Economic analyses supported the cost-effectiveness of this approach. The guideline algorithm for salvage therapy was clarified. Bismuth quadruple therapy has been confirmed as the standard second-line treatment. For third-line therapy, we analyzed the efficacy of levofloxacin-based regimens, rifabutin-based therapy, and bismuth add-on therapy with two previously unused antibiotics. The 2025 Korean guidelines establish quadruple therapies as the new standard through a dual strategy: pragmatic empirical treatment and PCR-guided tailored therapy, with P-CABs and bismuth-based regimens as key components.

Purpose: This study aims to investigate and compare the incidence, demographic characteristics, clinical manifestations, preoperative diagnostic methods, anatomical classifications, associated anomalies, operative treatments, and postoperative outcomes of patients with intestinal atresia treated by the members of the Korean Association of Pediatric Surgeons (KAPS) through three nationwide surveys. Methods: KAPS conducted 3 national surveys in 1998, 2010, and 2024 to examine the patients diagnosed with intestinal atresia. In preparation for the survey, we developed a customized case registration form to obtain data on patient sex, birth weight, gestational age, clinical manifestations, preoperative diagnostic methods, anatomical types, associated anomalies, operative treatments, and postoperative outcomes. Authorized KAPS members completed the case registration form. Results: The first, second, and third national surveys included 218, 222, and 236 individuals diagnosed with intestinal atresia, respectively. The male-to-female ratios were 1.5:1, 1.1:1, and 1.1:1, respectively. The first, second, and third national surveys revealed that 34.3%, 43.3%, and 53.4% of patients were born before 37 weeks of gestation, respectively. Additionally, 28.7%, 32.0%, and 40.7% of patients had a birth weight under 2,500 g. In the third national survey, duodenoduodenostomy was the most common procedure, performed in 70 out of 82 patients diagnosed with duodenal atresia. Resection and anastomosis were the main surgical procedures conducted in 47 out of 54 cases of jejunal atresia and 74 out of 92 cases of ileal atresia. The mortality rates in the first, second, and third national surveys were 13.8%, 3.6%, and 1.3% respectively, with the lowest rate observed in the third national survey. Conclusion These national surveys offer valuable insights into the current state of intestinal atresia, including specific surgical interventions and postoperative outcomes in South Korea. For pediatric surgeons aiming to enhance their understanding of intestinal atresia and its treatment options, these surveys could be an indispensable resource and guide.

Purpose: : This study aimed to understand the current state of patient-centered care for people with disabilities by reviewing the key definitions, elements, and aspects of previously published care models/programs that borrow a patient-centered approach using a scoping review methodology. Methods : Following Arksey and O’Malley’s five-step methodology, we conducted a keyword search in EMBASE, Web of Science, and Pubmed for articles published from 2000 to January 2022, and a total of 30 articles were selected from 1,305 initially extracted articles. Results : A total of 13 studies developed models of care for people with disabilities based on the concept of patient-centeredness, 11 studies developed and evaluated care programs with patient- centered components, and 6 studies prospectively evaluated the effectiveness of patient-centered programs in clinical trials. The studies were generally based on multidisciplinary teams and emphasized two-way communication, collaborative relationships, multidimensional assessment, and measurement of patient needs. However, elements of patient-centeredness varied across studies, and methodologies for measuring needs and evaluating effectiveness were inconsistent. Conclusion : Based on this study, there is a need for systematic research to identify integrated and desirable patient-centeredness elements in healthcare models/programs for people with disabilities. This will enable the development of more patient-centered and friendly healthcare services for people with disabilities.

Purpose: : Health literacy, or the ability to find, understand, and use health information, is a key focus in South Korea’s ‘5th National Health Promotion Comprehensive Plan.’ However, despite South Korea’s high internet penetration, research on digital health information use among people with developmental disabilities is limited. This study assesses the current state of digital health literacy in this population. Methods: : A survey was conducted on the people with disabilities and people without disabilities. General digital health information was measured using an 8-item scale by Skinner (2006), and COVID-19-related health information was assessed with a 10-item tool developed by the research team. A total of 365 responses were analyzed, comprising people with physical disabilities (189), developmental disabilities (82), and those without disabilities (94). Data analysis was performed using SPSS version 28, including MANOVA and descriptive statistics. Results: : eHealth scores for individuals with developmental disabilities (24.6 ± 9.8) were significantly lower than those with physical disabilities (32.6 ± 7.9) and those without disabilities (33.9 ± 9.1). Similarly, Covid-eHealth scores were lower for individuals with developmental disabilities (24.6 ± 8.4) compared to those with physical disabilities (29.5 ± 6.8) and those without disabilities (31.3 ± 7.7). The differences in both cases were statistically significant (p < 0.001). Conclusion : This study represents the first comprehensive examination of digital health literacy among people with developmental disabilities in South Korea. The findings indicate that while this group has lower digital health literacy, appropriate education and support can improve their skills. This underscores the need for policies and support systems to ensure they can access and effectively use digital health information, especially as healthcare becomes more digital.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

Background/Aims: Prokinetic agents and neuromodulators are among the treatment options for functional dyspepsia (FD), but their comparative efficacy is unclear. We aimed to compare the efficacy of mosapride controlled-release (CR) and nortriptyline in patients with FD after 4 weeks of treatment. Methods: Participants with FD were randomly assigned (1:1) to receive mosapride CR (mosapride CR 15 mg and nortriptyline placebo) or nortriptyline (mosapride CR placebo and nortriptyline 10 mg) in double-placebo, double-blinded, randomized controlled, parallel clinical study. The primary endpoint was defined as the proportion of patients with overall dyspepsia improvement after 4 weeks treatment. The secondary endpoints were changes in individual symptom scores, anxiety, depression, and quality of life. Results: One hundred nine participants were recruited and assessed for eligibility, and 54 in the mosapride CR group and 50 in the nortriptyline group were included in the modified intention-to-treat protocol. The rate of overall dyspepsia improvement was similar between groups (53.7% vs 54.0%, P = 0.976). There was no difference in the efficacy of mosapride CR and nortriptyline in a subgroup analysis by FD subtype (59.3% vs 52.5% in postprandial distress syndrome, P = 0.615; 44.4% vs 40.0% in epigastric pain syndrome, P = > 0.999; 50.0% vs 59.1% in overlap, P = 0.565; respectively). Both treatments significantly improved anxiety, depression, and quality of life from baseline. Conclusion Mosapride CR and nortriptyline showed similar efficacy in patients with FD regardless of the subtype. Both treatments could be equally helpful for improving quality of life and psychological well-being while also relieving dyspepsia.

Background/Aims: Acid-suppressive drugs, such as proton pump inhibitors (PPIs), are treatment options for functional dyspepsia (FD). However, the efficacy of potassium-competitive acid blockers (P-CABs) in treating FD has not yet been established. This prospective multicenter clinical trial-based study aimed to assess the efficacy and safety of tegoprazan as a P-CAB treatment in patients with FD. Methods: FD was diagnosed using the Rome IV criteria. All patients received tegoprazan 50 mg once daily for 8 weeks. Dyspeptic symptoms were assessed using a dyspepsia symptom questionnaire (5-point Likert scale, Nepean Dyspepsia Index-Korean [NDI-K], and gastroesophageal reflux disease–health-related quality of life [GERD-HRQL]). The main outcome was satisfactory symptom relief rates at 8 weeks. Results: In this study, from the initial screening of 209 patients, 173 were included in the per-protocol set analysis. Satisfactory symptom relief rates at 8 and 4 weeks were 86.7% and 74.6%, respectively. In addition, the NDI-K and GERD-HRQL scores significantly improved at 8 and 4 weeks compared with the baseline scores. The efficacy of tegoprazan was not influenced by the FD subtype or Helicobacter pylori status. In patients with overlapping FD and GERD, there was a greater improvement in the NDI-K and GERD-HRQL scores than in patients with FD symptoms only. No serious drug-related adverse events occurred during this study. Conclusion Tegoprazan (50 mg) administered once daily provided satisfactory symptom relief for FD.

Purpose: : This study aimed to understand the current state of patient-centered care for people with disabilities by reviewing the key definitions, elements, and aspects of previously published care models/programs that borrow a patient-centered approach using a scoping review methodology. Methods : Following Arksey and O’Malley’s five-step methodology, we conducted a keyword search in EMBASE, Web of Science, and Pubmed for articles published from 2000 to January 2022, and a total of 30 articles were selected from 1,305 initially extracted articles. Results : A total of 13 studies developed models of care for people with disabilities based on the concept of patient-centeredness, 11 studies developed and evaluated care programs with patient- centered components, and 6 studies prospectively evaluated the effectiveness of patient-centered programs in clinical trials. The studies were generally based on multidisciplinary teams and emphasized two-way communication, collaborative relationships, multidimensional assessment, and measurement of patient needs. However, elements of patient-centeredness varied across studies, and methodologies for measuring needs and evaluating effectiveness were inconsistent. Conclusion : Based on this study, there is a need for systematic research to identify integrated and desirable patient-centeredness elements in healthcare models/programs for people with disabilities. This will enable the development of more patient-centered and friendly healthcare services for people with disabilities.

Purpose: : Health literacy, or the ability to find, understand, and use health information, is a key focus in South Korea’s ‘5th National Health Promotion Comprehensive Plan.’ However, despite South Korea’s high internet penetration, research on digital health information use among people with developmental disabilities is limited. This study assesses the current state of digital health literacy in this population. Methods: : A survey was conducted on the people with disabilities and people without disabilities. General digital health information was measured using an 8-item scale by Skinner (2006), and COVID-19-related health information was assessed with a 10-item tool developed by the research team. A total of 365 responses were analyzed, comprising people with physical disabilities (189), developmental disabilities (82), and those without disabilities (94). Data analysis was performed using SPSS version 28, including MANOVA and descriptive statistics. Results: : eHealth scores for individuals with developmental disabilities (24.6 ± 9.8) were significantly lower than those with physical disabilities (32.6 ± 7.9) and those without disabilities (33.9 ± 9.1). Similarly, Covid-eHealth scores were lower for individuals with developmental disabilities (24.6 ± 8.4) compared to those with physical disabilities (29.5 ± 6.8) and those without disabilities (31.3 ± 7.7). The differences in both cases were statistically significant (p < 0.001). Conclusion : This study represents the first comprehensive examination of digital health literacy among people with developmental disabilities in South Korea. The findings indicate that while this group has lower digital health literacy, appropriate education and support can improve their skills. This underscores the need for policies and support systems to ensure they can access and effectively use digital health information, especially as healthcare becomes more digital.