Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder affecting the sacroiliac joints and axial spine. Along with pharmacotherapy, non-pharmacological interventions for axSpA are crucial and constitute the cornerstone of treatment. Here, we review the evidence for non-pharmacological treatment of axSpA as a basis for the 2023 Korean treatment recommendations for patients with axSpA. The effectiveness of the core non-pharmacological approaches, such as education, smoking cessation, and exercise, has been reaffirmed. High-quality research on surgical treatment is limited. However, total hip replacement is advised in patients with ongoing pain or disability and visible structural damage to the hip on imaging. Urgent spinal intervention should be considered in cases of acute spinal pain with neurological deficiency or concurrent unstable fractures. Evidence for complementary therapies, including spas and acupuncture, remains insufficient.

Background/Aims: Asthma is characterized by chronic inflammation. Inhaled corticosteroids (ICS) remain the cornerstone of anti-inflammatory therapy, targeting both the large and small airways. Methods: This randomized open-label crossover trial included 30 patients receiving step 3 inhaled medication according to the Global Initiative for Asthma (GINA). Patients received beclomethasone/formoterol (BDP/F) for maintenance and reliever therapy for 6 weeks, followed by budesonide/formoterol (BUD/F) for 6 weeks, or vice versa, with a 4-week washout period in between. Assessments at each visit included the Asthma Control Test (ACT), Asthma Control Questionnaire, Quality of Life Questionnaire for Adult Korean Asthmatics, and pulmonary function test. The primary endpoint was the change in forced expiratory flow between 25% and 75% of vital capacity (FEF25–75% pred). Results: Twenty-four patients (15 females, mean age 39.3 years) completed the study. The changes in FEF25–75% pred were comparable between BDP/F and BUD/F (5.79 ± 38.34 vs. -1.36 ± 14.93, p = 0.399). No significant differences were observed between the BDP/F and BUD/F groups in terms of improvement in asthma control or quality of life. However, in the subgroup of patients with positive methacholine bronchial provocation tests, BDP/F significantly improved ACT scores compared to BUD/F (0.92 ± 2.25 vs. -1.31 ± 3.04, p = 0.044). Conclusions Our study demonstrated that extrafine ICS treatment provided no significant advantage over non-extrafine ICS in improving small airway obstruction or overall asthma control in moderate asthma. This suggests that factors other than particle size may contribute to treatment outcomes.

RESULTS: Resveratrol significantly reduced cardiac hypertrophy and remodeling in aging hearts. In addition, resveratrol significantly ameliorated aging-induced mitochondrial dysfunction (e.g., decreased oxygen respiration and increased hydrogen peroxide emission) and mitochondria-dependent apoptotic signaling (the Bax/Bcl-2 ratio, mitochondrial permeability transition pore opening sensitivity, and cleaved caspase-3 protein levels).Resveratrol also significantly attenuated aging-induced apoptosis (determined via cleaved caspase-3 staining and TUNEL-positive myonuclei) in cardiac muscles. CONCLUSION This study demonstrates that resveratrol treatment has a beneficial effect on aging-induced cardiac remodeling by ameliorating mitochondrial dysfunction and inhibiting mitochondria-mediated apoptosis in the heart.

Objective: This study investigates the reciprocal, longitudinal relationship between smartphone dependence and externalizing behavior problems in children. Methods: A total of 379 school-aged children (7–12 years old) were assessed using the Smartphone Overdependency Observer Scale and the Korean Version of the Child Behavior Checklist for Ages 6–18 at four six-month intervals from June 2021 to June 2022. Among them, 338 children completed at least two assessments. An autoregressive cross-lagged model was employed to examine the bidirectional relationships and temporal stability between smartphone overdependence and externalizing behavior problems while controlling for gender, age, and baseline internalizing behavior problems. Results: Both variables demonstrated significant autoregressive effects, indicating stability over time. Cross-lagged analysis revealed that higher smartphone dependence predicted increased externalizing behavior problems in subsequent periods while externalizing behavior problems did not predict future smartphone dependence. Conclusion Smartphone dependence appears to contribute to externalizing behavior problems in children, highlighting the critical need for early interventions that promote healthy digital habits to mitigate behavioral challenges.

Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder affecting the sacroiliac joints and axial spine. Along with pharmacotherapy, non-pharmacological interventions for axSpA are crucial and constitute the cornerstone of treatment. Here, we review the evidence for non-pharmacological treatment of axSpA as a basis for the 2023 Korean treatment recommendations for patients with axSpA. The effectiveness of the core non-pharmacological approaches, such as education, smoking cessation, and exercise, has been reaffirmed. High-quality research on surgical treatment is limited. However, total hip replacement is advised in patients with ongoing pain or disability and visible structural damage to the hip on imaging. Urgent spinal intervention should be considered in cases of acute spinal pain with neurological deficiency or concurrent unstable fractures. Evidence for complementary therapies, including spas and acupuncture, remains insufficient.

Background/Aims: Asthma is characterized by chronic inflammation. Inhaled corticosteroids (ICS) remain the cornerstone of anti-inflammatory therapy, targeting both the large and small airways. Methods: This randomized open-label crossover trial included 30 patients receiving step 3 inhaled medication according to the Global Initiative for Asthma (GINA). Patients received beclomethasone/formoterol (BDP/F) for maintenance and reliever therapy for 6 weeks, followed by budesonide/formoterol (BUD/F) for 6 weeks, or vice versa, with a 4-week washout period in between. Assessments at each visit included the Asthma Control Test (ACT), Asthma Control Questionnaire, Quality of Life Questionnaire for Adult Korean Asthmatics, and pulmonary function test. The primary endpoint was the change in forced expiratory flow between 25% and 75% of vital capacity (FEF25–75% pred). Results: Twenty-four patients (15 females, mean age 39.3 years) completed the study. The changes in FEF25–75% pred were comparable between BDP/F and BUD/F (5.79 ± 38.34 vs. -1.36 ± 14.93, p = 0.399). No significant differences were observed between the BDP/F and BUD/F groups in terms of improvement in asthma control or quality of life. However, in the subgroup of patients with positive methacholine bronchial provocation tests, BDP/F significantly improved ACT scores compared to BUD/F (0.92 ± 2.25 vs. -1.31 ± 3.04, p = 0.044). Conclusions Our study demonstrated that extrafine ICS treatment provided no significant advantage over non-extrafine ICS in improving small airway obstruction or overall asthma control in moderate asthma. This suggests that factors other than particle size may contribute to treatment outcomes.

Background and Objectives: Obstructive sleep apnea (OSA) has been associated with an increased risk of cancer in various organs. OSA is also linked to chronic inflammation in the biliary tract and pancreas, a well-established risk factor for carcinogenesis in these organs. However, its relationship with biliary tract and pancreatic cancers remains unclear and has been rarely investigated. Therefore, we aimed to evaluate whether OSA serves as an independent risk factor for these malignancies by analyzing a nationwide healthcare claims database in South Korea. Methods: A retrospective cohort study was conducted using the Korean National Health Insurance Service (KNHIS) database. Adults aged ≥20 years who were newly diagnosed with OSA (ICD-10: G47.30) between 2007 and 2014 were identified and propensity score-matched (1:5) with controls based on age, sex, and comorbidities. Individuals with pre-existing cancer diagnoses were excluded. The primary endpoints were the incidence of overall cancer, biliary tract cancer (C23–C24), and pancreatic cancer (C25). Cox proportional hazards regression models were used to calculate hazard ratios (HRs), adjusting for demographic and clinical factors. Results: A total of 1,191,444 individuals were included, comprising 198,574 patients diagnosed with OSA and 992,870 matched controls. OSA was associated with an increased overall cancer incidence (HR, 1.132; 95% confidence interval [CI], 1.097–1.169); however, it was not significantly associated with pancreatic cancer (HR, 0.941; 95% CI, 0.823–1.072) or biliary tract cancer (HR, 0.931; 95% CI, 0.751–1.142). Subgroup analyses stratified by sex and age revealed no statistically significant associations across these groups. Conclusion Our findings do not support OSA as an independent risk factor for biliary tract or pancreatic cancers.

Emerging evidence suggests that systemic inflammation may play a critical role in neurological disorders. Recent studies have shown the connection between inflammatory bowel diseases (IBD) and neurological disorders, revealing a bidirectional relationship through the gut-brain axis.Immunotherapies, such as Treg cells infusion, have been proposed for IBD. However, the role of adaptive immune cells in IBD-induced neuroinflammation remains unclear. In this study, we established an animal model for IBD in mice with severe combined immune-deficient (SCID), an adaptive immune deficiency, to investigate the role of adaptive immune cells in IBD-induced neuroinflammation. Mice were fed 1%, 3%, or 5% dextran sulfate sodium (DSS) for 5 days. We measured body weight, colon length, disease activity index (DAI), and crypt damage. Pro-inflammatory cytokines were measured in the colon, while microglial morphology, neuronal count, and inflammatory cytokines were analyzed in the brain. In the 3% DSS group, colitis symptoms appeared at day 7, with reduced colon length and increased crypt damage showing colitis-like symptoms. By day 21, colon length and crypt damage persisted, while DAI showed recovery. Although colonic inflammation peaked at day 7, no significant increase in inflammatory cytokines or microglial hyperactivation was observed in the brain. By day 21, neuroinflammation was detected, albeit with a slight delay, in the absence of adaptive immune cells. The colitis-induced neuroinflammation model provides insights into the fundamental immune mechanisms of the gut-brain axis and may contribute to developing immune cell therapies for IBD-induced neuroinflammation.

Objective: To evaluate the effectiveness of a squatting posture grading system established to screen for limited ankle dorsiflexion. Methods: The squat posture grading system categorizes subjects’ squat posture into three grades. Grade 1 is defined as being able to maintain a squatting posture with heels on the ground in full ankle dorsiflexion without effort. Grade 2 is defined as being able to perform the same position, but unable to maintain the position for more than 5 seconds or requiring trunk and leg muscle efforts to maintain the position. Grade 3 is defined as being unable to maintain the same position and falling backwards immediately if attempted to touch the ground with heels. Next, subjects’ ankle dorsiflexion angles were directly measured in knee flexed and extended position by goniometer. Results: Out of the 92 total subjects, 35 were in grade 1, 18 were in grade 2, and 39 were in grade 3. The average ankle dorsiflexion angle with knee flexed position were 23.13° for grade 1, 16.03° for grade 2, and 9.31° for grade 3. The average ankle dorsiflexion angle with knee extended position were 15.16° for grade 1, 7.92° for grade 2, and 3.40° for grade 3. Ankle dorsiflexion angles showed a significant decrease from grade 1 to 3 (p<0.05). Conclusion The squatting posture grading system defined in this study effectively graded the subjects based on the difference in their average ankle dorsiflexion angle. This system could be used as a quick screening method for limited ankle dorsiflexion.

RESULTS: Resveratrol significantly reduced cardiac hypertrophy and remodeling in aging hearts. In addition, resveratrol significantly ameliorated aging-induced mitochondrial dysfunction (e.g., decreased oxygen respiration and increased hydrogen peroxide emission) and mitochondria-dependent apoptotic signaling (the Bax/Bcl-2 ratio, mitochondrial permeability transition pore opening sensitivity, and cleaved caspase-3 protein levels).Resveratrol also significantly attenuated aging-induced apoptosis (determined via cleaved caspase-3 staining and TUNEL-positive myonuclei) in cardiac muscles. CONCLUSION This study demonstrates that resveratrol treatment has a beneficial effect on aging-induced cardiac remodeling by ameliorating mitochondrial dysfunction and inhibiting mitochondria-mediated apoptosis in the heart.