Journal of Korean Medical Science最新文献

{"title":"Global Burden of Intracerebral Hemorrhage, 1990-2021, and Projections to 2050: A Global Burden of Disease Study 2021.","authors":"Na Yun Kim, Yeona Jo, Dongjin Yeo, Sooji Lee, Jeongseon Oh, Tae Hyeon Kim, Jinyoung Jeong, Yuseon Kang, Hanseul Cho, Jiseung Kang, Masoud Rahmati, Ho Geol Woo, Dong Keon Yon","doi":"10.3346/jkms.2026.41.e210","DOIUrl":"10.3346/jkms.2026.41.e210","url":null,"abstract":"<p><strong>Background: </strong>Despite resulting in significant mortality and long-term disability, research on the burden of intracerebral hemorrhage (ICH) remains insufficient. Therefore, this study estimated the global burden of ICH and projected changes in the disease burden through 2050 under scenarios of improved risk factor profiles.</p><p><strong>Methods: </strong>The burden of ICH was estimated using data from the Global Burden of Disease Study 2021, based on incidence, mortality, and disability-adjusted life years (DALYs), and was stratified by region, age, year, sex, and Socio-demographic Index (SDI) level. In addition, we conducted an attribution analysis of the ICH burden, focusing on behavioral (including dietary risks and tobacco) and metabolic risk factors, and developed scenario-based projections through 2050 to estimate the potential impact of improved risk management.</p><p><strong>Results: </strong>In 2021, a total of 3,444.34 thousand incident cases (95% uncertainty interval [UI], 3,053.01-3,812.04) of ICH were reported worldwide, along with 3,308.37 thousand deaths (3,021.08-3,594.72) attributable to ICH. Males exhibited a higher disease burden, with an age-standardized incidence rate (ASIR) per 100,000 population of 48.71 (95% UI, 43.07-54.27), compared to 33.61 (29.47-37.22) in females. The burden progressively increased with age, with notably higher mortality observed among individuals aged ≥ 65 years. There were substantial disparities in the ASIR by SDI level, with high SDI countries showing the lowest rates at 16.30 per 100,000 population (95% UI, 14.51-18.02), compared to 57.83 (51.95-63.27) in low SDI countries. Among behavioral and metabolic risk factors, high systolic blood pressure and smoking were identified as the leading modifiable risk factors for ICH. Forecasts based on the improved behavioral and metabolic risk scenario project a reduction in the age-standardized DALY rate to 166.13 per 100,000 population (95% UI, 132.31-209.64) by 2050, compared to 599.04 (482.89-744.16) projected under the baseline scenario.</p><p><strong>Conclusion: </strong>Although the global burden of ICH has declined, it remains a major concern in several regions. Projections through 2050 suggest that improvements in the behavioral and metabolic risk profiles could substantially reduce the future burden of ICH, emphasizing the importance of targeted strategies to support evidence-based public health policy.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e210"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Long-Term Survival After Hepatic Resection for Hepatocellular and Intrahepatic Cholangiocarcinoma: Population-Based Analysis in Korea.","authors":"Jung Min Lee, Sung Jae Kim, Tae Yoo, Wontae Cho","doi":"10.3346/jkms.2026.41.e245","DOIUrl":"10.3346/jkms.2026.41.e245","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the two major types of primary liver cancer, accounting for approximately 70% and 15% of all cases, respectively. South Korea remains a high-incidence region for both malignancies. Despite advances in surgical and imaging techniques, long-term survival outcomes and their changing trends over time have not been fully evaluated in population-based studies. This study aims to analyze survival rates and their influencing factors among patients with HCC and ICC who underwent hepatic resection in Korea.</p><p><strong>Methods: </strong>Using the Korea Central Cancer Registry, we analyzed data from 43,537 patients who underwent hepatectomy between 2004 and 2018. Patients were categorized by time period (2004-2008, 2009-2013, 2014-2018), and 5-year survival rates were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazards models identified prognostic factors associated with survival.</p><p><strong>Results: </strong>A total of 36,380 patients with HCC and 7,157 with ICC underwent liver resection. Both cancers showed a male predominance, more pronounced in HCC. Major hepatectomy was frequent, particularly in ICC, which was associated with longer hospital stays, higher medical costs than HCC. Over time, the proportion of patients residing in metropolitan areas declined, more than half of surgeries continued to be performed there, indicating persistent geographic disparity between residence and treatment location. Surgeries at high-volume centers increased, hospital stays shortened, and 5-year survival improved in HCC but remained unchanged in ICC. Multivariable analysis identified male sex, advanced age, major hepatectomy, surgical region as independent predictors of poorer survival, with low income adversely affecting survival only in HCC.</p><p><strong>Conclusion: </strong>Postoperative survival following hepatectomy has improved for HCC but remains unchanged for ICC. Better outcomes were observed for surgeries performed in metropolitan areas, likely reflecting differences in institutional experience and resources. These findings highlight persistent disparities in treatment outcomes and underscore the need for regionally balanced healthcare resources and further studies to refine prognostic determinants in primary liver cancers surgery.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e245"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cement Use in Bipolar Hemiarthroplasty and Its Association With Cancer Risk.","authors":"Jung-Wee Park, Danbee Kang, Hyunsoo Kim, Eunjee Kang, Juhee Cho, Young-Kyun Lee","doi":"10.3346/jkms.2026.41.e196","DOIUrl":"10.3346/jkms.2026.41.e196","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have been unable to confirm a direct relationship between polymethylmethacrylate use and cancer risk in hemiarthroplasty (HA) due to a lack of differentiation between cemented and cementless fixation in cancer risk assessment. This study aimed to clarify this by examining the incidence of cancer in patients who underwent cemented HA compared to those who received cementless HA.</p><p><strong>Methods: </strong>This study was a retrospective nationwide cohort study using the Korean National Health Insurance Service database, which represents nearly the entire Republic of Korea (South Korea) population. We included adult patients aged over 19 years who underwent HA between January 1, 2003, and December 31, 2019 (N = 160,394). Patients with previous revision surgeries, bilateral procedures, or prior cancer history were excluded. Cemented and cementless groups were defined based on the type of femoral stem used. The primary outcome was the incidence of cancer, measured through cancer-specific insurance codes and cancer diagnosis codes. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate cancer risk differences between cemented and cementless HA groups.</p><p><strong>Results: </strong>Among the patients, 37.6% underwent HA with cemented fixation. During a follow-up period of up to 12 years, no significant differences were observed between the cemented and cementless groups in the risk of developing any cancer, solid tumors, or hematologic cancers. However, the cemented group had a 1.8-fold (95% confidence interval [CI], 1.12-2.99) increased risk of multiple myeloma compared to the cementless group. This association was particularly pronounced among patients under 70 years of age (adjusted hazard ratio, 3.44; 95% CI, 1.10-10.82) relative to those aged 70 or older.</p><p><strong>Conclusion: </strong>Patients who underwent cemented HA showed a higher risk of multiple myeloma than those who received cementless HA. The association between cement use and multiple myeloma was especially evident in younger patients. These findings highlight the importance of evaluating long-term risks associated with cemented HA to inform safer surgical approaches and guide treatment selection.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06307145.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e196"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunochemical Markers and Quality of Life in Severe Atopic Dermatitis: A Real-World Analysis.","authors":"Gil-Soon Choi, Ji Hyun Oh, Hee Kyoo Kim","doi":"10.3346/jkms.2026.41.e67","DOIUrl":"10.3346/jkms.2026.41.e67","url":null,"abstract":"<p><strong>Background: </strong>Severe atopic dermatitis (AD) impacts quality of life substantially, however the major clinical and immunologic contributors to this burden remain unclear. This study aimed to compare clinical and immunochemical profiles between patients with non-severe and severe AD and to identify key factors associated with QoL impairment in those with severe disease.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 371 patients diagnosed with AD from 2020 to 2023 at Kosin University Gospel Hospital. Patients were categorized according to Eczema Area and Severity Index (EASI) scores, with severe AD defined as EASI > 21. Clinical characteristics, immunologic markers, and Dermatology Life Quality Index (DLQI) scores were assessed. Multivariate regression was used to identify factors independently associated with DLQI.</p><p><strong>Results: </strong>Among all patients, 140 (37.7%) had severe AD. This group exhibited significantly higher EASI and DLQI scores, more widespread skin involvement, and increased skin infections. Laboratory findings showed elevated total IgE, eosinophil counts, and specific IgE to <i>Pityrosporum orbiculare</i>. In the severe AD group, higher DLQI scores, indicating poorer QoL, were positively associated with eosinophil percentage, specific IgE to <i>P. orbiculare</i>, EASI score, and pruritus score, whereas total IgE and white blood cell (WBC) count showed an inverse relationship with DLQI.</p><p><strong>Conclusion: </strong>Clinical severity and immunologic activity were associated with QoL in patients with severe AD. Total IgE, specific IgE to <i>P. orbiculare</i>, WBC and eosinophil counts, pruritus, and EASI scores were identified as factors influencing QoL. These findings highlight the importance of heterogeneous immunologic profiles in assessing QoL in severe AD. Future large-scale cohort studies are needed to elucidate the dynamic interactions among immunologic profiles, treatment response, and QoL in severe AD.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e67"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Sleep Quality as a Mediator Between Occupational Stress and Depression: The Moderating Role of Work Engagement.","authors":"Jiwan Moon, Sang-Won Jeon, Sra Jung, Sung Joon Cho","doi":"10.3346/jkms.2026.41.e199","DOIUrl":"10.3346/jkms.2026.41.e199","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in the role of sleep-related factors, particularly perceived sleep quality, in the relationship between occupational stress and depression. Work engagement has been proposed as a potential protective factor against depression. This study aimed to examine the relationships among occupational stress, perceived sleep quality, and depression, as well as the role of work engagement in these relationships.</p><p><strong>Methods: </strong>A total of 2,425 Korean employees participated in this study. The participants completed a series of questionnaires, including the Korean Occupational Stress Scale, the Center for Epidemiologic Studies Depression Scale, a single-item measure of perceived sleep quality, and the Utrecht Work Engagement Scale-9. The mediating and moderating effects were analysed using the PROCESS macro in the Statistical Package for the Social Sciences.</p><p><strong>Results: </strong>Perceived sleep quality mediated the association between occupational stress and depressive symptoms (b = 0.051; 95% confidence interval [CI], 0.040-0.062). Work engagement moderated the effects of both occupational stress and perceived sleep quality on depressive symptoms.</p><p><strong>Conclusion: </strong>This study highlights the role of perceived sleep quality and work engagement as mediators and moderators of occupational stress and depressive symptoms, respectively. Improving perceived sleep quality and promoting work engagement may help reduce the risk of depression among employees experiencing occupational stress.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e199"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Interferon-γ Is Associated With Refractory <i>Mycoplasma pneumoniae</i> Pneumonia in Children.","authors":"Hye Young Han, Jeong-Min Oh, Jung-Woo Rhim, Mea-Young Chang, Eun-Ae Yang","doi":"10.3346/jkms.2026.41.e219","DOIUrl":"10.3346/jkms.2026.41.e219","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma pneumoniae</i> (MP) infection is associated with refractory severe clinical course, and steroid therapy has been suggested as an effective treatment for refractory MP pneumonia.</p><p><strong>Methods: </strong>A total of 53 patients with MP pneumonia and 9 patients with viral pneumonia patients were enrolled. Point mutations at residues 2063, 2064, and 2067 in domain V of 23S rRNA gene were analyzed, and serum levels of interferon (IFN)-γ, interleukin (IL)-6, TNF-α, IL-10, and IL-1β were measured before and after steroid treatment.</p><p><strong>Results: </strong>There was no significant difference in serum cytokine concentrations between the MP pneumonia group and the viral pneumonia group. The A2063G point mutation was identified in 72% (18/25) of tested MP pneumonia patients. IFN-γ and IL-6 levels showed significant positive correlations with the duration of hospitalization, fever after admission and duration of steroid treatment. The macrolide-resistant MP (MRMP) group tended to have higher IFN-γ levels than the macrolide-sensitive MP group (<i>P</i> = 0.055). Notably, all patients (n = 9) with the highest IFN-γ levels (ranked in descending order) belonged to the MRMP group. Steroid treatment significantly reduced IFN-γ and IL-6 levels, suggesting effective modulation of excessive immune responses. LDH and AST levels were also correlated with IFN-γ and IL-6.</p><p><strong>Conclusion: </strong>Therefore, IFN-γ may serve as a valuable biomarker for predicting a refractory clinical course of MP pneumonia. In addition, LDH and AST levels, which showed the closest correlation to IFN-γ and IL-6, may also be proposed as indicators of disease severity.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e219"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Renal Biomarkers in Sarcopenia or Frailty in Patients With Liver Cirrhosis.","authors":"Jung Hee Kim, Jae Yoon Jeong, Ju-Yeon Cho, Soo Jin Park, Heon-Ju Kwon, Kyoung A Ko, Hyunwoo Oh, Yong Kyun Cho, Byung Ik Kim, Won Sohn","doi":"10.3346/jkms.2026.41.e192","DOIUrl":"10.3346/jkms.2026.41.e192","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia and frailty are risk factors for poor prognosis in patients with liver cirrhosis. This study investigated the role of renal biomarkers in sarcopenia or frailty in patients with cirrhosis.</p><p><strong>Methods: </strong>A total of 78 patients with liver cirrhosis and serum creatinine levels < 1.5 mg/dL were analysed for serum renal biomarkers (creatinine-to-cystatin C ratio, interleukin [IL]-18, kidney injury molecule [KIM]-1, and neutrophil gelatinase-associated lipocalin [NGAL]), sarcopenia, and liver frailty index. Sarcopenia was assessed using the skeletal muscle index of the third vertebra. We analysed the risk of sarcopenia or frailty based on various renal biomarkers of cirrhosis.</p><p><strong>Results: </strong>The mean age was 59.2 years and 67.9% were men. The Child-Pugh class B score was noted in 17.9%. Sarcopenia or frailty (pre-frail and frail) was observed in 43 patients (55.1%). No significant differences in serum IL-18 (<i>P</i> = 0.285), NGAL (<i>P</i> = 0.537), or KIM-1 (<i>P</i> = 0.482) levels were observed according to sarcopenia or frailty. However, the creatinine-to-cystatin C ratio was significantly lower in patients with sarcopenia or frailty than in those without sarcopenia or frailty (0.73 vs. 0.83, <i>P</i> = 0.002). Multivariable analysis indicated that the risk factors for sarcopenia or frailty were Child-Pugh class B (odds ratio [OR], 9.04; 95% confidence interval [CI], 1.06-76.85; <i>P</i> = 0.044) and creatinine-to-cystatin C ratio < 0.8 (OR, 4.03; 95% CI, 1.45-11.25; <i>P</i> = 0.008). Serum IL-18, NGAL, and KIM-1 levels were not associated with sarcopenia or frailty.</p><p><strong>Conclusion: </strong>A lower serum creatinine-to-cystatin C ratio was associated with an increased risk of sarcopenia or frailty in patients with cirrhosis and favourable renal function.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e192"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Impact of Extended-Criteria Donor Use According to Recipient Status in Lung Transplantation: A Nationwide Cohort Study.","authors":"Hye Ju Yeo, Jin Ho Jang, Eunjeong Choi, Jin Gu Lee, Song Yee Kim, Samina Park, Kyeongman Jeon, Seokjin Haam, Woo Hyun Cho","doi":"10.3346/jkms.2026.41.e197","DOIUrl":"10.3346/jkms.2026.41.e197","url":null,"abstract":"<p><strong>Background: </strong>The use of extended-criteria donors (ECDs) in lung transplantation remains high in Korea; however, their impact on survival outcomes is not fully understood.</p><p><strong>Methods: </strong>We retrospectively analyzed 1,251 adult lung transplant recipients registered with the Korea Network for Organ Sharing (2010-2023). ECDs were defined as donors aged ≥ 55 years with a smoking history ≥ 20 pack-years or a PaO₂/FiO₂ ratio ≤ 300. Survival outcomes were assessed using Kaplan-Meier analysis and multivariable Cox regression, with subgroup comparisons by urgency (status 0 vs. status 1-4) and age (< 65 vs. ≥ 65 years).</p><p><strong>Results: </strong>Of the 1,251 recipients, 33.7% received ECD lungs. In the multivariable analysis, recipient age, urgency status 0, and ECD use were independently associated with increased one-year mortality. In subgroup analyses, ECD use was consistently associated with higher mortality in status 1-4 recipients (<i>P</i> < 0.001), whereas in status 0 recipients it showed only a trend toward decreased survival (<i>P</i> = 0.056). Among elderly recipients, ECD use significantly increased mortality in status 1-4 but showed only a trend toward decreased survival in status 0 (<i>P</i> = 0.071). In contrast, among younger recipients, ECD use increased mortality in status 1-4 but had no significant effect in status 0.</p><p><strong>Conclusion: </strong>ECD use was consistently associated with higher one-year mortality in recipients with urgency status 1-4, irrespective of age. In contrast, among status 0 recipients, the effect differed by age. These findings highlight the importance of incorporating both recipient urgency and age into donor lung selection.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 30","pages":"e197"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proper Utilization of Generative AI in Scholarly Writing: The Researcher and Author Perspective.","authors":"Dong Hoon Suh, Dong Soo Han","doi":"10.3346/jkms.2026.41.e304","DOIUrl":"10.3346/jkms.2026.41.e304","url":null,"abstract":"<p><p>The use of generative artificial intelligence (AI) in scholarly publishing is expanding rapidly, yet clear standards for its appropriate use and disclosure remain lacking. Surveys indicate that many researchers already use AI tools for manuscript preparation, particularly for writing assistance and error detection. However, attitudes toward acceptable AI use and disclosure requirements remain inconsistent, especially regarding the use of AI in drafting manuscripts and in the peer-review process. Analyses of manuscript submissions to major journal groups suggest that the proportion of authors disclosing AI use is substantially lower than estimates from researcher surveys, indicating possible underreporting or uncertainty about reporting requirements. It is therefore essential to implement standardized frameworks that require explicit disclosure of AI use to ensure transparency and uphold trust in scholarly communication.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 29","pages":"e304"},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13406942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Structured Transparency: A Governance Framework for AI Use in Biomedical Publishing.","authors":"Jong-Min Kim","doi":"10.3346/jkms.2026.41.e318","DOIUrl":"10.3346/jkms.2026.41.e318","url":null,"abstract":"<p><p>The rapid adoption of large language models and generative artificial intelligence (AI) is transforming biomedical research and publishing. Although international organizations such as the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE) have established the principle that AI cannot be recognized as an author, and the ICMJE, in its January 2026 revision, has introduced a dedicated section addressing AI use by authors, peer reviewers, and editors, journal-level Instructions for Authors still require further operational detail to apply these principles consistently throughout the publication process. This review critically examines current AI-related policies in the <i>Journal of Korean Medical Science</i> (<i>JKMS</i>) and the Korean Association of Medical Journal Editors (KAMJE) and identifies three major challenges: the practical limitations of the AI non-authorship principle, the inadequacy of current AI disclosure practices, and the emergence of AI-specific conflicts of interest that extends beyond conventional financial disclosures. We argue that medical publishing should move from a restrictive approach toward a framework of structured transparency that systematically documents, evaluates, and verifies AI use. To achieve this goal, we propose a practical governance framework that includes a three-tiered AI disclosure system, strengthened accountability for corresponding authors, expanded institutional conflict-of-interest disclosures, transparent reporting of AI use by peer reviewers, and formal editorial policies governing AI-assisted editorial activities. Future revisions of the KAMJE and <i>JKMS Instructions for Authors</i> should prioritize transparent and accountable AI governance rather than restricting AI use. Adoption of a structured, publication-wide framework encompassing authors, peer reviewers, and editors would strengthen research integrity while supporting the responsible integration of AI into biomedical publishing.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 29","pages":"e318"},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13406945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}