Comparison of the Data of a Next-Generation Sequencing Panel from K-MASTER Project with That of Orthogonal Methods for Detecting Targetable Genetic Alterations / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#K-MASTER project is a Korean national precision medicine platform that screened actionable mutations by analyzing next-generation sequencing (NGS) of solid tumor patients. We compared gene analyses between NGS panel from the K-MASTER project and orthogonal methods. @*Materials and Methods@#Colorectal, breast, non–small cell lung, and gastric cancer patients were included. We compared NGS results from K-MASTER projects with those of non-NGS orthogonal methods (KRAS, NRAS, and BRAF mutations in colorectal cancer [CRC]; epidermal growth factor receptor [EGFR], anaplastic lymphoma kinase [ALK] fusion, and reactive oxygen species 1 [ROS1] fusion in non–small cell lung cancer [NSCLC], and Erb-B2 receptor tyrosine kinase 2 (ERBB2) positivity in breast and gastric cancers). @*Results@#In the CRC cohort (n=225), the sensitivity and specificity of NGS were 87.4% and 79.3% (KRAS); 88.9% and 98.9% (NRAS); and 77.8% and 100.0% (BRAF), respectively. In the NSCLC cohort (n=109), the sensitivity and specificity of NGS for EGFR were 86.2% and 97.5%, respectively. The concordance rate for ALK fusion was 100%, but ROS1 fusion was positive in only one of three cases that were positive in orthogonal tests. In the breast cancer cohort (n=260), ERBB2 amplification was detected in 45 by NGS. Compared with orthogonal methods that integrated immunohistochemistry and in situ hybridization, sensitivity and specificity were 53.7% and 99.4%, respectively. In the gastric cancer cohort (n=64), ERBB2 amplification was detected in six by NGS. Compared with orthogonal methods, sensitivity and specificity were 62.5% and 98.2%, respectively. @*Conclusion@#The results of the K-MASTER NGS panel and orthogonal methods showed a different degree of agreement for each genetic alteration, but generally showed a high agreement rate.

Community-wide Early Response to COVID-19 in Dongnae-gu of Busan City / 農村醫學 地域保健

Objectives@#We did this study to summarize and review and charcterize the community-wide early response to COVID-19 in Dongnae-gu of Busan Metropolitan City where first confirmed case of COVID_19 occurred in Busan. @*Methods@#Research team from college of medicine participated as advisor to response team of local government. Research team consulted and educated and interviewed response team and wrote and reviewed COVID-19 white paper of local government. @*Results@#Political commitment of District mayor made possible community-wide co-operation between public-private section. Early mobilization of District-wide resource was possible through political commitment. Whole-of-government response developoed to whole-of-society approach including economic support. @*Conclusions@#Proactive community-wide response were mobilized under commitment of city mayor of local government to address the first CIVID-19 incidence in Busan Metropolitan City.

Predictors of Ischemic Cardiomyopathy in Patients with Acute Myocardial Infarction who Underwent Percutaneous Coronary Intervention / 대한내과학회지

Background/Aims@#Many patients with acute myocardial infarction (AMI) suffer from heart failure due to progressive ischemic left ventricular (LV) remodeling. This study investigated the predictors of ischemic cardiomyopathy (ICMP) in patients with AMI who underwent successful percutaneous intervention. @*Methods@#A total of 547 patients with AMI were divided into two groups: ICMP (n = 66, 67.1 ± 11.9 years, 78.8% males) and non-ICMP (n = 481, 62.5 ± 12.2 years, 70.1% males). @*Results@#On echocardiography, the LVEF was significantly decreased (41.7 ± 10.5 vs. 55.4 ± 10.3%, p 55 mm (OR 4.511, 95% CI 1.561–13.038, p = 0.005), and ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e’) ≥ 15 (OR 3.270, 95% CI 1.168–9.155, p = 0.024) were independent predictors of ICMP development. @*Conclusions@#The present study demonstrates that a larger LV size, lower LV function, and increased E/e’ (≥ 15) were independent predictors of ICMP. Therefore, the development of ICMP should be carefully monitored in AMI patients with these features.

Efficacy and safety of cisplatin and weekly docetaxel in patients with recurrent or metastatic squamous cell carcinoma of the head and neck

BACKGROUND/AIMS@#We investigated the efficacy and toxicity of a weekly schedule of docetaxel and cisplatin as a first-line treatment in patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC).@*METHODS@#In this study, 18 patients with previously diagnosed R/M HNSCC were treated with combination chemotherapy of weekly docetaxel 35 mg/m² (day 1 and 8) and cisplatin 70 mg/m² (day 1) as first-line chemotherapy, repeated every 3 weeks.@*RESULTS@#Partial response and stable disease were observed in six patients (33.3%; 95% confidence interval [CI], 11.1% to 55.6%) and six patients (33.3%; 95% CI, 11.1% to 55.6%), respectively. The median overall survival and progression-free survival were 11.26 months (95% CI, 8.87 to 15.83) and 5.68 months (95% CI, 4.80 to 6.51), respectively. The major toxicity was grade 1/2 anemia (50%). Grade 3/4 neutropenia was observed in one patient (5.6%). Among the non-hematologic toxicities, grade 1/2 hepatotoxicity was most common (22.2%), and grade 3/4 infection was observed in one patient (5.6%). There was no treatment-related mortality.@*CONCLUSIONS@#For patients with R/M HNSCC, a cisplatin and weekly docetaxel regimen showed high efficacy with tolerable toxicity as a first-line treatment.

Phase II Study of Dovitinib in Patients with Castration-Resistant Prostate Cancer (KCSG-GU11-05) / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Fibroblast growth factor (FGF) signals are important in carcinogenesis and progression of prostate cancer. Dovitinib is an oral, pan-class inhibitor of vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor, and fibroblast growth factor receptor (FGFR). We evaluated the efficacy and toxicity of dovitinib in men with metastatic castration resistant prostate cancer (mCRPC). MATERIALS AND METHODS: This study was a single-arm, phase II, open-label, multicenter trial of dovitinib 500 mg/day (5-days-on/2-days-off schedule). The primary endpoint was 16-week progression-free survival (PFS). Secondary endpoints were overall survival (OS), toxicity and prostate-specific antigen (PSA) response rate. Biomarker analyses for VEGFR2, FGF23, and FGFR2 using multiplex enzyme-linked immunosorbent assay was performed. RESULTS: Forty-four men were accrued from 11 hospitals. Eighty percent were post-docetaxel. Median PSA was 100 ng/dL, median age was 69, 82% had bone metastases, and 23% had liver metastases. Median cycles of dovitinib was 2 (range, 0 to 33). Median PFS was 3.67 months (95% confidence interval [CI], 1.36 to 5.98) and median OS was 13.70 months (95% CI, 0 to 27.41). Chemotherapy-naïve patients had longer PFS (17.90 months; 95% CI, 9.23 to 28.57) compared with docetaxel-treated patients (2.07 months; 95% CI, 1.73 to 2.41; p=0.001) and the patients with high serum VEGFR2 level over median level (7,800 pg/mL) showed longer PFS compared with others (6.03 months [95% CI, 4.26 to 7.80] vs. 1.97 months [95% CI, 1.79 to 2.15], p=0.023). Grade 3 related adverse events were seen in 40.9% of patients. Grade 1-2 nausea, diarrhea, fatigue, anorexia, and all grade thrombocytopenia are common. CONCLUSION: Dovitinib showed modest antitumor activity with manageable toxicities in men with mCRPC. Especially, patients who were chemo-naïve benefitted from dovitinib.

Anisakiasis Induced Segmental Jejunum Obstruction / 대한소화기학회지

Human anisakiasis is a disease caused by an infestation of the third stage larvae of family anisakidae. The ingested larvae invade the gastrointestinal wall, causing clinical symptoms that include abdomen pain, nausea, and vomiting. Although enteric anisakiasis is extremely rare, it can induce intestinal obstruction. We report a case in which emergency surgery was needed due to intestinal obstruction that coincided with symptoms related to anisakiasis, along with a brief literature review.

Cancer Survivorship Care among Oncology Nurses in Korea

PURPOSE: The purpose of this study was to examine the cancer survivorship care practices among oncology nurses in Korea. METHODS: This study was a secondary analysis based on the Korean data from the international service-mapping study for the survivorship care for patients with cancer after treatment completion in the Asia-Pacific Region. The data, collected from 100 Korean nurses who took care of cancer patients, were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis, and multiple regression. RESULTS: Statistically significant relationships were found between responsibility and frequency of survivorship care (r=-.20, p=.050), between confidence and frequency of survivorship care (r=.47, p<.001), and between impediments to organization and frequency of survivorship care (r=-.22, p=.027). The frequency of survivorship care was influenced by confidence (β=-.37, p<.001) which explained about 24% of the variance of survivorship care. CONCLUSION: These findings show that development of survivorship care education program for oncology nurses should be considered to increase confidence in survivorship care for oncology nurses.

The Experience of Illness in Non-Hodgkin Lymphoma Patients

PURPOSE: The purpose of the study was to explore the illness experiences of Korean patients with non-Hodgkin lymphoma. METHODS: Data were collected through individual in-depth interviews with 9 patients. Thematic analysis was used to analyze the data. RESULTS: Five themes emerged as a result of the analysis. "Embarrassment from unfamiliar diagnosis and rapid progression" delineates lymphoma as a very cancer. "Maelstrom in dilemma of cancer treatment" describes suffering due to side effects and complications with lack of information about treatments. "Rearrangement of relationships due to social prejudice" describes interpersonal relationships with others and family members. "Keeping psychological stability through balancing alertness and oblivion" illustrates strategies to overcome the fear of recurrence. "A new life obtained by introspection" delineates the outcome of overcoming cancer through self-reflection. CONCLUSION: Patients with non-Hodgkin lymphoma experienced tremendous physical and psychosocial problems. There are significant knowledge gaps between patients and health professionals. Based on the results of the study, health professionals could develop effective nursing interventions to improve the quality of life of non-Hodgkin lymphoma patients.

Factors Influencing Quality of Life in Multiple Myeloma Patients

PURPOSE: The purpose of the study was to investigate the relationships among fatigue, pain, anxiety, depression, and quality of life in Korean patients with multiple myeloma and to identify factors influencing their quality of life. METHODS: The study design was a crosssectional descriptive study. The participants were 92 multiple myeloma patients who visited the outpatient department at a university hospital in Seoul, Korea. The data were collected from January to April in 2013 with self-reporting questionnaires. RESULTS: The mean scores of quality of life in all dimensions were relatively low. Fatigue, pain, anxiety and depression were all correlated to the global heath/quality of life, functional quality of life, and symptom quality of life (p<.001). Fatigue, pain and depression accounted for 65.1% (p<.001) in global health/quality of life and 73.6% (p<.001) in functional quality of life, respectively. And fatigue and pain accounted for 66.4% (p<.001) in symptom quality of life. CONCLUSION: The results of the study showed that fatigue, pain and depression were major predictors of quality of life for patients with multiple myeloma. Therefore, psychological symptoms, such as depression, and physical symptoms should be integrated into the nursing intervention to improve their quality of life.

A study on nutritional intakes in middle income adults based on data from the 5th Korean National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study was conducted to evaluate nutritional status in middle-class adults compared with low income or high income adults according to gender difference. METHODS: Data from the 2012 Korea National Health and Nutrition Examination Survey was used. A total of 7,082 adults aged from 30 to 64 were included and classified according to household income level into three groups. Dietary data was collected using 24-hr recall methods. RESULTS: Most nutrients including energy, protein, vitamins, and minerals such as iron and calcium differed according to income levels. Iron intake of middle-class men was higher than that of the lowest income group, whereas that of middle-class women was similar to that of the lowest income group. In addition, no significant difference in carbohydrate, protein, fat, thiamin, and niacin intakes per 1,000 kcal and iron intake was found between the middle and high income group only in male subjects. In summary, our results showed that the relationship between nutritional status and income level as a socioeconomic parameter could vary according to gender difference. CONCLUSION: According to our results, it could be suggested that not only the lowest income people but also middle class women should be concerned in development of nutritional policies. Gender difference should be considered. It is a very meaningful implication for application to policy for obesity prevention or intervention.

Novel Germline Mutation of BRCA1 Gene in a 56-Year-Old Woman with Breast Cancer, Ovarian Cancer, and Diffuse Large B-Cell Lymphoma / Journal of the Korean Cancer Association, 대한암학회지

We report a case of a 56-year-old woman with breast cancer, ovarian cancer, and diffuse large B-cell lymphoma with a BRCA1 gene mutation. Evidence is mounting that there is a large increase in the risk for hematologic malignancies among patients with genetic changes in the BRCA pathways. The genomic analysis demonstrated a frameshift mutation in the BRCA1 gene: 277_279delinsCC (Phe93fs). It is a novel BRCA1 mutation that has never been reported, and caused malignant lymphoma as well as breast and ovarian cancer.

Case Report of Pulmonary Sarcoidosis Suspected to be Pulmonary Metastasis in a Patient with Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

Standard endocrine therapy and chemotherapy can induce long-term remission in breast cancer patients; however, breast cancer can recur at any site. Pulmonary nodules with lymphadenopathy in advanced cancer patients are likely to be assumed as metastases. A 44-year-old woman with a history of breast cancer was presented to our institution with abnormal findings on 18-fluorodeoxyglucose positron emission tomography imaging, which suggested lung metastasis. She had previously been diagnosed with breast cancer (T1N2M0, Stage IIIa, intraductal carcinoma, triple negative cancer). Histological analysis of the mediastinal lymph node biopsy demonstrated sarcoidosis, showing a chronic, non-caseating, granulomatous inflammation. Our case highlights the need for non-malignant diagnoses in those with prior malignancies, and the need for histological evaluations in the event of first recurrence following potentially curative therapy.

The Effect of Nurse's Competency Empowerment and Boss' Job Competency Recognition Level on Work Performance / 한국직업건강간호학회지

PURPOSE: This study is to investigate the effect of nurse's competency empowerment and boss' job competency recognition on work performance. METHODS: 216 nurses participated for data collection which was conducted from September 1, 2011 to September 10, 2011. The collected data were analyzed with SPSS/WIN 16.0 and with frequency test, ANOVA, Scheffe test and Multiple regression. RESULTS: Firstly, the work performance in accordance with subject's general characteristics was found to be significant in the 50s, graduate school or higher education, Roman Catholic, charge nurse and 21-years or older. Secondly, the correlation among nurse's competency empowerment, boss' competency recognition and work performance was found to be positively related (r=.501~.639, p<.001). Thirdly, competency empowerment was found to be the most effective factor for work performance, followed by boss' competency recognition and career year, and these factors accounted for 63.5%. CONCLUSION: As the results show that the work performance is highly affected by the nurse's competency empowerment, boss' competency recognition level and career level in clinical environment, effective education programs are required to provide an appropriate experience to both entry-level and experienced nurses, as well as to enhance boss' competency empowerment at the same time.

Successful treatment of disseminated interdigitating dendritic cell sarcoma with adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy / 대한혈액학회지

Interdigitating dendritic cell sarcoma (IDCS) is a very rare and aggressive neoplasm that arises from antigen presenting cells. IDCS usually involves lymph nodes; however, extra-nodal involvement has also been reported. Because a consistent standard therapy for IDCS has not been established to date, we report a case of the successful treatment of disseminated IDCS using ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine). A 64-year-old man was diagnosed with IDCS on the basis of immunohistochemical findings of a biopsy specimen of the inferior nasal concha. Immunohistochemical staining showed a positive reaction for CD68, leukocyte common antigen, and S-100 protein, but a negative reaction for CD34, CD1a, and CD21. Imaging studies showed cervical and axillary lymphadenopathies, subcutaneous nodules, and a soft tissue lesion in the nasal cavity. Treatment with the ABVD regimen resulted in complete remission after 8 cycles of chemotherapy.

The Effects of Nurse's Communication and Self-Leadership on Nursing Performance / 한국직업건강간호학회지

PURPOSE: The study is to investigate the effect of communication and self-leadership on nursing performance. METHODS: The subjects of study were composed of 358 nurses at a G city university hospital, tested with structured questionnaire from September 15 to 30, 2010. The collected data were analyzed with ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: The level of communication, self-leadership, and nursing performance was 3.37, 3.38 and 3.70 respectively in average. The variables showing significant difference in communication were as follows: age, marital status, religious status, education, monthly income, work department and work experience. Also, the variables in nursing performance were as follows: age, marital status, religious status, education, education, monthly income, position, working department and work experience. Communication, self-leadership and nursing performance of nurse showed significant positive correlation. Nursing performance was positively correlated with monthly income, when it exceeded 2.01 million won, career experience and self-leadership (p<.001). These variables explained 53.7% of the regression model. CONCLUSION: Since monthly income, work experience, communication and self-leadership have positive effect on nursing performance, an effective strategy is required to improve self-leadership and nurse's communication.

Optimal time for repeating the IgM anti-hepatitis A virus antibody test in acute hepatitis A patients with a negative initial test / 대한간학회지

BACKGROUND/AIMS: The nonspecific clinical presentation of acute hepatitis A (AHA) mandates the detection of anti-hepatitis A virus IgM antibodies (IgM anti-HAV) in the serum for obtaining a definitive diagnosis. However, IgM anti-HAV might not be present during the early phase of the disease. The aim of this study was to determine the optimal time for repeating the IgM anti-HAV test (HAV test) in AHA patients with a negative initial test. METHODS: In total, 261 patients hospitalized with AHA were enrolled for this retrospective study. AHA was diagnosed when the test for IgM anti-HAV was positive and the serum alanine aminotransferase (ALT) level was > or =400 IU/L. Repeat HAV test was conducted after 1-2 weeks if the initial HAV test was negative but AHA was still clinically suspected. RESULTS: The results of the initial HAV test were negative in 28 (10.7%) patients. The intervals from symptom onset to the initial-HAV-test day and from the peak-ALT day to the initial-HAV-test day were significantly shorter in the negative-initial-HAV-test group, but on multivariate analysis only the latter was significantly associated with negative results for the initial HAV test (beta=-0.978; odds ratio [95% confidence interval]=0.376 [0.189-0.747]; P=0.005). The HAV test was positive in all patients when it was performed at least 2 days after the peak-ALT day. CONCLUSIONS: The results of HAV tests were significantly associated with the interval from the peak-ALT day to the HAV-test day. The optimal time for repeating the HAV test in clinically suspicious AHA patients with a negative initial HAV test appears to be at least 2 days after the peak-ALT day.

Effects of Nurse's Organizational Conflict on Organizational Commitment and Labor Union Commitment in University Hospitals / 간호행정학회지

PURPOSE: This study was done to investigate the effects of university hospital nurses' organizational conflict between organizational commitment and labor union commitment, so as to provide data on prevention of conflict with the hospital and to improve work achievement with commitment of two different groups: hospital and labor union commitment. METHODS: Data collection was conducted from May 15 to 31, 2011 for nurses registered in the labor union of a university hospital. The collected data were analyzed using t-test, ANOVA, Scheffe test and multiple regression. RESULTS: Organizational commitment of the nurses showed significant differences according to age, position and work experience, and degree of labor union commitment according to academic achievement. The factors affecting labor union commitment were organizational conflict and recognition of need for labor union, which accounted for 19% of the variance. Factors affecting organizational commitment were organizational conflict, recognition of need for labor union, participation in organizational events, and renewal of membership in the union, which accounted for 33% of the variance. CONCLUSION: The results of this study indicate that there is a need to improve work achievement by minimizing conflict and preventing labor disputes for better organizational commitment and labor union commitment of nurses.

Metastasis to the Iliopsoas Muscle from Advanced Gastric Carcinoma: an Unusual Site of Metastasis / 대한내과학회지

Advanced gastric cancer with skeletal muscle metastasis is a rare occurrence. Here, we report a rare case of gastric carcinoma with psoas muscle metastasis. This patient had advanced gastric carcinoma and complained of inability to extend the left hip joint due to pain. Because magnetic resonance imaging (MRI) revealed an iliopsoas mass showing heterogeneous signal intensity with fluid collection and enhancement around the mass, we speculated that the mass was an intramuscular metastatic tumor from primary gastric carcinoma as well as an intramuscular abscess. Histopathologically, the patient had a metastasis from primary gastric adenocarcinoma. Therefore, the patient was treated with radiotherapy and subsequent chemotherapy.

Metastasis to the Iliopsoas Muscle from Advanced Gastric Carcinoma: an Unusual Site of Metastasis / 대한내과학회지

Advanced gastric cancer with skeletal muscle metastasis is a rare occurrence. Here, we report a rare case of gastric carcinoma with psoas muscle metastasis. This patient had advanced gastric carcinoma and complained of inability to extend the left hip joint due to pain. Because magnetic resonance imaging (MRI) revealed an iliopsoas mass showing heterogeneous signal intensity with fluid collection and enhancement around the mass, we speculated that the mass was an intramuscular metastatic tumor from primary gastric carcinoma as well as an intramuscular abscess. Histopathologically, the patient had a metastasis from primary gastric adenocarcinoma. Therefore, the patient was treated with radiotherapy and subsequent chemotherapy.

A Case of Peripheral T-cell Lymphoma of the Duodenum and Jejunum / 대한소화기내시경학회지

Primary T-cell lymphoma of the duodenum is uncommon, and peripheral T-cell lymphoma of the duodenum is extremely rare. Approximately 90% of primary gastrointestinal lymphomas originate from B-cells and fewer than 10% originate from T-cells. A peripheral T-cell lymphoma involved in the small intestine is usually detected by complications such as gastrointestinal bleeding, perforation, or obstruction. A 57-year-old man complained of postprandial discomfort and weight loss of 5 kg for 1 month. An esophagogastroduodenoscopy showed a deep ulcer with blood clots and whitish exudates. We conducted a Whipple's operation because of the high risk of ulcer perforation and difficulty in distinguishing the ulcer from malignancy. The resected tissue was confirmed as a peripheral T-cell lymphoma. We reported a case of peripheral T-cell lymphoma of the duodenum and jejunum that extended to the pancreatic head where a diffuse lesion was found without any complications or specific symptoms.