1.Multicenter evaluation of the PASS score as a negative predictive tool and the impact of inter-observer variability in pheochromocytoma and paraganglioma risk stratification
Sungyeon JUNG ; Hye-Ri SHIN ; Su-Jin SHIN ; Hee Young NA ; Soon-Won HONG ; So Yeon PARK ; Chan Kwon JUNG ; Kyeong Cheon JUNG ; Young Lyun OH ; Jae-Kyung WON
Journal of Pathology and Translational Medicine 2026;60(2):202-213
The Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) is widely used for risk stratification in pheochromocytoma and paraganglioma (PPGL), but its clinical utility is limited by inter-observer variability of its parameters and inconsistent predictive performance. Methods: We conducted a multicenter retrospective study of 1,518 patients with PPGL from five tertiary referral centers in Korea. Prognostic utility of PASS system was assessed using logistic regression, Kaplan-Meier analysis, and receiver operating characteristic (ROC) curve analysis. Inter-observer variability was inferred by comparing area under the ROC curve (AUCs) across institutions. Simplified PASS systems were developed based on multivariable analysis of key histopathological parameters. Results: The PASS system was a significant predictor of adverse events and recurrence-free survival. Although the PASS system demonstrated only modest discriminative ability (AUC, 0.673), it showed a high negative predictive value (NPV, 0.885), supporting its usefulness as a screening tool for benign behavior. However, there was significant inter-institutional variability in PASS performance (AUC; range, 0.513 to 0.727; p < .05). The 3-factor Simple PASS, which incorporates necrosis, spindling, and mitotic figures, exhibited less inter-observer variation. The 4-factor Simple PASS, which adds vascular invasion to the 3-factor model, also showed reduced inter-observer variability and improved AUC and NPV compared to the original PASS system. Conclusions: In this multicenter cohort, the PASS system demonstrated high NPV and screening potential, but significant inter-observer variability remains a challenge. Simplification of the PASS system and enhanced pathologist training may improve reproducibility and clinical utility in PPGL risk stratification.
2.Advanced Combination Therapy in Inflammatory Bowel Disease
The Korean Journal of Gastroenterology 2026;86(2):85-103
Despite the advances in biological and small-molecule therapies, a substantial proportion of patients with inflammatory bowel disease (IBD) experience multiple treatment failures, constituting difficult-to-treat IBD with remission rates plateauing at 30–50%.Advanced combination therapy (ACT), defined as the concomitant use of two advanced therapies with distinct mechanisms of action, has become a strategy to overcome this therapeutic ceiling. This review aims to synthesize the rationale, clinical evidence, safety profile, and practical implementation strategies of ACT in IBD. A narrative review of randomized controlled trials (RCTs), meta-analyses, and real-world observational studies evaluating ACT in IBD was performed, focusing on the mechanistic rationale, efficacy outcomes, safety data, and clinical application strategies. ACT is supported by pharmacokinetic synergy (reduced immunogenicity and improved drug exposure) and pharmacodynamic complementarity (simultaneous blockade of multiple inflammatory pathways). Proof-of-concept RCTs, including VEGA and EXPLORER, along with meta-analyses, revealed higher clinical and endoscopic remission rates with ACT than with monotherapy in refractory populations. The safety profiles are generally comparable to monotherapy, but regimen-specific heterogeneity exists. Although vedolizumab- or ustekinumab-based combinations show favorable long-term safety, regimens including natalizumab or JAK inhibitors warrant caution and close monitoring. Detailed clinical strategies include induction-bridge approaches with JAK inhibitors, safety-anchor strategies with gut-selective agents, mechanistic complementarity strategies for treatment failures, and double-indication strategies for extraintestinal manifestations. ACT is a promising rescue strategy for D2T IBD with encouraging efficacy and acceptable safety. Future research should focus on large-scale RCTs and biomarker-driven strategies to optimize patient selection and treatment protocols for ACT.
3.Retrospective Study on Risk Factors for Repeated Hospitalization in Adolescents With Suicidal and Self-Harm Behaviors
Ha-Kyung CHUNG ; So-Yeon LEE ; Hee Jin KIM ; Young-Chul JUNG ; Junghan LEE ; Keun-Ah CHEON
Journal of Korean Neuropsychiatric Association 2025;64(4):249-257
Objectives:
This retrospective study aimed to identify the sociodemographic and clinical risk factors associated with repeated hospitalizations in adolescents with suicidal and self-harm behaviors.
Methods:
This study reviewed the medical records of 86 adolescents aged 11 to 19 years, first hospitalized between January 2019 and December 2022. The participants were categorized into a re-admission group (hospitalized three or more times within 1 year of the first admission) and a control group (hospitalized one to two times). The groups were compared based on the sociodemographic characteristics and psychological assessments.
Results:
The school attendance status at the last admission was significantly different between the two groups, with the re-admission group showing greater attendance difficulties. In addition, the number of suicide attempts was higher in the re-admission group, while other sociodemographic factors and psychological assessment results showed no significant differences between the groups.
Conclusion
School attendance has emerged as a key differentiating factor in the likelihood of repeated psychiatric hospitalizations among adolescents with suicidal and self-harm behaviors.Therefore, enhancing school engagement through targeted interventions may help reduce the risk of re-admission in this vulnerable population.
4.Clinical Practice Recommendations for the Use of Next-Generation Sequencing in Patients with Solid Cancer: A Joint Report from KSMO and KSP
Miso KIM ; Hyo Sup SHIM ; Sheehyun KIM ; In Hee LEE ; Jihun KIM ; Shinkyo YOON ; Hyung-Don KIM ; Inkeun PARK ; Jae Ho JEONG ; Changhoon YOO ; Jaekyung CHEON ; In-Ho KIM ; Jieun LEE ; Sook Hee HONG ; Sehhoon PARK ; Hyun Ae JUNG ; Jin Won KIM ; Han Jo KIM ; Yongjun CHA ; Sun Min LIM ; Han Sang KIM ; Choong-kun LEE ; Jee Hung KIM ; Sang Hoon CHUN ; Jina YUN ; So Yeon PARK ; Hye Seung LEE ; Yong Mee CHO ; Soo Jeong NAM ; Kiyong NA ; Sun Och YOON ; Ahwon LEE ; Kee-Taek JANG ; Hongseok YUN ; Sungyoung LEE ; Jee Hyun KIM ; Wan-Seop KIM
Cancer Research and Treatment 2024;56(3):721-742
In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.
5.Effects of a forest therapy camp on cancer survivors’ stress, mood and natural killer cells in Korea
Young Ran CHAE ; Su Youn PARK ; So Yean KANG ; Hyo Young KANG ; Sun Hee LEE ; Young Mi JO ; In Sun CHEON
Journal of Korean Biological Nursing Science 2024;26(3):185-194
Purpose:
This study investigated changes in psychological and physiological indices in cancer survivors who participated in a forest therapy camp in Korea.
Methods:
A total of 37 cancer survivors (19 and 18 in the experimental and control groups, respectively) participated in this study. Over a 2-night and 3-day period, the participants in the experimental group took part in a forest therapy camp that included activities such as gymnastics, walking, five-senses experiences, and meditation. Both groups completed self-report questionnaires that measured their stress levels and profile of mood states, both before and after the forest therapy camp. Blood samples were collected to measure the levels of cortisol, serotonin, and natural killer (NK) cells.
Results:
After the forest therapy camp, the experimental group exhibited reduced stress levels (p = .031) and a significant improvement in total mood disturbance (p = .047) when compared with the control group. The level of serotonin also significantly increased (p < .001). However, in contrast to the prediction, a significant increase in cortisol was noted in the experimental group relative to the control group (p = .016). Moreover, no significant difference in NK cells was noted between the two groups.
Conclusion
Forest therapy can be easily applied to cancer survivors. The positive psychological effects of the forest therapy camp were confirmed by improvements in stress and mood states and the increased level of serotonin in forest therapy camp participants. However, there is a need for a follow-up evaluation of cortisol and NK cells due to the absence of significant between-group differences.
6.Clinical practice recommendations for the use of next-generation sequencing in patients with solid cancer: a joint report from KSMO and KSP
Miso KIM ; Hyo Sup SHIM ; Sheehyun KIM ; In Hee LEE ; Jihun KIM ; Shinkyo YOON ; Hyung-Don KIM ; Inkeun PARK ; Jae Ho JEONG ; Changhoon YOO ; Jaekyung CHEON ; In-Ho KIM ; Jieun LEE ; Sook Hee HONG ; Sehhoon PARK ; Hyun Ae JUNG ; Jin Won KIM ; Han Jo KIM ; Yongjun CHA ; Sun Min LIM ; Han Sang KIM ; Choong-Kun LEE ; Jee Hung KIM ; Sang Hoon CHUN ; Jina YUN ; So Yeon PARK ; Hye Seung LEE ; Yong Mee CHO ; Soo Jeong NAM ; Kiyong NA ; Sun Och YOON ; Ahwon LEE ; Kee-Taek JANG ; Hongseok YUN ; Sungyoung LEE ; Jee Hyun KIM ; Wan-Seop KIM
Journal of Pathology and Translational Medicine 2024;58(4):147-164
In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.
7.Implementation of Pharmaceutical Care Services During the COVID-19 Pandemic Worldwide
So Yeon LEE ; Seunghyun CHEON ; Hye Won PARK ; Sang Hyeon OH ; Jee-Eun CHUNG ; Sook Hee AN
Korean Journal of Clinical Pharmacy 2024;34(4):242-251
Background:
This study sought to research the implementation of pharmaceutical care services and review the pharmaceutical care services used for coronavirus disease 2019 (COVID-19) prevention, diagnosis, therapy, and vaccination during the COVID-19 pandemic.
Methods:
All articles reporting pharmacists’ implementation of pharmaceutical care services during the COVID-19 pandemic were comprehensively searched in PubMed/Medline, Embase, and the Cochrane Library databases up toJuly 7, 2021, then included in this study. Twenty-four items of pharmaceutical care services were classified into the following 5categories: patient evaluation and monitoring, clinical decision support, compounding/dispensing/administration, patient consultation and education, and drug-related policy research and development.
Results:
A total of 674 articles from 100 countrieswere included, with the United States of America being the most frequently studied country. Across the 5 classified categories,compounding/dispensing/administration was most frequently examined (28.9%), followed by patient consultation and education (25.2%). Among the 24 items of pharmaceutical care services, medicine supply management was most frequently reported on (11.4%), followed by patient consultations (11.0%). The primary implemented pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination were public health education, COVID-19 testing services, medicine supply management, and vaccination, respectively.
Conclusion
Pharmacists have implemented diverse pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination globally. Further studies should be conducted to determine the correlation between the characteristics of healthcare accessibility in a country and the implemented pharmaceutical care services for COVID-19.
8.Implementation of Pharmaceutical Care Services During the COVID-19 Pandemic Worldwide
So Yeon LEE ; Seunghyun CHEON ; Hye Won PARK ; Sang Hyeon OH ; Jee-Eun CHUNG ; Sook Hee AN
Korean Journal of Clinical Pharmacy 2024;34(4):242-251
Background:
This study sought to research the implementation of pharmaceutical care services and review the pharmaceutical care services used for coronavirus disease 2019 (COVID-19) prevention, diagnosis, therapy, and vaccination during the COVID-19 pandemic.
Methods:
All articles reporting pharmacists’ implementation of pharmaceutical care services during the COVID-19 pandemic were comprehensively searched in PubMed/Medline, Embase, and the Cochrane Library databases up toJuly 7, 2021, then included in this study. Twenty-four items of pharmaceutical care services were classified into the following 5categories: patient evaluation and monitoring, clinical decision support, compounding/dispensing/administration, patient consultation and education, and drug-related policy research and development.
Results:
A total of 674 articles from 100 countrieswere included, with the United States of America being the most frequently studied country. Across the 5 classified categories,compounding/dispensing/administration was most frequently examined (28.9%), followed by patient consultation and education (25.2%). Among the 24 items of pharmaceutical care services, medicine supply management was most frequently reported on (11.4%), followed by patient consultations (11.0%). The primary implemented pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination were public health education, COVID-19 testing services, medicine supply management, and vaccination, respectively.
Conclusion
Pharmacists have implemented diverse pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination globally. Further studies should be conducted to determine the correlation between the characteristics of healthcare accessibility in a country and the implemented pharmaceutical care services for COVID-19.
9.Implementation of Pharmaceutical Care Services During the COVID-19 Pandemic Worldwide
So Yeon LEE ; Seunghyun CHEON ; Hye Won PARK ; Sang Hyeon OH ; Jee-Eun CHUNG ; Sook Hee AN
Korean Journal of Clinical Pharmacy 2024;34(4):242-251
Background:
This study sought to research the implementation of pharmaceutical care services and review the pharmaceutical care services used for coronavirus disease 2019 (COVID-19) prevention, diagnosis, therapy, and vaccination during the COVID-19 pandemic.
Methods:
All articles reporting pharmacists’ implementation of pharmaceutical care services during the COVID-19 pandemic were comprehensively searched in PubMed/Medline, Embase, and the Cochrane Library databases up toJuly 7, 2021, then included in this study. Twenty-four items of pharmaceutical care services were classified into the following 5categories: patient evaluation and monitoring, clinical decision support, compounding/dispensing/administration, patient consultation and education, and drug-related policy research and development.
Results:
A total of 674 articles from 100 countrieswere included, with the United States of America being the most frequently studied country. Across the 5 classified categories,compounding/dispensing/administration was most frequently examined (28.9%), followed by patient consultation and education (25.2%). Among the 24 items of pharmaceutical care services, medicine supply management was most frequently reported on (11.4%), followed by patient consultations (11.0%). The primary implemented pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination were public health education, COVID-19 testing services, medicine supply management, and vaccination, respectively.
Conclusion
Pharmacists have implemented diverse pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination globally. Further studies should be conducted to determine the correlation between the characteristics of healthcare accessibility in a country and the implemented pharmaceutical care services for COVID-19.
10.Implementation of Pharmaceutical Care Services During the COVID-19 Pandemic Worldwide
So Yeon LEE ; Seunghyun CHEON ; Hye Won PARK ; Sang Hyeon OH ; Jee-Eun CHUNG ; Sook Hee AN
Korean Journal of Clinical Pharmacy 2024;34(4):242-251
Background:
This study sought to research the implementation of pharmaceutical care services and review the pharmaceutical care services used for coronavirus disease 2019 (COVID-19) prevention, diagnosis, therapy, and vaccination during the COVID-19 pandemic.
Methods:
All articles reporting pharmacists’ implementation of pharmaceutical care services during the COVID-19 pandemic were comprehensively searched in PubMed/Medline, Embase, and the Cochrane Library databases up toJuly 7, 2021, then included in this study. Twenty-four items of pharmaceutical care services were classified into the following 5categories: patient evaluation and monitoring, clinical decision support, compounding/dispensing/administration, patient consultation and education, and drug-related policy research and development.
Results:
A total of 674 articles from 100 countrieswere included, with the United States of America being the most frequently studied country. Across the 5 classified categories,compounding/dispensing/administration was most frequently examined (28.9%), followed by patient consultation and education (25.2%). Among the 24 items of pharmaceutical care services, medicine supply management was most frequently reported on (11.4%), followed by patient consultations (11.0%). The primary implemented pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination were public health education, COVID-19 testing services, medicine supply management, and vaccination, respectively.
Conclusion
Pharmacists have implemented diverse pharmaceutical care services for COVID-19 prevention, diagnosis, therapy, and vaccination globally. Further studies should be conducted to determine the correlation between the characteristics of healthcare accessibility in a country and the implemented pharmaceutical care services for COVID-19.

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