Purpose: In Korea, the Health Insurance Review and Assessment Service (HIRA) mandates patient participation in outpatient multidisciplinary team (MDT) meetings as part of national cancer quality assessment. However, the necessity of involving patients and families in MDT discussions remains debatable. This study explored international expert perspectives on patient participation in gastric cancer MDTs. Methods: A cross-national expert survey was conducted in September 2021 among 15 gastric cancer specialists from Korea, China, Japan, Singapore, and the United States. The survey assessed the frequency of patient and family member attendance, perceived pros and cons, and preferences regarding mandatory versus selective involvement. Additionally, MDT structures and policies were reviewed by countries. Results: Most respondents reported that patients and families rarely or never attend MDT meetings: nine stated that patients are never included, three reported “usually not,” and three indicated “sometimes.” None consistently included patients. The most cited benefits were sharing opinions with patients and families simultaneously, followed by improved explanation of treatment and legal protection. Major concerns included hindered discussion, inefficiency, and logistical challenges. Only four respondents supported routine participation, while 11 favored case-dependent involvement. Conclusion International experts do not widely support mandatory patient participation in MDT meetings. A flexible approach that allows MDTs to operate with or without patient involvement may better reflect actual clinical practice.

Transcription factor CP2-like protein 1 (Tfcp2l1), a naïve pluripotency transcription factor, is expressed in both early embryonic and adult tissues, where it enforces pluripotency of embryonic stem cells (ESCs) and stemness features of cancer cells, respectively. However, the detailed molecular pathways by which Tfcp2l1 is regulated in early embryonic development and cancer cells remain unknown. Here, we identified the pseudophosphatase dual specificity phosphatase 27 (Dusp27), also known as serine/threonine/tyrosine-interacting like-2, as a novel Tfcp2l1-interacting protein through a sterile alpha motif-like domain in the C-terminus of Tfcp2l1 in murine ESCs. The interaction between Dusp27 and Tfcp2l1 was dependent on the cell cycle status and increased during mitosis. Expression of Dusp27 was upregulated during naïve pluripotency and repressed during spontaneous differentiation of murine ESCs. Ectopic expression of Dusp27 enhanced the transcriptional activity of Tfcp2l1 and promoted features associated with the naïve pluripotent state, while suppressing meso-endodermal lineage differentiation. The present study demonstrates that Dusp27 is a novel positive regulator of Tfcp2l1 through a physical interaction and thereby fine-tunes the pluripotency status and meso-endodermal differentiation of murine ESCs.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Purpose: Risk factors predicting distant metastasis (DM) in extrahepatic bile duct cancer (EHBDC) patients treated with curative resection were investigated. Materials and Methods: Medical records of 1,418 EHBDC patients undergoing curative resection between Jan 2000 and Dec 2015 from 14 institutions were reviewed. After resection, 924 patients (67.6%) were surveilled without adjuvant therapy, 297 (21.7%) were treated with concurrent chemoradiotherapy (CCRT) and 148 (10.8%) with CCRT followed by chemotherapy. To exclude the treatment effect from innate confounders, patients not treated with adjuvant therapy were evaluated. Results: After a median follow-up of 36.7 months (range, 2.7 to 213.2 months), the 5-year distant metastasis-free survival (DMFS) rate was 57.7%. On multivariate analysis, perihilar or diffuse tumor (hazard ratio [HR], 1.391; p=0.004), poorly differentiated histology (HR, 2.014; p < 0.001), presence of perineural invasion (HR, 1.768; p < 0.001), positive nodal metastasis (HR, 2.670; p < 0.001) and preoperative carbohydrate antigen (CA) 19-9 ≥ 37 U/mL (HR, 1.353; p < 0.001) were significantly associated with inferior DMFS. The DMFS rates significantly differed according to the number of these risk factors. For validation, patients who underwent adjuvant therapy were evaluated. In patients with ≥ 3 factors, additional chemotherapy after CCRT resulted in a superior DMFS compared with CCRT alone (5-year rate, 47.6% vs. 27.7%; p=0.001), but the benefit of additional chemotherapy was not observed in patients with 0-2 risk factors. Conclusion Tumor location, histologic differentiation, perineural invasion, lymph node metastasis, and preoperative CA 19-9 level predicted DM risk in resected EHBDC. These risk factors might help identifying a subset of patients who could benefit from additional chemotherapy after resection.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Background/Aims: Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI. Methods: A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups. Results: The percentage change of LDL-C level at 1–3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1–3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001). Conclusions Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.

Objective: The coronavirus disease 2019 (COVID-19) pandemic has not yet been controlled and herd immunity through vaccination against COVID-19 has been considered the best option to prevent the spread of COVID-19 worldwide. We encountered several patients in our emergency department presenting with adverse reactions after COVID-19 vaccinations. Hence, we investigated the clinical characteristics of patients with adverse reactions after vaccination. Methods: In South Korea, 10,510 doses of the BNT162b2 mRNA COVID-19 vaccine was administered to 5,304 medical staff. To investigate adverse reactions, we reviewed the case report forms from the vaccination centers and the medical charts from the date of first dose administration until two weeks after the last planned second dose. Results: A total of 187 cases, out of the 10,510, experienced adverse reactions and these were more common in females. Dizziness (44.4%), nausea and vomiting (28.3%), and fever (24.1%) were the most reported adverse reactions. Immediate adverse reactions included dizziness, nausea, and vomiting, palpitation, sensory changes, and delayed adverse reactions included fever, myalgia, headache, nausea, and vomiting. The delayed reactions of fever and myalgia were significantly more common after the second, rather than after the first dose (P<0.01 and P=0.03, respectively). One case of anaphylaxis was reported. All adverse reactions improved after conservative care. Conclusion Our findings show diverse adverse reactions to the BNT162b2 mRNA COVID-19 vaccine, but none of them required hospitalization. However, since this vaccine has been manufactured using a newly developed technique, more research focused on the clinical significance of the adverse reactions is necessary.