Purpose: This study aimed to explore the practices, perceptions, and barriers related to specialty palliative care (SPC) referrals among oncologists in Korea, highlighting the clinical implications of early integration. Materials and Methods: A cross-sectional online survey targeting board-certified hemato-oncology specialists was conducted between August 1-25, 2024. The survey assessed referral practices, attitudes toward early SPC integration, referral criteria, barriers, and institutional characteristics. Results: A total of 227 oncologists participated (response rate, 36.7%). Among them, 68.7% reported frequent SPC referrals, with higher referral rates observed among younger physicians, those in tertiary hospitals, and institutions with in-house SPC teams (p < 0.001). Although 74.9% supported early SPC integration, referrals were often inconsistently timed, frequently occurring after disease progression or at the discontinuation of chemotherapy. For time-based referrals, the most commonly endorsed triggers were disease progression despite palliative second-line treatment and a prognosis of expected mortality within 6-12 months. Need-based referral triggers such as patient or family requests (96.5%), psychological distress (89.9%), or uncontrolled symptoms (83.3%), were also widely endorsed. The major barriers to early SPC integration included patient and family resistance (70.0%) and limited availability of SPC teams (34.4%). Conclusion This study emphasizes the importance of systematic efforts to promote timely SPC integration in Korea, including education to raise patient awareness, improved referral systems, and enhanced infrastructure. The positive attitudes toward early SPC among oncologists reflect a growing recognition of its value, highlighting the need for strategies that align with international standards.

Purpose: This study aimed to develop and implement an antimicrobial stewardship education program for physician assistant nurses and to evaluate its effects on their knowledge and clinical performance. Methods: A quasi-experimental, single-group pre-post design was conducted with 50 physician assistant nurses at a university hospital in Seoul, Republic of Korea. The antimicrobial stewardship education program, developed using the ADDIE model, consisted of 12 sessions including lectures and case-based learning (CBL)-based discussions.Knowledge was measured before and immediately after the intervention, while performance was assessed pre-intervention and four weeks post-program. Data were analyzed using paired t-tests, Wilcoxon signed-rank tests, and analysis of covariance (ANCOVA). Results: Knowledge scores significantly improved from 44.65±7.45 to 58.50±10.11 (p<.001), and all subdomains showed significant increases (p<.001). Performance scores increased from 3.68±0.77 to 4.28±0.68 (p<.001). Knowledge gain did not differ significantly between the medical and surgical departments (p=.710). Likewise, after adjusting for pre-test scores, no significant difference in performance improvement was observed between the two departments (ANCOVA, p=.170). These results indicate that the program was effective across both departments regardless of their characteristics. Conclusion The antimicrobial stewardship education program improved both knowledge and performance among physician assistant nurses. This program may contribute to the standardization of antimicrobial stewardship education and to appropriate antimicrobial use and the reduction of antimicrobial resistance.

Background: Haemophilus influenzae is the causative pathogen for various infectious diseases, such as respiratory infections, otitis media, sinusitis, and meningitis. This study aimed to investigate the prevalence and molecular characteristics of β-lactam resistance in non-typeable H. influenzae isolates in South Korea. Methods: In total, 115 non-duplicated H. influenzae isolates were included in this study.Bacterial identification and serotyping were performed using matrix assisted laser desorption ionization-time of flight mass spectrometry and polymerase chain reaction (PCR) of bexA, respectively. Antimicrobial susceptibility was tested using the broth microdilution method.The production of β-lactamase was determined using nitrocefin disks. The presence of blaTEM and blaROB was confirmed using PCR. ftsI was analyzed to identify amino acid mutations in penicillin-binding protein (PBP) 3. Results: Resistance rates to ampicillin, amoxicillin–clavulanate, and cefuroxime were 67.8%, 13.9%, and 32.2%, respectively. None of the isolates were resistant to cefotaxime or ceftriaxone. Among 78 ampicillin-resistant isolates, 71 were β-lactamase-producing ampicillinresistant (BLPAR), and 7 were β-lactamase-non-producing ampicillin-resistant. All BLPAR isolates carried blaTEM, and none carried blaROB. Among 16 amoxicillin–clavulanate-resistant isolates, 15 β-lactamase producers harbored blaTEM. Four to 7 PBP3 mutations per isolate were detected in all 16 non-β-lactamase-producing ampicillin-resistant or cephalosporinresistant isolates. Conclusion Beta-lactam resistance in non-typeable H. influenzae isolates is highly prevalent in South Korea, primarily because of blaTEM and various PBP3 mutations. Therefore, continuous monitoring of antimicrobial resistance rates and mechanisms in non-typeable H.influenzae is necessary.

Purpose: Esophagojejunostomy leakage (EJL) remains one of the most critical complications following total gastrectomy for gastric cancer. This study aimed to evaluate the evolving therapeutic approaches and clinical outcomes of EJL using data from a large-scale multicenter retrospective cohort. Methods: Among 6,577 patients who underwent total gastrectomy or proximal gastrectomy with double tract reconstruction at nine institutions from 2003 to 2024, 196 (3.0%) developed EJL. Of these, 162 patients with comprehensive clinical data were included in the final analysis. The study examined treatment modalities, changes in management over time, patient characteristics, surgical variables, and clinical outcomes. Four groups were defined according to treatment approach: conservative, endoscopic, reoperation, and multimodal (combined) therapy. Results: Endoscopic therapy was first introduced in 2011 and has progressively supplanted reoperation, now comprising 32.5% of cases. The average time to EJL diagnosis was 8.4 days after surgery. Overall in-hospital mortality was 6.1% (10/162). When conservative management was excluded, endoscopic treatment demonstrated the highest rate of therapeutic success (94.3%, p = 0.004). Both the duration until diet resumption and length of hospital stay were notably reduced in the endoscopic and conservative groups compared with reoperation and multimodal therapy (p < 0.001). Moreover, although the highest post-leakage hospitalization costs were observed with multimodal treatment (p < 0.001), overall hospitalization expenses were significantly lower for patients managed conservatively or with endoscopic intervention (p < 0.001). Conclusion Over the past two decades, management of EJL has shifted toward endoscopic approaches. Endoscopic therapies yield superior clinical outcomes and should be considered a primary option for appropriate candidates.

Objectives: This preliminary, randomized, double-blind, multi-center study evaluated the efficacy of alternate-day tegoprazan (50 mg) versus daily lansoprazole (15 mg) as for maintenance therapy in patients with non-erosive reflux disease (NERD). Methods: Forty five participants were enrolled and treated for 8 weeks. The primary endpoint was the proportion of symptom-free days. The secondary endpoints were changes in Gastrointestinal Symptom Rating Scale (GSRS) and Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) scores. Results: It showed no significant difference between groups in the proportion of symptom-free days between both groups (tegoprazan: 60.4%±6.3%; lansoprazole: 74.0%±6.5%). The GSRS and GERD-HRQL score improvements were also comparable between both groups. Both treatments were well tolerated, with no serious adverse events reported. Conclusions These findings suggest that alternate-day tegoprazan offers comparable efficacy and safety to daily lansoprazole therapy and may serve as a more flexible and patient-friendly maintenance option for NERD.

Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.

Background: and Purpose: We aimed to develop the diagnostic matrix of the Seoul Cognitive Status Test (SCST) and compare its performance with traditional paper-and-pencil neuropsychological tests, including the Seoul Neuropsychological Screening Battery-II (SNSB-II) and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K). Methods: We recruited 197 participants from the head-to-head SCST-SNSB cohort, and 204 participants from the head-to-head SCST-CERAD cohort. They underwent either SNSB-II or CERAD-K, in addition to SCST. The diagnostic matrix was developed by combining cognitive function, determined by neuropsychological tests, and activities of daily living (ADL), determined by Instrumental-ADL scales. Results: The diagnostic agreement between the SCST and the SNSB-II was 83.9% (weighted kappa=0.87). The agreement between the SCST and the CERAD-K was 84.3% (weighted kappa=0.88). In the SCST-SNSB cohort, all differences in SCST scores between the cognitively unimpaired (CU), mild cognitive impairment (MCI), and dementia diagnosed with the SNSB-II were significant in all cognitive domains (all p<0.01), except for the executive domain between CU and MCI (p=0.145). In the SCST-CERAD cohort, all differences in SCST scores between the 3 groups diagnosed with the CERAD-K were significant in all cognitive domains (all p<0.01), except for the language and visuospatial domains between MCI and dementia (p=0.169 and p=0.778, respectively). Conclusions Our findings suggest that the tablet-based SCST may be another option to traditional paper-and-pencil neuropsychological tests, especially in situations where time and space are relatively limited, and neuropsychological testing specialists are not available.

Purpose: The purpose of this study was to investigate the impact of nurse educators’ competency on their job satisfaction. Methods: The subjects of this study were nurses in charge of nursing education at the general hospital level or higher organization. Data were collected via an online survey from May 3 to May 20, 2024, from 91 respondents. The survey questionnaires included general characteristics, competency, and job satisfaction. Descriptive statistics, Pearson’s correlation coefficients, t-tests, and simple linear regression were performed using SPSS 21. Results: There was a positive correlation between nurse educators’ competency and job satisfaction. Specifically, professional knowledge (r=.47, p<.001), research competency (r=.47, p<.001), task standardization competency (r=.46, p<.001), communication skills (r=.42, p<.001), and educational implementation competency (r=.42, p<.001) showed positive correlations with job satisfaction. The differences in competency based on completing the advanced nurse training course was not significant (t=-1.46, p=.149).However, competency level was found to significantly affect job satisfaction (β=.49, p<.001). Conclusion The study highlights the need for competency-based education programs to strengthen nurse educators’ qualifications systematically.

Purpose: This study aimed to assess the real-world clinical outcomes of consolidative durvalumab in patients with unresectable locally advanced non–small cell lung cancer (LA-NSCLC) and to explore the role of radiotherapy in the era of immunotherapy. Materials and Methods: This retrospective study assessed 171 patients with unresectable LA-NSCLC who underwent concurrent chemoradiotherapy (CCRT) with or without consolidative durvalumab at Asan Medical Center between May 2018 and May 2021. Primary outcomes included freedom from locoregional failure (FFLRF), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS). Results: Durvalumab following CCRT demonstrated a prolonged median PFS of 20.9 months (p=0.048) and a 3-year FFLRF rate of 57.3% (p=0.008), compared to 13.7 months and 38.8%, respectively, with CCRT alone. Furthermore, the incidence of in-field recurrence was significantly greater in the CCRT-alone group compared to the durvalumab group (26.8% vs. 12.4%, p=0.027). While median OS was not reached with durvalumab, it was 35.4 months in patients receiving CCRT alone (p=0.010). Patients positive for programmed cell death ligand 1 (PD-L1) expression showed notably better outcomes, including FFLRF, DMFS, PFS, and OS. Adherence to PACIFIC trial eligibility criteria identified 100 patients (58.5%) as ineligible. The use of durvalumab demonstrated better survival regardless of eligibility criteria. Conclusion The use of durvalumab consolidation following CCRT significantly enhanced locoregional control and OS in patients with unresectable LA-NSCLC, especially in those with PD-L1–positive tumors, thereby validating the role of durvalumab in standard care.

Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.