1.Comparison of Broad-Spectrum Antibiotic Use According to Hospice Utilization Among Patients with Cancer at the End of Life in South Korea: A Nationwide Analysis
Ye Sul JEUNG ; Hak Jun KIM ; Jiwon YU ; Jeong-Han KIM ; Jin-Ah SIM ; Shin Hye YOO
Journal of Hospice and Palliative Care 2026;29(2):41-50
Purpose:
We aimed to compare broad-spectrum antibiotic use between hospice and nonhospice patients with cancer at the end of life using nationwide data from Korea.
Methods:
In this retrospective cohort study, we analyzed the Korean National Health Insurance Service data of adult patients with cancer who died between 2018 and 2021. Hospice users were defined as patients who received inpatient, home-based, or consultation-based hospice care before death. We applied propensity score matching (1:2) to balance the baseline characteristics of the hospice and non-hospice groups. Broad-spectrum antibiotic use, including anti-pseudomonal penicillins, anti-pseudomonal cephalosporins, carbapenems, and glycopeptides, was assessed during the last 3 months of life using prescription proportions and days of therapy per 1,000 patient-days.
Results:
After matching, 38,102 hospice and 75,736 non-hospice users were analyzed. During the last 3 months of life, 74.6% of hospiceand 79.0% of non-hospice users received at least one broad-spectrum antibiotic (P<0.001).The proportion of patients receiving broad-spectrum antibiotics was generally lower amonghospice users across all time intervals (P<0.001), and the number of days of therapy wasalso lower, with the largest differences observed during the final week and last 3 days of life.Subgroup analyses showed the highest antibiotic exposure among patients with hematologic and pancreatobiliary cancers, particularly in the non-hospice group.
Conclusion
Hospice involvement was associated with lower use and reduced exposure to broad-spectrum antibiotics among patients with cancer near the end of life. These findings support the alignment of end-of-life treatment decisions with the comfort-oriented goals of hospice care.
2.DNA Damage and Nuclear Anaplasia Induced by Trastuzumab Deruxtecan in Cancer Cells with Variable HER2 Expression and Homologous Recombination Deficiency Status
So Hyeon KIM ; Yoonjung PARK ; Ahrum MIN ; Hye Yeon PARK ; Yu-Jin KIM ; Sujin HAM ; Jiwon KOH ; Seongyeong KIM ; Dae-Won LEE ; Han Suk RYU ; Jin-Soo KIM ; Kyung-Hun LEE ; Seock-Ah IM
Cancer Research and Treatment 2026;58(2):407-422
Purpose:
Human epidermal growth factor receptor 2 (HER2) is amplified or overexpressed in various malignancies, including breast and gastric cancers, and is associated with poor prognosis. Although HER2-targeted therapies, such as trastuzumab, improve outcomes in HER2-positive tumors, resistance often develops, and HER2-low tumors remain largely untargeted. Trastuzumab deruxtecan (T-DXd; DS-8201a) is a HER2-targeted antibody-drug conjugate with potent activity in HER2-positive and HER2-low tumors. This study evaluates its antitumor mechanisms and efficacy in HER2-positive, HER2-low, and homologous recombination deficiency (HRD)–associated models.
Materials and Methods:
Effects of T-DXd were assessed in cancer cell lines with diverse HER2 expression and HRD status. In vivo efficacy was evaluated using a xenograft model derived from HER2-low SNU-601 gastric cancer cells.
Results:
T-DXd reduced HER2 phosphorylation and downstream signaling (AKT, ERK) in HER2-positive cells. It induced DNA damage accumulation, as evidenced by increased γH2AX and p-Chk1 expression, and triggered apoptosis through cleaved poly(ADP-ribose) polymerase and caspase-3 activation, confirmed by annexin V staining. Similar effects were observed in HER2-low cells, with greater sensitivity in HRD cells. In xenografts, T-DXd reduced tumor volume by up to 80% at 4 mg/kg and 10 mg/kg. Histological analyses showed decreased Ki-67 and increased apoptosis. Furthermore, T-DXd induced G2/M cell cycle arrest and nuclear anaplasia, suggesting disruption of chromosomal stability as a potential antitumor mechanism. No significant toxicity, including body weight loss, was observed.
Conclusion
These findings highlight T-DXd’s effectiveness in HER2-low and HRD tumors, supporting its broader clinical application, including strategies targeting DNA damage repair pathways.
3.Associations Between Multiple Falls and Mental Health Indices in Korean Older Adults: A Cross-sectional Study
Chaelyn LIM ; Hyun-Jin SON ; Byung-Gwon KIM ; Byeng-Chul YU ; Jiwon KIM ; Young-Seoub HONG
Journal of Preventive Medicine and Public Health 2025;58(3):269-277
Objectives:
This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.
Methods:
We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.
Results:
Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.95 (95% confidence interval, 2.49 to 3.50).
Conclusions
We identified associations between various mental health-related factors—including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score—and the occurrence of multiple falls.
4.Diagnosis of Oral-Facial-Digital Syndrome I in a Patient with Suspected Polycystic Kidney Disease
Jiwon LEE ; Jong Eun PARK ; Sang-Woong HAN ; Mi-Yeon YU
Korean Journal of Medicine 2025;100(1):40-43
Polycystic kidney disease (PKD) typically manifests as genetic disease, which is commonly attributed to mutations in PKD genes. In this particular case, however, genetic analysis revealed that the patient’s PKD is linked to a novel, likely pathogenic variant (c.2184del; p.Thr729Leufs*88) in the oral-facial-digital syndrome type I (OFD1) gene. This is the first confirmed genetic diagnosis of mutations in the OFD1 gene in Korea. This investigation emphasizes the critical utility of panel sequencing of PKD in offering precise diagnosis and understanding the genetic profiles of PKD.
5.Diagnosis of Oral-Facial-Digital Syndrome I in a Patient with Suspected Polycystic Kidney Disease
Jiwon LEE ; Jong Eun PARK ; Sang-Woong HAN ; Mi-Yeon YU
Korean Journal of Medicine 2025;100(1):40-43
Polycystic kidney disease (PKD) typically manifests as genetic disease, which is commonly attributed to mutations in PKD genes. In this particular case, however, genetic analysis revealed that the patient’s PKD is linked to a novel, likely pathogenic variant (c.2184del; p.Thr729Leufs*88) in the oral-facial-digital syndrome type I (OFD1) gene. This is the first confirmed genetic diagnosis of mutations in the OFD1 gene in Korea. This investigation emphasizes the critical utility of panel sequencing of PKD in offering precise diagnosis and understanding the genetic profiles of PKD.
6.Associations Between Multiple Falls and Mental Health Indices in Korean Older Adults: A Cross-sectional Study
Chaelyn LIM ; Hyun-Jin SON ; Byung-Gwon KIM ; Byeng-Chul YU ; Jiwon KIM ; Young-Seoub HONG
Journal of Preventive Medicine and Public Health 2025;58(3):269-277
Objectives:
This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.
Methods:
We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.
Results:
Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.95 (95% confidence interval, 2.49 to 3.50).
Conclusions
We identified associations between various mental health-related factors—including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score—and the occurrence of multiple falls.
7.Associations Between Multiple Falls and Mental Health Indices in Korean Older Adults: A Cross-sectional Study
Chaelyn LIM ; Hyun-Jin SON ; Byung-Gwon KIM ; Byeng-Chul YU ; Jiwon KIM ; Young-Seoub HONG
Journal of Preventive Medicine and Public Health 2025;58(3):269-277
Objectives:
This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.
Methods:
We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.
Results:
Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.95 (95% confidence interval, 2.49 to 3.50).
Conclusions
We identified associations between various mental health-related factors—including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score—and the occurrence of multiple falls.
8.Diagnosis of Oral-Facial-Digital Syndrome I in a Patient with Suspected Polycystic Kidney Disease
Jiwon LEE ; Jong Eun PARK ; Sang-Woong HAN ; Mi-Yeon YU
Korean Journal of Medicine 2025;100(1):40-43
Polycystic kidney disease (PKD) typically manifests as genetic disease, which is commonly attributed to mutations in PKD genes. In this particular case, however, genetic analysis revealed that the patient’s PKD is linked to a novel, likely pathogenic variant (c.2184del; p.Thr729Leufs*88) in the oral-facial-digital syndrome type I (OFD1) gene. This is the first confirmed genetic diagnosis of mutations in the OFD1 gene in Korea. This investigation emphasizes the critical utility of panel sequencing of PKD in offering precise diagnosis and understanding the genetic profiles of PKD.
9.Diagnosis of Oral-Facial-Digital Syndrome I in a Patient with Suspected Polycystic Kidney Disease
Jiwon LEE ; Jong Eun PARK ; Sang-Woong HAN ; Mi-Yeon YU
Korean Journal of Medicine 2025;100(1):40-43
Polycystic kidney disease (PKD) typically manifests as genetic disease, which is commonly attributed to mutations in PKD genes. In this particular case, however, genetic analysis revealed that the patient’s PKD is linked to a novel, likely pathogenic variant (c.2184del; p.Thr729Leufs*88) in the oral-facial-digital syndrome type I (OFD1) gene. This is the first confirmed genetic diagnosis of mutations in the OFD1 gene in Korea. This investigation emphasizes the critical utility of panel sequencing of PKD in offering precise diagnosis and understanding the genetic profiles of PKD.
10.Effects of the Nursing Practice Environment, Teamwork, and Generational Conflict on Organizational Commitment among General Hospital Nurses
Yu-Jin LEE ; Jiwon HONG ; Se-Young JUNG
Korean Journal of Occupational Health Nursing 2025;34(2):76-84
Purpose:
This study aimed to identify the influence of nursing practice environment, teamwork, and generational conflict within organizations on organizational commitment among hospital nurses.
Methods:
Data were collected from June 12 to August 14, 2024, from 190 nurses at five hospitals, including general hospitals located in B city, U city, and Y city. Descriptive statistics, t-test, ANOVA, Scheffé’s test, Pearson’s correlation coefficients, and multiple linear regression analysis using SPSS/WIN 28.0 were used to analyze the collected data.
Results:
The level of organizational commitment was positively correlated with nursing practice environment (r=.63, p<.001) and teamwork (r=.48, p<.001) and negatively correlated with generational conflict within the organization (r=-.16,p=.028). Organizational commitment was significantly affected by nursing practice environment (β=.50, p<.001),teamwork (β=.21, p=.001), and clinical career (β=-.16, p=.004).
Conclusion
These findings indicate that nursing practice environment, teamwork, and clinical career are associated with organizational commitment. Therefore, to enhance hospital nurses’ organizational commitment, interventions and policies should be developed to increase nurses’ teamwork and improve nursing practice environments at the hospital level.

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