1.Differences in Treatment Outcomes Depending on the Adjuvant Treatment Modality in Craniopharyngioma
Byung Min LEE ; Jaeho CHO ; Dong-Seok KIM ; Jong Hee CHANG ; Seok-Gu KANG ; Eui-Hyun KIM ; Ju Hyung MOON ; Sung Soo AHN ; Yae Won PARK ; Chang-Ok SUH ; Hong In YOON
Yonsei Medical Journal 2025;66(3):141-150
Purpose:
Adjuvant treatment for craniopharyngioma after surgery is controversial. Adjuvant external beam radiation therapy (EBRT) can increase the risk of long-term sequelae. Stereotactic radiosurgery (SRS) is used to reduce treatment-related toxicity.In this study, we compared the treatment outcomes and toxicities of adjuvant therapies for craniopharyngioma.
Materials and Methods:
We analyzed patients who underwent craniopharyngioma tumor removal between 2000 and 2017. Of the 153 patients, 27 and 20 received adjuvant fractionated EBRT and SRS, respectively. We compared the local control (LC), progression-free survival (PFS), and overall survival between groups that received adjuvant fractionated EBRT, SRS, and surveillance.
Results:
The median follow-up period was 77.7 months. For SRS and surveillance, the 10-year LC was 57.2% and 57.4%, respectively. No local progression was observed after adjuvant fractionated EBRT. One patient in the adjuvant fractionated EBRT group died owing to glioma 94 months after receiving radiotherapy (10-year PFS: 80%). The 10-year PFS was 43.6% and 50.7% in the SRS and surveillance groups, respectively. The treatment outcomes significantly differed according to adjuvant treatment in nongross total resection (GTR) patients. Additional treatment-related toxicity was comparable in the adjuvant fractionated EBRT and other groups.
Conclusion
Adjuvant fractionated EBRT could be effective in controlling local failure, especially in patients with non-GTR, while maintaining acceptable treatment-related toxicity.
2.Clinical Profiles of Multidrug-Resistant and Rifampicin-Monoresistant Tuberculosis in Korea, 2018–2021: A Nationwide Cross-Sectional Study
Jinsoo MIN ; Yousang KO ; Hyung Woo KIM ; Hyeon-Kyoung KOO ; Jee Youn OH ; Doosoo JEON ; Taehoon LEE ; Young-Chul KIM ; Sung Chul LIM ; Sung Soon LEE ; Jae Seuk PARK ; Ju Sang KIM
Tuberculosis and Respiratory Diseases 2025;88(1):159-169
Background:
This study aimed to identify the clinical characteristics of multidrug-resistant/ rifampicin-resistant tuberculosis (MDR/RR-TB) in the Republic of Korea.
Methods:
Data of notified people with tuberculosis between July 2018 and December 2021 were retrieved from the Korea Tuberculosis Cohort database. MDR/RR-TB was further categorized according to isoniazid susceptibility as follows: multidrug-resistant tuberculosis (MDR-TB), rifampicin-monoresistant tuberculosis (RMR-TB), and RR-TB if susceptibility to isoniazid was unknown. Multivariable logistic regression analysis was conducted to identify the factors associated with MDR/RR-TB.
Results:
Between 2018 and 2021, the proportion of MDR/RR-TB cases among all TB cases and TB cases with known drug susceptibility test results was 2.1% (502/24,447). The proportions of MDR/RR-TB and MDR-TB cases among TB cases with known drug susceptibility test results were 3.3% (502/15,071) and 1.9% (292/15,071), respectively. Among all cases of rifampicin resistance, 31.7% (159/502) were RMR-TB and 10.2% (51/502) were RR-TB. Multivariable logistic regression analyses revealed that younger age, foreigners, and prior tuberculosis history were significantly associated with MDR/ RR-TB.
Conclusion
Rapid identification of rifampicin resistance targeting the high-risk populations, such as younger generations, foreign-born individuals, and previously treated patients are necessary for patient-centered care.
3.Differences in Treatment Outcomes Depending on the Adjuvant Treatment Modality in Craniopharyngioma
Byung Min LEE ; Jaeho CHO ; Dong-Seok KIM ; Jong Hee CHANG ; Seok-Gu KANG ; Eui-Hyun KIM ; Ju Hyung MOON ; Sung Soo AHN ; Yae Won PARK ; Chang-Ok SUH ; Hong In YOON
Yonsei Medical Journal 2025;66(3):141-150
Purpose:
Adjuvant treatment for craniopharyngioma after surgery is controversial. Adjuvant external beam radiation therapy (EBRT) can increase the risk of long-term sequelae. Stereotactic radiosurgery (SRS) is used to reduce treatment-related toxicity.In this study, we compared the treatment outcomes and toxicities of adjuvant therapies for craniopharyngioma.
Materials and Methods:
We analyzed patients who underwent craniopharyngioma tumor removal between 2000 and 2017. Of the 153 patients, 27 and 20 received adjuvant fractionated EBRT and SRS, respectively. We compared the local control (LC), progression-free survival (PFS), and overall survival between groups that received adjuvant fractionated EBRT, SRS, and surveillance.
Results:
The median follow-up period was 77.7 months. For SRS and surveillance, the 10-year LC was 57.2% and 57.4%, respectively. No local progression was observed after adjuvant fractionated EBRT. One patient in the adjuvant fractionated EBRT group died owing to glioma 94 months after receiving radiotherapy (10-year PFS: 80%). The 10-year PFS was 43.6% and 50.7% in the SRS and surveillance groups, respectively. The treatment outcomes significantly differed according to adjuvant treatment in nongross total resection (GTR) patients. Additional treatment-related toxicity was comparable in the adjuvant fractionated EBRT and other groups.
Conclusion
Adjuvant fractionated EBRT could be effective in controlling local failure, especially in patients with non-GTR, while maintaining acceptable treatment-related toxicity.
4.Needs Assessment for Public Health Competency in Infection Prevention and Control: Importance and Performance Analysis (IPA) of Infectious Disease Response Practitioners
Youngjon KIM ; Jin GWACK ; Yunhyung KWON ; Moon Joo CHEONG ; Ju-Hyung LEE
Journal of Korean Medical Science 2025;40(1):e23-
Background:
The Field Epidemiology Training Program Frontline, initiated by the Korea Disease Control and Prevention Agency in 2019, aims to enhance the competencies of infectious disease practitioners across 17 regions in South Korea. With the September 2024 amendment to the Infectious Disease Prevention Act mandating infectious disease prevention and crisis response training for government employees who are associated with infectious diseases responses, there is an urgent need to assess and optimize the effectiveness and cost-efficiency of such competency-based education programs amidst constraints of budget and manpower.
Methods:
This study examined the educational needs and priorities of public health competencies among infectious disease practitioners. The competency framework for Infectious Disease Response Practitioners (IDRP) in South Korea was used to evaluate the validity, importance, and performance level of competencies for infectious disease response personnel. For the training needs analysis, differences in performance by group were analyzed, and an importance performance analysis (IPA) was conducted using the Borich Needs Assessment based on the IPA matrix to derive training priorities.
Results:
The analysis revealed a significant gap between perceived importance and selfreported performance levels in most competencies, especially epidemiologic methods.Competencies related to safety and ethics, fieldwork, and crisis management have high importance and performance ratings, indicating a need for ongoing training. Of the 27 competencies, the IPA identified specific training needs and priorities, suggesting eight competencies for focused intervention to strengthen the capacity of IDRPs.
Conclusion
The IDRP competency framework in South Korea plays a pivotal role in establishing a standardized, competency-based approach to training IDRP. The identified gaps and training priorities highlight the need for continued curriculum development and the integration of real-world, field-based scenarios into training programs.
5.Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment
Oh Beom KWON ; Hyung Woo KIM ; Ju Sang KIM ; Eung Gu LEE ; Yeonhee PARK ; Sung Soo JUNG ; Jin Woo KIM ; Jee Youn OH ; Sang Haak LEE ; Seunghoon KIM ; Sun-Hyung KIM ; Jiwon LYU ; Yousang KO ; Sun Jung KWON ; Ganghee CHAE ; Jinsoo MIN
Journal of Korean Medical Science 2025;40(17):e73-
Background:
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
Methods:
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Results:
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72–3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35–1.94) remained statistically significant in the multivariate analysis.
Conclusion
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
6.Needs Assessment for Public Health Competency in Infection Prevention and Control: Importance and Performance Analysis (IPA) of Infectious Disease Response Practitioners
Youngjon KIM ; Jin GWACK ; Yunhyung KWON ; Moon Joo CHEONG ; Ju-Hyung LEE
Journal of Korean Medical Science 2025;40(1):e23-
Background:
The Field Epidemiology Training Program Frontline, initiated by the Korea Disease Control and Prevention Agency in 2019, aims to enhance the competencies of infectious disease practitioners across 17 regions in South Korea. With the September 2024 amendment to the Infectious Disease Prevention Act mandating infectious disease prevention and crisis response training for government employees who are associated with infectious diseases responses, there is an urgent need to assess and optimize the effectiveness and cost-efficiency of such competency-based education programs amidst constraints of budget and manpower.
Methods:
This study examined the educational needs and priorities of public health competencies among infectious disease practitioners. The competency framework for Infectious Disease Response Practitioners (IDRP) in South Korea was used to evaluate the validity, importance, and performance level of competencies for infectious disease response personnel. For the training needs analysis, differences in performance by group were analyzed, and an importance performance analysis (IPA) was conducted using the Borich Needs Assessment based on the IPA matrix to derive training priorities.
Results:
The analysis revealed a significant gap between perceived importance and selfreported performance levels in most competencies, especially epidemiologic methods.Competencies related to safety and ethics, fieldwork, and crisis management have high importance and performance ratings, indicating a need for ongoing training. Of the 27 competencies, the IPA identified specific training needs and priorities, suggesting eight competencies for focused intervention to strengthen the capacity of IDRPs.
Conclusion
The IDRP competency framework in South Korea plays a pivotal role in establishing a standardized, competency-based approach to training IDRP. The identified gaps and training priorities highlight the need for continued curriculum development and the integration of real-world, field-based scenarios into training programs.
7.Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment
Oh Beom KWON ; Hyung Woo KIM ; Ju Sang KIM ; Eung Gu LEE ; Yeonhee PARK ; Sung Soo JUNG ; Jin Woo KIM ; Jee Youn OH ; Sang Haak LEE ; Seunghoon KIM ; Sun-Hyung KIM ; Jiwon LYU ; Yousang KO ; Sun Jung KWON ; Ganghee CHAE ; Jinsoo MIN
Journal of Korean Medical Science 2025;40(17):e73-
Background:
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
Methods:
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Results:
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72–3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35–1.94) remained statistically significant in the multivariate analysis.
Conclusion
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
8.Clinical Profiles of Multidrug-Resistant and Rifampicin-Monoresistant Tuberculosis in Korea, 2018–2021: A Nationwide Cross-Sectional Study
Jinsoo MIN ; Yousang KO ; Hyung Woo KIM ; Hyeon-Kyoung KOO ; Jee Youn OH ; Doosoo JEON ; Taehoon LEE ; Young-Chul KIM ; Sung Chul LIM ; Sung Soon LEE ; Jae Seuk PARK ; Ju Sang KIM
Tuberculosis and Respiratory Diseases 2025;88(1):159-169
Background:
This study aimed to identify the clinical characteristics of multidrug-resistant/ rifampicin-resistant tuberculosis (MDR/RR-TB) in the Republic of Korea.
Methods:
Data of notified people with tuberculosis between July 2018 and December 2021 were retrieved from the Korea Tuberculosis Cohort database. MDR/RR-TB was further categorized according to isoniazid susceptibility as follows: multidrug-resistant tuberculosis (MDR-TB), rifampicin-monoresistant tuberculosis (RMR-TB), and RR-TB if susceptibility to isoniazid was unknown. Multivariable logistic regression analysis was conducted to identify the factors associated with MDR/RR-TB.
Results:
Between 2018 and 2021, the proportion of MDR/RR-TB cases among all TB cases and TB cases with known drug susceptibility test results was 2.1% (502/24,447). The proportions of MDR/RR-TB and MDR-TB cases among TB cases with known drug susceptibility test results were 3.3% (502/15,071) and 1.9% (292/15,071), respectively. Among all cases of rifampicin resistance, 31.7% (159/502) were RMR-TB and 10.2% (51/502) were RR-TB. Multivariable logistic regression analyses revealed that younger age, foreigners, and prior tuberculosis history were significantly associated with MDR/ RR-TB.
Conclusion
Rapid identification of rifampicin resistance targeting the high-risk populations, such as younger generations, foreign-born individuals, and previously treated patients are necessary for patient-centered care.
9.Clinical Profiles of Multidrug-Resistant and Rifampicin-Monoresistant Tuberculosis in Korea, 2018–2021: A Nationwide Cross-Sectional Study
Jinsoo MIN ; Yousang KO ; Hyung Woo KIM ; Hyeon-Kyoung KOO ; Jee Youn OH ; Doosoo JEON ; Taehoon LEE ; Young-Chul KIM ; Sung Chul LIM ; Sung Soon LEE ; Jae Seuk PARK ; Ju Sang KIM
Tuberculosis and Respiratory Diseases 2025;88(1):159-169
Background:
This study aimed to identify the clinical characteristics of multidrug-resistant/ rifampicin-resistant tuberculosis (MDR/RR-TB) in the Republic of Korea.
Methods:
Data of notified people with tuberculosis between July 2018 and December 2021 were retrieved from the Korea Tuberculosis Cohort database. MDR/RR-TB was further categorized according to isoniazid susceptibility as follows: multidrug-resistant tuberculosis (MDR-TB), rifampicin-monoresistant tuberculosis (RMR-TB), and RR-TB if susceptibility to isoniazid was unknown. Multivariable logistic regression analysis was conducted to identify the factors associated with MDR/RR-TB.
Results:
Between 2018 and 2021, the proportion of MDR/RR-TB cases among all TB cases and TB cases with known drug susceptibility test results was 2.1% (502/24,447). The proportions of MDR/RR-TB and MDR-TB cases among TB cases with known drug susceptibility test results were 3.3% (502/15,071) and 1.9% (292/15,071), respectively. Among all cases of rifampicin resistance, 31.7% (159/502) were RMR-TB and 10.2% (51/502) were RR-TB. Multivariable logistic regression analyses revealed that younger age, foreigners, and prior tuberculosis history were significantly associated with MDR/ RR-TB.
Conclusion
Rapid identification of rifampicin resistance targeting the high-risk populations, such as younger generations, foreign-born individuals, and previously treated patients are necessary for patient-centered care.
10.Differences in Treatment Outcomes Depending on the Adjuvant Treatment Modality in Craniopharyngioma
Byung Min LEE ; Jaeho CHO ; Dong-Seok KIM ; Jong Hee CHANG ; Seok-Gu KANG ; Eui-Hyun KIM ; Ju Hyung MOON ; Sung Soo AHN ; Yae Won PARK ; Chang-Ok SUH ; Hong In YOON
Yonsei Medical Journal 2025;66(3):141-150
Purpose:
Adjuvant treatment for craniopharyngioma after surgery is controversial. Adjuvant external beam radiation therapy (EBRT) can increase the risk of long-term sequelae. Stereotactic radiosurgery (SRS) is used to reduce treatment-related toxicity.In this study, we compared the treatment outcomes and toxicities of adjuvant therapies for craniopharyngioma.
Materials and Methods:
We analyzed patients who underwent craniopharyngioma tumor removal between 2000 and 2017. Of the 153 patients, 27 and 20 received adjuvant fractionated EBRT and SRS, respectively. We compared the local control (LC), progression-free survival (PFS), and overall survival between groups that received adjuvant fractionated EBRT, SRS, and surveillance.
Results:
The median follow-up period was 77.7 months. For SRS and surveillance, the 10-year LC was 57.2% and 57.4%, respectively. No local progression was observed after adjuvant fractionated EBRT. One patient in the adjuvant fractionated EBRT group died owing to glioma 94 months after receiving radiotherapy (10-year PFS: 80%). The 10-year PFS was 43.6% and 50.7% in the SRS and surveillance groups, respectively. The treatment outcomes significantly differed according to adjuvant treatment in nongross total resection (GTR) patients. Additional treatment-related toxicity was comparable in the adjuvant fractionated EBRT and other groups.
Conclusion
Adjuvant fractionated EBRT could be effective in controlling local failure, especially in patients with non-GTR, while maintaining acceptable treatment-related toxicity.

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