1.Exploring Oncologists’ Perspectives on the Early Integration of Specialty Palliative Care in Korea: Challenges, Needs, and Clinical Implications
Shin Hye YOO ; Yu Jung KIM ; Ye Sul JEUNG ; Jung Sun KIM ; Kwonoh PARK ; Eun Mi NAM ; Si Won LEE ; Jun Ho JI ; Jwa Hoon KIM ; Joon Young HUR ; Song Ee PARK ; Jung Lim LEE ; Su-Jin KOH
Cancer Research and Treatment 2026;58(1):339-348
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.
2.Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Journal of Korean Medical Science 2025;40(3):e8-
Background:
Identifying factors associated with early post-discharge outpatient care is crucial to prevent relapse and suicide in patients with schizophrenia. This study aimed to investigate factors associated with receiving follow-up care within seven days after hospital discharge among patients with schizophrenia.
Methods:
This nationwide population-based study was conducted using data from the National Health Insurance Claim Database of South Korea. All patients aged ≥ 18 years, newly admitted to the hospital with schizophrenia between January 1, 2017, and December 31, 2018, were included. The outcome of interest was the receipt of outpatient follow-up care within seven days of hospital discharge. Patients’ general characteristics and healthcare services were included as independent variables. A generalized estimating equation model was used to examine factors associated with the outcome.
Results:
Of 17,565 patients with schizophrenia, 37.6% received outpatient follow-up care within seven days after hospital discharge. Patients who were older and male were less likely to receive follow-up care seven days after discharge. Patients with prior psychiatric outpatient care to their index admission were more likely to receive follow-up care than those without prior outpatient care. A longer hospital stay significantly decreased the likelihood of receiving outpatient follow-up. However, comorbid alcohol use disorder was not associated with receiving follow-up care within seven days of discharge.
Conclusion
This study highlights the need to ensure continuity of care for patients with schizophrenia during discharge planning, with particular attention to vulnerable patients.
3.Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Journal of Korean Medical Science 2025;40(3):e8-
Background:
Identifying factors associated with early post-discharge outpatient care is crucial to prevent relapse and suicide in patients with schizophrenia. This study aimed to investigate factors associated with receiving follow-up care within seven days after hospital discharge among patients with schizophrenia.
Methods:
This nationwide population-based study was conducted using data from the National Health Insurance Claim Database of South Korea. All patients aged ≥ 18 years, newly admitted to the hospital with schizophrenia between January 1, 2017, and December 31, 2018, were included. The outcome of interest was the receipt of outpatient follow-up care within seven days of hospital discharge. Patients’ general characteristics and healthcare services were included as independent variables. A generalized estimating equation model was used to examine factors associated with the outcome.
Results:
Of 17,565 patients with schizophrenia, 37.6% received outpatient follow-up care within seven days after hospital discharge. Patients who were older and male were less likely to receive follow-up care seven days after discharge. Patients with prior psychiatric outpatient care to their index admission were more likely to receive follow-up care than those without prior outpatient care. A longer hospital stay significantly decreased the likelihood of receiving outpatient follow-up. However, comorbid alcohol use disorder was not associated with receiving follow-up care within seven days of discharge.
Conclusion
This study highlights the need to ensure continuity of care for patients with schizophrenia during discharge planning, with particular attention to vulnerable patients.
4.Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Journal of Korean Medical Science 2025;40(3):e8-
Background:
Identifying factors associated with early post-discharge outpatient care is crucial to prevent relapse and suicide in patients with schizophrenia. This study aimed to investigate factors associated with receiving follow-up care within seven days after hospital discharge among patients with schizophrenia.
Methods:
This nationwide population-based study was conducted using data from the National Health Insurance Claim Database of South Korea. All patients aged ≥ 18 years, newly admitted to the hospital with schizophrenia between January 1, 2017, and December 31, 2018, were included. The outcome of interest was the receipt of outpatient follow-up care within seven days of hospital discharge. Patients’ general characteristics and healthcare services were included as independent variables. A generalized estimating equation model was used to examine factors associated with the outcome.
Results:
Of 17,565 patients with schizophrenia, 37.6% received outpatient follow-up care within seven days after hospital discharge. Patients who were older and male were less likely to receive follow-up care seven days after discharge. Patients with prior psychiatric outpatient care to their index admission were more likely to receive follow-up care than those without prior outpatient care. A longer hospital stay significantly decreased the likelihood of receiving outpatient follow-up. However, comorbid alcohol use disorder was not associated with receiving follow-up care within seven days of discharge.
Conclusion
This study highlights the need to ensure continuity of care for patients with schizophrenia during discharge planning, with particular attention to vulnerable patients.
5.Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Journal of Korean Medical Science 2025;40(3):e8-
Background:
Identifying factors associated with early post-discharge outpatient care is crucial to prevent relapse and suicide in patients with schizophrenia. This study aimed to investigate factors associated with receiving follow-up care within seven days after hospital discharge among patients with schizophrenia.
Methods:
This nationwide population-based study was conducted using data from the National Health Insurance Claim Database of South Korea. All patients aged ≥ 18 years, newly admitted to the hospital with schizophrenia between January 1, 2017, and December 31, 2018, were included. The outcome of interest was the receipt of outpatient follow-up care within seven days of hospital discharge. Patients’ general characteristics and healthcare services were included as independent variables. A generalized estimating equation model was used to examine factors associated with the outcome.
Results:
Of 17,565 patients with schizophrenia, 37.6% received outpatient follow-up care within seven days after hospital discharge. Patients who were older and male were less likely to receive follow-up care seven days after discharge. Patients with prior psychiatric outpatient care to their index admission were more likely to receive follow-up care than those without prior outpatient care. A longer hospital stay significantly decreased the likelihood of receiving outpatient follow-up. However, comorbid alcohol use disorder was not associated with receiving follow-up care within seven days of discharge.
Conclusion
This study highlights the need to ensure continuity of care for patients with schizophrenia during discharge planning, with particular attention to vulnerable patients.
6.A Case of ITGA3 Mutation-Induced Junctional Epidermolysis Bullosa without Pulmonary or Renal Involvement
Seong Jin JU ; Sang Eun LEE ; Song-Ee KIM ; Miri KIM
Korean Journal of Dermatology 2025;63(6):174-177
Junctional epidermolysis bullosa (JEB) is a subtype of epidermolysis bullosa characterized by the formation of blisters within the basement membrane, particularly in the lamina lucida. Clinical manifestations of JEB include fragile skin with blisters and erosion. This case report presents a 35-year-old male with JEB caused by ITGA3mutations (p.Arg875Ter, p.Cys162Tyr) without pulmonary or renal complications. The patient exhibited various cutaneous signs such as persistent exfoliative patches, nail hypoplasia, and diffuse alopecia, with additional ophthalmic complications such as symblepharon and limbal stem cell deficiency. ITGA3 mutations are typically linked to interstitial lung disease and nephrotic syndrome, a characteristic group of symptoms known as ILNEB (‘Interstitial Lung disease, Nephrotic syndrome and Epidermolysis Bullosa’). However, the patient showed no evidence of renal or pulmonary involvement, with normal urinalysis and chest X-ray results, making the diagnosis more difficult until next generation sequencing confirmed the ITGA3 mutation.
7.Expression of Antimicrobial Peptides in Psoriasiform Mouse Models
Song-Ee KIM ; Sang Eun LEE ; Soo-Chan KIM ; Jong Hoon KIM
Korean Journal of Dermatology 2022;60(9):585-592
Background:
Psoriasis is a chronic inflammatory skin disease. Despite the current focus on T cells in the pathogenesis of psoriasis, keratinocytes within the psoriatic epidermis are also abnormal in many respects including excessive production of antimicrobial peptides (AMPs). Recently, several studies have used imiquimod (IMQ)- and interleukin (IL)-23-induced mouse models to explore the immunological significance of psoriasis. However, the expression of AMPs in these models remains unclear.
Objective:
In this study, we evaluated the protein and mRNA expression of AMPs, including cathelicidin-related antimicrobial peptides (CRAMP), mouse β-defensin 3 (mBD3), and psoriasin (S100 calcium-binding protein A7, S100A7) in IMQ- and IL-23-induced psoriasiform mouse models. In addition, we investigated whether ustekinumab, an inhibitor of IL-12 and IL-23, reduces the expression levels of AMPs in these mouse models.
Methods:
We used IMQ- and IL-23-induced psoriasiform mouse models. Gene and protein expression levels of AMPs were evaluated using quantitative real-time polymerase chain reaction and immunofluorescence staining, respectively.
Results:
We found that the protein and mRNA expression levels of CRAMP, mBD3, and S100A7 were increased in both mouse models. Ustekinumab decreased AMP expression levels in the two mouse models.
Conclusion
These data showed that the elevated expression of AMPs in the epidermis decreased following ustekinumab treatment in both psoriasiform mouse models. Therefore, AMP expression levels may be used as an indicator of treatment efficacy.
8.Cognitive and Behavioral Outcomes of School-aged Children Born Extremely Preterm: a Korean Single-center Study with Long-term Follow-up
Eun Sun KIM ; Ee-Kyung KIM ; Sae Yun KIM ; In Gyu SONG ; Young Hwa JUNG ; Seung Han SHIN ; Han-Suk KIM ; Johanna Inhyang KIM ; Bung Nyun KIM ; Min-Sup SHIN
Journal of Korean Medical Science 2021;36(39):e260-
Background:
School-aged children born very preterm have been suggested to have worse cognitive and behavioral outcomes than children born full-term. Executive function (EF) is a higher level of cognitive function related to academic achievement. The present study aimed to evaluate the cognitive (including EF) and behavioral outcomes of Korean children born extremely preterm (EP) and to analyze any biological or socioeconomic risk factors for poor cognitive outcomes in this population.
Methods:
A total of 71 infants weighing < 1,000 g at birth or born before 30 weeks of gestation (EP group) who were admitted to the neonatal intensive care unit from 2008 to 2009 were included in this study and compared with 40 term-birth controls. The Korean Wechsler Intelligence Scale for Children-Fourth Edition, Advanced Test of Attention (ATA), Stroop test, Children's Color Trails Test (CCTT), and Wisconsin Card Sorting Test (WCST) were used.Additionally, the Korean Child Behavior Checklist (K-CBCL) and Korean ADHD Rating Scale (K-ARS) were completed. Perinatal and demographic data were collected and analyzed.
Results:
The mean full-scale intelligence quotient (FSIQ) score in the EP group was significantly lower than that of the term control group (89.1 ± 18.3 vs. 107.1 ± 12.7; P < 0.001).In the EP group, 26 (37%) children had an FSIQ score below 85, compared to only one child (3%) in the control group. Furthermore, the EP group showed significantly worse EF test results (ATA, Stroop test, CCTT, WCST). Except for the higher social immaturity subscore in the EP group, the K-CBCL and K-ARS scores were not different between the two groups. EP children who received laser treatment for retinopathy of prematurity (ROP) had an 8.8-fold increased risk of a low FSIQ score, and a 1-point increase in the discharge weight Z-score decreased the risk of a low FSIQ score by approximately half in this EP cohort.
Conclusion
This is the first Korean study to investigate the cognitive and behavioral outcomes of school-aged children born EP. In the study cohort, EP children exhibited significantly lower FSIQ scores and EF than their full-term peers, and 37% of them had cognitive problems. Nonetheless, except for social immaturity, the behavioral problems werenot different in EP children. Severe ROP and low discharge weight Z-score were identified as independent risk factors for low FSIQ score after adjusting for birth weight.
9.Cognitive and Behavioral Outcomes of School-aged Children Born Extremely Preterm: a Korean Single-center Study with Long-term Follow-up
Eun Sun KIM ; Ee-Kyung KIM ; Sae Yun KIM ; In Gyu SONG ; Young Hwa JUNG ; Seung Han SHIN ; Han-Suk KIM ; Johanna Inhyang KIM ; Bung Nyun KIM ; Min-Sup SHIN
Journal of Korean Medical Science 2021;36(39):e260-
Background:
School-aged children born very preterm have been suggested to have worse cognitive and behavioral outcomes than children born full-term. Executive function (EF) is a higher level of cognitive function related to academic achievement. The present study aimed to evaluate the cognitive (including EF) and behavioral outcomes of Korean children born extremely preterm (EP) and to analyze any biological or socioeconomic risk factors for poor cognitive outcomes in this population.
Methods:
A total of 71 infants weighing < 1,000 g at birth or born before 30 weeks of gestation (EP group) who were admitted to the neonatal intensive care unit from 2008 to 2009 were included in this study and compared with 40 term-birth controls. The Korean Wechsler Intelligence Scale for Children-Fourth Edition, Advanced Test of Attention (ATA), Stroop test, Children's Color Trails Test (CCTT), and Wisconsin Card Sorting Test (WCST) were used.Additionally, the Korean Child Behavior Checklist (K-CBCL) and Korean ADHD Rating Scale (K-ARS) were completed. Perinatal and demographic data were collected and analyzed.
Results:
The mean full-scale intelligence quotient (FSIQ) score in the EP group was significantly lower than that of the term control group (89.1 ± 18.3 vs. 107.1 ± 12.7; P < 0.001).In the EP group, 26 (37%) children had an FSIQ score below 85, compared to only one child (3%) in the control group. Furthermore, the EP group showed significantly worse EF test results (ATA, Stroop test, CCTT, WCST). Except for the higher social immaturity subscore in the EP group, the K-CBCL and K-ARS scores were not different between the two groups. EP children who received laser treatment for retinopathy of prematurity (ROP) had an 8.8-fold increased risk of a low FSIQ score, and a 1-point increase in the discharge weight Z-score decreased the risk of a low FSIQ score by approximately half in this EP cohort.
Conclusion
This is the first Korean study to investigate the cognitive and behavioral outcomes of school-aged children born EP. In the study cohort, EP children exhibited significantly lower FSIQ scores and EF than their full-term peers, and 37% of them had cognitive problems. Nonetheless, except for social immaturity, the behavioral problems werenot different in EP children. Severe ROP and low discharge weight Z-score were identified as independent risk factors for low FSIQ score after adjusting for birth weight.

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