1.The Mediating Effect of Work Stress in the Relationship between Organizational Culture and Work-life Balance among Hospital Nurses
Sunhee PARK ; Sumi OH ; Kyung Ah AHN ; Sung A PARK ; Hee-Soon YANG ; Chang Gi PARK
Journal of Korean Clinical Nursing Research 2025;31(3):258-268
Purpose:
This study aimed to examine the impact of organizational culture on work-life balance among hospital nurses, and to explore the mediating role of work stress in this relationship.
Methods:
A cross-sectional, descriptive correlational study design was employed. A total of 535 nurses from 10 hospitals in S City and J City, South Korea, participated in the study. Data were collected through self-reported online questionnaires between December 1 and 31, 2023. The measures included organizational culture (clan, hierarchy, adhocracy, and market), work-life balance(interference and enhancement), and work stress. Data were analyzed using descriptive statistics, Pearson's correlation coefficients, and path analysis.
Results:
The findings showed that clan culture was associated with decreased work-life interference and increased work-life enhancement, with work stress partially mediating these relationships. Hierarchy and market cultures did not show a direct effect on work-life interference; however, work stress fully mediated these relationships. Adhocracy culture showed no significant association with work-life balance, and no mediating effect of work stress was identified.
Conclusion
The findings suggest the need for organizational strategies aimed at reducing work stress and fostering supportive work environments, which can improve nurses' work-life balance.
2.Does intradiscal steroid injection accelerate the histological degeneration of the human disc?
Jin Hwan KIM ; Sunhee CHANG ; Byung Ho KIM ; Gyu Heon LEE ; Sung Tan CHO
Osteoporosis and Sarcopenia 2024;10(3):108-113
Objectives:
Intradiscal steroid injection (ISI) use has been proven as a low-risk and rapid treatment for disc degeneration disease (DDD). However, the histological effects of steroids on human discs remain poorly understood. The purpose of this study is to investigate whether ISI induces histologic degeneration of the disc.
Methods:
In this study, a histological analysis was carried out on the nucleus pulposus obtained from 150 patients who underwent posterior lumbar interbody fusion. Among these individuals, 59 received ISI before the surgery, while 91 did not. After staining with hematoxylin and eosin, the histological classification was performed based on chondrocyte proliferation (C1, C2, and C3) and granular matrix change (M1 and M2). Logistic regression analysis was used to identify the main factors influencing chondrocyte proliferation and granular matrix change.Additionally, histological differences between the ISI group and the non-ISI group were analyzed.
Results:
Chondrocyte proliferation and granular matrix changes were not significantly different between the ISI and non-ISI groups. The logistic regression analysis indicated that age is the most significant risk factor for both chondrocyte proliferation (P = 0.02) and granular matrix changes (P < 0.01).
Conclusions
The most crucial factor in disc degeneration is age. ISI does not accelerate the histological degeneration of chondrocyte proliferation and granular matrix. Therefore, the ISI could be considered as a histologically safe alternative in patients with DDD.
3.A Case of Desmoplastic Spitz Nevus with Pseudo-Gland Formation
Seona OH ; Su Min LEE ; Sunhee CHANG ; Mee JOO ; Ji-Ye KIM ; Hai-Jin PARK
Korean Journal of Dermatology 2023;61(6):374-377
Desmoplastic Spitz nevus is a rare variant of Spitz nevus characterized by predominantly spindle-shaped or epithelioid nevus cells within the fibrotic stroma that can be confused with fibrous lesions. A 43-year-old woman presented with a 1-cm-sized dome-shaped papule on the dorsum of her left foot. The lesion showed histopathological features of a desmoplastic Spitz nevus with structures that resemble adenoma. Immunohistochemical staining was positive for S-100 protein, Melan-A, and SOX-10. Herein, we report this case because desmoplastic Spitz nevus is rare and can lead to confusion regarding the diagnosis of adnexal neoplasms.
4.Usefulness of BRAF VE1 immunohistochemistry in non–small cell lung cancers: a multi-institutional study by 15 pathologists in Korea
Sunhee CHANG ; Yoon-La CHOI ; Hyo Sup SHIM ; Geon Kook LEE ; Seung Yeon HA ;
Journal of Pathology and Translational Medicine 2022;56(6):334-341
Background:
Next-generation sequencing (NGS) is an approved test to select patients for BRAF V600E targeted therapy in Korea. However, the high cost, long turnaround times, and the need for sophisticated equipment and skilled personnel limit the use of NGS in daily practice. Immunohistochemistry (IHC) is a rapid and relatively inexpensive assay available in most laboratories. Therefore, in this study, we evaluate the usefulness of BRAF VE1 IHC in terms of predictive value and interobserver agreement in non–small cell lung cancers (NSCLCs).
Methods:
A total of 30 cases with known BRAF mutation status were selected, including 20 cases of lung adenocarcinomas, six cases of colorectal adenocarcinomas, and four cases of papillary thyroid carcinomas. IHC for BRAF V600E was carried out using the VE1 antibody. Fifteen pathologists independently scored both the staining intensity and the percentage of tumor cell staining on whole slide images.
Results:
In the lung adenocarcinoma subset, interobserver agreement for the percentage of tumor cell staining and staining intensity was good (percentage of tumor cell staining, intraclass correlation coefficient = 0.869; staining intensity, kappa = 0.849). The interobserver agreement for the interpretation using the cutoff of 40% was almost perfect in the entire study group and the lung adenocarcinoma subset (kappa = 0.815). Sensitivity, specificity, positive predictive value, and negative predictive value of BRAF VE1 IHC were 80.0%, 90.0%, 88.9%, and 81.8%, respectively.
Conclusions
BRAF VE1 IHC could be a screening test for the detection of BRAF V600E mutation in NSCLC. However, further studies are needed to optimize the protocol and to establish and validate interpretation criteria for BRAF VE1 IHC.
5.Collagenous Fibroma at the Surgical Site after Thyroidectomy for Papillary Thyroid Carcinoma
Ji Min YUN ; Sunhee CHANG ; Yoon Kyoung SO
Korean Journal of Otolaryngology - Head and Neck Surgery 2021;64(12):932-936
Collagenous fibroma (CF) is a rare benign tumor that occurs at various anatomical sites including the head and neck. CFs are often omitted from differential diagnosis before surgery. We describe a case of CF in a 54-year-old male who presented with a growing neck mass of 1-year duration at the site of previous right hemithyroidectomy for papillary thyroid carcinoma (PTC). Although radiologic findings demonstrated a benign tumor, surgical excision was carried out per patient’s preference and to rule out recurrent thyroid cancer. The mass was severely adherent to the surrounding muscles, but was resected completely without any injury to the adjacent structures. Histological studies revealed CF. The postoperative course was uneventful without vocal fold paralysis. CFs can be a diagnostic challenge in preoperative evaluation. Conservative excision was sufficient in most cases without recurrence. Clinicians should be aware of CFs in diagnosis, especially in postoperative site.
6.Molecular biomarker testing for non–small cell lung cancer: consensus statement of the Korean Cardiopulmonary Pathology Study Group
Sunhee CHANG ; Hyo Sup SHIM ; Tae Jung KIM ; Yoon-La CHOI ; Wan Seop KIM ; Dong Hoon SHIN ; Lucia KIM ; Heae Surng PARK ; Geon Kook LEE ; Chang Hun LEE ;
Journal of Pathology and Translational Medicine 2021;55(3):181-191
Molecular biomarker testing is the standard of care for non–small cell lung cancer (NSCLC) patients. In 2017, the Korean Cardiopulmonary Pathology Study Group and the Korean Molecular Pathology Study Group co-published a molecular testing guideline which contained almost all known genetic changes that aid in treatment decisions or predict prognosis in patients with NSCLC. Since then there have been significant changes in targeted therapies as well as molecular testing including newly approved targeted drugs and liquid biopsy. In order to reflect these changes, the Korean Cardiopulmonary Pathology Study Group developed a consensus statement on molecular biomarker testing. This consensus statement was crafted to provide guidance on what genes should be tested, as well as methodology, samples, patient selection, reporting and quality control.
7.Molecular biomarker testing for non–small cell lung cancer: consensus statement of the Korean Cardiopulmonary Pathology Study Group
Sunhee CHANG ; Hyo Sup SHIM ; Tae Jung KIM ; Yoon-La CHOI ; Wan Seop KIM ; Dong Hoon SHIN ; Lucia KIM ; Heae Surng PARK ; Geon Kook LEE ; Chang Hun LEE ;
Journal of Pathology and Translational Medicine 2021;55(3):181-191
Molecular biomarker testing is the standard of care for non–small cell lung cancer (NSCLC) patients. In 2017, the Korean Cardiopulmonary Pathology Study Group and the Korean Molecular Pathology Study Group co-published a molecular testing guideline which contained almost all known genetic changes that aid in treatment decisions or predict prognosis in patients with NSCLC. Since then there have been significant changes in targeted therapies as well as molecular testing including newly approved targeted drugs and liquid biopsy. In order to reflect these changes, the Korean Cardiopulmonary Pathology Study Group developed a consensus statement on molecular biomarker testing. This consensus statement was crafted to provide guidance on what genes should be tested, as well as methodology, samples, patient selection, reporting and quality control.
8.Development and Validation of a Deep Learning Based Diabetes Prediction System Using a Nationwide Population-Based Cohort
Sang Youl RHEE ; Ji Min SUNG ; Sunhee KIM ; In-Jeong CHO ; Sang-Eun LEE ; Hyuk-Jae CHANG
Diabetes & Metabolism Journal 2021;45(4):515-525
Background:
Previously developed prediction models for type 2 diabetes mellitus (T2DM) have limited performance. We developed a deep learning (DL) based model using a cohort representative of the Korean population.
Methods:
This study was conducted on the basis of the National Health Insurance Service-Health Screening (NHIS-HEALS) cohort of Korea. Overall, 335,302 subjects without T2DM at baseline were included. We developed the model based on 80% of the subjects, and verified the power in the remainder. Predictive models for T2DM were constructed using the recurrent neural network long short-term memory (RNN-LSTM) network and the Cox longitudinal summary model. The performance of both models over a 10-year period was compared using a time dependent area under the curve.
Results:
During a mean follow-up of 10.4±1.7 years, the mean frequency of periodic health check-ups was 2.9±1.0 per subject. During the observation period, T2DM was newly observed in 8.7% of the subjects. The annual performance of the model created using the RNN-LSTM network was superior to that of the Cox model, and the risk factors for T2DM, derived using the two models were similar; however, certain results differed.
Conclusion
The DL-based T2DM prediction model, constructed using a cohort representative of the population, performs better than the conventional model. After pilot tests, this model will be provided to all Korean national health screening recipients in the future.
9.Development and Validation of a Deep Learning Based Diabetes Prediction System Using a Nationwide Population-Based Cohort
Sang Youl RHEE ; Ji Min SUNG ; Sunhee KIM ; In-Jeong CHO ; Sang-Eun LEE ; Hyuk-Jae CHANG
Diabetes & Metabolism Journal 2021;45(4):515-525
Background:
Previously developed prediction models for type 2 diabetes mellitus (T2DM) have limited performance. We developed a deep learning (DL) based model using a cohort representative of the Korean population.
Methods:
This study was conducted on the basis of the National Health Insurance Service-Health Screening (NHIS-HEALS) cohort of Korea. Overall, 335,302 subjects without T2DM at baseline were included. We developed the model based on 80% of the subjects, and verified the power in the remainder. Predictive models for T2DM were constructed using the recurrent neural network long short-term memory (RNN-LSTM) network and the Cox longitudinal summary model. The performance of both models over a 10-year period was compared using a time dependent area under the curve.
Results:
During a mean follow-up of 10.4±1.7 years, the mean frequency of periodic health check-ups was 2.9±1.0 per subject. During the observation period, T2DM was newly observed in 8.7% of the subjects. The annual performance of the model created using the RNN-LSTM network was superior to that of the Cox model, and the risk factors for T2DM, derived using the two models were similar; however, certain results differed.
Conclusion
The DL-based T2DM prediction model, constructed using a cohort representative of the population, performs better than the conventional model. After pilot tests, this model will be provided to all Korean national health screening recipients in the future.
10.Current status and future perspectives of liquid biopsy in non-small cell lung cancer
Sunhee CHANG ; Jae Young HUR ; Yoon-La CHOI ; Chang Hun LEE ; Wan Seop KIM
Journal of Pathology and Translational Medicine 2020;54(3):204-212
With advances in target therapy, molecular analysis of tumors is routinely required for treatment decisions in patients with advanced non-small cell lung cancer (NSCLC). Liquid biopsy refers to the sampling and analysis of circulating cell-free tumor DNA (ctDNA) in various body fluids, primarily blood. Because the technique is minimally invasive, liquid biopsies are the future in cancer management. Epidermal growth factor receptor (EGFR) ctDNA tests have been performed in routine clinical practice in advanced NSCLC patients to guide tyrosine kinase inhibitor treatment. In the near future, liquid biopsy will be a crucial prognostic, predictive, and diagnostic method in NSCLC. Here we present the current status and future perspectives of liquid biopsy in NSCLC.

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