Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Purpose: Risk factors predicting distant metastasis (DM) in extrahepatic bile duct cancer (EHBDC) patients treated with curative resection were investigated. Materials and Methods: Medical records of 1,418 EHBDC patients undergoing curative resection between Jan 2000 and Dec 2015 from 14 institutions were reviewed. After resection, 924 patients (67.6%) were surveilled without adjuvant therapy, 297 (21.7%) were treated with concurrent chemoradiotherapy (CCRT) and 148 (10.8%) with CCRT followed by chemotherapy. To exclude the treatment effect from innate confounders, patients not treated with adjuvant therapy were evaluated. Results: After a median follow-up of 36.7 months (range, 2.7 to 213.2 months), the 5-year distant metastasis-free survival (DMFS) rate was 57.7%. On multivariate analysis, perihilar or diffuse tumor (hazard ratio [HR], 1.391; p=0.004), poorly differentiated histology (HR, 2.014; p < 0.001), presence of perineural invasion (HR, 1.768; p < 0.001), positive nodal metastasis (HR, 2.670; p < 0.001) and preoperative carbohydrate antigen (CA) 19-9 ≥ 37 U/mL (HR, 1.353; p < 0.001) were significantly associated with inferior DMFS. The DMFS rates significantly differed according to the number of these risk factors. For validation, patients who underwent adjuvant therapy were evaluated. In patients with ≥ 3 factors, additional chemotherapy after CCRT resulted in a superior DMFS compared with CCRT alone (5-year rate, 47.6% vs. 27.7%; p=0.001), but the benefit of additional chemotherapy was not observed in patients with 0-2 risk factors. Conclusion Tumor location, histologic differentiation, perineural invasion, lymph node metastasis, and preoperative CA 19-9 level predicted DM risk in resected EHBDC. These risk factors might help identifying a subset of patients who could benefit from additional chemotherapy after resection.

Background/Aims: Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI. Methods: A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups. Results: The percentage change of LDL-C level at 1–3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1–3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001). Conclusions Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.

Objective: The coronavirus disease 2019 (COVID-19) pandemic has not yet been controlled and herd immunity through vaccination against COVID-19 has been considered the best option to prevent the spread of COVID-19 worldwide. We encountered several patients in our emergency department presenting with adverse reactions after COVID-19 vaccinations. Hence, we investigated the clinical characteristics of patients with adverse reactions after vaccination. Methods: In South Korea, 10,510 doses of the BNT162b2 mRNA COVID-19 vaccine was administered to 5,304 medical staff. To investigate adverse reactions, we reviewed the case report forms from the vaccination centers and the medical charts from the date of first dose administration until two weeks after the last planned second dose. Results: A total of 187 cases, out of the 10,510, experienced adverse reactions and these were more common in females. Dizziness (44.4%), nausea and vomiting (28.3%), and fever (24.1%) were the most reported adverse reactions. Immediate adverse reactions included dizziness, nausea, and vomiting, palpitation, sensory changes, and delayed adverse reactions included fever, myalgia, headache, nausea, and vomiting. The delayed reactions of fever and myalgia were significantly more common after the second, rather than after the first dose (P<0.01 and P=0.03, respectively). One case of anaphylaxis was reported. All adverse reactions improved after conservative care. Conclusion Our findings show diverse adverse reactions to the BNT162b2 mRNA COVID-19 vaccine, but none of them required hospitalization. However, since this vaccine has been manufactured using a newly developed technique, more research focused on the clinical significance of the adverse reactions is necessary.

Purpose: The value of the genomic profiling by targeted gene-sequencing on radiation therapy response prediction was evaluated through integrated analysis including clinical information. Radiation response prediction model was constructed based on the analyzed findings. Materials and Methods: Patients who had the tumor sequenced using institutional cancer panel after informed consent and received radiotherapy for the measurable disease served as the target cohort. Patients with irradiated tumor locally controlled for more than 6 months after radiotherapy were defined as the durable local control (DLC) group, otherwise, non-durable local control (NDLC) group. Significant genomic factors and domain knowledge were used to develop the Bayesian Network model to predict radiotherapy response. Results: Altogether, 88 patients were collected for analysis. Of those, 41 (43.6%) and 47 (54.4%) patients were classified as the NDLC and DLC group, respectively. Somatic mutations of NOTCH2 and BCL were enriched in the NDLC group, whereas, mutations of CHEK2, MSH2, and NOTCH1 were more frequently found in the DLC group. Altered DNA repair pathway was associated with better local failure–free survival (hazard ratio, 0.40; 95% confidence interval, 0.19 to 0.86; p=0.014). Smoking somatic signature was found more frequently in the DLC group. Area under the receiver operating characteristic curve of the Bayesian network model predicting probability of 6-month local control was 0.83. Conclusion Durable radiation response was associated with alterations of DNA repair pathway and smoking somatic signature. Bayesian network model could provide helpful insights for high precision radiotherapy. However, these findings should be verified in prospective cohort for further individualization.

For patients with acute myocardial infarction, current management guidelines recommend implantation of a drug-eluting stent, dual antiplatelet therapy (including potent P2Y 12 inhibitors) for at least 1 year, and maintenance of life-long antiplatelet therapy.However, a pilot study showed favorable results with antithrombotic therapy without stent implantation when plaque erosion, not definite plaque rupture, was confirmed using optical coherence tomography (OCT), despite the patients having acute myocardial infarction. Here, we present a case where successful primary percutaneous coronary intervention was performed without stenting with the aid of OCT in a patient with ST-elevation myocardial infarction who developed thrombotic total occlusion of the right coronary artery.