Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Purpose: We aimed to assess the real-world efficacy of nab-paclitaxel in metastatic breast cancer patients. Materials and Methods: This is a retrospective study performed in two tertiary referral hospitals in Korea. Patients with metastatic breast cancer treated with nab-paclitaxel (Abraxane®) between March 2016 and March 2020 were enrolled. Results: A total of 102 patients with metastatic breast cancer were included. Patients were heavily pre-treated with a median of four prior lines of chemotherapy (5 lines when including endocrine therapy in hormone-receptor-positive patients), and 66 patients (64.7%) were exposed to taxanes in the metastatic setting. According to St. Gallen molecular subtypes, 36 patients (35.3%) were luminal A, 28 (27.5%) were luminal B, 18 (17.7%) were human epidermal growth factor receptor 2–positive and 20 (19.6%) had triple-negative disease. Fifty patients (49.0%) were treated with a 3-weekly regimen (260 mg/m2 on day 1 every 3 weeks), and 52 (51.0%) were treated with a weekly regimen (100 mg/m2 every week). Objective response rate was 22.9%. After a median follow-up of 22.0 months, median progression-free survival (PFS) was 4.0 months (95% confidence interval [CI], 2.6 to 4.8) and median overall survival was 8.7 months (95% CI, 7.5 to 11.2). Patients treated with weekly regimen had longer PFS compared to 3-weekly regimen (5.5 vs. 2.3 months, p < 0.001). Multivariate analysis revealed the treatment regimen as an independent prognostic factor for PFS. There was no grade 3 or 4 hypersensitivity reaction. Conclusion This real-world data shows that nab-paclitaxel is a reasonable treatment option in heavily pre-treated and/or taxane-exposed metastatic breast cancer patients.

Purpose: Endocrine therapy is a standard treatment for hormone receptor-positive breast cancer, which accounts for 60%–75% of all breast cancer. Hormone receptor positivity is a prognostic and predictive biomarker in breast cancer. Approximately 50%–80% of breast cancer is also positive for androgen receptor (AR), but the prognostic and predictive value of AR expression in breast cancer is controversial. Here, we investigated AR expression and its prognostic value in patients with surgically resected breast cancer in Korea. Methods: We retrospectively reviewed the medical records of patients who had surgically resected breast cancer to collect AR expression data and other clinicopathological data. The optimal cut-off for AR positivity was determined using a receiver operating characteristic curve analysis. Results: We reviewed 957 patients with surgically resected breast cancer from June 2012 to April 2013. The median follow-up was 62 months, and relapse events occurred in 101 (10.6%) patients. Unlike the cut-off value of 1% or 10% in previous reports, 35% was determined to be best for predicting relapse-free survival (RFS) in this study. At the cut-off value of 35%, 654 (68.4%) patients were AR-positive. AR expression was more prevalent in luminal A (87.6%) and luminal B (73.1%) types than in human epidermal growth factor receptor 2-positive (56.2%) or triple-negative (20.6%) types. AR expression of ≥ 35% was significantly related to longer RFS in a multivariate analysis (hazard ratio, 0.430; 95% confidence interval, 0.260–0.709; p = 0.001). Conclusion We propose a cut-off value of 35% to best predict RFS in patients with surgically resected breast cancer. AR expression was positive in 68.4% of patients, and AR positivity was found to be an independent prognostic factor for longer RFS.

Purpose: This study was conducted to review the web-based trauma-education programs for mental-health professionals reported in English and Korean. Methods: A systematic literature search was conducted using the PubMed, CINALH, EMBASE, Cochrane Library, PsycINFO, Web of Science, RISS, KISS, NDSL, US National Library of Medicine, Clinical Research Information Service, and Virginia Henderson International Nursing Library. The database search identified 11,852 articles. The selection of articles involved a three-phase process, in which duplications were identified and, titles and abstracts of retrieved articles were determined according to inclusion criteria, followed by full-text reading of articles identified. Finally, a total of three studies were included in this review, which published in the United States in 2011, 2014, and 2019. One was a pilot randomized controlled trial and two were pre- and post- studies. Only one included nurses as participants. Selected studies were rated for quality assessment using the Risk of Bias tool of Cochrane’s collaboration. Results: Although the specific content of the programs was unknown, they improved mental health professionals' knowledge level, performance confidence, satisfaction, and education-completion rate. Conclusion More well-designed studies are needed of the optimal content for web-based education programs in mediating trauma for a broad spectrum of mental-health professionals.

Purpose: The amis of this study were to examine the suicide traumatic experiences and attitudes toward suicide and examine their associations with depression, self-efficacy, and social support in general adults. Methods: In this descriptive cross-sectional study, data were collected through a web-based survey (N=500). We analyzed 441 respondents considering missing data. A structured questionnaire included Attitude Toward Suicide (ATTS), experiences and characteristics related to suicide, depression, self-efficacy, and social support. The data were analyzed using descriptive statistics, one-way ANOVA with Scheffé tests, Fisher’s exact tests, and Pearson’s correlation coefficients with SPSS/WIN 23. Results: Among study participants, 34.9% reported suicide traumatic experiences. When they had more acceptability’ and ‘understandability’ in the attitudes toward suicide, they were younger, more depressive, and at the lower level of self-efficacy. There were somewhat differences of associations of ‘understandability’ in the attitudes toward suicide with depression, suicide attempt, suicide thought, and experience counseling between the suicide trauma and non-trauma groups. There were positive correlations for ‘acceptability’, ‘understandability’, ‘tabooing’, and depression and negative correlations for ‘acceptability’, self-efficacy, and social support. Conclusion Our study findings suggest that educational programs need to improve nurse’s ability in suicide-related practices considering psychological factors and development of comprehensive nursing interventions.

PURPOSE: The aims of this study was to verify the validity and reliability of the Attitudes Towards Suicide (ATTS) scale for Korean adults.METHODS: Participants were 441 adults in South Korea, who completed in a self-reported online survey of ATTS. A total of 37 items were used for conducting item analyses, exploratory factor analyses, and confirmatory factor analyses, as well as examining the internal consistency.RESULTS: Based on findings of item reduction and exploratory factor analyses, three factors were identified based on 16 items, such as ‘acceptability (7 items)‘, ‘understandability (5 items)‘, and ‘tabooing (4 items)‘. These factors accounted for 49.4% of the total variance of ATTS. Known-groups, item convergent, and item discriminant validity were confirmed; Fitness of the modified mode was acceptable (χ²=375.51, CFI=.84, TLI=.81, GFI=.90, AGFI=.87, RMSEA=.08). The Cronbach's α coefficient for the 16 items was .82.CONCLUSION: Three factors of the short version of ATTS may be useful to evaluate the suicidal attitudes of Korean adults effectively and accurately. Our study findings suggest that suicide attitude questionaries need to be constantly revised to consider socio-cultural environment.
Adult ; Attitude to Death ; Humans ; Korea ; Reproducibility of Results ; Suicide ; Surveys and Questionnaires

PURPOSE: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. METHODS: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. RESULTS: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. CONCLUSIONS: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.
Child ; Chungcheongnam-do ; Disease Transmission, Infectious ; Education ; Exanthema ; Fatigue ; Humans ; Latent Tuberculosis ; Mass Screening ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: The purposes of this study are to review the literature on quality of life intervention programs and to recommend further research and clinical considerations to improve the quality of life among patients with schizophrenia. METHODS: Three electronic databases - PubMed, CHINAHL and RISS - were searched using the search terms of “schizophrenia” AND “quality of life” AND “intervention*” OR “program*.” The search was limited to studies published in English and Korean. RESULTS: Ten studies were selected for the final analysis and evaluated in terms of contextual and methodological quality. The 10 studies consisted of 5 randomized controlled trials, 4 quasi-experimental studies, and 1 case report. The selected studies utilized an educational program, art and music therapy, physical activity therapy, and community-based integrated programs to alleviate psychological symptoms and showed effectiveness in improving quality of life. CONCLUSION: Interdisciplinary interventions and programs using multiple components reduced psychological symptoms and improved the quality of life of patients with schizophrenia.
Humans ; Motor Activity ; Music Therapy ; Non-Randomized Controlled Trials as Topic ; Quality of Life ; Schizophrenia