Purpose: This subgroup analysis of the Korean subset of patients in the phase 3 LASER301 trial evaluated the efficacy and safety of lazertinib versus gefitinib as first-line therapy for epidermal growth factor receptor mutated (EGFRm) non–small cell lung cancer (NSCLC). Materials and Methods: Patients with locally advanced or metastatic EGFRm NSCLC were randomized 1:1 to lazertinib (240 mg/day) or gefitinib (250 mg/day). The primary endpoint was investigator-assessed progression-free survival (PFS). Results: In total, 172 Korean patients were enrolled (lazertinib, n=87; gefitinib, n=85). Baseline characteristics were balanced between the treatment groups. One-third of patients had brain metastases (BM) at baseline. Median PFS was 20.8 months (95% confidence interval [CI], 16.7 to 26.1) for lazertinib and 9.6 months (95% CI, 8.2 to 12.3) for gefitinib (hazard ratio [HR], 0.41; 95% CI, 0.28 to 0.60). This was supported by PFS analysis based on blinded independent central review. Significant PFS benefit with lazertinib was consistently observed across predefined subgroups, including patients with BM (HR, 0.28; 95% CI, 0.15 to 0.53) and those with L858R mutations (HR, 0.36; 95% CI, 0.20 to 0.63). Lazertinib safety data were consistent with its previously reported safety profile. Common adverse events (AEs) in both groups included rash, pruritus, and diarrhoea. Numerically fewer severe AEs and severe treatment–related AEs occurred with lazertinib than gefitinib. Conclusion Consistent with results for the overall LASER301 population, this analysis showed significant PFS benefit with lazertinib versus gefitinib with comparable safety in Korean patients with untreated EGFRm NSCLC, supporting lazertinib as a new potential treatment option for this patient population.

Objective: This study aimed to identify the effect of coronavirus disease (COVID-19)–related lifestyle changes on depression. Methods: This secondary data analysis study included 229,269 adults from a community health survey conducted in the South Korea in 2020. Data were collected using a structured questionnaire about participants’ lifestyle changes related to COVID-19 and the Patient Health Questionnaire-9. The data were analyzed using a complex sample independent t-test, analysis of variance, Pearson’s correlation coefficient, and multiple regression analysis. Results: The mean age of the participants was 48.76; 49.6% were male, and 50.4% were female. The multiple regression showed that depression increased due to COVID-19–related lifestyle changes (physical activity, sleep duration, consumption of convenience foods, alcohol consumption, smoking, and use of public transportation). The explanatory power was 27.3%, and the model was suitable (Wald F=63.75, p<0.001). Conclusion This study identified the effect of COVID-19–related lifestyle changes on depression, and the results have implications for future depression-relieving interventions.

Purpose: The effects of a prevention program applied on psychodrama for female high school students were examined. Methods: Thirty-seven students at a female high school in D and G city participated. The study was conducted from September 8 to November 21, 2014. To test the effects of the program, participants were divided into two groups of 17 students experimental group and 20 students control group. A nonequivalent control group, non- synchronized pre-posttest quasi-experimental research design was used. The tools included a self-efficacy scale, an anger scale, and a suicide ideation scale. x 2 test, t-test, and ANCOVA were used to analyze the data with the SPSS/WIN 23.0 program. Results: Significant differences between the two groups were found in the anger scale (F=12.43, p=001), self-efficacy (F=4.23, p=.048), and a suicide ideation (F=29.98, p<.001). Conclusion Results suggest that the suicide prevention program applied on psychodrama is an effective nursing intervention, for improving self-efficacy as well as decreasing anger and suicide ideation among female high school students.

PURPOSE: The purpose of this study was to investigate decision patterns to reduce the risks of BRCArelated breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and riskreducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers. MATERIALS AND METHODS: The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management. RESULTS: Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC,which significantly differed between BRCA1 and BRCA2 carriers (p < 0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 of the 83 carriers (71.1%) with BC and the 39 of 79 unaffected carriers (49.4%) underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of RR surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p < 0.001). CONCLUSION: RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness.
Breast ; Breast Neoplasms ; Female ; Humans ; Korea ; Male ; National Health Programs ; Ovarian Neoplasms ; Prophylactic Surgical Procedures

OBJECTIVES: This study investigated the effects of chronic medical diseases on depressive symptoms in individuals at high risk for depression living in rural areas, over a 1-year period.METHODS: A community-based longitudinal study was conducted; 67 participants aged 18–79 years residing in rural areas were included. In the first survey, all participants completed a self-report questionnaire battery. An interview was also conducted to obtain data on demographic variables and current or past chronic medical diseases. In the first survey, participants with the Center for Epidemiologic Studies Depression scale(CES-D) scores of 16 or higher were categorized as being at high risk for depression; the same assessments were carried out 1 year later in a follow-up survey. Multiple regression analysis was performed to determine the association of chronic medical diseases with 1-year follow-up depressive symptoms in the high-risk group.RESULTS: In model 1, which controlled for sociodemographic variables, the number of chronic medical diseases (p =0.026), baseline severity of depressive symptoms(p =0.002), and presence of diabetes(p =0.039) were significantly associated with the follow-up CES-D scores. In model 2, which further adjusted for Alcohol Use Disorder Identification Test and Beck Anxiety Inventory scores, the number of chronic medical diseases(p =0.036), baseline severity of depressive symptoms(p =0.017), and prevalence of diabetes(p =0.037) were also significantly associated with the follow-up CES-D scores.CONCLUSION: This study suggests that the number of chronic medical diseases, prevalence of diabetes, and severity of depressive symptoms are significantly associated with 1-year follow-up depressive symptoms in individuals at high risk for depression.
Anxiety ; Depression ; Diabetes Mellitus ; Epidemiologic Studies ; Follow-Up Studies ; Longitudinal Studies ; Prevalence ; Rural Population

PURPOSE: Recently, considering the large number of adolescents suffering from chronic illness, it is important to identify the factors affecting the quality of life (QoL) in order to develop intervention programs. METHODS: Data were analyzed using IBM SPSS 21.0. The general characteristics, psychosocial health status, and life satisfaction distributions of the participants were analyzed using frequency, percentage, mean, and standard deviation. Cronbach's alpha coefficients were calculated to test the reliability of the instrument. The differences in psychosocial health status and life satisfaction according to gender were tested with t-test and Chi-square test. Additionally, multiple regression analysis was used to examine the effect of psychosocial health status on life satisfaction. RESULTS: The multiple regression analysis revealed that depression, ego resilience, and self-esteem were associated with the QoL in both male and female participants. Economic status, subjective health, peer attachment, and smart phone addiction were associated with the QoL in male participants, while exercise time during physical education classes, social withdrawal, and school adaptation were associated with the QoL in female participants. CONCLUSION: The findings suggest that a health promotion program should be developed, which reflects gender differences, to improve the QoL of adolescents with chronic illness.
Adolescent ; Chronic Disease ; Depression ; Diagnostic Self Evaluation ; Ego ; Female ; Health Promotion ; Humans ; Male ; Physical Education and Training ; Quality of Life ; Smartphone ; Social Class

BACKGROUND: This study was conducted to explore the effect of known risk factors, focusing on risk factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, in consideration of interaction among East-Asian women. METHODS: Case-control study with 2,123 cases and 2,121 controls with mammographic density was conducted. Using the mammographic film, breast density was measured using Breast Imaging-Reporting and Data System. To identify the association of selected reproductive factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, stratified analysis was conducted according to breast density groups and interaction effects was assessed. The results were presented with adjusted OR and 95% CIs. RESULTS: Significant interaction effect between age at first birth and breast density on breast cancer (P = 0.048) was observed. Women with age at first birth ≥ 28 years old showed increased breast cancer risk in extremely dense breast group (≥ 75%) (OR = 1.627, 95% CI = 1.190–2.226). However, women with fatty breast (< 50%) and heterogeneously dense breast (50%–75%) did not show an increased association. Age at menarche, age at menopause, number of children, and family history of breast cancer did not show significant interaction with breast cancer and similar risk patterns were observed. CONCLUSIONS: Age at first birth showed significant interaction with breast density on breast cancer risk. Further studies considering biologically plausable model between exposure, intermediate outcomes and breast cancer risk with prospective design need to be undertaken in East Asian women.
Asian Continental Ancestry Group ; Birth Order ; Breast Neoplasms ; Breast ; Case-Control Studies ; Child ; Female ; Humans ; Information Systems ; Menarche ; Menopause ; Prospective Studies ; Reproductive History ; Risk Factors

PURPOSE: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. METHODS: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. RESULTS: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. CONCLUSION: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.
Colon ; Communicable Diseases ; Delivery of Health Care ; Disease Transmission, Infectious ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Infection Control ; Patient Isolation

PURPOSE: This study was conducted to investigate the health behaviors and disease prevalence associated with high-risk drinking among Korean women and conduct risk factor analysis of high-risk drinking. METHODS: The 2012 Korea Community Health Survey (KCHS) was used to sample 59,522 adult women aged 19~64 age who had at least one drink during the previous one year. Data were analyzed using descriptive statistics, t-tests, Chi-squared tests, and logistic regression. RESULTS: The results revealed that 19~44 year old, unmarried women - who had graduated high school were high as high-risk drinking. Moreover, smoking, depression and stress were many. Finally, multiple logistic analysis showed that age, marital status, education level, smoking and obesity were significantly related to high-risk drinking. CONCLUSIONS: When investigating factors influencing high-risk drinking, it is important to develop appropriate health promotion programs for women who exhibit high-risk drinking behavior. The results of this study will be useful to development of such programs.
Adult ; Depression ; Drinking Behavior ; Drinking* ; Education ; Female ; Health Behavior* ; Health Promotion ; Health Surveys ; Humans ; Korea ; Logistic Models ; Marital Status ; Obesity ; Prevalence* ; Risk Factors* ; Single Person ; Smoke ; Smoking

Essential thrombocythemia (ET) is characterized by most cases in which platelet counts exceed 1 million/µL. ET is usually no symptoms during non-pregnancy, but arterial and venous thrombosis and hemorrhage may develop in pregnancy. Pregnancy in these patients is associated with many complications in both pregnant women and fetuses such as recurrent abortion, intrauterine fetal growth restriction, preterm delivery, preeclampsia, and stillbirth. In these patients, aspirin, low-molecular-weight heparin (LMWH), and interferon alpha (INF-α) are recommended during pregnancy. We report a case of four consecutive abortions despite being treated with INF-α, low dose aspirin, and LMWH in patient with ET.
Abortion, Habitual* ; Aspirin ; Female ; Fetal Development ; Fetus ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Humans ; Interferon-alpha ; Platelet Count ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Stillbirth ; Thrombocythemia, Essential* ; Venous Thrombosis