1.Are TERT Promoter Mutations a Poor Prognostic Factor in Anaplastic Thyroid Carcinoma?
Hyun Jin RYU ; Young Lyun OH ; Jung HEO ; Hyunju PARK ; Tae Hyuk KIM ; Sun Wook KIM ; Jae Hoon CHUNG
International Journal of Thyroidology 2024;17(2):286-294
Background and Objectives:
Telomerase reverse transcriptase (TERT) promoter mutations are a poor prognostic factor in differentiated thyroid carcinoma (DTC). However, their prognostic value in anaplastic thyroid carcinoma (ATC) is unclear. Therefore, we investigated whether TERT promoter mutations also act as an independent poor prognostic factor in ATC.
Materials and Methods:
We reviewed the medical records of 41 patients with ATC who underwent the TERT promoter mutations test at Samsung Medical Center between November 1995 and December 2022. The aggressive treatment group was defined as patients who underwent surgery, external radiotherapy, and systemic therapy.
Results:
Among 41 patients, 15 (36.6%) showed TERT promoter mutations. There only differences in the clinicopathological characteristics between the TERT-mutant and wild-type groups were tumor size and coexistence of DTC. Median tumor size in the TERT-mutant group was 5.1 cm (3.0-11.0), which was significantly larger than that in the wild-type group (4.1 cm, 0.8-8.0, p=0.010). Nevertheless, the TERT-mutant group received relatively more aggressive treatment (53.3% vs. 19.2%, p=0.056), and the overall survival of the TERT-mutant group was longer than that of the wild-type group (9.4 months [0.4-51.5] vs. 7.1 months [0.4-49.5]), but its difference was not significant (p=0.458). In multiple regression analysis, distant metastasis was a significant prognostic factor, but TERT promoter mutation was not.
Conclusion
Unlike in DTC, TERT promoter mutations were not an independent poor prognostic factor in ATC.
2.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
3.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
4.Are TERT Promoter Mutations a Poor Prognostic Factor in Anaplastic Thyroid Carcinoma?
Hyun Jin RYU ; Young Lyun OH ; Jung HEO ; Hyunju PARK ; Tae Hyuk KIM ; Sun Wook KIM ; Jae Hoon CHUNG
International Journal of Thyroidology 2024;17(2):286-294
Background and Objectives:
Telomerase reverse transcriptase (TERT) promoter mutations are a poor prognostic factor in differentiated thyroid carcinoma (DTC). However, their prognostic value in anaplastic thyroid carcinoma (ATC) is unclear. Therefore, we investigated whether TERT promoter mutations also act as an independent poor prognostic factor in ATC.
Materials and Methods:
We reviewed the medical records of 41 patients with ATC who underwent the TERT promoter mutations test at Samsung Medical Center between November 1995 and December 2022. The aggressive treatment group was defined as patients who underwent surgery, external radiotherapy, and systemic therapy.
Results:
Among 41 patients, 15 (36.6%) showed TERT promoter mutations. There only differences in the clinicopathological characteristics between the TERT-mutant and wild-type groups were tumor size and coexistence of DTC. Median tumor size in the TERT-mutant group was 5.1 cm (3.0-11.0), which was significantly larger than that in the wild-type group (4.1 cm, 0.8-8.0, p=0.010). Nevertheless, the TERT-mutant group received relatively more aggressive treatment (53.3% vs. 19.2%, p=0.056), and the overall survival of the TERT-mutant group was longer than that of the wild-type group (9.4 months [0.4-51.5] vs. 7.1 months [0.4-49.5]), but its difference was not significant (p=0.458). In multiple regression analysis, distant metastasis was a significant prognostic factor, but TERT promoter mutation was not.
Conclusion
Unlike in DTC, TERT promoter mutations were not an independent poor prognostic factor in ATC.
5.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
6.Are TERT Promoter Mutations a Poor Prognostic Factor in Anaplastic Thyroid Carcinoma?
Hyun Jin RYU ; Young Lyun OH ; Jung HEO ; Hyunju PARK ; Tae Hyuk KIM ; Sun Wook KIM ; Jae Hoon CHUNG
International Journal of Thyroidology 2024;17(2):286-294
Background and Objectives:
Telomerase reverse transcriptase (TERT) promoter mutations are a poor prognostic factor in differentiated thyroid carcinoma (DTC). However, their prognostic value in anaplastic thyroid carcinoma (ATC) is unclear. Therefore, we investigated whether TERT promoter mutations also act as an independent poor prognostic factor in ATC.
Materials and Methods:
We reviewed the medical records of 41 patients with ATC who underwent the TERT promoter mutations test at Samsung Medical Center between November 1995 and December 2022. The aggressive treatment group was defined as patients who underwent surgery, external radiotherapy, and systemic therapy.
Results:
Among 41 patients, 15 (36.6%) showed TERT promoter mutations. There only differences in the clinicopathological characteristics between the TERT-mutant and wild-type groups were tumor size and coexistence of DTC. Median tumor size in the TERT-mutant group was 5.1 cm (3.0-11.0), which was significantly larger than that in the wild-type group (4.1 cm, 0.8-8.0, p=0.010). Nevertheless, the TERT-mutant group received relatively more aggressive treatment (53.3% vs. 19.2%, p=0.056), and the overall survival of the TERT-mutant group was longer than that of the wild-type group (9.4 months [0.4-51.5] vs. 7.1 months [0.4-49.5]), but its difference was not significant (p=0.458). In multiple regression analysis, distant metastasis was a significant prognostic factor, but TERT promoter mutation was not.
Conclusion
Unlike in DTC, TERT promoter mutations were not an independent poor prognostic factor in ATC.
7.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
8.Development and effect of hybrid simulation program for nursing students: focusing on a case of pediatric cardiac catheterization in Korea: quasi-experimental study
Child Health Nursing Research 2024;30(4):277-287
Purpose:
Hybrid simulation has emerged to increase the practicality of simulation training by combining simulators and standardized patient (SP) that implement realistic clinical environments at a high level. This study aimed to develop a hybrid simulation program focused on case of pediatric cardiac catheterization and to evaluate its effectiveness. Methods: The hybrid simulation program was developed according to the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model. And deep learning-based analysis program was used to analyze non-verbal communication with SP and applied it for debriefing sessions. To verify the effect of the program, a quasi-experimental study using a random assignment design was conducted. In total, 48 nursing students (n=24 in the experimental group; n=24 in the control group) participated in the study.
Results:
Knowledge (F=3.53, p=.038), confidence in clinical performance (F=9.73, p<.001), and communication self-efficacy (F=5.20, p=.007) showed a significant difference in both groups and interaction between time points, and the communication ability of the experimental group increased significantly (t=3.32, p=.003).
Conclusion
Hybrid simulation program developed in this study has been proven effective, it can be implemented in child nursing education. Future research should focus on developing and incorporating various hybrid simulation programs using SP into the nursing curriculum and evaluating their effectiveness.
9.Adequate Dose of Levothyroxine for Thyroid-Stimulating Hormone Suppression after Total Thyroidectomy in Patients with Differentiated Thyroid Cancer
Hyun Jin RYU ; Min Sun CHOI ; Hyunju PARK ; Tae Hyuk KIM ; Jae Hoon CHUNG ; So Young PARK ; Sun Wook KIM
Endocrinology and Metabolism 2024;39(4):615-621
Background:
The adequate dose of levothyroxine (LT4) for patients who have undergone total thyroidectomy (TT) for differentiated thyroid cancer (DTC) is uncertain. We evaluated the LT4 dose required to achieve mild thyroid-stimulating hormone (TSH) suppression in DTC patients after TT.
Methods:
The electronic medical records of patients who underwent TT for DTC and received mild TSH suppression therapy were reviewed. Linear regression analysis was performed to evaluate the association between LT4 dose (μg/kg) and an ordinal group divided by body mass index (BMI). We also evaluated the trend in LT4 doses among groups divided by BMI and age.
Results:
In total, 123 patients achieved mild TSH suppression (0.1 to 0.5 mIU/L). The BMI variable was divided into three categories: <23 kg/m2 (n=46), ≥23 and <25 kg/m2 (n=30), and ≥25 kg/m2 (n=47). In the linear regression analysis, BMI was negatively associated with the LT4 dose after adjusting for age and sex (P<0.001). The LT4 doses required to achieve mild TSH suppression based on the BMI categories were 1.86, 1.71, and 1.71 μg/kg, respectively (P for trend <0.001). Further analysis with groups divided by age and BMI revealed that a higher BMI was related to a lower LT4 dose, especially in younger patients aged 20 to 39 (P for trend=0.011).
Conclusion
The study results suggest an appropriate LT4 dose for mild TSH suppression after TT based on body weight in patients with DTC. Considering body weight, BMI, and age in estimating LT4 doses might help to achieve the target TSH level promptly.
10.Establishing a Framework for Evaluating the Effectiveness of Vaccines Targeting National Vaccination Programs
Cho Ryok KANG ; Young June CHOE ; Jeeyeon SHIN ; Hang Jin JEONG ; Sunghee KWON ; Hyunju LEE
Journal of Korean Medical Science 2024;39(25):e193-
Background:
The increasing number of vaccines and the complexity of immunization programs, along with continuous changes in the epidemiology of infectious diseases, necessitate a systematic approach to vaccine effectiveness (VE) evaluation. This study presents a preliminary survey to establish a VE evaluation framework in Korea, focusing on the National Immunization Program.
Methods:
Experts’ opinions were collected through a two-round online survey targeting key stakeholders. The first round consisted of two multiple-choice questions and two openended questions. The second round was a quantitative survey with 17 questionnaires based on five domains derived by analyzing the results of the first-round survey.
Results:
The results emphasize the necessity and urgency of a government-led VE evaluation system and the establishment of a multidisciplinary evaluation organization. Key considerations include personnel, budget, data integration, legal standards, and surveillance system enhancements.
Conclusion
These findings provide valuable insights for policymakers, emphasizing the need for collaboration, financial support, and robust data management in developing evidence-based vaccination policies.

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