1.First Nationwide Mpox Vaccination Program in the Republic of Korea:Implications for an Enhanced Public Health Response
Seunghyun Lewis KWON ; Minju SONG ; Wonkyung LEE ; Jeeyeon SHIN ; Su-Yeon LEE ; Sang-Gu YEO ; Minjeong KIM ; Sanggyun JEONG ; Joonku PARK ; Dongwoo LEE ; Sookyoung LIM
Journal of Korean Medical Science 2024;39(32):e235-
On May 1, 2024, the Republic of Korea lifted the infectious disease crisis alert for mpox, almost two years after the first case was reported. The Korea Disease Control and Prevention Agency (KDCA) has led the response, which included diagnosis, epidemiological investigations, treatment, and vaccination. This article particularly reviews the vaccination strategy implemented and proposes suggestions for enhancing future response efforts. Initially, the KDCA recommended pre-exposure prophylaxis for high-risk groups, later expanding to include broader demographics as domestic cases rose. By April 2024, a total of 6,863 individuals had received their first vaccine dose, with 3,875 completing the second dose of third-generation vaccines. Strategies to improve future responses include addressing stigma, securing nationally representative safety data, and conducting vaccine cost-benefit analyses.These measures will help ensure a robust and effective response to future outbreaks.
2.Targeted Therapy Following Metastasectomy for Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-analysis
Hui Mo GU ; Seung Il JUNG ; Dongdeuk KWON ; Myung Ha KIM ; Jae Hung JUNG ; Mi Ah HAN ; Seung Hwan LEE ; In Gab JEONG ; Sun Il KIM ; Eu Chang HWANG
Journal of Urologic Oncology 2024;22(1):34-41
Purpose:
The aim of this study was to assess the effects of tyrosine kinase inhibitors (TKIs) following metastasectomy in patients with metastatic renal cell carcinoma (mRCC).
Materials and Methods:
A systematic search of multiple electronic databases was conducted. The inclusion criteria encompassed randomized clinical trials evaluating the use of TKIs after metastasectomy in mRCC patients. Study outcomes were relapse-free survival (RFS)/disease-free survival (DFS), overall survival (OS), and adverse events of TKIs.
Results:
Two studies with 197 randomized participants that compared TKIs following metastasectomy versus metastasectomy alone were identified. According to these studies, TKIs following metastasectomy may result in little to no difference in RFS/DFS (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.65–1.57; I2=29%; low-certainty evidence). TKIs after metastasectomy may slightly increase OS, but the CI crossed the line of no effect (HR, 0.80; 95% CI, 0.06–9.87; I2=86%; low-certainty evidence). TKIs after metastasectomy likely resulted in a large increase in adverse events (risk ratio, 2.76; 95% CI: 1.65–4.62; I2=not applicable; moderatecertainty evidence).
Conclusions
TKIs following metastasectomy did not improve RFS/DFS, but slightly improved OS. It is likely that TKIs following metastasectomy increase adverse events compared to surgery only. The certainty of evidence ranged from moderate (signaling confidence that the reported effect size is likely close to the true effect) to low (indicating that the true effect may be substantially different from the effect estimate). The findings of this study should help to inform future guidelines and clinical decision-making at the point of care.
3.Clinical Significance of Human Papillomavirus DNA Test and p16 Overexpression in Oropharyngeal Cancer
Juhyun LEE ; Kwang Yoon JUNG ; Soon-Young KWON ; Jeong-Soo WOO ; Jae-Gu CHO ; Kyoung-Ho OH ; Jaehyeong KIM ; Seung-Kuk BAEK
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(6):336-343
Background and Objectives:
Oropharyngeal squamous cell carcinoma (OPSCC) can be caused by human papilloma virus (HPV) infection or other factors like smoking. The 8th Edition of the AJCC Cancer Staging Manual recommends different staging and treatment approaches based on etiology. Despite criticisms of its low specificity, the current guidelines suggest using p16 immunohistochemistry (IHC) as a surrogate marker for the HPV-related OPSCC. This study assessed the reliability of p16 as a surrogate marker by correlating the survival rates of OPSCC patients with the results of p16 IHC and HPV-DNA testing.Subjects and Method A retrospective analysis was performed on patients treated for tonsil squamous cell carcinoma at a tertiary medical institution between 1994 and 2018. All patients underwent p16 immunostaining and HPV-DNA chip tests. Out of 88 patients, 17 were excluded due to insufficient data or secondary primary cancer, leaving 71 patients.
Results:
Among the 71 patients, 51 were p16 positive and 49 were HPV-DNA positive; both tests were associated with extended survival. However, discrepancies were noted in 18 patients: specifically, 11 patients were p16 positive but HPV-DNA negative, displaying a different survival pattern compared to HPV-associated and non-HPV-associated patients.
Conclusion
Both p16 immunostaining and HPV-DNA testing have their pros and cons. p16 immunostaining is cost-effective but has lower specificity. The study found discrepancies in 18 patients, suggesting that relying solely on p16 immunostaining may have limitations. It would be advisable to complement it with additional tests like the HPV-DNA chip test to predict the disease’s prognosis more accurately.
5.Analysis of YouTube Content on Oral Disease Information about the Elderly
Ji-Won KIM ; Hanna GU ; Hye-Jin KWON ; Jeong-Hyun LIM ; Hee-Jung LIM
Journal of Dental Hygiene Science 2022;22(1):1-8
Background:
The elderly have, a higher disease morbidity than other age groups due to a decrease in resistance to the diseaseand have complex diseases, so care should be taken. Accordingly, it is considered important to provide information for improving the health of the elderly. Health information plays an important role in individual health promotion and education, so the degree of exposure to information about oral health of the elderly is expected to have a significant impact on understanding and acquiring information on oral content videos on the importance, prevention, and management of oral health of the elderly in the future.
Methods:
This study analyzed video content related to oral diseases of the elderly in a total of 150 videos uploaded on YouTubefrom January 1, 2012 to May 13, 2021, using a total of three books of dental hygiene for the elderly.
Results:
Forty-nine broadcasters accounted for the most of this information. Among the information providers, there were twodental hygienists. They accounted for 1.3% of all the information providers. The highest number of dental hygienists who broadcasted information was 42 in 2019. The average number of views was 37,303 periodontal diseases, the highest. Among the videos, dry mouth was the most common with 34 oral diseases.
Conclusion
The number of images for each disease varies, so it seems that information should be provided in various ways. Dentalhygienists should widely improve oral health knowledge by providing various dental hygiene management images for each oral disease to improve the oral health of the general public. In addition, based on the information of the Health Insurance Review and Assessment Service, the development and provision of content should be actively carried out so that people can obtain the information they desire.
6.Comparison of the Voice Outcome After Injection Laryngoplasty: Unilateral Vocal Fold Paralysis Due to Cancer Nerve Invasion and Iatrogenic Injury
Yongmin CHO ; Hyunseok CHOI ; Kyoung Ho OH ; Seung-Kuk BAEK ; Jeong-Soo WOO ; Soon Young KWON ; Kwang-Yoon JUNG ; Jae-Gu CHO
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2022;33(3):172-178
Background and Objectives:
Injection laryngoplasty is a common method for treatment of unilateral vocal fold paralysis. Unilateral vocal fold paralysis has various causes, including idiopathic, infection, stroke, neurologic condition, surgery and nerve invasion by cancer. To the knowledge of the authors, there was no study on the relationship between the causes of vocal cord paralysis and the outcome of injection laryngoplasty. Therefore, we tried to investigate the difference in the outcomes of injection laryngoplasty between vocal cord paralysis after surgery group and nerve invasion by cancer group.Materials and Method A retrospective analysis was performed for 24 patients who underwent vocal cord injection due to unilateral vocal cord paralysis caused by surgery or nerve invasion by cancer. The objective quality of the voice was assessed by acoustic voice analysis with the Multi-Dimensional Voice Program.
Results:
Both group showed an improvement of fundamental frequemcy (F0), jitter percent, shimmer (percent), and noise to hearmonic ratio (NHR) after injection laryngoplasty. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of F0, shimmer percent and NHR than the vocal cord paralysis due to surgery group, but there was not statistically significant.
Conclusion
Our study did not show a statistically significant difference in outcome between vocal cord paralysis due to cancer invasion group and surgery group, but statistically tendency was suggested. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of acoustic voice analysis than surgery group.
7.Safety of acupotomy in a real-world setting: A prospective pilot and feasibility study.
Sang-Hoon YOON ; Chan-Young KWON ; Hee-Geun JO ; Jae-Uk SUL ; Hyangsook LEE ; Jiyoon WON ; Su Jin JEONG ; Jun-Hwan LEE ; Jungtae LEEM
Journal of Integrative Medicine 2022;20(6):514-523
OBJECTIVE:
Acupotomy is a modern acupuncture method that includes modern surgical methods. Since acupotomy is relatively more invasive than filiform acupuncture treatment, it is important to establish the safety profile of this practice. To justify further large-scale prospective observational studies, this preliminary study was performed to assess the feasibility of the approach and investigate the safety profile and factors potentially associated with adverse events (AEs).
METHODS:
This was a prospective pilot study that assessed the feasibility of a large-scale forthcoming safety study on acupotomy treatment in a real-world setting. The feasibility (call response rate, drop-out rate, response rate for each variable and recruitment per month) and safety profile (incidence, type, severity and causality of AEs, and factors potentially associated with AEs) were measured.
RESULTS:
A total of 28 participants joined the study from January to May 2018. A follow-up assessment was achieved in 258 (1185 treatment points) out of 261 sessions (1214 treatment points). The response rate via telephone on the day after treatment was 87.3%. There were 8 systemic AEs in all the sessions (8/258; 3.11%) and 27 local AEs on the total points treated (27/1185; 2.28%). Severe AEs did not occur. Total AE and local AE occurrence were associated with blade width and the number of needle stimulations per treatment point.
CONCLUSION:
The findings suggest that it could be feasible to analyze the safety of acupotomy in a real-world setting. Moreover, the primary data on some relevant AEs could be determined. We are planning large-scale prospective studies based on these findings.
TRIAL REGISTRATION
Clinical Research Information Service (CRIS) KCT0002849 (https://cris.nih.go.kr/cris/search/detailSearch.do/11487).
Humans
;
Feasibility Studies
;
Prospective Studies
;
Pilot Projects
;
Acupuncture Therapy/methods*
;
Research Design
;
Treatment Outcome
8.Genomic Surveillance of SARS-CoV-2: Distribution of Clades in the Republic of Korea in 2020
Ae Kyung PARK ; Il-Hwan KIM ; Junyoung KIM ; Jeong-Min KIM ; Heui Man KIM ; Chae young LEE ; Myung-Guk HAN ; Gi-Eun RHIE ; Donghyok KWON ; Jeong-Gu NAM ; Young-Joon PARK ; Jin GWACK ; Nam-Joo LEE ; SangHee WOO ; Jin Sun NO ; Jaehee LEE ; Jeemin HA ; JeeEun RHEE ; Cheon-Kwon YOO ; Eun-Jin KIM
Osong Public Health and Research Perspectives 2021;12(1):37-43
Since a novel beta-coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019, there has been a rapid global spread of the virus. Genomic surveillance was conducted on samples isolated from infected individuals to monitor the spread of genetic variants of SARS-CoV-2 in Korea. The Korea Disease Control and Prevention Agency performed whole genome sequencing of SARS-CoV-2 in Korea for 1 year (January 2020 to January 2021). A total of 2,488 SARSCoV-2 cases were sequenced (including 648 cases from abroad). Initially, the prevalent clades of SARSCoV-2 were the S and V clades, however, by March 2020, GH clade was the most dominant. Only international travelers were identified as having G or GR clades, and since the first variant 501Y.V1 was identified (from a traveler from the United Kingdom on December 22 nd , 2020), a total of 27 variants of 501Y.V1, 501Y.V2, and 484K.V2 have been classified (as of January 25 th , 2021). The results in this study indicated that quarantining of travelers entering Korea successfully prevented dissemination of the SARS-CoV-2 variants in Korea.
9.Analysis of Medical Use and Treatment Costs of Hepatocellular Carcinoma Patients Using National Patient Sample Data
Byeong-Chan OH ; Jeong-Yeon CHO ; Sun-Hong KWON ; Eui-Kyung LEE ; Hye-Lin KIM
Korean Journal of Clinical Pharmacy 2021;31(2):153-159
Background:
With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE).
Methods:
We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service–National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC.
Results:
A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K).
Conclusion
By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.
10.Hyaluronic Acid Coating on Hydrophobic Tracheal Scaffold Enhances Mesenchymal Stem Cell Adhesion and Tracheal Regeneration
Ji Suk CHOI ; Min Sang LEE ; Jooyoung KIM ; Min Rye EOM ; Eun Ji JEONG ; Minhyung LEE ; Su A PARK ; Ji Hoon JEONG ; Seong Keun KWON
Tissue Engineering and Regenerative Medicine 2021;18(2):225-233
BACKGROUND:
Long segmental tracheal repair is challenging in regenerative medicine due to low adhesion of stem cells to tracheal scaffolds. Optimal transplantation of stem cells for tracheal defects has not been established. We evaluated the role of hyaluronic acid (HA) coating of tracheal scaffolds in mesenchymal stem cell (MSC) adhesion and tracheal regeneration in a rabbit model.
METHODS:
A three-dimensionally printed tubular tracheal prosthesis was incubated with dopa-HA-fluorescein isothiocyanate in phosphate-buffered saline for 2 days. MSCs were incubated with an HA-coated scaffold, and their adhesion was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. HA coated scaffolds with or without MSC seeding were transplanted at the circumferential tracheal defect in rabbits, and survival, rigid bronchoscopy, radiologic findings, and histologic findings were compared between the two groups.
RESULTS:
HA-coated scaffolds showed better MSC adhesion than non-coated scaffolds. The HA-coated scaffolds with MSC group showed a wider airway and greater mucosal regeneration compared to the HA-coated scaffolds without MSC group.
CONCLUSION
HA coating of scaffolds can promote MSC adhesion and tracheal regeneration.

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