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Abstract Background With the significant growth of migration and expatriation, facilitated by increased global mobility, the number of Koreans living abroad as of 2016 is approximately 7.4 million (15% of the Korean population). Healthcare utilization or health problems, especially among expatriates in developing countries, have not been well researched despite the various health risks these individuals are exposed to. Consequently, we identified the health utilization patterns and healthcare needs among Korean expatriates in Vietnam, Cambodia, and Uzbekistan. Methods This cross-sectional survey examined 429 Korean expatriates living in Vietnam (n = 208), Cambodia (n = 60), and Uzbekistan (n = 161) who had access to the Internet and were living abroad for at least 6 months. A 67-item questionnaire was used, and feedback was received via an online survey program. Stepwise logistic regression analyses were performed to evaluate factors associated with unmet healthcare needs and preferences of certain type of telemedicine. Results We found that 45.5% (195/429) of respondents had used medical services in their country of stay. Among those who visited health institutions > 3 times, the most popular choice was general hospitals (39.4%, 15/38); however, they initially visited Korean doctors’ or local doctors’ offices. The most essential criteria for healthcare service facilities was a “skilled professional” (39.3%, 169/429), 42% wanted a health program for chronic disease management, and 30% wanted specialized internal medicine. A substantial number wanted to access telemedicine services and were willing to pay for this service. They were particularly interested in experts’ second opinion (61.5%, 264/429) and quick, 24-h medical consultations (60.8%, 261/429). Having unmet healthcare needs and being younger was strongly associated with all types of telemedicine networks. Conclusions Nearly half of the expatriates in developing countries had unmet healthcare needs. Telemedicine is one potential solution to meet these needs, especially in developing countries.

Background: The epidermal growth factor receptor (EGFR) has been reported to be overexpressed in anaplastic thyroid carcinoma (ATC). In vitro studies have shown that EGFR tyrosine kinase inhibitors (TKIs) greatly inhibit cellular growth and induced opoptasis in the ATC cell lines, while somatic mutations in the tyrosine kinose domain or an increased gene copy number are associated with increased sensitivity to TKIs in non-small cell lung cancer. Aim: To investigate the prevalence of EGFR overexpression, gene amplification and activating mutation in the tyrosine kinase domain in patients with ATC. Methods: The EGFR gene status and protein expression were investigated by direct DNA sequencing of the authors' affiliations hot-spot regions in exons 18, 19 and 21, fluorescence in situ hybridisation (FISH), and immunohistochemistry in tumour tissues from 23 patients with ATC. Results: On mutational analysis and FISH, neither mutations in the hot-spots nor gene amplification was observed. However, high polysomy was identified in 14/23 (60.9%) patients with ATC. All cases with immunohistachemistry (IHC) positivity (n=6) had high polysomy, whereas 8/17 (47.1%) cases with IHC negativity had high polysomy (p=0.048). High polysomy was observed in all 10 cases with giant cell subtype, but in only 4/11 (36.3%) with squamoid and 0/2 with spindle cell sarcomatoid subtype. There was no statistically significant correlation between FISH positivity of ATC tumour and presence of well-differentiated component. Conclusion: Despite the low incidence of somatic EGFR gene mutation and amplification in the study samples, in view of the Fact that high polysomy was often identified by FISH, as well as the current lack of therapeutic options, EGFR TKIs ore worth investigating far treating the patients with ATC who have at least giant cell subtype. [ABSTRACT FROM AUTHOR]

Background Between 10 and 30% of the fine needle aspiration biopsies (FNABs) of thyroid nodules are diagnosed as ‘indeterminate’. A molecular diagnostic method is needed to reduce unnecessary surgery in this group. In Korea, most thyroid cancer is the classic papillary type and the BRAFV600E mutation is highly prevalent. Aim To evaluate the role of pre-operative detection of BRAFV600E mutation in the FNAB specimens of thyroid nodules in a BRAFV600E mutation-prevalent geographical area. Patients and methods In 137 specimens of FNAB (107 papillary thyroid carcinomas (PTC); 3 follicular thyroid carcinomas (FTC); 2 undifferentiated thyroid carcinomas; 25 benign lesions), both direct DNA sequencing and PCR-RFLP were used for detecting the BRAFV600E mutation. The sensitivity and specificity were calculated. We analysed the association between BRAFV600E mutation and the clinico-pathological parameters. Results The BRAFV600E mutation was present in 93 (83%) of 112 thyroid cancers. Direct DNA sequencing showed a sensitivity of 83·0% and a specificity of 96·0%. The sensitivity and specificity of PCR-RFLP were 78·6% and 80·0%, respectively. Among 25 cases with indeterminate FNAB cytology, 8 patients had malignant lesions (5 PTC and 3 FTC). Three (60%) of 5 PTCs and 1 out of 17 benign lesions had BRAFV600E mutation (only one false positive case and the definitive pathology showed atypical nodular hyperplasia that could be a premalignant lesion). The diagnostic accuracy of this molecular method in only the 25 indeterminate nodules was 76% (19/25). No mutation was found in 3 FTCs. Among 107 PTCs, there was no significant association of the BRAFV600E mutation with the known risk factors. Conclusion Detection of the BRAFV600E mutation in FNAB specimens refines the FNAB-cytology diagnosis, especially in a BRAFV600E mutation-prevalent area. Direct DNA sequencing was a more reliable method than PCR-RFLP for detecting the BRAFV600E mutation with a high sensitivity and specificity. [ABSTRACT FROM AUTHOR]