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No, either or both parents with metabolic syndrome: comparative study of its impact on sons and daughters
No full textBACKGROUND: Metabolic syndrome (MetS) is known to have parental influence on children's metabolic health, increasing the risk for the cardiometabolic diseases. However, the extent of the association and its sex-specific differences remain unclear. OBJECTIVE: This retrospective, comparative study aimed to investigate the influence of parental MetS on their offspring, utilizing data from the Korea National Health and Nutritional Examination Survey. METHODS: The study population was narrowed to 5,245 participants. Each sex was further divided into three groups: children with neither parent having MetS were labeled as "No," those with only one affected parent was labeled as "Either," and those with both parents affected were labeled as "Both." Analysis of covariance and multiple regression analysis were used to compare the cardiometabolic risk factors among the three groups. RESULTS: Children with one or both parents affected by MetS had significantly higher waist circumference, blood pressure, triglycerides, and fasting glucose levels. These associations were more profound in boys than in girls. CONCLUSION: Metabolic risk factors were more strongly associated with parental MetS in boys than in girls. The number of parental MetS cases appeared to have a proportional impact on metabolic components in boys, unlike the variable results observed in girls. These results emphasize the need for targeted interventions in families with a history of MetS
Ambient fine particulate matter and mortality risk among people with disability in Korea based on the National Health Insurance database: a retrospective cohort study
No full textBACKGROUND: People with disabilities (PWD) may be more vulnerable to the adverse health effects of air pollution than the general population. This study examined the association between long-term exposure to ambient fine particulate matter (PM(2.5)) and mortality risk in PWD considering disability type and severity. METHODS: Data from the Korean National Health Insurance Service and Statistics Korea were analyzed in this retrospective cohort study, including 2,880,265 individuals (41,501,709 person-years), of which 176,410 were PWD (2,011,231 person-years). PM(2.5) exposure was estimated using simulated data from 2006 to 2019. Causes of death included all causes, non-accidental causes, respiratory disease, lung cancer, and cardiovascular disease. Cox proportional hazard models were used to estimate hazard ratios (HRs) for mortality associated with PM(2.5) stratified by disability type and severity. RESULTS: PWD, particularly those with severe disabilities or specific impairments such as kidney problems or brain lesions, showed significantly high mortality risks from all causes, non-accidental causes, and cardiovascular diseases due to PM(2.5) exposure. For individuals with kidney impairment, the HR (95% confidence interval) for mortality on increasing PM(2.5) by 10 microg/m(3) was 1.79 (1.27-2.52) from all causes, while for those with brain lesions, it was 1.10 (1.00-1.22) from cardiovascular disease. PWD were not susceptible to mortality from respiratory causes. CONCLUSIONS: This study highlights the increased vulnerability of PWD, especially those with severe disabilities or specific impairments, to the adverse effects of PM(2.5) exposure. Targeted interventions tailored to disability type and severity, along with stricter air quality standards and specialized healthcare approaches, are needed
Corrigendum to The risk of pregnancy-related adverse outcomes after COVID-19 vaccination: propensity score-matched analysis with influenza vaccination
No full textMinimally invasive surgery versus open surgery in advanced stage endometrial cancer
No full textAim: Staging surgery in early stage endometrial cancer has been shown to be feasible and safe with minimally invasive surgery (MIS) in many previous studies. However, there is limited literature on MIS's safety in advanced stages. This study aims to identify factors associated with survival in stage III endometrial cancer and investigate survival differences based on surgical approach. Methods: Patients with stage III endometrial cancer who underwent staging surgery from March 2002 to March 2023 were included in this study. Various clinicopathological features, disease-free survival (DFS), and overall survival (OS) were evaluated. Results: Among the 79 patients included in this study, 20 patients underwent MIS (25.3%) and 59 patients underwent open surgery (74.7%). The open surgery group had a higher prevalence of aggressive histology, a higher median pretreatment CA-125 level, and a greater number of harvested lymph nodes compared to the MIS group. Five-year OS and DFS was higher in the open surgery group than in the MIS group (DFS: 67.9% vs. 59.9%, p = 0.046; OS: 74.3 vs. 50.6%, p = 0.008). In multivariate analysis, younger than 55 years old (OR, 2.778; 95% CI, 1.078–7.156; p = 0.034), and open surgery (OR, 3.671; 95% CI, 1.581–8.522; p = 0.002) was related to improved OS. Conclusions: Open staging surgery showed better survival outcomes when compared to MIS in stage III endometrial cancer patients in our study. For patients who are older than 55 years old and have aggressive histology in endometrial biopsy, considering open surgery may help improve their prognosis, even if preoperative MRI suggests early-stage endometrial cancer
Conversion Therapy for Stage IV Gastric Cancer: Report From the Expert Consensus Meeting at KINGCA WEEK 2024
No full textConversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC). To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy. The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion therapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%). Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy
Inhibition of HDAC6 elicits anticancer effects on head and neck cancer cells through Sp1/SOD3/MKP1 signaling axis to downregulate ERK phosphorylation
No full textOxidative stress caused by reactive oxygen species (ROS) and superoxides is linked to various cancer-related biological events. Extracellular superoxide dismutase (SOD3), an antioxidant enzyme that removes superoxides, contributes to redox homeostasis and has the potential to regulate tumorigenesis. Histone deacetylase 6 (HDAC6), a major HDAC isoform responsible for mediating the deacetylation of non-histone protein substrates, also plays a role in cancer progression. In this study, we examined the potential effects of HDAC6 inhibition on SOD3 expression in head and neck cancer (HNC) cells and its impact on cell proliferation, which remains unaddressed. We found that functional inactivation of HDAC6, through the use of chemical inhibitors such as tubastatin A (TubA), gene knockdown, or overexpression of an inactive mutant, strongly upregulated protein and mRNA levels of SOD3 in HNC cell lines FaDu and Detroit562. Mechanistically, TubA induced acetylation of the transcription factor Sp1 at Lys703, which consequently enhanced its binding to the SOD3 proximal promoter region and increased SOD3 expression. An acetylation-defective Sp1 mutant (K703R) was much less effective in inducing SOD3 expression compared to wild-type Sp1. TubA reduced intracellular ROS and superoxide levels, and this antioxidative effect was attenuated in SOD3 knockdown cells. Similar to the changes in ROS levels, HDAC6 inhibition as well as SOD3 overexpression suppressed cell proliferation and the stimulatory phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2), whereas SOD3 knockdown produced opposite effects in both resting and TubA-treated conditions. In addition, SOD3 overexpression prevented ROS-induced ERK1/2 phosphorylation and enhanced the protein stability of mitogen-activated protein kinase phosphatase 1 (MKP1), thereby counteracting ERK1/2 phosphorylation. We further showed that SOD3-mediated ERK1/2 dephosphorylation was moderated in MKP1 knockdown cells. Collectively, these results suggest that HDAC6 inhibition elicits anticancer effects on HNC cells by promoting Sp1 acetylation-dependent SOD3 upregulation, leading to MKP1 stabilization and subsequent ERK1/2 inactivation
Orphan nuclear receptor NR4A1 regulates both osteoblastogenesis and adipogenesis in human mesenchymal stem cells
No full textThe nuclear receptor subfamily 4 group A member 1 (NR4A1) gene plays a crucial role in both osteoporosis and adipogenesis. The present study investigated the mechanisms by which NR4A1 influences osteoblastogenesis and adipogenesis in human bone marrow-derived mesenchymal stem cells (BMD-MSCs). NR4A1 was overexpressed or knocked down in mouse MC3T3-E1 osteoblast cells and 3T3-L1 adipocyte cells, as well as in PCS-500-012, a BMD-MSC line. The alkaline phosphatase (ALP) assay and Alizarin Red S staining were performed using MC3T3-E1 and BMD-MSCs to assess ALP activity and mineralization, while Oil Red O staining was used to assess the lipid content in 3T3-L1 cells and BMD-MSCs. Total RNA was isolated from control, NR4A1-overexpressing and NR4A1 small interfering RNA (siRNA; siNR4A1)-treated BMD-MSCs. RNA sequencing (RNA-seq) was performed to identify differentially expressed genes, followed by ingenuity pathway analysis (IPA) to determine the role of NR4A1 in osteoblastogenesis and adipogenesis. NR4A1 or Nr4a1 knockdown tended to increase ALP activity and significantly increased calcification in BMD-MSCs (P<0.005) and MC3T3-E1 cells (P<0.005), respectively. By contrast, NR4A1 or Nr4a1 overexpression significantly decreased ALP activity and calcification. NR4A1 or Nr4a1 knockdown and overexpression significantly decreased and increased adipogenesis, respectively, in BMD-MSCs (P<0.005 and <0.05, respectively) and 3T3-L1 cells (P<0.005 in both). Treatments of BMD-MSCs with an NR4A1 antagonist, 1,1-bis(3'-indolyl)-1-(p-hydroxyphenyl) methane and siNR4A1 showed similar results. RNA-seq and IPA in control, NR4A1 knockdown and NR4A1 overexpressing cells indicated that Notch signaling mediated the effects of NR4A1 in osteoblastogenesis and adipogenesis. Expression of mastermind-like transcriptional coactivator 3 was reduced in the Notch signaling pathway in cells treated with siNR4A1. In conclusion, NR4A1 suppressed osteoblastogenesis and promotes adipogenesis in human BMD-MSCs. The present study also suggested that NR4A1 plays a role in the progression of osteoporosis and adipogenesis by modulating the Notch signaling cascade
Korean Gastric Cancer Association-Led Nationwide Survey on Surgically Treated Gastric Cancers in 2023
No full textPURPOSE: Since 1995, the Korean Gastric Cancer Association (KGCA) has been periodically conducting nationwide surveys on patients with surgically treated gastric cancer. This study details the results of the survey conducted in 2023. MATERIALS AND METHODS: The survey was conducted from March to December 2024 using a standardized case report form. Data were collected on 86 items, including patient demographics, tumor characteristics, surgical procedures, and surgical outcomes. The results of the 2023 survey were compared with those of previous surveys. RESULTS: Data from 12,751 cases were collected from 66 institutions. The mean patient age was 64.6 years, and the proportion of patients aged >/=71 years increased from 9.1% in 1995 to 31.7% in 2023. The proportion of upper-third tumors slightly decreased to 16.8% compared to 20.9% in 2019. Early gastric cancer accounted for 63.1% of cases in 2023. Regarding operative procedures, a totally laparoscopic approach was most frequently applied (63.2%) in 2023, while robotic gastrectomy steadily increased to 9.5% from 2.1% in 2014. The most common anastomotic method was the Billroth II procedure (48.8%) after distal gastrectomy and double-tract reconstruction (51.9%) after proximal gastrectomy in 2023. However, the proportion of esophago-gastrostomy with anti-reflux procedures increased to 30.9%. The rates of post-operative mortality and overall complications were 1.0% and 15.3%, respectively. CONCLUSIONS: The results of the 2023 nationwide survey demonstrate the current status of gastric cancer treatment in Korea. This information will provide a basis for future gastric cancer research
Diagnostic Decision Points of Specific Immunoglobulin E Concentrations for Seafood Allergies in Korean Children: A Nationwide Multicenter Study
No full textShellfish and fish are common causes of food allergy (FA) in Asia, with significant prevalence rates reported across various countries. This study aimed to identify the diagnostic decision points (DDPs) for shrimp, crab, and cod allergies in Korean children. We enrolled participants aged 18 years or younger with suspected shrimp, crab, or cod allergies through a retrospective review of medical records from a nationwide 14-center study between January 2018 and March 2022. FA was diagnosed using an open oral food challenge or a reproducible and convincing history with positive serum specific immunoglobulin E (sIgE) levels. The sIgE cut-off values for shrimp, crab, and cod were determined by analyzing receiver operating characteristic curves. Out of 266 children, 90 (33.8%) were confirmed to have a shrimp allergy. Crab allergies were found in 37 (39.8%) of 93 children. Of 66 children, 15 (22.7%) were found to be allergic to cod. The optimal sIgE cut-off values based on the largest area under the curve were 1.43, 3.25, and 2.05 kU/L for shrimp, crab, and cod, respectively. Levels of sIgE with more than 90% positive predictive value (PPV) were 33.8, 47.5, and 29.9 kU/L for shrimp, crab, and cod, respectively. Levels of sIgE with greater than 90% negative predictive value (NPV) were 0.36, 0.04, and 3.93 kU/L for shrimp, crab, and cod, respectively. Our results suggest that DDPs of sIgE levels with high PPV and NPV can be used to diagnose shrimp, crab, and cod allergies in Korean children
Videofluoroscopic swallowing study predicts clinical outcomes in critically Ill children with dysphagia: a retrospective observational study
No full textBACKGROUND: This retrospective observational study aimed to investigate the features of acute dysphagia observed during videofluoroscopic swallowing study (VFSS) in critically ill children and their potential to anticipate clinical outcomes. METHODS: Administrative healthcare data of children aged 1-18 were analyzed. Data were collected from the pediatric intensive care unit (PICU) of a single tertiary medical center in South Korea between March 2019 and December 2022. We reviewed VFSS conducted on patients in the PICU who were referred by clinicians suspecting dysphagia. RESULTS: A total of 36 children were included in the study; 52.8% exhibited aspiration on VFSS. In this investigation, participants were provided with pureed food, liquids, solids, and a combination of solids and liquids (referred to as mixed) during the examination. Any occurrence of aspiration throughout the examination was deemed as aspiration. All individuals displaying aspiration were found to have silent aspiration. Silent aspiration was associated with a longer length of stay (LOS) in the PICU. Logistic regression analysis revealed that the time from PICU admission to VFSS and intubation duration significantly influenced LOS. Abnormal findings in the VFSS, including aspiration, delayed swallowing reflex, insufficient laryngeal closure, and residue, were statistically significant variables in determining the feeding mode at discharge. CONCLUSION: This study highlights the importance of VFSS in assessing swallowing function in critically ill children. It suggests that VFSS findings, such as silent aspiration, can aid in predicting patient outcomes, including LOS and the delay in oral feeding