Publications by authors named "Dong Hoon Lee"

633 Publications

Actinomycosis of the nasal cavity.

Braz J Otorhinolaryngol 2021 May 25. Epub 2021 May 25.

Chonnam National University Medical School & Hwasun Hospital, Department of Otolaryngology-Head and Neck Surgery, Hwasun, South Korea.

Introduction: Actinomycosis of the nasal cavity is very rare.

Objective: The purpose of this study was to investigate the clinical features, treatment methods, and treatment results of actinomycosis of the nasal cavity in our hospital.

Methods: We retrospectively enrolled 11 patients with histopathologically identified actinomycosis of the nasal cavity from January 2010 to May 2020.

Results: This study included five males and six females. The most common symptom was purulent nasal discharge (36.4%). Nasal actinomycosis occurred in the maxillary sinus in 5 (45.5%) patients, the ethmoid sinus in two, the hard palate in two, the frontal sinus in one, and the nasal septum in one. After surgery, intravenous administration of antibiotics was performed on average for 7.4 days and oral antibiotics were prescribed for about 120.5 days. The clinical characteristics of the patients with nasal actinomycosis and the duration of antibiotic usage were not significantly different. Trauma was significantly associated with repeated nasal actinomycosis infections (p < 0.05).

Conclusion: Actinomycosis of the nasal cavity should be suspected when a patient with chronic sinusitis does not respond to medical therapy and has a history of dental treatment, local surgery or radiation therapy. Nasal can be sufficiently treated with antibiotics and endoscopic surgery.
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http://dx.doi.org/10.1016/j.bjorl.2021.05.003DOI Listing
May 2021

Association between weight cycling and risk of kidney cancer: a prospective cohort study and meta-analysis of observational studies.

Cancer Causes Control 2021 Jun 5. Epub 2021 Jun 5.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Purpose: Weight cycling is common in populations. However, it is unclear whether frequency and magnitude of weight cycling is associated with kidney cancer risk, independent of body mass index (BMI).

Methods: A prospective cohort study followed 85,562 participants from Health Professionals Follow-up Study and Nurses' Health Study (1992-2014). At baseline, participants reported frequency and magnitude of intentional weight loss in the past 4 years. Cox proportional hazard model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). We also conducted a meta-analysis of all available observational studies including our two cohorts.

Results: During 22 years of follow-up, we identified 441 kidney cancer cases. Compared with non-weight cyclers (no attempt of intentional weight loss), severe cyclers (≥ 3 times of intentional weight loss of ≥ 4.5 kg) were at increased kidney cancer risk after adjusting for BMI before weight cycling (pooled multivariable-adjusted HR, 1.78; 95% CI, 1.19, 2.66). Additional adjustment for attained BMI after weight cycling had minimal influence. There was a positive trend between weight cycling by frequency and magnitude and kidney cancer risk (P-trend = 0.01). Moreover, the observed positive association did not differ by subtypes of cyclers (e.g., adiposity status, weight-loss methods). In the meta-analysis, we found a strong positive association between weight cycling and kidney cancer risk (summary relative risk for weight cyclers vs. non-cyclers, 1.51; 95% CI, 1.16, 1.96; I: 52.2%; 6 studies).

Conclusion: Frequent substantial weight cycling was associated with increased risk of kidney cancer, independent of BMI. Our study suggests that weight cycling may be an important risk factor for kidney cancer.
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http://dx.doi.org/10.1007/s10552-021-01455-9DOI Listing
June 2021

The Long-Term Functional Effect of Thrombectomy on Patients with Middle Cerebral Artery Occlusion Who Exhibit Moderate to Severe Disability.

Medicina (Kaunas) 2021 May 19;57(5). Epub 2021 May 19.

Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Korea.

: Endovascular thrombectomy (EVT is an emerging gold standard treatment for acute cerebral infarction and may allow functional improvement after subacute cerebral infarction. However, the long-term functional benefits of EVT in patients with moderate to severe disability remain unclear. We investigated the effects of EVT on the activities of daily living (ADL), handicap, gait, and eating in patients with middle cerebral artery (MCA) occlusion who exhibited moderate to severe disability (score of 3-5 on the modified Rankin scale (mRS)) due to stroke, up to six months after onset. : This retrospective longitudinal case-control study assessed 45 patients with MCA occlusion who exhibited moderate to severe disability (mRS score ≥ 3): 15 underwent EVT and 30 served as controls. Clinical assessments were conducted at two weeks (12-16 days), four weeks (26-30 days), and six months (180-210 days) after stroke onset. Functional assessments comprised the Korean version of the modified Barthel index (MBI), mRS, functional ambulation category (FAC), and dysphagia outcome severity scale (DOSS) to assess disability, handicap, gait, and eating. : The MBI, mRS, FAC, and DOSS scores all improved significantly (all < 0.05) in the EVT group, compared to the controls. : EVT has favorable effects on performing routine ADL, the handicap itself, walking, and eating. Therefore, EVT is recommended for patients with acute MCA occlusion, including those with severe disability at the initial assessment.
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http://dx.doi.org/10.3390/medicina57050509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8161388PMC
May 2021

Hypertension, renin-angiotensin-aldosterone-system-blocking agents, and COVID-19.

Clin Hypertens 2021 Jun 1;27(1):11. Epub 2021 Jun 1.

Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Background: There have been concerns regarding the safety of renin-angiotensin-aldosterone-system (RAAS)-blocking agents including angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) during the coronavirus disease 2019 (COVID-19) pandemic. This study sought to evaluate the impact of hypertension and the use of ACEI/ARB on clinical severity in patients with COVID-19.

Methods: A total of 3,788 patients aged 30 years or older who were confirmed with COVID-19 with real time reverse transcription polymerase chain reaction were identified from a claims-based cohort in Korea. The primary study outcome was severe clinical events, a composite of intensive care unit admission, need for ventilator care, and death.

Results: Patients with hypertension (n = 1,190, 31.4 %) were older and had higher prevalence of comorbidities than those without hypertension. The risk of the primary study outcome was significantly higher in the hypertension group, even after multivariable adjustment (adjusted odds ratio [aOR], 1.67; 95 % confidence interval [CI], 1.04 to 2.69). Among 1,044 patients with hypertensive medical treatment, 782 (74.9 %) were on ACEI or ARB. The ACEI/ARB subgroup had a lower risk of severe clinical outcomes compared to the no ACEI/ARB group, but this did not remain significant after multivariable adjustment (aOR, 0.68; 95 % CI, 0.41 to 1.15).

Conclusions: Patients with hypertension had worse COVID-19 outcomes than those without hypertension, while the use of RAAS-blocking agents was not associated with increased risk of any adverse study outcomes. The use of ACE inhibitors or ARBs did not increase the risk of adverse COVID-19 outcomes, supporting current guidance to continue these medications when indicated.
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http://dx.doi.org/10.1186/s40885-021-00168-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166420PMC
June 2021

Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies.

Int J Behav Nutr Phys Act 2021 05 29;18(1):69. Epub 2021 May 29.

Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil.

Background: Physical activity has been associated with reduced risk of seven types of cancer. It remains unclear, however, whether muscle-strengthening activities also reduce cancer incidence and mortality.

Methods: PubMed, Embase, Web of Science and Scopus were searched from inception to March 2020. Summary hazard ratio (HR) and 95% confidence intervals (CI) were estimated using random-effects models.

Results: Twelve studies (11 cohorts; 1 case-control), 6 to 25 years of follow-up, including 1,297,620 participants, 32,196 cases and 31,939 deaths, met inclusion criteria. Muscle-strengthening activities were associated with a 26% lower incidence of kidney cancer (HR for high vs low levels of muscle-strengthening activities: 0.74; 95% CI 0.56 to 0.98; I 0%; 2 studies), but not with incidence of other 12 types of cancer. Muscle-strengthening activities were associated with lower total cancer mortality: HRs for high vs low levels of muscle-strengthening activities was 0.87 (95% CI 0.73 to 1.02; I 58%; 6 studies); and HR for ≥2 times/week vs < 2 times/week of muscle-strengthening activities was 0.81 (95% CI 0.74 to 0.87; I 0%; 4 studies). Regarding the weekly duration of muscle-strengthening activities, HR for total cancer mortality were 0.91 (95% CI 0.82 to 1.01; I 0%; 2 studies) for 1-59 min/week and 0.98 (95% CI 0.89 to 1.07; I 0%) for ≥60 min/week vs none. Combined muscle-strengthening and aerobic activities (vs none) were associated with a 28% lower total cancer mortality (HR 0.72; 95% CI 0.53 to 0.98; I 85%; 3 studies).

Conclusions: Muscle-strengthening activities were associated with reduced incidence of kidney cancer and total cancer mortality. Combined muscle-strengthening and aerobic activities may provide a greater reduction in total cancer mortality.
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http://dx.doi.org/10.1186/s12966-021-01142-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164763PMC
May 2021

Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Predicting the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage.

J Stroke Cerebrovasc Dis 2021 May 21;30(8):105861. Epub 2021 May 21.

Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.

Objectives: Inflammatory response plays a pivotal role in the progress of aneurysmal subarachnoid hemorrhage (aSAH). As novel inflammatory markers, systemic inflammation response index (SIRI) and systemic immune-inflammation (SII) index could reflect clinical outcomes of patients with various diseases. The aim of this study was to ascertain whether initial SIRI and SII index were associated with prognosis of aSAH patients.

Methods: A total of 680 patients with aSAH were enrolled. Their prognosis was evaluated with modified Rankin Scale (mRS) at 3 months, and unfavorable clinical outcome was defined as mRS score of 3-6. Receiver operating characteristic (ROC) curve analysis was performed to identify cutoff values of SIRI and SII index for predicting clinical outcomes. Univariate and multivariate regression analyses were performed to explore relationships of SIRI and SII index with prognosis of patients.

Results: Optimal cutoff values of SIRI and SII index to discriminate between favorable and unfavorable clinical outcomes were 3.2 × 10/L and 960 × 10/L, respectively (P < 0.001 and 0.004, respectively). In multivariate analysis, SIRI value ≥ 3.2 × 10/L (odds ratio [OR]: 1.82, 95% CI: 1.46-3.24; P = 0.021) and SII index value ≥ 960 × 10/L (OR: 1.68, 95% CI: 1.24-2.74; P = 0.040) were independent predicting factors for poor prognosis after aSAH.

Conclusions: SIRI and SII index values are associated with clinical outcomes of patients with aSAH. Elevated SIRI and SII index could be independent predicting factors for a poor prognosis after aSAH.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105861DOI Listing
May 2021

Validity of the EOS-determined pelvic parameters and orientation with pelvic positional variation: a phantom study.

Sci Rep 2021 May 17;11(1):10468. Epub 2021 May 17.

Department of Orthopedic Surgery, Ajou University School of Medicine, Ajou University Medical Center, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea.

The EOS is a medical imaging system that incorporates simultaneous orthogonal images, producing three-dimensional (3D) reconstructions of the whole skeletal system in various functional positions. Despite growing interest in the pelvic 3D position, the validity of the EOS has not yet been well studied. We investigated the trueness and precision of EOS imaging for pelvic parameters and orientation and assessed whether the measurement using the EOS was affected by the pelvic orientation itself. The orientation of the anterior pelvic plane and pelvic parameters of a custom-made pelvic phantom were measured by three raters using the EOS, and the measurements obtained were compared with the true values. The standard deviations of the measurement errors were 3.23°, 0.26°, 0.23°, 2.98°, 0.88°, and 3.22° for flexion, obliquity, rotation, pelvic incidence, spinopelvic tilt, and sacral slope, respectively. The root-mean square averages of the standard deviation of each measurement were 4.05°, 0.41°, 0.28°, 4.80°, 0.99°, and 5.13°, respectively. The measurement errors for sacral slope correlated significantly with geometric means of flexion, obliquity, and rotation (r = 0.364, p = 2.67 × 10). The EOS rendered accurate and reliable measurements regarding pelvic 3D position, even with positional variation, but positional variation could affect measurements of sacral slope.
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http://dx.doi.org/10.1038/s41598-021-89958-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129068PMC
May 2021

Oleic acid in Angus and Hanwoo (Korean native cattle) fat reduced the fatty acid synthase activity in rat adipose tissues.

J Anim Sci Technol 2021 Mar 31;63(2):380-393. Epub 2021 Mar 31.

Department of Animal Science, Chungbuk National University, Cheongju 28644, Korea.

This study aimed to determine the blood lipid profiles, fatty acid composition, and lipogenic enzyme activities in rat adipose tissues as affected by the Angus beef fat (ABF) and Hanwoo beef fat (HBF) containing high oleic acid (OA) content. We assigned 60 Sprague Dawley rats with a mean bodyweight of 249 ± 3.04 g to three groups (n = 20 each) to receive diets containing 7% coconut oil (CON), 7% ABF, or 7% HBF. The OA content was highest in the HBF (45.23%) followed by ABF (39.51%) and CON (6.10%). The final body weight of the HBF-fed group was significantly increased, probably due to increased feed intake, indicating the palatability of the diet. The HBF and ABF significantly increased high-density lipoprotein cholesterol (HDL-C), decreased triglyceride (TG) and total cholesterol (TC) levels, and also tended to attenuate glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) levels in the bloodstream of the rats compared to CON. As compared to CON, lauric, myristic, and palmitic acids were significantly lower, and those of OA and α-linolenic acid (ALA) were significantly higher in the adipose tissues of HBF and ABF-fed groups. The HBF and ABF also reduced lipogenesis as induced by depleted fatty acid synthase (FAS) activity in rat adipose tissues. Nevertheless, between the two fats, HBF showed high feed intake due to its high palatability but reduced lipogenic enzyme activity, specifically that of FAS, and increased HDL-C, decreased TC and TG levels in the bloodstream, reduced saturated fatty acids (SFA), and increased oleic and ALA contents in rat adipose tissues indicating that HBF consumption does not pose significant risks of cardiovascular disease.
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http://dx.doi.org/10.5187/jast.2021.e4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071735PMC
March 2021

Actinomycosis of the parotid gland: case series.

Ann Palliat Med 2021 May 7. Epub 2021 May 7.

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea.

Background: Actinomycosis of the parotid gland is very rare. We sought to examine the clinical features, treatment methods, and treatment results of actinomycosis of the parotid gland in our hospital.

Methods: We retrospectively enrolled 5 patients with histopathologically identified actinomycosis of the parotid gland from January 2010 to May 2020.

Results: This study included 3 male and 2 female subjects. All patients had a common complaint of the mass in the parotid gland. Skin necrosis was observed in one patient. However, skin necrosis and fistula track occurred in the other 2 patients after fine-needle aspiration cytology (FNAC). Based on the result of FNAC two cases of inflammation and abscess were identified. Four patients with suspicion of parotid tumors before surgery underwent parotidectomy, and one patient with consideration of parotid abscess underwent incision and drainage. After surgery, intravenous administration of antibiotics was performed for an average of 6 days and oral antibiotics were prescribed for about 2 months for patients with actinomycosis of the parotid gland.

Conclusions: In case of skin necrosis of the parotid lesion without evidence of a malignant tumor, or if FNAC does not reveal the presence of cancerous cells, and fistula tract or skin necrosis occurs after the FNAC, then actinomycosis of the parotid gland should be suspected. If the actinomycosis of the parotid gland was localized to the parotid gland and removed surgically, it would be sufficient to treat the patients with antibiotics for about 2 months while observing the clinical response.
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http://dx.doi.org/10.21037/apm-21-755DOI Listing
May 2021

Higher Frequency of Undetected Acute Coronary Syndrome in Elderly Patients with Chest Pain Who Visited the Emergency Department: A Large-Cohort Retrospective Study.

Biomed Res Int 2021 10;2021:6611051. Epub 2021 Apr 10.

Department of Emergency Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.

Background: Acute coronary syndrome (ACS) is a critical disease encountered in the emergency department (ED). Despite the development of diagnostic tools, it may be difficult to diagnose ACS because of atypical symptoms and equivocal test results. We investigated the difference in the rates of revisit and undetected ACS between adult and elderly patients who visited the ED with chest pain.

Method: Data from 11,323 patients who visited the ED with chest pain at university hospitals in Korea were retrospectively analyzed. The cohort was categorized into two age groups: the adult (30-64 years) and elderly (>65 years). Baseline characteristic data (age, sex, vital signs, triage category, etc.) were obtained. We selected patients who revisited the ED within 30 d and investigated whether ACS was diagnosed.

Result: The revisit rate was higher in the elderly (12%) than in the adult group (8.3%). The rate of undetected ACS among the revisited patients was 2.91% (18/7,186) in adults and 6.08% (16/1,998) in elderly patients.

Conclusion: Elderly patients with chest pain had an increased rate of ED revisits and undetected ACS than adult patients. We recommend that old patients should be hospitalized to observe the progression of cardiac complaints or receive short-term follow-up.
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http://dx.doi.org/10.1155/2021/6611051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068555PMC
April 2021

Mucosal resurfacing of the suprastructure maxillectomy cavity using nasal cavity mucosa flaps.

Oral Oncol 2021 Apr 25:105289. Epub 2021 Apr 25.

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea. Electronic address:

Objective: We analyzed clinical data of patients in which the suprastructure maxillectomy site was covered with nasal cavity mucosa flaps with or without free mucosa graft from the nasal septum, to determine the usefulness of this procedure.

Patients And Methods: A total of four edentulous patients who had the suprastructure maxillectomy site covered using nasal cavity mucosa flaps with or without free mucosa graft from the nasal septum between 2014 and 2020, were analyzed.

Results: All patients underwent suprastructure maxillectomy using the external approach. There were no major complications resulting from surgical intervention. Radiotherapy (RT) was performed in all patients after surgery. All nasal cavity mucosa flaps survived after RT. There was mild cheek retraction, but to a degree that was cosmetically tolerable in all patients. Local recurrence and distant metastasis to the orbit occurred in one patient. Among four patients, two patients died during follow-up, including one tumor related death and one death from old age.

Conclusion: We demonstrated that the use of nasal cavity mucosal flap to cover the suprastructure maxillectomy cavity was effective in improving the patient's quality of life by minimizing wound problems and facial contour changes such as cheek retraction despite postoperative RT.
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http://dx.doi.org/10.1016/j.oraloncology.2021.105289DOI Listing
April 2021

The utility of predicted values in place of directly measured body composition.

Am J Clin Nutr 2021 Apr 20. Epub 2021 Apr 20.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

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http://dx.doi.org/10.1093/ajcn/nqab127DOI Listing
April 2021

Inferior Turbinate Mucocele.

J Craniofac Surg 2021 Jun;32(4):1638-1640

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea.

Objective: In what follows, it is extremely rare for the inferior turbinate to occur with a mucocele. The authors aim to evaluate the characteristics, clinical features, and treatment outcome of the inferior turbinate mucocele in our hospital.

Patients And Methods: Five patients with radiologically confirmed inferior turbinate mucocele between January 2006 and December 2017 were enrolled in this study.

Results: Out of the 5 patients with inferior turbinate mucocele reviewed, 2 out of the 5 patients had symptoms of nasal obstruction and headache respectively, whereas the other 3 remaining patients were found incidentally by radiological examinations without any nasal symptoms. Four patients were performed the surgery by the transnasal endoscopic marsupialization. One patient had a very small size of an inferior turbinate mucocele and had no symptoms, and in that case the authors decided to do a periodic observation without a surgical intervention. There were no major complications resulting from this surgical intervention, and no recurrence of the inferior turbinate mucocele.

Conclusions: The inferior turbinate mucocele is an extremely rare disease and can be diagnosed accurately by the use of radiologic examinations. The prevailing discipline is that endoscopic marsupialization is the best treatment for the inferior turbinate mucocele, which is known for showing very good results without recurrence of the condition.
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http://dx.doi.org/10.1097/SCS.0000000000007583DOI Listing
June 2021

Endoscopic Surgical Treatment of Maxillary Sinus Organized Hematoma.

J Craniofac Surg 2021 Apr 5. Epub 2021 Apr 5.

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea.

Objective: The purpose of this study was to analyze the clinical characteristics and treatment outcomes of patients who underwent endoscopic surgery for a maxillary sinus organized hematoma during a 15-year period in our hospital.

Methods: The authors analyzed 25 patients who underwent endoscopic surgery for a maxillary sinus organized hematoma from January 2004 to December 2019.

Results: Twenty-five patients with a maxillary sinus organized hematoma underwent endoscopic surgical treatment and complete removal of the maxillary sinus organized hematoma was achieved in all cases. The main symptoms were nasal bleeding in 14 patients, followed by a nasal obstruction in nine, and facial swelling in 2. Of the 25 patients, 13 underwent endoscopic medial maxillectomy and 12 underwent endoscopic sinus surgery. There were no major surgical complications or recurrences.

Conclusion: The authors demonstrated that endoscopic surgery is a safe and reliable treatment method for a maxillary sinus organized hematoma.
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http://dx.doi.org/10.1097/SCS.0000000000007582DOI Listing
April 2021

Simple Sugar and Sugar-Sweetened Beverage Intake During Adolescence and Risk of Colorectal Cancer Precursors.

Gastroenterology 2021 Mar 19. Epub 2021 Mar 19.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Background & Aims: Recent increasing trends in early-onset colorectal cancer (CRC) strongly supports that early-life diet is involved in CRC development. However, data are lacking on the relationship with high sugar intake during early life.

Methods: We prospectively investigated the association of adolescent simple sugar (fructose, glucose, added sugar, total sugar) and sugar-sweetened beverage (SSB) intake with CRC precursor risk in 33,106 participants of the Nurses' Health Study II who provided adolescent dietary information in 1998 and subsequently underwent lower gastrointestinal endoscopy between 1999 and 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression for clustered data.

Results: During follow-up, 2909 conventional adenomas (758 high-risk) and 2355 serrated lesions were identified (mean age at diagnoses, 52.2 ± 4.3 years). High sugar and SSB intake during adolescence was positively associated with risk of adenoma, but not serrated lesions. Per each increment of 5% of calories from total fructose intake, multivariable ORs were 1.17 (95% CI, 1.05-1.31) for total and 1.30 (95% CI, 1.06-1.60) for high-risk adenoma. By subsite, ORs were 1.12 (95% CI, 0.96-1.30) for proximal, 1.24 (95% CI, 1.05-1.47) for distal, and 1.43 (95% CI, 1.10-1.86) for rectal adenoma. Per 1 serving/day increment in SSB intake, ORs were 1.11 (95% CI, 1.02-1.20) for total and 1.30 (95% CI, 1.08-1.55) for rectal adenoma. Contrary to adolescent intake, sugar and SSB intake during adulthood was not associated with adenoma risk.

Conclusions: High intake of simple sugars and SSBs during adolescence was associated with increased risk of conventional adenoma, especially rectal adenoma.
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http://dx.doi.org/10.1053/j.gastro.2021.03.028DOI Listing
March 2021

Amide Proton Transfer-weighted 7-T MRI Contrast of Myelination after Cuprizone Administration.

Radiology 2021 May 16;299(2):428-434. Epub 2021 Mar 16.

From the Departments of Radiology (D.W.L., J.K.K.) and Convergence Medicine (H.H., D.C.W.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Convergence Medicine Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.); and Department of Radiation Convergence Engineering, Yonsei University, Baekwun Hall 1, Room 417, Yonseidae-gil, Wonju 26493, Republic of Korea (D.H.L.).

Background Investigations of amide proton signal changes in the white matter of demyelinating diseases may provide important biophysical information for diagnostic and prognostic assessments. Purpose To evaluate amide proton signals in cuprizone-induced rats using amide proton transfer-weighted (APT) MRI, which provides in vivo image contrast by changing amide proton concentrations during demyelination (DEM) and subsequent remyelination (REM). Materials and Methods In this animal study, APT 7-T MRI was performed in 21 male Wistar rats divided into cuprizone-induced ( = 14) and control ( = 7) groups from February to August 2020. The cuprizone-induced group was further subdivided into DEM ( = 7) and REM ( = 7) groups. Seven weeks after cuprizone feeding, rats in the DEM group were killed prior to transmission electron microscopy and myelin staining, while rats in the REM group were changed to a normal chow diet and fed for 5 weeks. In each group, the APT signals were calculated using a conventional magnetization transfer ratio at 3.5 ppm based on regions of interest in the corpus callosum. Statistical differences in APT signals among the groups were analyzed with one-way analysis of variance followed by Tukey post hoc tests. Results The mean APT signals in the control and DEM groups were -4.42% ± 0.60 (standard deviation) (95% CI: -4.98, -3.86) and -2.57% ± 0.48 (95% CI: -3.01, -2.12), respectively, indicating higher in vivo APT signals in the DEM lesion ( < .001). After REM, mean APT signal in the REM group was -3.83% ± 0.67 (95% CI: -4.45, -3.22), similar to that in the control group ( = .18) and lower than that in the DEM group ( < .001). Conclusion Significant amide proton transfer-weighted (APT) metric changes coupled with the histologic characteristics of the demyelination and remyelination processes indicate the potential usefulness of APT 7-T MRI to monitor earlier myelination processes. © RSNA, 2021 See also the editorial by van Zijl in this issue.
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http://dx.doi.org/10.1148/radiol.2021203766DOI Listing
May 2021

Preliminary Experience of Neuroform Atlas Stenting as a Rescue Treatment after Failure of Mechanical Thrombectomy Caused by Residual Intracranial Atherosclerotic Stenosis.

J Korean Neurosurg Soc 2021 Mar 26;64(2):198-206. Epub 2021 Feb 26.

Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Objective: The low-profile Neuroform Atlas stent can be deployed directly without an exchange maneuver by navigating into the Gateway balloon. This retrospective study assessed the safety and efficacy of Neuroform Atlas stenting as a rescue treatment after failure of mechanical thrombetomy (MT) for large artery occlusion.

Methods: Between June 2018 and December 2019, a total of 31 patients underwent Neuroform Atlas stenting with prior Gateway balloon angioplasty after failure of conventional MT caused by residual intracranial atherosclerotic stenosis (ICAS). Primary outcomes were successful recanalization and patency of the vessel 24 hours after intervention. Secondary outcomes were vessel patency after 14 days and 3-month modified Rankin Scale. Peri-procedural complications, intracerebral hemorrhage (ICH), and 3-month mortality were reviewed.

Results: With a 100% of successful recanalization, median value of stenosis was reduced from 79.0% to 23.5%. Twenty-eight patients (90.3%) showed tolerable vessel patency after 14 days. New infarctions occurred in three patients (9.7%) over a period of 14 days; two patient (6.5%) underwent stent occlusion at 24 hours, and the other patient (3.2%) with delayed stent occlusion had a non-symptomatic dot infarct. There were no peri-procedural complications. Two patients (6.5%) developed an ICH immediately after the procedure with one of them is symptomatic.

Conclusion: Neuroform Atlas stenting seems to be an effective and safe rescue treatment modality for failed MT with residual ICAS, by its high successful recanalization rate with tolerable patency, and low peri-procedural complication rate. Further multicenter and randomized controlled trials are needed to confirm our findings.
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http://dx.doi.org/10.3340/jkns.2020.0146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969043PMC
March 2021

A comparison of the gut microbiota among adult patients with drug-responsive and drug-resistant epilepsy: An exploratory study.

Epilepsy Res 2021 May 8;172:106601. Epub 2021 Mar 8.

Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Approximately one-third of epilepsy patients suffer from drug-resistant epilepsy. The gut microbiome, which is the total genetic makeup of all of the total microbes inhabiting the gut, can affect the CNS through various mechanisms. However, there are only limited studies about the relationship between the gut microbiome and epilepsy. We investigated the composition and characteristics of the gut microbiota among adult patients who have drug-responsive and drug-resistant epilepsy.

Methods: We prospectively included 44 adult epilepsy patients and classified them into drug-responsive and drug-resistant groups. We collected fecal samples for the next-generation sequencing analysis. We statistically estimated the bacterial differences and alpha and beta diversities in each category.

Results: Although there was no difference in demographic factors between the drug-responsive and drug-resistant groups, there was a significant difference in the composition of the gut microbiota. While the relative abundance of Bacteroides finegoldii and Ruminococcus_g2 increased in the drug-responsive group, the relative abundance of Negativicutes, which belong to Firmicutes increased in the drug-resistant group. Bifidobacterium was relatively abundant in epilepsy patients with a normal electroencephalogram. There was no significant difference between the two groups in analyses of alpha and beta diversities.

Conclusions: We found a significant difference in the composition of the gut microbiota among adult patients with drug-responsive and drug-resistant epilepsy. Difference in gut microbiota can be used as a novel biomarker to predict prognosis and evaluate treatment response in epilepsy patients. In addition, modification of gut microbiome can be an effective treatment strategy for patient with drug-resistant epilepsy.
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http://dx.doi.org/10.1016/j.eplepsyres.2021.106601DOI Listing
May 2021

Retreatment of Chronic Hepatitis C Failed to Daclatasvir Plus Asunaprevir by Other Direct-acting Antivirals.

Korean J Gastroenterol 2021 02;77(2):88-91

Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

The pegylated interferon plus ribavirin combination therapy has been used as the primary treatment for chronic hepatitis C (CHC) but fails to produce a sustained viral response (SVR) in many patients. In recent years, the treatment of CHC has been rapidly changing because of the introduction of direct-acting antivirals (DAAs), which have a high cure rate. However, retreatment of patients after failure of the first DAA therapy is difficult. We report two rare cases of CHC that showed acquired SVR with other DAA combinations after failure to daclatasvir and asunaprevir.
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http://dx.doi.org/10.4166/kjg.2020.145DOI Listing
February 2021

Association between HbA1C (glycated hemoglobin) and clinical outcomes in patients with subarachnoid hemorrhage after neuro-intervention.

Curr Neurovasc Res 2021 Feb 24. Epub 2021 Feb 24.

Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul. Korea.

Objective: Our study investigated the association between level of HbA1c (glycated hemoglobin) at admission and the prognosis of aneurysmal subarachnoid hemorrhage (SAH).

Methods: A total of 510 patients treated with neuro-intervention for aneurysmal SAH and with data for admission HbA1c (glycated hemoglobin) were included. Favorable clinical outcome was defined as Modified Rankin Scale (mRS) score of 0-2 at 3 months. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value of HbA1C for unfavorable clinical outcomes. Logistic regression was used to evaluate the association between HbA1C level and outcomes.

Results: The optimal cutoff value of HbA1C was identified as 6.0% (P < 0.001), and patients with a high HbA1C (≥ 6.0%) had a lower prevalence of favorable clinical outcomes than patients with low HbA1C (< 6.0%) (P < 0.001). High HbA1C (≥ 6.0%) was independently associated with unfavorable clinical outcome (OR 2.84; 95% CI: 1.52-5.44; P = 0.004). The risk of unfavorable clinical outcome was significantly increased in patients with HbA1C (≥ 7.0%, < 8%) and HbA1C (≥ 8.0%) compared with lower baseline HbA1C (≥ 6.0%, < 7%) values (OR 2.17; 95% CI: 1.87-5.13; P = 0.011 and OR 4.25; 95% CI: 3.17-8.41; P = 0.005).

Conclusions: Our study showed that HbA1C could be an independent predictor of worse outcome following neuro-intervention for aneurysmal SAH. High HbA1C (≥ 6.0%) was associated with unfavorable clinical outcome, and gradual elevation of HbA1C contributed to an increase in the risk of worse clinical outcome after SAH.
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http://dx.doi.org/10.2174/1567202618666210225103057DOI Listing
February 2021

Effect on successful recanalization of thrombus length in susceptibility-weighted imaging in mechanical thrombectomy with stent-retrieval.

Curr Neurovasc Res 2021 Feb 24. Epub 2021 Feb 24.

Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea. Korea.

Introduction: Susceptibility-weighted imaging (SWI) enables visualization of thrombotic material in acute ischemic stroke. We analyzed the association between thrombus length on SWI and the success rate of recanalization in stent-retriever mechanical thrombectomy.

Materials And Methods: A retrospective study was performed on 128 patients with middle cerebral artery (MCA) thrombus on pretreatment SWI. The patients were divided into 2 groups, the successful recanalization and the failed recanalization group. Thrombus visibility and location on SWI were compared to those on maximum intensity projection (MIP) in computed tomography (CT) angiography. A comparative analysis was performed in terms of clinical and radiologic outcomes as well as complications with respect to multiple categories.

Results: No significant differences were noted in terms of baseline characteristics and clinical outcomes between the 2 groups. However, compared with the successful recanalization group, the failed recanalization group had a larger number of stent-retriever passages and a longer thrombus length (p = 0.027 and 0.014, respectively). Multivariate analyses revealed that a larger mean number of stent-retriever passages was a predictive factor for failure of recanalization (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.12 - 2.08; p = 0.04). Thrombus length (OR 9.91; 95% CI 3.89-13.87; p < 0.001) and atrial fibrillation (OR 5.38; 95% CI 1.51 - 9.58; p = 0.008) were separately associated with more than 3 stent-retriever passages.

Conclusions: Thrombus length has been identified as a predictor of recanalization failure in mechanical thrombectomy. A significant decline in the success rate of recanalization was associated with longer thrombus length.
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http://dx.doi.org/10.2174/1567202618666210225102029DOI Listing
February 2021

The Significance of Extra-Cage Bridging Bone via Radiographic Lumbar Interbody Fusion Criterion.

Global Spine J 2021 Feb 18:2192568221993097. Epub 2021 Feb 18.

Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea.

Study Design: Prospective observational study.

Objectives: We aimed to analysis the distributional patterns of the intra- and extra-cage bridging bone (InCBB and ExCBB) and the significance of ExCBB using suggested lumbar interbody fusion criterion.

Methods: This study included the patients with planned single-level transforaminal lumbar interbody fusion. We divided bridging bone into InCBB (in void of right or left cage) and ExCBB (outside of cages; anterior, posterior, intermediate, right, or left) and graded bridging scores from 0 to 2 on postoperative 1-year computed tomography. The fusion was defined as at least having one or more graded 2 and the evaluation were conducted twice by 2 raters.

Results: Sixty-five patients were enrolled. All values of intra- and inter-rater reliability in left InCBB, anterior, and posterior ExCBB showed good agreements (≥0.75). Both InCBBs showed similar mean bridging scores (Rt:1.43 vs Lt:1.48), and in ExCBBs, the anterior was the highest (1.43), followed by the posterior (1.14); the right and left were the lowest (0.49 and 0.52 respectively). In subjects determined as fusion (85.4%), complete bridging was observed more in ExCBB (88.8%) than in InCBB (69.9%).

Conclusions: Given the higher bridging scores in both InCBBs and Ant. ExCBB, bone grafting is important promoting factor to increase the interbody bridging bone regardless of outside or in void of cages. Based on our suggested criterion, ExCBB has a greater proportion compared to InCBBs for determining the fusion and extra-cage bone grafting should be considered as important procedures for interbody fusion.
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http://dx.doi.org/10.1177/2192568221993097DOI Listing
February 2021

HDAC6-selective inhibitors enhance anticancer effects of paclitaxel in ovarian cancer cells.

Oncol Lett 2021 Mar 12;21(3):201. Epub 2021 Jan 12.

Department of Pharmacy, College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon 21983, Republic of Korea.

Histone deacetylase 6 (HDAC6)-selective inhibitors are potent anticancer agents that are gaining increasing attention and undergoing various developments. These have been approved or are under clinical trials for use with other anticancer agents, such as pomalidomide, anti-programmed death-ligand 1 antibody and paclitaxel, for various types of cancer, including solid tumors. In the present study, a second generation HDAC6-selective inhibitor, ACY-241 (citarinostat), and a novel inhibitor, A452, exhibited synergistic anticancer effects with paclitaxel in AT-rich interaction domain 1A-mutated ovarian cancer . Co-treatment of paclitaxel and the two HDAC6 inhibitors synergistically decreased cell growth and viability of TOV-21G. Furthermore, the protein expression levels of pro-apoptotic markers, such as poly(ADP-ribose) polymerase, cleaved caspase-3, Bak and Bax, were increased, whereas the expression levels of anti-apoptotic markers, such as Bcl-xL and Bcl-2, were decreased synergistically. Treatment with all drug combinations increased the portion of apoptotic cells in fluorescence-activated cell sorting analysis. These results demonstrated synergy between paclitaxel and HDAC6-selective inhibitors, providing further impetus for clinical trials of combination therapy using HDAC6-selective inhibitors, not only in ovarian cancer but also in other tumors.
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http://dx.doi.org/10.3892/ol.2021.12462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816281PMC
March 2021

HDAC6-Selective Inhibitor Overcomes Bortezomib Resistance in Multiple Myeloma.

Int J Mol Sci 2021 Jan 29;22(3). Epub 2021 Jan 29.

College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon 21983, Korea.

Although multiple myeloma (MM) patients benefit from standard bortezomib (BTZ) chemotherapy, they develop drug resistance, resulting in relapse. We investigated whether histone deacetylase 6 (HDAC6) inhibitor A452 overcomes bortezomib resistance in MM. We show that HDAC6-selective inhibitor A452 significantly decreases the activation of BTZ-resistant markers, such as extracellular signal-regulated kinases (ERK) and nuclear factor kappa B (NF-κB), in acquired BTZ-resistant MM cells. Combination treatment of A452 and BTZ or carfilzomib (CFZ) synergistically reduces BTZ-resistant markers. Additionally, A452 synergizes with BTZ or CFZ to inhibit the activation of NF-κB and signal transducer and activator of transcription 3 (STAT3), resulting in decreased expressions of low-molecular-mass polypeptide 2 (LMP2) and LMP7. Furthermore, combining A452 with BTZ or CFZ leads to synergistic cancer cell growth inhibition, viability decreases, and apoptosis induction in the BTZ-resistant MM cells. Overall, the synergistic effect of A452 with CFZ is more potent than that of A452 with BTZ in BTZ-resistant U266 cells. Thus, our findings reveal the HDAC6-selective inhibitor as a promising therapy for BTZ-chemoresistant MM.
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http://dx.doi.org/10.3390/ijms22031341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866276PMC
January 2021

Glutamine Synthetase as a Therapeutic Target for Cancer Treatment.

Int J Mol Sci 2021 Feb 8;22(4). Epub 2021 Feb 8.

College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon 21983, Korea.

The significance of glutamine in cancer metabolism has been extensively studied. Cancer cells consume an excessive amount of glutamine to facilitate rapid proliferation. Thus, glutamine depletion occurs in various cancer types, especially in poorly vascularized cancers. This makes glutamine synthetase (GS), the only enzyme responsible for de novo synthesizing glutamine, essential in cancer metabolism. In cancer, GS exhibits pro-tumoral features by synthesizing glutamine, supporting nucleotide synthesis. Furthermore, GS is highly expressed in the tumor microenvironment (TME) and provides glutamine to cancer cells, allowing cancer cells to maintain sufficient glutamine level for glutamine catabolism. Glutamine catabolism, the opposite reaction of glutamine synthesis by GS, is well known for supporting cancer cell proliferation via contributing biosynthesis of various essential molecules and energy production. Either glutamine anabolism or catabolism has a critical function in cancer metabolism depending on the complex nature and microenvironment of cancers. In this review, we focus on the role of GS in a variety of cancer types and microenvironments and highlight the mechanism of GS at the transcriptional and post-translational levels. Lastly, we discuss the therapeutic implications of targeting GS in cancer.
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http://dx.doi.org/10.3390/ijms22041701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915753PMC
February 2021

Negative pressure wound therapy for skin necrosis prevention after snakebite in the emergency department: A retrospective cohort study.

Medicine (Baltimore) 2021 Jan;100(3):e24290

Department of Emergency Medicine, College of Medicine, Chung-Ang University, 47, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea.

Abstract: This retrospective cohort study aimed to compare the effectiveness of conventional treatment and ultra-early application of negative pressure wound therapy (NPWT) in patients with snakebites.Patients who visited the emergency department within 24 hours after a snakebite were assigned to the non- NPWT or NPWT group. Swelling resolution time and rates of necrosis, infection, and operations were compared between the 2 groups. The Stony Brook Scar Evaluation Scale was used to measure short- and long-term wound healing results.Among the included 61 patients, the swelling resolution time was significantly shorter in the NPWT group than in non- NPWT group (P = .010). The NPWT group showed lower necrosis (4.3% versus 36.8%; P = .003) and infection (13.2% and 4.3%; P = .258) rates than the non- NPWT group. The median Stony Brook Scar Evaluation Scale scores were higher in the NPWT group than in the non- NPWT group (P< .001).These findings suggest that ultra-early application of NPWT reduces edema, promotes wound healing, and prevents necrosis in patients with snakebites.
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http://dx.doi.org/10.1097/MD.0000000000024290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837876PMC
January 2021

Treatment Outcomes of Patients with Head and Neck Squamous Cell Carcinoma of Unknown Primary.

Chonnam Med J 2021 Jan 25;57(1):58-61. Epub 2021 Jan 25.

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, Korea.

The purpose of this study was to evaluate clinical characteristics and treatment outcome of patients with head and neck squamous cell carcinoma of unknown primary (HNSCCUP), treated according to the method of our hospital. Six patients with histopathologically and radiologically confirmed HNSCCUP January 2010-December 2016 were enrolled in this study. All patients underwent radical neck dissection involving level I-V, bilateral tonsillectomy, and diagnostic esophagoscopy and postoperative radiotherapy (RT), with or without concurrent chemotherapy. There were no major complications resulting from surgical intervention. Duration of follow-up was 56.3±20.2 months (range, 28-82 months). There was no recurrence or late detection of primary site of HNSCCUP. All patients with HNSCCUP except one were alive, at the time of the last follow-up. The other patient had no recurrence of HNSCCUP, but died of colon cancer at 58 months postoperatively. We have successfully treated patients with HNSCCUP by performing radical neck dissection, bilateral tonsillectomy, and diagnostic esophagoscopy and postoperative RT with concurrent chemotherapy, and recommend using this method as the main treatment method.
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http://dx.doi.org/10.4068/cmj.2021.57.1.58DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840340PMC
January 2021

Association of Inflammatory and Insulinemic Potential of Diet and Lifestyle with Risk of Hepatocellular Carcinoma.

Cancer Epidemiol Biomarkers Prev 2021 Apr 29;30(4):789-796. Epub 2021 Jan 29.

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Background: We prospectively examined the extent to which greater inflammatory and insulinemic potential of diet and lifestyle are associated with the risk of developing hepatocellular carcinoma (HCC) in two nationwide cohorts.

Methods: Five kinds of pattern scores, including the empirical dietary inflammatory pattern (EDIP), empirical dietary index for hyperinsulinemia (EDIH) and insulin resistance (EDIR), empirical lifestyle pattern score for hyperinsulinemia (ELIH) and insulin resistance (ELIR) were calculated. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression.

Results: After an average follow-up of 25.6 years among 119,316 participants, 142 incident HCC cases were documented. Higher adherence to EDIP (HR by comparing extreme tertiles: 2.03; 95% CI, 1.31-3.16; = 0.001), EDIH (HR, 1.61; 95% CI, 1.06-2.43; = 0.02), and EDIR (HR, 1.62; 95% CI: 1.08-2.42; = 0.02) was associated with increased risk of HCC. Likewise, participants with higher scores of ELIH (HR, 1.89; 95% CI, 1.25-2.87; = 0.001) and ELIR (HR, 2.05; 95% CI, 1.34-3.14, = 0.0004) had higher risk of developing HCC. Additional adjustment for diabetes mellitus and/or body mass index attenuated the magnitude of the associations, indicating that diabetes and/or adiposity may partly mediate the association of these patterns with HCC risk.

Conclusions: Our findings suggest that inflammation and insulin resistance/hyperinsulinemia are potential mechanisms linking dietary or lifestyle factors and HCC development.

Impact: Inflammation and insulin resistance/hyperinsulinemia may partly mediate the association of diet and other lifestyles with HCC development, and interventions to reduce the adverse effect of pro-inflammatory and hyperinsulinemic diet and lifestyle may reduce HCC risk.
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http://dx.doi.org/10.1158/1055-9965.EPI-20-1329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026660PMC
April 2021

Time trends of colorectal cancer incidence and associated lifestyle factors in South Korea.

Sci Rep 2021 Jan 28;11(1):2413. Epub 2021 Jan 28.

Department of Food Science and Biotechnology, Dongguk University Graduate School, Gyeonggi, 10325, South Korea.

Worldwide, South Korea had the second highest incidence rates of colorectal cancer (CRC) in 2018. To inform public health policy to prevent CRC, we aimed to identify major modifiable lifestyle factors underlying the alarming increase in CRC incidence. We obtained information on CRC statistics from the Korea National Cancer Incidence Database and on the distribution of dietary and lifestyle factors known to modify CRC risk from the Korea National Health and Nutrition Examination Survey. To examine time trends between 2001 and 2013, we calculated annual percent changes of CRC incidence rates and of prevalence of etiologic factors by sex and age. Across all sex and age groups, the most commonly diagnosed cancer was rectal cancer while the most rapidly increasing cancer was distal colon cancer. For the lifestyle factors examined, decreases in exercise were observed across all age groups of both sexes. Yet, obesity and alcoholic drinks appear more relevant CRC contributor to men, smoking to women aged 30-49 years, and processed meat intake to adults aged 30-49 years. The heterogeneous results suggest that dietary and lifestyle target to prevent CRC be tailored by sex and age.
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http://dx.doi.org/10.1038/s41598-021-81877-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844005PMC
January 2021