Background: Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods: This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results: Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.

Purpose: Prostate cancer ranks as the second most common cancer in men globally, representing a significant cause of cancer-related mortality. Metastasis, the spread of cancer cells from the primary site to distant organs, remains a major challenge in managing prostate cancer. Pyruvate dehydrogenase kinase 4 (PDK4) is implicated in the regulation of aerobic glycolysis, emerging as a potential player in various cancers. However, its role in prostate cancer remains unclear. This study aims to analyze PDK4 expression in prostate cancer cells and human samples, and to explore the gene's clinical significance. Materials and Methods: PDK4 expression was detected in cell lines and human tissue samples. Migration ability was analyzed using Matrigel-coated invasion chambers. Human samples were obtained from the Kyungpook National University Chilgok Hospital. Results: PDK4 expression was elevated in prostate cancer cell lines compared to normal prostate cells, with particularly high levels in DU145 and LnCap cell lines. PDK4 knockdown in these cell lines suppressed their invasion ability, indicating a potential role of PDK4 in prostate cancer metastasis. Furthermore, our results revealed alterations in epithelial-mesenchymal transition markers and downstream signaling molecules following PDK4 suppression, suggesting its involvement in the modulation of invasion-related pathways. Furthermore, PDK4 expression was increased in prostate cancer tissues, especially in castration-resistant prostate cancer, compared to normal prostate tissues, with PSA and PDK4 expression showing a significantly positive correlation. Conclusions PDK4 expression in prostate cancer is associated with tumor invasion and castration status. Further validation is needed to demonstrate its effectiveness as a therapeutic target.

Background: Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods: This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results: Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.

Background: Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods: This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results: Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.

Background: Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods: This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results: Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.

Purpose: This study examined the effects of residual fragments (RF) on the patient-reported quality of life (QOL) after kidney stone surgery, such as retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using the Korean version of the Wisconsin Stone Quality of Life Questionnaire (K-WISQOL). Materials and Methods: The medical records of 156 patients who underwent RIRS or PCNL and completed the preoperative and postoperative K-WISQOL from January 2021 to September 2023 were analyzed retrospectively. The patients were divided into RIRS and PCNL groups by the surgical method. The participants completed the K-WISQOL within four weeks before and after treatment. The patients’ baseline characteristics, surgical outcomes, and K-WISQOL scores were compared according to the presence of RF in each surgical group. Results: Of the 156 patients, 95 underwent RIRS, and 61 underwent PCNL. In the RIRS group, the patients’ baseline characteristics and surgical outcomes were similar in the stone-free (SF) and RF subgroups. The changes in all K-WISQOL domain scores and total scores were similar in the two subgroups. In the PCNL group, the RF subgroup had a significantly higher proportion of staghorn stones, a significantly larger mean stone diameter and significantly longer operation time than those of the SF subgroup. But, the changes in all K-WISQOL domain scores and total scores were not significantly different between the two subgroups, as observed in the RIRS group. Conclusions This study showed that the presence of RFs after endoscopic kidney surgery did not affect the short-term patient-reported QOL regardless of the surgical methods.

Purpose: This study examined the effects of residual fragments (RF) on the patient-reported quality of life (QOL) after kidney stone surgery, such as retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using the Korean version of the Wisconsin Stone Quality of Life Questionnaire (K-WISQOL). Materials and Methods: The medical records of 156 patients who underwent RIRS or PCNL and completed the preoperative and postoperative K-WISQOL from January 2021 to September 2023 were analyzed retrospectively. The patients were divided into RIRS and PCNL groups by the surgical method. The participants completed the K-WISQOL within four weeks before and after treatment. The patients’ baseline characteristics, surgical outcomes, and K-WISQOL scores were compared according to the presence of RF in each surgical group. Results: Of the 156 patients, 95 underwent RIRS, and 61 underwent PCNL. In the RIRS group, the patients’ baseline characteristics and surgical outcomes were similar in the stone-free (SF) and RF subgroups. The changes in all K-WISQOL domain scores and total scores were similar in the two subgroups. In the PCNL group, the RF subgroup had a significantly higher proportion of staghorn stones, a significantly larger mean stone diameter and significantly longer operation time than those of the SF subgroup. But, the changes in all K-WISQOL domain scores and total scores were not significantly different between the two subgroups, as observed in the RIRS group. Conclusions This study showed that the presence of RFs after endoscopic kidney surgery did not affect the short-term patient-reported QOL regardless of the surgical methods.

Purpose: This study examined the effects of residual fragments (RF) on the patient-reported quality of life (QOL) after kidney stone surgery, such as retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using the Korean version of the Wisconsin Stone Quality of Life Questionnaire (K-WISQOL). Materials and Methods: The medical records of 156 patients who underwent RIRS or PCNL and completed the preoperative and postoperative K-WISQOL from January 2021 to September 2023 were analyzed retrospectively. The patients were divided into RIRS and PCNL groups by the surgical method. The participants completed the K-WISQOL within four weeks before and after treatment. The patients’ baseline characteristics, surgical outcomes, and K-WISQOL scores were compared according to the presence of RF in each surgical group. Results: Of the 156 patients, 95 underwent RIRS, and 61 underwent PCNL. In the RIRS group, the patients’ baseline characteristics and surgical outcomes were similar in the stone-free (SF) and RF subgroups. The changes in all K-WISQOL domain scores and total scores were similar in the two subgroups. In the PCNL group, the RF subgroup had a significantly higher proportion of staghorn stones, a significantly larger mean stone diameter and significantly longer operation time than those of the SF subgroup. But, the changes in all K-WISQOL domain scores and total scores were not significantly different between the two subgroups, as observed in the RIRS group. Conclusions This study showed that the presence of RFs after endoscopic kidney surgery did not affect the short-term patient-reported QOL regardless of the surgical methods.

Purpose: Oligoprogressive lesions are observed in a subset of patients who progress to castration-resistant prostate cancer (CRPC), while other lesions remain controlled by systemic therapy. This study evaluates the impact of progression-directed therapy (PDT) on these oligoprogressive lesions. Materials and Methods: This retrospective study included 40 patients diagnosed with oligoprogressive CRPC. PDT was performed for treating all progressive sites using radiotherapy. Fifteen patients received PDT using radiotherapy for all progressive sites (PDT group) while 25 had additional first-line systemic treatments (non-PDT group). In PDT group, 7 patients underwent PDT and unchanged systemic therapy (PDT-A group) and 8 patients underwent PDT with additional new line of systemic therapy on CRPC (PDT-B group). The Kaplan–Meier method was used to assess treatment outcomes. Results: The prostate specific antigen (PSA) nadir was significantly lower in PDT group compare to non-PDT group (p=0.007). A 50% PSA decline and complete PSA decline were observed in 13 patients (86.7%) and 10 patients (66.7%) of PDT group and in 18 patients (72.0%) and 11 patients (44.0%) of non-PDT group, respectively. The PSA-progression free survival of PDT-B group was significantly longer than non-PDT group. The median time to failure of first-line systemic therapy on CRPC was 30.2 months in patients in PDT group and 14.9 months in non-PDT group (p=0.014). PDT-B group showed a significantly longer time to progression than non-PDT group (p=0.025). Minimal PDT-related adverse events were observed. Conclusions PDT can delay progression of disease and enhance treatment efficacy with acceptable tolerability in oligoprogressive CRPC.

Purpose: This study examined the effects of residual fragments (RF) on the patient-reported quality of life (QOL) after kidney stone surgery, such as retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using the Korean version of the Wisconsin Stone Quality of Life Questionnaire (K-WISQOL). Materials and Methods: The medical records of 156 patients who underwent RIRS or PCNL and completed the preoperative and postoperative K-WISQOL from January 2021 to September 2023 were analyzed retrospectively. The patients were divided into RIRS and PCNL groups by the surgical method. The participants completed the K-WISQOL within four weeks before and after treatment. The patients’ baseline characteristics, surgical outcomes, and K-WISQOL scores were compared according to the presence of RF in each surgical group. Results: Of the 156 patients, 95 underwent RIRS, and 61 underwent PCNL. In the RIRS group, the patients’ baseline characteristics and surgical outcomes were similar in the stone-free (SF) and RF subgroups. The changes in all K-WISQOL domain scores and total scores were similar in the two subgroups. In the PCNL group, the RF subgroup had a significantly higher proportion of staghorn stones, a significantly larger mean stone diameter and significantly longer operation time than those of the SF subgroup. But, the changes in all K-WISQOL domain scores and total scores were not significantly different between the two subgroups, as observed in the RIRS group. Conclusions This study showed that the presence of RFs after endoscopic kidney surgery did not affect the short-term patient-reported QOL regardless of the surgical methods.