Purpose: Triple-negative breast cancer (TNBC) is a particularly aggressive subtype of breast cancer, with approximately 30% of patients eventually developing brain metastases (BM), which result in poor outcomes. An understanding of the tumor microenvironment (TME) at both primary and metastatic sites offers insights into the mechanisms underlying BM and potential therapeutic targets. Materials and Methods: Spatial RNA sequencing (spRNA-seq) was performed on primary TNBC and paired BM tissues from three patients, one of whom had previously received immune checkpoint inhibitors before BM diagnosis. Specimen regions were categorized into tumor, proximal, and distal TME based on their spatial locations. Gene expression differences across these zones were analyzed, and immune cell infiltration was estimated using TIMER. A gene module analysis was conducted to identify key gene clusters associated with BM. Results: Distinct gene expression profiles were noted in the proximal and distal TMEs. In BM, the proximal TME exhibited neuronal gene expression, suggesting neuron-tumor interactions compared to tumor, and upregulation of epithelial genes compared to the distal TME. Immune cell analysis revealed dynamic changes in CD8+ T cells and macrophages across the tumor and TME zones. Gene module analysis identified five key modules, including one related to glycolysis, which correlated with patient survival. Drug repurposing analysis identified potential therapeutic targets, including VEGFA, RAC1, EGLN3, and CAMK1D. Conclusion This study provides novel insights into the transcriptional landscapes in TNBC BM using spRNA-seq, emphasizing the role of neuron-tumor interactions and immune dynamics. These findings suggest new therapeutic strategies and underscore the importance of further research.

Purpose: Benign prostatic hyperplasia (BPH) is a major disease that causes lower urinary tract symptoms (LUTS) such as abdominal pressure, urgency, residual urine, weak urination, and delayed urination in elderly men. We attempted to identify risk factors for the development of BPH-LUTS, including particulate matter (PM). Materials and Methods: We utilized customized research database of the National Health Insurance Corporation. A total of 2,200,546 subjects were included, consisting of BPH-LUTS (n=601,291) and non–BPH-LUTS (n=1,599,255). We classified the PM10 exposure level based on median PM10 value (56.3 μg/m3 ). We assessed using multivariate Cox proportional hazard regression analysis to find an association of incidence of BPH-LUTS and PM10 exposure. Results: PM10 exposure is a risk factor to develop BPH-LUTS. All subgroups were vulnerable to even moderate PM10 exposure: age, waist circumference, body mass index, smoking, alcohol consumption, physical activity, dyslipidemia, diabetes, and high blood pressure. The hazard ratio was from 1.019 (60s group) to 1.097 (exercise 3 or more times a week). Interestingly, when total cholesterol levels or fasting blood sugar or high blood pressure were normal, the risk of BPH was higher in those with high PM10 compared to those with low PM10 . Even if those who exercise more than three times a week, high PM10 exposure may increase their risk of BPH. Conclusions This study is significant that, based on Korean standards, even normal PM10 exposure is a risk factor for the development of BPH-LUTS. This study provides a basis for establishing health policies related to exposure to PM.

Purpose: This study aimed to explore the trends in research keywords and topics in the field of urology based on text mining over the recent decades. The investigation looked into changes in frequent subject keywords and the trends in prevailing research topics, as reflected in representative urology journals over recent decades. Materials and Methods: A total of 27,129 bibliographic documents were collected from four urology journals, including European Urology, Journal of Urology, BJU International, and World Journal of Urology. The study then examined the changes in the most frequent author keywords over the decades. Moreover, structured topic modeling was employed to identify twenty prevailing research topics in urology and to examine their trends across different periods. Results: The study observed consistently increasing patterns in author keywords and topics related to the prostate and oncology.Conversely, research fields such as pediatrics, male infertility, voiding dysfunction, and cancer biology exhibited a downward trend in urology. Potential factors or reasons underlying these trends were further discussed in this study. Conclusions This exploratory study uncovered major research topics in the discipline of urology. The findings of this study depict the domain of urology research in recent decades, providing insights for both researchers and clinicians seeking to better understand the research trends in the discipline.

Background: This study investigates the association between serum iron levels and frequency-specific hearing loss in Korean female population, a topic previously unexplored in auditory health research. Methods: This study enrolled Korean female participants from the general population. Serum iron levels and hearing thresholds at low (1 kHz) and high (4 kHz) frequencies were assessed, adjusting for potential confounders. Participants were stratified into quartiles based on serum iron levels. Results: The mean age of the study population was 51.1 ± 10.1 years. Among the 2,987 participants, 344 (11.5%) had abnormal low-frequency hearing thresholds, and 719 (24.1%) had abnormal high-frequency thresholds. Multiple linear regression analysis demonstrated a significant negative association between serum iron levels and low-frequency hearing thresholds (β = –0.012, p = 0.017), whereas no significant association was observed with high-frequency thresholds (β = –0.006, p = 0.352). In a stratified analysis using 50 years (the average menopausal age) as a cutoff, no statistically significant association was identified in participants younger than 50 years. However, in those aged 50 years and older, the negative association between serum iron levels and low-frequency hearing thresholds remained statistically significant. Conclusions This study is the first to identify an association between serum iron levels and low-frequency hearing loss in females aged 50 years and older, underscoring the potential role of iron in auditory function. These findings highlight the importance of further research in diverse populations to elucidate the underlying mechanisms and broader clinical implications.

Background: The life expectancy of people living with human immunodeficiency virus (PLWH) has significantly improved with advancements in antiretroviral therapy (ART). However, aging PLWH face a growing burden of noncommunicable diseases (NCDs), polypharmacy, and drug-drug interactions (DDIs), which pose challenges in their management. This study investigates the prevalence of NCDs, polypharmacy, and DDIs among PLWH aged ≥50 years in Korea and their impact on quality of life (QOL). Materials and Methods: A cross-sectional study was conducted among 243 PLWH aged ≥50 years receiving ART for at least three months at three university hospitals in Korea between January and July 2022. Data were collected through electronic medical records and personal interviews, assessing demographics, comorbidities, polypharmacy, ART adherence, and QOL using the Korean version of WHOQOL-HIV BREF scale. Potential DDIs were analyzed using the University of Liverpool HIV Drug Interaction Database, and potentially inappropriate medications (PIMs) were identified using the 2023 American Geriatrics Society Beers Criteria. We classified participants into three age groups:50–<65 years, 65–<75 years, and ≥75 years. Results: The prevalence of comorbidities was 71.6%, with older participants (≥75 years) showing a significantly higher burden, including bone diseases, osteoarthritis, and dementia (P<0.001). Polypharmacy was observed in 28.4% of participants and increased with age, with 53.3% of those aged ≥75 years taking ≥10 pills daily.Polypharmacy was associated with poorer QOL (71.6 vs. 76.6, P=0.010). Amber-flag DDIs were found in 81 participants (33.3%), most commonly involving metformin and divalent cations. No red-flag DDIs were identified.PIMs were observed in 6.6% of participants aged ≥65 years. Conclusion Aging PLWH in Korea face significant challenges from comorbidities, polypharmacy, and DDIs, which negatively impact QOL. Integrated, age-specific, and multidisciplinary care strategies are urgently needed to improve outcomes and ensure the well-being of older PLWH.

Background: Among gliomas, the most common primary malignant brain tumor, incidental gliomasaccount for 2.5%–5% of cases. The controversy over whether to pursue immediate treatment or adopt a wait-and-see approach remains, and more molecular and immunological evidence is needed for definitive treatment decisions. Methods: Total RNA sequencing (RNA-seq) data and single cell RNA sequencing (scRNA-seq)data were retrospectively analyzed to compare the molecular and immunological tumor microenvironment differences between incidental glioma and symptomatic glioma samples. These were classified using symptom data from The Cancer Genome Atlas (TCGA) and public dataset. Results: RNA-seq analysis of the GBMLGG dataset identified 343 genes upregulated in symp-tomatic glioma and 118 in incidental glioma, with 104 common genes upregulated in symptomatic glioma across both the TCGA and Chinese Glioma Genome Atlas (CGGA) datasets. Enrichment analysis revealed that these 104 genes in symptomatic glioma were significantly associated with immunological pathways. scRNA-seq analysis of glioma revealed 11 cell types, including T cells, myeloid cells, and oligodendrocytes, with the tumor necrosis factor (TNF) signaling pathway strongly influencing other cell types, particularly myeloid cells. Enrichment and survival analyses showed that TNF signaling is associated with temozolomide resistance and poorer prognosis in glioma patients. Conclusion The findings suggest that symptomatic glioma enhances inflammatory responseslinked to poor prognosis and chemoresistance. This supports the hypothesis that immediate treatment of incidental glioma may improve patient outcomes over a wait-and-see approach.

Background: The life expectancy of people living with human immunodeficiency virus (PLWH) has significantly improved with advancements in antiretroviral therapy (ART). However, aging PLWH face a growing burden of noncommunicable diseases (NCDs), polypharmacy, and drug-drug interactions (DDIs), which pose challenges in their management. This study investigates the prevalence of NCDs, polypharmacy, and DDIs among PLWH aged ≥50 years in Korea and their impact on quality of life (QOL). Materials and Methods: A cross-sectional study was conducted among 243 PLWH aged ≥50 years receiving ART for at least three months at three university hospitals in Korea between January and July 2022. Data were collected through electronic medical records and personal interviews, assessing demographics, comorbidities, polypharmacy, ART adherence, and QOL using the Korean version of WHOQOL-HIV BREF scale. Potential DDIs were analyzed using the University of Liverpool HIV Drug Interaction Database, and potentially inappropriate medications (PIMs) were identified using the 2023 American Geriatrics Society Beers Criteria. We classified participants into three age groups:50–<65 years, 65–<75 years, and ≥75 years. Results: The prevalence of comorbidities was 71.6%, with older participants (≥75 years) showing a significantly higher burden, including bone diseases, osteoarthritis, and dementia (P<0.001). Polypharmacy was observed in 28.4% of participants and increased with age, with 53.3% of those aged ≥75 years taking ≥10 pills daily.Polypharmacy was associated with poorer QOL (71.6 vs. 76.6, P=0.010). Amber-flag DDIs were found in 81 participants (33.3%), most commonly involving metformin and divalent cations. No red-flag DDIs were identified.PIMs were observed in 6.6% of participants aged ≥65 years. Conclusion Aging PLWH in Korea face significant challenges from comorbidities, polypharmacy, and DDIs, which negatively impact QOL. Integrated, age-specific, and multidisciplinary care strategies are urgently needed to improve outcomes and ensure the well-being of older PLWH.