BACKGROUND: The catalytic subunit of telomerase, hTERT (telomerase reverse transcriptase), is one of the most important components of telomerase, and performs a pivotal role in the mechanism underlying the regulation of telomerase activity in cellular immortalization and carcinogenesis. The principal objective of this study was to investigate hTERT expression in patients with non-small cell lung carcinomas (NSCLCs), and to evaluate its clinical significance and association with the expression of p16 and p53. METHODS: Using tissue microarray, the protein expression profiles of hTERT, p16 and p53 were investigated via immunohistochemistry in 167 samples of NSCLCs. RESULTS: Expression was observed in 54.5% (91/167) of the tumors, which were predominantly squamous cell carcinomas. Patients evidencing hTERT expression in their tumors exhibited significantly poorer survival rates than did patients without hTERT expression in early-stage NSCLCs (p=0.0125). According to the results of our Cox regression analysis, hTERT expression proved to be an independent prognostic factor (p=0.006), particularly for squamous cell carcinomas (p=0.019). hTERT expression was not correlated with p16 expression, but was rather associated with the expression of p53 (p=0.002). CONCLUSIONS: Our results show that hTERT may perform a function in the progression of NSCLC, and that its detection may be useful in predicting the prognosis of NSCLC patients in the early stages of the disease, as well as in the development of a targeted therapy in these tumors.
Carcinogenesis ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Catalytic Domain ; Humans ; Immunohistochemistry ; Lung* ; Prognosis ; Survival Rate ; Telomerase*

OBJECTIVES: Autonomic nerve system dysfunction has been reported in patients following traumatic brain injury (TBI). However, studies providing direct evidence of a link between the two have been scarce. The purpose of the present study was to evaluate cardiac autonomic modulation in post-acute ambulatory outpatients with TBI using an analysis of heart rate variability (HRV). METHODS: Twenty-one patients with TBI and 21 age- and gender-matched normal controls were evaluated. The HRV assessments were performed using conventional time and frequency domain analyses as well as non-linear complexity analysis. RESULTS: In the patient group, standard deviation values of the RR intervals (SDNN), the square root of the mean squared differences of successive normal sinus intervals (RMSSD), total successive RR interval difference (TSRD), and the very low frequency (VLF) power spectral parameter were significantly lower than in the control group. The patients with moderate severity of TBI exhibited a significantly lower value of VLF than those with mild severity. The severity of anxiety symptoms had a tendency to be correlated with the mean heart rate and the ratio of low-to-high frequency spectral power. CONCLUSION: The results of the present study provide evidence that TBI is associated with reduced HRV, suggesting the critical involvement of central autonomic structures in the pathogenesis of TBI. The HRV measures may serve as an index for monitoring aspects of autonomic function in patients with TBI.
Aluminum Hydroxide ; Anxiety ; Autonomic Nervous System ; Autonomic Pathways ; Brain Injuries ; Carbonates ; Heart ; Heart Rate ; Humans ; Outpatients

OBJECTIVES: To characterize the usage patterns of new types of tobacco products (NTTPs) to develop effective strategies for the regulation of NTTPs in Korea. METHODS: We conducted focus group interviews to identify the NTTP usage patterns of research subjects. The NTTPs were limited to electronic cigarettes (e-cigarettes), waterpipe tobacco, and rolling tobacco. We categorized 30 research subjects into 4 groups. The e-cigarette group was divided into adult and adolescent groups. Each group contained 7-8 subjects. An interview lasting approximately 2 hours was conducted with each group. RESULTS: Ninety percent of NTTP users used an NTTP in combination with conventional cigarettes. Subjects mostly bought NTTPs online, unlike how they bought cigarettes. Additionally, a great deal of information, such as how to use NTTPs and descriptions of NTTP products, was exchanged through online or offline societies. The primary reason why the subjects used NTTPs was that NTTPs offer a greater range of flavors and aromas than cigarettes. Moreover, NTTPs were felt to be less repulsive than cigarettes. NTTPs were not used as a cigarette substitute; rather, they were mostly used in places and situations where traditional cigarette smoking was not allowed. CONCLUSIONS: Based on the results of this study, the government should conduct studies on the effects of the combined use of NTTPs and cigarettes on the human body, obtain and provide accurate data regarding NTTP use, and develop and implement polices to ban NTTP advertising, which may arouse adolescents' curiosity, and the addition of flavoring substances to tobacco products.
Adolescent ; Adult ; Electronic Cigarettes ; Exploratory Behavior ; Focus Groups* ; Human Body ; Humans ; Korea ; Research Subjects ; Smoking ; Tobacco Products* ; Tobacco*

We report a case of nonfunctioning neuroendocrine tumor of the pancreas in a 15-year-old girl who presented with back pain. On physical examination, there was mild tenderness in the left upper quadrant of the abdomen. The patient had no pancreatic hormone-associated symptoms. An abdominal ultrasonography showed a well-demarcated hypervascular solid mass with calcification in the tail of the pancreas. An abdominal computed tomography scan showed a 6x5cm sized well-encapsulated enhancing solid mass with cystic component in the tail of the pancreas. Distal pancreatectomy was performed. Pathology revealed awell- differentiated nonfunctioning low grade malignant neuroendocrine tumor of the pancreas. The postoperative course was uneventful.
Abdomen ; Adolescent ; Back Pain ; Humans ; Neuroendocrine Tumors ; Pancreas ; Pancreatectomy ; Physical Examination

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.
Cooperative Behavior ; Dyspnea ; Exercise Tolerance ; Hospice Care ; Hospices* ; Humans ; Korea ; Lung ; Mortality ; Palliative Care* ; Primary Health Care ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation ; Respiratory Therapy

BACKGROUND: The claudins are a family of transmembrane proteins associated with tight junctions and they are critical for maintaining cell-to-cell adhesion in sheets of epithelial cells. However, their role in the progression of cancer remains largely unexplored. The aims of this study were to evaluate the expression patterns of claudin-1 and -4 in benign lesions and invasive ductal carcinomas (IDC) of the breast, and relationships between the expression of these markers and the clinicopathological characteristics in IDC patients. METHODS: We examined the claudin-1 and -4 protein expressions by performing immunohistochemical stainings in 54 benign lesions and 120 IDCs via the tissue microarray method. We evaluated the correlation between the expression of these markers and the clinicopathological characteristics of IDC. RESULTS: The expressions of claudin-1 (p=0.099) and -4 (p=0.000) were up-regulated in IDCs as compared with benign lesions. The claudin-1 expression correlated with the loss of estrogen receptor (p=0.036) and progesterone receptor (p=0.011). The claudin-4 expression correlated with lymph node metastasis (p=0.043), the nuclear grade (p=0.030), the histologic grade (p=0.007), and the loss of estrogen receptor (p=0.001) and progesterone receptor (p= 0.029). CONCLUSIONS: These results suggest that claudin-1 and -4 may play a significant role in the carcinogenesis of IDC of the breast and these may represent novel markers for this disease.
Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Claudin-1* ; Claudin-4 ; Claudins ; Epithelial Cells ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Progesterone ; Tight Junctions

Tobacco products are rapidly evolving. Since the World Health Organization Framework Convention on Tobacco Control came to effect in 2005, the parties of the treaty have been aiming to control tobacco use. Moreover, the social norm of smoking has changed. These changes have prompted the tobacco industry to evolve their products and business model. There have been several evolutions in tobacco products. Firstly, new tobacco products, such as electronic cigarettes and heated tobacco products were introduced into markets that were previously dominated by conventional cigarettes. Thus, smokers are able to select alternative tobacco products. Secondly, new devices for tobacco use, including universal serial bus, smart watch, and car key devices, have been developed and released. These devices are popular among females and youth, who wish to hide their smoking behavior. Thirdly, nicotine, which is used in tobacco products, has also evolved. Typically, ‘free-base nicotine’ has been the main form used in tobacco products, because it helps to deliver nicotine quickly to the smoker's brain. However, a new form of nicotine, ‘nicotine salt’, is used in electronic cigarettes. It can deliver a more highly concentrated dose of nicotine to the smoker’s brain. To regulate these evolving products, laws are required to prevent the easy access of new tobacco products in the Korean market and therefore, a new organization for monitoring the evolution of tobacco products is required. Additionally, we need to encourage young people and scholars to develop interest in tobacco product control, thus ensuring adequate regulation of new tobacco products.
Adolescent ; Brain ; Commerce ; Electronic Cigarettes ; Female ; Hot Temperature ; Humans ; International Cooperation ; Jurisprudence ; Nicotine ; Smoke ; Smoking ; Social Norms ; Tobacco Industry ; Tobacco Products ; Tobacco Use ; Tobacco ; World Health Organization

A survival prediction model has recently been developed to evaluate the prognosis of resected nonmetastatic pancreatic ductal adenocarcinoma based on a Cox model using two nationwide databases: Surveillance, Epidemiology and End Results (SEER) and Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP). In this study, we applied two machine learning methods—random survival forests (RSF) and support vector machines (SVM)—for survival analysis and compared their prediction performance using the SEER and KOTUS-BP datasets. Three schemes were used for model development and evaluation. First, we utilized data from SEER for model development and used data from KOTUS-BP for external evaluation. Second, these two datasets were swapped by taking data from KOTUS-BP for model development and data from SEER for external evaluation. Finally, we mixed these two datasets half and half and utilized the mixed datasets for model development and validation. We used 9,624 patients from SEER and 3,281 patients from KOTUS-BP to construct a prediction model with seven covariates: age, sex, histologic differentiation, adjuvant treatment, resection margin status, and the American Joint Committee on Cancer 8th edition T-stage and N-stage. Comparing the three schemes, the performance of the Cox model, RSF, and SVM was better when using the mixed datasets than when using the unmixed datasets. When using the mixed datasets, the C-index, 1-year, 2-year, and 3-year time-dependent areas under the curve for the Cox model were 0.644, 0.698, 0.680, and 0.687, respectively. The Cox model performed slightly better than RSF and SVM.

Tobacco products are rapidly evolving. Since the World Health Organization Framework Convention on Tobacco Control came to effect in 2005, the parties of the treaty have been aiming to control tobacco use. Moreover, the social norm of smoking has changed. These changes have prompted the tobacco industry to evolve their products and business model. There have been several evolutions in tobacco products. Firstly, new tobacco products, such as electronic cigarettes and heated tobacco products were introduced into markets that were previously dominated by conventional cigarettes. Thus, smokers are able to select alternative tobacco products. Secondly, new devices for tobacco use, including universal serial bus, smart watch, and car key devices, have been developed and released. These devices are popular among females and youth, who wish to hide their smoking behavior. Thirdly, nicotine, which is used in tobacco products, has also evolved. Typically, ‘free-base nicotine’ has been the main form used in tobacco products, because it helps to deliver nicotine quickly to the smoker's brain. However, a new form of nicotine, ‘nicotine salt’, is used in electronic cigarettes. It can deliver a more highly concentrated dose of nicotine to the smoker’s brain. To regulate these evolving products, laws are required to prevent the easy access of new tobacco products in the Korean market and therefore, a new organization for monitoring the evolution of tobacco products is required. Additionally, we need to encourage young people and scholars to develop interest in tobacco product control, thus ensuring adequate regulation of new tobacco products.

Tobacco products are rapidly evolving. Since the World Health Organization Framework Convention on Tobacco Control came to effect in 2005, the parties of the treaty have been aiming to control tobacco use. Moreover, the social norm of smoking has changed. These changes have prompted the tobacco industry to evolve their products and business model. There have been several evolutions in tobacco products. Firstly, new tobacco products, such as electronic cigarettes and heated tobacco products were introduced into markets that were previously dominated by conventional cigarettes. Thus, smokers are able to select alternative tobacco products. Secondly, new devices for tobacco use, including universal serial bus, smart watch, and car key devices, have been developed and released. These devices are popular among females and youth, who wish to hide their smoking behavior. Thirdly, nicotine, which is used in tobacco products, has also evolved. Typically, ‘free-base nicotine’ has been the main form used in tobacco products, because it helps to deliver nicotine quickly to the smoker's brain. However, a new form of nicotine, ‘nicotine salt’, is used in electronic cigarettes. It can deliver a more highly concentrated dose of nicotine to the smoker’s brain. To regulate these evolving products, laws are required to prevent the easy access of new tobacco products in the Korean market and therefore, a new organization for monitoring the evolution of tobacco products is required. Additionally, we need to encourage young people and scholars to develop interest in tobacco product control, thus ensuring adequate regulation of new tobacco products.