Background: Sedentary behavior is associated with increased cardiovascular disease (CVD) risk. We investigated this association of sedentary time and physical activity with increased 10-year CVD risk in Korean adults. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (2014–2017). In total, 14,551 participants aged 30–74 years (6,323 men, 8,228 women) were analyzed. The usual length of sedentary time per day was categorized into three groups (<6, 6–<9, or ≥9 h/d), and physical activity (metabolic equivalents [METs]∙min/wk) was categorized into two groups (low, <600 METs∙min/wk; moderate/high, ≥600 METs∙min/wk). Logistic regression analysis was performed to assess the association between sedentary time and increased CVD risk (predicted 10-year risk ≥10%). Adjusted variables were age, sex, body mass index, marital status, employment, household income, alcohol use, family history of CVD, and comorbidity (hypertension, diabetes, and dyslipidemia). Results: The average sedentary time for the 14,551 participants was 7.49 h/d, with an average 10-year CVD risk of 9.58%. There was no significant association between sedentary time and increased 10-year CVD risk in the moderate/ high physical activity group. In the low physical activity group, sedentary time ≥9 h/d had a significant association with increased CVD risk (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.04–1.62). However, when the sedentary time was <6 h/d, no significant associations were found (OR, 1.17; 95% CI, 0.92–1.49). Conclusion In the low physical activity group, reduction of sedentary time might be important for preventing increased CVD risk.

Purpose: Targeted next-generation sequencing (NGS) panels for solid tumors have been useful in clinical framework for accurate tumor diagnosis and identifying essential molecular aberrations. However, most cancer panels have been designed to address a wide spectrum of pan-cancer models, lacking integral prognostic markers that are highly specific to gliomas. Materials and Methods: To address such challenges, we have developed a glioma-specific NGS panel, termed “GliomaSCAN,” that is capable of capturing single nucleotide variations and insertion/deletion, copy number variation, and selected promoter mutations and structural variations that cover a subset of intron regions in 232 essential glioma-associated genes. We confirmed clinical concordance rate using pairwise comparison of the identified variants from whole exome sequencing (WES), immunohistochemical analysis, and fluorescence in situ hybridization. Results: Our panel demonstrated high sensitivity in detecting potential genomic variants that were present in the standard materials. To ensure the accuracy of our targeted sequencing panel, we compared our targeted panel to WES. The comparison results demonstrated a high correlation. Furthermore, we evaluated clinical utility of our panel in 46 glioma patients to assess the detection capacity of potential actionable mutations. Thirty-two patients harbored at least one recurrent somatic mutation in clinically actionable gene. Conclusion We have established a glioma-specific cancer panel. GliomaSCAN highly excelled in capturing somatic variations in terms of both sensitivity and specificity and provided potential clinical implication in facilitating genome-based clinical trials. Our results could provide conceptual advance towards improving the response of genomically guided molecularly targeted therapy in glioma patients.

PURPOSE: The Gleason score is an important predictor of outcome that is used in conjunction with clinical stage and prostate-specific antigen to guide clinical decision making. The prostate biopsy Gleason grade frequently differs from the radical prostatectomy grade. The aim of this study was to determine the risk factors of Gleason upgrading in patients with low-risk prostate cancer after radical prostatectomy. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 146 patients who underwent radical prostatectomy between 1998 and 2008 in two hospitals of Jeonbuk province in Korea. Pathological Gleason score upgrading was defined as an increase in the Gleason score from < or =6 to > or =7 between the biopsy and radical prostatectomy specimen. Pretreatment clinical and pathological parameters were used to identify predictors of pathological upgrading. RESULTS: Of the total 146 patients, 51 (34.9%) were upgraded postoperatively. Small prostate volume (p=0.008), abnormality on the digital rectal examination, and positive surgical margin (p=0.001) were significantly and positively associated with upgrading after radical prostatectomy. A total of 17 of 65 patients with low-risk prostate cancer (26.2%) were upgraded postoperatively. Small prostate volume (<30 ml) was significantly (p=0.026) and positively associated with upgrading after radical prostatectomy in patients with low-risk prostate cancer. CONCLUSIONS: Overall, 26% of patients with low-risk disease were upgraded postoperatively. Small prostate volume was associated with an increased risk for pathological upgrading after radical prostatectomy. These conclusions should be kept in mind when making treatment decisions for men with low-risk prostate cancer.
Biopsy ; Decision Making ; Digital Rectal Examination ; Humans ; Korea ; Male ; Medical Records ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Retrospective Studies ; Risk Factors

PURPOSE: Nephron-sparing surgery for renal tumors in solitary kidneys has several technical difficulties and complications, including renal failure. We evaluated operative outcome and feasibility in patients with renal cell carcinoma in a solitary kidney treated with laparoscopic partial nephrectomy. MATERIALS AND METHODS: Between September 2003 and September 2008, 59 patients with renal tumors underwent laparoscopic partial nephrectomy. Among them, 4 patients with a solitary kidney were enrolled in the study. The mean age of the 2 male and 2 female patients was 66.8 years old, and their mean body mass index was 24.7. The mean size of the tumor was 3.5 cm. RESULTS: The mean operative time was 138.5 minutes, and estimated blood loss was 163.8 ml. In 2 patients, warm ischemic times were 25 and 55 minutes. Initiation of postoperative oral intake and ambulation were at 1.0 and 1.5 days. The mean hospital stay was 15.0 days. One patient had a complication of urinary leakage. Pathologic examination revealed renal cell carcinomas with negative surgical margins in all patients. The mean serum creatinine level of preoperative and postoperative day 1 was 1.04 and 1.73 mg/dl, respectively. One patient required temporary hemodialysis. At the mean follow-up of 21.3 months, there was no recurrence of tumors. The mean serum creatinine level at the final visit was 1.36 mg/dl. CONCLUSIONS: Laparoscopic partial nephrectomy for renal tumors in solitary kidneys can be performed safely. Although it is a possible modality with excellent outcome, long-term follow-up for cancer control, along with advanced laparoscopic technique and experience, is necessary.
Body Mass Index ; Carcinoma, Renal Cell ; Creatinine ; Female ; Follow-Up Studies ; Humans ; Kidney ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Male ; Nephrectomy ; Operative Time ; Recurrence ; Renal Dialysis ; Renal Insufficiency ; Walking ; Warm Ischemia

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.
Anoxia ; Fibroblasts ; Humans ; Keloid ; Oxygen ; Shoulder ; Thorax ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Wound Healing

PURPOSE: GFR(glomerular filtration rate) is a fundamental parameter in detecting renal impairment and predicts the progression of renal disease. Because serum creatinine has several disadvantages, serum cystatin C has been recently proposed as a new endogenous marker for GFR. We compared serum cystatin C with creatinine and creatinine clearance to investigate the clinical usefulness of cystatin C. METHODS: We retrospectively analyzed 46 patients(60 case numbers) who had various renal diseases and classified them into 3 groups according to creatinine clearance(Group 1 : CrCl <40 mL/min/1.73m2, Group 2 : CrCl 40-60 mL/min/1.73m2, Group 3 : CrCl >60 mL/min/1.73 m2). We measured serum creatinine, cystatin C and creatinine clearance and also analyzed the correlations among them. RESULTS: Serum cystatin C and creatinine showed a similar correlation to creatinine clearance (r=0.685, r=0.640, respectively) and showed similar diagnostic accuracy in detecting decreased GFR(AUC, cystatin C 0.829 vs. creatinine 0.826, P=0.848). Serum cystatin C showed a greater sensitivity for detecting a decreased GFR than creatinine in Group 2 and 3(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%). CONCLUSIONS: Serum cystatin C could be a useful endogenous marker for GFR and would be superior to serum creatinine in early detection of renal impairment in pediatric patients with renal diseases.
Child* ; Creatinine ; Cystatin C* ; Filtration ; Glomerular Filtration Rate ; Humans ; Retrospective Studies

BACKGROUND: LOH11A is a region with frequent allele loss (>75%) in lung cancer that is located on the centromeric part of chromosome 11p15.5. Clinical and cell biological studies suggest that this region contains a gene associated with metastatic tumor spread. RRM1 encoding the M1 subunit of ribonucleotide reductase, which is an enzyme that catalyses the rate-limiting step in deoxyribonucleotide synthesis, is located in the LOH11A region. METHODS: Polymorphisms were found at nucleotide position (-)37 (C/A) and (-)524 (C/T) from the beginning of exon 1 of the RRM1 gene that might regulate the expression of RRM1. We studied the polymorphisms in 127 Korean individuals (66 lung cancer and 61 normal controls) and compared with those of 140 American patients with lung cancer. RESULTS: CC, AC and AA were found at the (-)37 position in 64(50.4%), 55(43.3%), and 8(6.3%) out of 127 Korean individuals (66 cancer, 61 non-cancer patients), respectively. There was a similar frequency of allele A at (-)37 in the American(27.9%) and Korean population(28.0%). CC, CT and TT was found at the (-)524 position in 24(18.9%), 44(34.6%), and 59(46.5%) out of the 127 Korean individuals, respectively. There was a similar frequency of allele C at (-)524 in the American(34.6%) and Korean population(36.2%).There was no difference in the frequency of the (-)37 and (-)524 genotypes between the cancer and non-cancer group. However there was a significant correlation of the genotypes between (-)37 and (-)524 (p<0.001), which suggests the possible coordination of these polymorphisms in the regulation of the promoter activity of the RRM1 gene. CONCLUSION: RRM1 promoter polymorphisms were not found to be significant risk factors for lung cancer. However, a further study of the promoter activity and expression of the RRM1 gene according to the pattern of the polymorphism will be needed.
Alleles ; Catalysis ; Exons ; Genes, vif ; Genotype ; Humans ; Lung Neoplasms* ; Lung* ; Ribonucleotide Reductases ; Risk Factors

PURPOSE: To assess the current status of endourology and laparoscopy in Korea. MATERIALS AND METHODS: Using the database directory of the Korean Urological Association, 83 urology training hospitals were identified. A detailed questionnaire was designed and sent by post and e-mail. The questionnaire included questions regarding the number of various endourological and laparoscopic procedures between 1998 and 2002. The questionnaires of those responding were analyzed. RESULTS: Responses were received from 45 hospitals (response rate 54.2%). 133 antegrade and 626 retrograde endourological procedures for urinary strictures were performed during the period of the study in 12 and 35 hospitals, respectively. 42 hospitals (93.3%) were performing shock wave lithotripsy for urinary stone disease. 29 hospitals (64.4%) reported having performed more than one laparoscopic procedure during the five years. The annual total numbers of laparoscopic procedures increased from 217 in 1998 to 725 in 2002. Simple laparoscopic nephrectomy was the most widely accepted procedure, and was being performed in 18 hospitals. Laparoscopic adrenalectomy, radical nephrectomy, diagnostic laparoscopy, laparoscopic renal cyst marsupialization, nephroureterectomy and donor nephrectomy were performed in more than 10 hospitals. However, the actual number of laparoscopic procedures was limited in most hospitals. More than 40 laparoscopic procedures per year were performed by only four hospitals. CONCLUSIONS: This survey revealed an increasing number of endourological and laparoscopic procedures. However, laparoscopy seems to be mainly a larger hospital-based technology in Korea. These results can be utilized as fundamental data for establishing future developmental requirements of endourology and laparoscopy in Korea.
Adrenalectomy ; Constriction, Pathologic ; Electronic Mail ; Endoscopy ; Humans ; Korea ; Laparoscopy* ; Lithotripsy ; Nephrectomy ; Surveys and Questionnaires ; Shock ; Surgical Procedures, Minimally Invasive ; Tissue Donors ; Urinary Calculi ; Urology*

BACKGROUND: Although smoking is a major cause of chronic obstructive pulmonary disease (COPD), only 10-20% of cigarette smokers develop symptomatic COPD, which suggests the presence of genetic susceptibility. This genetic susceptibility to COPD might depend on variations in the activities of the enzyme that detoxify hazardous chemical products, such as microsomal epoxide hydrolase (mEPHX) and glutathione-S transferase M1 subunit (GSTM1) genes. METHODS: The genotypes of 58 patients with COPD, and 79 age matched control subjects, were determined by a polymerase chain reaction, followed by restriction fragment length polymorphism (PCR-RFLP) for the mEPHX, and multiplex PCR for the GSTM1. RESULTS: GSTM1 was deleted in 53.3% of the subjects. There was no difference in GSTM1 deletion rates between the COPD patients (32/58, 55.2%) and the control subjects (41/79, 51.9%). The combination patterns of two polymorphisms of mEPHX showed slow enzyme activity in 29(21.2%), normal in 73(53.3%) and fast in 32(23.4%). The COPD group (7/57, 12.3%) showed a significantly lower incidence of slow enzyme activity compared to the control subjects (22/77, 28.6%, p<0.05). However, when the COPD and control groups were compared with smokers only, there were no significant differences in the genotypes of GSTM1 and mEPHX. CONCLUSION: The genotypes of GSTM1 and mEPHX were not significant risk factors of COPD in this cohort of study.
Cohort Studies ; Epoxide Hydrolases ; Genetic Predisposition to Disease ; Genotype ; Humans ; Incidence ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length ; Pulmonary Disease, Chronic Obstructive* ; Risk Factors ; Smoke ; Smoking ; Tobacco Products ; Transferases

PURPOSE: Although 80~90% of patients with lung cancer are smokers, only 11% of smokers develop lung cancer. Genetic susceptibility according to the polymorphism of the epoxide hydrolase (mEPHX) gene and homozygous deletion of GSTM1 (M1 subunit of Glutathione S transferase) was studied in this case control study. MATERIALS AND METHODS: Genomic DNA from 76 subjects with lung cancer (40 squamous cell carcinoma, 13 adenocarcinoma, 10 subtype undetermined non-small cell lung cancer, and 13 small cell lung carcinoma) and 62 age- matched controls were extracted from peripheral white blood cells. PCR and RFLP (restriction fragments length polymorphism) with restriction enzyme (RsaI) and automatic sequencing were used for mEPHX genotyping (T-->C, Tyr113His) in exon 3 and (A-->G, His139Arg) in exon 4. Looking for homozygous deletions of GSTM1, multiplex PCR with primers for the GSTM1 gene and coagulation factor V gene (as positive control) were performed. RESULTS: The age distribution between the cancer and control groups were similar (63.6 7.2 vs. 61.1 7.9 years). The lung cancer group, however, had more smokers (73.3%, 44/60) than the control group (21/54, 38.9%, p<0.001). The rate of homozygous deletion of the GSTM1 gene was significantly higher in the lung cancer group (65.8%, 50/76) than in the control group (46.8%, 29/62, p<0.05), causing the relative risk of GSTM1 deletion for lung cancer as 2.19 (95% CI: 1.10~4.35, p=0.02). Among 118 subjects whose mEPHX gene polymorphisms were studied, 62 (52.5%) subjects showed genotypes with slow enzyme activity while 45 (38.1%) showed normal enzyme activity and 11 (9.3%) showed fast enzyme activity. There was no significant difference in the distribution of mEPHX gene polymorphisms between the two groups. CONCLUSION: The homozygous deletion of the GSTM1 gene was associated with high lung cancer susceptibility, whereas the mEPHX genotype showed no significant connection with risk of lung cancer in a sample Korean population.
Adenocarcinoma ; Age Distribution ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Case-Control Studies ; DNA ; Exons ; Factor V ; Genetic Predisposition to Disease ; Genotype ; Glutathione ; Glutathione Transferase ; Humans ; Leukocytes ; Lung Neoplasms* ; Lung* ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length