Objective: Although high-density lipoprotein cholesterol (HDL-C) is inversely associated with hematologic malignancies, modification by smoking has not been reported. We investigated how smoking and menopausal status modify these association. Methods: This population-based cohort study enrolled cancer-free individuals who underwent a national cancer screening in 2010 and followed up until December 2017. HDL-C levels were classified into eight groups based on 10 mg/dL intervals: (<30, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89, or ≥90 mg/dL). Results: Among 4,517,892 participants, 5887 had lymphoma, 3348 had leukemia, and 12151 had unspecified hematologic malignancies. The adjusted hazard ratios (aHRs) for the lowest HDL-C levels compared to the 70–79 mg/dL range were 1.83 (1.45–2.31) for lymphoma, 3.14 (2.41–4.08) for leukemia, and 2.34 (2.01–2.72) for unspecified hematologic malignancy.The effects of low HDL-C levels on hematologic malignancies were similar in both men and women. Low HDL-C levels were associated with a higher risk of leukemia regardless of smoking status, but extremely high HDL-C levels were linked to a higher risk of leukemia (aHR, 2.32; 95% confidence interval [95% CI], 1.18–4.55) only in current smokers.The hazardous effect of low HDL-C levels on lymphoma was significant only in never smokers (aHR, 2.01; 95% CI, 1.51–2.68). Hazardous effects of low HDL-C levels on leukemia were observed only in post-menopausal women (aHR, 2.94; 95% CI, 1.69–5.11). Conclusion Low HDL-C levels were associated with a higher risk of leukemia and lymphoma, with discrepancies based on smoking and menopausal status.

Objective: Although high-density lipoprotein cholesterol (HDL-C) is inversely associated with hematologic malignancies, modification by smoking has not been reported. We investigated how smoking and menopausal status modify these association. Methods: This population-based cohort study enrolled cancer-free individuals who underwent a national cancer screening in 2010 and followed up until December 2017. HDL-C levels were classified into eight groups based on 10 mg/dL intervals: (<30, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89, or ≥90 mg/dL). Results: Among 4,517,892 participants, 5887 had lymphoma, 3348 had leukemia, and 12151 had unspecified hematologic malignancies. The adjusted hazard ratios (aHRs) for the lowest HDL-C levels compared to the 70–79 mg/dL range were 1.83 (1.45–2.31) for lymphoma, 3.14 (2.41–4.08) for leukemia, and 2.34 (2.01–2.72) for unspecified hematologic malignancy.The effects of low HDL-C levels on hematologic malignancies were similar in both men and women. Low HDL-C levels were associated with a higher risk of leukemia regardless of smoking status, but extremely high HDL-C levels were linked to a higher risk of leukemia (aHR, 2.32; 95% confidence interval [95% CI], 1.18–4.55) only in current smokers.The hazardous effect of low HDL-C levels on lymphoma was significant only in never smokers (aHR, 2.01; 95% CI, 1.51–2.68). Hazardous effects of low HDL-C levels on leukemia were observed only in post-menopausal women (aHR, 2.94; 95% CI, 1.69–5.11). Conclusion Low HDL-C levels were associated with a higher risk of leukemia and lymphoma, with discrepancies based on smoking and menopausal status.

Objective: Although high-density lipoprotein cholesterol (HDL-C) is inversely associated with hematologic malignancies, modification by smoking has not been reported. We investigated how smoking and menopausal status modify these association. Methods: This population-based cohort study enrolled cancer-free individuals who underwent a national cancer screening in 2010 and followed up until December 2017. HDL-C levels were classified into eight groups based on 10 mg/dL intervals: (<30, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89, or ≥90 mg/dL). Results: Among 4,517,892 participants, 5887 had lymphoma, 3348 had leukemia, and 12151 had unspecified hematologic malignancies. The adjusted hazard ratios (aHRs) for the lowest HDL-C levels compared to the 70–79 mg/dL range were 1.83 (1.45–2.31) for lymphoma, 3.14 (2.41–4.08) for leukemia, and 2.34 (2.01–2.72) for unspecified hematologic malignancy.The effects of low HDL-C levels on hematologic malignancies were similar in both men and women. Low HDL-C levels were associated with a higher risk of leukemia regardless of smoking status, but extremely high HDL-C levels were linked to a higher risk of leukemia (aHR, 2.32; 95% confidence interval [95% CI], 1.18–4.55) only in current smokers.The hazardous effect of low HDL-C levels on lymphoma was significant only in never smokers (aHR, 2.01; 95% CI, 1.51–2.68). Hazardous effects of low HDL-C levels on leukemia were observed only in post-menopausal women (aHR, 2.94; 95% CI, 1.69–5.11). Conclusion Low HDL-C levels were associated with a higher risk of leukemia and lymphoma, with discrepancies based on smoking and menopausal status.

Objective: Although high-density lipoprotein cholesterol (HDL-C) is inversely associated with hematologic malignancies, modification by smoking has not been reported. We investigated how smoking and menopausal status modify these association. Methods: This population-based cohort study enrolled cancer-free individuals who underwent a national cancer screening in 2010 and followed up until December 2017. HDL-C levels were classified into eight groups based on 10 mg/dL intervals: (<30, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89, or ≥90 mg/dL). Results: Among 4,517,892 participants, 5887 had lymphoma, 3348 had leukemia, and 12151 had unspecified hematologic malignancies. The adjusted hazard ratios (aHRs) for the lowest HDL-C levels compared to the 70–79 mg/dL range were 1.83 (1.45–2.31) for lymphoma, 3.14 (2.41–4.08) for leukemia, and 2.34 (2.01–2.72) for unspecified hematologic malignancy.The effects of low HDL-C levels on hematologic malignancies were similar in both men and women. Low HDL-C levels were associated with a higher risk of leukemia regardless of smoking status, but extremely high HDL-C levels were linked to a higher risk of leukemia (aHR, 2.32; 95% confidence interval [95% CI], 1.18–4.55) only in current smokers.The hazardous effect of low HDL-C levels on lymphoma was significant only in never smokers (aHR, 2.01; 95% CI, 1.51–2.68). Hazardous effects of low HDL-C levels on leukemia were observed only in post-menopausal women (aHR, 2.94; 95% CI, 1.69–5.11). Conclusion Low HDL-C levels were associated with a higher risk of leukemia and lymphoma, with discrepancies based on smoking and menopausal status.

Purpose: This study aims to explore the relationship between soy food consumption and gastric cancer (GC) risk, accounting for Helicobacter pylori infection status. Materials and Methods: We analyzed data from patients with GC and healthy individuals prospectively enrolled by 6 hospitals between 2016 and 2018. Dietary intake was evaluated using questionnaires that categorized seven dietary habits and 19 food groups. Multivariate logistic regression models were applied to examine associations. Model I adjusted for various epidemiological factors, while Model II included further adjustments for H. pylori infection.Primary exposures examined were consumption frequencies of nonfermented, unsalted soy foods (soybean/tofu) and fermented, salty soy foods (soybean paste stew). Results: A total of 5,535 participants were included, with 1,629 diagnosed with GC. In Model I, the frequency of soybean/tofu consumption was inversely related to GC risk; adjusted odd ratios (aORs) were 0.62 (95% confidence interval [CI], 0.48–0.8), 0.38 (95% CI, 0.3–0.49), 0.42 (95% CI, 0.33–0.53), and 0.33 (95% CI, 0.27–0.42) for 1 time/week, 2 times/week, 3 times/week, and ≥4 times/week. Consumption of 2 servings/week of soybean paste stew showed the lowest GC association, forming a V-shaped curve. Both low (aOR, 4.03; 95% CI, 3.09–5.26) and high serving frequencies of soybean paste stew (aOR, 2.23; 95% CI, 1.76–2.82) were associated with GC. The association between soy foods and GC in Model II was similar to that in Model I. The soy food-GC associations were consistent across sexes in Model I.Nonetheless, the positive correlation between frequent consumption of soybean paste stew (≥5 times/week) and GC was more pronounced in women (aOR, 7.58; 95% CI, 3.20–17.99) compared to men (aOR, 3.03; 95% CI, 1.61–5.88) in Model II. Subgroup analyses by H. pylori status and salty diet revealed a consistent inverse relationship between soybean/tofu and GC risk. In contrast, soybean paste stew showed a V-shaped relationship in H. pylori-positive or salty diet groups and no significant association in the H. pylori-negative group. Conclusions Soybean/tofu intake is consistently associated with a decreased risk of GC.However, the relationship between soybean paste stew consumption and GC risk varies, depending on H. pylori infection status and dietary salt intake.

Objective: This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. Methods: Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic–pituitary–adrenal (HPA) axis. Results: Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with “adrenal exhaustion stage” was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). Conclusion This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.

Objective: Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. Methods: The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Results: Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Conclusion Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.

Purpose: To compare the diagnostic accuracy of differentiating polypoidal choroidal vasculopathy (PCV) from exudative age-related macular degeneration (AMD), using color fundus photography (CFP), optical coherence tomography (OCT), and swept-source OCT angiography (SS-OCTA) without using indocyanine green angiography (ICGA). Methods: Treatment-naive eyes with exudative AMD that underwent CFP, OCT, SS-OCTA, and ICGA imaging before treatment were identified. Images of each patient were categorized into two sets (set A, CFP + OCT; set B, CFP + SS-OCTA). In set B, both the en face and cross-sectional B scans were analyzed. Each set was reviewed by two graders, and it was determined whether the presumed diagnosis was PCV. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for the diagnosis of PCV were assessed for each set by comparing diagnoses that included ICGA. The number of polypoidal lesions in each set was calculated and compared to ICGA. Results: A total of 94 eyes from 94 patients with AMD were included in the study, of which 66.0% were male, and the mean age was 71.8 ± 9.0 years. The PCV diagnosis rate using ICGA was 45.7%. The sensitivity was 0.88 for set A and 0.93 for set B, while the specificity was 0.94 for set A and 0.96 for set B. The AUC was 0.90 (95% confidence interval [CI], 0.83–0.97) for set A and 0.96 (95% CI, 0.90–1.00) for set B. Set A detected 1.28 ± 0.91 polypoidal lesions, while set B detected 1.47 ± 1.01; ICGA showed 1.51 ± 0.86. Conclusions This study highlights that, without using ICGA, both CFP combined with OCT and CFP combined with SS-OCTA demonstrate high sensitivity, specificity, and AUC in diagnosing PCV. It is evident that SS-OCTA contributes to enhancing sensitivity, specificity, and AUC for PCV diagnosis.

Purpose: To evaluate the long-term effects of conventional corneal cross-linking in patients with progressive keratoconus. Methods: A total of 18 eyes of 9 patients diagnosed with keratoconus were analyzed retrospectively. One eye was diagnosed with progressive keratoconus and conventional corneal crosslinking was performed. The other eye was classified as non-progressive and remained untreated. All patients were assessed with best corrected visual acuity (BCVA), maximum keratometry (Kmax), mean keratometry (Kmean), corneal astigmatism, and corneal thickness. Clinical data were collected before the procedure and at 1, 3, 6 months and 1 to 10 years after the procedure. Results: The BCVA significantly improved from 0.63 ± 0.18 logarithm of the minimum angle of resolution (logMAR) to 0.46 ± 0.25 logMAR at 10 years after conventional corneal crosslinking (p = 0.027). The Kmax and Kmean decreased from 65.90 ± 9.43 D and 52.82 ± 5.16 D to 62.83 ± 8.16 D and 51.52 ± 5.18 D, respectively (p = 0.021, p = 0.028, respectively). Corneal astigmatism decreased from 6.97 ± 2.21 D to 5.53 ± 1.64 D (p = 0.008). The thinnest corneal thickness decreased from 435.11 ± 53.37 μm to 369.22 ± 64.00 μm 1 month after the procedure (p = 0.008), and gradually improved over time. At 10 years, the thinnest corneal thickness increased to 410.11 ± 61.32 μm (p = 0.097). In the untreated eyes, the mean keratometry significantly increased after 4 years of follow-up, but other factors did not change significantly. Although corneal opacity persisted for up to 10 years in 3 eyes of the treatment group, there was no significant difference of BCVA compared to the treated eyes without corneal opacity (p = 0.714). Conclusions In patients with progressive keratoconus, conventional corneal crosslinking is a safe and effective procedure that suppresses long-term progression.

Purpose: To report a case of nutritional optic neuropathy due to folic acid deficiency and who recoverd from oral supplementation with folic acid.Case summary: A 45-year-old man was referred to our hospital because of visual disturbance and color vision on the both eye without pain. There were no abnormal findings in the anterior segment and retina. An afferent pupillary defect was found in the left eye. Visual field examination showed central scotoma in both eyes and total color blindness on Hahn color vision test. The patient had a history of chronic alcoholism and had not eaten often recently. The folic acid level was decreased in the blood and after oral folic acid supplementation, visual acuity and visual field recovered after 6 weeks. Conclusions We report a new case of nutritional optic neuropathy due to folic acid deficiency and who recovered from oral supplementation with folic acid.