Immune checkpoint inhibitors (ICIs) have achieved promising clinical results in cancer treatment over the past decade. However, the efficacy of ICIs is less than 30% in most tumor types, and studies are underway to identify the predictive factors responsive to ICIs. More than 1,000 species of microorganisms live in the human body, and the second human genome project, The Human Microbiome Project, has been conducted to understand human diseases through interactions with microbes. As the microbiome project has progressed, many studies have reported on the association between microorganisms and human diseases, including preclinical and clinical studies on the relationship between ICIs and the microbiome. Therefore, in this manuscript, the relationship between the microbiome and cancer, especially the effectiveness of ICIs, is reviewed.

Immune checkpoint inhibitors (ICIs) have achieved promising clinical results in cancer treatment over the past decade. However, the efficacy of ICIs is less than 30% in most tumor types, and studies are underway to identify the predictive factors responsive to ICIs. More than 1,000 species of microorganisms live in the human body, and the second human genome project, The Human Microbiome Project, has been conducted to understand human diseases through interactions with microbes. As the microbiome project has progressed, many studies have reported on the association between microorganisms and human diseases, including preclinical and clinical studies on the relationship between ICIs and the microbiome. Therefore, in this manuscript, the relationship between the microbiome and cancer, especially the effectiveness of ICIs, is reviewed.

OBJECTIVES: Little is yet known about the determinants of bone mineral density (BMD) in young adults. Thus, in this study, we aimed to determine the factors that have an impact on BMD in young men. METHODS: Questionnaires were sent out to 111 male medical students. Information on age, socio-economic status, medical history, lifestyle, physical activity during adolescence, school club participation, current physical activity, and dietary intake were collected by the survey. Height, weight, percent body fat and muscle mass were estimated by bioelectrical impedance, and BMD was obtained using calcaneal quantitative ultrasound. Using the Poisson regression model, prevalence ratios (PRs) were used to estimate the degree of association between risk factors and osteopenia. RESULTS: The height and current physical activity showed a correlation to the Osteoporosis Index. Among the categorized variables, past physical activity during adolescence (p=0.002) showed a positive effect on the bone mineral content. In the multivariate model, past physical activity (> or =1 time/wk) had a protective effect on osteopenia (PR, 0.37; 95% confidence interval [CI], 0.18 to 0.75) and present physical activity (1000 metabolic equivalent of task-min/wk) decreased the risk of osteopenia (PR, 0.64; 95% CI, 0.44 to 0.91). CONCLUSIONS: Past physical activity during adolescence is as important as physical activity in the present for BMD in young men.
Adult ; Body Mass Index ; *Bone Density ; Calcium, Dietary ; Humans ; Male ; *Motor Activity ; Questionnaires ; Risk Factors ; Smoking ; Socioeconomic Factors ; Students, Medical/psychology ; Young Adult

OBJECTIVE: Effects of life style modifications on lipid profiles have been well established. However, data is scarce in Korean patients. We tried to quantify the effect of life style modifications on lipid profiles in relatively large number of Korean hyperlipidemic patients. METHODS: This study enrolled 1037 consecutive hyperlipidemic patients (total cholesterol or triglyceride levels ≥200 mg/dL) from 2003 to 2013. They were consisted of patients with hypercholesterolemia (n=308), borderline hypercholesterolemia (n=302), mixed hyperlipidemia (n=107), borderline mixed hyperlipidemia (n=156), and hypertriglyceridemia (n=164). Blood lipid levels were measured before and after life style modification for 2-4 months. RESULTS: Life style modification showed a small but significant reduction of body weight in all groups. It reduced low density lipoprotein (LDL) cholesterol by 9.1% (p=0.000), 5.9% (p=0.000), and 4.8% (p=0.003) in patients with hypercholesterolemia, borderline hypercholesterolemia, and mixed hyperlipidemia, respectively. LDL cholesterol was elevated in hypertriglyceridemic patients by 35% (p=0.000). Triglyceride levels decreased in patients with hypertriglyceridemia by 22% (p=0.000) and increased in hypercholesterolemic patients. There were no different effects of life style modification between men and women. CONCLUSION: Life style modification made significant improvement in lipid profiles in Korean patients. The degree of improvement from this study may provide useful data for the management of Korean hyperlipidemic patients.
Body Weight ; Cholesterol ; Cholesterol, LDL ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Hypertriglyceridemia ; Life Style* ; Lipoproteins ; Male ; Triglycerides

BACKGROUND: Hypertension is a common problem for hemodialysis patients and is associated with an increased cardiovascular mortality. We analyzed ambulatory blood pressure (ABP) in hemodialysis patients and investigated if an adjustment of dry weight can be used to control blood pressure. METHODS: ABP was measured for twenty-four hours after hemodialysis. A bioimpedance Analysis (BIA) was conducted. Patients were divided into two groups by the edema index. A normohydration (NH) group included patients with the edema index less than 0.40, and an overhydration (OH) group included patients with the edema index 0.40 or more. We accordingly adjusted the dry weight based on BIA results. RESULTS: Thirty-six patients were recruited, comprising twenty-two men and fourteen women. In regard to the ABP, 24-hour systolic and diastolic blood pressures were 140.2 +/- 19.7 mm Hg and 79.0 +/- 10.6 mm Hg, respectively. There was a significant association between 24-hour systolic blood pressure and the edema index (r = 0.501, p = 0.002). Twenty four-hour systolic blood pressure was significantly different between the NH and OH groups (median value, 132.0 vs. 150.5 mm Hg; p = 0.008). In OH group, after adjustment of the dry weight, the edema index was decreased from 0.411 +/- 0.009 to 0.389 +/- 0.047 and office systolic blood pressure was also decreased from 144.7 +/- 32.7 mm Hg to 125.3 +/- 15.4 mm Hg in OH group (p = 0.028 and p = 0.018, respectively). CONCLUSIONS: The edema index obtained by the bioimpedance analysis is significantly correlated with 24-hour systolic blood pressure in hemodialysis patients. Also, an adjustment of dry weight can be used to control blood pressure in hemodialysis patients.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Edema ; Female ; Humans ; Hypertension ; Male ; Renal Dialysis

OBJECTIVE: Previous studies have shown that fenofibrate therapy increases serum creatinine level and that there is a return of serum creatinine to baseline level after the discontinuation of the drug. We evaluated the effect of long-term fenofibrate therapy on creatinine levels and its reversibility in patients with hypertension and hypertriglyceridemia. METHODS: This retrospective study enrolled 54 hypertensive and hypertriglyceridemic patients taking fenofibrate for 3–6 years (Fenofibrate group) and 30 control patients with similar age, sex, follow-up duration, and creatinine levels (Control group). In 23 patients taking fenofibrate with low triglyceride level and/or with high creatinine levels, fenofibrate was discontinued, and creatinine levels were measured after 2 months. RESULTS: Creatinine levels increased in both the fenofibrate group (from 0.91±0.18 mg/dL to 1.09±0.23 mg/dL, p < 0.001) and the control group (from 0.94±0.16 mg/dL to 0.98±0.16 mg/dL, p=0.04) compared to baseline. However, the elevation was more pronounced in the fenofibrate group than in the control group (21.1±15.4% vs. 4.5±11.3%, p < 0.001). The discontinuation of fenofibrate lowered creatinine levels (from 1.39±0.32 mg/dL to 1.15±0.24 mg/dL, p < 0.001) which were still higher than pre-treatment levels (p=0.013). CONCLUSION: Long-term fenofibrate therapy significantly increased creatinine levels in hypertensive and hypertriglyceridemic patients. The effect of fenofibrate on creatinine level was partially reversible. This finding suggests that follow-up creatinine level is necessary with fenofibrate therapy.
Creatinine* ; Fenofibrate* ; Follow-Up Studies ; Humans ; Hypertension* ; Hypertriglyceridemia ; Retrospective Studies ; Triglycerides

Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

Purpose: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA2DS2-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m2 ), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA2DS2-VASc score 0–1. Materials and Methods: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. Results: Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA2DS2-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P–Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, p=0.003). Conclusion The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA2DS2-VASc score 0–1.