1.Clinical Impact of Microbiome Characteristics in Treatment-Naïve Extranodal NK/T-Cell Lymphoma Patients
Sang Eun YOON ; Woorim KANG ; Junhun CHO ; Mauricio CHALITA ; Je Hee LEE ; Dong-Wook HYUN ; Hyun KIM ; Seok Jin KIM ; Won Seog KIM
Cancer Research and Treatment 2025;57(2):597-611
Purpose:
Extranodal natural killer/T-cell lymphoma (ENKTL) predominantly manifests in East Asia and Latin America. Despite shared intrinsic factors, such as ethnic and genetic backgrounds, the progression of ENKTL can be influenced by extrinsic factors related to changing lifestyle patterns.
Materials and Methods:
This study collected stool samples from newly diagnosed (ND)–ENKTL patients (n=40) and conducted whole genome shotgun sequencing.
Results:
ND-ENKTL revealed reduced alpha diversity in ND-ENKTL compared to healthy controls (HCs) (p=0.008), with Enterobacteriaceae abundance significantly contributing to the beta diversity difference between ENKTL and HCs (p < 0.001). Functional analysis indicated upregulated aerobic metabolism and degradation of aromatic compounds in ND-ENKTL. Enterobacteriaceae were associated not only with clinical data explaining disease status (serum C-reactive protein, stage, prognosis index of natural killer cell lymphoma [PINK], and PINK-E) but also with clinical outcomes (early relapse and short progression-free survival). The relative abundance of Enterobacteriaceae at the family level was similar between ENKTL and diffuse large B-cell lymphoma (DLBCL) (p=0.140). However, the ENKTL exhibited a higher abundance of Escherichia, in contrast to the prevalence of Enterobacter and Citrobacter in DLBCL. Linear regression analysis demonstrated a significant association between Escherichia abundance and programmed cell death-ligand-1 (PD-L1) levels in tissue samples (p=0.025), whereas no correlation with PD-L1 was observed for Enterobacteriaceae at the family level (p=0.571).
Conclusion
ND-ENKTL exhibited an abundance of Enterobacteriaceae and a dominant presence of Escherichia. These microbial characteristics correlated with disease status, treatment outcomes, and PD-L1 expression, suggesting the potential of the ENKTL microbiome as a biomarker and cause of lymphomagenesis, which warrants further exploration.
2.Clinical Impact of Microbiome Characteristics in Treatment-Naïve Extranodal NK/T-Cell Lymphoma Patients
Sang Eun YOON ; Woorim KANG ; Junhun CHO ; Mauricio CHALITA ; Je Hee LEE ; Dong-Wook HYUN ; Hyun KIM ; Seok Jin KIM ; Won Seog KIM
Cancer Research and Treatment 2025;57(2):597-611
Purpose:
Extranodal natural killer/T-cell lymphoma (ENKTL) predominantly manifests in East Asia and Latin America. Despite shared intrinsic factors, such as ethnic and genetic backgrounds, the progression of ENKTL can be influenced by extrinsic factors related to changing lifestyle patterns.
Materials and Methods:
This study collected stool samples from newly diagnosed (ND)–ENKTL patients (n=40) and conducted whole genome shotgun sequencing.
Results:
ND-ENKTL revealed reduced alpha diversity in ND-ENKTL compared to healthy controls (HCs) (p=0.008), with Enterobacteriaceae abundance significantly contributing to the beta diversity difference between ENKTL and HCs (p < 0.001). Functional analysis indicated upregulated aerobic metabolism and degradation of aromatic compounds in ND-ENKTL. Enterobacteriaceae were associated not only with clinical data explaining disease status (serum C-reactive protein, stage, prognosis index of natural killer cell lymphoma [PINK], and PINK-E) but also with clinical outcomes (early relapse and short progression-free survival). The relative abundance of Enterobacteriaceae at the family level was similar between ENKTL and diffuse large B-cell lymphoma (DLBCL) (p=0.140). However, the ENKTL exhibited a higher abundance of Escherichia, in contrast to the prevalence of Enterobacter and Citrobacter in DLBCL. Linear regression analysis demonstrated a significant association between Escherichia abundance and programmed cell death-ligand-1 (PD-L1) levels in tissue samples (p=0.025), whereas no correlation with PD-L1 was observed for Enterobacteriaceae at the family level (p=0.571).
Conclusion
ND-ENKTL exhibited an abundance of Enterobacteriaceae and a dominant presence of Escherichia. These microbial characteristics correlated with disease status, treatment outcomes, and PD-L1 expression, suggesting the potential of the ENKTL microbiome as a biomarker and cause of lymphomagenesis, which warrants further exploration.
3.Clinical Impact of Microbiome Characteristics in Treatment-Naïve Extranodal NK/T-Cell Lymphoma Patients
Sang Eun YOON ; Woorim KANG ; Junhun CHO ; Mauricio CHALITA ; Je Hee LEE ; Dong-Wook HYUN ; Hyun KIM ; Seok Jin KIM ; Won Seog KIM
Cancer Research and Treatment 2025;57(2):597-611
Purpose:
Extranodal natural killer/T-cell lymphoma (ENKTL) predominantly manifests in East Asia and Latin America. Despite shared intrinsic factors, such as ethnic and genetic backgrounds, the progression of ENKTL can be influenced by extrinsic factors related to changing lifestyle patterns.
Materials and Methods:
This study collected stool samples from newly diagnosed (ND)–ENKTL patients (n=40) and conducted whole genome shotgun sequencing.
Results:
ND-ENKTL revealed reduced alpha diversity in ND-ENKTL compared to healthy controls (HCs) (p=0.008), with Enterobacteriaceae abundance significantly contributing to the beta diversity difference between ENKTL and HCs (p < 0.001). Functional analysis indicated upregulated aerobic metabolism and degradation of aromatic compounds in ND-ENKTL. Enterobacteriaceae were associated not only with clinical data explaining disease status (serum C-reactive protein, stage, prognosis index of natural killer cell lymphoma [PINK], and PINK-E) but also with clinical outcomes (early relapse and short progression-free survival). The relative abundance of Enterobacteriaceae at the family level was similar between ENKTL and diffuse large B-cell lymphoma (DLBCL) (p=0.140). However, the ENKTL exhibited a higher abundance of Escherichia, in contrast to the prevalence of Enterobacter and Citrobacter in DLBCL. Linear regression analysis demonstrated a significant association between Escherichia abundance and programmed cell death-ligand-1 (PD-L1) levels in tissue samples (p=0.025), whereas no correlation with PD-L1 was observed for Enterobacteriaceae at the family level (p=0.571).
Conclusion
ND-ENKTL exhibited an abundance of Enterobacteriaceae and a dominant presence of Escherichia. These microbial characteristics correlated with disease status, treatment outcomes, and PD-L1 expression, suggesting the potential of the ENKTL microbiome as a biomarker and cause of lymphomagenesis, which warrants further exploration.
4.Combined effect of anemia and chronic rhinitis on hearing loss in Korean adults: a nationwide observational study
Yeong Jun JU ; Woorim KIM ; Jina HAN ; Soon Young LEE
Epidemiology and Health 2024;46(1):e2024063-
OBJECTIVES:
Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship.
METHODS:
Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term.
RESULTS:
Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition.
CONCLUSIONS
Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.
5.Combined effect of anemia and chronic rhinitis on hearing loss in Korean adults: a nationwide observational study
Yeong Jun JU ; Woorim KIM ; Jina HAN ; Soon Young LEE
Epidemiology and Health 2024;46(1):e2024063-
OBJECTIVES:
Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship.
METHODS:
Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term.
RESULTS:
Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition.
CONCLUSIONS
Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.
6.Combined effect of anemia and chronic rhinitis on hearing loss in Korean adults: a nationwide observational study
Yeong Jun JU ; Woorim KIM ; Jina HAN ; Soon Young LEE
Epidemiology and Health 2024;46(1):e2024063-
OBJECTIVES:
Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship.
METHODS:
Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term.
RESULTS:
Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition.
CONCLUSIONS
Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.
7.Combined effect of anemia and chronic rhinitis on hearing loss in Korean adults: a nationwide observational study
Yeong Jun JU ; Woorim KIM ; Jina HAN ; Soon Young LEE
Epidemiology and Health 2024;46(1):e2024063-
OBJECTIVES:
Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship.
METHODS:
Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term.
RESULTS:
Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition.
CONCLUSIONS
Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.
8.The Effect of Chronic Disease Management Program on the Risk of Complications in Patients With Hypertension in Korea
Sang Ah LEE ; Hyeki PARK ; Woorim KIM ; Sun Ok SONG ; Hyunsun LIM ; Sung-Youn CHUN
Journal of Korean Medical Science 2022;37(31):e243-
Background:
A chronic disease management program was implemented in April 2012 to lower out-of-pocket costs for repeat visits to the same clinic. The aim of this study was to investigate the association between participating in this program and the onset of complications among patients with hypertension using whole-nation claims data.
Methods:
We used National Health Insurance Service data (2011–2018) and patients with newly detected hypertension from 2012 to 2014 were selected. Chronic disease management program reduces the out-of-pocket expenses of consultation fee from 30% to 20% when patients enroll in this program by agreeing to visit the same clinic for the treatment of hypertension or diabetes. As the dependent variable, acute myocardial infarction (MI), stroke, chronic kidney disease (CKD), and heart failure (HF) were selected. For analysis, cox proportional hazards model was used.
Results:
Total participants were 827,577, among which 102,831(12.6%) subjects participated in the chronic disease management. Participants of the chronic disease management program were more likely to show lower hazard ratios (HRs) than those of non-participants in terms of all complications (MI: HR, 0.75; 95% confidence interval [CI], 0.68–0.82; stroke: HR, 0.75; 95% CI, 0.72–0.78; CKD: HR, 0.90; 95% CI, 0.85–0.96; HF: HR, 0.56; 95% CI, 0.52–0.61).
Conclusion
The results showed that participants of the chronic disease management program were less likely to have hypertension complications compared to non-participants. Enhancing the participation rate may be related to better outcomes and reducing medical expenses among patients with chronic diseases.
9.Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease
Kyu-Tae HAN ; Dong Wook KIM ; Woorim KIM
The Korean Journal of Gastroenterology 2022;63(11):1043-1049
Purpose:
Chronic diseases and cardiovascular diseases (CVD) have been independently linked to poorer cancer outcomes. This study investigated whether gastric cancer patients with hypertension, diabetes, or dyslipidemia have higher mortality if diagnosed with CVD in the past year before cancer diagnosis.
Materials and Methods:
Data were obtained from the National Health Insurance database for 2002 to 2019. The study population consisted of gastric cancer patients with hypertension, diabetes, or dyslipidemia. The outcome measure was 5-year mortality in relation to incident status of CVD within 1 year before cancer diagnosis. A survival analysis was conducted using the Cox proportional hazards model. Subgroup analysis was conducted according to age, economic status, and type of hospital first visited for cancer treatment.
Results:
Of a total of 6458 individuals, 2123 (32.7%) were diagnosed with CVDs in the past year before cancer diagnosis. Compared to participants without a history of CVD, those who were diagnosed with CVD showed a higher risk of 5-year mortality (hazard ratio 1.259, 95% confidence interval 1.138–1.394). The extent to which the mortality risk differed between those with and without CVD was greater for individuals of low economic status and in those receiving their initial cancer treatment in a general hospital.
Conclusion
Patients with gastric cancer and hypertension, diabetes, or dyslipidemia diagnosed with CVD within 1 year before their cancer diagnosis had a higher mortality risk, emphasizing the importance of managing cancer patients with chronic disease and subsequent incidence of CVDs.
10.Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease
Kyu-Tae HAN ; Dong Wook KIM ; Woorim KIM
Yonsei Medical Journal 2022;63(11):1043-1049
Purpose:
Chronic diseases and cardiovascular diseases (CVD) have been independently linked to poorer cancer outcomes. This study investigated whether gastric cancer patients with hypertension, diabetes, or dyslipidemia have higher mortality if diagnosed with CVD in the past year before cancer diagnosis.
Materials and Methods:
Data were obtained from the National Health Insurance database for 2002 to 2019. The study population consisted of gastric cancer patients with hypertension, diabetes, or dyslipidemia. The outcome measure was 5-year mortality in relation to incident status of CVD within 1 year before cancer diagnosis. A survival analysis was conducted using the Cox proportional hazards model. Subgroup analysis was conducted according to age, economic status, and type of hospital first visited for cancer treatment.
Results:
Of a total of 6458 individuals, 2123 (32.7%) were diagnosed with CVDs in the past year before cancer diagnosis. Compared to participants without a history of CVD, those who were diagnosed with CVD showed a higher risk of 5-year mortality (hazard ratio 1.259, 95% confidence interval 1.138–1.394). The extent to which the mortality risk differed between those with and without CVD was greater for individuals of low economic status and in those receiving their initial cancer treatment in a general hospital.
Conclusion
Patients with gastric cancer and hypertension, diabetes, or dyslipidemia diagnosed with CVD within 1 year before their cancer diagnosis had a higher mortality risk, emphasizing the importance of managing cancer patients with chronic disease and subsequent incidence of CVDs.

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