Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Purpose: This study aimed to investigate the incidence and risk factors for secondary malignant neoplasms (SMN) in pediatric solid tumors, focusing on the effects of tandem high-dose chemotherapy (HDCT). Materials and Methods: Patients (aged < 19 years) diagnosed with or treated for pediatric solid tumors between 1994 and 2014 were retrospectively analyzed. The cumulative incidence of SMN was estimated using competing risk methods by considering death as a competing risk. Results: A total of 1,435 patients (413 with brain tumors and 1,022 with extracranial solid tumors) were enrolled. Seventy-one patients developed 74 SMNs, with a 10-year and 20-year cumulative incidence of 2.680±0.002% and 10.193±0.024%, respectively. The types of SMN included carcinoma in 28 (37.8%), sarcoma in 24 (32.4%), and hematologic malignancy in 15 (20.3%) cases. Osteosarcoma and thyroid carcinoma were the most frequently diagnosed tumors. Multivariate analysis showed that radiotherapy (RT) > 2, 340 cGy, and tandem HDCT were significant risk factors for SMN development. The SMN types varied according to the primary tumor type; carcinoma was the most frequent SMN in brain tumors and neuroblastoma, whereas hematologic malignancy and sarcomas developed more frequently in patients with sarcoma and retinoblastoma, respectively. Conclusion The cumulative incidence of SMN in pediatric patients with solid tumors was considerably high, especially in patients who underwent tandem HDCT or in those who received RT > 2,340 cGy. Therefore, the treatment intensity should be optimized based on individual risk assessment and the long-term follow-up of pediatric cancer survivors.

OBJECTIVES: Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011. METHODS: Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign. RESULTS: For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively). CONCLUSIONS A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.

Background/Aims: To investigate whether non-alcoholic fatty liver disease (NAFLD) in individuals without generalized obesity is associated with visceral fat obesity (VFO), sarcopenia, and/or myosteatosis. Methods: This cross-sectional analysis included 14,400 individuals (7,470 men) who underwent abdominal computed tomography scans during routine health examinations. The total abdominal muscle area (TAMA) and skeletal muscle area (SMA) at the 3rd lumbar vertebral level were measured. The SMA was divided into the normal attenuation muscle area (NAMA) and low attenuation muscle area, and the NAMA/TAMA index was calculated. VFO was defined by visceral to subcutaneous fat ratio, sarcopenia by body mass index-adjusted SMA, and myosteatosis by the NAMA/TAMA index. NAFLD was diagnosed with ultrasonography. Results: Of the 14,400 individuals, 4,748 (33.0%) had NAFLD, and the prevalence of NAFLD among non-obese individuals was 21.4%. In regression analysis, both sarcopenia (men: odds ratio [OR] 1.41, 95% confidence interval [CI] 1.19–1.67, P<0.001; women: OR=1.59, 95% CI 1.40–1.90, P<0.001) and myosteatosis (men: OR=1.24, 95% CI 1.02–1.50, P=0,028; women: OR=1.23, 95% CI 1.04–1.46, P=0.017) were significantly associated with non-obese NAFLD after considering for VFO and other various risk factors, whereas VFO (men: OR=3.97, 95% CI 3.43–4.59 [adjusted for sarcopenia], OR 3.98, 95% CI 3.44–4.60 [adjusted for myosteatosis]; women: OR=5.42, 95% CI 4.53–6.42 [adjusted for sarcopenia], OR=5.33, 95% CI 4.51–6.31 [adjusted for myosteatosis]; all P<0.001) was strongly associated with non-obese NAFLD after adjustment with various known risk factors. Conclusions In addition to VFO, sarcopenia and/or myosteatosis were significantly associated with non-obese NAFLD.

Purpose: DA-8010 is a novel muscarinic M3 receptor antagonist with significant selectivity for bladder over salivary gland in preclinical studies. We evaluated the clinical efficacy and safety of DA-8010 in overactive bladder (OAB) patients. Methods: This phase 2, randomized, double-blind, parallel-group, active reference- and placebo-controlled trial was conducted at 12 centers in South Korea (NCT03566134). Patients aged ≥19 years with OAB symptoms for ≥3 months were enrolled. Three hundred six patients (30.07% male) were randomized to 12 weeks of treatment among 4 groups; 2 experimental groups (DA-8010 2.5 or 5 mg), an active reference group (solifenacin 5 mg), and a placebo group. The change from the baseline of (=∆) 24-hour frequency at 12 weeks (primary endpoint), episodes of urgency, overall/urgency urinary incontinence, average/ maximum voided volume, nocturia, and patients’ subjective responses were analyzed. Results: In the full analysis set, the mean (standard deviation) [median] values for ∆ 24-hour frequency at 12 weeks were -1.01 (2.44) [-1.33] for placebo, -1.22 (2.05) [-1.33] for DA-8010 2.5 mg, and -1.67 (2.25) [-1.67] for DA-8010 5 mg; DA-8010 5 mg showed a significant decrease compared with placebo (P=0.0413). At 4 and 8 weeks, both DA-8010 2.5 mg (P=0.0391 at 4 weeks, P=0.0335 at 8 weeks) and DA-8010 5 mg (P=0.0001 at 4 weeks, P=0.0210 at 8 weeks) showed significant decrease in ∆ 24-hour frequency compared with placebo. DA-8010 5 mg achieved a significant decrease in ∆ number of urgency episodes, compared with placebo at 4 (P=0.0278) and 8 (P=0.0092) weeks. Adverse drug reactions (ADRs) were observed in 3.95% of placebo, 6.67% of DA-8010 2.5 mg, 18.42% of DA-8010 5 mg, and 17.33% of solifenacin 5 mg groups. No serious ADRs were observed in any patient. Conclusions Both DA-8010 2.5 mg and 5 mg showed therapeutic efficacy for OAB without serious ADRs. Therefore, both dosages of DA-8010 can advance to a subsequent large-scale phase 3 trial.

Purpose: Endovascular aneurysm repair (EVAR) has lower perioperative mortality and morbidity rates and shorter hospital stays when compared to open surgical repair (OSR) in octogenarian patients. However, its long-term results remain unclear. Hence, we aimed to analyze and compare the long-term outcomes of OSR and EVAR in this aging population. Methods: This single-center, retrospective, observational study analyzed the data of patients older than 80 years who underwent primary repair of an abdominal aortic aneurysm (AAA) between 2011 and 2016 in our hospital. The primary outcomes were in-hospital complications and 30-day mortality, while the secondary outcomes included all-cause mortality and reintervention rate. Results: Among the 48 patients with elective AAA repair, 13 underwent OSR and 35 underwent EVAR. In-hospital complications occurred in 10 patients (20.8%), 5 for OSR (38.5%) and 5 for EVAR (14.3%) with no significant difference between the groups (P = 0.067). In the OSR group, pulmonary complications were the most common events; in the EVAR group, 2 patients had ischemic colitis diagnosed with sigmoidoscopy and recovered by conservative treatment. The 1- and 5-year survival rates were 77.8% and 55.6% in the OSR group, and 66.0% and 54.9% in the EVAR group, respectively. The reintervention rate was 8.6% for the EVAR group; none of the OSR group were readmitted. Conclusion The difference in procedures did not affect patient survival. Therefore, OSR does not necessarily have a worse prognosis than EVAR. Individual risk stratification must be preceded before the selection of an appropriate treatment method.

Background: Venipuncture is one of the one of the most commonly performed, minimally-invasive procedures; however, it may lead to peripheral nerve injury. Here, we describe the diagnosis, treatment, and prognosis of two self-reported cases of nerve injury during venipuncture with the aim of drawing attention to possible needle-related nerve injuries.Case: Two anesthesiologists in our hospital experienced an injury of the lateral antebrachial cutaneous branch of the musculocutaneous nerve during venipuncture. Immediately, they underwent ultrasound examinations and nerve blocks with oral medication, resulting in full recovery. Conclusions Ultrasonography is important for the early and confirmative diagnosis of a nerve injury during venipuncture, and for immediate treatment with a nerve block. Moreover, it is imperative for both the practitioner and the patient to be aware of the possible complication of nerve injury after venipuncture.