Background and Objectives: To investigate the association between metabolic syndrome (MetS) and hearing impairment (HI) in elderly Korean adults using a large-scale cohort data.Subjects and Method Data was collected on 729664 adults who underwent at least one health screening between 2009 and 2012 from the Korea National Health Insurance Service-Senior Cohort. The study utilized a Cox proportional hazards regression model to assess the relationship between MetS and the risk of developing HI. The results were presented as an adjusted hazard ratio (aHR) with 95% confidence intervals (CI). All subjects were monitored until the occurrence of HI, death, or December 31, 2019. Results: A total of 10102 cases of HI were identified during the follow-up period of 4920397 person-years. In the crude model, MetS was linked to an increased risk of developing HI (HR, 1.14; 95% CI, 1.10-1.19). No significant association was found after adjusting for potential confounding factors (aHR, 1.03; 95% CI, 0.99-1.08). Abnormal triglyceride (TG) levels were associated with a higher risk of HI compared to normal TG levels (aHR, 1.07; 95% CI, 1.03-1.12). In addition, the risk of HI increased as TG levels increased (>150 mg/dL). Conclusion Abnormalities in TG levels were independently associated with an increased risk of HI among elderly adults. Management of TG levels may protect against the risk of incident HI.

Background and Objectives: To investigate the association between metabolic syndrome (MetS) and hearing impairment (HI) in elderly Korean adults using a large-scale cohort data.Subjects and Method Data was collected on 729664 adults who underwent at least one health screening between 2009 and 2012 from the Korea National Health Insurance Service-Senior Cohort. The study utilized a Cox proportional hazards regression model to assess the relationship between MetS and the risk of developing HI. The results were presented as an adjusted hazard ratio (aHR) with 95% confidence intervals (CI). All subjects were monitored until the occurrence of HI, death, or December 31, 2019. Results: A total of 10102 cases of HI were identified during the follow-up period of 4920397 person-years. In the crude model, MetS was linked to an increased risk of developing HI (HR, 1.14; 95% CI, 1.10-1.19). No significant association was found after adjusting for potential confounding factors (aHR, 1.03; 95% CI, 0.99-1.08). Abnormal triglyceride (TG) levels were associated with a higher risk of HI compared to normal TG levels (aHR, 1.07; 95% CI, 1.03-1.12). In addition, the risk of HI increased as TG levels increased (>150 mg/dL). Conclusion Abnormalities in TG levels were independently associated with an increased risk of HI among elderly adults. Management of TG levels may protect against the risk of incident HI.

Background and Objectives: To investigate the association between metabolic syndrome (MetS) and hearing impairment (HI) in elderly Korean adults using a large-scale cohort data.Subjects and Method Data was collected on 729664 adults who underwent at least one health screening between 2009 and 2012 from the Korea National Health Insurance Service-Senior Cohort. The study utilized a Cox proportional hazards regression model to assess the relationship between MetS and the risk of developing HI. The results were presented as an adjusted hazard ratio (aHR) with 95% confidence intervals (CI). All subjects were monitored until the occurrence of HI, death, or December 31, 2019. Results: A total of 10102 cases of HI were identified during the follow-up period of 4920397 person-years. In the crude model, MetS was linked to an increased risk of developing HI (HR, 1.14; 95% CI, 1.10-1.19). No significant association was found after adjusting for potential confounding factors (aHR, 1.03; 95% CI, 0.99-1.08). Abnormal triglyceride (TG) levels were associated with a higher risk of HI compared to normal TG levels (aHR, 1.07; 95% CI, 1.03-1.12). In addition, the risk of HI increased as TG levels increased (>150 mg/dL). Conclusion Abnormalities in TG levels were independently associated with an increased risk of HI among elderly adults. Management of TG levels may protect against the risk of incident HI.

Background and Objectives: To investigate the association between metabolic syndrome (MetS) and hearing impairment (HI) in elderly Korean adults using a large-scale cohort data.Subjects and Method Data was collected on 729664 adults who underwent at least one health screening between 2009 and 2012 from the Korea National Health Insurance Service-Senior Cohort. The study utilized a Cox proportional hazards regression model to assess the relationship between MetS and the risk of developing HI. The results were presented as an adjusted hazard ratio (aHR) with 95% confidence intervals (CI). All subjects were monitored until the occurrence of HI, death, or December 31, 2019. Results: A total of 10102 cases of HI were identified during the follow-up period of 4920397 person-years. In the crude model, MetS was linked to an increased risk of developing HI (HR, 1.14; 95% CI, 1.10-1.19). No significant association was found after adjusting for potential confounding factors (aHR, 1.03; 95% CI, 0.99-1.08). Abnormal triglyceride (TG) levels were associated with a higher risk of HI compared to normal TG levels (aHR, 1.07; 95% CI, 1.03-1.12). In addition, the risk of HI increased as TG levels increased (>150 mg/dL). Conclusion Abnormalities in TG levels were independently associated with an increased risk of HI among elderly adults. Management of TG levels may protect against the risk of incident HI.

Background and Objectives: To investigate the association between metabolic syndrome (MetS) and hearing impairment (HI) in elderly Korean adults using a large-scale cohort data.Subjects and Method Data was collected on 729664 adults who underwent at least one health screening between 2009 and 2012 from the Korea National Health Insurance Service-Senior Cohort. The study utilized a Cox proportional hazards regression model to assess the relationship between MetS and the risk of developing HI. The results were presented as an adjusted hazard ratio (aHR) with 95% confidence intervals (CI). All subjects were monitored until the occurrence of HI, death, or December 31, 2019. Results: A total of 10102 cases of HI were identified during the follow-up period of 4920397 person-years. In the crude model, MetS was linked to an increased risk of developing HI (HR, 1.14; 95% CI, 1.10-1.19). No significant association was found after adjusting for potential confounding factors (aHR, 1.03; 95% CI, 0.99-1.08). Abnormal triglyceride (TG) levels were associated with a higher risk of HI compared to normal TG levels (aHR, 1.07; 95% CI, 1.03-1.12). In addition, the risk of HI increased as TG levels increased (>150 mg/dL). Conclusion Abnormalities in TG levels were independently associated with an increased risk of HI among elderly adults. Management of TG levels may protect against the risk of incident HI.

C-C chemokine receptor type 5 (CCR5) regulates the trafficking of various immune cells to sites of infection. In this study, we showed that expression of CCR5 and its ligands was rapidly increased in the kidney after systemic Candida albicans infection, and infected CCR5−/−mice exhibited increased mortality and morbidity, indicating that CCR5 contributes to an effective defense mechanism against systemic C. albicans infection. The susceptibility of CCR5−/− mice to C. albicans infection was due to impaired fungal clearance, which in turn resulted in exacerbated renal inflammation and damage. CCR5-mediated recruitment of NK cells to the kidney in response to C. albicans infection was necessary for the anti-microbial activity of neutrophils, the main fungicidal effector cells. Mechanistically, C. albicans induced expression of IL-23 by CD11c+ dendritic cells (DCs). IL-23 in turn augmented the fungicidal activity of neutrophils through GM-CSF production by NK cells. As GM-CSF potentiated production of IL-23 in response to C. albicans, a positive feedback loop formed between NK cells and DCs seemed to function as an amplification point for host defense. Taken together, our results suggest that CCR5-mediated recruitment of NK cells to the site of fungal infection is an important step that underlies innate resistance to systemic C. albicans infection.

BACKGROUND: The numbers of patients on dialysis and their life expectancies are increasing. Reduced renal function is associated with an increased risk of cancer, but the cancer incidence and sites in dialysis patients compared with those of the general population require further investigation. We investigated the incidences of various cancers in dialysis patients in Korea and used national health insurance data to identify cancers that should be screened in dialysis clinics. METHODS: We accessed the Korean National Health Insurance Database and excerpted data using the International Classification of Disease codes for dialysis and malignancies. We included all patients who commenced dialysis between 2004 and 2013 and selected the same number of controls via propensity score matching. RESULTS: A total of 48,315 dialysis patients and controls were evaluated; of these, 2,504 (5.2%) dialysis patients and 2,201 (4.6%) controls developed cancer. The overall cancer risk was 1.54-fold higher in dialysis patients than in controls (adjusted hazard ratio, 1.71; 95% confidence interval, 1.61–1.81). The cancer incidence rate (incidence rate ratio [IRR], 3.27) was especially high in younger dialysis patients (aged 0–29 years). The most common malignancy of end-stage renal disease patients and controls was colorectal cancer. The major primary cancer sites in dialysis patients were liver and stomach, followed by the lung, kidney, and urinary tract. Kidney cancer exhibited the highest IRR (6.75), followed by upper urinary tract (4.00) and skin cancer (3.38). The rates of prostate cancer (0.54) and oropharyngeal cancer (0.72) were lower than those in the general population. CONCLUSION: Dialysis patients exhibited a higher incidence of malignancy than controls. Dialysis patients should be screened in terms of colorectal, liver, lung, kidney and urinary tract malignancies in dialysis clinics.
Colorectal Neoplasms ; Dialysis ; Epidemiology ; Humans ; Incidence ; International Classification of Diseases ; Kidney ; Kidney Failure, Chronic ; Kidney Neoplasms ; Korea ; Life Expectancy ; Liver ; Lung ; National Health Programs ; Oropharyngeal Neoplasms ; Propensity Score ; Prostatic Neoplasms ; Renal Dialysis ; Skin Neoplasms ; Stomach ; Urinary Tract

BACKGROUND/AIMS: Since patients with human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) have favorable outcomes after treatment, treatment de-escalation for these patients is being actively investigated. However, not all HPV-positive HNSCCs are curable, and some patients have a poor prognosis. The purpose of this study was to identify poor prognostic factors in patients with HPV-positive HNSCC. METHODS: Patients who received a diagnosis of HNSCC and tested positive for HPV from 2000 to 2015 at a single hospital site (n = 152) were included in this retrospective analysis. HPV typing was conducted using the HPV DNA chip assay or liquid bead microarray system. Expression of p16 in the tumors was assessed by immunohistochemistry. To determine candidate factors associated with overall survival (OS), univariate and multivariable Cox regression analyses were performed. RESULTS: A total of 152 patients with HPV-positive HNSCC were included in this study; 82.2% were male, 43.4% were current or former smokers, and 84.2% had oropharyngeal cancer. By univariate analysis, old age, performance status ≥ 1, non-oropharyngeal location, advanced T classification (T3–4), and HPV genotype 18 were significantly associated with poor OS. By multivariable analysis, performance status ≥ 1 and non-oropharyngeal location were independently associated with shorter OS (hazard ratio [HR], 4.36, p = 0.015; HR, 11.83, p = 0.002, respectively). Furthermore, HPV genotype 18 positivity was also an independent poor prognostic factor of OS (HR, 10.87, p < 0.001). CONCLUSIONS Non-oropharyngeal cancer, poor performance status, and HPV genotype 18 were independent poor prognostic factors in patients with HPV-positive HNSCC. Patients with these risk factors might not be candidates for de-escalation treatment.

OBJECTIVE: This retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC). METHODS: Patients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m²/day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m²/day IV on days 1 to 5, every 21 days. RESULTS: From August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0–30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P < 0.010). However, treatment free interval before ETI, number of prior chemotherapy regimen, and optimality of primary surgery did not show significant difference for RR or OS. Grade 3 or 4 hematologic toxicities were observed in 7 cases (3%) of the 232 cycles of ETI. CONCLUSION: The ETI combination regimen shows comparatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC patients with more than 6 months of PFI after last platinum treatment.
Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Follow-Up Studies ; Humans ; Ifosfamide* ; Ovarian Neoplasms* ; Platinum ; Recurrence ; Retrospective Studies*

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been an established treatment for indicated early gastric cancer (EGC) without deterioration of quality of life (QOL) compared with surgical resection. The aim of this study was to evaluate long-term QOL in patients undergoing ESD for EGC. METHODS: Patients scheduled to undergo curative ESD for EGC were prospectively enrolled from 12 institutions between May 2010 and December 2011. Assessments of QOL with Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaire-core (QLQ-C30) and a gastric cancer-specific questionnaire (STO22) were performed at baseline and at 7 days, 3 months, and 6 months after ESD. RESULTS: A total of 666 subjects were assessed for QLQ-C30 and QLQ-STO22. The mean QLQ-C30 score was 69.5 at baseline, 68.8 at 7 days, 73.1 at 3 months, and 73.2 at 6 months. The global health status on the EORTC QLQ-C30 was significantly improved after 3 and 6 months (p=0.0003 and p<0.0001, respectively). The QLQ-C30 and STO22 scores were not significantly different, or they only slightly deteriorated between before and immediately after ESD, but they were significantly improved after 3 and 6 months (p<0.05). CONCLUSIONS: QOL did not deteriorate immediately after ESD, and it improved more significantly at up to 6 months in patients who underwent curative ESD for EGC without significant complications.
Cohort Studies* ; Global Health ; Humans ; Prospective Studies* ; Quality of Life* ; Stomach Neoplasms*