Risk Factors of Cardiovascular Disease according to Alcohol Behavioral Change after Cancer Diagnosis / 가정의학회지

Background@#Problem drinking increases the incidence of all-cause mortality and specific cancers, and persistent drinking is associated with cardiovascular disease in certain cancer survivors. This study analyzed the cardiovascular risk factors before and after diagnosis in Korean cancer survivors. @*Methods@#Data for the period between 2002 and 2013 were collected from the National Health Insurance Service Health-Examinee Cohort Database. Among the 27,835 patients included, those with moderate alcohol consumption before and after cancer diagnosis were excluded. Problem drinking was defined as males under 65 years consuming over 14 glasses a week, and males over 65 years or females consuming over seven glasses a week. A t-test, chi-square test, and linear regression analysis were performed for differences in cardiovascular risk factors and differences according to cancer types. @*Results@#There was a difference in the body mass index, systolic and diastolic blood pressure, and total cholesterol among patients who became moderate drinkers after diagnosis, but fasting blood glucose did not show any significant changes. Risk factors for cardiovascular disease were analyzed in patients with liver, stomach, rectal, and breast cancer with improved drinking behavior, and there were significant differences in body mass index, systolic and diastolic blood pressure, fasting blood glucose, and total cholesterol in stomach cancer patients. @*Conclusion@#Moderate drinking can lower cardiovascular risk in cancer survivors, and among the many drinking-related cancers, stomach cancer patients demonstrated significantly reduced cardiovascular risk factors.

Comparison of the Marginal Utility and Disease Burden of Hearing Loss and Other Chronic Diseases / 가정의학회지

BACKGROUND: Compared with other chronic diseases, hearing loss is generally overlooked from the perspective of disease burden. However, hearing loss is emerging as an important issue in the current society. The objective of this study was to investigate disease burdens and marginal utilities associated with hearing loss and other chronic diseases. METHODS: This study analyzed the cross-sectional data of 32,986 participants aged 19 years and older who completed the Korea National Health and Nutrition Examination Surveys between 2009 and 2013. Additionally, this study used the pure tone audiometric test, European Quality of Life-Five Dimensions Questionnaire, and chronic disease status. The data were analyzed using a multiple linear regression method. RESULTS: The data of 23,297 people who underwent a pure tone audiogram and completed the European Quality of Life-Five Dimensions Questionnaire were used in this analysis. The marginal utility of hearing loss ranked fifth among nine chronic diseases. The estimated loss of quality-adjusted life years associated with hearing loss was −93.69 years per 100,000 people, which is similar to other chronic diseases. CONCLUSION: This study assessed the marginal utilities and public burdens of hearing loss and eight chronic diseases in a South Korean population. Although the values may vary depending on country and race, this study may provide an indispensable foundation for more detailed studies on hearing loss.

Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue

BACKGROUND/AIMS: Currently, the videofluoroscopic swallowing study (VFSS) is the standard tool for evaluating dysphagia. We evaluated whether the addition of endoscopist-directed flexible endoscopic evaluation of swallowing (FEES) to VFSS could improve the detection rates of penetration, aspiration, and pharyngeal residue, compared the diagnostic efficacy between VFSS and endoscopist-directed FEES and assessed the adverse events of the FEES. METHODS: In single tertiary referral center, a retrospective analysis of prospectively collected data was conducted. Fifty consecutive patients suspected of oropharyngeal dysphagia were enrolled in this study between January 2012 and July 2012. RESULTS: The agreement in the detection of penetration and aspiration between VFSS and FEES of viscous food (kappa=0.34; 95% confidence interval [CI], 0.15 to 0.53) and liquid food (kappa=0.22; 95% CI, 0.02 to 0.42) was "fair." The agreement in the detection of pharyngeal residue between the two tests was "substantial" with viscous food (kappa=0.63; 95% CI, 0.41 to 0.94) and "fair" with liquid food (kappa=0.37; 95% CI, 0.10 to 0.63). Adding FEES to VFSS significantly increased the detection rates of penetration, aspiration, and pharyngeal residue. No severe adverse events were noted during FEES, except for two cases of epistaxis, which stopped spontaneously without requiring any packing. CONCLUSIONS: This study demonstrated that the addition of endoscopist-directed FEES to VFSS increased the detection rates of penetration, aspiration, and pharyngeal residue.

A Case of Locally Invasive Thyroid Papillary Cancer Diagnosed by Esophagoscopy / 대한소화기내시경학회지

Papillary carcinoma is the most common malignant tumor of the thyroid gland, and it only infrequently invades the upper aerodigestive tract. When such invasion does occur, it is a source of significant morbidity as well as mortality. Although most thyroid tumors first clinically manifest as a neck mass, there have been few reports of patients whose initial compliant was a disturbance of the aerodigestive tract. The patient in our present study had no significant past medical history, and esophagoscopy and biopsy revealed papillary adenocarcinoma. We report here on a case of thyroid papillary carcinoma that was diagnosed by esophagoscopic biopsy.

A Case of Advanced Gastric Cancer and the First Symptom was a Skin Lesion / 대한소화기내시경학회지

Cutaneous metastasis of internal malignancies is rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% for patients with all types of malignancies. Furthermore, cutaneous metastasis from advanced gastric cancer is exceedingly rare. A 43-year-old man presented with a single, symptomatic, erythematous nodule on the chest wall. A biopsy taken from the nodule showed an adenocarcinoma of the poorly differentiated type. An endoscopic examination and biopsy was done and these showed the same histologic findings. We reported here on this unusual case of advanced gastric cancer and the patient's first symptom was a skin lesion.

A Case of Spontaneous Regression of Non-small-cell Lung Cancer / 결핵및호흡기질환

Lung cancer is one of the most prevalent cancers and it has the highest mortality of all forms of cancers. Although surgery, chemotherapy and radiotherapy are routinely used for the treatment of lung cancer treatment, little progress has been made in the treatment of this condition over the past 20 years. The histological subtype of squamous cell carcinoma (SCC) accounts for approximately 30% of all lung cancer patients. Spontaneous regression of non-small-cell lung cancer (NSCL) is an extremely rare phenomenon. Spontaneous regression of cancer (SR) is defined as a complete or partial, temporary or permanent disappearance of all or at least some the relevant parameters of soundly diagnosed malignant disease without any medical treatment or with treatment that is considered inadequate to produce the resulting regression.