Lung Cancer Incidence by Smoking Status in Korean Men: 16-Years of Observations in the Seoul Male Cancer Cohort Study

The relative risk (RR) of smoking and mortality of lung cancer in British doctors was previously reported to have increased throughout a 40-yr period. Here, we evaluated this RR based on the incidence of lung cancer in Korean men using a longer follow-up period. We compared our data to the RR reported in a study using a 10-yr follow-up period; the subjects and methods were identical to those of the previous paper with the exception of the follow-up period, which ended on December 31, 2008. We found that the RR of smoking habits in patients with lung cancer did not increase, and that the data showed narrowing 95% confidence intervals over a longer observation in Korean men. Estimated lung cancers attributable to smoking were 55.6%. These results highlight the need for an intervention program to help patients quit smoking in Korea.

Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality Among Middle-aged Men in Korea: The Seoul Male Cohort Study / 예방의학회지

OBJECTIVES: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. METHODS: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. RESULTS: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. CONCLUSIONS: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

Pulmonary Tuberculosis and Lung Cancer Risk in Current Smokers: The Seoul Male Cancer Cohort Study

Authors evaluated pulmonary tuberculosis (PTB) history as a risk factor for lung cancer in current male smokers in a prospective, population-based cohort study. The subjects were the 7,009 males among the participants in the Seoul Male Cancer Cohort Study for whom there was full information on PTB history and smoking habits. With a 16-yr follow-up, 93 cases of lung cancer occurred over the 99,965 person-years of the study. The estimated relative risk (RR) of PTB history of current smokers in lung cancer after adjusting for three confounders - intake of coffee and tomatoes, and age at entry - was 1.85 (95% CI: 1.08-3.19). The observed joint RRs and attributable risks (ARs) across strata of three confounders were greater than the expected, indicating a positive interaction. Thus a history of PTB in current smokers may be another risk factor for lung cancer. Based on a synergic interaction, a heavy male smoker with a PTB history would be expected to belong to the group at high risk of lung cancer.

Completeness of Cancer Case Ascertainment in Korea Radiation Effect and Epidemiology Cohort Study

The aim of this study was to evaluate whether the completeness of case ascertainment during the follow-up of a cohort differed between the exposed and the nonexposed groups in Korea Radiation Effect and Epidemiology Cohort (KREEC). The completeness was defined as the proportion of the number of detected cases to the number of estimated cases, in which the estimation was performed by capture-recapture method. Data were obtained from the cancer registries, death certificates, and medical records during years 2004-2007. Among 11,367 subjects in the exposed group and 24,809 subjects in the unexposed group, the completeness of cancer case ascertainment were 88.2% vs 87.2% in cancer registry, 38.2% vs 41.1% in death certificate and 57.9% vs 62.0% in medical records data, 96.9% vs 97.1% for all combined sources and were not statistically different between the two groups. In conclusion, the method of ascertaining the cases in the KREEC was not biased depending on the exposure status, and thus adds credibility to the outcomes of the KREEC study as well as confirming the incident cases in the two groups.

Impact of Individual and Combined Health Behaviors on All Causes of Premature Mortality Among Middle Aged Men in Korea: The Seoul Male Cohort Study / 예방의학회지

OBJECTIVES: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea. METHODS: In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score. RESULTS: Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively. CONCLUSIONS: Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.

Low Cholesterol is Associated with Mortality from Cardiovascular Diseases: A Dynamic Cohort Study in Korean Adults

This study was conducted to evaluate the association of single serum total cholesterol (TC) measurement with cardiovascular diseases (CVD) deaths in Korean adults. The study subjects were taken from the multi-site collaborative dynamic prospective cohort for epidemiologic investigation on cancer risk in residents nearby nuclear power plants in Korea. A total of 12,740 adults aged 40 to 69 yr who underwent a mass screening examination were followed up from 1993 to 2008. Occurring CVD deaths were confirmed by the death certificates in the National Statistical Office, Korea. Groups with the lowest group having TC = 240 mg/dL were associated with higher CVD mortality in Cox proportional hazards analysis adjusting for age, sex, smoking and drinking status, body mass index, level of blood pressure, triglyceride and high density lipoprotein cholesterol. The distribution of adjusted hazard ratios showed the U-shaped curve. Based on the results of this study, caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk in Korean adults.

Cancer Risk in Adult Residents near Nuclear Power Plants in Korea: A Cohort Study of 1992-2010

This study evaluated cancer risk for adult residents near Nuclear Power Plants (NPPs) in Korea through a valid prospective cohort study during 1992-2010. The study cohort was composed of 11,367 adults living within a five km radius from the NPPs for the exposed and 24,809 adults for the non-exposed or reference cohort set at two different levels of proximity; 5-30 km radius and more than 30 km radius away from NPPs. In 303,542.5 person-years of follow-up, a total of 2,298 cancer cases of all sites, or 1,377 radio-inducible cancers diagnosed during 1992-2008 were ascertained. Multiple adjusted hazard ratios and 95% confidence intervals were estimated using multivariate Cox proportional hazard model. There were no epidemiological evidence for increased risk of cancer due to radiation from NPPs. Radiological study results or surveillance data of radiation doses around NPPs could be well documented for risk estimation of radio-inducible cancers, instead of epidemiological study results of the long-time required. Continuous surveillance of quantitative measures of dose levels around NPPs and radiation exposures to the residents is warranted.

Power Estimation and Follow-Up Period Evaluation in Korea Radiation Effect and Epidemiology Cohort Study / 예방의학회지

OBJECTIVES: The objective of this study was to calculate sample size and power in an ongoing cohort, Korea radiation effect and epidemiology cohort (KREEC). METHOD: Sample size calculation was performed using PASS 2002 based on Cox regression and Poisson regression models. Person-year was calculated by using data from '1993-1997 Total cancer incidence by sex and age, Seoul' and Korean statistical informative service. RESULTS: With the assumption of relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, sample size calculation was 405 events based on a Cox regression model. When the relative risk was assumed to be 1.5 then number of events was 170. Based on a Poisson regression model, relative risk=1.3, exposure:non-exposure=1:2 and power=0.8 rendered 385 events. Relative risk of 1.5 resulted in a total of 157 events. We calculated person-years (PY) with event numbers and cancer incidence rate in the non-exposure group. Based on a Cox regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, 136 245PY was needed to secure the power. In a Poisson regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, person-year needed was 129517PY. A total of 1939 cases were identified in KREEC until December 2007. CONCLUSIONS: A retrospective power calculation in an ongoing study might be biased by the data. Prospective power calculation should be carried out based on various assumptions prior to the study.

Comparison of Prevalence of Metabolic Syndrome Between Korean Emigrants and Host Country Residents in Japan and China-The Korean Emigrant Study / 한국역학회지

OBJECTIVES: This study aims to compare the prevalence of metabolic syndrome between Korean emigrants (KEs) and their host country residents in Japan and China. METHODS: The Korean Emigrant Study (KES) is a cohort study initiated in 2005 to elucidate the effect of genetic susceptibility and environmental change on hypertension, diabetes, and metabolic syndrome. Equal numbers of KEs and host country residents, aged 30 or over, were recruited from three regions; Kobe-Osaka in Japan (total number=965), Yanbian in China (n=1,019), and Changchun in China (n=949). RESULTS: The age-adjusted prevalences of metabolic syndrome among KEs in Kobe-Osaka were significantly higher than those among Japanese (in men 24.0% vs. 15.6%, p=0.04, in women 8.4% vs. 2.7%, p=0.01), while the age-adjusted prevalences among KEs in Changchun were similar to those among Chinese (in men 11.7% vs. 16.1%, p=0.37, in women 28.3% vs. 30.1%, p=0.91). The age-adjusted prevalences were generally higher in Yanbian than other regions, and KEs had higher prevalence than Chinese in men but not in women (in men 37.9% vs. 28.3%, p=0.03, women 46.0% vs. 50.6%, p=0.44). The components with significant ethnic differences in prevalence were high blood pressure and abdominal obesity in Japan, and triglyceride in China. The most influential component in diagnosing metabolic syndrome was abdominal obesity in men and triglyceride in women. CONCLUSION: The prevalence of metabolic syndrome was higher in KEs than in host country residents in Japan but not in China. Abdominal obesity and triglyceride are both discriminating and influential components in metabolic syndrome.

Reliability of Covariates in Baseline Survey of a Cohort Study: Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea / 예방의학회지

OBJECTIVES: We evaluated the reliability of the possible covariates of the baseline survey data collected for the Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea. METHODS: Follow-up surveys were conducted for 477 participants of the cohort at less than 1 year after the initial survey. The mean interval between the initial and follow-up surveys was 282.5 days. Possible covariates were identified by analyzing the correlations with the exposure variable and associations with the outcome variables for all the variables. Logistic regression analysis with stepwise selection was further conducted among the possible covariates to select variables that have covariance with other variables. We considered that these variables can be representing other variables. Seven variables for the males and 3 variables for the females, which had covariance with other possible covariates, were selected as representative variables. The Kappa index of each variable was calculated. RESULTS: For the males, the Kappa indexes were as follow; family history of cancer was 0.64, family history of liver diseases in parents and siblings was 0.56, family history of hypertension in parents and siblings was 0.51, family history of liver diseases was 0.50, family history of hypertension was 0.44, a history of chronic liver diseases was 0.53 and history of pulmonary tuberculosis was 0.36. For females, the Kappa indexes were as follow; family history of cancer was 0.58, family history of hypertension in parents and siblings was 0.56 and family history of hypertension was 0.47. CONCLUSIONS: Most of the possible covariates showed good to moderate agreement.

Curative effect of stereotactic 186Re endocavitary irradiation on cystic craniopharyngioma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the treatment results of stereotactic (186)Re intracavitary irradiation in the patients with craniopharyngioma.</p><p><b>METHODS</b>Nineteen patients were treated with stereotactic (186)Re intracavitary irradiation, including 12 males and 7 females (average age, 37.2 years). Among them 12 patients had a solitary cyst, whereas 7 patients with mixed structure (e.g., a large cyst with a small solid portion). The mean volume of the cystic portion of the tumor before irradiation was 8390 mm(3).</p><p><b>RESULTS</b>The patients were followed up for 6 months to 3 years. The retraction of the cyst was complete in 7 patients, cyst volume decreased more than 50% in 5 patients and less than 50% in 7 cases. Among the 8 patients with visual acuity deficit before irradiation, 5 were improved. No hypopituitarism occurred in patients with normal pituitary function before treatment. One of the 4 patients with hypopituitarism was improved, 3 of the 5 patients with diabetes insipidus was improved.</p><p><b>CONCLUSION</b>Stereotactic (186)Re endocavitary irradiation for the treatment of cystic craniopharyngioma is a safe and effective procedure.</p>

Treatment of recurrent malignant gliomas by surgery combined with recombinant adenovirus-p53 injection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and toxicity of combination therapy with surgery and recombinant adenovirus-p53 injection of recurrent malignant gliomas.</p><p><b>METHODS</b>38 patients with recurrent malignant gliomas were included in this study. Among them, 18 patients of combined treatment group had Ommaya reservoirs placed into the tumor cavities after the resection of the tumors and received regular recombinant adenovirus-p53 injections after the operation. The other 20 patients received surgery alone.</p><p><b>RESULTS</b>The 6-month and 1-year survival rates after the combination therapy were 66.7% (14/18) and 44.4% (8/18), respectively. The median survival time was 9.7 months. Compared with the surgery-alone group, the combined treatment group achieved significant improvement (P < 0.05). The Karnofsky score was significantly improved at 6 months after the combination therapy compared with that before the treatment (P < 0.05).</p><p><b>CONCLUSION</b>The recombinant adenovirus-p53 injection is safe and effective in treatment of recurrent malignant gliomas. The combination therapy of surgery and recombinant adenovirus-p53 injection may improve the life quality and the prognosis in patients with recurrent malignant gliomas.</p>

Relationship between plasma cortisol levels and stress ulcer following acute and severe head injury

This study was designed to investigate the relationship between plasma cortisol levels and stress ulcer following acute severe head injury. The plasma cortisol levels were prospectively measured by radioimmunoassay in 68 patients following acute head injury. The diagnosis of stress ulcer was based on clinical evidence and was confirmed by endoscopic examination. Patients with stress ulcer and gastrointestinal bleeding [n = 30, 44.1%] were older than those without stress ulcer [38.2 +/- 7.9 vs. 28.3 +/- 9.7 years, P< 0.01]. The combined rate of poor recovery and death in the stress ulcer patients [70.0%] was significantly higher than in the nonulcer patients [42.1%, p = 0.02]. On each of the first 3 days following the head injury, the average plasma cortisol levels in the stress ulcer patients were higher than in the nonulcer patients [p< 0.01]. Univariate analysis showed a positive relationship between plasma cortisol on admission and stress ulcer [r= 0.329, p = 0.01]. Logistic regression analysis revealed that plasma cortisol levels on admission [OR = 2.326, 95% Cl = 1.982-2.466] and age [OR = 1.064, 95% Cl = 0.861-1.219] were independent predictors of stress ulcer. The data showed that acute severe head injury was associated with a significant increase in plasma cortisol. Plasma levels of cortisol and age were independent predictors of stress ulcer following acute head injury

Cigarette Smoking and Risk of Lung Cancer in Korean Men: The Seoul Male Cancer Cohort Study

Lung cancer is the leading cause of cancer deaths in Korea. The aim of this study was to estimate lung cancer risk of cigarette smoking in Korean men by a 10-yr follow-up prospective cohort study using the primary databases. The number of subjects was 14,272 men, who had full information of smoking habits among participants in the Seoul Male Cancer Cohort Study (SMCC). Total 125,053 personyears were calculated by determining the number of days from the start of followup, January 1, 1993, until the date of lung cancer diagnosis, death from another cause, or the end of follow-up, December 31, 2002, followed by converting the number of days to years. The information of outcome was obtained by the database of Korea Central Cancer Registry, Seoul Regional Cancer Registry, and Korea Statistical Office. The relative risk (RR) and its 95% confidence interval (CI) values of smoking were calculated using Cox proportional hazards regression stratified on potential confounders. During the follow-up periods, 78 cases of lung cancer occurred. The cigarette smoking is the major risk factor and increases the 4.18-fold risk of lung cancer in Korean men. In order to control lung cancer, intervention of quitting smoking is needed.

Effect of L-dicentrine on contractility of the sprips of porcine coronary artery / 中国临床药理学与治疗学

Aim & methods The antagonism of L-dicentrine to contraction of isolated porcine coronary artery strips induced by 5-HT KCl and Ca2+ was observed with U-135 electrophsiological recorder.Results The contractions induced by 5-HT KCl and Ca2+ after high K+ depolarization in the strips of porcine coronary artery were markediy inhibited by L-dicentrine.L-dicentrine significantly depressed maximal response and caused rightward displacement of the dose -response curve. Showing a non-competitive antagonism. In Ca2+ free solution,L-dicentrine inhibited 5-HT-induced contraction of porcine coronary artery,which is dependent on Ca2+ relesed from intracellular store. After Ca2+ concentration in bath solution was restored,L-dicentrine did not influence the contraction of porcine coronary artery depending on extracellular Ca2+.Conclusion L-D have significant relaxation on porcine coronary artery ,which possibly has 5-HT receptor and histamine receptor.