Search

PurposeTo evaluate genetic influence on macular ganglion cell inner plexiform layer (GCIPL) thickness.MethodsMacular GCIPL thickness was measured with optical coherence tomography in nine macular subfields defined by the E TDRS. Intraclass correlation coefficients (ICC) of GCIPL thickness by different types of family relationships were estimated to assess intrafamilial resemblance. Then, heritability of GCIPL thickness was estimated.ResultsThree hundred and sixty-one Korean adults from 89 families with normal healthy eyes were included. GCIPL thickness was highest in inner subfields and lowest in fovea. Monozygotic twin pairs showed significantly higher ICCs of GCIPL thickness in all subfields compared to those in parent–offspring pairs and sibling pairs. GCIPL thickness was highly heritable in the centre (0.71) and outer subfields but moderate to highly heritable in inner subfields. Heritability of GCIPL thickness in outer subfields was 0.69, 0.67, 0.72 and 0.68 for superior, inferior, temporal and nasal fields, respectively. Heritability of GCIPL thickness in inner subfields was 0.55, 0.56, 0.75 and 050 for superior, inferior, temporal and nasal subfields, respectively.ConclusionMacular GCIPL thickness is significantly influenced by genetic factors. It varies according to subfields with moderate to high heritability in all subfields.

This study aimed to evaluate factors associated with pneumococcal vaccination uptake (PVU) of cancer survivors. A total of 2032 Korean adult cancer survivors diagnosed between June of 1975 and February of 2018 have participated. Information on PVU status and selected variables were collected through self-administered questionnaires and medical record review. Factors associated PVU were investigated using multiple logistic regression analysis. PVU rate markedly differed by age strata and cancer sites: 73.9% for elderly (≥ 65 years) survivors and 34.6% for younger (

Evidence of the association between anemia and risk of PD (Parkinson’s disease) have been accumulating. This study aimed to examine the relationship between anemia and risk of PD in Korean older adults. Korean adults aged 50 years or older who participated in the Korean National Screening Program (n = 12,342,278) between 2009 and 2013 were followed until 2015. Cox proportional hazards regression models were used to calculate the hazard ratio (HR) of PD, and participants were followed for a mean period of 5.0 years. At the end of follow-up, 3,844 adults were diagnosed with PD. After adjusting for potential confounders, participants with anemia had decreased risk of PD compared to adults without anemia (adjusted HR (aHR) 0.894, 95% CI: 0.809–0.989). Furthermore, aHR of PD was 0.698 (95% CI: 0.546–0.891) in moderate to severe anemia and 0.938 (95% CI: 0.843–1.044) in mild anemia. The protective effect of anemia was also more profound in men (aHR 0.888, 95% CI: 0.774–1.02) than in women (aHR 0.905, 95% CI: 0.782–1.048). In conclusion, anemia was associated with lower risk of PD, particularly for patients with moderate to severe anemia. Our study suggests that further studies may be needed to clarify the relationship between anemia and PD.

The purpose of the study is to evaluate the heritability of inner retinal layer (IRL) and outer retinal layer (ORL) thicknesses in the healthy Korean population. This was a cross-sectional, twin and family study. We included 374 Korean adults with healthy eyes from 89 families. IRL thickness (from the internal limiting membrane to the external limiting membrane) and ORL thickness (from the external limiting membrane to the outer border of the retinal pigment epithelium layer) were measured in the nine macular subfields as defined by the Early Treatment of Diabetic Retinopathy Study using optical coherence tomography. The heritability on IRL and ORL thicknesses were investigated using a variance decomposition model. The heritability of IRL thickness was 0.87, 0.58, 0.85, 0.89, and 0.74 for the central, inner superior, inner inferior, inner temporal, inner nasal subfields, respectively; and 0.62, 0.83, 0.62, and 0.60 for the outer superior, outer inferior, outer temporal, outer nasal subfields, respectively. The heritability of ORL thickness was 0.56, 0.75, 0.66, 0.72, and 0.56 for the central, inner superior, inner inferior, inner temporal, inner nasal subfields, respectively; and 0.64, 0.63, 0.73, 0.54 for the outer superior, outer inferior, outer temporal, and outer nasal subfields, respectively. The heritability estimates of IRL thickness and ORL thickness ranged from moderate to high. The IRL thickness at the central, inner temporal, and inner inferior subfields had particularly high heritability.

An increased risk of influenza-related morbidity and mortality in childhood cancer survivors could be significantly reduced through vaccinations. This study aimed to examine influenza vaccination practices by caregivers of childhood cancer survivors. Study subjects were 364 caregivers, recruited at three major hospitals in South Korea. We collected demographic and medical information through self-administered questionnaires, along with clinical information of childhood cancer survivors by reviewing medical records. Multiple logistic regression analysis was performed to analyze factors associated with influenza vaccination of caregivers. A total of 55.2% of caregivers had received influenza vaccination at least once and 24.2% had received yearly influenza vaccinations during the last 3 years. Caregivers with highest education level were more likely to receive influenza vaccination than caregivers with lowest education level: aOR (95% CI) was 3.42 (1.17, 9.99) for ever-receipt of vaccination and 3.33 (1.15, 9.58) for yearly vaccination. One-year increase in caregiver age was inversely associated with ever-receipt of vaccination (aOR (95% CI), 0.94 (0.90, 0.98)) as well as yearly vaccination (aOR (95% CI), 0.92 (0.88, 0.97)). Increasing time lapse since the end of treatment was also associated with lower vaccinations. Influenza vaccination rates of childhood cancer survivor caregivers were suboptimal. Time lapse after completing cancer treatment, caregiver age, and educational level were independently associated with receipt of influenza vaccination by caregivers. To promote influenza vaccination in caregivers of childhood cancer survivors to prevent influenza-related morbidity and mortality in childhood cancer survivors is necessary.

We analyzed the association between individual frailty-related factors and depression in older adults.A total of 796 older adults who underwent geriatric assessments were included in this cross-sectional study. The frailty-related factors studied were grip strength, physical activity, walking speed, weight loss, and recurrent falls. Depression was based on the Geriatric Depression Scale.After adjustment for covariates, recurrent falls were associated with depression in males (OR 3.84, 95% CI 1.30-11.35). Among females, weakest grip strength, slow walking speed, and weight loss were associated with depression (OR 2.61, 95% CI 1.52-4.49; OR 1.78, 95% CI 1.02-3.11; and OR 2.52, 95% CI 1.17-5.44, respectively). Having more frailty-related factors was also associated with higher odds of depression.The associations between individual frailty-related factors and depression differed among males and females. Further prospective studies on depression and individual frailty-related factors by sex may help elucidate specific targets to be prioritized for clinical assessment and intervention.Older adults affected by depression and frailty may present different clinical manifestations based on sex, and require different treatment approaches. Clinicians should assess both physical and psychological needs for integrated care in frail older adults.

Anemia is a common health problem in older adults and is associated with risk factors for fracture such as low physical function and low bone mass. The aim of this study was to examine the relationship between anemia and fracture risk in older adults. We conducted a retrospective cohort study from 2003 to 2013. The participants were community-dwelling Korean adults aged 65 years and older who participated in the National Health Screening Program (n = 72,131) between 2003 and 2008. Anemia (

The effect of light-to-moderate alcohol consumption on cancer risk remains controversial. We examined the association between low-level alcohol consumption and cancer mortality. A cohort study included 331,984 Korean adults free of cancer at baseline who underwent a comprehensive health checkup examination. Participants were categorized into never drinkers, former drinkers, and current drinkers who were further divided into light, moderate, heavy, and very heavy drinkers. Vital status and cancer-related deaths were ascertained through links to national death records. During 1,633,906 person-years of follow-up (median 5.3 years interquartile range 3.8–6.2), 374 cancer-related deaths were identified (cancer-cause mortality rate of 23 per 105 person-years). When former and never drinkers were classified as non-drinkers, the light drinkers had a lowest risk of cancer mortality compared with non-drinkers and other current drinkers (J-shaped); however, with consideration of lifetime abstinence history, current drinking was positively associated with cancer mortality in a dose-dependent manner. When changes in alcohol drinking status and confounders during follow-up were updated as time-varying covariates and never drinkers were used as the reference, the multivariable-adjusted hazard ratios (HRs) (95% confidence intervals, CIs) for cancer mortality among current light, moderate, heavy, and very heavy drinkers were 1.58 (1.03–2.43), 2.28 (1.41–3.70), 2.34 (1.42–3.85), and 2.97 (1.80–4.90), respectively, and the highest risk of cancer mortality was observed in former drinkers, who had an HR (95% CI) of 3.86 (2.38–6.28). Alcohol consumption was significantly and positively associated with an increased risk of cancer mortality in a dose-dependent manner, beginning with light drinkers.

Additional file 1: Table S1. Comparisons of demographic and clinical characteristics between participants and non-participants. Table S2. Distribution of baseline and new comorbidities according to the level of care coordination. Table S3. Percent difference (95% confidence interval) of quality of life indices and fear of cancer recurrence associated with increase in level of care coordination.

Objectives This study evaluated an association between testosterone, sex hormone-binding globulin (SHBG) and metabolic syndrome (MetS).We also evaluated the genetic and environmental influences on the association. Design Cross-sectional. Setting Community-based study. Participants A total of 1098 Korean adult men including 139 monozygotic twin pairs. Main outcome measure MetS was defined using the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP ATP III) and International Diabetes Federation (IDF) criteria. The associations between MetS and sex hormones were evaluated using linear mixed model and generalized estimating equation model. Results After considering covariates such as smoking, alcohol consumption and physical exercises as well as SHBG or testosterone, the risk of MetS defined by NCEP ATP III criteria decreased by 31%, 29%, and 48%, respectively, with 1-standard deviation increase in total testosterone (TT), free testosterone (cFT) and SHBG. Similar findings were revealed with IDF criteria. Metabolic component specific analysis showed that sex hormones were inversely associated with several components of MetS: TT with abdominal obesity, low high-density lipoprotein cholesterol (HDL-C) and high blood pressure; cFT with abdominal obesity and high blood pressure; SHBG with all components except high blood pressure. Cotwin control analysis found an inverse correlation between within-pair differences in testosterone and SHBG levels and within-pair differences in waist circumference only. Conclusion Both testosterone and SHBG were inversely associated with MetS although the inverse associations with the sex hormones were not consistently found across individual metabolic components. Findings from cotwin analysis suggest a significant contribution of unshared unique environmental effect to the association between testosterone and SHBG and abdominal obesity.

An accessory navicular bone (AN) is the most common accessory ossicle in the foot. The presence of an AN bone can trigger various foot problems, such as posterior tibial tendon pathology, flattening of the medial longitudinal arch, and medial foot pain. Despite the clinical influence of presence of an AN in foot disease, the research regarding its inheritance is still insufficient. A total of 135 pairs of monozygotic (MZ) twins, 25 pairs of dizygotic (DZ) twins, and 676 singletons from families were enrolled in order to estimate genetic influences on AN. After confirmation of zygosity and family relationship with a tandem repeat marker kit and questionnaires, the presence and type of the AN was classified through bilateral feet radiographic examination. The heritability of an AN was estimated using quantitative genetic analysis based on a variance decomposition model considering various types of family relationships: father–offspring pair, mother–offspring pair, and pooled DZ twin and sibling pairs. As a result, approximately 40.96% of the participants in this study had an AN in either foot, with type II being the most common type. The heritability for the presence of any type of an AN in any foot was estimated as 0.88 (95% CI [0.82, 0.94]) after adjusting for age and sex. Specifically, type II AN showed the highest heritability of 0.82 (95% CI [0.71–0.93]). The high heritability of an AN found in this large twin and family study suggests that an AN is determined by the substantial influence of genetic factor.

Background This study aimed to evaluate the factors associated with drinking behavior of cancer survivors after cancer diagnosis. Methods The study subjects were 906 adult cancer survivors who had reportedly drunk alcohol before cancer diagnosis and participated in the Korean National Health and Nutrition Examination Surveys conducted from 2007 to 2013. Among them, 360 abstained from alcohol drinking after cancer diagnosis. We categorized remaining 546 persistent drinkers into high-risk drinker (consuming ≥ 7 glasses of alcohol for men and ≥ 5 glasses of alcohol for women at one sitting at the frequency of at least once a month) or moderate drinker. We used multiple logistic regression analysis to evaluate risk factors associated with drinking behavior. Results The high-risk drinkers occupied 27.1% (148 survivors) of the persistent alcohol drinking survivors. Age increase (OR = 0.96; 95% CI 0.93-0.99), female sex (OR = 0.15; 95% CI 0.08-0.28), and increase of time lapse (by 1-year) after cancer diagnosis (OR = 0.94; 95% CI 0.92-0.97) were associated with a lower risk of high-risk drinking as compared with moderate drinking. Meanwhile, ≤ 9 years of education (OR = 1.99; 95% CI 1.10-3.60), alcohol-related cancer (OR = 2.09; 95% CI 1.23-3.56), and current smoking (OR = 1.92; 95% CI 1.03-3.59) were associated with increased risk of high-risk drinking of cancer survivors. Conclusions These findings suggest that greater efforts for preventing high-risk drinking should be laid on the cancer survivors, with consideration of individual sociodemographic characteristics, especially when the survivors had been diagnosed with alcohol-related cancer.

BackgroundTo determine relationship between cancer survivors’ perception of care coordination and their health outcomes.MethodsStudy subjects were 1306 Korean adulthood cancer survivors who were enrolled in two academic hospital and completed a questionnaire consisting of questions asking two aspects of care coordination for cancer treatment they had received: 1) who played a main coordinator role and 2) whether care services had met their necessitated health concerns. We measured health outcomes including new comorbidity, number of clinic visits, health-related quality of life (HRQoL) and fear of cancer recurrence (FCR). Associations between the level of care coordination and health outcomes were evaluated by multiple logistic regression analysis after adjusting for covariates.ResultsSurvivors with uncoordinated care were more likely to have more new comorbidities after cancer diagnosis, visit clinic more frequently and have worse HRQoL and higher FCR. Females and unmarried survivors were more likely to have received uncoordinated care than males and ever married survivors. Uncoordinated care group had an increased the risk of new comorbidity (odds ratio 1.73, [95% confidence interval] 1.02–2.92), multiple clinic visits (1.69, 1.00–2.88), severe FCR (2.28, 1.33–3.93), low EuroQoL Visual Analogue Scale (1.82, 1.28–2.60), low global health status (1.51, 1.04–2.21), and poor physical (2.00, 1.31–3.04), role (2.46, 1.69–3.56) and emotional function (2.62, 1.81–3.78).ConclusionsCoordinated care of Korean cancer survivors was associated with their health outcomes, including new comorbidity, clinic visits, HRQoL and FCR. Good care coordination may be reinforced to improve outcomes of survivorship care.

Background/aimCharacterising genetic effect on macular retinal nerve fibre layer (RNFL) is needed to obtain better understanding of various retinopathies and optic neuropathies. The purpose of this study was to evaluate genetic influence on macular RNFL thickness.MethodsThis is a cross-sectional, twin and family study. Three hundred and sixty-two Korean adults with healthy eyes were included in the study from 79 households with two or more family members. Macular RNFL thickness was measured with optical coherence tomography at nine macular subfields defined by the ETDRS. Intraclass correlation coefficients (ICCs) were estimated to assess intrafamilial resemblance of RNFL thickness by different types of family relationship. Heritability of RNFL thickness was evaluated using variance decomposition model.ResultsRNFL thickness increased from central subfield to outer subfields. Temporal quadrant RNFL was thinner compared with other quadrants. Monozygotic twin pairs showed the highest ICCs of RNFL thickness, although the ICC level varied across different subfields. Heritability of RNFL thickness was the highest at central subfield (0.81). RNFL thicknesses of outer subfields were moderately to highly heritable: 0.53, 0.71, 0.47 and 0.66 for superior, inferior, temporal and nasal fields, respectively. RNFL thicknesses at inner subfields showed the lowest heritability: 0.21, 0.24, 0.27 and 0.27 for superior, inferior, temporal and nasal subfields, respectively.ConclusionMacular RNFL thickness is significantly influenced by genetic factors. It varies largely by subfields with the highest heritability at the central subfield and a relatively lower heritability at inner subfields.

Objective This study explored the association between healthcare needs and quality of life (QoL) of Korean cancer family caregivers according to the time lapse after cancer diagnosis. Methods Self-administered comprehensive needs assessment tool and EuroQol-5-dimension index for 686 cancer family caregivers were classified into four groups according to time lapse after cancer diagnosis (≤12, 13-36, 37-60,>60 months). We estimated the association between unmet needs and QoL by multiple linear regression analyses after adjusting for age, sex, cancer site and caregivers' comorbid conditions. Results Female or elder caregivers had lower QoL and higher unmet needs. The highest unmet needs existed in healthcare staff domain followed by information/education domain persistently along all periods. QoL of caregivers was significantly associated with family/social support and health/psychological problem during the time lapse of ≤12 months as well as >60 months. Practical support was consistently associated with QoL across all time lapses. Religious/spiritual support and hospital facilities and services showed significant association with QoL only in ≤12 months and >60 months respectively. Conclusions The QoL of Korean cancer family caregivers was differentially associated with their unmet needs according to the time lapse after cancer diagnosis and by specific domains of needs.

Background Hypovitaminosis D is prevalent worldwide. It is more prevalent in Eastern Asia region, including Korea. In addition to various environmental factors that influence serum 25-hydroxyvitamin D (25(OH)D) concentration, genetic influence also plays a significant role based on studies estimating the heritability of 25(OH)D in non-Asian populations. The objective of this study was to determine the genetic influence on serum 25(OH)D concentration in Korean men using the twin and family data. Methods A total of 1126 Korean male adult twins and family members from the Healthy Twin Study with serum 25(OH)D measurement were included in this cross-sectional study. Intraclass correlation coefficients (ICCs) and heritability were calculated by mixed linear regression analysis and quantitative genetic analysis after adjusting for environmental and lifestyle factors. Results Mean (± standard deviation; SD) of serum 25(OH)D concentration was 15.34 ± 6.18 ng/ml. The prevalence of vitamin D insufficiency was 19.8% and that of vitamin D deficiency was 77.9%. After adjusting for age, the highest ICC (0.61) was observed for monozygotic twin pairs while the lowest ICC (0.31) was found for father-son pairs. Age-adjusted heritability was estimated to be 58%. When physical activity, multivitamin intake and season of blood sampling were further considered, the ICC and heritability did not materially change. In the sensitivity analysis after excluding known multivitamin users, age-adjusted heritability was reduced to 44%. Conclusions In our study of Korean male twins and family members, heritability of 25(OH)D was moderately high. This supports the finding that genetic factors have significant influence on vitamin D status. Electronic supplementary material The online version of this article (10.1186/s12263-018-0621-7) contains supplementary material, which is available to authorized users.

A cancer pain clinic (CPC) service is a thorough, comprehensive consultation service for patients with uncontrolled cancer pain. The aim of this study was to determine the success of a new CPC service with enrollment via electronic health record-based automatic screening at 1 cancer center in Korea.A case-control study and a satisfaction survey.The intervention group (n = 158) was enrolled in the CPC service, whereas the control group (n = 158), which was matched using propensity scores, did not participate in the service. The pain scores of participants were compared using an independent t test. Thirty-nine patients and 20 physicians completed a self-administered survey on instructions for pain-relief medications, effective usage of long-acting and short-acting opioids, perceptions of or barriers to CPC services, knowledge of opioid use, and overall satisfaction.Although the baseline pain score of the intervention group was significantly higher than that of the control group (P = .013), the difference in the decrease of pain between the groups was significant at days 1 (P = .001) and 2 (P = .039). Although the difference in pain scores disappeared on day 3, total pain score was significantly lower in the intervention group than in the control group (P = .012). When comparing pain relief events (4 points on a 0-10 numeric rating scale that measured pain daily), the intervention group experienced more relief events than did controls (P = .017). Patients were satisfied with their physicians giving clear instructions and considering their opinions about pain-relief medications. The oncology residents expressed satisfaction with the management of patients with opioid-naïve or intractable pain.The new CPC service seems to provide effective pain relief and users seem to be highly satisfied with it. These results support the importance of an integrated and specialized approach to cancer-related pain management.

The original version of this article unfortunately contained a mistake in affiliation of the 1st, 4th, and corresponding author.

Study participants flowchart. (PDF 52 kb)

Background The objective of this study was to investigate the effect of excessive alcohol consumption on heart reflected by various echocardiographic parameters according to the presence or absence of flushing reaction that might reflect acetaldehyde metabolism. Methods A total of 854 Korean men without significant cardiovascular diseases who underwent echocardiography and participated in the Korean Healthy Twin Study were used as subjects of this study. These subjects were classified into 3 categories: nondrinker, moderate drinker (≤196 g/wk), and heavy drinker (>196 g/wk) within 2 strata of flushing reaction to alcohol drinking. Association between echocardiographic measurements and categories of the amount of alcohol consumption considering flushing reaction were evaluated using mixed linear regression model. Results The proportion of flushers among drinkers was 39.5% (278 of 703). In stratified analysis by flushing reaction, nonflushers showed significantly higher left ventricular mass index (β: 4.605; 95% CI: 0.966, 8.243) and significantly lower ratio of peak early diastolic velocities (E peak) over peak late diastolic velocities of mitral inflow (β: -0.103; 95% CI: -0.198, -0.008) in heavy drinkers compared to nondrinkers. Flushers showed significantly higher left atrial (LA) volume index (β: 2.712; 95% CI: 0.456, 4.968) in heavy drinkers and significantly lower ratio of E peak over the peak early diastolic mitral annular velocities (β: -0.493; 95% CI: -0.902, -0.085) in moderate drinkers compared to nondrinkers. However, the interaction according to flushing reaction was only statistically significant for the association between alcohol consumption and LA volume index (p for interaction = 0.004). Conclusions Alcohol consumption is associated with changes in cardiac structure and function. Such association might be influenced by acetaldehyde metabolism.

Background In spite of the increasing incidence of in situ breast cancer, the information about the risk factors of in situ breast cancer (DCIS) is scarce as compared to the information available for invasive ductal breast cancer (IDC), with inconsistent findings regarding the difference in risk factors between DCIS and IDC. Methods We enrolled 472 women with IDC and 90 women with DCIS and 1088 controls matching for age and menopausal status. Information on risk factors was collected through self-administered questionnaire. Percent mammographic dense area (PDA), absolute mammographic dense area (ADA), and nondense area were assessed using a computer-assisted thresholding technique. Odds ratio (OR) and 95% confidence intervals (CI) were estimated by conditional logistic regression model with adjustment for covariates. Results Later age at menarche and regular physical exercise were associated with decreased risk of IDC, whereas alcohol consumption, previous benign breast disease, and family history of breast cancer were associated with increased risk of IDC. For DCIS, previous benign breast disease and alcohol consumption were associated with the increased risk, and regular physical exercise was associated with decreased risk. Increase of ADA by 1-quartile level and PDA increase by 10% were associated with 1.10 (95% CI: 1.01, 1.21) and 1.10 (95% CI: 1.01, 1.19) times greater risk of IDC, respectively. The increase of ADA by 1-quartile level and PDA increase by 10% were associated with 1.17 (95% CI: 0.91, 1.50) times and 1.11 (95% CI:0.90,1.37) times greater risk of DCIS, respectively, but the associations were not statistically significant. There was no significant difference in the association with risk factors and mammographic density measures between IDC and DCIS (P > 0.1). Conclusions Differential associations of DCIS with mammographic density and risk factors as compared with the associations of IDC were not evident. This finding suggests that IDC and DCIS develop through the shared causal pathways. Electronic supplementary material The online version of this article (10.1186/s12885-017-3841-0) contains supplementary material, which is available to authorized users.

Background Cardiovascular disease (CVD) is a common cause of death in cancer survivors. We evaluated the risk of comorbid CVD in long-term cancer survivors according to specific cancer site. Methods Study subjects included 47,171 Koreans aged over 40 years who visited a health promotion centre between 2010 and 2012. Information on CVD and cancer was obtained from self-report. Comorbid CVD was defined as stroke, myocardial infarction or angina pectoris. The risk of comorbid CVD in survivors was compared with that in non-cancer subjects using multiple logistic regression analysis. Results Among cancer survivors (n = 3,753), 330 events of CVD were reported. Age- and sex-adjusted analysis showed that odds ratio (OR) for comorbid CVD in survivors was 1.52 (95% confidence interval: 1.34-1.72) compared to non-cancer subjects (n = 43,418). After adjusting for health-related behaviour and medical history, only lung cancer survivors had 2.44 (1.01-5.89)-fold higher OR for CVD. In stratified analysis, significantly higher OR for CVD was evident in lung cancer survivors with hypertension who did not perform regular physical exercise. Conclusions Adult cancer survivors may have an increased risk of comorbid CVD that might be mediated in part by known cardiovascular risk factors depending on the specific cancer site.

Influence of the method of subjects recruitment on the association of the clinical, reproductive, and mammographic density characteristics with invasive ductal carcinoma and ductal carcinoma in situ. Table S2 Association of body mass index with breast cancer according to menopausal status. (DOCX 23 kb)

Background Optic nerve head (ONH) and surrounding structures such as β-zone peripapillary atrophy (PPA) are important structures in glaucomatous pathogenesis. Thus, for understanding genetic components in glaucoma pathogenesis, it is necessary to evaluate the heritability of ONH and surrounding structures. The present study investigated the genetic influences on ONH and surrounding structures such as β-zone PPA and retinal vessels. Methods A total of 1,205 adult twins and their family members (362 monozygotic (MZ) twin subjects (181 pairs), 64 dizygotic (DZ) twin subjects (32 pairs), and 779 singletons from 261 families), were part of the Korean Healthy Twin Study. ONH parameters including the vertical cup-to-disc ratio, the presence, the area and the location of β-zone PPA and the angular location of retinal vein were measured. The genetic influences on the structures were evaluated using variance-component methods. Results The intraclass correlation coefficient (ICC) values of axial length were highest among the parameters. The ICCs of the area and location of PPA were similar to those of vertical cup-to-disc ratio. However, retinal vessel angular locations showed low ICC values even in MZ twins. After age and sex adjustment, for axial length, vertical cup-to-disc ratio, the presence, area and location of PPA, the estimated narrow-sense heritability was 0.85, 0.48, 0.76, 0.50 and 0.65 in the right eye and 0.84, 0.47, 0.72, 0.46 and 0.72 in the left eye, respectively. The estimated narrow-sense heritability of angular location of the superior and inferior vein was 0.17 and 0.12 in the right eye and 0.13 and 0.05 in the left eye, respectively. Conclusions ONH and surrounding structures such as vertical cup-to-disc ratio and the presence, the area and the location of β-zone PPA seemed to be determined by the substantial genetic influence, whereas the venous angular location did not.

Fear of cancer recurrence (FCR) is one of the most prevalent unmet psychosocial needs. This study aimed to confirm the cultural equivalence, reliability, and validity of the Korean version of Fear of Cancer Recurrence Inventory (K-FCRI). We conducted a forward–backward translation of the English version FCRI to Korean version through meticulous process including transcultural equivalence test. The psychometric property of the K-FCRI was then validated in 444 survivors from cancers at various sites. The Korean translation was accepted well by participants. There was a good cultural equivalence between the Korean version and the English version of FCRI. Confirmatory factor analysis supported the original seven-factor structure with slightly insufficient level of goodness-of-fit indices (comparative fit index = 0.900, non-normed fit index = 0.893, root mean square error of approximation = 0.060). The K-FCRI had high internal consistency (α = 0.85 for total scale and α = 0.77–0.87 for subscales) and test-retest reliability (r = 0.90 for total scale and r = 0.54–0.84 for subscales). The K-FCRI had significant correlations with the Korean version of Fear of Progression Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0, Hospital Anxiety and Depression Scale, and Fatigue Severity Score, supporting the good construct validity and psychometric properties of K-FCRI. The K-FCRI was confirmed as a valid and reliable psychometric test for measuring FCR of Korean survivors from cancers at various sites., Graphical Abstract

The prevalence of obesity has been increasing worldwide, which raises concerns about the disease burden associated with obesity. Socioeconomic status (SES) has been suggested to be associated with obesity and obesity related diseases. This study aimed to evaluate the time trend in socioeconomic inequality in obesity-related mortality over the last decade in Korean population. We evaluated the influence of education level, as an indicator of SES, on obesity-related mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases. The rate ratio of the mortality of people at the lowest education level as compared with those at the highest education level (relative index of inequality [RII]) was estimated using Poisson regression analysis. Between 2001 and 2011, RII (95% confidence interval) for overall obesity-related disease mortality increased from 2.10 (2.02–2.19) to 6.50 (6.19–6.82) in men, and from 1.94 (1.79–2.10) to 3.25 (3.05–3.45) in women, respectively. Cause-specifically, the same trend in RII was found for cardiovascular mortality and mortality from diabetes mellitus, whereas the RII of mortality from obesity-related cancers in men did not show the similar trend. Subgroup analysis stratified by age revealed that the RII of obesity-related mortality was much higher in younger people than in older people. In conclusion, there has been persistent socioeconomic inequality in obesity-related mortality in Korea, which was more evident in younger people than in older people and has been deepened over the last decade especially for cardiovascular disease and diabetes., Graphical Abstract

Background: This cross-sectional study aimed to evaluate the prevalence of depressive disorders and factors associated in long-term cancer survivors. Methods: A total of 702 long-term cancer survivors over 5-years in remission were recruited in a university-affiliated tertiary hospital in Korea. Self-report using the Patient Health Questionnaire-2 and the Fatigue Severity Scale assessed depression and fatigue, respectively. Demographic characteristics, cancer-related clinical characteristics, comorbidity, health behaviors, and physical symptoms were assessed through the review of medical records or a structured self-administered questionnaire. Results: We identified 26.1% of patients who had a depressed mood or displayed a loss of interest. The most prevalent primary site of cancer was the stomach (65.2%), followed by lung, breast, colorectal, and thyroid cancer. We also found that 5.7% of subjects experienced double or triple primary cancers. Larger proportion among depressive group (89.1%) complained at least one physical problem than among non-depressive group (53.2%). Physical symptoms including sleep problems, dry mouth, indigestion, pain, decreased appetite, and febrile sense were more frequent in the depressive group than in the non-depressive group. The Fatigue Severity Scale scores were higher in the depressive group than in the non-depressive group (P

Background Health-related quality of life (HRQoL) is considered an important outcome measure in chronic diseases, in particular cardiovascular disease (CVD), which is known to be associated with impaired HRQoL. However, few studies have examined HRQoL in individuals at high risk of CVD. Methods Using the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, we analyzed data from 10,307 adults aged ≥30 years. The study subjects were stratified into 3 groups on the basis of their Framingham risk score-a 10-year estimate of CVD risk