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Supplementary Tables 1-3 from Polymorphisms in Telomere Maintenance Genes and Risk of Lung Cancer

This study was conducted to comprehensively evaluate the associations between polymorphisms in telomere maintenance genes (TERT, TRF1, TNKS1, TRF2, RAP1, and POT1) and lung cancer risk. We captured 35 polymorphisms in the genes and determined their frequencies in 27 healthy Koreans. Ten haplotype-tagging polymorphisms were examined in a case-control study that consisted of 720 lung cancer patients and 720 healthy controls. The TERT rs2735940 g.C > T and rs2736098 g.G > A, and TNKS1 rs6985140 g.A > G were significantly associated with the risk of lung cancer. In the haplotype analysis, the TERT rs2735940T/rs2736098A haplotype (ht4) was associated with a significantly increased risk of lung cancer compared with the rs2735940C/rs2736098G haplotype (adjusted odds ratio, 1.26; 95% confidence interval, 1.07-1.50; P = 0.008). When the TERT ht4 and TNKS1 rs6985140G as risk alleles, the risk of lung cancer increased in a dose-dependent manner as the number of risk alleles increased (Ptrend < 0.001). Subjects with two to four risk alleles were at a significantly increased risk of lung cancer (adjusted odds ratio, 1.67; 95% confidence interval, 1.23-2.27; P = 0.001) compared with subjects with zero risk allele. These findings suggest that genetic variants in the TERT and TNKS1 genes contribute to genetic susceptibility to lung cancer. (Cancer Epidemiol Biomarkers Prev 2009;18(10):2773–81)

Purpose To determine the long-term prevalence and characteristics of acute hydrofluoric acid (HF) exposure in 2223 patients during the first 30 months after a mass-casualty exposure, and to confirm the antidotal effect of nebulized calcium on inhalation burns caused by HF. Methods This observational cohort study included patients after an HF spill in the Republic of Korea on September 27, 2012; registered patients were followed until April 2015. We assessed toxic effects, distance from spill, degree of acute poisoning, and the effect of nebulized calcium in HF-exposed individuals. Results Overall, 2223 patients received emergency management or antidote therapy for 20 days. Seventy-four of 134 patients with dermal toxicity received calcium–lidocaine gel, and 368 individuals with bronchial irritation signs received calcium gluconate via nebulizer nCG. A total 377 ampoules 786 g of calcium gluconate were used in the nCG formulation. Calcium administration did not cause adverse reactions during the observation period. Long-term cohort observation showed that 120 patients (120/2233, 5.4%) returned to medical facilities for management of HF-related symptoms within 1 month; 18 persons (18/1660, 1.1%) returned 1–3 months later with chronic cough and respiratory symptoms; and 3 patients (3/1660, 0.2%) underwent medical treatment due to upper-airway toxic symptoms more than 2 years after HF exposure. Conclusion Respiratory toxicity after mass exposure to an HF spill was successfully treated by calcium nebulizer. Based on our experience, detoxification processes and the amounts of antidote stocked are important when planning for future chemical disasters at the community level.

Teachers’ attitudes towards parental involvement play an important role in the ways they approach children’s families. This study examined Hong Kong pre-service early childhood teachers’ at...

BACKGROUND Some studies have hypothesized that vitamin D may have a role to play in protection against influenza virus infections and illnesses, and that seasonal fluctuation in serum 25-hydroxyvitamin D [25(OH)D] may affect seasonal patterns of influenza virus infections. OBJECTIVE We aimed to investigate whether serum 25(OH)D concentrations were associated with the incidence of influenza virus infections and illnesses in children and adults in Hong Kong. METHODS In 2009-2010, 3030 children and adults of all ages from 796 households in Hong Kong were followed up to identify acute respiratory illnesses. Sera from 2694 participants were collected at baseline and after ∼1 mo, 6 mo, and 12 mo. Influenza virus infections were confirmed by reverse transcriptase-polymerase chain reaction performed on nasal and throat swab samples collected during illness episodes. Serologic evidence of influenza virus infection was measured by hemagglutination inhibition assays in unvaccinated participants. The serum 25(OH)D concentrations were measured after collection of all specimens. Each individual's baseline serum 25(OH)D concentration on 1 January 2010 was predicted by a random-effects linear regression model. RESULTS We found that, in children and adults who had not received a seasonal influenza vaccine, baseline serum 25(OH)D concentrations (

Background & aims This study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use. Methods Data from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients' expectations of CAM efficacies were compared before and after use. Results Out of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies. Conclusions There was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use.

Sang Geun Bae,1 Sin Kam,2 Ki Soo Park,3,4 Keon-Yeop Kim,2 Nam-Soo Hong,2 Ki-Su Kim,2 Yu-mi Lee,2 Won Kee Lee,2 Michael Sung Pil Choe5 1Department of Preventive Medicine, Regional Cardiocerebrovascular Disease Center, Kyungpook National University Hospital, 2Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, 3Department of Preventive Medicine and Institute of Health Sciences, Gyeongsang National University School of Medicine, 4Department of Preventive Medicine, Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, 5Department of Emergency Medicine, CHA Gumi Medical Center, CHA University, Gumi, Korea Purpose: We assessed medication nonadherence, categorized as intentional or unintentional, and related factors in elderly patients with hypertension, correlating the data with measurement of blood pressure as the final target of medication adherence and other possible influencing factors, such as lifestyle. Patients and methods: Subjects were aged ≥65 years, resided in a rural area, and were taking antihypertensive drugs. The survey was conducted in July 2014. Participants were divided into the following three groups: “Adherence”, “Unintentional nonadherence”, and “Intentional nonadherence”. Individual cognitive components, such as necessity and concern as well as self-efficacy and other related factors, were compared according to adherence groups. The interrelationships between those factors and nonadherence were tested using structural equation modeling analysis. Results: Of the 401 subjects, 182 (45.6%) were in the adherence group, 107 (26.7%) in the unintentional nonadherence group, and 112 (27.9%) in the intentional nonadherence group. Necessity and self-efficacy were found to have a significant direct influence on unintentional nonadherence behaviors (necessity β=–0.171, P=0.019; self-efficacy β=–0.433, P

BackgroundFalling is one of the leading causes of injury among elderly populations. As the population over 65 years old increases, medical costs due to falling will also increase. Urban and rural areas have different fall characteristics, and research into these differences is lacking.MethodsA survey was conducted on 2,012 people over 60 years old between September 1, 2015 to October 12, 2015. Guro-gu (Seoul), Yeongdeungpo-gu (Seoul), and Jung-gu (Daegu) were classified as urban areas and included 1,205 of the study participants. Dalseong-gun (Daegu) and Yangpyeong-gun (Gyeonggi-do) were categorized as rural areas and included 807 participants. Several region characteristics, including population density, were considered to distinguish between urban and rural areas. The survey included questions about fall history, cause, season and time of recent falls, and external conditions associated with recent falls, like floor or ground material and shoe types.ResultsRural respondents were older than urban respondents (pConclusionsA fall-prevention program that reflects the characteristics and differences of falls in urban and rural areas should be developed and used to effectively prevent falling among elderly people.

Acinetobacter baumannii, a strictly aerobic, non-fermentative, Gram-negative coccobacillary rod-shaped bacterium, is an opportunistic pathogen in humans. We recently isolated a multidrug-resistant A. baumannii strain KBN10P02143 from the pus sample drawn from a surgical patient in South Korea. We report the complete genome of this strain, which consists of 4,139,396 bp (G + C content, 39.08%) with 3,868 protein-coding genes, 73 tRNAs and six rRNA operons. Identification of the genes related to multidrug resistance from this genome and the discovery of a novel conjugative plasmid will increase our understanding of the pathogenicity associated with this species.

This study aims to examine the trend in household catastrophic medical expenditure according to the healthcare coverage types and its associated factors based on the raw data of the Korean Health Panel over the years2008 to 2011. Correspondence analysis was used to investigate the trend in the incidence rates of annual catastrophic medical expenditure and generalized estimating equation to examine the factors influencing the incidence of catastrophic medical expenditure. The annual mean incidence rates of household catastrophic medical expenditure were25.1%, 15.4%, 10.1%, 5.4% and 3.2% in the threshold levels of 10%, 15%, 20%, 30%, and 40% respectively. Theincidence rate of household catastrophic medical expenditure was higher when the total annual household income waslower, the education level of the householder was lower, the healthcare coverage type was National Health Insurance,the householder had disability, the age of the householder was older, the number of household members was smaller,the subjective health status of household members was lower, and the prevalence rate of the chronic disease of thehousehold was higher(p

The SF-36 is the most common instrument to check the quality of life for dialysis patients with chronic renal failure. However, there were too much burden for them to answer 36 items of it. So we purposed to develop the RFQoL-K reduced type of the SF-36. Participants who had newly registered for dialysis were enrolled in 29 medical centers during 45months from 2009. We developed the RFQoL-K through 355 people who applied the SF-36 at 3 and 12 months after registration and then checked it`s internal validity. External validity about it was checked via 411 people who answered only one time survey after registration. In conclusion, the RFQoL-K had total 14 items which was consisted of 8 items on physical factors and 6 items on mental factors from the SF-36. The RFQoL-K summary scores explained 91-93% of the SF-36 summary scores. The RFQoL-K was well reflected SF-36 because the correlation and the internal consistency between two tools were very high 0.96 to 0.98 and 0.96 to 0.98 respectively.

Objectives Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas. Methods The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year. Results A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance. Conclusions Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea.

This study was conducted to investigate the responsiveness and its related factors of public health center for novel influenza A (H1N1) epidemic. The data was collected through a web-based survey conducted during February to April 2011. The 182 respon-dents were team leaders or persons who were responsible for H1N1-related work at public health centers during the H1N1 preva-lence. The related factors affecting the responsiveness were different by urban or rural area. In the level of gu (urban) area, coopera-tion with the public organizations, preparing its own response plan were the significant factors. But, in the level of si or gun (rural) area, cooperation with private organizations (clinic or pharmacy), physical (facilities, equipments, and medicines), and human infra-structures (public health professions, education and knowledge, and motivation) were more important factors. Therefore, how to cope with H1N1 prevalence in the future should be different by local characteristics. As a result, there are several challenges that public health centers should prepare for the further emerging infectious diseases. First, it is needed to make standard manuals which could strengthen education and training in order to respond appropriately, as well as to prepare enough physical infrastruc-tures for the crisis. Next, the public health center should prepare correct media response and cooperation system with public and private organizations.Keywords: H1N1 influenza; Public health center; Responsiveness

Objectives: Osteoporosis is one of the key problems of public health in the elderly. This study was performed to understand how abdominal obesity affects bone mineral density (BMD). Methods: We selected 6,333 participants aged 19–93 years (2,908 men, 1,987 pre-menopausal and 1,438 post-menopausal women) from the data of the Korea National Health and Nutrition Examination Survey IV (KNHANES 2008–2009). Waist circumference value was set as an index of abdominal obesity. Demographic, social, and clinical parameters were investigated as potential risk factors of BMD. Findings: BMD were positively affected by exercise, income, and education (p < 0.001). Women’s fat mass (FM) showed a positive correlation with BMD. The total lean mass (TLM) of all groups strongly correlated to BMD (p < 0.0001). Our models suggest that abdominal obesity has a strong negative relationship with BMD in Korean men and pre-menopausal women with statistical significance (standardized β = -0.111, P

Objective: With the increased survival rate of cancer patients, positive changes in health behaviors, including smoking cessation, are becoming progressively more important. While studies in the general population have demonstrated the beneficial effects of high perceived support of smoking cessation and continuing abstinence, few studies have addressed such issues in cancer survivors. We examined the factors related to continued smoking among cancer survivors with specific attention given to the role of perceived social support. Methods: A nationwide, multicenter survey was conducted with 1956 cancer patients. Smoking status at the time of diagnosis and at the time of survey, and perceived social support, as measured by the Duke-UNC Functional Social Support Questionnaire, were collected by self-reported questionnaire. Results: Among 493 participants who were smoking at the time of cancer diagnosis, 131 (26.6%) were continued smokers at the time of survey. In a multivariate logistic regression analysis, current alcohol consumption (odds ratio, 3.29; 95% confidence interval, 1.91–5.65), early cancer stage (Pfor trend, 0.01), lung cancer diagnosis (odds ratio, 0.41; 95% confidence interval, 0.19 –0 .88), and high perceived social support (odds ratio, 0.59; 95% confidence interval, 0.37–0.96) showed significant associations with continued smoking. Conclusions: Cancer survivors with low perceived social support were more likely to continue smoking. Our study suggests that perceived social support may be an important factor for smoking cessation and maintenance of smoking cessation in this population.

Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p

X-linked inhibitor of apoptosis protein (XIAP)-associated factor 1 (XAF1) has been implicated as a novel tumor suppressor, which was proposed to exert pro-apoptotic effect by antagonizing the anticaspase activity of XIAP. Here, we delineated the domain architecture of XAF1 by applying limited proteolysis and peptide mass fingerprinting analysis. Our results indicated that XAF1 has a distinct domain organization, with a highly compact N-terminal domain (XAF1NTD) followed by a middle domain (XAF1MD), a 42-residue unstructured linker and a C-terminal domain (XAF1CTD). The search of XIAP binding region within XAF1 revealed that a modest affinity XIAPRING binding site (dissociation constant, Kd, ∼18 μM) is located at the C-terminal portion of XAF1. This C-terminal region, embracing XAF1CTD and a flexible tail at C-terminus (residue Thr251-Ser301), is functionally identified as XIAPRING-binding domain of XAF1 (XAF1RBD) in the present study. We have also mapped the interaction sites for XAF1RBD on XIAPRING by using NMR spectroscopy. By applying in vitro ubiquitination assay, we observed that XAF1RBD/XIAP interaction is essential for the ubiquitination of GST-XAF1RBD fusion protein. In addition, the C-terminal XAF1 fragment harboring XAF1RBD was found to be substantially ubiquitinated by XIAPRING. Base on these observations, we speculate a possible role of XAF1RBD in targeting XAF1 for XIAP-mediated ubiquitination.

Results: Of the 2,295 subjects, 735 (32.0%) had suffered from fall-related injuries during the previous year. The direct costs of these injuries calculated to be 596,466,000 Won (56.6%). The indirect costs was 458,081,000 Won (43.4%). Of the indirect cost, loss of productivity was 274,993,000 Won, health function foods was 65,531,100 Won, nursing care was 48,755,000 Won, and transportation was 43,122,000 Won. The total socioeconomic costs (direct costs+indirect costs) of the study subjects was 1,054,547,000 Won. The socioeconomic costs per person was 459,500 Won for the total number of study subjects and 1,435,000 Won for the 735 subjects. Conclusion: When the above calculated socioeconomic cost for the 2,295 subjects is applied to the 1,067,262 Korean rural elderly population in 2009, the socioeconomic costs owing to fall-related injuries can be estimated to as much as 343,614,988,000 Won. In the future, the socioeconomic costs due to injuries such as falls is expected to increase as the elderly population increases. Therefore, injury prevention programs and studies for reducing the socioeconomic costs in the elderly community are needed.

Two series of aliphatic hydrocarbon-based G1-G3 dendritic 2-ureido-4-pyrimidinones (UPy) (S-Gn)₂ and (L-Gn)₂, differing from one another by the distance between the branching juncture to the urea end, were prepared and characterized. These hydrocarbon dendrons were also appended to a p-aminonitrobenzene solvatochromic chromophore in order to probe their microenvironment polarity. While positive solvatochromism was observed which indicated the chromophore was solvent accessible, there was no significant difference between the microenvironment polarities on going from the G1 to the G3 dendrons. The self-assembling behavior and tautomeric preference of the dendritic UPy derivatives were examined by ¹H NMR spectroscopy. The dimerization constants (K(dim*)) of the DDAA tautomers were unchanged at 10⁷ M⁻¹ in CDCl₃ at both 25 and 50°C, which were comparable to those of UPy compounds bearing other nonpolar substituents. Furthermore, the lower limits on the K'(dim*) of the DADA tautomeric forms of the (S-Gn)₂ and (L-Gn)₂ series were determined to be 10⁶ and 10⁵ M⁻¹ in CDCl₃, respectively. It was found that a closer proximity of the dendron branching juncture to the UPy unit could lead to a destabilization effect on the dimeric states. Hence, the (L-Gn)₂ dimers are more stable than those of (S-Gn)₂ in the DDAA form, but the latter are more stable than the former in the tautomeric DADA state. This study showed that both the highly nonpolar microenvironment and the proximity of the dendritic branching juncture to the UPy motif could alter the strength and profile of the hydrogen bond-mediated self-assembling process.