Objective To investigate whether screening for thyroid cancer led to the current “epidemic” in South Korea.Design Review of the medical records of nationally representative samples of patients with a ...diagnosis of thyroid cancer in 1999, 2005, and 2008.Setting Sample cases were randomly selected from South Korea’s nationwide cancer registry, using a systematic sampling method after stratification by region.Participants 5796 patients with thyroid cancer were included (891 in 1999, 2355 in 2005, and 2550 in 2008).Main outcome measures The primary outcome was age standardised incidence of thyroid cancer and the changes in incidence between 1999 and 2008 according to the methods used to detect tumours (screen detection versus clinical detection versus unspecified).Results Between 1999 and 2008, the incidence of thyroid cancer increased 6.4-fold (95% confidence interval 4.9-fold to 8.4-fold), from 6.4 (95% confidence interval 6.2 to 6.6) per 100 000 population to 40.7 (40.2 to 41.2) per 100 000 population. Of the increase, 94.4% (34.4 per 100 000 population) were for tumours less than 20 mm, which were detected mainly by screening. 97.1% of the total increase was localised and regional tumours according to the Surveillance, Epidemiology, and End Results (SEER) summary stage. Where cases were clinically detected, 99.9% of the increased incidences (6.4 per 100 000 population) over the same period were tumours less than 20 mm.Conclusion The current “epidemic” of thyroid cancer in South Korea is due to an increase in the detection of small tumours, most likely as a result of overdetection. Concerted efforts are needed at a national level to reduce unnecessary thyroid ultrasound examinations in the asymptomatic general population.
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BFBNIB, CMK, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
We developed a new exercise method called the submandibular push exercise that can strengthen the suprahyoid muscle by inducing only the motion of the hyoid bone without neck flexion. In this study, ...we aimed to investigate and compare the muscle activity of the suprahyoid and infrahyoid muscles in the course of performing three different swallowing exercises. Twenty healthy participants and fifteen patients with dysphagia were recruited. Each participant consecutively performed three exercises: Shaker, CTAR, and submandibular push exercises. To investigate muscle activation, surface electromyography was performed on the suprahyoid, infrahyoid, and SCM muscles, during the exercises. Root mean square (RMS) was measured. In healthy participants, the submandibular push exercise showed a significantly higher RMS value in the suprahyoid and infrahyoid muscles than the Shaker and CTAR exercises using repeated ANOVA with Tukey's post hoc test (p < 0.05). In patients with dysphagia, the submandibular push and Shaker exercises showed significantly higher RMS value in the suprahyoid and infrahyoid muscles than the CTAR exercise. However, no significant difference was found between the submandibular push and Shaker exercises. In both healthy and patients with dysphagia, the mean RMS values of the SCM muscles during the submandibular push exercise were significantly lower than those during the Shaker exercise using repeated ANOVA with Tukey's post hoc test (p < 0.05). In conclusion, considering the relatively superior selectiveness in suprahyoid and infrahyoid muscle contraction, the submandibular push exercise using visual feedback from pressure sensor could be an efficient supplementary exercise to the conventional swallowing muscle exercises. However, further studies may be necessary to confirm the improvement in swallowing difficulty.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background
Improved cancer survival is expected to increase noncancer deaths; however, detailed causes of death have rarely been discussed. Changing landscapes in mortality patterns and noncancer ...mortality risks in patients with cancer require evaluation.
Methods
We identified cancer and noncancer‐related causes of death using data from the 2000‐2016 national cancer registry in Korea (n = 2 707 520), and we characterized the leading causes of death and proportionate mortalities over time. Risks of noncancer deaths relative to the general population were estimated using standardized mortality ratios (SMRs).
Results
Of 1 105 607 identified deaths, 87% were due to the primary cancer. Proportionate mortalities of primary cancer among overall deaths remained high in patients with liver (86%) and lung (70%) cancers and in female patients with breast cancer (77%), even 5 to 10 years following diagnosis, whereas proportionate mortalities reduced to ≤50% in patients with stomach (men, 39%; women, 48%), prostate (47%), and female thyroid (27%) cancers. Despite the predominance of index cancer deaths, the proportion of noncancer deaths among all deaths increased over time. There was a 20‐fold increase in cardiovascular disease deaths among patients with cancer from 2000 to 2016, and the risk of suicide among patients with cancer was higher than that among the general population (SMR: 1.68 95% confidence interval (CI): 1.63‐1.74 in men, SMR: 1.42 95% CI: 1.33‐1.55 in women).
Conclusions
Deaths from primary cancer remain a major concern; however, follow‐up is required for both cancer and noncancer‐related health issues in cancer survivors, especially concerning suicide and cardiovascular deaths.
Death from primary cancer is still the major concern, but noncancer deaths are expected to become an important issue. Higher risks of suicide death and increasing number of cardiovascular disease deaths in cancer patients highlight the need for preventing suicide and cardiovascular disease in cancer patients.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background The technique of endoscopic submucosal dissection (ESD) was introduced to be able to obtain en bloc specimens of large early GI neoplasms. The drawback of ESD is its technical difficulty, ...which, consequently, is associated with a higher rate of complication and which requires advanced endoscopic techniques and a long procedure time. Objective To assess the therapeutic outcome of ESD by expert endoscopists who have at least 3 years' experience of EMR in Korea. Design A retrospective, multicenter study. Patients From January 2006 to June 2007, 1000 early gastric cancers in 952 patients (502 men, 450 women; mean age 62.1 years, range 43-90 years) were treated by using ESD at 6 Korean ESD study group (KESG)–related university hospitals in Korea. Intervention We performed ESD procedures with typical sequences (marking, incision, and submucosal dissection). Main Outcome Measurements The rate of en bloc resection, incidence of complication, and length of procedure. Predetermined factors (various endoscopic and final pathologic features) for these outcomes. Results The rates of en bloc resection, complete en bloc resection, vertical incomplete resection, and piecemeal resection were 95.3%, 87.7%, 1.8%, and 4.1%, respectively. The rates of delayed bleeding, significant bleeding, perforation, and surgery related to complication were 15.6%, 0.6%, 1.2%, and 0.2%, respectively. The mean procedure time was 47.8 ± 38.3 minutes. The rates of en bloc resection differed significantly in relation to the location of the lesions (upper portion vs middle portion vs lower portion of the stomach, 88.6% vs 95.2% vs 96.0%, respectively; P = .02), presence of a scar (no vs yes, 96.0% vs 89.5%, respectively; P = .002), and histologic type (low-grade adenoma vs high-grade adenoma vs differentiated early gastric cancer vs undifferentiated early gastric cancer, 95.8% vs 94.6% vs 96.2% vs 83.8%, respectively; P = .007). The rates of delayed bleeding differed significantly in relation to location (upper portion vs lower portion of the stomach, 28.6% vs 13.8%, respectively; P = .003), the size of the tumor (>40 mm vs <20 mm, 28.6% vs 13.7%, respectively; P = .009), recurrent lesion (29.4% vs 15.1%, respectively; P = .024), and macroscopic type (flat vs elevated, 18.8% vs 12.4%, respectively; P = .047). Factors related to the longer procedure time were location (upper portion vs lower portion of the stomach, 64.8 vs 44.1 minutes, respectively; P < .001), the size of the tumor (>40 mm vs < 20 mm, 67.1 vs 42.0 minutes, respectively; P < .001), the presence of ulcer (54.6 vs 46.8 minutes; P < .045), and the presence of a scar (69.2 vs 45.0 minutes; P < .001). Conclusions ESD is an effective and safe therapy in the management of early gastric neoplasms. Endoscopists have to accept the need for advanced endoscopic techniques for performing ESD in the case of large lesions, scar lesions, undifferentiated cancers, or for the lesions in the upper portion of the stomach. Endoscopists require more experience to decrease complications in patients who have a large or recurrent lesion in the upper portion of the stomach; these lesions also take more time to complete the ESD procedure.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
We report the production of a two-dimensional (2D) heterostructured gas sensor. The gas-sensing characteristics of exfoliated molybdenum disulfide (MoS2) connected to interdigitated metal electrodes ...were investigated. The MoS2 flake-based sensor detected a NO2 concentration as low as 1.2 ppm and exhibited excellent gas-sensing stability. Instead of metal electrodes, patterned graphene was used for charge collection in the MoS2-based sensing devices. An equation based on variable resistance terms was used to describe the sensing mechanism of the graphene/MoS2 device. Furthermore, the gas response characteristics of the heterostructured device on a flexible substrate were retained without serious performance degradation, even under mechanical deformation. This novel sensing structure based on a 2D heterostructure promises to provide a simple route to an essential sensing platform for wearable electronics.
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IJS, KILJ, NUK, PNG, UL, UM
Metabolic syndrome is a cluster of metabolic indicators that increase the risk of diabetes and cardiovascular diseases. Visceral obesity and factors derived from altered adipose tissue, adipokines, ...play critical roles in the development of metabolic syndrome. Although the adipokines leptin and adiponectin improve insulin sensitivity, others contribute to the development of glucose intolerance, including visfatin, fetuin-A, resistin, and plasminogen activator inhibitor-1 (PAI-1). Leptin and adiponectin increase fatty acid oxidation, prevent foam cell formation, and improve lipid metabolism, while visfatin, fetuin-A, PAI-1, and resistin have pro-atherogenic properties. In this review, we briefly summarize the role of various adipokines in the development of metabolic syndrome, focusing on glucose homeostasis and lipid metabolism.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The aim of this study was to report nationwide cancer statistics in Korea, including incidence, mortality, survival, and prevalence, and their trends.
Incidence data from 1993 to 2012 were obtained ...from the Korea National Cancer Incidence Database, and vital status was followed through December 31, 2013. Mortality data from 1983 to 2012 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, and prevalence, and relative survival were calculated.
A total of 224,177 cancer cases and 73,759 cancer deaths were reported in 2012, and there were 1,234,879 prevalent cases identified in Korea as of January 1, 2013. Over the past 14 years (1999-2012), overall incidence rates have increased by 3.3% per year. The incidence rates of liver and cervical cancers have decreased, while those of thyroid, breast, prostate, and colorectal cancers have increased. Notably, incidence of thyroid cancer increased by 22.3% per year in both sexes and has been the most common cancer since 2009. The mortality for all cancers combined decreased by 2.7% per year from 2002 to 2012. Five-year relative survival rates of patients diagnosed in the last 5 years (2008-2012) have improved by 26.9% compared with those from 1993 to1995.
Overall cancer mortality rates have declined since 2002 in Korea, while incidence has increased and survival has improved.
Several exercise methods, such as the Shaker exercise, tongue press exercise, chin tuck against resistance (CTAR) exercise, and submandibular push exercise, have been introduced to strengthen the ...muscles involved in swallowing. In this study, we compared the effectiveness of the CTAR, submandibular push, and Shaker exercises for the induction of selective supra- and infrahyoid muscle contractions using surface electromyography (EMG). This study is a prospective non-randomized controlled study. Twenty-five healthy subjects and 20 patients experiencing swallowing difficulty were enrolled. During the three different types of exercises, the root mean square (RMS) values of the sternocleidomastoid (SCM), suprahyoid (anterior belly of the digastric and mylohyoid muscles), and infrahyoid (sternothyroid and thyrohyoid muscles) muscles were analyzed using surface EMG. Differences in the activity of swallowing muscles among the three different exercises were analyzed using one-way repeated measured analysis of variance. In terms of both the maximum and mean RMS values of the suprahyoid muscle, the submandibular push exercise showed a larger RMS value than the CTAR and Shaker exercises in healthy subjects (p < 0.05). In terms of both the maximum and mean RMS values of the suprahyoid muscle, the Shaker exercise and submandibular push exercise showed a larger RMS value than the CTAR exercise in patients with swallowing difficulty (p < 0.05). The submandibular push exercise may be effective as a swallowing muscle exercise owing to its superiority in inducing selective contractions of the supra- and infrahyoid muscles. The CTAR and Shaker exercises are also effective in this regard.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We present SCAPS-1D simulations of 2-junction tandem cells with chalcopyrite top subcells with various bandgaps and a c-Si bottom subcell using realistic input parameters.
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...•Performances of CIGS/c-Si tandem solar cells are simulated by the SCAPS-1D program.•The Eg values of the top CIGS cells are set to be from 1.4 to 1.7eV (ΔEg=0.1eV).•The CIGS cell is thinned to yield the same JMPP or JSC to that of the c-Si cell.•The 1.6- and 1.7-eV CIGS top cells (t⩾0.2μm) exhibit current matching conditions.•The improvement of top wide-bandgap CIGS cells is a key for further improvement.
In this work, we present SCAPS-1D simulations of dual-junction tandem cells with chalcopyrite top subcells with various bandgaps (Eg=1.4, 1.5, 1.6, and 1.7eV) and a c-Si bottom subcell. The purpose of these simulations is to assess achievable device performances with a CIGS/c-Si tandem structure when a realistic efficiency of each subcell is applied. The top subcell conditions are simulated based on the state-of-the-art records, and the bottom c-Si cell is designed to have an efficiency of approximately 19%. When the Eg of the top chalcopyrite cell is below 1.5eV, the current matching condition between the top cell and bottom cell is not obtained until the top cell’s thickness is 0.2μm. However, with Eg values of the top chalcopyrite cells at 1.6eV and 1.7eV, the current matching conditions could be found. Nevertheless, because the efficiency from the top chalcopyrite cell is approximately 12%, it is predicted that the tandem structure exhibits a similar device performance to the bottom c-Si cell. This result suggests that improving the efficiency of the wide bandgap cell is essential for the tandem cell to overcome the efficiency form a single-junction solar cell.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
To investigate whether dental status, represented by the DMFT score, was affected by the presence of NCDs and determined the NCDs that had a greater impact on the DMFT score. This retrospective ...cross-sectional study included a total of 10,017 individuals. The presence of NCDs was investigated based on self-reported medical history recorded on each patient's dental hospital record. Individual DMFT score was evaluated on the basis of the dental records and panoramic radiographs. The data were further analyzed using multiple regression analysis and chi-squared automatic interaction detection (CHAID) analysis. A total of 5,388 individuals had more than one NCD among hypertension (HT), diabetes mellitus (DM), hyperlipidemia, cardiovascular disease (CVD), and osteoporosis. The average DMFT score was 8.62 ± 7.10 in the NCD group, significantly higher than that in those without NCD (5.53 ± 5.48) (P < 0.001). In the regression analysis, age, NCDs, and psychiatric problems were selected as risk factors of DMFT score. In the CHAID decision tree analysis, age was the risk factor that most influenced the DMFT score. HT was the most influential factor in a newly generated decision tree excluding age, and osteoporosis, DM, and CVD were important risk factors acting in the subgroups. Patients with NCD had worse dental conditions than those who did not, and some combinations of NCDs related highest risk for a dental caries-related index. In clinical practice, dentists should provide meticulous care for dental caries in elderly patients with NCDs, especially when certain diseases, such as HT, osteoporosis, DM, and CVD, are present together.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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