Association between body mass index and the risk of falls: a nationwide population-based study.

The association of BMI with falls differed between men and women in Korea. Obesity was associated with a greater risk of falls in women, whereas underweight seemed to increase the risk of falls compared with normal weight in men. PURPOSE: This study examined the sex-specific association between body mass index (BMI) and falls in Korean adults using data from a large population-based survey. METHODS: We analyzed 113,805 men and women (age ≥ 50 years) who participated in the Korean Community Health Survey in 2013. Logistic regression was used to assess the relationship between BMI and falls. RESULTS: The mean (± standard deviation) age and BMI of all participants were 63.8 ± 9.6 years and 23.2 ± 2.9 kg/m2, respectively. Among the 113,805 subjects, 19.1% and 6.7% had histories of falls and recurrent falls, respectively. The association of BMI with recurrent falls differed between men and women. The multivariable-adjusted odd ratios (ORs) for recurrent falls were 0.98 (95% confidence interval [CI] 0.86-1.12), 1.23 (1.14-1.32), and 1.51 (1.26-1.81) in women with BMIs of < 18.5, 25-29.9, and ≥ 30 kg/m2, respectively, relative to those with BMIs of 18.5-24.9 kg/m2. The corresponding ORs for men were 1.20 (95% CI 1.01-1.42), 1.05 (0.96-1.14), and 0.97 (0.69-1.38), respectively. Older age and low economic level were associated independently with higher ORs of recurrent falls in men and women, respectively. In addition, comorbidities, including diabetes, stroke, arthritis, osteoporosis, and asthma, correlated significantly with an increased risk of recurrent falls (all p < 0.001). CONCLUSIONS: Obesity was associated with a greater risk of recurrent falls in women, whereas underweight seemed to be associated with a greater risk of falls in men.

Complete sequence analysis of human norovirus GII.17 detected in South Korea.

Norovirus, a major cause of gastroenteritis in people of all ages worldwide, was first reported in South Korea in 1999. The most common causal agents of pediatric acute gastroenteritis are norovirus and rotavirus. While vaccination has reduced the pediatric rotavirus infection rate, norovirus vaccines have not been developed. Therefore, prediction and prevention of norovirus are very important. Norovirus is divided into genogroups GI-GVII, with GII.4 being the most prevalent. However, in 2012-2013, GII.17 showed a higher incidence than GII.4 and a novel variant, GII.P17-GII.17, appeared. In this study, 204 stool samples collected in 2013-2014 were screened by reverse transcriptase-polymerase chain reaction; 11 GI (5.39%) and 45 GII (22.06%) noroviruses were identified. GI.4, GI.5, GII.4, GII.6 and GII.17 were detected. The whole genomes of the three norovirus GII.17 were sequenced. The whole genome of GII.17 consists of three open reading frames of 5109, 1623 and 780 bp. Compared with 20 GII.17 strains isolated in other countries, we observed numerous changes in the protruding P2 domain of VP1 in the Korean GII.17 viruses. Our study provided genome information that might aid in epidemic prevention, epidemiology studies and vaccine development.

Low normal fasting glucose and risk of accidental death in Korean adults: A prospective cohort study.

AIM: This study aimed to prospectively examine whether low normal glucose levels and hypoglycaemia are associated with increased mortality due to external causes, especially unintentional accidents. METHODS: A total of 345,318 normoglycaemic Korean adults who had undergone health examinations during 2002-2003 were followed-up to 2013. To avoid potential biases related to glucose-lowering medication use, those with known diabetes or hyperglycaemia were excluded. RESULTS: During 3.6 million person-years of follow-up, 1293 participants died because of unintentional accidents. Hazard ratios (HRs) for these accidental deaths were 1.26 (95% CI: 1.11-1.42), 1.60 (1.21-2.11) and 3.07 (1.37-6.85) for fasting serum glucose (FSG) levels of 70-79, 55-69 and <55mg/dL (3.9-4.4, 3.05-3.83 and <3.05mmol/L), respectively, compared with 80-99mg/dL (4.44-5.5mmol/L). FSG levels<80mg/dL were associated with an approximately 30% higher mortality due to accidents: specifically, 40% were non-fall-related injury; 50% were automobile-related; and 80% were motorcycle-related. The associations were weak (approximately 10% higher mortality, with P>0.05 for each cause) for deaths due to traffic accidents (pedestrians, pedal cyclists), falls, intentional self-harm and physical assault. The population attributable risks for FSG levels <80mg/dL were 10% (95% CI: 2-18%) for non-fall-related injury, 11% (6-17%) for car accidents and 17% (6-27%) for motorcycle accidents. CONCLUSION: FSG levels of 70-79mg/dL (3.9-4.4mmol/L) as well as <70mg/dL are risk factors for accidental death. Appropriate management of the impact of FSG levels <80mg/dL might reduce unintended deaths due to non-fall-related injury, and automobile and motorcycle accidents, by ≥10%.

Comparison of gynecologic cancer risk factors, incidence and mortality trends between South Korea and Israel, 1999-2013.

OBJECTIVE: To discuss possible causes of disparities in incidence and mortality rates of ovarian cancer, uterine cancer and cervical cancer between two diverse populations from east and west Asia. METHODS: Incidence and mortality data from 1999 to 2013 were extracted from Korean and Israeli cancer registries. Age-standardized rates and annual percent changes were calculated. Trends were analyzed using Joinpoint analysis and discussed with respect to risk factor exposure. RESULTS: Age-standardized rate of ovarian cancer significantly increased in Korea (annual percent change 1.7%) but decreased among Jews (annual percent change -2.15%). Age-standardized rate of uterine cancer increased among both Koreans and Israeli Jews (annual percent changes 5.8 and 1.17%, respectively). Incidence of cervical cancer significantly decreased in Korea (annual percent change -3.8%) while remained stable on Israel. Mortality trends paralleled incidence trends with a significant increase in ovarian cancer and uterine cancer mortality in Korea (annual percent changes 1.2 and 4.6%, respectively) and a drop in cervical cancer mortality from 2002 (annual percent change -5.8%). Among Israeli Jews, uterine cancer mortality increased (annual percent change 1.01%), while ovarian cancer mortality decreased (annual percent change -0.58%). Uterine cancer mortality among Arabs declined (annual percent change -0.5%), while cervical cancer mortality remained unchanged. CONCLUSIONS: Gynecologic malignancies show different incidence trends in Korea and Israel. Uterine cancer is rising in both countries and is correlated to changing trends in obesity and dietary habits. Ovarian cancer is rising in Korea but declining among Israeli Jews along with changes in parity, childbearing age, contraceptive use and increasing awareness to BRCA gene carriers and risk reduction salpingo-oophorectomy. Cervical cancer is declining in Korea along with an effective screening program implemented. Mortality trends follow incidence trends in both countries.

Whole-genome sequencing analysis of human bocavirus detected in South Korea.

Human bocaviruses (HBoVs) have been detected in human gastrointestinal infections worldwide. In 2005, HBoV was also discovered in infants and children with infections of the lower respiratory tract. Recently, several genotypes of this parvovirus, including HBoV genotype 2 (HBoV2), genotype 3 (HBoV3) and genotype 4 (HBoV4), were discovered and found to be closely related to HBoV. HBoV2 was first detected in stool samples from children in Pakistan, followed by detection in other countries. HBoV3 was detected in Australia and HBoV4 was identified in stool samples from Nigeria, Tunisia and the USA. Recently, HBoV infection has been on the rise throughout the world, particularly in countries neighbouring South Korea; however, there have been very few studies on Korean strains. In this study, we characterised the whole genome and determined the phylogenetic position of CUK-BC20, a new clinical HBoV strain isolated in South Korea. The CUK-BC20 genome of 5184 nucleotides (nt) contains three open-reading frames (ORFs). The genotype of CUK-BC20 is HBoV2, and 98.77% of its nt sequence is identical with those of other HBoVs, namely Rus-Nsc10-N386. Especially, the ORF3 amino acid sequences from positions 212-213 and 454 corresponding to a variable region (VR)1 and VR5, respectively, showed genotype-specific substitutions that distinguished the four HBoV genotypes. As the first whole-genome sequence analysis of HBoV in South Korea, this information will provide a valuable reference for the detection of recombination, tracking of epidemics and development of diagnosis methods for HBoV.

Use of Terlipressin in an Elderly Patient With Moderate Aortic Valve Stenosis Accompanied by Episodic Atrial Fibrillation During Liver Transplantation: A Case Report.

Anesthesia for patients with moderate aortic stenosis accompanied by atrial fibrillation during high-risk surgery such as liver transplantation remains a challenge in maintaining control of heart rate and maintenance of cardiac output. The action of terlipressin on vasopressin receptors (mainly V1 receptors) leads to splanchnic vasoconstriction and is the key mechanism responsible for increasing systemic vascular resistance and reducing heart rate. We report successful anesthetic management using low-dose terlipressin infusion in an elderly patient who had moderate aortic stenosis with atrial fibrillation during urgent deceased-donor liver transplantation.

Variations in fat mass contribution to bone mineral density by gender, age, and body mass index: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011.

UNLABELLED: The relationship of body composition and bone mineral density is complex and controversial. When classifying Korean population based on gender, age, and body mass index, fat mass had varying contributions to bone mineral density. INTRODUCTION: The relationship between body composition and bone mineral density (BMD) is complex, and it is uncertain how components of body mass variably affect BMD. METHODS: This cross-sectional observational study was performed in subjects ≥20 years based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2011. Among 17,583 subjects, the mean ages were 49.1 ± 16.0 years (M, n = 7495) and 49.3 ± 16.3 years (F, n = 10,088). Subjects were divided into age groups, either <50 or ≥50 years for males, or menopausal state, either premenopausal or postmenopausal, for females. A further classification used BMI, either <25 or ≥25 kg/m(2). Anthropometric and body composition parameters were compared and evaluated to look for correlations with BMD. Further, appendicular lean mass (ALM), fat mass (FM), fat percentage (FP), and waist circumference (WC) were included for multivariate analysis with BMD, controlling for covariates in each age group and BMI subgroup. RESULTS: Anthropometric and body composition parameters significantly correlated with BMD in all age groups for both genders. After adjusting for covariates, ALM strongly affected BMD in all age groups for both genders. FM, FP, and WC significantly affected BMD in both age groups of women and in older men, but they did not affect BMD in younger men. Fat indices positively affected BMD of all sites in all non-obese women and in non-obese older men. However, little contribution was found in obese subgroups of both genders and in non-obese younger men. CONCLUSION: Considering different weights of covariates, ALM strongly contributed to BMD in all gender, age, and BMI groups. On the other hand, fat indices positively affected BMD of both age groups in women and older men with normal BMI, but they showed little contribution to BMD within the same age groups with high BMI or any BMI subgroups of younger men.

Effect of Perioperative Terlipressin on Postoperative Renal Function in Patients Who Have Undergone Living Donor Liver Transplantation: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Recent studies have shown the efficacy of terlipressin on postoperative renal function in patients who have undergone living donor liver transplantation (LDLT). OBJECTIVES: To evaluate the effect of perioperative terlipressin on postoperative renal function in patients who have undergone LDLT and to analyze the hemodynamic data during transplantation surgery. STUDY DESIGN: A meta-analysis. METHODS: We assessed the postoperative peak serum creatinine level and changes in the hemodynamic data (e.g. the mean arterial pressure, heart rate, and systemic vascular resistance). We collected randomized controlled trials from PubMed, EMBASE Drugs and Pharmacology, Cochrane Controlled Trials Register, and Cochrane Database on Systematic Reviews. Analysis was conducted using RevMan 5.2. Data from each trial were pooled and weighted by their mean differences and corresponding 95% confidence intervals (CI). A heterogeneity assessment was performed. RESULTS: Three trials (151 patients) were included. The difference in the mean (95% CI) peak serum creatinine (mg/dL) levels postoperatively was not significant between the intervention and control groups (weighted mean difference [WMD]: -0.27; CI: -0.55-0.01; P = .06). Terlipressin significantly decreased heart rate during the anhepatic phase (WMD: -6.58; 95% CI: -8.85 to -4.31; P < .00001) with a low heterogeneity (I(2) = 41%) and significantly decreased heart rate during the neohepatic phase (WMD: -9.82; 95% CI: -11.96 to -7.68; P < .00001), although the heterogeneity was high (I(2) > 50%). CONCLUSIONS: An intravenous infusion of terlipressin perioperatively for LDLT has no effect on the creatinine values postoperatively. Larger randomized controlled trials on terlipressin infusions during liver transplantation are needed.

Trends in the incidence of and survival rates for oral cavity cancer in the Korean population.

OBJECTIVE: This study assessed trends in the incidence of and survival rates for oral cavity cancer in the Korean population. MATERIALS AND METHODS: Data from the Korea Central Cancer Registry were extracted for 10,282 patients diagnosed with oral cavity cancer (C01-C06) between 1999 and 2010 to evaluate the age-standardised incidence rate, annual percentage change (APC) and 5-year relative survival rate (RSR) according to gender and age. RESULTS: In males, the incidence rate slightly decreased [APC of -0.2% (P = 0.6427)]; in females, the incidence rate increased [APC of 3.1% (P < 0.05)]. In males and females, the incidence of oral tongue cancer (C02) significantly increased [APC of 2.2% and 4.1%, respectively (P < 0.05)]. This increase in oral tongue cancer incidence was most prominent in the younger age group (<40 years, APC = 6.1%, P < 0.05). The incidence of buccal cheek cancer increased only among males [APC of 4.8% (P < 0.05)]. The 5-year RSR improved from 42.7% (1993-1995) to 59.5% (2006-2010), corresponding to an increase of 16.8% from 1993 to 2010 (P < 0.05). CONCLUSION: The incidence of oral cavity cancer in females increased, whereas it stabilised or decreased in males. However, the incidence of oral tongue cancer increased in both males and females, especially in the younger age group.

The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery.

BACKGROUND: We conducted a population-based retrospective cohort study to investigate the influence of hospital volume, delay of surgery, and both together on the long-term survival of postoperative cancer patients. METHODS: Using information from the Korea Central Cancer Registry from 2001 through 2005 and the National Health Insurance claim database, we determined survival for 147 682 patients who underwent definitive surgery for any of six cancers. RESULTS: Regardless of cancer site, surgical patients in low- to medium-volume hospitals showed significantly worse survival [adjusted hazard ratio (aHR) = 1.36-1.86] than those in high-volume hospitals in multivariable analyses. Among the latter, treatment delays > 1 month were not associated with worse survival for stomach, colon, pancreatic, or lung cancer but were for rectal [aHR = 1.28; 95% confidence interval (CI), 1.17-1.40] and breast (aHR = 1.59; 95% CI, 1.37-1.84) cancer. For patients in low- to medium-volume hospitals, treatment delay was associated with worse survival for all types of cancer (aHR = 1.78-3.81). CONCLUSION: Our findings suggest that the effect of hospital volume and surgical treatment delay on overall survival of cancer patients should be considered in formulating or revising national health policy.

The incidence of postoperative nausea and vomiting after thyroidectomy using three anaesthetic techniques.

The choice of anaesthetics can affect the incidence of postoperative nausea and vomiting (PONV). This study compared the incidence of PONV in 177 female patients who underwent thyroidectomy, with anaesthesia induced and maintained using one of three regimens: (i) sevoflurane (thiopental sodium 4 - 5 mg/kg and sevoflurane 2.0 - 2.5 vol% in 50% air); (ii) total intravenous anaesthesia (TIVA; propofol-remifentanil [target blood concentrations 2.5 - 3.5 µg/ml and 3.5 - 4.5 ng/ml, respectively]); or (iii) combined inhalation and intravenous anaesthesia (sevoflurane 1.0 vol% in 50% air plus propofol-remifentanil [target blood concentrations 1.5 - 2.5 µg/ml and 2.5 - 3.5 ng/ml, respectively]). The incidence and severity of PONV and the need for rescue antiemetics were assessed at 0 - 24 h postoperatively. Overall, the incidence of PONV was significantly lower in the TIVA and combined groups compared with the sevoflurane group (33.9%, 39.0% and 64.4%, respectively). In conclusion, the maintenance of anaesthesia with propofol-remifentanil or sevoflurane-propofol-remifentanil decreased the incidence of PONV compared with sevoflurane alone.

Cancer survival in Busan, Republic of Korea, 1996-2001.

The Busan cancer registry was established in 1996; cancer registration is done by passive and active methods. The registry contributed survival data for 48 cancer sites or types registered during 1996-2001. Follow-up information has been gleaned predominantly by passive methods with median follow-up ranging between 1-57 months for various cancers. The proportion with histologically verified diagnosis for different cancers ranged between 20-100%; death certificates only (DCOs) comprised 0-53%; 47-100% of total registered cases were included for survival analysis. The top-ranking cancers on 5-year age-standardized relative survival rates were penis (94%), thyroid (91%), non-melanoma skin (89%), placenta (86%), breast (76%), Hodgkin lymphoma (75%) and testis (72%). Five-year relative survival by age group showed a decreasing trend with increasing age groups for cancers of the nasopharynx, gall bladder, lung, bone, soft tissue, breast, cervix, corpus uteri, thyroid, multiple myeloma, lymphoid leukaemia and myeloid leukaemia or was fluctuating for other cancers.

Reduction of microemulsion propofol-induced injection pain via target-controlled remifentanil infusion.

The intravenous injection of microemulsion propofol to induce anaesthesia causes more intense and frequent pain than lipid emulsion propofol. This study investigated whether different target effect-site concentrations of remifentanil could prevent pain due to microemulsion propofol injection. In total, 96 patients were randomly assigned to one of three groups receiving target effect-site concentrations of remifentanil 0 (control group), 4 or 6 ng/ml, followed by injection with microemulsion propofol. Remifentanil pretreatment significantly reduced the incidence and severity of injection pain compared with the control group. Although no difference in pain reduction between the two remifentanil-treated groups was observed, those receiving a target effect-site concentration of 6 ng/ml exhibited an increased rate of complications, compared with those receiving 4 ng/ml. In conclusion, prior administration of remifentanil at a target effect-site concentration of 4 ng/ml is a useful strategy to decrease the injection pain of microemulsion propofol.

Smoking, alcohol and gastric cancer risk in Korean men: the National Health Insurance Corporation Study.

We investigated the risk of gastric cancer by subsite in relation to cigarette smoking and alcohol in a large population-based cohort of 669 570 Korean men in an insurance plan followed for an average 6.5 years, yielding 3452 new cases of gastric cancer, of which 127 were cardia and upper-third gastric cancer, 2409 were distal gastric cancer and 1007 were unclassified. A moderate association was found between smoking, cardia and upper-third (adjusted relative risk (aRR) 2.2; 95% confidence interval (CI) 1.4-3.5) and distal cancers (aRR=1.4; 95% CI=1.3-1.6). We also found a positive association between alcohol consumption and distal (aRR=1.3; 95% CI=1.2-1.5) and total (aRR=1.2; 95% CI=1.1-1.4) gastric cancer. Combined exposure to high levels of tobacco and alcohol increased the risk estimates further; cardia and upper-third gastric cancers were more strongly related to smoking status than distal gastric cancer.British Journal of Cancer (2007) 97, 700-704. doi:10.1038/sj.bjc.6603893 www.bjcancer.com Published online 17 July 2007.

Ovarian cancer incidence and survival in Korea: 1993-2002.

This study examined incidence rates, histologic and stage distribution, and long-term survival rates of patients with ovarian cancer in Korea. A total of 11,404 patients diagnosed with ovarian cancer between 1993 and 2002 were reported to the Korea Central Cancer Registry and the Gynecologic Oncology Committee of Korean Society of Obstetrics and Gynecology. All rates were expressed per 100,000. The age-standardized incidence rates were 3.79 and 4.74 per 100,000 women in 1993 and 2002, respectively. The incidence rates of ovary cancer increased with age in Korea, and over half of the patients were in the stage IA (24.8%) and IIIC (26.8%) in this study. The 5-year relative survival rate was 59.6%. Relative survivals according to the stage of FIGO at 5 years were 91.1%, 75.2%, 46.4%, and 21.2% for stages I, II, III, and IV, respectively. The 5-year relative survivals of germ cell tumors and epithelial ovarian cancer were 89.0% and 58.3%, respectively. Surgical stage and histology were the most important prognostic factors of ovarian cancer. However, the 5-year survival rate of FIGO stage IC was significantly higher than that of stage IB.

Cervical cancer incidence and survival in Korea: 1993-2002.

This study examined the incidence rates, histologic and stage distribution, and long-term survival rates of patients with cervical cancer in Korea. A total of 44,182 patients diagnosed with cervical cancer between 1993 and 2002 were reported to the Korea Central Cancer Registry and the Gynecologic Oncology Committee of Korean Society of Obstetrics and Gynecology. The age-standardized incidence rates were 19.0, 17.8, and 15.1 per 100,000 women in 1993-1995, 1996-1998, and 1999-2002, respectively. The incidence rates of adenocarcinoma (AC) have been in the range between 1.2 in 1993-1995 and 1.4 in 1999-2002, while those of squamous cell carcinoma declined from 15.1 in 1993-1995 to 12.2 in 1999-2002. The 5-year relative survival rate was 79.2%. Relative survival rates, according to stage by the FIGO, at 5 years were 94.2%, 69.7%, 38.9%, and 21.1% for stages I, II, III, and IV respectively. Relative survivals improved between 1993 and 1997, probably due to the introduction of cervical cancer screening and effective treatment. The incidence rates of AC have been constant despite decreased cervical cancer in Korea. Introduction of cervical cancer screening and effective treatment may have contributed to the improved relative survival.

Upregulation of c-Kit receptor and stem cell factor in cerebellar inhibitory synapses in response to kainic acid.

Neuronal stimulation was induced in rats by systemic administration of kainic acid (KA) to determine if such stimulation is responsible for changes in the expression patterns of c-Kit and stem cell factor (SCF) in cerebellar synapses between inhibitory interneurons and Purkinje cells. Using immunocytochemistry and immunoblotting analyses, we demonstrate that c-Kit receptor tyrosine kinase and its ligand SCF are present on the pre- and postsynaptic sides of inhibitory synapses on Purkinje cells. These proteins are upregulated during the first 48 hr after KA treatment, whereas their levels fall below that of the control by 1 week and remain as such thereafter. Expression of both c-Kit and SCF are significantly elevated in the Purkinje cell layer 24 hr after KA administration, and the Purkinje cell layer exhibits a loss of calbindin D-28K immunoreactivity. Expression of c-Kit in basket cell axon terminals is activated until 48 hr after KA treatment, suggesting the transient participation of c-Kit receptor tyrosine kinase in the maintenance of these axonal terminals. Also during the first 48 hr after KA treatment, SCF levels increase in axonal processes of Purkinje cells, and these SCF-positive axons correlate with c-Kit-positive pinceau structures. The increased expression of c-Kit and SCF in response to KA-induced neuronal stimulation may indicate that c-Kit receptor tyrosine kinase and its ligand SCF function in the inhibitory synapse between cerebellar interneurons and Purkinje cells, and that this role is most pronounced during the first 48 hr after KA treatment.

Annual Report of the Central Cancer Registry in Korea-1999: Based on Registered Data from 128 Hospitals.

PURPOSE: The Central Cancer Registry Center in Korea (KCCR) conducted a nationwide hospital-based cancer registry to provide basic statistical data on cancer. MATERIALS AND METHODS: In 1999, 128 hospitals participated in the cancer registry program. All cancer registry data, which was submitted from the participating hospitals by diskettes during the year, were reviewed and analyzed by the committee members who were all Board-qualified clinical oncologists and pathologists. To avoid duplication, every resident registration number was compared by a computer. Cases that had been diagnosed by a histological examination were preferentially chosen for inclusion in this data. RESULTS: Of 94,003 cases that were registered, there was a total of 8,452 (9.0%) duplication cases which were excluded. Of the remaining 85,551 cases, there were 3,231 cases (3.8%) of carcinoma in situ (morphology code/2) which were excluded. A final total of 82,320 cases were analyzed. Of the analyzed cases, 46,908 (57.0%) were males and 35,412 (43.0%) were females. The leading age groups in the order of their relative frequency were those who were 60~64 years of age (15.3%), followed by the 55~59 age group (13.8%). The six leading primary cancer sites in the order of their relative frequency were stomach (20.7%), followed by the bronchus and lung (12.1%), the liver and intrahepatic bile duct (12.0%), the colorectum (9.9%), the breast (6.4%), and then the uterine cervix (5.0%). In males, the five leading primary cancer sites were the stomach (24.2%), the liver and intrahepatic bile duct (16.3%), the bronchus and lung (16.1%), the colorectum (9.7%), and the urinary bladder (3.3%). In females, the stomach (16.2%) was the most common cancer site, followed by the breast (14.7%), the uterine cervix (11.6%), the colorectum (10.2%), and the thyroid (6.8%). Among the 1,077 cases of childhood malignancies, leukemia (35.4%), CNS tumors (16.7%), malignant lymphomas (7.0%), and sympathetic nervous system tumors (6.9%) were the most common cancer types. CONCLUSION: We analyzed and report the KCCR data from 128 nationwide hospitals during 1999.

A PCR analysis of ERalpha and ERbeta mRNA abundance in rats and the effect of ovariectomy.

To study the relative abundance and the changes of both estrogen receptor alpha (ERalpha) and ERbeta mRNA before and after ovariectomy in major organs important to the regulation of calcium homeostasis, we compared the degree of mRNA expression of ERalpha to that of ERbeta in rat tissues by performing competitive reverse transcription polymerase chain reaction (RT-PCR) with internal standards. Both ERalpha and ERbeta were highly expressed in the ovary {ERalpha[(2.2 +/- 0.33) x 10(7) copies/microg of total RNA] > ERbeta[(1.2 +/- 0.33) x 10(5) copies/microg of total RNA]} as we expected. The bone marrow and renal cortex were very important target organs of estrogen because ERalpha was highly expressed approximately 2 x 10(5) copies/microg of total RNA, but marrow cells revealed only a very weak expression of ERbeta [(0.7 +/- 0.21) x 10(2) copies/microg of total RNA]. Both ERalpha and ERbeta were expressed in the trabecular bone [(3.2 +/- 0.56) x 10(3) copy/microg of RNA] and [(2.8 +/- 0.21) x 102 copy/microg of RNA], respectively. However, they were not detected in the cortical bone. In the jejunum, the expression of ERalpha was not detectable, while ERbeta was expressed very weakly [(1.1 +/- 0.24) x 10(2) copies/microg of total RNA]. The thyroid gland expressed low copy numbers of ERbeta [(6.0 +/- 0.23) x 10(2) copies/microg of total RNA], but the parathyroid gland was negative for both ERalpha and ERbeta mRNA. In cultured stromal cells, ERalpha and ERbeta mRNAs were not detected after a 24-h culture; however, the rates of mRNA expression of ERalpha and ERbeta reached approximately 105 copies/microg of total RNA and approximately 10(2) copies/microg of total RNA, respectively, after 9-, 11-, and 13-day cultures. After ovariectomy, the expression of ERalpha mRNA decreased abruptly in the bone marrow and renal cortex, and both ERalpha and ERbeta were barely detected in the trabecular bone. In conclusion, ERalpha might be the main ER in organs important for calcium homeostasis, except in the jejunum. The mRNA expression of ERalpha in the bone marrow and renal cortex decreased abruptly after ovariectomy, which may partially explain why the effect of estrogen deficiency can be amplified and why trabecular bone loss is more predominant than cortical bone loss shortly after surgical or natural menopause.