Consuming Green Tea at Least Twice Each Day Is Associated with Reduced Odds of Chronic Obstructive Lung Disease in Middle-Aged and Older Korean Adults.

Background: The frequent consumption of green tea has been shown to have antioxidant and anti-inflammatory effects and to reduce the risk of lung cancer and type 2 diabetes. However, few studies have investigated the relation between green tea consumption and the risk of chronic obstructive lung disease (COPD). Objective: This study aimed to examine the association between green tea intake and COPD with the use of a nationwide representative database. Methods: This study was designed as a cross-sectional survey with the use of data from the Korean National Health and Nutritional Examination Survey collected between 2008 and 2015. Of these participants, 13,570 participants aged ≥40 y were included in the study population. COPD was defined as forced expiratory volume in 1 s (FEV1) divided by forced vital capacity (FVC) <0.70. Multiple linear and logistic regression models were used to examine the association between the frequency of green tea intake and risk of COPD after adjusting for age, sex, body mass index, smoking status, alcohol consumption, physical activity, and socioeconomic status. Results: The incidence of COPD decreased from 14.1% to 5.9% with increased frequency of green tea intake from never to ≥2 times/d (P < 0.001). In the fully adjusted multiple linear regression model, the frequency of green tea intake showed a linear dose-response relation with FEV1/FVC (P-trend = 0.031). In the multiple logistic regression model, the OR for COPD among people who consumed green tea ≥2 times/d was 0.62 (95% CI: 0.40, 0.97), compared with those who never drank green tea, after adjusting for all covariates. Conclusion: This study suggests that the consumption of green tea ≥2 times/d is associated with a reduced risk of COPD in Korean populations.

Blood cadmium levels are associated with a decline in lung function in males.

BACKGROUND: Cadmium exposure was found to cause a decline in lung function among the general population, but these findings were limited to smokers and gender differences were not explored. OBJECTIVES: To examine the relationship between cadmium and chronic obstructive pulmonary disease (COPD) according to gender and smoking status in Korea. METHODS: Cross-sectional data from the Korean National Health and Nutrition Examination Survey from 2008 to 2011 were analyzed. COPD was defined by a pre-bronchodilator forced expiratory volume in 1s divided by forced vital capacity of <0.70. A logistic regression model was used to elucidate the association between blood cadmium levels and COPD according to gender and smoking status. RESULTS: Among 3861 eligible participants, 3622 were included in the analysis. The prevalence of COPD demonstrated an increasing trend in males (P for trend<0.001), but not in females (P for trend=0.67). After adjusting for covariates, a higher blood cadmium level, but within the normal range, was associated with COPD in males, including those who had never-smoked (P for trend <0.001 and P for trend=0.008). However, a higher blood cadmium level was not significantly associated with COPD in females, including those who had never smoked (P for trend=0.39 and P for trend=0.43). CONCLUSIONS: A higher blood cadmium level, within the normal range, was associated with COPD in males, including those who had never smoked. However, there was no significant association between blood cadmium levels and COPD in females.

Is lesion size an independent indication for endoscopic resection of biopsy-proven low-grade gastric dysplasia?

BACKGROUND/AIM: The standard treatment for patients with gastric low-grade dysplasia (LGD) remains controversial, even though diagnosis of LGD is increasingly common as esophagogastrodeuodenoscopy becomes more available. The aim of this study was to identify a lesion size cut-off as an indication for endoscopic resection (ER) for patients with LGD. RESULTS: We retrospectively reviewed 285 lesions initially diagnosed as LGD by endoscopic forceps biopsies (EFB) from 2007 to 2010 in Kyung Hee University Hospital, Seoul, Korea. All patients underwent ER. A total of 285 lesions from 257 patients were assessed. After ER, 239 LGD (83.9 %) showed histological concordance and the remaining 46 (16.1 %) cases revealed an upgraded histology [22 high-grade dysplasia (7.7 %), and 24 differentiated adenocarcinoma (8.4 %)]. Univariate analyses demonstrated that lesion size, erythema, depression, and erosion were significant predictors of upgraded LGD (P < 0.001). Multivariate analysis showed that a lesion size ≥2 cm, erythema, and a depressed-type lesion were independent predictors of upgraded histology (P = 0.014, odds ratio 3.27, 95 % confidence interval 1.28-8.39). CONCLUSIONS: Our data suggest that a substantial number of LGD diagnoses based on EFB were not representative of the entire lesion. We recommend ER if gastric LGD has at least one of the following risk factors: surface erythema and a depressed type regardless of size, or ≥2 cm size regardless of abnormal surface configuration.

Knee derangements: comparison of isotropic 3D fast spin-echo, isotropic 3D balanced fast field-echo, and conventional 2D fast spin-echo MR imaging.

PURPOSE: To compare diagnostic performance, subjective image quality, and artifacts of isotropic three-dimensional (3D) intermediate-weighted (IW) fast spin-echo (SE), isotropic 3D balanced fast field-echo (FFE), and conventional two-dimensional (2D) fast SE 3.0-T MR sequences in evaluation of cartilage, ligaments, menisci, and osseous knee structures in symptomatic patients. MATERIALS AND METHODS: Institutional review board approval and waiver of informed consent were obtained for this HIPAA-compliant study. One hundred MR studies, each with three data sets (3D IW fast SE, 3D balanced FFE, 2D fast SE), were reviewed retrospectively. Two radiologists independently evaluated images for cartilaginous defects, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus (MM), lateral meniscus (LM) tears, subchondral bone marrow signal abnormalities, subjective image quality, and image artifacts. Arthroscopic results were the reference standard. Statistical analysis was performed to calculate interobserver agreement and compare diagnostic performance of sequences. RESULTS: Sensitivity and specificity were greater than 85% for all lesions. For cartilaginous defects, sensitivity of 3D IW fast SE was significantly greater than that of 3D balanced FFE (95.5% vs 89.7%). Sensitivity of 3D IW fast SE and 2D fast SE for MM, LM, and ACL tears tended to be greater than that of 3D balanced FFE. IW fast SE had a higher detection rate for subchondral bone marrow signal abnormality than did 3D balanced FFE (34% vs 21%); it also had the best image quality and fewest artifacts, followed by 2D fast SE and 3D balanced FFE. Interobserver agreement was excellent for evaluation of all intraarticular structures (κ = 0.85-1) and good to excellent for detection of subchondral bone marrow signal abnormality (κ = 0.76-0.91). CONCLUSION: The performance of IW fast SE is superior to that of balanced FFE in evaluation of cartilaginous defects, with no significant difference in performance between 2D fast SE, 3D IW fast SE, and 3D balanced FFE in evaluation of meniscal and ligament tears. Subchondral bone marrow signal abnormality is more easily seen on 3D IW fast SE images, with better subjective image quality and fewer artifacts, than on images obtained with other techniques.

Qualitative and quantitative assessment of wrist MRI at 3.0T: comparison between isotropic 3D turbo spin echo and isotropic 3D fast field echo and 2D turbo spin echo.

BACKGROUND: Isotropic three-dimensional (3D) magnetic resonance imaging (MRI) has been applied to various joints. However, comparison for image quality between isotropic 3D MRI and two-dimensional (2D) turbo spin echo (TSE) sequence of the wrist at a 3T MR system has not been investigated. PURPOSE: To compare the image quality of isotropic 3D MRI including TSE intermediate-weighted (VISTA) sequence and fast field echo (FFE) sequence with 2D TSE intermediate-weighted sequence of the wrist joint at 3.0 T. MATERIAL AND METHODS: MRI was performed in 10 wrists of 10 healthy volunteers with isotropic 3D sequences (VISTA and FFE) and 2D TSE intermediate-weighted sequences at 3.0 T. The signal-to-noise ratio (SNR) was obtained by imaging phantom and noise-only image. Contrast ratios (CRs) were calculated between fluid and cartilage, triangular fibrocartilage complex (TFCC), and the scapholunate ligament. Two radiologists independently assessed the visibility of TFCC, carpal ligaments, cartilage, tendons and nerves with a four-point grading scale. Statistical analysis to compare CRs (one way ANOVA with a Tukey test) and grades of visibility (Kruskal-Wallis test) between three sequences and those for inter-observer agreement (kappa analysis) were performed. RESULTS: The SNR of 2D TSE (46.26) was higher than those of VISTA (23.34) and 3D FFE (19.41). CRs were superior in 2D TSE than VISTA (P = 0.02) for fluid-cartilage and in 2D TSE than 3D FFE (P < 0.01) for fluid-TFCC. The visibility was best in 2D TSE (P < 0.01) for TFCC and in VISTA (P = 0.01) for scapholunate ligament. The visibility was better in 2D TSE and 3D FFE (P = 0.04) for cartilage and in VISTA than 3D FFE (P < 0.01) for TFCC. The inter-observer agreement for the visibility of anatomic structures was moderate or substantial. CONCLUSION: Image quality of 2D TSE was superior to isotropic 3D MR imaging for cartilage, and TFCC. 3D FFE has better visibility for cartilage than VISTA and VISTA has superior visibility for TFCC to 3D FFE and the visibility for scapholunate ligament was best on VISTA.

Polymorphisms of the Interferon gamma gene and coronary artery disease in the Korean population.

Abundant evidence supports the hypothesis that inflammation plays an important role in the development of coronary artery disease (CAD). In this study, we investigated whether genetic polymorphisms of the Interferon gamma (IFNG) gene were associated with the number of diseased vessels in CAD patients in the Korean population. To observe the association between the IFNG gene and the number of diseased vessels, we genotyped 635 CAD patients for a single nucleotide polymorphism (SNP, rs2430561) and a microsatellite (CA(n) repeats, rs3138557) located in the first intron of the IFNG gene using the direct sequencing and gene scan method. The number of microsatellites was increased in the one- and two-vessel disease groups. A combined analysis of the genotype of rs2430561 and the number of microsatellites revealed that the number of diseased vessels was associated with CA(12)-TT and CA(13)-TT. Our results suggest that the IFNG gene may be one of the factors determining the extent of CAD in the Korean population. Larger collaborative studies are needed to confirm these results.

Relationship between socioeconomic variables and obesity in Korean adolescents.

BACKGROUND: Despite the importance of obesity and its association with socioeconomic status, little is known about this condition in Korean adolescents. We examined the relationship between obesity in Korean adolescents and several socioeconomic variables and compared the association of obesity with conventional and subjective indicators of socioeconomic status. METHODS: The study comprised 60 643 Korean adolescents aged 12 to 18 years who participated in the 2007 Korea Youth Risk Behavior Web-Based Survey. The dependent variable, obesity, and the independent variables of parental education levels, family affluence scale, subjective family economic status, and subjective school achievement were collected by using a self-administered anonymous questionnaire. Data on behavioral and psychological characteristics were also collected and used as confounding factors. Multivariate logistic regression was conducted to identify associations between socioeconomic status and obesity. RESULTS: In the descriptive analysis, adolescents with low parental education, low family affluence level, low subjective family economic status, and low subjective school achievement were more likely to be obese. However, after controlling for other risk factors in multivariate analysis, only the associations with subjective family economic status and subjective school achievement remained statistically significant. CONCLUSIONS: Our results provide further evidence that the prevalent pattern of obesity in Korean adolescents-i.e., the inverse relationship between obesity and socioeconomic status-is similar to that in developed countries. In addition, these findings support the hypothesis that, as compared with objective socioeconomic status, subjective social status is more closely related to obesity.

Quantitative computed tomographic indexes in diffuse interstitial lung disease: correlation with physiologic tests and computed tomography visual scores.

PURPOSE: To assess the correlation among quantitative indexes of computed tomography (CT), spirometric pulmonary function tests (PFTs), and visual scores (VSs) of CT in patients with diffuse interstitial lung disease (DILD) and to prove the estimated value of CT quantification for the prediction of the possibility of pulmonary function impairment. METHODS AND MATERIALS: A total of 157 patients (male to female ratio, 96:61; mean age, 63 ± 11 years) with DILD were enrolled in this study. All patients underwent volume thin-section CT in the supine position at full inspiration. During the same period, 23 people (male to female ratio, 10:13; mean age, 55 ± 13 years) with no history of DILD and with normal PFTs and CT findings were used as a control group. Quantitative indexes were obtained using a commercial CAD system (Brilliance Workspace v3.0; Philips Medical Systems). Quantitative indexes included total lung volume (TLV), mean lung attenuation, variation of lung attenuation, emphysema volume (<-950 Hounsfield units [HU]), functioning lung volume (-700 HU > pixel > -950 HU), and interstitial lung disease volume (>-700 HU). Visual scores were measured semiquantitatively and included the overall extent of pulmonary parenchymal abnormality as well as the extent of consolidation, ground glass opacity, reticulation, and honeycomb opacities. Quantitative indexes were correlated with PFT and VSs using the Pearson correlation test. RESULTS: Quantitative indexes, PFT results, and VSs differed significantly between the DILD group and the control group, except for emphysematous parameters (P < 0.05).Pulmonary function test results showed significant correlation with quantitative indexes in the DILD group. Functioning lung volume showed positive correlation with forced vital capacity and forced expiratory volume in 1 second (r = 0.80 and 0.73, P < 0.001). Total lung capacity showed positive correlation with TLV (r = 0.83, P < 0.001).Visual scores were correlated with the ratio of a specific volume to TLV (indicated as ®). Interstitial lung disease volume® showed positive correlation (r = 0.53, P < 0.001), and FLV® showed a negative correlation with the overall extent of ILD (r = -0.52, P < 0.001). variation of lung attenuation showed a positive correlation with honeycombing extent (r = 0.37, P < 0.001), and mean lung attenuation showed a positive correlation with reticulation extent (r = 0.42, P < 0.001). CONCLUSIONS: Quantitative indexes measured by a commercial workstation showed good correlation not only with the extent of DILD estimated by visual inspection but also with PFT results. Quantitative indexes can be used as an objective tool for quantitative evaluation of disease extent and for follow-up of the progression or improvement of a DILD.

The relation of menarcheal age to anthropometric profiles in Korean girls.

The aim of this study was to represent the trend of early menarche and to assess the association of age at menarche with anthropometric profiles of Korean children and adolescents. A cross sectional survey was conducted with 13,371 girls aged 10 to 18 yr, recruited nationwide from April, 2005 to March, 2006. Height, weight and waist circumference of the subjects were measured; and the subjects self-reported their ages at menarche. We found that the menarcheal girls were taller (P<0.05 for the girls between 10 and 14 yr) and heavier (P<0.05 for the girls between 10 and 18 yr) than non-menarcheal ones. Menarcheal girls also showed higher body mass index (BMI), and greater waist circumference than non-menarcheal ones. Significant differences were represented according to the age at menarche in terms of BMI, waist circumference, % body fat mass, waist hip ratio and neck circumference as well as height and weight (P<0.05). In conclusion, girls who matured early were taller and heavier in early adolescence than those who matured later.

Three-dimensional isotropic shoulder MR arthrography: comparison with two-dimensional MR arthrography for the diagnosis of labral lesions at 3.0 T.

PURPOSE: To compare the diagnostic accuracy of three-dimensional (3D) isotropic magnetic resonance (MR) arthrography with two-dimensional (2D) MR arthrography for the diagnosis of labral lesions of the shoulder performed by using a 3.0-T imager. MATERIALS AND METHODS: Institutional review board approval was given for this retrospective study and informed consent was waived. From March 2006 to January 2007, 100 patients underwent 3D isotropic and 2D MR shoulder arthrographic imaging by using a 3.0-T imager and subsequent arthroscopic surgery. The 3D isotropic sequences were performed by using fast gradient-echo imaging with fat suppression (voxel size, 0.6 x 0.6 x 0.6 mm; imaging time, 5 minutes 32 seconds) and were evaluated for the presence of superior, anterior, and posterior labral lesions by using 3D isotropic and 2D MR arthrography. The statistical differences between the sensitivity and specificity for both methods were analyzed by using the McNemar test, with arthroscopic findings regarded as reference standard. RESULTS: Surgical findings confirmed 53 superior labral anterior posterior (SLAP) lesions, 17 anterior labral lesions, and five posterior labral lesions. Respective sensitivity and specificity were 85% and 96% for SLAP lesions, 100% and 98% for anterior labral lesions, and 80% and 99% for posterior labral lesions by using 2D MR arthrography and 83% and 96% for SLAP lesions, 100% and 96% for anterior labral lesions, and 80% and 99% for posterior labral lesions by using 3D isotropic MR arthrography. There was no significant difference in sensitivities and specificities of both methods; however, the power of this study was limited and larger comparison is needed. CONCLUSION: Isotropic 3D shoulder MR arthrography combined with a multiplanar reconstruction technique can help in the diagnosis of shoulder labral lesions as does 2D MR arthrography, but with shorter imaging times.

Diagnosis of internal derangement of the knee at 3.0-T MR imaging: 3D isotropic intermediate-weighted versus 2D sequences.

PURPOSE: To compare three-dimensional (3D) isotropic fast spin-echo (SE) intermediate-weighted magnetic resonance (MR) imaging with two-dimensional (2D) fast SE MR imaging-both performed at 3.0 T-for performance in the diagnosis of internal derangements of the knee. MATERIALS AND METHODS: The institutional review board approved this HIPAA-compliant study, and the requirement for informed consent was waived. The authors retrospectively reviewed 87 knee MR images obtained in 85 patients who had undergone both 3D isotropic and 2D MR examinations of the knee at 3.0 T and subsequent arthroscopic surgery. The 2D MR images included intermediate-weighted coronal and sagittal images, intermediate-weighted axial images with fat saturation, and T2-weighted sagittal images. The 3D isotropic MR images were obtained with multiplanar reformation (MPR), a fast SE intermediate-weighted sequence, and a reconstruction voxel size of 0.5 x 0.5 x 0.5 mm. Two radiologists retrospectively and independently evaluated the 2D and 3D data sets, at different sessions, for the presence of medial meniscus (MM), lateral meniscus (LM), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) tears. These interpretations were compared with the arthroscopic surgery findings. The statistical differences between the sensitivities, specificities, and accuracies of the two methods were determined at McNemar testing, with surgical findings serving as the reference standard. Interobserver agreement was calculated by using kappa coefficients. RESULTS: For both reviewers, the sensitivity, specificity, and accuracy of both MR techniques were higher than 95% for the diagnosis of ACL and PCL tears, higher than 85% for the diagnosis of MM tears, and higher than 80% for the diagnosis of LM tears. There were no significant differences in sensitivity, specificity, or accuracy between the two methods. Interobserver agreement for evaluation of all lesions was excellent and ranged from 0.81 (LM tears evaluated with 3D and 2D sequences) to 0.93 (ACL tears evaluated with 3D and 2D sequences, PCL tears evaluated with 2D sequence, and MM tears evaluated with 3D sequence). CONCLUSION: The performance of 3D isotropic fast SE intermediate-weighted MR imaging with MPR was not significantly different from that of 2D MR imaging in the diagnosis of cruciate ligament and meniscal tears of the knee.

Comparison study of indirect MR arthrography and direct MR arthrography of the shoulder.

OBJECTIVE: To compare the diagnostic value of indirect magnetic resonance arthrography (I-MRA) with that of direct MR arthrography (D-MRA) for labral tears, rotator cuff tears, and long head of biceps tendon (LHBT) tears using a 3-T MR unit. MATERIALS AND METHODS: Institutional review board approval was given; written informed consent was obtained from all patients. From November 2005 to June 2006, 19 patients (eight men and 11 women; mean age, 51 years) who had undergone both I-MRA and D-MRA underwent arthroscopic surgery. Both methods were performed in fat-saturated axial, coronal oblique, and sagittal oblique T1-weighted sequences, as well as axial and coronal oblique T2-weighted sequences. Two radiologists independently and retrospectively evaluated two sets of MRA for the diagnosis of superior and anterior labral tears, subscapularis tendon (SSC), and supraspinatus-infraspinatus tendon (SSP-ISP) tears, and LHBT tears. With the arthroscopic finding as a gold standard, we analyzed statistical differences of sensitivities and specificities between two sets of MRA and inter-observer agreement was evaluated using the kappa value. RESULTS: The sensitivity and specificity of I-MRA and D-MRA for reader 1 were 79/80% and 71/80%, respectively, for superior labral tears; 100/100% and 100/100%, respectively, for anterior labral tears; 64/75% and 64/100%, respectively, for SSC tears; 100/86% and 100/100%, respectively, for SSP-ISP tears; and 67/100% and 78/100%, respectively, for LHBT tears. Those of I-MRA and D-MRA for reader 2 were 86/80% and 71/100%, respectively, for superior labral tears; 100/83% and 100/100%, respectively, for anterior labral tears; 64/88% and 82/100%, respectively, for SSC tears; 92/86% and 100/100%, respectively, for SSP-ISP tears; and 78/90% and 89/100%, respectively, for LHBT tears. No significant differences were found between the methods. Inter-observer agreements were higher than moderate (kappa > 0.41) with both methods. CONCLUSIONS: Based on a relatively small number of patients, no significant difference was detected between I-MRI and D-MRI with regard rotator cuff, labral, and LHBT tears.

Efficacy of PET/CT in the characterization of solid or partly solid solitary pulmonary nodules.

We aimed to evaluate the efficacy of (18)fluorine fluorodeoxyglucose ((18)F FDG) PET/CT for the characterization of solitary pulmonary nodules (SPNs) compared with the use of PET alone or CT alone. Our institutional review board approved this retrospective study with a waiver of informed consent. We selected 100 patients (M:F=56:44, mean age; 58 years) with a pathologically proven solid or partly solid SPN. Three chest radiologists assessed the nodule characteristics independently and retrospectively. Diagnostic efficacies were compared for three different approaches: consideration of CT findings only, PET findings only, and both PET and CT findings. The McNemar test, kappa statistics, and receiver operating characteristics (ROC) curve analysis were performed. Sixty patients had benign and 40 had malignant nodules. Overall sensitivity values for malignant SPNs for CT, PET and PET/CT were 82%, 88%, and 88%, respectively, whereas the specificity values were 66%, 71%, and 77%, respectively. PET/CT was significantly better in terms of specificity than the use of PET alone or CT alone (P<.05). The areas under curve (Az) values for the ROC analyses of PET/CT and PET alone, respectively, were larger than that of CT alone (P<.05). Interobserver agreement was moderate (kappa=0.46-0.56) for CT, good to excellent (kappa=0.78-0.90) for PET, and good for PET/CT (kappa=0.64-0.78). For the characterization of SPNs, integrated PET/CT provides significantly better specificity than CT alone or PET alone and both integrated PET/CT and PET alone allow more confidence than CT alone.

Genetic association between 5'-upstream single-nucleotide polymorphisms of PDGFRB and schizophrenia in a Korean population.

PDGFRB is located on chromosome 5q31-q32, a chromosomal region identified by linkage analyses to contain a susceptibility gene for schizophrenia (SCZ). Recent research has focused on the role of the N-methyl-d-aspartate (NMDA) receptor in the pathogenesis of SCZ. D4 dopamine receptor-mediated transactivation of the gene encoding platelet-derived growth factor receptor beta (PDGFRB) has immediate effects on synaptic neurotransmission via calcium-dependent inactivation of NMDA receptors. In this study, we investigate the association between the PDGFRB gene and SCZ in a Korean population. We screened 6 single-nucleotide polymorphisms (SNPs) in the 5'-upstream region of PDGFRB and conducted a case-control study of 381 SCZ patients and 752 controls. The genotype and haplotype frequencies of 3 of the 6 SNPs [SNP1 (g.-1924T>C, rs3756314), SNP3 (g.-1772A>G, rs3756312) and SNP4 (rs3756311, g.-1658G>A)] were significantly associated with SCZ [SNP1, corrected p=0.012 (co-dominant model), 0.002 (Dominant model), and 0.506 (Recessive model); SNP3 and 4, corrected p=0.003, 0.009, and 0.049]. Haplotype analysis also revealed that ht1 (CGG) and ht2 (TAA) were significantly associated with SCZ (ht1, corrected p=0.018, 0.340, and 0.010; ht2, corrected p=0.002, 0.009, and 0.016). Transient transfection in neuronal cells revealed that ht1 had higher luciferase activity than the vector alone. Furthermore, Pdgfrb expression was increased in the frontal cortex and hippocampus in a mouse model of SCZ induced by MK801. We conclude that SNPs of the 5'-upstream region of PDGFRB are associated with SCZ in a Korean population. These are weak positives that require future studies to confirm these results.

Association study of polymorphisms between DISC1 and schizophrenia in a Korean population.

To further clarify schizophrenia (SCZ), disrupted in schizophrenia 1 (DISC1) is a promising candidate gene expressed predominantly within the hippocampus. Several lines of evidence suggest that DISC1 may be involved in susceptibility to SCZ. In this study, we investigated whether genetic polymorphisms in the coding region of DISC1 were associated with several SCZ clinical phenotypes in a Korean population. To examine any association between DISC1 and SCZ, we genotyped three clinical single nucleotide polymorphisms (SNPs) (rs3738401, R264Q; rs3738402, L465L; rs821616, S704C) in the coding region of the DISC1 gene using the Illumina Sentrix Array Matrix chip and direct sequencing in 303 patients with SCZ and 300 healthy controls. Our case-control analysis showed that none of these SNPs was associated with SCZ. In further endophenotype stratification, however, we found a significant association between rs821616 and the poor concentration subgroup of SCZ, determined using the Operational Criteria Checklist (codominant model, p=0.015). Our results suggest that DISC1 may be a susceptibility gene for poor concentration among Korean patients with SCZ.

Coronary calcium screening using low-dose lung cancer screening: effectiveness of MDCT with retrospective reconstruction.

OBJECTIVE: The purpose of our study was to show the usefulness of nongated low-dose chest CT for coronary screening by comparing the results of coronary artery calcium measurement with that of dedicated calcium-scoring CT. MATERIALS AND METHODS: One hundred twenty-eight consecutive participants (all men; mean age, 52 +/- 7 years) underwent low-dose chest CT and calcium-scoring CT with prospective ECG gating using 40-MDCT. Low-dose chest CT volume data were reconstructed as 25-cm field of view and three slice thicknesses: 1, 2.5, and 5 mm. For each examination, the lesion area, Agatston calcium score, and calcium mass were measured at 90- and 130-H thresholds. All measurements (130-H threshold) from the calcium-scoring CT were used as reference standards. Spearman's correlation test was used to compare the results. RESULTS: Among the low-dose chest CT examinations, sensitivity was best determined with a 1-mm slice thickness at 130 H and 2.5-mm slice thickness at 90 H. Specificity was best determined with a 5-mm slice thickness at 130 H. Accuracy (90%) was best determined with a 2.5-mm slice thickness at 130 H. Of all protocols, calcium area, score, and mass from a 2.5-mm slice thickness at 130 H correlated best with the reference results (r = 0.89 for all three criteria). CONCLUSION: Using a low radiation dose and nongated MDCT, we can detect coronary artery calcium and obtain results comparable to those obtained with dedicated calcium-scoring CT that uses a higher dose and ECG gating.

Pelvic bone complications after radiation therapy of uterine cervical cancer: evaluation with MRI.

OBJECTIVE: The purpose of this study was to assess the prevalence and distribution of radiation-induced insufficiency fractures and to investigate other bony complications of the female pelvis associated with radiation therapy using MR images. MATERIALS AND METHODS: Two radiologists retrospectively evaluated pelvic MR images of 510 patients (mean age, 54.7 years) who underwent pelvic irradiation for uterine cervical cancer for the presence and location of insufficiency fractures by consensus. We calculated the cumulative prevalence of pelvic insufficiency fractures on the basis of their results. In addition, we identified other associated bony complications of the female pelvis by reviewing the MR images. RESULTS: Insufficiency fractures were diagnosed in 100 patients; the 5-year cumulative prevalence was 45.2%. An insufficiency fracture was diagnosed a median of 16.9 months after radiation therapy. The fracture sites were the sacrum body and alae, medial side of the iliac bone, the roof of the acetabulum, superior rami of the pubic bone, femoral heads, and L5 vertebra. Sixty-one patients (61%) developed multiple fractures, and among them, 40 (40%) had bilateral symmetric lesions of the sacral alae. Other complications associated with the radiation therapy, as determined by evaluation of the MR images, were osteolysis and avascular necrosis of the femoral head. CONCLUSION: Radiation-induced pelvic insufficiency fractures are a frequent complication of radiation therapy for uterine cervical cancer. Osteolysis and avascular necrosis of the femoral head were also diagnosed using MRI after radiation therapy.

Anthropometric changes in children and adolescents from 1965 to 2005 in Korea.

The aim of this study was to assess the secular growth changes in Korean children and adolescents during the last four decades. In 2005, 68,790 boys and 62,557 girls were recruited for this study across the nation in 2005. Anthropometric data (weight, height, etc.) were measured. We compared the results of previous nationwide growth studies with this study. The results of this survey indicate that the growth and developmental status of Korean children and adolescents has been changed substantially compared with those in 1965, 1975, 1984, and 1997. The data presented in this study show a distinct secular increase in growth in body height and weight of Korean children and adolescents spanning this period. A nationwide survey every 5 years would be beneficial to establish a reference standard for the growth of children and adolescents according to the socioeconomic, environmental, and nutritional changes.

Anal incontinence after childbirth: incidence in the Korean population.

AIMS: To investigate the incidence and risk factors for anal incontinence after childbirth in Korea. METHODS: We retrospectively examined the records of 1,123 unselected women who delivered live infants at the KyungHee University Hospital between January 2006 and December 2006. Symptoms of anal incontinence were assessed by telephone interview using standard questionnaires. RESULTS: A total of 966 women (86%) responded to the survey, and the overall incidence of anal incontinence was 6.1% (9 fecal and flatal incontinence, 50 flatal incontinence). Of the study population, 562 (58.2%) had vaginal deliveries and 404 (41.8%) had cesarean sections. Vacuum extraction was used in 160 (28.5%) cases, and sphincter tears occurred in 16 (2.8%). Multivariate analysis showed that anal incontinence was associated with multiparity [2.75 (1.17-6.47)], maternal weight increase >or=15 kg [2.11 (1.03-4.31)], vaginal delivery with vacuum extraction [2.74 (1.23-6.14)], sphincter laceration [14.74 (4.69-46.27)], and cesarean section after second-stage labor [16.82 (4.61-61.40)]. CONCLUSION: Koreans had a lower incidence of post-birth anal incontinence than Westerners (6.1 and 29.3%, respectively), even though the risk factors were similar. These findings suggest that further studies examining differences in the incidence of anal incontinence based on ethnicity are warranted as such information may provide clues in terms of prevention and management of this disorder.

Tumor spatial heterogeneity in myxoid-containing soft tissue using texture analysis of diffusion-weighted MRI.

The objective of this study was to examine the tumor spatial heterogeneity in myxoid-containing soft-tissue tumors (STTs) using texture analysis of diffusion-weighted imaging (DWI). A total of 40 patients with myxoid-containing STTs (23 benign and 17 malignant) were included in this study. The region of interest (ROI) was manually drawn on the apparent diffusion coefficient (ADC) map. For texture analysis, the global (mean, standard deviation, skewness, and kurtosis), regional (intensity variability and size-zone variability), and local features (energy, entropy, correlation, contrast, homogeneity, variance, and maximum probability) were extracted from the ADC map. Student's t-test was used to test the difference between group means. Analysis of covariance (ANCOVA) was performed with adjustments for age, sex, and tumor volume. The receiver operating characteristic (ROC) analysis was performed to compare diagnostic performances. Malignant myxoid-containing STTs had significantly higher kurtosis (P = 0.040), energy (P = 0.034), correlation (P<0.001), and homogeneity (P = 0.003), but significantly lower contrast (P<0.001) and variance (P = 0.001) compared with benign myxoid-containing STTs. Contrast showed the highest area under the curve (AUC = 0.923, P<0.001), sensitivity (94.12%), and specificity (86.96%). Our results reveal the potential utility of texture analysis of ADC maps for differentiating benign and malignant myxoid-containing STTs.