Challenges and complications and their management of the transarterial microembolization for chronic musculoskeletal pain.

Transarterial microembolization (TAME) is an increasingly well-known novel and minimally invasive treatment option for painful chronic musculoskeletal diseases that is gaining popularity. Although the safety and effectiveness of TAME have been established, limited knowledge of intraarticular and musculocutaneous arterial anatomy may lead to challenges and complications. This article aims to present cases illustrating these challenges and complications, based on multicenter experiences and a comprehensive literature review. Furthermore, the article also provides preventive tips, solutions, and follow-up strategies to reduce the learning curve for interventional radiologists and facilitate familiarity with post-TAME follow-up images for diagnostic radiologists. CLINICAL RELEVANCE STATEMENT: This article illustrates the intra- and post-interventional complications of transarterial microembolization (TAME) through detailed pictorial reviews, including how to distinguish them from normal angiographic findings. It provides strategies for their prevention, management, and follow-up, which can further improve clinical outcomes. KEY POINTS: • Transarterial microembolization for chronic musculoskeletal pain may result in intrainterventional challenges (IIC) and postinterventional complications (PIC), and their importance may be underestimated. • The intrainterventional challenges include microarterial perforation, arterial dissection, and catheter tip fracture, whereas postinterventional complications include tissue ischemia-related complications, puncture site hemorrhage, and arterial injury. • Being familiar with the intrainterventional challenges and postinterventional complications may help minimize the procedure risk and improve outcomes.

Adaptation of Medical Students During Clinical Training: Effects of Holistic Preclinical Education on Clerkship Performance.

THEORY: Taiwan's medical undergraduate program at a university or medical center is a continuation of 12 years of compulsory citizenship education rooted in holistic philosophies. Students acquire both technical knowledge and nontechnical attributes, which are necessary for success in further work and life. The early clinical learning experiences of medical students are primarily acquired through clerkships. These clerkships require medical students to apply and extend what they learned during their preclinical education; however, previous studies have explored this issue through examining fragmentary factors such as preclinical course grades and traits but not undertaking comprehensive, whole-person investigations. HYPOTHESES: To account for the potential benefits of a holistic approach in medical students' learning, we propose three hypotheses: Medical students' preclinical performance on Taiwan's technical and nontechnical higher education assessments are positively associated with their clinical competence (Hypothesis 1) and psychological well-being (Hypothesis 2) during clerkships, and medical students' psychological well-being during clerkships is positively associated with their clinical competence (Hypothesis 3). METHOD: We studied a cohort of 65 medical students engaged in clerkships from September 2013 to April 2015. Their preclinical technical knowledge scores-formal curricular grades received from course instructors-were obtained from their medical school's archival dataset. Their nontechnical attributes-moral and social performance scores received from student mentors and physical performance scores received from course instructors-were also obtained from the school's archival data set. The medical students' competence in their 2-year clinical clerkships was measured using the objective structured clinical examination scores from the end of both clerkship years. The medical students' psychological well-being during their 2-year clerkships was measured according to burnout level, which was determined using routine online surveys that employed validated, structured, and self-administered questionnaires at each specialty rotation. Multiple regressions and linear mixed-effects model were employed for statistical analysis. RESULTS: Our study revealed that higher preclinical technical knowledge predicted superior clinical competence and a higher level of burnout during clerkships. By contrast, higher preclinical nontechnical attributes (i.e., higher preclinical moral, social, and physical performance) predicted lower level of burnout. However, no relationship was discovered between clerkship burnout and the clinical competence of the medical students. CONCLUSIONS: Our study verified the value of a holistic education that encompasses both technical knowledge and nontechnical attributes during the preclinical learning stage for medical students. Our findings can serve as a reference for medical educators designing preclinical educational programs for medical students.

Matrix metalloproteinase 14 modulates diabetes and Alzheimer's disease cross-talk: a meta-analysis.

Diabetes mellitus is associated with dementia, but whether diabetes is associated with Alzheimer's disease remains controversial. Alzheimer's disease is characterized by amyloid beta aggregation. We hypothesized that genes, involved in amyloid beta degradation, may be altered due to diabetes and thus participate in progression of Alzheimer's disease. Expression profiling of amyloid beta-degrading enzymes in streptozotocin-induced diabetic mice and their correlation with expression of amyloid precursor protein in hippocampus of Alzheimer's disease patients were accessed. We found that matrix metalloproteinase 14 decreased in brain but not in other tissues of streptozotocin-induced diabetic mice, and was negatively correlated with expression of amyloid precursor protein in hippocampus of Alzheimer's disease patients. These findings suggested matrix metalloproteinase 14 may link insulin-deficient diabetes to Alzheimer's disease.

Predicting peak inundation depths with a physics informed machine learning model.

Timely, accurate, and reliable information is essential for decision-makers, emergency managers, and infrastructure operators during flood events. This study demonstrates that a proposed machine learning model, MaxFloodCast, trained on physics-based hydrodynamic simulations in Harris County, offers efficient and interpretable flood inundation depth predictions. Achieving an average R 2 of 0.949 and a Root Mean Square Error of 0.61 ft (0.19 m) on unseen data, it proves reliable in forecasting peak flood inundation depths. Validated against Hurricane Harvey and Tropical Storm Imelda, MaxFloodCast shows the potential in supporting near-time floodplain management and emergency operations. The model's interpretability aids decision-makers in offering critical information to inform flood mitigation strategies, to prioritize areas with critical facilities and to examine how rainfall in other watersheds influences flood exposure in one area. The MaxFloodCast model enables accurate and interpretable inundation depth predictions while significantly reducing computational time, thereby supporting emergency response efforts and flood risk management more effectively.

Association of poly(ADP-ribose) polymerase-1 polymorphism with Tourette syndrome.

Tourette syndrome (TS) is an etiologically heterogeneous disorder, the pathogenesis of which is incompletely understood. Poly(ADP-ribose) polymerase 1 (PARP1) is involved in regulation of developmental processes and cellular differentiation, in transcription regulation, in DNA repair, and in cell death. However, the relationship between TS and single nucleotide polymorphisms (SNPs) of PARP1 is unknown. Therefore, the aim of this experiment was to test the hypothesis that whether the PARP1 SNP, rs1805404 (c.243C>T, Asp81Asp), had an association with TS. A case-control experiment was designed to test this hypothesis. 123 TS children and 122 normal children were enrolled in this study. Polymerase chain reaction restriction fragment length polymorphism was used for the detection of the PARP1 SNP, rs1805404, in TS patients and normal children. The data showed that there is a significant difference in genotype distributions between these two groups. The CT genotype was a risk factor for TS with an odds ratio of 2.34 for the CT versus TT genotype (95% CI 1.16-4.74). The data also showed this SNP had an association with TS under recessive model (P = 0.0426), and TT genotype had a protective effect against TS with an odds ratio of 0.50 (95% CI 0.26-0.98). The findings of this study suggested that variants in the PARP1 gene might play a role in susceptibility to TS.

Time trend analysis of the prevalence and incidence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007: a population-based study.

BACKGROUND: The prevalence of type 2 diabetes has rapidly increased in the Taiwanese population with the increasing prevalence of a sedentary lifestyle and high-calorie dietary intake. This study aims to determine the annual trends of the prevalence and incidence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007. METHODS: A population-based study of all residents aged 20 years and over (12,191,076 in 2000 and 18,772,180 in 2007) enrolled in the National Health Insurance (NHI) program, the database of which was used to identify patients diagnosed with type 2 diabetes. The annual prevalence and incidence of diagnosed type 2 diabetes were estimated using the International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes based on age, gender, insurance premium, and urbanization degree. Logistic regression was used to estimate the odds ratios (OR) of risk factors, as well as to examine the trend in the annual prevalence or incidence of diagnosed type 2 diabetes from 2000 to 2007. RESULTS: The crude annual prevalence of diagnosed type 2 diabetes increased significantly from 5.79% in 2000 to 8.30% in 2007. The increase was highest in 2007, among men, individuals aged ≥ 80 years, and individuals residing in aging society areas [OR (95% CI): 1.416 (1.412-1.420), 1.033 (1.032-1.034), 31.810 (31.690-31.931), and 1.090 (1.085-1.094), respectively]. The crude incidence fluctuated throughout the study period, ranging from 7.72 per 1,000 in 2006 to 8.98 per 1,000 in 2000. The decrease was highest in 2006, among individuals with an insurance premium ≥ median value [0.933 (0.925-0.942) and 0.810 (0.805-0.815), respectively]. The greatest increase was among men, individuals aged 60 to 79 years, and individuals residing in aging society areas [1.150 (1.145-1.155), 15.452 (15.329-15.576), and 1.127 (1.113-1.142), respectively]. CONCLUSION: This study demonstrated the substantial increase in annual prevalence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007. The incidence fluctuated between 2000 and 2007.

Association of tyrosyl-DNA phosphodiesterase 1 polymorphism with Tourette syndrome in Taiwanese patients.

BACKGROUND: Genetic, environmental, immunological, and hormonal factors contribute to the etiology of Tourette syndrome (TS). From the genetic standpoint, TS is a heterogeneous disorder. In our previous study, we found that a single nucleotide polymorphism (SNP) of x-ray repair cross-complementing group 1 (XRCC1), a DNA repair gene, was associated with TS. Previous studies also showed that tyrosyl-DNA phosphodiesterase 1 (TDP1) interacts with XRCC1 to repair damaged DNA. However, the relationship between TS and SNPs of TDP1 gene is unknown. Therefore, the aim of this study was to test the hypothesis that if the TDP1 SNP, rs28365054 (c.400G>A, Ala134Thr), was associated with TS or not. METHODS: A case-control study was designed to test the hypothesis. A total of 122 TS children and 106 normal children participated in the study. We used polymerase chain reaction to identify the SNP, rs28365054, of the TDP1 gene in the TS patients and the normal children. RESULTS: A polymorphism at position rs28365054 in the TDP1 gene had a significant difference (P < 0.05) in the genotype distributions between the TS patients and the control group. The AG genotype was a risk factor for TS with an odds ratio of 2.26 for the AG versus AA genotype (95% CI 1.08-4.72). CONCLUSION: The findings of this study suggested that variants in the TDP1 gene might play a role in TS susceptibility.

Survival Benefit of Experience of Liver Resection for Advanced Recurrent Hepatocellular Carcinoma Treated with Sorafenib: A Propensity Score Matching Analysis.

Several studies have shown that liver resection (LR) confers better survival outcomes in intermediate- and advanced-stage hepatocellular carcinoma (HCC) patients. However, the postoperative recurrence rate is high, and little is known about the survival benefits of LR for recurrent HCC patients who have already received systemic treatment. This study aimed to evaluate the impact of LR on recurrent advanced-stage HCC patients who received sorafenib as a systemic treatment. In this study, 147 advanced HCC patients were enrolled between 1 January 2012 and 31 December 2019. Two study groups were classified, based on whether they underwent LR or not. To reduce the possible selection bias, a propensity score matching (PSM) analysis was performed. The primary study endpoint was set as overall survival (OS), and the secondary endpoint was set as progression-free survival (PFS). Our study results revealed that advanced HCC patients who received sorafenib with LR had a longer OS than did those without LR, whether before or after PSM (15.0 months vs. 6.0 months, HR 0.45, 95% CI 0.31-0.67, p < 0.001; 15.0 months vs. 5.0 months, HR 0.46, 95% CI 0.28-0.76, p = 0.001). Similar results were obtained in PFS, before or after PSM (4.14 months vs. 2.60 months, HR 0.60, 95% CI 0.40-0.89, p = 0.01; 4.57 months vs. 2.63 months, HR 0.58, 95% CI 0.34-0.97, p = 0.037). Multivariate analysis showed that the experience of LR was independent of other factors associated with better OS and PFS, whether before or after PSM (p < 0.05). Therefore, advanced HCC patients who have undergone liver resection should be encouraged to continue sorafenib treatment to improve prognosis.

Quality of Stormwater Infrastructure Systems in Vulnerable Communities: Three Case Studies from Texas.

A properly functioning local stormwater drainage system is essential for mitigating flood risks. This study evaluates the quality of roadside drainage channels in three underserved communities in Texas: the Sunnyside neighborhood in Houston (Harris County), a neighborhood in the City of Rockport (Aransas County), and the Hoehn colonia (Hidalgo County). These communities have a history of flooding, are highly socially vulnerable, and rely on roadside ditches as their principal stormwater drainage system for runoff control. Mobile lidar (Light Detection and Ranging) measurements were collected for 6.09 miles of roadside channels in these communities. The raw lidar measurements were processed to evaluate drainage conditions based on the channel's geometric properties, hydraulic capacity, and level of service. The assessment results are linked to a Geographic Information System (GIS) tool for enhanced visualization. Finally, the paper provides insights regarding the quality of stormwater infrastructure in the study communities and discusses their practical implications.

Joint relationship between renal function and proteinuria on mortality of patients with type 2 diabetes: the Taichung Diabetes Study.

BACKGROUND: Estimated glomerular filtration rate (eGFR) is a powerful predictor of mortality in diabetic patients with limited proteinuria data. In this study, we tested whether concomitant proteinuria increases the risk of mortality among patients with type 2 diabetes. METHODS: Participants included 6523 patients > 30 years with type 2 diabetes who were enrolled in a management program of a medical center before 2007. Renal function was assessed by eGFR according to the Modification of Diet in Renal Disease Study equation for Chinese. Proteinuria was assessed by urine dipstick. RESULTS: A total of 573 patients (8.8%) died over a median follow-up time of 4.91 years (ranging from 0.01 year to 6.42 years). The adjusted expanded cardiovascular disease (CVD)-related mortality rates among patients with proteinuria were more than three folds higher for those with an eGFR of 60 mL/min/1.73 m2 or less compared with those with an eGFR of 90 mL/min/1.73 m2 or greater [hazard ratio, HR, 3.15 (95% confidence interval, CI, 2.0-5.1)]. The magnitude of adjusted HR was smaller in patients without proteinuria [1.98 (95% CI, 1.1-3.7)]. An eGFR of 60 mL/min/1.73 m2 to 89 mL/min/1.73 m2 significantly affected all-cause mortality and mortality from expanded CVD-related causes only in patients with proteinuria. Similarly, proteinuria affected all outcomes only in patients with an eGFR of <60 mL/min/1.73 m2. CONCLUSION: The risks of all-cause mortality, as well as expanded and non-expanded mortality from CVD-related causes associated with proteinuria or an eGFR of 90 mL/min/1.73 m2 or greater are independently increased. Therefore, the use of proteinuria measurements with eGFR increases the precision of risk stratification for mortality.

Association of genetic variations in X-ray repair cross-complementing group 1 and Tourette syndrome.

BACKGROUND: X-ray repair cross-complementing group 1 (XRCC1) plays a central role in mammalian DNA repair process. The polymorphism rs25487 (Arg>Gln at codon 399) of this gene is common in Han Chinese population. OBJECTIVES: The objective of this study was to analyze the association between this functional SNP of XRCC1 and Tourette syndrome (TS) in Han Taiwan Chinese population. METHODS: Genotyping was performed by using PCR-RFLP method on 73 TS patients and 158 normal controls. RESULTS: Our data indicated that genotype frequency of A/G polymorphism at codon 399 of the patients differed from the controls (P = 0.026, OR: 2.22, 95% CI: 1.22-4.03). The allele frequency analysis also showed significant differences with higher A allele frequency in patients (P = 0.015, OR: 1.70, 95% CI: 1.11-2.62). CONCLUSION: Our study indicates that the functional SNP at codon 399 of XRCC1 is associated with TS development.

Specifying evacuation return and home-switch stability during short-term disaster recovery using location-based data.

The objectives of this study are: (1) to specify evacuation return and home-switch stability as two critical milestones of short-term recovery during and in the aftermath of disasters; and (2) to understand the disparities among subpopulations in the duration of these critical recovery milestones. Using privacy-preserving fine-resolution location-based data, we examine evacuation and home move-out rates in Harris County, Texas in the context of the 2017 Hurricane Harvey. For each of the two critical recovery milestones, the results reveal the areas with short- and long-return durations and enable evaluating disparities in evacuation return and home-switch stability patterns. In fact, a shorter duration of critical recovery milestone indicators in flooded areas is not necessarily a positive indication. Shorter evacuation return could be due to barriers to evacuation and shorter home move-out rate return for lower-income residents is associated with living in rental homes. In addition, skewed and non-uniform recovery patterns for both the evacuation return and home-switch stability were observed in all subpopulation groups. All return patterns show a two-phase return progress pattern. The findings could inform disaster managers and public officials to perform recovery monitoring and resource allocation in a more proactive, data-driven, and equitable manner.

Community-scale big data reveals disparate impacts of the Texas winter storm of 2021 and its managed power outage.

Aggregated community-scale data could be harnessed to provide insights into the disparate impacts of managed power outages, burst pipes, and food inaccessibility during extreme weather events. During the winter storm that brought historically low temperatures, snow, and ice to the entire state of Texas in February 2021, Texas power-generating plant operators resorted to rolling blackouts to prevent collapse of the power grid when power demand overwhelmed supply. To reveal the disparate impact of managed power outages on vulnerable subpopulations in Harris County, Texas, which encompasses the city of Houston, we collected and analyzed community-scale big data using statistical and trend classification analyses. The results highlight the spatial and temporal patterns of impacts on vulnerable subpopulations in Harris County. The findings show a significant disparity in the extent and duration of power outages experienced by low-income and minority groups, suggesting the existence of inequality in the management and implementation of the power outage. Also, the extent of burst pipes and disrupted food access, as a proxy for storm impact, were more severe for low-income and minority groups. Insights provided by the results could form a basis from which infrastructure operators might enhance social equality during managed service disruptions in such events. The results and findings demonstrate the value of community-scale big data sources for rapid impact assessment in the aftermath of extreme weather events.

Mutation analysis and characterization of alternative splice variants of the Wilson disease gene ATP7B.

UNLABELLED: Wilson disease is a copper metabolism disorder caused by mutations in ATP7B, a copper-transporting adenosine triphosphatase. A molecular diagnosis was performed on 135 patients with Wilson disease in Taiwan. We identified 36 different mutations, eight of which were novel: five missense mutations (Ser986Phe, Ile1348Asn, Gly1355Asp, Met1392Lys, and Ala1445Pro), one deletion (2810delT) in the coding region, and two nucleotide substitutions (-133A→C and -215A→T) in the promoter region. These mutations were not observed in 100 control subjects and reduced the activity of the mutated protein by at least 50% when compared with wild-type ATP7B. In addition to exon 8, our data indicate another mutation hotspot in exon 12 where 9.62% of all mutations occurred. An alternative splice variant of ATP7B lacking exon 12 was observed in one patient who had a homozygous 2810delT mutation and very mild clinical symptoms. Clinical examination and functional characterization of alternative splice variants of ATP7B lacking exon 12 showed that they retained 80% of their biological activity. The 2810delT mutation increased the expression of these variants, which may have explained the mild symptoms in the patient with the 2810delT mutation. We also discovered that treating liver cancer cells with a Na(+)/H(+) exchanger inhibitor, 5-(N-ethyl-N-isopropyl)-amiloride, significantly enhanced the expression of the alternative splice variant of ATP7B lacking exon 12. CONCLUSION: This study suggests a novel therapeutic strategy for patients with mutations in exon 12.

A Novel Graph Neural Network Methodology to Investigate Dihydroorotate Dehydrogenase Inhibitors in Small Cell Lung Cancer.

Small cell lung cancer (SCLC) is a particularly aggressive tumor subtype, and dihydroorotate dehydrogenase (DHODH) has been demonstrated to be a therapeutic target for SCLC. Network pharmacology analysis and virtual screening were utilized to find out related proteins and investigate candidates with high docking capacity to multiple targets. Graph neural networks (GNNs) and machine learning were used to build reliable predicted models. We proposed a novel concept of multi-GNNs, and then built three multi-GNN models called GIAN, GIAT, and SGCA, which achieved satisfactory results in our dataset containing 532 molecules with all R^2 values greater than 0.92 on the training set and higher than 0.8 on the test set. Compared with machine learning algorithms, random forest (RF), and support vector regression (SVR), multi-GNNs had a better modeling effect and higher precision. Furthermore, the long-time 300 ns molecular dynamics simulation verified the stability of the protein-ligand complexes. The result showed that ZINC8577218, ZINC95618747, and ZINC4261765 might be the potentially potent inhibitors for DHODH. Multi-GNNs show great performance in practice, making them a promising field for future research. We therefore suggest that this novel concept of multi-GNNs is a promising protocol for drug discovery.

Using IVIM Parameters to Differentiate Prostate Cancer and Contralateral Normal Tissue through Fusion of MRI Images with Whole-Mount Pathology Specimen Images by Control Point Registration Method.

The intravoxel incoherent motion (IVIM) model may enhance the clinical value of multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa). However, while past IVIM modeling studies have shown promise, they have also reported inconsistent results and limitations, underscoring the need to further enhance the accuracy of IVIM modeling for PCa detection. Therefore, this study utilized the control point registration toolbox function in MATLAB to fuse T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) MRI images with whole-mount pathology specimen images in order to eliminate potential bias in IVIM calculations. Sixteen PCa patients underwent prostate MRI scans before undergoing radical prostatectomies. The image fusion method was then applied in calculating the patients' IVIM parameters. Furthermore, MRI scans were also performed on 22 healthy young volunteers in order to evaluate the changes in IVIM parameters with aging. Among the full study cohort, the f parameter was significantly increased with age, while the D* parameter was significantly decreased. Among the PCa patients, the D and ADC parameters could differentiate PCa tissue from contralateral normal tissue, while the f and D* parameters could not. The presented image fusion method also provided improved precision when comparing regions of interest side by side. However, further studies with more standardized methods are needed to further clarify the benefits of the presented approach and the different IVIM parameters in PCa characterization.

Correction: Visual light perceptions caused by medical linear accelerator: Findings of machine-learning algorithms in a prospective questionnaire-based case-control study.

[This corrects the article DOI: 10.1371/journal.pone.0247597.].

Visual light perceptions caused by medical linear accelerator: Findings of machine-learning algorithms in a prospective questionnaire-based case-control study.

This study aimed to investigate the possible incidence of visual light perceptions (VLPs) during radiation therapy (RT). We analyzed whether VLPs could be affected by differences in the radiation energy, prescription doses, age, sex, or RT locations, and whether all VLPs were caused by radiation. From November 2016 to August 2018, a total of 101 patients who underwent head-and-neck or brain RT were screened. After receiving RT, questionnaires were completed, and the subjects were interviewed. Random forests (RF), a tree-based machine learning algorithm, and logistic regression (LR) analyses were compared by the area under the curve (AUC), and the algorithm that achieved the highest AUC was selected. The dataset sample was based on treatment with non-human units, and a total of 293 treatment fields from 78 patients were analyzed. VLPs were detected only in 122 of the 293 exposure portals (40.16%). The dataset was randomly divided into 80% and 20% as the training set and test set, respectively. In the test set, RF achieved an AUC of 0.888, whereas LR achieved an AUC of 0.773. In this study, the retina fraction dose was the most important continuous variable and had a positive effect on VLP. Age was the most important categorical variable. In conclusion, the visual light perception phenomenon by the human body during RT is induced by radiation rather than being a self-suggested hallucination or induced by phosphenes.

Central obesity and atherogenic dyslipidemia in metabolic syndrome are associated with increased risk for colorectal adenoma in a Chinese population.

BACKGROUND: Metabolic syndrome (MetS) is composed of cardiovascular risk factors including insulin resistance, obesity, dyslipidemia, and hypertension. Most of the components of MetS have been linked to the development of neoplasm. The purpose of this study was to evaluate the relationship between individual components of MetS and colorectal adenoma. METHODS: The study subjects were recruited from a pool of 4872 individuals who underwent a health check-up examination during the period January 2006 to May 2008. Each participant fulfilled a structured questionnaire. MetS was defined based on the America Heart Association and National Heart Lung Blood Institute criteria. Subjects with history of colon cancer, colon polyps, colitis, or prior colonic surgery were excluded. RESULTS: A total of 4122 subjects were included for final analysis (2367 men and 1755 women; mean age, 49.6 +/- 11.7 years). Of them, MetS was diagnosed in 708 men (29.9%) and in 367 women (20.9%). Among the patients with MetS, 34.6% had adenoma, 31.7% had hyperplastic polyps and 23.3% were polyp-free (p < 0.0001, Chi-square test). The adjusted OR for colorectal adenoma was significantly higher in the subjects with MetS (OR, 1.31, CI: 1.09-1.57). A stronger association between MetS and colorectal adenoma was found in men (OR:1.44, CI:1.16-1.80) than in women (OR:1.04, CI:0.74-1.46). The adjusted OR for adenoma increased as the number of MetS components increased (p for trend = 0.0001 ). When the individual components of MetS were analyzed separately, only central obesity (OR:1.36, CI:1.14-1.63), low HDL cholesterol levels (OR:1.30, CI:1.10-1.54) and high triglyceride levels (OR:1.26, CI:1.04-1.53) were independently associated with colorectal adenoma. CONCLUSIONS: Of the components of MetS analyzed in this study, central obesity and dyslipidemia are independent risk factors for colorectal adenoma. With regard to the prevention of colorectal neoplasm, life-style modification such as weight reduction is worthwhile.