Impact of Radiofrequency Exposure From Mobile Phones on the Risk of Developing Brain Tumors in Korean and Japanese Adolescents: A MOBI-Kids Case-control Study.

BACKGROUND: This study aimed to examine the association between risk of brain tumors and radiofrequency (RF) exposure from mobile phones among young people in Korea and Japan. METHODS: This case-control study of brain tumors in young people was conducted in Korea and Japan under the framework of the international MOBI-Kids study. We included 118 patients diagnosed with brain tumors between 2011 and 2015 and 236 matched appendicitis controls aged 10-24 years. Information on mobile phone use was collected through face-to-face interviews. A detailed RF exposure algorithm, based on the MOBI-Kids algorithm and modified to account for the specificities of Japanese and Korean phones and networks, was used to calculate the odds ratios (ORs) for total cumulative specific energy using conditional logistic regression. RESULTS: The adjusted ORs in the highest tertile of cumulative call time at 1 year before the reference date were 1.61 (95% confidence interval [CI], 0.72-3.60) for all brain tumors and 0.70 (95% CI, 0.16-3.03) for gliomas, with no indication of a trend with exposure. The ORs for glioma specifically, were below 1 in the lowest exposure category. CONCLUSION: This study provided no evidence of a causal association between mobile phone use and risk of brain tumors as a whole or of glioma specifically. Further research will be required to evaluate the impact of newer technologies of communication in the future.

Dosimetric assessment in the brain for downlink EMF exposure in Korean mobile communication networks.

Because the position and direction of the human body is not fixed in an actual environment, the incidence direction of the electromagnetic field (EMF) from mobile communication base stations, WiFi access points, broadcasting towers, and other far-field sources is arbitrary. To analyze the overall health effects of radio frequency EMF exposure, the dosimetric assessment for such environmental exposures created from an unspecified number of sources in daily life, along with exposures from specific EMF sources, must be quantified. This study is aimed at numerically evaluating the time-averaged specific absorption rate (SAR) of the human brain for environmental EMF exposure in the frequency range of 50-5800 MHz. Whole-body exposure to EMFs that are evenly incident spatially is considered. By comparing the results of several incidence directions and the number of polarizations, an optimal calculation condition has been derived. Finally, based on the results measured in Seoul at the end of 2021, the SAR and daily specific energy absorption (SA) in the brains of both a child and an adult for downlink exposures from 3G to 5G base stations are reported. Comparison results of the daily brain SA for exposure to DL EMF in all 3G to 5G mobile networks and exposure to a 10-min voice call (uplink EMF) using a mobile phone connected to a 4G network show that the SA from the downlinks is much higher than that from the uplinks.

An International Collaborative Animal Study of the Carcinogenicity of Mobile Phone Radiofrequency Radiation: Considerations for Preparation of a Global Project.

Radiofrequency radiation (RFR) was classified as a "possible" human carcinogen in 2011, which caused great public concern. A carcinogenicity study by the National Toxicology Program (NTP) found Code Division Multiple Access-and Global System for Mobile Communications-modulated mobile phone RFR to be carcinogenic to the brain and heart of male rats. As part of an investigation of mobile phone carcinogenesis, and to verify the NTP study results, a 5-year collaborative animal project was started in Korea and Japan in 2019. An international animal study of this type has two prerequisites: use of the same study protocol and the same RF-exposure system. This article discusses our experience in the design of this global study on radiofrequency electromagnetic fields (RF-EMFs).© 2022 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society.

Effect of radiofrequency exposure on body temperature: Real-time monitoring in normal rats.

Radiofrequency radiation (RFR) can generate heat in living organisms. In this study, we monitored the body temperature of healthy animals during RFR exposure in real time using an implantable iButton data logger. A reverberation chamber system for small animals was used for this radiofrequency (RF) exposure in vivo study. Healthy male Sprague-Dawley rats were divided into two groups: with versus without iButton implantation (n = 20 per group). Each group was further divided into a sham-exposed and RF-exposed group (n = 10 per subgroup). Rats were exposed to a 1,760-MHz long-term evolution (LTE) signal in the reverberation chamber system at a whole-body average specific absorption rate of 0 W/kg (sham-exposed) or 4 W/kg (RF-exposed) for 6 h. The body temperature of iButton-implanted rats was recorded using an intraperitoneally implanted iButton every minute over 6 h of RF exposure, whereas that of non-implanted rats was measured directly using a rectal thermometer immediately before and after the 6-h RF exposure period. The temperature values measured by the two types of thermometers were significantly positively correlated (r = 0.63, P < 0.01, linear regression), and changes in body temperatures recorded in iButton-implanted and non-implanted rats measured using two thermometers after 6 h of RF exposure were maintained within <1°C (P = 0.87, general linear model, followed by univariate model). Similar results were obtained for rectal thermometer measurements (P = 0.12, paired t-test). These results suggest that RF exposure at a whole-body average specific absorption rate of 4 W/kg does not induce significant changes in body temperature in healthy rats over a 6-h RF exposure period.

Mobile Phone Use and Time Trend of Brain Cancer Incidence Rate in Korea.

This study evaluated the time trends in mobile phone subscriber number by mobile network generation (G) and brain cancer incidence by type in Korea. We obtained data from the Information Technology Statistics of Korea (1984-2017) and Korea Central Cancer Registry (1999-2017). The average annual percent change was estimated using Joinpoint regression analysis. We evaluated 29,721 brain cancer cases with an age-standardized incidence rate (ASR) of 2.89/100,000 persons. The glioma and glioblastoma annual ASR significantly increased in 2.6% and 3.9% of males and 3.0% and 3.8% of females, respectively. The ASR for frontal lobe involvement was the highest. The ASR of gliomas of unspecified grade annually increased by 7.8%; those for unspecified topology and histology decreased. The incidence of glioma, glioblastoma, frontal, temporal, and high-grade glioma increased among those aged ≥60 years. No association was observed between the mobile phone subscriber number and brain cancer incidence in Korea. Furthermore, long-term research is warranted because of the latency period of brain cancer. © 2021 Bioelectromagnetics Society.

Effect of Exposure to a Radiofrequency Electromagnetic Field on Body Temperature in Anesthetized and Non-Anesthetized Rats.

Exposure to a radiofrequency (RF) signal at a specific absorption rate (SAR) of 4 W/kg can increase the body temperature by more than 1 °C. In this study, we investigated the effect of anesthesia on the body temperature of rats after exposure to an RF electromagnetic field at 4 W/kg SAR. We also evaluated the influence of body mass on rats' body temperature. Rats weighing 225 and 339 g were divided into sham- and RF-exposure groups. Each of the resulting four groups was subdivided into anesthetized and non-anesthetized groups. The free-moving rats in the four RF-exposure groups were subjected to a 915 MHz RF identification signal at 4 W/kg whole-body SAR for 8 h. The rectal temperature was measured at 1-h intervals during RF exposure using a small-animal temperature probe. The body temperatures of non-anesthetized, mobile 225 and 339 g rats were not significantly affected by exposure to an RF signal. However, the body temperatures of anesthetized 225 and 339 g rats increased by 1.9 °C and 3.3 °C from baseline at 5 and 6 h of RF exposure, respectively. Three of the five 339 g anesthetized and exposed rats died after 6 h of RF exposure. Thus, anesthesia and body mass influenced RF exposure-induced changes in the body temperature of rats. Bioelectromagnetics. 2020;41:104-112. © 2019 Bioelectromagnetics Society.

Dawn of the Visible Monkey: Segmentation of the Rhesus Monkey for 2D and 3D Applications.

BACKGROUND: To properly utilize the sectioned images in a Visible Monkey dataset, it is essential to segment the images into distinct structures. This segmentation allows the sectioned images to be compiled into two-dimensional or three-dimensional software packages to facilitate anatomy and radiology education, and allows them to be used in experiments involving electromagnetic radiation. The purpose of the present study was to demonstrate the potential of the sectioned images using the segmented images. METHODS: Using sectioned images of a monkey's entire body, 167 structures were segmented using Adobe Photoshop. The segmented images and sectioned images were packaged into the browsing software. Surface models were made from the segmented images using Mimics. Volume models were made from the sectioned images and segmented images using MRIcroGL. RESULTS: In total, 839 segmented images of 167 structures in the entire body of a monkey were produced at 0.5-mm intervals (pixel size, 0.024 mm; resolution, 8,688 × 5,792; color depth, 24-bit color; BMP format). Using the browsing software, the sectioned images and segmented images were able to be observed continuously and magnified along with the names of the structures. The surface models of PDF file were able to be handled freely using Adobe Reader. In the surface models, the space information of all segmented structures was able to be identified using Sim4Life. On MRIcroGL, the volume model was able to be browsed and sectioned at any angle with real color. CONCLUSION: Browsing software, surface models, and volume models are able to be produced based on the segmentation of the sectioned images. These will be helpful for students and researchers studying monkey anatomy and radiology, as well as for biophysicists examining the effects of electromagnetic radiation.

Proposal of 28 GHz In Vitro Exposure System Based on Field Uniformity for Three-Dimensional Cell Culture Experiments.

This paper proposes a novel in vitro exposure system operating at millimeter-wave (mmWave) 28 GHz, one of the frequency bands under consideration for fifth generation (5G) communication. We employed the field uniformity concept along cross-sectional observation planes at shorter distances from the radiation antenna for better efficiency and a small-size system. A choke-ring antenna was designed for this purpose in consideration of a wider beamwidth (BW) and a symmetric far-field pattern across three principal planes. The permittivity of Dulbecco's modified Eagle's medium solution was measured to examine the specific absorption rate (SAR) of the skin cell layer inside a Petri dish model for a three-dimensional (3D) cell culture in vitro experiment. The best deployment of Petri dishes, taking into account a geometrical field symmetry, was proposed. Local SAR values within the cell layer among the Petri dishes were determined with different polarization angles. It was determined that this polarization effect should be considered when the actual exposure and deployment were conducted. We finally proposed an in vitro exposure system based on the field uniformity including downward exposure from an antenna for 3D cell culture experiments. A small-size chamber system was obtained, and the size was estimated using the planar near-field chamber design rule. Bioelectromagnetics. 2019;40:445-457. © 2019 Bioelectromagnetics Society.

Neurodevelopment for the first three years following prenatal mobile phone use, radio frequency radiation and lead exposure.

BACKGROUND: Studies examining prenatal exposure to mobile phone use and its effect on child neurodevelopment show different results, according to child's developmental stages. OBJECTIVES: To examine neurodevelopment in children up to 36 months of age, following prenatal mobile phone use and radiofrequency radiation (RFR) exposure, in relation to prenatal lead exposure. METHODS: We analyzed 1198 mother-child pairs from a prospective cohort study (the Mothers and Children's Environmental Health Study). Questionnaires were provided to pregnant women at ≤20 weeks of gestation to assess mobile phone call frequency and duration. A personal exposure meter (PEM) was used to measure RFR exposure for 24h in 210 pregnant women. Maternal blood lead level (BLL) was measured during pregnancy. Child neurodevelopment was assessed using the Korean version of the Bayley Scales of Infant Development-Revised at 6, 12, 24, and 36 months of age. Logistic regression analysis applied to groups classified by trajectory analysis showing neurodevelopmental patterns over time. RESULTS: The psychomotor development index (PDI) and the mental development index (MDI) at 6, 12, 24, and 36 months of age were not significantly associated with maternal mobile phone use during pregnancy. However, among children exposed to high maternal BLL in utero, there was a significantly increased risk of having a low PDI up to 36 months of age, in relation to an increasing average calling time (p-trend=0.008). There was also a risk of having decreasing MDI up to 36 months of age, in relation to an increasing average calling time or frequency during pregnancy (p-trend=0.05 and 0.007 for time and frequency, respectively). There was no significant association between child neurodevelopment and prenatal RFR exposure measured by PEM in all subjects or in groups stratified by maternal BLL during pregnancy. CONCLUSIONS: We found no association between prenatal exposure to RFR and child neurodevelopment during the first three years of life; however, a potential combined effect of prenatal exposure to lead and mobile phone use was suggested.

Assessment of extremely low frequency magnetic field exposure from GSM mobile phones.

Although radio frequency (RF) electromagnetic fields emitted by mobile phones have received much attention, relatively little is known about the extremely low frequency (ELF) magnetic fields emitted by phones. This paper summarises ELF magnetic flux density measurements on global system for mobile communications (GSM) mobile phones, conducted as part of the MOBI-KIDS epidemiological study. The main challenge is to identify a small number of generic phone models that can be used to classify the ELF exposure for the different phones reported in the study. Two-dimensional magnetic flux density measurements were performed on 47 GSM mobile phones at a distance of 25 mm. Maximum resultant magnetic flux density values at 217 Hz had a geometric mean of 221 (+198/-104) nT. Taking into account harmonic data, measurements suggest that mobile phones could make a substantial contribution to ELF exposure in the general population. The maximum values and easily available variables were poorly correlated. However, three groups could be defined on the basis of field pattern indicating that manufacturers and shapes of mobile phones may be the important parameters linked to the spatial characteristics of the magnetic field, and the categorization of ELF magnetic field exposure for GSM phones in the MOBI-KIDS study may be achievable on the basis of a small number of representative phones. Such categorization would result in a twofold exposure gradient between high and low exposure based on type of phone used, although there was overlap in the grouping.

Estimation of RF and ELF dose by anatomical location in the brain from wireless phones in the MOBI-Kids study.

Wireless phones (both mobile and cordless) emit not only radiofrequency (RF) electromagnetic fields (EMF) but also extremely low frequency (ELF) magnetic fields, both of which should be considered in epidemiological studies of the possible adverse health effects of use of such devices. This paper describes a unique algorithm, developed for the multinational case-control MOBI-Kids study, that estimates the cumulative specific energy (CSE) and the cumulative induced current density (CICD) in the brain from RF and ELF fields, respectively, for each subject in the study (aged 10-24 years old). Factors such as age, tumour location, self-reported phone models and usage patterns (laterality, call frequency/duration and hands-free use) were considered, as was the prevalence of different communication systems over time. Median CSE and CICD were substantially higher in GSM than 3G systems and varied considerably with location in the brain. Agreement between RF CSE and mobile phone use variables was moderate to null, depending on the communication system. Agreement between mobile phone use variables and ELF CICD was higher overall but also strongly dependent on communication system. Despite ELF dose distribution across the brain being more diffuse than that of RF, high correlation was observed between RF and ELF dose. The algorithm was used to systematically estimate the localised RF and ELF doses in the brain from wireless phones, which were found to be strongly dependent on location and communication system. Analysis of cartographies showed high correlation across phone models and across ages, however diagonal agreement between these cartographies suggest these factors do affect dose distribution to some level. Overall, duration and number of calls may not be adequate proxies of dose, particularly as communication systems available for voice calls tend to become more complex with time.

Radiation dose from computed tomography scans for Korean pediatric and adult patients.

Background: In recent events of the Coronavirus Disease 2019 (COVID-19) pandemic, CT scans are being globally used as a complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. It will be important to be aware of major organ dose levels, which are more relevant quantity to derive potential long-term adverse effect, for Korean pediatric and adult patients undergoing CT for COVID-19. Materials and Methods: We calculated organ dose conversion coefficients for Korean pediatric and adult CT patients directly from Korean pediatric and adult computational phantoms combined with Monte Carlo radiation transport techniques. We then estimated major organ doses delivered to the Korean child and adult patients undergoing CT for COVID-19 combining the dose conversion coefficients and the international survey data. We also compared our Korean dose conversion coefficients with those from Caucasian reference pediatric and adult phantoms. Results and discussion: Based on the dose conversion coefficients we established in this study and the international survey data of COVID-19-related CT scans, we found that Korean 7-year-old child and adult males may receive about 4 - 32 mGy and 3 - 21 mGy of lung dose, respectively. We learned that the lung dose conversion coefficient for the Korean child phantom was up to 1.5-fold greater than that for the Korean adult phantom. We also found no substantial difference in dose conversion coefficients between Korean and Caucasian phantoms. Conclusion: We estimated radiation dose delivered to the Korean child and adult phantoms undergoing COVID-19-related CT examinations. The dose conversion coefficients derived for different CT scan types can be also used universally for other dosimetry studies concerning Korean CT scans. We also confirmed that the Caucasian-based CT organ dose calculation tools may be used for the Korean population with reasonable accuracy.

Organ dose conversion coefficients calculated for Korean pediatric and adult voxel phantoms exposed to external photon fields.

Background: Dose conversion coefficients (DCCs) have been commonly used to estimate radiation dose absorbed in human organs from physical measurements of fluence or kerma. The International Commission on Radiological Protection (ICRP) reported a library of DCCs but few studies were conducted on their applicability to non-Caucasian populations. In the present study, we collected a total of eight Korean pediatric and adult voxel phantoms to calculate organ DCCs for idealized external photon irradiation geometries. Materials and methods: We adopted one pediatric female phantom (ETRI Child), two adult female phantoms (KORWOMAN and HDRK Female), and five adult male phantoms (KORMAN, ETRI Man, KTMAN1, KTMAN2, and HDRK Man). A general-purpose Monte Carlo radiation transport code, MCNPX2.7, was employed to calculate dose conversion coefficients for 13 major radiosensitive organs in six irradiation geometries (antero-posterior, postero-anterior, right lateral, left lateral, rotational, and isotropic) and 33 photon energy bins (0.01 - 20 MeV). Results and discussion: The DCCs for major radiosensitive organs (e.g., lungs and colon) in AP geometry reasonably agreed across the eight Korean phantoms whereas those for deep-seated organs (e.g., gonads) significantly varied. DCCs of the child phantom were overall greater than those of the adult phantoms. Comparison with the ICRP Publication 116 data showed reasonable agreements with Korean phantom-based data. The variations in organ DCCs were well explained using the distribution of organ depths from the phantom surface. Conclusion: A library of dose conversion coefficients for major radiosensitive organs in a series of pediatric and adult Korean voxel phantoms was established and compared with the reference data from ICRP. Comparison with the data from the ICRP reference adult voxel phantoms showed that our Korean phantom-based data is overall in a reasonable agreement with the ICRP reference data.

S VALUES FOR NEUROIMAGING PROCEDURES ON KOREAN PEDIATRIC AND ADULT HEAD COMPUTATIONAL PHANTOMS.

Over the past decades, the application of single-photon emission computed tomography and positron emission tomography in neuroimaging has markedly increased. In the current study, we used a series of Korean computational head phantoms with detailed cranial structures for 6-, 9-, 12-, 15-y-old children and adult and a Monte Carlo transport code, MCNPX, to calculate age-dependent specific absorbed fraction (SAF) for mono-energetic electrons ranging from 0.01 to 4 MeV and S values for seven radionuclides widely used in nuclear medicine neuroimaging for the combination of ten source and target regions. Compared to the adult phantom, the 6-y phantom showed up to 1.7-fold greater SAF (cerebellum < cerebellum) and up to 1.4-fold greater S values (vitreous body < lens) for 123I. The electron SAF data, combined with our previous photon SAF data, will facilitate absorbed dose calculations for various cranial structures in patients undergoing neuroimaging procedures.

Brain SAR of average male Korean child to adult models for mobile phone exposure assessment.

This paper aims to implement average head models of Korean males and investigate age-related differences in the brain for exposure from radiation from mobile phones. Four male head models composed of a total of 69 structures were developed through a statistical investigation of the anatomical morphology for the age groups of 6, 9, 15 and 20-24 years in age, which are named KR-6, KR-9, KR-15, and KR-22 herein. Three numerical bar phone models with a dual-band built-in antenna were applied to calculate the specific absorption rate (SAR) in the brain; the body lengths of models M avg and M long have the mean value and upper 5th percentile value of commercial bar phone models, respectively, with an antenna at the bottom, whereas M rev has an antenna on top of the phone body, which is the same as in M avg but rotated 180°. The cheek and tilt positions were employed for SAR simulations. As a result, a higher peak spatial-average SAR (psSAR) was observed in the brain for the child groups of KR-6 and KR-9 than for the adult groups of KR-15 and KR-22. In most configurations, the position-averaged psSAR10 g in the child brain was 62% (M long, 835 MHz), 61% (M avg, 835 MHz), 102% (M long, 1850 MHz), 108% (M avg, 1850 MHz), and 125% (M rev, 1850 MHz) higher than in the adult brain. The higher frequency of 1850 MHz showed a wider difference in the brain psSAR between the child and adult groups owing to the shorter penetration depth. When a long phone with an antenna at the bottom operates at a higher frequency, it significantly reduces the brain exposure.

VK-phantom male with 583 structures and female with 459 structures, based on the sectioned images of a male and a female, for computational dosimetry.

The anatomical structures in most phantoms are classified according to tissue properties rather than according to their detailed structures, because the tissue properties, not the detailed structures, are what is considered important. However, if a phantom does not have detailed structures, the phantom will be unreliable because different tissues can be regarded as the same. Thus, we produced the Visible Korean (VK) -phantoms with detailed structures (male, 583 structures; female, 459 structures) based on segmented images of the whole male body (interval, 1.0 mm; pixel size, 1.0 mm2) and the whole female body (interval, 1.0 mm; pixel size, 1.0 mm2), using house-developed software to analyze the text string and voxel information for each of the structures. The density of each structure in the VK-phantom was calculated based on Virtual Population and a publication of the International Commission on Radiological Protection. In the future, we will standardize the size of each structure in the VK-phantoms. If the VK-phantoms are standardized and the mass density of each structure is precisely known, researchers will be able to measure the exact absorption rate of electromagnetic radiation in specific organs and tissues of the whole body.

Averaged head phantoms from magnetic resonance images of Korean children and young adults.

Increased use of mobile phones raises concerns about the health risks of electromagnetic radiation. Phantom heads are routinely used for radiofrequency dosimetry simulations, and the purpose of this study was to construct averaged phantom heads for children and young adults. Using magnetic resonance images (MRI), sectioned cadaver images, and a hybrid approach, we initially built template phantoms representing 6-, 9-, 12-, 15-year-old children and young adults. Our subsequent approach revised the template phantoms using 29 averaged items that were identified by averaging the MRI data from 500 children and young adults. In females, the brain size and cranium thickness peaked in the early teens and then decreased. This is contrary to what was observed in males, where brain size and cranium thicknesses either plateaued or grew continuously. The overall shape of brains was spherical in children and became ellipsoidal by adulthood. In this study, we devised a method to build averaged phantom heads by constructing surface and voxel models. The surface model could be used for phantom manipulation, whereas the voxel model could be used for compliance test of specific absorption rate (SAR) for users of mobile phones or other electronic devices.

Assessment of radiofrequency electromagnetic field exposure from personal measurements considering the body shadowing effect in Korean children and parents.

We aimed to assess the personal radiofrequency electromagnetic field (RF-EMF) exposure levels of children and adults through their activities, with consideration to the body shadowing effect. We recruited 50 child-adult pairs, living in Seoul, Cheonan, and Ulsan, South Korea. RF-EMF measurements were performed between September and December 2016, using a portable exposure meter tailored to capture 14 Korean radiofrequency (RF) bands ranging from 87.5 to 5875MHz. The participants carried the device for 48h and kept a time-activity diary using a smartphone application in flight mode. To enhance accuracy of the exposure assessment, the body shadowing effect was compensated during the statistical analysis with the measured RF-EMF exposure. The compensation was conducted using the hybrid model that represents the decrease of the exposure level due to the body shadowing effect. A generalized linear mixed model was used to compare the RF-EMF exposure levels by subjects and activities. The arithmetic (geometric) means of the total power density were 174.9 (36.6) µW/m2 for all participants, 226.9 (44.6) for fathers, 245.4 (44.8) for mothers, and 116.2 (30.1) for children. By compensating for the body shadowing effect, the total RF-EMF exposure increased marginally, approximately 1.4 times. Each frequency band contribution to total RF-EMF exposure consisted of 76.7%, 2.4%, 9.9%, 5.0%, 3.3%, and 2.6% for downlink, uplink, WiFi, FM Radio, TV, and WiBro bands, respectively. Among the three regions, total RF-EMF exposure was highest in Seoul, and among the activities, it was highest in the metro, followed by foot/bicycle, bus/car, and outside. The contribution of base-station exposure to total RF-EMF exposure was the highest both in parents and children. Total and base-station RF-EMF exposure levels in Korea were higher than those reported in European countries.

The relationship between depressive symptoms in outpatients with chronic illness and health care costs.

PURPOSE: To evaluate the relationship between depressive symptoms and health care costs in outpatients with chronic medical illnesses in Korea, we screened for depressive symptoms in 1,118 patients with a chronic medical illness and compared the severity of somatic symptoms and health care costs. PATIENTS AND METHODS: Data were compared between outpatients with depressive symptoms and those without depressive symptoms. Depression and somatic symptoms were measured by Zung's Self-rating Depression Scale (SDS) and Patient Health Questionnaire (PHQ)-15, respectively. We also investigated additional data related to patients' health care costs (number of visited clinical departments, number of visits made per patients, and health care costs). A total of 468 patients (41.9%) met the criteria for depressive disorder. RESULTS: A high rate of severe depressive symptoms was found in elderly, female and less-educated patients. A positive association between the severity of somatic symptoms and depressive symptoms was also identified. The effects of depressive symptoms in patients with chronic illnesses on three measures of health services were assessed by controlling for the effects of demographic variables and the severity of somatic symptoms. We found that the effects of depressive symptoms on the number of visited departments and number of visits made per patients were mediated by the severity of somatic symptoms. However, for health care costs, depressive symptoms had a significant main effect. Furthermore, the effect of gender on health care costs is moderated by the degree of a patient's depressive symptoms. CONCLUSION: In summary, there is clearly a need for increased recognition and treatment of depressive symptoms in outpatients with chronic medical illnesses.

Mobile phone types and SAR characteristics of the human brain.

Mobile phones differ in terms of their operating frequency, outer shape, and form and location of the antennae, all of which affect the spatial distributions of their electromagnetic field and the level of electromagnetic absorption in the human head or brain. For this paper, the specific absorption rate (SAR) was calculated for four anatomical head models at different ages using 11 numerical phone models of different shapes and antenna configurations. The 11 models represent phone types accounting for around 86% of the approximately 1400 commercial phone models released into the Korean market since 2002. Seven of the phone models selected have an internal dual-band antenna, and the remaining four possess an external antenna. Each model was intended to generate an average absorption level equivalent to that of the same type of commercial phone model operating at the maximum available output power. The 1 g peak spatial SAR and ipsilateral and contralateral brain-averaged SARs were reported for all 11 phone models. The effects of the phone type, phone position, operating frequency, and age of head models on the brain SAR were comprehensively determined.