Defining "High Recurrence" of Depressive Episodes for Predicting Diagnostic Conversion from Major Depressive Disorder to Bipolar Disorder: A 5-year Retrospective Study.

Objective: This study determined the threshold for recurrent depressive episodes that predicted conversion from major depressive disorder (MDD) to bipolar disorder (BD). Methods: We retrospectively reviewed the medical records of 296 patients diagnosed with MDD for a minimum of 5 years in two university hospitals. We examined their the Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnoses and detailed clinical information at the initial admission and yearly assessments after discharge to establish the threshold for recurrent depressive episodes indicating a risk of diagnostic conversion from MDD to BD. Optimal cut-offs were derived using receiver operating characteristic (ROC) curves. Results: ROC curve analysis revealed that more than four recurrent depressive episodes was indicative of potential diagnostic conversion from MDD to BD (area under the curve, 0.604; sensitivity, 0.353; specificity, 0.855; positive predictive value, 0.421; negative predictive value, 0.816). Conclusion: These findings suggest that the best predictor of conversion from MDD to BD is more than four recurrent depressive episodes. Our findings have the potential to enhance diagnostic accuracy and treatment efficiency. To validate our results, longitudinal prospective studies are necessary.

Metformin administration is associated with enhanced response to transarterial chemoembolization for hepatocellular carcinoma in type 2 diabetes patients.

Transarterial chemoembolization (TACE) is often used as a locoregional therapy for early hepatocellular carcinoma (HCC) when local ablation or resection are not feasible, but incomplete response and recurrence are commonly observed. In this study, we sought to determine the association between metformin administration and TACE outcomes for single nodular HCC in patients with type 2 diabetes mellitus (T2DM). The retrospective cohort analysis included 164 T2DM patients with single nodular HCC who underwent TACE as an initial treatment, and 91 were exposed to metformin before and after TACE. Propensity score (PS) matching was used to balance covariates. Logistic regression analysis was used to determine the predictors of tumor response after TACE, and Cox regression analysis assessed independent predictors of local tumor recurrence (LTR) in patients with complete response after TACE. Metformin use was associated with significantly higher objective response rate (ORR) in the overall and PS-matched cohort (79.1% vs. 60.3 and 78.7% vs. 57.5%; p = 0.008 and p = 0.029, respectively). Logistic regression analysis showed that metformin use was an independent predictor of ORR in all and PS-matched patients (odds ratio = 2.65 and 3.06; p = 0.016 and 0.034, respectively). Cox regression analysis showed metformin administration was an independent predictor for lower LTR in all and PS-matched patients (hazard ratio = 0.28 and 0.27; p = 0.001 and 0.007, respectively). Metformin administration is associated with better initial response and lower local recurrence after TACE for single nodular HCC in T2DM.

Incidence and Pattern of Aminotransferase Elevation During Anti-Hypertensive Therapy With Angiotensin-II Receptor Blockers.

BACKGROUND: Angiotensin type II receptor blockers (ARBs) are the most widely used anti-hypertensive drugs. This study aimed to elucidate the likelihood and pattern of ARB-induced liver injury in a hospital-based cohort. METHODS: Data of patients receiving fimasartan (n = 5,543), candesartan (n = 6,406), valsartan (n = 6,040), and losartan (n = 9,126) were retrieved from the clinical data warehouse of two tertiary hospitals. Patients with alanine aminotransferase (ALT) levels > 5 times the upper normal limit were assessed according to the Roussel Uclaf Causality Assessment Method (RUCAM). RESULTS: A total of 27,115 patients were enrolled, including 14,630 (54.0%) men, with a mean age of 64.6 years (standard deviation, 13.6). During 31,717 person-years of ARB therapy, serum ALT levels > 120 IU/L were found in 558 (2.1%) person-years, and levels > 200 IU/L were found in 155 (0.6%) person-years. The incidence of ALT elevation > 120 IU/L per 106 cumulative defined daily doses was 6.6, 3.6, 3.9, and 4.0 in the fimasartan, candesartan, valsartan, and losartan groups, respectively (P = 0.002). An ALT level > 200 IU/L with RUCAM score ≥ 6 was found in 20 patients, suggesting probable drug-induced liver injury for 11 (0.2%) patients receiving fimasartan, five (0.1%) receiving candesartan, four (0.1%) receiving valsartan, and none receiving losartan (P < 0.001). CONCLUSION: Approximately 2% of patients receiving ARB therapy had significant ALT elevation (4.24/106 cumulative defined daily doses [cDDDs]), which was associated with probable ARB-related liver injury in 0.07% of patients (0.15/106 cDDDs). Elevation of ALT was more commonly associated with fimasartan than the other ARBs. Clinicians should be aware of the possibility of ARB-related ALT elevation in patients with unexplained chronic abnormal ALT.

Evaluation of accuracy of 3-dimensional printed dental models in reproducing intermaxillary relational measurements: Based on inter-operator differences.

OBJECTIVE: Although, digital models have recently been used in orthodontic clinics, physical models are still needed for a multitude of reasons. The purpose of this study was to assess whether the printed models can replace the plaster models by evaluating their accuracy in reproducing intermaxillary relationships and by appraising the clinicians' ability to measure the printed models. METHODS: Twenty sets of patients' plaster models with well-established occlusal relationships were selected. Models were scanned using an intraoral scanner (Trios 3, 3Shape Dental System) by a single operator. Printed models were made with ZMD-1000B light-curing resin using the stereolithography method 3-dimensional printer. Validity, reliability, and reproducibility were evaluated using measurements obtained by three operators. RESULTS: In evaluation of validity, all items showed no significant differences between measurements taken from plaster and printed models. In evaluation for reliability, significant differences were found in the distance between the gingival zeniths of #23-#33 (DZL_3) for the plaster models and at #17-#43 (DZCM_1) for the printed models. In evaluation for reproducibility, the plaster models showed significant differences between operators at midline, and printed models showed significant differences at 7 measurements including #17-#47 (DZR_7). CONCLUSIONS: The validity and reliability of intermaxillary relationships as determined by the printed model were clinically acceptable, but the evaluation of reproducibility revealed significant inter-operator differences. To use printed models as substitutes for plaster models, additional studies on their accuracies in measuring intermaxillary relationship are required.

Posttraumatic Symptoms and Change of Complicated Grief among Bereaved Families of the Sewol Ferry Disaster: One Year Follow-up Study.

BACKGROUND: The objective of this study was to determine whether severity and severity change of coexisting psychiatric symptoms might affect change of complicated grief (CG) regarding the Sewol ferry disaster. METHODS: Data from a cross-sectional survey were obtained 18 months (Time 1) and 30 months (Time 2) after the disaster. We ascertained sociodemographic variables and variables obtained from self-reporting questionnaires (i.e., CG, depression, anxiety, post-traumatic stress disorder [PTSD], insomnia, embitterment, and suicidal risk) among 56 bereaved family members. RESULTS: Severity of other psychiatric symptoms at Time 1 had no effect on change of CG at Time 2. However, changes in severity of PTSD over a year affected change of CG. CONCLUSION: It is important to evaluate changes in severity of PTSD and its treatment during management of CG, especially when it involves bereaved families experiencing a traumatic accident.

Embitterment and bereavement: The Sewol ferry accident example.

OBJECTIVE: On Wednesday, April 16, 2014, 261 high school students on a field trip died in the sinking of the Sewol ferry. The bereaved family of the Sewol ferry accident experienced one of the most painful traumatic losses such as the sudden death of one's child through an accident. This article reviewed and discussed embitterment related to traumatic loss through the example of the Sewol ferry accident. METHOD: Embitterment-related issues and problems in coping with the accident that is caused by societal factors were described. In addition, embitterment-related findings of several previous studies based on bereaved families' mental health cohort study were reviewed. RESULTS: Traumatic loss of the human-made ferry accident was accompanied with feelings of being cheated, injustice, incompetence, wrongdoing by a perpetrator, and the destruction of one's belief and value system, causing severe embitterment. Embitterment was related to other mental health problems including depression, anxiety, and complicated grief. CONCLUSION: Social support and positive individual resource including optimism and wisdom can be helpful for recovery from posttraumatic embitterment. The goal of grief is to remember the decedent, understand the changes created by the loss, and determine how to reinvest in life. Embitterment may disturb the process of grief. Without the management of the embitterment, true grief may not be possible. The breakdown of value systems and severe embitterment should get more attention in future research. (PsycINFO Database Record

Phototherapy for Vitiligo: A Systematic Review and Meta-analysis.

Importance: References to the expected treatment response to phototherapy would be helpful in the management of vitiligo because phototherapy requires long treatment durations over several months. Objective: To estimate the treatment response of vitiligo to phototherapy. Data Sources: A comprehensive database search of MEDLINE, EMBASE, and the Cochrane library from inception to January 26, 2016, was performed for all prospective studies. The main keywords used were vitiligo, phototherapy, psoralen, PUVA, ultraviolet, NBUVB, and narrowband. Study Selection: All prospective studies reporting phototherapy outcome for at least 10 participants with generalized vitiligo were included. Of 319 studies initially identified, the full texts of 141 studies were assessed for eligibility, and 35 were finally included in the analysis. Of these, 29 studies included 1201 patients undergoing narrowband UV-B (NBUVB) phototherapy, and 9 included 227 patients undergoing psoralen-UV-A (PUVA) phototherapy. Data Extraction and Synthesis: Two reviewers independently extracted the following data: study design, number and characteristics of the participants, phototherapy protocol, and rate of repigmentation based on the quartile scale. Single-arm meta-analyses were performed for the NBUVB and PUVA groups. Sample size-weighted means were calculated using a random-effects model for the repigmentation rates of the included studies. Main Outcomes and Measures: The primary outcomes were at least mild (≥25%), at least moderate (≥50%), and marked (≥75%) responses on a quartile scale. Response rates were calculated as the number of participants who showed the corresponding repigmentation divided by the number of all participants enrolled in the individual studies. Results: The meta-analysis included 35 unique studies (1428 unique patients). For NBUVB phototherapy, an at least mild response occurred in 62.1% (95% CI, 46.9%-77.3%) of 130 patients in 3 studies at 3 months, 74.2% (95% CI, 68.5%-79.8%) of 232 patients in 11 studies at 6 months, and 75.0% (95% CI, 60.9%-89.2%) of 512 patients in 8 studies at 12 months. A marked response was achieved in 13.0% (95% CI, 2.1%-23.9%) of 106 patients in 2 studies at 3 months, 19.2% (95% CI, 11.4%-27.0%) of 266 patients in 13 studies at 6 months, and 35.7% (95% CI, 21.5%-49.9%) of 540 patients in 9 studies at 12 months. For PUVA phototherapy, an at least mild response occurred in 51.4% (95% CI, 28.1%-74.7%) of 103 patients in 4 studies at 6 months and 61.6% (95% CI, 20.2%-100%) of 72 patients in 3 studies at 12 months. In the subgroup analyses, marked responses were achieved on the face and neck in 44.2% (95% CI, 24.2%-64.2%), on the trunk in 26.1% (95% CI, 8.7%-43.5%), on the extremities in 17.3% (95% CI, 8.2%-26.5%), and on the hands and feet in none after at least 6 months of NBUVB phototherapy. Conclusions and Relevance: Long-duration phototherapy should be encouraged to enhance the treatment response in vitiligo. The greatest response is anticipated on the face and neck.

The Efficacy and Safety of Lidocaine-Containing Hyaluronic Acid Dermal Filler for Treatment of Nasolabial Folds: A Multicenter, Randomized Clinical Study.

BACKGROUND: The use of injectable hyaluronic acid-based gel is well established in aesthetic facial procedures especially on the nasolabial fold (NLF). OBJECTIVE: To compare the efficacy and safety of PP-501-A-Lidocaine dermal filler with RestylaneLidocaine(®) when administered to the NLF. METHODS: Sixty-six subjects seeking correction of NLFs, with moderate or severe wrinkle severity, were recruited for this multicenter, randomized, patient and evaluator-blind, matched pairs, and active-controlled design clinical study. PP-501-A-Lidocaine and RestylaneLidocaine(®) were injected into the deep layer of the dermis and/or subcutis of the NLF. The first validity evaluation variable was the average wrinkle severity rating scale (WSRS), as scored by independent blinded evaluators at week 24. The second validity evaluation variable including the global aesthetic improvement scale (GAIS), the WSRS, and adverse event reporting at weeks 8, 16, and 24 were also performed. RESULTS: The mean improvement in the WSRS from baseline was 1.58 ± 0.68 for the PP-501-A-Lidocaine and 1.51 ± 0.66 for the RestylaneLidocaine(®) at week 24. The average value at week 8 after the final application was 1.62 ± 0.78 and 1.60 ± 0.75 in parts subject to PP-501-A-Lidocaine and RestylaneLidocaine(®), respectively, and 1.58 ± 0.70 and 1.57 ± 0.68 at week 16, respectively. Both improvement and duration of the treatment effect were similar between the two groups. GAIS data rated by the treating investigator and participants showed no statistically significant differences. Both fillers were well tolerated and adverse reactions were mild and transient in most cases. CONCLUSION: PP-501-A-Lidocaine showed an equivalent efficacy and safety observed after 6 months of follow-up compared to RestylaneLidocaine(®). LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

Stepwise tapering of remifentanil at the end of surgery decreased postoperative pain and the need of rescue analgesics after thyroidectomy.

BACKGROUND: This study was designed to investigate whether stepwise tapering of remifentanil at the end of surgery could decrease postoperative pain scores and requirements of rescue analgesics after remifentanil-desflurane anesthesia in patients with thyroidectomy. METHODS: Sixty two patients undergoing thyroidectomy under general anesthesia were randomly allocated into two groups. All patients were anesthetised with desflurane and high-dose remifentanil. Remifentnail was infused at the rate of 0.3 µg/kg/min until the end of surgery in patients of the control group (group A) whereas remifentanil was tapered gradually from 0.3 to 0.1 µg/kg/min until the end of surgery for at least 30 minutes in patients with group B. Pain scores (0-100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30 min, 2 h, 6 h, 12 h, and 24 h after operation. RESULTS: There was a significant decrease in pain scores at 30 min (20 [0-80] vs. 50 [0-100], P = 0.002) and 2 h (30 [10-60] vs. 40 [20-80], P = 0.018) after surgery in group B compared with group A. In addition, rescue analgesics are less required in group B than in group A postoperatively (2 [1-3] vs. 3 [2,3], P = 0.039). There were no significant differences in adverse events between the two groups. CONCLUSIONS: Tapering of remifentanil at the end of surgery decreased postoperative pain scores immediately after thyroidectomy with desflurane and high-dose remifentanil anesthesia. TRIAL REGISTRATION: Clinical Research information Service (CRiS, registration number KCT0000589).

Clinical significance of serum ferritin level as an independent predictor of insulin resistance in Korean men.

AIMS: Elevated serum ferritin level has been reported to be associated with type 2 diabetes mellitus and metabolic syndrome, which have significant relation with insulin resistance (IR). However, clinical association between serum ferritin level and IR remained unclear. Accordingly, this study was designed to evaluate the longitudinal effects of baseline serum ferritin level on the development of IR. METHODS: An IR-free 22,057 healthy Korean men (HOMA-IR<2.7), who had participated in a medical health check-up program in 2005, were followed up until 2010. During follow up, the development rate of IR, defined in case of HOMA-IR≥2.7, was monitored according to the quartile groups of serum ferritin levels. Cox proportional hazards models were used to measure the hazard ratios (HRs) of baseline serum ferritin levels on IR. RESULTS: During 77,471.1 person-years of follow-up, 4494 incident cases of insulin resistance developed between 2006 and 2010 (overall development rate: 20.4%). The development rate of IR increased in proportion to the baseline serum ferritin levels (quartile 1: 16.7%, quartile 2: 18.5%, quartile 3: 19.9%, quartile 4: 25.5%, P<0.001). After adjusting for multiple covariates, the HRs (95% CI) for IR, comparing the second to the fourth quartile of serum ferritin levels with the first quartile, were 1.11 (0.99-1.24), 1.19 (1.07-1.33) and 1.51 (1.35-1.68), respectively (P for trend <0.001). CONCLUSIONS: Elevated serum ferritin level was independently associated with the future development of IR in Korean men.

A prospective, randomized, double-blind, multicenter trial to evaluate the therapeutic efficacy and safety of palonosetron in the treatment of postoperative nausea and vomiting over a 72-h period.

PURPOSE: We performed a multicenter, randomized, double-blind trial to assess the efficacy and safety of a single, fixed, intravenous dose of palonosetron (0.075 mg) in the treatment of established postoperative nausea and vomiting (PONV). METHODS: Three hundred and eighty-four patients who had at least one risk factors of PONV and underwent surgery under general anesthesia were screened. Those who developed PONV were randomized to receive either 0.075 mg intravenous palonosetron or a placebo. The incidence of nausea and vomiting, severity of nausea, requirements for rescue anti-emetics, and adverse effects at 2, 24, and 72 h after drug administration were evaluated. Complete response (CR) and complete control (CC) rate were compared for 24 and 72 h. RESULTS: Among the 384 patients, 152 (39.6 %) developed PONV and were randomized to either the palonosetron (n = 75) or placebo (n = 77) group. The number of patients with CR at 24 and 72 h was higher in the palonosetron group than the placebo group [0-24 h: n = 49 (68.1 %) vs. n = 30 (40.5 %), p < 0.001; 0-72 h: n = 47 (65.3 %) vs. n = 28 (37.8 %), p < 0.001]. The incidence of PONV at 2, 24, and 72 h periods was lower in the palonosetron group than the placebo group (29.2, 45.8, and 50.0 % in the palonosetron group vs. 50.0, 62.2, and 66.2 % in the placebo group, p = 0.010, 0.048, 0.047, respectively). The incidence of adverse events was not different between the groups. CONCLUSION: A single 0.075 mg IV dose of palonosetron effectively increased the CR rates at 24 and 72 h in these moderate-risk patients with established PONV.

Mechanisms and applications of cyclometalated Pt(ii) complexes in photoredox catalytic trifluoromethylation.

The incorporation of a trifluoromethyl group into an existing scaffold can provide an effective strategy for designing new drugs and agrochemicals. Among the numerous approaches to trifluoromethylation, radical trifluoromethylation mediated by visible light-driven photoredox catalysis has gathered significant interest as it offers unique opportunities for circumventing the drawbacks encountered in conventional methods. A limited understanding of the mechanism and molecular parameters that control the catalytic actions has hampered the full utilization of photoredox catalysis reactions. To address this challenge, we evaluated and investigated the photoredox catalytic trifluoromethylation reaction using a series of cyclometalated Pt(ii) complexes with systematically varied ligand structures. The Pt(ii) complexes were capable of catalyzing the trifluoromethylation of non-prefunctionalized alkenes and heteroarenes in the presence of CF3I under visible light irradiation. The high excited-state redox potentials of the complexes permitted oxidative quenching during the cycle, whereas reductive quenching was forbidden. Spectroscopic measurements, including time-resolved photoluminescence and laser flash photolysis, were performed to identify the catalytic intermediates and directly monitor their conversions. The mechanistic studies provide compelling evidence that the catalytic cycle selects the oxidative quenching pathway. We also found that electron transfer during each step of the cycle strictly adhered to the Marcus normal region behaviors. The results are fully supported by additional experiments, including photoinduced ESR spectroscopy, spectroelectrochemical measurements, and quantum chemical calculations based on time-dependent density functional theory. Finally, quantum yields exceeding 100% strongly suggest that radical propagation significantly contributes to the catalytic trifluoromethylation reaction. These findings establish molecular strategies for designing trifluoromethyl sources and catalysts in an effort to enhance catalysis performance.

Early oral feeding following laparoscopic colorectal cancer surgery.

BACKGROUND: Early oral feeding (EOF) following colorectal surgery can accelerate patient recovery and shorten hospital stay. However, some patients are intolerable to postoperative early oral feeding. The aim of this study was to evaluate the tolerability of EOF following laparoscopic colorectal cancer surgery and the effects of intravenous lidocaine. METHODS: The cohort in this randomized, placebo-controlled trial (ClinicalTrial.gov, NCT01346917) comprised of 77 patients undergoing elective laparoscopic colorectal cancer surgery. For patients randomized to the lidocaine group, a loading dose of 1 mg/kg lidocaine prior to skin incision, and a continuous dose of 1 mg/kg/h lidocaine with 90 mg ketorolac (non-steroidal anti-inflammatory drug) (in normal saline, total 240 mL) was administered for 24 h. Patients randomized to the placebo group received a loading dose of 5 mL saline and a continuous dose of 90 mg ketorolac in 240 mL saline. The primary outcome measure was prevalence of postoperative nausea/vomiting and intolerance to EOF. RESULTS: Altogether, 68 patients completed the study and were analyzed. Postoperative nausea and vomiting were higher in the control group but did not reach statistical significance (P = 0.054). Tolerability of EOF was 96.9% in the lidocaine group and 91.7% in the control group (P = 0.62). There was no difference in postoperative pain, opioid consumption, bowel function recovery or postoperative hospital stay. CONCLUSION: Perioperative intravenous lidocaine administered for laparoscopic colorectal cancer surgery might reduce postoperative nausea and vomiting. However, a high tolerability to EOF following colorectal surgery can be achieved by laparoscopic surgery alone without other supportive treatment.

Elevated fasting serum insulin level predicts future development of hypertension.

BACKGROUND: Studies have investigated clinical association between fasting insulin level and hypertension. However, it is still debatable whether elevated fasting insulin actually increases the risk of hypertension with the passage of time. Thus, this study was aimed at investigating the association between baseline fasting insulin level and the development of hypertension. METHODS: 25,062 normotensive, non-diabetic Korean men participating in a medical health check-up program were followed up from 2005 until 2010. They were divided into 4 groups according to baseline fasting insulin levels (first quartile-fourth quartile). The incidence of hypertension was compared among 4 groups, and Cox proportional hazards model was used to determine if hypertension was associated with higher baseline fasting insulin level. RESULTS: The incidence of hypertension increased according to the baseline fasting insulin level (first quartile: 13.3%, second quartile: 15.4%, third quartile: 17.5%, fourth quartile: 23.2%, P<0.001). Even after adjusting for multiple covariates, the HRs (95% CI) for hypertension were higher for the second (1.12; 0.96-1.31), third (1.39; 1.20-1.62) and fourth quartile group (1.75; 1.51-2.03), compared to the first quartile group, respectively (P for trend<0.001). CONCLUSION: The risk of hypertension was in proportion to the baseline fasting insulin level. In addition, hyperinsulinemia was an independent risk factor for the future development of hypertension. These findings suggest the value of fasting insulin level as an early predictor of hypertension.

A split-face, evaluator-blind randomized study on the early effects of Q-switched Nd:YAG laser versus Er:YAG micropeel in light solar lentigines in Asians.

BACKGROUND: Asians are prone to develop epidermal pigmentary lesions as a result of photoaging. Solar lentigines, especially those which are light in color, show somewhat limited response to pigment lasers and intense pulsed light sources. OBJECTIVES: We sought to compare the early effects as well as side effects of Q-switched Nd:YAG and Er:YAG micropeel in treating light solar lentigines in Asians. PATIENT AND METHODS: This was a split-face, evaluator-blind, randomized controlled study. A single session of treatment was performed on Asian patients with light facial lentigines. Q-switched Nd:YAG laser was allocated to one half of the face, and Er:YAG micropeel to the other half. The response to therapy was evaluated by two independent dermatologists with standardized photographs taken 2 weeks and 1 month after the laser treatment. Patients' satisfaction and preference in treatment were also assessed. RESULTS: Fifteen patients completed the study and were analyzed. A reduction in pigment was observed with both lasers during the study period. The degree of pigment reduction in the Q-switched Nd:YAG treated side of the face was significantly higher than that of the Er:YAG micropeel treated side at 2-week follow-up (p < 0.001). The degree of pigment reduction between the Q-switched Nd:YAG-treated side and the Er:YAG micropeel-treated side was similar at 1-month follow-up (p = 0.110). CONCLUSION: While there is no perfect therapy for light solar lentigines, a single session of Q-switched Nd:YAG laser and Er:YAG micropeel was shown to reduce pigmentation. The immediate effects (2-week follow-up) were better with the Q-switched Nd:YAG laser but there was no great difference between the two laser types at 1-month follow-up due to the greater degree of post-inflammatory hyperpigmentation following Q-switched Nd:YAG. Both laser types could be applied either singly in turns, or in combination for maximal efficacy in future.

Association between serum ferritin levels and the incidence of obesity in Korean men: a prospective cohort study.

Elevated serum ferritin levels are associated with insulin resistance, type 2 diabetes, cardiovascular disease, and metabolic syndrome. To date, however, no cohort studies have examined whether serum ferritin levels are an independent risk factor for the obesity. Therefore, we conducted a prospective cohort study to evaluate the temporal relationship between serum ferritin levels and obesity development in Korean men. Total 17,812 healthy Korean men who participated in a medical health check-up program in 2005 were followed-up until 2010. Obesity was defined as a body mass index ≥25 kg/m(2). Cox proportional hazards model was used to measure the hazard ratio of the quartile groups of serum ferritin levels. During 64,446.5 person-years of follow-up carried out, 2,627 patients became obese. After adjusting for multiple covariates, we found that the hazard ratios (95% confidence interval) for incident obesity when we compared the second, third and fourth quartiles of serum ferritin levels with the first quartile were 1.08 (0.95-1.23), 1.14 (1.00-1.30), and 1.24 (1.09-1.41), respectively (p for trend = 0.003). Both severe obesity (body mass index ≥ 30 kg/m(2)) and abdominal obesity based on waist circumference (>90 cm) showed consistent longitudinal associations (p for trend <0.001). Elevated serum ferritin levels may have been a predictive factor for obesity during the 5-year follow-up in 17,812 Korean men.

Interfacial magnetic anisotropy of Co90Zr10 on Pt layer.

Spin Transfer Torque (STT) is of great interest in data writing scheme for the Magneto-resistive Random Access Memory (MRAM) using Magnetic Tunnel Junction (MTJ). Scalability for high density memory requires ferromagnetic electrodes having the perpendicular magnetic easy axis. We investigated CoZr as the ferromagnetic electrode. It is observed that interfacial magnetic anisotropy is preferred perpendicular to the plane with thickness dependence on the interfaces with Pt layer. The anisotropy energy (K(u)) with thickness dependence shows a change of magnetic-easy-axis direction from perpendicular to in-plane around 1.2 nm of CoZr. The interfacial anisotropy (K(i)) as the directly related parameters to switching and thermal stability, are estimated as 1.64 erg/cm2 from CoZr/Pt multilayered system.