The Association between Obesity Phenotypes and Early Renal Function Decline in Adults without Hypertension, Dyslipidemia, and Diabetes.

BACKGROUND: The prevalence of chronic kidney disease is increasing worldwide. Several studies have suggested that obesity is associated with early renal dysfunction. However, little is known about the relationship between obesity phenotypes and early renal function decline. Therefore, this study aimed to identify the relationship between obesity phenotypes and early renal function decline in adults without hypertension, dyslipidemia, and diabetes. METHODS: We conducted a cross-sectional analysis of clinical and anthropometric data from 1,219 patients who underwent a routine health checkup in 2014. We excluded adults with cardiovascular disease, renal disease, diabetes, hypertension, dyslipidemia, or low glomerular filtration rate (<60 mL/min/1.73 m2). Renal function was determined according to the estimated glomerular filtration rate calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation. RESULTS: Age, sex, body mass index, waist circumference, triglyceride, low-density lipoprotein, and fasting glucose had an association with the estimated glomerular filtration rate. After adjusting for age, sex, smoking status, and alcohol intake, the odds ratios of the metabolically abnormal normal weight and metabolically abnormal obese phenotypes for the presence of low estimated glomerular filtration rates were 1.807 (95% confidence interval, 1.009- 3.236) and 1.834 (95% confidence interval, 1.162-2.895), compared with the metabolically healthy normal weight phenotype. However, the metabolically healthy obese phenotype did not show a significant association with early renal function decline. CONCLUSION: In this cross-sectional study, we confirmed the association between the metabolically abnormal normal weight and metabolically abnormal obese phenotypes and early kidney function decline in adults without hypertension, dyslipidemia, and diabetes.

The Association of Body Fat and Arterial Stiffness Using the Brachial-Ankle Pulse Wave Velocity.

BACKGROUND: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. METHODS: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. RESULTS: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. CONCLUSION: Lower pBF in obese men may be associated with improved cardiovascular risk.

Patterns of malignant non-mass enhancement on 3-T breast MRI help predict invasiveness: using the BI-RADS lexicon fifth edition.

Background Non-mass enhancements (NME) with invasive components account for 10-42% of total malignant NMEs. The factors associated with invasiveness on magnetic resonance imaging (MRI) could be useful for clinical assessment and treatment. Purpose To evaluate the clinical significances of the distributions and internal enhancement patterns (IEP) of malignant NMEs on 3-T breast MRI. Material and Methods A total of 448 consecutive women with newly diagnosed breast cancer that had undergone preoperative MRI and surgery between February 2013 and March 2016 were identified. After exclusions, 72 malignant NMEs without a mass in 72 women (mean age = 51.5 years) were included. Two readers independently assessed distributions and IEPs of NME, according to the Breast Imaging Reporting and Data System lexicon fifth edition. Collected data included the presence of invasion and histopathologic factors. Results A clustered ring IEP was significantly associated with invasive cancer (75.0%, P = 0.001, Reader1; 72.9%, P < 0.001, Reader 2), absence of necrosis (79.0%, P < 0.001; 72.1%, P < 0.001, respectively), and high Ki-67 expression (74.2%, P = 0.048; 74.2%, P = 0.003, respectively). A clumped IEP was related to ductal carcinoma in situ (33.3%, P = 0.025; 50.0%, P = 0.001, respectively), absence of lymph node metastasis (24.1%, P = 0.029; 31.5%, P = 0.030, respectively), and presence of necrosis (34.5%, P = 0.003; 44.8%, P = 0.001, respectively). Conclusion The presence of a clustered ring IEP in patients with breast cancer was found to be significantly associated with invasive breast cancer and high Ki-67 expression.

Effects of a new medical insurance payment system for hospice patients in palliative care programs in Korea.

BACKGROUND: This study investigates the effects of a new medical insurance payment system for hospice patients in palliative care programs and analyzes length of survival (LoS) determinants. METHOD: At the Pusan National University Hospital hospice center, between January 2015 and April 2016, 276 patients were hospitalized with several diagnosed types of terminal stage cancer. This study separated patients into two groups, "old" and "new," by admission date, considering the new system has been applied from July 15, 2015. The study subsequently compared LoS, total cost, and out-of-pocket expenses for the two groups. RESULTS: Overall, 142 patients applied to the new medical insurance payment system group, while the old medical insurance payment system included 134 patients. The results do not show a significantly negative difference in LoS for the new system group (p = 0.054). Total cost is higher within the new group (p <  0.001); however, the new system registers lower patient out-of-pocket expenses (p <  0.001). CONCLUSION: The novelty of this study is proving that the new medical insurance payment system is not inferior to the classic one in terms of LoS. The total cost of the new system increased due to a multidisciplinary approach toward palliative care. However, out-of-pocket expenses for patients overall decreased, easing their financial burden.

Shift Work Is Associated with Metabolic Syndrome in Young Female Korean Workers.

BACKGROUND: Shift work is associated with health problems, including metabolic syndrome. This study investigated the association between shift work and metabolic syndrome in young workers. METHODS: A total of 3,317 subjects aged 20-40 years enrolled in the 2011-2012 Korean National Health and Nutrition Examination Survey were divided into shift and day workers. We conducted a cross-sectional study and calculated odds ratios using multivariate logistic regression analysis in order to examine the association between shift work and metabolic syndrome. RESULTS: The prevalence of metabolic syndrome was 14.3% and 7.1% among male and female shift workers, respectively. After adjusting for confounding factors, shift work was associated with metabolic syndrome in female workers (odds ratio, 2.53; 95% confidence interval, 1.12 to 5.70). CONCLUSION: Shift work was associated with metabolic syndrome in young women. Timely efforts are necessary to manage metabolic syndrome in the workplace.

Association Between Serum 25-Hydroxyvitamin D Levels and Dry Eye in Korean Adults: A Study Based on Korean National Health and Nutrition Examination Survey, 2010-2011.

BACKGROUND: Dry eye is a common disease. Many patients continue to experience residual symptoms despite optimal treatment. Thus, new treatment options are required. The purpose of this study was to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and dry eye. METHODS: This study was performed using data from the fifth Korean National Health and Nutrition Examination Survey, which is a cross-sectional study of the Korean population that was conducted from 2010 to 2011. We included adults aged >19 years who underwent ophthalmologic interviews and examinations. We excluded subjects who had comorbid conditions (rheumatoid arthritis, thyroid disease, chronic kidney disease, or depression) that are associated with dry eye. The subjects were divided into normal and dry eye groups. The dry eye group consisted of those who had clinically diagnosed dry eye syndrome or symptoms. Multiple logistic regression analysis was conducted to determine the association between serum 25(OH)D levels and dry eye. RESULTS: In the univariate model, the 25(OH)D levels were lower in the dry eye group than in the normal group (P=0.01). A significant association was found between severe vitamin D deficiency (<10 ng/mL) and dry eye (P=0.04). However, after multivariate adjustment, the statistical significance of the association disappeared (P-values= 0.49, vitamin D insufficiency; P=0.33, vitamin D deficiency; P=0.18, severe vitamin D deficiency). CONCLUSION: Severe vitamin D deficiency was associated with dry eye in an unadjusted model, but the association was not statistically significant after adjustment.

Metabolic Syndrome is Associated with Lower Plasma Levels of Desacyl Ghrelin and Total Ghrelin in Asymptomatic Middle-aged Korean Men.

BACKGROUND: Desacyl ghrelin is acylated by ghrelin O-acyltransferase (GOAT) and converted to acyl ghrelin. To date, little is known about the relationship among the levels of these two forms of ghrelin, GOAT level, and insulin resistance in Asian individuals. The purpose of this study was to determine the relationship between insulin resistance and the levels of plasma acyl ghrelin, desacyl ghrelin, and GOAT in asymptomatic middle-aged Korean men. METHODS: This cross-sectional study evaluated 78 asymptomatic middle-aged Korean men with metabolic syndrome (MS). We examined the correlation between the plasma levels of acyl ghrelin, desacyl ghrelin, and GOAT and sociodemographic, dietary, anthropometric, and metabolic parameters, as well as the association between insulin resistance and plasma levels of acyl ghrelin, desacyl ghrelin, and GOAT. RESULTS: The levels of desacyl ghrelin and total ghrelin were significantly lower in the MS group than in the non-MS group (P<0.017, P=0.01, respectively). HOMA-IR values showed a significant negative correlation with desacyl ghrelin (r=-0.271, P=0.017) and total ghrelin (r=-0.271, P=0.016) levels. Acyl ghrelin and GOAT were not significantly correlated with HOMA-IR, and no correlation was found between the plasma levels of the two ghrelin types and GOAT. CONCLUSION: The plasma levels of desacyl ghrelin and total ghrelin in middle-aged Korean men with MS were lower than in those without MS. A significant negative correlation was observed between desacyl ghrelin level and HOMA-IR; however, no correlation was found between plasma levels of acyl ghrelin and GOAT and HOMA-IR.

Association between uterine leiomyoma and metabolic syndrome in parous premenopausal women: A case-control study.

Previous studies have reported that uterine leiomyoma (UL) may share pathogenic features with obesity and hypertension, which are components of metabolic syndrome (MetS). We examined the association between UL and MetS in premenopausal parous women.This 1:1 case-control study was conducted on 615 asymptomatic women with UL and 615 women without UL that were matched for age, reproductive history, and hormonal use, who underwent a comprehensive health examination. UL was diagnosed by a gynecologist based on transvaginal ultrasonography findings. Blood pressure (BP), body composition, fasting plasma glucose, lipid profiles, insulin, and HOMA-IR were checked.Median age of the 1230 study subjects was 44 (40-47) years and 7% had MetS. Women with UL had significantly higher waist circumferences and body fat, BP, and low-density lipoprotein cholesterol (LDL-C) than women without UL. Although nonsignificant, the prevalence of MetS was higher in the UL group than in the non-UL group (9.3% vs 5.7%). In addition, the prevalence of UL increased as the number of abnormal metabolic components increased and was higher than in women without UL. Conditional logistic regression analysis, after adjustment for confounding factors, showed that hyperglycemia was significantly associated with an increased risk of UL (odds ratio = 1.45; 95% confidence interval, 1.10-1.89).Prevalence of abnormal metabolic component was higher in premenopausal women with UL than in normal controls, regardless of age or reproductive history. Furthermore, the study suggests that UL may share pathogenic features with the components of MetS and that women with UL be considered eligible for the early screening of metabolic abnormalities.

Is Hypovitaminosis D Associated with Stress Perception in the Elderly? A Nationwide Representative Study in Korea.

Hypovitaminosis D and stress are common problems among the elderly. The aim of this cross-sectional nationally representative study was to evaluate the association between hypovitaminosis D and stress perception using large-scale nationally representative data from the Korea National Health and Nutrition Examination Survey (2012-2013). In our study, a total of 1393 elders (≥65 years old) were included to evaluate the association between hypovitaminosis D and stress perception. Serum 25-hydroxyvitamin D levels were determined using radioimmunoassay, and perceived stress status was assessed by a self-reporting questionnaire. The association between hypovitaminosis D and stress perception according to sex was examined using logistic regression analysis. After multivariate adjustment for sociodemographic and lifestyle factors and comorbidities, hypovitaminosis D was significantly associated with perceived stress (odds ratio, 2.73; 95% confidence interval, 1.10-6.77; p = 0.029) among women; however, this association was not significant among men. Hypovitaminosis D was a risk factor for higher stress perception in older Korean women. Even though the role of vitamin D in stress perception is still unclear, we suggest screening for hypovitaminosis D among the elderly.

Prevalence of Reduced Kidney Function by Estimated Glomerular Filtration Rate Using an Equation Based on Creatinine and Cystatin C in Metabolic Syndrome and Its Components in Korean Adults.

BACKGROUND: It is known that metabolic syndrome (MetS) is associated with chronic kidney disease. We evaluated and compared the prevalence of reduced kidney function in MetS and its components by estimated glomerular filtration rate (eGFR) using an equation based on creatinine (eGFRcr), cystatin C (eGFRcys), and combined creatinine-cystatin C (eGFRcr-cys) in Korean adults. METHODS: We analyzed data from 3,649 adults who participated in a comprehensive health examination. RESULTS: Mean values of eGFRcys were higher compared with mean values of eGFRcr (96.1±18.2 mL/min/1.73 m² vs. 91.2±13.6 mL/min/1.73 m²) in total subjects. The prevalence of reduced kidney function increased with age (9.6% for eGFRcys vs. 5.8% for eGFRcr-cys vs. 4.9% for eGFRcr, in subjects aged ≥60 years), and significantly increased with MetS, abdominal obesity, hypertension, high triglyceride, low high density lipoprotein (HDL), and high insulin resistance. The prevalence of MetS, abdominal obesity, hypertension, high insulin resistance, low HDL, and hepatic steatosis was significantly increased in subjects with reduced kidney function. This increased prevalence and the odds ratio of reduced kidney function for prevalence of MetS was highest for eGFRcys, followed by those of eGFRcr-cys, and eGFRcr. CONCLUSION: The prevalence of reduced kidney function by eGFR was significantly increased in subjects with MetS and its related components. eGFRcys and eGFRcr-cys were superior to eGFRcr in detecting reduced kidney function.

Low Bone Mineral Density Is Associated with Tooth Loss in Postmenopausal Women: A Nationwide Representative Study in Korea.

BACKGROUND: Osteoporosis and tooth loss are major health problems in postmenopausal women in a fast-aging country. In this study, we investigated the relationship between low bone mineral density (BMD) and edentulism. METHODS: Data for this cross-sectional study were obtained from the fifth Korean National Health and Nutrition Examination Survey 2011-2012. BMD was measured, and a dental examination was performed on the 2,129 postmenopausal (50-80 years) female participants. Multivariate logistic regression through complex sampling was used to estimate the odds ratio (OR) for osteopenia and osteoporosis in women with loss of at least eight teeth. RESULTS: The average number of missing teeth was significantly lower in women with a normal BMD than in those with osteopenia and osteoporosis (4.5 ± 0.4 vs. 6.7 ± 0.3 vs. 10.4 ± 0.5; p < 0.001). Women with abnormal BMD of the femoral neck were at higher risk of losing eight or more teeth than women with a normal BMD in the femoral neck (OR, 2.37; 95% confidence interval [CI], 1.88-2.99). Women with osteoporosis in the lumbar spine were also at a higher risk of losing eight or more teeth [OR, 1.89; 95% CI, 1.52-2.36] than were women with a normal BMD in the lumbar spine. CONCLUSIONS: Excessive edentulism might be associated with low BMD in postmenopausal women. Regular dental examination is recommended for the postmenopausal women with osteopenia or osteoporosis to prevent tooth loss.

Effect of autologous platelet-rich plasma application on cutaneous wound healing in dogs.

This study was conducted to identify the effectiveness of platelet-rich plasma (PRP) and efficacy of intralesional injection as a method of application to acute cutaneous wounds in dogs. Healthy adult beagles (n = 3) were used in this study. Autologous PRP was separated from anticoagulant treated whole blood in three dogs. Cutaneous wounds were created and then treated by intralesional injection of PRP in the experimental group, while they were treated with saline in the control group on days 0, 2 and 4. The healing process was evaluated by gross examination throughout the experimental period and histologic examination on day 7, 14 and 21. In PRP treated wounds, the mean diameter was smaller and the wound closure rate was higher than in the control. Histological study revealed that PRP treated wounds showed more granulation formation and angiogenesis on day 7, and faster epithelialization, more granulation formation and collagen deposition were observed on day 14 than in control wounds. On day 21, collagen deposition and epithelialization were enhanced in PRP treated groups. Overall, PRP application showed beneficial effects in wound healing, and intralesional injection was useful for application of PRP and could be a good therapeutic option for wound management in dogs.

Vitamin-Mineral Supplement Use Patterns in Elderly Koreans: Data from the 2007-2008 Korean National Health and Nutrition Examination Survey.

BACKGROUND: Vitamin-mineral supplements are the most popular dietary supplements in Korea. However, few studies have assessed the relationship between vitamin-mineral supplementation and associated factors among the Korean elderly. The purpose of this study was to assess the use of vitamin-mineral supplements among elderly in Korea as well as its association with sociodemographic factors, health-related behaviors, medical conditions, and nutrient intake. METHODS: This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008 to 2009. Data from 3,294 elderly men and women (65 years of age and older) were analyzed. Multivariable-weighted logistic regression model analysis was used to evaluate the association between vitamin-mineral supplement use and sociodemographic factors, health-related habits, and medical conditions. RESULTS: Vitamin-mineral supplementation was reported by 16.3% of the participants. The most common reason for using dietary supplements was recommendations from friends and acquaintances. Highly educated person, female participants had a greater likelihood of taking vitamin-mineral supplements. In addition, analysis of nutrient intake from food sources alone revealed a lower proportion of vitamin-mineral supplement users with nutrient intakes below the estimated average requirements for vitamin A, vitamin C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus, compared to nonusers. However, vitamin-mineral supplementation was not associated with health-related behaviors or medical conditions. CONCLUSION: Highly educated person, elderly Korean women had a greater likelihood of using vitamin-mineral supplements. In addition, nutrient intakes from food sources alone were significantly higher among vitamin-mineral supplement users. Finally, vitamin-mineral supplementation may be an indicator of healthier diet in elderly Koreans.

Hyperhomocysteinaemia as a potential marker of early renal function decline in middle-aged Asian people without chronic kidney disease.

PURPOSE: High levels of serum total homocysteine (tHcy), often observed in chronic kidney disease (CKD) patients, are a risk factor for cardiovascular disease. However, little is known about the relationship between tHcy and renal function in healthy individuals. We examined whether tHcy levels are related to renal function in Asian individuals without CKD. METHODS: This cross-sectional study examined 2032 subjects, aged 40-64 years. Individuals with kidney diseases or other conditions that could affect tHcy were excluded. Renal function was determined by estimated glomerular filtration rate (eGFR) from levels of serum creatinine (sCr) and cystatin C. RESULTS: Age, tHcy, sCr, and cystatin C of the subjects were 54.1 ± 6.0 years, 9.5 (8.0-11.4) µmol/L, 0.81 ± 0.1 mg/dL, and 0.82 ± 0.1 mg/L, respectively. In a multiple linear regression analysis, tHcy was a significant independent determinant of sCr and cystatin C in men (ß = 0.206 and ß = 0.282, respectively) and women (ß = 0.247 and ß = 0.229, respectively). Highest tHcy levels were independently associated with increased cystatin C (>s1.10 mg/L) with an odds ratio (OR) of 5.00 [95% confidence interval (CI) 2.81-8.09] and decreased eGFR (<90 mL/min/1.73 m(2)) with an OR of 1.69 (95% CI 1.36-2.11) compared to tHcy levels in the 1st-3rd quartiles. CONCLUSIONS: Higher levels of tHcy are independently associated with sCr and cystatin C elevation. Our study suggests that tHcy levels may be influenced by renal function in Asian populations without CKD. Future studies are needed to define the role of tHcy in renal function.

The Association of Serum Cystatin C with Glycosylated Hemoglobin in Korean Adults.

BACKGROUND: Cystatin C has been known to be associated not only with early renal impairment but also with the incidence of diabetic conditions (prediabetes plus diabetes). However, it is not clear whether cystatin C levels are associated with the prevalence of diabetic conditions in Asian populations. We evaluated this association using glycosylated hemoglobin (HbA1c) levels as the definition of diabetes in Korean adults. METHODS: We analyzed data from 1,559 Korean adults (937 men and 622 women) with available serum cystatin C and HbA1c values. RESULTS: The serum cystatin C levels in subjects with prediabetes and diabetes were significantly increased (0.91±0.14 mg/L in prediabetes and 0.91±0.17 mg/L in diabetes vs. 0.88±0.13 mg/L in patients with normal glucose levels, P=0.001). At increasing cystatin C levels, the prevalence of subjects with prediabetes (30.2% vs. 14.6%, P<0.001) and those with diabetes (10.6% vs. 8.0%, P<0.001) significantly increased in the group with the highest cystatin C levels. The group with the highest cystatin C levels had a significantly increased odds ratio (OR) for the presence of diabetic conditions compared to the group with the lowest values in total subjects (OR, 2.35; 95% confidence interval [CI], 1.54 to 3.58; P<0.001) and in women (OR, 4.13; 95% CI, 1.97 to 8.65; P<0.001), though there was no significant increase after adjusting for multiple variables. CONCLUSIONS: Higher levels of serum cystatin C are associated with an increased prevalence of diabetic conditions in Korean adults. Our findings may extend the positive association of cystatin C with diabetes incidence to an Asian population.

Diagnostic performance and radiation dose of lower extremity CT angiography using a 128-slice dual source CT at 80 kVp and high pitch.

BACKGROUND: Multi-detector computed tomography (MDCT) angiography is now used for the diagnosing patients with peripheral arterial disease. The dose of radiation is related to variable factors, such as tube current, tube voltage, and helical pitch. PURPOSE: To assess the diagnostic performance and radiation dose of lower extremity CT angiography (CTA) using a 128-slice dual source CT at 80 kVp and high pitch in patients with critical limb ischemia (CLI). MATERIAL AND METHODS: Twenty-eight patients (mean, 64.1 years; range, 39-80 years) with CLI were enrolled in this retrospective study and underwent CTA using a 128-slice dual source CT at 80 kVp and high pitch and subsequent intra-arterial digital subtraction angiography (DSA), which was used as a reference standard for assessing diagnostic performance. RESULTS: For arterial segments with significant disease (>50% stenosis), overall sensitivity, specificity, and accuracy of lower extremity CTA were 94.8% (95% CI, 91.7-98.0%), 91.5% (95% CI, 87.7-95.2%), and 93.1% (95% CI, 90.6-95.6%), respectively, and its positive and negative predictive values were 91.0% (95% CI, 87.1-95.0%), and 95.1% (95% CI, 92.1-98.1%), respectively. Mean radiation dose delivered to lower extremities was 266.6 mGy.cm. CONCLUSION: Lower extremity CTA using a 128-slice dual source CT at 80 kVp and high pitch was found to have good diagnostic performance for the assessment of patients with CLI using an extremely low radiation dose.

Comparison of the image qualities of filtered back-projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction for CT venography at 80 kVp.

PURPOSE: To evaluate the subjective and objective qualities of computed tomography (CT) venography images at 80 kVp using model-based iterative reconstruction (MBIR) and to compare these with those of filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASIR) using the same CT data sets. MATERIALS AND METHODS: Forty-four patients (mean age: 56.1 ± 18.1) who underwent 80 kVp CT venography (CTV) for the evaluation of deep vein thrombosis (DVT) during 4 months were enrolled in this retrospective study. The same raw data were reconstructed using FBP, ASIR, and MBIR. Objective and subjective image analysis were performed at the inferior vena cava (IVC), femoral vein, and popliteal vein. RESULTS: The mean CNR of MBIR was significantly greater than those of FBP and ASIR and images reconstructed using MBIR had significantly lower objective image noise (p < .001). Subjective image quality and confidence of detecting DVT by MBIR group were significantly greater than those of FBP and ASIR (p < .005), and MBIR had the lowest score for subjective image noise (p < .001). CONCLUSION: CTV at 80 kVp with MBIR was superior to FBP and ASIR regarding subjective and objective image qualities. KEY POINTS: • MBIR provides superior image quality compared with FBP and ASIR • CTV at 80kVp with MBIR improves diagnostic confidence in diagnosing DVT • CTV at 80kVp with MBIR presents better image quality with low radiation.

Urinary Malondialdehyde Is Associated with Visceral Abdominal Obesity in Middle-Aged Men.

The purpose of the present study was to investigate multiple anthropometric parameters used to evaluate obesity, particularly visceral abdominal fat area, and various metabolic parameters including malondialdehyde (MDA) as an oxidative stress marker. We evaluated various measures of obesity, including body mass index (BMI), waist circumference (WC), sagittal abdominal diameter, fat percentages using dual-energy X-ray absorptiometry, visceral fat area (VFA), subcutaneous fat area, multiple biomarkers related to metabolic disease, and urinary MDA, in 73 asymptomatic middle-aged men who were not severely obese. We examined relationships between multiple measures of obesity, metabolic markers, and urinary MDA levels and evaluated associations between VFA and urinary MDA. In the visceral obesity group, γ-glutamyl transferase (GGT), uric acid, and urinary MDA levels were significantly higher than in the nonvisceral obesity group (P = 0.008, P = 0.002, and P = 0.018). Urinary MDA (r = 0.357, P = 0.002) and uric acid (r = 0.263, P = 0.027) levels were only significantly positively correlated with VFA among measures of obesity. Urinary MDA, serum GGT, and serum CRP were significantly positively associated with VFA (P = 0.001, P = 0.046, and P = 0.023, resp.), even after adjusting for BMI and WC.

Comparison of full-field digital mammography and digital breast tomosynthesis in ultrasonography-detected breast cancers.

OBJECTIVE: To determine what percentage of cancers, detected by screening ultrasonography (US), were detectable by full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT). MATERIALS AND METHODS: Eighty-four consecutive women in whom mammography was negatively interpreted and supplementary screening US initially detected breast cancers at outside hospitals underwent both FFDM and DBT. We excluded cases with overt suspicious findings on repeat mammography and ineligible cases. In the remaining 41 cases, three radiologists who were blinded to tumor location, even though they were aware that they had breast cancers independently reviewed both FFDM and DBT. The reference standard was the reference FFDM made by two unblinded reviewers who were aware of the tumor location and shape on DBT, US, and magnetic resonance imaging (MRI). The visibility score based on the correct marking was compared between FFDM and DBT. RESULTS: Among the 41 cases, the cancers were visible in 25 (61.0%) on FFDM and in 34 (82.9%) on DBT (P = 0.047) by the unblinded review. In the blinded analysis, the cancers were significantly more "constantly visible" in the three radiologists on DBT than on FFDM [53.7% (22/41) vs. 26.8% (11/41), respectively, P = 0.013]. The dominant lesion type was "focal asymmetry" on DBT (39.0%) and "asymmetry" on FFDM (31.7%). CONCLUSIONS: Our analysis suggests that 54% of cancers that were detected by US and were not evident on 2D mammography were detectable by screening using DBT. Additional 29% of cancers were visualized on DBT, when the area of concern was known.

Image quality of CT angiography with model-based iterative reconstruction in young children with congenital heart disease: comparison with filtered back projection and adaptive statistical iterative reconstruction.

To retrospectively evaluate the image quality of CT angiography (CTA) reconstructed by model-based iterative reconstruction (MBIR) and to compare this with images obtained by filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASIR) in newborns and infants with congenital heart disease (CHD). Thirty-seven children (age 4.8 ± 3.7 months; weight 4.79 ± 0.47 kg) with suspected CHD underwent CTA on a 64detector MDCT without ECG gating (80 kVp, 40 mA using tube current modulation). Total dose length product was recorded in all patients. Images were reconstructed using FBP, ASIR, and MBIR. Objective image qualities (density, noise) were measured in the great vessels and heart chambers. The contrast-to-noise ratio (CNR) was calculated by measuring the density and noise of myocardial walls. Two radiologists evaluated images for subjective noise, diagnostic confidence, and sharpness at the level prior to the first branch of the main pulmonary artery. Images were compared with respect to reconstruction method, and reconstruction times were measured. Images from all patients were diagnostic, and the effective dose was 0.22 mSv. The objective image noise of MBIR was significantly lower than those of FBP and ASIR in the great vessels and heart chambers (P < 0.05); however, with respect to attenuations in the four chambers, ascending aorta, descending aorta, and pulmonary trunk, no statistically significant difference was observed among the three methods (P > 0.05). Mean CNR values were 8.73 for FBP, 14.54 for ASIR, and 22.95 for MBIR. In addition, the subjective image noise of MBIR was significantly lower than those of the others (P < 0.01). Furthermore, while FBP had the highest score for image sharpness, ASIR had the highest score for diagnostic confidence (P < 0.05), and mean reconstruction times were 5.1 ± 2.3 s for FBP and ASIR and 15.1 ± 2.4 min for MBIR. While CTA with MBIR in newborns and infants with CHD can reduce image noise and improve CNR more than other methods, it is more time-consuming than the other methods.