Validation of nutrient intake of smartphone application through comparison of photographs before and after meals / 한국영양학회지

Purpose@#This study was conducted to evaluate the validity of the Gene-Health application in terms of estimating energy and macronutrients. @*Methods@#The subjects were 98 health adults participating in a weight-control intervention study. They recorded their diets in the Gene-Health application, took photographs before and after every meal on the same day, and uploaded them to the Gene-Health application. The amounts of foods and drinks consumed were estimated based on the photographs by trained experts, and the nutrient intakes were calculated using the CAN-Pro 5.0 program, which was named ‘Photo Estimation’. The energy and macronutrients estimated from the Gene-Health application were compared with those from a Photo Estimation. The mean differences in energy and macronutrient intakes between the two methods were compared using paired t-test. @*Results@#The mean energy intakes of Gene-Health and Photo Estimation were 1,937.0 kcal and 1,928.3 kcal, respectively. There were no significant differences in intakes of energy, carbohydrate, fat, and energy from fat (%) between two methods. The protein intake and energy from protein (%) of the Gene-Health were higher than those from the Photo Estimation. The energy from carbohydrate (%) for the Photo Estimation was higher than that of the Gene-Health. The Pearson correlation coefficients, weighted Kappa coefficients, and adjacent agreements for energy and macronutrient intakes between the two methods ranged from 0.382 to 0.607, 0.588 to 0.649, and 79.6% to 86.7%, respectively. @*Conclusion@#The Gene-Health application shows acceptable validity as a dietary intake assessment tool for energy and macronutrients. Further studies with female subjects and various age groups will be needed.

An association of urinary sodium-potassium ratio with insulin resistance among Korean adults

BACKGROUND/OBJECTIVES: This study was conducted to investigate the effects of sodium-potassium ratio on insulin resistance and sensitivity in Korean adults. SUBJECTS/METHODS: Subjects were 3,722 adults (1,632 men and 2,090 women) aged 40–69 years participating in the Korean genome and epidemiology study_Ansan and Ansung study. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HoMA-IR) and fasting insulin, and insulin sensitivity was assessed by using the quantitative insulin sensitivity check index (QUICKI). The 24-h urinary sodium and potassium excretion were estimated from spot urinary samples using the Tanaka formula. The generalized linear model was applied to determine the association between urinary sodium-potassium ratio and insulin resistance. RESULTS: HoMA-IR (P-value = 0.029, P-trend = 0.008) and fasting insulin (P-value = 0.017, P-trend = 0.005) levels were positively associated with 24-h estimated urinary sodium-potassium ratio in the multivariable model. QUICKI was inversely associated with 24-h estimated urinary sodium-potassium ratio in all models (P-value = 0.0002, P-trend < 0.0001 in the multivariate model). CONCLUSION: The present study suggests that high sodium-potassium ratio is related to high insulin resistance and low insulin sensitivity. Decreasing sodium intake and increasing potassium intake are important for maintaining insulin sensitivity. Further studies are needed to confirm these findings in longitudinal studies.

Associations of serum levels of vitamins A, C, and E with the risk of cognitive impairment among elderly Koreans

BACKGROUND/OBJECTIVES: Korea is quickly becoming an aged society. Dementia is also becoming a vital public health problem in Korea. Cognitive impairment as a pre-stage of dementia shares most risk factors for dementia. The aim of the present study was to determine associations of serum levels of vitamins A, C, and E with the risk of cognitive impairment among elderly Koreans. SUBJECTS/METHODS: In this cross-sectional study, a total of 230 participants aged 60–79 years from Yangpyeong cohort were included. Cognitive function was assessed by the Korean version of the Mini-Mental State Examination for Dementia Screening. The logistic multivariable regression model was applied to determine the effect of serum vitamins A, C, and E on the risk of cognitive impairment. RESULTS: There was no significant association between the risk of cognitive impairment and serum levels of vitamin A and vitamin C. There was a significant odd ratio when the second tertile group of beta-gamma tocopherol level was compared to the first tertile group [odds ratio (OR) = 0.37, 95% confidence interval (CI) = 0.14–0.98, P for trend = 0.051]. In subgroup analyses, there were significant negative associations between beta-gamma tocopherol level and the risk of cognitive impairment in men (OR = 0.17, 95% CI = 0.03–0.87, P for trend = 0.028), non-drinkers or former drinkers (OR = 0.13, 95% CI = 0.02–0.66, P for trend = 0.025), and non-smokers or former smokers (OR = 0.27, 95% CI = 0.09–0.82, P for trend = 0.017). CONCLUSION: Serum beta-gamma tocopherol levels tended to be inversely associated with the risk of cognitive impairment. Further prospective large-scaled studies are needed to examine this association.

Perception and importance for country-of-origin labeling at restaurants in college students in Jeju / 한국영양학회지

PURPOSE: This study analyzed the perception and importance of country-of-origin labeling at restaurants in 500 college students in Jeju surveyed from April 15 to May 5, 2016 with the aim of providing basic data. A total of 465 questionnaires out of 500 were used as base data for this study. METHODS: The data were analyzed using descriptive analysis, χ2-test, and t-test using the SPSS Win program (version 21.0). RESULTS: Regarding food safety-related dietary behaviors, average score was 3.65 points (out of 5), and ‘put the food in a refrigerator or freezer immediately (4.07)’ showed the highest score, whereas ‘cool rapidly hot food prior to putting it in the refrigerator (3.08)’ showed the lowest score. Regarding the awareness of country-of-origin labeling at restaurants, 67.5% of subjects were aware of it. With regard to dietary behavior of food safety, the high group showed a higher score than the low group (p < 0.001). Regarding reliability of the system, 4.9% of subjects indicated ‘very reliable’ and 45.4% ‘somewhat reliable’. For perception of subject's country-of-origin labeling, the average score was 3.77 (out of 5). Regarding checking country-of-origin labeling at restaurants, 68.0% of subjects checked country-of-origin labeling, and the high group in the safety-related dietary behavior score ranking showed a higher rate (79.3%) than the low group (57.1%) (p < 0.001). With regard to importance by item, 'honest country-of-origin labeling of restaurants' showed the highest score at 4.27 (out of 5). CONCLUSION: It is necessary to provide continuing education for college students in order to enhance their perception of country-of-origin labeling at restaurants. Moreover, a systematic and appropriate support and control system by the government and local government needs to be developed in order to improve country-of-origin labeling at restaurants.

Circulating folate levels and colorectal adenoma: a case-control study and a meta-analysis

BACKGROUND/OBJECTIVES: The relationship between folate and colorectal neoplasia remains controversial. We examined the association between serum folate concentrations and colorectal adenomas in a case-control study of Korean adults and conducted a meta-analysis. SUBJECTS/METHODS: Our case-control study included 113 pairs of case and control who underwent colonoscopy and provided blood samples. We used multivariable conditional logistic regression models to obtain the odds ratios and 95% confidence interval (CIs). For meta-analysis, we identified the relevant studies by searching the PubMed database up to February 2017, included our case-control study and combined the study-specific relative risks (RRs) using a random-effects model. RESULTS: In this case-control study, we included 58 men and 55 women with colorectal adenomas and sex and fasting status matched the controls. We did not find any significant association between the serum folate levels and colorectal adenomas in either men or women. For meta-analysis, a total of eleven studies were included in our analysis and classified into two groups; polyp clearance group (PC) for the studies that included participants who underwent endoscopies and had their polyps removed at baseline; and no polyp clearance group (NPC) for the studies that included participants whose histories of endoscopies were unknown or who underwent their first endoscopies. Four PC (1,311 cases and 1,672 non-cases) and eight NPC studies (3,501 cases and 11,347 non-cases) were included. The combined RRs (95% CIs) comparing the bottom with the top categories of circulating folate levels were 1.07 (0.97-1.18) for the NPC group but 1.45 (1.16-1.74) for the PC group. CONCLUSIONS: Low circulating folate levels were associated with new adenoma formation.

Non-Mass Image-Forming Low Echoic Areas on Breast US: Pathologic Correlation

PURPOSE: We wanted to analyze the mammographic and clinical findings of the non-mass image-forming low echoic areas seen on breast ultrasonography (US) and investigate their pathologic results. MATERIALS AND METHODS: Sixty-nine patients with 72 non-mass image-forming low echoic areas seen on breast US and who had undergone mammography and biopsy were included in this study. The mammographic findings were divided into 2 groups: 1) the negative or probably benign group and 2) the suspicious for malignancy group. The US findings were divided into 3 groups: focal, segmental and diffuse distributions. The clinical findings were divided into 2 groups: the non-palpable and palpable groups. We investigated the pathologic results according to each group. RESULTS: Of the 72 lesions, 49 (68.1%) were benign and 23 (31.9%) were malignant. On the mammography, 42 (93.3%) of the 45 negative or probably benign findings and 7 (25.9%) of 27 suspicious for malignancy findings were pathologically benign (p < 0.001). On the US, 38 (76%) of the 50 focal distributions and 11 (52.4%) of 21 segmental distributions were benign (p = 0.090). Thirty (73.2%) of the 41 nonpalpable lesions and 19 (61.3%) of the 31 palpable lesions were benign (p = 0.609). CONCLUSIONS: A non-mass image-forming low echoic area seen on breast US was malignant at a higher rate when it was found in conjunction with suspicious mammographic finding. There was no significant correlation between the distribution of the non-mass image-forming low echoic areas on US or their palpability and the pathologic results.

Metastatic Spinal Epidural Leiomyoma: A Case Report

We report here on a case of a spinal extradural leiomyoma in a 67-year-old woman, and this tumor was in a very unusual location for a leiomyoma. Because the patient underwent hysterectomy for a uterine leiomyoma 20 years ago, we can speculate that the spinal lesion was a metastatic leiomyoma.

The Usefulness of Dynamic MR Imaging for the Evaluation of Cervical Cancer

PURPOSE: We wished to evaluate the diagnostic usefulness of dynamic MRI in assessing tumor visualization and the parametrial invasion of cervical cancer, and we also wished to determine the most adequate enhancing time by comparing the T2-weighted image (T2WI) and enhanced T1-weighted image (Gd-T1WI). MATERIALS AND METHODS: Fifty-three women with histopathologically proven cervical cancer underwent a preoperative MRI. Using a 1.5 T magnet, the fast spin echo axial T2WI without fat saturation was taken; after contrast administration, 20, 40, 60, 90, 120 sec-dynamic MRIs were taken using fast SPGR and spin echo axial Gd-T1WI. Tumor conspicuity and parametrial invasion in each pulse sequence and the most adequate enhancing time for the evaluation of the tumor on dynamic MRI were evaluated prospectively by three radiologists working at three separate sessions. The results were then correlated with the histopathologic findings. RESULTS: The conspicuity of tumor on dynamic MRI (99.4%) and T2WI (95.6%) were better than on Gd-T1WI (89.3%). In the assessment of parametrial invasion of the tumor, the diagnostic accuracy of dynamic MRI, Gd-T1WI and T2WI was 79.9%, 78% and 76.1%, respectively; the highest values were for the dynamic MRI, but there was no statistically significant difference among three pulse sequences. The most adequate enhancing time on dynamic MRI was between 90 seconds and 120 seconds. CONCLUSION: Dynamic MRI is useful for the assessment of tumor visualization of cervical cancer, and the most appropriate scan time on dynamic MRI is between 90 seconds and 120 seconds. For the determination of parametrial invasion, the dynamic MRI revealed a higher diagnostic accuracy than that of T2WI or Gd-T1WI, but the differences were statistically insignificant.

Usefulness of Magnetic Resonance Cholangiography and Additional T2-Weighted Axial Image in Evaluating Focal Intrahepatic Ductal Dilatation

PURPOSE: To evaluate the value of MR cholangiography (MRC) and MRC with additional T2-weighted axial imaging for evaluating the cause and determining the therapeutic plan in patients with a focal dilatation of the intrahepatic bile ducts(IHBD). MATERIALS AND METHODS: Forty nine patients (male, 27; female, 22; age range, 12-72 (mean, 51) years) with a focal intrahepatic ductal dilatation confirmed surgically and pathologically (lobectomy, 34; biopsy, 7; surgical finding and T-tube cholangiography, 7; percutanous transhepatic biliary drainage with bile cytology, 1) underwent MRC and T2-weighted axial imaging. The MRC were obtained in one of two ways (a single slab or multi-slice acquisition under chemical fat saturation) using RARE (31 patients, source images and single slice images), or TSE (18 patients, source images and MIP reconstruction images). Two radiologists reviewed the MRC images alone, and the MRC images with the T2-weighted axial images. A diagnosis was determined by consensus. RESULTS: In 37 out of 49 patients, the causes of a bile duct dilation were benign diseases (IHBD stones in 33 cases, liver abscesses with IHBD stones in three cases, one inflammatory pseudotumor). Twelve patients had cholangiocarcinomas (mass-forming type in seven cases, intraductal type in three cases, and periductal infiltrating type in two cases). A correct diagnosis was confirmed in 47 out of 49 cases(96.0%), i.e. all the 37 benign lesions and 10 out of 12 malignant lesions. The addition of the T2-weighted axial image to the MRC did not alter the diagnosis of the causes of the focal intrahepatic ductal dilatation, but was helpful in 10 cases (20.4%). Nine cases (7 cholangiocarcinomas and 2 abscesses), in which MRC showed masses, were visualized more definitely on the additional T2-weighted axial images to the MRC than on the MRC alone. The remaining cases were hepatolithiasis, where stones could be easily differentiated from air by the air-fluid level on the axial images. CONCLUSION: MRC is a good diagnostic modality for evaluating a focal dilatation of IHBD, and the addition of T2-weighted axial image to MRC is helpful.

Gd(DTPA)2--enhanced, and Quantitative MR Imaging in Articular Cartilage

PURPOSE: Early degeneration of articular cartilage is accompanied by a loss of glycosaminoglycan (GAG) and the consequent change of the integrity. The purpose of this study was to biochemically quantify the loss of GAG, and to evaluate the Gd(DTPA)2--enhanced, and T1, T2, rho relaxation map for detection of the early degeneration of cartilage. MATERIALS AND METHODS: A cartilage-bone block in size of 8mmx10 mm was acquired from the patella in each of three pigs. Quantitative analysis of GAG of cartilage was performed at spectrophotometry by use of dimethylmethylene blue. Each of cartilage blocks was cultured in one of three different media: two different culture media (0.2 mg/ml trypsin solution, 1mM Gd (DTPA)2- mixed trypsin solution) and the control media (phosphate buffered saline (PBS)). The cartilage blocks were cultured for 5 hrs, during which MR images of the blocks were obtained at one hour interval (0 hr, 1 hr, 2 hr, 3 hr, 4 hr, 5 hr). And then, additional culture was done for 24 hrs and 48 hrs. Both T1-weighted image (TR/TE, 450/22 ms), and mixed-echo sequence (TR/TE, 760/21-168ms; 8 echoes) were obtained at all times using field of view 50 mm, slice thickness 2 mm, and matrix 256x512. The MRI data were analyzed with pixel-by-pixel comparisons. The cultured cartilage-bone blocks were microscopically observed using hematoxylin & eosin, toluidine blue, alcian blue, and trichrome stains. RESULTS: At quantitation analysis, GAG concentration in the culture solutions was proportional to the culture durations. The T1-signal of the cartilage-bone block cultured in the Gd(DTPA)2- mixed solution was significantly higher (42% in average, p0.05). However the focal increase in T1 relaxation time at superficial and transitional layers of cartilage was seen in Gd(DTPA)2- mixed culture. Toluidine blue and alcian blue stains revealed multiple defects in whole thickness of the cartilage cultured in trypsin media. CONCLUSION: The quantitative analysis showed gradual loss of GAG proportional to the culture duration. Microimagings of cartilage with Gd(DTPA)2--enhancement, relaxation maps were available by pixel size of 97.9x195 micrometer. Loss of GAG over time better demonstrated with Gd(DTPA)2--enhanced images than with T1, T2, rho relaxation maps. Therefore Gd(DTPA)2--enhanced T1-weighted image is superior for detection of early degeneration of cartilage.

Fat Necrosis Simulating Breast Malignancy Following Reduction Mammoplasty: A Case Report

Fat necrosis is well depicted on imaging by characteristic findings such as oil cysts. However it may be rarely indistinguishable from carcinoma clinically and radiologically, and require biopsy for diagnosis. We report a case of fat necrosis simulating malignancy following reduction mammoplasty. The screening mammogram of a 63-year-old woman, who had received bilateral reduction mammoplasties 10 months previously, showed an irregular high-density lesion with a spiculated margin in the upper inner quadrant of the left breast. Ultrasonography revealed a 1.5 cm sized, ill-defined, and irregular hypoechoic lesion with posterior acoustic shadowing. The confirm diagnosis was fat necrosis, by ultrasonography-guided core needle biopsy. On the 6-month follow-up ultrasonography, the lesion was found to have decreased in size.