Scientific Publications on Thyroid Ultrasound between 2001 and 2020: Differences in Research Characteristics by Disciplines

Objective@#To analyze the characteristics and trends of scientific publications on thyroid ultrasound (US) from 2001 to 2020, specifically examining the differences among disciplines. @*Materials and Methods@#The MEDLINE database was searched for scientific articles on thyroid US published between 2001 and 2020 using the PubMed online service. The evaluated parameters included year of publication, type of document, topic, funding, first author’s specialty, journal name, subject category, impact factor, and quartile ranking of the publishing journal, country, and language. Relationships between the first author’s specialty (radiology, internal medicine, surgery, otorhinolaryngology, and miscellaneous) and other parameters were analyzed. @*Results@#A total of 2917 thyroid US publications were published between 2001 and 2020, which followed an exponential growth pattern, with an annual growth rate of 11.6%. Radiology produced the most publications (n = 1290, 44.2%), followed by internal medicine (n = 716, 24.5%), surgery (n = 409, 14.0%), and otorhinolaryngology (n = 171, 5.9%). Otorhinolaryngology and internal medicine published significantly more case reports than radiology (p < 0.001, each). Radiology published a significantly higher proportion of publications on imaging diagnosis (p < 0.001 for all) and a significantly lower proportion of publications on biopsy (p < 0.001 for all) than the other disciplines. Publications produced by radiology authors were less frequently published in Q1 journals than those from other disciplines (p < 0.005 for internal medicine and miscellaneous disciplines and < 0.01 for surgery and otorhinolaryngology). China contributed the greatest number of publications (n = 622, 21.3%), followed by South Korea (n = 478, 16.4%) and the United States (n = 468, 16.0%). @*Conclusion@#Radiology produced the most publications for thyroid US than any other discipline. Radiology authors published more notably on imaging diagnosis compared to other topics and in journals with lower impact factors compared to authors in other disciplines.

Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features

Purpose@#To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. @*Materials and Methods@#We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. @*Results@#Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). @*Conclusion@#Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

Prognosis after Curative Resection of Single Hepatocellular Carcinoma with A Focus on LI-RADS Targetoid Appearance on Preoperative Gadoxetic Acid-Enhanced MRI

Objective@#To evaluate the prognostic implications of preoperative magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) with a focus on those with targetoid appearance based on the Liver Imaging Reporting and Data System (LI-RADS), as well as known microvascular invasion (MVI) features. @*Materials and Methods@#This retrospective study included 242 patients (190 male; mean age, 57.1 years) who underwent surgical resection of a single HCC (≤ 5 cm) as well as preoperative gadoxetic acid-enhanced MRI between January 2012 and March 2015. LI-RADS category was assigned, and the LR-M category was further classified into two groups according to rim arterial-phase hyperenhancement (APHE). The imaging features associated with MVI were also assessed. The overall survival (OS), recurrence-free survival (RFS), and their associated factors were evaluated. @*Results@#Among the 242 HCCs, 190 (78.5%), 25 (10.3%), and 27 (11.2%) were classified as LR-4/5, LR-M with rim APHE, and LR-M without rim APHE, respectively. LR-M with rim APHE (vs. LR-4/5; hazard ratio [HR] for OS, 5.48 [p = 0.002]; HR for RFS, 2.09 [p = 0.042]) and tumor size (per cm increase; HR for OS, 6.04 [p = 0.009]; HR for RFS, 1.77 [p = 0.014]) but not MVI imaging features (p > 0.05) were independent factors associated with OS and RFS. Compared to the 5-year OS and RFS rates in the LR-4/5 group (93.9% and 66.8%, respectively), the LR-M with rim APHE group had significantly lower rates (68.0% and 45.8%, respectively, both p 0.05). @*Conclusion@#Further classification of LR-M according to the presence of rim APHE may help predict the postoperative prognosis of patients with a single HCC.

Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features

Purpose@#To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. @*Materials and Methods@#We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. @*Results@#Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). @*Conclusion@#Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases / 대한소화기학회지

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.

Harmonic ultrasonography for the detection of microlithiasis in the gallbladder

PURPOSE: To validate the use of harmonic ultrasonography (US) in the detection of gallbladder microlithiasis. METHODS: From November 30, 2012, to January 18, 2014, fundamental US (FUS) and harmonic US with a high background noise (HUS-N) were performed for evaluation of gallbladder during the routine abdomen US. During the US, a dot-like stone (or stones) with Brownian motion was regarded as a positive finding of microlithiasis. Fifty-five patients with microlithiasis in the gallbladder detected on US were enrolled as the subjects of a retrospective review. With respect to the obtained images, two abdominal radiologists independently scored the conspicuity of gallbladder microlithiasis on FUS and HUS-N by using a 4-grade scale. The statistical analysis employed a kappa test and a Wilcoxon rank-sum test. RESULTS: For FUS, the conspicuity grades of gallbladder microlithiasis were G1 in 25 and 37, G2 in 21 and 9, G3 in 6 and 6, G4 in 3 and 3 patients, while HUS-N showed G1 in 0 and 0, G2 in 3 and 2, G3 in 12 and 15, and G4 in 40 and 38 patients, respectively, by each of the two radiologists. The kappa value was 0.633 for FUS between the two radiologists and 0.708 for HUS-N. HUS-N showed better conspicuity of gallbladder microlithiasis than FUS with significant P-values of less than 0.001 and 0.001 for the two radiologists, respectively. CONCLUSION: Compared with FUS, HUS-N enables better detection of microlithiasis in the gallbladder.

Relationship between the risk of bile duct injury during laparoscopic cholecystectomy and the types of preoperative magnetic resonance cholangiopancreatiocography (MRCP)

BACKGROUNDS/AIMS: Bile duct injury is one of the potential severe complications that can occur during laparoscopic cholecystectomy, which can be cause by anatomic variations in the confluence of the bile duct. Recently magnetic resonance cholangiopancreatiocography (MRCP) has become a helpful tool to detect bile duct variation on a preoperative basis and to prevent bile duct injury during laparoscopic cholecystectomy, as well other hepatic surgeries. This study aimed to clarify the types of bile duct on MRCP and to search for a method of avoiding injury during laparoscopic cholecystectomy. METHODS: Between January 2009 and December 2010, 277 patients underwent laparoscopic cholecystectomy with preoperative MRCP in our institution. On a retrospective basis, the bile ducts were categorized into 5 types according to the Couinaud classification system. RESULTS: The proportion of types was revealed type A (70.4%), type B (8.7%), type C (19.5%), type D (0.7%), type E (0%), and type F (0.7%), respectively. Bile duct injury occurred in 4 cases (1.4%) during laparoscopic cholecystectomy. In particular, the possibility of aberrant extrahepatic confluence (Type C and F) represented the highest risk of duct injury (OR=11.89 [CI: 1.21-116.53]). CONCLUSIONS: Preoperative evaluation of the bile duct anatomy is important to avoid injury of duct during laparoscopic cholecystectomy. Specific types of bile duct variation should be considered as a high risk group for bile duct injury.

Korea's Contribution to Radiological Research Included in Science Citation Index Expanded, 1986-2010

OBJECTIVE: To evaluate scientific papers published by Korean radiologists in the Science Citation Index Expanded (SCIE) radiology journals, between 1986 and 2010. MATERIALS AND METHODS: The Institute for Scientific Information Web of Knowledge-Web of Science (SCIE) database was searched for all articles published by Korean radiologists, in SCIE radiology journals, between 1986 and 2010. We performed the analysis by typing "Korea" and "radiol" in the address section and selecting the subject area of "Radiology, Nuclear Medicine, and Medical Imaging" with the use of the general search function of the software. Analyzed parameters included the total number of publications, document types, journals, and institutions. In addition, we analyzed where Korea ranks, compared to other countries, in terms of the number of published articles. All these data were analyzed according to five time periods: 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2010. RESULTS: Overall, 4974 papers were published by Korean radiologists, in 99 different SCIE journals, between 1986 and 2010, of which 4237 (85.2%) were article-type papers. Of the total 115395 articles, worldwide, published in radiology journals, Korea's share was 3.7%, with an upward trend over time (p < 0.005). The journal with the highest number of articles was the American Journal of Roentgenology (n = 565, 13.3%). The institution which produced the highest number of publications was Seoul National University (n = 932, 22.0%). CONCLUSION: The number of scientific articles published by Korean radiologists in the SCIE radiology journals has increased significantly between 1986 and 2010. Korea was ranked 4th among countries contributing to radiology research during the last 5 years.

Calcified Carcinoma of the Gallbladder with Calcified Nodal Metastasis Presenting as a Porcelain Gallbladder: A Case Report / Journal of the Korean Cancer Association, 대한암학회지

Porcelain gallbladder is regarded as a risk factor of gallbladder cancer. A porcelain gallbladder with calcified regional lymph nodes was found using computed tomography (CT) and magnetic resonance imaging (MRI) in a 43-year-old man who presented with nausea, vomiting, and abdominal pain. His cholecystectomy specimen showed diffuse wall thickening and contained small gallstones. Histological examination revealed diffuse infiltrative adenocarcinoma with extensive intratumoral calcification (calcified carcinoma). The majority of the calcified material was located within or replaced the tumor glands, and was not found in the stroma. A lymph node was totally replaced with a calcified metastatic adenocarcinoma. To the best of our knowledge, only one case of calcified lymph node metastasis from a calcified carcinoma of the gallbladder has been previously reported in the literature. We herein add a case of calcified carcinoma of the gallbladder with calcified lymph node metastasis, presenting as a porcelain gallbladder on CT and MRI.

CT, MR, and Angiography Findings of a Solitary Fibrous Tumor of the Larynx: a Case Report

This report details the CT, MR, and angiography findings of a solitary fibrous tumor involving the larynx of a 34-year-old man. A precontrast CT scan revealed a well-defined isodense mass in the submucosal region of the supraglottic larynx. The tumor appeared as a mixed intensity lesion on the T1- and T2-weighted MR images. A T2-weighted MR image showed a central, round, and low signal intensity area within the mass. For both the CT and MR images, the mass demonstrated heterogeneous enhancement following the administration of contrast material. The angiography showed a hypervascular tumor with heterogeneous persistent staining.

Publication Rates for Abstracts Presented by Korean Investigators at Major Radiology Meetings

OBJECTIVE: To determine the publication rate of abstracts presented by Korean investigators at national and international radiological meetings, and to identify predictive factors of publication. MATERIALS AND METHODS: Abstracts presented at the annual meetings of the Korean Radiological Society (KRS), and abstracts presented by Korean investigators at the annual meetings of the Radiological Society of North America (RSNA) and European Congress of Radiology (ECR) from 2001 to 2002 were searched for subsequent publication, using PubMed and the Korean Medical Database. The following variables were evaluated. 1) The overall publication rate; 2) the publication rates according to the radiological subspecialty, presentation type (oral or poster), sample size ( 50), study design (prospective or retrospective), statistical analysis (present or absent), and study outcome (positive or negative); 3) the time to publication; 4) the journal where the study was published; 5) consistency between the abstract and the final publication. RESULTS: Of 1,097 abstracts, 301 (27.4%) were subsequently published, at an average of 15.8 +/- 13.8 months after presentation in 48 journals. The publication rates for studies presented at the RSNA (35.4%) and ECR (50.5%) conferences were significantly higher than that for the KRS conference (23.6%, p < 0.05). Vascular/interventional radiology studies had the highest publication rate (33.1%), whereas musculoskeletal radiology studies had the lowest publication rate (17.1%). Other factors associated with subsequent publication were prospective design, use of statistical testing, and a positive study outcome. CONCLUSION: The publication rate is significantly lower for the KRS (23.6%) meeting abstracts as compared to those of the RSNA (35.4%) and ECR (50.5%). Prospective design, use of statistical testing, and positive study outcome have a statistically significant effect on the publication rate.

The association of Pro12Ala polymorphism of peroxisome proliferator-activated receptor-gamma gene with serum osteoprotegerin levels in healthy Korean women

Recent evidences suggest that the activation of peroxisome proliferator-activated receptor (PPAR)-gamma, which is an important transcriptional factor in adipocyte differentiation, also plays an important role in the bone microenvironment. The objective of the study was to clarify whether Pro12Ala polymorphism was related to the serum OPG levels and bone mineral metabolism in healthy Korean women. In 239 Korean women (mean age 51 years), who participated in medical check-up program in a health promotion center, anthropometric measurements, lumbar spine and femoral neck bone mineral density (BMD), bone turnover markers, such as serum total alkaline phosphatase (ALP) levels, urine deoxypyridinoline levels, and 24-h urine calcium excretion were measured. Serum levels of OPG were measured with ELISA method. DNAs were extracted from the samples and the genotyping of the Pro12Ala polymorphism (rs1801282) in the PPAR-gamma gene was performed via an allelic discrimination assay using a TaqMan probe. In addition, we examined the haplotype analysis between two polymorphisms of PPAR-gamma gene, Pro12Ala in exon B and C161T in exon 6 (rs3856806). Allelic frequencies were 0.950 for Pro allele and 0.050 for Ala allele, which was in compliance with Hardy- Weinberg equilibrium, and there was no Ala12Ala genotype among the genotyped subjects. Mean serum OPG level was significantly lower (P=0.035), and serum total ALP was significantly higher (P=0.014) in the Pro12Ala genotype group compared with the Pro12Pro genotype group, which were consistently significant even after adjustment for weight, height, and serum follicle stimulating hormone (FSH). In multiple regression analysis with serum OPG as the dependent variable and age, weight, ALP, femoral neck BMD and Pro12Ala genotype included in the model, only Pro12Ala genotype was significant determinant of serum OPG level (beta=-0.136, P=0.035). The haplotype analysis with C161T polymorphism revealed that subjects with Ala and T alleles showed significantly lower serum OPG levels compared with those with Pro12Pro/CC genotype, which were consistently significant even after adjustment for age, weight, height and FSH (P=0.010). This result suggests statistically significant association of Pro12Ala polymorphisms with serum OPG levels in Korean females.

Factors affecting serum levels of adipokines in Korean male patients with nonalcoholic fatty liver disease / 대한내과학회지

BACKGROUND: Adipokines are associated with various metabolic disorders including insulin resistance, obesity and dyslipidemia. Metabolic disorders have also been reported to be associated with nonalcoholic fatty liver disease (NAFLD). We aimed to estimate changes in serum adipokines levels according to the degrees of steatosis and to determine independent factors influencing serum adipokines levels in Korean male patients with NAFLD. METHODS: 65 Korean male patients were subjected. The degrees of steatosis were stratified into the three groups, Group I: normal liver (27 subjects), Group II: mild fatty liver (24 subjects) and Group III: moderate to severe fatty liver (14 subjects), according to ultrasonographic liver findings. The anthropometric parameters, fasting serum adipokine levels including leptin, adiponectin and resistin were measured in all subjects. The level of insulin resistance was estimated using the HOMA-IR. RESULTS: Serum leptin levels were significantly different among the three groups (mean+/-SD: Group I (2.052+/-1.071), Group II (2.879+/-1.016), Group III (4.457+/-1.965 ng/mL), p<0.001). Serum adiponectin and resistin levels were not significantly different among the three groups (p=0.184, p=0.649, respectively). BMI and HOMA-IR were independent factors of changes in serum leptin levels (p=0.026, p=0.001, respectively), but independent factors of changes in serum adiponectin and resistin levels were not observed. CONCLUSIONS: Our study support a indirect role to induce metabolic disorder for leptin in the pathogenesis of NAFLD, but do not support roles for adiponectin and resistin in the pathogenesis of NAFLD. BMI and HOMA-IR were only independent factors of changes in serum leptin levels.

Laparoscopic Removal of a Retained Gallbladder with Remnant Cystic Duct Calculi

Laparoscopic cholecystectomy has been widely performed as a gold standard in patients with symptomatic gallstone disease. To avoid bile duct injury during operation, it is recommended that dissection should be kept close to the gallbladder despite the potential risk of long cystic duct stump. Post-cholecystectomy syndrome refers to a wide spectrum of conditions that often pose a diagnostic and therapeutic dilemma for surgeon. Cystic duct remnant may cause postcholecystectomy syndrome in the presence of stones. A case is presented in which a symptomatic gallbladder remnant with gallstone was removed successfully by laparoscopic technique. In the era of laparoscopic surgery, which favors a long cystic duct remnant, we should be aware of cystic duct remnant stones as a possible cause of post-cholecystectomy syndrome.

The Detection of Gallstones on MR Cholangiopancreatography: Comparison between the Single-Shot Turbo Spin-Echo Pulse Sequence and the Three-Dimensional Turbo Spin-Echo Pulse Sequence with the SENSE Technique

PURPOSE: We wanted to evaluate the detectability of gallstones on magnetic resonance cholangiopancreatography (MRCP) and to compare the accuracy between the single-shot turbo spin-echo (SSTSE) sequence and the three-dimensional turbo spin-echo (3DTSE) sequence with the sensitivity encoding (SENSE) technique. MATERIALS AND METHODS: A total of 141 patients who had undergone MRCP for a year period since August, 2003 were involved in the study. The source axial-SSTSE, coronal-SSTSE, source coronal-3D TSE and maximum intensity projection (MIP)-3DTSE images were obtained. Based on the operative findings and the findings of the ultrasound and CT examinations, the results of the reading by two investigators for the presence of gallstones were compared and analyzed. RESULTS: Among 141 patients, 135 patients were included in the study. 69 cases (51%) were found to have gallstones. In terms of detection of gallstones, the accuracy was 85%. The reading by one investigator greatly accorded with that of the other investigator (κ=0.94). As a result of comparing the four kinds of images obtained with the different techniques, it was found that gallstones were seen best on the source axial-SSTSE and source coronal-3DTSE images; the coronal-SSTSE image was the next best image and the MIP-3DTSE image followed (p<0.01). CONCLUSION: The detectability of gallstones on MRCP was relatively excellent and the source axial-SSTSE and source coronal-3DTSE imagings should be included for the detection of gallstones.

The relationship between osteoprotegerin gene polymorphism and aortic calcification in Korean women / 대한내과학회지

BACKGROUND: Osteoprotegerin (OPG) is a recently identified cytokine that acts as a decoy receptor for the receptor activator of NF-kappa B ligand (RANKL). OPG has been shown to be an important inhibitor of osteoclastogenesis and arterial calcification in animal models. Recently, OPG has been proposed as a link molecule between osteoporosis and arterial calcification, but the relationship between OPG gene and cardiovascular system in human populations is unclear. Thus, the aim of this study was to investigate the relationship between OPG gene polymorphisms and aortic calcification in healthy Korean women. METHODS: We observed 251 healthy Korean women (mean age, 51.3+/-6.9 yr). We determined cardiovascular risk factors. Thoracic and abdominal aortic calcifications were examined by simple radiological methods. A163G, G209A, T245G, and T950C polymorphisms of OPG gene were analyzed by allelic discrimination using the 5' nuclease polymerase chain reaction assay. RESULTS: The frequency of mutant allele was increased in the aortic calcification (+) group as compared with aortic calcification (-) group (G209A, 28.6% vs. 18.7%, p=0.029; T950C, 75.9% vs. 65.4%, p=0.017). However, no significant relationship was found between OPG gene polymorphisms and serum OPG levels and cardiovascular risk factors. CONCLUSIONS: We observed that the OPG gene polymorphisms were partly associated with aortic calcification in healthy Korean women. Further studies are needed to clarify this relationship.

A Case of Peritoneal Mesothelioma without a History of Asbestos Exposure / 대한소화기학회지

Peritoneal mesothelioma is an unusual disease which diffusely involves the peritoneal surface. The incidence is approximately one per 1,000,000, and one fifth to one third of all mesothelioma are peritoneal in origin. Asbestos exposure is linked to the development of peritoneal mesothelioma as a significant etiology, but further investigation shoud be conducted. Abdominal sonography, abdominal CT and cytologic examination of ascitic fluid are used to confirm the diagnosis, but rarely provides proper diagnosis. Laparoscopy with biopsy is the most common diagnostic method for definite diagnosis of mesothelioma. Cytoreductive surgery and intraperitoneal chemotherapy have been suggested for better survival since the median survival after the initial diagnosis is near to 50 months. This report describes a case of 73-years-old male patient presented with abdominal pain and distension. This patient had not been exposed to asbestos. Abdominal sonography and CT showed massive ascites, multiple omental masses and peritoneal thickening. It was difficult to distinguish peritoneal mesothelioma from carcinomatosis. Laparoscopy and peritoneal biopsy was conducted and immunostaining examination confirmed the diagnosis of peritoneal mesothelioma.

Diagnostic Usefulness of CT Attenuation Coefficients of Urine after Enteral Administration of Iodinated Water (Iohexol) in Neonates with NEC

PURPOSE: We wanted to evaluate the clinical efficacy of an increased computed tomography attenuation coefficient (CTAC) of urine after the oral administration of iohexol in neonates who are suspected of suffering with neonatal necrotizing enterocolitis (NEC). MATERIALS AND METHODS: During a recent 1 year-period, seventeen neonates were admitted for suspected NEC, and they were divided into the suspected and definite groups based on their clinical signs and radiographic findings; we also included ten normal neonates as the control group. Diluted iohexol was administered and the CTACs of collected urine samples at 8-12 hour intervals were measured. Comparative analysis of the three groups was done and statistical significance was determined by the Scheffe test. RESULTS: Among 17 neonates, there were 13 neonates in the suspect group and 4 neonates in the definite group. The mean CTACs of urine in each group were 2711 HU (control group), 3411 HU (suspected group), and 7625 HU (definite group), respectively. There was a significant difference between the mean CTAC of the definite group and that of the control or suspected groups (Scheffe t >2.65). However, no statistically significant difference was seen between the suspected and control groups (Scheffe t=1.14). CONCLUSION: Although measurements of the CTAC of urine showed no significant diagnostic efficacy in the suspected group, the CTAC of urine, which reflects the correlated degree of bowel mucosal injury, can be a useful aid for determining the severity and progression of NEC.

Change of serum ghrelin concentration according to severity of hepatosteatosis / 대한내과학회지

BACKGROUND: Recently, ghrelin has been reported to be associated with insulin resistance. Nonalcoholic fatty liver disease (NAFLD) is a condition in which insulin resistance relatively plays a pivotal role. The aim of this study was to evaluate the change of serum ghrelin concentration according to severity of hepatosteatosis. METHODS: Sixty five apparently normal male adults who underwent health screen examinations were classified into three groups, Group I: normal (27 subjects), Group II: mild (24 subjects) and Group III: moderate to severe fatty liver (14 subjects), according to ultrasonographic findings of liver. We analyzed the association between serum ghrelin concentration and severity of hepatosteatosis by ANOVA test. And the independent correlation between serum ghrelin concentration and insulin resistance related factors, HOMA (homeostatic model assessment), BMI (body mass index), WC (waist circumference), HC (hip circumference), WHR (waist to hip circumference ratio) were analyzed by multiple linear regression analysis. RESULTS: Serum ghrelin concentration tended to decrease according to severity of hepatosteatosis (Group I: 230.9+/-94.3, Group II: 195.2+/-97.2, Group III: 164.3+/-71.4 pmol/L). But this was statistically insignificant (p=0.081). The independent correlation between serum ghrelin concentration and insulin resistance related factors were not observed. CONCLUSIONS: Our study did not prove the correlation between insulin resistance related factors and serum ghrelin concentration in NAFLD according to severity of hepatosteatosis. However, we found a tendency to decrease serum ghrelin concentration according to severity of hepatosteatosis. So, further studies are required for certification these correlations.

The Relationship Between Serum Adiponectin Level and Serum Alanine Aminotransferase Elevation in Korean Male with Nonalcoholic Fatty Liver Disease / 대한간학회지

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) comprises a large part of chronic liver diseases. Recently it was reported that adipokines are closely associated with the common risk factors for NAFLD, such as obesity, diabetes, dyslipidemia, and insulin resistance. We aimed to evaluate the changes in serum adiponectin, resistin and leptin concentrations related to alanine aminotransferase (ALT) elevations in Korean men with NAFLD. METHODS: We studies 38 men who were diagnosed with fatty liver by abdominal ultrasonography. None had a history of excessive alcohol consumption, autoimmune hepatitis, inherited or metabolic liver disease or viral hepatitis. The subjects were divided into two groups. One group had normal levels of ALT (n=28) and the other had increased ALT (n=10). We compared anthropometrical parameters, biochemical items and serum adipokine levels between these two groups. RESULTS: Serum adiponectin levels were lower in the increased ALT group than in the normal ALT group (3.89 +/- 1.77 vs 7.01 +/- 2.54 microgram/dL, P=0.001). But there were no significant differences in serum leptin and resistin levels between two groups (4.02 +/- 2.04 vs 3.26 +/- 1.41 ng/mL, p=0.245, 80.14 +/- 14.8 vs 80.5 +/- 11.34 ng/mL, P=0.937, respectively). Multiple linear regression analyses demonstrated that the serum adiponectin level is inversely correlated with serum ALT level and that the serum aspartate aminotransferase (AST) level is positively correlated with the serum ALT level. CONCLUSIONS: Our study shows that hypoadiponectinemia is associated with an ALT elevation in patients with NAFLD. Adiponectin may play an indirect role in the development of NAFLD.