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Purpose@#Several artificial intelligence (AI) models for the detection and prediction of cardiovascular-related diseases, including arrhythmias, diabetes, and sleep apnea, have been reported. This systematic review and meta-analysis aimed to identify AI models developed for or applicable to wearable and mobile devices for diverse cardiovascular-related diseases. @*Materials and Methods@#The searched databases included Medline, Embase, and Cochrane Library. For AI models for atrial fibrillation (AF) detection, a meta-analysis of diagnostic accuracy was performed to summarize sensitivity and specificity. @*Results@#A total of 102 studies were included in the qualitative review. There were AI models for the detection of arrythmia (n=62), followed by sleep apnea (n=11), peripheral vascular diseases (n=6), diabetes mellitus (n=5), hyper/hypotension (n=5), valvular heart disease (n=4), heart failure (n=3), myocardial infarction and cardiac arrest (n=2), and others (n=4). For quantitative analysis of 26 studies reporting AI models for AF detection, meta-analyzed sensitivity was 94.80% and specificity was 96.96%. Deep neural networks showed superior performance [meta-analyzed area under receiver operating characteristics curve (AUROC) of 0.981] compared to conventional machine learning algorithms (meta-analyzed AUROC of 0.961). However, AI models tested with proprietary dataset (meta-analyzed AUROC of 0.972) or data acquired from wearable devices (meta-analyzed AUROC of 0.977) showed inferior performance than those with public dataset (meta-analyzed AUROC of 0.986) or data from in-hospital devices (meta-analyzed AUROC of 0.983). @*Conclusion@#This review found that AI models for diverse cardiovascular-related diseases are being developed, and that they are gradually developing into a form that is suitable for wearable and mobile devices.
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Background/Aims@#While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm. @*Methods@#The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath. @*Results@#The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm. @*Conclusions@#We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.
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Background@#In hemodialysis patients, brachial-ankle pulse wave velocity (baPWV) levels are affected by particulate matter with an aerodynamic diameter of 10 μm or less (PM10). We conducted this study to determine whether there is an association between short- and long-term PM10 exposure and baPWV in apparently healthy adults aged 40 years and older. @*Methods@#A total of 1,628 subjects who underwent health examinations between 2006 and 2009 were included in the study. On the basis of the day of medical screening, the 1–3-day and 365-day moving averages of PM10 concentrations were used to evaluate the association between short- and long-term exposure to PM10 and high baPWV (≥the third quartile of baPWV, 1,534 cm/s) using logistic regression models. Additional subgroup analyses were conducted according to age, sex, obesity (body mass index ≥25.0 kg/m2), and comorbidities such as metabolic syndrome. @*Results@#No statistically significant associations were identified between short-term and long-term exposure to PM10 and baPWV in any of the subjects and subgroups. A 10-μg/m3 increase in the 2-day moving average of PM10 exposure was marginally associated with high baPWV in non-obese subjects (odds ratio, 1.059; P=0.058). This association in non-obese subjects was significantly different from that in obese subjects (P=0.038). @*Conclusion@#This study did not show statistically significant associations between short-term and long-term exposure to PM10 and baPWV in apparently healthy subjects. With short-term exposure to PM10, non-obese subjects showed a marginally unfavorable association with baPWV. Further studies are necessary to validate and elucidate the mechanism underlying the effect of PM10 on baPWV.
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The effects of the conditions of microarc oxidation (MAO) and hydrothermal treatments on the formation of micro-nano hybrid surface on titanium has been studied. Titanium metals were microarc oxidized using the electrolyte containing Ca and P ions for 30, 60, 120, 180, and 240 s, respectively. These MAO-treated specimens were hydrothermally treated using alkaline solution (HT-treatment) or P-containing alkaline solution (HTP-treatment). The porous morphology was appeared after MAO treatment for more than 60 s. The Ca and P ions in oxide layer were detected clearly after MAO treatment for 120 s, and their contents increased as MAO-treatment time increased. After hydrothermal treatment, micro-sized hydroxyapatite (HAp) and nano-sized TiO2 crystallites were formed on porous surfaces. The size of HAp crystallites formed by HTP-treatment was larger than that formed by HT-treatment, while the size of TiO2 crystallites showed the opposite tendency. Surface roughness of MAO-treated groups increased with MAO-treatment time. After hydrothermal treatment, the roughnesses of the specimens MAO-treated for 30 and 60 s decreased, while the roughness increased after MAO treatment for 120 s. The hydrophilicity of MAO-treated specimens increased with MAO-treatment time. The hydrophilicity of the specimens MAO-treated for 30 and 60 s decreased after hydrothermal treatment. However, the hydrophilicity of the specimens treated with MAO over 120 s and subsequent HT- or HTP- treatments increased with the formation of HAp on their surfaces.
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Background@#This study evaluated the relationship between guideline adherence for heart failure (HF) with reduced ejection fraction (HFrEF) at discharge and relevant clinical outcomes in patients with acute HF with preserved ejection fraction (HFpEF) with or without atrial fibrillation (AF). @*Methods@#We analyzed Korean Acute Heart Failure Registry data for 707 patients with HFpEF with documented AF and 687 without AF. Guideline adherence was defined as good or poor according to the prescription of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and mineralocorticoid receptor antagonists. Anticoagulation adherence was also incorporated for the AF group. @*Results@#Among patients with normal sinus rhythm, those with poor guideline adherence had a reduced prevalence of comorbidities and favorable clinical characteristics when compared with those with good guideline adherence. Using inverse probability of treatment weighting (IPTW) to address the bias of nonrandom treatment assignment, good adherence was associated with a poor 60-day composite endpoint in the multivariable Cox model (weighted hazard ratio [wHR], 1.74; 95% confidence interval [CI], 1.01–3.00; P = 0.045). For patients with AF, baseline clinical characteristics were similar according to the degree of adherence. The IPTW-adjusted analysis indicated that good adherence was significantly associated with the 60-day composite endpoint (wHR, 0.47; 95% CI, 0.27–0.79; P = 0.005). In the analysis excluding warfarin, good adherence was associated with 60-day rehospitalization (wHR, 0.60; 95% CI, 0.37–0.98; P = 0.040), 1-year re-hospitalization (wHR, 0.67; 95% CI, 0.48–0.93; P = 0.018), and the composite endpoint (wHR, 0.77; 95% CI, 0.59–0.99; P = 0.041). @*Conclusion@#Our findings indicate that good adherence to guidelines for HFrEF is associated with a better 60-day composite endpoint in patients with HFpEF with AF.
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Background@#In hemodialysis patients, brachial-ankle pulse wave velocity (baPWV) levels are affected by particulate matter with an aerodynamic diameter of 10 μm or less (PM10). We conducted this study to determine whether there is an association between short- and long-term PM10 exposure and baPWV in apparently healthy adults aged 40 years and older. @*Methods@#A total of 1,628 subjects who underwent health examinations between 2006 and 2009 were included in the study. On the basis of the day of medical screening, the 1–3-day and 365-day moving averages of PM10 concentrations were used to evaluate the association between short- and long-term exposure to PM10 and high baPWV (≥the third quartile of baPWV, 1,534 cm/s) using logistic regression models. Additional subgroup analyses were conducted according to age, sex, obesity (body mass index ≥25.0 kg/m2), and comorbidities such as metabolic syndrome. @*Results@#No statistically significant associations were identified between short-term and long-term exposure to PM10 and baPWV in any of the subjects and subgroups. A 10-μg/m3 increase in the 2-day moving average of PM10 exposure was marginally associated with high baPWV in non-obese subjects (odds ratio, 1.059; P=0.058). This association in non-obese subjects was significantly different from that in obese subjects (P=0.038). @*Conclusion@#This study did not show statistically significant associations between short-term and long-term exposure to PM10 and baPWV in apparently healthy subjects. With short-term exposure to PM10, non-obese subjects showed a marginally unfavorable association with baPWV. Further studies are necessary to validate and elucidate the mechanism underlying the effect of PM10 on baPWV.
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The effects of the conditions of microarc oxidation (MAO) and hydrothermal treatments on the formation of micro-nano hybrid surface on titanium has been studied. Titanium metals were microarc oxidized using the electrolyte containing Ca and P ions for 30, 60, 120, 180, and 240 s, respectively. These MAO-treated specimens were hydrothermally treated using alkaline solution (HT-treatment) or P-containing alkaline solution (HTP-treatment). The porous morphology was appeared after MAO treatment for more than 60 s. The Ca and P ions in oxide layer were detected clearly after MAO treatment for 120 s, and their contents increased as MAO-treatment time increased. After hydrothermal treatment, micro-sized hydroxyapatite (HAp) and nano-sized TiO2 crystallites were formed on porous surfaces. The size of HAp crystallites formed by HTP-treatment was larger than that formed by HT-treatment, while the size of TiO2 crystallites showed the opposite tendency. Surface roughness of MAO-treated groups increased with MAO-treatment time. After hydrothermal treatment, the roughnesses of the specimens MAO-treated for 30 and 60 s decreased, while the roughness increased after MAO treatment for 120 s. The hydrophilicity of MAO-treated specimens increased with MAO-treatment time. The hydrophilicity of the specimens MAO-treated for 30 and 60 s decreased after hydrothermal treatment. However, the hydrophilicity of the specimens treated with MAO over 120 s and subsequent HT- or HTP- treatments increased with the formation of HAp on their surfaces.
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Background@#This study evaluated the relationship between guideline adherence for heart failure (HF) with reduced ejection fraction (HFrEF) at discharge and relevant clinical outcomes in patients with acute HF with preserved ejection fraction (HFpEF) with or without atrial fibrillation (AF). @*Methods@#We analyzed Korean Acute Heart Failure Registry data for 707 patients with HFpEF with documented AF and 687 without AF. Guideline adherence was defined as good or poor according to the prescription of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and mineralocorticoid receptor antagonists. Anticoagulation adherence was also incorporated for the AF group. @*Results@#Among patients with normal sinus rhythm, those with poor guideline adherence had a reduced prevalence of comorbidities and favorable clinical characteristics when compared with those with good guideline adherence. Using inverse probability of treatment weighting (IPTW) to address the bias of nonrandom treatment assignment, good adherence was associated with a poor 60-day composite endpoint in the multivariable Cox model (weighted hazard ratio [wHR], 1.74; 95% confidence interval [CI], 1.01–3.00; P = 0.045). For patients with AF, baseline clinical characteristics were similar according to the degree of adherence. The IPTW-adjusted analysis indicated that good adherence was significantly associated with the 60-day composite endpoint (wHR, 0.47; 95% CI, 0.27–0.79; P = 0.005). In the analysis excluding warfarin, good adherence was associated with 60-day rehospitalization (wHR, 0.60; 95% CI, 0.37–0.98; P = 0.040), 1-year re-hospitalization (wHR, 0.67; 95% CI, 0.48–0.93; P = 0.018), and the composite endpoint (wHR, 0.77; 95% CI, 0.59–0.99; P = 0.041). @*Conclusion@#Our findings indicate that good adherence to guidelines for HFrEF is associated with a better 60-day composite endpoint in patients with HFpEF with AF.
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Purpose@#After kidney transplantation (KT), a large amount of drainage can delay postoperative recovery. Viscum album extract is an agent used in pleurodesis, and the purpose of this study was to evaluate the efficacy of this agent in reducing the amount of drainage after KT. @*Methods@#Medical records of patients with a large amount of drainage (≥ 100 mL/day) on postoperative day (POD) 7 after KT who had undergone V. album extract instillation through drainage tube (n = 115) or conservative management (n = 177) were retrospectively reviewed. The primary endpoint was a decrease in the amount of drainage on POD 14 from POD 7. @*Results@#A decrease in the amount of drainage on POD 14 from POD 7 was larger in the V. album extract instillation group than in the conservative management group (–228.3 ± 181.6 mL vs. –144.6 ± 202.0 mL, P < 0.001). Duration of hospitalization after operation was shorter in the V. album extract instillation group than in the conservative management group (15.9 ± 3.2 days vs. 18.1 ± 5.3 days, P < 0.001). In multivariate analysis, there was a statistically significant association of V. album extract instillation with lower risk of persistent large amount of drainage (≥ 100 mL/day on POD 14), with an odds ratio of 0.57 (95% confidence interval, 0.35–0.93; P = 0.026). @*Conclusion@#Retroperitoneal V. album extract instillation could be effective in reducing the amount of drainage and promoting postoperative recovery in patients with a large amount of drainage after KT.
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Purpose@#Polymyxin B hemoperfusion (which treats septic shock by removing endotoxins of gram-negative bacteria), has been proposed as a treatment modality for intraabdominal sepsis. However, there are few studies about the factors that need to be taken into consideration for a better outcome. The aim of this study was to assess the effectiveness of polymyxin B hemoperfusion in abdominal septic shock and analyze the factors affecting the outcome of this therapy. @*Methods@#A retrospective review was performed in 41 patients who were diagnosed with abdominal septic shock. There were 12 patients treated with polymyxin B hemoperfusion, and 29 patients treated with conventional therapy. The clinical outcomes of the 2 groups were compared to identify the factors affecting the outcome of hemoperfusion. @*Results@#The decrement of vasopressor requirement represented by vasopressor dependency index was 2.5 in the hemoperfusion group and 0.1 in the conventional therapy group (p = 0.021), and in-hospital mortality was 33.3% in the hemoperfusion group and 69.0% in the conventional therapy group (p = 0.045). In logistic regression analysis, hemoperfusion was identified as a factor reducing in-hospital mortality in patients with sufficient source control, but not in patients with insufficient source control. In patients who had undergone hemoperfusion, the longer time to initiate hemoperfusion was identified as a risk factor of in-hospital mortality (p = 0.039). @*Conclusion@#Polymyxin B hemoperfusion may be an effective therapy for treating abdominal septic shock, and early use of this modality with definite source control might be important for a better outcome.
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Purpose@#Polymyxin B hemoperfusion (which treats septic shock by removing endotoxins of gram-negative bacteria), has been proposed as a treatment modality for intraabdominal sepsis. However, there are few studies about the factors that need to be taken into consideration for a better outcome. The aim of this study was to assess the effectiveness of polymyxin B hemoperfusion in abdominal septic shock and analyze the factors affecting the outcome of this therapy. @*Methods@#A retrospective review was performed in 41 patients who were diagnosed with abdominal septic shock. There were 12 patients treated with polymyxin B hemoperfusion, and 29 patients treated with conventional therapy. The clinical outcomes of the 2 groups were compared to identify the factors affecting the outcome of hemoperfusion. @*Results@#The decrement of vasopressor requirement represented by vasopressor dependency index was 2.5 in the hemoperfusion group and 0.1 in the conventional therapy group (p = 0.021), and in-hospital mortality was 33.3% in the hemoperfusion group and 69.0% in the conventional therapy group (p = 0.045). In logistic regression analysis, hemoperfusion was identified as a factor reducing in-hospital mortality in patients with sufficient source control, but not in patients with insufficient source control. In patients who had undergone hemoperfusion, the longer time to initiate hemoperfusion was identified as a risk factor of in-hospital mortality (p = 0.039). @*Conclusion@#Polymyxin B hemoperfusion may be an effective therapy for treating abdominal septic shock, and early use of this modality with definite source control might be important for a better outcome.
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The expansion of allergen-specific CD4⁺ T cells is a critical step in inducing airway inflammation during allergic asthma. Such clonal expansion of T cells is initiated through the interaction between allergen-bearing dendritic cells and allergen-specific naïve T cells in the draining lymph nodes. Whether such T cell clonal expansion also occurs in the lung, the primary organ encountering inhaled allergens, remains unclear. Compared with wild-type mice, we found similar frequencies of CD4⁺ T cells in the lung of lymph node-deficient Rorgt(gfp/gfp) mice after repeated exposure to inhaled allergens. In addition, we observed an evident population of CD4⁺ T cells that underwent clonal expansion in the lung of allergen-challenged mice treated with an S1P antagonist FTY720 in an in vivo proliferation study with CFSE-labeled OT-II T cells. Moreover, the expansion of allergen-specific CD4⁺ T cells was significantly enhanced in the lungs of Rorgt(gfp/gfp) mice in comparison to that of wild-type mice. These results together demonstrate that the clonal expansion of allergen-specific CD4⁺ T cells occurs in the absence of the lymph nodes, indicating that the lung can act as a primary site of the clonal expansion of CD4⁺ T cells in response to inhaled allergens.
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Animais , Camundongos , Alérgenos , Asma , Células Dendríticas , Cloridrato de Fingolimode , Inflamação , Pulmão , Linfonodos , Linfócitos TRESUMO
The percutaneous transhepatic biliary drainage (PTBD) is an effective intervention as a palliative therapy for relieving a jaundice and cholangitis. It may be used in place of Endoscopic retrograde cholangiopancreatography (ERCP) in the obstructive biliary disease. Recently, by developing invasive procedures, the incidence of the complications such as bleeding and perforation has been increasing in the diagnosis and treatment of hepatobiliary disease. We report here on a case of remained drawstring after PTBD in a 85-year-old man. The patient was conducted PTBD for relieving a jaundice and cholangitis. And then the patient had complained of abdominal pain constantly. A few days later, we removed PTBD and attempted ERCP for removal of CBD stone. The ERCP showed remained drawstring around ampulla of vater and we removed it by IT knife. The drawstring was successfully removed.
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Idoso de 80 Anos ou mais , Humanos , Dor Abdominal , Ampola Hepatopancreática , Colangiopancreatografia Retrógrada Endoscópica , Colangite , Diagnóstico , Drenagem , Hemorragia , Incidência , Icterícia , Cuidados PaliativosRESUMO
Immunoglobulin (Ig) G4-related disease was recently recognized as a systemic fibro-inflammatory disease characterized by dense lymphoplasmacytic infiltrates, storiform fibrosis, and obliterative phlebitis with IgG4-positive cells in the target tissues. This disease can localize to a single organ or be diffuse in multiple organs. Pulmonary manifestation in IgG4-related lung disease presents as various sized nodules, lung masses, patchy ground-glass opacities, consolidation, thickened bronchovascular bundles, nodular pleural lesions, and interstitial lung disease. Traditional treatment for IgG4-related lung disease includes systemic (cortico) steroids. Here, we report a case of IgG4-related lung disease presenting as multiple cavitary nodules that spontaneously regressed without systemic steroid use.
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Corticosteroides , Fibrose , Imunoglobulina G , Imunoglobulinas , Pneumopatias , Doenças Pulmonares Intersticiais , Pulmão , Nódulos Pulmonares Múltiplos , Flebite , EsteroidesRESUMO
Primary central nervous system marginal zone B-cell lymphoma (MZBCL) is very rare, with only a few reported cases worldwide. It has an indolent disease course with high cure potential. We experienced a rare case of dural MZBCL of mucosa-associated lymphoid tissue (MALT) in a 69-year-old man who presented with headache. A magnetic resonance imaging scan of brain showed a 1.9×3.6-cm-sized extra-axial mass with a broad based dural attachment to the anterosuperior aspect of the falx cerebri, radiographically consistent with meningioma. Surgical resection yielded a MZBCL of the MALT type. Histopathology revealed a lymphoplasmacytic infiltration of the dura, and immunohistochemical study showed a B-cell phenotype with CD20, bcl-2, MUM-1, Ki-67 positive. He was treated with chemotherapy after complete surgical resection and remained free of disease at 30 months after chemotherapy. MALT lymphoma must be considered in the differential diagnosis in patients presenting radiographically with meningioma.
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Idoso , Humanos , Linfócitos B , Encéfalo , Sistema Nervoso Central , Neoplasias do Sistema Nervoso Central , Diagnóstico Diferencial , Tratamento Farmacológico , Dura-Máter , Cefaleia , Tecido Linfoide , Linfoma de Zona Marginal Tipo Células B , Imageamento por Ressonância Magnética , Meningioma , FenótipoRESUMO
Primary central nervous system marginal zone B-cell lymphoma (MZBCL) is very rare, with only a few reported cases worldwide. It has an indolent disease course with high cure potential. We experienced a rare case of dural MZBCL of mucosa-associated lymphoid tissue (MALT) in a 69-year-old man who presented with headache. A magnetic resonance imaging scan of brain showed a 1.9×3.6-cm-sized extra-axial mass with a broad based dural attachment to the anterosuperior aspect of the falx cerebri, radiographically consistent with meningioma. Surgical resection yielded a MZBCL of the MALT type. Histopathology revealed a lymphoplasmacytic infiltration of the dura, and immunohistochemical study showed a B-cell phenotype with CD20, bcl-2, MUM-1, Ki-67 positive. He was treated with chemotherapy after complete surgical resection and remained free of disease at 30 months after chemotherapy. MALT lymphoma must be considered in the differential diagnosis in patients presenting radiographically with meningioma.
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Idoso , Humanos , Linfócitos B , Encéfalo , Sistema Nervoso Central , Neoplasias do Sistema Nervoso Central , Diagnóstico Diferencial , Tratamento Farmacológico , Dura-Máter , Cefaleia , Tecido Linfoide , Linfoma de Zona Marginal Tipo Células B , Imageamento por Ressonância Magnética , Meningioma , FenótipoRESUMO
Solid pseudopapillary tumor (SPT) of the pancreas is a rare tumor that typically affects young women without causing significant clinical symptoms. No case of SPT in an old man has been reported in South Korea, and such cases are very rare worldwide. We report a 70-year-old man with SPT of the pancreas with multiple organ metastasis. Although surgical resection is the treatment of choice for SPT, we decided not to treat, considering his age and the disease severity.
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Idoso , Feminino , Humanos , Diagnóstico , Coreia (Geográfico) , Metástase Neoplásica , PâncreasRESUMO
Radiation therapy for variety of human solid tumors utilizes mechanism of cell death after DNA damage caused by radiation. In response to DNA damage, cytochrome c was released from mitochondria by activation of pro-apoptotic Bcl-2 family proteins, and then elicits massive Ca2+ release from the ER that lead to cell death. It was also suggested that irradiation may cause the deregulation of Ca2+ homeostasis and trigger programmed cell death and regulate death specific enzymes. Thus, in this study, we investigated how cellular Ca2+ metabolism in RKO cells, in comparison to radiation-resistant A549 cells, was altered by gamma (gamma)-irradiation. In irradiated RKO cells, Ca2+ influx via activation of NCX reverse mode was enhanced and a decline of [Ca2+]i via forward mode was accelerated. The amount of Ca2+ released from the ER in RKO cells by the activation of IP3 receptor was also enhanced by irradiation. An increase in [Ca2+]i via SOCI was enhanced in irradiated RKO cells, while that in A549 cells was depressed. These results suggest that gamma-irradiation elicits enhancement of cellular Ca2+ metabolism in radiation-sensitive RKO cells yielding programmed cell death.
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Humanos , Cálcio , Morte Celular , Neoplasias Colorretais , Citocromos c , Dano ao DNA , Homeostase , Receptores de Inositol 1,4,5-Trifosfato , Metabolismo , MitocôndriasRESUMO
BACKGROUND: We attempted to determine the prevalence and characteristics of metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) individuals in a large cohort of middle-aged Koreans. METHODS: 8,987 non-diabetic subjects were selected from the Chungju Metabolic disease Cohort Study performed in 2003-2006. MONW was defined as a body mass index (BMI) > or = 18.5 and or = 25 kg/m2 with HOMA-IR in the lowest quartile. RESULTS: The mean age of the subjects was 62.3 +/- 10.5 years (men 40.4%). The age-adjusted prevalence of MONW and MHO were 4.3% (5.3% men, 3.7% women) and 5.6% (3.6% men, 7.0% women), respectively. 14.2% of men and 12.9% of women were classified as MONW among the normal weight population, whereas 10.7% of men and 14.5% of women were classified as MHO among the obese subjects. The prevalence of prediabetes was significantly higher in the MONW group than in the MHO group (34.7 vs. 12.5%, P < 0.0001 in men; 23.1 vs. 8.8%, P < 0.0001 in women). The MONW group evidenced an equivalent risk of coronary heart disease (CHD) relative to the MHO group (10.77 +/- 0.68 vs. 10.22 +/- 0.90% in men; 7.02 +/- 0.34 vs. 7.26 +/- 0.26% in women, means +/- standard error [SE]). CONCLUSION: The subjects in the MONW group are characterized by a high risk of diabetes and CHD, despite their normal weights. Their substantial prevalence in the population emphasizes the importance of identifying subjects in the MONW group, and warrants more intensive risk management.
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Feminino , Humanos , Masculino , Índice de Massa Corporal , Estudos de Coortes , Doença das Coronárias , Homeostase , Resistência à Insulina , Doenças Metabólicas , Estado Pré-Diabético , Prevalência , Gestão de Riscos , Pesos e MedidasRESUMO
OBJECTIVES: Increasing evidence suggests the presence of neurobiological bases for temperamental characteristics in humans. Brain correlates of harm avoidance(HA) have been most extensively studied using functional and structural brain imaging methods due to its potential link with anxiety and depressive disorders. To date, however, we are not aware of any reports that have examined the potential relationship between HA levels and regional cortical thickness. The aim of the current study is to examine the cortical thickness which is associated with HA temperament in healthy young subjects. METHODS: Twenty-eight young, healthy individuals(13 men and 15 women, mean age, 29.4 +/- 6.3 years) were screened for eligibility and administered the Korean version of the Cloninger's Temperament and Character Inventory and underwent high-resolution structural magnetic resonance imaging scanning. RESULTS: HA was associated with cortical thickness in the right superior frontal cortex and in the left parietal cortex, adjusted for age and sex and corrected for multiple comparisons using the permutation testing method. CONCLUSION: Individual temperamental differences in HA are associated with structural variations in specific areas of the brain. The fact that these brain regions are involved in top-down modulations of subcortical fear reactions adds functional significance to current findings.