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Added Value of Chemical Exchange-Dependent Saturation Transfer MRI for the Diagnosis of Dementia

  • Jang-Hoon Oh;Bo Guem Choi;Hak Young Rhee;Jin San Lee;Kyung Mi Lee;Soonchan Park;Ah Rang Cho;Chang-Woo Ryu;Key Chung Park;Eui Jong Kim;Geon-Ho Jahng
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.770-781
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    • 2021
  • Objective: Chemical exchange-dependent saturation transfer (CEST) MRI is sensitive for detecting solid-like proteins and may detect changes in the levels of mobile proteins and peptides in tissues. The objective of this study was to evaluate the characteristics of chemical exchange proton pools using the CEST MRI technique in patients with dementia. Materials and Methods: Our institutional review board approved this cross-sectional prospective study and informed consent was obtained from all participants. This study included 41 subjects (19 with dementia and 22 without dementia). Complete CEST data of the brain were obtained using a three-dimensional gradient and spin-echo sequence to map CEST indices, such as amide, amine, hydroxyl, and magnetization transfer ratio asymmetry (MTRasym) values, using six-pool Lorentzian fitting. Statistical analyses of CEST indices were performed to evaluate group comparisons, their correlations with gray matter volume (GMV) and Mini-Mental State Examination (MMSE) scores, and receiver operating characteristic (ROC) curves. Results: Amine signals (0.029 for non-dementia, 0.046 for dementia, p = 0.011 at hippocampus) and MTRasym values at 3 ppm (0.748 for non-dementia, 1.138 for dementia, p = 0.022 at hippocampus), and 3.5 ppm (0.463 for non-dementia, 0.875 for dementia, p = 0.029 at hippocampus) were significantly higher in the dementia group than in the non-dementia group. Most CEST indices were not significantly correlated with GMV; however, except amide, most indices were significantly correlated with the MMSE scores. The classification power of most CEST indices was lower than that of GMV but adding one of the CEST indices in GMV improved the classification between the subject groups. The largest improvement was seen in the MTRasym values at 2 ppm in the anterior cingulate (area under the ROC curve = 0.981), with a sensitivity of 100 and a specificity of 90.91. Conclusion: CEST MRI potentially allows noninvasive image alterations in the Alzheimer's disease brain without injecting isotopes for monitoring different disease states and may provide a new imaging biomarker in the future.

The Effect of Lung Volume on the Size and Volume of Pulmonary Subsolid Nodules on CT: Intraindividual Comparison between Total Lung Capacity and Tidal Volume (전산화단층촬영에서 폐 반고형결절의 크기와 용적에 호흡이 미치는 영향: 개인 내 전폐용량과 일호흡량 간 비교)

  • Hyunji Lee;Chansik An;Seok Jong Ryu
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1534-1544
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    • 2021
  • Purpose To examine the effect of lung volume on the size and volume of pulmonary subsolid nodules (SSNs) measured on CT. Materials and Methods A total of 42 SSNs from 31 patients were included. CT examination was first performed at total lung capacity (TLC), and a section containing the nodule was additionally scanned at tidal volume (TV). The diameter and volume of each SSN, as well as the cross-sectional lung area containing the nodule, were measured. The significance of the changes in measurements between TLC and TV within the same individuals was evaluated. Results The lung area and the diameter and volume of SSNs decreased significantly at TV by 12.7 cm2, 0.5 mm, and 46.4 mm3 on average, respectively (p < 0.001), compared to those at TLC. Changes in lung area between TV and TLC were positively correlated with the change in SSN diameter (p = 0.027) and volume (p = 0.014). However, after correction (by considering the change in lung area), the changes in SSN diameter (p = 0.124) and volume (p = 0.062) were not significantly different. Conclusion SSN size and volume can be significantly affected by lung volume during CT scans of the same individuals.

Association between shift work and serum homocysteine level in female electronic manufacturing services workers

  • Jae Won Lim;Chan Woo Kim;Hyoung Ouk Park;Eui Yup Chung;Changho Chae;JunSeok Son;Young Hoo Shin;Seung Hyun Park;Sang Moon Choi
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.4.1-4.11
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    • 2023
  • Background: Shift work has been shown to increase the risk of cardiovascular disease (CVD) based on several evidences. The classic risk factors of CVD include age, hypertension, smoking, obesity and diabetes. Recently, the serum homocysteine level has been reported to be a valuable indicator of CVD risk. This study aimed to determine the variation in serum homocysteine level as a cardiovascular risk indicator among female workers according to shift work. Methods: The data of regular health examination of workers at an electronic manufacturing services company in Yeongnam region, South Korea in 2019 were examined in this study. The investigation was based on a cross-sectional study conducted on 697 female workers (199 day workers and 498 shift workers). The sociodemographic and biochemical characteristics were compared between day workers and shift workers. Through a logistic regression analysis, the odds ratio (OR) of the increased serum homocysteine level in relation to shift work was determined. Results: Compared to female day workers, female shift workers showed significantly higher level of serum homocysteine (8.85 ± 2.16 vs. 9.42 ± 2.04 μmol/mL; p = 0.001). The OR of day workers against shift workers was 1.81 (95% confidence interval [CI]: 1.25-2.63). With the adjustment of variables that may influence the level of serum homocysteine, the adjusted OR was 1.68 (95% CI: 1.09-2.60). Conclusions: The serum homocysteine level was significantly higher in shift workers than in day workers. It is thus likely to be a useful predictor of CVD in shift workers.

Intake of energy and macronutrients according to household income among elementary, middle, and high school students before and during the COVID-19 pandemic: a cross-sectional study (코로나19 팬데믹 전후 초·중·고등학생의 가구소득별 에너지 및 다량영양소 섭취: 국민건강영양조사 (2016-2022) 자료 활용)

  • Chae-Eun Jeong;Heejin Lee;Jung Eun Lee
    • Korean Journal of Community Nutrition
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    • v.29 no.3
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    • pp.234-252
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    • 2024
  • Objectives: This study examined the intake of energy and macronutrients among elementary, middle, and high school students according to household income before the COVID-19 pandemic (2016-2019), during the social distancing period (2020-2021), and after the social distancing measures were lifted (2022). Methods: We included 5,217 students aged 5-18 from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2016 and 2022. Dietary intake was assessed using one-day 24-hour dietary recalls. We estimated the least squares means (LS-means) of intake according to household income for each period using a weighted linear regression model, adjusted for age and sex. Differences in LS-means between the periods were analyzed using the t-test. Results: During the social distancing period, the LS-means of energy intake among students decreased significantly by 143.2 kcal/day compared to pre-pandemic levels (P < 0.001). Students from low-income households experienced a more pronounced decrease in energy intake (-379.1 kcal/day, P < 0.001) and macronutrient intake compared to those from other income groups. Energy intake at school significantly declined for all income groups during the social distancing period compared to before the pandemic. No significant changes in home energy intake were observed among low-income students, whereas there was an increase for students from higher-income groups. Before the pandemic, 8.5% of students from low-income households reported insufficient food due to economic difficulties; this figure rose to 21.3% during the pandemic. Conclusions: During the pandemic, students from low-income families experienced significantly lower intake of energy and macronutrients compared to pre-pandemic levels. The most substantial reductions were noted among low-income students, largely due to the lack of compensation for decreased school-based intake with increased intake at home.

Suggestion of Learning Objectives in Social Dental Hygiene: Oral Health Administration Area (사회치위생학의 학습목표 제안: 구강보건행정 영역)

  • Park, Su-Kyung;Lee, Ga-Yeong;Jang, Young-Eun;Yoo, Sang-Hee;Kim, Yeun-Ju;Lee, Sue-Hyang;Kim, Han-Nah;Jo, Hye-Won;Kim, Myoung-Hee;Kim, Hee-Kyoung;Ryu, Da-Young;Kim, Min-Ji;Shin, Sun-Jung;Kim, Nam-Hee;Yoon, Mi-Sook
    • Journal of dental hygiene science
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    • v.18 no.2
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    • pp.85-96
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    • 2018
  • The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into 'dental hygiene job relevance', 'dental hygiene competency relevance', 'timeliness', and 'value discrimination of educational goal setting' to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.

Study on Glomerular Filtration Rate comparison according to renal depth measurement of kidney donors (신 공여자에서 신장 깊이 측정에 따른 사구체여과율의 비교에 관한 고찰)

  • Lee, Han Wool;Park, Min Soo;Kang, Chun Goo;Cho, Seok Won;Kim, Joo Yeon;Kwon, O Jun;Lim, Han Sang;Kim, Jae Sam;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.48-56
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    • 2014
  • Purpose $^{99m}Tc$-DTPA renal scintigraphy serves as a key indicator to measure a kidney donor's Glomerular Filtration Rate (GFR) and determine the possibility of kidney transplant. The Gates method utilized to measure GFR considers 3 variables of renal depth, injection dose, and net kidney counts. In this research, we seek to compare changes in kidney donors' GFR according to renal depth measurement methods of the 3 variables. Materials and Methods We investigated 32 kidney donors who had visited the hospital from October, 2013 to March, 2014 and received abdominal CT and $^{99m}Tc$-DTPA GFR examination. With the cross-section image of the CT and the lateral image from a gamma camera, we measured the renal depth and compared with renal depth calculation equations-Tonnesen, Taylor, and Itoh methods. Renal depth-specific GFR was calculated by using Xeleris Ver. 2.1220 of GE. Then the results were compared with MDRD (Modification of Diet Renal Disease) GFRs based on serum creatinine level. Results The renal depths measured based on the CT and gamma camera images showed high correlation. Tonessen equation gave the lowest GFR value while the value calculated by using the renal depth of CT image was the highest with a 16.62% gap. MDRD GFR showed no statistically significant difference among values calculated through Taylor, Itoh, CT and gamma camera renal depth application (P>0.05), but exhibited a statistically significant change in the value based on Tonnesen equation (P<0.05). Conclusion This research has found that, in GFR evaluation in kidney donors by utilizing $^{99m}Tc$-DTPA, Tonnesen equation-based Gates method underestimated the value than the MDRD GFR. Therefore, if a MDRD GFR value shows a huge difference from the actual examination value, using an image-based renal depth measurement, instead of Tonnesen equation applied to Gates method, is expected to give an accurate GFR value to kidney donors.

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Flavonoid intake according to food security in Korean adults: Based on the Korea National Health and Nutrition Examination Survey 2007~2012 (한국 성인의 식품안정성에 따른 플라보노이드 섭취 실태: 2007~2012년 국민건강 영양조사 자료를 이용하여)

  • Jun, Shinyoung;Hong, Eunju;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.507-518
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    • 2015
  • Purpose: The aim of this study was to examine the association of food security with the total and individual flavonoid intakes among Korean adults. Methods: Study subjects were 13,454 men and 19,563 women aged 19 years and older who participated in the 2007~2012 Korea National Health and Nutrition Examination Survey. Subjects were classified into food-secure and food-insecure groups using the answers to a self-reported question on food sufficiency of subjects' household. The total and individual flavonoid intakes were calculated by linking 24-h dietary recall data of subjects with a flavonoid database. Mean differences in dietary outcomes by food security status, and major food sources of total flavonoids were examined. Results: In this cross-sectional study, 5.8% of male adults and 6.6% of female adults were in food insecure households. Mean daily intakes of total flavonoids, flavonols, flavones, flavanones, flavan-3-ols, isoflavones, and proanthocyanidins were significantly lower in food-insecure groups than food-secure groups among both male and female adults. The differences were maintained in total flavonoids, flavones, flavanones, and flavan-3-ols after adjusting for total energy intake. Mean intakes of fruits and vegetables were significantly lower in food-insecure groups and the total flavonoid intake from fruits and vegetables was also significantly lower in food-insecure groups. The major food sources of total flavonoids were apples (20.7%), mandarines (12.0%), and tofu (11.5%) in the food-secure group, and apples (14.9%), tofu (13.3%), and mandarines (12.6%) in the food-insecure group. Conclusion: This study showed that food insecurity was associated with lower intakes of flavonoids and reduced intakes of fruits and vegetables in a representative Korean population.

Health Assessment of Shift Workers in a Automobile Manufacturing Plant (자동차공장 교대작업 근로자들의 건강상태평가)

  • Lee, Jung-Jeung;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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    • pp.103-121
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    • 1995
  • An investigation on psychophysiological health and social well-being of shift workers been carried out on workers of a automobile manufacturing plant in Ulsan, for 1 month from April, 1993. This cross-sectional survey compared shift workers(n=544) with day workers(n=115). Each subject completed a questionnaire about his personal habit, background, shift schedule, sleep and eating patterns, subjective digestive symptom and psychological well-being and distress using the General Well-Being Schedule(GWB) by self administrated questionnaire that was developed for the U.S. Health and Nutrition Examination Surveys (HANES I). Chi-square analysis was used for discontinuous data and the t-test was used for continous data to determine whether differences noted between the two groups. In terms of sleep quality, a greater percentage of shift workers frequently had trouble getting back to sleep once awakend(p<0.01), and a greater percentage of shift workers awakend tired or sleepy frequently more often than day workers(p<0.05). In rating the quality of their sleep, more shift workers rated their sleep fair to poor than day workers, and greater percentage of shift workers felt tired or sleepy at work two or more times per week(p<0.01) and a much higher percentage of shift workers felt tired or sleepy after work every days(p<0.01). In terms of sleep patterns, a much higher percentage of day workers reported uninterrupted sleep per 24hours than shift workers. The shift workers reported different eating patterns from day workers but there were no statistically significant and rate of their appetite. Thirteen percent of day workers reported the best appetite but only 6.6% of shift workers had the best appetite. The gastric complaints is more frequent in shift workers than day workers(p<0.01). Among subscores in General Well-Being Schedule, anxiety, depression, positive well-being and vitality subscale of shift workers were lower than those of day workers(p<0.05) and general health and self control subscale of shift workers were lower than .those of day workers but there were no statistical significant difference. Based on these study result, it could be concluded that the shift work has significant effects on some psychophysiological conditions of the workers.

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Comparison of the mental health, metabolic syndrome and nutrient intake by Gender in Problem drinkers ; Based on The Fifth(2010-2012) Korean National Health and Nutrition Examination Survey (성별에 따른 문제음주자의 정신건강, 대사증후군과 영양소 섭취; 제 5기(2010-2012) 국민건강 영양조사를 중심으로)

  • Choi, Young -Sil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5159-5168
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    • 2014
  • The study examined the relationship among metal health, metabolic syndrome and nutrient acceptance according to gender. Implemented until 2010-2012, the 5th Korean National Health and Nutrition Examination Survey, as an original document, was used for the study. The target was problem drinkers with more than 12 points under AUDIT. Regarding mental health, it was classified into stress, depression and suicidal impulse. Metabolic syndrome was defined when three causes of BMI, waist circumference, FBS, HDL and BP were out of the normal range. The nutrient intake was obtained to confirm the energy intake of nine non-nutrients (Nutrient adequacy ratio: NAR) and the proper intake of the average non-nutrient (Mean adequacy ratio: MAR). These variables were analyzed by frequency, cross analysis and multiple regression analysis through SPSS18.0. In the general features, there was a significant difference according to age, occupation and marital status. In mental health, stress, depression and suicidal impulse were examined. Metabolic syndrome was dependant on FBS, HDL and BP. The nutrient acceptance depended on calcium, vitamin A, thiamine, riboflavin, niacin, vitamin C, and MAR. Logistic regression analysis performed on the variables showed significant differences. Stress, depression, and thoughts of suicide was significantly higher in men aged 19-29 years, and women aged 30-49 years. In the case of the male, those who employed have metabolic syndrome more than those who unemployed. In terms of female, those who were belonged into the middle - low economic level have undergone with metabolic syndrome. In the part of a Mean adequacy ratio(MAR), the male who unmarried, employed, were in the middle low economic levelwere higher. In the case of the female, it was higher for those who were in the middle - low economic level. Overall, an effective way of planning the solution regarding mental health, metabolic syndrome and nutrient intake can be found by considering these features.

Relationship among practicing healthy diet and metabolic syndrome indicators in adults - From the Korea National Health and Nutrition Examination Survey, 2013~2014 (성인 남녀에서 건강식생활 실천 여부와 대사증후군 지표와의 관련성 연구 : 2013~2014 국민건강영양조사 자료를 이용하여)

  • Bae, Yun-Jung
    • Journal of Nutrition and Health
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    • v.49 no.6
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    • pp.459-470
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    • 2016
  • Purpose: The purpose of the present study is to identify the relationship between practicing healthy diet and metabolic syndrome indicators in Koreans. Methods: This research is a cross-sectional study based on the 2013~2014 Korea National Health and Nutritional Examination Survey. This study investigated 6,748 adults aged 19 to 64 yr (19~49 yr: n = 4,230, 50~64 yr: n = 2,518) to examine practice of healthy diet and metabolic syndrome indicators. In this study, according to practicing healthy diet, we classified subjects into the "Practicing healthy diet (PHD)" group (19~49 yr: n = 1,782, 50~64 yr: n = 937) and "Non-practicing healthy diet (NPHD)" group (19~49 yr: n = 2,448, 50~64 yr: n = 1,581). PHD score was determined by adding the number of practicing factors: adequate fat intake, sodium intake ${\leq}2,000mg/day$, fruit & vegetable intake ${\geq}500g/day$, and using nutrition label information in food selection. Results: Female adults had a larger proportion of subjects who practiced a healthy diet compared to male adults (p < 0.001), and the percentages of 19~49 yr and 50~64 yr were 40.46% and 37.07%, respectively. The PHD group consumed significantly more calcium, vitamin $B_1$, $B_2$, and vitamin C density compared to the NPHD group. In 50~64 yr females, the subjects practicing healthy diet (PHD score ${\geq}2$) was inversely associated with risk of abdominal obesity (OR: 0.71, 95% CI: 0.54~0.93, p value = 0.0131) and metabolic syndrome (OR: 0.70, 95% CI: 0.52~0.94, p value = 0.0166) after adjustments for multiple confounding factors, compared with the lower PHD score (PHD score ${\leq}1$). Conclusion: Good dietary practice such as adequate fat intake, sodium intake ${\leq}2,000mg/day$, sufficient fruit & vegetable intake, and using nutrition label information in food selection could be useful in decreasing metabolic syndrome risk of Korean adults.