Publications by authors named "Yoon Ho Choi"

120 Publications

The relationship between breast density change during menopause and the risk of breast cancer in Korean women.

Cancer Prev Res (Phila) 2021 Sep 10. Epub 2021 Sep 10.

Health Promotion Center, Samsung Medical Center

Background: The aim of this study was to investigate the relationship between changes in breast density during menopause and breast cancer (BC) risk.

Methods: This study was a retrospective, longitudinal cohort study for women over 30 years of age who had undergone breast mammography serially at baseline and postmenopause during regular health checkups at Samsung Medical Center. None of the participants had been diagnosed with BC at baseline. Mammographic breast density was measured using the American College of Radiology Breast Imaging Reporting and Data System.

Results: During 18,615 person-years of follow-up (median follow-up 4.8 years; interquartile range 2.8-7.5 years), 45 participants were diagnosed with BC. The prevalence of dense breasts was higher in those who were younger, underweight, had low parity or using contraceptives. The cumulative incidence of BC increased 4 years after menopause in participants, and the consistently extremely dense group had a significantly higher cumulative incidence (CI) of BC compared with other groups (CI of extremely dense vs. others [incidence rate per 100,000 person-years]: 375 vs. 203, p<0.01).

Conclusion: Korean women whose breast density was extremely dense before menopause and who maintained this density after menopause were at two-fold greater risk of BC.
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http://dx.doi.org/10.1158/1940-6207.CAPR-20-0542DOI Listing
September 2021

COVID-19 Vaccination-Associated Lymphadenopathy on FDG PET/CT: Distinctive Features in Adenovirus-Vectored Vaccine.

Clin Nucl Med 2021 Oct;46(10):814-819

From the Department of Nuclear Medicine.

Purpose: This study investigated 18F-FDG PET/CT features of adenovirus-vectored vaccination against COVID-19 in healthy subjects.

Patients And Methods: Thirty-one health care workers had been vaccinated Vaxzevria and underwent FDG PET/CT as an optional test for a cancer screening program. Size and FDG uptake of the hypermetabolic lymph nodes were measured. Uptake value of spleen was also measured with liver for comparison.

Results: All examinees who underwent FDG PET/CT within 14 days' interval showed hypermetabolic lymphadenopathies ipsilateral to vaccine injection. All examinees with hypermetabolic lymphadenopathy had simultaneous muscular uptakes until 23 days' interval. Among 12 examinees who underwent FDG PET/CT more than 15 days after vaccination, only 3 male examinees did not show hypermetabolism in the axillary lymph nodes. There was no female examinee with negative hypermetabolic lymphadenopathy until 29 days after vaccination.

Conclusions: Hypermetabolic reactive lymphadenopathy in the ipsilateral axillary area with or without supraclavicular area is most likely to occur in a healthy person with recent adenovirus-vectored COVID-19 vaccination on FDG PET/CT.
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http://dx.doi.org/10.1097/RLU.0000000000003800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411598PMC
October 2021

Deep learning for detection and segmentation of artefact and disease instances in gastrointestinal endoscopy.

Med Image Anal 2021 05 17;70:102002. Epub 2021 Feb 17.

Instituto Onclologico Veneto, IOV-IRCCS, Padova, Italy.

The Endoscopy Computer Vision Challenge (EndoCV) is a crowd-sourcing initiative to address eminent problems in developing reliable computer aided detection and diagnosis endoscopy systems and suggest a pathway for clinical translation of technologies. Whilst endoscopy is a widely used diagnostic and treatment tool for hollow-organs, there are several core challenges often faced by endoscopists, mainly: 1) presence of multi-class artefacts that hinder their visual interpretation, and 2) difficulty in identifying subtle precancerous precursors and cancer abnormalities. Artefacts often affect the robustness of deep learning methods applied to the gastrointestinal tract organs as they can be confused with tissue of interest. EndoCV2020 challenges are designed to address research questions in these remits. In this paper, we present a summary of methods developed by the top 17 teams and provide an objective comparison of state-of-the-art methods and methods designed by the participants for two sub-challenges: i) artefact detection and segmentation (EAD2020), and ii) disease detection and segmentation (EDD2020). Multi-center, multi-organ, multi-class, and multi-modal clinical endoscopy datasets were compiled for both EAD2020 and EDD2020 sub-challenges. The out-of-sample generalization ability of detection algorithms was also evaluated. Whilst most teams focused on accuracy improvements, only a few methods hold credibility for clinical usability. The best performing teams provided solutions to tackle class imbalance, and variabilities in size, origin, modality and occurrences by exploring data augmentation, data fusion, and optimal class thresholding techniques.
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http://dx.doi.org/10.1016/j.media.2021.102002DOI Listing
May 2021

Enhancement in external quantum efficiency of AlGaInP red μ-LED using chemical solution treatment process.

Sci Rep 2021 Feb 25;11(1):4535. Epub 2021 Feb 25.

Department of Materials Science and Engineering, The University of Texas at Dallas, 800 W Campbell Rd., Richardson, TX, 75080, USA.

To investigate the effects of their surface recovery and optical properties, extremely small sized (12 µm × 12 µm mesa area) red AlGaInP micro light emitting diodes ([Formula: see text] LED) were fabricated using a diluted hydrofluoric acid (HF) surface etch treatment. After the chemical treatment, the external quantum efficiencies (EQEs) of [Formula: see text]-LED at low and high injection current regions have been improved by 35.48% and 12.86%, respectively. The different phenomena of EQEs have a complex relationship between the suppression of non-radiative recombination originating from the etching damage of the surface and the improvement of light extraction of the sidewalls. The constant enhancement of EQE at a high injection current it is attributed to the expansion of the active region's sidewall surface area by the selective etching of AlInP layers. The improved EQE at a low injection current is related to the minimization of the surface recombination caused by plasma damage from the surface. High-resolution transmission electron microscopy (HR-TEM) revealed physical defects on the sidewall surface, such as plasma-induced lattice disorder and impurity contamination damage, were eliminated using chemical treatment. This study suggests that chemical surface treatment using diluted HF acid can be an effective method for enhancing the [Formula: see text]-LED performance.
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http://dx.doi.org/10.1038/s41598-021-83933-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907351PMC
February 2021

Robust Indoor Localization Methods Using Random Forest-Based Filter against MAC Spoofing Attack.

Sensors (Basel) 2020 Nov 26;20(23). Epub 2020 Nov 26.

School of Computer Science and Engineering, Pusan National University, Busan KS012, Korea.

With the development of wireless networks and mobile devices, interest on indoor localization systems (ILSs) has increased. In particular, Wi-Fi-based ILSs are widely used because of the good prediction accuracy without additional hardware. However, as the prediction accuracy decreases in environments with natural noise, some studies were conducted to remove it. So far, two representative methods, i.e., the filtering-based method and deep learning-based method, have shown a significant effect in removing natural noise. However, the prediction accuracy of these methods severely decreased under artificial noise caused by adversaries. In this paper, we introduce a new media access control (MAC) spoofing attack scenario injecting artificial noise, where the prediction accuracy of Wi-Fi-based indoor localization system significantly decreases. We also propose a new deep learning-based indoor localization method using random forest(RF)-filter to provide the good prediction accuracy under the new MAC spoofing attack scenario. From the experimental results, we show that the proposed indoor localization method provides much higher prediction accuracy than the previous methods in environments with artificial noise.
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http://dx.doi.org/10.3390/s20236756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730504PMC
November 2020

Proton pump inhibitors use and the risk of fatty liver disease: A nationwide cohort study.

J Gastroenterol Hepatol 2021 May 22;36(5):1235-1243. Epub 2020 Oct 22.

Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.

Background And Aim: Proton pump inhibitor (PPI)-induced hypochondria can change the composition of the gut microbiota, inducing overgrowth of small bowel bacteria, which has been suggested to promote the development of fatty liver disease through the gut-liver axis. In this study, we aimed to investigate the association between PPI use and the risk of fatty liver disease.

Methods: A retrospective cohort study was conducted using the Korean National Health Insurance Service-National Sample Cohort, a nationwide population-based representative sample, from January 1, 2002, to December 31, 2015. PPI use was identified from treatment claims and considered as a time-varying variable.

Results: During 1 463 556 person-years of follow-up, 75 727 patients had at least one PPI prescription, and 3735 patients developed fatty liver disease. The hazard ratio for fatty liver disease comparing PPI users with non-PPI users was 1.68 (95% confidence interval, 1.61-1.75). When adjusted for multiple confounders, including age, sex, body mass index, smoking, alcohol intake, exercise, income level, and comorbidities, the association was still significant (hazard ratio, 1.50; 95% confidence interval, 1.44-1.57). After considering the amounts of PPIs stratified by cumulative defined daily dose, the dose-response effect was observed until 180 days. Subgroup analysis also revealed that PPI use was correlated to an increased risk of fatty liver disease.

Conclusions: This current national wide cohort study suggests that PPI use was associated with an increased risk of fatty liver disease compared with non-use of PPIs. Clinicians should consider fatty liver as a potential risk when prescribing PPI.
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http://dx.doi.org/10.1111/jgh.15236DOI Listing
May 2021

Secure and Blockchain-Based Emergency Driven Message Protocol for 5G Enabled Vehicular Edge Computing.

Sensors (Basel) 2019 Dec 25;20(1). Epub 2019 Dec 25.

School of Computer Science and Engineering, Pusan National University, Busan 46241, Korea.

Basic safety message (BSM) are messages that contain core elements of a vehicle such as vehicle's size, position, speed, acceleration and others. BSM are lightweight messages that can be regularly broadcast by the vehicles to enable a variety of applications. On the other hand, event-driven message (EDM) are messages generated at the time of occurrence such as accidents or roads sliding and can contain much more heavy elements including pictures, audio or videos. Security, architecture and communication solutions for BSM use cases have been largely documented on in the literature contrary to EDM due to several concerns such as the variant size of EDM, the appropriate architecture along with latency, privacy and security. In this paper, we propose a secure and blockchain based EDM protocol for 5G enabled vehicular edge computing. To offer scalability and latency for the proposed scenario, we adopt a 5G cellular architecture due to its projected features compared to 4G tong-term evaluation (LTE) for vehicular communications. We consider edge computing to provide local processing of EDM that can improve the response time of public agencies (ambulances or rescue teams) that may intervene to the scene. We make use of lightweight multi-receiver signcryption scheme without pairing that offers low time consuming operations, security, privacy and access control. EDM records need to be kept into a distributed system which can guarantee reliability and auditability of EDM. To achieve this, we construct a private blockchain based on the edge nodes to store EDM records. The performance analysis of the proposed protocol confirms its efficiency.
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http://dx.doi.org/10.3390/s20010154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6983214PMC
December 2019

IDRiD: Diabetic Retinopathy - Segmentation and Grading Challenge.

Med Image Anal 2020 01 3;59:101561. Epub 2019 Oct 3.

Individual Researcher, India.

Diabetic Retinopathy (DR) is the most common cause of avoidable vision loss, predominantly affecting the working-age population across the globe. Screening for DR, coupled with timely consultation and treatment, is a globally trusted policy to avoid vision loss. However, implementation of DR screening programs is challenging due to the scarcity of medical professionals able to screen a growing global diabetic population at risk for DR. Computer-aided disease diagnosis in retinal image analysis could provide a sustainable approach for such large-scale screening effort. The recent scientific advances in computing capacity and machine learning approaches provide an avenue for biomedical scientists to reach this goal. Aiming to advance the state-of-the-art in automatic DR diagnosis, a grand challenge on "Diabetic Retinopathy - Segmentation and Grading" was organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI - 2018). In this paper, we report the set-up and results of this challenge that is primarily based on Indian Diabetic Retinopathy Image Dataset (IDRiD). There were three principal sub-challenges: lesion segmentation, disease severity grading, and localization of retinal landmarks and segmentation. These multiple tasks in this challenge allow to test the generalizability of algorithms, and this is what makes it different from existing ones. It received a positive response from the scientific community with 148 submissions from 495 registrations effectively entered in this challenge. This paper outlines the challenge, its organization, the dataset used, evaluation methods and results of top-performing participating solutions. The top-performing approaches utilized a blend of clinical information, data augmentation, and an ensemble of models. These findings have the potential to enable new developments in retinal image analysis and image-based DR screening in particular.
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http://dx.doi.org/10.1016/j.media.2019.101561DOI Listing
January 2020

Software-Defined Network-Based Vehicular Networks: A Position Paper on Their Modeling and Implementation.

Sensors (Basel) 2019 Aug 31;19(17). Epub 2019 Aug 31.

Department of Computer Engineering, Dong-Eui University, Busan 614-714, Korea.

There is a strong devotion in the automotive industry to be part of a wider progression towards the Fifth Generation (5G) era. In-vehicle integration costs between cellular and vehicle-to-vehicle networks using Dedicated Short Range Communication could be avoided by adopting Cellular Vehicle-to-Everything (C-V2X) technology with the possibility to re-use the existing mobile network infrastructure. More and more, with the emergence of Software Defined Networks, the flexibility and the programmability of the network have not only impacted the design of new vehicular network architectures but also the implementation of V2X services in future intelligent transportation systems. In this paper, we define the concepts that help evaluate software-defined-based vehicular network systems in the literature based on their modeling and implementation schemes. We first overview the current studies available in the literature on C-V2X technology in support of V2X applications. We then present the different architectures and their underlying system models for LTE-V2X communications. We later describe the key ideas of software-defined networks and their concepts for V2X services. Lastly, we provide a comparative analysis of existing SDN-based vehicular network system grouped according to their modeling and simulation concepts. We provide a discussion and highlight vehicular ad-hoc networks' challenges handled by SDN-based vehicular networks.
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http://dx.doi.org/10.3390/s19173788DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749579PMC
August 2019

Risk of comorbid cardiovascular disease in Korean long-term cancer survivors.

Eur J Cancer Care (Engl) 2019 Nov 21;28(6):e13151. Epub 2019 Aug 21.

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Background: Cardiovascular disease (CVD) is a common cause of death in cancer survivors. We evaluated the risk of comorbid CVD in long-term cancer survivors according to specific cancer site.

Methods: Study subjects included 47,171 Koreans aged over 40 years who visited a health promotion centre between 2010 and 2012. Information on CVD and cancer was obtained from self-report. Comorbid CVD was defined as stroke, myocardial infarction or angina pectoris. The risk of comorbid CVD in survivors was compared with that in non-cancer subjects using multiple logistic regression analysis.

Results: Among cancer survivors (n = 3,753), 330 events of CVD were reported. Age- and sex-adjusted analysis showed that odds ratio (OR) for comorbid CVD in survivors was 1.52 (95% confidence interval: 1.34-1.72) compared to non-cancer subjects (n = 43,418). After adjusting for health-related behaviour and medical history, only lung cancer survivors had 2.44 (1.01-5.89)-fold higher OR for CVD. In stratified analysis, significantly higher OR for CVD was evident in lung cancer survivors with hypertension who did not perform regular physical exercise.

Conclusions: Adult cancer survivors may have an increased risk of comorbid CVD that might be mediated in part by known cardiovascular risk factors depending on the specific cancer site.
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http://dx.doi.org/10.1111/ecc.13151DOI Listing
November 2019

Lack of Association between Past Infection and Diabetes: A Two-Cohort Study.

Nutrients 2019 Aug 12;11(8). Epub 2019 Aug 12.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.

() may be involved in diabetes and other insulin-related processes. This study aimed to investigate the associations between infection and the risks of type 2 diabetes, impaired glucose tolerance (IGT), diabetic nephropathy, and poor glycemic control. We retrospectively evaluated 16,091 subjects without diabetes at baseline who underwent repeated health examinations. Subjects were categorized according to whether they were seropositive and seronegative for infection. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models. The serological results were validated using an independent cohort ( = 42,351) based on a histological diagnosis of infection. During 108,614 person-years of follow-up, 1338 subjects (8.3%) developed newly diagnosed diabetes, although the cumulative incidence of diabetes was not significantly related to serological status. The multivariate Cox proportional-hazards regression models revealed that seropositivity was not significantly associated with diabetes (HR: 1.01, 95% CI: 0.88-1.16; = 0.854), IGT (HR: 0.98, 95% CI: 0.93-1.04; = 0.566), diabetic nephropathy (HR: 0.99, 95% CI: 0.82-1.21; = 0.952), or poor glycemic control (HR: 1.05, 95% CI: 0.90-1.22; = 0.535). Similarly, histopathological findings of infection were not significantly associated with diabetes ( = 0.311), diabetic nephropathy ( = 0.888), or poor glycemic control ( = 0.989). The findings from these large Korean cohorts indicate that there does not appear to be a role for past infection in the development of diabetes, IGT, diabetic nephropathy, or poor glycemic control.
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http://dx.doi.org/10.3390/nu11081874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723734PMC
August 2019

Synergistic alveolar bone resorption by diabetic advanced glycation end products and mechanical forces.

J Periodontol 2019 12 3;90(12):1457-1469. Epub 2019 Aug 3.

Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, South Korea.

Background: The association between diabetes mellitus (DM) and bone diseases is acknowledged. However, the mechanistic pathways leading to the alveolar bone (AB) destruction remain unclear. This study aims to elucidate the mechanical forces (MF)-induced AB destruction in DM and its underlying mechanism.

Methods: In vivo periodontal tissue responses to MF were evaluated in rats with diabetes. In vitro human periodontal ligament (PDL) cells were either treated with advanced glycation end products (AGEs) alone or with AGEs and MF.

Results: In vivo, the transcription of VEGF-A, colony stimulating factor-1 (CSF-1), and Ager was upregulated in diabetes, whereas changes in DDOST and Glo1 mRNAs were negligible. DM induced VEGF-A protein in the vascular cells of the PDL and subsequent angiogenesis, but DM itself did not induce osteoclastogenesis. MF-induced AB resorption was augmented in DM, and such augmentation was morphologically substantiated by the occasional undermining resorption as well as the frontal resorption of the AB by osteoclasts. The mRNA levels of CSF-1 and vascular endothelial growth factor (VEGF) during MF application were highly elevated in diabetes, compared with those of the normal counterparts. In vitro, AGEs treatment elevated Glut-1 and CSF-1 mRNA levels via the p38 and JNK pathways, whereas OGT and VEGF levels remained unchanged. Compressive MF especially caused upregulation of VEGF, CSF-1, and Glut-1 levels, and such upregulation was further enhanced by AGEs treatment.

Conclusions: Overloaded MF and AGEs metabolites may synergistically aggravate AB destruction by upregulating CSF-1 and VEGF. Therefore, regulating the compressive overloading of teeth, as well as the levels of diabetic AGEs, may prove to be an effective therapeutic modality for managing DM-induced AB destruction.
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http://dx.doi.org/10.1002/JPER.18-0453DOI Listing
December 2019

Obesity and Risk of Peptic Ulcer Disease: A Large-Scale Health Check-Up Cohort Study.

Nutrients 2019 Jun 6;11(6). Epub 2019 Jun 6.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

The association between obesity and peptic ulcer disease (PUD) is inconclusive. To evaluate the association of obesity and metabolically healthy obesity (MHO) with PUD risk, we performed a retrospective cohort study of 32,472 subjects without PUD at baseline who underwent repeated health examinations. Participants were stratified by body mass index (BMI) and metabolically healthy state. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard modelling. During the follow-up period, 1940 PUD cases occurred. PUD, particularly gastric ulcer (GU), had significantly higher cumulative incidence in obese subjects compared to non-obese subjects ( value < 0.001). The HR for developing GU was 1.32 (95% CI, 1.16-1.49; value <0.001); after adjusting for confounding factors (lifestyle, metabolic, and status), the association was no more significant ( value = 0.789). For duodenal ulcer (DU), cumulative incidence between obese and non-obese groups was not significantly different ( value = 0.464). The risk of developing DU in the obese group was not significantly different from the non-obese group (HR 0.95; 95% CI, 0.83-1.09; value = 0.469) and consistently showed no association after adjusting for metabolic parameters ( value = 0.199). Furthermore, MHO subjects had no increase in GU or DU risks. In this large cohort study, PUD risk was not associated with obesity or MHO.
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http://dx.doi.org/10.3390/nu11061288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627340PMC
June 2019

Effect of age on the clinical outcomes of patients with early gastric cancer with undifferentiated-type histology.

Surgery 2019 04 11;165(4):802-807. Epub 2018 Dec 11.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Undifferentiated-type early gastric cancers account for a large proportion of gastric cancers in younger patients. Therefore, the clinical outcomes of endoscopic resection in younger patients are a major concern. We aimed to investigate the influence of age on lymph node metastasis and long-term survival after surgery for undifferentiated-type early gastric cancers.

Methods: We identified 4,236 patients who underwent surgery for undifferentiated-type early gastric cancers. For each T stage, the correlation between age and lymph node metastasis was analyzed using a multivariate logistic regression. Lymph node metastasis rates were compared between younger (<40 years) and older patients (≥40 years) who fulfilled the expanded criteria for endoscopic resection. The Kaplan-Meier method was used to compare long-term survival between younger and older patients.

Results: Younger age groups (20-29 and 30-39 years) had the highest lymph node metastasis rate within each T stage (5.7% and 5.7% for T1a, 26.3% and 24.1% for T1b, respectively). After adjusting for possible covariates, however, age did not have a significant effect on lymph node metastasis in either T stage (P = .127 for T1a, P = .114 for T1b). Among patients fulfilling the expanded indication for endoscopic resection, younger patients had a slightly higher lymph node metastasis rate compared with older patients (2.7% versus 2.0%), although this difference was not statistically significant. Although younger patients had a significantly better overall survival (P < .001), no significant age-related differences were observed in recurrence-free and disease-specific survival (P = .051 and P = .069) CONCLUSION: Endoscopic resection may be feasible in young patients with undifferentiated-type early gastric cancers because these patients share a similar lymph node metastasis rate and long-term survival outcomes with older patients.
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http://dx.doi.org/10.1016/j.surg.2018.11.001DOI Listing
April 2019

Relation of Exercise Heart Rate Recovery to Predict Cardiometabolic Syndrome in Men.

Am J Cardiol 2019 02 24;123(4):582-587. Epub 2018 Nov 24.

Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health, Royal Oak, Michigan.

We examined the hypothesis that delayed heart rate recovery (HRR) after exercise testing, an estimate of decreased autonomic function, predicts the risk of cardiometabolic syndrome (MetS) and is associated with continuous MetS risk scores in healthy men. Participants were 2,740 men who underwent general health examinations and had no evidence of MetS, cardiovascular diseases, diabetes, and hypertension at baseline. Baseline HRR was calculated as the difference between peak heart rate attained during exercise testing and the heart rate at 1 (HRR 1) and 2 minutes (HRR 2) after test termination. Incident MetS was defined as participants having ≥3 MetS components, and continuous MetS risk score was computed as the sum of z-score of 5 risk factors at follow-up. The incidence of MetS was 61/1,000 person-years during an average follow-up of 5 years. The relative risks and 95% confidence interval (CI) of incident MetS in the lowest quartiles of HRR 1 and HRR 2 versus the highest quartile were 1.24 (95% CI 1.02 to 1.51) and 2.02 (95% CI 1.58 to 2.60), respectively, after adjusting for potential confounders, including peak oxygen uptake and resting heart rate. HRR 1 (ß = -0.052, p = 0.005) and HRR 2 (ß = -0.058, p = 0.009) were independently associated with clustered MetS risk scores after adjusting for covariates. In conclusion, the independent association between delayed HRR after exercise testing and incident MetS and continuous MetS risk scores suggests that decreased autonomic function may be considered as a parameter to predict the future likelihood of MetS.
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http://dx.doi.org/10.1016/j.amjcard.2018.11.017DOI Listing
February 2019

The association between inflammatory markers and general psychological distress symptoms.

Gen Hosp Psychiatry 2019 Jan - Feb;56:9-12. Epub 2018 Nov 16.

Dept. of Psychiatry, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Center for Health Promotion, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:

Objective: This study explored the association between low-grade inflammation measured using multiple common inflammatory markers and general psychological distress symptoms.

Method: A total of 68,463 Korean adults were included. White blood cell counts with differential count, fibrinogen, C-reactive protein (CRP), ferritin and rheumatoid factor were measured. General psychological distress symptoms were assessed using 18 questions of psychosocial well-being index short form (PWI-SF).

Results: Among the eight inflammatory markers measured, WBC count, segmented neutrophil count, monocyte and CRP level were significantly and independently associated with broad psychological symptoms. In contrast, fibrinogen and ferritin showed a weak association with limited number of items. No significant association was detected with lymphocyte and RF.

Conclusion: General psychological distress symptoms were associated with multiple inflammatory markers in Korean adults. The association patterns differed by the types of inflammatory markers. Additional investigation into the relationship between general inflammatory markers and diverse psychological distress symptoms is warranted.
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http://dx.doi.org/10.1016/j.genhosppsych.2018.11.002DOI Listing
May 2019

An Enhanced Map-Matching Algorithm for Real-Time Position Accuracy Improvement with a Low-Cost GPS Receiver.

Sensors (Basel) 2018 Nov 8;18(11). Epub 2018 Nov 8.

Department of Electronic Engineering, Kyonggi University, Suwon 16227, Kyonggi-Do, Korea.

This paper proposes a real-time position accuracy improvement method for a low-cost global positioning system (GPS), which uses geographic data for forming a digital road database in the digital map information. We link the vehicle's location to the position on the digital map using the map-matching algorithm to improve the position accuracy. In the proposed method, we can distinguish the vehicle direction on the road and enhance the horizontal accuracy using the geographic data composed of the vector point set of the digital map. We use the iterative closest point (ICP) algorithm that calculates the rotation matrix and the translation vector to compensate for the disparity between the GPS and the digital map information. We also use the least squares method to correct the error caused by the rotation of the ICP algorithm and link on the digital map to eliminate the residual disparity. Finally, we implement the proposed method in real time with a low-cost embedded system and demonstrate the effectiveness of the proposed method through various experiments.
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http://dx.doi.org/10.3390/s18113836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263877PMC
November 2018

Young Age and Risk of Lymph Node Metastasis in Differentiated Type Early Gastric Cancer.

Ann Surg Oncol 2018 Sep 13;25(9):2713-2719. Epub 2018 Jul 13.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Young patients with gastric cancer reportedly have a worse prognosis than older patients due to delayed diagnosis and more aggressive tumor behavior. However, it is unclear whether this applies to early gastric cancer (EGC), for which endoscopic resection is indicated. We investigated the association between age and lymph node metastasis (LNM).

Methods: We identified 4055 patients diagnosed with EGC of differentiated histology who underwent surgery. The association between age and LNM was examined using logistic regression for each T stage separately with adjustments for multiple covariates. We compared LNM rates for each of the Japanese Endoscopic Resection Guidelines criteria in younger (< 40 years) and older patients (40 years).

Results: The median number of lymph nodes examined was the same for T1a and T1b stages (n = 34). The median number of lymph nodes examined was not significantly different within T1a stage (P = 0.093), but within T1b stage, the number of lymph nodes examined was significantly different (P = 0.019). The highest number was between 50 and 59 years (median = 37), and the lowest number was in the 20 to 49 years and older than 70 age brackets (median = 34). LNM rate and age were not significantly associated within each stage (P values 0.269, 0.783 for T1a and T1b, respectively). Among patients fulfilling endoscopic resection criteria, the LNM rate in younger patients was lower than in older patients.

Conclusions: In differentiated-type EGC, young age at diagnosis was not associated with LNM rate. Therefore, endoscopic resection criteria for early gastric cancer can be applied to younger patients.
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http://dx.doi.org/10.1245/s10434-018-6659-3DOI Listing
September 2018

Efficient Proximity Computation Techniques Using ZIP Code Data for Smart Cities .

Sensors (Basel) 2018 Mar 24;18(4). Epub 2018 Mar 24.

School of Computer Science and Engineering, Pusan National University, Busan 46241, Korea.

In this paper, we are interested in computing ZIP code proximity from two perspectives, proximity between two ZIP codes () and neighborhood proximity (). Such a computation can be used for ZIP code-based target marketing as one of the smart city applications. A naïve approach to this computation is the usage of the distance between ZIP codes. We redefine a distance metric combining the centroid distance with the intersecting road network between ZIP codes by using a weighted sum method. Furthermore, we prove that the results of our combined approach conform to the characteristics of distance measurement. We have proposed a general and heuristic approach for computing proximity, while for computing proximity, we have proposed a general approach only. Our experimental results indicate that our approaches are verifiable and effective in reducing the execution time and search space.
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http://dx.doi.org/10.3390/s18040965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5948496PMC
March 2018

Relation of serum uric acid to an exaggerated systolic blood pressure response to exercise testing in men with normotension.

J Clin Hypertens (Greenwich) 2018 03 19;20(3):551-556. Epub 2018 Feb 19.

Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI, USA.

The authors investigated the hypothesis that high serum uric acid concentrations may be related to an exaggerated systolic blood pressure (SBP) response to maximal exercise testing in men with normotension, independent of potential confounding variables. In 4640 healthy men with normotension who underwent maximal treadmill exercise testing and fasting blood chemistry studies, including serum uric acid concentrations, an exaggerated SBP response, defined as SBP ≥ 210 mm Hg, was detected in 152 men (3.3%). After adjusting for potential confounders, participants in the highest quartile of serum uric acid (>6.6 mg/dL) had a higher odds ratio of demonstrating an exaggerated SBP to maximal exercise (odds ratio, 2.19; 95% confidence interval, 1.24-3.86) compared with participants in the lowest quartile of serum uric acid (<5.1 mg/dL). High serum uric acid concentrations are associated with an exaggerated SBP response to maximal exercise testing in men with normotension, independent of established coronary risk factors.
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http://dx.doi.org/10.1111/jch.13219DOI Listing
March 2018

Measurement of tumor volume is not superior to diameter for prediction of lymph node metastasis in early gastric cancer with minute submucosal invasion.

Oncotarget 2017 Dec 4;8(69):113758-113765. Epub 2017 Dec 4.

Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background/aim: The current indication for endoscopic resection in early gastric cancer (EGC) with minute (< 500 µm) submucosal invasion is based on tumor diameter, which may be insufficient to predict lymph node metastasis (LNM). We investigated whether tumor volume might more accurately predict LNM in EGC with minute submucosal invasion.

Materials And Methods: Among patients who underwent gastrectomy for gastric cancer, 346 with well/moderately differentiated EGC with submucosal invasion <500 µm were evaluated. Three-dimensional tumor volume was calculated using an endoscopically resected specimen and compared with 1-dimensional tumor diameter. Predictive ability of tumor diameter or volume for LNM was evaluated using receiver operating characteristic curve analysis.

Results: Tumor diameter and volume predicted LNM with an area under the curve (AUC) of 0.567 and 0.589, respectively. AUC, sensitivity, specificity, positive and negative predictive values, and accuracy of the 2 models were not significantly different. Tumor diameter ≥ 3 cm showed a significant association with LNM (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.01-6.57; = 0.049), whereas a tumor volume cutoff value of 752.8 cm3 showed no significant association with LNM (OR, 1.52; 95% CI, 0.59-3.88; = 0.385).

Conclusions: Tumor volume had no advantage over diameter for predicting LNM in well/moderately differentiated EGC with minute submucosal invasion.
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http://dx.doi.org/10.18632/oncotarget.22894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768361PMC
December 2017

Physical Activity Protects Against the Risk of Erosive Esophagitis on the Basis of Body Mass Index.

J Clin Gastroenterol 2019 02;53(2):102-108

Department of Medicine, Samsung Medical Center.

Goal: To determine whether physical activity lowers the risk for erosive esophagitis on the basis of body mass index (BMI).

Background: Although previous studies have shown that physical activity is closely associated with erosive esophagitis, these data may be confounded by obesity.

Study: In this retrospective study, we included 182,409 patients who underwent an upper endoscopy and were diagnosed with erosive esophagitis. The impact of the amount and intensity of physical activity on the risk for erosive esophagitis was analyzed based on BMI groups. Subjects were classified into three BMI groups with equal numbers in each group.

Results: Overall, 10.3% (n=18,859) of patients were diagnosed with erosive esophagitis. After adjusting for confounding factors, a greater amount of exercise [lower tertile: odd ratio (OR), 0.86; 95% confidence interval (CI), 0.77-0.96; middle tertile: OR, 0.91; 95%, CI 0.84-1.00; upper tertile: OR, 0.79; 95% CI, 0.73-0.85) and increased exercise intensity (lower tertile, moderate: OR, 0.61; 95% CI, 0.52-0.71; vigorous: OR, 0.51; 95% CI, 0.44-0.58; middle tertile, moderate: OR, 0.62; 95% CI, 0.55-0.70; vigorous: OR, 0.58; 95% CI, 0.51-0.65; upper tertile, moderate: OR, 0.58; 95% CI, 0.53-0.65; vigorous: OR, 0.58; 95% CI, 0.53-0.64) was associated with a decreased risk for erosive esophagitis in all 3 BMI groups. In addition, we observed that increased physical activity intensity notably decreased the risk for erosive esophagitis in subjects performing lesser physical activity, but slightly decreased the risk for erosive esophagitis in subjects performing more physical activity.

Conclusion: Physical activity is inversely associated with erosive esophagitis.
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http://dx.doi.org/10.1097/MCG.0000000000000947DOI Listing
February 2019

Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis.

J Gastroenterol Hepatol 2018 May 14;33(5):1039-1046. Epub 2018 Feb 14.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background And Aim: Little is known about the risk factors associated with serrated polyps, because the early studies, which occurred before the new World Health Organization classification was introduced, included mixtures of serrated polyps. This study aimed to evaluate the risk factors associated with the presence of sessile serrated adenomas (SSAs) and traditional serrated adenomas (TSAs) using big data analytics.

Methods: Using a case-control design, we evaluated the risk factors associated with the presence of SSAs and TSAs. Subjects who underwent colonoscopies from 2002 to 2012 as part of the comprehensive health screening programs undertaken at the Samsung Medical Center, Korea, participated in this study.

Results: Of the 48 677 individuals who underwent colonoscopies, 183 (0.4%) had SSAs and 212 (0.4%) had TSAs. The multivariate analysis determined that being aged ≥ 50 years (odds ratio [OR] 1.91, 95% confidential interval [CI] 1.27-2.90, P = 0.002) and a history of colorectal cancer among first-degree relatives (OR 3.14, 95% CI 1.57-6.27, P = 0.001) were significant risk factors associated with the presence of SSAs and that being aged ≥ 50 years (OR 2.61, 95% CI 1.79-3.80, P < 0.001), obesity (OR 1.63, 95% CI 1.12-2.36, P = 0.010), and a higher triglyceride level (OR 1.63, 95% CI 1.12-2.36, P = 0.010) were independent risk factors associated with the presence of TSAs.

Conclusions: We used big data analytics to determine the risk factors associated with the presence of specific polyp subgroups, and individuals who have these risk factors should be carefully scrutinized for the presence of SSAs or TSAs during screening colonoscopies.
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http://dx.doi.org/10.1111/jgh.14035DOI Listing
May 2018

Breast Cancer Risk Associations with Digital Mammographic Density by Pixel Brightness Threshold and Mammographic System.

Radiology 2018 02 16;286(2):433-442. Epub 2017 Oct 16.

From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.).

Purpose To compare three mammographic density measures defined by different pixel intensity thresholds as predictors of breast cancer risk for two different digital mammographic systems. Materials and Methods The Korean Breast Cancer Study included 398 women with invasive breast cancer and 737 control participants matched for age at mammography (±1 year), examination date, mammographic system, and menopausal status. Mammographic density was measured by using the automated Laboratory for Individualized Breast Radiodensity Assessment (LIBRA) software and the semiautomated Cumulus software at the conventional threshold (Cumulus) and at increasingly higher thresholds (Altocumulus and Cirrocumulus, respectively). Measures were Box-Cox-transformed and adjusted for age, body mass index, and menopausal status. Conditional logistic regression was used to estimate risk associations. For calculation of measures of predictive value, the change in odds per standard deviation (OPERA) and the area under the receiver operating characteristic curve (AUC) were used. Results For dense area, with use of the direct conversion system the OPERAs were 1.72 (95% confidence interval [CI]: 1.38, 2.15) for LIBRA, 1.58 (95% CI: 1.27, 1.97) for Cumulus, 2.04 (95% CI: 1.60, 2.59) for Altocumulus, and 3.48 (95% CI: 2.45, 4.47) for Cirrocumulus (P < .001). The corresponding AUCs were 0.70, 0.69, 0.76, and 0.89, respectively. With use of the indirect conversion system, the corresponding OPERAs were 1.50 (95% CI: 1.28, 1.76), 1.36 (95% CI: 1.16, 1.59), 1.40 (95% CI: 1.19, 1.64), and 1.47 (95% CI: 1.25, 1.73) (P < .001) and the AUCs were 0.64, 0.60, 0.61, and 0.63, respectively. Conclusion It is possible that mammographic density defined by higher pixel thresholds could capture more risk-predicting information with use of a direct conversion mammographic system; the mammographically bright, rather than white, regions are etiologically important. RSNA, 2017.
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http://dx.doi.org/10.1148/radiol.2017170306DOI Listing
February 2018

Secure and Lightweight Cloud-Assisted Video Reporting Protocol over 5G-Enabled Vehicular Networks.

Sensors (Basel) 2017 Sep 23;17(10). Epub 2017 Sep 23.

School of Computer Science and Engineering, Pusan National University, Busan 46241, Korea.

In the vehicular networks, the real-time video reporting service is used to send the recorded videos in the vehicle to the cloud. However, when facilitating the real-time video reporting service in the vehicular networks, the usage of the fourth generation (4G) long term evolution (LTE) was proved to suffer from latency while the IEEE 802.11p standard does not offer sufficient scalability for a such congested environment. To overcome those drawbacks, the fifth-generation (5G)-enabled vehicular network is considered as a promising technology for empowering the real-time video reporting service. In this paper, we note that security and privacy related issues should also be carefully addressed to boost the early adoption of 5G-enabled vehicular networks. There exist a few research works for secure video reporting service in 5G-enabled vehicular networks. However, their usage is limited because of public key certificates and expensive pairing operations. Thus, we propose a secure and lightweight protocol for cloud-assisted video reporting service in 5G-enabled vehicular networks. Compared to the conventional public key certificates, the proposed protocol achieves entities' authorization through anonymous credential. Also, by using lightweight security primitives instead of expensive bilinear pairing operations, the proposed protocol minimizes the computational overhead. From the evaluation results, we show that the proposed protocol takes the smaller computation and communication time for the cryptographic primitives than that of the well-known Eiza-Ni-Shi protocol.
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http://dx.doi.org/10.3390/s17102191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676728PMC
September 2017

Characterization of Rotational Stacking Layers in Large-Area MoSe Film Grown by Molecular Beam Epitaxy and Interaction with Photon.

ACS Appl Mater Interfaces 2017 Sep 31;9(36):30786-30796. Epub 2017 Aug 31.

Department of Physics, Yonsei University , Seoul 120-749, Korea.

Transition metal dichalcogenides (TMDCs) are promising next-generation materials for optoelectronic devices because, at subnanometer thicknesses, they have a transparency, flexibility, and band gap in the near-infrared to visible light range. In this study, we examined continuous, large-area MoSe film, grown by molecular beam epitaxy on an amorphous SiO/Si substrate, which facilitated direct device fabrication without exfoliation. Spectroscopic measurements were implemented to verify the formation of a homogeneous MoSe film by performing mapping on the micrometer scale and measurements at multiple positions. The crystalline structure of the film showed hexagonal (2H) rotationally stacked layers. The local strain at the grain boundaries was mapped using a geometric phase analysis, which showed a higher strain for a 30° twist angle compared to a 13° angle. Furthermore, the photon-matter interaction for the rotational stacking structures was investigated as a function of the number of layers using spectroscopic ellipsometry. The optical band gap for the grown MoSe was in the near-infrared range, 1.24-1.39 eV. As the film thickness increased, the band gap energy decreased. The atomically controlled thin MoSe showed promise for application to nanoelectronics, photodetectors, light emitting diodes, and valleytronics.
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http://dx.doi.org/10.1021/acsami.7b05475DOI Listing
September 2017

Impact of Cardiorespiratory Fitness and Risk of Systemic Hypertension in Nonobese Versus Obese Men Who Are Metabolically Healthy or Unhealthy.

Am J Cardiol 2017 Sep 15;120(5):765-768. Epub 2017 Jun 15.

Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, Michigan.

Few data are available regarding the influence of body phenotype on systemic hypertension (SH) and whether cardiorespiratory fitness (CRF) attenuates this relation. We tested the hypothesis that obesity phenotypes and CRF would predict incident hypertension, evaluating 3,800 Korean men who participated in 2 health examinations in1998 to 2009. All participants were normotensive at baseline and were divided into 4 groups based on body mass index using the Asia-Pacific descriptors for obesity and metabolic health status and the National Cholesterol Education Program's adult treatment panel III (ATP-III) criteria. A metabolically healthy obese (MHO) phenotype was defined as a body mass index of ≥25 kg/m with <2 metabolic abnormalities. CRF was directly measured by peak oxygen uptake, and the participants were divided into unfit and fit categories based on age-specific peak oxygen uptake percentiles. Compared with the metabolically healthy nonobese phenotype, MHO and metabolically unhealthy nonobese (MUNO) phenotypes were at increased risk of SH (relative risk [RR] = 1.47; 95% confidence interval [CI], 1.07 to 2.02 and 1.62, 1.21 to 2.16) after adjusting for potential confounders. Joint analysis showed that MHO or MUNO unfit men had 1.91 and 2.27 greater risk of incident SH, respectively. However, MHO fit men had no significant RR of incident SH (RR 1.37; 95% CI, 0.93 to 2.03), whereas MUNO fit men remained at increased risk (RR 1.48; 95% CI, 1.04 to 2.11) compared with their metabolically healthy nonobese fit counterparts. In conclusion, MHO and MUNO men were at increased risk of SH, but these risks were attenuated by fitness.
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http://dx.doi.org/10.1016/j.amjcard.2017.05.054DOI Listing
September 2017

Silicotungstate, a Potential Electron Transporting Layer for Low-Temperature Perovskite Solar Cells.

ACS Appl Mater Interfaces 2017 Aug 20;9(30):25257-25264. Epub 2017 Jul 20.

Department of Chemistry and Chemical Engineering, Inha University , Incheon 22212, Korea.

Thin films of a heteropolytungstate, lithium silicotungstate (LiSiWO, termed Li-ST), prepared by a solution process at low temperature, were successfully applied as electron transporting layer (ETL) of planar-type perovskite solar cells (PSCs). Dense and uniform Li-ST films were prepared on FTO glass by depositing a thin Li-ST buffer layer, followed by coating of a main Li-ST layer. The film thickness was controlled by varying the number of coating cycles, consisting of spin-coating and thermal treatment at 150 °C. In particular, by employing 60 nm-thick Li-ST layer obtained by two cycles of coating, the fabricated CHNHPbI PSC device demonstrates the photovoltaic conversion efficiency (PCE) of 14.26% with J of 22.16 mA cm, V of 0.993 mV and FF of 64.81%. The obtained PCE is significantly higher than that of the PSC employing a TiO layer processed at the same temperature (PCE = 12.27%). Spectroscopic analyses by time-resolved photoluminescence and pulsed light-induced transient measurement of photocurrent indicate that the Li-ST layer collects electrons from CHNHPbI more efficiently and also exhibits longer electron lifetime than the TiO layer thermally treated at 150 °C. Thus, Li-ST is considered to be a promising ETL material that can be applied for the fabrication of flexible PSC devices.
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http://dx.doi.org/10.1021/acsami.7b05146DOI Listing
August 2017

Comparison of anthropometric measurements associated with the risk of endoscopic erosive esophagitis: A cross-sectional study.

Obes Res Clin Pract 2017 Nov - Dec;11(6):694-702. Epub 2017 Apr 25.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: In this cross-sectional study, we assessed five anthropometric measurements to determine the most reliable indicator of the erosive esophagitis (EE) risk: body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI).

Methods: This study included 182,407 participants who underwent an esophagogastroduodenoscopy as part of a routine health check-up. We used the area under the receiver-operating characteristic curve (AUC) to assess the discriminatory power of each anthropometric measure as an indicator of EE risk.

Results: The prevalence of EE increased per quartile for all five anthropometric measurements in patients of both sexes (1st quartile vs. 4th quartile, all P<0.05). ABSI had the lowest AUCs for EE in both sexes (AUC: 0.524, 95% CI: 0.519-0.529 for male patients; AUC: 0.524, 95% CI: 0.513-0.535 for female patients). In contrast, BRI was the best predictor of EE in male patients (OR: 2.095, 95% CI: 1.982-2.215, P<0.0001), and WC was the best predictor of EE in female patients (OR: 2.028, 95% CI: 1.785-2.307, P<0.0001). WC showed the highest AUC values for EE in both male patients (AUC: 0.571, 95% CI: 0.566-0.576) and female patients (AUC: 0.596, 95% CI: 0.585-0.608).

Conclusions: BRI and WC were the most relevant indicators of EE risk in male and female patients, respectively. ABSI was the least reliable indicator of EE risk in patients of both sexes.
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http://dx.doi.org/10.1016/j.orcp.2017.04.005DOI Listing
June 2018
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