Yun-Hee Kim

The Sasang Constitutional Types Can Act as a Risk Factor for Hypertension

It has been suggested that an approach to hypertension based on the constitutional make-up of an individual may be effective. We conducted a retrospective chart review to explore the association of Sasang constitution with hypertension. The results show that the prevalence of hypertension was highest in the Taeeum (TE) constitutional type, and that the TE constitutional type can act as an independent risk factor for hypertension (OR in TE group = 1.37 (CI 1.06–1.78) (vs. non-TE group)). This indicates that the Sasang constitutional type could explain the variability in individual susceptibilities to hypertension, suggesting a novel constitution-based approach to hypertension.

Pineal gland metabolism in patients with adolescent idiopathic scoliosis

The scoliosis observed in chickens after pinealectomy resembles that seen in humans with an adolescent idiopathic scoliosis, suggesting that melatonin deficiency may be responsible. However, to date there have been no studies of pineal gland glucose metabolism in patients with adolescent idiopathic scoliosis that might support this hypothesis. We examined the excretion of urinary 6-sulfatoxyl-melatonin as well as the glucose metabolism of the pineal gland in 14 patients with an adolescent idiopathic scoliosis and compared them with those of 13 gender-matched healthy controls using F-18 fluorodeoxyglucose brain positron emission tomography. There was no significant difference in the level of urinary 6-sulfatoxyl-melatonin or pineal gland metabolism between the study and the control group. We conclude that permanent melatonin deficiency is not a causative factor in the aetiology of adolescent idiopathic scoliosis.

Comparison of early and delayed quantified indices of double-phase 99mTc MIBI scintimammography in the detection of primary breast cancer

Purpose: To compare the diagnostic accuracy and incremental diagnostic role of quantitative indices of early and delayed lesion to non‐lesion ratios (L/Ns) in the detection of primary breast cancer. Material and Methods: Double‐phase 99mTc MIBI scintimammography (SMM) (early 10 min, delayed 3 h) was performed after injection of 750 MBq of 99mTc MIBI in 446 highly suspected breast cancer patients (malignant: 311, benign: 135). For visual analysis, five scoring methods were used, and, for quantitative analysis, early and delayed L/Ns were calculated. Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal visual grade, and to calculate cut‐off values of quantitative indices for differentiation of malignant and benign diseases and to investigate whether the quantitative indices could provide incremental diagnostic values in addition to visual analysis. Results: Optimal visual grades were above 4 and 5 in the detection of breast cancer. Sensitivity was 84.2% and specificity 79.3%; the area under the curve (AUC) was 0.832 (95% CI, 0.794–0.866) and standard error was 0.019. Early and delayed L/Ns of malignant breast disease were significantly higher than those of benign disease (early: 2.01±0.99 versus 1.13±0.26 (P<0.001); delayed: 1.68±0.69 versus 1.11±0.23 (P<0.001)). The optimal L/Ns for the detection of primary breast cancer were 1.27 for early and 1.12 for delayed imaging. When early L/N 1.27 was used as cut‐off value for the detection of primary breast cancer, the sensitivity of SMM was 77.8% and specificity 85.2%. The AUC was 0.856 (95% CI, 0.820–0.888). When delayed L/N 1.12 was used, sensitivity and specificity were 81.4% and 78.5%, respectively. The AUC was 0.834 (95% CI, 0.796–0.867). The ROC comparison of early and delayed L/N showed no statistical difference in the detection of malignant breast disease (P = 0.403). When the delayed L/N was added to the early one, early plus delayed quantitative analysis (E+D) showed 86.5% sensitivity and 74.8% specificity. However, the AUCs of E+D (0.854, 95% CI, 0.767–0.842) and early L/N (E) (0.856) showed no statistical difference (P = 0.614). When grades 4 and 5 were used as cut‐off visual grade, sensitivity and specificity were 84.2% and 79.3%, respectively. When the E was added to visual grade, visual plus early L/N (V+E) showed 89.4% sensitivity and 77% specificity. The AUC of V+E (0.867, 95% CI, 0.832–0.897) was significantly higher than that of visual analysis (V) (0.832, 95% CI, 0.794–0.866, P<0.001). When the delayed L/N (D) was added to visual grade, visual plus delayed L/N (V+D) showed 89.4% sensitivity and 74.1% specificity. The AUCs of V+D (0.852, 95% CI, 0.816–0.884) and V revealed no statistical differences (P = 0.052). Conclusion: From this study, the optimal visual grades for diagnosis of breast cancer were grades 4 and 5; the cut‐off values of L/Ns were 1.27 for early and 1.12 for delayed imaging. It was also found that early L/Ns provide incremental value in addition to visual analysis. However, delayed L/N revealed no incremental value. Therefore, the delayed image should not be routinely performed for purposes of primary breast cancer detection