BackgroundTo determine whether the TyG index, a product of the levels of triglycerides and fasting plasma glucose (FPG) might be a valuable marker for predicting future diabetes.MethodsA total of 5,354 nondiabetic subjects who had completed their follow-up visit for evaluating diabetes status were selected from a large cohort of middle-aged Koreans in the Chungju Metabolic Disease Cohort study. The risk of diabetes was assessed according to the baseline TyG index, calculated as ln[fasting triglycerides (mg/dL) × FPG (mg/dL)/2]. The median follow-up period was 4.6 years.ResultsDuring the follow-up period, 420 subjects (7.8%) developed diabetes. The baseline values of the TyG index were significantly higher in these subjects compared with nondiabetic subjects (8.9±0.6 vs. 8.6±0.6; P<0.0001) and the incidence of diabetes increased in proportion to TyG index quartiles. After adjusting for age, gender, body mass index, waist circumference, systolic blood pressure, high-density lipoprotein (HDL)-cholesterol level, a family history of diabetes, smoking, alcohol drinking, education level and serum insulin level, the risk of diabetes onset was more than fourfold higher in the highest vs. the lowest quartile of the TyG index (relative risk, 4.095; 95% CI, 2.701–6.207). The predictive power of the TyG index was better than the triglyceride/HDL-cholesterol ratio or the homeostasis model assessment of insulin resistance.ConclusionsThe TyG index, a simple measure reflecting insulin resistance, might be useful in identifying individuals at high risk of developing diabetes.

One of the challenges of minimally invasive surgery is the dexterous manipulation and precise control of small‐diameter continuum surgical instruments. Herein, a magnetic continuum device with variable stiffness (VS) is presented, whose tip is precisely shaped and controlled using an external magnetic field. Based on a low melting point alloy (LMPA), the serial segments composing the continuum device are independently softened via electrical current and remotely deformed under a magnetic torque, whereas the rest of the device is locked in place. The resulting system has the advantage of combining the precision of magnetic navigation with additional degrees of freedom provided by changing the segments stiffness. With a minimum diameter as small as 2.33 mm and an inner working channel, the magnetic continuum device with VS is adapted to use in several therapeutic scenarios, including radio‐frequency cardiac ablations and interventional endoscopy in the gastrointestinal tract. The magnetic torque is used to remotely control the shape of the soft sections, whereas the stiff sections remain unchanged, thus adding degrees of freedom to the magnetic continuum device.

Purpose: To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC mean , ADC minimal ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. Materials and Methods:A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC mean and ADC minimal of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test.Results: The mean ADC minimal was 0.78 6 0.24 (Â10 À3 mm 2 /s), and the mean ADC mean was 1.01 6 0.23 (Â10 À3 mm 2 /s). There was a significant correlation of the ADCmean value with ER expression (P ¼ 0.027) and HER2 expression (P ¼ 0.018). There was no significant relationship between ADC minimal and prognostic factors or between ADC mean and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P ¼ 0.022). The margin of mass was significantly associated with lymph node metastasis (P ¼ 0.031), ER expression (P ¼ 0.013), PR expression (P ¼ 0.036), HER2 expression (P ¼ 0.019), and EGRF expression (P ¼ 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P ¼ 0.008). Conclusion:The low ADC mean value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules.

ObjectiveTo evaluate the interobserver variability and performance in the interpretation of ultrasonographic (US) findings of thyroid nodules.Materials and Methods72 malignant nodules and 61 benign nodules were enrolled as part of this study. Five faculty radiologists and four residents independently performed a retrospective analysis of the US images. The observers received one training session after the first interpretation and then performed a secondary interpretation. Agreement was analyzed by Cohen's kappa statistic. Degree of performance was analyzed using receiver operating characteristic (ROC) curves.ResultsAgreement between the faculties was fair-to-good for all criteria; however, between residents, agreement was poor-to-fair. The area under the ROC curves was 0.72, 0.62, and 0.60 for the faculties, senior residents, and junior residents, respectively. There was a significant difference in performance between the faculties and the residents (p < 0.05). There was a significant increase in the agreement for some criteria in the faculties and the senior residents after the training session, but no significant increase in the junior residents.ConclusionIndependent reporting of thyroid US performed by residents is undesirable. A continuous and specialized resident training is essential to enhance the degree of agreement and performance.