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Marateb HR, Mohebian MR, Javanmard SH, Tavallaei AA, Tajadini MH, Heidari-Beni M, Mañanas MA, Motlagh ME, Heshmat R, Mansourian M, Kelishadi R. Prediction of dyslipidemia using gene mutations, family history of diseases and anthropometric indicators in children and adolescents: The CASPIAN-III study. Comput Struct Biotechnol J 2018; 16:121-130. [PMID: 30026888 PMCID: PMC6050175 DOI: 10.1016/j.csbj.2018.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 12/12/2022] Open
Abstract
Dyslipidemia, the disorder of lipoprotein metabolism resulting in high lipid profile, is an important modifiable risk factor for coronary heart diseases. It is associated with more than four million worldwide deaths per year. Half of the children with dyslipidemia have hyperlipidemia during adulthood, and its prediction and screening are thus critical. We designed a new dyslipidemia diagnosis system. The sample size of 725 subjects (age 14.66 ± 2.61 years; 48% male; dyslipidemia prevalence of 42%) was selected by multistage random cluster sampling in Iran. Single nucleotide polymorphisms (rs1801177, rs708272, rs320, rs328, rs2066718, rs2230808, rs5880, rs5128, rs2893157, rs662799, and Apolipoprotein-E2/E3/E4), and anthropometric, life-style attributes, and family history of diseases were analyzed. A framework for classifying mixed-type data in imbalanced datasets was proposed. It included internal feature mapping and selection, re-sampling, optimized group method of data handling using convex and stochastic optimizations, a new cost function for imbalanced data and an internal validation. Its performance was assessed using hold-out and 4-foldcross-validation. Four other classifiers namely as supported vector machines, decision tree, and multilayer perceptron neural network and multiple logistic regression were also used. The average sensitivity, specificity, precision and accuracy of the proposed system were 93%, 94%, 94% and 92%, respectively in cross validation. It significantly outperformed the other classifiers and also showed excellent agreement and high correlation with the gold standard. A non-invasive economical version of the algorithm was also implemented suitable for low- and middle-income countries. It is thus a promising new tool for the prediction of dyslipidemia.
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Affiliation(s)
- Hamid R Marateb
- Department of Biomedical Engineering, Facultyof Engineering, University of Isfahan, Isfahan, Iran.,Department of Automatic Control, Biomedical Engineering Research Center, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Barcelona, Spain
| | - Mohammad Reza Mohebian
- Department of Biomedical Engineering, Facultyof Engineering, University of Isfahan, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Applied physiology researchcenter, Isfahan cardiovascular research institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Ali Tavallaei
- Department of Biomedical Engineering, Facultyof Engineering, University of Isfahan, Isfahan, Iran
| | | | - Motahar Heidari-Beni
- Nutrition Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease,Isfahan University of Medical Sciences, Isfahan, Iran
| | - Miguel Angel Mañanas
- Department of Automatic Control, Biomedical Engineering Research Center, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Barcelona, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterialsand Nanomedicine (CIBER-BBN), Barcelona, Spain
| | | | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and MetabolismPopulation Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Mansourian
- Applied physiology researchcenter, Isfahan cardiovascular research institute, Isfahan University of Medical Sciences, Isfahan, Iran.,Biostatistics and Epidemiology Department, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Hosseini-Esfahani F, Mirmiran P, Daneshpour MS, Mottaghi A, Azizi F. The Effect of Interactions of Single Nucleotide Polymorphisms of APOA1/APOC3 with Food Group Intakes on the Risk of Metabolic Syndrome. Avicenna J Med Biotechnol 2017; 9:94-103. [PMID: 28496949 PMCID: PMC5410135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the interaction of dietary food groups and genetic variants of APOA1/APOC3, relative to Metabolic Syndrome (MetS) risk in adults. METHODS In this matched nested case-control study, 414 MetS subjects and 414 controls were selected from among participants of Tehran Lipid and Glucose Study. Dietary intake was assessed with the use of a valid and reliable semi-quantitative food frequency questionnaire. Single Nucleotide Polymorphisms (SNPs), APOA1 (rs670, -75G>A and rs5069, +83C>T/APOC3 rs5128 C3238>G) were genotyped by the conventional polymerase chain reaction and restriction fragment length polymorphism. RESULTS The mean (SD) of age was 40.7 (13) and 41.2 (13) years in male cases and controls versus 44.0 (11) and 44.0 (12) years in female case and controls. A significant interaction between intake quartiles of the sugar group and APOA1 combined group (GA+AA/CT+TT) SNPs was found; The ORs for these genotype carriers were (1, 0.44, 0.36, 0.23; P trend<0.001) in quartiles of intake, relative to other combined genotypes (P interaction=0.02). MetS risk appeared to be increased significantly in higher quartiles of sweet beverages and fish intakes in the GA+AA/CT+TT/CC genotypes of APOA1/APOC3 SNPs, compared to other genotypes (P interaction=0.01). The combined effect of genotypes of APOC3/APOA1 showed further decrease in MetS risk in higher quartiles of sugar group intakes (OR: 1, 0.24, 0.26, 0.14, P trend=0.001) relative to other combinations (P interaction=0.008). CONCLUSION Results obtained demonstrate that some dietary food groups (sugar, fish, and sweet beverages) modulate the effect of APOA1/APOC3 SNPs in relation to MetS risk.
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Affiliation(s)
- Firoozeh Hosseini-Esfahani
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S. Daneshpour
- Cellular Molecular and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Mottaghi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Azadeh Mottaghi, Ph.D., Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tel: +98 21 22432503, Fax: +98 21 22402463, E-mail:
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ren S, Chen X, Jiang L, Zhu B, Jiang Q, Xi X. Deleted in malignant brain tumors 1 protein is a potential biomarker of acute respiratory distress syndrome induced by pneumonia. Biochem Biophys Res Commun 2016; 478:1344-9. [PMID: 27565730 DOI: 10.1016/j.bbrc.2016.08.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022]
Abstract
Acute respiratory distress syndrome (ARDS) is associated with high mortality and morbidity. Early diagnosis and risk stratification in patients with ARDS should improve prognosis. Unfortunately, no clinical biomarkers are available for use in early diagnosis. Quantitative proteomics is a powerful tool for biomarker discovery in cancer, autoimmune diseases, and ARDS. Here, we employed isobaric tags for relative and absolute quantitation (iTRAQ) technology to identify potential biomarkers for early ARDS diagnosis and predict the risk for increased disease severity induced by pneumonia. We collected the bronchoalveolar lavage fluid (BALF) and plasma from ARDS patients with differing degrees of ARDS severity. We identified 338 proteins dysregulated in ARDS through iTRAQ, 18 of which showed significant differences with at least 1.5-fold differential expression in patients with mild or severe ARDS. Differential plasma expression of pulmonary surfactant associated protein A, apolipoprotein A1, and deleted in malignant brain tumors 1 protein (DMBT1) was verified in plasma samples. Our results indicate that DMBT1 can potentially serve as a biomarker for early ARDS diagnosis and disease severity assessment.
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Affiliation(s)
- Shan Ren
- Intensive Care Unit, Fu Xing Hospital, Capital Medical University, 20A Fuxing Men Wai Avenue, Beijing 100038, People's Republic of China; Intensive Care Unit, Hebei General Hospital, 348 Heping Western Road, Shijiazhuang 050051, People's Republic of China.
| | - Xia Chen
- Intensive Care Unit, Fu Xing Hospital, Capital Medical University, 20A Fuxing Men Wai Avenue, Beijing 100038, People's Republic of China.
| | - Li Jiang
- Intensive Care Unit, Fu Xing Hospital, Capital Medical University, 20A Fuxing Men Wai Avenue, Beijing 100038, People's Republic of China.
| | - Bo Zhu
- Intensive Care Unit, Fu Xing Hospital, Capital Medical University, 20A Fuxing Men Wai Avenue, Beijing 100038, People's Republic of China.
| | - Qi Jiang
- Intensive Care Unit, Fu Xing Hospital, Capital Medical University, 20A Fuxing Men Wai Avenue, Beijing 100038, People's Republic of China.
| | - Xiuming Xi
- Intensive Care Unit, Fu Xing Hospital, Capital Medical University, 20A Fuxing Men Wai Avenue, Beijing 100038, People's Republic of China.
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Dietary patterns interact with APOA1/APOC3 polymorphisms to alter the risk of the metabolic syndrome: the Tehran Lipid and Glucose Study. Br J Nutr 2015; 113:644-53. [DOI: 10.1017/s0007114514003687] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The interaction of genetic and dietary factors, as an area of CVD research, has been explored poorly. The aim of the present study was to examine the interaction of dietary patterns and three genetic variants of APOA1 and APOC3, both independently and in combination, relative to the risk of the metabolic syndrome (MetS) in Tehranian adults. In the present matched, nested case–control study, 414 subjects with the MetS and 414 controls were selected from the participants of the Tehran Lipid and Glucose Study. Dietary patterns were determined by factor analysis. APOC3 (rs5128 3238C>G) and APOA1 (rs670, − 75G>A and rs5069,+83C>T) SNP were genotyped by the conventional PCR followed by the restriction fragment length polymorphism technique. Overall, three major dietary patterns were extracted: healthy dietary pattern (HDP); Western dietary pattern (WDP); fat–sweet dietary pattern (FSDP). The A and T allele carriers of the APOA1 SNP had a greater risk of developing the MetS in the highest quartile of WDP scores (OR 3·22, 95 % CI 1·21, 8·58, Pinteraction= 0·03). Compared with other genotype combinations, the combined effect of APOC3/APOA1 (CC/GA+AA/CT+TT) genotypes showed a further increase in the risk of the MetS in the highest quartile of WDP scores (OR 1, 2·49, 8·73, 6·32, Ptrend< 0·001, Pinteraction= 0·003). A significant interaction was found between the quartiles of FSDP scores and the APOA1 diplotype (GA+AA/CT+TT). OR for these genotype carriers were 1, 0·65, 0·57 and 0·22 (Ptrend= 0·006) in the lowest to the highest quartile of FSDP scores when compared with the other combined genotypes (Pinteraction= 0·03). Our findings suggest that the WDP and FSDP are associated with APOA1 and APOC3 SNP in relation to the risk of the MetS.
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Hao J, He XD. Haplotype analysis of ApoAI gene and sepsis-associated acute lung injury. Lipids Health Dis 2014; 13:79. [PMID: 24885977 PMCID: PMC4040506 DOI: 10.1186/1476-511x-13-79] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 04/10/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Apolipoprotein A1 (ApoA1) is the major apoprotein constituent of high density lipoprotein (HDL) which exerts innate protective effects in systemic inflammation. However, its role in the acute lung injury (ALI) has not been well studied. In the present study we investigated the association between polymorphisms of ApoA1 gene and ALI in a Chinese population. METHODS Three polymorphisms of the ApoA1 gene (rs11216153, rs2070665, and rs632153) were genotyped by TaqMan method in 290 patients with sepsis-associated ALI, 285 patients sepsis alone and 330 age- and sex-matched healthy controls. RESULTS We found rs11216153 polymorphism of ApoA1 was associated with ALI, the GG genotype and G allele was common in the ALI patients (76.9%, 88.1%, respectively) than both in the control subjects (55.8%, 75.8%, respectively) and in the sepsis alone patients (58.2%, 78.4%, respectively). Haplotype consisting of these three SNPs strengthened the association with ALI susceptibility. The frequency of haplotype GTG in the ALI samples was significantly higher than that in the healthy control group (OR = 2.261, 95% CI: 1.735 ~ 2.946, P <0.001) and the sepsis alone group (OR = 1.789, 95% CI: 1.373 ~ 2.331.P < 0.001). Carriers of the haplotype TTG had a lower risk for ALI compared with healthy control group (OR = 0.422, 95% CI: 0.310 ~ 0.574, P < 0.001) and sepsis alone group (OR = 0.491, 95% CI: 0.356 ~ 0.676, P <0.001). CONCLUSIONS These results indicated that genetic variants in the ApoA1 gene might be associated with susceptibility to sepsis-associated ALI in Han Chinese population.
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Affiliation(s)
- Jian Hao
- ICU Departments, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - Xian-Di He
- ICU Departments, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
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Ivanova N, Postadzhiyan A, Apostolova M. An Application of Logistic Regression and Multifactor Dimensionality Reduction Analyses for Detecting Genotype-Phenotype Interactions Associated with Developing of Atherosclerosis in Bulgarian Cohort. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.5504/50yrtimb.2011.0035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Tu J, Zhang B, Chen Y, Liang B, Liang D, Liu G, He F. Association of apolipoprotein A1 -75 G/A polymorphism with susceptibility to the development of acute lung injury after cardiopulmonary bypass surgery. Lipids Health Dis 2013; 12:172. [PMID: 24209603 PMCID: PMC3827984 DOI: 10.1186/1476-511x-12-172] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 10/28/2013] [Indexed: 01/16/2023] Open
Abstract
Introduction Apolipoprotein A1 (apoA1) is the major apoprotein constituent of high density lipoprotein (HDL) which exerts innate protective effects in systemic inflammation. However, its role in the acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) has not been well studied. The objective of this study was to investigate the potential association between APOA1 -75 G/A polymorphism and the development of ALI after cardiopulmonary bypass (CPB) surgery. Materials and methods A hospital-based case–control study was conducted in patients with ALI (n = 300), patients without ALI (n = 300) and healthy controls (n = 300). Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay was applied to assess the APOA1 -75 G/A genotypes. Results Patients with ALI had a significantly higher frequency of APOA1 -75 AA genotype [odds ratio (OR) =1.75, 95% confidence interval (CI) = 1.04, 2.92; P = 0.03] than patients without ALI. APOA1 -75 AA genotype (OR =3.47, 95% CI = 1.60, 7.52; P = 0.002) and A allele (OR =1.92, 95% CI = 1.24, 2.96; P = 0.003) were the significant independent prognostic factors for the 30-day survival rate of patients with ALI after CPB surgery. Conclusion Our study suggested that APOA1 -75 AA genotype was associated with a higher ALI risk after CPB surgery. Patients with the APOA1 -75 AA genotype and A allele had higher 30-day mortality of ALI after CPB surgery. Additional studies are needed to confirm this finding.
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Affiliation(s)
| | - Bingdong Zhang
- Institute of cardiovascular Diseases, The First Affiliated Hospital of Guangxi, Medical University, 6 ShuangYong Road, Nanning, Guangxi 530021, China.
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Onat A, Can G, Örnek E, Sansoy V, Aydın M, Yüksel H. Abdominal obesity with hypertriglyceridaemia, lipoprotein(a) and apolipoprotein A-I determine marked cardiometabolic risk. Eur J Clin Invest 2013; 43:1129-39. [PMID: 24020867 DOI: 10.1111/eci.12150] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 08/04/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND Risks for coronary heart disease (CHD) and diabetes (T2DM) of the 'hypertriglyceridemic waist' phenotype (HtgW) warrant further investigation. We studied this issue and whether partial proinflammatory conversion of apolipoprotein (apo) A-I by lipoprotein(a) [Lp(a)] is a codeterminant. MATERIALS AND METHODS In a population-based prospective study, 1328 Turkish adults were analysed in four groups by the presence of abdominal obesity and elevated triglycerides (Htg). RESULTS LDL-cholesterol levels, significantly elevated in isolated Htg, were lower in HtgW, yet significantly higher apoB and complement C3 values existed in women with HtgW in whom also the lowest Lp(a) values prevailed. Lp(a) was linearly associated, more strongly in HtgW than in the remaining groups, with apoB and, in women inversely, with gamma-glutamyltransferase. Incident HtgW was predicted, not in men, but in women inversely by Lp(a) (OR 0.80 [95%CI 0.65; 0.97]), regardless of adjustment for relevant confounders. After adjustment for conventional risk factors, HtgW (OR 2.84) and high apoA-I/HDL-C ratio (OR 1.50) were significantly and additively associated with combined prevalent and incident CHD risk. High apoA-I and low HDL-cholesterol levels interacted therein in women. Type-2 diabetes was strongly predicted by HtgW, mediated in men by high apoA-I/HDL-C ratio. CONCLUSION HtgW is associated with excess inflammatory markers, is predicted in women paradoxically by lower circulating Lp(a) and is associated in both sexes with marked excess cardiometabolic risk to which high apoA-I/HDL-C ratio contributes additively. These findings are consistent in women with apoA-I being oxidized via aggregation to Lp(a).
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Affiliation(s)
- Altan Onat
- Turkish Society of Cardiology, Istanbul, Turkey; Department of Cardiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
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Kurbanov RD, Bekmetova FM, Shek AB, Kan LE, Khashimov SU. LIPID TRANSPORT GENETIC POLYMORPHISM AND ANGIOTENSIN-CONVERTING ENZYME I/D GENETIC POLYMORPHISM IN UZBEK PATIENTS WITH UNSTABLE ANGINA AND CORONARY HEART DISEASE IN FAMILY HISTORY. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2013. [DOI: 10.15829/1728-8800-2013-2-46-51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | | | - A. B. Shek
- Republican Specialised Centre of Cardiology, Tashkent
| | - L. E. Kan
- Republican Specialised Centre of Cardiology, Tashkent
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Kim SH, Jeong MH, Lee MG, Ko JS, Park KH, Sim DS, Hong YJ, Kim JH, Ahn Y, Kang JC. The Relationship between the Levels of Lipoprotein (a) and Fibrinogen and Clinical Outcome in Patients with Acute Myocardial Infarction. Chonnam Med J 2010. [DOI: 10.4068/cmj.2010.46.1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Su Hyun Kim
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Min Goo Lee
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jum Suk Ko
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Keun-Ho Park
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Doo Sun Sim
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Young Joon Hong
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Ju Han Kim
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Youngkeun Ahn
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jung Chaee Kang
- The Heart Center of Chonnam National University Hospital, Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
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