Purpose: This study aimed to compare the accuracy of breast ultrasonography (US) and magnetic resonance imaging (MRI) in measuring tumor size preoperatively in breast cancer patients, by comparing their measurements with postoperative pathological tumor size. Methods: A retrospective analysis was conducted on 418 breast cancer patients who underwent surgery between January and December 2018. Tumor sizes measured by US and MRI were compared with pathological tumor size using paired t-tests. Results: The mean tumor size was 1.9±1.2 cm in pathology, 2.2±1.4 cm in US, and 2.2±1.5 cm in MRI. The mean absolute difference between pathological size and US measurements was 0.4±0.8 cm, while for MRI it was 0.5±0.9 cm. Paired t-test analysis showed no statistically significant difference between the accuracy of US and MRI measurements (p=0.244). Conclusion This study demonstrates that US and MRI have comparable accuracy in preoperative tumor size assessment, supporting US as a cost-effective, accessible alternative for surgical planning. However, since US results may vary with operator expertise, future studies should compare measurements across practitioners with varying skill levels to establish methods for optimizing accuracy. Future research should address multifocal tumors, microcalcifications, molecular subtypes, and age-related hormonal influences to refine imaging guidelines.

Purpose: To evaluate the effectiveness of an instrument devised for slit-lamp examination of donor corneas suspended in preservation medium. Methods: The study examined two donor corneas received at Yeouido St. Mary's Hospital in February 2023 and March 2023. The instrument has three main components: a plastic holder to hold the preservation medium bottle, a cube with a mirror for reflecting the slit beam, and a stand to attach the device to the slit-lamp. Using the instrument, the donor corneas were examined via slit-lamp: microscopy with the endothelium facing upward and downward. Specular microscopy and anterior segment optical coherence tomography (OCT) were also performed on the preserved donor corneas. Results: Slit-lamp examination of donor corneas in preservation medium using the instrument showed overall corneal buttoning and optical sections of the donor cornea. Using specular reflection and retroillumination, the endothelial layer was partially visible. However, specular microscopy and anterior segment OCT could not examine the donor cornea in preservation medium using the instrument. Conclusions The devised instrument facilitates slit-lamp examination of donor corneas in preservation medium, enabling a qualitative assessment of donor corneas before corneal transplantation surgery.

Purpose: In the present study, we determined the prevalence of obstructive meibomian gland dysfunction (MGD), hyposecretory MGD, grossly normal MG, and hypersecretory MGD in patients with dry eye syndrome using lipid layer thickness (LLT) and MG dropout. Methods: Eighty-eight patients with dry eye syndrome were included in the study. Patients were categorized into four groups according to the LLT and weighted total meiboscore. The proportion of patients in each group was calculated. The age, sex, Ocular Surface Disease Index, LLT, Schirmer, tear film breakup time, cornea stain, weighted total meiboscore, expressibility, and quality of meibum were compared between the four groups. Results: Fifteen eyes (17.0%) had obstructive MGD, two eyes (2.3%) had hyposecretory MGD, 40 eyes (45.5%) had grossly normal MG, and 17 eyes (19.3%) had hypersecretory MGD. The obstructive MGD group was younger than the grossly normal MG group. In obstructive MGD, the ratio of men to women was higher than that of the other groups. However, Ocular Surface Disease Index, Schirmer, tear film breakup time, and corneal stain did not show statistically significant differences between the four groups. The meibum expressibility of the hyposecretoy MGD group was worse than those of the other groups. The meibum expressibility of the hyposecretoy MGD group was poor than those of the obstructive and hypersecretory MGD group. Conclusions This categorization was expected to help determine the best treatment method for dry eye syndrome, according to the MG status.

Purpose: To introduce an intuitive method for measuring conjunctival microvascular blood flow velocity by imaging bulbar conjunctival microvessels using a slit-lamp biomicroscope equipped with a zoom lens and an ultra-high-speed camera. Methods: After obtaining consent from 10 patients (1 male, 9 females) who visited Yeouido St. Mary’s Hospital from August 21, 2020, to June 12, 2021, the patients were examined under a slit lamp microscope equipped with an ultra-high-speed camera and zoom lens. The blood flow in the conjunctival microvessels was photographed. The captured images were analyzed with ImageJ software to measure the blood flow velocity in the conjunctival microvessels, and we investigated whether the blood flow velocity correlated with the vessel diameter and age. Results: The median age of the subjects was 49.0 years. The mean conjunctival blood flow velocity in 53 microvessels was 0.786 ± 0.468 mm/s. The median conjunctival microvascular diameter was 7.06 μm (interquartile range 5.84 to 9.23 μm). The conjunctival microvascular diameter and blood flow velocity were not significantly correlated (Spearman’s p = 0.177), and the subjects’ age and conjunctival microvascular blood flow velocity were also not correlated (Spearman’s p = 0.669). Conclusions In this study, the blood flow velocity in the bulbar conjunctival microvessels could be measured easily by means of image analysis using a slit-lamp microscope equipped with an ultra-high-speed camera with a zoom lens.

Background: Fractional flow reserve (FFR) based on computed tomography (CT) has been shown to better identify ischemia-causing coronary stenosis. However, this current technology requires high computational power, which inhibits its widespread implementation in clinical practice. This prospective, multicenter study aimed at validating the diagnostic performance of a novel simple CT based fractional flow reserve (CT-FFR) calculation method in patients with coronary artery disease. Methods: Patients who underwent coronary CT angiography (CCTA) within 90 days and invasive coronary angiography (ICA) were prospectively enrolled. A hemodynamically significant lesion was defined as an FFR ≤ 0.80, and the area under the receiver operating characteristic curve (AUC) was the primary measure. After the planned analysis for the initial algorithm A, we performed another set of exploratory analyses for an improved algorithm B. Results: Of 184 patients who agreed to participate in the study, 151 were finally analyzed.Hemodynamically significant lesions were observed in 79 patients (52.3%). The AUC was 0.71 (95% confidence interval [CI], 0.63–0.80) for CCTA, 0.65 (95% CI, 0.56–0.74) for CT-FFR algorithm A (P = 0.866), and 0.78 (95% CI, 0.70–0.86) for algorithm B (P = 0.112). Diagnostic accuracy was 0.63 (0.55–0.71) for CCTA alone, 0.66 (0.58–0.74) for algorithm A, and 0.76 (0.68–0.82) for algorithm B. Conclusion This study suggests the feasibility of automated CT-FFR, which can be performed on-site within several hours. However, the diagnostic performance of the current algorithm does not meet the a priori criteria for superiority. Future research is required to improve the accuracy.

Purpose: To analyze trends in corneal transplantation surgery and determine the number of domestic and imported corneal grafts used in South Korea.Method: The total number of keratoplasties and number of each individual surgical procedure conducted in 2010 and 2020 were identified using Health Insurance Review and Assessment Service data. The number of keratoplasties using domestic corneas in 2010 and 2020 was determined from the annual report of the Korean Network for Organ Sharing (KONOS). The number of keratoplasties using imported corneas was calculated by subtracting the number of keratoplasties using domestic corneas from the total number of keratoplasties. Results: In 2010, 802 keratoplasties were performed in Korea, of which 299 (37.3%) used imported corneas; 715 (89.2%) were penetrating keratoplasties and 87 (10.8%) were anterior lamellar keratoplasties. In 2020, 911 keratoplasties were done in Korea and 564 (61.9%) used imported corneas; 541 (59.4%) were penetrating keratoplasties, 60 (6.6%) were anterior lamellar keratoplasties, and 310 (34.0%) were endothelial keratoplasties. From 2010 to 2020, the number of penetrating keratoplasties in Korea decreased, while the numbers of endothelial keratoplasties and keratoplasties using imported corneas increased. Conclusions There was a 30% decrease in the number of penetrating keratoplasties from 2010 to 2020, and a 30% increase in the numbers of endothelial keratoplasties and keratoplasties using imported corneas. The proportions of endothelial keratoplasties and imported corneas have increased steadily in Korea over the last 10 years.

Purpose: The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea. Materials and Methods: We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016. Results: The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003). Conclusion Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index. SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION: The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.
Adult ; Caregivers ; Child ; Dizziness ; Humans ; Methods ; Reproducibility of Results ; Weights and Measures

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index.SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.

An 84-year-old man was admitted to our hospital with fever, jaundice, and itching. He had been diagnosed previously with chronic renal failure and diabetes, and had been taking allopurinol medication for 2 months. A physical examination revealed that he had a fever (38.8degrees C), jaundice, and a generalized maculopapular rash. Azotemia, eosinophilia, atypical lymphocytosis, elevation of liver enzymes, and hyperbilirubinemia were detected by blood analysis. Magnetic resonance cholangiography revealed multiple cysts similar to choledochal cysts in the liver along the biliary tree. Obstructive jaundice was suspected clinically, and so an endoscopic ultrasound examination was performed, which ruled out a diagnosis of obstructive jaundice. The patient was diagnosed with DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome due to allopurinol. Allopurinol treatment was stopped and steroid treatment was started. The patient died from cardiac arrest on day 15 following admission.
Aged, 80 and over ; Allopurinol/adverse effects ; Biliary Tract/pathology ; Biliary Tract Diseases/diagnosis ; Bilirubin/blood ; Creatine/blood ; Drug Hypersensitivity Syndrome/*diagnosis/etiology ; Endosonography ; Eosinophils/cytology ; Humans ; Magnetic Resonance Angiography ; Male ; Tomography, X-Ray Computed