Purpose: To assess the reliability and accuracy of an automated Cobb angle measurement (ACAM) using a convolutional neural network (CNN) for scoliosis evaluation and to compare measurement times. Materials and Methods: ACAM was applied to spine radiographs in 411 patients suspected of scoliosis. Observer 1 (consensus of two musculoskeletal radiologists) and observer 2 (a radiology resident) measured Cobb angle (CA). CA measurements were categorized using observer 1’s measurements as the reference standard. Inter-observer reliability and correlation were assessed using intraclass correlation coefficient (ICC) and Spearman’s rank correlation coefficient, respectively. Accuracy and measurement time of ACAM and observers were evaluated. Results: ACAM demonstrated excellent reliability and very high correlation with observer 1 (ICC = 0.976, Spearman’s rank correlation = 0.948), with a mean CA difference of 1.1. Overall accuracy was high (88.2%), particularly in mild (92.2%) and moderate (96%) scoliosis. Accuracy was lower in spinal asymmetry (77.1%) and higher in severe scoliosis (95%), although the CA was lower compared to the observers. ACAM significantly reduced measurement time by nearly half compared to the observers (p < 0.001). Conclusion ACAM using CNN enhances CA measurement for assessing mild or moderate scoliosis, despite limitations in spinal asymmetry or severe scoliosis. Nonetheless, it substantially decreases measurement time.

Purpose: To assess the reliability and accuracy of an automated Cobb angle measurement (ACAM) using a convolutional neural network (CNN) for scoliosis evaluation and to compare measurement times. Materials and Methods: ACAM was applied to spine radiographs in 411 patients suspected of scoliosis. Observer 1 (consensus of two musculoskeletal radiologists) and observer 2 (a radiology resident) measured Cobb angle (CA). CA measurements were categorized using observer 1’s measurements as the reference standard. Inter-observer reliability and correlation were assessed using intraclass correlation coefficient (ICC) and Spearman’s rank correlation coefficient, respectively. Accuracy and measurement time of ACAM and observers were evaluated. Results: ACAM demonstrated excellent reliability and very high correlation with observer 1 (ICC = 0.976, Spearman’s rank correlation = 0.948), with a mean CA difference of 1.1. Overall accuracy was high (88.2%), particularly in mild (92.2%) and moderate (96%) scoliosis. Accuracy was lower in spinal asymmetry (77.1%) and higher in severe scoliosis (95%), although the CA was lower compared to the observers. ACAM significantly reduced measurement time by nearly half compared to the observers (p < 0.001). Conclusion ACAM using CNN enhances CA measurement for assessing mild or moderate scoliosis, despite limitations in spinal asymmetry or severe scoliosis. Nonetheless, it substantially decreases measurement time.

Purpose: To assess the reliability and accuracy of an automated Cobb angle measurement (ACAM) using a convolutional neural network (CNN) for scoliosis evaluation and to compare measurement times. Materials and Methods: ACAM was applied to spine radiographs in 411 patients suspected of scoliosis. Observer 1 (consensus of two musculoskeletal radiologists) and observer 2 (a radiology resident) measured Cobb angle (CA). CA measurements were categorized using observer 1’s measurements as the reference standard. Inter-observer reliability and correlation were assessed using intraclass correlation coefficient (ICC) and Spearman’s rank correlation coefficient, respectively. Accuracy and measurement time of ACAM and observers were evaluated. Results: ACAM demonstrated excellent reliability and very high correlation with observer 1 (ICC = 0.976, Spearman’s rank correlation = 0.948), with a mean CA difference of 1.1. Overall accuracy was high (88.2%), particularly in mild (92.2%) and moderate (96%) scoliosis. Accuracy was lower in spinal asymmetry (77.1%) and higher in severe scoliosis (95%), although the CA was lower compared to the observers. ACAM significantly reduced measurement time by nearly half compared to the observers (p < 0.001). Conclusion ACAM using CNN enhances CA measurement for assessing mild or moderate scoliosis, despite limitations in spinal asymmetry or severe scoliosis. Nonetheless, it substantially decreases measurement time.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Owing to advances in diagnostics and the increase in invasive procedures, and immunocompromised patients, cutaneous nontuberculous mycobacteria (NTM) infection is rising. NTM should be suspected in patients with persistent skin lesions refractory to treatment with a history of immunosuppression or skin injury. A 59-year-old woman presented with a 4-week history of multiple erythematous tender nodules on left arm. A year prior, multiple nodules appeared on left hand dorsum, followed by recurrent suppurative nodules in left arm. She has been taking methotrexate and leflunomide for 7 years due to rheumatoid arthritis (RA). Skin biopsy revealed granulomatous inflammation, and NTM polymerase chain reaction test was positive. Furthermore, she had cut her left finger with a knife 14 months ago. Based on these findings, cutaneous NTM infection was diagnosed. Herein, we report a case of cutaneous NTM infection in an immunosuppressed patient with RA, emphasizing differentiating subcutaneous nodules from rheumatoid nodules in RA.

Background: The epidemiology of pathogenic bacteria varies according to the socioeconomic status and antimicrobial resistance status. However, longitudinal epidemiological studies to evaluate the changes in species distribution and antimicrobial susceptibility of pathogenic bacteria nationwide are lacking. We retrospectively investigated the nationwide trends in species distribution and antimicrobial susceptibility of pathogenic bacteria over the last 20 years in Korea. Methods: From 1997 to 2016, annual cumulative antimicrobial susceptibility and species distribution data were collected from 12 university hospitals in five provinces and four metropolitan cities in South Korea. Results: The prevalence of Staphylococcus aureus was the highest (13.1%) until 2012 but decreased to 10.3% in 2016, consistent with the decrease in oxacillin resistance from 76.1% in 2008 to 62.5% in 2016. While the cefotaxime resistance of Escherichia coli increased from 9.0% in 1997 to 34.2% in 2016, E. coli became the most common species since 2013, accounting for 14.5% of all isolates in 2016. Pseudomonas aeruginosa and Acinetobacter baumannii rose to third and fifth places in 2008 and 2010, respectively, while imipenem resistance increased from 13.9% to 30.8% and 0.7% to 73.5% during the study period, respectively.Streptococcus agalactiae became the most common pathogenic streptococcal species in 2016, as the prevalence of Streptococcus pneumoniae decreased since 2010. During the same period, pneumococcal penicillin susceptibility decreased to 79.0%, and levofloxacin susceptibility of S. agalactiae decreased to 77.1% in 2016. Conclusion The epidemiology of pathogenic bacteria has changed significantly over the past 20 years according to trends in antimicrobial resistance in Korea. Efforts to confine antimicrobial resistance would change the epidemiology of pathogenic bacteria and, consequently, the diagnosis and treatment of infectious diseases.

Background: Neurogenic differentiation 1 (NeuroD1) is a representative small cell lung cancer (SCLC) transcription regulator involved in the carcinogenesis and behavior of SCLC.Histone modifications play an important role in transcription, and H3 lysine 4 trimethylation (H3K4me3) is primarily associated with promoter regions. Methods: We investigated the association between single nucleotide polymorphisms (SNPs) in NeuroD1 and H3K4me3 coincident regions, selected using ChIP sequencing (ChIP-seq), and the clinical outcomes of 261 patients with SCLC. Results: Among 230 SNPs, two were significantly associated with both the chemotherapy response and overall survival (OS) of patients with SCLC. RNF145 rs2043268A>G was associated with worse chemotherapy response and OS (under a recessive model, adjusted odds ratio [aOR], 0.50, 95% confidence interval [CI], 0.26–0.94, P = 0.031, and adjusted hazard ratio [aHR], 1.88, 95% CI, 1.38–2.57, P < 0.001). CINP rs762105A>G was also associated with worse chemotherapy response and OS (under a dominant model, aOR, 0.47, 95% CI, 0.23–0.99, P = 0.046, and aHR, 2.03, 95% CI, 1.47–2.82, P < 0.001). ChIP–quantitative polymerase chain reaction and luciferase assay confirmed that the two SNPs were located in the active promoter regions and influenced the promoter activity of each gene. Conclusion To summarize, among SNPs selected using ChIP-seq in promoter regions with high peaks in both NeuroD1 and H3K4me3, RNF145 rs2043268A>G and CINP rs762105A>G were associated with clinical outcomes in patients with SCLC and also affected the promoter activity of each gene.

Objective: glucometer is one of POCT(point-of-care testing) devices used by EMS. Accurate measurement value is important for patient decision making. Quality control is necessary for this, but most EMS are still using glucometer without quality control it. Therefore, management status and quality control status of glucometers used by 119 paramedics waswere investigated. Methods: 6 and 8 of glucometers and blood glucose test strips were submitted from 4 safety centers in 2010 and 8 safety centers in 2012, respectively. Glucometers submitted by local safety centers were analyzed in 2010 and 2012. The control glucometer, which was well managed at A University Hospital, was assumed to be accurate for at blood glucose measurement. Glucose values of various quality control materials control solutions were measured and analyzed using linear regression and Pearson’s correlation test. Error rates were obtained via error tolerance range required by the 2011 ISO(International Organization for Standardization) guideline. For statistics, Excel and MedCalC programs were used. Results: mong 14 safety centers in the region, 4 centers(28.5%) in 2010 and 8 centers(57.1%) in 2012 submitted 6 and 8 glucometers. In the first evaluation in 2010, 2 out of 6(33.3%) glucometers were untestable due to error, and 45 out of 6(66.683.3%) blood glucose test strips' validity were expired. In the second evaluation in 2012, 1 out of 8(13.5%) glucometers were untestable due to lack of battery, and 2 out of 8(25%) blood glucose test strips' validity were expired. All correlation coefficients were above 0.989 in 2010 and above 0.997 in 2012. Error rates were generally high when using expired blood glucose test strips. Conclusion Among 119 paramedics’ guideline, quantity and operation status of POCT devices are well managed, but quality control is not. Therefore, it is necessary to add management status and quality control status of POCT devices to the EMS’ field work guideline.