1.Association of Intensive Endoscopic Burden with Esophageal Cancer Detection: A Nationwide Cohort Study
Yeunji LEE ; Eunyoung LEE ; Bumhee PARK ; Gil Ho LEE ; Sun Gyo LIM ; Sung Jae SHIN ; Choong-Kyun NOH ; Kee Myung LEE
Gut and Liver 2025;19(1):59-68
		                        		
		                        			 Background/Aims:
		                        			Early diagnosis of esophageal cancer (EC) remains challenging despite the increasing frequency of endoscopic screenings globally. The rapidly increasing number of endoscopic screenings performed over a certain period might influence diagnostic performance. This study evaluated the association between the number of endoscopic screenings and EC detection rates in a nationwide cohort. 
		                        		
		                        			Methods:
		                        			This retrospective population-based study used the Korean National Cancer Screening Program database, comprising 32,774,742 males and females aged ≥40 years between 2015and 2019. Negative binomial regression model and least-squares mean evaluation were used to assess the association between month of the year and EC detection rates. 
		                        		
		                        			Results:
		                        			This study enrolled 28,032,590 participants who underwent upper endoscopy. The number of participants in the fourth quarter (October to December: 10,923,142 [39.0%]) was 2.1 times higher than that in the first quarter (January to March: 5,085,087 [18.1%]); this trend continued for all 5 years. Contrarily, detection rates for EC in the fourth quarter (0.08/1,000 person) were half that in the first quarter (0.15/1,000 person). The odds of detecting EC were lowest in November; in 2015 the odds were 0.57 (95% confidence interval, 0.41 to 0.79; p=0.001) times lower and in 2016, they were 0.51 (95% confidence interval, 0.37 to 0.68; p<0.001) times lower compared to January. The predicted detection rates showed a decreasing trend toward the end of the year (p>0.05 for all). 
		                        		
		                        			Conclusions
		                        			The workload of endoscopists increased excessively with the rising number of endoscopies toward the end of the year, which was reflected by the decreased EC detection rates during this period. 
		                        		
		                        		
		                        		
		                        	
2.Association of Intensive Endoscopic Burden with Esophageal Cancer Detection: A Nationwide Cohort Study
Yeunji LEE ; Eunyoung LEE ; Bumhee PARK ; Gil Ho LEE ; Sun Gyo LIM ; Sung Jae SHIN ; Choong-Kyun NOH ; Kee Myung LEE
Gut and Liver 2025;19(1):59-68
		                        		
		                        			 Background/Aims:
		                        			Early diagnosis of esophageal cancer (EC) remains challenging despite the increasing frequency of endoscopic screenings globally. The rapidly increasing number of endoscopic screenings performed over a certain period might influence diagnostic performance. This study evaluated the association between the number of endoscopic screenings and EC detection rates in a nationwide cohort. 
		                        		
		                        			Methods:
		                        			This retrospective population-based study used the Korean National Cancer Screening Program database, comprising 32,774,742 males and females aged ≥40 years between 2015and 2019. Negative binomial regression model and least-squares mean evaluation were used to assess the association between month of the year and EC detection rates. 
		                        		
		                        			Results:
		                        			This study enrolled 28,032,590 participants who underwent upper endoscopy. The number of participants in the fourth quarter (October to December: 10,923,142 [39.0%]) was 2.1 times higher than that in the first quarter (January to March: 5,085,087 [18.1%]); this trend continued for all 5 years. Contrarily, detection rates for EC in the fourth quarter (0.08/1,000 person) were half that in the first quarter (0.15/1,000 person). The odds of detecting EC were lowest in November; in 2015 the odds were 0.57 (95% confidence interval, 0.41 to 0.79; p=0.001) times lower and in 2016, they were 0.51 (95% confidence interval, 0.37 to 0.68; p<0.001) times lower compared to January. The predicted detection rates showed a decreasing trend toward the end of the year (p>0.05 for all). 
		                        		
		                        			Conclusions
		                        			The workload of endoscopists increased excessively with the rising number of endoscopies toward the end of the year, which was reflected by the decreased EC detection rates during this period. 
		                        		
		                        		
		                        		
		                        	
3.Association of Intensive Endoscopic Burden with Esophageal Cancer Detection: A Nationwide Cohort Study
Yeunji LEE ; Eunyoung LEE ; Bumhee PARK ; Gil Ho LEE ; Sun Gyo LIM ; Sung Jae SHIN ; Choong-Kyun NOH ; Kee Myung LEE
Gut and Liver 2025;19(1):59-68
		                        		
		                        			 Background/Aims:
		                        			Early diagnosis of esophageal cancer (EC) remains challenging despite the increasing frequency of endoscopic screenings globally. The rapidly increasing number of endoscopic screenings performed over a certain period might influence diagnostic performance. This study evaluated the association between the number of endoscopic screenings and EC detection rates in a nationwide cohort. 
		                        		
		                        			Methods:
		                        			This retrospective population-based study used the Korean National Cancer Screening Program database, comprising 32,774,742 males and females aged ≥40 years between 2015and 2019. Negative binomial regression model and least-squares mean evaluation were used to assess the association between month of the year and EC detection rates. 
		                        		
		                        			Results:
		                        			This study enrolled 28,032,590 participants who underwent upper endoscopy. The number of participants in the fourth quarter (October to December: 10,923,142 [39.0%]) was 2.1 times higher than that in the first quarter (January to March: 5,085,087 [18.1%]); this trend continued for all 5 years. Contrarily, detection rates for EC in the fourth quarter (0.08/1,000 person) were half that in the first quarter (0.15/1,000 person). The odds of detecting EC were lowest in November; in 2015 the odds were 0.57 (95% confidence interval, 0.41 to 0.79; p=0.001) times lower and in 2016, they were 0.51 (95% confidence interval, 0.37 to 0.68; p<0.001) times lower compared to January. The predicted detection rates showed a decreasing trend toward the end of the year (p>0.05 for all). 
		                        		
		                        			Conclusions
		                        			The workload of endoscopists increased excessively with the rising number of endoscopies toward the end of the year, which was reflected by the decreased EC detection rates during this period. 
		                        		
		                        		
		                        		
		                        	
4.Association of Intensive Endoscopic Burden with Esophageal Cancer Detection: A Nationwide Cohort Study
Yeunji LEE ; Eunyoung LEE ; Bumhee PARK ; Gil Ho LEE ; Sun Gyo LIM ; Sung Jae SHIN ; Choong-Kyun NOH ; Kee Myung LEE
Gut and Liver 2025;19(1):59-68
		                        		
		                        			 Background/Aims:
		                        			Early diagnosis of esophageal cancer (EC) remains challenging despite the increasing frequency of endoscopic screenings globally. The rapidly increasing number of endoscopic screenings performed over a certain period might influence diagnostic performance. This study evaluated the association between the number of endoscopic screenings and EC detection rates in a nationwide cohort. 
		                        		
		                        			Methods:
		                        			This retrospective population-based study used the Korean National Cancer Screening Program database, comprising 32,774,742 males and females aged ≥40 years between 2015and 2019. Negative binomial regression model and least-squares mean evaluation were used to assess the association between month of the year and EC detection rates. 
		                        		
		                        			Results:
		                        			This study enrolled 28,032,590 participants who underwent upper endoscopy. The number of participants in the fourth quarter (October to December: 10,923,142 [39.0%]) was 2.1 times higher than that in the first quarter (January to March: 5,085,087 [18.1%]); this trend continued for all 5 years. Contrarily, detection rates for EC in the fourth quarter (0.08/1,000 person) were half that in the first quarter (0.15/1,000 person). The odds of detecting EC were lowest in November; in 2015 the odds were 0.57 (95% confidence interval, 0.41 to 0.79; p=0.001) times lower and in 2016, they were 0.51 (95% confidence interval, 0.37 to 0.68; p<0.001) times lower compared to January. The predicted detection rates showed a decreasing trend toward the end of the year (p>0.05 for all). 
		                        		
		                        			Conclusions
		                        			The workload of endoscopists increased excessively with the rising number of endoscopies toward the end of the year, which was reflected by the decreased EC detection rates during this period. 
		                        		
		                        		
		                        		
		                        	
5.Impact of Active Surveillance for Carbapenem-resistant Enterobacterales in a Homeless Patient Ward
Dong Hoon SHIN ; Jeong Eun YOON ; Inhyang EOM ; Namhee KIM ; Mi Seon HAN ; Sang Won PARK ; Eunyoung LEE
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(2):128-136
		                        		
		                        			 Background:
		                        			Hospital environments, particularly shared rooms, are vulnerable to the transmission of carbapenem-resistant Enterobacterales (CRE). The incidence of CRE colonization in the Korean homeless population remains unknown. This study aimed to analyze the impact of targeted active surveillance of CRE in hospital wards following two outbreaks. 
		                        		
		                        			Methods:
		                        			This retrospective study was conducted in a homeless ward with shared rooms at a municipal hospital in Seoul. The CRE incidence was calculated from October 1, 2023, to May 31, 2024. Active surveillance was initiated on January 22, 2024. Poisson regression analysis was used to compare CRE incidence events at three months before and four months after the intervention. The risk factors for CRE colonization were also analyzed. 
		                        		
		                        			Results:
		                        			The CRE colonization rate decreased from 1.149 to 0.815 per 1,000 patient-days post-intervention; however, the change was not statistically significant (rate ratio: 0.986, 95% confidence interval (95% CI): 0.389-2.496, P=0.976). In contrast to the secondary cases, one acquired CRE case was detected after the intervention without an outbreak. The CRE colonization rate was higher in the homeless ward than in the general ward. CRE colonization was significantly associated with age (adjusted odds ratio (aOR), 1.071; 95% CI: 1.014-1.132;P=0.014), previous antibiotic exposure (aOR, 6.796; 95% CI: 1.215-38.029; P=0.029), and co-colonization with other multidrug resistant bacteria (aOR, 7.168; 95% CI: 2.224-23.096;P=0.001). 
		                        		
		                        			Conclusion
		                        			A relatively high incidence of CRE colonization was observed in the homeless ward. After active surveillance, no CRE outbreaks occurred following the implementation. 
		                        		
		                        		
		                        		
		                        	
6.Impact of Active Surveillance for Carbapenem-resistant Enterobacterales in a Homeless Patient Ward
Dong Hoon SHIN ; Jeong Eun YOON ; Inhyang EOM ; Namhee KIM ; Mi Seon HAN ; Sang Won PARK ; Eunyoung LEE
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(2):128-136
		                        		
		                        			 Background:
		                        			Hospital environments, particularly shared rooms, are vulnerable to the transmission of carbapenem-resistant Enterobacterales (CRE). The incidence of CRE colonization in the Korean homeless population remains unknown. This study aimed to analyze the impact of targeted active surveillance of CRE in hospital wards following two outbreaks. 
		                        		
		                        			Methods:
		                        			This retrospective study was conducted in a homeless ward with shared rooms at a municipal hospital in Seoul. The CRE incidence was calculated from October 1, 2023, to May 31, 2024. Active surveillance was initiated on January 22, 2024. Poisson regression analysis was used to compare CRE incidence events at three months before and four months after the intervention. The risk factors for CRE colonization were also analyzed. 
		                        		
		                        			Results:
		                        			The CRE colonization rate decreased from 1.149 to 0.815 per 1,000 patient-days post-intervention; however, the change was not statistically significant (rate ratio: 0.986, 95% confidence interval (95% CI): 0.389-2.496, P=0.976). In contrast to the secondary cases, one acquired CRE case was detected after the intervention without an outbreak. The CRE colonization rate was higher in the homeless ward than in the general ward. CRE colonization was significantly associated with age (adjusted odds ratio (aOR), 1.071; 95% CI: 1.014-1.132;P=0.014), previous antibiotic exposure (aOR, 6.796; 95% CI: 1.215-38.029; P=0.029), and co-colonization with other multidrug resistant bacteria (aOR, 7.168; 95% CI: 2.224-23.096;P=0.001). 
		                        		
		                        			Conclusion
		                        			A relatively high incidence of CRE colonization was observed in the homeless ward. After active surveillance, no CRE outbreaks occurred following the implementation. 
		                        		
		                        		
		                        		
		                        	
7.Impact of Active Surveillance for Carbapenem-resistant Enterobacterales in a Homeless Patient Ward
Dong Hoon SHIN ; Jeong Eun YOON ; Inhyang EOM ; Namhee KIM ; Mi Seon HAN ; Sang Won PARK ; Eunyoung LEE
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(2):128-136
		                        		
		                        			 Background:
		                        			Hospital environments, particularly shared rooms, are vulnerable to the transmission of carbapenem-resistant Enterobacterales (CRE). The incidence of CRE colonization in the Korean homeless population remains unknown. This study aimed to analyze the impact of targeted active surveillance of CRE in hospital wards following two outbreaks. 
		                        		
		                        			Methods:
		                        			This retrospective study was conducted in a homeless ward with shared rooms at a municipal hospital in Seoul. The CRE incidence was calculated from October 1, 2023, to May 31, 2024. Active surveillance was initiated on January 22, 2024. Poisson regression analysis was used to compare CRE incidence events at three months before and four months after the intervention. The risk factors for CRE colonization were also analyzed. 
		                        		
		                        			Results:
		                        			The CRE colonization rate decreased from 1.149 to 0.815 per 1,000 patient-days post-intervention; however, the change was not statistically significant (rate ratio: 0.986, 95% confidence interval (95% CI): 0.389-2.496, P=0.976). In contrast to the secondary cases, one acquired CRE case was detected after the intervention without an outbreak. The CRE colonization rate was higher in the homeless ward than in the general ward. CRE colonization was significantly associated with age (adjusted odds ratio (aOR), 1.071; 95% CI: 1.014-1.132;P=0.014), previous antibiotic exposure (aOR, 6.796; 95% CI: 1.215-38.029; P=0.029), and co-colonization with other multidrug resistant bacteria (aOR, 7.168; 95% CI: 2.224-23.096;P=0.001). 
		                        		
		                        			Conclusion
		                        			A relatively high incidence of CRE colonization was observed in the homeless ward. After active surveillance, no CRE outbreaks occurred following the implementation. 
		                        		
		                        		
		                        		
		                        	
8.Impact of Active Surveillance for Carbapenem-resistant Enterobacterales in a Homeless Patient Ward
Dong Hoon SHIN ; Jeong Eun YOON ; Inhyang EOM ; Namhee KIM ; Mi Seon HAN ; Sang Won PARK ; Eunyoung LEE
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(2):128-136
		                        		
		                        			 Background:
		                        			Hospital environments, particularly shared rooms, are vulnerable to the transmission of carbapenem-resistant Enterobacterales (CRE). The incidence of CRE colonization in the Korean homeless population remains unknown. This study aimed to analyze the impact of targeted active surveillance of CRE in hospital wards following two outbreaks. 
		                        		
		                        			Methods:
		                        			This retrospective study was conducted in a homeless ward with shared rooms at a municipal hospital in Seoul. The CRE incidence was calculated from October 1, 2023, to May 31, 2024. Active surveillance was initiated on January 22, 2024. Poisson regression analysis was used to compare CRE incidence events at three months before and four months after the intervention. The risk factors for CRE colonization were also analyzed. 
		                        		
		                        			Results:
		                        			The CRE colonization rate decreased from 1.149 to 0.815 per 1,000 patient-days post-intervention; however, the change was not statistically significant (rate ratio: 0.986, 95% confidence interval (95% CI): 0.389-2.496, P=0.976). In contrast to the secondary cases, one acquired CRE case was detected after the intervention without an outbreak. The CRE colonization rate was higher in the homeless ward than in the general ward. CRE colonization was significantly associated with age (adjusted odds ratio (aOR), 1.071; 95% CI: 1.014-1.132;P=0.014), previous antibiotic exposure (aOR, 6.796; 95% CI: 1.215-38.029; P=0.029), and co-colonization with other multidrug resistant bacteria (aOR, 7.168; 95% CI: 2.224-23.096;P=0.001). 
		                        		
		                        			Conclusion
		                        			A relatively high incidence of CRE colonization was observed in the homeless ward. After active surveillance, no CRE outbreaks occurred following the implementation. 
		                        		
		                        		
		                        		
		                        	
9.Automated Versus Handheld Breast Ultrasound for Evaluating Axillary Lymph Nodes in Patients With Breast Cancer
Sun Mi KIM ; Mijung JANG ; Bo La YUN ; Sung Ui SHIN ; Jiwon RIM ; Eunyoung KANG ; Eun-Kyu KIM ; Hee-Chul SHIN ; So Yeon PARK ; Bohyoung KIM
Korean Journal of Radiology 2024;25(2):146-156
		                        		
		                        			 Objective:
		                        			Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017–May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. 
		                        		
		                        			Results:
		                        			The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS–HHUS agreement was 95.9% (236/246; Cohen’s kappa = 0.883). 
		                        		
		                        			Conclusion
		                        			Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS. 
		                        		
		                        		
		                        		
		                        	
10.Infectious Skin Diseases of Korean National Wrestlers: A Cross-sectional Observational Study
Yunjo CHOUNG ; Bumjo OH ; Jongseung KIM ; Jung-sun LIM ; Sujeong HAN ; Eunyoung SHIN ; Jungjoong YOON ; Moonjung BAE ; Jeh-Kwang RYU
The Korean Journal of Sports Medicine 2024;42(2):99-104
		                        		
		                        			 Purpose:
		                        			Wrestlers have a lot of direct skin-to-skin contact between wrestlers during matches, and many studies show that wrestlers are vulnerable to the spread of skin infections. However, there have been few studies on skin infections in Korean wrestlers. The purpose of this study was to compare the characteristics of skin diseases in wrestlers and other athletes. 
		                        		
		                        			Methods:
		                        			Athletes who visited for skin diseases in the Department of Family Medicine in the Jincheon National Training Center in 2018 were investigated. We calculated the duration of skin disease per training period (DSD/TP) as the number of visits×7 days×1,000/official training days. Athletes with a DSD/TP above the median value or equal to were defined as the high DSD/TP group, and the others were defined as the low DSD/TP group. A chi-square test was used to compare the odds ratio [OR] for these groups about infectious and noninfectious skin diseases. 
		                        		
		                        			Results:
		                        			Thirty wrestlers and 89 other sports players visited the infirmary with skin diseases. The probability of belonging to the high DSD/TP group was significantly higher when the wrestlers visited for skin infections than the other athletes (OR, 7.714; 95% confidence interval [CI], 2.699–22.048). However, there was no significant difference in noninfectious skin diseases between wrestling and other sports (OR, 0.569; 95% CI, 0.246–1.320). 
		                        		
		                        			Conclusion
		                        			This is the first study that shows Korean national wrestlers with skin diseases receive more treatment for infectious skin diseases than other sports. This study can provide important information on the prevention of wrestlers for skin infections. 
		                        		
		                        		
		                        		
		                        	
            
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