Breast cancer is the most common malignancy in Korean women, and its incidence continues to increase. The Korean Breast Cancer Society (KBCS) established a nationwide breast cancer database through its online enrollment program in 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea, and to assess the pattern of changes in breast cancer management in 2018. We analyzed the KBCS and Korea Central Cancer Registry (KCCR) databases in 2018. In 2018, 28,157 patients were newly diagnosed with breast cancer, of whom 4,510 had noninvasive breast cancer and 23,647 had invasive breast cancer. The age-standardized rate of breast cancer in 2018 was 79.0 per 100,000 women (65.6 invasive, 13.4 noninvasive). The median age of female patients diagnosed with breast cancer in 2018 was 52 years, and the incidence of breast cancer was the highest in the 40–49-years age group (9,432 patients, 33.6%). The proportion of patients with stage 0 and stage I breast cancer continued to increase, accounting for 63.8% of cases, and breast-conserving surgery was performed more often than mastectomy (66.2% vs. 33.0%). The most common subtypes of breast cancer were hormone receptor [HR]-positive and human epidermal growth factor receptor-2 (HER2)-negative types (65.9% of cases), while the HR-negative and HER2-positive types accounted for 9.2% of cases. According to the KCCR data, from 2014 to 2018, the 5-year relative survival rate of patients with breast cancer was 93.3%, which was 14.0% higher than that from 1993 to 1995 (79.3%). The clinical characteristics of breast cancer in Korea have been changing, and national databases can improve our understanding of the disease characteristics of Korean women. Therefore, updating the KBCS registry is important for the effective management of breast cancer in Korea.

Objective: This study evaluated the deep learning (DL) algorithm performance to detect lesions that suggest pneumonia in chest X-rays (CXR) of suspected coronavirus disease 2019 (COVID-19) patients. Methods: This retrospective study included consecutive patients who visited a screening clinic in Daegu, and were suspected to be afflicted with the COVID-19 during the COVID-19 epidemic. CXR were analyzed using the commercial artificial intelligence product that provides free online DL algorithms to the public for COVID-19. Computerized tomography was used as the standard reference. Performance of the DL algorithm was evaluated by the sensitivity and specificity, and results were compared to the CXR records of emergency physicians (EP) in charge of the actual screening triage clinic during the COVID-19 epidemic. Results: Totally, 114 patients were evaluated, of which 38 patients were positive for COVID-19. In 85 CXRs examined (36 COVID-19 and 49 non-COVID-19) with findings of pneumonia in computerized tomography, the DL algorithm showed significantly higher sensitivity as compared to the EP (DL, 98.8% [93.6%-99.9%] vs. EP, 85.9% [76.6%-92.5%]; P<0.01). Moreover, the DL algorithm showed significantly higher sensitivity for detecting CXRs with COVID-19 pneumonia, as compared to the EP (DL, 100.0% [90.3%-100%] vs. EP, 91.7% [77.5%-98.3%]; P=0.08). Conclusion We conclude that for examining the CXR of patients with suspected COVID-19, sensitivity of the DL algorithm is superior than the EP for detecting lesions suggesting pneumonia. Thus, the application of the DL algorithm is potentially useful in screening triage clinics to detect COVID-19 pneumonia.

Breast cancer is the most common malignancy in Korean women, and its incidence continues to increase. The Korean Breast Cancer Society (KBCS) established a nationwide breast cancer database through its online enrollment program in 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea, and to assess the pattern of changes in breast cancer management in 2018. We analyzed the KBCS and Korea Central Cancer Registry (KCCR) databases in 2018. In 2018, 28,157 patients were newly diagnosed with breast cancer, of whom 4,510 had noninvasive breast cancer and 23,647 had invasive breast cancer. The age-standardized rate of breast cancer in 2018 was 79.0 per 100,000 women (65.6 invasive, 13.4 noninvasive). The median age of female patients diagnosed with breast cancer in 2018 was 52 years, and the incidence of breast cancer was the highest in the 40–49-years age group (9,432 patients, 33.6%). The proportion of patients with stage 0 and stage I breast cancer continued to increase, accounting for 63.8% of cases, and breast-conserving surgery was performed more often than mastectomy (66.2% vs. 33.0%). The most common subtypes of breast cancer were hormone receptor [HR]-positive and human epidermal growth factor receptor-2 (HER2)-negative types (65.9% of cases), while the HR-negative and HER2-positive types accounted for 9.2% of cases. According to the KCCR data, from 2014 to 2018, the 5-year relative survival rate of patients with breast cancer was 93.3%, which was 14.0% higher than that from 1993 to 1995 (79.3%). The clinical characteristics of breast cancer in Korea have been changing, and national databases can improve our understanding of the disease characteristics of Korean women. Therefore, updating the KBCS registry is important for the effective management of breast cancer in Korea.

Objective: This study evaluated the deep learning (DL) algorithm performance to detect lesions that suggest pneumonia in chest X-rays (CXR) of suspected coronavirus disease 2019 (COVID-19) patients. Methods: This retrospective study included consecutive patients who visited a screening clinic in Daegu, and were suspected to be afflicted with the COVID-19 during the COVID-19 epidemic. CXR were analyzed using the commercial artificial intelligence product that provides free online DL algorithms to the public for COVID-19. Computerized tomography was used as the standard reference. Performance of the DL algorithm was evaluated by the sensitivity and specificity, and results were compared to the CXR records of emergency physicians (EP) in charge of the actual screening triage clinic during the COVID-19 epidemic. Results: Totally, 114 patients were evaluated, of which 38 patients were positive for COVID-19. In 85 CXRs examined (36 COVID-19 and 49 non-COVID-19) with findings of pneumonia in computerized tomography, the DL algorithm showed significantly higher sensitivity as compared to the EP (DL, 98.8% [93.6%-99.9%] vs. EP, 85.9% [76.6%-92.5%]; P<0.01). Moreover, the DL algorithm showed significantly higher sensitivity for detecting CXRs with COVID-19 pneumonia, as compared to the EP (DL, 100.0% [90.3%-100%] vs. EP, 91.7% [77.5%-98.3%]; P=0.08). Conclusion We conclude that for examining the CXR of patients with suspected COVID-19, sensitivity of the DL algorithm is superior than the EP for detecting lesions suggesting pneumonia. Thus, the application of the DL algorithm is potentially useful in screening triage clinics to detect COVID-19 pneumonia.

This article describes the breast cancer statistics in Korea, including the incidence, type of surgical procedure, stage, and molecular subtype, using the Korean Breast Cancer Society (KBCS) and Korea Central Cancer Registry data. There were a total of 26,534 new breast cancer diagnoses in 2017 in Korea, of which 4,139 were carcinoma in situ cases and 22,395 were invasive cancer cases. The age standardized rate of breast cancer was 75.3 per 100,000 women in 2017 (63.0 of invasive carcinoma and 12.3 of carcinoma in situ), and it has been steadily increasing across all age groups. Breast cancer occurred most commonly in the 40–49 age group. Compared to 2016, breast conserving surgery (BCS) has increased, and 67.4% of patients were treated with BCS in 2017. The proportions of stage 0 and stage I have continued to increase, accounting for 60.7%. The most common subtype of breast cancer was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (HER2) negative type comprising 65.9% of the cases, whereas HR negative and HER2 positive type was the rarest comprising 10.2% of the cases. The 5-year relative survival rate of breast cancer patients had increased by 14.0% from 79.2% in 1993–1995 to 93.2% in 2013–2017. It is essential to actively enter breast cancer data into the KBCS registry to improve our understanding.

PURPOSE: This study shows the change in emergency room use behavior by homeless patients after implementation of the ‘Seoul Type Citizen Sympathy Emergency Room Project’ in July 2015. METHODS: A retrospective study was conducted in a public hospital between January 2014 and December 2014 and January 2016 and December 2016. Homeless patients who visited the emergency room in 2014 and 2016 were compared based on age, gender, mode of insurance, admission, revisit within 48 hours, length of stay (LOS) in the emergency department (ED), total cost, and major diagnostic category. RESULTS: A total of 3,642 homeless patients were enrolled during the study period, of which 1,876 visited in 2014 and 1,766 in 2016. Fewer homeless patients in 2016 revisited within 48 hours (p=0.046). Homeless in 2016 had a shorter ED LOS (p < 0.001) and lower total cost (p=0.040). More homeless patients who visited due to alcohol revisited within 48 hours in 2016 (p=0.036). Moreover, these patients did not have a different ED LOS (p=0.060) or total cost (p=0.475). Medicaid homeless patients were less connected compared health insurance by screening, brief intervention, referral to treatment program. CONCLUSION: Comparison of homeless patients who visited the emergency room in 2014 and 2016 revealed fewer total homeless patients in 2016, as well as less revisits within 48 hours, shorter ED LOS and lower total cost. These findings indicate that the ‘Seoul Type Citizen Sympathy Emergency Room Project’ was effective in the emergency room, but improvements for alcohol and medicaid homeless patients are needed.
Alcoholics ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Health Policy ; Homeless Persons ; Hospitals, Public ; Humans ; Insurance ; Insurance, Health ; Length of Stay ; Mass Screening ; Medicaid ; Referral and Consultation ; Retrospective Studies

PURPOSE: To compare the clinical results after implantation of three one-piece aspheric lenses, Acrysof IQ SN60WF, Tecnis 1-piece ZCB00 and the newly developed IOL HOYA AF-1 NY-60. METHODS: In total 66 eyes, one of three one-piece aspheric lenses, Acrysof IQ SN60WF, TECNIS 1-piece ZCB00 or HOYA AF-1 NY-60 was implanted after cataract extraction. Best corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA) were assessed at postoperative 3 months. Total spherical aberration, high order aberration and modulation transfer function of 5.0 mm pupil size zone were evaluated. RESULTS: There were no significant differences of UCVA, BCVA, the accuracy of postoperative refractive power and modulation transfer function among three groups. High order aberrations of the entire eye and internal optics showed almost no significant differences except some aberration values. CONCLUSIONS: The newly developed intraocular lens, HOYA AF-1 NY-60 showed almost equal clinical results in comparison with Acrysof IQ SN60WF and TECNIS 1-piece ZCB00.
Cataract Extraction ; Eye ; Lenses, Intraocular ; Pupil ; Visual Acuity

Erdheim-Chester disease is a rare non-Langerhans-cell histiocytosis involving bones and multiple organs. Its clinical course can vary, from an asymptomatic state to a fatal disease, with renal involvement being a common cause of death. A 41-year-old man presented with a 10-month history of bilateral lower limb pain. Left perirenal soft-tissue infiltration had been found incidentally two years earlier. No progression of the lesion or deterioration of renal function was observed for a period of two years. At admission, plain radiography and magnetic resonance imaging of the patient's lower limbs showed patchy osteosclerosis. Biopsy of the tibia revealed histiocytic infiltration, which was found to be positive for CD68 and negative for CD1a. This report describes an unusual case of Erdheim-Chester disease involving a stationary course of disease with no specific treatment for a long period of time.
Adult ; Asymptomatic Diseases ; Biopsy ; Cause of Death ; Erdheim-Chester Disease ; Histiocytosis, Non-Langerhans-Cell ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Osteosclerosis ; Retroperitoneal Fibrosis ; Tibia

PURPOSE: To evaluate the influence of pupil size on uncorrected visual acuity and spherical aberration of the TECNIS 1-piece intraocular lens (IOL). METHODS: In this study 61 eyes were implanted with a TECNIS 1-piece IOL. Pupil size was checked by standard pupil card with cobalt blue light postoperatively. Best corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA) were assessed postoperatively. Total spherical aberration and high-order aberration for mesopic pupil size zone were measured. RESULTS: There were no significant differences of spherical equivalent, age, preoperative astigmatism, BCVA between two groups, but small pupil group revealed better UCVA (p = 0.02) and lower ocular aberration than large pupil group. CONCLUSIONS: After cataract surgery, pupil size greater than 5.0 mm increases total aberration. Thus, visual acuity with small pupil after aspheric TECNIS 1-piece IOL implantation show better clinical result on uncorrected visual acuity.
Astigmatism ; Cataract ; Cobalt ; Eye ; Lenses, Intraocular ; Light ; Miosis ; Pupil ; Visual Acuity

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization