1.Epidemiology of Nontyphoidal Salmonella Infections in Korean Children and Genetic Factors Associated with Extra-intestinal Invasion: A Whole-genome Sequencing Analysis
Hyun Mi KANG ; Jiyon CHU ; In Hyuk YOO ; In Young YOO ; Jeong-Ih SHIN ; Mi-Ran SEO ; Yeun-Jun CHUNG ; Seung-Hyun JUNG ; Yeon Joon PARK
Annals of Laboratory Medicine 2025;45(3):312-321
Background:
Understanding the virulence and pathogenicity of invasive nontyphoidal Salmonella (iNTS) in children may support timely treatment and enable closer monitoring of chronic infections. iNTS epidemiology in Asia remains inadequately described. We analyzed the genetic diversity and virulence genes associated with extra-intestinal invasion in Korean children.
Methods:
Salmonella isolates from children < 18 yrs of age diagnosed with moderate-tosevere salmonellosis between January 2019 and December 2021 were subjected to antibiotic susceptibility testing and whole-genome sequencing.
Results:
In total, 58 cases were included. We identified 20 serotypes, the most prevalent being Salmonella Enteritidis (N = 21), followed by Infantis (N = 6), I 4,[5],12:i:- (N = 5), and Bareilly (N = 5). Extra-intestinal invasion occurred in 12 (20.7%) cases involving Salmonella Oranienburg (2/2), Give (1/1), Javiana (1/1), Paratyphi B var. L(+) tartrate+ (1/1), Schwarzengrund (1/1), Singapore (1/1), Montevideo (1/2), Saintpaul (1/2), I 4:b:- (1/2), Infantis (1/6), and Enteritidis (1/21). While the numbers of total virulence genes and genes belonging to major virulence categories did not significantly differ between iNTS and noniNTS, several genetic factors, including Salmonella pathogenicity island (SPI)-1 (P = 0.039), SPI-2 (P = 0.020), SPI-5 (P = 0.014), SPI-13 (P = 0.010), cytolethal distending toxin-related genes (P = 1.4 × 10 –4 ), fepC (P = 0.021), and tcpC (P = 0.040) were more frequent in invasive isolates.
Conclusions
Salmonella Enteritidis-ST11 predominated in infections among Korean children, but invasive isolates were rare. Early detection of genetic factors associated with extra-intestinal invasion will be helpful for prompt and appropriate treatment.
2.Comparison of In-Shoe Pedobarographic Variables between 2 Orthoses during Toe and Heel Gaits
Min Gyu KYUNG ; Hyun Seok SEO ; Young Sik YOON ; Dae-Yoo KIM ; Seung Min LEE ; Dong Yeon LEE
Clinics in Orthopedic Surgery 2024;16(6):987-993
Background:
The choice of an appropriate type of orthosis depends on the patient’s specific condition and needs. Different types of orthoses can affect plantar pressure distribution during certain gait patterns. Toe and heel gaits are common patterns of gait assigned for optimal recovery in patients with foot or ankle injuries. This study aimed to evaluate differences in plantar pressure between postoperative shoes and walker boots during toe and heel gaits in healthy individuals.
Methods:
A total of 30 healthy individuals with a mean age of 21.7 ± 1.2 years were included in this study. Two types of gaits, toe and heel, were performed while wearing each orthosis on the right side of the foot. A standardized running shoe was worn on the left side of the foot. Plantar pressure variables including contact area, peak pressure, and maximum force were collected using the Pedar-X in-shoe pressure measuring system.
Results:
During toe gait, while both orthoses demonstrated similar offloading in the hindfoot areas, walker boots were superior in reducing the peak pressure (first toe, p = 0.003; second to fifth toes, p < 0.001) and contact area (first toe, p = 0.003; second to fifth toes, p = 0.003) in the forefoot areas. During heel gait, both orthoses demonstrated similar offloading in the toe areas; however, the walker boots were superior in reducing the peak pressure in the lateral hindfoot (p < 0.001).
Conclusions
The results of our study can serve as a guideline for orthopedic physicians in prescribing an appropriate type of orthosis during specific types of gait for patients following foot and ankle injury and postoperative recovery.
3.Deep Learning-Assisted Quantitative Measurement of Thoracolumbar Fracture Features on Lateral Radiographs
Woon Tak YUH ; Eun Kyung KHIL ; Yu Sung YOON ; Burnyoung KIM ; Hongjun YOON ; Jihe LIM ; Kyoung Yeon LEE ; Yeong Seo YOO ; Kyeong Deuk AN
Neurospine 2024;21(1):30-43
Objective:
This study aimed to develop and validate a deep learning (DL) algorithm for the quantitative measurement of thoracolumbar (TL) fracture features, and to evaluate its efficacy across varying levels of clinical expertise.
Methods:
Using the pretrained Mask Region-Based Convolutional Neural Networks model, originally developed for vertebral body segmentation and fracture detection, we fine-tuned the model and added a new module for measuring fracture metrics—compression rate (CR), Cobb angle (CA), Gardner angle (GA), and sagittal index (SI)—from lumbar spine lateral radiographs. These metrics were derived from six-point labeling by 3 radiologists, forming the ground truth (GT). Training utilized 1,000 nonfractured and 318 fractured radiographs, while validations employed 213 internal and 200 external fractured radiographs. The accuracy of the DL algorithm in quantifying fracture features was evaluated against GT using the intraclass correlation coefficient. Additionally, 4 readers with varying expertise levels, including trainees and an attending spine surgeon, performed measurements with and without DL assistance, and their results were compared to GT and the DL model.
Results:
The DL algorithm demonstrated good to excellent agreement with GT for CR, CA, GA, and SI in both internal (0.860, 0.944, 0.932, and 0.779, respectively) and external (0.836, 0.940, 0.916, and 0.815, respectively) validations. DL-assisted measurements significantly improved most measurement values, particularly for trainees.
Conclusion
The DL algorithm was validated as an accurate tool for quantifying TL fracture features using radiographs. DL-assisted measurement is expected to expedite the diagnostic process and enhance reliability, particularly benefiting less experienced clinicians.
4.Deep Learning-Assisted Quantitative Measurement of Thoracolumbar Fracture Features on Lateral Radiographs
Woon Tak YUH ; Eun Kyung KHIL ; Yu Sung YOON ; Burnyoung KIM ; Hongjun YOON ; Jihe LIM ; Kyoung Yeon LEE ; Yeong Seo YOO ; Kyeong Deuk AN
Neurospine 2024;21(1):30-43
Objective:
This study aimed to develop and validate a deep learning (DL) algorithm for the quantitative measurement of thoracolumbar (TL) fracture features, and to evaluate its efficacy across varying levels of clinical expertise.
Methods:
Using the pretrained Mask Region-Based Convolutional Neural Networks model, originally developed for vertebral body segmentation and fracture detection, we fine-tuned the model and added a new module for measuring fracture metrics—compression rate (CR), Cobb angle (CA), Gardner angle (GA), and sagittal index (SI)—from lumbar spine lateral radiographs. These metrics were derived from six-point labeling by 3 radiologists, forming the ground truth (GT). Training utilized 1,000 nonfractured and 318 fractured radiographs, while validations employed 213 internal and 200 external fractured radiographs. The accuracy of the DL algorithm in quantifying fracture features was evaluated against GT using the intraclass correlation coefficient. Additionally, 4 readers with varying expertise levels, including trainees and an attending spine surgeon, performed measurements with and without DL assistance, and their results were compared to GT and the DL model.
Results:
The DL algorithm demonstrated good to excellent agreement with GT for CR, CA, GA, and SI in both internal (0.860, 0.944, 0.932, and 0.779, respectively) and external (0.836, 0.940, 0.916, and 0.815, respectively) validations. DL-assisted measurements significantly improved most measurement values, particularly for trainees.
Conclusion
The DL algorithm was validated as an accurate tool for quantifying TL fracture features using radiographs. DL-assisted measurement is expected to expedite the diagnostic process and enhance reliability, particularly benefiting less experienced clinicians.
5.Deep Learning-Assisted Quantitative Measurement of Thoracolumbar Fracture Features on Lateral Radiographs
Woon Tak YUH ; Eun Kyung KHIL ; Yu Sung YOON ; Burnyoung KIM ; Hongjun YOON ; Jihe LIM ; Kyoung Yeon LEE ; Yeong Seo YOO ; Kyeong Deuk AN
Neurospine 2024;21(1):30-43
Objective:
This study aimed to develop and validate a deep learning (DL) algorithm for the quantitative measurement of thoracolumbar (TL) fracture features, and to evaluate its efficacy across varying levels of clinical expertise.
Methods:
Using the pretrained Mask Region-Based Convolutional Neural Networks model, originally developed for vertebral body segmentation and fracture detection, we fine-tuned the model and added a new module for measuring fracture metrics—compression rate (CR), Cobb angle (CA), Gardner angle (GA), and sagittal index (SI)—from lumbar spine lateral radiographs. These metrics were derived from six-point labeling by 3 radiologists, forming the ground truth (GT). Training utilized 1,000 nonfractured and 318 fractured radiographs, while validations employed 213 internal and 200 external fractured radiographs. The accuracy of the DL algorithm in quantifying fracture features was evaluated against GT using the intraclass correlation coefficient. Additionally, 4 readers with varying expertise levels, including trainees and an attending spine surgeon, performed measurements with and without DL assistance, and their results were compared to GT and the DL model.
Results:
The DL algorithm demonstrated good to excellent agreement with GT for CR, CA, GA, and SI in both internal (0.860, 0.944, 0.932, and 0.779, respectively) and external (0.836, 0.940, 0.916, and 0.815, respectively) validations. DL-assisted measurements significantly improved most measurement values, particularly for trainees.
Conclusion
The DL algorithm was validated as an accurate tool for quantifying TL fracture features using radiographs. DL-assisted measurement is expected to expedite the diagnostic process and enhance reliability, particularly benefiting less experienced clinicians.
6.Practice guidelines for managing extrahepatic biliary tract cancers
Hyung Sun KIM ; Mee Joo KANG ; Jingu KANG ; Kyubo KIM ; Bohyun KIM ; Seong-Hun KIM ; Soo Jin KIM ; Yong-Il KIM ; Joo Young KIM ; Jin Sil KIM ; Haeryoung KIM ; Hyo Jung KIM ; Ji Hae NAHM ; Won Suk PARK ; Eunkyu PARK ; Joo Kyung PARK ; Jin Myung PARK ; Byeong Jun SONG ; Yong Chan SHIN ; Keun Soo AHN ; Sang Myung WOO ; Jeong Il YU ; Changhoon YOO ; Kyoungbun LEE ; Dong Ho LEE ; Myung Ah LEE ; Seung Eun LEE ; Ik Jae LEE ; Huisong LEE ; Jung Ho IM ; Kee-Taek JANG ; Hye Young JANG ; Sun-Young JUN ; Hong Jae CHON ; Min Kyu JUNG ; Yong Eun CHUNG ; Jae Uk CHONG ; Eunae CHO ; Eui Kyu CHIE ; Sae Byeol CHOI ; Seo-Yeon CHOI ; Seong Ji CHOI ; Joon Young CHOI ; Hye-Jeong CHOI ; Seung-Mo HONG ; Ji Hyung HONG ; Tae Ho HONG ; Shin Hye HWANG ; In Gyu HWANG ; Joon Seong PARK
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(2):161-202
Background:
s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021.
Methods:
Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop.
Results:
In November 2021, the finalized draft was presented for public scrutiny during a formal hearing.
Conclusions
The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.
7.Comparison of In-Shoe Pedobarographic Variables between 2 Orthoses during Toe and Heel Gaits
Min Gyu KYUNG ; Hyun Seok SEO ; Young Sik YOON ; Dae-Yoo KIM ; Seung Min LEE ; Dong Yeon LEE
Clinics in Orthopedic Surgery 2024;16(6):987-993
Background:
The choice of an appropriate type of orthosis depends on the patient’s specific condition and needs. Different types of orthoses can affect plantar pressure distribution during certain gait patterns. Toe and heel gaits are common patterns of gait assigned for optimal recovery in patients with foot or ankle injuries. This study aimed to evaluate differences in plantar pressure between postoperative shoes and walker boots during toe and heel gaits in healthy individuals.
Methods:
A total of 30 healthy individuals with a mean age of 21.7 ± 1.2 years were included in this study. Two types of gaits, toe and heel, were performed while wearing each orthosis on the right side of the foot. A standardized running shoe was worn on the left side of the foot. Plantar pressure variables including contact area, peak pressure, and maximum force were collected using the Pedar-X in-shoe pressure measuring system.
Results:
During toe gait, while both orthoses demonstrated similar offloading in the hindfoot areas, walker boots were superior in reducing the peak pressure (first toe, p = 0.003; second to fifth toes, p < 0.001) and contact area (first toe, p = 0.003; second to fifth toes, p = 0.003) in the forefoot areas. During heel gait, both orthoses demonstrated similar offloading in the toe areas; however, the walker boots were superior in reducing the peak pressure in the lateral hindfoot (p < 0.001).
Conclusions
The results of our study can serve as a guideline for orthopedic physicians in prescribing an appropriate type of orthosis during specific types of gait for patients following foot and ankle injury and postoperative recovery.
8.Comparison of In-Shoe Pedobarographic Variables between 2 Orthoses during Toe and Heel Gaits
Min Gyu KYUNG ; Hyun Seok SEO ; Young Sik YOON ; Dae-Yoo KIM ; Seung Min LEE ; Dong Yeon LEE
Clinics in Orthopedic Surgery 2024;16(6):987-993
Background:
The choice of an appropriate type of orthosis depends on the patient’s specific condition and needs. Different types of orthoses can affect plantar pressure distribution during certain gait patterns. Toe and heel gaits are common patterns of gait assigned for optimal recovery in patients with foot or ankle injuries. This study aimed to evaluate differences in plantar pressure between postoperative shoes and walker boots during toe and heel gaits in healthy individuals.
Methods:
A total of 30 healthy individuals with a mean age of 21.7 ± 1.2 years were included in this study. Two types of gaits, toe and heel, were performed while wearing each orthosis on the right side of the foot. A standardized running shoe was worn on the left side of the foot. Plantar pressure variables including contact area, peak pressure, and maximum force were collected using the Pedar-X in-shoe pressure measuring system.
Results:
During toe gait, while both orthoses demonstrated similar offloading in the hindfoot areas, walker boots were superior in reducing the peak pressure (first toe, p = 0.003; second to fifth toes, p < 0.001) and contact area (first toe, p = 0.003; second to fifth toes, p = 0.003) in the forefoot areas. During heel gait, both orthoses demonstrated similar offloading in the toe areas; however, the walker boots were superior in reducing the peak pressure in the lateral hindfoot (p < 0.001).
Conclusions
The results of our study can serve as a guideline for orthopedic physicians in prescribing an appropriate type of orthosis during specific types of gait for patients following foot and ankle injury and postoperative recovery.
9.Prognostic Significance Of Sequential 18f-fdg Pet/Ct During Frontline Treatment Of Peripheral T Cell Lymphomas
Ga-Young SONG ; Sung-Hoon JUNG ; Seo-Yeon AHN ; Mihee KIM ; Jae-Sook AHN ; Je-Jung LEE ; Hyeoung-Joon KIM ; Jang Bae MOON ; Su Woong YOO ; Seong Young KWON ; Jung-Joon MIN ; Hee-Seung BOM ; Sae-Ryung KANG ; Deok-Hwan YANG
The Korean Journal of Internal Medicine 2024;39(2):327-337
Background/Aims:
The prognostic significance of 18F-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT) in peripheral T-cell lymphomas (PTCLs) are controversial. We explored the prognostic impact of sequential 18F-FDG PET/CT during frontline chemotherapy of patients with PTCLs.
Methods:
In total, 143 patients with newly diagnosed PTCLs were included. Sequential 18F-FDG PET/CTs were performed at the time of diagnosis, during chemotherapy, and at the end of chemotherapy. The baseline total metabolic tumor volume (TMTV) was calculated using the the standard uptake value with a threshold method of 2.5.
Results:
A baseline TMTV of 457.0 cm3 was used to categorize patients into high and low TMTV groups. Patients with a requirehigh TMTV had shorter progression-free survival (PFS) and overall survival (OS) than those with a low TMTV (PFS, 9.8 vs. 26.5 mo, p = 0.043; OS, 18.9 vs. 71.2 mo, p = 0.004). The interim 18F-FDG PET/CT response score was recorded as 1, 2–3, and 4–5 according to the Deauville criteria. The PFS and OS showed significant differences according to the interim 18F-FDG PET/CT response score (PFS, 120.7 vs. 34.1 vs. 5.1 mo, p < 0.001; OS, not reached vs. 61.1 mo vs. 12.1 mo, p < 0.001).
Conclusions
The interim PET/CT response based on visual assessment predicts disease progression and survival outcome in PTCLs. A high baseline TMTV is associated with a poor response to anthracycline-based chemotherapy in PTCLs. However, TMTV was not an independent predictor for PFS in the multivariate analysis.
10.Comparison of In-Shoe Pedobarographic Variables between 2 Orthoses during Toe and Heel Gaits
Min Gyu KYUNG ; Hyun Seok SEO ; Young Sik YOON ; Dae-Yoo KIM ; Seung Min LEE ; Dong Yeon LEE
Clinics in Orthopedic Surgery 2024;16(6):987-993
Background:
The choice of an appropriate type of orthosis depends on the patient’s specific condition and needs. Different types of orthoses can affect plantar pressure distribution during certain gait patterns. Toe and heel gaits are common patterns of gait assigned for optimal recovery in patients with foot or ankle injuries. This study aimed to evaluate differences in plantar pressure between postoperative shoes and walker boots during toe and heel gaits in healthy individuals.
Methods:
A total of 30 healthy individuals with a mean age of 21.7 ± 1.2 years were included in this study. Two types of gaits, toe and heel, were performed while wearing each orthosis on the right side of the foot. A standardized running shoe was worn on the left side of the foot. Plantar pressure variables including contact area, peak pressure, and maximum force were collected using the Pedar-X in-shoe pressure measuring system.
Results:
During toe gait, while both orthoses demonstrated similar offloading in the hindfoot areas, walker boots were superior in reducing the peak pressure (first toe, p = 0.003; second to fifth toes, p < 0.001) and contact area (first toe, p = 0.003; second to fifth toes, p = 0.003) in the forefoot areas. During heel gait, both orthoses demonstrated similar offloading in the toe areas; however, the walker boots were superior in reducing the peak pressure in the lateral hindfoot (p < 0.001).
Conclusions
The results of our study can serve as a guideline for orthopedic physicians in prescribing an appropriate type of orthosis during specific types of gait for patients following foot and ankle injury and postoperative recovery.

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