Performance Comparison Between Fourier-Transform Infrared Spectroscopy–based IR Biotyper and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry for Strain Diversity

Background@#Development of an accessible method to routinely evaluate the clonality of strains is needed in microbiology laboratories. We compared the discriminatory power of the Fourier-transform infrared (FTIR) spectroscopy–based IR Biotyper (Bruker Daltonics GmbH, Bremen, Germany) to matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), using whole-genome sequencing (WGS) as the reference method. @*Methods@#Eighty-three extended-spectrum β-lactamase–producing Escherichia coli isolates were tested using WGS, MALDI-TOF MS, and IR Biotyper. Simpson’s diversity index (SDI), a statistical analysis for testing the homogeneity of a dendrogram, and the adjusted Rand index (aRI) were used to compare the discriminatory ability between typing tests. @*Results@#The SDI (95% confidence interval) was 0.969 (0.952–0.985) for WGS, 0.865 (0.807–0.924) for MALDI-TOF MS, and 0.974 (0.965–0.983) for IR Biotyper. Compared with WGS, IR Biotyper showed compatible diversity, whereas MALDI-TOF MS did not. The concordance and aRI improved from 66.3% to 84.3% and from 0.173 to 0.538, respectively, for IR Biotyper versus MALDI-TOF MS with WGS as the reference method. IR Biotyper showed substantially improved performance in strain typing compared with MALDI-TOF MS. @*Conclusions@#IR Biotyper is useful for diversity analysis with improved discriminatory power over MALDI-TOF MS in comparison with WGS as a reference method. IR Biotyper is an accessible method to evaluate the clonality of strains and could be applied in epidemiological analysis during an outbreak of a health care facility, as well as for research on the transmission of resistant bacteria in community settings.

A simplified risk scoring system for predicting high-risk groups in gene expression tests for patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-positive breast cancer

Purpose@#The gene expression test (GET) was used to predict the response to chemotherapy and the recurrence risk.Several randomized clinical trials have demonstrated that some patients with node-positive disease can achieve favorable survival outcomes even without adjuvant chemotherapy. This study aimed to predict the results of Oncotype DX (Genomic Health) and MammaPrint (Agendia) using traditional clinicopathological factors. @*Methods@#We reviewed the records of 311 patients who underwent GET for hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative primary invasive breast cancer with node-positive disease between 2015 and 2022 at Severance Hospital and Gangneung Asan Medical Center. Univariate and multivariate logistic regression analyses assessed the relationships between clinicopathological variables and risk stratification using the GET results. @*Results@#A simple scoring system was created by assigning integer values to each variable. A score of 3 was assigned for histological grade 3, a score of 2 for pathologic T2 or above, and a score of 1 for a lower progesterone receptor (1–20 or Alled score 3–6), HER2 2-positive, and high Ki-67 (>20). In the validation cohort, overall accuracy was 0.798 (95% confidence interval, 0.744–0.844). @*Conclusion@#The high GET risk results can be predicted using traditional clinicopathological factors: tumor size, progesterone receptor, histological grade, HER2, and Ki-67. These results will be useful for treatment decision-making among clinically high-risk patients with HR-positive/HER2-negative and node-positive disease, helping to identify patients to whom the GET assay may not apply.

Acne Severity Scoring Using Deep Learning / 대한피부과학회지

BACKGROUND: Acne is a chronic inflammatory disease of the pilosebaceous unit, mainly on the face. It can have various clinical manifestations and should be appropriately treated based on the severity. In Korea, the ‘Korea Acne Severity Rating System (KAGS)’ is a standardized index to determine the severity of acne according to specific Korean characteristics. However, the actual use of the KAGS in clinical settings has been limited. OBJECTIVE: We sought to analyze whether we could effectively measure acne severity using a deep learning algorithm, which is an image learning method. METHODS: Acne severity was classified into three levels of mild, moderate, and severe based on the KAGS, and learning and verification were performed using the CNN (Convolutional Neural Network), a deep learning technique. RESULTS: GoogLeNet's Inception-v3 algorithm showed the highest accuracy at 86.7%. CONCLUSION: This study confirmed that the use of a deep learning algorithm may facilitate the scoring of acne severity.

Comparison of Damage Degrees After Corneal Epithelial Debridement Using Different Instruments in Rabbit Eyes

PURPOSE: A corneal epithelial debridement using three different instruments was performed in rabbits, and the rates of corneal epithelium recovery were compared. Additionally, the extent of corneal damage as determined by the scanning electron microscopy was evaluated in each group. METHODS: Nineteen eyes of ten rabbits were classified into three groups according to the instruments used. The corneal epithelial debridement was performed using three different instruments: a Beaver blade (group A), a Bard-Parker blade No.15 (group B) and a dry cotton-tipped ap plicator (group C). After epithelial debridement, each cornea was observed every 24 hours for three days. After completion of the corneal recovery, each cornea was severed along the limbus and observed under the scanning electron microscope. RESULTS: The rate of corneal epithelial healing of the group C (dry cotton-tipped applicator) showed no statistical significance from those of the other groups. However, according to the corneal status observed under scanning electron microscope after debridement, cracks in the corneal surface in portions of group A and B were observed in contrast with no creaks in group C. CONCLUSIONS: Based on these results, corneal epithelial debridement using a cotton-tipped applicator is expected to reduce the occurrence of postoperative corneal complications. Use of a dry cotton-tipped applicator for corneal epithelial debridement in vitreoretinal surgery is suggested.

The Results of Nation-Wide Registry of Age-related Macular Degeneration in Korea

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.

Intraocular Pressure Change in Rabbits with Intraocular Gas During Ascending Car Travel

PURPOSE: The authors studied the change according to altitude in the intraocular pressure (IOP) of rabbit models after intravitreal gas injection. METHODS: We injected C3F8 gas (pure gas, 0.4 cc) into the vitreous cavity in six pairs of rabbits. The six rabbits were divided into the Fast group and the Slow group. After 3 days, we measured the rabbits' IOPs at five different check points along the Young-Dong Expressway while traveling in a car. RESULTS: The IOPs of the Fast and the Slow groups at each check point, respectively, were 11.83+/-2.14, 13.00+/-3.69 (p=0.518) in Won-ju (130 m), 20.00+/-2.28, 21.17+/-2.14 (p=0.382) in Hoeng-seong (560 m), 28.00+/-2.60, 24.83+/-1.94 (p=0.038) in Pyeong-chang (580 m), 30.83+/-3.60, 26.67+/-1.63 (p=0.027) in Dae-gwall-yeong (805 m) and 9.83+/-1.17, 10.83+/-2.14 (p=0.338) in Kang-neung (70 m). We found that IOP increased with increased altitude in both groups. The IOP of the Fast group was significantly higher than that of the Slow group at the Pyeong-chang and Dae-gwall-yeong check points. CONCLUSIONS: We observed that IOP increased during car travel as altitude increased. In addition, we found that the rate of ascent was a risk factor for increased IOP. Therefore, it is important to inform patients with intraocular gas to avoid fast ascents during car travel and to ascend slowly after IOP has stabilized.