Objectives: As endoscopic, laparoscopic, and robotic surgical procedures become more common, surgical videos are increasingly being treated as records and serving as important data sources for education, research, and developing new solutions with recent advances in artificial intelligence (AI). However, most hospitals do not have a system that can store and manage such videos systematically. This study aimed to develop a system to help doctors manage surgical videos and turn them into content and data. Methods: We developed a video archiving and communication system (VACS) to systematically process surgical videos. The VACS consists of a video capture device called SurgBox and a video archiving system called SurgStory. SurgBox automatically transfers surgical videos recorded in the operating room to SurgStory. SurgStory then analyzes the surgical videos and indexes important sections or video frames to provide AI reports. It allows doctors to annotate classified indexing frames, “data-ize” surgical information, create educational content, and communicate with team members. Results: The VACS collects surgical and procedural videos, and helps users manage archived videos. The accuracy of a convolutional neural network learning model trained to detect the top five surgical instruments reached 96%. Conclusions With the advent of the VACS, the informational value of medical videos has increased. It is possible to improve the efficiency of doctors’ continuing education by making video-based online learning more active and supporting research using data from medical videos. The VACS is expected to promote the development of new AI-based products and services in surgical and procedural fields.

Objectives: As endoscopic, laparoscopic, and robotic surgical procedures become more common, surgical videos are increasingly being treated as records and serving as important data sources for education, research, and developing new solutions with recent advances in artificial intelligence (AI). However, most hospitals do not have a system that can store and manage such videos systematically. This study aimed to develop a system to help doctors manage surgical videos and turn them into content and data. Methods: We developed a video archiving and communication system (VACS) to systematically process surgical videos. The VACS consists of a video capture device called SurgBox and a video archiving system called SurgStory. SurgBox automatically transfers surgical videos recorded in the operating room to SurgStory. SurgStory then analyzes the surgical videos and indexes important sections or video frames to provide AI reports. It allows doctors to annotate classified indexing frames, “data-ize” surgical information, create educational content, and communicate with team members. Results: The VACS collects surgical and procedural videos, and helps users manage archived videos. The accuracy of a convolutional neural network learning model trained to detect the top five surgical instruments reached 96%. Conclusions With the advent of the VACS, the informational value of medical videos has increased. It is possible to improve the efficiency of doctors’ continuing education by making video-based online learning more active and supporting research using data from medical videos. The VACS is expected to promote the development of new AI-based products and services in surgical and procedural fields.

During the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 vaccination-induced hyperglycemia and related complications have been reported. However, there have been few reports of type 1 diabetes triggered by COVID-19 vaccines in subjects without diabetes.Here, we report the case of a 56-year-old female patient who developed hyperglycemia after the second dose of COVID-19 mRNA-based vaccination without a prior history of diabetes. She visited our hospital with uncontrolled hyperglycemia despite administration of oral hyperglycemic agents. Her initial glycated hemoglobin level was high (11.0%), and fasting serum C-peptide level was normal. The fasting serum C-peptide level decreased to 0.269 ng/ mL 5 days after admission, and the anti-glutamic acid decarboxylase antibody was positive.The patient was discharged in stable condition with insulin treatment. To our knowledge, this is the first case of the development of type 1 diabetes without diabetic ketoacidosis after mRNA-based COVID-19 vaccination, and is the oldest case of type 1 diabetes development under such circumstances.

Purpose: In the emergency department (ED), triage significantly impacts patient safety. Therefore, triage nurses must make decisions accurately and timeously. This study aims to investigate how South Korean pediatric emergency nurses perceive urgency and classify severity using the Q methodology, which examines individuals' subjectivity. Methods: We collected 84 statements from a Q population based on a literature review and interviews and selected 33 Q samples. The P samples included 30 pediatric emergency nurses at a Seoul tertiary care hospital. The principal component factor analysis method was used to analyze data using the PC-QUANL program. Results: Four urgency perception types were identified among pediatric ED nursesdType 1: “Experiential coping”; Type 2: “Careful reasoning”; Type 3: “Patient-centered thinking”; and Type 4: “Intuitive prediction.” These types appear to be an integrated process of knowledge and clinical experience that considers children's characteristics and developmental stages. Conclusion This study may serve as a basis for future education to improve pediatric ED nurses 0 urgency judgment and severity classification skills.

Purpose: In the emergency department (ED), triage significantly impacts patient safety. Therefore, triage nurses must make decisions accurately and timeously. This study aims to investigate how South Korean pediatric emergency nurses perceive urgency and classify severity using the Q methodology, which examines individuals' subjectivity. Methods: We collected 84 statements from a Q population based on a literature review and interviews and selected 33 Q samples. The P samples included 30 pediatric emergency nurses at a Seoul tertiary care hospital. The principal component factor analysis method was used to analyze data using the PC-QUANL program. Results: Four urgency perception types were identified among pediatric ED nursesdType 1: “Experiential coping”; Type 2: “Careful reasoning”; Type 3: “Patient-centered thinking”; and Type 4: “Intuitive prediction.” These types appear to be an integrated process of knowledge and clinical experience that considers children's characteristics and developmental stages. Conclusion This study may serve as a basis for future education to improve pediatric ED nurses 0 urgency judgment and severity classification skills.

Purpose: In the emergency department (ED), triage significantly impacts patient safety. Therefore, triage nurses must make decisions accurately and timeously. This study aims to investigate how South Korean pediatric emergency nurses perceive urgency and classify severity using the Q methodology, which examines individuals' subjectivity. Methods: We collected 84 statements from a Q population based on a literature review and interviews and selected 33 Q samples. The P samples included 30 pediatric emergency nurses at a Seoul tertiary care hospital. The principal component factor analysis method was used to analyze data using the PC-QUANL program. Results: Four urgency perception types were identified among pediatric ED nursesdType 1: “Experiential coping”; Type 2: “Careful reasoning”; Type 3: “Patient-centered thinking”; and Type 4: “Intuitive prediction.” These types appear to be an integrated process of knowledge and clinical experience that considers children's characteristics and developmental stages. Conclusion This study may serve as a basis for future education to improve pediatric ED nurses 0 urgency judgment and severity classification skills.

A 3-year-old boy with purulent otitis media received a chest radiograph as the part of a routine work up. The patient was normal appearing, in no acute distress. The patient's lung and heart sounds were clear and normal. The patient's abdomen was soft, non-distended, and non-tender. An anterior cardiophrenic mass was incidentally identified on the lateral chest radiograph. A computed tomography scan demonstrated a diaphragmatic hernia with bowel loops in the retrosternal space. An exploratory operation revealed a diaphragmatic defect (4 cm in diameter) on the left side of the falciform ligament, through which transverse colon was protruded. There was no hernia sac, and the defect was closed with interrupted No. 2 silk sutures. The child was discharged on the 8th postoperative day without any complications. During 6 months of follow-up period, recurrence was not noticed.
Abdomen ; Child ; Child, Preschool* ; Colon, Transverse ; Follow-Up Studies ; Heart Sounds ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Ligaments ; Lung ; Male* ; Otitis Media, Suppurative ; Radiography, Thoracic ; Recurrence ; Silk ; Sutures

Purpose: : This study aims to establish an optimal cut-off score on the Braden scale for the assessment of pressure injury to detect pressure injury risks among inpatients in a South Korean tertiary hospital. Methods: : This retrospective study used electronic medical records, from January to December 2022. A total of 654 patients were included in the study. Of these, 218 inpatients with pressure injuries and 436 without pressure injuries were classified and analyzed using 1:2 Propensity Score Matching (PSM), and the generalized estimating equation was performed using SPSS Version 26 and the R Machlt package program. Results: : The cut-off value on the Braden scale for distinguishing pressure injury was 17 points, and the AUC (area under the ROC curve) was 0.531 (0.484–0.579). The sensitivity was 56.6% (45.5–67.7%) and the specificity was 69.7% (66.0– 73.4%). With 17 points, the Braden scale cut-off distinguished those who had pressure injuries from those who did not at the time of admission (p ＜ .03). In the pressure injury group, the Braden score on the day of the pressure injury was 14, with significant results in all subcategories except the moisture category. Conclusion : Our findings revealed that a cut-off value of 17 was optimal for predicting the risk of pressure injuries among tertiary hospital inpatients. Future studies should evaluate the optimal cut-off values in different clinical environments. Additionally, it is necessary to conduct multicenter large sample studies to verify the effectiveness of a 17 value in PI risk assessments.

Background: Postsurgical hypocalcemia is the most common and troublesome consequence of thyroidectomy. We investigated the potential role of routine calcium or vitamin D supplementation in preventing postsurgical hypocalcemia. Methods: We searched MEDLINE and Embase for English-language publications using the keywords “calcium,” “vitamin D,” and “thyroid cancer.” The primary outcome was any postoperative hypocalcemia, and the secondary outcome was symptomatic hypocalcemia. Results: Four studies that included 381 patients were eligible for this meta-analysis. A random-effects model showed no significant difference in the occurrence of hypocalcemia between calcium/vitamin D treatment and placeboo treatment. However, the occurrence of symptomatic hypocalcemia was lower in patients with calcium/vitamin D treatment. In the combined results, preoperative calcium and vitamin D supplementation were associated with a reduced incidence of symptomatic hypocalcemia. Conclusions Our findings support the use of preoperative calcium and vitamin D supplementation in conjunction with routine postsurgical supplementation for patients after total thyroidectomy.

Objectives: The Regional CardioCerebroVascular Center (RCCVC) project was initiated to improve clinical outcomes for patients with acute myocardial infarction or stroke in non-capital areas of Korea. The purpose of this study was to evaluate the outcomes and issues identified by the Busan RCCVC project in the treatment of ST-segment elevation myocardial infarction (STEMI). Methods: Among the patients who were registered in the Korean Registry of Acute Myocardial Infarction for the RCCVC project between 2007 and 2019, those who underwent percutaneous coronary intervention (PCI) for STEMI at the Busan RCCVC were selected, and their medical data were compared with a historical cohort. Results: In total, 1161 patients were selected for the analysis. Ten years after the implementation of the Busan RCCVC project, the median door-to-balloon time was reduced from 86 (interquartile range [IQR], 64-116) to 54 (IQR, 44-61) minutes, and the median symptom-to-balloon time was reduced from 256 (IQR, 180-407) to 189 (IQR, 118-305) minutes (p<0.001). Inversely, the false-positive PCI team activation rate increased from 0.6% to 21.4% (p<0.001). However, the 1-year cardiovascular death and major adverse cardiac event rates did not change. Even after 10 years, approximately 75% of the patients had a symptom-to-balloon time over 120 minutes, and approximately 50% of the patients underwent inter-hospital transfer for primary PCI. Conclusions A decade after the implementation of the Busan RCCVC project, although time parameters for early reperfusion therapy for STEMI improved, at the cost of an increased false-positive PCI team activation rate, survival outcomes were unchanged.