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.

BACKGROUND AND PURPOSE: There are few studies that have investigated predictive factors related to migraine prophylaxis of which produced inconsistent results. The aim of this study was to identify factors that can predict the treatment response to topiramate prophylaxis in pediatric patients with migraine. METHODS: One hundred and thirteen patients who were older than 7 years and received topiramate for at least 3 months were recruited from the Seoul National University Bundang Hospital outpatient clinic from 2005 to 2014. A positive response was defined as a reduction of more than 50% in the number of migraine episodes after topiramate treatment. Proposed predictive factors such as migraine characteristics including severity and frequency were assessed, as were other data on sex, disease duration, associated symptoms, family history, and impairment of daily activities. RESULTS: Seventy patients (61.9%) responded to prophylactic treatment with topiramate. Patients who experienced significant impairment in daily activities showed significant benefit from the treatment (p=0.004). Sex, the severity, frequency, and duration of migraine episodes, disease duration, treatment duration, age at onset, and associated symptoms were not significantly related to a response to topiramate treatment. CONCLUSIONS: Migraine characteristics and associated symptoms were not significantly related to a response to topiramate treatment. However, patients with significant impairment in daily activities showed significant benefit from the treatment, and so prophylactic topiramate treatment should be strongly encouraged in this patient group.
Age of Onset ; Humans ; Migraine Disorders* ; Outpatient Clinics, Hospital ; Seoul

BACKGROUND AND PURPOSE: To identify whether serum uric acid levels are significantly higher in patients with benign convulsion associated with mild gastroenteritis (CwG) than in patients with acute gastroenteritis. METHODS: This retrospective study compared the serum levels of uric acid between CwG, acute gastroenteritis, and febrile seizure after correcting for the varying degree of mild dehydration using serum HCO3⁻ levels. We also compared the serum uric acid levels between patients with CwG and febrile seizures in order to exclude the effect of seizures on uric acid. RESULTS: This study included 154 CwG patients (age range 0.73–3.19 years), 2,938 patients with acute gastroenteritis, and 154 patients with febrile seizure. The serum uric acid level was significantly higher in CwG patients than in patients with acute gastroenteritis [9.79±2.16 mg/dL vs. 6.04±2.3 mg/dL (mean±SD), p<0.001]. This difference was also significant after correcting for dehydration. The serum uric acid level was significantly higher in CwG patients than in dehydration-corrected acute gastroenteritis patients (9.79±2.16 mg/dL vs. 6.67±2.48 mg/dL, p<0.001). The serum uric acid level was not elevated in patients with febrile seizure. CONCLUSIONS: We have confirmed that serum uric acid is elevated in CwG patients even after correcting for their dehydration status, and that this was not a postictal phenomenon. Highly elevated serum uric acid in CwG could be a useful clinical indicator of CwG in patients with acute gastroenteritis.
Child ; Dehydration ; Gastroenteritis ; Humans ; Retrospective Studies ; Seizures ; Seizures, Febrile ; Uric Acid

Unfortunately, the authors confirmed that some of the data was missing from categories ‘Acute gastroenteritis’ and ‘Febrile seizure’ of Table 2 in the original version.

Blau syndrome (BS) is a rare autosomal dominant, inflammatory syndrome that is characterized by the clinical triad of granulomatous dermatitis, symmetric arthritis, and recurrent uveitis. Mutations in the nucleotide oligomerization domain 2 (NOD2) gene are responsible for causing BS. To date, up to 30 Blau-associated genetic mutations have been identified within this gene. We report a novel NOD2 genetic mutation that causes BS. A girl, aged 8 years, and her brother, aged 10 years, developed erythematous skin rashes and uveitis. The computed tomography angiogram of the younger sister showed features of midaortic dysplastic syndrome. The brother had more prominent joint involvement than the sister. Their father (38 years) was also affected by uveitis; however, only minimal skin involvement was observed in his case. The paternal aunt (39 years) and her daughter (13 years) were previously diagnosed with sarcoidosis. Mutational analysis revealed a novel c.1439 A>G mutation in the NOD2 gene in both siblings. The novel c.1439 A>G mutation in the NOD2 gene was found in a familial case of BS. Although BS is rare, it should always be considered in patients presenting with sarcoidosis-like features at a young age. Early diagnosis of BS and prompt multisystem workup including the eyes and joints can improve the patient's outcome.
Arthritis ; Dermatitis ; Early Diagnosis ; Exanthema ; Fathers ; Female ; Humans ; Joints ; Nuclear Family ; Polymorphism, Single Nucleotide ; Sarcoidosis ; Siblings ; Skin ; Uveitis

Background: and Purpose: The myelin oligodendrocyte glycoprotein (MOG) antibody is detected at a high rate in childhood acquired demyelinating syndrome (ADS). This study aimed to determine the diagnostic value of the MOG antibody in ADS and the spectrum of MOGantibody-positive demyelinating diseases in children. Methods: This study included 128 patients diagnosed with ADS (n=94) or unexplained encephalitis (n=34). The MOG antibody in serum was tested using an in-house live-cell-based immunofluorescence assay. Results: The MOG antibody was detected in 48 patients (46 ADS patients and 2 encephalitis patients, comprising 23 males and 25 females). Acute disseminated encephalomyelitis (ADEM) (35.4%) was the most-common diagnosis, followed by the unclassified form (17.4%), isolated optic neuritis (ON) (15.2%), neuromyelitis optica spectrum disorder (13.0%), multiple sclerosis (MS) (10.8%), other clinically isolated syndromes [monophasic event except ADEM, isolated ON, or transverse myelitis (TM)] (8.7%), and unexplained encephalitis (4.3%). At the initial presentation, 35 out of the 46 patients with ADS had brain lesions detected in magnetic resonance imaging, and 54% of these 35 patients had encephalopathy. Nine of the 11 patients without brain lesions exhibited only ON. Thirty-nine percent of the patients experienced a multiphasic event during the mean follow-up period of 34.9 months (range 1.4–169.0 months). Encephalopathy at the initial presentation was frequently confirmed in the monophasic group (p= 0.011). Conclusions MOG antibodies were identified in all pediatric ADS phenotypes except for monophasic TM. Therefore, the MOG antibody test is recommended for all pediatric patients with ADS, especially before a diagnosis of MS and for patients without a clear diagnosis.