This pilot study evaluates an artificial intelligence (AI)-assisted electrocardiography (ECG) analysis system, QCG, to enhance urgent coronary angiography (CAG) decision-making for acute chest pain in the emergency department (ED). We retrospectively analyzed 300 ED cases, categorized as non-coronary chest pain (Group 1), acute coronary syndrome (ACS) without occlusive coronary artery disease (CAD) (Group 2), and ACS with occlusive CAD (Group 3). Six clinicians made urgent CAG decision using a conventional approach (clinical data and ECG) and a QCG-assisted approach (including QCG scores). The QCG-assisted approach improved correct CAG decisions in Group 2 (36.0% vs. 45.3%, P = 0.003) and Group 3 (85.3% vs. 90.0%, P = 0.017), with minimal impact in Group 1 (92.7% vs. 95.0%, P = 0.125). Diagnostic accuracy for ACS improved from 77% to 81% with QCG assistance and reached 82% with QCG alone, supporting AI's potential to enhance urgent CAG decisionmaking for ED chest pain cases.

This pilot study evaluates an artificial intelligence (AI)-assisted electrocardiography (ECG) analysis system, QCG, to enhance urgent coronary angiography (CAG) decision-making for acute chest pain in the emergency department (ED). We retrospectively analyzed 300 ED cases, categorized as non-coronary chest pain (Group 1), acute coronary syndrome (ACS) without occlusive coronary artery disease (CAD) (Group 2), and ACS with occlusive CAD (Group 3). Six clinicians made urgent CAG decision using a conventional approach (clinical data and ECG) and a QCG-assisted approach (including QCG scores). The QCG-assisted approach improved correct CAG decisions in Group 2 (36.0% vs. 45.3%, P = 0.003) and Group 3 (85.3% vs. 90.0%, P = 0.017), with minimal impact in Group 1 (92.7% vs. 95.0%, P = 0.125). Diagnostic accuracy for ACS improved from 77% to 81% with QCG assistance and reached 82% with QCG alone, supporting AI's potential to enhance urgent CAG decisionmaking for ED chest pain cases.

This pilot study evaluates an artificial intelligence (AI)-assisted electrocardiography (ECG) analysis system, QCG, to enhance urgent coronary angiography (CAG) decision-making for acute chest pain in the emergency department (ED). We retrospectively analyzed 300 ED cases, categorized as non-coronary chest pain (Group 1), acute coronary syndrome (ACS) without occlusive coronary artery disease (CAD) (Group 2), and ACS with occlusive CAD (Group 3). Six clinicians made urgent CAG decision using a conventional approach (clinical data and ECG) and a QCG-assisted approach (including QCG scores). The QCG-assisted approach improved correct CAG decisions in Group 2 (36.0% vs. 45.3%, P = 0.003) and Group 3 (85.3% vs. 90.0%, P = 0.017), with minimal impact in Group 1 (92.7% vs. 95.0%, P = 0.125). Diagnostic accuracy for ACS improved from 77% to 81% with QCG assistance and reached 82% with QCG alone, supporting AI's potential to enhance urgent CAG decisionmaking for ED chest pain cases.

This pilot study evaluates an artificial intelligence (AI)-assisted electrocardiography (ECG) analysis system, QCG, to enhance urgent coronary angiography (CAG) decision-making for acute chest pain in the emergency department (ED). We retrospectively analyzed 300 ED cases, categorized as non-coronary chest pain (Group 1), acute coronary syndrome (ACS) without occlusive coronary artery disease (CAD) (Group 2), and ACS with occlusive CAD (Group 3). Six clinicians made urgent CAG decision using a conventional approach (clinical data and ECG) and a QCG-assisted approach (including QCG scores). The QCG-assisted approach improved correct CAG decisions in Group 2 (36.0% vs. 45.3%, P = 0.003) and Group 3 (85.3% vs. 90.0%, P = 0.017), with minimal impact in Group 1 (92.7% vs. 95.0%, P = 0.125). Diagnostic accuracy for ACS improved from 77% to 81% with QCG assistance and reached 82% with QCG alone, supporting AI's potential to enhance urgent CAG decisionmaking for ED chest pain cases.

Heterotopic gastric mucosa tissue is also called gastric choristoma, and this type of lesion can be found anywhere in the alimentary tract. However, gastric choristoma in the pharynx is very rare; only 10 cases of pharyngeal gastric choristoma have been reported in the English medical literature. A 32-yr-old woman was referred to our institution for the evaluation of a large mass that originated from the posterior wall of the oropharynx. The mass did not cause any symptoms except for the occasional sensation of a foreign body. Gadolinium-enhanced T1 weighted imaging showed a 5 cm-sized mass with central enhancement and hypointense portions, yet the radiological diagnosis was not clear. Transoral mass excision was performed with using electrocautery for making the diagnosis and for treating the mass. The microscopic analysis revealed gastric choristoma.
Choristoma ; Electrocoagulation ; Female ; Foreign Bodies ; Gastric Mucosa ; Humans ; Oropharynx ; Pharynx ; Sensation

BACKGROUND: This study was performed to characterize the long term observations after the use of a round needle for the management of chronic musculoskeletal pain. METHODS: The study subjects were 71 patients with musculoskeletal pain who had failed at least two previous treatments. They received interventional muscle and nerve stimulation (IMNS) using a 0.8 to 1.2 mm diameter dry needle with a streamlined shaped and a round tip from March, 2002 to July, 2002. Patients received IMNS as a bilateral segmental treatment mainly in the paraspinal, sometimes in the radicular region at 2 week intervals. The follow-up rate was 97%. Follow-up occurred at 6 months after the last IMNS treatment. Main outcomes were measured using a pain relief scale and a visual analog scale. RESULTS: Spinal stenosis, Herniated Nucleus Pulposus and an unclassified group (radicular symptoms existed, but no correlatable radiographic findings of radiculopathy were found) produced positive responses whereas fibromyalgia and failed back surgery syndrome did not. CONCLUSIONS: These results reveal that IMNS has a potential value in musculoskeletal pain originating from a spinal nerve root.
Failed Back Surgery Syndrome ; Fibromyalgia ; Fluoroscopy* ; Follow-Up Studies ; Humans ; Musculoskeletal Pain ; Needles ; Radiculopathy ; Spinal Nerve Roots ; Spinal Stenosis ; Visual Analog Scale

BACKGROUND AND OBJECTIVES: Cervical metastasis of unknown origin (MUO) comprises 3-5% of all head and neck malignancy. Standardized diagnostic approach is not established and standard treatment regimen is not established either. The purpose of this study was to evaluate diagnostic approaches to detect the primary site in patients with neck mass of metastatic squamous cell carcinoma and analyze treatment modalities and their outcomes as well. SUBJECTS AND METHOD: Of 710 patients who had been diagnosed with squamous cell carcinoma of the head and neck site from Jan. 1992 through Dec. 2005, 73 patients were referred to or visited our clinic regarding the presence of neck mass. With retrospective review of the medical record, the diagnostic approaches were evaluated. Thirty patients, in whom the primary sites were not found after all, were included for analysis of treatments and outcomes. RESULTS: The diagnostic steps that revealed the primary sites were as follows: physical examination in 29 cases (39.7%), conventional imaging (CT or MRI) in 5 cases (6.8%), PET scan in 1 case (1.4%), OPD based directed biopsy in 3 cases (4.1%), and intraoperative directed biopsy in 5 cases (6.8%). Primary sites were not detected in 30 cases (41.1%). Complete remission was obtained in 24 patients, for whom 5-year disease free survival rate was 62.1%. CONCLUSION: Thorough physical examination and directed biopsy are strongly recommended for the diagnosis of MUO, but the diagnostic value of PET scan needs to be followed up with more cases.
Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Disease-Free Survival ; Head ; Humans ; Medical Records ; Neck ; Neoplasm Metastasis ; Physical Examination ; Positron-Emission Tomography ; Prognosis* ; Retrospective Studies

Purpose: The objective of this study was to identify the factors influencing maternal identity in pregnant women. Methods: Using a descriptive research design, a cross-sectional survey was conducted. In total, 127 pregnant women were recruited from a tertiary hospital in Korea from January to April 2019. Measurements included maternal identity, stress, depression, spousal and familial support, and demographic and obstetric characteristics. Data were analyzed by descriptive statistics, the independent t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS version 25.0. Results: The mean score for maternal identity was 131.15 out of 160, and the mean scores for stress, depression, and spousal and familial support were 14.59 (out of 40), 6.82 (out of 30), and 109.04 (out of 132), respectively. Stress (r=–.38, p<.001), depression (r=–.37, p<.001), and spousal and familial support (r=.37, p<.001) were significantly correlated with maternal identity. In multiple regression analysis, stress (β=–0.27, p=.005) and spousal and familial support (β=0.23, p=.014) were found to be significant factors influencing maternal identity in pregnant women (F=14.17, p<.001). Conclusion It is necessary to develop effective strategies to mitigate stress and to encourage spousal and familial support in pregnant women. Such strategies could further enable pregnant women to enhance their maternal identity.

undergo radical neck dissection. Subsequent chyle leakage can cause complications such as skin flap necrosis, orocutaneous fistula, electrolyte imbalance and protein loss. Chyle leakage is managed conservatively with total parenteral nutrition and mediumchain triglyceride diet or is treated surgically with leakage site ligation or thoracic duct ligation. Sclerotherapy can be one of the treatment options and tetracycline and povidone-iodine have been reported to be used as sclerosing agents. However, Picibanil sclerotheray for post-neck dissection chyle leakage has not been reported. This paper presents our experience in the management of a intractable chyle leakage which was irresponsive to conservative management and thoracic duct ligation, by successfully employing Picibanil.
Chyle ; Diet ; Fistula ; Ligation ; Neck ; Neck Dissection ; Necrosis ; Parenteral Nutrition, Total ; Picibanil ; Povidone-Iodine ; Sclerosing Solutions ; Sclerotherapy ; Skin ; Tetracycline ; Thoracic Duct

Purpose: : The study aimed to identify relationship among intensive care unit (ICU) nurses’ critical thinking disposition, medication error risk level of high-alert medication, and medication safety competency, as well as the factors affecting medication safety competency. Methods: : The participants were 266 ICU nurses of one higher-tier general hospital and one general hospital in Province. The data were collected using structured self-administered questionnaire from August 10 to August 31, 2021. Measurements included the critical thinking disposition questionnaire, nurses’s knowledge of high-alert medication questionnaire, the medication safety competency scale. Data were analyzed using hierarchical multiple regressions using SPSS/WIN 28.0. Results: : In the multiple regression analysis, the medication safety competence has a statistically significant correlation with the working department, the critical thinking disposition, and medication error risk level of high-alert medication. Conclusion : Based on the results of this study, it is suggested to develop and apply an educational strategy that can strengthen the knowledge and skills of critical thinking disposition and medication error risk level of high-alert medication to improve the ICU nurse’s medication safety competency.