Objective: This study aimed to evaluate the effects of a digital group reminiscence program on elderly patients with mild dementia who were registered with Day Care Centers. Methods: The study was conducted with elderly patients with mild dementia in Day Care Centers in D city. The patients were randomly assigned to either the experimental group or the control group and were assessed for cognitive function, depression, and ego integrity using pre-test and post-test designs. A digital group reminiscence program was applied to the experimental group. Data was collected from July 5 to September 17, 2021, using questionnaires in three sessions. Results: The pre-test cognitive function score was 12.00 in the experimental group and 11.09 in the control group. The post-test cognitive function score was 19.20 in the experimental group and 14.42 in the control group. The later cognitive function score was 18.00 in the experimental group and 13.31 in the control group. The pre-test depression score was 8.32 in the experimental group and 9.91 in the control group. The post-test depression score was 6.05 in the experimental group and 8.82 in the control group.The later depression score was 6.94 in the experimental group and 9.02 in the control group. The pre-test ego integrity score was 41.39 in the experimental group and 39.55 in the control group. The post-test ego integrity score was 57.95 in the experimental group and 51.41 in the control group. The later ego integrity score was 55.88 in the experimental group and 42.15 in the control group. Cognitive function, depression, and ego integrity showed significant differences according to group (p<.05), time (p<.001), and interaction between group and time (p<.01). Conclusion The digital group reminiscence program was found to be effective in improving cognitive function and ego integrity and reducing depression in elderly patients with mild dementia. Further research is needed to explore the effects of repetitive digital group recall programs based on the progress, course, age, and communication level of dementia.

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

PURPOSE: Adverse drug events (ADEs) are associated with high health and financial costs and have increased as more elderly patients treated with multiple medications emerge in an aging society. It has thus become challenging for physicians to identify drugs causing adverse events. This study proposes a novel approach that can improve clinical decision making with recommendations on ADE causative drugs based on patient information, drug information, and previous ADE cases. MATERIALS AND METHODS: We introduce a personalized and learning approach for detecting drugs with a specific adverse event, where recommendations tailored to each patient are generated using data mining techniques. Recommendations could be improved by learning the associations of patients and ADEs as more ADE cases are accumulated through iterations. After consulting the system-generated recommendations, a physician can alter prescriptions accordingly and report feedback, enabling the system to evolve with actual causal relationships. RESULTS: A prototype system is developed using ADE cases reported over 1.5 years and recommendations obtained from decision tree analysis are validated by physicians. Two representative cases demonstrate that the personalized recommendations could contribute to more prompt and accurate responses to ADEs. CONCLUSION: The current system where the information of individual drugs exists but is not organized in such a way that facilitates the extraction of relevant information together can be complemented with the proposed approach to enhance the treatment of patients with ADEs. Our illustrative results show the promise of the proposed system and further studies are expected to validate its performance with quantitative measures.
Aged ; Aging ; Clinical Decision-Making ; Complement System Proteins ; Data Mining ; Decision Trees ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Learning* ; Prescriptions

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.
Cardiopulmonary Resuscitation ; Clinical Alarms ; Comorbidity ; Critical Care ; Emergencies* ; Humans ; Intensive Care Units ; Internal Medicine ; Korea* ; Length of Stay ; Monitoring, Physiologic ; Mortality ; Observational Study ; Patients' Rooms ; Pilot Projects* ; Retrospective Studies ; Vital Signs

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.
Cardiopulmonary Resuscitation ; Clinical Alarms ; Comorbidity ; Critical Care ; Emergencies ; Humans ; Intensive Care Units ; Internal Medicine ; Korea ; Length of Stay ; Monitoring, Physiologic ; Mortality ; Observational Study ; Patients' Rooms ; Pilot Projects ; Retrospective Studies ; Vital Signs

The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length.
Aorta, Thoracic* ; Aortic Aneurysm, Thoracic ; Blood Vessel Prosthesis* ; Endovascular Procedures ; Polyethylene Terephthalates* ; Rupture* ; Stents* ; Thoracotomy ; Transplants*

BACKGROUND: This study was conducted in order to survey the current state of cleaning, disinfection, rinsing, drying, and storage of gastrointestinal endoscopes. METHODS: Eighty hospitals were selected through convenient sampling. Self-reported questionnaire was distributed from September 14 to October 10 in 2015. RESULTS: The response rate was 67.5% (54/80). In 88.9% of the hospitals, reprocessing was performed in a cleaning space separated from the laboratory and 88.9% used an enzymatic cleaner. Disinfectants used were ortho-phthalaldehyde in 63.0%, and paracetic acid in 33.3%. Eighty seven percent of the hospitals used test strips in order to test the effective concentration of disinfectant and in 61.1%, drying was done through passing air and over 70% alcohol. Microbial culture for the quality control of gastrointestinal endoscopes was performed in 77.8%. In the comparison of the adequacy of gastrointestinal endoscope reprocessing, it was observed that gastrointestinal endoscopes were reprocessed more adequately in larger and tertiary care hospitals. CONCLUSION: Gastrointestinal endoscopes were reprocessed in similar manners, but there were differences in the detailed process. It is still necessary to segment reprocessing into stages, to prepare standardized guidelines, and to monitor compliance with the guidelines.
Compliance ; Disinfectants ; Disinfection ; Endoscopes, Gastrointestinal* ; Korea* ; o-Phthalaldehyde ; Quality Control ; Tertiary Healthcare

Pseudoaneurysm of the right ventricular outflow tract (RVOT) has been reported as a rare complication of RVOT reconstruction performed using conduit replacement or patch repair. Rarely, it may present alongside symptoms secondary to the compression of adjoining mediastinal structures. We report the case of a patient who developed a symptomatic RVOT pseudoaneurysm one month after a total correction of tetralogy of Fallot. In the present case, superior vena cava syndrome was caused by compression of the superior vena cava, which was a very unusual presentation.
Aneurysm, False* ; Humans ; Superior Vena Cava Syndrome* ; Tetralogy of Fallot ; Vena Cava, Superior

Unlike studies of Europeans and Americans, many epidemiological studies of the Korean population have indicated that their risk for cardiovascular disease does not decrease with a vegetable-rich diet. The different dietary practices of Koreans, who consume salted vegetables instead of fresh vegetables (common in the Western diet), has been suggested as a reason for this observation. Korea is in a period of rapid epidemiologic transition, which includes dietary and disease patterns; therefore, this study investigated differences in the food consumption pattern and blood lipid profiles of Koreans compared to Europeans and Americans. The identification of dietary patterns related to blood lipid abnormalities was carried out using the 2007~2009 Korean National Health and Nutrition Survey data from 14,056 subjects. Dietary patterns were analyzed according to food group and nutrient intake. Blood lipid abnormalities were classified into three groups: hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterolemia (hypo-HDL-cholesterolemia). The prevalence of hypercholesterolemia, hypertriglyceridemia, and hypo-HDL-cholesterolemia was 12.4%, 16.2%, and 27.7% respectively. In our analysis, the low consumption of all food groups was related to hypercholesterolemia. The high consumption of vegetable-containing foods, alcoholic beverages, and the low consumption of milk products were associated with hypertriglyceridemia and hypo-HDL-cholesterolemia. Thus, unlike Europeans and Americans, the low consumption of all food groups is related to hypercholesterolemia and a low consumption of milk products is related to hypertriglyceridemia and hypo-HDL-cholesterolemia. Dietary pattern might play a role in epidemiologic transition of Korean. Also, this study implies necessity of further research using longitudinal data.
Adult ; Alcoholic Beverages ; Cardiovascular Diseases ; Diet ; Epidemiologic Studies ; Humans ; Hypercholesterolemia ; Hypertriglyceridemia ; Korea ; Milk ; Nutrition Surveys ; Prevalence ; Vegetables

Hypertension is a well-known risk factor for cardiovascular disease. Previous studies have shown that changes in diet and lifestyle factors can prevent the development of hypertension, but the combined effects of these modifiable factors on hypertension are not well established. The objective of this study is to investigate associations of diet and lifestyle factors, evaluated both individually and in combination, with prevalent hypertension among Korean adults. We analyzed data obtained from the 2007-2008 Korean National Health and Nutritional Examination Survey, a nationwide cross-sectional study using a stratified, multistage probability sampling design. The associations of 12 nutrient intakes and lifestyle factors with risk of hypertension were explored using restricted cubic spline regression and logistic regression models among 6,351 adults. Total energy and several nutrients and minerals, including, calcium, vitamin A, vitamin C, and sodium, showed non-linear relationships with the risk of prevalent hypertension. In multivariate logistic regression models, dietary score, obesity and alcohol intake were independently associated with the risk of prevalent hypertension, but smoking and physical activity were not. Overall, participants whose dietary habits and lifestyle factors were all in the low-risk group had 68% lower prevalence of hypertension (OR: 0.32, 95 CI: 0.14-0.74) compared to those who were at least one in the high-risk group of any dietary or lifestyle factors. The result suggests that combined optimal lifestyle habits are strongly associated with lower prevalence of hypertension among Korean adults.
Adult ; Ascorbic Acid ; Calcium ; Cardiovascular Diseases ; Cross-Sectional Studies ; Diet ; Food Habits ; Humans ; Hypertension ; Life Style ; Logistic Models ; Minerals ; Motor Activity ; Nutrition Surveys ; Obesity ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Sodium ; Vitamin A