Purpose: In 2024, the South Korean government proposed an essential medical care package, including the expansion of medical college admissions, which faced strong opposition from the medical community. Consequently, residents resigned, increasing the workload of the remaining staff and putting public health at risk. This study analyzed changes in the hospitalization patterns of trauma patients during this political conflict period using single-center data from the National Health Insurance Service Ilsan Hospital. Methods: Data from the entire year 2023 and from March to August 2024 were used for analysis, excluding January and February 2024 when the conflict escalated. The selection criteria included patients with trauma who visited the emergency room, and comparisons were made between the periods before and during the medical conflict. Results: In 2023, the total number of patients with trauma were 1,182 (an average of 98.5 per month). From March to August 2024, the number dropped to 204 (34.2 per month), reflecting a significant reduction in the monthly average number of patients with trauma. Despite the overall decline, the number of severe trauma cases remained relatively stable, indicating a shift toward more critical patient care. Emergency department length of stay decreased significantly from 295 min in 2023 to 187 min in 2024. Conclusion The ongoing strain on emergency and support department risks leads to an irreversible collapse if critical points are reached. To address this, localized trauma centers are needed to relieve the burden on larger medical institutions and improve the efficiency of trauma care systems during crises.

Purpose: In 2024, the South Korean government proposed an essential medical care package, including the expansion of medical college admissions, which faced strong opposition from the medical community. Consequently, residents resigned, increasing the workload of the remaining staff and putting public health at risk. This study analyzed changes in the hospitalization patterns of trauma patients during this political conflict period using single-center data from the National Health Insurance Service Ilsan Hospital. Methods: Data from the entire year 2023 and from March to August 2024 were used for analysis, excluding January and February 2024 when the conflict escalated. The selection criteria included patients with trauma who visited the emergency room, and comparisons were made between the periods before and during the medical conflict. Results: In 2023, the total number of patients with trauma were 1,182 (an average of 98.5 per month). From March to August 2024, the number dropped to 204 (34.2 per month), reflecting a significant reduction in the monthly average number of patients with trauma. Despite the overall decline, the number of severe trauma cases remained relatively stable, indicating a shift toward more critical patient care. Emergency department length of stay decreased significantly from 295 min in 2023 to 187 min in 2024. Conclusion The ongoing strain on emergency and support department risks leads to an irreversible collapse if critical points are reached. To address this, localized trauma centers are needed to relieve the burden on larger medical institutions and improve the efficiency of trauma care systems during crises.

Purpose: In 2024, the South Korean government proposed an essential medical care package, including the expansion of medical college admissions, which faced strong opposition from the medical community. Consequently, residents resigned, increasing the workload of the remaining staff and putting public health at risk. This study analyzed changes in the hospitalization patterns of trauma patients during this political conflict period using single-center data from the National Health Insurance Service Ilsan Hospital. Methods: Data from the entire year 2023 and from March to August 2024 were used for analysis, excluding January and February 2024 when the conflict escalated. The selection criteria included patients with trauma who visited the emergency room, and comparisons were made between the periods before and during the medical conflict. Results: In 2023, the total number of patients with trauma were 1,182 (an average of 98.5 per month). From March to August 2024, the number dropped to 204 (34.2 per month), reflecting a significant reduction in the monthly average number of patients with trauma. Despite the overall decline, the number of severe trauma cases remained relatively stable, indicating a shift toward more critical patient care. Emergency department length of stay decreased significantly from 295 min in 2023 to 187 min in 2024. Conclusion The ongoing strain on emergency and support department risks leads to an irreversible collapse if critical points are reached. To address this, localized trauma centers are needed to relieve the burden on larger medical institutions and improve the efficiency of trauma care systems during crises.

Fournier’s gangrene is infectious, necrotizing, life-threatening fasciitis of the perineal, genital, and perianal regions leading to soft-tissue necrosis and sepsis, and is treated with aggressive surgical debridement and antimicrobial agents. Negative-pressure wound therapy can be used if septic risk is controlled. An 82-year-old woman presented with Fournier’s gangrene and septic shock. After emergency debridement, perineal resection, a colostomy, and daily wound debridement was performed under general anesthesia (1 week). Multiple intubations and extubations under general anesthesia are a risk factor for poor patient outcomes. Therefore, negative-pressure wound therapy was performed under light sedation using noninvasive ventilation in the intensive care unit after extubation and for wound debridement. One month later, the perineum was reconstructed. Procedures performed under light sedation should be considered for patients requiring periodic invasive surgical procedures who are burdened by repeated general anesthesia. The number of general anesthesia sessions was significantly reduced by using noninvasive ventilation.

Fournier’s gangrene is infectious, necrotizing, life-threatening fasciitis of the perineal, genital, and perianal regions leading to soft-tissue necrosis and sepsis, and is treated with aggressive surgical debridement and antimicrobial agents. Negative-pressure wound therapy can be used if septic risk is controlled. An 82-year-old woman presented with Fournier’s gangrene and septic shock. After emergency debridement, perineal resection, a colostomy, and daily wound debridement was performed under general anesthesia (1 week). Multiple intubations and extubations under general anesthesia are a risk factor for poor patient outcomes. Therefore, negative-pressure wound therapy was performed under light sedation using noninvasive ventilation in the intensive care unit after extubation and for wound debridement. One month later, the perineum was reconstructed. Procedures performed under light sedation should be considered for patients requiring periodic invasive surgical procedures who are burdened by repeated general anesthesia. The number of general anesthesia sessions was significantly reduced by using noninvasive ventilation.

Fournier’s gangrene is infectious, necrotizing, life-threatening fasciitis of the perineal, genital, and perianal regions leading to soft-tissue necrosis and sepsis, and is treated with aggressive surgical debridement and antimicrobial agents. Negative-pressure wound therapy can be used if septic risk is controlled. An 82-year-old woman presented with Fournier’s gangrene and septic shock. After emergency debridement, perineal resection, a colostomy, and daily wound debridement was performed under general anesthesia (1 week). Multiple intubations and extubations under general anesthesia are a risk factor for poor patient outcomes. Therefore, negative-pressure wound therapy was performed under light sedation using noninvasive ventilation in the intensive care unit after extubation and for wound debridement. One month later, the perineum was reconstructed. Procedures performed under light sedation should be considered for patients requiring periodic invasive surgical procedures who are burdened by repeated general anesthesia. The number of general anesthesia sessions was significantly reduced by using noninvasive ventilation.

The prevalence of thyroid cancer in pregnant women is unknown; however, given that thyroid cancer commonly develops in women, especially young women of childbearing age, new cases are often diagnosed during pregnancy. This recommendation summarizes the follow-up and treatment when thyroid cancer is diagnosed during pregnancy and when a woman with thyroid cancer becomes pregnant. If diagnosed in the first trimester, surgery should be postponed until after delivery, and the patient should be monitored with ultrasound. If follow-up before 24–26 weeks of gestation shows that thyroid cancer has progressed, surgery should be considered. If it has not progressed at 24–26 weeks of gestation or if papillary thyroid cancer is diagnosed after 20 weeks of pregnancy, surgery should be considered after delivery.

The selected treatment for a nodule that is diagnosed as thyroid cancer is surgery. Imaging and blood tests are performed prior to surgery to determine the extent of the surgery. An Ultrasound (US) of the thyroid and neck should be performed to evaluate the size of the cancer, whether it is multifocal and has invaded surrounding tissues, and the status of the cervical lymph nodes (LNs). In addition to US, contrast-enhanced computed tomography may help detect cervical LN metastasis and evaluate patients suspected with invasive thyroid cancer.Generally, routine preoperative measurement of serum thyroglobulin and thyroglobulin antibody concentrations is not recommended. Integrated 18F-fluorodeoxyglucose positron-emission/computed tomography may be helpful either in patients with suspected lateral cervical LNs or distant metastasis or in patients with aggressive histology.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

Purpose: Despite guidelines on the prevention of central venous line-associated bloodstream infection, it is left to the clinical judgment of the attending physician to determine the risk of infection and how long a central line should remain in place. This study aimed to identify risk factors for peripherally inserted central venous catheter (PICC)-associated infection. Methods: This retrospective study included 1,136 patients with a PICC who were hospitalized at the National Health Insurance Service Ilsan Hospital (January 2015 to January 2022). Electronic medical records were reviewed for patients with positive blood cultures. Patients with suspicion of infection at the PICC insertion site or with unclear infection at other sites were defined as having a PICC-associated infection. Results: Thirty-five patients (3.08%) had a PICC-associated infection. There were significant differences in hypertension (p = 0.026), lung disease (p = 0.001), PICC duration > 14 days, and antibiotic use before PICC insertion (p = 0.016) between no PICC-associated infection, and infection in the bloodstream. Total parenteral nutrition with PICC was not significantly different between groups. Logistic regression analysis identified hypertension, lung disease, PICC duration > 14 days (OR 2.088, 95% CI 1.032-4.224, p = 0.041), and antibiotic use before PICC insertion (OR 0.159, 95% CI 0.049-0.515, p = 0.002) as independent risk factors for PICC-associated infection. Conclusion The study suggested that PICCs maintained longer than 14 days is a risk factor for PICC-associated infection. Antibiotic use prior to PICC insertion was observed as a negative factor for PICC-associated infection.