This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

Background/Aims: Elevated troponin levels predict in-hospital mortality and influence decisions regarding thrombolytic therapy in patients with acute pulmonary embolism (PE). However, the usefulness of high-sensitivity troponin T (hsTnT) regarding PE remains uncertain. We aimed to establish the optimal cut-off level and compare its performance for precise risk stratification. Methods: 374 patients diagnosed with acute PE were reviewed. PE-related adverse outcomes, a composite of PE-related deaths, cardiopulmonary resuscitation incidents, systolic blood pressure < 90 mmHg, and all-cause mortality within 30 days were evaluated. The optimal hsTnT cut-off for all-cause mortality, and the net reclassification index (NRI) was used to assess the incremental value in risk stratification. Results: Among 343 normotensive patients, 17 (5.0%) experienced all-cause mortality, while 40 (10.7%) had PE-related adverse outcomes. An optimal hsTnT cut-off value of 60 ng/L for all-cause mortality (AUC 0.74, 95% CI 0.61–0.85, p < 0.001) was identified, which was significantly associated with PE-related adverse outcomes (OR 4.07, 95% CI 2.06–8.06, p < 0.001). Patients with hsTnT ≥ 60 ng/L were older, hypotensive, had higher creatinine levels, and right ventricular dysfunction signs. Combining hsTnT ≥ 60 ng/L with simplified pulmonary embolism severity index ≥1 provided additional prognostic information. Reclassification analysis showed a significant shift in risk categories, with an NRI of 1.016 ± 0.201 (p < 0.001). Conclusions We refined troponin’s predictive value in patients with acute PE, proposing a new cut-off value of hsTnT ≥ 60 ng/L. Validation through large-scale studies is essential to offer clinically useful guidance for managing patient population.

Purpose: Persistent postoperative stiffness is a common complication after arthroscopic rotator cuff repair (ARCR).We hypothesized that a subacromial steroid injection (SAI) may improve the early outcomes in patients with persistent stiffness without increasing steroid-associated complications. Therefore, we evaluated the effectiveness and safety of SAI in patients with persistent stiffness 3 months after ARCR. Methods: We retrospectively analyzed 300 ARCR cases performed between January 2012 and May 2014, in which repair integrity was confirmed at postoperative 3 months. Patients were divided into SAI and control groups. The SAI group received a single SAI (triamcinolone 40 mg and ropivacaine 52.5 mg) to address postoperative stiffness, with no additional SAI thereafter. The control group did not receive any injections until the final follow-up. Functional and radiological outcomes were compared between the two groups. Results: The mean follow-up period was 18.1±4.7 months (range, 12.1–37.2 months), with no difference between groups (p=0.731). At the time of injection, the range of motion was significantly lower in the SAI (all p＜0.001). However, functional outcomes were comparable between the two groups at 3 months after injection and the final follow-up (all p＞ 0.05). The healing failure rate at the final follow-up also did not differ between the SAI and control groups (14.9% vs. 13.2%, p=0.671). Conclusion This short-term follow-up study suggests that the administration of a single SAI to treat persistent stiffness at 3 months after ARCR may improve functional recovery without increasing the risk of healing failure.

Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

Background/Aims: Elevated troponin levels predict in-hospital mortality and influence decisions regarding thrombolytic therapy in patients with acute pulmonary embolism (PE). However, the usefulness of high-sensitivity troponin T (hsTnT) regarding PE remains uncertain. We aimed to establish the optimal cut-off level and compare its performance for precise risk stratification. Methods: 374 patients diagnosed with acute PE were reviewed. PE-related adverse outcomes, a composite of PE-related deaths, cardiopulmonary resuscitation incidents, systolic blood pressure < 90 mmHg, and all-cause mortality within 30 days were evaluated. The optimal hsTnT cut-off for all-cause mortality, and the net reclassification index (NRI) was used to assess the incremental value in risk stratification. Results: Among 343 normotensive patients, 17 (5.0%) experienced all-cause mortality, while 40 (10.7%) had PE-related adverse outcomes. An optimal hsTnT cut-off value of 60 ng/L for all-cause mortality (AUC 0.74, 95% CI 0.61–0.85, p < 0.001) was identified, which was significantly associated with PE-related adverse outcomes (OR 4.07, 95% CI 2.06–8.06, p < 0.001). Patients with hsTnT ≥ 60 ng/L were older, hypotensive, had higher creatinine levels, and right ventricular dysfunction signs. Combining hsTnT ≥ 60 ng/L with simplified pulmonary embolism severity index ≥1 provided additional prognostic information. Reclassification analysis showed a significant shift in risk categories, with an NRI of 1.016 ± 0.201 (p < 0.001). Conclusions We refined troponin’s predictive value in patients with acute PE, proposing a new cut-off value of hsTnT ≥ 60 ng/L. Validation through large-scale studies is essential to offer clinically useful guidance for managing patient population.

Purpose: Persistent postoperative stiffness is a common complication after arthroscopic rotator cuff repair (ARCR).We hypothesized that a subacromial steroid injection (SAI) may improve the early outcomes in patients with persistent stiffness without increasing steroid-associated complications. Therefore, we evaluated the effectiveness and safety of SAI in patients with persistent stiffness 3 months after ARCR. Methods: We retrospectively analyzed 300 ARCR cases performed between January 2012 and May 2014, in which repair integrity was confirmed at postoperative 3 months. Patients were divided into SAI and control groups. The SAI group received a single SAI (triamcinolone 40 mg and ropivacaine 52.5 mg) to address postoperative stiffness, with no additional SAI thereafter. The control group did not receive any injections until the final follow-up. Functional and radiological outcomes were compared between the two groups. Results: The mean follow-up period was 18.1±4.7 months (range, 12.1–37.2 months), with no difference between groups (p=0.731). At the time of injection, the range of motion was significantly lower in the SAI (all p＜0.001). However, functional outcomes were comparable between the two groups at 3 months after injection and the final follow-up (all p＞ 0.05). The healing failure rate at the final follow-up also did not differ between the SAI and control groups (14.9% vs. 13.2%, p=0.671). Conclusion This short-term follow-up study suggests that the administration of a single SAI to treat persistent stiffness at 3 months after ARCR may improve functional recovery without increasing the risk of healing failure.