Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Background: Genetic alterations play a pivotal role in multiple myeloma (MM) development and therapeutic resistance. Traditionally, the genetic profiling of MM requires invasive bone marrow (BM) procedures; however, these procedures are associated with patient discomfort and cannot fully capture the spatial and temporal heterogeneity of the disease.Therefore, we investigated the clinical implications of liquid biopsy using targeted deep sequencing. Methods: We analyzed the genetic profiles of circulating tumor DNA (ctDNA) by targeted deep sequencing from 102 patients, including those with monoclonal gammopathy of undetermined significance (MGUS, N = 7), smoldering MM (N = 6), and symptomatic MM (N = 89). Results: The number of ctDNA mutations increased with disease progression from MGUS to MM, with averages of 1.0 mutations in MGUS, 1.8 mutations in smoldering MM, and 1.9 mutations in MM, respectively. Shared mutations between BM and ctDNA were more prevalent in MM (68.9%) than in MGUS (25.0%). RAS/RAF and TP53 mutations were significantly enriched in MM ctDNA. Specific mutations were associated with clinical features in patients with MM: hypercalcemia and TET2 (P = 0.006), renal insufficiency and NRAS (P = 0.012), paramedullary myeloma and TP53(P = 0.02), and extramedullary myeloma and NRAS (P = 0.007). TET2 mutations significantly affected 2-yr progression-free survival (hazard ratio = 7.11, P = 0.003). Serial ctDNA profiling accurately predicted treatment response in patients with MM. Conclusions Our findings highlight the potential of liquid biopsy for understanding MM progression and prognosis utilizing a minimally invasive approach, paving the way for its integration into personalized treatment strategies and real-time disease monitoring.

Intracranial growing teratoma syndrome (iGTS) is a rare phenomenon in patients with non-germinomatous germ cell tumor (NGGCT) after chemotherapy or radiotherapy. It manifests as paradoxical growth of teratomatous components, with multiple cystic lesions on cranial imaging despite normalized tumor markers. This paper presents a 22-year-old male with iGTS, diagnosed one month after chemotherapy against NGGCT. Initially diagnosed with presumptive pineal NGGCT causing obstructive hydrocephalus, the patient underwent endoscopic third ventriculostomy and extraventricular drainage with tumor biopsy followed by two chemotherapy cycles. Despite normalization of tumor markers, follow-up MRI showed increased tumor size with honeycomb-like cystic patterns. The patient underwent suboccipital craniotomy for tumor removal via combined telovelar and infratentorial supracerebellar approaches.The final pathology confirmed mature teratoma. However, postoperative bleeding and left thalamic infarction occurred, resulting in severe neurological deficits. Despite challenges, the patient eventually regained the ability to follow simple commands. To understand iGTS pathophysiology, several hypotheses, including the differentiation of immature components and the uninhibited growth of mature components induced by chemotherapy or radiotherapy, were explored. Surgical intervention remains as an ideal treatment, while clinical trials investigate chemotherapy options. Frequent imaging followups are crucial for early detection in iGTS for NGGCT patients.

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.

Objective: This study evaluated the efficacy and effectiveness of a new patient handover system developed for better handover in a metropolitan emergency department (ED). Methods: A retrospective observational study was designed to evaluate the appropriateness and satisfaction level of the new ED handover system. The participants were pre-hospital emergency medical service (EMS) providers with patient transport experience before and after the pilot of the new handover system. Results: A questionnaire was completed by 37 pre-hospital EMS providers who transported patients to the emergency department. Based on the results, pre-hospital EMS providers felt an increased level of kindness from the ED healthcare professionals during patient handover (P<0.001), from 3.19±1.05 points before the introduction of the system to 3.97±0.96 points after its introduction, and the activeness of ED healthcare professionals also increased, from 3.35±1.03 to 4.14±0.86 points (P<0.001). The sufficiency of contents of patient handover information to explain a patient’s condition increased from 3.59±0.76 to 4.08±0.72 points (P<0.003). The score for overall satisfaction felt by the EMS providers during patient handover increased from 3.46±0.96 to 3.76±0.86 points, which was not statistically significant (P=0.020). Conclusion Our findings suggest that the introduction of a new patient handover system between EMS providers and the ED staff is effective for both pre-hospital EMS providers and ED staff.

Primary aldosteronism (PA) is a common, yet underdiagnosed cause of secondary hypertension. It is characterized by an overproduction of aldosterone, leading to hypertension and/or hypokalemia. Despite affecting between 5.9% and 34% of patients with hypertension, PA is frequently missed due to a lack of clinical awareness and systematic screening, which can result in significant cardiovascular complications. To address this, medical societies have developed clinical practice guidelines to improve the management of hypertension and PA. The Korean Endocrine Society, drawing on a wealth of research, has formulated new guidelines for PA. A task force has been established to prepare PA guidelines, which encompass epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, and follow-up care. The Korean clinical guidelines for PA aim to deliver an evidence-based protocol for PA diagnosis, treatment, and patient monitoring. These guidelines are anticipated to ease the burden of this potentially curable condition.