Objective: This study was conducted to examine the trends in patient visits to the emergency departments (EDs) during the coronavirus disease 2019 (COVID-19) pandemic and analyze the changes in the pattern of ED utilization over time. Methods: We analyzed the National Emergency Department Information System data on ED visits for 3 years, from January 1, 2018 to December 31, 2020. Results: A total of 25,260,790 patients visited the ED during the study period. There was a notable 23.3% decrease in visits in 2020 during the pandemic compared to the preceding year. The number of patients visiting the ED appeared to decrease in response to the increase in confirmed COVID-19 cases. In 2020, a total of 13,801 patients were diagnosed with COVID-19 in the ED, accounting for 22.7% of the confirmed COVID-19 cases in the country. In 2018, 2019, and 2020, ED visitors presenting with respiratory symptoms as their chief complaint numbered 1,438,137 (15.5%), 1,605,551 (17.7%), and 1,019,314 (14.7%), respectively. The length of stay of these patients increased at the regional and local emergency centers. However, a reverse trend was observed at local emergency medical agencies. Conclusion During the COVID-19 pandemic in 2020, patient visits to the ED decreased, irrespective of patient’s health status. The concentration of emergency and isolation-requiring patients at regional emergency medical centers and local emergency medical centers led to an increase in the length of stay. Further analysis and research are needed to assess the role of the local emergency medical agencies in the response to infectious diseases in the future.

Objective: This study was conducted to examine the trends in patient visits to the emergency departments (EDs) during the coronavirus disease 2019 (COVID-19) pandemic and analyze the changes in the pattern of ED utilization over time. Methods: We analyzed the National Emergency Department Information System data on ED visits for 3 years, from January 1, 2018 to December 31, 2020. Results: A total of 25,260,790 patients visited the ED during the study period. There was a notable 23.3% decrease in visits in 2020 during the pandemic compared to the preceding year. The number of patients visiting the ED appeared to decrease in response to the increase in confirmed COVID-19 cases. In 2020, a total of 13,801 patients were diagnosed with COVID-19 in the ED, accounting for 22.7% of the confirmed COVID-19 cases in the country. In 2018, 2019, and 2020, ED visitors presenting with respiratory symptoms as their chief complaint numbered 1,438,137 (15.5%), 1,605,551 (17.7%), and 1,019,314 (14.7%), respectively. The length of stay of these patients increased at the regional and local emergency centers. However, a reverse trend was observed at local emergency medical agencies. Conclusion During the COVID-19 pandemic in 2020, patient visits to the ED decreased, irrespective of patient’s health status. The concentration of emergency and isolation-requiring patients at regional emergency medical centers and local emergency medical centers led to an increase in the length of stay. Further analysis and research are needed to assess the role of the local emergency medical agencies in the response to infectious diseases in the future.

Objective: This study was conducted to examine the trends in patient visits to the emergency departments (EDs) during the coronavirus disease 2019 (COVID-19) pandemic and analyze the changes in the pattern of ED utilization over time. Methods: We analyzed the National Emergency Department Information System data on ED visits for 3 years, from January 1, 2018 to December 31, 2020. Results: A total of 25,260,790 patients visited the ED during the study period. There was a notable 23.3% decrease in visits in 2020 during the pandemic compared to the preceding year. The number of patients visiting the ED appeared to decrease in response to the increase in confirmed COVID-19 cases. In 2020, a total of 13,801 patients were diagnosed with COVID-19 in the ED, accounting for 22.7% of the confirmed COVID-19 cases in the country. In 2018, 2019, and 2020, ED visitors presenting with respiratory symptoms as their chief complaint numbered 1,438,137 (15.5%), 1,605,551 (17.7%), and 1,019,314 (14.7%), respectively. The length of stay of these patients increased at the regional and local emergency centers. However, a reverse trend was observed at local emergency medical agencies. Conclusion During the COVID-19 pandemic in 2020, patient visits to the ED decreased, irrespective of patient’s health status. The concentration of emergency and isolation-requiring patients at regional emergency medical centers and local emergency medical centers led to an increase in the length of stay. Further analysis and research are needed to assess the role of the local emergency medical agencies in the response to infectious diseases in the future.

Elsberg syndrome is a rare disease of lumbosacral myeloradiculitis, mostly caused by herpes simplex virus type 2 (HSV-2). It frequently has concomitant myelitis, and immunocompromised patients can be fatal with ascending myelitis. Since anti-viral agents might lead to good recovery, clinicians need to be suspicious for conditions of cauda equina syndrome. Detection of viral DNA from cerebrospinal fluid ensures the diagnosis. We report a case of Elsberg syndrome caused by HSV-2 and are to delineate the clinical and radiologic spectrum.

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

Objective: The length of stay in the emergency department (ED) is a major contributor to ED overcrowding, which in turn negatively affects the quality of emergency care. Several efforts have been made to reduce the ED length of stay (ED-LOS), including a mandatory target to limit ED-LOS within certain parameters. However, the association between ED-LOS and treatment results is yet to be clarified. The authors investigated the influence of ED-LOS on patient survival by comparing severity-adjusted survival. Methods: This study was a retrospective analysis of data registered in 2018 in the National Emergency Department Information System (NEDIS). Cases registered by the regional and local emergency centers were included for analysis. The standardized W scores (Ws) based on the Emergency Department Initial Evaluation Score were used to assess treatment outcomes represented by severity-standardized survival, and the correlation between the Ws and the ED-LOS was analyzed. Results: A total of 2,281,526 cases were included for analysis. The overall mortality comprised 52,284 cases (2.3%) and the median ED-LOS was 165 minutes (interquartile range, 96-301). Although a longer ED-LOS was associated with poorer outcomes overall, the association was not apparent when an analysis of cases eligible for ED-LOS evaluation in the national evaluation program was carried out. Moreover, in the analysis of severe cases with a predicted survival probability of less than 0.9, an ED-LOS shorter than 6 hours was associated with significantly poorer severity-adjusted survival. Conclusion The study revealed that the current ED-LOS criteria used in the national evaluation program were not associated with better survival.

There is some dissatisfaction with the term “nonalcoholic fatty liver disease (NAFLD),” which overemphasizes alcohol and underemphasizes the importance of metabolic risk factors in this disease. Recently, a consensus recommended “metabolic (dysfunction)-associated fatty liver disease (MAFLD)” as a more appropriate term to describe fatty liver diseases (FLD) associated with metabolic dysfunction. During the definition change from NAFLD to MAFLD, subjects with FLD and metabolic abnormalities, together with other etiologies of liver diseases such as alcohol, virus, or medication who have been excluded from the NAFLD criteria, were added to the MAFLD criteria, while subjects with FLD but without metabolic abnormality, who have been included in the NAFLD criteria, were excluded from the MAFLD criteria. This means that there is an emphasis on the metabolic dysfunction in MAFLD which may underestimate the prognostic value of hepatic steatosis itself, whereas the MAFLD criteria might better identify subjects who are at a higher risk of hepatic or cardiovascular outcomes. However, non-metabolic risk NAFLD subjects who are excluded from the MAFLD criteria are missed from the diagnosis, and their potential risk can be the cause of future diseases. Although huge controversies remain, this review focused on summarizing recent studies that compared the clinical and prognostic characteristics between subjects with NAFLD and MAFLD.