Myiasis, a parasitic infestation caused by dipteran larvae in living humans or animals, is rarely encountered postmortem. Here, we report a case of myiasis identified during postmortem inspection in a 40-year-old man with a 10-year history of untreated schizophrenia. During the winter between late 2022 and early 2023, the decedent walked outdoors barefoot and sustained frostbite and was advised to undergo limb amputation at a university hospital in March 2024. He died at home in late May 2024. At the scene, the body showed displaceable livor mortis and absence of rigor mortis, suggesting a short postmortem interval. Severe necrosis was present below the knees, and numerous third-instar larvae without postfeeding stage were observed within the necrotic tissue, suggesting myiasis development at the frostbite sites. Species identification via larval sampling was not possible; thus, photographic analysis was attempted. The larva at the most advanced developmental stage was most likely a third-instar Lucilia sericata, the most common species causing myiasis in Korea. Assuming a skin temperature of 34°C under blanket coverage, the estimated post-oviposition interval ranged from 38.9–71.7 hours. Considering the estimated postmortem interval, the oviposition may have occurred antemortem. Since myiasis can indicate neglect or contribute to death, forensic pathologist should assess whether the postmortem interval aligns with the developmental stage of the larvae. For accurate forensic entomological analysis, adequate sampling of larvae is essential during postmortem inspections.

Purpose: Older cancer patients face unique challenges due to age-related physiological changes, increasing their vulnerability to treatment-related toxicities. Geriatric assessment (GA) is a validated tool for optimizing care, yet there is no consensus on integrating geriatric interventions into oncology. This study evaluates the feasibility of a tailored onco-geriatric intervention model incorporating the KG-7 screening tool. Materials and Methods: This prospective study included 30 patients aged ≥ 70 years with solid tumors undergoing adjuvant or palliative chemotherapy. Patients scoring ≤ 5 of KG-7 were eligible. Tailored interventions incorporating KG-7 included polypharmacy, functional status, mobility, nutrition, cognition, emotional well-being, insomnia, social support, and medical problem. KG-7, GA, and quality of life (QoL) were followed at 12 weeks. Results: Participants (median age, 79.5 years) had colon (43.3%), pancreatic (23.3%), or gastric cancer (23.3%). At baseline, most patients showed independent activities of daily living (100%)/instrumental activities of daily living (90%). However, 93.3% had abnormal GA. Particularly, 86.7% were either malnourished or at risk of malnutrition. The most frequently identified intervention needs included polypharmacy (70.0%), nutritional support (60.0%), and emotional well-being (50.0%) with high adherence (100.0%, 88.9%, and 46.7%, respectively). At 12 weeks, KG-7 scores improved in 43.8% of patients, and 69.2% of GA domains were improved. QoL analysis revealed modest improvement in Global Health Status (mean difference, 6.3; p=0.176). One-year survival rates were 92.3% and 79.4% for adjuvant and palliative groups, respectively. Conclusion The onco-geriatric intervention model incorporating KG-7 demonstrated high feasibility and potential to enhance clinical outcomes. Future studies should validate this approach in randomized trials to optimize care for older cancer patients.

Purpose: To develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically evaluating recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revision, thereby providing an evidence-based standard for clinicians and policymakers. Methods: A multidisciplinary committee developed the guidelines using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The process included formulation of three key questions addressing screening efficacy, diagnostic accuracy, and optimal screening age and interval. A systematic review of international guidelines and primary literature was conducted, yielding 327 eligible studies. In addition, a utility-based analysis using a Markov model was performed to determine optimal screening ages and intervals. Results: The evidence synthesis identified high-certainty evidence supporting the use of the fecal immunochemical test (FIT) for reducing CRC mortality and moderate-certainty evidence for colonoscopy. Evidence for computed tomographic colonography (CTC) and stool DNA testing was rated as very low certainty. Based on the evidence review and cost-utility analysis, the committee conditionally recommends CRC screening for asymptomatic, average-risk adults aged 45–74 years using either colonoscopy every 10 years or FIT every 1–2 years. CTC and stool DNA testing were not recommended owing to insufficient evidence. Conclusion The 2025 Korean Guidelines for Colorectal Cancer Screening present updated, evidence-based recommendations tailored to the domestic healthcare context. By conditionally endorsing both colonoscopy and FIT for individuals aged 45–74 years, these guidelines aim to improve population-level screening effectiveness and reduce the burden of CRC in South Korea.

Ketamine is commonly used in the emergency department for procedural sedation. It is the most commonly chosen sedative drug in children because of its rapid onset, short half-life, little respiratory depression, and can be administered intravenously and intramuscularly. Common side effects include hallucination, visual disturbance, dizziness, nausea, and vomiting. Recently, it has also been used as an anticonvulsant for refractory status epilepticus. The authors encountered a case of generalized tonic-clonic seizure in a four-year-old boy after an intramuscular injection of ketamine for procedural sedation. This case is reported to share the author’s experience with medical professionals who use ketamine and raise awareness.

Background: This study examined the effects of electroporation (EP) and sonophoresis (SP) on the skin permeation of various ingredients and the resulting changes in skin properties. Methods: Twenty participants used whitening and hyaluronic ampoules as adjunctive cosmetics. The intervention group used an EP with an SP device for application while the control group used their hands, both groups over a 4-week period. The outcomes measured included skin elasticity, gloss, pores, tone, and soothing.In addition, this study determined the absorption amount, absorption rate, and skin permeation of the cosmetic ampoules 30 minutes after applying the cosmetics in a clinical test. Results: Significant improvements in skin hydration, elasticity, tone, and pigmentation were observed in the intervention group. In particular, the most pronounced effects were observed immediately after use. In addition, application with EP and SP led to a more than 200% increase in the absorption amount, absorption depth, and absorption speed of cosmetics compared to hand application. Conclusion These findings suggest that simultaneous EP and SP significantly enhance skin permeability and cosmetic absorption, improving skin properties.

Background: The delivery of desired drugs through the skin can enhance the effectiveness of cosmetic treatments and further enhance skin recovery and collagen regeneration. This study evaluated the potential of a device to achieve noninvasive transdermal drug delivery using simultaneous electroporation (EP) and lowfrequency sonophoresis (SP). Methods: The percutaneous absorption after applying the device that administered EP and SP was evaluated using an ex vivo porcine skin model. Porcine skin tissue was placed on a polyurethane foam dressing impregnated with 3% povidone-iodine (PI). Four drops of ampoule were applied, and the device was applied to the skin for 3 minutes. The reaction between the penetrated whitening agents and 3% PI, indicated by color changes, was analyzed using an Antera 3D camera. Results: The simultaneous application of EP with SP to skin tissue at a specific ratio for 3 minutes resulted in a significant increase in the area that reacted with iodine after skin penetration. The results showed that exposure to hyaluronic acid ampoule (HAA) increases type I collagen synthesis in human dermal fibroblasts in a concentration- and time-dependent manner. In addition, treatment with HAA combined with the application of EP with SP increased cell proliferation and significantly increased type I collagen levels in human dermal fibroblasts, with device-assisted synthesis showing greater efficiency. Conclusion These results suggest that simultaneous EP and SP efficiently deliver large molecules, such as hyaluronic acid, deep into the skin without causing skin damage.

Purpose: Apixaban is recommended for patients with atrial fibrillation. Although routine monitoring of plasma concentrations is not typically advised, factors such as ethnicity, sex, and comorbidities can influence these levels. Our study analyzed the plasma apixaban concentrations (PAC) in patients to explore whether these levels, along with underlying conditions, offer enhanced insights for risk stratification. Methods: This study analyzed 49 patients with atrial fibrillation who had been taking apixaban for over a month, examined factor Xa levels within 6 h post-administration, and correlated PAC with clinical characteristics such as age, body weight, estimated glomerular filtration rate (eGFR), presence of heart failure, and bleeding events. Results: The mean plasma concentration of apixaban in all patients was 160.3 ± 77.5 ng/mL. Those taking apixaban 5 mg twice daily had higher plasma concentrations than those taking 2.5 mg twice daily (191.2 ± 75.3 ng/mL vs.137.2 ± 72.0 ng/mL, p = 0.014). Among the patients receiving a reduced dose, renal function and heart failure were significantly associated with plasma concentrations. No factors were associated with the plasma concentrations in patients receiving the standard dose. Notably, reduced-dose patients with heart failure had plasma concentrations comparable to those of individuals receiving the standard dose and exhibited a higher incidence of bleeding than the other groups. Conclusions PAC measurement revealed that apixaban dosages, classified based on age, body weight, and eGFR, were generally effective. Nonetheless, heart failure may increase plasma levels and correlate with an increased bleeding risk in Korean patients on reduced doses. Therefore, tailoring apixaban prescriptions to account for heart failure and other comorbidities may enhance treatment efficacy.

and Relevance: Despite molecular evidence of active viral evolution, companion animals currently pose a limited pandemic risk owing to no sustained zoonotic transmission chains. Critical knowledge gaps remain regarding subclinical infection frequency, natural transmission efficiency, and host genetic factors that influence susceptibility. Surveillance should prioritize high-risk interfaces, including raw pet food supply chains and veterinary facilities, while maintaining the perspective of actual versus theoretical risks. Understanding companion animal influenza virus dynamics is essential for comprehensive pandemic preparedness strategies.

Purpose: In Korea, the Health Insurance Review and Assessment Service (HIRA) mandates patient participation in outpatient multidisciplinary team (MDT) meetings as part of national cancer quality assessment. However, the necessity of involving patients and families in MDT discussions remains debatable. This study explored international expert perspectives on patient participation in gastric cancer MDTs. Methods: A cross-national expert survey was conducted in September 2021 among 15 gastric cancer specialists from Korea, China, Japan, Singapore, and the United States. The survey assessed the frequency of patient and family member attendance, perceived pros and cons, and preferences regarding mandatory versus selective involvement. Additionally, MDT structures and policies were reviewed by countries. Results: Most respondents reported that patients and families rarely or never attend MDT meetings: nine stated that patients are never included, three reported “usually not,” and three indicated “sometimes.” None consistently included patients. The most cited benefits were sharing opinions with patients and families simultaneously, followed by improved explanation of treatment and legal protection. Major concerns included hindered discussion, inefficiency, and logistical challenges. Only four respondents supported routine participation, while 11 favored case-dependent involvement. Conclusion International experts do not widely support mandatory patient participation in MDT meetings. A flexible approach that allows MDTs to operate with or without patient involvement may better reflect actual clinical practice.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.