Objectives: In May 2025, clusters of salmonellosis were identified in 7 cities in the Republic of Korea, all associated with consumption of identical bakery products. This investigation aimed to characterize the outbreak, identify potential contributing factors, and inform strategies for preventing similar multi-facility foodborne outbreaks. Methods: A case series study was conducted among individuals who consumed Manufacturer H’s Product I and Product II on May 15–16, 2025 at 7 facilities (n = 1,235). Clinical specimens from symptomatic individuals, retained food samples, and environmental samples were collected and tested. Food-exposure histories were assessed, and active case finding was implemented across all supplied facilities. Traceback investigations were conducted at the manufacturer, distributor, and egg farms. Human and food isolates underwent pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS). Results: A total of 323 cases met the outbreak case definition (attack rate, 26.2%), of which 48 were laboratory-confirmed. Salmonella Enteritidis was isolated from both clinical specimens and retained bakery products. PFGE patterns were indistinguishable between human and food isolates, and WGS demonstrated high genetic relatedness. These findings confirmed a common-source outbreak linked to the implicated bakery products. Conclusion This outbreak underscores the value of integrating epidemiological investigation, active case finding, and molecular typing to identify common food vehicles in outbreaks involving widely distributed manufactured foods. Coordinated collaboration between public health and food safety authorities is essential for the effective detection, response, and prevention of multi-facility foodborne outbreaks.

Purpose: Autism spectrum disorder (ASD) exhibits heterogeneous developmental trajectories; however, longitudinal studies using the Korean Childhood Autism Rating Scale (K-CARS) are scarce. This study examined diagnostic changes and related developmental characteristics through repeated K-CARS assessments. Methods: We retrospectively reviewed the medical records of children who underwent repeated K-CARS assessments between May 2021 and December 2024 at Gyeongsang National University Hospital. Based on diagnostic status at the initial (T1) and follow-up (T2) evaluations, participants were classified as having persistent ASD (ASD at T1 and T2), emerging ASD (non-ASD at T1 but ASD at T2), or desisting ASD (ASD at T1 but non-ASD at T2). Developmental profiles were evaluated using the social quotient (SQ), visual-motor integration (VMI), and language quotients. Results: Forty-three children (32 boys; median age, 2.9 years at T1 and 4.3 years at T2) were included. Twenty-two met ASD criteria at T1, and 15 (68%) retained the diagnosis at T2. Across the cohort, 15 (35%) had persistent ASD, 21 (49%) had emerging ASD, and seven (16%) had desisting ASD. The desisting group showed higher baseline VMI and better outcomes at follow-up. The emerging group initially had higher SQ and VMI than the persistent group, but these differences disappeared over time. Higher baseline VMI was associated with desisting status and higher baseline SQ with emerging ASD (odds ratios, 3.14 and 2.59 per standard deviation increase, respectively; P=0.06 and P=0.07). Conclusion Early ASD diagnoses were generally stable yet variable, supporting repeated assessment. Baseline VMI and SQ may relate to later diagnostic changes.

Background: Psoriasis is a chronic inflammatory skin disorder typified by well-demarcated erythematous plaques with scales. While considered an immune-driven condition, its underlying molecular triggers remain insufficiently defined. Cold-inducible RNA-binding protein (CIRP), a stress-response protein, has recently been recognized as a damage-associated molecular pattern that can stimulate immune responses. Objective: This study aimed to explore the potential association between circulating CIRP levels and the clinical as well as histological characteristics of psoriasis. Methods: Serum CIRP concentrations were analyzed in 67 individuals diagnosed with psoriasis and 20 healthy controls. Relationships between CIRP expression and various clinical and histological indices were also examined. Results: Patients with psoriasis exhibited significantly elevated serum CIRP levels compared to healthy individuals. Although correlations were observed between CIRP and certain clinical and histological indicators, CIRP levels did not significantly differ based on disease severity (Psoriasis Area and Severity Index score), joint involvement, or nail changes. Conclusion Our findings support the notion that CIRP may be involved in the immunopathogenesis of psoriasis and could be considered a prospective target for therapeutic modulation.

Background: Alitretinoin, a pan-retinoid receptor agonist approved for chronic hand eczema, exhibits immunomodulatory effects that may benefit alopecia areata (AA). However, clinical evidence for its use in AA is limited. Objective: To evaluate alitretinoin's clinical efficacy and immunological mechanism in patients with AA. Methods: We reviewed retrospectively twenty-one patients with AA who were treated with alitretinoin, either as monotherapy (n=9) or add-on therapy (n=12). Treatment response was assessed using the Severity of Alopecia Tool (SALT) scores, and in vitro studies used human outer root sheath cells stimulated with interferon-γ and polyinosinic:polycytidylic acid to investigate the drug’s effects on inflammatory pathways. Results: Both groups showed significant reductions in SALT scores (p=0.04 and p=0.02, respectively). Patients with baseline SALT scores below 50 demonstrated superior improvement.Adverse events were mild, with headache (33.3%) and cheilitis (4.8%) being the most common. In vitro, alitretinoin suppressed interleukin-6 and tumor necrosis factor-α expression, decreased phosphorylation of signal transducer and activator of transcription (STAT) 1/STAT3, and downregulated major histocompatibility complex class I expression, suggesting restoration of hair follicle immune privilege. Conclusion Alitretinoin appears to be a safe and potentially effective treatment for patients with mild to moderate AA unresponsive to conventional therapies. Its role as a monotherapy or adjunctive option in selected cases warrants further investigation through larger controlled studies.

Background: Rosacea is a chronic inflammatory skin disorder characterized by erythema, papules, ocular symptoms, and heightened sensitivity. Patients with neurogenic symptoms such as burning or stinging remain particularly difficult to manage. Current guidelines often underrepresent energy-based devices (EBDs), pigmentary sequelae, psychosocial burden, and ocular comorbidities. Objective: To examine Korean dermatologists’ expert perspectives on rosacea management, focusing on skin sensitivity, neurogenic symptoms, pigmentary changes, psychosocial impact, ocular involvement, and EBD use. Methods: A web-based, 29-item survey was administered to 25 board-certified Korean dermatologists (May–June 2025). Quantitative and qualitative responses were analyzed. Results: Erythematotelangiectatic and papulopustular phenotypes with sensitivity skin predominated. EBDs (pulsed dye laser, intense pulsed light) were frequently used but limited by cost and sensitivity issues. Neurogenic symptoms were recognized but rarely treated with neuromodulators. Post-inflammatory hyperpigmentation was infrequent, yet monitoring was inconsistent.Psychosocial and ocular aspects were acknowledged but seldomly systematically addressed.Respondents expressed interest in emerging adjunctive treatments such as cold plasma, skin boosters, and holistic care approaches. Conclusion Korean dermatologists adopt individualized strategies for rosacea, yet practice gaps remain regarding neurogenic symptoms, pigmentary complications, and psychosocial and ocular comorbidities. Findings support the need for updated multidisciplinary, phenotype-driven guidelines aligned with real-world practice.

Background: The 2020 European Society of Cardiology (ESC) 0-hr/1-hr algorithm using high-sensitivity cardiac troponin I (hs-cTnI) for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) aims at early diagnosis and shorter emergency department (ED) stays. While this algorithm has been well-established in controlled studies, real-world implementation remains challenging. We evaluated the algorithm’s clinical performance and risk stratification capability in patients with chest pain or discomfort. Methods: We measured hs-cTnI in 4,678 patients suspected of NSTE-ACS between August 2022 and July 2023, using an Atellica IM Analyzer (Siemens Healthineers, Erlangen, Germany). We categorized patients into rule-in, observe, or rule-out groups according to the algorithm and assessed its diagnostic performance for NSTE-ACS. The final diagnosis of NSTE-ACS was adjudicated by two independent physicians. Additionally, we evaluated 30-day all-cause mortality, hazard risk, and ED length of stay across the three groups. Results: The algorithm categorized 3,408 (72.9%), 573 (12.2%), and 697 (14.9%) patients into the rule-out, observe, and rule-in groups, respectively. Among 90 patients diagnosed as having NSTE-ACS, none were falsely categorized into the rule-out group. Survival analysis revealed significant differences (P < 0.001), with Cox hazard ratios of 2.38 (95% confidence interval: 1.20–4.71) and 6.39 (3.45–11.86) in the observe and rule-in groups, respectively. ED stays shortened in the order of rule-out, observe, and rule-in groups (P < 0.001). Conclusions The 2020 ESC 0-hr/1-hr algorithm demonstrates excellent diagnostic accuracy without false rule-outs and effective risk stratification, and contributes to efficient ED throughput, supporting its clinical utility in real-world emergency settings.

Background: The spread of antimicrobial-resistant bacteria has close relationships among humans, animals, and the environment, necessitating the implementation of the “One Health” approach. In previous study, the prevalence and molecular epidemiology of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) were investigated across multiple pig industry sectors in Korea. In this study, animal developmental stages and antimicrobial usage policies on farms were also considered. Methods: A total of 6,288 non-duplicated samples were collected from pig farms, slaughterhouses, and their personnel from three provinces in Korea between 2020 and 2022.Antimicrobial susceptibility and ESBL gene characterization were performed on the samples. Results: Overall, 1,084 ESBL-EC isolates were collected, with positivity detection rates of 24.7%, 23.3%, 12.7%, 3.9%, 17.2% in pigs, workers, the environment, meat, and total samples, respectively. Common ESBL types were blaCTX-M-55 (N = 628), blaCTX-M-15 (N = 204), and blaCTX-M-14 (N = 127). Pig-derived E. coli isolates had antimicrobial resistance (AMR) rates of 80.4%, 47.2%, 32.6%, 36.7%, 43.4%, 62.4%, and 72.1% to ampicillin, piperacillin, cefazoline, ciprofloxacin, cotrimoxazole, chloramphenicol, and tetracycline, respectively.AMR rates were lower in the finishing stage pigs than in the lactating stage pigs and tended to decrease during animal development for most antimicrobials. AMR rates were higher in pig farms with a customary antimicrobial use policy than in those with a low-level antimicrobial use policy. Conclusions The findings highlight the significance of elucidating AMR networks among humans, animals, and the environment. Prudent antimicrobial usage and continuous AMR monitoring in the pig industry are crucial to safeguard food safety.

Purpose: We aimed to compare the final adult height (FAH) of male patients with central precocious puberty (CPP) after treatment with a gonadotropin-releasing hormone agonist (GnRHa). Specifically, we compared FAH with the target height (TH) and the predicted adult height (PAH) before and after GnRHa treatment to quantify height gain and identify predictive factors. Methods: We retrospectively reviewed the medical records of 92 male patients with CPP and known FAH after GnRHa treatment at the Department of Pediatrics of Severance Children’s Hospital between January 2000 and June 2024. Results: The mean duration of GnRHa treatment was 2.7±1.3 years. A significant 1.1±0.9 years narrowing was observed in the difference between bone age (BA) and chronological age (CA) during treatment (P<0.001). TH was 172.4±3.4 cm. FAH was 173.6±6.4 cm. FAH was greater than TH by 1.2±5.9 cm (P=0.047). PAH before and after treatment was 179.9±8.1 and 181.2±7.4 cm, respectively. PAH was increased by 1.3±4.9 cm (P=0.012) after treatment. As the PAH standard deviation score (SDS) before GnRHa treatment increased, FAH tended to exceed TH. In contrast, higher testosterone levels before treatment are associated with FAH falling below TH. A longer duration of treatment and taller TH are associated with an FAH SDS greater than height SDS before treatment. Conversely, a greater weight SDS, BA–CA difference, and testis size before treatment are associated with FAH SDS being less than height SDS before GnRHa treatment. Conclusion GnRHa treatment improved FAH and inhibited bone maturation in male patients with CPP.

Purpose: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Materials and Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes.Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Older adults are potential beneficiaries of digital health technologies but remain vulnerable to the digital divide. This study aimed to compare digital accessibility, perceptions, and intention to use digital healthcare services among urban and rural older adults, and to identify associated factors. Methods: A cross-sectional descriptive study was conducted with 140 community-dwelling older adults aged 65 and above in urban and rural areas. Data were collected using structured questionnaires covering digital device ownership, usage patterns, perceived ease of use, digital self-efficacy, and perceptions of digital healthcare—assessed in four dimensions: expectations, concerns, emotional responses, and perceived necessity. Statistical analyses included t-tests, chi-square tests, and binary logistic regression. Results: Urban older adults had higher ownership and usage rates of smartphones (χ2=5.78, p=.016) and the internet (χ2=18.53, p<.001), and significantly more experience with digital device education compared to rural older adults (χ2=5.85, p=.016). While no significant differences were found in expectations, concerns, and emotional responses, rural participants showed significantly higher perceived necessity (t=-2.30, p=.023). The overall intention to use digital healthcare services was high in both groups, and binary logistic regression analysis revealed that expectations (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.10~2.89, p=.019) and perceived necessity (OR=2.24, 95% CI=1.39~3.60, p=.001) were significant predictors of intention to use. Conclusion: Promoting digital healthcare adoption among older adults requires enhancing individual expectations and perceived needs beyond simply providing technology. In rural areas, strategies should focus on improving digital accessibility and offering tailored education programs.