Objectives: This study evaluated the effectiveness of government epidemic control policies centered on diagnostic testing and examined their impact on the in vitro diagnostics (IVD) industry. It also analyzed the complex interplay among policy interventions, epidemic dynamics, and the IVD industry’s value chain to identify key leverage points for managing future public health crises. Methods: A system dynamics (SD) model calibrated using national data from the Republic of Korea simulated the interactions between epidemic progression and the IVD value chain.We conducted a scenario analysis encompassing 6 policy interventions: research and development (R&D) investment, public–private collaboration, regulatory easing, diagnostic test performance, testing intensity, and social distancing. Results: Policies promoting investment, public–private collaboration, and regulatory easing accelerated the market entry of diagnostics, thereby reducing infections and deaths. However, these interventions were associated with lower overall industry revenue, attributable toincreased market competition and a reduced patient population. A critical trade-off was noted:although regulatory speed is advantageous, using low-sensitivity diagnostics substantially worsened public health outcomes. Aggressive testing strategies and stringent social distancingwere also confirmed to be effective in reducing both infections and mortality. Conclusion This study provides a strategic framework for understanding interactions between pandemic control policies and the IVD industry. Sustained pre-crisis investment in R&D,public–private networks, and public health infrastructure is essential for effective pandemicpreparedness. During a crisis, policymakers must carefully manage the critical trade-off between regulatory speed and diagnostic quality to ensure that rapid responses do not compromise public health outcomes.

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.

Background/Aims: The optimal vascular access strategy for very elderly patients initiating hemodialysis (HD) remains unclear. Arteriovenous fistulas (AVFs) offer long-term benefits but may be limited due to vascular aging. This study evaluated vascular access outcomes in patients aged ≥ 80 years. Methods: We conducted a retrospective cohort study using data from the Korean National Health Insurance Service between 2008 and 2019. Patients aged ≥ 80 years who initiated HD with a newly created AVF or arteriovenous graft (AVG) were included. Primary outcomes were primary, assisted primary, and secondary patency. The secondary outcome was all-cause mortality. Outcomes were compared using Kaplan–Meier analysis and multivariable Cox regression. Results: Among 8,487 patients, 5,124 (60.4%) received AVFs (AVF group) and 3,363 (39.6%) received AVGs (AVG group). AVFs were associated with significantly lower rates of patency loss across all definitions. The adjusted hazard ratios (HRs) for AVG vs. AVF were 1.76 (95% confidence interval [CI], 1.67–1.86) for primary patency loss, 1.90 (95% CI, 1.77–2.03) for assisted primary, and 3.18 (95% CI, 2.81–3.61) for secondary patency loss. All-cause mortality was also higher in the AVG group (adjusted HR, 1.24; 95% CI, 1.17–1.30). Conclusions In this large-scale study, AVF use was associated with superior patency and lower mortality compared with AVG in patients aged ≥ 80 years. These findings suggest that AVF remains a beneficial option for appropriately selected elderly patients and that age alone should not be a primary barrier to its creation.

Initial gastrointestinal endocrine cells (GIECs) likely appear at the proximal and distal sites of abdominal intestines and may take a close topographical relation with neural elements in the gut. We examined immunohistochemically-stained sections from 10 fetuses at approximately 8–18 weeks of gestational age (36–155 mm of crown-rump length). Irrespective of whether physiological herniation was present (early 5 specimens) or absent (the other 5), the duodenum and jejunum had well-developed mucosa with villi containing abundant flask-like chromogranin-positive cells. In the earlier 5 specimens, the rectum, standing up to a level of the umbilicus, had a lumen and villi with a few positive cells, but the colon carried neither the lumen or chromogranin-positive cells. The initial GIECs seemed to appear in the basal payer of the epithelium at the distal and proximal foci depending on double pathways of neural crest cell migration. Less number of the colic chromograninpositive cells, more than 5-times difference in density relative to small intestine, was seen in the larger 5 specimens. The appearance of GIECs was delayed at the anal transitional zone (a border area between the columnar and squamous epithelia).The reactivity of neuronal nitric oxide synthase was restricted in the myenteric plexus, whereas clusters of slender calretininpositive cells existed in the lamina propria or core of villi in the duodenum and colon. Relatively small, round or oval positive cells were also seen in the basal layer of the columnar epithelium. Therefore, calretinin-positive cells might exist closely to GIECs in the developing villi.

The nasal mucosa and submucosa likely contain both vascular beds against cold and dry air and resident immunoreactive cells against various antigens. Therefore, a specific fibrous structure seems to be necessary. Using histological specimens from 20 elderly cadavers, we examined the nasal mucosal and submucosal architecture. The ciliated columnar epithelium of the nasal mucosa was characterized by 1) a thick basal lamina, 2) few elastin-positive fibers beneath the epithelium, that was quite different from the nearby mucocutaneous junction area with a thick layer (0.3–0.8 mm) of elastic and oxytalan fibers corresponding to the skin dermis, 3) CD34-positive cells distributing diffusely in the submucosal tissue, and 4) few smooth muscle actin (SMA)-positive fibers beneath the epithelium. Some of submucosal fibrous structure appeared to express both elastin and CD34. CD34-positive arterioles were abundant beneath the ciliated epithelium, but they appeared negative for SMA antibody that cross-reacts with endothelium. Notably, the ciliated columnar epithelium was thin in the lateral wall of the nasal cavity, while the inferior concha carried the thick pseudostratified columnar epithelium.Strangely, the inferior or palatal wall of the nasal cavity was covered by the thick stratified epithelium. We found SMApositive mucosal venous plexus in the lateral wall of nasal cavity, but the submucosa was filled with glands in the inferior concha. Vascular beds might be replaced by glands in the nasal submucosa. The site-dependent difference in the mucosal morphology as well as the absence of vascular beds might be a result of secondary change with aging.

Neck epaxial muscles, which are differentiated for suspending the head, occupy a large space posterior to the cervical lordosis. Limited information exists regarding developmental process that determines the muscle fiber direction and bony attachment of neck epaxial muscles. We examined histological sections of 28 human fetuses aged approximately 7–18 weeks (crown-rump length, 20–150 mm). In place of the underdeveloped lordosis, the transverse process of cervical vertebrae was shifted anteriorly at the cervicothoracic junction. The semispinalis and longissimus were distinguished by the direction of muscle fibers connecting between the surface aponeurosis and transverse process. The semispinalis capitis and splenius capitis had a bulky anterior margin without bony attachments. The obliquus capitis inferior continued to both the rectus capitis posterior major and the semispinalis cervicis, but the obliquus capitis superior was consistently independent. Muscle attachments to the scapula were quite different from the final morphology: 1) the levator and rhomboidei usually extended inferiorly along the developing scapula beyond the inferior angle and 2) the splenius capitis or semispinalis cervicis rarely issued an aberrant bundle attaching to the scapula. The scaleni, rhomboidei, levator scapulae, iliocostalis and longissimus were arranged in parallel from the anteromedial to the posterolateral planes and together formed a thick oblique muscle bundle originating from the cervical transverse process and running toward the upper thoracic vertebra and ribcage. The transient oblique muscle bundle seen in early fetuses seemed to provide the so-called intermediate axial muscle between the epaxial-hypaxial muscles: a concept postulated in recent molecular neurology and embryology.

Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Background: Activin A is involved in the inflammatory response, wound repair, and skin fibrosis. Serum activin A concentrations change during the menstrual cycle, and this can lead to periodic exacerbation of atopic dermatitis. Objective: To determine the effect of activin A on the cytokine expression profiles of human fibroblasts and keratinocytes under atopic dermatitis-like conditions. Methods: Cultured human fibroblasts and keratinocytes were treated with activin A in combination with interleukin (IL)-4 and IL-13 to determine the changes in cytokine concentrations. Results: Activin A decreased the expression of IL-1β and IL-23 mRNA in fibroblasts. IL-4 and IL-13 increased the expression of IL-6 and IL-16 and decreased the expression of IL-1α, IL-1β, IL-8, IL-10, and IL-23 in fibroblasts. In keratinocytes, IL-4 and IL-13 increased the expression of IL-1α and IL-1β and decreased the expression of IL-8. Activin A treatment in combination with IL-4 and IL-13 significantly increased the expression of IL-1α, IL-6, IL-8, IL-10, IL-16, and IL-23 and decreased the expression of IL-1β in fibroblasts. In keratinocytes, only IL-8 expression was significantly increased following treatment with activin A, IL-4, and IL-13. Conclusion Activin A modulates cytokine expression in a cell type dependent manner under conditions mimicking atopic dermatitis, suggesting its potential involvement in cutaneous inflammatory regulation.

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.