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Immune checkpoint inhibitor (ICI)-induced adverse events due to excessive immune stimulation are problematic in immunotherapy. The activation of viral infection triggered by ICI-induced dysregulated immunity has been proposed; however, this association remains inconsistent. This study investigated the association between ICI administration and cytomegalovirus (CMV) infections, a pathogen linked to immune abnormalities and reactivation, using the Food and Drug Administration Adverse Event Reporting System. We used the crude data set and immunocompromise-free data set from the fourth quarter of 2012 to 2023. The disproportionality between CMV infection and ICI was analyzed using reporting odds ratio (ROR) and information component (IC) methodologies. Disproportionality between ipilimumab and nivolumab combination case and CMV infection was observed in the crude (ROR: 2.83, 95% confidence interval [CI]: 2.32-3.47; IC: 1.48, 95% CI: 1.14-1.73) and immunocompromise-free data set (ROR: 1.76, 95% CI: 1.33-2.33; IC: 0.80, 95% CI: 0.33-1.14), whereas disproportionality between other ICI and CMV infection was not observed in the immunocompromise-free data set. Multiple sensitivity analyses and time-scan analysis also revealed the consistent disproportionality between ipilimumab and nivolumab combination cases and CMV infection, regardless of the host's immune status. While further research is warranted to validate our findings, these results highlight new insights into ICI-induced viral infections and suggest the importance of considering the possibility of CMV infections during ipilimumab and nivolumab combination therapy, regardless of the host's immune status., (© 2024 UICC.)

Purpose: Recently, the utility of non-contrast MR endolymphatic hydrops imaging was reported, but the pitfall was indicated based on T2 preparation pulse sensitiveness to local static magnetic field (B0) inhomogeneity. The purpose of this study is to clarify the effects of surrounding magnetic environment of temporal bone to lymphatic fluid signal intensity on the T2 preparation and fluid attenuated inversion recovery pulse combination (T2prep 3D-FLAIR) technique in human inner ear study., Methods: We prepared a custom-made phantom comprising a chicken leg bone submersed in saline. To evaluate signal characteristics of saline close to bone, multiple TE gradient echoes, T2 relaxation time measurement, and T2prep 3D-FLAIR image were acquired. In the vicinity of the vestibule of a healthy volunteer, similar examinations were executed. Additionally, to investigate the influence of the magnetic environment from B0, the evaluation was performed in five head position settings relative to B0., Results: In both the phantom case and volunteer case, together with T2 star signal intensity attenuation, T2 relaxation time shortening was observed on fluid around bone. Specifically, at the outer edge in the vestibule and cochlea of the volunteer, T2 relaxation time was shorter than that of center of vestibule and that of cochlea. In the T2prep 3D-FLAIR image, higher signal intensity was observed at the same location on the outer edge of them. These results showed that bone affects surrounding fluid magnetic environment. Also, for B0 influence, despite a large area variation ratio, there is no statistically significant difference correlated to orientation within B0., Conclusion: The surrounding magnetic environment of the temporal bone affects lymphatic fluid signals of the peripheral part of the human inner ear on T2prep 3D-FLAIR technique.

Study Design: Retrospective comparative study OBJECTIVES: To investigate whether the presence or absence of preoperative lower extremities neurological symptoms (LENS) influences clinical outcomes following tumor resection in patients with cervical intradural extramedullary (IDEM) tumors., Setting: The single institution in Japan., Methods: Ninety-two patients with cervical IDEM tumors requiring surgical resection were included. Based on the degree of preoperative LENS assessed using the modified McCormick scale (MMCS), patients were categorized into LENS (-) and (+) groups. Demographic and surgical characteristics were compared between both groups., Results: There were no significant differences observed in sex, tumor location, tumor size, surgical time, estimated blood loss, approach for tumorectomy, or tumor histopathology between the two groups. Additionally, the overall surgical outcomes were favorable for both groups. At the final follow-up, 91.1% of the patients in the LENS (+) group were able to walk without support. Improvement in LENS was observed after surgery in most patients with preoperative MMCS II-IV, but it persisted in approximately 40% of patients with preoperative MMCS V. In the LENS (+) group, there were no significant differences in demographic or surgical data between the patients with MMCS I and II-III at the final follow-up., Conclusions: Regardless of the presence or absence of preoperative LENS, clinical improvement was observed after tumor resection in most patients with cervical IDEM tumors. These findings suggest that neurological status is likely to improve sufficiently if tumor resection is performed before preoperative LENS deteriorates to an extremely severe stage as MMCS V., Competing Interests: Competing interests: The authors declare no competing interests. Ethical approval: The study was conducted in accordance with the guidelines of the Declaration of Helsinki and was approved by the Ethics and Institutional Review Board of Keio University School of Medicine (approval number: #20110142). Informed consent was obtained from all participants prior to surgery. We confirm that all relevant governmental and institutional regulations regarding the ethical use of human subjects were strictly followed throughout the study., (© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.)