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Introduction Choroidal metastasis from renal cell carcinoma is relatively rare and unresponsive to systemic treatment. Case presentation A man in his eighties with left renal cell carcinoma and pulmonary metastasis developed visual impairment in the left eye during primary treatment with ipilimumab and nivolumab followed by secondary treatment with cabozantinib. Consultation with an ophthalmologist revealed choroidal metastasis, which was subsequently treated with local radiotherapy (3 Gy × 10 Fr), resulting in a significant reduction in the metastatic lesions. Conclusion If visual impairment arises while treating renal cell carcinoma, it is essential to consider the possibility of intraocular metastasis. In terms of treatment, local therapies such as radiotherapy should be taken into consideration.

Abstract We present a study on nanoscale skyrmionic spin textures in $$\hbox {NdMn}_{{2}}\hbox {Ge}_{{2}}$$ , a rare-earth complex noncollinear ferromagnet. We confirm, using X-ray microscopy, that $$\hbox {NdMn}_{{2}}\hbox {Ge}_{{2}}$$ can host lattices of metastable skyrmion bubbles at room temperature in the absence of a magnetic field, after applying a suitable field cooling protocol. The skyrmion bubbles are robust against temperature changes from room temperature to 330 K. Furthermore, the skyrmion bubbles can be distorted, deformed, and recovered by varying strength and orientation of the applied magnetic field. We have used nitrogen-vacancy nanoscale magnetic imaging to estimate and map the magnetic stray fields originating from our $$\hbox {NdMn}_{{2}}\hbox {Ge}_{{2}}$$ lamella samples and find stray field magnitudes on the order of a few mT near the sample surface. Micromagnetic simulations show an overall agreement with the observed behaviour of the sample under different magnetic field protocols. We also find that the presence of the Dzyaloshinskii-Moriya interaction is not required to reproduce our experimental results. Its inclusion in the simulation leads to a reversal of the skyrmionic object core polarity, which is not experimentally observed. Our results further corroborate the stability and robustness of the skyrmion bubbles formed in $${\hbox {NdMn}_2\hbox {Ge}_2}$$ and their potential for future spintronic applications.

Aim: This study was performed to evaluate the association between left atrial (LA) stiffness and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). Methods and Results: This study involved 279 patients with aortic stenosis (AS) who underwent TAVI at Kumamoto University Hospital between 2015 and 2023. During a median follow-up of 468 days (interquartile range: 258–825 days), 42 deaths occurred. Pre-TAVI echocardiography showed that the LA stiffness index (E/e′ ratio/LA strain during the reservoir phase [LASr]) was significantly higher in the all-cause death group than in the survival group (2.80 ± 2.56 vs. 1.70 ± 1.23, p

Highly translucent zirconia (TZ) is frequently used in dentistry. The properties of several highly translucent zirconia materials available in the market require an in-depth understanding. In this study, we assessed the translucency, crystalline phase, mechanical properties, and microstructures of three newly developed highly translucent zirconia materials (Zpex 4. m, 4 mol% yttria-stabilized zirconia: 4YSZ; Zpex Smile.m, 5YSZ; ZR Lucent ULTRA, 6YSZ). The translucency parameter (TP) was analyzed using the CIELAB system. X-ray diffraction was conducted for the crystalline phase analysis, followed by Rietveld refinement. A biaxial flexural strength test using the Weibull analysis was performed to evaluate the mechanical properties. Scanning electron microscopy, grain size distribution, and average grain size were used to analyze the microstructures. The TP content of the ZR Lucent ULTRA was the highest among the samples investigated. The Rietveld analysis revealed that the cubic zirconia phase content of the ZR Lucent ULTRA was the highest. The biaxial flexural strength of the ZR Lucent ULTRA was the lowest (622.9 MPa). The average grain size and proportion of large grains (1.0 µm < x) were the highest in ZR Lucent ULTRA. Therefore, extra-high translucent zirconia has the potential for use in anterior monolithic restorations owing to its esthetics and strength.

Background/Objectives: We previously demonstrated that the intranasal administration of cell-penetrating Tat peptide-modified carrier, PEG-PCL-Tat, improves drug delivery to the central nervous system. This study aimed to evaluate the potential of the post-onset intranasal administration of N-acetyl-L-cysteine (NAC) combined with PEG-PCL-Tat (NAC/PPT) for neuropathic pain. Methods: Neuropathic pain was induced by partial sciatic nerve ligation (PSNL) in mice. Mechanical allodynia was assessed using the von Frey test on days 11–14 post-ligation. NAC or NAC/PPT was intranasally administered after pain onset. Western blotting and immunohistochemistry were conducted to evaluate ionized calcium-binding adapter molecule 1 (Iba-1) expression and microglial activation in the spinal cord. Results: Mechanical allodynia was exacerbated 11 days after the ligation in PSNL mice. The intranasal administration of NAC alone prevented allodynia exacerbation but failed to provide a therapeutic effect against allodynia in PSNL mice. In contrast, NAC/PPT administration ameliorated PSNL-induced tactile allodynia, with maximum efficacy seen 13 and 14 days after ligation. Western blotting demonstrated that Iba-1 levels tended to increase in PSNL mice compared to controls. This trend of increased Iba-1 levels in PSNL mice was attenuated by the administration of NAC/PPT, but not by NAC alone. Immunohistochemistry revealed an increased number of Iba-1-stained microglia in the ipsilateral spinal cord of PSNL mice, which were significantly suppressed by the administration of NAC/PPT. Conclusions: These results suggest that the post-onset intranasal administration of NAC/PPT ameliorates mechanical allodynia by suppressing microglia induction and that intranasal delivery with PEG-PCL-Tat might be a useful tool for the pharmacological management of neuropathic pain.

Collagen I is the most abundant type of intramuscular collagen. Lysyl oxidase promotes collagen cross-link formation, which helps stabilize the extracellular matrix. Furthermore, matrix metalloproteinases, responsible for collagen degradation, maintain typical muscle structure and function through remodeling. Although it is well known that aging leads to delayed recovery of muscle fibers, the impact of aging on the remodeling of intramuscular collagen is not well understood. In this study, we investigated the impact of aging on collagen remodeling during muscle injury recovery using young and old mouse models. Muscle injury was induced in the right tibialis anterior (TA) muscle of male C57BL/6J mice [aged 21 weeks (young) and 92 weeks (old)] using intramuscular cardiotoxin injection, with the left TA serving as a sham with saline injection. Following a one-week recovery period, aging was found to delay the recovery of the fiber cross-sectional area. The intensity and area of immunoreactivity for collagen I were significantly increased in old mice compared to young mice post-injury. Additionally, Lox expression and the number of LOX (+) cells in the extracellular matrix significantly increased in old mice compared to young mice post-injury. Furthermore, Mmp9 and MMP9 expression levels after muscle injury were higher in old mice than in young mice. These results suggest that muscle injury in old mice can lead to increased collagen I accumulation, enhanced collagen cross-link formation, and elevated MMP9 expression compared to young mice. [ABSTRACT FROM AUTHOR]

This study investigates the subcritical crack growth behavior of a 3D woven SiC‐based composite under cyclic loading at 1100°C in air. The composite was subjected to monotonic tension and tension–tension fatigue tests using both unnotched dumbbell‐shaped and edge‐notched specimens. Detailed examinations of crack growth were conducted through optical microscopy and X‐ray computed tomography (XCT). While the monotonic tensile strength was found to be insensitive to millimeter‐sized notches, the fatigue strength was reduced by 20%–30% in the presence of such notches. Crack growth was found to be irregular and chaotic at the mesoscale, influenced by the complex interplay of chemical and mechanical processes and spatial variability in the composite microstructure. The study emphasizes the importance of XCT imaging for accurate internal crack tracking. It also proposes a phenomenological fracture mechanics model to describe crack growth and lifetime prediction, highlighting the nonmonotonic nature of crack growth rates. [ABSTRACT FROM AUTHOR]

Background/Objectives: We previously demonstrated that the intranasal administration of cell-penetrating Tat peptide-modified carrier, PEG-PCL-Tat, improves drug delivery to the central nervous system. This study aimed to evaluate the potential of the post-onset intranasal administration of N-acetyl-L-cysteine (NAC) combined with PEG-PCL-Tat (NAC/PPT) for neuropathic pain. Methods: Neuropathic pain was induced by partial sciatic nerve ligation (PSNL) in mice. Mechanical allodynia was assessed using the von Frey test on days 11–14 post-ligation. NAC or NAC/PPT was intranasally administered after pain onset. Western blotting and immunohistochemistry were conducted to evaluate ionized calcium-binding adapter molecule 1 (Iba-1) expression and microglial activation in the spinal cord. Results: Mechanical allodynia was exacerbated 11 days after the ligation in PSNL mice. The intranasal administration of NAC alone prevented allodynia exacerbation but failed to provide a therapeutic effect against allodynia in PSNL mice. In contrast, NAC/PPT administration ameliorated PSNL-induced tactile allodynia, with maximum efficacy seen 13 and 14 days after ligation. Western blotting demonstrated that Iba-1 levels tended to increase in PSNL mice compared to controls. This trend of increased Iba-1 levels in PSNL mice was attenuated by the administration of NAC/PPT, but not by NAC alone. Immunohistochemistry revealed an increased number of Iba-1-stained microglia in the ipsilateral spinal cord of PSNL mice, which were significantly suppressed by the administration of NAC/PPT. Conclusions: These results suggest that the post-onset intranasal administration of NAC/PPT ameliorates mechanical allodynia by suppressing microglia induction and that intranasal delivery with PEG-PCL-Tat might be a useful tool for the pharmacological management of neuropathic pain. [ABSTRACT FROM AUTHOR]

Highly translucent zirconia (TZ) is frequently used in dentistry. The properties of several highly translucent zirconia materials available in the market require an in-depth understanding. In this study, we assessed the translucency, crystalline phase, mechanical properties, and microstructures of three newly developed highly translucent zirconia materials (Zpex 4. m, 4 mol% yttria-stabilized zirconia: 4YSZ; Zpex Smile.m, 5YSZ; ZR Lucent ULTRA, 6YSZ). The translucency parameter (TP) was analyzed using the CIELAB system. X-ray diffraction was conducted for the crystalline phase analysis, followed by Rietveld refinement. A biaxial flexural strength test using the Weibull analysis was performed to evaluate the mechanical properties. Scanning electron microscopy, grain size distribution, and average grain size were used to analyze the microstructures. The TP content of the ZR Lucent ULTRA was the highest among the samples investigated. The Rietveld analysis revealed that the cubic zirconia phase content of the ZR Lucent ULTRA was the highest. The biaxial flexural strength of the ZR Lucent ULTRA was the lowest (622.9 MPa). The average grain size and proportion of large grains (1.0 µm < x) were the highest in ZR Lucent ULTRA. Therefore, extra-high translucent zirconia has the potential for use in anterior monolithic restorations owing to its esthetics and strength. [ABSTRACT FROM AUTHOR]

We present a study on nanoscale skyrmionic spin textures in , a rare-earth complex noncollinear ferromagnet. We confirm, using X-ray microscopy, that can host lattices of metastable skyrmion bubbles at room temperature in the absence of a magnetic field, after applying a suitable field cooling protocol. The skyrmion bubbles are robust against temperature changes from room temperature to 330 K. Furthermore, the skyrmion bubbles can be distorted, deformed, and recovered by varying strength and orientation of the applied magnetic field. We have used nitrogen-vacancy nanoscale magnetic imaging to estimate and map the magnetic stray fields originating from our lamella samples and find stray field magnitudes on the order of a few mT near the sample surface. Micromagnetic simulations show an overall agreement with the observed behaviour of the sample under different magnetic field protocols. We also find that the presence of the Dzyaloshinskii-Moriya interaction is not required to reproduce our experimental results. Its inclusion in the simulation leads to a reversal of the skyrmionic object core polarity, which is not experimentally observed. Our results further corroborate the stability and robustness of the skyrmion bubbles formed in and their potential for future spintronic applications. [ABSTRACT FROM AUTHOR]

Patients with neuronal intranuclear inclusion disease (NIID) can present with encephalitis‐like symptoms such as recurrent paroxysmal fever and unconsciousness. To date, no specific triggers for these symptoms have been reported. In our case, an 78‐year‐old woman became unconscious and developed fever after cerebral angiography. The patient had experienced four episodes of unconsciousness and fever in the past 7 years. Postangiography, she immediately became unconscious and developed fever. No vascular abnormalities were found and magnetic resonance imaging of the brain revealed expanding white matter lesions and hyperintense lesions along the corticomedullary junction. Genetic analysis revealed an abnormal GGC repeat expansion in NOTCH2NLC. Thus, we diagnosed the patient with NIID. We suggest that cerebral angiography is a possible trigger for encephalitis‐like symptoms in NIID. [ABSTRACT FROM AUTHOR]

Diagnostic errors frequently represent significant adverse events that can occur in any medical setting, particularly in rushed handovers and constrained timing. Cases that result in emergency hospitalization at the time of the initial outpatient visit are more likely to have complex or serious patient conditions and more detrimental diagnostic errors. Our study investigated diagnostic errors in these under reported situations.We conducted a retrospective study using electronic medical record data on patients who were directly admitted to a newly established outpatient clinic at a single university hospital in Japan. Diagnostic errors were assessed independently by two physicians using the Revised Safer Dx instrument. We analyzed patient demographics, symptoms, referrals, and resident doctor (postgraduate-year-1) involvement using logistic regression to compare groups with and without diagnostic error. Additionally, we employed the Diagnostic Error Evaluation and Research (DEER) taxonomy and Generic Diagnostic Pitfalls (GDP) to examine the factors associated with diagnostic errors.The study included 321 patients, with diagnostic errors identified in 39 cases (12.1 %). Factors contributing to diagnostic errors included the involvement of young residents, male patients, the number of symptoms, and atypical presentation. The most common causes of diagnostic errors were “too much weight given to competing/coexisting diagnosis” as indicated by DEER and “atypical presentation” by GDP.The frequency of diagnostic errors in this study was higher than those in previous studies of new outpatient visits, underscoring the imperative for heightened scrutiny in cases involving medical residents especially when patients present with multiple or atypical symptoms. This vigilance is crucial to mitigating the risk of diagnostic inaccuracies in these settings. Cases that result in emergency hospitalization at the time of the initial outpatient visit are more likely to have complex or serious patient conditions and more detrimental diagnostic errors. [ABSTRACT FROM AUTHOR]