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A portion of individuals diagnosed with primary central nervous system lymphomas (PCNSL) may experience early relapse or refractory (R/R) disease following treatment. This research explored the potential of MRI-based radiomics in forecasting R/R cases in PCNSL. Forty-six patients with pathologically confirmed PCNSL diagnosed between January 2008 and December 2020 were included in this study. Only patients who underwent pretreatment brain MRIs and complete postoperative follow-up MRIs were included. Pretreatment contrast-enhanced T1WI, T2WI, and T2 FLAIR imaging were analyzed. A total of 107 radiomic features, including 14 shape-based, 18 first-order statistical, and 75 texture features, were extracted from each sequence. Predictive models were then built using five different machine learning algorithms to predict R/R in PCNSL. Of the included 46 PCNSL patients, 20 (20/46, 43.5%) patients were found to have R/R. In the R/R group, the median scores in predictive models such as support vector machine, k-nearest neighbors, linear discriminant analysis, naïve Bayes, and decision trees were significantly higher, while the apparent diffusion coefficient values were notably lower compared to those without R/R (p < 0.05). The support vector machine model exhibited the highest performance, achieving an overall prediction accuracy of 83%, a precision rate of 80%, and an AUC of 0.78. Additionally, when analyzing tumor progression, patients with elevated support vector machine and naïve Bayes scores demonstrated a significantly reduced progression-free survival (p < 0.05). These findings suggest that preoperative MRI-based radiomics may provide critical insights for treatment strategies in PCNSL.

Abstract Background Staphylococcus hyicus causes porcine exudative epidermitis, predominantly affecting suckling and weaned piglets. This bacterium produces various exfoliative toxins (ExhA, ExhB, ExhC, ExhD, SHETA, and SHETB), which are responsible for the clinical manifestations of exudative epidermitis. However, treatment failure is common due to frequent antimicrobial resistance in porcine strains. Therefore, this study aimed to identify the genes encoding exfoliative toxins and assess the antimicrobial resistance profiles of S. hyicus. A total of 17 S. hyicus isolates were collected from piglets with skin lesions from 2014 to 2021. All strains were subjected to species-specific polymerase chain reaction targeting sodA to confirm the presence of S. hyicus, and polymerase chain reaction amplification of exfoliative toxin genes (exhA, exhB, exhC, exhD, sheta, and shetb) was performed to differentiate toxigenic strains. Pulsed-field gel electrophoresis analysis and minimum inhibitory concentration tests using broth microdilution were conducted to further analyze the strains. Results Exfoliative toxin genes were detected in 52.9% (n = 9) of the S. hyicus isolates, with notable detection of exhB (17.6%), exhC (17.6%), exhD (11.8%), exhA (5.9%), sheta (0%), and shetb (0%). Pulsed-field gel electrophoresis analysis categorized the isolates into 11 pulsotypes with 70% similarity. Among 18 tested antimicrobials, all isolates exhibited 100% susceptibility to ceftiofur and sulfonamides and high susceptibility rates to neomycin, tilmicosin, and tetracyclines. Whereas the susceptibility rate of spectinomycin was 0% in all isolates, multidrug resistance was observed in 82.4% of the isolates, and in all toxigenic strains. Conclusions These findings provide crucial insights for monitoring and devising effective treatment strategies for managing exudative epidermitis in pigs caused by S. hyicus.

Postpregnancy bleeding is common after failed pregnancy, termination of pregnancy, and postnatally after both vaginal and cesarean delivery. Pelvic ultrasound (US) is usually the initial imaging modality of choice to ascertain the cause when the bleeding is heavy or prolonged. When used in combination with Doppler studies, US can help differentiate retained products of conception (RPOC) from rarer uterine vascular malformations (UVM), including true arterial vascular malformations and areas of enhanced endometrial vascularity (EMV), which may themselves be associated with any RPOC present. While the management of RPOC is well established and has evolved from an almost universal surgical approach to increasingly more medical or expectant alternatives, clinical decisions over the management of a concurrent UVM are less clear and treatment options need to be individualized depending on features of the lesion and the clinical situation with hysteroscopy featured as an important modality, especially when dealing with EMV’s. In this review, we discuss the role of hysteroscopy in the treatment of enhanced myometrial vascularity with and without associated RPOC and propose a management algorithm.

The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II–III obesity, defined as a body mass index (BMI) of 30 kg/m2 or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m2 or higher, or those with a BMI of 30 kg/m2 or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m2. From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.

Abstract Breast cancer categorized into hormone receptor-positive (HR+), HER2-positive (HER2+), and triple-negative (TNBC) subtypes, exhibits varied outcomes based on the number of tumor-infiltrating lymphocytes (TILs). To explore the divergent roles of TIL levels across different subtypes, we employed single-cell RNA sequencing on 31 patients with breast cancer. HR+ breast cancer with high TIL levels (TIL-high) revealed increased SPP1+ macrophages, increased SPP1 expression in other monocytes/macrophages (mono/macro) subgroups, and enriched pathways associated with extracellular matrix (ECM) remodeling in mono/macro. Moreover, cell–cell interaction analyses revealed enhanced SPP1, MIF, and FN1 signaling in the interaction between SPP1+ macrophages and T-cells in TIL-high HR+ breast cancer. Spatial transcriptomics data highlighted the close proximity of SPP1+ macrophages, CD8+ T-cells, and CD4+ T-cells in TIL-high HR+ breast cancer. Our findings unveil the novel influence of SPP1+ macrophages on T-cells in TIL-high HR+ breast cancer, potentially explaining the poor prognosis and offering insights for targeted interventions.

Background: The Fourth Industrial Revolution highlights the importance of artificial intelligence (AI) and digital literacy in dental hygiene education. However, research on students’ attitudes toward AI and their digital literacy levels is limited. Therefore, this study investigated the attitudes of dental hygiene students toward AI and digital literacy levels. Methods: In total, 167 dental hygiene students in Baekseok University participated in the study and provided informed consent. The survey tool included general characteristics, smartphone usage patterns, attitudes toward AI, and digital literacy levels. Attitudes toward AI and digital literacy based on general characteristics and smart device usage were analyzed using t-tests and one-way ANOVA. Correlations among attitudes toward AI, digital literacy awareness, and digital literacy behaviors were analyzed using Pearson’s correlation analysis. The impact of AI attitudes and digital literacy awareness on digital literacy behavior was examined using linear regression analysis. Results: Students with higher interest in their major had more positive attitudes toward AI, and those with higher smart device usage showed increased AI attitudes and digital literacy (p＜0.05). Simple frequency or duration of smartphone use did not affect digital literacy, but students who perceived their smart device usage positively and believed that they used smart devices effectively in their studies exhibited higher levels of digital literacy (p＜0.05). A positive attitude toward AI is associated with higher levels of digital literacy (p＜0.05). Digital literacy awareness and attitudes toward AI influenced digital literacy behavior (p＜0.05). Conclusion: These results suggest that the qualified utilization and application of digital devices in dental hygiene education are important. Improving the educational curriculum is necessary; as a result, digital technology can be effectively utilized, and various educational programs should be introduced to enhance digital literacy.

Various diseases can affect the esophagus. Endoscopic ultrasound (EUS), which provides precise information about the layers of the esophageal wall, is the primary approach used to investigate esophageal diseases. However, CT is one of the most important imaging modalities for diagnosing esophageal diseases as it can elucidate mediastinal involvement, adjacent lymphadenopathy, and distant disease spread. These two modalities complement each other in the diagnosis of esophageal diseases. Although radiologists may be unfamiliar with EUS procedures and their interpretation, understanding them aids in the differential diagnosis of esophageal conditions. This pictorial essay illustrates the EUS and CT findings of various esophageal diseases originating in the esophageal wall.

Abstract The Ames test is used worldwide to initially screen the mutagenic potential of new chemicals. In the standard Ames test, S. typhimurium strains (TA100, TA98, TA1535, and TA1537) and Escherichia coli (WP2uvrA) are treated with substances with/without cytochrome P450s (CYPs)-induced rat S9 fractions for identifying mutagens and pro-mutagens. However, many substances show completely different toxicity patterns depending on whether the liver S9 fraction belongs to rats or humans. The natural product Polygoni Multiflori Radix (PMR) can also show bacterial reverse mutation, followed by the rat or human liver S9 fraction. While PMR elicits reverse mutations in the TA1537 strain in rat liver S9 but not in human liver S9, this mechanism has not been verified yet. To explain this, the differences in metabolic enzymes compositions commonly observed between rats and humans have been implicated. This study aimed to explore the key factors that cause differences in the genotoxicity of PMR between rat and human liver S9 metabolic enzymes. The results of next-generation sequencing (NGS) analysis showed that both rat and human metabolic enzymes caused similar mutations in TA1537. However, when the metabolic enzymes in each S9 fraction were analyzed using ion mobility tandem mass spectrometry (IM-MS), rat- and human-specific enzymes were identified among the cytochrome (CYP) family, especially aryl hydrocarbon receptor (AHR)-related CYPs. These findings suggest that CYP1A1 isoforms contribute to the mechanism of PMR in the Ames test. Therefore, an in vitro Ames test might be more reliable in predicting genotoxicity for both rodents and humans. This will also help overcome the limitations of laboratory animal-based toxicity evaluations, which provide unreliable results due to interspecies differences between humans and rodents.

Background Impact of previous radiation therapy and neoadjuvant chemotherapy (NACT) on early complications in direct-to-implant (DTI) breast reconstruction has not been elucidated. This study investigated whether DTI reconstruction is viable in patients with NACT or a history of preoperative chest wall irradiation.

Spinal cord injury (SCI) is a destructive neuropathological condition characterized by the temporary or permanent impairment of spinal cord function, resulting in motor, sensory, and autonomic dysfunctions. Based on the principles of evidence-based medicine, the development of clinical practice guidelines of integrated Chinese and western medicine rehabilitation for SCI can provide clinicians with a comprehensive and standardized framework for SCI treatment and rehabilitation. This scientific, standardized and unified practice guideline covers the technical scope, normative references documents, terms and definitions, SCI classifications and clinical diagnosis, rehabilitation assessment, rehabilitation diagnosis and treatment program and treatment of common complications, etc. Rehabilitation assessment of SCI mainly includes sensory examination, motor examination, motor or sensory function rating, quality of life assessment, functional assessment and psychological function assessment (stress assessment, cognitive function assessment, and emotional state assessment). Rehabilitation diagnosis and treatment program of SCI mainly includes early treatment principles, drug therapy, physical therapy (muscle strength training, balance and gait training, aerobic exercise, electrical stimulation and other therapies), occupational therapy (joint range of motion training, activities of daily living training, resting motor skill training, upper limb function training and wheelchair skills training), assistive devices, traditional Chinese medicine therapy, including single drug therapy (ligustrazine, salvia miltiorrhiza injection, roasted nux vomica, etc.) and compound therapy (salvia miltiorrhiza ligustrazine injection, Buyang Huanwu decoction, Huoxue Tongdu decoction, erxian decoction, Yiqi Huoxue decoction and self-formulated decoction, etc.), acupuncture therapy and other therapies (new drug therapy, cell therapy, neuromodulation technology and brain-spine interface technology). Common complications of SCI include autonomic hyperreflexia, deep vein thrombosis, heterotopic ossification, orthostatic hypotension, pressure ulcers and urinary tract infection. This guideline can provide guidance for all kinds of rehabilitation institutions at all levels as well as the department of orthopedics and traumatology of traditional Chinese medicine, department of orthopedics of integrated traditional Chinese and western medicine, acupuncture and moxibustion department, Tuina department and rehabilitation medicine department in the hospitals of traditional Chinese medicine or general hospitals in China to perform SCI clinical diagnosis, rehabilitation assessment, rehabilitation treatment and treatment of common complications, with good clinical applicability, safety and effectiveness.