Hematological Second Primary Malignancy in Pediatric Retinoblastoma: A Case Report and Systematic Review.

PURPOSE: The impact of heredity and treatment modalities on the development of hematologic second primary malignancies (SPMs) is unclear. This study primarily reviewed the literature on patients with hematologic SPMs after retinoblastoma. METHODS: The PubMed and Web of Science databases were searched to identify all cases of hematologic SPMs after retinoblastoma through December 2023 (International prospective register of systematic reviews CRD42023488273). RESULTS: Sixty-one patients from 35 independent publications and our case were included. Within the cohort, 15 patients (51.7%) were male, and 14 patients (48.3%) were female. Of the 43 cases with known heritability status, 27 (62.8%) were classified as heritable and 16 (37.2%) as nonheritable. The median age at diagnosis was 18 months (IQR: 7.00-36.00). The geographic distribution of patients was diverse, with North America accounting for 35.0% (21/60) of cases. The following treatment strategies were used: 11.9% (5/42) of patients received neither chemotherapy nor radiotherapy, 33.3% (14/42) received chemotherapy alone, 11.9% (5/42) received radiotherapy alone, and 42.9% (18/42) received a combination of chemotherapy and radiotherapy. The median delay between retinoblastoma diagnosis and SPM diagnosis was 40 months (IQR: 22.00-85.00). Among the 61 cases, acute myeloid leukemia accounted for 44.3% (27/61), followed by acute lymphoblastic leukemia in 21.3% (13/61), Hodgkin's lymphoma in 11.5% (7/61), non-Hodgkin's lymphoma in 9.8% (6/61), chronic myeloid leukemia in 3.3% (2/61), and acute natural killer cell leukemia in 1.6% (1/61). CONCLUSIONS: Vigilant systemic surveillance for hematologic SPMs in retinoblastoma survivors, especially those treated with systemic chemotherapy and those with hereditary conditions, is warranted to improve management strategies and patient outcomes.

Supramolecular Metal-Organic Framework for the High Stability of Aqueous Rechargeable Zinc Batteries.

Aqueous rechargeable Zn batteries (AZBs) are considered to be promising next-generation battery systems. However, the growth of Zn dendrites and water-induced side reactions have hindered their practical application, especially with regard to long-term cyclability. To address these challenges, we introduce a supramolecular metal-organic framework (SMOF) coating layer using an α-cyclodextrin-based MOF (α-CD-MOF-K) and a polymeric binder. The plate-like α-CD-MOF-K particles, combined with the polymeric binder create dense and homogeneous Zn2+ ion conductive pore channels that can vertically transport Zn2+ ions through the cavity while restricting the contact of water molecules. Molecular dynamics (MD) simulation verifies that Zn2+ ions can reversibly migrate through the pores of α-CD-MOF-K by partial dehydration. The uniform Zn deposition/dissolution promotes a smooth solid-electrolyte interface layer on the Zn metal anode and effectively suppresses side reactions with free water molecules. The α-CD-MOF-K@Zn symmetric cell exhibits stable cycling and a small polarization voltage of 70 mV for 800 h at 5 mA cm-2, and the α-CD-MOF-K@Zn|α-MnO2 full cell shows only 0.12% capacity decay per cycle at a rate of 1 A g-1.

ETV6::ABL1 fusion: from overlooked minor clone in myeloproliferative neoplasm to major player in leukemic transformation.

The ETV6::ABL1 fusion defines a subgroup of myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions. We report a case of extramedullary involvement and leukemic transformation in myeloproliferative neoplasm (MPN), where ETV6::ABL1 was initially overlooked but later detected in the blast phase. ETV6::ABL1 burden was very low during the MPN phase but increased substantially during the blast phase. This correlation between ETV6::ABL1 burden and disease phenotype indicated that an immature leukemic clone is the sole carrier of ETV6::ABL1, suggesting that ETV6::ABL1 is not the primary driver of the MPN phase. Moreover, only the blast phase revealed somatic mutations in RUNX1 and STAG2, or complex karyotype, while the MPN phase revealed no molecular and cytogenetic abnormalities. Therefore, it remains uncertain whether the small clone of ETV6::ABL1 influenced the manifestation of MPN or if another underlying driver was responsible for the MPN phase, necessitating further research.

Effects of microplastics on reproductive characteristics and mechanisms of the marine rotifer Brachionus plicatilis.

Microplastic pollution, especially secondary microplastics (MPs), poses a significant threat to marine ecosystems. Despite its prevalence, the impact of natural-aged MPs on marine organisms, hindered by collection challenges, remains poorly understood. This study focused on 1-3 µm natural-aged MPs collected from Japan's coastal sea, investigating their effects on the rotifer Brachionus plicatilis sensu stricto and its reproductive mechanisms. Rotifers exposed to varying MP concentrations (0, 20, and 200 particles/mL) over 14-day batch cultures exhibited reduced population growth and fertilization rates. Down-regulation of reproductive genes and up-regulation of oxidative stress-related genes were observed, indicating MP-induced disruptions. Enhanced activities of superoxide dismutase and acetylcholinesterase and elevated malondialdehyde levels further emphasized oxidative stress. These findings underscore the detrimental impact of MPs on rotifer reproductivity, shedding light on the underlying mechanisms.

Comparison between botulinum toxin type A injection on masseter muscle only and additional injection on anterior belly of digastric muscle in sleep bruxism patients: A clinical trial.

OBJECTIVE: This study aims to evaluate the effects on bite force and muscle thickness of the botulinum toxin (BoNT) injection for patients with sleep bruxism (SB) by comparing injections into the masseter muscle only and both the masseter and the anterior belly of the digastric muscle (ABDM) in a clinical trial. METHODS: Twelve SB patients received BoNT-A injections using US-guided techniques into the masseter muscle only (Group A), while the remaining 12 SB patients received injections into both the masseter and ABDM (Group B). Bite force and muscle thickness were measured before injection, as well as 1 and 2 months after injection. RESULTS: The bite force and masseter muscle thickness decreased in both Group A and Group B before injection, and at 1 and 2 months after injection. However, there was no significant difference (p > .05, repeated measures analysis of variance) between the two groups, and there was also no significant difference in ABDM thickness (p > .05, repeated measures analysis of variance). CONCLUSION: This study is the first to assess the short-term effects of BoNT injected into ABDM for SB control. Results show no influence on SB reduction, suggesting the need for further research on BoNT's effectiveness in controlling intense ABDM contractions during sleep and assessing suprahyoid muscle potential impact on rhythmic masticatory muscle activity occurrence.

Electrospun Silicon Dioxide/poly(vinylidene fluoride) Nanofibrous Membrane Comprising a Skin Multicore-Shell Nanostructure as a New High-Heat-Resistant Separator for Lithium-Ion Polymer Batteries.

Porous silicon dioxide (SiO2)/poly(vinylidene fluoride) (PVdF), SiO2/PVdF, and fibrous composite membranes were prepared by electrospinning a blend solution of a SiO2 sol-gel/PVdF. The nanofibers of the SiO2/PVdF (3/7 wt. ratio) blend comprised skin and nanofibrillar structures which were obtained from the SiO2 component. The thickness of the SiO2 skin layer comprising a thin skin layer could be readily tuned depending on the weight proportions of SiO2 and PVdF. The composite membrane exhibited a low thermal shrinkage of ~3% for 2 h at 200 °C. In the prototype cell comprising the composite membrane, the alternating current impedance increased rapidly at ~225 °C, and the open-circuit voltage steeply decreased at ~170 °C, almost becoming 0 V at ~180 °C. After being exposed at temperatures of >270 °C, its three-dimensional network structure was maintained without the closure of the pore structure by a melt-down of the membrane.

DNA methylome analysis reveals epigenetic alteration of complement genes in advanced metabolic dysfunction-associated steatotic liver disease.

Background/Aims: Blocking the complement system is a promising strategy to impede the progression of metabolic dysfunction-associated steatotic liver disease (MASLD). However, the interplay between complement and MASLD remains to be elucidated. This comprehensive approach aimed to investigate the potential association between complement dysregulation and the histological severity of MASLD. Methods: Liver biopsy specimens were procured from a cohort comprising 106 Korean individuals, which included 31 controls, 17 with isolated steatosis, and 58 with metabolic dysfunction-associated steatohepatitis (MASH). Utilizing the Infinium Methylation EPIC array, thorough analysis of methylation alterations in 61 complement genes was conducted. The expression and methylation of nine complement genes in a murine MASH model were examined using quantitative RT-PCR and pyrosequencing. Results: Methylome and transcriptome analyses of liver biopsies revealed significant (P <0.05) hypermethylation and downregulation of C1R, C1S, C3, C6, C4BPA, and SERPING1, as well as hypomethylation (P <0.0005) and upregulation (P <0.05) of C5AR1, C7, and CD59, in association with the histological severity of MASLD. Furthermore, DNA methylation and the relative expression of nine complement genes in a MASH diet mouse model aligned with human data. Conclusions: Our research provides compelling evidence that epigenetic alterations in complement genes correlate with MASLD severity, offering valuable insights into the mechanisms driving MASLD progression, and suggests that inhibiting the function of certain complement proteins may be a promising strategy for managing MASLD.

Novel single-entry point injection technique for masseter hypertrophy treatment using botulinum neurotoxin based on patient-reported comfort.

INTRODUCTION: Botulinum neurotoxin (BoNT) injections are widely used for the treatment of masseter muscle hypertrophy in Southeast Asia. However, there remains a lack of consensus regarding the optimal injection technique. This study aimed to compare the efficacy and patient discomfort associated with single-entry point injections versus multiple three-point injections for masseter muscle hypertrophy treatment with BoNT. MATERIALS AND METHODS: Sixteen participants, comprising both male and female Korean adults aged 22-63, were enrolled in the study. On the left side of the face, single-entry point injections were administered, followed by multidirectional injections, while on the right side, three-point injections were given. Pain intensity during the procedure was assessed using visual analogue scale scores. RESULT: Our results revealed that participants experienced lower levels of pain with single-entry point injections compared to three-point injections (average visual analogue scores of 3.31 and 5.19, respectively). CONCLUSION: These findings highlight the potential benefits of single-entry point injections in reducing patient discomfort during masseter muscle hypertrophy treatment with BoNT. We advocate for further research to validate these findings and encourage practitioners to consider single-entry point injections as a viable option for enhancing treatment outcomes in their clinical practice.

Sihler's staining of the anterior belly of digastric muscle for botulinum toxin injection.

PURPOSE: The anterior belly of the digastric muscle (ABDM) is the target of botulinum toxin injection; however, anatomical considerations related to the injection point are absent. This study used Sihler's staining to analyze the intramuscular nerve distribution of ABDM to identify the most effective botulinum toxin injection points. METHODS: We used 12 specimens from 6 embalmed cadavers in this study. The specimens were manually dissected to preserve the mylohyoid nerve and subjected to Sihler's staining. From the gnathion to and hyoid bone, the ABDM was divided into three equal parts, distinguishing the anterior, middle, and posterior thirds. RESULTS: Only a branch of the mylohyoid nerve entered the ABDM, and its entry point was located in the middle-third region in all cases. The nerve endings were concentrated in the middle third (100%), followed by the anterior third (58.3%) and were not observed in the posterior third. CONCLUSION: The landmarks used in this study (gnathion and hyoid bone) are easily palpable on the skin surface, allowing clinicians to target the most effective injection site (middle third of ABDM). These results provide scientific and anatomic evidence for injection points, and will aid in the management of ABDM injection procedures in clinical practice.

Improvements in Resistive and Capacitive Switching Behaviors in Ga2O3 Memristors via High-Temperature Annealing Process.

This study investigates the effect of a high-temperature annealing process on the characteristics and performance of a memristor based on a Ag/Ga2O3/Pt structure. Through X-ray diffraction analysis, successful phase conversion from amorphous Ga2O3 to ß-Ga2O3 is confirmed, attributed to an increase in grain size and recrystallization induced by annealing. X-ray photoelectron spectroscopy analysis revealed a higher oxygen vacancy in annealed Ga2O3 thin films, which is crucial for conductive filament formation and charge transport in memristors. Films with abundant oxygen vacancies exhibit decreased set voltages and increased capacitance in a low-resistive state, enabling easy capacitance control depending on channel presence. In addition, an excellent memory device with a high on/off ratio can be implemented due to the reduction of leakage current due to recrystallization. Therefore, it is possible to manufacture a thin film suitable for a memristor by increasing the oxygen vacancy in the Ga2O3 film while improving the overall crystallinity through the annealing process. This study highlights the significance of annealing in modulating capacitance and high-resistive/low-resistive state properties of Ga2O3 memristors, contributing to optimizing device design and performance. This study underscores the significance of high-temperature annealing in improving the channel-switching characteristics of Ga2O3-based memristors, which is crucial for the development of low-power, high-efficiency memory device.

Incidence of Late-Onset Psoriasis Following Tonsillectomy: A Longitudinal Follow-Up Study Using a National Health Screening Cohort.

Tonsillectomy has been suggested as a potential intervention to resolve psoriasis; however, its preventive effects on the development of psoriasis remain unclear. This study aimed to investigate the risk of developing late-onset psoriasis among a Korean adult population who had undergone tonsillectomy. Data from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2019 were utilized. Out of a total of 514,866 participants, 1082 participants aged 40 years or older who had undergone tonsillectomy were matched with 4328 control participants using overlap weighting adjustment based on the propensity score. The incidence and hazard ratio (HR) of psoriasis were calculated for both tonsillectomy and control groups. The incidence rates of psoriasis were 1.30% in the tonsillectomy group and 1.20% in the control group. The incidence of psoriasis (overlap-weighted HR = 1.08, 95% confidence of interval = 0.69-1.69, and p = 0.732) did not differ significantly between the patients who underwent tonsillectomy and those in the control group. The cumulative probability of developing psoriasis was not different between the two groups (Log-rank test: p = 0.440). These findings were consistent across subgroups divided by age, sex, income, and region of residence. We found that tonsillectomy did not confer a preventive effect on the development of late-onset psoriasis in the Korean adult population.

Side- and Sinus-Specific Relationships between Chronic Rhinosinusitis and Ischemic Stroke Using Imaging Analyses.

Recent studies have reported chronic rhinosinusitis (CRS) as an independent risk factor for stroke. However, the association with stroke depending on the affected sinuses has not been explored. This study aimed to elucidate the side- and sinus-specific relationship between CRS and ischemic stroke through imaging analyses. We retrospectively reviewed the medical records of patients who were diagnosed with ischemic stroke at a tertiary center. CRS was defined as having a total score of greater than or equal to 4, according to the Lund-Mackay scoring system, through brain magnetic resonance imaging or computed tomography. We investigated the side- and sinus-specific correlation between CRS and ischemic stroke. Subgroup analyses were performed for different age groups. CRS prevalence in patients with ischemic stroke was 18.4%, which was higher than the previously reported prevalence in the general population. Overall, there was no correlation between the directions of the CRS and ischemic stroke (p > 0.05). When each sinus was analyzed, the frontal (Cramer's V = 0.479, p < 0.001), anterior (Cramer's V = 0.396, p < 0.001)/posterior (Cramer's V = 0.300, p = 0.008) ethmoid, and sphenoid (Cramer's V = 0.383, p = 0.005) sinuses showed a statistically significant correlation with the side of stroke, but the maxillary sinus (Cramer's V = 0.138, p = 0.208) did not. In subgroup analyses, a significant right-side correlation between the two diseases was observed in the older-age subgroup (≥65 years old, Cramer's V = 0.142, p = 0.040). Diabetes mellitus (odds ratio = 1.596, 95% confidence interval = 1.204-2.116) was identified as an independent risk factor for having CRS in patients with ischemic stroke. CRS of the frontal, anterior/posterior ethmoid, and sphenoid sinuses has a directional relationship with ischemic stroke. Our results on which sinuses correlate with stroke advocate for the active surveillance of CRS in patients at high risk of ischemic stroke.

Singular entry point technique for forehead and temple filler augmentation: Anatomical and clinical perspectives.

BACKGROUND: The depressed volume of the forehead and temple is resolved by filler injection. However, the current method has the potential to cause pain and side effects in patients, depending on the skill of the clinician. Therefore, this study proposes a new method for safer and simpler injection using only one injection entry point. METHODS: Using the novel injection method, the filler was injected into the forehead and temple regions in three unembalmed cadavers and two healthy Korean volunteers. The cannula and filler locations were identified using dissection, ultrasonography, and three-dimensional (3D) scanning. RESULTS: Ultrasonographic images and dissection results showed that the filler injected into the cadavers was in the target layer. The cannula and filler were located on the layer as the supraperiosteal layer on the forehead and the supra deep temporal fascia layer in the temple. Finally, 3D scanning images showed that the filler was injected precisely and effectively into the forehead and temples of the volunteer who underwent the procedure. CONCLUSIONS: This method can reduce pain and minimize externally visible wounds caused by injections. The injected filler was naturally connected from the forehead to the temple and maintained for around 3 months. Additionally, it is possible to inject fillers into the forehead and temple at a constant and safe depth without requiring specific skills. It is expected that this method will become a universal method because it minimizes the burden on both patients and clinicians.

Prenatal opioid exposure by likelihood of exposure and risk to prenatal development: Medicaid-covered births in Wisconsin, 2010-2019.

Prenatal opioid exposure is an established public health problem, in particular among Medicaid-covered births. Yet, existing prevalence rates are plausibly underestimated. We leverage extensive linked longitudinal administrative data for all Medicaid-covered live births in Wisconsin from 2010 to 2019 to estimate a range of prevalence rates using an innovative strategy that jointly accounts for both likelihood of exposure and potential risk to prenatal development. We find that 20.8% of infants may have been prenatally exposed to opioids, with 1.7% diagnosed with neonatal abstinence syndrome and an additional 1.2% having a high combined likelihood of exposure and potential risk to prenatal development, 2.6% a moderate combined likelihood and risk, and 15.3% a low or uncertain combined likelihood and risk. We assess improvements in prevalence estimates based on our nuanced classification relative to those of prior studies. Our strategy could be broadly used to quantify the scope of the opioid crisis for pregnant populations, target interventions, and promote child health and development.

A novel zwitterion incorporated Nano-crystalline ceramic and polymer for bacterial resistant dental CAD-CAM block.

OBJECTIVES: To create bacteria-resistant dental CAD-CAM blocks with a biofilm-resistant effect by incorporating Nano-crystalline ceramic and polymer (NCP) with 2-methacryloyloxyethyl phosphorylcholine (MPC) and sulfobetaine methacrylate (SBMA) and at an equimolar ratio, referred to as MS. METHODS: Experimental groups comprised NCP blocks containing zwitterions at 0.15wt% (MS015) and 0.45wt% (MS045). NCP blocks without MS served as control (CTRL). Flexural strength, surface hardness, water sorption and solubility, photometric properties, and cytotoxicity were assessed for all samples. Additionally, the resistance to single and multi-species bacterial adhesion was investigated. RESULTS: MS045 showed significant reduction in flexural strength (P < 0.01) compared to both CTRL and MS015. Both MS015 and MS045 showed significantly increased water sorption and significant reduction in water solubility compared to CTRL. Light transmission remained consistent across all MS content levels, but the irradiance value decreased by 12 % in the MS045 group compared to the MS015 group. Notably, compared to the CTRL group, the MS015 group exhibited enhanced resistance to adhesion by Porphyromonas gingivalis and a multi-species salivary biofilm, with biofilm thickness and biomass reduced by 45 % and 56 %, respectively. CONCLUSIONS: NCP containing 0.15 % MS can effectively reduce adhesion of multiple species of bacteria while maintaining physical and mechanical properties. CLINICAL SIGNIFICANCE: NCP integrating zwitterions is clinically advantageous in resisting bacterial adhesion at internal and external margins of milled indirect restoration.

Commemoration of body donors in a religiously diverse society: A tale of two Korean medical schools.

Although a diversity of religions exists in South Korea, with Buddhism and Christianity (Protestantism and Catholicism) being the two main faiths, Korean beliefs are deeply rooted in Confucianism. Despite the notion that the Confucian norm of filial piety discourages body donation to medical science, there has been a mindset shift in favor of body donation, driven by a heightened awareness of the body bequest programs and the care and dignity accorded to the altruistic body donors, together with the institution of commemorative services to honor them. As spirituality and religion are known to be factors that influence body donation, how religious- and non-religious-based memorial services are held to honor the donors as exemplified by two Korean medical schools-from a public university with no religious affiliation and from a Protestant-based university-are described here. The key concept of expressing gratitude and respect for the donors and their family members has positively impacted body bequest programs in this multi-religious society. Commemorative services held to pay tribute to the altruistic body donors may play an important role in inspiring a humanistic spirit in students, regardless of religious or non-religious beliefs, as exemplified by the two Korean medical schools. The takeaway here is that the elevation of spirituality in memorial services effectively resonates with society, thereby demonstrating the impact of spiritual principles independent of religious influence.