Prussian Blue-Type Sodium-ion Conducting Solid Electrolytes for All Solid-State Batteries.

Conventional solid electrolyte frameworks typically consist of anions such as sulphur, oxygen, chlorine, and others, leading to inherent limitations in their properties. Despite the emergence of sulphide, oxide, and halide-based solid electrolytes for all-solid-state batteries, their utilization is hampered by issues, including the evolution of H2 S gas, the need for expensive elements, and poor contact. Here, we first introduce Prussian Blue analogue (PBA) open-framework structures as a solid electrolyte that demonstrates appreciable Na+ conductivity (>10-2 mS cm-1 ). We delve into the relationship between Na+ conductivity and the lattice parameter of N-coordinated transition metal, which is attributed to the reduced interaction between Na+ and the framework, corroborated by the distribution of relaxation times and density functional theory calculations. Among the five PBAs studied, Mn-PBA have exhibited the highest Na+ conductivity of 9.1×10-2 mS cm-1 . Feasibility tests have revealed that Mn-PBA have maintained a cycle retention of 95.1 % after 80cycles at 30 °C and a C-rate of 0.2C. Our investigation into the underlying mechanisms that play a significant role in governing the conductivity and kinetics of these materials contributes valuable insights for the development of alternative strategies to realize all-solid-state batteries.

COMPARISON OF SURGEON MUSCULAR PROPERTIES BETWEEN STANDARD OPERATING MICROSCOPE AND DIGITALLY ASSISTED VITREORETINAL SURGERY SYSTEMS.

PURPOSE: To quantitatively analyze surgical ergonomics between standard operating microscope (SOM) and digitally assisted vitreoretinal surgery (DAVS) systems. METHODS: The surgeon conducted procedures on 110 patients; 52 patients underwent a combined phacoemulsification and pars plana vitrectomy (Phaco-PPV group, 24 using SOM and 28 using DAVS), and 58 patients underwent phacoemulsification (Phaco group, 30 using SOM and 28 using DAVS). The surgeon's muscle tone and stiffness in the sternocleidomastoid and the two positions of the upper trapezius (UT), which are 2-cm intervals along the UT muscle fibers, UT1 and UT2, were measured at preoperative, intraoperative, and postoperative time points. RESULTS: In the Phaco-PPV group using the SOM, intraoperative muscle tone and stiffness were higher than preoperative and postoperative values in the sternocleidomastoid ( P < 0.001, respectively), UT1 ( P < 0.001, respectively), and UT2 ( P < 0.001 and P < 0.01, respectively). In the Phaco group using the SOM, intraoperative muscle tone and stiffness were higher than pre- and postoperative values in the sternocleidomastoid ( P < 0.001, respectively) and UT1 ( P < 0.001 and P < 0.01, respectively). By contrast, when the surgeon used the DAVS, there were no differences in muscle properties at any measurement site or during any time point in the Phaco-PPV and Phaco groups ( P > 0.05). CONCLUSION: This study provides quantitative measurement of retina surgeon ergonomics, suggesting that compared with a SOM, the DAVS can reduce intraoperative muscle fatigue.

Development and evaluation of hot-melt-extruded diquafosol tetrasodium formulations for ophthalmic inserts: A design of experiments approach.

This study aimed to develop, optimize, and evaluate hot-melt-extruded ophthalmic inserts capable of sustained release of diquafosol tetrasodium (DQS) via a design of experiments approach. DQS, a tear stimulant for dry eye management, faces challenges of frequent administration and low bioavailability. The developed insert uses biodegradable polymers in varied proportions to achieve sustained release. Optimized through mixture design, the insert completely dissolved within 24 h and maintained a stable drug content, thickness, and surface pH over three months at room temperature. In vitro corneal permeation studies on excised rabbit corneas demonstrated increased bioavailability, suggesting a reduced dosing frequency compared with conventional eye drops. Therefore, this insert has potential to enhance treatment outcomes by improving patient compliance and providing sustained drug effects.

Whole-body MRI for preventive health screening in a general population: Prevalence of incidental findings around the hip.

PURPOSE: To report the frequencies of incidental findings on whole body MRI (WB-MRI) around the hip and to characterize the significance of incidental findings in a general population. MATERIALS AND METHODS: This retrospective study included 7287 cases that underwent WB-MRI as part of a preventive health screening. WB-MR images were reviewed by two musculoskeletal radiologists in consensus. According to clinical severity and urgency of medical intervention, each finding was classified into two subgroups as clinically significant and insignificant. The clinically significant group included findings that suggested abnormalities requiring further evaluation or follow-up, such as avascular necrosis (AVN), bone tumor (enchondroma), soft tissue tumor, and fracture. The clinically less significant group included subcortical cyst, bone marrow edema, para-labral cyst, simple bone cysts, and ganglion cysts. RESULTS: The prevalence of clinically significant and less significant incidental findings of the hip on WB-MRI was substantial overall. The incidences were recorded as 1.2% and 19.9%, respectively. Besides bone and soft tissue tumor or tumor-like lesions, AVN of the femoral head was one of the findings with a 0.3% prevalence. CONCLUSIONS: An awareness of the prevalence of incidental findings can be helpful for radiologists and clinicians when interpreting WB-MRI for health screening and explaining the results to subjects.

Zinc insulin hexamer loaded alginate zinc hydrogel: Preparation, characterization and in vivo hypoglycemic ability.

Alginate zinc hydrogel loaded with zinc insulin hexamer was prepared and characterized for oral insulin administration. The hydrogel was fabricated by dripping zinc insulin hexamer into sodium alginate solution and followed by crosslinking by zinc chloride. SEM image reveals the zinc insulin hexamer was integrated into the matrix of hydrogel. Zinc insulin hexamer loaded hydrogel shows no obvious cytotoxicity to both HT29 and Caco-2 cells. The developed hydrogel retards the burst release of insulin in simulated gastric fluid but promotes the release when in simulated intestinal fluid. In the diabetic mice, zinc insulin hexamer loaded alginate hydrogel demonstrates significant and prolonged hypoglycemic effect.

Effect of cinnamon on starch hydrolysis of rice pudding: Comparing static and dynamic in vitro digestion models.

Two in vitro digestion methods (static and dynamic) were applied in this study to investigate the effect of cinnamon on starch hydrolysis of rice pudding during in vitro digestion. The dynamic model simulated the major physiological processes including gastric emptying, motility, gastric acidification, and digestive secretions. The INFOGEST static method, which is widely adopted in digestion simulation studies, was conducted as a comparison. Two meals (i.e., rice pudding with and without cinnamon) were digested in the oral, gastric, and small intestinal phases in both models. Higher starch hydrolysis was observed in the gastric and intestinal phases in the dynamic model compared to the static model (p < 0.05). Furthermore, a significant inhibitory effect of cinnamon on starch hydrolysis was exclusively observed in the dynamic model . The difference could be attributed to the distinct gastric conditions including pH profiles, gastric emptying, and gastrointestinal motility in the two models. Our results indicated that the dynamic model could more closely estimate the effect of cinnamon on starch hydrolysis during digestion by simulating physiologically important gastrointestinal conditions in humans. Our findings also contribute to the growing body of scientific data suggesting that cinnamon may benefit hyperglycemic management due to its inhibitory effects on digestion enzymes.

Development of Molecular Magnetic Resonance Imaging Tools for Risk Stratification of Carotid Atherosclerotic Disease Using Dual-Targeted Microparticles of Iron Oxide.

Identification of patients with high-risk asymptomatic carotid plaques remains a challenging but crucial step in stroke prevention. Inflammation is the key factor that drives plaque instability. Currently, there is no imaging tool in routine clinical practice to assess the inflammatory status within atherosclerotic plaques. We have developed a molecular magnetic resonance imaging (MRI) tool to quantitatively report the inflammatory activity in atherosclerosis using dual-targeted microparticles of iron oxide (DT-MPIO) against P-selectin and VCAM-1 as a smart MRI probe. A periarterial cuff was used to generate plaques with varying degree of phenotypes, inflammation and risk levels at specific locations along the same single carotid artery in an Apolipoprotein-E-deficient mouse model. Using this platform, we demonstrated that in vivo DT-MPIO-enhanced MRI can (i) target high-risk vulnerable plaques, (ii) differentiate the heterogeneity (i.e. high vs intermediate vs low-risk plaques) within the asymptomatic plaque population and (iii) quantitatively report the inflammatory activity of local plaques in carotid artery. This novel molecular MRI tool may allow characterisation of plaque vulnerability and quantitative reporting of inflammatory status in atherosclerosis. This would permit accurate risk stratification by identifying high-risk asymptomatic individual patients for prophylactic carotid intervention, expediting early stroke prevention and paving the way for personalised management of carotid atherosclerotic disease.

The Need of Enterococcal Coverage in Severe Intra-Abdominal Infection: Evidence from Animal Study.

Intra-abdominal infection (IAI) is a common and important cause of infectious mortality in intensive care units. Adequate source control and appropriate antimicrobial regimens are key in the management of IAI. In community-acquired IAI, guidelines recommend the use of different antimicrobial regimens according to severity. However, the evidence for this is weak. We investigated the effect of enterococcal coverage in antimicrobial regimens in a severe polymicrobial IAI model. We investigated the effects of imipenem/cilastatin (IMP) and ceftriaxone with metronidazole (CTX+M) in a rat model of severe IAI. We observed the survival rate and bacterial clearance rate. We identified the bacteria in blood culture. We measured lactate, alanine aminotransferase (ALT), creatinine, interleukin (IL)-6, IL-10, and reactive oxygen species (ROS) in the blood. Endotoxin tolerance of peripheral blood mononuclear cells (PBMCs) was also estimated to determine the level of immune suppression. In the severe IAI model, IMP improved survival and bacterial clearance compared to CTX+M. Enterococcus spp. were more frequently isolated in the CTX+M group. IMP also decreased plasma lactate, cytokine, and ROS levels. ALT and creatinine levels were lower in IMP group. In the mild-to-moderate IAI model, however, there was no survival difference between the groups. Immune suppression of PBMCs was observed in IAI model, and it was more prominent in the severe IAI model. Compared to CTX+M, IMP improved the outcome of rats in severe IAI model.

Bioanalysis of niclosamide in plasma using liquid chromatography-tandem mass and application to pharmacokinetics in rats and dogs.

Niclosamide, which is an anti-tapeworm drug, was developed in 1958. However, recent studies have demonstrated the antiviral effects of niclosamide against the SARS-CoV-2 virus, which causes COVID-19. In this study, we developed and validated a quantitative analysis method for the determination of niclosamide in rat and dog plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS), and used this method for pharmacokinetic studies. Biological samples were prepared using the protein precipitation method with acetonitrile. Ibuprofen was used as an internal standard. The mobile phase used to quantify niclosamide in rat or dog plasma consisted of 10 mM ammonium formate in distilled water-acetonitrile (30:70, v/v) or 5 mM ammonium acetate-methanol (30:70, v/v). An XDB-phenyl column (5 µm, 2.1 × 50 mm) and a Kinetex® C18 column (5 µm, 2.1 × 500 mm) were used as reverse-phase liquid chromatography columns for rat and dog plasma analyses, respectively. Niclosamide and ibuprofen were detected under multiple reaction monitoring conditions using the electrospray ionization interface running in the negative ionization mode. Niclosamide presented linearity in the concentration ranges of 1-3000 ng/mL (r = 0.9967) and 1-1000 ng/mL (r = 0.9941) in rat and dog plasma, respectively. The intra- and inter-day precision values were < 7.40% and < 6.35%, respectively, for rat plasma, and < 3.95% and < 4.01%, respectively, for dog plasma. The intra- and inter-day accuracy values were < 4.59% and < 6.63%, respectively, for rat plasma, and < 12.1% and < 10.9%, respectively, for dog plasma. In addition, the recoveries of niclosamide ranged between 87.8 and 99.6% and 102-104% for rat and dog plasma, respectively. Niclosamide was stable during storage under various conditions (three freeze-thaw cycles, 6 h at room temperature, long-term, and processed samples). A reliable LC-MS/MS method for niclosamide detection was successfully used to perform pharmacokinetic studies in rats and dogs. Niclosamide presented dose-independent pharmacokinetics in the dose range of 0.3-3 mg/kg after intravenous administration, and drug exposure in rats and dogs after oral administration was very low. Additionally, niclosamide presented high plasma protein binding (>99.8%) and low metabolic stability. These results can be helpful for further developing and understanding the pharmacokinetic characteristics of niclosamide to expand its clinical use.

Meniscus regeneration with injectable Pluronic/PMMA-reinforced fibrin hydrogels in a rabbit segmental meniscectomy model.

Injectable hydrogel systems are a facile approach to apply to the damaged meniscus in a minimally invasive way. We herein developed a clinically applicable and injectable semi-interpenetrated network (semi-IPN) hydrogel system based on fibrin (Fb), reinforced with Pluronic F127 (F127) and polymethyl methacrylate (PMMA), to improve the intrinsic weak mechanical properties. Through the dual-syringe device system, the hydrogel could form a gel state within about 50 s, and the increment of compressive modulus of Fb hydrogels was achieved by adding F127 from 3.0% (72.0 ± 4.3 kPa) to 10.0% (156.0 ± 9.8 kPa). The shear modulus was enhanced by adding PMMA microbeads (26.0 ± 1.1 kPa), which was higher than Fb (13.5 ± 0.5 kPa) and Fb/F127 (21.7 ± 0.8 kPa). Moreover, the addition of F127 and PMMA also delayed the rate of enzymatic biodegradation of Fb hydrogel. Finally, we confirmed that both Fb/F127 and Fb/F127/PMMA hydrogels showed accelerated tissue repair in the in vivo segmental defect of the rabbit meniscus model. In addition, the histological analysis showed that the quality of the regenerated tissues healed by Fb/F127 was particularly comparable to that of healthy tissue. The biomechanical strength of the regenerated tissues of Fb/F127 (3.50 ± 0.35 MPa) and Fb/F127/PMMA (3.59 ± 0.89 MPa) was much higher than that of Fb (0.82 ± 0.05 MPa) but inferior to that of healthy tissue (6.63 ± 1.12 MPa). These results suggest that the reinforcement of Fb hydrogel using FDA-approved synthetic biomaterials has great potential to be used clinically.

Akt and calcium-permeable AMPA receptor are involved in the effect of pinoresinol on amyloid ß-induced synaptic plasticity and memory deficits.

Alzheimer's disease (AD) is one of the most prevalent neurodegenerative disorders characterized by memory deficits. Although no drug has given promising results, synaptic dysfunction-modulating agents might be considered potential candidates for alleviating this disorder. Pinoresinol, a lignan found in Forsythia suspensa, is a memory-enhancing agent with excitatory synaptic activation. In the present study, we tested whether pinoresinol reduces learning and memory and excitatory synaptic deficits in an amyloid ß (Aß)-induced AD-like mouse model. Pinoresinol enhanced hippocampal long-term potentiation (LTP) through calcium-permeable AMPA receptor, which was mediated by Akt activation. Moreover, pinoresinol ameliorated LTP deficits in amyloid ß (Aß)-treated hippocampal slices via Akt signaling. Oral administration of pinoresinol ameliorated Aß-induced memory deficits without sensory dysfunction. Moreover, AD-like pathology, including neuroinflammation and synaptic deficit, were ameliorated by pinoresinol administration. Collectively, pinoresinol may be a good candidate for AD therapy by modulating synaptic functions.

Diagnosis and treatment of dyslipidemia in children and adolescents

Atherosclerotic cardiovascular disease is a major cause of morbidity and mortality worldwide, including in South Korea. Dyslipidemia is an independent risk factor for the development of atherosclerotic cardiovascular diseases. There is strong evidence that atherosclerosis begins early in life and that elevated lipid levels in childhood predict elevated lipid levels into adulthood.Current Concepts: A universal approach for cholesterol screening in all children is recommended. Lipid profiles should be studied for all children aged 9 to 11 years and then for those aged 17 to 21 years, as cholesterol levels may vary after puberty. The non-fasting lipid profile can be as useful in detecting severe genetic dyslipidemias as the fasting lipid profile and thus can be used as a first-line screening in children. The initial treatment for dyslipidemia in a child always begins with a 6-month trial of lifestyle modifications, such as improvements in dietary and physical activity patterns. Statins are as effective in children as in adults and can lower low-density lipoprotein cholesterol levels by up to 50%. Therefore, they are considered first-line therapy for children who meet the criteria for pharmacological therapy.Discussion and Conclusion: Statins and non-statin lipid-lowering agents can lower cholesterol levels with minimal adverse effects in children and adolescents with hypercholesterolemia. However, limited data is currently available on the long-term safety and efficacy of lipid-lowering agents in the pediatric population. Furthermore, non-statin lipid-lowering agents are used far less frequently in children. Therefore, further long-term safety and efficacy studies on lipid-lowering agents in pediatric populations and clinical trials with non-statin lipid-lowering agents are required.

Usefulness of the odontogenic ameloblast-associated protein and quantitative analysis of periodontal disease-associated bacteria as biomarkers for evaluation of improvement in periodontal status following scaling intervention / 대한구강보건학회지

Objectives@#In this study, we investigated the validity and effectiveness of biomarkers and oral microbiome analysis for evaluation of periodontal status following scaling intervention. @*Methods@#The study included 15 participants who were selected based on inclusion/exclusion criteria. Periodontal indices, including the plaque index, probing depth, modified sulcus bleeding index, and calculus index were measured to evaluate clinical periodontal status and disease progression.Pre- and post-scaling gingival crevicular fluid (GCF) was obtained from 12-20 sites per patient to measure changes in the odontogenic ameloblast-associated protein (ODAM) concentration using an enzyme-linked immunosorbent assay. Additionally, pre- and post-treatment salivary samples were obtained for quantitative analysis of oral microbiome distribution. @*Results@#All clinical parameters showed significant differences in pre- and post-scaling values and significant changes in the ODAM concentration in the GCF in patients with initial and moderate periodontitis. Quantitative analysis performed after scaling intervention revealed changes in eight oral disease-causing bacteria associated with periodontal disease, including Aggregatibacter, Porphyromonas, Tannerella, Treponema, Prevotella, and Fusobacterium. Specifically, Tannerella forsythia and Fusobacterium nucleatum (well-known major periodontal pathogens) numbers were significantly decreased following non-surgical periodontal therapy. However, no significant association was observed between changes in the salivary oral microbiota and ODAM concentration in the GCF, following treatment. @*Conclusions@#Based on the findings of this study, we propose the use of ODAM protein and quantitative analysis of periodontal disease-associated bacteria as objective and quantitative biomarkers for evaluation of improvement in periodontal disease following scaling intervention.

Examination of medical students’ opinions on multimedia learning materials according to social cues: focusing on sound principles / 한국의학교육

Purpose@#Although interest in various forms of learning media is increasing due to the coronavirus disease 2019 (COVID-19) pandemic there is relatively little research on influencing student motivation by intervening in cognitive processing. The purpose of this study was to present the optimal form of learning materials provided to medical students. @*Methods@#This study provided learning materials in class at a level according to social cues (script, video [artificial intelligence (AI) voice], video [professor voice]) based on the principle of voices among the principles of personalization, voices, image, and embodiment of social cues in multimedia learning, and surveyed students’ opinions. @*Results@#There was no statistically significant difference according to social clues in satisfaction and learning help, but both appeared in the order of silent videos containing the professor’s voice, followed by videos containing the AI voice. @*Conclusion@#This study is significant in that there is no research on the impact of student motivation on the provision of learning materials for medical school education in Korea, and we hope that it will help provide learning materials for self-directed learning of medical students in the post-COVID-19.

Optimizing the Hospital Blood Bank Stock in Korea:A Comparative Analysis of the Uniform 5-Day Stock Index and a Novel Blood Stock Index

Background@#Maintaining optimal blood inventory levels in hospitals is important to prevent blood shortage and wastage. We aimed to provide an efficient blood inventory management strategy for hospital blood banks nation-wide by comparing the current use of 5-day issuable stock (IS) with Lim’s IS as a novel target IS. @*Methods@#The average and CV of daily usage (DU) were calculated from information entered into Korea’s Blood Management System by 194 participating hospitals in 2019 and 2020. Using these data, Lim’s IS was calculated by determining the simulated annual average blood shortage day nearest to 1 for each blood group in each hospital. The 5-day IS (5IS) was estimated by multiplying the average DU in 2018 by five to count the shortage days in 2019. @*Results@#The average DU (0.3–231.3 units) and corresponding CV (0.33–7.14) in the participating hospitals were inversely proportional (r = –0.699 to –0.695). The hypothetical averages of 5IS and Lim’s IS were 27.0 ± 41.2 and 24.7 ± 20.8, respectively (P = 0.006). The shortage days for 5IS and Lim’s IS were 8.9 ± 22.7 and 1.0 ± 1.9, respectively (P < 0.001). @*Conclusions@#While 5IS was unacceptable for universal application, Lim’s IS remained near one shortage day and is considered more efficient than 5IS. Hospitals should implement indicators that consider DU and its variations. This is the first study to introduce Lim’s IS as an indicator of optimal blood inventory, and the data are expected to provide guidance for effective blood inventory management nationwide, particularly during blood shortages.

Non-suicidal Self-injury and Quantified Electroencephalogram in Adolescents and Young Adults with Depression

Objective@#This study investigated the association between non-suicidal self-injury (NSSI) and quantified electroencephalogram (QEEG) in patients with depression. We aimed to identify clinical features of NSSI and differences in QEEG findings. @*Methods@#This retrospective study used the medical records of 52 inpatients with major depressive episodes, aged from 15 to 30. The patients were categorized according to their history of NSSI. Their main diagnosis and sex were also considered. To evaluate clinical symptoms, self-reported scales were used. The absolute power and the Z-scores of various waves were included. @*Results@#NSSI was associated with suicidal ideations (p = 0.001) and trauma history (p = 0.014). In the binary logistic regression analysis, the Z-score of absolute alpha power was higher on the FP2 node (p = 0.029), lower on the F4 node (p = 0.029) in the NSSI group. The absolute high beta power in the NSSI group was higher on the FP2 and the F3 node, but lower on the F7 and F8 node. Patients with NSSI showed higher Z-score of the absolute delta power at the FP2 node (p = 0.044). The absolute gamma power was higher on the FP2 (p = 0.012) and the F3 node (0.043), lower on the FP1 (p = 0.019) and the F7 node (0.018) in the NSSI group. The absolute high gamma power at the FP2 (p = 0.017) and F8 nodes (p = 0.045) were higher in the NSSI group. @*Conclusion@#Patients with NSSI may have clinical features distinct from those of patients without NSSI. QEEG results have shown some differences, although it is less applicable due to some limitations.

Prediction of Syndesmotic Instability according to the Lateral Malleolus Fracture Pattern in Supination-External Rotation Type Ankle Fractures:Short Oblique versus Long Oblique Fracture

Purpose@#This study examined whether preoperative radiological evaluations can predict syndesmotic instability according to the lateral malleolus fracture pattern in supination-external rotation-type ankle fractures. @*Materials and Methods@#This study enrolled 132 patients (132 ankles) with supination-external rotation stage 3 and 4 ankle fractures. Three-dimensional computed tomography was used for the morphological classification of the lateral malleolus fractures. A long oblique fracture was defined when the posterior cortical bone height of the fracture was 4.5 cm or more from the plafond of the distal tibial articular surface. A short oblique fracture was defined when the height was less than 4.5 cm. The demographic characteristics and syndesmotic instability of the two groups were evaluated. @*Results@#Short oblique fractures were confirmed in 102 cases, and long oblique fractures were confirmed in 30 cases. Long oblique fractures occurred at a statistically significantly higher incidence in younger ages and among males compared to short oblique fractures. Syndesmotic instability was more common in long oblique fractures. @*Conclusion@#In supination-external rotation-type ankle fractures, syndesmotic instability was observed in approximately 13%. Specifically, when the fracture pattern of the lateral malleolus is long oblique, the incidence of syndesmotic instability is approximately three times higher than in short oblique fractures. Therefore, meticulous evaluations of the lateral malleolus fracture pattern and establishing an appropriate treatment plan before surgery are crucial.

Global Use of Cryopreserved Platelets / 대한수혈학회지

The Valeri method, introduced in 1972 with dimethyl sulfoxide (DMSO) as a cryoprotective agent, has evolved into a no-wash technique widely employed for cryopreservation of platelets. Cryopreserved platelets (CP) are a viable alternative to liquid platelets (LP) and address the limitations of LP. CP have an extended shelf file, are a reliable supply for rare blood types, and can be transported to challenging terrains for use in military settings and remote areas and places where blood supply is imbalanced. Despite CP exhibiting a lower recovery rate compared to LP, the superior hemostatic efficacy makes it advantageous for use in bleeding patients. Some countries have already implemented CP for civilian use in disasters caused by natural hazards or human-induced events, and clinical trials are underway to expand applications among civilians. The absence of national regulations and standardized guidelines for CP preparation and evaluation is a significant obstacle to the extensive use of CP. A consensus is needed among academic societies, blood centers, the military, and governments to lend support and interest in the development of CP as a viable alternative to LP. This review presents information on the initial attempts to produce CP, in vitro changes of thawed CP, utilization of CP, and the current usage status in various countries. The goal was to evaluate the potential need to introduce CP domestically and provide insights on the strengths and challenges.

Spontaneous Regression of Glioma–Mimicking Brainstem Lesion in a Child: A Case Report

Differential diagnosis of focal brainstem lesions detected on MRI is challenging, especially in young children. Formerly, brainstem gliomas were classified mainly based on MRI features and location. However, since 2016, the World Health Organization’s brainstem lesion classification requires tissue biopsy to reveal molecular characteristics. Although modern techniques of stereotactic or navigation-guided biopsy ensure accurate biopsy of the lesion with safety, biopsy of brainstem lesions is still generally not performed. Here, we report a focal brainstem lesion mimicking brainstem glioma in a 9-year-old girl. Initial MRI, MR spectroscopy, and 11 C-methionine positron emission tomography (PET) features suggested low-grade glioma or diffuse intrinsic pontine glioma. However, repeated MR spectroscopy, perfusion MRI, and 18 fluorodeoxyglucose PET findings suggested that it was more likely a non-tumorous lesion. As the patient presented not with a neurological manifestation but with precocious puberty, the attending oncologist chose to observe with regular follow-up MRI. The pontine lesion with high signal intensity on T2-weighted MRI regressed from the 6-month follow-up and became invisible on the 1.5-year follow-up MRI. We reviewed brainstem glioma–mimicking lesions in the literature and discussed the key points of differential diagnosis.

Various Pathologic Conditions of Sinus Tarsi Syndrome Assessed by Imaging and Arthroscopic Findings / 대한족부족관절학회지

Purpose@#Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. @*Materials and Methods@#Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary’s angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. @*Results@#The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary’s angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order:synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. @*Conclusion@#In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.