Infiltration and activation of peripheral immune cells are critical in the progression of multiple sclerosis and its experimental animal model, experimental autoimmune encephalomyelitis (EAE). This study investigates the role of high mobility group box 1 (HMGB1) in oligodendrocyte precursor cells (OPCs) in modulating pathogenic T cells infiltrating the central nervous system through the blood-brain barrier (BBB) by using OPC-specific HMGB1 knockout (KO) mice. We found that HMGB1 released from OPCs promotes BBB disruption, subsequently allowing increased immune cell infiltration. The migration of CD4+ T cells isolated from EAE-induced mice was enhanced when co-cultured with OPCs compared to oligodendrocytes (OLs). OPC-specific HMGB1 KO mice exhibited lower BBB permeability and reduced immune cell infiltration into the CNS, leading to less damage to the myelin sheath and mitigated EAE progression. CD4+ T cell migration was also reduced when co-cultured with HMGB1 knock-out OPCs. Our findings reveal that HMGB1 secretion from OPCs is crucial for regulating immune cell infiltration and provides insights into the immunomodulatory function of OPCs in autoimmune diseases.
Animals ; Encephalomyelitis, Autoimmune, Experimental/metabolism* ; HMGB1 Protein/deficiency* ; Mice, Knockout ; Oligodendrocyte Precursor Cells/immunology* ; Mice, Inbred C57BL ; CD4-Positive T-Lymphocytes/immunology* ; Cell Movement ; Blood-Brain Barrier/immunology* ; Mice ; Myelin Sheath/pathology* ; Disease Models, Animal ; Coculture Techniques ; Oligodendroglia/metabolism* ; Female ; Cells, Cultured

Taste buds relay taste sensory information to the primary taste neurons but depend on those same neurons for essential components to maintain function. While denervation-induced taste bud degeneration and subsequent regeneration were discovered decades ago, the mechanisms underlying these phenomena (e.g., heterogenous cellular responses to nerve injury and the signaling pathways involved) remain poorly understood. Here, using mouse genetics, nerve injury models, pharmacologic manipulation, and taste bud organoid models, we identify a specific subpopulation of taste cells, predominantly c-Kit-expressing sweet cells, that exhibit superior resistance to nerve injury. We found the c-Kit inhibitor imatinib selectively reduced the number of residual c-Kit-expressing sweet cells at post-operation week 2, subsequently attenuating the re-emergence of other type II cells by post-operation week 4. In taste bud organoids, c-Kit-expressing cells were resistant to R-spondin withdrawal but susceptible to imatinib, while other taste cell types showed the opposite behavior. We also observed a distinct population of residual taste cells that acquired stem-like properties, generating clonal descendent cells among suprabasal keratinocytes independent of c-Kit signaling. Together, our findings reveal that c-Kit signaling confers resilience on c-Kit-expressing sweet cells and supports the broader reconstruction of taste buds during the later regenerative stage following nerve injury.
Animals ; Taste Buds/metabolism* ; Proto-Oncogene Proteins c-kit/metabolism* ; Mice ; Signal Transduction ; Imatinib Mesylate/pharmacology* ; Mice, Inbred C57BL

Various acupuncture clinical trials have been conducted on migraine; however, the conclusions remain controversial especially when acupuncture was compared with sham acupuncture. Sham acupuncture is sometimes performed at the same acupuncture points used for verum acupuncture despite the evidence on acupuncture point specificity. Four databases were searched for sham acupuncture or waiting list-controlled acupuncture trials for migraine on December 25, 2023. Sham acupuncture was classified according to the needling points: sham acupuncture therapy at verum points (SATV) or at sham points (SATS). Network meta-analysis was performed based on the frequentist framework for headache pain intensity and response rate. A total of 18 studies involving 1936 participants were analyzed. Headache pain intensity and response rate were significantly improved in verum acupuncture compared with SATS. However, there was no significant difference between SATV and verum acupuncture. When comparing SATS and SATV, there was no significant difference in headache pain intensity and response rate; however, the results were in favor of SATV. The effect of the risk of bias on the certainty of evidence between verum and sham acupunctures was judged to be generally low. SATV should not be misused as a placebo control to evaluate the efficacy of acupuncture.
Humans ; Migraine Disorders/therapy* ; Acupuncture Therapy/methods* ; Acupuncture Points ; Treatment Outcome ; Randomized Controlled Trials as Topic

OBJECTIVE: Despite the global decrease in influenza infections during the coronavirus disease 2019 (COVID-19) pandemic, seasonal influenza remains a significant health issue. South Korea, known for its robust pandemic response and high influenza vaccination rates, offers a unique context for examining changes in vaccination trends during the pandemic. Using nationally representative data, we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups. METHODS: We analyzed influenza vaccination rates in South Korea between 2011-2022, focusing on pandemic-related impacts. The data of 2,426,139 adults (≥ 19 years) from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors. RESULTS: We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013 (weighted prevalence: 46.68% [95% confidence interval ( CI): 46.55-46.82]) to 2017-2019 (weighted prevalence: 52.50% [95% CI: 52.38-52.63]). However, a significant decline was observed in 2022, the late-COVID-19 pandemic period (weighted prevalence: 55.78% [95% CI: 55.56-56.01]), compared with the mid-pandemic period in 2021 (weighted prevalence: 59.12% [95% CI: 58.91-59.32]), particularly among populations traditionally prioritized for influenza vaccination, including older adults (≥ 65 years) and patients with chronic diseases and low educational and income levels. CONCLUSION The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic, showing a notable decrease among vulnerable demographic groups. This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates, particularly among high-risk populations.
Humans ; Republic of Korea/epidemiology* ; COVID-19/epidemiology* ; Adult ; Middle Aged ; Influenza Vaccines/administration & dosage* ; Male ; Female ; Influenza, Human/epidemiology* ; Aged ; Vaccination/statistics & numerical data* ; Young Adult ; Pandemics ; SARS-CoV-2

Postoperative pain management is critical for short-term recovery and long-term outcomes. Insufficient acute pain control can lead to persistent postsurgical pain (PPSP), delayed recovery, and diminished quality of life. Therefore, understanding the impact of various pain management strategies on long-term outcomes is paramount.Current Concepts: Multimodal and regional anesthesia play critical roles in mitigating the risks associated with poorly managed postoperative pain, expediting recovery, and improving patient satisfaction. By integrating pharmacological and non-pharmacological strategies, multimodal analgesia has been demonstrated to effectively reduce opioid-related side effects. Regional anesthesia techniques, including nerve blocks and neuraxial analgesia, contribute to decreased incidence of chronic pain and facilitate early mobilization. The enhanced recovery after surgery (ERAS) protocol, which prioritizes patient-centered care and emphasizes multidisciplinary collaboration, improves recovery outcomes by incorporating evidence-based interventions that reduce pain and postoperative complications. Furthermore, insights derived from open datasets in perioperative medicine have the potential to refine pain management protocols and develop personalized therapeutic strategies. Lastly, preoperative patient education and psychological preparation are increasingly acknowledged as crucial components for optimizing postoperative outcomes.Discussion and Conclusion: Despite these advances, challenges remain in ensuring the consistent application of evidence-based pain management techniques. Collaboration among anesthesiologists, surgeons, and pain specialists is essential for developing integrated strategies. Addressing systemic barriers, such as resource limitations and variability in clinical practice, remains critical. Discussions on ERAS in South Korea have highlighted structural factors influencing its adoption. Personalized, evidence-based approaches within multidisciplinary frameworks can enhance recovery, reduce chronic pain, and improve quality of life. Future research should prioritize bridging existing gaps and optimizing care delivery.

Background: This study evaluated the use of brainstem score (BSS) on pre-procedural diffusion-weighted imaging (DWI) to predict outcomes after mechanical thrombectomy (MT) in acute basilar artery occlusion (ABAO) patients and compared its predictive effectiveness to the critical area perfusion score (CAPS) on perfusion magnetic resonance imaging (MRI) using RAPID. Methods: This study focused on ABAO patients who underwent MT after MRI at Dong-A University Hospital from 2013 to 2023. Ischemic lesion volume and DWI BSS were measured for all. For the group that underwent perfusion MRI using RAPID, CAPS were measured. The primary end point was a poor outcome at 90 days (modified Rankin scale [mRS], >2). Results: 71 patients had ABAO and underwent MT after MRI. The poor outcome group (66.2%) had significantly larger ischemic lesion volume and higher DWI BSS compared with the good outcome group. In the multiple logistic regression analysis, DWI BSS (odds ratio, 8.27; 95% confidence interval, 1.93-35.50; p<0.01) was an independent predictor of poor outcomes. In 26 patients, CAPS was measured on perfusion MRI. In this subgroup, poor outcome group (50.0%) had higher DWI BSS and CAPS than the good outcome group. In the multiple logistic regression analysis, DWI BSS remained a valid independent predictor for predicting outcomes, but CAPS did not function as an independent predictor. Conclusion In this study, the DWI BSS before MT in ABAO patients emerged as a useful imaging marker for predicting post-procedural outcomes. Its predictive ability is not only comparable to but even superior to CAPS on perfusion MRI.

Purpose: We present a case of anterior displacement of the lens-iris diaphragm associated with Vogt–Koyanagi–Harada (VKH) disease.Case summary: A 35-year-old woman presented with decreased vision in her right eye. Examination revealed corrected visual acuity of 0.6 in the right eye and 1.0 in the left eye. Intraocular pressure (IOP) was 14 and 16 mmHg in the right and left eye, respectively. Spherical equivalent (SE) was -17.25 D in the right eye and -9.75 D in the left eye. Slit lamp examination and three-dimensional anterior segment photography revealed anterior displacement of the lens-iris diaphragm in both eyes. Two days later, the left eye developed similar symptoms with an SE of -15.5 D. Fundus examination revealed serous retinal detachment and fluorescein fundus photography demonstrated focal leakage leading to the diagnosis of atypical VKH disease. The patient was treated with oral corticosteroids and her symptoms resolved after 3 weeks. The Final SE was -10.25 D in the right eye and -9.75 D in the left eye. Conclusions We suggest there is an association between atypical VKH and anterior lens-iris diaphragm displacement in the absence of elevated IOP; early myopic shift may be associated with this presentation. Therefore, patients with isolated lens-iris diaphragm displacement, particularly those without a history of medications should be monitored for the possibility of developing VKH disease.

Purpose: To confirm the clinical features of hemicentral retinal vein occlusion and identify predictors of visual outcomes. Methods: A retrospective analysis was conducted on patients diagnosed with hemicentral retinal vein occlusion between January 2018 and December 2022 and followed for more than 6 months. Patients underwent intravitreal injections as necessary for intraretinal edema. Visual acuity, central macular thickness, ellipsoid zone damage, and the location of inner retinal layer edema were assessed. Patients were categorized into groups A and group B based on the visual acuity at 6 months. Results: In total, 20 eyes were followed, with 15 eyes observed for up to 12 months. Seven patients (35.0%) had diabetes and 11 (55.0%) had hypertension. There was a correlation between poor vision at 6 months and hypertension (p = 0.033). The visual acuity of all patients improved from a logMAR of 0.96 at the initial visit to a logMAR of 0.35 at 6 months (p = 0.005). In the group with good initial visual acuity, there were no significant changes in visual acuity during the follow-up period (p = 0.444). The group with good visual acuity at 6 months had a lower degree of photoreceptor ellipsoid zone disruption compared to the group with poor initial vision, indicating a normal structure (p = 0.015). Conclusions During follow-up of patients with hemicentral retinal vein occlusion, overall visual acuity improved over time. Patients with good initial acuity maintained it. Favorable visual outcomes can be expected if the ellipsoid zone has a normal structure at the time of the first examination.

Purpose: To describe a case of posterior scleritis accompanied by optic disc edema following the surgical removal of a traumatic intraocular foreign body.Case Summary: A 32-year-old man presented to the hospital after suspecting that a foreign body had entered his left eye while nailing. Slit lamp examination revealed a 2-mm corneal laceration, iris defect, and lens opacity. Lensectomy, vitrectomy, and intraocular foreign body removal were subsequently performed. A magnetic foreign body approximately 1 mm in diameter was extracted from the vitreous cavity. One week after surgery, during an outpatient visit, optic disc swelling and retinal vessel thickening were observed. Oral steroids were initiated and tapered over 2 months. After discontinuing the medication, the patient experienced acute ocular pain and severe ciliary body hyperemia, and B-scan imaging showed thickening of the posterior ocular coat. The diagnosis was posterior scleritis with optic disc swelling, and oral steroids were prescribed and tapered over 12 weeks. Following the secondary intraocular lens scleral fixation, no recurrence of posterior scleritis was noted. Conclusions Posterior scleritis should be considered in cases presenting with ocular pain, ciliary body hyperemia, or optic nerve swelling after intraocular foreign body removal surgery.

Purpose: To investigate the short-term outcomes of intravitreal injections of the ranibizumab biosimilar SB11 in patients with neovascular age-related macular degeneration (AMD). Methods: This retrospective comparative study assessed changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in patients diagnosed with neovascular AMD who received three monthly injections of SB11. The outcomes were compared to those of patients who received the same treatment using the ranibizumab originator. Within the SB11 group, comparisons were made between BCVA and CRT at diagnosis and after three injections. The proportion of patients with resolved subretinal fluid/intraretinal fluid was also evaluated. Results: The study included 46 eyes. In the SB11 group (n = 23), the average BCVA improved significantly from a baseline of logarithm of minimal angle of resolution 0.54 ± 0.42 to 0.40 ± 0.32 after three injections (p = 0.008). The average CRT decreased significantly from 447.4 ± 167.7 µm at baseline to 267.9 ± 66.9 µm after treatment (p < 0.001). Complete resolution of macular edema was observed in 19 eyes (82.7%). No significant differences were found in the degree of change in BCVA (p = 0.883) and CRT (p = 0.629) when compared to the ranibizumab originator group (n = 23). No complications such as intraocular inflammation or retinal detachment were noted. Conclusions Treatment with SB11 loading injections in neovascular AMD led to significant improvements in vision and reductions in macular thickness. The extent of improvement was comparable to that achieved with the ranibizumab originator and no severe complications were observed.