In frontal sinus surgery, stenosis of the frontal sinus opening after surgery remains a challenge for many surgeons. Different surgical approaches such as Lynch procedure, Draf type II, and extended modified Lothrop procedure may decrease adverse surgical results but also accompany inherent complications. The use of various kinds of stents have been also suggested to prolong the patency of the frontal sinus opening. However, no definite consensus has been reached about frontal stents use. Here we introduce the experience of using a new omega shaped silicon stent, which has shown promising results in keeping the frontal sinus opening patent.

Purpose: Helicobacter pylori is a Gram-negative bacterium that is associated with peptic ulcer disease (PUD) and gastric cancer. However, studies on the endoscopic finding and factors related to H. Pylori infection in children are lacking. This study aimed to evaluate the prevalence and factors associated with H. Pylori infection in children with dyspepsia. Methods: We retrospectively analyzed the medical records of patients aged <18 years who underwent upper endoscopy for dyspepsia between January 2015 and December 2022.H. Pylori was diagnosed using a rapid urease test, and the dyspeptic symptoms included postprandial fullness, early satiation, epigastric pain, and nausea. Results: Among 185 patients, the prevalence of H. Pylori infection was 16.2%. Obesity and a family history of H. Pylori infection were more frequently observed in patients with H.pylori infection than in those without. Anemia was also more common in patients with H.pylori infection than in those without. H. Pylori was detected in six (18.8%) patients with PUD (n=32). All six patients had duodenal ulcers and anemia, and complications such as obstruction and bleeding were significantly more common among patients with PUD who were positive for H. Pylori infection than among those without. Conclusion We observed a low prevalence of H. Pylori infection in children with dyspepsia;however, these children exhibited a more severe clinical course. Therefore, caution should be exercised in detecting H. Pylori infection in children, especially, who had obesity or family history of H. Pylori infection.

Papillary adenocarcinoma is a histological type of gastric adenocarcinoma with a very low incidence; therefore, little research has been conducted into this tumor type and no clear treatment guidelines have been developed. Papillary adenocarcinoma is classified as a differentiated-type gastric cancer, according to the Japanese guidelines, but is known to have a high risk of lymph node metastasis. Although the use of endoscopic submucosal dissection in the treatment of early gastric cancer is gradually expanding, its application in patients with papillary early gastric cancer remains controversial. This study helps to identify appropriate indications for endoscopic submucosal dissection in patients with papillary early gastric cancer.

Background/Aims: The kidneys and retina are highly vascularized organs that frequently exhibit shared pathologies, with nephropathy often associated with retinopathy. Previous studies have successfully predicted estimated glomerular filtration rates (eGFRs) using fundus photographs. We evaluated the performance of the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas in eGFR prediction. Methods: We enrolled patients with fundus photographs and corresponding creatinine measurements taken on the same date. One photograph per eye was randomly selected, resulting in a final dataset of 45,108 patients (88,260 photographs). Data including sex, age, and blood creatinine levels were collected for eGFR calculation using the MDRD and CKD-EPI formulas. EfficientNet B3 models were used to predict each parameter. Results: Deep neural network models accurately predicted age and sex using fundus photographs. Sex was identified as a confounding variable in creatinine prediction. The MDRD formula was more susceptible to this confounding effect than the CKD-EPI formula. Notably, the CKD-EPI formula demonstrated superior performance compared to the MDRD formula (area under the curve 0.864 vs. 0.802). Conclusions Fundus photographs are a valuable tool for screening renal function using deep neural network models, demonstrating the role of noninvasive imaging in medical diagnostics. However, these models are susceptible to the influence of sex, a potential confounding factor. The CKD-EPI formula, less susceptible to sex bias, is recommended to obtain more reliable results.

Schwann cells are the most abundant cells in the peripheral nervous system, maintaining the development, function and regeneration of peripheral nerves. Defects in these Schwann cells injury response potentially contribute to the pathogenesis of diabetic peripheral neuropathy (DPN), a common complication of diabetes mellitus. The protein p66shc is essential in regulating oxidative stress responses, autophagy induction and cell survival, and is also vital in the development of DPN. In this study, we hypothesized that p66shc mediates high glucose-induced oxidative stress and autophagic dysfunction. In Schwann cells treated with high glucose; p66shc expression, levels of reactive oxygen species, autophagy impairment, and early apoptosis were elevated. Inhibition of p66shc gene expression by siRNA reversed high glucose-induced oxidative stress, autophagy impairment, and early apoptosis. We also demonstrated that the levels of p66shc was increased, while autophagy-related proteins p62 and LC3 (LC3-II/I) were suppressed in the sciatic nerve of streptozotocin-induced diabetes mice. P66shc-deficient mice exhibited the improvement in autophagy impairment after diabetes onset. Our findings suggest that the p66 plays a crucial role in Schwann cell dysfunction, identifying its potential as a therapeutic target.

The role of acetylated apurinic/apyrimidinic endonuclease 1/redox factor 1 (APE1/Ref-1) in ovarian cancer remains poorly understood. Therefore, this study aimed to investigate the combined effect of recombinant human APE1/Ref-1 (rhAPE1/Ref-1) and aspirin (ASA) on two ovarian cancer cells, PEO-14, and CAOV3.The viability and apoptosis of ovarian cancer cells treated with rhAPE1/Ref-1 or ASA were assessed. Our results demonstrated that ASA induced rhAPE1/Ref-1 acetylation and widespread hyperacetylation in PEO-14 cells. Additionally, co-treatment with rhAPE1/Ref-1 and ASA substantially reduced cell viability and induced PEO-14 cell apoptosis, not CAOV3, in a dose-dependent manner. ASA increased the expression and membrane localization of the receptor for advanced glycation endproducts (RAGEs). Acetylated APE1/Ref-1 showed enhanced binding to RAGEs. In contrast, RAGE knockdown reduced cell death and poly(ADP-ribose) polymerase cleavage caused by rhAPE1/Ref-1 and ASA combination treatment, highlighting the importance of the APE1/Ref-1-RAGE interaction in triggering apoptosis. Moreover, combination treatment with rhAPE1/Ref-1 and ASA effectively induced apoptosis in 3D spheroid cultures of PEO-14 cells, a model that better mimics the tumor microenvironment. These results demonstrate that acetylated APE1/Ref-1 and its interaction with RAGE is a potential therapeutic target for ovarian cancer. Thus, the combination of ASA and APE1/Ref-1 may offer a promising new strategy for inducing cancer cell death.

Purpose: Skeletal muscle atrophy, characterized by a reduction in muscle mass and size, is known to be associated with inflammation and oxidative stress. This study aimed to examine the effect of blackcurrant extract on tumor necrosis factor-alpha (TNF)-α-induced myotube atrophy. Methods: C2C12 myotubes were treated with blackcurrant extract and cultured with TNF-α for 24 hours. The myotubes were stained using May-Grunwald Giemsa staining to measure the myotube diameter. In addition, reactive oxygen species (ROS) levels were assessed.The mRNA expression of inflammation-related markers such as interleukin (IL)-6, IL-1β, cyclooxygenase-2 (COX-2), inducible NO synthase (iNOS), as well as mitochondria dynamicsrelated markers, including mitochondrial fission protein 1 (Fis1), optic atrophy 1 (Opa1) were measured by quantitative real-time polymerase chain reaction. The expression of muscle protein degradation markers, including muscle ring finger protein 1 (MuRF-1), atrogin-1, and forkhead box protein O3 (FoXO3), as well as mitochondrial biogenesis markers such as silent information regulator T1 (Sirt1) and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α), were assessed by western blot analysis. Results: Treatment with blackcurrant extract increased the myotube diameter, which was decreased in TNF-α-induced myotube atrophy. Treatment with TNF-α increased ROS levels and the expression of MuRF-1 and atrogin-1, and these increases were significantly inhibited by treatment with the blackcurrant extract. In contrast, the phosphorylation of FoXO3 was increased by the blackcurrant extract. Furthermore, the blackcurrant extract treatment decreased the mRNA expression of IL-6, IL-1β, COX-2, and iNOS elevated by TNF-α treatment. Additionally, blackcurrant extract treatment suppressed the expression of Fis1, while increasing the expression of Opa1, Sirt1, and PGC-1α. Conclusion These results suggest that blackcurrant extract reduces TNF-α-induced muscle protein degradation by the enhancement of mitochondrial biogenesis and mitochondrial dynamics. Thus, this study provides foundational data supporting the potential of blackcurrant extract as a functional ingredient for the prevention of muscle atrophy.

Background: Although the presence of both obesity and reduced muscle mass presents a dual metabolic burden and additively has a negative effect on a variety of cardiometabolic parameters, data regarding the associations between their combined effects and left ventricular diastolic function are limited. This study investigated the association between the ratio of skeletal muscle mass to visceral fat area (SVR) and left ventricular diastolic dysfunction (LVDD) in patients with preserved ejection fraction using random forest machine learning. Methods: In total, 1,070 participants with preserved left ventricular ejection fraction who underwent comprehensive health examinations, including transthoracic echocardiography and bioimpedance body composition analysis, were enrolled. SVR was calculated as an index of sarcopenic obesity by dividing the appendicular skeletal muscle mass by the visceral fat area. Results: In the random forest model, age and SVR were the most powerful predictors of LVDD. Multivariate logistic regression analysis demonstrated that older age (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI], 1.07 to 1.15) and lower SVR (adjusted OR, 0.08; 95% CI, 0.01 to 0.57) were independent risk factors for LVDD.SVR showed a significant improvement in predictive performance and fair predictability for LVDD, with the highest area under the curve noted in both men and women, with statistical significance. In non-obese and metabolically healthy individuals, the lowest SVR tertile was associated with a greater risk of LVDD compared to the highest SVR tertile. Conclusion Decreased muscle mass and increased visceral fat were significantly associated with LVDD compared to obesity, body fat composition, and body muscle composition indices.

Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy typically associated with dismal outcomes. Most patients present with advanced disease, often precluding curative resection. We report a case of intrathyroidal ATC incidentally identified in a 72-year-old male who underwent diagnostic lobectomy for a low-suspicion, predominantly cystic huge thyroid nodule. Final pathology revealed a completely resected, intrathyroidal ATC without extrathyroidal extension. Postoperative imaging showed no evidence of residual or metastatic disease. Based on multidisciplinary discussion, the patient underwent completion thyroidectomy and central neck dissection without adjuvant therapy. No residual malignancy was identified, and the patient remains recurrence-free at six months. This case highlights that early-stage intrathyroidal ATC may present without overt malignant features and can be curatively treated with complete surgical excision. Careful evaluation and multidisciplinary decision-making are essential in managing rapidly enlarging thyroid nodules with atypical features.