Cardiac organoids have emerged as invaluable tools for assessing the impact of diverse substances on heart function.This report introduces guidelines for general requirements for manufacturing cardiac organoids and conducting cardiac organoid-based assays, encompassing protocols, analytical methodologies, and ethical considerations. In the quest to employ recently developed three-dimensional cardiac organoid models as substitutes for animal testing, it becomes imperative to establish robust criteria for evaluating organoid quality and conducting toxicity assessments. This guideline addresses this need, catering to regulatory requirements, and describes common standards for organoid quality and toxicity assessment methodologies, commensurate with current technological capabilities. While acknowledging the dynamic nature of technological progress and the potential for future comparative studies, this guideline serves as a foundational framework. It offers a comprehensive approach to standardized cardiac organoid testing, ensuring scientific rigor, reproducibility, and ethical integrity in investigations of cardiotoxicity, particularly through the utilization of human pluripotent stem cell-derived cardiac organoids.

PURPOSE: The purpose of this study was to identify effects of a maternal-child health education program for nurses in Tigray, Ethiopia. METHODS: One-group pre-posttest design was used. The maternal-child health (MCH) education program was given to nurses from 5 health centers in Tigray, Ethiopia. Knowledge and confidence levels were measured before and after each education session. Data were analyzed using paired t-test. RESULTS: The topics of the 5 educational sessions were family planning, antenatal care, care during labor, immunization, and integrated management of neonate, and child illness. Knowledge scores (1st: Z=3.931, p=.001; 2nd: Z=6.189, p<.001; 3rd: Z=5.658, .001, 4th: Z=8.734, .001, 5th: Z=14.167, .001) and confidence levels (1st: Z=8.467, .001; 2nd: Z=4.183, .001; 3rd: Z=4.992, .001) improved significantly. CONCLUSION: The findings of this study imply that the MCH education program for nurses was effective in developing the maternal-child health capacity of the nurses in Tigray, Ethiopia.
Child ; Education ; Education, Nursing ; Ethiopia* ; Family Planning Services ; Health Education* ; Humans ; Immunization ; Infant, Newborn ; Maternal Health Services

Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.
Brain Neoplasms ; Disease Progression ; Female ; Glioma* ; Headache ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Optic Chiasm ; Radiosurgery ; Third Ventricle

Aortic aneurysms infected by Klebsiella pneumoniae are rarely seen. We describe a 50-year-old man with infected aortic aneurysm that was successfully treated with endovascular aneurysm repair (EVAR). Diagnosis was confirmed using blood culture and computed tomography (CT). Intravenous antibiotics were immediately administered, with improvements in clinical findings and negative blood cultures before the procedure. Twenty-four months after the procedure, the patient was stable and serial CT revealed regression of the infected aortic aneurysm. Therefore, after controlling bacteremia and fever with targeted antibiotic therapy, EVAR can be considered as an alternative for patients who have serious comorbidities and are ineligible for conventional surgery.

Purpose: To determine the multidetector CT (MDCT) findings that differentiate adenomyoma of the ampulla of Vater (AOV) from localized adenocarcinoma of the AOV. Materials and Methods: Sixteen and 30 patients with adenomyoma and localized adenocarcinoma of the AOV, respectively, were evaluated using MDCT. We analyzed the size and attenuation value and presence of uniform enhancement of the lesions, diameters of the extrahepatic bile duct (EHD) and main pancreatic duct, presence of regional lymph node enlargement, and laboratory findings. We determined the independent findings for differentiating adenomyoma from localized adenocarcinoma of the AOV using multivariate analysis. Results: The size of the lesion and diameter of the EHD were significantly smaller for adenomyoma than those for localized adenocarcinoma of the AOV (all p < 0.001). In multivariate analyses, a lesion size of ≤ 1.3 cm, an EHD diameter of ≤ 1.3 cm, and an alanine transaminase level of ≤ 31 IU/L significantly differentiated adenomyoma from localized adenocarcinoma of the AOV. When all of these three findings were met, the specificity for adenomyoma of the AOV was 93.3%. Conclusion MDCT imaging may facilitate the differential diagnosis of adenomyoma and localized adenocarcinoma of the AOV based on the size of the lesion and diameter of the EHD.

Purpose: To determine the multidetector CT (MDCT) findings that differentiate adenomyoma of the ampulla of Vater (AOV) from localized adenocarcinoma of the AOV. Materials and Methods: Sixteen and 30 patients with adenomyoma and localized adenocarcinoma of the AOV, respectively, were evaluated using MDCT. We analyzed the size and attenuation value and presence of uniform enhancement of the lesions, diameters of the extrahepatic bile duct (EHD) and main pancreatic duct, presence of regional lymph node enlargement, and laboratory findings. We determined the independent findings for differentiating adenomyoma from localized adenocarcinoma of the AOV using multivariate analysis. Results: The size of the lesion and diameter of the EHD were significantly smaller for adenomyoma than those for localized adenocarcinoma of the AOV (all p < 0.001). In multivariate analyses, a lesion size of ≤ 1.3 cm, an EHD diameter of ≤ 1.3 cm, and an alanine transaminase level of ≤ 31 IU/L significantly differentiated adenomyoma from localized adenocarcinoma of the AOV. When all of these three findings were met, the specificity for adenomyoma of the AOV was 93.3%. Conclusion MDCT imaging may facilitate the differential diagnosis of adenomyoma and localized adenocarcinoma of the AOV based on the size of the lesion and diameter of the EHD.

Pseudoaneurysm formation in the profunda femoris artery (PFA) is a rare complication of femur shaft fractures or, more usually, a consequence of operative repair. Over the past few years, percutaneous transcatheter arterial embolization (TAE) has increasingly been considered the most effective treatment for pseudoaneurysms of the PFA. We report two cases with pseudoaneurysms of the PFA that were caused by femur shaft fractures and were successfully treated using TAE with n-butyl cyanoacrylate (NBCA). When a pseudoaneurysm of the PFA occurs due to a femur shaft fracture, early recognition and prompt radiologic intervention may prevent severe vascular injury without the need for additional surgery. The advent of TAE using NBCA enables minimally invasive treatment to be undertaken and it is effective for managing pseudoaneurysms of the PFA.

Purpose: To investigate potential differences in the frequency of preterm births (PTB) between pregnancies with or without prophylactic cerclage in women with a history of conization. Materials and Methods: We identified women who had their first singleton delivery after conization between 2013 and 2018 using records in the National Health Insurance Service of Korea claims database. We only included women who had undergone a health examination and interview within 2 years before delivery. We used timing of maternal serum alpha-fetoprotein (MSAFP) tests to differentiate early (before) from late (after the MSAFP test) cerclage. The frequency of adverse pregnancy outcomes, including PTB, preterm labor and premature rupture of membranes, antibiotics and tocolytics use, cesarean delivery, and number of admissions before delivery, were compared. Results: A total of 8322 women was included. Compared to the no cerclage group (n=7147), the risks of adverse pregnancy outcomes were higher in the cerclage group (n=1175). After categorizing patients with cerclage into two groups, the risk of PTB was still higher in the early cerclage group than in the no cerclage group after adjusting for baseline factors (4.48%, 30/669 vs. 2.77%, 159/5749, odds ratio 2.42, 95% confidence interval 1.49, 3.92). Other adverse pregnancy outcomes were also more frequent in the early cerclage group than the no cerclage group. Conclusion Early cerclage performed before MSAFP testing does not prevent PTB in pregnancy with a history of conization, but increases the risk of adverse pregnancy outcomes, including PTB.

A 74-year-old woman presented with a progressive pattern of dysphagia and odynophagia over one month.Magnetic resonance imaging of the neck revealed diffuse swelling from the tongue base and velum extending to the posterior pharyngeal wall. Instrumental evaluation of swallowing showed decreased peristalsis in the esophageal phase, accompanied by severe swelling of the hypopharynx, which limited laryngeal elevation and subsequently led to decreased bolus clearance and impaired airway protection. Laboratory studies revealed a 61% increase in eosinophil count. An endoscopic biopsy of the esophagus confirmed the diagnosis of eosinophilic esophagitis. The patient was administered intravenous dexamethasone at a total dosage of 45 mg/day for 7 days. The eosinophil count dropped to the normal range, correlating with the improvement in dysphagia and aspiration. Eosinophilic esophagitis often presents in children and rarely involves the oropharyngeal structures. Due to its specific involvement of the esophagus, it seldom leads to aspiration. By contrast, the extension of eosinophilic inflammation from the esophagus to the oropharynx in this case resulted in atypical symptoms such as odynophagia and aspiration. The therapeutic approach can be challenging due to the difficulty in administering topical steroids, which are often the treatment of choice. However, the condition showed an excellent response to intravenous steroid therapy.

A 74-year-old woman presented with a progressive pattern of dysphagia and odynophagia over one month.Magnetic resonance imaging of the neck revealed diffuse swelling from the tongue base and velum extending to the posterior pharyngeal wall. Instrumental evaluation of swallowing showed decreased peristalsis in the esophageal phase, accompanied by severe swelling of the hypopharynx, which limited laryngeal elevation and subsequently led to decreased bolus clearance and impaired airway protection. Laboratory studies revealed a 61% increase in eosinophil count. An endoscopic biopsy of the esophagus confirmed the diagnosis of eosinophilic esophagitis. The patient was administered intravenous dexamethasone at a total dosage of 45 mg/day for 7 days. The eosinophil count dropped to the normal range, correlating with the improvement in dysphagia and aspiration. Eosinophilic esophagitis often presents in children and rarely involves the oropharyngeal structures. Due to its specific involvement of the esophagus, it seldom leads to aspiration. By contrast, the extension of eosinophilic inflammation from the esophagus to the oropharynx in this case resulted in atypical symptoms such as odynophagia and aspiration. The therapeutic approach can be challenging due to the difficulty in administering topical steroids, which are often the treatment of choice. However, the condition showed an excellent response to intravenous steroid therapy.