To develop a novel polyamino acid-based nanohydrogel drug delivery system for dexamethasone to enhance its delivery efficiency to the inner ear.

Objective: To compare the quality of deep learning-reconstructed turbo spin-echo (DL-TSE) and conventionally interpolated turbo spin-echo (Conv-TSE) techniques in contrast-enhanced MRI of the neck. Materials and Methods: Contrast-enhanced T1-weighted DL-TSE and Conv-TSE images were acquired using 3T scanners from 106 patients. DL-TSE employed a closed-source, ‘work-in-progress’ (WIP No. 1062, iTSE, version 10; Siemens Healthineers) algorithm for interpolation and denoising to achieve the same in-plane resolution (axial: 0.26 x 0.26 mm 2 ; coronal: 0.29 x 0.29 mm 2 ) while reducing scan times by 15.9% and 52.6% for axial and coronal scans, respectively. The full width at half maximum (FWHM) and percent signal ghosting were measured using stationary and flow phantom scans, respectively. In patient images, non-uniformity (NU), contrast-to-noise ratio (CNR), and regional mucosal FWHM were evaluated. Two neuroradiologists visually rated the patient images for overall quality, sharpness, regional mucosal conspicuity, artifacts, and lesions using a 5-point Likert scale. Results: FWHM in the stationary phantom scan was consistently sharper in DL-TSE. The percent signal ghosting outside the flow phantom was lower in DL-TSE (0.06% vs. 0.14%) but higher within the phantom (8.92% vs. 1.75%) compared to ConvTSE. In patient scans, DL-TSE showed non-inferior NU and higher CNR. Regional mucosal FWHM was significantly better in DL-TSE, particularly in the oropharynx (coronal: 1.08 ± 0.31 vs. 1.52 ± 0.46 mm) and hypopharynx (coronal: 1.26 ± 0.35 vs. 1.91 ± 0.56 mm) (both P < 0.001). DL-TSE demonstrated higher overall image quality (axial: 4.61 ± 0.49 vs. 3.32 ± 0.54) and sharpness (axial: 4.40 ± 0.56 vs. 3.11 ± 0.53) (both P < 0.001). In addition, mucosal conspicuity was improved, especially in the oropharynx (axial: 4.41 ± 0.67 vs. 3.40 ± 0.69) and hypopharynx (axial: 4.45 ± 0.58 vs. 3.58 ± 0.63) (both P < 0.001).Extracorporeal ghost artifacts were reduced in DL-TSE (axial: 4.32 ± 0.60 vs. 3.90 ± 0.71, P < 0.001) but artifacts overlapping anatomical structures were slightly more pronounced (axial: 3.78 ± 0.74 vs. 3.95 ± 0.72, P < 0.001). Lesions were detected with higher confidence in DL-TSE. Conclusion DL-based reconstruction applied to accelerated neck MRI improves overall image quality, sharpness, mucosal conspicuity in motion-prone regions, and lesion detection confidence. Despite more pronounced ghost artifacts overlapping anatomical structures, DL-TSE enables substantial scan time reduction while enhancing diagnostic performance.

Hysteroscopy is particularly valuable for the diagnosis of uterine cavity abnormalities through direct visualization. The development of office hysteroscopy has expanded the range of diagnostic and surgical procedures available. These detailed guidelines include patient counseling and the selection and setting of office hysteroscopy, including room, equipment, and medical staff. Analgesia or local anesthesia is often required in selective office hysteroscopy cases. Cervical dilation and preparation using medical or mechanical methods are required for most diagnostic hysteroscopic procedures. Methods for optimizing visualization and choosing suitable distension media are important for a successful office hysteroscopy. It is crucial to adhere to guidelines to prevent complications, such as vasovagal syncope, cervical trauma, uterine perforation, fluid overload, and embolism. Vaginoscopy can be a good alternative option for alleviating pain, especially in cases where the insertion of a vaginal speculum is expected to be challenging.

Cancer immunotherapy is widely used to treat various cancers to augment the weakened host immune response against tumors. Dendritic cells (DCs) are specialized antigen-presenting cells that play dual roles in inducing innate and adaptive immunity. Toxoplasma gondii is a protozoan parasite that exhibits anti-tumor activity against certain types of cancers. However, little is known about the anti-tumor effects of T. gondii or tumor/parasite antigen-pulsed DCs (DC vaccines, DCV) in breast cancer. In this study, C57BL/6 mice were administered E0771 mouse breast cancer cells (Cancer-injected) subcutaneously, T. gondii Me49 cysts orally (TG-injected), or DCs pulsed with breast cancer cell lysate antigen and T. gondii lysate antigens (DCV-injected) intraperitoneally. Tumor size and immunological characteristics were subsequently evaluated. We also evaluated matrix metalloproteinase (MMP)-2 and MMP-9 levels in E0771 mouse breast cancer cells co-cultured with T. gondii or DCs by RT-PCR. The tumor volumes of mice injected with breast cancer cells and antigen-pulsed DCs (Cancer/DCV-injected mice) were similar to those of Cancer-injected mice; however, they were significantly reduced in T. gondii-infected tumor-bearing (TG/Cancer-injected) mice. Moreover, tumor volumes were significantly reduced by adding antigen-pulsed DCs (TG/Cancer/DCV-injected mice) compared to TG/Cancer-injected mice. The levels of IFN-γ, serum IgG2a levels, and CD8+ T cell populations were significantly higher in DCV- and TG-injected mice than in control mice, while no significant differences between Cancer- and Cancer/DCV-injected mice were observed. The levels of IFN-γ, the IgG2a levels, and the percentage of CD8+ T cells were significantly increased in TG/Cancer- and TG/Cancer/DCV-injected mice than in Cancer-injected mice. IFN-γ levels and serum IgG2a levels were further increased in TG/Cancer/DCV-injected mice than in TG/Cancer-injected mice. The MMP-2 and MMP-9 mRNA expressions were significantly decreased in mouse breast cancer cells co-cultured with live T. gondii, T. gondii lysate antigen, or antigen-pulsed DCs (DCV) but not in inactivated DCs. These results indicate that T. gondii induces anti-tumor effects in breast cancer-bearing mice through the induction of strong Th1 immune responses, but not in antigen-pulsed DCs alone. The addition of antigen-pulsed DCs further augments the anti-tumor effects of T. gondii.

Purpose: It is important for emergency physicians to be able to evaluate and manage pediatric respiratory distress, which is rare in general emergency departments. Despite this importance, the emergency departments show inconsistency in pediatric readiness, while emergency medicine (EM) residents express discomfort in caring for critically ill children due to limited exposure during their residency training. The purpose of this study was to meet this educational need by developing and implementing a curriculum to prepare EM residents to provide safe care for pediatric respiratory distress. Methods: We prospectively assessed 20 senior EM residents after undergoing a 3-hour simulation-based curriculum at Indiana University School of Medicine. The curriculum was developed using the Kern’s methodology by content experts. Pre- and post-curriculum confidence, knowledge, competency, and situational awareness were assessed using the 5-point Likert scale, multiple-choice questions, checklists of a pediatric acute respiratory distress scenario, and a novel modified video version of the situational awareness global assessment technique, respectively. Results: From the pre- to post-intervention phases, the confidence improved from 3.2 ± 0.4 to 3.9 ± 0.2 on the Likert scale (P < 0.001). The knowledge improved from 50.3% ± 12.9% to 75.3% ± 10.6% on the multiple-choice questions (P < 0.001). The competency improved from 46.8% ± 16.0% to 73.6% ± 10.6% (P < 0.001) with significant improvements in 7 of the 14 checklist items. The situational awareness raised both data perception (P < 0.001) and comprehension (P = 0.004) with no significant improvements in data extrapolation (P = 0.120). Conclusion Preliminary findings suggest that a 3-hour simulation-based curriculum for EM residents, including implementation of a novel situational awareness assessment tool, can improve learner’s confidence, knowledge, competency, and situational awareness of pediatric respiratory distress.

The increasing incidence of dyslipidemia among children and adolescents has emerged as a significant public health concern due to its associated risk of long-term cardiovascular complications. The prevalence of dyslipidemia has increased in parallel with rising obesity rates, highlighting the importance of early intervention. In this narrative review, we explore the epidemiology, screening, diagnosis, and treatment of dyslipidemia in pediatric populations, focusing on recent advancements and updates in clinical management. Key diagnostic criteria and risk assessment strategies are discussed, emphasizing the role of lipid profile screening in high-risk groups. Lifestyle and dietary interventions are key for managing dyslipidemia, while pharmacological treatments including statins, cholesterol absorption inhibitors, and emerging therapies are reviewed in cases requiring further intervention. Updated guidelines and evidence-based recommendations from Korean and other international institutions are consolidated to provide a comprehensive overview. These findings underscore the necessity of a multidisciplinary approach combining early detection, tailored treatment, and lifestyle modifications to mitigate the long-term health risks associated with dyslipidemia in younger individuals.

Recent advancements in tuberculosis treatment research emphasize innovative strategies that enhance treatment efficacy, reduce adverse effects, and adhere to patient-centered care principles. As tuberculosis remains a significant global health challenge, integrating new and repurposed drugs presents promising avenues for more effective management, particularly against drug-resistant strains. Recently, the spectrum concept in tuberculosis infection and disease has emerged, underscoring the need for research aimed at developing treatment plans specific to each stage of the disease. The application of precision medicine to tailor treatments to individual patient profiles is crucial for addressing the diverse and complex nature of tuberculosis infections. Such personalized approaches are essential for optimizing therapeutic outcomes and improving patient adherence—both of which are vital for global tuberculosis eradication efforts. The role of tuberculosis cohort studies is also emphasized, as they provide critical data to support the development of these tailored treatment plans and deepen our understanding of disease progression and treatment response. To advance these innovations, a robust tuberculosis policy framework is required to foster the integration of research findings into practice, ensuring that treatment innovations are effectively translated into improved health outcomes worldwide.

Lung cancer remains a leading cause of cancer-related mortality worldwide. Low-dose computed tomography (LDCT) screening has demonstrated efficacy in reducing lung cancer mortality by enabling early detection. In several countries, including Korea, LDCT-based screening for high-risk populations has been incorporated into national healthcare policies. However, in regions with a high tuberculosis (TB) burden, the effectiveness of LDCT screening for lung cancer may be influenced by TB-related pulmonary changes. Studies indicate that the screen-positive rate in TB-endemic areas differs from that in low-TB prevalence regions. A critical challenge is the differentiation between lung cancer lesions and TB-related abnormalities, which can contribute to false-positive findings and increase the likelihood of unnecessary invasive procedures. Additionally, structural lung damage from prior TB infections can alter LDCT interpretation, potentially reducing diagnostic accuracy. Nontuberculous mycobacterial infections further complicate this issue, as their radiologic features frequently overlap with those of TB and lung cancer, necessitating additional microbiologic confirmation. Future research incorporating artificial intelligence and biomarkers may enhance diagnostic precision and facilitate a more personalized approach to lung cancer screening in TB-endemic settings.