Objective: Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up. Methods: A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point. Results: Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010). Conclusion This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.

Objective: Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up. Methods: A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point. Results: Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010). Conclusion This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.

Objective: Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up. Methods: A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point. Results: Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010). Conclusion This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.

Objective: Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up. Methods: A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point. Results: Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010). Conclusion This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.

Objective: Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up. Methods: A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point. Results: Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010). Conclusion This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.

Objectives: Skin cancer is a prevalent type of malignancy, necessitating efficient diagnostic tools. This study aimed to develop an automated skin lesion classification model using the dynamically expandable representation (DER) incremental learning algorithm. This algorithm adapts to new data and expands its classification capabilities, with the goal of creating a scalable and efficient system for diagnosing skin cancer. Methods: The DER model with incremental learning was applied to the HAM10000 and ISIC 2019 datasets. Validation involved two steps: initially, training and evaluating the HAM10000 dataset against a fixed ResNet-50; subsequently, performing external validation of the trained model using the ISIC 2019 dataset. The model’s performance was assessed using precision, recall, the F1-score, and area under the precision-recall curve. Results: The developed skin lesion classification model demonstrated high accuracy and reliability across various types of skin lesions, achieving a weighted-average precision, recall, and F1-score of 0.918, 0.808, and 0.847, respectively. The model’s discrimination performance was reflected in an average area under the curve (AUC) value of 0.943. Further external validation with the ISIC 2019 dataset confirmed the model’s effectiveness, as shown by an AUC of 0.911. Conclusions This study presents an optimized skin lesion classification model based on the DER algorithm, which shows high performance in disease classification with the potential to expand its classification range. The model demonstrated robust results in external validation, indicating its adaptability to new disease classes.

Objective: : Spinal intramedullary hemangioblastoma is a rare and highly vascularized benign tumor. The characteristics of the tumor, its corresponding location, and surgical outcomes remain unknown. The purpose of this study was to identify risk factors and strategies for neurologic deterioration following hemangioblastoma surgery. Methods: : A comprehensive retrospective analysis was undertaken to evaluate patients who underwent surgical intervention for intramedullary hemangioblastoma at our institution from 1993 to 2022. Patients with at least 1 year of follow-up data were included. The analysis covered patient demographics, pre- and post-operative modified McCormick scale (MMCS), tumor location, and tumor size. Results: : This study included 25 cases. One-year after surgery, neurological deterioration was observed in five cases (20.0%), and neurological improvement was found in nine cases (36.0%). Five cases were ventrally located, and twelve cases were dorsally located. Ventrally located cases were larger in tumor axial size (p=0.029) than dorsal location tumors, resulting in poorer follow-up MMCS and a higher prevalence of von Hippel-Lindau syndrome (VHL) (p=0.042). Three of them were confirmed to be supplied by the anterior spinal artery. In the case of dorsally located cases, there was no neurologic deterioration. Conclusion : In intramedullary spinal cord hemangioblastomas, cases located ventrally had a higher incidence of neurological deterioration following surgery than those located dorsally or in intramedullary extramedullary cases. Ventrally located hemangioblastomas were larger than those in other locations. They were mainly supplied by the anterior spinal artery in VHL patients.

Isolated spinal artery aneurysms are rare vascular lesions of the spinal cord. Due to their rarity, the natural disease course and treatment guidelines have not been clearly defined. Here, we report a case of an angiography-negative isolated spinal aneurysm in the thoracic spine surgically that was treated without neurological compromise using indocyanine green (ICG) and intraoperative neurophysiological monitoring (IONM). A 52-year-old man without any prior medical history presented to the emergency room with acute lower back and bilateral leg pain accompanied by worsening voiding and difficulty defecating. Magnetic resonance imaging (MRI) of the lumbar spine showed a diffuse subarachnoid hemorrhage in the lumbar spine. The patient was initially treated conservatively with painkillers, but experienced a rapid recurrence of symptoms. A follow-up MRI scan showed subacute transformation and expansion of the subarachnoid hematoma, as well as a non-enhancing, intradural, extramedullary lesion at the T12/L1 level. Angiography did not show any remarkable findings, and surgical exploration revealed a thrombosed aneurysmal lesion. The lesion did not show ICG uptake, and temporary clipping of the caudal end of the lesion did not lead to changes in motor-evoked potential signals. A pathological examination revealed a capillary vascular structure in granulation tissue with organizing thrombi, favoring a thrombosed, granulated lesion over a vascular neoplasm. Ruptured, isolated spinal aneurysms can be especially difficult to diagnose and treat when angiography findings are negative. We report that a spinal artery aneurysm can be safely excised using intraoperative ICG and IONM.

Objective: Multilevel posterior cervical fusion (PCF) and decompression surgery is a viable treatment option for multilevel ossification of posterior longitudinal ligament (OPLL) and spondylotic myelopathy. Since OPLL is known to affect bone formation, this study aimed to examine the effect of OPLL on the incidence of pseudarthrosis following PCF in a cohort study. Methods: We conducted a retrospective cohort study of patients with PCF and laminectomy at our institution. This study included patients who underwent C3 to C6 posterior fusion surgery involving lateral mass screw fixation without anterior surgery for OPLL or spondylotic myelopathy. Fusion status was evaluated 1 year postoperatively with computed tomography. Bone mineral density (BMD) and sagittal parameters were also evaluated as potential contributing factors to the fusion rate. Results: Eighty patients were included. Pseudarthrosis was observed in 22.5% (n=18) of patients. Pseudarthrosis incidence was lower in patients with OPLL (spondylosis vs. OPLL, 33.3% vs. 12.2%; p=0.003), and a higher BMD T-score (pseudarthrosis vs. fusion, -1.9 ± 0.7 vs. -0.6 ± 1.3; p<0.01), a larger preoperative range of motion (ROM) (26.7 ± 13.3 vs. 17.6 ± 10.9; p=0.01), and a greater preoperative-to-postoperative decrease in cervical lordosis (-8.1 ± 7.9 vs. -2.7 ± 7.9; p<0.01). Pseudarthrosis was associated with worsening neck pain after surgery. Conclusion The absence of OPLL, lower BMD, larger preoperative ROM, and a greater decrease in postoperative cervical lordosis were identified as risk factors for pseudarthrosis after multiple PCF.

Objective: Spinal stenosis is a prevalent condition; however, the optimal surgical treatment for central lumbar stenosis remains controversial. This study compared the clinical outcomes and radiological parameters of 3 surgical methods: unilateral laminectomy bilateral decompression with unilateral biportal endoscopy (ULBD-UBE), conventional subtotal laminectomy (STL), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Methods: This retrospective study included 86 patients, divided into ULBD-UBE (n=34), STL (n=24), and MIS-TLIF (n=28) groups. We evaluated demographics and perioperative factors and assessed clinical outcomes using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and neurogenic intermittent claudication (NIC). Radiological parameters assessed included lumbar lordosis, L4S1 Cobb angle (L4S1), T12S1 Cobb angle (T12S1), increased cross-sectional dural area (CSA), dynamic angulation (DA), dynamic slip (DS), and development of postoperative instability. Results: The ULBD-UBE group showed a significantly shorter hospital stay duration and operation time and reduced blood loss than the other groups (p<0.001). ULBD-UBE group showed a trend towards greater VAS and ODI improvement at 1 month and postoperative NIC symptom relief. Radiologically, MIS-TLIF group exhibited lower postoperative DA and DS (p<0.001), indicating higher postoperative stability. Postoperative instability was lower in the ULBD-UBE group (2.9%) than in the STL group (16.7%) and similar to the MIS-TLIF group (0.0%) (p=0.028). The CSA was highest in the MIS-TLIF group (295.5%) compared to that in the other groups (ULBD-UBE, 216.3%; STL, 245.2%) (p<0.001). Conclusion Compared to other procedures, ULBD-UBE is a safe, effective, and viable surgical procedure for treating lumbar central stenosis.