Postmastectomy radiation therapy (PMRT) can compromise soft-tissue quality and cause progressive fibrosis and contracture, thereby complicating delayed breast reconstruction even after prior implant removal. Delayed reconstruction is particularly challenging when radiation-associated distortion of the breast and nipple-areola complex (NAC) coexists with contralateral ptosis, because achieving symmetry requires coordinated restoration of both breast contour and nipple position. We report the case of a 50-year-old woman with invasive ductal carcinoma of the right breast who underwent nipple-sparing mastectomy followed by immediate tissue expander reconstruction with acellular dermal matrix. During adjuvant chemotherapy, she developed a periprosthetic infection that necessitated expander removal and capsulectomy. She subsequently completed PMRT, after which progressive breast contracture and severe NAC distortion developed. Ten months after completion of PMRT, delayed breast reconstruction was performed using a muscle-sparing free transverse rectus abdominis myocutaneous flap, with excision of compromised mastectomy skin, simultaneous free NAC grafting onto the flap skin paddle, and contralateral mastopexy to improve symmetry. The postoperative course was uneventful, and breast symmetry improved relative to the preoperative condition. This case illustrates a practical reconstructive option for managing severe NAC distortion in an irradiated, contracted breast after prosthetic failure.

Postoperative epistaxis is the most common complication after endoscopic sinus surgery (ESS) and septoplasty; however, it is usually immediate and self-limited. Delayed, severe hemorrhage is rare and should prompt evaluation for systemic causes. We report a rare case of acute immune thrombocytopenia (ITP) presenting as delayed, severe epistaxis after routine nasal surgery. A 46-year-old man with no history of bleeding disorders and normal coagulation profiles and platelet counts underwent ESS and revision septoplasty. On postoperative day 5, he presented with massive epistaxis and hypovolemic shock. Laboratory evaluation demonstrated severe isolated thrombocytopenia, with a platelet count of 5×103/μL. He was treated successfully with intravenous immunoglobulin and high-dose corticosteroids, which resulted in platelet recovery and cessation of bleeding. Although uncommon, surgical stress may act as a precipitating trigger for ITP, and this diagnosis should be included in the differential diagnosis of delayed, massive postoperative hemorrhage after routine nasal surgery.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Cervicofacial necrotizing fasciitis (CNF) of the face is a rare and potentially life-threatening bacterial infection that requires immediate intervention. CNF involving the buccal fat pad particularly demands surgical drainage, with attention to the surrounding anatomical structures to prevent vascular or nerve damage. In this study, we reviewed the anatomy of buccal fat pads to suggest appropriate surgical approaches. A retrospective chart review was conducted on seven patients with CNF who had a buccal fat pad abscess requiring surgical incision and drainage between January 2022 and August 2023. Abscesses within the central buccal fat pad and its pterygoid extensions were drained via intraoral incisions. Abscesses in the temporal extension were addressed by the Dingman approach. All patients underwent our surgical drainage regimen combined with proper intravenous antibiotics, leading to successful treatment of CNF without significant functional sequelae, with an average stay of 18.71 days. The buccal fat pad, which corresponds to the deep space of the face, is surrounded by vital structures such as the facial artery, vein, nerve, and parotid duct. When treating abscesses in the buccal fat pad, it is important to understand the relationship of the fat pad to other vital structures for optimal outcomes.

Cancer cells, which divide indefinitely and without control, are frequently exposed to various stress factors but manage to adapt and survive. The mechanisms by which cancer cells maintain cellular homeostasis and exploit stress conditions are not yet clear. Here, we elucidate the roles of diverse cellular metabolism and its regulatory mechanisms, highlighting the essential role of metabolism in cellular composition and signal transduction. Cells respond to various stresses, including DNA damage, energy stress, and oxidative stress, thereby causing metabolic alteration. We provide profound insight into the adaptive mechanisms employed by cancer cells to ensure their survival among internal and external stressors through a comprehensive analysis of the correlation between metabolic alterations and cellular stress. Furthermore, this research establishes a robust framework for the development of innovative therapeutic strategies that specifically target the cellular adaptations of cancer cells.

Anosmia, characterized by the loss of smell, is associated not only with dysfunction in the peripheral olfactory system but also with changes in several brain regions involved in olfactory processing. Specifically, the orbitofrontal cortex is recognized for its pivotal role in integrating olfactory information, engaging in bidirectional communication with the primary olfactory regions, including the olfactory cortex, amygdala, and entorhinal cortex. However, little is known about alterations in structural connections among these brain regions in patients with anosmia. In this study, highresolution T1-weighted images were obtained from participants. Utilizing the volumes of key brain regions implicated in olfactory function, we employed a structural covariance approach to investigate brain reorganization patterns in patients with anosmia (n=22) compared to healthy individuals (n=30). Our structural covariance analysis demonstrated diminished connectivity between the amygdala and entorhinal cortex, components of the primary olfactory network, in patients with anosmia compared to healthy individuals (z=-2.22, FDR-corrected p=0.039). Conversely, connectivity between the orbitofrontal cortex—a major region in the extended olfactory network—and amygdala was found to be enhanced in the anosmia group compared to healthy individuals (z=2.32, FDR-corrected p=0.039). However, the structural connections between the orbitofrontal cortex and entorhinal cortex did not differ significantly between the groups (z=0.04, FDR-corrected p=0.968). These findings suggest a potential structural reorganization, particularly of higher-order cortical regions, possibly as a compensatory effort to interpret the limited olfactory information available in individuals with olfactory loss.

Cognitive dysfunction, a significant complication of type 2 diabetes mellitus (T2DM), can potentially manifest even from the early stages of the disease. Despite evidence of global brain atrophy and related cognitive dysfunction in early-stage T2DM patients, specific regions vulnerable to these changes have not yet been identified. The study enrolled patients with T2DM of less than five years’ duration and without chronic complications (T2DM group, n=100) and demographically similar healthy controls (control group, n=50). High-resolution T1-weighted magnetic resonance imaging data were subjected to independent component analysis to identify structurally significant components indicative of morphometric networks. Within these networks, the groups’ gray matter volumes were compared, and distinctions in memory performance were assessed. In the T2DM group, the relationship between changes in gray matter volume within these networks and declines in memory performance was examined. Among the identified morphometric networks, the T2DM group exhibited reduced gray matter volumes in both the precuneus (Bonferronicorrected p=0.003) and insular-opercular (Bonferroni-corrected p=0.024) networks relative to the control group. Patients with T2DM demonstrated significantly lower memory performance than the control group (p=0.001). In the T2DM group, reductions in gray matter volume in both the precuneus (r=0.316, p=0.001) and insular-opercular (r=0.199, p=0.047) networks were correlated with diminished memory performance. Our findings indicate that structural alterations in the precuneus and insular-opercular networks, along with memory dysfunction, can manifest within the first 5 years following a diagnosis of T2DM.