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.

Objectives: Since the enactment of the School Nutrition Act in 1981, school lunch programs in South Korea have grown quantitatively and qualitatively with a current student participation rate of 99.8%. Nonetheless, educational materials are needed to reduce misunderstanding and ignorance about school lunch programs. This study aimed to develop 3 educational videos that help students of various ages (kindergarteners/lower-grade elementary, upper-grade elementary, and secondary school, respectively), understand the school lunch program. Methods: A scenario was created, was made, and the opinions on the scenario from experts in foodservice sectors were collected. A survey was conducted to students and parents to determine topics they wanted to know about school foodservice. The final videos were produced using this information and the expert opinions. The data were analyzed using SPSS 27.0 for Mac (IBM Corp., Armonk, NY, USA); a P-value of < 0.05 was considered significant. Results: Three videos on school foodservice were developed for various age levels of students: kindergarten/lower-grade elementary, upper-grade elementary, and secondary school. Additionally, English subtitles were included for the multicultural student population. These videos, each lasting about 7 minutes, cover topics such as nutrition, hygiene, and the cultural significance of the school lunch program. The survey results showed that parents and students wanted to know the following topics about the school lunch program: “nutritionally balanced diet” (11.9%), “purchasing safe food ingredients” (10.9%), and “healthy eating habits” (9.9%). Conclusions The developed videos will serve as valuable educational resources on school foodservice, foster a deeper understanding of the school lunch program in parents and students, and potentially address their inquiries regarding production processes, nutrition, hygiene, cultural heritage, and health.

Background: By analyzing small bowel capsule endoscopy (SBCE) performed in two large hospitals in Kazakhstan, we aimed to explore the characteristics of patients representative of Central Asia and the technical characteristics of SBCE. Methods: SBCE cases were retrospectively analyzed. A descriptive analysis was conducted on the patients’ demographic data, diagnosis, and clinical symptoms. The results of SBCE, such as the lesions found, transit time and retention rate in the stomach and small bowel, and bowel visualization quality, were analyzed. Complications related to SBCE were investigated. Results: SBCE was performed in 123 patients. Abdominal pain (81.3%) and chronic diarrhea (66.7%) were the most common symptoms, followed by weight loss (25.2%) and gastrointestinal bleeding (15.4%). The most common disease was Crohn’s disease (52.0%). Definite lesions, such as ulcers, polyps, and bleeding, were identified in 55.3% of patients. SBCE was successfully completed in all cases except for 11 (9.1%). The average small bowel transit time was 4 hours and 28 minutes. Excellent visualization (>75% of mucosa) was reported in 82.5% of patients. No patients experienced complications. Conclusions SBCE performed in Kazakhstan showed a high diagnostic yield with high-quality patient selection and no complications.

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.