Secondary rhabdoid tumors (RTs) with atypical teratoid/rhabdoid tumor-like features rarely arise from, or coexist with, pleomorphic xanthoastrocytomas (PXAs), and their clinicopathological and molecular characteristics remain poorly understood. We report a 17-year-old girl with a temporal lobe mass that, upon gross total resection, pathologically contained both RT and PXA components. Immunohistochemistry revealed loss of INI1 expression restricted to the RT component, while the PXA area retained INI1. Next-generation sequencing identified a shared BRAF::TRIM24 fusion and homozygous deletion of CDKN2A/2B in both components, indicating a shared clonal origin. Additionally, a germline ATM frameshift mutation (c.5288_5289insGA) was identified in both tumor components, making the first such report in central nervous system tumors. SMARCB1 loss was confined to the RT component, further supporting the hypotheses of clonal evolution and secondary transformation. Despite gross total resection, craniospinal irradiation, and chemotherapy, the patient developed rapid leptomeningeal dissemination and died 5 months after surgery. This case provides clinicopathological and molecular evidence for clonal evolution and secondary transformation of PXA into an RT. The presence of germline ATM mutation may have therapeutic and biological relevance. Further studies are required to clarify the pathogenesis and optimal management of these rare and aggressive tumors.

Background: Early recognition and prompt intramuscular epinephrine administration are critical for the treatment of anaphylaxis. The special emergency medical service team (SEMST) is a reorganization plan that incorporates first-level emergency medical technicians (EMTs) and nurses from Korea to give the authority to administer epinephrine. This study evaluates the experience of SEMST and aims to investigate further needs in the pre-hospital management of anaphylaxis. Methods: An online survey of 29 questions on the Gangwon-do 119 EMST was conducted.IBM SPSS Statistics ver. 20.0 (IBM Co., Armonk, NY, USA) and R ver.4.0.3. were used for statistical analysis. Results: A total of 428 (44.6%) participants responded to the questionnaire, and 55.6% (238/428) experienced anaphylaxis. The common presumed cause was insect sting/animal bites at 84.5% (201/238), followed by food (7.6%, 18/238), and drugs (6.3%, 15/238). The frequency of occurrence was highest for tourist attractions (58.6%, 167/285), followed by homes (31.9%, 91/285) and workplace (3.5%, 10/285). Among 136 medical personnel (31.8%) who were currently active or had been active as the SEMST, 95 (70.0%) experienced anaphylaxis, and 58 (61.1%) used epinephrine, which was significantly lower in the nonSEMST group (n = 36, 25.2%). The biggest difficulty in pre-hospital treatment was the limitation of drug administration authority (23.4%, 22/95). The lack of experience and tricky treatment are the chief difficulties in pediatric anaphylaxis. The percentage of correct answers regarding anaphylaxis awareness was significantly higher in the educated (n = 374) than in the non-educated group (n = 54), both for diagnosis (24.9% vs. 11.1%) and treatment (73.5% vs. 37.0%). Conclusion Proper administration of epinephrine is particularly important for pre-hospital anaphylaxis management in rural areas. Expanding SEMST and conducting periodic education using virtual experiences is necessary.

PURPOSE: To investigate the effect of coating material in RF coil, which is one of main parts in MRI machine, on the Q-factor and SNR(signal-to-noise ratio) in MR images. MATERIALS AND METHODS: RF coils with inner diameter of 1.7 mm were made by using copper wires coated with polyester, polyurethane, polyimide, polyamideimide, and polyester-imide, and by using copper wires in which coating materials had been removed. Q-factors of the RF coils were measured by network analyzer, and SNR values in the spin-echo MR images obtained by 600 MHz (14.1 T, Bruker DMX600) micro-imaging system for the coated and uncoated cases. RESULTS: The measured SNRs were almost same for the RF coils with coat-removed copper wires, however SNRs and Q-factors were different for the coated cases depending on the coating material. They were maximized in the polyurethane-coated case in which the SNR was >30% greater than polyester-coated case. CONCLUSION: We made solenoid-type RF coils which were easily used for MR micro-imaging in Bruker MRI probe. There was a significant coating-material dependence in the measured Q values and SNRs for the home-made RF coils. The study demonstrated that the choice of coating material of RF coil may be a critical factor in the MRI sensitivity based on SNR value.
Copper ; Polyesters ; Polyurethanes ; Signal-To-Noise Ratio