Purpose: This study aimed to report a series of cases of cytomegalovirus retinitis reactivation in immunocompromised patients, focusing on the characteristic clinical and laboratory findings associated with reactivation.Case summary: We retrospectively reviewed the medical records of patients diagnosed with cytomegalovirus retinitis at our clinic between January 2012 and November 2023. We analyzed ophthalmologic clinical findings and diagnostic test results, including quantitative cytomegalovirus polymerase chain reaction (CMV PCR). Reactivation was defined as the resolution or stabilization of the overall lesions on fundus examination, followed by the identification of new retinitis or vitreitis findings. The analysis excluded patients with cytomegalovirus retinitis resistant to ganciclovir or foscarnet. Among 24 patients (34 eyes) treated for cytomegalovirus retinitis, four showed reactivation, and the remaining 20 patients showed improvement with initial treatment. Recurrence occurred at an average of 24.8 days (18–35) after discontinuation of ganciclovir maintenance treatment, and in all cases, new lesions were discovered at the border of existing lesions. The CMV PCR test value tended to increase an average of 8 days (4–14) before recurrence was observed on fundus examination, and declined absolute neutrophil count preceded the increase in CMV PCR by an average of 12.8 days (6–26). Conclusions Monitoring quantitative CMV PCR tests in immunocompromised patients with cytomegalovirus retinitis could be helpful in predicting reactivation.

Purpose: Developmentally regulated GTP-binding protein 2 (DRG2) regulates microtubule dynamics and G2/M arrest during docetaxel treatment. Poly ADP-ribose polymerase (PARP) acts as an important repair system for DNA damage caused by docetaxel treatment. This study investigated whether DRG2 expression affects response to PARP inhibitors (olaparib) using prostate cancer cell lines PC3, DU145, LNCaP-FGC, and LNCaP-LN3. Materials and Methods: The cell viability and DRG2 expression levels were assessed using colorimetric-based cell viability assay and western blot. Cells were transfected with DRG2 siRNA, and pcDNA6/V5-DRG2 was used to overexpress DRG2. Flow cytometry was applied for cell cycle assay and apoptosis analysis using the Annexing V cell death assay. Results: The expression of DRG2 was highest in LNCaP-LN3 and lowest in DU145 cells. Expressions of p53 in PC3, DU145, and the two LNCaP cell lines were null-type, high-expression, and medium-expression, respectively. In PC3 (DRG2 high, p53 null) cells, docetaxel increased G2/M arrest without apoptosis; however, subsequent treatment with olaparib promoted apoptosis. In DU145 and LNCaP-FGC (DRG2 low), docetaxel increased sub-G1 but not G2/M arrest and induced apoptosis, whereas olaparib had no additional effect. In LNCaP-LN3 (DRG2 high, p53 wild-type), docetaxel increased sub-G1 and G2/M arrest, furthermore olaparib enhanced cell death. Docetaxel and olaparib combination treatment had a slight effect on DRG2 knockdown PC3, but increased apoptosis in DRG2-overexpressed DU145 cells. Conclusions DRG2 and p53 expressions play an important role in prostate cancer cell lines treated with docetaxel, and DRG2 levels can predict the response to PARP inhibitors.

Infectious mononucleosis is caused by the Epstein-Barr virus (EBV) and may rarely result in neurological complications. Here, we report a case of brachial neuritis following EBV-induced infectious mononucleosis. A 28-year-old female presented with a sore throat and mild fever and was diagnosed with infectious mononucleosis. At that time, she also experienced bilateral shoulder pain and muscle weakness, for which she received intravenous steroid pulse therapy followed by oral steroids. Despite treatment, she continued to exhibit persistent muscle weakness. An electrodiagnostic study later revealed axonal neuropathy with signs of regeneration in both the axillary and suprascapular nerves, consistent with brachial neuritis. The patient was instructed in exercises to strengthen her shoulder muscles and maintain joint range of motion during outpatient visits, leading to an improvement in her symptoms.

Xerostomia or dry mouth is commonly associated with medications, head and neck radiation therapy, and Sjögren’s syndrome. Studies report that it predominantly affects older adults and females; however, there is limited research focusing on the atypical and lowrisk groups. This report presents a case of xerostomia in a 35-year-old male following a mandibular fracture (MF). Initial self-care attempts were insufficient, necessitating pharmacological intervention with pilocarpine, which improved both the salivary function and symptoms. This case highlights MF as a rare yet plausible cause of xerostomia, mediated by trauma-induced neural and physiological disruptions. The potential mechanisms include cranial nerve injury, autonomic dysfunction, psychological stress, and the effects of trauma-related medications. These findings emphasize the need to consider xerostomia in nontraditional populations, particularly in those with facial trauma, and call for further research to elucidate its underlying mechanisms and guide effective management strategies.

Background: This study focuses on the development of a hydrogel wound patch incorporating natural extracts, designed to function as a sun patch. By maintaining a moist environment and delivering bioactive compounds, the patch promotes wound healing while also providing cooling and ultraviolet (UV) protection. This dual-purpose approach enhances skin recovery and shields damaged areas from external stressors. The study aims to optimize the formulation and evaluate its efficacy for both therapeutic and cosmetic applications. Methods: Hydrogel solutions prepared using acrylamide, glycerol, and carboxymethyl cellulose were enriched with extracts from Saururus chinensis, Styrax japonicus, and Centella asiatica. The enriched solutions were processed into patches and tested for their adhesion, cooling effects, and UV protective abilities. Additionally, the wound healing efficacy was evaluated in a mouse model. Results: The hydrogel patches demonstrated comparable adhesion properties, effective skin cooling, and high UV protection rates similar to those of commercially available products. In the mouse model, the patches significantly improved wound closure and tissue regeneration in the experimental group as compared to the control group. Conclusion The study confirms that hydrogel sun patches enriched with natural extracts have the ability to effectively promote wound healing and offer substantial UV protection and cooling benefits, demonstrating their potential medical and cosmetic applications.

This paper explored the intersection of contemporary psychoanalytic theory and quantum psychology, offering a novel reinterpretation of Franz Kafka’s ‘The Metamorphosis’ through the lens of quantum-psychoanalytic concepts. By integrating Wilfred Bion’s Grid and Alpha Function with principles of quantum mechanics, this study delved into complex psychological dynamics at play within the protagonist, Gregor Samsa. Transformation of Gregor into a giant insect was reinterpreted not merely as a manifestation of his repressed emotions, but as a failure of psychic transformation within Bion’s framework, where unprocessed beta elements resulted in a catastrophic physical metamorphosis. Additionally, the observer effect was applied to analyze multifacetedpsychological interactions between Gregor and his family members, highlighting how observation and perception could influencepsychological states. This interdisciplinary approach not only provides deeper insight into psychological underpinnings of Kafka’s narrative, but also demonstrates the potential for psychoanalytic theory and quantum psychology to mutually inform and enrich each other in the analysis of literary texts.

Background: Infantile hemangioma (IH) is a common benign vascular tumor that occurs during infancy. Oral propranolol is used as a first-line treatment. However, standardized guidelines for evaluating treatment efficacy, particularly the appropriate timing and parameters for Doppler ultrasound (US), have not been established. This study reports on the evaluation of therapeutic efficacy of oral propranolol solution in IH patients using Doppler US, and aims to propose the appropriate timing and parameters for using Doppler US based on this experience. Methods: A retrospective analysis was conducted on 120 patients with IH who were treated with oral propranolol solution and maintained for over 6 months from May 2017 to April 2023. Doppler US evaluation of IH was performed at diagnosis, 1-2 and 6-12 months after treatment initiation, and 6 months post-therapy cessation. A complete response (CR) was identified as a reduction in vascularity along with a decrease in longest diameter (LD) or thickness of 50% or more. Recurrence was evaluated based on increased vascularity or size 6 months after treatment discontinuation. Results: Of 120 patients with IH, 82 females and 38 males were analyzed. IH was first detected at a median age of 12 days (range, 1-240 days), and treatment began at 76 days (range, 27-570 days), continuing for an average of 10.4 months (range, 5-24 months). Initial Doppler US measurements showed an LD of 2.65±1.52 cm and a thickness of 0.79±0.55 cm, with prominent vascularity. After 1-2 months of treatment, LD and thickness decreased by 12.9% and 25.9%, respectively. By 6-12 months, reductions reached 37.2% and 53.6%. CR occurred in 77 patients (64.2%) after 6-12 months of treatment. Eleven patients (9.2%) experienced a recurrence. Conclusion Doppler US is a valuable modality for evaluating the characteristics, treatment response, and recurrence of IH treated with oral propranolol.

Objective: This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD). Methods: Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted. Results: Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education. Conclusion The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.

Background: This study aimed to compare the intraoperative stability and early clinical outcomes of 40-mm diameter dual mobility (DM)-total hip arthroplasty (THA) with 36-mm ceramic head (large head) THA in active elderly patients with hip fractures. Methods: A prospective randomized controlled trial was conducted from May 2022 to December 2022. Inclusion criteria were as follows: age ≥ 60 years, displaced femoral neck fracture, Koval grade 1 or 2, planned 54-mm acetabular component, and over 1-year follow-up. Intraoperative stability tests were performed on all patients (internal rotation at 45°, 60°, and 90° of hip fracture). Functional outcomes (Harris Hip Score and University of California, Los Angeles [UCLA] Score) were evaluated at 6 weeks and 3 months postoperatively. Gait analysis using artificial intelligence (AI) techniques was conducted at 3 months postoperatively. Results: The study included 36 DM-THA patients (mean age, 69.6 ± 2.2 years; 44% women) and 37 large head THA patients (mean age, 69.6 ± 1.2 years; 64% women). No statistically significant differences were observed in functional outcomes and hip range of motion between the 2 groups. However, there was a significant difference in the gait speed and stance-swing phase of the large head THA group and the DM-THA group: the DM-THA group demonstrated superior gait speed (2.85 ± 0.83 kph vs. 2.04 ± 1.04 kph, p = 0.003) and higher stance phase ratios (operated side: 63.57% ± 3.82% vs. 48.19% ± 5.50%, p < 0.001; opposite side: 62.77% ± 2.27% vs. 49.93% ± 6.94%, p < 0.001). In the stability test at 90° of hip flexion, the DM-THA group had a measurement of 48.40° ± 5.17°, while the large head THA group had a measurement of 30.94° ± 2.98° (p = 0.012). Despite the lack of statistical significance, the intraoperative stability test showed the dislocation angle was notably different between the groups in the hip flexion position of 60° (51.60° ± 6.09° in the DM-THA group and 40.00° ± 2.80° in the large head THA group, p = 0.072). Conclusions Superior results were observed in the intraoperative stability test and early recovery of gait after DM-THA compared to large head THA. We believe that DM-THA can be a useful surgical option for THA in elderly patients with hip fractures.

Background: The Enhanced Recovery After Surgery (ERAS) protocol has garnered global attention for optimizing perioperative care. It holds significant potential for orthopedic hip surgery, especially in elderly patients requiring rehabilitation. However, largescale studies or meta-analyses specific to this field remain limited. Methods: A systematic search was performed using Medline (PubMed), Embase, and Cochrane Library databases for studies assessing the effects of the ERAS protocol in hip surgery up to August 13, 2024. A double-arm meta-analysis was designed to compare perioperative outcomes, including postoperative pain scores, transfusion rates, medical and surgical complications, and length of hospital stay, between ERAS and control groups. Results: Twenty-one studies were systematically reviewed, and 13 were included in the pooled analysis, comprising 1,004 patients in the ERAS group and 1,159 in the control group. Meta-analysis results demonstrated that the ERAS protocol significantly improved postoperative pain management, reduced blood transfusion requirements, decreased medical complications, and shortened hospital stays compared to standard protocols. Conclusions This meta-analysis supports the hypothesis that the ERAS protocol enhances perioperative outcomes in orthopedic hip surgery.