Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: This study aimed to examine the effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on final height outcomes in girls with idiopathic central precocious puberty (CPP) from the start of treatment to their postmenarche visit. Methods: We conducted a retrospective analysis of 200 girls with idiopathic CPP who received GnRHa therapy, focusing on auxological and clinical outcomes at treatment initiation, treatment completion, and the last, postmenarche visit. Results: The mean chronological age (CA) at GnRHa treatment initiation was 8.24±0.73 years. The mean duration of GnRHa treatment was 3.12±0.81 years. The average age at menarche was 12.73±0.56 years, occurring a mean of 17.15±5.52 months after completing GnRHa therapy. The predicted adult height (PAH) standard deviation score (SDS) after menarche (0.48±0.99) was significantly greater than before treatment (-1.33±1.46) (P<0.001). Factors including greater bone age advancement (P<0.001), lower height SDS for CA at treatment initiation (P<0.001), and higher midparental height SDS (P=0.001) were positively associated with an increase in PAH SDS at the last visit. However, near-final height and the increase in PAH SDS at the last visit were not significantly different between patients who received early treatment (<8 years) and those who received later treatment (8–9 years). Conclusion GnRHa treatment improved the final height outcomes in all girls with CPP, including those treated between 8 and 9 years of age.

Objective: To evaluate the effectiveness of a squatting posture grading system established to screen for limited ankle dorsiflexion. Methods: The squat posture grading system categorizes subjects’ squat posture into three grades. Grade 1 is defined as being able to maintain a squatting posture with heels on the ground in full ankle dorsiflexion without effort. Grade 2 is defined as being able to perform the same position, but unable to maintain the position for more than 5 seconds or requiring trunk and leg muscle efforts to maintain the position. Grade 3 is defined as being unable to maintain the same position and falling backwards immediately if attempted to touch the ground with heels. Next, subjects’ ankle dorsiflexion angles were directly measured in knee flexed and extended position by goniometer. Results: Out of the 92 total subjects, 35 were in grade 1, 18 were in grade 2, and 39 were in grade 3. The average ankle dorsiflexion angle with knee flexed position were 23.13° for grade 1, 16.03° for grade 2, and 9.31° for grade 3. The average ankle dorsiflexion angle with knee extended position were 15.16° for grade 1, 7.92° for grade 2, and 3.40° for grade 3. Ankle dorsiflexion angles showed a significant decrease from grade 1 to 3 (p<0.05). Conclusion The squatting posture grading system defined in this study effectively graded the subjects based on the difference in their average ankle dorsiflexion angle. This system could be used as a quick screening method for limited ankle dorsiflexion.

Purpose: Pathologic lesions may occur in an axillary accessory breast (AAB). This study aimed to evaluate the characteristics of tumors arising from AABs and to recommend appropriate treatment. Methods: This retrospective study involved 3,544 women (18–65 years old) with AAB at Damsoyu Hospital in Korea from 2014 to 2023. The patients were divided into an AAB with benign tumors (TAAB) group and an AAB without tumors (AAB) group, and the tumors’ pathologies were reviewed. A core biopsy was performed on tumors with possible malignancy identified by preoperative ultrasonography. All patients underwent complete excision of accessory mammary gland (AMG) tissue, including tumors. The postoperative results were checked 6 months after surgery. Results: Fifty-two out of 3,554 patients had tumors confirmed by preoperative ultrasonography. Preoperative core biopsies were performed on 11 patients. Two patients had malignant tumors (invasive ductal carcinoma) identified by core biopsy.Fifty patients had benign tumors identified by postoperative pathological analysis (46 fibroadenomas, 2 fibrocystic changes, and 2 sclerosing adenoses). Carcinoma in situ was confirmed in 2 patients using postoperative pathological analysis. No patients in either group developed tumors in the axilla during the follow-up period. All patients were satisfied with the axillary pain relief and the disappearance of bulging lesions. Conclusion We recommend a core biopsy if preoperative ultrasonography indicates a possibly malignant tumor. AAB patients may experience tumors, pain, and bulging appearance of an AMG; thus, complete AMG excision is necessary.

Acute Respiratory Distress Syndrome (ARDS) is a severe condition characterized by extensive lung inflammation and increased alveolar-capillary permeability, often triggered by infections or systemic inflammatory responses. Mesenchymal stem cells (MSCs)-based therapy holds promise for treating ARDS, as MSCs manifest immunomodulatory and regenerative properties that mitigate inflammation and enhance tissue repair. Primed MSCs, modified to augment specific functionalities, demonstrate superior therapeutic efficacy in targeted therapies compared to naive MSCs. This study explored the immunomodulatory potential of MSCs using mixed lymphocyte reaction (MLR) assays and co-culture experiments with M1/M2 macrophages. Additionally, RNA sequencing was employed to identify alterations in immune and inflammation-related factors in primed MSCs. The therapeutic effects of primed MSCs were assessed in an LPS-induced ARDS mouse model, and the underlying mechanisms were investigated through spatial transcriptomics analysis. The study revealed that MSCs primed with IFN-γ and IL-1β significantly enhanced the suppression of T cell activity compared to naive MSCs, concurrently inhibiting TNF-α while increasing IL-10 production in macrophages. Notably, combined treatment with these two cytokines resulted in a significant upregulation of immune and inflammation-regulating factors. Furthermore, our analyses elucidated the mechanisms behind the therapeutic effects of primed MSCs, including the inhibition of inflammatory cell infiltration in lung tissue, modulation of immune and inflammatory responses, and enhancement of elastin fiber formation. Signaling pathway analysis confirmed that efficacy could be enhanced by modulating NFκB and TNF-α signaling. In conclusion, in early-phase ARDS, primed MSCs displayed enhanced homing capabilities, improved lung function, and reduced inflammation.

Ovarian cancer usually metastasizes from the ovary to adjacent organs through direct invasion with blood vessels formed by endothelial cells. Targeting apoptosis of ovarian cancer and angiogenesis is promising for anticancer therapy. Leaves of Ipomoea sp. have reportedly shown promise in treating ovarian cancer. Here, we investigated the apoptosis-inducing and anti-angiogenic effects of compounds isolated from Ipomoea batatas vines (IBV). Phytochemical examination of IBV led to the isolation and verification of eight compounds (1-8): chlorogenic acid (1), 3,4-dicaffeoylquinic acid (2), 3,5-dicaffeoylquinic acid (3), 4,5-dicaffeoylquinic acid (4), 1,3,5-tricaffeoylquinic acid (5), N-trans-feruloyltyramine (6), scopoletin (7), and esculetin (8). Of these, 1,3,5-tricaffeoylquinic acid (5) showed the highest cytotoxicity in A2780 human ovarian cancer cells, inducing apoptotic death in more than 37% cells and decreasing viability to less than 25% at 100 μM. Compound 5 increased the levels of cleaved caspase-8, Bax, cleaved PARP, and caspase-3/9, and decreased the levels of cleaved Bcl-2. Further, 5 inhibited tubule formation in HUVECs.VEGFR2, ERK, PI3K, Akt, and mTOR protein expression was also suppressed by 5. Then, a simple, rapid, and reliable LC-MS/ MS method was developed to determine the contents of the isolated compounds from IBV. Overall, 5 has potential for treating ovarian cancer as it induces apoptosis in ovarian cancer cells and inhibits tube formation.

Triple-negative breast cancer (TNBC) is an aggressive cancer subtype lacking targeted therapies and is characterized by highrecurrence rates and poor prognosis. Recent advances in targeting DNA damage response (DDR) pathways using poly (ADP‒ri-bose) polymerase (PARP) inhibitors offer promising therapeutic strategies, especially for TNBC patients with BRCA1/2 mutations.This study reports the development and characterization of ART-446, a novel and selective CHK2 inhibitor. ART-446 showed potent activity against TNBC, regardless of BRCA deficiency, and it also reversed PARP inhibitor resistance. ART-446 potentlyinhibited CHK2 (IC50 : 9.06 nM) with high selectivity over other kinases; it synergized with the PARP inhibitor olaparib, enhancingDNA damage, inducing G2/M cell cycle arrest, and promoting apoptosis in both BRCA-mutant and wild-type TNBC cells. Mechanistic analyses revealed that ART-446 sensitized BRCA mutant and WT cells to PARP inhibitors by impairing DNA repair and increasing the accumulation of DNA damage. Importantly, ART-446 disrupted both homologous recombination and nonhomologous end-joining repair pathways, addressing a key limitation of PARP inhibitor monotherapy—resistance in BRCA-proficient cancers.In vivo, the combination of ART-446 and olaparib significantly reduced tumor growth in TNBC xenograft models without noticeable toxicity. The combined treatment increased DNA damage signaling, as evidenced by elevated γH2AX levels, and enhanced the sensitivity of BRCA2-deficient cells to ART-446. These findings underscore the potential of ART-446 to exploit DNA repair deficiencies and overcome resistance mechanisms associated with PARP inhibitors. By addressing the limitations of current treatments and expanding the utility of PARP inhibitors, ART-446 represents a promising candidate for DDR-targeted therapies, offering a novel approach to improve the outcomes of patients with TNBC.