Purpose: Carotid artery stenting (CAS) is an established alternative to carotid endarterectomy for selected patients with symptomatic carotid stenosis. Although predictors of periprocedural ischemic lesions detected on diffusion-weighted imaging (DWI) have been described, the relationship between these lesions and long-term functional outcomes remains incompletely understood. This study aimed to identify factors associated with early ischemic lesions after CAS and to evaluate whether these lesions are associated with 1-year clinical outcomes. Materials and Methods: We retrospectively analyzed 190 patients who underwent CAS for symptomatic carotid artery stenosis at a single tertiary center. The primary outcome was the occurrence of new ischemic lesions on DWI within 24 hours after CAS. Secondary outcomes included periprocedural ischemic or hemorrhagic complications, recurrent ischemic cerebrovascular events within 1-year, restenosis at 1-year, and functional outcome at 1-year assessed by the modified Rankin Scale (mRS). Univariable and multivariable logistic regression analyses were performed to identify predictors of early embolic lesions and good functional outcome (mRS 0–2). Results: New ischemic lesions on DWI were identified in 52 patients (27.4%). In multivariable analysis, atrial fibrillation was independently associated with early ischemic lesions (odds ratio, 4.747; 95% confidence interval, 1.133–19.888; P=0.033), whereas lesion severity and procedural factors were not. Periprocedural ischemic stroke with neurological deterioration occurred in 2.1% of patients, and symptomatic intracranial hemorrhage occurred in 1.1%. Good functional outcome (mRS 0–2) at 1-year was achieved in 82.1% of patients. New ischemic lesions were not independently associated with 1-year functional outcome, whereas baseline neurological severity was the primary determinant. Conclusion New ischemic lesions on DWI were frequently observed after CAS but were not associated with long-term functional outcome. CAS was associated with low periprocedural complication rates and favorable 1-year outcomes in symptomatic patients treated at an experienced center.

Background: Breakage of balloon-less Racz neuroplasty catheters is a rare complication of neuroplasty; however, shearing of balloon catheters during epidural neuroplasty has not been reported.Case: Herein, we report a case of a broken epidural balloon catheter during neuroplasty. A 76-year-old female underwent percutaneous epidural neuroplasty (PEN) using a Racz catheter, epidural steroid injection, and medial branch block for lumbar spinal stenosis 6 months ago. However, her symptoms did not improve. Subsequently, we performed a PEN using an inflatable balloon catheter. During the procedure, the epidural balloon catheter became trapped, broke, and could not be retrieved. Subsequently, the patient complained of leg pain and numbness. Therefore, surgery was performed to remove the broken catheter, resolving the leg pain and numbness. Conclusions This case report supports the surgical removal of broken catheters to avoid the aggravation of symptoms and the development of neurological deficits.

Purpose: This study aimed to evaluate the functional and anatomical effects of switching to faricimab in patients with polypoidal choroidal vasculopathy (PCV) refractory to other anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: This retrospective study analyzed the medical records of patients with PCV who were switched to faricimab. Prior to the initial faricimab injections, all patients underwent spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography. Changes in best-corrected visual acuity were recorded, while anatomic outcomes including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), pigment epithelial detachment (PED) height, and presence of retinal fluid were measured by SD-OCT. Results: A total of 19 eyes from 17 patients were included. The mean age was 71.3 ± 7.3 years. Prior to faricimab treatment, patients had received a mean of 20.2 ± 9.5 (range 8–40) injections. The mean follow-up duration from the initial faricimab injection was 38.6 ± 17.6 weeks (range 16–68). At baseline, the mean CMT, PED height, and SFCT were 443.8 ± 220.9 µm, 331.0 ± 389.3 µm, and 289.5 ± 148.9 µm, respectively. During faricimab treatment, significant anatomical improvements were observed in CMT (314.9 ± 110.5 µm), PED height (158.0 ± 152.5 µm), and SFCT (239.0 ± 110.1 µm) (all p < 0.05). A good PED response (≥50% reduction in height) was achieved in 7 eyes (41.1%), a partial response (<50% reduction) in 7 eyes (41.1%), and a poor response (no change in height) in 3 eyes (17.6%). At the final visit, 11 eyes (57.8%) achieved a dry macula, representing the absence of intraretinal or subretinal fluid. Conclusions Faricimab may represent a safe and effective treatment strategy for improving anatomical outcomes, though larger patient cohorts are required to validate these findings. This drug could emerge as a valuable alternative for patients experiencing PCV refractory to other anti-VEGF injections.

Skin aging results from complex interactions of intrinsic and extrinsic factors, leading to structural and biochemical changes such as wrinkles and dryness. Ultraviolet (UV) irradiation leads to the degradation of hyaluronic acid (HA) in the skin, and the fragmented HA contributes to inflammation. This study revealed that the synergistic combination of carnosine and retinol (ROL) increases HA production in normal human epidermal keratinocytes (NHEKs) by upregulating hyaluronan synthase 2 (HAS2) gene transcription. Simultaneously, the combined treatment of carnosine and ROL significantly attenuates UVB-induced prostaglandin E2 (PGE2) synthesis in NHEKs. A significant correlation exists between the increase of HA synthesis and the inhibition of PGE2 production. This study suggests that combined treatment of carnosine and ROL can improve skin aging phenotypes associated with UVB irradiation.

Sesquiterpene lactones, a class of natural compounds abundant in the Asteraceae family, have gained attention owing to their diverse biological activities, and particularly their anti-proliferative effects on human cancer cells. In this study, we systematically investigated the structure-activity relationship of ten sesquiterpene lactones with the aim of elucidating the structural determinants for the STAT3 inhibition governing their anti-proliferative effects. Our findings revealed a significant correlation between the STAT3 inhibitory activity and the anti-proliferative effects of sesquiterpene lactones in MDA-MB-231 breast cancer cell lines. Among the compounds tested, alantolactone and isoalantolactone emerged as the most potent STAT3 inhibitors, highlighting their potential as candidates for anticancer drug development. Through protein-ligand docking studies, we revealed the structural basis of STAT3 inhibition by sesquiterpene lactones, emphasizing the critical role of hydrogen-bonding interactions with key residues, including Arg609, Ser611, Glu612, and Ser613, in the SH2 domain of STAT3. Furthermore, our conformational analysis revealed the decisive role of the torsion angle within the geometry-optimized structures of sesquiterpene lactones in their STAT3 inhibitory activity (R=0.80, p<0.01). These findings not only provide preclinical evidence for sesquiterpene lactones as promising phytomedicines against diseases associated with abnormal STAT3 activation, but also highlight the importance of stereochemical aspects in their activity.

Background: and Purpose: Voice, reflecting cerebral functions, holds potential for analyzing and understanding brain function, especially in the context of cognitive impairment (CI) and Alzheimer’s disease (AD). This study used voice data to distinguish between normal cognition and CI or Alzheimer’s disease dementia (ADD). Methods: This study enrolled 3 groups of subjects: 1) 52 subjects with subjective cognitive decline; 2) 110 subjects with mild CI; and 3) 59 subjects with ADD. Voice features were extracted using Mel-frequency cepstral coefficients and Chroma. Results: A deep neural network (DNN) model showed promising performance, with an accuracy of roughly 81% in 10 trials in predicting ADD, which increased to an average value of about 82.0%±1.6% when evaluated against unseen test dataset. Conclusions Although results did not demonstrate the level of accuracy necessary for a definitive clinical tool, they provided a compelling proof-of-concept for the potential use of voice data in cognitive status assessment. DNN algorithms using voice offer a promising approach to early detection of AD. They could improve the accuracy and accessibility of diagnosis, ultimately leading to better outcomes for patients.

Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis. Methods: We identified 136 patients aged 2–17 years with newly diagnosed IBD (94 Crohn’s disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017. We reclassified these 136 patients using the revised Porto criteria. To estimate the population-based prevalence, we analyzed Korean administrative healthcare data between 2005 and 2016, which revealed 3,650 IBD patients, including 2,538 CD and 1,112 UC. By extrapolating the reclassified results to a population-based dataset, we estimated the prevalence of PIBD subtypes. Results: Among the 94 CD, the original diagnosis remained unchanged in 93 (98.9%), while the diagnosis of one (1.1%) patient was changed to IBDU. Among the 42 UC, the original diagnosis remained unchanged in 13 (31.0%), while the diagnoses in 11 (26.2%), 17 (40.5%), and one (2.4%) patient changed to atypical UC, IBDU, and CD, respectively. The estimated prevalences of CD, UC, atypical UC, and IBDU in the Korean population were 69.5%, 9.4%, 8.0%, and 13.1%, respectively. Conclusion This study is the first in Korea to estimate the prevalence of pediatric IBDU.This prevalence (13.1%) aligns with findings from Western studies. Large-scale prospective multicenter studies on PIBDU are required to examine the clinical features and outcomes of this condition.