This article provides a narrative review of the risk factors for anterior cruciate ligament reconstruction (ACLR) failures, as well as strategies to prevent such failures. Early timing for ACLR is not a risk factor for arthrofibrosis anymore according to recent studies. Vancomycin-soaked grafts appear to decrease infection rates after ACLR and are cost-effective. Proper tunnel placement is critical for anatomic ACLR to restore knee kinematics and joint stability. The article proposes a reproducible and accurate method for tunnel positioning. Increased sagittal plane tibial slope has been identified as a risk factor for primary ACLR failure. An anterior closing wedge proximal tibial osteotomy is suggested as a viable option for reducing posterior tibial slope. The lateral extra-articular tenodesis procedure in ACLR is effective in restoring both anterior tibial translation and rotatory stability.

Background: Gliomas, prevalent and lethal brain tumors, present limited treatment options despite advancements in understanding their molecular features. SLC4A7, an SLC4 family member and potential biomarker, is involved in acid-base regulation, affecting cancer cell growth. Targeting this mechanism may offer new therapeutic strategies. Aim: This study examines SLC4A7's role in gliomas and its potential as a therapeutic target. Methods: Genomic, whole exon sequencing, and single-cell sequencing datasets from glioma patients were processed and analyzed, followed by gene set enrichment analysis (GSEA). Cellular components and immune cell populations were investigated using 12-cell state and CIBERSORT analyses. Tissue microarray and immunohistochemistry were employed, with an automated semi-quantitative system scoring staining. ANOVA determined the significance of immunostaining scores related to clinical parameters. Results: Our data found increased SLC4A7 in tumor components correlated with higher tumor grading and poorer prognosis. Immunohistochemistry confirmed a relationship between SLC4A7 protein expression with tumor grade and the proliferation index. GSEA linked high SLC4A7 to cell proliferation and inflammation signaling. PIK3CAs were identified as a potential upstream in IDH mutant glioma but not in IDH wildtype. A positive correlation between heightened SLC4A7 expression and tumor mutation burden suggested genomic instability's role in SLC4A7 upregulation. Cellular heterogeneity analysis highlighted the importance of inflammatory cells, particularly macrophage M0. Conclusion: This study emphasizes SLC4A7's significance in adult gliomas, associating increased expression with high tumor grade, poor prognosis, enhanced proliferation, and inflammation. Investigating SLC4A7 may provide insights into cancer biology and contribute to developing innovative therapeutic targets for improved brain tumor treatments.

Background: Histology laboratory courses comprise the study of cell structures, tissues, and body organs, which are mainly examined using a microscope. Two types of examinations assess learning outcomes in these courses in Taiwan: the traditional, light microscope station (LMS) examination and the Microsoft PowerPoint (MS PPT) examination. Whether these examinations exhibit different influences on students' grade performances remains to be examined. Aim: The aim is to compare the grade performance and opinion of students in a medical center for the LMS and MS PPT examinations. Methods: We compared the grade performances of students who completed LMS (3 cohorts) or MS PPT (2 cohorts) examinations retrospectively and conducted a survey to investigate the students' learning attitude between these two types of examinations. Results: Grade performances in the MS PPT group were not significantly higher than those in the LMS group. The average scores of students who failed the LMS examination were significantly lower than those of students who failed the MS PPT examination. Questionnaire survey results showed that the MS PPT examination was easier for students and that they may spend less time studying for it. The LMS examination positively influenced learning attitudes among students with a rather low self-demand. Conclusion: Examination type may affect learning attitude, especially among students with a rather low self-demand. The MS PPT examination seems to be easier for students and was connected to remarks about less study time in the histology laboratory course, and for students with low self-demands, the traditional LMS examination may be a better option. We believe that with the advance of digital whole histology slide imaging, there is an opportunity to revolutionize both learning and evaluating for all medical school students.

Background: Flavivirus comprises several important viruses, including dengue virus (DENV), Zika virus (ZIKV), and Japanese encephalitis virus (JEV). A large outbreak of DENV and ZIKV occurred in these years, leading to many cases of illness and death. However, despite the decades of efforts, there are no specific therapeutic drugs against DENV and ZIKV. Several studies had shown that histone deacetylase 6 inhibitors (HDAC6 inhibitors) possess antiviral effects on influenza A virus, hepatitis C virus, and JEV. Aim: The purpose of this study is to examine the antiviral effect of the compound J34803, a newly synthesized HDAC6 inhibitor, against DENV and ZIKV in vitro and in vivo. Methods: We investigated whether the compound J34803 inhibited viral infection by western blot and virus titer determination. The signaling pathway of inhibition was also determined by western blot. Results: The compound J34803 exhibited superior antiviral activities against DENV-2, DENV-4, and ZIKV compared to Tubastatin A (TBSA), and its antiviral mechanism may through suppressing HDAC6 and its downstream signaling pathway. Moreover, treatment with the compound J34803 could reduce viremia levels in DENV-2-and ZIKV-infected AG129 mice. Conclusion: We demonstrated that the compound J34803 had better therapeutic efficacy in virus infection as compared to TBSA and could be a potential potent therapeutic drug against emerging flaviviral infections.

Background: Measurement of regional cerebral oxygen saturation (rSO₂) is a safe, noninvasive, and portable optical method that can be used to monitor activity within the cortical areas of the human brain. Making use of specific wavelengths of light, near-infrared spectroscopy (NIRS) provides measurements of oxygenated hemoglobin (Hb) and deoxygenated Hb that is in direct relation with hemodynamic changes in the brain. Aim: The aim of this study was to compare the changes in rSO₂ at different time points between propofol and sevoflurane anesthesia during gynecological laparoscopic surgery. After approval by the institutional ethics committee, written informed consent was taken from all eligible patients. Methods: This randomized clinical study was conducted in a gynecology operation theater complex. Thirty-four patients aged between 18 and 60 years categorized between the American Society of Anesthesiologists (ASA) class I I and II who are scheduled for gynecological laparoscopic surgery under general anesthesia were randomized into two groups with 17 patients in each group. The Group 1 patients receive sevoflurane anesthesia and Group 2 patients receive total intravenous anesthesia using an infusion of propofol. The rSO₂ values were continuously monitored using NIRS. The bispectral index target range during maintenance was 40–50. Results: The sevoflurane group showed significantly higher rSO₂ values than the propofol group in gynecological laparoscopic surgery. Conclusion: It can be inferred that the sevoflurane group showed significantly higher rSO₂ values than the propofol group in gynecological laparoscopic surgery not only during pneumoperitoneum in the Trendelenburg position but also after desufflation of the abdomen in the neutral position (supine).

Intraorbital cavernous hemangiomas are the most known benign vascular tumors of the orbit in adults, however, multiple lesions diagnosed as cavernous hemangiomas in the orbits are very rarely reported. The most common presenting complaints are slowly progressive painless proptosis. They rarely present with vision impairment. Multiple cavernous hemangiomas, although rare, systemic evaluation of the patients should be done in these cases to rule out multi-centric lesions. Complete excision of the tumors should be done surgically, and the patients need to be followed on a long-term to monitor for recurrence. Here, we report a case of multiple unilateral cavernous hemangiomas in a 44-year-old male patient, who was treated as a case of neurofibroma clinically based on radiological investigations.

Neurofibromatosis type 1 (NF1) is one of the most frequently encountered familial tumor syndromes. NF1 patients are highly prone to have multiple nervous system tumors, and are also at increased risk for various nonnervous mesenchymal or neuroendocrine tumor developments. This is an NF1 patient who developed two different unusual tumors: an intramedullary anaplastic astrocytoma of the thoracic spine and myxoid liposarcoma of the lower limb. The family members were carefully investigated as per the NF1 diagnostic criteria. A strong cutaneous NF1 penetrance was found in 6 of the 14 family members in four successive generations, two of whom had NF1 and developed breast cancer and bilateral optic gliomas. The NF1 tumor syndrome highlights a wide-ranging tumor spectrum, and clinicians should keep an eye on tumor surveillance and encourage medical counseling, and long-term NF1 family follow-up is warranted for prophylactic warning.

Headache is a common problem in patients with cancer undergoing active treatment or in cancer survivors. However, severe orthostatic headache is less common and should be carefully differentiated. Spontaneous intracranial hypotension (SIH) is a rare and often misdiagnosed disorder. Neuroimaging is crucial for diagnosing and monitoring SIH. Awareness of SIH is essential because patients with SIH often suffer from severe impairment of quality of life and psychological distress before receiving a correct diagnosis and treatment. We present a case of a 66-year-old man who had squamous cell carcinoma of the tonsil, stage IV with multiple metastases, and was diagnosed with SIH during the period of palliative treatment.