To determine whether repetition-based saccadic fatigability measured with three-dimensional video-oculography (VOG) distinguishes myasthenia gravis (MG) from unilateral ocular motor cranial nerve palsy (CNP) in patients with diplopia.

In this prospective cross-sectional diagnostic study conducted from August 2022 to July 2024, consecutive patients with MG or unilateral third, fourth, or sixth CNP, and healthy controls underwent repetitive horizontal and vertical saccade testing (±°15 targets; 75 cycles at 0.25 Hz). Prespecified index metrics were percentage change in saccadic range and time to target acquisition from the second saccade to the mean of the last five saccades. Diagnostic discrimination was assessed using receiver operating characteristic (ROC) curves.

The cohort comprised 231 participants: 93 with MG, 54 with CNP and 84 healthy controls. MG showed greater repetition-related range decrement and longer time to target acquisition than healthy controls and axis-matched CNP. In the horizontal comparison (MG vs. sixth CNP), AUCs were 0.800 for percentage range change and 0.787 for percentage time-to-target change. In the vertical comparison (MG vs. third/fourth CNP), percentage range change showed the best discrimination (AUC 0.868, 95% CI 0.783 to 0.934); a threshold of -5.95% yielded 79.6% sensitivity and 87.5% specificity. CNP showed early baseline slowing, whereas MG showed progressive hypometria with relatively preserved peak velocity.

Repetition-based VOG captures a dynamic fatigability signature in MG that differs from the more static deficit of unilateral ocular motor CNP. Quantitative saccadic fatigability may provide a useful objective adjunct to the neuro-ophthalmic evaluation of diplopia.

To compare follow-up preferences and health-related quality of life between newly operated endometrial cancer patients and those already enrolled in a traditional hospital-based follow-up program, and to explore whether preferences differ depending on follow-up experience. Patient/material and methods: In this prospective cross-sectional study, patients who underwent primary surgery for endometrial cancer in northern Sweden were included. Group 1 consisted of newly operated patients recruited before entering follow-up, and Group 2 included patients already participating in the standard hospital-based follow-up program. Participants completed questionnaires on sociodemographic characteristics, follow-up preferences, and quality of life (EORTC QLQ-C30). Clinical data were obtained from medical records. The primary outcome was follow-up preference; secondary outcomes included quality of life and associations with clinical and demographic variables.

Of the 121 invited patients, 92 (76%) responded, and 90 were included in the analysis (48 in Group 1; 42 in Group 2). The groups were comparable in baseline characteristics. Newly operated patients demonstrated more diverse follow-up preferences, with 51.1% preferring physician-led hospital visits compared to 82.9% in Group 2 (p = 0.035). Global quality of life did not differ significantly (p = 0.165), although Group 1 reported lower functional scores, particularly in role and emotional functioning. Appetite loss was the only symptom that differed significantly between groups.

Newly operated patients are more open to alternative follow-up models despite similar overall quality of life. Integrating patient preferences into follow-up care may enhance personalization and sustainability.

This study aims to evaluate the radiologic outcomes of lateral access corpectomy to identify perioperative predictors associated with mechanical failure.

We retrospectively reviewed 42 patients who underwent single-level lateral access corpectomy with posterior instrumentation between January 2019 and July 2024. Clinical indications included osteoporotic vertebral fractures (n = 23), spinal metastases (n = 10), and destructive spondylitis (n = 9). Radiologic parameters including total interbody height (TIH) and local segmental angle (SA) were assessed at each time point. Univariate and logistic regression analyses were performed to identify risk factors for mechanical failure.

Postoperatively, the mean TIH gain was 8.42 mm and the mean kyphosis correction was 9.85°. Mechanical failure occurred in 6 cases (14.3%), including pedicle screw pullout (n = 3), rod fracture (n = 1), and severe endplate destruction (n = 2). Logistic regression analysis identified short-segment fixation as a significant risk factor for mechanical failure (OR 8.00, 95% CI 1.19-53.93, p = 0.033). All mechanical failure cases occurred in patients with expandable cages. While expandable cages achieved greater initial TIH gain and kyphosis correction compared with mesh cages, they also demonstrated a greater degree of correction loss at final follow-up (TIH loss 6.62 mm vs. 3.93 mm, p = 0.061).

Among patients undergoing lateral access corpectomy, short-segment fixation was the only factor significantly associated with mechanical failure, and its combination with an expandable cage carried the highest failure rate. Given the small number of failure events, these findings are hypothesis-generating and suggest that long-segment fixation should be prioritized whenever clinically feasible.

Microwave ablation (MWA) has emerged as a minimally invasive alternative to surgery for selected patients with low-risk papillary thyroid carcinoma (PTC). While thyroid autoimmunity is frequently observed in PTC, the impact of preoperative thyroid autoantibodies (TAb) on post-ablation absorption kinetics remains unclear.

This retrospective study included 150 patients with PTC who underwent MWA between December 2019 and December 2024 with a median follow-up of 18 months (range: 6-54 months). Patients were categorized according to preoperative thyroid autoantibody status. Volume reduction rate, complete absorption rate, tumor recurrence rate, incidence of new nodules, and thyroid function were evaluated during follow-up. Kaplan-Meier analysis and Cox proportional hazards regression were used to assess factors associated with time to complete absorption.

During follow-up, ablation zone volume gradually decreased in all patients, but absorption was significantly slower in TAb-positive patients. The TAb-positive group exhibited a longer median time to complete absorption than the TAb-negative group (median: 30 vs. 19 months; log-rank p = 0.01). Subgroup analyses demonstrated that preoperative thyroglobulin antibody (TgAb) positivity, but not thyroid peroxidase antibody (TPOAb) positivity, was significantly associated with delayed absorption. TgAb positivity remained independently associated in multivariate Cox analysis (adjusted hazard ratio = 0.27; 95% confidence interval: 0.09-0.78; p = 0.015). No malignant recurrence occurred. TPOAb-positive patients showed a higher incidence of newly detected benign nodules. Thyroid function remained stable throughout follow-up.

Preoperative TgAb positivity is associated with delayed absorption of the ablation zone after MWA for PTC without compromising treatment completeness.

Aggressive angiomyxoma is a rare mesenchymal tumor involving soft tissue of the vulvovaginal and perineal region in females of reproductive age. A 42-year-old, para-2 female presented with an elongated swelling on the left labia majora for 10 years. She presented to us because she was feeling uncomfortable while sitting. Local examination showed an elongated mass measuring 8 x 6 cm in the longitudinal direction protruding from the lower part of the left labia majora. The mass was soft, spongy, and non-tender without any involvement of adjacent structures. Sonography of the local area showed an echogenic soft-tissue mass with increased color flow, likely a lipoma of the vulva. She underwent a wide local excision of the tumor. On histopathology, it was diagnosed as an aggressive angiomyxoma of the vulva. Angiomyxoma arises from the mesenchymal tissue, and it is locally invasive with a high recurrence rate. It has to be differentiated from Bartholin cyst, lipoma, Gartner cyst, and pelvic hernia. The diagnosis can be aided by imaging modalities such as ultrasonography, magnetic resonance imaging, and computed tomography. Wide excision is the treatment of choice. Histology, along with immunohistochemistry, can confirm the lesion. Long-term follow-up is needed as recurrences are high.

Ameloblastic carcinoma (AC) is a highly aggressive malignant odontogenic epithelial tumor. It may occur in a pre-existing ameloblastoma, odontogenic cyst, or de novo. The condition is typically painful, highly invasive, and multifocally metastasizing in nature, with the lungs being the most common secondary tumor site. The condition is most often encountered in adult men during the sixth decade, with a propensity towards the posterior mandible. Radiographic examinations typically exhibit ill-defined and aggressive lesions with massive bone loss. Histopathological examination shows classic cytonuclear atypia in the ameloblastic element. The immunohistochemical staining is generally found to be intense in markers such as Ki-67, p53, and p63. The majority of cases also carry mutations in the BRAF V600E gene. In this case report, we discuss the presentation pertaining to AC in a 29-year-old male patient, with an emphasis on the relevant clinical-radiological-pathological diagnostic aspects. The primary treatment of AC is surgical removal, occasionally in conjunction with dissection of the neck or radiation therapy to manage local and metastatic spread. In our case, surgical removal was performed. AC is a rare, aggressive, and invasive odontogenic epithelial malignant neoplasm. Further future studies regarding its pathogenesis, molecular genetics, and immunohistochemical aspects will help researchers in better understanding this novel entity.

Solitary plasmacytoma is a localized form of plasma cell neoplasm and is important to differentiate from multiple myeloma (MM) using clinical assessment, imaging, and bone marrow evaluation. Extramedullary plasmacytoma (EMP) develops from soft tissue and is a rare occurrence, although a large proportion of cases are in the head and neck. We describe a 59-year-old man who presented with a progressively enlarging left-sided neck mass. Imaging revealed a lesion in the left tongue base and supraclavicular and cervical lymphadenopathy. Biopsy of the left tongue base lesion revealed mature plasma cell proliferation, with positivity for CD79a, CD138, and CD38, a low Ki-67 proliferative index, and lambda light-chain restriction. Whole-body positron emission tomography-computed tomography (PET-CT) also revealed hypermetabolic disease at the base of the tongue and the nodes, and bone marrow evaluation was negative for systemic disease. After multidisciplinary review, a diagnosis of primary EMP of the left tongue base with regional nodal involvement was made, and the patient agreed to radical radiotherapy (RT) (50 Gy in 25 fractions over 5 weeks). This case underlines the importance of keeping EMP as a differential in the diagnosis of masses involving the tongue base or oral cavity in the context of cervical lymphadenopathy. PET-CT and bone marrow examination are important for staging and treatment decision-making, and radiotherapy is an important treatment option for localized disease.

Gastric cancer is a leading cause of cancer death worldwide. Targeted therapy is shifting from blocking signaling pathways to precise gene regulation. This review covers three key areas: antibody drugs, RNAi, and nanocarriers. Anti-HER2 agents, VEGFR2 inhibitors, Claudin 18.2-directed therapies and PD-1/PD-L1 inhibitors improve survival in biomarker-selected patients-but resistance and low response rates (ORR < 20% in unselected groups) limit their use. RNAi silences key oncogenes to reverse chemoresistance and reprogram the immunosuppressive tumor microenvironment, but it suffers from rapid degradation, poor endosomal escape, off-target effects, and weak tumor penetration. Nanocarrier systems-including lipid nanoparticles (LNPs), stimuli-responsive micelles, and mesoporous silica-combined with aptamers enable targeted delivery of therapeutic antibodies and siRNA, penetration across stromal barriers, and controlled, tumor microenvironment-triggered cargo release. Altogether, the future of gastric cancer therapy is moving beyond monotherapy to a five-part strategy: antibody targeting, RNA silencing, nanocarrier delivery, AI-guided decisions, and immune remodeling.

Spatial transcriptomics provides unprecedented insights into gene expression in the spatial context of tissues; however, some mainstream techniques lack quantitative analysis of uncertainty.

In this study, we propose a computational framework-Spatial Deconvolution via Deep Gaussian Processes (SDDGP)-that integrates deep Gaussian processes with Bayesian inference for spatially aware deconvolution of spatial transcriptomics data. The framework consists of three tightly coupled components. A multi-layer deep Gaussian process (DGP) captures nonlinear spatial dependencies in cell-type composition by propagating spatial coordinates through successive Gaussian process (GP) layers, each equipped with sparse variational inducing points and a radial basis function (RBF) kernel that can be combined with an external Matern spatial kernel. The DGP output serves as an adaptive, spatially informed prior for per-spot cell-type proportions, which are then estimated via a Negative-Binomial Markov chain Monte Carlo (MCMC) sampler with automatic proposal tuning, thinning, and split-chain convergence diagnostics.

We compared our method with existing approaches on two datasets: a pancreatic ductal adenocarcinoma (PDAC) dataset with matched single-cell RNA sequencing and spatial transcriptomics, and a human thymus dataset. Across both datasets, our method estimated cell type proportions more accurately than existing methods, particularly for rare cell types, and recovered biologically meaningful spatial patterns such as the distribution of T cells and plasma cells in PDAC. The Bayesian formulation also provides a quantification of uncertainty for each estimate, which aids the interpretation of spatial heterogeneity in complex tissues.

To compare tegileridine-based and sufentanil-based patient-controlled intravenous analgesia (PCIA) for postoperative gastrointestinal recovery in elderly patients undergoing laparoscopic colorectal cancer surgery.

In this single-center, double-blind, randomized controlled trial, patients scheduled for elective laparoscopic colorectal cancer surgery were randomized 1:1 to tegileridine-based PCIA (Group T) or sufentanil-based PCIA (Group S). The primary outcome was the Intake, Feeling nauseated, Emesis, physical Exam, and Duration of symptoms (I-FEED) score on postoperative day 3 (POD3). Secondary outcomes included I-FEED scores on POD1-5 (excluding POD3), incidence of postoperative gastrointestinal dysfunction (POGD), time to first flatus and defecation, analgesic outcomes, quality of recovery, and adverse events.

One hundred patients were included in the primary analysis (Group T, n = 51; Group S, n = 49). Compared with Group S, Group T had significantly lower I-FEED scores on POD1 (estimated marginal mean [EMM] difference, -0.60; 95% CI, -1.03 to -0.17; P = 0.006), POD2 (EMM difference, -0.66; 95% CI, -1.14 to -0.18; P = 0.008), and POD3 (EMM difference, -0.72; 95% CI, -1.17 to -0.27; P = 0.002), a lower incidence of POGD (11.8% vs 28.6%; P = 0.036), and a shorter time to first flatus (36 h vs 40 h; P = 0.025). Pain scores, PCIA use, and rescue analgesia were comparable between groups. Quality of Recovery-15 (QoR-15) scores were higher in Group T on POD2 and POD3. Group T also had a lower overall incidence of adverse events (27.5% vs 49.0%; P = 0.027) and a lower incidence of nausea and vomiting (23.5% vs 44.9%; P = 0.024).

In elderly patients undergoing laparoscopic colorectal cancer surgery, tegileridine-based PCIA provided analgesia comparable to sufentanil under the prespecified dosing regimens. It was associated with better gastrointestinal recovery during the first three postoperative days and fewer adverse events. This regimen may be a safe and effective analgesic option in this population.