An Insufficient Preoperative Diagnosis of Borrmann Type 4 Gastric Cancer in Spite of EMR

Borrmann type 4 gastric cancers are notorious for the difficulty of finding cancer cells in the biopsy samples obtained from gastrofiberscopy. It is important to obtain the biopsy results for making surgical decisions. In cases with Borrmann type 4 gastric cancer, even though the radiological findings (such as an upper gastrointestinal series, abdominal computed tomography and positron emission tomography/computed tomography) or the macroscopic findings of a gastrofiberscopy examination imply a high suspicion of cancer, there can be difficulty in getting the definite pathologic results despite multiple biopsies. In these cases, we have performed endoscopic mucosal resection under gastrofiberscopy as an alternative to simple biopsies. Here we report on a case in which no cancer cells were found even in the endoscopic mucosal resection specimen, but the radiologic evidence and clinical findings were highly suspicious for gastric cancer. The patient finally underwent total gastrectomy with lymph node resection, and she was pathologically diagnosed as having stage IV gastric cancer postoperatively

InMD-X: Large Language Models for Internal Medicine Doctors

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios

Renal Cell Carcinoma in a Right Malrotated Kidney

The authors report a case of renal cell carcinoma in a right malrotated (horizontal axis) kidney. The patient was treated by hand-assisted laparoscopic radical nephrectomy. This is the first report of a horizontal axis malrotated kidney with renal cell carcinoma

Have different kinds of photon-pair sources the same indistinguishability in quantum silicon photonics?

In the same silicon photonic integrated circuit, we compare two types of integrated degenerate photon-pair sources (microring resonators or waveguides) by means of Hong-Ou-Mandel (HOM) interference experiments. Two nominally identical microring resonators are coupled to two nominally identical waveguides which form the arms of a Mach-Zehnder interferometer. This is pumped by two lasers at two different wavelengths to generate by spontaneous four-wave mixing degenerate photon pairs. In particular, the microring resonators can be thermally tuned in or out of resonance with the pump wavelengths, thus choosing either the microring resonators or the waveguides as photon-pair sources, respectively. In this way, an on-chip HOM visibility of 94% with microring resonators and 99% with straight waveguides is measured. We compare our experimental results with theoretical simulations of the joint spectral intensity and the purity of the degenerate photon pairs. We verify that the visibility is connected to the sources' indistinguishability, which can be quantified by the overlap between the joint spectral amplitudes (JSA) of the photon pairs generated by the two sources. We estimate a JSA overlap of 98% with waveguides and 89% with microring resonators

The relationship between temporomandibular joint disk displacement and mandibular asymmetry in skeletal Class III patients

Objective: To investigate the relationship between temporomandibular joint disk displacement (TMJ DD) and facial asymmetry in skeletal Class III patients. Materials and Methods: The subjects comprised 97 skeletal Class III adult patients seeking orthodontic treatment. In addition to the routine lateral and posteroanterior (PA) cephalograms, and regardless of the TMJ status, each subject consented to magnetic resonance imaging (MRI) to evaluate their TMJs. According to MRI readings, subjects were classified into four groups: group 1, bilateral normal disk position; group 2, bilateral DD with or without reduction; group 3, DD more advanced on the right side; and group 4, DD more advanced on the left side. PA and lateral cephalometric variables were analyzed to compare the four groups. Results: When the TMJ DD was more advanced on one side than on the other, the chin point usually deviated to the advanced side. When the TMJ DD status was equal or bilaterally normal, the amount of mandibular deviation was not significant. Conclusions: If a skeletal Class III patient has an asymmetric face, especially in the mandibular region, careful examination is necessary with regard to the status of the TMJ during orthodontic diagnosis and treatment planning. (Angle Orthod. 2011;81:624-631.)

Effects of insertion angle and implant thread type on the fracture properties of orthodontic mini-implants during insertion

Objective: To determine the effects of insertion angle (IA) and thread type on the fracture properties of orthodontic mini-implants (OMIs) during insertion. Materials and Methods: A total of 100 OMIs (self-drilling cylindrical; 11 mm in length) were allocated into 10 groups according to thread type (dual or single) and IA (0 degrees, 8 degrees, 13 degrees, 18 degrees, and 23 degrees) (n = 10 per group). The OMIs were placed into artificial materials simulating human tissues: two-layer bone blocks (Sawbones), root (polymethylmethacrylate stick), and periodontal ligament (Imprint-II Garant light-body). Maximum insertion torque (MIT), total insertion energy (TIE), and peak time (PT) were measured and analyzed statistically. Results: There were significant differences in MIT, TIE, and PT among the different IAs and threads (all P<.001). When IA increased, MIT increased in both thread groups. However, TIE and PT did not show significant differences among 0 degrees, 8 degrees, and 13 degrees IAs in the dual-thread group or 8 degrees, 13 degrees, and 18 degrees IAs in the single-thread group. The dual-thread groups showed higher MIT at all IAs, higher TIE at 0 degrees and 23 degrees IAs, and longer PT at a 23 degrees IA than the single-thread groups. In the 0 degrees, 8 degrees, and 13 degrees IA groups, none of the OMIs fractured or became deformed. However, in the 18 degrees IA group, all the OMIs were fractured or deformed. Dual-thread OMIs showed more fracturing than deformation compared to single-thread OMIs (P < .01). In the 23 degrees IA group, all OMIs penetrated the artificial root without fracturing and deformation. Conclusions: When OMIs contact artificial root at a critical contact angle, the deformation or fracture of OMIs can occur at lower MIT values than those of penetration.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/8SEQ:8PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:1.184FILENAME:조일식-백승학.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Enhancement of paclitaxel-induced breast cancer cell death via the glycogen synthase kinase-3 beta-mediated B-cell lymphoma 2 regulation

Glycogen synthase kinase-3 beta (GSK-3 beta) is a serine/threonine protein kinase that is known to mediate cancer cell death. Here, we show that B-cell lymphoma 2 (Bcl-2), an anti-apoptotic protein, is regulated by GSK-3 beta and that GSK-3 beta-mediated regulation of Bcl-2 is crucial for mitochondrial-dependent cell death in paclitaxel-stimulated cells. We demonstrate that MCF7 GSK3 beta siRNA cells are more sensitive to cell death than MCF7 GFP control cells and that in the absence of GSK-3 beta, Bcl-2 levels are reduced, a result enhanced by paclitaxel. Paclitaxel-induced JNK (c-Jun N-terminal kinase) activation is critical for Bcl-2 modulation. In the absence of GSK-3 beta, Bcl-2 was unstable in an ubiquitination-dependent manner in both basal-and paclitaxel-treated cells. Furthermore, we demonstrate that GSK-3 beta-mediated regulation of Bcl-2 influences cytochrome C release and mitochondrial membrane potential. Taken together, our data suggest that GSK-3 beta-dependent regulation of Bcl-2 is crucial for mitochondria-dependent cell death in paclitaxel-mediated breast cancer therapy.clos

Epitaxial Growth of a Single-Crystal Hybridized Boron Nitride and Graphene layer on a Wide-Band Gap Semiconductor

Vertical and lateral heterogeneous structures of two-dimensional (2D) materials have paved the way for pioneering studies on the physics and applications of 2D materials. A hybridized hexagonal boron nitride (h-BN) and graphene lateral structure, a heterogeneous 2D structure, has been fabricated on single-crystal metals or metal foils by chemical vapor deposition (CVD). However, once fabricated on metals, the h-BN/graphene lateral structures require an additional transfer process for device applications, as reported for CVD graphene grown on metal foils. Here, we demonstrate that a single-crystal h-BN/graphene lateral structure can be epitaxially grown on a wide-gap semiconductor, SiC(0001). First, a single-crystal h-BN layer with the same orientation as bulk SiC was grown on a Si-terminated SiC substrate at 850 oC using borazine molecules. Second, when heated above 1150 oC in vacuum, the h-BN layer was partially removed and, subsequently, replaced with graphene domains. Interestingly, these graphene domains possess the same orientation as the h-BN layer, resulting in a single-crystal h-BN/graphene lateral structure on a whole sample area. For temperatures above 1600 oC, the single-crystal h-BN layer was completely replaced by the single-crystal graphene layer. The crystalline structure, electronic band structure, and atomic structure of the h-BN/graphene lateral structure were studied by using low energy electron diffraction, angle-resolved photoemission spectroscopy, and scanning tunneling microscopy, respectively. The h-BN/graphene lateral structure fabricated on a wide-gap semiconductor substrate can be directly applied to devices without a further transfer process, as reported for epitaxial graphene on a SiC substrate.Comment: 23 pages, 7 figure

Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea

Objectives Healthcare facilities are high-risk sites for infection. This study analyzed the epidemiological characteristics of a coronavirus disease 2019 (COVID-19) outbreak in a tertiary hospital after COVID-19 vaccination had been introduced in Republic of Korea. Vaccine effectiveness (VE) and shared anti-infection strategies are also assessed. Methods The risk levels for 4,074 contacts were evaluated. The epidemiological characteristics of confirmed cases were evaluated using the chi-square test. The “1 minus relative risk” method was used to determine VE in preventing infection, progression to severe disease, and death. In the largest affected area (the 8th floor), a separate relative risk analysis was conducted. A multivariate logistic regression analysis (with 95% confidence interval [CIs]) was used to identify transmission risk factors with a significance level <10% via the backward elimination method. Results In total, 181 cases of COVID-19 were confirmed, with an attack rate of 4.4%. Of those cases, 12.7% progressed to severe disease, and 8.3% died. In the cohort isolation area on the 8th floor, where 79.0% of the confirmed cases occurred, the adjusted odds ratio was 6.55 (95% CI, 2.99–14.33) and 2.19 (95% CI, 1.24–3.88) for caregivers and the unvaccinated group, respectively. VE analysis revealed that 85.8% of the cases that progressed to severe disease and 78.6% of the deaths could be prevented by administering a second vaccine. Conclusion Caregiver training for infection prevention and control is necessary to reduce infection risk. Vaccination is an important intervention to reduce the risk of progression to severe disease and death