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Background: Neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) has been shown to improve sphincter preservation and local pelvic control, but the efficacy of nCRT plateaus due to metastasis. CXC chemokine ligand 12 (CXCL12) has a critical impact on cancer development and metastasis. Methods: By investigating public databases containing LARC patient data, CXCL12, CXCR4 and FAPα expression was analyzed via the Tumor Immune Estimation Resource (TIMER) and GSEA. Immunohistochemistry was applied to a total of 121 surgically resected specimens consisting of 61 LARCs after nCRT and 60 LARCs with no nCRT and 16 cases with endoscopic resection of high-grade colorectal adenoma. Results: By investigating public databases containing LARC patient data, CXCL12 expression is correlated with poor prognosis, immune cell infiltration, epithelial- mesenchymal transition, and angiogenesis in LARC. Furthermore, radiation selectively induced CXCL12, CXCR4 and FAPα expression in tumor tissues. Immunohistochemistry results showed that the levels of CXCL12, CXCR4, and FAPα in LARC cells after nCRT were higher than in LARC cells untreated with nCRT (p < 0.001 for each). Elevated levels of CXCL12 in the plasma membrane of LARC cells after nCRT demonstrated an association with the period of freedom from recurrence (FFR) in univariate and multivariate survival analyses (p = 0.005 and p = 0.031, respectively). Conclusions: The expression of CXCL12 may influence the survival and invasive properties of LARC cells during nCRT and promote cancer recurrence. We suggest that CXCL12 expression in the plasma membrane of radioresistant LARC cells may be a predictive factor of recurrence and a viable therapeutic strategy to control radioresistant LARC recurrence.

Gastric endoscopic screening is an effective way to decide appropriate gastric cancer (GC) treatment at an early stage, reducing GC-associated mortality rate. Although artificial intelligence (AI) has brought a great promise to assist pathologist to screen digitalized whole slide images, existing AI systems are limited in fine-grained cancer subclassifications and have little usability in planning cancer treatment. We propose a practical AI system that enables five subclassifications of GC pathology, which can be directly matched to general GC treatment guidance. The AI system is designed to efficiently differentiate multi-classes of GC through multi-scale self-attention mechanism using 2-stage hybrid Vision Transformer (ViT) networks, by mimicking the way how human pathologists understand histology. The AI system demonstrates reliable diagnostic performance by achieving class-average sensitivity of above 0.85 on a total of 1,212 slides from multicentric cohort. Furthermore, AI-assisted pathologists show significantly improved diagnostic sensitivity by 12% in addition to 18% reduced screening time compared to human pathologists. Our results demonstrate that AI-assisted gastric endoscopic screening has a great potential for providing presumptive pathologic opinion and appropriate cancer treatment of gastric cancer in practical clinical settings.

Additional file 1.

Objective The present study examines the effects of attachment styles on the grief response and the indirect effect of rumination in parents who lost a child in the Sewol Ferry accident.Methods Bereaved parents (n=81) completed self-report questionnaires evaluating their attachment style (Experience in Close Relationship-Short form), traumatic loss related rumination (Event-Related Rumination Inventory), degree of complicated grief (Inventory of Complicated Grief), and post-traumatic growth (Post-Traumatic Growth Inventory). Data were analyzed using correlation analysis, structural equation modeling, and bootstrapping.Results The indirect effect of event-related intrusive rumination was significant in the relationship between attachment avoidance and complicated grief. The path from attachment avoidance to post-traumatic growth via deliberate rumination was not significant. With respect toattachment anxiety and post-traumatic growth, the indirect effect of deliberate rumination was significant. But the indirect effect of intrusive rumination was not significant in the relationships among attachment anxiety, complicated grief, and post-traumatic growth.Conclusion Individuals with attachment anxiety could obtain post-traumatic growth via deliberate rumination. By contrast, attachment avoidance was associated with the risk of maladaptive grief. Grief interventions should account for individual differences in attachment styles through interventions that manage intrusive rumination and strengthen deliberate rumination.

Background Since 1995, the Korean Society for Cytopathology has overseen the Continuous Quality Improvement program for cytopathology laboratories. The Committee of Quality Improvement has carried out an annual survey of cytology data for each laboratory and set standards for proficiency tests. Methods Evaluations were conducted four times per year from 2008 to 2018 and comprised statistics regarding cytology diagnoses of previous years, proficiency tests using cytology slides provided by the committee, assessment of adequacy of gynecology (GYN) cytology slides, and submission of cytology slides for proficiency tests. Results A total of 206 institutes participated in 2017, and the results were as follows. The number of cytology tests increased from year to year. The ratio of liquid-based cytology in GYN gradually decreased, as most of the GYN cytology had been performed at commercial laboratories. The distribution of GYN diagnoses demonstrated nearly 3.0% as atypical squamous cells. The rate for squamous cell carcinoma was less than 0.02%. The atypical squamous cell/squamous intraepithelial lesion ratio was about 3:1 and showed an upward trend. The major discordant rate of cytology-histology in GYN cytology was less than 1%. The proficiency test maintained a major discordant rate less than 2%. The rate of inappropriate specimens for GYN cytology slides gradually decreased. Conclusions The Continuous Quality Improvement program should be included in quality assurance programs. Moreover, these data can contribute to development of national cancer examination guidelines and facilitate cancer prevention and treatment.

Phosphoserine phosphatase (PSPH) is one of the key enzymes of the L-serine synthesis pathway. PSPH is reported to affect the progression and survival of several cancers in an L-serine synthesis-independent manner, but the mechanism remains elusive. We demonstrate that PSPH promotes lung cancer progression through a noncanonical L-serine-independent pathway. PSPH was significantly associated with the prognosis of lung cancer patients and regulated the invasion and colony formation of lung cancer cells. Interestingly, L-serine had no effect on the altered invasion and colony formation by PSPH. Upon measuring the phosphatase activity of PSPH on a serine-phosphorylated peptide, we found that PSPH dephosphorylated phospho-serine in peptide sequences. To identify the target proteins of PSPH, we analyzed the protein phosphorylation profile and the PSPH-interacting protein profile using proteomic analyses and found one putative target protein, IRS-1. Immunoprecipitation and immunoblot assays validated a specific interaction between PSPH and IRS-1 and the dephosphorylation of phospho-IRS-1 by PSPH in lung cancer cells. We suggest that the specific interaction and dephosphorylation activity of PSPH have novel therapeutic potential for lung cancer treatment, while the metabolic activity of PSPH, as a therapeutic target, is controversial.

Intraosseous hemangioma is a rare, slow-growing, benign tumor of blood vessels. Primary hemangioma of the skull is a benign lesion that may appear as a palpable mass or accidentally detected during image evaluation. Simple radiography is the most commonly used technique to localize a lesion and computed tomography (CT) may help determine the effect of a lesion. We report a case of multifocal intraosseous calvarial hemangioma developed in the subgaleal plane of an elderly male patient. Ultrasonography examination revealed hyperechoic striated septae parallel to the skin and discontinuity of the focal cortex, however, the underlying bone cortex appeared relatively intact. No significant flow is observed on Doppler ultrasonography. Based on these evaluations, the mass was interpreted by a radiologist as a subgaleal lipoma. This case highlights the importance of additional CT examination in a patient presenting with a scalloping sign of the underlying calvarium. Clinicians also should be aware of the possibility of intraosseous calvarial hemangiomas in lesion. Furthermore, the proper choice of congenital vascular malformation term is still quite confusing with misconception present in the literature.

본고는 ‘장소인문학’의 일환으로 식민지시기, 경성, 어린이 문화를 중심으로 어린이들이 향유했던 문화의 실상을 장소와 내용으로 점검하여 이를 현대에 활용하는 데 목적이 있다. 식민지시기 어린이 문화를 크게 (1) 어린이날 행진 (2) 동화회(童話会) 관람과 공연 (3) 신문 및 잡지의 독자투고 (4) 사진을 통한 현실 인식으로 살펴보았다. 경운동에서 시작한 어린이날 거리 행진은 탑골공원에까지 이르렀고, 어린이들을 귀하게 여겨달라는 선전 문구를 전달하였다. 천도교중앙대교당은 어린이들이 동화, 동요, 동극을 가장 많이 관람할 수 있는 장소이다. 또한, 탑골공원 옆에 위치한 경성도서관 내에 설치된 아동도서관에서는 동화회, 유성기 음악듣기, 표본실 등을 운영하여 어린이들이 문학과 음악을 즐기고 감상할 수 있는 기회를 제공하였다. 탑골공원은 다양한 정책에 따라서 변화했고, 현재는 3·1운동의 역사성을 재현하기 위한 공간으로 조성중이다. 탑골공원과 종로 주변을 노인뿐만 아니라 젊은층이 어울릴 수 있는 공간으로 만들기 위해서는 식민지시기 경성의 어린이 문화를 기억할 필요성이 있다. 탑골공원 주변은 다양한 어린이 문화가 향유된 공간으로 어린이 문화의 복합지라고 할 수 있다. 사람들이 많이 모여서 의견을 교류하고 소통할 수 있었던 공간이 바로 탑골공원이었다. 이러한 역사성은 현재에도 이어지고 있다. 탑골공원이 지닌 이야기마당, 소통마당으로서의 역할을 현대에 되살릴 필요성이 있다. 이를 위해서 어린이날 거리 행진 구간인 광화문에서 탑골공원, 천도교중앙대교당에 이르는 구간을 어린이 문화의 길로 복원할 수 있다. 또한, 이들 구간에 어린이 문화와 관련 있는 문화유산을 탐방코스로 개발하여 현대 서울시민과 어린이들이 즐길 수 있는 공간으로 조성할 수 있다. 탑골공원 주변 지역이 어린이청소년층, 장년층, 노년층 등 세대가 함께 교류할 수 있는 공간으로 조성된다면 3·1운동의 역사성을 계승하고 종로 일대에 남아있는 어린이 문화의 정체성을 회복할 수 있는 길이 될 것이다.

Additional file 2: Supplemental material 2. Electrocardiographic features of high and low risk group defined by deep learning based algorithm.

Additional file 1: Supplemental material 1. Performance of deep learning algorithm based on single lead electrocardiography.

Additional file 3: Supplemental material 3. Features of cardiac arrest patients in validation datasets.

Table S1. Comparison the number of YAP and pYAP immunohistochemical expression. Table S2. Comparison the number of PKCι and p-PKCι, immunohistochemical expression. Table S3. Comparison the number of PKCζ and p-PKCζ immunohistochemical expression. Table S4. Multivariate analysis of p-PKCι with overall survival. (DOCX 22 kb)

본 연구는 일본의 복합리조트개발정책을 대상으로 정책의제설정과정을 분석하였다. 이론적 고찰에서 복합리조트개발정책, 정책의제설정과정, 정책의제설정과정 연구에 대해서 검토하였으며, 이를 바탕으로 분석의 틀 및 연구문제를 설정하였다. 연구방법으로는 Yin(2009)의 사례연구방법을 적용하였으며, 일본 복합리조트개발정책관련 문헌자료를 활용하여 분석을 실시하였다. 분석결과, 1기(1999~2009)는 경제적 요인이 정책의제설정에 영향을 미쳤으며 행위자로는 도쿄도지사의 역할이 컸으나 문제의 성격에서 유의성과 지속성 확보가 미흡했다. 정책의제설정과정은 사회문제가 정책의제로 전환되었고, 유형은 동원모형으로 나타났으며, 정책산출은 실패하였다. 2기(2010~2015)에서는 정치적 요인과 국제적 요인이 정책의제설정에 영향을 미쳤으며, 행위자는 아베 총리ㆍ일본 유신회가 주로 활동하였고 문제의 성격에 있어서 유의성과 지속성이 확보되었다. 정책의제설정과정은 사회문제가 정책의제로 전환되었고 유형은 동원모형과 내부접근모형의 복합형으로 나타났으며 정책의제가 설정되었다. 본 연구의 이론적 기여로는 정책의제설정과정 분석을 위한 설명적 논리모형의 적용과 해외사례연구의 시도를 들 수 있으며, 실무적 시사점으로는 공중의제화 단계의 중요성이 제시되었다.