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Abstract We investigated an asymmetric slab grating structure to achieve significant tuning of the quality (Q) factor for a leaky mode while minimizing frequency variation. This structure comprises two identical gratings placed on the top and bottom of a slab waveguide, with one grating laterally shifted to introduce asymmetry. Simulations demonstrate that lateral shifting of one grating induces extensive changes in the Q-factor with minimal frequency variation, particularly near the band-flip filling fraction because the band-flip filling fraction remains unaffected by the shifting. The independence of the band-flip filling fraction from lateral shifting is attributed to the superposition property of Bragg scattering processes in the asymmetric grating structure. Experimental verification in the terahertz range confirms significant control over the Q-factor of the leaky mode of the structure. The proposed asymmetric slab grating structure offers possibilities for mechanically controllable optical devices, which are applicable to tunable filters and sensors. This study advances our understanding and application of leaky modes in asymmetric grating structures, revealing a previously unexplored aspect of asymmetric optical lattice.

Abstract In this paper, we propose a terahertz (THz) guided-mode resonance (GMR) notch filter made of a monolithic polyethylene terephthalate (PET) film, which has a monolayer grating structure. The proposed configuration shows both polarization-dependent and polarization-independent notch filter characteristics for the incident THz wave depending on the rotation angle of the second grating film. When the rotation angle is 0°, the filtering strength (transmittance) at resonance frequency changes from 0.4 (0.996) to 99.0% (0.010) according to the incident polarization. The transmittance continuously decreases with increasing rotation angle until 90°. When the rotation angle is 90°, the transmittance converges to 0.065 (± 0.015) independent of the incident wave polarization. When the incident polarization angle ranges from 90° to 180°, paradoxically, the transmittance through the two GMR grating films is greater than the transmittance through only the first GMR grating film due to the enhancement of the vertical component of the THz wave. These results agree well with a calculation using a polar coordinate system.

The gastrointestinal tract is the most common extranodal site for lymphomas, and mucosa-associated lymphoid tissue lymphoma is the second most common histological lymphoma subtype. However, primary esophageal mucosa-associated lymphoid tissue lymphomas are extremely rare. Few such cases are documented, and the reports demonstrate inconsistent diagnostic and therapeutic strategies. Herein, a 54-year-old man was referred to our hospital for treatment of dysphagia. Esophagogastroduodenoscopy revealed a large, horseshoe-shaped subepithelial mass in the upper esophagus. Endoscopic ultrasonography and computed tomography revealed that the mass was well-demarcated and confined to the muscularis mucosa, with no abnormalities in other organs or lymph nodes. The mass was presumptively diagnosed as benign, and the patient underwent endoscopic mucosal dissection for pathological confirmation and symptom relief. Pathological examination of the dissection specimen revealed that it was a primary esophageal mucosa-associated lymphoid tissue lymphoma. As the patient had an elevated immunoglobulin G level and Helicobacter pylori infection, we administered adjuvant eradication therapy. The patient remains under surveillance and is free of lymphoma recurrence 36 months postoperatively. This case report demonstrates that endoscopic resection and H. pylori eradication are effective treatment strategies for early-stage esophageal mucosa-associated lymphoid tissue lymphoma.

Background This study presents a novel technical tip for intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip for totally laparoscopic distal gastrectomy in patients with middle-third gastric cancer and describes the short-term results of its application. Methods In total, 42 patients with middle-third gastric cancer who underwent intraoperative tumor localization using a titanium ring strip and determination of the proximal resection line through intraoperative radiography between January 2020 and December 2021 were enrolled in this study. We retrospectively analyzed patients’ prospectively collected clinical, pathological, and surgical data. Results Twenty-six men and 16 women with a mean age of 58.3±12.5 years were enrolled. The mean operation time and estimated blood loss were 212.6±43.0 minutes and 122.4±77.6 mL, respectively. The lengths of the proximal and distal resection margin were 2.0±0.4 cm (range, 0.8–3.7 cm) and 10.5±4.1 cm (range, 0.4–20.4 cm), respectively. Roux-en-Y anastomosis was performed in 30 patients, while Billroth II with Braun anastomosis was performed in 12 patients. There were no procedure-related complications, and the mean postoperative hospital stay was 7.2±1.9 days. For all patients, the negative proximal resection margin was confirmed by postoperative pathological examinations. Conclusions Intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip is a useful alternative method that can be easily and safely performed. This method is especially useful for patients with middle-third gastric cancer requiring an appropriate proximal resection margin.

An umbilical venous catheter (UVC) is commonly placed for central venous access in preterm or critically ill full-term neonates to provide total parenteral nutrition (TPN) and medication. However, UVCs can result in complications, including infection, portal vein thrombosis, and hepatic tissue injury. The inadvertent administration of hypertonic fluid through a malpositioned UVC can also cause hepatic parenchymal damage with mass-like fluid collection that simulates a tumorous condition during imaging. Ultrasonography and radiographic examinations play an essential role in detecting UVC-related complications. This pictorial essay aims to present the imaging findings of UVC-related hepatic complications in neonates.

Introduction: Sterol regulatory element binding protein (SREBP) cleavage-associating protein (SCAP) is a sterol-regulated escort protein that translocates SREBPs from the endoplasmic reticulum to the Golgi apparatus, thereby activating lipid metabolism and cholesterol synthesis. Although SCAP regulates lipid metabolism in metabolic tissues, such as the liver and muscle, the effect of macrophage-specific SCAP deficiency in adipose tissue macrophages (ATMs) of patients with metabolic diseases is not completely understood. Objectives: Here, we examined the function of SCAP in high-fat/high-sucrose diet (HFHS)-fed mice and investigated its role in the polarization of classical activated macrophages in adipose tissue. Methods: Macrophage-specific SCAP knockout (mKO) mice were generated through crossbreeding lysozyme 2-cre mice with SCAP floxed mice which were then fed HFHS for 12 weeks. Primary macrophages were derived from bone marrow cells and analyzed further. Results: We found that fat accumulation and the appearance of proinflammatory M1 macrophages were both higher in HFHS-fed SCAP mKO mice relative to floxed control mice. We traced the effect to a defect in the lipopolysaccharide-mediated increase in SREBP-1a that occurs in control but not SCAP mKO mice. Mechanistically, SREBP-1a increased expression of cholesterol 25-hydroxylase transcription, resulting in an increase in the production of 25-hydroxycholesterol (25-HC), an endogenous agonist of liver X receptor alpha (LXRα) which increased expression of cholesterol efflux to limit cholesterol accumulation and M1 polarization. In the absence of SCAP mediated activation of SREBP-1a, increased M1 macrophage polarization resulted in reduced cholesterol efflux downstream from 25-HC-dependent LXRα activation. Conclusion: Overall, the activation of the SCAP-SREBP-1a pathway in macrophages may provide a novel therapeutic strategy that ameliorates obesity by controlling cholesterol homeostasis in ATMs.

Abstract Glucose utilization by visceral adipose tissue (VAT) reflects inflammatory activity, which also promotes tumor growth and carcinogenesis. The effect of metabolically active VAT on survival outcomes in breast cancer is unknown. We investigated survival outcomes in patients with breast cancer based on the standardized uptake value (SUV) of VAT (SUVmean-VAT) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). A total of 148 patients with breast cancer were divided into high- and low groups according to their SUVmean-VAT and SUVmax-tumor. Clinical characteristics and survival outcomes were compared between the groups. High SUVmean-VAT was associated with poor recurrence-free survival (RFS; hazard ratio [HR], 2.754; 95% confidence interval [CI], 1.090–6.958, p = 0.032) and distant metastasis-free survival (DMFS; HR, 3.500; 95% CI, 1.224–10.01, p = 0.019). Multivariate analysis showed that high SUVmean-VAT was a significant factor for poor RFS and poor DMFS (p = 0.023 and 0.039, respectively). High SUVmax-tumor was significantly associated with short RFS (p = 0.0388). Tumors with a high SUV tended to have a short DMFS, although the difference was not significant (p = 0.0718). Our findings showed that upregulated glucose metabolism in the VAT measured using 18F-FDG PET/CT may be a prognostic biomarker for adverse outcomes in breast cancer.

Summary: Detection of landmines without harming personnel is a global issue. The bacterial transcription factor YhaJ selectively detects metabolites of explosives, and it can be used as a key component of DNT biosensors. However, the wild-type YhaJ has a binding affinity that is not sufficient for the detection of trace amounts of explosives leaked from landmines buried in the soil. Here, we report crystal structures of the effector-binding domain of YhaJ in both the apo- and effector-bound forms. A structural comparison of the two forms revealed that the loop above the primary effector-binding site significantly switches its conformation upon effector binding. The primary effector-binding site involves hydrophobic and polar interactions, having specificity to hydroxyl-substituted benzene compounds. The structures explain the mechanism of activity-enhancing mutations and provide information for the rational engineering of YhaJ biosensors for the sensitive detection of explosives.

Abstract The biosynthesis of host lipids and/or lipid droplets (LDs) has been studied extensively as a putative therapeutic target in diverse viral infections. However, directly targeting the LD lipolytic catabolism in virus-infected cells has not been widely investigated. Here, we show the linkage of the LD-associated lipase activation to the breakdown of LDs for the generation of free fatty acids (FFAs) at the late stage of diverse RNA viral infections, which represents a broad-spectrum antiviral target. Dysfunction of membrane transporter systems due to virus-induced cell injury results in intracellular malnutrition at the late stage of infection, thereby making the virus more dependent on the FFAs generated from LD storage for viral morphogenesis and as a source of energy. The replication of SARS-CoV-2 and influenza A virus (IAV), which is suppressed by the treatment with LD-associated lipases inhibitors, is rescued by supplementation with FFAs. The administration of lipase inhibitors, either individually or in a combination with virus-targeting drugs, protects mice from lethal IAV infection and mitigates severe lung lesions in SARS-CoV-2-infected hamsters. Moreover, the lipase inhibitors significantly reduce proinflammatory cytokine levels in the lungs of SARS-CoV-2- and IAV-challenged animals, a cause of a cytokine storm important for the critical infection or mortality of COVID-19 and IAV patients. In conclusion, the results reveal that lipase-mediated intracellular LD lipolysis is commonly exploited to facilitate RNA virus replication and furthermore suggest that pharmacological inhibitors of LD-associated lipases could be used to curb current COVID-19- and future pandemic outbreaks of potentially troublesome RNA virus infection in humans.

Extraskeletal osteochondroma, a variant of chondroma, typically arises in the para-articular location of hands and feet. It is a rare disease and is particularly uncommon when joint components are not involved or localized away from joints. Herein, we report a case of extraskeletal osteochondroma in the posterior neck of a 66-year-old female. The characteristic radiologic finding of our case is presented, along with the typical findings of the disease and review of related literature reports.

Biliary atresia is a progressive, idiopathic, obliterative disease of the extrahepatic biliary tree that presents with biliary obstruction in the neonatal period. It is the most common indication for liver transplantation in children. If untreated, progressive liver cirrhosis leads to death by two years of age. Nowadays, more than 90% of biliary atresia patients survive into adulthood with the development of Kasai portoenterostomy and liver transplantation technology. Early diagnosis is critical since the success rate of the Kasai portoenterostomy decreases with time. This study comprehensively reviews the recent advances in the etiology, classification, prevalence, clinical manifestations, treatment, and prognosis of biliary atresia.

Despite the efforts made to minimize the illegal trafficking of hazardous waste and prevent environmental pollution worldwide in accordance with the 1989 Basel Convention (BC), the illegal transboundary movement of waste and associated environmental pollution are ongoing. This study proposes a three-stage theoretical approach to effectively managing this waste. In stage one, the Convention, including its 2019 revisions, stipulates six primary requirements: clear declaration, hazardous waste, onsite inspection, responsibility, transport management, and final disposal after import. In stage two, the export and import management system is divided into four facets: customs preprocessing, customs processing, follow-up, and law. The challenges are presented of how to align the waste disposal with the Basel Convention's main requirements. Stage three presents a discussion of the effectiveness of the countermeasures derived in stage two for disposing of waste both within individual nations and internationally. Then, the theoretical approach was applied to analyzing South Korea Ministry of Environment's Act on the Transboundary Movement of Hazardous Waste and Their Disposal (revised in 2017). The strategy was demonstrated to be an improvement, and these study results can be foundational data to newly establish laws or revise existing acts on transboundary movement of waste (TMW) in each country.

Background/Aims: Although gastrointestinal endoscopy (GIE) is a major contributor to the carbon footprint of national healthcare, the amount of medical waste generated by GIE procedures is not reported in South Korea. This study aimed to measure the amount of medical waste generated from GIE procedures in South Korea. Methods: We conducted a 5-day audit of medical waste generated during GIEs at seven hospitals. During the study period, medical waste in the endoscopy examination rooms was measured twice daily and documented as mass (kg). To calculate the mean mass of disposable waste generated during one esophagogastroduodenoscopy (EGD) and one colonoscopy, the mean mass of medical waste generated from seven examinations was calculated. The mean mass of medical waste generated during GIEs was calculated by dividing the total mass of medical waste generated by the number of GIE procedures. Results: Overall, 3,922 endoscopies were performed and 4,558 kg of waste was generated. The mean weight of medical waste generated per endoscopy was 1.34 kg. Each EGD and colonoscopy generated a mean of 0.24 kg and 0.43 kg of disposable waste, respectively. Applying the mean waste estimates from this study to annual GIE procedures performed in South Korea in 2022 showed that the total medical waste produced from GIE was 13,704,453 kg. In addition, the total masses of medical waste produced during EGD and colonoscopy procedures were 819,766 kg and 2,889,478 kg, respectively. Conclusions: Our quantitative measurement showed that a large amount of medical waste is generated from GIE procedures. However, further research is warranted to reduce medical waste generated during GIE, which is an urgent unmet need. [ABSTRACT FROM AUTHOR]

The enigmatic relationship of birnessite and buserite, the two most representative phases in submarine nodules, has been established to reveal that buserite is a super-hydrated form of birnessite, forming at shallow terrestrial depth in the presence of water

Pulmonary sclerosing pneumocytoma (PSP) is a tumor of pneumocytic origin that is classified as a benign neoplasm. To date, aggressive behavior of this tumor has rarely been reported. Here, we describe a case of a 56-year-old woman with a huge, 19-cm PSP that resulted in mediastinal shift and showed microscopic endobronchial invasion and necrosis. The differential diagnosis included malignant mesenchymal tumors, such as solitary fibrous tumor; however, PSP was confirmed based on the characteristic thyroid transcription factor 1 positivity and membranous expression of Ki-67 on immunohistochemical staining of tumor cells.

Abstract Miniaturized untethered soft robots are recently exploited to imitate multi‐modal curvilinear locomotion of living creatures that perceive change of surrounding environments. Herein, the use of Caenorhabditis elegans (C. elegans) is proposed as a microscale model capable of curvilinear locomotion with mechanosensing, controlled by magnetically reconfigured 3D microtopography. Static entropic microbarriers prevent C. elegans from randomly swimming with the omega turns and provide linear translational locomotion with velocity of ≈0.14 BL s−1. This velocity varies from ≈0.09 (for circumventing movement) to ≈0.46 (for climbing) BL s−1, depending on magnetic bending and twisting actuation coupled with assembly of microbarriers. Furthermore, different types of neuronal mutants prevent C. elegans from implementing certain locomotion modes, indicating the potential for investigating the correlation between neurons and mechanosensing functions. This strategy promotes a platform for the contactless manipulation of miniaturized biobots and initiates interdisciplinary research for investigating sensory neurons and human diseases.

Abstract Serum inflammatory markers are used in the prognostication of colorectal cancer (CRC); however, the corresponding role of positron emission tomography (PET)-derived inflammatory markers remains unclear. This study aimed to investigate the prognostic value of 18F-fluorodeoxyglucose (FDG) uptake in the bone marrow and spleen of patients with CRC and evaluate the relationship between FDG uptake estimates in these organs and serum inflammatory markers. In total, 411 patients who underwent preoperative FDG PET/computed tomography (CT) within 1 month of surgery were enrolled. The mean standardized uptake values of the bone marrow and spleen were normalized to the value of the liver, thereby generating bone marrow-to-liver uptake ratio (BLR) and spleen-to-liver uptake ratio (SLR) estimates. The value of BLR and SLR in predicting overall survival (OS) was assessed using the Cox proportional hazards model. The correlation between BLR or SLR and neutrophil-to-lymphocyte ratio (NLR) was evaluated. The predictive accuracy of BLR alone and in combination with SLR was compared using the integrated area under the receiver operating characteristic curves (iAUC). In the univariate analysis, BLR (> 1.06) and SLR (> 0.93) were significant predictors of OS. In the multivariate analysis, BLR was an independent predictor of OS (hazard ratio = 5.279; p

Importance: Porcine epidemic diarrhea virus (PEDV) binds to particular cell surface receptors to penetrate cells. The virus specifically identifies certain carbohydrate structures present on the surface of the cell to facilitate the binding process. Nevertheless, the influence of viral infections on specific alterations of glycoconjugates in the small intestines remains unexplored. Objective: This work aimed to examine the alterations in glycoconjugates in the small intestines of piglets naturally infected with PEDV using lectin histochemistry. Methods: Six piglets including three PEDV-infected and three non-infected piglets were evaluated. Small intestinal samples were histopathologically examined, and lectin histochemistry was performed. Results: Piglets infected with PEDV had significant histological abnormalities in their small intestines, such as pronounced villous atrophy, varying degrees of villous fusion, and diverse mucosal alterations. Specific regions of the duodenum, jejunum, and ileum showed discernible variations in glycoconjugate distribution, as determined by lectin histochemistry. Compared with the controls, the PEDV-infected piglets showed significant changes in N-acetylglucosamine- and galactose-binding lectins (particularly wheat germ agglutinin and Arachis hypogaea (peanut) agglutinin) in multiple intestinal regions. Conclusions and Relevance: These findings can enhance understanding of how viruses such as PEDV impact the glycoconjugate composition of the small intestines and emphasize the potential connection between the pathogenesis of PEDV and glycoconjugate. [ABSTRACT FROM AUTHOR]

In South Korea, hazardous characteristics of wastes to be recycled are managed through the “Environmental Impact Assessment of Recycling” system. The ecotoxicity of medium-contact recyclable wastes, that is, those in contact with soil, groundwater, surface water, etc., is managed according to this system and is determined based on whether or not they exceed an ecotoxicity value (TU) of 2.0. The ecotoxicity of wastes is tested and determined by using pretreated eluate samples according to the Official Wastes Test Standard and applying the Official Water Pollution Process Test Standard. However, no ecotoxicity management limits are stipulated for medium-contact recycling using wastes in numerous other countries. This study aims to evaluate applicability and safety of the ecotoxicity test for wastes used in medium-contact recycling and establish an efficient management plan for hazardous characteristic wastes. Target wastes for the survey were selected based on the Wastes Control Act in South Korea. Nine types of waste were selected, which are representative types of wastes to which ecotoxicity is applied. In order to secure the representativeness of the target samples, a total of 45 samples were collected by selecting 5 cases each of the 9 waste types in consideration of the type of industry and amount of waste generated. Limit exceedance was calculated for each category of hazardous substances (leaching, total content), pH, and ecotoxicity of a total of 45 samples, and was found to increase in the order of leaching 2.22%

Albite is one of the major constituents in the Earth’s crust. Here, the authors report that under hydrous cold subduction conditions, albite undergoes breakdown into hydrated smectite and other phases, which release alkaline fluids into the mantle wedge.

Abstracts Purpose The purpose of this study was to determine the effects of exercise on physical fitness and strength according to their frailty level of the hypertensive female elderly aged over 65. Methods Female elderly subjects (>65 year) with hypertension (n=90) were classified according to their level of frailty (Fr_), and were divided into control group (Ctrl) and exercise group (Ex). Hypertensive female elderly in exercise groups were subjected to 8-week combined exercise of aerobic (stretching and walking) and resistance (elastic band and weight training) exercise twice per week (50 minutes×2 times×8 weeks). Body composition, functional fitness and skeletal muscle strength were evaluated as main variables (Ctrl, n=27; Ex, n=23; Fr_Ctrl, n=17; Fr_Ex, n=23). Results Body composition, blood pressure, fasting glucose level (include hemoglobin A1c) and blood lipid profile did not interact with the exercise intervention and frailty level. Records of 30-second chair stretch test, two-minute walk test and arm curl increased after exercise intervention regardless of frailty level. The strength of quadriceps femoris increased after exercise intervention regardless of the level of frailty. However, the strength of biceps femoris (p

Botryoid Wilms tumor, a very rare variant of Wilms tumor, arises from the pelvocalyceal system, and its occurrence in the fetal or neonatal period has never been reported in the literature. Herein, we report an exceedingly rare and challenging case of botryoid Wilms tumor in a neonate who initially presented with fetal hydronephrosis. Postnatal ultrasonography revealed multiple lobulating hypoechoic masses with varying degrees of intralesional vascularity within the dilated pelvocalyceal system. To our knowedge, this is a case report of botryoid Wilms tumor of the youngest child in English literature.

As a consequence of the issues resulting from global climate change many nations are starting to transition to being low or net zero carbon economies. To achieve this objective practical alternative fuels are urgently required and hydrogen gas is deemed one of the most desirable substitute fuels to traditional hydrocarbons. A significant challenge, however, is obtaining hydrogen from sources with low or zero carbon footprint i.e. so called ‘green’ hydrogen. Consequently, there are a number of strands of research into processes that are practical techniques for the production of this ‘green’ hydrogen. Over the past five decades there has been a significant body of research into photocatalytic (PC)/photoelectrocatalytic processes for hydrogen production through water splitting or water reduction. There have, however been significant issues faced in terms of the practical capability of this promising technology to produce hydrogen at scale. This road map article explores a range of issues related to both PC and photoelectrocatalytic hydrogen generation ranging from basic processes, materials science through to reactor engineering and applications for biomass reforming.

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that requires significant experiences and skills and has various procedure-related complications, some of which can be severe and even result in the death of patients. Expanding ERCP availability has the advantage of increasing accessibility for patients. However, ERCP poses a substantial risk if performed without proper quality management. ERCP quality management is essential for both ensuring safe and successful procedures and meeting the social demands for enhanced healthcare competitiveness and quality assurance. To address these concerns, the Korean Pancreatobiliary Association established a task force to develop ERCP quality indicators (QIs) tailored to the Korean medical environment. Key questions for five pre-procedure, three intra-procedure, and four post-procedure measures were formulated based on a literature search related to ERCP QIs and a comprehensive clinical review conducted by experts. The statements and recommendations regarding each QI item were selected through peer review. The developed ERCP QIs were reviewed by external experts based on the latest available evidence at the time of development. These domestically tailored ERCP QIs are expected to contribute considerably to improving ERCP quality in Korea. [ABSTRACT FROM AUTHOR]

Background: Survival rates for anaplastic thyroid cancer (ATC) have not improved in the past four decades; however, preliminary clinical data indicate that lenvatinib may provide efficacy benefits for patients with ATC. This real-world study aimed to define the potential role of lenvatinib in ATC by examining the impact of treatment administered alongside existing therapies.Methods: This was a retrospective, single-center analysis of Korean patients with confirmed ATC who received lenvatinib between October 2015 and February 2018. Eighteen patients were included (mean ± standard deviation age, 64.9 ± 11.1 years; 61.1% female). Six [33.3%] had resectable disease that progressed after a combination of surgery, radiotherapy, and chemotherapy, and 12 [66.7%] had unresectable disease that progressed after radiation treatment and chemotherapy. Study endpoints were overall survival (OS) and change in volume of the largest tumor assessed via imaging.Results: Median OS for the 18 lenvatinib-treated patients was 230 days (range 64–839 days). Survival rates at 6 months and 1 year were 61.1 and 22.2%, respectively. Three patients (16.7%) survived beyond 1 year; 15 patients died, of whom four (26.7%) had local disease and 11 (73.3%) had distant metastasis. Two patients (11.1%) had tumor volume increases of 9–10%. The other 16 patients (88.9%) had tumor volume reductions of 2–69%. Six patients (33.3%) had tumor volume reductions ≥50%.Conclusions: In patients with ATC who had progressed on prior therapy, addition of lenvatinib could improve survival duration and reduce tumor volume. Further studies of lenvatinib in ATC are warranted.

Abstract A breakthrough utilizing an anionic redox reaction (O2−/On−) for charge compensation has led to the development of high‐energy cathode materials in sodium‐ion batteries. However, its reaction results in a large voltage hysteresis due to the structural degradation arising from an oxygen loss. Herein, an interesting P2‐type Mn‐based compound exhibits a distinct two‐phase behavior preserving a high‐potential anionic redox (≈4.2 V vs Na+/Na) even during the subsequent cycling. Through a systematic series of experimental characterizations and theoretical calculations, the anionic redox reaction originating from O 2p‐electron and the reversible unmixing of Na‐rich and Na‐poor phases are confirmed in detail. In light of the combined study, a critical role of the anion‐redox‐induced two‐phase reaction in the positive‐negative point of view is demonstrated, suggesting a rational design principle considering the phase separation and lattice mismatch. Furthermore, these results provide an exciting approach for utilizing the high‐voltage feature in Mn‐based layered cathode materials that are charge‐compensated by an anionic redox reaction.

X-linked hypophosphatemic rickets is caused by loss-of-function mutations in PHEX, which encodes a phosphate-regulating endopeptidase homolog. We report a 26-year-old man with X-linked hypophosphatemic rickets who showed decreased serum phosphate accompanied by bilateral genu valgum and short stature. He had received medical treatment with vitamin D (alfacalcidol) and phosphate from the age of 3 to 20 years. He underwent surgery due to valgus deformity at the age of 14 and 15. Targeted gene panel sequencing for Mendelian genes identified a nonsense mutation in PHEX (c.589C>T; p.Gln197Ter) and a mosaic pattern where only 38% of sequence reads showed the variant allele. This mutation was not found in his mother, who had a normal phenotype. This is a case of a sporadic nonsense mutation in PHEX and up to date, this is the first case of a mosaic mutation in PHEX in Korea.

The hepatic artery can have numerous variations. However, a common hepatic artery originating from the left gastric artery and the entire hepatic blood supply furnished by the left gastric artery is an extremely rare anomaly. We encountered this anomaly in a patient with advanced gastric cancer. A surgeon should recognize this image appearance and identify the anomaly. Without knowledge of this anomaly and given the strategy for extensive lesser sac dissection generally employed during gastric cancer surgery, a surgeon could easily inadvertently divide this vessel, resulting in critical liver damage. We report a case of common hepatic artery originating from left gastric artery and review of the literatures.

Primary neuroendocrine tumors originating from the extrahepatic bile duct are rare. Among these tumors, large cell neuroendocrine carcinomas (NECs) are extremely rare. A 59-year-old man was admitted to Sanggye Paik Hospital with jaundice that started 10 days previously. He had a history of laparoscopic cholecystectomy, which he had undergone 12 years previously due to chronic calculous cholecystitis. Laboratory data showed abnormally elevated levels of total bilirubin 15.3 mg/dL (normal 0.2-1.2 mg/dL), AST 200 IU (normal 0-40 IU), ALT 390 IU (normal 0-40 IU), and gamma-glutamyl transferase 1,288 U/L (normal 0-60 U/L). Serum CEA was normal, but CA 19-9 was elevated 5,863 U/mL (normal 0-37 U/mL). Abdominal CT revealed a 4.5 cm sized mass involving the common bile duct and liver hilum and dilatation of both intrahepatic ducts. Percutaneous transhepatic drainage in the left hepatic duct was performed for preoperative biliary drainage. The patient underwent radical common bile duct and Roux-en-Y hepaticojejunostomy for histopathological diagnosis and surgical excision. On histopathological examination, the tumor exhibited large cell NEC (mitotic index >20/10 high-power field, Ki-67 index >20%, CD56 [+], synaptophysin [+], chromogranin [+]). Adjuvant concurrent chemotherapy and radiotherapy were started because the tumor had invaded the proximal resection margin. No recurrence was detected at 10 months by follow-up CT.

Abstract Background There are no objective and accurate rating tools for permanent impairment of traumatized ankles. The purpose of this study is to assess the role of 18F-Sodium fluoride (18F-NaF) positron emission tomography-computed tomography (PET/CT) bone scans in evaluating patients with limited ankle range of motion (ROM) after trauma. Methods 18F-NaF PET/CT was performed in 121 patients (75 men, 46 women; mean age: 45.8) who had ROM 2.5 was automatically obtained from the 3D volume that included the ankle joint. The maximum & mean SUV (SUVmax & SUVmean), and the total lesion activity (TLA) were measured. Results The median period from injury to performing 18F-NaF PET/CT was 290 days. The causes of injury were as follows: fracture (N = 95), Achilles tendon rupture (N = 12), and ligament injury (N = 12). Hot uptake in the ankle was seen in 113 of 121 patients. The fracture group had higher SUVmax, SUVmean, and TLA values than the non-fracture group. More limited ROM correlated with higher hot-uptake parameters (SUVmax, SUVmean, TLA). In subgroup analysis, the same correlations were present in the fracture, but not in the non-fracture group. Conclusions 18F-NaF PET/CT can provide considerable information in impairment evaluations of limited ankle ROM, particularly in fracture around the ankle. Thus, 18F-NaF bone PET/CT may provide an additional option as an objective imaging tool in disability assessment after ankle injury.

MRI plays a crucial role in bone marrow (BM) assessment, and has very high sensitivity in diagnosing marrow disorders. However, for radiologists who may not frequently encounter pediatric imaging, distinguishing pathologic BM lesion from normal BM can be challenging. Conditions involving the BM in pediatric patients, such as leukemia and metastatic neuroblastoma, often manifest with diverse musculoskeletal symptoms and may be diagnosed using musculoskeletal MRI examinations. Accurate interpretation of pediatric MRI requires not only an understanding of the normal composition of BM but also an awareness of agerelated developmental changes in the marrow and familiarity with conditions that commonly involve pediatric BM. We aim to describe the composition of normal BM and outline the normal and abnormal MRI findings in pediatric BM. Additionally, we aim to present clinical cases of malignant BM disorders including leukemia, neuroblastoma metastasis, and other malignant BM disorders. [ABSTRACT FROM AUTHOR]

Abstract Background The prognosis of a gastrointestinal stromal tumor (GIST) is influenced by its anatomic site; however, few studies on the prognosis of gastric GISTs have been reported. The aims of this study were to evaluate long-term prognoses of patients who underwent surgical resection for gastric GISTs and to compare the clinical efficacy of two staging systems: the National Institutes of Health (NIH) consensus criteria and the 7th Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) tumor-node-metastasis (TNM) staging system. Methods We conducted a retrospective observational study of 145 patients who underwent surgical resection for gastric GISTs between February 2001 and June 2012 at Pusan National University Hospital (Busan, Korea). Recurrence and 5-year recurrence-free survival (RFS) rates were analyzed. Results During a median follow-up period of 44 months (range, 6–144 months), 11 recurrent lesions were detected in 9 patients (6.4%). On multivariate analysis, tumor size (>5 cm), mitotic count (>5/50 high-power fields), and epithelioid and mixed pathological type were significantly associated with recurrence. The overall 5-year RFS rate was 93.4%. Although no statistically significant differences were detected (C-statistic difference P = 0.886), all metrics showed lower values for the UICC/AJCC TNM staging system than for the NIH consensus criteria, suggesting that the UICC/AJCC TNM staging system may be a better model. Conclusions The 5-year RFS rate in patients who underwent curative resection for gastric GISTs was excellent. The UICC/AJCC TNM staging system may be more useful than the NIH consensus criteria for risk categorization of patients with gastric GISTs.

Abstract Perturbation of potassium homeostasis can affect various cell functions and lead to the onset of programmed cell death. Although ionophores have been intensively used as an ion homeostasis disturber, the mechanisms of cell death are unclear and the bioapplicability is limited. In this study, helical polypeptide‐based potassium ionophores are developed to induce endoplasmic reticulum (ER) stress‐mediated apoptosis. The polypeptide‐based potassium ionophores disturb ion homeostasis and then induce prolonged ER stress in the cells. The ER stress results in oxidative environments that accelerate the activation of mitochondria‐dependent apoptosis. Moreover, ER stress‐mediated apoptosis is triggered in a tumor‐bearing mouse model that suppresses tumor proliferation. This study provides the first evidence showing that helical polypeptide‐based potassium ionophores trigger ER stress‐mediated apoptosis by perturbation of potassium homeostasis.

Malrotation and midgut volvulus are surgical emergencies that commonly occur within the first month of life. The classic symptom is acute bilious vomiting, while nonspecific symptoms such as recurrent abdominal pain may be present in older children. Malrotation can be associated with duodenal obstruction caused by an abnormal peritoneal fibrous band or congenital anomalies, such as an annular pancreas or a preduodenal portal vein. Volvulus can lead to bowel ischemia and a life-threatening condition, thus prompt and accurate diagnosis is crucial. Diagnosis can be made through upper gastrointestinal series, ultrasonography, and CT, with ultrasonography being preferred as a screening tool due to its rapid and accurate diagnosis, without radiation exposure, in children. This pictorial essay discusses the key imaging findings and diagnostic approaches for malrotation and midgut volvulus, as well as diagnostic pitfalls based on actual cases. [ABSTRACT FROM AUTHOR]