A 13-year-old neutered male Shih Tzu presented with diffuse intestinal thickening extending from the lower part of the duodenum to the middle part of the jejunum. A portion of the jejunum was biopsied and submitted for histopathological diagnosis. Microscopically, the villi of the mucosal layer were thickened and atrophied, and round tumor cells had infiltrated the intestinal epithelial cells, crypt epithelial cells and lamina propria. Immunohistochemically, the neoplastic cells were immunoreactive to CD3. Based on these results, the intestinal mass from jejunum was diagnosed as epitheliotropic intestinal T-cell lymphoma.

A case of xanthogranulomatous metritis in a 5-year-old Korean short-haired cat is presented. Yellowish-white nodules, 1 to 2 cm in diameter and protruding from the perimetrium, were detected. Histopathological examination revealed extensive inflammatory nodules extending from the endometrium to the perimetrium. The inflammatory nodules primarily consisted of numerous macrophages, along with a smaller number of multinucleated giant cells and lymphocytes. Immunostaining for Iba-1 and Major Histocompatibility Complex class II showed positive reactions in macrophages and multinucleated giant cells. Based on these findings, a diagnosis of xanthogranulomatous metritis in the feline uterus was diagnosed. Because xanthogranulomatous metritis could be clinically diagnosed as a neoplastic lesion, it is considered to have important obstetric value in the differential diagnosis.

Purpose: To determine subjective symptoms and medical history of patients with intermittent exotropia in a large study population. Methods: The Korean Intermittent Exotropia Multicenter Study (KIEMS) is a nationwide, observational, cross-sectional, multicenter study conducted by the Korean Association for Pediatric Ophthalmology and Strabismus including 5,385 patients with intermittent exotropia. Subjective symptoms and medical history of patients with intermittent exotropia were extracted by a comprehensive survey based on a self-administered questionnaire according to the study protocol of the KIEMS. Results: The mean age of symptom onset was 5.5 years. The most common symptom reported in patients with intermittent exotropia was photophobia (52.1%), followed by diplopia at near fixation (7.3%) and distance fixation (6.2%). Preterm birth was found in 8.8%, and 4.1% had perinatal complications. A family history of strabismus was present in 14.9%, and 5.5% of patients had a family member who underwent strabismus surgery. Conclusions The KIEMS is one of the largest clinical studies on intermittent exotropia. Intermittent exotropia frequently caused photophobia and diplopia, and patients with a family history was not uncommon.

With the advances of digital scanning technology in dentistry, the interests in facial scanning in orthodontics have increased.There are many different manufacturers of facial scanners marketing to the dental practice. How do you know which one will work best for you? What questions should you be asking? We suggest a clinical guideline which may help you make an informed decision when choosing facial scanners. The characteristics of 7 facial scanners were discussed in this article. Here are some considerations for choosing a facial scanner. *Accuracy: For facial scanners to be of real value, having an appropriate camera resolution is necessary to achieve more accurate facial image representation. For orthodontic application, the scanner must create an accurate representation of an entire face. *Ease of Use: Scanner-related issues that impact their ease of use include type of light; scan type; scan time; file type generated by the scanner; unit size and foot print; and acceptance of scans by third-party providers. *Cost: Most of the expenses associated with facial scanning involve the fixed cost of purchase and maintenance. Other expenses include technical support, warranty costs, transmission fees, and supply costs. This article suggests a clinical guideline to make the right choice for facial scanner in orthodontics.

Purpose: To unravel the mechanism regulating the phosphorylation of glycogen synthase kinase 3 (GSK3) and the correlation between the inhibitory phosphorylation of GSK3α and sperm motility in human. Materials and Methods: The phosphorylation and priming phosphorylated substrate-specific kinase activity of GSK3 were examined in human spermatozoa with various motility conditions. Results: In human spermatozoa, GSK3α/β was localized in the head, midpiece, and principal piece of tail and p-GSK3α(Ser21) was enriched in the midpiece. The ratio of p-GSK3α(Ser21)/GSK3α was positively coupled with normal sperm motility criteria of World Health Organization. In high-motility spermatozoa, p-GSK3α(Ser21) phosphotyrosine (p-Tyr) proteins but p-GSK3α(Tyr279) markedly increased together with decreased kinase activity of GSK3 after incubation in Ca2+ containing medium. In high-motility spermatozoa, p-GSK3α(Ser21) levels were negatively coupled with kinase activity of GSK3, and which was deregulated in low-motility spermatozoa. In high-motility spermatozoa, 6-bromo-indirubin-3′-oxime, an inhibitor of kinase activity of GSK3 increased p-GSK3α(Ser21) and p-Tyr proteins. p-GSK3α(Ser21) and p-Tyr protein levels were decreased by inhibition of PKA and Akt. Calyculin A, a protein phosphatase-1/2A inhibitor, markedly increased the p-GSK3α(Ser21) and p-Tyr proteins, and significantly increased the motility of low-motility human spermatozoa. Conclusions Down regulation of kinase activity of GSK3α by inhibitory phosphorylation was positively coupled with human sperm motility, and which was regulated by Ca2+, PKA, Akt, and PP1. Small-molecule inhibitors of GSK3 and PP1 can be considered to potentiate human sperm motility.

Granular cell tumor was described in the testis of two rabbits. Testis from each rabbit was surgically removed and submitted for histopathological diagnosis. Both testes were about 2.0 cm in diameter, firm, and tan. Microscopically, testicular mass consisted of compact sheets of round to polygonal and occasional spindle-shaped cells. The neoplastic cells contain a large amount of eosinophilic granular material in the cytoplasm. The cytoplasmic eosinophilic granules were positive for periodic acid Schiff stain. Immunohistochemically, the neoplastic cells were immunoreactive to Melan-A and vimentin. Based on these results, the testicular mass was diagnosed as a granular cell tumor.

Purpose: Trocar-site burns occurring during laparoscopic surgery have been reported in various cases, and several efforts to reduce them are underway. This study aimed to analyze the effect of capacitive coupling on trocar site by observing electrical and histological changes for electrical skin burn injury. Methods: To measure the electrical changes relating to capacitive coupling, the temperature, current, voltage, and impedance around the trocar were measured when an open circuit and a closed circuit were formed using insulation intact instruments and repeated after insulation failure. After the experiment, the tissue around the trocar was collected, and microscopic examination was performed. Results: When open circuits were formed with the intact insulation, the impedance was significantly reduced compared to the cases of closed circuits (142.0 Ω vs. 109.3 Ω, p = 0.040). When the power was 30 W and there was insulation failure, no significant difference was measured between the open circuit and the closed circuit (147.7 Ω vs. 130.7 Ω, p = 0.103). Collagen hyalinization, nuclear fragmentation, and coagulation necrosis suggesting burns were observed in the skin biopsy at the trocar insertion site. Conclusion This study demonstrated that even with a plastic trocar and electrosurgical instruments that have intact insulation, if an open circuit is formed, capacitive coupling increases, and trocar-site burn can occur. When using electrocautery, careful manipulation must be taken to avoid creating an open circuit to prevent capacitive coupling related to electrical skin burn.

Objective: To compare the clinical and radiological features of various etiologies of chronic diffuse lacrimal gland enlargement. Materials and Methods: We retrospectively reviewed 91 consecutive patients who underwent surgical biopsy for chronic diffuse lacrimal gland enlargement and were diagnosed with non-specific dacryoadenitis (DA) (n = 42), immunoglobulin G4-related dacryoadenitis (IgG4-RD) (n = 33), and lymphoma (n = 16). Data on patient demographics, clinical presentation, and CT imaging findings (n = 73) and MRI (n = 43) were collected. The following radiologic features of lacrimal gland enlargement were evaluated: size, unilaterality, wedge sign, angle with the orbital wall, heterogeneity, signal intensity, degree of enhancement, patterns of dynamic contrast-enhanced, and apparent diffusion coefficient value. Radiological features outside the lacrimal glands, such as extra-lacrimal orbital involvement and extra-orbital head and neck involvement, were also evaluated. The clinical and radiological findings were compared among the three diseases. Results: Compared to the DA and IgG4-RD groups, the lymphoma group was significantly older (mean 59.9 vs. 46.0 and 49.4 years, respectively; p = 0.001) and had a higher frequency of unilateral involvement (62.5% vs. 31.0% and 15.2%, respectively;p = 0.004). Compared to the IgG4-RD and lymphoma groups, the DA group had significantly smaller lacrimal glands (2.3 vs. 2.8 and 3.3 cm, respectively; p < 0.001) and a lower proportion of cases with a wedge sign (54.8% vs. 84.8% and 87.5%, respectively; p = 0.005). The IgG4-RD group showed more frequent involvement of the extra-orbital head and neck structures, including the infraorbital nerve (36.4%), paranasal sinus (72.7%), and salivary gland (58.6%) compared to the DA and lymphoma groups (4.8%–28.6%) (all p < 0.005). Conclusion Patient age, unilaterality, lacrimal gland size, wedge sign, and extra-orbital head and neck involvement differed significantly different between lymphoma, DA, and IgG4-RD. Our results will be useful for the differential diagnosis and proper management of chronic lacrimal gland enlargement.

Purpose: This study aimed to identify the effect of integrated nursing using cognicise and neurofeedback on cognition and ⍺ waves among elderly individuals. Methods: This quasi-experimental single group pretest-posttest study included 29 Korean adults aged 65 years or older who participated at a senior welfare center in Y city from February to May 2019. Each integrated nursing session consisted of cognicise (10 minutes) and neurofeedback (20 minutes). Subjects participated twice a week for 10 weeks. Structured questionnaires to assess participants' general characteristics and the Korean version of the Mini-Mental Status Examination for Dementia Screening (K-MMSE-DS) were applied. Alpha waves were measured using BrainMaster. Results: Following the integrated nursing program, alpha waves improved in F3 (t=2.41, p=.023), C3 (t=3.00, p=.006), C4 (t=2.60, p=.015), P3 (t=2.43, p=.022), O1 (t=2.30, p=.029), T3 (t=3.05, p=.005), T4 (t=2.28, p=.030), T5 (t=2.91, p=.007), Fz (t=2.30, p=.029), Cz (t=2.73, p=.011), and Pz (t=2.23, p=.034). Most subjects experienced improvement in concentration after participating in the intervention. Conclusion This study provides evidence for the use of a neuroscientific approach including brain wave measurement to improve cognitive health among community-living elderly people.

Although various studies on predictive markers in the use of PD-1/PD-L1 inhibitors are in progress, only PD-L1 expression levels in tumor tissues are currently used. In the present study, we investigated whether baseline serum levels of IL-6 can predict the treatment response of patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In our cohort of 125 NSCLC patients, the objective response rate (ORR) and disease control rate (DCR) were significantly higher in those with low IL-6 (<13.1 pg/ml) than those with high IL-6 (ORR 33.9% vs. 11.1%, p=0.003; DCR 80.6% vs. 34.9%, p<0.001). The median progression-free survival was 6.3 months (95% confidence interval [CI], 3.9–8.7) in the low IL-6 group, significantly longer than in the high IL-6 group (1.9 months, 95% CI, 1.6–2.2, p<0.001). The median overall survival in the low IL-6 group was significantly longer than in the high IL-6 group (not reached vs. 7.4 months, 95% CI, 4.8–10.0). Thus, baseline serum IL-6 levels could be a potential biomarker for predicting the efficacy and survival benefit of PD-1/PD-L1 inhibitors in NSCLC.