Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Objectives: This study was performed to evaluate the utilization patterns of acid suppressants following the withdrawal of ranitidine in Korea. Methods: Health Insurance Review & Assessment Service (HIRA) data from January 2016 to May 2023 were utilized to assess the usage of histamine H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) for acid-related diseases. Drug utilization was calculated for each agent based on the defined daily dose (DDD). To evaluate changes in utilization following the ranitidine recall, an interrupted time series analysis was conducted using segmented linear regression and an autoregressive integrated moving average model. Results: Before the withdrawal of ranitidine, the DDD per 100 000 inhabitants per day was increasing by 6.9 (95% confidence interval [CI], 4.7 to 9.0) for H2RAs and by 19.3 (95% CI, 16.9 to 21.8) for PPIs each month. After the recall, H2RA utilization immediately declined by -1041.7 (95% CI, -1115.8 to -967.7), followed by a monthly increase of 6.6 (95% CI, 3.7 to 9.6) above the previous trend. PPI utilization temporarily surged by 235.2 (95% CI, 149.1 to 321.3), then displayed a monthly increase of 4.1 (95% CI, 0.7 to 7.6) on top of the pre-recall trend. Among PPIs, esomeprazole and rabeprazole demonstrated notable increases, representing the most commonly used acid suppressants in 2023. Conclusions PPI usage rose prominently following the withdrawal of ranitidine from the market. Considering the potential adverse effects of PPIs, further research is necessary to evaluate the public health implications of shifts in the utilization of acid suppressants.

This study analyzed dental treatments under general anesthesia at the Department of Pediatric Dentistry of Pusan National University Dental Hospital from 2014 to 2023. The study results indicated an increased use of general anesthesia, primarily for younger patients, highlighting the increasing need for specialized healthcare professionals in pediatric dentistry. The study population predominantly consisted of male patients and those residing in Gyeongsangnam-do province. The most common treatment for dental caries was restorative, followed by surgical procedures and orthodontic interventions. The number of surgical procedures abruptly increased after 2020. However, pulp treatments and restorations using stainless steel or zirconia crowns decreased over time, with increased resin restorations. Individuals with disabilities more frequently undergo repeat dental procedures under general anesthesia, indicating potential barriers to access for this population. This study emphasizes the need for comprehensive and equitable dental care for all individuals, particularly those with disabilities. Future research should focus on expanding the scope of the analysis to include multiple institutions and exploring long-term outcomes of patients receiving dental treatment under general anesthesia to inform policy development and best practices in pediatric dentistry.

This study examined the transverse relationship between the maxilla and mandible in children with mixed dentition. The study focused on the primary second molar and the permanent first molar in relation to the anteroposterior skeletal patterns using cone-beam computed tomography (CBCT). A total of 102 patients from the Pediatric Dentistry Department at Pusan Dental Hospital were classified into three skeletal groups (Class I, Ⅱ, Ⅲ) based on the ANB angle (angle formed by A-point-nasion-B-point). CBCT scans were analyzed to assess the transverse dimensions of basal bone and dento-alveolar measurements. The results showed that Class Ⅲ patients exhibited a significantly narrower maxillary basal bone compared with Class I and Ⅱ patients. The mandibular basal width was not significantly different between the classes. For primary second molars, Class Ⅲ patients showed significantly narrower maxillary alveolar bone width at the root bifurcation level (51.7 ± 2.5 mm, p < 0.05) compared with Class I and II patients. For permanent first molars, the maxillary occlusal fossa distance was smallest in Class II (45.4 ± 2.4 mm, p < 0.05), and was significantly different from Class I and Class Ⅲ. Maxillary first molar inclination was more lingually inclined in Class Ⅱ patients (99.0 ± 4.2°, p < 0.05) compared with Class Ⅲ patients, whereas Class Ⅲ patients exhibited more buccal inclination. This study highlights the correlation between transverse discrepancies and anteroposterior skeletal classifications, with Class Ⅲ showing a narrower maxillary base and Class Ⅱ patients presenting greater lingual compensation. These findings may aid pediatric dentists in diagnosing transverse relationships in mixed dentition.

This study aims to analyze anatomical and structural changes related to abnormal eruption of the maxillary first premolar in children, focusing on the correlation between maxillary sinus pneumatization volume and positional shifts in the premolar and canine. Twenty-nine children, with Hellman dental age IIIA, exhibiting unilateral abnormal eruption of the maxillary first premolar, were selected. Maxillary sinus morphology and the positions of tooth buds were assessed through CBCT images, and 3D-scanned diagnostic models were used to evaluate the upper arch form. The affected and control sides were compared in terms of sinus pneumatization and the positions of the first premolar and canine tooth buds. Maxillary sinus pneumatization on the affected side was significantly increased (p = 0.0202), while no significant difference was found in the total sinus volume (p = 0.9694). On the affected side, the apex of the first premolar was positioned more anteriorly (p = 0.0029) and more palatally (p = 0.0011) than that on the unaffected side. Additionally, the apex of the canine was positioned more posteriorly on the affected side compared to that on the unaffected side (p = 0.0039). Model analysis revealed that the anteroposterior total arch length on the affected side was longer than that on the control side (p < 0.0001), while the transverse width did not show any statistically significant difference. These findings suggest a potential relationship between maxillary sinus pneumatization and the abnormal eruption path of the first premolar, as well as possible effects on the eruption of canines.

Objectives: This study aims to evaluate the accuracy and effectiveness of temporomandibular joint (TMJ) arthrocentesis using the three-dimensional (3D)-printed TMJ injection guide in cases of hemarthrosis caused by condyle fractures. Materials and Methods: A retrospective chart review was conducted for patients treated with the customized TMJ arthrocentesis guide to address hemarthrosis. Inclusion criteria included adults older than 18 years with condylar fractures not indicated for open reduction and internal fixation. The guide was fabricated using computed tomography or cone-beam computed tomography scans and 3D printing to control the degree and depth of the needle through the guide to aspirate hemarthrosis. Results: Six joints from five patients (average age 52.4 years) were treated using the guide. Post-procedural magnetic resonance imaging confirmed complete resolution of hemarthrosis in all cases. A representative case demonstrated successful outcomes with normal healing and no complications at 8 months post-procedure. Conclusion The customized TMJ injection guide, using ear-based reference points, significantly enhances the accuracy and safety of TMJ arthrocentesis. This innovation is expected to increase the accessibility and effectiveness of TMJ-related treatments for clinicians without specialized TMJ expertise.

A schwannoma is a benign soft tissue tumor derived from Schwann cells of the nerve sheath. The lateral femoral cutaneous nerve is a sensory nerve originating from the second and third lumbar vertebra nerve roots, passing under the inguinal ligament and dividing into anterior and posterior branches. The anterior branch which is a major division and the main nerve that causes meralgia paresthetica supplies the knee joint from the anterior thigh. In addition, the posterior branch supplies the lateral thigh at the greater trochanter level.This paper reports the case of a 52-year-old woman with a very rare schwannoma in the terminal twig of posterior branch of the lateral femoral cutaneous nerve of right thigh protruded through the fascia lata with literatures review.

Objective: This study examined the up-to-date facts from real cases of emergency medical litigations to provide information to act appropriately in medical lawsuits against emergency medicine specialists. Methods: Data were collected from lawsuits from 2008 to 2020. Thirty-nine cases were collected and analyzed retrospectively. Six emergency medicine specialists and one resident with a lawyer’s license participated in the analysis. Results: Medical litigations have surged since 2015. The lawsuits were due mainly to misdiagnoses and violations of the duty to explain. Medical staff won in 12 (38.7%) cases and lost in 19 (61.3%). The main reason for losing was a violation of the duty of care. In criminal claims, 50% of cases resulted in confinement. The win rate was 1.4 times higher in cases where consultation was requested from other specialties (42.9% and 29.4% win with consultation and without, respectively). Conclusion The win rate in lawsuits is decreasing, and the level of penalty is becoming more severe. The decrease in the violation of duty to explain was attributed to education through the years. The win rate was higher when consulting with other specialists. Hence, active consultation is recommended. In addition, the system of radiology interpretation requires improvement because of the many misdiagnoses from reading diagnostic images.