We observed 2-time efficiency increase in THz parametric generation when reducing the thickness of a lithium-niobate waveguide from 1 to 0.5 mm. Efficient THz emitted from such a waveguide OPO with an intracavity grazing-incidence grating.
Background: To evaluate the clinicopathologic factors affecting the clinical outcomes in pathological T4aN0 (pT4aN0) buccal mucosal or gingival squamous cell carcinoma (SCC). Methods: This was a retrospective study of 113 consecutive patients with diagnoses of pT4aN0 buccal mucosal or gingival SCC between January 2010 and November 2018. The median follow-up was 38 months (range, 1–119 months). Kaplan-Meier and Cox proportional-hazards models were used for survival analysis. Results: In the entire study, 5-year overall survival (OS) and disease-free survival (DFS) rates were 73.7% and 83.6%, respectively. Univariate analysis revealed that lymphovascular invasion (LVI), perineural invasion (PNI), and margin status had significant effects on the DFS rate, and tumor cell differentiation had a significant effect on OS rate. Multivariate Cox regression analysis revealed margin status was the only significant factor affecting DFS. The patients (n=38) without the inadequate margin, LVI, PNI, and poorly differentiated tumor cells had a better 5-year DFS rate (P=0.023) whether they had received adjuvant treatment or not (91.5% versus 100%). However, no significant effect on the OS rate was found (P=0.544). Conclusions: The patients who had no adverse pathologic factors exhibited fair DFS rate without adjuvant therapy. The adjuvant therapy may not be considered for this subgroup.
This study aimed to evaluate the efficacy and tolerability oforal sulfate solution (OSS) and 2-L polyethylene glycol with ascorbic acid (PEG+Asc) in split doses for bowel cleansing prior to colonoscopy.
The clinical manifestations of acute organic arsenic intoxication in humans have seldom been described and the associated treatment has been thought to be the same as that of acute inorganic arsenic intoxication. We have studied a collection of patients from 1996 to 2001 who called the Poison Control Center of Kaohsiung Medical University Hospital asking for information regarding acute organic arsenic intoxication. The 17 patients ranged in age from 23 to 64 years old, with 5 females and 12 males. The cause of arsenic ingestion was attempted suicide. Abdominal pain and vomiting were the main symptoms. There were no differences in results between patients treated with and those treated without chelating agents. We therefore believe that the results of acute organic intoxication are not same as acute inorganic intoxication and it is unnecessary to use chelating agents in such conditions.
Congenital adrenal hyperplasia (CAH) is a common autosomal recessive disorder caused mainly by defects in the steroid 21‐hydroxylase ( CYP21 ) gene. More than 90% of CAH cases are caused by mutations of the CYP21 gene on chromosome 6p21.3. The wide range of CAH phenotypes is associated with multiple mutations known to affect 21‐hydroxylase enzyme activity. To date, 56 different CYP21 mutations have been reported, mostly point mutations, but small deletions or insertions have been described too, as well as complete gene deletions. Fifteen mutations, constituting 90–95% of alleles, are derived from intergenic recombination of DNA sequences between the CYP21 gene and the highly homologous CYP21P pseudogene, while the remaining are spontaneous mutations. A reliable and accurate detection of CYP21 mutations is not only important for clinical diagnosis, but also for carrier detection as there is a high variability in the basal level of 17‐hydroxyprogesterone between normal and heterozygous individuals. Several strategies based on polymerase chain reaction (PCR)‐driven amplification with allele‐specific oligonucleotides to the CYP21 gene have been developed. It has been demonstrated that one reaction for PCR amplification of the CYP21 gene and the chimeric CYP21P/CYP21 gene using mixed primers in combination with nested PCR and single‐strand conformation polymorphism is considered highly efficient and accurate for molecular diagnosis of CAH due to 21‐hydroxylase deficiency.
In this report we presented a rare case of papillary thyroid carcinoma with neurological deficits as sole manifestation. With the patient's refusal of craniotomy, stereotactic radiotherapy (SRT) was administered to the tumor in the right petrous bone and the patient later pronounced improvement in most neurological abnormalities. The long-standing mass in left side of her neck proved to be goiter cytologically. Once surgical exploration of the thyroid gland was employed, discovery of cancerous tissue in the right lobe led to further imaging with radioactive iodine. A 131I whole body scintigraphy divulged metastatic thyroid tissue in the base of skull and differentiated intracranial metastatic thyroid carcinoma from neurogenic tumors.
In this study, features are extracted from time vibration signals for the purpose of diagnosing motor faults. On the basis of the specific distance criterion, a simple genetic algorithm (GA) is employed to evaluate and select the optimized features for induction motor fault classification. The selected features are applied to the decision tree and the k-nearest neighbour (k-NN) algorithm in order to show the efficiency of the proposed feature selection method. The diagnostic results show that the optimal feature selection is useful to improve the fault diagnosis performance.
Colorectal cancer (CRC) of the clinical tumor stage T4b (cT4b) refers to advanced tumors with direct invasion of adjacent structures and the tumors are considered unresectable. Despite advancements in aggressive surgery and combination chemotherapy, the prognosis of cT4b CRC remains poor. Optimizing the therapeutic sequence administered to patients with cT4b CRC to improve clinical outcomes is crucial. In the present study, patients with unresectable cT4b and nodal stage N1‑2 CRC were investigated at a single institution. A total of 20 consecutive patients were treated with pre‑operative concurrent chemoradiation by using 5‑fluorouracil/leucovorin/oxaliplatin (FOLFOX) since February 2015 and were regularly followed up until March 2020. Due to their poor response to concurrent chemoradiation (CCRT) with FOLFOX, the chemotherapy regimen was changed to irinotecan plus 5‑fluorouracil/leucovorin (FOLFIRI) as the second‑line neoadjuvant treatment. Genetic alterations, such as microsatellite instability (MSI), were documented, and the expression levels of excision repair cross‑complementing group 1 (ERCC1) and ERCC2 were examined. Of the 20 patients, the tumors of 14 patients (70%) became resectable after FOLFIRI administration. The median duration between the last date of radiotherapy and surgery was 32.7 weeks (range, 10.1‑59.3 weeks). Of note, 4 of the 14 patients with resectable tumors (28.6%) achieved a pathologic complete response. The median overall survival and progression‑free survival were 27.5 months (range, 12‑39 months) and 27.5 months (range, 8‑39 months), respectively. The cancerous specimens of all of the patients (100%) exhibited ERCC2 overexpression and 18 specimens (90%) had ERCC1 overexpression. Only one tumor (5%) exhibited high MSI. The present study indicated that ERCC overexpression associated with the poor response of FOLFOX‑based CCRT and FOLFIRI after FOLFOX‑based CCRT failure may have a potential role in conversion to resectable tumors by neoadjuvant treatment in cT4b CRC. However, a further prospective study with more patients is required to improve the precision of the conclusions.
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