Although endoscopic submucosal dissection (ESD) is increasingly utilized to treat early neoplasms of the gastrointestinal tract, its use for duodenal neoplasms is limited by the thin wall and narrow lumen of the duodenum. We have reviewed cases where ESD was used to treat sessile, nonampullary duodenal neoplasms. To do this, we retrospectively reviewed the medical records of patients treated with ESD for adenomas of the duodenum from January 2001 to December 2010, assessing the curative outcomes and complication rates. A total of 14 cases were reviewed. Mean patient age was 56.4 years. The mean size of tumors and mean size of the specimens were 17.1 mm and 26.4 mm, respectively. The en bloc resection rate with ESD was 78.6%, and the complete (R0) resection rate was 85.7%. No patient in the study experienced major bleeding. However, second-look endoscopy revealed minor bleeding requiring endoscopic homeostasis in one case (7.1%). Perforations were observed in five cases (35.7%). Two of the five patients with perforation underwent surgery. The ESD methods yielded acceptable curative resection rates for duodenal adenomas, although ESD was associated with a higher rate of perforation. Therefore, duodenal ESD should be performed with care and only in selected patients to avoid serious complications.

Early detection of synchronous esophageal squamous cell neoplasm (ESCN) in head and neck squamous cell carcinoma (HNSCC) patients can significantly affect their prognosis. We investigated the prevalence of synchronous ESCN and the risk factors for developing ESCN in patients with HNSCC, and evaluated the effect of routine endoscopic screening in these patients. Subjects who were diagnosed as HNSCC from May 2010 to January 2014 were eligible. All patients underwent conventional white light endoscopic examinations with narrow band imaging and Lugol chromoendoscopy. Among 458 subjects screened, 28 synchronous ESCN were detected in 24 patients (5.2%). The prevalence of ESCN was greatest in patients with hypopharyngeal cancer (20.9%). In multivariate analysis, pyriform sinus involvement was independent risk factor for developing synchronous ESCN (odds ratio 171.2, P < 0.001). During the follow-up period (median, 24 months), the 3-year overall survival rates was significantly lower in patients with ESCN than in patients without ESCN (54.2% vs. 78.3%, P = 0.0013). Routine endoscopic screening for detecting synchronous ESCN should be recommended for patients with HNSCC, especially those with pyriform sinus involvement.

A novel imaging adaptor providing the capability to extend a standard single-band infrared (IR) camera into a two-color or dual-band device has been developed for application to high-speed IR thermography on the National Spherical Tokamak Experiment (NSTX). Temperature measurement with two-band infrared imaging has the advantage of being mostly independent of surface emissivity, which may vary significantly in the liquid lithium divertor installed on NSTX as compared to that of an all-carbon first wall. In order to take advantage of the high-speed capability of the existing IR camera at NSTX (1.6-6.2 kHz frame rate), a commercial visible-range optical splitter was extensively modified to operate in the medium wavelength and long wavelength IR. This two-band IR adapter utilizes a dichroic beamsplitter, which reflects 4-6 μm wavelengths and transmits 7-10 μm wavelength radiation, each with >95% efficiency and projects each IR channel image side-by-side on the camera's detector. Cutoff filters are used in each IR channel, and ZnSe imaging optics and mirrors optimized for broadband IR use are incorporated into the design. In-situ and ex-situ temperature calibration and preliminary data of the NSTX divertor during plasma discharges are presented, with contrasting results for dual-band vs. single-band IR operation.

Endometriosis is a major cause of infertility and pelvic pain, affecting more than 10% of reproductive-aged women. Progesterone resistance has been observed in the endometrium of women with this disease, as evidenced by alterations in progesterone-responsive gene and protein expression. cAMP-Response Element-Binding 3-like protein 1 (Creb3l1) has previously been identified as a progesterone receptor (PR) target gene in mouse uterus via high density DNA microarray analysis. However, CREB3L1 function has not been studied in the context of endometriosis and uterine biology. In this study, we validated progesterone (P4) regulation of Creb3l1 in the uteri of wild-type and progesterone receptor knockout (PRKO) mice. Furthermore, we observed that CREB3L1 expression was significantly higher in secretory phase human endometrium compared to proliferative phase and that CREB3L1 expression was significantly decreased in the endometrium of women with endometriosis. Lastly, by transfecting CREB3L1 siRNA into cultured human endometrial stromal cells (hESCs) prior to hormonal induction of in vitro decidualization, we showed that CREB3L1 is required for the decidualization process. Interestingly, phosphorylation of ERK1/2, critical factor for decidualization, was also significantly reduced in CREB3L1-silenced hESCs. It is known that hESCs from patients with endometriosis show impaired decidualization and that dysregulation of the P4-PR signaling axis is linked to a variety of endometrial diseases including infertility and endometriosis. Therefore, these results suggest that CREB3L1 is required for decidualization in mice and humans and may be linked to the pathogenesis of endometriosis in a P4-dependent manner.

No abstract

This report introduces a method for ultrasound-guided transcervical forceps extraction (UTCE) of unruptured interstitial pregnancies; this method does not necessitate elective caesarean delivery for future pregnancies. This report also compares this technique with conventional methods. A retrospective review was conducted involving 16 women treated for interstitial pregnancies. Among these women, UTCE was successfully performed in six of 16 women, with only one woman requiring additional intervention; conventional treatment was performed in the other ten women. UTCE is a safe, effective and minimally invasive option for treating interstitial pregnancies and should be considered as an alternative treatment modality.

Crankshaft, the core element of the engine of a vehicle, transforms the translational motion generated by combustion to rotational motion. Its failure will cause serious damage to the engine so its reliability verification must be performed. In this study, the S-N data of the bending fatigue limit of a crankshaft are derived. To evaluate the reliability of the crankshaft, reliability verification and analysis are performed. For the purpose of further evaluation, the bending test of the original crankshaft is carried out, and failure mode analysis is made. The appropriate number of samples, the applied load, and the test time are computed. On the basis of the test results, Weibull analysis for the shape and scale parameters of the crankshaft is estimated. Likewise, the B 10 life under 50% of the confidence level and the MTTF are exactly calculated, and the groundwork for improving the reliability of the crankshaft is laid.

The objective of the study was to evaluate the relationship between self-reported bruxism and torus mandibularis in patients with temporomandibular disorders (TMD). The subjects of the study were 375 patients diagnosed with TMD and 433 control patients at Chosun University Dental Hospital from November 1, 2017 to June 30, 2018. Self-reported bruxism and torus mandibularis in each group were investigated and compared statistically. Female in sex distribution and prevalence of self-reported bruxism and torus mandibularis was more common in TMD group than in control group (p<0.05). Bruxism and torus mandibularis might be useful as indicators of increased risk of TMD.