[User]
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Planning for delayed healing post endodontic therapy. Brief history/status: Bufomix Easyhaler, Amlodipine, Levaxin, Metoprolol, Esomeprazole, Calcichew-D3, Insulin glargine. Desired treatment: Measure crest-to-canal distances mandibularly in 36-46, and implant feasibility maxillary 17-27.

[Assistant] Review of CBCT volume dated 201028. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 12: bone height ~ 20.0 mm; implant space ~ 16.1 mm; nearest critical structure: nasal floor. Region 37: bone height ~ 9.4 mm; implant space ~ 6.9 mm; nearest critical structure: mandibular canal. Region 42: bone height ~ 12.1 mm; implant space ~ 3.8 mm; nearest critical structure: anterior loop. Region 34: bone height ~ 5.7 mm; implant space ~ 0.0 mm; nearest critical structure: anterior loop. Region 43: bone height ~ 18.3 mm; implant space ~ 9.9 mm; nearest critical structure: mental foramen. Region 33: bone height ~ 7.0 mm; implant space ~ 1.6 mm; nearest critical structure: anterior loop. Region 16: bone height ~ 19.4 mm; implant space ~ 16.8 mm; nearest critical structure: incisive canal. Region 17: bone height ~ 6.1 mm; implant space ~ 0.0 mm; nearest critical structure: nasal floor. Region 24: bone height ~ 12.7 mm; implant space ~ 4.1 mm; nearest critical structure: sinus floor. Region 45: bone height ~ 11.6 mm; implant space ~ 7.3 mm; nearest critical structure: anterior loop. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Streak artifacts from metallic restorations locally reduce interpretability. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.

Question: Planning for delayed healing post endodontic therapy. Brief history/status: Bufomix Easyhaler, Amlodipine, Levaxin, Metoprolol, Esomeprazole, Calcichew-D3, Insulin glargine. Desired treatment: Measure crest-to-canal distances mandibularly in 36–46, and implant feasibility maxillary 17–27.

Answer: Review of CBCT volume dated 201028. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 12: bone height ≈ 20.0 mm; implant space ≈ 16.1 mm; nearest critical structure: nasal floor. Region 37: bone height ≈ 9.4 mm; implant space ≈ 6.9 mm; nearest critical structure: mandibular canal. Region 42: bone height ≈ 12.1 mm; implant space ≈ 3.8 mm; nearest critical structure: anterior loop. Region 34: bone height ≈ 5.7 mm; implant space ≈ 0.0 mm; nearest critical structure: anterior loop. Region 43: bone height ≈ 18.3 mm; implant space ≈ 9.9 mm; nearest critical structure: mental foramen. Region 33: bone height ≈ 7.0 mm; implant space ≈ 1.6 mm; nearest critical structure: anterior loop. Region 16: bone height ≈ 19.4 mm; implant space ≈ 16.8 mm; nearest critical structure: incisive canal. Region 17: bone height ≈ 6.1 mm; implant space ≈ 0.0 mm; nearest critical structure: nasal floor. Region 24: bone height ≈ 12.7 mm; implant space ≈ 4.1 mm; nearest critical structure: sinus floor. Region 45: bone height ≈ 11.6 mm; implant space ≈ 7.3 mm; nearest critical structure: anterior loop. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Streak artifacts from metallic restorations locally reduce interpretability. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.


[User]
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Planning for assessment of residual ridge. Brief history/status: Betolvex, Esomeprazole, Amlodipine, Bricanyl, Bufomix Easyhaler. Desired treatment: Please analyze bone height, width, and proximity to critical anatomy across 33-43 and 36-46.

[Assistant] Review of CBCT scan dated 250812. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 21: bone height ~ 19.6 mm; implant space ~ 12.6 mm; nearby structure: sinus floor. Region 18: bone height ~ 15.3 mm; implant space ~ 8.3 mm; nearby structure: mental foramen. Region 28: bone height ~ 13.5 mm; implant space ~ 8.7 mm; nearby structure: mandibular canal. Region 41: bone height ~ 16.7 mm; implant space ~ 11.4 mm; nearby structure: mental foramen. Region 22: bone height ~ 4.7 mm; implant space ~ 0 mm; nearby structure: nasal floor. Region 25: bone height ~ 8.2 mm; implant space ~ 4.8 mm; nearby structure: anterior loop. Region 11: bone height ~ 22.0 mm; implant space ~ 14.3 mm; nearby structure: nasal floor. Region 43: bone height ~ 6.0 mm; implant space ~ 4.3 mm; nearby structure: nasal floor. Region 23: bone height ~ 18.8 mm; implant space ~ 15.0 mm; nearby structure: mental foramen. Region 44: bone height ~ 7.4 mm; implant space ~ 1.3 mm; nearby structure: mandibular canal. Maxillary sinus shows mild mucosal thickening bilaterally. Periapical radiolucency visible at 26, additional smaller lesion near 16. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Chronic apical periodontitis noted at 36 and 41; recommend endodontic consultation.

Question: Planning for assessment of residual ridge. Brief history/status: Betolvex, Esomeprazole, Amlodipine, Bricanyl, Bufomix Easyhaler. Desired treatment: Please analyze bone height, width, and proximity to critical anatomy across 33–43 and 36–46.

Answer: Review of CBCT scan dated 250812. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 21: bone height ≈ 19.6 mm; implant space ≈ 12.6 mm; nearby structure: sinus floor. Region 18: bone height ≈ 15.3 mm; implant space ≈ 8.3 mm; nearby structure: mental foramen. Region 28: bone height ≈ 13.5 mm; implant space ≈ 8.7 mm; nearby structure: mandibular canal. Region 41: bone height ≈ 16.7 mm; implant space ≈ 11.4 mm; nearby structure: mental foramen. Region 22: bone height ≈ 4.7 mm; implant space ≈ 0 mm; nearby structure: nasal floor. Region 25: bone height ≈ 8.2 mm; implant space ≈ 4.8 mm; nearby structure: anterior loop. Region 11: bone height ≈ 22.0 mm; implant space ≈ 14.3 mm; nearby structure: nasal floor. Region 43: bone height ≈ 6.0 mm; implant space ≈ 4.3 mm; nearby structure: nasal floor. Region 23: bone height ≈ 18.8 mm; implant space ≈ 15.0 mm; nearby structure: mental foramen. Region 44: bone height ≈ 7.4 mm; implant space ≈ 1.3 mm; nearby structure: mandibular canal. Maxillary sinus shows mild mucosal thickening bilaterally. Periapical radiolucency visible at 26, additional smaller lesion near 16. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Chronic apical periodontitis noted at 36 and 41; recommend endodontic consultation.


[User]
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Planning for pre-surgical bone mapping. Brief history/status: Levaxin, Bricanyl, Amlodipine, Bufomix Easyhaler, Duroferon, Metoprolol. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 15-25.

[Assistant] Review of CBCT volume dated 251102. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 35: bone height ~ 7.1 mm; implant space ~ 2.0 mm; nearest critical structure: mental foramen. Region 26: bone height ~ 21.9 mm; implant space ~ 14.6 mm; nearest critical structure: incisive canal. Region 47: bone height ~ 10.3 mm; implant space ~ 7.1 mm; nearest critical structure: mandibular canal. Region 15: bone height ~ 21.6 mm; implant space ~ 15.7 mm; nearest critical structure: sinus floor. Region 46: bone height ~ 10.8 mm; implant space ~ 1.9 mm; nearest critical structure: mental foramen. Region 18: bone height ~ 14.8 mm; implant space ~ 10.1 mm; nearest critical structure: incisive canal. Region 28: bone height ~ 8.3 mm; implant space ~ 3.0 mm; nearest critical structure: sinus floor. Region 31: bone height ~ 11.7 mm; implant space ~ 9.9 mm; nearest critical structure: anterior loop. Region 23: bone height ~ 17.4 mm; implant space ~ 15.4 mm; nearest critical structure: incisive canal. Region 16: bone height ~ 9.1 mm; implant space ~ 4.0 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Streak artifacts from metallic restorations locally reduce interpretability. Impression: Cyst-like well-defined radiolucency near 16, likely radicular cyst.

Question: Planning for pre-surgical bone mapping. Brief history/status: Levaxin, Bricanyl, Amlodipine, Bufomix Easyhaler, Duroferon, Metoprolol. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 15–25.

Answer: Review of CBCT volume dated 251102. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 35: bone height ≈ 7.1 mm; implant space ≈ 2.0 mm; nearest critical structure: mental foramen. Region 26: bone height ≈ 21.9 mm; implant space ≈ 14.6 mm; nearest critical structure: incisive canal. Region 47: bone height ≈ 10.3 mm; implant space ≈ 7.1 mm; nearest critical structure: mandibular canal. Region 15: bone height ≈ 21.6 mm; implant space ≈ 15.7 mm; nearest critical structure: sinus floor. Region 46: bone height ≈ 10.8 mm; implant space ≈ 1.9 mm; nearest critical structure: mental foramen. Region 18: bone height ≈ 14.8 mm; implant space ≈ 10.1 mm; nearest critical structure: incisive canal. Region 28: bone height ≈ 8.3 mm; implant space ≈ 3.0 mm; nearest critical structure: sinus floor. Region 31: bone height ≈ 11.7 mm; implant space ≈ 9.9 mm; nearest critical structure: anterior loop. Region 23: bone height ≈ 17.4 mm; implant space ≈ 15.4 mm; nearest critical structure: incisive canal. Region 16: bone height ≈ 9.1 mm; implant space ≈ 4.0 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Streak artifacts from metallic restorations locally reduce interpretability. Impression: Cyst-like well-defined radiolucency near 16, likely radicular cyst.


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Planning for prosthetic design planning. Brief history/status: Metoprolol, Bufomix Easyhaler, Levaxin, Betolvex, Calcichew-D3, Atorvastatin, Insulin glargine. Desired treatment: Quantify vertical bone height reduction and comment on trabecular density.

[Assistant] Review of CBCT dated 200922. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 35: bone height ~ 12.7 mm; implant space ~ 10.5 mm; nearby mandibular canal. Region 31: bone height ~ 21.7 mm; implant space ~ 19.5 mm; nearby mental foramen. Region 32: bone height ~ 12.4 mm; implant space ~ 5.3 mm; nearby incisive canal. Region 23: bone height ~ 11.9 mm; implant space ~ 7.6 mm; nearby anterior loop. Region 38: bone height ~ 14.7 mm; implant space ~ 12.4 mm; nearby incisive canal. Region 44: bone height ~ 8.3 mm; implant space ~ 3.2 mm; nearby anterior loop. Region 12: bone height ~ 20.4 mm; implant space ~ 16.5 mm; nearby mandibular canal. Region 13: bone height ~ 11.0 mm; implant space ~ 4.2 mm; nearby mental foramen. Region 43: bone height ~ 14.1 mm; implant space ~ 8.8 mm; nearby sinus floor. Region 48: bone height ~ 16.4 mm; implant space ~ 14.3 mm; nearby mandibular canal. Periapical radiolucency observed near 38; minor sclerosis near 21. Image artifacts due to metallic restorations reduce detail locally. Impression: Impacted molar in quadrant 4 associated with mild follicular space widening.

Question: Planning for prosthetic design planning. Brief history/status: Metoprolol, Bufomix Easyhaler, Levaxin, Betolvex, Calcichew-D3, Atorvastatin, Insulin glargine. Desired treatment: Quantify vertical bone height reduction and comment on trabecular density.

Answer: Review of CBCT dated 200922. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 35: bone height ≈ 12.7 mm; implant space ≈ 10.5 mm; nearby mandibular canal. Region 31: bone height ≈ 21.7 mm; implant space ≈ 19.5 mm; nearby mental foramen. Region 32: bone height ≈ 12.4 mm; implant space ≈ 5.3 mm; nearby incisive canal. Region 23: bone height ≈ 11.9 mm; implant space ≈ 7.6 mm; nearby anterior loop. Region 38: bone height ≈ 14.7 mm; implant space ≈ 12.4 mm; nearby incisive canal. Region 44: bone height ≈ 8.3 mm; implant space ≈ 3.2 mm; nearby anterior loop. Region 12: bone height ≈ 20.4 mm; implant space ≈ 16.5 mm; nearby mandibular canal. Region 13: bone height ≈ 11.0 mm; implant space ≈ 4.2 mm; nearby mental foramen. Region 43: bone height ≈ 14.1 mm; implant space ≈ 8.8 mm; nearby sinus floor. Region 48: bone height ≈ 16.4 mm; implant space ≈ 14.3 mm; nearby mandibular canal. Periapical radiolucency observed near 38; minor sclerosis near 21. Image artifacts due to metallic restorations reduce detail locally. Impression: Impacted molar in quadrant 4 associated with mild follicular space widening.


[User]
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Planning for implant planning evaluation. Brief history/status: Losartan, Esomeprazole, Levaxin, Duroferon, Calcichew-D3. Desired treatment: Assess mandibular canal course and distance to apices in 16-26.

[Assistant] Review of CBCT volume dated 201206. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 22: bone height ~ 16.4 mm; implant space ~ 13.4 mm; nearest critical structure: nasal floor. Region 47: bone height ~ 13.2 mm; implant space ~ 4.2 mm; nearest critical structure: anterior loop. Region 11: bone height ~ 7.2 mm; implant space ~ 0.0 mm; nearest critical structure: incisive canal. Region 44: bone height ~ 4.3 mm; implant space ~ 2.8 mm; nearest critical structure: mental foramen. Region 18: bone height ~ 18.1 mm; implant space ~ 10.8 mm; nearest critical structure: sinus floor. Region 33: bone height ~ 6.1 mm; implant space ~ 0.0 mm; nearest critical structure: mental foramen. Region 24: bone height ~ 9.7 mm; implant space ~ 6.3 mm; nearest critical structure: nasal floor. Region 23: bone height ~ 8.3 mm; implant space ~ 1.8 mm; nearest critical structure: nasal floor. Region 32: bone height ~ 10.4 mm; implant space ~ 3.6 mm; nearest critical structure: mental foramen. Region 14: bone height ~ 12.8 mm; implant space ~ 5.0 mm; nearest critical structure: incisive canal. Periapical radiolucency near 16; lamina dura loss noted. Smaller radiolucency at 18. Impression: Impaction of third molar in quadrant 2 with mesioangular inclination.

Question: Planning for implant planning evaluation. Brief history/status: Losartan, Esomeprazole, Levaxin, Duroferon, Calcichew-D3. Desired treatment: Assess mandibular canal course and distance to apices in 16–26.

Answer: Review of CBCT volume dated 201206. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 22: bone height ≈ 16.4 mm; implant space ≈ 13.4 mm; nearest critical structure: nasal floor. Region 47: bone height ≈ 13.2 mm; implant space ≈ 4.2 mm; nearest critical structure: anterior loop. Region 11: bone height ≈ 7.2 mm; implant space ≈ 0.0 mm; nearest critical structure: incisive canal. Region 44: bone height ≈ 4.3 mm; implant space ≈ 2.8 mm; nearest critical structure: mental foramen. Region 18: bone height ≈ 18.1 mm; implant space ≈ 10.8 mm; nearest critical structure: sinus floor. Region 33: bone height ≈ 6.1 mm; implant space ≈ 0.0 mm; nearest critical structure: mental foramen. Region 24: bone height ≈ 9.7 mm; implant space ≈ 6.3 mm; nearest critical structure: nasal floor. Region 23: bone height ≈ 8.3 mm; implant space ≈ 1.8 mm; nearest critical structure: nasal floor. Region 32: bone height ≈ 10.4 mm; implant space ≈ 3.6 mm; nearest critical structure: mental foramen. Region 14: bone height ≈ 12.8 mm; implant space ≈ 5.0 mm; nearest critical structure: incisive canal. Periapical radiolucency near 16; lamina dura loss noted. Smaller radiolucency at 18. Impression: Impaction of third molar in quadrant 2 with mesioangular inclination.


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Planning for maxillary sinus evaluation. Brief history/status: Bufomix Easyhaler, Esomeprazole, Metoprolol, Amlodipine, Losartan, Duloxetine. Desired treatment: Assess healing of extraction sockets and bone regeneration at 33-43.

[Assistant] Review of CBCT dated 240911. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 14: bone height ~ 9.9 mm; implant space ~ 7.5 mm; nearby incisive canal. Region 45: bone height ~ 11.6 mm; implant space ~ 8.7 mm; nearby mental foramen. Region 25: bone height ~ 16.9 mm; implant space ~ 10.7 mm; nearby mental foramen. Region 32: bone height ~ 13.9 mm; implant space ~ 7.5 mm; nearby anterior loop. Region 24: bone height ~ 18.3 mm; implant space ~ 13.0 mm; nearby nasal floor. Region 42: bone height ~ 21.7 mm; implant space ~ 15.3 mm; nearby incisive canal. Region 34: bone height ~ 16.0 mm; implant space ~ 11.6 mm; nearby nasal floor. Region 44: bone height ~ 8.3 mm; implant space ~ 1.0 mm; nearby incisive canal. Region 47: bone height ~ 11.4 mm; implant space ~ 7.3 mm; nearby mandibular canal. Region 37: bone height ~ 10.5 mm; implant space ~ 9.2 mm; nearby mental foramen. Maxillary sinus: mucosal thickening mild on both sides. Image artifacts due to metallic restorations reduce detail locally. Impression: Vertical root fracture suspected at 24, extending coronally.

Question: Planning for maxillary sinus evaluation. Brief history/status: Bufomix Easyhaler, Esomeprazole, Metoprolol, Amlodipine, Losartan, Duloxetine. Desired treatment: Assess healing of extraction sockets and bone regeneration at 33–43.

Answer: Review of CBCT dated 240911. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 14: bone height ≈ 9.9 mm; implant space ≈ 7.5 mm; nearby incisive canal. Region 45: bone height ≈ 11.6 mm; implant space ≈ 8.7 mm; nearby mental foramen. Region 25: bone height ≈ 16.9 mm; implant space ≈ 10.7 mm; nearby mental foramen. Region 32: bone height ≈ 13.9 mm; implant space ≈ 7.5 mm; nearby anterior loop. Region 24: bone height ≈ 18.3 mm; implant space ≈ 13.0 mm; nearby nasal floor. Region 42: bone height ≈ 21.7 mm; implant space ≈ 15.3 mm; nearby incisive canal. Region 34: bone height ≈ 16.0 mm; implant space ≈ 11.6 mm; nearby nasal floor. Region 44: bone height ≈ 8.3 mm; implant space ≈ 1.0 mm; nearby incisive canal. Region 47: bone height ≈ 11.4 mm; implant space ≈ 7.3 mm; nearby mandibular canal. Region 37: bone height ≈ 10.5 mm; implant space ≈ 9.2 mm; nearby mental foramen. Maxillary sinus: mucosal thickening mild on both sides. Image artifacts due to metallic restorations reduce detail locally. Impression: Vertical root fracture suspected at 24, extending coronally.


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Planning for sinus-related complaints. Brief history/status: Amlodipine, Losartan, Trulicity, Insulin glargine, Atorvastatin, Betolvex, Levaxin, Metoprolol. Desired treatment: Measure crest-to-canal distances mandibularly in 17-27, and implant feasibility maxillary 37-47.

[Assistant] Review of CBCT volume dated 200217. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 25: bone height ~ 6.3 mm; implant space ~ 1.4 mm; nearest critical structure: nasal floor. Region 11: bone height ~ 4.9 mm; implant space ~ 0.0 mm; nearest critical structure: incisive canal. Region 27: bone height ~ 15.6 mm; implant space ~ 13.1 mm; nearest critical structure: incisive canal. Region 22: bone height ~ 8.2 mm; implant space ~ 4.2 mm; nearest critical structure: sinus floor. Region 34: bone height ~ 14.3 mm; implant space ~ 9.1 mm; nearest critical structure: anterior loop. Region 18: bone height ~ 21.9 mm; implant space ~ 17.7 mm; nearest critical structure: incisive canal. Region 41: bone height ~ 18.3 mm; implant space ~ 10.2 mm; nearest critical structure: mandibular canal. Region 23: bone height ~ 8.5 mm; implant space ~ 4.7 mm; nearest critical structure: incisive canal. Region 48: bone height ~ 16.7 mm; implant space ~ 10.0 mm; nearest critical structure: anterior loop. Region 45: bone height ~ 4.6 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency present near 44; lamina dura loss noted. Secondary small radiolucency adjacent to 33. Impression: Cyst-like well-defined radiolucency near 12, likely radicular cyst.

Question: Planning for sinus-related complaints. Brief history/status: Amlodipine, Losartan, Trulicity, Insulin glargine, Atorvastatin, Betolvex, Levaxin, Metoprolol. Desired treatment: Measure crest-to-canal distances mandibularly in 17–27, and implant feasibility maxillary 37–47.

Answer: Review of CBCT volume dated 200217. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 25: bone height ≈ 6.3 mm; implant space ≈ 1.4 mm; nearest critical structure: nasal floor. Region 11: bone height ≈ 4.9 mm; implant space ≈ 0.0 mm; nearest critical structure: incisive canal. Region 27: bone height ≈ 15.6 mm; implant space ≈ 13.1 mm; nearest critical structure: incisive canal. Region 22: bone height ≈ 8.2 mm; implant space ≈ 4.2 mm; nearest critical structure: sinus floor. Region 34: bone height ≈ 14.3 mm; implant space ≈ 9.1 mm; nearest critical structure: anterior loop. Region 18: bone height ≈ 21.9 mm; implant space ≈ 17.7 mm; nearest critical structure: incisive canal. Region 41: bone height ≈ 18.3 mm; implant space ≈ 10.2 mm; nearest critical structure: mandibular canal. Region 23: bone height ≈ 8.5 mm; implant space ≈ 4.7 mm; nearest critical structure: incisive canal. Region 48: bone height ≈ 16.7 mm; implant space ≈ 10.0 mm; nearest critical structure: anterior loop. Region 45: bone height ≈ 4.6 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency present near 44; lamina dura loss noted. Secondary small radiolucency adjacent to 33. Impression: Cyst-like well-defined radiolucency near 12, likely radicular cyst.


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Planning for implant planning and sinus evaluation. Brief history/status: Insulin glargine, Omeprazole, Amlodipine, Bricanyl, Atorvastatin. Desired treatment: Measure vertical height from alveolar crest to anatomical constraints for 16-26.

[Assistant] Review of CBCT scan dated 220623. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 45: bone height ~ 7.2 mm; implant space ~ 0.2 mm; nearby structure: sinus floor. Region 13: bone height ~ 13.3 mm; implant space ~ 11.6 mm; nearby structure: sinus floor. Region 25: bone height ~ 5.8 mm; implant space ~ 0 mm; nearby structure: anterior loop. Region 33: bone height ~ 19.6 mm; implant space ~ 16.6 mm; nearby structure: mandibular canal. Region 32: bone height ~ 7.1 mm; implant space ~ 4.0 mm; nearby structure: anterior loop. Region 23: bone height ~ 9.6 mm; implant space ~ 4.3 mm; nearby structure: nasal floor. Region 14: bone height ~ 15.7 mm; implant space ~ 12.0 mm; nearby structure: anterior loop. Region 31: bone height ~ 14.5 mm; implant space ~ 13.2 mm; nearby structure: mandibular canal. Region 48: bone height ~ 5.5 mm; implant space ~ 0 mm; nearby structure: nasal floor. Region 22: bone height ~ 6.7 mm; implant space ~ 3.7 mm; nearby structure: anterior loop. Impression: Findings indicate sufficient bone height with mild sinus mucosal thickening.

Question: Planning for implant planning and sinus evaluation. Brief history/status: Insulin glargine, Omeprazole, Amlodipine, Bricanyl, Atorvastatin. Desired treatment: Measure vertical height from alveolar crest to anatomical constraints for 16–26.

Answer: Review of CBCT scan dated 220623. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 45: bone height ≈ 7.2 mm; implant space ≈ 0.2 mm; nearby structure: sinus floor. Region 13: bone height ≈ 13.3 mm; implant space ≈ 11.6 mm; nearby structure: sinus floor. Region 25: bone height ≈ 5.8 mm; implant space ≈ 0 mm; nearby structure: anterior loop. Region 33: bone height ≈ 19.6 mm; implant space ≈ 16.6 mm; nearby structure: mandibular canal. Region 32: bone height ≈ 7.1 mm; implant space ≈ 4.0 mm; nearby structure: anterior loop. Region 23: bone height ≈ 9.6 mm; implant space ≈ 4.3 mm; nearby structure: nasal floor. Region 14: bone height ≈ 15.7 mm; implant space ≈ 12.0 mm; nearby structure: anterior loop. Region 31: bone height ≈ 14.5 mm; implant space ≈ 13.2 mm; nearby structure: mandibular canal. Region 48: bone height ≈ 5.5 mm; implant space ≈ 0 mm; nearby structure: nasal floor. Region 22: bone height ≈ 6.7 mm; implant space ≈ 3.7 mm; nearby structure: anterior loop. Impression: Findings indicate sufficient bone height with mild sinus mucosal thickening.


[User]
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Planning for delayed healing post endodontic therapy. Brief history/status: Esomeprazole, Metoprolol, Atorvastatin, Insulin glargine, Amlodipine. Desired treatment: Measure crest-to-canal distances mandibularly in 15-25, and implant feasibility maxillary 36-46.

[Assistant] Review of CBCT volume dated 250610. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 37: bone height ~ 12.8 mm; implant space ~ 7.1 mm; nearest critical structure: anterior loop. Region 46: bone height ~ 21.7 mm; implant space ~ 14.0 mm; nearest critical structure: mental foramen. Region 25: bone height ~ 12.2 mm; implant space ~ 5.9 mm; nearest critical structure: sinus floor. Region 14: bone height ~ 12.4 mm; implant space ~ 7.1 mm; nearest critical structure: sinus floor. Region 18: bone height ~ 9.7 mm; implant space ~ 5.8 mm; nearest critical structure: nasal floor. Region 48: bone height ~ 15.0 mm; implant space ~ 8.9 mm; nearest critical structure: mental foramen. Region 23: bone height ~ 20.2 mm; implant space ~ 17.2 mm; nearest critical structure: sinus floor. Region 43: bone height ~ 7.9 mm; implant space ~ 5.2 mm; nearest critical structure: anterior loop. Region 41: bone height ~ 4.3 mm; implant space ~ 0.5 mm; nearest critical structure: mandibular canal. Region 24: bone height ~ 10.5 mm; implant space ~ 8.2 mm; nearest critical structure: incisive canal. Periapical radiolucency present near 11; lamina dura loss noted. Secondary small radiolucency adjacent to 21. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.

Question: Planning for delayed healing post endodontic therapy. Brief history/status: Esomeprazole, Metoprolol, Atorvastatin, Insulin glargine, Amlodipine. Desired treatment: Measure crest-to-canal distances mandibularly in 15–25, and implant feasibility maxillary 36–46.

Answer: Review of CBCT volume dated 250610. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 37: bone height ≈ 12.8 mm; implant space ≈ 7.1 mm; nearest critical structure: anterior loop. Region 46: bone height ≈ 21.7 mm; implant space ≈ 14.0 mm; nearest critical structure: mental foramen. Region 25: bone height ≈ 12.2 mm; implant space ≈ 5.9 mm; nearest critical structure: sinus floor. Region 14: bone height ≈ 12.4 mm; implant space ≈ 7.1 mm; nearest critical structure: sinus floor. Region 18: bone height ≈ 9.7 mm; implant space ≈ 5.8 mm; nearest critical structure: nasal floor. Region 48: bone height ≈ 15.0 mm; implant space ≈ 8.9 mm; nearest critical structure: mental foramen. Region 23: bone height ≈ 20.2 mm; implant space ≈ 17.2 mm; nearest critical structure: sinus floor. Region 43: bone height ≈ 7.9 mm; implant space ≈ 5.2 mm; nearest critical structure: anterior loop. Region 41: bone height ≈ 4.3 mm; implant space ≈ 0.5 mm; nearest critical structure: mandibular canal. Region 24: bone height ≈ 10.5 mm; implant space ≈ 8.2 mm; nearest critical structure: incisive canal. Periapical radiolucency present near 11; lamina dura loss noted. Secondary small radiolucency adjacent to 21. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.


[User]
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Planning for evaluation of post-implant healing. Brief history/status: Omeprazole, Insulin glargine, Amlodipine, Levaxin, Atorvastatin. Desired treatment: Provide measurements for alveolar ridge width and height at 13-23.

[Assistant] Review of CBCT dated 240808. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 31: bone height ~ 18.9 mm; implant space ~ 17.7 mm; nearby nasal floor. Region 34: bone height ~ 8.5 mm; implant space ~ 1.5 mm; nearby anterior loop. Region 38: bone height ~ 17.1 mm; implant space ~ 9.6 mm; nearby anterior loop. Region 14: bone height ~ 13.9 mm; implant space ~ 8.7 mm; nearby anterior loop. Region 28: bone height ~ 10.9 mm; implant space ~ 3.6 mm; nearby anterior loop. Region 42: bone height ~ 10.0 mm; implant space ~ 5.1 mm; nearby mandibular canal. Region 11: bone height ~ 16.6 mm; implant space ~ 12.7 mm; nearby incisive canal. Region 32: bone height ~ 16.1 mm; implant space ~ 15.1 mm; nearby mandibular canal. Region 17: bone height ~ 7.1 mm; implant space ~ 0 mm; nearby nasal floor. Region 33: bone height ~ 14.4 mm; implant space ~ 13.2 mm; nearby mandibular canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 28; minor sclerosis near 12. Impression: Vertical root fracture suspected at 41, extending coronally.

Question: Planning for evaluation of post-implant healing. Brief history/status: Omeprazole, Insulin glargine, Amlodipine, Levaxin, Atorvastatin. Desired treatment: Provide measurements for alveolar ridge width and height at 13–23.

Answer: Review of CBCT dated 240808. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 31: bone height ≈ 18.9 mm; implant space ≈ 17.7 mm; nearby nasal floor. Region 34: bone height ≈ 8.5 mm; implant space ≈ 1.5 mm; nearby anterior loop. Region 38: bone height ≈ 17.1 mm; implant space ≈ 9.6 mm; nearby anterior loop. Region 14: bone height ≈ 13.9 mm; implant space ≈ 8.7 mm; nearby anterior loop. Region 28: bone height ≈ 10.9 mm; implant space ≈ 3.6 mm; nearby anterior loop. Region 42: bone height ≈ 10.0 mm; implant space ≈ 5.1 mm; nearby mandibular canal. Region 11: bone height ≈ 16.6 mm; implant space ≈ 12.7 mm; nearby incisive canal. Region 32: bone height ≈ 16.1 mm; implant space ≈ 15.1 mm; nearby mandibular canal. Region 17: bone height ≈ 7.1 mm; implant space ≈ 0 mm; nearby nasal floor. Region 33: bone height ≈ 14.4 mm; implant space ≈ 13.2 mm; nearby mandibular canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 28; minor sclerosis near 12. Impression: Vertical root fracture suspected at 41, extending coronally.


[User]
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Planning for pathology review. Brief history/status: Betolvex, Calcichew-D3, Losartan, Trulicity, Amlodipine, Duloxetine, Bufomix Easyhaler, Bricanyl. Desired treatment: Quantify vertical bone height reduction and comment on trabecular density.

[Assistant] Review of CBCT dated 210408. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 41: bone height ~ 17.5 mm; implant space ~ 15.2 mm; nearby nasal floor. Region 15: bone height ~ 10.5 mm; implant space ~ 7.9 mm; nearby mandibular canal. Region 45: bone height ~ 18.5 mm; implant space ~ 11.2 mm; nearby anterior loop. Region 13: bone height ~ 11.6 mm; implant space ~ 8.6 mm; nearby mandibular canal. Region 43: bone height ~ 9.2 mm; implant space ~ 4.4 mm; nearby mental foramen. Region 14: bone height ~ 6.2 mm; implant space ~ 1.0 mm; nearby nasal floor. Region 23: bone height ~ 8.9 mm; implant space ~ 5.1 mm; nearby mandibular canal. Region 24: bone height ~ 9.3 mm; implant space ~ 7.9 mm; nearby incisive canal. Region 38: bone height ~ 10.9 mm; implant space ~ 6.8 mm; nearby anterior loop. Region 11: bone height ~ 16.2 mm; implant space ~ 14.0 mm; nearby incisive canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 46; minor sclerosis near 33. Impression: Residual ridge height sufficient for short implants; grafting optional.

Question: Planning for pathology review. Brief history/status: Betolvex, Calcichew-D3, Losartan, Trulicity, Amlodipine, Duloxetine, Bufomix Easyhaler, Bricanyl. Desired treatment: Quantify vertical bone height reduction and comment on trabecular density.

Answer: Review of CBCT dated 210408. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 41: bone height ≈ 17.5 mm; implant space ≈ 15.2 mm; nearby nasal floor. Region 15: bone height ≈ 10.5 mm; implant space ≈ 7.9 mm; nearby mandibular canal. Region 45: bone height ≈ 18.5 mm; implant space ≈ 11.2 mm; nearby anterior loop. Region 13: bone height ≈ 11.6 mm; implant space ≈ 8.6 mm; nearby mandibular canal. Region 43: bone height ≈ 9.2 mm; implant space ≈ 4.4 mm; nearby mental foramen. Region 14: bone height ≈ 6.2 mm; implant space ≈ 1.0 mm; nearby nasal floor. Region 23: bone height ≈ 8.9 mm; implant space ≈ 5.1 mm; nearby mandibular canal. Region 24: bone height ≈ 9.3 mm; implant space ≈ 7.9 mm; nearby incisive canal. Region 38: bone height ≈ 10.9 mm; implant space ≈ 6.8 mm; nearby anterior loop. Region 11: bone height ≈ 16.2 mm; implant space ≈ 14.0 mm; nearby incisive canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 46; minor sclerosis near 33. Impression: Residual ridge height sufficient for short implants; grafting optional.


[User]
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Planning for implant planning. Brief history/status: Duloxetine, Esomeprazole, Bricanyl, Trulicity, Insulin glargine, Metoprolol, Atorvastatin. Desired treatment: Assess proximity to mandibular canal and sinus floor for 33-43 and 13-23.

[Assistant] Review of CBCT dated 210512. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 45: bone height ~ 4.5 mm; implant space ~ 0 mm; nearby sinus floor. Region 11: bone height ~ 17.3 mm; implant space ~ 16.2 mm; nearby mental foramen. Region 17: bone height ~ 11.7 mm; implant space ~ 6.6 mm; nearby mandibular canal. Region 18: bone height ~ 5.2 mm; implant space ~ 3.0 mm; nearby mandibular canal. Region 15: bone height ~ 10.6 mm; implant space ~ 2.6 mm; nearby incisive canal. Region 44: bone height ~ 21.6 mm; implant space ~ 20.4 mm; nearby sinus floor. Region 46: bone height ~ 14.8 mm; implant space ~ 7.4 mm; nearby incisive canal. Region 41: bone height ~ 14.5 mm; implant space ~ 11.1 mm; nearby anterior loop. Region 26: bone height ~ 12.0 mm; implant space ~ 10.1 mm; nearby nasal floor. Region 23: bone height ~ 9.1 mm; implant space ~ 3.0 mm; nearby mandibular canal. Periapical radiolucency observed near 27; minor sclerosis near 38. Impression: Radiolucent lesion at 48 consistent with radicular cyst; recommend correlation.

Question: Planning for implant planning. Brief history/status: Duloxetine, Esomeprazole, Bricanyl, Trulicity, Insulin glargine, Metoprolol, Atorvastatin. Desired treatment: Assess proximity to mandibular canal and sinus floor for 33–43 and 13–23.

Answer: Review of CBCT dated 210512. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 45: bone height ≈ 4.5 mm; implant space ≈ 0 mm; nearby sinus floor. Region 11: bone height ≈ 17.3 mm; implant space ≈ 16.2 mm; nearby mental foramen. Region 17: bone height ≈ 11.7 mm; implant space ≈ 6.6 mm; nearby mandibular canal. Region 18: bone height ≈ 5.2 mm; implant space ≈ 3.0 mm; nearby mandibular canal. Region 15: bone height ≈ 10.6 mm; implant space ≈ 2.6 mm; nearby incisive canal. Region 44: bone height ≈ 21.6 mm; implant space ≈ 20.4 mm; nearby sinus floor. Region 46: bone height ≈ 14.8 mm; implant space ≈ 7.4 mm; nearby incisive canal. Region 41: bone height ≈ 14.5 mm; implant space ≈ 11.1 mm; nearby anterior loop. Region 26: bone height ≈ 12.0 mm; implant space ≈ 10.1 mm; nearby nasal floor. Region 23: bone height ≈ 9.1 mm; implant space ≈ 3.0 mm; nearby mandibular canal. Periapical radiolucency observed near 27; minor sclerosis near 38. Impression: Radiolucent lesion at 48 consistent with radicular cyst; recommend correlation.


[User]
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Planning for implant planning evaluation. Brief history/status: Duroferon, Atorvastatin, Trulicity, Insulin glargine, Losartan, Bricanyl, Amlodipine, Levaxin, Calcichew-D3. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 16-26.

[Assistant] Review of CBCT volume dated 250818. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 17: bone height ~ 12.4 mm; implant space ~ 5.5 mm; nearest critical structure: incisive canal. Region 18: bone height ~ 5.8 mm; implant space ~ 1.1 mm; nearest critical structure: incisive canal. Region 31: bone height ~ 7.0 mm; implant space ~ 0.0 mm; nearest critical structure: mental foramen. Region 23: bone height ~ 20.5 mm; implant space ~ 12.7 mm; nearest critical structure: incisive canal. Region 48: bone height ~ 10.6 mm; implant space ~ 6.6 mm; nearest critical structure: mandibular canal. Region 42: bone height ~ 19.2 mm; implant space ~ 13.7 mm; nearest critical structure: mandibular canal. Region 15: bone height ~ 4.1 mm; implant space ~ 0.0 mm; nearest critical structure: nasal floor. Region 35: bone height ~ 17.0 mm; implant space ~ 8.0 mm; nearest critical structure: mandibular canal. Region 32: bone height ~ 5.0 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Region 21: bone height ~ 13.9 mm; implant space ~ 8.7 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 37; lamina dura loss noted. Smaller radiolucency at 13. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: No acute pathology identified; anatomy within expected limits for planned procedures.

Question: Planning for implant planning evaluation. Brief history/status: Duroferon, Atorvastatin, Trulicity, Insulin glargine, Losartan, Bricanyl, Amlodipine, Levaxin, Calcichew-D3. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 16–26.

Answer: Review of CBCT volume dated 250818. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 17: bone height ≈ 12.4 mm; implant space ≈ 5.5 mm; nearest critical structure: incisive canal. Region 18: bone height ≈ 5.8 mm; implant space ≈ 1.1 mm; nearest critical structure: incisive canal. Region 31: bone height ≈ 7.0 mm; implant space ≈ 0.0 mm; nearest critical structure: mental foramen. Region 23: bone height ≈ 20.5 mm; implant space ≈ 12.7 mm; nearest critical structure: incisive canal. Region 48: bone height ≈ 10.6 mm; implant space ≈ 6.6 mm; nearest critical structure: mandibular canal. Region 42: bone height ≈ 19.2 mm; implant space ≈ 13.7 mm; nearest critical structure: mandibular canal. Region 15: bone height ≈ 4.1 mm; implant space ≈ 0.0 mm; nearest critical structure: nasal floor. Region 35: bone height ≈ 17.0 mm; implant space ≈ 8.0 mm; nearest critical structure: mandibular canal. Region 32: bone height ≈ 5.0 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Region 21: bone height ≈ 13.9 mm; implant space ≈ 8.7 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 37; lamina dura loss noted. Smaller radiolucency at 13. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: No acute pathology identified; anatomy within expected limits for planned procedures.


[User]
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Planning for maxillary sinus evaluation. Brief history/status: Omeprazole, Insulin glargine, Levaxin, Duroferon, Bricanyl, Amlodipine, Esomeprazole. Desired treatment: Please evaluate bone height, implant space, and anatomical constraints for regions 33-43 and 36-46.

[Assistant] Review of CBCT dated 220620. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 46: bone height ~ 6.0 mm; implant space ~ 3.4 mm; nearby mandibular canal. Region 42: bone height ~ 5.0 mm; implant space ~ 2.0 mm; nearby mental foramen. Region 11: bone height ~ 18.7 mm; implant space ~ 15.9 mm; nearby incisive canal. Region 24: bone height ~ 18.1 mm; implant space ~ 11.3 mm; nearby incisive canal. Region 48: bone height ~ 18.3 mm; implant space ~ 17.0 mm; nearby incisive canal. Region 26: bone height ~ 7.5 mm; implant space ~ 0.8 mm; nearby incisive canal. Region 13: bone height ~ 12.3 mm; implant space ~ 8.3 mm; nearby nasal floor. Region 32: bone height ~ 15.3 mm; implant space ~ 11.9 mm; nearby mental foramen. Region 47: bone height ~ 16.1 mm; implant space ~ 14.2 mm; nearby mental foramen. Region 43: bone height ~ 8.4 mm; implant space ~ 5.7 mm; nearby nasal floor. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 31; minor sclerosis near 47. Impression: Signs of early osseointegration failure at 24; consider clinical review.

Question: Planning for maxillary sinus evaluation. Brief history/status: Omeprazole, Insulin glargine, Levaxin, Duroferon, Bricanyl, Amlodipine, Esomeprazole. Desired treatment: Please evaluate bone height, implant space, and anatomical constraints for regions 33–43 and 36–46.

Answer: Review of CBCT dated 220620. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 46: bone height ≈ 6.0 mm; implant space ≈ 3.4 mm; nearby mandibular canal. Region 42: bone height ≈ 5.0 mm; implant space ≈ 2.0 mm; nearby mental foramen. Region 11: bone height ≈ 18.7 mm; implant space ≈ 15.9 mm; nearby incisive canal. Region 24: bone height ≈ 18.1 mm; implant space ≈ 11.3 mm; nearby incisive canal. Region 48: bone height ≈ 18.3 mm; implant space ≈ 17.0 mm; nearby incisive canal. Region 26: bone height ≈ 7.5 mm; implant space ≈ 0.8 mm; nearby incisive canal. Region 13: bone height ≈ 12.3 mm; implant space ≈ 8.3 mm; nearby nasal floor. Region 32: bone height ≈ 15.3 mm; implant space ≈ 11.9 mm; nearby mental foramen. Region 47: bone height ≈ 16.1 mm; implant space ≈ 14.2 mm; nearby mental foramen. Region 43: bone height ≈ 8.4 mm; implant space ≈ 5.7 mm; nearby nasal floor. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 31; minor sclerosis near 47. Impression: Signs of early osseointegration failure at 24; consider clinical review.


[User]
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Planning for implant planning evaluation. Brief history/status: Insulin glargine, Bufomix Easyhaler, Duroferon, Losartan, Trulicity, Esomeprazole. Desired treatment: Please report bone height and available implant space for regions 37-47 and 16-26.

[Assistant] Review of CBCT volume dated 210206. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 21: bone height ~ 21.9 mm; implant space ~ 18.8 mm; nearest critical structure: incisive canal. Region 28: bone height ~ 17.0 mm; implant space ~ 13.8 mm; nearest critical structure: nasal floor. Region 25: bone height ~ 12.0 mm; implant space ~ 4.5 mm; nearest critical structure: nasal floor. Region 31: bone height ~ 7.5 mm; implant space ~ 1.2 mm; nearest critical structure: mandibular canal. Region 14: bone height ~ 12.2 mm; implant space ~ 6.4 mm; nearest critical structure: nasal floor. Region 15: bone height ~ 5.9 mm; implant space ~ 0.0 mm; nearest critical structure: incisive canal. Region 42: bone height ~ 6.0 mm; implant space ~ 3.2 mm; nearest critical structure: mental foramen. Region 46: bone height ~ 4.3 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Region 12: bone height ~ 16.8 mm; implant space ~ 7.9 mm; nearest critical structure: incisive canal. Region 17: bone height ~ 13.2 mm; implant space ~ 10.9 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 42; lamina dura loss noted. Smaller radiolucency at 38. Impression: Normal bone density throughout; suitable for implant placement.

Question: Planning for implant planning evaluation. Brief history/status: Insulin glargine, Bufomix Easyhaler, Duroferon, Losartan, Trulicity, Esomeprazole. Desired treatment: Please report bone height and available implant space for regions 37–47 and 16–26.

Answer: Review of CBCT volume dated 210206. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 21: bone height ≈ 21.9 mm; implant space ≈ 18.8 mm; nearest critical structure: incisive canal. Region 28: bone height ≈ 17.0 mm; implant space ≈ 13.8 mm; nearest critical structure: nasal floor. Region 25: bone height ≈ 12.0 mm; implant space ≈ 4.5 mm; nearest critical structure: nasal floor. Region 31: bone height ≈ 7.5 mm; implant space ≈ 1.2 mm; nearest critical structure: mandibular canal. Region 14: bone height ≈ 12.2 mm; implant space ≈ 6.4 mm; nearest critical structure: nasal floor. Region 15: bone height ≈ 5.9 mm; implant space ≈ 0.0 mm; nearest critical structure: incisive canal. Region 42: bone height ≈ 6.0 mm; implant space ≈ 3.2 mm; nearest critical structure: mental foramen. Region 46: bone height ≈ 4.3 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Region 12: bone height ≈ 16.8 mm; implant space ≈ 7.9 mm; nearest critical structure: incisive canal. Region 17: bone height ≈ 13.2 mm; implant space ≈ 10.9 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 42; lamina dura loss noted. Smaller radiolucency at 38. Impression: Normal bone density throughout; suitable for implant placement.


[User]
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Planning for radiolucency investigation. Brief history/status: Trulicity, Omeprazole, Levaxin, Metoprolol, Losartan, Amlodipine. Desired treatment: Provide detailed bone mapping and canal proximity data for 36-46.

[Assistant] Review of CBCT scan dated 240221. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 24: bone height ~ 21.2 mm; implant space ~ 14.9 mm; nearby structure: mandibular canal. Region 46: bone height ~ 7.0 mm; implant space ~ 5.4 mm; nearby structure: anterior loop. Region 41: bone height ~ 9.7 mm; implant space ~ 7.1 mm; nearby structure: anterior loop. Region 34: bone height ~ 6.4 mm; implant space ~ 1.4 mm; nearby structure: mental foramen. Region 26: bone height ~ 9.5 mm; implant space ~ 4.5 mm; nearby structure: mental foramen. Region 28: bone height ~ 14.3 mm; implant space ~ 12.6 mm; nearby structure: nasal floor. Region 35: bone height ~ 19.2 mm; implant space ~ 14.6 mm; nearby structure: mandibular canal. Region 31: bone height ~ 12.6 mm; implant space ~ 9.4 mm; nearby structure: anterior loop. Region 27: bone height ~ 12.9 mm; implant space ~ 11.7 mm; nearby structure: mental foramen. Region 23: bone height ~ 11.0 mm; implant space ~ 4.8 mm; nearby structure: mandibular canal. Periapical radiolucency visible at 38, additional smaller lesion near 28. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Cystic lesion in posterior mandible region 36, likely odontogenic cyst.

Question: Planning for radiolucency investigation. Brief history/status: Trulicity, Omeprazole, Levaxin, Metoprolol, Losartan, Amlodipine. Desired treatment: Provide detailed bone mapping and canal proximity data for 36–46.

Answer: Review of CBCT scan dated 240221. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 24: bone height ≈ 21.2 mm; implant space ≈ 14.9 mm; nearby structure: mandibular canal. Region 46: bone height ≈ 7.0 mm; implant space ≈ 5.4 mm; nearby structure: anterior loop. Region 41: bone height ≈ 9.7 mm; implant space ≈ 7.1 mm; nearby structure: anterior loop. Region 34: bone height ≈ 6.4 mm; implant space ≈ 1.4 mm; nearby structure: mental foramen. Region 26: bone height ≈ 9.5 mm; implant space ≈ 4.5 mm; nearby structure: mental foramen. Region 28: bone height ≈ 14.3 mm; implant space ≈ 12.6 mm; nearby structure: nasal floor. Region 35: bone height ≈ 19.2 mm; implant space ≈ 14.6 mm; nearby structure: mandibular canal. Region 31: bone height ≈ 12.6 mm; implant space ≈ 9.4 mm; nearby structure: anterior loop. Region 27: bone height ≈ 12.9 mm; implant space ≈ 11.7 mm; nearby structure: mental foramen. Region 23: bone height ≈ 11.0 mm; implant space ≈ 4.8 mm; nearby structure: mandibular canal. Periapical radiolucency visible at 38, additional smaller lesion near 28. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Cystic lesion in posterior mandible region 36, likely odontogenic cyst.


[User]
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Planning for sinus-related complaints. Brief history/status: Betolvex, Atorvastatin, Trulicity, Amlodipine, Omeprazole, Esomeprazole, Duroferon, Levaxin. Desired treatment: Check the bone healing and trabecular fill post extraction sites 15-25.

[Assistant] Review of CBCT volume dated 230408. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 48: bone height ~ 18.1 mm; implant space ~ 11.7 mm; nearest critical structure: anterior loop. Region 16: bone height ~ 15.0 mm; implant space ~ 10.3 mm; nearest critical structure: incisive canal. Region 14: bone height ~ 4.8 mm; implant space ~ 2.4 mm; nearest critical structure: incisive canal. Region 37: bone height ~ 10.8 mm; implant space ~ 8.7 mm; nearest critical structure: mandibular canal. Region 47: bone height ~ 14.9 mm; implant space ~ 10.7 mm; nearest critical structure: mental foramen. Region 44: bone height ~ 18.8 mm; implant space ~ 16.7 mm; nearest critical structure: mandibular canal. Region 25: bone height ~ 5.7 mm; implant space ~ 0.0 mm; nearest critical structure: incisive canal. Region 35: bone height ~ 14.7 mm; implant space ~ 8.7 mm; nearest critical structure: mental foramen. Region 13: bone height ~ 4.3 mm; implant space ~ 0.0 mm; nearest critical structure: sinus floor. Region 32: bone height ~ 16.6 mm; implant space ~ 12.8 mm; nearest critical structure: mandibular canal. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Peri-implant bone loss at 45 within the coronal third, suggestive of peri-implantitis.

Question: Planning for sinus-related complaints. Brief history/status: Betolvex, Atorvastatin, Trulicity, Amlodipine, Omeprazole, Esomeprazole, Duroferon, Levaxin. Desired treatment: Check the bone healing and trabecular fill post extraction sites 15–25.

Answer: Review of CBCT volume dated 230408. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 48: bone height ≈ 18.1 mm; implant space ≈ 11.7 mm; nearest critical structure: anterior loop. Region 16: bone height ≈ 15.0 mm; implant space ≈ 10.3 mm; nearest critical structure: incisive canal. Region 14: bone height ≈ 4.8 mm; implant space ≈ 2.4 mm; nearest critical structure: incisive canal. Region 37: bone height ≈ 10.8 mm; implant space ≈ 8.7 mm; nearest critical structure: mandibular canal. Region 47: bone height ≈ 14.9 mm; implant space ≈ 10.7 mm; nearest critical structure: mental foramen. Region 44: bone height ≈ 18.8 mm; implant space ≈ 16.7 mm; nearest critical structure: mandibular canal. Region 25: bone height ≈ 5.7 mm; implant space ≈ 0.0 mm; nearest critical structure: incisive canal. Region 35: bone height ≈ 14.7 mm; implant space ≈ 8.7 mm; nearest critical structure: mental foramen. Region 13: bone height ≈ 4.3 mm; implant space ≈ 0.0 mm; nearest critical structure: sinus floor. Region 32: bone height ≈ 16.6 mm; implant space ≈ 12.8 mm; nearest critical structure: mandibular canal. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Peri-implant bone loss at 45 within the coronal third, suggestive of peri-implantitis.


[User]
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Planning for radiolucency investigation. Brief history/status: Atorvastatin, Betolvex, Duloxetine, Omeprazole, Insulin glargine, Metoprolol. Desired treatment: Assess implant site quality and need for sinus lift or graft in 16-26.

[Assistant] Review of CBCT scan dated 240306. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 37: bone height ~ 13.4 mm; implant space ~ 5.7 mm; nearby structure: sinus floor. Region 26: bone height ~ 15.7 mm; implant space ~ 14.4 mm; nearby structure: sinus floor. Region 14: bone height ~ 11.7 mm; implant space ~ 10.0 mm; nearby structure: mandibular canal. Region 23: bone height ~ 11.2 mm; implant space ~ 7.5 mm; nearby structure: mental foramen. Region 18: bone height ~ 5.1 mm; implant space ~ 0 mm; nearby structure: anterior loop. Region 21: bone height ~ 17.5 mm; implant space ~ 14.3 mm; nearby structure: nasal floor. Region 42: bone height ~ 4.0 mm; implant space ~ 1.1 mm; nearby structure: nasal floor. Region 16: bone height ~ 8.7 mm; implant space ~ 7.7 mm; nearby structure: mental foramen. Region 33: bone height ~ 13.6 mm; implant space ~ 6.5 mm; nearby structure: mental foramen. Region 43: bone height ~ 21.4 mm; implant space ~ 18.8 mm; nearby structure: sinus floor. Maxillary sinus shows mild mucosal thickening bilaterally. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Adequate bone density throughout; implant feasible without augmentation.

Question: Planning for radiolucency investigation. Brief history/status: Atorvastatin, Betolvex, Duloxetine, Omeprazole, Insulin glargine, Metoprolol. Desired treatment: Assess implant site quality and need for sinus lift or graft in 16–26.

Answer: Review of CBCT scan dated 240306. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 37: bone height ≈ 13.4 mm; implant space ≈ 5.7 mm; nearby structure: sinus floor. Region 26: bone height ≈ 15.7 mm; implant space ≈ 14.4 mm; nearby structure: sinus floor. Region 14: bone height ≈ 11.7 mm; implant space ≈ 10.0 mm; nearby structure: mandibular canal. Region 23: bone height ≈ 11.2 mm; implant space ≈ 7.5 mm; nearby structure: mental foramen. Region 18: bone height ≈ 5.1 mm; implant space ≈ 0 mm; nearby structure: anterior loop. Region 21: bone height ≈ 17.5 mm; implant space ≈ 14.3 mm; nearby structure: nasal floor. Region 42: bone height ≈ 4.0 mm; implant space ≈ 1.1 mm; nearby structure: nasal floor. Region 16: bone height ≈ 8.7 mm; implant space ≈ 7.7 mm; nearby structure: mental foramen. Region 33: bone height ≈ 13.6 mm; implant space ≈ 6.5 mm; nearby structure: mental foramen. Region 43: bone height ≈ 21.4 mm; implant space ≈ 18.8 mm; nearby structure: sinus floor. Maxillary sinus shows mild mucosal thickening bilaterally. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Adequate bone density throughout; implant feasible without augmentation.


[User]
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Planning for assessment for guided surgery. Brief history/status: Esomeprazole, Duloxetine, Amlodipine, Metoprolol, Calcichew-D3, Duroferon, Levaxin, Atorvastatin, Bufomix Easyhaler. Desired treatment: Provide measurements relevant to guided surgery stent planning for 36-46 and 37-47.

[Assistant] Review of CBCT volume dated 250815. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 13: bone height ~ 4.2 mm; implant space ~ 2.1 mm; nearest critical structure: sinus floor. Region 12: bone height ~ 20.0 mm; implant space ~ 15.0 mm; nearest critical structure: sinus floor. Region 16: bone height ~ 16.0 mm; implant space ~ 11.1 mm; nearest critical structure: incisive canal. Region 26: bone height ~ 8.1 mm; implant space ~ 1.5 mm; nearest critical structure: sinus floor. Region 41: bone height ~ 21.0 mm; implant space ~ 12.3 mm; nearest critical structure: mental foramen. Region 18: bone height ~ 20.8 mm; implant space ~ 15.5 mm; nearest critical structure: sinus floor. Region 24: bone height ~ 16.1 mm; implant space ~ 9.7 mm; nearest critical structure: sinus floor. Region 47: bone height ~ 20.2 mm; implant space ~ 17.6 mm; nearest critical structure: mental foramen. Region 23: bone height ~ 15.4 mm; implant space ~ 9.8 mm; nearest critical structure: incisive canal. Region 34: bone height ~ 20.2 mm; implant space ~ 11.6 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.

Question: Planning for assessment for guided surgery. Brief history/status: Esomeprazole, Duloxetine, Amlodipine, Metoprolol, Calcichew-D3, Duroferon, Levaxin, Atorvastatin, Bufomix Easyhaler. Desired treatment: Provide measurements relevant to guided surgery stent planning for 36–46 and 37–47.

Answer: Review of CBCT volume dated 250815. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 13: bone height ≈ 4.2 mm; implant space ≈ 2.1 mm; nearest critical structure: sinus floor. Region 12: bone height ≈ 20.0 mm; implant space ≈ 15.0 mm; nearest critical structure: sinus floor. Region 16: bone height ≈ 16.0 mm; implant space ≈ 11.1 mm; nearest critical structure: incisive canal. Region 26: bone height ≈ 8.1 mm; implant space ≈ 1.5 mm; nearest critical structure: sinus floor. Region 41: bone height ≈ 21.0 mm; implant space ≈ 12.3 mm; nearest critical structure: mental foramen. Region 18: bone height ≈ 20.8 mm; implant space ≈ 15.5 mm; nearest critical structure: sinus floor. Region 24: bone height ≈ 16.1 mm; implant space ≈ 9.7 mm; nearest critical structure: sinus floor. Region 47: bone height ≈ 20.2 mm; implant space ≈ 17.6 mm; nearest critical structure: mental foramen. Region 23: bone height ≈ 15.4 mm; implant space ≈ 9.8 mm; nearest critical structure: incisive canal. Region 34: bone height ≈ 20.2 mm; implant space ≈ 11.6 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.


[User]
<image>
Planning for chronic sinusitis evaluation. Brief history/status: Calcichew-D3, Losartan, Omeprazole, Amlodipine, Insulin glargine, Betolvex. Desired treatment: Assess implant site quality and need for sinus lift or graft in 36-46.

[Assistant] Review of CBCT scan dated 211207. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 33: bone height ~ 20.5 mm; implant space ~ 14.9 mm; nearby structure: sinus floor. Region 37: bone height ~ 19.9 mm; implant space ~ 13.2 mm; nearby structure: nasal floor. Region 21: bone height ~ 4.4 mm; implant space ~ 0 mm; nearby structure: sinus floor. Region 16: bone height ~ 10.5 mm; implant space ~ 8.3 mm; nearby structure: nasal floor. Region 23: bone height ~ 5.9 mm; implant space ~ 1.2 mm; nearby structure: sinus floor. Region 41: bone height ~ 20.1 mm; implant space ~ 15.8 mm; nearby structure: anterior loop. Region 14: bone height ~ 9.3 mm; implant space ~ 4.1 mm; nearby structure: nasal floor. Region 22: bone height ~ 4.8 mm; implant space ~ 0 mm; nearby structure: anterior loop. Region 25: bone height ~ 4.7 mm; implant space ~ 0 mm; nearby structure: mandibular canal. Region 27: bone height ~ 10.3 mm; implant space ~ 5.2 mm; nearby structure: anterior loop. Impression: Adequate bone density throughout; implant feasible without augmentation.

Question: Planning for chronic sinusitis evaluation. Brief history/status: Calcichew-D3, Losartan, Omeprazole, Amlodipine, Insulin glargine, Betolvex. Desired treatment: Assess implant site quality and need for sinus lift or graft in 36–46.

Answer: Review of CBCT scan dated 211207. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 33: bone height ≈ 20.5 mm; implant space ≈ 14.9 mm; nearby structure: sinus floor. Region 37: bone height ≈ 19.9 mm; implant space ≈ 13.2 mm; nearby structure: nasal floor. Region 21: bone height ≈ 4.4 mm; implant space ≈ 0 mm; nearby structure: sinus floor. Region 16: bone height ≈ 10.5 mm; implant space ≈ 8.3 mm; nearby structure: nasal floor. Region 23: bone height ≈ 5.9 mm; implant space ≈ 1.2 mm; nearby structure: sinus floor. Region 41: bone height ≈ 20.1 mm; implant space ≈ 15.8 mm; nearby structure: anterior loop. Region 14: bone height ≈ 9.3 mm; implant space ≈ 4.1 mm; nearby structure: nasal floor. Region 22: bone height ≈ 4.8 mm; implant space ≈ 0 mm; nearby structure: anterior loop. Region 25: bone height ≈ 4.7 mm; implant space ≈ 0 mm; nearby structure: mandibular canal. Region 27: bone height ≈ 10.3 mm; implant space ≈ 5.2 mm; nearby structure: anterior loop. Impression: Adequate bone density throughout; implant feasible without augmentation.


[User]
<image>
Describe the different representations of the alpha helix shown in the image.

[Assistant] The image illustrates the structure of an alpha helix using four different models: (A) a ribbon depiction showing the backbone and side chains, (B) a ball-and-stick model highlighting the hydrogen bonds between NH and CO groups with dashed lines, (C) an end-on view showing the coiled backbone and outward-projecting side chains, and (D) a space-filling model demonstrating the tightly packed interior core of the helix.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_0120.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed.md

I. The Mol cu ar Design of L

e

3. Protein S

uc re and Fu

ctio

3.

Secondary St uc e: Polyp

tide Cha ns

Fold Int

Regular St

c

es u h a

t

e Alpha H

ix, t e B

a Sh t,

nd Tur s a

Lo p

Figure 3.29. Structure of the α Helix. (A) A ribbon depiction with the α -carbon atoms and side chains (green) shown. (B) A side view of a ball-and-stick version depicts the hydrogen bonds (dashed lines) between NH and CO groups. (C) An end view shows the coiled backbone as the inside of the helix and the side chains (green) projecting outward. (D) A space-filling view of part C shows the tightly packed interior core of the helix.

<!--image-->

(A)

(B)

(C)

(D)

I. The Mol cu ar Design of L

e

3. Protein S

uc re and Fu

ctio

3.

Secondary St uc e: Polyp

tide Cha ns

Fold Int

Regular St

c

es u h a

t

e Alpha H

ix, t e B

a Sh t,

nd Tur s a

Lo p

Figure 3.30. Hydrogen-Bonding Scheme For an α helix. In the α helix, the CO group of residue n forms a hydrogen bond with the NH group o


[User]
<image>
Explain the relationship between the protein structure shown in (A) and the hydropathy plot in (B).

[Assistant] The diagram in (A) illustrates the structure of glycophorin, a membrane protein that spans the lipid bilayer once. The segment of the protein embedded within the hydrophobic lipid bilayer (highlighted in yellow) consists of nonpolar amino acids. The hydropathy plot in (B) quantifies the hydrophobicity of the protein sequence; the peak that rises above the 'criterion level' corresponds to this hydrophobic transmembrane alpha-helix, confirming its ability to reside within the lipid membrane.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_0695.png


[User]
<image>
Describe the biochemical process shown in the diagram.

[Assistant] The diagram illustrates the catalytic mechanism of the enzyme triose phosphate isomerase, which interconverts dihydroxyacetone phosphate and glyceraldehyde 3-phosphate. The reaction proceeds through an enediol intermediate. Glu 165 acts as a general base to abstract a proton from the substrate, while His 95 acts as a general acid to donate a proton, facilitating the rearrangement of the molecule.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_0919.png


[User]
<image>
What does this diagram illustrate regarding the structure of a photosynthetic protein complex?

[Assistant] This diagram illustrates the structural organization of a photosynthetic protein complex, likely Photosystem I, embedded within a thylakoid membrane. The left panel shows a side view of the complex spanning the membrane, separating the stroma from the thylakoid lumen. It highlights key functional components, including the 'special pair' of chlorophyll molecules involved in light-driven electron transfer and '4Fe-4S clusters' which act as electron carriers. The right panel provides a top-down view, revealing the arrangement of the protein subunits and associated pigments (chlorophylls) within the complex.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1106.png


[User]
<image>
Describe the metabolic pathway shown in the diagram.

[Assistant] The diagram illustrates the urea cycle, a metabolic pathway in terrestrial vertebrates that converts excess ammonium ions (NH4+) and carbon dioxide (CO2) into urea for excretion. The cycle begins with the synthesis of carbamoyl phosphate from NH4+ and bicarbonate (HCO3-), which then reacts with ornithine to form citrulline. Citrulline is subsequently converted through a series of steps into argininosuccinate and then arginine, which is finally cleaved to release urea and regenerate ornithine to continue the cycle.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1272.png

23.

The First S

p n Ami

o

c d Degra tion Is

he R moval f Nitrogen

Figure 23.14. Reaction Choice. In aspartate aminotransferase, the C α -H bond is most nearly perpendicular to the π -orbital system and is cleaved. In serine hydroxymethyltransferase, a small rotation about the N-C α bond places the C α -C β bond perpendicular to the π system, favoring its cleavage.

<!--image-->

Aspartate

Serine

aminotransferase

transferase

Band most nearly

perendicular

to =orhitals

I . Transduci

g

Storing E

e

y

23. Protein Tu v r and Ami

o

c d Cat bolism

23.

The First S

p n Ami

o

c d Degra tion Is

he R moval f Nitrogen

Figure 23.15. The Alanine Cycle. Glutamate in muscle is transaminated to alanine, which is released into the bloodstream. In the liver, alanine is taken up and converted into pyruvate for subsequent metabolism.

<!--image-->

MUSCLE

LIER

CH

H

OOC

"CH;

Glutamale

Alanine

I . Transduci

g

Storing E

e

y

23. Protein Tu v r and Ami

o

c d Cat bolism

##


[User]
<image>
Describe the biochemical pathway shown in the image.

[Assistant] The image illustrates the synthesis of bile salts from cholesterol. It shows the conversion of trihydroxycoprostanoate into cholyl CoA, which then undergoes conjugation with either glycine to form glycocholate or taurine to form taurocholate.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1514.png


[User]
<image>
What structural features are highlighted in this ribbon diagram of an immunoglobulin domain?

[Assistant] This ribbon diagram illustrates the structure of an immunoglobulin domain, which is a common structural motif in proteins like antibodies and T-cell receptors. Key features highlighted include the hypervariable loops (shown in magenta), which are typically involved in antigen binding, and a conserved disulfide bond that stabilizes the protein's fold.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1912.png

R c ptors

Figure 33.21. Intracellular Pathogen. An electron micrograph showing mycobacteria (arrows) inside an infected macrophage. [Courtesy of Dr. Stanley Falkow.]

<!--image-->

IV. Respondi g t

E v ronme tal Ch nges

3

. The Im un System

3

.5 Major-Hist

c

mpa bil ty-Comp ex Pr

t

ins

e

t P

p ide Ant g s o

Cel

Surfac s o

Re gnit o

by T-Cel

R c ptors

Figure 33.22. Presentation of Peptides from Cytosolic Proteins. Class I MHC proteins on the surfaces of most cells display peptides that are derived from cytosolic proteins by proteolysis.

<!--image-->

Peptides bound

Cytosolic

toclass

protein

Delivery

Frcteclysis

Peptides

ER

Transport

IV. Respondi g t

E v ronme tal Ch nges

3

. The Im un System

3

.5 Major-Hist

c

mpa bil ty-Comp ex Pr

t

ins

e

t P

p ide Ant g s o

Cel

Surfac s o

Re gnit o

by T-Cel

R c ptors

Figure 33.23. Class I MHC Protein. A protein of this class consists of two chains. The α chain begins with two domains that include α helices


[User]
<image>
Describe the structural interaction shown in the image between the T-cell receptor and the MHC class I molecule.

[Assistant] The image illustrates the structural interaction between a T-cell receptor (TCR) and an MHC class I molecule. The left panel shows a side view of the TCR (with alpha and beta chains) docked onto the MHC class I molecule. The top right panel shows the bottom view of the TCR, highlighting the interface that contacts the MHC, while the bottom right panel shows the top view of the MHC class I molecule, highlighting the peptide-binding groove where the TCR interacts.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1941.png


[User]
<image>
What does the molecular diagram in the image illustrate regarding myosin?

[Assistant] The image illustrates the lever-arm motion in the S1 fragment of scallop muscle myosin. It shows the dramatic conformational changes that occur when the bound nucleotide changes (e.g., from ADP-VO4 3- to ADP), resulting in a nearly 90-degree reorientation of the lever arm.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1968.png

34.1 Most lecu ar-Mot

P

eins Ar Memb s of the P-L

op NTPase Sup rf mily

<!--image-->

Light

chains

Head

domains

Figure 34.7. Kinesin at Low Resolution. An electron micrograph of conventional kinesin reveals an elongated structure with two heads at one end. The position of the light chains was confirmed through the use of antibody labels. [After N. Hirokawa, K. K. Pfister, H. Yorifuji, M. C. Wagner, S. T. Brady, and G. S. Broom. Cell 56 (1989):867.]

IV. Respondi g t

E v ronme tal Ch nges

34. Molecu ar to s

34.1 Most lecu ar-Mot

P

eins Ar Memb s of the P-L

op NTPase Sup rf mily

Figure 34.8. Structure of Head Domain of Kinesin at High Resolution. The head domain of kinesin has the structure of a P-loop NTPase core (indicated by purple shading).

<!--image-->

Nucleoride

P-loop

binding site

IV. Respondi g t

<!--image-->

E v ronme tal Ch nges

34. Molecu ar to s

34.1 Most lecu ar-Mot

P

eins Ar Memb s of the P-L

op NTPase Sup rf mily

Figure 34.9. Dynein Head-Domain


[User]
<image>
Describe the chemical reaction mechanism shown in the image.

[Assistant] The image illustrates the catalytic mechanism of a pyridoxal phosphate (PLP)-dependent enzyme, specifically the conversion of serine to aminoacrylate. The process begins with the formation of an external aldimine between the enzyme-bound PLP and the amino group of serine. This is followed by the abstraction of the alpha-proton and the elimination of the hydroxyl group (as water) to form an aminoacrylate intermediate. Finally, the aminoacrylate is released, and the PLP cofactor is regenerated in its original form.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_2084.png


[User]
<image>
Identify the major organelles labeled in this diagram of a eukaryotic cell.

[Assistant] This diagram illustrates the structure of a eukaryotic cell, highlighting several key organelles: the nucleus (containing the nucleolus and chromatin network), the rough and smooth endoplasmic reticulum, the Golgi body, mitochondria, lysosomes, and free ribosomes, all enclosed within the cell membrane and suspended in the cytosol.

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0006.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil.md


[User]
<image>
Explain the process of tRNA charging as shown in the diagram.

[Assistant] The diagram illustrates the process of tRNA charging (aminoacylation), which is essential for protein synthesis. First, an amino acid reacts with ATP in the presence of an aminoacyl-tRNA synthetase enzyme and magnesium ions (Mg++), releasing pyrophosphate (ppi) and forming an amino acid-AMP-enzyme complex. Subsequently, this activated amino acid is transferred to the 3' end of a specific tRNA molecule (which terminates in the sequence CCA), releasing AMP and resulting in a charged aminoacyl-tRNA.

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0112.png

Fig. 8.27 Charging of tRNA

<!--image-->

Amino acyl

tRNA

Amino acid + ATP

Amino acid - AMP-Enzyme

complex

tRNA

Activated amino acid

A

C

C

5'

AMP

5'

3'

3'

Amino acyl tRNA synthesis

Mg + +

ppi

A

C

C

## Elongation of Polypeptide Chain

It is the successive addition of coded amino acids to the first amino acid on the surface of ribosome to form a polypeptide chain.

Elongation of polypeptide chain can be described in the following steps such as:

## · Peptide bond formation

- -The second tRNA-amino acid complex enters ribosome at A site. The tRNA contains anticodons which help in its pairing with codons on mRNA through hydrogen bonding.
- -The bond between COOH group of 1st amino acid and OH group in CCA of 1st tRNA is split. The COOH group of 1st amino acid at P site forms a peptide bond with NH2 group of 2nd amino acid at A site. Reaction is catalyzed by peptidyl transferase enzyme (ribozyme).
- -The 2nd tRNA located at A site carries a dipeptide (methionine amino


[User]
<image>
Describe the biochemical process shown in the diagram.

[Assistant] The diagram illustrates the oxidative deamination of amino acids. It begins with the transamination of an amino acid with alpha-ketoglutarate to form L-glutamate. Subsequently, L-glutamate undergoes oxidative deamination catalyzed by the enzyme L-glutamate dehydrogenase, using NAD+ as a cofactor. This produces alpha-imino-glutaric acid, which is then hydrolyzed in the presence of water to release ammonia (NH3) and regenerate alpha-ketoglutaric acid.

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0195.png


[User]
<image>
Describe the biochemical pathway shown in the image.

[Assistant] The image illustrates the initial steps of glycolysis. It shows the phosphorylation of glucose to glucose-6-phosphate by hexokinase or glucokinase (using ATP and Mg++), the isomerization of glucose-6-phosphate to fructose-6-phosphate by phosphohexoisomerase, and the subsequent phosphorylation of fructose-6-phosphate to fructose-1,6-bisphosphate by phosphofructokinase (using ATP and Mg++).

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0206.png


[User]
<image>
Describe the metabolic pathway shown in the image.

[Assistant] The image illustrates the pathway of glycolysis, which is the metabolic process that converts glucose into pyruvate or lactate, generating ATP in the process. It shows the sequential enzymatic reactions starting from glycogen or glucose, through various phosphorylated intermediates like fructose 1,6-bisphosphate and 3-phosphoglycerate, and highlights key regulatory enzymes such as hexokinase, phosphofructokinase, and pyruvate kinase. The diagram also indicates points of inhibition, such as the inhibition of enolase by fluoride and glyceraldehyde-3-phosphate dehydrogenase by iodoacetate, as well as the connection to the mitochondrial respiratory chain.

__lib_book_Biochemistry_ Harper_s Illustrated Biochemistry by Harper 26th Ed/img_0176.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Biochemistry_ Harper_s Illustrated Biochemistry by Harper 26th Ed.md

The subsequent step is catalyzed by enolase and involves a dehydration, forming phosphoenolpyruvate. Enolase is inhibited by fluoride. To prevent glycolysis in the estimation of glucose, blood is collected in tubes containing fluoride. The enzyme is also dependent on the presence of either Mg 2+ or Mn 2+ . The phosphate of phosphoenolpyruvate is transferred to ADP by pyruvate kinase to generate, at this stage, two molecules of ATP per molecule of glucose oxidized. The product of the enzyme-catalyzed reaction, enolpyruvate, undergoes spontaneous (nonenzymic) isomerization to pyruvate and so is not available to

Figure 17-2. The pathway of glycolysis. ( P ,  PO3 2 -; P i, HOPO3 2 -; -, inhibition.) At asterisk: Carbon atoms 1-3 of fructose bisphosphate form dihydroxyacetone phosphate, whereas carbons 4-6 form glyceraldehyde 3-phosphate. The term 'bis-,' as in bisphosphate, indicates that the phosphate groups are separated, whereas diphosphate, as in adenosine diphosphate, indicates that


[User]
<image>
Describe the process of anterograde vesicular transport as illustrated in the diagram.

[Assistant] The diagram illustrates the cycle of anterograde vesicular transport. It begins with the budding of a vesicle from a donor membrane (like the ER), facilitated by ARF and coatomer proteins. Once formed, the coated vesicle undergoes uncoating, which is necessary for fusion. The vesicle then targets the destination membrane (like the CGN) through the interaction of v-SNAREs on the vesicle and t-SNAREs on the target membrane. The fusion process is mediated by the assembly of the SNARE complex with SNAPs and the ATPase NSF. The cycle also includes a retrograde transport step to recycle components, which can be inhibited by Nocodazole.

__lib_book_Biochemistry_ Harper_s Illustrated Biochemistry by Harper 26th Ed/img_0515.png

Step 4: Coat disassembly (involving dissociation of ARF and coatomer shell) follows hydrolysis of bound GTP; uncoating is necessary for fusion to occur.

Step 5: Vesicle targeting is achieved via members of a family of integral proteins, termed v-SNAREs, that tag the vesicle during its budding. v-SNAREs pair with cognate t-SNAREs in the target membrane to dock the vesicle.

It is presumed that steps 4 and 5 are closely coupled and that step 4 may follow step 5, with ARF and the coatomer shell rapidly dissociating after docking.

Step 6: The general fusion machinery then assembles on the paired SNARE complex; it includes an ATPase (NSF; NEM-sensitive factor) and the SNAP (soluble NSF attachment factor) proteins. SNAPs bind to the SNARE (SNAP receptor) complex, enabling NSF to bind.

Step 7: Hydrolysis of ATP by NSF is essential for fusion, a process that can be inhibited by NEM ( N -ethylmaleimide). Certain other proteins and calcium are also required.

/

Figure 46-7. Model of the step


[User]
<image>
What is the chemical structure shown in the image?

[Assistant] The image shows the chemical structure of Coenzyme A (CoA-SH). It consists of a phosphopantetheine group linked to an adenosine 3',5'-bisphosphate molecule. The terminal sulfhydryl (-SH) group, which is capable of forming thioesters with acyl groups, is highlighted in blue.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_0399.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition.md


[User]
<image>
Explain the components and process shown in this diagram of DNA replication.

[Assistant] This diagram illustrates the process of DNA replication at a replication fork. Key components include: 1) Helicase, which unwinds the parental DNA double helix. 2) Topoisomerase, which relieves torsional strain ahead of the replication fork. 3) Primase, which synthesizes short RNA primers (indicated by zigzag lines) to initiate DNA synthesis. 4) DNA polymerase alpha and delta, which are responsible for synthesizing the new DNA strands. The leading strand is synthesized continuously in the direction of the replication fork, while the lagging strand is synthesized discontinuously in the opposite direction, requiring multiple RNA primers.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_0713.png


[User]
<image>
Describe the chemical process shown in the diagram regarding FAD and FMN.

[Assistant] The diagram illustrates the stepwise reduction of the coenzyme FAD (Flavin adenine dinucleotide). FAD can accept two electrons and two protons in two separate steps. First, it accepts one electron and one proton to form the semiquinone intermediate, FADH-. Then, it accepts a second electron and proton to become fully reduced to FADH2.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_1112.png


[User]
<image>
Describe the biochemical process shown in the diagram.

[Assistant] The diagram illustrates the catalytic mechanism of the enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH) during glycolysis. The process involves four main steps: (1) the binding of glyceraldehyde-3-phosphate to the enzyme's active site cysteine residue, (2) the oxidation of the substrate to form a thioester intermediate while reducing NAD+ to NADH, (3) the release of NADH and binding of a new NAD+, and (4) the phosphorolysis of the thioester intermediate by inorganic phosphate (Pi) to release 1,3-bisphosphoglycerate and regenerate the enzyme.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_1257.png


[User]
<image>
Explain the process shown in the diagram regarding starch digestion.

[Assistant] The diagram illustrates the enzymatic hydrolysis of starch by salivary and pancreatic alpha-amylase. Alpha-amylase acts on the starch molecule (a polysaccharide) by breaking specific glycosidic bonds, as indicated by the arrows. This process results in the production of smaller carbohydrate molecules, including maltose (a disaccharide), isomaltose, trisaccharides, and alpha-dextrins (oligosaccharides containing alpha-1,6 branches).

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_1474.png


[User]
<image>
Describe the biochemical pathway shown in the diagram.

[Assistant] The diagram illustrates the glycolytic pathway, showing the conversion of glucose into phosphoenolpyruvate (PEP). Key steps include the phosphorylation of glucose by glucokinase to form glucose 6-phosphate, the conversion of fructose 6-phosphate to fructose 1,6-bisphosphate by phosphofructokinase 1, and the subsequent breakdown into triose phosphates. It also shows the entry of glycerol into the pathway via glycerol 3-phosphate. The diagram includes regulatory markers indicating where enzymes are inhibited, induced, or inactive.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_1663.png

Changes in the metabolism of glucose that occur during the switch from the fed to the fasting state are regulated by the hormones insulin and glucagon . Insulin is elevated in the fed state, and glucagon is elevated during fasting. Insulin stimulates the transport of glucose into certain cells such as those in muscle and adipose tissue. Insulin also alters the activity of key enzymes that regulate metabolism, stimulating the storage of fuels. Glucagon counters the effects of insulin, stimulating the release of stored fuels and the conversion of lactate, amino acids, and glycerol to glucose.

Fig. 31.1. Glycolysis and gluconeogenesis in the liver. The gluconeogenic pathway is almost the reverse of the glycolytic pathway, except for three reaction sequences. At these three steps, the reactions are catalyzed by different enzymes. The energy requirements of these reactions differ, and one pathway can be activated while the other is inhibited.

<!--image-->

2-Phosphoglycerate

Glucose

Glu


[User]
<image>
Describe the biochemical pathway shown in the diagram.

[Assistant] The diagram illustrates the de novo pyrimidine nucleotide biosynthesis pathway. It begins with the synthesis of carbamoyl phosphate from glutamine, CO2, and 2 ATP, catalyzed by the enzyme CPS-II, which is regulated by UTP (feedback inhibition) and PRPP (activation). The pathway proceeds through several intermediates, including orotate, UMP, UDP, and UTP. UTP can be converted to CTP for RNA synthesis. Additionally, the pathway shows the reduction of CDP to dCDP by ribonucleotide reductase (RR), leading to the formation of dCTP for DNA synthesis. Finally, dUMP is converted to dTMP (using 5,10-methylene-FH4) and subsequently to dTTP, which is also used for DNA synthesis.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_2131.png


[User]
<image>
Describe the metabolic pathways occurring in the intestinal epithelial cell as shown in the diagram.

[Assistant] The diagram illustrates the metabolism of glutamine and other substrates within an intestinal epithelial cell. In the postprandial and postabsorptive states, glutamine is taken up from the gut lumen and blood, converted to glutamate, and then to alpha-ketoglutarate (a-KG) via glutamate dehydrogenase (GDH) or transamination (TA). This process releases ammonia (NH4+) into the blood. The cell also processes other substrates like glucose, branched-chain amino acids (BCAA), and ketone bodies, which feed into the TCA cycle or are converted into products such as alanine, lactate, citrulline, and ornithine, which are then released into the blood.

__lib_book_Biochemistry_ Marks_ Basic Medical Biochemistry A Clinical Approach_ 2nd Edition/img_2175.png


[User]
<image>
What does the increase in mRFP intensity relative to GFP in these treated tumor spheroids indicate?

[Assistant] The increase in mRFP intensity relative to the GFP signal indicates the progression of autophagy. Specifically, it signals the formation of autolysosomes, where the acidic environment causes the GFP signal to fade while the pH-insensitive mRFP signal remains constant.

__lib_book_Cancer_ Cancer Cell Signaling Methods and Protocols by Robles Flores_ M 2nd Ed/img_0006.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Cancer_ Cancer Cell Signaling Methods and Protocols by Robles Flores_ M 2nd Ed.md

<!--image-->

b

2

3

3.2.2 Live Cell Imaging Using Confocal Laser Scanning Microscopy (CLSM)

Image over time the drug effects in cellular spheroids with an automated motorized confocal microscope. Employ a long workingdistance objective lens with high numerical aperture and an intermediate magnifi cation (e.g., 20×), in order to obtain a large enough fi eld of view (Fig. 5 ). This is important, since spheroids move across the well during time-lapse imaging ( see Note 5 ). Each substance should be tested at least in triplicate, and at least one control triplicate should be conducted in order to achieve a statistical signifi cance. In the case that a motorized automated confocal microscope is not available, the spheroids can be cultured in a CO 2 incubator for the duration of the experiment, and images can be recorded at fi xed intervals ( see Note 6 ). Defi ne the confocal z -stack by choosing a relatively small number of planes (e.g., 10) across the whole spheroids (outer superfi ci


[User]
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What do the violin plots in the image represent regarding miRNA expression in breast cancer?

[Assistant] The violin plots illustrate the relative fold change in expression levels of seven specific circulating miRNAs (miR-10b, miR-21, miR-125b, miR-145, miR-155, miR-191, and miR-382) and a combined ratio (miR-145/miR-155/miR-382) in breast cancer (BC) patients compared to healthy controls (NC). The data shows that all these miRNAs are significantly upregulated in breast cancer serum samples, with all p-values being less than 0.005.

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RT-qPCR miRNA profi ling on serum could discriminate between breast cancer patients ( n = 61) and healthy controls ( n = 10). The relative expression values of seven circulating miRNAs are related with breast cancer. All miRNAs were signifi cantly higher in breast cancer serum than in healthy controls ( p < 0.001) as shown in Fig. 1 .
7. Construct AROC curves to evaluate the sensitivity and specifi city of the assay ( see Note 17 ). Additionally, you can calculate the effi ciency of a diagnostic test ( see Note 18 ). Figure 2 shows AROC curves constructed for circulating miRNAs tested in this assay, and Table 1 shows the results of sensitivity, specifi city, and effi ciency of our assay.
1. There are many options of protocols for total RNA extraction, but a protocol that includes miRNAs must be chosen. We choose miRNeasy kit from Qiagen because it is a very convenient tool for isolation of good-quality RNA in a relatively short time.
2. TaqMan MicroRNA Assays employ a novel target-s


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Describe the flow cytometry analysis strategy for target cells shown in the figure.

[Assistant] The figure illustrates the analysis strategy for target cells in a flow cytometry assay. Panel (a) uses an FSC-H vs. FSC-A plot to gate for singlet events (R1). Panel (b) uses an SSC-A vs. FSC-A plot to gate for the target cell population (R2). Panels (c), (d), and (e) show the gating strategy for fluorescence: (c) represents unstained cells to establish autofluorescence limits, (d) shows the CFSE control where target cells are CFSE+, and (e) shows the positive control (temperature-induced dead cells) where cells are both CFSE+ and 7-AAD+.

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asional (approximately every hour) manual stirring.
6. Wash cells with 1 mL cool PBS/tube and centrifuge at 400 × g for 5 min.
1. Eliminate supernatant and resuspend in 100 μ L of antiCD56- PE diluted in PBS plus 1 % FBS ( see Note 15 ). Some samples will not require CD56 staining (see Table 1 ), and in this case, cells should be resuspended in 50 μ L of PBS and kept on ice until 7-AAD staining.
2. Incubate for 30 min at 4 °C, in the dark, with occasional (approximately every 10 min) manual stirring.
3. Wash the tube with 1.2 mL of PBS plus 10 % FBS and centrifuge at 400 × g for 5 min.
4. Resuspend the pellets in 50 μ L/tube of PBS.
1. Dilute 7-AAD to 2.5 μ g/mL in PBS. Volume should be enough to use 50 μ L/tube ( see Table 1 ).
2. Add 50 μ L/tube of 7-AAD solution (0.125 μ g/tube).
3. Incubate at 4 °C for 10 min in the dark.
4. Wash with 1 mL of cool PBS plus 10 % FBS, and centrifuge at 400 × g for 5 min.
5. Resuspend cell pellet in 200 μ L of PBS, and transfer the suspension to fl ow


[User]
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Explain the process shown in this diagram regarding the development of cancer.

[Assistant] This diagram illustrates a multistep model of carcinogenesis. It shows that cancer development often begins with an inherited genetic susceptibility (such as single gene defects or polymorphisms). Through cell division and the influence of environmental factors-specifically radiation, tumor viruses, and chemical carcinogens-the cell accumulates acquired somatic genetic mutations, which eventually lead to the development of cancer.

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C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Cancer_ Molecular Biology Of Cancer by Pelengaris_ Stella.md


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Explain the role of the spindle assembly checkpoint in regulating the cell cycle as shown in the diagram.

[Assistant] The spindle assembly checkpoint ensures accurate chromosome segregation during mitosis. As shown in the diagram, when kinetochores are incorrectly attached to microtubules, they recruit a complex of BUB and MAD proteins. This complex inhibits CDC20, which in turn keeps the Anaphase-Promoting Complex/Cyclosome (APC/C) in an inactive state. Consequently, securin is not ubiquitinated and remains stable, preventing the cell from progressing into anaphase. Once correct attachment and tension are achieved, the checkpoint proteins are released from the kinetochores. This allows CDC20 to activate the APC/C, which then ubiquitinates securin, targeting it for degradation by the proteasome and permitting the cell to proceed through anaphase.

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Fig. 4.7 The G 2 /M checkpoint. The G 2 /M DNA damage checkpoint prevents the cell from entering mitosis (M phase) if the genome is damaged. The CDK1 (CDC2)-cyclin B kinase is a key regulator of this transition. During G 2 , CDK1 is maintainedin an inactive state by the kinases WEE1 andMYT1. As M phase approaches, the phosphatase CDC25 is activatedby the polo-kinase PLK1. CDC25 then activates CDK1, establishing a feed back amplification loop that efficiently drives the cell into mitosis. DNA damage activates the ATM/ATR kinases, initiating two parallel cascades that inactivate CDK1-cyclin B. The first cascade rapidly inhibits progression into mitosis: the CHK kinases phosphorylate andinactivate CDC25, which can no longer activate CDK1. Phosphorylation of p53 dissociates it from MDM2, activating its DNA binding activity. Acetylation by p300/PCAF further activates its transcriptional activity. The genes that are activated by p53 encode proteins including 14-33s, which bindphosphorylatedC


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Based on the diagram, what are the primary functional domains of the human c-MYC protein and which proteins interact with it?

[Assistant] The human c-MYC protein is organized into three main regions: the N-terminal domain (NTD), a central region, and the C-terminal domain (CTD). The NTD contains conserved 'cMYC boxes' I and II (MBI and MBII) essential for transactivation, while the central region contains MBIII. The CTD contains the basic helix-loop-helix leucine zipper (bHLH-LZ) motif, which facilitates dimerization with the Max protein for DNA binding. Interacting proteins include TRRAP and TIP48/49 (which bind to the NTD/MBII region), SP1 (which binds to the central region), and MIZ1 and MAX (which bind to the CTD).

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Before launching into a description of the mechanis msby which c-MYC activatesvarious biological processes, whether it be within a normal healthy cell or in a tumor cell, this section highlights what we know about c-MYC in human cancersand why we have had to look towardsmous e tumor modelsin order to gain further insight into MYC's oncogenic role in vivo .

In the intact organism, c-MYC is expressed ubiquitously during development in growing tissues. There also exist other homologs of c-MYC (L-MYC, N-MYC - Box 6.1), and the expression of each is normally restricted to certain

Fig. 6.5 Functional domainsof human c-MYC protein. (a) The C-terminal domain (CTD) of human c-MYC protein harborsthe bas ic (b) helix-loop-helix leucine zipper (bHLH-LZ) motif for dimerization with itspartner, Max, and subsequent DNA binding of c-MYC-Max heterodimers. The N-terminal domain (NTD) harbors conserved 'cMYC boxes' I and II (MBI and MBII) essential for transactivation of c-MYC target genes. Recently th


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Explain the principle behind the detection of methylated promoters as shown in the diagram.

[Assistant] The detection of methylated promoters relies on the differential sensitivity of DNA to sodium bisulfite treatment. Sodium bisulfite converts unmethylated cytosine residues to uracil, while methylated cytosines remain unchanged. By designing specific PCR primers that target these sequence differences, researchers can selectively amplify either the nonmethylated or methylated DNA sequences. If the primer sequences match the treated DNA, PCR amplification occurs; if they do not match, no amplification takes place, allowing for the identification of the methylation status of the promoter region.

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Several methods exist for detecting methylated DNA, one of which relies on a method based on the amplification of DNA fragments by the polymerase chain reaction (PCR) of high molecular weight genomic DNA treated with sodium bisulfite. Sodium bisulfite converts cytosine (C) residues to uracil (U) rather than guanine (G), but only when the C residues are not methylated. Therefore, primers can be designed that allow differentiation between sequences of nonmethylated and methylated DNA by virtue of the stability of the complexes formed between the DNA and the primers. In other words, if the sequences do not match, the PCR reaction will not occur and the DNA will not be amplified. Clearly, this method requires knowledge of the sequences in the promoter region of the gene under investigation, which can be found in the genome project database or be determined by sequencing (Box 7.1).

Thus, DNA methylation and gene silencing are linked to growth and differentiation regulatory pathways that ar