Improved Survival with Immunotherapy but Lack of Synergistic Effect with Radiation for Stage IV Melanoma of the Head and Neck.
Babcock B, Rodrigues M, Kearns D, Solomon N, Reeves ME, Senthil M, Garberoglio CA, Namm JP.
Abstract
Prospective randomized studies have demonstrated a survival benefit of immunotherapy in stage IV cutaneous melanoma. Some retrospective studies have hypothesized a synergistic effect of radiation and immunotherapy. Our objective was to identify whether there is a survival benefit for patients treated with radiation and immunotherapy in stage IV cutaneous melanoma of the head and neck (CMHN). The National Cancer Database was used to identify patients with stage IV CMHN between 2012 and 2014. These patients were stratified based on receipt of radiation and immunotherapy. Adjusted Cox regression was used to analyze overall survival. A total of 542 patients were identified with stage IV CMHN, of whom 153 (28%) patients received immunotherapy. Receipt of immunotherapy (hazard ratio [HR] 0.69, P = 0.02) and negative LNs (HR 0.50, P = 0.002) were independently associated with improved survival, whereas radiation conferred no survival benefit (HR 1.17, P = 0.26). Patients who received immunotherapy without radiation were associated with significantly improved survival compared with those who received immunotherapy with radiation (P < 0.0001). However, of patients who received radiation, the addition of immunotherapy did not seem to improve survival (P = 0.979). In stage IV CMHN, immunotherapy confers a 32 per cent survival benefit. The use of immunotherapy in patients who require radiation, however, is not associated with improved survival.

PMID: 31657306
Select item 31657129
2.
J Med Radiat Sci. 2019 Oct 28. doi: 10.1002/jmrs.359. [Epub ahead of print]
Implementing user-defined atlas-based auto-segmentation for a large multi-centre organisation: the Australian Experience.
Hu Y1,2, Byrne M3, Archibald-Heeren B2,3, Thompson K4, Fong A3, Knesl M5, Teh A1,3,6, Tiong E7, Foster R8, Melnyk P1, Burr M3, Thompson A3, Lim J3, Moore L3, Gordon F3, Humble R9, Hardy A10, Williams S11.
Author information
1
ICON Cancer Centre Gosford, Gosford, New South Wales, Australia.
2
Centre for Radiation Medical Physics, University of Wollongong, Wollongong, New South Wales, Australia.
3
ICON Cancer Centre Wahroonga, Sydney Adventist Hospital, Wahroonga, New South Wales, Australia.
4
Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
5
ICON Cancer Centre Maroochydore, Maroochydore, Queensland, Australia.
6
Sydney Adventist Hospital Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
7
ICON Cancer Centre Midland, Midland, Western Australia, Australia.
8
ICON Cancer Centre Hobart, Hobart, Tasmania, Australia.
9
ICON Cancer Centre Cairns, Liz Plummer Cancer Care Centre, Cairns, Queensland, Australia.
10
ICON Cancer Centre Springfield, Level 1, Cancer Care Centre, Mater Private Hospital, Springfield, Queensland, Australia.
11
ICON Cancer Centre Rockingham, Rockingham, Western Australia, Australia.
Abstract
INTRODUCTION:
Contouring has become an increasingly important aspect of radiation therapy due to inverse planning, and yet is extremely time-consuming. To improve contouring efficiency and reduce potential inter-observer variation, the atlas-based auto-segmentation (ABAS) function in Velocity was introduced to ICON cancer centres (ICC) throughout Australia as a solution for automatic contouring.

METHODS:
This paper described the implementation process of the ABAS function and the construction of user-defined atlas sets and compared the contouring efficiency before and after the introduction of ABAS.

RESULTS:
The results indicate that the main limitation to the ABAS performance was Velocity's sub-optimal atlas selection method. Three user-defined atlas sets were constructed. Results suggested that the introduction of the ABAS saved at least 5 minutes of manual contouring time (P < 0.05), although further verification was required due to limitations in the data collection method. The pilot rollout adopting a 'champion' approach was successful and provided an opportunity to improve the user-defined atlases prior to the national implementation.

CONCLUSION:
The implementation of user-defined ABAS for head and neck (H&N) and female thorax patients at ICCs was successful, which achieved at least 5 minutes of efficiency gain.

© 2019 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

KEYWORDS:
Atlas-based auto-segmentation; contouring; efficiency gain; multi-centre organisation; radiotherapy

PMID: 31657129 DOI: 10.1002/jmrs.359
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Select item 31657104
3.
Head Neck. 2019 Oct 27. doi: 10.1002/hed.25992. [Epub ahead of print]
Assessment of shoulder function following scapular free flap.
Patel KB1, Low TH2, Partridge A1, Nichols AC1, MacNeil SD1, Yoo J1, Fung K1.
Author information
1
Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.
2
Head and Neck Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
Abstract
BACKGROUND:
The scapular system free flap has been increasing in popularity to reconstruct short segment mandibular bony defects. It is important to assess donor site morbidities systematically.

METHODS:
Prospective cohort study using objective measures of range of motion (ROM) and shoulder strength were measured. Subjective disability was evaluated with validated questionnaires-Neck Disability Impairment Index and Shoulder Pain and Disability Index.

RESULTS:
Twenty-six patients were recruited-19 with scapular tip and 7 with lateral border scapular free flap. Decreased ROM on the operated side was noted for shoulder abduction, shoulder flexion, and external rotation. No significant difference was noted for shoulder extension. Strength was reduced for shoulder flexion, shoulder abduction, and external rotation. Subjective measurements did not indicate significant shoulder function disruption.

CONCLUSION:
Patients with scapular free flap reconstruction did not experience significant shoulder morbidity. Measures of shoulder ROM and power were objectively affected; however, subjective measures of shoulder disability were not significantly affected.

© 2019 Wiley Periodicals, Inc.

KEYWORDS:
neck dissection; scapula free flap; scapula lateral border-free flap; scapula tip free flap; shoulder dysfunction; shoulder function

PMID: 31657104 DOI: 10.1002/hed.25992
Similar articles
Select item 31657099
4.
Head Neck. 2019 Oct 27. doi: 10.1002/hed.25983. [Epub ahead of print]
Prognostic significance of MTOR expression in HPV positive and negative head and neck cancers treated by chemoradiation.
Wilson TG1, Hanna A1, Recknagel J2, Pruetz BL3, Baschnagel AM4, Wilson GD1.
Author information
1
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan.
2
Oakland University William Beaumont School of Medicine, Oakland University, Rochester, Michigan.
3
Beaumont BioBank, William Beaumont Hospital, Royal Oak, Michigan.
4
Department of Human Oncology, University of Wisconsin Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Abstract
BACKGROUND:
The mechanistic target of rapamycin (MTOR) plays a key role in regulating cell growth and metabolism and is commonly overexpressed in head and neck cancer (HNSCC). This study investigated the association of MTOR with clinical outcome in human papilloma virus (HPV) positive and negative HNSCC patients treated by chemoradiation.

METHODS:
A tissue microarray (TMA) consisting of cores from 109 HNSCC patients treated by definitive chemoradiation was constructed and stained with antibodies against p16 and MTOR and expression correlated with clinicopathological features and clinical outcome.

RESULTS:
MTOR varied widely between tumor cores and was not associated with HPV status or clinicopathological features. There was a positive correlation with pre-treatment FDG uptake. (P = .01). In HPV negative patients, MTOR predicted for shorter locoregional control (P = .02), diseases free survival (P = .02), and overall survival (P = .04). MTOR expression was not associated with outcome in HPV positive patients.

CONCLUSIONS:
Prognostic significance of MTOR expression depends on HPV status.

© Wiley Periodicals, Inc.

KEYWORDS:
HPV; MTOR; chemoradiation; head and neck cancer; image analysis

PMID: 31657099 DOI: 10.1002/hed.25983
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Grant support
Select item 31656941
5.
OTO Open. 2019 Sep 13;3(3):2473974X19875077. doi: 10.1177/2473974X19875077. eCollection 2019 Jul-Sep.
Institutional Experience of Treatment and Outcomes for Cutaneous Periauricular Squamous Cell Carcinoma.
Kovatch KJ1, Smith JD2, Birkeland AC1, Hanks JE1, Jawad R2, McLean SA1, Durham AB3, Srinivasan A4, McHugh JB5, Basura GJ1.
Author information
1
Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA.
2
School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
3
Department of Dermatology, Michigan Medicine, Ann Arbor, Michigan, USA.
4
Department of Radiology, Michigan Medicine, Ann Arbor, Michigan, USA.
5
Department of Pathology, Michigan Medicine, Ann Arbor, Michigan, USA.
Abstract
OBJECTIVES:
To report our institutional experience, management, and outcomes of cutaneous periauricular squamous cell carcinoma (SCC).

STUDY DESIGN:
Retrospective chart review.

SETTING:
Tertiary academic center.

SUBJECTS:
Patients undergoing treatment of cutaneous periauricular SCC from 2000 to 2016.

RESULTS:
A total of 112 patients had a median follow-up of 24.5 months, a mean ± SD age of 75.7 ± 10.6 years, and a strong male predominance (93.8%). Site distribution shows 87 (77.7%) auricular, 26 (23.2%) preauricular, and 10 (8.8%) postauricular lesions. Of auricular lesions, tumors involved the tragus (n = 3, 3.4%), helix/antihelix (n = 47, 54.0%), conchal bowl (n = 31, 35.6%), external auditory canal (n = 18, 16.1%), and lobule (n = 3, 3.4%). Most patients presented at stage I (52.7%) versus stages II (28.6%), III (6.3%), and IV (12.5%). Patients were largely treated surgically with primary tumor resection ranging from wide local excision to lateral temporal bone resection (± parotidectomy and neck dissection), with 17.0% and 5.4% receiving adjuvant radiation and chemoradiation, respectively. Metastatic spread was seen to the parotid (25.9%) and neck (26.8%), with most common cervical spread to level II. Overall survival, disease-specific survival, and disease-free survival at 3 years were 62%, 89%, and 56%, respectively. Nodal disease was associated with worse disease-specific survival (P < .001) and disease-free survival (P = .042). Pre- and postauricular sites were associated with worse overall survival (P = .007) relative to auricular sites.

CONCLUSION:
Among cutaneous SCC, periauricular subsites pose treatment challenges related to surrounding anatomy and represent a unique tumor population. The reported propensity toward recurrence and patterns of metastasis may better guide treatment of aggressive tumors to include regional nodal dissection.

© The Authors 2019.

KEYWORDS:
cutaneous; periauricular; preauricular; squamous cell carcinoma

PMID: 31656941 PMCID: PMC6791998 DOI: 10.1177/2473974X19875077
Similar articles
Select item 31656712
6.
Cureus. 2019 Aug 25;11(8):e5483. doi: 10.7759/cureus.5483.
Definitive Radiation Therapy for Merkel Cell Carcinoma Misdiagnosed as a Metastatic Tumor: A Case Report.
Matsui T1, Oike T1, Shirai K2, Ohno T1.
Author information
1
Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, JPN.
2
Department of Radiology, Saitama Medical Center, Jichi Medical University, Omiya, JPN.
Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine neoplasia. Surgical resection is the first-line therapeutic option, and radiation therapy is an alternative treatment for inoperable cases. Herein, we report a case of primary MCC (cT2N0M0, stage IIA) of the head and neck region. This case was misdiagnosed as a metastatic tumor and referred to the department of radiation oncology for palliative irradiation. Additional immunohistochemical analysis confirmed the diagnosis of MCC, and the tumor was treated with definitive radiation therapy (66 Gy in 33 fractions), leading to complete in-field control. This case indicates that even in patients with suspected metastatic tumors referred for palliative treatment, patient characteristics and pathology should be carefully examined to avoid missing potentially controllable primary tumors. In such cases, MCC, although rare, should be included in the differential diagnosis of head and neck lesions.

Copyright © 2019, Matsui et al.

KEYWORDS:
case report; diagnosis; merkel cell carcinoma; pathology; radiation therapy

PMID: 31656712 PMCID: PMC6812966 DOI: 10.7759/cureus.5483
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Conflict of interest statement
Publication type
Select item 31656683
7.
J Thorac Dis. 2019 Sep;11(9):4072-4084. doi: 10.21037/jtd.2019.09.38.
Next-generation care pathways for allergic rhinitis and asthma multimorbidity: a model for multimorbid non-communicable diseases-Meeting Report (Part 2).
Bousquet J1,2,3,4,5,6,7,8, Pham-Thi N9, Bedbrook A2, Agache I10, Annesi-Maesano I11, Ansotegui I12, Anto JM13,14,15, Bachert C16, Benveniste S17,18, Bewick M19, Billo N20, Bosnic-Anticevich S21, Bosse I22, Brusselle G23, Calderon MA24, Canonica GW25, Caraballo L26, Cardona V27, Carriazo AM28, Cash E29, Cecchi L30, Chu DK31, Colgan E32, Costa E33, Cruz AA34, Czarlewski W35, Durham S36, Ebisawa M37, Erhola M38, Fauquert JL39, Fokkens WJ8,40, Fonseca JA41, Guldemond N42, Iinuma T43, Illario M44, Klimek L45, Kuna P46, Kvedariene V47, Larenas-Linneman D48, Laune D49, Le LTT50, Lourenço O51, Malva JO52, Marien G8, Menditto E53, Mullol J54, Münter L55, Okamoto Y43, Onorato GL2, Papadopoulos NG56,57, Perala M58, Pfaar O59, Phillips A60, Phillips J61, Pinnock H62, Portejoie F2, Quinones-Delgado P63, Rolland C64, Rodts U65, Samolinski B66, Sanchez-Borges M67, Schünemann HJ30, Shamji M68, Somekh D69, Togias A70, Toppila-Salmi S71, Tsiligianni I72, Usmani O73, Walker S74, Wallace D75, Valiulis A76, Van der Kleij R77, Ventura MT78, Williams S79, Yorgancioglu A80, Zuberbier T81.
Author information
1
University Hospital Montpellier, Montpellier, France.
2
MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
3
INSERM U1168, VIMA, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.
4
Université Versailles St-Quentin-en Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
5
Euforea, Brussels, Belgium.
6
Charité, Universitätsmedizin Berlin, Humboldt-Universitätzu Berlin, Berlin, Germany.
7
Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany.
8
EUFOREA, Brussels, Belgium.
9
Allergy Department, Pasteur Institute, Paris, France.
10
Faculty of Medicine, Transylvania University, Brasov, Romania.
11
Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Universités, Medical School Saint Antoine, Paris, France.
12
Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain.
13
ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
14
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
15
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
16
Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
17
National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France.
18
Mines ParisTech CRI - PSL Research University, Fontainebleau, France.
19
iQ4U Consultants Ltd, London, UK.
20
Independent Consultant, Joensuu, Finland.
21
Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia.
22
Allergist, La Rochelle, France.
23
Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
24
Imperial College London-National Heart and Lung Institute, London, UK.
25
Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano (MI), and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
26
Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer piso, Cartagena, Colombia, and Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia.
27
Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain.
28
Regional Ministry of Health of Andalusia, Seville, Spain.
29
College of Psychology, Nova Southeastern University and School-related Psychological Assessments and Clinical Interventions Clinic, Ft Lauderdale, Florida, USA.
30
SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
31
Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
32
Department of Health, Social Services and Public Safety, Northern Ireland, Belfast, UK.
33
UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, Porto, Portugal.
34
ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Executive Committee, Bahia, Brazil.
35
Medical Consulting Czarlewski, Levallois, France.
36
Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK.
37
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan.
38
National Institute for Health and Welfare, Helsinki, Finland.
39
CHU Clermont-Ferrand, Unité d'Allergologie de l'Enfant, Pôle Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France.
40
Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands.
41
CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto, Portugal.
42
Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, the Netherlands.
43
Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
44
Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy.
45
Center for Rhinology and Allergology, Wiesbaden, Germany.
46
Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
47
Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, and Institute of Clinical Medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius, Lithuania.
48
Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
49
KYomed INNOV, Montpellier, France.
50
University of Medicine and Pharmacy, Hochiminh City, Vietnam.
51
Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
52
Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, and Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
53
CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy.
54
Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
55
Danish Committee for Health Education, Copenhagen East, Denmark.
56
Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
57
Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
58
University of Oulu, Faculty of Medicine, Oulun Yliopisto, Finland.
59
Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany.
60
Department of Health and Social Services, Welsh Government, Cardiff, UK.
61
Director, Centre For Empowering Patients and Communities, Dublin, Ireland.
62
Asthma UK Centre for Applied Research, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
63
Agency for Social Services and Dependency, Regional Government for Equality, Social Policies and Conciliation of Andalucia, Seville, Spain.
64
Association Asthme et Allergie, Paris, France.
65
KanopyMed, Paris, France.
66
Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
67
Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela.
68
Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK.
69
European Health Futures Forum (EHFF), Dromahair, Ireland.
70
Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA.
71
Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
72
Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
73
National Heart and Lung Institute (NHLI), Imperial College London & Royal Brompton Hospital, Airways Disease Section, London, UK.
74
Asthma UK, London, UK.
75
Nova Southeastern University, Fort Lauderdale, Florida, USA.
76
Vilnius University Faculty of Medicine, Institute of Clinical Medicine & Institute of Health Sciences, Vilnius, Lithuania.
77
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
78
University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
79
International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
80
Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.
81
Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany.
PMID: 31656683 PMCID: PMC6790426 DOI: 10.21037/jtd.2019.09.38
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Conflict of interest statement
Publication type
Select item 31656273
8.
Biosci Trends. 2019 Oct 27. doi: 10.5582/bst.2019.01282. [Epub ahead of print]
Mutation analysis of the SLC26A4 gene in three Chinese families.
Wen C1, Wang S2, Zhao X1, Wang X1, Wang X1, Cheng X1, Huang L1.
Author information
1
Beijing Tongren Hospital, Capital Medical University; Beijing Institute of Otolaryngology; Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education.
2
No. 731 Hospital of China Aerospace Science and Industry Corp.
Abstract
In order to investigate the genetic causes of hearing loss in a Chinese proband (in Family A) with enlarged vestibular aqueduct (EVA) and to investigate the genotype of two Chinese probands with SLC26A4 singe-allelic mutation and normal hearing (in Families B and C, respectively), the three probands and their parents were clinically and genetically evaluated. Twenty exons and flanking splice sites of the SLC26A4 gene were screened for pathogenic mutations via amplification with PCR and bidirectional sequencing. As controls, a group of 400 healthy newborns from the same ethnic background underwent SLC26A4 gene screening using the same method. The three probands all harbored two mutations in the SLC26A4 gene in the form of compound heterozygosity. The genotypes of mutations in Families A, B, and C are c.1211C>A/c.919-2A>G, c.1729G>A/c.919-2A>G, and c.1286C>A/c.919-2A>G, respectively. The missense mutations c.1211C>A (p.T430Q) in exon 10 and c.1729G>A (p.V577I) in exon 16 are both reported for the first time and were absent in 400 healthy newborns. c.1211C>A has Glutamine (Gln) at amino acid 430 instead of Threonine (Thr), and c.1729G>A has Isoleucine (Ile) at amino acid 577 instead of Valine (Val). c.1286C>A, a mutation previously reported in DVD and HGMD, was associated with Mondini deformity, but a proband with the c.1286C>A mutation in this study was normal. This study has demonstrated that the novel missense mutation c.1211C>A in compound heterozygosity with c.919-2A>G in the SLC26A4 gene is likely to be the cause of deafness in Family A. A novel variant, c.1729G>A, was identified and is likely benign. The pathogenicity of the c.1286C>A mutation warrants more in-depth study. These findings will broaden the spectrum of known SLC26A4 mutations in the Chinese population, providing more information for genetic counseling and diagnosis of hearing loss with EVA.

KEYWORDS:
SLC26A4; enlarged vestibular aqueduct; novel mutation

PMID: 31656273 DOI: 10.5582/bst.2019.01282
Similar articles
Select item 31655914
9.
J Mater Sci Mater Med. 2019 Oct 26;30(11):121. doi: 10.1007/s10856-019-6323-x.
Addition of decellularized extracellular matrix of porcine nasal cartilage improves cartilage regenerative capacities of PCL-based scaffolds in vitro.
Wiggenhauser PS1,2, Schwarz S3,4, Koerber L5, Hoffmann TK3, Rotter N3,6.
Author information
1
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany. severin.wiggenhauser@med.uni-muenchen.de.
2
Department of Hand, Plastic and Aesthetic Surgery, Klinikum der LMU Muenchen, Pettenkoferstr. 8a, 80336, Munich, Germany. severin.wiggenhauser@med.uni-muenchen.de.
3
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany.
4
Department of Anatomy, Paracelsus Medical University, Salzburg and Nuremberg, Prof. Ernst Nathan Str. 1, 90419, Nuremberg, Germany.
5
Institute of Bioprocess Engineering, University of Erlangen, Paul-Gordan-Str. 3, 91052, Erlangen, Germany.
6
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Abstract
Composite scaffolds can improve regenerative capacities of scaffolds in various tissue-engineering approaches. In order to generate a 3D printable scaffold that is capable of cartilage regeneration, decellularized extracellular matrix (DECM) of porcine nasal cartilage was added to 3D printed polycaprolactone (PCL) scaffolds. Subsequently, scaffolds (PCL, PCL/DECM and DECM) were seeded with human primary nasoseptal chondrocytes and differentiated with cartilage inductive medium for up to 42 days in vitro. Afterwards samples were analyzed with scanning electron microscopy, histology, biochemical assays and gene expression analysis. In short, results showed cell attachment and proliferation on all scaffolds. There was a trend towards ossification on pure PCL scaffolds, whereas we found evidence for cartilage tissue formation on DECM scaffolds as well as on PCL/DECM scaffolds. Moreover, biochemical analysis indicated an enhanced differentiation on novel PCL/DECM scaffolds. In conclusion, the addition of DECM to 3D printable PCL scaffolds may yield a new composite material for regenerative approaches in cartilage for facial reconstructive surgery. Further research will be necessary to evaluate these findings in vivo.

PMID: 31655914 DOI: 10.1007/s10856-019-6323-x
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Select item 31655881
10.
Eur Arch Otorhinolaryngol. 2019 Oct 26. doi: 10.1007/s00405-019-05704-1. [Epub ahead of print]
The time course of nasal cytokine secretion in patients with aspirin-exacerbated respiratory disease (AERD) undergoing aspirin desensitization: preliminary data.
San Nicoló M1, Högerle C2, Gellrich D2, Eder K2, Pfrogner E2, Gröger M2.
Author information
1
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany. Marion.Sannicolo@med.uni-muenchen.de.
2
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
Abstract
PURPOSE:
Aspirin-exacerbated respiratory disease (AERD) is a severe form of chronic rhinosinusitis with nasal polyps (CRSwNP) accompanied by asthma and an aspirin intolerance. The underlying pathomechanism of AERD still remains unclear, recent data suggest a complex inflammatory imbalance. In the present study, we investigated the cytokine patterns in AERD, CRSwNP and healthy control patients. Furthermore, we describe the change in cytokine level in the course of aspirin desensitization (AD) with continuous intake of aspirin.

METHODS:
The study included a total of 104 participants, 48 healthy controls, 45 patients with nasal polyps and 11 patients with AERD undergoing AD. Nasal secretions were analyzed for IL-1β, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17, THF-α, IFN-γ, eotaxin and ECP using Bio-Plex Human Cytokine Assay and Uni-CAP FEIA. Baseline measurements of cytokine levels were performed in all 104 patients; in patients with AERD, follow-up was performed 1-6 and 6-24 months after the initiation of AD.

RESULTS:
Our preliminary results show a TH2 dominated, eosinophilic milieu in AERD patients, which decreased in the first weeks of AD. However, after 6 months of AD, proinflammatory cytokines show a tendency to increase again. Also, TH1 as well as Treg associated cytokine seem to increase over time.

CONCLUSIONS:
For the first time, the present work shows the cytokine pattern in nasal secretions of AERD patients before and during AD. Further investigation of the complex interaction of inflammatory cytokines during AD might reveal important insights into the disease entity of AERD and open up new horizons for a targeted therapy.

KEYWORDS:
AERD; Aspirin desensitization; Chronic rhinosinusitis; Cytokine; Polyposis

PMID: 31655881 DOI: 10.1007/s00405-019-05704-1
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Select item 31655838
11.
Med Oral Patol Oral Cir Bucal. 2019 Oct 27. pii: 23131. doi: 10.4317/medoral.23131. [Epub ahead of print]
Impact of xerostomia on the quality of life of patients submitted to head and neck radiotherapy.
Nascimento ML1, Farias AB, Carvalho AT, Albuquerque RF, Ribeiro LN, Leão JC, Silva IH.
Author information
1
Hospital of Cancer of Pernambuco Avenida Cruz Cabugá 1597 - Santo Amaro Recife - PE. Brazil, 50040-000 Igorecife@hotmail.com.
Abstract
BACKGROUND:
The aim of the present work was to evaluate the impact of xerostomia on the quality of life of patients who underwent radiotherapy in the head and neck region.

MATERIAL AND METHODS:
This was a cross-sectional, quantitative study. The sample comprised 40 patients whose xerostomia was classified through the xerostomia inventory and the quality of life evaluated through the oral health impact profile questionnaire (OHIP).

RESULTS:
The majority of participants were male (75%), mean age 58.7 years. According to the degree of severity of the xerostomia, the average score among the participants was 36 points, this being considered moderate xerostomia. A significant impact was observed, with the median score 11 points, with the highest scores in the domains related to functional limitation, physical pain and physical disability. The majority of the participants (97.5%) had reduced salivary flow after the end of radiotherapy. There was a significant positive correlation between the degree of xerostomia and reduced quality of life, Pearson correlation 0.5421, (p<0.05).

CONCLUSION:
Based upon the results it is concluded that xerostomia has a negative impact on the quality of life of patients who undergo radiotherapy in the head and neck region.

PMID: 31655838 DOI: 10.4317/medoral.23131
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Select item 31655832
12.
Med Oral Patol Oral Cir Bucal. 2019 Oct 27. pii: 23085. doi: 10.4317/medoral.23085. [Epub ahead of print]
Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review.
Ustrell-Borràs M1, Traboulsi-Garet B, Gay-Escoda C.
Author information
1
Faculty of Medicine and Health Sciences, Oral Surgery and Implantology University of Barcelona, Campus de Bellvitge C/FeixaLlarg, s/n, Pavelló Govern, 2da Planta 08907 L'Hospitalet de Llobregat, Barcelona, Spain basselt.121@gmail.com.
Abstract
BACKGROUND:
Oral and pharynx cancer represent a serious global problem, reaching an incidence of half a million cases annually. The role of tobacco and alcohol have been studied and proven to be one of its risk factors. We also know that mouthwashes contain a variable percentage of alcohol, so there is a reasonable concern about their role in carcinogenesis.

MATERIALS AND METHODS:
To answer the PICOS (Population; Intervention; Comparison; Outcomes; Study) question: "Do patients (Population) who use alcohol-based mouthwashes (Intervention) compared to those who do not use them (Comparison) have higher acetaldehyde levels in saliva or higher risk of oral cancer development? (Outcomes)" Meta-analyses, systematic reviews, randomized and non-randomized clinical trials, case-control studies, and prospective and retrospective cohort studies were included (Study). Two independent authors conducted literature screening through MEDLINE, Scopus and the Cochrane Library, and they also conducted article and data extraction to undertake quality analyses. The main outcome measures were salivary acetaldehyde levels or the risk of oral cancer development. The most relevant data was extracted and the risk of bias from the studies included was also evaluated.

RESULTS:
497 references were obtained in the initial search. After eliminating the duplicates and evaluating titles and abstracts, a total of 26 articles were chosen to analyze the full text. 18 of these articles were excluded and finally 8 studies were included in the qualitative analysis: two meta-analyses, a clinical trial, three case-control studies and two cohort studies.

CONCLUSIONS:
It cannot be guaranteed that the use of mouthwash represents an independent risk factor for the development of head and neck cancer. However, the risk does increase when it occurs in association with other carcinogenic risk factors.

PMID: 31655832 DOI: 10.4317/medoral.23085
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Select item 31655398
13.
Phys Med. 2019 Oct 23;67:34-39. doi: 10.1016/j.ejmp.2019.10.023. [Epub ahead of print]
Medical physics aspects of Intensity-Modulated Radiotherapy practice in Malaysia.
Hizam NDA1, Ung NM2, Jong WL1, Zin HM3, Rahman ATA4, Loh JPY1, Ng KH5.
Author information
1
Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
2
Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: nm_ung@um.edu.my.
3
Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.
4
Institute of Science, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia; Faculty of Applied Sciences, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia.
5
Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia.
Abstract
PURPOSE:
Intensity Modulated Radiotherapy (IMRT) has changed the practice of radiotherapy since its implementation in the 1990s. The purpose of this study is to review current practice of IMRT in Malaysia.

METHODS:
A survey on medical physics aspects of IMRT is conducted on radiotherapy departments across Malaysia to assess the usage, experience and QA in IMRT, which is done for the first time in this country. A set of questionnaires was designed and sent to the physicist in charge for their responses. The questionnaire consisted of four sections; (i) Experience and qualification of medical physicists, (ii) CT simulation techniques (iii) Treatment planning and treatment unit, (iv) IMRT process, delivery and QA procedure.

RESULTS:
A total of 26 responses were collected, representing 26 departments out of 33 radiotherapy departments in operation across Malaysia (79% response rate). Results showed that the medical physics aspects of IMRT practice in Malaysia are homogenous, with some variations in certain areas of practices. Thirteen centres (52%) performed measurement-based QA using 2D array detector and analysed using gamma index criteria of 3%, 3 mm with variation confidence range. In relation to the IMRT delivery, 44% of Malaysia's physicist takes more than 8 h to plan a head and neck case compared to the UK study possibly due to the lack of professional training.

CONCLUSIONS:
This survey provides a picture of medical physics aspects of IMRT in Malaysia where the results/data can be used by radiotherapy departments to benchmark their local policies and practice.

Copyright © 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:
IMRT QA; Intensity Modulated Radiotherapy; National Survey; Planning time

PMID: 31655398 DOI: 10.1016/j.ejmp.2019.10.023
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Select item 31655347
14.
Hear Res. 2019 Oct 15;384:107813. doi: 10.1016/j.heares.2019.107813. [Epub ahead of print]
Recovery from tympanic membrane perforation: Effects on membrane thickness, auditory thresholds, and middle ear transmission.
Cai L1, Stomackin G2, Perez NM3, Lin X2, Jung TT4, Dong W5.
Author information
1
VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; Department of Radiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, China.
2
VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA.
3
VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; School of Computer Science and Engineering, California State University San Bernardino, San Bernardino, CA, 92407, USA.
4
VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, 92350, USA.
5
VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, 92350, USA. Electronic address: Wei.dong@va.gov.
Abstract
Sounds delivered to the ear move the tympanic membrane (TM), which drives the middle-ear (ME) ossicles and transfers the acoustic energy to the cochlea. Perforations of the TM result in hearing loss because of less efficient sound conduction through the ME. The patterns of TM motions, and thus ME sound transmission, vary with frequency and depend on many factors, including the TM thickness. In this study, we measured TM thickness, auditory brainstem responses (ABR), and ME transmission immediately following a controlled pars tensa perforation and after 4 weeks of spontaneous recovery in a gerbil model. It is found that after recovery, the hearing thresholds showed a sloping pattern across frequencies: almost back to normal levels at frequencies between 2 and 8 kHz, sloping loss in the low (<2 kHz) and mid-frequency (8-30 kHz) range, and little restoration at frequencies above 30 kHz. This pattern was confirmed by the measured ME pressure gains. The thickness of the healed TM did not return to normal but was 2-3 times thicker over a significant portion of the membrane. The increased thickness was not limited to the perforated area but expanded into intact regions adjacent to the perforation, which led to an increased thickness in general. Combined, these results suggest that TM thickness is an important factor in determining its vibration patterns and efficiency to transfer sounds to the ossicles and thus influencing ME sound transmission, especially for high-frequency sounds. The results provided both structural and functional observations to explain the conductive hearing loss seen in patients with abnormal TMs, e.g., caused by otitis media, spontaneously healed post-perforation, or repaired via tympanoplasty in the clinic.

Published by Elsevier B.V.

KEYWORDS:
Healed tympanic-membrane post-perforation; Hearing; Middle-ear pressure gain; Middle-ear sound transmission; Optical coherence tomography; Tympanic-membrane thickness

PMID: 31655347 DOI: 10.1016/j.heares.2019.107813
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Select item 31655324
15.
Sleep Med. 2019 Jun 14;64:37-42. doi: 10.1016/j.sleep.2019.06.005. [Epub ahead of print]
Nocturnal dialysis improves sleep apnea more than daytime dialysis: a meta-analysis of crossover studies.
Lavoie MR1, Patel JA2, Camacho M3.
Author information
1
Madigan Army Medical Center, Department of Medicine, 9040A Jackson Ave, Joint Base Lewis-McChord, WA, 98431, USA. Electronic address: mattrlavoie@gmail.com.
2
Madigan Army Medical Center, Department of Otolaryngology, 9040A Jackson Ave, Joint Base Lewis-McChord, WA, 98431, USA.
3
Tripler Army Medical Center, Division of Otolaryngology-Head and Neck Surgery, 1 Jarrett White Rd, Tripler AMC, HI, 96859, USA. Electronic address: drcamachoent@yahoo.com.
Abstract
PURPOSE:
To systematically review the literature for articles evaluating differences in polysomnography (PSG) data when patients are on primarily daytime hemodialysis (conventional hemodialysis or continuous ambulatory peritoneal dialysis) versus nocturnal hemodialysis (nocturnal hemodialysis or nocturnal peritoneal dialysis). Then to perform a meta-analysis on the available PSG data, specifically evaluating differences in apnea hypopnea index (AHI) and mean saturation of oxygen (SpO2) between these two groups.

METHODS:
Two authors systematically searched MEDLINE/Pubmed, Scopus, EMBASE, CINAHL, and Cochrane. Searches were performed through December 6, 2018.

RESULTS:
A total of four adult crossover studies (91 patients, age 50.4 ± 12.4, BMI 25.1 ± 5.3) reported PSG data. The daytime hemodialysis (DHD) and nocturnal hemodialysis (NHD) AHI decreased from 24.6 ± 18.2 to 12.6 ± 11.8 (events/hour) with a mean difference of -11.9 [95% CI -13.47, -10.37], Z score of 15.07 (P < 0.00001). The standardized mean difference was -1.35 [95% CI -2.70, 0.01]. Two studies reported mean SpO2 changes during PSG. The DHD and NHD SpO2 increased from 92.7 ± 2.4 to 94.7 ± 2.2 with a mean difference of 2.26 [95% CI -0.18, 4.71], Z score 1.82 (P = 0.07).

CONCLUSION:
In the current literature, nocturnal hemodialysis improves AHI more than daytime hemodialysis. A trend towards improvement in mean SpO2 with nocturnal dialysis was noted, but did not reach statistical significance. Consideration can be given for transitioning patients who have end stage renal disease and sleep apnea from daytime to nocturnal hemodialysis as an adjunct to other treatment modalities.

Published by Elsevier B.V.

KEYWORDS:
Apnea hypopnea index; Fluid shift; Nocturnal hemodialysis; Sleep apnea

PMID: 31655324 DOI: 10.1016/j.sleep.2019.06.005
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Select item 31654937
16.
Oral Oncol. 2019 Oct 22;99:104438. doi: 10.1016/j.oraloncology.2019.09.030. [Epub ahead of print]
Prognostic value of radiologic extranodal extension and its potential role in future N classification for nasopharyngeal carcinoma.
Lu T1, Hu Y1, Xiao Y2, Guo Q3, Huang SH4, O'Sullivan B4, Fang Y2, Zong J5, Chen Y2, Lin S5, Chen Y6, Pan J7.
Author information
1
Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fuzhou, China.
2
Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China.
3
Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China; Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.
4
Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
5
Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China.
6
Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China. Electronic address: yunbinchen@126.com.
7
Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Medical University Cancer Hospital, Fuzhou, China. Electronic address: panjianji1956@fjmu.edu.cn.
Abstract
PURPOSE:
We evaluated the prognostic value of various grades of radiologic extranodal extension (rENE) and their potential roles in N-classification refinement for nasopharyngeal carcinoma (NPC).

METHODS AND MATERIALS:
All NPC patients treated with IMRT in our institution between 2005 and 2011 were included. Pre-treatment MR of cN+ cases were reviewed and rENE was recorded asG0: lymph nodes (LNs) without rENE; G1: tumor infiltrating beyond individual nodal capsule(s) into the surrounding fat plane; G2: coalescent nodal mass with unequivocal evidence of rENE; G3: tumor infiltrating beyond nodal capsule into adjacent structures. Multivariable analysis (MVA) assessed prognostic value of rENE for distant metastasis (DM) and death adjusted for age, gender, LDH, T-classification, N-classification, and chemotherapy cycles.

RESULTS:
A total of 1390 of 1616 (86%) NPC were cN+, and rENE was detected in 826/1390 (59%) patients: 256 (18.4%) G1-rENE, 487 (35%) G2-rENE, and 83 (6%) G3-rENE. MVA confirmed that G2-/G3-rENE had increased risk of DM (HR: 2.05/3.18, both p < 0.001) and death (HR: 1.62/2.39, p = 0.002/p < 0.001), while G1-rENE was non-prognostic (DM: p = 0.172; death: p = 0.320). We propose a refined N: New-N1: N1/N2 without G2-/G3-rENE; New-N2: N1_G2-rENE; New-N3: N2_G2-rENE, N1/N2_G3-rENE, or N3. The New-N classification had a lower AIC and higher c-index for DM (AIC: 3809.6 vs 3830.9; c-index: 0.700 vs. 0.677) and death (AIC: 3693.8 vs. 3705.9; c-index: 0.735 vs. 0.725) versus TNM-8 N.

CONCLUSIONS:
G2- and G3-rENE are independently prognostic for DM and death in NPC. Compared to the TNM8 N-classification, a refined N-classification incorporating G2- and G3-rENE improves prognostication of DM and mortality risk.

Copyright © 2019 Elsevier Ltd. All rights reserved.

KEYWORDS:
Extranodal extension; Head and neck cancers; N classification; Nasopharyngeal carcinoma; Prognostication

PMID: 31654937 DOI: 10.1016/j.oraloncology.2019.09.030
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Select item 31654690
17.
Hum Pathol. 2019 Oct 22. pii: S0046-8177(19)30166-2. doi: 10.1016/j.humpath.2019.09.001. [Epub ahead of print]
The evolving landscape of HPV-related Neoplasia in the head and neck.
Devins KM1, Tetzlaff MT2, Baloch Z3, LiVolsi VA3.
Author information
1
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104. Electronic address: kyle.devins@uphs.upenn.edu.
2
Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030.
3
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.
Abstract
Human papilloma virus (HPV) has emerged as the key etiologic driver in the majority of cancers at head and neck mucosal sites. First described in the uterine cervix and subsequently in oropharyngeal squamous cell carcinomas, the morphologic and clinical spectrum of HPV-related neoplasia has continued to expand and now includes a newly described entity in the sinonasal tract. A recent study has also suggested a role of HPV in some ocular adnexal sebaceous carcinomas. Herein, we review and concisely summarize the spectrum of HPV-driven neoplasia in the head and neck, with a focus on variant morphologies and newly-described entities including key differential diagnoses and clinical implications.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
Human Papilloma Virus; Multiphenotypic Sinonasal Carcinoma; Oropharyngeal Carcinoma; Oropharynx; Squamous Cell Carcinoma

PMID: 31654690 DOI: 10.1016/j.humpath.2019.09.001
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Select item 31654680
18.
Toxicon. 2019 Oct 22. pii: S0041-0101(19)30722-6. doi: 10.1016/j.toxicon.2019.10.239. [Epub ahead of print]
BOTULINUM TOXIN INJECTIONS TO CRANIAL SUTURES FOR CHRONIC MIGRAINE Rewinding the Technique Using Ultrasound Imaging.
Kara M1, Gürçay E2, Aydın G3, Kaymak B1, Sekizkardeş M4, Akıncı A1, Uludüz D5, Özçakar L1.
Author information
1
Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.
2
Gaziler Training and Research Hospital, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.
3
Yıldırım Beyazıt University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.
4
İstanbul Physical and Rehabilitation Medicine Training and Research Hospital, Department of Physical and Rehabilitation Medicine, İstanbul, Turkey. Electronic address: merve.sekizkardes@gmail.com.
5
İstanbul University Cerrahpaşa Medical School, Department of Neurology, İstanbul, Turkey.
Abstract
The treatment of chronic migraine headache is quite challenging and new alternatives are still being explored for its management. Onabotulinum toxin A (BoNT-A) applied into extracranial muscles has been shown to inhibit the release of acetylcholine and local nociceptive peptides at the sensory nerve endings. As the highest concentration of extracranial pain fibers are located at/nearby the sutures, extracranial applications of BoTN-A are suggested to be performed to sutures rather than into the head and neck muscles in the treatment of chronic migraine. Moreover, in an animal study, BoTN-A is found to be more effective for decreasing the chemosensitivity of meningeal nociceptors when the total dose is injected along the sutures in comparison to being divided into sutures and cranial muscles. Of note, since BoNT-A injections performed with the blind/nontargeted technique have lower effectivity and several complications (muscle weakness, ptosis, facial paresis, etc.), the use of ultrasound guidance for targeting the cranial sutures is definitely expected to provide technical ease, better pain relief and toxin tolerance in chronic migraine.

Copyright © 2019. Published by Elsevier Ltd.

KEYWORDS:
Headache; intervention; pain; ultrasonography

PMID: 31654680 DOI: 10.1016/j.toxicon.2019.10.239
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Select item 31654540
19.
Psychooncology. 2019 Oct 26. doi: 10.1002/pon.5257. [Epub ahead of print]
Content comparison of unmet needs self-report measures used in patients with head and neck cancer: a systematic review.
Shunmuga Sundaram C1,2, Rutherford C3,4, Butow PN1,2, Sundaresan P5,6, Dhillon HM1,2.
Author information
1
Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, NSW, Australia.
2
Psycho-Oncology Cooperative Research Group, University of Sydney.
3
Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney.
4
Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, Australia.
5
Radiation Oncology Network, Western Sydney Local Health District, Sydney, Australia.
6
Sydney Medical School, University of Sydney, Sydney, Australia.
Abstract
OBJECTIVE:
Morbidity from head and neck cancers (HNCs) and their treatment is significant, given their proximity to anatomical sites impacting facial appearance and function. Assessing the needs of HNC patients throughout their cancer journey is critical to informing quality care and improving quality of life. We aimed to identify available unmet needs measures in the HNC setting and appraise their content and psychometric properties.

METHODS:
We conducted a systematic search of five electronic databases (July 2007-July 2019) to identify studies of unmet needs in patients with HNC. In addition, three web-based patient-reported outcome measures (PROMs) databases were searched for unmet needs measures. Citations were screened for eligibility and identified measures reviewed for content coverage and psychometric properties. From identified measures and literature, a conceptual framework with 12 clinically relevant aspects of unmet needs was developed and used to assess the conceptual coverage of available unmet needs measures.

RESULTS:
Literature search identified 273 records of which 28 studies assessing unmet needs in HNC cancer met eligibility criteria. Seven unmet needs measures were identified from retrieved studies and seven additional measures from PROM databases. Thus 14 measures in total were reviewed. Content mapping revealed that three measures demonstrated excellent content validity (> 80% conceptual coverage): Patient Concerns Inventory (PCI), Needs Assessment for Advanced Cancer Patients (NA-ACP), and James Supportive Care Screening (JSCS).

CONCLUSION:
We recommend PCI be used to measure unmet needs in the HNC setting considering the importance of content validity over quantitative psychometric properties.

This article is protected by copyright. All rights reserved.

KEYWORDS:
cancer; head and neck cancer; oncology; psychological distress; reliability; self-report measures; systematic review; unmet needs; validity

PMID: 31654540 DOI: 10.1002/pon.5257
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Select item 31654522
20.
Med Sci Monit. 2019 Oct 26;25:8025-8033. doi: 10.12659/MSM.911697.
Xanthoxyletin Inhibits Proliferation of Human Oral Squamous Carcinoma Cells and Induces Apoptosis, Autophagy, and Cell Cycle Arrest by Modulation of the MEK/ERK Signaling Pathway.
Wen Q1, Luo K2, Huang H1, Liao W3, Yang H1.
Author information
1
Department of Head and Neck Oncology Surgery, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
2
The Research Institute, Cancer Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
3
Department of Radiation Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
Abstract
BACKGROUND This study aimed to investigate the effects of xanthoxyletin, a plant-derived coumarin, on human oral squamous cancer cells in vitro and in mouse xenografts in vivo. MATERIAL AND METHODS The study included SCC-1 human oral cancer cells and EBTr normal embryonic bovine tracheal epithelial cells, which were treated with 0 µM, 5 µM, 10 µM, and 20 µM of xanthoxyletin for 24 hours. The MTT assay assessed cell viability, and autophagy was detected by electron microscopy. Cell apoptosis was investigated using 4',6-diamidino-2-phenylindole (DAPI), annexin V, and propidium iodide (PI) fluorescence flow cytometry, which was also used to investigate the cell cycle. Protein expression was measured by Western blot. Mouse xenografts were used for the in vivo evaluation of the effects of xanthoxyletin. RESULTS Xanthoxyletin significantly inhibited the proliferation of oral cancer cells (IC₅₀, 10-30 µM) with lower cytotoxicity for normal cells. Xanthoxyletin treatment was associated with G2/M arrest of the cell cycle and with increased apoptosis and autophagy of SCC-1 cells. Apoptosis and autophagy induced by xanthoxyletin were also associated with changes in expression of the apoptosis-associated proteins, Bax and Bcl-2, and the autophagy-associated proteins, LC3I, LC3II, Beclin 1, p62, and VSp34. Xanthoxyletin inhibited the expression of components of the signaling cascade of the MEK/ERK pathway in the SCC-1 oral cancer cells. The in vivo effects of xanthoxyletin showed inhibition of growth of mouse xenografts. CONCLUSIONS Xanthoxyletin inhibited the proliferation of human oral squamous carcinoma cells and induced apoptosis, autophagy, and cell cycle arrest by modulation of the MEK/ERK signaling pathway.

PMID: 31654522 DOI: 10.12659/MSM.911697