J Otolaryngol Head Neck Surg. 2019 Oct 24;48(1):54. doi: 10.1186/s40463-019-0380-5.
Impact of marginalization on tobacco use in individuals diagnosed with head and neck Cancer.
Scott GM1, Best C2, Fung K3, Gupta M4, Sommer DD4, Szeto C5, Micomonaco DC5.
Author information
1
Department of Rural and Northern Health, Laurentian University, Sudbury, Canada. gracemargaretscott@gmail.com.
2
Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada.
3
Department of Otolaryngology-Head & Neck Surgery, Western University, London, Canada.
4
Otolaryngology-Head & Neck Surgery Division, McMaster University-Dept. of Surgery, Hamilton, Canada.
5
Department of Otolaryngology-Head & Neck Surgery, Northern Ontario School of Medicine, Sudbury, Canada.
Abstract
BACKGROUND:
Considerable evidence now indicates that individuals living in underprivileged neighbourhoods have higher rates of mortality and morbidity independent of individual-level characteristics. This study explored the impact of geographical marginalization on smoking cessation in a population of individuals with a diagnosis of head and neck cancer. The aims of this study were twofold: (1) assess the prevalence of smoking cessation in those with a previous diagnosis of head and neck cancer, (2) analyze the determinants of smoking alongside area-based measures of socioeconomic status.

METHODS:
This was a cross-sectional study. We administered a self-reported nicotine dependence package to participants between the ages of 20-90 with a previous mucosal head and neck cancer diagnosis and with a history of tobacco use. Using the Canadian Marginalization (CAN-Marg) Index tool based on 2006 Canada Census data we compared the degree of marginalization to the smoking status. For those individuals who were currently smoking, nicotine dependence and readiness to quit were assessed. A summative score of marginalization was compared to smoking status of individuals.

RESULTS:
The results from this study indicate that the summative level of marginalization developed from the combined factors of residential instability, material deprivation, ethnic concentration and dependency may be important factors in smoking cessation.

CONCLUSIONS:
This analysis of determinants of smoking alongside area-based measures of socioeconomic status may implicate the need for targeted population-based smoking cessation interventions.

KEYWORDS:
Addiction; Cancer; Smoking; Tobacco

PMID: 31651374 DOI: 10.1186/s40463-019-0380-5
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Select item 31651361
62.
Mil Med Res. 2019 Oct 25;6(1):32. doi: 10.1186/s40779-019-0224-7.
Boron neutron capture therapy: moving towards targeted therapy for locally recurrent head and neck squamous cell carcinoma.
Sun Y1.
Author information
1
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China. sunying@sysucc.org.cn.
Abstract
Locally recurrent head and neck squamous cell carcinoma (HNSCC) is often unresectable, and a repeat course of radiotherapy is associated with incremental toxicities. Boron neutron capture therapy (BNCT) is a novel targeted radiotherapy modality that can achieve a high dose gradient between cancerous and adjacent normal tissues. However, the relationships among the dose resulting from BNCT, tumor response to BNCT, and survival are not completely understood. Recently, a study published in Radiotherapy and Oncology investigated the efficacy of BNCT in the treatment of patients with locally recurrent HNSCC and the factors associated with favorable treatment response and survival. In this article, the findings, strengths and limitations of this study are discussed in depth, and the significance of the study and motivations for future research are highlighted.

KEYWORDS:
Boron neutron capture therapy; Locally recurrent head and neck squamous cell carcinoma; Treatment efficacy

PMID: 31651361 DOI: 10.1186/s40779-019-0224-7
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Select item 31651348
63.
Diagn Pathol. 2019 Oct 24;14(1):118. doi: 10.1186/s13000-019-0887-0.
Overexpression of carboxypeptidase X M14 family member 2 predicts an unfavorable prognosis and promotes proliferation and migration of osteosarcoma.
Zhao X1, Li R2, Wang Q3, Wu M4, Wang Y5.
Author information
1
Orthopedic Department, The Second Hospital of Jilin University, No. 128 Ziqiang Road, Changchun, 130041, China.
2
Department of Joint Surgery and Sports Medicine, The Second Hospital of Jilin University, No. 128 Ziqiang Road, Changchun, 130041, China.
3
Otolaryngology Head and Neck Surgery, First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China.
4
Orthopedic Department, The Second Hospital of Jilin University, No. 128 Ziqiang Road, Changchun, 130041, China. wuminfei100@163.com.
5
Orthopedic Department, The Second Hospital of Jilin University, No. 128 Ziqiang Road, Changchun, 130041, China. ybwjlu@126.com.
Abstract
BACKGROUND:
Carboxypeptidase X, M14 family member 2 (CPXM2), has been associated with several human developmental disorders. However, whether CPXM2 is involved in oncogenesis or tumor progression remains unclear. Currently, the clinical relevance and function of CPXM2 in human osteosarcoma were investigated.

MATERIALS AND METHODS:
The expression of CPXM2 in osteosarcoma cell lines and tissues were explored by immunohistochemistry and western blotting assays. A eukaryotic expression plasmid was transfected into fetal osteoblast cells to overexpress CPXM2 and the endogenous CPXM2 in osteosarcoma cells was silenced through an RNA interference (RNAi) method transfection. These transfections were validated via western blotting, and the expression levels of several key molecules involved in the epithelial mesenchymal transition was also determined via western blotting. The expression levels of CPXM2 in a fetal osteoblast cell line with CPXM2 overexpressing and an osteosarcoma CPXM2-knockout cell line was confirmed via reverse transcription-quantitative polymerase chain reaction (RT-qPCR), western blotting and immunofluorescence. The malignant phenotype of osteosarcoma cells was indicated by the cholecystokinin octapeptide, colony formation assay, scratch wound healing assay, and Transwell® migration assay.

RESULTS:
We found that CPXM2 was overexpressed in osteosarcoma and that the overexpression was associated with an unfavorable prognosis and tumor node metastasis staging. The knockdown of CPXM2 in cultured osteosarcoma cells significantly impeded cell proliferation and migration. In addition, the upregulation of CPXM2 in fetal osteoblast cells significantly promoted cell proliferation and migration. Besides, western blotting results revealed that several key molecules involved in the epithelial mesenchymal transition (EMT) were regulated by CPXM2.

CONCLUSION:
Taken together, these results imply an active role for CPXM2 in promoting tumor aggressiveness via epithelial to mesenchymal transition (EMT) modulation in osteosarcoma.

KEYWORDS:
Carboxypeptidase X, M14 family member 2; Epithelial mesenchymal transition; Metastasis; Osteosarcoma

PMID: 31651348 DOI: 10.1186/s13000-019-0887-0
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Select item 31651195
64.
Future Oncol. 2019 Oct 25. doi: 10.2217/fon-2019-0365. [Epub ahead of print]
Relationship of single nucleotide polymorphisms and haplotype interaction of mitochondrial unfolded protein response pathway genes with head and neck cancer.
Ahmed MW1, Mahjabeen I1, Gul S1, Khursheed A1, Mehmood A1, Kayani MA1.
Author information
1
Cancer Genetics & Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai Kalan, Islamabad Pakistan.
Abstract
Aim: In this study, we evaluated the effect of selected polymorphisms of mitochondrial unfolded protein response (UPRmt) pathway in 500 head and neck cancer (HNC) patients and 500 healthy controls from Pakistan. Materials & methods: The experiments were conducted using tetra-ARMS PCR followed by DNA sequencing. Results: Multivariate analysis showed that AA genotype of rs3782116 showed fivefold, GG genotype of rs6598072 approximately twofold and CC genotype of rs4946936 and TT genotype of rs12212067 showed twofold increased risk of HNC. Furthermore, haplotype analysis showed that certain haplotypes of UPRmt pathway single nucleotide polymorphisms have significant association with increased HNC risk. Conclusion: These results show that genetic aberrations in UPRmt pathway genes have association with increased HNC risk and can be an indicator of advance clinical outcome especially invasion and metastasis.

KEYWORDS:
HNC; UPRmt mechanism; clinical outcome; haplotype analysis; metastasis

PMID: 31651195 DOI: 10.2217/fon-2019-0365
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Select item 31651072
65.
Head Neck. 2019 Oct 25. doi: 10.1002/hed.25991. [Epub ahead of print]
Degree of technical difficulty of thyroidectomy for autoimmune thyroid disease.
Saadi R1, Brandt A2, Kim Y3, Cottrill E4, Saunders B5, Schaefer E6, Goldenberg D1.
Author information
1
Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
2
College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania.
3
Department of Dermatology, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
4
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
5
Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
6
Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
Abstract
BACKGROUND:
Our goal was to elucidate the differences in degree of technical difficulty of thyroidectomy in patients with autoimmune thyroid diseases.

METHODS:
Charts of adult patients who had undergone thyroidectomy were reviewed. Patients with Hashimoto's Thyroiditis (HT) or Graves' Disease (GD) were individually compared to a control group of patients with early stage malignancy or goiter.

RESULTS:
The HT (n = 65) group was significantly more likely to have friable (P = .001) and fibrotic (P < .001) thyroids, longer operative times (P = .02), and a 22-modifier (P = .005). The GD (n = 169) group was significantly more likely to have friable (P < .001), vascular (P < .001), fibrotic (P = .038), and heavy (P = .002) thyroids, longer operative times (P = .03), increased length of stay (P = .01) and a 22-modifier (P = .01).

CONCLUSION:
Our experience at an institution with a high-volume thyroid practice demonstrates that patients with autoimmune thyroid disease have consistent qualitative changes of the thyroid and significantly increased operative times and surgical difficulty.

© 2019 Wiley Periodicals, Inc.

KEYWORDS:
Graves' disease; Hashimoto's thyroiditis; difficulty; outcomes; thyroidectomy

PMID: 31651072 DOI: 10.1002/hed.25991
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Select item 31650962
66.
Diagn Interv Radiol. 2019 Oct 25. doi: 10.5152/dir.2019.18542. [Epub ahead of print]
Percutaneous sclerotherapy with gelified ethanol of low-flow vascular malformations of the head and neck region: preliminary results.
Ierardi AM1, Colletti G2, Biondetti P1, Dessy M2, Carrafiello G1.
Author information
1
Department of Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy.
2
Department of Maxillofacial Surgery, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy.
Abstract
PURPOSE:
Evaluation of safety and efficacy of percutaneous sclerotherapy using gelified ethanol in patients with low-flow malformations.

METHODS:
A retrospective study was performed, analyzing treatment and outcome data of 6 patients that presented with 7 low-flow malformations (LF-Ms) (3 lymphatic and 3 venous). Median diameter of LF-Ms was 6 cm (iqr 4.5-8.5 cm). Data regarding pain, functional and/or cosmetic issues were assessed. Diagnosis was performed clinically and confirmed Doppler Ultrasound, while extension of disease was assessed by Magnetic Resonance Imaging (MRI). Percutaneous puncture was performed with 23G needle directly or with ultrasound guidance. All the LF-Ms were treated with gelified ethanol injection. The median volume injected per treatment session resulted 4.4 mL.

RESULTS:
Technical and clinical success were obtained in all cases. No recurrences were registered during a median follow up of 17 months (iqr 12-19 months). Among the 6 patients, 83% of the patients had complete relief (5/6) and the other showed improvement of symptoms. The median VAS score was 7 (iqr 6-7.5) before and 0 (iqr 0-0) after treatment. All patients had functional and aesthetic improvement (100%). Four patients (66.7%) had a very good acceptance and two patients (33.3%) a good acceptance. No major complications neither systemic side effects were observed.

CONCLUSION:
Gelified ethanol may be considered easy to handle, well-tolerated, safe and effective in the short-term follow up. Longer follow up efficacy is mandatory for further conclusions.

PMID: 31650962 DOI: 10.5152/dir.2019.18542
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Select item 31650657
67.
Head Neck. 2019 Oct 24. doi: 10.1002/hed.25986. [Epub ahead of print]
The relations of dosimetric parameters with long-term outcomes and late toxicities in advanced T-stage nasopharyngeal carcinoma with IMRT.
Gou X1,2, Duan B1, Shi H1, Qin L1, Xiao J1, Chen N1.
Author information
1
Department of Head and Neck Oncology and Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
2
Department of Head and Neck Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Abstract
BACKGROUND:
Balancing the dose requirements between targets and normal tissue is a challenge in radiation of nasopharyngeal carcinoma (NPC). The purpose of this study is to evaluate the dosimetric parameters and clinical outcomes in NPC.

METHODS:
We presented a retrospective review of patients with T3-4 NPC treated by intensity-modulated radiation therapy (IMRT). Patient characteristics, dosimetric parameters, and the follow-up data for survival and late toxicities were analyzed.

RESULTS:
The 5-year overall survival, local relapse-free survival, and distant metastasis-free survival were 83.0%, 90.1%, and 82.4%, respectively. Multivariate analysis revealed that the volume of involved lymph node was an independent prognostic factor. The volume of primary tumor and the maximal dose were significant factors affecting temporal lobe injury.

CONCLUSIONS:
IMRT provided satisfactory local control for advanced T-stage NPC, with acceptable late toxicities. The dose constraint criteria of selected critical structures can be appropriately loosen.

© 2019 The Authors. Head & Neck published by Wiley Periodicals, Inc.

KEYWORDS:
clinical outcomes; dosimetry; intensity-modulated radiation therapy; nasopharyngeal carcinoma; organ at risk

PMID: 31650657 DOI: 10.1002/hed.25986
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Select item 31650620
68.
Scand J Immunol. 2019 Oct 25:e12817. doi: 10.1111/sji.12817. [Epub ahead of print]
Is it worthy to take full-course immunotherapy for allergic rhinitis? About efficacy biomarker of allergen immunotherapy.
Wang W1, Yin J2.
Author information
1
Department of otolaryngology, head and neck surgery, Peking University Ninth School of Clinical Medicine, Beijing, China.
2
Department of otolaryngology, head and neck surgery, Peking University Ninth School of Clinical Medicine, Capital Medical University affiliated Beijing Shijitan Hospital, Beijing, China.
Abstract
Nowadays, people pay more attention to biomarkers that can predict clinical efficacy of immunotherapy for allergic rhinitis. As the only recognized aetiological treatment, the efficacy of allergen immunotherapy (AIT) has been proved by many studies. However, treatment success depends on compliance and persistence greatly, which can be impaired by the lengthy duration of AIT and socioeconomic status of patients. Besides, ineffectiveness is another factor that accounts for non-adherence. If the clinical efficacy can be predicted in the early stage of immunotherapy, it can help patients choose appropriate treatment plans, increase patient compliance and optimize the allocation of medical resources. This paper mainly focuses on five candidate biomarkers, the sIgE/tIgE ratio before treatment, serum inhibitory activity for IgE, decreased basophil activation, upregulation of Tregs and tolerogenic DCs, reviews the time when potential biomarkers can predict or monitor the efficacy of AIT, discusses the reason why these indicators could serve as efficacy biomarkers and interactions among potential biomarkers.

© 2019 The Scandinavian Foundation for Immunology.

KEYWORDS:
allergy < processes; antibodies/immunoglobulins < molecules; dendritic cells < cells; human < Subject; hypersensitivity/allergy; hypersensitivity/allergy < diseases; mast cells/basophils < cells

PMID: 31650620 DOI: 10.1111/sji.12817
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Select item 31650567
69.
J Surg Oncol. 2019 Oct 25. doi: 10.1002/jso.25732. [Epub ahead of print]
Surgical management of the neck in patients with metastatic melanoma in parotid lymph nodes.
Den Hondt M1,2, Starr MW3,4, Millett MC5, Smyth J6, Scolyer RA3,6,7, Shannon KF1,3, Thompson JF3,4,6, Ch'ng S1,2,3,4.
Author information
1
Department of Head and Neck Surgery, Chris O'Brien Lifehouse Cancer Centre, Sydney, Australia.
2
The Institute of Academic Surgery at RPA, The University of Sydney, Sydney, Australia.
3
Melanoma Institute Australia, The University of Sydney, Sydney, Australia.
4
Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
5
Royal North Shore Hospital, Sydney, Australia.
6
Sydney Medical School, The University of Sydney, Sydney, Australia.
7
Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
Abstract
BACKGROUND:
The role and extent of neck dissection in patients with parotid metastatic cutaneous head and neck melanoma remain unclear. The aims of this study were to determine the incidence and patterns of cervical node involvement in patients with parotid metastatic melanoma, and to determine if a limited lymphadenectomy of the clinically negative neck is appropriate.

METHODS:
Patients who underwent parotidectomy and neck dissection for clinically apparent parotid metastatic melanoma, irrespective of neck status, were identified from two prospectively maintained databases.

RESULTS:
A total of 276 patients fulfilled the study criteria. Median follow-up was 23 months. A total of 185 necks were clinically negative, 82 were clinically positive. A total of 36 elective neck-dissection specimens harbored occult metastases; these were found in levels I (16.7%), II (58.3%), III (36.1%), IV (13.9%), and V (30.6%). Regional recurrence occurred in 32 patients with a clinically negative neck, the majority being in-transit metastases (n = 15). Only one case of recurrence could have potentially been avoided by a comprehensive lymphadenectomy.

CONCLUSIONS:
In patients with clinically apparent parotid melanoma metastases, elective comprehensive neck dissection reduces failure rates in cervical nodes, and provides more accurate staging and prognostic information. However, our findings support the emerging trend for more limited elective neck dissection. Levels I and IV can probably be safely omitted.

© 2019 Wiley Periodicals, Inc.

KEYWORDS:
melanoma; neck dissection; neoplasm metastasis; parotid gland

PMID: 31650567 DOI: 10.1002/jso.25732
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Select item 31650293
70.
Support Care Cancer. 2019 Oct 25. doi: 10.1007/s00520-019-05084-6. [Epub ahead of print]
Oral microbial influences on oral mucositis during radiotherapy treatment of head and neck cancer.
Vesty A1, Gear K2, Biswas K3, Mackenzie BW3, Taylor MW4,5, Douglas RG3.
Author information
1
Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand. aves920@aucklanduni.ac.nz.
2
Department of Otorhinolaryngology, Auckland City Hospital, Auckland, 1023, New Zealand.
3
Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand.
4
School of Biological Sciences, The University of Auckland, Auckland, 1010, New Zealand.
5
Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, 1010, New Zealand.
Abstract
PURPOSE:
Oral mucositis (OM) remains a significant complication developed by many patients undergoing radiotherapy (RT) to the head and neck region. Emerging data suggest oral microbes may contribute to the onset and severity of this acute side effect.

METHODS:
In this study, saliva and oral swabs from head and neck cancer patients undergoing RT were collected. We employed molecular microbiological techniques to study the bacterial communities present in saliva, and both the bacterial and fungal communities present on the buccal mucosa and lateral tongue. Changes in microbiota composition with increasing radiation dose and the presence of mucositis were examined.

RESULTS:
The data suggest that the salivary microbiota remain stable during RT and are consistently dominated by Streptococcus, Prevotella, Fusobacterium and Granulicatella. Obligate and facultative anaerobic Gram-negative bacilli (GNB) Bacteroidales G2, Capnocytophaga, Eikenella, Mycoplasma and Sneathia, as well as anaerobic GNB in the periopathogenic genera Porphyromonas and Tannerella, were all positively correlated with ≥ grade 2 OM. Significant increases in the relative abundances of Bacteroidales G2, Fusobacterium and Sneathia were identified in buccal mucosa swabs at sites of ≥ grade 2 OM (p < 0.05). Furthermore, the abundance of several GNB (Fusobacterium, Haemophilus, Tannerella, Porphyromonas and Eikenella) on the buccal mucosa may influence patient susceptibility to developing OM. Candida was widely detected in buccal mucosa swabs, regardless of mucositis status.

CONCLUSIONS:
Our findings support previously hypothesized associations between oral health and the pathogenesis of OM, highlighting the importance of oral health interventions for head and neck cancer patients.

KEYWORDS:
Anaerobes; Head and neck cancer; Oral microbiome; Oral mucositis; Radiotherapy

PMID: 31650293 DOI: 10.1007/s00520-019-05084-6
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Grant support
Select item 31650190
71.
Pediatr Radiol. 2019 Oct 18. doi: 10.1007/s00247-019-04527-w. [Epub ahead of print]
Capturing infant swallow impairment on videofluoroscopy: timing matters.
McGrattan KE1,2, McGhee HC3,4, McKelvey KL3,4, Clemmens CS5, Hill EG6, DeToma A6, Hill JG7, Simmons CE7, Martin-Harris B3,5,8.
Author information
1
Department of Speech-Language and Hearing Sciences, University of Minnesota, 164 Pillsbury Drive SE, Minneapolis, MN, 55455, USA. kmcgratt@umn.edu.
2
Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA. kmcgratt@umn.edu.
3
Evelyn Trammell Institute for Voice and Swallowing, Medical University of South Carolina, Charleston, SC, USA.
4
Department of Speech Language Pathology, Medical University of South Carolina, Charleston, SC, USA.
5
Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
6
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
7
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
8
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.
Abstract
BACKGROUND:
Infant videofluoroscopic swallow studies (VFSSs) require clinicians to make determinations about swallowing deficits based on a limited number of fluoroscopically observed swallows. Although airway protection is known to decline throughout a bottle-feed, the paucity of data regarding the timing of this degradation has limited the development of procedural protocols that maximize diagnostic validity.

OBJECTIVE:
We tested the stability of key components of swallow physiology and airway protection at four standardized timepoints throughout the VFSS.

MATERIALS AND METHODS:
Thirty bottle-fed infants with clinical signs of swallow dysfunction underwent VFSS. Fluoroscopy was turned on to allow visualization of five swallows at 0:00, 0:30, 1:30 and 2:30 (minutes:seconds [min:s]). We evaluated swallows for components of swallow physiology (oral bolus hold, initiation of pharyngeal swallow, timing of swallow initiation) and airway protection (penetration, aspiration). We used model-based linear contrasts to test differences in the percentage of swallows with low function component attributes.

RESULTS:
All components of swallow physiology exhibited a change throughout the VFSS (P≤0.0005). Changes were characterized by an increase in the number of sucks per swallow (P<0.0001), percentage of swallows with incomplete bolus hold (P=0.0005), delayed initiation of pharyngeal swallow (P<0.0001), delayed timing of swallow initiation (P=0.0004) and bolus airway entry (P<0.0001). These findings demonstrate that infants with dysphagia exhibit a change in swallow physiology throughout the videofluoroscopic swallow exam.

CONCLUSION:
Fluoroscopic visualization that is confined to the initial swallows of the bottle feed limit the exam's diagnostic validity. Developing evidence-based procedural guidelines for infant VFSS execution is crucial for maximizing the exam's diagnostic and treatment yield.

KEYWORDS:
Dysphagia; Infants; Standardization; Swallowing; Videofluoroscopic swallow studies

PMID: 31650190 DOI: 10.1007/s00247-019-04527-w
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Select item 31649975
72.
JAAD Case Rep. 2019 Sep 25;5(10):868-870. doi: 10.1016/j.jdcr.2019.08.003. eCollection 2019 Oct.
An atypical case of ectopic extramammary Paget disease presenting on the lateral neck.
Sharma P1, Waldman A1, Xu J2, Vleugels FR1.
Author information
1
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
2
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
KEYWORDS:
EMPD, extramammary Paget disease; Mohs; dermatologic oncology; ectopic extramammary Paget disease; head and neck; rare cancer; rare disease; skin cancer

PMID: 31649975 PMCID: PMC6804557 DOI: 10.1016/j.jdcr.2019.08.003
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Select item 31649890
73.
Front Oncol. 2019 Oct 9;9:1035. doi: 10.3389/fonc.2019.01035. eCollection 2019.
SEMA3C Promotes Cervical Cancer Growth and Is Associated With Poor Prognosis.
Liu R1,2,3, Shuai Y2,3,4, Luo J2,3,4, Zhang Z2,3,4.
Author information
1
Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
2
Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
3
Tianjin's Clinical Research Center for Cancer, Tianjin, China.
4
Department of Maxillofacial and Otorhinolaryngology Oncology and Department of Head and Neck Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
Abstract
Introduction: Aberrant activation of Semaphorin3C(SEMA3C) is widespread in human cancers. We aimed to analyze SEMA3C expression in cervical cancer and investigate the role of SEMA3C in cervical cancer and its underlying mechanism, which is important for exploring new therapeutic targets and prognostic factors. Materials and Methods: The expression of SEMA3C was examined in paraffin-embedded cervical cancer specimens. In vivo and in vitro assays were performed to validate the effect of SEMA3C on cervical cancer cell proliferation and p-ERK pathway activation. Gene Set Enrichment Analysis (GSEA) was performed using The Cancer Genome Atlas (TCGA) data set. Results: SEMA3C expression was associated with poor survival in both the TCGA cohort and our cohort. Silencing of SEMA3C suppressed cervical cancer cell proliferation, colony formation ability, and the activation of the p-ERK signaling pathway in vitro. SEMA3C depletion inhibited tumor growth in vitro. GSEA also showed that the epithelial mesenchymal transition (EMT), TGFβ signaling pathway, angiogenesis, and extracellular matrix (ECM) receptor interactions are associated with a high SEMA3C expression phenotype. Conclusion: SEMA3C is correlated with poor prognosis of cervical cancer patients and promotes tumor growth via the activation of the p-ERK pathway.

Copyright © 2019 Liu, Shuai, Luo and Zhang.

KEYWORDS:
GSEA; SEMA3C; TCGA; cervical cancer; p-ERK signaling pathway

PMID: 31649890 PMCID: PMC6794562 DOI: 10.3389/fonc.2019.01035
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Select item 31649876
74.
Front Oncol. 2019 Oct 9;9:1006. doi: 10.3389/fonc.2019.01006. eCollection 2019.
Head and Neck Cancer in Belgium: Quality of Diagnostic Management and Variability Across Belgian Hospitals Between 2009 and 2014.
Leroy R1, De Gendt C2, Stordeur S1, Schillemans V2, Verleye L1, Silversmit G2, Van Eycken E2, Savoye I1, Grégoire V3, Nuyts S4, Vermorken J5,6.
Author information
1
Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
2
Belgian Cancer Registry, Brussels, Belgium.
3
Centre Léon Bérard, Lyon, France.
4
Department of Radiotherapy-Oncology, University Hospitals Leuven, University of Leuven, KU Leuven, Leuven, Belgium.
5
Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium.
6
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Abstract
Aims: The study assessed the quality of diagnosis and staging offered to patients with a head and neck squamous cell carcinoma (HNSCC) and the variability across Belgian hospitals. Methods: In total, 9,245 patients diagnosed with HNSCC between 2009 and 2014, were identified in the population-based Belgian Cancer Registry (BCR). The BCR data were coupled with other databases providing information on diagnostic and therapeutic procedures reimbursed by the compulsory health insurance, vital status data, and comorbidities. The use of diagnosis and staging procedures was assessed by four quality indicators (QI) (i.e., use of dedicated head and neck imaging studies, use of PET-CT, TNM reporting and interval between diagnosis and start of treatment), for which a target was defined before the analysis. The association between the binary QIs and observed survival was assessed using Cox proportional hazard models adjusted for potential confounders. Results: Overall, 82.5% of patients received staging by MRI and/or CT of the head and neck region before the start of treatment. In 47.6% of stage III-IV patients eligible for treatment with curative intent, a whole-body FDG-PET(/CT) was performed. The proportion of patients whose cTNM and pTNM stage was reported to the BCR was 80.5 and 78.4%, respectively. The median interval from diagnosis to first treatment with curative intent was 32 days (IQR: 19-46). For none of these QIs the pre-set targets were reached and a substantial variability between centers was observed for all quality indicators. No binary QI was significantly associated with observed survival. Conclusions: The four quality indicators related to diagnosis and staging in HNSCC all showed substantial room for improvement. For none of them the pre-set targets were met at the national level and the variability between centers was substantial. Each Belgian hospital received an individual feedback report in order to stimulate reflection and quality improvement processes.

Copyright © 2019 Leroy, De Gendt, Stordeur, Schillemans, Verleye, Silversmit, Van Eycken, Savoye, Grégoire, Nuyts and Vermorken.

KEYWORDS:
diagnosis; head and neck cancer; quality indicators; quality of care; squamous cell carcinoma; staging; variability in care

PMID: 31649876 PMCID: PMC6794682 DOI: 10.3389/fonc.2019.01006
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Select item 31649759
75.
Int Arch Otorhinolaryngol. 2019 Oct;23(4):e403-e407. doi: 10.1055/s-0039-1696702. Epub 2019 Oct 22.
A Retrospective Analysis of Peroperative Risk Factors Associated with Posttonsillectomy Reactionary Hemorrhage in a Teaching Hospital.
Manimaran V1, Mohanty S1, Jayagandhi SK1, Umamaheshwaran P1, Jeyabalakrishnan S1.
Author information
1
Department of Otolaryngology and Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India.
Abstract
Introduction  Tonsillectomy is one of the most common otolaryngology procedures performed worldwide. It is also one of the first procedures learnt by residents during their training period. Although tonsillectomy is viewed relatively as a low-risk procedure, it can be potentially harmful because of the chance of posttonsillectomy hemorrhage. Objective  The objective of the present study is to analyze the effects of peroperative factors and experience of the surgeon on the incidence and pattern of posttonsillectomy reactionary hemorrhage. Methods  A retrospective review of medical charts was performed from 2014 to 2017 in a tertiary care hospital. A total of 1,284 patients who underwent tonsillectomy and adenoidectomy were included in the study. The parameters assessed were experience of the surgeon, operating time, intraoperative blood loss, difference in mean arterial pressure (MAP) and pulse rate. Results  A total of 23 (1.79%) out of the 1,284 patients had reactionary hemorrhage. Out of those 23, 16 (69.5%) patients had been operated on by trainees, while 7 (30.5%) had been operated on by consultants ( p  = 0.033, odds ratio [OR] = 0.04). Operating time, intraoperative blood loss, difference in MAP and pulse rate were significantly higher in the reactionary hemorrhage group, and showed a positive association with risk of hemorrhage ( p  < 0.05; OR >1). Re-exploration to control the bleeding was required in 10 (76.9%) out of the 23 cases. Conclusion  The experience of the surgeon experience and peroperative factors have an association with posttonsillectomy hemorrhage. Close surveillance and monitoring of the aforementioned peroperative factors will help in the identification of patients at risk of hemorrhage.

KEYWORDS:
hemorrhage; peroperative risk factors; reactionary hemorrhage; tonsillectomy

PMID: 31649759 PMCID: PMC6805177 DOI: 10.1055/s-0039-1696702
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Select item 31649318
76.
Br J Cancer. 2019 Oct 25. doi: 10.1038/s41416-019-0601-8. [Epub ahead of print]
Long-term survival in patients with metastatic head and neck squamous cell carcinoma treated with metastasis-directed therapy.
Beckham TH1, Leeman JE1, Xie P1, Li X1, Goldman DA2, Zhang Z2, Sherman E3, McBride S1, Riaz N1, Lee N1, Tsai CJ4.
Author information
1
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
2
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
3
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
4
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. tsaic@mskcc.org.
Abstract
BACKGROUND:
Our objective was to evaluate the outcomes of metastatic head and neck squamous cell carcinoma (HNSCC) by disease burden with an emphasis on metastasis-directed therapy (MDT) in patients with limited metastatic disease burden.

METHODS:
In total, 186 patients who developed metastatic disease after definitive therapy for HNSCC were included. Clinically and radiographically apparent metastases were enumerated. Kaplan-Meier methods were used to estimate survival. Cox regression was used to assess the association between clinical variables.

RESULTS:
Patients with a single metastasis had a 5-year overall survival (OS) of 35% (95% CI 16-54%) in contrast to patients with multiple metastases with a 5-year OS of 4% (95% CI 2-9%). Thirty patients (16.1%) underwent MDT. On multivariable analysis, oral cavity or sinonasal primary (HR 2.22 95% CI 1.16-4.25, p = 0.015; HR 4.88, 95% CI 1.10-21.70, p = 0.037, respectively) were associated with higher risk of death, whereas receipt of MDT (HR 0.36, 95% CI 0.17-0.74, p = 0.006) was associated with lower hazard of death. Median subsequent metastasis-free survival and 5-year survival after MDT (n = 30) were estimated at 26.4 months (95% CI: 9.8-54.0) and 31%, (95% CI: 15-48%).

CONCLUSIONS:
HNSCC patients with limited metastatic disease may derive significant benefit from MDT. Prospective trials evaluating MDT in HNSCC are warranted.

PMID: 31649318 DOI: 10.1038/s41416-019-0601-8
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Select item 31649289
77.
Sci Rep. 2019 Oct 24;9(1):15247. doi: 10.1038/s41598-019-51792-8.
Human Sensation of Transcranial Electric Stimulation.
Zeng FG1, Tran P2, Richardson M2, Sun S2,3, Xu Y2,4.
Author information
1
Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, California, 92697, USA. fzeng@uci.edu.
2
Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, California, 92697, USA.
3
Department of Otolaryngology - Head and Neck Surgery, The First Affiliated Hospital, Zhengzhou University, Henan, 450052, China.
4
Department of Precision Instrument, Tsinghua University, Beijing, 100084, China.
Abstract
Noninvasive transcranial electric stimulation is increasingly being used as an advantageous therapy alternative that may activate deep tissues while avoiding drug side-effects. However, not only is there limited evidence for activation of deep tissues by transcranial electric stimulation, its evoked human sensation is understudied and often dismissed as a placebo or secondary effect. By systematically characterizing the human sensation evoked by transcranial alternating-current stimulation, we observed not only stimulus frequency and electrode position dependencies specific for auditory and visual sensation but also a broader presence of somatic sensation ranging from touch and vibration to pain and pressure. We found generally monotonic input-output functions at suprathreshold levels, and often multiple types of sensation occurring simultaneously in response to the same electric stimulation. We further used a recording circuit embedded in a cochlear implant to directly and objectively measure the amount of transcranial electric stimulation reaching the auditory nerve, a deep intercranial target located in the densest bone of the skull. We found an optimal configuration using an ear canal electrode and low-frequency (<300 Hz) sinusoids that delivered maximally ~1% of the transcranial current to the auditory nerve, which was sufficient to produce sound sensation even in deafened ears. Our results suggest that frequency resonance due to neuronal intrinsic electric properties need to be explored for targeted deep brain stimulation and novel brain-computer interfaces.

PMID: 31649289 DOI: 10.1038/s41598-019-51792-8
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Grant support
Select item 31649229
78.
Med J Malaysia. 2019 Oct;74(5):450-451.
Dilemma in management of cervico-facial cystic hygroma.
Tamilselvi R1, Tang IP2, Linger S3, Mohd Soffian MS4.
Author information
1
Universiti Sains Malaysia, School of Medical Sciences, Department of ORL-Head & Surgery, Kota Bahru, Kelantan, Malaysia. frezzyblue@yahoo.co.uk.
2
University Malaysia Sarawak, Faculty of Medicine & Health Sciences, Department of Otorhinolaryngology - Head and Neck, Kota Samarahan, Sarawak, Malaysia.
3
Universiti Sains Malaysia, School of Medical Sciences, Department of ORL-Head & Surgery, Kota Bahru, Kelantan, Malaysia.
4
Hospital Miri, Department of Otorhinolaryngology- Head and Neck, Miri, Sarawak, Malaysia.
Abstract
Cervico facial cystic hygroma and tongue lymphagioma is rare representative of spectrum of lymphatic malformations. Conservative management with sclerosants alone has proven to be successful. However, sudden enlargement of these cervico facial lymphangiomas leads to catastrophic airway obstruction leading to debility in feeding and speech. Therefore, surgery is indicated in such case to prevent such a catastrophic problem. We report here the case of a 3-yearold boy with cervico facial hygroma involving the tongue. We successfully treated him with a combination of surgery and OK432 injection.

PMID: 31649229
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Select item 31649051
79.
Br J Ophthalmol. 2019 Oct 24. pii: bjophthalmol-2019-315011. doi: 10.1136/bjophthalmol-2019-315011. [Epub ahead of print]
Conjunctival intraepithelial neoplasia and carcinoma: distinct clinical and histological features in relation to human papilloma virus status.
Ramberg I1,2, Toft PB2, Georgsen JB3, Siersma VD4, Funding M5, Jensen DH6, von Buchwald C6, Heegaard S7,2.
Author information
1
Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
2
Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
3
Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
4
The Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
5
Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
6
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
7
Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark sthe@sund.ku.dk.
Abstract
AIMS:
Human papillomavirus (HPV) is considered a causative agent for the development of a broad range of human carcinomas. The role of HPV in the development of conjunctival intraepithelial neoplasia (CIN) and carcinoma (cSCC) remains unclear. The purpose of the present study was to investigate the HPV prevalence in a nationwide cohort and to describe clinical and histopathological features in relation to HPV status.

METHODS:
All cases of CIN and cSCC in Denmark from 1980 to 2016 were included. We combined p16 immunohistochemistry (IHC), RNA in situ hybridisation (RNA ISH) and HPV DNA PCR to detect HPV. The results were correlated to clinical and histopathological parameters.

RESULTS:
One hundred twelve primary tumours and 33 recurrent tumours were included for HPV analysis. Twenty-four (21%) of the primary tumours were HPV positive by PCR. Eighteen of out 19 HPV-positive tumours were positive by RNA ISH. HPV16 was the most prevalent genotype (n=18, 75%). The patients with HPV-positive tumours were significantly younger (mean difference 11.5 years, 95% CI 5.2 to 17.9, p=0.0005) and had a higher recurrence compared with patients with HPV-negative tumours (HR 2.30, 95% CI 1.02 to 5.21, p=0.046). The HPV-positive tumours were associated with a positive p16 IHC and a non-keratinising morphology.

CONCLUSION:
We describe distinct clinical and histopathological features associated with HPV status in cSCC. The finding of transcriptionally active HPV in this material lends support to a causal role of HPV in a subset of cSCC.

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

KEYWORDS:
conjunctiva; epidemiology; infection; ocular surface; pathology

PMID: 31649051 DOI: 10.1136/bjophthalmol-2019-315011
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Conflict of interest statement
Select item 31648901
80.
Sleep Med. 2019 Jul 3. pii: S1389-9457(19)30227-8. doi: 10.1016/j.sleep.2019.06.014. [Epub ahead of print]
Expansion of the maxilla in adults with OSAS: myth or reality?
Machado Júnior AJ1, Crespo AN2.
Author information
1
Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil. Electronic address: almiromachadophd@gmail.com.
2
Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
PMID: 31648901 DOI: 10.1016/j.sleep.2019.06.014