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BACKGROUND AIMS: Natural killer (NK) cell-based cancer immunotherapy is effective when combined with other treatment modalities such as irradiation and chemotherapy. NK cell's antitumor function to treat solid tumor, including head and neck squamous cell carcinoma (HNSCC), has been targeted recently. This study assessed NK cell recruitment in response to chemoradiation therapy (CRT) in HNSCC. METHODS: Ex vivo expansion of NK cell, flow cytometry, cell viability assay, cytotoxicity assay, immunohistochemistry, and animal model were performed. RESULTS: Mouse NK cells were recruited to the tumor site by CRT in a nude mouse model. Furthermore, expanded and activated human NK cells (eNKs) were recruited to the tumor site in response to CRT, and CRT enhanced the anti-tumor activity of eNK in an NOD/SCID IL-2Rγnull mouse model. Various HNSCC cancer cell lines exhibited different NK cell ligand activation patterns in response to CRT that correlated with NK cell-mediated cytotoxicity. CONCLUSIONS: Identifying the activation patterns of NK cell ligands during CRT might improve patient selection for adjuvant NK cell immunotherapy combined with CRT. This is the first study to investigate the NK cell's antitumor function and recruitment with CRT in HNSCC mouse model.
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Neoplasias de Cabeça e Pescoço , Células Matadoras Naturais , Humanos , Animais , Camundongos , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Modelos Animais de Doenças , Linhagem Celular Tumoral , Camundongos Endogâmicos NOD , Camundongos SCID , Células Matadoras Naturais/metabolismo , Quimiorradioterapia , Neoplasias de Cabeça e Pescoço/terapia , Neoplasias de Cabeça e Pescoço/metabolismoRESUMO
OBJECTIVE: We analyzed and compared the clinical characteristics of benign and malignant parotid gland tumors. PATIENTS AND METHODS: A total of 992 patients who underwent surgical treatment for parotid gland tumors from January 2010 to December 2020 were included in this study. This study population was subdivided into benign (n = 812, 81.9 %) and malignant parotid gland tumors (n = 180, 18.1 %). RESULTS: Pleomorphic adenoma is the most common benign tumor and mucoepidermoid carcinoma is the most common malignant tumor. The patients with malignant parotid gland tumors were older than the patients with benign lesions. The duration of symptoms was longer in patients with benign parotid gland tumors compared to those with malignant lesions. The size of the malignant tumors was larger than that of the benign lesions. Preoperative fine-needle aspiration cytology had a diagnostic sensitivity of 50.3 %, diagnostic specificity of 98.7 %, a positive predictive value of 89.5 %, a negative predictive value of 89.9 %, and accuracy of 89.9 % for diagnosing malignant parotid gland tumors. For benign parotid gland tumors, superficial parotidectomy was most frequently performed, and for malignant parotid gland tumors, total parotidectomy was most frequently performed. Facial palsy was observed in 19.4 % of the patients with malignant parotid gland tumors compared to 5.4 % of those with benign tumors. CONCLUSION: The clinical features of benign and malignant parotid gland tumors showed differences in age, symptoms, duration of symptoms, size and site of the parotid tumors, surgical procedures, and postoperative facial nerve palsy.
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Adenoma Pleomorfo , Paralisia de Bell , Paralisia Facial , Neoplasias Parotídeas , Humanos , Neoplasias Parotídeas/patologia , Glândula Parótida/cirurgia , Estudos Retrospectivos , Glândulas Salivares/patologia , Adenoma Pleomorfo/patologiaRESUMO
Pharyngocutaneous fistula (PCF) caused by a previous anterior cervical spine fixation plate more than a decade ago has not been reported yet. A 70-year-old man with dysphagia was diagnosed as supraglottic cancer. After partial laryngectomy and concurrent chemoradiation, due to increasing arytenoid lesion, total laryngectomy was followed. Pharyngocutaneous fistula occurred but resolved spontaneously. However, retropharyngeal granulation tissue emerging from the anterior cervical spine fixation plate caused delayed PCF. Dysphagia and PCF resolved after fixation plate removal.
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Fístula Cutânea , Transtornos de Deglutição , Neoplasias Laríngeas , Doenças Faríngeas , Masculino , Humanos , Idoso , Laringectomia/efeitos adversos , Transtornos de Deglutição/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Fístula Cutânea/diagnóstico por imagem , Fístula Cutânea/etiologia , Fístula Cutânea/cirurgia , Doenças Faríngeas/diagnóstico por imagem , Doenças Faríngeas/etiologia , Doenças Faríngeas/cirurgia , Vértebras Cervicais/cirurgia , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/complicações , Estudos RetrospectivosRESUMO
BACKGROUND: The use of natural killer (NK) cells is a promising approach in the field of cancer immunotherapy; however, combination treatments are required to enhance the effects of NK cell immunotherapy. In this study, we assessed the potential of irradiation and cisplatin as a chemoradiotherapy (CRT) regimen to augment the effects of NK cell immunotherapy in head and neck squamous cell carcinoma (HNSCC). METHODS: NK cells were expanded using our recently established K562-OX40 ligand and membrane-bound interleukin (IL)-18 and IL-21 feeder cells in the presence of IL-2/IL-15 from peripheral blood of healthy donors. RESULTS: The results showed an increase in the purity of NK cells and expression of activation markers such as NKG2D and lymphocyte function-associated antigen 1 during the expansion process, which is positively correlated to the NK cell infiltration and overall survival in patients with HNSCC. CRT induced NK cell activation ligand (ULBP2) and adhesion molecules (ICAM-1, -2 and -3) on HNSCC, leading to enhanced cytotoxicity of NK cells against HNSCC. CONCLUSIONS: Our findings suggest that the NK cells have a potent anti-tumor effect in combination with CRT against HNSCC.
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Neoplasias de Cabeça e Pescoço , Células Matadoras Naturais , Linhagem Celular Tumoral , Quimiorradioterapia , Citotoxicidade Imunológica , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Imunoterapia/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapiaRESUMO
OBJECTIVES: The objective of this study was to determine factors affecting the survival of pedicled latissimus dorsi (LD) flap. MATERIALS AND METHODS: Medical records of 20 pedicled LD flap patients for head and neck reconstruction by a single operator from 2015 to 2019 in a tertiary hospital were reviewed. Factors including flap size and pedicle's length from the most distal end of the flap to the axilla (Fp) and from the most distal end of the defect to the axilla (Dfp) were assessed. Partial flap loss requiring procedures and total loss were considered as failure. Descriptive statistics, the Pearson χ 2 test, and linear-by-linear association analysis were performed. RESULTS: Seventy percent of patients showed success. There was no significant difference in various factors including preoperative body mass index, underlying diseases such as hypertension and diabetes, preoperative treatment either radiation or chemotherapy, lab results, and operation time between the survival and the failure group. Rotation arc (Dfp/Fp) showed significant difference between 2 groups ( P =0.001). Unlike Fp, Dfp tend to be shorter on the success group ( P =0.053). CONCLUSIONS: Low rotation arc through shorter Dfp affects survival of pedicled LD flap significantly.
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Mamoplastia , Músculos Superficiais do Dorso , Humanos , Axila , Mamoplastia/métodos , Músculos Superficiais do Dorso/transplante , Retalhos CirúrgicosRESUMO
BACKGROUND: We designed a new 1-handed chest compression method, the "elbow-lock" chest compression (ELCC), for a single rescuer in pediatric cardiopulmonary resuscitation (CPR). Then, we compared the effectiveness between the ELCC and standard chest compression (SCC) method. METHODS: This prospective, randomized controlled, crossover simulation trial studied 34 emergency medical professionals, including physicians, nurses, and EMTs. We compare the quality of chest compression and fatigue point time between the ELCC and the SCC. RESULTS: Participants who performed the ELCC method maintained a proper depth of compression compared with SCC method (50.0 ± 0.3 mm vs 40.5 ± 0.4 mm, P < 0.001). However, the 2 methods did not differ in terms of compression velocity since neither reached the standard velocity (96.7 ± 7.1/minutes vs 91.7 ± 7.0/minutes, P < 0.016). With respect to the overall score, ELCC was more effective than the SCC (91.6 ± 3.7% vs 85.3 ± 8.8%, P = 0.002). In addition, the fatigue point time was slower in the ELCC group than the SCC group (7.3 ± 0.3/minutes vs 6.1 ± 0.4/minutes, P < 0.001). CONCLUSIONS: The single rescuer ELCC method is an effective alternative to the SCC method for pediatric CPR because the ELCC method can prevent elbow flexion.Trial registration: Our research is simulation manikin study. So we do not need to "trial registration".
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Reanimação Cardiopulmonar , Cotovelo , Criança , Estudos Cross-Over , Humanos , Manequins , Estudos ProspectivosRESUMO
Competition and collaboration are strategies that can be used to optimize the outcomes of social interactions. Research into the neuronal substrates underlying these aspects of social behavior has been limited due to the difficulty in distinguishing complex activation via univariate analysis. Therefore, we employed multivoxel pattern analysis of functional magnetic resonance imaging to reveal the neuronal activations underlying competitive and collaborative processes when the collaborator/opponent used myopic/predictive reasoning. Twenty-four healthy subjects participated in 2 × 2 matrix-based sequential-move games. Searchlight-based multivoxel patterns were used as input for a support vector machine using nested cross-validation to distinguish game conditions, and identified voxels were validated via the regression of the behavioral data with bootstrapping. The left anterior insula (accuracy = 78.5%) was associated with competition, and middle frontal gyrus (75.1%) was associated with predictive reasoning. The inferior/superior parietal lobules (84.8%) and middle frontal gyrus (84.7%) were associated with competition, particularly in trials with a predictive opponent. The visual/motor areas were related to response time as a proxy for visual attention and task difficulty. Our results suggest that multivoxel patterns better represent the neuronal substrates underlying the social cognition of collaboration and competition intermixed with myopic and predictive reasoning than do univariate features.
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Antecipação Psicológica/fisiologia , Mapeamento Encefálico , Córtex Cerebral/fisiologia , Comportamento Competitivo , Comportamento Cooperativo , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Reconhecimento Automatizado de Padrão , Cognição Social , Máquina de Vetores de Suporte , Pensamento/fisiologia , Adulto , Córtex Cerebral/diagnóstico por imagem , HumanosRESUMO
OBJECTIVE: To determine the clinical characteristics and treatment results of benign and malignant tumors of the hard palate in our hospital. PATIENTS AND METHODS: A total of 25 patients who underwent surgical treatment for hard palate tumors between 2008 and 2018 were included in this study. Their demographic characteristics, smoking status, alcohol consumption, symptoms, duration of symptoms, size and localization of hard palate tumor, status of mucosal surface, radiologic examinations, surgery, reconstruction method, histopathologic results, treatment outcomes, oral intake start time, adjuvant treatment, postoperative complications, and recurrence were reviewed. RESULTS: Of the 25 patients with hard palate tumors, 15 (60.0%) had benign tumors and 10 (40.0%) had malignant tumors. Both benign and malignant tumors of the hard palate occurred more frequently in females than in the males. The most common symptom of hard palate tumor was palate mass. The most common benign tumor was pleomorphic adenoma (n = 13). The most common malignant tumors were squamous cell carcinoma and carcinoma ex pleomorphic adenoma (n = 3 for each). All patients were operated via transoral approach without external incision. We did not experience any recurrence in this study. The oral intake start time was late in malignant hard palate tumors (p < 0.05). CONCLUSION: The comparison of clinical features of benign and malignant hard palate tumors showed a statistical significance only for oral intake start time. Transoral surgical removal with clear margin is a safe and effective procedure for benign and malignant hard palate tumors.
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Adenoma Pleomorfo , Carcinoma de Células Escamosas , Neoplasias das Glândulas Salivares , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia , Palato Duro/cirurgiaRESUMO
The enantioselective synthesis of 2,3-disubstituted benzomorpholines, analogues of 1,4-benzodioxane natural products, has been achieved via addition of electron-rich aromatic donors to acyl-iminium ions derived from benzomorpholine aminols. Subsequent modification of the benzomorpholine scaffold allows side chains mimicking those found in 1,4-benzodioxane lignans to be added. Antiproliferative testing of the prepared analogues showed promising results against MDA-MB-231 and HCT116 cancer cell lines.
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Produtos Biológicos/síntese química , Lignanas/química , Morfolinas/síntese química , Produtos Biológicos/química , Espectroscopia de Ressonância Magnética Nuclear de Carbono-13 , Morfolinas/química , Espectroscopia de Prótons por Ressonância Magnética , Espectrometria de Massas por Ionização por Electrospray , EstereoisomerismoRESUMO
A series of pyrrole analogues of combretastatin (CA-4) were synthesized and tested for their anti-proliferative activity. The highly diastereoselective acyl-Claisen rearrangement was used to provide 2,3-syn disubstituted morpholine amides which were used as precursors for the various analogues. This synthesis allows for the preparation of 1,2- and 2,3-diaryl-1H-pyrroles which are both geometrically similar to CA-4. These pyrrolic analogues were tested for their anti-proliferative activity against two human cell lines, K562 and MDA-MB-231 with 2,3-diaryl-1H-pyrrole 35 exhibiting the most potent activity with IC50 value of 0.07µM against MDA-MB-231 cell line.
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Antineoplásicos/farmacologia , Guaiacol/análogos & derivados , Pirróis/farmacologia , Estilbenos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais , Guaiacol/síntese química , Guaiacol/química , Guaiacol/farmacologia , Humanos , Concentração Inibidora 50 , Pirróis/síntese química , Pirróis/química , Estilbenos/síntese química , Estilbenos/química , Relação Estrutura-AtividadeRESUMO
BACKGROUND AND OBJECTIVES: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. METHODS: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009-2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. RESULTS: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8-11.4-fold), admission for HF (2.6-10.5-fold), hospitalization for any cause (2.4-2.7-fold), all-cause death (4.1-5.0-fold), and composite outcomes (3.4-5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). CONCLUSIONS: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.
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The cortical source activity during the P300-based guilty knowledge test (GKT) conducted using Korean sentences was investigated. Thirty male students performed a guilty or an innocent scenario, and then underwent an electroencephalogram test. The stimuli consisted of target, probe, and irrelevant stimuli that were presented visually. A target stimulus is a task-relevant stimulus that is presented rarely, attracts subjects' attention, and induces a P300 wave. A probe stimulus, also presented rarely, contains crime-relevant information that induces P300 in a guilty subject. A guilty subject would be also attentive to the probe stimulus as to the target stimulus. An irrelevant stimulus is not related to the task or to the crime, and is frequently presented. Event-related potential (ERP) data showed a marked difference between the guilty and innocent groups. Compared to irrelevant stimuli, the probe stimulus elicited larger P300 amplitude in the bilateral frontoparietal region in the guilty group. However, this pattern was not observed in the innocent group. Standardized low-resolution electromagnetic tomography (sLORETA) analysis showed significant activation increases for the probe stimulus in the guilty group. It appears that the guilty and innocent groups use different cognitive mechanisms when processing the crime-relevant sentence. With regards to the cortical activity in response to the probe stimulus, the frontal activation for verb elements seems to reflect a working memory process, episodic memory retrieval, and response inhibition, while parietal activation for complement (adverb) and object (noun) elements seems to reflect selective attention and target discrimination. To our knowledge, this is the first research to examine the cortical source of the ERP evoked by the P300-based GKT using separate Korean sentence elements.
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Potenciais Evocados P300/fisiologia , Lobo Frontal/fisiologia , Culpa , Detecção de Mentiras/psicologia , Lobo Parietal/fisiologia , Adolescente , Adulto , Eletroencefalografia , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVES: Parotid lymphoma is a rare disease and proves challenging to differentiate from other masses. In this study, we aimed to analyze the clinical characteristics of parotid lymphoma to identify diagnostic factors to facilitate a diagnosis of parotid lymphoma. MATERIALS AND METHODS: We retrospectively enrolled 7 patients with parotid lymphoma, which was diagnosed at our hospital from 2012 to 2023. RESULTS: All participants had a well-defined, homogeneous solid mass; moreover, 5 patients had bilateral multiple lymphadenopathy that was detected on neck computed tomography (CT). Three patients had lymphocyte-related findings in fine-needle aspiration cytology (FNAC). CONCLUSION: Despite the challenges in diagnosing a parotid lymphoma, CT and FNAC findings can facilitate a differential diagnosis of parotid lymphoma.
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Linfoma , Neoplasias Parotídeas , Humanos , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/patologia , Linfoma/diagnóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Glândula Parótida/patologiaRESUMO
The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.
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INTRODUCTION: Neoplasms of the tongue base are rare, but they range from benign neoplasms to congenital diseases and malignant neoplasms. The purpose of this study is to analyze the clinical features and recurrence factors of benign tumors of the tongue base. METHODS: The study included 27 cases of benign neoplasms of the tongue base from January 2010 to February 2022. RESULTS: Of these 27 patients, 19 were male and 8 were female. Most cases were found incidentally without any specific symptoms, and squamous papilloma was the most common tumor. We performed microscopic or endoscopic transoral resection of benign neoplasms of the tongue base under general anesthesia in all patients without any complications. The recurrence rate was 14.8%, and we found that the younger the patient, the higher the recurrence rate (p < 0.001). CONCLUSION: We performed transoral resection of benign neoplasms of the tongue base in all patients without any complications. The recurrence of benign neoplasms of the tongue base was statistically significant only in terms of age.
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Neoplasias Encefálicas , Carcinoma de Células Escamosas , Laringe , Neoplasias Orofaríngeas , Doenças da Língua , Neoplasias da Língua , Carcinoma de Células Escamosas/patologia , Endoscopia , Feminino , Humanos , Laringe/patologia , Masculino , Neoplasias Orofaríngeas/patologia , Língua/patologia , Língua/cirurgia , Neoplasias da Língua/patologia , Neoplasias da Língua/cirurgiaRESUMO
Metastases to the vocal cord from a distant organ are extremely rare. This case showed metastatic adenocarcinoma on the vocal cord of lung origin in a 75-year-old nonsmoking female with a history of lung adenocarcinoma surgery 2 years earlier. The vocal cord mass was surgically removed, and the biopsy confirmed metastatic adenocarcinoma of lung origin with thyroid transcription factor (TTF)-1 positivity. A further evaluation found recurrence in the lung. The patient received gefitinib. Here, we report an extremely rare case of metastatic adenocarcinoma on the vocal cord from the lung which is the first report to our knowledge.
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BACKGROUND: Actinomycosis of the parotid gland is very rare. We sought to examine the clinical features, treatment methods, and treatment results of actinomycosis of the parotid gland in our hospital. METHODS: We retrospectively enrolled 5 patients with histopathologically identified actinomycosis of the parotid gland from January 2010 to May 2020. RESULTS: This study included 3 male and 2 female subjects. All patients had a common complaint of the mass in the parotid gland. Skin necrosis was observed in one patient. However, skin necrosis and fistula track occurred in the other 2 patients after fine-needle aspiration cytology (FNAC). Based on the result of FNAC two cases of inflammation and abscess were identified. Four patients with suspicion of parotid tumors before surgery underwent parotidectomy, and one patient with consideration of parotid abscess underwent incision and drainage. After surgery, intravenous administration of antibiotics was performed for an average of 6 days and oral antibiotics were prescribed for about 2 months for patients with actinomycosis of the parotid gland. CONCLUSIONS: In case of skin necrosis of the parotid lesion without evidence of a malignant tumor, or if FNAC does not reveal the presence of cancerous cells, and fistula tract or skin necrosis occurs after the FNAC, then actinomycosis of the parotid gland should be suspected. If the actinomycosis of the parotid gland was localized to the parotid gland and removed surgically, it would be sufficient to treat the patients with antibiotics for about 2 months while observing the clinical response.
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Actinomicose , Neoplasias Parotídeas , Actinomicose/diagnóstico , Feminino , Humanos , Masculino , Glândula Parótida , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
Anaplastic thyroid cancer (ATC) is characterized by a rapid and aggressive course of progression. Despite significant advances in surgery, radiotherapy and chemotherapy, the diseasespecific mortality due to ATC is approximately 100%. New strategies, such as molecular targeted therapies, are imperative for improving survival. Livin, a member of the human inhibitor of apoptosis protein family, has been found to be associated with tumor progression and poor prognosis in various human cancers. The aim of the present study was to evaluate the role of Livin in cancer progression and chemoradioresistance of ATC and to investigate its potential as a therapeutic target. Endogenous Livin expression in the human BHT101 ATC cell line was silenced by Livinspecific small interfering RNA. To assess the impact of Livin on cancer cell behavior in human ATC cells, various methods such as cell invasion, cell viability and cell apoptosis assays were applied. To assess the expression of Livin and the change of apoptosisrelated proteins associated with Livin expression, reverse transcriptionquantitative PCR and western blotting were performed. Immunohistochemistry was performed to detect Livin protein expression in human ATC tissues. The association between Livin expression and apoptotic/proliferation index was analyzed in human ATC cells. Livinknockdown suppressed tumor cell invasion; and conversely, it enhanced cell apoptosis, with elevated expression levels of cleaved caspase3 and 7 and cleaved PARP. Livinknockdown enhanced radiationinduced apoptosis, while reducing cell viability following radiotherapy, as well as lenvatinib treatment. In addition, human ATC tissues with high Livinexpression exhibited a high Ki67 labeling index and low apoptotic index. In summary, these findings indicate the contribution of Livin to tumor progression and chemoradioresistance in ATC.
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Proteínas Adaptadoras de Transdução de Sinal/antagonistas & inibidores , Proteínas Inibidoras de Apoptose/antagonistas & inibidores , Proteínas de Neoplasias/antagonistas & inibidores , Carcinoma Anaplásico da Tireoide/metabolismo , Carcinoma Anaplásico da Tireoide/terapia , Neoplasias da Glândula Tireoide/terapia , Proteínas Adaptadoras de Transdução de Sinal/biossíntese , Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Idoso , Apoptose/efeitos dos fármacos , Apoptose/efeitos da radiação , Resistencia a Medicamentos Antineoplásicos , Feminino , Técnicas de Silenciamento de Genes , Humanos , Proteínas Inibidoras de Apoptose/biossíntese , Proteínas Inibidoras de Apoptose/genética , Proteínas Inibidoras de Apoptose/metabolismo , Masculino , Invasividade Neoplásica , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Compostos de Fenilureia/farmacologia , Quinolinas/farmacologia , RNA Interferente Pequeno/administração & dosagem , RNA Interferente Pequeno/genética , Tolerância a Radiação , Carcinoma Anaplásico da Tireoide/genética , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/metabolismoRESUMO
OBJECTIVES: Sound field (SF) audiometry tests are usually conducted in audiometric booths measuring greater than 2×2 m in size. However, most private ENT clinics carry about 1×1-m-sized audiometric booths, making SF audiometry testing difficult to perform. The aims of this study were to develop an SF audiometry system for use in smaller audiometric booths and compare its performance with traditional system. METHODS: The newly developed SF audiometry system can yield an SF signal at a distance of about 30 cm from the subject's ears. Its height can be adjusted according to the subject's head height. We compared SF hearing results between the new SF system and the traditional SF audiometry system in 20 adults with normal hearing (40 ears) and 24 adults with impaired hearing levels (38 ears) who wore hearing aids. Comparative parameters included warble tone audiometry threshold, a speech reception threshold (SRT), and a speech discrimination score (SDS). For statistical analysis, paired t-test was used. The equivalence of both SF systems was tested using two one-sided test (TOST) with a margin of 5 dB (normal hearing participants) and 10 dB (hearing aids wearing participants). RESULTS: Among participants with normal hearing, warble tone hearing thresholds of 0.5, 1, 2, and 4 kHz, average values of these four frequencies, and SRT were similar between the two systems (all P>0.05). Participants with hearing aids showed similar warble tone threshold and SRT (P>0.05) in both systems except for threshold of 4 kHz (P=0.033). SDS was significantly higher in the newly developed system (P<0.05). TOST results showed equivalent SF audiometry results using either system. CONCLUSION: Audiometric results of the newly developed SF audiometry system were equivalent to those of a traditional system. Therefore, the small SF audiometry system can be used at small audiometric booths present in most private ENT clinics.
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BACKGROUND: Tailoring healthcare to patients' individual needs is a central goal of precision medicine. Combining smartphone-based interventions with machine learning approaches may help attaining this goal. The aim of our study was to explore the predictability of the success of smartphone-based psychotherapeutic micro-interventions in eliciting mood changes using machine learning. METHODS: Participants conducted daily smartphone-based psychotherapeutic micro-interventions, guided by short video clips, for 13 consecutive days. Participants chose one of four intervention techniques used in psychotherapeutic approaches. Mood changes were assessed using the Multidimensional Mood State Questionnaire. Micro-intervention success was predicted using random forest (RF) tree-based mixed-effects logistic regression models. Data from 27 participants were used, totaling 324 micro-interventions, randomly split 100 times into training and test samples, using within-subject and between-subject sampling. RESULTS: Mood improved from pre- to post-intervention in 137 sessions (initial success-rate: 42.3%). The RF approach resulted in predictions of micro-intervention success significantly better than the initial success-rate within and between subjects (positive predictive value: 0.732 (95%-CI: 0.607; 0.820) and 0.698 (95%-CI: 0.564; 0.805), respectively). Prediction quality was highest using the RF approach within subjects (rand accuracy: 0.75 (95%-CI: 0.641; 0.840), Matthew's correlation coefficient: 0.483 (95%-CI: 0.323; 0.723)). LIMITATIONS: The RF approach does not allow firm conclusions about the exact contribution of each factor to the algorithm's predictions. We included a limited number of predictors and did not compare whether predictability differed between psychotherapeutic techniques. CONCLUSIONS: Our findings may pave the way for translation and encourage scrutinizing personalized prediction in the psychotherapeutic context to improve treatment efficacy.