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1.
J Neurol Phys Ther ; 48(4): 188-197, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39164804

RESUMEN

BACKGROUND AND PURPOSE: Dual-task walking is challenging for people with Parkinson disease (PD). Gait performance worsens while executing dual tasks, possibly due to a decline in executive function (EF). This study aimed to investigate the effects of dual-task training on EF and dual-task cost (DTC) in people with PD and to explore whether training-induced changes in EF were associated with changes in DTC. METHODS: This study was a randomized controlled trial. A total of 28 people with PD participated. Participants were randomly assigned to the experimental group (dual-task training) and the control group (treadmill training). Both groups received a total of 16 training sessions during the 8 weeks. Assessments were conducted at baseline and postintervention. Primary outcomes included EF and dual-task cost. RESULTS: Significant time-by-group interactions were found in executive function and DTC. The experimental group showed significant improvement in frontal assessment battery (FAB), trail-making test (TMT) part A, Stroop color and word test (SCWT), and DTC on speed in cognitive dual-task walking. There was a moderate to high correlation between the change values of the FAB, TMT part A, SCWT, and the change values of DTC in cognitive dual-task walking. DISCUSSION AND CONCLUSIONS: Compared to treadmill training, dual-task training resulted in greater improvements in EF and DTC. Training-induced changes in EF were linked to changes in DTC when walking while performing a cognitive task but not when walking while performing a motor task. VIDEO ABSTRACT: For more insights from the authors Supplemental Digital Content available at http://links.lww.com/JNPT/A485.


Asunto(s)
Función Ejecutiva , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/rehabilitación , Enfermedad de Parkinson/fisiopatología , Función Ejecutiva/fisiología , Masculino , Femenino , Anciano , Persona de Mediana Edad , Caminata/fisiología , Terapia por Ejercicio
2.
J Formos Med Assoc ; 123(3): 347-356, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37739911

RESUMEN

BACKGROUND: Postoperative pulmonary complications (PPCs) increase the risk of morbidity and mortality in patients who underwent oral cancer surgery with free flap reconstruction. The association between PPC and preoperative risk factors has been investigated; however, reports on intraoperative factors are limited. Therefore, we investigated PPC incidence and its associated preoperative and intraoperative risk factors in these patients. METHODS: We retrospectively analyzed medical records of patients who underwent free flap reconstruction between 2009 and 2019. PPC was defined as presence of atelectasis, pneumonia, and respiratory failure based on radiological confirmation and clinical symptoms during hospitalization. Mortality, hospital stay, preoperative factors (including age and tumor stages), American Society of Anesthesiologists (ASA) classification, and intraoperative factors (including intraoperative fluids and medications) were recorded. RESULTS: PPC incidence among the 993 patients included in this study was 25.8% (256 patients). Six patients with PPCs died; death was not observed among patients without PPCs (p < 0.001). Patients with PPCs had longer hospitalization than those without PPCs (30.3 vs 23.3 days; p < 0.001). Tumor stage (stage I: reference; stage II [OR]: 3.3, p = 0.019; stage III: 4.4, p = 0.002; stage IV: 4.8, p = 0.002), age (OR: 1.0; p < 0.001), and ASA grade >2 (OR: 1.4; p = 0.020) were independent risk factors of PPC; using labetalol was a borderline significant factor (OR: 1.4; p = 0.050). CONCLUSION: The PPC incidence was 25.8% in patients undergoing oral cancer surgery with free flap reconstruction. Tumor stage, age, and ASA >2 were risk factors of developing PPC.


Asunto(s)
Colgajos Tisulares Libres , Neoplasias de la Boca , Humanos , Estudios Retrospectivos , Incidencia , Colgajos Tisulares Libres/efectos adversos , Factores de Riesgo , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/diagnóstico , Neoplasias de la Boca/cirugía
3.
J Formos Med Assoc ; 123(3): 390-399, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37704482

RESUMEN

BACKGROUND/PURPOSE: Fibroblast growth factor (FGF) 5 is a member of the FGF family that functions as a regulator of tissue growth and regeneration. Aberrant FGF5 expression has been previously associated with the progression of a number of different malignancies. However, its potential role in oral cancer remains unclear. In this study, we explored the relationship between the expression of FGF5 protein in oral squamous cell carcinomas (OSCCs) and the clinicopathological parameters of OSCCs and whether the expression of FGF5 protein in OSCCs could be a prognostic factor for OSCC patients. METHODS: The FGF5 protein expression was examined in 64 OSCC and 34 normal oral mucosal specimens by immunohistochemical staining. Stress induced upregulation and intracellular redistribution of FGF5 were verified using xenograft animal model and OSCC cell lines. RESULTS: The mean FGF5 protein labelling index was significantly higher in OSCC than in normal oral mucosal samples, with high FGF5 protein labelling index (>58%) being correlated with advanced stage and poor survival of OSCC patients. Apart from the peri-cytoplasmic staining pattern characteristic of paracrine growth factors, FGF5 protein was localized as distinct punctate structures in the cytoplasm of advanced stage or stressed-induced cells. This redistribution and upregulation of FGF5 protein could be sustained after termination of the stress induction in cell line and xenograft animal models. CONCLUSION: FGF5 can be induced by cellular stress and risk factors of OSCC, where high expression levels of FGF5 is potentially a useful parameter for predicting OSCC progression and patient survival.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Humanos , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas de Cabeza y Cuello , Neoplasias de la Boca/metabolismo , Factor 5 de Crecimiento de Fibroblastos , Pronóstico
4.
Cancer Sci ; 114(10): 3957-3971, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37496288

RESUMEN

Lysyl oxidase-like 2 (LOXL2) is a matrix-remodeling enzyme that has recently been identified as an important regulator of tumor progression and metastasis. This study discovered that LOXL2 expression in oral squamous cell carcinoma (OSCC) tissues was significantly associated with tumor clinical stage, lymph node metastasis and patients' overall survival time. LOXL2-overexpressing human buccal SCC TW2.6 (TW2.6/LOXL2) and hypopharyngeal SCC FaDu (FaDu/LOXL2) cells exhibited enhanced migration, invasion, epithelial-mesenchymal transition (EMT), and cancer stem cell (CSC) phenotypes, independently of its enzymatic activity. Moreover, TW2.6/LOXL2 significantly increased tumor-initiating frequency in SCID mice. We further demonstrated that LOXL2 increased the levels of interferon-induced protein with tetratricopeptide repeats 1 (IFIT1) and IFIT3 in TW2.6/LOXL2 and FaDu/LOXL2 cells. We also identified IFIT1 and IFIT3 as key downstream components of LOXL2 action in migration, invasion, EMT, and CSC phenotypes in TW2.6 and FaDu cells. Furthermore, a significant positive correlation between LOXL2 expression and IFIT1 and IFIT3 overexpression in human OSCC tissues was observed. In addition, TW2.6/LOXL2 and FaDu/LOXL2 cells were 3.3- to 3.6-fold more susceptible to the epidermal growth factor receptor (EGFR) inhibitor gefitinib than were their respective control cells. The antitumor effect of gefitinib on orthotopic TW2.6/LOXL2 xenograft tumor was fourfold higher than that on controls. Our results indicate that LOXL2 expression is a strong prognostic factor for OSCC and may be used as a marker to identify patients most likely to respond to EGFR-targeted therapy.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Animales , Ratones , Humanos , Gefitinib/farmacología , Carcinoma de Células Escamosas/patología , Proteína-Lisina 6-Oxidasa , Ratones SCID , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Carcinoma de Células Escamosas de Cabeza y Cuello/tratamiento farmacológico , Proteínas de Unión al ARN/genética , Receptores ErbB , Regulación Neoplásica de la Expresión Génica , Transición Epitelial-Mesenquimal , Línea Celular Tumoral , Péptidos y Proteínas de Señalización Intracelular
5.
Cancer Sci ; 114(10): 3857-3872, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37525561

RESUMEN

The suppressive regulatory T cells (Treg) are frequently upregulated in cancer patients. This study aims to demonstrate the hypothesis that arecoline could induce the secretion of mitochondrial (mt) DNA D-loop and programmed cell death-ligand 1 (PD-L1) in extracellular vesicles (EVs), and attenuate T-cell immunity by upregulated Treg cell numbers. However, the immunosuppression could be reversed by whole glucan particle (WGP) ß-glucan in oral squamous cell (OSCC) patients. Arecoline-induced reactive oxygen specimen (ROS) production and cytosolic mtDNA D-loop were analyzed in OSCC cell lines. mtDNA D-loop, PD-L1, IFN-γ, and Treg cells were also identified for the surgical specimens and sera of 60 OSCC patients. We demonstrated that higher mtDNA D-loop, PD-L1, and Treg cell numbers were significantly correlated with larger tumor size, nodal metastasis, advanced clinical stage, and areca quid chewing. Furthermore, multivariate analysis confirmed that higher mtDNA D-loop levels and Treg cell numbers were unfavorable independent factors for survival. Arecoline significantly induced cytosolic mtDNA D-loop leakage and PD-L1 expression, which were packaged by EVs to promote immunosuppressive Treg cell numbers. However, WGP ß-glucan could elevate CD4+ and CD8+ T-cell numbers, mitigate Treg cell numbers, and promote oral cancer cell apoptosis. To sum up, arecoline induces EV production carrying mtDNA D-loop and PD-L1, and in turn elicits immune suppression. However, WGP ß-glucan potentially enhances dual effects on T-cell immunity and cell apoptosis and we highly recommend its integration with targeted and immune therapies against OSCC.


Asunto(s)
Carcinoma de Células Escamosas , Vesículas Extracelulares , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , beta-Glucanos , Humanos , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas de Cabeza y Cuello , Arecolina , Antígeno B7-H1/genética , Neoplasias de la Boca/patología , Glucanos , beta-Glucanos/farmacología , ADN Mitocondrial/genética , Terapia de Inmunosupresión , Vesículas Extracelulares/metabolismo
6.
J Bone Miner Metab ; 41(6): 772-784, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37898986

RESUMEN

INTRODUCTION: CCN1 is an immediate-early gene product pivotal for arthritis progression. We have previously shown that sirtuin 6 (SIRT6) inhibited hypoxia-induced CCN1 expression in osteoblasts. Herein we examined the contribution of cyclic AMP-responsive element binding protein (CREB)/CRE to this suppressive action and the influence of CCN1 on cyclooxygenase (COX) 2 synthesis. MATERIALS AND METHODS: MC3T3-E1 murine osteoblasts were cultured under normoxia (21% oxygen) or hypoxia (2% oxygen). Expressions of CCN1, phospho-CREB (Ser133), COX2 and relevant kinases were assessed by Western blot. SIRT6 was overexpressed in cultured osteoblasts and arthritic joints by a lentiviral-based technique. Activities of CCN1 gene promoter constructs were examined by luciferase reporter assay. Interaction between CREB and CCN1 promoter was assessed by chromatin immunoprecipitation (ChIP). Collagen-induced arthritis (CIA) was established in 20 rats to evaluate the effects of SIRT6 therapy on osteoblastic expressions of phospho-CREB, CCN1 and COX2. RESULTS: SIRT6 suppressed hypoxia-enhanced CCN1 expression and CREB phosphorylation. Attenuation of calcium/calmodulin-dependent protein kinase II (CaMKII) may be responsible for SIRT6-induced CREB inhibition. CRE at - 286 bp upstream of the ATG start codon was essential for CCN1 expression under hypoxia and SIRT6 reduced hypoxia-stimulated CREB/CRE interaction. Forced expression of CREB rescued SIRT6-suppressed CCN1 synthesis. CCN1 induced COX2 expression in osteoblasts. In rat CIA, the therapeutic effect of SIRT6 was accompanied by decreases in osteoblastic expressions of phospho-CREB, CCN1 and COX2. CONCLUSION: Our study indicated that the benefits of SIRT6 to inflammatory arthritis and bone resorption are at least partially derived from its modulation of CREB/CCN1/COX2 pathway in osteoblasts.


Asunto(s)
Artritis Experimental , Sirtuinas , Ratas , Ratones , Animales , Ciclooxigenasa 2/genética , Ciclooxigenasa 2/metabolismo , Ciclooxigenasa 2/farmacología , Osteoblastos/metabolismo , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/metabolismo , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/farmacología , Hipoxia , Artritis Experimental/genética , Artritis Experimental/metabolismo , Fosforilación , Oxígeno/metabolismo , Oxígeno/farmacología , Sirtuinas/metabolismo , Sirtuinas/farmacología , AMP Cíclico/metabolismo , AMP Cíclico/farmacología
7.
J Periodontal Res ; 58(1): 155-164, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36451314

RESUMEN

BACKGROUNDS: Periodontitis is an oral-bacteria-directed disease that occurs worldwide. Currently, periodontal pathogens are mostly determined using traditional culture techniques, next-generation sequencing, and microbiological screening system. In addition to the well-known and cultivatable periodontal bacteria, we aimed to discover a novel periodontal pathogen by using DNA sequencing and investigate its role in the progression of periodontitis. OBJECTIVE: This study identified pathogens from subgingival dental plaque in patients with periodontitis by using the Oxford Nanopore Technology (ONT) third-generation sequencing system and validated the impact of selected pathogen in periodontitis progression by ligature-implanted mice. METHODS: Twenty-five patients with periodontitis and 25 healthy controls were recruited in this study. Subgingival plaque samples were collected for metagenomic analysis. The ONT third-generation sequencing system was used to confirm the dominant bacteria. A mouse model with ligature implantation and bacterial injection verified the pathogenesis of periodontitis. Neutrophil infiltration and osteoclast activity were evaluated using immunohistochemistry and tartrate-resistant acid phosphatase assays in periodontal tissue. Gingival inflammation was evaluated using pro-inflammatory cytokines in gingival crevicular fluids. Alveolar bone destruction in the mice was evaluated using micro-computed tomography and hematoxylin and eosin staining. RESULTS: Scardovia wiggsiae (S. wiggsiae) was dominant in the subgingival plaque of the patients with periodontitis. S. wiggsiae significantly deteriorated ligature-induced neutrophil infiltration, osteoclast activation, alveolar bone destruction, and the secretion of interleukin-6, monocyte chemoattractant protein-1, and tumor necrosis factor-α in the mouse model. CONCLUSION: Our metagenome results suggested that S. wiggsiae is a dominant flora in patients with periodontitis. In mice, the induction of neutrophil infiltration, proinflammatory cytokine secretion, osteoclast activation, and alveolar bone destruction further verified the pathogenic role of S. wiggsiae in the progress of periodontitis. Future studies investigating the metabolic interactions between S. wiggsiae and other periodontopathic bacteria are warranted.


Asunto(s)
Actinobacteria , Pérdida de Hueso Alveolar , Placa Dental , Periodontitis , Ratones , Animales , Microtomografía por Rayos X/efectos adversos , Pérdida de Hueso Alveolar/patología , Periodontitis/metabolismo , Bacterias , Placa Dental/complicaciones
8.
Arch Phys Med Rehabil ; 104(6): 950-964, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36574531

RESUMEN

OBJECTIVE: To explore the effects of dual task (DT) training on DT gait performance and cognitive function in individuals with Parkinson disease (PD) and to examine factors that might influence the effects of DT training. DATA SOURCES: PubMed, Wiley Online Library, Cochrane Library, CINAHL, and Medline were searched for articles published from January 2006 to December 2021. STUDY SELECTION: Randomized controlled trials comparing DT training with usual care or general exercise were included. DATA EXTRACTION: The outcomes studied were DT gait parameters including speed, step and stride length, cadence, step and stride time variability, dual-task cost on gait speed, and Trail Making Tests presented as standardized mean differences (SMDs). The Grading of Recommendations, Assessment, Development, and Evaluation was used to evaluate the quality of evidence. DATA SYNTHESIS: Ten randomized controlled trials with 466 participants were included in the meta-analysis. The included studies presented, in general, with a low to high risk of bias. Meta-analyses used a random-effects model for all analyses. The meta-analysis showed the DT training effects on DT gait speed (SMD=0.825, P=.012), DT step and stride length (SMD=0.400, P=.015), Trail Making Tests-part A (TMT-A; SMD=0.533, P=.010), and Trail Making Tests-part B (SMD=0.516, P=.012) compared with the control group. Only the effect on TMT-A was maintained at the follow-up assessment. The results of meta-regression showed that participants with slower initial single task gait speed improved more after DT training on DT step and stride length. CONCLUSIONS: The DT training improved more in DT gait speed with moderate-quality evidence as compared with usual care or conventional physical training in individuals with PD. The beneficial effects of DT training on DT step and stride length, attention, and executive function were also demonstrated in this meta-analysis. Furthermore, the improvement in the DT walking step and stride length was related to the participant's initial single task gait speed.


Asunto(s)
Enfermedad de Parkinson , Humanos , Marcha , Caminata , Cognición , Análisis y Desempeño de Tareas , Ensayos Clínicos Controlados Aleatorios como Asunto
9.
Oral Dis ; 29(2): 505-514, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34145953

RESUMEN

OBJECTIVES: This hospital-based cohort study evaluated whether ZNF582 and PAX1 methylation levels at baseline can be used as biomarkers to identify lesions with a high potential for malignant transformation in patients with normal mucosa and oral potentially malignant disorders. PATIENTS AND METHODS: We recruited 171 adult patients with normal mucosa and oral potentially malignant disorders in 2012-2014. They were followed until 2017. Outcomes, including advanced histopathological findings and oral cancer occurrence, were obtained from medical charts, the Taiwan Cancer Registry, and cause-of-death data. Kaplan-Meier analysis and Cox proportional hazards regression models were used to examine the association of ZNF582 and PAX1 methylation levels at baseline with subsequent outcome occurrences. RESULTS: After 260,192 days of follow-up, 11 cases of oral cancer and 4 cases of advanced histopathological progression occurred. Patients with higher ZNF582 and PAX1 methylation levels at baseline had a higher incidence of disease progression. After adjustment for all studied factors using Cox proportional hazards regression models, ZNF582m level (adjusted hazard ratio, 11.41; 95% CI, 2.05-63.36; p = 0.005) was the only significant and independent predictor of disease progression. CONCLUSIONS: ZNF582 hypermethylation can be an effective and noninvasive biomarker for identifying oral lesions with a high potential for malignant transformation.


Asunto(s)
Biomarcadores de Tumor , Neoplasias de la Boca , Adulto , Humanos , Pronóstico , Estudios de Cohortes , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Factores de Transcripción Paired Box/genética , Factores de Transcripción Paired Box/metabolismo , Factores de Transcripción de Tipo Kruppel/genética , Factores de Transcripción de Tipo Kruppel/metabolismo , Metilación de ADN , Neoplasias de la Boca/genética , Neoplasias de la Boca/patología , Progresión de la Enfermedad
10.
Oral Dis ; 28(1): 182-192, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33254278

RESUMEN

OBJECTIVES: The aim of this study was to find out the prognosis of medication-related osteonecrosis of the jaws (MRONJ) in prostate cancer patients who received two different types of antiresorptive agents for bone metastasis. MATERIALS AND METHODS: We retrospectively surveyed a cohort of 95 metastatic prostate cancer patients with 122 MRONJ lesions treated in a single medical center. Treatment outcomes and prognostic factors were investigated. The cumulative complete response rate was calculated with the Kaplan-Meier method, and significance was examined with the log-rank and Breslow tests. Cox regression was used for the univariate and multivariate analyses of prognostic factors. RESULTS: The cumulative complete response rate of all patients at 12 months was 37.8%, and that of patients treated with zoledronic acid and denosumab was 22.9% and 70.5%, respectively. Denosumab, pretreatment C-terminal telopeptide of collagen I (CTX) level > 150 pg/ml, and anemia were identified as independent prognostic factors in a multivariate analysis with adjusted hazard ratios of 3.18 (95% confidence interval [CI], 1.24-8.11), 3.24 (95% CI, 1.39-7.53), and 0.42 (95% CI, 0.19-0.93), respectively. CONCLUSION: A higher pretreatment level of CTX, using denosumab as the antiresorptive agent and without anemia, indicates a better treatment outcome of MRONJ in prostate cancer patients.


Asunto(s)
Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Osteonecrosis , Neoplasias de la Próstata , Conservadores de la Densidad Ósea/efectos adversos , Denosumab/efectos adversos , Difosfonatos , Humanos , Maxilares , Masculino , Pronóstico , Neoplasias de la Próstata/tratamiento farmacológico , Estudios Retrospectivos
11.
Oral Dis ; 28(6): 1484-1495, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33655573

RESUMEN

OBJECTIVES: The myeloid-derived suppressor cells (MDSCs) frequently have a high expansion in cancer patients. This research explored whether administration of ß-glucan could increase anti-tumor immunity in oral squamous cell carcinoma (OSCC) patients. MATERIALS AND METHODS: This study evaluated the MDSC level of circulating blood as CD33+ /CD11b+ /HLA-DR-/low by flow cytometry in 30 healthy donors (HDs, group I), in 48 oral squamous cell carcinoma (OSCC) patients before and after 14-day preoperative administration of ß-glucan (group II), and in 52 OSCC patients without taking ß-glucan (group III). RESULTS: A significantly higher mean MDSC level was observed in 100 OSCC patients than in 30 HDs (p < .001). There was a significant reduction of the mean MDSC level in group II patients after taking ß-glucan (p < .001). Moreover, we discovered a significantly higher recurrence-free survival (RFS) in group II than in group III patients (p = .026). Finally, the multivariate Cox regression further identified the MDSC level ≤1% and administration of ß-glucan as more favorable prognostic factors for OSCC patients. CONCLUSION: Preoperative administration of ß-glucan can augment anti-tumor immunity and increase RFS rate via subversion of suppressive function of MDSC in OSCC patients.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Células Supresoras de Origen Mieloide , beta-Glucanos , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/patología , Neoplasias de Cabeza y Cuello/patología , Humanos , Células Supresoras de Origen Mieloide/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , beta-Glucanos/farmacología , beta-Glucanos/uso terapéutico
12.
Geriatr Nurs ; 47: 273-279, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36057254

RESUMEN

With the aging population, the incidence of Parkinson's disease (PD) increases over time. In this study, a popular and interesting exercise called the square-stepping exercise (SSE) was chosen as an intervention for people with PD. The purpose of the study was to investigate the effects of SSE on cognitive function, especially executive function. Twenty-eight participants were recruited and randomly assigned to the experimental group (n=14) or the control group (n=14). The duration of the intervention for both groups was 8 weeks, twice a week. The outcomes, including the trail making test, the digit span task, the Montreal cognitive assessment, and the Parkinson's disease questionnaire, were evaluated before the intervention, after the intervention, and at 1-month follow-up. The results showed that executive function improved significantly on the digit span task after SSE training. Consequently, SSE could be an effective intervention to improve executive function in people with PD.


Asunto(s)
Función Ejecutiva , Enfermedad de Parkinson , Anciano , Cognición , Ejercicio Físico , Humanos , Pruebas Neuropsicológicas , Enfermedad de Parkinson/psicología , Proyectos Piloto
13.
BMC Geriatr ; 21(1): 36, 2021 01 09.
Artículo en Inglés | MEDLINE | ID: mdl-33421996

RESUMEN

BACKGROUND: Motoric cognitive risk syndrome (MCR) is defined by slow gait speed combined with subjective cognitive complaint. MCR is a predementia syndrome, similar to mild cognitive impairment (MCI). However, there is currently no study comparing the differences in cognitive performance and physical function between these two types of cognitive impairment. Thus, the aim of this study is to compare cognitive performance and physical function in individuals with MCR versus MCI. METHODS: A total of 77 participants, free of dementia, were recruited from the neurological outpatient clinic of a medical center in Taiwan. Participants were separated into 2 groups, MCR (n = 33) and MCI (n = 44) groups, based on definition criteria from previous studies. The priority was to assign a diagnosis of MCR first, followed by MCI. Hence, "pure" MCI had no overlap with MCR syndrome. Cognitive performance, including executive function, attention, working memory, episode memory, visuospatial function, and language, were measured. Physical functions such as activities in daily living, the Tinetti Assessment Scale, and the Timed Up and Go test were also measured. RESULTS: Executive function, attention, working memory, episodic memory and language were all significantly lower in the MCR group than the MCI group. Abilities related to physical function, including those measured by the Tinetti Assessment Scale and the Timed Up and Go test, were significantly lower in the MCR group than the MCI group. CONCLUSIONS: We noted that cognitive performance and physical function were lower in MCR individuals than MCI but without MCR syndrome. However, the conclusions were based on the enrollment procedure of participants prioritizes the MCR syndrome. Because of the overlap of MCR and MCI, future studies should use different enrollment strategies to further clarify the status of these two populations.


Asunto(s)
Disfunción Cognitiva , Equilibrio Postural , Cognición , Disfunción Cognitiva/diagnóstico , Marcha , Humanos , Pruebas Neuropsicológicas , Taiwán , Estudios de Tiempo y Movimiento
14.
J Formos Med Assoc ; 120(8): 1572-1580, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33309430

RESUMEN

BACKGROUND/PURPOSE: Anti-resorptive agents are commonly used in cancer patients with bone metastasis or multiple myeloma (MM). An adverse event termed medication-related osteonecrosis of the jaws (MRONJ) was discovered in patients using these agents but relatively little attention has been paid to its prognosis. Our aims were to find out the treatment outcomes and prognostic indicators of MRONJ in cancer patients who received zoledronic acid as antiresorptive therapy. METHODS: We retrospectively surveyed a cohort of 133 cancer patients who received zoledronic acid. A total of 150 MRONJ lesions were included for investigation. Cumulative complete response rate after treatment was calculated with the Kaplan-Meier method, and significance was examined with the log-rank tests. Cox regression was used for univariate and multivariate analyses of prognostic factors. RESULTS: The cumulative complete response rate of all patients at 24 months was 53.2%, and those of patients with MM, breast cancer and prostate cancer were 27.8%, 60.7% and 68.0%, respectively. Having MM was identified as an independent prognostic factor in a multivariate analysis with adjusted hazard ratios of 0.28 (95% confidence interval, 0.09-0.83). CONCLUSION: For cancer patients with ONJ related to zoledronic acid, patients with MM endure a worse treatment outcome.


Asunto(s)
Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Neoplasias Óseas , Osteonecrosis , Osteonecrosis de los Maxilares Asociada a Difosfonatos/epidemiología , Conservadores de la Densidad Ósea/efectos adversos , Neoplasias Óseas/tratamiento farmacológico , Difosfonatos/efectos adversos , Humanos , Maxilares , Masculino , Pronóstico , Estudios Retrospectivos , Ácido Zoledrónico/efectos adversos
15.
J Immunol ; 199(2): 467-476, 2017 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-28600287

RESUMEN

Human oral squamous cell carcinoma (OSCC) constitutes an inflammatory microenvironment enriched with chemokines such as CCL20, which promote cancer cell invasion and tumor progression. We found that in OSCC there is a correlation between the expression of CCL20 and FOXP3 mRNA. Therefore, we hypothesized that OSCC may favor the recruitment and retention of regulatory T (Treg) cells that express the CCL20 receptor, CCR6. Interestingly, most (∼60%) peripheral blood Treg cells express CCR6, and CCR6+ Treg cells exhibit an activated effector/memory phenotype. In contrast, a significant portion (>30%) of CCR6- Treg cells were found to be CD45RA+ naive Treg cells. Compared to CCR6- naive or memory Treg cells, CCR6+ Treg cells exhibit stronger suppressive activity and display higher FOXP3 expression along with lower methylation at the Treg-specific demethylated region of the FOXP3 gene. This predominance of CCR6+ Treg cells was also found in the draining lymph nodes and tumor-infiltrating lymphocytes of OSCC patients with early or late clinical staging. Moreover, CCR6+ Treg cells isolated from tumor-infiltrating lymphocytes or draining lymph nodes maintained similar phenotypic and suppressive characteristics ex vivo as did their counterparts isolated from peripheral blood. These results suggest that CCR6 marks activated effector or memory Treg phenotypes with superior suppressive activity in humans.


Asunto(s)
Carcinoma de Células Escamosas/inmunología , Neoplasias de la Boca/inmunología , Receptores CCR6/inmunología , Linfocitos T Reguladores/inmunología , Adulto , Carcinoma de Células Escamosas/patología , Quimiocina CCL20/genética , Quimiocina CCL20/inmunología , Femenino , Factores de Transcripción Forkhead/genética , Factores de Transcripción Forkhead/inmunología , Humanos , Memoria Inmunológica , Antígenos Comunes de Leucocito/genética , Antígenos Comunes de Leucocito/inmunología , Ganglios Linfáticos/citología , Ganglios Linfáticos/inmunología , Linfocitos Infiltrantes de Tumor/inmunología , Masculino , Metilación , Persona de Mediana Edad , Receptores CCR6/deficiencia , Receptores CCR6/genética , Linfocitos T Reguladores/fisiología
16.
J Formos Med Assoc ; 118(9): 1299-1307, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31202497

RESUMEN

BACKGROUND/PURPOSE: Our previous studies found relatively higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with different types of oral mucosal diseases. This study evaluated whether patients with oral precancerous lesions (oral precancer patients) had significantly higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects. METHODS: The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects were measured and compared. RESULTS: We found significantly lower mean serum iron (for women only), vitamin B12, and folic acid levels and a significantly higher mean serum homocysteine level in oral precancer patients than in healthy control subjects (all P-values < 0.05). Moreover, 131 oral precancer patients had significantly higher frequencies of blood hemoglobin (3.1%), vitamin B12 (43.5%), and folic acid (46.6%) deficiencies and hyperhomocysteinemia (22.1%) than 131 healthy control subjects (all P-values < 0.05). Of 131 oral precancer patients, lower mean serum folic acid levels were found in 87 cigarette smokers than in 44 non-smokers (P = 0.002), in 26 smokers consuming > 20 cigarettes per day than in 61 smokers consuming ≤ 20 cigarettes per day (P = 0.024), and in 52 betel quid chewers than in 79 non-chewers (P = 0.051). CONCLUSION: There are significantly higher frequencies of anemia, serum vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in oral precancer patients than in healthy control subjects.


Asunto(s)
Autoanticuerpos/sangre , Hiperhomocisteinemia/sangre , Leucoplasia Bucal/sangre , Enfermedades de la Boca/sangre , Adulto , Anciano , Anemia/etiología , Estudios de Casos y Controles , Índices de Eritrocitos , Femenino , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/sangre , Hematínicos , Hemoglobinas/análisis , Humanos , Hierro/sangre , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patología , Células Parietales Gástricas/inmunología , Factores Sexuales , Taiwán , Vitamina B 12/sangre , Deficiencia de Vitamina B 12/sangre
17.
J Formos Med Assoc ; 118(10): 1393-1400, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31200999

RESUMEN

BACKGROUND/PURPOSE: Gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) may be present in oral mucosal disease patients. This study mainly assessed the frequencies of serum GPCA, TGA, and TMA positivities in 131 oral precancer patients. METHODS: Serum GPCA, TGA, and TMA levels were measured in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects. RESULTS: We found that 131 oral precancer patients had higher frequencies of serum GPCA (10.7% vs. 2.3%, P = 0.012, statistically significant), TGA (4.6% vs. 2.3%, P = 0.498), and TMA (8.4% vs. 2.3%, P = 0.054, marginal significance) positivities than 131 healthy control subjects. We also found that 1 (0.8%), 6 (4.6%), and 16 (12.2%) oral precancer patients had the presence of three (GPCA + TGA + TMA), two (GPCA + TGA, GPCA + TMA, or TGA + TMA), or one (GPCA only, TGA only, or TMA only) autoantibody in their sera, respectively. Of 10 TGA/TMA-positive oral precancer patients whose serum thyroid-stimulating hormone (TSH) levels were measured, 80%, 10%, and 10% of these 10 TGA/TMA-positive oral precancer patients had normal, lower, and higher serum TSH levels, respectively. We also found a significantly higher GPCA positive rate in 26 smokers consuming >20 cigarettes per day than in 61 smokers consuming ≤20 cigarettes per day (P = 0.008). CONCLUSION: Approximately 17.6% of 131 oral precancer patients have serum GPCA/TGA/TMA positivity. Only approximately 20% of TGA/TMA-positive oral precancer patients have either hypothyroidism or hyperthyroidism.


Asunto(s)
Autoanticuerpos/sangre , Leucoplasia Bucal/sangre , Mucosa Bucal/patología , Neoplasias de la Boca/sangre , Células Parietales Gástricas/inmunología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Hiperplasia/sangre , Hiperplasia/inmunología , Leucoplasia Bucal/inmunología , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/inmunología , Fumar/sangre , Tirotropina/sangre
18.
J Formos Med Assoc ; 118(12): 1616-1622, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31377113

RESUMEN

BACKGROUND/PURPOSE: Oral cancer patients who survive for more than 5 years are supposed to have a reduced local cancer recurrence rate and survive longer. This study evaluated whether oral cancer patients who survived for more than 5 years might have reduced rates of local cancer recurrence, development of the second or third primary oral cancer, or the late regional cervical lymph node metastasis. METHODS: This study analyzed the clinical outcomes of 127 oral cancer patients (101 men and 26 women; mean age, 50.8 ± 12.1 years) who survived for more than 5 years after proper treatments of the initial primary oral cancers. RESULTS: The 127 primary oral cancers included 117 squamous cell carcinomas (SCCs), 7 mucoepidermoid carcinomas, and 3 others. Of the 127 oral cancer patients who survived for more than 5 years, 47 survived for 5-9 years, 45 for 10-14 years, 22 for 15-19 years, 10 for 20-24 years, two for 25-29 years, and one for 30 years. Ten patients had local cancer recurrence 5.4 years-13.7 years, 12 patients had a second or a third primary oral cancer 3.6 years-17.2 years, and one mucoepidermoid carcinoma patient had a late regional cervical lymph node metastasis 11.9 years after total excision of the initial primary oral cancers. CONCLUSION: Oral cancer patients who survive for more than 5 years may still have local cancer recurrence, the second or third primary oral cancer, or the late regional cervical lymph node metastasis but with a reduced rate.


Asunto(s)
Carcinoma Mucoepidermoide/mortalidad , Carcinoma de Células Escamosas/mortalidad , Neoplasias de la Boca/mortalidad , Recurrencia Local de Neoplasia/mortalidad , Neoplasias Primarias Secundarias/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/cirugía , Estadificación de Neoplasias , Tasa de Supervivencia , Taiwán , Factores de Tiempo , Adulto Joven
19.
BMC Neurol ; 17(1): 186, 2017 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-28923025

RESUMEN

BACKGROUND: Frontotemporal degeneration (FTD) is a clinically and genetically heterogeneous neurodegenerative disorder characterized by deficits in executive function that frequently overlaps with parkinsonism and motor neuron disorders. Several genes have been identified to cause autosomal dominant forms of FTD, including the gene coding for the protein associated with microtubule tau (MAPT). While most reported pathogenic mutations in MAPT occur in exons 9-13, few families have been reported with mutations outside of this region. Herein, we report a first Taiwanese family having the exon 1 p.Arg5His mutation in MAPT with intrafamilial phenotype heterogeneity. CASE PRESENTATION: A 63-year-old man presented with progressive non-fluent speech and impaired memory for 3 years. He then developed apraxia, myoclonus and parkinsonism feature at his right hand. Extensive neurologic and neurocognitive examination lead to a diagnosis of FTD mixed with corticobasal syndrome. Magnetic resonance imaging revealed asymmetric atrophy in the left frontal and temporal lobes and single-photon emission computed tomography indicated decreased metabolism in the same areas as well as the left basal ganglia. The patient's mother had been diagnosed with amyotrophic lateral sclerosis (ALS) at the age of 60 and was deceased 10 years later due to respiratory failure. The patient's younger sister had persistent depressive disorder in her early forties and did not have any prominent cognitive or motor dysfunctions. We performed genetic analysis applying a targeted next generation sequencing (NGS) panel covering MAPT, GRN, VCP, FUS, CHMP2B, and TARDBP on the proband, followed by Sanger sequencing of candidate genes in eight family members. Hexanucleotide repeat expansion of C9Orf72 was determined by repeat-primed PCR. We identified a missense mutation in exon 1 of MAPT gene, c.14G > A (p.R5H), which was previously reported in only two Japanese patients in a literature review. This substitution co-segregated with the disease phenotypes in the family. CONCLUSIONS: This is the first report of the occurrence of the MAPT p.R5H mutation in the Taiwanese population. Our findings extend the current knowledge of phenotypic heterogeneity among family members carrying the MAPT p.R5H mutation.


Asunto(s)
Demencia Frontotemporal/patología , Proteínas tau/genética , Esclerosis Amiotrófica Lateral/patología , Pueblo Asiatico , Atrofia/patología , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedad de la Neurona Motora/patología , Mutación , Trastornos Parkinsonianos/patología , Lóbulo Temporal/patología , Tomografía Computarizada de Emisión de Fotón Único
20.
J Formos Med Assoc ; 116(10): 798-805, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28755796

RESUMEN

BACKGROUND/PURPOSE: Langerhans cells (LCs) are antigen-presenting cells. This study assessed the LC counts in odontogenic keratocysts (OKCs). METHODS: The LC numbers in the lining epithelia and subepithelial connective tissues were counted at 60 OKC sites without inflammation, 39 OKC sites with mild/moderate inflammation, and 13 OKC sites with severe inflammation from 60 OKC specimens immunostained with anti-S100 antibodies. RESULTS: The mean LC counts in the lining epithelia and subepithelial connective tissues increased significantly from no inflammation (0.5 ± 0.4 and 0.7 ± 0.6 cell/high-power field or HPF, respectively) through mild/moderate inflammation (5.9 ± 2.7 and 5.0 ± 3.5 cells/HPF, respectively) to severe inflammation OKC sites (14.7 ± 5.3 and 13.3 ± 6.8 cells/HPF, respectively; all P-values < 0.001). OKC sites with inflammation had thicker lining epithelia than those without inflammation. Moreover, the mean LC counts in the lining epithelia and subepithelial connective tissues of OKCs were significantly higher in the thicker lining epithelium (>100 µm) group (7.7 ± 5.6 and 6.5 ± 5.8 cells/HPF, respectively) than in the thinner lining epithelium (≦ 100 µm) group (1.0 ± 2.0 and 1.4 ± 2.6 cells/HPF, respectively; both P-values < 0.001). CONCLUSION: A significant association of inflammation grade with the number of LCs in OKCs is found. The paucity of finding LCs in the lining epithelia of OKCs without inflammation indicates the loss of immunosurveillance ability against the OKC lining epithelial cells; this can explain why OKCs have aggressive clinical behavior, a great growth potential, and a high recurrence rate.


Asunto(s)
Inflamación/complicaciones , Células de Langerhans/citología , Quistes Odontogénicos/patología , Tumores Odontogénicos/patología , Adolescente , Adulto , Anciano , Niño , Epitelio/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Monitorización Inmunológica , Recurrencia Local de Neoplasia , Proteínas S100/metabolismo , Adulto Joven
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