[HPV-related oropharyngeal squamous cell carcinoma-Incidence steadily rising]. / Das HPV-positive Oropharynxkarzinom ­ eine Entität mit steigender Inzidenz.

The incidence of human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is steadily increasing worldwide and has already exceeded cervical cancer rates in the USA. Due to their tumor biology, HPV-positive tumors of the oropharynx, which have been included in the eighth edition of the AJCC/UICC (American Joint Committee on Cancer/Union Internationale Contre le Cancer) Staging Manual since 2018, represent a separate entity. Following biopsy, diagnostic confirmation is performed by immunohistochemical detection of p16 expression, with p16 acting as a surrogate marker. Therapeutically, surgical and radiotherapeutic approaches are considered equivalent in terms of efficacy. With a 5-year overall survival of up to 80%, patients with HPV-positive OPSCC have a better prognosis compared to patients with HPV-negative OPSCC, where survival rates are between 40 and 50%.

[Update on HPV-associated head and neck cancer-highlights from the 2019 ASCO Annual Meeting]. / Update zu HPV-assoziierten Kopf-Hals-Karzinomen ­ Highlights der ASCO-Jahrestagung 2019.

At this year's Annual Meeting of the American Society for Clinical Oncology (ASCO), the keyword search "HPV-associated head and neck cancer" resulted in 920 hits-74% of the hits on human papillomavirus (HPV). This underlines the relevance of the topic. The spectrum ranged from validation and separation of the prognostic groups of patients with HPV-associated oropharyngeal carcinoma (OPSCC) according to TNM 8, to the characterization of new tumor markers and tumor mutational burden for possible de-escalation strategies to avoid toxicity of standard multimodal treatments. It has been shown that the separation of p16-positive OPSCC into Union for International Cancer Control (UICC) stages I and II with the current TNM 8 classification without further markers is not sufficiently successful to justify de-escalation strategies. Following publication of the results of the De-ESCALaTE- and RTOG-1016 trials in 2018, which confirm the current standard of care for p16-positive OPSCC, no further phase III studies on de-escalation were presented. In a presented prospective phase II study (NCT02281955), the radiotherapy dose was reduced to cumulative 60 Gy, whereby the simultaneous chemotherapy regimen with cisplatin 30 mg/m2 weekly is not standard of care and could be administered as an alternative to cisplatin cetuximab. Some work dealt with the oral and intestinal microbiota as prognostic markers or their treatment-related changes, particularly under immunotherapy. Modification seems to have a positive impact on the success of therapy. However, robust data are still lacking for the various modified treatments for HPV-associated OPSCC, which are needed before their implementation in daily practice.

Real-time implementation of Kalman filter to improve accuracy in the measurement of time of flight in an ultrasonic pulse-echo setup.

In this paper, we demonstrate a hardware implementation of Kalman filter to enhance accuracy in the measurements of time-of-flight in an ultrasonic pulse echo technique (operated at 10 MHz). Pulser-receivers and other respective circuit units are designed using off-the-shelf electronic components. The advanced reduced instruction-set computing machine processor based Raspberry Pi single board computer is used to implement the Kalman filter and control various processes. Additionally, a graphical user interface is designed using Qt software, under the Debian open source operating system. The software has capability to measure and display the time-of-flight and ultrasonic propagation velocity in a liquid under test. The designed system with the Kalman filter exhibited an extremely small error of about 0.01% in the time-of-flight measurements compared with other systems. The functionality of the developed approach to measure time of flight and thereby ultrasonic velocity with significant improvement has been discussed in this article. It was experimentally verified that by improving other parameters such as the separation between the transducer and the reflector and cell structure, significant improvement in the accuracy of ultrasonic velocity in the liquid under test is achieved.

[HPV-associated oropharyngeal cancer-incidence, trends, diagnosis, and treatment]. / Das HPV-getriebene Oropharynxkarzinom ­ Inzidenz, Trends, Diagnose und Therapie.

A rising incidence of oropharyngeal squamous cell carcinoma (OPSCC) is reported by many countries worldwide and OPSCC associated with human papillomavirus (HPV) has been recently defined as a new class of head and neck cancers. Besides tobacco and alcohol consumption, HPV is an accepted risk and prognostic factor for OPSCC. Although the incidence increase of HPV-associated OPSCC is convincing, cancer registry studies and studies based on cohorts often have drawbacks regarding data linkage to comparable experimental data, comparable anatomical definitions or HPV diagnostics. Patients with HPV-associated OPSCC have remarkably better prognosis and the tumors differ from HPV-negative OPSCC with respect to molecular and genetic aspects. Nevertheless, choice of therapy is independent of HPV, and rather is subject to the individual patient's condition, local preference and anatomic characteristics. New concepts emerge in immune-checkpoint oncology, which might be a valuable add-on to established concepts. Also, treatment de-escalation (e.g., by reduction of radiation dosage) might be suitable for patients with certain risk profiles. Prophylactic vaccination can contribute to reducing HPV-induced disease, likewise OPSCC. Prerequisite is a high rate of vaccination, which is currently not sufficient in Germany. Because of currently low vaccination rates and the rather long time between initial infection and HPV-induced carcinogenesis, reduction of incidence increase or prevalence of HPV-associated OPSCC is not expected in the near future.

[Update on HPV-associated head and neck cancer-highlights of the 2018 ASCO Annual Meeting]. / Update zu HPV-assoziierten Kopf-Hals-Karzinomen ­ Highlights der ASCO-Jahrestagung 2018.

Rising incidence rates in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) and a significantly improved prognosis have brought this entity into scientific focus. At this year's American Society of Clinical Oncology (ASCO) Annual Meeting, 291 studies with the keyword "HPV" were presented, the majority of which were in head and neck cancer. Due to high rates of late toxicities after conventional therapy, de-intensified treatment concepts are being increasingly discussed, although data from prospective phase III studies were not presented. Retrospective data on the latest TNM staging (downstaging in many HPV-associated patients) and other risk stratification systems were presented. HPV diagnostics based solely on p16 immunohistochemistry were discussed. Many groups presented work on the HPV association and its prognostic relevance not only in oropharyngeal carcinoma, but also in oral cavity, hypopharyngeal, and locally advanced laryngeal squamous cell carcinoma. New prognostic biomarkers such as methylation signatures appear to be promising. New data suggest equal survival rates in HPV-associated stage I OPSCC treated with surgery alone in comparison to patients who received adjuvant therapy after surgery. A possible negative effect on overall survival in stage III HPV-associated OPSCC with a cisplatin dose ≤200 mg/m2 was discussed. Results of de-escalation studies are urgently awaited, in order to be able to treat HPV-associated OPSCC patients as precisely and as specifically as possible and ensure long-term quality of life.

[Human papillomavirus and squamous cell cancer of the head and neck region : Prognostic, therapeutic and prophylactic implications]. / Humane Papillomviren bei Plattenepithelkarzinomen der Kopf- und Halsregion : Relevanz für Prognose, Therapie und Prophylaxe.

Human papilloma viruses (HPV) are responsible for approximately half of all oropharyngeal squamous cell carcinomas (OPSCC) and incidence rates of HPV-associated OPSCC continue to increase substantially. The defined viral carcinogenesis permits development of specific diagnostic, therapeutic, and prophylactic approaches. Laboratory identification of HPV-associated OPSCC may be achieved by p16(INK4a) immunohistochemistry combined with HPV DNA detection by polymerase chain reaction (PCR) using tumor tissue. Patients with HPV-associated OPSCC have a relatively good prognosis; therefore, the HPV status plays an important role in patient guidance. Due to the relatively favorable prognosis, ongoing studies are evaluating whether less rigorous therapy for HPV-positive patients results in equally good cure rates. The criteria for patient selection are, however, still uncertain. Particularly markers for detection of HPV-positive patients with a high risk of treatment failure are lacking. Besides tumor stage and comorbidities, distinct genomic, epigenetic, and immunologic alterations are prognostically relevant for HPV-associated OPSCC, and might be of predictive value. Furthermore, the characteristic molecular alterations suggest the possibility of novel vigilant and specific therapy approaches. These may be inhibitors of the phosphatidylinositol 3­kinase (PI3K) pathway, which is frequently activated in HPV-associated OPSCC, and immunotherapeutic methods, e. g., therapeutic vaccination. Although prophylactic HPV vaccinations may also prevent development of HPV-associated OPSCC, foreseeable effects on OPSCC incidence will be low, given the low vaccination rates in Germany. This highlights the fact that interdisciplinary research networks should enhance the necessary activities related to HPV-associated OPSCC.

[Spontaneous bone regeneration following ceratocystic odontogenic tumor]. / Spontane Knochenregeneration nach keratozystischem odontogenem Tumor.

A patient presents with a keratocystic odontogenic tumour of the left maxillary sinus. In computed tomography scans, extensive pressure-induced osseous atrophy of the sinus walls is detected. Endoscopic cystectomy of the tumour was performed, with subsequent clinical follow-up. A second computed tomography scan revealed almost complete regeneration of the sinus walls. Where spontaneous regeneration of osseous structures is possible, restraint should be exercised when assessing indications for bony reconstruction during initial conservative surgery such as enucleation.

[Current practice of tumour endoscopy in German ENT-clinics]. / Praxis der Tumorendoskopie an deutschen HNO-Kliniken.

BACKGROUND: Second primary carcinomas (SPC) essentially influence therapy and the outcome in head and neck cancer. This study presents the current status of tumour endoscopy in German ENT-clinics. MATERIAL AND METHODS: A standardised questionnaire regarding indication, time of event, examined anatomical region and technique of tumour endoscopy was compiled, sent to all German ENT-clinics (n=159) and subsequently analysed. RESULTS: In 94-100% of the clinics, tumour endoscopy is being conducted when primary carcinoma lies within oral cavity, pharynx, larynx or is a CUP-syndrome. In 80%, 2-stage surgical procedure is preferred. Nasal cavity and tracheobronchial system (47%, 74%) are often not included in the examination. When primary cancer is seen, in 7% of the clinics a standardised biopsy of unsuspicious anatomic areas is conducted. In CUP-syndrome, unsuspicious surfaces within the pharynx do not undergo routine biopsy in 10-20% of the clinics. In tracheobronchoscopy (63.0%) and esophagoscopy (93.3%) rigid scopes are mainly used. 65% of the clinics conduct endoscopy as follow-up care. CONCLUSION: Practice of tumour endoscopy in German ENT-clinics is widespread but does not follow standardised mechanisms. Current international literature shows that there is no common consensus on value and techniques of tumour endoscopy, however, due to highly developed radiological diagnostics, risks of rigid endoscopies and unknown incidence of second primary tumours it is discussed more and more negative. To establish future guidelines, controlled studies or analysis of large populations seem to be necessary.

Re-dispersible Li+ and Eu3+ co-doped nanocrystalline ZnO: luminescence and EPR studies.

Nano-crystals of ZnO, Eu3+ doped ZnO, and Li+, Eu3+ co-doped ZnO have been prepared by urea hydrolysis in ethylene glycol medium at 150 degrees C. Ethylene glycol acts as capping agent for nanoparticles. Three colors 437 (blue), 540 (green) and 615 nm (red) from 2 at.% Li+ and 5 at.% Eu3+ co-doped ZnO have been observed from luminescence studies compared to that from 5 at.%. Eu3+ doped ZnO, which shows emission at 437 and 615 nm. It is established that green light is originated from the oxygen vacancy brought by Li+ incorporation into ZnO. Particles are redispersible in organic solvent such as ethanol, and are able to incorporate into polymer-based material such as SiO2 matrix.

Measurement of ultrasonic velocity with improved accuracy in pulse echo setup.

In the present work a personal computer based circuit adopted in pulseecho setup has been developed for the measurement of time-of-flight between the two successive echoes using a differential time measurement with a 16 bit counter and an external clock frequency of 32 MHz. A control program is developed in C to display the time of flight and wave propagation velocity on a user screen. The technique, so developed, minimizes the errors in time delay measurements due to the variation in threshold trigger points of echoes and improves the ultrasonic velocity measurement.

An evaluation of three methods of polishing porcelain by comparison of surface topography with the original glaze.

The value of a procedure for polishing porcelain restorations that would avoid the necessity of glazing in a furnace following minor chairside adjustments is discussed. The efficacy of three polishing systems--a diamond paste, a pumice and water slurry followed by whiting, and a proprietary method--were tested in the laboratory using surface profile recording. The results showed that both the diamond paste and the pumice/whiting gave surface finishes similar to the original glazed surface. The smoothest surface was produced by the diamond paste. The proprietary porcelain finishing kit created the least smooth surface.