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1.
Toxicol Lett ; 387: 35-49, 2023 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-37774809

RESUMEN

Despite increasing use of in vitro models that closely resemble in vivo human biology, their application in understanding downstream effects of airway toxicity, such as inflammation, are at an early stage. In this study, we used various assays to examine the inflammatory response induced in MucilAir™ tissues and A549 cells exposed to three products known to induce toxicity. Reduced barrier integrity was observed in tissues following exposure to each product, with reduced viability and increased cytotoxicity also shown. Similar changes in viability were also observed in A549 cells. Furthermore, whole cigarette smoke (CS) induced downstream phenotypic THP-1 changes and endothelial cell adhesion, an early marker of atherosclerosis. In contrast, exposure to next-generation delivery product (NGP) aerosol did not induce this response. Cytokine, histological and RNA analysis highlighted increased biomarkers linked to inflammatory pathways and immune cell differentiation following exposure to whole cigarette smoke, including GM-CSF, IL-1ß, cleaved caspase-3 and cytochrome P450 enzymes. As a result of similar observations in human airway inflammation, we propose that our exposure platform could act as a representative model for studying such events in vitro. Furthermore, this model could be used to test the inflammatory or anti-inflammatory impact posed by inhaled compounds delivered to the lung.


Asunto(s)
Fumar Cigarrillos , Productos de Tabaco , Humanos , Nicotina/análisis , Fumar Cigarrillos/efectos adversos , Pulmón , Nicotiana/toxicidad , Productos de Tabaco/toxicidad , Productos de Tabaco/análisis , Inflamación/inducido químicamente , Inflamación/patología
2.
Psychol Med ; 53(16): 7707-7719, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37381780

RESUMEN

BACKGROUND: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.


Asunto(s)
Trastorno Autístico , Problema de Conducta , Preescolar , Humanos , Niño , Masculino , Femenino , Emociones , Padres , Atención
3.
Mol Autism ; 14(1): 6, 2023 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-36765403

RESUMEN

BACKGROUND: There is emerging evidence that the neuroanatomy of autism forms a spectrum which extends into the general population. However, whilst several studies have identified cortical morphology correlates of autistic traits, it is not established whether morphological differences are present in the subcortical structures of the brain. Additionally, it is not clear to what extent previously reported structural associations may be confounded by co-occurring psychopathology. To address these questions, we utilised neuroimaging data from the Adolescent Brain Cognitive Development Study to assess whether a measure of autistic traits was associated with differences in child subcortical morphology, and if any observed differences persisted after adjustment for child internalising and externalising symptoms. METHODS: Our analyses included data from 7005 children aged 9-10 years (female: 47.19%) participating in the Adolescent Brain Cognitive Development Study. Autistic traits were assessed using scores from the Social Responsiveness Scale (SRS). Volumes of subcortical regions of interest were derived from structural magnetic resonance imaging data. RESULTS: Overall, we did not find strong evidence for an association of autistic traits with differences in subcortical morphology in this sample of school-aged children. Whilst lower absolute volumes of the nucleus accumbens and putamen were associated with higher scores of autistic traits, these differences did not persist once a global measure of brain size was accounted for. LIMITATIONS: It is important to note that autistic traits were assessed using the SRS, of which higher scores are associated with general behavioural problems, and therefore may not be wholly indicative of autism-specific symptoms. In addition, individuals with a moderate or severe autism diagnosis were excluded from the ABCD study, and thus, the average level of autistic traits will be lower than in the general population which may bias findings towards the null. CONCLUSIONS: These findings from our well-powered study suggest that other metrics of brain morphology, such as cortical morphology or shape-based phenotypes, may be stronger candidates to prioritise when attempting to identify robust neuromarkers of autistic traits.


Asunto(s)
Trastorno Autístico , Humanos , Niño , Femenino , Trastorno Autístico/diagnóstico por imagen , Neuroimagen , Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética , Núcleo Accumbens
4.
bioRxiv ; 2023 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-38187655

RESUMEN

Bioelectrical signaling, intercellular communication facilitated by membrane potential and electrochemical coupling, is emerging as a key regulator of animal development. Gap junction (GJ) channels can mediate bioelectric signaling by creating a fast, direct pathway between cells for the movement of ions and other small molecules. In vertebrates, GJ channels are formed by a highly conserved transmembrane protein family called the Connexins. The connexin gene family is large and complex, presenting a challenge in identifying the specific Connexins that create channels within developing and mature tissues. Using the embryonic zebrafish neuromuscular system as a model, we identify a connexin conserved across vertebrate lineages, gjd4, which encodes the Cx46.8 protein, that mediates bioelectric signaling required for appropriate slow muscle development and function. Through a combination of mutant analysis and in vivo imaging we show that gjd4/Cx46.8 creates GJ channels specifically in developing slow muscle cells. Using genetics, pharmacology, and calcium imaging we find that spinal cord generated neural activity is transmitted to developing slow muscle cells and synchronized activity spreads via gjd4/Cx46.8 GJ channels. Finally, we show that bioelectrical signal propagation within the developing neuromuscular system is required for appropriate myofiber organization, and that disruption leads to defects in behavior. Our work reveals the molecular basis for GJ communication among developing muscle cells and reveals how perturbations to bioelectric signaling in the neuromuscular system_may contribute to developmental myopathies. Moreover, this work underscores a critical motif of signal propagation between organ systems and highlights the pivotal role played by GJ communication in coordinating bioelectric signaling during development.

5.
Toxicol In Vitro ; 79: 105299, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34920082

RESUMEN

Animals have been indispensable in testing chemicals that can pose a risk to human health, including those delivered by inhalation. In recent years, the combination of societal debate on the use of animals in research and testing, the drive to continually enhance testing methodologies, and technology advancements have prompted a range of initiatives to develop non-animal alternative approaches for toxicity testing. In this review, we discuss emerging in vitro techniques being developed for the testing of inhaled compounds. Advanced tissue models that are able to recreate the human response to toxic exposures alongside examples of their ability to complement in vivo techniques are described. Furthermore, technology being developed that can provide multi-organ toxicity assessments are discussed.


Asunto(s)
Técnicas In Vitro , Exposición por Inhalación , Pruebas de Toxicidad/métodos , Línea Celular , Humanos
6.
Mol Autism ; 12(1): 57, 2021 08 14.
Artículo en Inglés | MEDLINE | ID: mdl-34391468

RESUMEN

BACKGROUND: Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. METHODS: The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years. RESULTS: The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age. LIMITATIONS: The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children. CONCLUSIONS: These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Trastorno del Espectro Autista/diagnóstico , Niño , Cognición , Humanos , Pruebas de Inteligencia , Estudios Longitudinales
7.
Dev Cogn Neurosci ; 29: 4-10, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-27769716

RESUMEN

An enhanced ability to detect visual targets amongst distractors, known as visual search (VS), has often been documented in Autism Spectrum Disorders (ASD). Yet, it is unclear when this behaviour emerges in development and if it is specific to ASD. We followed up infants at high and low familial risk for ASD to investigate how early VS abilities links to later ASD diagnosis, the potential underlying mechanisms of this association and the specificity of superior VS to ASD. Clinical diagnosis of ASD as well as dimensional measures of ASD, attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms were ascertained at 3 years. At 9 and 15 months, but not at age 2 years, high-risk children who later met clinical criteria for ASD (HR-ASD) had better VS performance than those without later diagnosis and low-risk controls. Although HR-ASD children were also more attentive to the task at 9 months, this did not explain search performance. Superior VS specifically predicted 3 year-old ASD but not ADHD or anxiety symptoms. Our results demonstrate that atypical perception and core ASD symptoms of social interaction and communication are closely and selectively associated during early development, and suggest causal links between perceptual and social features of ASD.


Asunto(s)
Atención/fisiología , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/fisiopatología , Visión Ocular/fisiología , Ansiedad/diagnóstico , Ansiedad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Preescolar , Femenino , Humanos , Lactante , Masculino , Riesgo
8.
Biophys Rev ; 9(4): 299-308, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28752365

RESUMEN

Antibodies have been indispensable tools in molecular biology, biochemistry and medical research. However, a number of issues surrounding validation, specificity and batch variation of commercially available antibodies have prompted research groups to develop novel non-antibody binding reagents. The ability to select highly specific monoclonal non-antibody binding proteins without the need for animals, the ease of production and the ability to site-directly label has enabled a wide variety of applications to be tested, including imaging. In this review, we discuss the success of a number of non-antibody reagents in imaging applications, including the recently reported Affimer.

9.
Dev Cogn Neurosci ; 26: 84-90, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28654838

RESUMEN

Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are associated with varied executive function (EF) difficulties. Callous-unemotional (CU) traits, a proposed antecedent of adult psychopathy, are often associated with intact or enhanced EF. Here we test whether CU traits may therefore modulate EF in ASD and ADHD, in which EF is typically impaired. We collected CU traits and measured event-related potentials (ERPs) that index EF during a cued-continuous performance test (CPT-OX) in boys with ASD, ADHD, comorbid ASD+ADHD and typical controls. We examined attentional orienting at cues (Cue-P3), inhibitory processing at non-targets (NoGo-P3) and conflict monitoring between target and non-target trials (Go-N2 vs. NoGo-N2). In children with ASD, higher CU traits were associated with an enhanced increase in N2 amplitude in NoGo trials compared to Go trials, which suggests relatively superior conflict monitoring and a potential cognitive strength associated with CU traits. The results emphasise the importance of considering the effects of co-occurring traits in the assessment of heterogeneity of EF profiles in neurodevelopmental disorders.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno del Espectro Autista/fisiopatología , Función Ejecutiva/fisiología , Adolescente , Niño , Potenciales Evocados , Femenino , Humanos , Masculino , Proyectos Piloto
10.
Eur Child Adolesc Psychiatry ; 26(8): 947-956, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28247068

RESUMEN

While some children with callous unemotional (CU) behaviours show difficulty recognizing emotional expressions, the underlying developmental pathways are not well understood. Reduced infant attention to the caregiver's face and a lack of sensitive parenting have previously been associated with emerging CU features. The current study examined whether facial emotion recognition mediates the association between infants' mother-directed gaze, maternal sensitivity, and later CU behaviours. Participants were 206 full-term infants and their families from a prospective longitudinal study, the Durham Child Health and Development Study (DCHDS). Measures of infants' mother-directed gaze, and maternal sensitivity were collected at 6 months, facial emotion recognition performance at 6 years, and CU behaviours at 7 years. A path analysis showed a significant effect of emotion recognition predicting CU behaviours (ß = -0.275, S.E. = 0.084, p = 0.001). While the main effects of infants' mother-directed gaze and maternal sensitivity were not significant, their interaction significantly predicted CU behaviours (ß = 0.194, S.E. = 0.081, p = 0.016) with region of significance analysis showing a significant negative relationship between infant gaze and later CU behaviours only for those with low maternal sensitivity. There were no indirect effects of infants' mother-directed gaze, maternal sensitivity or the mother-directed gaze by maternal sensitivity interaction via emotion recognition. Emotion recognition appears to act as an independent predictor of CU behaviours, rather than mediating the relationship between infants' mother-directed gaze and maternal sensitivity with later CU behaviours. This supports the idea of multiple risk factors for CU behaviours.


Asunto(s)
Emociones , Fijación Ocular/fisiología , Conducta del Lactante/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Niño , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Responsabilidad Parental , Estudios Prospectivos
11.
Dev Rev ; 34(3): 189-207, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25187673

RESUMEN

A fast growing field, the study of infants at risk because of having an older sibling with autism (i.e. infant sibs) aims to identify the earliest signs of this disorder, which would allow for earlier diagnosis and intervention. More importantly, we argue, these studies offer the opportunity to validate existing neuro-developmental models of autism against experimental evidence. Although autism is mainly seen as a disorder of social interaction and communication, emerging early markers do not exclusively reflect impairments of the "social brain". Evidence for atypical development of sensory and attentional systems highlight the need to move away from localized deficits to models suggesting brain-wide involvement in autism pathology. We discuss the implications infant sibs findings have for future work into the biology of autism and the development of interventions.

12.
J Child Lang ; 40(1): 29-46, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23217290

RESUMEN

Children's assignment of novel words to nameless objects, over objects whose names they know (mutual exclusivity; ME) has been described as a driving force for vocabulary acquisition. Despite their ability to use ME to fast-map words (Preissler & Carey, 2005), children with autism show impaired language acquisition. We aimed to address this puzzle by building on studies showing that correct referent selection using ME does not lead to word learning unless ostensive feedback is provided on the child's object choice (Horst & Samuelson, 2008). We found that although toddlers aged 2;0 at risk for autism can use ME to choose the correct referent of a word, they do not benefit from feedback for long-term retention of the word-object mapping. Further, their difficulty using feedback is associated with their smaller receptive vocabularies. We propose that difficulties learning from social feedback, not lexical principles, limits vocabulary building during development in children at risk for autism.


Asunto(s)
Trastorno Autístico/psicología , Retroalimentación Psicológica , Desarrollo del Lenguaje , Trastorno Autístico/etiología , Preescolar , Femenino , Humanos , Trastornos del Desarrollo del Lenguaje/etiología , Trastornos del Desarrollo del Lenguaje/psicología , Masculino , Factores de Riesgo , Vocabulario
14.
Vox Sang ; 98(1): 85-6, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20017864

RESUMEN

A survey of blood centre organizations was carried out to establish the degree of progress towards the implementation of global standards for coding and labelling blood components. The survey was performed through questionnaires completed by blood organizations. Of nearly 32 million blood donations collected annually by the participants, 43% are identified with ISBT 128 donation numbers and 36% are fully compliant with the ISBT 128 Standard. Planned implementations indicate that 85% of donations will be identified by ISBT 128 donation numbers by 2011.


Asunto(s)
Almacenamiento de Sangre/métodos , Donantes de Sangre , Adhesión a Directriz , Bancos de Sangre/normas , Transfusión de Componentes Sanguíneos , Procesamiento Automatizado de Datos , Humanos , Etiquetado de Productos , Encuestas y Cuestionarios
15.
Opt Lett ; 32(2): 136-8, 2007 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-17186042

RESUMEN

The high-frequency modulation characteristics of GaAs-based bipolar cascade vertical cavity surface-emitting lasers operating at 980 nm with GaAs tunnel junctions and p-doped Al0.98Ga0.02As oxide apertures have been measured. We achieve -3 dB laser output modulations of 6.5 GHz for two-stage and 9.4 GHz for three-stage devices in response to small-signal current injection at an operating temperature of -50 degrees C.

16.
Acta Anaesthesiol Scand ; 49(8): 1084-7, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16095448

RESUMEN

BACKGROUND: Previously, we have shown in adult patients that bispectral index score (BIS) values are significantly higher during halothane anesthesia (53-61 units) as compared with those observed during equipotent concentrations of sevoflurane (39-43 units). Because halothane is frequently used in the pediatric setting, we tested the hypothesis that BIS values observed in children might also be higher during general anesthesia with halothane than with sevoflurane. METHODS: Forty-one healthy, unpremedicated pediatric patients scheduled for elective operations received either halothane or sevoflurane titrated as appropriate for surgical stimulation. RESULTS: During maintenance sevoflurane anesthesia (n=20), the mean BIS values and percent end-tidal concentrations were 44+/-14 and 2.1+/-0.6, respectively, whereas for the halothane group (n=21) the corresponding values were 61+/-7 and 1.1+/-0.4, respectively. CONCLUSION: These findings suggest that BIS values are higher during halothane vs. sevoflurane anesthesia in children, but not in infants.


Asunto(s)
Anestésicos por Inhalación/farmacología , Electroencefalografía/efectos de los fármacos , Halotano/farmacología , Éteres Metílicos/farmacología , Factores de Edad , Niño , Preescolar , Humanos , Lactante , Valores de Referencia , Sevoflurano
18.
Am J Transplant ; 1(2): 157-61, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12099364

RESUMEN

Biliary reconstruction continues to be a major source of morbidity following orthotopic liver transplantation. We wished to determine if choledochocholedochostomy without a T-tube was associated with fewer biliary complications and was less costly than choledochocholedochostomy with a T-tube. A retrospective cohort study of patients who underwent liver transplantation was performed. Patients were stratified into two groups: group I had bile duct reconstruction with T-tube and group II did not have a T-tube. The results were interpreted on an intention-to-treat analysis. We identified 147 adult patients who underwent initial liver transplantation. There were 76 patients in group I and 71 patients in group II. There were no statistical differences between the two groups regarding underlying cause of liver disease, patient age, gender or United Network for Organ Sharing status. As the decision to use a T-tube was made at the time of surgery, the two groups may not be strictly comparable. The mean hospital stay was longer in group I (31.1 +/- 27.9d) than in group II (18.8 +/- 15.5d) (p = 0.001). Biliary complications were statistically more frequent in patients from group I patients (25/76, 32.9%) than in patients from group II (11/71, 15.5%) (p = 0.01). There was a trend for the costs associated with diagnostic and therapeutic procedures for the management of biliary complications to be greater for group I than for group II, although this was not statistically significant (p = 0.235). Our study suggests choledochocholedochostomy without T-tube reconstruction is the preferred strategy for biliary reconstruction in orthotopic liver transplantation. It is not only associated with fewer biliary complications, but also less costly than using choledochocholedochostomy over a T-tube. Randomized prospective studies are needed to confirm our results.


Asunto(s)
Enfermedades de los Conductos Biliares/epidemiología , Conductos Biliares/cirugía , Colangiopancreatografia Retrógrada Endoscópica/economía , Trasplante de Hígado/métodos , Anastomosis Quirúrgica/economía , Estudios de Cohortes , Análisis Costo-Beneficio , Femenino , Rechazo de Injerto/epidemiología , Humanos , Tiempo de Internación/economía , Hepatopatías/clasificación , Hepatopatías/cirugía , Trasplante de Hígado/economía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/clasificación , Complicaciones Posoperatorias/economía , Estudios Retrospectivos , Estados Unidos
19.
Chem Commun (Camb) ; (17): 1540-1, 2001 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-12240371

RESUMEN

Simple tricyclohexylphosphine adducts of palladium complexes with orthometallated N-donor ligands show by far the highest activity yet reported in the Suzuki coupling of aryl chlorides, even under aerobic conditions.

20.
Am Surg ; 66(9): 827-31, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10993609

RESUMEN

The accuracy of endoscopic ultrasound (EUS) for initial staging of esophageal cancer is widely accepted. There is, however, considerable variability in the reported accuracy of EUS for restaging of esophageal neoplasms after neoadjuvant therapy. From June 1995 through December 1999, we prospectively studied a series of 26 patients who underwent neoadjuvant treatment for esophageal cancer and were subsequently restaged by EUS before resection. Twenty-four patients had adenocarcinoma (92%), and two patients had squamous cell carcinoma (8%). EUS correctly predicted tumor stage in seven of 26 patients for an overall accuracy of 27 per cent. EUS overestimated the depth of tumor penetration in 18 patients (69%) and underestimated depth of penetration in one patient (4%). Lymph nodes were correctly staged in 15 of 26 patients for an overall accuracy of 58 per cent. Levels of sensitivity for detecting N0 and N1 disease were 44 per cent and 80 per cent respectively. Patients with a complete pathologic response were staged as T4N1 (one patient), T3N1 (three patients), T3N0 (one patient), and T2N1 (two patients). EUS cannot distinguish tumor involvement of the esophageal wall and lymph nodes from the postinflammatory changes that characterize effective neoadjuvant treatment. EUS is of limited utility in guiding clinical decision making after neoadjuvant therapy.


Asunto(s)
Endosonografía , Neoplasias Esofágicas/diagnóstico por imagen , Terapia Neoadyuvante , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/patología , Adenocarcinoma/radioterapia , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Toma de Decisiones , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/radioterapia , Esófago/diagnóstico por imagen , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Planificación de Atención al Paciente , Estudios Prospectivos , Dosificación Radioterapéutica , Inducción de Remisión , Sensibilidad y Especificidad
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