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Purpose Lymph node metastasis (LNM) is a strong prognostic factor in many solid cancers, including head and neck squamous cell carcinomas (HNSCC), and LNM can be dependent upon primary tumor biology, as well as tumor dimension. Here, we investigate the relative risk of LNM in accordance to tumor dimension and biology in HNSCC subsites. Materials and Methods Medical data of 295 HNSCC patients who had undergone the initial curative surgery (oral tongue 174, oropharynx 75, hypopharynx 46) were analyzed to identify the significant predictive factor for LNM. Tumor volume and thickness were set as tumor dimensional variables, and biological variables included lymphovascular, perineural invasion, and tumor differentiation. Statistical analyses were conducted to assess the predictability of LNM from variables, and subgroup analyses according to the tumor subsites. In addition, we evaluated the impacts of tumor dimension and biological variables on the treatment outcomes and survival in HNSCC subsites. Results The overall tumor dimension and biological variables had a similar impact on the prediction of LNM in HNSCC (area under the curve, 0.7682 and 0.7717). The prediction sensitivity of LNM in oral tongue cancer was mainly dependent on tumor dimension, while LNM in oroand hypo-pharynx cancers was more influenced by biological factors. Survival analyses also confirmed that biological factor was more powerful in estimating disease-free survival of hypopharyngeal cancer patients, while tumor dimension was more significant in that of oral cancer patients. Conclusion Tumor dimension and biology have a significant, tumor subsite-dependent impact on the occurrence of LNM and disease-free survival in HNSCC. [ABSTRACT FROM AUTHOR]

Objective. Evaluation of the vibratory pattern of vocal folds is of paramount importance to diagnose vocal fold disorders. Currently, laryngeal videokymography (VKG) and digital kymography from high-speed videolaryngoscopy are the available techniques for studying aperiodic vibrations of vocal folds. But VKG has the fundamental limitation that only linear portion of the vocal fold mucosa can be visualized. Digital kymography has the disadvantages of no immediate feedback during examination, considerable waiting time before kymographic visualization, recoding duration limited to seconds, and extreme demands on storage space. We developed a new system-two-dimensional (2D) scanning VKG-for evaluation of the vibratory pattern of vocal folds, and the method provided a possible alternative with its advantages and disadvantages. Thus, we aimed to evaluate the feasibility of the new device for the vocal fold vibration in excised canine larynx model. Methods. The vibrating pattern for vocal folds was evaluated using high-speed videolaryngoscopic and 2D scanning videokymographic system in the excised canine larynx model. Results. The images of canine vocal folds were captured with high-speed videolaryngoscopic system and converted to the kymographic images using the software. The kymographic image acquired by 2D scanning VKG was comparable with multi-line digital kymography at multiple locations. Conclusions. The vocal fold vibration could be evaluated in the excised canine larynx model using 2D scanning VKG. And this new device is expected to be a promising tool to evaluate the vocal fold vibration for clinical practice and voice research. [ABSTRACT FROM AUTHOR]

Lacteals are lymphatic vessels located at the center of each intestinal villus and provide essential transport routes for lipids and other lipophilic molecules. However, it is unclear how absorbed molecules are transported through the lacteal. Here, we used reporter mice that express GFP under the control of the lymphatic-specific promoter Prox1 and a custom-built confocal microscope and performed intravital real-time visualization of the absorption and transport dynamics of fluorescence-tagged fatty acids (FAs) and various exogenous molecules in the intestinal villi in vivo. These analyses clearly revealed transepithelial absorption of these molecules via enterocytes, diffusive distribution over the lamina propria, and subsequent transport through lacteals. Moreover, we observed active contraction of lacteals, which seemed to be directly involved in dietary lipid drainage. Our analysis revealed that the smooth muscles that surround each lacteal are responsible for contractile dynamics and that lacteal contraction is ultimately controlled by the autonomic nervous system. These results indicate that the lacteal is a unique organ-specific lymphatic system and does not merely serve as a passive conduit but as an active pump that transports lipids. Collectively, using this efficient imaging method, we uncovered drainage of absorbed molecules in small intestinal villus lacteals and the involvement of lacteal contractibility. [ABSTRACT FROM AUTHOR]

To unveil the organotypic role and vulnerability of lymphatic vessels, we generated a lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1)-Cro/iDTR double-transgenic mouse and ablated LYVE-1-expressing lymphatic vessels in adult mice in a diphtheria toxin (DTHnducible manner based on selective expression of LYVE-1 in most lymphatic vessels. Strikingly, lymphatic vessels in the small intestine and lymph nodes were rapidly ablated, but lymphatic vessels in the other organs were relatively intact at 24 hours after DT administration. Unexpectedly, LYVE-1-Cre/iDTR mice died of sepsis without visible edema at 24 and 60 hours after DT administration. The cause of death appeared to be related to acute failure of immune surveillance systems in the small intestine and draining lymph nodes. Of note, acute loss of lymphatic lacteals in intestinal villi appeared to trigger distortion of blood capillaries and the whole architecture of the villi, whereas acute loss of lymphatic vessels in lymph nodes caused dysfunction of lymph drainage and abnormal distribution of dendritic cells and macrophages. Thus, intact lymphatic vessels are required for structural and functional maintenance of surrounding tissues in an organotypic manner, at least in the intestine and lymph nodes. [ABSTRACT FROM AUTHOR]

Background/Aims: Although tonsil-mesenchymal stem cells (T-MSCs) have been studied as a new autologous or homologous source of MSCs, research on specific markers of MSCs and localization for purified T-MSC isolation has not yet been reported. This study investigates the expression of W5C5 (SUSD2) in tonsil stromal cells and the colony-forming ability and differentiation potential of W5C5+ cells to determine the usefulness of W5C5+ MSCs as a marker that can be used for the purification of T-MSCs. In addition, the location of W5C5+ cells expressed in the tonsil tissues is examined. Methods: T-MSCs were isolated from the tonsillar tissues of 12 patients undergoing tonsillectomy. The colony-forming ability, surface markers, proliferation potential, and differentiation capacities of purified W5C5+ MSCs, W5C5- MSCs, and unselected T-MSCs were evaluated. The location of the W5C5+ cells in the tonsillar tissues was also investigated by immunohistochemistry. Results: W5C5 was expressed in 2.5±0.4% of fresh human tonsil stromal cells. W5C5+ cells formed many colonies, but W5C5- cells did not form any colonies. The colony-forming number of W5C5+ cells (74.4 ± 9.8) was significantly higher than that of unselected tonsil stromal cells (23.6 ± 3.7). However, the differences in proliferation potential, surface marker expression, and differentiation potential between W5C5+ T-MSCs and unselected T-MSCs were not significant. W5C5+ cells were identified in the perivascular area around the blood vessels. Conclusion: W5C5+ T-MSCs possessed typical MSC properties with high colony-forming efficiency, and niches of W5C5+ T-MSCs were located in the perivascular area of tonsil tissues. These findings suggest that W5C5 is a useful single marker for the isolation of purified T-MSCs.

ObjectivesThere is still debate concerning the reason for the high initial failure rate of positive airway pressure (PAP) treatment. The objective of this study is to investigate the factors of the initial adherence to PAP, with an emphasis on the role of upper airway narrowing.MethodsThe patients were divided into two groups according to the continuation of therapy within the first three months of treatment. The demographic and polysomnographic findings, the minimal nasal cross sectional area (MCA), the degree of palatine tonsilar hypertrophy (PTH) and the modified Mallampati grade of the oropharynx inlet (Orophx) were compared between the study groups.ResultsAmong 36 patients, 23 continued the auto-adjusting positive airway pressure (APAP) therapy (the adherent group) and 13 discontinued APAP within three months (the non-adherent group). The apnea-hypopnea index (AHI) was significantly higher in the adherent group than in the non-adherent group (P