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Background Recurrent laryngeal/hypopharyngeal squamous cell carcinoma (LHSCC) is commonly associated with poor survival outcomes. We evaluated the prognostic role of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) parameters quantitatively measured in patients who underwent salvage treatments for recurrent LHSCC. Methods This study involved 100 consecutive LHSCC patients who underwent 18 F-FDG PET/CT for recurrent staging and subsequent salvage treatments. Maximum standardized uptake value (SUVmax ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using 18 F-FDG PET/CT. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18 F-FDG PET/CT parameters and other clinicopathological factors with progression-free survival (PFS) and overall survival (OS). Results Two-year postsalvage PFS and OS rates were 67.9% and 74.3%, respectively. All 18 F-FDG PET parameters of SUVmax , MTV, and TLG were significantly associated with poor PFS and OS outcomes after salvage treatment (all P 6.5 mL), and TLG (>17.1 g) were independent variables predictive of PFS. Karnofsky score, SUVmax (>4.0), and TLG (>17.1 g) were the independent prognostic factors for OS. Conclusions 18 F-FDG PET/CT can be useful in predicting postsalvage recurrence and survival in patients with recurrent LHSCC.

Background Distinguishing lung adenocarcinoma (ADC) from squamous cell carcinoma (SCC) has a tremendous therapeutic implication. Sometimes, the commonly used immunohistochemistry (IHC) markers fail to discriminate between them, urging for the identification of new diagnostic biomarkers. Methods We performed IHC on tissue microarrays from two cohorts of lung cancer patients to analyse the expression of beta-arrestin-1, beta-arrestin-2 and clinically used diagnostic markers in ADC and SCC samples. Logistic regression models were applied for tumour subtype prediction. Parallel reaction monitoring (PRM)-based mass spectrometry was used to quantify beta-arrestin-1 in plasma from cancer patients and healthy donors. Results Beta-arrestin-1 expression was significantly higher in ADC versus SCC samples. Beta-arrestin-1 displayed high sensitivity, specificity and negative predictive value. Its usefulness in an IHC panel was also shown. Plasma beta-arrestin-1 levels were considerably higher in lung cancer patients than in healthy donors and were higher in patients who later experienced a progressive disease than in patients showing complete/partial response following EGFR inhibitor therapy. Conclusions Our data identify beta-arrestin-1 as a diagnostic marker to differentiate ADC from SCC and indicate its potential as a plasma biomarker for non-invasive diagnosis of lung cancer. Its utility to predict response to EGFR inhibitors is yet to be confirmed.

Radiotherapy is a well-established therapeutic modality used in the treatment of many cancers. However, radioresistance remains a serious obstacle to successful treatment. Radioresistance can cause local recurrence and distant metastases in some patients after radiation treatment. Thus, many studies have attempted to identify effective radiosensitizers. Eph receptor functions contribute to tumor development, modulating cell-cell adhesion, invasion, neo-angiogenesis, tumor growth and metastasis. However, the role of EphA3 in radioresistance remains unclear. In the current study, we established a stable radioresistant head and neck cancer cell line (AMC HN3R cell line) and found that EphA3 was expressed predominantly in the radioresistant head and neck cancer cell line through DNA microarray, real time PCR and Western blotting. Additionally, we found that EphA3 was overexpressed in recurrent laryngeal cancer specimens after radiation therapy. EphA3 mediated the tumor invasiveness and migration in radioresistant head and neck cancer cell lines and epithelial mesenchymal transition- related protein expression. Inhibition of EphA3 enhanced radiosensitivity in the AMC HN 3R cell line in vitro and in vivo study. In conclusion, our results suggest that EphA3 is overexpressed in radioresistant head and neck cancer and plays a crucial role in the development of radioresistance in head and neck cancers by regulating the epithelial mesenchymal transition pathway.

BACKGROUND Lymphadenoma (LA) of the salivary gland, nonsebaceous type, is an uncommon benign lymphoepithelial neoplasm. The histogenesis of the lymphoid component of LA is under debate as in Warthin's tumor. A recent study has described immunoglobulin (Ig) class switching to IgG4 in a subset of Warthin's tumors. The aim of this study is to evaluate IgG4 status of LA and presume the role of IgG4 status in pathogenesis of LA. MATERIALS AND METHODS The distribution of IgG-positive and IgG4-positive cells was compared by immunohistochemistry among 15 lymphoepithelial lesions of the salivary gland (8 LAs, 3 lymphoepithelial carcinomas, and 4 lymphoepithelial cysts). Epstein-Barr virus in situ hybridization was also performed. RESULTS IgG-positive and IgG4-positive plasma cells were observed in all cases, but to a remarkable degree (IgG4>100/hpf) in 2 of 8 LAs. The IgG4 plasma cells in LA were distributed in interfollicular areas and in the vicinity of epithelial nests. Among all cases, the mean number of IgG4 plasma cells was not correlated with the presence of germinal centers (12/15) or Epstein-Barr virus positivity (2/15). CONCLUSIONS Increased IgG4 plasma cells in LA suggest involvement of an immune reaction in the pathogenesis of LA similar to Warthin's tumor.

OBJECTIVE Patients with head and neck cancer (HNC) can die of index tumor progression and second tumor or non-cancer causes. Here, we investigated the risk factors for competing non-cancer mortality (NCM) in a prospective cohort of patients with advanced-stage HNC. MATERIALS AND METHODS A prospective observational study was conducted with 604 patients who underwent definitive treatment for advanced-stage HNC between 2010 and 2015. Main outcomes were NCM and cancer mortality (CM) defined as death from non-cancer causes and HNC or second cancers, respectively. Cumulative incidence and cause-specific hazard functions were used to analyze the risk factors of NCM and CM. RESULTS Age, smoking, Charlson comorbidity index (CCI), performance status, body mass index, rural residence, education and hemoglobin level at diagnosis, and chemotherapy were significantly associated with NCM (all p

OBJECTIVE To compare the diagnostic accuracy of 18 F-FDG PET/CT and conventional contrast-enhanced CT for the re-staging of recurrent salivary gland carcinoma (SGC). MATERIALS AND METHODS This study included 58 consecutive patients who underwent recurrent SGCs after definitive treatment. The recurrences were evaluated by 18 F-FDG PET/CT and contrast-enhanced CT of the neck and chest. McNemar's test was used to compare the diagnostic accuracy of 18 F-FDG PET/CT with standard neck and chest CT imaging, and a Cox proportional hazards model was used to assess the prognostic value of PET/CT. RESULTS Of 58 patients with recurrent SGCs, 17 (29%) had a local recurrence, 17 (29%) had a regional recurrence, and 38 (66%) had a distant metastasis, with these classifications showing overlap. The sensitivity and accuracy of 18 F-FDG PET/CT for the detection of distant metastases were significantly higher than those of CT (p 0.1). The 18 F-FDG PET/CT-positive findings at distant sites were predictors of poor progression-free and overall survival outcome (all p

The Pluronic/heparin nanoparticles (NPs) were prepared for chemo-photodynamic combination cancer therapy through photoinduced caspase-3 activation. Doxorubicin (DOX) prodrug and methylene blue (MB) were assembled into a single structure by electrostatic interaction with heparin and further loaded into the NPs. MB is a photosensitizer, which can be used for photodynamic therapy, which can elicit cell death by producing reactive oxygen species (ROS). The DOX prodrug was DOX conjugated to a labile tetrapeptide (DEVD) by caspase-3 upon apoptosis. ROS was measured to verify ROS-mediated apoptosis. Membrane integrity test and flow cytometry analysis were performed to examine induced apoptosis. The tumor targeting and the in vivo antitumor efficacy were measured to evaluate chemo-photodynamic combination cancer therapy in tumor-bearing mice.

Amplification of fibroblast growth factor receptor 1 ( FGFR1) has been reported in many squamous cell carcinomas, and human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma has been characterized as a distinct subset with favorable prognosis. Here, we investigated the FGFR1 amplification and HPV status in tonsillar squamous cell carcinoma (TSCC) and analyzed the clinical characteristics. HPV in situ hybridization (HPV ISH) and FGFR1 fluorescence in situ hybridization (FISH) were performed using tissue microarray from 89 cases of TSCC. Fourteen of 89 (15.7%) TSCC cases had FGFR1 amplification, and HPV was detected in 59 of 89 (66.3%) cases. FGFR1 amplification status was not associated with HPV positivity ( p=0.765). Outcomes were not significantly different between FGFR1 amplified and non-amplified patients. Although FGFR1 amplified patients ( n=4) in the HPV ISH–negative group ( n=30) had a tendency for poorer overall survival, no statistical significance was identified ( p=0.150, log-rank). FGFR1 protein overexpression showed better disease-free survival ( p=0.031, log-rank) in HPV-negative TSCC. This study suggests FGFR1 amplification may be important in the pathogenesis of TSCC regardless of HPV status.

Compost application has been considered to be one of the most promising methods for sustaining soil quality and crop productivity and possibly attenuates the impact of methane (CH4) emission in rice paddies. The physico-chemical and biological characteristics of manure may vary, depending on the maturity of the compost. Therefore, compost obtained from different stages of maturation could differentially influence CH4 production in rice paddies following input into the fields. In composting samples, we investigated the effect of composting on alterations in physico-chemical characteristics and changes in methanogenic abundance and community structure in manure during the maturation process using a conventional static chamber method. Thereafter, CH4 production potential was monitored in soil samples amended with compost obtained from different composting stages (0 as a starting material, 7, 14, 21, 28, and 35 days after installation) via an incubation experiment. The results show that manure composting significantly decreased the methanogenic abundance and altered the methanogenic community structure by qPCR and T-RFLP analyses, respectively. The physico-chemical properties, such as labile carbon (C) and nitrogen (N) availabilities in manure, were gradually changed due to high temperature and oxygen supplement. These changes result in decreasing CH4 production in a rice field soil amended with composts. Our results suggest that composting is a promising approach to mitigate the impact of CH4 emissions in rice paddy fields with manure. In conclusion, composting should be indispensable for mitigating the impact of CH4 emission in manure-amended paddy soil during cultivation.

Circulating biomarker (CB) is a convenient, emerging predictive tool for treatment response and outcomes in human cancers. Therefore, we examined the prognostic value of pre-treatment and early post-treatment CBs and their summated scores in patients with head and neck squamous cell carcinoma (HNSCC).This study prospectively included 310 consecutive patients who underwent definitive treatment for previously untreated advanced-stage HNSCC between 2010 and 2015. The CB score was determined by complete blood counts (CBCs) and blood chemistry before and 2 months after the treatment, and the number of abnormal CB was counted from 0 to 10. Univariate and multivariate analyses with Cox proportional hazards models were used to find factors associated with disease-free survival (DFS) and overall survival (OS).Most CBC profiles were significantly changed at 2-months post-treatment compared with those at pre-treatment. Univariate analyses showed that hypoalbuminemia, leucocytosis, C-reactive protein, high CB scores (≥6), age, performance status and comorbidity and tumour site were significantly associated with DFS and OS (all P 0.05). Both pre- and post-treatment CB scores were independent factors predictive of DFS and OS outcomes in the multivariate analyses (P 0.05). High CB scores at pre-treatment were associated with 7-10-fold increased risk of unfavourable DFS and OS outcomes, and those at 2-months post-treatment were associated with 2 to 4-fold increased risk of poor survival outcomes (all P 0.05).CB scores at pre-treatment and early post-treatment are useful for predicting survival outcomes in patients with advanced-stage HNSCC.

Currently, there is great interest in the development of ways to achieve the benefits of radiation treatments with reduced negative effects. The present study demonstrates the utilization of radio-luminescent particles (RLPs) as a means to achieve radio-sensitization and enhancement and their ability to affect head- and neck-cancer-cell cultures (in vitro) and xenografts (in vivo). Our approach utilizes a naturally abundant radio-luminescent mineral, calcium tungstate (CaWO4), in its micro or nanoparticulate form for generating secondary UV-A light by γ ray or X-ray photons. In vitro tests demonstrate that unoptimized RLP materials (uncoated CaWO4 (CWO) microparticles (MPs) and PEG–PLA-coated CWO nanoparticles (NPs)) induce a significant enhancement of the tumor-suppressive effect of X-rays and γ rays in both radio-sensitive- and radio-resistant-cancer models; uncoated CWO MPs and PEG–PLA-coated CWO NPs demonstrate comparable radio-sensitization efficacies in vitro. Mechanistic studies reveal that concomi...

Objectives Adenoid cystic carcinoma (AdCC) in the salivary gland shows a high rate of distant metastasis, which is related to the resulting poor prognosis. We therefore examined the role of pretreatment 18F-FDG PET/CT for prediction of distant metastasis, recurrence/progression, and survival in AdCC. Methods This study included 52 patients who underwent pretreatment 18F-FDG PET/CT scanning and subsequent treatments for AdCC. Maximum, mean, and peak standardized uptake value (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Univariate and multivariate Cox proportional hazards regression analyses were used to identify associations between the quantitative measurements of 18F-FDG PET, and progression-free survival (PFS), distant metastasis-free survival (DMFS), and disease-specific survival (DSS). Results Distant metastases were found in 20 (39%) patients: 6 (12%) at initial diagnosis and 14 (27%) during the median follow-up of 72 months after treatment. Univariate analyses showed that all the 18F-FDG PET parameters of SUVmax, SUVmean, SUVpeak, MTV, and TLG were significantly associated with overall PFS, DMFS, and OS (all P 14.8 mL showed a 5.9-fold higher risk of distant metastasis and a 4.2-fold higher risk of disease-specific death than those with a lower MTV. Conclusions Quantitative measurements using 18F-FDG PET/CT are useful for predicting tumor progression, distant metastasis, and survival in patients with AdCC.

We consider an excitatory population of subthreshold Izhikevich neurons which cannot fire spontaneously without noise. As the coupling strength passes a threshold, individual neurons exhibit noise-induced burstings. This neuronal population has adaptive dynamic synaptic strengths governed by the spike-timing-dependent plasticity (STDP). In the absence of STDP, stochastic burst synchronization (SBS) between noise-induced burstings of subthreshold neurons was previously found to occur over a large range of intermediate noise intensities. Here, we study the effect of additive STDP on the SBS by varying the noise intensity $D$ in the Barab\'asi-Albert scale-free network (SFN) for the case of symmetric preferential attachment. This type of SFN exhibits a power-law degree distribution, and hence it becomes an inhomogeneous one with a few "hubs" (i.e., super-connected nodes). Occurrence of a "Matthew" effect in synaptic plasticity is found to occur due to a positive feedback process. Good burst synchronization gets better via long-term potentiation (LTP) of synaptic strengths, while bad burst synchronization gets worse via long-term depression (LTD). Consequently, a step-like rapid transition to SBS occurs by changing $D$, in contrast to a relatively smooth transition in the absence of STDP. In the presence of additive STDP, we also investigate the effects of network architecture on the SBS for a fixed $D$. Emergences of LTP and LTD of synaptic strengths are investigated in details via microscopic studies based on both the distributions of time delays between the burst onset times of the pre- and the post-synaptic neurons and the pair-correlations between the pre- and the post-synaptic IIBRs (instantaneous individual burst rates). Finally, a multiplicative STDP case (depending on states) is also investigated in comparison with the additive STDP case (independent of states)., Comment: arXiv admin note: substantial text overlap with arXiv:1704.03150

Livestock manure has been widely used in agriculture to improve soil productivity and quality. However, intensive application can significantly enhance soil nitrogen (N) availability and facilitate ammonia (NH3) volatilization during rice cultivation. The effects of different rates of manure application on the NH3 volatilization rate, its mechanism, and their relationships have not been comprehensively investigated. In this study, field trials were conducted to investigate NH3 volatilization in rice paddy soils amended with different livestock manure, cattle manure (CM), and swine manure (SM), at a rate of 0 (NPK), 10, 20, and 40 Mg ha−1 during cultivation. Moreover, the soil physicochemical and biological properties and rice N uptake were investigated. Ultra-fine particulate matter (PM2.5) was measured quantitatively and qualitatively. Manure application significantly increased NH3 emissions compared to the control. Much higher volatilization rates were observed in the SM soils than in the CM soils, even when the same amount of N was applied. This is mainly related to the higher labile NH4+ concentration and urease activity in SM soils. With increasing application levels, NH3 emission rates proportionally increased in the SM, but there was no significant difference in the CM. Livestock manure application significantly increased NH3 volatilization, particularly during the initial manure application and additional fertilization stages during rice cultivation. The results showed that the application of livestock manure significantly increased NH3 volatilization. Moreover, the biochemical properties of manure composts, including labile N and urease activity, mainly affected NH3 dynamics in rice paddies during cultivation rather than their type. Irrespective of manure application, PM2.5, did not show a significant difference at the initial stage of cultivation. NH3 volatilization was not significantly correlated with the formation of PM2.5. It is necessary to develop effective strategies for mitigating NH3 volatilization and maintaining soil quality without decreasing rice productivity in paddy ecosystems.

Despite the excellent prognosis of early glottic cancer (T1-T2), the significance of preoperatively measured tumor thickness has not been elucidated. We evaluated the role of tumor thickness measured using computed tomography (CT) as a predictive factor for recurrence of early glottic cancer after transoral laser microsurgery (TLM).The medical records of 134 patients who were diagnosed with early glottic squamous cell carcinoma and underwent TLM were reviewed. Age, sex, clinical stage, preoperative biopsy, anterior commissure involvement, CT findings, recurrence, and overall survival were evaluated.Seventy-three patients (54 T1a, 2 T1b, and 17 T2) were enrolled. Tumor thickness on pathology increased proportionally with increased tumor thickness on CT. The recurrence-free survival (RFS) and overall survival rates were 82.2 and 91.2%, respectively. Upon univariate analysis, RFS was affected by the type of cordectomy, tumor differentiation, margin involvement, anterior commissure involvement, impaired vocal fold mobility, and tumor thickness ( 4 mm) on CT scan (all p 0.01). Among the relevant covariates, an involved or close resection margin [hazard ratio (HR) 19.2; 95% confidence interval (CI) 3.5-105.6; p 0.01], impaired vocal cord mobility (HR 8.5; 95% CI 1.45-49.2; p = 0.02), and pathological tumor thickness ( 4 mm) (HR 6.0; p = 0.02) were predictive of RFS.Tumor thickness may be another predictive factor for recurrence in early glottic cancer. Before TLM, reviewing the extent of tumor thickness will help to improve local control in cases of early glottic cancer.

The bacterial strain Bacillus velezensis GH1-13, isolated from rice paddy soil in Korea, has been shown to promote plant growth and have strong antagonistic activities against pathogens. Here, we report the complete genome sequence of GH1-13, revealing that it possesses a single 4,071,980-bp circular chromosome with 46.2% GC-content. The chromosome encodes 3,930 genes, and we have also identified a unique plasmid in the strain that encodes a further 104 genes (71,628bp and 31.7% GC-content). The genome was found to contain various enzyme-encoding operons, including indole-3-acetic acid (IAA) biosynthesis proteins, 2,3-butanediol dehydrogenase, various non-ribosomal peptide synthetases, and several polyketide synthases. These properties are responsible for the promotion of plant growth and the biosynthesis of secondary metabolites. They therefore have multiple beneficial effects that could be applied to agriculture. Through curing, we found that the unique plasmid of GH1-13 has important roles in the production of phytohormones, such as IAA, and in shaping phenotypic and physiological characteristics. The plasmid therefore likely influences the biological activities of GH1-13. The complete genome sequence of B. velezensis GH1-13 contributes to our understanding of this beneficial strain and will encourage research into its development for agricultural or biotechnological applications, enhancing productivity and crop quality.

We consider an inhomogeneous small-world network (SWN) composed of inhibitory short-range (SR) and long-range (LR) interneurons, and investigate the effect of network architecture on emergence of synchronized brain rhythms by varying the fraction of LR interneurons plong. The betweenness centralities of the LR and SR interneurons (characterizing the potentiality in controlling communication between other interneurons) are distinctly different. Hence, in view of the betweenness, SWNs we consider are inhomogeneous, unlike the "canonical" Watts-Strogatz SWN with nearly the same betweenness centralities. For small plong, the load of communication traffic is much concentrated on a few LR interneurons. However, as plong is increased, the number of LR connections (coming from LR interneurons) increases, and then the load of communication traffic is less concentrated on LR interneurons, which leads to better efficiency of global communication between interneurons. Sparsely synchronized rhythms are thus found to emerge when passing a small critical value plong(c)(≃0.16). The population frequency of the sparsely synchronized rhythm is ultrafast (higher than 100 Hz), while the mean firing rate of individual interneurons is much lower (∼30 Hz) due to stochastic and intermittent neural discharges. These dynamical behaviors in the inhomogeneous SWN are also compared with those in the homogeneous Watts-Strogatz SWN, in connection with their network topologies. Particularly, we note that the main difference between the two types of SWNs lies in the distribution of betweenness centralities. Unlike the case of the Watts-Strogatz SWN, dynamical responses to external stimuli vary depending on the type of stimulated interneurons in the inhomogeneous SWN. We consider two cases of external time-periodic stimuli applied to sub-populations of the LR and SR interneurons, respectively. Dynamical responses (such as synchronization suppression and enhancement) to these two cases of stimuli are studied and discussed in relation to the betweenness centralities of stimulated interneurons, representing the effectiveness for transfer of stimulation effect in the whole network.

Current guidelines advocate no prophylactic dissection of the lateral neck compartment for papillary thyroid carcinoma (PTC) without clinical evidence of lateral neck metastasis (cN1b). However, lateral neck recurrence can affect patient treatment outcomes and quality of life. Therefore, this study examined the risk factors for lateral neck recurrence after the definitive treatment of PTC without cN1b. The study enrolled 1928 consecutive patients who underwent total thyroidectomy between 2006 and 2012 for PTC without cN1b. Logistic regression analysis was used to identify the relationship of clinicopathologic factors with lateral neck recurrence. Uni- and multivariate Cox-proportional hazards regression analyses were used to identify factors predictive of lateral neck recurrence-free survival (LRFS). During a median follow-up period of 94 months (range, 24–133 months), lateral neck recurrence occurred in 47 patients (2.4%). Binary logistic regression showed that tumor size (>2 cm), multifocality, clinical central neck metastasis (cN1a), number of positive lymph nodes (LNs, >5), and LN ratio (>0.5) were significantly associated with lateral neck recurrence (P

Chemotherapy have commonly been used in maximum tolerated dose to completely eradicate the cancer. However, such treatments often failed due to the complex and dynamic nature of cancer. Therefore, it has been suggested that cancer should be treated as a chronic disease, controlling its growth by providing continuous therapeutic pressure for long-term. Such an approach, however, requires a therapy that is non-toxic and orally available with sufficient potency. Herein, we propose a radiotherapy-assisted orally available metronomic apoptosis-targeted chemotherapy, which delivers doxorubicin continuously to the irradiated tumor with high selectivity while causing minimal toxicities to the normal tissues. DEVD-S-DOX/DCK complex is the anticancer prodrug for our strategy that could selectively release doxorubicin in the irradiated tumor tissue with sufficient oral bioavailability. The prodrug was completely inactive by itself, but displayed potent anticancer activity when coupled with radiotherapy. Consequently, the daily oral administration of DEVD-S-DOX/DCK in combination with the low-dose radiotherapy effectively suppressed the growth of tumor in vivo with no significant systemic toxicities despite that the accumulated dose of doxorubicin exceeded 150 mg/kg. Therefore, the our novel therapy using DEVD-S-DOX/DCK complex is considered as an outstanding treatment option for treating cancer for long-term attributed to its oral availability and low-toxicity profile as well as the potent anticancer effect.

Acetylsalicylic acid (aspirin) and non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with reduced risks for certain human cancers. However, the effects of aspirin and NSAIDs on head and neck squamous cell carcinoma (HNSCC) remain controversial, and the prognostic effects of these drugs in patients with HNSCC are largely unknown. This study examined the clinical impact of aspirin and NSAIDs on disease recurrence and survival in patients with HNSCC. This study analysed a cohort of 1392 consecutive patients who received definitive treatment for previously untreated HNSCC at our tertiary referral center. Aspirin or NSAID use was considered positive if the patients were receiving aspirin or NSAID medication from HNSCC diagnosis to at least 1 year after treatment initiation. Cox proportional hazard models were utilised to determine the association of aspirin and/or NSAID use with recurrence, survival, and second primary cancer occurrence. Of 1392 patients, 81 (5.8%) and 89 (6.4%) received post-diagnosis treatment with aspirin and NSAIDs, respectively. After controlling for clinical factors, aspirin and NSAIDs were not significantly associated with recurrence, survival, or second cancer occurrence (P > 0.05). The cumulative dose of aspirin or NSAIDs did not alter survival outcomes (P > 0.05). Our data illustrated that the use of aspirin or NSAIDs has no effect on survival or recurrence in patients with HNSCC.

Background Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma with distinct pathologic characteristics. The histogenesis of BSCC is not fully understood, and the cancer has been suggested to originate from a totipotent primitive cell in the basal cell layer of the surface epithelium or in the proximal duct of secretory glands. Methods Twenty-six cases of head and neck BSCC from Asan Medical Center, Seoul, Korea, reported during a 14-year-period were subclassified into basal, ductal, and mixed subtypes according to the expression of basal (cytokeratin [CK] 5/6, p63) or ductal markers (CK7, CK8/18). The cases were also subject to immunohistochemical study for CK19, p53, cyclin D1, epidermal growth factor receptor (EGFR), and p16 and to in situ hybridization for human papillomavirus (HPV), and the results were clinico-pathologically compared. Results Mixed subtype (12 cases) was the most common, and these cases showed hypopharyngeal predilection, older age, and higher expression of CK19, p53, and EGFR than other subtypes. The basal subtype (nine cases) showed frequent comedo-necrosis and high expression of cyclin D1. The ductal subtype (five cases) showed the lowest expression of p53, cyclin D1, and EGFR. A small number of p16- and/or HPV-positive cases were not restricted to one subtype. BSCC was the cause of death in 19 patients, and the average follow-up period for all patients was 79.5 months. Overall survival among the three subtypes was not significantly different. Conclusions The results of this study suggest a heterogeneous pathogenesis of head and neck BSCC. Each subtype showed variable histology and immunoprofiles, although the clinical implication of heterogeneity was not determined in this study.

There have been few studies evaluating the effect of bottom ash (BA) on immobilization of heavy metals and reducing their phytoavailability. Further, work has not been conducted to evaluate the effect of BA along with mature animal manure compost (CP) on immobilization of cadmium (Cd) in soil and phytoavailability of this metal in contaminated soil. Therefore, this study was conducted to determine the effect of application of BA and CP on Cd phytoextractability. To elucidate the mechanism of Cd immobilization with BA and CP, soil was mixed without BA and CP, with BA only, with CP only, and with BA and CP together in the incubation. Bottom ash was applied at rates of 0 and 30 Mg/ha under different application rates of CP (0 and 30 Mg/ha) 2 weeks before sowing lettuce (Lactuca sativa). Our first experiment clearly demonstrated that reduced extractability of Cd with addition of BA, CP, and BA + CP was mainly the result of Cd adsorption by an increase in pH and negative charge of soil. Concentration of bioavailable Cd fraction (F1) effectively decreased with BA, CP, and BA + CP from 1.33 mg Cd/kg in control to 0.98, 0.29, and 0.26 mg Cd/kg, respectively. Applying BA and CP alone or together effectively reduced Cd uptake by lettuce. Concentration of Cd in lettuce decreased from 13.9 mg Cd/kg in control to 10.3 and 7.6 mg Cd/kg with application of BA and CP alone, respectively. However, applying BA with CP increased fresh lettuce yields more than BA applied alone. Therefore, combined application of BA and CP might be a good management practice in Cd contaminated arable soil from the view point of Cd phytoavailability and crop productivity.

Background and Objectives Stratification of extranodal extension (ENE) extent has the potential to improve the accuracy of risk estimations in papillary thyroid carcinoma (PTC). This study examined the prognostic importance of nodal factors, including ENE, in PTC patients. Methods This study enrolled 2071 consecutive patients with treatment-naive PTC who underwent thyroidectomy between 2006 and 2010. Microscopic/macroscopic ENE was determined by pathological and operative findings. Univariate and multivariate analyses were used to identify the relationship of factors with recurrence and survival in all study patients and in the node-positive subset. Results Of 2071 patients, 975 (47.1%) had positive lymph nodes, and 271 (13.1%) and 70 (3.4%) had microscopic and macroscopic ENE, respectively. During a median follow-up of 96 months, 114 (5.5%) patients had post-treatment recurrence. Multivariate analyses showed that, in all patients, the number of positive nodes, lymph node ratio, ENE status, and ATA risk group were independent variables affecting recurrence (P

For studying how dynamical responses to external stimuli depend on the synaptic-coupling type, we consider two types of excitatory and inhibitory synchronization (i.e., synchronization via synaptic excitation and inhibition) in complex small-world networks of excitatory regular spiking (RS) pyramidal neurons and inhibitory fast spiking (FS) interneurons. For both cases of excitatory and inhibitory synchronization, effects of synaptic couplings on dynamical responses to external time-periodic stimuli S(t) (applied to a fraction of neurons) are investigated by varying the driving amplitude A of S(t). Stimulated neurons are phase-locked to external stimuli for both cases of excitatory and inhibitory couplings. On the other hand, the stimulation effect on non-stimulated neurons depends on the type of synaptic coupling. The external stimulus S(t) makes a constructive effect on excitatory non-stimulated RS neurons (i.e., it causes external phase lockings in the non-stimulated sub-population), while S(t) makes a destructive effect on inhibitory non-stimulated FS interneurons (i.e., it breaks up original inhibitory synchronization in the non-stimulated sub-population). As results of these different effects of S(t), the type and degree of dynamical response (e.g., synchronization enhancement or suppression), characterized by the dynamical response factor \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$D_f$$\end{document}Df (given by the ratio of synchronization degree in the presence and absence of stimulus), are found to vary in a distinctly different way, depending on the synaptic-coupling type. Furthermore, we also measure the matching degree between the dynamics of the two sub-populations of stimulated and non-stimulated neurons in terms of a “cross-correlation” measure \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$M_c$$\end{document}Mc. With increasing A, based on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$M_c$$\end{document}Mc, we discuss the cross-correlations between the two sub-populations, affecting the dynamical responses to S(t).

Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. P AVFs w ere present i n the rig ht l ung, and rig ht l ung perfusion was nearly a bsent. A fter c oil embolization, t akedown of the G lenn s hunt, a nd r econstruction of t he rig ht pulmonary a rtery, the p atient’s s ymptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.

Photo-induced apoptosis-targeted chemotherapy (PIATC) was designed and characterized to propose a new protocol for improved chemotherapy. Intratumoral injection was selected as the mode of administration of the anticancer drug, doxorubicin (DOX). To extend the retention time of DOX at the tumor parenchyma, in-situ gel formation was induced through the sol-gel transition of the Pluronic NPs containing a prodrug of DOX or a photosensitizer. The prodrug (DEVD-S-DOX) was designed to be inactive with a peptide moiety (Aspartic acid-Glutamic acid-Valine-Aspartic acid: DEVD) linked to DOX and to be cleaved into free DOX by caspase-3 expressed with apoptosis. For reactive oxygen species (ROS)-mediated apoptosis, photo-irradiation with methylene blue (MB, photosensitizer) was utilized. The sol-gel transition of the Pluronic NPs containing reactive species, DEVD-S-DOX or MB, was examined by measuring the cloud point and the gel strength in response to temperature change. ROS-mediated apoptosis was observed by measuring the ROS and membrane integrity with induced apoptosis. The in vivo antitumor efficacy of PIATC was measured with a cardiotoxicity assay in tumor-bearing mice.

Objectives/Hypothesis Poor nutritional status in patients with head and neck squamous cell carcinoma (HNSCC) is associated with tumor progression and survival. This study examined the prognostic value of nutritional and hematological markers in patients with HNSCC who received definitive treatments. Study Design A prospective observational cohort study. Methods This study included 338 consecutive patients who underwent surgery and/or radiotherapy/chemoradiotherapy for treatment-naive HNSCC. Body weight and nutritional and hematological parameters were regularly measured before and after treatment. Univariate and multivariate analyses using Cox proportional hazards models were performed to identify factors associated with disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). Results Body weight, serum total protein and albumin levels, and hematological variables significantly decreased after treatment. Univariate analyses illustrated that age, tumor site, T and N classifications, overall stage, pretreatment serum albumin (

In temperate rice paddy fields, winter cover cropping and its biomass application are strongly recommended to increase soil organic carbon (SOC) stock and decrease global warming potential (GWP). However, its biomass application may increase greenhouse gas (GHG) emissions, particularly methane (CH4), during flooded rice cultivation. To evaluate the effect of cover cropping and its biomass application on the annual net GWP in a mono-rice cultivation system, we evaluated the emission rates of CH4, nitrous oxide (N2O), and carbon dioxide (CO2) under different cover cropping during the fallow and rice-growing seasons. In cover cropping treatments, barley, hairy vetch, and a barley and hairy vetch mixture were cultivated as winter cover crops without fertilization during the fallow season. Moreover, the total aboveground biomass was incorporated as a green manure one week before rice transplanting. The recommended levels of chemical fertilizers were applied for rice cultivation in the control treatment (NPK) for comparison. The emission rates of CH4, soil respiration, and N2O gases were simultaneously monitored once a week using the closed-chamber method. However, the soil respiration fluxes included only soil respiration and excluded soil C sequestration through cover cropping and its biomass recycling. The net ecosystem C budget (NECB), which is defined as the difference between the total organic C input and output, was estimated to ascertain the pure soil respiration emission fluxes by mass balance approach. Finally, the net GWP was compared among treatments for the two cultivation seasons. During the dry fallow season, cover cropping significantly increased the soil respiration, and this treatment mineralized C loss significantly increased the seasonal net GWP. In comparison, the cover crop biomass application as green manure increased the soil C balance (NECB) during the rice growing season but more significantly increased the CH4 emission. As a result, the cover cultivation and its biomass application greatly increased the annual net GWP scale upon cover cropping rice paddy soil. Therefore, soil management practices that can decrease CH4 emission during rice cultivation should be adopted in cover cropping of the rice paddy soil.

Soil and plant samples were collected from 84 fields where medicinal plants were cultivated to determine the effect of soil phosphate (P) on the concentration of plant-available arsenic (As) and cadmium (Cd) and on the uptake of these toxic elements by medicinal plants. Concentrations of total P and available P in soils affected the phytoavailability of As and Cd differentially. Plant-available As in the soil and its uptake in the plant increased with increasing concentration of plant-available P in the soil due to competition between arsenate and P for the adsorption site at the soil surface and an increase in soil pH caused by specific adsorption of P. In contrast, phytoavailability of Cd decreased with increasing concentration of available P in soil. This was mainly attributed to an increase in Cd adsorption caused by P-induced negative charge of soil.

Background Posttreatment detection of recurrence may lead to salvage treatment and prognostic prediction in patients with head and neck squamous cell carcinoma (HNSCC). We evaluated the diagnostic and prognostic values of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) after definitive treatment of HNSCC. Methods This prospective study included 278 consecutive patients who underwent curative surgery ( n = 143, 51.4%) or definitive radiotherapy/chemoradiotherapy ( n = 135, 48.6%) for previously untreated HNSCC. The patients were regularly followed up and evaluated by 18 F-FDG PET/CT, head and neck CT/magnetic resonance imaging (MRI), and chest CT at regular intervals after treatment. The imaging interpretations were compared with the histological results for recurrence. Receiver operating characteristics curves analysis, McNemar's test and logistic regression using generalised estimating equations were used to compare the diagnostic accuracy of 18 F-FDG PET/CT and standard imaging of CT/MRI or chest CT, and a Cox proportional hazards model was used to assess the prognostic value of PET/CT. Results During a median follow-up of 44 months (range, 24–62 months), 73 patients (26.3%) had recurrence or persistent diseases. The area under curves for 18 F-FDG PET/CT and CT/MRI were 0.975 (0.964–0.992) and 0.789 (0.713–0.874), respectively ( P 18 F-FDG PET/CT detected 65 of 66 recurrences (98.5%) not suggested by physical examination and endoscopy. Positive findings on 18 F-FDG PET/CT scans were independent predictors of poorer cancer-specific and overall survival outcomes ( P Conclusions Posttreatment 18 F-FDG PET/CT surveillance helps to properly detect recurrence and to predict the survival following treatment of HNSCC.

Background: The aim of this study was to analyze the preoperative attributes and clinical impacts of complete pericardiectomy in chronic constrictive pericarditis. Methods: A total of 26 patients were treated from January 2001 to December 2013. The pericardium was resected as widely as possible. When excessive bleeding or hemodynamic instability occurred intraoperatively, a cardiopulmonary bypass (CPB; n=3, 11.5%) or an apical suction device (n=8, 30.8%) was used. Patients were divided into 2 groups: those who underwent ≥ 80% resection of the pericardium (group A, n=18) and those who underwent ＜80% resection of the pericardium (group B, n=8). Results: The frequency of CPB use was not significantly different between groups A and B (n=2, 11.1% vs. n=1, 12.5%; p=1.000). However, the apical suction device was more frequently applied in group A than group B (n=8, 30.8% vs. n=0, 0.0%; p=0.031). The postoperative New York Heart Association functional classification improved more in group A (p=0.030). Long-term follow-up echocardiography also showed a lower frequency of unresolved constriction in group A than in group B (n=1, 5.60% vs. n=5, 62.5%; p=0.008). Conclusion: Patients with chronic constrictive pericarditis demonstrated symptomatic improvement through complete pericardiectomy. Aggressive resection of the pericardium may correct constrictive physiology and an apical suction device can facilitate the approach to the posterolateral aspect of the left ventricle and atrioventricular groove area without the aid of CPB.

Squamous cell carcinoma of unknown primary of the head and neck (SCCUP) is a heterogeneous disease entity that requires careful examination to locate the occult primary. We examined the diagnostic value of expression of biomarkers, such as human papillomavirus (HPV), p16 and Epstein–Barr virus (EBV), in metastatic lymph nodes vs. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). We prospectively enrolled 54 consecutive SCCUP patients who received HPV, p16 and EBV analyses of lymph node fine-needle aspirates and 18F-FDG PET/CT scans and subsequently underwent examinations and biopsies under general anesthesia to detect primary tumors. The diagnostic performance of the biomarkers and 18F-FDG PET/CT were compared by using receiver operating characteristics (ROC) curve analyses with histopathological results for identification of primary tumors. Primary tumors were identified in 28 (51.9%) of 54 patients: the palatine tonsil in 24, base of the tongue in 1, nasopharynx in 2, and hypopharynx in 1. The sensitivity of p16 (85.7%) and accuracy of HPV (85.2%) were higher than those (42.9% and 68.5%) of 18F-FDG PET/CT (p

Mannosylphosphorylated glycans are found only in fungi, including yeast, and the elimination of mannosylphosphates from glycans is a prerequisite for yeast glyco-engineering to produce human-compatible glycoproteins. In Saccharomyces cerevisiae, MNN4 and MNN6 genes are known to play roles in mannosylphosphorylation, but disruption of these genes does not completely remove the mannosylphosphates in N-glycans. This study was performed to find unknown key gene(s) involved in N-glycan mannosylphosphorylation in S. cerevisiae. For this purpose, each of one MNN4 and five MNN6 homologous genes were deleted from the och1Δmnn1Δmnn4Δmnn6Δ strain, which lacks yeast-specific hyper-mannosylation and the immunogenic α(1,3)-mannose structure. N-glycan profile analysis of cell wall mannoproteins and a secretory recombinant protein produced in mutants showed that the MNN14 gene, an MNN4 paralog with unknown function, is essential for N-glycan mannosylphosphorylation. Double disruption of MNN4 and MNN14 genes was enough to eliminate N-glycan mannosylphosphorylation. Our results suggest that the S. cerevisiae och1Δmnn1Δmnn4Δmnn14Δ strain, in which all yeast-specific N-glycan structures including mannosylphosphorylation are abolished, may have promise as a useful platform for glyco-engineering to produce therapeutic glycoproteins with human-compatible N-glycans.

With the projected rise in the global human population, agriculture intensification and land-use conversion to arable fields is anticipated to meet the food and bio-energy demand to sustain a growing population. Moving towards a circular economy, agricultural intensification results in the increased re-investment of bio-based residues in agricultural soils, with consequences for microbially mediated greenhouse gas (GHG) emission, as well as other aspects of soil functioning. To date, systematic studies to address the impact of bio-based residue amendment on the GHG balance, including the soil microorganisms, and nutrient transformation in agricultural soils are scarce. Here, we assess the global warming potential (GWP) of in situ GHG (i.e., CO2, CH4, and N2O) fluxes after application of six bio-based residues with broad C : N ratios (5–521) in two agricultural soils (sandy loam and clay; representative of vast production areas in north-western Europe). We relate the GHG emission to the decomposability of the residues in a litter bag assay and determined the effects of residue input on crop (common wheat) growth after incubation. The shift in the bacterial community composition and abundance was monitored using IonTorrentTM sequencing and qPCR, respectively, by targeting the 16S rRNA gene. The decomposability of the residues, independent of C : N ratio, was proportional to the GWP derived from the GHG emitted. The soils harbored distinct bacterial communities, but responded similarly to the residue amendments, because both soils exhibited the highest mean GWP after addition of the same residues (sewage sludge, aquatic plant material, and compressed beet leaves). Our results question the extent of using the C : N ratio alone to predict residue-induced response in GHG emission. Taken together, we show that although soil properties strongly affect the bacterial community composition, microbially mediated GHG emission is residue dependent.

Background The purpose of this study was to identify the prevalence of cancer cachexia and its prognostic impact in patients with advanced head and neck squamous cell carcinoma (HNSCC). Methods The prevalence of cancer cachexia was analyzed according to the follow-up periods during the first year after curative initial treatment. Recurrences, noncancer health events (NCHEs), and cause-specific survival outcomes were also analyzed according to the incidence of cancer cachexia during follow-up. Results Cancer cachexia was identified in 22 (6.1%), 148 (41%), 66 (18.4%), and 65 (18.7%) of 361 enrolled patients at pretreatment, immediately after treatment, 6-months after treatment, and 12-months after treatment, respectively. Sustained or newly developed cachexia at 6 and 12 months showed a significant association with recurrence and NCHE occurrence (p

Background/aim Lymph node (LN) metastasis of solid types of tumors has important clinical significance and it is therefore critical to identify molecular biomarkers that would enable the selection of patients with LN metastases. Patients and methods We evaluated the expression of stabilin-2 in primary oral tongue tumors and metastatic LNs using immunohistochemical staining. The correlation between risk factors and nodal metastasis was assessed and disease-free survival was analyzed. Results Stabilin-2 expression remained a significant predictor of LN metastasis and the factor affecting recurrence in tongue cancer. Most importantly, all metastatic tumors of tongue, lung, stomach and colon cancers stained positive for stabilin-2 and stabilin-2 was expressed strongly in the sinusoidal endothelial cell of metastatic LNs. Conclusion Stabilin-2 can play a critical role in the first entrapping step of LN metastasis through homotypic interaction with the lymphatic endothelium and appears to be a tumor biomarker predicting for LN metastasis in patients with solid tumors.

The purpose of this study was to evaluate the changes in body weight following tracheostomy in pediatric patients.Ninety-eight patients who underwent tracheostomy at the age of 0-6 years were enrolled. The body weight and growth percentile were measured before tracheostomy and at 1, 6, and 12 months after surgery. The body weight and growth percentile were plotted against time, which was compared with Korean growth chart curve. A Retrospective observational cohort study was performed.The mean body weight increased gradually from 6.7 (±0.51) kg to 10.84 (±0.15) kg at 12 months post-surgery (p 0.01). The growth percentile also increased from 24.41 (±3.18) to 40.6 (±4.10) during the follow-up period (p 0.01). We analyzed the patients with a low growth percentile (≤50th percentile). In these patients, the mean body weight increased from 4.92 (±0.27) kg to 8.97 (±0.27) kg and the growth percentile also increased from 11.02 (±1.32) to 30.56 (±3.31) (all p 0.01). Ventilator-independent patients also presented similar pattern of body weight and its percentile.Body weight increased after tracheostomy that was safely performed in children requiring airway management.

Soft tissue sarcomas of the head and neck (HNSTS) show various histological types and clinical behaviour. Recently, the 8th edition of the American Joint Committee on Cancer (AJCC) proposed a staging system for HNSTS independent of other body soft tissue sarcomas, which requires validation. Therefore, we evaluated the prognostic factors for the survival of HNSTS patients through a comparison between previous and current AJCC staging systems.This study involved 135 consecutive HNSTS patients who underwent primary surgery, chemoradiotherapy or chemotherapy. Patients were grouped into staged (S) and not staged (NS) cancer according to the AJCC 8th edition staging. Cox proportional-hazard regression analyses were used to identify factors associated with overall survival (OS), and progression-free survival (PFS) in all, S or NS patients.Median follow-up period was 75 months and the 5-year OS and PFS rates of all patients were 67.8% and 53.4%, respectively, which was similar between S and NS groups. Age, tumour size and grade, overall stage (7th edition) and resection margin were the significant prognostic factors for OS and PFS in all patients and NS group (all P 0.05), whereas positive resection margin was the only significant factor for OS and PFS in the S group (P 0.001). While OS was poorly discriminated among different 8th edition T-categories, different 7th edition showed good discrimination among overall stages in all patients and the NS group.The revised staging system may not provide an improved risk stratification for survival of HNSTS patients.

Papillary thyroid carcinoma (PTC) is generally associated with favorable outcomes; however, intermediate-risk requires further evaluation. We therefore examined risk factors for posttreatment recurrence in patients with intermediate-risk PTC.This study involved 1782 patients who underwent thyroidectomy for intermediate-risk PTC. Univariate and multivariate Cox proportional hazard regression analyses were used to identify the significant factors predictive of posttreatment recurrence-free survival (RFS).Of intermediate-risk factors, univariate analyses showed that clinical and pathological cervical lymph node (LN) positivity (cN1 and pN1), aggressive histology, and multifocality with microscopic extrathyroidal extension were significantly associated with RFS outcomes (all P 0.05). In multivariate analyses, cN1,5 pN1, and posttreatment radioactive iodine (RAI)-avid metastatic foci of intermediate risk remained the independent factors predictive of RFS (all P 0.05). The combination of any three or more of these intermediate-risk factors appeared to increase the posttreatment recurrence rate.Clinical nodal positivity, the number of positive LNs, and the presence of RAI-avid metastatic foci in the ATA intermediate-risk category might independently decrease RFS in patients with intermediate-risk PTC.

Background and Aims Data are limited regarding the impact of age and sedation on cardiocerebrovascular disease (CCD) adverse events after GI endoscopy. We investigated the incidence of and risk factors for CCD adverse events after diagnostic GI endoscopy and the impact of age and sedation on these unfavorable outcomes. Methods In this nationwide population-based study, the incidence of and risk factors for newly diagnosed CCD within 14 days after diagnostic endoscopy were analyzed using Health Insurance Review and Assessment Service data from January to December 2015. Results Among 1,943,150 subjects, CCD adverse events occurred in approximately 2.23% within 14 days after endoscopy. According to the performance of sedation during endoscopy (60.1% nonsedation vs 39.9% sedation, midazolam alone [96.4%]), the incidence rates of CCD adverse events (per 10,000 persons) were 275.8 versus 302.8 for EGD, 116.9 versus 143.8 for colonoscopy, and 230.4 versus 243.2 for EGD + colonoscopy, respectively. On multivariate analysis, older age (70-99 years) and sedation were independent risk factors for CCD adverse events. Regarding CCD risk stratified by age and sedation, older age had a significant impact on CCD adverse events in individuals who underwent EGD only or EGD + colonoscopy, but sedation did not. However, both older age and sedation had considerable influence on CCD adverse events in individuals who underwent colonoscopy only. Sedation during endoscopy was significantly associated with minor but not major CCD adverse events. CCD adverse events were significantly higher for inpatients. Conclusion CCD adverse events after diagnostic endoscopy were significantly frequent in individuals with older age (70-99 years) and/or sedation during endoscopy. Stratification by age and sedation shows that the impact of these 2 factors on CCD adverse events differs according to endoscopy type.

A 2-year field experiment was carried out on rice (Oryza sativa, Japonica type) cultivation in South Korea. The objective of this study was to investigate the effect of application of liquid pig manure on biomass production and nutrient supply of green barley (Hordeum vulgare L.) and hairy vetch (Vicia villosa Roth) green manure crops and to evaluate the effect of nutrients supplied from these sources on rice yield and soil quality in a rice-green manure crop rotation system. Over the 2-year study period, application of liquid pig manure increased biomass production of green manure crops of barley and hairy vetch by more than 216% and 135%, respectively, compared with without liquid pig manure. Moreover, the results showed that the application of liquid pig manure significantly increased the nutrient supply levels in green barley- and hairy vetch-treated areas. Positive effects related to nutrient supply in green barley and hairy vetch treated with liquid pig manure were observed on rice yield, soil chemical characteristics, and microbial biomass C and N contents. In conclusion, the addition of liquid pig manure systems using green manure crops of green barley and hairy vetch improved rice productivity and soil quality. It is suggested that these combinations can be effective in developing resource cycling agriculture in a rice-green manure crop rotation system as it reduces the need for inorganic fertilizer.

Objective: Conservative parotidectomy is known to reduce morbidity, but has been rarely examined in patients with clinically node-negative (cN0) parotid cancers. We evaluated the clinicopathological variables influencing the outcomes of these patients and the efficacy of conservative parotidectomy. Methods: We reviewed the clinical and pathological data of 256 patients with cN0 parotid carcinomas who underwent curative surgery at our institution. Of these, 110 and 146 underwent conservative and total parotidectomy, respectively, with 83 undergoing elective neck dissection and 135 receiving postoperative radiotherapy. Univariate and multivariate analyses of variables predicting recurrence-free survival (RFS) and overall survival (OS) were performed. Morbidity, survival, and recurrence rates were compared between the conservative and total parotidectomy groups. Results: The 5-year RFS and OS rates in all patients were 85.7 and 91.4%, respectively. Multivariate analysis showed that advanced T classification, positive resection margin, and high-histologic grade were independent prognostic factors for both RFS and OS. Among the 201 patients with low- or intermediate-grade parotid cancers, those who underwent total parotidectomy had a greater chance of facial nerve paralysis than those who underwent conservative parotidectomy (p < 0.001). The 5-year RFS and OS after conservative parotidectomy (93.7 and 100%, respectively) were not worse than those after total parotidectomy (85.5 and 90.9%, respectively). Conclusion: Patients with cN0 parotid cancers may be stratified by histological grade and T classification. Conservative parotidectomy may be suitable for early T1–2 low- or intermediate-grade tumors if a resection margin is secured.

Objectives Diminished skeletal muscle mass (SMM) is a reliable marker of poor survival outcomes in patients with cancer. SMM or body composition is generally assessed at the third lumbar vertebra (L3) by abdominal computed tomography (CT) scans, not routinely evaluated in patients with head and neck squamous cell carcinoma (HNSCC). Therefore, we evaluated the effectiveness of head and neck CT images to assess SMM in patients with HNSCC for predicting their overall survival. Materials and Methods SMM was assessed in 305 consecutive patients with stage III–IV HNSCC by measuring the cross-sectional area (CSA) at the third lumbar and cervical (C3) vertebrae levels. A formula for predicting the L3 SMM was established using linear regression analysis obtained from C3 CSA and other clinical factors. The actual SMM CSAs measured at L3 level and those obtained from the prediction model were compared using correlation analysis. The predictive power of our formula for estimating overall survival was compared using C-index. Results Median SMM CSAs at the L3 and C3 levels were 174.5 cm2 and 56.3 cm2, respectively, and were not strongly correlated (adjusted R2 = 0.421). Prediction model 2 included the strongest predictive factors including sex, age, weight, and C3 SMM CSA, and significantly increased the L3 SMM correlation power (adjusted R2 = 0.721). The C-index of the prediction model was 0.713 (95% confidence interval 0.692–0.747). Conclusions Head and neck CT imaging might be useful to estimate L3 SMM and predict overall survival in HNSCC patients.

BACKGROUND CIP2A may activate multiple oncogenic proteins and promote the proliferation of various cancer cells. METHODS We investigated that the role of CIP2A in radioresistant head and neck cancer (HNC) cell line with TP53 mutation and the effect of the rapamycin on the response of HN31 with TP53 mutation cells to irradiation related to CIP2A expression. RESULTS CIP2A expression was stimulated by p53 mutation and critical for the inhibition of senescence induction in response to radiation. The treatment with radiation alone neither induced cytotoxicity in HN31 cells nor completely suppressed the activation of CIP2A. However, the combination of radiation and rapamycin increase the radiosensitivity through the induction of senescence with downregulation of CIP2A expression both in vivo and in vitro. CONCLUSION Our results suggest that CIP2A may serve as a therapeutic target of rapamycin through induction of senescence in radioresistant HNC with TP53 mutation.