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Anggelia MR, Cheng HY, Lai PC, Hsieh YH, Lin CH, Lin CH. Cell Therapy in Vascularized Composite Allotransplantation. Biomed J 2022; 45:454-464. [PMID: 35042019 PMCID: PMC9422067 DOI: 10.1016/j.bj.2022.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/02/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
Allograft rejection is one of the obstacles in achieving a successful vascularized composite allotransplantation (VCA). Treatments of graft rejection with lifelong immunosuppression (IS) subject the recipients to a lifelong risk of cancer development and opportunistic infections. Cell therapy has recently emerged as a promising strategy to modulate the immune system, minimize immunosuppressant drug dosages, and induce allograft tolerance. In this review, the recent works regarding the use of cell therapy to improve allograft outcomes are discussed. The current data supports the safety of cell therapy. The suitable type of cell therapy in allotransplantation is clinically dependent. Bone marrow cell therapy is more suitable for the induction phase, while other cell therapies are more feasible in either the induction or maintenance phase, or for salvage of allograft rejection. Immune cell therapy focuses on modulating the immune response, whereas stem cells may have an additional role in promoting structural regenerations, such as nerve regeneration. Source, frequency, dosage, and route of cell therapy delivery are also dependent on the specific need in the clinical setting.
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Aguilar M, Cavasonza LA, Ambrosi G, Arruda L, Attig N, Barao F, Barrin L, Bartoloni A, Başeğmez-du Pree S, Battiston R, Behlmann M, Beranek B, Berdugo J, Bertucci B, Bindi V, Bollweg K, Borgia B, Boschini MJ, Bourquin M, Bueno EF, Burger J, Burger WJ, Burmeister S, Cai XD, Capell M, Casaus J, Castellini G, Cervelli F, Chang YH, Chen GM, Chen GR, Chen HS, Chen Y, Cheng L, Chou HY, Chouridou S, Choutko V, Chung CH, Clark C, Coignet G, Consolandi C, Contin A, Corti C, Cui Z, Dadzie K, Dass A, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Felice V, Díaz C, Dimiccoli F, von Doetinchem P, Dong F, Donnini F, Duranti M, Egorov A, Eline A, Feng J, Fiandrini E, Fisher P, Formato V, Freeman C, Gámez C, García-López RJ, Gargiulo C, Gast H, Gervasi M, Giovacchini F, Gómez-Coral DM, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Haino S, Han KC, Hashmani RK, He ZH, Heber B, Hsieh TH, Hu JY, Incagli M, Jang WY, Jia Y, Jinchi H, Karagöz G, Khiali B, Kim GN, Kirn T, Konyushikhin M, Kounina O, Kounine A, Koutsenko V, Krasnopevtsev D, Kuhlman A, Kulemzin A, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Li JQ, Li M, Li Q, Li S, Li JH, Li ZH, Liang J, Light C, Lin CH, Lippert T, Liu JH, Liu Z, Lu SQ, Lu YS, Luebelsmeyer K, Luo JZ, Luo X, Machate F, Mañá C, Marín J, Marquardt J, Martin T, Martínez G, Masi N, Maurin D, Medvedeva T, Menchaca-Rocha A, Meng Q, Mikhailov VV, Molero M, Mott P, Mussolin L, Negrete J, Nikonov N, Nozzoli F, Oliva A, Orcinha M, Palermo M, Palmonari F, Paniccia M, Pashnin A, Pauluzzi M, Pensotti S, Phan HD, Plyaskin V, Pohl M, Poluianov S, Qin X, Qu ZY, Quadrani L, Rancoita PG, Rapin D, Conde AR, Robyn E, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Schael S, von Dratzig AS, Schwering G, Seo ES, Shakfa Z, Shan BS, Siedenburg T, Solano C, Song JW, Song XJ, Sonnabend R, Strigari L, Su T, Sun Q, Sun ZT, Tacconi M, Tang XW, Tang ZC, Tian J, Ting SCC, Ting SM, Tomassetti N, Torsti J, Urban T, Usoskin I, Vagelli V, Vainio R, Valencia-Otero M, Valente E, Valtonen E, Vázquez Acosta M, Vecchi M, Velasco M, Vialle JP, Wang CX, Wang L, Wang LQ, Wang NH, Wang QL, Wang S, Wang X, Wang Y, Wang ZM, Wei J, Weng ZL, Wu H, Xiong RQ, Xu W, Yan Q, Yang Y, Yashin II, Yi H, Yu YM, Yu ZQ, Zannoni M, Zhang C, Zhang F, Zhang FZ, Zhang JH, Zhang Z, Zhao F, Zheng C, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zuccon P. Periodicities in the Daily Proton Fluxes from 2011 to 2019 Measured by the Alpha Magnetic Spectrometer on the International Space Station from 1 to 100 GV. PHYSICAL REVIEW LETTERS 2021; 127:271102. [PMID: 35061443 DOI: 10.1103/physrevlett.127.271102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/24/2021] [Accepted: 11/08/2021] [Indexed: 06/14/2023]
Abstract
We present the precision measurement of the daily proton fluxes in cosmic rays from May 20, 2011 to October 29, 2019 (a total of 2824 days or 114 Bartels rotations) in the rigidity interval from 1 to 100 GV based on 5.5×10^{9} protons collected with the Alpha Magnetic Spectrometer aboard the International Space Station. The proton fluxes exhibit variations on multiple timescales. From 2014 to 2018, we observed recurrent flux variations with a period of 27 days. Shorter periods of 9 days and 13.5 days are observed in 2016. The strength of all three periodicities changes with time and rigidity. The rigidity dependence of the 27-day periodicity is different from the rigidity dependences of 9-day and 13.5-day periods. Unexpectedly, the strength of 9-day and 13.5-day periodicities increases with increasing rigidities up to ∼10 GV and ∼20 GV, respectively. Then the strength of the periodicities decreases with increasing rigidity up to 100 GV.
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Kang CJ, Wen YW, Lee SR, Lee LY, Hsueh C, Lin CY, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Fang KH, Yen TC, Cheng NM, Tsai TY, Tai SF, Tsai CY. Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study. Cancers (Basel) 2021; 14:cancers14010015. [PMID: 35008181 PMCID: PMC8749941 DOI: 10.3390/cancers14010015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary While the prognostic role of surgical margins in oral cavity squamous cell carcinoma is well-established, the optimal cutoff values for margin status remain controversial. This study addressed this issue in a large sample of 13,768 patients included in a nationwide registry in Taiwan. The identification of the most suitable cutoff value for surgical margins was conducted using 5-year local control as the outcome of interest. On analyzing the margin status—categorized as 0, 0.1–4 and > 4 mm—the 5-year outcomes were as follows: local control, 87, 89 and 92%; disease-specific survival, 57, 76 and 81%; overall survival, 47, 67 and 74%, respectively. Collectively, these data indicate that a margin status >4 mm can be considered as adequate. Abstract (1) Background: The optimal cutoff value that maximizes the prognostic value of surgical margins in patients with resected oral cavity squamous cell carcinoma has not yet been identified. (2) Methods: Data for this study were retrieved from the Taiwan Cancer Registry Database. A total of 13,768 Taiwanese patients with oral cavity squamous cell carcinoma were identified and stratified according to different margin statuses (0, 0.1–4 and > 4 mm). The five-year local control, disease-specific survival and overall survival rates were the main outcome measures. (3) Results: The 5-year local control, disease-specific survival and overall survival rates of patients with close margins (0 and 0.1–4 mm) were significantly lower than those observed in patients with clear margins (> 4 mm; all p values < 0.001). In multivariate analysis, margin status, depth of invasion and extra-nodal extension were identified as independent adverse prognostic factors for 5-year local control. (4) Conclusions: A thorough assessment of surgical margins can provide a reliable prognostic prediction in patients with OCSCC. This has potential implications for treatment approaches tailored to the individual level. The achievement of clear margins (>4 mm) should be considered a key surgical goal to improve outcomes in this patient group.
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Chang CH, Wu WJ, Lee HY, Lin CH, Yue CT, Jiang YH, Lee YK, Huang KH, Tsai YC. Impact of Pathology Review in Adverse Histological Characteristics and pT Stages of Upper Tract Urothelial Cancer in a Multicenter Study. Front Oncol 2021; 11:757359. [PMID: 34900706 PMCID: PMC8655678 DOI: 10.3389/fonc.2021.757359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/25/2021] [Indexed: 01/18/2023] Open
Abstract
Purpose Pathology reviews for upper urinary tract cancer (UTUC) remained scarce in the literature. Here, we reported the interobserver variation among the review and local pathologies of featured histologic characteristics for UTUC. Methods Patients who underwent definitive surgical treatments for UTUC were retrospectively reviewed for eligibility of pathology review. In the Taiwan UTUC Collaboration cohort, 212 cases were reviewed, of which 154 cases were eligible for pathology review. Agreement between original pathology and review pathology was measured by the total percentage of agreement and by simple kappa statistics. The prognostic impact was analyzed by the Cox regression model with the estimation of hazard ratios (HR) and 95% confidence intervals. Results There were 80 women and 74 men enrolled in this study, and the median age at treatment was 71.7 years. The agreement is moderate agreement for surgical margin status (87.7%; κ = 0.61), tumor grade (82.5%; κ = 0.43), tumor invasiveness (76.6%; κ = 0.45), lymphovascular invasion (70.8%; κ = 0.42) and T stage (67.5%; κ = 0.52). The interobserver agreements for perineural invasion and variant histology identification were slight. Kaplan–Meier analysis for disease-free survival revealed comparable results in local and review pathology for localized (Tis, Ta, T1–2) or advanced T stage (T3–4). Conclusions Pathology review of UTUC had minimal impact on clinical practice based on current available disease treatment guidelines. However, significant interobserver variations were observed in featured adverse histopathological characters.
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Sakarya AH, Tsai KY, Hsu CC, Chen SH, Do NK, Anggelia MR, Lin CH, Lin CH. Free tissue transfers for reconstruction of weight-bearing heel defects: Flap selection, ulceration management, and contour revisions. J Plast Reconstr Aesthet Surg 2021; 75:1557-1566. [PMID: 34969626 DOI: 10.1016/j.bjps.2021.11.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/20/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Soft tissue defects in the weight-bearing heel represent a reconstructive challenge because of tissue complexity and lack of local/regional coverage. This study presents our reconstruction outcomes of different defect aetiologies, reconstruction timing, and flap selection. METHODS Patients with weight-bearing heel defects who underwent free tissue transfer from 2003 to 2014 and with at least 6 months of follow-up were retrospectively reviewed. Flap types (fasciocutaneous vs muscle/musculocutaneous), timing of reconstruction (early vs subacute vs delayed), and defect aetiology were compared in terms of flap failure, vascular complications, and ulceration. RESULTS Seventy-four flaps were used to reconstruct weight-bearing heel defects in 70 patients. Defect aetiology included trauma in 53 patients (75%), chronic wound in 12 patients (17%), and tumour resection in 6 patients (8%). Flap survival was 97% (72/74). There was no significant difference in flap failures between muscle and fasciocutaneous flaps. The timing of reconstruction showed no difference in flap survival. There was a significant difference in ulceration rate between the trauma and non-trauma groups (p = 0.001). Twenty-eight ulcers (39%) developed, 12 (43%) of which presented 3 years postoperatively, while only 6 cases (21%) presented within one year postoperatively. CONCLUSION Our experience represents one of the highest survival rates reported regarding free flap weight-bearing heel reconstruction. The anterolateral thigh flap was our first choice for extensive heel defects. Ulceration incidence was directly related to trauma and tends to develop 3 years after reconstruction. Delayed reconstruction was at least as safe as early or subacute reconstruction though with less need for debulking.
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Cheng NM, Kang CJ, Tsai CY, Lee LY, Lin CY, Hsueh C, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Liao CT. Improved prognostic stratification of patients with pN3b oral cavity cancer based on maximum standardized uptake value of metastatic nodes, lymph node ratio, and level of cervical nodal metastases. Oral Oncol 2021; 123:105593. [PMID: 34768211 DOI: 10.1016/j.oraloncology.2021.105593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The prognosis of pN3b oral cavity squamous cell carcinoma (OCSCC) remains heterogeneous. We sought to improve the prognostic stratification of patients with pN3b OCSCC through a combined analysis of FDG-PET parameters and clinicopathological risk factors (RFs). METHODS From 2001 to 2019, complete data on maximum standardized uptake values derived from FDG-PET of neck metastatic nodes (SUV-nodal-max) and clinicopathological RFs were available for 257 patients with pN3b disease. RESULTS Using the 5-year disease-free survival (DFS) as the outcome of interest, the optimal cutoff points for SUV-nodal-max and lymph node ratio (LNR) were 15.9 and 0.17, respectively. The 5-year DFS rates/(number of cases) for patients with pN3b disease were as follows: SUV-nodal-max < 15.9 versus ≥ 15.9, 49%(226)/21%(31), p = 0.000003; LNR < 0.17 versus ≥ 0.17, 49%(230)/17%(27), p = 0.000117; absence versus presence of neck level IV/V metastases, 49%(230)/15%(27), p = 0.000004. Multivariable analyses revealed that SUV-nodal-max ≥ 15.9, LNR ≥ 0.17, and level IV/V metastases were independent prognosticators for 5-year distant metastases (DM), DFS, disease-specific survival (DSS), and overall survival (OS) rates. Based on these variables, we devised a scoring system that identified three distinct prognostic subgroups at low (score 0, n = 190), intermediate (score 1, n = 51), and high (scores 2-3, n = 16) risk. The 5-year rates of patients with pN3b disease deemed to be at low/intermediate/high risk were as follows: DM, 31%/52%/89%; DFS, 54%/26%/0%; DSS, 59%/36%/8%; OS, 42%/31%/6%, respectively; all p < 0.001. CONCLUSIONS A scoring system based on SUV-nodal-max, LNR, and level IV/V metastases improves the prognostic stratification of OCSCC patients with pN3b disease.
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Liao CT, Wen YW, Lee SR, Ng SH, Liu TW, Tsai ST, Tsai MH, Lin JC, Chien CY, Lou PJ, Wang CP, Chu PY, Leu YS, Tsai KY, Terng SD, Chen TM, Wang CH, Chen WC, Lee LY, Lin CY, Wang HM, Fang TJ, Huang SF, Kang CJ, Chang KP, Yen TC, Yang LY, Lin CH. Clinical Outcomes of Taiwanese Patients with Resected Oral Cavity Squamous Cell Carcinoma Who Underwent Reconstruction with Free Versus Local Flaps. Ann Surg Oncol 2021; 29:1130-1140. [PMID: 34668119 DOI: 10.1245/s10434-021-10524-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 07/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND We sought to compare the clinical outcomes of Taiwanese patients with resected oral cavity squamous cell carcinoma (OCSCC) who underwent reconstruction with free versus local flaps. METHODS From 2011 to 2017, we examined 8646 patients with first primary OCSCC who received surgery either with or without adjuvant therapy. Of these patients, 7297 and 1349 received free and local flap reconstruction, respectively. Two propensity score-matched groups of patients who underwent free versus local flap (n = 1268 each) reconstructions were examined. Margin status was not included as a propensity score-matched variable. RESULTS Compared with local flaps, patients who received free flaps had a higher prevalence of the following variables: male sex, age < 65 years, pT3-4, pN1-3, p-Stage III-IV, depth ≥ 10 mm, margin > 4 mm, extranodal extension (ENE), and adjuvant therapy (all p < 0.0001). Multivariable analysis identified the reconstruction method (local vs. free flaps, only overall survival [OS]), age ≥ 65 years, pT3-4, pN1-3, p-Stage III-IV, depth ≥ 10 mm (only OS), margins ≤ 4 mm, and ENE as independent adverse prognosticators for disease-specific survival (DSS) and OS. The results of propensity score-matched analyses revealed that, compared with free flaps, patients who underwent local flap reconstruction showed less favorable 5-year DSS (hazard ratio [HR] 1.26, 82%/77%; p = 0.0100) and OS (HR 1.21, 73%/68%; p = 0.0079). CONCLUSIONS After adjusting for covariates using multivariate models, and also by propensity score modeling, OCSCC patients who underwent free flap reconstruction showed a higher frequency of clear margins and a significant survival advantage compared with those who received local flaps.
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Aguilar M, Cavasonza LA, Alpat B, Ambrosi G, Arruda L, Attig N, Barao F, Barrin L, Bartoloni A, Başeğmez-du Pree S, Battiston R, Behlmann M, Beranek B, Berdugo J, Bertucci B, Bindi V, Bollweg K, Borgia B, Boschini MJ, Bourquin M, Bueno EF, Burger J, Burger WJ, Burmeister S, Cai XD, Capell M, Casaus J, Castellini G, Cervelli F, Chang YH, Chen GM, Chen GR, Chen HS, Chen Y, Cheng L, Chou HY, Chouridou S, Choutko V, Chung CH, Clark C, Coignet G, Consolandi C, Contin A, Corti C, Cui Z, Dadzie K, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Felice V, Díaz C, Dimiccoli F, von Doetinchem P, Dong F, Donnini F, Duranti M, Egorov A, Eline A, Feng J, Fiandrini E, Fisher P, Formato V, Freeman C, Gámez C, García-López RJ, Gargiulo C, Gast H, Gervasi M, Giovacchini F, Gómez-Coral DM, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Haino S, Han KC, Hashmani RK, He ZH, Heber B, Hsieh TH, Hu JY, Incagli M, Jang WY, Jia Y, Jinchi H, Khiali B, Kim GN, Kirn T, Konyushikhin M, Kounina O, Kounine A, Koutsenko V, Krasnopevtsev D, Kuhlman A, Kulemzin A, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Li JQ, Li M, Li Q, Li S, Li JH, Li ZH, Liang J, Light C, Lin CH, Lippert T, Liu JH, Liu Z, Lu SQ, Lu YS, Luebelsmeyer K, Luo JZ, Luo X, Machate F, Mañá C, Marín J, Marquardt J, Martin T, Martínez G, Masi N, Maurin D, Medvedeva T, Menchaca-Rocha A, Meng Q, Mikhailov VV, Molero M, Mott P, Mussolin L, Negrete J, Nikonov N, Nozzoli F, Oliva A, Orcinha M, Palermo M, Palmonari F, Paniccia M, Pashnin A, Pauluzzi M, Pensotti S, Phan HD, Plyaskin V, Pohl M, Poluianov S, Qin X, Qu ZY, Quadrani L, Rancoita PG, Rapin D, Conde AR, Robyn E, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Schael S, von Dratzig AS, Schwering G, Seo ES, Shakfa Z, Shan BS, Siedenburg T, Solano C, Song JW, Song XJ, Sonnabend R, Strigari L, Su T, Sun Q, Sun ZT, Tacconi M, Tang XW, Tang ZC, Tian J, Ting SCC, Ting SM, Tomassetti N, Torsti J, Tüysüz C, Urban T, Usoskin I, Vagelli V, Vainio R, Valencia-Otero M, Valente E, Valtonen E, Vázquez Acosta M, Vecchi M, Velasco M, Vialle JP, Wang CX, Wang L, Wang LQ, Wang NH, Wang QL, Wang S, Wang X, Wang Y, Wang ZM, Wei J, Weng ZL, Wu H, Xiong RQ, Xu W, Yan Q, Yang Y, Yashin II, Yi H, Yu YM, Yu ZQ, Zannoni M, Zhang C, Zhang F, Zhang FZ, Zhang JH, Zhang Z, Zhao F, Zheng C, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zuccon P. Erratum: Properties of a New Group of Cosmic Nuclei: Results from the Alpha Magnetic Spectrometer on Sodium, Aluminum, and Nitrogen [Phys. Rev. Lett. 127, 021101 (2021)]. PHYSICAL REVIEW LETTERS 2021; 127:159901. [PMID: 34678040 DOI: 10.1103/physrevlett.127.159901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.127.021101.
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Huang HY, Chuang CH, Lin CH. Cystic neutrophilic granulomatous mastitis: Focus on preoperative cytology and intraoperative consultation. Kaohsiung J Med Sci 2021; 38:176-177. [PMID: 34595816 DOI: 10.1002/kjm2.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/11/2022] Open
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Lin CH, Lin YH, Tzeng IS, Kuo CY. An Association Rule Analysis of the Acupressure Effect on Sleep Quality. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:1399258. [PMID: 34630604 PMCID: PMC8494578 DOI: 10.1155/2021/1399258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sleep is recognized as an all-important physiological process, which also contributes to maintaining several bodily functions and systems. According to the Pittsburgh Sleep Quality Index (PSQI), also known as the most widely used tool in the field of subjective assessment of self-perceived sleep quality, a combination of acupoints could be more effective than single acupoint treatment in improving sleep quality. METHODS The present study was based on the extracted eligible studies rooted in a previous meta-analysis that worked on the basis of association rule mining and examined the potential kernel acupoint combinations for improving sleep quality. RESULTS Depending on the Apriori algorithm, we summarized 26 acupoints as binary data from the 32 eligible studies based on a previous meta-analysis and analyzed them. The top 10 most frequently selected acupoints were HT7, SP6, PC6, KI1, GV20, EM5, EX-HN3, EX-HN16, KI3, and MA-TF1. Furthermore, as deduced from 21 association rules, the primary relevant rules in the combination of acupoints are (EX-HN3, EX-HN16)=>(GV20) and (HT7, KI1)=>(PC6). CONCLUSIONS In order to use acupuncture to improve sleep quality, integrating (EX-HN3, EX-HN16, GV20) with (HT7, KI1, PC6) acupoints could be deemed as the kernel acupoint combination.
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Lin CY, Lee LY, Cheng NM, Lee SR, Tsai CY, Hsueh C, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Kang CJ, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Liao CT. cN+pN0 disease does not portend a less favorable prognosis compared with cN0pN0 in patients with resected oral cavity squamous cell carcinoma. Cancer Med 2021; 10:6947-6958. [PMID: 34558224 PMCID: PMC8525126 DOI: 10.1002/cam4.4187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/22/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background We compared the clinical outcomes of patients with oral cavity squamous cell carcinoma (OCSCC) with cN+pN0 versus cN0pN0 disease. Methods A total of 1309 OCSCC patients with pN0 disease were included. Of them, 1019 and 290 cases had cN0pN0 and cN+pN0 disease, respectively. For comparison purposes, we also examined 799 patients with pN+disease (cN0pN+/cN+pN+, n = 239/560). Subgroup analysis was performed in a propensity score‐matched cohort with cN0pN0 and cN+pN0 disease (n = 284 each). Results Compared with cN0pN0, patients with cN+pN0 had a higher prevalence of the following variables: betel chewing, pT3−4, depth ≥10 mm, perineural invasion, and treatment with surgery and adjuvant therapy. The prognosis of patients with cN+pN0 (mean: 52 nodes) and cN0pN0 (mean: 39 nodes) disease was similar both in the original cohort and after propensity score matching. However, the 5‐year outcomes were more favorable for cN+pN0/cN0pN0 compared with cN0pN+/cN+pN+ (local control, 88%/88%/83%/81%; neck control, 94%/93%/82%/76%; distant metastases, 4%/3%/13%/31%; disease‐free survival, 84%/83%/68%/52%; disease‐specific survival, 92%/92%/77%/57%; overall survival, 81%/82%/59%/42%; all p values <0.001; cN+pN0 versus cN0pN0, all p values >0.05). cN+pN0 disease (vs. cN0pN0) was not significantly associated with local control, neck control, distant metastases, and survivals either in univariable or multivariable analyses. Conclusions Despite a higher risk factor burden, the prognosis of patients with cN+pN0 disease did not differ from that of cases with cN0pN0. The higher nodal yield and the more frequent use of adjuvant therapy in cN+pN0 disease may explain the lack of significant differences in terms of neck control compared with cN0pN0 disease.
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Lee LY, Lin CY, Cheng NM, Tsai CY, Hsueh C, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Kang CJ, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Liao CT. Poor tumor differentiation is an independent adverse prognostic variable in patients with locally advanced oral cavity cancer--Comparison with pathological risk factors according to the NCCN guidelines. Cancer Med 2021; 10:6627-6641. [PMID: 34533269 PMCID: PMC8495291 DOI: 10.1002/cam4.4195] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023] Open
Abstract
Methods We sought to compare the prognostic impact of tumor differentiation with respect to adverse risk factors (RFs) identified by the National Comprehensive Cancer Network (NCCN) guidelines––including extranodal extension (ENE), positive/close margins, perineural invasion, lymphatic invasion, and vascular invasion––in patients with locally advanced oral cavity squamous cell carcinoma (OCSCC). Results Between 1996 and 2018, 1179 consecutive patients with first primary pT3–4 OCSCC were included. A three‐level grading system was adopted––in which the final classification was assigned according to the most prevalent tumor grade. We identified 382/669/128 patients with well/moderately/poorly differentiated tumors, respectively. Compared with well/moderately differentiated tumors, poorly differentiated OCSCC had a higher prevalence of the following variables: female sex (4%/6%/11%), ENE, (14%/36%/61%), positive margins (0.5%/2%/4%), close margins (10%/14%/22%), perineural invasion (22%/50%/63%), lymphatic invasion (2%/9%/17%), vascular invasion (1%/4%/10%), and adjuvant therapy (64%/80%/87%). The 5‐year rates of patients with well/moderately/poorly differentiated OCSCC were as follows: local control (LC, 85%/82%/84%, p = 0.439), neck control (NC, 91%/83%/70%, p < 0.001), distant metastases (DM, 6%/18%/40%, p < 0.001), disease‐free survival (DFS, 78%/63%/46%, p < 0.001), disease‐specific survival (DSS, 85%/71%/49%, p < 0.001), and overall survival (OS, 68%/55%/39%, p < 0.001). Multivariable analysis identified the following variables as independent prognosticators for 5‐year outcomes: ENE (LC/NC/DM/DFS/DSS/OS), poorly differentiated tumors (NC/DM/DFS/DSS/OS), positive margins (LC/DFS), lymphatic invasion (DFS/DSS/OS), perineural invasion (DM), and age ≥65 years (OS). Conclusions In addition to ENE, poor tumor differentiation was identified as the second most relevant adverse RF for patients with pT3–4 OCSCC. We suggest that the NCCN guidelines should include poor tumor differentiation as an adverse RF to refine and tailor clinical management.
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Cheng HC, Kuo CY, Huang CW, Shih HH, Lin CH, Wang JY. Unusual paediatric sigmoid perivascular epithelioid cell tumour with regional lymph node metastasis treated using gemcitabine and docetaxel: a case report and literature review. J Int Med Res 2021; 49:3000605211041509. [PMID: 34510959 PMCID: PMC8442492 DOI: 10.1177/03000605211041509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Perivascular epithelioid cell tumour (PEComa) is an extremely rare neoplasm with
distinctive morphology and specific expression of immunohistochemical markers.
The lesion is typically diagnosed in middle-aged women, with few reports of
paediatric cases, and there is no standardized treatment for the tumour type.
Here, the case of a 17-year-old female, who presented with painless
haematochezia for 2 days and was diagnosed with gastrointestinal PEComa of the
sigmoid colon with regional lymph node metastasis after serial examination, is
presented. She was treated by surgical resection of the tumour and cytotoxic
chemotherapy comprising 900 mg/m2 gemcitabine and 100
mg/m2 docetaxel every 3 weeks for six cycles. Haematochezia did
not recur, and complete response was achieved, with progression-free survival at
the 24-month follow-up examination. Surgical resection with adjuvant
conventional cytotoxic chemotherapy may be considered as an option for treating
gastrointestinal PEComa.
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Yao ZG, Cheng XK, Lin CH, Li J, Lyu BB, Li JM, Jing HY, Qin YJ, Sun XC. [Genetic analysis of 45 patients with suspected Lynch syndrome using next-generation sequencing]. ZHONGHUA ZHONG LIU ZA ZHI [CHINESE JOURNAL OF ONCOLOGY] 2021; 43:843-849. [PMID: 34407589 DOI: 10.3760/cma.j.cn112152-20190717-00441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the value of next generation sequencing (NGS) in the genetic testing of Lynch syndrome. Methods: Immunohistochemical method was used to detect the expressions of DNA mismatch repair (MMR) proteins, including MutL homolog 1 (MLH1), PMS1 homolog 2 (PMS2), MutS homolog 2 (MSH2) and MutS homolog 6 (MSH6) in colorectal cancer, gastric cancer and endometrial cancer tissues collected from Shandong Provincial Hospital between 2016 and 2018. The genomic DNA of 45 patients who were suspected with Lynch syndrome was extracted from non-cancerous tissue paraffin samples, which were postoperatively confirmed by microscope. The mutations of 12 genes including MLH1 and MSH2 were detected using NGS. The germline mutant sites and significance were analyzed by bioinformatics technology and further confirmed by using Sanger sequencing. Results: The immunohistochemical results showed that the 45 cases of suspected Lynch syndrome included 22 cases of MLH1 and PMS2 deficient expression, 16 cases of MLH2 and MSH6 deficient expression, and 7 cases of MMR proteins normal expression. The NGS result showed that 28 cases of adjacent sample from colon cancer patients included 4 cases of MLH1 pathogenic mutation, 1 case of suspected MLH1 mutation, 2 cases of MLH2 pathogenic mutation, 2 cases of suspected MLH2 mutation. No MMR gene mutation was found in adjacent samples of 6 cases of rectal cancer, 6 cases of gastric cancer and 7 cases of colorectal cancer with MMR normal expression. One case of MLH1 or MHL2 pathogenic mutation and one case of MLH1 suspected mutation was detected in adjacent samples of 5 cases of endometrial cancer. Moreover, NGS also detected many other genes mutations and unreported gene mutation sites. Pathogenic and suspected MLH1 and MSH2 mutations were verified by Sanger sequencing. Conclusions: High-throughput NGS is a quick, accurate and reliable technique to identify gene variants in suspected Lynch syndrome patients. It has a wide application prospect for gene testing of tumors associated with Lynch syndrome.
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Aguilar M, Cavasonza LA, Alpat B, Ambrosi G, Arruda L, Attig N, Barao F, Barrin L, Bartoloni A, Başeğmez-du Pree S, Battiston R, Behlmann M, Beranek B, Berdugo J, Bertucci B, Bindi V, Bollweg K, Borgia B, Boschini MJ, Bourquin M, Bueno EF, Burger J, Burger WJ, Burmeister S, Cai XD, Capell M, Casaus J, Castellini G, Cervelli F, Chang YH, Chen GM, Chen GR, Chen HS, Chen Y, Cheng L, Chou HY, Chouridou S, Choutko V, Chung CH, Clark C, Coignet G, Consolandi C, Contin A, Corti C, Cui Z, Dadzie K, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Felice V, Díaz C, Dimiccoli F, von Doetinchem P, Dong F, Donnini F, Duranti M, Egorov A, Eline A, Feng J, Fiandrini E, Fisher P, Formato V, Freeman C, Gámez C, García-López RJ, Gargiulo C, Gast H, Gervasi M, Giovacchini F, Gómez-Coral DM, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Haino S, Han KC, Hashmani RK, He ZH, Heber B, Hsieh TH, Hu JY, Incagli M, Jang WY, Jia Y, Jinchi H, Khiali B, Kim GN, Kirn T, Konyushikhin M, Kounina O, Kounine A, Koutsenko V, Krasnopevtsev D, Kuhlman A, Kulemzin A, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Li JQ, Li M, Li Q, Li S, Li JH, Li ZH, Liang J, Light C, Lin CH, Lippert T, Liu JH, Liu Z, Lu SQ, Lu YS, Luebelsmeyer K, Luo JZ, Luo X, Machate F, Mañá C, Marín J, Marquardt J, Martin T, Martínez G, Masi N, Maurin D, Medvedeva T, Menchaca-Rocha A, Meng Q, Mikhailov VV, Molero M, Mott P, Mussolin L, Negrete J, Nikonov N, Nozzoli F, Oliva A, Orcinha M, Palermo M, Palmonari F, Paniccia M, Pashnin A, Pauluzzi M, Pensotti S, Phan HD, Plyaskin V, Pohl M, Poluianov S, Qin X, Qu ZY, Quadrani L, Rancoita PG, Rapin D, Conde AR, Robyn E, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Schael S, von Dratzig AS, Schwering G, Seo ES, Shakfa Z, Shan BS, Siedenburg T, Solano C, Song JW, Song XJ, Sonnabend R, Strigari L, Su T, Sun Q, Sun ZT, Tacconi M, Tang XW, Tang ZC, Tian J, Ting SCC, Ting SM, Tomassetti N, Torsti J, Tüysüz C, Urban T, Usoskin I, Vagelli V, Vainio R, Valencia-Otero M, Valente E, Valtonen E, Vázquez Acosta M, Vecchi M, Velasco M, Vialle JP, Wang CX, Wang L, Wang LQ, Wang NH, Wang QL, Wang S, Wang X, Wang Y, Wang ZM, Wei J, Weng ZL, Wu H, Xiong RQ, Xu W, Yan Q, Yang Y, Yashin II, Yi H, Yu YM, Yu ZQ, Zannoni M, Zhang C, Zhang F, Zhang FZ, Zhang JH, Zhang Z, Zhao F, Zheng C, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zuccon P. Properties of a New Group of Cosmic Nuclei: Results from the Alpha Magnetic Spectrometer on Sodium, Aluminum, and Nitrogen. PHYSICAL REVIEW LETTERS 2021; 127:021101. [PMID: 34296911 DOI: 10.1103/physrevlett.127.021101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/30/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
We report the properties of sodium (Na) and aluminum (Al) cosmic rays in the rigidity range 2.15 GV to 3.0 TV based on 0.46 million sodium and 0.51 million aluminum nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. We found that Na and Al, together with nitrogen (N), belong to a distinct cosmic ray group. In this group, we observe that, similar to the N flux, both the Na flux and Al flux are well described by the sums of a primary cosmic ray component (proportional to the silicon flux) and a secondary cosmic ray component (proportional to the fluorine flux). The fraction of the primary component increases with rigidity for the N, Na, and Al fluxes and becomes dominant at the highest rigidities. The Na/Si and Al/Si abundance ratios at the source, 0.036±0.003 for Na/Si and 0.103±0.004 for Al/Si, are determined independent of cosmic ray propagation.
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Kang CJ, Tsai CY, Lee LY, Lin CY, Yang LY, Cheng NM, Hsueh C, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Liao CT. Prognostic stratification of patients with AJCC 2018 pStage IVB oral cavity cancer: Should pT4b and pN3 disease be reclassified? Oral Oncol 2021; 119:105371. [PMID: 34174527 DOI: 10.1016/j.oraloncology.2021.105371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/22/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES pStage IVB oral cavity squamous cell carcinoma (OCSCC) is defined as either pT4b or pN3 disease. We sought to devise an improved prognostic stratification of this patient group. METHODS Between December 2003 and January 2018, we retrospectively reviewed the clinical records of 1331 consecutive patients with OCSCC who received tumor excision and neck dissection. The number of patients with pT4a/pT4b, pT1N3b/pT2N3b/pT3N3b/pT4N3b, and pStage IVA/IVB was 370/83, 3/49/42/142, and 332/295, respectively. RESULTS The 5-year rates of disease-free survival (DFS) and disease-specific survival (DSS) for patients with pT4a/pT4b disease were 64%/63% (p = 0.973) and 72%/69% (p = 0.672), respectively. The 5-year DFS and DSS rates for patients with pT1N3b/pT2N3b/pT3N3b/pT4N3b disease were 67%/65%/40%/42% (p < 0.001; pT1-2N3b versus pT3-4N3b, p = 0.002) and 100%/68%/45%/49% (p < 0.001; pT1-2N3b versus pT3-4N3b, p = 0.002), respectively. We devised a new definition for pStage IV by considering patients with pT4bN0-2 and pT1-2N3b diseases as pStage-IVA. The number of patients with pStage IVA/IVB (pT3-4N3b) was 443/184. The 5-year rates of AJCC pStage IVA/IVB and the newly proposed pStage IVA/IVB (pT3-4N3b) were as follows: DFS, 74%/52% and 72%/42%; DSS, 83%/58% and 81%/47%; respectively, all p value < 0.001. CONCLUSIONS The clinical outcomes of pT4b and pT4a OCSCC are similar. However, patients with pT3-4N3b disease have a less favorable 5-year prognosis compared with cases with pT1-2N3b. In light of the unfavorable outcomes, pT3-4N3b disease should continue to be classified as pStage IVB. Conversely, pT4bN0-2 and pT1-2N3b diseases portend a less adverse prognosis and should therefore be downstaged to pStage IVA.
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Tu CL, Lin CH. Metastasis of pulmonary adenocarcinoma to the thyroid closely mimics papillary thyroid carcinoma. Kaohsiung J Med Sci 2021; 37:831-832. [PMID: 34139099 DOI: 10.1002/kjm2.12410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
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Anggelia MR, Cheng HY, Chuang WY, Hsieh YH, Wang AYL, Lin CH, Wei FC, Brandacher G, Lin CH. Unraveling the Crucial Roles of FoxP3+ Regulatory T Cells in Vascularized Composite Allograft Tolerance Induction and Maintenance. Transplantation 2021; 105:1238-1249. [PMID: 33141809 DOI: 10.1097/tp.0000000000003509] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The role of regulatory T cells (Treg) in tolerance induction of vascularized composite allotransplantation (VCA) remains unclear. This study was designed to examine characteristics of Treg after VCA and their capacity to rescue allografts from rejection. METHODS Osteomyocutaneous allografts were transplanted from Balb/c to C57BL/6 mice. All mice received costimulatory blockade and a short course of rapamycin. To elucidate the role of Treg for tolerance induction, Treg depletion was performed at postoperative day (POD) 0, 30, or 90. To assess capacity of Treg to rescue allografts from rejection, an injection of 2 × 106 Treg isolated from tolerant mice was applied. RESULTS Eighty percent of VCA recipient mice using costimulatory blockade and rapamycin regimen developed tolerance. The tolerant recipients had a higher ratio of circulating Treg to effector T cells and elevated interleukin-10 at POD 30. A significantly higher rejection rate was observed when Treg were depleted at POD 30. But Treg depletion at POD 90 had no effect on tolerance. Treg from tolerant recipients showed stronger suppressive potential and the ability to rescue allografts from rejection. Furthermore, transplanted Treg-containing skin grafts from tolerant mice delayed rejection elicited by adoptively transferred effector T cells to Rag2-/- mice. CONCLUSIONS Circulating Treg are crucial for inducing VCA tolerance in the early posttransplant phase, and allograft-residing Treg may maintain tolerance. Treg may, therefore, serve as a potential cellular therapeutic to improve VCA outcomes.
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Tsai CY, Lee SR, Lee LY, Hsueh C, Lin CY, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Kang CJ, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Cheng NM, Wen YW, Liao CT. Clinical outcomes of Taiwanese patients with resected squamous cell carcinoma of the upper and lower gum. Oral Oncol 2021; 118:105334. [PMID: 34020150 DOI: 10.1016/j.oraloncology.2021.105334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/07/2021] [Accepted: 05/05/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This large-scale cohort study was designed to compare the clinical outcomes of Taiwanese patients with squamous cell carcinoma (SCC) of the upper versus lower gum. METHODS Between 2004 and 2017, we identified 4244 patients with first primary SCC of the gum (694 upper gum; 3550 lower gum) who were treated with surgery either with or without adjuvant therapy. Of them, 1990 patients (329 upper gum; 1661 lower gum) enrolled from 2011 to 2017 had a higher number of histopathological variables and entered subgroup analyses. Five-year disease-specific survival (DSS) and overall survival (OS) rates served as outcome measures. RESULTS The 5-year DSS and OS rates of patients with upper gum SCC were lower than those of cases with lower gum SCC (65%/74%, p < 0.0001; and 55%/65%, respectively, p < 0.0001). Compared with lower gum SCC, upper gum SCC had a higher prevalence of the following variables: female sex, age ≥ 65 years, pNx (without neck dissection), no-betel chewing (2011-2017), no-smoking (2011-2017), and margin status ≤ 4 mm (positive and close margins, 2011-2017). On multivariable analysis, gum subsite (upper versus lower), age (≥65 versus < 65 years), pT (T3 - 4 versus T1 - 2), pN (N1 - 3 versus N0/Nx), depth (≥10 mm versus < 10 mm, 2011-2017), ENE (present versus absent, 2011-2017), and margins (≤4 mm versus > 4 mm 2011-2017, only DSS) were identified as independent adverse prognostic factors for 5-year DSS and OS. CONCLUSIONS Compared to lower gum SCC, upper gum SCC had less favorable 5-year outcomes. Wide resection margins are recommended to improve prognosis of upper gum SCC.
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Chuang SY, Chen CY, Yang SC, Alalaiwe A, Lin CH, Fang JY. 2,4-Dimethoxy-6-Methylbenzene-1,3-diol, a Benzenoid From Antrodia cinnamomea, Mitigates Psoriasiform Inflammation by Suppressing MAPK/NF-κB Phosphorylation and GDAP1L1/Drp1 Translocation. Front Immunol 2021; 12:664425. [PMID: 34054833 PMCID: PMC8162112 DOI: 10.3389/fimmu.2021.664425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Antrodia cinnamomea exhibits anti-inflammatory, antioxidant, and immunomodulatory activities. We aimed to explore the antipsoriatic potential of 2,4-dimethoxy-6-methylbenzene-1,3-diol (DMD) derived from A. cinnamomea. The macrophages activated by imiquimod (IMQ) were used as the cell model for examining the anti-inflammatory effect of DMD in vitro. A significantly high inhibition of IL-23 and IL-6 by DMD was observed in THP-1 macrophages and bone marrow-derived mouse macrophages. The conditioned medium of DMD-treated macrophages could reduce neutrophil migration and keratinocyte overproliferation. DMD could downregulate cytokine/chemokine by suppressing the phosphorylation of mitogen-activated protein kinases (MAPKs) and NF-κB. We also observed inhibition of GDAP1L1/Drp1 translocation from the cytoplasm to mitochondria by DMD intervention. Thus, mitochondrial fission could be a novel target for treating psoriatic inflammation. A psoriasiform mouse model treated by IMQ showed reduced scaling, erythema, and skin thickening after topical application of DMD. Compared to the IMQ stimulation only, the active compound decreased epidermal thickness by about 2-fold. DMD diminished the number of infiltrating macrophages and neutrophils and their related cytokine/chemokine production in the lesional skin. Immunostaining of the IMQ-treated skin demonstrated the inhibition of GDAP1LI and phosphorylated Drp1 by DMD. The present study provides insight regarding the potential use of DMD as an effective treatment modality for psoriatic inflammation.
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Lim KA, Lin CH, Lin CH. A 19-Year Experience With Clavicular Defects: An Algorithm for Flap Selection and Surgical Outcomes. Ann Plast Surg 2021; 86:562-567. [PMID: 33939654 DOI: 10.1097/sap.0000000000002547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The clavicle contributes to the stability and functional integrity of the shoulder. Clavicle bone defects are uncommon, and the strategy for their management is variable. METHOD Six patients presented with clavicle bone defects. The causes were as follows: traumatic defects (2 patients), electric injury (1 patient), osteoradionecrosis (2 patients), and nonunion (1 patient). One patient had upper limb palsy for 40 years, and another had posttraumatic shoulder function impairment. A pedicled pectoralis major myocutaneous flap was used for the patient with a dysfunctional limb, and 5 bone flaps (3 free fibular flaps, 1 free iliac flap, and 1 pedicled rib flap) were used for reconstruction in the other patients. RESULT All flaps (2 pedicled flaps and 4 free flaps) were successfully used for wound repair; the pedicled rib flap demonstrated partial marginal necrosis, and the free fibular flap required reexploration for venous kinking. Five functionally impaired upper limbs showed functional improvements postoperatively. CONCLUSION For functionless composite clavicles and soft tissue defects, a soft tissue flap will be required for wound repair. A bone flap, especially a fibular flap, is required for the upper limb to show functional recovery. The variety of flaps will be planned according to the defect size comparison between the bone and soft tissue, and ipsilateral upper limb function, and a proposed algorithm will be discussed.
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Lin CH, Kornhuber J, Zheng F, Alzheimer C. Tonic Control of Secretory Acid Sphingomyelinase Over Ventral Hippocampal Synaptic Transmission and Neuron Excitability. Front Cell Neurosci 2021; 15:660561. [PMID: 33897374 PMCID: PMC8062921 DOI: 10.3389/fncel.2021.660561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
The acid sphingomyelinase (ASM) converts sphingomyelin into ceramide. Recent work has advanced the ASM/ceramide system as a major player in the pathogenesis of major depressive disorder (MDD). Indeed, ASM activity is enhanced in MDD patients and antidepressant drugs like fluoxetine act as functional inhibitors of ASM. Here, we employed the specific ASM inhibitor ARC39 to explore the acute effects of the enzyme on hippocampal synaptic transmission and cell excitability in adult mouse brain slice preparations. In both field potential and whole-cell recordings, ARC39 (1-3 μM) enhanced excitatory synaptic input onto ventral hippocampal CA1 pyramidal cells. The specificity of drug action was demonstrated by its lacking effect in slices from ASM knockout mice. In control condition, ARC39 strongly reduced firing in most CA1 pyramidal cells, together with membrane hyperpolarization. Such pronounced inhibitory action of ARC39 on soma excitability was largely reversed when GABAA receptors were blocked. The idea that ARC39 recruits GABAergic inhibition to dampen cell excitability was further reinforced by the drug's ability to enhance the inhibitory synaptic drive onto pyramidal cells. In pyramidal cells that were pharmacologically isolated from synaptic input, the overall effect of ARC39 on cell firing was inhibitory, but some neurons displayed a biphasic response with a transient increase in firing, suggesting that ARC39 might alter intrinsic firing properties in a cell-specific fashion. Because ARC39 is charged at physiological pH and exerted all its effects within minutes of application, we propose that the neurophysiological actions reported here are due to the inhibition of secretory rather than lysosomal ASM. In summary, the ASM inhibitor ARC39 reveals a tonic control of the enzyme over ventral hippocampal excitability, which involves the intrinsic excitability of CA1 pyramidal cells as well as their excitatory and inhibitory synaptic inputs.
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Lin CH, Kudva A. Simultaneous Reconstruction of Mandibular and Maxillary Defects Using the Single Free Fibular Osseocutaneous Flap: Case Series and Review of the Literature. Ann Plast Surg 2021; 86:428-433. [PMID: 33587455 DOI: 10.1097/sap.0000000000002436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The facial profile requires adequate maxillary and mandibular projection. Although oral cancer tumor ablation might create ipsilateral maxillary and mandibular defect, fibular flap is popular in mandibular defect reconstruction. However, the maxillary defect results in sunken cheek or oral contracture. A single fibular flap can provide several struts to rebuild 2 jaws with adequate 3-dimensional spatial placement. MATERIALS AND METHODS In total, 7 cases of secondary oral contracture and 2 cases of primary oncologic tumor ablation underwent single fibular flap for 2 jaws. Using multiple osteotomies, the distal fibular struts were used for the upper jaw, the second struts were discarded (3-4 cm), and proximal struts were used for mandible defect reconstruction. There were 5 accompanying free flaps for facial lining (2) and contralateral oral contracture release (3). RESULTS All flaps survived without distal strut avascular necrosis, but 2 patients died from tumor metastasis. These patients presented adequate middle and lower facial profile. One patient underwent mandibular fibula strut distraction osteogenesis followed by integrated teeth on both jaws. CONCLUSIONS Single fibular transfer can accomplish 2 jaw bony defects and facial profile reconstruction. It can release oral contracture functionally and correct sunken cheek aesthetically. The reconstructed fibula can allow secondary teeth implantation rehabilitation.
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Li CR, Wang JC, Lin CH, Hsu JS. Focal IgG4-related autoimmune pancreatitis mimicking pancreatic tumor. Kaohsiung J Med Sci 2021; 37:741-742. [PMID: 33728789 DOI: 10.1002/kjm2.12380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 11/11/2022] Open
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Chen JT, Lin CH, Huang HW, Wang YP, Kao PC, Yang TP, Wang SK. Novel REST Truncation Mutations Causing Hereditary Gingival Fibromatosis. J Dent Res 2021; 100:868-874. [PMID: 33719663 DOI: 10.1177/0022034521996620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare genetic disorder featured by nonsyndromic pathological overgrowth of gingiva. The excessive gingival tissues can cause dental, masticatory, and phonetic problems, which impose severe functional and esthetic burdens on affected individuals. Due to its high recurrent rate, patients with HGF have to undergo repeated surgical procedures of gingival resection, from childhood to adulthood, which significantly compromises their quality of life. Unraveling the genetic etiology and molecular pathogenesis of HGF not only gains insight into gingival physiology and homeostasis but also opens avenues for developing potential therapeutic strategies for this disorder. Recently, mutations in REST (OMIM *600571), encoding a transcription repressor, were reported to cause HGF (GINGF5; OMIM #617626) in 3 Turkish families. However, the functions of REST in gingival homeostasis and pathogenesis of REST-associated HGF remain largely unknown. In this study, we characterized 2 HGF families and identified 2 novel REST mutations, c.2449C>T (p.Arg817*) and c.2771_2793dup (p.Glu932Lysfs*3). All 5 mutations reported to date are nonsenses or frameshifts in the last exon of REST and would presumably truncate the protein. In vitro reporter gene assays demonstrated a partial or complete loss of repressor activity for these truncated RESTs. When coexpressed with the full-length protein, the truncated RESTs impaired the repressive ability of wild-type REST, suggesting a dominant negative effect. Immunofluorescent studies showed nuclear localization of overexpressed wild-type and truncated RESTs in vitro, indicating preservation of the nuclear localization signal in shortened proteins. Immunohistochemistry demonstrated a comparable pattern of ubiquitous REST expression in both epithelium and lamina propria of normal and HGF gingival tissues despite a reduced reactivity in HGF gingiva. Results of this study confirm the pathogenicity of REST truncation mutations occurring in the last exon causing HGF and suggest the pathosis is caused by an antimorphic (dominant negative) disease mechanism.
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