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Tsai YT, Fang KH, Chen WC, De Vito A, Liao CT, Kang CJ, Hsu CM, Huang EI, Tsai MS, Chang GH, Lee YC, Lai CH. Survival-weighted quality of life profiles in patients treated for laryngeal and hypopharyngeal cancers. J Cancer 2024; 15:1805-1815. [PMID: 38434970 PMCID: PMC10905404 DOI: 10.7150/jca.92400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
Objectives: This study assessed functional outcomes and quality of life (QoL) in the long term in individuals treated for laryngohypopharyngeal cancer (LHC) by estimating their life expectancy (LE), survival-weighted psychometric scores (SWPSs), and quality-adjusted LE (QALE). Materials and methods: To estimate survival outcomes, we retrospectively reviewed the data of 1576 patients treated for primary LHC between January 2010 and December 2018 and followed them until death or December 2020. We also prospectively collected QoL and functional data between October 2013 and November 2022 from 232 patients by administering the Taiwanese Chinese versions of the QoL Questionnaire Core 30, Head and Neck 35, and EQ-5D-3L. To estimate LE, we employed linear extrapolation of a logit-transformed curve. We calculated QALE and SWPSs by combining the QoL data with the LE results. Results: We estimated the LE of the patients with LHC to be 7.8 years and their loss of LE to be 15.7 years. The estimated QALE was 7.0 QALYs, with a loss of QALE of 16.5 QALYs. Lifetime impairment durations were estimated for cognitive (4.9 years), physical (4.2 years), emotional (3.4 years), social (3.4 years), and role functions (2.7 years). We estimated the durations of problems related to swallowing, speech, and teeth to be 6.2, 5.6, and 4.8 years, respectively. The patients were expected to be dependent on feeding tubes for 1.2 years. Conclusions: Patients with LHC experience significant reductions in both LE and QALE. SWPSs may constitute a valuable tool for obtaining subjective information regarding how LHC affects multifaceted QoL outcomes.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ku-Hao Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Wen-Cheng Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Andrea De Vito
- Ear Nose Throat (ENT) Unit, Department of Surgery, Forlì Hospital Health Local Agency of Romagna, Italy
| | - Chun-Ta Liao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
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Tsai YT, Fang KH, Tsai MH, Lai CH, Ko CA, Tsai MS, Chang GH, Liao CT, Kang CJ, Hsu CM, Huang EI, Lee YC, Tsai YH, Luan CW. Prognostic utility of preoperative platelet-to-albumin ratio in surgically treated oral cavity cancer patients. Head Neck 2024; 46:386-397. [PMID: 38071495 DOI: 10.1002/hed.27592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/10/2023] [Accepted: 11/24/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND This study aimed to explore the prognostic utility of the preoperative platelet-to-albumin ratio (PAR) among patients with oral cavity squamous cell carcinoma (OSCC). METHODS We retrospectively reviewed of 355 patients with surgically-treated OSCC between 2008 and 2017. The optimal PAR cutoff for patient stratification was determined through X-tile analysis. Prognostic variables for disease-free survival (DFS) and overall survival (OS) were identified using Cox proportional hazards models. We developed a PAR-based nomogram to predict personalized OS. RESULTS We determined the optimal PAR cutoff to be 7.45. A PAR of ≥7.45 was an independent negative prognostic factor for DFS and OS (hazard ratio = 1.748 and 2.386; p = 0.005 and p < 0.001, respectively). The developed nomogram demonstrates the practical utility of PAR and accurately predicts personalized OS. CONCLUSIONS The preoperative PAR is a promising and cost-effective prognostic biomarker for patients with surgically-treated OSCC; the PAR-based nanogram accurately predicts OS for such patients.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ku-Hao Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Hsien Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chien-An Ko
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Ta Liao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ethan I Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yuan-Hsiung Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chih-Wei Luan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Lo Sheng Sanatorium and Hospital Ministry of Health and Welfare, Taoyuan, Taiwan
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Tsai HW, Chao WC, Lee YH, Tsai YT, Tsai MS, Lee YC. Sublabial excision versus transnasal endoscopic marsupialization for nasolabial cysts: A systematic review and meta-analysis. Clin Otolaryngol 2024; 49:102-108. [PMID: 37818679 DOI: 10.1111/coa.14105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES To compare the intraoperative and postoperative outcomes of sublabial excision and transnasal endoscopic marsupialization, the two primary surgical approaches for nasolabial cysts. DESIGN AND SETTING A comprehensive meta-analysis of studies identified from PubMed, Embase, and the Cochrane Library. PARTICIPANTS Patients diagnosed with nasolabial cysts who underwent surgical treatment. MAIN OUTCOME MEASURES Operative time, postoperative pain, overall postoperative complications, admission rate, length of hospital stay, use of general anaesthesia, medical costs, and recurrence rate. RESULTS The pooled analysis revealed that the transnasal endoscopic marsupialization group had shorter operative time (mean differences [MD], -32.51; 95% confidence interval [CI], -38.52 to -26.51), reduced postoperative pain (MD, -4.25; 95% CI, -7.62 to -0.89), fewer overall postoperative complications (risk difference [RD], -0.68; 95% CI, -0.90 to -0.46), lower admission rates (RD, -0.86; 95% CI, -1.11 to -0.61), shorter hospital stays (MD, -1.74; 95% CI, -2.58 to -0.89), decreased use of general anaesthesia (RD, -0.40; 95% CI, -0.76 to -0.03), and reduced medical costs (MD, -229.69; 95% CI, -338.64 to -120.75). The recurrence rate between the two groups showed no significant difference (RD, -0.01; 95% CI, -0.05 to 0.04). CONCLUSION Transnasal endoscopic marsupialization presents as a promising alternative to sublabial excision in the treatment of nasolabial cysts. It offers advantages like reduced operative time, decreased postoperative pain, fewer complications, lower admission rates, shorter hospital stays, diminished need for general anaesthesia, and cost savings. Clinicians can leverage these findings to select the most suitable surgical approach for their patients.
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Affiliation(s)
- Hao-Wen Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chieh Chao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yi-Hsuan Lee
- Department of Orthopedic Surgery, Buddhist Tzu-Chi General Hospital, Taipei, Taiwan
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
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Li ST, Chou YH, Huang HJ, Chang HC, Lee YC. Exploring the Benefits of 3D-Printed Bolus in Cone Beam CT for Modified Radical Mastectomy Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e685. [PMID: 37786014 DOI: 10.1016/j.ijrobp.2023.06.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To improve the accuracy of superficial dose coverage for patients undergoing modified radical mastectomy (MRM), boluses are frequently applied to the skin surface of targeted region during radiotherapy. The irregular curvature of MRM breast cases results in discrepancies of dosimetry and poor contact. Additionally, the presence of an air gap causes unnecessary high-dose escalation and uncertainty in dose calculation, making the use of commercial flat bolus problematic. This study evaluated the effectiveness of 3D-printed bolus by comparing it to commercial bolus in setup variations and dosimetric compliance through daily cone-beam computed tomography (CBCT) scans. MATERIALS/METHODS Ten patients underwent MRM were divided into 2 groups. 5 patients treated with 0.5 cm commercial bolus as group A while the other 5 patients covered by 3D Bolus as group B. 3D bolus was made of polylactic acid filament (PLA) and contoured in advance with thickness of 0.5 cm on the surface of target. Positional errors were recorded through daily image guidance and compared with the images. Both groups had right-sided breast with neck lymph nodes involved and received 50 Gy in 25 fractions using 4 partial arcs of the volumetric modulated arc therapy (VMAT) technique. The CBCTs were recalculated through treatment planning system (TPS) to assess superficial dose coverage. A two-tailed student's t-test was applied. RESULTS Groups A and B pitch angles were -0.203 ± 0.837° and 0.334 ± 0.909° (p = 0.0003). Roll angle were 0.313 ± 0.728° and -0.633 ± 1.286° (p = 0.0000013). Yaw angle were -0.034 ± 0.872° and 0.018 ± 0.883° (p = 0.721). There was a trend of differences in the Z-axis and significant statistical differences in the pitch and roll angles due to aligning gel layers directly with group A's body surface, while 3D bolus rigidly adherence to group B's delineated curve. In the planned target volume (PTV), the CI and HI of group A were 0.9448±0.0208 and 1.2061±0.0448, respectively, while 0.9776±0.0144 and 1.1472±0.0206 (p<0.005) were for group B. As for the superficial region, which is defined from body surface to 0.5cm inside PTV, CI and HI of A were 0.8290±0.0599 and 1.4675±0.2434, while for B, they were 0.9753±0.0214 and 1.1330±0.0126, respectively (p<0.005). CONCLUSION The study analyzed the results through image comparison and investigated the CI and HI between two types of boluses. The 3D bolus reduces setup errors and improves dose coverage especially when superficial region is concerned. Better consistency of patient repositioning and dosimetry can be achieved and proved by daily assessment of CBCT scan. The customization of 3D bolus with integration of TPS and CT scans provides a solution to the inadequacies of commercial bolus. The results suggest that the use of 3D bolus is a promising development in radiation therapy for MRM breast cancer patients.
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Affiliation(s)
- S T Li
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y H Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H J Huang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H C Chang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Yang HF, Ke YF, Tsai PF, Chan HM, Chen HL, Lee YC. The Effectiveness of Music Interventions for Improving Anxiety Symptoms in Cancer Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e453. [PMID: 37785457 DOI: 10.1016/j.ijrobp.2023.06.1641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Being alone in the treatment room during radiation therapy (RT) often causes anxiety which may lead to treatment failure. The benefit of music interventions in reducing anxiety among cancer patients during RT simulations is still controversial. The goal of this study is to evaluate the effect of music on anxiety symptoms among patients undergoing initial RT and a randomized trial was conducted. MATERIALS/METHODS Patients who received RT for the first time were enrolled and were randomly allocated into groups of experiment and control. The questionnaire of mood thermometer (BSRS-5), distress thermometer (DT), and the Beck Anxiety Inventory (BAI-C) and were given before and after RT. We also measured the changes in physiological symptoms for ten consecutive days since the first day of RT. The experimental group was given music during RT, while the control group was not. The generalized linear mixed model was used to estimate the pre-post difference of music interventions on the BSRS-5, DT, and BAI-C compared with control group after considering the random intercept and the unstructured residual variance-covariance matrix. RESULTS A total of 50 patients in the experimental group and 50 patients in the control group were enrolled in this study. The satisfaction degree of treatment in the experimental group was 100%, but it was 96% in control group (p = 0.0048). The pre-test BSRS-5 was 3.4±2.3 for the experimental group versus 2.6±2.3 for the control group (p = 0.0815), the post-test BSRS-5 score was significantly reduced in the experimental group (1.6±1.4 for experimental group versus 2.7±2.2 for the control group, p = 0.0057), the significant pre-post difference of BSRS-5 between group was found (p = 0.0024). When the experimental group withdrew from the music intervention, the BSRS-5 rebounded to 3.7±3.0. The pre-test DT was 4.3±1.5 and 3.4±1.7 in the experimental group and control group (p = 0.0051), and the post-test DT score was significantly reduced in the experimental group (2.7±1.2 for the experimental group and 3.5±1.3 for the control group, p = 0.0021), the significant pre-post difference of DT between group was found (p<.0001). When the experimental group withdrew from the music intervention, the DT rebounded to 3.7±1.4. The pre-test BAI-C was 6.7±11.7 and 7.8±8.5 in the experimental group and control group (p = 0.5878), and the post-test BAI-C score was significantly lower in the experimental group (1.7±3.7 for the experimental group and 7.4±8.0 for the control group, p<.0001), however, the pre-post difference of BAI-C between group was not significant (p = 0.0619). When the experimental group withdrew from the music intervention, the BAI-C rebounded to 6.5±8.7. There is a significantly increased systolic blood pressure in the control group compared with the patients had music intervention. CONCLUSION This study's results provide evidence that playing music routinely (music intervention) during RT can be an excellent way to relieve patients' anxiety and improve their comfort.
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Affiliation(s)
- H F Yang
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y F Ke
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - P F Tsai
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H M Chan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H L Chen
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Yarlagadda S, Kutuk T, Saxena A, Roy M, Tolakanahalli RP, Appel H, La Rosa de Los Rios AF, Tom MC, Hall MD, Wieczorek DJ, Lee YC, McDermott MW, Ahluwalia M, Gutierrez A, Mehta MP, Kotecha R. Stereotactic Radiosurgery for Small Intact Brain Metastasis: A Comparative Evaluation of 3 Different Single Fraction Prescription Doses. Int J Radiat Oncol Biol Phys 2023; 117:e159-e160. [PMID: 37784753 DOI: 10.1016/j.ijrobp.2023.06.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) While single-fraction stereotactic radiosurgery (SRS) in the treatment of small brain metastases (SBM, ≤ 2 cm) is well established, prescription dosing varies considerably across institutions and clinical trials. The choice of prescription dose is a delicate balance between local failure (LF) and radiation necrosis (RN) risks. In the modern era, historically-established dosing thresholds may no longer be applicable. To evaluate the impact of prescription dose on outcomes, we performed a comparative analysis of patients with SBM treated with definitive SRS using three different prescriptions, at a single tertiary institution. MATERIALS/METHODS Consecutive patients with intact SBM treated with SRS from January 2017 and December 2021 were analyzed. Baseline patient characteristics and dosing parameters were abstracted from the medical record. To limit the integral brain dose when treating multiple brain metastases, the institutional practice was to reduce prescription dose as the total number of lesions increased (i.e., 24 Gy for ≤10 lesions, 22 Gy for 11-20, and 20 Gy for >20). A per lesion analysis, where each lesion was followed from the date of SRS to the last follow-up, was conducted with primary endpoints of LF and RN. Gray's test was used to compare the cumulative incidence of the LF and RN, with death as a competing risk. Factors affecting LF were analyzed using Cox hazard regression analysis. RESULTS A total of 1318 SBM in 250 patients received SRS and met the inclusion criteria. The median age was 62 years (range: 18-90), median KPS was 90 (range: 50-100) and 66% were female. The most common primary tumors were lung (55.5%) and breast cancers (26.4%). With a median follow-up of 12 months, 136 (11%) LF in 44 patients and 70 (5.7%) RN events in 46 patients occurred. The actuarial 1-year cumulative rate of LF was lower in lesions treated with 24 Gy (6.4%, 95% CI: 4.7-8.6%) or 22 Gy (5.8%, 95% CI: 3.7-8.7%) compared to 20 Gy (15.4%, 95% CI: 10.9-20.5%) (p<0.01). 22 Gy and 24 Gy prescription doses were associated with a 44% and 52% reduction in risk in LF compared to 20 Gy (HR: 0.56; 95% CI: 0.36-0.9; p = 0.01 and HR: 0.48; 95% CI: 0.31-0.74; p<0.01, respectively). In a subset analysis of radiosensitive tumors, 1-year LF rate was still lower with 24 Gy (7.4%, 95% CI: 5.3-9.9%) and 22 Gy (6.1%, 95% CI: 3.7-9.4%) than 20 Gy (15.7%, 95% CI: 11.2-21%) (p = 0.01). The cumulative 1-year RN rate numerically declined with dose, but was not statistically significantly different, with 3.6% (95% CI: 2.3-5.3%) for 24 Gy, 2.6% (95% CI: 1.3-4.8%) for 22 Gy and 1.4% (95% CI: 0.4-3.7%) for 20 Gy. CONCLUSION Patients treated with single fraction SRS to intact SBM were at increased risk of LF with prescription doses of 20 Gy compared to 22-24 Gy, without an increased risk of RN. Even in patients with radiosensitive histologies, higher LF rates were still observed following 20 Gy compared to 22-24 Gy.
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Affiliation(s)
- S Yarlagadda
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - T Kutuk
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A Saxena
- Department of Biostatistics, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M Roy
- Department of Biostatistics, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - R P Tolakanahalli
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - H Appel
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A F La Rosa de Los Rios
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M C Tom
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M D Hall
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - D J Wieczorek
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - Y C Lee
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - M W McDermott
- Department of Neurosurgery, Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL
| | - M Ahluwalia
- Department of Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A Gutierrez
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - M P Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - R Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
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Chang BJ, Lee YC. Src Kinase Activates Signal Transducer and Activator of Transcription 3 to Enhance Radioresistance in Triple Negative Breast Cancer Cells. Int J Radiat Oncol Biol Phys 2023; 117:e244. [PMID: 37784959 DOI: 10.1016/j.ijrobp.2023.06.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Triple-negative breast cancer (TNBC) is known to be insensitive to radiation therapy, and it requires to development radiosensitizer for TNBC. MATERIALS/METHODS We previously established a radioresistant sub-line from MDA-MB-231 cells, called 231-RR, and have demonstrated that 231-RR cells displayed high cancer stem cell (CSC) activity. And 231-RR cells were treated with dasatinib, a Src inhibitor. RESULTS In the present study, we discovered that the activation of Src kinase was increased in 231-RR cells. Treatment of dasatinib, an Src inhibitor, sensitized 231-RR cells to radiotherapy, along with the increased p-γH2Axser139, indicated the enhancement of DNA damage. Dasatinib also caused the downregulation of cancer stemness factors, including c-Myc, OCT4, and the Notch intracellular domain, as well as the decrease of phosphorylation of Signal Transducer and Activator of Transcription 3 (STAT3). The treatment of C188-9, a STAT3 inhibitor, also sensitized 231-RR cells toward radiotherapy along with the increased p-γH2Axser139, but without changing the phosphorylation of Src, indicating that STAT3 is a downstream event of Src activation. CONCLUSION In conclusion, our data suggests that the inhibitors of Src or STAT3 could function as radiosensitizers or CSC targeting agents for TNBC radiotherapy.
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Affiliation(s)
- B J Chang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Luan CW, Kuo LT, Wang YT, Liao CT, Kang CJ, Lee YC, Chen KY, Lai CH, Tsai YH, Huang EI, Tsai MS, Hsu CM, Chang GH, Tsai YT. Utility of modified Glasgow prognostic score for head and neck squamous cell carcinoma: Systematic review and meta-analysis. Head Neck 2023. [PMID: 37161915 DOI: 10.1002/hed.27397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/30/2023] [Indexed: 05/11/2023] Open
Abstract
Whether the modified Glasgow prognostic score (mGPS) is useful for patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. An electronic database search on EMBASE, PubMed, and the Cochrane Library from inception to 30 June 2022 was performed for study selection and data extraction. The associations between the mGPS and survival outcomes were evaluated using a random-effects meta-analysis and expressed as pooled hazard ratios (HRs) and 95% CIs. We included 11 studies involving a total of 2017 patients with HNSCC. A higher mGPS was associated with poorer progression-free survival (HR = 2.39, 95% CI 1.69-3.38), overall survival (HR = 2.40, 95% CI 1.94-2.98), disease-specific survival (HR = 2.57, 95% CI 1.71-3.88), and disease-free survival (HR = 2.67, 95% CI 1.51-4.73, all p ≤ 0.001) in HNSCC. The mGPS can function as a valid prognostic biomarker for patients diagnosed as having HNSCC.
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Affiliation(s)
- Chih-Wei Luan
- Department of Otorhinolaryngology - Head and Neck Surgery, LO-Sheng Hospital Ministry of Health and Welfare-Home, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Lunghwa University of Science and Technology, Taoyuan, Taiwan
| | - Liang-Tseng Kuo
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yun-Ting Wang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chun-Ta Liao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Kuan-Yin Chen
- School of Dentistry, National Yang Ming University, Hsinchu, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ethan I Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
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9
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Tsai YT, Lai CH, Chang GH, Hsu CM, Tsai MS, Liao CT, Kang CJ, Tsai YH, Lee YC, Huang EI, Tsai MH, Fang KH. A Nomogram Incorporating Neutrophil-to-Lymphocyte Ratio and Squamous Cell Carcinoma Antigen Predicts the Prognosis of Oral Cancers. Cancers (Basel) 2023; 15:cancers15092492. [PMID: 37173956 PMCID: PMC10177202 DOI: 10.3390/cancers15092492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
We introduced a novel squamous cell carcinoma inflammatory index (SCI) and explored its prognostic utility for individuals with operable oral cavity squamous cell carcinomas (OSCCs). We retrospectively analyzed data from 288 patients who were given a diagnosis of primary OSCC from January 2008 to December 2017. The SCI value was derived by multiplying the serum squamous cell carcinoma antigen and neutrophil-to-lymphocyte ratio values. We appraised the associations of the SCI with survival outcomes by performing Cox proportional hazards and Kaplan-Meier analyses. We constructed a nomogram for survival predictions by incorporating independent prognostic factors in a multivariable analysis. By executing a receiver operating characteristic curve analysis, we identified the SCI cutoff to be 3.45, and 188 and 100 patients had SCI values of <3.45 and ≥3.45, respectively. The patients with a high SCI (≥3.45) were associated with worse disease-free survival and overall survival than those with a low SCI (<3.45). An elevated preoperative SCI (≥3.45) predicted adverse overall survival (hazard ratio [HR] = 2.378; p < 0.002) and disease-free survival (HR = 2.219; p < 0.001). The SCI-based nomogram accurately predicted overall survival (concordance index: 0.779). Our findings indicate that SCI is a valuable biomarker that is highly associated with patient survival outcomes in OSCC.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Chun-Ta Liao
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Yuan-Hsiung Tsai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
| | - Ethan I Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Ming-Hsien Tsai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kaohsiung 833253, Taiwan
| | - Ku-Hao Fang
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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10
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Fang KH, Lai CH, Hsu CM, Liao CT, Kang CJ, Lee YC, Huang EI, Chang GH, Tsai MS, Tsai YT. Prognostic impact of the hemoglobin-albumin-lymphocyte-platelet score in patients with oral cavity cancer undergoing surgery. Head Neck 2023; 45:1558-1571. [PMID: 37080923 DOI: 10.1002/hed.27372] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/08/2023] [Accepted: 04/09/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND We aimed to probe the hemoglobin-albumin-lymphocyte-platelet (HALP) score's prognostic value in oral cavity squamous cell carcinoma (OSCC). METHODS Medical data of 350 patients with primary operated OSCC were retrospectively reviewed. We derived the optimal HALP cutoff by executing receiver operating characteristic curve analysis, and patients were then grouped based on this cutoff value. Cox proportional hazards model were used to discover survival outcome-associated factors. RESULTS We derived the optimal HALP cutoff as 35.4. A low HALP score (<35.4) predicted poorer overall and disease-free survival (hazard ratio: 2.29 and 1.92, respectively; both p < 0.001) and was significantly associated with OSCC aggressiveness. We established a HALP-based nomogram that accurately predicted overall survival (concordance index: 0.784). CONCLUSION The HALP score may be a useful prognostic biomarker in patients with OSCC undergoing surgery, and the HALP-based nomogram can be a promising prognostic tool in clinical setting.
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Affiliation(s)
- Ku-Hao Fang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Jan Kang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ethan I Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
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11
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Wang YT, Kuo LT, Lai CH, Tsai YH, Lee YC, Hsu CM, Liao CT, Kang CJ, Huang EI, Tsai MS, Chang GH, Tsai YT. Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis. J Cancer 2023; 14:281-289. [PMID: 36741261 PMCID: PMC9891875 DOI: 10.7150/jca.80955] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/25/2022] [Indexed: 01/12/2023] Open
Abstract
Background: Studies have indicated that a low albumin-to-globulin ratio (AGR) before treatment is linked to poor prognosis of many cancers, but the prognostic impact of AGR remains controversial in head and neck cancer (HNC). This meta-analysis examined the prognostic value of AGR in HNC. Methods: We systematically searched the Embase, PubMed, and Cochrane library for relevant articles from inception to July 22, 2022. Studies conducted from 2000 to 2022 exploring the prognostic value of AGR in HNC were retrieved. We employed a random-effects model and calculated pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) to examine the associations of AGR with survival outcome. Results: Our analysis included nine studies involving 3211 patients with HNC. The pooled results revealed significant associations between low pretreatment AGRs and poor disease-free survival (HR = 1.97, 95% CI 1.58-2.45, p < 0.001), distant metastasis-free survival (HR = 1.64, 95% CI 1.25-2.16, p < 0.001), overall survival (HR = 2.18, 95% CI 1.65-2.88, p < 0.001), T3-T4 status (OR = 2.22, 95% CI 1.43-3.44, p < 0.001), stage III-IV disease (OR = 2.62, 95% CI 1.62-4.23, p < 0.001), and lymph node metastasis (OR = 1.95, 95% CI 1.29-2.82, p = 0.001) in patients with HNC. Conclusion: AGR can serve as a prognostic biomarker in managing HNC, and a low pretreatment AGR is strongly associated with adverse survival outcomes and advanced cancer status. Additional large-scale prospective trials must be conducted to assess the validity of our findings.
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Affiliation(s)
- Yun-Ting Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Tseng Kuo
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Ta Liao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,✉ Corresponding author: Yao-Te Tsai, MD, Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. Address: No.6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan. E-mail: ; Tel: +886 975014653
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12
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Ho CF, Hsin LJ, Yang SW, Tsai YT, Tsai MS, Lee YC. Postauricular incision versus conventional transcervical incision in submandibular gland excision: A systematic review and meta-analysis. Asian J Surg 2023; 46:18-23. [PMID: 35382969 DOI: 10.1016/j.asjsur.2022.03.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/11/2022] [Accepted: 03/17/2022] [Indexed: 12/16/2022] Open
Abstract
Surgical removal of the submandibular gland is indicated for different conditions affecting the gland, such as neoplasm, sialadenitis, and sialolithiasis, and different types of surgical approaches have been reported. The purpose of this meta-analysis was to evaluate the differences between the postauricular approach and conventional transcervical approach in submandibular gland excision. A systematic review was performed using PubMed, Embase and the Cochrane Library to identify studies comparing outcomes of submandibular gland surgery via the postauricular approach and conventional transcervical approach. The data of interest were analyzed with Comprehensive Meta-Analysis software (version 3; Biostat, Englewood, NJ). Dichotomous data and continuous data were analyzed by calculating the risk difference (RD) and the mean difference (MD) with the 95% confidence interval (CI), respectively. The results show that the postauricular incision is a feasible approach to access the submandibular gland, and compared with the conventional transcervical approach, it requires a longer operative duration but has a similar complication rate and yields better cosmetic outcomes.
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Affiliation(s)
- Che-Fang Ho
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Shih-Wei Yang
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan.
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13
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Cheng YY, Gregorich Z, Prajnamitra RP, Lundy DJ, Ma TY, Huang YH, Lee YC, Ruan SC, Lin JH, Lin PJ, Kuo CW, Chen P, Yan YT, Tian R, Kamp TJ, Hsieh PC. Metabolic Changes Associated With Cardiomyocyte Dedifferentiation Enable Adult Mammalian Cardiac Regeneration. Circulation 2022; 146:1950-1967. [PMID: 36420731 PMCID: PMC9808601 DOI: 10.1161/circulationaha.122.061960] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/29/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cardiac regeneration after injury is limited by the low proliferative capacity of adult mammalian cardiomyocytes (CMs). However, certain animals readily regenerate lost myocardium through a process involving dedifferentiation, which unlocks their proliferative capacities. METHODS We bred mice with inducible, CM-specific expression of the Yamanaka factors, enabling adult CM reprogramming and dedifferentiation in vivo. RESULTS Two days after induction, adult CMs presented a dedifferentiated phenotype and increased proliferation in vivo. Microarray analysis revealed that upregulation of ketogenesis was central to this process. Adeno-associated virus-driven HMGCS2 overexpression induced ketogenesis in adult CMs and recapitulated CM dedifferentiation and proliferation observed during partial reprogramming. This same phenomenon was found to occur after myocardial infarction, specifically in the border zone tissue, and HMGCS2 knockout mice showed impaired cardiac function and response to injury. Finally, we showed that exogenous HMGCS2 rescues cardiac function after ischemic injury. CONCLUSIONS Our data demonstrate the importance of HMGCS2-induced ketogenesis as a means to regulate metabolic response to CM injury, thus allowing cell dedifferentiation and proliferation as a regenerative response.
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Affiliation(s)
- Yuan-Yuan Cheng
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Zachery Gregorich
- Department of Medicine and Stem Cell and Regenerative Medicine Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
| | | | - David J. Lundy
- Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei 110, Taiwan
| | - Ting-Yun Ma
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yu-Hsuan Huang
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yi-Chan Lee
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Shu-Chian Ruan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Jen-Hao Lin
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Po-Ju Lin
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Chiung Wen Kuo
- Research Center for Applied Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Peilin Chen
- Research Center for Applied Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yu-Ting Yan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Rong Tian
- Mitochondria and Metabolism Center, Department of Anesthesiology and Pain Medicine and Department of Bioengineering, University of Washington, Seattle, WA 98109, USA
| | - Timothy J. Kamp
- Department of Medicine and Stem Cell and Regenerative Medicine Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Patrick C.H. Hsieh
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- Department of Medicine and Stem Cell and Regenerative Medicine Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
- Graduate Institute of Medical Genomics and Proteomics and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
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14
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Li HY, Tsai MS, Lee LA, Hsin LJ, Lee YC, Lin WN, Lu YA, Shen SC, Cheng WN, Chaing YT. Palatal hybrid surgery for obstructive sleep apnea-state-of-the-art annotation of uvulopalatopharyngoplasty. Biomed J 2022; 46:100568. [PMID: 36356890 DOI: 10.1016/j.bj.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/16/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Surgery for obstructive sleep apnea (OSA) has changed in concept and technique that transformed from radical excision to functional reconstruction. The aim of this study was to investigate the safety and effectiveness of palatal hybrid surgery in OSA patients. METHODS Palatal hybrid surgery is a tissue-specific technique (mucosa-preservation, tonsil-excision, fat-ablation, muscle-relocation/suspension) used in treating OSA patients with velopharyngeal obstruction. The study included 46 consecutive adults OSA patients. The palatal hybrid surgery annotates uvulopalatopharyngoplasty in stereoscopic reconstruction of tonsillar fossa (pharyngoplasty), omni-suspension of the soft palate (palatoplasty) and advancement of uvula (uvuloplasty). RESULTS No patient experienced airway compromise, voice change or persistent nasal regurgitation following palatal hybrid surgery. One patient existed postoperative tonsillar fossa bleeding received conservative treatment. Postoperative pain in visual analogue scale (VAS) showed average score of 3, 3, 2, 0 at the 1st, 3rd, 7th, 14th day, respectively. Perioperative snoring severity (VAS) (8.7 vs 2.6) and daytime sleepiness (Epworth Sleepiness Scale) (11.3 vs 5.5) all improved significantly (p < 0.001). Posterior air space in retropalatal area increased from 8.4 to 11.1 mm (p < 0.001). Home sleep test showed that apnea-hypopnea index significantly reduced from 41.8 to 18.2 event/h and minimal oxygen saturation increased from 72.4 to 81.5% (p < 0.001). The success rate in individual Friedman stage was 100% (stage I), 63% (stage II) and 58% (stage III) with a total success rate of 63%. CONCLUSION Palatal hybrid surgery using tissue-specific maneuver annotates UPPP in concept and technique. The results show that palatal hybrid surgery is mini-invasive with low morbid and is effective in improving subjective clinic symptoms, objective sleep parameters and success rate of OSA.
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Affiliation(s)
- Hsueh-Yu Li
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Departments of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital at Chayi, Chayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Li-Ang Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Departments of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Wan-Ni Lin
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-An Lu
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Shen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Departments of Otolaryngology - Head & Neck Surgery, New Taipei City Municipal Tucheng Hospital, New Taipei, Taiwan
| | - Wen-Nuan Cheng
- Department of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Yen-Ting Chaing
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan
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15
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Ko CA, Fang KH, Tsai MS, Lee YC, Lai CH, Hsu CM, Huang EI, Chang GH, Tsai YT. Prognostic Value of Neutrophil Percentage-to-Albumin Ratio in Patients with Oral Cavity Cancer. Cancers (Basel) 2022; 14:cancers14194892. [PMID: 36230814 PMCID: PMC9564168 DOI: 10.3390/cancers14194892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/17/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
This study investigated preoperative neutrophil percentage-to-albumin ratio (NPAR) for predicting oral cavity squamous cell carcinoma (OSCC) survival. We retrospectively analyzed 368 patients who received curative OSCC surgery between 2008 and 2017. Receiver operating characteristic curve analyses were employed to identify the optimal NPAR cutoff (16.93), and the patients were then separated into low-NPAR and high-NPAR groups. Intergroup differences in survival were determined through Kaplan−Meier analysis and log-rank tests. Disease-free survival (DFS) and overall survival (OS) predictors were identified using Cox proportional-hazards models. A nomogram integrating independent prognostic factors was proposed to increase the accuracy of OS prediction. A high NPAR (≥16.93) was associated with worse median OS and DFS than was a low NPAR (both p < 0.001); this finding was confirmed through multivariate analyses (hazard ratio (HR) for OS = 2.697, p < 0.001; and HR for DFS = 1.671, p = 0.008). The nomogram’s favorable predictive ability was confirmed by the calibration plots and concordance index (0.784). The preoperative NPAR is thus a promising prognostic biomarker in patients with OSCC after external validation in a larger cohort. Our nomogram can facilitate clinical use of the NPAR and provides accurate individualized OS predictions.
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Affiliation(s)
- Chien-An Ko
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Ku-Hao Fang
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 60040, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan
- Correspondence:
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16
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Tsao YN, Ho CF, Hsin LJ, Yang SW, Tsai YT, Tsai MS, Lee YC. Postauricular Incision Versus Modified Blair Incision in Parotidectomy: A Systematic Review and Meta-Analysis. Surg Innov 2022:15533506221120484. [PMID: 36128913 DOI: 10.1177/15533506221120484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The mainstay of first-line treatment of parotid tumors is adequate surgical removal. The present study was conducted to compare the differences between parotidectomy with postauricular incision (PI) and modified Blair incision (MBI). DATA SOURCES A systematic search of PubMed, Embase and the Cochrane Library was performed. METHODS The data of interest and study characteristics were extracted from the included studies. Statistical analysis was performed with Comprehensive Meta-Analysis software (version 3; BioStat, Englewood, NJ). Dichotomous data and continuous data were analyzed by calculating the risk difference and the mean difference with the 95% confidence interval respectively. RESULTS Four retrospective studies were included in the present meta-analysis. The pooled results revealed that the cosmetic satisfaction score was higher in the PI group (MD = 2.67; 95% CI, 2.12 to 3.23) and that intraoperative blood loss was lower in the PI group (MD = -55.35; 95% CI, -100.33 to -10.36). The operative duration (MD = -5.15; 95% CI, -24.06 to 13.75), tumor size (MD = -.07; 95% CI, -.27 to .13) and incidences of common postoperative complications were comparable between the two groups. CONCLUSIONS According to these findings, the use of PI in parotidectomies may be one of the options for improving cosmetic outcomes. This technique may be considered if oncological safety can be secured.
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Affiliation(s)
- Yu-Ning Tsao
- Department of Otolaryngology - Head and Neck Surgery, 38014Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan
| | - Che-Fang Ho
- College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology - Head and Neck Surgery, 63329Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology - Head and Neck Surgery, 38014Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan
| | - Shih-Wei Yang
- College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology - Head and Neck Surgery, 63329Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yao-Te Tsai
- College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, 125573Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, 125573Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- College of Medicine, 38014Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology - Head and Neck Surgery, 63329Chang Gung Memorial Hospital, Keelung, Taiwan
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17
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Tsai YT, Ko CA, Chen HC, Hsu CM, Lai CH, Lee YC, Tsai MS, Chang GH, Huang EI, Fang KH. Prognostic Value of CRP-Albumin-Lymphocyte (CALLY) Index in Patients Undergoing Surgery for Oral Cavity Cancer. J Cancer 2022; 13:3000-3012. [PMID: 36046647 PMCID: PMC9414026 DOI: 10.7150/jca.74930] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The prognostic value of the CRP-albumin-lymphocyte index (CALLY index) was analyzed in patients with oral cavity squamous cell carcinoma (OSCC) undergoing curative surgery. Methods: We retrospectively included 279 patients who were diagnosed as having primary OSCC and being treated with surgery. The optimal cutoff for the preoperative CALLY index was identified by considering the area under the receiver operating characteristic curve; subsequently, the discriminatory ability of the cutoff was determined. We employed Kaplan-Meier analysis and the log-rank test to elucidate associations between the CALLY index and survival outcomes. We identified prognostic variables by using the Cox proportional hazards model. Finally, we devised a nomogram based on the CALLY index for predicting individualized survival. Results: The cutoff value of the CALLY index was determined to be 0.65. A CALLY index < 0.65 exhibited a significant association with pathological aggressiveness as well as shorter overall and disease-free survival (OS and DFS, both P < 0.001). A low CALLY index was an independent risk factor for short OS and DFS [hazard ratio = 3.816; 95% confidence interval (CI) 2.393-6.086; P < 0.001; and hazard ratio = 2.103; 95% CI 1.451-3.049; P < 0.001, respectively] in multivariate Cox analysis. The prognostic nomogram based on the CALLY index yielded accurate predictions of OS, as revealed by a concordance index of 0.797. Conclusions: The preoperative CALLY index is easy and inexpensive to calculate and, in patients with OSCC, can be a valuable prognostic biomarker. The CALLY-index-based nomogram established in this study provides accurate survival predictions.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-An Ko
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hung-Chin Chen
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ethan I Huang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ku-Hao Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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18
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Huang SY, Hsu CM, Yang YH, Tsai YH, Tsai MS, Chang GH, Liu CY, Lee YC, Huang EI, Tsai YT. Elevated risk of acute epiglottitis in patients with chronic obstructive pulmonary disease: A nationwide cohort study. PLoS One 2022; 17:e0273437. [PMID: 35984835 PMCID: PMC9390908 DOI: 10.1371/journal.pone.0273437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Objective
In individuals with epiglottitis, chronic obstructive pulmonary disease (COPD) is a common comorbidity; however, the impact of COPD under such circumstances is not well documented. Therefore, we performed this population-based study to determine whether, in adults, COPD is a risk factor for epiglottitis.
Methods
In this retrospective matched-cohort study, data obtained from the Taiwan National Health Insurance Research Database were analyzed. We identified all patients newly diagnosed as having COPD in 2000–2011 and performed frequency matching and propensity-score matching for every patient with COPD individually to another patient without a COPD diagnosis. We used epiglottitis occurrence as the study endpoint, and we investigated the hazard ratio of epiglottitis by using the Cox proportional hazards model after adjustment for potential confounders.
Results
In the frequency matching, the cumulative epiglottitis incidence was significantly higher (p = 0.005) in the COPD cohort. According to the adjusted Cox proportional hazard model, COPD exhibited a significant association with elevated epiglottitis incidence (adjusted hazard ratio: 1.76; 95% confidence interval: 1.15–2.70, p = 0.009). Similar trend was observed in the propensity-score matching analysis (adjusted hazard ratio: 1.50; 95% confidence interval: 0.99–2.29, p = 0.057). Our subgroup analysis revealed COPD to be an epiglottitis risk factor in male patients and those aged 40–64 years.
Conclusions
This is the first nationwide matched-cohort research to examine the association of COPD with epiglottitis. Our results revealed that COPD may be a potential risk factor for epiglottitis; thus, clinicians should be mindful of the potential increased risk of epiglottitis following COPD.
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Affiliation(s)
- Shu-Yi Huang
- Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- Department of Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- * E-mail:
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19
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Nicholson M, Huang CY, Wang JY, Chien-Yu T, Cheng YC, Chan D, Lee YC, Hsu CC, Chang CM, Hsieh ML, Cheng YY, Lin YL, Chen CH, Wu YT, Hacker TA, Wu JC, Kamp T, Hsieh PC. Abstract P3120: Cardio And Neurotoxicity Of Repurposed Anti-COVID-19 Drugs. Circ Res 2022. [DOI: 10.1161/res.131.suppl_1.p3120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In December 2019, the novel coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spread around the globe resulting in ~435 million confirmed cases and ~6 million related deaths as of March 2022, according to the World Health Organization. To combat COVID-19 quickly, there have been many attempts to repurpose current FDA-approved drugs or to revive old drugs with anti-viral properties. However, aside from the biological stress imposed by the virus, many of the current treatment options have been known to cause adverse drug reactions. We established a population-based human induced pluripotent stem cell drug screening platform to assess the toxicity of the first line of anti-COVID-19 drugs and to understand viral infection of cardiomyocytes and neurons. We found that iPSC-derived cardiomyocytes express the ACE2 receptor which correlated with a higher infection of the SARS-CoV-2 virus (r=0.86). However, ACE2 expression was undetectable in neurons which correlated with low infection of neurons. We then assessed the toxicity of anti-COVID-19 drugs and identified two cardiotoxic compounds (remdesivir and arbidol) and 4 neurotoxic compounds (arbidol, remdesivir, hydroxychloroquine, and chloroquine) which were validated by dose-response curves. These data show that this platform can quickly and easily be employed to further our understanding of cell-specific infection and identify drug toxicity of potential treatment options helping clinicians better decide on treatment options.
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20
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Wang YT, Kuo LT, Weng HH, Hsu CM, Tsai MS, Chang GH, Lee YC, Huang EI, Tsai YT. Systemic Immun e–Inflammation Index as a Predictor for Head and Neck Cancer Prognosis: A Meta-Analysis. Front Oncol 2022; 12:899518. [PMID: 35814369 PMCID: PMC9263088 DOI: 10.3389/fonc.2022.899518] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/26/2022] [Indexed: 12/24/2022] Open
Abstract
Background Studies have reported inconsistent results regarding the prognostic value of the systemic immune–inflammation index (SII) in head and neck cancer (HNC). Thus, the present meta-analysis assessed the literature on the prognostic value of SII in those with HNC. Methods The Cochrane Library, EMBASE, and PubMed databases were searched, and study methodological quality was assessed using the Newcastle–Ottawa quality assessment scale. To determine the association of the SII with survival outcomes, pooled hazard ratios (HRs) as well as the associated 95% confidence intervals (CIs) were used. To assess the associations of the SII with clinicopathological features, the odds ratios (ORs) and corresponding 95% CIs were considered. Begg’s funnel plot and Egger’s linear regression test were used to assess publication bias. Results A total of 12 studies that together enrolled 4369 patients with HNC were analyzed. In the pooled results, a high pretreatment SII was correlated with poorer overall survival (HR = 2.09, 95% CI = 1.62–2.70, p < 0.001), disease-free survival (HR = 2.79, 95% CI = 1.99−3.89, p < 0.001), and progression-free survival (HR = 1.80, 95% CI = 1.30−2.48, p < 0.001). A stratified analysis indicated that SII for overall survival was applicable regardless of tumor site, treatment modality, overall stage, sample size, SII cutoff, and method for determining the SII cutoff. Furthermore, a high SII was correlated with a more advanced T classification (OR = 1.14, 95% CI = 1.09–1.18, p < 0.001) and nodal metastasis (OR = 1.55, 95% CI = 1.18–2.05, p = 0.002) in patients with HNC. Conclusions An elevated pretreatment SII predicts more advanced tumor and nodal status and poorer survival outcomes in cases of HNC. Because the measurement of SII is convenient and its use is cost-effective, we suggest that it can be applied by clinicians in the management of HNC.
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Affiliation(s)
- Yun-Ting Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Liang-Tseng Kuo
- Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hsu-Huei Weng
- Department of Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- *Correspondence: Yao-Te Tsai,
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21
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Nicholson MW, Huang CY, Wang JY, Ting CY, Cheng YC, Chan DZH, Lee YC, Hsu CC, Hsu YH, Chang CMC, Hsieh ML, Cheng YY, Lin YL, Chen CH, Wu YT, Hacker TA, Wu JC, Kamp TJ, Hsieh PCH. Cardio- and Neurotoxicity of Selected Anti-COVID-19 Drugs. Pharmaceuticals (Basel) 2022; 15:ph15060765. [PMID: 35745684 PMCID: PMC9231250 DOI: 10.3390/ph15060765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 12/10/2022] Open
Abstract
Since December 2019, the novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected ~435 million people and caused ~6 million related deaths as of March 2022. To combat COVID-19, there have been many attempts to repurpose FDA-approved drugs or revive old drugs. However, many of the current treatment options have been known to cause adverse drug reactions. We employed a population-based drug screening platform using 13 human leukocyte antigen (HLA) homozygous human induced pluripotent cell (iPSC) lines to assess the cardiotoxicity and neurotoxicity of the first line of anti-COVID-19 drugs. We also infected iPSC-derived cells to understand the viral infection of cardiomyocytes and neurons. We found that iPSC-derived cardiomyocytes express the ACE2 receptor which correlated with a higher infection of the SARS-CoV-2 virus (r = 0.86). However, we were unable to detect ACE2 expression in neurons which correlated with a low infection rate. We then assessed the toxicity of anti-COVID-19 drugs and identified two cardiotoxic compounds (remdesivir and arbidol) and four neurotoxic compounds (arbidol, remdesivir, hydroxychloroquine, and chloroquine). These data show that this platform can quickly and easily be employed to further our understanding of cell-specific infection and identify drug toxicity of potential treatment options helping clinicians better decide on treatment options.
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Affiliation(s)
| | - Ching-Ying Huang
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Jyun-Yuan Wang
- Genomics Research Center, Academia Sinica, Taipei 115, Taiwan
| | - Chien-Yu Ting
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yu-Che Cheng
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Darien Z H Chan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yi-Chan Lee
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Ching-Chuan Hsu
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yu-Hung Hsu
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Cindy M C Chang
- Cardiovascular Physiology Core Facility, Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Marvin L Hsieh
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- Cardiovascular Physiology Core Facility, Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Yuan-Yuan Cheng
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yi-Ling Lin
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Chien-Hsiun Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Ying-Ta Wu
- Genomics Research Center, Academia Sinica, Taipei 115, Taiwan
| | - Timothy A Hacker
- Cardiovascular Physiology Core Facility, Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Timothy J Kamp
- Department of Medicine and Stem Cell and Regenerative Medicine Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Patrick C H Hsieh
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- Department of Medicine and Stem Cell and Regenerative Medicine Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Institute of Clinical Medicine, National Taiwan University, Taipei 106, Taiwan
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22
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Tsai MS, Chen HC, Liu SYC, Lee LA, Lin CY, Chang GH, Tsai YT, Lee YC, Hsu CM, Li HY. Holistic care for obstructive sleep apnea (OSA) with an emphasis on restoring nasal breathing: A review and perspective. J Chin Med Assoc 2022; 85:672-678. [PMID: 35507064 DOI: 10.1097/jcma.0000000000000737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Obstructive sleep apnea (OSA) is characterized by partial or complete airway blockage during sleep. Nocturnal nasal obstruction usually leads to mouth breathing while sleeping, which worsens sleep apnea by aggravating tongue base and lateral pharyngeal wall collapse. The pathogenesis of OSA is multifactorial, and the precipitating factors vary significantly among individuals. Although continuous positive airway pressure (CPAP) is considered the first-line therapy for OSA, its adherence rate remains a challenge. Oral appliances are more suitable for simple snorers or patients with mild OSA. Maxillomandibular advancement (MMA) is highly effective for treating those with mandibular retrognathia and moderate-to-severe OSA. Intrapharyngeal surgeries yield favorable outcomes in patients with large tonsils and low tongue resting position (Friedman Stage I); however, their efficacy declines with time. Each therapy has its own strength and weakness; thus, the principle of multimodality treatment should be adopted. Nasal surgery plays an indispensable role in the holistic care for OSA. In addition to alleviating nasal congestion, nasal surgery significantly reduces snoring intensity and daytime sleepiness, which improves the quality of life of patients with OSA. Although it significantly reduces the respiratory disturbance index, its effect on the apnea-hypopnea index remains controversial. A combination of nasal surgery and multilevel pharyngeal surgery may result in better prognosis. Nasal surgery can significantly reduce the therapeutic pressure and improve the CPAP compliance of patients undergoing CPAP therapy. In conclusion, multimodality treatment and holistic care for OSA should involve nasal surgery for optimizing treatment outcomes.
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Affiliation(s)
- Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Hung-Chin Chen
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Stanley Yung-Chuan Liu
- Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Li-Ang Lee
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Cheng-Yu Lin
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
- Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
- Sleep Medicine Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Geng-He Chang
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yi-Chan Lee
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
| | - Cheng-Ming Hsu
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Hsueh-Yu Li
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
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23
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Lee YC, Hsin LJ, Yang SW, Tsai MS, Tsai YT, Ho CF. Endoscope-assisted versus conventional neck dissection in patients with oral cancer: a systematic review and meta-analysis. J Otolaryngol Head Neck Surg 2022; 51:20. [PMID: 35546415 PMCID: PMC9097363 DOI: 10.1186/s40463-022-00567-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background Neck dissection is an integral component of the treatment of head and neck cancers. The present meta-analysis aimed to compare the use of endoscope-assisted neck dissection (END) with conventional neck dissection (CND) in the existing English literature. Methods A search of PubMed (MEDLINE), Embase, and the Cochrane Library for articles reporting the results of the two techniques of neck dissection was completed independently by two individuals. The authors analyzed the data from each study using a random-effects model. Results The pooled analysis demonstrated comparable lymph node yield, intraoperative blood loss, incidence of locoregional recurrence, and incidence of complications between the two groups. A significantly longer operative time but a shorter length of hospital stay was observed in the END group compared with the other group. Conclusions Compared with conventional techniques, END offers similar oncologic outcomes and complication rates; however, it requires a longer operative time. Future studies with long-term follow-up and assessment of patient satisfaction are needed to confirm the clinical use of END. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40463-022-00567-9.
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Affiliation(s)
- Yi-Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung City, 204, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Wei Yang
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung City, 204, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Che-Fang Ho
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung City, 204, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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24
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Chen SWT, Hsin LJ, Lin WN, Tsai YT, Tsai MS, Lee YC. LigaSure versus Conventional Parotidectomy: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10040706. [PMID: 35455883 PMCID: PMC9027715 DOI: 10.3390/healthcare10040706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Surgery with parotidectomy is the preferable treatment for most parotid tumors. Our meta-analysis compared the differences between the use of the LigaSure (LS) device and the conventional suture ligation technique (CT) in parotidectomies. A literature search in databases including EMBASE, MEDLINE, and the Cochrane Library was carried out. Studies including parotidectomy using LS and CT were included with the intraoperative and postoperative parameters collected. Continuous operative time data were measured by mean differences (MDs). Discrete data on postoperative complications, including facial palsy, postoperative bleeding, and salivary complications, were evaluated with risk differences (RDs). All values were reported with 95% confidence intervals (CIs). Five studies were included in our meta-analysis. The pooled analysis demonstrated a significant reduction in operative time in the LS group (MD: −21.92; 95% CI, −30.18 to −13.66). In addition, the analysis indicated that the incidence of postoperative complications, including permanent facial palsy (RD, −0.01; 95% CI, −0.06 to 0.05), temporary facial palsy (RD, 0.00; 95% CI, −0.03 to 0.04), salivary complications (RD, −0.01; 95% CI, −0.08 to 0.06), and postoperative bleeding (RD, −0.02; 95% CI, −0.07 to 0.04), were all similar between the LS group and the CT group. According to the results, the LS device appears to be a safe and useful tool and could shorten the operative time in patients needing parotidectomy.
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Affiliation(s)
- Sonia Wei-Ting Chen
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
| | - Li-Jen Hsin
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Wan-Ni Lin
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Correspondence: ; Tel.: +886-2-2431-3131 (ext. 6255); Fax: +886-2-2431-1190
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25
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Tsai MS, Chen HC, Li HY, Tsai YT, Yang YH, Liu CY, Lee YC, Hsu CM, Lee LA. Sleep Apnea and Risk of Influenza-Associated Severe Acute Respiratory Infection: Real-World Evidence. Nat Sci Sleep 2022; 14:901-909. [PMID: 35586456 PMCID: PMC9109977 DOI: 10.2147/nss.s346984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We executed the presented retrospective cohort study with the purpose of probing the risk of severe acute respiratory infection (SARI) following influenza in patients with sleep apnea. MATERIALS AND METHODS We executed this real-world study by gathering Taiwan National Health Insurance Research Database (NHIRD) data. From a database containing 1 million individuals sampled at random from the NHIRD, we identified all patients aged 20 years or older with a sleep apnea diagnosis between 1997 and 2013 as the study group. We established a comparison cohort of individuals without sleep apnea by randomly matching patients with respect to monthly income, gender, urbanization level, and age at a 1:4 ratio. Follow-up was performed until death or the end of 2015 for both groups. We determined the study outcome to be the occurrence of influenza-associated SARI. RESULTS We enrolled 6508 and 26,032 patients into the study and comparison groups, respectively. A significantly higher cumulative incidence of influenza-associated SARI was discovered in the study group (p < 0.001). In our multivariate analysis, sleep apnea, chronic obstructive pulmonary disease, and coronary artery disease were independent risk factors for influenza-associated SARI. The hazard ratio of sleep apnea for influenza-associated SARI was 1.98 (95% CI: 1.26-3.10) after adjustment for all comorbidities, gender, age, monthly income, and urbanization level. CONCLUSION Sleep apnea increased the risk of influenza-associated SARI. We suggest that physicians be cautious about the development of severe influenza illness in patients with sleep apnea. Vaccination and early oseltamivir administration should be actively considered in this group of patients.
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Affiliation(s)
- Ming-Shao Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Hung-Chin Chen
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Hsueh-Yu Li
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Otolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.,Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Yi-Chan Lee
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Otolaryngology - Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung, 204, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Li-Ang Lee
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Otolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.,School of Medicine, National Tsing Hua University, Hsinchu, 300, Taiwan
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26
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Abstract
Despite the growing recognition of a host genetic effect on shaping gut microbiota composition, the genetic determinants of oral microbiota remain largely unexplored, especially in the context of oral diseases. Here, we performed a microbiome genome-wide association study in 2 independent cohorts of patients with oral squamous cell carcinoma (OSCC, n = 144 and 67) and an additional group of noncancer individuals (n = 104). Besides oral bacterial dysbiosis and signatures observed in OSCC, associations of 3 loci with the abundance of genus-level taxa and 4 loci with β diversity measures were detected (q < 0.05) at the discovery stage. The most significant hit (rs10906082 with the genus Lachnoanaerobaculum, P = 3.55 × 10-9 at discovery stage) was replicated in a second OSCC cohort. Moreover, the other 2 taxonomical associations, rs10973953 with the genus Kingella (P = 1.38 × 10-9) and rs4721629 with the genus Parvimonas (P = 3.53 × 10-8), were suggestive in the meta-analysis combining 2 OSCC cohorts. Further pathway analysis revealed that these loci were enriched for genes in regulation of oncogenic and angiogenic responses, implicating a genetic anchor to the oral microbiome in estimation of casual relationships with OSCC. Our findings delineate the role of host genotypes in influencing the structure of oral microbial communities.
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Affiliation(s)
- S F Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - C W Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - C Y Chuang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - W H Chung
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - H C Lai
- Department of Medical Biotechnology and Laboratory Science, and Microbiota Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Central Research Laboratory, XiaMen Chang Gung Hospital, XiaMen, China
| | - L C Chang
- Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL, USA
| | - S C Su
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Central Research Laboratory, XiaMen Chang Gung Hospital, XiaMen, China
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27
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Tsai YT, Hsu CM, Chang GH, Tsai MS, Lee YC, Huang EI, Lai CH, Fang KH. Advanced Lung Cancer Inflammation Index Predicts Survival Outcomes of Patients With Oral Cavity Cancer Following Curative Surgery. Front Oncol 2021; 11:609314. [PMID: 34660250 PMCID: PMC8514840 DOI: 10.3389/fonc.2021.609314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/13/2021] [Indexed: 12/13/2022] Open
Abstract
Aim The aim of our study was to investigate the prognostic value of preoperative advanced lung cancer inflammation index (ALI) and to establish prognostic nomograms for the prediction of survival outcomes in patients with oral cavity squamous cell carcinoma (OSCC). Materials and Methods A total of 372 patients who received primary curative surgery for OSCC during 2008–2017 at a tertiary referral center were enrolled. We used the receiver operating characteristic curve to determine the optimal cutoff point of ALI. Through a Cox proportional hazards model and Kaplan–Meier analysis, we elucidated the ALI–overall survival (OS) and ALI–disease-free survival (DFS) associations. Prognostic nomograms based on ALI and the results of multivariate analysis were created to predict the OS and DFS. We used the concordance indices (C-indices) and calibration plots to assess the discriminatory and predictive ability. Results The results revealed that the ALI cutoff was 33.6, and 105 and 267 patients had ALI values of <33.6 and ≥33.6, respectively. ALI < 33.6 significantly indicated lower OS (44.0% vs. 80.1%, p < 0.001) and DFS (33.6% vs. 62.8%; p < 0.001). In multivariate analysis, ALI < 33.6 was independently associated with poor OS and DFS (both p < 0.001). The C-indices of established nomograms were 0.773 and 0.674 for OS and DFS, respectively; moreover, the calibration plots revealed good consistency between nomogram-predicted and actual observed OS and DFS. Conclusion ALI is a promising prognostic biomarker in patients undergoing primary surgery for OSCC; moreover, ALI-based nomograms may be a useful prognostic tool for individualized OS and DFS estimations.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-He Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ethan I Huang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ku-Hao Fang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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28
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Tsai YT, Chen WC, Hsu CM, Tsai MS, Chang GH, Lee YC, Huang EI, Fang CC, Lai CH. Survival-Weighted Health Profiles in Patients Treated for Advanced Oral Cavity Squamous Cell Carcinoma. Front Oncol 2021; 11:754412. [PMID: 34660322 PMCID: PMC8511634 DOI: 10.3389/fonc.2021.754412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/15/2021] [Indexed: 01/22/2023] Open
Abstract
Objectives For patients with oral cavity squamous cell carcinoma (OSCC), particularly for those with advanced disease, quality of life (QoL) is a key outcome measure. Therefore, we estimated survival-weighted psychometric scores (SWPS), life expectancy (LE), and quality-adjusted LE (QALE) in patients with advanced OSCC. Methods and Materials For estimation of survival function, we enrolled 2313 patients with advanced OSCC diagnosed between January 1, 2007, and December 31, 2013. The patients were followed until death or December 31, 2014. To acquire the QoL data, data from 194 patients were collected by employing the Taiwan Chinese versions of the Quality of Life Questionnaire Core 30 and Quality of Life Questionnaire Head and Neck 35 developed by the European Organisation for Research and Treatment of Cancer and the EQ-5D-3L between October 1, 2013, and December 31, 2017. The LE of the patients with OSCC were estimated through linear extrapolation of a logit-transformed curve. SWPS and QALE were determined by integrating the LE and corresponding QoL outcomes. Results For the patients with advanced OSCC, the estimated LE and QALE were 8.7 years and 7.7 quality-adjusted life years (QALYs), respectively. The loss of LE and QALE was 19.0 years and 20.0 QALYs, respectively. The estimated lifetime impairments of swallowing, speech, cognitive functioning, physical functioning, social functioning, and emotional functioning were 8.3, 6.5, 6.5, 6.1, 5.7, and 5.4 years, respectively. The estimated lifetime problems regarding mouth opening, teeth, social eating, and social contact were 6.6, 6.1, 7.5, and 6.1 years, respectively. The duration of feeding tube dependency was estimated to be 1.6 years. Conclusions Patients with advanced OSCC had an estimated LE of 8.7 years and QALE of 7.7 QALYs. SWPS provided useful information regarding how advanced OSCC affects the subjective assessment of QoL. Our study results may serve as a reference for the allocation of cancer treatment resources.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wen-Cheng Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ethan I Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chiung-Cheng Fang
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
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29
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Su SC, Yeh CM, Lin CW, Hsieh YH, Chuang CY, Tang CH, Lee YC, Yang SF. A novel melatonin-regulated lncRNA suppresses TPA-induced oral cancer cell motility through replenishing PRUNE2 expression. J Pineal Res 2021; 71:e12760. [PMID: 34339541 DOI: 10.1111/jpi.12760] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/20/2021] [Accepted: 07/29/2021] [Indexed: 12/25/2022]
Abstract
The inhibitory effect of melatonin on cancer cell dissemination is well established, yet the functional involvement of lncRNAs in melatonin signaling remains poorly understood. In this study, we identified a melatonin-attenuated lncRNA acting as a potential melatonin-regulated oral cancer stimulator (MROS-1). Downregulation of MROS-1 by melatonin suppressed TPA-induced oral cancer migration through replenishing the protein expression of prune homolog 2 (PRUNE2), which functioned as a tumor suppressor in oral cancer. Melatonin-mediated MROS-1/PRUNE2 expression and cell motility in oral cancer were regulated largely through the activation of JAK-STAT pathway. In addition, MROS-1, preferentially localized in the nuclei, promoted oral cancer migration in an epigenetic mechanism in which it modulates PRUNE2 expression by interacting with a member of the DNA methylation machinery, DNA methyltransferase 3A (DNMT3A). Higher methylation levels of PRUNE2 promoter were associated with nodal metastases and inversely correlated with PRUNE2 expression in head and neck cancer. Collectively, these findings suggest that MROS-1, serving as a functional mediator of melatonin signaling, could predispose patients with oral cancer to metastasize and may be implicated as a potential target for antimetastatic therapies.
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Affiliation(s)
- Shih-Chi Su
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan
- Drug Hypersensitivity Clinical and Research Center, Department of Dermatology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Central Research Laboratory, XiaMen Chang Gung Hospital, XiaMen, China
| | - Chia-Ming Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Hsien Hsieh
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Yi Chuang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsin Tang
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
- Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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30
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Hennige SJ, Larsson AI, Orejas C, Gori A, De Clippele LH, Lee YC, Jimeno G, Georgoulas K, Kamenos NA, Roberts JM. Using the Goldilocks Principle to model coral ecosystem engineering. Proc Biol Sci 2021; 288:20211260. [PMID: 34375552 PMCID: PMC8354746 DOI: 10.1098/rspb.2021.1260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The occurrence and proliferation of reef-forming corals is of vast importance in terms of the biodiversity they support and the ecosystem services they provide. The complex three-dimensional structures engineered by corals are comprised of both live and dead coral, and the function, growth and stability of these systems will depend on the ratio of both. To model how the ratio of live : dead coral may change, the ‘Goldilocks Principle’ can be used, where organisms will only flourish if conditions are ‘just right’. With data from particle imaging velocimetry and numerical smooth particle hydrodynamic modelling with two simple rules, we demonstrate how this principle can be applied to a model reef system, and how corals are effectively optimizing their own local flow requirements through habitat engineering. Building on advances here, these approaches can be used in conjunction with numerical modelling to investigate the growth and mortality of biodiversity supporting framework in present-day and future coral reef structures.
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Affiliation(s)
- S J Hennige
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - A I Larsson
- Department of Marine Sciences, Tjärnö Marine Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - C Orejas
- Instituto Español de Oceanografía, Centro Oceanográfico de Gijón, IEO, CSIC, Gijón, Spain
| | - A Gori
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - L H De Clippele
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Y C Lee
- School of Engineering, Computing and Mathematics, University of Plymouth, Devon, UK
| | - G Jimeno
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - K Georgoulas
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - N A Kamenos
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - J M Roberts
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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31
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Hsu CM, Tsai YT, Chang GH, Yang YH, Fang TJ, Lee YC, Liu CY, Lin MH, Wang YT, Tsai MS. Reduction in Short- and Long-term Pneumonia Rate With Laryngoplasty for Unilateral Vocal Fold Paralysis. Otolaryngol Head Neck Surg 2021; 166:343-349. [PMID: 34058910 DOI: 10.1177/01945998211015174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP). STUDY DESIGN Population-based retrospective cohort study. SETTING Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan. METHODS In the LHID2000, we identified 439 patients having new diagnoses of UVFP from 1997 to 2013. We grouped the aforementioned patients according to UVFP treatment and probed the occurrence of pneumonia: 305 patients underwent laryngoplasty or voice therapy, and 134 patients did not undergo treatment. Follow-up procedures were executed for the enrollees until death or December 31, 2013, representing the end of the study period. We assessed the association of UVFP treatment and pneumonia by executing Cox proportional hazards regression. RESULTS The pneumonia cumulative incidence was significantly higher among enrolled patients without treatment than in those receiving treatment (P < .001). The pneumonia incidence was significantly lower in patients receiving UVFP treatment (hazard ratio, 0.49; 95% CI, 0.27-0.88; P = .018), as validated by the Cox proportional hazards model after adjustment. Patients undergoing laryngoplasty with or without voice therapy had a significantly lower incidence of pneumonia at 6 months and 1, 3, and 5 years, whereas those undergoing voice therapy alone did not. CONCLUSION Laryngoplasty was associated with a lower incidence of short- and long-term pneumonia in patients with UVFP. Physicians should encourage patients with UVFP at risk of aspiration to receive prompt evaluation as well as treatment.
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Affiliation(s)
- Cheng-Ming Hsu
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Geng-He Chang
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan.,Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan.,Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi
| | - Tuan-Jen Fang
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan.,Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan
| | - Yi-Chan Lee
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan.,Department of Otolaryngology-Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi
| | - Yun-Ting Wang
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.,Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan.,Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi
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Ko CA, Fang KH, Hsu CM, Lee YC, Chang GH, Huang EI, Tsai MS, Tsai YT. The preoperative C-reactive protein-lymphocyte ratio and the prognosis of oral cavity squamous cell carcinoma. Head Neck 2021; 43:2740-2754. [PMID: 33991004 DOI: 10.1002/hed.26738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/01/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We aimed to investigate the preoperative C-reactive protein (CRP)-lymphocyte ratio (CLR) as a prognostic biomarker in oral cavity squamous cell carcinoma (OSCC). METHODS Three hundred and sixteen patients with OSCC treated with curative surgery were retrospectively assessed and the receiver operating characteristic curve was used to evaluate the discriminative ability of inflammatory markers. The prognostic value of CLR was investigated with Cox proportional hazards analysis. RESULTS The CLR cutoff of 3.88 (p < 0.001) demonstrated optimal prognostic performance compared with other inflammatory combinations. A higher preoperative CLR (≥3.88) was significantly associated with clinicopathological aggressiveness and predicted unfavorable overall survival and disease-free survival (hazard ratios = 3.498 and 1.994, respectively; both p < 0.001). The CLR-based nomogram provided accurate survival prediction (concordance index: 0.803). CONCLUSIONS Preoperative CLR is a feasible prognostic biomarker in patients with OSCC, and the CLR-based nomogram might serve as prognostic tool in era of personalized medicine.
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Affiliation(s)
- Chien-An Ko
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ku-Hao Fang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ethan I Huang
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
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Lee YC, Fang TJ, Kuo IC, Tsai YT, Hsin LJ. Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: A systematic review and meta-analysis. Clin Otolaryngol 2021; 46:692-698. [PMID: 33345446 DOI: 10.1111/coa.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 10/27/2020] [Accepted: 11/29/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Total laryngectomy (TL) is a life-saving procedure for individuals with advanced laryngeal cancer and those suffering from recurrence after initial treatment. The present study aimed to evaluate the differences between stapler closure (SC) and manual closure (MC) of the pharynx during TL for patients with laryngeal cancer. DESIGN/SETTING A systematic literature search was performed using the PubMed, EMBASE and Cochrane Library databases. The data were analysed using Comprehensive Meta-Analysis software (Version 3; Biostat). Dichotomous data were calculated as odds ratios (ORs), and continuous data were calculated as mean differences (MD) with 95% confidence intervals (CI). MAIN OUTCOME/RESULTS A total of seven studies (535 patients) were included in this meta-analysis. Pooled analysis showed that the operative time of TL was significantly reduced in the SC group (MD, -63.2; 95% CI, -106.0 to -20.4). Moreover, the SC group had a lower incidence of pharyngocutaneous fistula (OR = 0.38; 95% CI, 0.18 to 0.83; P = .016) and hospital stay (MD, -2.9; 95% CI, -5.6 to -0.1). The incidence of postoperative surgical site infection (OR = 0.41; 95% CI, 0.02 to 8.73; P = .565) was comparable between the two groups. CONCLUSION Based on these results, SC may be a useful option for patients who need TL.
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Affiliation(s)
- Yi-Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - I-Chun Kuo
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Li-Jen Hsin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Kuo TC, Chao WC, Yang CH, Tsai MS, Tsai YT, Lee YC. Intratympanic steroid injection versus hyperbaric oxygen therapy in refractory sudden sensorineural hearing loss: a meta-analysis. Eur Arch Otorhinolaryngol 2021; 279:83-90. [PMID: 33751195 DOI: 10.1007/s00405-021-06616-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/08/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The present meta-analysis aims to compare the efficacy of intratympanic steroid (ITS) injection and hyperbaric oxygen (HBO) therapy as salvage treatments for refractory sudden sensorineural hearing loss (SSNHL). DATA SOURCES Comprehensive searches were performed in PubMed, EMBASE and the Cochrane Library from the date of the database inception to June 2020. All studies reporting the use of salvage ITS and HBO treatments in refractory SSNHL patients were included. Subsequently, the full texts of the eligible studies were evaluated. METHODS The quality and bias of the studies were assessed using the Newcastle-Ottawa Scale and Cochrane's risk of bias tools for nonrandomized and randomized studies, respectively. The data were analyzed using Comprehensive Meta-Analysis software (Version 3; Biostat, Englewood, NJ). RESULTS Three hundred and fourteen subjects in 3 observational studies and 1 randomized controlled trial met our inclusion criteria. The pooled results demonstrated that there were no significant differences in the mean posttreatment hearing gain between the ITS and HBO groups. The changes in word discrimination and hearing gain at 250, 500, 1000, 2000, 4000 and 8000 Hz were also comparable between the two salvage treatment groups. CONCLUSIONS The pooled results demonstrated that there were no significant differences in hearing improvements between salvage ITS injection and salvage HBO therapy after failed primary systemic steroid treatment in patients with SSNHL. However, spontaneous recovery could bias the treatment outcomes, and these results should be interpreted with caution. Clinicians may choose these salvage treatments according to personal experience and treatment availability. In cases in which specialized HBO facilities are difficult to access, salvage ITS injection can be provided with comparable responses.
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Affiliation(s)
- Tz-Ching Kuo
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wei-Chieh Chao
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chao-Hui Yang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Ding MC, Hsu CM, Liu SYC, Lee YC, Yang YH, Liu CY, Chang GH, Tsai YT, Lee LA, Yang PR, Li HY, Tsai MS. Deep Neck Infection Risk in Patients with Sleep Apnea: Real-World Evidence. Int J Environ Res Public Health 2021; 18:ijerph18063191. [PMID: 33808734 PMCID: PMC8003369 DOI: 10.3390/ijerph18063191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 12/20/2022]
Abstract
(1) Background: Sleep apnea may be a risk factor for deep neck infection (DNI). The objective of this study was to investigate the effects of sleep apnea on DNI. (2) Methods: In this first nationwide retrospective cohort study on the sleep apnea–DNI correlation, we obtained data from the Longitudinal Health Insurance Database 2005, a subset of the Taiwan National Health Insurance Research Database. Patients who were newly diagnosed with sleep apnea between 1997 and 2012 were identified, and patients without sleep apnea were matched at a 1:4 ratio in age, sex, socioeconomic status, and urbanization level. The primary outcome of this study was DNI occurrence. The treatment modalities for sleep apnea and the comorbidities that occurred during the study period were also analyzed. (3) Results: Our sleep apnea and comparison (non-sleep apnea) cohorts comprised 6114 and 24,456 patients, respectively. We compared the cumulative incidence of DNI between these cohorts and found a greater incidence of DNI in the sleep apnea cohort (p < 0.001). A strong sleep apnea–DNI association was found following analysis via the adjusted Cox proportional-hazards model (full model hazard ratio, 1.71; 95% confidence interval, 1.28–2.28; p < 0.001). In the subgroup analysis, sleep apnea increased DNI risk in men, in those aged < 50 years, and in those without diabetes mellitus, end-stage renal disease, liver cirrhosis, autoimmune disease, obesity, tonsillectomy, or adenotonsillectomy. (4) Conclusions: Our results confirmed sleep apnea to be an independent risk factor for DNI. Physicians should be aware of the potential occurrence of DNI in patients with sleep apnea.
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Affiliation(s)
- Meng-Chang Ding
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
| | - Cheng-Ming Hsu
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
| | - Stanley Yung-Chuan Liu
- Division of Sleep Surgery, Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology–Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Yao-Hsu Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Geng-He Chang
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Pei-Rung Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Hsueh-Yu Li
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Correspondence: (H.-Y.L.); (M.-S.T.); Tel.: +886-3-328-1200 (ext. 3968) (H.-Y.L.); +886-5-362-1000 (ext. 2076) (M.-S.T.); Fax: +886-3-397-9361 (H.-Y.L.); +886-5-3623002 (M.-S.T.)
| | - Ming-Shao Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: (H.-Y.L.); (M.-S.T.); Tel.: +886-3-328-1200 (ext. 3968) (H.-Y.L.); +886-5-362-1000 (ext. 2076) (M.-S.T.); Fax: +886-3-397-9361 (H.-Y.L.); +886-5-3623002 (M.-S.T.)
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Fang KH, Chang SW, Lee YC, Huang EI, Lai CH, Chang GH, Tsai MS, Hsu CM, Tsai YT. Preoperative prognostic nutritional index predicts prognosis of patients with oral cavity cancer. Oral Dis 2021; 28:1816-1830. [PMID: 33690959 DOI: 10.1111/odi.13840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/26/2021] [Accepted: 03/07/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate whether prognostic nutritional index (PNI) predicts patient survival outcomes in oral cavity squamous cell carcinoma (OSCC). MATERIALS AND METHODS The data of a total of 360 patients subjected to primary surgery for OSCC were retrospectively analysed. Patients were categorised into high-PNI (≥51.75) and low-PNI (<51.75) groups based on the PNI cut-off value attained from receiver operating characteristic analyses (p < .001), and the intergroup differences in clinicopathological features were determined. The Kaplan-Meier method and Cox proportional hazard model were employed to determine the survival prediction ability of the PNI, and a nomogram based on the PNI was established for individualised survival prediction. RESULTS A low PNI was noted to exhibit a significant association with shorter overall survival (OS) and disease-free survival (DFS) (both p < .001). Multivariate Cox analyses showed that a lower PNI independently indicated shorter OS and DFS (hazard ratio [HR] = 2.187; p = .001 and HR = 1.459; p = .023, respectively). The concordance index and calibration plots of the PNI-based nomogram revealed the high discriminative ability for OS. CONCLUSIONS Preoperative PNI is a valuable biomarker for predicting OSCC prognosis, and the proposed PNI-based nomogram can provide individualised prognostic prediction.
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Affiliation(s)
- Ku-Hao Fang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
| | - Sheng-Wei Chang
- Department of Radiology, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Keelung Branch Library, Keelung, Taiwan
| | - Ethan I Huang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Geng-He Chang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
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Liao WC, Hsin LJ, Li HY, Tsai MS, Tsai YT, Yu CC, Lee YC. Effect of compression stockings on overnight rostral fluid shift and obstructive sleep apnea: A meta-analysis. Auris Nasus Larynx 2021; 48:934-941. [PMID: 33691935 DOI: 10.1016/j.anl.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/05/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The overnight rostral fluid shift from the lower limbs is one of the causes of obstructive sleep apnea (OSA). Compression stockings (CS) prevent lower limb fluid retention and have been reported to decrease nighttime fluid shift. The aim of this study is to evaluate the effect of CS on fluid shift and the severity of OSA. METHODS A systematic literature search was performed in the PubMed, EMBASE and Cochrane Library databases. The data were analyzed using Comprehensive Meta-Analysis software (Version 3; Biostat, Englewood, NJ). Studies evaluating the effect of CS on the overnight fluid shift and OSA severity were included in the analysis. RESULTS A total of 4 studies were included in this meta-analysis. The pooled analysis showed that the apnea-hypopnea index (AHI) of the overall study group was significantly lower after using CS (SMD, -1.08; 95% CI, -1.49 to -0.67). Decreases in the AHI were also observed in the normal fluid status (SMD, -1.05; 95% CI, -1.73 to -0.37) and fluid overload status (SMD, -1.17; 95% CI, -1.76 to -0.58) populations. The overall study group had significant decreases in overnight changes in neck circumference (SMD, -1.05; 95% CI, -2.06 to -0.03) and leg fluid volume (SMD, -1.14; 95% CI, -1.88 to -0.41) after using CS. However, no significant differences in overnight changes in neck circumference and leg fluid volume were observed in normal fluid status patients. CONCLUSION CS may help decrease overnight fluid shift and could be a treatment option for OSA.
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Affiliation(s)
- Wei-Chih Liao
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsueh-Yu Li
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Chieh Yu
- Division of Pulmonary, Critical Care, and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Lee PC, Kao FY, Liang FW, Lee YC, Li ST, Lu TH. Existing Data Sources in Clinical Epidemiology: The Taiwan National Health Insurance Laboratory Databases. Clin Epidemiol 2021; 13:175-181. [PMID: 33688263 PMCID: PMC7935352 DOI: 10.2147/clep.s286572] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/30/2021] [Indexed: 01/28/2023] Open
Abstract
This paper provides an introduction to laboratory databases established by Taiwan National Health Insurance Administration (NHIA) since 2015 and released for research since June 2017. The National Health Insurance (NHI) is a government-run single-payer program introduced in 1995 that now covers more than 99% of 23 million Taiwanese citizens. To prevent duplication of medication prescriptions and laboratory test and examination prescriptions, contracted health care providers are required to upload the results of laboratory tests and reports of examinations to the NHIA. The cumulative number of laboratory test results was 5.64 billion from January 2015 to the end of August 2020 for 602 types of test. There are 35 variables for each laboratory test result stored in the databases that can be used for research. However, different hospitals might use different format in reporting the results. The researchers therefore have to develop algorithms to include and exclude incompatible records and to determine whether the results are positive or negative (normal or abnormal). The NHIA suggests that researchers release their source codes of algorithms so that other researchers can modify the codes to improve inter-study comparability. Through the unique personal identification number, the laboratory data can be linked to NHI inpatient and outpatient claims data for further value-added analyses. Non-Taiwanese researchers can collaborate with Taiwan researchers to access the NHI laboratory databases.
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Affiliation(s)
- Po-Chang Lee
- National Health Insurance Administration, Ministry of Health & Welfare, Taipei, Taiwan
| | - Feng-Yu Kao
- National Health Insurance Administration, Ministry of Health & Welfare, Taipei, Taiwan
| | - Fu-Wen Liang
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chan Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Tun Li
- Department of Industrial and Information Management, College of Management, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Hsueh Lu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Garrett PM, Wang Y, White JP, Hsieh S, Strong C, Lee YC, Lewandowsky S, Dennis S, Yang CT. Young Adults View Smartphone Tracking Technologies for COVID-19 as Acceptable: The Case of Taiwan. Int J Environ Res Public Health 2021; 18:1332. [PMID: 33540628 PMCID: PMC7908157 DOI: 10.3390/ijerph18031332] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/22/2021] [Accepted: 01/29/2021] [Indexed: 12/26/2022]
Abstract
Taiwan has been successful in controlling the spread of SARS-CoV-2 during the COVID-19 pandemic; however, without a vaccine the threat of a second outbreak remains. Young adults who show few to no symptoms when infected have been identified in many countries as driving the virus' spread through unidentifiable community transmission. Mobile tracking technologies register nearby contacts of a user and notifies them if one later tests positive to the virus, potentially solving this issue; however, the effectiveness of these technologies depends on their acceptance by the public. The current study assessed attitudes towards three tracking technologies (telecommunication network tracking, a government app, and Apple and Google's Bluetooth exposure notification system) among four samples of young Taiwanese adults (aged 25 years or younger). Using Bayesian methods, we find high acceptance for all three tracking technologies (>75%), with acceptance for each technology surpassing 90% if additional privacy measures were included. We consider the policy implications of these results for Taiwan and similar cultures.
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Affiliation(s)
- Paul M. Garrett
- School of Psychology, University of Melbourne, Melbourne 3010, Australia; (P.M.G.); (J.P.W.); (S.D.)
| | - YuWen Wang
- Department of Psychology, National Cheng Kung University, Tainan 701, Taiwan; (Y.W.); (S.H.)
| | - Joshua P. White
- School of Psychology, University of Melbourne, Melbourne 3010, Australia; (P.M.G.); (J.P.W.); (S.D.)
| | - Shulan Hsieh
- Department of Psychology, National Cheng Kung University, Tainan 701, Taiwan; (Y.W.); (S.H.)
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan 701, Taiwan
- Department of Public Health, National Cheng Kung University, Tainan 701, Taiwan;
| | - Carol Strong
- Department of Public Health, National Cheng Kung University, Tainan 701, Taiwan;
| | - Yi-Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 114, Taiwan;
| | | | - Simon Dennis
- School of Psychology, University of Melbourne, Melbourne 3010, Australia; (P.M.G.); (J.P.W.); (S.D.)
- Unforgettable Research Services, Melbourne 3010, Australia
| | - Cheng-Ta Yang
- Department of Psychology, National Cheng Kung University, Tainan 701, Taiwan; (Y.W.); (S.H.)
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan 701, Taiwan
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Wang YT, Chang GH, Yang YH, Liu CY, Tsai YT, Hsu CM, Lee YC, Lee LA, Yang PR, Tsai MS, Li HY. Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence. Healthcare (Basel) 2021; 9:healthcare9010036. [PMID: 33401606 PMCID: PMC7824592 DOI: 10.3390/healthcare9010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/16/2022] Open
Abstract
Allergic rhinitis (AR) is correlated with diseases including allergic laryngitis, chronic obstructive pulmonary disease (COPD), asthma, and chronic rhinosinusitis (CRS). The unified airway model suggests that inflammation can spread in both lower and upper respiratory tracts. Moreover, some voice problems-laryngeal edema, dysphonia, and vocal nodules-have been associated with AR. We examined the association between AR and laryngeal pathology. We investigated 51,618 patients with AR between 1 January 1997 and 31 December 2013, along with 206,472 patients without AR matched based on age, gender, urbanization level, and socioeconomic status at a 1:4 ratio. We followed patients up to the end of 2013 or their death. The occurrence of laryngeal pathology was the primary outcome. Individuals with AR had a 2.43 times higher risk of laryngeal pathology than the comparison cohort group (adjusted HR: 2.43, 95% CI: 2.36-2.50, p < 0.001). Patients diagnosed as having AR exhibited higher comorbidity rates, including of asthma, COPD, CRS, gastroesophageal reflux disease, and nasal septum deviation, than those of the comparison cohort. Our results strongly indicate that AR is an independent risk factor for laryngeal pathology. Therefore, when treating AR and voice problems, physicians should be attuned to possible laryngeal pathology.
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Affiliation(s)
- Yun-Ting Wang
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
| | - Geng-He Chang
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Yao-Hsu Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Yao-Te Tsai
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
| | - Cheng-Ming Hsu
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology—Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology—Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Pei-Rung Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Correspondence: (M.-S.T.); (H.-Y.L.); Tel.: +886-5-3621-000 (ext. 2076) (M.-S.T.); Fax: +886-5-3623-002 (M.-S.T.)
| | - Hsueh-Yu Li
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology—Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Correspondence: (M.-S.T.); (H.-Y.L.); Tel.: +886-5-3621-000 (ext. 2076) (M.-S.T.); Fax: +886-5-3623-002 (M.-S.T.)
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Kuo IC, Hsin LJ, Lee LA, Fang TJ, Tsai MS, Lee YC, Shen SC, Li HY. Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length. Nat Sci Sleep 2021; 13:1985-1992. [PMID: 34764713 PMCID: PMC8573216 DOI: 10.2147/nss.s336019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study aims to explore the factors that contribute to epiglottic collapse (EC) in patients with obstructive sleep apnea (OSA). METHODS This study enrolled 35 patients (34 males; median age, 39 years; median apnea-hypopnea index (AHI), 55.4 events/h; median body mass index (BMI), 26.9 kg/m2). EC (epiglottis attaching onto the posterior pharyngeal wall) was diagnosed by drug-induced sleep computed tomography (DI-SCT). Three dimensions were assessed for comparison between the EC and non-EC (NEC) groups that included anatomical measurement: epiglottic length and angle, endoscopic classification of epiglottis obstructing the glottis (Type I, none; Type II, partial; and Type III, total), and dynamic hyoid movement during DI-SCT (Δ hyoid = √(x2 + y2), maximal displacement of hyoid in x and y axes during sleep breathing cycle). RESULTS EC was found in 12 patients (34%). No difference in age, gender, AHI, and BMI between the two groups was noted. The anatomical measurement revealed that epiglottis length was significantly different between the EC and NEC groups (21.2 vs 15.8 mm; p < 0.001), with a cutoff value of 16.6 mm (sensitivity, 100%; specificity, 65.2%). The EC group patients showed larger hyoid movement than the NEC group patients (Δ hyoid, 4.8 vs 3.0 mm; p = 0.027). By contrast, epiglottic angle and endoscopic classification revealed an insignificant difference between the two groups. CONCLUSION Epiglottis is a potential collapse site among multilevel obstruction in moderate to severe OSA patients. Epiglottic length is highly sensitive in predicting EC, with the cutoff value of 16.6 mm. Hyoid movement plays a role in contributing to EC in OSA patients.
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Affiliation(s)
- I-Chun Kuo
- Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan.,College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Li-Jen Hsin
- Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan.,College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Li-Ang Lee
- Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan.,College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Tuan-Jen Fang
- Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan.,College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi City, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung City, Taiwan
| | - Shih-Chieh Shen
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Departments of Otolaryngology-Head & Neck Surgery, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Hsueh-Yu Li
- Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan.,College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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Tsai YT, Lai CH, Huang TH, Hsieh CC, Huang EI, Lee YC, Yeh HK, Tsai MS, Chang GH, Hsu CM. Association of malnutrition with postoperative complication risk after curative surgery for oral cancer: Observational study. Medicine (Baltimore) 2020; 99:e23860. [PMID: 33350779 PMCID: PMC7769301 DOI: 10.1097/md.0000000000023860] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 11/21/2020] [Indexed: 02/02/2023] Open
Abstract
Malnutrition is common among patients who have oral cavity squamous cell carcinoma (OSCC), but its effect on the incidence of postoperative complications remains uncertain. Validated nutrition and complication assessment tools were used to evaluate the effects of nutrition on the likelihood of postoperative complications after curative surgery for OSCC.A retrospective study that spanned January 2014 to December 2018 enrolled 70 patients who received curative surgery for OSCC. Nutritional status before surgery was evaluated with the scored Patient-Generated Subjective Global Assessment (PG-SGA), and patients were classified as either well-nourished (rating A) or malnourished (ratings B and C). Complications 30 days after the operation were graded using Clavien-Dindo classification. The perioperative clinicopathological characteristics of the groups were compared, and risk factors for postoperative complications were identified through logistic regression.A total of 44 (62.8%) patients formed the malnourished group, and they tended to be older (P = .03), weigh less (P = .001), have lower Body Mass Index (P = .003), higher PG-SGA scores (P < .001), higher neutrophil-to-lymphocyte ratio (P = .034), more postoperative complications (P < .001), and longer hospital stays (P = .021). Major complications (Clavien-Dindo classification ≥ IIIa) were experienced by 18.5% (n = 13) of patients and were more common in the malnourished group (P = .007). Multivariate logistic regression demonstrated that PG-SGA score ≥4 was an independent risk factor for postoperative complications (hazard ratio = 4.929, P = .008).Malnutrition defined using the PG-SGA is an independent risk factor for postoperative complications of curative surgery in patients with OSCC. More prospective studies are warranted to confirm our findings.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery
| | | | - Tzu-Hao Huang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi
| | | | | | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung
| | - Hsuan-Keng Yeh
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | | | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery
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Su PC, Chen BH, Lee YC, Yang YS. Silicon Nanowire Field-Effect Transistor as Biosensing Platforms for Post-Translational Modification. Biosensors (Basel) 2020; 10:bios10120213. [PMID: 33371301 PMCID: PMC7767353 DOI: 10.3390/bios10120213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 02/06/2023]
Abstract
Protein tyrosine sulfation (PTS), a vital post-translational modification, facilitates protein–protein interactions and regulates many physiological and pathological responses. Monitoring PTS has been difficult owing to the instability of sulfated proteins and the lack of a suitable method for detecting the protein sulfate ester. In this study, we combined an in situ PTS system with a high-sensitivity polysilicon nanowire field-effect transistor (pSNWFET)-based sensor to directly monitor PTS formation. A peptide containing the tyrosine sulfation site of P-selectin glycoprotein ligand (PSGL)-1 was immobilized onto the surface of the pSNWFET by using 3-aminopropyltriethoxysilane and glutaraldehyde as linker molecules. A coupled enzyme sulfation system consisting of tyrosylprotein sulfotransferase and phenol sulfotransferase was used to catalyze PTS of the immobilized PSGL-1 peptide. Enzyme-catalyzed sulfation of the immobilized peptide was readily observed through the shift of the drain current–gate voltage curves of the pSNWFET before and after PTS. We expect that this approach can be developed as a next generation biochip for biomedical research and industries.
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Affiliation(s)
- Ping-Chia Su
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan; (P.-C.S.); (B.-H.C.); (Y.-C.L.)
| | - Bo-Han Chen
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan; (P.-C.S.); (B.-H.C.); (Y.-C.L.)
| | - Yi-Chan Lee
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan; (P.-C.S.); (B.-H.C.); (Y.-C.L.)
| | - Yuh-Shyong Yang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan; (P.-C.S.); (B.-H.C.); (Y.-C.L.)
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-3-5731983
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Hayashi K, Nikolos F, Lee YC, Jain A, Tsouko E, Gao H, Kasabyan A, Leung HE, Osipov A, Jung SY, Kurtova AV, Chan KS. Tipping the immunostimulatory and inhibitory DAMP balance to harness immunogenic cell death. Nat Commun 2020; 11:6299. [PMID: 33288764 PMCID: PMC7721802 DOI: 10.1038/s41467-020-19970-9] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 11/04/2020] [Indexed: 12/21/2022] Open
Abstract
Induction of tumor cell death is the therapeutic goal for most anticancer drugs. Yet, a mode of drug-induced cell death, known as immunogenic cell death (ICD), can propagate antitumoral immunity to augment therapeutic efficacy. Currently, the molecular hallmark of ICD features the release of damage-associated molecular patterns (DAMPs) by dying cancer cells. Here, we show that gemcitabine, a standard chemotherapy for various solid tumors, triggers hallmark immunostimualtory DAMP release (e.g., calreticulin, HSP70, and HMGB1); however, is unable to induce ICD. Mechanistic studies reveal gemcitabine concurrently triggers prostaglandin E2 release as an inhibitory DAMP to counterpoise the adjuvanticity of immunostimulatory DAMPs. Pharmacological blockade of prostaglandin E2 biosythesis favors CD103+ dendritic cell activation that primes a Tc1-polarized CD8+ T cell response to bolster tumor rejection. Herein, we postulate that an intricate balance between immunostimulatory and inhibitory DAMPs could determine the outcome of drug-induced ICD and pose COX-2/prostaglandin E2 blockade as a strategy to harness ICD.
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Affiliation(s)
- K Hayashi
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - F Nikolos
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Y C Lee
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei City, Taiwan
| | - A Jain
- Alkek Center for Molecular Discovery, Proteomics Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - E Tsouko
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - H Gao
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - A Kasabyan
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - H E Leung
- Alkek Center for Molecular Discovery, Proteomics Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - A Osipov
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - S Y Jung
- Alkek Center for Molecular Discovery, Proteomics Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - A V Kurtova
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - K S Chan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
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Tsai YT, Tsai MS, Hsu CM, Fang KH, Huang EI, Liu CY, Lin MH, Yang YH, Lee YC, Chang GH. End-stage renal disease as a risk factor for epiglottitis: a population-based cohort study in Taiwan. BMJ Open 2020; 10:e038683. [PMID: 33148739 PMCID: PMC7640511 DOI: 10.1136/bmjopen-2020-038683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Patients with uremia are prone to infection; however, end-stage renal disease (ESRD) as a risk factor for acute epiglottitis warrants study. We investigated the risk of severe epiglottitis requiring hospitalisation in patients with ESRD. SETTING We conducted a retrospective matched cohort study by using the claims data of Taiwan's National Health Insurance Research Database. PARTICIPANTS We identified an ESRD cohort with 87 908 patients newly diagnosed in 2000-2013 and underwent dialysis. The non-ESRD cohort comprised patients who had not received a diagnosis of ESRD, and they were matches to the ESRD cohort (1:1) by sex, age, residence urbanisation level, monthly income, and diabetes and hypertension status. PRIMARY AND SECONDARY OUTCOME MEASURES The cumulative incidence of epiglottitis at the end of 2013 was analysed with Kaplan-Meier methods and log-rank tests. The HR of epiglottitis was calculated using the Cox proportional hazards model after adjustment for confounding factors. RESULTS The overall epiglottitis incidence rate was 94% greater in the ESRD cohort than in the non-ESRD cohort (10.3 vs 5.3 cases per 100 000 person-years, p=0.002), with an adjusted HR of 1.89 (95% CI: 1.23 to 2.91, p=0.004). In the log-rank analysis, compared with the non-ESRD group, the epiglottitis cumulative incidence was significantly higher in the ESRD group (p=0.003). Epiglottitis did not exhibit an association with higher rates of airway interventions, intensive care unit admissions or longer hospitalisation in patients with ESRD than in controls. CONCLUSIONS This nationwide matched cohort study indicated that ESRD patients should be monitored for the risk of severe epiglottitis requiring hospitalisation.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Ku-Hao Fang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ethan I Huang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Geng-He Chang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan
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Abstract
PURPOSE As the designated tertiary referral centre for infectious diseases in Hong Kong, our hospital received the city's first group of patients diagnosed with coronavirus disease 2019 (COVID-19). Herein, we studied the earliest patients admitted to our centre in order to clarify the typical radiological findings, particularly computed tomography (CT) findings, associated with COVID-19. METHODS From 22 January 2020 to 29 February 2020, 19 patients with confirmed COVID-19 underwent high-resolution or conventional CT scans of the thorax in our centre. The CT imaging findings of these patients with confirmed COVID-19 in Hong Kong were reviewed in this study. RESULTS Ground-glass opacities (GGO) with peripheral subpleural distribution were found in all patients (100%). No specific zonal predominance was observed. All lobes were involved in 16 (84.2%) patients, focal subsegmental consolidations were observed in 14 (73.7%) patients, and interlobular septal thickening was present in 12 (63.2%) patients. No mediastinal lymph node enlargement, centrilobular nodule, or pleural effusion was detected in any of the patients. Other imaging features present in several patients include bronchial dilatation, bronchial wall thickening, and crazy-paving patterns. CONCLUSIONS Peripheral subpleural GGO without zonal predominance in the absence of centrilobular nodule, pleural effusion, and lymph node enlargement were consistent findings in patients with confirmed COVID-19. The observed radiological patterns on CT scans can help identify COVID-19 and assess affected patients in the context of the ongoing outbreak.
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Affiliation(s)
- S K Li
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - F H Ng
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K F Ma
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - W H Luk
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - Y C Lee
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K S Yung
- Department of Radiology, Princess Margaret Hospital, Hong Kong
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Ho CF, Lee YC, Hsin LJ, Lee LA, Li HY, Fang TJ. Low-Dose LEMG-Guided Botulinum Toxin Type A Injection for Intractable Vocal Process Granulomas. J Voice 2020; 36:277-282. [PMID: 32595029 DOI: 10.1016/j.jvoice.2020.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Vocal process granuloma (VPG) has a varied treatment success rate and may frustrate patients and physicians due to poor outcomes. There is still a lack of standard protocols to manage VPG. This study aimed to review the efficiency of a standardized low-dose laryngeal electromyographic (LEMG)-guided botulinum toxin A (BTA) injection in intractable vocal granulomas. METHODS Twenty-four patients with intractable VPG were recruited. All patients underwent percutaneous LEMG-guided BTA injection on the thyroarytenoid-lateral cricoarytenoid muscle complex in an office setting. The injecting dose was standardized to 1 U in 0.1 mL normal saline at a time. We evaluated the treatment effect by measuring the lesion size with serial laryngoscope evaluations. RESULTS The postinjection follow-up time varied from 3 to 23 months. Twenty-one patients (87.5%) experienced complete regression of the granuloma over 1-7 months (median 3 months). No major adverse effects were noted during the follow-up period. CONCLUSION For recalcitrant VPG, LEMG-guided low-dose BTA injection has the potential to be a safe, efficient, and effective treatment.
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Affiliation(s)
- Che-Fang Ho
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Ang Lee
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsueh-Yu Li
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Wang YT, Fang KH, Hsu CM, Chang GH, Lai CH, Lee YC, Tsai MS, Huang EI, Tsai YT. Retrospective study on the potential of albumin/globulin ratio as a prognostic biomarker for oral cavity cancer patients. Eur Arch Otorhinolaryngol 2020; 278:227-238. [DOI: 10.1007/s00405-020-06145-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023]
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Fang KH, Lai CH, Hsu CM, Huang E, Tsai MS, Chang GH, Lee YC, Tsai YT. A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma. PeerJ 2020; 8:e9361. [PMID: 32587804 PMCID: PMC7304427 DOI: 10.7717/peerj.9361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/25/2020] [Indexed: 12/18/2022] Open
Abstract
Background Although the C-reactive protein-to-albumin ratio (CAR) can predict poor outcomes in assorted cancers, its prognostic value in oral cavity squamous cell carcinoma (OSCC) remains unclear. We explored the value of preoperative CAR in predicting clinical outcomes in OSCC patients treated with radical surgery. Methods All the recommended cutoff values were defined analyzing receiver operating characteristic curves or overall survival (OS). Dichotomization was performed on the basis of optimal CAR cutoff, and we compared the clinicopathological features between groups. Kaplan-Meier analysis was also performed to compare OS curves between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to find the clinical characteristics that were most closely correlated with disease free survival (DFS) and overall survival (OS). A nomogram incorporated CAR and several clinicopathological factors was established to predict prognosis and its accuracy was evaluated using concordance index (c-index). Results In this retrospective study, a total of 326 patients with newly diagnosis of OSCC and received primary surgery between 2008 and 2017 were enrolled. Through the executed ROC curve analyses, the optimal CAR cutoff derived was 0.195 (area under the curve = 0.718, p < 0.001), with this cutoff exhibiting a discrimination ability superior to that of other inflammation-based prognostic scores after comparing the area under curves. Multivariate analysis demonstrated that CAR (≥0.195/<0.195) was associated with OS (hazard ratio 3.614; 95% CI [1.629-8.018]; p = 0.002) and DFS (hazard ratio 1.917; 95% CI [1.051-3.863]; p = 0.029). Kaplan-Meier analysis and log rank test revealed a significant difference in DFS and OS curves between patients with low CAR (<0.195) and those with high CAR (≥0.195; both p < 0.001). The c-index of the nomogram based on TNM system alone was 0.684 and could be increased to 0.801 if CAR and other clinicopathological factors were included. Conclusions Preoperative CAR could constitute an independent prognostic indicator for OS and DFS prediction in OSCC patients treated with curative surgery. The established nomogram that incorporated CAR and prognostic factors might increase the accuracy of prognostic prediction for patients with OSCC.
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Affiliation(s)
- Ku-Hao Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ethan Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
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Ju HJ, Kwon JW, Lee YC, Bae JM. Seasonal variation in chronic skin diseases: real-world evidence from a nationwide population-based study in Korea. J Eur Acad Dermatol Venereol 2020; 34:e793-e795. [PMID: 32386445 DOI: 10.1111/jdv.16612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H J Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J-W Kwon
- Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Y C Lee
- Department of Otolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - J M Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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