Pre-irradiation dental care: Ready-to-use templates for oropharyngeal cancers

Aim

To develop a tool in order to guide pre-irradiation dental care (PIDC) for patients with oropharyngeal cancers.

An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation

The objective

To determine whether a simple oral hygiene protocol improves the oral health of inpatients in stroke rehabilitation.

The background data discussing the present status of the field

Poor oral health can lead to serious complications, such as pneumonia. The comorbidities associated with stroke, such as dysphagia, hemiparesis and cognitive impairment, can further impede independent oral care. International stroke guidelines recommend routine oral care but stop short of detailing specific regimes.

Materials and methods

The oral health assessment tool (OHAT) was conducted by speech‐language pathologists with 100 patients with and without dysphagia in three metropolitan inpatient stroke rehabilitation facilities. A simple nurse‐led oral hygiene regime was then implemented with all participants, which included twice daily tooth brushing and mouth rinsing after lunch, and oral health was measured again one week later.

Results

Initially, dysphagia was negatively associated with OHAT scores, and independence for oral hygiene was positively associated with oral health. After one week of a simple oral hygiene regime, the OHAT scores available for 89 participants indicated an improvement on average for all participants. In particular, 59% of participants with dysphagia had an improvement of 1 or more points. None of the participants developed pneumonia.

Conclusion

A simple, inexpensive oral hygiene regime resulted in positive outcomes for patients with and without dysphagia in inpatient stroke rehabilitation settings. Oral health assessments and oral hygiene regimes that are simple to implement by the interdisciplinary team can be incorporated into standard stroke care with positive effect.     

Dosimetric impact of volumetric modulated arc therapy for nasopharyngeal cancer treatment

BackgroundThe purpose of the study was to evaluate the toxicity and outcome of nasopharyngeal carcinoma patients treated using 3-dimensional conformal radiotherapy (3DCRT) or volumetric modulated arc therapy (VMAT) technique.Materials and methods68 patients treated between 2006 and 2018 were retrospectively analysed. Since 2009 patients received 3DCRT with 50/70 Gy to the elective/boost volumes in 35 fractions; from then, VMAT with simultaneous integrated boost (SIB) with 54.45/69.96 Gy in 33, or 54/66 Gy in 30 fractions. Induction chemotherapy was administered in 74% of the patients, concomitant cisplatinum in 87%. Acute and late toxicity data, progression-free survival PSF and overall survival OS, and toxicity correlations with dose metrics were reported.ResultsWith a median follow-up of 64 months, complete remission at the last evaluation was in 68% of the patients, while 28% and 9% had locoregional relapse and distant disease, respectively. The 5- and 10-year progression free survival (PFS) rates were 62.7 ± 6.5% and 53.2 ± 8.7%, respectively. The 5- and 10-year OS rates were 78.9 ± 5.5% and 61.4 ± 9.2%, respectively. At the multivariate Cox analysis TNM stage (p = 0.02) and concomitant chemotherapy (p = 0.01) resulted significant for PFS, concomitant chemotherapy (p = 0.04) for OS.Improvements in acute toxicity were presented for VMAT patients due to its ability to spare OARs. Odds ratio (OR) for acute salivary toxicity, between VMAT and 3DCRT, was 4.67 (p = 0.02). Dosimetrically, salivary toxicity correlated with mean parotid dose (p = 0.05), dysphagia with laryngeal (p = 0.04) and mean oral cavity (p = 0.06) doses, when dose-volume histograms (DVHs) are corrected for fractionation.ConclusionThis study is a proof of a significant benefit of the VMAT technique compared with 3DCRT in terms of side effects in nasopharynx patients, and adds dosimetric correlations.     

Promoter hypermethylation using 24-gene array in early head and neck cancer

Silencing of tumor suppressor genes (TSGs) by DNA promoter hypermethylation is an early event in carcinogenesis and a potential target for personalized cancer treatment. In head and neck cancer, little is known about the role of promoter hypermethylation in survival. Using methylation specific multiplex ligation-dependent probe amplification (MS-MLPA) we investigated the role of promoter hypermethylation of 24 well-described genes (some of which are classic TSGs), which are frequently methylated in different cancer types, in 166 HPV-negative early oral squamous cell carcinomas (OSCC), and 51 HPV-negative early oropharyngeal squamous cell carcinomas (OPSCC) in relation to clinicopathological features and survival. Early OSCC showed frequent promoter hypermethylation in RARB (31% of cases), CHFR (20%), CDH13 (13%), DAPK1 (12%), and APC (10%). More hypermethylation (≥ 2 genes) independently correlated with improved disease specific survival (hazard ratio 0.17, P = 0.014) in early OSCC and could therefore be used as prognostic biomarker. Early OPSCCs showed more hypermethylation of CDH13 (58%), TP73 (14%), and total hypermethylated genes. Hypermethylation of two or more genes has a significantly different effect on survival in OPSCC compared with OSCC, with a trend toward worse instead of better survival. This could have a biological explanation, which deserves further investigation and could possibly lead to more stratified treatment in the future.     

改善吞咽功能食品增稠剂的研究

为了提供一种适合老年吞咽障碍患者使用的增稠剂,以黄原胶和罗望子胶及麦芽糊精为原料,粘度及溶解时间为指标,采用单因素实验和正交实验相结合的方法确定胶体最适的复配比例。结果表明:复配后的胶体粘度均大于单一胶体的粘度,且三种胶体复配后的溶解速度得到了显著地提高。黄原胶、罗望子胶和麦芽糊精的最适复配比例为3∶1∶30,粘度为611mPa·s,溶解时间为3min。随后通过流变仪对复配溶液的流变特性及粘度进行分析验证。最后将最适配方的增稠剂与市面上具有代表性的国内外增稠剂进行对比,表明该配方的增稠剂不仅具有成本低及速溶的优势,还能应用于医学钡餐造影。     

Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models

This study adapted human videofluoroscopic swallowing study (VFSS) methods for use with murine disease models for the purpose of facilitating translational dysphagia research. Successful outcomes are dependent upon three critical components: test chambers that permit self-feeding while standing unrestrained in a confined space, recipes that mask the aversive taste/odor of commercially-available oral contrast agents, and a step-by-step test protocol that permits quantification of swallow physiology. Elimination of one or more of these components will have a detrimental impact on the study results. Moreover, the energy level capability of the fluoroscopy system will determine which swallow parameters can be investigated. Most research centers have high energy fluoroscopes designed for use with people and larger animals, which results in exceptionally poor image quality when testing mice and other small rodents. Despite this limitation, we have identified seven VFSS parameters that are consistently quantifiable in mice when using a high energy fluoroscope in combination with the new murine VFSS protocol. We recently obtained a low energy fluoroscopy system with exceptionally high imaging resolution and magnification capabilities that was designed for use with mice and other small rodents. Preliminary work using this new system, in combination with the new murine VFSS protocol, has identified 13 swallow parameters that are consistently quantifiable in mice, which is nearly double the number obtained using conventional (i.e., high energy) fluoroscopes. Identification of additional swallow parameters is expected as we optimize the capabilities of this new system. Results thus far demonstrate the utility of using a low energy fluoroscopy system to detect and quantify subtle changes in swallow physiology that may otherwise be overlooked when using high energy fluoroscopes to investigate murine disease models.     

Identification and characterization of the mitochondrial membrane sorting signals in phosphatidylserine decarboxylase 1 from Saccharomyces cerevisiae

Phosphatidylserine decarboxylase 1 (Psd1p) catalyzes the formation of the majority of phosphatidylethanolamine (PE) in the yeast Saccharomyces cerevisiae. Psd1p is localized to mitochondria, anchored to the inner mitochondrial membrane (IMM) through membrane spanning domains and oriented towards the mitochondrial intermembrane space. We found that Psd1p harbors at least two inner membrane-associated domains, which we named IM1 and IM2. IM1 is important for proper orientation of Psd1p within the IMM (Horvath et al., J. Biol. Chem. 287 (2012) 36744–55), whereas it remained unclear whether IM2 is important for membrane-association of Psd1p. To discover the role of IM2 in Psd1p import, processing and assembly into the mitochondria, we constructed Psd1p variants with deletions in IM2. Removal of the complete IM2 led to an altered topology of the protein with the soluble domain exposed to the matrix and to decreased enzyme activity. Psd1p variants lacking portions of the N-terminal moiety of IM2 were inserted into IMM with an altered topology. Psd1p variants with deletions of C-terminal portions of IM2 accumulated at the outer mitochondrial membrane and lost their enzyme activity. In conclusion we showed that IM2 is essential for full enzymatic activity, maturation and correct integration of yeast Psd1p into the inner mitochondrial membrane.     

miR-214通过调控Notch1信号对口咽鳞状细胞癌细胞株增殖、侵袭及凋亡的作用机制研究

目的研究miR-214通过调控Notch1信号对口咽鳞状细胞癌（OSCC）细胞株增殖、侵袭及凋亡的作用机制。 方法在ATCC细胞库购买OSCC细胞株,分为3组：抑制组（IN组）、模拟组（SI组）及对照组（CO组）。通过Western blot法、qRT-PCR法、TUNEL法、侵袭实验及CCK-8法分析3组癌细胞中Notch1的蛋白、mRNA表达水平、细胞凋亡、迁移及增殖能力的差异性,三组间比较采用单因素方差分析,组间两两比较采用LSD-t检验。 结果IN、SI、CO组细胞内miR-214mRNA表达量分别为1.15±0.26,3.34±0.89,2.08±0.67,SI组分别与IN组、CO组比较,差异具有统计学意义（t = 5.281,P = 0.002;t = 2.529,P = 0.045）;SI组、IN组的Notch1-UTR表达分别为0.42±0.11、0.86±0.09,差异具有统计学意义（t = 5.362,P = 0.006）;IN、SI、CO组的OSCC细胞凋亡率分别为（0.78±0.10）﹪、（0.32±0.06）﹪、（0.56±0.12）﹪,IN组分别与CO组、SI组比较,差异具有统计学意义（t = 3.149,P = 0.020;t = 8.823,P < 0.001）;IN、SI、CO组癌细胞的增殖率分别为（0.65±0.05）﹪、（1.26±0.06）﹪、（1.89±0.04）﹪,IN组与SI组、IN组与CO组比较,差异具有统计学意义（t = 11.056,P < 0.001;t = 27.394,P < 0.001）,CO组与SI组比较,差异具有统计学意义（t = 12.365,P < 0.001）;IN、SI、CO组癌细胞侵袭率分别为（0.13±0.02）﹪、（0.89±0.13）﹪、（0.48±0.11）﹪,SI组与CO组、SI组与IN组比较,差异具有统计学意义（t = 4.176,P = 0.006;t = 10.147,P < 0.001）;IN、SI、CO组的Notch1蛋白含量分别为：2.38±1.34、0.94±0.23、1.76±0.67,SI组与CO组、SI组与IN组比较,差异具有统计学意义（t = 2.588,P = 0.041;t = 2.368,P = 0.056）;IN、SI、CO组的Notch1 mRNA表达量分别为4.26±1.06、1.45±0.38、2.46±0.87,IN组与CO组、IN组与SI组比较,差异具有统计学意义（t = 2.935,P = 0.026;t = 5.583,P = 0.001）。 结论miR-214可能与OSCC细胞株增殖呈负相关,在细胞中miR-214含量升高,可能抑制Notch1信号通路表达,从而促进癌细胞增长、侵袭,抑制癌细胞凋亡。