Head Region Research Articles

Case Report: Activated B-cell-diffuse large B-cell lymphoma

Lymphomas of the oral and oropharyngeal regions are rather uncommon, and diagnosis can be challenging and confusing due to the multiple histological subgroups. Lymphomas are the third most common type of tumor in the head and neck region and are brought on by the lymphoreticular system. The two forms of lymphoma are Hodgkin’s lymphoma and non-Hodgkin’s lymphoma (NHL). Herein, we present a case report of oropharyngeal lymphoma. The female patient reported with a complaint of swelling over the palatal region for two to three months. An ulceroproliferative lesion was evident over the posterior palatal region. We diagnosed reactive lymphadenitis based on an incisional biopsy. To confirm the diagnosis and rule out other conditions, a punch biopsy followed by immunohistochemical studies were done. Features suggestive of activated B-cell-diffuse large B-cell lymphoma were confirmed. Among malignant lymphomas, diffuse large B-cell lymphoma is the most prevalent variety. Much progress has been made in recent years in understanding the molecular pathophysiology of this disease. In this case report, we aim to correlate the clinical presentation, histology features and immunohistochemical significance in order to promote early discovery, diagnosis, and treatment for a better prognosis of the patient.

Systemic sequelae and craniofacial development in survivors of pediatric rhabdomyosarcoma

IntroductionThe aim of this study was to evaluate the systemic sequelae, as well as the dental and craniofacial development, of patients with rhabdomyosarcoma in relation to the treatment received and clinical-pathological variables. Materials and MethodsA retrospective cross-sectional study was performed. All individuals diagnosed with RMS between 1990 and 2022 were considered eligible. Cases who survived the primary tumor were included. Data were collected from medical records, and patients were called for clinical and radiographic examinations. ResultsThirty-eight patients were assessed, with a mean disease-free survival of 216.68 months (±84.99). The primary location of the tumor was mainly the head and neck region (57.9 %). All patients received chemotherapy, and 30 (78.9 %) also underwent radiotherapy. The most frequently observed sequela was sensory impairment, which was significantly associated with tumors in the head and neck (p < 0.05), as well as with the use of radiotherapy (p = 0.034). Root formation failure was observed in 60 % of cases, microdontia in 50 %, and delayed tooth eruption in 40 %. A convex profile was predominant (80 %), along with maxillary (50 %) and mandibular (80 %) retrusion and a skeletal class II diagnosis (60 %). ConclusionsLate systemic, dental, and craniofacial developmental sequelae are observed in pediatric rhabdomyosarcoma survivors, especially in patients who underwent radiotherapy in the head and neck region. Younger individuals at the time of treatment are at greater risk of late sequelae.

Granular Cell Tumor of the Anal Canal: Case Report and Literature Review

AbstractGranular cell tumors (GCTs) are rare benign neoplasms that can occur anywhere in the body but are most commonly found in the head and neck region. These tumors are often asymptomatic and are incidentally discovered during routine rectal examination. In some cases, symptoms may include bleeding, pain, and a palpable mass. Imaging studies such as colonoscopy, ultrasound, magnetic resonance imaging (MRI), or computed tomography can be used to characterize and measure the tumor. Treatment typically involves local resection, with or without adjuvant radiotherapy, depending on the size, location, and pathological characteristics of the tumor. The prognosis for GCTs of the anal canal is generally good, with few cases of recurrence or metastasis reported, but long-term follow-up is recommended due to the potential for late recurrence or malignant transformation. The present study reports a 39-year-old female patient who presented with anal itching associated with protrusion of a perianal mass and who underwent treatment between November 2022 and December 2023. The MRI scan revealed a nodular image in its caudal aspect with involvement of the internal sphincter between 12 and 5 o'clock, which was successfully resected. Histopathology was compatible with GCT, and the patient had a satisfactory recovery and was discharged. In conclusion, GCTs of the anal canal are rare and extremely unusual tumors that can be difficult to diagnose and manage, requiring a multidisciplinary approach for optimal management.

Prevalence of Ameloblastoma in Sub-Saharan Africa: A systematic review and meta-analysis

IntroductionAmeloblastoma is the most common odontogenic tumor (OT) accounting for about 1- 3 % of all tumors and tumor-like lesions of the head and neck region. Contrasting reports from documented studies have observed that the relative frequency of ameloblastomas is higher in the black population as compared to Caucasians. This is a systematic review and meta-analysis of Sub-Sahara African prevalence of Ameloblastoma. MethodsThe MEDLINE, SCOPUS, and AJOL databases were searched for relevant studies published from 1980 till date. Papers selected for full-text review were included in the systematic review if they provided a hospital or population-based prevalence of Ameloblastoma. Manual searching of selected articles’ reference list was also performed to include additional studies. Two individuals independently performed abstract and full-text reviews, data extraction, and quality assessment of the papers. Random-effects models and/or meta-regression were used to generate pooled estimates by country, sex, and year of data collection. ResultsOf 264 abstracts screened, 166 articles were selected for full-text review. A total of 22 studies met the inclusion criteria and all articles were hospital-based. The pooled prevalence for Ameloblastoma was 12 % (CI 95 %: 9 % - 15 %). Increasing participant age was not associated with a higher Ameloblastoma prevalence. Prevalence was higher in Nigeria (13 %, CI 95 %: 10 % - 17 %) than in other sub-Saharan countries (9 %, CI 95 %: 6 % - 14 %). Sex, country, and year of data collection were not associated with statistically significant different estimates of prevalence. ConclusionSignificant gaps in data collection and overall knowledge about its epidemiology were identified, particularly about the population-based incidence of Ameloblastoma in sub-Saharan countries. Accurate estimates of the prevalence and incidence of Ameloblastoma are needed to plan for the health and social services that will be required to deal with this enigmatic lesion.

WTAP promotes laryngeal carcinoma cell progression by posttranscriptional activation of CTHRC1 in an m6A-YTHDF1-dependent way.

Laryngeal carcinoma is one of the malignancies in the head and neck region with high incidence and mortality. Despite advances in therapeutic modalities, the 5-year survival rate remains low. Wilms tumor 1-associated protein (WTAP) has been reported to regulate cancer progression, however, its role and mechanism in regulating laryngeal carcinoma development remain unclear. In this study, the expressions of WTAP, collagen triple helix repeat containing 1 (CTHRC1), and YTH N6-methyladenosine RNA binding protein F1 (YTHDF1) and other molecules were detected by quantitative real-time polymerase chain reaction or western blotting. Cell viability and colony formation rate were determined by cell counting kit-8 assay and cell colony formation assay. Cell migration and invasion were investigated by transwell assay. The relationship between CTHRC1 and YTHDF1 was identified by RNA immunoprecipitation assay. The results showed that WTAP and CTHRC1 were upregulated in laryngeal carcinoma tissues and cells. WTAP or CTHRC1 silencing inhibited the proliferation, migration and invasion of laryngeal carcinoma cells. WTAP knockdown inhibited CTHRC1 mRNA stability by suppressing CTHRC1 m6A modification and YTHDF1 from recognizing CTHRC1 m6A sites. Moreover, CTHRC1 overexpression attenuated WTAP knockdown-mediated effects on laryngeal carcinoma cell phenotypes and the expression of β-catenin, C-myc and cyclinD1. Thus, WTAP facilitated CTHRC1 mRNA stability in an m6A-dependent manner to activate the Wnt/β-catenin pathway and promote laryngeal carcinoma cell malignant phenotypes.

Oblique pole-side crash assessment using the six-year-old HBM PIPER

Side impact crashes are one of the most dangerous impact scenarios that a child can suffer. Studies by the National Highway Traffic Safety Administration (NHTSA) have shown that the head and Thorax regions are affected severely. The objective of this work is to perform a numerical evaluation of the oblique pole-side test considering the FMVSS 214-P standard to estimate the Head, Neck, and Thorax injuries for a six-year-old child positioned in the rear seat without any Child Restraint System, two configurations were performed for the oblique pole-side impact: a nearside and a far-side positioning configuration. A six-year-old Human Body Model (HBM) denominated Scalable PIPER Child Model, and the Ford Explorer 2003 were used to perform the test in the LS DYNA® software to assess the biomechanics involved in the crash scenarios. The approach considered a comparative case study with the baseline of the six-year-old child PIPER model to ensure that the positioning adjustment has not affected the mesh quality and interior components for the PIPER child model. The outcomes obtained in case 1 show that the modified PIPER child model has slight outcomes at the shoulder and pelvis zone due to the differences in the body positioning and not by the mesh or the interior interaction between the components. The outcomes obtained in case 2 reflect that the nearside setup obtained the higher measurements for the child occupant. The Ac3ms for Head at nearside test to overcome the Side Criteria established by the Assessment Protocol Child Occupant Protection by Euro NCAP, the kinematics behavior demonstrates the importance of researching children in side crashes to enhance child security, especially in the oblique pole side impact.

Reirradiation in head and neck squamous cell carcinoma; prognostic indicators, oncologic and functional outcomes

ObjectivesPatients with recurrent squamous cell carcinoma of the head and neck (HNSCC) have a poor prognosis and limited therapeutic alternatives. While reirradiation is feasible, it is usually associated with high treatment toxicity and is not yet considered the standard of care. Based on current NCCN guidelines, in the context of very advanced head and neck cancer (recurrent and/or persistent disease), surgical intervention is explored initially with/without adjuvants while unresectable disease is approached with radiation and/or systemic therapies. Specific and reliable prognostic indicators for both -oncologic and functional outcomes- have yet to be defined for this population. MethodsRetrospective chart review of 54 patients treated with reirradiation at a tertiary academic institution between January of 1998 and January of 2024. Only patients with non-metastatic recurrent, and second primary HNSCC were included in the series. Demographics, staging, radiation dose and technique, additional therapy, histopathologic variables, EORTC toxicity, pre- and post-treatment PEG/tracheotomy dependency and oncologic outcomes were retrieved. ResultsThe study cohort consisted of 54 patients (37 males, 17 females) with HNSCC, averaging 62.7 years in age. Initial tumors were locally advanced in over 42 % of cases, with 58 % being node-negative. The head and cutaneous regions (24.5 %) and tongue (20.8 %) were the most common tumor sites. Primary surgical resection and adjuvant radiation were performed in 47.2 % of cases, and concurrent chemotherapy was used in 40.7 %. Reirradiation was mainly for local or regional recurrence (88.9 %), often following salvage surgery (68.5 %), with a mean dose of 5623 Gy over 52.5 fractions. Positive surgical margins were present in 29.4 % of cases, and extracapsular spread in 59.5 %. No significant differences were found between the salvage surgery and definitive reirradiation groups except for tumor site (P = 0.022). Median follow-up was 52.6 months, with 27 deaths reported. Lymphovascular invasion was significantly correlated with overall survival (P = 0.017), while initial tumor T-stage and neck disease involvement were linked to local-regional control (P = 0.030 and P = 0.033, respectively). Reirradiation increased tracheotomy and PEG-tube dependency by 20 % (P = 0.011) and 23 % (P = 0.003), respectively. ConclusionsReirradiation is a feasible therapeutic alternative in recurrent head and neck SCC. Oncologic outcomes observed in this series compare favorably to most published reports. Complete response and perineural invasion were independent prognostic factors for survival and locoregional control. While no mortality directly associated with treatment was observed in this series, reirradiation had a significant impact in functional outcomes in terms of increased risk of tracheotomy and peg tube dependency. Further studies are required to define the role of this treatment in head and neck cancer.

Changes in Ocular Blood Flow After Intravitreal Injection for Diabetic Macular Edema Between Aflibercept and Faricimab.

In this study, we aimed to evaluate and compare the effects of intravitreal aflibercept (IVA) and intravitreal faricimab (IVF) injections on the blood flow of retinal vessels in the peripapillary region and optic nerve head (ONH) in eyes with diabetic macular edema (DME) using laser speckle flowgraphy (LSFG). This study included 20 eyes of 18 patients treated with IVA and 15 eyes of 11 patients treated with IVF for DME. The mean blur rate (MBR) of the ONH and retinal artery and vein of the peripapillary region were measured using LSFG at baseline and 1 month after injection. Central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured for all patients. CRT decreased significantly in both IVA-treated (p = 0.0003) and IVF-treated groups (p = 0.0004). Some of the MBR-related parameters of the ONH, such as MBR of all areas (MA), MBR of vascular areas (MV), and MBR of tissue areas (MT), decreased significantly 1 month after IVA and IVF compared to baseline values (MA of IVA, p < 0.0001; MT of IVA, p = 0.0220; MA of IVF, p = 0.0002; MT of IVF, p = 0.0461). MBR of the retinal artery (MBR-A) and vein (MBR-V) also decreased significantly 1 month after IVA and IVF compared with baseline values (MBR-A of IVA, p = 0.0002; MBR-V of IVA, p = 0.0010; MBR-A of IVF, p = 0.0368). No significant difference in ocular perfusion was observed between the IVA-treated and IVF-treated groups. Intravitreal injection led to a reduction in ocular blood flow in both retinal peripapillary vessels and the ONH in both IVA-treated and IVF-treated groups. No significant difference was observed in MBR reduction between the IVA-treated and IVF-treated groups. Our findings warrant further long-term investigations to reveal differences between aflibercept and faricimab.

Reorganization of Snowfall beneath Cloud Top within the Comma Head Region of Two Extreme U.S. East Coast Winter Cyclones

Abstract This paper examines ice particle reorganization by three-dimensional horizontal kinematic flows within the comma head regions of two U.S. East Coast winter storms and the effect of reorganization on particle concentrations within snowbands in each storm. In these simplified experiments, the kinematic flows are from the initialization of the HRRR model. Ice particles falling through the comma head were started from either 9-, 8-, or 7-km altitude, spaced every 200 m, and were transported north or northwest, arriving within the north or northwest half of the primary snowband in each storm. The greatest particle concentration enhancement within each band was a factor of 2.32–3.84 for the 16–17 December 2020 storm and 1.76–2.32 for the 29–30 January 2022 storm. Trajectory analyses for particles originating at 4 km on the southeast side of the comma head beneath the dry slot showed that this region supplied particles to the south side of the band with particle enhancements of factor of 1.36–2.08 for the 16–17 December 2020 storm and 1.04–2.16 for the 29–30 January 2022 storm. Snowfall within the bands had two source regions: 1) on the north/northwestern side, from ice particles falling from the comma head, and 2) on the southeastern side, from particles forming at or below 4-km altitude and transported northwestward by low-level flow off the Atlantic. While the findings give information on the source of particles in the bands, they do not definitively determine the cause of precipitation banding since other factors, such as large-scale ascent and embedded convection, also contribute to snow growth. Significance Statement Wintertime storms along the east coast of North America can produce heavy snowfall, high winds, coastal flooding, and cold temperatures, resulting in major economic impacts within the northeast U.S. urban corridor. The heaviest snowfall typically occurs within snowbands, elongated narrow regions identifiable by high reflectivity on radar. This paper examines the potential sources of the ice particles contributing to the snowbands and how the flow fields throughout the storm can contribute to enhanced particle concentrations within the bands.

Prototype Aplikasi Real Count Pemilihan Kepada Daerah Pada Badan Pengawas Pemilihan Umum Kota Palembang

PILKADA (Regional Head Election) and its deputy are routine activities carried out by each region to carry out democratic government activities. The Provincial KPU carries out Pilkada, and Regency / City KPU is collectively responsible for implementing general elections, supervised by the Provincial Bawaslu and Regency / City Bawaslu. The Palembang City Bawaslu's task in the vote counting process is to oversee the movement of recapitulation data from the TPS Supervisor level, Village / Sub-district Supervisors (PKD), and District Election Supervisory Committee (Panwascam) to the City Bawaslu so that there is no vote inflation which is considered dishonest and unfair. The process of collecting C1 and C-Plano form data to be recapitulated from the lower level to the upper level at the Palembang City Bawaslu collected, the process will take a relatively long time if done manually, especially limited by the long distance and poor natural conditions. In line with the development of increasingly modern technology, considering the need for data and the need for rapid dissemination of information on Pilkada results, in this study, the author will design Real Counting (also known as parallel vote aggregation) as a helpful way to monitor and accelerate the vote aggregation process in the form of an application prototype. This study aims to provide a prototype design for the Pilkada real count application at Bawaslu Palembang City. The software development method used in this study is the waterfall model method, which consists of analysis, design, coding, testing, and support or maintenance.

Morphometric analysis and functional insights into the serotonergic system of Girardia tigrina (Tricladida, Platyhelminthes).

Using immunocytochemistry, serotonergic nerve elements were documented in the nervous system of the planarian Girardia tigrina. Serotonin-immunopositive components were observed in the brain, ventral, dorsal and longitudinal nerve cords, transverse nerve commissures connecting the nerve cords, and in the nerve plexus. Whole-mount preparations of G. tigrina were analyzed by fluorescent and confocal laser scanning microscopy. An essential quantitative morphometric measurement of serotonin-immunopositive structures was conducted in three body regions (anterior, middle, and posterior) of the planarian. The number of serotonin neurons was maximal in the head region. The ventral nerve cords gradually decreased in thickness from anterior to posterior body ends. Physiological action of exogenously applied serotonin was studied in G. tigrina for the first time. It was found that serotonin (0.1 and 1 µmol L-1) accelerated eye regeneration. The transcriptome sequencing performed for the first time for the planarian G. tigrina revealed the transcripts of the tryptophan hydroxylase (trph), amino acid decarboxylase (aadc) and serotonin transporter (sert) genes. The data obtained indicate the presence of the components of serotonin pathway in G. tigrina. The identified transcripts can take part in serotonin turnover and participate in the realization of biological effects of serotonin in planarians, associated with eyes regeneration and differentiation.

Retrospective Review of Congenital Anomaly Cases in Ruminants

This study was designed to provide data on the incidence rates of congenital anomalies and their distribution by organs and systems in calves, lambs and kids brought to Van Yuzuncu Yil University, Surgery Clinic between 2017-2023. The animal material of the study consisted of 1104 ruminants, including 886 calves, 183 lambs and 35 kids, aged 0-6 months. In addition to clinical examination, anomalies were diagnosed by using direct and indirect radiographic examinations when necessary. In some cases, a definitive diagnosis was made by performing experimental laparotomy based on clinical and radiological examinations. 341 out of 1104 ruminants, including 234 calves, 96 lambs and 11 kids, suffered from congenital anomalies. Of the ruminants with congenital anomalies, 208 (61.00%) were male, 132 (38.70%) female and 1 (0.30%) hermaphrodite. Abdominal wall anomalies were determined with the highest number of 112 (32.9%) cases. These were followed by musculoskeletal system anomalies in 83 (24.4%) cases and gastrointestinal system anomalies in 56 (16.5%) cases. Head region anomalies occurred in 41 cases (12.1%), urinary system anomalies in 23 cases (6.8%) and CNS anomalies in 9 cases (2.6%). Multiple anomalies were recorded in 16 (4.7%) cases. In conclusion, congenital anomalies are frequently seen as pathologies in ruminants in our country, especially in our region. Avoiding inbreeding, making artificial insemination widespread, improving the care and nutrition of the dam during pregnancy, correcting adverse environmental conditions and eliminating stress factors, avoiding over-the-counter medication misuse during pregnancy and most importantly informing field veterinarians and animal owners about the subject will contribute to the prevention of congenital malformations and losses in livestock.

Evaluation of the Regional Head Age Limit Policy in Indonesia After the Supreme Court Decision Number 23 P / HUM / 2024

This study evaluates the regional head age limit policy in Indonesia following the Supreme Court Decision Number 23 P/HUM/2024 through a normative juridical analysis. The age limit policy, governed by Law No. 10 of 2016, aims to ensure capable leadership by imposing a minimum age requirement for candidates. However, the Supreme Court's decision raises questions about the policy's alignment with constitutional principles of equality, non-discrimination, and democratic participation. The analysis examines statutory regulations, legal principles, and comparative insights from other democratic countries to understand the policy's rationale and implications. Findings highlight the need for a balanced approach that ensures legal consistency and promotes inclusive, effective regional governance. Recommendations include lowering the minimum age requirement, implementing a flexible age range, and incorporating empirical evidence to refine the policy, ensuring it serves the principles of justice, democratic participation, and effective governance.

THE INFLUENCE OF COORDINATION AND JOB DESCRIPTION ON WORK PRODUCTIVITY THROUGH WORK DISCIPLINE OF REGIONAL HEAD PROTOCOLARY EMPLOYEES IN THE PROTOCOL AND COMMUNICATION SECTION OF BONDOWOSO REGIONAL SECRETARIAT LEADERS

Measuring the work productivity of Regional Head Protocol employees in the Protocol and Communication Section of the Bondowoso Regency Regional Secretariat Leadership is an important concern in the context of optimizing the implementation of protocol events and public services. The aim of this research is to determine and analyze the influence of coordination and job descriptions on work productivity through the work discipline of Regional Head Protocol employees in the Protocol and Communication Section of the Bondowoso Regency Regional Secretariat Leadership. The population and sample in this research were 50 employees, so the sampling technique used was saturated sampling or census. The research method used in this research is descriptive and verification methods. The data analysis technique used in this research is path analysis with the help of the SPSS application. The test results prove that coordination and job descriptions have a significant effect on work discipline and the work productivity of employees in the Protocol and Communication Section of the Regional Secretariat of Bondowoso Regency. Work discipline is able to provide a mediating effect between coordination and job description on work productivity. Keywords: coordination, job description, work discipline and productivity. Keywords: coordination, job description, work discipline and productivity

Implementasi Prinsip Demokrasi dalam Pengangkatan Penjabat Kepala Daerah pada Masa Pilkada Serentak

The implementation of the 2024 simultaneous general elections has serious political implications because it creates a power vacuum in the regions. The regional head vacancy occurred due to the abolition of the 2022 and 2023 regional elections, which resulted in most regions at the provincial to district / city level not having a definitive regional head. To anticipate the government vacancy, in accordance with Law No.10/2016 on Regional Head Elections, the appointment or appointment of acting regional heads is carried out. The need for affirmation regarding the process of filling vacancies in the position of regional head is also still within the scope of democratic interpretation as stipulated in Article 18 Paragraph (4) of the 1945 Constitution. Therefore, it needs to be taken into consideration and attention for the government to issue implementing regulations as a follow-up to Article 201 of Law No.10/2016.

Comparison of clinicopathological characteristics of young and old North Indian patients of oral squamous cell carcinoma

IntroductionOral squamous cell carcinoma (OSCC) ranks among the most prevalent epithelial malignancies in the head and neck region. Although it predominantly affects older individuals, there has been a concerning rise in incidence among the younger population in recent years. This study aimed to compare the clinicopathological features of OSCC at our institution distinguishing between young and older age groups. MethodsIn the present retrospective study, histopathologically confirmed cases of OSCC were retrieved and assigned into two groups based on their age. Demographic data along with histopathological parameters were assessed. The data collected were statistically analysed using descriptive analysis, chi-square, kappa and multinomial logistic regression tests. A p-value less than or equal to 0.05 was considered statistically significant. ResultsOf the 707 OSCC patients, 585 were over 40 years old, while 122 were 40 or younger. Both the groups exhibited comparable observations with a high degree of keratinization, moderate nuclear pleomorphism, type 3 pattern of invasion, low tumor budding, high stromal and low intratumoral infiltration of lymphocytes, except lymphoplasmacytic infiltrate which was marked in a higher number of young cases. ConclusionOSCC in young and older individuals exhibited similar clinical as well as histopathological findings. Although the increased incidence of OSCC in the young is a cause of concern, so future multicentric studies with a larger sample size are warranted, to shed more light on the behavior and prognosis of OSCC in the young.

Fucoxanthin Inhibits the Proliferation and Metastasis of Human Pharyngeal Squamous Cell Carcinoma by Regulating the PI3K/Akt/mTOR Signaling Pathway.

Human pharyngeal squamous cell carcinoma (HPSCC) is the most common malignancy in the head and neck region, characterized by high mortality and a propensity for metastasis. Fucoxanthin, a carotenoid isolated from brown algae, exhibits pharmacological properties associated with the suppression of tumor proliferation and metastasis. Nevertheless, its potential to inhibit HPSCC proliferation and metastasis has not been fully elucidated. This study represents the first exploration of the inhibitory effects of fucoxanthin on two human pharyngeal squamous carcinoma cell lines (FaDu and Detroit 562), as well as the mechanisms underlying those effects. The results showed dose-dependent decreases in the proliferation, migration, and invasion of HPSCC cells after fucoxanthin treatment. Further studies indicated that fucoxanthin caused a significant reduction in the expression levels of proteins in the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mechanistic target of rapamycin (mTOR) pathway, as well as the downstream proteins matrix metalloproteinase (MMP)-2 and MMP-9. Specific activators of PI3K/AKT reversed the effects of fucoxanthin on these proteins, as well as on cell proliferation and metastasis, in FaDu and Detroit 562 cells. Molecular docking assays confirmed that fucoxanthin strongly interacted with PI3K, AKT, mTOR, MMP-2, and MMP-9. Overall, fucoxanthin, a functional food component, is a potential therapeutic agent for HPSCC.

Superior vena cava syndrome: presentation of 7 cases and literature review

Superior vena cava syndrome (SVCS) is the result of obstruction of venous flow through the SVC. Mortality due to SVCS is rare (0.3%); however, the median survival in patients with SVCS secondary to malignancy is 6 months. Extrinsic occlusion due to malignancy is the most common cause; however, intraluminal thrombosis secondary to central venous catheters and pacemaker wires represents 30% of cases. The SVC is the main drainage pathway for the head, neck, and upper torso region, so SVCS is characterized by facial and neck edema, dyspnea, and distension of the neck and chest veins. Symptoms vary depending on the severity, location, and speed of onset of the obstruction and the establishment of collateral veins. Diagnosis is based on clinical presentation and imaging studies such as chest angiotomography and digital subtraction venography (gold standard). Regarding treatment, radiation therapy and chemotherapy were considered first-line; however, nowadays endovascular therapy (ET) (angioplasty, stent placement, and catheter-directed thrombus extraction) has demonstrated higher success rates and lower recurrence rates. Surgical diversion is reserved for cases of extensive venous thrombosis or occlusion not amenable to ET. We conducted a literature review and described 7 cases of SVCS treated with successful ET and their main complications at the national cancer institute of Mexico. SVCS is a condition with a diagnostic challenge. Currently, the use of endovascular treatment through angioplasty and stent placement leads to immediate improvement in patients, thus establishing it as first-line treatment.

Landmark-based auto-contouring of clinical target volumes for radiotherapy of nasopharyngeal cancer.

The delineation of clinical target volumes (CTVs) for radiotherapy for nasopharyngeal cancer is complex and varies based on the location and extent of disease. The current study aimed to develop an auto-contouring solution following one protocol guidelines (NRG-HN001) that can be adjusted to meet other guidelines, such as RTOG-0225 and the 2018 International guidelines. The study used 2-channel 3-dimensional U-Net and nnU-Net framework to auto-contour 27 normal structures in the head and neck (H&N) region that are used to define CTVs in the protocol. To define the CTV-Expansion (CTV1 and CTV2) and CTV-Overall (the outer envelope of all the CTV contours), we used adjustable morphological geometric landmarks and mimicked physician interpretation of the protocol rules by partially or fully including select anatomic structures. The results were evaluated quantitatively using the dice similarity coefficient (DSC) and mean surface distance (MSD) and qualitatively by independent reviews by two H&N radiation oncologists. The auto-contouring tool showed high accuracy for nasopharyngeal CTVs. Comparison between auto-contours and clinical contours for 19 patients with cancers of various stages showed a DSC of 0.94±0.02 and MSD of 0.4±0.4mm for CTV-Expansion and a DSC of 0.83±0.02 and MSD of 2.4±0.5mm for CTV-Overall. Upon independent review, two H&N physicians found the auto-contours to be usable without edits in 85% and 75% of cases. In 15% of cases, minor edits were required by both physicians. Thus, one physician rated 100% of the auto-contours as usable (use as is, or after minor edits), while the other physician rated 90% as usable. The second physician required major edits in 10% of cases. The study demonstrates the ability of an auto-contouring tool to reliably delineate nasopharyngeal CTVs based on protocol guidelines. The tool was found to be clinically acceptable by two H&N radiation oncology physicians in at least 90% of the cases.

Kimura’s disease: rare inflammatory condition mimicing as soft tissue neoplasm

Kimura’s disease is rare benign chronic inflammatory condition of unknown etiology involving head and neck region. The characteristic features of this condition are elevated serum IGE levels and microscopic picture reveals lymphoid proliferation with eosinophilic infiltration. It is commonly misdiagnosed as soft tissue neoplasm. Surgical wide local excision is the main stay of treatment. Sometimes combined therapy (excision and postoperative radiotherapy) is needed. Here we are presenting one interesting rare case, 32-year-old male with post auricular swelling, diagnosed as soft tissue tumor preoperatively, after excision came out as kimura’s disease.