Associations between Sex and Risk Factors for Predicting Chronic Kidney Disease.

Gender is an important risk factor in predicting chronic kidney disease (CKD); however, it is under-researched. The purpose of this study was to examine whether gender differences affect the risk factors of early CKD prediction. This study used data from 19,270 adult health screenings, including 5101 with CKD, to screen for 11 independent variables selected as risk factors and to test for the significant effects of statistical Chi-square test variables, using seven machine learning techniques to train the predictive models. Performance indicators included classification accuracy, sensitivity, specificity, and precision. Unbalanced category issues were addressed using three extraction methods: manual sampling, the synthetic minority oversampling technique, and SpreadSubsample. The Chi-square test revealed statistically significant results (p < 0.001) for gender, age, red blood cell count in urine, urine protein (PRO) content, and the PRO-to-urinary creatinine ratio. In terms of classifier prediction performance, the manual extraction method, logistic regression, exhibited the highest average prediction accuracy rate (0.8053) for men, whereas the manual extraction method, linear discriminant analysis, demonstrated the highest average prediction accuracy rate (0.8485) for women. The clinical features of a normal or abnormal PRO-to-urinary creatinine ratio indicated that PRO ratio, age, and urine red blood cell count are the most important risk factors with which to predict CKD in both genders. As a result, this study proposes a prediction model with acceptable prediction accuracy. The model supports doctors in diagnosis and treatment and achieves the goal of early detection and treatment. Based on the evidence-based medicine, machine learning methods are used to develop predictive model in this study. The model has proven to support the prediction of early clinical risk of CKD as much as possible to improve the efficacy and quality of clinical decision making.

Using platelet-rich fibrin scaffolds with diced cartilage graft in the treatment of empty nose syndrome.

Empty nose syndrome (ENS) is a rare entity in patients who undergo sinonasal surgery due to over-resection of the turbinate. This syndrome leads to debilitating symptoms that include dry nose, painful nasal breathing, paradoxical nasal obstruction, crusting, and sleep disorder. The goal of surgical treatment is to reestablish the volume of the turbinates to rehabilitate the nasal resistance. Endonasal microplasty with cartilage implants on the lateral wall of the nasal cavity is useful for creating the neoturbinate. Here, we present 2 cases that describe the management of empty nose syndrome by endonasal microplasty using platelet-rich fibrin (PRF) scaffolds embedded with a diced cartilage graft. The integration of the PRF scaffolds with diced cartilage efficiently facilitated the reestablishment of the neoturbinate. This autologous biomaterial is suitable for the treatment of ENS.

Capsaicin acts through tNOX (ENOX2) to induce autophagic apoptosis in p53-mutated HSC-3 cells but autophagy in p53-functional SAS oral cancer cells.

Despite the progress that has been made in diagnosing and treating oral cancers, they continue to have a poor prognosis, with a 5-year overall survival rate of approximately 50%. We have intensively studied the anticancer properties of capsaicin (a burning constituent of chili pepper), mainly focusing on its apoptotic properties. Here, we investigated the interplay between apoptosis and autophagy in capsaicin-treated oral cancer cells with either functional or mutant p53. Cytotoxicity was determined by cell impedance measurements and WST-1 assays, and cell death was analyzed by flow cytometry. The interaction between capsaicin and tumor-associated NADH oxidase (tNOX, ENOX2) was studied by cellular thermal shift assay (CETSA) and isothermal dose-response fingerprint curves (ITDRFCETSA). Our CETSA data suggested that capsaicin directly engaged with tNOX, resulting in its degradation through the ubiquitin-proteasome and the autophagy-lysosome systems. In p53-functional SAS cells, capsaicin induced significant cytotoxicity via autophagy but not apoptosis. Given that tNOX catalyzes the oxidation of NADH, the direct binding of capsaicin to tNOX also inhibited the NAD+-dependent activity of sirtuin 1 (SIRT1) deacetylase, we found that capsaicin-induced autophagy involved enhanced acetylation of ULK1, which is a key player in autophagy activation, possibly through SIRT1 inhibition. In p53-mutated HSC-3 cells, capsaicin triggered both autophagy and apoptosis. In this case, autophagy occurred before apoptosis: during this early stage, autophagy seemed to inhibit apoptosis; at a later stage, in contrast, autophagy appeared to be essential for the induction of apoptosis. Western blot analysis revealed that the reduction in tNOX and SIRT1 associated with enhanced ULK1 acetylation and c-Myc acetylation, which in turn, reactivated the TRAIL pathway, ultimately leading to apoptosis. Taken together, our data highlight the potential value of leveraging capsaicin and tNOX in therapeutic strategies against oral cancer.

Adenoid cystic carcinoma of head and neck: A retrospective clinical analysis of a single institution.

Objective: In this study, patients with head and neck adenoid cystic carcinoma were investigated with respect to disease characteristics, treatments, and potentially prognostic variables. Materials and Methods: Between January 1995 and December 2010, 29 patients with ACC of the head and neck treated at our institution were retrospectively reviewed. Results: The 29 patients had a mean age of 54.7 years. Of the 29 patients, 4 (13.8%) underwent surgical resection only, 21 (72.4%) underwent surgery with radiotherapy, and 4 (13.8%) received postoperative chemoradiotherapy. Of 9 patients (31.0%) who experienced a recurrence within the follow-up period, 3 (10.3%) had local recurrence and 5 (17.2%) had distant metastasis; 1 (3.4%) patient had both local recurrence and distant metastatic spread. Conclusion: ACC is a relatively rare tumor associated with long survival, even in metastatic settings. Despite aggressive therapy with surgery, radiotherapy, and chemo- therapy, a marked potential for local and distant recurrence still remains.

PBK/TOPK Expression Predicts Prognosis in Oral Cancer.

Oral cancer is a common cancer with poor prognosis. We evaluated the expression of PBK/TOPK (PDZ-binding kinase/T-LAK cell-originated protein kinase) and its prognostic significance in oral cancer. PBK/TOPK expression was measured by immunohistochemical staining of samples from 287 patients with oral cancer. The association between PBK/TOPK expression and clinicopathological features was analyzed. The prognostic value of PBK/TOPK for overall survival was determined by Kaplan-Meier analysis and Cox proportional hazard models. A high PBK/TOPK expression level was correlated with long overall survival. The prognostic role of PBK/TOPK expression was significant in young patients (p < 0.05), patients with smoking habits (p < 0.05), and late stage disease (p < 0.05). Our results suggest that PBK/TOPK expression is enhanced in oral cancer. High PBK/TOPK expression, either alone or in subgroups according to clinicopathological features, may serve as a favorable prognostic marker for patients with oral cancer.

Minimally invasive resection of olfactory neuroblastoma by transnasal endoscopy.

Olfactory neuroblastoma is rare. We conducted a retrospective study to review our experience with minimally invasive resection of olfactory neuroblastomas via a transnasal endoscopic technique, including an analysis of surgical outcomes. Our series included 5 patients-3 men and 2 women, aged 29 to 75 years (mean: 48). Surgical outcomes were evaluated on the basis of each patient's preoperative Dulguerov classification and postoperative evaluation on computed tomography and magnetic resonance imaging. One patient was treated with surgery alone, 3 with surgery plus radiotherapy, and 1 with surgery, radiotherapy, and chemotherapy. During follow-up of 18 to 115 months, all 5 patients remained alive and disease-free. We found that endoscopic resection of olfactory neuroblastoma is a feasible and effective procedure, even in patients with more aggressive stages of disease. We also believe that the Dulguerov classification is more useful than other classifications for clinical management and surgical planning. Long-term follow-up is necessary to look for late recurrence.

Endoscopic resection of intranasal meningo-encephalocele accompanying meningioma.

This paper aims to present the case of a 43-year-old woman diagnosed with a rare condition of meningoencephalocele that arose from a meningioma, and treated with endoscope-assisted transnasal tumor extirpation and repair of the skull base defect with tensor fascia lata flap. Endoscope-assisted operation is a viable and minimally invasive alternative to traditional craniotomy. With improved endoscopic equipment and operative technique, we can perform more reliable surgery and provide better quality of life for these patients.