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The tumor microenvironment is important in the initiation and progression of lung adenocarcinoma (LUAD). In this study, we aim to analyze the expression profile of immune-related genes in LUADs, examine the differential expression of immune-related genes in epidermal growth factor receptor (EGFR) wild-type and mutant LUADs, and the clinicopathologic significance of these differentially expressed genes. We used the NanoString PanCancer Immune Profiling Panel to examine 34 cases of LUADs (18 EGFR wild-type, 16 EGFR mutant). In EGFR wild-type LUADs, the macrophage and neutrophil signatures are significantly higher, and significantly higher expression of chemokines, interleukins, leukocyte, macrophage, natural killer cell, pathogen defense, Tumor necrosis factor superfamily, and transporter function signatures are also observed. TNFRSF10B mRNA was preferentially expressed in EGFR wild-type LUADs (P = 6.15e-6, adjusted P = .0244). Immunohistochemical staining for TRAIL-R2 (encoded by TNFRSF10B) on 134 tissue microarray LUAD cases demonstrated strong, moderate, and weak staining in 75 (56.0%), 46 (34.3%), and 13 (9.7%) cases, respectively. Strong TRAIL-R2 expression was significantly associated with poor overall survival (OS) in all stages and EGFR wild-type LUADs, but not in EGFR-mutant tumors. Furthermore, strong TRAIL-R2 expression (P = .004) was an independent risk factor for poor OS. In summary, TNFRSF10B mRNA revealed significantly higher expression in EGFR wild-type LUADs, and strong TRAIL-R2 expression predicts an unfavorable prognosis for these tumors. These patients may benefit from additional treatment with TRAIL-R2-targeted therapies.

Aims: Mucinous adenocarcinoma arising in congenital pulmonary airway malformation (CPAM) is a rare complication, with little being known about its natural course. The aims of this article are to describe a series of mucinous adenocarcinomas arising from CPAMs, and present their clinicopathological features, genetics, and clinical outcome. Methods and results: Thirty-seven cases were collected within a 34-year period, and the subtype of adenocarcinoma and CPAM, tumour location, stage, growth patterns, molecular data and follow-up were recorded. The cohort comprised CPAM type 1 (n = 33) and CPAM type 2 (n = 4). Morphologically, 34 cases were mucinous adenocarcinomas (21 in situ; 13 invasive), and three were mixed mucinous and non-mucinous adenocarcinoma. Seventeen cases showed purely extracystic (intra-alveolar) adenocarcinoma, 15 were mixed intracystic and extracystic, and five showed purely intracystic proliferation. Genetically, nine of 10 cases tested positive for KRAS mutations, four with exon 2 G12V mutation and five with exon 2 G12D mutation. Residual disease on completion lobectomy was observed in two cases, and three cases recurred 7, 15 and 32 years after the original diagnosis. Two patients died of metastatic invasive mucinous adenocarcinoma. Conclusions: Most adenocarcinoma that arise in type 1 CPAMs, are purely mucinous, and are early-stage disease. Intracystic proliferation is associated with lepidic growth, an absence of invasion, and indolent behaviour, whereas extracystic proliferation may be associated with more aggressive behaviour and advanced stage. Most cases are cured by lobectomy, and recurrence/residual disease seems to be associated with limited surgery. Long-term follow-up is needed, as recurrence can occur decades later.

High temperature polymer electrolyte membrane fuel cell is a clean energy conversion device that generates electricity directly from the electrochemical reaction. Since the working temperature is about 160?C, the heating and cooling mechanisms are critical factors to maintain the optimal working condition and prevent the cell from degradation. Simulation models of high temperature polymer electrolyte membrane fuel cell were built for investigating the temperature distribution on the working area of fuel cells and temperature gradient across the stack. The ordinary method of heating by using heating pads and cooling by applying forced convection air was compared with the heat pipe heating and cooling technique. The results showed that heat pipe provided a more uniform temperature distribution and current density across the fuel cells stack. The temperature gradient of 0.214?C per cell during heating and 0.054?C per cell during cooling processes were observed. Meanwhile, only 0.44 mA/cm2 per cell of cur-rent density gradient was found.

The structure of electrochemical reaction zone and the catalyst layer (CL) thickness affect the performance of high temperature polymer electrolyte membrane fuel cells. In this study, the physical structures and compositions of CL are investigated by electron microscopy and polarization curve techniques. The Pt concentration of Pt/C decides the thickness of CL when the Pt loading is fixed. A higher weight percentage Pt/C contains a lower amount of carbon powder results in a thin CL and limited space for electrochemical reaction. On the other hand, the lower weight percent Pt/C provides larger space and smaller size of platinum catalyst which engenders the electrochemical reaction in CL more easily. The ionomer binds electrocatalysts Pt/C particles together and offers the ion conducting phase. Two different ionomers, Polytetrafluoroethylene (PTFE) and Polyvinylidene difluoride (PVDF), were tested. SEM results showed that PTFE forms a better uniform CL structure than PVDF. With 10 wt% Pt/C, PTFE ionomer possesses a higher gas permeability property which induces a higher reactant flow rate in CL, and consequently results in a 42.9% higher cell potential than the PVDF at 0.4 A/cm2 current density output. A proper combination of 10 wt% Pt/C with PTFE ionomer is able to gain 0.62 A/cm2 output at 0.3067 V for the HT-PEMFC.

Activated carbon is widely used in many applications. This study aims to optimize the most influential processing parameters of the activated carbon production from rubber seed shell. The Taguchi method is applied to gain 9 combinations of experimental design from three processing parameters, namely chemical reagent concentration, activation temperature, and activation time. By using the analysis of variance (ANOVA), the most influential processing parameters of activated carbon production are found as chemical reagent concentration and activation temperature. The optimal product yield and amorphous percentage can be achieved when chemical reagent concentration, activation temperature, and activation time are chosen as 25 wt.%—600 °C—1.0 h and 25 wt.%—600 °C—2.5 h, respectively. As conclusions, the product yield is influenced by the activation temperature, while the amorphous percentage is affected by the activation time. The Taguchi method is an appropriate approach for optimizing the parameters to produce the activated carbon.

Neoadjuvant chemoradiotherapy (neoCRT) followed by surgery is the cornerstone treatment strategy in locally advanced esophageal squamous cell carcinoma (ESCC). Despite this high- intensity multimodality therapy, most patients still experience recurrences and metastases, especially those who do not achieve a pathological complete response (pCR) after neoCRT. Here, we focused on identifying poor prognostic factors. In this retrospective cohort study; we enrolled 140 patients who completed neoCRT plus surgery treatment sequence with no interval metastasis. Overall, 45 of 140 patients (32.1%) achieved a pCR. The overall survival, disease-free survival (DFS), and metastasis-free survival was significantly better in patients with a pCR than in patients with a non-pCR. In the non-pCR subgroup, the presence of perineural invasion (PNI) and preexisting type 2 diabetes (T2DM) were two factors adversely affecting DFS. After adjusting for other factors, multivariate analysis showed that the hazard ratio (HR) was 2.354 (95% confidence interval [CI] 1.240–4.467, p = 0.009) for the presence of PNI and 2.368 (95% CI 1.351–4.150, p = 0.003) for preexisting T2DM. Patients with a combination of both factors had the worst survival. In conclusion, PNI and preexisting T2DM may adversely affect the prognosis of patients with ESCC receiving neoadjuvant chemoradiotherapy.

Invasive mucinous adenocarcinoma (IMA) is a rare variant of adenocarcinoma that comprises mucinous epithelial cells. The expression of hepatocyte nuclear factor 4α (HNF4α) has been previously reported as a marker for IMA, but controversy remains regarding whether HNF4α is a reliable marker for lung IMAs. In the present study, we compared HNF4α expression levels between IMA and nonmucinous adenocarcinoma (NMA) cases using 2 different HNF4α clones. We used 2 HNF4α antibody clones, H1 and H1415, to examine HNF4α expression in 36 IMA and 40 NMA cases, which comprised the control group. HNF4α immunostaining intensity (range, 0 to 3) and percentage of intensity (range, 0% to 100%) were evaluated by 3 pathologists and ImageJ software, and average H-scores were calculated for each case. Interobserver agreement was assessed using intraclass correlation coefficient. Receiver-operating characteristic curve was used to analyze sensitivity and specificity of the clones. The mean H-score was higher in the IMA group than in the NMA group for both the H1415 (141.3 vs. 9.3) and H1 (67.3 vs. 3.4) clones. The intraclass correlation coefficient for agreement among the 4 observers was good (0.806 and 0.711). The H1415 clone exhibited comparable sensitivity (83.3% vs. 83.3%) with higher specificity (97.5% vs. 92.5%) compared with the H1 clone when using cutoff values of 36.2 (H1415) and 9.5 (H1), respectively. Our analyses suggest that HNF4α should be considered as a reliable marker for primary IMA of the lung. The H1415 clone should be preferred for use in clinical practice.

Background Studies have reported the application of conventional optical coherence tomography (OCT) in the diagnosis of basal cell carcinoma (BCC). The new OCT provides cellular details similar to those in pathology slides and may reduce user learning time. This study aimed to demonstrate the quality of ex vivo full-field cellular-resolution OCT images and compare the diagnostic accuracy between physicians with varying pathology experience. Materials and methods Sixty histologically confirmed BCCs were selected. Tissue samples were sectioned and scanned using OCT, and their features were compared with those of hematoxylin and eosin (H&E)-stained sections. Thirty images were selected for the test administered to dermatology residents, dermatopathology fellows, and board-certified general pathologists without any OCT experience. The pretest learning included a 3-min instruction and 10-min self-study of four BCC variants. Results Histopathological BCC and normal histological features were clearly recognizable on the OCT images. The pathological BCC features observed in the OCT images correlated with those found in the H&E-stained sections. Seven participants completed the test. The correct answer rates of the residents, fellows, and pathologists were 71%, 68%, and 83% for BCC and 44%, 57%, and 57% for the BCC subtypes, respectively. Conclusion All the participants identified BCC in >70% cases with a learning time of only 13 minutes. The results indicated that cellular-resolution OCT provided high-quality images similar to the conventional pathology slides. Pathology experience did reflect the diagnostic accuracy. However, a longer training time is still needed at all levels to recognize the BCC subtypes correctly.

A major breakthrough in classification of soft tissue tumors has been the recent identification of NTRK-fusion related neoplasms which are amenable to highly effective targeted therapies. Despite these therapeutic oportunities, diagnostic challenges have emerged in recognizing tumors characterized by protein kinase fusions, as they are associated with a wide morphologic spectrum, variable risk of malignancy and a rather non-specific immunoprofile. As such, NTRK-related fusions may occur in infantile fibrosarcoma, lipofibromatosis-like neural tumors, tumors resembling malignant peripheral nerve sheath tumors, etc. Triggered by an index case resembling lipofibromatosis-like neural tumor but harboring RET gene rearrangement, we investigated our files for cases showing RET gene abnormalities in order to establish their clinicopathologic features. Tumors were tested with a combination of targeted RNA sequencing and FISH methods. Six cases with RET gene rearrrangements were identified, all except one occured in children, including 4 infants. Their morphologic spectrum was quite diverse, but closely reproduced the phenotype of NTRK-fusion positive tumors, including lipofibromatosis-like neural tumors (n=3), infantile fibrosarcoma-like tumor (n=2) and malignant peripheral nerve sheath tumor-like (n=1). Three cases showed co-expression of S100 and CD34, while the remaining 3 had a non-specific immunoprofile. The tumors ranged morphologically and clinically from benign to highly malignant. None of the lipofibromatosis-like neural tumor cases recurred, while 2 patients with a malignant histology had a highly aggressive course with distant metastases to lung and other viscera. By targeted RNA sequencing these tumors harbored RET fusions with an identical break in exon 12, which retains the tyrosine kinase domain in the fusion oncoprotein, and involving various gene partners (CLIP2, CCDC6, SPECC1L, MYH10 and NCOA4). Our results suggest that RET fusion-positive neoplasms share a similar phenotypic spectrum with the NTRK-positive tumors, displaying either fibroblastic or neural-like differentiation, and spanning a wide spectrum of clinical behavior. These findings open new avenues for targeted therapy with RET inhibitors currently available in clinical trials.

Objective Gastric antral vascular ectasia (GAVE) and portal hypertensive gastropathy (PHG) can cause gastrointestinal bleeding in cirrhotic patients. Distinguishing diffuse-type GAVE and severe PHG is important but difficult by conventional endoscopy and endoscopic biopsy. The aim of this study is to evaluate the value of magnifying endoscopy with narrow-band image for diagnosing diffuse-type GAVE in cirrhotic patients. Methods From January 2010 to December 2013, cirrhotic patients with diffuse red spots of stomach in suspicion of diffuse-type GAVE on conventional endoscopy in a tertiary medical center were included. The detection of diffuse red spots on magnifying endoscopy with narrow-band image (NBI) was classified into ring-pattern which suggested GAVE and mosaic-pattern which suggested non-GAVE. The golden diagnosis of GAVE was based on histological criteria of GAVE score ≥3 by any one of two endoscopic sessions. Results Total 27 cirrhotic patients were included. Twenty-two patients reached the diagnosis of GAVE and five patients were diagnosed of non-GAVE by histology. The diagnostic rate of conventional endoscopy was 81.5% (22/27). The positive rate of initial endoscopic biopsy was 77.2%. On magnifying endoscopy with NBI, the sensitivity, specificity, positive, negative predicted rate and accuracy of ring-pattern for the diagnosis of GAVE were 100, 90, 96.4, 100 and 97.3%. Kappa coefficient of inter-observer agreement for differentiating the ring and mosaic-pattern was 0.92. Conclusions The efficacy and accuracy of magnifying endoscopy with NBI for diagnosing diffuse-type GAVE in cirrhotic patients have been demonstrated. It can avoid repeated endoscopy to confirm diagnosis and obviate the invasive biopsy in cirrhotic patients.

Correct sensible heat curve (virtual baseline) during phase change is a must for accurate evaluation of latent heat. In this article, the dynamically moving interface (DMI) model for any phase change material (PCM) measured with a differential scanning calorimeter (DSC) is devised not only for elucidating the complex mechanisms of transient heat transfer in the five stages from solid phase to liquid phase, but also for constructing a correct sensible heat curve during phase change. We derive all the governing relations in exact or analytic form to describe the corresponding heat currents in the five stages of transient heat transfer together with the correct sensible heat curve during phase change inside any tiny PCM sample. The error budget analysis for the expanded uncertainty of specific latent heat about the tiny indium sample is detailed after the full assessment to specific latent heats of several PCMs.

Background Tolumnia genus (equitant Oncidium) is a group of small orchids with vivid flower color. Thousands of hybrids have been registered on Royal Horticulture Society and showed great potential for ornamental plant market. The aim of this study is to establish an efficient method for in vitro propagation. Results Leaf explants taken from in vitro-grown plants were used to induce direct somatic embryogenesis on a modified 1/2 MS medium supplemented with five kinds of cytokinins, 2iP, BA, kinetin, TDZ and zeatin at 0.3, 1 and 3 mg l−1 in darkness. TDZ at 3 mg l−1 gave the highest percentage of explants with somatic globular embryos after 90 days of culture. It was found that 2,4-D and light regime highly retarded direct somatic embryogenesis and showed 95–100% of explant browning. Histological observations revealed that the leaf cells divided into meristematic cells firstly, followed by somatic proembryos, and then somatic globular embryos. Eventually, somatic embryos developed a bipolar structure with the shoot apical meristem and the root meristem. Scanning electron microscopy observations showed that the direct somatic embryogenesis from leaf explants was asynchronously. The somatic embryos were found on the leaf tip, the adaxial surface and also the mesophyll through a cleft, and it reflected the heterogeneity of the explant. The 90-day-old globular embryos were detached from the parent explants and transferred onto a hormone-free 1/2 MS medium in light condition for about 1 month to obtain 1-cm-height plantlets. After another 3 months for growth, the plantlets were potted with Sphagnum moss and were acclimatized in a shaded greenhouse. After 1 month of culture, the survival rate was 100%. Conclusions In this report, a protocol for efficient regenerating a Tolumnia orchid, Louise Elmore ‘Elsa’, was established via direct somatic embryogenesis and might reveal an alternative approach for mass propagation of Tolumnia genus in orchid industry.

Penelitian ini mengelola energi dari PEMFC yang diatur untuk mengamati konsumsi energi, kecepatan maksimum, dan kemampuan kendaraan dalam melakukan pendakian. Pemodelan kendaraan listrik dikerjakan menggunakan ADVISOR. Fuel cell yang digunakan 200W sebagai sumber energi utama yang dikombinasikan dengan baterai NiMH sebagai sumber energi cadangannya. Masing-masing baterai NiMH memiliki tegangan sebesar 1,2 V dan 1,9 AH. Kinerja PEMFC dan baterai NiMH diamati dengan memberikan beban sesuai kebutuhan daya pada kendaraan hibrida. Hasil pengujian menunjukkan daya maksimum PEMFC antara 40-60 % daya baterai NiMH sehingga kendaraan dapat tetap bergerak. Energi dipasok oleh baterai ketika daya kendaraan lebih rendah dari 40% sehingga PEMFC dapat berhenti memasok energinya. Ketika daya yang dibutuhkan lebih besar dari daya maksimum PEMFC maka baterai NiMH akan menyeimbangkan pasokan daya ke kendaraan. Mobil hibrida dapat menanjak pada kemiringan 3,5%, konsumsi bahan bakar 40,6 liter/100 km, jarak tempuh sejauh 33,9 m/ 5 det, dan 0,4 km/26,1 det. Kata kunci: Manajemen Energi , ADVISOR, PEMFC, NiMH, CVT ABSTRACT In this research, the PEMFC energy management were set to inspect energy usage, maximum speed, and the ability of the vehicle to climb. The modeling of the electric vehicle is carried out using ADVISOR. The fuel cell with 200W as the main energy source in combination with NiMH batteries as energy source support. Every NiMH battery has a 1.2 V and 1.9 AH. The performance of PEMFC and NiMH batteries was observed by providing a load according to the power requirements of the hybrid car. The test results indicate the maximum power of the PEMFC around 40-60% of the NiMH battery power so the vehicle can keep moving. The battery will supply the energy when the vehicle power is lower than 40% so the PEMFC can stop supplying its energy. When the power needed is larger than the PEMFC maximum power then the NiMH battery will balance the power supply to the car. The hybrid car able to climb a 3.5% slopping road, fuel consumption 40.6 liters/ 100 km, the distance as far as 33.9 m/ 5 s and 0.4 km/ 26.1 s. Keywords: Energy Management, ADVISOR, PEMFC, NiMH, CVT

Objectives The role of decoy receptor 3 (DcR3) in lung cancer, particularly adenocarcinoma, has not been well studied. In this study, we aim to investigate the expression profile and the clinicopathologic implications of DcR3 expression in lung adenocarcinoma. Methods Immunohistochemistry was used to examine DcR3 expression in 461 lung adenocarcinomas. The differences in DcR3 expression among the various histopathologic patterns were analyzed. The relationship between DcR3 expression and clinicopathologic parameters, including epidermal growth factor receptor (EGFR) mutation, was also investigated. Results DcR3 expression was more frequently expressed in solid, micropapillary, and acinar patterns (P < .0001) and in tumors with wild-type EGFR status (P = .018). In addition, DcR3 expression portends a less favorable disease-free survival in stage I patients (P = .012). Conclusions The expression of DcR3 might be involved in the differentiation and progression of lung adenocarcinoma. Therefore, DcR3 may be applied clinically for prediction of tumor progression in stage I lung adenocarcinoma.

Objectives This study aimed to evaluate the adverse clinicopathologic features of oral squamous cell carcinoma (OSCC), including margin status, depth of invasion, lymphovascular invasion, perineural invasion, and extranodal extension that significantly affect survival outcomes. Materials and methods This retrospective cross-sectional study included 341 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The Kaplan–Meier method was used to estimate survival outcomes. A multivariable Cox regression model was used to evaluate the associations of various clinicopathologic features with 5-year overall survival (OS) outcomes in patients with pN0 and pN+ tumors. Results Overall, the patients had 5-year OS and progression-free survival rates of 60.0 and 47.9%, respectively. In the pN0 group, the multivariate analysis identified a positive margin (odds ratio [OR] = 16.3, 95% confidence interval [95% CI]: 3.7–72.3; P = 0.001), depth of invasion >5 mm (OR = 2.1, 95% CI: 1.2–3.7; P = 0.012), presence of lymphovascular space invasion (OR = 5.4, 95% CI: 1.3–22.0; P = 0.018), and presence of perineural invasion (OR = 4.3, 95% CI: 1.7–11.1; P = 0.002) as independent and significant prognosticators of OS. In the pN+ group, only the presence of extranodal extension independently predicted OS (OR = 1.7, 95% CI: 1.1–2.7; P = 0.0026). Conclusions When determining survival prognosis for patients with a pN0 status, we recommended including all adverse features. In contrast, extranodal extension was the most important prognostic factor for patients with a pN+ status.

Segments taken from young leaves of an orchid (Oncidium Gower Ramsey) produced clusters of somatic embryos directly from epidermal and mesophyll cells of leaf tips and wound surfaces without an intervening callus within 1 month when cultured on a GelriteTM-gelled 1/2-MS basal medium supplemented with a low dosage (0.3–1 mg/l) of thidiazuron. Subculturing of these embryo clusters produced more embryos and subsequent plantlet formation on the same medium. The high-frequency embryogenesis of these leaf cells in this orchid is strong evidence of their totipotency, and further modification of the protocol for plant formation could be useful for the mass propagation and transformation of selected elite lines.

Nodal explants obtained from 10-year-old field-grown culms of Bambusa edulis produced multiple shoots on a Murashige-and-Skoog-based medium supplemented with 0.1 mg/l of thidiazuron (TDZ). Hundreds of regenerated shoots rooted well on a medium supplemented with 0.01 mg/l TDZ and 0.5 mg/l 2,4-dichlorophenoxyacetic acid and were successfully transferred to soil for field trials. Albinism occurred at the rate of about 30% among the regenerated shoots, and isolated albino shoots also proliferated on the medium containing TDZ. Some of the green and albino shoots also flowered on the medium containing TDZ. A potted plant also flowered and survived after flowering.

Totipotent calli of Cymbidium ensifolium var. misericors, a locally grown orchid of high commercial value, were induced from sections of pseudobulbs, rhizomes and roots of seed-derived plantlets on 1/2-strength Murashige and Skoog medium plus 10 mg/l 2,4-dichlorophenoxyacetic acid and 0.1 mg/l thiadiazuron. The calli could be maintained by subculturing in the same medium. The calli could be induced to develop further along one of three distinct morphogeneic routes: (1) production of rhizomes, (2) production of shoot buds, or (3) development of granular embryoids. Efficient mass propagation was possible via rhizome proliferation and embryoid formation.

Judul: Optimalisasi rendemen karbon aktif menggunakan metode Taguchi dalam mensintesis karbon aktif dari arang kayu Title: Optimization of activated carbon yield using the Taguchi method in synthesizing activated carbon from wood charcoal Arang kayu telah digunakan sebagai bahan baku pembuatan karbon aktif. Tujuan penelitian ini adalah untuk mendapatkan parameter signifikan dan optimal dalam proses preparasi karbon aktif dengan product yield yang tinggi. Karbon aktif telah dibuat dengan metode impregnation-activation (IA). Dalam proses ini, kalium hidroksida telah difungsikan sebagai reagen kimia. Tiga parameter proses yang divariasikan yaitu konsentrasi KOH (25-75%), suhu aktivasi (600-850°C), dan waktu aktivasi (1-2,5 jam). Rancangan eksperimen didesain dengan metode Taguchi. Dalam analisis, Signal to noise (S/N) ratio digunakan untuk mendapatkan level optimal, sedangkan parameter proses yang paling signifikan diidentifikasi dengan analisis ANOVA. Berdasarkan Taguchi orthogonal array design , multiple regression model dikembangkan untuk menunjukkan hubungan antara parameter proses dengan activated carbon yield (AC yield). Berdasarkan hasil tersebut, suhu aktivasi merupakan parameter yang paling signifikan untuk memaksimalkan AC yield , sedangkan ondisi optimum pembuatan karbon aktif adalah konsentrasi KOH 50 wt. %, suhu aktivasi 700 ° C, dan waktu aktivasi 2,5 jam. Activated carbon yield optimum berdasarkan prediksi dan hasil eksperimen adalah 87, 3 dan 67, 6%. Sebagai kesimpulan, hasil-hasil dari penelitian ini menunjukkan bahwa metode Taguchi memiliki efektivitas dalam proses sintesis karbon aktif. Wood charcoal (WC) was used as raw material for synthesizing activated carbon (AC). This research aims to determine optimum preparation conditions for activated carbon. The wood charcoal activated carbon (ACWC) was prepared by the impregnation-activation (IA) method. In this process, potassium hydroxide (KOH) has functioned as a chemical reagent. Three process parameters were varied such as KOH concentration (25-75 wt. %), activation temperature (600-850 °C), and activation time (1-2.5 hours). The design of the experiment was arranged with the Taguchi method. For analysis, the signal to noise (S/N) ratio was utilized to find the optimal levels, while the most significant process parameter was identified via ANOVA analysis. The multiple regression model was developed to associate the process parameters with activated carbon yield (AC yield) based on the Taguchi orthogonal array design. According to the results, activation temperature was the most significant parameter for maximizing the AC yield. The optimum conditions for preparing activated carbon were found as follows: KOH concentration of 50 wt. %, activation temperature of 700 °C, and activation time of 2.5 hours. The predicted and experimental results for optimum activated carbon yield were 87.3% and 67.6 %, respectively. In conclusion, the results of this study indicated that the Taguchi optimization method has effectiveness in the synthesis of activated carbon.

Lung cancer is the leading cause of cancer death, and therefore the discovery of novel therapeutic targets is crucial. P21-activated kinase (PAK1) is an important oncogene involved in the signaling of actin cytoskeleton organization. Although PAK1 inhibition has been shown to suppress cancer progression, specific PAK1 inhibitors are not available due to the complex structure and insufficient understanding of this kinase. The Hippo signaling effector TAZ is known to be elevated in multiple human cancers and to promote cancer metastasis. This study aimed to explore the role of TAZ in regulating the tumor suppressor ankyrin repeat domain 52 (ANKRD52) and PAK1 activity. A negative correlation between TAZ and ANKRD52 was observed, with knockdown of TAZ leading to enhanced ANKRD52 promoter activity and increased mRNA levels. Moreover, reduced ANKRD52 levels were associated with late-stage lung cancer. Knockdowns of ANKRD52 resulted in elevated cell mobility, while forced ANKRD52 expression attenuated cell mobility. ANKRD52 is a subunit of the protein phosphatase 6 (PP6) holoenzyme. Mass spectrometry analysis revealed the interaction between PAK1 and the ANKRD52-PP6 complex. Knockdown of ANKRD52 or PP6c resulted in upregulated PAK1 phosphorylation. Our study demonstrates that the novel tumor suppressor protein ANKRD52 is transcriptionally inhibited by TAZ, regulating cell mobility through interactions with PP6c and dephosphorylation of PAK1.

Background: Oral squamous cell carcinoma (OSCC) is the most frequently found malignant tumor of the oral cavity, and the annual death rate of OSCC patients has been increasing rapidly among the Taiwanese population. Aim: The aim of this study is to evaluate if poor nutrition is a potential adverse prognostic factor in patients with OSCC. Methods: This cross-sectional study included 322 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The pretreatment body mass index (BMI) and serum uric acid and albumin levels were measured as common indicators of the nutritional status, and overall survival (OS) was analyzed using the Kaplan–Meier method and a Cox regression model. Results: The optimal cut-off values were 24.0 kg/m[2], 5.05 mg/dL, and 3.85 g/dL for BMI, serum uric acid, and serum albumin, respectively. The multivariate Cox regression analysis indicated lower BMI (hazard ratio [HR] = 1.557, 95% confidence interval [95% CI]: 1.070–2.265; P = 0.021), lower serum uric acid (HR = 1.857, 95% CI: 1.265–2.724; P = 0.002), and lower serum albumin (HR = 2.011, 95% CI: 1.278–3.163; P = 0.003) as independent and significant prognosticators of OS. Advanced stage, depth of invasion of more than 5 mm, and extranodal extension were prognostic predictors of poor OS. Conclusion: A lower preoperative BMI and lower serum uric acid and albumin levels are predictors of significantly worse survival among OSCC patients. Maintaining a healthy nutritional status is crucial to improving the survival of patients with oral cancer. The treatment for patients with poor nutritional status should be more aggressive and cautious.

Dysregulation of histone demethylase Jumonji-C domain-containing protein 5 (JMJD5) has been identified as a great effect on tumorigenesis. Silibinin is a commonly used anti-hepatotoxic drug and exhibits anticancer effect in various cancers. However, the antitumor mechanism between silibinin and JMJD5 in oral squamous cell carcinoma (OSCC) remains unclear. In this study, the clinical significance of JMJD5 on OSCC patients was assessed through tissue microarray. Furthermore, mice bearing patient-derived tumor xenografts (PDTXs) and tongue cancer cell lines were treated with silibinin and evaluated for tumor growth and JMJD5 expression. High expression of JMJD5 in oral cancer was significantly associated with tumor size (P = 0.0241), cervical node metastasis (P = 0.0001) and clinical stage (P = 0.0002), was associated with worse survival rate compared with that of the total cohort (P = 0.0002). Collectively the data indicate that JMJD5 expression may be suitable for detection of unfavorable prognosis in OSCC patients, based in part on its apparent role as a marker of metastasis. In addition, silibinin inhibits cancer growth in vitro and in PDTX models. Furthermore, metastasis-associated protein 1 (MTA1) could regulate the expression for JMJD5 and had a positive correlation with JMJD5. Moreover, silibinin could downregulate JMJD5 and MTA1 in oral cancer. Present study thus identifies that JMJD5 might be an essential prognostic indicator and therapeutic target against OSCC progression. In addition, silibinin is a potential candidate among novel chemotherapeutic agents or adjuvants for modulating JMJD5 in OSCC, through a mechanism likely involving MTA1/JMJD5 axis.

The primary strategy for treating oral squamous cell carcinoma (OSCC) is therapeutic resection, with the trismus resection defect reconstructed via free flap. The most popular free flaps include the radial forearm free flap (RFFF) and anterolateral thigh free flap (ALT). This study investigated the relationships between the hospitalization period and a variety of surgical outcomes, as well as maximum inter-incisor distance (IID), in trismus patients who chewed betel nuts. Forty-nine primary OSCC patients who chewed betel nuts and underwent surgical resection and reconstruction between 2010 and 2016 were enrolled in this retrospective study. The data were from a single center in Taiwan. The outcome variable after flap recovery surgery was the duration of postoperative hospitalization. Other factors that were analyzed comprised correlations between hospitalization and a variety of factors, including postoperative inter-incisor distances (IIDs), operative time, gender, and WBC count, upon stratification into two reconstruction groups. The mean postoperative hospitalization duration in the ALT group was 22.9 ± 7.2 days, which was significantly shorter than that in the RFFF group (27.8 ± 7.0 days; p = 0.019). Two-week postoperative IID (ALT group: 16.1 ± 0.8 mm; RFFF group: 7.0 ± 0.6 mm) was inversely related to the duration of hospitalization (p = 0.022, r = − 0.372). The ALT flap is more effective than the RFFF flap to reduce the length of hospitalization in trismus patients. The ALT flap should be considered as a first-line technique in OSCC reconstruction in trismus patient reconstruction.

Background Aberrant expression of decoy receptor 3 (DcR3) is considered to be a diagnostic and therapeutic target for human cancers. The aim of this study was to assess DcR3 as a target of the anticancer effects of triptolide (TPL) in preclinical patient‐derived tumor xenograft (PDTX) models of oral squamous cell carcinoma (OSCC). Methods The expression of DcR3 was evaluated through immunohistochemistry, and correlations were examined using clinical variables. The effects of TPL on the expression of DcR3 and cell proliferation were investigated in OSCC cell lines and in PDTX models. Results DcR3 overexpression was associated with overall survival and tumor size. TPL significantly decreased tumor growth. Moreover, TPL inhibited the expression of metastasis‐associated protein 1 (MTA1), a transcription factor for DcR3 in vivo, in vitro, and in PDTX models. Conclusion TPL appeared to exert anticancer effects by repressing DcR3 and MTA1 in vitro, in vivo, and in PDTX models.

The effects of NaH2PO4, sucrose, activated charcoal, polyvinylpyrrolidone (PVP), and strength of MS medium were studied to optimize thidiazuron (TDZ)-induced direct somatic embryogenesis from leaf explants of Phalaenopsis aphrodite subsp. formosana. The results showed that full- and quarter-strength macroelements of MS medium were not suitable for direct embryo induction from leaf explants. Thus, a half-strength macroelement and full-strength microelements of MS nutrients plus full-strength of MS vitamins, 170 mg l−1 NaH2PO4, 1 g l−1 peptone, 3 mg l−1 TDZ, and 20 g l−1 sucrose are proposed as a suitably modified medium. In addition, PVP at 0.25 g l−1 significantly promoted direct embryogenesis on the cut ends of the explants, but activated charcoal at 0.5–1 g l−1 was inhibitory.

Objectives To evaluate whether low body mass index (BMI) is a potential adverse prognostic factor in patients with oral squamous cell carcinoma (OSCC). Material and methods This cross-sectional study included 320 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The pretreatment BMI was measured as a common indicator of the pretreatment nutritional status to calculate the overall survival in Kaplan-Meier method. The adverse histopathological features of margin status, depth of invasion (DOI), lymphovascular invasion (LVSI), perineural invasion (PNI), and extranodal extension (ENE) were analyzed using the Cox regression model. Results Low BMI (underweight), DOI > 5 mm, and ENE were identified as detrimental prognostic factors. On multivariate Cox regression analysis, the low BMI group (odds ratio [OR] = 1.683; 95% confidence interval [95% CI] 1.116–2.539; P = 0.022), DOI > 5 mm (OR = 2.399; 95% CI 1.459–3.943; P = 0.001), and ENE (OR = 2.467; 95% CI 1.540–3.951; P = 0.000) yielded reduced survival rate. Conclusions The lower BMI had an important and significant effect on the survival of patients with oral cancer and their surgical outcomes. In addition to the adverse histopathological features, a DOI > 5 mm and positive ENE were also identified as the most important prognostic factors. Clinical relevance Underweight patients with low BMI, DOI of > 5 mm, and positive ENE should receive more intensive nutritional supplementation and postoperative adjuvant therapy.

Infantile fibrosarcomas (IFS) represent a distinct group of soft tissue tumors occurring in patients under 2 years of age and most commonly involving the extremities. Most IFS show recurrent ETV6-NTRK3 gene fusions, sensitivity to chemotherapy, and an overall favorable clinical outcome. However, outside these well-defined pathologic features, no studies have investigated IFS lacking ETV6-NTRK3 fusions, or tumors with the morphology resembling IFS in older children. This study was triggered by the identification of a novel SEPT7-BRAF fusion in an unclassified retroperitoneal spindle cell sarcoma in a 16-year-old female by targeted RNA sequencing. Fluorescence in situ hybridization screening of 9 additional tumors with similar phenotype and lacking ETV6-NTRK3 identified 4 additional cases with BRAF gene rearrangements in the pelvic cavity (n=2), paraspinal region (n=1), and thigh (n=1) of young children (0 to 3 y old). Histologically, 4 cases including the index case shared a fascicular growth of packed monomorphic spindle cells, with uniform nuclei and fine chromatin, and a dilated branching vasculature; while the remaining case was composed of compact cellular sheets of short spindle to ovoid cells. In addition, a minor small blue round cell component was present in 1 case. Mitotic activity ranged from 1 to 9/10 high power fields. Immunohistochemical stains were nonspecific, with only focal smooth muscle actin staining demonstrated in 3 cases tested. Of the remaining 5 BRAF negative cases, further RNA sequencing identified 1 case with EML4-NTRK3 in an 1-year-old boy with a foot IFS, and a second case with TPM3-NTRK1 fusion in a 7-week-old infant with a retroperitoneal lesion. Our findings of recurrent BRAF gene rearrangements in tumors showing morphologic overlap with IFS expand the genetic spectrum of fusion-positive spindle cell sarcomas, to include unusual presentations, such as older children and adolescents and predilection for axial location, thereby opening new opportunities for kinase-targeted therapeutic intervention.

This study investigated the clinical effectiveness of intervention with an open-mouth exercise device designed to facilitate maximal interincisal opening (MIO) and improve quality of life in patients with head and neck (H&N) cancer and oral submucous fibrosis (OSF). Sixty patients with H&N cancer, OSF, and trismus (MIO

Objectives Lymph node metastasis in oral squamous cell carcinoma (OSCC) is a poor prognostic factor. The histopathologic stage (e.g., pN) is used to evaluate the severity of lymph node metastasis; however, the current staging system insufficiently predicts survival and recurrence. We investigated clinical outcomes and lymph node density (LND) in betel nut-chewing individuals. Material and methods We retrospectively analyzed 389 betel nut-exposed patients with primary OSCC who underwent surgical resection in 2002–2015. The prognostic significance of LND was evaluated by overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. Results Kaplan-Meier analyses showed that the 5-year OS and DFS rates in all patients were 60.9 and 48.9%, respectively. Multivariate analysis showed that variables independently prognostic for OS were aged population (hazard ratio [HR] = 1.6, 95% confidence interval [95% CI] = 1.1–2.5; P = .025), and cell differentiation classification (HR = 2.4, 95% CI = 1.4–4.2; P = .002). In pathologic N-positive patients, a receiver operating characteristic (ROC) curve for OS was used and indicated the best cutoff of 0.05, and the multivariate analysis showed that LND was an independent predictor of OS (HR = 2.2, 95% CI = 1.3–3.7; P = .004). Conclusions Lymph node density, at a cutoff of 0.05, was an independent predictor of OS and DFS. OS and DFS underwent multiple analyses, and LND remained significant. The pathologic N stage had no influence in the OS analysis. Clinical relevance LND is a more reliable predictor of survival in betel nut-chewing patients for further post operation adjuvant treatment, such as reoperation or adjuvant radiotherapy.

a Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan b Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan c Mackay Medical College, New Taipei City, Taiwan d Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan e Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan f Division of Gastroenterology, Department of Internal Medicine, Health Evaluation Center, Mackay Memorial Hospital, Taipei, Taiwan