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In a review of strategies for preventing oral cancer, an expert panel reports that the use of tobacco (both smoking and smokeless), areca nut exposure, and heavy alcohol consumption are major contributors to this illness.

Peroxiredoxin 2 (PRDX2) is upregulated in various cancers including oral squamous cell carcinoma (OSCC). It is a known tumor promoter in some cancers, but its role in OSCC is unclear. This study aimed to investigate the effect of arecoline, an alkaloid of the betel nut, and human papillomavirus type 16 (HPV16) E6/E7 oncoproteins on induction of PRDX2 expression, and also the effects of PRDX2 overexpression in oral cell lines. Levels of PRDX2 protein were determined using western blot analysis of samples of exfoliated normal oral cells (n = 75) and oral lesion cells from OSCC cases (n = 75). Some OSCC cases were positive for HPV infection and some patients had a history of betel quid chewing. To explore the level of PRDX2 by western blot, the proteins were extracted from oral cell lines that were treated with arecoline or retroviruses containing HPV16 E6 gene and HPV16 E6/E7 expressing vector. For analysis of PRDX2 functions, cell proliferation, cell-cycle progression, apoptosis and migration was compared between oral cells overexpressing PRDX2 and cells with PRDX2-knockdown. PRDX2 expression levels tended to be higher in OSCC samples that were positive for HPV infection and had history of betel quid chewing. Arecoline treatment in vitro at low concentrations and overexpression of HPV16 E6 or E6/E7 in oral cells induced PRDX2 overexpression. Interestingly, in oral cells, PRDX2 promoted cell proliferation, cell-cycle progression (G2/M phase), cell migration and inhibited apoptosis. Upregulation of PRDX2 in oral cells was induced by arecoline and HPV16 oncoproteins and promoted growth of OSCC cells.

Recently, the specific association between Sinonasal inverted papilloma (SIP) and EGFR exon 20 mutations has been reported. To investigate the link between specific EGFR mutations and SIP development, we established organotypic raft culture system using nasal polyp-derived immortalized NP2 (iNP2) cells expressing EGFR exon 20 mutants or an exon 19 mutant, and SIP-derived iIP4 cells harboring P772_H773insPYNP mutation. In the raft culture, iIP4 cells showed the inverted growth pattern characteristic to SIP. Interestingly, iNP2 cells expressing EGFR exon 20 duplication mutants, S768_D770dup and N771_H773dup, but not of EGFR exon 19 mutant, E746_A750del, showed the inverted growth pattern. Enhanced activation of the PI3K/AKT signaling pathway was observed in iNP2_S768_D770dup and iIP4 cells, while increased MAPK signaling was found in iNP2_N771_H773dup. Increased cell migration and invasion were found in all cells carrying EGFR mutations when compared to iNP2 cells, and this effect was inhibited by either PI3K or MEK inhibitor. Notably, iNP2 cells expressing the N771_H773dup mutant showed the highest migration and invasion abilities. These results suggest that specific mutations in EGFR exon 20 play a crucial role in SIP development, partially though hyper-activation of the PI3K/AKT and MAPK signaling pathways. This study presents the first in vitro model for SIP development, which could facilitate further investigations into SIP pathogenesis and preclinical studies for new therapeutic agents.

To better understand the pathogenesis of nasal polyps (NPs) and sinonasal inverted papillomas (SIPs), we aimed to establish cell lines from fresh tissues of NPs and SIPs and characterize them. Primary cell cultures were obtained from two NP tissues (NP2 and NP3) and one SIP tissue (IP4). All the cells were polygonal in shape, expressed cytokeratin 14, and had normal diploid chromosome status. HPV58 DNA was detected in NP3. To obtain immortal primary cells, NP2 and IP4 cells were transduced with a combination of mutant CDK4, cyclinD1 and TERT. These cells were thereafter named NP2/K4DT and IP4/K4DT, respectively. HPV58-positive NP3 cells were transduced with TERT alone, the resulting cells named NP3/T. Phenotypic and genotypic identity of original tissues and derived cells was investigated. All the cell cultures with transgenes were confirmed to be derived from their parental cells and primary tumor tissues by analysis of short tandem repeats (STR) and maintained in vitro growth, genetic profiles and gene expression characteristics of the primary cells. These virtually immortalized cells, as well as the primary cells, have potential as in vitro models for studying the pathogenesis of NPs and SIPs and for preclinical study to develop new therapeutic agents.

Background Hearing aids are important assistive devices for hearing rehabilitation. However, the cost of commonly available commercial hearing aids is often higher than the average monthly income of individuals in some developing countries. Therefore, there is a great need to locally produce cheaper, but still effective, hearing aids. The Thai-produced P02 hearing aid was designed to meet this requirement. Objective To compare the effectiveness of the P02 hearing aid with two common commercially available digital hearing aids (Clip-II™ and Concerto Basic®). Methods A prospective, randomized controlled trial with a cross-over design was conducted from October 2012 to September 2014 in a rural Thai community. There were 73 participants (mean age of 73.7 ± 7.3 years) included in this study with moderate to severe hearing loss who were assessed for hearing aid performance, including probe microphone real-ear measurement, functional gain, speech discrimination, and participant satisfaction with the overall quality of perceived sound and the design of the device. Results There were no statistically significant differences in functional gain or speech discrimination among the three hearing aids evaluated ( p -value > 0.05). Real-ear measurements of the three hearing aids met the target curve in 93% of the participants. The best real-ear measurement of the hearing aid following the target curve was significantly lower than that of Clip-II™ and Concerto Basic® ( p -value < 0.05) at high frequency. However, participants rated the overall quality of sound higher for the P02 hearing aid than that of Clip-II™ but lower than that of Concerto Basic ® ( p -value > 0.05). Participants revealed that the P02 hearing aid provided the highest satisfaction ratings for design and user-friendliness with statistical significance ( p -value < 0.05). Conclusion The P02 hearing aid was an effective device for older Thai adults with hearing disabilities. Additionally, its modern design, simplicity of use, and ease of maintenance were attractive to this group of individuals. These benefits support the rehabilitation potential of this hearing aid model and its positive impact on the quality of life of older adults in developing countries. Trial registration This study was registered under Clinicaltrial.gov NCT01902914 . Date of registration: July 18, 2013.

Otosyphilis is one contributing cause of hearing loss in adult patients. There are limited studies on the treatment regimens of otosyphilis. Penicillin G sodium (PGS) plus additional medications, such as benzathine penicillin and probenecid, is an effective regimen. This study investigated the efficacy of PGS alone for the treatment of otosyphilis. We conducted a retrospective study and included all consecutive patients diagnosed with otosyphilis who received only PGS treatment. The study period was from 2009 to 2013. The PGS treatment regimen was PGS 4 mu intravenously every four hours (24 mu/day) for 14 days. Clinical and audiogram outcomes were evaluated one year after treatment. There were 34 otosyphilis patients that were treated with PGS. After one year of treatment, 18 patients (52.9%) had a clinical improvement and 11 patients (32.4%) had an audiogram improvement. In conclusion, PGS at 24 mu/day for two weeks provided an audiogram improvement one year after treatment in one-third of the patients.

Aims Sinonasal inverted papillomas (SIP) and sinonasal squamous cell carcinomas (SNSCC) are sinonasal tumors with unclear etiology and pathogenesis. Epstein-Barr virus (EBV) has been detected in these tumors but information concerning their association is still limited. This study aimed to investigate the prevalence in, and association of EBV infection with SIP and SNSCC in northeastern Thailand. Methods DNA was extracted from 226 formalin-fixed, paraffin-embedded tissues including 80 nasal polyps (NP; the control group), 64 SIP and 82 SNSCC samples. Presence of EBV in these tissues was investigated using real-time PCR and their localization within tissues was confirmed using in situ hybridization (ISH). Characteristics of patients and the association of EBV prevalence with sinonasal tumors were analyzed. Results SIP and SNSCC were frequently found in people aged > 50 years and more often in males than in females (3:1 ratio). EBV infection was detected in 33.75, 64.06 and 37.80% of NP, SIP and SNSCC tissues, respectively, by real-time PCR. There was a statistically significant association between EBV infection and SIP (odds ratio [OR] = 3.52). This was not the case for SNSCC when compared to the NP group (OR = 1.83). Interestingly, EBV infection tended to be associated with inflammation and dysplasia in SIP. In SNSCC, EBV was mostly found in samples with undifferentiated or poorly differentiated cell types as well as in recurrent cases and lymph-node metastasis. Using ISH, EBV was detected only in infiltrating lymphocytes within the tumor stroma, not in the tumor epithelial cells. Conclusions Infiltrating lymphocytes containing EBV in the tumor microenvironment might enhance tumorigenesis of SIP and SNSCC. The mechanism by which EBV promotes development of SIP and SNSCC needs to be elucidated in the future.

The core components of most bebop solos encompass four key musical constituents: scale fragments, arpeggios, chromatic inflections, and blues tonality. These elements serve as the foundational building blocks of bebop’s linguistic structure, contributing to the distinct sonic tapestry of modern jazz. This study investigates the research question: What are the relative proportions of bebop’s four core elements, and how can these insights be applied to pedagogy for novice jazz learners? To address this, I analyzed ten historically significant bebop solos and coded each note according to the four categories. The findings demonstrate not only the ratios of these elements, but also their essential role in shaping bebop’s sound. Central to this paper’s argument is the proposition that while comprehension of theoretical constructs in jazz improvisation literature holds importance, it may not be the optimal approach for beginners. Instead, novice students may benefit more from directing their attention to these four elements from an auditory standpoint. By immersing themselves in listening experiences, transcribing passages, and recognizing these categories in context, students can organically synthesize the components of bebop. This study’s contribution lies in reframing solo analysis as a pedagogical tool, offering educators a simplified framework for guiding beginners toward intuitive and musically coherent improvisation.

Objectives: To document the burden of oral cancer in South East Asia (SEA) and to examine the gaps in acquiring accurate data within these countries. Methods: Epidemiological data on oral cancer from countries in SEA were obtained and reviewed from public population-based databases. Descriptions on the incidence and mortality of oral cancer were based on data obtained from GLOBOCAN 2012, and prediction of the number of cases and deaths due to oral cancer were also taken from the same database. The availability of and accessibility to population-based cancer registry were also documented. Results: Five of the eleven countries in SEA have national cancer registries, but the reporting periods varied from 2002 to 2014 across these countries. Whilst incidence and mortality data were obtainable for all SEA countries from GLOBOCAN 2012, data quality varied substantially across the countries. Estimated incidences of oral cancer ranged from 1.6 to 8.6/100,000 per annum with similar rates in males and females for most countries. The incidence was the highest in Myanmar and Brunei for males and females, respectively. Mortality due to oral cancer was reported to be 0.4 to 5.3/100,000, with the highest mortality in Myanmar and Timor-Leste among males and females, respectively. Based on the predicted number of cases and deaths for 2020, oral cancer incidence and mortality is expected to increase and the trends are similar between males and females, which is not surprising as with population growth, the disease burden will rise further. Conclusion: This study demonstrates a severe lack of accurate epidemiological data on oral cancer and underscores the urgent need to develop expertise within this region that can address this issue. While there is a clear need for improved primary prevention, for increased skilled workforce and for improved diagnostic and treatment facilities, an essential first step is to establish robust cancer registries so that progress or lack thereof can be monitored accurately, and appropriate action planned.

In Thailand, five cancer types—breast, cervical, colorectal, liver and lung cancer—contribute to over half of the cancer burden. The magnitude of these cancers must be quantified over time to assess previous health policies and highlight future trajectories for targeted prevention efforts. We provide a comprehensive assessment of these five cancers nationally and subnationally, with trend analysis, projections, and number of cases expected for the year 2025 using cancer registry data. We found that breast (average annual percent change (AAPC): 3.1%) and colorectal cancer (female AAPC: 3.3%, male AAPC: 4.1%) are increasing while cervical cancer (AAPC: −4.4%) is decreasing nationwide. However, liver and lung cancers exhibit disproportionately higher burdens in the northeast and north regions, respectively. Lung cancer increased significantly in northeastern and southern women, despite low smoking rates. Liver cancers are expected to increase in the northern males and females. Liver cancer increased in the south, despite the absence of the liver fluke, a known factor, in this region. Our findings are presented in the context of health policy, population dynamics and serve to provide evidence for future prevention strategies. Our subnational estimates provide a basis for understanding variations in region-specific risk factor profiles that contribute to incidence trends over time.