The automatic segmentation of the pancreatic cyst lesion (PCL) is essential for the automated diagnosis of pancreatic cyst lesions on endoscopic ultrasonography (EUS) images. In this study, we ...proposed a deep-learning approach for PCL segmentation on EUS images. We employed the Attention U-Net model for automatic PCL segmentation. The Attention U-Net was compared with the Basic U-Net, Residual U-Net, and U-Net++ models. The Attention U-Net showed a better dice similarity coefficient (DSC) and intersection over union (IoU) scores than the other models on the internal test. Although the Basic U-Net showed a higher DSC and IoU scores on the external test than the Attention U-Net, there was no statistically significant difference. On the internal test of the cross-over study, the Attention U-Net showed the highest DSC and IoU scores. However, there was no significant difference between the Attention U-Net and Residual U-Net or between the Attention U-Net and U-Net++. On the external test of the cross-over study, all models showed no significant difference from each other. To the best of our knowledge, this is the first study implementing segmentation of PCL on EUS images using a deep-learning approach. Our experimental results show that a deep-learning approach can be applied successfully for PCL segmentation on EUS images.
Glioblastoma multiforme (GBM) displays cellular hierarchies harboring a subpopulation of stem-like cells (GSCs). Enhancer of Zeste Homolog 2 (EZH2), the lysine methyltransferase of Polycomb ...repressive complex 2, mediates transcriptional repression of prodifferentiation genes in both normal and neoplastic stem cells. An oncogenic role of EZH2 as a transcriptional silencer is well established; however, additional functions of EZH2 are incompletely understood. Here, we show that EZH2 binds to and methylates STAT3, leading to enhanced STAT3 activity by increased tyrosine phosphorylation of STAT3. The EZH2-STAT3 interaction preferentially occurs in GSCs relative to non-stem bulk tumor cells, and it requires a specific phosphorylation of EZH2. Inhibition of EZH2 reverses the silencing of Polycomb target genes and diminishes STAT3 activity, suggesting therapeutic strategies.
•EZH2 activates STAT3 signaling via lysine methylation of STAT3•EZH2 and STAT3 preferentially interact in stem-like tumor cells•AKT serves as an upstream inducer of EZH2 to promote activation of STAT3•EZH2 inhibition reverses Polycomb-mediated silencing and decreases STAT3 activity
Purpose
The aim of this time‐dependent study was to analyze the prevalence of mental disorders in ovarian cancer survivors using claims data in South Korea.
Materials and methods
We confirmed mental ...disorders in a nationwide cohort of 9763 patients who were diagnosed with ovarian cancer between January 1, 2010 and December 31, 2014. We categorized the prevalence of mental disorders based on the age and the time of diagnosis.
Results
A total of 821 ovarian cancer patients were diagnosed with a mental disorder, 1 year prior to the cancer diagnosis. Of those patients, 311 were diagnosed with depression (37.9%) and 245 with anxiety (29.8%) during their first visit. The overall frequency of mental disorders peaked within 2 months after the cancer diagnosis. The highest rate of increase after diagnosis was noted in stress reaction/adjustment disorders. While depression was relatively high (40.4%) in the younger age group under 60 years, anxiety was higher (39.4%) in the elderly group over 60 years old. Age was a significant predictive factor for mental disorders (P = 0.002), and patients over 50 years were at a higher risk for mental disorders (hazard ratio: 1.29, P = 0.002).
Conclusion
Mental disorders in ovarian cancer survivors showed different patterns of prevalence depending on age at the time of diagnosis and the nature of disease. Timely diagnosis and intervention for psychological distress could increase the quality of life for ovarian cancer survivors.
A visible‐light‐induced selenocyclization of ortho‐vinylanilides to 4H‐3,1‐benzoxazines has been developed under controlled O2 atmosphere. The low O2 content in reaction medium promotes the aerobic ...selenol oxidation to diselenides for the full use of 2 equiv. selenyl radicals in a redox‐neutral way, avoiding the aerobic oxidation of ortho‐vinylanilides under higher O2 content. The developed visible light‐induced selenocyclization of ortho‐vinylanilides utilizes only visible light with low O2 content, eliminating the use of exogenous photocatalyst and chemical oxidant.
The purpose of this study was to examine how coaching styles affect athletes' moral disengagement. To achieve our objectives, we examined the relationships among perceived coaching types, pride, and ...moral disengagement in the context of elite taekwondo athletes (
= 322). Direct and indirect effects among coaching types, pride, and moral disengagement were assessed through path analysis. The results indicated that the autonomy-support coaching type reduced moral disengagement by decreasing hubristic pride, while the controlled coaching type increased moral disengagement through hubristic pride. Our study found a chain of effects according to the controlled coaching type perceived by taekwondo athletes, hubristic pride, and moral disengagement; therefore, the controlled coaching type and hubristic pride should be closely managed in sport society, as they elicit greater moral disengagement. Managerial strategies to diminish hubristic pride through the autonomy-support coaching type are recommended.
For early-stage orbital mucosa-associated lymphoid tissue lymphoma (MALToma), radiotherapy (RT) is known to be the treatment of choice. The classical recommended treatment field is the entire ...ipsilateral orbit, exposing normal orbital structures such as the lacrimal gland and lens, which are sensitive to moderate doses of radiation, to the full treatment dose. Herein we aimed to evaluate the clinical outcomes and dosimetric values in patients with orbital MALToma who received RT.
This study was a retrospective study.
Forty patients with orbital MALToma treated with curative RT.
The patients were classified into the conjunctival RT (n = 23), partial-orbit RT (n = 10), and whole-orbit RT (n = 7) groups. The treatment outcomes and dosimetric values of the orbital structures were reviewed.
We found the 5-year local, contralateral orbit, and overall relapse rates to be 5.0%, 5.9%, and 16.0%, respectively. Local relapse events occurred in 2 patients in the conjunctival RT group. No relapse was observed in the partial-orbit RT group. Whole-orbit RT caused significantly higher rates of dry eyes during treatment. The partial-orbit RT group showed a significantly lower ipsilateral eyeball mean dose and ipsilateral eyelid mean dose than the other groups.
Partial-orbit RT showed encouraging clinical, toxicity, and dosimetric outcomes in patients with orbital MALToma and has the potential to be a treatment option for such patients.
We analyzed the changes in absolute lymphocyte count and its changes over time in 139 patients treated with preoperative chemoradiotherapy for locally advanced rectal cancer. The baseline absolute ...lymphocyte count was defined as the median of absolute lymphocyte count levels measured during 30 days before preoperative chemoradiotherapy. Absolute lymphocyte count at 1 month, 0.5 to 1 year, 1 to 2 years, and 2 to 3 years were determined by the median values of the absolute lymphocyte counts during the respective periods. Absolute lymphocyte count decreased after delivering preoperative chemoradiotherapy, reached minimum level at 1 month, and then gradually increased after the completion of chemoradiotherapy. Baseline absolute lymphocyte count had significant correlations with the absolute lymphocyte count of every period (range of coefficient, 0.41-0.64, P < .001). The overall survival of the group with high baseline absolute lymphocyte count was significantly higher than that of the group with low baseline absolute lymphocyte count (5-year overall survival: 82.4% vs 62.9%, P = .012). In multivariable analyses, the baseline absolute lymphocyte count remained as a significant prognostic factor for overall survival, favoring the group with a high baseline absolute lymphocyte count (hazard ratio = 0.405, P = .017). This study showed that the level of baseline absolute lymphocyte count was an independent prognostic factor, and it correlated with the absolute lymphocyte counts across varying periods of treatments and follow-up in patients treated with preoperative chemoradiotherapy for rectal adenocarcinoma.
Aim
This time‐dependent study aimed to analyze the prevalence of psychological distress in prostate cancer survivors by using claims data in South Korea.
Methods
In a nationwide cohort, 32 005 ...patients were identified who were diagnosed with prostate cancer between January 2010 and December 2014. We referred the diagnostic codes of mental disorders as psychological distress. We categorized the prevalence of psychological distress based on age and specific times before and after the cancer diagnosis.
Results
The median age at diagnosis of prostate cancer was 70 years. Among 32 005 patients, 3074 (9.6%) were diagnosed at least once with a mental disorder between 1 year before the cancer diagnosis and the last follow‐up. Among the first diagnoses of each patient, the common mental disorders were anxiety (39.1%) and depression (33.0%). In the total cohort, there were 54 666 claims for mental disorders and over 48.0% (26 256) were for depression. The frequency of psychological distress peaked just before cancer diagnosis. Anxiety was frequent before diagnosis of prostate cancer, whereas depression was frequent after diagnosis. Although stress reaction/adjustment disorders were relatively high in the younger group, depression was relatively high in the elderly group.
Conclusion
Psychological distress in prostate cancer survivors showed different patterns of prevalence between before and after cancer diagnosis, as well as between age groups. Timely diagnosis and intervention for mental health could promote quality of life for prostate cancer survivors.
To investigate whether common terminology criteria for adverse events (CTCAE) grade 4 lymphopenia (<200 cells/μl) during concurrent chemoradiotherapy (CCRT) is relevant to poor survival.
We analyzed ...124 patients with newly diagnosed Federation of Gynecology and Obstetrics (FIGO) stage I-III cervical cancer who received weekly cisplatin-based CCRT and brachytherapy using Kaplan-Meier curves and the Cox proportional hazard models.
Grade 4 lymphopenia significantly predicted disease-specific survival (DSS) and progression-free survival (PFS) (adjusted hazard ratio (95% confidence interval (CI))=3.6 (1.37-9.44), p=0.009 and 3.28 (1.27-8.48), p=0.014, respectively). The 5-year DSS and 3-year PFS were significantly higher among patients with grade 2-3 lymphopenia (≥200 cells/μl) than among those with grade 4 lymphopenia (84.8% vs. 50.4%, p<0.001, and 80.7% vs. 50%, p=0.002, respectively).
Severe lymphopenia during CCRT could predict poor survival.
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