Naresuan University

Purpose Skull base osteosarcoma is an exceedingly rare malignancy. Unlike maxillofacial osteosarcomas, there are only few cases of skull base tumors reported in literature, and their clinical behavior and treatment outcome are not well defined. This study aims to characterize the clinical features and outcomes of primary skull base osteosarcoma based on our experiences of 9 cases and to review available literature data. Methods A retrospective analysis was done on 9 cases of skull base osteosarcoma diagnosed at IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy, from 1995 to 2023. Clinicopathologic features were reported, and survival outcomes were analyzed. Literature review was performed by searching the PubMed database for published cases of skull base osteosarcoma. Kaplan–Meier survival analysis was used to calculate 1-year, 3-year, and 5-year survival rates. Results Patients were 5 males and 4 females, with an age range of 5–72 years (mean: 39 years). Tumor location was frontal (3), sphenoid/ethmoid (3), occipital (2), and temporal (1) bone. Seven patients had subtotal resections; Two had total resection, but only one achieved negative margin. Follow-up duration ranged from 4 to 256 months (median: 28 months). Local recurrence occurred in 4 patients. At last follow-up, 5 patients were alive, with 3 had no evidence of disease (NED) and 2 alive with disease (AWD), while 4 patients died of disease (DOD). One-year, 3-year, and 5-year survival were 88.9%, 76.2%, and 57.1%, respectively. Literature review showed 1-year, 3-year, and 5-year survival of 50.3%, 22.6%, and 6.7%, respectively. Conclusion Skull base osteosarcoma is a rare malignancy with limited data on its clinical behavior. Surgical resection with negative margins is critical for better outcomes but is challenging due to the complex anatomy. Multidisciplinary treatment approaches are essential to improve our understanding of the tumor and survival outcomes.

The incidence of cancer is sharply rising worldwide. Numerous factors like poor clinical outcomes, drug resistance, restricted treatment options, and delayed diagnosis are to blame for the higher incidence rate. Recent research indicates that epigenetic modifications are necessary in the etiology of cancer. Modifications to noncoding RNA, histones, and DNA methylation influence cancer. In epigenetic drug discovery, notable progress has been made recently. Additionally, the development of nanotechnologies in medicine has opened up new avenues for increasing epi-drugs’ effectiveness by targeting drug delivery, their stability and solubility, and reducing side effects. Effective molecular epidemiological screening techniques and omics technologies enable patient classification and tailored management of emerging diagnostic and prognostic epigenetic biomarkers. This chapter aims to clarify and explore the current status of epigenetics in the initiation and progression of cancer, as well as how epigenetic therapy—often used along with other therapies—will soon prove to be an effective instrument for managing cancer.

The fundamental role of biotechnology in the breakthrough of cancer drugs is a sign of a transformative influence that has markedly elevated our intellectual capacity and strategies for dealing with cancer. Biotechnology utilizes modern methods and technologies to make sense of the complexities of cancer biology, identify novel targets, and establish various innovative therapies. Recognizing these issues enables the prompt implementation of measures to augment the possibility of success. A choice of essential basics emphasizes the consequences of biotechnology in this field. Despite the extensive scientific data accumulated in the field of cancer research, this infirmity continues to set as a noteworthy global cause of mortality. It compels a substantial societal burden due to its allied comorbidities. In this context, it is decisive to improve cancer therapy approaches by focusing on advancing drug discovery technologies, optimizing them, and rapidly developing bioinformatics programs. The landscape of cancer research and drug development has entered a new phase, marked by the real-time materialization of advanced technologies like whole-genome profiling, proteome profiling, and exome sequencing. These innovative approaches have yielded groundbreaking information. Utilizing artificial intelligence, there may also be an advanced approach for identifying novel anticancer targets and uncovering novel drugs inside biological networks. This is achievable as these networks efficiently conserve and enumerate the interactions between components of cell systems that underlie human diseases, including cancer. It covers a wide range of topics, from understanding cancer biology putting into practice using high-tech technologies. It also accentuates advancements achieved, complications encountered, and the optimistic outlook for cancer combat through biotech-driven strategies. Biotechnology plays a pivotal and groundbreaking role in the exploration of cancer drugs, employing a comprehensive approach that involves unraveling the molecular intricacies of cancer, developing targeted therapies, and advancing personalized medicine. The realms of drug discovery and personalized medicine are closely interconnected, with advancements in personalized medicine significantly influencing the drug discovery journey. Utilizing state-of-the-art genomic and proteomic techniques, biotechnology aims to decipher intricate resistance mechanisms within oncological scenarios. This reveals molecular abnormalities and crucial signaling cascades that are central to evading therapeutic interventions. The enduring advancement of biotechnological tools holds the potential for additional breakthroughs in the ongoing fight against cancer.

MicroRNAs are endogenous, highly conserved, tiny noncoding RNA chains of 21–24 nucleotide sequences. They play central function in posttranscriptional regulation of gene by targeting mRNAs. Generally, a wide range of cellular processes such as cell cycle regulation, differentiation, cell stress response, and apoptosis are under the control of miRNAs due to their regulatory mechanisms. Studies have revealed that some events such as mutation in miRNA genes, defects in miRNA processing, and dysregulation of miRNA may cause diverse human diseases including cancers. Under certain circumstances, miRNAs can act as oncogenes or tumor suppressor genes. The dysregulated miRNAs have been observed to affect the characteristics of cancer, including its proliferation, inhibition of programmed cell death, invasion, metastasis, and angiogenesis. miRNAs have garnered interest in recent years as potential diagnostic, prognostic, and therapeutic tools for a variety of human malignancies. This chapter highlights key aspects of miRNAs in context to cancer, covering the biogenesis of miRNAs and its dysregulation. Furthermore, the role of miRNAs in cancer metastasis and its potential as cancer biomarker are also discussed.

Biotechnology has influenced various fields for decades, often before the underlying science was fully understood. At its essence, biotechnology utilizes living organisms and their byproducts for a wide range of applications, influencing various scientific fields. Among these, medical biotechnology is particularly significant as it applies biotechnological principles to achieve medical outcomes. In recent years, medical biotechnology has become increasingly interdisciplinary, incorporating advancements in stem cell technology, nanotechnology, robotics, and biopharmaceuticals. As the field continues to evolve, it is expected to become even more integrated into medicine, offering not only general disease prevention and treatment but also tailored therapeutic strategies based on environmental influences, individual’s genetics, and lifestyle. These advancements are poised to revolutionize medicine, paving the way for even greater innovations. Historically, the application of biotechnology in medicine has achieved significant milestones, such as gene synthesis, recombinant DNA experiments, the development of genetically engineered organisms, monoclonal antibodies, gene therapy trials, the Human Genome Project, CRISPR-Cas9 gene editing, and the creation of mRNA vaccines for COVID-19. These advancements have expanded treatment options and significantly improved patient outcomes. The continuous evolution of medical biotechnology enables it to push the boundaries of medical science, providing solutions to complex health challenges. This chapter aims to provide readers with a clear and accessible understanding of the fundamental concepts, techniques, and breakthroughs in medical biotechnology. It prepares readers to appreciate the current contributions of biotechnology to medicine and anticipate its future impact on healthcare.

An investigation of black hole thermodynamics based on Tsallis statistical mechanics is explored through the study of the thermodynamics of a gas system located near the horizon of a black hole. In spite of the difficulty in exploring black hole thermodynamics through statistical mechanics, the entropy of the nearby gas system is found to be proportional to the black hole’s horizon area using Gibbs–Boltzmann statistical mechanics. This allows us to study black hole thermodynamics by using statistical mechanics through the thermodynamic behaviors of the gas system. Since the entropy of the black hole is proportional to the horizon area, it is more suitable to use non-extensive statistical mechanics instead of the usual Gibbs–Boltzmann ones. In this work, the black hole entropy is derived based on Tsallis statistical mechanics, one of well-known non-extensive statistical mechanics. It is found that the black hole entropy gets a modification due to non-extensivity. By using such an entropy, the black hole can be stabilized due to the non-extensivity, and the bound on the non-extensive parameter is also determined.

In this work, we investigate the fluctuations of the net-proton number in Au + Au collisions at sNN = 14.5 and 19.6 GeV by calculating cumulants and their ratios within the framework of the ultra-relativistic quantum molecular dynamics (UrQMD) model. Our results are consistent with STAR data of C2/C1 and C3/C2. Furthermore, we also calculated the sixth-order cumulants of net-proton at sNN = 14.5, 16.5, and 19.6 GeV. The results reveal the cumulant ratios approach zero as the centrality increases. We also analyze the energy dependence of the net-proton distribution at eight different energies and compare these results with STAR experiment data. The analysis shows a monotonic trend for C2/C1 and C3/C2, while the UrQMD model cannot describe the non-monotonic energy dependence for C4/C2 for the most central Au + Au collisions measured by STAR. Finally, we investigated the energy dependence of proton factorial cumulants and found a sign change, as well as fluctuations at low energies. Although the UrQMD simulations do not incorporate the physics of the quantum chromodynamic (QCD) critical point, the results provide a baseline for the search for the QCD critical point.

Hyperlipidemia and oxidative stress are significantly related to atherosclerotic cardiovascular disease. Probiotic supplements have been demonstrated to reduce hyperlipidemia and might minimize atherosclerotic risk. This study aimed to evaluate the therapeutic ability of Lactobacillus reuteri TISTR 2736 (LR) on vascular damage in high‐cholesterol diet (HCD)‐induced hyperlipidemic rats and elucidate their possible mechanisms. Male Sprague–Dawley rats received a standard diet or HCD, and LR (2 × 10 ⁸ CFU/rat/day) was orally administered to HCD‐fed rats for 8 weeks. Compared to the HCD‐fed group, LR administration reduced serum levels of TC, TG, LDL, and endothelin‐1 but elevated levels of aortic nitric oxide and serum HDL. Additionally, LR reversed the HCD‐induced aortic histological changes. The protein levels of adhesion molecules (VCAM‐1 and ICAM‐1), lectin‐like oxidized low‐density lipoprotein receptor‐1 (LOX‐1), NADPH oxidase subunits p47 phox , eNOS monomer/dimer ratio, oxidative stress markers (4‐hydroxynonenal and 3‐nitrotyrosine), and pro‐inflammatory cytokines (TNF‐α and IL‐6) were decreased, while those of nuclear factor erythroid 2‐related factor 2 (Nrf2) and heme oxygenase‐1 (HO‐1), and the activity of superoxide dismutase were increased in the aortas of LR‐treated rats. These findings suggest that LR supplementation ameliorates HCD‐induced vascular dysfunction and inflammation, possibly by lowering hyperlipidemia, suppressing ROS production, and increasing antioxidant enzyme activities.

Rice (Oryza sativa L.) is a vital global crop with a predominant presence in Asia, including Thailand. However, it faces a significant threat from bacterial blight disease (BB), primarily caused by Xanthomonas oryzae pv. oryzae (Xoo). This research aims to provide an insights into the genetic virulence and variation of Xoo strains isolated in Thailand. Our phylogenetic analysis unveils that the 20 Thai strains align with the Asian strains, setting them apart from African and USA strains. Remarkably, the Average Nucleotide Identity (ANI) values, in comparison to the Xanthomonas oryzae type strain 35933 (XO35933), consistently exceed 99%. These strains can be classified into three assigned ribosomal sequence types (rST). Our investigation into the pangenome and the phylogenetic relationships of these 20 Xoo genomes reveals a diverse genetic landscape, with the pangenome comprising 11,872 orthologous gene clusters, of which roughly 30% form the core genome. Notably, all of these genomes exhibit the presence of a CRISPR-Cas I-C array, indicative of their adaptive immune mechanisms. All strains belonged to BXO1 type LPS cassette with high identity. Furthermore, our analysis identifies two distinct types of plasmids, namely, Xanthomonas oryzae pv. oryzicola strain GX01 plasmid pXOCgx01 (A46, A57, A83, A112, D, and E) and the Xanthomonas oryzae strain AH28 plasmid pAH28 (A97). This genomic resource will be valuable for advancing research on surveillance, prevention, management, and comparative studies of this critical pathogen in the future.

Purpose: Controversy exists on whether a drug holiday is necessary for patients on antiresorptive medication for osteoporosis or bone metastasis and undergoing dental procedures to lower the risk of medication-related osteonecrosis of the jaw (MRONJ). This study evaluated the effects of discontinuing different antiresorptive regimens on MRONJ in these patients. Methods: Publications from PubMed, EMBASE, Cochrane Library and EBSCO Open Dissertations were searched from inception to September 2023 following PRISMA guidelines, and the review was registered in PROSPERO. Eligibility criteria included clinical studies on the effects of continued and discontinued antiresorptive medications for osteoporosis or bone metastasis in patients undergoing dental procedures. The involved antiresorptive agents were oral bisphosphonates (BPs), intravenous (IV) BPs and denosumab (Dmab). Relative risk (RR) with 95% confidence interval (CI) was estimated using a random-effects model. Results: Of the 2,590 records identified, six studies (n = 717) were included. Discontinued use of oral BPs had a lower MRONJ risk than discontinuation of IV BPs (RR = 0.05; 95% CI: 0.00-0.83) and continuation of IV BPs (RR = 0.03; 95% CI: 0.00-0.46). Continuing oral BPs also resulted in a lower MRONJ risk compared to both discontinuation and continuation of IV BPs, with RR = 0.04 (95% CI: 0.00-0.67) and RR = 0.03 (95% CI: 0.00-0.37), respectively. No significant difference was found between continuation and discontinuation of oral BPs, along with other comparisons. Conclusions: A drug holiday may not be necessary before dental procedures for oral BPs. Temporary discontinuation of IV BPs or Dmab is also unlikely to reduce MRONJ risk compared to continued medication.

BACKGROUND Adjusting basal insulin doses is essential for lowering blood glucose while minimizing the risk of hypoglycemia. Despite various basal insulin titration strategies being available, their comparative effectiveness remains unclear. PURPOSE To compare the effectiveness of different basal insulin titration strategies on glycemic control in patients with type 2 diabetes. DATA SOURCES PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and EBSCO Open Dissertations were searched from inception to January 2024. STUDY SELECTION We included published trials with evaluation of basal insulin titration strategies for glycemic control in type 2 diabetes. DATA EXTRACTION Data on HbA1c and severe hypoglycemia were extracted. DATA SYNTHESIS Studies were categorized with the theme, intensity, and provider/platform (TIP) framework. “Theme” referred to conventional titration (Conv) or self-titration (ST), “intensity” was categorized as high (Conv, >1/month; ST, ≥2/week) or low (Conv, ≤1/month; ST, <2/week), and for “provider/platform” categories included supported by health care provider (HCP for Conv or S-HCP for ST), patient led (Pt), and supported by application (S-App). The ST/High/S-HCP strategy resulted in the greatest HbA1c reduction in comparison with all others (e.g., ST/High/S-App, mean difference −0.75 [95% CI −1.26, −0.25], and Conv/Low/HCP, −1.19 [95% CI −1.67, −0.72]). Severe hypoglycemia risk did not differ significantly across strategies. LIMITATIONS The number of studies per network meta-analysis was limited, and not all TIP combinations were evaluated. CONCLUSIONS Self-titration at least twice a week with health care provider support leads to superior HbA1c reduction in comparison with other strategies, without increasing the risk of severe hypoglycemia. This approach should be considered for clinical practice, where appropriate, to achieve optimal glycemic control in patients with type 2 diabetes.

Objective Yes-associated protein (YAP) and Ki-67 are known to be involved in cell proliferation. While their overexpression is associated with aggressive behaviors in oral squamous cell carcinoma (OSCC), their roles in odontogenic cysts have not been thoroughly investigated. Therefore, this study aimed to evaluate the immunohistochemical expression of YAP and Ki-67 in odontogenic cysts. Material and Methods Tissue samples included 12 radicular cysts, 10 dentigerous cysts, 9 odontogenic keratocysts, and 9 normal oral mucosa specimens. Immunohistochemical analysis was conducted both manually and using ImageJ software for comparison. Statistical analysis The Kruskal–Wallis, followed by the Mann–Whitney U-test was used to assess the differences in the YAP and Ki-67 immunoexpression levels among various group lesions. The correlation between those two proteins in individual groups was tested by Spearman correlation. A p-value of less than 0.05 was considered statistically significant. SPSS software version 25.0 was used. Results There was a strong nuclear staining of YAP in basal and superficial cells and an intense cytoplasmic YAP positivity in odontogenic keratocysts, whereas a weaker YAP staining in both the nucleus and cytoplasm throughout the epithelial thickness was observed in dentigerous cyst, radicular cyst, and normal oral mucosa, respectively. YAP expression differed significantly in all odontogenic cysts compared with normal oral mucosa (p < 0.05). Ki-67 expression was notably higher in odontogenic keratocysts relative to other cysts and normal oral mucosa. Although no statistically significant correlation was found between YAP and Ki-67 across the groups, both proteins displayed similar positive trends in odontogenic keratocysts. Conclusion These findings suggest that YAP activation may be related to the proliferative behavior of odontogenic cysts, especially in more aggressive lesions, but less likely to influence the inflammatory cysts. This insight could improve understanding of their pathogenesis and pave the way for new diagnostic and therapeutic approaches.

Background Various therapeutic options have been introduced for enlarged facial pores including low cross‐linked hyaluronic acid (HA) fillers. Newer formulations of HA‐based dermal fillers are continuously introduced into the market, but their effectiveness in reducing enlarged facial pores has not yet been determined. Objectives To compare the efficacy of HA‐based dermal fillers (Cohesive Polydensified Matrix HA filler; CPM‐HA20) versus CPM‐HA20 with glycerol (CPM‐HA20G) in terms of minimizing enlarged facial pores and skin quality improvement. Methods Thirty subjects with enlarged facial pores were enrolled in this randomized, double‐blinded, split‐face study. Participants were randomly assigned to be injected with 1 mL of CPM‐HA20 filler on one side of their medial cheek and 1 mL of CPM‐HA20G on the contralateral side for 3 sessions spaced 4 weeks apart. Pore volume was objectively measured by an Antera 3D. Skin biophysical properties were evaluated. Participant satisfaction and adverse events were recorded. Results Twenty‐nine participants completed the study. Both treatment groups showed a reduction in the mean pore volume from the baseline through Week 32. The CPM‐HA20G treated side showed a 24.2% higher reduction in mean pore volume from baseline compared to the CPM‐HA20 treated side (p = 0.038). Both treatment groups showed improvement in skin hydration from baseline to Week 32. There was no significant difference in patient satisfaction between the CPM‐HA20G and CPM‐HA20 treated sides. Only mild adverse events such as pain, edema, and bruising were reported. Conclusion Three‐monthly injections of CPM‐HA20G and CPM‐HA20 were effective in minimizing enlarged face pores and improving skin hydration. CPM‐HA20G demonstrated superior efficacy in terms of pore size reduction. Adverse events were generally mild and tolerable.

Computed tomography (CT) imaging is an essential tool for diagnostic purposes but exposes patients, including those who are pregnant, to ionizing radiation, potentially impacting fetal health. Accurate dose estimation is necessary to manage these risks effectively. This study aimed to determine conversion factors for effective dose and uterus dose for CT imaging in pregnant patients, adjusted for gestational stages and various scan regions. The National Cancer Institute dosimetry system for computed tomography (NCICT) simulated photon interactions in hybrid phantoms representing pregnant patients at different gestational stages. A CT scanner model was used across eight gestational stages and for seven different scan regions. Dose length product, effective dose, and uterus dose values were recorded, and conversion factors were calculated for estimating effective dose and fetus dose. The study generated gestational age-specific conversion factors, which varied based on CT scan region. The results reveal a reduction in radiation dose with advancing gestational age, particularly in abdomen and pelvis scans, emphasizing the importance of gestation-specific dose adjustments. The study offers valuable conversion factors for improved radiation dose management in pregnant patients, reducing unnecessary exposure risks, and improving diagnostic practices in CT imaging.

Background: Gastrointestinal tract duplications are rare congenital anomalies, with the jejunum being the second most common site after the ileum. These duplications can vary in size, location, and presence of ectopic mucosa, significantly impacting clinical presentation and often requiring surgical intervention. Case presentation: A 10-year-old Thai boy with haemoglobin (Hb) E trait and iron deficiency anaemia presented with significant oedema and abdominal distention. Laboratory investigations revealed isolated hypoalbuminemia. Imaging studies, including computed tomography (CT) scan, demonstrated a large, loculated, rim-enhancing air-fluid collection adjacent to the jejunum, along with mild dilatation and wall thickening of the affected jejunal loop. The patient underwent exploratory laparotomy, which included jejunal resection and jejunojejunal end-to-end anastomosis. Conclusion: Jejunal duplications are uncommon in children and can present diagnostic challenges, potentially leading to serious complications. This case underscores the importance of considering jejunal duplication in paediatric patients with unexplained abdominal distention and protein-losing enteropathy. Early recognition and timely surgical management are crucial to prevent severe complications and improve patient outcomes.

This study addressed the challenge of accurately identifying stranded marine mammal species which currently relies heavily on morphological characteristics and is prone to damage or incompleteness. A DNA barcode combined with high resolution melting analysis (Bar-HRM) was used for accurate identification at the species level. Mitochondrial DNA, specifically the D-loop and cytochrome b gene, was utilized for Bar-HRM to differentiate 13 marine mammal species (n = 26) commonly found in Thai waters. Results demonstrated that Bar-HRM, using specific primers (MMCytb2 and MMCytb3), produced distinct normalized melting curves for all species (100.00% success rate). In blind tests, Bar-HRM demonstrated high accuracy rates in species differentiation, reaching 86.67% and 90.00% for Bar-HRM using MMCytb2 and MMCytb3 primers, respectively. The method also enabled 100.00% species identification in unknown samples (n = 20), with a minimum DNA concentration requirement of 0.01 ng per reaction for both primers. Multiplex HRM incorporating MMCytb2 or MMCytb3 with the SRY gene for sex determination showed effectiveness rates (100.00%). Morever, species identification using Bar-HRM was more cost-effective than DNA barcode sequencing. Taken together, this approach showed considerable potential for improving marine mammal species identification with accuracy, speed and cost effectiveness, thus enhancing conservation efforts and aiding in the assessment of their endangered status.

In our study, we prepared Fe3O4 nanoparticles (NPs) using food waste extract of Mealworm (Tenebrio molitor) larvae fed spinach (Spinacia oleracea), which is rich in iron. A coating was applied to Fe3O4 NPs containing hyperbranched spermine-polyethylene glycol-folic acid (FHSPF) and spermine-polyethylene glycol-folic acid (FSMPF). Polymer was loaded with siRNA or DNA. DLS¹, H-NMR, FTIR, EDX, Zeta potential and TEM were used to analyze morphology of NPs. Biocompatibility, DNA release, and gene transfer properties were evaluated. Coats concentration in our NPs increased zeta potential, DNA release, encapsulation, and gene delivery efficiency. As determined by cell viability, our NPs exhibit low cytotoxicity and good compatibility; on the other hand, we evaluated their ability to transfer into MCF-7 cells using fluorescence microscopy and flow cytometry. According to this analysis, increasing DNA or siRNA concentration in NPs improved gene transfer efficiency. As a result of cytotoxicity assay, FHSPF2 NPs showed high biocompatibility; NPs were demonstrated to deliver siRNA-FAM to breast cancer cells and mice in vivo, and they were also rated excellent for delivering siRNA-FAM to the tumor site using external magnetic fields. Magnetic fields significantly cause NPs to adsorb at the tumor site.