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Background Using dose-painted intensity-modulated radiation therapy, specific dose volume constraints or implantation of tissue expanders prior to radiotherapy are validated options for reducing radiation dose on the bowel and therefore minimizing acute gastrointestinal toxicity during chemoradiation for anorectal malignancies. We describe the rare case of a female patient with a locally advanced anal carcinoma where a large myomatous uterus served as a natural spacer to protect the bowel during radiation therapy. Case presentation Initially the patient presented with anal pain, proctoscopy followed by an excisional biopsy confirmed the diagnosis of a squamous cell carcinoma of the anus. Imaging examination showed a locally advanced tumor and in addition a large uterus with typical leiomyomas up to 11.5 cm in diameter. The patient underwent chemoradiation; because of the large leiomyomas there was almost no dose burden for the small intestine and therefore practically no gastrointestinal toxicity. Conclusion As we know, this report describes the situation that a large myomatous uterus served as a natural spacer during radiation therapy in a way that is unique to date.

Blast furnace (BF) ironmaking process has complex and nonlinear dynamic characteristics. The molten iron temperature (MIT) as well as Si, P and S contents of molten iron is difficult to be directly measured online, and large-time delay exists in offline analysis through laboratory sampling. A nonlinear multivariate intelligent modeling method was proposed for molten iron quality (MIQ) based on principal component analysis (PCA) and dynamic genetic neural network. The modeling method used the practical data processed by PCA dimension reduction as inputs of the dynamic artificial neural network (ANN). A dynamic feedback link was introduced to produce a dynamic neural network on the basis of traditional back propagation ANN. The proposed model improved the dynamic adaptability of networks and solved the strong fluctuation and resistance problem in a nonlinear dynamic system. Moreover, a new hybrid training method was presented where adaptive genetic algorithms (AGA) and ANN were integrated, which could improve network convergence speed and avoid network into local minima. The proposed method made it easier for operators to understand the inside status of blast furnace and offered real-time and reliable feedback information for realizing close-loop control for MIQ. Industrial experiments were made through the proposed model based on data collected from a practical steel company. The accuracy could meet the requirements of actual operation.

Aim： To investigate the effects of ROS scavenger N-acetylcysteine （NAC） on angiotensin II （Ang II）-mediated renal fibrosis in vivo and in vitro. Methods： Mice were subjected to unilateral ureteral obstruction （UUO）, and then treated with vehicle or NAC （250 mg/kg, ip） for 7 days. Histological changes of the obstructed kidneys were observed with Masson＇s trichrome staining. ROS levels were detected with DHE staining. The expression of relevant proteins in the obstructed kidneys was assessed using Western blotting assays. Cultured rat renal fibroblast NRK-49F cells were used for in vitro experiments. Results： In the obstructed kidneys, Ang II levels were significantly elevated, and collagen I was accumulated in the interstitial spaces. Furthermore, ROS production and the expression of p47 （a key subunit of NADPH oxidase complexes） were increased in a time- dependent manner; the expression of fibronectin, α-SMA and TGF-β were upregulated. Administration of NAC significantly alleviated the fibrotic responses in the obstructed kidneys. In cultured NRK-49F cells, treatment with Ang II （0.001-10 pmol/L） increased the expression of fibronectin, collagen I, α-SMA and TGF-β in dose-dependent and time-dependent manners. Ang II also increased ROS production and the phosphorylation of Smad3. Pretreatment with NAC （5 pmol/L） blocked Ang II-induced oxidative stress and ECM production in the cells. Conclusion＂ In mouse obstructed kidneys, the fibrotic responses result from Ang II upregulation can be alleviated by the ROS scavenger N-acetylcysteine.

Assessing the risk of chemical mixtures is an intricate process that should integrate published laboratory data; comparisons with the composition, toxicity, and functionality of similar mixtures; complete analytical characterization of the mixture components; and in silico modeling. Various tiered assessment protocols have been proposed to address this need, and these protocols may be adapted on a case-by-case basis for both mixture-based and component-based evaluations. Emerging technologies have enabled rapid mixture testing in alternative animal models, such as human organotypic cultures and zebrafish. In addition, quantitative modeling that uses systems toxicology approaches can identify exposure-induced cellular and molecular alterations that would not be detected by standard toxicology assays. This review summarizes the approaches to risk assessment of complex chemical mixtures as presented at the Eighth International Congress of the Asian Society of Toxicology, June 2018.

Background Sarcopenia, the critical depletion of skeletal muscle mass, is an independent prognostic factor in several tumor entities for treatment-related toxicity and survival. In esophageal cancer, there have been conflicting results regarding the value of sarcopenia as prognostic factor, which may be attributed to the heterogeneous patient populations and the retrospective nature of previous studies. The aim of our study was therefore to determine the impact of sarcopenia on prospectively collected specific outcomes in a subgroup of patients treated within the phase III study SAKK 75/08 with trimodality therapy (induction chemotherapy, radiochemotherapy and surgery) for locally advanced esophageal cancer. Methods Sarcopenia was assessed by skeletal muscle index at the 3rd lumbar vertebra (L3) in cross-sectional computed tomography scans before induction chemotherapy, before radiochemotherapy and after neoadjuvant therapy in a subgroup of 61 patients from four centers in Switzerland. Sarcopenia was determined by previously established cut-off values (Martin et al., PMID: 23530101) and correlated with prospectively collected outcomes including treatment-related toxicity, postoperative morbidity, treatment feasibility and survival. Results Using the published cut-off values, the prevalence of sarcopenia increased from 29.5% before treatment to 63.9% during neoadjuvant therapy ( p  < 0.001). Feasibility of neoadjuvant therapy and surgery was not different in initially sarcopenic and non-sarcopenic patients. We observed in sarcopenic patients significantly increased grade ≥ 3 toxicities during chemoradiation (83.3% vs 52.4%, p  = 0.04) and a non-significant trend towards increased postoperative complications (66.7% vs 42.9%, p  = 0.16). No difference in survival according to sarcopenia could be observed in this small study population. Conclusions Trimodality therapy in locally advanced esophageal cancer is feasible in selected patients with sarcopenia. Neoadjuvant chemoradiation increased the percentage of sarcopenia. Sarcopenic patients are at higher risk for increased toxicity during neoadjuvant radiochemotherapy and showed a non-significant trend to more postoperative morbidity.