Concurrent image-guided intensity modulated radiotherapy and chemotherapy following neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma

<p>Abstract</p> <p>Background</p> <p>To evaluate the experience of induction chemotherapy followed by concurrent chemoradiationwith helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC).</p> <p>Methods</p> <p>Between August 2006 and December 2009, 28 patients with pathological proven nonmetastatic NPC were enrolled. All patients were staged as IIB-IVB. Patients were first treated with 2 to 3 cycles of induction chemotherapy with EP-HDFL (Epirubicin, Cisplatin, 5-FU, and Leucovorin). After induction chemotherapy, weekly based PFL was administered concurrent with HT. Radiation consisted of 70 Gy to the planning target volumes of the primary tumor plus any positive nodal disease using 2 Gy per fraction.</p> <p>Results</p> <p>After completion of induction chemotherapy, the response rates for primary and nodal disease were 96.4% and 80.8%, respectively. With a median follow-up after 33 months (Range, 13-53 months), there have been 2 primary and 1 nodal relapse after completion of radiotherapy. The estimated 3-year progression-free rates for local, regional, locoregional and distant metastasis survival rate were 92.4%, 95.7%, 88.4%, and 78.0%, respectively. The estimated 3-year overall survival was 83.5%. Acute grade 3, 4 toxicities for xerostomia and dermatitis were only 3.6% and 10.7%, respectively.</p> <p>Conclusion</p> <p>HT for locoregionally advanced NPC is feasible and effective in regard to locoregional control with high compliance, even after neoadjuvant chemotherapy. None of out-field or marginal failure noted in the current study confirms the potential benefits of treating NPC patients by image-guided radiation modality. A long-term follow-up study is needed to confirm these preliminary findings.</p

A Novel Anti-Inflammatory and Pro-Resolving Role for Resolvin D1 in Acute Cigarette Smoke-Induced Lung Inflammation

Introduction: Cigarette smoke is a profound pro-inflammatory stimulus that contributes to acute lung injuries and to chronic lung disease including COPD (emphysema and chronic bronchitis). Until recently, it was assumed that resolution of inflammation was a passive process that occurred once the inflammatory stimulus was removed. It is now recognized that resolution of inflammation is a bioactive process, mediated by specialized lipid mediators, and that normal homeostasis is maintained by a balance between pro-inflammatory and pro-resolving pathways. These novel small lipid mediators, including the resolvins, protectins and maresins, are bioactive products mainly derived from dietary omega-3 and omega-6 polyunsaturated fatty acids (PUFA). We hypothesize that resolvin D1 (RvD1) has potent anti-inflammatory and pro-resolving effects in a model of cigarette smoke-induced lung inflammation. Methods: Primary human lung fibroblasts, small airway epithelial cells and blood monocytes were treated with IL-1β or cigarette smoke extract in combination with RvD1 in vitro, production of pro-inflammatory mediators was measured. Mice were exposed to dilute mainstream cigarette smoke and treated with RvD1 either concurrently with smoke or after smoking cessation. The effects on lung inflammation and lung macrophage populations were assessed. Results: RvD1 suppressed production of pro-inflammatory mediators by primary human cells in a dose-dependent manner. Treatment of mice with RvD1 concurrently with cigarette smoke exposure significantly reduced neutrophilic lung inflammation and production of pro-inflammatory cytokines, while upregulating the anti-inflammatory cytokine IL-10. RvD1 promoted differentiation of alternatively activated (M2) macrophages and neutrophil efferocytosis. RvD1 also accelerated the resolution of lung inflammation when given after the final smoke exposure. Conclusions: RvD1 has potent anti-inflammatory and pro-resolving effects in cells and mice exposed to cigarette smoke. Resolvins have strong potential as a novel therapeutic approach to resolve lung injury caused by smoke and pulmonary toxicants

Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

Pro-Resolving Lipid Mediators in the Resolution of Lung Inflammation

Thesis (Ph.D.)--University of Rochester. School of Medicine & Dentistry. Dept. of Pathology and Laboratory Medicine, 2015.Acute and chronic inflammation is a major component of many pulmonary illnesses, including asthma, cancer, and chronic obstructive pulmonary disease (COPD). Normally, inflammation can be fully resolved once the stimulus has been removed (e.g. cigarette smoke, air pollutants, microbial particles). However, in many cases inflammatory responses persist without complete resolution. A new paradigm indicates that the resolution of inflammation is a bioactive process that involves a group of lipid molecules called “specialized pro-resolving lipid mediators” (SPMs). These SPMs, which include resolvins, protectins, maresins and lipoxins, are known to actively antagonize acute inflammatory signaling, to promote resolution of inflammation, and to enable return of homeostasis. Here, we show that the pro-resolving lipid mediator, resolvin D1 (RvD1), plays crucial roles in lung homeostasis and may be a potential treatment for inflammatory lung diseases. In a murine model of acute cigarette smoke-induced lung inflammation, RvD1 not only reduced or attenuated acute lung inflammation, but also shortened the duration of the inflammatory response, thus promoting the resolution of inflammation. Moreover, RvD1 promoted neutrophil efferocytosis and the differentiation of alternatively activated (M2) macrophages, indicating that RvD1 is not immunosuppressive. In a murine model of chronic cigarette smoke-induced emphysema, RvD1 inhibited smoke-induced airspace enlargement. Furthermore, RvD1-treated animals showed a reduction in chronic inflammation, oxidative stress, and cell death, highlighting the protective effects of RvD1 against chronic cigarette smoke exposure. An in vitro culture model was utilized to gain a better understanding of the mechanism by which RvD1 modulates pro-inflammatory signaling. In primary human small airway epithelial cells, RvD1 inhibited the production of proinflammatory mediators by blocking the phosphorylation of extracellular signalregulated kinases (ERK)-1and 2 and nuclear translocation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65, a response that is typically elicited by a viral mimetic ligand poly(I:C). Importantly, RvD1 attenuated the phosphorylation of transforming growth factor beta-activated kinase (TAK)-1, an upstream effector protein that regulates both the MAP-kinase and NF-κB pathways. Most importantly, RvD1 attenuated the formation of a poly(I:C)- mediated signaling complex composed of TAK1, TAK1-binding protein (TAB)-1, and tumor necrosis factor (TNF) receptor-associated factor (TRAF)-6. The final result was the inhibition of TAK1 activation. Overall, these results suggest that RvD1 targets multiple pro-inflammatory signaling pathways and may have significant therapeutic potential in the treatment of complex inflammatory diseases, including pulmonary fibrosis, asthma, and COPD

HCL Control Strategy for an Adaptive Roadway Lighting Distribution

This study aims to develop a human-centric, intelligent lighting control system using adaptive LED lights in roadway lighting, integrated with an imaging luminance meter that uses an IoT sensor driver to detect the brightness of road surfaces. AI image data are collected for luminance and vehicle conditions analyses to adjust the output of the photometric curve. Type-A lenses are designed for R3 dry roads, while Type-B lenses are designed for W1 wet roads, to solve hazards caused by slippery roads, for optimizing safety and for visual clarity for road users. Data are collected for establishing formulae to optimize road lighting. First, the research uses zonal flux analysis to design secondary optical components of LED roadway lighting. Based on the distribution of LED lights and the target photometric curve, the freeform surface calculation model and formula are established, and control points of each curved surface are calculated using an iterative method. The reflection coefficient of a roadway is used to design optical lenses that take into account the illuminance and luminance uniformity to produce photometric curves accordingly. This system monitors roadway luminance in real time, which simulates drivers’ visual experiences and uses the ZigBee protocol to transmit control commands. This optimizes the output of light according to weather and produces quality roadway lighting, providing a safer driving environment