The effect of RORa expression on the development of biological malignancy of urinary bladder cancer

Background: Morbidity and mortality relating to urinary bladder cancer have remained largely unchanged for many years. Similarly, the five-year survival rate in this disease has not improved considerably. New developments in individualized therapy necessitate the search for novel factors that could predict the development of malignancy in UBC. In this study, we provide the first evidence that the expression of ROR alpha transcription factor influences the development of malignancy in UBC. Materials and methods: 105 patients with stage pT1-pT4 urothelial bladder carcinoma who underwent cystectomy were included in the study. 4 μm tissue samples were stained immunohistochemically with a polyclonal anti-RORa antibody. The expression of RORa by the tumor cells (TCs) was assessed by counting TCs with a cytoplasmic and/or nuclear staining for RORa per 1000 TCs. The association between the extent of RORa expression and non-classic differentiation, tumor advancement (pT), grade (G) and regional lymph node spread was analyzed. Results: The cytoplasmic expression of RORa was detected in near all analyzed tumor samples (104/105). The extent of RORa expression was significantly higher in tumors which were more malignant with more propensity for non-classic differentiation and lymph node metastasis. We noted a lower percentage of TCs expressing RORa in poorly differentiated tumors (G3), compared to tumors moderately and higher differentiated (G1/G2). Conclusions: Our results suggest that RORa may play a significant role in the progression of urinary bladder cancer. RORa has a broad spectrum of regulatory activity relating to cell and tissue differentiation the mechanism of which is not fully understood. This study represents another step in the process of understanding the mechanisms of RORa regulation and highlights its potential role as a therapeutic target in urothelial bladder cancer

Expression of PD-L1 in tumor and immune system cells affects the survival of patients with urinary bladder cancer

Background: The prediction of tumor malignancy is still one of the most demanding diagnostic tasksin urinary bladder cancer because of its clinicopathological heterogeneity. The aim of this study was toevaluate the expression of PD-L1 in tumor cells (TCs) and immune effector cells (IECs) as well as thepattern of distribution of PD-L1+ IECs within the tumor (dispersed or aggregated) and their associationwith survival of patients with pT1-pT4 urinary bladder cancer.Materials and methods: 110 patients with stage pT1-pT4 urothelial bladder carcinoma who underwentradical cystectomy/cystoprostatectomy between 2011 and 2014 were included in the study. Paraffin blocksmost representative of the tumor were selected for H&E staining as well as immunostaining with the useof rabbit anti-PD-L1 (Ventana clone SP142, Roche). In each sample, the area of the tumor containing PDL1+IECs, as well as, the pattern of distribution (dispersed or aggregated) of PD-L1+ immune effectorcells within the tumor were analyzed. In addition, the expression of PD-L1 in TCs was also assessed.Results: Patients had a shorter survival time in pT2-pT4 cases without TCs expressing PD-L1 (p = 0.007)and/or when PD-L1+ IECs displayed a predominantly dispersed pattern of distribution (p = 0.013).Conclusions: The expression of PD-L1 on TCs and IECs is a prognostic factor which allows for stratificationof patient survival in UBC. The predominance of dispersed or aggregated pattern of distribution ofPD-L1+ IECs in the tumor may be considered as a new prognostic factor in pT1-T4 UBC and indicate thefunctional status of the immune system

WYKORZYSTANIE PLATFORMY CDE WE WSPÓŁPRACY ZESPOŁOWEJ W BIM

In project processes, group collaboration and project documentation management are important aspects. In order for the cooperation of all project participants to be effective, it should be based first and foremost on adequate and effective communication. All project participants should use such solutions so that they can exchange, manage and combine information quickly and efficiently throughout the entire investment process, thus providing a complete picture of the situation. To this end, it is necessary to develop a catalogue of good practices supported by a variety of examples, as well as rules for group cooperation when using a CDE-type solution. The aim of this article was to show the advantages and benefits as well as the disadvantages and limitations in group collaboration when working on a single BIM model.W procesach projektowych ważny aspekt stanowi współpraca grupowa oraz zarządzanie dokumentacją projektową. Aby współpraca wszystkich uczestników projektu była efektywna, powinna opierać się przede wszystkim na odpowiedniej i efektywnej komunikacji. Wszyscy uczestnicy projektu powinni używać takich rozwiązań, aby przez cały proces inwestycyjny mogli szybko i sprawnie wymieniać się informacjami, zarządzać nimi i łączyć je ze sobą, dostarczając w ten sposób kompletny obraz danej sytuacji. W tym celu konieczne jest opracowanie katalogu dobrych praktyk podpartych różnorodnymi przykładami oraz zasad współpracy grupowej przy stosowaniu rozwiązań typu CDE. Celem artykułu było pokazanie zalet i korzyści oraz wad i ograniczeń we współpracy grupowej podczas pracy na jednym modelu BIM

Stent fracture as a complication of superficial femoral artery stenting – a case report

Introduction: Peripheral artery disease (PAD) is an atherosclerotic vascular disease that results in obstruction of blood flow in the arteries other than those in the coronary circulation. PAD is often located in lower extremities, with patients presenting symptoms of intermittent claudication or critical lower limb ischemia. Angioplasty and stent implantation are often used in the treatment of PAD. Although these methods are considered as a low invasive and low risk, some factors may limit stent patency in the future. The fracture of the implanted stent may be one of these. Case report: A 68 old man, long-term smoker, with a history of chronic limb ischemia and many vascular surgeries because of PAD was admitted to the hospital with symptoms of the acute limb ischemia. Angiography showed a fracture of the stent implanted during the earlier hospitalization, with a fragment displacement to the left external iliac artery. The patient was successfully treated with catheter-directed thrombolysis. Discussion: Stent fracture is usually asymptomatic, however, it may cause complications, such as restenosis, pseudoaneurysm, perforation of the vessel, and in-stent embolism. The cumulative incidence of the femoropopliteal stent fracture varies from 2 to 65% in several studies. Incidence increases with stent length and is significantly lower in the second generation of nitinol stents, that was designed to have enhanced flexibility and durability

Unstable atherosclerotic plaque of the internal carotid artery in the case of a patient with high surgical risk treated endovascularly

Introduction: Internal carotid artery (ICA) stenosis in a majority is caused by atherosclerotic plaque. Symptoms of ICA stenosis manifest most likely a transient ischemic attack (TIA). The dynamics of ICA stenosis progression is unpredictable, the disease may progress quickly or slowly or remain stable for many years. The method of treatment implemented also depends on it. The task of pharmacological treatment is to reduce the progression of the disease and protect against the onset of stroke. Among the invasive methods of treating ICA stenosis, the standard procedure is endarterectomy of a carotid artery (CEA), i.e. surgical removal of atherosclerotic plaque. Another method of treatment is endovascular carotid artery stenting (CAS). CAS should be considered especially in the case of re-operated patients, also after radiotherapy and tracheostomy. CAS is a less invasive procedure, it avoids complications typical for CEA such as cranial nerve palsy or complications at the site of the wound. On the other hand, the risk of postoperative ischemic stroke is greater in the case of CAS. In recent years, the improved CAS method seems to be the implantation of dual-layered mesh-covered carotid stent systems (DLS). Case report: We present the case of a 69 old man, long-term smoker, with hypertension and coronary heart disease. In 2001 diagnosed with larynx cancer and underwent surgical laryngectomy and radiotherapy. He was admitted in scheduled mode due to symptomatic carotid artery stenosis. In USG examination there was visible stenosis of the right internal carotid artery (80%) caused by an unstable atherosclerotic plaque with irregular structure and thrombotic clots. Due to the obvious difficulties of performing endarterectomy following radiotherapy in the neck area and laryngectomy, the endovascular method has been considered. In spite of the unstable plaque, which is a contraindication to perform the endovascular procedures CAS has been decided to perform. The patient underwent implantation of a dual-layered carotid stent in the combination with proximal balloon occlusion protection with a MoMa device. After procedure arteriography confirmed the optimization of the carotid artery flow and the correct position of the stent. The treatment was carried out without complications. After a few days of hospitalization, the patient was discharged home. Discussion: The method of treatment of internal carotid artery stenosis is selected taking into consideration morphology and localization of atherosclerotic plaque, anatomical conditions and the local condition of the surgical area as well as the general condition of the patient and coexisting diseases. On the one hand, the patient underwent cervical radiotherapy and laryngectomy which are contraindications for CEA. On the other hand, an atherosclerotic plaque was unstable with the features of stratification which is a contraindication to the performance of CAS. In the described case it was decided to make implantation of dual-layered carotid stent system (DLS) connected with proximal balloon occlusion protection with a MoMa device allowed to reduce the risk of embolization