Ten-year experience of transbronchial endosonography in single center

Objective Transbronchial endosonography (EBUS) is a relatively new method for diagnosing of the pathological condition of the thoracic organs. Analysis of 10 years of our experience in the use of transbronchial endosonography in a specialized center.Material and Methods During the period from April 2010 to April 2020, 756 transbronchial endosonographies were conducted on 756 patients. The studies were carried out for various indications: 1) Group 1 (483) – transbronchial puncture of the lymph nodes in order to obtain morphological confirmation of the etiology; 2) Group 2 (260) – staging of suspected or verified lung cancer to determine the descriptor N; 3) Group 3 (13) – a study that ended only with obtaining an endosonographic image. All patients underwent transbronchial endosonography using the special ultrasound bronchoscope EB-1970UK (Pentax Corp.) and the ultrasound scanner EUB 5000 Plus G OB/GYN – Vascular Ultrasound (HITACHI Corp.).Results General information content was 78%; verification of mediastinal lymphadenopathy was 72% (57, 79, 58% for smears, cytoblocks and smears + cytoblocks, cytoblocks vs smears + cytoblocks, p < 0.05). Verification of local changes in the mediastinum – 66%; verification of peribronchial tumor – 87%. Lung cancer staging – 87% (82, 88, 86% for smears, cytoblocks vs smears + cytoblocks, respectively, р > 0.05)Conclusion Тhe diagnostic utility of EBUS for the verification of mediastinal lymphadenopathy can range from 37,5 to 83% and rise with increasing experience for all persons involved. The use of cytoblocks showed the best results. The diagnostic utility of staging varies from 60 to 100% and does not depend on the method of processing the aspiration material

Simulations of M87 and Sgr A* imaging with the Millimetron Space Observatory on near-Earth orbits

High resolution imaging of supermassive black holes shadows is a direct way to verify the theory of general relativity at extreme gravity conditions. Very Long Baseline Interferometry (VLBI) observations at millimeter/sub-millimeter wavelengths can provide such angular resolution for supermassive black holes, located in Sgr A* and M87. Recent VLBI observations of M87 with the Event Horizon Telescope (EHT) has shown such capabilities. The maximum obtainable spatial resolution of EHT is limited by Earth diameter and atmospheric phase variations. In order to improve the image resolution longer baselines are required. Radioastron space mission has successfully demonstrated the capabilities of Space-Earth VLBI with baselines much larger than Earth diameter. Millimetron is a next space mission of the Russian Space Agency that will operate at millimeter wavelengths. Nominal orbit of the observatory will be located around Lagrangian L2 point of the Sun-Earth system. In order to optimize the VLBI mode, we consider a possible second stage of the mission that could use near-Earth high elliptical orbit (HEO). In this contribution a set of near-Earth orbits is used for the synthetic space-ground VLBI observations of Sgr A* and M87 in joint Millimetron and EHT configuration. General-relativistic magnetohydrodynamic models (GRMHD) for black hole environment of Sgr A* and M87 are used for static and dynamic imaging simulations at 230 GHz. A comparison preformed between ground and space-ground baselines demonstrates that joint observations with Millimetron and EHT significantly improve the image resolution and allow the EHT+Millimetron to obtain snapshot images of Sgr A* probing dynamics at fast timescales.Comment: 12 pages, 6 figure

Immunosuppressive potential of human amnion epithelial cells in the treatment of experimental autoimmune encephalomyelitis

BACKGROUND: Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system (CNS). In recent years, it has been found that cells such as human amnion epithelial cells (hAECs) have the ability to modulate immune responses in vitro and in vivo and can differentiate into multiple cell lineages. Accordingly, we investigated the immunoregulatory effects of hAECs as a potential therapy in an MS-like disease, EAE (experimental autoimmune encephalomyelitis), in mice. METHODS: Using flow cytometry, the phenotypic profile of hAECs from different donors was assessed. The immunomodulatory properties of hAECs were examined in vitro using antigen-specific and one-way mixed lymphocyte proliferation assays. The therapeutic efficacy of hAECs was examined using a relapsing-remitting model of EAE in NOD/Lt mice. T cell responsiveness, cytokine secretion, T regulatory, and T helper cell phenotype were determined in the peripheral lymphoid organs and CNS of these animals. RESULTS: In vitro, hAECs suppressed both specific and non-specific T cell proliferation, decreased pro-inflammatory cytokine production, and inhibited the activation of stimulated T cells. Furthermore, T cells retained their naïve phenotype when co-cultured with hAECs. In vivo studies revealed that hAECs not only suppressed the development of EAE but also prevented disease relapse in these mice. T cell responses and production of the pro-inflammatory cytokine interleukin (IL)-17A were reduced in hAEC-treated mice, and this was coupled with a significant increase in the number of peripheral T regulatory cells and naïve CD4+ T cells. Furthermore, increased proportions of Th2 cells in the peripheral lymphoid organs and within the CNS were observed. CONCLUSION: The therapeutic effect of hAECs is in part mediated by inducing an anti-inflammatory response within the CNS, demonstrating that hAECs hold promise for the treatment of autoimmune diseases like MS

Management of patients with multidrug-resistant tuberculosis

Funding Information: JH and CL are supported by the German Center for Infection Research (DZIF). TS is supported by The Swedish Heart and Lung Foundation and the Swedish Research Council. KD is supported by the South African Medical Research Council and the European Union (EDCTP) Publisher Copyright: © 2019 The Union.The emergence of multidrug-resistant tuberculosis (MDR-TB; defined as resistance to at least rifampicin and isoniazid) represents a growing threat to public health and economic growth. Never before in the history of mankind have more patients been affected by MDRTB than is the case today. The World Health Organization reports that MDR-TB outcomes are poor despite staggeringly high management costs. Moreover, treatment is prolonged, adverse events are common, and the majority of affected patients do not receive adequate treatment. As MDR-TB strains are often resistant to one or more second-line anti-TB drugs, in-depth genotypic and phenotypic drug susceptibility testing is needed to construct personalised treatment regimens to improve treatment outcomes. For the first time in decades, the availability of novel drugs such as bedaquiline allow us to design potent and well-tolerated personalised MDR-TB treatment regimens based solely on oral drugs. In this article, we present management guidance to optimise the diagnosis, algorithm-based treatment, drug dosing and therapeutic drug monitoring, and the management of adverse events and comorbidities, associated with MDRTB. We also discuss the role of surgery, physiotherapy, rehabilitation, palliative care and smoking cessation in patients with MDR-TB. We hope that incorporating these recommendations into patient care will be helpful in optimising treatment outcomes, and lead to more MDRTB patients achieving a relapse-free cure.publishersversionPeer reviewe

Non-perturbative approximations of path integrals with some applications to quantum statistics

Some methods for constructing uniform non-perturbative approximations of path integrals over a conditional Wiener measure are examined. The relation of these methods and the results obtained with their help to the ones known in the literature is established. The concrete analytical procedures and the formulae for the corresponding approximations are constructed and some applications in quantum statistical mechanics are considered. © 1994 Società Italiana di Fisica

International Effort Helps Decipher Mysteries of Paleoclimate from Antarctic Ice Cores

Ice cores drilled at Vostok Station, Antarctica, and studied over the past 10 years by Russia, France, and the United States (Figure 1) are providing a wealth of information about past climate and environmental changes over more than a full glacial-interglacial cycle. The ice cores show that East Antarctica was colder and drier during glacial periods than during the Holocene and that large-scale atmospheric circulation was more vigorous during glacial times. They also support evidence from deep-sea sediment studies favoring orbital forcing of Pleistocene climate, reveal direct correlations of carbon dioxide and methane concentrations with temperature, and indicate how the accumulation of trace compounds have changed through time

International Effort Helps Decipher Mysteries of Paleoclimate From Antarctic Ice Cores

International audienceIce cores drilled at Vostok Station, Antarctica, and studied over the past 10 years by Russia, France, and the United States (Figure 1) are providing a wealth of information about past climate and environmental changes over more than a full glacial-interglacial cycle. The ice cores show that East Antarctica was colder and drier during glacial periods than during the Holocene and that large-scale atmospheric circulation was more vigorous during glacial times. They also support evidence from deep-sea sediment studies favoring orbital forcing of Pleistocene climate, reveal direct correlations of carbon dioxide and methane concentrations with temperature, and indicate how the accumulation of trace compounds have changed through time