Stability Analysis for Autonomous Dynamical Switched Systems through Nonconventional Lyapunov Functions

The stability of autonomous dynamical switched systems is analyzed by means of multiple Lyapunov functions. The stability theorems given in this paper have finite number of conditions to check. It is shown that linear functions can be used as Lyapunov functions. An example of an exponentially asymptotically stable switched system formed by four unstable systems is also given

Chemo- and stereocontrolled alkylation of 1,2-disubstituted at the lower rim 1,2-alternate p-tert-butylthiacalix[4]arene

1,2-Alternate p-tert-butylthiacalix[4]arene bearing at the lower rim 1,2-positioned acetamide fragments reacts with ethyl bromoacetate to give mono-O-alkylation product when Na2CO3 is used as a base and O,O′,N,N′-tetraalkylation one in the case of K 2CO3. © 2011 Mendeleev Communications. All rights reserved

Fast optical variability of SS 433

We study the optical variability of the peculiar Galactic source SS 433 using the observations made with the Russian Turkish 1.5-m telescope (RTT150). A simple technique which allows to obtain high-quality photometric measurements with 0.3-1 s time resolution using ordinary CCD is described in detail. Using the test observations of nonvariable stars, we show that the atmospheric turbulence introduces no significant distortions into the measured light curves. Therefore, the data obtained in this way are well suited for studying the aperiodic variability of various objects. The large amount of SS 433 optical light curve measurements obtained in this way allowed us to obtain the power spectra of its flux variability with a record sensitivity up to frequencies of ~0.5 Hz and to detect its break at frequency =~2.4e-3 Hz. We suggest that this break in the power spectrum results from the smoothing of the optical flux variability due to a finite size of the emitting region. Based on our measurement of the break frequency in the power spectrum, we estimated the size of the accretion-disk photosphere as 2e12 cm. We show that the amplitude of the variability in SS 433 decreases sharply during accretion-disk eclipses, but it does not disappear completely. This suggests that the size of the variable optical emission source is comparable to that of the normal star whose size is therefore R_O \approx 2e12 cm \approx 30 R_sun. The decrease in flux variability amplitude during eclipses suggests the presence of a nonvariable optical emission component with a magnitude m_R=~13.2.Comment: 12 pages, 11 figures. Accepted for publication in Astronomy Letters. The original version in Russian is available at http://hea.iki.rssi.ru/rtt150/ru/ss433_pazh10/pss433_fast.pd

P-tert-Butyl thiacalix[4]arenes functionalized at the lower rim by amide, hydroxyl and ester groups as anion receptors

New p-tert-butyl thiacalix[4]arenes differently substituted at the lower rim with amide, hydroxyl and ester groups were synthesized. Binding properties of the compounds toward some tetrabutylammonium salts n-Bu4NX (X = F-, Cl-, Br-, I-, CH 3CO2 -, H2PO4 -, NO3 -) were studied by UV spectroscopy. It was found that the stoichiometry of the complexes, generally, is 1:1, and the association constants are in the range of 103-105 M-1. The p-tert-butyl thiacalix[4]arenes containing secondary amide groups trisubstituted at the lower rim bind the studied anions most effectively. Selective receptors for fluoride and dihydrogen phosphate salts of tetrabutylammonium were found. © 2011 The Royal Society of Chemistry

Лечение и прогноз больных переходноклеточным раком мочевого пузыря с метастазами в регионарные лимфоузлы

Objective: to assess the results of treatment and to identify the predictors of survival in patients with transitional cell carcinoma of the urinary bladder with regional lymph node metastasis.Material and methods. A retrospective analysis of 56 patients with transitional cell carcinoma of the bladder (pT1—4aN1—2M0—1,) who underwent radical cystectomy at the N.N. Blokhin Russian Cancer Center between 1980 and 2005 was performed. Their median age was 58.6 years; males and females were 85.7 and 14.3%, respectively. Studer`s (19.7%), Bricker`s (73.2%) procedures and ureterocutaneostomy (7.1%) were used for urinary divertion. Thirty-six (64.3%) of the 56 patients received additional treatment: neoadjuvant chemotherapy (CT) (n = 2 (3.6%)), adjuvant therapy (n = 32 (57.1%)); CT (n = 24 (42.8%)), and radiotherapy (n = 6 (10.7%)), chemoradiation therapy (n = 2 (3.6%)), and neo- and adjuvant CT (n = 2 (3.6%)). The median follow-up was 21.7 months (1-97.6 months).Results. The effect of neoadjuvant CT was assessed as stabilization in all cases. Less than 15 lymph nodes were removed in 27 (48.2%), 15 lymph nodes or more were removed in 29 (51.8%) patients. The category pN+ was diagnosed in all cases: pN1 in 19 (33.9%), pN2 in 37 (66.1%). Involvement of nonregional (paraaortic) lymph nodes (pM+) was detected in 3 (5.4%) patients. Recurrences developed in 41 (71.9%) of the 56 patients on an average of 11.8 months after termination of treatment: localized regional and distant metastases in 3 (5.3%) and 35 (61.4%) patients, respectively; their combination in 3 (5.3%). In all 56 patients, overall, tumor-specific, and relapse-free 5-year survival was 32.1, 34.0, and 17.9%, respectively. Univariate analysis indicated that a history of superficial carcinoma (p = 0.036), as well as nonregional lymphogenic metastases (p = 0.036), and additional treatment (p = 0.020) were significant predictors. There was a trend for better survival in patients with pT < 3a (p = 0.056), after removal of more than 15 lymph nodes (p = 0.084), Bricker's operation (p = 0.055), and adjuvant therapy (p = 0.065).Conclusion. Multimodal approach for transitional cell carcinoma of the urinary bladder with regional metastases improves tumor-specific 5-year survival as compared with that after radical cystectomy alone.

Брахитерапия рака предст ательной железы: сравнительная характеристика методик

The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC). The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT). Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary) (HDR-BT) and low-dose rate (permanent) (LDR-BT) brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.Внутритканевое введение источников излучения является самым «молодым» методом радикального лечения больных раком предстательной железы (РПЖ). Высокий уровень эффективности, сопоставимый с простатэктомией при существенно более низкой частоте осложнений обусловливает стремительный рост клинического использования брахитерапии (БТ). В зависимости от мощности источника излучения и способа его введения в предстательную железу различают два вида БТ – высокодозную (ВДБТ), характеризующуюся кратковременным внутритканевым введением источника высокой мощности дозы (временную), и низкодозную (НДБТ), при которой осуществляется перманентная установка источника низкой мощности дозы (постоянную). В основе этих 2 методов лежит единый принцип введения источника гамма-излучения непосредственно в опухоль. Вместе с тем методические и технические особенности ВДБТ и НДБТ обусловливают существенные различия в показаниях к их использованию, эффективности у больных с различной распространенностью и агрессивностью опухолевого процесса, а также в частоте, характере, степени выраженности и продолжительности нежелательных эффектов лечения

Когнитивная мпМРТ/ТРУЗИ fusion-биопсия предстательной железы с использованием компрессионной соноэластографии

Purpose. To evaluate the effectiveness of prostate cancer detection with method of cognitive mpMRI/TRUS fusion biopsy using strain sonoelastography.Materials and methods. Cognitive transrectal fusion biopsy of prostate was performed in 32 patients. According to the data of a preliminary conducted mpMRI, 33 foci suspicious of prostate cancer were included (PIRADSv2 = 3–5). Before the biopsy, all patients underwent ultrasound planning using compression sonoelastography.Results. The overall sensitivity was 76% for the targeted biopsy, and 49% for systematic biopsy. The number of biopsy specimens with a clinically significant Gleason grade in the targeted biopsy group was 85% of all columns with cancer specimens, in the systematic biopsy group this number was 68%. On average, the Gleason grade after targeted biopsy was 7.5 ± 0.9, and it was 7.2 ± 0.9 in the columns after systematic biopsy. On average, the percentage of tumor in the columns after targeted biopsy was 72% ± 29% and it was 55% ± 35% in the columns after systematic biopsy. The false positive for mpMRI was 15%. The overall sensitivity for the strain sonoelastography was 69% in this study, clinically significant cancer was detected in 71% of all columns with cancer specimens. False positive for elastography was observed in 18% of cases.Conclusion. Comparing with systematic biopsy, cognitive mpMRI / TRUS fusion biopsy can improve the detection rate of clinically significant prostate cancer and reduce the number of detected cases of clinically insignificant cancer. In cases of a total or subtotal tumor lesion in the peripheral zone detected on mpMRI, it is possible to take fewer columns for morphological verification of the tumor. The use of compression sonoelastography as an additional parameter of navigation in cognitive mpMRI/TRUS fusion biopsy can be considered as a promising way to increase the detection rate of clinically significant prostate cancer.Цель иследования: оценка эффективности обнаружения рака предстательной железы методом когнитивной мпМРТ/ТРУЗИ fusion-биопсии предстательной железы, в том числе с использованием компрессионной соноэластографии.Материал и методы. Когнитивная трансректальная fusion-биопсия предстательной железы проведена 32 п ациентам. По данным предварительно проведенной мпМРТ заподозрено 33 очага, подозрительных на рак предстательной железы (PI-RADSv2 = 3–5). Перед биопсией всем пациентам было выполнено ультразвуковое планирование с использованием компрессионной соноэластографии. Оценка результатов точности производилась по данным патоморфологического исследования биоптатов предстательной железы.Результаты. Общая чувствительность прицельной биопсии составила 76%, системной – 49%. Количество биоптатов с клинически значимой суммой Глисона в группе прицельной биопсии – 85% от столбиков с выявленной опухолью, в группе системной биопсии – 68%. В среднем сумма Глисона в прицельных столбиках – 7,5 ± 0,9, в системных – 7,2 ± 0,9. В среднем в прицельных столбиках процент опухоли составил 72,0 ± 29%, в системных – 55± 35%. При этом суммарный ложноположительный результат мпМРТ составил 15%. Общая чувствительность компрессионной соноэластографии в выявлении опухолевого очага составила 69%, клинически значимый рак выявлен в 71% всех столбиков с обнаруженной карциномой. Ложноположительный результат эластографии наблюдался в 18% случаев.Заключение. Когнитивная мпМРТ/ТРУЗИ fusionбиопсия способна улучшить обнаружение клинически значимого рака предстательной железы и уменьшить количество выявленных случаев клинически незначимого рака по сравнению с системной биопсией. При тотальном или субтотальном опухолевом поражении по данным мпМРТ для морфологической верификации опухоли возможно взятие меньшего количества столбиков. Применение компрессионной соноэластографии как дополнительного параметра навигации при когнитивной мпМРТ/ТРУЗИ fusion-биопсии может рассматриваться как перспективный способ повышения выявляемости клинически значимого рака предстательной железы

Subsequent therapy following pembrolizumab + axitinib or sunitinib treatment for advanced renal cell carcinoma (RCC) in the phase III KEYNOTE-426 study

Background: In the phase III KEYNOTE-426 study, pembrolizumab + axitinib showed significant improvement in OS, PFS, and ORR vs sunitinib in patients with RCC. This analysis assessed subsequent treatment in patients enrolled in KEYNOTE-426. Methods: Treatment-naive patients with clear cell RCC, KPS score �70%, and measurable disease (RECIST v1.1) were randomly assigned 1:1 to receive pembrolizumab 200 mg IV every 3 weeks for up to 35 doses + axitinib 5 mg orally twice daily or sunitinib 50 mg once daily (4 weeks on/2 weeks off) until progression, toxicity, or withdrawal. Type of and time to subsequent therapy were assessed. Results: Of patients in the pembrolizumab + axitinib arm and in the sunitinib arm, 81.4% (349/432) and 90.6% of patients (385/429), respectively, discontinued treatment; radiologic or clinical PD was the most common reason for discontinuation in both (pembrolizumab + axitinib: 65.0% [227/349]; sunitinib: 68.1% [262/385]). Of patients who discontinued, 58.5% of patients (204/349) in the pembrolizumab + axitinib arm and 73.0% (281/385) in the sunitinib arm received subsequent therapy (Table). Although a similar proportion of patients in both arms received subsequent therapy with a VEGF/VEGFR inhibitor (pembrolizumab + axitinib: 88.2% [180/204]; sunitinib: 68.7% [193/281]), a greater proportion of patients in the sunitinib arm (74.4% [209/281]) received subsequent PD-1/PD-L1 inhibitor therapy than in the pembrolizumab + axitinib arm (21.6% [44/204]). Of patients in the pembrolizumab + axitinib arm and the sunitinib arm, 32.4% (66/204) and 22.8% (64/281), respectively, received other therapies

ВЛИЯНИЕ ЗАДЕРЖКИ ДИАГНОСТИКИ НА ДОГОСПИТАЛЬНОМ ЭТАПЕ НА РЕЗУЛЬТАТЫ ЛЕЧЕНИЯ БОЛЬНЫХ С ГЕРМИНОГЕННЫМИ ОПУХОЛЯМИ ЯИЧКА В САНКТ-ПЕТЕРБУРГЕ

Over the past quarter-century germ cell tumors are one of the few cancers for which highly effective treatment is found. However there is a lack of awareness of young men and general practitioners about germ cell tumors which is often cause of late medical aid appealability and potential diagnostic errors. Reducing the time between patient's medical aid appealability and final diagnosis may contribute to the diagnostics of germ cell tumors in the early stages, reducing the amount of treatment and improving survival rates.За последние четверть века герминогенные опухоли (ГО) стали одним из немногих онкологических заболеваний, при которых возможно высокоэффективное лечение. Однако сохраняется недостаточная осведомленность молодых мужчин и врачей общей практики о герминогенных опухолях, что часто является причиной поздней обращаемости и возможных диагностических ошибок. Сокращение времени от обращения пациента до окончательной постановки диагноза может способствовать диагностике ГО яичка на ранних стадиях, уменьшению объема необходимых лечебных мероприятий и улучшению показателей выживаемости больных

Исследование безопасности и эффективности химиотерапии доцетакселом перед радикальной простатэктомией у больных раком предст ательной железы промежуточного и высокого риска (наблюдение в течение 11,4 года)

Objective. Our retrospective study is aimed to assess safety, pathological response rate, and long-term oncologic outcomes of radical prostatectomy after neoadjuvant chemotherapy for intermediate- to high-risk PCa.Materials and methods. Forty-four patients were involved in this study, with a 11.4-year follow-up period, on average. We assessed the RPE results in patients with intermediate and high risk of prostate cancer (PSA>10 ng/ml, Gleason score 7 and more, or clinical stage cT2c and more) after weekly treatment with docetaxel (36 mg/m2 for up to 6 cycles, 21 patients) and compared them with those in the second cohort (23 patients) who met oncologic inclusion criteria but received radical prostatectomy only. The long-term oncologic outcomes in both groups of the patients are reported.Results. Toxicity has been mostly grade 1-2 in intensity and grade 3 and more complication rate does not exceed 10%. A statistically significant of more than 50% reduction in PSA level (pre- vs. post-chemotherapy) was observed in 52.4% cases. During the 11.4-year follow-up period, improvement in cancer-specific survival (CSS) was noted in 90% of patients from the neoadjuvant chemotherapy group, as compared with 60.9% in radical prostatectomy only group. The biochemical recurrence-free survival (BCR) was 68.5 % and 37.7 %, and the overall survival (OS) was 75.5 % and 54.6 % in the combined treatment group and surgery only group, respectively. However, the differences in BCR and OS were not statistically significant.Conclusion. The use of neoadjuvant chemotherapy represents a safe and practicable treatment strategy resulting in reduced prostate volume and PSA level. Neoadjuvant docetaxel chemotherapy followed by radical prostatectomy was associated with higher observed BCR and OS, as compared with a surgical treatment only group. A statistically significant improvement of CSS is found in the combined treatment group. Therefore, the benefits of this treatment modality need to be validated for feasible implementation in the modern standard practices of prostate cancer treatment.Цель исследования – оценка безопасности, частоты патоморфологических изменений и длительных онкологических результатов при проведении радикальной простатэктомии (РПЭ) после неоадъювантной химиотерапии (НХТ) у больных раком предстательной железы (РПЖ) промежуточного и высокого риска.Материалы и методы. Нами проведен анализ результатов лечения 44 больных РПЖ, проводимого в период с 1998 по 2003 г. при средней длительности наблюдения 11,4 года. Мы оценили результаты РПЭ у больных РПЖ промежуточного и высокого риска (сТ2с–T3a и/или уровень простатспецифического антигена (ПСА) ≥ 10 нг/мл и/или сумма баллов по шкале Глисона ≥ 7) после еженедельного введения доцетаксела (в дозе 36 мг/м2, 6 циклов) и сравнили результаты с группой, в которой проводилось толькохирургическое лечение (n = 23). Критерием эффективности лечения были безрецидивная выживаемость (БРВ), раковоспецифическая (скорригированная) выживаемость (РСВ) и общая выживаемость (ОВ) в течение периода наблюдения 11,4 года.Результаты. Среди развившихся осложнений химиотерапии преобладала токсичность I–II степени, а частота III степени токсичности не превышала 10 %. Статистически значимое более чем на 50 % уменьшение уровня ПСА отмечено в 52,4 % случаев. При наблюдении 11,4 года РСВ составила 90 % в группе НХТ и 60,9 % в группе хирургического лечения (p = 0,042). БРВ составила 68,5 и 37,7 %, а ОВ – 75,5 и 54,6 % в группах комбинированного лечения и только оперативного лечения соответственно.Однако в отличие от РСВ различия в БРВ (p = 0,25) и ОВ (p = 0,09) не были статистически достоверны.Заключение. Использование НХТ представляет собой безопасный и эффективный метод лечения, приводящий к уменьшению объема предстательной железы и снижению уровня ПСА. НХТ с последующей РПЭ ассоциируется с более высокой БРВ и ОВ по сравнению с пациентами, перенесшими только хирургическое лечение. Отмечено статистически значимое улучшение РСВ в группе комбинированного лечения