Clustering as an integration pattern of business activity

The article deals with the analysis of business activity of companies and suggests the clustering as a key integration pattern of the central and peripheral region areas. Prerequisites of clustering formation and development are considered in the article. Moreover, the authors stressed that clustering increases the investment prospects of both the industry and the region.peer-reviewe

Thyroglossal duct cyst carcinoma

Not required for Clinical Vignette

Patterns of rapid weight loss in elite sambo athletes

Background: Rapid weight loss (RWL) is commonly practiced in combat sports. Both magnitude and methods used to induce RWL are largely similar among combat sports, but currently, there is no data on RWL methodology used by sambo athletes. Therefore, the aim of this study was to determine RWL procedures sambo athletes apply to lose weight rapidly. Methods: The sample consisted of 199 participants, of which 132 males and 67 females who participated in the World Sambo Championship 2020 held in Novi Sad, Serbia. Each participant received RWL questionnaire that was available in multiple languages, and every participant was instructed how to fill it out. Results: Almost 87% of sambo participants declared to have intentionally cut their weight prior to the competition, whereby 5.27 kg (SD: ±7.57) was lost. Gradual dieting, sauna use and skipping meals were the most dominant methods used to reduce weight prior to competition while more extreme methods of RWL such as the use of laxatives, diuretics, diet pills and vomiting were also implemented but by much smaller fragment of the participants involved. Conclusions: Findings from our study largely match with previously conducted RWL studies in terms of prevalence, magnitude and methods used by combat sport athletes, especially in judo and wrestling. Knowing the hazardous consequences of RWL, alternative methods of sustainable weight loss should be considered

The effect of local immunity on gastric cancer prognosis

Aim. To study the state of local immunity in patients with gastric adenocarcinoma. Materials and methods. From 2017 to 2018, 45 previously untreated patients with gastric adenocarcinoma (25 with stage IIII, 20 with stage IV) received surgical/combined treatment or chemotherapy, respectively, at the Blokhin Scientific Research Center of Oncology. Tumor tissue was taken before treatment. By using flow cytometry there were evaluated the percentage of tumor tissue infiltration by lymphocytes (CD45+CD14-TIL); T cells (CD3+CD19-TIL); B cells (CD3-CD19+TIL); NK cell (CD3-CD16+CD56+TIL); effector cells CD16 (CD16+Perforin+TIL) and CD8 (CD8+Perforin+TIL) with their cytotoxic potential active CD16TIL and active CD8TIL; subpopulations of regulatory T cells NKT cells (CD3+CD16+CD56+TIL), regulatory cells CD4 (CD4+CD25+CD127-TIL) and CD8 (CD8+CD11b-CD28-TIL). The prognostic value of immune cells for overall survival (OS) and progression-free survival (PFS) was assessed. Results. A favorable prognosis factor for progression-free survival in patients with local and locally advanced forms of gastric cancer was an increase in the number of CD3-CD19+TIL (HR 0.862, 95% CI 0.7820.957, p=0.005), and an unfavorable prognosis was an increase in NK cells (CD3-CD16+CD56+TIL); HR 1.382, 95% CI 1.0871.758, p=0.008. The negative effect of the relative content of NK cells (CD3-CD16+CD56+TIL) and NKT cells (CD3+CD16+CD56+TIL) on OS of patients with metastatic gastric cancer noted (HR 1.249, 95% CI 0.9971.564, p=0.053; HR 1.127, 95% CI 1.0251.239, p=0.013). At the same time, an increase in the percentage of tumor tissue infiltration by lymphocytes (CD45+CD14-TIL) and an increase in the age of patients (HR 1.005, 95% CI 1.0021.008, p=0.003; HR 1.098, 95% CI 1.0311.170, p=0.004) reduce the incidence of PFS in patients with metastatic gastric carcinoma. Conclusion. Indices of local immunity can serve as additional prognostic factors for gastric carcinoma

How to Tackle Integer Weighted Automata Positivity

International audienceThis paper is dedicated to candidate abstractions to capture relevant aspects of the integer weighted automata. The expected effect of applying these abstractions is studied to build the deterministic reachability graphs allowing us to semi-decide the positivity problem on these automata. Moreover, the papers reports on the implementations and experimental results, and discusses other encodings

Мутации изоцитратдегидрогеназ 1 и 2 и ме тилирование гена MGMT в глиомах

Gliomas are the most common brain tumors. It is difficult to detect them at early stages of disease and there is a few available therapies providing significant improvement in survival. Mutations of isocitrate dehydrogenase 1 and 2 genes (IDH1 and IDH2) play significant role in gliomogenesis, diagnostics and selection of patient therapy. We tested the distribution of IDH1 and IDH2 mutations in gliomas of different histological types and grades of malignancy by DNA melting analysis using our protocol with a sensitivity of 5 %. The results of this assay were confirmed by conventional Sanger sequencing. IDH1/2 mutations were detected in 74 % of lower grade gliomas (II and III, World Health Organization) and in 14 % of glioblastomas (IV, World Health Organization). Mutation rate in gliomas with oligodendroglioma component were significantly higher then in other glioma types (р = 0.014). The IDH1 mutations was the most common (79 % of general mutation number). IDH1/2 mutations can induce aberrant gene methylation. Detection of methylation rate of the gene encoding for O6-methylguanine-DNA-methyltransferase (MGMT), predictive biomarker for treatment of gliomas with the alkylating agents, has demonstrated a partial association with IDH1/2 mutations. In 73 % of IDH1/2-mutant tumors MGMT promoter methylation were observed. At the same time IDH1/2 mutations were not revealed in 67 % tumors with MGMT promoter methylation. These results indicate existence of another mechanism of MGMT methylation in gliomas. Our data strong support for necessity of both markers testing when patient therapy is selected.Глиомы – наиболее распространенные опухоли головного мозга, трудно поддающиеся ранней диагностике и лечению. Мутации в генах изоцитратдегидрогеназ 1 и 2 (IDH1 и IDH2) играют существенную роль в глиомогенезе, диагностике и выборе терапии пациентов. Было исследовано распределение мутаций IDH1 / 2 в глиомах различных гистологических типов и степеней злокачественности методом анализа кривых плавления ДНК с зондами TaqMan по разработанному нами протоколу, позволяющему определять мутации с чувствительностью 5 %. Специфичность определения мутаций подтверждена секвенированием по Сэнгеру. В глиомах II и III степеней злокачественности по классификации Всемирной организации здравоохранения частота мутаций IDH1 / 2 составила 74 %, в глиобластомах (IV степень злокачественности) – 14 %. Глиомы, содержащие клетки с олигодендроцитарным типом дифференцировки, достоверно чаще имели мутации IDH1 / 2, чем другие типы глиом (р = 0,014). Преобладающим типом мутаций являются мутации IDH1 (79 % от общего числа мутаций). Одно из последствий мутаций IDH1 / 2 – индукция аберрантного метилирования генов. Анализ метилирования промотора гена О6‑метилгуанин-ДНК-метил-трансферазы (MGMT, O6‑methylguanine-DNA-methyltransferase), предсказательного маркера чувствительности глиом к терапии алкилирующими агентами у тех же больных, показал частичную ассоциацию с мутациями IDH1 / 2. В 73 % случаев с мутациями IDH1 / 2 наблюдалось метилирование MGMT. В то же время в 67 % случаев с метилированием MGMT отсутствовали мутации IDH1 / 2, что указывает на существование других механизмов метилирования MGMT в глиомах. Данные свидетельствуют в пользу необходимости одновременного определения 2 биомаркеров при выборе послеоперационной терапии пациентов

Лапароскопическая резекция почки с использованием тулиевого волоконного лазера без тепловой ишемии

Background. Laparoscopic partial nephrectomy (LPN) in the treatment of small kidney tumors is widespread, but the operation is associated with warm ischemia, which adversely affects the functional state of the kidney. Research is underway on methods of partial nephrectomy with a reduction of thermal ischemia or zero ischemia. The laser energy is one of the directions in the search for options for LPN. The aim of our work is to improve the LPN using a thulium laser.Materials and methods. From 2017 to 2019 a LPN was performed for 16 patients with small tumors, using the thulium laser with a wavelength of 1.94 ^m. There were men 7 (43.8 %), women — 9 (56.2 %), average age was 51 (39—68) years, average kidney tumor size was 24.9 (15—40) mm. The evaluation of laser resectability on the RENAL scale was carried out using 3D modeling. We used the laparoscopic laser aspirator-irrigator to reduce smoke generation during the procedures.Results. The average time of LPN using a fiber thulium laser was 97.5 (70—131) min. The time for kidney resection was 25.6 (10—40) min. 14 (87.5 %) procedures performed completely without warm ischemia. The average blood loss during surgery was 111.3 (50—250) ml. The duration of postoperative treatment was 7.1 (5—9) days. A positive surgical margin was not observed. Histological examination revealed renal cell carcinoma in 14 (87.5 %) patients, G2 — 10 (71.4 %), G2 — 4 (28.6 %). When examining glomerular filtratoin rare in the operated patients after procedures, no changes were observed.Conclusion. The use of the thulium laser for LPN allows perform the procedure without warm ischemia in selected patients with a predominantly extrarenal tumor location. The use of a laparoscopic instrument the laser aspirator-irrigator with a drip water supply and simultaneous aspiration reduced smoke generation during laser thulium resection, the operation performed under conditions of improved visualization, which prevents the danger of a positive surgical edge. Further monitoring of the results of applying the method of thulium laser LPN is required.Введение. Лапароскопическая резекция почки (ЛРП) при лечении небольших опухолей почки получила большое распространение, однако операция связана с тепловой ишемией почки, что неблагоприятно сказывается на функциональном состоянии оперированного органа. Ведутся исследования методов резекции почки с уменьшением или полным отсутствием тепловой ишемии, в том числе с использованием лазерной энергии.Материалы и методы. С 2017 г. ЛРП с использованием тулиевого лазера длиной волны 1,94 мкм выполнена 16 пациентам (7 (43,8 %) мужчин и 9 (56,2 %) женщин). Средний возраст больных составил 51 (39—68) год. Средний размер опухоли почки — 24,9 (15—40) мм. Оценку резектабельности проводили по нефрометрической шкале RENAL с использованием трехмерного моделирования. Для уменьшения дымообразования во время операции применяли лапароскопический инструмент — лазерный аспиратор-ирригатор.Результаты. Среднее время операции составило 97,5(70—131) мин, время резекции почки с использованием лазера — 25,6 (10—40) мин. Без тепловой ишемии проведено 14 (87,5 %) операций, у 2 (12,5 %) пациентов время тепловой ишемии составило 7,5 (7—8) мин. Средний объем кровопотери во время операции — 111,3 (50—250) мл. При гистологическом обследовании в 14 (87,5 %) случаях обнаружена почечно-клеточная карцинома градации Gjу 10 (71,4 %) и G2у 4 (28,6 %) пациентов, в 2 (12,5 %) случаях — ангиолипома почки. Случаев положительного края резекции не отмечено. Длительность послеоперационного лечения составила 7,1 (5—9) дня. При изучении скорости клубочковой фильтрации прооперированных пациентов в ближайшем и отдаленном послеоперационном периоде существенных изменений не наблюдали.Заключение. Применение волоконного тулиевого лазера для ЛРП позволяет выполнить операцию без тепловой ишемии почки у строго отобранных больных. Использование лазерного аспиратора-ирригатора с капельной подачей воды и одновременной аспирацией позволяет уменьшить дымообразование при лазерной тулиевой резекции, операция проводится в условиях улучшенной визуализации, что предотвращает опасность получения положительного края резекции. Требуется дальнейшее наблюдение за результатами применения метода тулиевой лазерной ЛРП

Анализ системного иммунитета и воспаления в прогнозе аденокарциномы желудка

Objective: to study the state of cellular immunity in patients with gastric adenocarcinoma.Materials and methods. From 2017 to 2018, 45 previously untreated patients with gastric adenocarcinoma (25 with stage I–III, 20 with stage IV) received surgical / combined treatment or independent chemotherapy, respectively, at the N. N. Blokhin National Medical ResearchCenter of Oncology. Peripheral blood sampling was carried out before starting treatment. We studied the cellular composition of peripheral blood, as well as systemic immunity parameters determined by flow cytometry (CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+/CD8+; CD3–CD16+CD56+; CD3–CD19+), and their prognostic significance in relation to overall survival and progression-free survival.Results. The prognostic value of the relative indicator of platelet lymphocytic index was determined: progression-free survival in patients with a high level of platelet-lymphocytic index (>208.7) was higher: 8.1 months versus 4.5 months (p = 0.0027). A favorable prognosis for overall survival was an increase in the number of CD3–CD19+ lymphocytes (hazard ratio (HR) 0.91; 95 % confidence interval (CI) 0.85–0.97; p = 0.007), and an unfavorable prognosis was an increase in the number of neutrophils (HR 1.26; 95 % CI 1.05–1.50; p = 0.012), platelet count (HR 1.01; 95 % CI 1.0–1.01; p = 0.043), as well as an increase in the number of NK cells (HR 1.04, 95 % CI 1.0–1.09; p = 0.029).Conclusion. Indicators of the cellular composition of peripheral blood, characterizing a systemic inflammatory reaction, as well as indicators of systemic immunity, can serve as additional prognostic factors for gastric cancer.Цель исследования – изучить состояние клеточного иммунитета у больных аденокарциномой желудка.Материалы и методы. С 2017 по 2018 г. в НМИЦ онкологии им. Н. Н. Блохина 45 ранее нелеченных больных аденокарциномой желудка (25 – с I–III стадиями, 20 – с IV стадией) получили хирургическое / комбинированное лечение или самостоятельную химиотерапию соответственно. Забор периферической крови осуществляли перед началом лечения. Исследовали клеточный состав периферической крови, а также параметры системного иммунитета, определенных методом проточной цитометрии (CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+/CD8+; CD3–CD16+CD56+; CD3–CD19+), и их прогностическую значимость в отношении показателей общей выживаемости и выживаемости без прогрессирования.Результаты. Высокий (>208,7) уровень тромбоцитарно-лимфоцитарного индекса ассоциировался с высокими показателями выживаемости без прогрессирования (медиана 8,1 мес против 4,5 мес (р = 0,0027)). Фактором благоприятного прогноза в отношении общей выживаемости явилось повышение числа CD3–CD19+-лимфоцитов (отношение рисков (ОР) 0,91; 95 % доверительный интервал (ДИ) 0,85–0,97; р = 0,007), а неблагоприятного прогноза – повышение числа нейтрофилов (ОР 1,26; 95 % ДИ 1,05–1,50; р = 0,012), числа тромбоцитов (ОР 1,01; 95 % ДИ 1,0–1,01; р = 0,043), а также числа NK-клеток (ОР 1,04; 95 % ДИ 1,0–1,09; р = 0,029).Заключение. Показатели клеточного состава периферической крови, характеризующие системную воспалительную реакцию, а также показатели системного иммунитета могут служить дополнительными прогностическими факторами при раке желудка

Первый опыт применения лапароскопической цистэктомии в лечении инвазивного рака мочевого пузыря

Objective. Radical cystectomy is the gold standart in the treatment of muscle invasive bladder cancer. We report our initial experience with laparoscopic cystectomy with low-invasive laparotomy and formation of the neobladder by Studer. Results were compared with traditional cystectomy. Materials and Methods. Since 2003 five patients (1) underwent a laparoscopic cystectomy at our hospital. All patients were male (with a mean age of 57(51—67) and had T2N0M0 stage bladder cancer (G1-2). The procedure consists of two parts: 1 — laparoscopic mobilization of the bladder, ureters, prostate glang and vesicles; 2 — low invasive laparotomy (length 4—5 cm) with special tools and illumination, extraction of the bladder and formation of the neobladder by Studer. Traditional cystectomy (2) with orthotopic neobladder has been applied to 49 patients. There were 45 males and 4 females. Mean age was 62,7 (39—74). Results. In the first group (1) the mean time of procedure was 505 (430—570) min. Blood loss was between 150—300 ml. There were not serious postoperative complications. Function of intestines was restored in 4 days. The ureteral drainages were removed on 14 day, urethral catheters — on 16 postoperative day. Urodynamic studies after procedure revealed Q max — 18,4 (17—19) ml/sec. In the second group (2) the mean time of procedure was 306 (246—350) min. Blood loss was between 615 (300—1200) ml. Function of intestines was restored in 7 days. Conclusions. Our initial results indicate, that a laparoscopic cystectomy is an effective surgical method, which is less invasive and deleterious in comparison with open cystectomy.