RADIOLOGY OF UROLOGICAL COMPLICATIONS AFTER TREATMENT OF PELVIC TUMORS. PART I. URINARY FISTULAS

Urinary fistulas complicating treatment of pelvic tumors are the clinical diagnostic problem that needs research and decision. The top-priority radiological method for diagnostic urinary fistulas is computed tomography. About application magnetic resonance imaging (MRI) is less well knows. The possibilities MRI to diagnostic of urinary fistulas are illustrated in the article; we discuss the limitation of method requiring additional use of other radiological methods. A literature search on the topic of research was carried out on the databases PubMed and eLIBRARY

Компьютерная томография в оценке глубины опухолевой инвазии рака ободочной кишки

Objective: to study the symptoms of tumor lesions of colon and to determine the CT criteria for assessing the depth of tumor invasion in patients with colon cancer.Materials and methods. CT data were analyzed at 121 patients with colon cancer. All patients were fully resected and CT data were compared with data of morphological studies. Staging was performed according to TNM classification 7th ed. (2009).Results. We evaluated CT symptoms of tumor lesions in comparison with the data of pathological category T (pT): type of tumor, its structure, the condition of the external colon contour, the state of paracolon fat and its density, the presence of fat image between the tumor and adjacent organs and tissues, CT signs of invasion of malignant process in the neighboring organs and adjacent structures. For tumors with extraintestinal growth (T3–4 category) are characteristic CT symptoms: tumor heterogeneous structure (p < 0.001) with a fuzzy outer contour of the colon in the affected area (p < 0.05), the presence of changes in the paracolon fat whose density −76,95 HU and more, the invasion into adjacent organs at T4 category. The diagnostic efficiency of CT in determining T3–4 category was as follows: 90.9% accuracy, sensitivity 93.6%, specificity of 81.5%.Conclusions. Computed tomography is a highly informative method for determining extraorgan spread of colon cancer, which allows to determine the amount of preoperative surgical treatment and adjust treatment tactics.Цель исследования: изучить симптомы опухолевого поражения ободочной кишки и определить компьютерно-томографические (КТ) критерии для оценки глубины опухолевой инвазии у больных раком ободочной кишки.Материал и методы. Проанализированы КТ-данные 121 больного раком ободочной кишки. Все больные были радикально прооперированы и КТ-данные сопоставлены с результатами морфологического исследования. Стадирование проводили по классификации TNM (7-я редакция, 2009).Результаты. Проведена оценка КТ-симптомов опухо левого поражения в сравнении с данными патоморфологической категории Т (pT): вид опухоли, ее структура, состояние наружного контура кишки на уровне опухоли, состояние окружающей клетчатки и ее денситометрическая плотность, наличие изображения жировой клетчатки между опухолью и прилежащими органами и тканями, КТ-признаки инвазии злокачественного процесса в соседние органы и прилежащие структуры. Для опухолей с внекишечным ростом (категории Т3–4) характерны КТ-симптомы: опухоли неоднородной структуры (p < 0,001) с нечетким наружным контуром кишки в зоне поражения (p < 0,05), наличие изменения окружающей опухоль параколической клетчатки, плотность которой более −76,95 ед.Н, признаки инвазии в соседние органы при категории Т4. Диагностическая эффективность КТ при определении категории Т3–4 составила: точность – 90,9%, чувствительность – 93,6%, специфичность – 81,5%.Заключение. КТ является высокоинформативным методом для определения внеорганного распространения рака ободочной кишки, что позволяет на дооперационном этапе определить объем хирургического лечения и скорректировать тактику лечения

ЛОКАЛИЗОВАННЫЙ РАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ: ВОЗМОЖНОСТИ МАГНИТНО-РЕЗОНАНСНОЙ ТОМОГРАФИИ С ГИБКОЙ МАТРИЧНОЙ КАТУШКОЙ В ВЫЯВЛЕНИИ МИНИМАЛЬНОГО ЭКСТРАКАПСУЛЯРНОГО РАСПРОСТРАНЕНИЯ ОПУХОЛИ

Retrospective assessment of preoperative magnetic resonance imaging (MRI) data in 37 patients with prostate cancer, who had undergone radical prostatectomy, established the most diagnostically valuable MRI signs of minimal extracapsular spread (ECS): asymmetry of neurovascular fascicles (72 % accuracy, 93 % sensitivity, 77 % specificity, 73 % positive and 94% negative predictive values) and iron outline deformity/irregularity (66/80/64/60/82 %, respectively); as well as their higher diagnostic efficiency versus the clinical and laboratory predictors of ECS: total Gleason scores (58/87/55/57/86 %, respectively) and serum PSA levels (uninformative), which permits their consideration while choosing a more or less radical prostatectomy modality.При ретроспективной оценке дооперационных магнитно-резонансных (МР) томограмм 37 больных раком предстательной железы, которым была выполнена радикальная простатэктомия, установлены наиболее диагностически эффективные МР-признаки минимального экстракапсулярного распространения (ЭКР): асимметрия сосудисто-нервных пучков (точность 72 %, чувствительность 93 %, специфичность 77 %, прогностичность положительного и отрицательного результатов 73 и 94 %) и деформация/неровность контура железы (66/80/64/60/82 % соответственно) и установлена их более высокая диагностическая эффективность в сравнении с клинико-лабораторными предикторами ЭКР: суммой баллов по шкале Глисона (58/87/55/57/86 % соответственно) и уровнем простатспецифического антигена в сыворотке крови (неинформативен), что позволяет учитывать их при выборе более или менее радикального варианта иссечения предстательной железы

РЕЗУЛЬТАТЫ ДООПЕРАЦИОННОГО ОПРЕДЕЛЕНИЯ МЕСТНОЙ РАСПРОСТРАНЕННОСТИ РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ С ПОМОЩЬЮ МАГНИТНО-РЕЗОНАНСНОЙ ТОМОГРАФИИ У ПАЦИЕНТОВ, КОТОРЫМ БЫЛА ВЫПОЛНЕНА РАДИКАЛЬНАЯ ПРОСТАТЭКТОМИЯ

The values of the diagnostic efficiency and consistency of preoperative evaluations of locally advanced prostate cancer (PC) by magnetic resonance imaging (MRI) with a matrix coil were estimated in 37 patients with PC who had undergone radical prostatectomy. The accuracy of differentiation of T3 and T2 stages in prospective and retrospective assessments was 59 and 73 %; the sensitivity was 7 and 40 %, and the specificity was 96 and 9 %, respectively; with the moderate consistency of evaluations.Определены показатели диагностической эффективности и согласованности дооперационных оценок местной распространенности рака предстательной железы (РПЖ) с помощью магнитно-резонансной томографии с матричной катушкой у 37 больных РПЖ, которым была выполнена радикальная простатэктомия. Точность дифференциации Т3 и Т2 стадий при проспективнойи ретроспективной оценках составила 59 и 73 % , чувствительность 7 и 40 %, специфичность 96 и 96 % соответственно, при умеренной согласованности оценок

ИНТЕНСИВНОСТЬ ОБРАЗОВАНИЯ ТРОМБИНА У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА ПОСЛЕ КОРОНАРНОГО СТЕНТИРОВАНИЯ

This study is aimed at exploring the use of thrombin generation assay (TGA) in platelet-poor plasma to assess the contribution of the protein C system to the hypercoagulation development in patients with coronary heart disease (CHD) after intracoronary stenting. The study material, the venous blood, was taken in 63 patients with CHD at the age of 53 to 77 before and on Day 1 after the planned percutaneous coronary intervention (PCI) who were treated with antiplatelet agents and antithrombotic agents in standard doses, and in 35 subjects of comparable age and sex without clinical manifestations of CHD who were not treated with these drugs for any other purpose. Laboratory examination included the standard coagulologic tests. To assess the effects of activated protein C system, the TGA in platelet poor plasma was modified by adding human recombinant trombomodulin (rh-TM) to the reaction mixture. The standard coagulologic tests revealed changes in hemostasis relevant to the pathogenesis of CHD and the effects of antithrombotic agents. The TGA results showed an increase in ETP and Peak Thrombin in patients with CHD after PCI with respect to the control and initial values which is evidence of the increased coagulation after the intervention. The test results also showed a reduction of TGA values per cent decline when adding TM. The ETR, Peak thrombin and ttPeak per cent decline was the most significant under the influence of TM which was evidence of the contribution of protein C activity reduction to the development of hypercoagulation after PCI. The modified TGA in platelet-poor plasma used in this study can be applied in clinical practice for estimating the plasma-coagulation hemostasis status and reduction in sensitivity to TM, which characterizes the protein C system activity by degree of decrease in results of the test that was performed in plasma without and with the addition of rh-TM.Цель исследования — изучить возможности использования теста генерации тромбина (ТГТ) в бедной тромбоцитами плазме для оценки вклада системы протеина С в развитие гиперкоагуляции у больных ИБС после интракоронарного стентирования. Материалом для исследования являлась венозная кровь 63 больных ИБС в возрасте от 53 до 77 лет, полученная до и через сутки после планового чрескожного коронарного вмешательства (ЧКВ), получавших антиагрегантные и антикоагулянтные препараты в стандартных дозировках, а также 35 человек, сопоставимых по полу и возрасту, без клинических проявлений ИБС и не получавших данные препараты с какой-либо другой целью. При обследовании выполнялись стандартные коагулогические исследования. Для оценки влияния системы активированного протеина С постановка ТГТ в бедной тромбоцитами плазме была модифицирована добавлением в реакционную смесь человеческого рекомбинантного тромбомодулина (rh-TM). Стандартные коагулогические тесты выявили изменения гемостаза, соответствующие патогенезу ИБС и действию антитромботических препаратов. Среди показателей ТГТ было выявлено увеличение ЕТР и Peak thrombin у больных ИБС после ЧКВ по отношению к контрольным и к исходным значениям, что свидетельствовало об усилении гиперкоагуляции после вмешательства. Также было выявлено уменьшение процента снижения показателей ТГТ при добавлении ТМ. Наиболее значимым под воздействием ТМ оказалось уменьшение процента снижения ЕТР, Peak thrombin и ttPeak, что свидетельствовало о вкладе снижения активности системы протеина С в развитие гиперкоагуляции после ЧКВ. Использованная в данном исследовании модифицированная постановка ТГТ в бедной тромбоцитами плазме может применяться в клинической практике для оценки состояния плазменно-коагуляционного звена гемостаза и снижения чувствительности кТМ, характеризующей активность системы протеина С по степени снижения показателей теста, выполненного в плазме без и с добавлением rh-ТМ

Ex Vivo Expansion of Human CD8+ T Cells Using Autologous CD4+ T Cell Help

Background: Using in vivo mouse models, the mechanisms of CD4+ T cell help have been intensively investigated. However, a mechanistic analysis of human CD4+ T cell help is largely lacking. Our goal was to elucidate the mechanisms of human CD4+ T cell help of CD8+ T cell proliferation using a novel in vitro model. Methods/Principal Findings: We developed a genetically engineered novel human cell-based artificial APC, aAPC/mOKT3, which expresses a membranous form of the anti-CD3 monoclonal antibody OKT3 as well as other immune accessory molecules. Without requiring the addition of allogeneic feeder cells, aAPC/mOKT3 enabled the expansion of both peripheral and tumor-infiltrating T cells, regardless of HLA-restriction. Stimulation with aAPC/mOKT3 did not expand Foxp3+ regulatory T cells, and expanded tumor infiltrating lymphocytes predominantly secreted Th1-type cytokines, interferon-γ and IL-2. In this aAPC-based system, the presence of autologous CD4+ T cells was associated with significantly improved CD8+ T cell expansion in vitro. The CD4+ T cell derived cytokines IL-2 and IL-21 were necessary but not sufficient for this effect. However, CD4+ T cell help of CD8+ T cell proliferation was partially recapitulated by both adding IL-2/IL-21 and by upregulation of IL-21 receptor on CD8+ T cells. Conclusions: We have developed an in vitro model that advances our understanding of the immunobiology of human CD4+ T cell help of CD8+ T cells. Our data suggests that human CD4+ T cell help can be leveraged to expand CD8+ T cells in vitro

Invading Basement Membrane Matrix Is Sufficient for MDA-MB-231 Breast Cancer Cells to Develop a Stable In Vivo Metastatic Phenotype

1 - ArticleIntroduction: The poor efficacy of various anti-cancer treatments against metastatic cells has focused attention on the role of tumor microenvironment in cancer progression. To understand the contribution of the extracellular matrix (ECM) environment to this phenomenon, we isolated ECM surrogate invading cell populations from MDA-MB-231 breast cancer cells and studied their genotype and malignant phenotype. Methods: We isolated invasive subpopulations (INV) from non invasive populations (REF) using a 2D-Matrigel assay, a surrogate of basal membrane passage. INV and REF populations were investigated by microarray assay and for their capacities to adhere, invade and transmigrate in vitro, and to form metastases in nude mice. Results: REF and INV subpopulations were stable in culture and present different transcriptome profiles. INV cells were characterized by reduced expression of cell adhesion and cell-cell junction genes (44% of down regulated genes) and by a gain in expression of anti-apoptotic and pro-angiogenic gene sets. In line with this observation, in vitro INV cells showed reduced adhesion and increased motility through endothelial monolayers and fibronectin. When injected into the circulation, INV cells induced metastases formation, and reduced injected mice survival by up to 80% as compared to REF cells. In nude mice, INV xenografts grew rapidly inducing vessel formation and displaying resistance to apoptosis. Conclusion: Our findings reveal that the in vitro ECM microenvironment per se was sufficient to select for tumor cells with a stable metastatic phenotype in vivo characterized by loss of adhesion molecules expression and induction of proangiogenic and survival factors

Comparative web search questions

We analyze comparative questions, i.e., questions asking to compare different items, that were submitted to Yandex in 2012. Responses to such questions might be quite different from the simple “ten blue links” and could, for example, aggregate pros and cons of the different options as direct answers. However, changing the result presentation is an intricate decision such that the classification of comparative questions forms a highly precision-oriented task. From a year-long Yandex log, we annotate a random sample of 50,000 questions; 2.8% of which are comparative. For these annotated questions, we develop a precision-oriented classifier by combining carefully hand-crafted lexico-syntactic rules with feature-based and neural approaches—achieving a recall of 0.6 at a perfect precision of 1.0. After running the classifier on the full year log (on average, there is at least one comparative question per second), we analyze 6,250 comparative questions using more fine-grained subclasses (e.g., should the answer be a “simple” fact or rather a more verbose argument) for which individual classifiers are trained. An important insight is that more than 65% of the comparative questions demand argumentation and opinions, i.e., reliable direct answers to comparative questions require more than the facts from a search engine’s knowledge graph. In addition, we present a qualitative analysis of the underlying comparative information needs (separated into 14 categories like consumer electronics or health), their seasonal dynamics, and possible answers from community question answering platforms. © 2020 Copyright held by the owner/author(s).This work has been partially supported by the DFG through the project “ACQuA: Answering Comparative Questions with Arguments” (grants BI 1544/7-1 and HA 5851/2-1) as part of the priority program “RATIO: Robust Argumentation Machines” (SPP 1999). We thank Yandex and Mail.Ru for granting access to the data. The study was partially conducted during Pavel Braslavski’s research stay at the Bauhaus-Universität Weimar in 2018 supported by the DAAD. We also thank Ekaterina Shirshakova and Valentin Dittmar for their help in question annotation