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Background: The aim of this study was to test the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity compared to total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia. Methods: Patients were randomly allocated to either propofol-based (intravenous anesthetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both groups. Amounts of natural killer cells, total T lymphocytes, and T lymphocyte subpopulations in the blood samples collected from the patients before surgery, at the end of the surgery and postoperative days 1, 3, and 7, were determined by flow cytometric analysis. The natural killer (NK) cell count served as the primary endpoint of the study, whereas the total T lymphocyte count and cell counts for T lymphocyte subpopulations were used as the secondary endpoint. . Results: Our study showed that there were no significant differences in the amount of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol- and sevoflurane-based anesthesia groups when the anesthesia was administered in combination with epidural analgesia. Conclusions: The results of this pilot study did not support the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity than that of total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia.

This paper presents pioneering results on the evaluation of noble metal film hetero-structures to improve some functional characteristics of carbon-based implant materials: carbon-composite material (CCM) and carbon-fiber-reinforced polyetheretherketone (CFR-PEEK). Metal-organic chemical vapor deposition (MOCVD) was successfully applied to the deposition of Ir, Pt, and PtIr films on these carriers. A noble metal layer as thin as 1 µm provided clear X-ray imaging of 1–2.5 mm thick CFR-PEEK samples. The coated and pristine CCM and CFR-PEEK samples were further surface-modified with Au and Ag nanoparticles (NPs) through MOCVD and physical vapor deposition (PVD) processes, respectively. The composition and microstructural features, the NPs sizes, and surface concentrations were determined. In vitro biological studies included tests for cytotoxicity and antibacterial properties. A series of samples were selected for subcutaneous implantation in rats (up to 3 months) and histological studies. The bimetallic PtIr-based heterostructures showed no cytotoxicity in vitro, but were less biocompatible due to a dense two-layered fibrous capsule. AuNP heterostructures on CFR-PEEK promoted cell proliferation in vitro and exhibited a strong inhibition of bacterial growth (p < 0.05) and high in vitro biocompatibility, especially Au/Ir structures. AgNP heterostructures showed a more pronounced antibacterial effect, while their in vivo biocompatibility was better than that of the pristine CFR-PEEK, but worse than that of AuNP heterostructures.

Recently, film materials based on the combination of noble metals have showed promising results for surface modification of medical implants, allowing both to improve biocompatibility and to acquire the increased antibacterial effect. An important challenge here is to combine the developed coating morphology, which is favorable for biological response, with a high protective function, which, on the contrary, requires a compact coating microstructure. In this work, we aimed to solve this problem with respect to the TiNi implant material. We have tested two types of compact thin sublayers: Iridium (Ir’), formed by metal-organic chemical vapor deposition (MOCVD), and gold (Au), formed by physical vapor deposition (PVD). Subsequently these sublayers were coated with a developed-columnar-iridium (Ir) by MOCVD. Features of the microstructure, chemical and phase composition of all these film materials were studied using powder X-ray diffraction (XRD), scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The changes in the characteristics of TiNi martensitic transformation due to MOCVD experiments were also studied by differential scanning calorimetry (DSC). The biocompatibility of Ir’/TiNi, Au/TiNi, Ir/Ir’/TiNi, Ir/Au/TiNi samples was assessed by cytoxicity testing (Man-1 cells) and measuring of nickel content in the biological extracts. The application of both sublayers effectively reduces the release of nickel, which was previously shown for Ir/TiNi samples. This prevents the toxic effect. Note that the Ir’ sublayer better protects against nickel release, while the Au sublayer promotes cell proliferation.

Radiotherapy is an integral part of glioblastoma treatment affecting both cancer cells and tumour microenvironment, where proteoglycans (PGs) are key extracellular components. However, the molecular effects of radiotherapy on PGs expression and functional activity in brain tissue are poorly understood. Here, we aimed to study the short-term effects of X-ray irradiation on PGs expression in normal brain tissue in mouse model in vivo. Two-month-old male CBL/6Bl mice (n = 54) were used in this study, animals’ brains were irradiated using either research synchrotron VEPP-4 or clinical linear accelerator ElektaAxesse. Control (n = 18) and irradiated (n = 36) brain tissues were analysed at 24 h, 48 h and 72 h after irradiation. Morphology of the cortex and hippocampus was accessed by H&E staining, and expression of PGs (syndecan-1, glypican-1, HSPG2/perlecan, versican, brevican, neurocan, NG2/CSPG4, CD44, decorin, biglycan) was determined by RT-PCR. Single irradiation of mouse brain with a 7 Gy dose did not affect tissue morphology and mRNA levels of most highly-expressed PGs decorin and neurocan, although resulted in significant downregulation of brevican (3–10-fold) and NG2/CSPG4 (8–9-fold) expression both in cerebral cortex and subcortex. Research synchrotron and clinical linear accelerators demonstrated minor variability in their effects. Single X-ray irradiation with a 7 Gy dose does not significantly affect the mouse brain tissue morphology but selectively decreases expression levels of some PGs. The downregulation of brevican and NG2/CSPG4 but not decorin and neurocan reflects alteration of extracellular matrix in irradiated brain tissue, which might contribute to the formation of a permissive microenvironment for glioblastoma relapse development.

Lung cancer is one of major cancers, and survival of lung cancer patients is dictated by the timely detection and diagnosis. Cell-free circulating miRNAs were proposed as candidate biomarkers for lung cancer. These RNAs are frequently deregulated in lung cancer and can persist in bodily fluids for extended periods of time, shielded from degradation by membrane vesicles and biopolymer complexes. To date, several groups reported the presence of lung tumour-specific subsets of miRNAs in blood. Here we describe the profiling of blood plasma miRNAs in lung cancer patients, healthy individuals and endobronchitis patients using miRCURY LNA miRNA qPCR Serum/Plasma Panel (Exiqon). From 241 ratios differently expressed between cancer patients and healthy individuals 19 miRNAs were selected for verification using the same platform. LASSO-penalized logistic regression model, including 10 miRNA ratios comprised of 14 individual miRNAs discriminated lung cancer patients from both control groups with AUC of 0.979.

Urine of prostate cancer patients contains tumor-specific biopolymers, including protein- and microvesicles-associated miRNAs that can potentially be used as oncomarkers. Previously we have characterized urinary extracellular vesicles and demonstrated diagnostic potential of their miRNAs. In this study, we have performed a comparative analysis of 84 miRNA in paired samples of urine microvesicles and urine supernatant from healthy men, patients with benign prostate hyperplasia, and prostate cancer patients using miRCURY LNA miRNA qPCR Panels. In all groups of patients, miRNA subsets characterized by different distribution between the urinary fractions have been found. In this context, two groups of miRNAs have been identified, which are involved in several signaling pathways including those associated with prostate cancer development.

The micro-arc oxidation method was applied to modify the surface of 3D printed titanium implants with a complex internal structure. Two different electrolyte solutions were used for thesurface modification, for which the respective working parameters of the micro-arc oxidation process were developed. Surface coatings formed with these parameters on the 3D implants have the same chemical composition and have the same surface morphology as surface coatings on 2D substrates. The measurement of the coating thickness using the X-ray microtomography demonstrates that this method is a useful tool for the thickness control of porous surface coatings at the inside and outside of the 3D titanium implants.

Composite poly-L-lactide acid-based scaffolds with hydroxyapatite (HAp) content up to 75 wt.% were fabricated via solution blow spinning. The influence of HAp concentration on structure, wettability, mechanical properties and chemical and phase composition of the produced materials was examined. It was found that with an increase of HAp content the average fiber diameter was increased, the uniaxial strength and relative elongation were reduced, while the phase composition and surface wettability did not change. The performance of the scaffolds during implantation in the parietal bone of a rat skull for a period from 15 to 90 days was studied. The materials have shown high ability to integrate with both soft and hard tissues. It was found that scaffolds with 25 wt.% HAp content significantly enhance osteogenesis during scarification (damage) of the periosteum. Overall, the fabricated scaffolds proved to be highly efficient for replacing bone defects in long tubular bones.

The structure and properties of polytetrafluoroethylene (PTFE) polymeric membranes obtained by electrospinning from a suspension of PTFE in a solution of polyvinyl alcohol (PVA) with subsequent thermal treatment were presented. The effect of the PTFE suspension ratio in spinning solutions on the morphology, crystal structure, chemical composition, strength, and cytotoxicity of the formed PTFE membranes was evaluated. We found that a decrease in the PTFE suspension content in spinning solutions leads to a decrease in the number of defects in the membrane fibers, which increasing the strength and elongation. Membranes made from spinning solutions with a lower content of PTFE suspension have a higher degree of crystallinity and a more perfect crystal structure. It has been suggested that the products of PVA destruction during the heat treatment of PTFE/PVA membranes are capable of plasticizing effects on PTFE particles, improving the strength of PTFE membranes. The membranes after thermal treatment were not cytotoxic regardless of the PTFE suspension content in the spinning solutions. High biocompatibility of membranes was established during implantation into soft tissues.

Purpose: To find a correlation between prescribed dose on the irradiation area and dose on heart and ascending aorta, using the "breath holding" method in classical radiotherapy course for patients with Hodgkin and non-Hodgkin mediastinal lymphomas. Material and methods: For patients of reproductive age with diagnose Hodgkin, non-Hodgkin mediastinal lymphomas we conducted radiotherapy with contouring of tumor, and critical structures, include heart and ascending aorta. Radiotherapy was conducted on breath holding (ABC) for shielding radiation dose from heart, ascending aorta and lungs. We did calculations of length and diameter of the contoured aorta and dose that it and heart took. Also, we did correlation calculation of relationship between prescribed dose on the tumor and doses cover to the heart and aorta on 6 and 10 MV nominal energies. Results: According to the protocol RTOG 1005 for the heart zone, exceeding the threshold level for V20 < 5 % occurred in 11 cases out 21, and 8 cases from them are for 10 MV energy. For V10 < 30 % it happened in nine cases from 21, and seven cases from them are for 10 MV energy too. The correlation coefficient between the prescribed dose and the received dose for protocol RTOG 1005 V10 < 30 % was 0.71 and it showed the highest value. This index is lower on 13 % for protocol RTOG 0623 (V67) – 0..58, and it has the weakest coefficient correlation (V33) – 0.45. The value of the correlation coefficient for the aorta decreased with an increase in the volume to which the prescribed dose of the irradiation area falls and, consequently a 10 and 20 % of the aorta volume is getting a maximum value from the prescribed dose. Conclusion: Our research showed what contouring of ascending aorta is obligatorily procedure, because the average dose on it was 10.73 Gy for 10 MV and 6.50 Gy for 6 MV energies. It is obvious that using 6 MV energy is more organ-preserving method of thea radiotherapy treatment when using a such techniques as ABC. It is a very important to study the issue of the permissible dose per volume of ascending aorta without critical consequences for cardiovascular system. In addition, it particularly important if we take into account that all patients had a chemotherapy course before radiation therapy which also caused cardiotoxicity.

Melanoma is one of the most dangerous forms of skin cancer. Aggressive growth with a high risk of distant metastasis is the cause of the high death rate from skin melanoma worldwide. Melanoma that has metastasized beyond the lymph nodes requires more aggressive treatment. The standard treatment modalities including surgery, radiation therapy and chemotherapy are not very effective for most patients. The aggressive nature of this disease sustains an urgent need for more effective treatment methods. Immunotherapy is currently one of the most promising approaches for fighting cancer cells. The review analyses the main immunotherapeutic approaches to melanoma treatment, including therapeutic vaccines based on tumor cells, synthetic peptides and polyepitopic immunogens. Many of these vaccines are currently being studied in various clinical trials.

OBJECTIVE. The research evaluated the data of robotic thoracoscopic interventions. MATERIALS AND METHODS. The article presents the results of robotic surgery in 30 patients aged 41 to 78 years with lung tumors of various localization and tumors of anterior mediastinum. The non-typical resection of the upper lobe was performed on 17 patients and extended lobectomy was conducted in 10 cases. The removal of anterior mediastinal tumor was made in 3 patients. RESULTS. There weren’t noted any complications in early postoperative period. The length of non-typical resection consisted of 40-50 min, but in case of removal of lung lobe with lymphodissection the duration of surgery was 3-3,5 hours. The removal of tumor from the anterior mediastinum took from 80 min to 1,5 hours. The diagnosis was made according to postmortem examination in all cases. All the patients were discharged from hospital in order to continue treatment. CONCLUSIONS. The results obtained showed the safety and efficacy of robotic interventions.

Noble metals such as Ir, Pt, Au are promising as coatings for metal medical implants to improve biocompatibility and corrosion resistance. Moreover, these coatings can be used as a basis for the further formation of bimetallic hetero-structures with enhanced antibacterial properties. In this work, we develop an approach to obtain such coatings by metal-organic chemical vapor deposition (MOCVD). We have been focused on the formation of Ir coating with developed morphology and subsequent discrete Au coating onto the titanium nickelide (TiNi) implant material. Iridium was deposited in an oxidizing atmosphere from the volatile precursor [Ir(cod)(acac)] (cod = cyclooctadiene-1,5, acac = acetylacetonate-anion). The effects of the deposition temperature (290–350 °C) and amount of introduced oxygen on the composition (Ir, Ir + IrO2) and microstructure of the samples were studied. Hetero-metallic Au/Ir coatings were obtained using [(CH3)2Au(thd)] precursor (thd = dpm = dipivaloylmethanate-anion) at a deposition temperature of 240 °C in the presence of oxygen. To assess the biocompatibility, the toxicity of Ir/TiNi, Au/Ir/TiNi, and uncoated TiNi in relation to human embryonic stem cell line Man-1 was examined after 1, 3, and 5 days of incubation. The results obtained were explained based on the coating microstructures.

The purpose of the study was to assess immediate response to preoperative external beam radiotherapy in patients with soft tissue sarcomas. The study comprised 55 patients with primary and recurrent soft tissue sarcomas. All patients underwent external beam radiotherapy at a total dose of 38–44 Gy in 5 fractions of 3 Gy daily, followed by surgery with 10–15 Gy intraoperative radiotherapy. The objective tumor response to preoperative external beam radiotherapy was assessed using RECIST criteria. Partial response to preoperative radiotherapy was achieved in 9.1% of patients and disease stabilization in 90.9% of cases. Grade I pathological tumor response was observed in 25 (46.5 %) patients, grade II tumor response in 19 (34.5 %) patients and grade III tumor response in 11 (20 %) cases. A 3-week interval between radiotherapy and surgery was the most optimal time. Pathological tumor response with RECIST criteria is an additional parameter in assessment of immediate tumor response.

A rare clinical case of squamous cell lung cancer with metastases to the skin of the gluteal region after combined modality treatment has been presented. This case is of interest due to atypical localization of metastases, histological tumor type and disease prognosis.

The transthoracic puncture biopsy was performed under surveillance of X-ray computed tomography in order to verify diagnoses in 80 patients with lung tumors. This procedure allowed verification of diagnosis and choice of treatment strategy in 95% of cases. The complications obtained as result of intervention didn’t bring severe character and were arrested in term of two days.

Extraskeletal osteosarcoma is a rare malignant tumor with histologic similarities to primary bone osteosarcoma. However, there are distinct differences in epidemiology, imaging features, biological characteristics, prognosis, and management compared with osteogenic osteosarcoma. Extraskeletal osteosarcoma is usually characterized as high-grade neoplasm with clinically aggressive behavior, poor prognosis, frequent recurrence/lymphogenic metastatsis, and resistence to chemotherapy. A noteworthy feature of extraskeletal osteosarcoma is the fact that almost all existing biological phenomena described in mesenchymal oncopathology (except primary-multiple lesions) are present in this tumor, namely: secondary malignancy, association with syndromes, partial spontaneous regression of the tumor, dedifferentiation, bone invasion, biphasic pathology. In this paper, we have discussed in detail the tumor morphology, histological subtypes, prognostic factors and differential diagnosis.Экстраскелетная остеосаркома - редкая опухоль, имеющая при схожей морфологии с остеосаркомой кости принципиальные отличия от нее, касающиеся эпидемиологии, локализации, биологических характеристик и клинического поведения. Экстраскелетную остеосаркому отличает выраженное агрессивное поведение, проявляющееся низкой 5-летней выживаемостью, частым рецидивированием, высокой частотой лимфогенного метастазирования, резистентностью к химиотерапии. Примечательной особенностью экстраскелетной остеосаркомы является то, что практически все существующие биологические феномены, описанные в мезенхимальной онкопатологии (кроме первично-множественного поражения), встречаются при данной опухоли - вторичное озлокачествление, ассоциация с синдромами, частичная спонтанная регрессия опухоли, дедифференцировка, костная инвазия, бифазное строение опухоли. Детально представлена морфология опухоли, гистологические субтипы, факторы прогноза. Подробно освещены вопросы дифференциальной диагностики.