By co-culturing CAR19 T cells with bone-marrow fragments infiltrated with CLL cells we demonstrate that IL-21 reduces the immunosupressive activity of CLL cells against CAR19 T cells.
CAR19 T cells armed with IL-21 exhibited enhanced antitumor functions. IL-21 promoted their proliferation and cytotoxicity against chronic lymphocytic leukemia (CLL). The results suggest that arming CAR T cells with IL-21 could boost the effectiveness of CAR T-mediated therapies.
CAR19 T cells armed with IL-21 exhibited enhanced antitumor functions. IL-21 promoted their proliferation and cytotoxicity against chronic lymphocytic leukemia (CLL). The results suggest that arming CAR T cells with IL-21 could boost the effectiveness of CAR T-mediated therapies.
Radiography is an important tool in the diagnosis of trauma and diseases of the foot. Consistent image quality and anatomical appearances are essential to ensure that images are interpreted correctly and this study aims to evaluate current technique and use anthropomorphical phantoms in order to investigate the most optimal radiographic technique.
A two part study was conducted. An electronic survey was administered in order to ascertain the current radiographic technique utilised within the United Kingdom (UK) National Health Service (NHS) and compare this with techniques published within radiographic positioning textbooks in common use within the UK. A phantom experiment also sought to identify the most appropriate angulation of the central beam to employ in order to optimally visualise the anatomy for standard non-trauma radiography of the foot. A relative visual grading analysis technique was used to assess radiographic quality.
The electronic survey was completed by 38% of departments (n=69/182) and consistency of images, particularly when patient care is transferred between centres.
The refusal of blood transfusions compels surgeons to face ethical and clinical issues. A single-institution experience with a dedicated perioperative blood management protocol was reviewed to assess feasibility and short-term outcomes of true bloodless pancreatic surgery.
The institutional database was reviewed to identify patients who refused transfusion and were scheduled for elective pancreatic surgery from 2010 through 2018. A protocol to optimize the hemoglobin values by administration of drugs stimulating erythropoiesis was systematically used.
Perioperative outcomes of 32 Jehovah's Witnesses patients were included. Tauroursodeoxycholic Median age was 67 years (range, 31-77). Nineteen (59.4%) patients were treated with preoperative erythropoietin. Twenty-four (75%) patients underwent pylorus-preserving pancreaticoduodenectomy, 4 (12.5%) distal pancreatectomy (DP) with splenectomy, 3 (9.4%) spleen-preserving DP, and 1 (3.1%) total pancreatectomy. Median estimated blood loss and surgical duration were 400mL (range, 100transfusion with good short-term outcomes.
The frequency, nature and timeline of changes on thin-slice (≤3mm) multi-detector computerized tomography (CT) scans in the pre-diagnostic phase of pancreatic ductal adenocarcinoma (PDAC) are unknown. It is unclear if identifying imaging changes in this phase will improve PDAC survival beyond lead time.
From a cohort of 128 subjects (Cohort A) with CT scans done 3-36 months before diagnosis of PDAC we developed a CTgram defining CT Stages (CTS) I through IV in the radiological progression of pre-diagnostic PDAC. We constructed Cohort B of PDAC resected at CTS I and II and compared survival in CTS I and II in Cohort A (n=22 each; control natural history cohort) vs Cohort B (n=33 and 72, respectively; early interception cohort).
CTs were abnormal in 16% and 85% at 24-36 and 3-6 months respectively, before PDAC diagnosis. The PDAC CTgram stages, findings and median lead times (months) to clinical diagnosis were CTS I Abrupt duct cut-off/duct dilatation (-12.8); CTS II Low density mass confined to pancreas (-9.5), CTS III Peri-pancreatic infiltration (-5.8), CTS IV Distant metastases (only at diagnosis). PDAC survival was better in cohort B than in cohort A despite inclusion of lead time in Cohort A CTS I (36 vs 17.2 months, p=0.03), CTS II (35.2 vs 15.3 months, p=0.04).
Starting 12-18 months before PDAC diagnosis, progressive and increasingly frequent changes occur on CT scans. Resection of PDAC at the time of pre-diagnostic CT changes is likely to provide survival benefit beyond lead time.
Starting 12-18 months before PDAC diagnosis, progressive and increasingly frequent changes occur on CT scans. Resection of PDAC at the time of pre-diagnostic CT changes is likely to provide survival benefit beyond lead time.
To compare tumor conspicuity of small hepatocellular carcinomas (HCCs) and image quality on knowledge-based iterative model reconstruction low-dose computed tomography (IMR-LDCT) with hybrid iterative reconstruction standard-dose CT (iDose
-SDCT).
Thirty-two patients (mean age 61.9 ± 9.7 years; malefemale 275; mean body mass index 25.6 ± 3.8 kg/m
) with cirrhosis and 40 HCCs in IMR-LDCT group and 33 patients (mean age 60.1 ± 7.4 years; malefemale 285; body mass index 26.7 ± 3.2 kg/m
) with cirrhosis and 40 HCCs in iDose
-SDCT group were included in this retrospective study. Objective analysis of reconstructed iDose
and IMR images was done for contrast-to-noise ratio of HCCs (CNR
), image noise, signal-to-noise ratio of portal vein (SNR
)
and inferior vena cava (SNR
). Subjective analysis of tumor conspicuity and image quality was done by two independent reviewers in a blinded manner. Mean volume CT dose index, dose length product, and effective dose for both groups were compared.
The CNR
was significantly higher in IMR-LDCT compared to iDose
-SDCT in both arterial phase (AP), p < 0.0001, and delayed phase (DP), p < 0.0001. Image noise was significantly lower in IMR-LDCT compared to iDose
-SDCT in AP, portal venous phase, and DP with p < 0.0001. IMR-LDCT showed significantly higher SNR
(p < 0.0001) and SNR
(p < 0.0001) compared to iDose
-SDCT. On subjective analysis, IMR-LDCT images showed better image quality in AP, portal venous phase, and DP and better tumor conspicuity in AP and DP. IMR-LDCT (21.4 ± 4.6 mSv) achieved 36.9% reduction in the effective dose compared to iDose
-SDCT (33.9 ± 6.2 mSv).
IMR algorithm provides better image quality and tumor conspicuity with considerable decrease in image noise compared to iDose
reconstruction technique even on LDCT.
IMR algorithm provides better image quality and tumor conspicuity with considerable decrease in image noise compared to iDose4 reconstruction technique even on LDCT.Tauroursodeoxycholic
Top comments (0)