Hollow Organs Research Articles

Візуалізація у діагностиці ушкоджень органів черевної порожнини при бойовій травмі

The article presents the results of radiographic and ultrasound examinations in the diagnosis of injuries to the abdominal organs in the case of gunshot wounds in 67 patients. In case of gunshot wounds to the abdomen, damage to hollow organs was recorded significantly (P<0.001) more often than to parenchymal organs. The sensitivity of radiography in the diagnosis of pneumoperitoneum was 90.3%, specificity — 75.0%, accuracy — 88.6%. The sensitivity of ultrasound was 89.3%, specificity — 66.7%, accuracy — 82.9%, respectively. In the diagnosis of hemoperitheneum, the sensitivity of ultrasound was 88.9%, the specificity was 80.0%, and the accuracy was 93.8%. The sensitivity of radiography was 89.3%, specificity — 66.7%, accuracy — 82.9%, respectively.

050. Surviving Multiple Traumas: A 37-Year-Old Male with Gunshot-Induced Hematopneumothorax and Hollow Organ Perforation

Background: Traumatic gunshot wounds to the chest and abdomen pose significant challenges in emergency surgical management. This case report presents the rapid diagnosis and successful treatment of a 37-year-old male who sustained gunshot wounds to the chest and abdomen, leading to hematopneumothorax and hollow organ perforation. Case: The patient, a 37-year-old male, was admitted to Adam Malik Hospital with shortness of breath and severe abdominal pain following a gunshot injury to the chest and lower abdomen. On primary survey, the patient exhibited tachypnea (RR 26 tpm) and hypoxia (SpO2 94% on room air), which improved with oxygen therapy. Vital signs were stable, but a left-sided hematopneumothorax and abdominal tenderness suggested hollow organ perforation. Radiological and FAST ultrasound findings confirmed the diagnosis. Emergency chest tube insertion and exploratory laparotomy were performed. The chest tube revealed hemorrhagic effusion, and laparotomy identified two small bowel perforations at 100 cm and 130 cm from the ligament of Treitz, alongside an impaled object in the mesentery. Primary suturing of the perforations was performed, and the abdomen was irrigated thoroughly. Postoperative recovery was uneventful, with the patient showing rapid clinical improvement. Conclusion: Rapid emergency surgical response led to a favorable outcome in a patient with life-threatening thoracoabdominal gunshot wounds, emphasizing the role of timely interventions in trauma care.

Gastrointestinal fistulae: conservative vs surgical management

Background: Gastrointestinal fistulae are abnormal connections between two hollow organs of the gastrointestinal tract or between the hollow organ and the skin. They remain a major clinical problem, especially if complicated by sepsis, bacteraemia or cancer. General Principles of fistula management consist of- Phase of Diagnosis, Stabilization and Management. Methods: The study was conducted in Sir JJ Group of Hospitals, Mumbai. A total of 34 patients with gastrointestinal fistulae were studied between January 2020 to January 2023. The patients were studied on the basis of presenting signs and symptoms, details of initial surgery performed, investigations pertaining to the condition and their management. Results: Out of the 34 cases, 44% of the cases were from the small intestine, 39% cases we]re from the large intestine, and the rest of the cases were from stomach, duodenum, gastrojejunostomy site and appendicular stump following appendicectomy. Conclusions: The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.

A Study on Hollow Viscus Perforation in a Tertiary Care Hospital in South India.

Introduction Hollow viscus perforation refers to the perforation of the gastrointestinal tract, including the stomach, intestines, or other hollow organs, leading to leakage of the contents into the peritoneal cavity. This paper aims to explore the disease burden of hollow viscus perforation in Sree Balaji Medical College & Hospital in Chennai, India, and its relation to patients' age and sex and analyze the etiology of hollow viscus perforation. Materials and methods This single-center retrospective study was conducted between May 2022 and August 2023, with a sample size of 100 patients. Data were extracted from the hospital's medical records based on the study's parameters. Results Our study shows that among the study group, hollow viscus perforation was more common in males (n = 78; 78%) than females. The highest incidence was observed in the 41-50 age group (n = 35; 35%), with the mean age being 43 years. The most common cause of perforation was a duodenal ulcer. Wound infection was the most frequent postoperative complication, affecting less than one-third of the patients (n = 29; 29%), followed by pneumonia and acute respiratory distress syndrome. Although large intestinal pathology affected only eight patients in the sample, it showed a high case fatality rate, with one-quarter of the patients (n = 2; 25%) succumbing to the condition. Conclusion Hollow viscus perforation is a life-threatening condition that requires prompt recognition and treatment. The etiology is diverse, ranging from peptic ulcer disease and malignancy to trauma and inflammatory conditions. Early diagnosis and aggressive management are essential for improving the outcome for patients with this condition.

Intraoperative oximetry of hollow organs in case of gunshot injuries of the abdomen

Intraoperative oximetry of hollow organs in case of gunshot injuries of the abdomen

Expression of POU2F3 Transcription Factor and POU2AF2, POU2F3 Coactivator, in Tuft Cell-like Carcinoma and Other Tumors.

Epithelial chemosensory cells in hollow organs, also known as tuft cells, were implicated in tumorigenesis, including a tuft cell-like small cell lung carcinoma. Expression of the POU2F3 transcription factor is a marker of tuft cell lineage. However, tuft cell development, differentiation, and proliferation are controlled by the expression of the complex formed by POU2F3 and POU2AF2 or POU2AF3 transcriptional coactivators. A cohort of epithelial (n=6064) and mesenchymal/neuroectodermal (n=2730) tumors was screened for POU2F3 expression by immunohistochemistry. Variable immunoreactivity ranging from diffuse to scattered positive cells was found in ∼12.4% of epithelial and 4.6% of mesenchymal/neuroectodermal tumors. Cases with predominantly diffuse or patchy POU2F3 positivity representing various types of malignant tumors (n=43) were selected for further study, including POU2AF2 immunohistochemistry. Thirteen of 15 tumors with neuroendocrine differentiation originating from the lung, colon, head and neck, skin, and bladder revealed diffuse POU2F3 positivity. Most of those tumors (n=9) co-expressed POU2AF2, usually extensively. Seven squamous and basal cell carcinomas from the oral cavity, skin, lung, and thymus with diffuse POU2F3 immunostaining except one, lacked POU2AF2 expression. Other variably POU2F3-positive carcinomas (n=13) from the colon, pancreas, liver, kidney, testis, endometrium, ovary, and breast lacked POU2AF2 immunoreactivity. All POU2F3-positive mesenchymal and neuroectodermal tumors (n=8), including synovial sarcoma, solitary fibrous tumor, glioblastoma, Wilms tumor, and melanoma were POU2AF2-negative. POU2F3 expression is a highly sensitive but nonspecific indicator of tuft cell differentiation. Co-expression of POU2F3 and POU2AF2 appears to be a more specific marker, although it may not pinpoint tumors driven by the POU2F3-POU2AF3 complex.

Leakage of Intestinal Anastomoses: A New Solution to the Old Problem

Leakage of intestinal anastomoses remains an issue in view of the increasing number of patients who need reconstructive interventions in different parts of the gastrointestinal tract. Researchers around the world are actively looking for methods of strengthening intestinal anastomoses. The literature presents various approaches to sealing intestinal anastomoses in experimental animals using allografts, biological sealants, polymer film materials, etc. This article classifies and analyzes innovative methods of strengthening intestinal anastomoses to prevent their leakage. We also describe a concept of developing polymer membranes for interventions on hollow organs and our experience in this field of work and making of medical devices at the premises of a university research laboratory.

Free radical fragmentation and oxidation in the polar part of lysophospholipids: Results of the study of blood serum of healthy donors and patients with acute surgical pathology

The interaction of reactive oxygen species with cell membrane lipids is usually considered in the context of lipid peroxidation in the nonpolar component of the membrane. In this work, for the first time, data were obtained indicating that damage to human cell membranes can occur in the polar part of lysophospholipids at the interface with the aqueous environment due to free radical fragmentation (FRF) processes. FRF products, namely 1-hexadecanoyloxyacetone (PAc) and 1-octadecanoyloxyacetone (SAc), were identified in human serum, and a GC-MS method was developed to quantify PAc and SAc.The content of FRF products in serum samples of 52 healthy donors was found to be in the range of 1.98–4.75 μmol/L. A linear regression equation, CPAc&SAc (μmol/L) = 0.51 + 0.064 × years, was derived to describe the relationship between age and content of FRF products. In 70 patients with acute surgical pathology in comparison with the control group of healthy donors, two distinct clusters with different concentration levels of FRF products were revealed. The first cluster: groups of 43 patients with various localized inflammatory-destructive lesions of hollow organ walls and bacterial translocation (septic inflammation) of abdominal cavity organs. These patients showed a 1.5–1.9-fold (p = 0.012) decrease in the total concentration of PAc and SAc in serum. In the second cluster: groups of 27 patients with ischemia-reperfusion tissue damage (aseptic inflammation), – a statistically significant increase in the concentration of FRF products was observed: in 2.2–4.0 times (p = 0.0001).The obtained data allow us to further understand the role of free-radical processes in the damage of lipid molecules. FRF products can potentially be used as markers of the degree of free-radical damage of hydroxyl containing phospholipids.

A clinical case report of aberrant pancreas in the practice of a general practitioner

An aberrant pancreas is a fairly rare developmental anomaly, which, de spite its congenital genesis, is most often found in people of the middle age group. The article presents a clinical case of an aberrant pancreas with localization in the antrum of the stomach in a 52-year-old patient. Congenital pathology has an asymptomatic course for a long time, which is subsequently associated with late diagnosis and the need for a comprehensive examination of the patient. Despite the long-term symptomless course of the pathology, the secretory activity of the ab errant pancreas contributes to persistent inflammation of the gastric and duodenal mucosa, potentiates irreversible pathological changes, and increases the risk of complications, including gastric intestinal metaplasia. The patient under consider ation was diagnosed with a multimorbid chronic pathology of the gastrointestinal tract, which, despite ongoing therapy, was characterized by frequent exacerbations. Due to the established diagnosis, it was possible to prescribe successful conser vative treatment and avoid surgical intervention in this patient. According to the literature, differential diagnosis with malignant neoplasms is necessary. The choice of surgical treatment tactics is determined by the development of complications, among which both obstructive complications (dysphagia, pyloric stenosis, intus susception, intestinal obstruction, obstructive jaundice) and complications specific only to pancreatic tissue, such as pancreatitis, cysts and pseudocysts, ulcerative defects with perforation of the hollow organ, benign and malignant neoplasms, are described. The question of the expediency of surgical treatment of patients in the absence of complications remains debatable to the present day, which causes diffi culties in the management of these patients.

Effects of Chronic Exigencies on Efficacy of Myogenic Engine Among Elite Women

The heart is a myogenic engine of human body which propell the blood to meet the need of working muscles by supplying nutrients, oxygen and clear waste products. The human heart is a myogenic engine which is a hollow organ that will undergo the direct physical stress laid out by the performer when he/she exposed to a regular, panned, systematic and scientific training regimen. The acute and chronic impacts on the structure and functions of hollow myogenic organs leads to a variety of adaptations. The popularly coined statement that either structure decide the function or function decide the structure. This statement is complimentary with each other for any kind of physical stress. The heart will get direct impact, if the same stress in laydown for a prolonged period, then the heart will get certain changes those changes play an important role in deciding the cardiac dynamics like Heart rate at rest (HR), Stroke volume at rest (SV) and cardiac output at rest ( ). Based on these facts in the present study, the investigator would like to enlighten how a planned, systematic, prolonged physical stimulations will put impact on uninterruptedly working myogenic engine of elite athletes. To fulfill the condition of the study an elite woman of (N=15) fifteen each from long distance training, middle distance training, and weight lifting training were chosen as clients. All the volunteered clients had 7 to 9 years of sports age and trained by their respective coaches in their specific sports. The selected criterian parameters are Heart Rate at rest (HR), Stroke Volume at rest (SV) and Cardiac Output at rest ( ) and they were measure by M- Mode Doppler Echocardiography with the support of qualified cardiologist. Finally, the investigator came to an end that elite athletes from three experimental groups, underwent a significant alterations in the dynamics of myogenic engine. The level of significance was set at 0.01 level of assurance. In ordered to find out the significant difference the analysis of variance (ANOVA) was employed. When the ‘F’ ratio is significant, the Scheffe’s post-hock test was used to find the paired mean significant difference, if any, among the groups of chosen parameters.

Morphological changes in plasma-exposed poultry red mites (Dermanyssus gallinae) using high-resolution video camera and optical coherence tomography (OCT)

Dermanyssus gallinae, the poultry red mite (PRM), is a hematophagous temporary ectoparasite that causes serious economic losses and animal health impairment on laying hen farms worldwide. Control is limited by the parasite’s hidden lifestyle, restrictions on the use of chemical acaricides and the development of resistance against certain drug classes. As a result, research was conducted to explore alternative control methods. In recent years, atmospheric pressure plasma has been increasingly reported as an alternative to chemical acaricides for pest control. This physical method has also shown promising against PRM under laboratory conditions. However, the detailed mechanisms of action have not yet been elucidated. In the present study, the effects of cold atmospheric pressure plasma on PRM were investigated using digital videography and optical coherence tomography (OCT), an imaging technique that visualizes the topography of surfaces and internal structures. Digital videography showed that a redistribution of the contents of the intestinal tract and excretory organs (Malpighian tubules) occurred immediately after plasma exposure. The body fluids reached the distal leg segments of PRM and parts of the haemocoel showed whiter and denser clumps, indicating a coagulation of the haemocoel components. OCT showed a loss of the boundaries of the hollow organs in transverse and sagittal sectional images as well as in the three-dimensional image reconstruction. In addition, a dorso-ventral shrinkage of the idiosoma was observed in plasma-exposed mites, which had shrunk to 44.0% of its original height six minutes after plasma exposure.

Gastrointestinal involvement in neuromuscular disorders.

Although not often discussed, many of the neuromuscular disorders (NMDs) affect the gastrointestinal tract (GIT). Depending on the type of NMD, the prevalence of GIT involvement ranges from <5% (e.g. hereditary neuropathies, myofibrillar myopathies) to 100% (e.g. MNGIE, OPMD). Particularly in NMDs with multisystem affection, involvement of the GIT can dominate the clinical presentation or at least make up a significant part of the clinical picture. The most prominent representatives of NMDs with multisystem involvement are the mitochondrial disorders (MIDs) and the myotonic dystrophies. The best known syndromic MIDs with GIT involvement are MNGIE, MELAS, Leigh, and Pearson syndromes. Among neuropathies, GIT involvement is most commonly found in ALS and GBS. GIT involvement may also be a feature of myasthenia. The clinical manifestations of GIT involvement are diverse and can affect the entire GIT, from the teeth to the rectum, including the liver and pancreas. The most well-known clinical manifestations of GIT involvement are dysphagia, nausea, vomiting, reflux, hollow organ dysmotility, hepatopathy, diabetes, diarrhea, constipation, and fecal incontinence. Even if treatment can usually only be symptomatic, the therapeutic options are diverse, are often effective, and can significantly and beneficially influence the course of the underlying NMD.

Specific Features of Diagnostic and Treatment Tactics in Patients with Crushed Abdominal Hernias Without Resection of a Hollow Organ.

The purpose of the work is to analyze the results of the use of optimized diagnostic and therapeutic tactics in patients with strangulated abdominal hernias without resection of the hollow organ. Materials and methods: The work is based on the analysis of the results of surgical treatment of 665 patients with strangulated abdominal hernias without resection of the hollow organ, who were divided into 2 groups depending on the features of the diagnostic and treatment tactics. Unlike the patients of group 1, the following diagnostic tactics were used in group 2: substantiated laparoscopic diagnosis of abdominal organs; mandatory biochemical assessment of hernia water; mandatory intraoperative instrumental assessment of the state of the strangulated organ; expansion of indications for the use of laparoscopic interventions and components of the comprehensive Fast track program; substantiated complex prevention of malignancy. The clinical diagnostic algorithm included laboratory, instrumental and biochemical research methods. Results: The use of priority diagnostic and therapeutic tactics in the patients of group 2 allowed to increase the number of laparoscopic hernioplasty by 49.34%, the number of allohernioplasty by 18.62%, among which the "Sublay" technique was preferred for strangulated ventral hernias. This was accompanied by a decrease in the pain syndrome on the VAS scale during the four days of observation, both during coughing and at rest, and amounted to only 2.21 ± 0.29 points on the fourth day when at rest. In addition, and after 12 months, the patients of group 2 observed a better recovery according to the SF-36 questionnaire, which amounted to 76.77±6.63 points for the assessment of the general state of health, 70.81±5.86 points for the assessment of physical functioning, 68.88±5.37 points for the assessment of role functioning due to physical condition, 68.03±5.92 points for the assessment of role functioning due to emotional state, and social activity was characterized by 72.82±5.52 points. Conclusions: 1. The proposed diagnostic and treatment tactics in the patients of group 2 with strangulated abdominal hernias without resection of a hollow organ, in contrast to patients in group 1, made it possible to increase the number of laparoscopic operations to 227 (66.37%) in contrast to 55 (17.03%) in the first group, which was accompanied by a decrease in pain syndrome on the VAS scale on the fourth day when coughing from 4.35 ± 0.38 points to 2.97 ± 0.43 points. 2. The expansion of indications for the use of laparoscopic operations in patients of group 2, in contrast to patients of group 1, led to a decrease in the postoperative complications by 10.48% and the postoperative mortality by 2.29% and was characterized by better postoperative rehabilitation according to the assessment of the patients' condition after 12 months according to the SF-36 questionnaire..

The role of endoluminal surgery in a colorectal surgical practice. A global view

Patients with large colorectal polyps or mucosal neoplasms not amenable to standard polypectomy have traditionally undergone colon resection. However, minimally invasive surgical techniques have gained popularity over the past two decades. Transanal approaches such as transanal endoscopic microsurgery and transanal minimally invasive surgery have enabled surgeons to treat mucosal neoplasms located in the rectum. Later on, robotic surgery was incorporated into the transanal approach. Meanwhile, there was no such treatment option for more proximal colonic neoplasms then, and endoscopic mucosal resection and endoscopic submucosal dissection emerged in Japan to provide resection in treating such proximal lesions. Nowadays, all procedures performed in a hollow organ integrating standard surgical (dissection, resection, suturing, homeostasis) and oncological principles (en-bloc resection, clean surgical margins) are merged under endoluminal surgery. Within the scope of this review, we aimed to elaborate an overview of the role of endoluminal surgery in daily colorectal surgery practice while focusing on endoscopic procedures.

Benefits of Modern Imaging Techniques in Medicine

Relevance. For more than 100 years, medical practice has used imaging methods to observe pathological changes localized in the human body. The first method was radiography, which became popular among doctors, but later it turned out that high radiation exposure increases the incidence of tumor diseases, which is why standards for permissible radiation doses were developed for patients and radiologists. The introduction of radiocontrast agents also had contraindications that should be taken into account. Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and angiography methods have significantly increased the diagnostic capabilities of instrumental methods. The purpose of this review is to analyze the advantages and disadvantages of modern imaging methods in medicine. Methods. To achieve the purpose of the review, a literature search was conducted in Google Scholar and PubMed databases. Results. 1) The main indication for the X-ray method is visualization of bone structures. 2) X-ray contrast methods are optimal for studying hollow organs and blood vessels. 3) The advantage of MRI is the ability to visualize soft tissue well. 4) CT helps to reconstruct the spatial architecture of organs. 5) Ultrasound allows you to observe the condition of the embryo and fetus, as well as internal organs.

ХАРАКТЕРИСТИКА ЭЛЕКТРИЧЕСКОЙ АКТИВНОСТИ ОТДЕЛОВ ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА У ПОЛЬЗОВАТЕЛЕЙ ЭЛЕКТРОННЫХ СИСТЕМ ДОСТАВКИ НИКОТИНА

Introduction. Using electronic nicotine delivery systems has shown a steady growth in recent years, especially among young people. Researchers and professionals are also interested in what consequences the use of such systems may have, but most studies deal with respiratory system. Aim. The aim is to clarify the electrical activity of the gastrointestinal tract parts in users of electronic nicotine delivery systems. Materials and Methods. 35 people of both sexes were examined, divided into two comparable groups: The study group consisted of 17 people regularly using electronic nicotine delivery systems, and the comparator group consisted of 18 practically healthy individuals. All study participants were surveyed using the quality-of-life questionnaire in Gastrointestinal Symptom Rating Scale, clinical laboratory testing of blood and stool was performed, feces were tested for occult blood; and endoscopy, video colonoscopy, and electrogastroenterography were performed. The findings are presented as median (Me), as well as the first and the third quartiles (Q1; Q3). The significance of differences in groups was assessed using the Mann–Whitney test for independent quantitative variables. Differences were considered significant at p≤0.05. Results and Discussion. All individuals examined in the study group had significantly higher scores for gastroenterological symptoms on all syndrome scales of the Gastrointestinal Symptom Rating Scale questionnaire. Disturbances are shown in the electrical activity and frequency of contractions of hollow gastrointestinal organs in individuals using electronic cigarettes. Conclusions. Systematic consumption of nicotine-containing liquids via electronic nicotine delivery systems forms a specific variant of functional gastrointestinal diseases, expressed in electrophysiological disorders of the gastrointestinal tract, which is reflected in clinical symptoms.

Efficacy and Toxicity of Vincristine and CYP3A5 Genetic Polymorphism in Rhabdomyosarcoma Pediatric Egyptian Patients.

Rhabdomyosarcoma (RMS) is a rare cancer that develops in soft tissue, particularly skeletal muscle tissue and occasionally hollow organs like the bladder or uterus. Vincristine (VCR) is the main therapy used in treatment of RMS, it is an alkaloid produced from vinca and it is one of the most commonly prescribed drugs in pediatric oncology for the treatment of a number of tumors. The CYP3A5 enzyme is responsible for vincristine metabolism. The effect of CYP3A5 genetic polymorphism on the efficacy and toxicity of VCR on RMS patients still needs further research. Genotyping for CYP3A5 SNPs rs776746, rs10264272 and rs41303343 was performed using Taqman Real-Time PCR assays in a retrospective cohort study of 150 RMS pediatric patients treated with vincristine. The relationship between these genotypes and RMS survival was then examined. We found that patients with CYP3A5*3/*3 had the highest incidence of vincristine-induced neuropathy reaching 61.3%. Patients with CYP3A5*1/*3, CYP3A5*3/*6 and the normal metabolizers with CYP3A5*1/*1 had frequencies of 22%, 10.7%, and 4.7%. patients with the lowest frequency of 1.3% were those with the CYP3A5*1/*6 genotype. There was no correlation between the genotypes of CYP3A5*3, CYP3A5*6, CYP3A5*7, and RMS survival. Initial risk, metastasis, response, convulsions, unsteady gait and hepatotoxicity grade had a significant effect on overall survival with p<0.05. CYP3A5*1/*1 have less severe vincristine-induced neuropathy than CYP3A5 *1/*3, CYP3A5 *1/*6 and CYP3A5 *3/*3, CYP3A5 *3/*6. There is a significant influence of CYP3A5 mutation on neuropathy grade and assist of ADL as a part of neurotoxicity.

Botyroid Rhabdomyosarcoma of the Vagina in A Two-month-old Girl

Botyroid rhabdomyosarcoma is the most common malignant mesencymal tumor of the vagina in children and infants. It is a malignant tumor that arises from immature skeletal muscle cells (i.e., rhabdomyoblasts) lining the walls of hollow organs, including the vagina, bladder, and biliary tract. This cancer most commonly affects children under the age of 4, although it can sometimes present in older individuals. Botyroid sarcoma is usually found in the vagina during infancy and early childhood, in the cervix during reproductive years, and in the corpus uteri during postmenapausal years. Treatment is combination of surgery with adjuvants chemotherapy and radiotherapy. We report a case of two-month-old girl presented with a history of vaginal bleeding and a mass protruding from vagina. Diffusion Magnetic Resonance Imaging (MRI) showed an approximately 6 cm mass in rectovaginal septum. Excisional biopsy from the vagina confirmed the diagnosis of botyroid rhabdomyosarcoma. After biopsy the patient received multiple cycles of chemotherapy. The patient is disease-free on remission at this time.

Abstract 7040: Mutations in cytoskeleton genes SPTAN1/SPTBN1 serve as novel predictive markers for immunotherapy against bladder cancer

Abstract Cancer progression is often driven by somatic mutations. Despite several well-known driver mutations, more evidence has shown that genetic alterations in cytoskeleton organization enhance tumor aggressiveness and promote cancer progression, suggesting their roles as potential drivers. In this study, pan-cancer genetic analyses by using TCGA cohorts, more frequent mutation events were found in cytoskeleton-related genes as compared to total annotated genes, especially in cancers derived from hollow organs. High-dimensional analysis of molecular alterations in cancer (HD-MAC) suggested gene mutations in SPTAN1 and its partner SPTBN1 as potential prognostic biomarkers for clinical outcomes of patients with bladder cancer. Gene knockdown in either SPTAN1 or SPTBN1, mimicking silencing mutations in cancer tissues, caused cell morphology changes, DNA breaks, and alternations in cytokine profiles via activating cGAS-STING mediated interferon signaling. Xenograft tumor models also indicate accelerated tumor growth in SPTAN1- or SPTBN1-silenced cells, suggesting a more advanced cancer type. Based on immune staining in both human and mouse samples, increased CD8+ T cell infiltration was in tumor lesions with mutations or truncations in SPTAN1/SPTBN1 genes. In addition, several known substitution mutations were found as potent neo-antigens based on MHC II binding prediction, which could be utilized as targets for immune checkpoint therapy. This study provides a novel insight into how the cytoskeleton can contribute to cancer progression and find out predictive biological indicators with therapeutic values. Citation Format: Brian Yu-Ting Kuo. Mutations in cytoskeleton genes SPTAN1/SPTBN1 serve as novel predictive markers for immunotherapy against bladder cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7040.

Minimally invasive interventions on celiac plexus in patients with persistent abdominal pain caused by pancreatic cancer

Background. Chronic abdominal pain is common in 50 % of patients with intra-abdominal malignancies and has a huge impact on quality of their lives. As the number and doses of systemic analgesics increase, so does the frequency of side effects that can further worsen functional status, which is important for this cohort of patients who have a five-year survival rate of only 8 %. The purpose of the study: to assess the efficacy and safety of computed tomography-guided celiac plexus neurolysis as a method of reducing persistent, severe pain in patients with pancreatic cancer that affects their functional status. Materials and methods. The analysis of the results of 17 interventional procedures on the celiac plexus in 16 participants was conducted, sympatholysis was performed twice in one patient. Inclusion criteria: pancreatic cancer with persistent pharmacoresistant neuropathic abdominal pain for ≥ 3 months, which did not respond to medications, including opioids, anti-inflammatory drugs, and other conservative methods of treatment. Age of patients was 39 to 72 years (mean of 62.6 ± 8.2 years), 10 (62.5 %) research participants were male and 6 (37.5 %) were female. Results. Interventions were successfully performed for all patients on the first attempt. There were no cases of perforations of hollow organs, damage to blood vessels, pleural sinuses, or other structures of the abdominal and thoracic cavities. No neurological complications were recorded, and no one required blood transfusion. All study patients had a significant reduction in pain on the visual analogue scale compared to baseline, both one week after the procedure, from 9.7 ± 0.6 to 4.7 ± 1.4 (P &lt; 0.001), and in six months, from 9.7 ± 0.6 to 4.1 ± 1.4 (P &lt; 0.001). The average Karnofsky Performance Status Scale score compared to the data before the procedure, one week after increased from 64.7 ± 7.9 to 78.2 ± 6.4 (P &lt; 0.001). A significant improvement in functional status was maintained up to three months — 71.2 ± 6.9 (P &lt; 0.001). However, in six months, this indicator was 63.5 ± 6.0 (Р = 0.668), which may be related not only to the intensity of the pain syndrome, but also to other complications of the underlying disease (ascites, cachexia, tumor growth, palliative surgical interventions, etc.). Conclusions. Computed tomography-guided celiac plexus neurolysis is a safe and effective procedure for patients with abdominal pain caused by inoperable pancreatic cancer. Sympatholysis provides a long-term significant reduction in pain syndrome according to the visual analogue scale after 1, 3, 6 months (Р &lt; 0.001) and increases the functional status of patients according to the Karnofsky Performance Status Scale in 1 (Р &lt; 0.001), 3 months (Р = 0.023). Celiac plexus neurolysis should be considered as part of a multidisciplinary approach to the comprehensive treatment of upper abdominal pain associated with cancer in the early stages of the disease.