Evaluation of the parameters such as tumor microenvironment (TME) and tumor budding (TB) is one of the most important steps in colorectal cancer (CRC) diagnosis and cancer development prognosis. In recent years, artificial intelligence (AI) has been successfully used to solve such problems. In this paper, we summarize the latest data on the use of artificial intelligence to predict tumor microenvironment and tumor budding in histological scans of patients with colorectal cancer. We performed a systematic literature search using 2 databases (Medline and Scopus) with the following search terms: ("tumor microenvironment" OR "tumor budding") AND ("colorectal cancer" OR CRC) AND ("artificial intelligence" OR "machine learning " OR "deep learning"). During the analysis, we gathered from the articles performance scores such as sensitivity, specificity, and accuracy of identifying TME and TB using artificial intelligence. The systematic review showed that machine learning and deep learning successfully cope with the prediction of these parameters. The highest accuracy values in TB and TME prediction were 97.7% and 97.3%, respectively. This review led us to the conclusion that AI platforms can already be used as diagnostic aids, which will greatly facilitate the work of pathologists in detection and estimation of TB and TME as instruments and second-opinion services. A key limitation in writing this systematic review was the heterogeneous use of performance metrics for machine learning models by different authors, as well as relatively small datasets used in some studies.
Treatment of functional digestive disorders is not always effective. Therefore, a search for new application points for potential drugs is perspective. Our aim is to evaluate the effect of rebamipide on symptom severity, intestinal barrier status, and intestinal microbiota composition and function in patients with diarrheal variant of irritable bowel syndrome overlapping with functional dyspepsia (D-IBSoFD). Sixty patients were randomized to receive trimebutine (TRI group), trimebutine + rebamipide (T + R group), or rebamipide (REB group) for 2 months. At the beginning and end of the study, patients were assessed for general health (SF-36), severity of digestive symptoms (Gastrointestinal Symptom Rating and 7 × 7 scales), state of the intestinal barrier, and composition (16S rRNA gene sequencing) and function (short-chain fatty acid fecal content) of the gut microbiota. The severity of most digestive symptoms was reduced in the REB and T + R groups to levels similar to that observed in the TRI group. The duodenal and sigmoidal lymphocytic and sigmoidal eosinophilic infiltration was decreased only in the REB and T + R groups, not in the TRI group. Serum zonulin levels were significantly decreased only in the REB group. A decrease in intraepithelial lymphocytic infiltration in the duodenum correlated with a decrease in the severity of rumbling and flatulence, while a decrease in infiltration within the sigmoid colon correlated with improved stool consistency and decreased severity of the sensation of incomplete bowel emptying. In conclusion, rebamipide improves the intestinal barrier condition and symptoms in D-IBSoFD. The rebamipide effects are not inferior to those of trimebutine.
We present our experience of using the UROLASE+ surgical system, based on thulium laser technology, in the context of plastic surgery. Our work with the thulium fiber laser for soft tissue dissection in vitro, ex vivo, and in vivo is described, and the positive outcomes of using the thulium fiber laser, which has not previously been employed in aesthetic surgery of the face and body, are demonstrated in this study. Integration of the thulium fiber laser may enhance safety and facilitate tissue dissection through more precise interventions, reduced blood loss, and improved clinical outcomes. This is particularly relevant for patients who have undergone cosmetic procedures leading to fibrotic changes in soft tissues, which complicate inter-tissue dissection when using traditional methods.
Extramammary Paget’s disease is a rare malignant tumor that frequently presents in areas rich in apocrine glands, most often affecting the skin of the perianal area: the labia minora, clitoris, scrotum, penis, skin of the lower abdomen, and inguinal folds. Tumors localized outside the perianal region are relatively rare. We present a clinical case of a 70-year-old patient with a tumor localized on the skin of the right axillary region, with clinical, histological, and immunohistochemical characteristics. The diagnosis of extramammary Paget’s disease with atypical localization is relatively difficult to reach in time, as tumors are often mistakenly considered as inflammatory skin lesions, and the appropriate treatment may therefore be delayed.