Transperitoneal para-aortic lymphadenectomy by robot assisted laparoscopy in 10 steps

Mellie Heinemann,Isabelle Masquin,Guillaume Blache,Laura Sabiani,Camille Jauffret,Gilles Houvenaeghel,Eric Lambaudie 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.5

Objective: Para-aortic lymphadenectomy was the cornerstone of gynecologic oncology surgery. In endometrial cancer, the quality of para-aortic lymphadenectomy had direct impact on survival of patient. The launch of robot assisted laparoscopy started in 2005 in France, and in 2008 a transperitoneal para-aortic lymphadenectomy was described [1]. With the increase of robots, the robot assisted laparoscopy became more and more popular, hence the need of video tutorial to help less experienced surgeon in this surgical procedure [2]. Methods: We proposed a description in 10 key steps, of a transperitoneal para-aortic lymphadenectomy by robot assisted laparoscopy (Da Vinci® Si or Xi Robot Surgical System; Intuitive Surgical Inc., Sunnyvale, CA, USA), without other surgical procedure. Results: The 10 steps are Step 1: port placement and Da Vinci robot positioning Step 2: identification of the right ureter Step 3: identification of the left renal vein Step 4: latero-caval and aorto-caval lymph nodes dissection Step 5: identification of the left ureter Step 6: creation of peritoneal tent Step 7: identification of the inferior mesenteric artery Step 8: latero-aortal lymph nodes dissection Step 9: pre-sacral lymph nodes dissection Step 10: extraction of bags with specimen and surgical textile Conclusion: A standardization of transperitoneal para-aortic lymphadenectomy by robot-assisted laparoscopy is the basis of teaching and learning process. Also it increases the quality of surgery, and consequently decreases the risk of complications.

Dynamic Modelling of Low-Temperature Batch In-Bin Drying of Cobed Seed Maize: an Industrial Case Study

Makokha Augustine B.,Melly Samwel C.,Muchilwa Isaiah E. 한국농업기계학회 2020 바이오시스템공학 Vol.45 No.4

Purpose In this paper, dynamic models have been developed to predict the air temperature, specific humidity and drying rate in an industrial seed grain dryer. Methods An industrial dryer was utilised for experimental measurements. The dyer was modelled as a system of serial cells characterised by heat and mass transfer with air back-mixing. Model equations were solved numerically based on the Levenberg– Marquardt algorithm in MATLAB. The model response was optimised by signal matching technique. The sensitivity of the model parameters on the prediction accuracy was assessed using Monte Carlo simulation tests. The accuracy of the models was statistically checked using the coefficient of determination (R2), the root mean square error (RMSE), and the probability value (p value) approach. Results The results revealed a good agreement between the measured data and model predictions with the highest mean relative deviation (MRD) of 2.37% and p value of 0.0298 at 5% significance level. The model accuracy was highly sensitive to the parameter that defines the air residence time inside the drying bin. The dryer exhibited air back-mixing level of 45.8% and moisture decay rate constant (k) of 0.028 per hour. The convective heat transfer between the air and seed grain was determined as 0.96 kJ/h m2 °C. Conclusions The dynamic models developed here can adequately predict the outlet air temperature, specific humidity and solids temperature and subsequently the drying curve. The models could help to provide real-time insights of drying characteristics, which is necessary for the achievement of a stable and effective control of the drying process.

Antiproliferative Effect of Metformin on the Endometrium - a Clinical Trial

Tabrizi, Ali Dastranj,Melli, Manijeh Sayyah,Foroughi, Meraj,Ghojazadeh, Morteza,Bidadi, Sanam Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.23

Background: Unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. The aim of this study was to evaluate the anti-estrogenic effect of metformin on endometrial histology in comparison with progesterone. Materials and Methods: A total of 43 patients who were referred to our center for abnormal uterine bleeding and had a histologic diagnosis were disordered proliferative endometrium or simple endometrial hyperplasia were included and randomly distributed in two groups treated with metformin (500mg Bid) or megestrol (40mg daily), respectively, for three months. After this period the patients were evaluated by another endometrial biopsy to assess the impact of the two drugs in restoring normal endometrial histology. Results: Our findings revealed that metformin could induce endometrial atrophy in 21 out of 22 patients (95.5%) while this positive response was achieved in only 13 out of 21 patients (61.9%) in the megstrol group. In addition two low grade endometrial carcinomas in the metformin group responded very well. Conclusions: We conclude that metformin could be used as an effective antiestrogenic agent in control of abnormal endometrial proliferative disorders.

Service Quality in Distribution Through Academics, Administration, and Facilities, Affects Brand Performance

FAKHRUDIN, Arif,YUDIANTO, Kifni,DHARASTA, You She Melly Anne Korea Distribution Science Association 2023 유통과학연구 Vol.21 No.1

Purpose: The purpose of this study was to determine the effect of Service Quality on Brand Performance through Satisfaction at an aviation campus in the Special Region of Yogyakarta, Indonesia. Research design, data, and methodology: This research design was hypothesis testing using primary data obtained by distributing questionnaires directly to 200 respondents who were active students at an aviation campus in the Special Region of Yogyakarta, Indonesia. The analytical method used was the Structure Equation Model (SEM). Results: The results of this study show that: (1) there was a significant and positive relationship between Service Quality and Satisfaction, (2) there was a significant and positive relationship between Satisfaction with Brand Performance, and (3) there was a significant and positive relationship between Service Quality and Brand Performance. Conclusion: This study concludes that for the dimension of Academic service quality distribution from the service quality variable, it is suggested to improve detailed recording by academic teaching staff. For the dimensions of Administrative Service Quality distribution from the Service Quality variable, it is recommended to increase the hospitality in the campus environment. For the dimensions of Facility Service Quality distribution from the Service Quality variable, it is recommended to increase satisfaction in terms of facilities on campus. For the Satisfaction variable, it is suggested to improve the performance of the staff and the academic community.

Diagnostic Value of Protein Ki67 (MIB-1) in Atypical Pap Smears of Postmenopausal Women

Fakhrjou, Ashraf,Dastranj-Tabrizi, Ali,Ghojazadeh, Morteza,Ghorashi, Sona,Velayati, Atefeh,Piri, Reza,Vahedi, Amir,Sayyah-Melli, Manizhe,Smaeili, Heydar-Ali,Bonakdari, Amir,Halimi, Monireh,Naghavi-Beh Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.8

Background: Atrophic epithelium of cervix sampled from postmenopausal women may mimic high-grade cervical intraepithelial neoplasia in Papanicolaou-stained (Pap) smears. Ki-67 (MIB-1) protein presents on proliferating cells, and percentage of cells with positive nuclei provides a reliable tool for rapid evaluation of the growth fraction. The aim of this study was to determine the diagnostic value of protein Ki67 staining in atypical pap smears of postmenopausal women. Methods: In a case-control setting, pap smears of 75 women with an atypical pap smear (case group) and 75 with normal pap smears (controls) were obtained before and after estrogen treatment. Afterward, samples were exposed to the monoclonal antibody Ki-67 (MIB-1) and the immunohistochemically demonstrated Ki-67+ cells were compared. Results: Mean ages of cases and controls were $60.4{\pm}4.5$ and $59.9{\pm}4.3$ years respectively (P=0.50). There was one (2.7%) positive Ki-67 specimen in the case group, without any positive Ki-67 specimen in the control group (P=0.50). Conclusions: Measurement of proliferative activity index in Pap smears restrained with MIB1 is a simple, reliable, and cost-effective method for excluding negatives. This would imply that it might allow a substantial reduction of diagnostic estrogen courses and subsequent Pap smears in postmenopausal women with atypical findings.