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( Manolis Nikolopoulos ),( Michelle A. L. Godfrey ),( Fareeda Sohrabi ),( Min Wong ),( Deepali Bhatte ),( Rekha Wuntakal ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.6
Objective To investigate the rate of asymptomatic recurrence of stage 1 endometrioid endometrial cancer and assess the role of routine hospital follow-up after treatment. Methods We performed a retrospective case-note review study of women who were diagnosed with stage 1 endometrioid endometrial adenocarcinoma at Queen’s Hospital, Romford, between January 2008 and December 2016. Results We included 299 patients with a median follow-up period of 44.4 months. All the patients underwent total hysterectomy and bilateral salpingo-oophorectomy. Adjuvant radiotherapy was offered to the patients subsequent to discussions in the multidisciplinary team meeting in accordance with the risk stratification criteria. There was no significant correlation between the risk factors and disease recurrence. In total, 11 patients presented with recurrent disease with original staging: 1a, n=6/199; and 1b, n=5/100. Four patients presented with vaginal bleeding due to vault recurrence and one patient with abdominal pain due to pelvic mass. Locoregional recurrence was an incidental finding in two other patients. Four patients presented with symptomatic distant metastases to the lung (n=2), liver (n=1), and bone (n=1). No asymptomatic recurrences were identified on routine follow-ups, despite several hospital appointments and clinical examinations. The recurrence rate for patients with stage 1a and 1b, grade 1, and grade 2 disease was 3.53%, and that for patients with stage 1a, grade 1, and grade 2 disease was 2.7%. Conclusion Routine clinical examinations have a low yield in finding recurrence in asymptomatic women and should be questioned for their value, considering the limited resources of the National Health Service (NHS). Larger studies are required to support a stratified follow-up, which will include telephone and patient-initiated follow-up.
( Manolis Nikolopoulos ),( Michelle A. L. Godfrey ),( Rekha Wuntakal ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.3
Objective To assess the clinical efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the treatment of early-stage endometrial cancer in elderly morbidly obese women, whose multiple co-morbidities made the standard surgical treatment too risky to undertake. Methods A retrospective review was conducted and case series reports were prepared of all women diagnosed with endometrial cancer, from April 2011 to December 2016 at the Queen's Hospital, London, to identify women unfit for surgery and treated with the LNG-IUS. Results Out of 438 women with endometrial cancer, Eight women with early-stage endometrial cancer were deemed unfit for surgery and underwent treatment with the LNG-IUS. All had grade 1 endometrioid endometrial adenocarcinoma, radiologically staged as 1a. Four women died of their co-morbidities, not related to endometrial cancer. One of them had 68 months of progression-free survival before death due to co-morbidities. One patient required a hysterectomy after 32 months of treatment with LNG-IUS and oral progestogens due to heavy vaginal bleeding. Three women have continued the LNG-IUS treatment with no evidence of progressive disease symptoms till date at a mean follow-up of 35.7 months. Conclusion For women with multiple co-morbidities, the LNG-IUS offers an effective and safe treatment for early-stage, lowgrade endometrial cancer, with no cases of symptomatic progression reported in our case series. In the frail and elderly, where the quality of life is of paramount importance, surgical treatment may not offer additional long-term survival benefits.
Electrocardiographic Changes in a Patient With Pulmonary Embolism and Septic Shock
Antonios N Pavlidis,Leonidas E Poulimenos,Antreas K Giannakopoulos,Athanasios Tsoukas,Manolis S Kallistratos,Athanasios J Manolis 대한심장학회 2011 Korean Circulation Journal Vol.41 No.11
Various electrocardiography (ECG) abnormalities have been reported in patients who present with pulmonary embolism (PE). Severe sepsis is also associated with ECG changes that may mimic ST elevation myocardial infarction. We report a case of an elderly patient with PE and septic shock associated with striking ECG changes.
Computationally efficient 3D finite element modeling of RC structures
George Markou,Manolis Papadrakakis 사단법인 한국계산역학회 2013 Computers and Concrete, An International Journal Vol.12 No.4
A detailed finite element modeling is presented for the simulation of the nonlinear behavior of reinforced concrete structures which manages to predict the nonlinear behavior of four different experimental setups with computational efficiency, robustness and accuracy. The proposed modeling method uses 8-node hexahedral isoparametric elements for the discretization of concrete. Steel rebars may have any orientation inside the solid concrete elements allowing the simulation of longitudinal as well as transverse reinforcement. Concrete cracking is treated with the smeared crack approach, while steel reinforcement is modeled with the natural beam-column flexibility-based element that takes into consideration shear and bending stiffness. The performance of the proposed modeling is demonstrated by comparing the numerical predictions with existing experimental and numerical results in the literature as well as with those of a commercial code. The results show that the proposed refined simulation predicts accurately the nonlinear inelastic behavior of reinforced concrete structures achieving numerical robustness and computational efficiency.
Licochalcone A bound to bovine serum albumin: a spectroscopic, photophysical and structural study
Monti, Sandra,Manet, Ilse,Manoli, Francesco,Ottani, Stefano,Marconi, Giancarlo Korean Society of Photoscience 2009 Photochemical & photobiological sciences Vol.8 No.6
The interaction of Licochalcone A (LA) with bovine serum albumin (BSA) was studied by circular dichroism (CD), UV-Vis absorption, fluorescence and laser flash photolysis. The most stable 1 : 1 and 2 : 1 LA: BSA complexes were spectroscopically characterized. Two protein sites of similar affinity are involved in the LA association with both stoichiometries. The fluorescence quantum yield was found to be higher by ca. one order of magnitude for bound LA than for the free molecule. The emission lifetime strongly depended on the protein site. Binding induced an increase in the radiative rate constant for one location and a decrease of the non-radiative rate in the other location. Two LA triplets were evidenced in the protein environment, the first one shorter-lived and the second one longer-lived than in buffer. The BSA fluorescence was quenched in the complexes. FRET was found to be inefficient. Molecular mechanics (MM), molecular dynamics (MD) and quantum mechanical calculations of rotational strength combined with CD data afforded the likely structures of the complexes. One, involving the interaction of LA with Trp212 in domain II, was able to account for most of the observed photophysical effects. MM and MD calculations also showed LA associates in domain III, the lowest energy complex being one with the drug close to Tyr409.
Torsional parameters importance in the structural response of multiscale asymmetric-plan buildings
Bakas, Nikolaos,Makridakis, Spyros,Papadrakakis, Manolis Techno-Press 2017 Coupled systems mechanics Vol.6 No.1
The evaluation of torsional effects on multistory buildings remains an open issue, despite considerable research efforts and numerous publications. In this study, a large number of multiple test structures are considered with normally distributed topological attributes, in order to quantify the statistically derived relationships between the torsional criteria and response parameters. The linear regression analysis results, depict that the center of twist and the ratio of torsion (ROT) index proved numerically to be the most reliable criteria for the prediction of the modal rotation and displacements, however the residuals distribution and R-squared derived for the ductility demands prediction, was not constant and low respectively. Thus, the assessment of the torsional parameters' contribution to the nonlinear structural response was investigated using artificial neural networks. Utilizing the connection weights approach, the Center of Strength, Torsional Stiffness and the Base Shear Torque curves were found to exhibit the highest impact numerically, while all the other torsional indices' contribution was investigated and quantified.
Torsional parameters importance in the structural response of multiscale asymmetric-plan buildings
Bakas, Nikolaos,Makridakis, Spyros,Papadrakakis, Manolis 테크노프레스 2016 Multiscale and multiphysics mechanics Vol.1 No.4
The evaluation of torsional effects on multistory buildings remains an open issue, despite considerable research efforts and numerous publications. In this study, a large number of multiple test structures are considered with normally distributed topological attributes, in order to quantify the statistically derived relationships between the torsional criteria and response parameters. The linear regression analysis results, depict that the center of twist and the ratio of torsion (ROT) index proved numerically to be the most reliable criteria for the prediction of the modal rotation and displacements, however the residuals distribution and R-squared derived for the ductility demands prediction, was not constant and low respectively. Thus, the assessment of the torsional parameters' contribution to the nonlinear structural response was investigated using artificial neural networks. Utilizing the connection weights approach, the Center of Strength, Torsional Stiffness and the Base Shear Torque curves were found to exhibit the highest impact numerically, while all the other torsional indices' contribution was investigated and quantified.
Trimethylsulfonium Lead Triiodide: An Air-Stable Hybrid Halide Perovskite
Kaltzoglou, Andreas,Stoumpos, Constantinos C.,Kontos, Athanassios G.,Manolis, Georgios K.,Papadopoulos, Kyriakos,Papadokostaki, Kyriaki G.,Psycharis, Vasilis,Tang, Chiu C.,Jung, Young-Kwang,Walsh, Aro ACS AMERICAN CHEMICAL SOCIETY 2017 Inorganic Chemistry Vol.56 No.11
<P>We report on the synthesis, characterization, and optoelectronic properties of the novel trimethylsulfonium lead triiodide perovskite, (CH3)(3)SPbI3. At room temperature, the air-stable compound adopts a hexagonal crystal structure with a 1D network of face-sharing [PbI6] octahedra along the c axis. UV-vis reflectance spectroscopy on a pressed pellet revealed a band gap of 3.1 eV, in agreement with first-principles calculations, which show a small separation between direct and indirect band gaps. Electrical resistivity measurements on single crystals indicated that the compound behaves as a semiconductor. According to multi-temperature single-crystal X-ray diffraction, synchrotron powder X-ray diffraction, Raman spectroscopy, and differential scanning calorimetry, two fully reversible structural phase transitions occur at -5 and ca. -100 degrees C with reduction of the unit cell symmetry to monoclinic as temperature decreases. The role of the trimethylsulfonium cation regarding the chemical stability and optoelectronic properties of the new compound is discussed in comparison with APbI(3) (A = Cs, methylammonium, and formamidinium cation), which are most commonly used in perovskite solar cells</P>