Hautmann and Studer orthotopic neobladders : the Michigan experience 미시간 대학병원 경험

Lee, Kyung Seop,Montie, James E.,Dunn, Rodney L.,Lee, Cheryl T. 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.2

연구목적 : 요로전환술의 치료에 있어서 Hautmann과 Studer 정위방광대치술은 획기적인 방법이다. 이에 저자들은 Hautmann과 Studer 정위방광대치술을 시행했던 환자들을 대상으로 임상적 결과를 후향적으로 분석하였다. 대상 및 방법 : 1995년 3월 1일부터 2000년 9월 30일까지 미시간 대학 병원 비뇨기과에서 방광종양으로 방광절제술 후 Hautmann과 Studer 정위방광대치술을 시행받았던 130명(Hautmann 37명, Studer 93명)을 대상으로 하였다. 이 환자들을 대상으로 두 술식에 대한 환자의 나이, 성, 수술 소요 시간, 입원 기간, 수술 중 출혈 양, 병리학적 병기와 합병증율, 요자제율 및 재수술률을 비교분석해 보았다. 통계적 분석은 Fishers exact test, T-test와 Wilcoxon rank-sum 분석을 이용하였다. 결과 : Hautmann과 Studer 정위방광대치술에 걸린 수술 시간은 각각 5.9, 5.3시간이었다(p=0.003). 입원 기간은 7일과 8.3일로 Hautmann 정위방광대치술이 짧았다(p=0.02). 그 외 나이, 성, 수술 중 출혈 양, 병리학적 병기와 합병증률 및 재수술률은 차이를 보이지 않았다. 요 자제율은 Hautmann과 Studer 정위방광대치술 각각에서 낮 시간은 67%로 같았으며 밤 시간에는 47%와 40%로 비슷하였다. 결론 : Hautmann과 Studer 정위방광대치술 두 술식 모두 안전하고 쉽게 시행할 수 있는 좋은 방법이며 요 자제율 면에서 Hautmann 정위방광대치술이 좀 더 나은 것 같으나 통계적으로 유의하지는 않았다. 또한 Hautmann 정위방광대치술이 수술 시간이 좀 덜 걸리는 것은 요관문합에서의 차이로 생각되며 입원 기간 역시 좀 더 빨리 퇴원을 종용한 결과로 생각된다. Objectives: The development of Studer and Hautmann orthotopic neobladders has revolutionized the management of urinary diversion. Several series have promoted one technique over the other This study examines the clinical outcome of a contemporary cohort of bladder cancer patients who underwent either Hautmann or Studer orthotopic reconstruction. Materials and Methods: Retrospective analysis was performed on 130 patients (93 Studer and 37 Hautmann) who underwent cystectomy and orthotopic diversion between 1st march. 1995 and 30th September 2000. Clinical parameters evaluated were age, gender, procedure time, length of hospital stay, blood loss, pathologic stage, and rate of complication, continence, and reoperation. Diversion type was compared with clinical parameters using the Fishers exact Test, t-test, and Wilcoxon rank-sum analysis. Results: Studer and Hautmann techniques had mean procedure times of 5.9 and 5.3 hours, respectively (p=0.003); Hautmann patients also had a shorter mean length of hospital stay (LOS) (7.0 vs 8.3 days, respectively; p=0.02). When comparing both populations, there was no difference in age, gender, estimated blood loss (EBL), pathologic stage, or rate of complication or reoperation. Total continence was similar in the Hautmann and Studer cohorts, whether during daytime (67% vs 67%) or nighttime (47% vs 40%) hours, respectively. Conclusions: The data suggests that both orthotopic techniques can be performed in men and women in a safe and timely fashion. Continence rates appear better with the Hautmann technique, though the limited cohort size did not offer sufficient power to detect a statistical difference. The shortened procedure time in Hautmann patients likely relates to variations in th ureteral anastomosis. Decreased LOS may reflect recent trends of early patient discharge.

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.

장내 단쇄지방산의 생성과 생리적 반응(2)

kerley Monty S.,Sunvold Gregory D. 대한수의사회 1996 대한수의사회지 Vol.32 No.9

Parkinson’s Kinetigraph in the Selection of Levodopa-Carbidopa Intestinal Gel for Motor Fluctuations Refractory to Deep Brain Stimulation

Yassine Noui,Monty Adam Silverdale,Julian Evans,Lucy Partington-Smith,Christopher Kobylecki 대한파킨슨병및이상운동질환학회 2021 Journal Of Movement Disorders Vol.14 No.3

Despite rigorous selection and programming, some patients with Parkinson’s disease (PD) may not respond optimally to deep brain stimulation (DBS). Some evidence supports the joint use of DBS and other therapies, such as levodopa-carbidopa intestinal gel (LCIG). There is increasing interest in the use of wearable technologies in selecting patients for advanced therapies. Here, we present a patient with ongoing poorly controlled symptoms following DBS for whom the selection and titration of adjunctive LCIG was facilitated by the use of wearable technology.

Numerical simulations of mountain winds in an alpine valley

Cantelli, Antonio,Monti, Paolo,Leuzzi, Giovanni,Valerio, Giulia,Pilotti, Marco Techno-Press 2017 Wind and Structures, An International Journal (WAS Vol.24 No.6

The meteorological model WRF is used to investigate the wind circulation in Valle Camonica, Italy, an alpine valley that includes a large subalpine lake. The aim was to obtain the information necessary to evaluate the wind potential of this area and, from a methodological point of view, to suggest how numerical modeling can be used to locate the most interesting spots for wind exploitation. Two simulations are carried out in order to analyze typical scenarios occurring in the valley. In the first one, the diurnal cycle of thermally-induced winds generated by the heating-cooling of the mountain range encircling the valley is analyzed. The results show that the mountain slopes strongly affect the low-level winds during both daytime and nighttime, and that the correct setting of the lake temperature improves the quality of the meteorological fields provided by WRF significantly. The second simulation deals with an event of strong downslope winds caused by the passage of a cold front. Comparisons between simulated and measured wind speed, direction and air temperature are also shown.

Seismic loss-of-support conditions of frictional beam-to-column connections

Cristoforo Demartino,Giorgio Monti,Ivo Vanzi 국제구조공학회 2017 Structural Engineering and Mechanics, An Int'l Jou Vol.61 No.4

The evaluation of the loss-of-support conditions of frictional beam-to-column connections using simplified numerical models describing the transverse response of a portal-like structure is presented in this paper considering the effects of the seismic-hazard disaggregation. Real earthquake time histories selected from European Strong-motion Database (ESD) are used to show the effects of the seismic-hazard disaggregation on the beam loss-of-support conditions. Seismic events are classified according to different values of magnitudes, epicentral distances and soil conditions (stiff or soft soil) highlighting the importance of considering the characteristics of the seismic input in the assessment of the loss-of-support conditions of frictional beam-to-column connections. A rigid and an elastic model of a frame of a precast industrial building (2-DoF portal-like model) are presented and adopted to find the minimum required friction coefficient to avoid sliding. Then, the mean value of the minimum required friction coefficient with an epicentral distance bin of 10 km is calculated and fitted with a linear function depending on the logarithm of the epicentral distance. A complete parametric analysis varying the horizontal and vertical period of vibration of the structure is performed. Results show that the loss-of-support condition is strongly influenced by magnitude, epicentral distance and soil conditions determining the frequency content of the earthquake time histories and the correlation between the maxima of the horizontal and vertical components. Moreover, as expected, dynamic characteristics of the structure have also a strong influence. Finally, the effect of the column nonlinear behavior (i.e. formation of plastic hinges at the base) is analyzed showing that the connection and the column are a series system where the maximum force is limited by the element having the minimum strength. Two different longitudinal reinforcement ratios are analyzed demonstrating that the column strength variation changes the system response.

Demographic growth in dangerous places: Concentrating conflict risks

Jack A. Goldstone,Monty G. Marshall,Hilton Root 한국외국어대학교 국제지역연구센터 2014 International Area Studies Review Vol.17 No.2

Multi-criteria retrieval of CAD assembly models

Lupinetti, Katia,Giannini, Franca,Monti, Marina,Pernot, Jean-Philippe Society for Computational Design and Engineering 2018 Journal of computational design and engineering Vol.5 No.1

Being able to reuse existing design knowledge is of major interest to help designers during the creation of new products. This is true at the level of the parts and even more at the level of the assemblies of multiple parts. Meaningful information and knowledge can be extracted from existing geometric models and associated data and metadata, as well as from the processes followed to define them. This paper proposes a method to characterize and structure CAD assembly models to enable the retrieving of similar models from a database. A framework has been devised for the retrieval of globally and/or partially similar assembly models according to multiple user-specified search criteria. It is based on an assembly descriptor, called the Enriched Assembly Model, which is an attributed graph that encodes all the required data automatically extracted from the geometry and structure of the CAD models. The data are organized in four layers: structural, assembly interface, shape and statistic layers. Starting from a real CAD model or from an abstract query model, the algorithm retrieves models from the database by solving a matching problem. The matching between two assembly models is translated into the problem of finding a subisomorphism between two EAMs. The layered organization of the EAM allows partially defined queries, which can be further refined. The effectiveness of the proposed approach is illustrated with results obtained from the developed software prototype.

Numerical simulations of mountain winds in an alpine valley

Antonio Cantelli,Paolo Monti,Giovanni Leuzzi,Giulia Valerio,Marco Pilotti 한국풍공학회 2017 Wind and Structures, An International Journal (WAS Vol.24 No.6

The meteorological model WRF is used to investigate the wind circulation in Valle Camonica, Italy, an alpine valley that includes a large subalpine lake. The aim was to obtain the information necessary to evaluate the wind potential of this area and, from a methodological point of view, to suggest how numerical modeling can be used to locate the most interesting spots for wind exploitation. Two simulations are carried out in order to analyze typical scenarios occurring in the valley. In the first one, the diurnal cycle of thermally-induced winds generated by the heating-cooling of the mountain range encircling the valley is analyzed. The results show that the mountain slopes strongly affect the low-level winds during both daytime and nighttime, and that the correct setting of the lake temperature improves the quality of the meteorological fields provided by WRF significantly. The second simulation deals with an event of strong downslope winds caused by the passage of a cold front. Comparisons between simulated and measured wind speed, direction and air temperature are also shown.

CRY1 Variations Impacts on the Depressive Relapse Rate in a Sample of Bipolar Patients

Antonio Drago,Barbara Monti,Diana De Ronchi,Alessandro Serretti 대한신경정신의학회 2015 PSYCHIATRY INVESTIGATION Vol.12 No.1

ObjectiveaaA relevant part of the social and personal burden caused by Bipolar Disorder (BD) is related to depressive phases. Authors investigated the genetic impact of a set of variations located in CRY1, a gene involved in the control of the circadian rhythms, towards depressive episodes in a sample of bipolar patients from the STEP-BD sample. As a secondary analysis, CYR1 variations were analyzed as predictors of sleep disruption. Methodsaa654 bipolar patients were included in the analysis. Data were available genome-wide. The part of the genome coding for the CRY1 was imputed and pruned according to standards in the field. 7 SNPs were available for the analysis. A correction for multitesting was applied and we had sufficient power (0.80) to detect a small-medium effect size (0.22) between two allelic frequencies each one represented by at least 300 subjects. ResultsaaIntronic rs10861688 was associated with the number of depressive events corrected for the times patients were assessed during the period of observation. In particular, AA subjects (n=21) had 4.46±3.15 events, AG (n=141) had 3.08±3.17 and GG (n=342) 2.65±2.97 (p=0.0048, beta=-0.22). No other significant associations were reported. ConclusionaaWe bring further evidence that genes involved in the regulation of circadian rhythms may be relevant to depressive bipolar phases. Independent confirmation analyses are mandatory.