Background Pulmonary artery (PA) reconstruction for lung cancer is technically feasible with low morbidity and mortality. We assessed our experience with partial or circumferential resection of the ...PA during lung resection. Methods Between 1998 and 2013, we performed PA angioplasty in 150 patients with lung cancer. Partial PA resection was performed in 146 patients. PA reconstruction was performed by running suture in 113 patients and by using a pericardial patch in 33. A circumferential PA resection was performed in 4 patients, and reconstruction was made with polytetrafluoroethylene and by a custom-made bovine pericardial conduit. Bronchial sleeve resection was associated in 56 patients. Stage I disease was present in 32 patients, stage II in 43, stage IIIA in 51, and stage IIIB in 17. Seventy-five patients received induction chemotherapy, and 7 patients had a complete response. Results Thirty-day mortality was 3.3% (n = 5); two of these patients died of a massive hemoptysis. Pulmonary complications occurred in 33 patients, cardiac in 28, and air leaks in 17. Overall 5-year and 10-year survival was 50% and 39%, respectively. Survival at 5 and 10 years for stages I and II vs stage III was, respectively, 66% vs 32% and 56% vs 20% ( p < 0.0001). Five-year survival was 61% for N0 and N1 nodal involvement vs 28% for N2, and the respective 10-year survival was 45% vs 28% ( p = 0.001). Induction chemotherapy did not influence survival. Multivariate analysis yielded advanced stage, N2 status, and squamous cell carcinoma as negative prognostic factors. Conclusions PA reconstruction is safe, with excellent long-term survival. Our results support this technique as an effective option to pneumonectomy for patients with lung cancer.
Integrating finite rotations Bottasso, Carlo L.; Borri, Marco
Computer methods in applied mechanics and engineering,
10/1998, Letnik:
164, Številka:
3
Journal Article
Recenzirano
We study the integration of problems of evolution in the rotation group. Instead of attacking the problem in the nonlinear differential manifold SO(3) (pure rotational dynamics), as is usually done, ...we derive equations for the complete problem of motion (translational and rotational dynamics) on an extended manifold. We develop a generalization of Runge-Kutta methods that, by design, ensures that the solution will remain on the manifold for any choice of the tableau. This is obtained through configuration updates performed via the exponential map. We show how certain terms can be approximated, while retaining the order of accuracy of the scheme, and how the method conserves the total momentum of the system. Within this framework, we develop two nonlinearly unconditionally stable time integration schemes, that are associated with discrete laws of conservation/dissipation of the total energy. The dissipating algorithm generalizes to the nonlinear case the high frequency damping characteristics provided by some well-known conventional methods. We present numerical results to support our analysis, and we develop a complete application of this methodology to the nonlinear dynamics of three-dimensional rods undergoing large displacements and finite rotations, under the assumption of small strains.
A new species of the genus Lindapterys Petuch 1987 is described: L. soderii from Somalia. Moreover, the description of another specimen, from New Caledonia, is given without a new name because of the ...presence of only one specimen. Therefore, the genus Lindapterys currently includes two Indo-Pacific species and seven species in total.
An integrated 64-channel device for the read-out of parallel plate pixel and strip ionization detectors has been developed by the INFN and University of Torino. The detectors will be used for the ...monitoring and control of hadrontherapy beams. The ASIC has been designed in CMOS 0.8
μm technology and it is based on a current-to-frequency converter followed by a synchronous counter. In this paper, we present a detailed characterization of the device done with 113 chips.
This work presents a novel methodology for the dynamic analysis of general non-linear multibody systems composed of rigid and deformable bodies, the latter under the small strain assumption. In Part ...I we developed the 6-D compact representation and parameterization of motion for constrained bodies. Part II is devoted to the design of a class of modified Runge–Kutta (RK) methods dedicated to non-linear dynamics. These are capable of integrating on the configuration manifold and of preserving linear and angular momenta. Within this class of methods, two second-order algorithms are designed under the requirement of attaining non-linear unconditional stability: the energy preserving (EP) and energy decaying (ED) methods. These schemes are associated with an algorithmic law of conservation and dissipation, respectively, of the total mechanical energy of the system, together with the vanishing of the algorithmic work done by ideal, time-independent constraints. Their performances are assessed with the aid of some representative numerical applications which confirm the non-conventional properties predicted in the analysis.
This work presents a novel methodology for the dynamic analysis of general non-linear flexible multibody systems. In Part I we develop the 6-D compact representation of motion for those body models ...which motion may be described by a displacement field plus an independent rotation field. This approach explores the fundamental properties of rigid body motion, and in particular the coupled nature of linear and angular quantities in both kinematics and dynamics, inspiring a novel parameterization technique based on the exponential map. Using the proposed approach, we derive the governing equations for the case of multibody systems composed by rigid bodies and geometrically non-linear beams connected by holonomic constraints. These equations provide the starting point for the derivation of a class of numerical algorithms characterized by non-conventional conservation properties. In Part II of this work we develop the algorithms and illustrate their properties with the aid of some numerical applications.
Purpose The purpose of this study is to report the complications of superselective intra‐arterial chemotherapy with melphalan in children undergoing treatment for advanced intraocular retinoblastoma.
...Methods 49 eyes of 43 children with advanced intraocular retinoblastoma (Reese‐Ellsworth Group Vb or International Classification Group D) were treated with superselective intra‐ophthalmic artery infusion of melphalan. 22 eyes of 43 children were first diagnosis. 27 eyes of 43 children had previously failed traditional management with systemic chemotherapy and focal therapies and underwent intra‐ophthalmic artery infusion of melphalan as an alternative option to enucleation. Serial complications RETCAM images were collected.
Results Ophthalmic artery cannulation was successfully performed in 49 eyes of 43 patients. 9 eyes out of 43 (20.9%) patients were enucleated. 4 eyes out of 43 (9.3%) patients were lost to follow‐up. No severe systemic side effects occurred. Grade III neutropenia was seen in 3 patients (0.6%). No transfusions were required. 25 (58.1%) patients developed eyelid hyperaemia, 10 (23.2%) frontal region skin rash, 12 (27.9%) emiptosis, 6 (13.9%) eyelid edema, 2 (4.6%) frontal alopecia, 2 (4.6%) eyelashes loss, 2 (4.6%) chorioretinal atrophy, 1 (2.3%) acute ischemic optic neuropathy, all resolved spontaneously. 1 case (2.3%) with permanent ptosis underwent surgery. 1 case (2.3%) presented Roth’s spots.
Conclusion Ophthalmic intra‐arterial infusion with melphalan is a promising globe‐conserving treatment option in advanced retinoblastoma cases with minimal systemic side effects.
Background Extended resections (ER) for lung cancer may improve survival in selected patients. However, analysis on large series is still lacking. We reviewed our experience to identify prognostic ...factors useful for patient selection. Methods Between 1998 and 2010, 167 patients with involvement of one or more mediastinal organs underwent operations with the intent to perform ER. At thoracotomy, 42 patients (25%) were considered unresectable (explorative thoracotomy ET), and 125 (75%) underwent ER. The types of ER were superior vena cava in 43 patients (34.4%), carina in 33 (26.4%), combined with superior vena cava in 18 (14.4%), with the left atrium in 35 (28%), and with the aorta in 14 (11.2%). We excluded Pancoast tumors and vertebral resections. The minimum follow-up was 6 months. Kaplan-Meier method and log-rank test were used for statistical analysis of survival. Results There were 136 men (81.4%), with mean age of 63 years (range, 36 to 81 years). Of the 167 patients, induction chemotherapy was administered in 119 (71.3%), including 34 ET patients (81%) and 85 ER patients (68%). Complete resection was achieved in 106 patients (84.8%). The overall 5-year survival was 23% (27% in ER and 13% in ET, p = 0.41). Overall 30-day mortality was 4.8% and morbidity was 34.1%. Factors affecting survival were complete resection ( p < 0.01), pStage 0-I-II disease ( p < 0.0007), and age younger than 60 years ( p < 0.01). Conclusions ER for lung cancer invading mediastinal organs could improve long-term survival (46% at 5-years in pN0). The best surgical candidates are young patients without lymph nodes involvement who undergo radical resection. Multimodality treatment is suggested in case of mediastinal lymph node involvement.
Background The Glasgow prognostic score (GPS) is an inflammation-based score based on albuminemia and C-reactive protein concentration proved to be associated with cancer-specific survival in several ...neoplasms. The present study explored the immediate postoperative value of the GPS for patients undergoing pneumonectomy for lung cancer. Methods The value of the GPS preoperatively was studied in 250 patients undergoing pneumonectomy for non-small cell lung cancer (NSCLC). We analyzed overall postoperative complications, pulmonary and cardiac complications, 30-day postoperative death, reoperation for early complications, intensive care unit (ICU) length of stay and total length of hospital stay. Results Patients with a GPS of 0 and 1 had a mean ICU length of stay of 0.8 days, whereas patients with a GPS of 2 had a mean ICU stay of 5.0 days ( p = 0.004). The postoperative mortality rate in patients with a GPS of 2 was much higher than in patients with a GPS of 1 and 2, although it was not statistically significant ( p = 0.083). Conclusions A preoperative GPS of 2 effectively predicts a prolonged ICU stay in patients who undergo pneumonectomy for cancer. The score may be proposed as an easy-to-determine, economical, and fast preoperative tool to plan and optimize ICU admissions after elective pneumonectomy.
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