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Contemporary outcomes of patients undergoing robotic-assisted radical cystectomy:A comparative analysis between intracorporeal ileal conduit and neobladder urinary diversions

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Asian Journal of Urology 2023年第4期10卷 446-452页

作者： Jordan M.Rich Shivaram Cumarasamy Daniel Ranti Etienne Lavallee Kyrollis Attalla John P.Sfakianos nikhil Waingankar peter n.wiklund Reza Mehrazin Department of Urology Icahn School of Medicine at Mount SinaiNew YorkNYUSA Department of Urology Karolinska University HospitalSolnaSweden

Objective We aimed to compare perioperative and oncologic outcomes for patients undergoing robotic-assisted radical cystectomy(RARC)with intracorporeal ileal conduit(IC)and neobladder(nB)urinary *** Patients undergoing RARC with intracorporeal urinary diversion between January 2017 and January 2022 at the Icahn School of Medicine at Mount Sinai,new York,nY,USA were *** demographics,clinical characteristics,perioperative,and oncologic outcomes were *** was estimated with Kaplan-Meier *** Of 261 patients(206[78.9%]male),190(72.8%)received IC while 71(27.2%)received nB *** age was greater in the IC group(71[interquartile range,IQR 65-78]years vs.64[IQR 59-67]years,pnd BMI was 26.6(IQR 23.2-30.4)kg/m^(2).IC group was more likely to have prior abdominal or pelvic radiation(15.8%vs.2.8%,p=0.014).American Association of Anesthesiologists scores were comparable between *** IC group had a higher proportion of patients with pathological tumor stage 2(pT2)tumors(34[17.9%]vs.10[14.1%],p=0.008)and pathological node stages pn2-n3(28[14.7%]vs.3[4.2%],pn operative time(272[IQR 246-306]min vs.341[IQR 303-378]min,pnd estimated blood loss(250[150-500]mL vs.325[200-575]mL,p=0.002).Thirty-and 90-day complication rates were 44.4%and 50.2%,respectively,and comparable between ***-Dindo grades 3-5 complications occurred in 27(10.3%)and 34(13.0%)patients within 30 and 90 days,respectively,with comparable rates between *** follow-up was 324(IQR 167-552)days,and comparable between ***-Meier estimate for overall survival at 24 months was 89%for the IC cohort and 93%for the nB cohort(hazard ratio 1.23,95%confidence interval 1.05-2.42,p=0.02).Kaplan-Meier estimate for recurrence-free survival at 24 months was 74%for IC and 87%for nB(hazard ratio 1.81,95%confidence interval 0.82-4.04,p=0.10).Conclusion Patients undergoing intracorporeal IC urinary

关键词： Robotic Radical cystectomy Intracorporeal Ileal conduit neobladder Urinary diversion Oncologic outcome

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Medical therapy for spermatogenic failure

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Asian Journal of Andrology 2012年第1期14卷 57-60,176页

作者： Ranjith Ramasamy peter J Stahl peter n Schlegel Department of Urology Weill Cornell Medical College New York NY 10065 USA

Medical treatment of men with primary spermatogenic failure remains largely ineffective in contrast to those with secondary testicular failure. Treatment has been attempted with a multitude of agents ranging from hormones to nutritional supplements （antioxidants）. While some studies have demonstrated benefit to some treatments, no treatments have consistently demonstrated efficacy nor has it been possible to reliably identify patients likely to benefit. Idiopathic spermatogenic failure likely results from multiple discrete defects in sperm production that are as yet unidentified. A better understanding of these defects will yield more effective treatment options and appropriate triage of patients to specific therapeutic regimens. This review focuses on the rationale and current evidence for hormonal and antioxidant therapy in medical treatment of male infertility, spermatogenic failure in particular. Although empiric medical therapy for spermatogenic failure has been largely replaced by assisted reproductive techniques, both treatment modalities could play a role, oerhaos as combination therapy.

关键词： antioxidant hormones male infertility sperm spermatogenesis spermatogenic failure testicular failure

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Microdissection testicular sperm extraction： an update

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Asian Journal of Andrology 2013年第1期15卷 35-39页

作者： Ali A Dabaja peter n Schlegel Department of Urology Male Reproductive Medicine Weill Cornell Medical College New York NY 10065 USA

Patients with non-obstructive azoospermia （nOA） were once considered to be infertile with few treatment options due to the absence of sperm in the ejaculate. In the last two decades, the advent of intracytoplasmic sperm injection （ICSI）, and the application of various testicular sperm retrieval techniques, including fine needle aspiration （FnA）, conventional testicular sperm extraction （TESE） and microdissection testicular sperm extraction （micro-TESE） have revolutionized treatment in this group of men. Because most men with nOA will have isolated regions of spermatogenesis within the testis, studies have illustrated that sperm can be retrieved in most men with nOA, including Klinefelter＇s syndrome （KS）, prior history of chemotherapy and cryptorchidism. Micro-TESE, when compared with conventional TESE has a higher sperm retrieval rate （SRR） with fewer postoperative complications and negative effects on testicular function. In this article, we will compare the efficacy of the different procedures of sperm extraction, discuss the medical treatment and the role of testosterone optimization in men with nOA and describe the micro-TESE surgical technique. Furthermore, we will update our overall experience to allow counseling on the prognosis of sperm retrieval for the specific subsets of nOA.

关键词： azoospermia genetics male infertility microsurgery non-obstructive azoospermia sperm retrieval testicular sperm extraction

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Deletion or underexpression of the Y-chromosome genes CDY2 and HSFY is associated with maturation arrest in American men with nonobstructive azoospermia

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Asian Journal of Andrology 2012年第5期14卷 676-682页

作者： peter J Stahl Anna n Mielnik Christopher E Barbieri peter n Schlegel Darius A Paduch Department of Urology Weill Cornell Medical CollegeNew York Presbyterian HospitaI-CornellNew YorkNY 10065USA

Maturation arrest （MA） refers to failure of germ cell development leading to clinical nonobstructive azoospermia. Although the azoospermic factor （AZF） region of the human Y chromosome is clearly implicated in some cases, thus far very little is known about which individual Y-chromosome genes are important for complete male germ cell development. We sought to identify single genes on the Y chromosome that may be implicated in the pathogenesis of nonobstructive azoospermia associated with MA in the American population. Genotype-phenotype analysis of 132 men with Y-chromosome microdeletions was performed. Protein-coding genes associated with MA were identified by visual analysis of a genotype-phenotype map. Genes associated with MA were selected as those genes within a segment of the Y chromosome that, when completely or partially deleted, were always associated with MA and absence of retrievable testicular sperm. Expression of each identified gene transcript was then measured with quantitative RT-PCR in testicular tissue from separate cohorts of patients with idiopathic MA and obstructive azoospermia. Ten candidate genes for association with MA were identified within an 8.4-Mb segment of the Y chromosome overlapping the AZFb region. CDY2and HSFYwere the only identified genes for which differences in expression were observed between the MA and obstructive azoospermia cohorts. Men with obstructive azoospermia had 12-fold higher relative expression of CDY2transcript （1.33__.0.40 vs. 0.11＋_0.04; P=O.O003） and 16-fold higher expression of HSFYtranscript （0.78__.0.32 vs. 0.05_0.02; P=O.O005） compared to men with MA. CDY2 and HSFYwere also underexpressed in patients with Sertoli cell only syndrome. These data indicate that CDY2and HSFYare located within a segment of the Y chromosome that is important for sperm maturation, and are underexpressed in testicular tissue derived from men with MA. These observations suggest that impairments in CDY2 or HSFYexpression could be impli

关键词： CDY1 protein CDY2 protein genetics histology HSFY human make infertility nonobstructive azoospermia spermato-genesis sperm maturation

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Better together? Treating traumatic brain injury with minocycline plus n-acetylcysteine

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neural Regeneration Research 2022年第12期17卷 2589-2592页

作者： Siobhán Lawless peter J.Bergold Graduate Program in neural and Behavioral Sciences State University of New York-Downstate Health Sciences UniversityBrooklynNYUSA Department of Physiology and Pharmacology State University of New York-Downstate Health Sciences UniversityBrooklynNYUSA

Traumatic brain injury has a complex pathophysiology that produces both rapid and delayed brain damage. Rapid damage initiates immediately after injury. Treatment of traumatic brain injury is typically delayed many hours, thus only delayed damage can be targeted with drugs. Delayed traumatic brain injury includes neuroinflammation, oxidative damage, apoptosis, and glutamate toxicity. Both the speed and complexity of traumatic brain injury pathophysiology present large obstacles to drug development. Repurposing of Food and Drug Administration-approved drugs may be a highly efficient approach to get therapeutics to the clinic. This review examines the preclinical outcomes of minocycline and n-acetylcysteine as individual drugs and compares them to the minocycline plus n-acetylcysteine combination. Both minocycline and n-acetylcysteine are Food and Drug Administration-approved drugs with pleiotropic therapeutic effects. As individual drugs, minocycline and n-acetylcysteine are well tolerated, with known pharmacokinetics, and enter the brain through an intact blood-brain barrier. At concentrations greater than needed for antimicrobial action, minocycline is a potent anti-inflammatory minocycline, also acts as an antioxidant and inhibits multiple enzymes that promote brain injury including metalloproteases, caspases, and polyADP-ribose-polymerase-1. n-acetylcysteine alone is also an antioxidant. It increases brain glutathione, prevents lipid oxidation, and protects mitochondria. n-acetylcysteine also acts as an anti-inflammatory as well as increases extracellular glutamate by activating the X;cystine-glutamate antitransporter. These multiple actions of minocycline and n-acetylcysteine have made them attractive candidates to treat traumatic brain injury. When first dosed within the one hour after injury, either minocycline or n-acetylcysteine improves a diverse set of therapeutic outcome measures in multiple traumatic brain injury animal models. A small number of clinical

关键词： clinical trial outcome measures preclinical testing rodent models of traumatic brain injury therapeutic time window

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Isolated Bell's palsy-An unusual presentation of dengue infection

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Asian Pacific Journal of Tropical Medicine 2013年第1期6卷 82-84页

作者： Soumia peter Malhotra n peter P Sood R Department of Medicine Christian Medical College & Hospital Department of Radiodiagnosis Christian Medical College & Hospital

Dengue fever is a very common arthropod-borne infection in tropical *** complications in dengue fever are relatively uncommon and among these,isolated cranial neuropathies have been reported only very *** present an unusual neurological complication of Bell’s palsy(lower motor neuron 7 th nerve palsy) associated with dengue *** the best of our knowledge,there have been very few documented cases of Flavivirus causing isolated Bell’s palsy.

关键词： Dengue infection Bell’s palsy

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Semantic linking of complex properties,monitoring processes and facilities in web-based representations of the environment

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International Journal of Digital Earth 2016年第3期9卷 300-324页

作者： Adam M.Leadbetter peter n.Vodden Marine Institute Co.GalwayIreland Centre for Ecology and Hydrology Lancaster Environment CentreLancasterUK

Where a virtual representation of the Earth must contain data values observed within the physical Earth system,data models are required that allow the integration of data across the silos of various Earth and environmental sciences *** a mapping between the well-defined terminologies of these silos is a stubborn *** paper presents a generalised ontology for use within Web 3.0 services,which builds on European Commission spatial data infrastructure *** presented ontology acknowledges that there are many complexities to the description of environmental properties which can be observed within the physical Earth *** ontology is shown to be flexible and robust enough to describe concepts drawn from a range of Earth science disciplines,including ecology,geochemistry,hydrology and *** paper also demonstrates the alignment and compatibility of the ontology with existing systems and shows applications in which the ontology may be deployed.

关键词： observable properties monitoring properties environmental monitoring facilities semantic web geospatial data integration

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novel methylation specific real-time PCR test for the diagnosis of Klinefelter syndrome

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Asian Journal of Andrology 2014年第5期16卷 684-688,I0006页

作者： Akanksha Mehta Anna Mielnik peter n Schlegel Darius A Paduch Department of Urology Weill Cornell Medical College New York NY USA Department of Urology Emory University School of Medicine Atlanta GA USA

The aim of this study was to design a molecular assay for the diagnosis of Klinefelter syndrome （KS）, based on the detection of supernumerary X-chromosomes （X-chs）. DnA was extracted from peripheral blood samples of twenty-six 47,XXY males; two 46,XY/47,XXY males; twenty-two 46,XY males; and 15 females; and deaminated. Methylation-specific quantitative polymerase chain reaction （MS-qPCR） was performed using primers for unmethylated and methylated copies of the X-ch inactive-specific transcript （XIST-U and XIST-M） gene. X-ch disomy was determined on the basis of XIST methylation status. Degree of mosaicism in the 46,XY/47,XXY males was compared with karyotype and fluorescent in situ hybridization （FISH） results. Data analysis was performed using the Roche LightCycler software V. 3.5.3, including determination of crossing points （CPs） by fit-point analysis and melting curve analysis. Xoch disomy was detected in all female controls and KS patients; male controls expressed XIST-M only. CPs ranged from 29.5 to 32.5 （standard deviation （s.d.） 0.8） for XIST-U and from 29 to 31 （s.d. 0.6） for XIST-M. Limit of detection of mosaicism was 1%. Based on XlST-U/XIST-M ratios for the two 47,XXY/46,XY patients, the calculated degree of mosaicism （1.8% and 17.8%） was comparable to FISH results （2.3% and 15%, respectively）. Turnaround time from DnA deamination to final data analysis was under 9 h. We conclude that MS-qPCR is a sensitive, specific and rapid test for the detection of X-ch disomy, with applicability for the screening and diagnosis of KS, even in the setting of low grade 47,XXY/46,XY mosaicism.

关键词： DnA methylation Klinefelter syndrome mosaicism polymerase chain reaction

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The nonlinear optical properties of a magneto-exciton in a strained Ga_(0.2)In_(0.8)As/GaAs quantum dot

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Chinese Physics B 2013年第10期22卷 479-485页

作者： n.R.Senthil Kumar A.John peter Chang Kyoo Yoo Department of Physics SBM College of Engineering and Technology Department of Physics Govt.Arts CollegeMelur-625 106MaduraiIndia Center for Environmental Studies/Green Energy Center Deptartment of Environmental Science and EngineeringCollege of EngineeringKyung Hee UniversitySeocheon-dong 1Giheung-guYongin-SiGyeonggi-Do446-701South Korea

The magnetic field-dependent heavy hole excitonic states in a strained ***/GaAs quantum dot are investi- gated by taking into account the anisotropy, non-parabolicity of the conduction band, and the geometrical confinement. The strained quantum dot is considered as a parabolic dot of InAs embedded in a GaAs barrier material. The dependence of the effective excitonic g-factor as a function of dot radius and the magnetic field strength is numerically measured. The interband optical transition energy as a function of geometrical confinement is computed in the presence of a mag- netic field. The magnetic field-dependent oscillator strength of interband transition under the geometrical confinement is studied. The exchange enhancements as a function of dot radius are observed for various magnetic field strengths in a strained ***/GaAs quantum dot. Heavy hole excitonic absorption spectra, the changes in refractive index, and the third-order susceptibility of third-order harmonic generation are investigated in the Gao.2Ino.8As/GaAs quantum dot. The result shows that the effect of magnetic field strength is more strongly dependent on the nonlinear optical property in a low-dimensional semiconductor system.

关键词： oscillator strength exciton quantum dot

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natural forests in new Zealand–a large terrestrial carbon pool in a national state of equilibrium

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Forest Ecosystems 2021年第3期8卷 458-478页

作者： Thomas Paul Mark O.Kimberley peter n.Beets Scion Private Bag 3020Rotorua 3046New Zealand Environmental Statistics Ltd Whangapararoa 0930New Zealand retired(previously Scion) Rotorua 3010New Zealand

Background:natural forests cover approximately 29%of new Zealand’s landmass and represent a large terrestrial carbon *** 2002 new Zealand implemented its first representative plot-based natural forest inventory to assess carbon stocks and stock changes in these mostly undisturbed old-growth *** previous studies have provided estimates of biomass or carbon stocks,these were either not fully representative or lacked data from important pools such as dead wood(coarse woody debris).The current analysis provides the most complete estimates of carbon stocks and stock changes in natural forests in new ***:We present estimates of per hectare carbon stocks and stock changes in live and dead organic matter pools excluding soil carbon based on the first two measurement cycles of the new Zealand natural Forest Inventory carried out from 2002 to *** show that new Zealand’s natural forests are in balance and are neither a carbon source nor a carbon *** average total carbon stock was 227.0±14.4 tC·ha^(−1)(95%C.I.)and did not change significantly in the 7.7 years between measurements with the net annual change estimated to be 0.03±0.18 tC·ha^(−1)·yr^(−1).There was a wide variation in carbon stocks between forest *** forest had an averaged carbon stock of only 53.6±9.4 tC·ha^(−1) but had a significant sequestration rate of 0.63±0.25 tC·ha^(−1)·yr^(−1),while tall forest had an average carbon stock of 252.4±15.5 tC·ha^(−1),but its sequestration rate did not differ significantly from zero(−0.06±0.20 tC·ha^(−1)·yr^(−1)).The forest alliance with the largest average carbon stock in above and below ground live and dead organic matter pools was silver beech-red beech-kamahi forest carrying 360.5±34.6 tC·ha^(−1).Dead wood and litter comprised 27%of the total carbon ***:new Zealand’s natural Forest Inventory provides estimates of carbon stocks including estimates for difficult to measure pools such as dead wood and roots.I

关键词： Forest inventory natural forests Carbon stocks and change Terrestrial carbon pool

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