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Menon M, Addington J, Remington G. Examining Cognitive Biases in Patients With Delusions of Reference. Eur Psychiatry 2011; 28:71-3. [DOI: 10.1016/j.eurpsy.2011.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 03/28/2011] [Accepted: 03/29/2011] [Indexed: 11/16/2022] Open
Abstract
AbstractCognitive biases may not be seen in all subtypes of delusions, and might be more involved in the etiology of some delusional subtypes than others. A sample of patients with delusions of reference did not show the jumping to conclusions (JTC) bias. JTC appears to be more closely related to paranoia than referential delusions.
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Heath EI, Hwang C, Cher ML, Heilbrun LK, Powell I, Menon M, Li J, Heath M, Sethi S, Sarkar FH. A biomarker trial of BR-DIM (BioResponse 3,3’- Diindolylmethane) in patients with prostate cancer who undergo prostatectomy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sukumar S, Diaz M, Kaul S, Hwang C, Peabody J, Menon M, Rogers C. Predictors and outcomes of biochemical persistence versus recurrence after radical prostatectomy for prostate cancer diagnosed in the era of PSA screening. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rogers C, Sammon JD, Diaz M, Sukumar S, Hwang C, Peabody J, Menon M. Biochemical recurrence in 3,671 patients following robot-assisted radical prostatectomy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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55
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Mezher-Sikafi R, Jephcott C, Parmar J, Menon M. Timing of Surgery following Long Course Chemoradiation in the Management of Locally Advanced Rectal Cancers. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dabaja A, Menon M, Agarwal P. Prognostic indicators of aggressive disease in patients with locally advanced or metastatic prostate cancer: A focus on neutrophil to lymphocyte and platelet to lymphocyte ratios. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
62 Background: Prostate specific antigen (PSA) and Gleason Score (GS) are helpful in predicting aggressive disease. Recently, the neutrophil:lymphocyte ratio (NLR) and platlet:lymphocyte ratio (PLR) were identified as prognostic indicators in gastric cancer which has an inflammatory pathogenesis. We hypothesized that these indicators may be prognostic in prostate cancer which is also postulated to have an inflammatory mechanism of carcinogenesis. Our goal was to assess if NLR and PLR is predictive of aggressive prostate cancer, which will be measured by metastasis and overall survival in patients on hormonal therapy as treatment. Methods: We performed a retrospective analysis of 246 patients that were being treated with hormone therapy for either locally advanced or metastatic disease, or who were not surgical candidates or refused surgery. A logistic regression model was used to analyze various prognostic factors including total GS, pre-biopsy PSA, perineural invasion, % of core biopsies positive, NLR, and PLR. Endpoints studied were overall survival and metastasis. Results: The logistic regression showed only pre biopsy PSA as a predictor of metastasis (n=82). The increased risk when measured continuously was 0.6% increase in odds ratio (p<0.015). When PSA was measured categorically the % biopsy cores positive were predictive of increased risk of metastatic disease with a 2.9% increase in odds ratio (p<0.002). The % biopsy cores positive were predictive of a 3.7% increased odds ratio in cancer-specific mortality (p<0.002). These results were controlled for age, which gave a 7% increase in odds ratio of overall survival (p<0.049). Conclusions: Despite the thought that prostate cancer has an inflammatory pathogenesis, no correlation was found between N:L and P:L ratios and overall survival or bone metastasis in patients on hormone therapy for locally advanced disease. There was a negative correlation between increased % positive biopsy cores a decreased risk of survival. Further investigation is necessary to investigate the role of NLR and PLR as prognostic indicators in organ confined prostate cancer. No significant financial relationships to disclose.
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Srivastava AK, Madhavi S, Menon M, Ramanujan RV. Synthesis of Co/Co3O4 nanocomposite particles relevant to magnetic field processing. JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY 2010; 10:6580-6585. [PMID: 21137765 DOI: 10.1166/jnn.2010.2532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Co/Co3O4 nanocomposite particles of various morphologies were synthesized by the reverse micelle technique. Equiaxed, rod and faceted crystals with rectangular, pentagonal and hexagonal cross sections were observed. Annealing resulted in the formation of a composite of cobalt oxide (Co3O4) and fcc cobalt (Co). Removal of boron residues from the final product was established by surface characterization. Magnetic moment of these nanocomposite particles is relevant to magnetic field processing.
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Menon M, Soni S, Kusunam S, Bajaj S, Muoio V, Molmenti E, Jhaveri K, Bhaskaran M. 193: Elevated Human Chorionic Gonadotrophin (HCG) Levels in Patients With Chronic Kidney Disease. Am J Kidney Dis 2010. [DOI: 10.1053/j.ajkd.2010.02.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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59
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Puri A, Liang M, Perera S, Menon M, Devlin G. Long-Term Outcomes on Medically Managed Patients having Favourable Coronary Fractional Flow Reserve. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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60
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Puri A, Liang M, Perera S, Menon M, Devlin G. Long-Term Outcomes on Medically Managed Patients Having Favourable Coronary Fractional Flow Reserve. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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61
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Thamilselvan V, Menon M, Thamilselvan S. MP-19.03: Reactive Oxygen Species in Cell Injury: Mechanisms in Hyperoxaluria Induced Urolithiasis and Therapeutic Approaches. Urology 2009. [DOI: 10.1016/j.urology.2009.07.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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62
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Yuh B, Chandrasekhar R, Hussain A, Wilding G, Mohler J, Menon M, Peabody J, Guru K. MP-05.14: Robotics in Urology: Comparison of International Practice Patterns. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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63
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Korostil M, Kapur S, Tassopoulos M, Menon M, McIntosh AR. Neural strategies for language learning in schizophrenia. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71331-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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64
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Satyanarayana R, Krane L, Patil N, Rogers C, Bhandari M, Menon M. MP-4.17: Prostate Cancer is Significant Even in low PSA Ranges with a Family History. Urology 2008. [DOI: 10.1016/j.urology.2008.08.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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65
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Krane L, Patil N, Kheterpal E, Bhandari M, Peabody J, Menon M. MP-1.06: Is Diabetes Mellitus Associated with Aggressive Characteristics in Prostate Cancer? Urology 2008. [DOI: 10.1016/j.urology.2008.08.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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66
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Patil N, Javed K, Krane L, Bhandari M, Williams T, Menon M. POD-4.06: Evaluation of Cystographic Leak in Patients Undergoing Robotic Prostatectomy. Urology 2008. [DOI: 10.1016/j.urology.2008.08.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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67
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Patil N, Krane L, Pokala N, Satyanarayan R, Bhandari M, Menon M. MP-3.18: Robotic Prostatectomy in Patients Over Seventy Years. Urology 2008. [DOI: 10.1016/j.urology.2008.08.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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68
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Krane L, Laungani R, Patil N, Bhandari M, Rogers C, Stricker H, Peabody J, Menon M. POD-1.08: Suprapubic Cystostomy at Time of Vattikuti Institute Prostatectomy (VIP): Preliminary Results with Catheter Removal on Postoperative Day 1. Urology 2008. [DOI: 10.1016/j.urology.2008.08.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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69
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Krane S, Pokala N, Patil N, Peabody J, Menon M. UP.45: Role and Significance of Neo-Adjuvant Hormonal Therapy on Patients Undergoing Vattikuti Institute Robotic Radical Prostatectomy (RRP): A Case-Matched Comparative Study. Urology 2008. [DOI: 10.1016/j.urology.2008.08.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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70
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Pathak H, Morris C, Menon M. Technique for reducing incision-related postoperative pain. Ann R Coll Surg Engl 2008; 90:525. [PMID: 18780420 DOI: 10.1308/rcsann.2008.90.6.525b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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71
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McAleavey S, Menon M. 7B-3 Direct Estimation of Shear Modulus using Spatially Modulated Acoustic Radiation Force Impulses. ACTA ACUST UNITED AC 2007. [DOI: 10.1109/ultsym.2007.145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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72
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Thamilselvan V, Menon M, Thamilselvan S. MP-03.06: Oxalate-induced nadph oxidase mediated free radical generation is protein kinase C-dependent in renal epithelial cells. Urology 2007. [DOI: 10.1016/j.urology.2007.06.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Following the successful application of the da Vinci robot in minimally invasive radical prostatectomy, several surgeries are now being performed with the assistance of the robot. These include both upper tract and lower tract surgeries such as nephrectomy, pyeloplasty and sacrocolpopexy and both ablative and reconstructive procedures. This article attempts to put into perspective the current role of the da Vinci Surgical system in urologic surgery and discusses in brief new developments in robotic technology that are on the horizon. A MEDLINE search was performed and published data on robot-assisted urologic procedures were reviewed. Abstracts presented at major international conferences in the last two years were also reviewed. Studies presenting operative and functional data for more than five patients were used in the review. There has been an explosive increase in the number of urologic procedures being attempted using Da Vinci assistance. Many, such as partial nephrectomy, donor nephrectomy, cystoprostatectomy, ureteral reimplantation and vasovasostomy are in the phase of feasibility studies, however others such as radical prostatectomy and pyeloplasty have one year functional results available which are comparable to those of other minimally invasive approaches. We believe that robotic technology represents the future of minimally invasive surgery and applications for the robot will expand as more centers report their results.
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Kaul SA, Menon M. Da Vinci assisted cystoprostatectomy and urinary diversion: a paradigm shift in surgical management of bladder cancer. MINERVA UROL NEFROL 2007; 59:149-57. [PMID: 17571051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Radical cystoprostatectomy remains the gold standard treatment for muscle invasive bladder cancer. Use of minimally invasive approaches have gained prominence aided by surgical adjuncts such as harmonic scalpel and laparoscopic bowel staplers, however laparoscopic radical cystoprostatectomy remains extremely technically challenging even for experienced laparoscopic surgeons. Following the successful application of the da Vinci robotic surgical system for radical prostatectomy, attention has now turned to the use of robot assistance for laparoscopic cystoprostatectomy. Several centers have explored the feasibility of robotic cystoprostatectomy although long-term data is lacking. Controversy exists on the oncologic efficacy and safety, need for intracorporeal diversion and standardization of technique. This article details the history, technique, results and current status of robotic cystoprostatectomy and urinary diversion.
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Riske F, Smith M, Menon M, Goetschalck S, Goidsenhoven IV, Krul A, Pimpaneau V, Renaers I, Van Tichelt N, Van Houdt K, Hayes M, Lawrence C, Bigelow R, Schroeder J. A potential generic downstream process using Cibracon Blue resin at very high loading capacity produces a highly purified monoclonal antibody preparation from cell culture harvest. J Chromatogr B Analyt Technol Biomed Life Sci 2007; 848:108-15. [PMID: 16893691 DOI: 10.1016/j.jchromb.2006.06.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Revised: 06/07/2006] [Accepted: 06/24/2006] [Indexed: 11/26/2022]
Abstract
The use of a dye-ligand chromatography for the purification of monoclonal antibody (MAb) from cell culture and other feed streams has been largely overlooked in large scale production. Cibracon Blue dye (CB), a polycyclic anionic ligand, interacts with protein through a specific interaction between the dye, acting as a mimic of NAD+ and NADP+, or through non-specific electrostatic, hydrophobic, and other forces. In this paper, a CB resin was used to effectively and efficiently separate an IgG4 MAb from host and process impurities following the capture of the MAb on a Protein-A (PA) column. The CB unit operation, challenged at </=180 g MAb/L of resin with the PA eluate, reduced BSA (1-2 log), host cell protein (HCP; 2-3 log), MAb oligomer (31-85%), fragment (from approximately 0.8% to <0.1%), and other undesired MAb species. Purity, as measured by non-reducing (NR) SDS-PAGE, was improved 33-85%, to 92-99.5% overall (>99% by reducing SDS-PAGE). A facile three column scalable production scheme, employing CB as the second column in the process was used to generate highly purified MAb from cell culture harvest derived from two media of very different compositions. Free CB dye was </=1 ng/mg in MAb preparations purified through the three column process and then concentrated and buffer exchanged into the appropriate buffer using tangential flow filtration (TFF).
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76
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Sahabudin RM, Arni T, Ashani N, Arumuga K, Rajenthran S, Murali S, Patel V, Hemal A, Menon M. Development of robotic program: an Asian experience. World J Urol 2006; 24:161-4. [PMID: 16607550 DOI: 10.1007/s00345-006-0069-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Accepted: 03/06/2006] [Indexed: 10/24/2022] Open
Abstract
Robotic surgery was started in the Department of Urology, Hospital Kuala Lumpur, in April 2004. We present our experience in developing the program and report the results of our first 50 cases of robotic radical prostatectomy. A three-arm da Vinci robotic system was installed in our hospital in March 2004. Prior to installation, the surgeons underwent training at various centers in the United States and Paris. The operating theatre was renovated to house the system. Subsequently, the initial few cases were done with the help of proctors. Data were prospectively collected on all patients who underwent robot-assisted radical prostatectomy for localized carcinoma of the prostate. Fifty patients underwent robot assisted radical prostatectomy from March 2004 to June 2005. Their ages ranged from 52 to 75 years, (average age 60.2 years). PSA levels ranged from 2.5 to 35 ng/ml (mean 10.6 ng/ml). Prostate volume ranged from 18 to 130 cc (average 32.4 cc). Average operating time for the first 20 cases was 4 h and for the next 30 cases was 2.5 h. Patients were discharged 1-3 days post-operatively. Catheters were removed on the fifth day following a cystogram. The positive margin rate as defined by the presence of cancer cells at the inked margin was 30%. Twenty-one patients had T1c disease and one had T1b on clinical staging. Of these, two were apical margin positive. Twenty-six patients had T2 disease and eight of them were apical margin positive. Two patients had T3 disease, one of whom was apical margin positive. Five patients (10%) had PSA recurrence. Five patients had a poorly differentiated carcinoma and the rest had Gleason 6 or 7. Eighty percent of the patients were continent on follow-up at 3 months. Of those who were potent before the surgery, 50% were potent at 3-6 months. The robotic surgery program was successfully implemented at our center on the lines of a structured program, developed at Vattikuti Urology Institute (VUI). We succeeded in creating a team and safely implemented the robotic program in our system. Adequate funding and extensive training followed by a short term proctoring are essential for this implementation.
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Menon M. Intrapleural streptokinase does not improve outcomes in empyema. Thorax 2005. [DOI: 10.1136/thx.2005.la0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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78
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Salama ME, Guru K, Stricker H, Peterson E, Peabody J, Menon M, Amin MB, De Peralta-Venturina M. pT1 SUBSTAGING IN RENAL CELL CARCINOMA: VALIDATION OF THE 2002 TNM STAGING MODIFICATION OF MALIGNANT RENAL EPITHELIAL TUMORS. J Urol 2005; 173:1492-5. [PMID: 15821466 DOI: 10.1097/01.ju.0000154693.68717.12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Tumor size has been used as one of the criteria to stratify renal cell carcinoma (RCC) into different pathological stages (pT). The recent 2002 UICC/TNM classification of malignant epithelial renal tumors is modified to substratify pT1 RCC into pT1a (less than 4.0 cm) and pT1b (greater than 4.0 but less than 7.0 cm). In this study we ascertained if this stage modification has prognostic relevance. MATERIALS AND METHODS A total of 259 consecutive radical nephrectomy specimens of organ confined RCC from 1970 to 1997 at 1 institution, including 153 of conventional RCC (CRCC), 71 of papillary RCC, 28 of chromophobe RCC, 1 of collecting duct carcinoma and 6 of RCC not otherwise specified, with a mean clinical followup of 7.5 years (median 6.4) were included in the study. RESULTS There were 115 pT1a (44.4%), 95 pT1b (36.7%) and 49 pT2 tumors (18.9%). Disease recurrences (DR) and disease specific death occurred in 2 (1.7%) and 0 cases (0%) of pT1a, 7 (7.3%) and 5 (5.3%) of pT1b, and 16 (32.6%) and 12 (24.5%) of pT2. DR for pT1b was higher compared with pT1a (all histological subtypes RR 3.68), although this difference was not statistically significant (p = 0.106). If only CRCCs were analyzed, DR in the pT1b group was statistically higher compared with pT1a (RR 8.54, p = 0.047). Disease specific survival in pT1a could not be evaluated because no deaths occurred in this subgroup. DR and disease specific survival were significantly different between pT1b and pT2 tumors for all histological subtypes (RR 5.51, p = 0.001 and 5.49, p = 0.001) and for the CRCC subtype (RR 5.50, p = 0.001 and 5.18, p = 0.005, respectively). Using size as a continuous variable the logarithmic change in tumor size was a significant predictor of DR (RR 8.82, p = 0.001). All statistical analyses were adjusted for age and sex. CONCLUSIONS Substaging RCC into pT1a and pT1b yields prognostically important information, validating the 2002 TNM modification for malignant renal epithelial malignancies. The substratification of pT1 is particularly useful in tumors with CRCC histology.
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Tewari A, Bhandari A, Hemal A, Menon M. Robotic radical prostatectomy-a minimally invasive therapy for prostate cancer: results of initial 530 cases. Indian J Urol 2005. [DOI: 10.4103/0970-1591.19628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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80
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81
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Bhandari A, Hemal A, Menon M. Instrumentation, sterilization, and preparation of robot. Indian J Urol 2005. [DOI: 10.4103/0970-1591.19626] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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82
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Menon M. Sensitivity of pulmonary function tests in assessing whether bronchodilatation is different in healthy subjects and asthmatics. Thorax 2004. [DOI: 10.1136/thx.2004.la0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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83
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Gamito EJ, Tewari A, Crawford ED, Porter CR, Presti J, O'Donnell C, Bartsch G, Horninger W, Klocker H, Menon M. The mean probability of finding cancer in transrectal ultra sound guided prostate biopsy: An update. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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84
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Badani KK, Hemal AK, Menon M. Autosomal dominant polycystic kidney disease and pain - a review of the disease from aetiology, evaluation, past surgical treatment options to current practice. J Postgrad Med 2004; 50:222-6. [PMID: 15377813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Autosomal Dominant Polycystic Kidney Disease (ADPKD), often referred to as "adult" polycystic kidney disease, is one of the commonest hereditary disorders. It affects approximately 4 to 6 million individuals worldwide. The disease progresses to end-stage renal disease and it accounts for 10-15% of patients requiring dialysis in the United States. A comprehensive Medline search for aetiology, evaluation, screening, cellular biology, and treatment was utilized to locate, extract, and synthesize relevant data with respect to this topic. Special attention was focused on urologic literature and surgical textbooks regarding operative treatment of pain associated with ADPKD. Now, patients with ADPKD have more treatment options. More specifically, several therapeutic alternatives are now available for the management of pain in these patients. A recent review of literature supports the performance of open or laparoscopic cyst decortication procedures for control of pain and infection without the worry of causing further renal impairment in those with preserved renal function.
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Menon M, Hemal AK, Tewari A, Shrivastava A, Bhandari A. The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. BJU Int 2004; 93:715-9. [PMID: 15049978 DOI: 10.1111/j.1464-410x.2003.04748.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the technique of dissecting the apex of the prostate and a modified single running-suture urethrovesical anastomosis in patients undergoing robot-assisted radical prostatectomy for organ-confined prostate cancer. PATIENTS AND METHODS Over 550 robot-assisted radical prostatectomies have been undertaken using Vattikuti Institute Prostatectomy (VIP) technique in patients with localized carcinoma of the prostate. We present a critical analysis of the first 120 procedures by one surgeon (M.M.) at our institution using this newly developed technique of urethrovesical anastomosis preceded by dissecting the apex of the prostate. RESULTS The mean time for the urethrovesical anastomosis was 13 min. All but 24 patients had their catheter removed 4 days after surgery, as indicated by a cystogram. The catheter was removed successfully at 7 days in the remaining 24 patients who had a mild leak on cystography. Two patients had urinary retention within a week of removing the catheter and had to be re-catheterized. Continence was evaluated using standardized criteria before and after the procedure. The patients also replied to a mailed validated questionnaire survey; 96% were continent at 3 months and the remaining 4% used a thin pad for security. CONCLUSIONS We report a technique of dissecting the apex of the prostate and prostatovesical junction for dividing the bladder neck, and a modified single running-suture urethrovesical anastomosis, in patients undergoing robot-assisted radical prostatectomy for organ-confined cancer of the prostate. The same principles can also be applied for the anastomosis during pure laparoscopic procedures and for urethro-neovesical anastomosis in patients undergoing robotic radical cystoprostatectomy for carcinoma of the bladder.
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Menon M, Hemal AK, Tewari A, Shrivastava A, Shoma AM, El-Tabey NA, Shaaban A, Abol-Enein H, Ghoneim MA. Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversion. BJU Int 2003; 92:232-6. [PMID: 12887473 DOI: 10.1046/j.1464-410x.2003.04329.x] [Citation(s) in RCA: 391] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To develop a technique of nerve-sparing robot-assisted radical cystoprostatectomy (RRCP) for patients with bladder cancer. PATIENTS AND METHODS Robotic assistance should enhance the ability to preserve the neurovascular bundles during laparoscopic radical cystectomy. Thus we undertook RRCP and urinary diversion using a three-step technique. First, using a six-port approach and the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA), one surgeon carried out a complete pelvic lymphadenectomy and cystoprostatectomy using a technique developed specifically for robotic surgery. The neurovascular bundles were easily identified and dissected away, the specimen entrapped in a bag and removed through a 5-6 cm suprapubic incision. Second, a different surgical team exteriorized the bowel through this incision and created a neobladder extracorporeally. Third, the neobladder was internalized, the incision closed and the primary surgeon completed the urethro-neovesical anastomosis with robotic assistance. RESULTS RRCP was carried out in 14 men and three women by the primary surgeon (M.M.). The form of urinary reconstruction was ileal conduit in three, a W-pouch with a serosal-lined tunnel in 10, a double-chimney or a T-pouch with a serosal-lined tunnel in two each. The mean operative duration for robotic radical cystectomy, ileal conduit and orthotopic neobladder were 140, 120 and 168 min, respectively. The mean blood loss was < 150 mL. The number of lymph nodes removed was 4-27, with one patient having N1 disease. The margins of resection were free of tumour in all patients. CONCLUSIONS We developed a technique for nerve-sparing RRCP using the da Vinci system which allows precise and rapid removal of the bladder with minimal blood loss. The bowel segment can be exteriorized and the most complex form of orthotopic bladder can be created through the incision used to deliver the cystectomy specimen. Performing this part of the operation extracorporeally reduced the operative duration.
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Tewari A, Srivasatava A, Menon M. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int 2003; 92:205-10. [PMID: 12887468 DOI: 10.1046/j.1464-410x.2003.04311.x] [Citation(s) in RCA: 348] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
UNLABELLED The authors from the Vattikuti Institute in the USA report a prospective comparison of radical prostatectomy and robot-assisted prostatectomy. They found that the robot-assisted procedure was safer, and yielded favourable oncological and functional results. They also present work in association with the Department of Urology in Mansoura into robot-assisted radical cystoprostatectomy and urinary diversion, and point out the advantages and disadvantages associated with performing the most complex types of urinary diversion. There is also an interesting paper relating to the association between sexual factors and prostate cancer, from authors in institutions in Australia, New Zealand and Italy. They found that in a case-control study of men aged <70 years, ejaculatory frequency was negatively associated with the risk of prostate cancer. Technology has made many contributions to the management of urological patients. The classic example is that of urinary stone management. Authors from the USA evaluated cyroablation of renal carcinoma in patients with solitary kidneys. They are encouraged by their results and suggest that there is merit in this treatment, but indicate the need for a longer follow-up. OBJECTIVE To prospectively compare standard radical retropubic prostatectomy (RRP) and the robotically assisted Vattikuti Institute prostatectomy (VIP) in the management of localized prostate cancer. PATIENTS AND METHODS The study was a single-institution, prospective, unrandomized comparison of histopathological, and functional outcomes, at baseline and during and after surgery, in 100 patients undergoing RRP and 200 undergoing VIP. RESULTS While the variables before surgery, the operative duration (163 vs 160 min) and pathological stages were comparable, there were significant differences in the measured outcomes. The blood loss was 910 and 150 mL for RRP and VIP, respectively, and transfusion was greater after RRP (67% vs none; both P < 0.001). There were four times as many complications after RRP (20% vs 5%, P < 0.05), the haemoglobin level at discharge was lower (100 vs 130 g/L, P < 0.005) and the hospital stay longer (3.5 vs 1.2 days; P < 0.05). Most (93%) of VIP and none of the RRP patients were discharged within 24 h (P < 0.001); the duration of catheterization was twice as long after RRP (15.8 vs 7 days; P < 0.05). Positive margin was more frequent after RRP (23% vs 9%, P < 0.05). After VIP, patients achieved continence and return of erections more quickly than after RRP (160 vs 44, and 180 vs 440 days, both P < 0.5). The median return to intercourse was 340 days after VIP but after RRP half the patients have as yet not resumed intercourse at 700 days (P < 0.05). CONCLUSIONS The VIP procedure appears to be safer, less bloody and requires shorter hospitalization and catheterization. The oncological and functional results were favourable in patients undergoing VIP.
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Amendola A, Menon M, Clatworthy M, Fowler PJ. The effect of fixation technique on graft position in anterior cruciate ligament reconstruction. THE IOWA ORTHOPAEDIC JOURNAL 2003; 23:29-35. [PMID: 14575246 PMCID: PMC1888394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The purpose of this paper was to determine the extent to which the technique used in ACL reconstruction and fixation influences graft placement. This is a Comparative Radiographic cohort study. Precise graft placement is one of the most crucial components of a successful anterior cruciate ligament (ACL) reconstruction. Two commonly used techniques of ACL reconstruction are arthroscopic bone-patellar tendon-bone (B-PT-B) autograft with interference screw fixation and semi-tendinosus and gracilis (ST + G) tendon autograft with endobutton femoral and multiple staple belt buckle tibial fixation. Using radiographic measurements of bone tunnel position following ACL reconstruction this study quantified the extent to which these techniques influenced graft placement. Femoral and tibial tunnel position in ACL reconstruction was determined using the post-operative radiographs of 40 male patients who had undergone ACL reconstruction (20 B-PT-B and 20 ST + G). The primary outcome measure was location of bone tunnel position following ACL reconstruction. Measurements were based on the guidelines of Amis et al. Femoral tunnel position of B-PT-B grafts was an average of 9.36% more anterior in the sagittal plane than with ST + G grafts. The mean position of B-PT-B grafts was at 31.11% (SD = 5.45%). The mean position of the ST + G grafts was 21.76% (SD = 6.62%). This difference between the two was found to be significant (p < .001). As demonstrated by this study, placement and orientation may vary to accommodate technique and fixation. Clinical outcomes measured were similar in both groups.
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Afzal M, Ali M, Mohammed N, Al-Sweedan N, Fareed A, Menon M, Dhami MS. Modulation of bile acids induced by paraquat in rabbits. DRUG METABOLISM AND DRUG INTERACTIONS 2002; 11:301-15. [PMID: 12369754 DOI: 10.1515/dmdi.1994.11.4.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rabbit bile was examined for changes in composition induced by paraquat. Paraquat was administered intraperitoneally and changes in bile components were monitored by high performance liquid chromatography. Alterations in the ratios of total glycine/taurine conjugated bile acids (TGC/TTC), cholic acid/deoxycholic acid (CA/DC), cholic acid/chenodeoxycholic acid (CA/CDC) and cholic acid/cholesterol (CA/CH) were measured as an index of paraquat toxicity. A statistically significant increase in the ratio of TGC/TTC was observed, while CA/DC, CA/CDC and CA/CH showed a decrease. Phospholipids, protein, sugar, bilirubin, beta-carotene, vitamin A and vitamin E in the bile and serum of the experimental animals were also monitored. In bile, the levels of cholesterol, phospholipids, protein, sugar, and total bile acids increased while the levels of the antioxidants beta-carotene, vitamin A and vitamin E decreased. A decrease in the bilirubin content of the bile was also observed. These modifications may be useful clinically for assessment of paraquat toxicity.
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Dhami MS, Menon M, Aliling R, Afzal M, DiFonzo CJ, Ali B, Feuer G. Effect of environmental pollutants on hepatocellular function in rats: 3-methylcholanthrene and Aroclor-1254. DRUG METABOLISM AND DRUG INTERACTIONS 2002; 11:283-99. [PMID: 12369753 DOI: 10.1515/dmdi.1994.11.4.283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Environmental pollutants, Aroclor-1254 (PCB) and 3-methylcholanthrene (MC), were employed in this study to investigate some aspects of the induction of hepatic drug metabolism in rats. PCB and MC treatments increased 7-ethoxyresorufin and 7-ethoxycoumarin O-deethylase activities related to cytochrome P-448. Cytochrome P-450 reductase activity was increased by PCB while no effect was observed by MC treatment. Pretreatment with PCB resulted in approximately 50% increase in the phospholipid content of the microsomes whereas MC caused no change. Liver microsomal cholesterol content was decreased while triglycerides were increased by PCB. The ratio between saturated and unsaturated fatty acids (saturation index) decreased in the total microsomes and phospholipids with PCB treatment, whereas MC did not alter the ratio, except that the major effect of MC was observed in the acyl derivatives of microsomal phosphatidylethanolamine. It is proposed that the uniaxial rotation and mobility of hemoproteins may be restricted by an increase in the saturation index of the membrane, while a decreased index may facilitate contact with reductases for electron transfer by enhanced membrane fluidity. The decreased saturation index after treatment with MC may play a role in carcinogenicity by triggering induction of free radicals.
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Gabel M, McEvoy D, Fleming C, Tejwani S, Kloustin K, Javidan J, Peabody J, Stricker H, Demers R, Kim J, Menon M. E=MC2: a new formula for improving the prostate cancer patient’s care experience. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03588-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tewari A, Porter C, Peabody J, Crawford ED, Demers R, Johnson CC, Wei JT, Divine GW, O'Donnell C, Gamito EJ, Menon M. Predictive modeling techniques in prostate cancer. MOLECULAR UROLOGY 2002; 5:147-52. [PMID: 11790275 DOI: 10.1089/10915360152745812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A number of new predictive modeling techniques have emerged in the past several years. These methods can be used independently or in combination with traditional modeling techniques to produce useful tools for the management of prostate cancer. Investigators should be aware of these techniques and avail themselves of their potentially useful properties. This review outlines selected predictive methods that can be used to develop models that may be useful to patients and clinicians for prostate cancer management.
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Tewari A, Issa M, El-Galley R, Stricker H, Peabody J, Pow-Sang J, Shukla A, Wajsman Z, Rubin M, Wei J, Montie J, Demers R, Johnson CC, Lamerato L, Divine GW, Crawford ED, Gamito EJ, Farah R, Narayan P, Carlson G, Menon M. Genetic adaptive neural network to predict biochemical failure after radical prostatectomy: a multi-institutional study. MOLECULAR UROLOGY 2002; 5:163-9. [PMID: 11790278 DOI: 10.1089/10915360152745849] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Despite many new procedures, radical prostatectomy remains one of the commonest methods of treating clinically localized prostate cancer. Both from the physician's and the patient's point of view, it is important to have objective estimation of the likelihood of recurrence, which forms the foundation for treatment selection for an individual patient. Currently, it is difficult to predict the probability of biochemical recurrence (rising serum prostate specific antigen [PSA] concentration) in an individual patient, and approximately 30% of the patients do experience recurrence. Tools predicting the recurrence will be of immense practical utility in the treatment selection and planning follow up. We have utilized preoperative parameters through a computer based genetic adaptive neural network model to predict recurrence in such patients, which can help primary care physicians and urologists in making management recommendations. PATIENTS AND METHODS Fourteen hundred patients who underwent radical prostatectomy at participating institutions form the subjects of this study. Demographic data such as age, race, preoperative PSA, systemic biopsy based staging and Gleason scores were used to construct a neural network model. This model simulated the functioning of a trained human mind and learned from the database. Once trained, it was used to predict the outcomes in new patients. RESULTS The patients in this comprehensive database were representative of the average prostate cancer patients as seen in USA. Their mean age was 68.4 years, the mean PSA concentration before surgery was 11.6 ng/mL, and 67% patients had a Gleason sum of 5 to 7. The mean length of follow-up was 41.5 months. Eighty percent of the cancers were clinical stage T2 and 5% T3. In our series, 64% of patients had pathologically organ-confined cancer, 33% positive margins, and 14% had seminal vesicle invasion. Lymph node positive patients were not included in this series. Progression as judged by serum PSA was noted in 30.6%. With entry of a few routinely used parameters, the model could correctly predict recurrence in 76% of the patients in the validation set. The area under the curve was 0.831. The sensitivity was 85%, the specificity 74%, the positive predictive value 77%, and the negative predictive value of 83%. CONCLUSION It was possible to predict PSA recurrence with a high accuracy (76%). Physicians desiring objective treatment counseling can use this model, and significant cost savings are anticipated because of appropriate treatment selection and patient-specific follow-up protocols. This technology can be extended to other treatments such as watchful waiting, external-beam radiation, and brachytherapy.
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Hemal AK, Menon M. Laparoscopy, robot, telesurgery and urology: future perspective. J Postgrad Med 2002; 48:39-41. [PMID: 12082328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Hamon MA, Itkis ME, Niyogi S, Alvaraez T, Kuper C, Menon M, Haddon RC. Effect of rehybridization on the electronic structure of single-walled carbon nanotubes. J Am Chem Soc 2001; 123:11292-3. [PMID: 11697973 DOI: 10.1021/ja0109702] [Citation(s) in RCA: 150] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Andriotis AN, Menon M, Srivastava D, Chernozatonskii L. Rectification properties of carbon nanotube "Y-junctions". PHYSICAL REVIEW LETTERS 2001; 87:066802. [PMID: 11497841 DOI: 10.1103/physrevlett.87.066802] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2001] [Indexed: 05/23/2023]
Abstract
Quantum conductivity of single-wall carbon nanotube Y-junctions is calculated. The current versus voltage characteristics of these junctions show asymmetry and rectification, in agreement with recent experimental results. Furthermore, rectification is found to be independent of the angle between the branches of these junctions, indicating this to be an intrinsic property of symmetric Y-junctions. The implications for the Y-junction to function as a nanoscale molecular electronic switch are investigated.
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Pasticier G, Rietbergen JB, Guillonneau B, Fromont G, Menon M, Vallancien G. Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol 2001; 40:70-4. [PMID: 11528179 DOI: 10.1159/000049751] [Citation(s) in RCA: 158] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE We report our early experience of robotically assisted laparoscopic radical prostatectomy. MATERIAL AND METHODS Five consecutive patients, with an average age of 58 years, PSA 12, 1.6 positive biopsies, Gleason score 6, were operated in our institution over a period of 1 week by the same surgeon. A robotically assisted laparoscopic nerve sparing radical prostatectomy was performed according to the Montsouris technique with the Da Vinci robot (Intuitive Inc., Mountain View, Calif., USA). RESULTS The mean installation time was 93 min (range 76-149). The mean operating time (starting at the dissection of the seminal vesicles until the final stitch of the anastomosis) was 222 min (range 150-381 min). The average blood loss was 800 cm(3) (range 700-1,600 cm(3)). No postoperative complications were seen. Bladder catheter time: 6.5 days, hospital stay 5.5 days, urine leak 1/5, continence 4/5, positive margin 1/5. CONCLUSION After this short experience, we conclude that: The use of a tele manipulation system accompanied by a three-dimensional view of the operating field provides a real benefit for the surgeon, and the urethro-anastomosis is easier to perform. The benefit for the patient is presently not very clear in terms of operating time, postoperative course and functional results, our initial results show that the robotically assisted procedure is at least as safe and effective as the conventional laparoscopic procedure.
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