Un Universo di nuove tecnologie

Nel quinto numero de "I quaderni EduINAF" vi proponiamo un viaggio tra le nuove tecnologie applicate all'esplorazione dell'Universo

CFD approach for the induced effects of free wake past rivulets on cables of stayed bridges

Large-amplitude oscillations of stayed bridge cables appear under the combined effects of crosswind and rain. "Wave-like" oscillations along the whole cable length are born with large amplitudes even under low-speed wind and only the presence of the rain rivulet motion on the cable cross-section which guarantees an "all-or-none" amplification of the dynamic response of the cable. Even though this peculiar behavior has been studied, in a recent past, through dynamic and structural approaches, the phenomenon is not yet quite well understood, i.e., the quasi-cyclic oscillations seem to be activated to events (rain rivulets motion along the cables) compromising the circumferential geometry shape of the cable cross-section and the frequency of the vortex shedding of the leaving wake past the cable. The aim of the present work is to apply a Computational Fluid Dynamic (CFD) approach having in mind that the unsteady wake interaction with the cable dynamics could be useful to explain and predict how the cable fluctuates in an oscillatory fashion and its time-dependent evolution with the leaving vortex frequency under the combined actions of wind and rain. Due to the available computational resources, the K-epsilon turbulent model simulations of an unsteady and viscous wake flow past the cables is here employed with emphasis on capturing the time-dependent flow structures representing the wave-like nature of the aerodynamic loads under the above mentioned atmospheric conditions in which both the (in-phased) cable and rivulet cross-sections are considered to have the same azimuthal frequency and embedded in a free-stream with constant velocity. In this paper, the rivulet movement on the cable surface has been taken into account while a rigid translatory motion of the cable cross section is disregarded, being the aim of the current computational method to find (and predict) the inception mechanism of the elastic vibrations of the cable. As widely accepted and adopted in the current literature, in this initial computational step, the natural frequency of the cable has been fixed being that the only one a priori hypothesis

Re-treatment by intravesical therapy in recurring patients affected by intermediate risk non-muscle invasive bladder cancer (NMIBC)

Introduction & Objectives: Up to 70% of patients affected by intermediate risk NMI-BC recur after intravesical therapy (IT). The majority of them will be retreated by IT. The therapeutic strategy for these patients is not well defined. BCG is advocated when intravesical chemotherapy (ICH) fails. However, some patients are retreated by ICH and some others repeat BCG adopted as the first treatment. Not many studies have been published on second line IT. A retrospective analysis on 179 intermediate-risk patients undergoing re-treatment by IT is presented. Materials & Methods: The clinical files of patients affected by NMI-BC recurring after TUR and IT and retreated by IT were reviewed. The patients not receiving at least 6 instillations of BCG or ICH after the first diagnosis and again after the TUR of the first recurrence were excluded. Only mitomycin c and epirubicin were accepted as chemotherapy. Only intermediate-risk tumours with a recurrencerisk score between 5 and 9 according to the EORTC Risk Tables and in absence of Tis were selected. A multivariate analysis was performed for recurrence-free interval (RFI) and progression considering, first line IT (BCG versus ICH), previous recurrence free interval, tumour’s T-category, G-grade, multiplicity, second line IT (BCG versus ICH) and maintenance regimen. Results: The study included 179 patients. The first line IT was ICH in 131 (73.2%) and BCG in 48 (26.8%) patients. The median RFI was 16 months. At recurrence, BCG in 83 (46.4%) and ICH in 96 (53.6%) patients were administered, with maintenance of at least 12 months in 31% and 38% of patients respectively. Of the 48 patients previously treated by BCG, 40 (83.3%) received BCG again, while of the 131 previously treated by ICH, 88 (67.2%) received ICH again and 43 (32.8%) BCG. Thus, only 8 patients received ICH at recurrence after BCG. At a median follow-up of 29 months, 65 (36.3%) patients recurred with a median RFI of 15 months, 25 (30.1%) and 40 (41.7%) after BCG and ICH respectively. Thirteen patients showed progression at a median interval of 19 months. At multivariate analysis no statistically significant correlation was detected among the considered parameters. Surprisingly, no statistical difference emerged in terms of RFI between first and second line IT (16 versus 15 months), and between patients receiving BCG or ICH as second line therapy at recurrence after ICH (=0.28). Conclusions: No reduction in RFI emerged in patients with intermediate-risk NMIBC recurring after a first cycle of intravesical therapy and retreated by intravesical chemotherapy or BCG. In patients recurring after intravesical chemotherapy, intravesical chemotherapy and BCG, as a second line therapy, resulted equally effective in preventing recurrence

Adjuvant intravesical therapy in intermediate risk non-muscle invasive bladder cancer (NMIBC) recurring after first cycle of intravesical treatment.

Introduction and objectives The therapeutic management of intermediate risk NMI-BC recurring after intravesical therapy (IT) is not established. Cystectomy will be offered to patients at higher risk of progression but the majority will be retreated by IT. Although some Authors suggest BCG when intravesical chemotherapy (ICH) fails, some patients are retreated by ICH and some others repeat BCG adopted as first-line treatment. Not many studies have been published on this issue. The response to retreatment by intravesical therapy in terms of recurrence-free rate (RFR) and recurrence-free survival (RFS) is analyzed in 179 intermediate-risk patients. Materials and methods Only intermediate-risk tumours (EORTC Risk Tables recurrence-risk score 5-9) in absence of TIS were selected. The patients not receiving at least 6 instillations of BCG or ICH after the first diagnosis and again after the TUR of the first recurrence, were excluded. Only BCG, mitomycin c and epirubicin were accepted. All patients were submitted to cytology and cystoscopy 3-monthly for the first 2-years and then 6-monthly. A statistical analysis was performed for RFR and RFS and progression, considering first line IT (BCG versus ICH), previous recurrence free interval, T-category, G-grade, multiplicity, second line IT (BCG versus ICH) and maintenance regimen. Results The study included 179 patients. The first-line IT was ICH in 131 (73.2%) and BCG in 48 (26.8%) patients. The median recurrence free interval was 16 months. Intravesical therapy at recurrence was BCG in 83 (46.4%) and ICH in 96 (53.6%) patients. Maintenance of at least 12 months was given in 31.3% and 38.5% of patients respectively. Of the 48 patients previously treated by BCG, 40 (83.3%) repeated it, while of the 131 previously treated by ICH, 88 (67.2%) received ICH again and 43 (32.8%) BCG. Thus, only 8 patients received ICH after BCG. At a median follow-up of 29 months, 65 (36.3%) patients recurred, 25 (30.1%) and 40 (41.7%) after BCG and ICH respectively. No statistical difference emerged in terms of RFS between BCG and ICH (p=0.97). Thirteen patients showed progression at a median interval of 19 months. At multivariate analysis no statistically significant correlation was detected among the considered parameters. Surprisingly, no statistical difference emerged in terms of recurrence free interval between first and second line IT (16 versus 15 months, Mann Whitney U-Test p=0.38), and between patients receiving BCG or ICH as second line therapy after ICH (=0.28). Conclusions Intravesical re-treatment by chemotherapy or BCG did not show any reduction in terms of RFS when compared with the first line therapy. Moreover, in patients recurring after intravesical chemotherapy, chemotherapy and BCG resulted equally effective in terms of RFR and RFS

Long-term outcome of antiandrogen monotherapy in advanced prostate carcinoma. Twelve-year’s results of a phase II study.

OBJECTIVE: To present the long-term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first-line antiandrogen monotherapy. PATIENTS AND METHODS: From 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty-five patients (61%) had T3-T4N0M0 and 16 (39%) T2-4N0-3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years. RESULTS: Flutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an objective response in 17 (41%) patients; 20 (49%) had stable disease while four (10%) progressed. There were objective responses, lasting up to 150 months, in 82% of those with M0 and in 18% with M1 disease (P = 0.05). The median time to progression in patients with an objective response and stable disease was 45 and 16 months, respectively (P < 0.001). Thirty-one patients (76%) died from prostate cancer and 10 (24%) from unrelated diseases. The median survival was 67 and 36 months in patients with an objective response and stable disease, respectively (P < 0.001). There was an improvement in performance status in 85% and reduction in bone pain in 83% of the patients; sexual activity was maintained in 63%. CONCLUSION: Monotherapy with flutamide is well tolerated. Objective responses are more frequent in patients with locally advanced disease. Patients with an objective response within 6 months have a prolonged progression-free and overall survival

DISTRIBUTION OF GENITAL HUMAN PAPILLOMAVIRUS IN SICILIAN MEN WITH AND WITHOUT CLINICAL MANIFESTATIONS

Introduction: Infection Human Papillomavirus (HPV) is the cause of several disease in men and in women: genital warts, penile and cervical intraepithelial neoplasia, invasive penile carcinoma and cervical cancer. However, less is known about HPV infection and prevalence of HPV types in men. Materials and Methods: 820 genital samples of men (age 19-77; mean age: 36.7 ys) who had come to the Virology laboratory of the Department of Sciences for Health Promotion and Mother and Child Care (Policlinico, University of Palermo, Italy) were examined for HPV infection. The study included men with genital warts, men with atypical genital lesion, partners of HPV-positive women and asymptomatic men for Sexually Transmitted Diseases (STD) diagnostic evaluation. HPV-DNA genotyping was performed by the INNOLiPA HPV Genotyping Extra II Test (Fujirebio) and nested PCR/sequencing method. Results: 461/820 (56.2%) genital samples were HPV positive. The highest HPV detection rate was found in the 25-34 year age group (41.4%), followed by the 35-44 group (31.7%). Oncogenic types were found in 360 (78.1%) samples, alone 228 (63.3%) or with non-oncogenic types 132 (36.7%). Multiple HPV type infections were shown in 225 (48.8%) samples of whom 109 (23.6%) had two genotypes, 58 (12.6%) three genotypes, 38 (8.2%) four genotypes, 15 (3.2%) five genotypes, 3 (0.6%) six genotypes and then only 2 (0.4%) eight genotypes. Thirty-eight different HPV types were identified: the mostly frequent were HPV-16 (19.9% of HPV positive patients), -51 and -6 (18.2%), -31 (13.9%), -66 (13.7%), -53 (11%), -18 (7.6%), -44 (7.1%), -56 (7%), -11 (5.8%), -39 and \u201352 (5.6%), -54 (5.2%), -58 (5%), -62 (4.5%); other viral types occurred at a frequency of less than 4.0%. Men who have made the HPV test: 138 (16.8%) were diagnosed with genital warts, 3 (0.4%) carcinomas, 413 (50.3%) were HPV-positive women partners, 30 (3.6%) presence of an atypical genital lesion, 236 (28.7%) men who wanted a full assessment of sexual transmitted diseases. HPV infection was evident in 100% men with carcinomas, in 103 (74.6%) men with genital warts, in 254 men (61.5%) partners of HPV-positive women, in 11 (36.6%) men with presence of an atypical genital lesion and in 90 (38.1%) in asymptomatic men. HPV-16 was prevalent in 2 (66.7%) men with carcinoma, in 55 (21.6%) men HPV-positive women partners and in 3 (27.3) men with atypical genital lesion; HPV-6 in 36 (35%) men with genital warts and in 19 (21.1%) asymptomatic men. Discussion and conclusions: this study showed a high prevalence of genital HPV infection in Sicilian men. This information will contribute to elucidating the epidemiology of HPV infection in man, and it will also be helpful in the implementation of future prevention strategies