42 research outputs found
Treatment strategies for neuroendocrine liver metastases: a systematic review.
No full textBACKGROUND
Gastroenteropancreatic neuroendocrine tumors are often diagnosed when metastatic. The liver is the main site of metastases. Unfortunately, optimal management of neuroendocrine liver metastases remains a topic of debate. The aim of this study was to make a systematic review of the current literature about the results of the different treatments of neuroendocrine liver metastases.
METHODS
A systematic review was conducted for English language publications from 1995 to 2021. Outcomes were analyzed according to survival, disease-free survival, and in the case of systemic therapies, progression-free survival.
RESULTS
5509 patients were analyzed in the review. 67% of patients underwent surgery achieving 5 years overall survival despite only 30% percent without a recurrence. 60% of patients that had received a transplant reached 5 years survival with a low disease-free survival rate (20%). Five-year survival rate was 36.2% for patients undergoing loco-regional therapies.
CONCLUSION
Surgical resection is the best treatment when metastases are resectable, with the highest rate of survival, although liver transplantation shows good results for patients not eligible for surgery. Loco-regional therapies may be useful when surgical resection is contraindicated, or selectively used as a bridge to surgery or transplantation. Systemic therapies are indicated in patients for whom curative treatment cannot be obtained
Real-time intraoperative ureteral identification in minimally invasive colorectal surgery: a systematic review
No full textBackground: Although colorectal surgery (CRS) has currently almost entirely standardized surgical procedures, it can still show pitfalls such as the intraoperative ureteral injury. Intraoperative ureteral identification (IUI) could reduce the ureteral injuries rate but evidence is still lacking. We aimed to analyze the utility and the effectiveness of real-time IUI in minimally invasive CRS.Materials and Methods: A systematic review was performed examining available data on randomized and nonrandomized studies evaluating the utility of intraureteral fluorescence dye (IFD) and lighted ureteral stent (LUS) for intraoperative identification of ureters in CRS, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards. Primary endpoint was ureteral injuries rate. Secondary endpoints included acute kidney injury, hematuria, urinary tract infections (UTI), and fluorescence assessment.Results: After literature search, 158 studies have been recorded, 36 studies underwent full-text reviews and 12 studies met inclusion criteria. Overall, out of a total of 822 patients who successfully received IUI, 3 (0.33%) patients experienced ureteral injury. Hematuria was reported in 689 (97.6%) of patients following LUS-guided surgery and in 1 (2%) patient following IFD-guided surgery, although transient in all cases. UTI was reported in 15 (3.3%) LUS-guided resections and in 1 (2%) IFD-guided resections. Acute kidney injury occurred in 23 (2.5%) LUS-guided surgery and 1 (1%) IFD-guided surgery.Conclusions: Real-time ureteral identification techniques could represent a valid solution in complex minimally invasive CRS, safely, with no time consuming and always reproducible by surgeons. Prospective studies will be needed to confirm these findings
Solid pseudopapillary tumor of the pancreas. A systematic review of clinical, surgical and oncological characteristics of 1384 patients underwent pancreatic surgery
No full textBackground: Pancreatic solid pseudopapillary tumors (SPTs) are rare clinical entity, with low malignancy and still unclear pathogenesis. They account for less than 2% of exocrine pancreatic neoplasms. This study aimed to perform a systematic review of the main clinical, surgical and oncological characteristics of pancreatic SPTs.
Data sources: MEDLINE/PubMed, Web of Science and Scopus databases were systematically searched for the main clinical, surgical and oncological characteristics of pancreatic SPTs up to April 2021, in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards. Primary endpoints were to analyze treatments and oncological outcomes.
Results: A total of 823 studies were recorded, 86 studies underwent full-text reviews and 28 met inclusion criteria. Overall, 1384 patients underwent pancreatic surgery. Mean age was 30 years and 1181 patients (85.3%) were female. The most common clinical presentation was non-specific abdominal pain (52.6% of cases). Mean overall survival was 98.1%. Mean recurrence rate was 2.8%. Mean follow-up was 4.2 years.
Conclusions: Pancreatic SPTs are rare, and predominantly affect young women with unclear pathogenesis. Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up
Indocyanine green fluorescence in laparoscopic cholecystectomy: an easy procedure to prevent big troubles
No full textNo abstract avaiable
Major device-related complications during regional chemotherapy
No full textAbstract From September 1985 to December 1990, 51 patients were treated by locoregional chemotherapy by means of a totally implantable system: 35 patients for hepatic metastases from colorectal cancer and 2 for hepatocellular carcinoma had the system implanted in the hepatic artery via the gastroduodenal artery; 14 patients underwent peritoneal chemotherapy, 11 for peritoneal carcinomatosis and 3 for adjuvant therapy. Totally implantable arterial 'ports' were used for the hepatic chemotherapy, while Tenckhoff-type ports were used for peritoneal chemotherapy. Among the 51 cases, 6 major complications were observed, 5 in the group submitted to hepatic chemotherapy and one following intracavitary therapy. The complications observed were thrombosis of the hepatic artery in 2 cases, dislodgement of the catheter into the duodenal lumen in 2 cases, and 1 case of rupture of the catheter. The complications were treated by suspension of the therapy for hepatic artery thrombosis, endoscopic removal of the catheter from the duodenum (dislodgement) and explant of the system (rupture of the catheter). In 1 case we observed the dislodgement of the Tenckhoff port into the intestinal lumen and in this case laparotomy was necessary for catheter removal
An early-stage statement-level metric for energy characterization of embedded processors
No full textThis work presents an early stage statement-level metric for energy characterization of embedded processors. Definition and the framework for metric evaluation are provided. In particular, such a metric is based on an existing assembly-level analysis and some profiling activities performed on a given C benchmark, and it is related to the average energy consumption of a generic C statement, for a given target processor. Its evaluation is performed with a one-time effort and, once available, it can be used to rapidly estimate the energy consumption of a given C function for all the considered processors. Two reference embedded processors are then considered in order to show an example of usage of the proposed metric and framework. (C) 2020 The Author(s). Published by Elsevier B.V
Reassessing the Middle Palaeolithic lithic technology of Grotta Romanelli (Lecce, southern Italy)
No full textLocated in the southernmost part of the Italian Peninsula, specifically the Salento area in the Apulia region, Grotta Romanelli (Lecce) is one of Italy's most significant Palaeolithic sites. It shows evidence of human occupation from the Middle to the late Upper Palaeolithic. This study presents a re-analysis of historical lithic collections and also includes a new analysis of artefacts from recent excavations within Middle Palaeolithic Inside Stratigraphic Unit 3 (ISU3). This unit, formerly referred to as level G or “terre rosse”, is dated to at least the MIS 5 interglacial period. Our findings offer a revised perspective on past interpretations of Grotta Romanelli's Middle Palaeolithic lithic industry. Interpretations of this industry have varied over time, especially regarding the presence of Levallois core technology — an important cultural and chronological marker. The initial classification in the 1970s described the assemblage as Charentian Mousterian of Quina type, characterized by the absence of Levallois technology and the exclusive use of local materials. However, studies from the 2000s suggested a predominance of Levallois technology, along with a noteworthy, albeit limited, use of non-local materials. Our lithic analysis suggests instead a focus on expedient flake production using exclusively locally available raw materials, with no evidence of the Levallois method. These results contrast with previous hypotheses, indicating a distinctive role for Grotta Romanelli's lithic technology within the Middle Palaeolithic cultural framework of southern Italy. © 2025 The Author
Solar Powered Drones: PV Generator
No full textDrones are unmanned flying vehicles, which can be used for a broad spectrum of different applications. One of these applications is the generation of albedo maps. However, it could take some time to map an area. Therefore problems can occur the with respect to its flight range, which typically lies between 20 to 45 km for mini UAVs. The goal of this project is to design a PV powered drone that can create an albedo map of an area that is equal or bigger than the area of the Technical University of Delft. This is done by choosing and modelling an UAV system, where after choosing and modelling a PV generator system. Based on these models, power dynamics and flight ranges are calculated. The usability is tested for different weather conditions of Delft. The UAV system with PV generator without protection layers has a flying range between 129 and 250 km, depending in the irradiance. For the same system with protective layers, the flight range varies from 117 to 208 km. the total flight range that is needed to map the area of the TU Delft is 48.75 km. Therefore, there can be concluded that in both cases our goal has been achieved. When these results are compared to the weather conditions of the TU Delft, it can be concluded that on average a UAV system with PV generator will increase the flight range. However, when comparing this system to a system with additional batteries, the latter will achieve better results. In order to make sure that the PV generator system will guarantee a longer flight range, limitations regarding times, periods and places are made. Keep in mind that since these results are solely based on models of systems, it's best to create and test the physical system to validate the found results. This thesis is written in context of the Bachelor Graduation Project. We would like to express our gratitude to our daily supervisor Patrizio Manganiello and our supervisors Andres Calcabrini and Mirco Muttillo for their guidance during the project. Finally we would like to thank our colleagues: Laura Muntenaar and Sjoerd de Groot of the control algorithm project and Jetse Spijkstra and Martin Geertjes of the power electronics project for an enjoyable and productive collaboration. J. Koning & R. van der Hoorn Delft, June 2020</p
The AQUAS ECSEL Project Aggregated Quality Assurance for Systems: Co-Engineering Inside and Across the Product Life Cycle
No full textThere is an ever-increasing complexity of the systems we engineer in modern society, which includes facing the convergence of the embedded world and the open world. This complexity creates increasing difficulty with providing assurance for factors including safety, security and performance. In such a context, the AQUAS project investigates the challenges arising from e.g., the inter-dependence of safety, security and performance of systems and aims at efficient solutions for the entire product life-cycle. The project builds on knowledge of partners gained in current or former EU projects and will demonstrate the newly developed methods and techniques for co-engineering across use cases spanning Aerospace, Medicine, Transport and Industrial Control. © 2019 The Author
Revealing capacitive and inductive effects in modern industrial c-Si photovoltaic cells through impedance spectroscopy
No full textTo achieve a high performance in sub-module power conditioning circuits, it is important that power converters are designed in accordance with the photovoltaic (PV) cell impedance at the input. Taking this one step further, exploiting the impedance of cell strings could even support novel power conditioning approaches in PV modules. In this work, we characterize the impedance of eight single-cell laminates based on different industrial c-Si PV cell architectures. This characterization is carried out by impedance spectroscopy in dark conditions at room temperature, and the capacitive and inductive effects are evaluated through equivalent model fitting. By comparing the results for the different laminates, it is revealed how the cell design affects its impedance. Our experiments show that the PN junction capacitance at maximum power point varies for the different cells between 0.30 and 45.6 μF/cm2. The two main factors contributing to a high PV cell capacitance at maximum power point are (i) a low wafer dopant concentration and (ii) a high maximum power point voltage. In high-efficiency c-Si PV cells that will be fabricated in the coming years, increasing capacitances are expected for operation near the maximum power point. Furthermore, the single-cell laminates exhibit inductances between 63 and 130 nH, and our results indicate that the inductance is mostly affected by the number of busbars and the geometry of the metal contacts.Photovoltaic Materials and Device
