3,516 research outputs found
Thinking through the multimodal treatment of localized oesophageal cancer: the point of view of the surgeon
No full textPURPOSE OF REVIEW: This review examines current developments and controversies in the multimodal management of oesophageal cancer, with an emphasis on surgical dilemmas and outcomes from the surgeon's perspective.RECENT FINDINGS: Despite the advancement of oncological neoadjuvant treatments, there is still no consensus on what regimen is superior. The majority of patients may still fail to respond to neoadjuvant therapy and suffer potential harm without any survival advantage as a result. In patients who do not respond, adjuvant therapy is still often recommended after surgery despite any evidence for its benefit. We examine the implications of different regimens and treatment approaches for both squamous cell cancer and adenocarcinoma of the oesophagus.SUMMARY: The efficacy of neoadjuvant treatment is highly variable and likely relates to variability of tumour biology. Ongoing work to identify responders, or optimize treatment on an individual patient, should increase the efficacy of multimodal therapy and improve patient outcomes.</p
Supplemental material for Do pathologists agree with each other on the histological assessment of pT1b oesophageal adenocarcinoma?
No full textSupplemental Material for Do pathologists agree with each other on the histological assessment of pT1b oesophageal adenocarcinoma? by Annieke W Gotink, Fiebo JC ten Kate, Michael Doukas, Bas PL Wijnhoven, Marco J Bruno, Leendert HJ Looijenga, Arjun D Koch and Katharina Biermann in United European Gastroenterology Journal</p
Bas-Relief Modeling from Normal Layers
No full textBas-relief is characterized by its unique presentation of intrinsic shape properties and/or detailed appearance using materials raised up in different degrees above a background. However, many bas-relief modeling methods could not manipulate scene details well. We propose a simple and effective solution for two kinds of bas-relief modeling (i.e., structure-preserving and detail-preserving), which is different from the prior tone mapping alike methods. Our idea originates from an observation on typical 3D models which are decomposed into a piecewise smooth base layer and a detail layer in normal field. Proper manipulation of the two layers contributes to both structure-preserving and detail-preserving bas-relief modeling. We solve the modeling problem in a discrete geometry processing setup that uses normal-based mesh processing as a theoretical foundation. Specifically, using the two-step mesh smoothing mechanism as a bridge, we transfer the bas-relief modeling problem into a discrete space, and solve it in a least-squares manner. Experiments and comparisons to other methods show that (i) geometry details are better preserved in the scenario with high compression ratios, and (ii) structures are clearly preserved without shape distortion and interference from details.Accepted author manuscriptMaterials and Manufacturin
Adenocarcinomas of the gastro-oesophageal junction : from gene to clinic
No full textAdenocarcinomas of the gastro-oesophageal junction are thought to arise from
premalignant Barretr's epithelium. Barrett's epithelium is columnar epithelium that
has replaced the normal squamous cell lining of the oesopha",ous. This metaplastic
change is driven by duodeno-gastro-oesophageal reflu.'(, which leads to oesophagitis
and ultimately, in some patients, to Barrett's epithelium. The development of
Barrett's carcinoma involves multiple genetic changes.
In PART I, the general introduction of this thesis, CHAPTER 1 reviews our current
knowledge on these genetic changes involved in the progression from Barrett's
oesophagus to adenocarcinoma.
Over the past decades, many researchers focused on the role of cell-cell adhesion in
carcinogenesis. The E-cadherin-catenin complex is thought to be the most
important regulator of tight cell-cell adhesion in normal tissues, and perturbation of
this complex is associated with malignancy. There is evidence that dysfunction of
the E-cadherin-catenin complex also plays an important role in the pathogenesis of
adenocarcinomas of the gastro-oesophageal junction. In CHAPTER 2, the literature
on the role of the E-cadherin-catenin complex in human cancer and the possible
clinical implications are discussed. This chapter serves as an introduction to Part IV
(chapters 7-10).
PART II of the thesis deals ",~th epidemiological and clinical aspects of
adenocarcinomas of the gastro-oesophageal junction
Transthoracic esophagectomy compared to transhiatal extended gastrectomy for adenocarcinoma of the esophagogastric junction: a multicenter retrospective cohort study
No full textOptimal surgical treatment for Siewert type II esophagogastric junction adenocarcinoma is debated. The aim of this study was to compare transhiatal extended gastrectomy (TEG) and transthoracic esophagectomy (TTE). Patients with Siewert type II tumors who underwent a resection by TEG or TTE in two centers (Erasmus University Medical Center, Rotterdam, and University of Verona) between 2014 and 2019 were identified. To limit selection bias, patients were matched for baseline characteristics and compared with a multivariable logistic regression model. Some 159 patients treated by TEG (60 patients, 37.7%) or TTE (99 patients, 62.3%) were included. Patients in the TEG group were older, had less tumor invasion of the esophagus, and were more often excluded from neoadjuvant therapy. Post-operative morbidity was comparable (P = 0.88), while 90-day mortality was higher after TEG (90-day mortality 10.0% in TEG group vs. 2.0% in TTE group P = 0.01). R0 resection was achieved in 83.3% of patients after TEG and in 97.9% after TTE (P < 0.01), with the proximal resection margin involved in 16.6% of patients after TEG versus 0 in TTE group (P < 0.01). The 3-year overall survival was comparable (TEG: 36.5%, TTE: 48.4%, P = 0.12). At multivariable analysis, (y)pT category was an independent risk factor for 3-year recurrence. After matching, TEG was still associated with an increased risk of incomplete tumor resection (P = 0.03) and proximal margin involvement (P < 0.01), while there were no differences in post-operative morbidity (P = 0.56) and mortality (P = 0.31). Our data suggest that patients with Siewert type II tumors treated by TEG are exposed to a higher risk of positive proximal resection margin compared to TTE
ASO Author Reflections: Increasing National Performance on Complete Tumor Resection in Patients with Gastric Cancer by Awareness of Risk Factors and Network Organization for Gastric Cancer Surgery
No full textDefining a learning curve for laparoscopic cardiomyotomy
No full textBackgroundThis study was designed to determine whether there is a learning curve for laparoscopic cardiomyotomy for the treatment of achalasia.MethodsAll patients who underwent a primary laparoscopic cardiomyotomy for achalasia between 1992 and 2006 in our hospitals were identified from a prospective database. The institutional and the individual surgeon's learning experiences were assessed based on operative and clinical outcome parameters. The outcomes of cardiomyotomies performed by consultant surgeons versus supervised trainees also were compared.ResultsA total of 186 patients met the inclusion criteria; 144 procedures were undertaken by consultant surgeons and 42 by a surgical trainee. The length of operation decreased after the first ten cases in both the institutional and each individual experience. The rate of conversion to open surgery also was significantly higher in the first 20 cases performed. Intraoperative complications, overall satisfaction with the outcome, reoperation rate, and postoperative dysphagia were not associated with the institutional or the surgeon's operative experience. Although the length of the operation was greater for surgical trainees (93 versus 79 minutes; p ConclusionAn institutional (20 cases) and an individual (10 cases) learning curve for laparoscopic cardiomyotomy for achalasia can be defined. The clinical outcome for laparoscopic cardiomyotomy does not differ between supervised surgical trainees and consultant surgeons.Brechtje A. Grotenhuis, Bas P. L. Wijnhoven, Glyn G. Jamieson, Peter G. Devitt, Justin R. Bessell, David I. Watso
ASO Author Reflections: Multimodality Treatment in Esophageal Signet Ring Cell Adenocarcinoma
No full textFM Transceiver for Wireless Communication: Audio and Intermediate Frequency Amplifiers
No full textIn this bachelor thesis the design process of the audio and intermediate frequency amplifiers for a wireless FM tranceiver is documented and explained. The project was done using only descrete components for educational purposes.2019 Ivor Bas, Victor hoedemakerElectrical Engineerin
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