Node-negative colon cancer: histological, molecular, and stromal features predicting disease recurrence.

Background: Within the group of node-negative colon cancer patients, presumed to have a good prognosis, a significant percentage of patients develops cancer-recurrence. Current high-risk features prove inadequate to select these particular high-risk patients. In the process of tailor-made care and shared decision-making the need to identify these patients grows.

Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer.

Introduction: Management of rectal cancer has advanced, with an increasing use of neoadjuvant chemoradiotherapy (nCRT). This opens options for organ preserving treatment for those with a major response to nCRT. However, the degree of clinical response, based on MRI and post-treatment biopsies, only poorly matches the degree of actual pathological response.

A high tumour-stroma ratio (TSR) in colon tumours and its metastatic lymph nodes predicts poor cancer-free survival and chemo resistance.

Purpose: Despite known high-risk features, accurate identification of patients at high risk of cancer recurrence in colon cancer remains a challenge. As tumour stroma plays an important role in tumour invasion and metastasis, the easy, low-cost and highly reproducible tumour-stroma ratio (TSR) could be a valuable prognostic marker, which is also believed to predict chemo resistance.

Methods: Two independent series of patients with colon cancer were selected.

Assessment of stromal tumor infiltrating lymphocytes and immunohistochemical features in invasive micropapillary breast carcinoma with long-term outcomes.

Purpose: We studied the long-term outcomes of invasive micropapillary carcinoma (IMPCs) of the breast in relation to stromal tumor infiltrating lymphocytes (sTILs), prognostic biomarkers and clinicopathological features.

Methods: Stage I-III IMPCs treated with upfront surgery at our institution (January 2000 and December 2016) were included. Central pathology review was performed and sTILs (including zonal distribution and hot spot analysis) and tumor-associated plasma cells (TAPC) were evaluated.

Fractional Flow Reserve Evaluated as Metric of Coronary Stenosis - A Mathematical Model Study.

Coronary arterial stenosis may impair myocardial perfusion with myocardial ischemia and associated morbidity and mortality as result. The myocardial fractional flow reserve () is clinically used as a stenosis-specific index. This study aims to identify the relation between the and the degree of coronary arterial stenosis using a simple mathematical model of the coronary circulation.

The rationale of opportunistic bilateral salpingectomies (OBS) during benign gynaecological and obstetric surgery: a consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG).

Ovarian cancer (OC), is a disease difficult to diagnose in an early stage implicating a poor prognosis. The 5-year overall survival in Belgium has not changed in the last 18 years and remains 44 %. There is no effective screening method (secondary prevention) to detect ovarian cancer at an early stage.

Correction to: Extreme ST-segment elevations in seemingly no significant angiographic coronary artery abnormalities: a case report.

Following publication.

Extreme ST-segment elevations in seemingly no significant angiographic coronary artery abnormalities: a case report.

Background: Obstructive coronary artery disease is found in approximately 97% of patients presenting with ST-elevation myocardial infarction and 92% of patients with non ST-elevation myocardial infarction (Bainey KR, Welsh RC, Alemayehu W, Westerhout CM, Traboulsi D, Anderson T, et al. Int J Cardiol 264: 12-17, 2018). Recent studies showed that myocardial infarction without obstructive coronary atherosclerosis (MINOCA) is also associated with a long-term risk of adverse events (Bainey KR, Welsh RC, Alemayehu W, Westerhout CM, Traboulsi D, Anderson T, et al.

Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?

Purpose: Irreversible electroporation (IRE) induces apoptosis with high-voltage electric pulses. Although the working mechanism is non-thermal, development of secondary Joule heating occurs. This study investigated whether the observed conductivity rise during IRE is caused by increased cellular permeabilization or heat development.

Vascular narrowing in pulmonary arterial hypertension is heterogeneous: rethinking resistance.

In idiopathic pulmonary arterial hypertension (PAH), increased pulmonary vascular resistance is associated with structural narrowing of small (resistance) vessels and increased vascular tone. Current information on pulmonary vascular remodeling is mostly limited to averaged increases in wall thickness, but information on number of vessels affected and internal diameter decreases for vessels of different sizes is limited. Our aim was to quantify numbers of affected vessels and their internal diameter decrease for differently sized vessels in PAH in comparison with non-PAH patients.

Do mathematical model studies settle the controversy on the origin of cardiac synchronous trans-thoracic electrical impedance variations? A systematic review.

Impedance cardiography (ICG) is a method to evaluate cardiac-stroke volume and cardiac-output by measuring the cardiac-synchronous changes in the dynamic trans-thoracic electrical impedance (ΔZ). Clinical evaluations on the accuracy of ICG showed varying results. Consequently, the classic assumption in ICG-the aorta as a main source of ΔZ-is questioned and subsequently investigated in simulation studies using mathematical models of the electrical resistivity of the human body.

The Volume Regulation Graph versus the Ejection Fraction as Metrics of Left Ventricular Performance in Heart Failure with and without a Preserved Ejection Fraction: A Mathematical Model Study.

In left ventricular heart failure, often a distinction is made between patients with a reduced and a preserved ejection fraction (EF). As EF is a composite metric of both the end-diastolic volume (EDV) and the end-systolic ventricular volume (ESV), the lucidity of the EF is sometimes questioned. As an alternative, the ESV-EDV graph is advocated.

Chorangiocarcinoma of the placenta: a case report and clinical review.

Objective: We describe a case of chorangiocarcinoma, a complex lesion consisting of a trophoblastic proliferation within a chorangioma, presenting in a term placenta.

Materials And Methods: The lesion was diagnosed by ultrasound at a second trimester check-up after amniocentesis, performed because of increased combined risk at first trimester screening for trisomy 21. After uncomplicated vaginal delivery, a healthy child was born and the placenta was expelled spontaneously.

Proportional Relations Between Systolic, Diastolic and Mean Pulmonary Artery Pressure are Explained by Vascular Properties.

Recently, it was shown that proportional relationships exist between systolic, diastolic and mean pulmonary artery pressure (P(sys), P(dia) and P(mean)) and that they are maintained under various conditions in both health and disease. An arterial-ventricular interaction model was used to study the contribution of model parameters to the ratios P(sys)/P(mean), and P(dia)/P(mean). The heart was modeled by a time-varying elastance function, and the arterial system by a three-element windkessel model consisting of peripheral resistance, R(p), arterial compliance C(a), and pulmonary artery characteristic impedance Z(0).

Evaluation of model-independent deconvolution techniques to estimate blood perfusion.

This report evaluates several methods to estimate blood perfusion and residue functions in dynamic contrast enhanced (DCE) MRI. Among these are model-dependent and model-independent techniques. All methods were applied to series of Monte Carlo simulations to evaluate the accuracy in order to reproduce different underlying vascular residue functions and blood perfusions.

Estimation of three- and four-element windkessel parameters using subspace model identification.

A windkessel model is widely used to operationalize vascular characteristics. In this paper, we employ a noniterative subspace model identification (SMI) algorithm to estimate parameters in a three- and four-element windkessel model by application of physical foreknowledge. Simulation data of the systemic circulation were used to investigate systematic and random errors in the parameter estimations.

Assessing fluid responses after coronary surgery: role of mathematical coupling of global end-diastolic volume to cardiac output measured by transpulmonary thermodilution.

Background: Mathematical coupling may explain in part why cardiac filling volumes obtained by transpulmonary thermodilution may better predict and monitor responses of cardiac output to fluid loading than pressures obtained by pulmonary artery catheters (PACs).

Methods: Eleven consecutive patients with hypovolaemia after coronary surgery and a PAC, allowing central venous pressure (CVP) and continuous cardiac index (CCIp) measurements, received a femoral artery catheter for transpulmonary thermodilution measurements of global end-diastolic blood volume index (GEDVI) and cardiac index (CItp). One to five colloid fluid-loading steps of 250 ml were done in each patient (n = 48 total).

Modeling the instantaneous pressure-volume relation of the left ventricle: a comparison of six models.

Simulations are useful to study the heart's ability to generate flow and the interaction between contractility and loading conditions. The left ventricular pressure-volume (PV) relation has been shown to be nonlinear, but it is unknown whether a linear model is accurate enough for simulations. Six models were fitted to the PV-data measured in five sheep and the estimated parameters were used to simulate PV-loops.

GREIT: a unified approach to 2D linear EIT reconstruction of lung images.

Electrical impedance tomography (EIT) is an attractive method for clinically monitoring patients during mechanical ventilation, because it can provide a non-invasive continuous image of pulmonary impedance which indicates the distribution of ventilation. However, most clinical and physiological research in lung EIT is done using older and proprietary algorithms; this is an obstacle to interpretation of EIT images because the reconstructed images are not well characterized. To address this issue, we develop a consensus linear reconstruction algorithm for lung EIT, called GREIT (Graz consensus Reconstruction algorithm for EIT).

Cardiac phase-dependent time normalization reduces load dependence of time-varying elastance.

The time-varying elastance concept provides a comprehensive description of the intrinsic mechanical properties of the left ventricle that are assumed to be load independent. Based on pressure-volume measurements obtained with combined pressure conductance catheterization in six open-chest anesthetized sheep, we show that the time to reach end systole (defined as maximal elastance) is progressively prolonged for increasing ventricle pressures, which challenges the original (load-independent) time-varying elastance concept. Therefore, we developed a method that takes into account load dependency by normalization of time course of the four cardiac phases (isovolumic contraction, ejection, isovolumic relaxation, filling) individually.

A study of the brain's resting state based on alpha band power, heart rate and fMRI.

Considering that there are several theoretical reasons why fMRI data is correlated to variations in heart rate, these correlations are explored using experimental resting state data. In particular, the possibility is discussed that the "default network", being a brain area that deactivates during non-specific general tasks, is a hemodynamic effect caused by heart rate variations. Of fifteen healthy controls ECG, EEG and fMRI were co-registered.

Pulmonary vascular resistance and compliance stay inversely related during treatment of pulmonary hypertension.

Aims: Pulmonary arterial compliance (C) is increasingly being recognized as an important contributor to right ventricular afterload, but for monitoring of treatment of pulmonary hypertension (PH) most often still only pulmonary vascular resistance (R) is used. We aimed at testing the hypothesis that R and C are coupled during treatment of PH and that substantial changes in both R and C would result in more haemodynamic improvement than changes in R alone.

Methods And Results: Data were analysed of two right-heart catheterizations of 52 patients with pulmonary arterial hypertension and 10 with chronic-thromboembolic PH.

An analysis of 5'-inosine and 5'-guanosine monophosphate taste in rats.

Inosine monophosphate (IMP) and guanosine monophosphate (GMP) elicit an umami taste in humans and synergistically increase the intensity of the umami taste of monosodium glutamate (MSG). Conditioned taste aversion (CTA) studies in rodents indicate that these nucleotides and MSG elicit quite similar tastes, but recent physiological evidence suggests that these nucleotides and MSG may not activate the same population of taste receptors and therefore may not elicit identical taste qualities. This study reports the findings of several behavioral experiments with rats that compared the taste properties of IMP and GMP with each other and with those of MSG.

Quantification of right ventricular afterload in patients with and without pulmonary hypertension.

Right ventricular (RV) afterload is commonly defined as pulmonary vascular resistance, but this does not reflect the afterload to pulsatile flow. The purpose of this study was to quantify RV afterload more completely in patients with and without pulmonary hypertension (PH) using a three-element windkessel model. The model consists of peripheral resistance (R), pulmonary arterial compliance (C), and characteristic impedance (Z).

Correction of phase offset errors in main pulmonary artery flow quantification.

Purpose: To investigate whether an existing method for correction of phase offset errors in phase-contrast velocity quantification is applicable for assessment of main pulmonary artery flow with an MR scanner equipped with a high-power gradient system.

Materials And Methods: The correction method consists of fitting a surface through the time average of stationary pixels of velocity-encoded phase images, and subtracting this surface from the velocity images. Pixels are regarded as stationary if their time standard deviation falls into the lowest percentile.