Artificial intelligence-based tissue segmentation and cell identification in multiplex-stained histological endometriosis sections.

Study Question: How can we best achieve tissue segmentation and cell counting of multichannel-stained endometriosis sections to understand tissue composition?

Summary Answer: A combination of a machine learning-based tissue analysis software for tissue segmentation and a deep learning-based algorithm for segmentation-independent cell identification shows strong performance on the automated histological analysis of endometriosis sections.

What Is Known Already: Endometriosis is characterized by the complex interplay of various cell types and exhibits great variation between patients and endometriosis subtypes.

Study Design, Size, Duration: Endometriosis tissue samples of eight patients of different subtypes were obtained during surgery.

Randomized Controlled Trial: Acquisition of Basic Microsurgical Skills Through Smartphone Training Model.

Background: Microsurgery is essential in various surgical specialties, but learning these skills is challenging due to work hour limitations, patient safety concerns, documentation time, and ethical objections to practicing on live animals. This randomized controlled trial compares 2 microsurgical training models: the smartphone model and the microscope model.

Methods: Thirty students without prior microsurgery experience were randomized into 3 groups: control (CG), smartphone (SG), and microscope (MG).

The role of fibrosis in endometriosis: a systematic review.

Background: Fibrosis is an important pathological feature of endometriotic lesions of all subtypes. Fibrosis is present in and around endometriotic lesions, and a central role in its development is played by myofibroblasts, which are cells derived mainly after epithelial-to-mesenchymal transition (EMT) and fibroblast-to-myofibroblast transdifferentiation (FMT). Transforming growth factor-β (TGF-β) has a key role in this myofibroblastic differentiation.

Endometriotic tissue fragments are viable after cryopreservation in an ex vivo tissue model recapitulating the fibrotic microenvironment.

Study Question: Is it possible to establish an ex vivo endometriosis model using cryopreserved endometriotic tissue fragments?

Summary Answer: Cryopreserved endometriotic tissue fragments remain viable after thawing and during at least 3 days of culture and can therefore be used to establish an ex vivo endometriosis model to efficiently test potential therapeutic agents.

What Is Known Already: Endometriosis is the most prevalent benign gynecologic disease with an enormous societal burden; however, curative therapies are still lacking. To efficiently test potential new therapies, an ex vivo model based on previously cryopreserved endometriotic tissue that recapitulates the different endometriosis subtypes and their microenvironment is highly desirable.

Preterm birth and uterine fibroid necrosis: The clinical presentation illustrated in a case series.

Objective: Uterine fibroids increase the risk of preterm birth. The current study highlights uterine fibroid necrosis as a possible cause of (extreme) preterm birth.

Study Design: Retrospective cohort study in one Dutch academic hospital.

The ideal timing for revision surgery following an infected cranioplasty.

It is a challenge to define the ideal timing for revision surgery following an infected cranioplasty. Both healing of infected bone and preparedness of soft tissue must be considered. There is no gold standard regarding the timing of revision surgery and a lot of studies have contradictory findings.

Uterine Fibroids Causing Preterm Birth: A New Pathophysiological Hypothesis on the Role of Fibroid Necrosis and Inflammation.

According to recent studies and observations in clinical practice, uterine fibroids increase the risk of preterm birth. There are several theories on the pathogenesis of preterm birth in the presence of fibroids. One theory proclaims that fibroid necrosis leads to preterm birth, though pathophysiological mechanisms have not been described.

Necrotizing soft tissue infection of the upper leg as first presentation of necrotizing pancreatitis: a case report.

Acute pancreatitis can be complicated with necrosis of the pancreatic or peripancreatic tissue. This necrosis can become liquified and form a well-defined wall (walled-off necrosis or WON) and can become infected and form abscesses. Necrotizing soft tissue infections are rare infections of the deep tissue and subcutaneous fat and are mostly caused by trauma or perforated visceral organs.

Perineal bowel evisceration after extralevator abdominoperineal excision and vertical rectus abdominis myocutaneous flap closure.

Introduction: Perineal bowel evisceration is a rare complication after extralevator abdominoperineal excision (ELAPE). This surgical technique is used to resect low rectal and anal cancer, with a lower likelihood of positive surgical margins, but resulting in a larger perineal defect. A vertical rectus abdominis myocutaneous (VRAM) flap allows filling of the empty pelvic space and closure of the defect in the pelvic floor.

The risk of preterm birth in women with uterine fibroids: A systematic review and meta-analysis.

Background: Fibroids have been identified as a possible risk factor for preterm birth, however, the magnitude of this risk is unclear. Our objective was to determine the risk of total, spontaneous, and medically indicated preterm birth in women with fibroids.

Methods: A literature search was performed on 9 June 2021.

Emergency evacuation low-pressure suction for the management of extravasation injuries - a case report.

Background: Extravasation is the movement of fluid outside its conduit into the extracellular tissue, possibly leading to a local inflammatory reaction, compartment syndrome, tissue necrosis, and full thickness skin loss at the affected area. To prevent these complications, early recognition, referral and treatment of an extravasation injury is of utter importance.

Case Report: We present a case, illustrating an extravasation injury into the breast managed by a renovated surgical technique - emergency evacuation low-pressure suction (EELS).

A study to compare strengths of cadaveric tendon repairs with round-bodied and cutting needles.

This human cadaver study investigated whether flexor tendon repairs performed with round-bodied needles had a higher risk of pull-out compared with those performed with cutting needles. Forty human cadaver tendons were repaired (20 with each type of needle), subjected to tensile traction testing and evaluated by failure load and mode of failure. The average failure load was 50 N (SD 13 N) for tendons repaired with round-bodied needles, compared with 49 N (SD 16 N) for tendons repaired with cutting needles.

Are surgeons ready to get the COVID-19 vaccine?

Background: Vaccination against COVID-19 has started in several countries already and is on its way in others. However, there is an important hesitance towards the vaccine. The aim of this study is to evaluate the vaccination hesitance and main concerns towards the vaccine among surgeons.

Misdiagnosis of sebaceous carcinoma.

Background: Sebaceous carcinoma is an aggressive malignant tumour. To prevent mutilating surgery and improve patient outcomes, early diagnosis and prompt treatment are necessary. When the tumour invades surrounding tissues, treatment may become complex.

Ewing's sarcoma of the sternum necessitating complex resection and reconstruction.

We present a 30-year-old man with a sternal Ewing's sarcoma, who was treated by complex resection of the sternal body and reconstruction by a methyl methacrylate sandwich graft and a pedicled latissimus dorsi flap.

The effect of ventilation rate on outcome in adults receiving cardiopulmonary resuscitation.

Aim: To investigate whether a ventilation rate ≤10 breaths min in adult cardiac arrest patients treated with tracheal intubation and chest compressions in a prehospital setting is associated with improved Return of Spontaneous Circulation (ROSC), survival to hospital discharge and one-year survival with favourable neurological outcome, compared to a ventilation rate >10 breaths min.

Methods: In this retrospective study, prospectively acquired data were analysed. Ventilation rates were measured with end-tidal CO and ventilation pressures.

Ivory arthroplasty for trapeziometacarpal osteoarthritis: 10-year follow-up.

This prospective study investigates long-term functional outcome after total trapeziometacarpal joint replacement with the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis. Clinical outcome, overall function, pain, and radiologic outcome after a minimum of 10 years were evaluated for 26 Ivory arthroplasty in 24 patients. Two patients had bilateral arthroplasties.

Internal herniation through the falciform ligament of the liver: a case report.

An internal abdominal hernia is defined as the protrusion of a viscus through a mesenteric or peritoneal aperture within the peritoneal cavity. A less common type of internal herniation is a small bowel herniation through a defect in the falciform ligament of the liver. This defect can be congenital or iatrogenic after penetration of the falciform ligament with a trocar during laparoscopic surgery.

Ventilation rate in adults with a tracheal tube during cardiopulmonary resuscitation: A systematic review.

Aim: The optimal ventilation rate during cardiopulmonary resuscitation (CPR) with a tracheal tube is unknown. We evaluated whether in adults with cardiac arrest and a secure airway (tracheal tube), a ventilation rate of 10min, compared to any other rate during CPR, improves outcomes.

Methods: A systematic review up to 14 July 2016.

Higher energy states in the CO dimer: millimeter-wave spectra and rovibrational calculations.

New extensive millimeter-wave measurements of the 12C16O dimer have been made, and more than 300 new spectral transitions have been observed in the frequency range 81-135 GHz. A joint analysis of these and previous millimeter-wave data yielded the precise location of 33 new energy levels of A+ symmetry and 20 levels of A- symmetry. These energy levels are located at 8-18 cm(-1) above the zero-point level.