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*** of Assisi receives the stigma on his liver

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Hepatobiliary surgery and Nutrition 2023年第3期12卷 300-301页

作者： thom.s m.van gulik Department of surgery Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands

A remarkable painting of *** of Assisi is on display in the Indianapolis museum of Art at Newfields,UsA,painted by the Italian master Pietro da Rimini around 1330(Figure 1)(1).The painting is entitled‘saint Francis receives the stigmata’,and depicts the saint experiencing a vision as he *** sees Christ,bearing the wounds from his crucifixion,flying with an angel-like creature called a *** wounds of Christ represent the four places where nails were driven through his hands and feet during his crucifixion,each denoting a stigma.A fifth stigma appears as a wound on the right side of his chest,where he was stabbed with a lance between the ribs by the Roman soldier who wanted to ascertain his death.

关键词： Italian Figure painting

Couinaud’s corrosion casts of the liver

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Hepatobiliary surgery and Nutrition 2022年第2期11卷 174-175页

作者： thom.s m.van gulik Department of surgery Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands

Claude Couinaud[1922-2008],a French surgeon-anatomist,became famous for his classification of the segmental division of the *** defined each segment by its distinct portal venous anatomy and its intersegmental,watershed *** segment would function as an independent functional unit with its own biliary ductal system draining into the central bile *** from all segments is collected into the three main hepatic veins that drain into the caval vein.

关键词： drain watershed Blood

Babylonian clay tablet of the liver

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Hepatobiliary surgery and Nutrition 2023年第1期12卷 1-2页

作者： thom.s m.van gulik Department of surgery Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands

The Babylonians were an ancient people living from approximately 2000 BC to 1600 BC in southern mesopotamia,a fertile region situated between the Tigris and Euphrates river,an area for the greater part corresponding with modern *** reached a high level of civilization with their own Akkadian language,writings and *** the realm of their religion,they worshipped a host of gods and goddesses,each with different names and distinct functions.

关键词： situated approximate realm

Pathway engineering strategies for improved product yield in yeast-based industrial ethanol production

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synthetic and systems Biotechnology 2022年第1期7卷 554-566页

作者： Aafke C.A.van Aalsta sophie C.de Valk Walter m.van gulik mickel L.A.Jansen Jack T.Pronka Robert mans Department of Biotechnology Delft University of TechnologyVan der Maasweg 92629HZ Delftthe Netherlands Dsm Biotechnology Centre Alexander Fleminglaan 12613AX Delftthe Netherlands

Product yield on carbohydrate feedstocks is a key performance indicator for industrial ethanol production with the yeast saccharomyces *** paper reviews pathway engineering strategies for improving ethanol yield on glucose and/or sucrose in anaerobic cultures of this yeast by altering the ratio of ethanol production,yeast growth and glycerol *** attention is paid to strategies aimed at altering energy coupling of alcoholic fermentation and to strategies for altering redox-cofactor coupling in carbon and nitrogen meta-bolism that aim to reduce or eliminate the role of glycerol formation in anaerobic redox *** addition to providing an overview of scientific advances we discuss context dependency,theoretical impact and potential for industrial application of different proposed and developed strategies.

关键词： saccharomyces cerevisiae synthetic biology metabolic engineering Biofuels Redox metabolism Energy metabolism

Tumor progression in two-stage liver resections—is the shorter inter-stage period in associated liver partition and portal vein ligation for staged hepatectomy (ALPPs) of benefit to the patient?

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Hepatobiliary surgery and Nutrition 2019年第3期8卷 316-317页

作者： Ernesto sparrelid thom.s m.van gulik Division of surgery Department of Clinical ScienceIntervention and TechnologyKarolinska InstitutetKarolinska University HospitalStockholmSweden Department of surgery Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands

A two-stage liver resection is a surgical option in patients with bilobar liver tumors in whom a single procedure is not feasible because of insufficient functional volume of the future liver *** use of unilateral portal vein occlusion,such as portal vein embolization,induce hypertrophy of the future liver remnant in order to enable subsequent *** enhancement of tumor growth along with the hypertrophy response has raised concerns regarding oncological outcomes of the procedure.

关键词： occlusion portal partition

Artificial intelligence for characterization of diminutive colorectal polyps:A feasibility study comparing two computer-aided diagnosis systems

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Artificial Intelligence in Gastrointestinal Endoscopy 2024年第1期5卷 11-22页

作者： Quirine Eunice Wennie van der Zander Ramon m schreuder Ayla Thijssen Carolus H J Kusters Nikoo Dehghani thom.scheeve Bjorn Winkens mirjam C m.van der Ende-van Loon Peter H N de With Fons van der sommen Ad A m masclee Erik J schoon Department of Gastroenterology and Hepatology Maastricht University Medical CenterMaastricht 6202 AZNetherlands GROW School for Oncology and ReproductionMaastricht UniversityMaastricht 6200 MDNetherlands Division of Gastroenterology and Hepatology Catharina Hospital EindhovenEindhoven 5602 ZANetherlands Department of Electrical Engineering Eindhoven University of TechnologyEindhoven 5600 MBNetherlands Department of methodology and statistics Maastricht UniversityPostbus 6166200 MD MaastrichtNetherlands school for Public Health and Primary Care Maastricht UniversityMaastricht 6200 MDNetherlands

BACKGROUND Artificial intelligence(AI)has potential in the optical diagnosis of colorectal *** To evaluate the feasibility of the real-time use of the computer-aided diagnosis system(CADx)AI for ColoRectal Polyps(AI4CRP)for the optical diagnosis of diminutive colorectal polyps and to compare the performance with CAD EYE^(Tm)(Fujifilm,Tokyo,Japan).CADx influence on the optical diagnosis of an expert endoscopist was also *** AI4CRP was developed in-house and CAD EYE was proprietary software provided by *** CADxsystems exploit convolutional neural *** polyps were characterized as benign or premalignant and histopathology was used as gold ***4CRP provided an objective assessment of its characterization by presenting a calibrated confidence characterization value(range 0.0-1.0).A predefined cut-off value of 0.6 was set with valuess≥0.6 indicating premalignant colorectal *** confidence characterizations were defined as values 40%around the cut-off value of 0.6(0.76).self-critical AI4CRP’s diagnostic performances excluded low confidence *** AI4CRP use was feasible and performed on 30 patients with 51 colorectal ***-critical AI4CRP,excluding 14 low confidence characterizations[27.5%(14/51)],had a diagnostic accuracy of 89.2%,sensitivity of 89.7%,and specificity of 87.5%,which was higher compared to *** EYE had a 83.7%diagnostic accuracy,74.2%sensitivity,and 100.0%*** performances of the endoscopist alone(before AI)increased nonsignificantly after reviewing the CADx characterizations of both AI4CRP and CAD EYE(AI-assisted endoscopist).Diagnostic performances of the AI-assisted endoscopist were higher compared to both CADx-systems,except for specificity for which CAD EYE performed *** Real-time use of AI4CRP was *** confidence values provided by a CADx is novel and self-critical AI4CRP sho

关键词： Artificial intelligence Colorectal polyp characterization Computer aided diagnosis Diminutive colorectal polyps Optical diagnosis self-critical artificial intelligence

short-and long-term outcomes after hemihepatectomy for perihilar cholangiocarcinoma:does left or right side matter?

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Hepatobiliary surgery and Nutrition 2021年第2期10卷 154-162,I0001,I0002页

作者： Lotte C.Franken Pim B.Olthof Joris I.Erdmann Otto m.van Delden Joanne Verheij marc G.Besselink Olivier R.Busch thom.s m.van gulik Department of surgery Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamThe Netherlands Department of surgery Erasmus Medical CenterErasmus UniversityRotterdamThe Netherlands Department of Radiology and Nuclear medicine Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands Department of Pathology Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands

Background:The only potentially curative option for patients with perihilar cholangiocarcinoma(PHC)is resection,typically an extrahepatic bile duct resection in combination with(extended)liver *** such as bile leakage and liver failure have been suggested to be more common after right-sided resections compared to left-sided resections,whilst superior oncological outcomes have been reported after right-sided ***,data on outcomes after right-sided or left-sided liver resections in PHC are ***,we aimed to investigate short-and long-term outcomes after left and right hemihepatectomy in patients with ***:In this retrospective study,patients undergoing major liver resection for suspected PHC in a tertiary center between 2000-2018 were *** who had undergone left-sided resections were compared to patients with right-sided resections in terms of complications(90-day mortality,overall and severe morbidity and specific complications).For long-term outcomes,only patients with pathologically proven PHC were included in the survival ***:A total of 178 patients undergoing hemihepatectomy for suspected PHC were analysed,including 76 left-sided and 102 right-sided *** 90-day mortality was 14%(24 out of 178),with no significant difference after left-sided resection(11%;8 out of 76)versus right-sided resection(16%;16 out of 102)(P=0.319).severe morbidity(Clavein Dindo≥3)was also comparable in both groups:54%versus 61%(P=0.361).No differences in specific complications including bile leakage were observed,although liver failure appeared to occur more frequently after right hemihepatectomy(22%versus 11%,P=0.052).Five-year overall survival for pathologically proven PHC,excluding in-hospital mortality,did not differ;43.7%after left-sided resection *** 38.2%after right-sided resection(P=0.553).Conclusions:Both short-and long-term outcomes between patients undergoing left and right hemihepate

关键词： Perihilar cholangiocarcinoma(PHC) hepatectomy outcomes mortality survival

Interpatient heterogeneity in hepatic microvascular blood flow during vascular inflow occlusion (Pringle manoeuvre)

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Hepatobiliary surgery and Nutrition 2020年第3期9卷 271-283页

作者： Lucinda shen Zühre Uz Joanne Verheij Denise P.Veelo Yasin Ince Can Ince thom.s m.van gulik Department of Translational Physiology Amsterdam UMCLocation Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands Department of Intensive Care Laboratory of Translational Intensive CareErasmus MCUniversity Medical CenterRotterdamThe Netherlands Department of surgery Amsterdam UMCLocation Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands Department of Pathology Amsterdam UMCLocation Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands Department of Anesthesiology Amsterdam UMCLocation Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands

Background:Vascular inflow occlusion(VIO)during liver resections(Pringle manoeuvre)can be applied to reduce blood loss,however may at the same time,give rise to ischemia-reperfusion injury(IRI).The aim of this study was to assess the characteristics of hepatic microvascular perfusion during VIO in patients undergoing major liver ***:Assessment of hepatic microcirculation was performed using a handheld vital microscope(HVm)at the beginning of surgery,end of VIO(20 minutes)and during reperfusion after the termination of *** microcirculatory parameters assessed were:functional capillary density(FCD),microvascular flow index(mFI)and sinusoidal diameter(sinD).Results:A total of 15 patients underwent VIO;8 patients showed hepatic microvascular perfusion despite VIO(partial responders)and 7 patients showed complete cessation of hepatic microvascular perfusion(full responders).Functional microvascular parameters and blood flow levels were significantly higher in the partial responders when compared to the full responders during VIO(FCD:0.84±0.88 vs.0.00±0.00 mm/mm2,Pspectively,and mFI:0.69–0.22 vs.0.00±0.00,Pspectively).Conclusions:An interpatient heterogeneous response in hepatic microvascular blood flow was observed upon *** may explain why clinical strategies to protect the liver against IRI lacked consistency.

关键词： Liver perfusion microcirculation

The myth of Prometheus depicted by Jacob Jordaens in 1640

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Hepatobiliary surgery and Nutrition 2020年第6期9卷 693-693页

作者： thom.s m.van gulik Department of surgery Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands

Jacob Jordaens(1593-1678)was a Flemish artist who lived and worked in Antwerp,*** painting shows a scene of the myth of Prometheus,the pre-Olympian god who was punished by Zeus,the king of the gods,because he had stolen the fire of the Olympian gods to give to *** of this Olympic fire,humans were endowed with the ability to think and feel,with which they could cultivate science and *** was chained to a rock of the Caucasus mountains and every day,an eagle came and ate part of his *** night,his liver would regrow enabling him to endure his punishment for eternity(1).

关键词： mountains endowed think