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The impact of new technology on surgery for colorectal cancer

World Journal of Gastroenterology 2001年第5期7卷 612-621页

作者： GregoryBMakin DavidJBreen JohnRTMonson University of Hull academic Surgical unit and Depanment of radiology Castle Hill HospitalCastle RoadCottingham HU16 5JQUnited Kingdom

Advances in technology continue at a rapid pace and affect all aspects of life, including surgery. We have reviewed some of these advances and the impact they are having on the investigation and management of colorectal cancer. Modern endoscopes, with magnifying, variable stiffness and localisation capabilities are making the primary investigation of colonic cancer easier and more acceptable for *** investigations looking at primary, metastatic and recurrent disease are shifting to digital data sets, which can be stored, reviewed remotely, potentially fused with other modalities and reconstructed as 3 dimensional (3D) images for the purposes of advanced diagnostic interpretation and computer assisted surgery. They include virtual colonoscopy, trans-rectal ultrasound, magnetic resonance imaging, positron emission tomography and radioimmunoscintigraphy. Once a colorectal carcinoma is diagnosed, the treatment options available are expanding. Colonic stents are being used to relieve large bowel obstruction, either as a palliative measure or to improve the patient's overall condition before definitive surgery. Transanal endoscopic microsurgery and minimally invasive techniques are being used with similar outcomes and a lower mortality, morbidity and hospital stay than open trans-abdominal surgery. Transanal endoscopic microsurgery allows precise excision of both benign and early malignant lesions in the mid and upper rectum. Survival of patients with inoperable hepatic metastases following radiofrequency ablation is encouraging. Robotics and telemedicine are taking surgery well into the 21(st) century. Artificial neural networks are being developed to enable us to predict the outcome for individual patients. New technology has a major impact on the way we practice surgery for colorectal cancer.

关键词： Catheter Ablation Colonoscopy Colorectal Neoplasms Humans

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Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

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World Journal of Gastroenterology 2008年第32期14卷 5032-5038页

作者： Jaap Jacob Kloek Otto Marinus van Delden Deha Erdogan Fibo Jan ten Kate Erik Anthoni Rauws Olivier Robert Busch Dirk Joan Gouma Thomas Mathijs van Gulik Department of Surgery Academic Medical Center University of Amsterdam Department of radiology Academic Medical Center University of Amsterdam Department of Pathology Academic Medical Center University of Amsterdam Department of Gastroenterology Academic Medical Centre University of Amsterdam

AIM: To identify the criteria for the differentiation of hilar cholangiocarcinoma (HCCA) from benign strictures. METHODS: A total of 68 patients underwent resection of lesions suspicious for HCCA between 1998 and 2006. The results of laboratory investigations, imaging studies and brush cytology were collected. These fi ndings were analyzed to obtain the fi nal diagnosis. RESULTS: Histological examination of the resected specimens confirmed HCCA in 58 patients (85%, group Ⅰ) whereas 10 patients (15%, groupⅡ) were diagnosed to have benign strictures. The most common presenting symptom was obstructive jaundice in 77% patients (79% group Ⅰvs 60% group Ⅱ P = 0.23). Laboratory findings showed greater elevation of transaminase levels in group Ⅰcompared to group Ⅱ The various imaging modalities showed vascular involvement exclusively in the malignant group (36%,P < 0.05). Brush cytology was positive for malignant cells in only 50% patients in group Ⅰ whereas none in group Ⅱ showed malignant cells. CONCLUSION: Despite improvements in imaging techniques, 10 patients (15%) with a presumptive diagnosis of HCCA were ultimately found to have benign strictures. Except for vascular involvement which was associated significantly with malignancy, there were no conclusive features of malignancy on regular imaging modalities. This uncertainty should be taken into account when patients with a suspicious lesion at the liver hilum are considered for resection.

关键词： Biliary stricture Hilar cholangiocarcinoma Benign Radiological Vascular involvement cholangio

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Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease

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World Journal of Gastroenterology 2007年第22期13卷 3095-3100页

作者： Deha Erdogan Otto M van Delden Erik AJ Rauws Olivier RC Busch Johan S Lameris Dirk J Gouma Thomas M van Gulik Department of Surgery Academic Medical Center University of Amsterdam The Netherlands Department of radiology Academic Medical Center University of Amsterdam The Netherlands Department of Gastroenterology Academic Medical Center University of Amsterdam The Netherlands

AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.

关键词： Simple liver cyst Polycystic liver disease Percutaneous sclerotherapy Deroofing Complications

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Obstructive jaundice due to hepatobiliary cystadenoma or cystadenocarcinoma

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World Journal of Gastroenterology 2006年第35期12卷 5735-5738页

作者： Deha Erdogan Olivier RC Busch Erik AJ Rauws Otto M van Delden Dirk J Gouma Thomas M van Gulik Department of Surgery Academic Medical Center University of Amsterdam The Netherlands Department of Hepatology Academic Medical Center University of Amsterdam The Netherlands Department of Surgery radiology Academic Medical Center University of Amsterdam The Netherlands

Hepatobiliary cystadenomas (HBC) and cystadenocarci- nomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with ob- structive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies revealed a polypoid lesion in the left hepatic duct. The second patient had recurrent jaundice and cholangitis. Endoscopic retrograde cholan- giopancreatography (ERCP) showed a cystic lesion at the confluence of the hepatic duct. In the third patient with intermittent jaundice and cholangitis, cholangioscopy re- vealed a papillomatous structure protruding into the left bile duct system. In the fourth patient with obstructive jaundice, CT-scan showed slight dilatation of the intrahe- patic bile ducts and dilatation of the common bile duct of 3 cm. ERCP showed filling of a cystic lesion. All patients underwent partial liver resection, revealing HBC in the specimen. In the fifth patient presenting with obstructive jaundice, ultrasound examination showed a hyperecho- genic cystic lesion centrally in the liver. The resection specimen revealed a hepatobiliary cystadenocarcinoma. HBC and cystadenocarcinoma may give rise to obstruc- tive jaundice. Evaluation with cross-sectional imaging techniques is useful. ERCP is a useful tool to differentiate extraductal from intraductal obstruction.

关键词： Liver Hepatobiliary cystadenoma Cystadenocarcinoma Obstructive jaundice Endoscopic retrograde cholangiopancreatography

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A network-based cognitive training induces cognitive improvements and neuroplastic changes in patients with relapsing-remitting multiple sclerosis:an exploratory case-control study

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Neural Regeneration Research 2021年第6期16卷 1111-1120页

作者： Riccardo Manca Micaela Mitolo Iain D.Wilkinson David Paling Basil Sharrack Annalena Venneri Department of Neuroscience University of SheffieldSheffieldUK Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna Diagnostica Funzionale NeuroradiologicaBolognaItaly academic unit of radiology University of SheffieldSheffieldUK academic Department of Neuroscience Sheffield Teaching HospitalNational Health Service Foundation TrustSheffieldUK

Cognitive impairments are commonly observed in patients with multiple sclerosis and are associated with lower levels of quality of *** consensus has been reached on how to tackle effectively cognitive decline in this clinical population *** exploratory case-control study aims to investigate the effectiveness of a hypothesis-based cognitive training designed to target multiple domains by promoting the synchronous co-activation of different brain areas and thereby improve cognition and induce changes in functional connectivity in patients with relapsing-remitting multiple ***-five patients(36 females and 9 males,mean age 44.62±8.80 years)with clinically stable relapsing-remitting multiple sclerosis were assigned to either a standard cognitive training or to control groups(sham training and nonactive control).The standard training included twenty sessions of computerized exercises involving various cognitive functions supported by distinct brain *** sham training was a modified version of the standard training that comprised the same exercises and number of sessions but with increased processing speed *** non-active control group received no cognitive *** patients underwent comprehensive neuropsychological and magnetic resonance imaging assessments at baseline and after 5 *** and resting-state magnetic resonance imaging data were analyzed using repeated measures *** reassessment,the standard training group showed significant cognitive improvements compared to both control groups in memory tasks not specifically targeted by the training:the Buschke Selective Reminding Test and the Semantic Fluency *** standard training group showed reductions in functional connectivity of the salience network,in the anterior cingulate cortex,associated with improvements on the Buschke Selective Reminding *** changes were observed in the sham training *** findings suggest that multi-domain tr

关键词： cognitive training magnetic resonance imaging multiple sclerosis neuroplasticity neuropsychology rehabilitation salience network

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Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities

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World Journal of Orthopedics 2015年第11期6卷 944-953页

作者： Christiaan JA van Bergen Rogier M Gerards Kim TM Opdam Maaike P Terra Gino MMJ Kerkhoffs Department of Orthopedic Surgery Academic Medical Center Department of radiology Academic Medical Center

This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone(usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography(CT) and magnetic resonance imaging(MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.

关键词： Cartilage Subchondral bone Imaging Ankle Talus Radiography Computed tomography Magnetic resonance imaging Outcome assessment

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Percutaneous embolization by direct puncture for the treatment of high-flow priapism

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Asian Journal of Urology 2023年第2期10卷 208-209页

作者： Quentin Holay Michael Baboudjian Eric Lechevallier Marc Andre Pierre-Henri Savoie Department of radiology Conception Academic HospitalMarseilleFrance Department of Urology Conception Academic HospitalMarseilleFrance Department of Urology Sainte Anne HospitalToulonFrance

Dear Editor,High-flow priapism is a persistent erection,usually caused by blunt perineal trauma,resulting in pathologically increased arterial inflow to the corpora cavernosa[1].The therapeutic strategy of high-flow priapism,although codified,leaves room for a wide choice of techniques,ranging from conservative management,selective arterial embolization to surgical management[2].The aim of this letter was to report an alternative approach of percutaneous embolization by direct puncture for the treatment of high-flow priapism.

关键词： embolization puncture arterial

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Demographic determinants of risk,colon distribution and density scores of diverticular disease

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World Journal of Gastroenterology 2011年第8期17卷 1009-1017页

作者： Mark Golder Irina Chis Ster Pratusha Babu Amita Sharma Muhammad Bayat Abdulkadir Farah Centre for academic Surgery Institute of Cell and Molecular Science Barts and the London School of Medi-cine and Dentistry Queen Mary University MRC centre for Paediatric Epidemiology and Biostatistics University College Department of radiology University Hospital Lewisham

AIM:To investigate associations between ethnicity,age and sex and the risk,colon distribution and density scores of diverticular disease(DD).METHODS:Barium enemas were examined in 1000 patients:410 male,590 female;760 whites,62 Asians,44 black africans(BAs),and 134 other blacks(OBs).Risks and diverticula density of left-sided DD(LSDD) and rightsided-component DD(RSCDD = right-sided DD + right and left DD + Pan-DD) were compared using logistic ***:Four hundred and forty-seven patients had DD(322 LSDD and 125 RSCDD).Adjusted risks:(1) LSDD:each year increase in age increased the odds by 6%(95% CI:5-8,SE:0.8%,P < 0.001);Asians:odds ratio(OR):0.23(95% CI:0.10-0.53,SE:0.1,P ≤ 0.001) and OBs:OR:0.25(95% CI:0.14-0.43,SE:0.07,P ≤ 0.001) appeared protected vs Whites;(2) RSCDD:each year increase in age increased the odds by 4%(95% CI:2-6,SE:1%,P < 0.001);females were 0.60 times(95% CI:0.40-0.90,SE:0.12,P = 0.01) less likely than males to have RSCDD;BAs were 3.51 times(95% CI:1.70-7.24,SE:1.30,P < 0.001) more likely than Whites to have RSCDD;and(3) DD density scores:each year increase in age increased the odds of highdensity scores by 4%(95% CI:1-6,SE:1%,P < 0.001);RSCDD was 2.77 times(95% CI:1.39-3.32,SE:0.67,P < 0.001) more likely to be of high density than *** further signif icant differences were found in the adjusted ***:Right colonic DD might be more common and has higher diverticula density in the west than previously *** appear predisposed to DD,whereas other ethnic differences appear conserved following migration.

关键词： Diverticular disease Migration Barium enema Ethnicity Colon distribution Risk

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Can the computed tomography texture analysis of colorectal liver metastases predict the response to first-line cytotoxic chemotherapy?

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World Journal of Hepatology 2022年第1期14卷 244-259页

作者： Etienne Rabe Dania Cioni Laura Baglietto Marco Fornili Michela Gabelloni Emanuele Neri academic radiology Master in Oncologic ImagingDepartment of Translational ResearchUniversity of PisaPisa 56126Italy Bay radiology-Cancercare Oncology Centre Bay RadiologyPort Elizabeth 6001Eastern CapeSouth Africa Department of Clinical and Experimental Medicine University of PisaPisa 56126Italy

BACKGROUND Artificial intelligence in radiology has the potential to assist with the diagnosis,prognostication and therapeutic response prediction of various cancers.A few studies have reported that texture analysis can be helpful in predicting the response to chemotherapy for colorectal liver metastases,however,the results have *** metastases were not clearly excluded in these studies and in most studies the full range of texture analysis features were not *** study was designed to determine if the computed tomography(CT)texture analysis results of non-necrotic colorectal liver metastases differ from previous reports.A larger range of texture features were also evaluated to identify potential new *** To identify potential new imaging biomarkers with CT texture analysis which can predict the response to first-line cytotoxic chemotherapy in non-necrotic colorectal liver metastases(CRLMs).METHODS Patients who presented with CRLMs from 2012 to 2020 were retrospectively selected on the institutional radiology information system of our private radiology *** inclusion criteria were non-necrotic CRLMs with a minimum size of 10 mm(diagnosed on archived 1.25 mm portal venous phase CT(FOLFOX,FOLFIRI,FOLFOXIRI,CAPE-OX,CAPE-IRI or capecitabine).The final study cohort consisted of 29 *** treatment response of the CRLMs was classified according to the RECIST 1.1 *** means of CT texture analysis,various first and second order texture features were extracted from a single nonnecrotic target CRLM in each responding and non-responding *** between features and response to chemotherapy were assessed by logistic regression *** prognostic accuracy of selected features was evaluated by using the area under the *** There were 15 responders(partial response)and 14 non-responders(7 stable and 7 with progressive disease).The responders presented with a higher number of CRLMs(P=0.05).In univariable an

关键词： Colorectal cancer Liver metastases Radiomics Computed tomography texture analysis Response assessment

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A power analysis for future clinical trials on the potential adverse effects of SSRIs on amygdala reactivity

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Frontiers in Biology 2016年第3期11卷 256-259页

作者： M. A. Bottelier A. Schrantee G. van Wingen H. G. Ruhe M. B. de Ruiter L. Reneman Department of Child-andAdolescentPsychiatry Triversum Alkmaar The Netherlands Brain Imaging Center Academic Medical Center University of Amsterdam Amsterdam The Netherlands Department of radiology Academic Medical Center Amsterdam The Netherlands Department of Psychiatry Academic Medical Center Amsterdam The Netherlands Program for Mood and Anxiety Disorders Department of Psychiatry University Medical Center Groningen University of GroningenGroningen The Netherlands

Treatment of adolescents with antidepressants may induce an increased risk for suicidality in this population. The activity of the amygdala during processing of emotional faces with functional Magnetic Resonance Imaging （fMRI） is a well-known measure of emotional dysregulation. Based upon data of our prematurely ended randomized clinical trial with fluoxetine （NTR3103） in anxious and or depressed girls （12-14 years of age） we calculated that with the found effect size of r = 0.66, compared to placebo, only 8 subjects are heeded to demonstrate increased amygdala activity following 16 weeks of treatment with fluoxetine.

关键词： amygdala reactivity SSRI adverse effects anxiety depression

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