Biomedical subjects

J de Vries

Publications and source records attributed to J de Vries.

At least 19 recordsLinked to original sources

PubMed2006

[The 'Veenhuizen ophthalmia'].

In 1860 the institutions of the former Society of Welfare in Veenhuizen, the Netherlands, which had been taken over by the state, were struck by a mysterious eye disease. More than 5000 orphans and former beggars lived and worked in these institutions. The Minister of the Interior ordered an inquiry by the ophthalmologist Herman Snellen (1834-1908). He reported that the inmates slept in close proximity to one another and had to share dishes and towels. There was no clean water for washing or drinking. 788 (15%) people were found to be suffering from trachoma. On Snellen's advice, a start on improving the standards of hygiene was made but no more was done. The real reduction in prevalence came around 1900 and was probably connected with a reduction of the number of inmates and improvements in hygiene.

Endophthalmitis↗

PubMed2006

[Long-term follow-up is indicated after surgery for a phaeochromocytoma].

Two patients presented with symptoms that suggested a recurrence of phaeochromocytoma, 17 and 14 years after a first manifestation of this disease for which they had undergone successful surgery. The first patient, a 57-year-old man, had typical symptoms of phaeochromocytoma and had recently experienced deterioration of the glycaemic control of his diabetes mellitus type 2. After initial evaluation and treatment with alpha-adrenergic blockade and propranolol, he again underwent surgery. In addition to peritoneal metastases confirmed to be caused by malignant phaeochromocytoma he also had a carcinoma of the caecum. The second patient, a 32-year-old woman, complained of headache and palpitations and had liver-enzyme disorders. Ultrasound examination revealed a tumour in the right upper abdomen and a recurrence of phaeochromocytoma was diagnosed; an intact pregnancy was also found. After a healthy son had been born by caesarian section, she underwent debulking of the large intra-abdominal lymph nodes and of two metastases in the lung. At the last follow-up she was under treatment with radioactive 123I-meta-iodobenzylguanidine (123-MIBG) because of residual metastases. Studies report recurrence ofphaeochromocytoma in 8-20% of cases, and such a recurrence may be either benign or malignant. Factors predictive for recurrence are older age, a malignant primary tumour, tumour weight above 60 g, extra-adrenal origin of the tumour and peroperative tumour spill. Long-term follow-up of patients is indicated, even after successful initial surgery.

Adrenal Gland Neoplasms↗

PubMed2006

Expression profiling and prediction of distant metastases in head and neck squamous cell carcinoma.

BACKGROUND: For breast and prostate cancer, a gene expression signature of the tumour is associated with the development of distant metastases. Regarding head and neck squamous cell carcinoma (HNSCC), the only known risk factor is the presence of > or =3 tumour-positive lymph nodes. AIM: To evaluate whether a HNSCC gene expression signature can discriminate between the patients with and without distant metastases. METHODS: Patients with HNSCC with and without distant metastases had >3 tumour-positive lymph nodes, and did not differ with respect to other risk factors. Statistical analysis was carried out using Student's t test, as well as statistical analysis of microarrays (SAM), to assess the false discovery rate for each gene. These analyses were supplemented with a newly developed method that computed deviations from gaussian-order statistics (DEGOS). To validate the platform, normal mucosa of the head and neck was included as control. RESULTS: 2963 genes were differently expressed between HNSCC and normal mucosa (t test; p<0.01). More rigorous statistical analysis with SAM confirmed the differential expression of most genes. The comparison of genes in HNSCC with and without metastases showed 150 differently expressed genes (t test; p<0.01), none of which, however, could be confirmed using SAM or DEGOS. CONCLUSIONS: No evidence for a metastasis signature is found, and gene expression profiling of HNSCC has seemingly no value in determining the risk of developing distant metastases. The absence of such a signature can be understood when it is realised that, for HNSCC in contrast with breast cancer, the lymph nodes are a necessary in-between station for haematogenous spread.

Adult↗

PubMed2006

Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer.

BACKGROUND: In a prospective study, long term upper-limb morbidity, perceived disabilities in activities of daily life (ADL) and quality of life (QOL) were assessed before and 2 years after sentinel lymph node biopsy (SLNB) or axillary lymph node dissections (ALND) for breast cancer. METHODS: Two hundred and four patients with stage I/II breast cancer, mean age 55.6 years (SD: 11.6) entered the study and 181 patients (89%) could be evaluated after 2 years. Fifty-seven patients underwent SLNB (31%) and 124 patients underwent an ALND (69%). Assessments included pain, shoulder range of motion, muscle strength, arm volume, perceived shoulder disability in ADL and QOL. RESULTS: Significant (P<0.05) changes between before and 2 years after surgery were found in almost all assessments of shoulder function, ADL and several QOL subscales. Patients in the ALND group showed significant more changes in range of motion (ROM), grip strength, arm volume, ADL and QOL physical- and role functioning, pain and sleeplessness and arm symptoms compared to the SLNB group. Multivariate linear regression analysis showed that ALND could predict decrease of ROM, grip strength, ADL and physical functioning (QOL) and increase of arm volume, pain and arm symptoms score (QOL). Radiation on the axilla predicts an additional decrease in shoulder ROM and increase of arm volume. CONCLUSION: Two years after surgery for breast cancer, patients show significantly less treatment related upper limb morbidity, perceived disability in ADL and worsening of QOL after SLNB compared with ALND.

Activities of Daily Living↗

PubMed2006

'Schools without walls?' Developments and challenges in dental outreach teaching - report of a recent symposium.

During the 2004 annual meeting of the International Association for Dental Research, the Education Research Group held a symposium on dental outreach teaching. After a brief introduction, which reviews relevant aspects of the relatively sparse literature, this paper summarises the proceedings, the themes and conclusions that emerged and the research issues that were identified. It aims to describe aspects of current practice around the world and to promote future discussion. Presenters gave details of outreach programmes for dental undergraduates in Australia, Finland, Malaysia (and Southeast Asia), the United Kingdom and the United States. From these presentations four themes emerged. They were: reasons for the introduction of outreach teaching, its perceived beneficial effects, organisational issues, educational issues. The reasons included a recognition of the need to educate dental undergraduates as members of 'care teams' in the environments and communities where they were ultimately like to work and the current shortage of both suitable patients and teachers (faculty) in many dental schools. A wide range of potential benefits and some disadvantages were identified. The organisational issues were, in the main, seen to relate to finance and administration. The educational issues included the need to train and monitor the performance of teachers at outreach clinics and to assess the performance of the undergraduates whilst at the outreach locations. It was concluded that new technology made it easier to teach at a distance and it was possible to create a dental 'school without walls'. It was recognised that few evaluations of dental outreach teaching have been carried out and that there were many research questions to be answered, including: whether it should be a voluntary or compulsory part of the undergraduate curriculum, how long it should last and what type of outcomes should be assessed.

Asia, Southeastern↗

PubMed2006

Transversal wavelength-independent microradiography, a method for monitoring caries lesions over time, validated with transversal microradiography.

This paper describes a microradiographic method for measuring mineral concentration in a transversal geometry with thick (< or =3.2 mm) sections: transversal wavelength-independent microradiography (T-WIM). It was tested on bovine enamel and dentin samples in vitro, and the results were validated with those of transversal microradiography (TMR). 48 enamel and 48 dentin samples (3.2 x 3.2 x 1.5 mm) were embedded in acrylic resin, randomly divided into six groups of 8 dentin or 8 enamel samples, and demineralized for 0 (sound control), 1, 2, 3, 4, or 5 weeks. For T-WIM, samples were imaged on film with polychromatic 40-kV Cu X-rays with an Al (0.25 mm)/Ni (0.02 mm) filter together with an aluminium/zinc step wedge. TMR slices (about 80 mum for enamel and about 130 mum for dentine) were subsequently cut from the centre of the samples and subjected to TMR. Microradiographs from both methods were digitized and image analysis software was used to calculate lesion depth and mineral loss. The relations between T-WIM and TMR results for mineral loss (DeltaZ) and lesion depth were nearly linear (r > or = 0.96) for both enamel and dentin. The slopes of the regression lines were between 0.99 and 1.02 except for DeltaZ in dentine, which was 0.89. It was concluded that T-WIM is a suitable method for TMR on thick samples.

Animals↗

PubMed2006

Interactive forces between co-aggregating and non-co-aggregating oral bacterial pairs.

The temporo-spatial development of plaque is governed by adhesive interactions between different co-aggregating bacterial strains and species. Physico-chemically, these interactions are due to attractive Lifshitz-Van der Waals and acid-base forces, and occur despite electrostatic repulsion and with a critical influence of temperature. The forces between co-aggregating and non-co-aggregating pairs have never been measured, however. The aim here, thus, is to investigate, by atomic force microscopy, whether there is a difference in interactive forces between co-aggregating and non-co-aggregating bacterial pairs at 10 degrees C, 22 degrees C, and 40 degrees C. Actinomyces naeslundii 147 was immobilized on poly-L-lysine-coated tipless AFM cantilevers, while streptococci were immobilized on poly-L-lysine-coated glass surfaces. Upon approach, a repulsive force was measured, regardless of whether a co-aggregating or non-co-aggregating pair was involved. However, upon retraction, the co-aggregating pair exhibited larger adhesive forces and energies than did the non-co-aggregating pair. Adhesive interactions between the co-aggregating pair were smallest at 40 degrees C.

Actinomyces↗

PubMed2005

Compliance with guidelines is related to better local recurrence-free survival in ductal carcinoma in situ.

The aim was to study the effect of compliance with guidelines on local recurrence (LR)-free survival in patients treated for ductal carcinoma in situ (DCIS). From January 1992 to December 2003, 251 consecutive patients had been treated for DCIS in two hospitals in the North Netherlands. Every case in this two-hospital sample was reviewed in retrospect for its clinical and pathological parameters. It was determined whether treatment had been carried out according to clinical guidelines, and outcomes in follow-up were assessed. In addition, all patients treated for DCIS in this region (n=1389) were studied regarding clinical parameters, in order to determine whether the two-hospital sample was representative of the entire region. In the two-hospital sample, 31.4% (n=79) of the patients had not been treated according to the guidelines. Positive margins were associated with LR (hazard ratio (HR)=4.790, 95% confidence interval (CI) 1.696-13.531). Breast-conserving surgery and deviation from the guidelines were independent predictors of LR (HR=7.842, 95% CI 2.126-28.926; HR=2.778, 95% CI 0.982-6.781, respectively). Although the guidelines changed over time, time was not a significant factor in predicting LRs (HR=1.254, 95% CI 0.272-5.776 for time period 1992-1995 and HR=1.976, 95% CI 0.526-7.421 for time period 1996-1999). Clinical guidelines for the treatment of patients with DCIS have been developed and updated from existing literature and best evidence. Compliance with the guidelines was an independent predictor of disease-free survival. These findings support the application of guidelines in the treatment of DCIS.

Adult↗

PubMed2005

Positron emission tomography in patients with breast cancer using (18)F-3'-deoxy-3'-fluoro-l-thymidine ((18)F-FLT)-a pilot study.

BACKGROUND: This pilot study investigated the feasibility of (18)F-3'-deoxy-3'-fluoro-l-thymidine ((18)F-FLT) as a positron emission tomography (PET) tracer for the visualisation of breast cancer. METHODS: Patients with breast cancer underwent (18)F-FLT-PET prior to surgery. The uptake of (18)F-FLT was determined in the primary tumour and in the axilla. RESULTS: Eight tumours were visualized by (18)F-FLT-PET with a mean uptake value (SUV(mean)) of 1.7 and mean tumour-non-tumour ratio (TNT) of 5.0. In seven patients, axillary lymph-node metastases were found at pathological examinations, however, (18)F-FLT-PET showed uptake in only two large (and clinically evident) lymph-node metastases. CONCLUSIONS: (18)F-FLT shows uptake in most primary breast tumours and in large axillary lymph-node metastases.

Adult↗

PubMed2005

Guideline adherence for early breast cancer before and after introduction of the sentinel node biopsy.

This population-based study aimed to analyse variations in surgical treatment and guideline compliance with respect to the application of radiotherapy and axillary lymph node dissection (ALND), for early breast cancer, before and after the sentinel node biopsy (SNB) introduction. The study included 13 532 consecutive surgically treated stage I-IIIA breast cancer patients diagnosed in 1989-2002. Hospitals showed large variation in breast-conserving surgery (BCS) rates, ranging between 27 and 72% for T1 and 14 and 42% for T2 tumours. In multivariate analysis marked inter-hospital and time-dependent variation in the BCS rate remained after correction for case-mix. The guideline adherence was markedly lower for elderly patients. In 25.2% of the patients aged > or = 75 years either ALND or radiotherapy were omitted. The proportion of patients with no ALND after an SNB increased from 1.8% in 1999 to 37.8% in 2002. However, in 2002 also 12.2% of the patients with a positive SNB did not have an ALND. Guideline compliance for BCS, with respect to radiotherapy and ALND, fell since the SNB introduction, from 96.1% before 2000 to 91.4% in 2002 (P < 0.001). Noncompliance may however reflect patient-tailored medicine, as for elderly patients with small, radically resected primary tumours. The considerable variation in BCS-rates is more consistent with variations in surgeon preferences than patient's choice.

Aged↗

PubMed2005

Assessment of disease impact in patients with intermittent claudication: discrepancy between health status and quality of life.

OBJECTIVE: To describe similarities and differences between health status and quality of life in patients with intermittent claudication. METHODS: This was an observational study in the vascular outpatient department of a teaching hospital; it concerned 200 consecutive patients with intermittent claudication. Health status was assessed with the RAND-36, and quality of life was assessed with a reduced version of the World Health Organization Quality of Life assessment instrument-100. Scores were compared with those of sex- and age-matched healthy controls. Mann-Whitney U tests were used to detect statistically significant differences ( P < .01) between patients and healthy controls. Pearson correlations were calculated between health status and quality-of-life scores. Differences between correlations were examined by using Fisher z statistics. The upper and lower 10% of quality-of-life scores were compared with the response quartiles of the health status scores. RESULTS: Health status was significantly impaired in all domains. Quality of life was significantly worse with respect to aspects of physical health and level of independence and one global evaluative facets overall quality of life and general health. Quality-of-life assessment with the World Health Organization Quality of Life instrument disclosed patient-reported problems that had not been identified in health status. Conversely, patients did not regard all objective functional impairments as a problem. Pearson correlations ranged from 0.20 to 0.74. There were patients with excellent and very poor quality-of-life scores in nearly all the quartiles of the corresponding health status domains. CONCLUSIONS: Health status and quality of life represent different outcomes in patients with intermittent claudication. In addition to functional restrictions as measured in health status, quality of life also permits a personal evaluation of these restrictions. Objective functioning and subjective appraisal of functioning are complementary and not identical. Combining these measures should direct treatment in a way that meets patients' needs.

Adult↗

PubMed2005

Groundwater storage and water security: making better use of our largest reservoir.

Provision of sufficient storage capacity under growing water demands and increasing climate variability is one the main concerns for water managers in the coming decades. It is expected that 150-300 km3 of additional storage capacity will be needed by 2025 especially in semi-arid and arid regions where changes in climate variability will have most impact on rainfall and drought. Storage of substantial amounts of water can either be above ground, in reservoirs behind dams or underground in aquifers (sub-surface storage). Recharge enhancement through management of aquifer recharge (MAR) and sub-surface storage (SSS) is a known technology and already successfully applied in a number of countries for many years at different scales. MAR-SSS is a flexible and cost-effective means to increase storage capacity both at village level and in modern water management schemes. A dialogue and information exchange between climate experts and water managers can provide an effective contribution to the planning, design and operation of MAR-SSS schemes.

Conservation of Natural Resources↗

PubMed2004

Treatment-related upper limb morbidity 1 year after sentinel lymph node biopsy or axillary lymph node dissection for stage I or II breast cancer.

BACKGROUND: In a prospective study, upper limb morbidity and perceived disability/activities of daily life (ADLs) were assessed before and 1 year after sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). METHODS: A total of 204 patients with stage I/II breast cancer (mean age, 55.6 years; SD, 11.6 years) entered the study, and 189 patients (93%) could be evaluated after 1 year. Fifty-eight patients (31%) underwent only SLNB, and 131 (69%) underwent ALND. Assessments performed before surgery (t(0)) and 1 year after surgery (t(1)), included pain, shoulder range of motion, muscle strength, upper arm/forearm circumference, and perceived shoulder disability/ADL. RESULTS: Considerable treatment-related upper limb morbidity was observed. Significant (P < .05) changes between t(0) and t(1) were found in all assessments except strength of elbow flexors. Patients in the ALND group showed significantly more changes in the range of motion in forward flexion, abduction, and abduction/external rotation; grip strength and strength of shoulder abductors; circumference of upper arm and forearm; and perceived shoulder disability in ADLs compared with the SLNB group. Multivariate linear regression analysis showed that ALND could predict a decrease of range of motion in forward flexion, abduction, strength of shoulder abductors, grip strength, and shoulder-related ADLs and an increase in the circumference of the upper arm. Radiation of the axilla (19 patients) predicts an additional decrease in shoulder range of motion. CONCLUSIONS: One year after treatment of breast cancer, there is significantly less upper limb morbidity after SLNB compared with ALND. ALND is a predictor for upper limb morbidity.

Activities of Daily Living↗

PubMed2004

Dioxins, dioxin-like PCBs and non-dioxin-like PCBs in foodstuffs: occurrence and dietary intake in The Netherlands.

Data on occurrence of dioxins (polychlorinated dibenzo-p-dioxins [PCDDs] and dibenzofurans [PCDFs]), dioxin-like PCBs (polychlorinated non-ortho and mono-ortho biphenyls) and non-dioxin-like PCBs (as represented by the so-called indicator-PCBs: congeners 28, 52, 101, 118, 138, 153 and 180) in food products consumed in The Netherlands that were collected in measurement programs carried out during 1998 and 1999, and combined with food consumption data to assess the dietary intake of these persistent food contaminants. The estimated median life-long-averaged intake of the sum of dioxins and dioxin-like PCBs in the population is 1.2 pg WHO-TEQ (toxic equivalents) per kg body weight (bw) per day, while the estimated median life-long-averaged intake of indicator-PCBs is 5.6 ng per kg bw per day. The contribution of different food groups to the total intake of both dioxins + dioxin-like PCBs and non-dioxin-like PCBs is fairly uniformly distributed over the foods consumed: meat products (23% and 27%, respectively), dairy products (27% and 17%, respectively), fish (16% and 26%, respectively), eggs (4% and 5%, respectively), vegetable products (13% and 7%, respectively), and industrial oils and fats (17% and 18%, respectively). Compared with earlier intake estimations the present estimation shows a continued reduction in the intake of dioxins as well as PCBs. This reduction is related to the decrease in the concentration of these substances in the majority of foodstuffs. Nevertheless, a small part of the population still has a rather high life-long averaged intake: 8% of the population is exposed to intake levels above the tolerable weekly intake for dioxins and dioxin-like PCBs of 14 pg WHO-TEQ per kg bw per week, as recently derived by the Scientific Committee on Food of the European Commission. For the non-dioxin-like PCBs an internationally accepted maximum intake level is still lacking. However, to provide risk managers with a health-based guideline to prevent health effects of exposure to non-dioxin-like PCBs, the (international) derivation of a tolerable daily intake is recommended. Monitoring the dietary intake of PCBs is just as important as monitoring the intake of dioxins and dioxin-like PCBs, and attempts to decrease the exposure to both compound classes need continuous attention.

Adolescent↗

PubMed2004

Chlamydophila abortus infection in a pregnant woman associated with indirect contact with infected goats.

Reported here is the case of a pregnant woman who developed a severe Chlamydophila abortus infection after indirect contact with infected goats resulting in preterm stillbirth. The woman fully recovered after treatment with doxycycline. In the goat herd with which her husband worked Chlamydophila abortus was actively circulating, as shown by positive serology. When pregnant women present with rapidly worsening influenza-like illness, special attention should be given to possible contact (direct or indirect) with animals when recording the anamnesis. Pregnant women, especially those who live in rural areas, should generally be made aware of the risks of zoonotic diseases and how to avoid them.

Adult↗

PubMed2004

Promotion of fibroblast activity by coating with hydrophobins in the beta-sheet end state.

Hydrophobins such as SC3 and SC4 of Schizophyllum commune self-assemble into an amphipathic film at hydrophilic/hydrophobic interfaces. These proteins can thus change the nature of surfaces, which makes them attractive candidates to improve physio- and physico-chemical properties of implant surfaces. At a hydrophobic solid, assembly of the hydrophobin is arrested in an intermediate state, called the alpha-helical state. The conversion to the stable beta-sheet end state can be induced by treating the solid at elevated temperatures in the presence of detergent. We here show that SC3 and SC4 in the alpha-helical state homogeneously cover Teflon sheets when coating was performed at 20 degrees C. However, when the protein was adsorbed at 80 degrees C aggregates were shown to bind tightly to the adsorbed hydrophobin film. The transition to the beta-sheet state created pores of about 50 nm in the SC3 and SC4 coatings when coating was performed at 20 degrees C. Cell growth and morphology on SC4 coatings was better than on SC3. In case of both hydrophobins, fibroblast growth and morphology was not influenced by the coating temperature or the conformation of the protein. However, in contrast to the alpha-helical state, the beta-sheet state of both SC3 and SC4 hardly, if at all, affected mitochondrial activity.

Animals↗

PubMed2004

Breast cancer and the role of breast size as a contributory factor.

Several studies have been published on the incidence of breast cancer following augmentation mammaplasty, with very different conclusions. A lower incidence of breast cancer than expected was found in a study conducted by Deapen and Brody in women who had undergone augmentation surgery, and an anticarcinogenic effect of silicone implants has been suggested. Before accepting this conclusion it is important to study the relationship between breast size and the risk of developing breast cancer. It can be assumed that on average, women who have their breasts enlarged have smaller breasts, originally, than other women. Therefore, it seemed possible that breast size might be the predominant factor, and not the silicone implant. To test the hypothesis that women with breast cancer have statistically larger breasts than women who are not found to have breast cancer, a questionnaire was sent to each of 232 women who had undergone surgery for breast cancer; 146 of these questionnaires were returned. Body mass index (BMI) and breast size were compared against the corresponding values in a population-based control group. The results showed no statistical difference between the two groups in BMI or breast size. These findings seem to support the hypothesis that silicone breast implants have some kind of anticarcinogenic effect.

Adolescent↗

PubMed2004

Ductal carcinoma in situ presenting as microcalcifications: the effect of stereotactic large-core needle biopsy on surgical therapy.

The aim of this investigation was to study the efficacy of surgical therapy in patients with non-palpable ductal carcinoma in situ (DCIS) presenting as microcalcifications diagnosed by means of stereotactic large-core needle biopsy (SCNB). This is a retrospective study with a historical control group within a 12-year period. Two groups of consecutive patients diagnosed with DCIS (1991-2002) by means of needle-localised open breast biopsy (NLBB, n=49) and SCNB (n=51) were studied. Both groups were comparable for clinical, radiological and pathological characteristics. The therapeutic interval (time from presentation to definitive of therapy) was 62-days in the SCNB group versus 32-days in the NLBB group (p<0.001). In the SCNB group fewer surgical procedures were required for completion of surgical therapy (p=0.006) and after local excision the surgical margins were more often tumour free (p=0.002). It is postulated that the need for fewer surgical procedures and the greater frequency of tumour-free margins after local excision may be attributable to SCNB.

Aged↗