Surgical Treatment and Outcome of Extracranial Germ Cell Tumors in Childhood

Germ cell tumors (GCTs) are a heterogeneous group of very rare tumors, benign or malignant, which can occur from newborn to old age. They are thought to arise from primordial germ cells, and are found in a variety of sites. This thesis is composed of 2 major parts. In a first part, the hospital records of 193 infants and children with GCTs, treated between 1960 and 2003 in ErasmusMC-Sophia Children’s Hospital Rotterdam and between 1986 and 2003 in the Academic Hospital of the Free University of Brussels, are studied. The long-term outcome for the various anatomical sites and histologies, is studied. Pitfalls in diagnosis and treatment are reported. A second part of the thesis is devoted to the study of (a) 173 patients with sacrococcygeal teratoma, treated between 1970 and 2003 in the six centers of pediatric surgery in the Netherlands, and of (b) 70 patients with SCT treated between 1960 and 2003 in ErasmusMC-Sophia Children’s Hospital Rotterdam. In these patient populations, risk factors for recurrence are studied, as well as functional results and quality of life. Subject headings: 1. Introduction 2. Influence of Tumor Site and Histology on Long-Term Survival in 193 Children with Extracranial Germ Cell Tumors Treated between 1960 - 2003 3. Ovarian Germ Cell Tumors in Children: A Clinical Study of 66 Patients 4. Testicular Germ Cell Tumors in Children: Management and Outcome in a Series of 20 Patients 5. Strategy for Management of Newborns with Cervical Teratoma 6. Mediastinal Germ Cell Tumors: Clinical Aspects and Outcomes in 7 Children 7. Retroperitoneal Germ Cell Tumors: A Clinical Study of 12 Patients 8. Study of the Factors Associated with Recurrence in Children with Sacrococcygeal Teratoma 9. Factors Associated with Recurrence and Metastatic Disease in Sacrococcygeal Teratoma: Results in the Netherlands (1970-2003) 10. Sacrococcygeal Teratoma: Results of a Retrospective Multicentric Study in Belgium and Luxembourg 11. Long-Term Functional Sequelae of Sacrococcygeal Teratoma: A National Study in the Netherlands 12. General Discussio

MEAN-pinolla tehdyn järjestelmän yksikkötestaaminen

Tämä opinnäytetyö on laadittu tilaajayritys Mekiwi Oy:n tarpeisiin ja siinä tutkitaan yksikkötestejä sekä niiden merkitystä ja hyötyjä MEAN-pinolla tehdyssä järjestelmässä. Tarve opinnäytetyölle ilmeni, kun sen kohteena olevan järjestelmän testausta haluttiin helpottaa ja automatisoida. Tavoitteena oli tuottaa yritykselle tietoa yksikkötestauksesta ja yksikkötestien rakentamisesta sekä suunnitella ja toteuttaa yksikkötestit kattamaan järjestelmän koko lähdekoodi. Alusta asti oli selvää, että tutkimusta tarvittaisiin varsin vähän, sillä työn painopiste on toiminnallisuudessa. Lähteiden sisältö onkin suurimmaksi osaksi teoriapohjaa, jolla avataan tarvittavat käsitteet ja teknologiat itse toteutusosaa varten. Käytetyistä lähteistä suurin osa on kunkin käsiteltävän asian kotisivuja. Opinnäytetyön tuloksena on kaksi sarjaa yksikkötestejä, jotka testaavat järjestelmän asiakassovelluksen käyttäjiä koskevia tietokantatoimintoja ja HTTP-rajapintoja. Lisäksi sen tuloksena saatiin tietoa tarvittavista toimenpiteistä yksikkötestien tekemisestä kattamaan koko järjestelmän koodi. Pelkkä testien kirjoittaminen ei tule riittämään, sillä sekä järjestelmän palvelin- että asiakassovelluksessa on koodia, jonka yksikkötestaaminen ilman koodimuutoksia on vähintäänkin epäluotettavaa ellei jopa mahdotonta.This thesis was made for a company called Mekiwi Oy. The subject is to examine the purpose and benefits of unit tests in a software built with the MEAN stack. The need for this thesis arose when the company wanted to improve the testing of a software and to make it more automatic. The goal was to provide information to the company about unit testing and to design and produce unit tests to cover the whole of the software’s codebase. It was clear right from the start that the need for research would be limited because the main focus would be on the functional side. The majority of the source material used is information about the concepts and technologies described either in the theory section or in the implementation section. The vast majority of the references are links to a homepage of the subject in question. The end result was two sets of unit tests: one testing the database functionalities regarding users and one testing the HTTP application programming interfaces regarding users. Information on creating unit tests to cover the entire codebase was also uncovered. Mere writing the unit testing will not be sufficient because both the client and the server have code that will need refactoring to make unit testing it possible

Alternatives to the Swan-Ganz catheter

While the pulmonary artery catheter (PAC) is still interesting in specific situations, there are many alternatives. A group of experts from different backgrounds discusses their respective interests and limitations of the various techniques and related measured variables. The goal of this review is to highlight the conditions in which the alternative devices will suffice and when they will not or when these alternative techniques can provide information not available with PAC. The panel concluded that it is useful to combine different techniques instead of relying on a single one and to adapt the "package" of interventions to the condition of the patient. As a first step, the clinical and biologic signs should be used to identify patients with impaired tissue perfusion. Whenever available, echocardiography should be performed as it provides a rapid and comprehensive hemodynamic evaluation. If the patient responds rapidly to therapy, either no additional monitoring or pulse wave analysis (allowing continuous monitoring in case potential degradation is anticipated) can be applied. If the patient does not rapidly respond to therapy or complex hemodynamic alterations are observed, pulse wave analysis coupled with TPTD is suggested

Cent scientifiques répliquent à SEA (Suppression des Expériences sur l’Animal vivant) et dénoncent sa désinformation

La lutte contre la maltraitance animale est sans conteste une cause moralement juste. Mais elle ne justifie en rien la désinformation à laquelle certaines associations qui s’en réclament ont recours pour remettre en question l’usage de l’expérimentation animale en recherche

A requiem for silicone ?

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Septic shock

Septic shock is accompanied by profound cardiovascular alterations, including a decrease in vascular tone, hypovolemia, and myocardial depression. Hence, the hemodynamic treatment represents a true challenge for intensivists because all of these mechanisms of shock can be associated, and at any given moment the dominant mechanism may be different. Making the correct diagnosis thus becomes somewhat complicated, especially with adapted treatment. By its ability to assess the problem in a step-by-step fashion and independently of the different variables of cardiovascular function, echocardiography is particularly adapted to the situation. The role of echocardiography in septic shock is to evaluate fluid responsiveness and document whether left and/or right ventricular dysfunction are present and are contributing to circulatory failure. Indeed, it is quite common that left, but also right, ventricular dysfunction are observed, but these often do not compromise the hemodynamic response to sepsis. It one-third of patients in septic shock, cardiac dysfunction becomes a limiting factor. To differentiate between asymptomatic and symptomatic myocardial dysfunction, it is useful to measure cardiac output and evaluate its adequacy to oxygen demand. © 2011 Springer-Verlag Berlin Heidelberg.SCOPUS: ch.binfo:eu-repo/semantics/publishe

The role of invasive techniques in cardiopulmonary evaluation.

To discuss the role of the invasive monitoring techniques pulmonary artery catheter (PAC) and transpulmonary thermodilution (TPD) for cardiopulmonary monitoring in the critically ill patient.Journal ArticleReviewSCOPUS: re.jinfo:eu-repo/semantics/publishe