Het archeologisch onderzoek van de Kenenburg

The settlement Schipluiden dates from Roman times. During the second half of the 13th century extension of inhabitation changed Schipluiden into an independent parish with a parish church on the northern embankment of the canal the Gaag. In the 15th century the prominent castle Kenenburg was built in front of this church both buildings determining Schipluiden's skyline until the end of the 18th century. Archaeological research after this castle surrounded by moats has been carried out since 1966. Excavations in 1989 could complete the castle's plan and incidentally called attention to previous traces of inhabitation both and artefacts from the castle's moat. Present-day research of buried homesteads approaches these castles as on top of the regional social hierarchy of agricultural settlements. All kinds of data must throw a light on the castle's role in its regional context. Research after the frontal and main castle traced potsherds of earthenware, which indicate inhabitation from the 12th till the 14th century. Excavated stone building has been dated as constructed at the end of the 14th or the beginning of the 15th century. After digging the grooves for the foundations the moat round about the grounds was dug and thus the mowing field within these moats was enheightened with 1,5 m. The cellar was laid out at least one half below the new mowing field. Three engravings by Roelant Roghman (1646) reflect the Kenenburg's building process. Many remainders from before 1600 cannot be archaeologically defined anymore but excavations confirm Roghman's buildings after 1600 in detail. The 15th and 16th century frontal castle was situated to the east, while as opposed to the site of the main castle the mowing field hardly has been enheightened. Delfland being inundated in the middle of the 12th century the count of Holland attracted financially strong to help at the reclamation and the restoration of the dikes. In exchange the investors obtained a piece of land on which they had built their homesteads on a put up hill. Characteristic is the presence of farms at these buried homesteads. From the end of the 13th century these castles were built on a larger island surrounded by moats. Most of them have been demolished in the 14th century. According to the oldest discoveries on the site also Kenenburg came into being after the inundations. To the nobility sources of income consisted of the yields of their own landed estates and the rents and rights they exercised in a certain area. The possession of seigniories was the foundation of the nobility's political power. Studying buried homesteads one has to pay attention to the rights and properties the owner obtained in the course of time. Built on St. Maartenrecht's western point the Kenenburg was assured of this seigniory. Expansion of seigniorial rights only was possible in the 16th century, when Kenenburg became the seat of the Lord of Maasland, Schipluiden and St. Maartensrecht. When Philips van Dorp died childlessly in 1411 Philips de Blote had built a new Kenenburg surrounded by moats. Philips probably used the foundations and rising walls of his predecessors. The frontal castle of Kenenburg at the time must have been a very impressive building in Delfland, which impressiveness probably can be connected with the castle's upper local agricultural-economical function. The next owner Otto van Egmond had executed several alterations in the middle of the 16th century. The Kenenburg's fast rebuilding after the dismantling by the Spanish occupation as well as the fact Otto van Egmond was capable of buying the seigniories Maasland and Schipluiden points to a large financial capacity. In 1642 the sale of household goods and properties was started and in 1798 the Kenenburg definitively has been demolished. Discoveries from the castle's moats must provide a better insight into the Kenenburg's agricultural-economical position than at the moment is being revealed by historical sources. Thus these discoveries must explain the building of the impressive frontal castle and the role this important buried homestead has played in Delfland's agricultural economy of the 15th and 16th century

Anti-thymocyte globulin with CsA and MMF as GVHD prophylaxis in nonmyeloablative HLA-mismatched allogeneic HCT

Nonmyeloablative regimens are used for allogeneic hematopoietic cell transplantation (HCT) of older or medically unfit patients, but successful outcome is still hindered by graft-versus-host disease (GVHD), especially in the setting of HLA-mismatched HCT. New GVHD prophylaxis strategies are emerging, including the triple drug strategy, that improve the GVHD-free and relapse-free survival (GRFS). Because the impact of ATG in HLA-mismatched Flu-TBI-based nonmyeloablative HCT has not been investigated, we did a retrospective analysis in three Dutch centers. 67 patients were evaluable, with a median age of 56 years. Overall survival, relapse-free survival and GRFS at 4 years were 52%, 43%, and 38%, respectively. NRM findings and cumulative incidence of relapse at 4 years were 26% and 31%, respectively. At 1-year grade II-IV had occurred in 40% of the patients, and the incidence of moderate-severe chronic GVHD incidence was 16%. Acknowledging the limitations of retrospective analyses, we conclude that the use of ATG for HLA-mismatched truly nonmyeloablative Flu-TBI HCT is feasible and results in acceptable long term outcomes, especially with regards to GRFS. We consider ATG in combination with cyclosporin and mycophenolate mofetil as an alternative for the triple drug strategy that uses sirolimus for GVHD prophylaxis in this particular setting

Bone adaptation to altered loading after spinal cord injury: a study of bone and muscle strength

Bone loss from the paralysed limbs after spinal cord injury (SCI) is well documented. Under physiological conditions, bones are adapted to forces which mainly emerge from muscle pull. After spinal cord injury (SCI), muscles can no longer contract voluntarily and are merely activated during spasms. Based on the Ashworth scale, previous research has suggested that these spasms may mitigate bone losses. We therefore wished to assess muscle forces after SCI with a more direct measure and compare it to measures of bone strength. We hypothesized that the bones in SCI patients would be in relation to the loss of muscle forces. Six male patients with SCI 6.4 (SD 4.3) years earlier and 6 age-matched, able-bodied control subjects were investigated. Bone scans from the right knee were obtained by pQCT. The knee extensor muscles were electrically stimulated via the femoral nerve, isometric knee extension torque was measured and patellar tendon force was estimated. Tendon force upon electrical stimulation in the SCI group was 75% lower than in the control subjects (p<0.01). Volumetric bone mineral density of the patella and of the proximal tibia epiphysis were 50% lower in the SCI group than in the control subjects (p<0.01). Cortical area was lower by 43% in the SCI patients at the proximal tibia metaphysis, and by 33% at the distal femur metaphysis. No group differences were found in volumetric cortical density. Close curvilinear relationships were found between stress and volumetric density for the tibia epiphysis (r(2)=0.90) and for the patella (r(2)=0.91). A weaker correlation with the tendon force was found for the cortical area of the proximal tibia metaphysis (r(2)=0.63), and none for the distal femur metaphysis. These data suggest that, under steady state conditions after SCI, epiphyseal bones are well adapted to the muscular forces. For the metaphysis of the long bones, such an adaptation appears to be less evident. The reason for this remains unclear