Pathologic Assessment of Rectal Carcinoma after Neoadjuvant Radio(chemo)therapy: Prognostic Implications

Neoadjuvant radio(chemo)therapy is increasingly used in rectal cancer and induces a number of morphologic changes that affect prognostication after curative surgery, thereby creating new challenges for surgical pathologists, particularly in evaluating morphologic changes and tumour response to preoperative treatment. Surgical pathologists play an important role in determining the many facets of rectal carcinoma patient care after neoadjuvant treatment. These range from proper handling of macroscopic specimens to accurate microscopic evaluation of pathological features associated with patients' prognosis. This review presents the well-established pathological prognostic indicators and discusses challenging features in order to provide both surgical pathologists and treating physicians with a checklist that is useful in a neoadjuvant setting

The effect of cigarette smoke exposure on the development of inflammation in lungs, gut and joints of TNFΔARE mice

The inflammatory cytokine TNF-alpha is a central mediator in many immune-mediated diseases, such as Crohn's disease (CD), spondyloarthritis (SpA) and chronic obstructive pulmonary disease (COPD). Epidemiologic studies have shown that cigarette smoking (CS) is a prominent common risk factor in these TNF-dependent diseases. We exposed TNF Delta ARE mice; in which a systemic TNF-alpha overexpression leads to the development of inflammation; to 2 or 4 weeks of air or CS. We investigated the effect of deregulated TNF expression on CS-induced pulmonary inflammation and the effect of CS exposure on the initiation and progression of gut and joint inflammation. Upon 2 weeks of CS exposure, inflammation in lungs of TNF Delta ARE mice was significantly aggravated. However, upon 4 weeks of CS-exposure, this aggravation was no longer observed. TNF Delta ARE mice have no increases in CD4+ and CD8+ T cells and a diminished neutrophil response in the lungs after 4 weeks of CS exposure. In the gut and joints of TNF Delta ARE mice, 2 or 4 weeks of CS exposure did not modulate the development of inflammation. In conclusion, CS exposure does not modulate gut and joint inflammation in TNF Delta ARE mice. The lung responses towards CS in TNF Delta ARE mice however depend on the duration of CS exposure

A multi-model analysis of vertical ozone profiles

A multi-model study of the long-range transport of ozone and its precursors from major anthropogenic source regions was coordinated by the Task Force on Hemispheric Transport of Air Pollution (TF HTAP) under the Convention on Long-range Transboundary Air Pollution (LRTAP). Vertical profiles of ozone at 12-h intervals from 2001 are available from twelve of the models contributing to this study and are compared here with observed profiles from ozonesondes. The contributions from each major source region are analysed for selected sondes, and this analysis is supplemented by retroplume calculations using the FLEXPART Lagrangian particle dispersion model to provide insight into the origin of ozone transport events and the cause of differences between the models and observations. In the boundary layer ozone levels are in general strongly affected by regional sources and sinks. With a considerably longer lifetime in the free troposphere, ozone here is to a much larger extent affected by processes on a larger scale such as intercontinental transport and exchange with the stratosphere. Such individual events are difficult to trace over several days or weeks of transport. This may explain why statistical relationships between models and ozonesonde measurements are far less satisfactory than shown in previous studies for surface measurements at all seasons. The lowest bias between model-calculated ozone profiles and the ozonesonde measurements is seen in the winter and autumn months. Following the increase in photochemical activity in the spring and summer months, the spread in model results increases, and the agreement between ozonesonde measurements and the individual models deteriorates further. At selected sites calculated contributions to ozone levels in the free troposphere from intercontinental transport are shown. Intercontinental transport is identified based on differences in model calculations with unperturbed emissions and emissions reduced by 20% by region. Intercontinental transport of ozone is finally determined based on differences in model ensemble calculations. With emissions perturbed by 20% per region, calculated intercontinental contributions to ozone in the free troposphere range from less than 1 ppb to 3 ppb, with small contributions in winter. The results are corroborated by the retroplume calculations. At several locations the seasonal contributions to ozone in the free troposphere from intercontinental transport differ from what was shown earlier at the surface using the same dataset. The large spread in model results points to a need of further evaluation of the chemical and physical processes in order to improve the credibility of global model results

Tumours and tumour-like conditions of the anal canal and anus

info:eu-repo/semantics/publishe

Modulatie van chronisch inflammatoir darmlijden: van mechanisme tot gerichte therapie

info:eu-repo/semantics/publishe

Guidelines for adequate histopathological reporting of pancreatic ductal adenocarcinoma resection specimens.

GuidelineJournal ArticlePractice Guidelineinfo:eu-repo/semantics/publishe

Pathologic Assessment of Rectal Carcinoma after Neoadjuvant Radio(chemo)therapy: Prognostic Implications

Neoadjuvant radio(chemo)therapy is increasingly used in rectal cancer and induces a number of morphologic changes that affect prognostication after curative surgery, thereby creating new challenges for surgical pathologists, particularly in evaluating morphologic changes and tumour response to preoperative treatment. Surgical pathologists play an important role in determining the many facets of rectal carcinoma patient care after neoadjuvant treatment. These range from proper handling of macroscopic specimens to accurate microscopic evaluation of pathological features associated with patients’ prognosis. This review presents the well-established pathological prognostic indicators and discusses challenging features in order to provide both surgical pathologists and treating physicians with a checklist that is useful in a neoadjuvant setting

Interpretation of ileal biopsies: morphological features in normal and diseased mucosa

One of the advantages of flexible colonoscopy is that the terminal ileum can easily be reached and biopsied by an experienced operator. Thus, the pathologist will, with increasing frequency, receive ileal biopsies from patients who have or may not have ileal disease and it is therefore useful to have a good knowledge of the spectrum of ileal mucosal histology and pathology, of its normal function, and of the changes seen in different conditions. It is also desirable to be aware of diseases that occur less frequently. The ileal microscopic features are related to its absorptive function on the one hand, and to non-specific and specific defence mechanisms of the organism against potential hazardous components on the other. As a consequence the mucosa features a constant physiological and controlled inflammatory process. Part of the ileal mucosal structure is determined by the presence of the gut-associated lymphoid tissue (GALT) which plays a key role in discriminating harmless nutrients and harmful pathogens. It will be important to distinguish this normal situation from alterations seen in infectious or inflammatory pathology. Further, because of the therapeutic implications, it is necessary that acute and chronic (idiopathic) inflammation are recognized. This will in general be possible by evaluating the composition of the inflammatory infiltrate and the occurrence of epithelial and mucosal architectural changes.Journal ArticleReviewFLWINinfo:eu-repo/semantics/publishe