Het herstel van kasteel De Haar te Haarzuilens. Een middeleeuwse binnenplaats overdekt

This article deals with the restoration of the medieval castle De Haar near Utrecht, which started in 1892. Particularly the old courtyard draws one's attention. In the late summer of 1890 the Dutch architect P.J.H. Cuypers was involved in the early plans for a restoration of the ruins of castle De Haar, which in 1890 was inherited by Baron Etienne van Zuylen van Nijevelt, who had married the French Baroness Hélène de Rothschild in 1887. In September 1891 Cuypers and his son Joseph sent the first plans for the restoration to Van Zuylen. Besides the two official reasons for the restoration of the ruins (i.e. to have a holiday home in August and respect for the social and political history of the Van Zuylen family) there was probably another reason: a close connection between the grandparents of Hélène de Rothschild and the French emperor Napoleon III and his wife Eugénie de Montijo. By order of this couple the architect Viollet-le-Duc restored the castle Pierrefonds in France, and to Baron Etienne this castle was an important example for his ruins in The Netherlands. In the execution of the work the old medieval courtyard was covered by a barrelvault, constructed of cast iron, concrete and slates. In the interior of the house the vault was decorated with a gold-painted finish of wood. It is interesting that Cuypers and his son made a number of models of the Hall to show the Baron the various possibilities for this space. A few models have been saved and are in possession of the Stedelijk Museum Roermond. In 1897 the vault was nearly finished. The Hall is still one of the most attractive rooms of the castle

Interobserver Agreement of PD-L1/SP142 Immunohistochemistry and Tumor-Infiltrating Lymphocytes (TILs) in Distant Metastases of Triple-Negative Breast Cancer: A Proof-of-Concept Study. A Report on Behalf of the International Immuno-Oncology Biomarker Working Group

Patients with advanced triple-negative breast cancer (TNBC) benefit from treatment with atezolizumab, provided that the tumor contains 651% of PD-L1/SP142-positive immune cells. Numbers of tumor-infiltrating lymphocytes (TILs) vary strongly according to the anatomic localization of TNBC metastases. We investigated inter-pathologist agreement in the assessment of PD-L1/SP142 immunohistochemistry and TILs. Ten pathologists evaluated PD-L1/SP142 expression in a proficiency test comprising 28 primary TNBCs, as well as PD-L1/SP142 expression and levels of TILs in 49 distant TNBC metastases with various localizations. Interobserver agreement for PD-L1 status (positive versus negative) was high in the proficiency test: the corresponding scores as percentages showed good agreement with the consensus diagnosis. In TNBC metastases, there was substantial variability in PD-L1 status at the individual patient level. For one in five patients, the chance of treatment was essentially random, with half of the pathologists designating them as positive and half negative. Assessment of PD-L1/SP142 and TILs as percentages in TNBC metastases showed poor and moderate agreement, respectively. Additional training for metastatic TNBC is required to enhance interobserver agreement. Such training, focusing on metastatic specimens, seems worthwhile, since the same pathologists obtained high percentages of concordance (ranging from 93% to 100%) on the PD-L1 status of primary TNBCs

Het herstel van kasteel De Haar te Haarzuilens. Een middeleeuwse binnenplaats overdekt

This article deals with the restoration of the medieval castle De Haar near Utrecht, which started in 1892. Particularly the old courtyard draws one's attention. In the late summer of 1890 the Dutch architect P.J.H. Cuypers was involved in the early plans for a restoration of the ruins of castle De Haar, which in 1890 was inherited by Baron Etienne van Zuylen van Nijevelt, who had married the French Baroness Hélène de Rothschild in 1887. In September 1891 Cuypers and his son Joseph sent the first plans for the restoration to Van Zuylen. Besides the two official reasons for the restoration of the ruins (i.e. to have a holiday home in August and respect for the social and political history of the Van Zuylen family) there was probably another reason: a close connection between the grandparents of Hélène de Rothschild and the French emperor Napoleon III and his wife Eugénie de Montijo. By order of this couple the architect Viollet-le-Duc restored the castle Pierrefonds in France, and to Baron Etienne this castle was an important example for his ruins in The Netherlands. In the execution of the work the old medieval courtyard was covered by a barrelvault, constructed of cast iron, concrete and slates. In the interior of the house the vault was decorated with a gold-painted finish of wood. It is interesting that Cuypers and his son made a number of models of the Hall to show the Baron the various possibilities for this space. A few models have been saved and are in possession of the Stedelijk Museum Roermond. In 1897 the vault was nearly finished. The Hall is still one of the most attractive rooms of the castle

Preoperative assessment of liver function: a comparison of 99mTc-Mebrofenin scintigraphy with indocyanine green clearance test

BACKGROUND/AIMS: The indocyanine green (ICG) clearance test is the most frequently used test for preoperative assessment of liver parenchymal function but has its limitations. The aim of this study was to investigate the correlation between ICG clearance test and the liver uptake of 99-Technetium-labelled (99mTc)-Mebrofenin (99mTc-Mebrofenin) as measured with hepatobiliary scintigraphy. METHODS: Fifty-four patients were diagnosed as hepatocellular carcinoma (n=9), hilar tumours (n=20) and 25 patients with non-parenchymal tumours including colorectal metastasis (n=15) and miscellaneous tumours (n=10). One day prior to operation, hepatobiliary 99mTc-Mebrofenin scintigraphy was performed after intravenous injection of 85 MBq and the 15-min clearance rate of ICG (ICG-C15) was measured. RESULTS: The mean ICG-C15 was 86.86+/-1.19% (SEM). The mean 99mTc-Mebrofenin uptake rate was 12.87+/-0.52%/min. A significant correlation was obtained between 99mTc-Mebrofenin uptake rate by scintigraphy and ICG-C15 (r=0.73, P <0.0001). The mean clearance capacity of the right liver segments (79.83+/-1.63, range 47.75-95.97%) was larger than that of the left segments (20.24+/-1.55, range 6.51-52.51%). CONCLUSION: 99mTc-Mebrofenin uptake rate as assessed by scintigraphy is an efficient method for determining liver function and correlates well with ICG clearance. At the same time, 99mTc-Mebrofenin scintigraphy provides information of segmental functional liver tissue, which is of additional use when planning liver resectio