Soya bean tempe extracts show antibacterial activity against Bacillus cereus cells and spores

Aims: Tempe, a Rhizopus ssp.-fermented soya bean food product, was investigated for bacteriostatic and/or bactericidal effects against cells and spores of the food-borne pathogen Bacillus cereus. Methods and results: Tempe extract showed a high antibacterial activity against B. cereus ATCC 14579 based on optical density and viable count measurements. This growth inhibition was manifested by a 4 log CFU ml-1 reduction, within the first 15 min of exposure. Tempe extracts also rapidly inactivated B. cereus spores upon germination. Viability and membrane permeability assessments using fluorescence probes showed rapid inactivation and permeabilization of the cytoplasmic membrane confirming the bactericidal mode of action. Cooked beans and Rhizopus grown on different media did not show antibacterial activity, indicating the unique association of the antibacterial activity with tempe. Subsequent characterization of the antibacterial activity revealed that heat treatment and protease addition nullified the bactericidal effect, indicating the proteinaceous nature of the bioactive compound. Conclusions: During fermentation of soya beans with Rhizopus, compounds are released with extensive antibacterial activity against B. cereus cells and spores. Significance and Impact of Study: The results show the potential of producing natural antibacterial compounds that could be used as ingredients in food preservation and pathogen contro

On the Le Fort III Osteotomy

Patienten met een sterk verminderde ontwikkeling van het middengezicht kunnen al vroeg na de geboorte ernstige problemen met de ademhaling en een bedreigde visus ontwikkelen. Op kinderleeftijd worden grote operaties uitgevoerd om deze ernstige functionele symptomen te corrigeren. In dit proefschrift wordt een aantal fundamentele en klinische studies beschreven die handelen over de gevolgen van het chirurgisch naar voren verplaatsen van het middengezicht. Bij deze operatie wordt de neus, bovenkaak en jukbeenderen inclusief oogkassen naar voren geplaatst, de zogenaamde Le Fort III osteotomie (LF III). Het doel van dit proefschrift was om meer inzicht te verwerven in het effect van de LF III op de anatomie en te bepalen in hoeverre deze ingrepen het obstructief slaap apneu syndroom (OSAS) kan verbeteren. Ten slotte werd er gekeken naar de lange termijn uitkomsten van deze ingrepen en geassocieerde complicaties. Analyses van CT-scans wezen uit dat na een LF III een duidelijke voorwaartse verplaatsing van de onderste randen van de oogkas plaatsvindt samen met een significante volume toename van de oogkassen. De oogbol positie blijft nagenoeg onveranderd. Na LF III treedt verder bij het merendeel van de patienten een volume toename van de bovenste luchtweg op; een verbetering van OSAS treedt niet bij alle patienten op. Er werd geconcludeerd dat behalve de onderontwikkeling van het middengezicht, ook het samenvallen van de wand van de bovenste luchtweg en mogelijk luchtweg obstructies op niveau van de onderkaak een rol spelen. Als er sprake is van een duidelijke volumetoename van de bovenste luchtweg na LF III en de slaapstudie weinig winst laat zien, is endoscopie van de bovenste luchtweg geindiceerd om het niveau van de obstructie vast te stellen. Met betrekking tot de lange termijn resultaten kan gesteld worden dat de LF III een adequate behandeling is voor de onderontwikkeling van het middengezicht. Echter, een verkeerde stand van tanden en kiezen lijkt na de operatie frequent aanwezig te zijn. Hoewel een flink aantal patienten wel een indicatie heeft om deze verkeerde stand van tanden en kiezen later chirurgisch te laten corrigeren, vindt bij deze patientengroep slechts weinig additionele chirurgie plaats. Hoogstwaarschijnlijk zijn patientfactoren hier debet aan. Ten aanzien van de in deze studie geregistreerde milde en ernstige complicaties kan de conclusie worden getrokken dat die zowel verband houden met de ingreep zelf als met het apparaat dat na de operatie aan de schedel gefixeerd wordt om het aangezicht langzaam naar voren te laten bewegen. Door specifieke voorzorgsmaatregelen te nemen, het nauwkeurig bestuderen van de voorgeschiedenis en de medewerking van de patient vooraf door een psycholoog te laten evalueren, kunnen deze complicaties worden voorkomen en kan een optimaal behandelresultaat worden bereikt

Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer

Aims Lymphovascular space invasion (LVSI) in endometrial cancer (EC) is an important prognostic variable impacting on a patient's individual recurrence risk and adjuvant treatment recommendations. Recent work has shown that grading the extent of LVSI further improves its prognostic strength in patients with stage I endometrioid EC. Despite this, there is little information on the reproducibility of LVSI assessment in EC. Therefore, we designed a study to evaluate interobserver agreement in discriminating true LVSI from LVSI mimics (Phase I) and reproducibility of grading extent of LVSI (Phase II). Methods and results Scanned haematoxylin and eosin (H&E) slides of endometrioid EC (EEC) with a predefined possible LVSI focus were hosted on a website and assessed by a panel of six European gynaecological pathologists. In Phase I, 48 H&E slides were included for LVSI assessment and in Phase II, 42 H&E slides for LVSI grading. Each observer was instructed to apply the criteria for LVSI used in daily practice. The degree of agreement was measured using the two-way absolute agreement average-measures intraclass correlation coefficient (ICC). Reproducibility of LVSI assessment (ICC = 0.64, P < 0.001) and LVSI grading (ICC = 0.62, P < 0.001) in EEC was substantial among the observers. Conclusions Given the good reproducibility of LVSI, this study further supports the important role of LVSI in decision algorithms for adjuvant treatment

Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

<p>Abstract</p> <p>Background</p> <p>A modified form of high dose rate (HDR) brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT). EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer.</p> <p>Methods</p> <p>A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation.</p> <p>Results</p> <p>The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities.</p> <p>Conclusions</p> <p>EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.</p

Plan-library supported automated replanning for online-adaptive intensity-modulated proton therapy of cervical cancer

Background: Intensity-modulated proton therapy is sensitive to inter-fraction variations, including density changes along the pencil-beam paths and variations in organ-shape and location. Large dayto-day variations are seen for cervical cancer patients. The purpose of this study was to develop and evaluate a novel method for online selection of a plan from a patient-specific library of prior plans for different anatomies, and adapt it for the daily anatomy. Material and methods: The patient-specific library of prior plans accounting for altered target geometries was generated using a pretreatment established target motion model. Each fraction, the best fitting prior plan was selected. This prior plan was adapted using (1) a restoration of spot-positions (Bragg peaks) by adapting the energies to the new water equivalent path lengths; and (2) a spot addition to fully cover the target of the day, followed by a fast optimization of the spot-weights with the reference point method (RPM) to obtain a Pareto-optimal plan for the daily anatomy. Spot addition and spot-weight optimization could be repeated iteratively. The patient cohort consisted of six patients with in total 23 repeat-CT scans, with a prescribed dose of 45 Gy(RBE) to the primary tumor and the nodal CTV. Using a 1-plan-library (one prior plan based on all motion in the motion model) was compared to choosing from a 2-plan-library (two prior plans based on part of the motion). Results: Applying the prior-plan adaptation method with one iteration of adding spots resulted in clinically acceptable target coverage (V95% 95% and V107% 2%) for 37/46 plans using the 1-planlibrary and 41/46 plans for the 2-plan-library. When adding spots twice, the 2-plan-library approach could obtain acceptable coverage for all scans, while the 1-plan-library approach showed V107% > 2% for 3/46 plans. Similar OAR results were obtained. Conclusion: The automated prior-plan adaptation method can successfully adapt for the large day-today variations observed in cervical cancer patients

The in- or exclusion of non-breast cancer related death and contralateral breast cancer significantly affects estimated outcome probability in early breast cancer

A wide variation of definitions of recurrent disease and survival are used in the analyses of outcome of patients with early breast cancer. Explicit definitions with details both on endpoints and censoring are provided in less than half of published studies. We evaluated the effects of various definitions of survival and recurrent disease on estimated outcome in a prospectively determined cohort of 463 patients with primary breast cancer. Outcome estimates were determined both by the Kaplan–Meier and a competing risk method. In- or exclusion of contralateral breast cancer or non-disease related death in the definition of recurrent disease or survival significantly affects estimated outcome probability. The magnitude of this finding was dependent on patient-, tumour-, and treatment characteristics. Knowledge of the contribution of non-disease related death or contralateral breast cancer to estimated recurrent disease rate and overall death rate is indispensable for a correct interpretation and comparison of outcome analyses

Practical guidance for mismatch repair-deficiency testing in endometrial cancer

MTG8 - Moleculaire pathologie van gynecologische tumore

Aspergillus Genomes and the Aspergillus Cloud

Aspergillus Genomes is a public resource for viewing annotated genes predicted by various Aspergillus sequencing projects. It has arisen from the union of two significant resources: the Aspergillus/Aspergillosis website and the Central Aspergillus Data REpository (CADRE). The former has primarily served the medical community, providing information about Aspergillus and associated diseases to medics, patients and scientists; the latter has focused on the fungal genomic community, providing a central repository for sequences and annotation extracted from Aspergillus Genomes. By merging these databases, genomes benefit from extensive cross-linking with medical information to create a unique resource, spanning genomics and clinical aspects of the genus. Aspergillus Genomes is accessible from http://www.aspergillus-genomes.org.uk