Hypercirculatie bij hyperthyreoidie : een klinische studie over de invloed van het beta-adrenergische systeem

Hyperthyreoidie ten gevolge van een overmatige produktie van de schildklierhormonen thyroxine (T 4) en trüodothyronine (T 3) gaat gepaard met ingrijpende metabole veranderingen. De klinisch manifeste veranderingen hebben vooral betrekking op de bloedsomloop; men spreekt wel van hypercirculatie: de polsslag is snel en hartminuutvolume en polsdruk zijn toegenomen. Vaak zijn er klachten over palpitaties en de huid voelt warm aan als uiting van vasodilatatie. Er zijn aanwijzingen dat ook de nierdoorbloeding is toegenomen, evenals de plasma-renine activiteit. Deze verschijnselen vindt men ook bij een overmatige beta-adrenergische activiteit en zij suggereren een positieve relatie tussen de schildklierfunctie en het beta-adrenergische zenuwstelsel. Over deze intrigerende relatie is reeds veel onderzoek verricht (Harrison 1964, Waldstein 1966, Levey 1971, 1975, Spaulding en Noth 1975, Landsberg 1977). Ook heeft men op grond van het klinische beeld bij de behandeling van hyperthyreoidie veel gebruik gemaakt van sympaticolytica. En met succes. Vooral de stoffen die de beta-adrenoceptor blokkeren zijn erg populair. Desondanks is het juiste verband tussen schildklierfunctie en het adrenergische zenuwstelsel tot nu toe niet opgehelderd

Occult lymph node metastases in patients without residual muscle-invasive bladder cancer at radical cystectomy with or without neoadjuvant chemotherapy: a nationwide study of 5417 patients

Purpose Little is known about the prevalence of occult lymph node metastases (LNM) in muscle-invasive bladder cancer (MIBC) patients with pathological downstaging of the primary tumor. We aimed to estimate the prevalence of occult LNM in patients without residual MIBC at radical cystectomy (RC) with or without neoadjuvant chemotherapy (NAC) or neoadjuvant radiotherapy (NAR), and to assess overall survival (OS). Methods Patients with cT2-T4aN0M0 urothelial MIBC who underwent RC plus pelvic lymph node dissection (PLND) with curative intent between January 1995-December 2013 (retrospective Netherlands Cancer Registry (NCR) cohort) and November 2017-October 2019 (prospective NCR-BlaZIB cohort (acronym in Dutch: BlaaskankerZorg In Beeld; in English: Insight into bladder cancer care)) were identified from the nationwide NCR. The prevalence of occult LNM was calculated and OS of patients with y)pT2N0 vs. y)pT2N+ disease was estimated by the Kaplan-Meier method. Results In total, 4657 patients from the NCR cohort and 760 patients from the NCR-BlaZIB cohort were included. Of 1374 patients downstaged to y)pT2, 4.3% (N = 59) had occult LNM 4.1% (N = 49) of patients with cT2-disease and 5.6% (N = 10) with cT3-4a-disease. This was 4.0% (N = 44) in patients without NAC or NAR, 4.5% (N = 10) in patients with NAC, and 13.5% (N = 5) in patients with NAR but number of patients treated with NAR and downstaged disease was small. The prevalence of y)pT2N+ disease was 4.2% (N = 48) in the NCR cohort and 4.6% (N = 11) in the NCR-BlaZIB cohort. For patients with y)pT2N+ and y)pT2N0, median OS was 3.5 years (95% CI 2.5-8.9) versus 12.9 years (95% CI 11.7-14.0), respectively. Conclusion Occult LNM were found in 4.3% of patients with cT2-4aN0M0 MIBC with (near-) complete downstaging of the primary tumor following RC plus PLND. This was regardless of NAC or clinical T-stage. Patients with occult LNM showed considerable worse survival. These results can help in counseling patients for bladder-sparing treatments.Urolog

The PHENIX Experiment at RHIC

The physics emphases of the PHENIX collaboration and the design and current status of the PHENIX detector are discussed. The plan of the collaboration for making the most effective use of the available luminosity in the first years of RHIC operation is also presented.Comment: 5 pages, 1 figure. Further details of the PHENIX physics program available at http://www.rhic.bnl.gov/phenix

Genome-wide association meta-analysis of corneal curvature identifies novel loci and shared genetic influences across axial length and refractive error.

Corneal curvature, a highly heritable trait, is a key clinical endophenotype for myopia - a major cause of visual impairment and blindness in the world. Here we present a trans-ethnic meta-analysis of corneal curvature GWAS in 44,042 individuals of Caucasian and Asian with replication in 88,218 UK Biobank data. We identified 47 loci (of which 26 are novel), with population-specific signals as well as shared signals across ethnicities. Some identified variants showed precise scaling in corneal curvature and eye elongation (i.e. axial length) to maintain eyes in emmetropia (i.e. HDAC11/FBLN2 rs2630445, RBP3 rs11204213); others exhibited association with myopia with little pleiotropic effects on eye elongation. Implicated genes are involved in extracellular matrix organization, developmental process for body and eye, connective tissue cartilage and glycosylation protein activities. Our study provides insights into population-specific novel genes for corneal curvature, and their pleiotropic effect in regulating eye size or conferring susceptibility to myopia

An integral approach to programming sensor networks

In this paper we present a complete approach to programming sensor networks. The main contribution concerns the separation of three abstraction levels, viz., application level, network level and node level, leaving more room for standardization than with current practices. In addition we propose to program the network from an overall perspective rather than programming individual nodes. The proposed model is event- based, corresponding closely to the nature of wireless sensors and admits content-based addressing of nodes and groups of nodes. The paper describes how the three abstraction levels come together and gives examples of the approach at all three levels