Overkapping en stationskap Barendrecht

Dit jaar is gestart met de bouw van de overkapping van Barendrecht. Opdrachtgever is de Projectorganisatie Betuweroute. Het project maakt deel uit van de Betuweroute, maar is daarnaast ook nog onderdeel van de afronding van de viersporigheid tussen Rotterdam en Dordrecht en van één van de eerste uit te voeren projectdelen van de HSL-Zuid [1,2]. Dit verklaart direct de reden voor de bouw van de overkapping: vermindering van overlast voor omwonenden door treinen. Inpassing van de constructie in de Barendrechtse situatie was een van de meest belangrijke ontwerpeisen

Overkapping en stationskap Barendrecht

Dit jaar is gestart met de bouw van de overkapping van Barendrecht. Opdrachtgever is de Projectorganisatie Betuweroute. Het project maakt deel uit van de Betuweroute, maar is daarnaast ook nog onderdeel van de afronding van de viersporigheid tussen Rotterdam en Dordrecht en van één van de eerste uit te voeren projectdelen van de HSL-Zuid [1,2]. Dit verklaart direct de reden voor de bouw van de overkapping: vermindering van overlast voor omwonenden door treinen. Inpassing van de constructie in de Barendrechtse situatie was een van de meest belangrijke ontwerpeisen

On the significance of retinal vascular disease and hearing loss in facioscapulohumeral muscular dystrophy

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On the significance of retinal vascular disease and hearing loss in facioscapulohumeral muscular dystrophy

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Management of conjunctival melanoma with local excision and adjuvant brachytherapy

Background/objectives To evaluate the management of conjunctival melanoma with local excision and adjuvant brachytherapy. Subjects/methods Data of all patients who received local excision and adjuvant brachytherapy for conjunctival melanoma between 1999 and 2016 in a Dutch national referral centre were reviewed. A protocol with Sr-90 was used until 2012, a protocol with Ru-106 was used hereafter. Local recurrence, metastasis, survival, visual acuity and treatment complications were assessed. Results A total of 58 patients was identified: 32 patients were treated with Sr-90 and 26 with Ru-106. Mean follow-up time was 97.3 months (143.1 months after Sr-90, and 40.2 months after Ru-106). All lesions were epibulbar, the median tumour thickness was 0.9 mm. Local recurrence occurred in 13/58 cases (22%), with a 5-year recurrence rate of 21%. Local recurrence occurred equally often in both protocols, with 5-year recurrence rates of 19% (Sr-90) versus 23% (Ru-106) (p = 0.68). Metastasis developed in 3/58 cases (5%), with 2 cases after Sr-90, and 1 after Ru-106 (p = 1.00). The most reported complications were pain (29%), dry eyes (21%), symblepharon (9%), ptosis (12%) and cataract (9%). No severe corneal or scleral complications were observed. Median visual acuity was 1.00 pre-surgery, at the end of follow-up this was 1.00 (Sr-90) and 0.95 (Ru-106). Conclusion Local excision with adjuvant brachytherapy provides good tumour control with excellent visual outcome and mild side effects in patients with limited conjunctival melanoma. Results after Sr-90 or Ru-106 were comparable; a choice for either treatment may be based on experience of the clinician and availability of materials