32 results on '"Van der Hulst V"'
Search Results
2. Individual-patient meta-analysis of three randomized trials comparing endovascular versus open repair for ruptured abdominal aortic aneurysm
- Author
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Sweeting, M. J., Balm, R., Desgranges, P., Ulug, P., Powell, J. T., Koelemay, M. J. W., Idu, M. M., Kox, C., Legemate, D. A., Huisman, L. C., Willems, M. C. M., Reekers, J. A., van Delden, O. M., van Lienden, K. P., Hoornweg, L. L., Reimerink, J. J., van Beek, S. C., Vahl, A. C., Leijdekkers, V. J., Bosma, J., Montauban van Swijndregt, A. D., de Vries, C., van der Hulst, V. P. M., Peringa, J., Blomjous, J. G. A. M., Visser, M. J. T., van der Heijden, F. H. W. M., Wisselink, W., Hoksbergen, A. W. J., Blankensteijn, J. D., Visser, M. T. J., Coveliers, H. M. E., Nederhoed, J. H., van den Berg, F. G., van der Meijs, B. B., van den Oever, M. L. P., Lely, R. J., Meijerink, M. R., Voorwinde, A., Ultee, J. M., van Nieuwenhuizen, R. C., Dwars, B. J., Nagy, T. O. M., Tolenaar, P., Wiersema, A. M., Lawson, J. A., van Aken, P. J., Stigter, A. A., van den Broek, T. A. A., Vos, G. A., Mulder, W., Strating, R. P., Nio, D., Akkersdijk, G. J. M., van der Elst, A., van Exter, P., Becquemin, J.-P., Allaire, E., Cochennec, F., Marzelle, J., Louis, N., Schneider, J., Majewski, M., Castier, Y., Leseche, G., Francis, F., Steinmetz, E., Berne, J.-P., Favier, C., Haulon, S., Koussa, M., Azzaoui, R., Piervito, D., Alimi, Y., Boufi, M., Hartung, O., Cerquetta, P., Amabile, P., Piquet, P., Penard, J., Demasi, M., Alric, P., Canaud, L., Berthet, J.-P., Julia, P., Fabiani, J.-N., Alsac, J. M., Gouny, P., Badra, A., Braesco, J., Favre, J.-P., Albertini, J.-N., Martinez, R., Hassen-Khodja, R., Batt, M., Jean, E., Sosa, M., Declemy, S., Destrieux-Garnier, L., Lermusiaux, P., Feugier, P., Ashleigh, R., Gomes, M., Greenhalgh, R. M., Grieve, R., Hinchliffe, R., Sweeting, M., Thompson, M. M., Thompson, S. G., Cheshire, N. J., Boyle, J. R., Serracino-Inglott, F., Smyth, J. V., Hinchliffe, R. J., Bell, R., Wilson, N., Bown, M., Dennis, M., Davis, M., Howell, S., Wyatt, M. G., Valenti, D., Bachoo, P., Walker, P., MacSweeney, S., Davies, J. N., Rittoo, D., Parvin, S. D., Yusuf, W., Nice, C., Chetter, I., Howard, A., Chong, P., Bhat, R., McLain, D., Gordon, A., Lane, I., Hobbs, S., Pillay, W., Rowlands, T., El-Tahir, A., Asquith, J., Cavanagh, S., Dubois, L., and Forbes, T. L.
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- 2015
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3. Profiles of US and CT imaging features with a high probability of appendicitis
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van Randen, A., Laméris, W., van Es, H. W., ten Hove, W., Bouma, W. H., van Leeuwen, M. S., van Keulen, E. M., van der Hulst, V. P. M., Henneman, O. D., Bossuyt, P. M., Boermeester, M. A., and Stoker, J.
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- 2010
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4. Rapid reduction of leiomyoma volume during treatment with the GnRH antagonist ganirelix
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Flierman, P. A., Oberyé, J. J.L., van der Hulst, V. P.M., and de Blok, S.
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- 2005
5. Imaging of Extradural Tumors: Primary Tumors
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Van Buchem, M. A., primary, Van Der Hulst, V. P. M., additional, and Bloem, J. L., additional
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- 1998
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6. Graphical representation of eightchannel sphincter pressure profiles on a personal computer
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Dijkhuis, Th., Bemelman, W. A., and van der Hulst, V. P. M.
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- 1990
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7. Amsterdam Acute Aneurysm Trial
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Hoornweg, L. L., Balm, Ron, Legemate, D. A., Idu, M. M., Kox, C., Reekers, J. A., Van Lienden, K. P., Van Delden, O. M., Wisselink, W., Rauwerda, J. A., Van Den Berg, F. G., Vahl, A. C., Visser, M. J.T., Van Der Heijden, F. H.W.M., De Vries, C., Van Der Hulst, V. P.M., Montauban Van Swijndregt, A. D., Nagy, T. O.M., Wiersema, A. M., Voorwinde, A., Lawson, J. A., Van Der Broek, Th A.A., Cohen, R. A., Nio, D., Tijssen, J. P., De Mol, B. A.J.M., Eikelboom, B. C., VU University medical center, Surgery, Radiology and nuclear medicine, and Pathology
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Aortic Rupture ,Cost-Benefit Analysis ,Patient Selection ,General Medicine ,030204 cardiovascular system & hematology ,Ethics, Research ,03 medical and health sciences ,Treatment Outcome ,0302 clinical medicine ,Research Design ,Quality of Life ,cardiovascular system ,Humans ,Minimally Invasive Surgical Procedures ,Radiology, Nuclear Medicine and imaging ,Surgery ,cardiovascular diseases ,Emergencies ,Cardiology and Cardiovascular Medicine ,030217 neurology & neurosurgery ,Aortic Aneurysm, Abdominal - Abstract
The objective of the Amsterdam Acute Aneurysm Trial is to study the combined outcome of conventional emergency surgery versus endovascular treatment for ruptured abdominal aortic aneurysms. The design used was a multicenter randomized clinical trial conducted in two university hospitals and one teaching hospital in the Amsterdam region. The study included all patients with a ruptured abdominal aneurysm who were eligible for endovascular and conventional surgery. The primary end points were combined mortality and severe morbidity. The secondary end points were quality of life and cost-effectiveness. The background, design, and methods of this trial are presented, and the ethical and legal issues of this type of research are discussed.
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- 2006
8. Long-term results of arthroscopic and mini-open repair of small- to medium-size full-thickness rotator cuff tears.
- Author
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van Deurzen, D. F. P., Scholtes, V. A. B., Willems, W. J., Geerdink, H. H., van der Woude, H. J., van der Hulst, V. P. M., and van den Bekerom, M. P. J.
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ROTATOR cuff ,PATIENT satisfaction ,STANDARD deviations ,SHOULDER - Abstract
Background This retrospective cohort study evaluated functional outcome and structural integrity after arthroscopic- or mini-open repair of small- to medium-size rotator cuff tears assessed at long-term follow-up. Methods All patients operated between 2001 and 2004 were invited to participate. Functional outcome was measured by Constant–Murley Score, Disability of Arm, Shoulder and Hand and Oxford Shoulder Score. Quality of life was assessed with EuroQol Health 5 Dimension. Patient satisfaction was assessed in terms of pain and overall result. Structural integrity of the rotator cuff repair was determined using ultrasound. Results Of the eligible 62 patients, 44 patients were available for follow-up. After a mean of 11.3 years, 76% of the patients had good to excellent functional outcome on the Constant–Murley Score (median 82, range 29–95). The majority of patients reported good results on both Disability of Arm, Shoulder and Hand and Oxford Shoulder Score (median Disability of Arm, Shoulder and Hand 5.0, range 1.0–54; median Oxford Shoulder Score 19, range 13–39). The quality of life was also good (mean EuroQol Health 5 Dimension utility score 0.88, standard deviation 0.12). Eighty per cent was satisfied with the overall result. Ultrasound examination revealed structural integrity in 76% of all cases. Conclusion This study shows that functional outcome is good and structural integrity is high for the majority of patients 11.3 years after repair of small- to medium-size rotator cuff lesions. [ABSTRACT FROM AUTHOR]
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- 2019
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9. Effect of directed training on reader performance for CT colonography: multicenter study
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Halligan, S, Burling, D, Atkin, W, Bartram, C, Fenlon, H, Laghi, A, Stoker, J, Altman, Dg, Bassett, P, Frost, R, Taylor, S, Honeyfield, L, De Villiers, M, Nicholson, D, Renaut, L, Kay, C, Lowe, A, Williams Butt, J, Florie, J, Poulus, M, Van der Hulst, V, Lefere, P, Marrannes, J, Dessey, G, O'Hare, A, Foley, S, Neri, Emanuele, Vagli, P, Politi, B, Iannaccone, R, Mangiapane, F, Ori, S, Gallo, T, Nieddu, G, Signoretta, S, and EUROPEAN SOCIETY OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY CT COLONOGRAPHY GROUP INVESTIGATORS, Regge D.
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Male ,medicine.medical_specialty ,Inservice Training ,Virtual colonoscopy ,Population ,education ,Colonoscopy ,Colonic Polyps ,Sensitivity and Specificity ,Computed tomographic ,Professional Competence ,Informed consent ,Task Performance and Analysis ,medicine ,Training ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Computed tomography (CT) ,Observer Variation ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Fecal occult blood ,Healthy subjects ,Reproducibility of Results ,Middle Aged ,Interpretive performance ,United Kingdom ,Multicenter study ,Colonic Neoplasms ,Female ,Radiology ,business ,Colonography, Computed Tomographic - Abstract
Purpose: To define the interpretative performance of radiologists experienced in computed tomographic (CT) colonography and to compare it with that of novice observers who had undergone directed training, with colonoscopy as the reference standard. Materials and Methods: Physicians at each participating center received ethical committee approval and followed the committees' requests regarding informed consent. Nine experienced radiologists, nine trained radiologists, and 10 trained technologists from nine centers read 40 CT colonographic studies selected from a data set of 51 studies and modeled to simulate a population with positive fecal occult blood test results: Studies were obtained in eight patients with cancer, 12 patients with large polyp, four patients with medium polyp, and 27 patients without colonic lesions. Findings were verified with colonoscopy. An experienced radiologist used 50 endoscopically validated studies to train novice observers before they were allowed to participate. Observers used one software platform to read studies over 2 days. Responses were collated and compared with the known diagnostic category for each subject. The number of correctly classified subjects was determined for each observer, and differences between groups were examined with bootstrap analysis. Results: Overall, 28 observers read 1084 studies and detected 121 cancers, 134 large polyps, and 33 medium polyps; 448 healthy subjects were categorized correctly. Experienced radiologists detected 116 lesions; trained radiologists and technologists detected 85 and 87 lesions, respectively. Overall accuracy of experienced observers (74.2%) was significantly better than that of trained radiologists (66.6%) and technologists (63.2%). There was no significant difference (P = .33) between overall accuracy of trained radiologists and that of technologists; however, some trainees reached the mean performance achieved by experienced observers. Conclusion: Experienced observers interpreted CT colonographic images significantly better than did novices trained with 50 studies. On average, no difference between trained radiologists and trained technologists was found; however, individual performance was variable and some trainees outperformed some experienced observers. European Association of Radiology Kodak Scholarship
- Published
- 2006
10. Pressure and X-ray recording of reflux into the thoracic stomach
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Bemelman, W. A., Brummelkamp, W. H., van der Hulst, V. P., Reeders, J. W., Roos, C. M., Klopper, P. J., and Other departments
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digestive, oral, and skin physiology - Abstract
Anastomotic leakage, pulmonary aspiration and reflux-esophagitis might be induced or aggravated by the increased duodenogastric reflux observed in the thoracic stomach. In this study, the effect of respiration on the reflux-promoting pressure gradient in the intrathoracally located stomach was assessed. In nine patients pressure recording was done in the duodenum and the abdominal and thoracic part of the stomach. Intrapleural pressure was determined by recording mouth pressure during inspiratory occlusion. In addition, the course of injected contrast was examined fluoroscopically. The mean end-expiratory pressure gradient in the thoracic part of the stomach was 0.8 cm H2O, increasing up to 6.0 cm H2O and 21.3 cm H2O during normal and forced inspiration, respectively. Fluoroscopic examination showed reflux of contrast that coincided with the downward movement of the diaphragm. From this study, we conclude that reflux into the thoracic stomach is promoted by intraluminal pressure fluctuations induced by voluntary breathing. Performing a pyloroplasty or -myotomy after intrathoracic esophagogastrostomy destroys the integrity of the pyloric sphincter as a barrier to reflux, thus promoting duodenogastric reflux
- Published
- 1992
11. Rapid Reduction of Leiomyoma Volume During Treatment With the GnRH Antagonist Ganirelix
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Flierman, P A., primary, Obery??, J J. L., additional, van der Hulst, V P. M., additional, and de Blok, S, additional
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- 2005
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12. Hemodynamic significance of renal artery stenosis: digital subtraction angiography versus systolically gated three-dimensional phase-contrast MR angiography.
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Wasser, M N, primary, Westenberg, J, additional, van der Hulst, V P, additional, van Baalen, J, additional, van Bockel, J H, additional, van Erkel, A R, additional, and Pattynama, P M, additional
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- 1997
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13. Renal artery stenosis: endovascular flow wire study for validation of Doppler US.
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van der Hulst, V P, primary, van Baalen, J, additional, Kool, L S, additional, van Bockel, J H, additional, van Erkel, A R, additional, Ilgun, J, additional, and Pattynama, P M, additional
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- 1996
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14. The Lower Esophageal Sphincter Shown by a Computerized Representation
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Bemelman, W. A., primary, Van Der Hulst, V. P. M., additional, Dijkhuis, T., additional, Van Der Hoeven, C. W. P., additional, and Klopper, P. J., additional
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- 1990
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15. Veno-venous bypass without systemic heparinization using a centrifugal pump: a blind comparison of a heparin bonded circuit versus a non heparin bonded circuit
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van der Hulst, V. P., Henny, C. P., Moulijn, A. C., Engbers, G., ten Cate, H., Gründeman, P. F., Klopper, P. J., and Other departments
- Abstract
Veno-venous bypass without the use of systemic heparinization has recently become of increasing interest for application during liver transplantation and surgery on the large abdominal veins. However, possible adverse effects on blood components as demonstrated by means of hematologic and hemostatic parameters or on the occurrence of thromboembolic complications are until now not excluded. No consensus has been reached as to the efficacy of heparin coated circuits in those procedures. In the present study veno-venous bypass was performed for four hours in ten dogs using heparin coated and non coated circuits without further heparinization in a randomized blind fashion. No changes or significant intergroup differences were noted in the hematological and coagulation parameters. Macroscopic evaluation of the circuits revealed small strands of fibrin on all connector rims and clots in the center part of the pump head and at the cannula tips. The lungs showed two small emboli in large size pulmonary arteries and also two minor emboli in small size arteries. In four animals the emboli were equally divided between the two groups. As expected regarding the size of the clots no influences could be seen on hemodynamic or respiratory parameters. With Scanning Electronic Microscopy a monolayer of activated thrombocytes was observed on the surface of the bypass circuits in the coated as well as in the uncoated group. This study suggests that a veno-venous bypass without systemic heparinization is possible without serious damage to blood cellular elements or impressive activation of the coagulation system.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1989
16. Graphical representation of eight-channel sphincter pressure profiles on a personal computer.
- Author
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Dijkhuis, T, Bemelman, W A, van der Hulst, V P, and Klopper, P J
- Published
- 1990
17. Perinatal mortality: magnetic resonance imaging and autopsy compared in a multiethnic population.
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Alderliesten, M. E., Van Lith, J. M. M., Van Der Hulst, V. P. M., and Blaauwgeers, J. L. G.
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MAGNETIC resonance imaging ,DIAGNOSTIC imaging ,OBSTETRICS ,CHILDBIRTH ,PREGNANCY ,MEDICAL care - Abstract
The article presents abstract related to the significance of magnetic resonance imaging and autopsy compared in a multiethnic population in a perinatal mortality. Diagnostic studies revealing the cause of death in fetal and neonatal death are important for genetic counselling of the parents. Perinatal autopsy reveals in about 50 percent of cases more information about the cause of death. Such conclude that finding alternatives for autopsy seem useful.
- Published
- 2000
18. Fear of Missing Out: Constrained Trial of Blockchain in Supply Chain.
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Kromes R, Li T, Bouillon M, Güler TE, van der Hulst V, and Erkin Z
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- Fear, Awareness, Knowledge, Netherlands, Blockchain
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Blockchain's potential to revolutionize supply chain and logistics with transparency and equitable stakeholder engagement is significant. However, challenges like scalability, privacy, and interoperability persist. This study explores the scarcity of real-world blockchain implementations in supply chain and logistics since we have not witnessed many real-world deployments of blockchain-based solutions in the field. Puzzled by this, we integrate technology, user experience, and operational efficiency to illuminate the complex landscape of blockchain integration. We present blockchain-based solutions in three use cases, comparing them with alternative designs and analyzing them in terms of technical, economic, and operational aspects. Insights from a tailored questionnaire of 50 questions addressed to practitioners and experts offer crucial perspectives on blockchain adoption. One of the key findings from our work shows that half of the companies interviewed agree that they will miss the potential for competitive advantage if they do not invest in blockchain technology, and 61% of the companies surveyed claimed that their customers ask for more transparency in supply chain-related transactions. However, only one-third of the companies were aware of the main features of blockchain technology, which shows a lack of knowledge among the companies that may lead to a weaker blockchain adaption in supply chain use cases. Our readers should note that our study is specifically contextualized in a Netherlands-funded national project. We hope that researchers as well as stakeholders in supply chain and logistics can benefit from the insights of our work.
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- 2024
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19. Does the innate relative size of the humeral head and glenoid affect the risk of anterior shoulder instability?
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Willigenburg NW, Bouma RA, Scholtes V, van der Hulst V, van Deurzen D, and van den Bekerom M
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Background: Bony lesions after shoulder dislocation reduce the joint contact area and increase the risk of recurrent instability. It is unknown whether the innate relative sizes of the humeral head and glenoid may predispose patients to shoulder instability. This study evaluated whether anterior shoulder instability is associated with a larger innate humeral head/glenoid ratio (IHGR)., Methods: We evaluated CT scans of 40 shoulders with anterior shoulder instability and 48 controls. We measured axial humeral head diameter and glenoid diameter following native contours, discarding any bony lesions, and calculated IHGR by dividing both diameters. Multivariate logistic regression determined whether the IHGR, corrected for age and gender as potential confounders, was associated with anterior shoulder instability., Results: Mean IHGR was 1.48 ± 0.23 in the group with anterior shoulder instability and 1.42 ± 0.20 in the group without anterior shoulder instability. Measurements for axial humeral head and axial glenoid diameters demonstrated excellent intra-rater reliability (ICC range: 0.94-0.95). IHGR was not significantly associated with anterior shoulder instability (OR = 1.105, 95%CI = 0.118-10.339, p = 0.930)., Discussion: The innate ratio of humeral head and glenoid diameters was not significantly associated with anterior shoulder instability in this retrospective sample of 88 shoulder CT scans., (© 2018 The British Elbow & Shoulder Society.)
- Published
- 2019
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20. Clinical signs, diagnostics and successful treatment of a myocarditis in an adult chimpanzee (Pan troglodytes).
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van Zijll Langhout M, Wolters M, Horvath KM, Thiesbrummel H, Smits P, van Bolhuis H, van der Hulst V, and Riezebos R
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- Animals, Carbazoles therapeutic use, Carvedilol, Female, Losartan therapeutic use, Myocarditis diagnosis, Myocarditis drug therapy, Pan troglodytes, Propanolamines therapeutic use, Treatment Outcome, Adrenergic beta-Antagonists therapeutic use, Anti-Arrhythmia Agents therapeutic use, Ape Diseases diagnosis, Ape Diseases drug therapy, Myocarditis veterinary
- Abstract
A chimpanzee (Pan troglodytes) was presented with lethargic behaviour. Echocardiography and abnormal cardiac and inflammatory biomarkers revealed a myocarditis. The animal fully recovered after prolonged treatment with losartan and carvedilol. This is the first report of the diagnosis and successful treatment of myocarditis in this species., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2017
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21. [A man with FIP1L1/PDGFRA-positive chronic eosinophilic leukemia].
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Leeksma OC, de Ruiter GS, van der Hulst VP, Terpstra WE, Cools J, and Vandenberghe P
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- Adult, Anticoagulants therapeutic use, Benzamides, Gene Expression Regulation, Neoplastic, Humans, Imatinib Mesylate, Male, Protein Kinase Inhibitors therapeutic use, Remission Induction, Treatment Outcome, Antineoplastic Agents therapeutic use, Hypereosinophilic Syndrome drug therapy, Hypereosinophilic Syndrome genetics, Piperazines therapeutic use, Pyrimidines therapeutic use, Receptor, Platelet-Derived Growth Factor alpha genetics
- Abstract
A 39-year-old man was referred from Surinam to the Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands, for a right ventricular tumour, hypereosinophilia and mild thrombocytopenia. He appeared to have chronic eosinophilic leukaemia that was positive for the 'FIP1-like-1-platelet-derived growth factor receptor alpha' (FIP1L1-PDGFRA) gene. In addition, he had signs of a right ventricular thrombus that had existed for at least 6 months. The patient was treated with oral anticoagulants and the tyrosine kinase inhibitor imatinib. The latter therapy resulted in normalisation of leukocyte count and differential values. After 3 months of therapy, the FIP1L1-PDGFRA fusion transcript was no longer detectable in peripheral blood. After 1 year of follow up, the patient was in complete haematological and molecular remission for chronic eosinophilic leukaemia. The cardiac mass remained unchanged, but caused no haemodynamic problems.
- Published
- 2006
22. Polyp measurement and size categorisation by CT colonography: effect of observer experience in a multi-centre setting.
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Burling D, Halligan S, Altman DG, Atkin W, Bartram C, Fenlon H, Laghi A, Stoker J, Taylor S, Frost R, Dessey G, De Villiers M, Florie J, Foley S, Honeyfield L, Iannaccone R, Gallo T, Kay C, Lefere P, Lowe A, Mangiapane F, Marrannes J, Neri E, Nieddu G, Nicholson D, O'Hare A, Ori S, Politi B, Poulus M, Regge D, Renaut L, Rudralingham V, Signoretta S, Vagli P, Van der Hulst V, and Williams-Butt J
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- Chi-Square Distribution, Clinical Competence, Colonic Polyps pathology, Colonoscopy, Diagnosis, Differential, Europe, Female, Humans, Male, Observer Variation, Statistics, Nonparametric, Colonic Polyps diagnostic imaging, Colonography, Computed Tomographic
- Abstract
The extent measurement error on CT colonography influences polyp categorisation according to established management guidelines is studied using twenty-eight observers of varying experience to classify polyps seen at CT colonography as either 'medium' (maximal diameter 6-9 mm) or 'large' (maximal diameter 10 mm or larger). Comparison was then made with the reference diameter obtained in each patient via colonoscopy. The Bland-Altman method was used to assess agreement between observer measurements and colonoscopy, and differences in measurement and categorisation was assessed using Kruskal-Wallis and Chi-squared test statistics respectively. Observer measurements on average underestimated the diameter of polyps when compared to the reference value, by approximately 2-3 mm, irrespective of observer experience. Ninety-five percent limits of agreement were relatively wide for all observer groups, and had sufficient span to encompass different size categories for polyps. There were 167 polyp observations and 135 (81%) were correctly categorised. Of the 32 observations that were miscategorised, 5 (16%) were overestimations and 27 (84%) were underestimations (i.e. large polyps misclassified as medium). Caution should be exercised for polyps whose colonographic diameter is below but close to the 1-cm boundary threshold in order to avoid potential miscategorisation of advanced adenomas.
- Published
- 2006
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23. CT colonography interpretation times: effect of reader experience, fatigue, and scan findings in a multi-centre setting.
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Burling D, Halligan S, Altman DG, Atkin W, Bartram C, Fenlon H, Laghi A, Stoker J, Taylor S, Frost R, Dessey G, De Villiers M, Florie J, Foley S, Honeyfield L, Iannaccone R, Gallo T, Kay C, Lefere P, Lowe A, Mangiapane F, Marrannes J, Neri E, Nieddu G, Nicholson D, O'Hare A, Ori S, Politi B, Poulus M, Regge D, Renaut L, Rudralingham V, Signoretta S, Vagli P, Van der Hulst V, and Williams-Butt J
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- Europe, Humans, Linear Models, Observer Variation, Time Factors, Clinical Competence, Colonography, Computed Tomographic standards, Fatigue physiopathology
- Abstract
Our purpose was to assess the effect of reader experience, fatigue, and scan findings on interpretation time for CT colonography. Nine radiologists (experienced in CT colonography); nine radiologists and ten technicians (both groups trained using 50 validated examinations) read 40 cases (50% abnormal) under controlled conditions. Individual interpretation times for each case were recorded, and differences between groups determined. Multi-level linear regression was used to investigate effect of scan category (normal or abnormal) and observer fatigue on interpretation times. Experienced radiologists (mean time 10.9 min, SD 5.2) reported significantly faster than less experienced radiologists and technicians; odds ratios of reporting times 1.4 (CI 1.1, 1.8) and 1.6 (1.3, 2.0), respectively (P
- Published
- 2006
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24. Possible harmful effects of high intra-abdominal pressure on the pelvic girdle.
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Mens J, Hoek van Dijke G, Pool-Goudzwaard A, van der Hulst V, and Stam H
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- Computer Simulation, Humans, Manometry, Pelvic Pain prevention & control, Pressure, Risk Factors, Abdomen physiopathology, Models, Biological, Pelvic Pain etiology, Pelvic Pain physiopathology, Pelvis physiopathology, Risk Assessment methods
- Abstract
The present study explores the hypothesis that a high intra-abdominal pressure (IAP) loads the ligaments of the pelvic girdle to such an extent that frequent periods of high IAP might cause pain and/or interfere with recovery of patients with pelvic girdle pain (PGP). In a theoretical model the size of the load of IAP on the pelvic girdle was computed. The diameters of abdomen and pelvis needed for the calculations were measured on MRI scans; the IAP values during activities were gained from literature. In slim, healthy subjects the calculated load on the pelvic ring during activities of daily living was 26.0-52.0 N with peaks to 135 N. During straining, vigorous work or heavy exercises the load could increase to values ranging from 104 to 520 N. The load is higher in subjects with pain or fatigue, or in case of a distended abdomen. When the load on the pelvic ring induced by IAP is larger than 100 N, the force exceeds the force at which a pelvic belt relieves complaints in PGP; at 90 N, the force is larger than the force at which isometric hip adduction provokes pain in PGP. We conclude that the size of the load induced by IAP on the pelvic girdle seems to be sufficient to cause pain in patients with PGP and might interfere with recovery. It seems worthwhile to give patients with PGP instructions to reduce IAP as much as possible during activities.
- Published
- 2006
- Full Text
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25. Rapid reduction of leiomyoma volume during treatment with the GnRH antagonist ganirelix.
- Author
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Flierman PA, Oberyé JJ, van der Hulst VP, and de Blok S
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- Adult, Female, Hormones blood, Humans, Injections, Intradermal, Leiomyoma blood, Leiomyoma pathology, Magnetic Resonance Imaging methods, Premenopause, Prospective Studies, Uterine Neoplasms blood, Uterine Neoplasms pathology, Gonadotropin-Releasing Hormone administration & dosage, Gonadotropin-Releasing Hormone analogs & derivatives, Gonadotropin-Releasing Hormone antagonists & inhibitors, Hormone Antagonists administration & dosage, Leiomyoma drug therapy, Uterine Neoplasms drug therapy
- Abstract
Objective: To assess maximal volume reduction of leiomyomas and uterus and the duration of treatment required to reach these reductions with daily GnRH antagonist treatment., Design: Prospective, open-label study., Setting: Large teaching hospital in The Netherlands., Population: Premenopausal women with symptomatic fibroids, who were scheduled for surgery., Methods: Twenty women were treated with daily 2 mg of subcutaneous ganirelix. Prior to the first injection and weekly during treatment, the volume of leiomyomas and the uterus were assessed by ultrasound (USS) and serum hormones were measured. Prior to treatment and when maximal size reduction was observed by USS, the volume of the leiomyomas and the uterus were also assessed by magnetic resonance imaging (MRI)., Main Outcome Measures: Leiomyoma and uterine size reduction, time to maximal reduction., Results: One woman was excluded from the study due to incorrect administration dose of ganirelix. Data on the remaining 19 women (average age 39 years) with subserosal (n= 9), submucosal (n= 7), intramural (n= 10) and transmural (n= 1) leiomyomas were evaluated. Baseline leiomyoma volumes ranged from small (3-4 mL) to large (>1000 mL). The median duration of treatment up to maximal leiomyoma size reduction was 19 days (range 1-65 days). The maximal size reduction in leiomyomas measured by USS was -42.7% (-77.0% to 14.1%) and -29.2% (-62.2% to 35.6%) by MRI. Comparable uterine size reductions of -46.6% (-78.6% to -6.1%) and -25.2% (-63.6% to 28.9%) were observed by USS and MRI. During the first three weeks of treatment, 8 out of 19 women reported adverse events related to the induced hypoestrogenic state. Most of these events resolved within one week after treatment was discontinued., Conclusion: Daily treatment with 2 mg of ganirelix results in rapid reduction of leiomyoma and uterine volume in premenopausal women with minor side effects. If longer-acting GnRH antagonists become available, pretreatment with GnRH antagonist should be preferred over GnRH agonists prior to surgery.
- Published
- 2005
- Full Text
- View/download PDF
26. An unusual presentation and way to diagnose hepatocellular carcinoma.
- Author
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Novotný VM, van der Hulst VP, van der Wouw PA, Blaauwgeers JL, and Frissen PH
- Subjects
- Aged, Carcinoma, Hepatocellular complications, Diagnosis, Differential, Dyspnea etiology, Humans, Male, Pulmonary Disease, Chronic Obstructive complications, Carcinoma, Hepatocellular diagnosis
- Abstract
A 67-year-old man with a history of chronic obstructive pulmonary disease (COPD) was admitted with acute progression of dyspnoea, productive cough, fever, elevated central venous pressure, oedema and liver enzyme abnormalities. Pneumonia with secondary right-sided congestive heart failure was considered. Additional abdominal ultrasound examination confirmed by a CT scan showed a mass in the inferior vena cava (VCI) extending into the right atrium. The central liver location and impaired haemostasis rendered liver biopsy impossible. An alternative approach was discussed and guided by two-dimensional transoesophageal electrocardiography accessing the right internal jugular vein, biopsies were taken from the atrial mass with histology suggesting the presence of a hepatocellular carcinoma as the cause of acute dyspnoea.
- Published
- 2004
27. Coil embolization of a left pulmonary artery pseudoaneurysm after penetrating injury.
- Author
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de Jonge I, Vahl A, and van der Hulst V
- Subjects
- Aneurysm, False etiology, Humans, Male, Middle Aged, Aneurysm, False therapy, Embolization, Therapeutic methods, Pulmonary Artery, Wounds, Penetrating complications
- Abstract
Purpose: To report successful coil embolization of a rare traumatic pulmonary artery pseudoaneurysm., Case Report: A 57-year-old man developed a pulmonary artery pseudoaneurysm 14 days after he had been stabbed with a knife in the left lung. The pseudoaneurysm was diagnosed with contrast-enhanced computed tomography and confirmed by pulmonary arteriography. Coils were deployed in the feeding vessels to occlude the defect., Conclusions: Pulmonary artery pseudoaneurysm after penetrating chest injury can be treated by percutaneous catheter embolization, which is less invasive than surgery.
- Published
- 2003
- Full Text
- View/download PDF
28. [Endovascular treatment of 2 patients with an aneurysm of the descending thoracic aorta].
- Author
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Vahl AC, Manshanden CG, Bloemendaal K, Zandstra DF, Krommendijk EJ, and van der Hulst VP
- Subjects
- Aged, Aortic Aneurysm, Abdominal complications, Aortic Aneurysm, Thoracic complications, Aortic Rupture surgery, Diagnosis, Fatal Outcome, Humans, Male, Recurrence, Reoperation, Treatment Outcome, Aortic Aneurysm, Abdominal surgery, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis Implantation methods, Endoscopy methods
- Abstract
Two men, aged 71 and 70, who had previously experienced an abdominal aneurysm were found to have thoracic aortal aneurysms of respectively 8 cm and 7.5 cm in length. For the first patient an endovascular operation was carried out due to a high operative risk: with the help of a radiograph, four endoprostheses were inserted into the thoracic descending aorta via the femoral artery, after which the aorta diameter became more normal. A month later, the patient died from persistent renal failure, which had developed as a result of the previously ruptured abdominal aneurysm. In the second patient with an aneurysm of the proximal descending aorta, a left decompensation arose following aortal clamping during open surgical repair. Ten weeks later an endoprosthesis was inserted via the femoral artery. A year later the aortal diameter had decreased to 6.5 cm; the patient functioned well. The insertion of an endoprosthesis in the thoracic aorta is a minimally invasive procedure in which the patient experiences little perioperative inconvenience.
- Published
- 2001
29. Pressure and X-ray recording of reflux into the thoracic stomach.
- Author
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Bemelman WA, Brummelkamp WH, van der Hulst VP, Reeders JW, Roos CM, and Klopper PJ
- Subjects
- Duodenogastric Reflux diagnostic imaging, Fluoroscopy, Humans, Manometry, Pressure, Pylorus diagnostic imaging, Thorax, Duodenogastric Reflux physiopathology, Pylorus physiopathology, Respiration
- Abstract
Anastomotic leakage, pulmonary aspiration and reflux-esophagitis might be induced or aggravated by the increased duodenogastric reflux observed in the thoracic stomach. In this study, the effect of respiration on the reflux-promoting pressure gradient in the intrathoracally located stomach was assessed. In nine patients pressure recording was done in the duodenum and the abdominal and thoracic part of the stomach. Intrapleural pressure was determined by recording mouth pressure during inspiratory occlusion. In addition, the course of injected contrast was examined fluoroscopically. The mean end-expiratory pressure gradient in the thoracic part of the stomach was 0.8 cm H2O, increasing up to 6.0 cm H2O and 21.3 cm H2O during normal and forced inspiration, respectively. Fluoroscopic examination showed reflux of contrast that coincided with the downward movement of the diaphragm. From this study, we conclude that reflux into the thoracic stomach is promoted by intraluminal pressure fluctuations induced by voluntary breathing. Performing a pyloroplasty or -myotomy after intrathoracic esophagogastrostomy destroys the integrity of the pyloric sphincter as a barrier to reflux, thus promoting duodenogastric reflux.
- Published
- 1992
30. Three-dimensional pressure profilometry of the anal sphincter.
- Author
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van der Hulst VP, Bemelman WA, Dijkhuis T, and Klopper PJ
- Subjects
- Adolescent, Adult, Humans, Male, Pressure, Anal Canal physiology, Computer Graphics, Manometry methods, Signal Processing, Computer-Assisted
- Abstract
Single channel manometry is of limited value in determining the cause of sphincter dysfunction. This is due mainly to the recording variability caused by radial pressure asymmetry. Multi-channel manometry does not have this disadvantage, but is complicated and difficult to interpret. We report on computerized eight-channel manometry which permits three-dimensional reconstruction of the sphincter. Fifteen subjects were measured. At rest, lower pressures were recorded in the left, left-dorsal, and dorsal directions. Sphincter length was shortest in the right direction and ventral directions. The graphic reconstruction showed marked indentations in the right- and right anterior direction, and one indentation on the opposite side. At maximal squeeze the graphic reconstruction showed the same indentations, but they were more pronounced. In conclusion, computerized eight-channel manometry proved to be an efficient technique which could be routinely applicable. The graphic reconstruction provides insight into radial and axial pressure asymmetry.
- Published
- 1991
31. Long-term extracorporeal blood bypass in dogs at low flows without systemic heparinization. Heparin-coated versus uncoated circuits.
- Author
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van der Hulst VP, Gründeman PF, Moulijn AC, Rutten PJ, and Klopper PJ
- Subjects
- Animals, Biocompatible Materials, Dogs, Extracorporeal Circulation methods, Pulmonary Embolism etiology, Thrombosis etiology, Time Factors, Extracorporeal Circulation instrumentation, Heparin, Pulmonary Embolism prevention & control, Thrombosis prevention & control
- Abstract
A blind, randomized study of the effects of a heparin-coated bypass circuit on thromboembolus formation and hematologic and hemostatic parameters was carried out on 12 dogs. The dogs were anesthetized and bypassed for 24 hours using a centrifugal pump circuit with a mean flow of 475 ml/minute. Six of the dogs were bypassed with a heparin coated circuit and six with an uncoated circuit. No systemic heparin was administered to any of the dogs at any time during the procedure. Both the coated and uncoated circuits remained patent at low flows. Thrombus formation, however, primarily around the pump axis, was observed in both groups. Four of the dogs (two from either group) had no evidence of lung emboli. The remaining eight dogs all showed pulmonary emboli. Thromboemboli did not lead to clinical complications or hemodynamic disturbances. Hematologic and hemostatic parameters showed a reduction in hemoglobin, erythrocytes, thrombocytes, leukocytes, and antithrombin III, which was most pronounced in the uncoated group. This study showed that a low flow bypass circuit remains patent for 24 hours whether or not the circuit is coated with heparin. Although the heparin coating limits the reduction in antithrombin III and blood elements, it does not eliminate the risk of thromboembolus formation.
- Published
- 1991
32. Veno-venous bypass without systemic heparinization using a centrifugal pump: a blind comparison of a heparin bonded circuit versus a non heparin bonded circuit.
- Author
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van der Hulst VP, Henny CP, Moulijn AC, Engbers G, ten Cate H, Gründeman PF, and Klopper PJ
- Subjects
- Animals, Blood Cell Count, Dogs, Extracorporeal Circulation instrumentation, Femoral Vein, Hematocrit, Hemoglobins analysis, Hemostasis, Jugular Veins, Extracorporeal Circulation methods, Heparin administration & dosage
- Abstract
Veno-venous bypass without the use of systemic heparinization has recently become of increasing interest for application during liver transplantation and surgery on the large abdominal veins. However, possible adverse effects on blood components as demonstrated by means of hematologic and hemostatic parameters or on the occurrence of thromboembolic complications are until now not excluded. No consensus has been reached as to the efficacy of heparin coated circuits in those procedures. In the present study veno-venous bypass was performed for four hours in ten dogs using heparin coated and non coated circuits without further heparinization in a randomized blind fashion. No changes or significant intergroup differences were noted in the hematological and coagulation parameters. Macroscopic evaluation of the circuits revealed small strands of fibrin on all connector rims and clots in the center part of the pump head and at the cannula tips. The lungs showed two small emboli in large size pulmonary arteries and also two minor emboli in small size arteries. In four animals the emboli were equally divided between the two groups. As expected regarding the size of the clots no influences could be seen on hemodynamic or respiratory parameters. With Scanning Electronic Microscopy a monolayer of activated thrombocytes was observed on the surface of the bypass circuits in the coated as well as in the uncoated group. This study suggests that a veno-venous bypass without systemic heparinization is possible without serious damage to blood cellular elements or impressive activation of the coagulation system.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1989
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