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Universiteit Utrecht
1.
Buijs, M.A.M.
Intra-Arterial Treatment of Primary and Metastatic Liver Tumors.
Degree: 2009, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/37155 
► The aims of this thesis were, first, to investigate the toxicities associated with trans-arterial chemoembolization (TACE) of liver tumors and to evaluate the use of…
(more)
▼ The aims of this thesis were, first, to investigate the toxicities
associated with trans-arterial chemoembolization (TACE) of liver tumors
and to evaluate the use of MR imaging in characterizing tumor response
after this locoregional therapy, second, to further develop intra-arterial
therapy of liver tumors with 3-bromopyruvate (3-BrPA), a novel anti-cancer
agent, and finally, to assess the value of new MR imaging techniques in the
characterization of liver lesions. In Chapter 1, the general introduction, an
overview of these aims and an outline of the thesis are presented.
Advisors/Committee Members: Diest, P.J. van, Wall, E. van der, Geschwind, J.-F.H..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Buijs, M. A. M. (2009). Intra-Arterial Treatment of Primary and Metastatic Liver Tumors. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/37155
Chicago Manual of Style (16th Edition):
Buijs, M A M. “Intra-Arterial Treatment of Primary and Metastatic Liver Tumors.” 2009. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/37155.
MLA Handbook (7th Edition):
Buijs, M A M. “Intra-Arterial Treatment of Primary and Metastatic Liver Tumors.” 2009. Web. 27 Feb 2020.
Vancouver:
Buijs MAM. Intra-Arterial Treatment of Primary and Metastatic Liver Tumors. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2009. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/37155.
Council of Science Editors:
Buijs MAM. Intra-Arterial Treatment of Primary and Metastatic Liver Tumors. [Doctoral Dissertation]. Universiteit Utrecht; 2009. Available from: http://dspace.library.uu.nl:8080/handle/1874/37155
Universiteit Utrecht
2.
Claessen, J.H.L.
Protein quality control in the ER: balancing the ubiquitin chequebook.
Degree: 2012, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/254576
► In this thesis, work is discussed that addresses the machinery held responsible for substrate ubiquitylation, a novel method to block the UPS by expression of…
(more)
▼ In this thesis, work is discussed that addresses the machinery held responsible
for substrate ubiquitylation, a novel method to block the UPS by expression of a
‘hyperactive’ DUB, and the discovery of a cytosolic chaperone that is required for
the dislocation reaction.
Protein quality control in the ER selects dysfunctional proteins and targets them
for destruction by the ubiquitin proteasome system before they can escape to the
secretory pathway. Despite the identification of many proteins involved, the exact
mechanisms of key steps in the process remain to be more accurately defined. This thesis presents work that sheds light on the role of the ubiquitin machinery in
ER dislocation. It is shown, that the working of a membrane-anchored E2 enzyme critically depends on its interaction with the dislocation complex within the plane of the ER membrane. Once ubiquitylated, the misfolded protein recruits the p97 protein
complex to initiate extraction from the ER. This step critically depends on a deubiquitylating activity present at the p97 complex itself. Finally, to allow a smooth
exit, misfolded ER proteins associate with cytosolic chaperones.
Advisors/Committee Members: Ploegh, H.L., Wiertz, E.J.H.J..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Claessen, J. H. L. (2012). Protein quality control in the ER: balancing the ubiquitin chequebook. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/254576
Chicago Manual of Style (16th Edition):
Claessen, J H L. “Protein quality control in the ER: balancing the ubiquitin chequebook.” 2012. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/254576.
MLA Handbook (7th Edition):
Claessen, J H L. “Protein quality control in the ER: balancing the ubiquitin chequebook.” 2012. Web. 27 Feb 2020.
Vancouver:
Claessen JHL. Protein quality control in the ER: balancing the ubiquitin chequebook. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2012. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/254576.
Council of Science Editors:
Claessen JHL. Protein quality control in the ER: balancing the ubiquitin chequebook. [Doctoral Dissertation]. Universiteit Utrecht; 2012. Available from: http://dspace.library.uu.nl:8080/handle/1874/254576
Universiteit Utrecht
3.
Whitaker, I.S.
Molecular genetic microbiological and clinical analysis of Hirudo species (leeches) : implications for use in surgical practice.
Degree: 2009, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/44668
► The aims of this thesis are to investigate the historical journey of the use of leeches in medicine (Chapter 2) and to review the mechanisms…
(more)
▼ The aims of this thesis are to investigate the historical journey of the use of leeches in medicine (Chapter 2) and to review the mechanisms of action relevant to the reconstructive surgeon (Chapter 3). With a specific focus on infective complications following leech therapy, we will investigate the culturable and unculturable microbiota of Hirudo orientalis using contemporary molecular genetic techniques and accurately measure antibiotic sensitivities (see figure 2) (Chapter 4), present a 5 year follow up study of the use of antibiotics in the UK and suggest an appropriate antibiotic prophylactic regimen (Chapter 5 and 6). In Chapter 7, the largest individual series of patients post reconstructive surgery treated with leeches to date will be outlined (n=35 over a 4 year period). The previous largest clinical series can be seen in table 2. A comprehensive systemative review of the use of leeches in surgical practice (277 clinical cases) will be presented, with special consideration to the indications, outcomes and complications of associated with such therapy. (Chapter 8)
In chapter 9, we present and analyse mechanical and chemical alternatives to leech therapy. A summary of the thesis and potential implications of differences between the FDA approved, and other leech species are discussed in Chapter 10. Chapter 11 incorporates several appendices including a protocol for leech use and details on how to order leeches worldwide. In this thesis we will answer the following questions:
What species of medicinal leech are available for clinical use, and which are we using
currently? (Chapter 1); How long have we used leeches throughout history and for what indications? (Chapter 2); What is the mechanism of action of medicinal leeches relevant to the surgeon? (Chapter 3); What is the extent of use of medicinal leeches in reconstructive surgery?(Chapter 5); What do we know about the microbiota of the leech and what is the potential to cause infective complications? (Chapter 4);
Does infection affect salvage rates? (Chapter 7 & 8); How should we be preventing and treating these infections? (Chapters 4,6,7); Are we currently using appropriate antibiotic prophylaxis or treatment?(Chapter 5,6); What indications are leeches most commonly used for? (Chapter 7,8); Is there a viable alternative at present to leech use? (Chapter 9); Does it matter which species of medicinal leech we are using?
(Chapter 10).
Advisors/Committee Members: Kon, M..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Whitaker, I. S. (2009). Molecular genetic microbiological and clinical analysis of Hirudo species (leeches) : implications for use in surgical practice. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/44668
Chicago Manual of Style (16th Edition):
Whitaker, I S. “Molecular genetic microbiological and clinical analysis of Hirudo species (leeches) : implications for use in surgical practice.” 2009. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/44668.
MLA Handbook (7th Edition):
Whitaker, I S. “Molecular genetic microbiological and clinical analysis of Hirudo species (leeches) : implications for use in surgical practice.” 2009. Web. 27 Feb 2020.
Vancouver:
Whitaker IS. Molecular genetic microbiological and clinical analysis of Hirudo species (leeches) : implications for use in surgical practice. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2009. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/44668.
Council of Science Editors:
Whitaker IS. Molecular genetic microbiological and clinical analysis of Hirudo species (leeches) : implications for use in surgical practice. [Doctoral Dissertation]. Universiteit Utrecht; 2009. Available from: http://dspace.library.uu.nl:8080/handle/1874/44668
Universiteit Utrecht
4.
Nadery-Siddiqi, L.
Sympathetic nervous system overactivity in patients with chronic kidney disease : studies on the pathophysiology, clinical relevance and treatment.
Degree: 2011, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/204515
► The evidence summarized in Chapter 1, served as the rationale for the studies presented in this thesis. The questions addressed in this thesis are: -…
(more)
▼ The evidence summarized in Chapter 1, served as the rationale for the studies presented in this thesis. The questions addressed in this thesis are: - In chapter 3, we addressed the idea that sympathetic activity in CKD patients is related to cardiovascular organ damage. We hypothesized that patients with chronic kidney disease have agreater left ventricular mass than healthy volunteers independent of blood pressure and that MSNAis positively correlated to left ventricular mass; - In chapter 4, we studied the effect of the renin inhibitor aliskiren on MSNA. We hypothesized that aliskiren effectively lowers sympathetic activity in CKD patients. In addition, in this chapter we will look at the effect of 100% oxygen administration on sympathetic activity without and during chronic treatment with aliskiren; - The underlying mechanisms of antihypertensive effects of RAS inhibitors are difficult to study in humans. In chapter 5, we evaluate the changes in the blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) signal intensity induced by acute and chronic RAS inhibitors in CKD patients. We will compare these effects with BOLD signals in healthy volunteers after acute treatment with a RAS inhibitor. We hypothesized that a RAS inhibitor has an effect on the BOLD signal in CKD patients, whereas it has no effect in healthy controls; - There are some experimental studies that suggest that statins have a sympatholytic effect. However, this effect of statins is rarely studied in patients, and not yet in CKD patients. This is important because these agents are commonly prescribed in CKD patients. In chapter 6, the sympatholytic effect of statins will be tested in CKD patients, when added to RAS inhibitor; - In chapter 7, we briefly touch up on a novel application of an old concept: renal denervation as a new tool for treatment of hypertension; - Finally, I put the results presented in this thesis in perspective and speculate on the future
Advisors/Committee Members: Verhaar, M.C., Blankestijn, P.J..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Nadery-Siddiqi, L. (2011). Sympathetic nervous system overactivity in patients with chronic kidney disease : studies on the pathophysiology, clinical relevance and treatment. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/204515
Chicago Manual of Style (16th Edition):
Nadery-Siddiqi, L. “Sympathetic nervous system overactivity in patients with chronic kidney disease : studies on the pathophysiology, clinical relevance and treatment.” 2011. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/204515.
MLA Handbook (7th Edition):
Nadery-Siddiqi, L. “Sympathetic nervous system overactivity in patients with chronic kidney disease : studies on the pathophysiology, clinical relevance and treatment.” 2011. Web. 27 Feb 2020.
Vancouver:
Nadery-Siddiqi L. Sympathetic nervous system overactivity in patients with chronic kidney disease : studies on the pathophysiology, clinical relevance and treatment. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2011. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/204515.
Council of Science Editors:
Nadery-Siddiqi L. Sympathetic nervous system overactivity in patients with chronic kidney disease : studies on the pathophysiology, clinical relevance and treatment. [Doctoral Dissertation]. Universiteit Utrecht; 2011. Available from: http://dspace.library.uu.nl:8080/handle/1874/204515
Universiteit Utrecht
5.
Kokke, F.T.M.
Childhood constipation: diagnosis, treatment and the role of dietary fiber : good fibration?.
Degree: 2011, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/205839
► Constipation in childhood is a very common problem. In most cases it is short lived and can be treated easily. When constipation is diagnosed in…
(more)
▼ Constipation in childhood is a very common problem. In most cases it is short lived and can be treated easily. When constipation is diagnosed in a child a few organic diseases, like Hirschsprung’s disease, must be ruled out first, which can generally be done by taking a thorough history and performing a complete physical examination. When, as in most constipated children, no organic cause can be found, a diagnosis of functional constipation is made. No further investigations
are needed and a trial with laxative treatment for a limited amount of time is standard care. In this thesis, we reported the results of further research into the diagnosis and treatment of constipation in otherwise healthy children and in pediatric CF patients. The main focus in this thesis was the use of dietary fiber as a treatment option.
Advisors/Committee Members: Kimpen, J.L.L., Benninga, M.A., Houwen, R.H.J..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Kokke, F. T. M. (2011). Childhood constipation: diagnosis, treatment and the role of dietary fiber : good fibration?. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/205839
Chicago Manual of Style (16th Edition):
Kokke, F T M. “Childhood constipation: diagnosis, treatment and the role of dietary fiber : good fibration?.” 2011. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/205839.
MLA Handbook (7th Edition):
Kokke, F T M. “Childhood constipation: diagnosis, treatment and the role of dietary fiber : good fibration?.” 2011. Web. 27 Feb 2020.
Vancouver:
Kokke FTM. Childhood constipation: diagnosis, treatment and the role of dietary fiber : good fibration?. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2011. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/205839.
Council of Science Editors:
Kokke FTM. Childhood constipation: diagnosis, treatment and the role of dietary fiber : good fibration?. [Doctoral Dissertation]. Universiteit Utrecht; 2011. Available from: http://dspace.library.uu.nl:8080/handle/1874/205839
Universiteit Utrecht
6.
Van den Branden, B.J.L.
Innovation in intervention : new devices in interventional cardiology.
Degree: 2011, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/215185
► This thesis reports on the application of several new devices for percutaneous treatment of structural heart disease. A patent foramen ovale (PFO) is a tunnellike…
(more)
▼ This thesis reports on the application of several new devices for percutaneous treatment of structural heart disease. A patent foramen ovale (PFO) is a tunnellike communication between the right and the left atrium and has been associated with the occurrence of cryptogenic stroke. PFO closure has proven its efficacy in preventing recurrent TIA or stroke. An atrial septal defect (ASD) occurs when a part of the interatrial septum is missing and is characterized by a left-to-right shunt, resulting in volume overload of the right heart. Percutaneous closure has become common practice. New devices for PFO and ASD closure are being constructed to facilitate the procedure and to lower the complication rate. Mitral valve regurgitation (MR) is an important clinical issue. Less invasive transcatheter techniques are proposed as an alternative treatment option in highsurgical- risk patients. The aims of this thesis were to study the safety and the efficacy if this new devices and techniques. The general discussion describes the different treatment options for PFO, ASD, and MR. We provide an overview of the literature with implementation of our study results, highlighting new techniques with recommendations for further investigation.
Advisors/Committee Members: Doevendans, P.A.F.M., Budts, W.I.H.L., Suttorp, M.J., Post, M.C..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Van den Branden, B. J. L. (2011). Innovation in intervention : new devices in interventional cardiology. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/215185
Chicago Manual of Style (16th Edition):
Van den Branden, B J L. “Innovation in intervention : new devices in interventional cardiology.” 2011. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/215185.
MLA Handbook (7th Edition):
Van den Branden, B J L. “Innovation in intervention : new devices in interventional cardiology.” 2011. Web. 27 Feb 2020.
Vancouver:
Van den Branden BJL. Innovation in intervention : new devices in interventional cardiology. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2011. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/215185.
Council of Science Editors:
Van den Branden BJL. Innovation in intervention : new devices in interventional cardiology. [Doctoral Dissertation]. Universiteit Utrecht; 2011. Available from: http://dspace.library.uu.nl:8080/handle/1874/215185
Universiteit Utrecht
7.
Klemans, R.J.B.
Peanut allergy diagnosis and management: the role of allergen components.
Degree: 2014, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/300062
► Peanut and soy are both legumes and therefore phylogenetically related. Both peanut and soy should be addressed in the diagnostic work-up of a suspected allergy…
(more)
▼ Peanut and soy are both legumes and therefore phylogenetically related. Both peanut
and soy should be addressed in the diagnostic work-up of a suspected allergy to either
of these foods because of possible cross-reactivity. Allergic symptoms to both foods
can range from mild oral allergy symptoms to severe respiratory or even cardiovascular
symptoms. Therefore, it is important that peanut or soy allergy is not missed in the
diagnostic procedure and an adequate elimination diet is prescribed. An incorrect
diagnosis of food allergy on the other hand significantly impairs the quality of life and
increases the risk of impaired growth and inadequate nutrient intake in case of children.
Skin prick test (SPT) and IgE reactivity to peanut extract in serum are two methods that
are generally used to measure sensitization. Since sensitization is often not related to
clinical symptoms, test results can be ‘false-positive’ when used as a diagnostic test
for peanut or soy allergy. The reference standard on the other hand, a double-blind,
placebo-controlled food challenge, has many disadvantages: it is time-consuming,
has high costs, is stressful for the patient, might result in severe clinical reactions and
it requires highly dedicated hospital facilities. Therefore, there is strong need for an
accurate diagnostic test that is cheap, non-invasive and ideally can discriminate between
mild and severe allergy as well. One possibility of improving diagnostics is by combining
several predictors into one prediction model. Another possibility is by measuring serum
IgE (sIgE) to specific allergenic peanut proteins, also called components. At the moment,
6 peanut components are commercially available and can therefore be used in clinical
practice: Ara h 1, Ara h 2, Ara h 3, Ara h 6, Ara h 8, and Ara h 9. Their diagnostic accuracy can
be analyzed individually or in combination with each other or other clinical predictors.
In Chapter 2 we systematically reviewed current literature for studies addressing the
diagnostic accuracy of the current diagnostic tests (SPT and sIgE to peanut extract) or
measuring sIgE to one or more peanut components in diagnosing peanut allergy. All
eligible studies were scored for risk of bias and concerns regarding applicability. Our
results showed that sIgE to Ara h 2 had the best diagnostic accuracy of all diagnostic test
methods that were analyzed; it was best in both diagnosing as well as excluding peanut
allergy, while SPT and sIgE to peanut extract were primarily useful in excluding peanut
allergy.
Advisors/Committee Members: Bruijnzeel-Koomen, C.A.F.M., Knulst, A.C., Knol, E.F..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Klemans, R. J. B. (2014). Peanut allergy diagnosis and management: the role of allergen components. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/300062
Chicago Manual of Style (16th Edition):
Klemans, R J B. “Peanut allergy diagnosis and management: the role of allergen components.” 2014. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/300062.
MLA Handbook (7th Edition):
Klemans, R J B. “Peanut allergy diagnosis and management: the role of allergen components.” 2014. Web. 27 Feb 2020.
Vancouver:
Klemans RJB. Peanut allergy diagnosis and management: the role of allergen components. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2014. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/300062.
Council of Science Editors:
Klemans RJB. Peanut allergy diagnosis and management: the role of allergen components. [Doctoral Dissertation]. Universiteit Utrecht; 2014. Available from: http://dspace.library.uu.nl:8080/handle/1874/300062
Universiteit Utrecht
8.
Koning, D.
The T-cell repertoire in chronic viral infection.
Degree: 2014, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/300063
► In summary, this thesis aimed to determine the role of the T-cell repertoire in viralspecific immunity and revealed a number of interesting and novel findings.…
(more)
▼ In summary, this thesis aimed to determine the role of the T-cell repertoire in viralspecific
immunity and revealed a number of interesting and novel findings. Diversity (Chapter
II) and cross-reactivity (Chapter IV) of the T-cell repertoire appear to be most influenced by the
antigens to which they are directed. Also in HIV-infected individuals expressing the common
HLA alleles A*02 and B*08 (Chapter V), antigen was found to play an important role in TCR
evolution and T-cell response magnitude. The role of the T-cell repertoire in mediating HLAbased
delayed disease course is less clear (Chapter VI). Progressors and slow-progressors expressing
HLA-B*57 selected largely similar T-cell repertoires overall in terms of clonal breadth, clonotype
bias, and T-cell cross-recognition, T-cell features that were unique for HLA-B*57-restricted
T cells. Together, these observations show how the T-cell repertoire interacts with a chronic viral
infection (HIV) in a protective HLA background. Still, additional research will be required in
order to better understand our findings and how HLA-B*57 exerts its protective effect. Our data
and the T-cell efficacy model I proposed suggest great variation in T-cell responses between individuals
and even within subjects. Understanding how this variation arises and resolving the exact
principles that make up the anti-HIV T-cell response will be required in order to find curative
strategies for chronic infections like HIV.
Advisors/Committee Members: Meyaard, L., Baarle, D. van.
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Koning, D. (2014). The T-cell repertoire in chronic viral infection. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/300063
Chicago Manual of Style (16th Edition):
Koning, D. “The T-cell repertoire in chronic viral infection.” 2014. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/300063.
MLA Handbook (7th Edition):
Koning, D. “The T-cell repertoire in chronic viral infection.” 2014. Web. 27 Feb 2020.
Vancouver:
Koning D. The T-cell repertoire in chronic viral infection. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2014. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/300063.
Council of Science Editors:
Koning D. The T-cell repertoire in chronic viral infection. [Doctoral Dissertation]. Universiteit Utrecht; 2014. Available from: http://dspace.library.uu.nl:8080/handle/1874/300063
Universiteit Utrecht
9.
Swaans, M.J.
Transcatheter cardiac interventions and the role of interventional echocardiography.
Degree: 2014, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/301928
► This thesis concerns the application of three new procedures in the field of structural heart disease. Firstly, we investigate the mineral invasive transcatheter tgechnique to…
(more)
▼ This thesis concerns the application of three new procedures in the field of structural heart disease. Firstly, we investigate the mineral invasive transcatheter tgechnique to treat high-surgicval risk patients with severe symptomatic MR using edge-to-edge technique with the MitraClip system. Secondly, we describe a percutaneous device (Watchman) for exclusion of the LAA from the systemic circulation and hereby reducin gthe risk of stroke and abolishing the need for VKA and associated bleeding risk. Thirdly, we focus on a minimal invasive treatment of symptomatic peri-prosthetic leaks using a transapicla access in patients with a high operative mortality risk of who are denied for surgery. Finally, the additional value of 3DTEE for patient selection and guidance of these transcatheter cardiac interventions throughout this thesis is shown.
Advisors/Committee Members: Doevendans, P.A.F.M., Post, M.C., Rensing, B.J.W.M..
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Swaans, M. J. (2014). Transcatheter cardiac interventions and the role of interventional echocardiography. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/301928
Chicago Manual of Style (16th Edition):
Swaans, M J. “Transcatheter cardiac interventions and the role of interventional echocardiography.” 2014. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/301928.
MLA Handbook (7th Edition):
Swaans, M J. “Transcatheter cardiac interventions and the role of interventional echocardiography.” 2014. Web. 27 Feb 2020.
Vancouver:
Swaans MJ. Transcatheter cardiac interventions and the role of interventional echocardiography. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2014. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/301928.
Council of Science Editors:
Swaans MJ. Transcatheter cardiac interventions and the role of interventional echocardiography. [Doctoral Dissertation]. Universiteit Utrecht; 2014. Available from: http://dspace.library.uu.nl:8080/handle/1874/301928
Universiteit Utrecht
10.
Verbeek, R.E.
Malignant progression of Barrett's esophagus: pathogenesis, surveillance and follow-up.
Degree: 2014, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/301931
► This thesis demonstrated novel insights in the genetic and environmental contribution to the development of BE and EAC. Accordingly, the effect of surveillances strategies for…
(more)
▼ This thesis demonstrated novel insights in the genetic and environmental contribution to the development of BE and EAC. Accordingly, the effect of surveillances strategies for BE on EAC progression risk and mortality, and the efficacy of follow-up strategies in BE-associated neoplasia were elucidated. Altogether, for the best of patient interest, these results importantly contribute to optimizing current surveillance and follow-up strategies in BE in order to reduce progression towards EAC.
Advisors/Committee Members: Siersema, P.D., Baal, J.W.P.M. van, Oijen, M.G.H. van.
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Verbeek, R. E. (2014). Malignant progression of Barrett's esophagus: pathogenesis, surveillance and follow-up. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/301931
Chicago Manual of Style (16th Edition):
Verbeek, R E. “Malignant progression of Barrett's esophagus: pathogenesis, surveillance and follow-up.” 2014. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/301931.
MLA Handbook (7th Edition):
Verbeek, R E. “Malignant progression of Barrett's esophagus: pathogenesis, surveillance and follow-up.” 2014. Web. 27 Feb 2020.
Vancouver:
Verbeek RE. Malignant progression of Barrett's esophagus: pathogenesis, surveillance and follow-up. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2014. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/301931.
Council of Science Editors:
Verbeek RE. Malignant progression of Barrett's esophagus: pathogenesis, surveillance and follow-up. [Doctoral Dissertation]. Universiteit Utrecht; 2014. Available from: http://dspace.library.uu.nl:8080/handle/1874/301931
Universiteit Utrecht
11.
Trimarchi, S.
Insights into acute aortic dissection.
Degree: 2012, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/238672
► Aortic dissection represents one of the most catastrophic and complex cardiovascular diseases. Its origin is related to an intimal tear with course of blood flow…
(more)
▼ Aortic dissection represents one of the most catastrophic and complex cardiovascular diseases. Its origin is related to an intimal tear with course of blood flow into the aortic wall and division of the aortic lumen into two different lumens, defined as the true and false lumen, separated by a septum or intimal flap. Based on the location of the entry tear, aortic dissections are classified as type A when the proximal tear is located in the ascending aorta and as type B when the tear is present after the origin of the left subclavian artery (Stanford classification). The overall incidence of the acute aortic dissection as a cause of mortality in the population, seems to be around 0.5% per year, with a frequency of about 2.9-4 per 100.000 people/year, about two times higher than aortic aneurysm rupture.
The main objective of this thesis is to look insight acute aortic dissection in the contemporary era, during which new data modify continuously our knowledge and the consequent management of such patients. In particular, our studies focused on the role of the aortic diameter as cause of acute type B aortic dissection (ABAD), on the importance of the preoperative conditions of acute dissected patients in determining the outcome and on the currentusefulness and availability of specific biomarkers for making a rapid serologic diagnosis of acute dissection.
This research project showed some interesting results. The diameter may not be considered as a fundamental parameter to predict acute dissection, highlighting as it may occurs frequently in patients with a normal aortic diameter and not affected by predisposing factors like connective tissue disorders. In acute dissected patients requiring open or/and endovascular approaches, results are strictly associated with pre-operative conditions. In ABAD patients, presence of refractory pain and/or hypertension, in the absence of any hemodynamic and/or ischemic complication, categorizes a group at intermediate risk for in-hospital mortality. Such risk stratification is helpful in predicting the outcome and may assist surgeon in advising patients and their families about the realistic chances of the operation. Follow-up of ABAD patients treated medically in the acute setting evidenced as aortic diameter of less than 4 cm at presentation was associated with increased aortic expansion during follow-up while female gender, intramural hematoma and use of calcium channel blockers predicted decreased aortic expansion. For the assessment of acute and chronic diseases of the aorta, until now routine laboratory tests have played only a minor role and actually no standard blood-based test are yet available for the diagnosis and follow-up of these patients. Although not specific, actually only the D-dimer may be useful as serological diagnosis in the acute setting.
As Charcot stated in the 19th century, ”disease is very old and nothing about it has changed. It is we who change, as we learn to recognize what was formerly imperceptible.” With this thesis we tried to extend insights…
Advisors/Committee Members: Moll, F.L., Herwaarden, J.A. van, Muhs, B.E..
Subjects/Keywords: Geneeskunde; Geneeskunde; aortic dissection
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APA (6th Edition):
Trimarchi, S. (2012). Insights into acute aortic dissection. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/238672
Chicago Manual of Style (16th Edition):
Trimarchi, S. “Insights into acute aortic dissection.” 2012. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/238672.
MLA Handbook (7th Edition):
Trimarchi, S. “Insights into acute aortic dissection.” 2012. Web. 27 Feb 2020.
Vancouver:
Trimarchi S. Insights into acute aortic dissection. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2012. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/238672.
Council of Science Editors:
Trimarchi S. Insights into acute aortic dissection. [Doctoral Dissertation]. Universiteit Utrecht; 2012. Available from: http://dspace.library.uu.nl:8080/handle/1874/238672
Universiteit Utrecht
12.
Wall, E. van der.
High dose chemotherapy for solid tumors.
Degree: 1995, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/23245
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Wall, E. v. d. (1995). High dose chemotherapy for solid tumors. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/23245
Chicago Manual of Style (16th Edition):
Wall, E van der. “High dose chemotherapy for solid tumors.” 1995. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/23245.
MLA Handbook (7th Edition):
Wall, E van der. “High dose chemotherapy for solid tumors.” 1995. Web. 27 Feb 2020.
Vancouver:
Wall Evd. High dose chemotherapy for solid tumors. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1995. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/23245.
Council of Science Editors:
Wall Evd. High dose chemotherapy for solid tumors. [Doctoral Dissertation]. Universiteit Utrecht; 1995. Available from: http://dspace.library.uu.nl:8080/handle/1874/23245
Universiteit Utrecht
13.
Gispen, W.H.
Over de relatie tussen het gestoorde voorwaardelijke vluchtgedrag van hypofyseloze ratten en het RNA-metabolisme in de hersenstam.
Degree: 1970, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/3957
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Gispen, W. H. (1970). Over de relatie tussen het gestoorde voorwaardelijke vluchtgedrag van hypofyseloze ratten en het RNA-metabolisme in de hersenstam. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/3957
Chicago Manual of Style (16th Edition):
Gispen, W H. “Over de relatie tussen het gestoorde voorwaardelijke vluchtgedrag van hypofyseloze ratten en het RNA-metabolisme in de hersenstam.” 1970. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/3957.
MLA Handbook (7th Edition):
Gispen, W H. “Over de relatie tussen het gestoorde voorwaardelijke vluchtgedrag van hypofyseloze ratten en het RNA-metabolisme in de hersenstam.” 1970. Web. 27 Feb 2020.
Vancouver:
Gispen WH. Over de relatie tussen het gestoorde voorwaardelijke vluchtgedrag van hypofyseloze ratten en het RNA-metabolisme in de hersenstam. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1970. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/3957.
Council of Science Editors:
Gispen WH. Over de relatie tussen het gestoorde voorwaardelijke vluchtgedrag van hypofyseloze ratten en het RNA-metabolisme in de hersenstam. [Doctoral Dissertation]. Universiteit Utrecht; 1970. Available from: http://dspace.library.uu.nl:8080/handle/1874/3957
Universiteit Utrecht
14.
Matute Moreno, A.J.
Characteristics of common infections in Nicaragua.
Degree: 2006, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/13471
► The main purpose of the studies outlined in this thesis was to gain empirical epidemiological and therapeutic knowledge of some common infectious diseases in Nicaragua.…
(more)
▼ The main purpose of the studies outlined in this thesis was to gain empirical
epidemiological and therapeutic knowledge of some common infectious diseases in
Nicaragua. So far, relatively little was known about the incidence, etiology,
management and antibiotic resistance patterns of common infections. Of importance
is to note that because of a lack of knowledge, currently many patients are
unnecessarily treated with antibiotics for a presumed infection or the choice for the
specific drug is untargeted. Such inefficient use of antibiotics may accelerate adverse
drug reactions, increase costs, and most importantly contributes to the emerging
problem of antibiotic resistance. The studies were therefore set up to provide tools to
tackle common health problems effectively in the coming years. To provide the
required knowledge, we conducted several prevalence studies in the source area of
León, Nicaragua within the framework of the collaboration of the universities of León
and Utrecht in close collaboration with epidemiologists, intensivists, medical
microbiologist and infectious diseases specialists in the field. We focused on the
common infections such as urinary tract infection and community acquired
pneumonia (chapter 2, 3). In chapter 4 the adherence to a specifically developed
protocol of antimicrobial prophylaxis before surgery was studied in a third prevalence
study. In the final chapters (5, 6) we report on the prevalence of HIV and syphilis in
pregnant women and the epidemiology of clinically apparent HIV infection in
Nicaragua. Based on the results, we further elaborate on the recommended strategy
to improve daily medical and preventive practice within the health system and the community.
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Matute Moreno, A. J. (2006). Characteristics of common infections in Nicaragua. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/13471
Chicago Manual of Style (16th Edition):
Matute Moreno, A J. “Characteristics of common infections in Nicaragua.” 2006. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/13471.
MLA Handbook (7th Edition):
Matute Moreno, A J. “Characteristics of common infections in Nicaragua.” 2006. Web. 27 Feb 2020.
Vancouver:
Matute Moreno AJ. Characteristics of common infections in Nicaragua. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2006. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/13471.
Council of Science Editors:
Matute Moreno AJ. Characteristics of common infections in Nicaragua. [Doctoral Dissertation]. Universiteit Utrecht; 2006. Available from: http://dspace.library.uu.nl:8080/handle/1874/13471
Universiteit Utrecht
15.
Harten, P.N. van.
Movement disorders associated with neuroleptics : the Curaçao extrapyramidal syndromes study.
Degree: 1998, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/19037
► This thesis concerns extrapyramidal syndromes (EPS) and is divided into three parts because each part has its own study design. The focus of part 1…
(more)
▼ This thesis concerns extrapyramidal syndromes (EPS) and is divided into three parts because each part has its own study design. The focus of part 1 is on the epidemiology of the EPS tardive dyskinesia, tardive dystonia, parkinsonism, and akathisia. Part 2 focuses on tardive dystonia. It starts with a review of this syndrome and then reports the results of a clinical trial with clozapine. Part 3 opens with a review of acute dystonia and then the results are given of a prospective study that investigated whether the use of cocaine is a risk factor for neuroleptic induced acute dystonia.
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Harten, P. N. v. (1998). Movement disorders associated with neuroleptics : the Curaçao extrapyramidal syndromes study. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/19037
Chicago Manual of Style (16th Edition):
Harten, P N van. “Movement disorders associated with neuroleptics : the Curaçao extrapyramidal syndromes study.” 1998. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/19037.
MLA Handbook (7th Edition):
Harten, P N van. “Movement disorders associated with neuroleptics : the Curaçao extrapyramidal syndromes study.” 1998. Web. 27 Feb 2020.
Vancouver:
Harten PNv. Movement disorders associated with neuroleptics : the Curaçao extrapyramidal syndromes study. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1998. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/19037.
Council of Science Editors:
Harten PNv. Movement disorders associated with neuroleptics : the Curaçao extrapyramidal syndromes study. [Doctoral Dissertation]. Universiteit Utrecht; 1998. Available from: http://dspace.library.uu.nl:8080/handle/1874/19037
Universiteit Utrecht
16.
Verberg, M.F.G.
Mild strategies for IVF: from theory to practice.
Degree: 2007, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/24603
► Over the last 25 years, ovarian stimulation for IVF treatment has gradually become more complex, time consuming and expensive. Recently, the downsides of ovarian stimulation…
(more)
▼ Over the last 25 years, ovarian stimulation for IVF treatment has gradually become more complex, time consuming and expensive. Recently, the downsides of ovarian stimulation have attracted increasing attention. Currently, a shift in the focus of IVF is occurring from striving for maximizing instant success 'at all costs' to developing safer and more patient friendly protocols in which the risks of treatment are minimized while optimizing the chance of a singleton live birth. Strategies involving single embryo transfer and milder ovarian stimulation protocols) have been proposed to provide such a patient friendly strategy. An important concern regarding the use of mild treatment strategies remains the reduction in the per cycle chance of pregnancy. The principle aim of this thesis was to identify means of improving the efficacy and therefore the uptake of milder treatment strategies for IVF such as mild ovarian stimulation and SET. In this thesis it was shown that fear regarding the use of mild stimulation for a reduction in ovarian response or an increase of drop-outs (when the number of treatment cycles needed is increased) is unjustified. Indeed, the retrieval of a modest number of oocytes following mild ovarian stimulation was, in contrast to following conventional ovarian stimulation, associated with optimal pregnancy outcomes. Additionally, patients were found to be willing to undergo an increased number of treatment cycles as long as a mild ovarian stimulation protocol was applied. Furthermore, prediction models were developed to reduce the chance of cancellation following mild stimulation and to provide an evidence based method to identify women who may qualify for the transfer of a single versus two embryos. After external validation the first model should be able to reduce the chance of cancellation following mild stimulation to an average level, the second should lead to an increase the overall pregnancy rate per transfer while maintaining a low number of multiple pregnancies. These interventions could increase the efficacy and implementation of mild treatment strategies.
Subjects/Keywords: Geneeskunde; Infertility
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APA (6th Edition):
Verberg, M. F. G. (2007). Mild strategies for IVF: from theory to practice. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/24603
Chicago Manual of Style (16th Edition):
Verberg, M F G. “Mild strategies for IVF: from theory to practice.” 2007. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/24603.
MLA Handbook (7th Edition):
Verberg, M F G. “Mild strategies for IVF: from theory to practice.” 2007. Web. 27 Feb 2020.
Vancouver:
Verberg MFG. Mild strategies for IVF: from theory to practice. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2007. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/24603.
Council of Science Editors:
Verberg MFG. Mild strategies for IVF: from theory to practice. [Doctoral Dissertation]. Universiteit Utrecht; 2007. Available from: http://dspace.library.uu.nl:8080/handle/1874/24603
Universiteit Utrecht
17.
Delden, J.J.M. van.
Beslissen om niet te reanimeren : een medisch en ethisch vraagstuk.
Degree: 1993, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/253598
► The fight against an untimely death is an element of medical science which comes to the fore especially with cardiopulmonary resuscitation. A successful resuscitation constitutes…
(more)
▼ The fight against an untimely death is an element of medical science which
comes to the fore especially with cardiopulmonary resuscitation. A successful
resuscitation constitutes a victory over death. Hence modem resuscitation
techniques are considered one of the breakthroughs which advanced
medical science has offered humanity. The importance of resuscitation is
reinforeed by the fact that everyone eventually dies. For everyone there is
the moment when heartbeat and/or respiration fails. Thus all humanity is a
possible candidate for resuscitation.
However, resuscitation has its drawbacks. Resuscitation is more often
than not unsuccessful and practising it involves some technical violence.
When the resuscitation attempt is not successful, than the process of dying
can be severely disturbed while nothing positive can be attributed to the
intervention. Moreover, not for all people death needs to be fought with all
possible force. In short, somelimes it is better not to resuscitate at all. The
question which then needs to be faced is 'when not to resuscitate?'. This
question is the
subject of the present dissertation.
An added problem is the fact that the decision to resuscitate needs to be
taken quickly. Hence the question 'should this patient be resuscitated or
not?' must be answered when there is time to think it over. When this kind
of decision-making process leads to the decision not to intervene, a DO
NOT RESUSCITATE-decision has been taken. The central issue of this
thesis is: Which grounds allow a DNR-decision to be taken. This matter
derives its moral importance from the fact that by taking a DNR-decision
one takes the responsibility that the decision may shorten a patient's life.
The objective of this study is not limited to a norrnalive analysis of the
reasons not to resuscitate. The aim is to offer some considerations with
which to fonnulate a DNR-policy as well. In another aspect the study is
limited: the answers to the questions poscd are aimed at taking DNR-decisions
in hospitals and for patients who have reached majority.
Advisors/Committee Members: Schroten, E., Maas, P.J. van der.
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Delden, J. J. M. v. (1993). Beslissen om niet te reanimeren : een medisch en ethisch vraagstuk. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/253598
Chicago Manual of Style (16th Edition):
Delden, J J M van. “Beslissen om niet te reanimeren : een medisch en ethisch vraagstuk.” 1993. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/253598.
MLA Handbook (7th Edition):
Delden, J J M van. “Beslissen om niet te reanimeren : een medisch en ethisch vraagstuk.” 1993. Web. 27 Feb 2020.
Vancouver:
Delden JJMv. Beslissen om niet te reanimeren : een medisch en ethisch vraagstuk. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1993. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/253598.
Council of Science Editors:
Delden JJMv. Beslissen om niet te reanimeren : een medisch en ethisch vraagstuk. [Doctoral Dissertation]. Universiteit Utrecht; 1993. Available from: http://dspace.library.uu.nl:8080/handle/1874/253598
Universiteit Utrecht
18.
Dekkers, J.F.
How changes in lipid metabolism contribute to enhanced inflammation in cystic fibrosis.
Degree: 2010, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/45145
► Cystic fibrosis is a complex disease characterized by the presence of thick pulmonary mucus and recurrent and eventually chronic lung infections. Many studies report that…
(more)
▼ Cystic fibrosis is a complex disease characterized by the presence of thick pulmonary mucus and recurrent and eventually chronic lung infections. Many studies report that CFTR-deficient cells show enhanced proinflammatory signaling and proinflammatory cytokine secretion, even in the absence of any infection. CFTR deficiency not only affects anion transport, but also many intracellular mechanisms, such as apoptosis, calcium homeostasis, GSH transport, ROS production and lipid metabolism. Many studies found that these intrinsic cellular changes result in activation of inflammatory signaling routes leading to enhanced inflammation in CF cells compared to normal cells.
The most important alterations in lipid metabolism that may contribute to the proinflammatory state in CF cells are a decreased function and expression of the nuclear receptor PPAR-γ and an altered sphingolipid metabolism, in particular altered ceramide levels (summarized in figure 6). The CFTR-dependent defect in PPAR-γ function may either result from decreased PPAR-γ ligands, including 15-keto-PGE2 and DHA, or from PPAR-γ sequestration by TG2. The decreased 15-keto-PGE2 level in CFTR-deficient cells likely results from decreased levels of HPGD, the enzyme that converts PGE2 to 15-keto-PGE2. However, the specific molecular mechanisms and signaling events that connect CFTR defects with decreased PPAR-γ function still need to be defined.
Two in vivo studies address opposite conclusions about ceramide levels in murine CF cells. While Teichgraber and colleagues found excessive ceramide accumulation in respiratory tract epithelium of CFTR-deficient mice, Radzoich and associates note diminished ceramide levels in CF related organs of CF mice. Ceramide accumulation was attributed to a disturbed balance of pH-sensitive acid SMase and ceramidase present in lysosomes. However, as ceramide activates production of proinflammatory mediators, rather increased ceramide levels observed by Teichgraber and colleagues than decreased ceramide levels observed by Radzoich et al. correspond with enhanced inflammation observed in CF. Ceramide accumulation in CF cells could also explain enhanced production of arachidonic acid and PGE2 via induction of PLA2 and COX-2 (Fig. 6).
Activation of PPAR-γ by PPAR-γ ligands resolve abnormal lung symptoms in a murine model. Besides, normalization of ceramide levels in mice by either treatment with acid SMase inhibitors or fenretinide has beneficial effects on CF pathogenesis. These findings indicate that drugs that normalize altered lipid metabolism are promising for treating the pathofysiological lung symptoms in CF patients.
Advisors/Committee Members: Beekman, J.M..
Subjects/Keywords: Geneeskunde; Ceramide
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APA (6th Edition):
Dekkers, J. F. (2010). How changes in lipid metabolism contribute to enhanced inflammation in cystic fibrosis. (Masters Thesis). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/45145
Chicago Manual of Style (16th Edition):
Dekkers, J F. “How changes in lipid metabolism contribute to enhanced inflammation in cystic fibrosis.” 2010. Masters Thesis, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/45145.
MLA Handbook (7th Edition):
Dekkers, J F. “How changes in lipid metabolism contribute to enhanced inflammation in cystic fibrosis.” 2010. Web. 27 Feb 2020.
Vancouver:
Dekkers JF. How changes in lipid metabolism contribute to enhanced inflammation in cystic fibrosis. [Internet] [Masters thesis]. Universiteit Utrecht; 2010. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/45145.
Council of Science Editors:
Dekkers JF. How changes in lipid metabolism contribute to enhanced inflammation in cystic fibrosis. [Masters Thesis]. Universiteit Utrecht; 2010. Available from: http://dspace.library.uu.nl:8080/handle/1874/45145
Universiteit Utrecht
19.
Öner, F.C.
Thoracolumbar spine fractures: diagnostic and prognostic parameters.
Degree: 1999, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/359
► De juiste diagnose, classificatie en behandeling van thoraco-lumbale wervelfracturen blijven een problematisch en controversieël onderwerp in traumatologie. Een kort historisch overzicht (Hoofdstuk 1) laat zien…
(more)
▼ De juiste diagnose, classificatie en behandeling van thoraco-lumbale wervelfracturen blijven een problematisch en controversieël
onderwerp in traumatologie. Een kort historisch overzicht
(Hoofdstuk 1) laat zien dat de diagnose en behandeling van deze let-sels
vaak hebben geleid tot hevige discussies en onenigheden. Voordat
veilige en effectieve chirurgische technieken waren ontwikkeld, lag
het centrum van de discussie in de vragen of een poging tot gesloten
repositie iets toevoegde en hoe lang de rug geïmmobiliseerd moest
worden. De huidige discussie wordt gedomineerd door de vraag welke
letsels met welke benadering operatief behandeld dienen te worden.
Geen consensus is nog bereikt over deze vragen aan het eind van de
twintigste eeuw. Het lot van een patiënt met een gebroken rug hangt
nog steeds af van de chirurgisch-culturele voorkeuren van de kli-niek
waar de patiënt terechtkomt.
Onze studie over de diagnostische en prognostische parameters
betreffende deze letsels laat zien dat onze middelen voor onderscheid
van verschillende soorten letsels en onze schattingen van de prognose
nog niet voldoende zijn ontwikkeld, hoewel wij waarschijnlijk voor-uitgang
hebben geboekt in de behandeling van deze fracturen en hun
gevolgen.
Classificatie van deze letsels is altijd moeilijk geweest (Hoofdstuk 2).
Tientallen schema s en ontelbare modificaties van deze schema s
zijn ontwikkeld, gebruikt en verworpen. Dit is een aanwijzing dat de
fundamentele patronen van deze letsels moeilijk te herkennen zijn.
Alle inspanningen echter hebben bijgedragen tot de ontwikkeling van
abstracte concepten over de structuur en stabiliteit van een gebroken
rug. Het AO classificatie schema ontwikkeld door Magerl et al (1994)
is de culminatie van alle inspanningen sinds Böhler om deze letsels te
classificeren op basis van conventionele beeldvormende technieken.
Deze auteurs constateerden dat al de voorafgaande classificaties heb-ben
bijgedragen aan onze kennis en begrip van deze letsels, hoewel
geen enkele schema gezien kan worden als een alles-omvattende con-ceptualisatie.
Zij ontwikkelden een comprehensief systeem waar-mee
elke letsel ingedeeld kan worden op verschillende niveau s vol-gens
de richting van de trauma krachten, pathomorphologie en de
ernst van de resulterende fractuur. Maar dit schema is gebaseerd op?155
veronderstellingen over de toestand van niet-benige structuren zon-der
de middelen voor een directe beeldvorming. Wij hebben aange-toond
(Hoofdstuk 3) dat vanwege deze moeilijkheden de reproduceer-baarheid
van dit schema te wensen over laat vooral op de hoogste laag
waar de integriteit van deze structuren de belangrijkste factor is. De
AO classificatie dient gezien te worden als de laatste poging van unifi-catie
van alle inspanningen in de twintigste eeuw voor herkenning van
letselpatronen met beeldvormende technieken die geen direct beeld
kunnen geven van de omvang van niet-benige letsels.
Magnetic Resonance Imaging (MRI), is een krachtige nieuwe beeld-vormende
techniek waarmee zowel…
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Öner, F. C. (1999). Thoracolumbar spine fractures: diagnostic and prognostic parameters. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/359
Chicago Manual of Style (16th Edition):
Öner, F C. “Thoracolumbar spine fractures: diagnostic and prognostic parameters.” 1999. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/359.
MLA Handbook (7th Edition):
Öner, F C. “Thoracolumbar spine fractures: diagnostic and prognostic parameters.” 1999. Web. 27 Feb 2020.
Vancouver:
Öner FC. Thoracolumbar spine fractures: diagnostic and prognostic parameters. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1999. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/359.
Council of Science Editors:
Öner FC. Thoracolumbar spine fractures: diagnostic and prognostic parameters. [Doctoral Dissertation]. Universiteit Utrecht; 1999. Available from: http://dspace.library.uu.nl:8080/handle/1874/359
Universiteit Utrecht
20.
Busch, E.-M. (Eelco-Marcel).
On the dark side of light: Genesis and prevention of two spectral types of retinal light damage.
Degree: 1999, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/361
► This thesis is on light damage to the retina. Photochemical light damage to the retina can even occur under ambient light conditions as demonstrated by…
(more)
▼ This thesis is on light damage to the retina. Photochemical light damage to the retina can even occur under ambient light conditions as demonstrated by Noell et al. (1966) They found green light (500 nm) the most powerful in causing retinal damage. Under higher irradiance conditions the action spectrum changes: Short wavelengths are then the most harmful (Ham et al., 1979; Ham, Mueller and Sliney, 1982; Gorgels and van Norren, 1995). With ever increasing irradiance the domain of thermal damage is entered. The highest retinal irradiance used in the experiments in this thesis is approximately 300 mW/ cm . This is a rather high 2 level, but insufficient to increase the retinal temperature over 10 C; the generally accepted safety o limit (Ham et al., 1979). Another argument against thermal damage, is the duration of the exposure. Thermal damage occurs in less then a second, or not at all (Ham et al., 1979; van Norren, Keunen and Vos, 1998). In the experiments in this thesis longer exposures (from 8 to 100 minutes) were required to cause damage. Thus, we have always dealt with photochemical rather than thermal mechanisms in retinal light damage as investigated in this thesis.
The aims of the studies in this thesis were:
(1) To document the development of two spectrally determined types of photochemical light damage.
(2) To obtain more information about the mechanisms of these two spectral light damage types, and to evaluate possible protectors against retinal light damage.
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Busch, E. -. (. (1999). On the dark side of light: Genesis and prevention of two spectral types of retinal light damage. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/361
Chicago Manual of Style (16th Edition):
Busch, E -M (Eelco-Marcel). “On the dark side of light: Genesis and prevention of two spectral types of retinal light damage.” 1999. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/361.
MLA Handbook (7th Edition):
Busch, E -M (Eelco-Marcel). “On the dark side of light: Genesis and prevention of two spectral types of retinal light damage.” 1999. Web. 27 Feb 2020.
Vancouver:
Busch E-(. On the dark side of light: Genesis and prevention of two spectral types of retinal light damage. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1999. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/361.
Council of Science Editors:
Busch E-(. On the dark side of light: Genesis and prevention of two spectral types of retinal light damage. [Doctoral Dissertation]. Universiteit Utrecht; 1999. Available from: http://dspace.library.uu.nl:8080/handle/1874/361
Universiteit Utrecht
21.
Spoelstra, José Astrid.
Type 2 diabetes mellitus treatment strategies in primary care: Utrecht Diabetes Epidemiology Studies.
Degree: 2002, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/472
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Spoelstra, J. A. (2002). Type 2 diabetes mellitus treatment strategies in primary care: Utrecht Diabetes Epidemiology Studies. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/472
Chicago Manual of Style (16th Edition):
Spoelstra, José Astrid. “Type 2 diabetes mellitus treatment strategies in primary care: Utrecht Diabetes Epidemiology Studies.” 2002. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/472.
MLA Handbook (7th Edition):
Spoelstra, José Astrid. “Type 2 diabetes mellitus treatment strategies in primary care: Utrecht Diabetes Epidemiology Studies.” 2002. Web. 27 Feb 2020.
Vancouver:
Spoelstra JA. Type 2 diabetes mellitus treatment strategies in primary care: Utrecht Diabetes Epidemiology Studies. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2002. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/472.
Council of Science Editors:
Spoelstra JA. Type 2 diabetes mellitus treatment strategies in primary care: Utrecht Diabetes Epidemiology Studies. [Doctoral Dissertation]. Universiteit Utrecht; 2002. Available from: http://dspace.library.uu.nl:8080/handle/1874/472
Universiteit Utrecht
22.
Dik, Pieter.
Urological treatment and follow-up of patients with spinal dysraphism.
Degree: 2004, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/8537
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Dik, P. (2004). Urological treatment and follow-up of patients with spinal dysraphism. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/8537
Chicago Manual of Style (16th Edition):
Dik, Pieter. “Urological treatment and follow-up of patients with spinal dysraphism.” 2004. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/8537.
MLA Handbook (7th Edition):
Dik, Pieter. “Urological treatment and follow-up of patients with spinal dysraphism.” 2004. Web. 27 Feb 2020.
Vancouver:
Dik P. Urological treatment and follow-up of patients with spinal dysraphism. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2004. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/8537.
Council of Science Editors:
Dik P. Urological treatment and follow-up of patients with spinal dysraphism. [Doctoral Dissertation]. Universiteit Utrecht; 2004. Available from: http://dspace.library.uu.nl:8080/handle/1874/8537
Universiteit Utrecht
23.
Smakman, Niels.
Towards KRAS-directed therapy : Dependency of metastatic colorectal cancer cells on mutant KRAS.
Degree: 2006, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/8572
► The aims of this thesis were 1) to assess the dependency of late-stage colorectal carcinoma (CRC) cells on mutant KRAS and 2) to test the…
(more)
▼ The aims of this thesis were 1) to assess the dependency of late-stage colorectal carcinoma (CRC) cells on mutant KRAS and 2) to test the potential of reovirus T3D and COX-2 inhibitors as RAS-targeted therapeutics in experimental models of CRC and colorectal liver metastases.
The role of oncogenic RAS in the formation of colorectal liver metastases is evaluated in chapter 2. We give an overview of the existing literature of both experimental (in vitro and in vivo) and clinical studies that address this issue.
Imaging of tumor growth, tumor characteristics and the effect of therapeutic interventions in living animals (intravital imaging) has been made possible by new molecular and optical techniques. In chapter 3 we validate bioluminescence imaging as a minimally invasive tool to monitor tumor growth in the liver.
KRAS is important as an initiator of CRC tumorigenesis. In chapters 4 and 5 we asses the dependency of late stage CRC cells on mutant KRAS. We analyze this with a highly aggressive CRC cell line that harbors an endogenous KRAS mutation. In chapter 4 we assess the effect of endogenous mutant KRAS on the interplay between CRC cells and the immune system. In chapter 5 we analyze which distinct stages in the process of liver colonization are affected by endogenous mutant KRAS.
RAS proteins signal through a number of distinct signaling cascades. COX-2 is important in the development of multiple cancers, including CRC and bladder carcinoma. The exact relationship between endogenous mutant RAS and COX-2 is unclear. In chapter 6 we investigate this relationship in CRC cells. Furthermore, we investigate the potential therapeutic effects of selective COX-2 inhibitors in a mouse model of established CRC liver metastasis in chapter 6 and in a mouse model of bladder carcinomas in chapter 7.
In the ensuing chapters we focus on reovirus, one of the most promising RAS-directed therapeutics. We investigate the mechanism underlying the RAS-specificity of tumor cell killing in chapters 8 and 9. Next, in chapter 10 we assess the potential of reovirus as a therapeutic agent against experimental CRC liver metastases and investigate the role of the immune system on the therapeutic effect. In chapter 11 we investigate the susceptibility of freshly resected human liver metastases to reovirus T3D infection.
We conclude that late stage CRC cells are dependent on mutant KRAS for their invasiveness, metastatic potential and for immune evasion. This makes mutant KRAS an interesting therapeutic target with great potential against metastatic colorectal carcinomas. COX-2 is a direct target of mutant KRAS and selective COX-2 inhibitors have therapeutic potential against colorectal liver metastases and bladder carcinomas.
Mutant KRAS sensitizes CRC cells to reovirus T3D induced apoptosis. The therapeutic efficacy of reovirus T3D against established liver metastases is hampered by the host immune system but can be increased by concomitant immunosuppression. The mislocalization of the reovirus receptor JAM-1 in human colorectal…
Subjects/Keywords: Geneeskunde
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APA (6th Edition):
Smakman, N. (2006). Towards KRAS-directed therapy : Dependency of metastatic colorectal cancer cells on mutant KRAS. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/8572
Chicago Manual of Style (16th Edition):
Smakman, Niels. “Towards KRAS-directed therapy : Dependency of metastatic colorectal cancer cells on mutant KRAS.” 2006. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/8572.
MLA Handbook (7th Edition):
Smakman, Niels. “Towards KRAS-directed therapy : Dependency of metastatic colorectal cancer cells on mutant KRAS.” 2006. Web. 27 Feb 2020.
Vancouver:
Smakman N. Towards KRAS-directed therapy : Dependency of metastatic colorectal cancer cells on mutant KRAS. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2006. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/8572.
Council of Science Editors:
Smakman N. Towards KRAS-directed therapy : Dependency of metastatic colorectal cancer cells on mutant KRAS. [Doctoral Dissertation]. Universiteit Utrecht; 2006. Available from: http://dspace.library.uu.nl:8080/handle/1874/8572
Universiteit Utrecht
24.
Medema, R.H.
P21ras and insulin signal transduction.
Degree: 1993, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/8677
Subjects/Keywords: Geneeskunde
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Manager
APA (6th Edition):
Medema, R. H. (1993). P21ras and insulin signal transduction. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/8677
Chicago Manual of Style (16th Edition):
Medema, R H. “P21ras and insulin signal transduction.” 1993. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/8677.
MLA Handbook (7th Edition):
Medema, R H. “P21ras and insulin signal transduction.” 1993. Web. 27 Feb 2020.
Vancouver:
Medema RH. P21ras and insulin signal transduction. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 1993. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/8677.
Council of Science Editors:
Medema RH. P21ras and insulin signal transduction. [Doctoral Dissertation]. Universiteit Utrecht; 1993. Available from: http://dspace.library.uu.nl:8080/handle/1874/8677
25.
Hofman-Maas, K.W.
Clinical studies in Non-Small Cell Lung Cancer stage III.
Degree: 2013, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/287465
► Primary lung cancer was first recognized as a distinct disease in 1761, long before the advent of cigarette smoking.1 Although it was a rare disease…
(more)
▼ Primary lung cancer was first recognized as a distinct disease in 1761, long before the advent of
cigarette smoking.1 Although it was a rare disease at the start of the 20th century,2,3,4,5 at the end, lung cancer had become one of the leading causes of preventable death. Since the 1930s, lung cancer rates rapidly increased following the introduction of the manufactured cigarettes. Exposure to inhaled carcinogens with addictive properties combined with a increasing life span makes lung cancer one of the biggest medical challences of the 20th century. In 2010, 11.435 people were diagnosed with lung cancer in The Netherlands, 6.992 of these patients were male and 4.443 were female.During the first decade of the 21 century, the number of women who developed lung cancer increased from 2.479 to 4.443 (79%).This ‘epidemic’ is the result of the growing number of females, who started smoking since the 70s. On Prognosis and Clinical evaluation of lung cancer: Approximately 85% of patients with lung cancer are diagnosed with non-small cell lung cancer (NSCLC).10 The overall survival of NSCLC remains poor and has not changed much over the past three decades. In the Western world, the 5 years overall survival is nowadays around the 13%. This is caused by the fact that the vast majority of lung cancer patients are diagnosed in the advanced stages. Only 20% of the patients with NSCLC are candidates for surgery at presentation. About one third of the patients with NSCLC have stage III disease at presentation. Prognosis in NSCLC stage III is poor, with a relative survival of 12% in NSCLC stage IIIB and 20% in NSCLC stage IIIA after three years.1Most important prognostic factors are disease stage and performance status. Stage III is a heterogeneous group of patients, ranging from patients with potentially resectable disease with chest wall invasion and hilar lymph node metastases (T3N1) and patients with mediastinal invasion of the primary tumour (T4), to patients with unresectable disease due to mediastinal lymph node metastases (N2/N3). Defining patients with NSCLC stage III, depends on the spread to regional or distant lymph nodes or other metastatic sites. Patients are staged according to the international TNM staging system. Before 2009, patients were staged according the 6th TNM-staging system, and after 2009 they were staged according the revised 7th TNM staging system. The main goal of this thesis is to evaluate (minimal invasive) diagnostic techniques and the resultsof multimodality treatment in NSCLC stage III. Treatment of patients with supraclavicular lymph node metastases, invasion of the superior sulcus, brachial plexus or malignant pleural effusion will not be discussed. This thesis is divided into four sections. In the first section (chapter 2-5), the value of (minimal) invasive staging and restaging techniques in NSCLC stage III will be addressed. The second (chapter 6-8) includes clinical studies concerning the role of surgery in the treatment of NSCLC stage IIIA/B and its complications. Part three describes the…
Advisors/Committee Members: Grutters, J.C., Smit, E.F., Schramel, F.M.N.H..
Subjects/Keywords: Geneeskunde
…Geneeskunde
(NTVG), 2006.5 In non-small cell lung cancer (NSCLC) without…
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APA (6th Edition):
Hofman-Maas, K. W. (2013). Clinical studies in Non-Small Cell Lung Cancer stage III. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/287465
Chicago Manual of Style (16th Edition):
Hofman-Maas, K W. “Clinical studies in Non-Small Cell Lung Cancer stage III.” 2013. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/287465.
MLA Handbook (7th Edition):
Hofman-Maas, K W. “Clinical studies in Non-Small Cell Lung Cancer stage III.” 2013. Web. 27 Feb 2020.
Vancouver:
Hofman-Maas KW. Clinical studies in Non-Small Cell Lung Cancer stage III. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2013. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/287465.
Council of Science Editors:
Hofman-Maas KW. Clinical studies in Non-Small Cell Lung Cancer stage III. [Doctoral Dissertation]. Universiteit Utrecht; 2013. Available from: http://dspace.library.uu.nl:8080/handle/1874/287465
Universiteit Utrecht
26.
Pathanapitoon, K.
Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis.
Degree: 2010, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/179282
► In this thesis, we report on the so far unknown causes of uveitis in Thailand and describe their clinical manifestations. We found out that intraocular…
(more)
▼ In this thesis, we report on the so far unknown causes of uveitis in Thailand and describe their clinical manifestations. We found out that intraocular infections were the second most common cause of blindness and low vision in a tertiary center in northern Thailand. These infections predominantly consisted of CMV retinitis in HIV–infected patients. The spectrum of uveitis in northern Thailand included approximately 30% of HIV-infected patients with cytomegalovirus retinitis. Causes of HIV-negative uveitis seemed to be similar to those observed elsewhere in the Far East. However, PCR analysis of intraocular fluid revealed that CMV was the most frequent cause of infectious uveitis not only in HIV-positive patients but surprisingly also in HIV-negative patients. While CMV retinitis was most prevalent in HIV-positive patients, CMV-positive hypertensive anterior uveitis was typically present in HIV-negative patients. PCR analysis of intraocular fluids appeared to form a valuable diagnostic procedure as 45% of those examined exhibited positive results. We found out that positive intraocular HIV 1-RNA loads in HIV-positive patients with uveitis were predominantly present in the eyes of untreated patients with high plasma HIV loads. Further, we describe a novel infectious uveitis entity, namely HIV-induced anterior uveitis and report on its characteristics. Additionally we describe the clinical entities of HLA B27-associated AAU and ocular sarcoidosis in the Thai population and point out severe DRPE as an important masquerade of VKH disease. Principally, this thesis increases our knowledge in the field of uveitis in Southeast Asia and gives an account of the main uveitis entities present in this population. Based on the results reported in this thesis, future research should address the diagnostic role of Goldmann Witmer coefficient in patients with uveitis, which might assist the diagnosis of chronic ocular infections. Further exploration of clinical manifestations of ocular toxoplasmosis is desirable as the correct diagnosis makes the focused treatment possible. The presence of ocular sarcoidosis in Thailand could be clarified by a systemic study of radiologic and CT chest examinations in patients with uveitis and their diagnostic value in patients with uveitis could further be determined. The systematic taking of tissue biopsy and QuantiFeron tests could be further applied to determine the exact role of tuberculosis and sarcoidosis in Thai patients with uveitis. The study of human ocular tissues (using iris or retinal biopsies) might help to identify the exact cell population where HIV can replicate. Further analyses of intraocular HIV could determine whether the virus situated within the eye is distinct from the virus population present in the blood. Last, but not least, it would be valuable to expand the PCR facilities analyses and make the PCR analysis of intraocular fluids accessible to patients and ophthalmologists from the areas outside our hospital.
Advisors/Committee Members: Rothova, A..
Subjects/Keywords: Geneeskunde; Uveitis; Thailand
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APA (6th Edition):
Pathanapitoon, K. (2010). Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/179282
Chicago Manual of Style (16th Edition):
Pathanapitoon, K. “Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis.” 2010. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/179282.
MLA Handbook (7th Edition):
Pathanapitoon, K. “Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis.” 2010. Web. 27 Feb 2020.
Vancouver:
Pathanapitoon K. Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2010. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/179282.
Council of Science Editors:
Pathanapitoon K. Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis. [Doctoral Dissertation]. Universiteit Utrecht; 2010. Available from: http://dspace.library.uu.nl:8080/handle/1874/179282
Universiteit Utrecht
27.
Widdershoven, J.C.C.
Causes and treatment of velopharyngeal insufficiency in 22q11.2 Deletion Syndrome.
Degree: 2011, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/208191
► Het 22q11.2 deletie syndroom (22q11.2DS) is een autosomaal dominant overervende aandoening met een geschatte prevalentie van 1 op de 4000 pasgeborenen. Het wordt veroorzaakt door…
(more)
▼ Het 22q11.2 deletie syndroom (22q11.2DS) is een autosomaal dominant overervende
aandoening met een geschatte prevalentie van 1 op de 4000 pasgeborenen. Het wordt
veroorzaakt door een deletie op de lange arm van chromosoom 22 ter plaatse van band 11.2.
In ongeveer 90% van de gevallen is er sprake van een de novo deletie. Andere namen
waaronder het 22q11.2 deletie syndroom bekend staat zijn het velo-cardio-faciaal syndroom
(VCFS), Shprintzen syndroom, Cayler syndroom en Di George syndroom. Veel voorkomende
symptomen zijn cardiovasculaire afwijkingen, immunologische stoornissen, psychiatrische
stoornissen en velopharyngeale insufficiëntie. De inter- en intrafamiliale variabiliteit is groot.
Onderzoek naar de deletie wordt gedaan door middel van FISH- (fluorescence in situ
hybridization) of MLPA (multiplex ligation-dependent probe amplification) onderzoek.
Ongeveer een derde van de patiënten met de 22q11.2 deletie heeft een structurele afwijking
van het gehemelte, variërend van een bifide uvula tot een volledige palatoschisis. Daarnaast
vertoont ongeveer tweederde van de patiënten met 22q11.2DS symptomen van
velopharyngeale insufficiëntie, zoals een hypernasale spraak. Dientengevolge hebben patiënten
vaak een operatie (pharyngoplastiek) nodig om het overmatig ontsnappen van lucht via de neus
tegen te gaan. Het doel van een pharyngoplastiek is om de bestaande velopharyngeale opening
te verkleinen. Studies in het verleden hebben aangetoond dat de operatieresultaten van
pharyngoplastieken bij patiënten met 22q11.2DS minder gunstig zijn dan bij patiënten met
velopharyngeale insufficiëntie zonder de deletie.
Advisors/Committee Members: Kon, M., Beemer, F.A., Mink van der Molen, A.B..
Subjects/Keywords: Geneeskunde; Geneeskunde; Geneeskunde; velopharyngeal insufficiency; 22q11.2 deletion syndrome; speech problems; speech correcting surgery
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APA (6th Edition):
Widdershoven, J. C. C. (2011). Causes and treatment of velopharyngeal insufficiency in 22q11.2 Deletion Syndrome. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/208191
Chicago Manual of Style (16th Edition):
Widdershoven, J C C. “Causes and treatment of velopharyngeal insufficiency in 22q11.2 Deletion Syndrome.” 2011. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/208191.
MLA Handbook (7th Edition):
Widdershoven, J C C. “Causes and treatment of velopharyngeal insufficiency in 22q11.2 Deletion Syndrome.” 2011. Web. 27 Feb 2020.
Vancouver:
Widdershoven JCC. Causes and treatment of velopharyngeal insufficiency in 22q11.2 Deletion Syndrome. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2011. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/208191.
Council of Science Editors:
Widdershoven JCC. Causes and treatment of velopharyngeal insufficiency in 22q11.2 Deletion Syndrome. [Doctoral Dissertation]. Universiteit Utrecht; 2011. Available from: http://dspace.library.uu.nl:8080/handle/1874/208191
Universiteit Utrecht
28.
Jongh, M.A.C. de.
Population-based studies on trauma care: models and measurements of adverse outcome.
Degree: 2011, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/209202
► In this thesis we investigated whether population-based studies with routinely collected data are eligible to assess (adverse) outcome after trauma. We used the Dutch trauma…
(more)
▼ In this thesis we investigated whether population-based studies with routinely collected data are eligible to assess (adverse) outcome after trauma. We used the Dutch trauma registry
which was designed in order to get insight into the magnitude of trauma victims in the Netherlands and to measure, evaluate and improve the outcome of the quality of the trauma care. We evaluate outcome prediction models, the effect of several interventions and trauma systems, and the economic aspects of adverse outcome in trauma care.
Several international prediction models, based on the Trauma and Injury Severity Score (TRISS), can be used to calculate the probability of survival after trauma with adjustment for patient characteristics. In Chapter 2 the performance of these prediction models were tested in a single, large cohort. The results described in this chapter demonstrated that there was no single ‘best’ model. The discriminative power decreases in groups of patients with severe traumatic brain injury and those of older age with an isolated hip fracture. In Chapter 3 the results showed that the trauma care in the Dutch county Noord-Brabant is comparable with international norms. In Chapter 3 the admission policy for trauma patients in Noord-Brabant was evaluated also. Because there was no funding for centralisation of trauma care, the different chain partners in Noord-Brabant agreed to continue after the assignment of the trauma centre the existing policy of transporting trauma patients to the nearest hospital. After stabilisation, patients are further transferred to the trauma centre when necessary. The hypothesis that there is no difference in risk of hospital death between major trauma patients transferred from another hospital to the trauma centre and those directly admitted to the trauma centre was confirmed. In Chapter 4 we analysed the effect of the helicopter emergency medical services (HEMS) on mortality. The patients with severe traumatic brain injury had a non-significant association with a higher risk of dying when they were treated by the HEMS at the accident scene. Our study suggests that the higher mortality risk for patients with severe traumatic brain injury is caused by this increased prehospital time. For patients without severe brain injury the increased time did not have to seem a negative effect. Short distances and a high number of well equipped hospitals in the county could be an explanation for the results in Chapter 3 and 4.
The results of Chapter 5 show that diagnosis-related complications increase the costs of hospital care, with adjustment for age and injury severity, with a total monetary amount of € 5 420. Chapter 6 of is the basic step in the development of a model to predict with patient characteristics the probabilities of absence of various types of complications. Separate models for diagnosis- and institution-related complications were developed. Using these formulas the expected admissions without complications can be calculated and compared with those observed in order to measure and…
Advisors/Committee Members: Leenen, L.P.H., Schrijvers, A.J.P., Verhofstad, M.H.J..
Subjects/Keywords: Geneeskunde; Geneeskunde; Geneeskunde; prediction model; trauma; mortality; complications; casemix; quality of care; costs; trauma systems
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APA (6th Edition):
Jongh, M. A. C. d. (2011). Population-based studies on trauma care: models and measurements of adverse outcome. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/209202
Chicago Manual of Style (16th Edition):
Jongh, M A C de. “Population-based studies on trauma care: models and measurements of adverse outcome.” 2011. Doctoral Dissertation, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/209202.
MLA Handbook (7th Edition):
Jongh, M A C de. “Population-based studies on trauma care: models and measurements of adverse outcome.” 2011. Web. 27 Feb 2020.
Vancouver:
Jongh MACd. Population-based studies on trauma care: models and measurements of adverse outcome. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2011. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/209202.
Council of Science Editors:
Jongh MACd. Population-based studies on trauma care: models and measurements of adverse outcome. [Doctoral Dissertation]. Universiteit Utrecht; 2011. Available from: http://dspace.library.uu.nl:8080/handle/1874/209202
Universiteit Utrecht
29.
Spelbrink, A.L.L.
the justification of animal experiments: the truth behind the benefits.
Degree: 2009, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/31948
► The main argument for justifying the use of animals in research for human purposes is because animal experiments benefit humans. This thesis is a literature…
(more)
▼ The main argument for justifying the use of animals in research for human purposes is because animal experiments benefit humans. This thesis is a literature study about the justification of the use of animals in research experiments with the focus on the benefits of the experiments. These benefits need to be considered before the animal experiments are performed; ethical committees need to approve the use of animals in the experiments. These committees will compare the discomfort of the animals in the experiments with the potential benefits of the experiments. When these potential benefits are overruling the costs of the experiments, i.e. the discomfort of the animals, the use of animals is justified and the experiments will be approved. To determine on forehand whether the benefits are substantial higher than the costs, the ethical committees have to analyse the scientific validity of the experiment by setting and following specific criteria. However, even when the experiment is found scientifically valid, it is uncertain whether the results will be the expected results. With an evaluation of the results, the immediate and the long term results of the animal experiments can be determined, in other words, the contribution of animal experiments to medical science. Systematic reviews may provide an overview of the published animal experiments and help to determine the contribution of animal experiments to medical science. However, unexpected or negative results are often not published. To determine the relative relevance of animal experiments for humans, the unexpected and unpublished results of animal experiments should also be taken into account. A proper comparison of the results of animal experiments and the corresponding clinical trials help to determine the contribution of animals in research to medical science as well. However, there are plenty of examples that show that systematic reviews of animal experiments are not conducted properly or that the systematic reviews are not evaluated before the clinical trials start. For those examples, it is unsure whether the use of animals was necessary or that animal lives were spilled. The real contribution of the benefits of animal experiments to medical science is therefore hard to determine.
In conclusion, the benefits of animal experiments are important in justifying the use of animals in research for human purposes. Without the potential benefits, no animal experiment will be approved and no research will be performed. However, the benefits are hard to determine on forehand and can be hard to evaluate afterwards. Therefore, the contribution of the use of animals is difficult to determine. Using animals in research for human purposes is and probable always will be an unsolved dilemma, mostly because the benefits on one hand have contributed a lot to medical science but on the other hand can never be controlled and absolutely assured in future experiments.
Advisors/Committee Members: Stafleu, F. R..
Subjects/Keywords: Geneeskunde; Justification; animal experiments; benefits
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APA ·
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MLA ·
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CSE |
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Manager
APA (6th Edition):
Spelbrink, A. L. L. (2009). the justification of animal experiments: the truth behind the benefits. (Masters Thesis). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/31948
Chicago Manual of Style (16th Edition):
Spelbrink, A L L. “the justification of animal experiments: the truth behind the benefits.” 2009. Masters Thesis, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/31948.
MLA Handbook (7th Edition):
Spelbrink, A L L. “the justification of animal experiments: the truth behind the benefits.” 2009. Web. 27 Feb 2020.
Vancouver:
Spelbrink ALL. the justification of animal experiments: the truth behind the benefits. [Internet] [Masters thesis]. Universiteit Utrecht; 2009. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/31948.
Council of Science Editors:
Spelbrink ALL. the justification of animal experiments: the truth behind the benefits. [Masters Thesis]. Universiteit Utrecht; 2009. Available from: http://dspace.library.uu.nl:8080/handle/1874/31948
Universiteit Utrecht
30.
Holten, V.
Bio- and neurofeedback applications in stress regulation.
Degree: 2010, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/39457
► Chronically being stressed has a negative impact on health. Stress occurs when homeostasis in the body becomes disrupted. To bring the body back into a…
(more)
▼ Chronically being stressed has a negative impact on health. Stress occurs when homeostasis in the body becomes disrupted. To bring the body back into a homeostatic state, a stress response is initiated. The stress response activates the autonomic nervous system and the hypothalamic-pituitary-adrenal axis. Several biological parameters (EDA, heart rate, respiration rate) represent stress in the body. Biofeedback makes use of these parameters to decrease the amount of stress individuals perceive. By measuring the parameters reflecting stress and feeding these back to the individual, the brain should learn that some behaviours or thoughts are rewarding and therefore should be executed more often. Studies showed that this procedure works in decreasing the amount of stress in healthy people and PTSD patients. Especially the dorsolateral, prefrontal, anterior cingulate and parietal cortices, amygdala and basal ganglia increase activation after biofeedback relaxation training sessions.
Neurofeedback makes use of the EEG signal which consists of four main frequency bands, namely delta, theta, alpha and beta. Theta and alpha waves are related with relaxation and therefore these waves are often used in neurofeedback sessions aiming to increase relaxation. By feeding back the theta and alpha wave level in the EEG signal; the brain should learn how to permanently increase the amount of these waves. Studies showed that alpha theta neurofeedback training can increase relaxation, but a disadvantage is that these studies have a lot of limitations. In the future these limitations, such as a lack of control groups, have to be solved to get more powerful results. Based on the evidence provided by the current studies, biofeedback seems to be more effective in decreasing stress levels than neurofeedback.
Advisors/Committee Members: Vermetten, HGJM.
Subjects/Keywords: Geneeskunde; biofeedback, neurofeedback, stress regulation
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APA ·
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MLA ·
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CSE |
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to Zotero / EndNote / Reference
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APA (6th Edition):
Holten, V. (2010). Bio- and neurofeedback applications in stress regulation. (Masters Thesis). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/39457
Chicago Manual of Style (16th Edition):
Holten, V. “Bio- and neurofeedback applications in stress regulation.” 2010. Masters Thesis, Universiteit Utrecht. Accessed February 27, 2020.
http://dspace.library.uu.nl:8080/handle/1874/39457.
MLA Handbook (7th Edition):
Holten, V. “Bio- and neurofeedback applications in stress regulation.” 2010. Web. 27 Feb 2020.
Vancouver:
Holten V. Bio- and neurofeedback applications in stress regulation. [Internet] [Masters thesis]. Universiteit Utrecht; 2010. [cited 2020 Feb 27].
Available from: http://dspace.library.uu.nl:8080/handle/1874/39457.
Council of Science Editors:
Holten V. Bio- and neurofeedback applications in stress regulation. [Masters Thesis]. Universiteit Utrecht; 2010. Available from: http://dspace.library.uu.nl:8080/handle/1874/39457
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Open Access Theses and Dissertations
