The lumbar multifidus is characterised by larger type I muscle fibres compared to the erector spinae

Anouk Agten,Sjoerd Stevens,Jonas Verbrugghe,Bert O,Eijnde,Annick Timmermans,Frank Vandenabeele 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.2

The metabolic capacity of a muscle is one of the determinants of muscle function. Muscle fiber type characteristics give an indication about this metabolic capacity. Therefore it might be expected that the lumbar multifidus (MF) as a local stabilizer contains higher proportions of slow type I fibers, compared to the erector spinae (ES) as a global mobilizer. The aim of this study is to determine the muscle fiber characteristics of the ES and MF to provide insight into their structural and metabolic characteristics, and thereby the functional capacity of both muscles. Muscle fiber type characteristics in the ES and MF were investigated with an immunofluorescence staining of the myosin heavy chain isoforms. In both the ES and MF, type I muscle fibers are predominantly present. The cross-sectional area (CSA) of type I muscle fibers is significantly larger in the lumbar MF compared to the ES. However, the mean muscle fiber type percentage for type I was not significantly different, which resulted in an insignificant difference in relative cross-sectional area (RCSA) for type I. No significant differences were found for all other muscle fiber types. This may indicate that the MF displays muscle fiber type characteristics that tend to be more appropriate to maintain stability of the spine. However, because we could not demonstrate significant differences in RCSA between ES and MF, we cannot firmly state that there are functional differences between the ES an MF based only on structural characteristics.

Protein interaction with bioactive polymers grafted onto titanium surface

Anouk GALTAYRIES,Hamza CHOUIRFA,Dimitri MERCIER,Celine FALENTIN-DAUDRE,Veronique MIGONNEY 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

Simple hysterectomy SHAPE-ing up to be the treatment of choice for early cervical cancer under 2 cm

Anouk Benseler,Allan Covens 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.2

Cer vical cancer is the fourth most common cancer in women [1]. While we hope globalhuman papillomavirus vaccination efforts will change this reality, as a result of screeningprograms 42% of women in North America present with localized disease [2]. Radicalhysterectomy has been recommended for most patients, presenting with stage IA2 to 4 cmIB3 cancers [3]. Overall sur vival is excellent, however there are significant adverse effectsassociated with parametrial and vaginal resection [4]. We congratulate Plante et al. on completing this randomized non-inferiority trial of 700patients with stage 1A2 and 1B1 cer vical cancer comparing simple hysterectomy and pelvicnode dissection to radical hysterectomy and pelvic node dissection (recently published inthe New England Journal of Medicine) [5]. The primar y endpoint was designed to detect non-inferiority of pelvic-relapse free sur vival at 3 years, with secondar y outcomes including overallsur vival, parametrial involvement, quality of life and treatment-related toxicity. The 3-yearpelvic-recurrence rate was 2.5% in the simple hysterectomy group and 2.2% in the radicalhysterectomy group per intention to treat analysis (2.8% and 2.3% per protocol analysis) andthe upper 95% confidence limit did not meet the pre-defined threshold of inferiority. The3-year extra pelvic relapse-free sur vival and overall sur vival were 98.1% vs. 99.7% and 99.1%vs. 99.4%, respectively. Surgical margins were similar (2.4% SH vs. 2.7% RH). Patient reported outcomes of sexual health were measured by the Female Sexual FunctionIndex and the Female Sexual Distress Scale-Revised, and bowel, bladder and non-sexualvaginal symptoms were measured by EORTC QLQ-C30 with QLQ-CX24. Simple hysterectomywas associated with decreased pain experience and favorable sexual health. Patients whounder went simple hysterectomy reported less sexual worr ying and increased sexual enjoymentat 3 months, less sexual pain and improved sexual lubrication for the first 12 months, andimproved sexual vaginal functioning for the first 24 months. Overall better body image andincreased sexual activity was reported for up to 36 months. Decreased urinar y retentionand incontinence also favored simple hysterectomy (0.6% vs. 9.9% and 4.7% vs. 11%,respectively). These findings of decreased sexual health and increased bladder symptoms inpatients undergoing radical hysterectomy are consistent with the literature [6-9]. The ConCer v trial prospectively evaluated patients with cer vical cancer up to 2 cm, treatedwith conization or simple hysterectomy, and concluded conser vative surger y may be offeredbased on a cumulative recurrence of 3.5% over a median follow up of 36.3 months [10].A systematic review of the literature including 2,662 women demonstrated no significantassociation between mortality and simple vs. radical hysterectomy in patients withmicroscopic disease, and the recent SCCAN retrospective trial of 1,257 patients comparingtype B, C1 and C2 radical hysterectomy techniques found no sur vival difference for tumors upto 2 cm with increased radicality of surger y [11,12]. What can we conclude from all this? The evidence from these studies is congruent; nonradical surger y for small cer vical cancers is safe, not associated with increased relapse rates,and improves quality of life, measured through patient reported outcomes. Rarely do wefind a therapy, that relative to standard of care, is as effective yet less complex, less costly andbetter tolerated by patients. While it is unlikely this study will be replicated, these findingsstimulate additional questions. With no reason to suspect other wise, will the 5-year overallsur vival be consistent with these 3-year findings? Given that the majority of patients inthe ConCer v trial (96%) and the SHAPE trial (75%) under went minimally invasive surger yfor their hysterectomy, what is the optimal surgical approach for these patients [10,13]?Can sentinel node biopsy replace full pelvic lymphad...

An obvious proof of the perfect numbers conjecture

Ikorong Anouk Gilbert Nemron 장전수학회 2011 Proceedings of the Jangjeon mathematical society Vol.14 No.4

Pythagoras saw perfection in any integer that equaled the sum of all the other integers that divided evenly into it (see[1] or [2] or [3]). The first perfect number is 6. It's evenly divisible by 1, 2, and 3, and it's also the sum of 1, 2, and 3, [note 28, 469 and 33550336 are also perfect numbers (see[3])]. Perfect numbers are known for some integers > 33550336 and it is conjectured that there are infinitely many perfect numbers. In this paper, using only elementary logic underlyied by equivalence relations between two trivial assertions, elementary combinatoric, elementary arithmetic congruences, induction and reasoning by reduction to absurd, we prove a simple Theorem which immediately implies that the perfect numbers are infinite. Moreover, our paper clearly shows that the perfect numbers conjecture was only a simple arithmetic conjecture. Finally, our paper clearly shows that investigations used in the past to try to solve the perfect numbers conjecture, were not appropriate for that conjecture.

Chondroid metaplasia of paraspinal connective tissue in the degenerative spine

Sjoerd Stevens,Sjoerd Stevens,Anouk Agten,Erika Wisanto,Melissa Lo Monaco,Jonas Verbrugghe,Annick Timmermans,Ivo Lambrichts,Frank Vandenabeele 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.2

A 51-year-old male was routinely biopsied during a paraspinal muscle study. The biopsy sample was taken from the right erector spinae muscle at the fourth lumbar vertebra. The patient had no history of (diagnosed) major back trauma. The obtained sample was histologically analyzed (hematoxylin and eosin, safranin O), and complementary magnetic resonance imaging was performed. The biopsied sample contained chondroid tissue. Based on its location, the biopsy sample was appointed as chondroid metaplasia. Although chondroid metaplasia is not uncommon in humans, this is the first report of chondroid metaplasia within the paraspinal connective tissue. We propose a novel mechanism to explain the paraspinal chrondrogenic changes, related to spinal degeneration.

Eruption of Metastatic Paraganglioma After Successful Therapy with 177Lu/90Y-DOTATOC and 177Lu-DOTATATE

Katherine I. Wolf,Abhishek Jha,Anouk van Berkel,Damian Wild,Ingo Janssen,Corina M. Millo,M. J. R. Janssen,Melissa K. Gonzales,Henri J. K. M. Timmers,Karel Pacak 대한핵의학회 2019 핵의학 분자영상 Vol.53 No.3

Metastatic paraganglioma treatment options are limited. Peptide receptor radionuclide therapy (PRRT) has been introduced as a novel management option for metastatic neuroendocrine tumors demonstrating safety, efficacy, and increased quality of life.We present two cases of marked progression of metastatic paraganglioma following initial partial response to PRRT. Given their positivity on 68Ga-DOTATATE PET/CT and 111In-octreotide SPECT, they underwent PRRT. Imaging following treatment revealed significant improvement in size and intensity, with some foci nearly completely resolved in one patient, and disease regression with a decrease in the number and size of bone and liver lesions in the second patient.Within months, repeat imaging in both patients revealed extensive metastatic disease with new lesions, which eventually lead to their deaths. The mechanism for rapid disease progression after partial response is not well understood, although it could be related to initially high Ki-67 levels or 18F-FDG PET/CT SUVmax values. However, naturally rapid disease progression despite PRRT response cannot be excluded. This finding warrants the importance of proper patient counseling along with early and accurate pre-PRRT assessment, taking into consideration the above potential risk factors for therapy response in order to personalize treatment regimens and achieve maximum patient benefit.

경기도 전곡선사박물관 건축설계 국제공모전

김민호(편집자),김병현,이경훈(토론자),Nicolas Demazieres(토론자),Anouk Legendre(토론자),이혜윤(사회자) 현대건축사 2006 월간 CONCEPT Vol.- No.85