The Management of a Case With Mucin-Producing Adenocarcinoma Originating From the Urachus.

Urachal cancer is a rare and aggressive type of cancer, frequently characterized by a lack of prominent symptoms. We herein report a case of a 50-year-old female with mucin-producing adenocarcinoma originating from the urachus who underwent partial cystectomy and the patient remains disease-free for 30 months after treatment.

The Contemporary Role of Salvage Radical Prostatectomy in the Management of Recurrent Prostate Cancer: An Up-to-Date Review.

Prostate cancer is the second most common cancer among men, with many treatment modalities available for patients, such as radical prostatectomy, external beam radiotherapy, brachytherapy, high-intensity focused ultrasound, cryotherapy, electroporation and other whole-gland or focal ablative novel techniques. Unfortunately, up to 60% of men with prostate cancer experience recurrence at 5 to 10 years. Salvage radical prostatectomy can be offered as an option in the setting of recurrence after a primary non-surgical treatment. However, the complexity of salvage radical prostatectomy is considered to be greater than that of primary surgery, making it the least popular treatment of choice. With the wide use of robotic platforms in urologic oncologic surgery, salvage radical prostatectomy has attracted attention again because, compared to past data, modern series involving salvage Robot-Assisted Radical Prostatectomy have shown promising results. In this narrative literature review, we comprehensively examined data on salvage radical prostatectomy. We investigated the correlation between the different types of primary prostate cancer therapy and the following salvage radical prostatectomy. Furthermore, we explored the concept of a robotic approach and its beneficial effect in salvage surgery. Lastly, we emphasized several promising avenues for future research in this field.

Facilitating knowledge transfer: decision support tools in environment and health.

The HENVINET Health and Environment Network aimed to enhance the use of scientific knowledge in environmental health for policy making. One of the goals was to identify and evaluate Decision Support Tools (DST) in current use. Special attention was paid to four "priority" health issues: asthma and allergies, cancer, neurodevelopment disorders, and endocrine disruptors.We identified a variety of tools that are used for decision making at various levels and by various stakeholders. We developed a common framework for information acquisition about DSTs, translated this to a database structure and collected the information in an online Metadata Base (MDB).The primary product is an open access web-based MDB currently filled with 67 DSTs, accessible through the HENVINET networking portal http://www.henvinet.eu and http://henvinet.nilu.no. Quality assurance and control of the entries and evaluation of requirements to use the DSTs were also a focus of the work. The HENVINET DST MDB is an open product that enables the public to get basic information about the DSTs, and to search the DSTs using pre-designed attributes or free text. Registered users are able to 1) review and comment on existing DSTs; 2) evaluate each DST's functionalities, and 3) add new DSTs, or change the entry for their own DSTs. Assessment of the available 67 DSTs showed: 1) more than 25% of the DSTs address only one pollution source; 2) 25% of the DSTs address only one environmental stressor; 3) almost 50% of the DSTs are only applied to one disease; 4) 41% of the DSTs can only be applied to one decision making area; 5) 60% of the DSTs' results are used only by national authority and/or municipality/urban level administration; 6) almost half of the DSTs are used only by environmental professionals and researchers. This indicates that there is a need to develop DSTs covering an increasing number of pollution sources, environmental stressors and health end points, and considering links to other 'Driving forces-Pressures-State-Exposure-Effects-Actions' (DPSEEA) elements. Of interest to both researchers and decision makers should be the standardization of the way DSTs are described for easier access to the knowledge, and the identification of coverage gaps.

Mathematical Modelling and Simulation of Atherosclerosis Formation and Progress: A Review.

Cardiovascular disease (CVD) is a major threat to human health since it is the leading cause of death in western countries. Atherosclerosis is a type of CVD related to hypertension, diabetes, high levels of cholesterol, smoking, oxidative stress, and age. Atherosclerosis primarily occurs in medium and large arteries, such as coronary and the carotid artery and, in particular, at bifurcations and curvatures. Atherosclerosis is compared to an inflammatory disease where a thick, porous material comprising cholesterol fat, saturated sterols, proteins, fatty acids, calcium etc., is covered by an endothelial membrane and a fragile fibrous tissue which makes atheromatic plaque prone to rupture that could lead to the blockage of the artery due to the released plaque material. Despite the great progress achieved, the nature of the disease is not fully understood. This paper reviews the current state of modelling of all levels of atherosclerosis formation and progress and discusses further challenges in atherosclerosis modelling. The objective is to pave a way towards more precise computational tools to predict and eventually reengineer the fate of atherosclerosis.

Vascular wall flow-induced forces in a progressively enlarged aneurysm model.

The current study is focused on the numerical investigation of the flow field induced by the unsteady flow in the vicinity of an abdominal aortic aneurysm model. The computational fluid dynamics code used is based on the finite volume method, and it has already been used in various bioflow studies. For modelling the rheological behaviour of blood, the Quemada non-Newtonian model is employed, which is suitable for simulating the two-phase character of blood namely a suspension of blood cells in plasma. For examining its non-Newtonian effects a comparison with a corresponding Newtonian flow is carried out. Furthermore, the investigation is focused on the distribution of the flow-induced forces on the interior wall of the aneurysm and in order to study the development of the distribution with the gradual enlargement of the aneurysm, three different degrees of aneurysm-growth have been assumed. Finally and for examining the effect of the distribution on the aneurysm growth, a comparison is made between the pressure and wall shear-stress distributions at the wall for each growth-degree.

A simple mechanistic model of deposition of water-soluble aerosol particles in the mouth and throat.

Aerosol drugs are usually delivered to the lung by inhalation via the oral route, since aerosol deposition is much lower in the oral than in nasal airways. In the present study a practical, non-CFD-based, mechanistic model is developed, which permits an efficient calculation of deposition along the oral route with simple computational means. A simplified geometrical description of the mouth and throat region is used, based on a sequence of conducting ducts. The numerical model takes into account aerosol dynamics, which enables to express the impact on aerosol transport and deposition of the hygroscopic growth of water-soluble particles. Simulations are made for coarse particles in the range 1-17 microm, and the model predictions are found in good agreement with the available experimental data. The model predicts inertial impaction to be the dominant mechanism, and correctly reproduces the increase in the deposition with an increasing flow rate and particle diameter. Higher deposition is calculated in the oropharyngeal region than the laryngeal region, due to the significant flow direction change and constriction at the end of the oral cavity. According to the model, highly soluble particles may deposit up to 50% more than inert aerosols in the mouth-throat region. The proposed model will be useful for quick, practical calculations of deposition with a full account of aerosol dynamical processes.

Modeling of occupational exposure to accidentally released manufactured nanomaterials in a production facility and calculation of internal doses by inhalation.

BACKGROUND: Occupational exposure to manufactured nanomaterials (MNMs) and its potential health impacts are of scientific and practical interest, as previous epidemiological studies associate exposure to nanoparticles with health effects, including increased morbidity of the respiratory and the circulatory system. OBJECTIVES: To estimate the occupational exposure and effective internal doses in a real production facility of TiO2 MNMs during hypothetical scenarios of accidental release. METHODS: Commercial software for geometry and mesh generation, as well as fluid flow and particle dispersion calculation, were used to estimate occupational exposure to MNMs. The results were introduced to in-house software to calculate internal doses in the human respiratory tract by inhalation. RESULTS: Depending on the accidental scenario, different areas of the production facility were affected by the released MNMs, with a higher dose exposure among individuals closer to the particles source. CONCLUSIONS: Granted that the study of the accidental release of particles can only be performed by chance, this numerical approach provides valuable information regarding occupational exposure and contributes to better protection of personnel. The methodology can be used to identify occupational settings where the exposure to MNMs would be high during accidents, providing insight to health and safety officials.

Comparison of blood rheological models for physiological flow simulation.

The present study investigates the flow effects that different blood constitutive equations induce when employed in numerical simulations in the framework of computational hemodynamics. In accord with experimental studies on the rheological behavior of blood, three blood constitutive equations namely the Casson, Power-Law and Quemada models were used for simulating the shear flow behavior of blood. The case studied is the flow in a channel with a moving part of the boundary and was selected because it reproduces the flow phenomena occurring in realistic arterial conditions. Flow simulation for every model is carried out assuming the same flow rate at the inlet of the channel and different Strouhal numbers reflecting different intensities of the boundary movement. Results show that the modeling of blood as non-Newtonian fluid has marked qualitative and quantitative effects on both the flow field and the wall shear stress whereas comparison of the different models shows good agreement between the flow effects by the Casson and Quemada models.

A novel method for the generation of multi-block computational structured grids from medical imaging of arterial bifurcations.

In this study a description of a new approach, for the generation of multi-block structured computational grids on patient-specific bifurcation geometries is presented. The structured grid generation technique is applied to data obtained by medical imaging examination, resulting in a surface conforming, high quality, multi-block structured grid of the branching geometry. As a case study application a patient specific abdominal aorta bifurcation is selected. For the evaluation of the grid produced by the novel method, a grid convergence study and a comparison between the grid produced by the method and unstructured grids produced by commercial meshing software are carried out.