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Rasse T, Niederwanger L, Hornung J, Taha L, Arndt S, Offergeld C, Beutner D, Bevis N, Lenarz T, Teschner M, Schimanski E, Georg Sprinzl, Magele A, Skarżyński PH, Plichta Ł, Arnoldner C, Riss D, Loader B, Windisch F, Rubicz N, Zwittag PM. Short-term safety and effectiveness of the mCLIP partial prosthesis. Eur Arch Otorhinolaryngol 2024; 281:2353-2363. [PMID: 38133806 PMCID: PMC11024005 DOI: 10.1007/s00405-023-08359-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP Partial Prosthesis. METHODS Patients underwent tympanoplasty with implantation of a mCLIP Partial Prosthesis. Follow-up examination included ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. Thus, the follow-up times of each study center were different, which resulted in different follow-up times for the audiological analysis and for adverse events (AE). RESULTS 72 (66 adults, 6 children) patients were implanted with the mCLIP Partial Prosthesis. 68 (62 adults, 6 children) patients underwent audiological examination; all 72 patients were examined for adverse events. All patients (N = 68): 72.1% of the patients showed a PTA4 ABG of ≤ 20 dB. Individual post-operative bone conduction (BC) PTA4 thresholds were stable in 67 patients. The mean post-operative follow-up time was 78 ± 46 days. Children (N = 6): 5 out of 6 children showed a PTA4 ABG of ≤ 20 dB. None of the children reported a BC PTA4 deterioration of > 10 dB HL after the implantation. The mean post-operative follow-up time was 101 ± 45 days. Adverse events (all patients, N = 72): 15 (14 adults, 1 child) patients had AEs (27 AEs and 2 Follow-Ups). The mean post-operative follow-up time was 375 days. CONCLUSION Clinical data show satisfactory audiological parameters after implantation of the mCLIP Partial Prosthesis. The prosthesis is safe and effective for implantation in children and adults. TRIAL REGISTRATION NUMBER NCT05565339, 09 September 2022, retrospectively registered.
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Affiliation(s)
- Thomas Rasse
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600, Wels, Austria
| | - Lisa Niederwanger
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600, Wels, Austria
| | - Joachim Hornung
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Lava Taha
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Susan Arndt
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Christian Offergeld
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Dirk Beutner
- Department of Otolaryngology, University of Goettingen, 37075, Göttingen, Germany
| | - Nicholas Bevis
- Department of Otolaryngology, University of Goettingen, 37075, Göttingen, Germany
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, 30625, Hannover, Germany
| | - Magnus Teschner
- Department of Otolaryngology, Hannover Medical School, 30625, Hannover, Germany
- Department of Otolaryngology, Head and Neck Surgery, Stiftungsklinikum Proselis, Prosper-Hospital Recklinghausen, Recklinghausen, Germany
| | - Esther Schimanski
- Zentrum Fuer Mittelohrchirurgie (Centre for Middle Ear Surgery), ENT Practice, 44536, Luenen, Germany
| | - Georg Sprinzl
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic St. Poelten, 3100, St. Pölten, Austria
| | - Astrid Magele
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic St. Poelten, 3100, St. Pölten, Austria
| | - Piotr H Skarżyński
- Clinical Trials Department, Center of Hearing and Speech MEDINCUS, Kayetany, Poland
- Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
- Institute of Sensory Organs, Kajetany, Poland
- Faculty of Dental Medicine, Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Plichta
- World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Medical University of Vienna, 1090, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Medical University of Vienna, 1090, Vienna, Austria
| | - Benjamin Loader
- Department of Otorhinolaryngology, Head and Neck Surgery, 1030 Wiener Gesundheitsverbund, Klinik Landstraße, 1030, Vienna, Austria
| | - Franz Windisch
- Department of Otorhinolaryngology, Head and Neck Surgery, 1030 Wiener Gesundheitsverbund, Klinik Landstraße, 1030, Vienna, Austria
| | - Nina Rubicz
- Department of Otorhinolaryngology, Head and Neck Surgery, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria
- Medical Faculty, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Paul Martin Zwittag
- Department of Otorhinolaryngology, Head and Neck Surgery, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.
- Medical Faculty, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria.
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Erdmann L, Santos PI, Rieper P, Klafki HW, Beutner D, Wiltfang J, Outeiro TF, Setz C. Automated Capillary Electrophoresis Immunoblot for the Detection of Alpha-Synuclein in Mouse Tissue. J Parkinsons Dis 2024:JPD230379. [PMID: 38578903 DOI: 10.3233/jpd-230379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Background Alpha-synuclein (aSyn) is a key player in neurodegenerative diseases such as Parkinson's disease (PD), dementia with Lewy bodies, or multiple system atrophy. aSyn is expressed throughout the brain, and can also be detected in various peripheral tissues. In fact, initial symptoms of PD are non-motoric and include autonomic dysfunction, suggesting that the periphery might play an important role in early development of the disease. aSyn is expressed at relatively low levels in non-central tissues, which brings challenges for its detection and quantification in different tissues. Objective Our goal was to assess the sensitivity of aSyn detection in central and peripheral mouse tissues through capillary electrophoresis (CE) immunoblot, considering the traditional SDS-PAGE immunoblot as the current standard. Methods Tissues from central and non-central origin from wild type mice were extracted, and included midbrain, inner ear, and esophagus/stomach. aSyn detection was assessed through immunoblotting using Simple Western size-based CE and SDS-PAGE. Results CE immunoblots show a consistent detection of aSyn in central and peripheral tissues. Through SDS-PAGE, immunoblots revealed a reliable signal corresponding to aSyn, particularly following membrane fixation. Conclusion Our results suggest a reliable detection of aSyn in central and peripheral tissues using the CE Simple Western immunoblot system. These observations can serve as preliminary datasets when aiming to formally compare CE with SDS-PAGE, as well as for further characterization of aSyn using this technique.
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Affiliation(s)
- Leonie Erdmann
- Department of Experimental Neurodegeneration, University Medical Center Göttingen, Center for Biostructural Imaging of Neurodegeneration, Göttingen, Germany
| | - Patrícia I Santos
- Department of Experimental Neurodegeneration, University Medical Center Göttingen, Center for Biostructural Imaging of Neurodegeneration, Göttingen, Germany
| | - Petra Rieper
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Hans W Klafki
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Beutner
- Department of Otolaryngology-Head and Neck Surgery, University Medical Center Göttingen, Inner Ear Lab, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, University Medical Center Göttingen, Center for Biostructural Imaging of Neurodegeneration, Göttingen, Germany
- Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Cristian Setz
- Department of Otolaryngology-Head and Neck Surgery, University Medical Center Göttingen, Inner Ear Lab, Göttingen, Germany
- Department of Experimental Neurodegeneration, University Medical Center Göttingen, Center for Biostructural Imaging of Neurodegeneration, Göttingen, Germany
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Wiechens B, Backhaus SJ, Oestreicher D, Beutner D, Schliephake H, Meyer-Marcotty P, Brockmeyer P. Assessment of oropharyngeal respiratory volume and sleep apnoea scores using peripheral arterial tonometry may improve diagnosis and treatment planning of combined dysgnathia therapy approaches. J Oral Rehabil 2024; 51:733-742. [PMID: 38100245 DOI: 10.1111/joor.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Increased daytime sleepiness is a frequently reported symptom in patients with pronounced dysgnathia. OBJECTIVES This study investigated possible correlations using home peripheral arterial tonometry (PAT) and oropharyngeal airway volume determination in patients with dysgnathia and daytime sleepiness. METHODS Twenty patients (13 male, median age 27.6 ± 6.8 years) with abnormal sleep history and 10 skeletal neutral configured controls (6 male, median age 29.5 ± 4.2 years) with normal sleep history were examined. Patients and controls were evaluated for apnoea-hypopnoea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), snoring volume (dB), total sleep time (TST) and REM-percentage (REM). Airway volumetry was measured via CBCT. Individual user experience for PAT was assessed using the User Experience Questionnaire (UEQ). RESULTS Patients had significantly higher respiratory scores than controls. AHI increased 4.6-fold (p = .006), RDI 2.5-fold (p = .008) and ODI 6.4-fold (p < .001). Oropharyngeal volumes showed a 30% decrease (p = .003). dB, TST and REM showed no significant differences. AHI (r = -.51; p = .005), ODI (r = -.60; p < .001) and RDI (r = -.45; p = .016) correlated negatively with pharyngeal volume. Wits appraisal correlated negatively with oropharyngeal volume (r = -.47; p = .010) and positively with AHI (r = .41; p = .03) and ODI (r = .49; p = .007). dB and TST (r = -.49; p = .008) and REM and RDI (r = -.43; p = .02) correlated negatively. UEQ-KPI (2.17 ± 0.24) confirmed excellent usability of PAT. CONCLUSION Patients with mandibular retrognathia and abnormal sleep history showed significantly higher respiratory indices and smaller oropharyngeal volumes than neutrally configured controls. The dygnathia severity directly influenced the risk of obstructive sleep apnoea.
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Affiliation(s)
- Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Sören J Backhaus
- Department of Cardiology and Pneumology University Medical Center Goettingen, Goettingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Goettingen, Goettingen, Germany
| | - David Oestreicher
- Department of Otorhinolaryngology, University Medical Center Goettingen, Goettingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, University Medical Center Goettingen, Goettingen, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
| | | | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
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Dombrowski T, Pursche N, Beutner C, Beutner D. [High interaction potential of online-only courses with breakout sessions-results of a pilot study]. HNO 2024; 72:173-181. [PMID: 38260983 PMCID: PMC10879270 DOI: 10.1007/s00106-023-01407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The flipped classroom (FC) is nowadays a popular principle of blended student-centered learning. Students first prepare basic knowledge at home and subsequently meet for consolidation and a more in-depth look at a certain topic. During the COVID-19 pandemic, several groups developed approaches to also transform the characteristic FC second session into an online-only format. OBJECTIVE Herein, we present a pilot study on establishing an online-only FC format with elements of collaborative learning and its evaluation by medical students. MATERIALS AND METHODS The FC design related to diseases of the salivary glands was transformed into an online-only event. After studying the basic information online, supported by self-made interactive videos and/or lecture recordings, students met in a video conference enriched by breakout sessions, interactive demonstration of the related clinical examination including ultrasound, and a formative assessment. A questionnaire with 27 items was answered by participants to evaluate the concept and the event. RESULTS Use of common hard- and software systems led to a technically stable video conference. A total of 55 students completed the questionnaire and were included into data analysis. During the breakout sessions, lively interaction between participants was observed. The evaluation of both the event itself and the related learning progress showed good results despite the lack of preparation beforehand in 27% of participants. CONCLUSION Online-only FC designs can result in high satisfaction. High quality of online preparation, a solid technical platform, accurate time management, and a reasonable selection of topics are the main parameters contributing to successful course design. Nowadays, embedding medical imaging can be realized in appropriate quality for educational purposes. The implementation of breakout sessions and voting tools enables collaborative online learning with high levels of interaction and satisfaction for both teachers and students.
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Affiliation(s)
- Tobias Dombrowski
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
| | - Nils Pursche
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - Caroline Beutner
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Dirk Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
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Bevis N, Effertz T, Hüser M, Beutner D. Partial Ossicular Reconstruction With a Novel Ball Joint Prosthesis: The mCLIP ARC Partial Prosthesis. Laryngoscope 2024. [PMID: 38265185 DOI: 10.1002/lary.31301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/30/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Middle ear surgery involves reconstruction of the ossicular chain, predominately using rigid implants. New middle ear prostheses strive to mimic the physiologic micromovements of the ossicular chain and prevent dislocation, protrusion, and preloading of the annular ligament due to pressure fluctuations. METHODS Thirty-five patients were included in a monocentric, prospective observational study. Patients received tympanoplasty with ossicular reconstruction using the mCLIP ARC partial prosthesis. This titanium prosthesis is equipped with a clip mechanism for coupling at the stapes and a ball joint connecting headplate and shaft. At short-term (ST) and mid-term (MT) follow-up, pure-tone audiometry was performed and the pure tone average of 0.5, 1, 2, and 3 kHz (PTA4) was calculated. The audiological outcome was compared with retrospective data of the Dresden titanium clip prosthesis. RESULTS The new prosthesis shows favorable clinical results. Pure-tone audiometry showed satisfactory results in ST and MT follow-up, with the PTA4 air-bone gap (ABG) decreasing from 24.5 (±11) dB to 17.4 (±7.9) dB at the ST follow-up at 27 days to 15.6 (±10.3) dB at MT follow-up at 196 days (n = 32). A PTA4-ABG value of less than 20 dB was achieved by 63% of patients at ST follow-up and by 77% at MT follow-up. There was no significant difference in PTA4 ABG compared to the Dresden titanium clip prosthesis during ST follow-up (p = 0.18). CONCLUSION The mCLIP ARC partial prosthesis, a new middle ear prosthesis with a balanced ball joint, shows promising audiological results and is a safe and effective choice for patients with chronic ear disease. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- Nicholas Bevis
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, 37075, Göttingen, Germany
| | - Thomas Effertz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, 37075, Göttingen, Germany
| | - Marc Hüser
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, 37075, Göttingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, 37075, Göttingen, Germany
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Netzer C, von Arps-Aubert V, Mačinković I, von der Grün J, Küffer S, Ströbel P, von Knethen A, Weigert A, Beutner D. Association between spatial distribution of leukocyte subsets and clinical presentation of head and neck squamous cell carcinoma. Front Immunol 2024; 14:1240394. [PMID: 38322012 PMCID: PMC10844964 DOI: 10.3389/fimmu.2023.1240394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/28/2023] [Indexed: 02/08/2024] Open
Abstract
Background Interactions between tumor cells and cells in the microenvironment contribute to tumor development and metastasis. The spatial arrangement of individual cells in relation to each other influences the likelihood of whether and how these cells interact with each other. Methods This study investigated the effect of spatial distribution on the function of leukocyte subsets in the microenvironment of human head and neck squamous cell carcinoma (HNSCC) using multiplex immunohistochemistry (IHC). Leukocyte subsets were further classified based on analysis of two previously published HNSCC single-cell RNA datasets and flow cytometry (FC). Results IHC revealed distinct distribution patterns of leukocytes differentiated by CD68 and CD163. While CD68hiCD163lo and CD68hiCD163hi cells accumulated near tumor sites, CD68loCD163hi cells were more evenly distributed in the tumor stroma. PD-L1hi and PD-1hi cells accumulated predominantly around tumor sites. High cell density of PD-L1hi CD68hiCD163hi cells or PD-1hi T cells near the tumor site correlated with improved survival. FC and single cell RNA revealed high variability within the CD68/CD163 subsets. CD68hiCD163lo and CD68hiCD163hi cells were predominantly macrophages (MΦ), whereas CD68loCD163hi cells appeared to be predominantly dendritic cells (DCs). Differentiation based on CD64, CD80, CD163, and CD206 revealed that TAM in HNSCC occupy a broad spectrum within the classical M1/M2 polarization. Notably, the MΦ subsets expressed predominantly CD206 and little CD80. The opposite was observed in the DC subsets. Conclusion The distribution patterns and their distinct interactions via the PD-L1/PD-1 pathway suggest divergent roles of CD68/CD163 subsets in the HNSCC microenvironment. PD-L1/PD-1 interactions appear to occur primarily between specific cell types close to the tumor site. Whether PD-L1/PD-1 interactions have a positive or negative impact on patient survival appears to depend on both the spatial localization and the entity of the interacting cells. Co-expression of other markers, particularly CD80 and CD206, supports the hypothesis that CD68/CD163 IHC subsets have distinct functions. These results highlight the association between spatial leukocyte distribution patterns and the clinical presentation of HNSCC.
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Affiliation(s)
- Christoph Netzer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Vanessa von Arps-Aubert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Igor Mačinković
- Institute of Biochemistry I, Faculty of Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Jens von der Grün
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Frankfurt, Germany
| | - Stefan Küffer
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Philipp Ströbel
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas von Knethen
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Andreas Weigert
- Institute of Biochemistry I, Faculty of Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
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Kanzow P, Mielke K, Haupt F, Wiegand S, Schliephake H, Beutner D, Wiegand A. Oral health in patients with different sites of head and neck squamous cell carcinoma is not different. PLoS One 2023; 18:e0293665. [PMID: 37883511 PMCID: PMC10602310 DOI: 10.1371/journal.pone.0293665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
Oral health might not only act as risk factor for head and neck squamous cell carcinoma (HNSCC), but might also have a predictive value for the patients' survival. Currently, information on the effect of oral health on survival of patients with different sites of HNSCC is lacking. This single-center retrospective study aimed to compare oral health in patients with different sites of HNSCC and to analyse whether oral health is associated with survival in the different subsets of HNSCC patients. Dental records of HNSCC patients referred for dental assessment prior to radio(chemo)therapy were included. Patient-related parameters (age at time of diagnosis, sex, tobacco exposure, alcohol consumption, HPV status), treatment data (primary treatment, intent), performance status, tumor demographics (anatomical site, TNM staging), and oral health parameters (DMFT, periodontal health, teeth with/without root canal treatment and with/without periodontitis apicalis) were obtained. Oral health parameters were compared between different anatomical sites. Survival of all HNSCC patients and of individual subsets was assessed using Kaplan-Meier statistics, and the effect of tumor demographics, patient-related parameters, and oral health on survival was analysed by cox regression analyses (α = 5%). 371 patients with HNSCC (oral: n = 86, oropharyngeal: n = 174, hypopharyngeal: n = 59, laryngeal: n = 15, other: n = 37) were included. Oral health parameters did not differ between subsets (padj.≥0.199). Five-year cumulative survival of HNSCC patients amounted to 78.6%. Only for HNSCC originating in the oral cavity and oropharynx, survival was associated with the treatment intent (p = 0.015) or performance status (p = 0.007) in the multivariable analyses, respectively. Within the limitations of this study, oral health was not different between different subsets and had no significant effect on survival of HNSCC patients.
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Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Katharina Mielke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Susanne Wiegand
- Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Beutner C, Wrobel C, Dombrowski T, Beutner D, Forkel S, Buhl T. Inconsistent Skin Prick Tests for Allergy to Birch Homologous Trees May Result from Cross-Reacting Allergens or Technical Errors. Int Arch Allergy Immunol 2023; 184:841-848. [PMID: 37271127 DOI: 10.1159/000530201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/15/2023] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Skin prick tests (SPTs) are the gold standard for diagnosis of allergic rhinitis (AR). A decrease in the number of allergens included in standard SPT panels has recently been debated - particularly regarding the cross-reacting homologous pollen from birch, alder, and hazel trees - but has not yet been implemented in clinical guidelines. METHODS A subgroup of patients with AR (n = 69) who showed inconsistent SPT results among birch, alder, and hazel was investigated in detail. Beyond SPT, patient workup included assessment of clinical relevance and various serological parameters (total IgE, and specific IgE to birch, alder, and hazel and to Bet v 1, Bet v 2, and Bet v 4). RESULTS More than half the study group had negative SPT results for birch but positive results for alder and/or hazel, and 87% of the study group was polysensitized, showing at least one more positive SPT result for other plants. Whereas 30.4% of patients showed serological sensitization to birch pollen extract, only 18.8% displayed positive specific IgE to Bet v 1. Clinical assessment revealed that most patients with AR were polysensitized and had perennial symptoms or symptoms also occurring during times other than tree flowering times. If the SPT panel is limited to testing birch only, 52.2% of patients in this subgroup would have been overlooked. CONCLUSION Inconsistent SPT results in the birch homologous group may result from cross-reacting allergens or technical errors. If patients report convincing clinical symptoms despite negative results from a reduced SPT panel or inconsistent results for homologous allergens, SPT should be repeated, and molecular markers should be added to achieve a correct diagnosis.
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Affiliation(s)
- Caroline Beutner
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Wrobel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Tobias Dombrowski
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Susann Forkel
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Stachelscheid J, Jiang Q, Aszyk C, Warner K, Bley N, Müller T, Vydzhak O, Symeonidis K, Crispatzu G, Mayer P, Blakemore SJ, Goehring G, Newrzela S, Hippler S, Robrecht S, Kreuzer KA, Pallasch C, Krüger M, Lechner A, Fischer K, Stilgenbauer S, Beutner D, Hallek M, Auguin D, Hüttelmaier S, Bloehdorn J, Vasyutina E, Herling M. The proto-oncogene TCL1A deregulates cell cycle and genomic stability in CLL. Blood 2023; 141:1425-1441. [PMID: 36179280 DOI: 10.1182/blood.2022015494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/05/2022] [Accepted: 09/04/2022] [Indexed: 11/20/2022] Open
Abstract
Upregulation of the proto-oncogene T-cell leukemia/lymphoma 1A (TCL1A) is causally implicated in various B-cell and T-cell malignancies. High-level TCL1A correlates with aggressive disease features and inferior clinical outcomes. However, the molecular and cell biological consequences of, particularly nuclear, TCL1A are not fully elucidated. We observed here in mouse models of subcellular site-specific TCL1A-induced lymphomagenesis that TCL1A exerts a strong transforming impact via nuclear topography. In proteomic screens of TCL1A-bound molecules in chronic lymphocytic leukemia (CLL) cells and B-cell lymphoma lines, we identified regulators of cell cycle and DNA repair pathways as novel TCL1A interactors, particularly enriched under induced DNA damage and mitosis. By functional mapping and in silico modeling, we specifically identified the mitotic checkpoint protein, cell division cycle 20 (CDC20), as a direct TCL1A interactor. According to the regulatory impact of TCL1A on the activity of the CDC20-containing mitotic checkpoint and anaphase-promoting complexes during mitotic progression, TCL1A overexpression accelerated cell cycle transition in B-cell lymphoma lines, impaired apoptotic damage responses in association with pronounced chromosome missegregation, and caused cellular aneuploidy in Eμ-TCL1A mice. Among hematopoietic cancers, CDC20 levels seem particularly low in CLL. CDC20 expression negatively correlated with TCL1A and lower expression marked more aggressive and genomically instable disease and cellular phenotypes. Knockdown of Cdc20 in TCL1A-initiated murine CLL promoted aneuploidy and leukemic acceleration. Taken together, we discovered a novel cell cycle-associated effect of TCL1A abrogating controlled cell cycle transition. This adds to our concept of oncogenic TCL1A by targeting genome stability. Overall, we propose that TCL1A acts as a pleiotropic adapter molecule with a synergistic net effect of multiple hijacked pathways.
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Affiliation(s)
- Johanna Stachelscheid
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Qu Jiang
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Christoph Aszyk
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Kathrin Warner
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Senckenberg Institute of Pathology, Goethe-University, Frankfurt am Main, Germany
| | - Nadine Bley
- Section for Molecular Cell Biology, Institute of Molecular Medicine, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Charles Tanford Protein Center, Halle, Germany
| | - Tony Müller
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Olga Vydzhak
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Konstantinos Symeonidis
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Giuliano Crispatzu
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Petra Mayer
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Stuart James Blakemore
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Gudrun Goehring
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Sebastian Newrzela
- Senckenberg Institute of Pathology, Goethe-University, Frankfurt am Main, Germany
| | - Stephanie Hippler
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
| | - Sandra Robrecht
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
| | - Karl-Anton Kreuzer
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
| | - Christian Pallasch
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Marcus Krüger
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Axel Lechner
- Department of Otorhinolaryngology, University of Göttingen, Göttingen, Germany
| | - Kirsten Fischer
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
| | - Stephan Stilgenbauer
- Department of Internal Medicine III, Ulm University, Ulm, Germany
- Department of Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, University of Göttingen, Göttingen, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Daniel Auguin
- Université d'Orléans, INRA, USC1328, Orléans, France
- Structural Motility, Institut Curie, Paris Université Sciences et Lettres, Sorbonne Université, CNRS, Paris, France
| | - Stefan Hüttelmaier
- Section for Molecular Cell Biology, Institute of Molecular Medicine, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Charles Tanford Protein Center, Halle, Germany
| | | | - Elena Vasyutina
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Marco Herling
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Department of Hematology, Cellular Therapy, and Hemostaseology, University of Leipzig, Leipzig, Germany
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Chepurwar S, von Loh SM, Wigger DC, Neef J, Frommolt P, Beutner D, Lang-Roth R, Kubisch C, Strenzke N, Volk AE. A mutation in ATP11A causes autosomal-dominant auditory neuropathy type 2. Hum Mol Genet 2023; 32:1083-1089. [PMID: 36300302 DOI: 10.1093/hmg/ddac267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/06/2022] [Accepted: 10/24/2022] [Indexed: 11/14/2022] Open
Abstract
Auditory synaptopathy/neuropathy (AS/AN) is a distinct type of sensorineural hearing loss in which the cochlear sensitivity to sound (i.e. active cochlear amplification by outer hair cells) is preserved whereas sound encoding by inner hair cells and/or auditory nerve fibers is disrupted owing to genetic or environmental factors. Autosomal-dominant auditory neuropathy type 2 (AUNA2) was linked either to chromosomal bands 12q24 or 13q34 in a large German family in 2017. By whole-genome sequencing, we now detected a 5500 bp deletion in ATP11A on chromosome 13q34 segregating with the phenotype in this family. ATP11A encodes a P-type ATPase that translocates phospholipids from the exoplasmic to the cytoplasmic leaflet of the plasma membrane. The deletion affects both isoforms of ATP11A and activates a cryptic splice site leading to the formation of an alternative last exon. ATP11A carrying the altered C-terminus loses its flippase activity for phosphatidylserine. Atp11a is expressed in fibers and synaptic contacts of the auditory nerve and in the cochlear nucleus in mice, and conditional Atp11a knockout mice show a progressive reduction of the spiral ganglion neuron compound action potential, recapitulating the human phenotype of AN. By combining whole-genome sequencing, immunohistochemistry, in vitro functional assays and generation of a mouse model, we could thus identify a partial deletion of ATP11A as the genetic cause of AUNA2.
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Affiliation(s)
- Shashank Chepurwar
- Institute for Auditory Neuroscience and SFB889, Göttingen University Medical Center, Göttingen 37075, Germany
| | - Sarah M von Loh
- Institute for Human Genetics, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Daniela C Wigger
- Institute of Human Genetics, University of Ulm, Ulm 89081, Germany
| | - Jakob Neef
- Institute for Auditory Neuroscience and SFB889, Göttingen University Medical Center, Göttingen 37075, Germany
| | - Peter Frommolt
- Institute for Human Genetics, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, Göttingen University Medical Center, Göttingen 37075, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne 50931, Germany
| | - Ruth Lang-Roth
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne 50931, Germany
| | - Christian Kubisch
- Institute for Human Genetics, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Nicola Strenzke
- Institute for Auditory Neuroscience and SFB889, Göttingen University Medical Center, Göttingen 37075, Germany
| | - Alexander E Volk
- Institute for Human Genetics, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
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Dombrowski T, Pursche N, Beutner D, Bevis N. [Advanced head and neck ultrasound technique: strain elastography]. Laryngorhinootologie 2023. [PMID: 36913969 DOI: 10.1055/a-1971-1390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
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Kanzow P, Mielke K, Hrasky V, Wiegand S, Schliephake H, Beutner D, Wiegand A. Oral health in HPV-positive and HPV-negative patients with oropharyngeal squamous cell carcinoma. Front Oncol 2023; 13:1083067. [PMID: 36776286 PMCID: PMC9909218 DOI: 10.3389/fonc.2023.1083067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
This study compared oral health in oropharyngeal squamous cell carcinoma (OPSCC) patients with positive or negative human papillomavirus (HPV) status and analysed whether oral health was associated with survival. Patients referred for dental assessment prior to radio(chemo)therapy between 2009 and 2019 were included. Patient-related risk factors for OPSCC (alcohol, tobacco, HPV status), age, sex, treatment (primary treatment, intent), performance status, tumor/node/metastasis (TNM) staging, and oral health parameters (DMFT, periodontal status, teeth with/without root canal treatment and with/without periodontitis apicalis) were compared between HPV-negative and HPV-positive patients. Survival was assessed using Kaplan-Meier statistics. The effect of patient-related risk factors and oral health parameters was analysed by cox regression analyses (α=5%). A total of 119 patients (n=50 HPV-negative, n=69 HPV-positive) was included. HPV-positive patients showed more present teeth, a higher number of filled teeth, were less often edentulous and presented a lower DMFT compared to HPV-negative patients (padj.≤0.003). Among dentulous patients, HPV-positive patients showed more present teeth and fewer teeth with periodontitis apicalis lacking a root canal treatment (padj.≤0.036). Survival probability differed between groups (p=0.006) and trended towards being associated with HPV status, tobacco exposure, performance status, T stage, N stage, and the number of missing or filled teeth as well as the number of root canal treated teeth with periodontitis apicalis and the number of teeth with periodontitis apicalis lacking a root canal treatment (p≤0.077). However, only tobacco exposure, performance status, and the number of teeth with periodontitis apicalis lacking a root canal treatment in dentulous patients remained significant in the multivariate analyses (p≤0.047). HPV-negative patients with OPSCC showed a poorer oral health compared to HPV-positive patients, but survival was not associated with oral health.
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Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany,*Correspondence: Philipp Kanzow,
| | - Katharina Mielke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Valentina Hrasky
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Susanne Wiegand
- Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Bevis N, Effertz T, Beutner D. A Partial Ossicular Replacement Prosthesis With a Concentric Ball Joint in the Headplate. Laryngoscope 2022. [PMID: 36125256 DOI: 10.1002/lary.30390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In passive middle ear prosthetics, rigid implants have proven successful in reconstructing the ossicular chain. However, these cannot fully replicate the physiology of the ossicular chain. Pressure fluctuations cause high stresses in rigid passive prostheses, which can result in dislocation, protrusion, and pre-tension in the annular ligament resulting in unsatisfactory hearing results. METHODS In collaboration with MED-EL, we developed a new passive middle ear prosthesis that features a balanced, centered ball joint between the headplate and shaft of the prosthesis. We compared the sound transmission properties of this new prosthesis with those of a standard rigid prosthesis. Using Laser-Doppler-Vibrometry, we measured the sound-induced velocity of the stapes footplate relative to a given acoustic stimulus. RESULTS The new prosthesis showed equivalent sound transmission characteristics compared to the rigid prosthesis, whereas retaining the ability to compensate for pressure fluctuations due to its ball joint. This ensures good transmission properties even during displacements of the tympanic membrane. CONCLUSION This development is a further step toward a physiological reconstruction of the ossicular chain. LEVEL OF EVIDENCE N/A Laryngoscope, 2022.
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Affiliation(s)
- Nicholas Bevis
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Thomas Effertz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Goettingen, Goettingen, Germany
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Langer C, von der Heyde E, Hahn D, Kubuschok B, Bockmühl U, Mueller-Huesmann H, Klautke G, von der Grün J, Beutner D, Büntzel J, Busch CJ, Tamaskovics B, Riera Knorrenschild J, Gutsche K, Welslau M, Gauler T, Waldenberger D, Dietz A. 680P HANNA: Real-world data of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN), including first-line population, treated with nivolumab in Germany. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Wrobel C, Bevis NF, Klinge‐Strahl A, Strenzke N, Beutner D. Performance and self-perceived hearing impairment after cochlear implantation in Menière's disease. Laryngoscope Investig Otolaryngol 2022; 7:219-225. [PMID: 35155801 PMCID: PMC8823173 DOI: 10.1002/lio2.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/16/2021] [Accepted: 11/27/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Evaluation of the self-perceived hearing impairment and performance after cochlear implantation in patients with definite Menière's disease (MD). PATIENTS AND METHODS Seventeen unilaterally or bilaterally profoundly hearing-impaired patients suffering from MD who received a cochlear implantat (CI) were eligible for inclusion in this study. Their self-perceived hearing impairment using the short Speech Spatial and Qualities of Hearing Scale (SSQ12) as well as their performance in speech perception (German language Freiburger mono- and multisyllable test, Oldenburger sentence test) were compared with a best-matched control group of non-MD patients up to 24 months of follow-up. RESULTS MD patients improved significantly in perception of monosyllables presented at 65 dBSPL, from preoperatively best aided 18.2% [2.4, 34.0] to 51.7% [39.4, 63.9] 1 year after cochlear implantation (mean [95% confidence interval]). Their performance approached the matched controls with 63.2% [55.7, 70.8]. Monosyllables presented at a lower intensity of 55 dBSPL revealed a significant underperformance of the MD patients (21.1% [12.6, 29.6]) in contrast to the non-MD controls (39.1% [30.9, 47.4]) 12 months post-CI. Self-assessed hearing disability was significantly more pronounced in MD patients with a mean total SSQ12 score of 3.6 [2.4, 4.9] in comparison to 6.1 [5.4, 6.8] of the matched non-MD controls after 12 months of cochlear implantation. CONCLUSION Cochlear implantation substantially improves hearing capabilities in profoundly hearing-impaired patients with MD, but they tend to underperform in comparison to non-MD patients at least at lower sound pressure levels. This is likely one reason for the poorer self-assessed hearing function of cochlear implanted MD patients. LEVEL OF EVIDENCE 3, retrospective, nonrandomized follow-up study.
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Affiliation(s)
- Christian Wrobel
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Nicholas F. Bevis
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Astrid Klinge‐Strahl
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Nicola Strenzke
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
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16
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Geisthoff U, Al-Nawas B, Beutner D, Günzel T, Iro H, Koch M, Lell M, Luers JC, Schröder U, Sproll C, Teymoortash A, Ußmüller J, Vogl T, Wittekindt C, Zengel P, Zenk J, Guntinas-Lichius O. [Updated S2k AWMF guideline on obstructive sialadenitis]. Laryngorhinootologie 2021; 100:793-798. [PMID: 34614527 DOI: 10.1055/a-1298-4241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The update of this guideline was an important step to define standards for the use of sialendoscopy and other emerging minimally invasive techniques for the therapy of sialolithiasis and other obstructive salivary gland diseases. The current actualization was necessary to adapt the diagnostic and therapeutic algorithms to the current scientific knowledge. In this article they are presented in a shortened version with a focus on conservative therapeutic measures which are especially relevant for daily practice.
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Affiliation(s)
- Urban Geisthoff
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Gießen und Marburg - Standort Marburg, Germany
| | - Bilal Al-Nawas
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Plastische Operationen, Universitätsmedizin Mainz, Germany
| | - Dirk Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen Universitätsmedizin, Göttingen, Germany
| | - Thomas Günzel
- Belegabteilung Borromäus-Hospital Leer, HNO-Praxis Leer, Germany
| | - Heinrich Iro
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Koch
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Lell
- Institut für Radiologie und Nuklearmedizin, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - Jan Christoffer Luers
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie, Uniklinik Köln, Germany
| | - Ursula Schröder
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany
| | - Christoph Sproll
- Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum Düsseldorf, Germany
| | | | | | - Thomas Vogl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt, Germany
| | - Claus Wittekindt
- Hals-Nasen-Ohrenklinik, Städtisches Klinikum Dortmund gGmbH, Dortmund, Germany
| | | | - Johannes Zenk
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Augsburg, Germany
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17
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Bevis N, Sackmann B, Effertz T, Lauxmann M, Beutner D. The impact of tympanic membrane perforations on middle ear transfer function. Eur Arch Otorhinolaryngol 2021; 279:3399-3406. [PMID: 34570265 PMCID: PMC9130167 DOI: 10.1007/s00405-021-07078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
Purpose Injury or inflammation of the middle ear often results in the persistent tympanic membrane (TM) perforations, leading to conductive hearing loss (HL). However, in some cases the magnitude of HL exceeds that attributable by the TM perforation alone. The aim of the study is to better understand the effects of location and size of TM perforations on the sound transmission properties of the middle ear. Methods The middle ear transfer functions (METF) of six human temporal bones (TB) were compared before and after perforating the TM at different locations (anterior or posterior lower quadrant) and to different degrees (1 mm, ¼ of the TM, ½ of the TM, and full ablation). The sound-induced velocity of the stapes footplate was measured using single-point laser-Doppler-vibrometry (LDV). The METF were correlated with a Finite Element (FE) model of the middle ear, in which similar alterations were simulated. Results The measured and calculated METF showed frequency and perforation size dependent losses at all perforation locations. Starting at low frequencies, the loss expanded to higher frequencies with increased perforation size. In direct comparison, posterior TM perforations affected the transmission properties to a larger degree than anterior perforations. The asymmetry of the TM causes the malleus-incus complex to rotate and results in larger deflections in the posterior TM quadrants than in the anterior TM quadrants. Simulations in the FE model with a sealed cavity show that small perforations lead to a decrease in TM rigidity and thus to an increase in oscillation amplitude of the TM mainly above 1 kHz. Conclusion Size and location of TM perforations have a characteristic influence on the METF. The correlation of the experimental LDV measurements with an FE model contributes to a better understanding of the pathologic mechanisms of middle-ear diseases. If small perforations with significant HL are observed in daily clinical practice, additional middle ear pathologies should be considered. Further investigations on the loss of TM pretension due to perforations may be informative. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07078-9.
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Affiliation(s)
- Nicholas Bevis
- Department of Otolaryngology, University of Goettingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - Benjamin Sackmann
- Department of Mechanical Engineering, University of Reutlingen, 72762, Reutlingen, Germany
| | - Thomas Effertz
- Department of Otolaryngology, University of Goettingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Michael Lauxmann
- Department of Mechanical Engineering, University of Reutlingen, 72762, Reutlingen, Germany
| | - Dirk Beutner
- Department of Otolaryngology, University of Goettingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
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Müller-Huesmann H, von der Heyde E, Hahn D, Langer C, Kubuschok B, Bockmühl U, Klautke G, Mauz PS, Reuter B, Beutner D, Büntzel J, von der Grün J, Busch CJ, Tamaskovics B, Riera-Knorrenschild J, Gutsche K, Welslau M, Gauler T, Waldenberger D, Dietz A. 924P HANNA: Effectiveness and quality-of-life data from a real-world study of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) treated with nivolumab in Germany. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Bevis N, Walliser K, Rödel R, Beutner D, Dombrowski T. [From indication to analysis of the drug-induced sleep endoscopy (DISE)]. Laryngorhinootologie 2021; 100:791-792. [PMID: 34261136 DOI: 10.1055/a-1509-8965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Thelen M, Wennhold K, Lehmann J, Garcia-Marquez M, Klein S, Kochen E, Lohneis P, Lechner A, Wagener-Ryczek S, Plum PS, Velazquez Camacho O, Pfister D, Dörr F, Heldwein M, Hekmat K, Beutner D, Klussmann JP, Thangarajah F, Ratiu D, Malter W, Merkelbach-Bruse S, Bruns CJ, Quaas A, von Bergwelt-Baildon M, Schlößer HA. Cancer-specific immune evasion and substantial heterogeneity within cancer types provide evidence for personalized immunotherapy. NPJ Precis Oncol 2021; 5:52. [PMID: 34135436 PMCID: PMC8208982 DOI: 10.1038/s41698-021-00196-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
The immune response against cancer is orchestrated by various parameters and site-dependent specificities have been poorly investigated. In our analyses of ten different cancer types, we describe elevated infiltration by regulatory T cells as the most common feature, while other lymphocyte subsets and also expression of immune-regulatory molecules on tumor-infiltrating lymphocytes showed site-specific variation. Multiparametric analyses of these data identified similarities of renal and liver or lung with head and neck cancer. Co-expression of immune-inhibitory ligands on tumor cells was most frequent in colorectal, lung and ovarian cancer. Genes related to antigen presentation were frequently dysregulated in liver and lung cancer. Expression of co-inhibitory molecules on tumor-infiltrating T cells accumulated in advanced stages while T-cell abundance was related to enhanced expression of genes related to antigen presentation. Our results promote evaluation of cancer-specific or even personalized immunotherapeutic combinations to overcome primary or secondary resistance as major limitation of immune-checkpoint inhibition.
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Affiliation(s)
- Martin Thelen
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Kerstin Wennhold
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jonas Lehmann
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Maria Garcia-Marquez
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sebastian Klein
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Else Kröner Forschungskolleg Cologne "Clonal Evolution in Cancer", University of Cologne, Cologne, Germany
| | - Elena Kochen
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Philipp Lohneis
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Center, Ludwig Maximilians University, Munich, Germany
| | - Svenja Wagener-Ryczek
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Patrick Sven Plum
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Else Kröner Forschungskolleg Cologne "Clonal Evolution in Cancer", University of Cologne, Cologne, Germany
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Oscar Velazquez Camacho
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - David Pfister
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Fabian Dörr
- Department of Cardiothoracic Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Matthias Heldwein
- Department of Cardiothoracic Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Khosro Hekmat
- Department of Cardiothoracic Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Head and Neck Surgery, University of Göttingen, Göttingen, Germany
| | - Jens Peter Klussmann
- Department of Head and Neck Surgery, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Fabinshy Thangarajah
- Department of Gynecology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Dominik Ratiu
- Department of Gynecology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Wolfram Malter
- Department of Gynecology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sabine Merkelbach-Bruse
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christiane Josephine Bruns
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michael von Bergwelt-Baildon
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- German Cancer Consortium (DKTK), Heidelberg, Heidelberg, Germany
- Department of Internal Medicine III, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Hans A Schlößer
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Beutner D, Vent J, Seehawer J, Luers JC, Lang‐Roth R, Wrobel C. Taste-strip gustometry in cochlear implanted patients. Laryngoscope Investig Otolaryngol 2021; 6:496-502. [PMID: 34195371 PMCID: PMC8223453 DOI: 10.1002/lio2.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/11/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Investigation of the gustatory function in a large cohort of cochlear implanted patients using lateralized taste-strip tests. PATIENTS AND METHODS One hundred and seven unilaterally or bilaterally profoundly hearing impaired or deaf patients who received cochlear implants (n = 113) were included in this study. Data on gustometry, subjective gustatory dysfunction, and the detailed surgical procedure were acquired retrospectively. Gustatory function, assessed using lateralized taste-strip tests, was performed the day before, 3 days after cochlear implantation, and on the day of the initial CI adjustment (39 days ±7.3 SD). RESULTS Averaged taste-strip scores of the cohort declined significantly from preoperatively 12.3 [11.8; 12.7] (mean [95% confidence intervals]) to 10.5 [9.7; 11.2] on the implanted side about 6 weeks after surgery. Patients with intraoperatively exposed and rerouted, or a severed, chorda tympani nerve (CTN) showed significantly reduced unilateral postoperative scores (10.1 [8.8; 11.4] and 9.3 [8.1; 10.5], respectively), when compared to not exposing or to leaving a bony layer over the CTN. Total taste-strip test scores showed a significant decline 6 weeks postoperatively in CI-patients expressing a subjective gustatory dysfunction (from 23.6 [21.4; 25.8] to 17.5 [14.2; 20.8]), as opposed to patients with a documented subjectively normal taste. CONCLUSION We consider postoperative gustatory dysfunction as a relevant side effect post cochlear implantation, at least within the first month. Taste-strip based gustometry is a suitable diagnostic tool to assess taste function in CI patients and is recommended to be performed routinely. LEVEL OF EVIDENCE 3, retrospective, nonrandomized follow-up study.
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Affiliation(s)
- Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical FacultyUniversity Hospital CologneCologneGermany
| | - Julia Vent
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical FacultyUniversity Hospital CologneCologneGermany
| | - Julia Seehawer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical FacultyUniversity Hospital CologneCologneGermany
| | - Jan Christoffer Luers
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical FacultyUniversity Hospital CologneCologneGermany
| | - Ruth Lang‐Roth
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical FacultyUniversity Hospital CologneCologneGermany
| | - Christian Wrobel
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center GöttingenGöttingenGermany
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22
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Wrobel C, Bevis NF, Meyer AC, Beutner D. Access to the Apical Cochlear Modiolus for Possible Stem Cell-based and Gene Therapy of the Auditory Nerve. Otol Neurotol 2021; 42:e371-e377. [PMID: 33165157 DOI: 10.1097/mao.0000000000002941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Loss of spiral ganglion neurons (SGN) is permanent and responsible for a substantial number of patients suffering from hearing impairment. It can derive from the degeneration of SGNs due to the death of sensory hair cells as well as from auditory neuropathy. Utilizing stem cells to recover lost SGNs increasingly emerges as a possible therapeutic option, but access to human SGNs is difficult due to their protected location within the bony impacted cochlea. Aim of this study was to establish a reliable and practicable approach to access SGNs in the human temporal bone for possible stem cell and gene therapies. METHODS In seven human temporal bone specimen a transcanal approach was used to carefully drill a cochleostomy in the lateral second turn followed by insertion of a tungsten needle into the apical modiolus to indicate the spot for intramodiolar injections. Subsequent cone beam computed tomography (CBCT) served as evaluation for positioning of the marker and cochleostomy size. RESULTS The apical modiolus could be exposed in all cases by a cochleostomy (1.6 mm2, standard deviation ±0.23 mm2) in the lateral second turn. 3D reconstructions and analysis of CBCT revealed reliable positioning of the marker in the apical modiolus, deviating on average 0.9 mm (standard deviation ±0.49 mm) from the targeted center of the second cochlear turn. CONCLUSION We established a reliable, minimally invasive, transcanal surgical approach to the apical cochlear modiolus in the human temporal bone in foresight to stem cell-based and gene therapy of the auditory nerve.
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Affiliation(s)
- Christian Wrobel
- Department of Otorhinolaryngology.,InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
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23
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Warnholtz B, Schär M, Cuny P, Sonntag K, Beutner D, Dobrev I, Röösli C, Sim JH. A New Stapes-Head Coupler for the Vibrant Soundbridge System. Audiol Neurootol 2021; 26:287-294. [PMID: 33647905 DOI: 10.1159/000512600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 10/12/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The Vibrant Soundbridge (MED-EL Medical Electronics, Austria) is an active middle ear implant with a floating mass transducer (FMT) for patients with conductive, sensorineural, or mixed hearing loss. While the FMT is vertically aligned above the stapes head (SH) with the current Vibroplasty Clip coupler (MED-EL Medical Electronics), the new SH coupler was developed to mount the FMT on the inferior side of the stapes and to fit in the reduced middle ear space after canal-wall-down mastoidectomy. METHODS Using 11 human cadaveric temporal bones (TBs), placements of the new SH couplers on the stapes were examined, and effective stimuli to the cochlea were evaluated by measuring piston-like motion of the stapes footplate with a current of 1 mA on the FMT. The results were assessed in comparison with the Vibroplasty Clip coupler. RESULTS The new SH coupler showed perfect coupling on the stapes in 9 out of 11 TBs. A small gap between the SH and the plate of the connection link part was unavoidable in 2 TBs but had negligible effect on vibrational motion of the stapes. Vibrational motion of the stapes with the new SH coupler was reduced at frequencies above 3 kHz compared to the corresponding motion with the current Vibroplasty Clip coupler, but the relative attenuation over all 11 cadaveric temporal bones was <10 dB. CONCLUSIONS The new SH coupler provides an alternative with more stable fixation when placement of the current Vibroplasty Clip coupler is limited due to insufficient space after canal-wall-down mastoidectomy, while still delivering effective stimuli to the cochlea.
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Affiliation(s)
- Birthe Warnholtz
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland.,Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland
| | - Merlin Schär
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland.,Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland
| | - Pascale Cuny
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland.,Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland
| | | | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany
| | - Ivo Dobrev
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland.,Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland
| | - Christof Röösli
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland.,Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland
| | - Jae Hoon Sim
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland, .,Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland,
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24
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Stöver T, Dazert S, Plontke SK, Kramer S, Ambrosch P, Arens C, Betz C, Beutner D, Bohr C, Bruchhage KL, Canis M, Dietz A, Guntinas-Lichius O, Hagen R, Hosemann W, Iro H, Klussmann JP, Knopf A, Lang S, Leinung M, Lenarz T, Löwenheim H, Matthias C, Mlynski R, Olze H, Park J, Plinkert P, Radeloff A, Rotter N, Rudack C, Bozzato A, Schipper J, Schrader M, Schuler PJ, Strieth S, Stuck BA, Volkenstein S, Westhofen M, Wolf G, Wollenberg B, Zahnert T, Zenk J, Hoffmann TK. [Effects of the SARS-CoV‑2 pandemic on the otolaryngology university hospitals in the field of research, student teaching and specialist training]. HNO 2021; 69:633-641. [PMID: 33502578 PMCID: PMC7839289 DOI: 10.1007/s00106-021-01001-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
Hintergrund Ab Frühjahr 2020 kam es zur weltweiten Verbreitung von SARS-CoV‑2 mit der heute als erste Welle der Pandemie bezeichneten Phase ab März 2020. Diese resultierte an vielen Kliniken in Umstrukturierungen und Ressourcenverschiebungen. Ziel unserer Arbeit war die Erfassung der Auswirkungen der Pandemie auf die universitäre Hals-Nasen-Ohren(HNO)-Heilkunde für die Forschung, Lehre und Weiterbildung. Material und Methoden Die Direktorinnen und Direktoren der 39 Universitäts-HNO-Kliniken in Deutschland wurden mithilfe einer strukturierten Online-Befragung zu den Auswirkungen der Pandemie im Zeitraum von März bis April 2020 auf die Forschung, Lehre und die Weiterbildung befragt. Ergebnisse Alle 39 Direktorinnen und Direktoren beteiligten sich an der Umfrage. Hiervon gaben 74,4 % (29/39) an, dass es zu einer Verschlechterung ihrer Forschungstätigkeit infolge der Pandemie gekommen sei. Von 61,5 % (24/39) wurde berichtet, dass pandemiebezogene Forschungsaspekte aufgegriffen wurden. Von allen Kliniken wurde eine Einschränkung der Präsenzlehre berichtet und 97,5 % (38/39) führten neue digitale Lehrformate ein. Im Beobachtungszeitraum sahen 74,4 % der Klinikdirektoren die Weiterbildung der Assistenten nicht gefährdet. Schlussfolgerung Die Ergebnisse geben einen Einblick in die heterogenen Auswirkungen der Pandemie. Die kurzfristige Bearbeitung pandemiebezogener Forschungsthemen und die Einführung innovativer digitaler Konzepte für die studentische Lehre belegt eindrücklich das große innovative Potenzial und die schnelle Reaktionsfähigkeit der HNO-Universitätskliniken, um auch während der Pandemie ihre Aufgaben in der Forschung, Lehre und Weiterbildung bestmöglich zu erfüllen.
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Affiliation(s)
- T Stöver
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Frankfurt a.M., Frankfurt a.M., Deutschland.
| | - S Dazert
- Klinik für Hals-Nasen-Ohrenheilkunde, Ruhr-Universität-Bochum, St. Elisabeth-Hospital, Bochum, Deutschland
| | - S K Plontke
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Halle/S., Halle/S., Deutschland
| | - S Kramer
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Frankfurt a.M., Frankfurt a.M., Deutschland
| | - P Ambrosch
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Kiel, Kiel, Deutschland
| | - C Arens
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - C Betz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland
| | - D Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Göttingen, Göttingen, Deutschland
| | - C Bohr
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - K-L Bruchhage
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Lübeck, Lübeck, Deutschland
| | - M Canis
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, LMU München, München, Deutschland
| | - A Dietz
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - O Guntinas-Lichius
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Jena, Jena, Deutschland
| | - R Hagen
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - W Hosemann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Greifswald, Greifswald, Deutschland
- Helios Hanseklinikum Stralsund, Stralsund, Deutschland
| | - H Iro
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J P Klussmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Uniklinik Köln und Medizinische Fakultät, Universität zu Köln, Köln, Deutschland
| | - A Knopf
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - S Lang
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Essen, Essen, Deutschland
| | - M Leinung
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Frankfurt a.M., Frankfurt a.M., Deutschland
| | - T Lenarz
- Klinik für Hals-Nasen-Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - H Löwenheim
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - C Matthias
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Mainz, Mainz, Deutschland
| | - R Mlynski
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Rostock, Deutschland
| | - H Olze
- Klinik für Hals-Nasen-Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - J Park
- Klinik für Hals-Nasen-Ohrenheilkunde, Universität Witten/Herdecke, Witten/Herdecke, Deutschland
| | - P Plinkert
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - A Radeloff
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Oldenburg, Oldenburg, Deutschland
| | - N Rotter
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Mannheim, Mannheim, Deutschland
| | - C Rudack
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
| | - A Bozzato
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes, Saarlandes, Deutschland
| | - J Schipper
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - M Schrader
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Minden, Minden, Deutschland
| | - P J Schuler
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - S Strieth
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - B A Stuck
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - S Volkenstein
- Klinik für Hals-Nasen-Ohrenheilkunde, Ruhr-Universität-Bochum, St. Elisabeth-Hospital, Bochum, Deutschland
| | - M Westhofen
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Aachen, Aachen, Deutschland
| | - G Wolf
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Justus-Liebig-Universität, Gießen, Deutschland
- Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Deutschland
| | - B Wollenberg
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - T Zahnert
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Dresden, Dresden, Deutschland
| | - J Zenk
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland
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25
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Meyer MF, Wolber P, Arolt C, Wessel M, Quaas A, Lang S, Klussmann JP, Semrau R, Beutner D. Survival after parotid gland metastases of cutaneous squamous cell carcinoma of the head and neck. Oral Maxillofac Surg 2021; 25:383-388. [PMID: 33400041 PMCID: PMC8352831 DOI: 10.1007/s10006-020-00934-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
Purpose Malignant tumours in the parotid gland can originate either from the gland itself or as a result of metastatic spread of other tumours, such as cutaneous squamous cell carcinomas (CSCC) of the head and neck area. The aim of this study was to analyse and compare the clinical behaviour of primary as well as CSCC metastatic parotid cancers with special emphasis on therapy and oncologic outcome. Methods Clinical and histopathological data of 342 patients with parotid gland malignomas surgically treated in a tertiary referral centre between 1987 and 2015 were retrospectively assessed. Oncologic outcomes of all cases with CSCC metastasis of the parotid gland (n = 49) were compared to those of primary parotid gland carcinomas (n = 293). Results Mean age at diagnosis was 72.3 years for CSCC patients versus 56.8 years in patients with primary parotid carcinoma. A total of 83.7% of CSCC patients were male, compared to 48.8% in the group of primary carcinomas. Forty-five out of 49 CSCC patients underwent total parotidectomy and neck dissection (91.8%). A total of 93.9% out of all CSCC patients received adjuvant radiotherapy. Five-year overall survival (OS) was 32.6% in CSCC patients versus 77.2% in primary parotid carcinoma patients. Conclusion As compared to primary parotid cancers, we could show that patients suffering from CSCC metastases to the parotid gland presented with significantly higher age and worse survival.
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Affiliation(s)
- Moritz Friedo Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany.
| | - Philipp Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Christoph Arolt
- Department of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Maximilian Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Alexander Quaas
- Department of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Stephan Lang
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | | | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
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26
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Meinrath J, Haak A, Igci N, Dalvi P, Arolt C, Meemboor S, Siebolts U, Eischeidt-Scholz H, Wickenhauser C, Grünewald I, Drebber U, Büttner R, Quaas A, Klußmann JP, Odenthal M, Beutner D, Meyer M. Expression profiling on subclasses of primary parotid gland carcinomas. Oncotarget 2020; 11:4123-4137. [PMID: 33227073 PMCID: PMC7665229 DOI: 10.18632/oncotarget.27797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/17/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The underlying molecular mechanisms of parotid gland carcinomas (PGC) are still unknown. Knowledge about the tumor-driving signaling pathways is necessary either for diagnostics or developing new therapeutic options in this heterogeneous and rare entity. MATERIAL AND METHODS 94 matching RNA formalin-fixed and paraffin-embedded tissue samples from PGC and the corresponding non-tumor area, RNA quality and quantity were sufficient for gene expression profiling of 770 genes using the NanoString's nCounter technology. Oncogenic and tumor suppressor genes were examined in the three common PGC tumor entities: adenoid cystic carcinoma (ACC), adenocarcinoma NOS (AC-NOS), and mucoepidermoid carcinoma (MEC). RESULTS Expression profiling and subsequent hierarchical cluster analysis clearly differentiated between non-tumor gland tissue samples and PGC. In addition expression pattern of all three entities differed. The extensive pathway analysis proved a prominent dysregulation of the Wnt signaling pathway in the three PGC entities. Moreover, transcript upstream analysis demonstrated a pronounced activation of the PI3K pathway in ACC and MEC. DISCUSSION Our findings revealed divergent molecular expression profiles in MEC, ACC and AC-NOS that are presently studied for their potential application in PGC diagnostics. Importantly, identification of Wnt and PI3K signaling in PGC revealed novel options of PGC therapy.
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Affiliation(s)
- Jeannine Meinrath
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Anja Haak
- Department of Pathology, University of Halle, Halle, Germany
| | - Nesrin Igci
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Priya Dalvi
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany.,Center for Molecular Medicine, University of Cologne, Cologne, Germany
| | - Christoph Arolt
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Sonja Meemboor
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany.,Center of Integrative Oncology, University Hospital of Cologne, Cologne, Germany
| | - Udo Siebolts
- Department of Pathology, University of Halle, Halle, Germany
| | | | | | - Inga Grünewald
- Department of Pathology, University Hospital of Münster, Münster, Germany
| | - Uta Drebber
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany.,Center of Integrative Oncology, University Hospital of Cologne, Cologne, Germany
| | - Reinhard Büttner
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany.,Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Center of Integrative Oncology, University Hospital of Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany.,Center of Integrative Oncology, University Hospital of Cologne, Cologne, Germany
| | - Jens-Peter Klußmann
- Center of Integrative Oncology, University Hospital of Cologne, Cologne, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Margarete Odenthal
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany.,Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Center of Integrative Oncology, University Hospital of Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Moritz Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany
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27
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Arolt C, Meyer M, Hoffmann F, Wagener-Ryczek S, Schwarz D, Nachtsheim L, Beutner D, Odenthal M, Guntinas-Lichius O, Buettner R, von Eggeling F, Klußmann JP, Quaas A. Expression Profiling of Extracellular Matrix Genes Reveals Global and Entity-Specific Characteristics in Adenoid Cystic, Mucoepidermoid and Salivary Duct Carcinomas. Cancers (Basel) 2020; 12:cancers12092466. [PMID: 32878206 PMCID: PMC7564650 DOI: 10.3390/cancers12092466] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary The extracellular matrix (ECM), an important factor in tumour metastasis and therapy resistance, has not been studied in salivary gland carcinomas (SGC), so far. In this retrospective study, we profiled the RNA expression of 28 ECM-related genes in 11 adenoid cystic (AdCy), 14 mucoepidermoid (MuEp) and 9 salivary duct carcinomas (SaDu). Also, we validated our results in a multimodal approach. MuEp and SaDu shared a common gene signature involving an overexpression of COL11A1. In contrast, nonhierarchical clustering revealed a more specific gene expression pattern for AdCy, characterized by overexpression of COL27A1. In situ studies at RNA level indicated that in AdCy, ECM production results from tumour cells and not from cancer-associated fibroblasts as is the case in MuEp and SaDu. For the first time, we characterized the ECM composition in SGC and identified several differentially expressed genes, which are potential therapeutic targets. Abstract The composition of the extracellular matrix (ECM) plays a pivotal role in tumour initiation, metastasis and therapy resistance. Until now, the ECM composition of salivary gland carcinomas (SGC) has not been studied. We quantitatively analysed the mRNA of 28 ECM-related genes of 34 adenoid cystic (AdCy; n = 11), mucoepidermoid (MuEp; n = 14) and salivary duct carcinomas (SaDu; n = 9). An incremental overexpression of six collagens (including COL11A1) and four glycoproteins from MuEp and SaDu suggested a common ECM alteration. Conversely, AdCy and MuEp displayed a distinct overexpression of COL27A1 and LAMB3, respectively. Nonhierarchical clustering and principal component analysis revealed a more specific pattern for AdCy with low expression of the common gene signature. In situ studies at the RNA and protein level confirmed these results and indicated that, in contrast to MuEp and SaDu, ECM production in AdCy results from tumour cells and not from cancer-associated fibroblasts (CAFs). Our findings reveal different modes of ECM production leading to common and distinct RNA signatures in SGC. Of note, an overexpression of COL27A1, as in AdCy, has not been linked to any other neoplasm so far. Here, we contribute to the dissection of the ECM composition in SGC and identified a panel of deferentially expressed genes, which could be putative targets for SGC therapy and overcoming therapeutic resistance.
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Affiliation(s)
- Christoph Arolt
- Institute of Pathology, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (S.W.-R.); (M.O.); (R.B.); (A.Q.)
- Correspondence: ; Tel.: +49-221-478-4726
| | - Moritz Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (M.M.); (D.S.); (L.N.); (J.P.K.)
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Franziska Hoffmann
- Department of Otorhinolaryngology, MALDI Imaging and Innovative Biophotonics, Jena University Hospital, 07747 Jena, Germany;
| | - Svenja Wagener-Ryczek
- Institute of Pathology, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (S.W.-R.); (M.O.); (R.B.); (A.Q.)
| | - David Schwarz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (M.M.); (D.S.); (L.N.); (J.P.K.)
| | - Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (M.M.); (D.S.); (L.N.); (J.P.K.)
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Margarete Odenthal
- Institute of Pathology, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (S.W.-R.); (M.O.); (R.B.); (A.Q.)
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, 07747 Jena, Germany;
| | - Reinhard Buettner
- Institute of Pathology, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (S.W.-R.); (M.O.); (R.B.); (A.Q.)
| | - Ferdinand von Eggeling
- Department of Otorhinolaryngology, MALDI Imaging, Core Unit Proteome Analysis, DFG Core Unit Jena Biophotonic and Imaging Laboratory (JBIL), Jena University Hospital, 07747 Jena, Germany;
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (M.M.); (D.S.); (L.N.); (J.P.K.)
| | - Alexander Quaas
- Institute of Pathology, Medical Faculty, University of Cologne, 50937 Cologne, Germany; (S.W.-R.); (M.O.); (R.B.); (A.Q.)
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28
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Stöver T, Dazert S, Hoffmann TK, Plontke SK, Ambrosch P, Arens C, Betz C, Beutner D, Bohr C, Bruchhage KL, Canis M, Dietz A, Guntinas-Lichius O, Hagen R, Hosemann W, Iro H, Klussmann JP, Knopf A, Kramer S, Lang S, Leinung M, Lenarz T, Löwenheim H, Matthias C, Mlynski R, Olze H, Park J, Plinkert P, Radeloff A, Rotter N, Rudack C, Bozzato A, Schipper J, Schrader M, Strieth S, Stuck BA, Volkenstein S, Westhofen M, Wolf G, Wollenberg B, Zahnert T, Zenk J. [Effects of the SARS-CoV-2 pandemic on the otorhinolaryngology university hospitals in the field of medical care]. Laryngorhinootologie 2020; 99:694-706. [PMID: 32767296 PMCID: PMC7645814 DOI: 10.1055/a-1232-4911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Since December 2019, the SARS-CoV-2 virus has been rapidly spreading worldwide. In Germany, an exponential increase in the number of infections was registered at the beginning of March 2020 and led to a call of the Ministry of Health to create more capacity for intensive medical treatment in hospitals. The aim of the present study was to determine the effects of the SARS-CoV-2 pandemic on Oto-Rhino-Laryngology (ORL) university hospitals regarding patient care. MATERIALS AND METHODS An online survey was sent out to all chairmen of the 39 ORL university hospitals in Germany. The answers to the questions referred to the defined period from March 15th to April 15th 2020 and were carried out using the online survey tool "SurveyMonkey". 87 questions focused on general information, health care, and structural effects in the respective institution. RESULTS All chairmen of the 39 university hospitals in Germany participated in the survey. The collected data prove the considerable impact on organizational, structural and medical aspects of patient care. For example, the surveyed clinics reported a decrease in outpatient cases by 73.8 % to 26.2 ± 14.2 % and in surgical treatments by 65.9 % to 34.1 ± 13.9 %. In contrast, emergency treatment remained unchanged or even increased in 80 % of the facilities and surgical treatment of emergency patients remained unchanged or even increased in more than 90 %. Emergency outpatient and surgical treatment of patients was provided throughout the pandemic in all facilities. In total, about 35 000 outpatients and about 12 000 surgical cases were postponed. As a result of the acute structural changes, the potential danger of falling below current treatment standards was seen in individual areas of patient care. DISCUSSION The assessment of the impact of the SARS-CoV-2 pandemic is heterogeneous. The majority of the chairmen are critically aware of the risk of falling below current medical treatment standards or guidelines. In the phase of an exponential increase in the number of infections, significant changes in treatment processes had to be accepted for understandable reasons. However, with the currently significantly reduced number of infections, falling below treatment standards and guidelines should not be allowed to remain constant and tolerated. SUMMARY This study shows a differentiated picture with regard to the effects of the SARS-CoV-2 pandemic on outpatient, inpatient and operative patient care at the ORL university hospitals in Germany and illustrates the importance of these institutions for ensuring patient care during this critical phase.
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Affiliation(s)
- T Stöver
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt a. M
| | - S Dazert
- Klinik für Hals-Nasen-Ohrenheilkunde, Ruhr-Universität-Bochum, St. Elisabeth-Hospital
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - S K Plontke
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Halle/S
| | - P Ambrosch
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Kiel
| | - C Arens
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Magdeburg
| | - C Betz
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg Eppendorf
| | - D Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Göttingen
| | - C Bohr
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg
| | - K-L Bruchhage
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Lübeck
| | - M Canis
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, LMU München
| | - A Dietz
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig
| | | | - R Hagen
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Würzburg
| | - W Hosemann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Greifswald
| | - H Iro
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Erlangen
| | - J-P Klussmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Uniklinik Köln und Medizinische Fakultät, Universität zu Köln
| | - A Knopf
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Freiburg
| | - S Kramer
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt a. M
| | - S Lang
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Essen
| | - M Leinung
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt a. M
| | - T Lenarz
- Klinik für Hals-Nasen-Ohrenheilkunde, Medizinische Hochschule Hannover
| | - H Löwenheim
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Tübingen
| | - C Matthias
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Mainz
| | - R Mlynski
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock
| | - H Olze
- Klinik für Hals-Nasen-Ohrenheilkunde, Charité Berlin
| | - J Park
- Klinik für Hals-Nasen-Ohrenheilkunde, Universität Witten/Herdecke
| | - P Plinkert
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Heidelberg
| | - A Radeloff
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Oldenburg
| | - N Rotter
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Mannheim
| | - C Rudack
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Münster
| | - A Bozzato
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes
| | - J Schipper
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Düsseldorf
| | - M Schrader
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Minden
| | - S Strieth
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Bonn
| | - B A Stuck
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg
| | - S Volkenstein
- Klinik für Hals-Nasen-Ohrenheilkunde, Ruhr-Universität-Bochum, St. Elisabeth-Hospital
| | - M Westhofen
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Aachen
| | - G Wolf
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Justus-Liebig-Universität, Gießen
| | - B Wollenberg
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München
| | - T Zahnert
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Dresden
| | - J Zenk
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Augsburg
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29
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Grosheva M, Klußmann JP, Beutner D, Formanek M, Lill C, Laskawi R, Zenk J, Pick C, Erlacher B, Bemmer J, Thielker J, Jering M, Tostmann R, Guntinas-Lichius O. [Planning and design of European prospective randomized trial on the value of drain in parotidectomy]. Laryngorhinootologie 2020; 100:46-53. [PMID: 32516811 DOI: 10.1055/a-1178-0800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION There are no valid clinical studies on the value of wound drains in parotid surgery. The aim of the current trial is to analyze the influence of the closed wound drain (redon) on the incidence of postoperative complications such as bleeding, wound healing problems, infection, as well as salivary cyst and fistula after superficial or partial parotidectomy. METHODS A European-wide multicenter prospective randomized study was planned. The study protocol was prepared by the leading study center (ENT University Hospital Cologne) in cooperation with the ENT University Hospitals Jena and Göttingen. The calculation of the number of cases was carried out with G*Power. The study includes test persons with an indication for parotidectomy for a benign tumor without known coagulation disorder or ongoing anticoagulation. Preoperative randomization and data management is software-supported (REDCap 9.1.24, Vanderbilt University). RESULTS The study has been approved by the leading ethics committee in 10/2019 and is open since 04/2019. Currently, nine (9) ENT hospitals are participating in the study, 6 of them in Germany and 3 in Austria. Enrollment of patients is ongoing in 7 centers. With a calculated follow-up-to-treat population of 800 test persons, the planned duration of the study is 4 years. CONCLUSIONS The Redon-study is the first prospective randomized study worldwide to investigate the effect of a drain in parotidectomy. In order to achieve the recruitment goal within the planned time frame, the participation of further specialized study centers is needed. We also encourage all ENT physicians to make their patients aware of the Redon study, inform them about the possibility of participating in the study and refer them to one of the participating centers.
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Affiliation(s)
- Maria Grosheva
- HNO Uniklinik Köln, Medizinische Fakultät, University of Cologne, Köln, Germany
| | - Jens Peter Klußmann
- HNO Uniklinik Köln, Medizinische Fakultät, University of Cologne, Köln, Germany
| | - Dirk Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Michael Formanek
- HNO und Phoniatrie, Krankenhaus der Barmherzigen Brüder, Wien, Austria
| | - Claudia Lill
- Institut für Kopf- und Halserkrankungen, Evangelisches Krankenhaus Wien, Austria
| | - Rainer Laskawi
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Johannes Zenk
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Augsburg, Germany
| | - Carina Pick
- HNO Uniklinik Köln, Medizinische Fakultät, University of Cologne, Köln, Germany
| | - Birgit Erlacher
- HNO und Phoniatrie, Krankenhaus der Barmherzigen Brüder, Wien, Austria
| | - Julian Bemmer
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Jovanna Thielker
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Germany
| | - Monika Jering
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Augsburg, Germany
| | - Ralf Tostmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Orlando Guntinas-Lichius
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Jena, Germany
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Gundelach LA, Hüser MA, Beutner D, Ruther P, Bruegmann T. Towards the clinical translation of optogenetic skeletal muscle stimulation. Pflugers Arch 2020; 472:527-545. [PMID: 32415463 PMCID: PMC7239821 DOI: 10.1007/s00424-020-02387-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/05/2020] [Accepted: 04/28/2020] [Indexed: 12/27/2022]
Abstract
Paralysis is a frequent phenomenon in many diseases, and to date, only functional electrical stimulation (FES) mediated via the innervating nerve can be employed to restore skeletal muscle function in patients. Despite recent progress, FES has several technical limitations and significant side effects. Optogenetic stimulation has been proposed as an alternative, as it may circumvent some of the disadvantages of FES enabling cell type–specific, spatially and temporally precise stimulation of cells expressing light-gated ion channels, commonly Channelrhodopsin2. Two distinct approaches for the restoration of skeletal muscle function with optogenetics have been demonstrated: indirect optogenetic stimulation through the innervating nerve similar to FES and direct optogenetic stimulation of the skeletal muscle. Although both approaches show great promise, both have their limitations and there are several general hurdles that need to be overcome for their translation into clinics. These include successful gene transfer, sustained optogenetic protein expression, and the creation of optically active implantable devices. Herein, a comprehensive summary of the underlying mechanisms of electrical and optogenetic approaches is provided. With this knowledge in mind, we substantiate a detailed discussion of the advantages and limitations of each method. Furthermore, the obstacles in the way of clinical translation of optogenetic stimulation are discussed, and suggestions on how they could be overcome are provided. Finally, four specific examples of pathologies demanding novel therapeutic measures are discussed with a focus on the likelihood of direct versus indirect optogenetic stimulation.
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Affiliation(s)
- Lili A Gundelach
- Institute of Cardiovascular Physiology, University Medical Center, Göttingen, Germany
| | - Marc A Hüser
- Institute of Cardiovascular Physiology, University Medical Center, Göttingen, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center, Göttingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center, Göttingen, Germany
| | - Patrick Ruther
- Microsystem Materials Laboratory, Department of Microsystems Engineering (IMTEK), University of Freiburg, Freiburg, Germany
- BrainLinks-BrainTools Cluster of Excellence at the University of Freiburg, Freiburg, Germany
| | - Tobias Bruegmann
- Institute of Cardiovascular Physiology, University Medical Center, Göttingen, Germany.
- DZHK e.V. (German Center for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany.
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Thangavelu K, Martakis K, Fabian S, Venkateswaran M, Roth B, Beutner D, Lang‐Roth R. Prevalence and risk factors for hearing loss in high-risk neonates in Germany. Acta Paediatr 2019; 108:1972-1977. [PMID: 31074050 DOI: 10.1111/apa.14837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/11/2019] [Accepted: 05/06/2019] [Indexed: 11/29/2022]
Abstract
AIM Hearing loss in infants is often diagnosed late, despite universal screening programmes. Risk factors of hearing impairment in high-risk neonates, identified from population-based studies, can inform policy around targeted screening. Our aim was to determine the prevalence and the risk factors of hearing loss in a high-risk neonatal population. METHODS This was a retrospective cohort study of neonates hospitalised at the University Hospital Cologne, Germany from January 2009 to December 2014 and were part of the newborn hearing screening programme. Multivariable regression analyses using the lasso approach was performed. RESULTS Data were available for 4512 (43% female) neonates with a mean gestational age at birth of 35.5 weeks. The prevalence of hearing loss was 1.6%, and 42 (0.9%) neonates had permanent hearing loss. Craniofacial anomalies, hyperbilirubinaemia requiring exchange transfusion, oxygen supplementation after 36 weeks of gestation and hydrops fetalis showed associations with permanent hearing loss. CONCLUSION Our findings of risk factors for hearing loss were consistent with other studies. However, some commonly demonstrated risk factors such as perinatal infections, meningitis, sepsis and ototoxic drugs did not show significant associations in our cohort. Targeted screening based on risk factors may help early identification of hearing loss in neonates.
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Affiliation(s)
- Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Marburg University of Gießen and Marburg Marburg Germany
| | - Kyriakos Martakis
- Department of International Health, CAPHRI ‐ Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany
| | - Silke Fabian
- Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne Cologne Germany
| | - Mahima Venkateswaran
- Global Health Cluster, Division for Health Services Norwegian Institute of Public Health Oslo Norway
| | - Bernhard Roth
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery University of Göttingen Göttingen Germany
| | - Ruth Lang‐Roth
- Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne Cologne Germany
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Steffen A, Jost W, Bäumer T, Beutner D, Degenkolb-Weyers S, Groß M, Grosheva M, Hakim S, Kahl KG, Laskawi R, Lencer R, Löhler J, Meyners T, Rohrbach-Volland S, Schönweiler R, Schröder SC, Schröder S, Schröter-Morasch H, Schuster M, Steinlechner S, Urban R, Guntinas-Lichius O. [Hypersalivation - Update of the S2k guideline (AWMF) in short form]. Laryngorhinootologie 2019; 98:388-397. [PMID: 31167292 DOI: 10.1055/a-0874-2406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This update presents recent changes and innovation in the treatment of hypersalivation.Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, saliva aspiration, and oro-motor deficiencies. Clinical screening tools and diagnostics such as fiberoptic endoscopic evaluation of swallowing generate important data on therapy selection and control. Many cases profit from swallowing therapy programmes in order to activate compensation mechanisms as long compliances is given. In children with hypotonic oral muscles, oral stimulation plates can induce a relevant symptom release because of the improved lip closure. The pharmacologic treatment improved for pediatric cases as glycopyrrolate fluid solution (Sialanar®) is now indicated for hypersalivation within the E. U. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long lasting saliva reduction. Here, a phase III trial is completed for Incobotulinum toxin A and, in the U. S., is indicated for the treatment of adult patients with chronic hypersalivation. Surgical treatment should be reserved for isolated cases. External radiation is judged as a safe and effective therapy when using modern 3 D techniques to minimize tissue damage. Therapy effects and symptom severity has to be followed, especially in cases with underlying neurodegenerative disease.
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Affiliation(s)
| | | | - Tobias Bäumer
- Universitätsklinikum Münster Klinik für Psychiatrie und Psychotherapie
| | - Dirk Beutner
- Wissenschaftliches Institut für angewandte HNO-Heilkunde HNO-Praxis Bad Bramstedt
| | | | - Martin Groß
- Evangelische Hochschule Berlin Pflege- und Gesundheitswissenschaften
| | | | | | - Kai G Kahl
- Dr. von Haunersches Kinderspital Ludwig-Maximilians-Universität München Pädiatrische Neurologie und Entwicklungsneurologie
| | - Rainer Laskawi
- Ludwig-Maximilians-Universität München, Medizinische Fakultät, Institut für Phonetik und Sprachverarbeitung
| | - Rebekka Lencer
- Klinikum der Universität München, Klinik für Hals-, Nasen- und Ohrenheilkunde
| | | | - Thekla Meyners
- HELIOS Fachklinik Schleswig, Psychiatry and Psychosomatik Medicine
| | | | | | | | - Sebastian Schröder
- Georg-August-Universität Göttingen, Universitätsmedizin Klinik für Hals-Nasen-Ohrenheilkunde
| | - Heidrun Schröter-Morasch
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Medizinische Fakultät, Studiengang B. Sc. Logopädie
| | - Maria Schuster
- Evangelisches Krankenhaus Oldenburg Klinik für Neurologische Intensivmedizin und Frührehabilitation
| | - Susanne Steinlechner
- Uniklinik Köln Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie Köln
| | - Roland Urban
- Universität zu Lübeck, Klinik für Kiefer- und Gesichtschirurgie
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Steffen A, Jost W, Bäumer T, Beutner D, Degenkolb-Weyers S, Groß M, Grosheva M, Hakim S, Kahl KG, Laskawi R, Lencer R, Löhler J, Meyners T, Rohrbach-Volland S, Schönweiler R, Schröder SC, Schröder S, Schröter-Morasch H, Schuster M, Steinlechner S, Urban R, Guntinas-Lichius O. Hypersalivation: update of the German S2k guideline (AWMF) in short form. J Neural Transm (Vienna) 2019; 126:853-862. [DOI: 10.1007/s00702-019-02000-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/27/2019] [Indexed: 12/11/2022]
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34
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Huebbers CU, Verhees F, Poluschkin L, Olthof NC, Kolligs J, Siefer OG, Henfling M, Ramaekers FCS, Preuss SF, Beutner D, Seehawer J, Drebber U, Korkmaz Y, Lam WL, Vucic EA, Kremer B, Klussmann JP, Speel EJM. Upregulation of AKR1C1 and AKR1C3 expression in OPSCC with integrated HPV16 and HPV-negative tumors is an indicator of poor prognosis. Int J Cancer 2019; 144:2465-2477. [PMID: 30367463 DOI: 10.1002/ijc.31954] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/25/2022]
Abstract
Different studies have shown that HPV16-positive OPSCC can be subdivided based on integration status (integrated, episomal and mixed forms). Because we showed that integration neither affects the levels of viral genes, nor those of virally disrupted human genes, a genome-wide screen was performed to identify human genes which expression is influenced by viral integration and have clinical relevance. Thirty-three fresh-frozen HPV-16 positive OPSCC samples with known integration status were analyzed by mRNA expression profiling. Among the genes of interest, Aldo-keto-reductases 1C1 and 1C3 (AKR1C1, AKR1C3) were upregulated in tumors with viral integration. Additionally, 141 OPSCC, including 48 HPV-positive cases, were used to validate protein expression by immunohistochemistry. Results were correlated with clinical and histopathological data. Non-hierarchical clustering resulted in two main groups differing in mRNA expression patterns, which interestingly corresponded with viral integration status. In OPSCC with integrated viral DNA, often metabolic pathways were deregulated with frequent upregulation of AKR1C1 and AKR1C3 transcripts. Survival analysis of 141 additionally immunostained OPSCC showed unfavorable survival rates for tumors with upregulation of AKR1C1 or AKR1C3 (both p <0.0001), both in HPV-positive (p ≤0.001) and -negative (p ≤0.017) tumors. OPSCC with integrated HPV16 show upregulation of AKR1C1 and AKR1C3 expression, which strongly correlates with poor survival rates. Also in HPV-negative tumors, upregulation of these proteins correlates with unfavorable outcome. Deregulated AKR1C expression has also been observed in other tumors, making these genes promising candidates to indicate prognosis. In addition, the availability of inhibitors of these gene products may be utilized for drug treatment.
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Affiliation(s)
- Christian U Huebbers
- Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany
| | - Femke Verhees
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Leonard Poluschkin
- Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany
| | - Nadine C Olthof
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Molecular Cell Biology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jutta Kolligs
- Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany
| | - Oliver G Siefer
- Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany
| | - Mieke Henfling
- Department of Molecular Cell Biology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Frans C S Ramaekers
- Department of Molecular Cell Biology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Simon F Preuss
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Germany
| | - Julia Seehawer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Cologne, Cologne, Germany
| | - Uta Drebber
- Institute for Pathology, University Hospital of Cologne, Cologne, Germany
| | - Yüksel Korkmaz
- Institute for Experimental Dental Research and Oral Musculoskeletal Biology, University Hospital of Cologne, Cologne, Germany.,Department I of Anatomy, University Hospital of Cologne, Cologne, Germany.,Center for Biochemistry, University Hospital of Cologne, Cologne, Germany
| | - Wan L Lam
- Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, Canada
| | - Emily A Vucic
- Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, Canada
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jens P Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Cologne, Cologne, Germany
| | - Ernst-Jan M Speel
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
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Zahnert T, Mlynski R, Löwenheim H, Beutner D, Hagen R, Ernst A, Zehlicke T, Kühne H, Friese N, Tropitzsch A, Luers J, Todt I, Hüttenbrink KB. Long-Term Outcomes of Vibroplasty Coupler Implantations to Treat Mixed/Conductive Hearing Loss. Audiol Neurootol 2019; 23:316-325. [DOI: 10.1159/000495560] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022] Open
Abstract
Objective: To evaluate the long-term safety and performance of four different vibroplasty couplers (round window, oval window, CliP and Bell coupler) in combination with an active middle ear implant. Methods: This was a multicentre, prospective, long-term study including 5 German hospitals. Thirty adult subjects suffering from conductive or mixed hearing loss were initially enrolled for the study, 24 of these were included in the final analysis with up to 36 months of postsurgical follow-up data. Bone conduction and air conduction were measured pre- and postoperatively to evalu ate safety. Postoperative aided sound field thresholds and Freiburger monosyllable word recognition scores were compared to unaided pre-implantation results to confirm performance. Additional speech tests compared postoperative unaided with aided results. To determine patient satisfaction, an established quality-of-life questionnaire developed for conventional hearing aid usage was administered to all subjects. Results: Mean postoperative bone conduction thresholds remained stable throughout the whole study period. Mean functional gain for all couplers investigated was 38.5 ± 11.4 dB HL (12 months) and 38.8 ± 12.5 dB HL (36 months). Mean word recognition scores at 65 dB SPL increased from 2.9% in the unaided by 64.2% to 67.1% in the aided situation. The mean postoperative speech reception in quiet (or 50% understanding of words in sentences) shows a speech intelligibility improvement at 36 months of 17.8 ± 12.4 dB SPL over the unaided condition. The signal-to-noise ratio (SNR) improved by 5.9 ± 7.2 dB SNR over the unaided condition. High subjective device satisfaction was reflected by the International Inventory for Hearing Aids scored very positively. Conclusion: A significant improvement was seen with all couplers, and audiological performance did not significantly differ between 12 and 36 months after surgery.
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36
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Grosheva M, Pick C, Granitzka T, Sommer B, Wittekindt C, Klussmann JP, Guntinas‐Lichius O, Beutner D. Impact of extent of parotidectomy on early and long‐term complications: A prospective multicenter cohort trial. Head Neck 2019; 41:1943-1951. [DOI: 10.1002/hed.25651] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 08/21/2018] [Accepted: 12/21/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
- Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Cologne Cologne Germany
| | - Carina Pick
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Cologne Cologne Germany
| | - Thordis Granitzka
- Department of Otolaryngology, Head and Neck SurgeryJena University Hospital Jena Germany
| | - Barbara Sommer
- Department of Otolaryngology, Head and Neck SurgeryUniversity of Giessen Giessen Germany
| | - Claus Wittekindt
- Department of Otolaryngology, Head and Neck SurgeryUniversity of Giessen Giessen Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Cologne Cologne Germany
- Department of Otolaryngology, Head and Neck SurgeryUniversity of Giessen Giessen Germany
| | | | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Cologne Cologne Germany
- Department of Otolaryngology, Head and Neck SurgeryUniversity of Goettingen Goettingen Germany
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Lechner A, Schlößer HA, Thelen M, Wennhold K, Rothschild SI, Gilles R, Quaas A, Siefer OG, Huebbers CU, Cukuroglu E, Göke J, Hillmer A, Gathof B, Meyer MF, Klussmann JP, Shimabukuro-Vornhagen A, Theurich S, Beutner D, von Bergwelt-Baildon M. Tumor-associated B cells and humoral immune response in head and neck squamous cell carcinoma. Oncoimmunology 2019; 8:1535293. [PMID: 30723574 PMCID: PMC6350680 DOI: 10.1080/2162402x.2018.1535293] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 10/07/2018] [Accepted: 10/09/2018] [Indexed: 01/04/2023] Open
Abstract
B lymphocytes are important players in immune responses to cancer. However, their composition and function in head and neck squamous cell carcinoma (HNSCC) has not been well described. Here, we analyzed B cell subsets in HNSCC (n = 38), non-cancerous mucosa (n = 14) and peripheral blood from HNSCC patients (n = 38) and healthy controls (n = 20) by flow cytometry. Intratumoral B cells contained high percentages of activated (CD86+), antigen-presenting (CD86+/CD21-) and memory B cells (IgD-/CD27+). T follicular helper cells (CD4+/CXCR5+/CD45RA-/CCR7-) as key components of tertiary lymphoid structures and plasma cells made up high percentages of the lymphocyte infiltrate. Percentages of regulatory B cell varied depending on the regulatory phenotype. Analysis of humoral immune responses against 23 tumor-associated antigens (TAA) showed reactivity against at least one antigen in 56% of HNSCC patients. Reactivity was less frequent in human papillomavirus associated (HPV+) patients and healthy controls compared to HPV negative (HPV-) HNSCC. Likewise, patients with early stage HNSCC or MHC-I loss on tumor cells had low TAA responses. Patients with TAA responses showed CD4+ dominated T cell infiltration compared to mainly CD8+ T cells in tumors without detected TAA response. To summarize, our data demonstrates different immune infiltration patterns in relation to serological TAA response detection and the presence of B cell subpopulations in HNSCC that can engage in tumor promoting and antitumor activity. In view of increasing use of immunotherapeutic approaches, it will be important to include B cells into comprehensive phenotypic and functional analyses of tumor-associated lymphocytes.
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Affiliation(s)
- Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Center, Ludwig Maximilians University, Munich, Germany
- Gene Center, Ludwig Maximilians University, Munich, Germany
| | - Hans A. Schlößer
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany
| | - Martin Thelen
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
| | - Kerstin Wennhold
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
| | - Sacha I. Rothschild
- Department of Internal Medicine, Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Ramona Gilles
- Institute of Transfusion Medicine, University of Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Oliver G. Siefer
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Christian U. Huebbers
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Engin Cukuroglu
- Computational and Systems Biology, Genome Institute of Singapore, Singapore
| | - Jonathan Göke
- Computational and Systems Biology, Genome Institute of Singapore, Singapore
- National Cancer Centre, Singapore
| | - Axel Hillmer
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Birgit Gathof
- Institute of Transfusion Medicine, University of Cologne, Cologne, Germany
| | - Moritz F. Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Jens P. Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Alexander Shimabukuro-Vornhagen
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
| | - Sebastian Theurich
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Gene Center, Ludwig Maximilians University, Munich, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Cancer- and Immunometabolism Research Group, Dept. I of Internal Medicine, University Hospital Cologne, Cologne, Germany
- Department of Medicine III, University Hospital, LMU Munich, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany
| | - Michael von Bergwelt-Baildon
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department of Medicine III, University Hospital, LMU Munich, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany
- Partner Site, German Cancer Consortium (DKTK), Munich, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
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38
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Maus V, Kabbasch C, Beutner D. Vagales Paragangliom mit anatomischer Rarität der
Blutversorgung. Laryngorhinootologie 2018; 97:871-872. [PMID: 30536284 DOI: 10.1055/a-0747-7001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Volker Maus
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln
| | - Christoph Kabbasch
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln
| | - Dirk Beutner
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Uniklinik Köln
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Schlößer HA, Thelen M, Lechner A, Wennhold K, Garcia-Marquez MA, Rothschild SI, Staib E, Zander T, Beutner D, Gathof B, Gilles R, Cukuroglu E, Göke J, Shimabukuro-Vornhagen A, Drebber U, Quaas A, Bruns CJ, Hölscher AH, Von Bergwelt-Baildon MS. B cells in esophago-gastric adenocarcinoma are highly differentiated, organize in tertiary lymphoid structures and produce tumor-specific antibodies. Oncoimmunology 2018; 8:e1512458. [PMID: 30546950 PMCID: PMC6287776 DOI: 10.1080/2162402x.2018.1512458] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/09/2018] [Accepted: 08/11/2018] [Indexed: 12/29/2022] Open
Abstract
Tumor-infiltrating lymphocytes (TILs) are correlated to prognosis of several kinds of cancer. Most studies focused on T cells, while the role of tumor-associated B cells (TABs) has only recently gained more attention. TABs contain subpopulations with distinct functions, potentially promoting or inhibiting immune responses. This study provides a detailed analysis of TABs in gastro-esophageal adenocarcinoma (EAC). Flow cytometric analyses of single cell suspensions of tumor samples, mucosa, lymph nodes and peripheral blood mononuclear cells (PBMC) of EAC patients and healthy controls revealed a distinct B cell compartment in cancer patients. B cells were increased in tumor samples and subset-analyses of TILs showed increased proportions of differentiated and activated B cells and an enrichment for follicular T helper cells. Confocal microscopy demonstrated that TABs were mainly organized in tertiary lymphoid structures (TLS), which resemble lymphoid follicles in secondary lymphoid organs. A panel of 34 tumor-associated antigens (TAAs) expressed in EAC was identified based on public databases and TCGA data to analyze tumor-specific B cell responses using a LUMINEXTM bead assay and flow cytometry. Structural analyses of TLS and the detection of tumor-specific antibodies against one or more TAAs in 48.1% of analyzed serum samples underline presence of anti-tumor B cell responses in EAC. Interestingly, B cells were decreased in tumors with expression of Programmed Death Ligand 1 or impaired HLA-I expression. These data demonstrate that anti-tumor B cell responses are an additional and underestimated aspect of EAC. Our results are of immediate translational relevance to emerging immunotherapies.
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Affiliation(s)
- Hans A. Schlößer
- Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Martin Thelen
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Axel Lechner
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Department of Head and Neck Surgery, University of Göttingen, Göttingen, Germany
| | - Kerstin Wennhold
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | | | | | - Elena Staib
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Thomas Zander
- Department I of Internal Medicine I, University of Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Head and Neck Surgery, University of Göttingen, Göttingen, Germany
| | - Birgit Gathof
- Institute of Transfusion Medicine, University of Cologne, Cologne, Germany
| | - Ramona Gilles
- Institute of Transfusion Medicine, University of Cologne, Cologne, Germany
| | | | | | | | - Uta Drebber
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Christiane J. Bruns
- Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany
| | - Arnulf H. Hölscher
- Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany
| | - Michael S. Von Bergwelt-Baildon
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Internal Medicine III, University Hospital, Munich, Germany
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Maier H, Baumann U, Baumgartner WD, Beutner D, Caversaccio MD, Keintzel T, Kompis M, Lenarz T, Magele A, Mewes T, Müller A, Rader T, Rahne T, Schraven SP, Schwab B, Sprinzl GM, Strauchmann B, Todt I, Wesarg T, Wollenberg B, Plontke SK. Minimal Reporting Standards for Active Middle Ear Hearing Implants. Audiol Neurootol 2018; 23:105-115. [PMID: 30196279 DOI: 10.1159/000490878] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/13/2018] [Indexed: 11/19/2022] Open
Abstract
There is currently no standardized method for reporting audiological, surgical and subjective outcome measures in clinical trials with active middle ear implants (AMEIs). It is often difficult to compare studies due to data incompatibility and to perform meta-analyses across different centres is almost impossible. A committee of ENT and audiological experts from Germany, Austria and Switzerland decided to address this issue by developing new minimal standards for reporting the outcomes of AMEI clinical trials. The consensus presented here aims to provide a recommendation to enable better inter-study comparability.
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Affiliation(s)
- Hannes Maier
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
| | - Uwe Baumann
- University Hospital Frankfurt, ENT/Audiological Acoustics, Frankfurt, Germany
| | | | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Marco D Caversaccio
- University Hospital, Inselspital Department of ORL, Head and Neck Surgery, Bern, Switzerland
| | - Thomas Keintzel
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Martin Kompis
- University Hospital, Inselspital Department of ORL, Head and Neck Surgery, Bern, Switzerland
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
| | | | - Torsten Mewes
- Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - Alexander Müller
- Vivantes Hearing Center, ORL Department Friedrichshain Clinic, Berlin, Germany
| | - Tobias Rader
- Department of Otolaryngology and Head and Neck Surgery, Audiological Acoustics, University of Mainz, Mainz, Germany
| | - Torsten Rahne
- Department of Otolaryngology and Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sebastian P Schraven
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", University Medical Center Rostock, Rostock, Germany
| | | | | | - Bernd Strauchmann
- Department of Otorhinolaryngology, UniversityHospital Zürich, Head and Neck Surgery, Zürich, Switzerland
| | - Ingo Todt
- Department of Otolaryngology, Klinikum Bielefeld, Head and Neck Surgery, Bielefeld, Germany
| | - Thomas Wesarg
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical Center, Freiburg, Germany
| | - Barbara Wollenberg
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig Holstein, Campus Lübeck, Lübeck, Germany
| | - Stefan K Plontke
- Department of Otolaryngology and Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Rothschild U, Muller L, Lechner A, Schlsser HA, Beutner D, Lubli H, Zippelius A, Rothschild SI. Immunotherapy in head and neck cancer – scientific rationale, current treatment options and future directions. Swiss Med Wkly 2018; 148:w14625. [DOI: 10.4414/smw.2018.14625] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Uta Rothschild
- Division of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital Olten, Switzerland
| | - Laurent Muller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Basel, Switzerland
| | - Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany / Centre for Molecular Medicine Cologne (CMMC), Cologne, Germany / Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Centre, Ludwig-Maximi
| | - Hans A Schlsser
- Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Centre, Ludwig-Maximilians-University of Munich, Germany / Department of General, Visceral and Cancer Surgery, University of Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Göttingen, Georg August University, Göttingen, Germany
| | - Heinz Lubli
- University Hospital Basel, Department of Internal Medicine, Medical Oncology, Basel, Switzerland / Cancer Immunology, Department of Biomedicine, University of Basel, Switzerland
| | - Alfred Zippelius
- University Hospital Basel, Department of Internal Medicine, Medical Oncology, Basel, Switzerland / Cancer Immunology, Department of Biomedicine, University of Basel, Switzerland
| | - Sacha I Rothschild
- University Hospital Basel, Department of Internal Medicine, Medical Oncology, Basel, Switzerland / Cancer Immunology, Department of Biomedicine, University of Basel, Switzerland
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Hufbauer M, Maltseva M, Meinrath J, Lechner A, Beutner D, Huebbers CU, Akgül B. HPV16 increases the number of migratory cancer stem cells and modulates their miRNA expression profile in oropharyngeal cancer. Int J Cancer 2018; 143:1426-1439. [PMID: 29663357 DOI: 10.1002/ijc.31538] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/08/2018] [Accepted: 04/04/2018] [Indexed: 12/22/2022]
Abstract
Human papillomavirus type 16 (HPV16) is a major risk for development of oropharyngeal squamous-cell-carcinoma (OPSCC). Although HPV+ OPSCC metastasize faster than HPV- tumors, they have a better prognosis. The molecular and cellular alterations underlying this pathobiology of HPV+ OPSCC remain elusive. In this study, we examined whether expression of HPV16-E6E7 targets the number of migratory and stationary cancer stem cells (CSC). Furthermore, we wanted to elucidate if aberrantly expressed miRNAs in migratory CSC may be responsible for progression of OPSCCs and whether they may serve as potential novel biomarkers for increased potential of metastasis. Our studies revealed that HPV16-E6E7 expression leads to an increase in the number of stationary (CD44high /EpCAMhigh ) stem cells in primary keratinocyte cultures. Most importantly, expression of E6E7 in the cell line H357 increased the migratory (CD44high /EpCAMlow ) CSC pool. This increase in migratory CSCs could also be confirmed in HPV+ OPSCC. Differentially expressed miRNAs from HPV16-E6E7 positive CD44high /EpCAMlow CSCs were validated by RT-qPCR and in situ hybridization on HPV16+ OPSCCs. These experiments led to the identification of miR-3194-5p, which is upregulated in primary HPV16+ OPSCC and matched metastasis. MiR-1281 was also found to be highly expressed in HPV+ and HPV- metastasis. As inhibition of this miRNA led to a markedly reduction of CD44high /EpCAMlow cells, it may prove to be a promising drug target. Taken together, our findings highlight the capability of HPV16 to modify the phenotype of infected stem cells and that miR-1281 and miR3194-5p may represent promising targets to block metastatic spread of OPSCC.
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Affiliation(s)
- Martin Hufbauer
- Institute of Virology, University of Cologne, Cologne, Germany
| | - Margaret Maltseva
- Institute of Virology, University of Cologne, Cologne, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | | | - Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.,Cologne Interventional Immunology, Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Christian U Huebbers
- Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany
| | - Baki Akgül
- Institute of Virology, University of Cologne, Cologne, Germany
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43
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Wolber P, Volk G, Horstmann L, Finkensieper M, Shabli S, Wittekindt C, Klussmann J, Guntinas‐Lichius O, Beutner D, Grosheva M. Patient‘s perspective on long‐term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2‐year follow‐up. Clin Otolaryngol 2018; 43:1073-1079. [DOI: 10.1111/coa.13104] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P. Wolber
- Medical Faculty Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne CologneGermany
| | - G.F. Volk
- Department of Otorhinolaryngology, Head and Neck Surgery Jena University Hospital Jena Germany
| | - L. Horstmann
- Medical Faculty Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne CologneGermany
| | - M. Finkensieper
- Department of Otorhinolaryngology, Head and Neck Surgery Jena University Hospital Jena Germany
| | - S. Shabli
- Medical Faculty Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne CologneGermany
| | - C. Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery University of Giessen Giessen Germany
| | - J.P. Klussmann
- Medical Faculty Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne CologneGermany
| | - O. Guntinas‐Lichius
- Department of Otorhinolaryngology, Head and Neck Surgery Jena University Hospital Jena Germany
| | - D. Beutner
- Medical Faculty Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne CologneGermany
- Department of Otorhinolaryngology Head and Neck Surgery University of Göttingen Göttingen Germany
| | - M. Grosheva
- Medical Faculty Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne CologneGermany
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44
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Thierauf J, Weissinger SE, Veit JA, Affolter A, Laureano NK, Beutner D, Heiduschka G, Kadletz L, Meyer M, Quaas A, Plinkert P, Hoffmann TK, Hess J. Low SOX2 expression marks a distinct subset of adenoid cystic carcinoma of the head and neck and is associated with an advanced tumor stage. PLoS One 2018; 13:e0194989. [PMID: 29596469 PMCID: PMC5875788 DOI: 10.1371/journal.pone.0194989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 03/14/2018] [Indexed: 12/15/2022] Open
Abstract
Introduction The transcription factor SOX2 has been identified as a lineage survival oncogene in squamous cell carcinoma and copy number gain is a common event in several human malignancies including head and neck cancer. However, the regulation and function of SOX2 during carcinogenesis as well as its prognostic value appears to be highly context dependent. As an example, high SOX2 expression in lung squamous cell carcinoma (SCC) is related to a favorable prognosis, while it is associated with poor outcome in lung adenocarcinoma. More recently, higher SOX2 levels and improved survival was also reported for head and neck SCC (HNSCC), and silencing of SOX2 expression in HNSCC cell lines revealed a mesenchymal-like phenotype with prominent vimentin expression. So far, SOX2 expression and its clinical relevance for other head and neck cancers, such as adenoid cystic carcinoma (HNACC) have not been sufficiently investigated. Material and methods SOX2, vimentin and E-cadherin expression was assessed by immunohistochemical staining on serial sections from formalin fixed and paraffin embedded tissue samples of a patient cohort (n = 45) with primary ACC and correlated with patient and tumor characteristics as well as survival. Results High SOX2 expression was found in 14 (31%) primary tumor specimens and was significantly correlated with a N0 lymph node status (p = 0.04), while low SOX2 expression was correlated with a solid growth pattern (p = 0.031). Of the 45 patients, 27 tumor samples resembled an EMT-like phenotype, as assessed by high vimentin and low E-cadherin levels. However, in HNACC SOX2 levels were neither correlated with vimentin nor with E-cadherin expression, further supporting a context dependent regulation and function of SOX2 in distinct tumor entities. Conclusion The absence of SOX2 was predominantly found in solid HNACC, which are characterized by a more aggressive phenotype in ACC. However, the underlying molecular mechanisms of SOX2 regulation and function in distinct HNACC subgroups remain to be fully elucidated.
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Affiliation(s)
- Julia Thierauf
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Ulm, Ulm, Germany
- * E-mail:
| | | | - Johannes A. Veit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Ulm, Ulm, Germany
| | - Annette Affolter
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Natalia K. Laureano
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Gregor Heiduschka
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Vienna, Austria
| | - Lorenz Kadletz
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Vienna, Austria
| | - Moritz Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Peter Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas K. Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Ulm, Ulm, Germany
| | - Jochen Hess
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Heidelberg, Germany
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45
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Grünewald I, Trautmann M, Busch A, Bauer L, Huss S, Schweinshaupt P, Vollbrecht C, Odenthal M, Quaas A, Büttner R, Meyer MF, Beutner D, Hüttenbrink KB, Wardelmann E, Stenner M, Hartmann W. MDM2 and CDK4 amplifications are rare events in salivary duct carcinomas. Oncotarget 2018; 7:75261-75272. [PMID: 27662657 PMCID: PMC5342738 DOI: 10.18632/oncotarget.12127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 09/12/2016] [Indexed: 12/14/2022] Open
Abstract
Salivary duct carcinoma (SDC) is an aggressive adenocarcinoma of the salivary glands associated with poor clinical outcome. SDCs are known to carry TP53 mutations in about 50%, however, only little is known about alternative pathogenic mechanisms within the p53 regulatory network. Particularly, data on alterations of the oncogenes MDM2 and CDK4 located in the chromosomal region 12q13-15 are limited in SDC, while genomic rearrangements of the adjacent HMGA2 gene locus are well documented in subsets of SDCs. We here analyzed the mutational status of the TP53 gene, genomic amplification of MDM2, CDK4 and HMGA2 rearrangement/amplification as well as protein expression of TP53 (p53), MDM2 and CDK4 in 51 de novo and ex pleomorphic adenoma SDCs. 25 of 51 cases were found to carry TP53 mutations, associated with extreme positive immunohistochemical p53 staining levels in 13 cases. Three out of 51 tumors had an MDM2 amplification, one of them coinciding with a CDK4 amplification and two with a HMGA2 rearrangement/amplification. Two of the MDM2 amplifications occurred in the setting of a TP53 mutation. Two out of 51 cases showed a CDK4 amplification, one synchronously being MDM2 amplified and the other one displaying concurrent low copy number increases of both, MDM2 and HMGA2. In summary, we here show that subgroups of SDCs display genomic amplifications of MDM2 and/or CDK4, partly in association with TP53 mutations and rearrangement/amplification of HMGA2. Further research is necessary to clarify the role of chromosomal region 12q13-15 alterations in SDC tumorigenesis and their potential prognostic and therapeutic relevance.
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Affiliation(s)
- Inga Grünewald
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Marcel Trautmann
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Alina Busch
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Muenster, Muenster, Germany
| | - Larissa Bauer
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Sebastian Huss
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | | | - Claudia Vollbrecht
- Institute of Pathology, University Hospital Cologne, Cologne, Germany.,Current address: Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany
| | | | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Reinhard Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Karl-Bernd Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Eva Wardelmann
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Muenster, Muenster, Germany
| | - Wolfgang Hartmann
- Department of Pathology, University Hospital Muenster, Muenster, Germany
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46
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Jansen S, Boor M, Meyer MF, Pracht ED, Volland R, Klünter HD, Hüttenbrink KB, Beutner D, Grosheva M. Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers. Diving Hyperb Med 2018; 47:223-227. [PMID: 29241231 DOI: 10.28920/dhm47.4.223-227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/11/2017] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). METHODS This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The peak pressure difference between the R-tymp and the V-tymp (R-VdP) defined effectiveness of pressure equalization after Valsalva manoeuvres. We evaluated the change in compliance and peak pressure and correlated the results to the otoscopic findings and diving experience. RESULTS Twenty-three divers performed 144 dives. Middle ear barotrauma was assessed using the Edmonds modification of the TEED scoring system. In the ETFT, the R-tymp peak pressure displayed a negative shift from day one to three (P = 0.001) and differed significantly between the experience groups (P = 0.01). R-VdP did not change significantly on any of the three days of diving (all P > 0.05). Participants without MEBt showed significantly lower R-tymp values than did those with barotrauma (P = 0.019). CONCLUSION Repetitive pressure exposure during three consecutive days of freshwater diving led to a negative shift of the peak pressure in the middle ear. Less experienced divers showed significantly higher middle ear peak pressure and higher pressure differences after equalization manoeuvres. Higher middle ear peak pressure was also associated with a higher prevalence of barotrauma.
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Affiliation(s)
- Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Manuela Boor
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Kerpener Straβe 62, 50937 Cologne, Germany
| | | | - Ruth Volland
- Department of Paediatric Oncology and Haematology, University Children's Hospital of Cologne, Cologne, Germany
| | - Heinz D Klünter
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Karl-Bernd Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
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47
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Luers JC, Hüttenbrink KB, Beutner D. Surgical anatomy of the round window-Implications for cochlear implantation. Clin Otolaryngol 2018; 43:417-424. [PMID: 29240305 DOI: 10.1111/coa.13048] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND The round window is an important portal for the application of active hearing aids and cochlear implants. The anatomical and topographical knowledge about the round window region is a prerequisite for successful insertion for a cochlear implant electrode. OBJECTIVE OF REVIEW To sum up current knowledge about the round window anatomy and to give advice to the cochlear implant surgeon for optimal placement of an electrode. TYPE OF REVIEW Systematic Medline search. SEARCH STRATEGY Search term "round window[Title]" with no date restriction. Only publications in the English Language were included. All abstracts were screened for relevance, that is a focus on surgical anatomy of the round window. The search results were supplemented with hand searching of selected reviews and reference lists from included studies. EVALUATION METHOD Subjective assessment. RESULTS There is substantial variability in size and shape of the round window. The round window is regarded as the most reliable surgical landmark to safely locate the scala tympani. Factors affecting the optimal trajectory line for atraumatic electrode insertion are anatomy of the round window, the anatomy of the intracochlear hook region and the variable orientation and size of the cochlea's basal turn. CONCLUSIONS The very close relation to the sensitive inner ear structures necessitates a thorough anatomic knowledge and careful insertion technique, especially when implanting patients with residual hearing. In order to avoid electrode migration between the scalae and to achieve protect the modiolus and the basilar membrane, it is recommended to aim for an electrode insertion vector from postero-superior to antero-inferior.
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Affiliation(s)
- J C Luers
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - K B Hüttenbrink
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - D Beutner
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
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Meyer MF, Boor M, Jansen S, Pracht ED, Felsch M, Klünter HD, Hüttenbrink KB, Beutner D, Grosheva M. Influence of repetitive diving in saltwater on pressure equalization and Eustachian tube function in recreational scuba divers. Diving Hyperb Med 2017; 47:214-215. [PMID: 29241230 PMCID: PMC6706334 DOI: 10.28920/dhm47.4.216-222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 09/11/2017] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We investigated in a prospective, observational trial the feasibility of using the Eustachian tube function test (ETFT) to measure the effect of repetitive pressure exposure during open seawater dives on Eustachian tube function. METHODS The study included 28 adult divers during six consecutive days of diving in the Red Sea. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The R-tymp was obtained as 'baseline' peak pressure. After a Valsalva, the peak pressure should shift (positively), revealing a positive shift of the tympanic membrane. This pressure shift is defined here as R-VdP. The changes in compliance and peak pressure were recorded and correlated with otoscopic findings and diving experience. Middle ear barotrauma was scored using the Edmonds modified TEED scale. RESULTS The 28 participants performed 437 dives. Positive shift of pressure in the middle ear was evident with significant changes from day one to day three (P < 0.0001). Divers with barotrauma showed significantly lower values of R-tymp peak pressure and significantly higher negative R-VdP, compared to divers with normal otoscopic findings (P < 0.05). Diving experience significantly correlated with R-tymp peak pressure and prevalence of middle ear barotrauma. CONCLUSION Significant changes in middle ear pressure and pressure equalization from repeated pressure exposure in saltwater were seen using ETFT. Repetitive, multi-day diving led to significantly decreased compliance and increased R-tymp peak pressure (overpressure) in the middle ear. Most profound changes were observed in less and intermediate experienced divers.
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Affiliation(s)
- Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Kerpener Straβe 62, 50937 Cologne, Germany,
| | - Manuela Boor
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | | | - Moritz Felsch
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
| | - Heinz D Klünter
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Karl-Bernd Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
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49
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Gostian AO, Otte MS, Pazen D, Ortmann M, Schwarz D, Hüttenbrink KB, Beutner D. Influence of backside loading on the floating mass transducer: An in vitro experimental study. Clin Otolaryngol 2017; 43:538-543. [PMID: 29054109 DOI: 10.1111/coa.13017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 11/30/2022]
Abstract
HYPOTHESIS The vibration of the floating mass transducer (FMT) of a single active middle-ear implant (AMEI) is distinctly influenced by the properties of the material coupled to its back side. BACKGROUND In round window vibroplasty, the FMT needs to be padded against the surrounding bone opposite from the round window membrane. This represents one factor influencing its performance as a round window driver. Therefore, we examined the effects of different materials linked to the back side of an FMT on its vibration range. METHODS The back side of an FMT was glued to a silicone cylinder 1.0 mm in diameter and 1.0 mm - 1.5 mm in length and of 40A, 50A or 70A Shore hardness; to cartilage of equivalent size; or to a round window soft coupler (RWSC), all firmly fixed on a steel plate. The vibrations were determined by a laser Doppler vibrometer (LDV) measuring the velocity of the centre point on the front side of the FMT. RESULTS The materials on the back side of the FMT significantly influenced the vibration range of the FMT. The RWSC and silicone of 40A Shore hardness allowed for the highest detected velocities, while cartilage led to a distinct reduction similarly to 70A silicone. CONCLUSION The coupling on the back side of an FMT distinctly affects its vibration range. In this regard, the RWSC and silicone of 40A Shore hardness yield the least impairment of vibration. Thus, the RWSC may be a feasible option in round window vibroplasty when additionally connected to the FMT opposite from the round window membrane.
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Affiliation(s)
- A-O Gostian
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - M S Otte
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - D Pazen
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - M Ortmann
- Jean Uhrmacher-Institute for Clinical, ENT-Research, University of Cologne, Cologne, Germany
| | - D Schwarz
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - K B Hüttenbrink
- Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - D Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
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50
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Hinkelbein J, Jansen S, Iovino I, Kruse S, Meyer M, Cirillo F, Drinhaus H, Hohn A, Klein C, Robertis ED, Beutner D. Thirty Minutes of Hypobaric Hypoxia Provokes Alterations of Immune Response, Haemostasis, and Metabolism Proteins in Human Serum. Int J Mol Sci 2017; 18:E1882. [PMID: 28858246 PMCID: PMC5618531 DOI: 10.3390/ijms18091882] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 08/21/2017] [Accepted: 08/29/2017] [Indexed: 12/20/2022] Open
Abstract
Hypobaric hypoxia (HH) during airline travel induces several (patho-) physiological reactions in the human body. Whereas severe hypoxia is investigated thoroughly, very little is known about effects of moderate or short-term hypoxia, e.g. during airline flights. The aim of the present study was to analyse changes in serum protein expression and activation of signalling cascades in human volunteers staying for 30 min in a simulated altitude equivalent to airline travel. After approval of the local ethics committee, 10 participants were exposed to moderate hypoxia (simulation of 2400 m or 8000 ft for 30 min) in a hypobaric pressure chamber. Before and after hypobaric hypoxia, serum was drawn, centrifuged, and analysed by two-dimensional gel electrophoresis (2-DIGE) and matrix-assisted laser desorption/ionization followed by time-of-flight mass spectrometry (MALDI-TOF). Biological functions of regulated proteins were identified using functional network analysis (GeneMania®, STRING®, and Perseus® software). In participants, oxygen saturation decreased from 98.1 ± 1.3% to 89.2 ± 1.8% during HH. Expression of 14 spots (i.e., 10 proteins: ALB, PGK1, APOE, GAPDH, C1QA, C1QB, CAT, CA1, F2, and CLU) was significantly altered. Bioinformatic analysis revealed an association of the altered proteins with the signalling cascades "regulation of haemostasis" (four proteins), "metabolism" (five proteins), and "leukocyte mediated immune response" (five proteins). Even though hypobaric hypoxia was short and moderate (comparable to an airliner flight), analysis of protein expression in human subjects revealed an association to immune response, protein metabolism, and haemostasis.
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Affiliation(s)
- Jochen Hinkelbein
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, 50937 Cologne, Germany.
| | - Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50937 Cologne, Germany.
| | - Ivan Iovino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via S. Pansini, 5-80131 Napoli, Italy.
| | - Silvia Kruse
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, 50937 Cologne, Germany.
| | - Moritz Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50937 Cologne, Germany.
| | - Fabrizio Cirillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via S. Pansini, 5-80131 Napoli, Italy.
| | - Hendrik Drinhaus
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, 50937 Cologne, Germany.
| | - Andreas Hohn
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, 50937 Cologne, Germany.
| | - Corinna Klein
- CECAD Lipidomics & Proteomics Facilities, CECAD Research Center, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany.
| | - Edoardo De Robertis
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via S. Pansini, 5-80131 Napoli, Italy.
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50937 Cologne, Germany.
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