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Wegscheider AS, Tauber N, Graubner K, Ziegeler G, Behr M, Lindner C, Niendorf A. Synchronous High-Grade Squamous Intraepithelial Lesion of the Fimbria of the Fallopian Tube in a 51-Year-Old Woman with Invasive Squamous Cell Carcinoma of the Uterine Cervix. Diagnostics (Basel) 2023; 13:2836. [PMID: 37685373 PMCID: PMC10486700 DOI: 10.3390/diagnostics13172836] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Primary squamous cell carcinoma or squamous intraepithelial lesion of the fallopian tube is a very rare finding with only a small number of cases worldwide. We describe the case of a 51-year-old woman, undergoing an abdominal hysterectomy after the diagnosis of an HPV-associated invasive squamous cell carcinoma of the uterine cervix with the unexpected detection of an HPV16-positive high-grade squamous intraepithelial lesion of the fimbria of the right fallopian tube in the resection specimen. The finding of an isolated, HPV-associated squamous intraepithelial lesion in the fallopian tube raises the question of a de novo development in this body compartment (after exclusion of a continuous metastatic spread from the uterine cervix) by taking a virus-associated field effect into account and should encourage the inclusion of this possibility when examining the fallopian tube in a routine setting.
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Affiliation(s)
| | - Nikolas Tauber
- Department of Gynecology, Agaplesion Diakonieklinikum Hamburg, 20259 Hamburg, Germany
| | - Kirsten Graubner
- Department of Gynecology, Agaplesion Diakonieklinikum Hamburg, 20259 Hamburg, Germany
| | - Gudrun Ziegeler
- MVZ Prof. Dr. Med. A. Niendorf Pathologie Hamburg-West GmbH, 22767 Hamburg, Germany
| | - Michael Behr
- MVZ Prof. Dr. Med. A. Niendorf Pathologie Hamburg-West GmbH, 22767 Hamburg, Germany
| | - Christoph Lindner
- Department of Gynecology, Agaplesion Diakonieklinikum Hamburg, 20259 Hamburg, Germany
| | - Axel Niendorf
- MVZ Prof. Dr. Med. A. Niendorf Pathologie Hamburg-West GmbH, 22767 Hamburg, Germany
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Subodh Rao J, Behr M, von Lieres E. Resolving dispersion coefficients in reduced order chromatography models. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255015] [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: 11/06/2022]
Affiliation(s)
- J. Subodh Rao
- Forschungszentrum Jülich IBG-1 Wilhelm-Johnen Str. 1 52428 Jülich Germany
| | - M. Behr
- RWTH Aachen University CATS Schinkelstr. 2 52062 Aachen Germany
| | - E. von Lieres
- Forschungszentrum Jülich IBG-1 Wilhelm-Johnen Str. 1 52428 Jülich Germany
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Rosentritt M, Strasser T, Behr M, Schmid A. In vitro performance of CAD/CAM and conventional removable dentures. Int J Comput Dent 2021; 24:385-392. [PMID: 34931774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM Innovations in CAD/CAM technology and materials science offer new methodologies for removable prosthodontics. As clinical data are still rare, in vitro performance of both CAD/CAM and comparable conventional materials may help to estimate the clinical outcome. MATERIALS AND METHODS Specimens (n = 8 per group) from teeth (CediTEC, SR VivodentCAD, Vitapan), base materials (V-Print dentbase, IvoBase CAD, Paladur), adhesives (CediTEC Primer/Adhesive, IvoBase CAD Bond), and a fully printed specimen (Try-In) were created. All specimens underwent thermal cycling and mechanical loading (TCML): 1,200,000 × 50 N; 2x3000 x 5°C/55°C; H2O. Surviving specimens were loaded to fracture. Statistical tests used were the Shapiro-Wilk test and the Kaplan-Meier survival, with the level of significance set to α = 0.05. RESULTS Mean loading cycles until failure varied between 100 and 621,667 cycles. Up to five specimens per group failed during TCML. With one exception, all specimens of the entirely CAD/CAM-fabricated group survived TCML. The log-rank (Mantel-Cox) test showed significantly different (P = 0.000) loading cycles between the systems (chi-square test: 28,247; degree of freedom: 8). Failure of the dentures during TCML was characterized by failure of the denture base (2x), denture tooth (13x), mixed base/tooth (3x) or adhesive between base and tooth (1x). CONCLUSION TCML and fracture testing showed different aspects of denture tooth restoration. The results indicated no correlation between fracture force, fracture pattern, and survival cycles. Denture teeth (milled, heat-pressed), bases (milled, printed, pressed), and primer should be matched up to optimize the performance of dentures.
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Blanchard S, Behr M. Functional field protocol to optimize the choice of footwear on synthetic turf in rugby. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.02.010] [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: 11/28/2022]
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Evans V, Behr M, Gangwar A, Noseworthy MD, Kumbhare D. Potential Role of MRI Imaging for Myofascial Pain: A Scoping Review for the Clinicians and Theoretical Considerations. J Pain Res 2021; 14:1505-1514. [PMID: 34079365 PMCID: PMC8166277 DOI: 10.2147/jpr.s302683] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022] Open
Abstract
The most common cause of chronic musculoskeletal pain is chronic myofascial pain syndrome (MPS). MPS often presents with increased muscle stiffness, and the myofascial trigger point (MTrP). Imaging modalities have been used to identify the MTrP, but their role in the detection and diagnosis of MPS remains unclear. The purpose of this review was to identify evidence in literature for the use of imaging in the role of classifying and explaining the physiology of MTrPs. Since few imaging techniques have been performed on MTrPs, we explored the imaging techniques that can effectively image complex skeletal muscle microstructure, and how they could be used. As part of a scoping review, we conducted a systematic search from three medical databases (CINAHL, EMBASE and MEDLINE) from year to year to analyze past MTrP imaging, as well as analyzing imaging techniques performed on the microstructure of muscle. Previously, ultrasound has been used to differentiate active, latent MTrPs, but these studies do not adequately address their underlying anatomical structure. MRI remains the standard method of imaging skeletal muscle. The existing MRI literature suggests that the DTI technique can quantify muscle injury, strain, and structure. However, theoretically, HARDI and DKI techniques seem to provide more information for complex structural areas, although these modalities have a disadvantage of longer scan times and have not been widely used on skeletal muscle. Our review suggests that DTI is the most effective imaging modality that has been used to define the microstructure of muscle and hence, could be optimal to image the MTrP. HARDI and DKI are techniques with theoretical potential for analysis of muscle, which may provide more detailed information representative of finer muscle structural features. Future research utilizing MRI techniques to image muscle are necessary to provide a more robust means of imaging skeletal muscle and the MTrP.
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Affiliation(s)
- Valerie Evans
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada.,University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Michael Behr
- University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Anshika Gangwar
- University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Dinesh Kumbhare
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada.,University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
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Huber C, Rosentritt M, Strasser T, Behr M. Machine-driven simulation of removing luting agent remnants from implant surfaces: An investigator-independent assessment of cleaning protocols. J Mech Behav Biomed Mater 2021; 121:104584. [PMID: 34090119 DOI: 10.1016/j.jmbbm.2021.104584] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION To simulate removing luting agent remnants from crowns fixed onto implant-abutment analogs using a standardized machine-driven protocol including a scaler and air polishing or sonic. MATERIAL AND METHODS A motor-driven device was constructed that controlled the rotational speed of the specimens, machining distance, contact pressure, and working time. A standardized layer of cement (Provicol, VOCO; Cuxhaven, G; Ketac Cem, 3MEspe; Seefeld, G; or Rely X Unicem, 3MEspe, Seefeld, G) was placed onto the finishing line of the crowns luted onto titanium-abutment analogs. The cement layer was scaled with a fresh titanium scaler maneuvered by the motor-driven device and treated with air polishing or sonic. Protocol 1: Scaling only for 20s, 40s, or 60s; n=20; protocol 2: 40s of scaling plus 20s of air polishing; protocol 3: 20s of scaling plus 40s of air polishing; protocol 4: 20s of scaling plus 40s of sonic; protocol 5: 40s of scaling plus 20s of sonic; protocols 2-5: n=10. Cement remnants were counted digitally as "percentage of remnants". STATISTICS mean, standard deviation, Bonferroni post hoc tests; α=0.05. RESULTS Ketac Cem was easily removed by scaling only and Provicol by scaling and air polishing, but the self-adhesive resin composite cement Rely X Unicem was not removable with the device. Only remnants of Provicol could be significantly reduced by further treatment after scaling (p<0.001). CONCLUSION The presented motor-driven device enables reproducible investigations of various cleaning protocols and is thus useful to create an overview of cleaning protocols needed for the different types of cement.
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Affiliation(s)
- Christina Huber
- Department of Prosthodontics, University Hospital Regensburg, Germany.
| | - Martin Rosentritt
- Department of Prosthodontics, University Hospital Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthodontics, University Hospital Regensburg, Germany
| | - Michael Behr
- Department of Prosthodontics, University Hospital Regensburg, Germany
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Evans V, Behr M, Masani K, Kumbhare D. Quantitative response of healthy muscle following the induction of capsaicin: an exploratory randomized controlled trial. Trials 2020; 21:1020. [PMID: 33308274 PMCID: PMC7731533 DOI: 10.1186/s13063-020-04937-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/27/2020] [Indexed: 11/29/2022] Open
Abstract
Background Myofascial pain syndrome (MPS) is a prevalent chronic pain disorder primarily characterized by myofascial trigger points (MTrPs). There is limited knowledge on the pathophysiology and mechanisms underlying MTrP and its development. Research has previously demonstrated the identification of MTrPs using ultrasound and vibration sonoelastography, although there is some contradictory evidence regarding if MTrPs present as hyper or hypoechoic regions. Electromyography (EMG) investigations of MTrP have demonstrated that MTrPs are usually located proximal to innervation zones where the peak surface EMG signals are obtained from. Central sensitization has been proposed as the primary mechanism underlying MTrP development. Central sensitization is associated with hyperexcitability of neuronal responses to normal or noxious stimuli. There is a need for a study that measures ultrasound image textural changes and motor unit activity responses in the muscle following sensitization. The purpose of this study is to determine whether sensitizing healthy muscle using capsaicin induces a regional change in image texture variables within the specific and surrounding muscles, as well as the motor unit frequency and amplitude changes that accompany them. This is an exploratory trial that aims to provide preliminary evidence on whether central sensitization is a direct cause of taut band and MTrP development. Methods Ethical approval was obtained from the University Health Network (UHN) Research Ethics Board. This proposed study is a single centered, factorial, randomized placebo-controlled trial with two independent variables, depth of capsaicin application and dose of capsaicin, for a total of six treatment arms and three control treatment groups. Discussion This will be the first study that assesses the B-mode ultrasound image texture of induced sensitized muscles and will provide more evidence on muscle motor unit activity and regional changes of central sensitization. Findings from this study may support one of few hypotheses proposed delineating the involvement of central sensitization in the development of trigger points. Trial registration National Institutes of Health ClinicalTrials.gov NCT03944889. Registered on May 07, 2019
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Affiliation(s)
- Valerie Evans
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Michael Behr
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Kei Masani
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Dinesh Kumbhare
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada. .,Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada. .,Department of Medicine, Division of Physical Medicine and Rehabilitation, Toronto, Ontario, Canada.
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Rosentritt M, Preis V, Behr M, Strasser T. Fatigue and wear behaviour of zirconia materials. J Mech Behav Biomed Mater 2020; 110:103970. [DOI: 10.1016/j.jmbbm.2020.103970] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 01/10/2023]
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Rao J, Behr M, von Lieres E. High‐definition simulation of packed‐bed liquid chromatography. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055402] [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: 11/11/2022]
Affiliation(s)
- J. Rao
- Forschungszentrum Jülich IBG-1: Biotechnologie Wilhelm-Johnen-Str. 1 52428 Jülich Germany
- RWTH Aachen University CATS Schinkelstr. 2 52056 Aachen Germany
| | - M. Behr
- RWTH Aachen University CATS Schinkelstr. 2 52056 Aachen Germany
| | - E. von Lieres
- Forschungszentrum Jülich IBG-1: Biotechnologie Wilhelm-Johnen-Str. 1 52428 Jülich Germany
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Oberlin M, Andrès E, Behr M, Kepka S, Le Borgne P, Bilbault P. [Emergency overcrowding and hospital organization: Causes and solutions]. Rev Med Interne 2020; 41:693-699. [PMID: 32861534 DOI: 10.1016/j.revmed.2020.05.023] [Citation(s) in RCA: 2] [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: 01/04/2020] [Revised: 04/14/2020] [Accepted: 05/05/2020] [Indexed: 10/23/2022]
Abstract
Emergency Department (ED) overcrowding is a silent killer. Thus, several studies in different countries have described an increase in mortality, a decrease in the quality of care and prolonged hospital stays associated with ED overcrowding. Causes are multiple: input and in particular lack of access to lab test and imaging for general practitioners, throughput and unnecessary or time-consuming tasks, and output, in particular the availability of hospital beds for unscheduled patients. The main cause of overcrowding is waiting time for available beds in hospital wards, also known as boarding. Solutions to resolve the boarding problem are mostly organisational and require the cooperation of all department and administrative levels through efficient bed management. Elderly and polypathological patients wait longer time in ED. Internal Medicine, is the ideal specialty for these complex patients who require time for observation and evaluation. A strong partnership between the ED and the internal medicine department could help to reduce ED overcrowding by improving care pathways.
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Affiliation(s)
- M Oberlin
- Structure d'urgences, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67000 Strasbourg, France.
| | - E Andrès
- Service de Médecine Interne, Diabète et Maladies métaboliques, Hôpitaux Universitaires de Strasbourg, Clinique Médicale B - HUS, 1 porte de l'Hôpital, 67000 Strasbourg, France; Unité INSERM EA 3072 « Mitochondrie, Stress oxydant et Protection musculaire », Faculté de Médecine - Université de Strasbourg, 4 rue Kirschleger, 67085 Strasbourg, France
| | - M Behr
- Structure d'urgences, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67000 Strasbourg, France
| | - S Kepka
- Structure d'urgences, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67000 Strasbourg, France
| | - P Le Borgne
- Structure d'urgences, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67000 Strasbourg, France; Unité INSERM UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), Faculté de Médeine - Université de Strasbourg, 4 rue Kirschleger, 67085 Strasbourg, France
| | - P Bilbault
- Structure d'urgences, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67000 Strasbourg, France; Unité INSERM UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), Faculté de Médeine - Université de Strasbourg, 4 rue Kirschleger, 67085 Strasbourg, France
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Koh RGL, Behr M, Kirkwood M, Kumbhare D. Effect of Neighbourhood Size in Entropy Mapping of Ultrasound Images. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:2015-2018. [PMID: 33018399 DOI: 10.1109/embc44109.2020.9176526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Image filtering is a technique that can create additional visual representations of the original image. Entropy filtering is a specific application that can be used to highlight randomness of pixel grayscale intensities within an image. These image map created from filtering are based on the number of surrounding neighbourhood of pixels considered. However, there is no standard procedure for determining the correct "neighbourhood size" to use. We investigated the effects of neighbourhood size on the entropy calculation and provide a standardized approach for determining an appropriate neighbourhood size in entropy filtering in a musculoskeletal application. Ten healthy subjects showing no symptoms related to neuromuscular disease were recruited and ultrasound images of their trapezius muscle were acquired. The muscle regions in the images were manually isolated and regions of interest with varying neighbourhood sizes (increasing by 2 pixels) from 3x3 to 61X61 pixels were extracted. The entropy, relative signal entropy over noise entropy, statistical effect size as well as the percentage change of the effect size and instantaneous slope of the effect size was examined. The analysis showed that a neighbourhood size within the range of 21-25 pixels provides the maximum amount of information gained and coincides with a percentage change of the effect size of less than 5% and instantaneous slopes < 0.05.
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Behr M, Saiel S, Evans V, Kumbhare D. Machine Learning Diagnostic Modeling for Classifying Fibromyalgia Using B-mode Ultrasound Images. Ultrason Imaging 2020; 42:135-147. [PMID: 32174253 DOI: 10.1177/0161734620908789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Fibromyalgia (FM) diagnosis remains a challenge for clinicians due to a lack of objective diagnostic tools. One proposed solution is the use of quantitative ultrasound (US) techniques, such as image texture analysis, which has demonstrated discriminatory capabilities with other chronic pain conditions. From this, we propose the use of image texture variables to construct and compare two machine learning models (support vector machine [SVM] and logistic regression) for differentiating between the trapezius muscle in healthy and FM patients. US videos of the right and left trapezius muscle were acquired from healthy (n = 51) participants and those with FM (n = 57). The videos were converted into 64,800 skeletal muscle regions of interest (ROIs) using MATLAB. The ROIs were filtered by an algorithm using the complex wavelet structural similarity index (CW-SSIM), which removed ROIs that were similar. Thirty-one texture variables were extracted from the ROIs, which were then used in nested cross-validation to construct SVM and elastic net regularized logistic regression models. The generalized performance accuracy of both models was estimated and confirmed with a final validation on a holdout test set. The predicted generalized performance accuracy of the SVM and logistic regression models was computed to be 83.9 ± 2.6% and 65.8 ± 1.7%, respectively. The models achieved accuracies of 84.1%, and 66.0% on the final holdout test set, validating performance estimates. Although both machine learning models differentiate between healthy trapezius muscle and that of patients with FM, only the SVM model demonstrated clinically relevant performance levels.
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Affiliation(s)
- Michael Behr
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Saba Saiel
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Valerie Evans
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Dinesh Kumbhare
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Behr M, Schneider-Feyrer S, Huber C, Krifka S, Rosentritt M. The effect of sterilization and ultrasonic cleaning on resin cement interface of customized dental implant abutments. J Mech Behav Biomed Mater 2020; 104:103660. [PMID: 32174419 DOI: 10.1016/j.jmbbm.2020.103660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Michael Behr
- Department of Prosthodontics, Regensburg University Medical Center, Germany.
| | | | - Christina Huber
- Department of Prosthodontics, Regensburg University Medical Center, Germany
| | - Stefanie Krifka
- Department of Prosthodontics, Regensburg University Medical Center, Germany
| | - Martin Rosentritt
- Department of Prosthodontics, Regensburg University Medical Center, Germany
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15
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Hautmann MG, Rechner P, Neumaier U, Süß C, Dietl B, Putz FJ, Behr M, Kölbl O, Steger F. Radiotherapy for osteoarthritis—an analysis of 295 joints treated with a linear accelerator. Strahlenther Onkol 2019; 196:715-724. [DOI: 10.1007/s00066-019-01563-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/28/2019] [Indexed: 01/27/2023]
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16
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Siavikis G, Behr M, der Zel JMV, Feilzer AJ, Rosentritt M. Influence of Heat Treatment and Veneering on the Storage Modulus and Surface of Zirconia Ceramic. Eur J Dent 2019. [DOI: 10.1055/s-0039-1698879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
ABSTRACTObjectives: Glass-ceramic veneered zirconia is used for the application as fixed partial dentures. The aim of this investigation was to evaluate whether the heat treatment during veneering, the application of glass-ceramic for veneering or long term storage has an influence on the storage modulus of zirconia. Methods: Zirconia bars (Cercon, DeguDent, G; 0.5x2x20 mm) were fabricated and treated according to veneering conditions. Besides heating regimes between 680°C and 1000°C (liner bake and annealing), sandblasting (Al2O3) or steam cleaning were used. The bars were investigated after 90 days storage in water and acid. For investigating the influence of veneering, the bars were veneered in press- or layer technique. Dynamic mechanical analysis (DMA) in a three-point-bending design was performed to determine the storage modulus between 25°C and 200°C at a frequency of 1.66 Hz. All specimens were loaded on top and bottom (treatment on pressure or tensile stress side). Scanning electron microscopy (SEM) was used for evaluating the superficial changes of the zirconia surface due to treatment. Statistical analysis was performed using Mann Whitney U-test (α=0.05). Results: Sintered zirconia provided a storage modulus E’ of 215 (203/219) GPa and tan δ of 0.04 at 110°C. A 10%-decrease of E’ was found up to 180°C. The superficial appearance changed due to heating regime. Sandblasting reduced E’ to 213 GPa, heating influenced E’ between 205 GPa (liner bake 1) and 222 GPa (dentin bake 1). Steam cleaning, annealing and storage changed E’ between 4 GPa and 22 GPa, depending on the side of loading. After veneering, strong E’-reduction was found down to 84 GPa and 125 GPa. Conclusions: Veneering of zirconia with glass-ceramic in contrast to heat treating during veneering procedure had a strong influence on the modulus. The application of the glass-ceramic caused a stronger decrease of the storage modulus. (Eur J Dent 2011;5:191-198)
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Affiliation(s)
- Georgius Siavikis
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg, Germany
| | - Jef M van der Zel
- Department of Dental Materials Science, Academic Centre for Dentistry, Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, Holland
| | - Albert J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry, Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, Holland
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg, Germany
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Behr M, Noseworthy M, Kumbhare D. Feasibility of a Support Vector Machine Classifier for Myofascial Pain Syndrome: Diagnostic Case-Control Study. J Ultrasound Med 2019; 38:2119-2132. [PMID: 30614553 DOI: 10.1002/jum.14909] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/09/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Myofascial pain syndrome (MPS) is the most common cause of chronic pain worldwide. The diagnosis of MPS is subjective, which has created a need for a robust quantitative method of diagnosing MPS. We propose that using a support vector machine (SVM) along with ultrasound (US) texture features can differentiate between healthy and MPS-affected skeletal muscle. METHODS B-mode US video data were collected in the upper trapezius muscle of healthy (29) participants and patients with active (21) and latent (19) MPS, using an acquisition method outlined in previous works. Regions of interest were extracted and filtered to obtain a unique set of 917 images where texture features were extracted from each region of interest to characterize each image. These texture features were then used to train 4 separate binary SVM classifiers using nested cross-validation to implement feature selection and hyperparameter tuning. The performance of each kernel was estimated on the data and validated through testing on a final holdout set. RESULTS The radial basis function kernel classifier had the greatest Matthews correlation coefficient performance estimate of 0.627 ± 0.073 (mean ± SD) along with the largest area under the curve of 91.0% ± 3.0%. The final holdout test for the radial basis function classifier resulted in 86.96 accuracy, a Matthews correlation coefficient of 0.724, 88% sensitivity, and 86% specificity, validating our earlier performance estimates. CONCLUSIONS We have demonstrated that specific US texture features that have been used in other computer-aided diagnostic literature are feasible to use for the classification of healthy and MPS muscle using a binary SVM classifier.
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Affiliation(s)
- Michael Behr
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Michael Noseworthy
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
- Departments of Radiology, McMaster University, Hamilton, Ontario, Canada
- Departments of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
- Imaging Research Center, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Dinesh Kumbhare
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
- Imaging Research Center, St Joseph's Healthcare, Hamilton, Ontario, Canada
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Fitzgibbons T, Mejia M, Behr M, Landes B. Utilizing synchrotron-based X-ray scattering in polyolefin research. Acta Crystallogr A Found Adv 2019. [DOI: 10.1107/s0108767319095771] [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: 11/11/2022] Open
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Behr M, McNabb E, Noseworthy M, Sidkar S, Kumbhare D. Automatic ROI Placement in the Upper Trapezius Muscle in B-mode Ultrasound Images. Ultrason Imaging 2019; 41:231-246. [PMID: 30990127 DOI: 10.1177/0161734619839980] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Research involving B-mode ultrasound imaging often requires user defined regions of interest (ROIs) for analysis, traditionally drawn/selected by a trained operator. This manual process is incredibly time consuming and subjective. Here, we propose a fast and simple method of detecting the average location of aponeurosis layers in ultrasound images of the upper trapezius to place a rectangular ROI for quantitative image analysis. A total of 56 B-mode ultrasound images were analyzed, where rectangular ROIs were manually placed in the skeletal muscle by two trained operators. Interoperator agreement was determined between the ROI border locations using intercorrelation coefficient (ICC). Next, our automatic algorithm was applied (image thresholding, binary masking, and pixel intensity peak detection), estimating the mean position of both aponeurosis layers for rectangular ROI placement. The automatic estimation method was compared with the manual (visual) method by various statistics ( t test, linear correlation, Bland-Altman plot). The performance was also evaluated under additive noise conditions (Speckle). Finally, agreement of the overlapping ROI area between the manual and automatic methods was also computed. Performance of the automatic method compared with manual placement was excellent for both the superficial and deep ROI borders, performing consistently even with additive noise (error <0.674 ± 1.69 mm). Manual measurements indicated excellent consensus (ICC = 0.902) between operators. The overlapping area between the manual and automatic measurements demonstrated good agreement (90.65 ± 11.3%). With constraints, our method is robust even under large levels of noise addition making the automatic algorithm an acceptable replacement for manual ROI placement in the upper trapezius.
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Affiliation(s)
- Michael Behr
- 1 Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
| | - Evan McNabb
- 2 Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Michael Noseworthy
- 3 McMaster School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- 4 Imaging Research Centre, St. Joseph's Healthcare, Hamilton, ON, Canada
- 5 Department of Radiology, McMaster University, Hamilton, ON, Canada
- 6 Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
| | - Siddhartha Sidkar
- 7 Department of Engineering, George Mason University, Fairfax, VA, USA
| | - Dinesh Kumbhare
- 1 Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
- 3 McMaster School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- 4 Imaging Research Centre, St. Joseph's Healthcare, Hamilton, ON, Canada
- 8 University of Toronto, Toronto, ON, Canada
- 9 Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Abstract
This study investigated the handling properties and clinical performance of two commercially available resin materials with slight differences in filler composition for the fabrication of fixed interim restorations. In a dental university setting, patients requiring prosthetic treatment were supplied with fixed interim restorations fabricated from two commercially available resin materials. To clarify the handling properties of the resin materials, dentists and undergraduate students completed a questionnaire. Prior to insertion of the definitive restoration, the interim restorations were analyzed by calibrated examiners using a modification of the United States Public Health Service criteria. Eighty-two fixed interim restorations with a mean clinical service period of 44.5 (±28.3) days were included, including 39 single crowns, 30 fixed denture prostheses, 10 blocked crowns, and 3 partial coverage restorations. No significant differences between the two materials in the rating of their handling properties were identified, with the exception of the parameter "surface". Failures due to fractures were observed in 13% of the interim restorations. No significant differences between the materials in the rating of the clinical performance were identified. These results indicate that slight changes in the filler composition of commercial formulations account for few differences in handling properties and clinical performance.
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Affiliation(s)
- Sebastian Hahnel
- Department of Prosthodontics and Materials Science, University of Leipzig
| | - Stephanie Krifka
- Department of Prosthetic Dentistry, Regensburg University Medical Center
| | - Michael Behr
- Department of Prosthetic Dentistry, Regensburg University Medical Center
| | - Carola Kolbeck
- Department of Prosthetic Dentistry, Regensburg University Medical Center
| | - Reinhold Lang
- Department of Prosthetic Dentistry, Regensburg University Medical Center
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center
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Moser N, Mior S, Noseworthy M, Côté P, Wells G, Behr M, Triano J. Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial. BMJ Open 2019; 9:e025219. [PMID: 31142519 PMCID: PMC6549698 DOI: 10.1136/bmjopen-2018-025219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE It is hypothesised that cervical manipulation may increase the risk of cerebrovascular accidents. We aimed to determine whether cervical spine manipulation is associated with changes in vertebral artery and cerebrovascular haemodynamics measured with MRI compared with neutral neck position and maximum neck rotation in patients with chronic neck pain. SETTING The Imaging Research Centre at St. Joseph's Hospital in Hamilton, Ontario, Canada. PARTICIPANTS Twenty patients were included. The mean age was 32 years (SD ±12.5), mean neck pain duration was 5.3 years (SD ±5.7) and mean neck disability index score was 13/50 (SD ±6.4). INTERVENTIONS Following baseline measurement of cerebrovascular haemodynamics, we randomised participants to: (1) maximal neck rotation followed by cervical manipulation or (2) cervical manipulation followed by maximal neck rotation. The primary outcome, vertebral arteries and cerebral haemodynamics, was measured after each intervention and was obtained by measuring three-dimensional T1-weighted high-resolution anatomical images, arterial spin labelling and phase-contrast flow encoded MRI. Our secondary outcome was functional connectivity within the default mode network measured with resting state functional MRI. RESULTS Compared with neutral neck position, we found a significant change in contralateral blood flow following maximal neck rotation. There was also a significant change in contralateral vertebral artery blood velocity following maximal neck rotation and cervical manipulation. We found no significant changes within the cerebral haemodynamics following cervical manipulation or maximal neck rotation. However, we observed significant increases in functional connectivity in the posterior cerebrum and cerebellum (resting state MRI) after manipulation and maximum rotation. CONCLUSION Our results are in accordance with previous work, which has shown a decrease in blood flow and velocity in the contralateral vertebral artery with head rotation. This may explain why we also observed a decrease in blood velocity with manipulation because it involves neck rotation. Our work is the first to show that cervical manipulation does not result in brain perfusion changes compared with a neutral neck position or maximal neck rotation. The changes observed were found to not be clinically meaningful and suggests that cervical manipulation may not increase the risk of cerebrovascular events through a haemodynamic mechanism. TRIAL REGISTRATION NUMBER NCT02667821.
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Affiliation(s)
- Nicholas Moser
- Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Silvano Mior
- Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Michael Noseworthy
- Radiology, McMaster University Faculty of Engineering, Hamilton, Ontario, Canada
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Greg Wells
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Michael Behr
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - John Triano
- Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
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Rosentritt M, Preis V, Behr M, Krifka S. In-vitro performance of CAD/CAM crowns with insufficient preparation design. J Mech Behav Biomed Mater 2019; 90:269-274. [DOI: 10.1016/j.jmbbm.2018.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 11/17/2022]
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Guevara Perez SV, de la Rosa Castolo G, Thollon L, Behr M. A 3D characterization method of geometric variation in edentulous mandibles. Morphologie 2018; 102:255-262. [PMID: 30197034 DOI: 10.1016/j.morpho.2018.08.001] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to perform an exploratory analysis of the morphological variations of mandibles at diverse states of edentulousness using tridimensional geometric morphometrics. METHODS Twelve cadaveric mandibles were selected and divided in three groups: dentate (G1), partially edentate (G2) and totally edentate (G3). CT scans, segmentation and digital reconstruction of 3D surfaces of each specimen was made. Thirteen landmarks were defined; the measurement error was determined and 3D morphometrics exploratory analysis by principal components (PCs) and PC scores was performed. RESULTS The principal shape variations in G2 and G3 compared to G1 can be summarized as follows: (1) decrease in the mid body mandibular height of 24% in G2 and 41% in G3, (2) decrease of symphysis height of 16% in G2 and 37% in G3, (3) a decrease in posterior mandibular height of 30% in both G1 and G2, (4) a deeper sigmoid notch also in both groups and finally (5) a widening of 7.7% in the cross sectional morphology on the symphysis in G3. CONCLUSIONS The 3D morphometric methods, combined with surface morphing tools confirmed the main patterns of bone changes in edentulous mandibles, referenced in the literature. The average 3D mandibular morphologies of each edentulousness state group was also defined. These methods could offer more accurate definition of shape variations, which is critical in a clinical context. This study provides clinicians with highlights of 3D morphological mandibular variations at different states of edentulism and not only in 2D projections as they are currently described. The 3D surface model for each group in PDF3D file format, are include in supplementary material.
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Affiliation(s)
- S V Guevara Perez
- Oral Health Deptartment, Universidad Nacional de Colombia, 111321 Bogota, Colombia; Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
| | - G de la Rosa Castolo
- Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
| | - L Thollon
- Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
| | - M Behr
- Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
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Preis V, Hahnel S, Behr M, Rosentritt M. In vitro performance and fracture resistance of novel CAD/CAM ceramic molar crowns loaded on implants and human teeth. J Adv Prosthodont 2018; 10:300-307. [PMID: 30140397 PMCID: PMC6104500 DOI: 10.4047/jap.2018.10.4.300] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/07/2018] [Accepted: 05/08/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: 3000×5℃/3000×55℃; ML: 1.2×106 cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, α=.05). RESULTS All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between 1214±293 N (NPT) and 1324±498 N (NGT), differing significantly (P≤.003) from the polished reference EPT (2044±302 N). Fracture forces in implant groups varied between 934±154 N (NGI_L) and 1782±153 N (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant (P≥.066) between crowns of identical materials and abutment support. CONCLUSION Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.
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Affiliation(s)
- Verena Preis
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
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Pfeilschifter M, Preis V, Behr M, Rosentritt M. Edge strength of CAD/CAM materials. J Dent 2018; 74:95-100. [DOI: 10.1016/j.jdent.2018.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/21/2018] [Accepted: 05/08/2018] [Indexed: 11/26/2022] Open
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Ahmed S, Behr M, Noseworthy M, Kumbhare D. Quantitative ultrasound using texture analysis of myofascial pain syndrome in the trapezius. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1003] [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: 10/28/2022]
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Behr M, Acker J, Cohrs S, Deuschle M, Danker-Hopfe H, Göder R, Norra C, Richter K, Riemann D, Schilling C, Weeß HG, Wetter TC, Wollenburg LM, Pollmächer T. [Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders]. Nervenarzt 2018; 89:807-813. [PMID: 29876601 DOI: 10.1007/s00115-018-0545-x] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. METHODS In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. RESULTS With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. DISCUSSION The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.
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Affiliation(s)
- M Behr
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland
| | - J Acker
- Klinik für Schlafmedizin, Bad Zurzach, Schweiz
| | - S Cohrs
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Rostock, Rostock, Deutschland
| | - M Deuschle
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - H Danker-Hopfe
- Kompetenzzentrum Schlafmedizin, Klinik für Psychiatrie und Psychotherapie der Charité, Berlin, Deutschland
| | - R Göder
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - C Norra
- LWL-Klinik Paderborn, Paderborn, Deutschland
| | - K Richter
- Klinik für Psychiatrie und Psychotherapie, Klinikum Nürnberg Nord, Nürnberg, Deutschland
| | - D Riemann
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - C Schilling
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - H-G Weeß
- Schlafzentrum am Pfalzklinikum Klingenmünster, Klingenmünster, Deutschland
| | - T C Wetter
- Schlafmedizinisches Zentrum, Klinik für Psychiatrie und Psychotherapie, Universität Regensburg am Bezirksklinikum, Regensburg, Deutschland
| | - L M Wollenburg
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland
| | - T Pollmächer
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland.
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Preis V, Behr M, Rosentritt M. In Vitro Fatigue and Fracture Testing of Implant-Supported Anterior Ceramic Crowns. INT J PROSTHODONT 2018; 31:264-266. [DOI: 10.11607/ijp.5656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Sollmann N, Morandell C, Albers L, Behr M, Preuss A, Dinkel A, Meyer B, Krieg SM. Association of decision-making in spinal surgery with specialty and emotional involvement-the Indications in Spinal Surgery (INDIANA) survey. Acta Neurochir (Wien) 2018; 160:425-438. [PMID: 29322267 DOI: 10.1007/s00701-017-3459-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 12/01/2017] [Accepted: 12/28/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although recent trials provided level I evidence for the most common degenerative lumbar spinal disorders, treatment still varies widely. Thus, the Indications in Spinal Surgery (INDIANA) survey explores whether decision-making is influenced by specialty or personal emotional involvement of the treating specialist. METHOD Nationwide, neurosurgeons and orthopedic surgeons specialized in spine surgery were asked to answer an Internet-based questionnaire with typical clinical patient cases of lumbar disc herniation (DH), lumbar spinal stenosis (SS), and lumbar degenerative spondylolisthesis (SL). The surgeons were assigned to counsel a patient or a close relative, thus creating emotional involvement. This was achieved by randomly allocating the surgeons to a patient group (PG) and relative group (RG). We then compared neurosurgeons to orthopedic surgeons and the PG to the RG regarding treatment decision-making. RESULTS One hundred twenty-two spine surgeons completed the questionnaire (response rate 78.7%). Regarding DH and SS, more conservative treatment among orthopedic surgeons was shown (DH: odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7-9.7, p = 0.001; SS: OR 3.9, CI 1.8-8.2, p < 0.001). However, emotional involvement (PG vs. RG) did not affect these results for any of the three cases (DH: p = 0.213; SS: p = 0.097; SL: p = 0.924). CONCLUSIONS The high response rate indicates how important the issues raised by this study actually are for dedicated spine surgeons. Moreover, there are considerable variations in decision-making for the most common degenerative lumbar spinal disorders, although there is high-quality data from large multicenter trials available. Emotional involvement, though, did not influence treatment recommendations.
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Affiliation(s)
- Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Carmen Morandell
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Lucia Albers
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
- Institute of Social Pediatrics and Adolescents Medicine, Ludwig-Maximilians-Universität München, Haydnstr. 5, 80336 Munich, Germany
| | - Michael Behr
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Alexander Preuss
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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Lieber M, Behr M, Eichinger S, Eichinger W, Kühl H. First Transcatheter SAPIEN 3 Valve-in-Valve Implantation in an Early Degenerated Lotus Valve Prosthesis. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628120] [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: 10/28/2022]
Affiliation(s)
- M. Lieber
- Klinikum Bogenhausen, Herzchirurgie, München, Germany
| | - M. Behr
- Klinikum Harlaching, Kardiologie, München, Germany
| | - S. Eichinger
- Klinikum Bogenhausen, Herzchirurgie, München, Germany
| | - W. Eichinger
- Klinikum Bogenhausen, Herzchirurgie, München, Germany
| | - H. Kühl
- Klinikum Harlaching, Kardiologie, München, Germany
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Hessas S, Behr M. Influence of wedge stiffness on biomechanics during heel-strike transient phase. Comput Methods Biomech Biomed Engin 2017; 20:105-106. [DOI: 10.1080/10255842.2017.1382883] [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: 10/18/2022]
Affiliation(s)
- S. Hessas
- Hôpital Central de l’Armée, Kouba, Algérie
- Laboratoire de Biomécanique Appliquée, IFSTTAR, Aix-Marseille Université, Marseille, France
| | - M. Behr
- Laboratoire de Biomécanique Appliquée, IFSTTAR, Aix-Marseille Université, Marseille, France
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Rosentritt M, Preis V, Behr M, Hahnel S. Influence of preparation, fitting, and cementation on the vitro performance and fracture resistance of CAD/CAM crowns. J Dent 2017; 65:70-75. [DOI: 10.1016/j.jdent.2017.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/29/2017] [Accepted: 07/08/2017] [Indexed: 11/24/2022] Open
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Campion D, Dakhil N, Llari M, Evin M, Mo F, Thefenne L, Behr M. Finite element model of a below-knee amputation: a feasibility study. Comput Methods Biomech Biomed Engin 2017; 20:35-36. [PMID: 29088638 DOI: 10.1080/10255842.2017.1382848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D Campion
- a Laboratoire de Biomécanique Appliquée
| | - N Dakhil
- a Laboratoire de Biomécanique Appliquée
| | - M Llari
- a Laboratoire de Biomécanique Appliquée
| | - M Evin
- a Laboratoire de Biomécanique Appliquée
| | - F Mo
- b College of Vehicle and Mechanical Engineering , Hunan University , China
| | - L Thefenne
- c Hôpital d'Instruction des armées de Laveran
| | - M Behr
- a Laboratoire de Biomécanique Appliquée
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Aich G, Kuboth C, Behr M. Training von Multiplikatorinnen und Multiplikatoren nach dem Gmünder Modell zur Gesprächsführung mit Eltern (GMG). Disseminierung und Evaluation eines integrierten Konzepts für ein landesweites Lehrertraining. Psychologie in Erziehung und Unterricht 2017. [DOI: 10.2378/peu2017.art22d] [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: 11/23/2022]
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Wassmann T, Kreis S, Behr M, Buergers R. The influence of surface texture and wettability on initial bacterial adhesion on titanium and zirconium oxide dental implants. Int J Implant Dent 2017; 3:32. [PMID: 28714053 PMCID: PMC5511811 DOI: 10.1186/s40729-017-0093-3] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [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: 03/07/2017] [Accepted: 06/28/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This study aims to investigate bacterial adhesion on different titanium and ceramic implant surfaces, to correlate these findings with surface roughness and surface hydrophobicity, and to define the predominant factor for bacterial adhesion for each material. METHODS Zirconia and titanium specimens with different surface textures and wettability (5.0 mm in diameter, 1.0 mm in height) were prepared. Surface roughness was measured by perthometer (R a ) and atomic force microscopy, and hydrophobicity according to contact angles by computerized image analysis. Bacterial suspensions of Streptococcus sanguinis and Staphylococcus epidermidis were incubated for 2 h at 37 °C with ten test specimens for each material group and quantified with fluorescence dye CytoX-Violet and an automated multi-detection reader. RESULTS Variations in surface roughness (R a ) did not lead to any differences in adhering S. epidermidis, but higher R a resulted in increased S. sanguinis adhesion. In contrast, higher bacterial adhesion was observed on hydrophobic surfaces than on hydrophilic surfaces for S. epidermidis but not for S. sanguinis. The potential to adhere S. sanguinis was significantly higher on ceramic surfaces than on titanium surfaces; no such preference could be found for S. epidermidis. CONCLUSIONS Both surface roughness and wettability may influence the adhesion properties of bacteria on biomaterials; in this context, the predominant factor is dependent on the bacterial species. Wettability was the predominant factor for S. epidermidis and surface texture for S. sanguinis. Zirconia did not show any lower bacterial colonization potential than titanium. Arithmetical mean roughness values R a (measured by stylus profilometer) are inadequate for describing surface roughness with regard to its potential influence on microbial adhesion.
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Affiliation(s)
- Torsten Wassmann
- Present address: Department of Prosthodontics, University Medical Center Goettingen, Robert-Koch-Strasse 40, 37075, Goettingen, Germany.
| | - Stefan Kreis
- Department of Prosthetic Dentistry, Regensburg University Medical Centre, Regensburg, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, Regensburg University Medical Centre, Regensburg, Germany
| | - Ralf Buergers
- Present address: Department of Prosthodontics, University Medical Center Goettingen, Robert-Koch-Strasse 40, 37075, Goettingen, Germany.,Department of Prosthetic Dentistry, Regensburg University Medical Centre, Regensburg, Germany
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Rosentritt M, Schneider-Feyrer S, Behr M, Preis V. In Vitro Shock Absorption Tests on Implant-Supported Crowns: Influence of Crown Materials and Luting Agents. Int J Oral Maxillofac Implants 2017; 33:116–122. [PMID: 28518187 DOI: 10.11607/jomi.5463] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To investigate the force absorption capacity of implant-supported crowns made of different restorative materials and connected to abutments with different luting agents. MATERIALS AND METHODS Molar crowns were milled of different computer-aided design/computer-aided manufacture materials (n = 8 crowns per material): polymethyl methacrylate, polyether ether ketone, composite, lithium disilicate, titanium, and zirconia. Crowns were mounted on titanium implant replicas using different luting agents: uncemented, temporarily cemented (zinc oxide-eugenol cement), conventionally cemented (zinc oxide phosphate cement), and adhesively bonded. As a reference, one implant replica was tested without a crown. Force absorptions of the different combinations of crown materials and luting agents were determined by applying an increasing force (0 to 250 N) on the occlusal crown surface and measuring the resulting force below the implant. Mean curves of applied and resulting forces up to 200 N were determined (six measurements per group), and slopes were calculated. Statistical analysis was performed (one-way analysis of variance, Bonferroni post hoc test, α = .05). RESULTS Significant (P < .001) differences in the applied and resulting forces were found between the crown materials that were uncemented, temporarily cemented, cemented, and adhesively bonded. Materials with higher moduli of elasticity (ceramics, titanium) showed steeper slopes of the force curves and lower shock-absorbing capacity than resin-based materials, but were influenced more by the luting agents. The damping effects of resin-based materials were higher in combination with all cementation and luting modes. CONCLUSION Shock absorption tests exhibited a strong material-dependent damping behavior of implant-supported crowns. The shock-absorbing capacity of crown materials with high moduli of elasticity may benefit from conventional cementation.
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Raab P, Alamanos C, Hahnel S, Papavasileiou D, Behr M, Rosentritt M. Dental materials and their performance for the management of screw access channels in implant-supported restorations. Dent Mater J 2017; 36:123-128. [PMID: 28111384 DOI: 10.4012/dmj.2016-049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Unsuccessfully sealed screw access channels of prosthetic implant abutments may lead to malodor or peri-implant diseases in gingival tissues adjacent to implant-supported restorations. Therefore, 72 sets of screw channel analogs with six different materials incorporated (Polytetrafluoroethylene (PTFE), wax, gutta-percha, cavit, endofrost-pellets and cotton pellets) were exposed (2.5 h, 37°C) to Streptococcus mutans, oralis and Candida albicans suspensions. Bacterial adherence was quantified by using the fluorescence dye, Alamar Blue/resazurin, and an automated multifunctional reader. For quantification of fungal adherence the ATP-based bioluminescence approach was used. High relative fluorescence and luminescence intensities (>10,000), indicating high adhesion of streptococci and fungi were found for cotton and endofrost-pellets and low intensities (<5,000) for wax, gutta-percha, cavit and PTFE. The quantity of bacterial and fungal adhesion differed significantly between the assessed various sealing materials. In conclusion and within the limitations of this study, wax, gutta-percha, cavit and PTFE should be preferred as sealing materials.
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Affiliation(s)
- Philipp Raab
- Department of Prosthetic Dentistry, Regensburg University Medical Center
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Havunen R, Siurala M, Sorsa S, Grönberg-Vähä-Koskela S, Behr M, Tähtinen S, Santos JM, Karell P, Rusanen J, Nettelbeck DM, Ehrhardt A, Kanerva A, Hemminki A. Oncolytic Adenoviruses Armed with Tumor Necrosis Factor Alpha and Interleukin-2 Enable Successful Adoptive Cell Therapy. Mol Ther Oncolytics 2016; 4:77-86. [PMID: 28345026 PMCID: PMC5363700 DOI: 10.1016/j.omto.2016.12.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 12/20/2016] [Indexed: 01/18/2023]
Abstract
Adoptive cell therapy holds much promise in the treatment of cancer but results in solid tumors have been modest. The notable exception is tumor-infiltrating lymphocyte (TIL) therapy of melanoma, but this approach only works with high-dose preconditioning chemotherapy and systemic interleukin (IL)-2 postconditioning, both of which are associated with toxicities. To improve and broaden the applicability of adoptive cell transfer, we constructed oncolytic adenoviruses coding for human IL-2 (hIL2), tumor necrosis factor alpha (TNF-α), or both. The viruses showed potent antitumor efficacy against human tumors in immunocompromised severe combined immunodeficiency (SCID) mice. In immunocompetent Syrian hamsters, we combined the viruses with TIL transfer and were able to cure 100% of the animals. Cured animals were protected against tumor re-challenge, indicating a memory response. Arming with IL-2 and TNF-α increased the frequency of both CD4+ and CD8+ TILs in vivo and augmented splenocyte proliferation ex vivo, suggesting that the cytokines were important for T cell persistence and proliferation. Cytokine expression was limited to tumors and treatment-related signs of systemic toxicity were absent, suggesting safety. To conclude, cytokine-armed oncolytic adenoviruses enhanced adoptive cell therapy by favorable alteration of the tumor microenvironment. A clinical trial is in progress to study the utility of Ad5/3-E2F-d24-hTNFa-IRES-hIL2 (TILT-123) in human patients with cancer.
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Affiliation(s)
- Riikka Havunen
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
| | - Mikko Siurala
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland; TILT Biotherapeutics, Ltd., 00290 Helsinki, Finland
| | - Suvi Sorsa
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland; TILT Biotherapeutics, Ltd., 00290 Helsinki, Finland
| | | | - Michael Behr
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
| | - Siri Tähtinen
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
| | - João Manuel Santos
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland; TILT Biotherapeutics, Ltd., 00290 Helsinki, Finland
| | - Pauliina Karell
- Institute for Molecular Medicine Finland, University of Helsinki, 00290 Helsinki, Finland
| | - Juuso Rusanen
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
| | | | - Anja Ehrhardt
- Faculty of Health, Institute for Virology and Microbiology, University Witten/Herdecke, 58448 Witten, Germany
| | - Anna Kanerva
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland; Department of Obstetrics and Gynecology, Helsinki University Central Hospital, 00610 Helsinki, Finland
| | - Akseli Hemminki
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland; TILT Biotherapeutics, Ltd., 00290 Helsinki, Finland; Comprehensive Cancer Center, Helsinki University Hospital, 00290 Helsinki, Finland
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Auriault F, Thollon L, Pérès J, Behr M. Adverse fetal outcome in road accidents: Injury mechanism study and injury criteria development in a pregnant woman finite element model. Accid Anal Prev 2016; 97:96-102. [PMID: 27596046 DOI: 10.1016/j.aap.2016.08.026] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 08/06/2016] [Accepted: 08/25/2016] [Indexed: 06/06/2023]
Abstract
This study documents the development of adverse fetal outcome predictors dedicated to the analysis of road accidents involving pregnant women. To do so, a pre-existing whole body finite element model representative of a 50th percentile 26 weeks pregnant woman was used. A total of 8 accident scenarios were simulated with the model positioned on a sled. Each of these scenarios was associated to a risk of adverse fetal outcome based on results from real car crash investigations involving pregnant women from the literature. The use of airbags and accidents involving unbelted occupants were not considered in this study. Several adverse fetal outcome potential predictors were then evaluated with regard to their correlation to this risk of fetal injuries. Three predictors appeared strongly correlated to the risk of adverse fetal outcome: (1) the intra uterine pressure at the placenta fetal side area (r=0.92), (2) the fetal head acceleration (HIC) (r=0.99) and (3) area of utero-placental interface over a strain threshold (r=0.90). Finally, sensitivity analysis against slight variations of the simulation parameters was performed and assess robustness of these criteria.
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Affiliation(s)
- F Auriault
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France.
| | - L Thollon
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France
| | - J Pérès
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France
| | - M Behr
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France
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Siurala M, Havunen R, Santos J, Tähtinen S, Saha D, Vähä-Koskela M, Behr M, Nettelbeck DM, Ehrhardt A, Parviainen S, Hemminki A. Abstract B063: Oncolytic adenoviruses armed with tumor necrosis factor alpha and interleukin-2 enable successful adoptive T cell therapy of solid tumors. Cancer Immunol Res 2016. [DOI: 10.1158/2326-6066.imm2016-b063] [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: 11/16/2022]
Abstract
Abstract
Adoptive T-cell based therapy can promote dramatic tumor regressions in both pre-clinical tumor models and in patients with CD19+ hematological tumors. However, in the case of human solid tumors, anti-tumor effects are limited by T-cell tolerance and the immunosuppressive tumor microenvironment. Human data from cancer patients treated with oncolytic adenovirus indicated that lymphocytes traffic to tissues following virotherapy. Therefore, we hypothesized to enable successful T-cell therapy by arming viruses with immunostimulatory cytokines which can counteract tumor immunosuppression locally. Previously, we have identified interleukin-2 (IL-2) and Tumor Necrosis Factor alpha (TNFa) as the most promising factors to stimulate the graft used in adoptive T-cell therapy. Also, we have established that our arming approach results in long lasting, high level cytokine expression locally but low levels systemically in vivo and in patients, which is important for safety versus efficacy. One attractive aspect of this approach is the ease of combinations with standard therapies including checkpoint inhibiting antibodies (ongoing experiments). Non-replicating adenovirus vectors coding for murine TNFa and IL-2 were used together with intraperitoneally administered OT-I TCR transgenic T-cells in the murine B16.OVA melanoma model. The best antitumor efficacy was obtained when virally coded IL-2 and TNFa were both used with T-cell transfer. Moreover, IL-2/TNFa virus combination treatment was able to attract (111)In-labelled OT-I cells into B16.OVA tumors in SPECT/CT imaging experiments. In addition to mouse studies, we developed oncolytic adenoviruses expressing human TNFa and/or human IL-2 that were used in combination with intratumoral adoptive transfer of tumor-infiltrating lymphocytes (TIL) in immunocompetent and adenovirus-permissive Syrian hamsters. These viruses improved the efficacy of TIL therapy and protected animals from tumor rechallenge. Furthermore, we have shown that adenovirally delivered IL-2 is superior to systemically administered IL-2 with regard to antitumor efficacy and safety, in both mice and hamsters. TILT Biotherapeutics is in the process of confirming the results in clinical trials.
Citation Format: Mikko Siurala, Riikka Havunen, João Santos, Siri Tähtinen, Dipongkor Saha, Markus Vähä-Koskela, Michael Behr, Dirk M. Nettelbeck, Anja Ehrhardt, Suvi Parviainen, Akseli Hemminki. Oncolytic adenoviruses armed with tumor necrosis factor alpha and interleukin-2 enable successful adoptive T cell therapy of solid tumors [abstract]. In: Proceedings of the Second CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; 2016 Sept 25-28; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(11 Suppl):Abstract nr B063.
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Affiliation(s)
| | - Riikka Havunen
- 2Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - João Santos
- 1TILT Biotherapeutics Ltd, Helsinki, Finland
| | - Siri Tähtinen
- 2Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Dipongkor Saha
- 2Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Markus Vähä-Koskela
- 2Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Michael Behr
- 3German Cancer Research Center (DKFZ), Heidelberg, Germany
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Behr M, Rix J, Landes B, Barton B, Billovits G, Hukkanen E, Patton J, Wang W, Keane D, Weigand S. High-temperature tensile cell for in situ real-time investigation of carbon fibre carbonization and graphitization processes. J Synchrotron Radiat 2016; 23:1379-1389. [PMID: 27787243 DOI: 10.1107/s1600577516014181] [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] [Received: 03/09/2016] [Accepted: 09/05/2016] [Indexed: 06/06/2023]
Abstract
A new high-temperature fibre tensile cell is described, developed for use at the Advanced Photon Source at Argonne National Laboratory to enable the investigation of the carbonization and graphitization processes during carbon fibre production. This cell is used to heat precursor fibre bundles to temperatures up to ∼2300°C in a controlled inert atmosphere, while applying tensile stress to facilitate formation of highly oriented graphitic microstructure; evolution of the microstructure as a function of temperature and time during the carbonization and higher-temperature graphitization processes can then be monitored by collecting real-time wide-angle X-ray diffraction (WAXD) patterns. As an example, the carbonization and graphitization behaviour of an oxidized polyacrylonitrile fibre was studied up to a temperature of ∼1750°C. Real-time WAXD revealed the gradual increase in microstructure alignment with the fibre axis with increasing temperature over the temperature range 600-1100°C. Above 1100°C, no further changes in orientation were observed. The overall magnitude of change increased with increasing applied tensile stress during carbonization. As a second example, the high-temperature graphitizability of PAN- and pitch-derived commercial carbon fibres was studied. Here, the magnitude of graphitic microstructure evolution of the pitch-derived fibre far exceeded that of the PAN-derived fibres at temperatures up to ∼2300°C, indicating its facile graphitizability.
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Affiliation(s)
- Michael Behr
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - James Rix
- DND-CAT Synchrotron Research Center, Northwestern University, APS/ANL 432-A004, 9700 South Cass Avenue, Argonne, IL 60439, USA
| | - Brian Landes
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - Bryan Barton
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - Gerry Billovits
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - Eric Hukkanen
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - Jasson Patton
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - Weijun Wang
- Core Research and Development, The Dow Chemical Company, Midland, MI 48667, USA
| | - Denis Keane
- DND-CAT Synchrotron Research Center, Northwestern University, APS/ANL 432-A004, 9700 South Cass Avenue, Argonne, IL 60439, USA
| | - Steven Weigand
- DND-CAT Synchrotron Research Center, Northwestern University, APS/ANL 432-A004, 9700 South Cass Avenue, Argonne, IL 60439, USA
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Molitor D, Behr M, Hoffmann L, Evers D. Research Note: Benefits and Drawbacks of Pre-bloom Applications of Gibberellic Acid (GA3) for Stem Elongation in Sauvignon blanc. S AFR J ENOL VITIC 2016. [DOI: 10.21548/33-2-1119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Hemminki A, Havunen R, Siurala M, Tähtinen S, Saha D, Vähä-Koskela M, Behr M, Nettelbeck D, Ehrhardt A, Parviainen S. Enabling successful T-cell therapy of solid tumors with oncolytic adenoviruses armed with TNF&agr; and IL-2. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.34] [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: 11/12/2022] Open
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Maerz M, Morenz A, Puerckhauer K, Koelbl O, Behr M, Pohl F, Dobler B. Impact of iterative metal artifact reduction on dose calculation accuracy – Phantom study. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.465] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kammermeier A, Rosentritt M, Behr M, Schneider-Feyrer S, Preis V. In vitro performance of one- and two-piece zirconia implant systems for anterior application. J Dent 2016; 53:94-101. [PMID: 27528418 DOI: 10.1016/j.jdent.2016.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 01/12/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate the long-term in vitro performance and fracture resistance of one-piece and bonded two-piece zirconia implant systems for anterior application. METHODS Two groups of bonded two-piece zirconia (ZZB), four groups of one-piece zirconia (Z), and two groups of two-piece titanium (TTS, reference) implant systems were restored with identical monolithic zirconia crowns (n=10/group). Eight specimens per group were mounted at an angle of 135° in the chewing simulator and subjected to thermal cycling (TC:18,000 cycles; 5°/55°) and mechanical loading (ML:3.6×10(6) cycles; 100N) simulating an anterior situation. Fracture resistance and maximum bending stress were determined for specimens that survived aging and for two references per group after 24h water storage. SEM pictures were used for failure analysis. Data were statistically analysed (one-way-ANOVA, post-hoc Bonferroni, Kaplan-Meier-Log-Rank, α=0.05). RESULTS A one-piece zirconia and a two-piece titanium implant system survived TCML without failures. Both bonded two-piece zirconia implant systems and a one-piece zirconia implant system totally failed (fractures of abutment or implant). Failure numbers of the other systems varied between 1× (1 group) and 5× (2 groups). Significantly different survival rates were found (Log-Rank-test: p=0.000). Maximum fracture forces/bending stresses varied significantly ( ANOVA p=0.000) between 188.00±44.80N/381.02±80.15N/mm(2) and 508.67±107.00N/751.45±36.73N/mm(2). Mean fracture values after 24h water storage and TCML were not significantly different. CONCLUSION Zirconia implant systems partly showed material defects or connection insufficiencies. Bonded two-piece systems had higher failure rates and lower fracture resistance than one-piece implants. CLINICAL SIGNIFICANCE Individual zirconia implant systems may be applied in anterior regions with limitations.
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Affiliation(s)
- Armin Kammermeier
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Sibylle Schneider-Feyrer
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Verena Preis
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany.
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Rosentritt M, Hahnel S, Engelhardt F, Behr M, Preis V. In vitro performance and fracture resistance of CAD/CAM-fabricated implant supported molar crowns. Clin Oral Investig 2016; 21:1213-1219. [DOI: 10.1007/s00784-016-1898-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
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Schwaiger BJ, Behr M, Gersing AS, Meyer B, Zimmer C, Kirschke JS, Ryang YM, Ringel F. Computed Tomography Findings Associated with Clinical Outcome After Dynamic Posterior Stabilization of the Lumbar Spine. World Neurosurg 2016; 93:306-14. [PMID: 27327251 DOI: 10.1016/j.wneu.2016.06.048] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate whether preoperative multirow detector computed tomography (MDCT) findings were associated with clinical outcome 24 months after dynamic stabilization for painful degenerative lumbar spine disease. METHODS Preoperative MDCT examinations of 63 patients (66 ± 11.7 years; 60% women) treated with a dynamic screw rod system for painful degenerative segmental instability with/without spinal stenosis were assessed for quantitative and qualitative parameters defining degenerative changes of the thoracolumbar spine, including grades of disc herniation, degenerative spondylolisthesis, vertebral body sclerosis, cross-sectional area of the spinal canal at disc level, intervertebral disc height, ancillary bone mineral density, and anteroposterior diameter of intervertebral foramina. Clinical performance was assessed at baseline and 24 months with quantitative scales, including the Oswestry Disability Index and Short-Form 36 physical component summary. For statistical analysis classification and regression trees, linear regression and nonparametric tests were used. RESULTS Clinical scores improved substantially over 24 months compared with preoperative values (delta Oswestry Disability Index -32.1 ± 17.2, delta Short-Form 36 physical component summary 4.9 ± 2.3). Physical component summary improvement was significantly better in patients with lower grades of disc herniation (P < 0.001) and/or spondylolisthesis (P = 0.011), lower cross-sectional area of the spinal canal (P = 0.043), high intervertebral disc height (P = 0.006), and high grades of vertebral body sclerosis (P = 0.002). Patients with high bone mineral density and initially low diameter of intervertebral foramina showed a significantly better improvement of Oswestry Disability Index (P < 0.05). CONCLUSIONS Clinical improvement after dynamic stabilization was significantly associated with 7 independent baseline imaging findings. Preoperative evaluation of these MDCT parameters may improve therapy selection for patients with degenerative lumbar spine disease.
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Affiliation(s)
- Benedikt J Schwaiger
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, München, Germany.
| | - Michael Behr
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Yu-Mi Ryang
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, München, Germany; Department of Neurosurgery, Universitätsmedizin Mainz, University of Mainz, Mainz, Germany
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Auriault F, Brandt C, Chopin A, Gadegbeku B, Ndiaye A, Balzing MP, Thollon L, Behr M. Pregnant women in vehicles: Driving habits, position and risk of injury. Accid Anal Prev 2016; 89:57-61. [PMID: 26809074 DOI: 10.1016/j.aap.2016.01.003] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/09/2016] [Accepted: 01/10/2016] [Indexed: 06/05/2023]
Abstract
This study proposed to broadly examine vehicle use by pregnant women in order to improve realism of accident simulations involving these particular occupants. Three research pathways were developed: the first consisted in a questionnaire survey examining the driving habits of 135 pregnant women, the second obtained measurements of 15 pregnant women driving position in their own vehicle from the 6th to the 9th month of pregnancy by measuring distances between body parts and vehicle parts, and the third examined car accidents involving pregnant occupants. Results obtained indicate that between 90% and 100% of pregnant women wore their seat belts whatever their stage of pregnancy, although nearly one third of subjects considered the seat belt was dangerous for their unborn child. The measurements obtained also showed that the position of the pregnant woman in her vehicle, in relation to the various elements of the passenger compartment, changed significantly during pregnancy. In the studied accidents, no correlation was found between the conditions of the accident and the resulting fetal injury. Results reveal that pregnant women do not modify significantly the seat setting as a function of pregnancy stage. Only the distance between maternal abdomen and steering wheel change significantly, from 16 cm to 12 cm at 6 and 9 month respectively. Pregnant women are mainly drivers before 8 months of pregnancy, passengers after that. Car use frequency falls down rapidly from 6 to 9 months of pregnancy. Real crashes investigations indicate a low rate of casualties, i.e. 342 car accidents involving pregnant women for a period of 9 years in an approximately 1.7 million inhabitants area. No specific injury was found as a function of stage of pregnancy.
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Affiliation(s)
- F Auriault
- Aix-Marseille Université, IFSTTAR, LBA UMR_T24, F-13916 Marseille, France.
| | - C Brandt
- Ecole Universitaire de Maïeutique Marseille Méditerranée, F-13916 Marseille, France
| | - A Chopin
- Ecole Universitaire de Maïeutique Marseille Méditerranée, F-13916 Marseille, France
| | - B Gadegbeku
- IFSTTAR, TS2, UMRESTTE UMR_T9405, F-69500 Bron, France; Université de Lyon, F-69622 Lyon, France; Université Lyon 1, F-69373 Lyon, France
| | - A Ndiaye
- IFSTTAR, TS2, UMRESTTE UMR_T9405, F-69500 Bron, France; Université de Lyon, F-69622 Lyon, France; Université Lyon 1, F-69373 Lyon, France
| | - M-P Balzing
- Ecole Universitaire de Maïeutique Marseille Méditerranée, F-13916 Marseille, France
| | - L Thollon
- Aix-Marseille Université, IFSTTAR, LBA UMR_T24, F-13916 Marseille, France
| | - M Behr
- Aix-Marseille Université, IFSTTAR, LBA UMR_T24, F-13916 Marseille, France
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Engelhardt F, Zeman F, Behr M, Hahmel S. Prosthetic Complications and Maintenance Requirements in Locator-attached Implant-Supported Overdentures: A Retrospective Study. Eur J Prosthodont Restor Dent 2016; 24:31-35. [PMID: 27039476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Retrospective data of 32 patients supplied with implant-supported and Locator-attached overdentures were screened for prosthetic complications and maintenance requirements, which were recorded and statistically analyzed. Mean observation time was 4.78 ± 1.72) years. Loss of retention was the most frequently observed event (n = 22). Damage and exchange of the insert holders (n = 4) and loosening of locator attachments (n = 2) and fracture of the insert holder (n = 2) were uncommon events; no loss of locator attachments was observed. Loss of retention in Locator-attached overdentures is frequent; correlating patient-specific parameters with prosthetic complications is necessary to define recommendations for the use of Locator attachments.
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