1
|
Alkadi A, Alkhars N, Manning S, Xu H, Sohn M, Xiao J, Meng Y. The Associations between Snack Intake and Cariogenic Oral Microorganism Colonization in Young Children of a Low Socioeconomic Status. Nutrients 2024; 16:1113. [PMID: 38674804 PMCID: PMC11054055 DOI: 10.3390/nu16081113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Cariogenic microorganisms are crucial pathogens contributing to the development of early childhood caries. Snacks provide fermentable carbohydrates, altering oral pH levels and potentially affecting microorganism colonization. However, the relationship between snack intake and cariogenic microorganisms like Candida and Streptococcus mutans in young children is still unclear. This study aimed to assess this association in a prospective underserved birth cohort. Data from children aged 12 to 24 months, including oral microbial assays and snack intake information, were analyzed. Sweet and non-sweet indices based on the cariogenic potential of 15 snacks/drinks were created. Mixed-effects models were used to assess the associations between sweet and non-sweet indices and S. mutans and Candida carriage. Random forest identified predictive factors of microorganism carriage. Higher non-sweet index scores were linked to increased S. mutans carriage in plaques (OR = 1.67, p = 0.01), potentially strengthening with age. Higher sweet index scores at 12 months were associated with increased Candida carriage, reversing at 24 months. Both indices were top predictors of S. mutans and Candida carriage. These findings underscore the associations between snack intake and cariogenic microorganism carriage and highlight the importance of dietary factors in oral health management for underserved young children with limited access to dental care and healthy foods.
Collapse
Affiliation(s)
- Ahmed Alkadi
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14642, USA; (A.A.)
- Dental Department, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Naemah Alkhars
- Department of General Dental Practice, College of Dentistry, Health Science Center, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait;
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Hongzhe Xu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14642, USA; (A.A.)
| | - Ying Meng
- School of Nursing, University of Rochester, Rochester, NY 14642, USA
| |
Collapse
|
2
|
Jensen-Battaglia M, Sohn M, Consagra W, Wang Y, Zhang Z, Locastro M, Davis JN, Buettner K, Mortaz Hedjri S, El-Jawahri A, Loh KP. Trajectories of physical well-being among adults with acute myeloid leukemia. Blood Adv 2024:bloodadvances.2023011804. [PMID: 38429079 DOI: 10.1182/bloodadvances.2023011804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 03/03/2024] Open
Abstract
Patients with acute myeloid leukemia (AML) often undergo physical decline leading to negative outcomes. Identification of distinct trajectories may help guide clinical decision making and supportive care interventions. We built group-based trajectory models (GBTM) to find trajectories of change in the Functional Assessment of Cancer Therapy Physical Well-Being sub scale (FACT-PWB, up to 5 timepoints over 0 to 200 days of follow-up) using data from adults with newly diagnosed AML in four supportive care studies. We also estimated the association of baseline characteristics (age, marital status, education, AML risk, baseline FACT-PWB, depression, anxiety) with group membership. Among 343 patients with ≥ 2 FACT-PWB scores, mean age was 69.6 (SD 12.1) years; most had intermediate risk AML (178, 51.8%), received intensive treatment (244, 71.1%), and died during follow up (199, 58.0%). The GBTM with four distinct trajectories showed the best fit. The largest group (N=153, 45.0%) showed slight improvement, while the smallest experienced early decline with later improvement (N=8, 2.4%). Baseline FACT-PWB was the only characteristic statistically significantly associated with group membership. Adults with AML show distinct trajectories of physical well-being, and many experience some decline. Exploring trajectories of self-reported and objective physical function may inform decision making and interventions. Clinical trial registration: www.clinicaltrials.gov NCT02975869, NCT03310918, NCT03372291.
Collapse
Affiliation(s)
| | - Michael Sohn
- University of Rochester Medical Center, Rochester, New York, United States
| | - William Consagra
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Ying Wang
- James P. Wilmot Cancer Institute, United States
| | - Zhihong Zhang
- University of Rochester School of Nursing, Rochester, New York, United States
| | | | | | | | | | - Areej El-Jawahri
- Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Kah Poh Loh
- James P. Wilmot Cancer Institute, United States
| |
Collapse
|
3
|
Sanapala C, Jensen-Battaglia M, Watson EE, Konatham S, LoCastro M, Wang Y, Culakova E, Sohn M, Flannery M, Magnuson A, Wildes TM, Loh KP. In-person and virtual assessment of short physical performance battery test in older adults with myeloid malignancies. Blood Adv 2023; 7:4414-4417. [PMID: 36790922 PMCID: PMC10440456 DOI: 10.1182/bloodadvances.2022009396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/20/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Affiliation(s)
- Chandrika Sanapala
- Department of Medicine, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Marielle Jensen-Battaglia
- Department of Medicine, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
| | | | | | - Marissa LoCastro
- Department of Medicine, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Ying Wang
- Department of Medicine, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
| | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - Marie Flannery
- School of Nursing, University of Rochester Medical Center, Rochester, NY
| | - Allison Magnuson
- Department of Medicine, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
- Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Tanya M. Wildes
- Division of Hematology/Oncology, University of Nebraska Medical Center/Nebraska Medicine, Omaha, NE
| | - Kah Poh Loh
- Department of Medicine, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
- Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY
| |
Collapse
|
4
|
Beckmann MW, Borkenhagen A, Fahlbusch C, Gold D, Hoffmann J, Löhrs B, Luze H, Mirastschijski U, OʼDey DM, Pöschke P, Remmel E, Schaefer D, Schulmeyer CE, Schuster T, Sohn M, von Fritschen U, Beier JP. Reconstructive and Aesthetic Surgeries on the Female Genitalia. Guideline of the DGGG, DGPRÄC, OEGGG and SGGG (S2k-Level, AWMF Registry No. 009/019, May 2022). Geburtshilfe Frauenheilkd 2023; 83:802-826. [PMID: 37404977 PMCID: PMC10317568 DOI: 10.1055/a-2065-4458] [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: 03/08/2023] [Accepted: 03/26/2023] [Indexed: 07/06/2023] Open
Abstract
Aim This official guideline was coordinated and published by the German Society for Gynaecology and Obstetrics (DGGG), the German Society for Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC), the Austrian Society for Gynaecology and Obstetrics (OEGGG), and the Swiss Society for Gynaecology and Obstetrics (SGGG). The guideline aims to provide a consensus-based overview of reconstructive and aesthetic surgeries on female genitalia based on an evaluation of the relevant literature. Methods This S2k-guideline was developed by representative members from different medical professions on behalf of the guidelines commission of the DGGG, DGPRÄC, OEGGG and SGGG using a structured consensus process. Recommendations Statements and recommendations on the epidemiology, aetiology, classification, symptoms, diagnosis, and treatment of acquired changes of the external genitalia are presented and special situations are discussed.
Collapse
Affiliation(s)
- Matthias W. Beckmann
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg
(CCC ER-EMN), Erlangen, Germany
| | - Ada Borkenhagen
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Universität Magdeburg, Magdeburg, Germany
| | - Christine Fahlbusch
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg
(CCC ER-EMN), Erlangen, Germany
| | - Daniela Gold
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Gynäkologie, Medizinische Universität Graz, Graz, Austria
| | - Juergen Hoffmann
- Brustzentrum, Abteilung für Gynäkologie und Geburtshilfe, Universität Düsseldorf, Düsseldorf, Germany
| | - Bettina Löhrs
- Abteilung für Geburtshilfe und Gynäkologie, Klinikum Landshut, Landshut, Germany
| | - Hanna Luze
- Klinische Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Abteilung für Chirurgie, Medizinische Universität Graz, Graz, Austria
| | | | - Dan M. OʼDey
- Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Zentrum für Rekonstruktive Chirurgie weiblicher Geschlechtsmerkmale, Luisenhospital Aachen,
Lehrkrankenhaus der RWTH, Aachen, Germany
| | - Patrik Pöschke
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg
(CCC ER-EMN), Erlangen, Germany
| | - Eugenia Remmel
- Plastische & Ästhetische Chirurgie im Rheinland, Bonn, Germany
| | - Dirk Schaefer
- Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universitätsspital Basel, Basel, Switzerland
| | - Carla E. Schulmeyer
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg
(CCC ER-EMN), Erlangen, Germany
| | - Tobias Schuster
- Abteilung für Kinderchirurgie, Klinikum Augsburg, Augsburg, Germany
| | - Michael Sohn
- Klinik für Urologie, Agaplesion Markus-Krankenhaus, Frankfurt am Main, Germany
| | - Uwe von Fritschen
- Klinik für Plastische- und Ästhetische Chirurgie, Handchirurgie, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Justus P. Beier
- Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Universitätsklinik RWTH Aachen, Aachen, Germany
| |
Collapse
|
5
|
Johnson WL, Sohn M, Woeller CF, Wozniak RAF. Staphylococcal Enterotoxins Promote Virulence in Bacterial Keratitis. Invest Ophthalmol Vis Sci 2023; 64:5. [PMID: 37133835 PMCID: PMC10166116 DOI: 10.1167/iovs.64.5.5] [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: 05/04/2023] Open
Abstract
Purpose Staphylococcus aureus is an important cause of corneal infections (keratitis). To better understand the virulence mechanisms mediating keratitis, a recent comparative genomics study revealed that a set of secreted enterotoxins were found with higher prevalence among ocular versus non-ocular S. aureus clinical infection isolates, suggesting a key role for these toxins in keratitis. Although well known to cause toxic shock syndrome and S. aureus food poisoning, enterotoxins have not yet been shown to mediate virulence in keratitis. Methods A set of clinical isolate test strains, including a keratitis isolate that encodes five enterotoxins (sed, sej, sek, seq, ser), its corresponding enterotoxin deletion mutant and complementation strain, a keratitis isolate devoid of enterotoxins, and the non-ocular S. aureus strain USA300 along with its corresponding enterotoxin deletion and complementation strains, were evaluated for cellular adhesion, invasion and cytotoxicity in a primary corneal epithelial model as well as with microscopy. Additionally, strains were evaluated in an in vivo model of keratitis to quantify enterotoxin gene expression and measure disease severity. Results We demonstrate that, although enterotoxins do not impact bacterial adhesion or invasion, they do elicit direct cytotoxicity in vitro toward corneal epithelial cells. In an in vivo model, sed, sej, sek, seq, ser were found to have variable gene expression across 72 hours of infection and test strains encoding enterotoxins resulted in increased bacterial burden as well as a reduced host cytokine response. Conclusions Our results support a novel role for staphylococcal enterotoxins in promoting virulence in S. aureus keratitis.
Collapse
Affiliation(s)
- William L Johnson
- Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
| | - Collynn F Woeller
- Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
| | - Rachel A F Wozniak
- Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
| |
Collapse
|
6
|
Wu TT, Sohn M, Manning S, Beblavy R, Gill S, Quataert S, Vasani S, Jang H, Zeng Y, Bruno J, Vazquez A, Fiscella K, Xiao J. Metagenomic analysis examines oral microbiome changes and interplay with immune response following prenatal total oral rehabilitation. J Transl Med 2023; 21:172. [PMID: 36871005 PMCID: PMC9985285 DOI: 10.1186/s12967-023-03997-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Suboptimal maternal oral health during pregnancy is potentially associated with adverse birth outcomes and increased dental caries risks in children. This study aimed to assess the oral microbiome and immune response following an innovative clinical regimen, Prenatal Total Oral Rehabilitation (PTOR), that fully restores women's oral health to a "disease-free status" before delivery. METHODS This prospective cohort study assessed 15 pregnant women at baseline and 3 follow-up visits (1 week, 2 weeks, and 2 months) after receiving PTOR. The salivary and supragingival plaque microbiomes were analyzed using metagenomic sequencing. Multiplexed Luminex cytokine assays were performed to examine immune response following PTOR. The association between salivary immune markers and oral microbiome was further examined. RESULTS PTOR was associated with a reduction of periodontal pathogens in plaque, for instance, a lower relative abundance of Tannerella forsythia and Treponema denticola at 2 weeks compared to the baseline (p < 0.05). The alpha diversity of plaque microbial community was significantly reduced at the 1-week follow-up (p < 0.05). Furthermore, we observed significant changes in the Actinomyces defective-associated carbohydrate degradation pathway and Streptococcus Gordonii-associated fatty acid biosynthesis pathway. Two immune markers related to adverse birth outcomes significantly differed between baseline and follow-up. ITAC, negatively correlated with preeclampsia severity, significantly increased at 1-week follow-up; MCP-1, positively correlated with gestational age, was elevated at 1-week follow-up. Association modeling between immune markers and microbiome further revealed specific oral microorganisms that are potentially correlated with the host immune response. CONCLUSIONS PTOR is associated with alteration of the oral microbiome and immune response among a cohort of underserved US pregnant women. Future randomized clinical trials are warranted to comprehensively assess the impact of PTOR on maternal oral flora, birth outcomes, and their offspring's oral health.
Collapse
Affiliation(s)
- Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Robert Beblavy
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Steven Gill
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally Quataert
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Shruti Vasani
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jennifer Bruno
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
| |
Collapse
|
7
|
Mohamed MR, Loh KP, Mohile SG, Sohn M, Webb T, Wells M, Yilmaz S, Tylock R, Culakova E, Magnuson A, Sun CL, Bearden J, Hopkins JO, Faller BA, Klepin HD. External Validation of Risk Factors for Unplanned Hospitalization in Older Adults With Advanced Cancer Receiving Chemotherapy. J Natl Compr Canc Netw 2023; 21:273-280.e3. [PMID: 36898361 PMCID: PMC10966463 DOI: 10.6004/jnccn.2022.7094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/04/2022] [Indexed: 03/12/2023]
Abstract
BACKGROUND Older adults (age ≥65 years) receiving chemotherapy are at risk for hospitalization. Predictors of unplanned hospitalization among older adults receiving chemotherapy for cancer were recently published using data from a study conducted by the Cancer and Aging Research Group (CARG). Our study aimed to externally validate these predictors in an independent cohort including older adults with advanced cancer receiving chemotherapy. METHODS This validation cohort included patients (n=369) from the GAP70+ trial usual care arm. Enrolled patients were aged ≥70 years with incurable cancer and were starting a new line of chemotherapy. Previously identified risk factors proposed by the CARG study were ≥3 comorbidities, albumin level <3.5 g/dL, creatinine clearance <60 mL/min, gastrointestinal cancer, ≥5 medications, requiring assistance with activities of daily activities (ADLs), and having someone available to take them to the doctor (ie, presence of social support). The primary outcome was unplanned hospitalization within 3 months of treatment initiation. Multivariable logistic regression was applied including the 7 identified risk factors. Discriminative ability of the fitted model was performed by calculating the area under the receiver operating characteristic (AUC) curve. RESULTS Mean age of the cohort was 77 years, 45% of patients were women, and 29% experienced unplanned hospitalization within the first 3 months of treatment. The proportions of hospitalized patients with 0-3, 4-5, and 6-7 identified risk factors were 24%, 28%, and 47%, respectively (P=.04). Impaired ADLs (odds ratio, 1.76; 95% CI, 1.04-2.99) and albumin level <3.5 g/dL (odds ratio, 2.23; 95% CI, 1.37-3.62) were significantly associated with increased odds of unplanned hospitalization. The AUC of the model, including the 7 identified risk factors, was 0.65 (95% CI, 0.59-0.71). CONCLUSIONS The presence of a higher number of risk factors was associated with increased odds of unplanned hospitalization. This association was largely driven by impairment in ADLs and low albumin level. Validated predictors of unplanned hospitalization can help with counseling and shared decision-making with patients and their caregivers. CLINICALTRIALS gov identifier: NCT02054741.
Collapse
Affiliation(s)
- Mostafa R Mohamed
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Kah Poh Loh
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Tracy Webb
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Megan Wells
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Sule Yilmaz
- Department of Surgery, Supportive Care in Cancer, University of Rochester Medical Center, Rochester, New York
| | - Rachael Tylock
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Eva Culakova
- Department of Surgery, Supportive Care in Cancer, University of Rochester Medical Center, Rochester, New York
| | - Allison Magnuson
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Can-Lan Sun
- City of Hope Comprehensive Cancer Center, Duarte, California
| | - James Bearden
- Spartanburg Regional Medical Center, Spartanburg, South Carolina
| | - Judith O Hopkins
- Southeast Clinical Oncology Research Consortium NCORP/Novant Health Cancer Institute, Winston-Salem, North Carolina
| | | | - Heidi D Klepin
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| |
Collapse
|
8
|
Burger A, Kiehlmann M, Gruenherz L, Gousopoulos E, Sohn M, Lindenblatt N, Giovanoli P, Rieger UM. Donor Site Defect Coverage of the Forearm with Dermal Substitute After Harvesting Radial Forearm Free Flap for Phalloplasty: Is MatriDerm® Worth the Effort? Indian J Surg 2023. [DOI: 10.1007/s12262-023-03705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
AbstractAn aesthetically and functionally pleasing phalloplasty is most commonly performed by a free radial forearm flap. However, the problem with donor site morbidity on the forearm remains unsolved. The aim of this study was to evaluate if the use of a dermal template such as MatriDerm® on the donor site significantly decreases the incidence of complications based on the Clavien–Dindo classification, such as wound healing disorders and reoperation rate, and if it could shortens the duration of hospital stay. A case series analysis was conducted at our institution. A total of 21 patients divided into two groups undergoing the phallic construction after the Gottlieb and Levine design in a single center underwent the donor site defect coverage either by MatriDerm® and split-thickness skin graft from the thigh or by full-thickness skin graft from the groin area. The use of MatriDerm® and split-thickness skin graft showed to have a statistically significant impact on the rate of complications (p = 0.008). Complications that were treated conservatively as well as that require surgical revision were significantly lower in the MatriDerm® group than in the full-thickness skin graft group (p = 0.002). Complications occurred not only at the forearm but also at the groin, where the full-thickness skin graft was harvested. The large dimension of the free radial forearm flap used for phalloplasty resulted in a significant donor site morbidity, leading to wound healing disorders, reoperations, and extended length of hospital stay. Therefore, we consider the use of dermal templates such as MatriDerm® as worth the additional effort and costs in this patient collective.
Collapse
|
9
|
Lee H, Kwon Y, Ryu K, Sohn M, Chung H. The paid sick leave and sickness benefits for universal health coverage: a scoping review. Eur J Public Health 2022. [PMCID: PMC9594345 DOI: 10.1093/eurpub/ckac131.121] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The countries with paid sick leave (PSL) and sickness benefits (SB) mostly provide the benefit coverage to specific categories of workers, which results in health inequalities among employees in COVID-19. The PSL and SB are key factors to achieve universal health coverage (UHC) in that they protect access to healthcare and improve population health. This study attempted to investigate whether the policies helped achieve the UHC when they were expanded. Methods This review followed the scoping review protocol of PRISMA-ScR. On April 6, 2021, we extracted the literature using the keywords ‘paid sick leave', ‘sickness benefits', ‘paid sick day', and ‘earned sick leave’ from PubMed and Web of Science and added two studies through hand-search. All articles were written in English. We did not limit the publication date. Results Forty-four selected studies were based in four single countries and the European Union. Most of the studies were published after 2010 (84.1%) and were conducted as cross-sectional (72.7%) studies. Not only workers who use PSL and SB but also children whose parents use PSL and SB increased their use of healthcare services and getting flu shots. Also, using PSL and SB decreased their unmet healthcare needs and emergency use. The various health status factors, such as infectious disease incidence, mortality, and presenteeism, also decreased. Conclusions The provisions of PSL and SB offer individual and public health benefits by allowing employees and their families to use healthcare services. Group of employees, we can expect similar public health impacts on newly covered groups, thus contributing to achieving the UHC. Since more than 90% of articles are published from the United States, future studies need to evaluate the outcomes of health effects in various European or Asian countries. Key messages • The provision of PSL and SB positively affects employees and their families by allowing them to use healthcare services. • The expansion of PSL and SB contributes to the UHC by guaranteeing indirect medical costs that enable universal access to essential healthcare services.
Collapse
Affiliation(s)
- H Lee
- Department of Public Health Sciences, Graduate School, Korea University , Seoul, South Korea
- BK21FOUR Learning Health Systems, Korea University , Seoul, South Korea
| | - Y Kwon
- Department of Public Health Sciences, Graduate School, Korea University , Seoul, South Korea
- BK21FOUR Learning Health Systems, Korea University , Seoul, South Korea
| | - K Ryu
- Department of Public Health Sciences, Graduate School, Korea University , Seoul, South Korea
- BK21FOUR Learning Health Systems, Korea University , Seoul, South Korea
| | - M Sohn
- Division of Health and Medical Sciences, Cyber University of Korea , Seoul, South Korea
| | - H Chung
- BK21FOUR Learning Health Systems, Korea University , Seoul, South Korea
- School of Health Policy and Management, Korea University , Seoul, South Korea
| |
Collapse
|
10
|
Yu S, Moon D, Sohn M, Kim J, Chung H. A Sick Benefit Scheme Reduces Unmet Healthcare Needs: An Natural Experiment in Seoul. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.271] [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: 11/14/2022] Open
Abstract
Abstract
South Korea experiences four times more unmet healthcare needs than OECD countries (11.6% and 2.6% respectively). Unmet healthcare needs are caused by the double burden of direct and indirect costs including income loss, and OECD countries operate a sickness benefit scheme to resolve sudden loss of pay. Seoul introduced the first sickness benefit system, Seoul-Type Paid Sick Leave Support (hereinafter Seoul Sick Leave), for self-employed national healthcare insurance subscribers to reduce the rate of unmet healthcare needs. By comparing the amount of increasing medical expenses between the beneficiary and non-beneficiary before (2018) and after (2019-2020) the introduction of the system, the study was intended to confirm the reduced unmet healthcare needs. This study used data from the National Health Information Database (NHID) and the difference in differences (DID) analytic framework. 96 and 121 patients were included in benefit and non-benefit cohorts, respectively. As a result, the beneficiary group’s expenses were smaller than those of the non-beneficiary group (coef.=-1.24, p = 0.026). However, the beneficiary group had a greater amount of increase in hospitalization expenses before and after the introduction than the non-beneficiary group did (coef.=1.66, p = 0.005). Our finding showed that the Seoul Sick Leave helped the precarious workers as they were able to use inpatient services when they needed. If it is to be scaled up to the national level, it should be applied all people to enhance universal health insurance in Korea.
Key messages
• Identified the effectiveness of the first sickness benefit system as it helped the precarious workers as they were able to use inpatient services when they needed.
• By financially supporting them, the Seoul Sick Leave support can achieve health promotion through early detection and treatment.
Collapse
Affiliation(s)
- S Yu
- BK21FOUR R&E Center for Learning Health Systems, Korea University , Seoul, South Korea
- Health Policy and Management, Korea University , Seoul, South Korea
| | - D Moon
- Center for Labour and Health, People’s Health Institute , Seoul, South Korea
| | - M Sohn
- Division of Health and Medical Sciences, The Cyber University of Korea , Seoul, South Korea
| | - J Kim
- Health Policy and Management, Korea University , Seoul, South Korea
| | - H Chung
- BK21FOUR R&E Center for Learning Health Systems, Korea University , Seoul, South Korea
- Health Policy and Management, Korea University , Seoul, South Korea
| |
Collapse
|
11
|
Spennato S, Ederer IA, Borisov K, Kueenzlen L, Rothenberger J, Kühn S, Schlosshauer T, Kiehlmann M, Wehle A, Sohn M, Rieger UM. Radial Forearm Free Flap Phalloplasty in Female-to-Male Transsexuals - A Comparison Between Gottlieb and Levine's and Chang and Hwang's Technique. J Sex Med 2022; 19:661-668. [DOI: 10.1016/j.jsxm.2022.01.004] [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] [Received: 09/28/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 10/19/2022]
|
12
|
Noordhoek I, Sohn M, Wang L, Mohamed M, Mohile S, Loh K, Wildes T, Kyi K, Burnette B, Faller B, Bradley T, Magnuson A. Validation of the Cancer and Aging Research Group (CARG) Toxicity Score in the Community Oncology Setting. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00399-4] [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: 10/19/2022]
|
13
|
Gilmore N, Loh K, Sohn M, Mohile S, Vertino P, Liu S, Hu Q, Onitilo A, Corso S, Cole S, Yao S, Janelsins M. Longitudinal effects of chemotherapy on peripheral blood epigenetic age in patients with breast cancer. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00353-2] [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: 10/19/2022]
|
14
|
Sanapala C, Watson E, Jensen-Battaglia M, Culakova E, Sohn M, Flannery M, Magnuson A, Wildes T, Hazelwood D, Mohile S, Loh K. Correlation between the Short Physical Performance Battery (SPPB) and virtual SPPB (vSPPB) among older adults with myeloid malignancies. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00357-x] [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: 10/19/2022]
|
15
|
Kehoe L, Sohn M, Wang L, Mohile SG, Patil A, Wells M, Plumb S, Pang Y, Gilmore N, Kleckner A, Belcher E, Gudina A, Burnette BL, Bradley TP, Melnyk N, Loh KP. Associations of quality of social support and beliefs in curability among older adults with advanced cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.12049] [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: 11/20/2022] Open
Abstract
12049 Background: Prior studies suggest that social support plays a role in disease understanding of older patients with advanced cancer. In this study, we examined the association of quantity and quality of social support with belief in curability among older patients with advanced incurable cancer. Methods: We performed a secondary analysis of a cluster-randomized geriatric assessment trial (URCC 13070: PI Mohile) that recruited older adults (≥70) with advanced incurable cancer and caregivers. At enrollment, patients completed the Older Americans Resources and Services (OARS) Medical Social Support form to measure both quantity (number of close friends and relatives) and quality of social support. Quality of social support was measured using twelve questions, each ranged from 1 (none of the time) to 5 (all of the time). Higher cumulative scores indicated greater quality of support. For beliefs in curability, patients were asked, “What do you believe are the chances that your cancer will go away and never come back with treatment?” Responses were 0%, <50%, 50/50, >50%, and 100%. Ordinal logistic regression was used to investigate the association of social support with beliefs in curability, adjusting for adjusting for age, gender, education, race, number of Geriatric Assessment (GA) impairments, cancer type, and locality (rural versus urban). Results: We included 347 patients; mean age was 76.4 years, 91% were white, 52% were male, 46% had household income <$50,000, and 55% had high school degree or higher. For every unit increase in OARS Medical Social Support score, the odds of believing in curability decreases by 36.4% [Adjusted Odds Ratio (AOR) 0.733, 95% Confidence Interval (CI): (0.555, 0.969)], after controlling for covariates. Quantity of social support was not associated with belief in curability [AOR 1.033 95% CI: (0.921, 1.156)]. Conclusions: Our study revealed that older patients with advanced cancer who felt more supported by their social network were more likely to report that their cancer was not curable. Interventions that improve quality of social support may also affect disease understanding. Funding: Patient-Centered Outcomes Research Institute (PCORI) 4634 and NIH K24 AG056589 to SGM, NCI UG1CA189961, T32CA102618, NCI K99CA237744 to Loh.
Collapse
Affiliation(s)
- Lee Kehoe
- University of Rochester Medical Center, Rochester, NY
| | - Michael Sohn
- University of Rochester Medical Center, Rochester, NY
| | - Lu Wang
- University of Rochester, Rochester, NY
| | | | - Amita Patil
- University of Rochester Medical Center, Rochester, NY
| | - Megan Wells
- University of Rochester Medical Center, Rochester, NY
| | - Sandy Plumb
- University of Rochester Medical Center, Rochester, NY
| | - Yiping Pang
- University of Rochester Medical Center, Rochester, NY
| | | | | | | | - Abdi Gudina
- University of Rochester Medical Center, Rochester, NY
| | | | | | | | - Kah Poh Loh
- University of Rochester Medical Center, Rochester, NY
| |
Collapse
|
16
|
Abstract
BACKGROUND Growing awareness of gender identity issues and a rising prevalence of female-to-male transsexualism is increasing demand for surgical solutions that deliver both aesthetically and functionally satisfying outer genitalia for transmen. OBJECTIVE This article summarizes the available prosthetic options, describes different surgical approaches and reviews the outcome of prosthetics for transmen with a focus on penile prosthesis in phalloplasty. METHODS Current international standards of care, reviews and original publications are critically reviewed and correlated with our own experience with more than 400 transmen at two interdisciplinary referral centres in Frankfurt, Germany and London, UK. RESULTS Despite of a wide range of different phalloplasty techniques and prosthetic types, the currently most used technique is implantation of a three-piece, inflatable penile prosthesis in a radial-free-flap phalloplasty. There is still an ongoing debate about the number of implanted penile prosthesis cylinders, the use of customised corporoplasty-windsocks for the cylinder(s), and the location for the placement of the reservoir. At present there is only one penile prosthesis design for use in phalloplasties and long-term results are still pending. CONCLUSION There is still no ideal implant available for the use in phalloplasties. The current literature does not provide evidence-based treatment algorithms, which is also due to a lack of prospective randomised studies and validated measurement tools for the postoperative outcome. Initial data for the first transmen-specific penile prosthesis as well as an increase of transgender studies might lead to an improvement of treatment and the quality-of-life of the affected transmen.
Collapse
Affiliation(s)
- S C Morgenstern
- Sektion für rekonstruktive Urologie und geschlechtsangleichende Operationen, Klinik für Urologie und Klinik für roboterassistierte Urologie und Uroonkologie, AGAPLESION Markus-Krankenhaus Frankfurt, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Deutschland.
| | - M Sohn
- Sektion für rekonstruktive Urologie und geschlechtsangleichende Operationen, Klinik für Urologie und Klinik für roboterassistierte Urologie und Uroonkologie, AGAPLESION Markus-Krankenhaus Frankfurt, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Deutschland
| |
Collapse
|
17
|
Pawlowski S, Herzog B, Sohn M, Petersen‐Thiery M, Acker S. EcoSun Pass: A tool to evaluate the ecofriendliness of UV filters used in sunscreen products. Int J Cosmet Sci 2021; 43:201-210. [PMID: 33289148 PMCID: PMC8248045 DOI: 10.1111/ics.12681] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Sunscreens play a major role in the EU sun protection strategy in order to prevent humans from UV light-induced skin damage. In recent years, the demand for high-quality sunscreen products including aspects of broad range and photostability of the UV protection, showing good spreadability onto human skin and excellent sensorial properties during and after application has increased. Environmental aspects are considered. Sunscreens are complex compositions, with UV filters being the key element in the formulations reaching up to about 30% in content in the final product. Some of these ingredients, however, may be regarded as hazardous for the aquatic environment. Nevertheless, the aquatic ecosystem represents only a single environmental compartment, which may be impacted by UV filters. Therefore, the EcoSun Pass (ESP) tool was developed in order to assess the overall environmental impact of UV filters in combination with its efficacy (Sun Protection Factor, SPF and UVA Protection Factor, UVA-PF). METHODS For that purpose, at first 24 of the EU-approved UV filters for sunscreen applications were evaluated for their environmental hazard profiles. Nine example UV filter compositions representing both SPF 30 and 50 were evaluated for ecofriendliness using the ESP tool. RESULTS The results revealed that two out of four SPF 30 compositions are considered as ecofriendly. Likewise, from the SPF 50 two out of five did meet the criteria for ecofriendliness. Furthermore, the results showed that most ecofriendly example formulations have also the lowest overall UV filter content in the product, based on the use of highly innovative and least hazardous UV filters. CONCLUSION These results demonstrate that the tool is applicable to various formulations being present on the market and thus allows for a selection of most ecofriendly and efficient UV filters to be used in sunscreens.
Collapse
Affiliation(s)
| | - B. Herzog
- BASF Grenzach GmbHEMR/CUGlobal Development UV Protection/Scientific LiaisonsGrenzach‐WyhlenGermany
| | - M. Sohn
- BASF Grenzach GmbHEMR/CUGlobal Development UV Protection/Scientific LiaisonsGrenzach‐WyhlenGermany
| | - M. Petersen‐Thiery
- BASF Personal Care and Nutrition GmbHE‐EMC/QRProduct Stewardship & EHS Data ManagementMonheimGermany
| | - S. Acker
- BASF Grenzach GmbHEMR/CUGlobal Development UV Protection/Scientific LiaisonsGrenzach‐WyhlenGermany
| |
Collapse
|
18
|
Abstract
For many trans*women, the surgical assignment of the male genital into a female is a fundamental part of the transition. Erogenous sensation of the neoclitoris is achieved by meticulous preparation of the penile glans with the neurovascular bundle. Several techniques are available for the formation of a neovagina, the penile inversion technique developed by Burou in the 1950s being the gold standard. With this technique, the inverted penile shaft skin is used as a pedicled flap to line the neovaginal canal. Alternatively, free skin grafts can be used, which serve primarily as a technique for redo procedures. Another technique is the use of intestinal segments to line the vaginal canal. This method is mostly used for redo procedures, but can also be performed primarily if penile skin is too small. Due to the numerous steps involved in the preparation, a wide variety of complications must be expected. Injury to the rectum during dissection of the neovaginal space, with an incidence of 4.5%, represents the greatest challenge. The most common complications are urethra-associated; hereby both a deviation of the urinary stream and strictures of the urethra are possible. The subjective satisfaction of trans*women with the surgical outcome is high and is reported in various studies to be 72-92%. On the basis of validated questionnaires it could also be shown that gender reassignment surgery leads to an increase in the trans*specific quality of life and promotes both subjectively perceived well-being and sexual satisfaction.
Collapse
Affiliation(s)
- J Heß
- Klinik und Poliklinik für Urologie, Uroonkologie und Kinderurologie, Universitätsklinik Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
| | - M Sohn
- Klinik für Urologie, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Straße 4, 60431, Frankfurt am Main, Deutschland
| | - M Küntscher
- Klinik für Plastische Chirurgie und Handchirurgie, Evangelische Elisabeth Klinik, Lützowstraße 26, 10785, Berlin, Deutschland
| | - J Bohr
- Klinik für Urologie, Evang. Kliniken Essen-Mitte, Henricistr. 92, 45136, Essen, Deutschland
| |
Collapse
|
19
|
Abstract
BACKGROUND The increasing prevalence of gender dysphoria necessitates an evaluation of the literature of phalloplasty techniques for female to male transgender individuals. OBJECTIVE The following article provides an overview of the current surgical concepts and complications of phalloplasty, associated urethrogenitoplasty and the implantation of prostheses in phalloplasty. MATERIAL AND METHODS Current international reviews and original publications from 2010 to 2020 were reviewed and correlated with our referral center experience with more than 350 female to male transgender patients over the last 25 years. RESULTS Free radial forearm flap phalloplasty is the most widely used technique, followed by an anterolateral thigh flap (ALT flap) and pedicled or microsurgical transplantation. Hydraulic multicomponent prostheses are given preference and supplementary surgical techniques, such as scrotoplasty and glans sculpturing can make sense or be necessary. The complication rates after phalloplasty and after insertion of penile prostheses are substantial. Nevertheless, the overall patient reported satisfaction rate in the majority of studies is often over 80%. CONCLUSION Due to the increasing prevalence of gender dysphoria there is currently a need for interdisciplinary referral centers for gender reassignment surgery. A certain standardization of surgical techniques and timing would be desirable but a review of the current literature shows a high heterogeneity so that this cannot be derived from the currently available literature. It is hoped that the recently founded S2K guideline committee on operative treatment of gender dysphoria under the auspices of the German Society for Urology and the Society for Plastic and Reconstructive Surgery can report an initial collection of experiences in 2021.
Collapse
Affiliation(s)
- M Sohn
- Urologische Klinik und Klinik für robotisch assistierte Urologie, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Deutschland.
| | - U Rieger
- Klinik für Plastische, Ästhetische Chirurgie, Wiederherstellungs- und Handchirurgie, Agaplesion Markus Krankenhaus Frankfurt, Frankfurt, Deutschland
| | - S Morgenstern
- Urologische Klinik und Klinik für robotisch assistierte Urologie, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Deutschland
| |
Collapse
|
20
|
Rieger UM, Sohn M. [Evidence and Standards in Neo-Urethra Construction in Female-to-Male Gender Reassignment]. HANDCHIR MIKROCHIR P 2020; 52:308-309. [PMID: 32823365 DOI: 10.1055/a-0918-6276] [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: 10/23/2022] Open
Affiliation(s)
- Ulrich Michael Rieger
- Agaplesion Markus Krankenhaus Klinik für Plastische und Ästhetische, Wiederherstellungs- und Handchirurgie
| | | |
Collapse
|
21
|
Roth RH, Harrison E, Kang H, Lobo J, Logan J, Sohn M, Kwon Y. 0840 Sleep Quality in Clinically Indicated In-Laboratory Polysomnography. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.836] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Few studies have explored how patients sleep or what characteristics might be predictive of poor sleep during clinically-indicated polysomnography (PSG) in an in-laboratory setting.
Methods
We reviewed clinically indicated diagnostic PSG studies completed over a 10-year period in a single academic sleep center. Total sleep time (TST) and sleep efficiency (SE) were used as proxies for sleep quality. Patients were categorized as normal or poor sleepers based on TST <4 hours or SE <50%. Multivariate linear and logistic regression analyses were performed to determine factors associated with sleep quality while controlling for demographics, medications, comorbidities and measures of sleep.
Results
We included 4957 patients, who were mostly female (58.9%), middle-aged (52.9 y), Caucasian (69.3%), and overweight or obese (91.3%). 3682 patients (74.2%) were diagnosed with sleep apnea (Apnea Hypopnea Index(AHI)>5/hr).
Average TST was 5.75±1.43 hours (Interquartile range [IQR] = 4.94 - 6.73) and average SE was 75.1%±16.1% (IQR=66.9 - 87.2). TST and SE were lower for males compared to females (5.48 vs 5.93 hr, p<0.001; 73% vs 77%, p<0.001). In multivariable analysis, older age (TST: OR = 1.04, 95% CI:[1.03,1.05]; SE: OR = 1.04, 95% CI:[1.04,1.05]), male sex (TST: 1.38,[1.14,1.68]; SE: 1.34,[1.07,1.68]), normal body habitus (TST: 1.47,[1.02,2.08]; SE: 1.51,[1.01,2.27]) and a higher AHI (TST: 1.02,[1.02,1.03]; SE: 1.02,[1.003,1.03]) were significantly associated with being a poor sleeper for both TST and SE. Antidepressant use was associated with poor sleep for TST (0.77, [0.59,1]), but not for SE (0.98, [0.73,1.3]).
Conclusion
Sleep quality during the in-laboratory PSG differed by sex, age and presence of sleep apnea. Sleep quality during in-lab PSG is thought to be compromised by obtrusive monitoring and an unfamiliar environment, but average sleep quality may be higher than expected for patients in the laboratory. Future studies should consider examining in-lab sleep quality in different patient populations.
Support
N/A
Collapse
Affiliation(s)
- R H Roth
- University of Virginia School of Medicine, Charlottesville, VA
| | - E Harrison
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - H Kang
- University of Illinois College of Applied Health Sciences, Champaign, IL
| | - J Lobo
- University of Virginia Public Health Sciences, Charlottesville, VA
| | - J Logan
- University of Virginia School of Nursing, Charlottesville, VA
| | - M Sohn
- University of Kentucky College of Public Health, Lexington, KY
| | - Y Kwon
- University of Virginia School of Medicine, Charlottesville, VA
| |
Collapse
|
22
|
Schloßhauer T, Kueenzlen L, Spennato S, Bozkurt A, Sohn M, Rieger UM. [Microsurgical penile reconstruction in case of intersexuality and after penis carcinoma]. HANDCHIR MIKROCHIR P 2020; 52:297-307. [PMID: 32428939 DOI: 10.1055/a-1017-3629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The goals of penile reconstruction and phalloplasty include aesthetics as natural as possible and the ability of patients to void while standing and to have sexual intercourse. This article presents two more rare indications and techniques, the phalloplasty using free radial forearm flapin case of intersexuality and after penectomy due to penis carcinoma. PATIENTS AND METHODS In transsexual individuals numerous phalloplasties in Gottlieb and Levine`s technique, by means phalloplasty of free radial forearm-flap of the non-dominant forearm, were performed in our department over the last few years. However, this technique also has its significance for phalloplasty in non-transgender persons.Two patients are considered in detail with regard to indication and surgical technique and were followed up in a multimodal setting.Patient 1 is genetically male, thirty-five years old with a micropenis in the case of pseudohermaphroditism masculine and androgen resistance.Patient 2 is a fifty-one-year old genetically male and as a result of a penis carcinoma his penis had to be amputated at the level of penis root. After absence of recurrence for 1,5 years, the penile reconstruction took place after complete resection of the remaining residual penile stump and corpora cavernosa. Both patients underwent multimodal follow-up 15 months postoperatively with regard to phalloplasty sensors and donor-site restrictions. RESULTS An aesthetic and functional acceptable result could be obtained for both patients. Both patients are able to void while standing. The multimodal follow-up 15 months postoperatively revealed relevant differences in the sensory findings of both patients, which are due to the different anatomy of reinnervation. CONCLUSION In microsurgical experienced departments, the technique of A. radialis phalloplasty can also be used successfully in more rare indications, as shown here, a satisfying result can be achieved in terms of function and aesthetics. The complications shown here do not differ from those using phalloplasty in transgender persons.
Collapse
Affiliation(s)
- T Schloßhauer
- AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität Frankfurt am Main, Klinik für Plastische, Ästhetische, Wiederherstellungs- und Handchirurgie
| | - L Kueenzlen
- AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität Frankfurt am Main, Klinik für Plastische, Ästhetische, Wiederherstellungs- und Handchirurgie
| | - S Spennato
- AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität Frankfurt am Main, Klinik für Plastische, Ästhetische, Wiederherstellungs- und Handchirurgie
| | - A Bozkurt
- HELIOS Universitatsklinikum Wuppertal, Klinik für Plastische, Ästhetische und Handchirurgie
| | - M Sohn
- AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität Frankfurt am Main, Klinik für Urologie
| | - U M Rieger
- AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität Frankfurt am Main, Klinik für Plastische, Ästhetische, Wiederherstellungs- und Handchirurgie
| |
Collapse
|
23
|
Küenzlen L, Nasim S, van Neerven S, Kühn S, Burger AE, Sohn M, Rieger UM, Bozkurt A. Multimodal Evaluation of Functional Nerve Regeneration in Transgender Individuals After Phalloplasty With a Free Radial Forearm Flap. J Sex Med 2020; 17:1012-1024. [DOI: 10.1016/j.jsxm.2020.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
|
24
|
Spennato S, Burger AE, Schlosshauer T, Küenzlen L, Rothenberger J, Kühn S, Kiehlmann M, Radacki I, Sohn M, Rieger UM. Microsurgical Phalloplasty in Nontranssexual Patients - Considerations After a Retrospective Single-center Analysis of 23 Cases. Urology 2020; 141:154-161. [PMID: 32283166 DOI: 10.1016/j.urology.2020.03.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/16/2020] [Accepted: 03/22/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the outcome of a single-center series of penile reconstruction using the radial free forearm flap in rare indications. MATERIALS AND METHODS From April 1993 until September 2016, 23 nontranssexual patients underwent phallic reconstruction by the use of a neuromicrovascular free radial forearm flap in our clinic. Patient-specific characteristics, surgical techniques, complications, and outcomes were retrospectively evaluated and interpreted. RESULTS The indications for surgery were: disorders of sex development (34.8%), reconstruction after oncologic surgery (34.8%), automutilation (8.7%), iatrogenic (8.7%), microphallus (8.7%), and 1 case of priapism (4.3%). Two patients (8.7%) had a total flap necrosis and 2 patients (8.7%) had a partial flap necrosis; 3 out of these 4 patients were heavy smokers. Urinary fistulae and strictures were frequent but were successfully managed by urologists in all cases. There was no statistically significant correlation between smoking, comorbidities, number of venous anastomoses, and complications. CONCLUSION In departments experienced in microsurgery, the goals of penile reconstruction could also be achieved in patients with rare indications by the use of the neuromicrovascular free radial forearm flap. Despite the high rate of postoperative complications, penile reconstruction with the free radial forearm flap yields satisfying results. An intensive cooperation between the plastic-reconstructive team and the urological team is a prerequisite to achieve the best surgical result.
Collapse
Affiliation(s)
- Stefano Spennato
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany.
| | - Anna E Burger
- Department of Plastic Surgery, University Hospital of Zurich, Zurich, Switzerland
| | | | - Lara Küenzlen
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Jens Rothenberger
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Shafreena Kühn
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Marcus Kiehlmann
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Isabel Radacki
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Michael Sohn
- Department of Urology, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Ulrich M Rieger
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| |
Collapse
|
25
|
Milder M, Sohn M, Alber M, Hoogeman M. EP-1767 Validation and clinical use of a commercial Monte Carlo algorithm for Cyberknife patient-specific QA. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32187-5] [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: 12/01/2022]
|
26
|
Affiliation(s)
- H Dralle
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - K Kols
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hans-Böckler-Allee 3, 30173, Hannover, Deutschland.
| | - A Agha
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Minimal-invasive Chirurgie, Städtisches Klinikum München Bogenhausen, Englschalkinger Str. 77, 81925, München, Deutschland.
| | - M Sohn
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Minimal-invasive Chirurgie, Städtisches Klinikum München Bogenhausen, Englschalkinger Str. 77, 81925, München, Deutschland.
| | - I Gockel
- Klinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
| | - M Lainka
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Gefäßchirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| |
Collapse
|
27
|
Gundling F, Roggenbrod S, Schleifer S, Sohn M, Schepp W. Patient perception and approval of faecal microbiota transplantation (FMT) as an alternative treatment option for obesity. Obes Sci Pract 2019; 5:68-74. [PMID: 30820331 PMCID: PMC6381400 DOI: 10.1002/osp4.302] [Citation(s) in RCA: 11] [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: 04/21/2018] [Revised: 09/02/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Fecal microbiota transplantation (FMT) represents a treatment option for some diseases, e.g. recurring Clostridium difficile-associated colitis. However, there is also evidence that FMT can be effective in treating obesity. This pilot study established the approval and willingness of obese patients to undergo FMT. METHODS We conducted a survey of adults with obesity using a questionnaire containing 21 both multiple choice and open questions was dispatched to a cohort of 101 persons with obesity. It included questions aiming at the process of FMT itself, donors as well as possible concerns. Additionally aspects of social background and disease activity were dealt with. RESULTS The response rate amounted to 30.1% (n = 31). In our population, mean BMI was 40.5 kg/m2 while the vast majority already tried out treatment modalities to lose weight before. 25.8% of persons with obesity were aware of FMT. 62.1% were willing to undergo FMT if the donor was healthy and anonymous while only 6.9% clearly refused this option. Sixty preferred an anonymous donor or a person proposed by their doctor while colonoscopy was the preferred application by 76.7%. The absence of risks of the procedure (47.8%) formed the principal motivation while reduction of medication was considered as least important reason (in 26.1). Insufficient testing of the faeces concerning infections raised the most concerns (in 61.6%). CONCLUSION For the majority of the persons with obesity surveyed FMT represents a treatment option. Approximately two thirds of the questionees would consider FMT as an alternative treatment option, even in spite of a satisfactory disease response to current standard therapies. Unsurprisingly there are concerns in regard to the transmission of possible infectious agents as well as to the hygieneic implementation of FMT itself.
Collapse
Affiliation(s)
- F. Gundling
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Academic Teaching Hospital BogenhausenTechnical University of MunichMunichGermany
| | - S. Roggenbrod
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Academic Teaching Hospital BogenhausenTechnical University of MunichMunichGermany
| | - S. Schleifer
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Academic Teaching Hospital BogenhausenTechnical University of MunichMunichGermany
| | - M. Sohn
- Department of Visceral Surgery, Academic Teaching Hospital BogenhausenTechnical University of MunichMunichGermany
| | - W. Schepp
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Academic Teaching Hospital BogenhausenTechnical University of MunichMunichGermany
| |
Collapse
|
28
|
Djedovic G, Sohn M, Rieger UM. Reconstructive Possibilities. Dtsch Arztebl Int 2019; 116:11. [PMID: 30782309 DOI: 10.3238/arztebl.2019.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
29
|
|
30
|
Sohn M, Agha A, Trum E, Moser C, Iesalnieks I, Gundling F, Aigner F, Ritschl P. Frequency of metachronous polyps and adenocarcinoma in the interposed colon after esophagectomy in adults. coloproctology 2018; 40:349-351. [DOI: 10.1007/s00053-018-0280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
31
|
Sohn M, Iesalnieks I. Authors reply: Damage control surgery in patients with generalized peritonitis secondary to perforated diverticulitis-the risk of overtreatment. Tech Coloproctol 2018; 22:565-566. [PMID: 29980887 DOI: 10.1007/s10151-018-1815-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
Affiliation(s)
- M Sohn
- Clinic for General, Visceral, Endocrine, and Minimally Invasive Surgery, Bogenhausen Hospital, Munich, Germany.
| | - I Iesalnieks
- Clinic for General, Visceral, Endocrine, and Minimally Invasive Surgery, Bogenhausen Hospital, Munich, Germany
| |
Collapse
|
32
|
Shahin P, Rahardjo HE, Bannowsky A, Tsikas D, Sohn M, Kuczyk MA, Ückert S. Endopeptidase inhibition attenuates the contraction induced by big endothelin-1 of isolated human penile erectile tissue. Andrologia 2018; 50:e13008. [PMID: 29574984 DOI: 10.1111/and.13008] [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] [Accepted: 02/06/2018] [Indexed: 11/29/2022] Open
Abstract
Peptides, such as C-type natriuretic peptide (CNP), vasoactive intestinal polypeptide (VIP) and endothelin 1 (ET-1), are involved in the control of penile erectile tissue (corpus cavernosum = CC). Inhibiting the degradation of CNP and VIP or conversion of Big ET-1 into ET-1 by endopeptidase enzymes should result in an enhancement of CC smooth muscle relaxation. Using the tissue bath technique, responses of isolated CC, challenged by noradrenaline (NA, 1 μm), to increasing concentrations of the endopeptidase inhibitor KC 12615 (1 nm - 10 μm), CNP and VIP (0.1 nm - 1 μm), were investigated. Effects of CNP, VIP and Big ET-1 (0.1 nm - 100 nm) on the tissue tension were also evaluated following pre-exposure to 10 μm of KC 12615. Big ET-1 induced contraction of the CC amounting to a force generation of 1,200 mg. The contraction was attenuated in the presence of KC 12615 by 35% and 50%, respectively. The tension induced by NA was reversed by VIP and CNP to 38.7% ± 15.8% and 61% ± 13%, respectively, of the initial force. The findings might be of significance with regard to future pharmacological treatment options for male ED, where an endothelial dysfunction exists.
Collapse
Affiliation(s)
- P Shahin
- Department of Urology & Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany
| | - H E Rahardjo
- Department of Urology, School of Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | - A Bannowsky
- Department of Urology, Imland Klinik GmbH, Rendsburg, Germany
| | - D Tsikas
- Hannover Medical School, Center of Pharmacology & Toxicology, Hannover, Germany
| | - M Sohn
- Department of Urology, AGAPLESION St. Markus Hospital, Frankfurt am Main, Germany
| | - M A Kuczyk
- Department of Urology & Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany
| | - S Ückert
- Department of Urology & Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
33
|
Sohn M, Malburet C, Caliskan G, Büchse A, Grumelard J, Chambert M, Herzog B. In vitro water resistance testing using SPF simulation based on spectroscopic analysis of rinsed sunscreens. Int J Cosmet Sci 2018; 40:217-225. [PMID: 29574951 DOI: 10.1111/ics.12455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/14/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Water resistance retention (WRR) is the third performance attribute of sunscreens. Today, the standardized method for testing WRR is performed in vivo. For screening purposes, an in vitro method is highly preferable. Up to now, however, available methods have failed in accurately predicting in vivo WRR. In this study, we examine a novel in vitro approach aimed at enhancing in vivo prediction of WRR. METHODS We investigated two approaches, including a traditional procedure referred to as the 'plate method', which involves measuring in vitro sun-protection factor (SPF) before and after water immersion, and a new approach termed the 'solution method'. The latter employed a computational method to calculate the SPF using UV transmittance measurements of a sunscreen solution, obtained by rinsing the substrate without water immersion and with water immersion. It also had a model function for describing film irregularity. The aim was to avoid the effect of substrate-to-product affinity on the film distribution, which impacts the measured absolute value of the in vitro SPF occurring in the conventional approach. For both methodologies, we assessed two substrates for the sunscreen application based on different polymers, the widely used polymethylmethacrylate (PMMA) and the ethylene methacrylate acid copolymer (EMA). RESULTS The agreement between in vivo and in vitro WRR values obtained from each of the four test conditions was analysed using different sunscreens. No correlation was found between in vivo and in vitro WRR using the plate method, independently of the plate type. In contrast, the solution method, using EMA plates, revealed a significant correlation between in vivo and in vitro results, with an especially high correlation for in vivo non-water-resistant sunscreens. The results of two operators were comparable. The solution method was unsuitable for PMMA plates. CONCLUSION Despite the small discrepancy remaining between WRR values obtained from the in vitro solution method and in vivo method, which itself shows variability in results, this work provided a new insight into the in vitro testing of water resistance of sunscreens.
Collapse
Affiliation(s)
- M Sohn
- BASF Grenzach GmbH, Köchlinstrasse 1, 79639, Grenzach-Whylen, Germany
| | - C Malburet
- BASF Grenzach GmbH, Köchlinstrasse 1, 79639, Grenzach-Whylen, Germany
| | - G Caliskan
- BASF Grenzach GmbH, Köchlinstrasse 1, 79639, Grenzach-Whylen, Germany
| | - A Büchse
- BASF SE, Carl-Bosch-Strasse 38, 67056, Ludwigshafen am Rhein, Germany
| | - J Grumelard
- BASF Grenzach GmbH, Köchlinstrasse 1, 79639, Grenzach-Whylen, Germany
| | - M Chambert
- BASF Grenzach GmbH, Köchlinstrasse 1, 79639, Grenzach-Whylen, Germany
| | - B Herzog
- BASF Grenzach GmbH, Köchlinstrasse 1, 79639, Grenzach-Whylen, Germany
| |
Collapse
|
34
|
|
35
|
Karstens JH, Henrich MM, Sohn M, Glöckner W, Jakse G, Büll U, Reske SN. Nachweis des Skelettbefalls maligner Erkrankungen durch Immunszintigraphie des Knochenmarks. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1629652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungImmunszintigraphie des hämatopoetischen Knochenmarks und konventionelle Skelettszintigraphie wurden bei 141 Patienten mit malignen Grunderkrankungen verglichen. Die Immunszintigraphie des Knochenmarks wies in allen Patientenuntergruppen mehr metastasentypische Herdbefunde und einen ausgedehnteren Skelettbefall als das Skelettszintigramm nach. In 323 computertomographisch kontrollierten Skelettabschnitten fanden sich in 83,3% übereinstimmende Befunde zur Knochenmarkszintigraphie. Lediglich in 7 von 2135 (0,3%) Skelettabschnitten von 30 Patienten mit Fieber unklarer Ursache ohne maligne Grunderkrankung fanden sich immunszintigraphisch pathologische Herdbefunde. Bei 36 Patienten mit malignen Lymphomen waren immunszintigraphischer und histologischer/zytologischer Befund bei 14 Patienten übereinstimmend positiv und bei 17 Patienten übereinstimmend negativ. Die Immunszintigraphie des Knochenmarks stellt ein vielversprechendes, einfaches und routinefähiges Verfahren zum empfindlichen nichtinvasiven Nachweis des Skelettbefalls maligner Erkrankungen dar.
Collapse
|
36
|
Jee S, Sohn M, Lee J, Kim D, Lee S, Shin Y, Oh G, Lee Y, Joo M, Han E, Kim Y. Prediction for return to driving after the first-ever stroke in Korea: The KOSCO study. J Rehabil Med 2018; 50:800-805. [DOI: 10.2340/16501977-2373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
37
|
Kim JH, Choi BY, Kho AR, Lee SH, Jeong JH, Hong DK, Lee SH, Sohn M, Ryu OH, Choi MG, Suh SW. Acetylcholine precursor, citicoline (cytidine 5'-diphosphocholine), reduces hypoglycaemia-induced neuronal death in rats. J Neuroendocrinol 2018; 30. [PMID: 29247563 DOI: 10.1111/jne.12567] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 11/23/2017] [Accepted: 12/11/2017] [Indexed: 01/21/2023]
Abstract
Citicoline (cytidine 5'-diphosphocholine) is an important precursor for the synthesis of neuronal plasma membrane phospholipids, mainly phosphatidylcholine. The administration of citicoline serves as a choline donor for the synthesis of acetylcholine. Citicoline has been shown to reduce the neuronal injury in animal models with cerebral ischaemia and in clinical trials of stroke patients. Citicoline is currently being investigated in a multicentre clinical trial. However, citicoline has not yet been examined the context of hypoglycaemia-induced neuronal death. To clarify the therapeutic impact of citicoline in hypoglycaemia-induced neuronal death, we used a rat model with insulin-induced hypoglycaemia. Acute hypoglycaemia was induced by i.p. injection of regular insulin (10 U kg-1 ) after overnight fasting, after which iso-electricity was maintained for 30 minutes. Citicoline injections (500 mg/kg, i.p.) were started immediately after glucose reperfusion. We found that post-treatment of citicoline resulted in significantly reduced neuronal death, oxidative injury and microglial activation in the hippocampus compared to vehicle-treated control groups at 7 days after induced hypoglycaemia. Citicoline administration after hypoglycaemia decreased immunoglobulin leakage via blood-brain barrier disruption in the hippocampus compared to the vehicle group. Citicoline increased choline acetyltransferase expression for phosphatidylcholine synthesis after hypoglycaemia. Altogether, the present findings suggest that neuronal membrane stabilisation by citicoline administration can save neurones from the degeneration process after hypoglycaemia, as seen in several studies of ischaemia. Therefore, the results suggest that citicoline may have therapeutic potential to reduce hypoglycaemia-induced neuronal death.
Collapse
Affiliation(s)
- J H Kim
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| | - B Y Choi
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| | - A R Kho
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| | - S H Lee
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| | - J H Jeong
- Department of Medical Life Science, College of Medicine, Hallym University, Chuncheon, Korea
| | - D K Hong
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| | - S H Lee
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| | - M Sohn
- Department of Nursing, Inha University, Incheon, Korea
| | - O H Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University, College of Medicine, Chuncheon, Korea
| | - M-G Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University, College of Medicine, Chuncheon, Korea
| | - S W Suh
- Department of Physiology, Hallym University, College of Medicine, Chuncheon, Korea
| |
Collapse
|
38
|
Wirthmann AE, Majenka P, Kaufmann MC, Wellenbrock SV, Kasper L, Hüttinger S, Djedovic G, Bozkurt A, Sohn M, Rieger UM. Phalloplasty in Female-to-Male Transsexuals by Gottlieb and Levine's Free Radial Forearm Flap Technique-A Long-Term Single-Center Experience Over More than Two Decades. J Reconstr Microsurg 2017; 34:235-241. [PMID: 29141257 DOI: 10.1055/s-0037-1608656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The free radial forearm flap phalloplasty is the most utilized method for penile reconstruction. Among the techniques described in the literature, evidence for the flap design after Gottlieb and Levine is poor. METHODS From January 1993 until December 2015, 402 phalloplasties were performed in our clinic. Among the 247 free radial forearm flap phalloplasties, 232 free radial forearm flap phalloplasties were performed after Gottlieb and Levine in 229 patients. Operation and patient-specific characteristics were evaluated. RESULTS This study presents the highest number of free radial forearm flap phalloplasties after Gottlieb and Levine. The rate of total flap failure was 3%; 46% of the patients were heavy smokers. Urinary fistulae and strictures are common. The revision rate for urinary fistulae and/or strictures was 1.3 per patient. The number of postoperative complications, such as bleeding (14.2%), thrombosis of the flap requiring revision (11.2%), or delayed wound healing (16.8%) was considering the high rate of nicotine abuse (45.9%) reasonable. CONCLUSION The free radial forearm phalloplasty in the design by Gottlieb and Levine is well established at our institution and has proven safe and reliable since 1993. The operative results are satisfactory for both patients and surgeons even in the presence of relevant comorbidities and heavy smoking. We acknowledge the long ordeal and psychological pressure that our patients suffer from, before presenting in our outpatient clinic.
Collapse
Affiliation(s)
- Anna E Wirthmann
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Pawel Majenka
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | | | | | - Lara Kasper
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Susanne Hüttinger
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Gabriel Djedovic
- Department of Plastic Surgery, Helios Hospital, Wuppertal, Germany
| | - Ahmet Bozkurt
- Department of Plastic Surgery, Helios Hospital, Wuppertal, Germany
| | - Michael Sohn
- Department of Urology, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - Ulrich M Rieger
- Department of Plastic Surgery, AGAPLESION Markus Hospital, Frankfurt, Germany
| |
Collapse
|
39
|
Abstract
BACKGROUND Gender confirming surgery (GCS) represents a new and interdisciplinary urological field of activity. OBJECTIVES Based on more than 20 years of experience, the development of interdisciplinary strategies in the surgical management of male-to-female (MtF) and female-to-male (FtM) transgenders is summarized. MATERIALS AND METHODS The current national and international literature, as well as the surgical experience of the authors in the field of GCS, were evaluated, and aspects relevant for urologists are presented in a comprehensive review. RESULTS Since 1990 more than 1200 primary GCS in MtF transgenders and more than 230 primary GCS in FtM transgenders have been performed in the authors' institutions. Presuming an incidence of at least 1:20,000 for patients with gender dysphoria (GD) in the general population, the overall number of patients is limited. The complex surgical procedures should be realized in an interdisciplinary team, trained and specialized in this field of surgery, given the high rate of complications and secondary procedures with MtF GCS. CONCLUSION Postoperative satisfaction rates of FtM and MtF transgenders at over 80% are satisfactory. During the last few decades, surgical procedures have been widely standardized. In the field of penile reconstruction, the free forearm lap represents the preferred method, while several surgical alternatives arise from the current literature in this field.
Collapse
Affiliation(s)
- M Sohn
- Klinik für Urologie, Agaplesion Markus-Krankenhaus, Frankfurt am Main, Deutschland
| | - U M Rieger
- Klinik für Plastische Chirurgie, Wiederherstellungs- und Handchirurgie, Agaplesion Markus-Krankenhaus, Frankfurt am Main, Deutschland
| | - J Heß
- Klinik und Poliklinik für Urologie, Uroonkologie und Kinderurologie, Universitätsklinik Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
| |
Collapse
|
40
|
Ückert S, Albrecht K, Bannowsky A, Sohn M, Kuczyk MA, Hedlund P. Expression and distribution of the transient receptor potential cationic channel A1 (TRPA1) in the human clitoris-comparison to male penile erectile tissue. Int J Impot Res 2017; 29:179-183. [PMID: 28469181 DOI: 10.1038/ijir.2017.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 12/22/2016] [Accepted: 03/20/2017] [Indexed: 01/05/2023]
Abstract
The transient receptor potential cationic channel ankyrin 1 (TRPA1) is a channel protein assumed to act in various human tissues as mechano- and pain sensor and play a role in neurotransmission. The expression of TRPA has already been investigated in the human prostate and urethra, however, only very few studies have addressed the expression and distribution in the male and female genital tract. The present study aimed to investigate by means of immunohistochemistry (double-labeling technique, laser fluorescence microscopy) in the human clitoris and penile erectile tissue the localization of TRPA1 in relation to nNOS, the vasoactive intestinal polypeptide (VIP) and vesicular acetylcholine transporter (VAChT). In the clitoral tissue, TRPA1 was observed in basal epithelial cells and slender nNOS-positive nerve fibers transversing the subepithelial space. To a certain degree, in the clitoral epithelial cells, TRPA1 was found co-localized with vimentin. In human corpus cavernosum, immunoreactivity for TRPA1 was seen in nerves transversing the cavernous sinusoidal space and running alongside small arteries, these nerves also displayed expression of the vesicular acetylcholine transporter protein (VAChT). Varicose nerves containing nNOS or VIP were not immunoreactive for TRPA1. It seems likely that TRPA1 is involved in nitric oxide-mediated afferent sensory transmission in the clitoris while, in penile erectile tissue, a role for TRPA1 in cholinergic signaling might be assumed.
Collapse
Affiliation(s)
- S Ückert
- Division of Surgery, Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - K Albrecht
- Department of Legal (Forensic) Medicine, Hannover Medical School, Hannover, Germany
| | - A Bannowsky
- Department of Urology, Imland Klinik, Rendsburg, Germany
| | - M Sohn
- Department of Urology, AGAPLESION St Markus Hospital, Frankfurt, Germany
| | - M A Kuczyk
- Division of Surgery, Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - P Hedlund
- Faculty of Medicine, Division of Clinical Pharmacology and Drug Research, Linköping University, Linköping, Sweden
| |
Collapse
|
41
|
Stanhope C, Drake D, Alber M, Sohn M, Liang J, Habib C, Yan D. PO-0920: Utilizing monte carlo for log file-based delivery QA. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31357-9] [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: 11/25/2022]
|
42
|
Rieger UM, Majenka P, Wirthmann A, Sohn M, Bozkurt A, Djedovic G. Comparative Study of the Free Microvascular Groin Flap: Optimizing the Donor Site After Free Radial Forearm Flap Phalloplasty. Urology 2016; 95:192-6. [PMID: 27109597 DOI: 10.1016/j.urology.2016.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/04/2016] [Accepted: 04/06/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To improve the donor-site morbidity of the radial forearm flap through coverage with a free vascularized groin flap and comparing this flap coverage to the current standard, a full-thickness skin graft (FTSG). MATERIALS AND METHODS A retrospective analysis of all free radial forearm flap phalloplasties for transgender surgery at our institution was performed. We examined patient characteristics, donor site defects, surgical procedure, and clinical courses. RESULTS Between October 2013 and February 2016, 27 consecutive patients underwent phalloplasty for female-to-male reassignment surgery with free radial forearm flaps. A total of 7 free groin flaps (group A) and 20 full-thickness skin graft from the groin region (group B) for donor-site defect coverage of the forearm were performed. The mean age in group A was 28.4 years with a mean body mass index of 21.6 kg/m(2) and a mean follow-up time of 10.6 months. The mean surgery time was 724 minutes. The mean patients' functional rating was 3.6 accompanied by the mean patients' aesthetical rating of 3.7. The mean age in group B was 30.5 years with a mean body mass index of 23.7 kg/m(2) and a mean follow-up time of 13.4 months. The mean surgery time was 563 minutes. The mean patients' functional rating was 3.1 accompanied by the mean patients' aesthetical rating of 2.9. CONCLUSION We suggest that the free microvascular groin flap should be considered for immediate defect closure after phalloplasty with a radial forearm flap due to its beneficial functional and aesthetic results and the low rate of complications.
Collapse
Affiliation(s)
- Ulrich M Rieger
- Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Pawel Majenka
- Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Anna Wirthmann
- Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Michael Sohn
- Department of Urology, St. Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Ahmet Bozkurt
- Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Gabriel Djedovic
- Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt, Germany; Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
| |
Collapse
|
43
|
Rahardjo HE, Reichelt K, Sonnenberg JE, Sohn M, Kuczyk MA, Ückert S. Effects of endopeptidase inhibition on the relaxation response of isolated human penile erectile tissue to vasoactive peptides. Andrologia 2016; 48:1214-1219. [PMID: 27062177 DOI: 10.1111/and.12562] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2016] [Indexed: 11/29/2022] Open
Abstract
Peptides, such as CNP, CGRP and VIP, are involved in the function of male penile erectile tissue. Tissue levels of said peptides are controlled by the endopeptidase enzymes. Theoretically, the inhibition of the degradation of CNP, CGRP and/or VIP should result in an enhancement in penile smooth muscle relaxation. The effects were investigated of CNP or VIP (0.1 nm-1 μm), without and following pre-exposure of the tissue to a threshold concentration of the endopeptidase inhibitor KC 12615 (10 μm, for 20 min), on the reversion of tension induced by means of electrical field stimulation. Drug effects on the production of cyclic AMP/GMP were also evaluated. Neither KC 12615, CNP and VIP nor the combination of CNP plus KC 12615 or VIP plus KC 12615 increased the response of the tissue to EFS. While no effects were observed of a pre-exposure of the tissue to KC 12615 on the production of cyclic AMP in the presence of VIP, an enhancement was registered in the accumulation of cyclic AMP in the presence of CNP plus KC 12615. Further studies are indicated to investigate whether endopeptidase inhibitors might tend to be more effective in tissues affected by a decreased local production of vasoactive peptides.
Collapse
Affiliation(s)
- H E Rahardjo
- Department of Urology, Cipto Mangunkusumo Hospital, University of Indonesia School of Medicine, Jakarta, Indonesia
| | - K Reichelt
- Division of Surgery, Department of Urology & Urological Oncology, Hannover Medical School, Hannover, Germany
| | - J E Sonnenberg
- Urological Research Unit, Institute for Biochemical Research & Analysis, Barsinghausen am Deister, Germany
| | - M Sohn
- Department of Urology, AGAPLESION St. Markus Hospital, Frankfurt am Main, Germany
| | - M A Kuczyk
- Division of Surgery, Department of Urology & Urological Oncology, Hannover Medical School, Hannover, Germany
| | - S Ückert
- Division of Surgery, Department of Urology & Urological Oncology, Hannover Medical School, Hannover, Germany.,Urological Research Unit, Institute for Biochemical Research & Analysis, Barsinghausen am Deister, Germany
| |
Collapse
|
44
|
Chang W, Sohn M, Lee J, Kim D, Lee S, Shin Y, Oh G, Lee Y, Joo M, Han E, Kim J, Kim Y. Return to work after stroke: The KOSCO Study. J Rehabil Med 2016; 48:273-9. [DOI: 10.2340/16501977-2053] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
45
|
Kedia GT, Ückert S, Oelke M, Sonnenberg JE, Sohn M, Kuczyk MA, Hedlund P. Expression and distribution of phosphodiesterase isoenzymes in the human male urethra. Urology 2015; 85:964.e1-6. [PMID: 25704994 DOI: 10.1016/j.urology.2014.12.030] [Citation(s) in RCA: 6] [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] [Received: 03/14/2014] [Revised: 12/02/2014] [Accepted: 12/19/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the expression and distribution of phosphodiesterase (PDE) isoenzymes PDE1A, PDE2A, PDE4A, PDE4B, and PDE5A in human urethral tissue. METHODS Specimens of penile urethra were obtained from male subjects who had undergone male-to-female sex reassignment surgery. Using immunohistochemistry (immunofluorescence), the occurrence of PDE1A, PDE2A, PDE4A, PDE4B, and PDE5A, the neuronal nitric oxide synthase, calcitonin gene-related peptide, and vasoactive intestinal polypeptide was examined in urethral sections. Cytosolic supernatants prepared from isolated human urethral tissue were subjected to Western blot analysis using specific anti-PDE antibodies. RESULTS Immunosignals specific for PDE1A, 4A, 4B, and 5A were observed in the urethral smooth musculature. The smooth muscle bundles were seen innervated by slender nerve fibers, characterized by the expression of the neuronal nitric oxide synthase, calcitonin gene-related peptide, and vasoactive intestinal polypeptide. The expression of the PDE isoenzymes mentioned was confirmed by Western blotting. CONCLUSION The results provide evidence for a significance of both the cyclic adenosine monophosphate and cyclic guanosine monophosphate signaling in the control of human urethral smooth muscle. The selective inhibition of PDE isoenzymes might represent a pharmacologic option to influence the function of smooth musculature in the human outflow region.
Collapse
Affiliation(s)
- George T Kedia
- Department of Urology and Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany.
| | - Stefan Ückert
- Department of Urology and Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany; Urological Research Unit, Institute for Biochemical Research and Analysis, Barsinghausen am Deister, Germany
| | - Matthias Oelke
- Department of Urology and Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany
| | - Joachim E Sonnenberg
- Urological Research Unit, Institute for Biochemical Research and Analysis, Barsinghausen am Deister, Germany
| | - Michael Sohn
- Department of Urology, AGAPLESION Markus Hospital, Frankfurt am Main, Germany
| | - Markus A Kuczyk
- Department of Urology and Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany
| | - Petter Hedlund
- Urological Research Institute, University Vita Salute San Raffaele, Milano, Italy; Department of Clinical Pharmacology, Faculty of Medicine, Linköping University, Linköping, Sweden
| |
Collapse
|
46
|
|
47
|
Sohn M, Hoffmann M, Pohlen U, Lauscher JC, Zurbuchen U, Holmer C, Buhr HJ, Lehmann KS. [Stump closure in laparoscopic appendectomy. Influence of endoloop or linear stapler on patient outcome]. Chirurg 2015; 85:46-50. [PMID: 23780410 DOI: 10.1007/s00104-013-2549-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Even though laparoscopic appendectomy is one of the most frequent procedures in abdominal surgery, the technique of appendiceal stump closure is still not standardized. The aim of this retrospective study was to analyze the effect of the use of endoloops or linear staplers for appendiceal stump closure concerning surgical site infections (SSI) and intra-abdominal abscesses (IAA). PATIENTS AND METHODS All laparoscopic appendectomies between January 1st 2007 and May 31st 2010 were split into an endoloop group (ELG) and a linear stapler group (LSG). The groups were compared with respect to the outcome parameters SSI and IAA. RESULTS A total of 430 appendectomies were performed in the study period of which 105 operations were conducted laparoscopically. In this study 47.6 % (n = 50) were alloted to the LSG and 52.4 % (n = 55) to ELG. In LSG 3.1 % (n = 1) developed an SSI versus 10.0 % (n = 4, p = 0.254) in ELG. No IAAs occurred in LSG compared to 2 (5.1 %, p = 0.499) in ELG. CONCLUSION The use of EL for appendiceal stump closure is safe and cost effective for low-grade appendicitis but high-grade appendicitis should be treated with LS.
Collapse
Affiliation(s)
- M Sohn
- Abteilung für Allgemein-, Gefäß- und Thoraxchirurgie, Chirurgische Klinik I, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Deutschland,
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Kedia GT, Oelke M, Sonnenberg JE, Sohn M, Bannowsky A, Kuczyk MA, Ückert S. Phosphodiesterase isoenzymes in the human urethra: A molecular biology and functional study. Eur J Pharmacol 2014; 741:330-5. [DOI: 10.1016/j.ejphar.2014.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 07/29/2014] [Accepted: 08/10/2014] [Indexed: 10/24/2022]
|
49
|
Wagner M, Mulder B, Sohn M, Walker A. A-71 * Posterior Cortical Atrophy of the Non-Alzheimer's Type. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.71] [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: 11/13/2022] Open
|
50
|
Sohn M, Schmid R, Schepp W, Steiner P. [Left-sided infradiaphragmatic lesion : rare differential diagnosis in adulthood]. Chirurg 2014; 86:493-5. [PMID: 24994587 DOI: 10.1007/s00104-014-2782-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Sohn
- Klinik für Viszeral,-Gefäß- und Thoraxchirurgie, Klinikum Bogenhausen, Städtisches Klinikum München GmbH, Engelschalkinger Str. 77, 81925, München, Deutschland,
| | | | | | | |
Collapse
|